cssi/SciSciGPT-SciSciNet huggingface dataset:
321-OR: Effects of Canagliflozin (CANA) on Hospitalization for Heart Failure (HHF) by Baseline EGFR: Pooled Analysis from the CANVAS Program and CREDENCE

People with type 2 diabetes (T2D) are at high risk for CV events, including HHF, especially as kidney function declines. We examined the effects of CANA on risk of HHF by baseline eGFR in patients with T2D and high CV risk and/or chronic kidney disease from the CANVAS Program and CREDENCE. Patient-level data from the CANVAS Program (N = 10,142) and CREDENCE (N = 4401) were pooled. Cox proportional hazards model for the time to first/second HHF events and proportional means model based on cumulative mean function for recurrent HHF events were used to assess effects overall as well as within baseline eGFR strata ( 60 mL/min/1.73 m2). HHF events were independently and blindly adjudicated. In 14,540 participants with baseline eGFR values over a median follow-up of 130 weeks, 672 HHF events occurred; 357 (53%) were single events. CANA decreased the time to first HHF event (HR 0.58, 95% CI 0.48, 0.70; Figure), consistently regardless of baseline eGFR (interaction P = 0.84), and time to second HHF event (HR 0.67, 95% CI 0.46, 0.96; too few events to stratify by eGFR). CANA also decreased total HHF events overall (mean event ratio 0.63, 95% CI 0.54, 0.73) and across eGFR subgroups (interaction P = 0.51). In individuals with T2D in the CANVAS Program and CREDENCE, CANA decreased the risk of first and recurrent HHF events, with consistent benefits independent of baseline eGFR. Disclosure M. N. Kosiborod: Consultant; Self; Amgen Inc., Applied Therapeutics, AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Scientific Affairs, LLC., Merck & Co., Inc., Novo Nordisk, Sanofi, Vifor Pharma Management Ltd., Research Support; Self; AstraZeneca, Boehringer Ingelheim International GmbH. J. Gogate: Employee; Self; Janssen Research & Development, LLC. J. Seufert: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk, Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Sanofi, Speaker’s Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk, Sanofi. K. W. Mahaffey: Consultant; Self; Abbott, Amgen Inc., Anthos, AstraZeneca, Baim Institute for Clinical Research, Bayer Healthcare Pharmaceuticals Inc., Boehringer Ingelheim Pharmaceuticals, Inc., CSL Behring, Elsevier, Inova, Intermountain Health, Johnson & Johnson, Medscape, Mount Sinai, Mundipharma International, MyoKardia, National Institutes of Health, Novartis Pharmaceuticals Corporation, Novo Nordisk, Otsuka America Pharmaceutical, Inc., Portola Pharmaceuticals, Inc., Regeneron Pharmaceuticals Inc., SmartMedics, Theravance Biopharma, Research Support; Self; Afferent, AHA, Amgen Inc., Apple, AstraZeneca, Bayer Healthcare Pharmaceuticals Inc., Cardiva Medical, Inc, Eidos, Ferring Pharmaceuticals Inc., Gilead Sciences, Inc., Google, Johnson & Johnson, Luitpold Pharmaceuticals, Inc., Medtronic, Merck & Co., Inc., National Institutes of Health, Novartis Pharmaceuticals Corporation, Sanifit, Sanofi, St. Jude Medical. Funding Janssen Scientific Affairs, LLC
COVID-19 OUTCOMES IN PREGNANCY: A REVIEW OF 275 SCREENED STUDIES

In December 2019, a novel strain of severe acute respiratory syndrome (SARS-CoV-2), was declared as a cause of respiratory illness, called coronavirus 2019 (COVID-19), characterized by fever and cough. In diagnostic imaging, the afflicted population showed pathognomonic findings of pneumonia. What started out as an epidemic in China, rapidly spread across geographical locations with a significant daily increase in the number of affected cases. According to the World Health Organization (WHO) reports, the range of worldwide mortality is 3 to 4%. Maternal adaptations and immunological changes predispose pregnant women to a prolonged and severe form of pneumonia, which results in higher rates of maternal, fetal, and neonatal morbidity and mortality. There is limited data about the consequences of COVID-19 in pregnancy, thereby limiting the prevention, counseling, and management of these patients. The objective of this literature review is to explore pregnancy and perinatal outcomes of COVID-19, complications, morbidity, and mortality in this sub-population. We conducted a literature review pertaining to COVID-19 and pregnancy in databases such as: PubMed, Google Scholar, and Science Direct. The studies we chose to focus on were systematic reviews, meta-analysis, case series, and case reports. Twenty four articles were reviewed regarding COVID-19 and pregnancy, complications and their outcomes. Due to immunological changes during pregnancy as evidenced by the flaring of auto-immune diseases; pregnant women may be at an increased risk for infection. Women (19.7%) who had underlying comorbidities such as gestational DM, HTN, hypothyroidism, and autoimmune disease, COPD, or HBV infection were considered high risk. The most common maternal outcomes were premature rupture of membranes (PROM) and pre-eclampsia. Asthma was the most common comorbidity associated with maternal mortality. The most common neonatal complications were fetal distress leading to NICU admissions and preterm birth <37 weeks. The most common laboratory changes were elevated CRP and lymphocytopenia. Most patients underwent C-section due to their underlying comorbidities. Pregnant and lactating women did not shed viral particles through their vaginal mucus and milk, as evidenced by negative nucleic-acid tests of these secretions. Neonatal infections as demonstrated by positive RT-PCR were rare, but direct evidence supporting intrauterine transmission was not confirmed. Direct evidence indicating vertical transmission of COVID-19 is not available, but risk for transmission cannot be ruled out. Pregnant women should be closely monitored due to increased risk of adverse outcomes.
Communication Codes in Accounting

