cssi/SciSciGPT-SciSciNet huggingface dataset:
The Doctor will See You Elsewhere: Enterprise Information Systems and the Changing Control of Firm Activities

In this work, we examine how the adoption of enterprise information systems affects the ability of high agency organizational actors to control the activities performed by firms, including both what those activities are and where they are done. While extant research highlights the ability of managers to more carefully manipulate the activities performed by the firm when enterprise IT is adopted, work has yet to examine whether high agency subordinates will use such technology to appropriate rents. Empirically, we investigate whether surgeons reallocate patients to ambulatory care settings for treatment after the adoption of electronic health records (EHR). Findings suggest that while the adoption of basic EHR technology has limited effect, the adoption of advanced EHRs dramatically increases the number of patients treated in an ambulatory care setting. Interestingly, these relationships are strongly moderated by both the financial incentives of the physician and the profit motives of the hospital. Practical and theoretical implications are discussed within.
Sleep quality and glycaemic variability in a real-life setting in adults with type 1 diabetes

Suboptimal subjective sleep quality is very common in adults with type 1 diabetes. Reducing glycaemic variability is a key objective in this population. To date, no prior studies have examined the associations between objectively measured sleep quality and overnight glycaemic variability in adults with type 1 diabetes. We aimed to test the hypothesis that poor sleep quality would be associated with greater overnight glycaemic variability. Data were collected in the home setting from 20 adults (ten male and ten female participants) with type 1 diabetes who were current insulin pump users. Simultaneous assessments of objective sleep quality (Zmachine Insight+) and continuous glucose monitoring (CGM) were performed over multiple nights (up to 15 nights) in each participant. Due to the real-life nature of this study, the participants kept their usual CGM alerts for out-of-range glucose values. Sleep quality was categorised as ‘good’ or ‘poor’ using a composite of objective sleep features (i.e. sleep efficiency, wake after sleep onset and number of awakenings) based on the National Sleep Foundation’s consensus criteria. Glycaemic variability was quantified using SD and CV of overnight glucose values based on overnight CGM profiles. A total of 170 nights were analysed. Overall, 86 (51%) nights were categorised as good sleep quality, and 84 (49%) nights were categorised as poor sleep quality. Using linear mixed-effects models, poor sleep quality was significantly associated with greater glycaemic variability as quantified by SD (coefficient: 0.39 [95% CI 0.10, 0.67], p = 0.009) and CV (coefficient: 4.35 [95% CI 0.8, 7.9], p = 0.02) of overnight glucose values, after accounting for age, sex, BMI and overnight insulin dose. There was large inter- and intra-individual variability in sleep and glycaemic characteristics. Both pooled and individual-level data revealed that the nights with poor sleep quality had larger SDs and CVs, and, conversely, the nights with good sleep quality had smaller SDs and CVs. No associations were found between sleep quality and time spent in the target glucose range, or above or below the target glucose range, where CGM alarms are most likely to occur. Objectively measured sleep quality is associated with overnight glycaemic variability in adults with type 1 diabetes. These findings highlight an important role of sleep quality in overnight glycaemic control in type 1 diabetes. They also provide a strong incentive to both patients and healthcare providers for considering sleep quality in personalised type 1 diabetes glycaemic management plans. Future studies should investigate the mechanisms linking sleep quality to glycaemic variability.
Estimating Skeletal Maturity Using Knee Radiographs During Preadolescence: The Epiphyseal:Metaphyseal Ratio.

BACKGROUND Though skeletal maturity is most relevant during adolescence, it has utility in treatment of younger patients in some circumstances. Accurate estimation of skeletal maturity using knee radiographs would be useful when treating limb length discrepancy and other general medical conditions in preadolescent patients. Currently, a quick, accurate, and reproducible method of estimating skeletal maturity in preadolescents is lacking. METHODS Serial anteroposterior knee radiographs taken at historical growth study visits leading up to the chronological age associated with 90% of final height (an enhanced skeletal maturity standard as compared with peak height velocity) were analyzed in 75 children. Epiphyseal and metaphyseal widths of the distal femur, proximal tibia, and proximal fibula were measured and the epiphyseal:metaphyseal ratio was calculated. Greulich and Pyle (GP) bone ages were also assigned by an experienced pediatric endocrinologist using left hand radiographs. Stepwise linear regression and generalized estimating equation analyses were used to make a skeletal maturity model incorporating demographics (age+sex) and knee epiphyseal:metaphyseal ratios. RESULTS A total of 258 left knee radiographs from 39 girls (mean age 8.6 y, range: 2.9 to 13 y) and 36 boys (mean age 10.6 y, range: 3.8 to 15 y) were included. The demographics+ratios model had similar prediction accuracy (0.49 vs. 0.48 y, P=0.84) and rate of outliers (11% vs. 9%, P=0.11) as the demographics+GP model. The demographics+ratios model outperformed all other models evaluated, including a demographics-only model (P<0.001 for all). CONCLUSIONS When combined with chronological age and sex, epiphyseal:metaphyseal ratio measurement in the knee allows for skeletal maturity estimation comparable to using the GP technique. CLINICAL RELEVANCE We have defined a knee skeletal maturity system that could be applied in treatment of orthopaedic conditions in preadolescents where a knee radiograph is already obtained, avoiding the need for an additional hand radiograph.
Trajectories in quantitative and humanities self-efficacy during the first year of college

