cssi/SciSciGPT-SciSciNet huggingface dataset:
Resuscitation with Drag Reducing Polymers after Traumatic Brain Injury with Hemorrhagic Shock Reduces Microthrombosis and Oxidative Stress.

Outcome after traumatic brain injury (TBI) is worsened by hemorrhagic shock (HS); however, the existing volume expansion approach with resuscitation fluids (RF) is controversial as it does not adequately alleviate impaired microvascular cerebral blood flow (mCBF). We previously reported that resuscitation fluid with drag reducing polymers (DRP-RF) improves CBF by rheological modulation of hemodynamics. Here, we evaluate the efficacy of DRP-RF, compared to lactated Ringers resuscitation fluid (LR-RF), in reducing cerebral microthrombosis and reperfusion mitochondrial oxidative stress after TBI complicated by HS. Fluid percussion TBI (1.5 ATA, 50 ms) was induced in rats and followed by controlled HS to a mean arterial pressure (MAP) of 40 mmHg. DRP-RF or LR-RF was infused to restore MAP to 60 mmHg for 1 h (pre-hospital period), followed by blood re-infusion to a MAP = 70 mmHg (hospital period). In vivo 2-photon laser scanning microscopy over the parietal cortex was used to monitor microvascular blood flow, nicotinamide adenine dinucleotide (NADH) for tissue oxygen supply and mitochondrial oxidative stress (superoxide by i.v. hydroethidine [HEt], 1 mg/kg) for 4 h after TBI/HS, followed by Dil vascular painting during perfusion-fixation. TBI/HS decreased mCBF resulting in capillary microthrombosis and tissue hypoxia. Microvascular CBF and tissue oxygenation were significantly improved in the DRP-RF compared to the LR-RF treated group (p < 0.05). Reperfusion-induced oxidative stress, reflected by HEt fluorescence, was 32 ± 6% higher in LR-RF vs. DRP-RF (p < 0.05). Post-mortem whole-brain visualization of DiI painted vessels revealed multiple microthromboses in both hemispheres that were 29 ± 3% less in DRP-RF vs. LR-RF group (p < 0.05). Resuscitation after TBI/HS using DRP-RF effectively restores mCBF, reduces hypoxia, microthrombosis formation, and mitochondrial oxidative stress compared to conventional volume expansion with LR-RF.
Chapter 25 – Legal Issues

Patents on human gene sequences and relationships between gene variants and clinical phenotypes are controversial in clinical diagnostics. Proponents of gene patents claim they promote gene discovery and encourage the production of novel diagnostic tests. Opponents argue that they raise costs, decrease patient access, harm innovation in testing, and are unnecessary to promote gene discovery. The advent of large-scale sequencing has generated concerns that gene patenting will inhibit the implementation of new sequencing technologies. In the two US Supreme Court cases, Mayo v. Prometheus and Association for Molecular Pathology v. Myriad Genetics, the Court held that human DNA sequences and associations between biomarkers and human physiologic behavior represent unpatentable natural laws. These cases appear to have eliminated patent-based monopolization of clinical testing for mutations in human genes and genotype–phenotype relationships, and will help facilitate the introduction of next-generation sequencing into clinical practice. The incorporation of inherited disease testing into medical practice has generated apprehension about possibilities for “genetic discrimination” in employment and insurance. The Genetic Information Nondiscrimination Act (GINA) proscribes genetic discrimination in employment and health insurance. The exclusion of life, disability, and long-term care insurance from these protections has significant implications for reporting large-scale gene sequencing results.
Rheumatologic Manifestations of CF

While the pulmonary manifestations of cystic fibrosis (CF) most obviously contribute to the morbidity and mortality of the disease, many patients with CF suffer from bone and joint manifestations as well. A subset of patients with CF experience severe intermittent joint pain from an episodic arthropathy, progressive joint pain from hypertrophic pulmonary osteoarthropathy, or joint pain due to extensive use of fluoroquinolone antibiotics. Others may experience an idiopathic vasculitic rash. The majority of patients with CF will experience decreased bone mineral density as they age, in some cases leading to pathologic fractures. Understanding and treating these conditions is important to providing optimal care for children and adults with CF.
Impacts of Connected and Autonomous Vehicles on Traffic Flow with Heterogeneous Drivers Spatially Distributed over Large-Scale Networks:

Connected and automated vehicle technologies are expected to significantly contribute in improving mobility and safety. As connected and autonomous vehicles have not been used in practice at large ...
Parental Relationship Quality and Adolescent Depressive Symptoms: Investigating The Role of Parental Warmth and Hostility in United States Military Families.