A selected set of accounting concepts was subjected to analysis using multidimensional scaling techniques to evaluate the different communication codes used by academics and professional in the accounting field. The results verified a socio-linguistic thesis that predicts that academics will use a different communication code from professionals in their accounting concept perception.
A Way Forward: Establishing Financially Self-Sustaining Health-Insurance Exchanges under the Patient Protection and Affordable Care Act

When Congress passed the Patient Protection and Affordable Care Act in 2010, it created a slew of new issues in the field of health care. One such issue is how the states should structure the health insurance exchanges mandated by the new law. As funding is an important consideration in this decision, examining the approaches taken by the first eleven jurisdictions to act on the requirement may inform the decisions of other states. This Note examines the legislation passed by these “vanguard states” in response to the exchange mandate. In doing so, it denotes the array of funding options afforded to health insurance exchanges in the “vanguard states” and organizes them according to the governance models chosen by each state. The conclusion analyzes the rough trends apparent and recommends that states should choose the state-agency model in order to ensure the exchanges comply with the financial sustainability requirements of the Patient Protection and Affordable Care Act.
Development and evaluation of first wall materials for the National Ignition Facility

Several low-Z refractory materials are evaluated for use as the NIF first wall in terms of their cost and ability to survive laser light, target emissions and debris, as well as be cleanable and not outgas excessively. Best performers contain B, C, or both, with B{sub 4}C being the best overall. It appears possible at this time that plasma-sprayed B{sub 4}C can be fabricated with low enough porosity and cost to be preferred to hot-pressed B{sub 4}C, the conservative choice.
Chapter 8 Spatiotemporal Dynamics in Bacterial Cells: Real‐Time Studies with Single‐Event Resolution

To produce a quantitative picture of cellular life, one has to study the processes comprising it in individual living cells, quantifying intracellular dynamics with sufficient resolution to describe individual events in space and time. To perform such studies, we have recently developed a novel measurement approach, based on quantitative fluorescence microscopy, and applied it to the study of transcription in Escherichia coli and of the spatiotemporal dynamics of individual mRNA molecules in the cell (Golding and Cox, 2004, 2006a; Golding et al., 2005). The ability to detect individual events in real time depends on the engineering of an endogenous cellular process for amplifying the biological signal, in a way which allows signal detection to be independent of slow and highly stochastic cellular processes (Golding and Cox, 2006a). In this chapter, we describe the ingredients of our system and the way data is acquired and analyzed. We attempt to give general lessons for researchers who wish to implement a similar approach for the study of transcription in other organisms and, more generally, for the study of cellular processes with single-event resolution.
All-frequency relighting of non-diffuse objects using separable BRDF approximation

This paper presents a technique, based on pre-computed light transport and separable BRDF approximation, for interactive rendering of non-diffuse objects under all-frequency environment illumination. Existing techniques using spherical harmonics to represent environment maps and transport functions are limited to low-frequency light transport effects. Non-linear wavelet lighting approximation is able to capture all-frequency illumination and shadows for geometry relighting, but interactive rendering is currently limited to diffuse objects. Our work extends the wavelet-based approach to relighting of non-diffuse objects. We factorize the BRDF using separable decomposition and keep only a few low-order approximation terms, each consisting of a 2D light map paired with a 2D view map. We then pre-compute light transport matrices corresponding to each BRDF light map, and compress the data with a non-linear wavelet approximation. We use modern graphics hardware to accelerate precomputation. At run-time, a sparse light vector is multiplied by the sparse transport matrix at each vertex, and the results are further combined with texture lookups of the view direction into the BRDF view maps to produce view-dependent color. Using our technique, we demonstrate rendering of objects with several non-diffuse BRDFs under all-frequency, dynamic environment lighting at interactive rates.
The effect of leverage and liquidity on earnings and capital management: Evidence from U.S. commercial banks

