cssi/SciSciGPT-SciSciNet huggingface dataset:
Sa1491 Automating Endoscopy Unit Efficiency Metrics: Leveraging the Electronic Health Record for Process Improvement

Kaplan-Meier Curve: Requirement of further therapy in IBD and non-IBD patients. Sa1491 Automating Endoscopy Unit Efficiency Metrics: Leveraging the Electronic Health Record for Process Improvement Ziad Gellad*, David Chermak, Emmanuel Brown, Javad Taheri Duke University Medical Center, Durham, NC; Durham VA Medical Center, Durham, NC; Industrial and Systems Engineering, North Carolina State University, Raleigh, NC Purpose: Improving efficiency in GI endoscopy is both a business mandate and a quality imperative. Meaningful endoscopy unit efficiency metrics have been published but access to reliable time data impedes use of these measures. Methods: We developed a custom query of our electronic health record (Epic, Verona, WI) to obtain time tracking data for gastrointestinal endoscopy procedures occurring in our hospital based endoscopy unit and smaller ambulatory surgical center. Physicians in these units perform a broad array of diagnostic and therapeutic endoscopy with a mix of anesthesia and non-anesthesia sedation. To obtain time stamps, we first mapped the flow of patients through the endoscopy unit as a series of discrete events from check-in to discharge. Secondly, through a process of observation and qualitative analysis, we identified specific nursing and physician activities within the electronic health record that corresponded to the beginning and end of each discrete event. Thirdly, we identified specific data elements in the electronic record that indicated time parameters for these events. Fourth, we queried the electronic record data tables to build a custom dataset of time stamps for each completed patient encounter. Required time stamps were available in over 95% of encounters; missing time stamps were excluded from calculations. Finally, we calculated a set of efficiency metrics from this dataset that included: Procedure Volume, Room Utilization, Overtime, On-Time Start, Room Turnover Time, and Patient Waiting Time. Results: Between July 1, 2013 and June 30, 2014, we collected time stamp data on 3,741 cases in the ambulatory surgical site and 5,743 cases in the hospital based unit. Efficiency metrics, averaged monthly over the time period of collection, are outlined in the table. The ambulatory site was more efficient than the hospital based unit across all metrics. Conclusions: Through careful process mapping and workflow standardization, the electronic health record can be leveraged to collect time data for endoscopy unit efficiency metrics. Collection of these metrics can be used to benchmark against other practices and help guide process improvement activities. Average monthly endoscopy unit efficiency metrics (mean, sd)
Polycyclic Aromatic Hydrocarbon Formation in Opposed Flow Diffusion Flames of Ethane

Abstract The effect of fuel-side carbon density on the levels of polycyclic aromatic hydrocarbon (PAH) formation in atmospheric pressure, opposed flow, ethane diffusion flames has been studied using heated micro-probe sampling and gas chromatography/mass spectrometry (GC/MS). Mole fraction profiles of about 30 major and minor species, as well as trace aromatic and substituted aromatic hydrocarbons and PAHs (up to C14H10, e.g., cyclopenta[cd]pyrene), were quantified by direct gas analysis of samples withdrawn from within the flame without any pre-concentration. Results indicate that fuel-side carbon density and changes in flame temperature markedly influence the levels of benzene and PAH formed within opposed flow diffusion flames. Significant O2 penetration was also noted on the fuel-rich side of the flame at a lower fuel dilutions, suggesting PAH formation may be also associated with O2-catalyzed reactions.
Specifying the EKC: Downstream Dependence in Water Pollution

The present study provides a utility maximizing theoretical framework motivating the EKC model. Theoretical parameters are linked directly to the typical empirical parameters of the reduced form empirical EKC model. Linking the theory to the typical empirically estimated parameters is relevant for devising policy and future EKC studies.
Wealth Accumulation Over the Life Cycle and Precautionary Savings

This article constructs and simulates a life cycle model of wealth accumulation and estimates the parameters of the utility function (the rate of time preference and the coefficient of risk aversion) by matching the simulated median wealth profiles with those observed in the Panel Study of Income Dynamics and in the Survey of Consumer Finances. The estimates imply a low degree of patience and a high degree of risk aversion. The results are used to study the importance of precautionary savings in explaining wealth accumulation. They imply that wealth accumulation is driven mostly by precautionary motives at the beginning of the life cycle, whereas savings for retirement purposes become significant only closer to retirement.
Observation of Enhanced Diamagnetism above T c in Indium Due to Thermodynamic Fluctuations

We have observed a temperature-dependent enhanced diamagnetism above the critical temperature in pure bulk indium which we attribute to the effects of thermal fluctuations. The magnitude of the effect and the manner in which it scales with magnetic field are in agreement with a finite-field generalization of a zero-field result based on the Ginzburg-Landau theory.
Effects of nocodazole, a new synthetic microtubule inhibitor, on movement and spreading of mouse peritoneal macrophages