Military life is characterized by regular transitions; thus, parents are positioned to serve as stable protective factors for adolescents. We investigated a theory-informed model that assessed direct and indirect relationships between parental relationship quality, parental behaviors, and adolescent depressive symptomatology using cross-sectional data of military families in the United States (US). Participant families (N = 229), recruited via convenience sampling to take a computer-based survey, included an active duty father, his spouse, and an adolescent. Mother's couple relationship quality was indirectly linked to adolescent depressive symptoms through maternal warmth. Conversely, father's couple relationship quality was indirectly linked to adolescent depressive symptoms via paternal hostility. In other words, parental couple relationship quality was indirectly related to adolescent depressive symptoms, but this relationship differed by parent (i.e., warmth for mothers and hostility for fathers). Findings were similar for adolescent boys and girls.
N of 1 Data Sharing: The Impact of Data Sharing within the Hematology–Oncology Drug Products Division of the US FDA

Despite both enthusiasm and concern regarding data sharing from clinical trials, few studies have documented the outputs of data sharing. The FDA has a considerable collection of raw data from drugs for their marketing authorization. An examination of data sharing with the FDA provides a snapshot into studies that this may facilitate.
Frailty, Race/Ethnicity, Functional Status, and Adverse Outcomes After Total Hip/Knee Arthroplasty: A Moderation Analysis.

Abstract Background Although frailty has been shown to be associated with adverse outcomes in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA), prior studies have not examined how race/ethnicity might moderate these associations. We aimed to assess race/ethnicity as a potential moderator of the associations of frailty and functional status with arthroplasty outcomes. Methods The National Surgical Quality Improvement Program was queried for patients who underwent THA or TKA from 2011 to 2017. Frailty was assessed using the modified frailty index. Regression analyses were conducted to examine associations connecting frailty/functional status with 30-day readmission, adverse discharge, and length of stay (LOS). Further analyses were conducted to investigate race/ethnicity as a potential moderator of these relationships. Results We identified 219,143 TKA and 130,022 THA patients. Frailty and nonindependent functional status were positively associated with all outcomes (P Conclusion Disparities for Black non-Hispanic and Hispanic patients persist for readmission, adverse discharge, and LOS. However, the effects of increasing frailty and nonindependent functional status on these outcomes were the most pronounced among White non-Hispanic patients.
Foreign Exchange Market Organization in Selected Developing and Transition Economies; Evidence from a Survey

The foreign exchange market microstructures in developing and transition economies are characterized by the results from the IMF's 2001 Survey on Foreign Exchange Market Organization. The survey found that these markets are usually unified onshore spot markets for U.S. dollars, where transactions are concentrated at the bank-customer level. The trading mechanisms are usually dealer or mixed dealer/auction markets; the degree of transparency is often low; settlement systems remain risky; and the scope for price discovery is variable.
Instrumental variable meta-analysis of aggregated randomized drug trial data for evaluating proposed target mechanisms.

Clinical trials provide an opportunity to understand not only drug efficacy but also disease biology. Instrumental variable meta-analysis provides an approach to combining results from multiple trials into a single estimate of the effect of modifying a biological target on an outcome of interest.
Autonomous Security Analysis and Penetration Testing

Security Assessment of large networks is a challenging task. Penetration testing (pentesting) is a method of analyzing the attack surface of a network to find security vulnerabilities. Current network pentesting techniques involve a combination of automated scanning tools and manual exploitation of security issues to identify possible threats in a network. The solution scales poorly on a large network. We propose an autonomous security analysis and penetration testing framework (ASAP) that creates a map of security threats and possible attack paths in the network using attack graphs. Our framework utilizes: (i) state of the art reinforcement learning algorithm based on Deep-Q Network (DQN) to identify optimal policy for performing pentesting testing, and (ii) incorporates domain-specific transition matrix and reward modeling to capture the importance of security vulnerabilities and difficulty inherent in exploiting them. ASAP framework generates autonomous attack plans and validates them against real-world networks. The attack plans are generalizable to complex enterprise network, and the framework scales well on a large network. Our empirical evaluation shows that ASAP identifies non-intuitive attack plans on an enterprise network. The DQN planning algorithm employed scales well on a large network $\sim 60 -70(\mathrm{s})$ for generating an attack plan for network with 300 hosts.
Tracheostomy is Safe in Patients With Prolonged Intubation After Coronavirus Disease 2019 Infection.

Abstract Background Tracheostomy improves outcomes for critically ill patients requiring prolonged mechanical ventilation. Data are limited on the use and benefit of tracheostomies for intubated, critically ill coronavirus disease 2019 (COVID-19) patients. During the surge in COVID 19 infections in metropolitan New York/New Jersey, our hospital cared for many COVID-19 patients who required prolonged intubation. This study describes the outcomes in COVID-19 patients who underwent tracheostomy. Methods We present a case series of patients with COVID-19 who underwent tracheostomy at a single institution. Tracheostomies were performed on patients with prolonged mechanical ventilation beyond 3 wk. Patient demographics, medical comorbidities, and ventilator settings prior to tracheostomy were reviewed. Primary outcome was in-hospital mortality. Secondary outcomes included time on mechanical ventilation, length of ICU and hospital stay, and discharge disposition. Results Fifteen COVID-19 patients underwent tracheostomy at an average of 31 d post intubation. Two patients (13%) died. Half of our cohort was liberated from the ventilator (8 patients, 53%), with an average time to liberation of 14 ± 6 d after tracheostomy. Among patients off mechanical ventilation, 5 (63%) had their tracheostomies removed prior to discharge. The average intensive care length of stay was 47 ± 13 d (range 29-74 d) and the average hospital stay was 59 ± 16 d (range 34-103 d). Conclusions This study reports promising outcomes in COVID-19 patients with acute respiratory failure and need for prolonged ventilation who undergo tracheostomy during their hospitalization. Further research is warranted to establish appropriate indications for tracheostomy in COVID-19 and confirm outcomes.
Is Lactating in the Emergency Department a Letdown? Exploring Barriers and Supports to Workplace Lactation in Emergency Medicine.

