cssi/SciSciGPT-SciSciNet huggingface dataset:
The coagulation mechanism in acute bacterial infection.

Successive coagulation studies were performed in 34 adult patients hospitalized for treatment of acute bacterial infection. Increased fibrinogen, factor-VIII activity, and platelets were found in more than 50% of the patients studied. Classical disseminated intravascular coagulation occurred in three cases. Nine patients had elevated fibrin split products in various combinations with transient hypofibrinogenaemia, thrombocytopenia, and reduced factor-V activity. The appearance of elevated fibrin split products together with transient hypofibrinogenaemia, thrombocytopenia, and reduced factor-V activity in some patients may reflect the presence of subclinical disseminated intravascular coagulation.
Male genital lymphedema: clinical features and management in 25 pediatric patients.

Abstract Purpose Genital lymphedema in the pediatric population is poorly understood. The purpose of this study was to determine the epidemiology, morbidity, and treatment outcomes for males with genital lymphedema. Materials and methods Male patients with genital lymphedema evaluated at our vascular anomalies center between 1995 and 2011 were reviewed. Etiology, age-of-onset, location, morbidity, and treatment were analyzed. Results Of the 3889 patients with vascular anomalies, 25 (0.6%) had genital lymphedema: 92% (23/25) with primary and 24.0% (6/25) with familial/syndromic lymphedema. For primary disease, the mean age-of-onset was 4.5±6.3years with 60.9% (14/23) presenting in infancy, 13.0% (3/23) in childhood, and 26.1% (6/23) in adolescence. Combined penoscrotal lymphedema was identified in 72.0% (18/25) of patients; 19 children (76.0%) had concomitant lower extremity involvement. The most common complication was cellulitis (24.0%). Surgical contouring was performed in 44.0% (11/25) of patients. Patients with operative intervention and follow-up ( n =6) had sustained improvement after a median of 4.2years (range: 0.3–11.0). Conclusions Lymphedema of the male genitalia is typically idiopathic. Most patients develop swelling in infancy but can present in adolescence and occasionally childhood. The penis and scrotum are usually both involved and concurrent lower-extremity swelling is common. Surgical debulking can improve symptoms and appearance.
Assembly-based conceptual 3D modeling with unlabeled components using probabilistic factor graph

This work presents a novel and intuitive assembly based 3D modeling interface to support conceptual design exploration activities. In the presented modeling interface, unlabeled segmented components of the objects are assembled to create new 3D models. The development of the interface is motivated by two aspects. First, the focus is on novice users since they stand to gain the most from intuitive interfaces. Second, the intent is on creative reuse of a growing number and variety of 3D models available on vast online repositories like Turbosquid and Trimble 3D warehouse. Specifically, we have devised an automated component suggestion algorithm based on a probabilistic factor graph. This algorithm helps the user to easily browse and select components from a database that are most compatible with the current state of 3D models being assembled. The component suggestion algorithm incorporates various aspects such as shape similarity, repetitions of shapes, and adjacency relationships. Our new suggestive interface overcomes several limitations of traditional CAD interfaces by helping the users to quickly create and explore new conceptual designs. We present results on the conceptual design of several products. We present a novel 3D CAD tool for conceptual design exploration.Interactive concept exploration through assembly-based 3D modeling paradigm.Automated component suggestion algorithm based on probabilistic factor graph.Creative reuse of 3D models available on vast online repositories.
Social enterprise in community and economic development in the USA: theory, corporate form and purpose

Social enterprises intended to contribute to community development in the USA engage in a variety of activities ranging from retail businesses to counselling services. These enterprises are structured in various ways, including direct programmes and for-profit subsidiaries of nonprofit organisations, and alliances among non-profits and business corporations. The various forms reflect a range of purposes, organisational identities, and entrepreneurial motivations. This paper grounds this spectrum in economic and organisational theory, and examines a sample of ventures, finding that they commonly take the form of initiatives by non-profit organisations, often rely on external collaborations, and are concerned with direct contributions to social mission as well as net revenue generation.
Cost-effectiveness of prize-based incentives for stimulant abusers in outpatient psychosocial treatment programs

Objective—To evaluate the cost-effectiveness of a prize-based intervention as an addition to usual care for stimulant abusers. Methods—This cost-effectiveness analysis is based on a randomized clinical trial implemented within the National Drug Abuse Treatment Clinical Trials Network. The trial was conducted at eight community-based outpatient psychosocial drug abuse treatment clinics. 415 stimulant abusers were assigned to usual care (n = 206) or usual care plus abstinence-based incentives (n=209) for 12 weeks. Participants randomized to the incentive condition earned the chance to draw for prizes for submitting substance negative samples; the number of draws earned increased with continuous abstinence time. Incremental cost-effectiveness ratios were estimated to compare prize-based incentives relative to usual care. The primary patient outcome was longest duration of confirmed stimulant abstinence (LDA). Unit costs were obtained via surveys administered at the eight participating clinics. Resource utilizations and patient outcomes were obtained from the clinical trial. Acceptability curves are presented to illustrate the uncertainty due to the sample and to provide policy relevant information. Results—The incremental cost to lengthen the LDA by one week was $258 (95% confidence interval, $191 - $401). Sensitivity analyses on several key parameters show that this value ranges from $163 to $269. Conclusions—Compared with the usual care group, the incentive group had significantly longer LDAs and significantly higher costs.
Expanding Sales Taxation of Services: Options and Issues

