cssi/SciSciGPT-SciSciNet huggingface dataset:
Navigation in the electronic health record

Display Omitted Discussion of navigation was prevalent in usability evaluations of electronic health records.Navigating between multiple screens was frequently identified as a usability barrier.A lack of standard terminology to describe electronic health record navigation was observed. ObjectiveInefficient navigation in electronic health records has been shown to increase users cognitive load, which may increase potential for errors, reduce efficiency, and increase fatigue. However, navigation has received insufficient recognition and attention in the electronic health record (EHR) literature as an independent construct and contributor to overall usability. Our aims in this literature review were to (1) assess the prevalence of navigation-related topics within the EHR usability and safety research literature, (2) categorize types of navigation actions within the EHR, (3) capture relationships between these navigation actions and usability principles, and (4) collect terms and concepts related to EHR navigation. Our goal was to improve access to navigation-related research in usability. Materials and methodsWe applied scoping literature review search methods with the assistance of a reference librarian to identify articles published since 1996 that reported evaluation of the usability or safety of an EHR user interface via user test, analytic methods, or inspection methods. The 4336 references collected from MEDLINE, EMBASE, Engineering Village, and expert referrals were de-duplicated and screened for relevance, and navigation-related concepts were abstracted from the 21 articles eligible for review using a standard abstraction form. ResultsOf the 21 eligible articles, 20 (95%) mentioned navigation in results and discussion of usability evaluations. Navigation between pages of the EHR was the more frequently documented type of navigation (86%) compared to navigation within a single page (14%). Navigation actions (e.g., scrolling through a medication list) were frequently linked to specific usability heuristic violations, among which flexibility and efficiency of use, recognition rather than recall, and error prevention were most common. DiscussionDiscussion of navigation was prevalent in results across all types of evaluation methods among the articles reviewed. Navigating between multiple screens was frequently identified as a usability barrier. The lack of standard terminology created some challenges to identifying and comparing articles. ConclusionWe observed that usability researchers are frequently capturing navigation-related issues even in articles that did not explicitly state navigation as a focus. Capturing and synthesizing the literature on navigation is challenging because of the lack of uniform vocabulary. Navigation is a potential target for normative recommendations for improved interaction design for safer systems. Future research in this domain, including development of normative recommendations for usability design and evaluation, will be facilitated by development of a standard terminology for describing EHR navigation.
The APC capture: rapid identification of target CD8+ T cell epitopes by flow cytometry

Identifying immunoreactive CTLs by current technologies (cytokine secretion, intracellular cytokine, cytolytic release, ELISPOT, and MHC tetramer assays) is often difficult when probing multiple target antigens. We developed a rapid flow cytometry assay to detect targeted IFN-γ secretion by CD8+ T cells using commonly available reagents. PBMCs were obtained from HLA-A2+ healthy donors, and CD8+ and CD8− fractions were purified. FluMI-specific T cells were confirmed by HLA-A2/M1 tetramer, and pooled CEF peptides (a mixture of CMV-, EBV-, and Flu-specific HLA class I epitopes) immunoreactivity was shown by IFN-γ ELISPOT. The CD8+ fraction was rested for 5 days in IL-2 (20 U/ml) and IL-7 (5 ng/ml). In parallel, autologous APCs were generated from the CD4− CD8− fraction using recombinant CD40L (100 ng/ml), IL-4 (5ng/mL), and cyclosporin A (1 μg/ml). After 5 days, the APC culture was >70% CD19+ CD86+ HLA-DR+ activated B cells. The APCs were pulsed with DMSO control or CEF peptide pool (10ug/mL) overnight, labeled with commercial IFN-γ catch (Miltenyi Biotec), washed, and co-cultured for 6–8 hours with purified CD8+ T cells. APC-surface-bound IFN-γ was detected by flow cytometry. CEF-pulsed APCs showed robust presence of surface-captured IFN-γ (ranging from 14%–56.8%) compared to DMSO-pulsed APCs (ranging from 1.6%–4.5% IFN-γ+). APC IFN-γ capture was sensitive even at low effector-target ratios (as low as 1:1) and was applicable to the artificial APC K562/A2. In conclusion, we have demonstrated epitope-reactive CD8+ T cell detection of target cells by capturing IFN-γ onto APCs. We are evaluating capture of other cytokines and cytolytic effectors on target APCs in response to CD8+ recognition.
Effect of Controlled Ice Nucleation on Stability of Lactate Dehydrogenase During Freeze-Drying

Abstract Several controlled ice nucleation techniques have been developed to increase the efficiency of the freeze-drying process as well as to improve the quality of pharmaceutical products. Owing to the reduction in ice surface area, these techniques have the potential to reduce the degradation of proteins labile during freezing. The objective of this study was to evaluate the effect of ice nucleation temperature on the in-process stability of lactate dehydrogenase (LDH). LDH in potassium phosphate buffer was nucleated at −4°C, −8°C, and −12°C using ControLyo™ or allowed to nucleate spontaneously. Both the enzymatic activity and tetramer recovery after freeze-thawing linearly correlated with product ice nucleation temperature ( n = 24). Controlled nucleation also significantly improved batch homogeneity as reflected by reduced inter-vial variation in activity and tetramer recovery. With the correlation established in the laboratory, the degradation of protein in manufacturing arising from ice nucleation temperature differences can be quantitatively predicted. The results show that controlled nucleation reduced the degradation of LDH during the freezing process, but this does not necessarily translate to vastly superior stability during the entire freeze-drying process. The capability of improving batch homogeneity provides potential advantages in scaling-up from lab to manufacturing scale.
A Review of Meningococcal Disease and Vaccination Recommendations for Travelers

