Significant Factors Related to Failed Pediatric Dental General Anesthesia Appointments at a Hospital-based Residency Program

Purpose: The purposes of this study were to: (1) evaluate the relationship between appointment failure and the factors of age, gender, race, insurance type, day of week, scheduled time of surgery, distance traveled, and weather; (2) investigate reasons for failure; and (3) explore the relationships between the factors and reasons for failure. Methods: Electronic medical records were accessed to obtain data for patients scheduled for dental care under general anesthesia from May 2012 to May 2015. Factors were analyzed for relation to appointment failure. Results: Data from 3,513 appointments for 2,874 children were analyzed. Bivariate associations showed statistically significant (P<0.05) relationships between failed appointment and race, insurance type, scheduled time of surgery, distance traveled, snowfall, and temperature. Multinomial regression analysis showed the following associations between factors and the reason for failure (P<0.05): (1) decreased temperature and increased snowfall were associated with weather as reason for failure; (2) the African American population showed an association with family barriers; (3) Hispanic families were less likely to give advanced notice; and (4) the "additional races" category showed an association with fasting violation. Conclusion: Patients who have treatment under general anesthesia face specific barriers to care

A Medium-Resolution Near-Infrared Spectral Library of Late Type Stars: I

We present an empirical infrared spectral library of medium resolution (R~2000-3000) H (1.6 micron) and K (2.2 micron) band spectra of 218 red stars, spanning a range of [Fe/H] from ~-2.2 to ~+0.3. The sample includes Galactic disk stars, bulge stars from Baade's window, and red giants from Galactic globular clusters. We report the values of 19 indices covering 12 spectral features measured from the spectra in the library. Finally, we derive calibrations to estimate the effective temperature, and diagnostic relationships to determine the luminosity classes of individual stars from near-infrared spectra. This paper is part of a larger effort aimed at building a near-IR spectral library to be incorporated in population synthesis models, as well as, at testing synthetic stellar spectra.Comment: 34 pages, 12 figures; accepted for publication at ApJS; the spectra are available from the authors upon reques

Zcchc11 Uridylates Mature miRNAs to Enhance Neonatal IGF-1 Expression, Growth, and Survival

The Zcchc11 enzyme is implicated in microRNA (miRNA) regulation. It can uridylate let-7 precursors to decrease quantities of the mature miRNA in embryonic stem cell lines, suggested to mediate stem cell maintenance. It can uridylate mature miR-26 to relieve silencing activity without impacting miRNA content in cancer cell lines, suggested to mediate cytokine and growth factor expression. Broader roles of Zcchc11 in shaping or remodeling the miRNome or in directing biological or physiological processes remain entirely speculative. We generated Zcchc11-deficient mice to address these knowledge gaps. Zcchc11 deficiency had no impact on embryogenesis or fetal development, but it significantly decreased survival and growth immediately following birth, indicating a role for this enzyme in early postnatal fitness. Deep sequencing of small RNAs from neonatal livers revealed roles of this enzyme in miRNA sequence diversity. Zcchc11 deficiency diminished the lengths and terminal uridine frequencies for diverse mature miRNAs, but it had no influence on the quantities of any miRNAs. The expression of IGF-1, a liver-derived protein essential to early growth and survival, was enhanced by Zcchc11 expression in vitro, and miRNA silencing of IGF-1 was alleviated by uridylation events observed to be Zcchc11-dependent in the neonatal liver. In neonatal mice, Zcchc11 deficiency significantly decreased IGF-1 mRNA in the liver and IGF-1 protein in the blood. We conclude that the Zcchc11-mediated terminal uridylation of mature miRNAs is pervasive and physiologically significant, especially important in the neonatal period for fostering IGF-1 expression and enhancing postnatal growth and survival. We propose that the miRNA 3′ terminus is a regulatory node upon which multiple enzymes converge to direct silencing activity and tune gene expression

Further Evidence that Quasar X-Ray Emitting Regions Are Compact: X-Ray and Optical Microlensing in the Lensed Quasar Q J0158-4325

We present four new seasons of optical monitoring data and six epochs of X-ray photometry for the doubly-imaged lensed quasar Q J0158-4325. The high-amplitude, short-period microlensing variability for which this system is known has historically precluded a time delay measurement by conventional methods. We attempt to circumvent this limitation by application of a Monte Carlo microlensing analysis technique, but we are only able to prove that the delay must have the expected sign (image A leads image B). Despite our failure to robustly measure the time delay, we successfully model the microlensing at optical and X-ray wavelengths to find a half light radius for soft X-ray emission log(r_{1/2,X,soft}/cm) = 14.3^{+0.4}_{-0.5}, an upper limit on the half-light radius for hard X-ray emission log(r_{1/2,X,hard}/cm) <= 14.6 and a refined estimate of the inclination-corrected scale radius of the optical R-band (rest frame 3100 Angstrom) continuum emission region of log(r_s/cm) = 15.6+-0.3.Comment: 9 pages, 6 figures, submitted to Ap

Diagnostic Significance of Peritubular Capillary Basement Membrane Multilaminations in Kidney Allografts: Old Concepts Revisited

Injury to peritubular capillaries and capillary basement membrane multilamination (PTCL) is a hallmark of antibody-mediated chronic renal allograft rejection. However, the predictive diagnostic value of PTCL is incompletely studied

Central Serotonergic Neurons Activate and Recruit Thermogenic Brown and Beige Fat and Regulate Glucose and Lipid Homeostasis

SummaryThermogenic brown and beige adipocytes convert chemical energy to heat by metabolizing glucose and lipids. Serotonin (5-HT) neurons in the CNS are essential for thermoregulation and accordingly may control metabolic activity of thermogenic fat. To test this, we generated mice in which the human diphtheria toxin receptor (DTR) was selectively expressed in central 5-HT neurons. Treatment with diphtheria toxin (DT) eliminated 5-HT neurons and caused loss of thermoregulation, brown adipose tissue (BAT) steatosis, and a >50% decrease in uncoupling protein 1 (Ucp1) expression in BAT and inguinal white adipose tissue (WAT). In parallel, blood glucose increased 3.5-fold, free fatty acids 13.4-fold, and triglycerides 6.5-fold. Similar BAT and beige fat defects occurred in Lmx1bf/fePet1Cre mice in which 5-HT neurons fail to develop in utero. We conclude 5-HT neurons play a major role in regulating glucose and lipid homeostasis, in part through recruitment and metabolic activation of brown and beige adipocytes

A contingency analysis of precarious organizational temporariness

This paper extends our current understanding of organizational temporariness. The life of a temporary British trade union branch established to recruit Eastern European migrant workers reveals ‘precarious temporariness’, which is less predictable than the ‘planned temporariness’ typically portrayed in the literature. This different type of temporariness was associated with four key contingencies affecting the branch: dispersed governance, bottom-up initiatives, uncertain resourcing, and an effectuation logic. Analysis of the case extends our existing understanding of organizational temporariness and points to an extension of existing theorizing by highlighting the contingent nature of temporariness. The broader managerial implication of the findings is that for projects facing contingencies of the kind studied, the conventional linear approach of target setting and performance management will be less effective than an ongoing process of communication and consultation