cssi/SciSciGPT-SciSciNet huggingface dataset:
Using a rule-based system to define error in the emergency department.

Introduction The evaluation of peer-reviewed cases for error is key to quality assurance (QA) in emergency medicine, but defining error to ensure reviewer agreement and reproducibility remains elusive. The objective of this study was to create a consensus-based set of rules to systematically identify medical errors. Methods This is a prospective, observational study of all cases presented for peer review at an urban, tertiary care, academic medical center emergency department (ED) quality assurance (QA) committee between October 13, 2015, and September 14, 2016. Our hospital uses an electronic system enabling staff to self-identify QA issues for subsequent review. In addition, physician or patient complaints, 72-hour returns with admission, death within 24 hours, floor transfers to ICU < 24 hours, and morbidity and mortality conference cases are automatic triggers for review. Trained reviewers not involved in the patient's care use a structured 8-point Likert scale to assess for error and preventable or non-preventable adverse events. Cases where reviewers perceived a need for additional treatment, or that caused patient harm, are referred to a 20-member committee of emergency department leadership, attendings, residents, and nurses for consensus review. For this study, "rules" were proposed by the reviewers identifying the error and validated by consensus during each meeting. The committee then decided if a rule had been broken (error) or not broken (judgment call). If an error could not be phrased in terms of a rule broken, then it would not be considered an error. The rules were then evaluated by 2 reviewers and organized by theme into categories to determine common errors in emergency medicine. Results We identified 108 episodes of rules broken in 103 cases within a database of 920 QA reviewed cases. In cases where a rule was broken and therefore an error was scored, the following 5 major themes emerged: (1) not acquiring necessary information (eg, not completing a relevant physical exam), N = 33 (31%); (2) not acting on data that were acquired (eg, abnormal vital signs or labs), N = 25 (23%); (3) knowledge gaps by clinicians (eg, not knowing to reduce a hernia), N = 16 (15%); (4) communication gaps (eg, discharge instructions), N = 17 (16%); and (5) systems issues (eg, improper patient registration), N = 17 (16%). Conclusion The development of consensus-based rules may result in a more standardized and practical definition of error in emergency medicine to be used as a QA tool and a basis for research. The most common type of rule broken was not acquiring necessary information. A rule-based definition of medical error in emergency medicine may identify key areas for risk reduction strategies, help standardize medical QA, and improve patient care and physician education.
Identifying tumor clones in sparse single-cell mutation data.

MOTIVATION Recent single-cell DNA sequencing technologies enable whole-genome sequencing of hundreds to thousands of individual cells. However, these technologies have ultra-low sequencing coverage (<0.5× per cell) which has limited their use to the analysis of large copy-number aberrations (CNAs) in individual cells. While CNAs are useful markers in cancer studies, single-nucleotide mutations are equally important, both in cancer studies and in other applications. However, ultra-low coverage sequencing yields single-nucleotide mutation data that are too sparse for current single-cell analysis methods. RESULTS We introduce SBMClone, a method to infer clusters of cells, or clones, that share groups of somatic single-nucleotide mutations. SBMClone uses a stochastic block model to overcome sparsity in ultra-low coverage single-cell sequencing data, and we show that SBMClone accurately infers the true clonal composition on simulated datasets with coverage at low as 0.2×. We applied SBMClone to single-cell whole-genome sequencing data from two breast cancer patients obtained using two different sequencing technologies. On the first patient, sequenced using the 10X Genomics CNV solution with sequencing coverage ≈0.03×, SBMClone recovers the major clonal composition when incorporating a small amount of additional information. On the second patient, where pre- and post-treatment tumor samples were sequenced using DOP-PCR with sequencing coverage ≈0.5×, SBMClone shows that tumor cells are present in the post-treatment sample, contrary to published analysis of this dataset. AVAILABILITY AND IMPLEMENTATION SBMClone is available on the GitHub repository https://github.com/raphael-group/SBMClone. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
Fluorescent Intensity and Lifetime Measurement of Platinum-Porphyrin Film for Determining the Sensitivity of Transcutaneous Oxygen Sensor

In most optical-based oxygen sensors, fluorescent quenching is used as the sensing principle. Intensity and lifetime are two known measurement techniques that are employed to quantify the measured parameter. The lifetime measurement technique has superior features such as little or no sensitivity to changes in the optical path, degradation of the film or photo-bleaching. In this study, we conducted an experiment to analyze the performance of both the intensity and lifetime measurement techniques of a platinum-porphyrin fluorescent film, the sensing material, under different concentrations of oxygen. A prototype that deploys an analog front-end, a light emitting diode driver, and a power management block is implemented on a printed circuit board with commercial off-the-shelf components. The system resolves changes in oxygen pressure from 0.5 mmHg to 500 mmHg with a power consumption of 132 mW. This system could be potentially used to measure the concentration of oxygen diffused through the skin, also known as transcutaneous measurement of oxygen. These measurements are key to developing more sophisticated read-out circuits for reliable and sensitive medical purpose transcutaneous oxygen sensing.
Signature of cool cores in SZ clusters: a multiwavelength approach