Abstract Colchicine treatment enahnces movement and suppresses spreading of mouse peritoneal macrophages. The effects of colchicine could result either from disruption of cytoplasmic microtubules or from other actions of colchicine on mammalian cell processes. Nocodazole is a new synthetic microtubule inhibitor that is structurally dissimilar to colchicine and is therefore unlikely to share with colchicine any common action besides of inhibition of microtubule assembly. Nocodazole was shown here to have activities similar to colchicine on macrophage migration and spreading. This supports the idea of a direct relationship between disruption of cytoplasmic microtubules and macrophage migration and spreading.
Automatic Correction of Saturated Regions in Photographs using Cross-Channel Correlation

Incorrectly setting the camera's exposure can have a significant negative effect on a photograph. Over-exposing photographs causes pixels to exhibit unpleasant artifacts due to saturation of the sensor. Saturation removal typically involves user intervention to adjust the color values, which is tedious and time-consuming. This paper discusses how saturation can be automatically removed without compromising the essential details of the image. Our method is based on a smoothness prior: neighboring pixels have similar channel ratios and color values. We demonstrate that high quality saturation-free photos can be obtained from a simple but effective approach.
Approaches to an Yneamine Resin as a General-Purpose Condensing Agent

Abstract The synthetic utility and shortcomings of resins which activate carboxyl groups to form anhydrides, esters, or amides such as polycarbodiimide resins and poly-EEDQ resins are examined. The use of a polymer-bound yneamine function for such purposes is proposed, and synthetic approaches to this goal are described. Tentative evidence for the existence of a stable intermediate in the reaction of an insoluble yneamine with benzoic acid is also presented.
Effect of settling on performance of the upflow anaerobic sludge bed reactors

Abstract The effects of settler volume on the start-up and steady-state performance of 41. laboratory upflow sludge bed reactors treating bean blanching waste of 10,000 mg COD l−1 were determined. The rate of start-up, as well as the maximum loading rate, increased with increased settler volume and performance. A loading rate of 30 kg COD m−3 day−1 (based on reactor volume alone) and a COD removal of 95% was obtained with a 21. settling flask and a 4 to 1 recirculation rate. Without a settler, the maximum loading rate was 10 kg COD m−3 day−1. The sludge was flocculent rather than granular. Sludge profiles and characteristics in the reactors and settlers were determined.
A theory of the densification-induced fragmentation in glasses and ceramics under dynamic compression

A boundary of failure which follows a shock front is observed in glasses and ceramics above a critical compressive shock load. This boundary, called the failure wave leaves behind a damaged material with newly evolved properties. These include the Tresca yield behavior and the reduction in sound speed. The evolution of the Mescall zone during long-rod penetration of these materials is associated with this wave. But, the failure wave and this accompanying process of fragmentation under dynamic compression are still not understood. It is known that some brittle solids undergo an irreversible density increase when subjected to high compression. This phenomenon, called densification is linked to the formations of slip lines and cracks in intensely compressed regions of silica glass. It also corresponds directly to the losses in shock wave speeds. Once densified, a region tends to shrink, straining the interface between it and the original solid. Stressed interfaces are unstable and may roughen, causing local cracking. On this basis, the failure wave is idealized as a propagating fracture boundary layer where the solid is comminuted by a process of densification interface roughness. The kinetics for this process are established using the fluctuation dissipation theorem. Shear and tensile modes of fragmentation are studied in plane stress. The theory predicts the powder size in the Mescall zone of silica glass. Nevertheless, this theory still needs experimental verification.
Generalized flory equation of state for hard chain—hard monomer mixtures of unequal segment diameter

Abstract A generalized Flory equation of state is derived for hard chain—hard monomer mixtures, where the monomer diameter is different from the chain segment diameters. An alternate derivation of the osmotic equation of state for binary mixtures is also presented; the equation is derived by inserting both species simultaneously into the fluid. The alternative osmotic equation of state, combined with the generalized Flory theory, predicts the conformal solution mixing rule when the monomer and chain segments are of the same diameter. Chain insertion probabilities, required in the osmotic equation of state in order to predict thermodynamic properties, are estimated using monomer mixture insertion probabilities based on the equation of state of Mansoori and the generalized Flory theory. An extensive set of hard 4-mer—monomer and hard 8-mer—monomer Monte Carlo simulations have also been performed. Simulation compressibility factors are compared to the new equation of state's predictions; agreement is quite good.
The surgical pathology of pulmonary infarcts: diagnostic confusion with granulomatous disease, vasculitis, and neoplasia

Twenty-three cases of surgically resected pulmonary infarcts sent in consultation were reviewed to evaluate their morphology and to assess reasons for consultation. The morphology of these infarcts demonstrated that only a minority had the classical triangular shape at low magnification (26%) whereas the majority were either spherical (17%) or had a geographic pattern of necrosis (35%). The margin of the infarcted tissue often had a pseudogranulomatous appearance due to palisaded histiocytes, foam cells, or perpendicularly oriented proliferations of fibroblasts and myofibroblasts (74%) and occasional cholesterol- and hemosiderin-laden giant cells. Basophilic granular karyorrhectic necrosis was seen focally (52%) as was vascular inflammation (56%) raising the differential diagnosis of Wegener's granulomatosis or infectious granulomas. These nonclassical features combined with a low incidence of clinical hemoptysis, chest pain and pleurisy, and a primary radiographic diagnosis of 'nodule r/o malignancy' highlight the need to consider thromboembolic pulmonary infarcts in the differential diagnosis of necrotic lung nodules with a histiocytic and fibroproliferative rim.
Differential Halothane Binding and Effects on Serum Albumin and Myoglobin

