cssi/SciSciGPT-SciSciNet huggingface dataset:
A Multivariate Hidden Semi-Markov Model of Customer-Multichannel Engagement

In multichannel retailing, customers often use a mix of a firm’s online and physical stores for their search and buy activities. We define the customer’s “channel engagement” as a latent attitude or predisposition towards the firm’s online and offline channels which dynamically transitions between states of “high” and “low”. We propose that when in a “high” engagement state with a channel, a customer is likely to visit and purchase from that channel. Using customer level data on web visits, online and in-store purchases from a multichannel firm, we simultaneously model the customer’s online and offline channel engagement in a discrete time multivariate hidden semi-Markovian framework. An important implication of the semi-Markovian framework is that we can explicitly model the latent engagement state duration using any distribution. We examine the distributional properties of the state duration by comparing between Poisson and geometric processes under alternative state transition specifications. We find that the proposed Poisson duration model predicts the online visits and purchases better than the geometric, with slight over-prediction of offline purchases. The model’s ability to explicitly infer the state duration can assist marketers to target customers with channel specific interventions and to mitigate attrition risk.
Maximum Number of Almost Similar Triangles in the Plane

A triangle $T'$ is $\varepsilon$-similar to another triangle $T$ if their angles pairwise differ by at most $\varepsilon$. Given a triangle $T$, $\varepsilon>0$ and $n\in\mathbb{N}$, B\'ar\'any and F\"uredi asked to determine the maximum number of triangles $h(n,T,\varepsilon)$ being $\varepsilon$-similar to $T$ in a planar point set of size $n$. We show that for almost all triangles $T$ there exists $\varepsilon=\varepsilon(T)>0$ such that $h(n,T,\varepsilon)=n^3/24 (1+o(1))$. Exploring connections to hypergraph Tur\'an problems, we use flag algebras and stability techniques for the proof.
The Communist manifesto, 150 years later

The Communist manifesto does not have much to say about the pre-capitalist societies most archaeologists deal with, and still less about the primitive societies that interest most prehistorians. (Nothing from the Manifesto makes its way, for example, into the useful compendium brought together by Godelier (1973).) Much of what Marx and Engels had to say directly about antiquity consists of unpublished sketches and passing references, and even the systematic treatment of The origins of the family, private property and the state (1884) must be considered provisional: the changes that reading Morgan (1877) had on the discussions of the Formen (1857–58) and the Anti-Duhring (1878) can only suggest that the accumulation of positive evidence in the course of a century and a half of archaeological research would have caused Marx and Engels to revise substantially every one of their specific claims.
The ers standards for program evaluation: Guidance for a fledging profession

Abstract THE ERS Standards, together with those of the Joint Committee, symbolize a commitment to the professionalization of evaluation. The two sets of standards, however, differ on at least five important dimensions: the perceived linearity of evaluation activities; preferred and permitted approaches (with one set heavily favoring quantitative/experimental approaches over any others); the purposes of evaluation; obligations to clients and stakeholders; and whether or not social science can be value-free (objective). Because these fundamental assumptions are so divergent, the possibility of combining or effecting a compromise between the two sets appears unlikely at this time.
A Language Framework for Multi-Object Coordination

We have developed language support for the expression of multi-object coordination. In our language, coordination patterns can be specified abstractly, independent of the protocols needed to implement them. Coordination patterns are expressed in the form of constraints that restrict invocation of a group of objects. Constraints are defined in terms of the interface of the objects being invoked rather than their internal representation. Invocation constraints enforce properties, such as temporal ordering and atomicity, that hold when invoking objects in a group. A constraint can permanently control access to a group of objects, thereby expressing an inherent access restriction associated with the group. Furthermore, a constraint can temporarily enforce access restrictions during the activity of individual clients. In that way, constraints can express specialized access schemes required by a group of clients.
Role of the hippocampal-entorhinal loop in temporal lobe epilepsy: extra- and intracellular study in the isolated guinea pig brain in vitro.