We use the high quality pressure profiles of 239 galaxy clusters made available by the ACCEPT project (Cavagnolo et al. 2009) in order to derive the expected Sunyaev Zeldovich (SZ) signal in a variety of cases that hardly find a counterpart in the simulations. We made use of the Melin et al. (2006) cluster selection function for both the South Pole Telescope (SPT) and Planck instruments. We infer a clear effect of the cool core (CC) on the central Compton parameter y_0. We find that the presence of CCs introduces a small bias in cluster detection, especially around the mass at which the performance of the survey begins to decrease. If the CC were removed, a lower overall fraction of detected clusters would be expected. In order to estimate the presence of such a bias by means of SZ only surveys, we show that the ratio between y_0 and y_int anti-correlates with the cluster central cooling time. If multi-band optical cluster surveys are either available for a cross-match or a follow-up is planned, we suggest that likely CC clusters are those with a Brightest Cluster Galaxy (BCG) at least 0.3 magnitudes bluer than the average. A more robust estimate of the CC presence is given by UV-optical colours of the BCG, like the NUV-r, whose values can be 4 magnitudes off the NUV-r equivalent of the red sequence, in clusters with low excess entropy. We also find correlation of the y_0/y_int ratio with Halpha, IR and radio luminosities. We argue that the analysis of a combined SZ/optical/UV surveys can be also used to shed light on the suggested CC evolution with redshift. (abridged)
Africa Huru! Complex Events—Cold War, Residual Colonization and Apartheid

This chapter addresses the light that the OAU, once founded, shone on the twin issues of apartheid in South Africa and Ian Smith’s Unilateral Declaration of Independence (UDI). The OAU worked in concert with other IGOs such as the UN. Besides apartheid and UDI, African countries continued to gain independence: by 1968, 48 of 55 African countries (with Ethiopia / Eritrea and Sudan / South Sudan split) were free nations. As the largest bloc at the UN, and with the support of other voting blocs (e.g. Asian countries and G77 / NAM), the OAU was vocal, and benefitted from unusual allies: the USSR. USSR’s Cold War strategy saw Khrushchev sponsor UN Security Council resolutions to highlight US and its allies’ imperialist practices as they waged war against communist regimes around the world. Whether or not soviet support for decolonization stemmed from a belief of self-determination (despite its control in Eastern Europe and USSR member states) is in question, but Africa benefitted nonetheless. It also addresses tensions that were beginning to show in Africa, with some members (e.g. Malawi, Ivory Coast and Madagascar) supporting some rapprochement with South Africa and Rhodesia, in order to bring about changes in the country, especially based on economic interconnectedness, dependency on and benefits from South Africa.
The Association Between Light Physical Activity and Cognition Among Adults: A Scoping Review.

Background The physical and cognitive benefits of moderate-vigorous intensity physical activity (MVPA) for adults have been well documented. Recently, there has been increasing interest in the independent health benefits of light-intensity physical activity (LPA). This research has primarily focused on the relationship between LPA and morbidity and mortality risk, with few studies investigating cognitive associations. The purpose of this scoping review was to catalog existing evidence on the association between device-based or technologically measured LPA and cognition among adults, identify trends in the literature, and recommend future areas for research. Methods Six electronic databases were searched between January and June 2020. Forty published studies met the inclusion criteria, which included both healthy and clinical young and older adult populations. Among the 40 articles were 14 acute exercise studies, 4 randomized control trials (RCTs), 18 cross-sectional studies, and 4 longitudinal studies. Results 7/14 (50%) acute, 3/4 (75%) RCT, 10/18 (56%) cross-sectional, and 2/4 (50%) longitudinal studies reported a significant, positive relationship between LPA and one or more cognitive outcomes. These heterogeneous findings can largely be attributed to the diverse study designs and populations, as well as the numerous assessments used to test the cognitive domains. Conclusion These collective findings suggest LPA may be a potential lifestyle intervention to improve cognition across adulthood. However, the inconsistent approaches used among these studies suggest a more concerted, unified scientific approach is needed to further understand the LPA-cognition relationship.
Estimating sequencing error rates using families.