Study objective To explore the social and environmental conditions in emergency departments that contribute to perceived barriers and supports for workplace lactation among individuals working in emergency medicine. Methods Constructivist grounded theory was used by our team to understand the social processes and behaviors associated with workplace lactation for health care professionals working in EDs. A total of 24 interviews of individuals in EDs with recent return-to-work experience after childbirth were performed. The interviews yielded 36 unique experiences (from 21 faculty, 12 trainees, and 3 nurses) because some participants had more than 1 child, in which case all lactation experiences were discussed. Interview transcriptions were coded and analyzed iteratively for the development of themes, per constructivist grounded theory. Results Using constant comparative inductive methods, we describe 3 pervasive themes as they relate to workplace lactation that emerged from the analysis of interview data: (1) emergency medicine culture, (2) workplace lactation policies, and (3) supports for workplace lactation. Conclusion Although formalized workplace lactation policies and other identifiable supports for workplace lactation aid individuals desiring to lactate after returning to work in EDs, many individuals still experience cultural barriers to their desired lactation habits. Policies and individual support systems may continue to fall short of meeting the needs of lactating individuals in emergency medicine unless broader cultural change occurs. Our work offers initial recommendations for shifting the landscape of lactation practices in emergency medicine.
Predicting Symptom Onset in Sporadic Alzheimer Disease With Amyloid PET

BACKGROUND AND OBJECTIVES To predict when cognitively normal individuals with brain amyloidosis will develop symptoms of Alzheimer disease (AD). METHODS Brain amyloid burden was measured by amyloid PET with Pittsburgh compound B. The mean cortical standardized uptake value ratio (SUVR) was transformed into a timescale with the use of longitudinal data. RESULTS Amyloid accumulation was evaluated in 236 individuals who underwent >1 amyloid PET scan. The average age was 66.5 ± 9.2 years, and 12 individuals (5%) had cognitive impairment at their baseline amyloid PET scan. A tipping point in amyloid accumulation was identified at a low level of amyloid burden (SUVR 1.2), after which nearly all individuals accumulated amyloid at a relatively consistent rate until reaching a high level of amyloid burden (SUVR 3.0). The average time between levels of amyloid burden was used to estimate the age at which an individual reached SUVR 1.2. Longitudinal clinical diagnoses for 180 individuals were aligned by the estimated age at SUVR 1.2. In the 22 individuals who progressed from cognitively normal to a typical AD dementia syndrome, the estimated age at which an individual reached SUVR 1.2 predicted the age at symptom onset (R2 = 0.54, p < 0.0001, root mean square error [RMSE] 4.5 years); the model was more accurate after exclusion of 3 likely misdiagnoses (R2 = 0.84, p < 0.0001, RMSE 2.8 years). CONCLUSION The age at symptom onset in sporadic AD is strongly correlated with the age at which an individual reaches a tipping point in amyloid accumulation.
Criminal Confessions and the Mentally Disabled

Few sets of tea leaves are examined, analyzed, and pored over as closely as any United States Supreme Court decision involving what is generically known as a Miranda issue.1 The scholarly and popular debates that have raged since a badly fractured Warren Court attempted to establish a “bright line” test for admissibility of confessions in Miranda v Arizona2 have given Miranda a symbolic value that extends far beyond the decision’s actual impact on police interrogation.3 Although the Burger (and now the Rehnquist) Courts have expressed dissatisfaction with the constitutional and philosophical underpinnings of the doctrine, the “inescapably political overtones” of an outright reversal4 make it likely that Miranda will not be overruled “at this late date.”5 Even though the doctrine—by the Court’s own reckoning—remains “murky,”6 and its empirical impact remains questionable,7 it remains a “punch-drunk fighter, reeling on the ropes but not yet counted out.”8
An “anomalous” triggered lightning flash in Florida

[1] An “anomalous” rocket-and-wire triggered lightning flash, a flash whose leaders do not follow the triggering wire remnants to ground, is characterized via high-speed video images at 10 and 300 kilo-frames per second, still camera images, 66–72 MHz source locations from a Lightning Mapping Array, channel-base current, and electric field and electric field derivative (dE/dt) measurements. This is the first anomalous flash of about 410 classically triggered flashes in north-central Florida. The flash began with an upward positively charged leader (UPL) initiating from the tip of the upward-moving triggering wire about 280 m above ground level. All but the bottom 17 m of wire exploded (became luminous) 37.6 ms after UPL initiation. A stepped leader initiated, likely from the top of the wire remnants, 282 m above ground level about 1.3 ms after the wire explosion and propagated downward for 2.1 ms, attaching to the top of a grounded utility pole 117 m southwest of the launching facility. The line charge density on the stepped leader is estimated to be of the order of 10−3 C m−1. Contrary to previously reported “anomalous” flashes in France and New Mexico (roughly 16% and 31%, respectively, of their triggered flashes), in our event, there was not a tens of milliseconds current-zero period preceding the stepped leader, there was no observed downward dart leader in the UPL channel prior to the stepped leader to ground, and there was a failed attempt to reestablish current in the exploded-wire channel between the UPL and ground.
The composition of comets

