cssi/SciSciGPT-SciSciNet huggingface dataset:
Because It's there ... the education of George Mallory

Initiative, creativity, and resolve represent both the pillars of the Wilderness Medical Society (WMS) and the story of George Mallory. His journey from humble beginnings to his rise to become one of history's most legendary mountaineers is a testament to the impact of great mentors as well as the development of Mallory as a mentor himself. In this light, the path of George Mallory in mountaineering and the role of WMS in wilderness medicine share a common theme. This essay is not only a tribute to George Mallory but also a testament to the importance of mentorship and the role of WMS in inspiring mentorship and education to future pioneers.
Effect of GaN Surface Treatment on the Morphological and Optoelectronic Response of Violet Light Emitting Diodes

We report on the study of the effect of various surface chemical treatment processes of n-GaN template layers used for subsequent growth of light emitting diode (LED) structures. The treatment procedure included cleaning in organic solvents, organic solvents followed by 5 minutes of HCl, organic solvents and 5 minutes of HCl followed by 2 minutes and finally 10 minutes of HF treatment. Chemical, optical and electrical properties of the surfaces of GaN and InGaN-based LED structures were systematically investigated by x-ray photoemission spectroscopy (XPS), auger electron spectroscopy (AES), atomic force microscopy (AFM), photoluminescence (PL) and electroluminescence (EL) spectroscopy. GaN layers that were grown on the samples treated with HCl and HF showed dramatically different surfaces having high density of 3D structures with high roughness. As measured by AFM, growth of the LED structure on top of the GaN layer continued the 3D-growth mode. LED structures grown on the HCl and HF treated GaN template layers showed minimal to no PL and EL emission and failed after a short period. We suggest a qualitative model of the growth that could potentially explain the underlying phenomena leading to such pronounced changes in the optoelectronic properties and surface conditions of the LED structures due to the treatment of the initial template layers.
Will electronic health records improve healthcare quality? Challenges and future prospects

Health information technology has been widely touted as a key component to improving healthcare delivery along the six components of quality identified by the Institute of Medicine: effectiveness, ...
Bureaucratic Discretion, Business Investment, and Uncertainty

What determines whether policy environments attract or deter investment? Scholars worried about the vulnerability of market-supporting institutions to political manipulation have identified delegation to independent actors as way to increase policy environments’ predictability. Extant arguments, however, risk overgeneralizing from the experience of developed democracies. I argue that investors’ response to bureaucratic discretion—agents’ leeway to make decisions and act independently of political bodies—depends upon the broader institutional context. Where robust political institutions are lacking, bureaucratic discretion acts as a source of unpredictability that deters investors; conversely, political institutions that share the cost of monitoring help to mitigate uncertainty about how bureaucrats will use discretion in applying regulatory rules. Using survey data from over 600 enterprises in Russia, I find that perceptions of bureaucratic discretion are negatively associated with firm managers’ willingn...
The SXT/R391 Family of Integrative Conjugative Elements Is Composed of Two Exclusion Groups

Conjugative elements often encode entry exclusion systems that convert host cells into poor recipients for identical or similar elements. The diversity of exclusion systems within families of conjugative elements has received little attention. We report here the most comprehensive study to date of the diversity of exclusion determinants within a single family of conjugative elements. Unexpectedly, our analyses indicate that there are only two exclusion groups among the diverse members of the SXT/R391 family of integrative conjugative elements.
Hardware annealing in electronic neural networks

A simulated hardware annealing process for electronic neural circuits is derived from the analogy between the temperature in a Boltzmann machine and the amplifier gain in a VLSI chip. Here, varying the amplifier gain is equivalent to changing the temperature of the probability function in a Boltzmann machine. Decrease in the amplifier voltage gain is equivalent to temperature increase. The beginning and final annealing temperatures for the hardware annealing can be precisely determined. Theory and experimental results on a 4-b Hopfield analog-to-digital converters with simulated annealing are presented. >
Home Safe: No-Trade Clauses and Player Salaries in Major League Baseball

In this paper, we examine the wage effects of no-trade clauses in Major League Baseball. Using an accepted player salary equation and data from the 2003-2008 seasons, we find evidence that there is a trade-off between monetary compensation and the risk reduction provided by a no-trade clause. The results suggest that players may be able to simultaneously negotiate for a no-trade clause and higher salaries, but this is constrained when players also seek to guarantee their income stream with long-term contracts.
Induction of Immunologic Tolerance to Myelin Basic Protein Prevents Central Nervous System Autoimmunity and Improves Outcome After Stroke