Abstract Prior research shows that firms can manage earnings aggressively through making accounting choices affecting discretionary current accruals surrounding equity offerings as a means of smoothing earnings over time. Some evidence indicates that aggressive earnings management carries over to aggressive management of capital structure in the form of higher leverage and aggressive management of working capital in the form of lower liquidity. Earnings management by banks is achieved instead by managing accruals dealing with payment behavior on loans: the loan loss provision and net charge-offs. A regulatory change expressed in the Basel III accords has tightened requirements on leverage and liquidity and could have affected earnings and capital management. This study examines the effect of leverage and liquidity on the behavior of earnings and capital management in U.S. commercial banks over the period from 1999 to 2013. If aggressive earnings management behavior carries over to aggressive leverage and liquidity policies, we should expect a negative relation between earnings management measures and capital measures and a negative relation between earnings management and liquidity measures. We show that earnings and capital management measures consistently have a significant positive relationship with capital ratios and a significant negative relationship with liquidity ratios. These results suggest that regulators should be on guard for all forms of aggressive management behavior. In the post-crisis period, our results also show evidence of additional regulatory scrutiny with a significant positive relation between liquidity and earnings management, which could indicate that less liquid banks are prevented from engaging in earnings management by regulators.
Integration of propagation modelling assets for enhancing spectrum sensing capabilities in cognitive communication networking

Robust spectrum sensing and efficient cognitive communication networking (C2N) operation in various terrain environments require that the cognitive radio be proactive and dynamic in selecting the optimal sensing parameters for the current and future locations of mobile units. In spectrum sensing, the detector performance is characterized in terms of detection probability (the rate of C2N correctly sensing a busy channel and avoiding to use it), P d and false alarm probability (the rate at which a free channel is mistakenly identified as busy), P fa parameters. It is worth mentioning that providing higher detection probability should take precedence over providing lower false alarm rates, because a low P d leads to harmful interference which, in turn, adversely affects other mobile devices whereas a high P fa results in the C2N not using that specific channel.
Numerical simulations of viscous rotating flows using a new pressure-based method

Abstract This paper describes the development and application of a parabolic finite-volume procedure for the computation of viscous rotating flows having complex geometries. A parabolic numerical scheme has been developed to include the influence of the Coriolis force on pressure corrections. Two-equation turbulence models were employed to account for the effect of turbulence on the flows. Numerical tests for 2-D flows have been conducted, and the results show that computation with the new pressure-based method gives reasonably good agreement with the experiments.
Cationic lipids enhance siRNA-mediated interferon response in mice

RNA interference mediated by small interfering RNAs (siRNAs) shows promise as a powerful research tool for gene function studies. However, controversy exists over the potential of siRNA-induced interferon response in vitro and in vivo. In this study, we showed that although intravenous administration of siRNA alone is essentially inert, injection of siRNA complexed with cationic liposomes resulted in a potent induction of both type I and type II interferon responses. Furthermore, i.v. administration of cationic lipid/siRNA complexes led to activation of STAT1. This study suggests caution in data interpretation and the potential toxicity with in vivo use of siRNA, particularly when delivered via a cationic lipid vector. This study also suggests the potential of siRNA as an immunostimulatory agent for immunotherapy.
An influence of hormones on hoarding behavior in the Mongolian gerbil (Meriones unguiculatus)

Abstract Three experiments on food hoarding behavior in the Mongolian gerbil ( Meriones unguiculatus ) demonstrated (1) that females hoarded more than males, (2) that castration increased food hoarding in males, and (3) that administration of testosterone propionate to castrate males inhibited hoarding. The adaptive value of these relationships and their implications for a physiological model of food hoarding in the rodent are discussed.
Physicians and Drug Representatives: Exploring the Dynamics of the Relationship

Background Interactions between physicians and drug representatives are common, even though research shows that physicians understand the conflict of interest between marketing and patient care. Little is known about how physicians resolve this contradiction.
Personalities of Alcoholics who Leave and Seek Treatment

Alcoholic patients were administered the Differential Personality Inventory on their second day of hospitalization, during which time they were undergoing detoxification. Patients who were still at the hospital 12 days later (N = 48) were compared with those who had left against medical advice or were absent without leave (N = 24). Those who left the hospital before the 12th day reported significantly more Repression and Defensiveness and significantly less Insomnia, Broodiness, Familial Discord, Hostility, Ideas of Persecution, Irritability, and Somatic Complaints.
Pumiliotoxin alkaloids: a new class of sodium channel agents.

Abstract Pumiliotoxin B (PTX-B) and a variety of congeneric alkaloids and synthetic analogs stimulated sodium flux and phosphoinositide breakdown in guinea pig cerebral cortical synaptoneurosomes. The effects of PTX-B and active congeners and analogs on sodium flux in synaptoneurosomes were potentiated markedly by scorpion venom ( Leiurus quinquestriatus ). In neuroblastoma cells, PTX-B and active congeners had no effect on sodium flux unless synergized by α-scorpion toxin or scorpion venom. Certain inactive congeners, lacking hydroxyl groups in the 6-alkylidene side chain, inhibited sodium flux elicited by PTX-B, scorpion venom, or the sodium channel activator batrachotoxin. Such inhibition appeared different from inhibition by local anesthetics, since pumiliotoxins, unlike local anesthetics, had little or no effect on binding of [ 3 H]batrachotoxinin A benzoate to sodium channels. Thus, it appears likely that some “inactive” congeners bind to the PTX-B binding site, but do not activate sodium channels. In the absence of scorpion venom the stimulation of phosphoinositide breakdown in synaptoneurosomes was consonant with the stimulatory effects of these compounds on sodium flux through voltage-dependent sodium channels.
Intragenerational Occupational Mobility and Visiting With Kin and Friend