Abstract International travel has been steadily increasing since the middle of the twentieth century, including travel to regions with high levels of endemic meningococcal disease and areas with sporadic or sustained meningococcal outbreaks. Although invasive meningococcal disease (IMD) is relatively rare in travelers since the advent of quadrivalent meningococcal vaccines, it remains a serious concern because of its rapid progression, poor prognosis and outcomes, associated treatment delays, and the potential to precipitate outbreaks. Moreover, fatality occurs in up to 22% of those infected. This review will focus on IMD in travelers, with an emphasis on IMD epidemiology and the geographic regions of potential concern for international travelers. As vaccination is the best approach for preventing IMD among travelers, currently available meningococcal vaccines and corresponding country-specific national meningococcal vaccination recommendations, where available, will be summarized by age and type of vaccine recommended. The use of the quadrivalent meningococcal vaccines, specifically the tetanus toxoid conjugate vaccine (including MenACWY-TT; Nimenrix®), as a protective measure against IMD in travelers will be emphasized.
Is Psychiatric Depression a Presenting Neurologic Sign of Meningioma? A Critical Review of the Literature with Causative Etiology.

Background Benign meningiomas constitute 80%–90% of all meningiomas and represent the most common type of central nervous system tumor in adults. The vast majority of meningiomas are minimally symptomatic or asymptomatic early in their onset and thereby can often result in delayed diagnosis. Early diagnosis of meningioma is critical, as it can maximize treatment options and improve outcomes and survival. Although seizures and focal neurologic deficits are considered to be the most prevalent symptoms, depression also may be an important and significant sign. A subtle neurologic depression may be an even early presenting sign of meningioma and may precede more traditional presenting symptoms. Methods We performed a comprehensive literature review that analyzes the results of prospective studies and case reports on this topic. Results Our findings show evidence to suggest that depression may be correlated with meningioma presentation. Its prevalence is possibly increased with an anterior location of the tumor. Conclusions For patients who exhibit nuances of depression without a history of psychiatric illness, an index of suspicion for meningioma may be warranted.
Exceptional Points of Degeneracy in lossless Periodic Coupled Waveguides

We present general aspects of exceptional points of degeneracy (EPD) of order 2, 3, and 4, that appear also in lossless periodic waveguides. We report unconventional scaling of the quality factor in coupled resonators optical waveguides.
Antireflective light-blocking layers using a liquid top matte coating.

Methods exist for the creation of antireflective thin film layers; however, many of these methods depend on the use of high temperatures, harsh chemical etches, or are made with difficult pattern materials, rendering them unusable for many applications. In addition, most methods of light blocking are specifically designed to increase light coupling and absorption in the substrate, making them incompatible with some applications that also require blocking transmission of light. A method of forming a simple, patternable light-blocking layer that drastically reduces both transmission and reflection of light without dependence on processes that could damage underlying structures using a light scattering matte coating over a partially antireflective thin film light-blocking layer is presented.
NONHUMAN PRIMATES: A VULNERABLE RESOURCE

The exploitation of primate animals has become one of the most serious causes for their depletion. This is possible because the institutions which regulate acquisition, trade and usage of wild life do not take account of changes which have taken place in the recent past, and which are now part of an ungoing process.
Statistical analysis of modern seed assemblages from the San Francisco Bay: applications for the reconstruction of paleo-salinity and paleo-tidal inundation

The feasibility of developing a seed calibration data set to infer environmental constraints was examined by studying modern seed and vegetation assemblages from 53 stations at three distinct tidal marshes within the San Francisco Bay (salt, brackish and freshwater). Pearson's correlation indicates autochthonous derivation of seeds at the marsh sites. Multivariate statistical analysis of the vegetation and seed data indicates discrete assemblages, which can be used as a proxy for modern salinity and tidal inundation within the estuary. Canonical discriminant analysis indicates that the vegetation and seed assemblages of the three marsh types are statistically distinct. Cluster analysis suggests that marsh vegetation is zoned at the mean higher high water mark at all the sites. The calibration set was then applied to stratigraphic seed data from the estuary to infer changes in paleo-salinity and -tidal inundation during the Holocene. The results of the calibration are compared to earlier reconstructions within the estuary. While the calibrated reconstruction broadly compares to previous reconstructions, a period of inferred lower salinity within the estuary between 3800–2000 cal yr B.P. is calibrated as brackish and not fresh by the calibration model.
A simple dynamic-control macro model to examine the behavior of international reserves for selected economies

