cssi/SciSciGPT-SciSciNet huggingface dataset:
Preoperative chemoembolization in patients with hepatocellular carcinoma undergoing liver transplantation: influence of emergent versus elective procedures on patient survival and tumor recurrence rate.

Our purpose was to compare the recurrence rate and survival in patients with hepatocellular carcinoma (HCC) who had elective transarterial chemoembolization (TACE), immediate preoperative TACE, or no treatment prior to orthotopic liver transplantation (OLT). A total of 132 patients with HCC had TACE prior to OLT. Eighteen patients had no TACE before OLT and functioned as a control group. The urgent group included 35 patients embolized less than 24 h before OLT and the elective group included 97 patients embolized greater than 1 day before transplantation. These groups were compared with regard to tumor staging, hepatic synthetic function, and post-TACE tumor necrosis and survival and recurrence rates. Patients were followed for a mean of 780 days post OLT (1–2912 days). The tumor staging was similar between groups but the Childs-Pugh score in the urgent and untreated group was significantly higher than that of the other groups. The degree of necrosis at explant was also significantly different between the two treated groups, with an average 35% necrosis in the patients embolized less than 24 h before OLT vs 77% in the elective group (p < 0.002). Recurrence rate in the urgent group was 8 of 35 (23%) in a median of 580 days, 20 of 97 (21%) in a median of 539 days in the elective group, and 2 of 18 (11%) in a median of 331 days in the no-TACE group. Survival at 1, 3, and 5 years was 91%, 80%, and 72% in the elective group, 79%, 58%, and 39% in the urgent group, and 69%, 61%, and 41% in the no-TACE group, respectively. The urgent and no-TACE groups had significantly worse survival compared with the other groups; however, the tumor recurrence rates were statistically the same among all three groups. TACE within 24 h of OLT causes an average of 35% necrosis and elective TACE increases necrosis further to 77%. Despite this difference, the tumor recurrence rate in the three groups is equivalent and no different from that in the group that received no treatment before OLT. The decreased survival in the immediate and no-TACE groups was due to non-cancer-related deaths.
A Classroom Discussion with James R. Cargill

This interview with James R. Cargill was compiled from question-and-answer sessions during undergraduate and MBA-level family business management courses taught at the University of St. Thomas, Minneapolis, Minnesota. He offers a down-to-earth perspective on family enterprise that resonates with family business students and parents. Mr. Cargill is a director, major shareholder, and retired senior vice president of Cargill, Inc., America's largest family enterprise.
Biochemical and Cellular Properties of Three Immortalized Schwann Cell Lines Expressing Different Levels of the Myelin-Associated Glycoprotein

Biochemical and cellular properties of three immortalized Schwann cell lines expressing different levels of the myelin-associated glycoprotein (MAG) were compared. The S16 line generated by repetitive passaging was described previously and expresses a level of MAG comparable to that in adult sciatic nerve. The S42 line was generated independently by the same procedure, divides more slowly than the S16 line, and expresses an even higher level of MAG. The S16Y line arose spontaneously from a passage of the S16 cells, divides much more rapidly, and does not express MAG. The levels of MAG expression in the three lines are inversely related to their rates of proliferation, and MAG mRNA levels parallel the amounts of MAG. The S16 and S42 lines consist mainly of flat cells at low density and develop many processes at high density, whereas most of the S16Y cells are spindle-shaped, resembling primary Schwann cells in appearance. Surface immunostaining with the O4 antibody was positive for the S16 and S42 cells and negative for the S16Y cells, but all three lines were negative for surface staining with the O1 antibody. The overall protein compositions of the three lines are very similar, but the S16 and S42 cells express larger amounts of several glycoproteins than the S16Y cells, including the adhesion proteins, neural cell adhesion molecule, L1, and laminin. S16 and S42 cells (but not S16Y cells) also express P0 glycoprotein, galactocerebroside, and sulfatide, but, unlike MAG, these other myelin-related components were present at much lower levels than in adult nerve. Myelin basic protein and proteolipid protein were not detected in any of the lines, although all three lines contained proteolipid protein mRNA. 2',3'-Cyclic nucleotide 3'-phosphodiesterase and glial fibrillary acidic protein were present in all three lines. Conditions have not yet been found in which any of the lines will myelinate dorsal root ganglion neurons in vitro, but the S16 and S42 cells differ from the S16Y cells by clustering around neurons after 1 week in coculture. In many respects, the S16 and S42 cells biochemically resemble Schwann cells at an early stage in their preparation to myelinate and should be useful for investigating the cell biology of MAG and other myelin-related components.
Advanced cancers: eradication in all cases using 3-bromopyruvate therapy to deplete ATP.

