cssi/SciSciGPT-SciSciNet huggingface dataset:
Concomitant open ventral hernia repair: what is the financial impact of performing open ventral hernia with other abdominal procedures concomitantly?

Open ventral hernia repair (VHR) is often performed in conjunction with other abdominal procedures. Clinical outcomes and financial implications of VHR are becoming better understood; however, financial implications of concomitant VHR during other abdominal procedures are unknown. This study aimed to evaluate the financial implications of adding VHR to open abdominal procedures. This IRB-approved study retrospectively reviewed hospital costs to 180-day post-discharge of standalone VHRs, isolated open abdominal surgeries (bowel resection or stoma closure, removal of infected mesh, hysterectomy or oophorectomy, panniculectomy or abdominoplasty, open appendectomy or cholecystectomy), performed at our institution from October 1, 2011 to September 30, 2014. The perioperative risk data were obtained from the local National Surgery Quality Improvement Program (NSQIP) database, and resource utilization data were obtained from the hospital cost accounting system. 345 VHRs, 1389 open abdominal procedures as described, and 104 concomitant open abdominal and VHR cases were analyzed. The VHR-only group had lower ASA Class, shorter operative duration, and a higher percentage of hernias repaired via separation of components than the concomitant group (p < 0.001). The median hospital cost for VHR-alone was $12,900 (IQR: $9500–$20,700). There were significant increases to in-hospital costs when VHR was combined with removing an infected mesh (63%) or with bowel resections or stoma closures (0.7%). The addition of VHR did not cause a significant change in 180-day post-discharge costs for any of the procedures. This study noted decreased costs when combining VHR with panniculectomy or abdominoplasty and hysterectomy or oophorectomy. For removal of infected mesh and bowel resection or stoma closure, waiting, when feasible, is recommended. Given the impending changes in financial reimbursements in healthcare in the United States, it is prudent that future studies evaluate further the clinical and fiscal benefit of concomitant procedures.
The Effect of Prior Term Birth on Risk of Recurrent Spontaneous Preterm Birth.

Objective The objective of this study was to evaluate the effect of prior term birth on recurrent spontaneous preterm birth (sPTB) risk. Study Design Retrospective cohort study of 211 women with prior sPTB, comparing women with and without prior term births. The primary outcome was recurrent sPTB Results The overall sPTB rate was 33.7%, with no statistical difference between women with and without prior term births (28.9 vs. 37.7%, p = 0.2). Among women with prior second-trimester loss (16–236/7 weeks), those with a term birth had a decreased sPTB rate (15.4 vs. 43.2%, p = 0.02), which persisted after adjusting for age and 17-α hydroxyprogesterone caproate use. For women with prior sPTB ≥24 weeks, there was no difference in sPTB with and without prior term births (29.5 vs. 26.6%, p = 0.7). A term birth as the most recent delivery lowered, but did not eliminate, the sPTB risk (19.1 vs. 36.4%, p = 0.1). Conclusion Prior term birth lowers the risk of recurrent sPTB for women with prior second-trimester loss, but not for women with prior sPTB ≥24 weeks. Women with prior preterm and term births should be counseled accordingly and all sPTB prevention strategies should be recommended.
An N-th Order Equation

This chapter focuses on an N th order equation d n y/dx n = f ( x ). The general solution of the ordinary differential equation for y ( x ) d n y/dx n = f ( x ) can be found integrating with respect to x a total of n times. The chapter explores the ordinary differential equation y (4) – sin x; y (0) = 0 , y' (0) = 0; y“ (0) = 0 , y'“ (0) = 0 has the solution y ( x ) = ∫dx ∫dx∫dx∫ sin x dx. This solution may also be written as y ( x ) = 1/6 ∫ o ( x−t ) 3 sin t dt . Sometimes, it is easier to evaluate the expression in 1/6 ∫ o ( x−t ) 3 sin t dt, by expanding out ( x−t ) 3 and integrating the four terms to determine that y ( x ) = sin x – x+ x 3 /6 than it is to evaluate the expression y ( x ) = ∫dx ∫dx∫dx∫ sin x dx .
Stereotactic Ablative Radiotherapy Uncertainties: Delineation, Setup and Motion

Stereotactic ablative radiotherapy (SAbR), also known as stereotactic body radiation therapy, is biologically distinct from conventionally fractionated radiotherapy in that it is ablative, causing functional incapacitation of targeted tissue including margins added to avoid errors. In striking contrast, small 1.8-2Gy daily doses associated with historical fractionated radiotherapy cause more modest injury more likely to be repaired by normal tissue than tumor. Strategic plans to deal with uncertainties in tumor location, motion during treatment, dose deposition and heterogeneity effects, and tolerance require a novel approach for SAbR very different from what has been dogma for conventionally fractionated treatments. In essence, the targets must be kept absolutely as small as prudently possible without missing tumor deposits. Given the potency and clinical potential of SAbR, a more sophisticated and rigorous approach to uncertainties and margins is warranted.
Resolvin D1 decreases abdominal aortic aneurysm formation by inhibiting NETosis in a mouse model.