Background and Purpose— Animals subjected to an inflammatory insult at the time of stroke are predisposed to the development of an inflammatory autoimmune response to brain. This response is associated with worse neurological outcome. Because induction of immunologic tolerance to brain antigens before stroke onset is associated with improved outcome, we sought to determine whether this paradigm could prevent the deleterious autoimmune response to brain provoked by an inflammatory stimulus at the time of ischemia. Methods— Male Lewis rats were tolerized to myelin basic protein (MBP) or ovalbumin by intranasal administration before middle cerebral artery occlusion. At the time of reperfusion, all animals received lipopolysaccharide (1 mg/kg intraperitoneal). Behavioral tests were performed at set time intervals. Results— One month after middle cerebral artery occlusion, lymphocytes from the spleens of MBP-tolerized animals were less likely to evidence an autoimmune response and more likely to evidence a regulatory response (Treg) toward MBP than those from ovalbumin-tolerized animals. Animals that had an inflammatory response toward MBP (a Th1 response) performed worse on behavioral tests than those that did not. Fractalkine, a surrogate marker of inflammation, was elevated in animals with a Th1 response to MBP. Conclusions— These data extend our previous findings and suggest that deleterious autoimmunity to brain antigens can be prevented by prophylactically inducing regulatory T-cell responses to those antigens.
Stability from an operational viewpoint

The concept of stability for single-input/single-output linear time-invariant plants is reformulated within the framework of Mikusinski's generalized functions and then characterized; each plant is given by convolution with a generalized function called the impulse response. The impulse response of a stable plant is the generalized derivative of a function of bounded variation, and is therefore the sum of three uniquely determined functions: the first being an absolutely integrable function, the second being an absolutely convergent sum of at most countably many delays, and the third being an atomless singular measure, a stochastic phenomenon. >
On predicting phonological difficulty in second language acquisition

The amount of influence that a learner's native language has on the acquisition of a second language is an issue which has received considerable attention in research on second language acquisition. The thesis of this paper is that, within the context of the Interlanguage Hypothesis (Selinker 1972) and the Markedness Differential Hypothesis (Eckman 1977), some important properties of a learner's interlanguage (IL) can be predicted.More specifically, it is shown that speakers of Cantonese and Japanese internalize different IL rules in attempting to deal with English word-final voice contrasts. Whereas speakers of Cantonese devoice word-final obstruents in the target language, Japanese speakers insert a word-final schwa after the voiced obstruent. However, each of these rules can be correlated with facts about the phonology of the native language, supporting the conclusion that some important aspects of ILs can be predicted on the basis of a comparison of the native and target languages.
How does the estrogen receptor work

In breast cancer, interruption of estrogen receptor (ER)-α function is an effective therapeutic strategy. Despite the clinical benefit of interruption of ER-α function, the precise biological action of ER-α in breast tumors is not completely understood. Results of a recent study show that ER-α promotes growth of breast cancer cells by targeting expression of signaling components of the insulin-like growth factor system. Intriguingly, the authors of this study raise the possibility that unliganded ER-α itself may affect gene expression and breast cancer biology, and they suggest a potential mechanism for ER-α to stimulate proliferation in breast cancer.
New techniques for speech understanding

A standard semantic analyzer accepting dictated sentences belonging to a grammar is used in a vocal information retrieving system. The problems of managing sentences not in the grammar and errors from the speech recognizer are addressed. Three different methods are proposed, based, respectively, on alignment techniques, conceptual categories (CCs), and neural networks. To test and compare the three approaches, several benchmarks were run. Each benchmark is specific for a kind of query sentence category: in-grammar with recognition errors, out-of-grammar with no recognition errors, etc. It is concluded that the CCs extraction phase combined with the neural approach for evaluating logical rules leads to a solid speech understanding system. >
Chromatin silencing and Arabidopsis development: A role for polycomb proteins.

All organisms undergo dramatic shifts in gene expression patterns during early development, particularly at fertilization when the zygotic program is initiated. In flowering plants, fertilization launches four distinct developmental programs that lead to the formation of the embryo, endosperm, seed
Myocardial perforation by a stick foreign body in a dog

Objective: To report a case of myocardial perforation by a stick foreign body in a dog. Case Summary: A 3-year-old castrated male Labrador Retriever was examined because of a puncture wound seen after an unsupervised run in the woods. The wound was suspected to penetrate into the thoracic cavity on the basis of physical exam and radiographs. Uniform ventricular premature complexes (VPCs) and junctional beats were noted on electrocardiogram (ECG). Thoracotomy was performed and a 6-cm wooden stick was seen protruding from the right ventricle through the pericardium toward the sternum. The stick was removed while purse string sutures were tied around the resultant myocardial defect. Follow-up echocardiography revealed intact intracardiac structures. VPCs were treated with lidocaine and resolved completely within 24 hours of presentation. New or Unique Information Provided: Thoracic trauma can result in myocardial injury; penetration into the myocardium represents a life-threatening situation for the emergency clinician. Cardiac injury should be included in the differential diagnoses of penetrating thoracic foreign bodies.
The scent of a site: a system for analyzing and predicting information scent, usage, and usability of a Web site

Designers and researchers of users' interactions with the World Wide Web need tools that permit the rapid exploration of hypotheses about complex interactions of user goals, user behaviors, and Web site designs. We present an architecture and system for the analysis and prediction of user behavior and Web site usability. The system integrates research on human information foraging theory, a reference model of information visualization and Web data-mining techniques. The system also incorporates new methods of Web site visualization (Dome Tree, Usage Based Layouts), a new predictive modeling technique for Web site use (Web User Flow by Information Scent, WUFIS), and new Web usability metrics.
Benchmarking RNA-Seq quantification tools