The author writes that most states could improve their sales taxes and their tax systems in general with some expansion of the tax base to include services. The long-term viability of the sales tax depends on including services, the author says.
Perturbation Theorems for Waveguide Junctions, with Applications

Perturbation theorems are derived in the context of a theory of waveguide junctions. These theorems express changes in impedance or admittance matrix elements, due to changes in a waveguide junction, in terms of integrals over products of perturbed and unperturbed basis fields associated with the junction and with its adjoint. Media involved are required only to be linear. Concepts of first-order perturbation theory are discussed briefly, and the term "correct to the lowest order" is precisely defined. The need of explicit theorems telling when one may expect results actually correct to the lowest order is noted. Two problems are solved approximately by the perturbation approach: i) reflection at the junction of rectangular waveguide with filleted waveguide of the same main dimensions; and 2) the effect of finite conductivity of both obstacle and waveguide wall for half-round inductive obstacles in rectangular waveguide.
Understanding mechanisms and documenting plausibility of palliative interventions for dyspnea.

Purpose of reviewTo review the mechanisms for the perception of dyspnea and to consider the plausibility of interventions that palliate dyspnea after optimal treatment of the underlying disease.Recent findingsActivation of sensory receptors by blood gas abnormalities, mechanical respiratory loads, a
Self-Actualization: The Pursuit of Potential

When J. P. Guilford proposed that American psychology take up the study of creativity in 1950, he defined creativity as behaviors that came from creative personalities. As discussed in Chapters 2 and 3, Guilford’s focus was on cognitive traits contributing to ideation, but the larger challenge was to understand the overall creative personality. Other theorists have looked at creativity as essential to personality development. The humanistic psychologists who defined and promoted the concept of self-actualization have been particularly influential in this category, going beyond how creativity produces ideas and considering how it could be part of personal fulfillment.
Improving Patient Compliance

This article is one in a series written by APhA officers and staff discussing issues critical to the practice of pharmacy. Unless otherwise stated in the text, the remarks are not to be interpreted as necessarily reflecting Association policy or opinion. Reader response to these articles is welcomed.
Literature reviews and opinion

Steven R. Gambert, John Hopkins University School of Medicine, and Sinai Hospital, Baltimore, Maryland, USA Alluru S. Reddi, UMDNJ – New Jersey Medical School, Newark, New Jersey, USA Lisa Rosenberg, Division of Geriatric Medicine, Johns Hopkins Bayview Medical Center and Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Joselito T. Cabacar, Padmaja Kodali and Robert Czyzewski, UMDNJ – New Jersey Medical School, Newark, New Jersey, USA
On the simulation of amplified bow waves induced by motion in head seas

The prediction of bow wave amplification for a ship navigating in head seas is achieved by means of the 2D + t nonlinear slender-body theory. High-resolution numerical simulations show the development of spray sheets along the hull. For conditions of navigation severe enough, the thick jets rise and top the deck level, leading to the possibility of deck wetness. The overall capabilities of the method of calculation are demonstrated through a systematic study for a frigate. Continuous time domain pictures of the flow as the bow enters the incoming waves are presented. The relationship between the incoming wave parameters and the sequence of probable events (deck wetness, slamming, …) that occurs in the bow region is studied, leading to predictions of both the onset and strength of probable deck wetness, as well as forefoot emergence and possible slamming events. The probability of deck wetness in the numerical simulation is confirmed by model experiments. Results are summarized in charts that allow critical evaluation of a given design (see Figs. 8 and 9), including the nonlinear dynamic rise of the water elevation, experienced as a spray sheet along the hull-of critical importance for predicting the probable onset of deck wetness. These charts would seem extremely useful in the design phase, and it is our major purpose here to bring the possibility of computing them with the 2D + t method to the attention of naval architects.
Elucidation of Catalytic Strategies of Small Nucleolytic Ribozymes From Comparative Analysis of Active Sites

A number of small, self-cleaving ribozyme classes have been identified including the hammerhead, hairpin, hepatitis delta virus (HDV), Varkud satellite (VS), glmS, twister, hatchet, pistol, and twister sister ribozymes. Within the active sites of these ribozymes, myriad functional groups contribute to catalysis. There has been extensive structure–function analysis of individual ribozymes, but the extent to which catalytic devices are shared across different ribozyme classes is unclear. As such, emergent catalytic principles for ribozymes may await discovery. Identification of conserved catalytic devices can deepen our understanding of RNA catalysis specifically and of enzymic catalysis generally. To probe similarities and differences among ribozyme classes, active sites from more than 80 high-resolution crystal structures of self-cleaving ribozymes were compared computationally. We identify commonalities among ribozyme classes pertaining to four classic catalytic devices: deprotonation of the 2′OH nucleop...
Operative Time and Flap Failure in Unilateral and Bilateral Free Flap Breast Reconstruction.