Abstract Objective Resolvins have been shown to attenuate inflammation, whereas NETosis, the process of neutrophils releasing neutrophil extracellular traps (NETs), produces increased inflammation. It is hypothesized that treatment of animals with resolvin D1 (RvD1) would reduce abdominal aortic aneurysm (AAA) formation by inhibiting NETosis. Methods Wild-type 8- to 12-week-old C57BL/6 male mice (n = 47) and apolipoprotein E-deficient (ApoE−/−) mice (n = 20) were used in two models to demonstrate the effects of RvD1 on AAA growth. In the topical elastase AAA model, wild-type mice were divided into three groups: a deactivated elastase control group, in which sham surgery was performed using deactivated elastase and mice were intravenously injected with phosphate-buffered saline (PBS) once a day until harvest; an elastase group, in which active elastase was used to induce AAA and mice were injected with PBS daily until harvest; and an RvD1-treated group, in which AAA was induced and mice were injected with RvD1 daily until harvest. In the angiotensin II (Ang II)-induced AAA model, ApoE−/− mice were fed a high-fat diet and implanted with osmotic infusion pumps containing Ang II (1000 ng/kg/min). The Ang II model was divided into two groups: an Ang II control group, in which Ang II was delivered and mice were injected with PBS daily until harvest; and an RvD1-treated group, in which Ang II was delivered and mice were injected with RvD1 daily until harvest. On postoperative day 3, day 14, or day 28, aortic and blood samples were collected for Western blot, histology, cytokine array, enzyme-linked immunosorbent assay, and gelatin zymography after aortic diameter measurement. Results The day 14 RvD1-treated group demonstrated 42% reduced AAA diameter compared with the elastase group (P Conclusions RvD1-mediated inhibition of NETosis may represent a future medical treatment for the attenuation of AAA growth.
A graphical approach to assess the detectability of multiple simultaneous faults in air handling units

Abstract This paper presents a graphical approach to assess the detectability of multiple simultaneous faults in mechanical systems such as Air Handling Units (AHUs). Symptoms of multiple simultaneous faults can cancel each other out, resulting in no indication of abnormality and rendering these faults undetectable when the measurements collected from AHUs are processed. Still, such undetectable faults can lead to significant energy inefficiency and economic loss. We present a method to assess the detectability of a given set of faults provided the causal relations among the variables and the sensor configuration in the system. Fault detectability assessment informs decision makers about possible risk scenarios the system is exposed to and enables them to design/modify the system to reduce this exposure, e.g. by adding extra sensors where necessary. Our approach first constructs a graphical representation of a given system so that the causal relations among the variables and whether they are sensed can be visually observed, which can help predict until where a fault symptom can propagate. Then, our approach examines a given set of faults to check whether it is possible for that set to be detected by the given set of available sensors. We illustrate the application of our approach to an operational AHU and classify which sets of faults are detectable and which are not. We compare our approach with alternative methods and show that one of its benefits is the capability of handling systems with unpredictable input variables.
Transformative Learning and the Awareness of White Supremacy

This article describes the development of critical consciousness and the different intellectual traditions that have been influential in framing how this concept is understood. Prime amongst these is analytic philosophy, American pragmatism and Frankfurt School critical theory. Two particular critical moves are analyzed in detail; being willing to subject the assumptions that inform your own, and others’ reasoning and actions to regular scrutiny and being open to alternative perspectives and viewpoints. The author examines the critical theory tradition›s emphasis on deconstructing power and ideological control and uses his own experience of clinical depression to illustrate this. He argues that his depression could only be understood once he was ready to think critically about the ways that the dominant ideology of patriarchy had blocked a critical analysis of his mental state.
Sedation, Analgesia, and Paralysis in the Intensive Care Unit

Anxiety is an almost universal feature of ICU patients. Clinically significant anxiety has been reported in up to 70% of ICU patients. Severe anxiety is not limited to mechanically ventilated patients; indeed, Treggiari-Venzi and colleagues demonstrated that up to 30% of nonintubated surgical ICU patients had severe anxiety. Consequently, sedation is an integral component of the management of the ICU patient. The primary objective of sedation is to allay anxiety, enhance patient comfort, promote sleep, and facilitate mechanical ventilation. The desirable level of sedation/hypnosis will depend in large part upon the patient’s acute disease process as well as the need for mechanical ventilation. However, the ideal level of sedation is one from which the patient can be easily aroused with maintenance of the normal sleep-wake cycle. Assessing the degree of sedation and titrating the drug regimen to predetermined end points are essential, as both oversedation and inadequate sedation are associated with significant complications.
Impact of Operational Decisions and Size of Battery Energy Storage Systems on Demand Charge Reduction

Demand charge reduction is an influential application of BESS for distribution system utilities as well as microgrid operators that could be achieved through peak-shaving techniques. This paper studies the impact of the size of BESS and the BESS operational decisions including the initial state of charge (SoC) of a day, on peak-shaving. A linear programming-based algorithm is used for optimal energy management of BESS interfaced with Distributed Energy Resources (DERs) to determine the output power of the BESS for peak-shaving and demand charge reduction on each day. The problem is solved using MATLAB and implemented on a real-world distribution feeder modeled in OpenDSS, using predicted day-ahead demand and solar photovoltaic (PV) generation output. The results show that the BESS rated capacity is a more decisive factor than inverter rated power for effective peak shaving strategies. Moreover, a low initial SoC for the day is critical in achieving demand charge reduction.
How Patient Education Influences Utilization of Nonpharmacological Modalities for Persistent Pain Management: An Integrative Review.

