cssi/SciSciGPT-SciSciNet huggingface dataset:
Assessment of Adherence to Visual Correction and Occlusion Therapy in the Infant Aphakia Treatment Study.

Abstract Occlusion therapy throughout early childhood is believed to be efficacious in treating deprivation amblyopia but has not been rigorously assessed in clinical trials. Further, tools to assess adherence to such therapy over an extended period of time are lacking. Using data from the Infant Aphakia Treatment Study, a randomized clinical trial of treatment for unilateral congenital cataract, we examined the use of quarterly 48-h recall interviews and annual 7-day prospective diaries to assess reported hours of patching in 114 children throughout the first 5 years of life. Consistency of data reported was assessed using correlation coefficients and intraclass correlation coefficients. Both interview and diary data showed excellent consistency with Cronbach’s Alpha’s ranging from 0.69 to 0.88 for hours of patching and 0.60 to 0.73 for hours of sleep. However, caregivers reported somewhat more adherence in prospective diaries than retrospective interviews. Completion rates, on the other hand, were substantially higher for telephone interviews than prospective diaries. For example, four years after surgery response rates to telephone interviews exceeded 75% versus completion rates of only 54% for diaries. In situations where occlusion dose monitors cannot be used for assessing adherence to occlusion therapy, such as in infants or over an extended period of time, quantitative assessments of occlusion therapy can be obtained by parental report, either as a series of prospective diaries or a series of recall interviews.
No Such Thing as Ideal Blood Pressure: A Case for Personalized Medicine

![Figure][1] “The practice of making a sharp division between normal and pathologically high blood pressure is entirely arbitrary and is in the nature of artifact. Essential hypertension represents the upper end of a distribution curve showing continuous variation, with no definite evidence
‘Omnicentricity’ and The Concept of Ultimate Reality and Meaning

L'A. prend une nouvelle position sur l'enigme corps-esprit. Il propose une alternative plus scientifique au dualisme qui caracterise la relation de ces deux entites depuis Descartes qu'il appelle materialisme mecanique. Il avance que le cerveau constitue notre esprit. Il interroge ceux qui epouse cette deuxieme theorie avec une serie de 11 questions dont pourquoi les hommes sont-ils a la recherche de Dieu ?. Il propose une troisieme alternative qui concerne un esprit inexplicable, individuellement enigmatique qu'il nomme omnicentricite.
Duality and Complementary Slackness

In this chapter, we will develop the concept of duality, as well as the related theorem of complementary slackness which not only tells us when we have optimal solutions, but also leads us to the Dual Simplex Method.
Influence of rock mechanical properties and rake angle on the formation of rock fragments during cutting operation

Mechanical rock cutting is a process encountered in different engineering applications including rock excavation, mining, and deep oil well drilling. Rock mechanical properties vary with depth in the subsurface and also at different geographical locations due to different environmental conditions. Understanding of fragmentation mechanisms in specific rock materials allows the determination of optimum cutting parameters that improve cutting efficiency and increase tool life during cutting operations. In the present investigation, numerical models that accurately predict the rock fragmentation and stress profiles in the rock slab during cutting were developed using the explicit finite element method (FEM). In the numerical method, a damage material model was utilized to capture the rock fragmentation process when a rigid cutter of different rake angles was displaced at different velocities against a stationary rock slab for a cutting depth of 1 mm. Rock slabs with significantly different mechanical properties were incorporated in the material model, and a constant friction factor is utilized in the contact model. The variation of cutting forces and stresses and the size and morphology of rock fragmentation were analyzed. The simulation results indicated that the explicit FEM is a powerful tool for simulating rock cutting as the formation of discontinuous rock fragments were distinctly observed at different cutting conditions. The rock mechanical properties and tool rake angle were found to have the most significant effect on the rock fragmentation during cutting operations. The cutting forces were also influenced by mechanical properties of the rock and tool rake angle. The experimental and numerical results obtained in the literature found a good agreement with the current numerical predictions.
A mechanism for acetylcholine receptor gating based on structure, coupling, phi, and flip.

Nicotinic acetylcholine receptors are allosteric proteins that generate membrane currents by isomerizing (“gating”) between resting and active conformations under the influence of neurotransmitters. Here, to explore the mechanisms that link the transmitter-binding sites (TBSs) with the distant gate, we use mutant cycle analyses to measure coupling between residue pairs, phi value analyses to sequence domain rearrangements, and current simulations to reproduce a microsecond shut component (“flip”) apparent in single-channel recordings. Significant interactions between amino acids separated by >15 A are rare; an exception is between the αM2–M3 linkers and the TBSs that are ∼30 A apart. Linker residues also make significant, local interactions within and between subunits. Phi value analyses indicate that without agonists, the linker is the first region in the protein to reach the gating transition state. Together, the phi pattern and flip component suggest that a complete, resting↔active allosteric transition involves passage through four brief intermediate states, with brief shut events arising from sojourns in all or a subset. We derive energy landscapes for gating with and without agonists, and propose a structure-based model in which resting→active starts with spontaneous rearrangements of the M2–M3 linkers and TBSs. These conformational changes stabilize a twisted extracellular domain to promote transmembrane helix tilting, gate dilation, and the formation of a “bubble” that collapses to initiate ion conduction. The energy landscapes suggest that twisting is the most energetically unfavorable step in the resting→active conformational change and that the rate-limiting step in the reverse process is bubble formation.
Applied Behavior Analysis in Social and Community Action: A Bibliography