RNA-Seq, a deep sequencing technique, promises to be a potential successor to microarraysfor studying the transcriptome. One of many aspects of transcriptomics that are of interest to researchers is gene expression estimation. With rapid development in RNA-Seq, there are numerous tools available to estimate gene expression, each producing different results. However, we do not know which of these tools produces the most accurate gene expression estimates. In this study we have addressed this issue using Cufflinks, IsoEM, HTSeq, and RSEM to quantify RNA-Seq expression profiles. Comparing results of these quantification tools, we observe that RNA-Seq relative expression estimates correlate with RT-qPCR measurements in the range of 0.85 to 0.89, with HTSeq exhibiting the highest correlation. But, in terms of root-mean-square deviation of RNA-Seq relative expression estimates from RT-qPCR measurements, we find HTSeq to produce the greatest deviation. Therefore, we conclude that, though Cufflinks, RSEM, and IsoEM might not correlate as well as HTSeq with RT-qPCR measurements, they may produce expression values with higher accuracy.
Using synchronous distance education to deliver a weight loss intervention: A randomized trial.

Objective To implement a randomized trial to evaluate the effectiveness of a weight loss program delivered using synchronous distance education compared with a wait-list control group with 6-month follow-up. Methods Adults with a body mass index (BMI) ≥25 were randomized to the intervention (n = 42) or wait-list control group (n = 38). The intervention group participated in a synchronous, online, 15-week weight loss program; weight loss was the primary outcome. Secondary measures included height, BMI, and confidence in ability to be physically active and eat healthy. Assessments occurred at three and four time points in the intervention and control group, respectively. Results Participants who completed the program lost significantly more weight (1.8 kg) than those in the wait-list control group (0.25 kg) at week 15 [F(1,61) = 6.19, P = 0.02] and had a greater reduction in BMI (0.71 vs. 0.14 kg/m2), [F(1,61) = 7.45, P = 0.01]. There were no significant differences between the intervention and the wait-list control groups for change in confidence in ability to be physically active or eat healthy. Weight loss was maintained at 6 months. Conclusions Use of synchronous distance education is a promising approach for weight loss. The results of this study will help to inform future research that employs Web-based interventions.
The Good, the Beautiful, and the Useful: Montaigne's Transvaluation of Values*

Historians of political thought have failed to appreciate the importance of Montaigne's Essays as a major work of modern political philosophy. The neglect of the Essays as a political book is traceable to a widespread belief that Montaigne's thought is too fluctuating and unsystematic to embody a coherent and profound political teaching.This study challenges the prevailing interpretation of Montaigne's thought by analyzing his critique of the classical understanding of supreme or “heroic” moral virtue, concentrating especially on the chapter entitled “Of Cruelty.” A careful reading of this chapter reveals that underlying the seeming disunity or inconsistency of its argument is a carefully worked out political intention. The essence of Montaigne's political project involves the replacement of a traditional morality based on “beauty” (i.e., one in which humanity aspires to share in the divine) by one embodying “utility” (one in which we understand our needs in the light of what we share with the beasts). The analysis of this “transvaluation of values” helps one to comprehend the foundations of the “bourgeois” morality that characterizes modern liberal regimes.
Über den Einfluß von Feuchtigkeitsänderungen auf das Kriechen von Buchenholz quer zur Faser unter Berücksichtigung von Temperatur und Temperaturänderungen

Das Kriechen von Buchenholz in Tangentialrichtung, bei konstanter Temperatur und Feuchtigkeit konnte durch eine Exponentialgleichung dargestellt werden. Die Dehnungszahl erschien als Funktion von Feuchtigkeit, Temperatur und Belastung. Wurde die Feuchtigkeit wahrend des Versuchs geandert, so war ein groser Sorptionseinflus auf das Kriechen festzustellen. Dieser Sorptionseinflus stand in linearer Beziehung zu dem Ausmas der Feuchtigkeitsanderung, war aber bei gleicher Feuchtigkeitsstufe von der Lage im hygroskopischen Bereich, von der Sorptionsgeschwindigkeit, von vorherigem Kriechen bei konstanter Feuchtigkeit, und von der Temperatur unabhangig. Bei Desorption nahm der Sorptionseinflus mit steigender Belastung ab, wahrend bei Adsorption das Gegenteil beobachtet wurde. Temperaturanderungen wahrend des Kriechversuchs hatten ahnliche Folgen wie Feuchtigkeitsanderungen. Ansatze zu einer Deutung des Sorptionseinflusses wurden erortert.
Integrated HIC High-Q Resonators in Chalcogenide Glass

We have demonstrated the first planar waveguide-coupled chalcogenide glass micro-resonators using a CMOS-compatible lift-off technique. The microdisk resonators support whispering-gallery-mode (WGM) with cavity Q exceeding 2 × 105, the highest Q reported in chalcogenide resonators.
The Study of Pelvic Infection after Tran Svaginal Hysterectomy and the Way to Prevent It

Objective To provide reference of the way to prevent pelvic infection aftertransvaginal hysterectomy. Method retrospective study was down on 1660 patients after transvaginalhysterectomy in our hospital from January 1993 to December 2003.Results the infectious tate aftertransvaginal hysterectomy was 10.11%.The rate of pelvic infecrion was 2.11% and 1.68% patients wereinfected after nonprolapse of uterus ectomy.8.11% patients were infected after transvaginalhysteromyomectomy. Conclusions The patient co-infected uterine disorder and vaginitis is in high tiskof infection after transvaginal hysterectomy. Thinking highly of preparation of vagina and usingantibiotics begore operation and plancing dain tube in pelvic after operation may prevent infection orreduce the infectious rate.
Effects of phenethanolamines and propranolol on the proliferation of cultured chick breast muscle satellite cells.