Abstract Objectives Opioid analgesic misuse and abuse has given rise to an epidemic that has added to an increase in opioid-related overdoses and deaths. Adults with persistent noncancer pain (PNCP) are primarily treated with opioid analgesics. Many remain on these medications long term. Most of these patients are unaware of other effective measures for managing PNCP, such as nonpharmacologic modalities (NPMs). This lack of familiarity with NPMs presents a key contributor to the problem of NPM underuse among adult PNCP patients. This integrative review sought to identify key factors that contribute to NPMs underuse and the effect of education on patients’ adoption or use for PNCP management. Design Integrative review. Data Sources A literature search was conducted using PubMed, CINAHL, Embase, Cochrane, and hand-searching of the literature published between 2002 and November 2017. Review/Analysis Methods Systematic screening using the Johns Hopkins Nursing evidence appraisal tools yielded articles that were analyzed and synthesized to identify themes, and patterns. Results Nineteen research articles were identified with these main themes: NPMs are effective in PNCP management, lack of familiarity with NPMs influences patients’ willingness to try them, and access to local NPMs must be addressed to facilitate use. Conclusions Findings suggest that patient education about NPMs has the potential to motivate patients to try these modalities, which may increase overall use of NPMs for PCNP. Nurses could play a vital role in ensuring evidence-based NPMs are introduced to PNCP patients, which could increase patients’ use of these measures and improve outcomes.
Using artificial intelligence to improve adequacy of inspection in gastrointestinal endoscopy

Abstract Adequacy of manual endoscopic inspection of the upper and lower gastrointestinal mucosa is operator-dependent: it is common knowledge that the likelihood of finding lesions and the degree of cancer prevention of manual endoscopic procedures is dependent on the skillset and effort by endoscopists. Recent developments in artificial intelligence allow measurement of skillset and effort during actual endoscopic procedures. Many endoscopic features, representing skillset and effort, such as clarity of image, absence of stool, looking sideways, performing retroflexion and obtaining all possible mucosal views, can be classified or counted, and the results presented in real-time to endoscopists and stored at the end of the procedure as an automated, objective report with representative images documenting adequacy of inspection. Real-time feedback provides endoscopists the option, when measurements suggest inadequate or incomplete inspection, to change technique or repeat and expand inspection. However, responding to real-time feedback and obtaining best possible measurements or all possible mucosal views do not equate to careful inspection; endoscopists may be focused on obtaining best measurements instead of inspecting the mucosa. Therefore, prospective studies with long-term follow-up will be required to determine whether artificial intelligence driven real-time feedback will lead not only to better intra-procedural measurements but also to improved patient outcome, for example, a decrease in gastrointestinal cancer incidence and mortality.
From feedback to revisions: Effects of feedback features and perceptions

Abstract Although the effects of peer feedback have been studied from a number of perspectives, much remains to be learned about what leads students to act (or not) on their peers’ feedback in revisions. The present study examined the relationship between peer feedback features, student perceptions as potential mediators (understanding versus agreement with the feedback), and the likelihood of students’ implementation of the feedback. Peer feedback, back-evaluation comments, and revisions from 185 US high school students were analyzed. Investigated feedback features included four cognitive features (identification, explanation, solution, suggestion), and two affective features (mitigating praise, hedges). Logistic regression analyses revealed that: (1) both understanding and agreement with feedback predicted implementation; (2) presence of solutions predicted understanding of feedback; (3) mitigating praise predicted agreement of the problem; and (4) explanation and hedges predicted implementation separately from perception effects. Theoretical and practical implications of the findings are discussed.
A numerical investigation of support structure designs for overhangs in powder bed electron beam additive manufacturing

Abstract Overhang structures can be found in engineering components fabricated by powder bed electron beam additive manufacturing (EBAM) technology. The support structures are needed for an overhang, or severe overhang distortion may be caused by repeated rapid heating and cooling cycles in the layer-by-layer manufacturing process. Current overhang support generation methods usually utilize certain types of structures to fill the overhang space. They may overestimate the amount of support, thus, the post process time can be potentially increased. The objective of this study is to investigate an effective support design method to reduce support material usage and post process workload in EBAM process. In this research, a combined heat support and support anchor design method has been proposed. The stress and deformation of overhang configuration has been evaluated by a thermomechanical model. The design procedure has been introduced in details for a typical overhang example. The simulations have demonstrated that overhang warping can be effectively reduced by the application of a heat support beneath overhang region and support anchors which connect overhang and heat support.
The Aesthetics and Phenomenology of Grief: Two Meditations:

