cssi/SciSciGPT-SciSciNet huggingface dataset:
Psychodynamic intervention in brief psychotherapy

This paper will describe a framework for an intensive psychotherapeutic intervention useful in consultation and its extension in brief psychotherapy. The approach is designed to address symptomatic expressions of distress that arise as the expression of unconscious conflict provoked by situations of crisis. It may also be a model for selected patients in longer therapies that address ongoing problems. This therapeutic approach has elements familiar to any experienced therapist, but is specific in its conceptualization. What distinguishes this therapy from others is the induction and utilization of a special positive quality in the therapeutic relationship as a therapeutic aim and "curative factor" in its own right beyond its role as the substrate for a trusting relationship that underlies all successful psychotherapeutic elements. This involves a specific strategy and technique designed to develop a "benevolent transference" to effect change, sometimes to achieve symptom relief, sometimes as a precursor to meaningful insight. In this respect the relationship, considered to be a central feature of the therapy, compliments understanding as a vehicle for change. A variety of interventions are described to facilitate this process and are illustrated in case presentations. This presentation is a synthesis of a number of papers on active engagement of the patient in psychodynamic psychotherapy. Two DVDs that illustrate this approach in consultations with patients are available for presentation. One is a three-session psychotherapy with an eight-month follow-up. The patient interviews are edited and may be the focus of separate sessions.
Show and tell: Blending and expanding credit by exam and competency-based credit in sport management

Abstract Prior learning assessment has become a common strategy in higher education whereby institutions recognize and legitimize the meaningful learning that takes place outside of the formal educational setting. While institutional prior learning assessment methods vary, credit by exam is one example of a competency-based program that has grown in popularity due in part to its association with student success benefits. In advancing the conventional credit by exam concept, this article describes the Credit By Exam 2.0 program designed to explore alternative pathways in competency-based education. Different from a traditional College-Level Examination Program Test and credit by exam, the unconventional aspect of this program is its expansion beyond the ‘all or nothing’ approach to earning course credit by using a two-phase process that allows a student to test out of portions of course content that he/she can demonstrate as having already mastered. The novel features of this program and its implications will be discussed.
Sediment biomarkers elucidate the Holocene ontogeny of a shallow lake.

We carried out geochemical analyses on a sediment core from Lake Harris, Florida (USA) to identify sources of organic matter to the sediment throughout the Holocene, and relate changes in those sources to shifts in past climate and environmental conditions. We hypothesized that the sources of organic matter changed in response to regional hydrologic shifts following de-glaciation, and to human population expansion in the state during the 20th century. Hydroclimate shifts in Florida were related to: 1) a steady rise in relative sea level and the fresh water table that began in the early Holocene, 2) wetland formation and expansion ca. 5,000 cal yrs BP, and 3) the onset of the modern El Nino (ENSO) cycle ~3,000 cal yrs BP. Stratigraphic changes in sediment variables from Lake Harris reflect each of these hydroclimate periods. Early in the Holocene, Lake Harris was a marsh-like system in a relatively dry, open-prairie environment. Organic sediments deposited at that time were derived largely from terrestrial sources, as inferred from high TOC/TN ratios, a dominance of longer-chain of n-alkanes (n-C29-31), relatively negative organic carbon isotope values (δ13CTOC), and low biogenic silica concentrations. In the middle Holocene, a positive shift in δ13CTOC coincided with the onset of wetter conditions in Florida. Submerged macrophyte biomarkers (n-C21-23) dominated, and during that period bulk organic carbon isotope values were most similar to δ13C values of mid-chain-length n-alkanes. In the late Holocene, δ13CTOC values declined, CaCO3 levels decreased to trace amounts, organic carbon concentrations increased and diatom biogenic silica concentrations increased from 10 to 120 mg g-1. Around 2,900 cal yrs BP, the effects of ENSO intensified and many Florida lakes deepened to their current limnetic state. Concentrations of algal and cyanobacterial biomarkers in the Lake Harris core increased by orders of magnitude after about AD 1940, in response to human-induced eutrophication, an inference supported by values of δ15N that fluctuate around zero.
Successful Adaptation of Immigrants from the former Soviet Union to Project Renewal Neighborhoods: The Influential Factors

Migration has been an international phenomenon for centuries. The widespread trend toward migration in recent years has resulted in efforts to examine the factors involved in the adaptation of immigrants to life in the host country. This study examines the factors that effect immigrant adaptation and integration in urban neighborhoods in Israel that are undergoing a process of rehabilitation. Adaptation is defined by the variables : contact with neighbors, participation in community activities, sense of belonging to the community and well-being. These mediator and dependent variables were found to be directly effected by home and host related variables. These variables were not found to directly effect well-being. Proximity of family and ability to converse in Hebrew were found to have an indirect effect on well-being, constructed using community variables, which themselves directly effect well-being. The discussion of the findings refers both to Project Renewal for the Rehabilitation of Neighborhoods, and the role of professional community workers as planners and movers in the neighborhoods incorpororated in the project
Terramycin in treatment of pneumonias of childhood