Questions concerning the origin of comets are considered. It is pointed out that the molecular composition of a dense interstellar cloud appears to have exactly the composition needed to produce the observed features of the visible cometary spectrum, which consists mainly of emission bands of unstable free radicals. A working model of cometary structure is discussed together with the classical observations which have led to it. The discussed model was originally described by Whipple (1951). It is emphasized that the model can serve only as a rough guide in efforts to interpret the evolution of cometary behavior. A survey is provided of new techniques which have only recently been applied to cometary observations, taking into account the spectrum of a comet, radio observations, and ultraviolet observations.
Key issues for the unplanned transfer of VLSI technology

The authors point out that in unplanned transfers i.e. capacity overload of technology license, etc., many manufacturing issues must be resolved on an aggressive schedule and at the lowest possible cost. The key issues which exist under various conditions are covered. The balance between technology requirements and minimized impact is discussed in terms of processing tools and recipes. Critical issues are identified and potential solutions discussed. A working model for unexpected semiconductor technology transfer tasks is presented. The methodology used to meet constrained budgets and aggressive schedules are the basic assumption for the proposed model. >
Studies of the reductive half-reaction of milk xanthine dehydrogenase.

The reductive half-reaction of milk xanthine dehydrogenase (XDH) with NADH and with xanthine has been studied at pH 7.5, 25 degree C. NADH reduces XDH to the two-electron reduced form at a rate of 18 s-1, independent of NADH concentration over the range studied. Further reduction by NADH to the four-electron state is inhibited by excess NADH. Subsequent binding of NADH to the four-electron reduced form of the enzyme causes the redistribution of one electron from the flavin to the molybdenum center. The four-electron reduced species reached through reduction by NADH is the same as the species obtained upon reaction of NAD with fully reduced XDH. In contrast, xanthine rapidly reduces XDH to the four-electron level; further reduction is comparatively slow and is inhibited by excess xanthine. Studies using substoichiometric xanthine show that the reaction of XDH with 1 equivalent of xanthine involves rapid substrate binding and rapid reduction of the molybdenum center of the enzyme. Before the release of urate from the molybdenum active site, an electron is transferred at 15 s-1 from the reduced molybdenum center to one of the iron-sulfur centers of XDH. Urate is then released at a rate of 13 s-1, followed by a rapid electron redistribution within the protein. The reductive half-reaction of XDH with xanthine is rate-limiting in xanthine/NAD turnover, which appears to occur between the two- and four-electron reduced enzyme species. The reduction of XDH by substoichiometric amounts of the fluorescent substrate xanthopterin was also studied. This reaction, monitored by changes in both absorbance and fluorescence, was found to involve the formation of two molybdenum complexes (an Eox.S complex and an Ered.P complex) followed by the release of the product, leucopterin.
Crisis in capitalist welfare programmes

Examines the Kansas job opportunities and basic skills programme to analyse why education and training programmes fail to reduce poverty and promote self‐reliance for programme participants. Uses profit model analysis to examine the effect of the Kansas job opportunities and basic skills programme on job readiness and employment. Examines client accountability to evaluate compliance with programme directives. Concludes that welfare recipient participation rates in KanWork education and training hold the key to understanding why Kansas welfare programmes contribute little to clients gaining marketable job skills.
The Mechanics of Earthquakes and Faulting: Brittle fracture of rock

1.1 Theoretical concepts 1.1.1 Historical Understanding the basic strength properties of rock has been a practical pursuit since ancient times, both because of the importance of mining and because rock was the principal building material. The crafting of stone tools required an intuitive grasp of crack propagation, and mining, quarrying, and sculpture are trades that require an intimate knowledge of the mechanical properties of rock. The layout and excavation of quarries, for example, is a centuries-old art that relies on the recognition and exploitation of preferred splitting directions in order to maximize efficiency and yield. One of the principal properties of brittle solids is that their strength in tension is much less than their strength in compression. This led, in architecture, to the development of fully compressional structures through the use of arches, domes, and flying buttresses. Rock was one of the first materials for which strength was studied with scientific scrutiny because of its early importance as an engineering material. By the end of the nineteenth century the macroscopic phenomenology of rock fracture had been put on a scientific basis. Experimentation had been conducted over a variety of conditions up to moderate confining pressures. The Coulomb criterion and the Mohr circle analysis had been developed and applied to rock fracture with sufficient success that they
Fathers without amandla? Gender and Fatherhood among isiZulu speakers