These two short personal essays were written in response to anticipating the death of my mother in 2004. Living Art is written from New York City while working on my dissertation and Clipping Hair ...
QUARK-GLUON PLASMA AND THERMALIZATION

In these lectures, I will attempt a pedagogical and qualitative introduction to the theory of equilibrium and thermalization of quark-gluon plasmas. I assume only that the reader is familiar with quantum field theory at zero temperature and with QCD as the theory of the strong interactions. I focus on the limit of small αs, which in principle should be relevant at extremely high temperature because of asymptotic freedom, and in any case provides a clean theoretical context in which to discuss a variety of phenomena. Topics discussed include the basic equilibrium formalism for finite-temperature quantum field theory, Debye screening, electric deconfinement, magnetic confinement, dimensional reduction, plasma waves, kinetic theory, hydrodynamic properties such as viscosity, the Landau–Pomeranchuk–Migdal effect, thermalization in (arbitrarily high energy) heavy ion collisions, and QCD plasma instabilities.
Chemical genetic methodologies for identifying protein substrates of PARPs

Poly-ADP-ribose-polymerases (PARPs) are a family of 17 enzymes that regulate a diverse range of cellular processes in mammalian cells. PARPs catalyze the transfer of ADP-ribose from NAD+ to target molecules, most prominently amino acids on protein substrates, in a process known as ADP-ribosylation. Identifying the direct protein substrates of individual PARP family members is an essential first step for elucidating the mechanism by which PARPs regulate a particular pathway in cells. Two distinct chemical genetic (CG) strategies have been developed for identifying the direct protein substrates of individual PARP family members. In this review, we discuss the design principles behind these two strategies and how target identification has provided novel insight into the cellular function of individual PARPs and PARP-mediated ADP-ribosylation.
Subarachnoid hemorrhage

All patients who present with subarachnoid hemorrhage should be admitted to the intensive care unit for close neurologic and cardiorespiratory monitoring. Neurosurgical consultation should be obtained if external ventricular drain placement, arteriography, or surgical planning are considered. Seizure prophylaxis, antihypertensive treatment for mean arterial blood pressure greater than 130 mm Hg, pain control, and bed rest are important measures for the prevention of rebleeding, which is associated with a high mortality rate. Standard deep venous thrombosis and gastrointestinal prophylaxis are recommended to prevent medical complications associated with critical illness. In patients with good-grade subarachnoid hemorrhage, early arteriography and definitive aneurysm management are recommended. The location and neck size of the aneurysm and the medical condition of the patient are factors in the decision to proceed with surgical rather than interventional aneurysm management. Postoperatively, clinical examination and transcranial Doppler ultrasonography are recommended for surveillance of vasospasm. If clinical or arteriographic evidence of vasospasm is present, hemodilution, hypertension, and hypervolemia (triple H) therapy should be instituted. If vasospasm is resistant to conservative measures, balloon angioplasty or intra-arterial papaverine therapy should also be considered.
Normal tissue and tumor microenvironment adaptations to aerobic exercise enhance doxorubicin anti-tumor efficacy and ameliorate its cardiotoxicity in retired breeder mice

Aerobic exercise is receiving increased recognition in oncology for its multiple purported benefits. Exercise is known to induce physiologic adaptations that improve patient quality-of-life parameters as well as all-cause mortality. There also is a growing body of evidence that exercise may directly alter the tumor microenvironment to influence tumor growth, metastasis, and response to anticancer therapies. Furthermore, the physiologic adaptations to exercise in normal tissues may protect against treatment-associated toxicity and allow for greater treatment tolerance. However, the exercise prescription required to induce these beneficial tumor-related outcomes remains unclear. This study characterized the aerobic adaptations to voluntary wheel running in normal tissues and the tumor microenvironment. Female, retired breeder BALB/c mice and syngeneic breast adenocarcinoma cells were utilized in primary tumor and metastasis models. Aerobic exercise was found to induce numerous adaptations across various tissues in these mice, although primary tumor growth and metastasis were largely unaffected. However, intratumoral hypoxia and global metabolism were altered in the tumors of exercising hosts relative to non-wheel running controls. Doxorubicin chemotherapy also was found to be more efficacious at delaying tumor growth with adjuvant aerobic exercise. Additionally, doxorubicin-induced cardiac toxicity was ameliorated in exercising hosts relative to non-wheel running controls. Taken together, these data suggest that the normal tissue and tumor microenvironment adaptations to aerobic exercise can improve doxorubicin efficacy while simultaneously limiting its toxicity.
The dominant narrative of slavery in South Carolina’s history standards