The proposition that intragenerational occupational mobility inhibits participation in informal (primary) interpersonal relations is explored. The major contrast was assumed to be between mobile and nonmobile individuals and not between socioeconomic strata or due to the direction of mobility (up vs. down). Hypotheses were formulated and tested using data from an area-probability sample of white males, ages 55 to 64, living in Providence, Rhode Island. With present socioeconomic level controlled, mobility was found to be related to a lower frequency of visiting with siblings, both the respondent's and his wife's. This relationship was not found in the case of nonrelated friends and neighbors where no major differences appeared. In a few instances there even appeared to be a slight increase in the frequency of visiting for mobile respondents. Mobile individuals were also found to have friendships of shorter duration than nonmobile individuals. These findings would seem to indicate disruption of friendship ties in the past, but not a permanent lessening of participation in such relationships. O ne of the most intriguing aspects of social mobility is the possible consequences of mobility for individuals who are socially mobile. There is a growing body of material concerned with the relationship of occupational mobility and one of the many consequences which has been linked to vertical mobility, social isolation. It was long ago contended that social mobility results in isolation, or at least in the dis;ruption of integration of primaryand secondary-group structures (cf. Durkheim, 1951:252-254; Sorokin, 1927; Janowitz, 1956). This belief in the disruptive and disorganizing effect of mobility has led to formulation of the proposition that one consequence of mobility is the interference with participation in informal and formal interpersonal relationships. THEORETICAL BACKGROUND Attempts to explain the contention that mobility has an inhibiting effect for interpersonal relations have taken two major lines of reasoning, even if only implicitly. One reason given for disruption and interference with full participation is what has been called "status by association" (Litwak, 1960). As an individual's status is related not only to the social (prestige) position he occupies but is also further enhanced by association with individuals of equal or greater social position, the mobile individual who has moved differentially when compared to those around him * This report is based on data collected as part of the research for my Ph.D. dissertation. The research was supported by a grant from the National Science Foundation (GS-1533). In connection with the original research, I wish to acknowledge the suggestions and .advice of Professors Robert M. Marsh, Sidney Goldstein, and Robert von der Lippe. Any and all errors are, however, my own. This content downloaded from 207.46.13.28 on Wed, 31 Aug 2016 05:29:23 UTC All use subject to http://about.jstor.org/terms
Shell analysis of an inflatable arch subjected to snow and wind loading

Abstract A flexible material, such as a woven or braided fabric, may be tailored to form an arch when inflated. Such arches have been used as the framework for transportable shelters and are analyzed in this paper. It is assumed that the cross section of the pressurized arch is circular and that only in-plane (membrane) stresses are present. An analytical solution for these initial stresses is given for an arbitrary arch centerline shape. Then external loads are applied, and the additional stress resultants include bending and twisting moments. The linear thin-shell theory of Sanders is used to formulate the governing equations, including the effect of the initial membrane stresses. The material is linearly elastic, nonhomogeneous, and orthotropic. Approximate solutions are obtained using the Rayleigh–Ritz method. In the examples, the centerline of the arch is a semi-circle, the ends are fixed, and the material is homogeneous and isotropic. Four loads are treated: a symmetric (‘full’) snow load, an asymmmetric (‘half’) snow load, a wind load symmetric with respect to the plane of the arch centerline, and a distributed load acting sideways. The resulting deflections are computed and plotted.
Effect of Jet-Exhaust Streams on Structure of Vortex Wakes

The study reported here was initiated by observations of condensation trails that occur behind transport aircraft at cruise altitudes under certain atmospheric conditions. The objective of the study reported is to explain why the structure of condensation trails behind aircraft at cruise altitudes differ in some respects from those predicted by classical theory for the roll-up of lift-generated vortex sheets. Because classical roll-up theory does not include the effect of jet-engine exhaust on wake structure, numerical simulations were carried out for the time-dependent interaction of jet-exhaust streams with lift-generated vortex distributions. The simulations indicate that inclusion of jet-exhaust effects produces results that more closely represent observed wakes than those calculated by means of classical roll-up theory. In particular, jet-exhaust streams appear to cause wakes to separate into several nearby parts so that the vertical depth of the wake is increased by over a factor of two. It is therefore recommended that wake-prediction methods include the effect of jet-exhaust streams during takeoff, climb and cruise. Current prediction methods for wake-hazardous regions during approach and landing at airports probably do not need to be changed because engine thrust is small during those operations.
Current-voltage relationships and voltage sensitivity of the Cl− pump inHalicystis parvula

The current-voltage (I–V) relationships for internally perfused and nonperfused cells ofHalicystis parvula were determined. In both types of cells theI–V curve shows a conspicuous region of negative slope, beginning at vacuole potentials around −30 mV and continuing to values of +20 to +40mV. The negative slope in perfused cells is abolished by the metabolic inhibitors, darkness and low temperature. In order to determine the origin of this negative slope, we measured the voltage sensitivity of the unidirectional fluxes of Cl−, Na+ and K+ in perfused cells. The results show that the Cl− influx, which is mediated primarily by a Cl− pump, increases as the vacuole potential is clamped at increasingly morenegative values up to −50 mV, while the other fluxes measured changed in the directions predicted by the change in electrical driving force. The voltage sensitivity of the Cl− pump quantitatively accounts for the negative slope of theI–V curve. Also, we observed a large transient outward current of 10–20-sec duration following an abrupt depolarization by voltage clamping. This transient current was reduced or abolished by low temperature, which suggests that it may be due to the voltage-sensitive Cl− pump. Finally, we found an inverse relationship between the transprotoplasm resistance (Rm) and thePD under standard conditions, which suggests that the activity of the electrogenic Cl− pump lowerRm, i.e., it is a conductive pump.
Virtual First Impressions.