To understand further the weak molecular interactions between inhaled anesthetics and proteins, we studied the character and dynamic consequences of halothane binding to bovine serum albumin (BSA) and myoglobin using photoaffinity labeling and hydrogen-tritium exchange (HX). We find that halothane binds saturably and with submillimolar affinity to BSA, but either nonspecifically or with considerably lower affinity to myoglobin. Titration of halothane binding with guanidine hydrochloride suggested more protection of binding sites from solvent in BSA as compared with myoglobin. Protection factors for slowly exchanging albumin hydrogens are increased in a concentration-dependent manner by up to 27-fold with 10 mM halothane, whereas more rapidly exchanging groups of albumin hydrogens have either unaltered or decreased protection factors. Protection factors for slowly exchanging hydrogens in myoglobin are decreased by halothane, suggesting destabilization through binding to an intermediate or completely unfolded conformer. These results demonstrate the conformation dependence of halothane binding and clear dynamic consequences that correlate with the character of binding in these model proteins. Preferential binding and stabilization of different conformational states may underlie anesthetic-induced protein dysfunction, as well as provide an explanation for heterogeneity of action.
Current debates in global strategy

Debates help drive research forward. This paper is unique in its review of four current debates in the global strategy arena: (1) cultural vs institutional distance; (2) global vs regional geographic diversification; (3) convergence vs divergence in corporate governance; and (4) domestic vs overseas corporate social responsibility. For each debate, the history is tracked and the emerging tension highlighted. By introducing both sides of four lively and timely debates, the paper provides an innovative way of reviewing the literature and helping to advance the field. It is argued that an underlying theme connecting these four diverse debates is the institution-based view of global strategy.
Spillovers, spill-ins, and strategic entrepreneurship: America's first commercial jet airplane and Boeing's ascendancy in commercial aviation

Building on recent studies on knowledge spillovers and spill-ins, this study traces the post-World War II knowledge spillovers during the early days of the modern commercial aviation industry. It examines the impact these spillovers had on opportunity- and advantage-seeking behaviors (i.e., strategic entrepreneurship) of the leading American incumbents: Douglas, Lockheed, Boeing, and a new entrant, de Havilland of Great Britain. Specifically, it highlights the processes triggered by knowledge spillovers that led to internal knowledge generation, innovations and, ultimately, Boeing's ascendancy in commercial aviation. It shows that knowledge spillovers and the concomitant processes they trigger can provide a powerful lens for studying opportunity- and advantage-seeking behavior in incumbents and entrants and the resultant outcomes of this dynamic. This study sensitizes researchers to examine the nuanced and complex interplay among knowledge generation, knowledge spillovers and spill-ins, and strategic entrepreneurship within a specific industry context to explain performance outcomes. Copyright © 2010 Strategic Management Society.
Topics in decision tree based speech synthesis

Abstract Most modern speech synthesis systems using context dependent decision trees in their acoustic synthesis modules are unit selection style concatenative speech synthesis systems using the trees essentially as a form of pruning during their segment search. The IBM Trainable Speech Synthesis System is one such system. This paper begins by discussing the advantages and disadvantages of the decision tree and non-decision tree approaches to unit selection synthesis. It goes on to present the results of formal listening tests conducted on the IBM system to investigate a number of different topics pertinent to decision tree based systems. These include the use of extended context features during clustering, the effect of using trees with different numbers of leaves and different numbers of segments per leaf, and the performance of several different off-line segment preselection algorithms.
Modeling of Dynamically Loaded Open-Cell Metallic Foams: Yielding, Collapse, and Strain Rate Effects

Open-cell metallic foams exhibit properties desirable in engineering applications requiring mitigation of the adverse effects resulting from impact loading; however, the history dependent dynamic response of these cellular materials has not been clearly elucidated. This article contributes an approach for modeling the response of dynamically loaded open-cell metallic foams from ligament level to unit cell level to specimen level. The effective response captures the localized chaotic collapse phenomena through ligament reorientation at cell level while maintaining the history of plastic deformation at ligament level. First, the phenomenological elastoplastic constitutive behavior of the ligaments composing the unit cell is modeled. Then, using the constitutive ligament model, the effective unit cell response is obtained from a micromechanical model that enforces the principle of minimum action on a representative 3D unit cell. Finally, the macroscopic specimen response is predicted utilizing a finite element analysis program, which obtains the response at every Gauss point in the mesh from the microscopic unit cell model. The current communication focuses on the ability of the model to capture the yielding and collapse behaviors, as well as the strain rate effects, observed during impact loading of metallic foams.
Peripheral Spinal Cord Hypointensity on T2-weighted MR Images: A Reliable Imaging Sign of Venous Hypertensive Myelopathy