Given the relative lack of literature on the subject of fathers in South Africa, what follows is tentative and exploratory.' Sketching out the changing context of fathering and fatherhood over the 20th century, the article gives specific attention to fathers in the current period of unemployment and diminishing marital rates. The basic argument is that a disjuncture exists today between many men's relative ease at fathering children (in a biological sense) and their inability to fulfill the roles of fatherhood (in a social sense). This fissure, it tries to show, provides an important entry point for understanding the contradictory contours of male power in past-apartheid South Africa.
Aggressive Maneuvering Flight Tests of a Miniature Robotic Helicopter

In this paper we describe the control logic that enabled a small-scale unmanned helicopter to execute an aerobatic maneuver under computer control. The logic consists of steady-state trim trajectory controllers, used prior to, and upon the exit from the maneuver; and a maneuver logic inspired by human pilot strategies for maneuver execution. Extensive flight tests with this control logic demonstrated smooth entry into the maneuver, automatic recovery from the maneuver to a steady-state trim trajectory, and the robustness of the trim-trajectory control system toward measurement and modelling errors. This approach can be used with an advanced motion planning algorithm which utilizes the vehicle agility.
Enhanced antimetastatic activity of lymphokine-activated killer cells purified and expanded by their adherence to plastic.

We have recently reported a simple and reproducible technique for the purification and rapid expansion of homogeneous populations of large granular lymphocytes expressing a natural killer cell phenotype and high levels of broad antitumor cytotoxic activity [lymphokine-activated killer (LAK) activity]. This technique exploits the observation that, in the presence of recombinant interleukin 2 (rIL-2), large granular lymphocytes/natural killer cells become adherent to plastic surfaces, actively proliferate, and acquire high levels of LAK activity. Because of their adherent properties these cells have been termed adherent LAK or A-LAK cells. The present studies investigate the antimetastatic effects of A-LAK cells in a syngeneic rat model of experimental pulmonary and hepatic metastases. For pulmonary metastases, F344 rats received i.v. injections with a natural killer-resistant mammary adenocarcinoma, MADB106, and, for hepatic metastases, animals received an intrasplenic injection of MADB106 tumor cells followed by surgical splenectomy. Three days later, the animals were treated with A-LAK cells alone, A-LAK cells plus rIL-2, or rIL-2 alone. These treatments were compared to immunotherapy using standard cultures of LAK cells (unfractionated spleen cells) and rIL-2. The results indicate that the administration of unfractionated LAK cells plus interleukin 2 (IL-2) was effective in reducing established lung or liver metastases in this rat model. However, the results also indicate that purified populations of A-LAK cells in combination with rIL-2 demonstrate dramatic and superior antimetastatic effects when compared to LAK cells cultured under standard conditions. The antimetastatic effects of standard LAK cells or A-LAK cells plus IL-2 translated into significant survival benefits compared to animals receiving no therapy or IL-2 therapy alone. Survival after therapy with A-LAK cells plus IL-2 was significantly prolonged compared to treatment with standard LAK cells. These data suggest that purified populations of LAK cells (derived from natural killer cells) may prove superior for adoptive immunotherapy in the clinical setting.
Manufacturing: An Introduction to Production Technology, Quality Assurance, and SCM

This chapter gives a brief overview and description of production technology for electronic control unit (ECU) production using an engine ECU as a representative example of an ECU and also summarizes quality assurance approaches and methods during ECU production. Supplier chain management, which is an essential part of production activities, is also outlined in view of significant supply issues that have surfaced in recent years. Keywords: production technology; ECU ; electronic control units; quality assurance; SCM ; supply chain management; soldering; surface mounting technology
A kinesin family tree

The kinesin tree was built from a sequence alignment of 144 kinesin motor domains from 31 species using the heuristic search method of PAUP v. 4.0b4a ( [Swofford, 1998][1]), a maximum parsimony program, and random stepwise addition and ‘tree-bisection-reconnection’ (TBR) branch swapping. The
Human umbilical cord blood as a potential source of transplantable hematopoietic stem/progenitor cells

The purpose of this study was to evaluate human umbilical cord blood as an alternative to bone marrow in the provision of transplantable stem/progenitor cells for hematopoietic reconstitution. Although no direct quantitative assay for human hematopoietic repopulating cells is at present available, the granulocyte-macrophage progenitor cell (CFU-GM) assay has been used with success as a valid indicator of engrafting capability. We examined greater than 100 collections of human umbilical cord blood for their content of nucleated cells and granulocyte-macrophage, erythroid (BFU-E), and multipotential (CFU-GEMM) progenitor cells, in many cases both before and after cryopreservation. First it was determined that granulocyte-macrophage, erythroid, and multipotential progenitor cells remained functionally viable in cord blood untreated except for addition of anticoagulant for at least 3 days at 4 degrees C or 25 degrees C (room temperature), though not at 37 degrees C, implying that these cells could be satisfactorily studied and used or cryopreserved for therapy after transport of cord blood by overnight air freight carriage from a remote obstetrical service. Granulocyte-macrophage progenitor cells from cord blood so received responded normally to stimulation by purified recombinant preparations of granulocyte-macrophage, granulocyte, and macrophage colony-stimulating factors and interleukin 3. The salient finding, based on analysis of 101 cord blood collections, is that the numbers of progenitor cells present in the low-density (less than 1.077 gm/ml) fraction after Ficoll/Hypaque separation typically fell within the range that has been reported for successful engraftment by bone marrow cells. Another observation of practical importance is that procedures to remove erythrocytes or granulocytes prior to freezing, and washing of thawed cells before plating, entailed large losses of progenitor cells, the yield of unwashed progenitor cells from unfractionated cord blood being many times greater. The provisional inference is that human umbilical cord blood from a single individual is typically a sufficient source of cells for autologous (syngeneic) and for major histocompatibility complex-matched allogeneic hematopoietic reconstitution.
An evaluation of departmental radiation oncology incident reports: Anticipating a national reporting system