CASE 1.--J. B., a 4-month-old Negro male, entered the hospital Feb. 3, 1950, with a toxic appearance but a normal temperature. X-ray confirmed a diagnosis of bilateral bronchopneumonia. The blood cultures were all negative, but the nose and throat cultures revealed pneumococci group B and staphylococci. He was given 1.8 Gin. daily (300 mg. every four hours) of terramycin orally. All clinical and roentgenographic signs of illness disappeared by the fifth day of hospitalization.
Cognitive Components of Depression

Current thinking regarding childhood psycho-pathology stresses the necessity of viewing psycho-pathology from a developmental perspective. Cicchetti and Schneider-Rosen (1984), for example, argue that psychopathology in children should be looked at in terms of failure to negotiate important tasks of social-cognitive competency in the sequence of childhood development. Stage-relevant task mastery is seen as the mechanism by which children progress to new levels of cognitive organization and differentiation. Cognitive reorganization is seen as a process whereby prior levels of organization are subsumed under new hierachies of cognitive structure. As such, failure to negotiate one developmental task has relevance for mastery of subsequent stages and thus implications for later social-cognitive competence on into adulthood.
Clinical Impact of a Restrictive Labor Induction Approval Process

Background/aims The aim of this study was to evaluate the impact of a restrictive labor induction approval process on induction and primary cesarean delivery rates. Methods A retrospective cohort study was conducted at a tertiary care academic center from 2006 through 2012. The cohort of deliveries before (pre-intervention) and after (post-intervention) the process included term, singleton pregnancies with no contraindication to vaginal delivery. The primary outcome was induction of labor rates, subgrouped on the basis of whether it was medically or nonmedically indicated. Secondary outcomes included the primary cesarean rate and other maternal and neonatal outcomes. Results Of 13,753 deliveries, 6,746 met study inclusion criteria. There was a significant decrease in induction rates comparing the pre- and post-intervention periods (21.0 vs. 18.5%, p = 0.01). Nonmedically indicated induction rates also decreased significantly (2.9 vs. 0.6%, p 0.05). Conclusions Implementation of a labor induction approval process was associated with a significant reduction in overall and non-indicated induction rates but did not affect the primary cesarean rate or neonatal outcomes.
Acquisition of English Interjections ouch, yuck, and oops in Early Childhood

Interjections in a language must be learned. This paper discusses acquisition of three English interjections ouch, yuck, and oops by children of as young as 1;7 and by adult caretakers (for comparison). The data analyzed here were taken from three previously-collected data sets which are available in the CHILDES database. The results imply that children may acquire those interjections early but they start using them at different ages due to phonological constraints, and indicate that uses of these interjections may be different between children and adults.
Task Familiarity and Reliance on the Environment in Decision Making

The study investigated change in dependency on the environment as a function of increasing familiarity with the situation. 72 students formed 36 dyads which played a complex tactical and negotiations game for 6 one-half hour periods. Over periods, all subjects reduced their use of the environment as a source of influence on their decisions. Cognitively complex subjects reduced their dependency on the environment sooner and more sharply than simple subjects. It was concluded that as a task situation is mastered, decision makers gain the confidence to take a more active role in structuring it. The implications of increased familiarity with a task situation for the shift to risk phenomenon were indicated.
Do Gender-Appropriate Executive Actions Benefit Female CEOs?

Extant literature on executive gender suggests that female chief executive officers (CEOs) face a penalty for simply being female in a male-dominated role, yet our knowledge of whether such penalti...
National Trends in Location of Death in Patients With End-Stage Liver Disease

Despite improvement in the care of patients with end-stage liver disease (ESLD), mortality is rising. In the United States, patients are increasingly choosing to die at hospice and home, but data in patients with ESLD are lacking. Therefore, this study aimed to describe the trends in location of death in patients with ESLD. We conducted a retrospective cross-sectional analysis using the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research from 2003 to 2018. Death location was categorized as hospice, home, inpatient facility, nursing home, or other. Comparisons were made between sex, age, ethnicity, race, region, and other causes of death. Comparisons were also made between rates of change (calculated as annual percent change), proportion of deaths in 2018, and multivariable logistic regression. A total of 535,261 deaths were attributed to ESLD-most were male, non-Hispanic, and White. The proportion of deaths at hospice and home increased during the study period from 0.2% to 10.6% and 20.3% to 25.7%, respectively. Whites had the highest proportion of deaths in hospice and home. In multivariable analysis, elderly patients were more likely to die in hospice or home (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.07-1.35), whereas Black patients were less likely (OR, 0.58; 95% CI, 0.46-0.73). Compared with other causes of death, ESLD had the second highest proportion of deaths in hospice but lagged behind non-hepatocellular carcinoma malignancy. Deaths in patients with ESLD are increasingly common at hospice and home overall, and although the rates have been increasing among Black patients, they are still less likely to die at hospice or home. Efforts to improve this disparity, promote end-of-life care planning, and enhance access to death at hospice and home are needed.
Cardiac Magnetic Resonance Imaging to Detect Right Atrial Thrombus in Right Ventricular Endomyocardial Fibrosis

