cssi/SciSciGPT-SciSciNet huggingface dataset:
Rare‐event analysis methods for detection of fetal red blood cells in maternal blood

Methods for analyzing very small subpopulations of cells ("rare-event analysis methods") are of interest in many areas of biology. In this paper we demonstrate the ability to detect one Rh-positive erythrocyte per 100,000 Rh-negative erythrocytes. This is the level needed to detect human fetal red blood cells in the maternal circulation in the case of fetal-maternal Rh-incompatibility. Erythrocytes stained with fluorescent immunobeads are more than 100 times as bright as the same cells stained by indirect immunofluorescence (or almost 40 times as bright as cells stained by the biotin-avidin technique). More importantly there is greater than a sevenfold increase in signal-to-noise (S/N) ratio, which proves critical in detecting very low frequency ("rare event") cell subpopulations. Although equal mixtures of positive and negative cells can easily be detected, positives cannot be easily distinguished from negatives when they are present in relative frequencies of 1:1000 or less as measured by either indirect immunofluorescence or biotin-fluorescent avidin labeling of D antigens. However, use of fluorescent immunobeads and high-speed flow cytometry allows detection of subpopulations of the same cells at relative frequencies of less than 1:100,000. Based on calibrations using free-fluorescent immunobeads, the average Rh-positive cell (when present in a relative frequency of 1:100,000) labeled with 36 +/- 19 fluorescent immunobeads. Rh-positive cells of relative frequencies 1:10,000 and 1:100,000 can be detected above background (Rh-negative red blood cells treated with the same amount of fluorescent immunobeads). Using defined mixtures of Rh-positive and negative cells, the expected numbers of positive cells were observed over a range of 1:100 to 1:100,000 relative Rh-positive cell frequencies. These methods should prove of general use in applications where original frequency information about rare cell subpopulations is important and would be lost if enrichment procedures were to be used.
Production of hydrogen by steam reforming of glycerin over alumina-supported metal catalysts

Abstract Use of biodiesel and its production are expected to grow steadily in the future. With the increase in production of biodiesel, there would be a glut of glycerin in the world market. Glycerin is a potential feedstock for hydrogen production because one mol of glycerin can produce up to four mols of hydrogen. However, less attention has been given for the production of hydrogen from glycerin. The objective of this study is to develop, test and characterize promising catalysts for hydrogen generation from steam reforming of glycerin. Fourteen catalysts were prepared on ceramic foam monoliths (92% Al2O3, and 8% SiO2) by the incipient wetness technique. This paper discusses the effect of these catalysts on hydrogen selectivity and glycerin conversion in temperatures ranging from 600 to 900 °C. The effect of glycerin to water ratio, metal loading, and the feed flow rate (space velocity) was analyzed for the two best performing catalysts. Under the reaction conditions investigated in this study, Ni/Al2O3 and Rh/CeO2/Al2O3 were found as the best performing catalysts in terms of hydrogen selectivity and glycerin conversion. It was found that with the increase in water to glycerin molar ratio, hydrogen selectivity and glycerin conversion increased. About 80% of hydrogen selectivity was obtained with Ni/Al2O3, whereas the selectivity was 71% with Rh/CeO2/Al2O3 at 9:1 water to glycerin molar ratio, 900 °C temperature, and 0.15 ml/min feed flow rate (15300 GHSV). Although increase in metal loading increased glycerin conversion for both catalysts, hydrogen selectivity remained relatively unaffected. At 3.5 wt% of metal loading, the glycerin conversion was about 94% in both the catalysts.
Modeling Equatorial Annual Cycle with a Linear Coupled Model

Abstract A simple linear coupled ocean–atmosphere model is used to study the equatorial annual cycle. The ocean is a stab mixed-layer model and the atmosphere is the Lindzen–Nigam model. The model is shown to capture most features of the observed equatorial annual cycle. A significant part of the tropical annual cycle is found to be generated by the extratropical annual variability that propagates toward the equator through a coupled ocean–atmosphere wave. The back-pressure effect in the atmosphere model can contribute to several important aspects of the variability, especially in the vicinity of the equator. Comparison with other mechanisms for the equatorial annual cycle is also discussed.
RYR3 gene polymorphisms and cardiovascular disease outcomes in the context of antihypertensive treatment.