Abstract Using a critical analysis approach, I investigated the dominant narrative of slavery and African Americans prior to the Civil War in the 2011 South Carolina Social Studies Academic Standards Support Document for the 11th grade U.S. History course. Findings indicate that the Support Document does not offer a complete narrative of slavery and African Americans, perpetuates a negative image of African Americans, excludes themes of African American heroism, and maintains myths related to slavery. The dominant narrative found in the Support Document was compared to the scholarship of historians to construct a counter-narrative for teacher leaders to consider during curriculum development.
Consumer Preferences of Fast-Food Outlets in the U.S. and Canada: A Comparative Study

In recent years, a major food consumption trend in the U.S. and Canada is that more people are eating more meals outside their homes. As a result, greater market opportunities fastfood markets are offering for marketers. This comparative study explores consumers’ preferences of fast-food restaurants in Canada and the U.S.A. The findings of the study offer need oriented type of marketing strategies for both franchisors and franchisees in the fast-food industry to enable them to be more competitive in this fast changing fast-food business environment.
A non-treelike continuum that is not the 2-to-1 image of any continuum

Some thirteen years ago S. B. Nadler, Jr. and L. E. Ward, Jr., asked if any treelike continuum could be the 2-to-1 image of a continuum. In fact, it has been conjectured that the property of being treelike characterizes those continua that are not the 2-to-1 image of any continuum. But the characterization must be something else; this paper shows that many pseudosolenoids are not the 2-to-1 image of any continuum.
In search of quality in crowdsourcing for search engine evaluation

Crowdsourcing is increasingly looked upon as a feasible alternative to traditional methods of gathering relevance labels for the evaluation of search engines, offering a solution to the scalability problem that hinders traditional approaches. However, crowdsourcing raises a range of questions regarding the quality of the resulting data. What indeed can be said about the quality of the data that is contributed by anonymous workers who are only paid cents for their efforts? Can higher pay guarantee better quality? Do better qualified workers produce higher quality labels? In this paper, we investigate these and similar questions via a series of controlled crowdsourcing experiments where we vary pay, required effort and worker qualifications and observe their effects on the resulting label quality, measured based on agreement with a gold set.
Systems integration throughout the early life cycle

This paper presents various methodologies and approaches for performing systems integration and testing throughout the early and middle stages of the development life cycle. It discusses techniques for estimation and management of the integration early life cycle. Prevention and early detection of errors significantly reduces the cost of failure in a system. The systematic use of quality gates throughout the life cycle reduces the propagation of problems. The appropriate use of documentation standards ensures information and knowledge is disseminated to all those who require it. These and other techniques for effective control of integration and test are discussed, together with techniques for measuring the effectiveness of systems integration, such as test coverage analysis, metrics, and post-delivery assessment.
Moderated online communities

Online communities provide a social sphere for people to share information and knowledge. While information sharing is becoming a ubiquitous online phenomenon, how to ensure information quality or induce quality content, however, remains a challenge due to the anonymity of commentators. This paper introduces moderation into reputation systems. We show that moderation directly impacts strategic commentators’ incentive to generate useful information, and moderation is generally desirable to improve information quality. Interestingly, we find that when being moderated with different probabilities based on their reputations, commentators may display a pattern of reputation oscillation, in which they generate useful content to build up high reputation and then exploit their reputation. As a result, the expected performance from highreputation commentators can be inferior to that from low-reputation ones (reversed reputation). We finally investigate the optimal moderation resource allocation, and conclude that the seemingly abnormal reversed reputation could arise as an optimal result.
A single-chain class II MHC-IgG3 fusion protein inhibits autoimmune arthritis by induction of antigen-specific hyporesponsiveness.

T cells play a central role in many autoimmune diseases. A method to specifically target the function of autoreactive T cell clones would avoid the global immunosuppression associated with current therapies. To develop a molecule capable of inhibiting autoreactive T cell responses in vivo, single-chain peptide-I-A-IgG3 fusion proteins were constructed and expressed in both mammalian and insect cells. The fusion proteins were designed with an IgG3 Fc moiety to make them divalent, allowing TCR cross-linking, while lacking FcR binding and costimulation. The fusion proteins stimulated T cell hybridomas in vitro in a peptide-specific, MHC-restricted manner but failed to do so in soluble form. In vivo administration of an I-A q fusion protein, containing an immunodominant collagen II peptide, significantly delayed the onset and reduced the severity of collagen-induced arthritis in DBA/1 mice by induction of Ag-specific hyporesponsiveness. Such fusion proteins may be useful to study novel therapeutic approaches for T cell-mediated autoimmune diseases.
The Population Balance

This chapter discusses the development of population balances. The population balance can be used to conserve one of the following properties: number, length, area, or volume (or mass) when appropriate conservation equations are used in conjunction with the population balance. Population balances, together with a property conservation equation, associated mass, momentum, energy transport equations, and their associated boundary conditions, provide a unified predictive theory for particulate systems. The population balance was represented in two general forms: microscopic and macroscopic. Both the macro and micro population balances derived in this chapter conserve the number of particles. In some cases, it is appropriate to perform balances where the particles' length, area, or volume (or mass) is conserved. Each has advantages in the description of specific systems. These forms of the population balance, together with their restrictions and advantages, follow for easy reference. These two forms of the population balance can also be rewritten on either a discrete mass or cumulative mass basis.
Inactivation of bradykinin in the pulmonary circulation.

