cssi/SciSciGPT-SciSciNet huggingface dataset:
National assessment of HPV and Pap tests: Changes in cervical cancer screening, National Health Interview Survey

Abstract Background Major organizations recommend cytology screening (Pap test) every 3 years for women aged 21–65; women aged 30 to 65 have the option of adding the HPV test (co-test) every 5 years. We examined national percentages of cervical cancer screening, and we examined use of co-testing as an option for screening. Methods We used 2015 U.S. National Health Interview Survey (NHIS) data to examine recent cervical cancer screening (Pap test within 3 years among women aged 21–65 without a hysterectomy; N = 10,596) and co-testing (N = 9,125). We also conducted a multivariable analysis to determine odds of having had a Pap test or co-test by demographic variables. To evaluate changes in screening over time, we examined Pap testing during the years 2000, 2005, 2008, 2010, 2013 and 2015. Analysis completed in Atlanta, GA during 2016. Results Overall, 81.1% of eligible women reported having a Pap test within 3 years; percentages declined over time among all age groups. An estimated 14 million women aged 21–65 had not been screened within the past 3 years. Recent immigrants to the United States, women without insurance, and women without a usual source of healthcare had lower odds of being up to date with screening. About 1/3 of women up to date on Pap testing reported having a co-test with their most recent Pap test. Conclusions Declines in screening among women aged 21–65 are cause for concern. More research is needed on co-testing practices. Provider and patient education efforts may be needed to clarify recommended use of HPV tests.
Dense gray codes in mixed radices

The standard binary reflected Gray code produces a permutation of the sequence of integers (0, 1,…, n − 1), where n is a power of 2, such that the binary representation of each integer in the permuted sequence differs from the binary representation of the preceding integer in exactly one bit. In an earlier paper, we presented two methods to compute binary dense Gray codes, which extend the possible values of n to the set of all positive integers while preserving both the Gray-code property — only one bit changes between each pair of consecutive integers — and the denseness property — the sequence contains exactly the n integers 0 to n − 1. This paper generalizes our method for binary dense Gray codes to arbitrary radices that may be either a single fixed radix for all digits or mixed radices, so that each digit may have a different radix. That is, we show how to produce a permutation of (0, 1, …, n−1) represented in any set of radices, such that the representation of each number differs from the representation of the preceding number in exactly one digit, and the values of these digits differ by exactly 1. We provide a simple formula for this permuation, which we can use to quickly compute a Hamiltonian path for a dynamic array of n nodes, where the nodes are added and deleted in order along the k dimensions of a grid network.
Biomechanical Comparison of Single- Versus Double-Row Capsulolabral Repair for Shoulder Instability: A Review.

Background:The glenohumeral joint is the most commonly dislocated joint in the body. Failure rates of capsulolabral repair have been reported to be approximately 8%. Recent focus has been on restor...
Novel Methods for Screening: Contributions from Attachment and Biobehavioral Catch-up.

Preventative interventions are needed across the lifespan, including for children who have experienced maltreatment. However, interventions’ effect sizes are typically smaller in real-world settings than in clinical trials. Identifying providers who are likely to implement interventions with fidelity could promote implementation outcomes through targeted allocation of training resources. This study tested two pre-training screening measures as predictors of provider fidelity to Attachment and Biobehavioral Catch-up (ABC), a preventative intervention for maltreated infants. One measure assessed valuing of attachment/openness, and the other used vignettes to assess initial skill in a key intervention component. In a sample of 42 providers across 197 sessions, both screening measures predicted future ABC fidelity, even when controlling for experience and education. These results support the development of screening measures for other interventions, suggesting approaches that target specific qualities and behaviors are likely to predict implementation fidelity.
The Impact of the Veteran's Affairs Medical System on an Otolaryngology Residency Training Program.

Introduction The field of otolaryngology has become the leading specialty in the management of head and neck pathology and trauma. Graduate medical education programs tasked to train military head and neck surgeons within the Department of Defense (DoD) maintain certification by ensuring adequate surgical case volume and training. In recent years, surgical case numbers have declined due to an overall healthy active duty patient population and deployments of residency faculty. As such, a novel initiative between the San Antonio Military Medical Center and the South Texas Veteran's Healthcare system was developed to provide seamless care among active duty service members, dependents, retirees, and veterans. The goal of this study is to review the impact on Otolaryngology Key Indicator Procedures (KIP), as defined by the Accreditation Council for Graduate Medical Education (ACGME), following integration of a Veterans Affairs health care population into a military otolaryngology residency program. Further, we aim to assess the potential secondary benefits of an integrated health care initiative between the DoD and the Veteran's Affairs (VA) systems. Materials and methods Otolaryngology key indicator procedures, as defined by the ACGME, were reviewed at an academic military medical center before and after implementation of an ENT Federal Healthcare Consortium integrating care of VA patients at a military hospital. The surgical scheduling system at our institution was queried for cases within the KIP categories of "Head & Neck" and "Otology" from 2011 to 2015. Results Case data was reviewed from the San Antonio Military Medical Center before (2011-2012) and following integration of VA patient care (2013-2015). A total of 520 "Head & Neck" and 532 "Otology" KIP were performed following development of an ENT Federal Consortium. One hundred and sixty-five KIPs were performed on patients referred from the VA. The range of VA-generated cases contributing to total KIPs for "Head & Neck" and "Otology" ranged from 6.8% to 59.5% and 0% to 18.9% per year. Conclusions The establishment of a Federal Healthcare Consortium and integration of VA patient population provided a tangible and quantifiable increase in otolaryngology KIPs. Development of a training relationship with VA patients is beneficial in reaching outcome-oriented goals for otolaryngology residents.
Data on the risk perceptions of beach water safety in coastal Georgia