As next-generation sequencing technologies make their way into the clinic, knowledge of their error rates is essential if they are to be used to guide patient care. However, sequencing platforms and variant-calling pipelines are continuously evolving, making it difficult to accurately quantify error rates for the particular combination of assay and software parameters used on each sample. Family data provide a unique opportunity for estimating sequencing error rates since it allows us to observe a fraction of sequencing errors as Mendelian errors in the family, which we can then use to produce genome-wide error estimates for each sample. We introduce a method that uses Mendelian errors in sequencing data to make highly granular per-sample estimates of precision and recall for any set of variant calls, regardless of sequencing platform or calling methodology. We validate the accuracy of our estimates using monozygotic twins, and we use a set of monozygotic quadruplets to show that our predictions closely match the consensus method. We demonstrate our method’s versatility by estimating sequencing error rates for whole genome sequencing, whole exome sequencing, and microarray datasets, and we highlight its sensitivity by quantifying performance increases between different versions of the GATK variant-calling pipeline. We then use our method to demonstrate that: 1) Sequencing error rates between samples in the same dataset can vary by over an order of magnitude. 2) Variant calling performance decreases substantially in low-complexity regions of the genome. 3) Variant calling performance in whole exome sequencing data decreases with distance from the nearest target region. 4) Variant calls from lymphoblastoid cell lines can be as accurate as those from whole blood. 5) Whole-genome sequencing can attain microarray-level precision and recall at disease-associated SNV sites. Genotype datasets from families are powerful resources that can be used to make fine-grained estimates of sequencing error for any sequencing platform and variant-calling methodology.
Information Theoretic Clustering for Medical Image Segmentation

Analysis of medical images involves robust computational approaches to various optimization problems prior to interpretation of the embedded pathological changes. Major computational efforts are essential in unsupervised learning of structures in various medical images. Some unsupervised learning techniques that take advantage of information theory concepts provide a different perspective on the solution of automated learning methods. This chapter will review a recent approach to clustering examined under an information theoretic framework that efficiently finds a suitable number of clusters representing different tissue characteristics in a medical image. The proposed clustering approach optimizes an objective function which quantifies the quality of particular cluster configurations. Recent developments involving interesting relationships between spectral clustering (SC) and kernel principal component analysis (kPCA) are used in this technique to include the nonlinear domain. In this novel SC approach, the data is mapped to a new space where the points belonging to the same cluster are collinear if the parameters of a radial basis function (RBF) kernel are adequately selected. The effectiveness of this nonlinear approach is demonstrated in the segmentation of uterine cervix color images for early identification of cervical neoplasia, as an aid to cervical cancer diagnosis. The limitations of this method in the segmentation of specific medical images such as brain images with multiple sclerosis lesions and a strategy to overcome them are discussed.
Disabled people, digital campaigns, and contentious politics: upload successful or connection failed?

Disabled people are amongst those groups in society that could greatly benefit from the “civic affordances” of digital media. Yet, persistent issues of access and accessibility also put them at risk of further exclusion as online communications become increasingly integral to practices of democratic participation and public engagement. This paper explores the potential ambivalence of the internet as an agent of (dis-)empowerment for disabled people by seeking to transcend the digital divide “frame” that has so far been applied to studies of disability and ICTs. As such, it focuses on the opportunities for e-participation that are available to that sizeable minority amongst British disabled people who already are regular internet users. In order to do so, it proposes a multi-stage methodological approach to locate and evaluate the online spaces where the latter are likely discuss, organise, and take action at a time of political turmoil. Moving from the idea that online participation tends to cluster around issues that provide people with a strong enough motivation to debate and (possibly) act to influence decision-making, online search tools are used to identify campaigns concerned with current government plans for disability welfare reform. The online strategies of selected campaigns are then analysed by means of a matrix for the assessment of interaction potential that expands and updates more traditional frames for the study of party websites. Finally, an innovative frame for the study of user-generated online discussion is employed to analyse threads posted on the Facebook page of one of these groups. Key findings highlight the role of social media as a viable channel for the emergence of a new generation of technology-savvy disabled “leaders,” and the implications that this may have on disability activism as a whole.
Increased muscular fatigue in patients with neurogenic muscle weakness: Quantification and pathophysiology

Abstract The strength of maximum voluntary contraction (MVC) and muscular fatigue measured from ankle dorsiflexors and knee extensors of 15 patients with neurogenic muscle weakness was compared with those of 20 healthy subjects. Muscle weakness, defined as the failure to generate the expected force, was determined by two methods: (1) manual muscle testing and (2) measurement of MVC using a force transducer. Muscle strength was then quantified as the MVC in Newtons (N)/kg body weight. The percent decrease in both MVC (the Fatigue Index [FI]), and rectified integrated electromyogram (RIEMG) at the end of 60sec of sustained MVC were computed. There were three main findings. (1) Muscle strength was significantly ( p p r = −0.88, p p
Abstract P220: Exposure to Secondhand Smoke and the Risk of Stroke

Background: Stroke is a leading cause of death worldwide, and is a major public health concern in terms of morbidity, mortality, economic costs, and loss of productivity. While exposure to secondhand smoke (SHS) is a risk factor for cardiovascular disease, associations of SHS with risk of stroke have been inconsistent. Hypothesis: We investigated the hypotheses that SHS exposure is associated with increased incidence of stroke and stroke subtypes (ischemic stroke and hemorrhagic stroke) among non-smokers, including never and former smokers. Methods: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study enrolled a U.S. population sample of 30,239 Caucasian and African-American men and women aged >=45 years in 2003-7 and is following them for stroke outcomes. We calculated the hazard ratio (HR) of stroke among non-smokers with SHS exposure using Cox proportional hazard models. Results: The cohort, without prevalent smoking, stroke and TIA (n=21,743), included 62% Caucasians and 38% African-Americans, with 55% females. Twenty-three percent reported SHS exposure the year prior to enrollment, and these individuals were more likely to be younger, African-American, male (all p Conclusions: SHS exposure was not related to stroke after accounting for inflammation markers. Further research is needed to confirm these findings.
Influence of communication optimizations on on-chip multi-processor energy