Frequently, a nurse's first and only contact with a graduate school, legislator, public health official, professional organization, or school nursing colleague is made through e-mail. The format, the content, and the appearance of the e-mail create a virtual first impression. Nurses can manage their image and the image of the profession by communicating electronically in a manner appropriate for the professional role.
When Children Draw vs When Children Don’t: Exploring the Effects of Observational Drawing in Science

The purpose of this study was to investigate how kindergarten children’s observational drawings impact their information retention. This research was conducted in an urban school in a large metropolitan area in the southwestern United States. Forty-two kindergarten children participated in this study; approximately 97% of them qualified for free and/or reduced lunch. For this study, children’s retention of factual information was compared using a paired t-test of when they drew and when they didn’t. Children scored higher on all 7 items—descriptions of observation, location, action, color, size, shape, and sound—when they drew than when they didn’t. Findings were statistically significant for descriptions of observation (t = 3.08, p = .00) and location (t = 2.36, p = .02).
The Equilibrium Covariance Matrix of Dynamic Econometric Models

Abstract This paper presents a convenient form for the asymptotic, or equilibrium, covariance matrix of the endogenous variable vector of a dynamic econometric model.
Colour Changes in Hippolyte varians

THE demonstration by Perkins1 that colour changes in Palaemonetes vulgaris were controlled by a hormone that originated in the eye-stalks has since been confirmed and extended by a number of investigators (see Hanstrom's2 review). Gamble and Keeble3 in their classic study of colour changes in Hippolyte were the first to describe a diurnal rhythm which persisted under constant environmental conditions. Within the past five years, several papers on persisting diurnal rhythms in the pigmentary system of crustaceans have appeared. The two English investigators interpreted the phenomena of crustacean metachrosis, according to the view of chromatophoral activity prevalent at that time, as being dependent upon the nervous system. We reinvestigated the colour changes of Hippolyte to see whether the endocrinal control similar to that found in other crustaceans was present.
Histidine Kinetics in the Rat Following Administration of Glucagon and of Hydrocortisone

L-Histidine-imidazole-2-14C was administered to a group of control animals, a group of animals pretreated with glucagon 1/2 hr prior to injection of histidine and to a group of animals pretreated with hydrocortisone for 6 days prior to injection of histidine. The rate of metabolism of this material to 14CO2 during the first hour of each study was fitted to a 2 exponential function. F(t) = A(e−rt-e−rt). While the fitting parameters A and r1 were very nearly the same for the control and glucagon treated animals (A ≍ 3 × 10−3, r1 ≍ 2.5 × 10−2), the values for r2 were very different in the 2 groups. For the controls, r2 = 0.1681 ± 0.0137 and for the glucagon treated animals r2 = 0.6919 ± 0.0776. Application of a 2 compartment nonfeedback model to the curve fitting function led to an estimation of a 4-fold increase in the fractional turnover of the histidine compartment both into anabolic and catabolic processes attendant to the administration of glucagon. The patterns of incorporation of 14C from labeled hist...
Thalamic projections to layer I of striate cortex shown by retrograde transport of horseradish peroxidase

The diffusion of horseradish peroxidase was restricted to layers I and II of the striate cortex in Tupaia glis and Galago senegalensis. In the lateral geniculate body of Tupaia labeled cells were found only in layer 3; some labeled cells were also found in the lateral nucleus. In Galago labeled cells were found only in layers 4 and 5 of the lateral geniculate body; a band of cells was also found in the pulvinar nucleus. These results support the distinction between two overlapping thalamic systems, a layer I and a layer IV system.
Drug treatment of intermittent claudication.

The US FDA has approved two drugs for the management of intermittent claudication: pentoxifylline and cilostazol. The mechanism of action that provides symptom relief with pentoxifylline is poorly understood but is thought to involve red blood cell deformability as well as a reduction in fibrinogen concentration, platelet adhesiveness and whole blood viscosity. The recommended dose of pentoxifylline is 400mg three times daily with meals. Cilostazol is a potent, reversible, phosphodiesterase III inhibitor. The inhibition of phosphodiesterase allows for the increased availability of cyclic adenosine monophosphate (cAMP). cAMP mediates many agonist-induced platelet inhibitory, vasodilatory and vascular antiproliferative responses. Cilostazol, at a dose of 100mg twice daily, is recommended to be taken 30 minutes before or 2 hours after breakfast and dinner. In addition to pentoxifylline and cilostazol, clinical trials indicate many other drugs may relieve the symptoms of intermittent claudication. Ginkgo biloba, available as an over-the-counter extract, provides symptom relief comparable to pentoxifylline. Two European agents, naftidrofuryl and buflomedil, also have efficacy that is reported to be similar to pentoxifylline. Policosanol is a mixture of fatty alcohols derived from honeybee wax which, according to very limited data, reduces symptoms of claudication. Amino acids, certain peptides and prostaglandins may have a therapeutic role. Finally, novel approaches including angiogenesis mediated by growth factors, are currently under investigation.
The impact of metals on society part X: Brazil