Tropical endomyocardial fibrosis (EMF) is endemic in southern districts of Kerala state in India, and sporadic cases are reported from other parts of Kerala. Transthoracic echocardiogram (TTE) is the initial imaging tool and is diagnostic for this condition. The inherent limitation of TTE is its limited sensitivity in the detection of intracardiac thrombus. Transthoracic echocardiography, contrast-enhanced cardiac computed tomography, and cardiac magnetic resonance imaging (CMR) are the imaging modalities for the detection of intracardiac thrombus. This report describes a 46-year-old male with right ventricular EMF (RVEMF) who presented with right heart failure. The TTE diagnosed RVEMF but failed to demonstrate the right atrial thrombus which was clearly seen on CMR. The merits of different imaging modalities for the detection of intracardiac thrombus are discussed.
Brainstem motor neuron dysmorphology and excitatory/inhibitory imbalance in an animal model of autism.

Autism spectrum disorder (ASD) is a developmental disorder associated with in utero exposure to the antiepileptic valproic acid (VPA) in humans, and similar exposure serves as a validated animal model. Animals exposed to VPA in utero have a number of structural, function and behavioral deficits associated with ASD. Furthermore, VPA-exposed animals have shorter body lengths, lower body and brain weights. This difference in body weight may result from impaired caloric intake due to impaired oropharyngeal function. Specifically, it is hypothesized that in utero VPA exposure results in fewer lower motor neurons associated with feeding behaviors, that surviving neurons will exhibit dysmorphology and altered balance of excitatory and inhibitory inputs. Further, it is hypothesized that VPA exposure will result in altered oropharyngeal musculature that will impact skull morphology. These hypotheses were investigated using quantitative morphometrics and immunofluorescence. Results support dysmorphology and excitatory/inhibitory imbalance and these alterations may contribute to dysphagia and poor weight gain in VPA-exposed animals.
Physical Function Recovery Trajectories following Spinal Cord Injury.

Abstract Objective Explore trajectories of functional recovery that occur during the first two years after spinal cord injury (SCI). Design Observational cohort study. Setting Eight SCI Model System sites. Participants 479 adults with SCI completed four Spinal Cord Injury-Functional Index (SCI-FI) item banks within 4 months of injury and again at 2 weeks, 3, 6, 12, and 24 months following baseline assessment. Intervention None. Main Outcome Measures SCI-FI Basic Mobility/Capacity (C), Fine Motor Function/C, Self-Care/C, and Wheelchair Mobility/Assistive Technology (AT) item banks. Results Growth mixture modeling was used to identify groups with similar trajectory patterns. For the Basic Mobility/C and Wheelchair Mobility/AT domains, models specifying 2 trajectory groups were selected. For both domains, a majority class exhibited average functional levels and gradual improvement, primarily in the first six months. A smaller group of individuals made gradual improvements but had greater initial functional limitations. The Self Care/C domain exhibited a similar pattern; however, a third, small class emerged that exhibited substantial improvement in the first six months. Finally, for individuals with tetraplegia, trajectories of Fine Motor Function/C scores followed two patterns, with individuals reporting generally low initial scores and then making either modest or large improvements. In individual growth curve models, injury/demographic factors predicted initial functional levels but less so with regard to rates of recovery. Conclusions Trajectories of functional recovery followed a small number of change patterns, though variation around these patterns emerged. During the first two years after initial hospitalization, SCI-FI scores showed modest improvements; however, substantial improvements were noted for a small number of individuals with severe limitations in fine motor and self-care function. Future studies should further explore the personal, medical, and environmental characteristics that influence functional trajectories during these first two years and beyond.
Process Analysis and Identification with a Real Time Intelligent Bioreactor Supervisory Controller

Bioprocessing can be improved by utilizing all available information about the process. In particular, when knowledge about process dynamics is incomplete or during time of equipment failure, additional information derived from past data trends, expert process operators and the literature can be very useful in process analysis. In this work, an expert system based supervisory control scheme is developed and evaluated. The expert system utilizes on-line real time data as well as archived data, facts and heuristic information to analyze the process. The goal of the analysis is to assess the state of the process and to check for data agreement. In case inconsistency is detected, the expert system will estimate process variables and examine potential process faults. Based on the analysis, acceptable corrective actions and techniques to reconstruct corrupted data will be sought. The behavior and performance of some aspects of a real time implementation of the expert system controller to Clostridium acetobutylicum will be presented and discussed.
Nuclear Magnetic Resonance (NMR) Spectroscopy: Structural Analysis of Proteins and Nucleic Acids

Nuclear magnetic resonance spectroscopy (NMR) enables the determination of the three-dimensional structure of proteins and nucleic acids in solution. A set of NMR experiments identifies the residues in the molecule and determines the order of residues that comprises the primary structure. Distance and angular relationships are subsequently measured and utilized as input to the structure calculation. Keywords: NMR; proteins; nucleic acids; three-dimensional structure
Non-resonant, broad-band vibration-energy harvester based on self-assembled liquid bearing