Abstract These data reflect the perceptions of beach water quality drawn from a convenience sample of 238 visitors to Georgia (USA) beaches collected in June–July 2017 and are related to the research article entitled “Water quality and the perception of risk: a study of Georgia, USA, beachgoers” (Jones et al., 2018) [1] . Data were collected both via an online survey distributed through Facebook and through in-person questionnaires collected directly on the beaches.
An Overview of the Problem

States in the contemporary world have assumed greater international obligations than in the past, not only because areas of mutual concern and contacts among them have significantly increased during recent years but also because there has been an increase in the number of international organizations, both technical and political, which regulate international relations. This expansion of international obligations has been accompanied by efforts toward more effective international control of national affairs. Equally true is the observation that, as long as the basic unit of interplay in the international community remains the “sovereign” state, these units will be able to counter attempts to impose repugnant obligations upon them. Consequently, progress toward a more harmonious and united world, founded on the principles of peace and mutual security maintained by such international organizations as the United Nations, cannot be achieved unless there is a reasonable balance between the goals of individual states and those of international organizations.
Incompressible Flows Based Upon Stabilized Methods

We give a brief overview of our efforts in developing stabilized finite element methods for incompressible flows. In particular, we review some suggestions for stability parameters and comment once more on the curious relationships between some stable Galerkin and stabilized finite element methods.
Dynamic NMR Processes

Five trends are examined in the field of dynamic NMR processes, (i) Improved computer programs have been developed for handling complex spin systems. These programs permit direct analysis without synthetic deuteration and often allow differentiation of possible mechanisms of exchange. (ii) Two dimensional analysis of dynamic processes provides an alternative method for the assignment of exchanging nuclei and of the unraveling of complex exchange mechanisms. (iii) The availability of an increased variety of magnetically active nuclei, such as 15N, 17O, and metals, permits analysis of new problems. (iv) The relaxation time has been accepted as an additional observable from which kinetic information can be extracted. Relaxation times offer another method for the identification of exchanging spins, through saturation transfer, and an expanded dynamic range of kinetics. Whereas lineshape analysis has a range of about 100 to 104 sec−1 the family of relaxation methods has a range of about 10−3 to 1012 sec−1. (v) Analysis of exchanging spins in the solid, with cross polarization and magic angle spinning, offers both an expanded lower temperature range because of removal of constraints imposed by solution samples, and the opportunity to study the effects of lattice forces on dynamic processes.
Protecting Patients' Data: An Efficient Method for Health Data Privacy

In this work, we investigate privacy violations that occur when non-confidential medical data is combined with domain ontologies to infer confidential data. We propose enhancements to our existing framework to detect such privacy violations, and to eliminate undesired inferences in an efficient manner. Our enhanced inference channel removal methods are based on disruption covers and heuristic-guided modification of data items that contribute to an inference. We show that our method is sound and complete. Soundness means that we modify only data items that lead to undesired inferences. Completeness means that we remove all inferences leading to undesired data disclosures. Finally, we show that our solution is practical with respect to computational cost. An important aspect of our approach is that it sets the foundation for creating patient-specific privacy policies; an emerging need in the healthcare domain.
Postmodern Relativism as Enlightened Pluralism

Reasonable relativism, the view that judgments ought to be contextualized and that the contexts themselves keep realigning as such acts of judgments are undertaken, anchors a certain variant of postmodernism, the one explored here. Eschewing radical relativism with its nihilism on the one end of the spectrum and solipsism on the other, in what follows the potential for what may be called, provisionally, postmodern relativism, is explored. In this view, there is an opportunity to examine under what conditions multiple views, some contradictory, some complementary, may be found useful in the affairs of the state. The crux of the test for postmodern pluralism is how it contextualizes decision-making processes, the adaptation of public policies, and the moral judgments to which they appeal. Admittedly, it’s difficult to conduct this test since any behavior within a relativized context is itself dynamic and thereby changes the context itself.
2120 Long-acting reversible contraceptive uptake in female sex workers and single mothers in Rwanda and Zambia