The purpose of the paper is to show the construction of a simple dynamic-control macromodel, using an economy-wide preference (utility) function as the objective function with two variables, national income and international reserves. National income is the control variable and reserves is the state variable. The first-order equilibrium condition at each instant of time, t, shows that the two variables optimally must grow at different rates for it to be satisfied. The model is applied to the empirical data on income and reserves by examining the behavior of the ratio of income to reserves for a selected number of mature and developing economies over the time period 1970 to 2011. For both types of economies, the model shows that there is a trade-of f between income and reserves based on the utility function. However, for mature economies the trade-off is such that the ratio of income to reserves is trending upwards while for the developing economies the ratio is trending downwards. In either case, the model fits the data. The policy implications are briefly discussed within the context of the existing literature on international reserves.
A low-wavenumber analysis of the environmental and vortex-scale variables responsible for rapid intensity changes in landfalling tropical cyclones

Forecasting rapid intensity changes in tropical cyclones (TCs) is hard as the factors responsible span many scales. External and internal dynamical and thermodynamical variables act simultaneously in a nonlinear fashion, either complementing, amplifying, inhibiting or not impacting the TC intensity at all. We try to address the following question: What is the relative importance of the external and vortex-scale variables that influence rapid intensity changes within a TC? Further, which of these variables must be prioritized from an observational standpoint? To answer these questions, a systematic analysis was conducted on a large number of representative TCs to make statistically significant conclusions using discriminant analyses of wavenumber (WN) - filtered fields, with a principal component analysis to detect over-fitting and identify the subset of variables (from the environment and the vortex) consistently correlated with rapid intensity change. Our analyses indicate that a small number of variables wield the most influence on TC rapid intensity changes. The most important variables within the vortex are the WN 0 of precipitation within the radius of maximum winds, the amplitudes of WN 1 of precipitation and the mid-level horizontal moisture flux convergence in the rain band region. Likewise, the most important environmental variables are the angle of the driest air from the shear vector and the magnitude of environmental wind shear. These variables must be prioritized in future observational and consequent data assimilation efforts.
Antitumor efficacy of concurrent everolimus with hepatic transarterial bland embolization (evero-embo) in patients with metastatic well differentiated neuroendocrine tumor (NET).

4115Background: Hepatic transarterial embolization (HAE) is an effective loco-regional therapy for neuroendocrine tumor (NET) management. Systemic targeted therapies, such as everolimus and sunitin...
Effect of Drought-Induced Salinization on Wetland Methane Emissions, Gross Ecosystem Productivity, and Their Interactions

Salinity gradients across estuaries influence wetland carbon storage, methane (CH4) biogeochemistry, and plant productivity. Estuarine freshwater wetlands may experience increases in salinity during drought; however, the impact of salinization on greenhouse gas (GHG) emissions is uncertain. We measured ecosystem-scale GHG emissions from a wetland experiencing salinization during the 2011–2017 California drought and used information theory analyses to quantify couplings and causal interactions between CH4 fluxes and two dominant environmental drivers; gross ecosystem photosynthesis and temperature. Machine learning models were then used to estimate salinization-induced changes in CH4 fluxes and plant productivity. We observed dynamic CH4 flux-driver relationships across the salinization disturbance event, where temperature connections strengthened, and productivity connections dampened during salinization. Annual gross ecosystem productivity reduced by 64% during peak salinization, whereas annual CH4 emissions only reduced by 10%, suggesting that other CH4 substrate sources compensated for reductions in recent photosynthate. Our results demonstrate the value of applying information theory and machine learning approaches to ecological analyses and suggest that drought-induced salinization may increase GHG emissions from estuarine freshwater wetlands.
Poetry and Language: The Linguistics of Verse

Michael Ferber's accessible introduction to poetry's unusual uses of language tackles a wide range of subjects from a linguistic point of view. Written with the non-expert in mind, the book explores current linguistic concepts and theories and applies them to a variety of major poetic features. Equally appealing to linguists who feel that poetry has been unjustly neglected, the broad field of investigation touches on meter, rhyme (and other sound effects), onomatopoeia, syntax, meaning, metaphor, style, and translation, among others. Close study of poetic examples are mainly in English, but the book also focuses on several French, Latin, Greek, German, and Japanese examples, to show what is different and far from inevitable in English. This original, and unusually wide ranging study, delivers an engaging and often witty summary of how we define what poetry is.
Impact of the elimination of the donation service area on United States lung transplant practices and outcomes at high and low competition centers.

In November 2017, the donation service area (DSA) was removed as the primary unit of US donor lung allocation. Our primary objective was to evaluate the effect of this change on recipient characteristics, the use of pretransplant extracorporeal membrane oxygenation (ECMO), and on index hospitalization length of stay (LOS) and early posttransplant complications. We also assessed whether these outcomes differed in high and low competition centers, as defined by the Herfindahl-Hirschman Index. Following DSA removal, there was a 9-day decrease in median waitlist time (P = .001) and an increase in median lung allocation score (40 vs 42, P < .0001) but no difference in the need for pretransplant ECMO (incidence rate ratio = 1.16, P = .12). Median LOS increased from 17 to 19 days in the post-DSA era (P = .01). There was no difference in posttransplant outcomes, including prolonged ventilation, new dialysis, or early survival, in the general cohort or between competition groups. High competition centers saw an 18.5-minute increase in ischemic time compared to low competition centers (P = .04) but did not differentially increase single lung transplants or pretransplant ECMO utilization. Overall, DSA elimination was associated with increased posttransplant LOS but no significant differences in pretransplant ECMO or other posttransplant outcomes. Effects were largely similar at low and high competition centers.
Association, cause, and causal association, revised: reasoning and methods