Satellite cells were isolated from 20-d embryonic chick breast muscle via a Percoll density gradient fractionation technique. Culturing of these cells gave rise to at least 89% fusion (myotube nuclei number/total nuclei number). Proliferation of cultured satellite cells (indicated by myotube nuclei number) was increased in a dose-dependent manner when fibroblast growth factor (FGF) was included in the medium (25 to 200 ng/ml). Similar cultures were used to examine the effects of ractopamine and isoproterenol on satellite cell proliferation. Ractopamine and isoproterenol were added to culture medium (10(-11) to 10(-4) M) 24 h after initial plating. After a 72-h treatment period, the treatments were removed and replaced with a medium to promote fusion for 48 h. Cells then were fixed and stained, and myotube and total nuclei were counted. In later experiments, ractopamine and isoproterenol each increased (P less than .01) myotube nuclei number vs that observed in control cultures by 2.3 and 2.1 times, respectively. Similar differences were observed with total nuclei number. The number of myotube nuclei observed in cultures treated with 10(-6) M ractopamine or isoproterenol was reduced (P less than .01) by 25.4 and 23.6%, respectively, when propranolol, a beta adrenergic antagonist, was included at 10(-5) M with the respective agonist. These results indicate that ractopamine and isoproterenol each enhance the proliferative activity of chick satellite cells in culture and that the beta adrenergic receptor mediates this proliferative effect.
An experimental survey of feedback control methodologies for advanced lighting systems

Abstract Lighting constitutes a significant portion of building energy consumption. Various lighting control strategies exist that reduce the energy consumption by decreasing dimming level of the fixtures and also ensure the color quality of the achieved light. These strategies differ in their input parameters, control objectives, control algorithms, cost of installation, complexity of commissioning, availability of hardware, etc. Each of these control schemes has a unique set of factors that affect their performance in terms of energy savings as well as the achieved light quality. This paper presents an experimental survey of four state-of-the-art lighting control strategies, the formulation of their associated problems as well as their solution approaches, the experimental results obtained from their implementation in a standard testbed, and the factors affecting their performances.
Development of course modules for multidisciplinary STEM education

Traditional STEM education models in electrical engineering and computer science rely on structured classes, laboratories, and textbooks to transfer key concepts. Even though this process meets most of the ABET objectives, it does not respond well to current workforce needs that require widely accessible programs that will provide a large pool of graduates with STEM backgrounds, analytical and programming skills, critical thinking, and leadership abilities. In this work in progress paper, we describe our efforts to motivate students to pursue studies in STEM areas. We accomplish this by creating and disseminating modules that demonstrate how math and engineering theory enable modern applications such as those embedded in wireless devices.
Breast cancer stage variation and survival in association with insurance status and sociodemographic factors in US women 18 to 64 years old.

Background Few population-based studies have examined the association between health insurance status and breast cancer stage at diagnosis and survival. The degree to which sociodemographic characteristics explain this association is also unclear. This study examined associations between insurance status and sociodemographic characteristics and stage at diagnosis and survival. Methods Using the Surveillance, Epidemiology, and End Results 18 registries database, we identified 52,048 women aged 18 to 64 years who were diagnosed with breast cancer in 2007 and 2008. Associations between insurance status and sociodemographic variables and stage at diagnosis and survival were examined with logistic and Cox proportional hazards regression models to calculate adjusted odds ratios (ORs), hazard ratios (HRs), and associated confidence intervals (CIs). Results The odds of a later stage breast cancer diagnosis were increased in women with Medicaid (OR, 2.36; 95% CI, 2.19-2.55) and no insurance (OR, 2.64; 95% CI, 2.29-3.04) versus private insurance, in women who had reported black race (OR, 1.18; 95% CI, 1.09-1.28) versus white race, in women who were unmarried (OR, 1.25; 95% CI, 1.18-1.33) versus married at diagnosis, and in women who were 18 to 39 years old (OR, 1.29; 95% CI, 1.18-1.41) versus 40 to 64 years old at diagnosis. The hazard of breast cancer death was increased in association with Medicaid (HR, 1.40; 95% CI, 1.30-1.51) and no insurance (HR, 1.61; 95% CI, 1.41-1.84) versus private insurance, with reported black race (HR, 1.39; 95% CI, 1.29-1.50) versus reported white race, and with being unmarried (HR, 1.19; 95% CI, 1.12-1.27) versus being married. Conclusions Insurance status at diagnosis and sociodemographic factors are associated with breast cancer mortality. Factors underlying these associations warrant further study. Cancer 2017;123:3125-31. © 2017 American Cancer Society.
Fully printed and flexible carbon nanotube transistors designed for environmental pressure sensing and aimed at smart tire applications