Over 5,000 years, our quest for metals has led us to strange lands, on bold adventures, through terrible hardships, and to great riches and devastating failures. Immeasurably, the fates of entire nations and peoples have been shaped by this quest. Editor’s Note: One of 15 parts, this article and the installments that follow revisit the historical record and reference figures of the past to show how mining, minerals, and metals have profoundly influenced conflict, religion, technology, economics, and mass migration on both macroand microscales. The papers were prepared exclusively for JOM based on a keynote lecture delivered by the author to the International Symposium on Mining, which was held September 1997 in Fairbanks, Alaska.
Ultraviolet radiation pre-treatment modifies dairy wastewater, improving its utility as a medium for algal cultivation

Abstract Dairy wastewaters can be remediated through assimilation of nutrients into algal biomass, providing upcycling into valuable products. Unfortunately, these wastewaters are non-ideal for phototrophic organisms; high levels of dissolved organic matter (DOM) and heterotrophic microbial organisms result in limited light and nutrient availability. Ultraviolet (UV) radiation can modify aquatic systems, changing DOM quantity and quality and lowering microbial densities. We hypothesized that dairy wastewater would be similarly modified by UV radiation, allowing for improved algal growth. Two distinct dairy wastewaters, anaerobic digester effluent (ADE) and polyhydroxyalkanoate reactor effluent (PHAE) were investigated. UV pre-treatment of ADE resulted in modified growth kinetics of Chlorella vulgaris , increasing exponential growth rates up to 4 fold and decreasing time to stationary phase by 8 days. UV pre-treatment of PHAE resulted in no growth effects for C. vulgaris . A UV fluence of 1892.7 mW·s·cm − 2 reduced bacteria colony forming units in ADE and PHAE by 99% and 100% respectively, modified fluorescent DOM, and reduced light attenuation in both effluents. These findings suggest that UV successfully modifies and enhances ADE's utility as a growth medium for C. vulgaris , improving the economics for a waste-to-algae process, and providing potential for recycling of nutrients from agricultural waste.
How Group Dynamics Research Can Inform the Theory and Practice of Postsecondary Small Group Learning

After a brief review of integrative small group learning models that have appeared in the educational psychology literature, this article then looks into the group dynamics literature and describes one of that field’s most well-documented findings: that interactions among group members change somewhat predictably over time. How theorists from various traditions within educational psychology might explain and explore the phenomenon of “group development” is proposed, followed by a description of the theoretical and practical features of an increasingly popular post-secondary instructional strategy designed to stimulate group development and leverage it to instructional ends. This strategy is a very specific form of collaborative learning called Team-Based Learning (TBL), and is considered as a promising context for future research into learning group development.
Escaping the EHR trap--the future of health IT.

The myth that medicine requires complex, highly specialized information-technology (IT) systems continues to justify soaring costs, burdensome physician workloads, and stagnation in innovation. But there's a clear path toward better tools for health care's complex tasks.
Role of Carbonic Anhydrase in Bone Resorption: Effect of Acetazolamide on Basal and Parathyroid Hormone-Induced Bone Metabolism

The effects of the carbonic anhydrase inhibitor acetazolamide on basal and parathyroid hormone (PTH)-induced bone metabolism were studied to evaluate the manner in which acetazolamide inhibits bone resorption. Half-calvaria from 5 to 6-day-old mice were cultured using the following treatments: control; acetazolamide (10, 33, or 100 μM); PTH (16.7 nM bovine PTH 1-34); acetazolamide + PTH. The effects of acetazolamide on PTH-induced cAMP accumulation and protein synthesis were determined. Media from bones cultured for 48 hours were analyzed for calcium to assess bone resorption, glucose to assess calvarial glucose utilization, and lactic acid to assess calvarial lactic acid release. Media were also assayed for β-glucuronidase activity as an indicator of lysosomal enzyme release and for lactate dehydrogenase activity as an indicator of cytosolic enzyme release and cytotoxicity. Acetazolamide at 100 μM completely inhibited PTH-induced bone resorption. This inhibition did not appear to be due to cell death, as acetazolamide did not increase lactate dehydrogenase release. Acetazolamide had no effect on PTH-enhanced cAMP levels, indicating that receptor binding and adenylate cyclase activation were unaffected. Acetazolamide alone did not alter calvarial protein synthesis, but did significantly inhibit protein synthesis in the presence of PTH. PTH significantly enhanced calvarial glucose utilization, lactic acid release, and β-glucuronidase release. Acetazolamide inhibited all of these PTH-induced parameters in a manner that roughly paralleled its inhibition of bone resorption; acetazolamide alone had no effect on the basal values. Our results indicate that acetazolamide inhibition of bone resorptionin vitro may involve general alterations in hormonally stimulated bone cell metabolism secondary to carbonic anhydrase inhibition.
Mechanisms for the Success and Failure of Pacing for Termination of Ventricular Tachycardia: Clinical and Hypothetical Considerations