Purpose Systems to ensure patient safety are of critical importance. The electronic incident reporting systems (IRS) of 2 large academic radiation oncology departments were evaluated for events that may be suitable for submission to a national reporting system (NRS). Methods and Materials All events recorded in the combined IRS were evaluated from 2007 through 2010. Incidents were graded for potential severity using the validated French Nuclear Safety Authority (ASN) 5-point scale. These incidents were categorized into 7 groups: ( 1 ) human error, ( 2 ) software error, ( 3 ) hardware error, ( 4 ) error in communication between 2 humans, ( 5 ) error at the human-software interface, ( 6 ) error at the software-hardware interface, and ( 7 ) error at the human-hardware interface. Results Between the 2 systems, 4407 incidents were reported. Of these events, 1507 (34%) were considered to have the potential for clinical consequences. Of these 1507 events, 149 (10%) were rated as having a potential severity of ≥2. Of these 149 events, the committee determined that 79 (53%) of these events would be submittable to a NRS of which the majority was related to human error or to the human-software interface. Conclusions A significant number of incidents were identified in this analysis. The majority of events in this study were related to human error and to the human-software interface, further supporting the need for a NRS to facilitate field-wide learning and system improvement.
CONGENITAL ANEURYSMS OF THE VENTRICULAR SEPTUM.

Abstract Congenital aneurysms of the ventricular septum occur uncommonly. They apparently result from faulty shift of the septum and failure of proper rotation of the aorta, according to the theory originally advanced by Mall and later amplified by Lev and Saphir. Although many patients are without cardiac complaints, some with aneurysms of the ventricular septum do have symptoms. Often such symptoms are related to associated defects, such as aortic insufficiency, or to rupture of the aneurysm. Various disturbances in rhythm may occur and may be responsible for the death of the patient. Thrombi may be present and may give rise to embolic phenomena. The aneurysm may rupture into the right ventricle or into the right atrium. In our case the history of a thrill and bruit since the first few weeks of life suggests that the defect in the dome of the aneurysm was developmental rather than the result of later rupture. A case of aneurysm of the ventricular septum associated with a small left-to-right shunt through a defect in it has been described. The correct diagnosis was established by cineangiography, and corrective surgery was carried out successfully.
Mutational analysis of transgenic mouse B cell lymphomas: indication of a Trp53-independent pathway in tumor progression.

Abstract Deregulated myc, bcl-2 and/or TP53 gene expression is associated with non-Hodgkin’s B cell lymphomas (B-NHLs). Eμ-N-myc transgenic mice that misexpress N-myc protein and carry a non-disrupted bcl-2 gene develop indolent B cell lymphomas reminiscent of the B-NHL, follicular lymphoma. Tumors from mice with end-stage disease exhibited discrete, nodular lesions as well as areas of diffuse tumor likely due to coalescence of enlarged follicles. Tumor DNAs were screened for mutations in the Trp53 gene, the murine homologue of the TP53 gene, which participates in B cell differentiation and survival. By PCR-based sequence analyses, we determined there were no mutations in exons 5–8, the common sites of TP53 mutation in B-NHLs. These findings suggested that disease progression in our novel murine lymphoma model may proceed via a Trp53-independent pathogenetic pathway.
Dynamic failure of Dyneema SK76 single fibers under biaxial shear/tension

Abstract Dyneema SK76 single fibers have been subjected to various known levels of both torsional shear strain and axial tensile stress in efforts to determine the resulting combined loading effects. High rate axial tension experiments were performed on pre-twisted fibers utilizing a miniature tension Kolsky bar and MTS servo-hydraulic system, while the resulting torque generated by fibers loaded to specific degrees of shear strain was determined via implementation of a video-based torque sensing technique. Compilation of the two stress state environments has generated a biaxial failure surface criterion yielding the residual tensile strength of single fibers when subjected to a specific grade of shear stress. Further analysis of fiber surface damage reveals longitudinal surface striation development at elevated levels of shear strain. Propagation of these undulations has been also investigated in order to determine their penetration depth and resulting internal fiber damage.
Humming control interface for hand-held devices