As the sensor infrastructure needed to facilitate the internet-of-things (IoT) rapidly expands, printed electronics have been identified as a key approach for providing low-cost, ubiquitous sensor networks. In this work, we demonstrate the use of a fully printed carbon nanotube thin-film transistor (CNT-TFT) for sensing environmental pressure over a large pressure range. The transconductance of the transistor was found to be directly and linearly correlated with environmental pressure with a sensitivity of 48.1 pS/PSI. We also demonstrate the capability of wirelessly transmitting the data measured by the pressure sensor from within an automobile tire using a simple Bluetooth module. Furthermore, we package the sensor, along with a material thickness sensor developed in previous work, for a fully printed smart tire sensor system capable of mapping tire pressure and tread depth differentials.
An expert consensus for the management of chronic hepatitis B in Asian Americans.

Author(s): Tong, MJ; Pan, CQ; Han, S-HB; Lu, DS-K; Raman, S; Hu, K-Q; Lim, JK; Hann, HW; Min, AD | Abstract: BackgroundHepatitis B virus (HBV) infection is common with major clinical consequences. In Asian Americans, the HBsAg carrier rate ranges from 2% to 16% which approximates the rates from their countries of origin. Similarly, HBV is the most important cause of cirrhosis, hepatocellular carcinoma (HCC) and liver related deaths in HBsAg positive Asians worldwide.AimTo generate recommendations for the management of Asian Americans infected with HBV.MethodsThese guidelines are based on relevant data derived from medical reports on HBV from Asian countries as well as from studies in the HBsAg positive Asian Americans. The guidelines herein differ from other recommendations in the treatment of both HBeAg positive and negative chronic hepatitis B (CHB), in the approach to HCC surveillance, and in the management of HBV in pregnant women.ResultsAsian American patients, HBeAg positive or negative, with HBV DNA levels g2000 IU/mL (g104 copies/mL) and ALT values above normal are candidates for anti-viral therapy. HBeAg negative patients with HBV DNA g2000 IU/mL and normal ALT levels but who have either serum albumin l3.5 g/dL or platelet count l130 000 mm3 , basal core promoter (BCP) mutations, or who have first-degree relatives with HCC should be offered treatment. Patients with cirrhosis and detectable HBV DNA must receive life-long anti-viral therapy. Indications for treatment include pregnant women with high viraemia, coinfected patients, and those requiring immunosuppressive therapy. In HBsAg positive patients with risk factors, life-long surveillance for HCC with alpha-fetoprotein (AFP) testing and abdominal ultrasound examination at 6-month intervals is required. In CHB patients receiving HCC treatments, repeat imaging with contrast CT scan or MRI at 3-month intervals is strongly recommended. These guidelines have been assigned to a Class (reflecting benefit vs. risk) and a Level (assessing strength or certainty) of evidence.ConclusionsApplication of the recommendations made based on a review of the relevant literature and the opinion of a panel of Asian American physicians with expertise in HBV treatment will inform physicians and improve patient outcomes.
Medical Family Therapy in Obstetrics and Gynecology

The combined disciplines of obstetrics and gynecology (Ob-Gyn) are committed to the reproductive physiology of women’s health throughout the lifespan and include an integration of medical and surgical care. Ob-Gyn providers attend to the social, physiological, environmental, and genetic factors that influence or exacerbate health conditions in women. As such, Ob-Gyns’ expertise in and attention to diverse factors that influence the physical health of women makes medical family therapists (MedFTs) a logical partner for integrated behavioral healthcare (IBHC). Both disciplines train providers to recognize and care for the unique biopsychosocial-spiritual (BPSS) health needs (Engel, 1977, 1980; Wright, Watson & Bell, 1996) of each patient over the lifespan and in the context of her family system. Furthermore, both disciplines include training in their respective areas across prevention, health education, assessment, diagnostics, and intervention.
Deep venous thrombosis following lumbar laminotomy and laminectomy.

Abstract Sixty consecutive patients undergoing lumbar laminotomy or laminectomy underwent preoperative and postoperative compression ultrasonography of the lower extremities to detect acute deep venous thrombosis (DVT). Compression stockings were the only method of prophylaxis. Three patients (5%) developed postoperative calf DVT. Despite continued treatment with only compression stockings, serial scanning failed to detect propagation of the thrombus proximal to the knee in any patient. The average age of patients who developed DVT, 62 years, was significantly greater (P < .05) than the age of patients who did not, 45 years. There were no statistically significant differences in DVT rates when compared by: sex, addition of one- or two-level fusion, length of procedure, or number of days of bedrest.
Systems Approach to Patient Safety

Research on human subjects entails unique challenges, particularly when risks to patient safety are under scrutiny. Therefore, many factors must be considered in study design. This chapter serves to provide a broad overview of commonly used frameworks and methods for injury research related to patient safety. We review methods used to reveal hazards in health care, analyze and prioritize the risks associated with these hazards, and evaluate interventions to reduce these hazards.
Impact of a vancomycin restriction policy on use and cost of vancomycin and incidence of vancomycin-resistant Enterococcus.