Abstract Association and causation are often confused; the principle difference is that causation is directional. In this chapter we discuss the initial description of causation as it applies in biomedical studies, occurring first is a rather linear manner directly in a laboratory experiment, then expanding outward toward observational studies where many effects occur simultaneously. In doing so we introduce causal “mediation analysis” as methodologic technique to address multiple and complex confounding effects and intermediate or mediator factors by creating instrumental variables. We discuss how Mendelian randomization can also be used to address confounding through a similar instrumental variable approach, and how the explosion of genomic knowledge might also be incorporated into the direct causal framework. Finally, we muse about all these effects in the context of the public health.
Nicotiana tabacum L.: Tobacco

Tobacco (Nicotiana tabacum L.) is cultivated primarily for use in the manufacture of nicotine-containing products such as cigarettes, cigars, and smokeless tobacco products. Plant breeding methodologies are used to develop new tobacco cultivars with important trait combinations that contribute to the economy of crop production and to preferred characteristics for product manufacturing. Desired traits for new cultivars include high cured leaf yields, disease resistance, satisfactory physical cured leaf quality, appropriate cured leaf chemistry, and acceptable sensory attributes. Types of variation that might be used in tobacco breeding programs include that native to N. tabacum or its close relatives. De novo variation generated via mutation breeding, gene editing, or genetic engineering might also be considered. Methodologies used to combine desired traits into new commercial inbred lines and hybrids may vary according to the breeding program.
Repeatability and accuracy of various region-of-interest sampling strategies for hepatic MRI proton density fat fraction quantification

To evaluate repeatability of ROI-sampling strategies for quantifying hepatic proton density fat fraction (PDFF) and to assess error relative to the 9-ROI PDFF. This was a secondary analysis in subjects with known or suspected nonalcoholic fatty liver disease who underwent MRI for magnitude-based hepatic PDFF quantification. Each subject underwent three exams, each including three acquisitions (nine acquisitions total). An ROI was placed in each hepatic segment on the first acquisition of the first exam and propagated to other acquisitions. PDFF was calculated for each of 511 sampling strategies using every combination of 1, 2, …, all 9 ROIs. Intra- and inter-exam intra-class correlation coefficients (ICCs) and repeatability coefficients (RCs) were estimated for each sampling strategy. Mean absolute error (MAE) was estimated relative to the 9-ROI PDFF. Strategies that sampled both lobes evenly (“balanced”) were compared with those that did not (“unbalanced”) using two-sample t tests. The 29 enrolled subjects (23 male, mean age 24 years) had mean 9-ROI PDFF 11.8% (1.1–36.3%). With more ROIs, ICCs increased, RCs decreased, and MAE decreased. Of the 60 balanced strategies with 4 ROIs, all (100%) achieved inter- and intra-exam ICCs > 0.998, 55 (92%) achieved intra-exam RC < 1%, 50 (83%) achieved inter-exam RC < 1%, and all (100%) achieved MAE < 1%. Balanced sampling strategies had higher ICCs and lower RCs, and lower MAEs than unbalanced strategies in aggregate (p < 0.001 for comparisons between balanced vs. unbalanced strategies). Repeatability improves and error diminishes with more ROIs. Balanced 4-ROI strategies provide high repeatability and low error.
Hotel Experiences of People With Physical and Sensory Disabilities: A Qualitative Study.

IMPORTANCE Engaging in travel is linked to quality of life. People with disabilities travel less often than people without disabilities, likely because of the challenges they experience during hotel stays. OBJECTIVE To explore how people with various physical and sensory disabilities experience hotel stays and to identify opportunities for occupational therapy intervention. DESIGN Qualitative, phenomenological design with semistructured interviews. PARTICIPANTS Eight adults with physical or sensory disabilities who had at least two hotel stays in the past year. Outcomes and Measures: We used a semistructured interview guide to ask participants about their experiences during hotel stays. RESULTS We identified six themes: (1) customer service, (2) reservation process, (3) built environment challenges, (4) traits and skills, (5) use of technology, and (6) safety and emergency preparedness. CONCLUSION The physical, virtual, and social environments of hotels create challenges for people with physical and sensory disabilities. People with such disabilities use skills to improve their hotel experience. Occupational therapy practitioners can affect the hotel experience of people with disabilities through advocacy, consultation with hotels, and direct intervention with clients. What This Article Adds: This article offers novel information about the impact of the hotel environment on people with physical and sensory disabilities, the ways in which people with such disabilities manage these challenges, and intervention opportunities for occupational therapy practitioners.
Referral and utilization of paediatric bariatric surgery in an academic freestanding children's hospital with dedicated paediatric bariatric programme.