A bibliography of articles pertaining to behavioral intervention at the community and societal levels is presented, consisting of references appearing in the Journal of Applied Behavior Analysis between the years 1968-1983.
Paracrine-Mediated Systemic Anti-Inflammatory Activity of Intravenously Administered Mesenchymal Stem Cells: A Transformative Strategy for Cardiac Stem Cell Therapeutics

Stem cell therapy as a treatment option for acute myocardial infarction or heart failure caused by ischemic or nonischemic cardiomyopathy has focused on direct cardiac delivery of stem cells to facilitate cardiac engraftment. Once engrafted, it was believed that these cells would either transdifferentiate into new functioning myocytes or stimulate the expansion of resident myocardial stem cells. However, a sea change in thinking about cell therapy in cardiovascular disease has occurred as mounting evidence indicates that (1) inflammation is a major mechanism contributing to the progressive myocardial dysfunction seen in patients post-acute myocardial infarction and in patients with cardiomyopathy, and (2) systemic paracrine-mediated anti-inflammatory effects of stem cells can drive beneficial cardiac effects in these diseases. These concepts lead to a potentially transformative strategy that intravenous delivery of stem cells, through systemic anti-inflammatory mechanisms, improves myocardial function and thereby obviates the need for invasive methods of stem cell delivery. Until recently, the prevailing view of the mechanism responsible for any potential benefit of stem cells in patients with acute myocardial infarction (AMI) or with heart failure (HF) caused by ischemic or nonischemic cardiomyopathy (ICM/NICM) was that benefit derived from local effects—once engrafted in damaged myocardium, the stem cells either transdifferentiate into functional myocardium, stimulate resident myocardial stem cells to expand, and repopulate the heart with functioning myocytes or secrete substances leading to myocardial healing. This mechanistic perspective implied that the greater the number of engrafted cells in the myocardium, the greater the cardiac benefit. Because few intravenously administered stem cells engraft in injured myocardium, invasive strategies providing direct delivery of stem cells to the heart were uniformly adopted. This necessarily involved either catheter-based delivery (intracoronary or transendocardial injection) or surgical delivery (direct intramyocardial injection). A transformative concept relating to stem cell treatment of patients with AMI or ICM/NICM has recently …
Social relationships and social anxiety appeals in direct-to-consumer advertising

The use of social relationships as a promotional tool in direct-to-consumer (DTC) advertising has received limited attention despite relational impacts on illnesses and empirical evidence supportin...
An Exploration of Pick's Theorem in Space

(2008). An Exploration of Pick's Theorem in Space. Mathematics Magazine: Vol. 81, No. 2, pp. 106-115.
Who are Deemed the “Worthy” and “Unworthy” Victims of Mexico’s Drug-Related Violence?

There have been numerous victims of Mexico’s drug-related violence since 2006. This research addresses two questions: (1) Who are the individuals who have been involved and targeted by drug-traffic...
Crabapple (Malus spp.)

Crabapples are a member of the family Rosaceae and their primary importance is as ornamental trees because of their attractive flowers and fruits (den Boer 1959). Crabapples also have value as potential pollinizers in commercial apple orchards (Crassweller et al. 1980) and as indicator plants for the detection of latent apple viruses (Gilmer et al. 1971). Crabapples can be used as rootstocks for apples; for example, Malus robusta 5, which has the desirable feature of withstanding low temperatures would be suitable in areas where winter hardiness is a problem (Tukey 1964).
Primum Non Nocere: Refocusing Our Attention on Severe Hypoglycemia Prevention

Severe hypoglycemia, defined as low blood glucose requiring assistance for recovery, is arguably the most dangerous complication of type 1 diabetes as it can result in permanent cognitive impairment, seizure, coma, accidents, and death (1,2). Since the Diabetes Control and Complications Trial (DCCT) demonstrated that intensive intervention to normalize glucose prevents long-term complications but at the price of a threefold increase in the rate of severe hypoglycemia (3), hypoglycemia has been recognized as the major limitation to achieving tight glycemic control. Severe hypoglycemia remains prevalent among adults with type 1 diabetes, ranging from ∼1.4% per year in the DCCT/EDIC (Epidemiology of Diabetes Interventions and Complications) follow-up cohort (4) to ∼8% in the T1D Exchange clinic registry (5). One the greatest risk factors for severe hypoglycemia is impaired awareness of hypoglycemia (6), which increases risk up to sixfold (7,8). Hypoglycemia unawareness results from deficient counterregulation (9), where falling glucose fails to activate the autonomic nervous system to produce neuroglycopenic symptoms that normally help patients identify and respond to episodes (i.e., sweating, palpitations, hunger) (2). An estimated 20–25% of adults with type 1 diabetes have impaired hypoglycemia awareness (8), which increases to more than 50% after 25 years of disease duration (10). Screening for hypoglycemia unawareness to identify patients at increased risk of severe hypoglycemic events should be part of routine diabetes care. Self-identified impairment in awareness tends to agree with clinical evaluation (11). Therefore, hypoglycemia unawareness can be easily and effectively screened using multiple, self-administered methods (11). These range from single questions (i.e., “Do you know when your hypos are coming?” [7] and “Can you feel when you are low?” [12]) to longer assessments characterizing hypoglycemia exposure and the glycemic threshold for symptomatic response, as in the 8-item Clarke questionnaire (11 …
Pituitary tumour apoplexy within prolactinomas in children: a more aggressive condition?