OBJECTIF : Evaluer l'effet d'une politique assouplie de restriction qui requiert l'approbation du service d'infectiologie pour continuer l'administration de vancomycine plus de 72 heures sur la qualite de l'utilisation de la vancomycine, sur sa consommation et son cout, et sur l'incidence de souches d'Enterococcus resistant. DEVIS EXPERIMENTAL: Le dossier medical a ete revu de facon prospective en avril 1995. Les achats de vancomycine par la pharmacie et les donnees du laboratoire de microbiologie concernant les sensibilites ont ete compares pour la periode des 7 mois qui precedaient et qui ont suivi l'implantation de la politique. LIEU DE L'ETUDE: Centre universitaire de soins quatemaires de 725 lits. PATIENTS: Tous les patients a qui on a administre de la vancomycine en avril 1995. MESURES DE L'EFFET: La justesse de l'utilisation a ete determinee a partir des recommandations du CDC (Centers for Disease Control) concernant l'utilisation judicieuse de la vancomycine. RESULTATS: Au total, 333 episodes de traitement a la vancomycine ont ete revus. L'utilisation etait appropriee dans 219 (65%) cas. Pour les 114 episodes de traitement qui ne rencontraient pas les criteres du CDC, 76 (67%) utilisaient la vancomycine empiriquement 35 (31%) en prophylaxie, et 3 (2%) a visee therapeutique. Le nombre total de grammes utilises pour 1000 jours-patients est passe de 205 a 195 et le nombre total de patients ayant recu de la vancomycine a diminue de 0.5%. La comparaison des achats pour les deux periodes de 7 mois a montre une diminution de SI 5 788. il n'y a pas eu de changement de l'incidence d'Enterococcus resistant a la vancomycine pendant les 2 ans qui ont suivi l'implantation de la politique; le taux de resistance est reste a 30%. CONCLUSIONS : La politique assouplie de restriction a permis de reduire le nombre de grammes de vancomycine utilises mais l'utilisation est demeuree non appropriee dans le tiers des cas et l'incidence d'Enterococcus resistant n'a pas changee. Une politique plus stricte pourrait influencer ces parametres davantage.
Common-Wavelengths Design Scheme for Efficient Management of Spare Resources in WDM Networks

The author addresses the problem of self-healing capability to recover from network failures for WDM optical networks. One problem in realizing such survivable WDM networks is the inefficient utilization of large spare resources (wavelengths) designed for restoration of the failed traffic, which might not happen frequently. We study “common-wavelengths” design scheme to increase the utilization efficiency of these resources. The “common-wavelength” is an approach that allows some working paths under the failure to efficiently use the available common-wavelengths in the network. The effectiveness of this proposed approach and the effect of physical and traffic connectivity are investigated via simulations. Thus, the survivable WDM networks can be cost effectively designed according to the reliability levels of all working paths in the network.
Zika virus detection using antibody-immobilized disposable cover glass and AlGaN/GaN high electron mobility transistors

Zika virus detection was demonstrated using antibody-functionalized cover glasses externally connected to the gate electrode of an AlGaN/GaN high electron mobility transistor (HEMT). A pulsed bias voltage of 0.5 V was applied to an electrode on the region of the cover glass region functionalized with antibody, and the resulting changes of drain current of the HEMT were employed to determine the presence of Zika virus antigen concentration ranging from 0.1 to 100 ng/ml. The dynamic and static drain current changes as a function of Zika virus concentration were modeled with a spring-like elastic relaxation model and the Langmuir extension model, respectively. Excellent fits to the data were found with relaxation time constants of antibody and antigen molecules in the range of 11 μs and 0.66–24.4 μs, respectively, for the concentration range investigated. The ratio of antibody bound with antigen to the total available antibody on the functionalized contact window was in the range of 0.013–0.84 for the Zika antigen concentration range of 0.1–100 ng/ml. Since the HEMT is not exposed to the bio-solution, it can be used repeatedly. The functionalized glass is the only disposable part in the detection system, showing the potential of this approach for hand-held, low cost sensor packages for point-of-care applications.
FTDP-17 Mutations Alter the Aggregation and Microtubule Stabilization Propensity of Tau in an Isoform-Specific Fashion

More than 50 different intronic and exonic autosomal dominant mutations in the tau gene have been linked to the neurodegenerative disorder frontotemporal dementia with Parkinsonism linked to chromosome-17 (FTDP-17). Although the pathological and clinical presentation of this disorder is heterogeneous among patients, the deposition of tau as pathological aggregates is a common feature. Collectively, FTDP-17 mutations have been shown to alter tau's ability to stabilize microtubules, enhance its aggregation, alter mRNA splicing, or induce its hyperphosphorylation, among other effects. Previous in vitro studies from our lab revealed that these mutations differ markedly from each other in the longest 2N4R isoform of tau. However, it is not entirely known whether the effect of a single mutation varies when compared between different isoforms of tau. Differences in the isoelectric points of the N-terminal region of tau isoforms lead to changes in their biochemical properties, raising the possibility that isoforms could also be disproportionately affected by disease-related mechanisms such as mutations. We therefore performed a comparative study of three FTDP-17 mutations present in different regions of tau (R5L, P301L, and R406W) in the three 4R isoforms of tau. We observed significant differences in the effect these mutations exert on the total amount and kinetics of aggregation, aggregate length distributions, and microtubule stabilizing propensity of 4R tau isoforms for all three selected mutants. These results demonstrate that different combinations of FTDP-17 mutations and tau isoforms are functionally distinct and could have important implications for our understanding of disease and animal models of tauopathies.
Mucin-secreting tumors of the pancreas