A common feature of many advanced cancers is their enhanced capacity to metabolize glucose to lactic acid. In a challenging study designed to assess whether such cancers can be debilitated, we seeded hepatocellular carcinoma cells expressing the highly glycolytic phenotype into two different locations of young rats. Advanced cancers (2–3 cm) developed and were treated with the alkylating agent 3-bromopyruvate, a lactate/pyruvate analog shown here to selectively deplete ATP and induce cell death. In all 19 treated animals advanced cancers were eradicated without apparent toxicity or recurrence. These findings attest to the feasibility of completely destroying advanced, highly glycolytic cancers.
A Web Service Recommender System Using Enhanced Syntactical Matching

Service-oriented computing (SOC) enables organizations and individual users to discover openly-accessible capabilities realized as services over the Internet. However, service registries can potentially be very large preventing organizations from discovering services in real-time. In fact, consumers may not be aware of the services that can be of most benefit to them. In our work, we introduce a web service recommender system that proactively discovers and manages web services. This paper focuses on the underlying search and ranking algorithms that enable the recommendations. As an innovation, we have analyzed real, fully-operational web services currently available on the Internet and, as a result, have discovered insights into how real web service messages are defined. Using these general naming tendencies coupled with enhanced syntactical methods, we are able to aggregate services by their messages and accurately suggest candidate services to users as a part of daily routines.
Reading in the Undergraduate Psychology Curriculum

Scholars express concern about college students' declining reading levels when the need for critical literacy is growing. Burner's (1985, 1986) theory of two basic modes of thought—narrative and pa...
Averaged Iterative Water-Filling Algorithm: Robustness and Convergence

The convergence properties of the iterative water-filling (IWF) based algorithms have been derived in the ideal situation where the transmitters in the network are able to obtain the exact value of the interference plus noise (IPN) experienced at the corresponding receivers in each iteration of the algorithm. However, these algorithms are not robust because they diverge when there is time-varying estimation error of the IPN, a situation that arises in real communication system. In this correspondence, we propose an algorithm that possesses convergence guarantees in the presence of various forms of such time-varying error. Moreover, we also show by simulation that in scenarios where the interference is strong, the conventional IWF diverges while our proposed algorithm still converges.
Effects of clay platelets and natural nanotubes on mechanical properties and gas permeability of Poly (lactic acid) nanocomposites

Abstract Environmental concerns have resulted in the increased use of biodegradable polymers and their nanocomposites. We have developed a facile method for measuring the work of adhesion ( W a ) between nanoparticles and their matrix, which we showed can be used to determine their degree of intercalation within the matrix. This method was then applied to Poly (lactic acid) (PLA) nanocomposites with either sodium montmorillonite clays (C-Na+), organically modified clays (C-30B), resorcinol di (phenyl phosphate) (RDP) coated C-Na+ (C-RDP), Halloysite nanotubes (HNTs) and RDP coated HNTs (H-RDP). The C-30B showed the highest W a within the PLA matrix, followed by the C-RDP and the C-Na+. X-ray diffraction and TEM indicated that the C-30B platelets were highly exfoliated, the C-RDP were intercalated, while the C-Na+ were aggregated in the PLA matrix. Oxygen gas permeability measurements showed the largest decrease in permeability for the C-30B nanocomposites, followed by the C-RDP, and the C-Na+ nanocomposites. The values of the particle aspect ratios obtained using Nielsen model were consistent with the TEM images. In contrast to clay platelets, HNTs and H-RDP were not effective in decreasing oxygen gas permeability of PLA matrix, which was in excellent agreement with the model we derived. Despite the higher degree of exfoliation, the C-30B nanocomposites had a significantly lower Izod impact than the C-RDP nanocomposites. SEM images showed numerous micro-voids on the Izod impact fracture surface of C-30B nanocomposites. On the other hand, the nanotubes were much more effective in reinforcing the mechanical properties, with RDP coated tubes having the better performance, consistent with their higher value of W a with PLA matrix. These results showed that RDP coated silicate nanoparticles can provide environmentally safe alternatives for modifying the mechanical and gas barrier properties of PLA.
Natriuretic peptides and cardiac hypertrophy.

Cardiac hypertrophy, an increase in the size and/or thickness of the ventricles in the heart, is an important compensatory mechanism for pathophysiological states and an independent predictor of cardiovascular morbidity and mortality ([1,2][1]). Several studies have shown that left ventricular mass
Three-Phase Oil Relative Permeability in Water-Wet Media: A Comprehensive Study

We report experimental three-phase oil relative permeability in two water-wet media (a sandpack and a Berea sandstone core) along different saturation paths. Three oils with different viscosities, compositions, and spreading coefficients were used in the measurements. The data show that oil relative permeability can vary significantly along different saturation paths. Most importantly, we find that despite the significant (orders of magnitude) variation of oil relative permeability along different saturation paths, the oil relative permeability in each medium can be collapsed into a single relative permeability curve, once they are plotted as a function of mobile oil saturation. However, this collapsed curve varies depending on the porous media. We show that the same behavior occurs in the relative permeability data published over the past 50 years. These observations indicate that the key factor in differences between oil permeabilities in the same porous media is changes in the residual oil saturation. We examine the performance of most commonly used relative permeability models, i.e., Corey, Saturation-Weighted Interpolation (SWI), and Stone against our data. Given the importance of residual oil saturation, we fit the experimental data along different saturation paths by treating the residual oil saturation in these models as the fitting parameter while keeping the other parameters constant. We find that the Corey and SWI models fit the data very well while the Stone model performs poorly at low saturations. We find that residual oil saturation is a nonlinear function of gas/water saturation as opposed to linear relationship previously suggested by others.
DEMOGRAPHY AND SEX RATIO IN SOCIAL SPIDERS.