Background There is an increasing trend toward bilateral breast reconstruction. Using the National Surgical Quality Improvement Program (NSQIP) database, we sought to understand the association between unilateral and bilateral free flap breast reconstruction and operative time and flap failure. Methods We selected a cohort of patients undergoing free flap breast reconstruction using the 2005 to 2010 NSQIP database. Cases were divided into unilateral and bilateral reconstruction. Subgroup analyses were performed dividing cases into delayed and immediate reconstruction. The effect of patient characteristics including age, body mass index (BMI), history of diabetes, and the American Society of Anesthesiologists' classification on operative time and flap failure was examined using univariable and multivariable regression models. Rates and odds ratios (OR) were reported using the multivariable gamma and logistic regression models, respectively. Results There were 691 free flap breast reconstructions performed in the cohort and 29.1% were bilateral cases. There was a 78-minute increase in the median operative time when comparing unilateral and bilateral reconstruction (p = 0.005). Patients undergoing bilateral reconstructions were generally younger and had fewer comorbidities compared with unilateral reconstructions. There was no significant association between bilateral reconstruction and flap failure. Immediate bilateral reconstructions had a significant increase in median operative time compared with immediate unilateral reconstructions (563 versus 480 minutes, p = 0.002) but no significant increase in operative time was noted when comparing delayed unilateral and delayed bilateral reconstructions. Prolonged operative time was associated with flap failure after adjusting for age and BMI (OR 1.17, p Conclusions Bilateral free flap breast reconstruction can be performed safely despite an increase in operative time when compared with unilateral reconstruction.
Rapid MODIS-based detection of tree cover loss

Abstract This paper reports on recent improvements made to the FORMA ( Hammer et al., 2014a ) data product. The resulting system, FORMA250, is a 250-m alerting system updated daily. FORMA250 alerts are available through Global Forest Watch. These alerts can empower law enforcement officials, government agencies responsible for protecting forests, nongovernmental organizations, companies committed to sustainable forest management practices and supply chains, indigenous groups and forest-dependent communities. In addition, the alerts provide useful information for researchers who study temporal and spatial patterns of forest clearing.
ELASTIC CONSTANTS OF DISORDERED TERNARY CUBIC ALLOYS

Single crystal elastic constants of disordered alloys having body-centered cubic and face-centered cubic Bravais lattices can be calculated as functions of composition by modelling the lattice as a virtual crystal. The technique is based on the method of long waves applied to the virtual crystal. The three independent elastic constants are related to four, axisymmetric force constants (ASFC) for first and second neighbors. The ASFC are defined in terms of the first and second derivatives of a three-parameter, virtual pair potential, which is determined from the corresponding pair potentials of like and unlike atom pairs in the crystal weighted by the probabilities of their existence in the first and second neighbor shells. This technique permits calculation of single crystal elastic constants of multicomponent disordered alloys using data obtained from elastic constants of terminal solid solutions of binary alloys and pure elements when the elements have the same crystal structure as the alloys. An illustration of the technique is given for ternary alloys of copper, aluminium and nickel.
Understanding Diffusion-Induced-Stresses in Lithium Ion Battery Electrodes

Most lithium ion battery electrodes experience large volume expansion and contraction during lithiation and delithiation, respectively. Electrode failure, in the form of fracture and decrepitation, can occur as a result of repeated volume changes. In this paper, we provide an overview of our recent work on modeling the evolution of concentration, stress, and strain energy within a spherical- or cylindrical-electrode element under various charging-discharging conditions. Based on the analytic results, we propose tensile stress and strain energy based criteria for the initiation and propagation of cracks within the electrodes. We will also discuss “size effects” on stresses and fracture of electrodes. These results may help guide the development of new materials for lithium ion batteries with enhanced durability and performance.
Promoting In-Depth Analysis: A Three-Part Approach to Teaching Analogical Reasoning to Novice Legal Writers

Analogical reasoning is ubiquitous in every day discourse and in legal analysis. Law students are generally expected to incorporate this type of analysis into their writing in the context of essay exams and legal memoranda for their writing courses. Yet students often receive minimal guidance as to how to effectively create legal analogies and frequently struggle with this process. This article suggests a three-part approach to promoting effective use of reasoning by analogy in student writing. First, the article discusses in-class exercises that use non-legal examples to help demystify analogical reasoning and enable students to recognize that they already reason by analogy in their every day conversations. Second, the article suggests introducing students to a four-step construct for developing logical and legally relevant analogies in order to make the process of analogical reasoning more tangible. Finally, the article discusses methods of providing detailed and constructive feedback to students that will allow them to improve their use of analogical reasoning in their essay exam answers, legal memoranda, and in their employment.
The Axial Length/Corneal Radius Ratio in Emmetropia and Ametropia: A Review