Objective This report estimates the percent of medically eligible adolescents who are referred for metabolic and bariatric surgery (MBS) evaluation or factors associated with referral. Methods This cross-sectional retrospective review evaluated patients aged 13 to 18 years seen between 2017 and 2019 for demographics, insurance status, body mass index (BMI), obesity-related comorbidities, and compared these data to patients whom had been referred and received MBS. Results Half of the patients (86 411/163137, 53%) between ages of 13 and 18 years identified had BMI documented, of which, 1974 (2.3%) were medically eligible for MBS, 238 (12%) were referred for MBS and 52 (22%) underwent MBS. Females had similar odds of being eligible for MBS [odds ratio (OR) = 1.01, 95% confidence interval (CI) 0.92-1.11, P = .9], but greater odds of referral (OR = 1.58, 95% CI 1.13-2.23, P = .009). Independently, miniorities and patients with public insurance had higher odds of being eligible for MBS, but similar odds of being referred as non-Hispanic white patients. Black patients with public insurance had greater odds of being referred for MBS (OR = 12.22, 95% CI 2.08-235.15, P = .022). Patients' multiple comorbidities had greater odds of being referred for MBS (OR = 2.16, 95% CI 1.29-3.68, P = .004). Conclusions Referral is barrier for patients medically eligible for MBS; however, this barrier is not uniformly faced by all patients.
Association of Histamine-2 Blockers and Proton-Pump Inhibitors With Delirium Development in Critically Ill Adults: A Retrospective Cohort Study.

Histamine-2 receptor antagonists are commonly administered for stress ulcer prophylaxis in critically ill adults and may be associated with delirium development. We aimed to determine differential associations of histamine-2 receptor antagonist or proton-pump inhibitor administration with delirium development in patients admitted to a medical ICU. DESIGN Retrospective observational study using a deidentified database sourced from the University of North Carolina Health Care system. Participants were identified as having delirium utilizing an International Classification of Diseases-based algorithm. Associations among histamine-2 receptor antagonist, proton-pump inhibitor, or no medication administration and delirium were identified using relative risk. Multiple logistic regression was used to control for potential confounders including mechanical ventilation and age. SETTING Academic tertiary care medical ICU in the United States. PATIENTS Adults admitted to the University of North Carolina medical ICU from January 2015 to December 2019, excluding those on concurrent histamine-2 receptor antagonists and proton-pump inhibitors in the same encounter. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We identified 6,645 critically ill patients, of whom 29% (n = 1,899) received mechanical ventilation, 45% (n = 3,022) were 65 or older, and 22% (n = 1,487) died during their medical ICU encounter. Of the 6,645 patients, 31% (n = 2,057) received an histamine-2 receptor antagonist and no proton-pump inhibitors, 40% (n = 2,648) received a proton-pump inhibitor and no histamine-2 receptor antagonists, and 46% (n = 3,076) had delirium. The histamine-2 receptor antagonist group had a greater association with delirium than the proton-pump inhibitor group compared with controls receiving neither medication, after controlling for mechanical ventilation and age (risk ratio, 1.36; 1.25-1.47; p < 0.001) and (risk ratio, 1.15; 1.07-1.24; p < 0.001, respectively). CONCLUSIONS Histamine-2 receptor antagonists are more strongly associated with increased delirium than proton-pump inhibitors. Prospective studies are necessary to further elucidate this association and to determine if replacement of histamine-2 receptor antagonists with proton-pump inhibitors in ICUs decreases the burden of delirium in critically ill patients.
Lip Pits: Orthodontic Treatment, Dentition, and Occlusion – Associated Skeletal Structures

A cleft of the lip and palate is the result of the failure of lip elements and right and left palatal segments to come together within the first 9 weeks of fetal life. The loss of muscular continuity of the orbicularis oris-buccinator-superior constrictor ring in complete unilateral and bilateral clefts changes the normal muscular force diagram. The aberrant muscular forces act to displace tissue masses. In complete clefts of the lip and palate, if the lateral palatal cleft segments are detached from the vomer, they will be pulled laterally by the external aberrant lip-cheek muscular forces, as well as spread apart by the tongue pushing into the cleft space.
The Originalist Case for the “Individual Mandate”: Rounding out the Government’s Argument in the Health Care Case

The Supreme Court has now received the briefs and heard the oral arguments in the landmark case that concerns the federal health care law. Much attention has focused on the law’s minimum coverage provision, or so-called “individual mandate,” and in particular its constitutionality under the Commerce Clause and the Necessary and Proper Clause. This Article offers two observations about the arguments made to the Court on that issue. First, it shows that the challengers of the minimum coverage provision adopted a strategy of emphasizing originalist reasoning, while the federal government focused its defense of the law on practical considerations and modern precedents. This difference in tactics, it is suggested, may prove to be of great consequence to the outcome of the case in light of the current Court’s marked receptivity to originalist analysis. Second, the Article suggests that – contrary to the impression created by the submissions of the parties – there are in fact powerful originalism-based reasons for concluding that the minimum coverage provision is constitutional. Indeed, according to the treatment offered here, these arguments have their roots in in all key elements of originalist discourse – the text of the Constitution, the background understandings that gave rise to the relevant clauses, and early congressional and judicial precedents. To be sure, different observers who take different views of constitutional analysis will reach different conclusions about the constitutionality of minimum coverage provision. But this Article contends that originalism-based arguments that were not fully aired before the Court cut strongly in favor of the provision’s constitutionality.
Beaver herbivory of willow under two flow regimes: a comparative study on the Green and Yampa rivers