Abstract Although many studies have examined self-efficacy cross-sectionally, few have investigated how undergraduate students' self-efficacy changes over time, particularly during their first year of postsecondary education. The purpose of this study was to explore the trajectories of first-year college students' (N = 2167) self-efficacy in quantitative and humanities subjects and its relationship to academic achievement. A parallel process second-order latent growth model revealed that students' self-efficacy increased simultaneously in each broad domain. Whereas quantitative self-efficacy favored male students and STEM majors at baseline, the rate of change was slower for STEM majors than for non-STEM or undeclared majors. Humanities self-efficacy favored female students at baseline. Only the growth factors of quantitative self-efficacy were positively related to students' first-year cumulative GPA, controlling for gender, major, and high school GPA. Findings can help instructors know when, and to some extent, for whom to offer self-efficacy support during the first year of college.
“Evolutionary Theorizing in Sociology’s Formative Period: Implications for Theorizing Today”

Evolutionary analyses in sociology are uncommon despite the fact that evolutionary theory constitutes the core foundation of natural science. Moreover, when evolutionary dynamics are discussed in sociology, it is often in the context of biological evolution with reference to the genetic correlates of social behavior and attitudes. The current chapter instead develops the concept of cultural evolution, as conceived of by the founders of the discipline. Misconceptions about cultural evolution (i.e., that it is a linear process, that it implies deterministic development, that it is discriminatory or Eurocentric, and that it is irrelevant to present-day sociological concerns) abound. Here, we make an attempt to correct misconceptions and deepen understanding about the value of the ideas embedded in classical sociology’s best evolutionary theorists. We also describe some of the core issues and debates of modern cultural evolutionary analyses, across different fields, and do so from the vantage point of sociology’s accumulated knowledge on the topic. Our ultimate goal in this chapter is to provide a broad, yet sufficiently precise, overview of the most sophisticated ideas about cultural evolution from the classical period (1830–1930).
Prognostic indicators for upper tract urothelial carcinoma after radical nephroureterectomy: the impact of lymphovascular invasion

Study Type – Prognosis (case series) Level of Evidence 4 What's known on the subject? and What does the study add? In an array of urological and non-urological malignancies, lymphovascular invasion (LVI) is a pathological feature known to be associated with adverse outcomes for recurrence and survival. For some cancers, LVI has therefore been incorporated into American Joint Committee on Cancer TNM staging algorithms. This study presents an analysis of the impact of LVI in upper urinary tract urothelial carcinoma (UTUC) treated at our institution over a 20-year period. In addition to known associations with features of aggressive disease and overall survival, we were able to show that LVI-positive status upsets the TNM staging for UTUC. Namely, patients with superficial stage and LVI-positive disease have overall survival outcomes similar to those of patients with muscle-invasive LVI-negative carcinoma. Such evidence may support the addition of LVI to future TNM staging algorithms for UTUC. OBJECTIVE • To assess the impact of lymphovascular invasion (LVI) on the prognosis of patients with upper urinary tract urothelial cell carcinoma (UTUC) treated with radical nephroureterectomy (RNU). PATIENTS AND METHODS • The Columbia University Medical Center Urologic Oncology database was queried and 211 patients undergoing RNU for UTUC between 1990 and 2010 were identified. • These cases were retrospectively reviewed, and the prognostic significance of relevant clinical and pathological variables was analysed using log-rank tests and Cox proportional hazards regression models. • Actuarial survival curves were calculated using the Kaplan–Meier method. RESULTS • LVI was observed in 68 patients (32.2%). • The proportion of LVI increased with advancing stage, high grade, positive margin status, concomitant carcinoma in situ, and lymph node metastases. The 5- and 10-year overall survival rates were 74.7% and 53.1% in the absence of LVI, and 35.7% and 28.6% in the presence of LVI, respectively. • In multivariate analysis, age, race and LVI were independent predictors of overall survival. CONCLUSIONS • The presence of LVI on pathological review of RNU specimens was associated with worse overall survival in patients with UTUC. • LVI status should be included in the pathological report for RNU specimens to help guide postoperative therapeutic options. • With confirmation from large international studies, inclusion of LVI in the tumour-node-metastasis staging system for UTUC should be considered.
Studies on the Pathogenesis of Enteric Infections Caused by Invasive Bacteria