Nearly one-third of adults in the United States have hypertension, which is associated with increased cardiovascular disease (CVD) morbidity and mortality. The goal of antihypertensive pharmacogenetic research is to enhance understanding of drug response based on the interaction of individual genetic architecture and antihypertensive therapy to improve blood pressure control and ultimately prevent CVD outcomes. In the context of the Genetics of Hypertension Associated Treatment study and using a case-only design, we examined whether single-nucleotide polymorphisms in RYR3 interact with four classes of antihypertensive drugs, particularly the calcium channel blocker amlodipine versus other classes, to modify the risk of coronary heart disease (CHD; fatal CHD and non-fatal myocardial infarction combined) and heart failure (HF) in high-risk hypertensive individuals. RYR3 mediates the mobilization of stored Ca+2 in cardiac and skeletal muscle to initiate muscle contraction. There was suggestive evidence of pharmacogenetic effects on HF, the strongest of which was for rs877087, with the smallest P-value=0.0005 for the codominant model when comparing amlodipine versus all other treatments. There were no pharmacogenetic effects observed for CHD. The findings reported here for the case-only analysis of the antihypertensive pharmacogenetic effect of RYR3 among 3058 CHD cases and 1940 HF cases show that a hypertensive patient's genetic profile may help predict which medication(s) might better lower CVD risk.
Tetracaine blocks the responses of isolated acinar cells from rat parotid to carbachol but not to substance P.

Abstract Carbachol and substance P stimulated 45Ca2+ flux changes, 86Rb+ efflux, and amylase secretion from acinar cells isolated fromrat parotid. The local anesthetic tetracaine blocked all of these measured responsed to carbachol, but none of the responses to substance P. Tetracaine must act at either the cholinergic receptor or at a subsequent transducing step in the cholinergic stimulus-response sequence. If tetracaine acts at one of the transducing steps between cholinergic receptor occupation and the physiological responses then the action of tetracaine must be at a locus in the cholinergic reaction scheme not shared by substance P, because tetracaine did not block any response of the parotid to substance P.
Cytochrome P450 forms in fish: Catalytic, immunological and sequence similarities

1. Hepatic microsomal enzymes from teleost and elasmobranch fishes catalyse a diversity of monooxygenase reactions, consistent with the presence of multiple, distinct P450 forms. Protein purification and immunological studies have confirmed that multiple microsomal P450s occur in teleosts.2. A member of the aromatic hydrocarbon-inducible P450 IA family is present in all fish species examined to date. This protein appears to be most closely related to P450 IA1. Certain of the immunological probes for a teleost P450 IA1 (scup P450E) appear to be reagent antibodies, recognizing the homologous protein in members of all vertebrate groups examined. The nature of the epitope recognized by such antibodies is not known.3. Based on immunological and amino acid sequence comparisons, teleost P450 IA1 appears to be orthologous to both P450 IA1 and P450 IA2 in mammals. Multiple P450 IA genes may appear in teleosts, but divergence on separate lines from that involving mammalian P450 IA2 could include additional, new mem...
Obesity and sex steroid changes across puberty: evidence for marked hyperandrogenemia in pre- and early pubertal obese girls.

Context: Peripubertal obesity is associated with abnormal sex steroid concentrations, but the timing of onset and degree of these abnormalities remain unclear. Objective: The objective of the study was to assess the degree of hyperandrogenemia across puberty in obese girls and assess overnight sex steroid changes in Tanner stage 1–3 girls. Design: This was a cross-sectional analysis. Setting: The study was conducted at general clinical research centers. Subjects: Thirty normal-weight (body mass index for age < 85%) and 74 obese (body mass index for age ≥ 95%) peripubertal girls. Intervention: Blood samples (circa 0500–0700 h) were taken while fasting. Samples from the preceding evening (circa 2300 h) were obtained in 23 Tanner 1–3 girls. Main Outcome Measures: Hormone concentrations stratified by Tanner stage were measured. Results: Compared with normal-weight girls, mean free testosterone (T) was elevated 2- to 9-fold across puberty in obese girls, whereas fasting insulin was 3-fold elevated in obese Tan...
Identification of individuals with CKD from Medicare claims data: a validation study.

Background: Medicare claims data might provide an efficient source for outcomes research in patients with chronic kidney disease (CKD). However, in the absence of laboratory data, one would need to identify patients with CKD from diagnosis codes associated with health care claims. The validity of this approach to identify patients with CKD has not been sufficiently studied. Methods: From chart abstraction, we obtained the first serum creatinine measurement of 1,852 elderly Medicare beneficiaries upon hospitalization for myocardial infarction and estimated each patient's glomerular filtration rate. We then searched all Medicare claims of the preceding year for the presence of a diagnosis code for diabetic nephropathy, hypertensive nephropathy, chronic renal insufficiency, acute renal failure, and miscellaneous other renal diseases. Using the gold standard of an estimated glomerular filtration rate less than 60 mL/min/1.73 m 2 ( 2 ) for definition of CKD, we calculated the sensitivity, specificity, and positive and negative predictive values for each of these diagnoses and combinations of these diagnoses. Results: The sensitivity of individual diagnosis algorithms ranged from 2.7% for diabetic nephropathy to 17.5% for miscellaneous. However, miscellaneous had a lower specificity (95.5%) than all other individual diagnosis algorithms (all ≥99%). Using combinations of these algorithms improved sensitivity up to 26.6%, but at the cost of lower specificity. Positive predictive values generally were high (85.7% to 97.5%), but negative predictive values were low (32.4% to 37.4%). Conclusion: High positive predictive values indicate that Medicare claims data can be used to accurately identify patients with CKD for study. However, the utility of such databases for comparison of patients with CKD versus lesser degrees of CKD is limited.
Laser-heated high-temperature EPR spectroscopy

A CO2 laser‐heated sample holder for an EPR spectrometer capable of temperatures above 1200°C is described. Since only the sample is heated, this system permits rapid temperature changes and rotation of the magnet around the sample. The spectra of MgO containing Fe3+ and Cr3+ at room temperature and 1200°C are presented.
Conformational variability in structures of the nitrogenase iron proteins from Azotobacter vinelandii and Clostridium pasteurianum.