BACKGROUND AND PURPOSE: MR findings reported in conjunction with spinal dural arteriovenous fistula (SDAVF) include cord swelling, increased T2 signal within the spinal cord, and parenchymal enhancement, each of which is nonspecific. Enlarged vessels on the cord surface, the most specific MR finding, is noted in only half of SDAVF patients. Nevertheless, we have frequently observed MR peripheral hypointensity of the spinal cord in SDAVF on T2-weighted images, which is not characteristic of nonvascular or nonhemorrhagic causes of myelopathy and which has not been described in association with SDAVF. We hypothesized that peripheral cord hypointensity might reliably suggest the diagnosis of SDAVF or other causes of venous hypertensive myelopathy. METHODS: We reviewed the MR findings in 11 consecutive cases of angiographically confirmed symptomatic SDAVF and in four cases of intracranial dural arteriovenous fistula with spinal drainage, a lesion that also causes spinal cord deficits mediated by venous hypertensive myelopathy. RESULTS: In each case, T2 hypointensity involving the cord periphery was present. This sign has not been previously described in association with either SDAVF or other causes of venous hypertensive myelopathy. It appears, however, to be a relatively constant imaging feature of SDAVF. CONCLUSION: In the absence of spinal hemorrhage, T2 hypointensity involving the periphery of the spinal cord suggests venous hypertensive myelopathy as a cause of spinal cord dysfunction.
From EOQ Towards ZI

Zero Inventory ZI is a new and powerful concept to improve production efficiency. Underpinning ZI is set up reduction and this paper examines what eventuates when set up costs are cut. The folklore is that set up reduction lowers inventory and costs. We obtain results contrary to that. Reducing set up costs need not reduce inventory, for example. Likewise lowering set up costs need not necessarily lower total production and inventory costs. Furthermore, most investments produce marginally decreasing returns. Set up cost reduction prompts the opposite; it produces marginally increasing not decreasing returns. A parametric algorithm that calculates the benefit of set up cost reduction is provided. Most presentations of ZI have been descriptive with very few mathematical models of it yet untaken. By modeling certain ZI concepts mathematically, we scrutinize their validity and sometimes invalidity.
The effects of combined pressure–temperature on mechanical behavior of polypropylene

The effects of combined pressure and temperature on the mechanical behavior of polypropylene have been studied. Tests were conducted in tension and compression superimposed on various hydrostatic pressures up to 7 kbar at temperatures of 20, 50, and 75°C. The experimental data have been analyzed in view of molecular and continuum approaches. It has been observed that the Young's modulus and the yield strength in both tension and compression increased significantly with increasing pressure at all temperatures studied. However, the rate of increase of the Young's modulus undergoes abrupt change about the glass-transition pressure (Pg). The Pg is linearly dependent on the test temperature and the pressure coefficient of the Tg is estimated, from Pg versus temperature relations, to be about 18°C/kbar for the polypropylene samples of this study. Pressure dependence of the yield stress is described by a generalized Eyring theory incorporating pressure effects and two flow mechanisms, the α- and the β-relaxation processes. The theory predicts a bilinear dependence of the yield stress of polypropylene on hydrostatic pressure as observed in the tests. The paper also described a method of healing stress whitening in polypropylene by a combination of shear stress and hydrostatic pressure.
Antibacterial gene transfer across the tree of life

Though horizontal gene transfer (HGT) is widespread, genes and taxa experience biased rates of transferability. Curiously, independent transmission of homologous DNA to archaea, bacteria, eukaryotes, and viruses is extremely rare and often defies ecological and functional explanations. Here, we demonstrate that a bacterial lysozyme family integrated independently in all domains of life across diverse environments, generating the only glycosyl hydrolase 25 muramidases in plants and archaea. During coculture of a hydrothermal vent archaeon with a bacterial competitor, muramidase transcription is upregulated. Moreover, recombinant lysozyme exhibits broad-spectrum antibacterial action in a dose-dependent manner. Similar to bacterial transfer of antibiotic resistance genes, transfer of a potent antibacterial gene across the universal tree seemingly bestows a niche-transcending adaptation that trumps the barriers against parallel HGT to all domains. The discoveries also comprise the first characterization of an antibacterial gene in archaea and support the pursuit of antibiotics in this underexplored group.
Exploring Gender Differences on Internalizing and Externalizing Behavior Among Maltreated Youth: Implications for Social Work Action

This purpose of this study was to explore the moderating influence of gender on the relationship between child maltreatment and internalizing symptoms (e.g., affective and somatic problems) and externalizing behavior (e.g., rule breaking behavior and aggression) among children aged 7–12 years old. Using a longitudinal comparison group design and a sample of 300 youth of which 56% (n = 168) had substantiated cases of child maltreatment, results of a structural equation modeling revealed that internalizing symptoms exerted a mediating influence that was conditioned by gender. Only girls’ internalizing symptoms were found to mediate the link between child maltreatment and externalizing behavior while a direct relationship between maltreatment and externalizing behavior was found among boys. These findings provide evidence for gender differences in the pathways between being child maltreatment and maladaptive thoughts, feelings, and behaviors. Thus, adapting evidence-based strategies that target gender specific internalizing behaviors and externalizing behaviors among maltreated youth may significantly reduce the risk of short and long-term maladaptive behavior.
Angiogenic blockade and radiotherapy in hepatocellular carcinoma.