Spiders that live in large cooperative societies are scattered among several taxonomic groups. All quasisocial species appear to have female-biased sex ratios, while congeneric species with less advanced forms of sociality have 1:1 sex ratios. I present two sex-ratio models that examine the interaction between the genetic structure of populations and two aspects of colony demography-the changes as the colony grows larger in fecundity per female and in colony survivorship. In the first model, I assume that all members of the population produce the same sex ratio under all conditions (monomorphic strategy), while in the second model I assume that the sex ratio can be adjusted according to stage in the colony growth cycle (conditional strategy). The results of these models are consistent with the typically observed effects of within-sex competition among relatives; the sex ratio is biased toward the sex with less intense competition. In addition to these effects, a number of interesting interactions are revealed among relatedness, demography, and constraints of the sex-determining mechanism (monomorphic vs. conditional strategies). For example, when survivorship or fecundity increases as the colony grows larger, the predicted sex ratio becomes more female-biased. These demographic factors of changing viability and fecundity with changing colony size interact synergistically with relatedness, and the effect of this interaction on the sex ratio depends on the constraints of the sex-determining mechanism. There are two related roles for the models presented here. First, these models provide some general predictions about how complex variables of demography and population structure interact in shaping the evolution of social spider sex ratios. Second, the development of the models illustrates a theoretical method that provides a simple description of complex interactions between demography and population structure, as well as an example of the synergistic interaction between relatedness and cooperation in the context of a particular life history.
Abstract 12: Heart Failure Medications Prescribed at Discharge for Patients With Left Ventricular Assist Devices

Background: The longitudinal success of the heart failure (HF) patient with a left ventricular assist device (LVAD) depends on medications to maintain the device, such as antithrombotic agents to prevent pump thrombosis and antihypertensives to reduce stroke risk. However, the role of traditional, evidence-based HF medications for patients with concurrent LVAD support is not well known. This study aimed to determine use, temporal trends, and factors associated with prescription of HF medications at discharge among patients with advanced HF with and without LVADs, and to examine patient and hospital-level factors associated with HF medication prescription among LVAD recipients. Methods: We conducted a retrospective, observational analysis of 4,580 advanced HF patients from 215 hospitals participating in the Get With The Guidelines-Heart Failure registry from January 2009 to March 2015. We examined patterns of HF medication use at hospital discharge among patients with an in-hospital (n=258) or prior (n=326) LVAD implant, and those with advanced HF without an LVAD, as defined by a reduced left ventricular ejection fraction and intravenous inotrope or vasopressin antagonist receipt (n=3,996). Results: For beta-blocker and angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACE/ARB), discharge prescriptions were 58.9% and 53.5% for new LVAD recipients, 62.9% and 51.4% for prior LVAD recipients, and 78.7% and 60.7% for patients without LVAD support, respectively (p<0.0001 and p=0.0005). There was no significant difference in aldosterone antagonist use among the three groups (p=0.23) but its use quadrupled among LVAD patients during the study period (p<0.0001, see figure). Approximately 54% of new and prior LVAD patients and 66% of patients without an LVAD were discharged on two of the three HF medications (p<0.0001). In the multivariable analysis of LVAD patients, patient age was inversely associated with beta-blocker, ACE/ARB, and aldosterone antagonist use. Conclusion: Traditional HF therapies are commonly prescribed to LVAD recipients, although less frequently than to advanced HF patients without LVAD support. Aldosterone antagonists are prescribed increasingly to LVAD patients. Further research is needed on the optimal medical regimen for patients with LVADs. ![][1] [1]: /embed/graphic-1.gif
Expressions of survivin and caspase-9 in human primary hepatocellular carcinoma tissues and their significances

Objective To study the expressions of survivin and caspase-9 in human primary hepatocellular carcinoma(HCC) tissues and their relationship with apoptosis.Methods Immunohistochemical staining was uesed to detect the expressions of survivin and caspase-9 in paraffin sections of 96 cases including 42 HCC tissues,42 paired adjacent noncancerous tissues and 12 normal liver tissues. Apoptosis was detected by TUNEL.Results No immunoreactivity of survivin was seen in normal liver tissues.The positive rates of survivin in HCC and paired adjacent noncancerous tissues were 73.81% and 4.76%,respectively,there was significant difference between two groups(P0.01). The positive rates of caspase-9 in normal tissues,paired adjacent noncancerous tissues and HCC tissues were 83.33%,80.95% and 47.62%,respectively,and the positive rate of caspase-9 in HCC tissues was significantly lower than those in the other two kinds of tissues (P0.05),but the expression of caspase-9 in paired adjacent noncancerous tissues had no difference compared with normal tissues (P0.05).The expressions of survivin and caspase-9 in HCC tissues were not associated with age,sex and the size of tumor,but they were directly associated with tumor histological grade and metastasis.Conclusion High expression of survivin in HCC may inhibit apoptosis through depressing the expression of caspase-9,and it is an indicator of independent poor prognosis.
α1-Antitrypsin deficiency in a child with X-linked lymphoproliferative disease