Salmonellae, shigellae and some Escherichia coli must invade the intestinal epithelial cell and multiply within the mucosa to cause disease. Although the bacterial cell most likely possesses several properties essential to this invasive ability, the nature of the cell envelope complex is at present the only characteristic which has been implicated in this process. While a number of pathophysiological events result from invasion, some of our recent efforts have concerned the site and mechanism of intestinal fluid loss in salmonellosis and shigellosis. In both these disorders, bacterial invasion of the colonic mucosa, associated with an acute inflammatory reaction and mucosal damage, is regularly seen and colonic salt and water transport is abnormal. These defects may account for mild diarrhoea in salmonellosis and the dysenteric stools of shigellosis. However, in salmonella-infected animals with severe watery diarrhoea and in shigella-infected animals with diarrhoea alone or in combination with dysentery, the jejunum is in a net secretory state. This secretion occurs in the absence of bacterial invasion or morphological abnormalities. Thus, the diarrhoea caused by invasive bacteria may result from the inability of the colon to reabsorb the increased volume of fluid entering it from the small intestine. Although colonic mucosal damage is a feature of invasive-type diarrhoeas, the permeability of both the colon and small intestine to small molecules, mannitol and erythritol, is not altered. Thus intestinal fluid loss cannot be ascribed to transudation. In addition, the results of our Ussing chamber experiments, employing salmonella-infected rabbit ileum, reveal that salt and water secretion is an active process. Since secretion occurs in the jejunum in the absence of bacterial invasion, this might suggest the participation of an enterotoxin. Shigella dysenteriae I is the best-studied invasive organism in which an enterotoxin has been found, yet mutant strains which do not invade but retain the ability to elaborate enterotoxin fail to cause disease in either monkeys or man. Thus, the physiological relevance of Shiga enterotoxin and the mechanism of jejunal secretion in these disorders remain unclear. Recent data suggest that invasive enteropathogens, like the enterotoxin-producing bacteria, activate the mucosal adenylate cyclase-cyclic AMP system and that this activation may play a role in intestinal fluid secretion.
Test and evaluation of 23 electric vehicles for state-of-the-art assessment

Eleven of the electric vehicles were passenger cars and 12 were commercial vans. Tests were conducted in accordance with an ERDS test procedure which is based on the SAE J227a Test Procedure. Tests included range, acceleration, coast-down, and braking. The results of the tests are presented, and comments on reliability are made.
Inflammation in chronic thromboembolic pulmonary hypertension: accomplice or bystander in altered angiogenesis?

Evidence for the role of inflammation in the pathogenesis of PAH: a new study demonstrates inflammation in CTEPH http://ow.ly/OxixF
The Balance of Power A Brief History of Cray Research Hardware Architectures

Publisher Summary This chapter reviews that supercomputers and CRAY Research systems became synonymous with the introduction of the new company's first product, the CRAY-1 computer system. The CRAY-1 system was introduced in 1976 and shattered all previous performance records for scientific computing. Its technical and commercial success was due to three major advancements: a fast, 12.5 nsec, processor clock, which improved scalar processing over the CDC 7600 computer by a factor of two; successful vector implementation, which could improve performance over scalar processing by a factor of five to ten, and a large, 1 Mword, memory, which eliminated the need for the high-level language programmer to explicitly allocate arrays in Large Core Memory. In the most general sense, Cray Research's hardware philosophy was and remains a practical one of preserving balance among the three primary system functions: processing speed, memory size and speed, and I/O bandwidth. Maintaining this balance ensures that no one functions becomes a bottleneck that compromises system throughput. And each of these functions has evolved through technical innovations pioneered at Cray Research. It reviews that today an additional factor has come to play an increasingly large role, namely, system cost. Today, a successful supercomputer has to be able to deliver high performance with markedly improved price/performance compared to previous generations.
Reporting of harms and adverse events in otolaryngology journals

Objective: To identify the frequency and quality of harms and adverse events reporting in otolaryngology journals.Study Design: A literature review.Methods: Four major otolaryngology journals from ...
Two-dimensional 1H NMR studies of synthetic immobile holliday junctions

Two 32 base pair, four-arm immobile Holliday junctions have been prepared and studied by two-dimensional {sup 1}H nuclear magnetic resonance (NMR) spectroscopy. Two-quantum spectroscopy provides scalar (through bond) correlations for the 1{prime}H, 2{prime}H, and 2{double prime}H resonances of the deoxyribose sugar rings and the nonlabile cytosine and thymine base protons. Assignments in the deoxyribose sugars are extended to the 3{prime}H resonances principally from relayed connectivities in total correlation spectra. Severe overlap of resonances in the standard regions of two-dimensional nuclear Overhauser enhancement (NOE) spectra necessitated the use of a unique approach for obtaining sequence-specific assignments of duplex DNA, wherein all possible NOE connectivities in the spectra are analyzed. These studies of 64-residue structures represent a substantial step forward with respect to the size of oligonucleotide for which virtually complete assignments are obtained. The assignments form the critical background for the detailed analysis of Holliday junction structure and dynamics that is required to address key issues in understanding the role of Holliday junctions in genetic recombination and repair.
The E295K Cancer Variant of Human Polymerase β Favors the Mismatch Conformational Pathway during Nucleotide Selection