To evaluate clinical presentations, diagnosis and management of paediatric patients presenting with pituitary apoplexy. A retrospective case series describing a cohort of paediatric patients presenting with this condition from 2010–2016 to a tertiary referral children’s hospital in the United Kingdom. Pituitary apoplexy is a rare condition that seems to have a higher relative incidence in children than adults. Our series suggests that pituitary apoplexy in paediatric patients with adenomas appears more common than previously described. All our patients required surgery, either as an acute or delayed procedure, for visual compromise. Two patients had commenced growth hormone (GH) for GH deficiency two weeks prior to the onset of pituitary apoplexy. With only a limited number of published case reports surrounding this topic our case series contributes to help further understand and manage this condition.
Ethanol Exposure Increases miR-140 in Extracellular Vesicles: Implications for Fetal Neural Stem Cell Proliferation and Maturation.

Background Neural stem cells (NSCs) generate most of the neurons of the adult brain in humans, during the mid-first through second-trimester period. This critical neurogenic window is particularly vulnerable to prenatal alcohol exposure, which can result in diminished brain growth. Previous studies showed that ethanol (EtOH) exposure does not kill NSCs, but, rather, results in their depletion by influencing cell cycle kinetics and promoting aberrant maturation, in part, by altering NSC expression of key neurogenic miRNAs. NSCs reside in a complex microenvironment rich in extracellular vesicles, shown to traffic miRNA cargo between cells. Methods We profiled the miRNA content of extracellular vesicles from control and EtOH-exposed ex vivo neurosphere cultures of fetal NSCs. We subsequently examined the effects of one EtOH-sensitive miRNA, miR-140-3p, on NSC growth, survival, and maturation. Results EtOH exposure significantly elevates levels of a subset of miRNAs in secreted extracellular vesicles. Overexpression of one of these elevated miRNAs, miR-140-3p, and its passenger strand relative, miR-140-5p, significantly increased the proportion of S-phase cells while decreasing the proportion of G0 /G1 cells compared to controls. In contrast, while miR-140-3p knockdown had minimal effects on the proportion of cells in each phase of the cell cycle, knockdown of miR-140-5p significantly decreased the proportion of cells in G2 /M phase. Furthermore, miR-140-3p overexpression, during mitogen-withdrawal-induced NSC differentiation, favors astroglial maturation at the expense of neural and oligodendrocyte differentiation. Conclusions Collectively, the dysregulated miRNA content of extracellular vesicles following EtOH exposure may result in aberrant neural progenitor cell growth and maturation, explaining brain growth deficits associated with prenatal alcohol exposure.
VIP Interneurons Contribute to Avoidance Behavior by Regulating Information Flow across Hippocampal-Prefrontal Networks

Inhibitory interneurons expressing vasoactive intestinal polypeptide (VIP) are known to disinhibit cortical neurons. However, it is unclear how disinhibition, occurring at the single-cell level, interacts with network-level patterns of activity to shape complex behaviors. To address this, we examined the role of prefrontal VIP interneurons in a widely studied mouse behavior: deciding whether to explore or avoid the open arms of an elevated plus maze. VIP interneuron activity increases in the open arms and disinhibits prefrontal responses to hippocampal inputs, which are known to transmit signals related to open arm avoidance. Indeed, inhibiting VIP interneurons disrupts network-level representations of the open arms and decreases open arm avoidance specifically when hippocampal-prefrontal theta synchrony is strong. Thus, VIP interneurons effectively gate the ability of hippocampal input to generate prefrontal representations, which drive avoidance behavior. This shows how VIP interneurons enable cortical circuits to integrate specific inputs into network-level representations that guide complex behaviors. VIDEO ABSTRACT.
Data broker: a case for workflow enablement using a key/value approach

Complex problems can often only be solved with a workflow of different applications whose progress depends also on the need of shared data. There are different challenges that developers must overcome when sharing data in a workflow; each application may have very different requirements in how they access and consume shared data. For example, data access can be online or offline, data sizes and types may vary as well as the frequency they are consumed and produced by applications in the workflow. Moreover, producers and consumers may not run at the same time scale, thus introducing possible latency. Also, the deployment system itself plays an important role, especially when considering low latency read/write operations and reliability in case of failures.To facilitate the communication of information within a workflow, in this paper we present the Data Broker, a programming model helping applications to share data in the form of named tuples, relying on the concept of namespaces providing software-based data isolation. The client API provides access to the namespaces through mainly put/get primitives, enriched also with namespace management functions and key browsing/querying. Our programming model can support different backends for storing/retrieving the data: in this paper, we will focus on the Redis implementation. By using Redis as backend, we enable the Data Broker with the reliability and infrastructure provided by it, which allows users to have access to a fast local or remote in-memory distributed key-value/object store configured as a set of independent instances or a coordinated cluster.On top of Redis, we implement data access function, namespace management, asynchronous call with client-side queues per server, and key-space browsing.
Deep Learning in a Disorienting World