Designing cost-effective and scalable on-chip multi-processors demand careful attention be paid to software. In particular, if not optimized, the energy consumption due to interprocessor communication can be overwhelming. In this paper, we focus on array-intensive applications and study the energy impact of inter-processor communication optimizations on a private memory based on-chip multi-processor. Our results emphasize the importance of considering both computation energy and communication energy when applying optimizations that reduce inter-processor communication.
The Calcium Rationale in Aging and Alzheimer's Disease

Calcium is required for the function of all cells in the body, including neurons. Considerable research has described the function of calcium in the regulation of numerous processes including neurotransmitter release, cytoarchitecture and growth, and activation of enzyme systems including kinases and phosphatases. Calcium is intimately involved in a variety of “plastic” changes in the brain. For example, during adaptive processes such as learning and development, changes in transmembrane calcium fluxes correlate with changes in neuronal excitability and structural connectivity. Calcium thus is likely to have key roles in the cellular processes underlying aging-related changes in the brain, including normal age-associated memory impairments as well as more severe dementias, including Alzheimer’s disease. The pivotal role of calcium in so many neuronal processes dictates the need for precise regulation of its intracellular levels. Any dysregulation, however subtle, could lead to dramatic changes in normal neuronal function. Recent studies from our laboratory and those of others have implicated altered calcium influx with agingrelated changes at both the behavioral and the neurophysiological levels. These findings led to and continue to support the calcium hypothesis’s* which posits that in the aging brain, transient or sustained increases in the average concentration of intracellular free calcium contribute to impaired function, eventually leading to cell death. The hypothesis suggests that the final common pathway that may contribute to cognitive deterioration of aging vertebrates, including persons with Alzheimer’s disease or other aging-related dementias, is increased free calcium within neurons. The functional impairment that characterizes a patient at a particular time in the aging-related disease process may be relieved by reducing excessive calcium influx. Additionally, because calcium dysregulation terminating in cell death is likely to be
Mental status changes after hematopoietic stem cell transplantation.

Background—The growing numbers of survivors of innovative cancer treatments such as hematopoietic stem cell transplantation (HSCT) often report subsequent cognitive difficulties. The purpose of this study is to evaluate and compare neurocognitive changes in patients with chronic myelogenous leukemia (CML) or primary myelodysplastic syndrome (MDS) after allogeneic HSCT or other therapies. Methods—Prospective cohort study employing serial evaluations of attention, concentration, memory, mood and quality of life in a consecutive sample of 106 eligible patients with CML (n=91) or MDS (n=15) at enrollment, and then 12 and 18 months after HSCT or other therapy. Results—The three evaluations were completed by 98%, 95%, and 89% of surviving participants, respectively. Among all patients, there was significant improvement in memory over 18 months. For example, the 45 people receiving HSCT (42 with CML, 3 with MDS) compared favorably to those who had other treatment on most measures of neuropsychological function, except they had improved mental health (p=.034), worse physical function (p=.049), and more difficulty with coordination and fine motor speed bilaterally (dominant, p=.005, and non-dominant hands, p=.0019). CML patients overall had improved phonemic fluency (p=.014). Conclusions—Time and diagnosis may be important factors when assessing neurocognitive and other changes. Complaints about “chemobrain” following HSCT merit further study, as deficits may actually pre-date initiation of treatment and then subsequently improve. Study results could reassure prospective HSCT recipients since it compares favorably to other treatments when mental status side effects are considered.
Inclusion of forest harvest legacies, forest type, and regeneration spatial patterns in updated forest maps: A comparison of mapping results

Abstract In Maine and other heavily forested states, existing land cover maps quickly become dated due to forest harvesting and land use conversion; therefore, these maps may not adequately reflect landscape properties and patterns relevant to current resource management and ecosystem studies. By updating an older land cover product (the 1993 Maine GAP map) using Landsat imagery and established forest change detection techniques, we demonstrate a practical and accurate means of providing contemporary, spatially explicit forest cover data needed to quantify landscape change. For a 1.8 million hectares study area in northern Maine, we quantify the accuracy of forest harvest classes and compare mapped harvest and regeneration area between the 2004 GAP update product and the 2004 Maine Landcover Dataset (MeLCD), a map recently developed in coordination with the 2001 National Land-Cover Database (NLCD). For the period 1995–2004, the overall harvest/non-harvest accuracy of the GAP update map is 87.5%, compared to 62.1% for the MeLCD. Producer and user accuracy for harvest detection is 92.4% and 89.7%, respectively for the GAP update, and 48.8% and 92.5% for the MeLCD. Mapped harvest area differs considerably, reflecting a systematic under-representation of recent harvest activity on the part of the MeLCD. By integrating older land cover data, the GAP update retains the forest disturbance legacies of the late 1970s through the early 1990s while simultaneously depicting 2004 forest composition for harvested and regenerating stands. In contrast, the MeLCD (and 2001 NLCD) over-represents the area and connectivity of older forest (undisturbed since the late 1970s), and provides no forest composition information for mapped forest regeneration. Systematic misclassification of forest age classes and harvest history has serious implications for studies focused on wildlife habitat modeling, forest inventory, and biomass or carbon stock estimation. We recommend the integration of older land cover data and time-series forest change detection for retention of harvest or disturbance classes when creating new forest and land cover maps.
Snapshots of Fluoride Binding in an Aza Cryptand