DNA polymerase β (pol β) is responsible for gap filling synthesis during repair of damaged DNA as part of the base excision repair pathway. Human pol β mutations were recently identified in a high percentage (∼30%) of tumors. Characterization of specific cancer variants is particularly useful to further the understanding of the general mechanism of pol β while providing context to disease contribution. We showed that expression of the carcinoma variant E295K induces cellular transformation. The poor polymerase activity exhibited by the variant was hypothesized to be caused by the destabilization of proper active site assembly by the glutamate to lysine mutation. Here, we show that this variant exhibits an unusual preference for binding dCTP opposite a templating adenine over the cognate dTTP. Biochemical studies indicate that the noncognate competes with the cognate nucleotide for binding to the polymerase active site with the noncognate incorporation a function of higher affinity and not increased activity. In the crystal structure of the variant bound to dA:dCTP, the fingers domain closes around the mismatched base pair. Nucleotide incorporation is hindered because key residues in the polymerase active site are not properly positioned for nucleotidyl transfer. In contrast to the noncognate dCTP, neither the cognate dTTP nor its nonhydrolyzable analog induced fingers closure, as isomorphous difference Fourier maps show that the cognate nucleotides are bound to the open state of the polymerase. Comparison with published structures provides insight into the structural rearrangements within pol β that occur during the process of nucleotide discrimination.
ASYMMETRIC TWO-ELECTRON EXCITATIONS IN ATOMIC STRONTIUM AND BARIUM

We present a general nonperturbative calculation of the photoionization cross section for highly asymmetrical two-electron systems. The calculations were performed using the eigenchannel [ital R]-matrix procedure together with multichannel quantum-defect theory, including the effects of long-range multipole interactions. The isolated-core approximation is extended to treat two-photon absorption. The calculations permit a detailed interpretation of recent experimental measurements in atomic strontium and barium.
Synthesis of nanocrystalline Zn-22 Pct Al using cryomilling

In the present investigation, the synthesis of nanocrystalline Zn-22 pct Al by ball milling was studied. The microstructural evolution during cryomilling and subsequent annealing was characterized using transmission electron microscopy (TEM), scanning electron microscopy (SEM), and X-ray diffraction (XRD). Observations made during the cryomilling of the alloy reveal three findings. First, minimum average grain sizes of about 33 nm for the Al phase and 41 nm for the Zn phase are reached as cryomilling time increases to 16 hours. Second, the morphology of the powders changes from spherical (as-sprayed) to flaky (milled 8 hours) and then back to spherical again (milled 16 hours). Third, the microstructure transforms from two-phase coarse structure (0.8 µm, as-sprayed) to bimodal structure (milled 8 hours) and then to a uniform fine-grained structure (milled 16 hours). The minimum grain size characterized by the peak broadening of the XRD patterns is much larger than that reported in previous work on Al and Zn but agrees well with those predicted from the approximate linear relationship between the minimum grain size and the critical equilibrium distance between two edge dislocations in a pileup. The mechanism of grain size refinement is discussed at three different levels: macroscopic level (individual powders), mesoscopic level (individual small fragments), and microscopic level (individual grains). The excellent thermal stability of the milled powders during subsequent annealing has been attributed to three factors: the nature of the eutectoid structure, grain-boundary pining by dispersions, and microporosity in the particles.
Origins of the L-amino acid excess in carbonaceous meteorites

Carbonaceous meteorites provide the best direct evidence for the types and abundances of organic compounds that were present at approximately the time of formation of our solar system. The occurrence of eight amino acids in carbonaceous meteorites that are ubiquitous to all life as we know it has led to much discussion concerning their significance for the origin of life. The fact that several of the protein amino acids in carbonaceous meteorites have been reported to contain an L-enantiomer excess led to the initial speculation that the preferred stereochemistry for the organic constituents of life as we know it was derived from this extraterrestrial source1. Hypotheses that have been used to explain this extraterrestrial L-amino acid excess are discussed within the context of the results of recent laboratory experiments.
Phosphodiesterase-5 inhibition synergizes rho-kinase antagonism and enhances erectile response in male hypertensive rats

To evaluate the association between hypertension, male erectile function, Rho-kinase, and cyclic GMP pathways, we monitored neurogenic erectile response in spontaneously hypertensive (SHR) vs normotensive rats. We also evaluated SHR erectile function before and after intracavernosal injection of either the specific Rho-kinase inhibitor Y-27632 or a combination of Y-27632 and the PDE5 inhibitor zaprinast to prevent cGMP degradation. SHR had lower resting baseline corpus cavernosum pressure and a higher threshold for development of tumescence than normotensive rats. In SHR, Y-27632 administration reversed hypertension-related changes in male erectile function; Rho-kinase antagonism and PDE5 inhibition in combination had a synergistic effect in improving the neurogenic erectile response. Our data indicate that hypertension is associated with impairment in the SHR neurogenic erectile response that may involve a derangement in hemodynamic mechanisms in penile erectile tissue. Rho-kinase inhibition alone or combined with PDE5 inhibition may be of value in treating hypertension-related ED.
Iatrogenic ileal atresia secondary to clamping of an occult omphalocele

Abstract Clamping of an occult omphalocele has led to complete division of an entrapped loop of ileum in two instances. The proximal end has been sealed in the process, producing an iatrogenic ileal atresia. The clinical picture in both instances differed from that usually found with ileal atresia. Escape of a small amount of meconium from the transected cord was noted in one, and the stump of the cord in the other appeared red and engorged. Clamping the umbilical cord routinely at least 5 cm from the abdominal wall is recommended.
siRNA-mediated Allele-specific Silencing of a COL6A3 Mutation in a Cellular Model of Dominant Ullrich Muscular Dystrophy.