OBJECTIVES/SPECIFIC AIMS: Long-acting reversible contraception (LARC) has been well established as the most cost-effective form of contraception, but LARC usage in developing countries remains low. As part of a multi-center parent study on HIV incidence, we implemented an integrated family planning program to increase LARC uptake in single women in Rwanda and Zambia. We aim to evaluate rates of LARC uptake, LARC discontinuation and incident pregnancy following family planning counseling. METHODS/STUDY POPULATION: We enrolled 3 cohorts of single sexually active HIV-negative women between the ages of 18–45 years: single mothers (SM) in Zambia, female sex workers (FSW) in Zambia and FSW in Rwanda. Participants were followed every 3 months for up to 5 years. At each visit, we discussed fertility goals and counseled participants on HIV risk reduction and contraceptive options. Eligible participants (not pregnant, already using a LARC method, or using a permanent contraceptive method) were offered a LARC method, specifically the copper IUD or Jadelle implant. Data was collected on demographic factors, sexual behavior, sexual and reproductive history, and gynecological exams and laboratory tests were performed if necessary. RESULTS/ANTICIPATED RESULTS: In total, 458 Rwandan FSW, 555 Zambian FSW, and 521 Zambian SM were enrolled, with a median follow-up time of 6 months, 12 months, and 9 months, respectively. Accounting for any LARC uptake during longitudinal follow-up, our preliminary results show an increase in LARC usage from 21% at screening to 51% at the end of follow-up among Rwandan FSW, an increase from 12% to 42% in Zambian FSW and an increase from 18% to 44% in Zambian SM. We hypothesize that demographic factors (e.g., younger age, higher education level) and sexual history (e.g., greater number of sexual partners, any STIs or reproductive health disturbances) will be associated with increased rates of LARC uptake. We also hypothesize that LARC users will have significantly lower proportions of contraceptive method discontinuation and incident pregnancy compared to non-LARC users. DISCUSSION/SIGNIFICANCE OF IMPACT: FSW and SM are disproportionately affected by high rates of unintended pregnancy, which can lead to obstetric complications and poor psychosocial outcomes. It is imperative that family planning interventions in developing countries target these populations to overcome obstacles in reproductive health and promote gender equality. Our study will provide necessary insights to an integrated family planning program, which will guide future efforts to design, implement and evaluate family planning initiatives for high-risk populations.
Prospective Analysis of the Dynamic Intraoperative Standing Sling Technique A Novel Method of Performing the Single-Incision Sling Procedure

Abstract Objective: The aim of this research was to assess the 1-year success of the Dynamic Intraoperative Standing Sling Technique™ (DISST™) for the management of stress urinary incontinence (SUI...
Disposition of an Interest in a U.S. Partnership by a Foreign Person: The Saga of Revenue Ruling 91-32

ABSTRACT Rev. Rul. 91-32 treats the sale of a partnership interest by a foreign partner under the aggregate approach. Gain or loss is determined by the distributive share of gain or loss arising fr...
Safety and Effectiveness of Intermittent Magnesium Sulfate Administration in Pediatric Patients Experiencing Prolonged Status Asthmaticus in the non-intensive Care Setting

Objective: To determine if intermittent magnesium sulfate infusion can safely be administered in the non-intensive care setting to decrease duration of continuous albuterol therapy, decrease overall length of stay and reduce the need for increased level of care (non-invasive respiratory support). Methods: We performed a retrospective cohort analysis of children age 2-18 years admitted to the inpatient, non-intensive care units on continuous albuterol for > 6 hours for the management of status …
The Application of Formal Axiology to Medical Education through the Hartman Value Profile: A prospective cohort study.

Introduction: Many criteria such as USMLE scores, applicant resumes, Dean’s letters, ecommendation letters, personal discussions, interview scores and medical school transcripts can be used to predict the success of a medical trainee in the USA. This information is either relatively objective, or subjective. It would be valuable if we had some objective measures that might predict a successful resident performance early in the process or on the other side to allow remediation or redirection. Actual performance of a resident or fellow is based upon his or her ability to execute soundjudgments within the complex healthcare setting. The Hartman Value Profile (HVP) evaluates the structure and the dynamics of an individual value system. This study has the primary goal ofdetermining whether specific indices on the HVP correlate with the management’s evaluation of the residents established by the Department of Anesthesiology at Yale University.Methods: The protocol developed uses univariate correlations between residents’ HVP subscales and their performance scores, which will be determined with the Pearson correlation coefficient or Spearman rank coefficient as appropriate. Demographic and clinical variables will be reported descriptively. A two-sided alpha value of 0.05 will be used for identifying statistically significantfindings.Conclusion: The potential benefits are that obtaining specific indices on the HVP would enable management to better engage and work with residents. Experience gained from incorporating the HVP into the residency selection process suggests that it may add objectivity in predicting resident performance during training. Given the potential impact, it could be implemented as an adjuvant tool to the traditional evaluation process.
The State of States’ Assisted Living Websites: Information Available to Consumers