The ratio of axial length to corneal radius (AL/CR ratio) has a value of approximately 3.0 in emmetropia eyes, 3.0 in myopic eyes. There is evidence that in emmetropic children an AL/CR ratio greater than 3.0 indicates a risk for the development of myopia. In adult eyes, variance in the AL/CR ratio has been shown to account for as much as 93% of the variance in the eye’s refractive state. The results of 3 cross-sectional studies show that the AL/CR ratio, in emmetropic or near-emmetropic eyes, is remarkably stable with age.
Kogia breviceps (Pygmy sperm whale)

Skin and lung biopsies were grown from a male specimen washed ashore 1971 in San Diego, California, USA, identified as this species by skull preparation and body conformation. The karyotype of the female was donated by Dr. Debbie Duffield, Los Angeles, California. It came from cornea preparations of a specimen captured in the Atlantic Ocean in 1972.
RNA triphosphatase DUSP11 enables exonuclease XRN-mediated restriction of hepatitis C virus.

Seventy percent of people infected with hepatitis C virus (HCV) will suffer chronic infection, putting them at risk for liver disease, including hepatocellular carcinoma. The full range of mechanisms that render some people more susceptible to chronic infection and liver disease is still being elucidated. XRN exonucleases can restrict HCV replication and may help to resolve HCV infections. However, it is unknown how 5′ triphosphorylated HCV transcripts, primary products of the viral polymerase, become susceptible to attack by 5′ monophosphate-specific XRNs. Here, we show that the 5′ RNA triphosphatase DUSP11 acts on HCV transcripts, rendering them susceptible to XRN-mediated attack. Cells lacking DUSP11 show substantially enhanced HCV replication, and this effect is diminished when XRN expression is reduced. MicroRNA-122 (miR-122), a target of current phase II anti-HCV drugs, is known to protect HCV transcripts against XRNs. We show that HCV replication is less dependent on miR-122 in cells lacking DUSP11. Combined, these results implicate DUSP11 as an important component of XRN-mediated restriction of HCV.
Strength or Pathology: Ethical and Rhetorical Contrasts in Approaches to Practice:

Organizing concepts of “strength” and “pathology” are explored from the perspective of the limitations of language in defining and treating human problems. The derivation of these terms is describe...
Out of the Shadows, into the Dark: Ethnoracial Dissonance and Identity Formation among Afro-Latinxs:

A 2016 Pew report reported that 24 percent of Hispanics identify as Afro-Latinxs, but researchers know very little about the significance of Afro-Latinx identity and how it develops. Using survey d...
Examining Public Opinion About LGBTQ-Related Issues in the United States and Across Multiple Nations

Over the last three decades, many countries across the world, including the United States, have experienced major increases in support for LGBTQ (lesbian, gay, bisexual, transgender, and queer) ind...
Methods for Improving Representativeness in a Web Survey on Sexual Assault Among College Students.

Many colleges and universities conduct web-based campus climate surveys to understand the prevalence and nature of sexual assault among their students. When designing and fielding a web survey to m...
Telling a trusted adult: Factors associated with the likelihood of disclosing child sexual abuse prior to and during a forensic interview.

Abstract Background Many child sexual abuse (CSA) survivors delay or withhold disclosure of their abuse, even when presenting for formal investigation interviews. Objective This study examined factors that relate to the CSA disclosure process. Participants and Settings Participants were CSA victims (N = 1,732) presenting to a Child Advocacy Center (CAC) for a forensic interview. Method We tested a structural model to predict disclosure before and during a forensic interview using secondary data analysis. Results Youth were less likely to disclose before a forensic interview if they witnessed domestic violence (β = -.233, p Conclusions Findings highlight the importance of the family context and caregiver belief in the disclosure process for youth involved in formal CSA investigations.
Use of Ocular Point-of-Care Ultrasound in a Difficult Pediatric Examination: A Case Report of an Emergency Department Diagnosis of Retinoblastoma.

Abstract Background Eye examination in distressed young children can be challenging in a busy emergency department. A full, detailed evaluation is, however, often needed in ocular emergencies. Case Report A 2-year-old boy presented to our pediatric emergency department with refusal to open his left eye for 1 day. Eye examination was difficult and yielded limited findings, despite analgesia and parental facilitation. Under such circumstances, this might require sedation or forcibly everting the child's eyelids for the eye evaluation. A rapid ocular point-of-care ultrasound was performed, which revealed sonographic findings suggestive of a retinoblastoma in the left eye. Why Should an Emergency Physician Be Aware of This? The use of ocular point-of-care ultrasound facilitated the diagnosis of retinoblastoma in a child who was highly distressed and difficult to examine. Its use under such circumstances facilitated the patient's prompt evaluation and subsequent management.
Bacterial colonization reprograms the neonatal gut metabolome.