This article introduces a new experimental paradigm for the study of temporal lobe epilepsy. This approach utilizes the isolated guinea pig brain in vitro preparation, which generates a pattern of hypersynchronous neuronal activity similar to the peculiar 8–30 Hz rhythm characterizing stereoelectroencephalographic hippocampal recordings in human temporal lobe epilepsy. The present report describes an attempt to identify the functional events underlying the epileptiform activities observed in this preparation. Rhythmic epileptiform discharges (EDs), here defined as population spikes (PSs) recorded from somata or dendritic layers, were induced in the hippocampal formation of the isolated guinea pig brain maintained in vitro by tetanic stimulation of the entorhinal cortex (EC). Two patterns of EDs were distinguished by performing simultaneous field potential recordings along the dentate gyrus (DG), EC, CA1, and CA3. During stage 1, the first self-sustained EDs were isolated PSs occurring at a frequency of 2–3 Hz at all levels of the entorhinal- hippocampal loop, the only exception being the DG, where no signs of synchronized neuronal discharge could be found. Over the next 30–50 sec, the temporal organization of these EDs changed dramatically. During stage 2, at all levels of the entorhinal-hippocampal loop, EDs occurred in 0.3–0.5 sec trains of 16–25 Hz population spikes interrupted by 0.7–1.3 sec silent periods. The transition between stages 1 and 2 coincided with the occurrence of population spikes in the DG. Laminar analyses and multiple simultaneous field potential recordings revealed that the trains of EDs observed in stage 2 resulted from the repetitive, sequential activation of the hippocampal- entorhinal loop. In the transverse axis, the earliest event usually occurred in the CA3 region. Thereafter, population spikes occurred sequentially in the CA1 region, EC, DG, and back to the CA3 region. Intracellular recordings confirmed that the EDs recorded extracellularly resulted from the synchronous activation of the cells in phase with the locally recorded field potentials. Dentate granule cells, layer II entorhinal cells, as well as CA1 pyramids displayed large-amplitude EPSPs crowned by an isolated action potential phase locked to the locally recorded field potential. In contrast, the activity of CA3 pyramids consisted of typical paroxysmal depolarization shifts on which bursts of action potentials of decreasing amplitude were observed. These results suggest that reentrant loop activity in the hippocampal-entorhinal circuit represents the central event in the functional organization of hippocampal epileptic discharges.
CD4 T Cells Specific for a Latency-Associated γ-Herpesvirus Epitope Are Polyfunctional and Cytotoxic

The oncogenic γ-herpesviruses EBV and Kaposi sarcoma-associated herpesvirus are ubiquitous human pathogens that establish lifelong latent infections maintained by intermittent viral reactivation and reinfection. Effector CD4 T cells are critical for control of viral latency and in immune therapies for virus-associated tumors. In this study, we exploited γHV68 infection of mice to enhance our understanding of the CD4 T cell response during γ-herpesvirus infection. Using a consensus prediction approach, we identified 16 new CD4 epitope-specific responses that arise during lytic infection. An additional epitope encoded by the M2 protein induced uniquely latency-associated CD4 T cells, which were not detected at the peak of lytic infection but only during latency and were not induced postinfection with a latency-deficient virus. M2-specific CD4 T cells were selectively cytotoxic, produced multiple antiviral cytokines, and sustained IL-2 production. Identification of latency-associated cytolytic CD4 T cells will aid in dissecting mechanisms of CD4 immune control of γ-herpesvirus latency and the development of therapeutic approaches to control viral reactivation and pathology.
Object pose detection in the presence of background clutter and occlusion

This work explores image processing techniques that involve the application of eigenspace methods for pose detection. An eigenspace method for data compression used in the image processing field is commonly referred to as principal component analysis (PCA). We present some recently introduced eigenspace concepts for detecting the pose angle of an occluded object located in an image containing background clutter. To detect the pose of a target object in the presence of background and occlusions we analyze two eigendecomposition methods. The quadtree structure includes dividing the training images into quadrants and creating a subspace eigendecomposition for each level. A statistical robust approach is also applied that weights the background and occlusion pixels based on their influence on the reconstruction of the desired target object. We review both of these pose detection approaches and illustrate each application with an example.
A Meta-Analysis of Malingering on the MMPI-2:

With the widespread adoption of the MMPI-2 as an assessment tool, psychologists are frequently required to make important decisions regarding the validity of its clinical profiles and a determinati...
Perinatal fluid and electrolyte regulation: Role of arginine vasopressin

Not many years ago, the fetus was perceived to exert little impact on amniotic fluid homeostasis. It is now clear that the fetus plays an integral role in modulating fluid flux between the maternal, fetal, and amniotic fluid compartments. Moreover, fetal AVP secretion and the associated renal and cardiovascular responses represent important aspects of the potential to adapt to changes in the intrauterine environment. Although the physiologic significance of the increased AVP secretion observed in response to labor and delivery remain speculative, AVP regulation also is an essential aspect of neonatal adaptation. Still, many questions remain regarding both the regulation of fetal and neonatal fluid dynamics and the ontogeny of AVP receptor systems.
Photo and thermal reactions of ferrous hydroxide

The reactions of ferrous ion near neutral pH are of interest because of its known presence in the Archaean oceans. We have confirmed the long wavelength ultraviolet photochemical and the thermal reactions of ferrous hydroxide to form hydrogen. We have shown that a claim of the reduction of carbon dioxide to formaldehyde at neutral pH is mistaken. By the use of14C labelled compounds, we have found that less than 1 ppm of carbon dioxide is reduced to formaldehyde and less than 10 ppm of formate ion is so reduced. The thermal reaction to form hydrogen has a small activation energy of 7 kcal mole−1. We conclude that thermal and photochemical formation of hydrogen from ferrous ion in the Archaean ocean could be comparable at pH 8–9. At lower pH, toward its limit at pH 5, the photochemical reaction would predominate. Both the thermal and photochemical reactions are specific for ferrous hydroxide, being far slower for the phosphate (>50- and 7-fold) and the bicarbonate (2- and 30-fold) complexes.
Variation in Compensation Decisions by Managers: An Empirical Investigation