Background and objectives Assisted living (AL) is a growing sector of the U.S. long-term care market, with its development driven largely by private market choices. However, consumers need information to choose the right AL community (ALC). This paper examined information available on U.S. state websites concerning ALC quality, costs, and services. Research design and methods Based on prior research and their analysis of a sample of state websites, researchers identified 39 key informational elements and grouped them into four categories, (a) ALC characteristics, (b) payment and services, (c) quality, and (d) website usability. Researchers then examined the presence of the 39 elements on 51 websites (U.S. states and the District of Columbia), meeting regularly to discuss findings and resolve differences. Results A majority of states provided basic information about individual ALCs (e.g., number of beds, ownership). Only 35% listed payment(s) accepted (e.g., Medicaid), and 31% indicated the availability of memory care. Nearly 70% posted inspection results, while only 43% provided information about complaints. Many met basic usability guidelines (e.g., type size), but locating content on many sites required multiple steps, and none met 5th-grade-or-below readability standards. Discussion and implications A majority of websites provided important information, such as inspection results. However, many were lacking key elements concerning payment accepted and services. Finding what was available was burdensome. More work is needed to help states provide information that enables consumers to find ALCs that meet their needs. The lack of such information puts older adults at risk of inappropriate placements.
Intranasal esketamine: A novel drug for treatment-resistant depression

Purpose To review the efficacy, safety, and place in therapy of intranasal esketamine, a treatment modality for treatment-resistant depression. Summary An electronic literature search of PubMed, MEDLINE, and the ClinicalTrials.gov and Food and Drug Administration (FDA) websites covering the period April 2015 through June 2020 was performed using the following search terms: esketamine, intranasal esketamine, depression, and treatment-resistant depression. Other resources included review articles and the manufacturer's product labeling. All relevant English-language articles and reports on clinical trials conducted in humans were included. Esketamine (Spravato, Janssen Pharmaceuticals) is an intranasal antidepressant approved by FDA for management of treatment-resistant depression (TRD) in patients with inadequate response to traditional antidepressant therapy. Esketamine is self-administered under the supervision of a healthcare provider and is used as an adjunct to oral antidepressant therapy. Patients are supervised for 2 hours after self-administering the medication to monitor for sedation, dizziness, dissociation reactions, and increased blood pressure. Esketamine has a favorable risk-to-benefit profile, with demonstrated efficacy in reducing depressive symptoms more rapidly than monotherapy with traditional oral antidepressants. Reported adverse effects include sedation, dizziness, dissociation reactions, and blood pressure elevations, but these effects are primarily confined to the 2-hour postdose monitoring window. Conclusion Patients with moderate to severe depression who are not sufficiently responsive to traditional strategies for managing TRD may benefit from adjunctive esketamine therapy.
UMLS-based data augmentation for natural language processing of clinical research literature

OBJECTIVE The study sought to develop and evaluate a knowledge-based data augmentation method to improve the performance of deep learning models for biomedical natural language processing by overcoming training data scarcity. MATERIALS AND METHODS We extended the easy data augmentation (EDA) method for biomedical named entity recognition (NER) by incorporating the Unified Medical Language System (UMLS) knowledge and called this method UMLS-EDA. We designed experiments to systematically evaluate the effect of UMLS-EDA on popular deep learning architectures for both NER and classification. We also compared UMLS-EDA to BERT. RESULTS UMLS-EDA enables substantial improvement for NER tasks from the original long short-term memory conditional random fields (LSTM-CRF) model (micro-F1 score: +5%, + 17%, and +15%), helps the LSTM-CRF model (micro-F1 score: 0.66) outperform LSTM-CRF with transfer learning by BERT (0.63), and improves the performance of the state-of-the-art sentence classification model. The largest gain on micro-F1 score is 9%, from 0.75 to 0.84, better than classifiers with BERT pretraining (0.82). CONCLUSIONS This study presents a UMLS-based data augmentation method, UMLS-EDA. It is effective at improving deep learning models for both NER and sentence classification, and contributes original insights for designing new, superior deep learning approaches for low-resource biomedical domains.
Accessibility of Telehealth services for cancer care at cancer hospital in the United States