Mucinous pancreatic neoplasms present diagnostic and therapeutic challenges. These tumors behave in an indolent nature, with frequent overlap of symptoms and radiographic appearance with other forms of pancreatic cysts, pseudocysts, and malignancy. Some authors propose that all mucin-producing tumors of the pancreas are variants of the same basic entity and have subclassified them on the basis of their predominant location within the pancreas. These disorders must be considered in the evaluation of chronic abdominal pain, particularly in the presence of a cystic pancreatic lesion or when associated with idiopathic chronic or acute recurrent pancreatitis. The clinicopathologic features of IMHN overlap to a great extent with classic mucinous cystic neoplasms but are different significantly enough to be distinct clinical entities. These tumors originate from the pancreatic duct epithelium, produce mucin, demonstrate a papillary growth pattern, and are considered premalignant or frankly malignant at the time of diagnosis. Both lesions biologically are much less aggressive than that of pancreatic ductal adenocarcinoma and appear to infiltrate peripancreatic tissue and to metastasize to lymph nodes or other adjacent structures late in the course of disease. Nevertheless, IMHNs are located primarily in the head of the pancreas, commonly affect elderly men, and present clinically with obstructive pancreatitis, often leading to pancreatic insufficiency, whereas mucinous cystic neoplasms are more likely to develop in the pancreatic body or tail, predominate in young women, and present with symptoms referable to tumor compression of adjacent structures. The location of the lesion is the primary differentiating feature because the lining epithelium of the two tumor types is indistinguishable pathologically. In mucinous cystic tumors, the mucus is secreted and retained within the cyst lumen because of the absence of communication between the cyst and the main pancreatic duct. In contrast, mucus produced in MDE flows into the main pancreatic duct, resulting in obstructive pancreatitis and, ultimately, dilatation of the pancreatic duct. Intraductal mucus provides an important clue to the diagnosis of intraductal pancreatic neoplasms and, whenever present, should prompt an aggressive diagnostic evaluation. Both lesions are managed by resectional surgery because the opportunity for cure is high in the absence of metastatic disease.
Bat biosonar echo analysis using spatial audio and wideband matched-filter techniques

Bats and dolphins show tremendous aptitude in hunting prey in difficult conditions. These conditions include large amounts of clutter, perhaps reverberation, and interfering signals/noisy backgrounds. Bats have been extensively studied to learn more about how they detect, track, and intercept prey. One important aspect of many of these studies is to understand the acoustics around the bat’s head. In this work, a new reproduction methodology using spatial audio and matched-filter techniques will be presented. A custom-built tetrahedral 1st order soundfield microphone that captures high-frequency sound up to 80 kHz from all directions was developed to measure bat echoes in B-format. The three-dimensional echoes that the bat received, now in Ambisonic B-format were further processed using a wideband matched-filter. The matched-filter produces a wideband cross-ambiguity function (WAF) of received data and the transmitted signal for every 1 deg in azimuth and elevation. The thresholded matched-filter output provides precise estimates of bearing, elevation, range, and normal velocity. This poster will present details of the hardware and software development along with experimental results that illustrate the capabilities of this new approach.Bats and dolphins show tremendous aptitude in hunting prey in difficult conditions. These conditions include large amounts of clutter, perhaps reverberation, and interfering signals/noisy backgrounds. Bats have been extensively studied to learn more about how they detect, track, and intercept prey. One important aspect of many of these studies is to understand the acoustics around the bat’s head. In this work, a new reproduction methodology using spatial audio and matched-filter techniques will be presented. A custom-built tetrahedral 1st order soundfield microphone that captures high-frequency sound up to 80 kHz from all directions was developed to measure bat echoes in B-format. The three-dimensional echoes that the bat received, now in Ambisonic B-format were further processed using a wideband matched-filter. The matched-filter produces a wideband cross-ambiguity function (WAF) of received data and the transmitted signal for every 1 deg in azimuth and elevation. The thresholded matched-filter output pr...
A national survey of nurse practitioners' patient satisfaction outcomes.