Abstract We used a policy-capturing approach to study 3,104 pay allocation decisions of 97 managers (54 men, 43 women) working for a large nonprofit organization with a pay-for-performance policy. Subordinates' performance, the consistency in subordinates' past job performance, the importance of the subordinates' jobs in meeting managerial goals, and the degree of disruption that would occur if subordinates quit significantly affected managerial pay allocations. A major proportion of the variance across the managers was accounted for by sampling error and criterion unreliability. The subjects' explicit rankings of the four subordinate-related factors did not correspond highly with the rankings of their regression weights.
Extraction of interaction energies from scanning-tunneling- and field-ion-microscopy data.

The extraction of adatom-adatom interaction energies from scanning-tunneling- and field-ion-microscopy images is discussed. For the case of comparing experimental data with a solved model (e.g., Monte Carlo simulations), an expression for the expected precision is derived. It is demonstrated that in the absence of any Monte Carlo calculations the interaction energies can be extracted if measurements are made at more than one temperature. This technique requires a factor of ∼2.6 additional measurements to obtain the interaction energy to the same precision as for a solved model
Intra-arterial papaverine used to treat cerebral vasospasm reduces brain oxygen.

Intra-arterial papaverine (IAP) is used to treat symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH). IAP, however, can increase intracranial pressure (ICP). In this study we examined whether IAP alters brain oxygen (BtO2). Poor clinical grade (Hunt & Hess IV or V) SAH patients who underwent continuous ICP and BtO2 monitoring during IAP infusion for symptomatic cerebral vasospasm were evaluated as part of a prospective observational study. Data are available for five patients (median age 58) who received IAP for cerebral vasospasm 4 to 7 days after SAH. In each patient, angiographic vasospasm was improved on postinfusion angiogram. Mean ICP before IAP was 23.04±1.18 mmHg; it increased immediately after IAP infusion and remained elevated (29.89±1.18 mmHg; p<0.05) during IAP and for approximately 10 minutes after IAP ended. Baseline mean arterial pressure (MAP) was 110.55±1.36 mmHg. During IAP treatment MAP remained stable (110.90±2.00 mmHg; p=0.31). Mean BtO2 before IAP was 32.99±1.45 mmHg. There was a significant BtO2 decrease in all patients during IAP to a mean of 22.96±2.9 mmHg (p<0.05). BtO2 returned to baseline within 10 minutes after IAP ended. There was a modest relationship between the ICP increase and BtO2 decrease (R 2=0.526). IAP infusion to treat cerebral vasospasm following SAH can increase ICP and reduce BtO2. The IAP-induced reduction in BtO2 may help explain why IAP, although it reverses arterial narrowing, does not improve patient outcome.
Influence of sintering temperature on magnetic properties of samarium-cobalt magnets

Sintering of Sm-Co magnets was first reported on in 1969. Because of success in sintering, Sm-Co magnets are now enjoying added importance. Many processing parameters are critical in the preparation of high quality permanent magnets of Sm-Co. One of these is the sintering temperature. Varying the sintering temperature over a narrow range can produce great variations in properties. One particular Sm-Co alloy was chosen for this study. Sintering temperature was varied while all other processing parameters remained constant. Hysteresis measurements were then carried out in a 100 kOe air core magnet using a vibrating sample magnetometer. It was observed that high performance magnets could be obtained only within a narrow range of temperature, with precipitous drops in quality on both sides of the range. Within this narrow range, systematic and significant variations of some intrinsic properties were also observed.
Gas ventilation of the Saguenay fjord by an energetic tidal front

Abstract Dissolved noble gas samples were taken during a pilot study in the Saguenay Fjord, Quebec, Canada, in order to determine the contribution of different air‐sea gas exchange mechanisms in an estuary and to assess the contribution of tidal fronts to the aeration of subsurface waters. The noble gases He, Ne, Ar, Kr, and Xe span a large range of molecular diffusivities and solubilities and hence constitute a useful probe of various gas exchange and bubble injection processes. Samples were taken at flood tide upstream and downstream of an energetic tidal front that is generated by a hydraulically controlled flow over a shallow sill at the entrance to the Fjord. The results are interpreted with the help of hydrographic measurements of density and currents along cross‐sill transects describing the physical forcing at the sill. High gas saturations downstream of the sill indicate the aeration of water within the frontal region. An inverse model is used to compare the contribution of bubble injection in th...
Atmospheric correction errors under the Hawaii volcano: possible solutions

When aerosol from the Hawaii volcano plume are present then the water leaving radiance derived from the SeaWifs satellite using the SeaDas algorithm is too large. It is shown that this problem may be due to the use of an incorrect aerosol model. Furthermore, it is shown that using longer wavelengths may be needed to solve the atmospheric correction problem under Hawaii volcanic aerosols.
Players and thinkers and learners