Initial microbial colonization and later succession in the gut of human infants are linked to health and disease later in life. The timing of the appearance of the first gut microbiome, and the consequences for the early life metabolome, are just starting to be defined. Here, we evaluated the gut microbiome, proteome and metabolome in 88 African-American newborns using faecal samples collected in the first few days of life. Gut bacteria became detectable using molecular methods by 16 h after birth. Detailed analysis of the three most common species, Escherichia coli, Enterococcus faecalis and Bacteroides vulgatus, did not suggest a genomic signature for neonatal gut colonization. The appearance of bacteria was associated with reduced abundance of approximately 50 human proteins, decreased levels of free amino acids and an increase in products of bacterial fermentation, including acetate and succinate. Using flux balance modelling and in vitro experiments, we provide evidence that fermentation of amino acids provides a mechanism for the initial growth of E. coli, the most common early colonizer, under anaerobic conditions. These results provide a deep characterization of the first microbes in the human gut and show how the biochemical environment is altered by their appearance. Using a multi-omics approach to analyse meconium and stool samples from babies during the first few days of life, the authors show that the gut is detectably colonized within 16 h of birth, with Escherichia coli dominating, and that this correlates with proteome and metabolome changes including the fermentation of amino acids.
Offsetable Derivatives and Financial Stability

U.S. GAAP allows banks to offset derivative assets against derivative liabilities with the same counterparty and report only the net amount on the balance sheet. Derivatives offsetting under IFRS is much more restrictive, resulting in the single largest quantitative difference between amounts recognized under U.S. GAAP versus IFRS. Using a sample of U.S. GAAP and IFRS banks, we find that both recognized and disclosed offsetable derivatives are positively associated with banks’ default risk and exposure to systemic risk. We then examine whether these associations differ depending on whether offsetable derivatives are recognized (by IFRS banks) versus only disclosed (by U.S. GAAP banks), and find some evidence that the associations are stronger for recognized amounts. Taken together, our findings suggest that investors utilize both recognized and disclosed information about offsetable derivatives, with some evidence of a differential effect for recognition.
Evaluation of an evidence-based veterinary medicine exercise for instruction in clinical year of veterinary medicine program.

Introduction Evidence-based veterinary medicine (EBVM) is a fundamental core competency for new graduates. Our objectives were to evaluate clinical students' use, understanding of, and confidence in EBVM before undertaking an exercise consisting of an hour seminar in conjunction with a medical librarian, followed by a journal club and to evaluate students' knowledge of and ability to apply EBVM following the exercise. Methods In this cohort study, students undertaking a large animal ambulatory rotation completed questionnaires before the seminar, following the journal club, and at graduation. Students took a Fresno test evaluating EBVM knowledge at the end of the rotation. Results Prior to the seminar, 94% of students defined EBVM at least somewhat accurately, and 51% reported EBVM was at least 'quite important'. During previous rotations, 71% of students had performed literature searches to answer a clinician-assigned question; 89% had done this to answer their own questions. Students with previous research or EBVM training were more likely to perform self-directed literature searches. The most frequently used resource was textbooks. Eighty-seven per cent and 90% of students found the seminar and journal club, respectively, at least moderately useful in improving EBVM knowledge. Conclusions Our results support the inclusion of an EBVM exercise during the clinical year and suggest spaced repetition may be helpful in teaching this topic.
Treatment of Neonatal Opioid Withdrawal.

1. Priyadarshani Giri, MD* 2. Philip Roth, MD, PhD* 1. *Staten Island University Hospital/Northwell, Zucker School of Medicine at Hofstra Northwell, Staten Island, NY Neonatal abstinence syndrome (NAS), often used interchangeably with neonatal opioid withdrawal syndrome, is a constellation of clinical signs and symptoms of withdrawal that occurs when neonates are removed from long-term in utero substance exposure. The incidence of NAS rose fourfold from 2004 to 2013, in parallel with a similar increase in opioid use during pregnancy (1999 to 2014), resulting in prolonged length of stay (LOS) in the NICU and increasing hospital costs. NAS has changed in complexity over time from multiple factors, including an increase in illicit drug use (eg, heroin), prescription of opioid agonist therapy for maternal opioid use disorder (eg, methadone and buprenorphine), use or misuse of prescribed opioids (eg, oxycodone, hydrocodone), the proliferation of illicit synthetic opioids with long half-lives and high potencies, as well as prescription of anxiolytics and antidepressants. In an effort to decrease the overprescription of opioids, programs have been introduced to monitor prescribing practices. Similarly, a recent systematic review found that using a nonjudgmental and open-ended approach during the interview with women who use substances improved relationships with perinatal providers. Currently, medication for opioid use disorder, either methadone or buprenorphine, in combination with counseling and behavioral therapy, is recommended for management of opioid use in pregnancy to prevent risks associated with withdrawal. In fact, perinatal counseling of the mother and family is critical to establishing a good rapport and safe environment to improve maternal and infant management. Although the exact pathophysiology of NAS and the basis for symptom variability is not well understood, infants with NAS are clearly at increased risk for admission to the NICU, birth complications (low birthweight, jaundice, feeding intolerance), preterm …
Extracellular Vesicles as Therapeutic Tools for the Treatment of Chronic Wounds