The effectiveness of pacing techniques for termination of ventricular tachycardia is well established, and of great value in the elec-trophysiologic laboratory, and, to a more limited degree, for chronic therapy using implanted anti-tachycardia devices. Although it appears that most clinical ventricular tachycardias are due to reentrant mechanisms, responses to antitachycardia pacing have often been difficult to understand. In this paper, clinical observations are correlated with hypothetical constructs and considerations, in an attempt to derive some general principles related to the success and failure of pacing for ventricular tachycardia. In these analyses, it appears that properties of conductivity and refractoriness in the myocardium are as important as the properties of the tachycardia circuit. Programmed extrastimuli or rapid pacing result in shortening of the effective refractory period of the myocardium, together with depressed conduction velocity of the stimulated wavefront. However, the changes in wavefront conductivity do not occur in step with changes in the effective refractory period; as a result, the stimulated wavefront arrives at the tachycardia circuit in a pattern which differs from the stimulation pattern. In general, it appears that termination of the tachycardia is favored when the stimulated wavefront arrives at the tachycardia circuit at a point when it cannot enter the circuit in an antegrade direction. These conditions are favored by a refractory period in the circuit which is moderately long compared to that of the myocardium. Constructions explaining the observation of a tachycardia termination zone are presented, together with explanations for failure to achieve termination, and for various patterns of acceleration.
Growth hormone treatment in pediatric burns: a safe therapeutic approach.

Objective To determine the safety and efficacy of recombinant human growth hormone (rhGH) in the treatment of children who are severely burned. Background Data During the last decade, we have used recombinant human growth hormone (rhGH; 0.2 mg/kg/day SQ) to successfully treat 130 children with more than 40% total body surface area (TBSA) burns to enhance wound healing and decrease protein loss. A significant increase in the mortality of adult patients in the intensive care unit who were given rhGH has recently been reported in two large European trials which questions the therapeutic safety of rhGH. Methods The records of 263 children who were burned were reviewed. Patients receiving either rhGH at 0.2 mg/kg/day subcutaneously as part of a randomized clinical trial (n = 48) or therapeutically (n = 82) were compared with randomized placebo-administered controls (n = 54), contiguous matched controls (n = 48), and matched patients admitted after August 1997, after which no patients were treated with rhGH (n = 31). Morbidity and mortality, which might be altered by rhGH therapy, were considered with specific attention to organ function or failure, infection, hemodynamics, and calcium, phosphorous, and albumin balance. Results A 2% mortality was observed in both rhGH and saline placebo groups in the controlled studies, with no differences in septic complications, organ dysfunction, or heart rate pressure product identified. In addition, no difference in mortality could be shown for those given rhGH therapeutically versus their controls. No patient deaths were attributed to rhGH in autopsies reviewed by observers blinded to treatment. Hyperglycemic episodes and exogenous insulin requirements were higher among rhGH recipients, whereas exogenous albumin requirements and the development of hypocalcemia was reduced. Conclusions Data indicate that rhGH used in the treatment of children who were severely bumed is safe and efficacious.
United States Public Law 99‐457: An Ounce of Prevention

Abstract This brief article details the provisions of United States Public Law 99‐457 which authorizes early intervention services for handicapped infants, toddlers and preschoolers and their families, which are to be implemented by the 1990‐91 school year.
PTSD Checklist Scoring Rules for Elderly Veterans Affairs Outpatients

Objective To assess the diagnostic performance of the PTSD Checklist (PCL) for three age groups ( Methods The PCL was compared with the Clinician Administered PTSD Scale, a gold standard for the diagnosis of post-traumatic stress disorder. Receiver operating characteristic curves and the corresponding area under the receiver operating characteristic curve (AUC) and measures of sensitivity and specificity were used to assess the performance of and to determine optimal cutscores for the PCL across the three groups. Analyses were based on 858 randomly selected primary care patients who participated in a study conducted at four Veterans Administration medical centers. Results AUCs were high for all three age groups (87.55%–88.26%), and there were no significant differences in AUCs across age groups χ 2 . Optimal cutscores, however, varied considerably: 24 for the oldest group, 34 for the middle group, and 43 for the youngest group. Conclusion Recommend use of lower PCL cutscore for older Veterans Administration primary care patients.
The U.S. Corporate Tax Reform and Its Macroeconomic Outcomes