Abstract Background The research findings about nurse practitioner (NP) patient experiences (satisfaction) are limited to small sample sizes from local community clinics. No national studies with large sample sizes were found. Purpose To analyze responses from the Consumer Assessment of Healthcare Providers and Systems survey and compare the patient experiences from four different provider categories. Methods Secondary data analysis was completed on survey responses from 53,885 patients. Findings In the sample, medical doctor providers were disproportionately represented in greater number than NPs, doctor of osteopathy, or physician assistant. Further analysis comparing patient experiences between providers revealed NP to be rated significantly higher than their colleagues. Discussion Recognizing the factors associated with patient satisfaction with their providers can lead to improvements in patient-provider interactions that can result in increased quality of care. Conclusion Policy makers should find opportunities to employ NP in primary care settings and achieve greater patient satisfaction that can influence outcomes associated with patient-centered care initiatives.
Phytochemical analyses, antimicrobial and antioxidant activities of stem bark extracts of Distemonanthus benthamianus H. Baill. and fruit extracts of Solanum torvum Sw. from Gabon

Objective: To evaluate the phytochemical constituents, antimicrobial and antioxidant activities of the extracts of Distemonanthus benthamianus (D. benthamianus) stem bark and Solanum torvum (S. torvum) fruit which have been used as traditional medicinal herbs in Gabon. Methods: Plant extracts were subjected to a qualitative study (phytochemical screening) and a quantitative (dosing) study of secondary metabolites. Antioxidant activity was tested by 1,1- diphenyl-2-picrylhydrazyl and 2,2’-azino-bis 3-ethylbenzothiazoline-6-sulfonic acid assay. Bacteria and fungi susceptibility tests were performed on Mueller Hinton medium and solid Sabouraud, respectively, using the diffusion method, while minimum inhibitory concentration, minimum fungicidal concentration and minimum bactericidal concentration were evaluated by microdilution method. Results: The total phenol and tannin contents were significantly higher in the water-ethanol extract compared to the other extracts of D. benthamianus and S. torvum. The water-ethanol and water-acetone extracts showed significantly higher antioxidant activity than the aqueous extracts of the two medicinal plants. However, the extracts presented weak antioxidant activities compared to standards (Vitamin C, BHA). The water-acetone and water-ethanol extracts of S. torvum showed the highest antimicrobial activity against Bacillus cereus LMG 13569 BHI, Shigella dysenteriae 5451 CIP, Shigella dysenteriae and Neisseria gonorrhoeae. Conclusions: Our results show that D. benthamianus and S. torvum can be promising sources of natural products with potential antimicrobial and antioxidant activities.
Unusual cause of lower gastrointestinal bleed and abdominal pain

A young patient with a history of systemic lupus erythematosus (SLE) complicated by lupus nephritis presented to the emergency department with vomiting, diarrhoea and diffuse abdominal pain for 7 days. The diarrhoea was watery and yellow in colour with occasional mucus and blood. The patient had a similar presentation in the past, but no specific diagnosis had been made on prior admissions. Patient denied fever, chills, rashes, night sweats or joint pain. On physical examination, vitals were within normal limits. The examination was pertinent for a soft abdomen with diffuse tenderness to palpation, without peritoneal signs. CT of the abdomen and pelvis revealed thickening of small bowel and severe colitis with relative rectal sparing and moderate terminal ileitis (figure 1). Laboratory parameters were significant for anaemia with haemoglobin of 98 g/L, leucocytosis of 14 500 …
Comparison of Metal Plaque Formation and Metal Accumulation in Reeds Cultured in Acid Mine Drainage Solutions and Soils

ABSTRACTExperiments were conducted to compare the effect of citric acid (CA) on metal uptake in Phragmites australis cultured in artificial acid mine drainage (AMD) contaminated soil or aqueous sol...
Opening the Policy Window to Mobilize Action Against Corruption in the Health Sector Comment on "We Need to Talk About Corruption in Health Systems".

Corruption in the health sector has been a “dirty secret” in the health policy and international development community, but recent global activities point to a day when it will no longer be neglected as a key determinant of health. To further explore next steps forward, this commentary applies the Kingdon’s multiple-streams framework (MSF) to assess what opportunities are available to mobilize the global agenda to combat health corruption. Based on this analysis, it appears that Kingdon’s problem, policy, and political streams are coalescing to create a policy window opportunity that can be leveraged based on recent developments in the global health and international development community around corruption. This includes the recent formation of the Global Network on Anti-Corruption, Transparency and Accountability (GNACTA) led by the World Health Organization (WHO), the Global Fund, and the United Nations Development Programme in 2019. It also includes bridging shared goals of addressing corruption in order to make progress towards health-specific goals in the United Nations (UN) Sustainable Development Goals (SDGs) and for achieving universal health coverage.
Multiple Listeria Abscesses in an Immunocompetent Patient

Listeria monocytogenes is a ubiquitous organism that can potentially cause gastroenteritis and, less commonly, central nervous system infections. Brain abscess is rare and often associated with immunocompromised status. We report a case of multiple abscesses caused by Listeria in a previously immunocompetent elderly patient who developed a headache and left-sided hemiparesis over the course of days. Neuroimaging studies revealed multiple ring-enhancing lesions in the brain and midbrain territories. Blood culture, brain tissue aspirate, and cerebrospinal fluid nucleic acid amplification test were positive for Listeria. Extensive immunologic workup revealed no primary or secondary immunodeficiency disorders. After the initiation of antibiotics, the patient showed gradual clinical improvement and went to a skilled nursing facility after two weeks.