An 18-month-old white male infant with X-linked lymphoproliferative disease was evaluated for persistent hepatic dysfunction following primary Epstein-Barr virus infection. A liver biopsy revealed cirrhosis with a dense mononuclear cell infiltrate. These findings were confounding because cirrhosis is not a typical finding in either normal or immunodeficient individuals following infection with Epstein-Barr virus. An alpha 1-antitrypsin level obtained shortly after biopsy was spuriously within the lower limits of the physiologic range. Further investigation demonstrated a homozygous Z phenotype, the classic protease inhibitor variant described in alpha 1-antitrypsin deficiency. A repeat liver biopsy confirmed the presence of a second hereditary disease. This is a unique concurrence of two uncommon genetic disorders.
Prostaglandin F Production by Tissue Expiants from Term Pregnancies

Explants of various tissues obtained from pregnant women at term and from nonpregnant women were maintained in culture and their capacities to synthesize prostaglandin (PGF) were evaluated. Myometrial and decidual tissues from pregnant women produced significantly smaller amounts of PGF than those from nonpregnant women, suggesting that PGF production is inhibited during gestation. Decidual PGF synthesis was also inhibited by the addition of progesterone, estradiol or indomethacin. The PGF synthesis of the chorion of women in labor was lower than that of women not in labor. In the later group, the cohrion, decidua and myometrium produced significant amounts of PGF, but amniotic PGF production was negligible. Our findings show that the decidua and chorion, as well as the myometrium, are potentially important sources of PGF production. PGF synthesis during pregnancy also may be affected by local inhibitory influences.
Epidemiological study of selective IgA deficiency among 6 nationalities in China

The frequency of selective IgA deficiency (SIgAD) was determined in 33,171 Chinese distributed in six nationalities by Ouchterlony's double diffusion with 5 mg/dl as the limit of detection. Those who were found IgA-deficient were retested by single radial diffusion technique. Gel diffusion analysis of sera revealed apparent lack of IgA in 8 samples, all with normal levels of IgG and IgM (age-matched). The incidence was 0.024% (1:4,100). The incidences among the six nationalities were Han 1:2,600, Hui 1:5,000, Mongolia 1:2,700, Tujia 1:4,300, Zhuang 0:5,300, and Bai 1:4,800. All of the individuals, who had low levels of IgA or no IgA detectable, were below 16 years of age. Of these, 2 sera were autoantibody (anti-smooth muscle antibody) positive Delayed hypersensitivity skin tests were negative in one individual. The chief clinical manifestations were those of respiratory tract infections, of which about 50% were in subclinical state.
Prevalence of Noncardiac and Genetic Abnormalities in Neonates Undergoing Cardiac Operations: Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database

Background Among patients with congenital heart disease (CHD), the coexistence of noncardiac congenital anatomic abnormalities (NC), genetic abnormalities (GA), and syndromes (S) may influence therapeutic strategies and outcomes. The appreciated prevalence of these abnormalities has risen because increased screening and improved diagnostic precision enable identification of these comorbidities in a larger fraction of neonates with CHD. We examined the contemporary prevalence and distribution of NC/GA/S across diagnostic groups among neonates undergoing cardiac operations using a large nationally representative clinical registry. Methods The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) was queried to identify neonates (≤30 days) who underwent index cardiac operations from 2010 to 2013. The fundamental cardiac diagnosis was used to identify 10 diagnostic groups. The prevalence of NC/GA/S was reported across each group. Results The cohort included 15,376 index neonatal operations from 112 centers. Overall, 18.8% (2,894 of 15,376) of operations were performed in neonates with NC/GA/S. Patients with atrioventricular septal defect (212 of 357 [59.4%]), interrupted aortic arch (248 of 567 [43.7%]), truncus arteriosus (204 of 554 [36.8%]), and tetralogy of Fallot (417 of 1,383 [30.2%]) had the highest prevalence of NC/GA/S abnormalities, whereas those with transposition of the great arteries (111 of 2,778 [4.0%]) had the lowest prevalence. The most commonly identified NC/GA/S included heterotaxy (597 of 15,376 [3.9%]), DiGeorge syndrome or 22q11 deletion (550 of 15,376 [3.6%]), Down syndrome or trisomy 21 (318 of 15, 376 [2.1%]), intestinal malrotation (220 of 15,376 [1.4%]), and Turner syndrome or 45XO (189 of 15,376 [1.2%]). Conclusions The prevalence of NC/GA/S varies widely across CHD diagnostic groups. This information may be useful for patient counseling, recommendations for screening for anomalies and genetic disorders, and perioperative management.
Visual imagery and the corpus callosum: a theoretical note.