Much has been written about the escalating intolerance of worldviews other than one's own. Reasoned arguments based on facts and data seem to have little impact in our increasingly post-truth culture dominated by social media, fake news, tribalism, and identity politics. Recent advances in the study of human cognition, however, offer insights on how to counter these troubling social trends. In this book, psychologist Jon F. Wergin calls upon recent research in learning theory, social psychology, politics, and the arts to show how a deep learning mindset can be developed in both oneself and others. Deep learning is an acceptance that our understanding of the world around us is only temporary and is subject to constant scrutiny. Someone who is committed to learning deeply does not simply react to experiences, but engages fully with that experience, knowing that the inevitable disquietude is what leads to efficacy in the world.
Advances in High-Power Wireless Charging Systems: Overview and Design Considerations

Wireless charging systems are foreseen as an effective solution to improve the convenience and safety of conventional conductive chargers. As this technology has matured, recent broad applications of wireless chargers to electrified transportation have indicated a trend toward higher power, power density, modularity, and scalability of designs. In this article, commercial systems and laboratory prototypes are reviewed, focusing mostly on the advances in high-power wireless charging systems. The recent endeavors in magnetic pad designs, compensation networks, power electronics converters, control strategies, and communication protocols are illustrated. Both stationary and dynamic (in-motion) wireless charging systems are discussed, and critical differences in their designs and applications are emphasized. On that basis, the comparisons among different solutions and design considerations are summarized to present the essential elements and technology roadmap that will be necessary to support large-scale deployment of high-power wireless charging systems. The review is concluded with the discussion of several fundamental challenges and prospects of high-power wireless power transfer (WPT) systems. Foreseen challenges include utilization of advanced materials, electric and electromagnetic field measurement and mitigation, customization, communications, power metering, and cybersecurity.
Safety and prognostic value of vasodilator stress cardiovascular magnetic resonance in patients with heart failure and reduced ejection fraction (HFrEF)

Background Recent data suggest that patients with HFrEF [heart failure with reduced left ventricular ejection fraction (LVEF) Purpose To assess the safety and the prognostic value of vasodilator stress perfusion CMR in patients with HFrEF. Methods Between 2008 and 2018, we prospectively included consecutive patients with HFrEF defined by LVEF Results Of 1084 patients with HFrEF (65 ± 11 years, median LVEF 34.6 ± 4.9%), 1049 (97%) completed the CMR protocol and among those 952 (91%) completed the follow-up (median 5.6 ± 2.4 years). Stress CMR was well tolerated without severe adverse event. Using Kaplan–Meier analysis, the presence of inducible ischemia and LGE were significantly associated with the occurrence of MACE (hazard ratio [HR]: 2.46 [95% CI: 1.69–3.59]; P Fig. 1 ). In multivariable stepwise Cox regression including clinical characteristics and CMR, the inducible ischemia was an independent predictor of a higher incidence of MACE at follow-up (adjusted HR: 2.26 [95% CI: 1.52–3.35]; P Conclusions Stress CMR is safe and has a good discriminative prognostic value to predict the occurrence of MACE in patients with HFrEF.
Rapid Isolation of Phenol Degrading Bacteria by Fourier Transform Infrared(FTIR)Spectroscopy

Phenol is an important chemical engineering material and ubiquitous in industry wastewater,its existence has become a thorny issue in many developed and developing country.More and more stringent standards for effluent all over the world with human realizing the toxicity of phenol have been announced.Many advanced biological methods are applied to industrial wastewater treatment with low cost,high efficiency and no secondary pollution,but the screening of function microorganisms is certain cumbersome process.In our study a rapid procedure devised for screening bacteria on solid medium can degrade phenol coupled with attenuated total reflection fourier transform infrared(ATR-FTIR)which is a detection method has the characteristics of efficient,fast,high fingerprint were used.Principal component analysis(PCA)is a method in common use to extract fingerprint peaks effectively,it couples with partial least squares(PLS)statistical method could establish a credible model.The model we created using PCA-PLS can reach 99.5% of coefficient determination and validation data get 99.4%,which shows the promising fitness and forecasting of the model.The high fitting model is used for predicting the concentration of phenol at solid medium where the bacteria were grown.The highly consistent result of two screening methods,solid cultural with ATR-FTIR detected and traditional liquid cultural detected by GC methods,suggests the former can rapid isolate the bacteria which can degrade substrates as well as traditional cumbersome liquid cultural method.Many hazardous substrates widely existed in industry wastewater,most of them has specialize fingerprint peaks detected by ATR-FTIR,thereby this detected method could be used as a rapid detection for isolation of functional microorganisms those can degrade many other toxic substrates.
Histone H1 mutations in lymphoma: a link(er) between chromatin organization, developmental reprogramming, and cancer.