The effect of flow regulation on plant-herbivore ecology has received very little attention, despite the fact that flow regulation can alter both plant and animal abundance and environmental factors that mediate interactions between them. To determine how regulated flows have impacted beaver ( Castor Canadensis ) and sandbar willow ( Salix exigua ) ecology, we first quantified the abundance and mapped the spatial distribution of sandbar willow on alluvial sections of the flow-regulated Green River and free-flowing Yampa River in northwestern Colorado. We then established 16 and 15 plots (1 m x 2.7 m) in patches of willow on the Green and Yampa Rivers, respectively, to determine whether rates of beaver herbivory of willow differed between rivers (Green versus Yampa River), seasons (fall-winter versus spring-summer), and years (spring 1998-spring 1999 versus spring 1999-spring 2000). Areal extent of willow was similar on each river, but Green River willow patches were smaller and more numerous. Beavers cut more stems during fall and winter than spring and summer and cut over 6 times more stems (percentage basis) on the Green River than on the Yampa River. We attribute the between-river difference in herbivory to higher availability of willow, greater beaver density, and lower availability of young Fremont cottonwood ( Populus deltoids subsp. wislizenii ; an alternative food source) on the Green River. Flow regulation increased willow availability to beaver by promoting the formation of island patches that are continuously adjacent to water and feature a perimeter with a relatively high proportion of willow interfacing with water.
Epidemiology and prognosis of anorectal melanoma

Abstract Background: The epidemiology of anorectal melanoma has not been well studied despite its potential relevance to the cutaneous melanoma epidemic, and prognostic studies have generally been based on referred cases. Methods: Data reported to nine population-based registries in the United States during 1973 through 1987 were analyzed. Results: Fifty-five cases were reported (0.017 × 10 −5 /year)- The incidence among blacks was higher but not significantly higher than among whites [relative risk (RR), 1.7; 95% confidence interval (CI), 0.7–3.9]. Registries north of 40 ° latitude reported higher incidence than registries south of 38 ° (RR, 3.2; 95% CI, 1.5–7.1). Incidence was higher in women than men (RR, 2.3; 95% CI, 1.2–4.3) and increased steadily with age but did not change over time. Of the 46 (84%) cases with known stage at diagnosis, 37% were confined to the anorectum, 41% had regional spread, and 22% metastasized to distant sites. One and 5-year survivals (±SE) were 50% ± 7% and 15% ± 6%, respectively. One-year survival for local, regional, and distant disease was 75% ± 11%, 39% ± 12%, and 33% ± 16%, respectively. Prognosis improved over the 15 years of surveillance. Age, sex, race, and registry area were not associated with survival. Conclusions: Anorectal melanoma differs markedly from cutaneous melanoma in etiology (indeed, sun exposure may be protective) and has a very poor, although improving prognosis.
Symmetry Breaking in a Quantum Double-Well Chain

We present numerical evidence that quantum fluctuations can produce a symmetric ground-state in the double-well chain, restoring the symmetry that is broken classically. In particular, we present the phase diagram for this model that shows the symmetry restoration occurs more easily than predicted by a perturbation theory calculation of the continuum limit of the model.
The Role of Anti-Corruption Commissions in Changing Cultural Attitudes towards Corruption and the Rule of Law

This paper is narrow in scope and addresses how an emerging anti-corruption tool, the anti-corruption commission, can play an important role in changing cultural attitudes towards corruption and the rule of law. Citizen participation and engagement has been long-featured as a best practice for development; however, too much focus has been placed on directing this through civil society organisations. What this paper seeks to illustrate is that citizen engagement by government institutions can have a meaningful impact in changing perceptions towards the role of government and the meaning of the rule of law - especially in societies where the government has been long perceived as elitist and far from reach. Anti-corruption commissions are by no means a panacea; however, by directly engaging the public and creating a role for the citizen in the fight against corruption, anti-corruption commissions are able to include the once powerless directly into the process, and thereby help alleviate the culture of complacency that has plagued corrupt States.
Assessing Adequacy of Cholecalciferol Supplementation in Chicks Using Plasma Cholecalciferol Metabolite Concentrations as an Indicator