Can visual imagery training substantially improve verbal paired-associate learning in a partial callosal patient? A 20-yr.-old male with the posterior half of his corpus callosum sectioned did show...
The diagnostic use of insulin-like growth factor (IGF)-I and IGF binding protein measurements in growth hormone deficiency

The insulin-like growth factor (IGF) binding proteins (IGFBPs) are high-affinity carrier proteins that are present in all extracellular fluids. Because of their high affinity, they control the access of IGF-I and -II to receptors. Like IGF-I, several of the IGFBPs are hormonally regulated. Both insulin and growth hormone (GH) appear to be important regulators of their plasma concentrations. IGFBP-3 is stimulated by GH whereas IGFBP-2 is suppressed. Based on these observations, several investigators have evaluated the utility of IGFBP-3 and IGFBP-2 in confirming the diagnosis of GH deficiency and in monitoring the response to replacement therapy. In children, IGFBP-3 concentrations are an extremely sensitive and specific test for GH deficiency. In summary, measurement of IGFBPs provides additional useful information in patients with GH deficiency. The ultimate diagnostic utility of these measurements is currently being further defined.
Military Metaphors and Their Contribution to the Problems of Overdiagnosis and Overtreatment in the "War" Against Cancer.

Military metaphors have a long history within biomedical discourse. Pasteur used them as a way to explain the germ theory of disease. President Nixon declared “war” on cancer in the National Cancer...
Symptom profiles and inflammatory markers in moderate to severe COPD

Abstract Background Physical and psychological symptoms are the hallmark of patients’ subjective perception of their illness. The purpose of this analysis was to determine if patients with COPD have distinctive symptom profiles and to examine the association of symptom profiles with systemic biomarkers of inflammation. Methods We conducted latent class analyses of three physical (dyspnea, fatigue, and pain) and two psychological symptoms (depression and anxiety) in 302 patients with moderate to severe COPD using baseline data from a longitudinal observational study of depression in COPD. Systemic inflammatory markers included IL1, IL8, IL10, IL12, IL13, INF, GM-CSF, TNF-α (levels >75 th centile was considered high); and CRP (levels >3 mg/L was considered high). Multinominal logistic regression models were used to examine the association between symptom classes and inflammation while adjusting for key socio-demographic and disease characteristics. Results We found that a 4-class model best fit the data: 1) low physical and psychological symptoms (26%, Low-Phys/Low-Psych), 2) low physical but moderate psychological symptoms (18%, Low-Phys/Mod Psych), 3) high physical but moderate psychological symptoms (25%, High-Phys/Mod Psych), and 4) high physical and psychological symptoms (30%, High-Phys/High Psych). Unadjusted analyses showed associations between symptom class with high levels of IL7, IL-8 ( p ≤ .10) and CRP ( p Conclusions Patients with COPD can be classified into four distinct symptom classes based on five commonly co-occurring physical and psychological symptoms. Systemic biomarkers of inflammation were not associated with symptom class. Additional work to test the reliability of these symptom classes, their biological drivers and their validity for prognostication and tailoring therapy in larger and more diverse samples is needed. Trial registration Clinicaltrials.gov, NCT01074515 .
Tailoring the physicochemical and shape memory properties of the biodegradable polymer poly(glycerol dodecanoate) via curing conditions

A major challenge in the repair and regeneration of soft tissue damage occurring as a result of aging, injury, or disease is recapitulating the biomechanical properties of the native tissue. Ideally, a candidate biomaterial for soft tissue engineering applications should be biocompatible, nonlinearly elastic to match soft tissue mechanical behavior, biodegradable to enable tissue remodeling, and tailorable to achieve a range of nonlinear elastic mechanical properties to match specific soft tissues. In addition, for cardiac and other applications, the biomaterial should have shape memory characteristics to facilitate minimally invasive and/or catheter-based delivery. Poly(glycerol dodecanoate) (PGD) is a shape memory material that has nonlinear elastic properties at body temperature and elastic-plastic behavior at room temperature. In this study, we investigated the effects of curing conditions on the nonlinear elastic, shape memory, and biocompatibility properties of PGD. Increased curing and crosslinking resulted in an increase in both the initial stiffness and the nonlinear strain stiffening behavior of PGD. After shape fixation at 60% strain, 100% shape recovery was achieved within 1 min at body temperature for all conditions tested. Polymer curing had no adverse effects on the cellular biocompatibility or non-hemolytic characteristics of PGD, indicating the potential suitability of these formulations for blood-contacting device applications. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1618-1623, 2017.
Small Wins: The Case of Borrowed Materials

Behaviorists interested in large scale change might benefit from attending to the positive consequences of a "small-win" philosophy. As an example, by focusing on altering unfortunate events in our own immediate behavior settings, small wins can be earned, and these successes, limited as they are, might solidify our resolve to engage in large scale change efforts.
Adult Spinal Deformity: National Trends in the Presentation, Treatment, and Perioperative Outcomes From 2003 to 2010.