This paper reports a non-resonant, broad-band electromagnetic vibration-energy harvester based on self-assembled liquid bearing made of ferrofluid. The liquid bearing suspends magnet array over a microfabricated multi-layer coil plate such that the energy harvester does not rely on any mechanical resonance, and can harvest vibration energy over a broad frequency range. The non-resonant energy harvester (20.7 × 12 × 4.5 mm3) produces µW level of power from 1 g acceleration even at 2 – 4 Hz, a frequency range that would be too low for a resonant energy harvester.
Educating for Meaning in an Era of Banality

“How do we figure out the ‘end’ or purpose of education?” my students recently asked me in response to Neil Postman’s The End of Education. To answer their question, I turned to yet another work by Postman. In Teaching as a Conserving Activity, Postman draws upon the concept of homeostasis to assert that balance, created through the interplay of opposing elements, is the mark of a healthy democracy. He proposes that education should act as a counterargument to the excesses in society, much as a thermostat activates the air conditioner when the room gets too hot — or the heater when the room gets too cold. Accordingly, he suggests that teachers and philosophers of education identify and develop ways to counteract these excesses.
El criptojudaísmo castellano reexaminado

Previous studies have dealt with the intensive inquisitorial persecution in 1588-1600 of a native Castilian Judaizing nucleus located in the towns of Quintanar de la Orden and Alcazar de San Juan (under the jurisdictions of the Cuenca and Toledo courts). Because of date, location, numbers and autochtonous ethnicity of its victims, the episode constitutes somewhat of an anomaly in the annals of Castilian inquisitorial courts. Based on a study of the trial records, I. S. Revah and C. Amiel have concluded that these prove the reality of crypto-Judaism in both places and that therefore the religious quiddity of an inquisitorial document is a reliable historical source. Here, I submit the Marranism of late 16th century Quintanar and Alcazar, as presented by these authors, to a close reading. I have taken a fresh look at all 64 surviving trial records pertaining to this episode and arrived at conclusions far more shaded than those of my predecessors.
Packaging issues for optical time division multiplexed networks

Summary form only given. In this talk, optical time-domain multiplexed networks will be discussed in which optical signal processing is used at the interface between the high-bandwidth optical transmission medium and the low bit-rate electronics at each communication node.
Perchloroethylene (PCE) Removal

Perchloroethylene (C2Cl4) or PCE, an industrial solvent and common groundwater contaminant, can be degraded by several means, both biological and chemical. Its recalcitrance in the environment has been due in part to the fact that initial biological degradation must be a reduction of this highly oxidized compound, sequentially replacing each of the chlorines with hydrogen through the use of dehalogenase enzymes. Once reduced, dechlorination products of PCE may be further transformed by either reductive or oxidative pathways. The biological oxidation of the lesser chlorinated ethylenes requires particular oxygenase enzymes that perform cometabolic chemistry on the carbon–carbon double bond. Similarly, chemical transformation of PCE can be by either reduction or oxidation. The chemical reductive dechlorination process typically occurs using zero valent metals and is very similar to the biological process. Oxidation of the compound requires a strong chemical oxidant, such as potassium permanganate, or photooxidation using a titanium dioxide catalyst, which also attacks the carbon–carbon double bond of the chlorinated ethylene. Keywords: perchloroethylene; PCE; reductive dechlorination; cometabolic oxidation; VOC; zero valent metals; photocatalytic oxidation; potassium permanganate oxidation
A new estimate of the CaCO3 to organic carbon export ratio

[1] We use an ocean biogeochemical-transport box model of the top 100 m of the water column to estimate the CaCO3 to organic carbon export ratio from observations of the vertical gradients of potential alkalinity and nitrate. We find a global average molar export ratio of 0.06 ± 0.03. This is substantially smaller than earlier estimates of 0.25 on which a majority of ocean biogeochemical models had based their parameterization of CaCO3 production. Contrary to the pattern of coccolithophore blooms determined from satellite observations, which show high latitude predominance, we find maximum export ratios in the equatorial region and generally smaller ratios in the subtropical and subpolar gyres. Our results suggest a dominant contribution to global calcification by low-latitude nonbloom forming coccolithophores or other organisms such as foraminifera and pteropods.
Insulin resistance prevents AMPK-induced tau dephosphorylation through akt-mediated increase in AMPKSer-485 phosphorylation

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors including obesity, diabetes, and dyslipidemia, and insulin resistance (IR) is the central feature of MetS. Recent studies suggest that MetS is a risk factor for Alzheimer disease (AD). AMP-activated kinase (AMPK) is an evolutionarily conserved fuel-sensing enzyme and a key player in regulating energy metabolism. In this report, we examined the role of IR on the regulation of AMPK phosphorylation and AMPK-mediated Tau phosphorylation. We found that AMPK(Ser-485), but not AMPK(Thr-172), phosphorylation is increased in the cortex of db/db and high fat diet-fed obese mice, two mouse models of IR. In vitro, treatment of human cortical stem cell line (HK-5320) and primary mouse embryonic cortical neurons with the AMPK activator, 5-aminoimidazole-4-carboxamide 1-β-D-ribofuranoside (AICAR), induced AMPK phosphorylation at both Thr-172 and Ser-485. AMPK activation also triggered Tau dephosphorylation. When IR was mimicked in vitro by chronically treating the cells with insulin, AICAR specifically induced AMPK(Ser-485), but not AMPK(Thr-172), hyperphosphorylation whereas AICAR-induced Tau dephosphorylation was inhibited. IR also resulted in the overactivation of Akt by AICAR treatment; however, preventing Akt overactivation during IR prevented AMPK(Ser-485) hyperphosphorylation and restored AMPK-mediated Tau dephosphorylation. Transfection of AMPK(S485A) mutant caused similar results. Therefore, our results suggest the following mechanism for the adverse effect of IR on AD pathology: IR → chronic overactivation of Akt → AMPK(Ser-485) hyperphosphorylation → inhibition of AMPK-mediated Tau dephosphorylation. Together, our results show for the first time a possible contribution of IR-induced AMPK(Ser-485) phosphorylation to the increased risk of AD in obesity and diabetes.
“Why Are We Telling Lies?” The Creation of Soviet Space History Myths