Thirty years after the first observation of halide encapsulation by katapinand receptors, the authors have utilized {sup 19}F NMR spectroscopy in conjunction with X-ray crystallography to provide snapshots of fluoride binding in an aza cryptand, 1, over a range of pH values. The results provide definitive solution and solid-state evidence for the incorporation of fluoride in the cavity. This is the first study that integrates crystallographic findings with {sup 19}F NMR data as a means of understanding the binding patterns of fluoride as a function of pH.
Kinetic partitioning modulates human telomere DNA G-quadruplex structural polymorphism.

Telomeres are specialized chromatin structures found at the end of chromosomes and are crucial to the maintenance of eukaryotic genome stability. Human telomere DNA is comprised of the repeating sequence (T2AG3)n, which is predominantly double-stranded but terminates with a 3’ single-stranded tail. The guanine-rich tail can fold into secondary structures known as a G-quadruplexes (GQs) that may exist as a polymorphic mixture of anti-parallel, parallel, and several hybrid topological isomers. Using single-molecule Forster resonance energy transfer (smFRET), we have reconstructed distributions of telomere DNA GQ conformations generated by an in situ refolding protocol commonly employed in single-molecule studies of GQ structure, or using a slow cooling DNA annealing protocol typically used in the preparation of GQ samples for ensemble biophysical analyses. We find the choice of GQ folding protocol has a marked impact on the observed distributions of DNA conformations under otherwise identical buffer conditions. A detailed analysis of the kinetics of GQ folding over timescales ranging from minutes to hours revealed the distribution of GQ structures generated by in situ refolding gradually equilibrates to resemble the distribution generated by the slow cooling DNA annealing protocol. Interestingly, conditions of low ionic strength, which promote transient GQ unfolding, permit the fraction of folded DNA molecules to partition into a distribution that more closely approximates the thermodynamic folding equilibrium. Our results are consistent with a model in which kinetic partitioning occurs during in situ folding at room temperature in the presence of K+ ions, producing a long-lived non-equilibrium distribution of GQ structures in which the parallel conformation predominates on the timescale of minutes. These results suggest that telomere DNA GQ folding kinetics, and not just thermodynamic stability, likely contributes to the physiological ensemble GQ structures.
The Effect of Dietary Alfalfa of Varying Saponin Content on Yolk Cholesterol Level and Layer Performance

Abstract An experiment was carried out for five 28-day periods to determine the effects of feeding rations containing 10% of three alfalfa meals involving varying levels of saponin on the levels of yolk cholesterol and the performance of Single Comb White Leghorn pullets. A corn-soy ration and similar rations with 10% dehydrated alfalfa meal and low (.03%) and high (.62%) saponin suncured alfalfa meal were fed. No significant differences were found in the level of yolk cholesterol, mean hen-day egg production, Haugh units, specific gravity, and incidence of blood spots among the dietary treatments. Pullets fed the low and high saponin suncured alfalfa diets gained significantly (P≤.05) more weight during the experiment than pullets fed the corn-soy diet with dehydrated alfalfa. Mean feed conversions and egg weights were significantly higher and heavier (P≤.05), respectively, for pullets fed the alfalfa diets than pullets fed the corn-soy diet. Daily feed consumption was significantly more (P≤.05) for pullets fed the high saponin alfalfa diet than the corn-soy diet. These differences may be attributed to the lower energy in the alfalfa diets or the inadequate daily methionine intake per layer on the corn-soy diet.
MRSA Rates and Antibiotic Susceptibilities from Skin and Soft Tissue Cultures in a Suburban ED