The stronghold that games have on our society has made it imperative that educators understand the impact that video games can have. Owens (2012) presented two frames for how the press discussed the popular game Spore, which incorporates elements of science topics. One frame suggested that the game teaches children about intelligent design, while the other implied the game merely made students excited about science topics. While this debate is nothing new, having foundations in several theoretical perspectives; educators must identify their own perceptions of video games and how even commercial games can be used as tools for teaching.
Calculation of band gaps in molecular crystals using hybrid functional theory

Hybrid functional theory is applied for calculation of band gaps in the molecular crystals anthracene, pentaerythritol (PE), pentaerythritol tetranitrate (PETN), and cyclotrimethylene trinitramine (RDX). The B3LYP hybrid functional is observed to produce band gap estimates in reasonable agreement with experiment for anthracene and RDX. This approach, which has been successfully used recently for other materials, is efficient and practical, which is especially important for these large molecular crystals.
Prehistoric diet and subsistence of the Moche Valley, Peru.

Abstract A study of plant and animal remains from eleven archaeological sites in the Moche Valley, Peru, revealed that three major subsistence patterns prevailed between the time of the first permanent settlements (c. 2500 B.C.) and the arrival of the Spaniards (a.d. 1532). The first permanent settlements were predicated on marine resources and gave way gradually to larger inland polities with irrigation agriculture and a non‐marine animal protein source. The final shift saw the development of the Chimu state and associated satellite communities established to provide specific goods and services and linked to the state through an extensive system of redistribution. All three patterns are examined in terms of changes in diet and subsistence, and some effort is made to place them in proper cultural perspective.
Fusion of bone marrow-derived cells with cancer cells: metastasis as a secondary disease in cancer

This perspective article highlights the leukocyte-cancer cell hybrid theory as a mechanism for cancer metastasis. Beginning from the first proposal of the theory more than a century ago and continuing today with the first proof for this theory in a human cancer, the hybrid theory offers a unifying explanation for metastasis. In this scenario, leukocyte fusion with a cancer cell is a secondary disease superimposed upon the early tumor, giving birth to a new, malignant cell with a leukocyte-cancer cell hybrid epigenome.
What research does and doesn’t say about breastfeeding: a critical review

The authors review the research literature on breastfeeding benefits and promotion. Although breastfeeding confers numerous benefits to infants, mothers and society, the authors conclude that breastfeeding promotion efforts sometimes overstate or misrepresent what the research actually supports about the benefits of breastfeeding. Psychological or cognitive benefits, particularly for full‐term healthy infants, may be overstated. In some studies, variables such as income, education and maternal IQ are not adequately taken into account. Studies that do take these variables into account often find little or no association between breastfeeding and cognitive outcomes except in the case of premature or low birth weight infants. Although often promoted as a benefit of breastfeeding, there is little support of the assertion that breastfeeding enhances bonding between mothers and their infants. It is important that breastfeeding promotion efforts are accurate, appropriate to the audience and address barriers to b...
Preventing, stopping, or reversing coronary artery disease--triglyceride-rich lipoproteins and associated lipoprotein and metabolic abnormalities: the need for recognition and treatment.

Abstract A substantial number of treated patients with or at high risk for coronary artery disease continue to have fatal and nonfatal coronary artery events in spite of significant reduction of elevated levels of low-density lipoprotein cholesterol. Other lipoprotein abnormalities besides an elevated level of low-density lipoprotein cholesterol contribute to risk of coronary artery disease and coronary artery events, and the predominant abnormalities that appear to explain much of this continued risk are an elevated serum triglyceride level and a low level of high-density lipoprotein cholesterol. Most patients with coronary artery disease have a mixed dyshpidemia with hypertriglyceridemia, which is associated and metabolically intertwined with other atherogenic risk factors, including the presence of triglyceride-rich lipoprotein remnants, low levels of high-density lipoprotein cholesterol, small, dense, low-density lipoprotein particles, postprandial hyperlipidemia, and a prothrombotic state. Aggressive treatment of these patients needs to focus on these other lipoprotein abnormalities as much as on low-density lipoprotein cholesterol. Combination drug therapy will usually be required. Reliable assessment of risk of coronary artery disease from lipoprotein measurements and response to therapy requires inclusion of all atherogenic lipoproteins in laboratory measurements and treatment protocols. At present this may be best accomplished by use of non-high-density lipoprotein cholesterol (total cholesterol minus high-density lipoprotein cholesterol) calculated from standard laboratory lipoprotein values. Ultimately, a more comprehensive assessment of coronary artery disease risk and appropriate therapy may include measurement of lipoprotein subclass distribution including determination of low-density lipoprotein particle concentration and sizes of the various lipoprotein particles.
70 Macrophage Formation from Isolated Lymphocytes in Tissue Culture