On January 17, 1969, right after the landing of Soyuz-4, when the cosmonaut Vladimir Shatalov began climbing out of his spacecraft, someone suddenly shouted, “Where are you going?! Get back!” It turned out that a camera-man did not have time to point his camera at the scene.1 Shatalov obediently squeezed back into his capsule, and then re-emerged, properly smiling and waving. The historic moment was captured on film and preserved for posterity. By climbing out of his spacecraft Shatalov left the realm of history and entered a myth. Myth-making was part of a venerable tradition of Soviet propaganda. Soviet leaders sought legitimacy of their power and validation of current policies in the construction of historical breaks and continuities, in the overthrow of former idols, and in the creation of new ones. The promotion of state-sponsored myths of the October Revolution and the Great Patriotic War was accompanied by a systematic suppression of contradictory private memories, which often gave rise to counter-myths, such as the Great Terror and the Thaw. The term “myth” is used here without implying the truth or falsity of any particular historical claim, but merely to stress the foundational, identity-shaping character of such claims. Recent scholarship has moved beyond the examination of state policies and has increasingly focused on the interplay of official discourse and private memories and on the active role of multiple actors in political and cultural appropriations of memory.2
The application of intensity transients in ellipsometry.

The measurement of intensity offers a means of obtaining faster ellipsometric readings than are possible by manual nulling techniques. An analysis of the theoretical intensity relations gives rise to a technique of separately determining the changes in Δ and ψ by the use of successive transients. An experimental verification of the technique for the oxidation of iron was obtained.
An information theoretic approach to optical interferometry

In optical synthesis imaging, the incomplete sampling of the complex visibility function, atmospherically induced phase perturbations, detector noise, and low light levels all limit one's ability to produce high-fidelity images. One improves upon these limitations by using iterative non-linear deconvolution and self-calibration techniques to produce image models that are consistent with the data. The question of image fidelity, or how well these models faithfully represent the true object, is an important question to ask. A possible answer could be formulated using the concepts of statistical information theory. We apply the concepts of Shannon Information to an optical interferometer and propose methods for monitoring the information content of images as a measure of image quality.
Harnessing Shared Wide-area Clusters for Dynamic High End Services

Current trends in distributed computing have been moving towards the use of wide-area clusters that are managed by different entities. In this paper, we introduce middleware-level support to facilitate computational resource sharing with service guarantees using non-dedicated server systems in wide-area clusters. The aim is to ensure that sets of computational tasks submitted to such high end systems are completed reliably and in a timely fashion. Our approach develops methods that enhance basic job scheduling with information about the execution history and trust values for the computational nodes to which jobs are assigned. In essence, job scheduling is enriched with trust models constructed and maintained at runtime, and scheduling decisions are based on metrics that capture trust in remote server systems. An implementation of the approach is evaluated on Planetlab, with initial results demonstrating good success rates in completing jobs within their specific service level agreements, including under conditions of high system loads. Additional results are attained with a variant of the scheduling algorithm that uses redundancy to further improve the likelihood of meeting end user SLAs. A representative application considered in this paper is remote data visualization, where substantial computation must be applied to data before displaying it to end users. SLAs capture desired end-to-end delay, and distributed server or cluster systems are used to perform the required computations in a timely manner
Preexisting psychiatric disorders in burn patients.

The authors studied 51 of 56 consecutive eligible patients admitted to a burn unit. Sixty-nine percent of the patients had a preburn psychiatric diagnosis. Depression alone was present in more than half the sample. Few burns were strictly accidental; 68% involved some degree of complicity on the victim's part, but intentional burns were rare. Patients with depression were more likely to sustain their burns in a setting of risk-enhancing behavior. Language: en
The birth of an ethics charter for pain medicine.