The nitrogenase iron (Fe) protein performs multiple functions during biological nitrogen fixation, including mediating the mechanistically essential coupling between ATP hydrolysis and electron transfer to the nitrogenase molybdenum iron (MoFe) protein during substrate reduction, and participating in the biosynthesis and insertion of the FeMo-cofactor into the MoFe-protein. To establish a structural framework for addressing the diverse functions of Fe-protein, crystal structures of the Fe-proteins from Azotobacter vinelandii and Clostridium pasteurianum have been determined at resolutions of 2.2 A and 1.93 A, respectively. These two Fe-proteins are among the more diverse in terms of amino acid sequence and biochemical properties. As described initially for the A. vinelandii Fe-protein in a different crystal form at 2.9 A resolution, each subunit of the dimeric Fe-protein adopts a polypeptide fold related to other mononucleotide-binding proteins such as G-proteins, with the two subunits bridged by a 4Fe:4S cluster. The overall similarities in the subunit fold and dimer arrangement observed in the structures of the A. vinelandii and C. pasteurianum Fe-proteins indicate that they are representative of the conformation of free Fe-protein that is not in complex with nucleotide or the MoFe-protein. Residues in the cluster and nucleotide-binding sites are linked by a network of conserved hydrogen bonds, salt-bridges and water molecules that may conformationally couple these regions. Significant variability is observed in localized regions, especially near the 4Fe:4S cluster and the MoFe-protein binding surface, that change conformation upon formation of the ADP•AlF_4−stabilized complex with the MoFe-protein. A core of 140 conserved residues is identified in an alignment of 59 Fe-protein sequences that may be useful for the identification of homologous proteins with functions comparable to that of Fe-protein in non-nitrogen fixing systems.
A new approach to null space-based noise signal generation for secure wireless communications in transmit-receive diversity systems

An effective method was recently proposed to increase secrecy capacity in MIMO wireless communication systems. By adding artificially generated noise signal into the information-bearing signal, this method can degrade the eavesdropper's receiving signal, but does not affect the desired receiver. This method, however, can only be used in systems where the transmit antenna has more elements than the receive antenna. In this paper, we present a novel noise signal generation approach to enable secure wireless communications in a transmit-receive diversity system. In this approach, we generate our jamming noise signal based on the null space of an equivalent channel of the system. The presented wireless security mechanism can be applied to systems with arbitrary antenna configurations, unlike existing methods that only work for specific array configurations. In addition, the eavesdropper cannot increase its information detection capability by employing more antenna elements. With this scheme, we also enable more degrees of freedom for selecting parameters for jamming noise signal generation, making the decoding at the eavesdropper even harder due to the increased search space. We performed Monte Carlo simulations to evaluate the proposed method in an urban macro cellular environment using the 3rd Generation Partnership Project (3GPP) spatial channel model. Our simulation results show that the proposed approach can significantly increase secrecy capacity, which is independent of the eavesdropper's position and the element number of its antenna.
Teaching Electroconvulsive Therapy to Medical Students: Effects of Instructional Method on Knowledge and Attitudes

Objective To compare the effects of learning about electroconvulsive therapy (ECT) via live observation to learning via an instructional videotape.
Special issues when caring for the older person with acute coronary syndromes.

Persons 75 years of age or older constitute 6% of the US population but account for more than one third of those with acute coronary syndromes (ACS). Unfortunately, most randomized clinical trials have enrolled few older persons, and, as a result, few data are available to guide clinical practice. As in younger patients, aspirin, β-blockers, nitrates, clopidogrel, heparin, statins, and angiotensin-converting enzyme inhibitors are useful, beginning with lower doses and carefully observing the patient for symptoms of toxicity. Similarly, older patients should not be denied the benefit of reperfusion therapy and early invasive strategy because of their age. Although primary angioplasty is an optimal reperfusion strategy, thrombolytic therapy is a beneficial alternative in carefully selected older patients. Although glycoprotein IIb/IIIa inhibitors appear to be beneficial in select cases, bleeding concerns exist. Despite a growing body of evidence in support of aggressive ACS care in older persons, evidence-based therapy is underused in older patients. Continued efforts are required to improve the quality of care to this high-risk cohort of ACS patients.
Measurement of Electrical Conductivity in the Wake Neck