Background: The COVID-19 pandemic has dramatically accelerated the availability of telehealth services for patients with cancer. However, little national cross-sectional data is available to inform potential gaps in access. We aimed to characterize overall access to and trends in telehealth availability for new cancer care patients at hospitals across the United States. Methods: We performed a cross sectional secret-shopper study to evaluate the availability of telehealth services for new patients for three major cancer types- colorectal, breast, and skin cancer-at Commission on Cancer accredited hospitals during the period of April to November 2020. American Hospital Association and Center for Medicare and Medicaid Service databases were queried to determine hospital characteristics. We described hospital variation in access to telehealth services using descriptive statistics. Univariable and multivariable logistic regression were used to identify factors associated with telehealth availability. Results: Of 334 successfully contacted facilities, 248 (74%) offered new patient telehealth services for at least one cancer type. However, access differed by cancer site: telehealth availability for new patients with skin, colorectal, and breast cancer was 47%, 42%, and 38%, respectively. Of the facilities sampled, 47% offered telehealth for one cancer type, 40% for two cancer types, and 14% for all three cancer types. Rates of any telehealth access among the cancer types ranged from 61% at Community Cancer Programs to 100% at NCI Designated Programs. In multivariable logistic regression, facility type was significantly associated with telehealth access while factors such as bed size, ownership, and volume were not significantly associated. Conclusions: Although access to telehealth services for patients with cancer has increased, overall gaps in access remain. Within facility differences in telehealth access imply opportunities to better align services within institutions, though further investigation is warranted as these offerings mature. (Table Presented).
U.S. Paralympic Hopeful's Athletic Identity and How It Has Been Affected by the Sport Disruption of COVID-19

The purpose of this study was to explore the status of Paralympic hopefuls' athletic identity and how this identity was impacted by the training and competition cessation resulting from the COVID-19 pandemic. Researchers conducted in-depth semi-structured interviews that explored the experiences of 29 Paralympic hopefuls who compete in thirteen different Paralympic sports. A thematic analysis yielded two superordinate themes: a) Prominent athletic identity, multiplicity over exclusivity; b) Various Impact on AI: Mental adaptation helps overcome the lack of sport participation. Participants in this study possessed prominent strong athletic identities from the benefits of sport participation. Their prioritized athletic role still remains despite setbacks due to the pandemic. However, athletes identified with multiple roles rather than an exclusive athletic identity during COVID-19. As for the impacts on identity, the severity of challenges are determined by the mindset of the athletes. All of the athletes experienced a decreased amount of time and physical participation in their sport. Paralympians whose sole focus was on the loss of physical participation were impacted the most. Athletes who felt unchallenged did so because of their mental adaptation. Through a positive outlook and mentality, athletes were able to effectively cope and not dwell on the negative aspects brought on by the pandemic. In conclusion, having a strong AI did not necessarily coincide with a negative impact on identity from COVID-19, and those who do not possess a strong AI felt their AI was unchallenged by the pandemic. More importantly, Paralympians' mindset of how they view and interpret their AI is crucial to how the individual's AI is affected by the sport disruption of COVID-19.
Receptiveness and barriers to clinical trial participation for oncology patients from a public safety-net hospital.

83Background: Oncologic clinical trial enrollment is low, particularly in underserved populations. Increasing enrollment of public safety-net hospital patients is important to ensure representation...
Autonomy and ars moriendi

In a personal history,1 Dr. Steven Ringel argues both sides of two distressing cases. Both cases concern adults with decision-making capacity who have expressed a desire to live and for whom life-extending measures—albeit scarce or costly ones—are available. Both patients cede decision making to others and, as a consequence, die. In the main case, the argument attempts the familiar but impossible utilitarian task of weighing presumptions of quality against projections of quantity of life. The outcome: a young woman with Friedreich ataxia and end-stage heart failure lets her “overwhelmed” and “exhausted” parents take her home, rather than undergoing a heart transplant. In an ancillary case, which could be titled “For Love or Money,” a man with amyotrophic lateral sclerosis does not go on a ventilator because his wife, despite her deep …
The Regulation of Bilayer Stability in Bacteria

The membranes of prokaryotic and eukaryotic cells contain mixtures of amphipathic lipids. When isolated, the major lipids can form different phase structures upon hydration at physiological temperatures. As discussed in other lectures in this volume (de Kruijff, Op den Kamp), the structures of lipid aggregates are related to the generalized shapes of the molecules. Bilayer-forming lipids (type II) have roughly cylindrical shapes whereas HII phase lipids (type III) have a cone shape in which the area swept out by the motion of the hydrocarbon chains is larger than that occupied by the polar head groups. Hydration, charge repulsion, and hydrogen bonding, can affect the cross-sectional areas of the polar regions, and temperature and chain unsaturation influence the volumes occupied by the hydrocarbon chains (Rilfors et al., 1984; Cullis & Hope, 1985).Among the type II lipids found in prokaryotes are phosphatidylcholine (PC), phosphatidylglycerol (PG), phosphatidylserine (PS), cardiolipin (CL), and diglycosyldiacylglycerols. Among type III lipids are unsaturated species of phosphatidylethanolamine (PE), plasmenylethanolamine (PlaE) and monoglycosyldiacylglycerols (Goldfine, 1982). Lipids that aggregate to form micelles (Type I), for example lyso-phosphoglycerides, are rarely found in large amounts.
Solving Modern Family Dilemmas: An Assimilative Therapy Model