Circumstantial evidence for the conversion of lymphocytes into macrophages has accumulated for half a century, but attempts to demonstrate this change in tissue cultures of isolated lymphocytes have met with failure. In these latter studies lymphocytes were exposed in columns to glass, silicon, cotton or nylon surfaces during their separation from granulocytes and monocytes. Other data suggest that either contact with a foreign surface is injurious to lymphocytes or an important minor population of lymphoid cells sticks to such surfaces. For example, column-separated lymphocytes are not agglutinated by isoantisera to leukocytes, and they transform poorly into blastoid cells upon specific stimulation in tissue culture. Lymphocytes were therefore purified, without significant surface contact, by magnetic removal of ironladen phagocytes after incubation of whole defibrinated blood with micro-filings of iron. Erythrocytes were sedimented with the aid of gelatin. The resulting lymphocytes were agglutinated well by isoleukoagglutinins, and they underwent blastogenesis as readily as unseparated lymphocytes. One to 3 % macrophages regularly appeared in suspension cultures of these lymphocytes even though the preparations initially contained less than 0.2 % nonlymphoid nucleated cells. In monolayer cultures varying proportions of the lymphocytes attached to the surface and began to enlarge soon after culture. Other lymphocytes never did adhere to the glass. After one week most of the adherent cells had the typical morphologic features of macrophages and were phagocytic. It is apparent that at least one class of lymphocytes is capable of conversion into macrophages in the absence of nucleated cells. (Supported by NIH Grants AM-9112, AM-6469 and Tl HD-66) (SPR)
The Materials Science of “Permeable Polysilicon” Thin Films

Polycrystalline silicon thin films that are permeable to fluids, known as permeable polysilicon, have been reported by several researchers. Such films have great potential for the fabrication of difficult to make MEMS structures, but their use has been hampered by poor process repeatability and a lack of physical understanding of the origin of film permeability and how to control it. We have completed a methodical study of the relationship between process, microstructure, and properties for permeable polysilicon thin films. As a result, we have determined that the film permeability is caused by the presence of nanoscale pores, ranging from 10-50 nm in size, that form spontaneously during LPCVD deposition within a narrow process window. The unusual microstructure within this process window corresponds to the transition between a semicrystalline growth regime, exhibiting tensile residual stress, and a columnar growth regime exhibiting compressive residual stress. A simple kinetic model is proposed to explain the unusual morphology within this transition regime. It is determined that measurements of the film residual stress can be used to tune the deposition parameters to repeatably produce permeable films for applications. The result is a convenient, single-step process that enables the elegant fabrication of many previously challenging structures.
Preoperative clinical evaluation and noninvasive electroencephalogram in cortical dysplasia

The preoperative evaluation of patients with suspected cortical dysplasia involves detailed neurologic and neuropsychologic evaluations, electroencephalography, and comprehensive neuroimaging and functional studies. The goal is to identify a focal region of seizure onset and to assess for motor impairments, speech and language difficulties, or developmental delay. Although the electroencephalogram abnormalities in cortical dysplasia are nonspecific, they typically include unusual high-amplitude (slowing and focal) activity. The association of cortical dysplasia with cardiovascular, dermatologic, and other systemic disorders is discussed.
Cis, Trans Isomerism of the Eleostearate Isomers

The cis, trans isomers of the conjugated trienes present a difficult problem for complete determination of structure. Several methods of attack have been outlined, and application of two of them have been made to α and β eleostearic acids, α and β licanic acids, and to pseudoeleostearic acid. These results indicate the following structures: α eleostearic: cis-9, trans-11, trans-13 β eleostearic: trans-9, trans-11, trans-13 pseudoeleostearic: trans-10, trans-12, trans-14 α licanic: 4-keto, cis-9, trans-11, trans-13 β licanic: 4-keto, trans-9, trans-11, trans-13
Sampling error can significantly affect measured hospital financial performance of surgeons and resulting operating room time allocations.

UNLABELLED Hospitals with limited operating room (OR) hours, those with intensive care unit or ward beds that are always full, or those that have no incremental revenue for many patients need to choose which surgeons get the resources. Although such decisions are based on internal financial reports, whether the reports are statistically valid is not known. Random error may affect surgeons' measured financial performance and, thus, what cases the anesthesiologists get to do and which patients get to receive care. We tested whether one fiscal year of surgeon-specific financial data is sufficient for accurate financial accounting. We obtained accounting data for all outpatient or same-day-admit surgery cases during one fiscal year at an academic medical center. Linear programming was used to find the mix of surgeons' OR time allocations that would maximize the contribution margin or minimize variable costs. Confidence intervals were calculated on these end points by using Fieller's theorem and Monte-Carlo simulation. The 95% confidence intervals for increases in contribution margins or reductions in variable costs were 4.3% to 10.8% and 6.0% to 8.9%, respectively. As many as 22% of surgeons would have had OR time reduced because of sampling error. We recommend that physicians ask for and OR managers get confidence intervals of end points of financial analyses when making decisions based on them. IMPLICATIONS The common approach of using one fiscal year of perioperative accounting data can be insufficient to prevent random error from influencing important management decisions. When accounting data are used for hospital and operating room management decision making, confidence intervals should be calculated for the key financial variables (e.g., variable cost per hour of operating room time).
Structural biology with carbon nanotube AFM probes