O of the re-entry observables is the radar return from the weakly ionized wake." The flow in the wake neck forms the initial conditions for the observable wake. In the various theories for scattering of electromagnetic waves by the wake there are parameters, e.g., average ne or correlation length, that must be supplied as inputs. By proper choice of the parameters, one can make the theoretical cross section match observed values. Without direct measurement of the wake characteristics it is difficult to assess the various prediction schemes and select the best, or even an adequate, model. This Note discusses the feasibility of using a boom extending from the base of the vehicle for placement of an rf conductivity bridge within the wake neck. Double interpolation of the calculations presented by Huber were used to obtain graphs of electron density ne in thermal equilibrium vs dimensionless static enthalpy h/RTQ for various pressure ratios P/PQ. The value of TO is 273° K, and p0 is 1 atm. Similar graphs for electric conductivity were calculated using
Identification of genetic populations of the Pacific blue shrimp Penaeus stylirostris of the Gulf of California, Mexico

Species are often composed of discrete breeding units (i.e. populations or stocks) which, while not reproductively isolated from other such groups, may have limited opportunities to exchange genetic material because of geographic distance, barriers to migration, or spawning asynchrony. Low levels of gene flow between stocks may result, over time, in their genetic divergence, and species that are subdivided into morphologic or genetically distinct stocks are said to be structured. The aim of our investigation was to test whether or not Penaeus stylirostris from the Gulf of California (Mexico) was structured into genetically distinct populations. Shrimp samples were collected in 1996 from six regions of the Gulf where specimens with distinct morphologic characteristics had previously been identified. Statistical analysis of 324 RAPD loci (randomly amplified polymorphic DNA), resolved through polyacrylamide gels and scored for each of 78 specimens, permitted the quantification and comparison of between-stock genetic differences. The finding that genetically discrete stocks of P. stylirostris can be found in a small portion of the geographic distribution range of the species, disagrees with the long-held perception that this resource is panmictic in nature. This new evidence is not only of interest for selective breeding programs in the shrimp aquaculture industry, but is also relevant to the management of the Mexican shrimp fishery which, at present, is perceived and managed as a single stock.
SHOCK COMPRESSION OF A PERFECT GAS

The compression of a perfect gas between a uniformaly moving piston and a rigid wall is discussed in the one-dimensional case. If the piston moves with a finite speed, it will initiate a shock in the gas which will reflect successively from rigid wall and piston and cause the compression process to deviate from a reversible adiabatic process. Expressions are derived for the relative changes in pressure and density at each shock reflection. Then values of density and pressure after any number of shock reflections are computed relative to their initial values, and, in terms of these, the corresponding values of temperature and entropy, as well as shock speeds, are determined. The limiting value of the entropy change, as the number of reflections goes to infinity, is obtained as a function of the ratio of specific heats of the gas and the strength of the initial shock. Hence it is possible to estimate an upper limit to the deviation of the shock compression process from a reversible adiabatic process. Some illustrative numerical examples are given.
Decentralized nondeterministic supervisory control of discrete event systems

This paper studies the decentralized supervisory problem using nondeterministic supervisors. Nondeterministic supervisory control under partial observation was proposed by Kumar et al. (June 2004) by allowing nondeterminism in control policies, which lead to the existence condition of achievability that is weaker than controllability and observability combined and is algebraically better behaved. In this paper, we extend nondeterministic control to the decentralized setting. Using the simple conjunctive rule of decision fusion, we present a definition of co-achievability to characterize the languages which can be achieved through decentralized nondeterministic supervisors. Co-achievability is weaker than controllability and co-observability combined. Other properties of co-achievable languages are presented, and the relationship between achievability and co-achievability is established. We derive necessary and sufficient conditions for target and range control problems. The existence conditions are polynomially verifiable, and also local supervisors can be polynomially synthesized.
Arterial intima-media thickness: site-specific associations with HRT and habitual exercise.

We determined the site-specific relations of hormone replacement therapy (HRT) and habitual exercise status with intima-media thickness (IMT) in both elastic (carotid) and muscular (femoral) arteri...
Defending climate science

The National Center for Science Education (NCSE), which has long been in the lead in defending the teaching of evolution in public schools, has expanded its core mission to include defending climate science, the organization announced in January. “We consider climate change a critical issue in our own mission to protect the integrity of science education,” said NSCE executive director Eugenie Scott. “Climate affects everyone, and the decisions we make today will affect generations to come. We need to teach kids now about the realities of global warming and climate change so that they're prepared to make informed, intelligent decisions in the future.”
A particle model of coronal heating via recombination