This paper describes a control-by-humming interface in which a bluetooth-connected insertion earphone/microphone remotely controls a small portable system such as a modern assistive device, cell phone, etc. A pitch detection algorithm converts a subvocal hum input signal into pitch contours that are segmented into discrete "notes" and then grouped to form control commands. These commands cause transitions among operational states. An example application is given for hands-free control of a simplified (six-state) cell phone and music player system. Performance of the interface is discussed and future improvements are outlined.
Evolution of waviness on the surface of a strained elastic solid due to stress-driven diffusion

Abstract Surface diffusion is one mechanism by which surfaces roughen during high temperature processing of semiconductor materials. Here, the free energy of an elastic crystal is assumed to be the sum of the elastic strain energy and the surface energy, and these two quantities determine the chemical potential for mass transport by surface diffusion. A gradient in chemical potential along the surface provides the driving force for diffusive mass transport which tends to lower the overall free energy of the system. These concepts are applied in considering the transient evolution of waviness of a nearly flat surface in a highly strained elastic solid. In particular, the three-dimensional problem of growth or decay of an initial slight depression in a nominally flat surface is studied by solving the mass transport equation. The process can be described in considerable detail by adhering to an assumption that the amplitude of surface fluctuations is small.
Interfacility transfer and mortality for patients with ruptured abdominal aortic aneurysm

Objective Patients receiving interfacility transfer to a higher level of medical care for ruptured abdominal aortic aneurysms (rAAAs) are an important minority that are not well characterized and are typically omitted from outcomes and quality indicator studies. Our objective was to compare patients transferred for treatment of rAAAs with those treated without transfer, with particular emphasis on mortality and resource utilization. Methods We linked longitudinal data from 2005 to 2010 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and Emergency Department Databases from California, Florida, and New York. Patients were identified using International Classification of Diseases-Ninth Revision-Clinical Modification codes. Our main outcome variables were mortality, length of stay, and cost. Data included discharge information on the transfer-out and transfer-in hospital. We used univariate and multivariate analysis to identify variables independently associated with transfer and in-hospital mortality. Results Of 4439 rAAA patients identified with intent to treat, 847 (19.1%) were transferred before receiving operative repair. Of those transferred, 141 (17%) died without undergoing AAA repair. By multivariate analysis, increasing age in years (odds ratio [OR] 0.98; 95% confidence interval [CI], 0.97-0.99; P P P P = .03) was positively associated with transfer. Transfer was associated with a lower operative mortality (adjusted OR, 0.81; 95% CI, 0.68-0.97; P P = .01). Among the transferred patients, there was no significant difference in travel distance between those who survived and those who died (median, 28.7 vs 25.8 miles; P = .07). Length of stay (median, 10 vs 9 days; P = .008), and hospital costs ($161,000 vs $146,000; P = .02) were higher for those transferred. Conclusions The survival advantage for patients transferred who received treatment was eclipsed by increased mortality of the transfer process. Including 17% of transferred patients who died without receiving definitive repair, mortality was increased for patients transferred for rAAA repair compared with those not transferred after adjusting for demographic, clinical, and hospital factors. Transferred patients used significantly more hospital resources. Improving systems and guidelines for interfacility transfer may further improve the outcomes for these patients and decrease associated hospital resource utilization.
Effect of ablation of frequent premature ventricular complexes on left ventricular function in patients with nonischemic cardiomyopathy

Background Frequent idiopathic premature ventricular complexes (PVCs) can result in PVC-induced cardiomyopathy. Frequent PVCs can also aggravate ischemic cardiomyopathy. Objective The purpose of this study was to investigate the impact of frequent PVCs on nonischemic cardiomyopathy. Methods This was a consecutive series of 30 patients (mean age 59.1 ± 12.1; 18 men; mean ejection fraction [EF] 38% ± 15%) with structurally abnormal hearts based on the presence of scar on cardiac magnetic resonance imaging and/or a history of cardiomyopathy before the presence of frequent PVCs who were referred for ablation of frequent PVCs. Results Ablation was successful in 18 of 30 patients (60%), resulting in an increase of mean EF from 33.9% ± 14.5% to 45.7% ± 17% ( P P P = .85). The PVC site of origin was in scar tissue in 14 of 18 patients with a successful ablation procedure. Mean New York Heart Association functional class improved from 2.3 ± 0.6 to 1.1 ± 0.2 ( P P = 1). Conclusion In patients with frequent PVCs and nonischemic cardiomyopathy, EF and functional class can be improved but not always normalized by successful PVC ablation. In most patients with an effective ablation, the arrhythmogenic substrate was located in scar tissue.
Timing specification and analysis for service-oriented simulation

This paper is an attempt to complement service-oriented simulation with the timing concept of the DEVS formalism. One of the key features of DEVS is its timing specification; however, currently timing information is not available in service-oriented models such as WSDL and BPEL yet. This paper presents timing specification and associated analysis techniques for PSML, a service-oriented modeling language. Specifically, timing constraints such as delays, processing time, deadlines among elements can be specified, and consistency among timing constraints can be verified. The timing information can be used for static analysis to estimate time needed as well as dynamically to verify runtime behavior of service-oriented application.
Diel vertical distribution of postflexion larval Citharichthys spp. and Sebastes spp. off central California