Chronic wounds develop when the orderly process of cutaneous wound healing is delayed or disrupted. Development of a chronic wound is associated with significant morbidity and financial burden to the individual and health-care system. Therefore, new therapeutic modalities are needed to address this serious condition. Mesenchymal stem cells (MSCs) promote skin repair, but their clinical use has been limited due to technical challenges. Extracellular vesicles (EVs) are particles released by cells that carry bioactive molecules (lipids, proteins, and nucleic acids) and regulate intercellular communication. EVs (exosomes, microvesicles, and apoptotic bodies) mediate key therapeutic effects of MSCs. In this review we examine the experimental data establishing a role for EVs in wound healing. Then, we explore techniques for designing EVs to function as a targeted drug delivery system and how EVs can be incorporated into biomaterials to produce a personalized wound dressing. Finally, we discuss the status of clinically deploying EVs as a therapeutic agent in wound care.
Resolution of low-lying placenta and placenta previa is associated with increased risk of postpartum hemorrhage

OBJECTIVE To determine if women who experience resolution of low-lying placenta and placenta previa are at increased risk of postpartum hemorrhage compared to those with normal placentation throughout pregnancy. METHODS Retrospective cohort study including women who delivered at Mount Sinai Hospital between 2015 and 2019, diagnosed with low-lying placenta or placenta previa using transvaginal ultrasound at the time of second trimester anatomical survey with resolution of low placentation on subsequent ultrasound. Women undergoing second trimester anatomical survey diagnosed with normal placentation using transvaginal ultrasound were randomly identified for comparison. The primary outcome was rate of postpartum hemorrhage. Secondary outcomes included need for blood transfusion, use of additional uterotonic medication, need for additional procedures to control bleeding and maternal ICU admission. Outcomes were assessed using a multivariable logistic regression model. RESULTS 1,256 women were identified for analysis, 628 in the resolved low placentation cohort and 628 in the normal placentation cohort. Resolved low placentation was associated with commercial health insurance (p=0.04), older maternal age (mean age 33 ± 5.4 vs. 31.5 ± 5.8), lower BMI (mean BMI 27.9 ± 5.5 vs. 30.3 ± 6.0), use of in vitro fertilization, Non-Hispanic White race, and posterior placental location (all p<0.01). Patients with resolved low versus normal placentation had greater odds of postpartum hemorrhage (adjusted OR 3.5, 95% CI 2.0-6.0; p<0.01), additional uterotonic use (adjusted OR 2.2, 95% CI 1.5-3.1; p<0.01) and increased rates of additional procedures to control bleeding (adjusted OR 4.0, 95% CI 1.2-11.9; p=0.01). CONCLUSIONS Despite high rates of resolution of low-lying placentas and placenta previas at term, women with resolved low placentation remain at increased risk of postpartum hemorrhage compared to those with normal placentation throughout pregnancy. This article is protected by copyright. All rights reserved.
Novel interactions of a microbial superantigen with TLR2 and TLR4 differentially regulate IL-17 and Th17-associated cytokines

Mycoplasma arthritidis, an inflammatory murine pathogen, secretes a potent superantigen, Mycoplasma arthritidis mitogen (MAM) that contributes to toxic shock, arthritis and skin necrosis. Previously we showed that MAM induced type 2 T-cell cytokines in mice that express functional TLR2 and TLR4, but type 1 cytokines in mice that lack TLR4 function. We show here that IL-17, pSTAT3 and retinoid-related orphan nuclear receptorγt are rapidly expressed in wild-type C3H/HeSnJ (TLR2+/4+) mice but are significantly delayed in mutant C3H/HeJ (TLR2+/4-) mice. This marked kinetic difference was associated with a high level of IL-6 in TLR2+/4+ mice versus high levels of IL-1β and TNFα in TLR2+/4- mice. Also antibodies to IL-6 and IL-23, suppressed IL-17 responses to MAM in TLR2+/4+ mice whereas anti-IL-1β, but not anti-TNFα, enhanced IL-17 in TLR2+/4- mice. Antibody blocking of TLR4 in TLR2+/4+ mice decreased IL-17 and IL-6 but not IL-23. In addition both IL-17 and IL-6 but not IL-23 were elevated in TLR2 KO mice versus wild-type TLR2+/4+ mice given MAM. We conclude that the MAM interaction with TLR2 versus TLR4 leads to distinct cytokine pathways mediated primarily by IL-1β or IL-6/IL-17 signalling respectively. Our findings suggest that the differential interaction of MAM with different TLRs might play an important role in disease outcomes by M. arthritidis.
Virus–Host Cell Interactions

1 Introduction 2 Quantitative Aspects of Virus–Cell Interactions 3 Types of Virus–Host Cell Interactions 4 Adsorption of Viruses to Host Cells 5 Penetration and Uncoating 6 Effects on Host-Cell Metabolism 7 Cellular Responses to Viral Infection 8 Summary Keywords: virus–host cell interactions; cytopathic effect (CPE); Poisson distribution; cytocidal infections; nonproductive infections; apoptosis; latency; glycoprotein spikes
Stimulation of Sendai Virion Transcriptase by Polyanions