Carbon nanotubes represent ideal probes for high-resolution structural and chemical imaging of biomolecules with atomic force microscopy. Recent advances in fabrication of carbon nanotube probes with sub-nanometer radii promise to yield unique insights into the structure, dynamics and function of biological macromolecules and complexes.
Consultation with the Specialist: Home Care for Children Who Have Chronic Conditions

1. Gregory S. Liptak, MD, MPH* 1. 2. *Associate Professor, Divisions of General Pediatrics and Developmental Disabilities, University of Rochester School of Medicine and Dentistry, Rochester, NY. Until the early 1900s, children who were ill were cared for at home and followed by physicians who made house calls. As technical care improved, sick children were admitted to hospitals. Then, in the mid-1970s, as the benefits of care at home were discerned and hospitals reached capacity, increasing numbers of children began to be cared for at home with high technology equipment. With the recent escalating pressure to reduce health-care costs, the growth of medical home care services has exploded. Home care now includes a wide array of services: administration of intravenous medications; nutritional support, including enteral feedings and intravenous nutrition; monitoring for apnea and bradycardia; administration of supplemental oxygen; nebulization treatments; mechanical ventilation; phototherapy for hyperbilirubinemia; and rehabilitation/habilitation services. Although care at home can be cost-saving and provide a convenient, psychologically beneficial environment for the child, it also can increase the burden of care on the family (additional demands on time, responsibilities, and money) and diminish their privacy. The primary care pediatrician should be as familiar with the process of home care as he or she is with the process of inpatient care to guide families and coordinate care of subspecialists. The Table⇓lists the factors that must be addressed in all patients for whom home care is considered. The physician should evaluate the appropriateness of the child for home care, coordinate and monitor health care, help teach the child and family about the medical condition and its treatment, help train the family in the technical aspects of care, order the proper equipment and supplies, communicate with other providers and agencies, and continually monitor the child’s status. The nurses who provide the …
Chronic kidney disease: Blood-pressure targets in chronic kidney disease

The optimal blood-pressure goals to prevent progression of chronic kidney disease (CKD) remain controversial. The results of the AASK cohort study provide additional support for more aggressive blood-pressure control (<130/90 mmHg) in proteinuric but not nonproteinuric patients with hypertensive CKD.
Effects of Pin Detached Space on Heat Transfer in a Rib Roughened Channel

An experimental study is performed to investigate the heat transfer characteristics and frictional losses in a rib roughened walls combined with detached pin-fins. The overall channel geometry (W = 76.2 mm, E = 25.4 mm) simulates an internal cooling passage of wide aspect ratio (3:1) in a gas turbine airfoil. With a given pin diameter, D = 6.35 mm = 1/4E, three different pin-fin height-to-diameter ratios, H/D = 4, 3, and 2, were examined. Each of these three cases corresponds to a specific pin array geometry of detachment spacing (C) between the pin-tip and one of the endwalls, i.e. C/D = 0, 1, 2, respectively. The rib height-to-channel height ratio is 0.0625. Two newly proposed cross-ribs, namely the broken ribs and full ribs are evaluated in this effort. The broken ribs are positioned in between two consecutive rows of pin-fins, while the full ribs are fully extended adjacent to the pin fins. The Reynolds number, based on the hydraulic diameter of the unobstructed cross-section and the mean bulk velocity, ranges from 10,000 to 25,000. The experiment employs a hybrid technique based on transient liquid crystal imaging to obtain distributions of the local heat transfer coefficient over all of the participating surfaces, including the endwalls and all the pin elements. The presence of ribs has enhanced the local heat transfer coefficient on the endwall substantially by about 20% up to 50% as compared to the neighboring endwall. In addition, affected by the rib geometry, which is a relatively low profile as compared to the overall height of the channel, the pressure loss seems to be insensitive to the presence of the ribs. However, from the overall heat transfer enhancement standpoint, the baseline cases (without ribs) outperforms cases with broken ribs and full ribs.Copyright © 2011 by ASME
Serious overdosers admitted to a general hospital: comparison with nonoverdose self-injuries and medically ill patients with suicidal ideation