Aberrant cell fate decisions due to transcriptional misregulation are central to malignant transformation. Histones are the major constituents of chromatin, and mutations in histone-encoding genes are increasingly recognized as drivers of oncogenic transformation. Mutations in linker histone H1 genes were recently identified as drivers of peripheral lymphoid malignancy. Loss of H1 in germinal center B-cells results in widespread chromatin decompaction, redistribution of core histone modifications, and reactivation of stem cell-specific transcriptional programs. This review explores how linker histones and mutations therein regulate chromatin structure, highlighting reciprocal relationships between epigenetic circuits, and discusses the emerging role of aberrant three-dimensional chromatin architecture in malignancy.
MET Gene High Copy Number (Amplification/Polysomy) Identified in Melanoma for Potential Targeted Therapy.

OBJECTIVES Aberrant expression of the mesenchymal epithelial transition factor (MET) gene has been observed in several malignancies, and drugs targeting the MET gene have been implicated in clinical trials with promising results. Hence, MET is a potentially targetable oncogenic driver. We explored the frequency of MET gene high copy number in melanomas and carcinomas. METHODS The study group included 135 patients. Tissue microarrays were constructed with 19 melanomas and 116 carcinomas diagnosed from 2010 to 2012. We screened MET gene copy number by fluorescence in situ hybridization analysis using probes for MET gene and CEP7 as control. RESULTS We found MET gene amplification in 2 (11%) of 19 melanoma cases, whereas 5 (26%) of 19 melanoma cases showed polysomy. For carcinomas, there was no MET gene amplification identified. However, 8 (7%) of 116 cases showed polysomy. CONCLUSIONS In our study, MET gene amplification was identified in 11% of melanomas and is relatively concordant with few reported studies. However, about 26% of the additional melanoma cases showed MET gene polysomy, which has not been reported as per our knowledge. If these results are validated with further orthogonal studies, more of the melanoma cases could potentially benefit from targeted therapy with MET tyrosine kinase inhibitors.
Reactions of Metabolically Activated Carcinogens with Nucleic Acids

Interactions of chemical carcinogens with macromolecules were first noted over 30 years ago with findings that aminoazodyes and benzo[a]pyrene are bound to proteins in tissues in which they produce tumors. Later, covalent binding of residues of many chemical carcinogens with both nucleic acids and proteins in tumor-susceptible tissues was found. Although the extent of binding to DNA and RNA, but not to proteins, generally showed reasonable correlation with the carcinogenic potency, this was not always true. Although all adequately studied carcinogens bind covalently to cellular macromolecules in vivo, some exceptions have been noted thus far: one is the carcinogenic and mutagenic antitumor agent, adriamycin, which binds in vivo to DNA in a noncovalent fashion.
Clinical and radiographic outcomes of concentrated bone marrow aspirate with allograft and demineralized bone matrix for posterolateral and interbody lumbar fusion in elderly patients.

Cell-based therapies such as concentrated bone marrow aspirate (BMA) with allograft and demineralized bone matrix (DBM) have been developed as a potential alternative to iliac crest bone graft (ICBG) in spinal fusion. BMA contains mesenchymal stem cells (MSCs) and growth factors that confer osteogenic and osteoinductive potential to osteoconductive scaffolds like allograft and DBM. It is well established that there is an age-related decline in bone marrow MSC population and efficacy. This might be problematic in spine arthrodesis when utilizing BMA derived from elderly patients as a fusion aide. The goal of this study was to describe the outcomes of concentrated BMA with allograft and DBM in elderly patients undergoing posterolateral and interbody lumbar fusion. Thirty-one patients, age 65 and older, with a minimum of 12 months follow-up underwent combined primary posterolateral and transforaminal lumbar interbody fusion. Radiographic fusion, complications, reoperation rates and clinical outcomes were assessed. Multiple logistic regression analysis was used to examine the effects of variables such as patient age, gender, smoking, osteoporosis, Charlson co-morbidity index score, single versus multilevel fusion, length of hospital stay, and length of follow-up time on fusion outcome. The overall rate of a solid fusion (i.e. the concomitant presence of solid posterolateral and interbody fusion in a patient) was 83.9 % (26/31). Specifically, radiographic evidence of a successful posterolateral fusion was 83.9 % (26/31) while the radiographic evidence of a successful interbody fusion was 96.8 % (30/31). Using logistic regression analysis, none of the variables of interest had an association with non-solid unions. One (3.2 %) patient developed a seroma and one (3.2 %) patient developed clinical pseudarthrosis. None of the patients developed hardware-related complications or graft donor site morbidities. Five (16.1 %) patients required reoperation. Excellent or good results were achieved in 83.9 % of patients. Despite the concerns of reduced fusion potential in elderly patients, autologous concentrated BMA mixed with allograft and DBM in posterolateral and interbody fusions can achieve successful fusion rates with good clinical outcomes and low complication rates.
A review of medication incidents reported to the National Reporting and Learning System in England and Wales over 6 years (2005–2010)