In Webster's New International Dictionary, Second Edition, 1953, “ethics” is defined as “the science of moral duty; more broadly the science of the ideal human character and the ideal ends of human action.” From a more pragmatic point of view, ethics in the medical world and, more specifically, in pain medicine, is, by and large, a roadmap that allows us to keep practicing in the face of an increasingly complex—and often confusing and contradictory—environment without losing our way and ending in bedlam, jail, or forced retirement. Ethics has always been part of medicine. Through human history, morality has been an integral part of any medical decision. However, in the last 50 years, the field of medical ethics has been formally established and is now an essential part of the teaching and practice of medicine. Some sort of guidelines or laws for practicing morally acceptable medicine have existed for at least 4,000 years, through, for instance, the Code …
Improving Secondary School Discipline by Involving Students In the Process

What might happen if students shared responsibility for improving aspects of their classroom instruction and learning activities? Potential benefits are suggested by the improvement in 17 schools that formed a community of learners and leaders.
Evaluation of invalid vaccine doses.

Abstract Background The 2002 Recommended Childhood Immunization Schedule clarified the definition of an invalid dose of vaccine as any dose administered ≥5 days before the minimum age or interval had elapsed. Any invalid dose of vaccine should be repeated. Objective Determine the proportion of U.S. children who received an invalid dose of vaccine, evaluate the impact on vaccination coverage levels if invalid doses were not counted, and determine the vaccine purchase cost if at least one invalid dose is repeated. Methods Provider-reported vaccination histories of children aged 19 to 35 months sampled by the 2000 National Immunization Survey were evaluated. Analyses were performed in 2002 after the 2002 Advisory Committee on Immunization Practices (ACIP) Recommended Immunization Schedule was released. Any vaccine dose administered ≥5 days before the recommended minimum age or interval was classified as invalid. Change in vaccination coverage was determined by subtracting estimated valid-dose coverage (based on number of valid doses received) from the estimated up-to-date coverage (based on number of doses received regardless of age or spacing). Results Overall, 10.5% (±0.6%) of children had received at least one invalid dose of vaccine. Of the invalid doses, 51% were hepatitis B, 100% of which were the third dose; 19% were diphtheria–tetanus–pertussis (DTP/DTaP), 92% of which were the fourth dose; 12% were measles-containing vaccine (MCV); 15% were varicella vaccine; and 4% were polio vaccine, 96% of which were the first dose. Excluding invalid doses resulted in a small change in vaccination coverage: 2.2% for DTP/DTaP, 0.7% for polio, 6.5% for hepatitis B, 1.4% for MCV, and 1.7% for varicella. The vaccine purchase cost to repeat at least one invalid dose ranged from approximately $10 million (public-purchased) to approximately $18 million (private-purchased). Conclusions Nationally about 595,000 of children aged 19 to 35 months, born between February 1997 and May 1999, received at least one invalid dose of vaccine. The cost of revaccinating these children is substantial and may have a negative impact on parents, physicians, and vaccine purchasers. Educating immunization providers regarding proper immunization timing should be conducted to reduce the administration of invalid doses of vaccines.
Backoff mechanisms in narrow band and spread spectrum aloha networks

There exist several wireless networks that employ some form of Aloha for sharing the medium. The primary feature of Aloha is the random backoff mechanism, which chooses a random interval of time before transmitting the next packet. This mechanism allows a graceful degradation in per-user throughput as more users are added to the network. The optimal design of the backoff mechansim is well known for a narrow band network in which all users are within range. In this paper, we set up and solve a simple optimization problem to calculate the backoff interval for any network topology, for narrow band or spread spectrum. We then provide a few practical protocol designs based on the optimization and discuss the tradeoffs between them. Finally, we present the results of some preliminary simulations showing the performance of these protocols.
Long‐term intravenous hydroxyurea infusions in patients with advanced cancer. A phase I trial

Background. Hydroxyurea is an S-phase specific drug. Constant exposure of tumor cells with a low S-phase fraction to the agent may result in improved cell kill. Because of its short half-life, a continuous intravenous infusion may result in better tumor exposure than intake by mouth. The goal of this trial was to find the longest tolerable duration of a continued intravenous infusion of hydroxyurea (HU) given at escalating doses. Methods. Eligible patients had histologically confirmed cancer without effective alternate therapy, normal blood counts, liver and kidney function. After giving informed consent, the infusion began via a permanent indwelling catheter utilizing a portable pump. Dose levels (in g/m2/d) were 0.5 for level I, 1.0 for level II, 1.66 for level III, and 2.5 for level IV. Results. Fourteen patients were entered. Five were men. Median age was 56 years of age (range: 32–67), median performance status 1 (range: 0–2). Diagnoses were as follows: colorectal cancer, seven; unknown primary site, three; breast cancer, two; melanoma, one; and adenoidcystic carcinoma, one. Nine patients were pretreated with chemotherapy. Three patients were entered per dose level, except on level I, were five were entered. The mean duration of infusion was 12 weeks on level I, 5 weeks on II, 3 on III, 1 on IV. Toxicity included leukopenia below 2.0 K/mm3 in one patient each on levels III and IV, thrombocytopenia below 100 K/mm3 in one patient each on levels II and IV, and stomatitis in three patients (one on level II and two on IV). This toxicity was dose limiting. One patient on level III, with an unknown primary, had an objective response. HU levels were measured by a modification of the Fabricius-Rajewsky method. Mean plasma levels in micrograms per milliliter (SEM) were as follows: level I, 3.6 (0.23); level II, 5.1 (0.57); level III, 10.1 (1.55); and level IV, 16.7 (one point). Fetal hemoglobin rose two-fold and five-fold in two patients on level I after 9 and 16 weeks on therapy, respectively. Conclusions. HU as a continuous intravenous infusion is well tolerated; the maximum duration of therapy is related inversely with the dose given. No major antitumor activity was seen. The greatest interest in the drug rests in its future use as a modulator and radiation potentiator. The increase in hemoglobin F was of interest and may be important in the treatment of sickle cell disease.
ASSESSMENT OF SERUM LEVELS OF α-1-MICROGLOBULIN, β-2-MICROGLOBULIN, AND RETINOL BINDING PROTEIN IN THE FETAL BLOOD. A METHOD FOR PRENATAL EVALUATION OF RENAL FUNCTION