Purpose We report our preliminary experience of combining sunitinib and helical tomotherapy in patients with advanced HCC. Methods and Materials Records of patients with advanced hepatocellular carcinoma (HCC) treated with helical tomotherapy and sunitinib after radiation therapy (RT) from March 2007 to August 2008 were retrospectively reviewed. We report acute toxicities, radiologic response, serial α-fetoprotein (AFP) kinetics, and survival. Results Of 23 evaluable patients, 60% had ≥2 hepatic lesions, extrahepatic disease was present in 5 (21.7%), and all received 2 tablets (25 mg) of sunitinib at least 1 week before, during, and 2 weeks after RT. Thirteen patients continued maintenance sunitinib after RT until disease progression. Hypofractionated RT with a median target dose of 52.5 Gy/15 fractions was delivered. An objective response was achieved in 74% of patients. The 1-year survival rate was 70%, with median survival of 16 months. Multivariate analysis showed that maintenance sunitinib was the most significant factor for survival. The time to progression was 10 months in the maintenance group compared with 4 months in the control group. Eighteen out of 21 patients with elevated AFP (85.7%) had ≧50% decline of AFP within 2 months after RT. There were three episodes of upper gastrointestinal bleeding and one episode of pancreatitis; 10 patients had ≥Grade 2 elevation of liver enzymes, and 15 had ≥Grade 2 thrombocytopenia. Conclusions These preliminary results suggest that sunitinib and helical tomotherapy yield high Response Evaluation Criteria in Solid Tumors (RECIST) and AFP response rates in advanced HCC with an acceptable safety profile. Maintenance sunitinib after RT potentially prolongs survival. A randomized trial is warranted.
Assessing the Feasibility of Controlling Aedes aegypti with Transgenic Methods: A Model-Based Evaluation

Suppression of dengue and malaria through releases of genetically engineered mosquitoes might soon become feasible. Aedes aegypti mosquitoes carrying a conditionally lethal transgene have recently been used to suppress local vector populations in small-scale field releases. Prior to releases of transgenic insects on a wider scale, however, most regulatory authorities will require additional evidence that suppression will be effective in natural heterogeneous habitats. We use a spatially explicit stochastic model of an Ae. aegypti population in Iquitos, Peru, along with an uncertainty analysis of its predictions, to quantitatively assess the outcome of varied operational approaches for releases of transgenic strains with conditional death of females. We show that population elimination might be an unrealistic objective in heterogeneous populations. We demonstrate that substantial suppression can nonetheless be achieved if releases are deployed in a uniform spatial pattern using strains combining multiple lethal elements, illustrating the importance of detailed spatial models for guiding genetic mosquito control strategies.
The PANGLOSS MARK I MAT system

The goal of the PANGLOSS projecd is to develop a system which will, from the very beginning, produce highquality translations of unconstrained text. This can only be attained currently by keeping the human in the translation loop, in our case via a software module called the A U O ~ R . The main measure of progress in the development of the Pangloss system will therefore be the gradual decrease in need for user assistance, as the level of automation increases. The analyzer used in the first version of PANGLOSS, PANGLOSS MARK I, is a version of the ULTRA Spanish analyzer from NMSU [Farwell 1990], while generation is carried out by the PENMAN generator from ISI [Mann 1983]. The Translator's Workstation (TWS) provides the user interface and the integration platform [Nirenburg 1992]. This paper focuses on this use of TWS as a substrate for PANGLOSS. PANOLOSS operates in the following mode: a) a fullyautomated translation of each full sentence is attempted; if it fails, then b) a fully-automated translation of smaller chunks of text is attempted (in the first PANGLOSS configuration, PANGLOSS MARK I, these were noun phrases); c) the material that does not get covered by noun phrases is treated in "word-for-word" mode, whereby translation suggestions for each word (or phrase) are sought in the system's MT lexicons, a machine-readable dictionary, and a set of user glossaries; d) The resulting list of translated noun phrases and translation suggestions for words and phrases is displayed in a special editor window of TWS, where the human user finalizes the translation. At stages a) and b) there is an option of the user being presented by the system with disambiguation questions via the AUGMENTOR. We provide an intelligent environment, the CMAT (Constituent Machine-Aided Translation) editor, for postediting. It allows the user to select, move, and delete words and phrases (constituents) quickly and easily, using dynamically-changing menus. As can be seen in Figure 1, each constituent in the target window is surrounded by " >" characters. If the user clicks with the mouse anywhere within a constituent (between the " >" symbols), a CMAT menu for that constituent appears. It contains the word or phrase in the source text if available, the functions Move and Delete, and alternative translations of the word or phrase from the source text if any. Using these popup menus, the user moves, replaces, or deletes a constituent with a single mouse action, rapidly turning the list of translated words
Content delivery networks: protection or threat?