Ferreira & Vane (1967) have shown that less than 30% of bradykinin infused into the right atrium emerges in the ascending aorta. In blood the biological half-life was found to be 17 sec. Considering the brief circulation time from right atrium to ascending aorta (2-lOsec.; Spector, 1956), they concluded that enzymes of blood could not account for the degree of inactivation that occurred in the pulmonary circulation. A possible mechanism for the pulmonary inactivation of bradykinin is through hydrolysis by enzymes at or near the vascular endothelium. We have begun an investigation of this possibility by using a rat lung preparation in situ washed free of blood. Rats, weighing 0-2-0-4kg., were anaesthetized with pentobarbital (50mg./kg. body wt.) given by intraperitoneal injection. Polythene cannulae were placed in the left common carotid artery and the right external jugular vein. Another cannula was placed in the trachea and the lungs were ventilated mechanically. Saline (0.9% NaCI) was infused into the venous cannula and the rat was exsanguinated through the arterial cannula. Then a cannula was inserted through a slit in the right ventricle into the pulmonary artery and another was tied into the left ventricle. A Locke dextran solution (11. contained: dextran, 40g.; NaCl, 9 0g.; KCl, 0-42g.; CaCl2, 0-24g.; D-glucose, 10g.; NaHCO3, 0.2g.) was infused into the pulmonary artery at a rate of 4ml./min. and the effluent was collected from the cannula in the left ventricle. The infusion solutions were heated at 370 and were aerated with 02 + CO2 (95: 5). When the effluent became free of erythrocytes (after 3040min.) [2-L-proline-14C]bradykinin (28.6 ,uc/mg., lot no. 307-64; New England Nuclear Corp., Boston, Mass., U.S.A.) in Locke dextran solution was infused. The infusion rate was maintained at 4ml./min. Bradykinin was infused at 2-0 or 4 0,ug./
Models for Estimating Discount Rates for Long-Term Health Risks Using Labor Market Data

This article utilizes evidence from job choices involving fatality risks to estimate individual discount rates for adverse health outcomes. The study compares the results from five distinct models for estimating discount rates from labor market data. The estimated discount rates range from 1% to 14% with confidence intervals that usually include financial market rates for the same period. This result, and consistent findings of significant compensating differentials for fatality risk, provide strong support for life-cycle models of individual rationality in the choice of job risks. Discounted value-of-life estimates are also developed and compared to the crosssection estimates that are more prevalent in the literature.
Motor cortex brain activity induced by 1-Hz transcranial magnetic stimulation is similar in location and level to that for volitional movement.

RATIONALE AND OBJECTIVES. The relatively high temporal and spatial resolution of functional MR imaging was used to compare the blood oxygenation level dependent (BOLD) response associated with movement induced by transcranial magnetic stimulation (TMS) with that for a similar movement executed volitionally (VOL). METHODS. Seven healthy adults were studied in a 1.5-T MR scanner. One hertz TMS at 110% of motor threshold was applied over the motor cortex for the thumb in 21-pulse trains in alternation with VOL every 63 seconds and interleaved with functional MR imaging. RESULTS. BOLD increases in motor cortex associated with TMS and VOL movement were similar (2%–3%). Mean separation of their centers of activity was 3.7 ± 1.9 mm (mean displacement: left/right = 0.3 ± 4.1 mm; superior/inferior = 0.7 ± 1.9 mm). There was no indication of supraphysiological brain activity. CONCLUSIONS. Motor cortex BOLD response associated with thumb movement induced by 1-Hz TMS at 110% motor threshold is similar in both location and level to that caused by a similar movement executed volitionally.
Comparative pharmacokinetics of coumarin anticoagulants. XIV: relationship between protein binding, distribution, and elimination kinetics of warfarin in rats.

The relationships between the protein binding, distribution in the body, and kinetics of elimination of warfarin were studied. Individual rats eliminated warfarin by apparent firstorder kinetics, with a biological half-life of 5.9–41 hr and a total plasma clearance of 2.4–22 ml kg−1 hr−1. There is a strong positive correlation between the apparent volume of distribution (Vd) and the elimination rate constant (kel). There was no apparent concentration dependence of warfarin binding to serum proteins over a wide concentration range, but there were pronounced intersubject variations in protein binding, with the free fraction of drug (f) in serum ranging from 0.172 × 10−2 to 1.53 × 10−2. There are strong positive correlations between f and kel, f and Vd, and f and the kidney-serum concentration ratio of warfarin. Consistent with theory, there is an excellent positive linear correlation between f and total plasma clearance of the drug. The intersubject variation in f is not related to variations in serum albumin or total protein concentration. There is a strong correlation between values of f for serum and liver homogenate in individual animals, consistent with the lack of correlation between f in serum and the liver-serum concentration ratio of warfarin. These results show that the pronounced intersubject variation in the elimination of warfarin observed in this investigation was related to interindividual differences in plasma protein binding of the drug. The differences in protein binding cannot be ascribed to differences in plasma protein concentrations and may reflect configurational differences of proteins or the presence of an endogenous displacing agent at different concentrations.
Sustainable Community for Sustainable Development: A Case Study of the Mujeres Reunidas Cooperative in Hidalgo, Mexico