The concentrations of alpha-1-microglobulin, beta-2-microglobulin, and retinol binding protein were determined in fetal blood sampled by cordocentesis. The blood values of 126 fetuses without ultrasonographic findings of urinary tract abnormalities as controls were found to be independent of the week of gestation. In nine fetuses affected by a severe bilateral renal dysplasia or agenesis, elevated values of alpha-1-microglobulin but normal values of retinol binding protein were obtained. The authors recommend the determination of alpha-1-microglobulin and, with some restriction, also of beta-2-microglobulin in prenatal renal function diagnosis.
Loss of alleles from the distal short arm of chromosome 1 occurs late in melanoma tumor progression

The gene for familial malignant melanoma and its precursor lesion, the dysplastic nevus, has been assigned to a region of the distal short arm of chromosome 1, which is frequently involved in karyotypic abnormalities in melanoma cells. We have examined loci on chromosome 1p for loss-of-constitutional heterozygosity in 35 melanomas and 21 melanoma cell lines to analyze the role of these abnormalities in melanocyte transformation. Loss-of-heterozygosity at loci on chromosome 1p was identified in 15/35 (43%) melanomas and 11/21 (52%) melanoma cell lines. Analysis of multiple metastases derived from the same patient and of melanoma and lymphoblastoid samples from a family with hereditary melanoma showed that the loss-of-heterozygosity at loci on distal 1p is a late event in tumor progression, rather than the second mutation that would occur if melanoma were due to a cellular recessive mechanism. Comparisons with neuroblastoma and multiple endocrine neoplasia (MEN2) suggest that the frequent 1p loss-of-heterozygosity in these malignancies is a common late event of neuroectodermal tumor progression.
The Earth of the Modern

One of the central questions in comparative studies of colonialism is what makes more recent variants of imperial extension so culturally distinctive, aside from the more obvious political-economic dimensions? This set of papers focuses on how European and Euro-American promulgated variants of colonialism can be viewed as embodying central tenets of modernism, such as progressivism, technocentrism, and hybridity. Moreover, the authors demonstrate how colonial practices in the era of the modern were not merely the result of policies emanating from imperial capitals, but were an outgrowth of conflict, mediation, and accommodation between colonizer and colonized. Thus, archaeological research is important for stressing that the past five centuries have seen a time of contested modernities, rather than the growth of ‘a’ modernist sensibility.
In vivo Targeting of Alveolar Macrophages via RAFT-Based Glycopolymers

Targeting cell populations via endogenous carbohydrate receptors is an appealing approach for drug delivery. However, to be effective, this strategy requires the production of high affinity carbohydrate ligands capable of engaging with specific cell-surface lectins. To develop materials that exhibit high affinity towards these receptors, we synthesized glycopolymers displaying pendent carbohydrate moieties from carbohydrate-functionalized monomer precursors via reversible addition-fragmentation chain transfer (RAFT) polymerization. These glycopolymers were fluorescently labeled and used to determine macrophage-specific targeting both in vitro and in vivo. Mannose- and N-acetylglucosamine-containing glycopolymers were shown to specifically target mouse bone marrow-derived macrophages (BMDMs) in vitro in a dose-dependent manner as compared to a galactose-containing glycopolymer (30- and 19-fold higher uptake, respectively). In addition, upon macrophage differentiation, the mannose glycopolymer exhibited enhanced uptake in M2-polarized macrophages, an anti-inflammatory macrophage phenotype prevalent in injured tissue. This carbohydrate-specific uptake was retained in vivo, as alveolar macrophages demonstrated 6-fold higher internalization of mannose glycopolymer, as compared to galactose, following intratracheal administration in mice. We have shown the successful synthesis of a class of functional RAFT glycopolymers capable of macrophage-type specific uptake both in vitro and in vivo, with significant implications for the design of future targeted drug delivery systems.
How to assemble the parts: structures of protein complexes from their components.