Congenital muscular dystrophy type Ullrich (UCMD) is a severe disorder of early childhood onset for which currently there is no effective treatment. UCMD commonly is caused by dominant-negative mutations in the genes coding for collagen type VI, a major microfibrillar component of the extracellular matrix surrounding the muscle fibers. To explore RNA interference (RNAi) as a potential therapy for UCMD, we designed a series of small interfering RNA (siRNA) oligos that specifically target the most common mutations resulting in skipping of exon 16 in the COL6A3 gene and tested them in UCMD-derived dermal fibroblasts. Transcript analysis by semiquantitative and quantitative reverse transcriptase PCR showed that two of these siRNAs were the most allele-specific, i.e., they efficiently knocked down the expression from the mutant allele, without affecting the normal allele. In HEK293T cells, these siRNAs selectively suppressed protein expression from a reporter construct carrying the mutation, with no or minimal suppression of the wild-type (WT) construct, suggesting that collagen VI protein levels are as also reduced in an allele-specific manner. Furthermore, we found that treating UCMD fibroblasts with these siRNAs considerably improved the quantity and quality of the collagen VI matrix, as assessed by confocal microscopy. Our current study establishes RNAi as a promising molecular approach for treating dominant COL6-related dystrophies.
Regulate trade in rare plants

Patrick D. Shirey and Gary A. Lamberti call for action to stem the rising tide of species redistribution caused by Internet sales.
Counter-example to ‘Sufficient and necessary condition for the asymptotic stability of discrete linear interval systems’

Abstract In Jiang (1988), a condition is given which is supposedly necessary and sufficient for the stability of interval matrices in discrete-time systems. We demonstrate, via a counter-example, that the condition given is, in fact, not sufficient.
Studies in possibilistic recognition

This paper introduces an algorithm for pattern recognition. The algorithm will classify a measured object as belonging to one of N known classes or none of the classes. The algorithm makes use of fuzzy techniques and possibility is used instead of probability. The algorithm was conceived with the idea of recognizing fast moving objects, but it is shown to be more general. Fuzzy ISODATA's use as a front end to the algorithm is shown. The algorithm is shown to accomplish the objectives of correct classification or no classification. Values that describe possibility distributions are introduced with some of their properties investigated and illustrated. An expected value for a possibility distribution is also investigated. The algorithm actually proves to be adaptable to a wide variety of imprecise recognition problems. Some test results illustrate the use of the technique embodied in the algorithm and indicate its viability.
Process optimization of APEX-E

Excimer laser lithography combined with chemically amplified resists offers a viable approach to lithography at 0.5 micrometers and below. APEX-E, a positive tone deep-uv resist used in conjunction with a 0.44 NA excimer laser stepper is capable of 0.35 micrometers resolution. To improve the process window for this resist while reducing the performance variability, the Taguchi method of quality control was employed. The baseline process for APEX-E was characterized, then subsequently used as a comparison to the optimized process as suggested by the Taguchi experiments.
SEASONAL, REGIONAL, AND CIRCADIAN VARIATIONS OF ACUTE MYOCARDIAL INFARCTION: FINDINGS FROM THE GET WITH THE GUIDELINES- CORONARY ARTERY DISEASE (GWTG-CAD) PROGRAM

We evaluated seasonal and circadian variations in patients presenting with acute myocardial infarction (AMI), regional differences in these variations and their relationship to quality and outcomes in a large national database. Using data from GWTG-CAD, we analyzed 82,971 consecutive acute
Evaluating the need for complexity in energy-aware management for cloud platforms

In order to curtail the continuous increase in power consumption of modern datacenters, researchers are responding with sophisticated energy-aware workload management methods. This increases the complexity and cost of the management operation, and may lead to increases in failure rates. The goal of this paper is to illustrate that there exists considerable diversity in the effectiveness of different, potentially 'smarter' workload management methods depending on the target metric or the characteristics of the workload being managed. We conduct experiments on a datacenter prototype platform, virtualized with the VMware vSphere software, and using representative cloud applications -- a distributed key-value store and a map-reduce computation. We observe that, on our testbed, different workload placement decisions may be quite effective for some metrics, but may lead to only marginal impact on others. In particular, we are considering the impact on energy-related metrics, such as power or temperature, as corresponding energy-aware management methods typically come with greater complexity due to fact that they must consider the complex energy consumption trends of various components in the cloud infrastructure. We show that for certain applications, such costs can be avoided, as different management policies and placement decisions have marginal impact on the target metric. The objective is to understand whether for certain classes of applications, and/or application configurations, it is necessary to incur, or if it is benefitial to avoid, the use of complex management methods.
Ultrasonic Nakagami-parameter characterization of parotid-gland injury following head-and-neck radiotherapy: a feasibility study of late toxicity.