Abstract Study Design Retrospective review of a prospective database. Objectives To investigate adult spinal deformity (ASD) surgery outcome trends on a nationwide scale using the Nationwide Inpatient Sample (NIS) from 2003 to 2010. Methods ASD patients ≥25 years from 2003 to 2010 in the NIS undergoing anterior, posterior, or combined surgical approaches were included. Fractures, 9+ levels fused, or any cancer were excluded. Patient demographics, hospital data, and procedure-related complications were evaluated. Yearly trends were analyzed using univariate analysis and linear regression modeling. Results Of 10,966 discharges, 1,952 were anterior, 6,524 were posterior, and 1,106 were combined. The total surgical ASD volume increased by 112.5% (p = .029), and both the average patient age (p 65 years old significantly increased from 2003 to 2010 (p = .009). Anterior approach case volume decreased by 13.7% (p = .019), whereas that of combined increased by 22.7% (p = .047). Posterior case volume increased by 38.9% from 2003 to 2010, though insignificantly (p = .084). Total hospital charges for all approaches increased over the interval (p Conclusions For ASD surgery from 2003 to 2010, the volume of anterior approaches decreased, whereas posterior procedures did not change, and combined approaches increased. Total hospital charges increased for all considered procedures, length of hospital stay decreased, whereas operative patients were increasingly elderly, and more procedures were observed for patients >65 years old. For all approaches, morbidity increased whereas mortality did not change. Future study is required to develop methods to reduce morbidity and costs, thereby optimizing patient outcomes.
Failed Arthroscopic SLAP Repair in 35-Year-Old Male Police Officer

Superior labral anterior to posterior (SLAP) tears can cause persistent pain and disability, often with vague clinical presentation. SLAP tears represent a detachment of the labrum from anterior to posterior, with or without involvement of the anchor of the long head of the biceps tendon. Synder et al. first described a classification system, which was later expanded upon by Maffet et al., classifying lesions based on their stability and location (Maffet, Gartsman, Moseley. Am J Sports Med 23:93–98, 1995; Snyder, Karzel, Del Pizzo, Ferkel, Friedman. Arthroscopy 6:274–279, 1990). SLAP tears result from traction or compression injuries or with repetitive overhead activity. If nonoperative management fails, multiple surgical treatment options are available, including simple debridement, stabilization of the biceps-labrum complex with repair, biceps tenotomy, or biceps tenodesis (Chalmers, Monson, Frank, et al. Knee Surg Sports Traumatol Arthrosc 24:3870–76, 2016; Ek, Shi, Tompson, Freehill, Warner. J Shoulder Elb Surg 23:1059–1065, 2014; Werner, Brockmeier, Miller. J Am Acad Orthop Surg 22:554–65, 2014).
Bioethical pastoral: Life, ethics, and the politics of human dignity

The last decade of work on vital politics has seen a sharp and unexpected return to the figure of universal humanity. Despite this return, the canon of work on vital politics remains marked by a curious omission: little attention has been paid to the place of ‘human dignity’ in the governance of the biological body. The reasons for this omission are not obvious. After all, since World War II, talk of dignity has become a sine qua non of global counter-politics. If the reasons are not obvious, the significance is: dignitarian politics is distinguished by a refusal of the logic of biopolitics and an embrace of a political sensibility consistent with what Foucault called pastoral power: the demand that the pastorate must care, simultaneously, for all of the flock and for the soul of each member. This article seeks to highlight the place of pastoral power in the study of vital politics by examining one domain in which vital and dignitarian politics have become entangled: the figure of human dignity in bioethics. Tracing the situated ways dignity has been reimagined and remobilized in relation to the biopolitical body in the case of U.S. stem cell ethics, it seeks to cast new light on contemporary economies of life and power.
P7 An audit of the management of resuscitation drugs and trolley contents

Introduction Every clinical area is equipped with either a resuscitation trolley containing a red emergency drug box (2222 box) or only the 2222 box for emergencies such as cardiac arrests. According to national1 and local guidelines each of these trolleys contains a certain set of drugs and a CD size oxygen cylinder. Aims were to audit compliance of drugs, including the medical gas oxygen, with national1 and local guidelines to audit compliance with the required daily check of resuscitation trolleys and 2222 boxes to audit frequency of expired medicines to audit compliance with up to date resuscitation guidelines The aims of the audit were to assess the pharmaceutical contents in the resuscitation trolleys, monitor if regular checks are done to the trolleys, compare the pharmaceutical contents in the trolleys to those on the local clinical area’s stock list and review the resuscitation guidelines on the trolley. Method A data collection form was created which included the drugs and local Trust resuscitation trolley content list. A free text box was included to capture drugs or drug related guidelines found on the trolley that were not officially listed. Results Forty seven clinical areas were included in the data collection, 32 held a resuscitation trolley and a 2222 box, 15 held a 2222 box only. Compliance of drug content: 50%. Reason found for poor compliance was that most clinical areas (84.4%) did not keep 250 ml sodium chloride bags as routine stock on the ward causing a delay in replenishing following an emergency. Twenty of the trolleys contained drugs not included on the list. Compliance with equipment list Compliance of Oxygen cylinders on trolley: 5/29. Critical care unit trolleys did not keep oxygen cylinder as each bed space keeps a cylinder. One cylinder was found out of date. Compliance rate with daily trolley checks: 29/32 Guidelines were found on 31/32 trolleys. Where guidelines were found, revision of the information was required. Recommendations Actions following the audit included changing the trolley content list: 250 mL sodium chloride 0.9 bags to a 500 ml sodium chloride 0.9% w/v bag which is kept routinely in each area. The guidelines are being revised to provide clearer information on dosing and administration for children. The Trust resuscitation committee have agreed to re-audit at least every 6 months. Conclusion After the completion of the audit the results were presented to the Resuscitation Committee and implementations were suggested in order to improve the management of resuscitation trolleys in the hospital. Together it was agreed, that a re-audit should be done in the future (3–6 months’ time) to see if these recommendations have improved the current situation. Reference Resuscitation Council (UK). Acute care: Equipment and drug lists 2013. https://www.resus.org.uk/quality-standards/acute-care-equipment-and-drug-lists/#paed [Accessed: 6 April 2016].
A Community Perspective for Mental Health Research