Context is the unifying principle that guides a therapist’s formulation of the modern family’s presenting dilemmas, functioning, relationships, and attitudes. We can no longer assume that a family is comprised of a mother, father, and children; the composition and systems a family operates within can be fluid and ever-changing, requiring an equally elastic model. The Assimilative Family Therapy Model is sensitive to the many unique contexts presented by the modern family and is shaped by the inclusion of necessary interventions to address the specific dilemmas of a client or family. In Solving Modern Family Dilemmas, readers will learn about many schools of thought and experience their integration to help heal clients through differentiation, anxiety reduction, and lowering emotional reactivity. There is also no need for readers to abandon their theoretical framework; theories, concepts, and interventions can be inserted into the model, enabling readers to create their own model of family therapy. End-of-chapter questions enable self-examination, and readers are treated to references for further exploring theories, concepts, and interventions. Family therapists, psychologists, social workers, and mental health counselors find this book essential in their work with all clients, and professors use it in courses to teach different modes of integrating theories, concepts, and interventions.
An overview of device behavior and modeling of CMOS technology for RF IC design

This paper overviews the MOS downscaling and device behavior in RF CMOS technology, which is an attractive potential process candidate for wireless communication applications. The impact of downscaling of CMOS technology to the RF applications will be discussed first. Then the trend of the device performance will be summarized to understand the device behavior better for RF design requirements. Several important figure-of-merits for MOS transistors such as cutoff frequency (f/sup max/, noise figure (NF) and linearity etc. will be analyzed together with the discussion of other device behavior to explore the details of RF CMOS technology. Modeling issues are also introduced to develop good RF models for RF circuit optimization.
Medical school hotline: tropical cyclone Haiyan/Yolanda medical relief mission: perspectives of John A. Burns School of Medicine 2nd year medical students.

During the early morning hours of 8 November 2013, Typhoon Haiyan (locally known as Typhoon Yolanda) made landfall in the Philippines on the island of Samar. Haiyan was the strongest tropical cyclone to make landfall in recorded history, with maximum sustained winds of 195 mph. Typhoon Haiyan/Yolanda brought more than just heavy rain, strong wind, and a strong storm surge, but also devastation and chaos as it took with it homes, businesses, and the lives of over 6,000 people. Of the survivors, 29,000 were injured and 4.1 million were displaced. Most affected were Tacloban City and surrounding villages.
Saving the Savings Clause: Advocating a Broader Reading of the Miller Test to Enable States to Protect ERISA Health Plan Members by Regulating Insurance

ERISA’s broad preemption of state laws relating to employee benefit plans, with regard to health plans in particular, prevents states from regulating these plans even though ERISA itself provides almost no substantive regulation of their provisions. This has permitted insurance companies to largely control the terms of ERISA health benefit plans that provide coverage through the purchase of insurance. While this nation’s newly enacted health care reform places some limits on insurers’ coverage practices, it largely addresses the problem of the uninsured by mandating the purchase of insurance coverage. Therefore, the importance of enabling states to regulate insurers’ conduct has actually been magnified under health care reform. While ERISA clearly precludes states from regulating self-insured health benefit plans, its “savings clause” saves from preemption states’ regulation of insurance. Consequently, ERISA’s savings clause is currently the only means by which states can regulate the substantive terms of insured ERISA health plans. As these state insurance laws comprise the mainstay of protections available for ERISA health plan members, it is critical that the savings clause function as fully as possible to save state laws that regulate insurance. In 2003 in Kentucky Association of Health Plans, Inc. v. Miller, the United State Supreme Court devised a new test to determine savings, relaxing the requirements to save a greater range of state insurance laws. However, due to the test’s rather confused language, federal courts have continued to deliver inconsistent rulings as to whether particular state laws are saved from preemption. The unfortunate result is that state laws that legitimately regulate the relationship between insurers and insureds continue to be wrongfully preempted, depriving countless ERISA plan members of the state law protections that should be available to them. This Article argues for a broader reading of the Miller savings test, in keeping with the intent and expansive language of ERISA’s savings clause. Applying Miller to give full effect to the savings clause will unbind the states to indirectly regulate insured ERISA health benefit plans via their traditional role of regulating insurance business conducted within the states’ borders.
Gene encoding the alpha core subunit of Bacillus subtilis RNA polymerase is cotranscribed with the genes for initiation factor 1 and ribosomal proteins B, S13, S11, and L17.

Abstract We describe the genetic and transcriptional organization of the promoter-distal portion of the Bacillus subtilis alpha operon. By DNA sequence analysis of the region surrounding rpoA, the gene for the alpha core subunit of RNA polymerase, we identified six open reading frames by the similarity of their products to their counterparts in the Escherichia coli transcriptional and translational apparatus. Gene order in this region, given by gene product, was IF1-B-S13-S11-alpha-L17. Gene order in E. coli is similar but not identical: SecY-B-S13-S11-S4-alpha-L17. The B. subtilis alpha region differed most strikingly from E. coli in the presence of IF1 and the absence of ribosomal protein S4, which is the translational regulator of the E. coli alpha operon. In place of the gene for S4, B. subtilis had a 177-base-pair intercistronic region containing two possible promoter sequences. However, experiments with S1 mapping of in vivo transcripts, gene disruptions in the alpha region, and a single-copy transcriptional fusion vector all suggested that these possible promoters were largely inactive during logarithmic growth, that the major promoter for the alpha operon lay upstream from the region cloned, and that the genes in the IF1 to L17 interval were cotranscribed. Thus, the transcriptional organization of the region resembles that of E. coli, wherein the alpha operon is transcribed primarily from the upstream spc promoter, but the absence of the S4 gene suggests that the translational regulation of the region may differ more fundamentally.
Ocular Fundus Reflectometry