Purpose: The study aims to investigate whether Nakagami parameters—estimated from the statistical distribution of the backscattered ultrasound radio-frequency (RF) signals—could provide a means for quantitative characterization of parotid-gland injury resulting from head-and-neck radiotherapy. Methods: A preliminary clinical study was conducted with 12 postradiotherapy patients and 12 healthy volunteers. Each participant underwent one ultrasound study in which ultrasound scans were performed in the longitudinal, i.e., vertical orientation on the bilateral parotids. For the 12 patients, the mean radiation dose to the parotid glands was 37.7 ± 9.5 Gy, and the mean follow-up time was 16.3 ± 4.8 months. All enrolled patients experienced grade 1 or 2 late salivary-gland toxicity (RTOG/EORTC morbidity scale). The normal parotid glands served as the control group. The Nakagami-scaling and Nakagami-shape parameters were computed from the RF data to quantify radiation-induced parotid-gland changes. Results: Significant differences in Nakagami parameters were observed between the normal and postradiotherapy parotid glands. Compared with the control group, the Nakagami-scaling parameter of the postradiotherapy group decreased by 25.8% (p < 0.001), and the Nakagami-shape parameter decreased by 31.3% (p < 0.001). The area under the receiver operating characteristic curve was 0.85 for the Nakagami-scaling parameter and was 0.95 for the Nakagami-shape parameter,more » which further demonstrated the diagnostic efficiency of the Nakagami parameters. Conclusions: Nakagami parameters could be used to quantitatively measure parotid-gland injury following head-and-neck radiotherapy. Moreover, the clinical feasibility was demonstrated and this study provides meaningful preliminary data for future clinical investigation.« less
Development of achalasia secondary to laparoscopic Nissen fundoplication.

Dysphagia after laparoscopic Nissen fundoplication (LNF) is commonly attributed to edema and/or improperly constructed wraps, and in some instances the cause can be difficult to identify. We report, for the first time, the development of secondary achalasia after LNF as a cause of late-onset postoperative dysphagia. A total of 250 consecutive patients undergoing LNF were analyzed for the development of postoperative dysphagia at a university hospital. Patients were considered to have secondary achalasia if they met the following four criteria: (1) preoperative manometry demonstrating normal peristalsis and normal lower esophageal sphincter (LES) relaxation; (2) lack of esophageal peristalsis on postoperative manometry or fluoroscopy with or without incomplete LES relaxation; (3) no mucosal lesions seen on endoscopy; and (4) dysphagia refractory to dilatation. The following three groups of patients were identified: patients who developed secondary achalasia (group A, n = 7); patients with persistent dysphagia requiring and responding to postoperative dilatation (group B, n = 12 patients); and patients whose postoperative recovery was not complicated by dysphagia (group C, n = 231). The groups were comparable in terms of all preoperative variables except for age. Patients in group A were older than those in group B (57 years [range 27 to 66 years] vs. 36.5 years [range 27 to 63 years], P = 0.028) but were not significantly older than patients in group C (45 years [range 20 to 84 years], P = 0.42). The onset of severe dysphagia was later in group Athan in group B (135 days [range 15 to 300 days] vs. 20 days [range 9 to 70 days],P = 0.002). The median weight loss in group A was also significantly greater than in Group B (15 pounds [range 11 to 44 pounds] vs. 4 pounds [range 0 to 15 pounds], P = 0.0007). Two patients in group A who underwent reoperation failed to improve. Botulinum toxin injections were tried in two patients and Heller myotomy in one with good results. Nine patients in group B improved promptly after one dilatation, and three improved after two dilatations. Secondary achalasia should be considered as one of the causes of persistent dysphagia after an apparently successful antireflux operation. Secondary achalasia tends to occur in older patients and is characterized by a delayed onset of symptoms. Imaging studies are a reliable means of excluding mechanical obstruction as a cause of secondary achalasia, and a negative result should raise the suspicion of secondary achalasia. Esophageal motility studies are necessary to confirm the diagnosis. Failure to consider the diagnosis of secondary achalasia can lead to multiple fruitless attempts at dilatation or even inappropriate reoperations.
Synthesis, structure, and olefin polymerization with nickel(II) N-heterocyclic carbene enolates

Two novel N-heterocylic carbene enolate nickel complexes have been prepared and shown to be active for ethylene and propylene polymerization to yield linear polymers.
Anthracycline-related cardiotoxicity in childhood cancer survivors.

Purpose of reviewAnthracyclines have markedly improved the survival rates of children with cancer. However, anthracycline-related cardiotoxicity is also well recognized and can compromise the long-term outcome in some patients. The challenge remains of how to balance the chemotherapeutic effects of
Estimation of β-structure content of proteins by means of deconvolved FTIR spectra

Abstract Fourier self-deconvolution was applied to the infrared spectra of five globular proteins with a high β-structure content and to the essentially α-helical protein hemoglobin. The featureless amide I′ bands around 1650 cm −1 were thereby resolved into six to nine components, depending on the protein. Specific components were assigned to the β-structure segments in each protein. The frequencies and the number of ‘β-bands’ differ from one protein to another. The areas of the components were evaluated by means of a Gauss-Newton iteration procedure. It appears that the total area of the β-bands, as a fraction of the total amide I′ band area, reflects the relative β-structure content of each protein studied.
IgG and IgM autoantibody differences in discoid and systemic lupus patients.