Abstract We model coronal heating via recombination using a “Particle-MHD” model. In the model we follow the trajectories of particles in self-consistent fields under the influence of the Maxwell streesses and pressure gradients. Fluid properties are derived from the moments of the ion particle distributions. For the recombination process, the electron velocity moments determined from the model are compared against ion velocities. We observe that as ions recombine and exit the plasma, the remaining ions can tap greater energy from the fields generated by recombination, and undergo heating. In the described numerical experiments, ions undergoing recombination are introduced to an unperturbed box of ions which were not affected by recombination. It is observed that: (a) recombination serves as a seed in heating the plasma particles; (b) enhanced field fluctuations can cause ion heating in a feedback mechanism; and (c) the longer the elongation of the simulation box, the greater the resulting overall heating of the particles.
Improving oral reading fluency by influencing students' choice of instructional procedures: an experimental analysis with two students with behavioral disorders

Choice as an antecedent intervention has been shown to improve student behavior in a variety of ways. This investigation examined whether students could be influenced to choose whether and how to be instructed while directly measuring effects on academic performance. Using a multiple-probe design, the reading fluency of two middle school students with Behavioral Disorders was measured repeatedly across passages. Students could earn a tangible reward for meeting a pre-determined performance criterion in passage reading. Prior to reading the criterion passage, each student was told that he or she could choose to be instructed or not be instructed in a similar passage with high content overlap. Both students consistently chose to be instructed (as well as how they would be instructed) and stable increases in oral reading fluency were obtained. Results are discussed in terms of how motivational variables can be used to influence students' choice of instructional procedures in ways that increase their opportunities to respond and measured learning. Copyright © 2006 John Wiley & Sons, Ltd.
Phacoemulsification combined with silicone oil removal through posterior capsulorhexis.

Editor,—We read with interest the report by Frau et al and noted that our recent article in Ophthalmology was not cited as a reference.2 In this article we reported our experience at Moorfields Eye Hospital with 34 eyes prospectively evaluated to look …
Prediction and prevention of Type 1 diabetes mellitus

Type 1A diabetes mellitus (T1DM) is caused by autoimmune islet β-cell destruction with consequent severe insulin deficiency. We can now predict the development of T1DM by determining four biochemically characterized islet autoantibodies, namely those antibodies against insulin, glutamic acid decarboxylase 65, insulinoma antigen (IA)-2 (ICA512) and the zinc transporter ZnT8. We can also prevent T1DM in animal models, but the final goal is the prevention of T1DM in humans. Multiple clinical trials are underway investigating methods to prevent β-cell destruction.
Treatment options for patients with triple-negative breast cancer

Breast cancer is a heterogeneous disease composed of different subtypes, characterized by their different clinicopathological characteristics, prognoses and responses to treatment. In the past decade, significant advances have been made in the treatment of breast cancer sensitive to hormonal treatments, as well as in patients whose malignant cells overexpress or amplify HER2. In contrast, mainly due to the lack of molecular targets, little progress has been made in the treatment of patients with triple-negative breast cancer. Recent improved understanding of the natural history, pathophysiology, and molecular features of triple-negative breast cancers have provided new insights into management and therapeutic strategies for women affected with this entity. Ongoing and planned translational clinical trials are likely to optimize and improve treatment of women with this disease.
Exogenous Application of Glycinebetaine Increases Chilling Tolerance in Tomato Plants

Tomato (Lycopersicon esculentum Mill. cv. Moneymaker) plants are chilling sensitive, and do not naturally accumulate glycinebetaine (GB), a metabolite that functions as a stress protectant. We reported previously that exogenous GB application enhanced chilling tolerance in tomato. To understand its protective role better, we have further evaluated various parameters associated with improved tolerance. Although its effect was most pronounced in younger plants, this benefit was diminished 1 week after GB application. When administered by foliar spray, GB was readily taken up and translocated to various organs, with the highest levels being measured in meristematic tissues, including the shoot apices and flower buds. In leaves, the majority of endogenous GB was found in the cytosol; only 0.6-22.0% of the total leaf GB was localized in chloroplasts. Immediately after GB application, levels of H(2)O(2), catalase activity and expression of the catalase gene (CAT1) were all higher in GB-treated than in control plants. One day after exposure to chilling stress, the treated plants had significantly greater catalase activity and CAT1 expression, although their H(2)O(2) levels remained unchanged. During the following 2 d of this chilling treatment, GB-treated plants maintained lower H(2)O(2) levels but had higher catalase activity than the controls. These results suggest that, in addition to protecting macromolecules and membranes directly, GB-enhanced chilling tolerance may involve the induction of H(2)O(2)-mediated antioxidant mechanisms, e.g. enhanced catalase expression and catalase activity.
Nonlinear maximum likelihood estimation of autoregressive time series

Describes an algorithm for finding the exact, nonlinear, maximum likelihood (ML) estimators for the parameters of an autoregressive time series. The authors demonstrate that the ML normal equations can be written as an interdependent set of cubic and quadratic equations in the AR polynomial coefficients. They present an algorithm that algebraically solves this set of nonlinear equations for low-order problems. For high-order problems, the authors describe iterative algorithms for obtaining a ML solution.
Resistance to European Law and Constitutional Identity in Germany: Herbert Kraus and Solange in its Intellectual Context