There are few psychiatric studies of serious self-injury patients admitted to general hospitals. In order to better characterize patients whose overdoses are serious enough to require hospitalization on a toxicology service, we describe 207 consecutively admitted, serious overdose patients (OD), all of whom were psychiatrically evaluated. They were compared with 53 nonoverdose self-injury cases (NO) and 79 medical/surgical patients with suicidal ideation (SI) who were routinely referred for consultation during the same 2-year period. All data were contemporaneously compiled into a computerized database and analyzed. The attempters (OD and NO) were younger than the ideation patients (SI). The OD group was predominantly female (60%) and the NO and SI groups were predominantly male (72%). More OD cases were separated and more SI cases were widowed. Similar to previous reports, prior psychiatric contact was high in all groups. DSM-III-R diagnoses of depression, adjustment disorders, and substance abuse were most common in each group, without group differences. Only borderline personality disorder distinguished the groups, and the OD group had significantly more borderline patients. There were no seasonal differences for admission dates between groups, SI cases had longer hospital lengths of stay and were least likely to require further psychiatric care after discharge from the general hospital. Attempter groups were more similar to each other than the ideation patients. Clinicians should maintain a high index of suspicion for Axis I disorders in suicidal general hospital patients, though female borderline patients are particularly associated with the serious overdose method.
Repair and regeneration of functional synaptic connections : Cellular and molecular interactions in the leech

A major problem for neuroscience has been to find a means to achieve reliable regeneration of synaptic connections following injury to the adult CNS. This problem has been solved by the leech, where identified neurons reconnect precisely with their usual targets following axotomy, re-establishing in the adult the connections formed during embryonic development. It cannot be assumed that once axons regenerate specific synapses, function will be restored. Recent work on the leech has shown following regeneration of the synapse between S-interneurons, which are required for sensitization of reflexive shortening, a form of non-associative learning, the capacity for sensitization is delayed. The steps in repair of synaptic connections in the leech are reviewed, with the aim of understanding general mechanisms that promote successful repair. New results are presented regarding the signals that regulate microglial migration to lesions, a first step in the repair process. In particular, microglia up to 900 microm from the lesion respond within minutes by moving rapidly toward the injury, controlled in part by nitric oxide (NO), which is generated immediately at the lesion and acts via a soluble guanylate cyclase (sGC). The cGMP produced remains elevated for hours after injury. The relationship of microglial migration to axon outgrowth is discussed.
Separation of strontium from large amounts of calcium, with application to radiostrontium analysis.

Abstract The elution first of calcium and then of strontium by complex formation with cyclohexanediaminetetra-acetic acid (CyDTA) after sorption on ion-exchange columns, is shown to require careful control of pH and the concentrations of CyDTA and NH4+. A procedure is described for volumetric analysis of calcium and strontium, and for use of this separation procedure before determination of 90Sr in sea-water. Careful choice of reagents and materials is shown to be necessary for use of such a method in determination of trace amounts of radiostrontium.
Osteopetrosis With Combined Proximal and Distal Renal Tubular Acidosis

Abstract The association of osteopetrosis and renal tubular acidosis in the offspring of unaffected parents of consanguineous marriage is presented. Features of both distal (Type I) and proximal (Type II) renal tubular acidosis are documented. The findings are presented with reference to the 12 previously reported such cases. A possible protective role of the acidosis is discussed.
Is medicine hermeneutics all the way down

Several recent publications have suggested that hermeneutics, the method of literary criticism, might prove to be useful in medicine. In this essay I consider this thesis with particular attention to the claim that medicine “is hermeneutics all the way down”. After examining an anti-positivist critique of positivist medicine and arguing that hermeneutic interpretation involves a more radical critique of modern medicine, I examine the supposed consequences of hermeneutical universalism:relativism, skepticism andantirealism which further evaluation reveals to be only potential consequences of hermeneutics. A brief discussion ofphronesis and of the possible “texts” of medicine concludes the article.
Predator-induced and mating limitation-induced Allee effects in a discrete-time SIMS epidemic model

We use a Susceptible-Infected-Immune-Susceptible (SIMS) discrete-time epidemic model that incorporates both predator-induced and mating limitation-induced Allee effects in the demographic dynamics to study the impact of an infectious disease on population persistence or extinction. When the Allee effect is strong, with or without the disease, the total population goes extinct whenever the initial total population size is smaller than the Allee threshold. However, when the Allee effect is weak or the initial population sizes are high and the total population is either asymptotically constant or under geometric growth, we use the next generation method to compute the basic reproductive number, @?"0, and use it to predict the (uniform) persistence or extinction of the infective and immune populations.
Absence of Ki-ras mutations in exocrine pancreatic tumors from male rats chronically exposed to gabapentin