A review of all medication incidents reported to the National Reporting and Learning System (NRLS) in England in Wales between 1 January 2005 and 31 December 2010 was undertaken. The 526,186 medication incident reports represented 9.68% of all patient safety incidents. Medication incidents from acute general hospitals (394,951) represented 75% of reports. There were relatively smaller numbers of medication incident reports (44,952) from primary care, representing 8.5% of the total. Of 86,821 (16%) medication incidents reporting actual patient harm, 822 (0.9%) resulted in death or severe harm. The incidents involving medicine administration (263,228; 50%) and prescribing (97,097; 18%) were the process steps with the largest number of reports. Omitted and delayed medicine (82,028; 16%) and wrong dose (80,170; 15%) represented the largest error categories. Thirteen medicines or therapeutic groups accounted for 377 (46%) of the incidents with outcomes of death or severe harm. The National Patient Safety Agency (NPSA) has issued guidance to help minimize incidents with many of these medicines. Many recent incidents could have been prevented if the NPSA guidance had been better implemented. It is recommended that healthcare organizations in all sectors establish an effective infrastructure to oversee and promote safe medication practice, including an annual medication safety report. In the future, preventable harms from medication incidents can be further minimized by; the continued use of the NRLS to identify and prioritize important actions to improve medication safety, a central organization continuing to issue medication safety guidance to the service and better methods to ensure that the National Health Service has implemented this guidance.
The pre-pairing events in Tetrahymena thermophila. Analysis of blocks imposed by high concentrations of Tris-Cl.

Abstract Initiation, a process that occurs at the very onset of the sexual cycle in the ciliate Tetrahymena thermophila, is blocked by concentrations of Tris-Cl in excess of 50 mM. Cells starved in 60 mM Tris-Cl proceed through the first 30 min of initiation before arresting. Cells allowed to initiate for 15–45 min in 10 mM Tris-Cl before exposure to 60 mM Tris-Cl accumulate at a second point about 50 min through the process. Two variants which behave differently than wild type in 60 mM Tris-Cl are described. A model for initiation is proposed and its implications are discussed.
Health Action Process Approach: Application to Medication Adherence in Cardiac Rehabilitation Patients

The purpose of this study was to examine the relationship between Health Action Process Approach (HAPA) postintentional constructs (maintenance self-efficacy, recovery self-efficacy, action planning, coping planning) and medication adherence among phase II cardiac rehabilitation (CR) patients. Purposive sampling was used to recruit 91 phase II CR patients age 50 years and over. All respondents completed paper and pencil questionnaire examining HAPA postintentional constructs (action planning, coping planning, maintenance self-efficacy, recovery self-efficacy), medication adherence, and demographic characteristics. Validity and reliability were confirmed for all scales included in the questionnaire. Descriptive statistics were used to describe respondents’ characteristics. Bivariate statistics (correlation, Mann-Whitney U-test, Kruskal Wallis test) were used to examine associations between medication adherence and each HAPA postintention construct as well as medication adherence and respondent demographic ...
Haplotype-based approach to known MS-associated regions increases the amount of explained risk

Genome-wide association studies (GWAS), using single nucleotide polymorphisms (SNPs), have yielded 110 non-human leucocyte antigen genomic regions that are associated with multiple sclerosis (MS). Despite this large number of associations, however, only 28% of MS-heritability can currently be explained. Here we compare the use of multi-SNP-haplotypes to the use of single-SNPs as alternative methods to describe MS genetic risk. SNP-haplotypes (of various lengths from 1 up to 15 contiguous SNPs) were constructed at each of the 110 previously identified, MS-associated, genomic regions. Even after correcting for the larger number of statistical comparisons made when using the haplotype-method, in 32 of the regions, the SNP-haplotype based model was markedly more significant than the single-SNP based model. By contrast, in no region was the single-SNP based model similarly more significant than the SNP-haplotype based model. Moreover, when we included the 932 MS-associated SNP-haplotypes (that we identified from 102 regions) as independent variables into a logistic linear model, the amount of MS-heritability, as assessed by Nagelkerke's R-squared, was 38%, which was considerably better than 29%, which was obtained by using only single-SNPs. This study demonstrates that SNP-haplotypes can be used to fine-map the genetic associations within regions of interest previously identified by single-SNP GWAS. Moreover, the amount of the MS genetic risk explained by the SNP-haplotype associations in the 110 MS-associated genomic regions was considerably greater when using SNP-haplotypes than when using single-SNPs. Also, the use of SNP-haplotypes can lead to the discovery of new regions of interest, which have not been identified by a single-SNP GWAS.
Platelet collection and transfusion using the fenwal CS‐3000 cell separator

A prototype model of the Fenwal CS-3000 Blood Cell Separator (Deerfield, IL) was studied for plateletpheresis in 63 donors and 5 transfusions in patients. Donor effects were consistent with platelet removal and mild hemodilution. The incidence of reactions (9 of 63) was low and all were mild "citrate" type. A two-hour collection yielded 4.0 +/- 0.72 x 10(11) platelets at an efficiency of 45 +/- 6.9 per cent. The product had little contamination with leukocytes (0.26 +/- 1.2 x 10(9) and red blood cells (hematocrit less than 1%). Morphology and pH were well preserved during 24 hours of storage. Four patients with uncomplicated aregenerative thrombocytopenia were transfused on five occasions, with a mean of 4.5 +/- 0.87 x 10(11) platelets resulting in a mean platelet count increment of 55,000/microliter and dramatic reduction in template bleeding times.
(M,S)-optimality in selecting factorial designs