Abstract Background Prior studies suggest that more than half of all skin and soft tissue infections (SSTIs) are caused by methicillin-resistant Staphylococcus aureus (MRSA). These data mainly represent inner-city urban centers. Objective We determined the bacteriologic etiologies and antibiotic susceptibilities from wound cultures in the emergency department (ED). We hypothesized that in a suburban ED, MRSA would not represent the major pathogen. Methods The study design was a retrospective, electronic medical record review in a suburban tertiary care ED with 80,000 annual visits. Subjects included ED patients of all ages who had skin or soft tissue cultures obtained in 2005–2008. Demographics and clinical data, including type of SSTI (MRSA or methicillin-sensitive S. aureus [MSSA]), culture results, and antibiotic susceptibility, were analyzed using descriptive statistics. Results From the 1246 cultures obtained during the study period, 252 (20.2%) were MSSA and 270 (21.6%) were MRSA. The rates of MRSA infections over time increased from 13.5% to 25.7% during 2005–2008. The rates of MRSA in males and females were comparable at 23.3% and 19.6%, respectively. In 2008, MRSA was 97–100% susceptible to vancomycin, linezolid, rifampin, nitrofurantoin, chloramphenicol, gentamycin, tetracycline, and trimethoprim-sulfamethoxazole (TMP-SMZ). To a lesser extent it was susceptible to clindamycin (75%), erythromycin (62%), and levofloxacin (50%). Conclusions There has been a significant increase in the rates of MRSA SSTIs in a suburban ED, yet only 1 in 4 SSTIs are caused by MRSA. Both MRSA and MSSA are completely susceptible to vancomycin, linezolid, rifampin, nitrofurantoin, and chloramphenicol. Gentamicin, tetracycline, and TMP-SMZ cover > 97% of both isolates.
A "Rural" Indian Community in an Urban Setting

Rural communities in Wisconsin, like rural communities throughout the United States, have a demographic curve which contrasts sharply with that of urban areas. Relative to urban areas, rural areas generally have more children and young people, fewer people in the working age range (18 to 64), and more elderly people. In general, the degree of contrast varies directly with physical distance from urban centers, with the demographic curve of remote communities contrasting most markedly with that of urban centers. As a single index of demographic variation, median age generally reflects the demographic curves involved, with median age declining as territorial distance from urban centers increases.
Echocardiographic assessment of left ventricular function

Echocardiography provides a comprehensive assessment of most important parameters of LV systolic and diastolic function. In many clinical situations a combination of these will be required to establish a complete diagnosis and determine appropriate management decisions. In those patients in whom the diagnosis remains elusive after a complete resting Doppler echocardiographic study, stress echocardiography may also be performed. The application of new echocardiographic indices to evaluate LV function during exercise represents a new frontier in clinical research.
The risk factors for deep and superficial chest surgical-site infections after coronary artery bypass graft surgery are different

Abstract Objective: We sought to determine risk factors for deep and superficial chest wound infections after coronary artery bypass graft surgery to develop predictive models. Methods: We retrospectively analyzed data collected on 1980 consecutive patients undergoing coronary artery bypass surgery at our institution between January 1, 1996, and June 30, 1999, by using the Society of Thoracic Surgery database. Independent risk factors for surgical-site infection were identified with multivariate logistic regression. Results: There were 37 (1.9%) deep chest and 46 (2.3%) superficial chest surgical-site infections. Obese diabetic patients had a 7.7-fold increased risk of deep chest infections after controlling for intra-aortic balloon pump use (odds ratio, 3.1) and postoperative transfusion (odds ratio, 2.3). Independent risk factors for superficial surgical-site infections included obesity (odds ratio, 3.1), diabetes in persons 65 years of age or older (odds ratio, 2.7), and current smoking (odds ratio, 2.5). Use of antiplatelet drugs was associated with a lower risk of superficial infections (odds ratio, 0.4). Predicted operative mortality as a marker of severity of illness was not clearly predictive of deep or superficial surgical-site infection. Mortality in the year after the operation was increased in patients with deep chest infections compared with that seen in uninfected control subjects (8/37 [21.6%] vs 114/1612 [7.1%], P =.004) but not in patients with superficial chest infections (7/47 [15.2%] vs 114/1612 [7.1%], P =.075). Conclusions: Risk factors for deep and superficial chest surgical-site infections after coronary artery bypass surgery differ, suggesting different mechanisms of pathogenesis. Appropriate risk stratification models specific to these important outcomes must be developed. J Thorac Cardiovasc Surg 2002;124:136-45
Studies on the mechanism of action of A80915A, a semi-naphthoquinone natural product, as an inhibitor of gastric (H(+)-K+)-ATPase.

Abstract A semi-naphthoquinone natural product, A80915A, produced by Streptomyces aculeolatus was found to be a potent inhibitor of gastric (H + -K + )-ATPase, the enzyme responsible for acid secretion in the stomach. Enzyme activity was measured by potassium-stimulated hydrolysis of ATP or p -nitrophenolphosphate with enzyme prepared from the stomach fundic mucosa of pigs. Concentration-dependent inhibition was observed with an IC 50 of about 2–3 μM for both ATPase and p -nitrophenylphosphatase. A Hill plot indicated that the enzyme has two binding sites for A80915A. Inhibition was not affected by the presence of the reducing agent dithiothreitol, indicating a lack of involvement of enzyme sulfhydryl groups. A 30-min incubation of enzyme with increasing drug concentrations followed by a 10-fold dilution did not alter the IC 50 , indicating that A80915A does not covalently modify the enzyme. Coincubation of enzyme with 3.8 μM A80915A resulted in time-dependent inhibition. The rate of inhibition was slowed significantly by the presence of 20 mM potassium, rubidium and ammonium but not by 20 mM sodium, lithium and choline, or by 40 mM sucrose. The level of inhibition was influenced by the order of addition of potassium and drug to the enzyme. Taken together, these studies indicate that inhibition by A80915A is dependent on the conformation of gastric (H + -K + )-ATPase and that potassium slows the rate of inhibition by converting the enzyme to a conformation where the drug binding site is not as accessible. The mode of action of A80915A is distinct from that of two well characterized proton pump inhibitors, omeprazole and SCH 28080.
Attention-deficit/hyperactivity disorder in adults: an overview