Content Delivery Networks (CDNs) are commonly believed to offer their customers protection against application-level denial of service (DoS) attacks. Indeed, a typical CDN with its vast resources can absorb these attacks without noticeable effect. This paper uncovers a vulnerability which not only allows an attacker to penetrate CDN's protection, but to actually use a content delivery network to amplify the attack against a customer Web site. We show that leading commercial CDNs - Akamai and Limelight - and an influential research CDN - Coral - can be recruited for this attack. By mounting an attack against our own Web site, we demonstrate an order of magnitude attack amplification though leveraging the Coral CDN. We present measures that both content providers and CDNs can take to defend against our attack. We believe it is important that CDN operators and their customers be aware of this attack so that they could protect themselves accordingly.
Marijuana and sexual activity

Abstract This research was intended to discern any correlations between marijuana and human sexual activity. I was specifically interested in exploring the concept that the drug might produce different effects on males and females in regard to their sexual activity. Finally, I was concerned with the dosage of the drug which would produce the most pronounced effect on the majority of the users in regard to their sexual activity.
A New Method of Testing for Distortion in Audio-Frequency Amplifiers

A periodic voltage wave consisting of a series of straight lines is distorted into a series of curves when it passes through an amplifier which gives nonuniform amplification. As such distortion can very readily be detected visually with an oscillograph, it affords a means of testing for uniformity of amplification. Mathematical analysis shows that a "saw-tooth" voltage wave is distorted into a series of exponential curves in passing through a resistance-capacity-coupled amplifier, the distortion being considerable at low audio frequencies if the coupling capacity or the grid-leak resistance is too small. The analysis proves that a falling off in amplification of less than 1/2 per cent at low audio frequencies can be detected with ease. In other types of amplifiers the distortion is not necessarily exponential, but curvature of the output wave is in general a sign of nonuniform amplification or phase shift. The method is applicable to the testing of any type of coupling circuit. The apparatus required for this method of testing is very readily constructed and is of general laboratory usefulness.
High-power current source with real-time arbitrary waveforms for in vivo and in vitro studies of defibrillation

Defibrillators are standard tools for treating cardiac fibrillation; however, the mechanisms by which they terminate deadly cardiac arrhythmias are still not fully understood, and optimizations to lower energies are very desirable. Clinical defibrillators do not provide a precise control of shock timing, duration, and voltage (current), and operate with fixed waveforms. Therefore, they are not suitable for research, particularly when studying low-energy defibrillation methods that require an examination of arbitrary and strictly timed waveform shocks of varying strength and duration. We present a custom-made microcontroller voltage-to-current converter (V2CC) with an output isolated from the Earth ground, capable of delivering up to 1 A continuously and up to 5 A into a 40 Ω load for >500 ms in a pulsed regime. For currents lower than 5 A, the load resistance can be higher, so that the product current times resistance is guaranteed to be up to 200 V. Bandwidth is in excess of 1 kHz, timing accuracy, response time, and rise and fall times are better than 10 μs. In addition, multiple safety mechanisms are implemented to protect the device and the operator. In our feedback control experiments the device has been tested successfully on isolated rabbit hearts. The V2CC is primarily designed to be used in ex vivo cardiac experiments, but is suitable for a wide variety of settings that require a high-current source of arbitrary waveforms.
Design Wars: Developing student creativity through competition

Design Wars was developed as a multi-disciplinary design competition in which teams of students receive the same assignment, materials, technology tools for communication and time to complete the project. The student teams were separated into two groups - the documentation team (in the “design office”) and the actualization team (on the “build floor”). They were tasked with designing, constructing, and documenting an engineered solution to a complex problem on site within eight hours, with all design decisions communicated between the two groups via mobile computing. The competition was developed to challenge the students' creativity and communication skills; judging was based on the elements of creativity including originality, flexibility, fluency, elaboration and aesthetics. Additionally, students were judged on their ability to document their team's decisions and alternative solutions. Because creativity in engineering is unsuccessful without functionality, the final projects were penalized if they failed in execution.
Large displacement linear actuator