This article recasts our understanding of the Federal Constitutional Court's Solange decision by tracing its lineage within the domestic context and as part of a new history of EU law. The external dynamic of the decision, a moment of judicial discourse between two of Europe's highest panels, has been the focus of many studies. Much rarer are attempts to embed the decision within its internal context: the struggle within the German legal academy to accept the primacy of EU law. Central to this contextualisation is the reinvigoration of the ‘structural congruence’ theory of Herbert Kraus, which long shaped the German reception of EU law. This article recounts Kraus' theory, tracing the struggle for the German legal consciousness between three positions: constitutionalists, traditionalists, and the congruence advocates. While Hallstein's constitutionalism is most closely associated with Germany's early Europhilia, even he admitted by 1975 that Kraus had won the day
Computer-aided rehabilitation design

The conventional engineering design process consisting of three phases, synthesis, analysis and evaluation can be extended for solving rehabilitation problems by including a diagnosis phase during which abnormalities and malfunctions are identified and characterized. After diagnosis, the design objectives are clearly specified and the conventional engineering design process can begin. Different problem solving strategies, information representation, and processing are useful for the different phases of rehabilitation design. This paper describes the RETAIN knowledge-based rehabilitation design system which integrates a relational database, production rules and algorithmic functions. RETAIN diagnoses retaining wall failures and synthesizes preliminary rehabilitation designs and cost estimates. Its framework and methodology may be applied to other infrastructure components such as pavements, water and sewage networks, bridge piers and marine structures. RETAIN decomposes rehabilitation problems into influencing failure modes then identifies a set of rehabilitation strategies such that each strategy remedies one or more failure modes. Complete rehabilitation solutions are formed by searching and combining strategy components. Conceptual knowledge for design synthesis is organized in relational database tables. The paper includes an example of design synthesis with relational operations for selecting rehabilitation strategies and forming complete rehabilitation solutions.
Economic analysis of infant vs postpubertal orchiopexy to prevent testicular cancer.

Objectives To use decision analysis to determine the economic benefits of early vs late orchiopexy, specifically with respect to testicular cancer development and management. Studies have suggested that prepubertal orchiopexy might confer additional protection from the development of testicular cancer compared with postpubertal orchiopexy. Infant surgery is often performed by pediatric subspecialists and hence might be more costly. Although rare, testicular cancer can require significant medical expenditures. Methods We examined the resource index (RI) (physician charges and hospital costs) from the medical establishment's perspective. Economic modeling was performed to determine whether early or late orchiopexy minimized the RI. The stage- and histologic-specific costs of subsequent testicular cancer were incorporated into our models. The variables were tested over realistic ranges in the sensitivity analysis to determine the threshold values. Results In the base case analysis, the RI for infant and postpubertal orchiopexy was $7500 and $10 928 per patient, respectively. The sensitivity analysis demonstrated that the costs for operating room time, physicians' fees, operative times, and baseline cancer risk were important parameters. However, only the surgeons' fees demonstrated threshold values. The RI for treating cancer and the cancer risk reduction after early orchiopexy did not significantly affect our models. Conclusions Our models of orchiopexy for prevention of testicular cancer showed that infant orchiopexy is less costly than later surgery, provided that the surgeons' fees are not excessive. It appears that early surgery might significantly reduce the treatment costs of testicular cancer for cryptorchid boys and supports the current standard of care in the United States.
Autosomal Dominant Cerulean Cataract Is Associated with a Chain Termination Mutation in the Human β-Crystallin Gene CRYBB2

Congenital cataracts are a common major abnormality of the eye that frequently cause blindness in infants. At least a third of all cases are familial; autosomal dominant congenital cataract (ADCC) appears to be the most common familial form in the Western world. Cerulean cataracts have peripheral bluish and white opacifications in concentric layers with occasional central lesions arranged radially. Although the opacities may be observed during fetal development and childhood, usually visual acuity is only mildly reduced until adulthood, when lens extraction is generally necessary. We have been studying a family (ADCC-1) with cerulean blue ADCC, in which the affected daughter of a first cousin mating was presumed to be homozygous for the cataract gene. Recently, we mapped an ADCC gene in this family to a region of chromosome 22 containing three beta-crystallin genes. Here we report that a chain-termination mutation in CRYBB2 is associated with ADCC in this family.
Use of Linezolid, an Oxazolidinone, in the Treatment of Multidrug-Resistant Gram-Positive Bacterial Infections