A qualitative method for observation of the light reflected at the fundus was developed by Helmhotz in 1851. However, there was need for quantitative assessment and with the introduction of microprocessors, it was possible to measure spatial and spectral distribution of reflectance. Experimental models of observed wavelength dependence and reflectance of light from macula were initiated. The role of these experimental models using fundus reflectometry in basic and clinical research is summarized in the present chapter. Keywords: fundus reflectometry; photoreceptor; macular pigment; ophthalmoscope
Robust analog/RF circuit design with projection-based posynomial modeling

We propose a robust analog design tool (ROAD) for post-tuning analog/RF circuits. Starting from an initial design derived from hand analysis or analog circuit synthesis based on simplified models, ROAD extracts accurate posynomial performance models via transistor-level simulation and optimizes the circuit by geometric programming. Importantly, ROAD sets up all design constraints to include large-scale process variations to facilitate the tradeoff between yield and performance. A novel convex formulation of the robust design problem is utilized to improve the optimization efficiency and to produce a solution that is superior to other local tuning methods. In addition, a novel projection-based approach for posynomial fitting is used to facilitate scaling to large problem sizes. A new implicit power iteration algorithm is proposed to find the optimal projection space and extract the posynomial coefficients with robust convergence. The efficacy of ROAD is demonstrated on several circuit examples.
K-shell photoabsorption coefficients of O2, CO2, CO, and N2O

The total photoabsorption coefficient has been measured from 500 to 600 eV around the K edge of oxygen in gases O2, CO2, CO, and N2O by means of a gold continuum source and crystal spectrometer with better than 1-eV resolution. The cross sections are dominated by discrete molecular-orbital transitions below the K-edge energy. A few Rydberg transitions were barely detectable. Broad shape resonances appear at or above the K edge. Additional broad, weak features above the K edge possibly arise from shake up. Quantitative results are given that have about 10% accuracy except on the very strong peaks. All the measured features are discussed in relation to other related measurements and theory.
Host b7x promotes pulmonary metastasis of breast cancer

B7x (B7-H4 or B7S1) is an inhibitory member of the B7 family of T cell costimulation. It is expressed in low levels in healthy peripheral tissues, such as the lung epithelium, but is overexpressed in a variety of human cancers with negative clinical associations, including metastasis. However, the function of B7x in the context of cancer, whether expressed on cancer cells or on surrounding "host" tissues, has not been elucidated in vivo. We used the 4T1 metastatic breast cancer model and B7x knockout (B7x (-/-)) mice to investigate the effect of host tissue-expressed B7x on cancer. We found that 4T1 cells were B7x negative in vitro and in vivo, and B7x(-/-) mice had significantly fewer lung 4T1 tumor nodules than did wild-type mice. Furthermore, B7x(-/-) mice showed significantly enhanced survival and a memory response to tumor rechallenge. Mechanistic studies revealed that the presence of B7x correlated with reduced general and tumor-specific T cell cytokine responses, as well as with an increased infiltration of immunosuppressive cells, including tumor-associated neutrophils, macrophages, and regulatory T cells, into tumor-bearing lungs. Importantly, tumor-associated neutrophils strongly bound B7x protein and inhibited the proliferation of both CD4 and CD8 T cells. These results suggest that host B7x may enable metastasizing cancer cells to escape local antitumor immune responses through interactions with the innate and adaptive immune systems. Thus, targeting the B7x pathway holds much promise for improving the efficacy of immunotherapy for metastatic cancer.
Advances in 3.3 V logic

The benefits offered by 3.3 V based systems are significant. It is clear that the proliferation of 3.3 V ICs will continue to increase displacing the 20 year old 5 V TTL standard. Issues such as performance and power will be the dominant trends in the evolution of 3.3 V systems. This paper presents the main characteristics and market trends of 3.3 V products today. It offers guidelines in selecting 3.3 V products to meet the power-performance goals of 3.3 V designs. >
Homocysteine and cognitive function in the Sacramento Area Latino Study on Aging.