Use of the (M,S) criterion to select and classify factorial designs is proposed and studied. The criterion is easy to deal with computationally and it is independent of the choice of treatment contrasts. It can be applied to two-level designs as well as multilevel symmetrical and asymmetrical designs. An important connection between the (M,S) and minimum aberration criteria is derived for regular fractional factorial designs. Relations between the (M,S) criterion and generalized minimum aberration criteria on nonregular designs are also discussed. The (M,S) criterion is then applied to study the projective properties of some nonregular designs.
Estimation of net physical transport and hydraulic residence times for a coastal plain estuary using box models

A box model based on salinity distributions and freshwater inflow measurements was developed and used to estimate net non-tidal physical circulation and hydraulic residence times for Patuxent River estuary, Maryland, a tributary estuary of Chesapeake Bay. The box model relaxes the usual assumption that salinity is at steady-state, an important improvement over previous box model studies, yet it remains simple enough to have broad appeal. Average monthly 2-dimensional net non-tidal circulation and residence times for 1986–1995 are estimated and related to river flow and salt water inflow as estimated by the box model. An important result is that advective exchange at the estuary mouth was not correlated with Patuxent River flow, most likely due to effects of offshore salinity changes in Chesapeake Bay. The median residence time for freshwater entering at the head of the estuary was 68 d and decreased hyperbolically with increasing river flow to 30 d during high flow. Estimates of residence times for down-estuary points of origin showed that, from the head of the estuary to its mouth, control of flushing changed from primarily river flow to other factors regulating the intensity of gravitational circulation.
Celecoxib, a selective cyclooxygenase-2 inhibitor, inhibits retinal vascular endothelial growth factor expression and vascular leakage in a streptozotocin-induced diabetic rat model.

Overexpression of vascular endothelial growth factor (VEGF) is implicated in the development of vascular leakage and retinal neovascularization in diabetic subjects. The objective of this study was to determine whether celecoxib, a selective cyclooxygenase-2 enzyme inhibitor, reaches ocular tissues following oral administration and inhibits the retinal VEGF expression and vascular leakage in a streptozotocin-induced diabetic rat model. After administering a single intraperitoneal injection of streptozotocin (60 mg/kg) to Sprague-Dawley rats and ensuring the induction of diabetes at the end of 24 h, celecoxib was administered b.i.d. by oral gavage (50 mg/kg). On day 8, the animals were sacrificed and the retinal VEGF and cyclooxygenase-2 mRNA levels, ocular tissue celecoxib concentrations, and the vitreous/plasma protein ratio were determined. In diabetic rats, the retinal VEGF mRNA expression was 2.3-fold compared to controls, with a corresponding increase in cyclooxygenase-2 mRNA expression. Celecoxib treatment inhibited VEGF mRNA expression without any significant reduction in cyclooxygenase-2 mRNA. Furthermore, the retinal vascular leakage estimated as vitreous to plasma protein ratio increased in diabetic animals from 0.35+/-0.1 to 1.1+/-0.1 and celecoxib treatment significantly decreased this ratio to 0.4+/-0.1. Celecoxib levels were 24.8+/-6.6, 1.9+/-1, 1.7+/-0.8, and 6.9+/-0.9 ng/mg in the retina, vitreous, lens, and cornea, respectively. The plasma celecoxib levels were 85+/-24 ng/ml. Thus, celecoxib reaches the retina after oral administration and reduces diabetes-induced retinal VEGF mRNA expression and vascular leakage by inhibiting the activity of cyclooxygenase-2 enzyme.
Strengths of evaporated carbon films

Abstract We have tested the capability of unsupported carbon films to separate regions at different pressures. We find that a well-mounted foil behaves as if it had the yield tensile strength of bulk graphite (5.0 × 10 8 dyn/cm 2 ), and that the median breaking strength is somewhat less than half of this value.
Evaluation of Nanomaterials-biomolecule hybrids for signal enhancement of impedimetric biosensors

Five different Nano-materials (NMs) were used for making hybrid conjugates with Protein-A (PrA), a biomolecule that binds specifically with antibodies (Abs). The choice of NMs (Gold, CdS, SrTiO3, Graphene Oxide and Polystyrene) exhibit both inorganic and organic NMs, with a wide range of electrical characteristics i.e., from metal, semiconductor to non conducting dielectric materials. The NMs-PrA conjugates prepared were characterized using UV-visible spectroscopy and fluorescence microscopy before use for biosensor application. These hybrids were than compared for their relative efficacy in enhancing the biosensor signal as recorded using faradaic electrochemical impedance spectroscopy (EIS). A nanogap interdigitated electrodes array (IDEA) sensor was coated with rabbit IgG antibodies and the binding signal from NM-PrA was compared with that of PrA binding alone. The EIS signal was analyzed by fitting the data to a Randles equivalent circuit. Values of two prime circuit elements i.e., charge transfer resistance (R-Ct) and double layer capacitance (C-dl) were determined from the best fit. The difference between the two signals provided the insight into the mechanisms for different NMs and the relative efficiency in signal enhancement.
Hierarchical scheduling in an intelligent environmental control system