Abstract Exogenous polyribonucleotides stimulated the ribonucleic acid (RNA) transcriptase in Sendai virions. Added yeast RNA, polyadenylic acid, or polycytidylic acid increased incorporation of 3H-guanosine monophosphate as much as fivefold. The products of stimulated reactions were virus-specific as determined by hybridization with Sendai virion RNA, but they sedimented more slowly (13s) than the product of an unstimulated reaction (16s). The stimulating activity was nondialyzable and heat stable, but was abolished by alkaline hydrolysis. Nucleoside monophosphates, individually or in combination, were ineffective, confirming the requirement for a polymer. Among other substances tested for effects on Sendai virion transcriptase, polyaspartic acid and polyglutamic acid stimulated the enzyme; polyinosinic acid, polyuridylic acid, and polyamines had no effect; and dextran sulfate and polyvinyl sulfate were inhibitory.
Response to Dr Stone

Dr Elsa Stone, in her usual organized and lucid fashion, has presented the case for inclusion of pediatric nurse practitioners (PNPs) in private pediatric practices. She bases her conclusions on her nearly 10 years of positive experience with a PNP in her own practice in Connecticut. Dr Stone describes the PNP population and demography, describes the training curriculum of PNPs, and discusses the scope of work of these individuals. She concludes that "there is substantial evidence that PNPs provide quality health care and that collaborative teams of pediatricians and PNPs can provide high-quality, cost-effective care to a broader spectrum of children than can be served by either profession alone." The American Academy of Pediatrics (AAP) has insisted for several years that there is a shortage of pediatricians to meet the expanding needs of the children of the United States. Furthermore, pediatricians—because of system changes—will be expected increasingly to provide a variety of time-intensive services. Dr Stone believes that many of these services can be well provided by PNPs. Within the AAP, there have been some concerns about the role of PNPs. Of particular worry seems to be the possibility that PNPs might decide to practice independently, leading to a lower quality of care for their patients. Less often stated, but clearly an issue, is that PNPs are viewed by some pediatricians as potential competitors. Dr Stone9s demographic analysis of what PNPs are currently doing is relevant to these concerns. One third of PNPs work in private pediatric practices or health maintenance organizations.
Foreword: Pursuing Effective Integrated Education

The American dream of having a truly integrated society in which racial, sexual, and class identities do not obstruct one’s life chances, is built on a more specific American dream, that of having a truly integrated educational system, one that, throughout the system from K through 20 or so, affords opportunity to everyone, equal opportunity. It is hard to imagine the larger American dream without the specific American dream, without successfully integrating American schooling. Thus schools are, like it or not, perhaps the major site of America’s struggle to integrate itself. We should be proud that as a society we have made a public commitment to these dreams—a commitment signaled most strongly perhaps by the 1954 Brown v. Board Education Supreme Court Decision that desegregated American schooling, by the civil rights movement itself, and by the civil rights legislation of the 1960s. There was great optimism during that era. There was a sense that desegregation—simply opening the doors of previously segregated schools and universities—would be enough; that women and minorities would walk through those doors and fairness of opportunity would be achieved, an integrated society would be achieved. But soon, and certainly as the years went by, this optimism—and the dreams of integration themselves—began to fray a bit. Two opposing forces quickly emerged: (1) resistance to the very goal of integration in the face of competing priorities; and (2) the gradual recognition that integrated schools and classrooms might not automatically produce equal opportunity, certainly not equal performance and outcomes.
Upper Gastrointestinal pH in Seventy-Nine Healthy, Elderly, North American Men and Women

Gastric and duodenal pH levels were measured in 79 healthy, elderly men and women (mean ± SD = 71 ± 5 years) under both fasted and fed conditions using the Heidelberg capsule technique. The pH was recorded for 1 hr in the fasted state, a standard liquid and solid meal of 1000 cal was given over 30 min, then the pH was measured for 4 hr postprandially. Results are given as medians and interquartile ranges: fasted gastric pH, 1.3 (1.1–1.6); gastric pH during the meal, 4.9 (3.9–5.5); fasted duodenal pH, 6.5 (6.2–6.7); and duodenal pH during the meal, 6.5 (6.4–6.7). Although fasted gastric pH, fasted duodenal pH, and duodenal pH during the meal differ statistically from those observed in young subjects, the differences are not expected to be clinically significant in terms of drug absorption for the majority of elderly subjects. Following a meal, gastric pH decreased from a peak pH of 6.2 (5.8–6.7) to pH 2.0 within 4 hr in most subjects. This rate of return was considerably slower than in young, healthy subjects. Nine subjects (11%) had a median fasted gastric pH >5.0, and in five of these subjects the median pH remained >5.0 postprandially. In this group, drugs and dosage forms which require an acidic environment for dissolution or release may be poorly assimilated.
Landscape ecologists have a role in poverty relief