We report our experience with linezolid in an investigation of its use against resistant grampositive bacterial infections. Fifteen patients who had renal failure ( ), recent liver transn= 6 plantation ( ) or surgery ( ), cancer ( ), endocarditis ( ), or human imn= 5 n= 6 n= 3 n= 2 munodeficiency virus infection ( ), along with infections due to vancomycin-resistant n= 1 enterococcus (VRE), and 2 patients with infections due to methicillin-resistant Staphylococcus species who had adverse reactions to vancomycin were treated with linezolid (600 mg every 12 h for 5‐42 days ( , days). Abscess drainage or prosthetic device remean 5 SD 20.5 5 3.5 moval was undertaken. Microbiological cure occurred in all 10 patients who completed therapy, and all 7 patients alive at follow-up were free of infection. No deaths were attributable to the index infection. Adverse events associated with linezolid use were mild leukopenia in 1 patient and nausea in another. It appears that administration of linezolid, in conjunction with surgical intervention or device removal, is an effective treatment option for serious resistant gram-positive bacterial infections. The incidence of nosocomially acquired gram-positive bacterial infections has dramatically increased since the early 1980s. Between 1980 and 1989, the incidence of bacteremia due to coagulase-negative Staphylococcus species increased 754%, that due to Staphylococcus aureus increased 176%, and that due to enterococci increased 124% [1]. These 3 pathogens are now the most common nosocomially acquired causes of bloodstream infections [2, 3]. Unfortunately, antimicrobial resistance among nosocomially acquired gram-positive organisms is also rising. For instance, it is estimated that 79% and 25% of all nosocomially acquired coagulase-negative Staphylococcus species and S. aureus, respectively, are methicillin-resistant [3]. VRE, which now accounts for up to 47% of all Enterococcus faecium isolates, is of particular concern because of its increasing prevalence among severely ill patients [3‐5], including orthotopic liver transplant (OLT) recipients. Because of the extensive abdominal surgery, selective pressures of perioperative broad-spectrum antibiotics, high-dose immunosuppressive therapy, and prolonged postoperative stay in the intensive care unit, OLT recipients are at
Using qualitative and quantitative formative research to develop tailored nutrition intervention materials for a diverse low-income audience

More effective nutrition education to reach low-income and ethnic minority populations is needed. As part of a project to develop a tailored nutrition education intervention to meet the needs of low-income Hispanics and non-Hispanics, complementary, mixed methods of formative research were used to determine specific characteristics of the target population. The aim was to ensure that the full array of nutrition messages would be comprehensive enough to effectively tailor to the level of the individual. Barriers to healthy eating were delineated for three main dietary behaviors (numberofitems delineated in parentheses): lowering fat (11), increasing fruit (8) and increasing vegetables (6). Information was also collected regarding motivators for healthy eating (5), situational barriers to making healthy choices (4), other nutrition-related interests (8) and typical eating habits and food-related choices of the target audience.
Reliability and Validity of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in Older Men

Sleep complaints and sleep-disordered breathing (SDB) are common in older adults. Over half of elders report some difficulty falling or staying asleep, early waking, requiring a nap, or nonrestorative sleep (1). Estimates of SDB prevalence range as high as 62% in community-dwelling elders (2). The elevated prevalence of sleep disturbance in older adults is particularly troubling in light of studies linking poor sleep to adverse outcomes in this population, including cognitive (3,4) and functional impairment (1). Given the prevalence of sleep disturbance among elders and evidence for adverse consequences of poor sleep, reliable and valid measures are needed to maximize the rigor of late-life sleep assessment. Questionnaires commonly used to quantify sleep disturbance and its consequences include the Pittsburgh Sleep Quality Index (PSQI (5)) for sleep quality and the Epworth Sleepiness Scale (ESS (6)) for daytime sleepiness. The original PSQI validation was performed with mixed-age healthy controls, individuals with major depression, and sleep clinic patients (5). Additional research supports the reliability and validity of the PSQI in various populations, including patients with cancer and other medical conditions (7). The ESS was first shown to be reliable in medical students and patients with a range of sleep disorders (8); its validity was initially demonstrated in patients with sleep disorders and controls (6). We know little, however, about the reliability and validity of the PSQI and ESS in the general population of older adults. We recently studied the internal consistency reliability and construct validity of the PSQI and ESS in older women in the Study of Osteoporotic Fractures (SOF (9)). Total scores for both measures had good internal consistency, but multiple PSQI items and two subscales had low correlations with the total score (9). Advancement of knowledge regarding late-life sleep quality and daytime sleepiness also requires validation of these measures in older men. We evaluated the internal consistency reliability and construct validity of the PSQI and the ESS in a cohort of older men. We hypothesized that greater disturbance on the questionnaires would be associated with (a) poorer objective sleep as measured by greater objectively measured sleep fragmentation and daytime napping; (b) more depressive symptoms, greater mobility/instrumental activity of daily living (IADL) difficulty, and lower health-related quality of life; and (c) the presence of self-reported sleep disorders.
Understanding the vascular environment of myofascial trigger points using ultrasonic imaging and computational modeling