This article analyzes the role that communal values and structures play in facilitating women's ability to cope with the economic uncertainties brought about by the large-scale emigration of men fr...
Sources and Utilization of Amino Acids in Channel Catfish Diets: A Review

Abstract Alternatives to high-cost protein supplements in formulated diets for channel catfish Ictalurus punctatus are desirable to reduce feed costs and increase profits in modern channel catfish farming operations. Channel catfish feed manufacturers are focused on using plant proteins in least-cost diet formulations which typically contain at least 90% plant products. These diets are sometimes supplemented with purified crystalline amino acids to eliminate amino acid deficiencies associated with plant proteins, which often possess amino acid compositions that are less favorable for channel catfish than the animal products they replace. The efficiency with which channel catfish utilize these supplemented amino acids is discussed, and we describe evidence that amino acids provided in purified crystalline form are not used as effectively as the amino acids obtained from intact proteins in the feed ingredients. Because purified amino acids could be absorbed from the intestine faster than amino acids release...
The role of organizational procedures in the resolution of social conflict.

Employee-employer conflict can arise from the expression of social issues within an employment organization. Recently, public support for non-discrimination in employment has led to the existence of external forums-regulatory agencies and the courts-that allow appeals for complaints of discrimination by protected groups. This paper examines the role of organizational procedures for conflict resolution where individuals have the option of appealing to an external forum. Through the analysis of internal grievance procedures and external charges in three urban hospitals, the paper explores the origins and expressions of employee-employer conflict in the areas of discrimination, the impact of an internal system on the rate of external charges, and the general relationship between internal and external forums of conflict resolution.
Cystic fibrosis—correct chloride conductance can cure cells

We have used retrovirus-mediated gene transfer to demonstrate complementation of the cystic fibrosis (CF) defect in vitro. Amphotropic retroviruses were used to transduce a functional cystic fibrosis transmembrane conductance regulator (CFTR) cDNA into CFPAC-1, a pancreatic adenocarcinoma cell line derived from a patient with CF that stably expresses the chloride transport abnormalities characteristic of CF. CFPAC-1 cells were exposed to control virus (PLJ) and CFTR-expressing virus (PLJ-CFTR); viral-transduced clones were isolated and subjected to molecular and physiologic analysis. RNA analysis detected a viralderived CFTR transcript in all of the PLJ-CFTR clones that contained unrearranged proviral sequences. Agents that increase intracellular cAMP stimulated 125I efflux in PLJ-CFTR clones but not PLJ clones. Whole-cell patch-clamp performed on three responding clones showed that the anion efflux responses were due to cAMP stimulation of Cl conductance. Our findings indicate the expression of the normal CFTR gene confers cAMP-dependent Cl channel regulation on CF epithelial cells. The cystic fibrosis transmembrane conductance regulator (CFTR) was expressed in cultured cystic fibrosis airway epithelial cells and Cl− channel activation assessed in single cells using a fluorescence microscopic assay and the patch-clamp technique. Expression of CFTR, but not of a mutant form of CFTR (ΔF508), corrected the Cl channel defect. Correction of the phenotypic defect demonstrates a causal relationship between mutations in the CFTR gene and defective Cl transport which is the hallmark of the disease.
Pallidothalamic projections in the rat.

The purpose of this investigation was to examine pallidofugal projections to the thalamus of the rat using a selective silver degeneration method and autoradiography. Degenerating pallidothalamic projections emerging from the anterior part of the pallidum formed two diffuse groups of fibers; one coursed ventromedially directly through the internal capsule without forming a lenticular fasciculus and terminated uniformly in the reticular, VA, VD, VM and the medial part of the VE. The other group coursed ventrolaterally in the internal capsule and, without forming an ansa lenticularis, entered the zona incerta, swept medially through and ventral to the medial lemniscus, and terminated in the medial part of the VE and throughout the VD. Degenerating fibers from both of these groups also terminated in the rhomboid, gelatinous, and medial dorsal nuclei of the thalamus. Fibers from the intermediate and posterior parts of the pallidum crossed the internal capsule in diffuse bundles and terminated in the medial and posterior zones of the reticular nucleus respectively. Most of the fibers passed through the reticular nucleus and terminated uniformly in the VA, VD, VM and the ventral portion of the VE. Some terminated in the medial and midline thalamic nuclear groups. The character of terminal degeneration differed markedly. In the ventral aspect of the VE it had a fine dust-like appearance whereas in the VA, VD, and VM it was coarsely granular. Autoradiography confirmed the course and terminations described above except that reduced silver grains were not observed in the rhomboid, gelatinous and medial dorsal nuclei of the thalamus. Also, autoradiography confirmed that the dust-like terminal degeneration in the ventral VE was of the anterograde type since the leucine label was concentrated in precisely the same area.
Use of Bacillus subtilis in the three-hour cylinder-plate assay for penicillin.