Abstract To assess the validity of adult attention-deficit/hyperactivity disorder (ADHD), we reviewed clinical, family, psychopharmacologic, neurobiological, and outcome studies. We found multiple reports describing adults with clinical features highly reminiscent of the childhood ADHD. These adults, who are impulsive, inattentive, and restless, have the clinical “look and feel” of ADHD children. As with their childhood counterparts, many adults with ADHD suffer from antisocial, depressive, and anxiety disorders. They also show clinically significant impairments—histories of school failure, occupational problems, and traffic accidents. Studies of biological features show correspondences between child and adult cases of ADHD. Both show familial aggregation and a characteristic profile of neuropsychologic deficits; an emerging neuroimaging literature suggests that abnormalities in the same brain regions underlie both the child and adult forms of the disorder. Although these converging lines of evidence support the validity of ADHD in adults, follow-up studies of ADHD children have yielded ambiguous results. This ambiguity is in part due to differences in how researchers define the persistence of ADHD, a problem that suggests future research focus on how best to diagnose ADHD in adulthood.
Effects of pharmacological agents on acoustic priming of audiogenic seizures.

SummaryAmino-oxyacetic acid (AOAA), chlorpromazine, and Dilantin were examined for their effects on acoustic priming of audiogenic seizures. AOAA administered before priming exhibited a protective effect, increasing the severity of subsequent audiogenic seizures. Dilantin had opposite effects, suggesting that the increase of brain levels of GABA provided by all three agents was not causally related to their effects on priming. Nembutal had an effect similar to that seen with Dilantin, and it was proposed that the active drugs exerted their influence by altering the threshold of the auditory transducer.
Individual Productivity and Impact in Developmental Psychology

Abstract Individual eminence in developmental psychology was examined through a textbook citation analysis conducted on 10 current textbooks. For the 285 leading authors in this textbook citation study, data on individual research productivity in psychology (from 1983 to 1991) and on a subset of six journals of special importance for developmental psychology were obtained from the PsycLIT data base. An estimate of the scholarly impact of these authors was obtained from citation counts from the 1988-1991 volumes of the Social Sciences Citation Index (SSCI). The diversity of research interests (e.g., cognitive and social development, public policy) and age groups currently studied by developmental psychologists are reflected in the list of top contributors. The development of the discipline could be described through future productivity studies such as this one.
INSTABILITY-DRIVEN LIMITS ON HELIUM TEMPERATURE ANISOTROPY IN THE SOLAR WIND: OBSERVATIONS AND LINEAR VLASOV ANALYSIS

Kinetic microinstabilities in the solar wind arise when the plasma deviates too far from thermal equilibrium. Previously published work has provided strong evidence that the cyclotron, mirror, and parallel and oblique firehose instabilities limit proton (i.e., ionized hydrogen) temperature anisotropy. However, few studies have thoroughly explored whether a less-abundant ion species can also trigger these instabilities. This study considered the possibility of similar instability-driven limits on ?-particle (i.e., fully ionized helium) temperature anisotropy. Linear Vlasov analysis was used to derive the expected threshold conditions for instabilities driven by ?-particle temperature anisotropy. Measurements in situ of ?-particle temperature anisotropy from the Wind spacecraft's Faraday cups were found to be consistent with the limits imposed by these instability thresholds. This strongly suggests that ?-particles, which only constitute ~5% of ions in the solar wind, can drive an instability if their temperature anisotropy becomes sufficiently extreme.
Drive, reward, and training parameters, and the overlearning-extinction effect (OEE)

Abstract Two levels of drive (80 and 95% of ad libitum body wt), three of training (5, 15, and 60 trials), and two of reward (2 and 11, 45-mg pellets) were factorially varied during acquisition of a discrete-trial running response. Resistance to extinction (Rn) was monotonically related to number of training trials for all but the high-drive, large-reward condition. Here an inverted U-shaped function was found indicative of the overlearning-extinction effect (OEE). Given 60 training trials, drive and reward interacted to determine Rn, such that the high-drive, large-reward group extinguished fastest while the high-drive, small-reward group extinguished slowest. The low-drive groups were intermediate; however, here too, large reward produced faster extinction. The results were interpreted as supporting Amsel's frustration hypothesis.
Interaction of gangliosides with B cells in splenic fragment cultures