The diel and spatial distributions of postflexion larval Citharichthys spp. and Sebastes spp. at 67 stations off central California were examined during March 1994 with a 10 m2 MOCNESS during 24 h sampling operations. At each station, a CTD profiler with an attached PAR sensor was deployed to measure temperature, salinity, σt, dynamic height, and ambient light levels at depth. Catches of C. sordidus, C. stigmaeus, unidentified Sebastes spp., and S. jordani were larger at night than during the day and crepuscular periods, probably because of net avoidance during the day and crepuscular periods, and (for Citharichthys spp.) vertical migration into the upper water column at night. C. sordidus and C. stigmaeus migrated vertically through the pycnocline on a diurnal cycle, while Sebastes spp. apparently remained in the mixed layer above the pycnocline at all times. No definitive patterns were observed between horizontal contours of temperature, salinity, and σt at depth and catches of any larvae. This was attributed to the relatively homogeneous spatial pattern in the water column above the pycnocline, where the majority of the fish occurred.
Taxila LBM: a parallel, modular lattice Boltzmann framework for simulating pore-scale flow in porous media

The lattice Boltzmann method is a popular tool for pore-scale simulation of flow. This is likely due to the ease of including complex geometries such as porous media and representing multiphase and multifluid flows. Many advancements, including multiple relaxation times, increased isotropy, and others have improved the accuracy and physical fidelity of the method. Additionally, the lattice Bolzmann method is computationally very efficient, thanks to the explicit nature of the algorithm and relatively large amount of local work. The combination of many algorithmic options and efficiency means that a software framework enabling the usage and comparison of these advancements on computers from laptops to large clusters has much to offer. In this paper, we introduce Taxila LBM, an open-source software framework for lattice Boltzmann simulations. We discuss the design of the framework and lay out the features available, including both methods in the literature and a few new enhancements which generalize methods to complex geometries. We discuss the trade-off of accuracy and performance in various methods, noting how the Taxila LBM makes it easy to perform these comparisons for real problems. And finally, we demonstrate a few common applications in pore-scale simulation, including the characterization of permeability of a Berea sandstone and analysis of multifluid flow in heterogenous micromodels.
Off-pump surgery and alternatives to standard operation in redo coronary surgery.

Background: Reoperative coronary artery bypass grafting (CABG) has been associated with higher mortality and morbidity than first-time CABG. Off-pump surgery has been introduced in an effort to reduce morbidity associated with traditional on-pump CABG. However, these techniques present unique challenges in the reoperative setting. A review of our experience was undertaken to determine safety, efficacy, and technical challenges in beating heart reoperative CABG. Methods: From January 1999 through April 2003 reoperative CABG procedures performed by a single surgeon were treated on an “intention to treat” basis without cardiopulmonary bypass. A standardized operative technique employing suction stabilization and exposure devices were used for sternotomy procedures with stabilization devices employed for limited access single-vessel revascularization. Results: Eighty-six of eighty-seven (99%) consecutive patients undergoing reoperative CABG had the procedure initiated off-pump. There were 24 of 62 females/males (28%/72%) with a mean age of 64.3 (34 to 92). Eighty-one of eighty-six (94.2%) procedures were successfully completed off-pump. Five (5.8%) conversions were due to hemodynamic instability, inability to dissect dense adhesions (2), inability to locate an intramyocardial LAD (1). The procedures were performed via a median sternotomy in 67 patients (78%) and by limited anterior or lateral thoracotomy in 19 patients (22%). The operative mortality was 2 of 86, predicted risk 6.7%. There was no mortality in the converted patients. Postoperative length of stay was 5.5 days. There were no strokes or perioperative myocardial infarctions. Complications included reoperation for bleeding in 2.2%. Sixty-one of sixty-six (92.4%) patients were able to be extubated in the operating room. The rate of transfusion was 23 in 86 patients (26.5%), and atrial fibrillation was 5 in 86 patients (5.8%). Conclusion: Off-pump CABG can technically be performed safely in most patients presenting for reoperative CABG. Outcomes appear to be improved compared with published outcomes of reoperative on-pump CABG surgery.
Radioimmunoassay of a 26,000-dalton plasma insulin-like growth factor-binding protein: control by nutritional variables.

Insulin-like growth factor I (IGF-I) is a peptide growth factor that circulates bound to carrier proteins. One form of carrier protein (mol wt, ∼26K) is not believed to be GH dependent, is relatively unsaturated, and modulates the cellular response to IGF-I. This study was undertaken to determine the variables that control the plasma concentration of this protein, which was measured using a specific RIA. The mean plasma 26K IGF-binding protein (IGF-BP) concentration in 15 normal fasting subjects at 0800 h was 9.4 ± 4.4 (±sd) μg/L. The mean value in GH-deficient patients was increased to 19.5 ± 10.1 μg/L (n = 60; P < 0.05), and it was 7.3 ± 4.3 μg/L in patients with acromegaly (n = 31). The GH dependency of these changes is further supported by the observation that subjects who received GH injections had a 51% reduction in their fasting values. Nutritional intake appeared to be a more important controlling variable than GH. During an overnight fast plasma 26K IGFBP values increased approximately 4-fold in ...