Systemic lupus erythematosus (SLE) patients with discoid lupus erythematosus (DLE) were reported to have milder disease. To test this observation, we used sandwich arrays containing 98 autoantigens to compare autoantibody profiles of SLE subjects without DLE (DLE-SLE+) ( N =9), SLE subjects with DLE (DLE+SLE+) ( N =10), DLE subjects without SLE (DLE+SLE-) ( N =11), and healthy controls ( N =11). We validated differentially expressed autoantibodies using immunoassays in DLE-SLE+ ( N =18), DLE+SLE+ ( N =17), DLE+SLE- ( N =23), and healthy subjects ( N =22). Arrays showed 15 IgG autoantibodies (10 against nuclear antigens) and 4 IgM autoantibodies that were differentially expressed ( q -value P P
Effect of Acetylcholine on Pulmonary Vascular Resistance in a Patient with Idiopathic Pulmonary Hypertension

Necropsy studies in cases of pulmonary hypertension of unknown cause show structural changes in the pulmonary vessels that are called irreversible. Acetylcholine chloride was infused at a rate of 2 mg. per minute into the outflow tract of the right ventricle of a 48-year-old woman who had pulmonary hypertension. The mean pulmonary artery pressure decreased from 56 to 25 mm. Hg and the pulmonary flow increased slightly. These findings are consistent with the theory that so-called idiopathic pulmonary hypertension may at some stage be maintained by vasoconstriction.
A comparative study of book and journal use in four social science disciplines

ABSTRACT Academic librarians are challenged with development and maintenance of collections of research materials in various formats. Although it is assumed that they are monitoring the needs of their constituencies as a part of the collection management decision-making process, the literature reflects only a few studies that focus on direct solicitation of user opinions. This study included a 22-question survey sent to all faculty, staff, and graduate students in a cross-section of social science disciplines (anthropology, psychology, social work, and sociology) at one institution. Responses from 122 individuals (32.1% of faculty, 13.6% of graduate students, and 9.8% of staff) provide data about book and journal use that have informed collection development priorities and reveal shifting patterns of use in an increasingly hybrid (print and electronic) information environment. Results show that faculty and graduate students in all disciplines depend heavily on library collections and generally prefer to a...
Limitations of percutaneous endoscopic jejunostomy

Thirty-six patients at the University of Kentucky Medical Center underwent percutaneous endoscopic jejunostomy placement between January 1 and December 31, 1989. We retrospectively reviewed their charts for indications and complications of the procedure. Experience and outcome with the initial placement of the percutaneous jejunostomy tube was evaluated. Primary diagnoses at the time of insertion included central nervous system disorders (28), ventilator dependence (5), cancer (2), and gastroparesis (1). The follow-up period ranged from 2 to 131 days (median 16 days). Tube dysfunction or dislodgment occurred in 31% of patients. Other complications included pulmonary aspiration (11%) and bleeding at the insertion site (3%). The 30-day mortality rate was 19% with all but one death caused by the severity of the underlying primary illness. It is concluded that problems with the currently performed technique of percutaneous endoscopic jejunostomy, along with tube-related problems, seriously limit the usefulness of this technique. Improvements in technology, along with routine postprocedure radiographs to allow early detection of malpositioned jejunostomy tubes, may improve the outcome of this procedure. Newer techniques that have a higher success of distal small intestinal placement need to be evaluated.
Aerothermodynamic and Electrical Properties of Some Gas Mixtures to Mach 20

Pressure, temperature, chemical composition and electrical conductivity data are presented for gas mixtures behind strong air shocks and detonations of hydrogen-air and acetylene-air mixtures up to Mach 20. A digital computer program has been developed which solves the simultaneous aerodynamic and chemical equilibrium equations. The latest thermodynamic and collision crosssection data are used. Data are also presented wherein the initial gas composition was varied to obtain the maximum electrical conductivity for a given shock or detonation strength.
Fitting of growth curves over time when the data are obtained from a single realization

This paper focuses on the general problem of forecasting the maximum value of a time series which by the nature of the data must approach an asymptotic value. Examples of such series include the growth of organisms, the concentration of a chemical reagent during a reaction occurring over time or the amount of a fossil fuel resource which has been discovered or produced as a function of time. The approach taken below differs from the usual models for this type of data in that it assumes that an unobserved time series is actually driving the process, and that the observed data series is a function of the unobserved process. In the case of fossil fuels the unobserved series might be a measure of the exploratory drilling, the number of production days in a given time period or even the amount of fiscal resources devoted to exploratory activities. A maximum likelihood method is developed for estimating the parameters of the process, especially the maximum S, and the covariance structure of the estimators is developed. The methodology is illustrated on an example of oil production. Finally, methods are developed for forecasting the data into the near future.
Audio-visual biofeedback does not improve the reliability of target delineation using maximum intensity projection in 4-dimensional computed tomography radiation therapy planning.