Cholecalciferol (vitamin D) deficiency rickets remains an occasional problem in poultry. Diagnosis currently relies on analysis of feed and histopathological examination of bone. These experiments were designed to provide data that might allow diagnosis of cholecalciferol deficiency on the basis of plasma concentrations of 25-hydroxycholecalciferol, a circulating metabolite of cholecalciferol. Day-old broiler chicks were fed corn-soybean meal or purified ingredient cholecalciferol-deficient diets supplemented with 0, 5, 10, 15, 20, 25, 37.5 or 75 micrograms cholecalciferol/kg diet. Plasma and bone samples were collected 21 d later. Chicks fed the unsupplemented purified ingredient diet became truly deficient, having no detectable plasma concentrations of the cholecalciferol metabolites 25-hydroxycholecalciferol, 1,25-dihydroxycholecalciferol, or 24,25-dihydroxycholecalciferol. Chicks fed the corn-soybean meal diet without supplementation had low but detectable concentrations of both 25-hydroxycholecalciferol and 1,25-dihydroxycholecalciferol in plasma. Body weight, bone calcium and bone phosphorus concentrations of chicks fed the corn-soybean meal diet suggest that the cholecalciferol requirement of broiler chicks is at least 10 micrograms/kg diet. At this dietary level of cholecalciferol, plasma 25-dihydroxycholecalciferol concentration was 12.5 nmol/L. One hundred percent of the theoretical maximal response in body weight and bone calcium content was seen at 20 micrograms cholecalciferol/kg diet, which increased plasma 25-hydroxycholecalciferol concentration to 25 nmol/L in the chicks fed the corn-soybean meal diet. These data provide a nomogram of plasma 25-dihydroxycholecalciferol concentration that can be expected from including different concentrations of cholecalciferol in the diet, and also offer a means of diagnosing cholecalciferol deficiency in field cases of tickets.
GaAs and InP-based monolithically integrated transmitters and photoreceivers

High-performance GaAs and InP-based components are required for the development long- and short-distance communication links. Our work in the development of monolithically integrated transmitters and photoreceivers is described, with reference to ongoing work elsewhere. Challenges in terms of materials incompatibility and device design and intrinsic and extrinsic limits of device and circuit performance are discussed. >
Prolate collectivity in 187Tl.

High-spin states of [sup 187]Tl populated in the [sup 156]Gd([sup 35]Cl,4[ital n]) reaction have been investigated with [gamma]-ray coincidence techniques. Two decoupled bands feeding the oblate 9/2[sup [minus]] isomeric state have been established. These bands are built on [pi][ital h][sub 9/2] and [pi][ital i][sub 13/2] configurations associated with prolate shapes. The first observation of a low-[ital K] [pi][ital h][sub 9/2] structure in an odd-[ital A] Tl nucleus is used to draw conclusions on the role of this proton orbital in stabilizing the prolate minimum seen in light Hg isotopes.
Abstract 13900: Hyperamylinemia Exacerbates Sarcolemmal Lipid Peroxidation in Diabetic Hearts

Background: Chronic hypersecretion of the pancreatic hormone amylin leads to infiltration of oligomeric amylin in cellular membranes, which contributes to β-cell dysfunction and type-2 diabetes (T2D). We recently showed that oligomeric amylin also accumulates in myocardium of patients with obesity or T2D. Hypothesis: Oligomeric amylin may infiltrate the sarcolemma exposing membrane lipids to peroxidation by ROS, thus exacerbating myocardial oxidative stress. Methods: We investigated the relationship between incorporated amylin and lipid peroxidation in ventricular myocytes from obese patients (BMI≥30) with heart failure (HF) (O-HF group; N=6), obese humans without HF (O-NF group; N=6) and healthy people with BMI Results: Compared to L-NF controls, the myocyte level of amylin is increased in both O-HF group (10-fold; P 11 -BODIPY and Liperfluo indicates increased lipid peroxidation in HIP rat myocytes (2-fold; P Conclusions: Together, these findings support the hypothesis that circulating oligomeric amylin infiltrates cardiac myocytes in humans and exacerbates lipid peroxidation. Strategies to mitigate myocardial deposition of amylin should be pursued.
Molecular Characterization of Epiphytic Bacterial Communities on Charophycean Green Algae

Epiphytic bacterial communities within the sheath material of three filamentous green algae, Desmidium grevillii, Hyalotheca dissiliens, and Spondylosium pulchrum (class Charophyceae, order Zygnematales), collected from a Sphagnum bog were characterized by PCR amplification, cloning, and sequencing of 16S ribosomal DNA. A total of 20 partial sequences and nine different sequence types were obtained, and one sequence type was recovered from the bacterial communities on all three algae. By phylogenetic analysis, the cloned sequences were placed into several major lineages of the Bacteria domain: the Flexibacter/Cytophaga/Bacteroides phylum and the alpha, beta, and gamma subdivisions of the phylum Proteobacteria. Analysis at the subphylum level revealed that the majority of our sequences were not closely affiliated with those of known, cultured taxa, although the estimated evolutionary distances between our sequences and their nearest neighbors were always less than 0.1 (i.e., greater than 90% similar). This result suggests that the majority of sequences obtained in this study represent as yet phenotypically undescribed bacterial species and that the range of bacterial-algal interactions that occur in nature has not yet been fully described.
How Do the Powerful Attain Status? The Roots of Legitimate Power Inequalities

Power inequalities are coercive, based on relative control over resources, whereas status hierarchies are based on collectively endorsed conceptions of merit. How then do the powerful achieve status? We argue that using power for personal gain can lead to perceptions of the powerful as competent—enhancing status—but also selfish—diminishing status. Consequently, power users will be most likely to attain status when they successfully avoid perceptions of selfishness. Two experiments support this view, finding that power users achieve greater status when moderating their power use, forgoing maximal profits in exchange, or using philanthropic gestures to counteract perceptions of greed. Copyright © 2012 John Wiley & Sons, Ltd.
Genetic Population Structure of Black Drum in U.S. Waters