Abstract Human pancreatic malignancies originating from duct cells most frequently demonstrate activation of Ki-ras gene by G-to-A transition at codons 12 and 13. Rat pancreatic exocrine tumors more frequently and almost exclusively derive from acinar cells and thus differ morphologically from human pancreatic neoplasms. Male Wistar rats fed with 2% gabapentin (1-(aminomethyl)cyclohexane acetic acid) in diet for 2 years developed pancreatic exocrine adenomas and adenocarcinomas. To study the mutations in Ki-ras gene, rat pancreatic proliferative lesions induced by gabapentin were retrospectively analyzed by PCR amplification of DNA isolated from paraffin sections of formalin-fixed rat pancreatic adenomas and adenocarcinomas, using specific primers for regions encoding exon 1 (codon 12 13 ) and exon 2 (codon 61). The amplified 110-bp fragments of exon 1 and exon 2 were analyzed for mutations at codon 12 13 and 61. The results showed Ki-ras mutations at codon 12 in human pancreatic carcinomas. Novel mutations GGT-to-TGT and GGT-to-CGT were detected at codon 12 in 1 5 and 2 5 human pancreatic tumors. Rat adenomas or carcinomas induced by gabapentin expressed wild type sequences at codons 12, 13 and 61. These findings were confirmed by allele-specific oligonucleotide hybridization, single-strand confirmation polymorphism of exon 1 and direct sequencing of exon 1 and exon 2. The absence of mutations in these rat pancreatic tumors suggests that these tumors do not correspond to the human tumors, and that the pathogenesis of this rodent tumor formation may follow different molecular mechanisms.
Spectral analysis of civil conflict-induced forced migration on land-use/land-cover change: the case of a primate and lower-ranked cities in Sierra Leone

Involuntary migration triggered by war has the capacity to generate substantial socioeconomic and environmental changes in cities of developing countries, resulting in aberrant alterations to land use and land cover LULC. This scenario has the potential to diminish the quality of life of inhabitants of a city and present administrative challenges for government and other officials. Gauging the scope and trajectory of urban LULC changes in a war-related environment is pivotal for urban and regional planning, the sustainability of natural resources, and information needs of policy makers. Scholarships that link remote sensing to social science mostly focus on a non-conflict environment, resulting in little or no information on the ramifications of conflict-induced forced migration on changes in LULC. As a result, the role of civil conflict-induced forced migration on the composition and configuration of urban landscape in developing countries remains elusive. This study employs a dense time stack of Landsat-5 Thematic Mapper TM images and a hybrid classification approach that integrates linear spectral unmixing and an ensemble decision-tree classifier to characterize LULC in a primate city and two lower-ranked cities in Sierra Leone. The study examined three time-steps which span 1986–1991, 1991–2002, and 2002–2010 with the overarching goal of elucidating changes in LULC conditioned by civil conflict. Image classification accuracy overall accuracy ranged between 84.0% and 90.2%. The study demonstrated that civil conflict has the capacity to trigger notable growth in urban agricultural land 37.4% in a primate city, while the expansion of residential 112.7% and industrial/commercial 18.7% lands is more prominent in a lower-ranked city. The study further revealed that population expansion does not necessarily result in significant growth in residential area in a primate city that has experienced civil conflict.
Oversensing of Atrial Flutter in the Recipient Atrium of a Heart Transplant Patient with a Permanent Atrial Pacemaker

Sinus node dysfunction requiring permanent pacemaker implantation is a common problem following heart transplantation. There are unique problems to consider in pacing the transplanted heart. This report describes a case of far-field sensing of atrial flutter in the recipient atrial remnant, with resultant inhibition of the atrial pacemaker in the donor atrium, and symptomatic bradycardia. Although postulated to be a potential problem, oversensing of the recipient atrium has not been reported prior to this case. Awareness of this problem will provide for more effective pacemaker troubleshooting.
Transradial cardiac catheterization in patients with prior brachial artery cutdown.

The safety and efficacy of transradial cardiac catheterization in patients with prior ipsilateral brachial cutdown is not known. Using standard techniques we performed transradial catheterization in 278 consecutive patients, of which 63 had prior brachial cutdown. All patients had a strongly palpable radial pulse and a negative Allen's test. Although patients with prior cutdown were older and had a higher incidence of hypertension and prior coronary artery bypass surgery, there was no significant difference in success rates for transradial catheterization (93.6% vs. 95.3%; P = NS). There were no periprocedural complications. Brachial artery occlusion was responsible for only two unsuccessful catheterization attempts. We conclude that, with careful preprocedural screening, ipsilateral transradial cardiac catheterization can be successfully performed in a majority of patients with prior brachial cutdown. Cathet. Cardiovasc. Intervent. 48:271–274, 1999. © 1999 Wiley-Liss, Inc.
Protecting DSP circuits through obfuscation

This paper presents a novel approach to protect digital signal processing (DSP) circuits through obfuscation by using high-level transformations. The goal is to design DSP circuits that are harder to reverse engineer. High-level transformations of iterative data-flow graphs have been exploited for area-speed-power tradeoffs. This is the first attempt to develop a design flow to apply high-level transformations that not only meet these tradeoffs but also simultaneously obfuscate the architectures both structurally and functionally. Several modes of operations are introduced for obfuscation where the outputs are either meaningful from a signal processing point of view, but functionally incorrect, or non-meaningful. Experimental results show that the proposed methodology only introduces relatively small overhead, while a high level of obfuscation is achieved. For instance, the area overhead for a (3l)th-order IIR filter benchmark is only 17.7% with a 128-bit configuration key.