The design and performance of a large-force, large-amplitude electrostatic actuator that exhibits the best features of previous electrostatic actuator designs are described. A tangential drive (T-drive) polysilicon, linear actuator is presented. It produces large-magnitude tangential motion by flexing a microstructure in an essentially straight line with moderate input voltage. These devices are designed, fabricated, and successfully tested to have substantial displacements even for static positioning. The working principle of the T-drive is that the strong electrostatic forces of attraction between a fixed bar and a free bar are converted to large-amplitude tangential motion by the parallelogram flexural suspension of the free bar. Operating devices are capable of tangential displacements as great as 32 mu m. This displacement is stable and easily varied, because the tangential displacement can be controlled by adjusting the potential between the fixed electrode and the traversing bar. Static displacements are detectable for voltages as low as 15 VDC. Typical T-drives have free bars 200 mu m long and 12 mu m wide, with flexural suspensions 450 mu m long and 2 mu m wide. All component thicknesses are 2 mu m. Theoretical models for both the flexural suspension and electrostatic forces are derived, and they predict the relation between tangential displacement and excitation voltage. >
Aging and Informal Caregiving to People with HIV/AIDS:

This article reviews the growing research dealing with informal caregivers to peoplewith HIV infection or AIDS, focusing particularly on the intersection of this workwith research on aging. It contrasts AIDS caregiving with what is known aboutcaregiving in general, which is often associated with caring for a frail older person.This comparison points to a scholarly literature in which aging, gender, generationaldifferences, and life-course issues have been a central concern. In addition, using datafrom the UCSF Care Study, this article presents some results from analyses concernedspecifically with the interpretation of age-related effects and caregiving. It emphasizesthe diversity among AIDS caregivers, who may be friends, partners, or familyrelatives, and the diversity of their experiences with caregiving, loss, and aging. Italso outlines important methodological and conceptual links between a life-courseperspective on aging and AIDS caregiving and suggests how each scholarly concernmay inform the other.
Regional structure–function relationships in mouse aortic valve tissue

Site-specific biomechanical properties of the aortic valve play an important role in native valve function, and alterations in these properties may reflect mechanisms of degeneration and disease. Small animals such as targeted mutagenesis mice provide a powerful approach to model human valve disease pathogenesis; however, physical mechanical testing in small animals is limited by valve tissue size. Aortic valves are comprised of highly organized extracellular matrix compartmentalized in cusp and annulus regions, which have different functions. The objective of this study was to measure regional mechanical properties of mouse aortic valve tissue using a modified micropipette aspiration technique. Aortic valves were isolated from juvenile, adult and aged adult C57BL/6 wild type mice. Tissue tensile stiffness was determined for annulus and cusp regions using a half-space punch model. Stiffness for the annulus region was significantly higher compared to the cusp region at all stages. Further, aged adult valve tissue had decreased stiffness in both the cusp and annulus. Quantitative histochemical analysis revealed a collagen-rich annulus and a proteoglycan-rich cusp at all stages. In aged adult valves, there was proteoglycan infiltration of the annulus hinge, consistent with the observed mechanical differences over time. These findings indicate that valve tissue biomechanical properties vary in wild type mice in a region-specific and age-related manner. The micropipette aspiration technique provides a promising approach for studies of valve structure and function in small animal models, such as transgenic mouse models of valve disease.
Intermediate-Frequency Gain Stabilization with Inverse Feedback

Increased gain stability and gain-bandwidth product result from the use of inverse feedback in an intermediate-frequency amplifier. Improvement in gain stability is related to the number of cascaded stages, the stage gain, and the magnitude of the feedback. A circuit is described which uses feedback over a pair of cascaded stages. Generalized selectivity curves for this feedback couple axe shown, and the design procedure is outlined. A description of an experimental amplifier concludes the paper.
Does weight loss immediately before bariatric surgery improve outcomes: a systematic review

Abstract Background Preoperative weight loss before bariatric surgery has been proposed as a predictive factor for improved patient compliance and the degree of excess weight loss achieved after surgery. In the present study, we sought to determine the effect of preoperative weight loss on postoperative outcomes. Methods A search of MEDLINE was completed to identify the patient factors associated with weight loss after bariatric surgery. Of the 909 screened reports, 15 had reported on preoperative weight loss and the degree of postoperative weight loss achieved. A meta-analysis was performed that compared the postoperative weight loss and perioperative outcomes in patients who had lost weight preoperatively compared to those who had not. Results Of the 15 articles (n = 3404 patients) identified, 5 found a positive effect of preoperative weight loss on postoperative weight loss, 2 found a positive short-term effect that was not sustained long term, 5 did not find an effect difference, and 1 found a negative effect. A meta-analysis revealed a significant increase in the 1-year postoperative weight loss (mean difference of 5% EWL, 95% confidence interval 2.68–7.32) for patients who had lost weight preoperatively. A meta-analysis of other outcomes revealed a decreased operative time for patients who had lost weight preoperatively (mean difference 23.3 minutes, 95% confidence interval 13.8–32.8). Conclusion Preoperative weight loss before bariatric surgery appears to be associated with greater weight loss postoperatively and might help to identify patients who would have better compliance after surgery.
A Facilitated Release Mechanism for Quills of the North American Porcupine (Erethizon Dorsatum)