The method of penicillin assay involving physical development of seeded plates has been extended to include plates seeded with Bacillus subtilis. The optimum conditions for tests with this organism are described. Advantages of using B. subtilis instead of S. aureus in this procedure are that assays can be completed more rapidly with the former or ganism, and that, with optimum conditions, the demarcation between areas of inhibition and of noninhibition is sharper. This rapid assay method provides reliable estimates of total penicillin activity in mixtures of different penicillins but is not suitable for performing “differential” assays.
Low-frequency noise in serial arrays of MgO-based magnetic tunnel junctions

We have studied the low-frequency noise in MgO-based magnetic tunnel junctions (MTJs) in serial configurations. Two types of junctions were compared: MTJ Wheatstone bridges and MTJ discrete resistors closely packed on a wafer die. We have characterized each individual junction to ensure that they have uniform parameters such as linear field sensitivity and noise level. In the array of bridges, the low-frequency noise decreases with an increasing number ($N$) of bridges, but does not scale with $1/\sqrt{N}$, as expected from noise theory. The deviation is likely due to the statistical dispersions in MTJ bridge resistance and normalized voltage noise. The total noise of the discrete resistor series does not scale with $1/\sqrt{N}$ either, but rather exhibits a sinusoidal-like variation with $N$. We attribute it to the possible enhancement of noise from magnetic coupling among the tightly spaced MTJ elements.
Errors in medical interpretation: our concerns for public health and a call for caution.

To the Editor .— We read with concern Flores et al’s findings on errors in medical interpreting in the January 2003 edition of Pediatrics .1 However, upon closer inspection, we find several flaws in the study’s methods and analyses, which may unnecessarily alarm limited English proficiency (LEP) patients and the clinicians who work with them. Errors are an acknowledged part of medical practice.2 There exists a well-developed literature of the analysis of error in clinical practice in general.2–6 Among the error classification system used by the authors, we hold that omission, addition, substitution, editorialization, and false fluency are highly debatable categories, they lack reproducibility, and neither correlate necessarily with quality of interpretation nor the quality of care provided. There are other striking flaws in the study that lead to misleading conclusions: 1. Methodologically, the study lacks proper controls. At the very least, the encounters under analysis ought to have been compared with encounters between non-LEP patients and clinicians, as well as those between LEP patients and clinicians in the absence of an interpreter. 2. The errors are presented out of context: both interpreters and ad hoc “interpreters” are reported to commit, on average, 31 errors per encounter. This, however, represents only 0.81% of potential word errors (considering that each encounter averaged 3781 words), a far cry from the “alarmingly common” (p. 10) frequency claimed by the authors. 3. Errors committed by clinicians were attributed to interpreters. The authors defend this by stating that “the study focus was on errors of interpretation made by any staff member acting as a medical interpreter during a clinical encounter” (p. 7). However, their final comparison was not between the number of errors made when an interpreter was present vs. number of errors made when an interpreter was not present, but rather between …
Sol-gel coating technology for the preparation of solid-phase microextraction fibers of enhanced thermal stability.

A novel sol-gel method is described for the preparation of solid-phase microextraction (SPME) fibers. The protective polyimide coating was removed from a 1-cm end segment of a 200 μm o.d. fused-silica fiber, and the exposed outer surface was coated with a bonded sol-gel layer of poly(dimethylsiloxane) (PDMS). The chemistry behind this coating technique is presented. Efficient SPME-GC analyses of polycyclic aromatic hydrocarbons, alkanes, aniline derivatives, alcohols, and phenolic compounds in dilute aqueous solutions were achieved using sol-gel-coated PDMS fibers. The extracted analytes were transferred to a GC injector using an in-house-designed SPME syringe that also allowed for easy change of SPME fibers. Electron microscopy experiments suggested a porous structure for the sol-gel coating with a thickness of ∼10 μm. The coating porosity provided higher surface area and allowed for the use of thinner coatings (compared with 100-μm-thick coatings for conventional SPME fibers) to achieve acceptable stationary-phase loadings and sample capacities. Enhanced surface area of sol-gel coatings, in turn, provided efficient analyte extraction rates from solution. Experimental results on thermal stability of sol-gel PDMS fibers were compared with those for commercial 100-μm PDMS fibers. Our findings suggest that sol-gel PDMS fibers possess significantly higher thermal stability (>320 °C) than conventionally coated PDMS fibers that often start bleeding at 200 °C. This is due, in part, to the strong chemical bonding between the sol-gel-generated organic-inorganic composite coating and the silica surface. Enhanced thermal stability allowed the use of higher injection port temperatures for efficient desorption of less-volatile analytes and should translate into extended range of analytes that can be handled by SPME-GC techniques. Experimental evidence is provided that supports the operational advantages of sol-gel coatings in SPME-GC analysis.