X-ray crystallography and nuclear magnetic resonance have been utilized to determine the atomic resolution structures of many proteins and protein domains. It has proven more challenging to apply these same techniques to determine the structures of large protein complexes. This is an important problem since the formation of protein complexes is often critical to regulating protein function. One way to make progress toward determining structural features of an assembly of proteins is to solve the structure of each member and then dock these individual structures together. Toward this goal, computational docking algorithms have been developed and employed with great success to predict important structural features in a wide range of protein-protein interactions. Recent work on the bacterial chemotaxis proteins CheA and CheW (reviewed in (1xSee all References(1)) has demonstrated how long-range interprobe distance constraints between spin-labeled side chains can be obtained by modern pulsed electron paramagnetic resonance (EPR) methods and then utilized to guide the docking process.The work by Hilger et al. in the article on page 3675 utilizes a similar site-directed spin-labeling approach to determine the structure for the functional Na+/H+ antiporter dimer in a liposome starting from the known atomic resolution structure of the monomer. The authors describe a new scheme to account for the dimensions and flexibility of the spin-labeled side chains in the structure refinement process. As pointed out in several recent publications and as referenced in the article, this is an important step forward in using EPR-derived interprobe distances to build structural models since it is the distance between the unpaired electrons of the two interacting spin labels that is measured and not the distances between Cα carbons of the protein backbone. This work also points out that it is possible to utilize other methods including molecular dynamics to model the conformationally accessible space for the spin labels during the refinement process. Such work is being pursued in many laboratories around the world at this time. It is anticipated that continuing efforts along these lines will lead to the development of even more robust structure refinement tools in the future. However, the current work by Hilger et al., and references cited therein, demonstrate that site-directed spin labeling and modern EPR provides an important new capability for structural studies on large protein assemblies.
Transformation of urea and ammonium nitrate in an entisol and a spodosol under citrus production

Abstract Chemical transformations of ammonium nitrate (NH4NO3) and urea‐nitrogen (N), at different rates of application, were studied in a Candler (Typic Quartzipsamment) and Wabasso (sandy, Alfic Haplaquod) sand by incubating fertilized surface soil (from 0 to 15 cm depth) samples at 10% moisture content (by weight) in the laboratory at 25±1°C. During the 7 d incubation, the percentage of transformation of NH4‐N into NO3‐N was 33 to 41 and 37 to 41% in the Candler fine sand and Wabasso sand, respectively, at application rates of 1.00 g N kg1. In a parallel experiment, 85 to 96% of urea applied (equivalent to 0.25 to 1.00 g N kg‐1soil) was hydrolyzed to NH4‐N within 4 d in the Candler soil, whereas it required 7 d to hydrolyze 90 to 95% of the urea applied in the Wabasso soil. No nitrification was evident for 30 days in the Candler fine sand which received urea application equivalent to ≥ 0.50 g N kg‐1. In the urea‐amended Wabasso sand, the formation of NO3 decreased as the rate of urea‐N increased. Possi...
A branched fluorescent peptide probe for imaging of activated platelets.

Novel fluorescent probes for thrombi and activated-platelet detection were developed that were based on the glycoprotein IIb/IIIa (GP-IIb/IIIa) binding sequence, Pro-Ser-Pro-Gly-Asp-Trp. Linear, Pro-Ser-Pro-Gly-Asp-Trp-Aha-Gly-Cys(Cy5.5)-NH2 (1PF), and branched, (Pro-Ser-Pro-Gly-Asp-Trp-Aha)2-Lys-Gly-Cys(Cy5.5)-NH2 (2PF), fluorescent-labeled peptide probes were synthesized. A third probe, also branched, (Pro-Ser-Pro-Gly-Glu-Trp-Aha)2-Lys-Gly-Cys(Cy5.5)-NH2 (2CF), was synthesized as control. The platelet-binding activity of the probes was tested in clots generated from human platelet-rich plasma. Fluorescence reflectance imaging results showed that 2PF has a 16-fold increase in fluorescence intensity compared to the autofluorescence of clots. The linear conjugate, 1PF, and free dye did not show appreciable fluorescence enhancement. 2PF fluorescence was also found 5.5-fold higher than that of the control probe, 2CF. Overall, our results suggest that 2PF binds tightly to GP-IIb/IIIa and potentially can be us...
Candidemia in HIV-infected subjects.

The epidemiological features of 37 episodes of candidemia in HIV-infected subjects were analysed in a retrospective matched case-control study conducted over an 8-year period (1990–1997). Univariate analysis identified eight risk factors that were significantly associated with candidemia (P<0.05): i) use of central venous catheters; ii) administration of total parenteral nutrition; iii) previous antifungal therapy; iv) previous therapy with glycopeptides; v) presence of oral/esophageal candidiasis; vi) concomitant bacterial infections; vii) neutropenia; and viii) concomitant AIDS dementia complex. Stepwise logistic regression analysis revealed that the only independent risk factor for developing candidemia was the use of central venous catheters (P=0.0001). Candida albicans was the most frequently isolated pathogen, accounting for 18 (48%) episodes of candidemia, followed by Candida tropicalis (19%) and Candida glabrata (11%). The crude mortality rate was 62%. On univariate analysis concomitant opportunistic infections, presence of non-Candida albicans species of Candida and neutropenia were shown to be predictive of death. Multivariate analysis revealed that the presence of non-Candida albicans strains of Candida was the only significant factor associated with a worse prognosis (P=0.001). In conclusion, candidemia appears to be more common in patients with advanced HIV disease. Of the factors which influenced the onset of candidemia, use of central venous catheters seemed to be the most important one.