Myofascial pain syndrome (MPS) is a common, yet poorly understood, acute and chronic pain condition. MPS is characterized by local and referred pain associated with hyperirritable nodules known as myofascial trigger points (MTrPs) that are stiff, localized spots of exquisite tenderness in a palpable taut band of skeletal muscle. Recently, our research group has developed new ultrasound imaging methods to visualize and characterize MTrPs and their surrounding soft tissue. The goal of this paper was to quantitatively analyze Doppler velocity waveforms in blood vessels in the neighborhood of MTrPs to characterize their vascular environment. A lumped parameter compartment model was then used to understand the physiological origin of the flow velocity waveforms. 16 patients with acute neck pain were recruited for the study and the blood vessels in the upper trapezius muscle in the neighborhood of palpable MTrPs were imaged using Doppler ultrasound. Preliminary findings show that symptomatic MTrPs have significantly higher peak systolic velocities and negative diastolic velocities compared to latent MTrPs and normal muscle sites. Using compartment modeling, we show that a constricted vascular bed and an enlarged vascular volume could explain the observed flow waveforms with retrograde diastolic flow.
Measurement of the impact of risk adjustment for central line-days on interpretation of central line-associated bloodstream infection rates.

Objective. To describe methods to assess the practical impact of risk adjustment for central line-days on the interpretation of central line–associated bloodstream infection (BSI) rates, because collecting these data is often burdensome. Methods. We analyzed data from 247 hospitals that reported to the adult and pediatric intensive care unit component of the National Nosocomial Infections Surveillance System from 1995 through 2003. For each unit each year, we calculated the percentile error as the absolute value of the difference between the percentile based on a risk-adjusted or more-sophisticated measure (eg, the central line–day rate) and the percentile based on a crude or less-sophisticated measure (eg, the patient-day rate). Using rate per central line–day as the “gold standard,” we calculated performance characteristics (eg, sensitivity and predictive values) of rate per patient-day for finding central line–associated BSI rates higher or lower than the mean. Greater impact of risk adjustment is indicated by higher values for percentile error and lower values for performance characteristics. Results. The median percentile error was ± 7 (ie, the percentile based on central line-days could be 7% higher or lower than the percentile based on patient-days). This error was less than 10 percentile points for 62% of the unit-years, was between 10 and 19 percentile points for 22% of the unit-years, and was 20 percentile points or more for 15% of the unit-years. Use of the rate based on patient-days had a sensitivity of 76% and a positive predictive value of 61% for detecting a significantly high or low central line–associated BSI rate. Conclusions. We found that risk adjustment for central line–days has an important impact on the calculated central line–associated BSI percentile for some units. Similar methods can be used to evaluate the impact of other risk adjustment methods. Our results support current recommendations to use central line–days for surveillance of central line–associated BSI when comparisons are made among facilities.
Exploring the dynamic nature of "us": An integrative approach to relationship cognition

Most psychiatric disorders are associated with problems in interpersonal relationships. This is not surprising because people's relationships with others are an influential and integral component of their lives. The cognitive representations of these relationships can be important in understanding these relationships, and both the attachment and relational schema approaches have helped to better understand the nature of these cognitions. The attachment approach is widely researched and established, but it struggles to fully assess the content of relationship knowledge. The relational schema approach provides a strong framework for assessing the content of relationship knowledge, but it does not currently have established measures for this content. In this article, the authors suggest that these two approaches may be particularly suited for integration, and they propose a comprehensive model of relationship cognition. Issues involving the measurement of relational knowledge and future research directions are discussed. Finally, the clinical utility of the proposed model is discussed.
Response to Dr. Palma's letter to the editor.

All of the patients included in our study were diagnosed with primary dysautonomia. In other words, no patient was found to have a known primary cause of autonomic dysfunction (i.e. diabetes or neuropathy), autoimmune etiology, or alpha synucleinopathy. We made specific mention of excluding patients with Parkinson’s disease or multiple sclerosis as voiding dysfunction with these diseases is established, well described and not necessarily the result of a secondary dysautonomia.
Unconscious Emotional Memories and the Right Hemisphere

The problem of the possible relationships between hemispheric asymmetries and aspects of the psychoanalytic model of mind has been repeatedly raised during the past century. In a rather arbitrary manner, we could even say that this problem has passed through three distinct stages. In the first stage (roughly covering the first part of the twentieth century), psychoanalytically oriented authors, although acknowledging that some clinical phenomena could suggest a special link between aspects of psychoanalytical theory and the right hemisphere, substantially rejected the specificity of these relationships. In the second period, influenced by the influential work on split-brain patients of Sperry and co-workers [1], the interest that the right hemisphere could have for psychoanalysis has been explicitly acknowledged, but this has been made focusing attention more on cognitive than on emotional features and mapping onto the right and left hemispheres, in a rather global manner, two main constructs of the psychoanalytical theory, namely those of primary and secondary process [2, 3]. Finally, in the most recent period, Kandell’s paper [4], stressing the need for an intimate relationship between psychoanalysis and cognitive neuroscience, has suggested a new way of investigating the links between hemispheric asymmetries and the psychoanalytic model of mind.