The causes, consequences, and solutions to human poverty throughout the world lie squarely in the realm of landscape ecology. I believe the book ‘‘The End of Poverty: Economic Possibilities for our Time’’ by Jeffrey Sachs should motivate additional research and implementation of principles within landscape ecology into this critical arena. The bottom line from this book: the 1.1 billion people living in extreme poverty can be lifted onto the first rung of the economic ladder with financial input from persons, corporations, organizations, and (especially) governments from the rich countries. These investments, approximately $60/person/yr until about 2025, if they are carefully targeted and consistently provided, would allow the poor countries to attain a reasonably sustainable development (rather than the downward ecological, sociological, and economical spiral now occurring). Landscape ecologists can provide expertise to efficiently use funds to the greatest value and to research sustainable, integrated pathways to development. The Millennium Development Project, which Sachs leads, assists countries in reaching their Millennium Development Goals (MDG) by 2015 (www.undp.org/mdg). These eight internationally agreed upon goals include: (1) eradicate extreme poverty and hunger; (2) achieve universal primary education; (3) promote gender equality and empower women; (4) reduce child mortality; (5) improve maternal health; (6) combat HIV/AIDS, malaria, and other diseases; (7) ensure environmental sustainability; and (8) establish a global partnership for development. The MDG also have 18 targets and 48 indicators that provide measurable targets for 2015. The first target calls for the halving of extreme poverty (people living on less than $1 a day) and hunger (insufficient dietary energy consumption) by 2015. Sachs’ plan calls for finishing the job by 2025. Bono notes in the forward of this book that ‘‘...we could be the first generation to outlaw the kind of extreme, stupid poverty that sees a child die of hunger in a world of plenty...We are the first generation that can afford it....We can be the first generation that no longer accepts that an accident of latitude determines whether a child lives or dies––but will we be that generation?’’ This opportunity and responsibility involves landscape ecology at the local, national, and global scales––the movement and interactions of materials, resources, information, technology, and humans among a huge mosaic of disparate land types and capabilities. A key link is water security––1.8 million children die each year due to inadequate water and sanitation––a result of 1 billion people lacking safe water and 2.6 billion lacking adequate sanitation. Sachs initially presents an overview of the global poverty scene and presents startling facts: more than L. R. Iverson (&) Northern Research Station, USDA Forest Service, 359 Main Road, Delaware, OH 43015, USA e-mail: liverson@fs.fed.us
A new look at energy release rate in fracture mechanics

The energy balance for fracture in elastic/perfectly plastic solids is examined using the finite element method. An extension-release procedure that gives numerically converged solutions is employed in the numerical simulation of crack extensions in elastic/plastic solids. Increments of work and energy during crack extension are calculated for various loading conditions. Several conclusions are obtained. First, the elastic separation work of creating new crack surfaces is shown to be negligible, indicating that the Griffith-type energy release does not exist. Second, as the yield stress increases, the plastic dissipation work rate associated with crack extension converges to the energy release rate in the limiting elastic solid. The latter result can be adopted to interpret the classical energy release rate in elastic solids as plastic dissipation work rate taken in the limit as the yield stress approaches infinity during crack extension. Lastly, it is shown that the energy release rate obtained according to Irwin's plastic zone adjustment approach is equal to the plastic dissipation work rate for the original crack, provided the plastic zone size is less than 10% of the original crack size.
How Has Regulation Fair Disclosure Affected the Functioning ofFinancial Analysts

We analyze the impact of Regulation Fair Disclosure (Reg. FD) on the functioning of financial analysts. Heflin, Subramanyam and Zhang (2003) suggest that Reg. FD has not impacted forecast accuracy and dispersion. Using a longer post-FD period we confirm Heflin et al.'s result with respect to the forecast error and dispersion. The absence of a measurable adverse effect on forecast accuracy and dispersion is puzzling given that in the pre-FD period non-public information channels were very important sources of information for financial analysts. Using the model in Barron, Kim, Lim and Stevens (1998), we find that analysts are compensating for the deterioration in the precision of common information in the post-FD period by investing more effort in idiosyncratic information discovery. In order to increase the level of effort on information discovery individual analysts appear to be reducing coverage for well followed firms while increasing coverage of firms that were less followed prior to Reg. FD. Analysts who had preferential links with firms that they covered, such as analysts from large brokerage houses, tended to have greater forecast accuracy pre-FD. However, these analysts are unable to sustain their forecasting superiority post-FD suggesting a leveling of the information playing field among analysts. Overall our results reflect a trend towards greater independence from management and reliance on idiosyncratic information discovery on part of the financial analysts.
1,2,3,4,5,7‐Hexa­nitro­cubane

The hexanitro­cubane structure, C8H2N6O12, reported herein, is one of the last in the series of nitro­cubanes, ranging from mono- to octa­nitro­cubane. In this mol­ecule, the H atoms participate in short hydrogen-bonding contacts to the nitro O atoms in adjoining mol­ecules [2.50 (1) A], thus linking mol­ecules into a two-dimensional sheet in the bc plane. In addition, the O⋯O contacts in hexanitro­cubane are shorter than van der Waals contact distances. The shortest of these [2.766 (3) A] involve the O atoms of one of the attached nitro groups. These contacts involve mol­ecules in an extended two-dimensional sheet parallel to the ab plane.