Research on the mental health of American Indian and Alaska Native people is intended to delineate areas that need improvement or change. The Indian community must be involved in order to provide m...
Impact of prolonged dialysis prior to renal transplantation.

INTRODUCTION The new kidney allocation system (KAS) prioritizes patients based on date of dialysis initiation or waitlisting, whichever is earlier. We hypothesized that this change would increase transplant rates for patients with prolonged pretransplant dialysis times (DT) and aimed to assess the impact of prolonged DT on post-transplant outcomes. METHODS We used United Network for Organ Sharing registry data to assess outcomes for patients added to the renal transplant waitlist from January 1, 1998 to December 31, 2010 and patients transplanted from January 1, 1998 to December 3, 2012. RESULTS Compared with patients transplanted pre-emptively, patients with <5 years, 5-9 years, and ≥10 years DT had progressively decreased graft and patient survival (P < .001). The rates of short-term complications including delayed graft function, graft loss within 30 days, and patient death within 30 days were significantly higher in cohorts with ≥10 years DT than in cohorts with less DT (P < .001). CONCLUSIONS Patients with pretransplant DT of ≥10 years had worse outcomes than patients pre-emptively transplanted or transplanted with shorter DT. Durations of dialysis dependence beyond 10 years were associated with further deterioration in short-term but not long-term post-transplant outcomes.
Shapiro-Wilk Type Goodness-of-Fit Tests for Normality: Asymptotics Revisited

Regression type goodness-of-fit tests for normality based onL-statistics, proposed by Shapiro and Wilk (1965), are known to possess good power properties. However, due to some distributional problems (particularly for large sample sizes), various modifications have been considered in the literature. The intricacies of these asymptotics are presented here in a general setup, and in the light of that some theoretical explanations are provided for the asymptotic power of related tests.
Effect of movement speed on limb segment motions for reaching from a standing position

The performance of a standing reaching task that necessitates some forward bending requires: (1) the coordination of multiple joints (i.e., the trunk and limb segments) to reach the target, and (2) the preservation of postural stability. It has been proposed that the neural control of multijoint reaching tasks can be simplified by time scaling of joint motions while keeping joint excursions the same. To determine if time scaling of joint motions was used in this more complex reaching task, we had 20 healthy subjects (10 male and 10 female) reach for two targets located in a parasagittal plane while standing on a force platform. Subjects reached for the targets at a comfortable speed and a fast paced speed. Sagittal plane motions of the right shank, thigh, pelvis, trunk, humerus, and forearm were measured. At the fast paced movement speeds subjects had significantly larger excursions of the thigh, pelvis, humerus, and forearm compared to the comfortable speed. Thus, segment motions are not simply time scaled for standing multijoint reaches. We explored three possible reasons for not obeying time scaling: (1) to reduce scaling of peak kinetic energy, (2) to reduce scaling of peak horizontal ground reaction force, and (3) a convergence of movement strategies at faster speeds. While subjects modified their movement strategy in relationship to movement speed, these changes had no significant effect on the expected scaling of peak kinetic energy, or peak horizontal ground reaction forces. Given the intersubject differences in movement strategies used to perform these reaching tasks at the fast speeds, a convergence of movement strategies was ruled out. We propose that the increase in segment motions with speed may be a consequence of rules underlying motor output, the increases being greater for segments in which viscoelastic resistance to movement is more significant compared to inertial resistance.
Series-Connected Power Electronics as a Communication Medium

Current power line communications consist of a voltage mode based communications protocol that is effective for communication between devices connected in parallel. Recently, advances in power electronics have facilitated a series connection scheme. In order to establish communications with these series connected power electronics, a current mode based means of communication needs to be established. In this paper, we present a methodology to use series connected power electronics as a communications medium for a current mode based means of power line communications. We contribute a model, generalized for all series connected power electronics, which establishes a foundation for part the first layer of the OSI model, the physical layer. This model is then analyzed in use of a physical system consisting of series connected inverters used in solar power conversion. The results show how a current based communication scheme can be implemented with the result in this paper being a low bandwidth communication. With future work of a complete establishment of the physical layer, the traditional power line communication protocols, such as G3 or Prime, can then be utilized for upper layers of communication.
Burnout in Chairs of Academic Radiology Departments in the United States.