Quill-withdrawal experiments confirm a hypothesis proposing that North American porcupines (Erethizon dorsatum) give up a quill more easily if the quill's root is first thrust back sharply into the porcupine's skin. The hypothesis was tested in 8 porcupines. When quills are impacted in a way that mimics contact with a predator, the tension required to remove an impacted quill from the porcupine's skin was reduced from 90.3 g ± 16.8 SD by 38.1%. The phenomenon was observed only in quills that had been erected by porcupines. This tension-reducing mechanism allows a porcupine to separate more readily from an attacking predator and adds to the effectiveness of porcupine quills as smart weapons.
In vivo metabolism of ethyl-1-14C-N,N-di-n-propylthiolcarbamate in rats

Abstract A study of the metabolism of ethyl-1- 14 C- N,N -di- n -propylthiolcarbamate (EPTC) in adult female rats following oral doses, ranging from 0.6 to 103 mg, was carried out. Results revealed that increasing the dose led to a decrease in 14 CO 2 output with a corresponding increase in urinary excretion of radioactivity. Generally, 14 CO 2 elimination was completed within 15 hr for lower doses, but extended to approximately 35 hr for higher doses. The time for complete urinary elimination of radioactivity was likewise extended. The pattern of 14 CO 2 elimination was changed from a single peaked pattern with lower doses to multiple peaked ones with higher doses. Paper chromatography and radioautography revealed six major radioactive metabolites in the urine. The relative amounts of these metabolites changed with the dose. One of the major metabolites was identified as urea. Attempts to isolate the individual metabolites through ion exchange column chromatography or extraction with organic solvents have not been successful. These procedures, as well as elution of metabolites from the paper strips, demonstrated the labile nature of three major metabolites.
Feeling at Home: Learning, Law & Narrative

Brain science, simplified here, suggests that the first task is to “grab” someone’s attention because “better attention always equals better learning.” (Medina 74) One of the features of stories that captures attention better than cases is their emotional content. Emotionally charged events are more likely to capture our attention and to be remembered. A beneficial consequence of the emotional fixation is that it focuses attention on the context and meaning. Studies suggest that this context is the platform that allows later and successive integration of the details. Thus, stories “work” because they focus attention and provide a context for learning the “details,” i.e., the law. Moreover, the same principles that apply to the success of this strategy in the classroom can also bear fruit in the courtroom and in litigation documents. This paper is designed to complement Prof. O’Neill’s (Univ. of Washington SOL) paper on the use of print media stories about the recent financial crisis to teach contracts. The focus of my paper will be to consider theories and accounts from cognitive as well as evolutionary psychology, neuroscience, and cultural anthropology in order to explain why the use of stories is such an effective teaching and presentation strategy.
Effects of relationship context on contraceptive use among young women.

To understand how relationship status influences contraceptive use among young people.Data were collected as part of a longitudinal study on hormonal contraception among unmarried adolescent and young women who wanted to avoid pregnancy for at least one year, recruited at family planning clinics in the San Francisco Bay Area. Follow-up surveys were completed at 3, 6, and 12months. Longitudinal analysis was used to examine whether relationship characteristics, including type and length of sexual relationship are associated with current use of effective contraception.Among women with a partner at baseline, 78%, 70%, and 61% had the same partner at 3, 6, and 12months follow up, respectively. Women in casual relationships were less likely to use effective contraceptive methods, compared to women in consistent relationships (AOR=0.67, p<.01). Women in new relationships (0-3months) were less likely to use effective contraceptive methods (AOR=0.60, p<.001) compared to women in relationships more than one year in length. Younger women (AOR=0.76, p<.05), black women (AOR=0.67, p<.05) and Latina women (AOR=0.73, p<.05) were also significantly less likely to use effective contraception. These effects remained even after controlling for condom use.Relationship type and length are independently significantly associated with current effective contraceptive use among adolescent and young women. Women in casual relationships and new relationships were significantly less likely to use effective contraceptive methods.Family planning providers should discuss women's relationship context and association with contraceptive use in order to help women think of contraception as a long-term personal strategy. Since relationship status affects contraceptive use, providers and programs that aim to reduce unintended pregnancy can consider strategies to create a paradigm shift around contraceptive use that focuses on the woman's reproductive goals, current life stage, and life goals.
ZnO on Si3N4 Bimorphs with Large Deflections

Piezoelectric bimorphs and piezoelectric strain sensors based on sputtered ZnO films were fabricated on Si3N4 cantilever beams to form tactile sensors. The sensors were used to determine object positions. Deflections of the bimorphs showed a quadratic dependence on the applied voltages. Deflection as large as 1166 μm were registered for a bimorph of 2980 μm long. The apparent d31 of ZnO under a bias of -4 volts was - 103 × 10-12 m/V, which was approximately 20 times larger than the previously reported values of -5.12 × 10-12m/V. The large deflections of the bimorphs were due to the quadratic effect under strong electric field.
Cerebral Palsy and Neonatal Encephalopathy

The type and severity of cerebral palsy (CP) and pattern of associated disability in children with or without preceding neonatal encephalopathy (NE) were compared in a population-based case-control study of patients followed for 6 years at the Children’s Hospital, Westmead, Sydney, Australia.