This paper describes design and implementation of the hierarchical scheduling subsystem and graphical user interface in an intelligent environmental control system. The hierarchical scheduling system is capble of managing all environmental events occuring in widely different time scales as specified by the user. We employ a knowledge representation scheme called system entity structure to specify the environmental schedules in a hierarchical fashion. A system entity structure called TAL (Timed Action Language) is developed. TAL organizes a family of all possible long-/mid-/short-term schedules from which a specific schedule can be pruned by the user through graphical interface.
Contralateral Prophylactic Mastectomy: An Opportunity for Shared Decision Making

Most women who have contralateral prophylactic mastectomy (CPM) do not have clear clinical indications for undergoing the procedure, fueling concerns about overuse, as highlighted in the article by Hawley and colleagues.1 Focusing on improving informed decision-making is one starting point. However, breast cancer surgical decisions are made at an emotional time when fully understanding and weighing the true risks (e.g., surgical complications, self-image, and sexual effects) and benefits (e.g. reduced risk of contralateral cancer) associated with CPM might be difficult for some patients. Anxiety and fear certainly hamper optimal decision-making,2,3 and greater psychological and emotional support may prove invaluable in this setting. Further complicating informed decision-making is the tendency for people to not believe that risk estimates apply to them personally.4 An underlying tension exists between “do no harm,” viewing CPM as medically unnecessary given the lack of demonstrated benefit on recurrence and survival, and respect for patient preferences and autonomy. While CPM might be considered over-treating women without clinical indications, it might still be the right choice for some women for risk reduction, cosmetic and/or emotional reasons. The Institute of Medicine5 recently categorized shared decision making in the context of cancer care as “suboptimal”, underscoring a need for better patient-clinician communication. Decision-making surrounding early breast cancer, with respect to CPM in particular, provides an opportunity to encourage a supportive, shared, decision-making approach. Not only should pros and cons of different treatment options be communicated, but there needs to be consideration of the patient's personal circumstances and perceptions, all the while addressing anxiety and concerns about breast cancer recurrence and new primary disease (and the distinction between the two). Finding balance around this issue, like the decision process itself, should be a goal shared by patients and clinicians alike.
Calcium mass transport and sandstone diagenesis during compaction-driven flow: Stevens Sandstone, San Joaquin basin, California

Sediment compaction provides a limited source of fluids for diagenesis and drives fluid flow at average rates of only ∼1 mm/yr. Nevertheless, many geochemical and petrographic studies of diagenesis provide evidence of significant mass transport in systems where fluid flow appears to be compaction driven. This apparent discrepancy could arise because diagenetic studies generally are concerned with relatively permeable petroleum reservoirs. Focused fluid flow through permeable zones could increase local flow rates and allow mixing of fluids from different sources. This study uses the Stevens Sandstone of the San Joaquin basin to explore the potential diagenetic effects of fluid focusing during compaction-driven flow over a 5 m.y. period. Reactive-transport simulations incorporate a new kinetic expression for plagioclase dissolution and suggest that rate-limited plagioclase dissolution drove calcium enrichment of pore fluids and caused precipitation of calcite, kaolinite, and albite. In spite of the importance of this rate-limited reaction, simulations show that influx of fluids from compacting shale could limit the distribution of calcite and kaolinite in adjacent sandstones. Although calcium mass transport is predicted on a scale of kilometers, upward flow of calcium-rich fluids from deep beds does not significantly increase calcite volume relative to closed-system predictions. Increased transverse dispersivity increases mixing, which further limits precipitation of calcite and kaolinite. Results are consistent with field observations of fluid chemistry, although simulations account for
Public Service Motivation and Institutional-Occupational Motivations Among Undergraduate Students and ROTC Cadets

Given the current fiscal climate, budgetary pressures may have important implications for recruitment and retention of military personnel. In response to this issue, we join two literatures to stud...
Pharmacology Review: Premedication for Endotracheal Intubation of the Neonate: What is the Evidence?

Advances in the understanding of neonatal pain have created interest in the use of medications during commonly performed procedures in the neonatal intensive care unit. A number of small studies have examined the role of sedatives, narcotics, miscellaneous anesthetics, and neuromuscular blockers in providing a more comfortable experience for the patient during nonemergent tracheal intubation. However, the most effective combination and doses of these medications is currently unknown. This review discusses the findings of selected studies that have been used to improve the intubating experience of patient and clinician.
FRIENDLY VISITING: CONSIDERATIONS AND RESOURCES

It has been said that “as blood is to life, communication is to living.” A familiar, long‐standing communication avenue for older persons is the friendly visit. What do we know about friendship in old age? What is the history of friendly visiting? Who are those who offer friendly visits that are satisfying to the participants? How can one learn to be an effective friendly visitor? Included here are reviews of selected research and how‐to publications of substance pertinent to informal interactions with people who are in their later years. It is hoped that reader awareness will be heightened relative to the depth, complexity, and value of friendly visits and to training considerations that have potential to enhance that effort.