BACKGROUND Elevated plasma homocysteine (hyperhomocysteinemia), an independent risk factor for vascular disease, has been reported to be inversely correlated with objective measures of cognitive function in patients with Alzheimer disease and in community-dwelling older adults. OBJECTIVE We evaluated the cross-sectional relation between total plasma homocysteine concentration and cognitive function in elderly Latinos (aged > or = 60 y; n = 1789) participating in the Sacramento Area Latino Study on Aging. DESIGN Global cognitive function was assessed by using the Modified Mini-Mental State Examination, and specific cognitive functions were assessed by using 6 instruments developed for cross-cultural and multilingual neuropsychological evaluation of older persons. Associations between the cognitive function scores and total plasma homocysteine concentrations were then measured by multiple regression analysis with control for potential confounding by nutrient status (red blood cell folate, plasma vitamin B-12), kidney function (serum creatinine), demographic variables (age, sex, education, acculturation), and depressive symptoms. RESULTS Modest inverse associations were found between homocysteine concentrations and several indexes of cognitive function, including the global Modified Mini-Mental State Examination assessment and the picture-association, verbal attention-span, and pattern-recognition tests (P < or = 0.05). Demographic variables, particularly age and education, were more strongly associated with cognitive function scores than was homocysteine. CONCLUSIONS Homocysteine is a modest independent predictor of cognitive function in community-dwelling elderly Latinos. Reducing plasma homocysteine concentrations by administering B-vitamin supplements may provide some protection against cognitive decline in this and other elderly populations, but the effect may be limited.
Prospective evaluation of a clinical guideline for the diagnosis and management of iron deficiency anemia

Abstract Purpose We examined the effect of introducing an evidence-based clinical guideline on the diagnosis and evaluation of iron deficiency anemia. Subjects and methods The guideline recommended measurement of serum ferritin levels for all anemic patients with a mean corpuscular volume (MCV) ≤95 fL and endoscopic evaluation for those with a serum ferritin level less than 45 ng/mL. Physicians practicing in the general medicine inpatient and outpatient services of two university-affiliated hospitals were informed about the guideline and the data supporting it. Clinical evaluations during the 9 months before ("control period," n=3341 patients) and the 9 months after ("intervention period," n=3173 patients) the introduction of the guideline were compared. Results There was a 30% increase (95% confidence interval [CI]: 22% to 39%) in the proportion of anemic patients who underwent serum ferritin evaluation in the intervention period (41% [n = 1284]) compared with in the control period (31% [n = 1040]), and a 24% increase (95% CI: 4% to 48%) in the proportion with a serum ferritin level Conclusion Introduction of a guideline describing appropriate evaluation of iron deficiency anemia led to an increase in the proportions of patients evaluated for iron deficiency anemia and found to have serious gastrointestinal lesions.
Validation of consensus panel diagnosis in dementia.

Background The clinical diagnosis of dementing diseases largely depends on the subjective interpretation of patient symptoms. Consensus panels are frequently used in research to determine diagnoses when definitive pathologic findings are unavailable. Nevertheless, research on group decision making indicates that many factors can adversely affect panel performance. Objective To determine conditions that improve consensus panel diagnosis. Design Comparison of neuropathologic diagnoses with individual and consensus panel diagnoses based on clinical scenarios only, fludeoxyglucose F 18 positron emission tomography images only, and scenarios plus images. Setting Expert and trainee individual and consensus panel deliberations using a modified Delphi method in a pilot research study of the diagnostic utility of fludeoxyglucose F 18 positron emission tomography. Patients Forty-five patients with pathologically confirmed Alzheimer disease or frontotemporal dementia. Main Outcome Measures Statistical measures of diagnostic accuracy, agreement, and confidence for individual raters and panelists before and after consensus deliberations. Results The consensus protocol using trainees and experts surpassed the accuracy of individual expert diagnoses when clinical information elicited diverse judgments. In these situations, consensus was 3.5 times more likely to produce positive rather than negative changes in the accuracy and diagnostic certainty of individual panelists. A rule that forced group consensus was at least as accurate as majority and unanimity rules. Conclusions Using a modified Delphi protocol to arrive at a consensus diagnosis is a reasonable substitute for pathologic information. This protocol improves diagnostic accuracy and certainty when panelist judgments differ and is easily adapted to other research and clinical settings while avoiding the potential pitfalls of group decision making.
Cost Comparison of Radiofrequency Modification and Ablation of the Atrioventricular Junction in Patients With Chronic Atrial Fibrillation

Background Because it is not clear which technique is less expensive, the purpose of this study was to compare the cost of radiofrequency modification and ablation of the atrioventricular (AV) node in drug-refractory patients with atrial fibrillation and an uncontrolled ventricular rate. Methods and Results The initial nominal charges for a successful procedure were compared in 10 patients with chronic atrial fibrillation who underwent modification of the AV node ($13 109±2002) and 14 similar patients who underwent ablation and pacemaker implantation ($28 302±2023, P<.001). On the basis of the long-term follow-up of patients who underwent each procedure, it was assumed that 31% of patients selected for the modification procedure would require a permanent pacemaker for inadvertent AV block or because of AV nodal ablation after a failed modification procedure and that the recurrence rate after AV node ablation would be 2%. The annual charges during follow-up were predicted and adjusted for recurrences and t...