Purpose To investigate whether coaching patients' breathing would improve the match between ITV MIP (internal target volume generated by contouring in the maximum intensity projection scan) and ITV 10 (generated by combining the gross tumor volumes contoured in 10 phases of a 4-dimensional CT [4DCT] scan). Methods and Materials Eight patients with a thoracic tumor and 5 patients with an abdominal tumor were included in an institutional review board-approved prospective study. Patients underwent 3 4DCT scans with: ( 1 ) free breathing (FB); ( 2 ) coaching using audio-visual (AV) biofeedback via the Real-Time Position Management system; and ( 3 ) coaching via a spirometer system (Active Breathing Coordinator or ABC). One physician contoured all scans to generate the ITV 10 and ITV MIP . The match between ITV MIP and ITV 10 was quantitatively assessed with volume ratio, centroid distance, root mean squared distance, and overlap/Dice coefficient. We investigated whether coaching (AV or ABC) or uniform expansions (1, 2, 3, or 5 mm) of ITV MIP improved the match. Results Although both AV and ABC coaching techniques improved frequency reproducibility and ABC improved displacement regularity, neither improved the match between ITV MIP and ITV 10 over FB. On average, ITV MIP underestimated ITV 10 by 19%, 19%, and 21%, with centroid distance of 1.9, 2.3, and 1.7 mm and Dice coefficient of 0.87, 0.86, and 0.88 for FB, AV, and ABC, respectively. Separate analyses indicated a better match for lung cancers or tumors not adjacent to high-intensity tissues. Uniform expansions of ITV MIP did not correct for the mismatch between ITV MIP and ITV 10 . Conclusions In this pilot study, audio-visual biofeedback did not improve the match between ITV MIP and ITV 10 . In general, ITV MIP should be limited to lung cancers, and modification of ITV MIP in each phase of the 4DCT data set is recommended.
Excimer laser-assisted planarization of thick diamond films

The planarization of polycrystalline diamond films is critical for a large number of industrial applications. We have investigated a laser-assisted method for planarization of thick diamond films. This method is based on the application of excimer laser combined with simultaneous rotation of the sample. Thick diamond films (average surface roughness: ∼20 μm and thickness ∼500 μm) were fabricated by plasma jet chemical vapor deposition process. The planarization of diamond films was found to be critically dependent on the angle of incidence of laser beam. Smoother surfaces were obtained at higher incidence angles (θ = 80°). However, by combination of sample rotation with laser irradiation at higher incidence angles (θ = 80°), maximum surface planarization was achieved. Under optimum conditions, the surface roughness of the samples were reduced from 20 to 0.1 μm. The mechanisms for surface planarization of thick diamond films are discussed.
The effect of electrochemical oxygen pumping on the rate and selectivity of ethylene oxidation on polycrystalline silver

Abstract The selectivity and ethylene oxide yield of ethylene oxidation on polycrystalline silver can be affected significantly by electrochemical oxygen pumping. The reaction was studied in the solid electrolyte cell C 2 H 4 , C 2 H 4 O, CO 2 , O 2 , Ag¦ZrO 2 (Y 2 O 3 )¦Ag, air at temperatures near 400 °C and atmospheric pressure. Under open-circuit conditions the porous silver electrode exposed to the ethylene-O 2 mixture acts as a normal catalyst for C 2 H 4 , oxidation to C 2 H 4 O and CO 2 . It was found that when external voltages are applied to the cell and O 2− is “pumped” to the catalyst, the ethylene oxide selectivity and yield increase considerably. The opposite effect is observed upon inversion of the voltage polarity. The increase in the rate of C 2 H 4 O production can exceed the rate of O 2− pumping by a factor of 400, indicating a dramatic change in the properties of the silver catalyst. The phenomenon is reversible and typical relaxation times are of the order of a few minutes. A simple model is proposed in order to explain this new phenomenon.
Thermodynamic properties of liquid Si and Ge

Thermodynamic properties of liquid Si and Ge are calculated using standard variational techniques, with the hard-sphere system as a reference system. Third-order electron-ion pseudopotential contributions are included nonvariationally and are shown to have little effect on the free energy, although a larger one on the derivatives of the free energy. Two different model pseudopotentials are used and give similar results in good agreement with experiment.
Prothrombotic states in ischemic stroke

Abstract Ischemic stroke is a complex disease process consisting of multiple underlying mechanisms, including thromboembolic consequences of large arterial atherosclerotic disease. In addition to the traditional stroke risk factors, attention has also been focused on complex hemostatic functions, such as platelet aggregation, thrombin generation, and fibrinolysis. Information from prospective epidemilogic studies of hemostatic risk factors and ischemic stroke is incomplete and sometimes contradictory. There are fairly good data supporting an association between elevated fibrinogen and tissue plasminogen activator antigen and ischemic stroke. However, it is unknown if they are merely epiphenomena or pathogenic. The classic inherited risk factors for venous thromboembolic events (ie, antithrombin, protein C, and protein S deficiencies, and factor V Leiden and prothrombin G20210A polymorphisms) do not appear to be strong, independent risk factors in unselected stroke patients. Discovery of genetic polymorphisms in many hemostatic genes has stimulated searches for gene-disease associations, frequently before establishing that a polymorphism has an effect on protein expression or function. Future investigations into ischemic stroke risk factors should be prospective, enroll much larger numbers of subjects, rigorously classify strokes by subtype, and incorporate evolving molecular techniques to maximize collection of genetic information. This may lead to identification of unique gene-gene and gene-environmental interactions that may improve our understanding of the causes of ischemic strokes.