Objective We aimed to estimate the self-reported prevalence of burnout in chairs of academic radiology departments in the United States and identify factors associated with high burnout in chairs. Materials and Methods An anonymous cross-sectional online survey was conducted of members of the Society of Chairs of Academic Radiology Departments. Burnout was measured using the abbreviated Maslach Burnout Inventory Human Services Survey. Associations between survey participants’ characteristics and burnout were tested using Fisher's exact test and Wilcoxon rank sum test. Results Of the 123 chairs invited to complete the survey, 87 responded (response rate, 71%). The mean age of the participants was 58 years. The survey respondents had an average of 9 years of experience as department chair. The average number of work hours per week was 62 hours. Four participants (5%) of the academic chairs met all three criteria for high burnout including high emotional exhaustion, high depersonalization, and low personal accomplishment. Thirty-three participants (38%) had high emotional exhaustion and/or high depersonalization score. Low professional satisfaction score, low work-life balance satisfaction score, and low chair effectiveness score were significantly associated with high burnout. High emotional exhaustion and/or high depersonalization were significantly associated with numerous professional stressors. Lack of an institutional support group for chairs and lower number of faculty members in the department were significantly associated with burnout. Conclusion A significant proportion of chairs of academic radiology departments are experiencing 1 or more symptoms of burnout. Efforts to address burnout in radiology chairs should be initiated promptly at the national, institutional, and departmental levels.
Chapter 2 – Virus Structure

Simple viruses are genomes packaged in a protein shell called a capsid. Capsids are assembled from many copies of a single, or a few capsid proteins. Capsids are symmetrical structures stabilized by repeated contacts between protein subunits. Capsids of naked (unenveloped) viruses function in attachment and entry. Capsids also have roles in genome packaging and exit from the cell. Capsids accomplish these diverse tasks because they are dynamic structures that change conformation in response to environmental clues. Some viruses surround their capsids with a lipid bilayer called the envelope. Enveloped viruses encode proteins that associated with the lipid bilayer. They are usually glycosylated and contain transmembrane anchoring domains. They often project out from the surface of the envelope forming distinct spikes. Envelope proteins have attachment and fusion functions. Many enveloped viruses have a matrix (MA) protein positioned inside, and associated with the envelope (via direct membrane interactions or through interactions with the cytosolic tails of envelope glycoproteins). The MA protein forms a link between the membrane and the nucleocapsid. The terms nucleocapsid and core refer to the complex of viral nucleic acid and protein found within the envelope.
Loperamide Mimicking Brugada Pattern

Brugada syndrome is an inherited arrhythmia that increases a patient's risk of sudden cardiac death. Certain pharmacologic agents may induce a transient Brugada pattern on surface electrocardiogram (EKG). One of these is loperamide, an over-the-counter agent commonly used to manage diarrhea. We report the case of a patient who experienced EKG changes that mimicked Brugada pattern after excessive intake of loperamide.
Unilateral parietal brain injury increases risk-taking on a rat gambling task.

Traumatic brain injury (TBI) affects millions of individuals every year. Many of these injuries lead to lasting effects, particularly impairments in domains broadly classified as executive functions, such as impulse control and decision-making. While these impairments have been historically associated with frontal brain damage, other injuries such as concussion or parietal injury also contribute to similar dysfunction. However, it is unknown whether animal models of TBI would replicate these broad effects that are observed in human patients. In the current study, we delivered a unilateral parietal controlled cortical impact injury and assessed the performance of rats on a motoric task (rotarod) and a test of decision-making and impulsivity (rodent gambling task). TBI rats demonstrated significant motor impairments on the rotarod task; however, this did not extend to difficulties inhibiting motor actions (impulsivity). In addition, TBI caused chronic alterations to risk-based decision-making, extending out to 12 weeks post-injury. Specifically, rats with TBI preferred the riskiest, and most suboptimal option over all others. The current data suggest that models of unilateral TBI are sufficient for replicating some aspects of executive dysfunction (risky decision-making), while others are limited to frontal damage (impulsivity). These models may be used to develop therapeutics targeted at the chronic post-injury period when these symptoms often manifest in patients, a critically understudied area in preclinical TBI research.
100% Clean, Renewable Energy and Storage for Everything

Numerous laws – including the Green New Deal – have been proposed or passed in cities, states, and countries to transition from fossil fuels to 100% clean, renewable energy in order to address climate change, air pollution, and energy insecurity. This textbook lays out the science, technology, economics, policy, and social aspects of such transitions. It discusses the renewable electricity and heat generating technologies needed; the electricity, heat, cold, and hydrogen storage technologies required; how to keep the electric power grid stable; and how to address non-energy sources of emissions. It discusses the history of the 100% Movement, which evolved from a collaboration among scientists, cultural leaders, business people, and community leaders. Finally, it discusses current progress in transitioning to 100% renewables, and the new policies needed to complete the transition. Online course supplements include lecture slides, answers to the end-of-chapter student exercises, and a list of extra resources.