The effect of gangliosides upon murine adult B cells at the single precursor cell level was examined using the splenic focus assay. Adult B cells were stimulated in in vitro organ fragment culture by a hapten-modified carrier protein in the presence of an excess of carrier-primed T cells. The addition of a potential tolerogen in the form of antigen coupled to a carrier not previously presented to the T cells resulted in a temporary unresponsiveness of the onset of antibody production in adult B cells, but not a permanent state of tolerance. This delay could be eliminated by the addition of purified murine gangliosides during the presentation of the hapten coupled to the unrecognized carrier. The ganglioside preparation was fractionated by ion-exchange chromatography and the active fraction was found to be a disialoganglioside. These results suggest that the ganglioside may interfere with membrane receptor-related events occurring during or after antigen binding or cross-linking to responding B cells.
Group Disorders in Urban Schools The Effects of Racial Desegregation and Social Emancipation

This paper formulates and tests a causal model of racial violence in the public schools using data from a sample of 119 American cities. The results tend to support three conclu sions regarding the outbreak of school disorders during the latter 1960s. First, the data suggest that the causes of school disorders are rooted in the community-at-large as well as in the schools. Second, the results show that the most direct and immediate school factor is the extent to which urban school systems are racially desegregated. Finally, the data do not support riot theories based on the assumption of social marginality. Rather, the results appear most consistent with interpretations which stress their parapolitical character.
Age, Race, and Gender Differences in Depressive Symptoms: A Lifespan Developmental Investigation

This study considered depressive symptoms among a normative sample of 1,900 children, adolescents, and adults (950 males and 950 females) divided across four age-levels to investigate the developmental progression of depressive symptoms by age, race/ethnicity, and gender. The national normative sample of the Clinical Assessment of Depression (CAD) was used in this study, which provided a large, reliably assessed, representative sample for group comparisons. CAD age, gender, race/ethnicity analyses revealed that depressive symptoms appear to be experienced at fairly uniform levels across the age-span, by both genders, and among Whites, Blacks, and Hispanics. Specific differences within age, race, and gender groups and interactions are discussed.
Distinctive interactions of the Arabidopsis homolog of the 30 kD subunit of the cleavage and polyadenylation specificity factor (AtCPSF30) with other polyadenylation factor subunits

The Arabidopsis ortholog of the 30 kD subunit of the mammalian Cleavage and Polyadenylation Specificity Factor (AtCPSF30) is an RNA-binding endonuclease that is associated with other Arabidopsis CPSF subunits (orthologs of the 160, 100, and 73 kD subunits of CPSF). In order to further explore the functions of AtCPSF30, the subcellular distribution of the protein was examined by over-expressing fusion proteins containing fluorescent reporters linked to different CPSF subunits. It was found that AtCPSF30 by itself localizes, not to the nucleus, but to the cytoplasm. AtCPSF30 could be found in the nucleus when co-expressed with AtCPSF160 or AtCPSF73(I), one of the two Arabidopsis orthologs of CPSF73. This re-directing of AtCPSF30 indicates that AtCPSF30 is retained in the nucleus via interactions with either or both of these other CPSF subunits. Co-expression of AtCSPF30 with AtCPSF100 altered the location, not of AtCPSF30, but rather of AtCPSF100, with these proteins residing in the cytoplasm. Deletion of plant-specific N- or C-terminal domains of AtCPSF30 abolished various of the interactions between AtCPSF30 and other CPSF subunits, suggesting that the plant CPSF complex assembles via novel protein-protein interactions. These results suggest that the nuclear CPSF complex in plants is a dynamic one, and that the interactions between AtCPSF30 and other CPSF subunits are different from those existing in other eukaryotes.
Robotic-assisted locomotor training impact on neuromuscular properties and muscle strength in Spinal Cord Injury

We studied the effects of Robotic-Assisted Locomotor (LOKOMAT) Training on neuromuscular properties and muscle strength of the spastic ankle in persons with incomplete Spinal Cord Injury (SCI). LOKOMAT training was performed 3 days/week during a 1-hr period including set-up time. The training was provided for 4 weeks and subjects were evaluated before and after 1, 2, and 4 weeks of training. A system identification technique was used to quantify the effects of LOKOMAT training on neuromuscular abnormalities. The effect of LOKOMAT training on muscle strength was determined by measuring isometric maximum voluntary contraction (MVC) of ankle extensor and flexor muscles. Our results indicated that the reflex stiffness, abnormally increases in SCI, was significantly reduced (up to 65%) following 4-weeks of LOKOMAT training. Similarly, intrinsic (muscular) stiffness, which also abnormally increases in SCI, decreased significantly (up to 60%). MVCs were increased substantially (up to 93% in extensors and 180% in flexors) following 4-week training. These findings demonstrate that LOKOMAT training is effective in reducing spasticity and improving muscle strength in SCI.