AbstractThe Black Drum Pogonias cromis is an estuarine-dependent fish that supports recreational and commercial fisheries throughout its range along the U.S. Atlantic coast and Gulf of Mexico (GOM) coast. We used nuclear microsatellite markers and samples collected from multiple locations along both the U.S. Atlantic and GOM coasts to evaluate the stock structure of Black Drum and to examine small-scale spatial genetic population structure along the U.S. Atlantic coast. As no microsatellite primers had been developed for Black Drum, primers for Spotted Seatrout Cynoscion nebulosus and Red Drum Sciaenops ocellatus were screened, selected, and optimized for use with Black Drum DNA. Six polymorphic loci were identified and used to genotype samples. Results suggested (1) significant genetic divergence between Black Drum populations from the U.S. Atlantic coast and the GOM coast; and (2) either recent or current gene flow between the two regions. Along the U.S. Atlantic coast, there appeared to be weak but sig...
Alzheimer's Presenilin 1 Mutations Impair Kinesin-Based Axonal Transport

Several lines of evidence indicate that alterations in axonal transport play a critical role in Alzheimer's disease (AD) neuropathology, but the molecular mechanisms that control this process are not understood fully. Recent work indicates that presenilin 1 (PS1) interacts with glycogen synthase kinase 3beta (GSK3beta). In vivo, GSK3beta phosphorylates kinesin light chains (KLC) and causes the release of kinesin-I from membrane-bound organelles (MBOs), leading to a reduction in kinesin-I driven motility (Morfini et al., 2002b). To characterize a potential role for PS1 in the regulation of kinesin-based axonal transport, we used PS1-/- and PS1 knock-inM146V (KIM146V) mice and cultured cells. We show that relative levels of GSK3beta activity were increased in cells either in the presence of mutant PS1 or in the absence of PS1 (PS1-/-). Concomitant with increased GSK3beta activity, relative levels of KLC phosphorylation were increased, and the amount of kinesin-I bound to MBOs was reduced. Consistent with a deficit in kinesin-I-mediated fast axonal transport, densities of synaptophysin- and syntaxin-I-containing vesicles and mitochondria were reduced in neuritic processes of KIM146V hippocampal neurons. Similarly, we found reduced levels of PS1, amyloid precursor protein, and synaptophysin in sciatic nerves of KIM146V mice. Thus PS1 appears to modulate GSK3beta activity and the release of kinesin-I from MBOs at sites of vesicle delivery and membrane insertion. These findings suggest that mutations in PS1 may compromise neuronal function by affecting GSK-3 activity and kinesin-I-based motility.
A strategy for evaluating "psychogenic" symptoms.

Consultation and liaison psychiatrists are often asked to evaluate patients with physical symptoms in order to determine if those symptoms are emotionally caused. The author contends that the tradi...
Bivalve Response to Estuarine Eutrophication: The Balance between Enhanced Food Supply and Habitat Alterations

ABSTRACT As a result of insufficient sampling, differences in estuarine attributes, species variation, and poor links to anthropogenic sources, responses of bivalve mollucs to anthropogenic nutrient enrichment of coastal waters remains poorly defined for most systems worldwide. To establish the net effect of nutrient enrichment on bivalves, we compared changes in growth and survival of different bivalve species reported in 5 studies conducted in a representative estuarine system (on Cape Cod, MA) in which effects of eutrophication on food supply and habitat were quantified and related directly to land-derived nitrogen (N) sources. N-stable isotope ratios in suspended particulates and bivalve tissues demonstrated that N derived from anthropogenic wastewater was assimilated into bivalve tissues as N loads increased. Bivalve shell and soft-tissue growth also increased in response to increased chlorophyll a concentrations driven by land-derived N loads. Growth was accompanied by increased percent N content of...
AUTOMATION In INDEXING

There are two points to be considered under this general title, a the mechanization of the actual process of indexing, b the mechanization of the printing of indexes.
Cellular phones and traffic accidents

Cellular phone use in motor vehicles is becoming an increasing world-wide phenomenon. Using data obtained from traffic accidents reported between 1992 and 1995 in the state of Oklahoma, USA, this study examined statistical rate-ratios of accident characteristics between drivers with or without cellular phones. Rates were calculated between cellular phone involvement and reported accident causes, types of collision, driver actions immediately prior to the accident, location of the accident, the extent of fatalities, and age and gender of drivers. Results indicated a significant increased rate among drivers with cellular phones for inattention, unsafe speed, driving on wrong side of road, striking a fixed object, overturning their vehicle, swerving prior to the accident, and running off the roadway. People with phones stood an increased risk of being killed in an accident over persons without phones. Males with phones had a significantly higher rate than females for many of accident characteristics mentioned above. Rate-ratios of some accident characteristics and fatalities increased as age increased, with the exception of drivers under age 20 yrs, who had the highest fatality rate. Limitations of the study and possible prevention alternatives are discussed.