The corporate tax reform has been among the most controversial issues during the past U.S. presidential debates. Though much has been said about the adverse macroeconomic effects of the corporate tax hike, less attention has been paid to the magnitude of such effects. This study attempts to measure the adverse effects of the corporate tax hike on macroeconomic variables such as investment, real GDP, productivity growth, hourly wages, unemployment rate, natural rate of unemployment, and consumer price index (CPI). The estimated regression results with quarterly data from1960 to 2010suggest that a 10% increase in the effective corporate tax rate reduces private investment by3.1%, real GDP by 1.5%, productivity by 2.6%, and hourly wages by 4%. The results also indicate that this increase in the effective corporate tax rate raises short-term unemployment rate by 0.5%, the natural rate of unemployment by 1%, and the consumer price index (CPI) by 0.9%.
Antiapoptotic action of 1,25-dihydroxyvitamin D3 is associated with increased mitochondrial MCL-1 and RAF-1 proteins and reduced release of cytochrome c

Abstract Release of mitochondrial cytochrome c has been recently linked to the activation of the “executioner” phase of the cellular programs for death by apoptosis. This release is known to be negatively regulated by Bcl-2 and Bcl-X L proteins. We show here that treatment of human leukemia cells HL60 with 1,25-dihydroxyvitamin D 3 (1,25D 3 ) results in progressive increases in the levels of cellular antiapoptotic protein Mcl-1, a transient increase in Al protein level, but no increases in Bcl-2 or Bcl-X L proteins. The increase in Mcl-1 protein levels correlates with a reduced extent of apoptotic cell death induced by etoposide or the calcium ionophore A23187. The Mcl-1 protein is primarily localized in the mitochondria, and etoposide- or A23187-induced cytochrome c release is reduced in cells in which the mitochondria contain the Mcl-1 protein demonstrable by immunoblots. Raf-1 protein can also be detected in the mitochondrial fractions that contain Mcl-1 protein but not in the Mcl-1-negative fractions. These findings suggest that in these promyelocytic leukemia cells Mcl-1 has a function analogous to that of Bcl-2 in other cells, i.e., to target Raf-1 to mitochondria and to reduce cell damage-induced release of mitochondrial cytochrome c. Our findings provide a potential mechanism for the antiapoptotic action of 1,25D 3 and show that differentiation and apoptosis signaling pathways not only interact but involve a proliferation-associated gene, Raf-1.
Virginia Satir's Triad Theory for Couples Therapy

SUMMARY Virginia Satir's understanding of the fundamental building block of all human relationships, the triad, surpassed that of her colleagues. She went beyond their themes of conflict, opposition and pathology to emphasize the positive, constructive and nurturing potential of every human triadic interaction. Couples therapy is a triad and the author focuses on this specific context to illustrate some of the rich and varied uses of Satir s theory of triads.
BCG-induced chronic pulmonary inflammation and splenomegaly in mice: Suppression of PHA-induced proliferation, delayed hypersensitivity to sheep erythrocytes, and chronic pulmonary inflammation by soluble factors from adherent spleen cells

Abstract C57BL/6 (B6), but not CBA, mice develop intense chronic granulomatous inflammation (CGI) in the lungs and spleen in response to an iv injection with killed BCG in an oil-in-saline emulsion (BCG-E). Concomitant with the development of CGI, these mice show diminished responsiveness to PHA and LPS, as well as suppression of antibody synthesis and production of delayed hypersensitivity (DH) to sheep erythrocytes (SRBC). Suppression results from the development of adherent, Thy-1 − , Ig − spleen cells. The present study shows that cells from inflamed spleens of BCG-E-treated B6 mice elaborate factors in vitro which (a) inhibit PHA-induced proliferation of both normal syngeneic and allogencic cells, (b) suppress DH to SRBC in B6 mice, and (c) diminish the intensity of BCG-E-induced CGI in the lungs and spleens of B6 mice. These factors are produced by adherent Thy-1 − cells in BCG-injected mice but not in similarly treated CBA mice. These factors may be important in understanding the control of immunologically mediated chronic inflammation.
A steepest-descent method for optimization of mechanical systems

Steepest-descent optimal control techniques have been used extensively for dynamic systems in one independent variable and with a full set of initial conditions. This paper presents an extension of the steepest-descent technique to mechanical design problems that are described by boundary-value problems with one or more independent variables. The method is illustrated by solving finite-dimensional problems, problems with distribution of design over one space dimension, and problems with distribution of design over two space dimensions.
The Effects of Consensus-Breaking and Consensus-Preempting Partners on Reduction of Conformity.

A study was designed to investigate the magnitude of reduction in conformity and conflict of subjects responding in a perceptual task produced by (1) a partner who responds fourth and, in giving the correct answer, breaks the consensus of the previous three responders (Deviant 4 condition) as compared to (2) a partner who responds first with the correct answer prior to the agreement of the subsequent three responders on an incorrect answer, thereby preempting a consensus (Deviant 1 condition). Three levels of task difficulty were used. It was found, contrary to prediction, that Deviant 1 was more effective than Deviant 4 in reducing conformity as compared to a Unanimous Majority control, especially at the most difficult task level and, also, that Deviant 1 subjects experienced less response conflict (indexed by reaction times) at all task difficulty levels than did Deviant 4 subjects. It was speculated that early agreement on difficult tasks serves to consolidate one's initial impression, reducing the impact of a contrary majority.