cssi/SciSciGPT-SciSciNet huggingface dataset:
Communicating intersectionality through creative claims making: the queer undocumented immigrant project

Social movements confronting overlapping inequalities face the unique challenge of elucidating the heretofore invisible experiences of those whose identities lie at the intersection of existing mov...
The Dual Roles of Higher Education Institutions in the Knowledge Economy

This chapter discusses the dual roles of higher education institutions, as recipients of higher education policy and as agents for change in the knowledge economy. Primarily, they are recipients of policy change influenced at the European level. Second, they are agents of policy change in the knowledge-based economy, which is of increasing importance in the twenty-first century. This is a new kind of regional integration, influenced by Europeanization and intergovernmentalism in higher education policy, with the ultimate objectives of achieving (1) economic competitiveness and (2) social cohesion through a system of higher educational qualifications and their international recognition. The success of the European Commission’s study-abroad program, Erasmus, is discussed as a component of the Bologna Process, which has incorporated mobility objectives for higher education. The opportunity for greater mobility in international education corresponds with the ongoing trends in globalization.
Math instruction is not universal: Language-specific pedagogical knowledge in Korean/English Two-Way Immersion programs

ABSTRACTTwo-Way Immersion (TWI) programs have demonstrated positive outcomes in students’ academic achievement in English, yet less is known about content teaching and learning in the non-English l...
We Are All Teachers: A Collaborative Approach to Digital Collection Development

ABSTRACTIn libraries and archives, efforts to document underrepresented communities and diversify collections can be fraught with political tension. We explore an interdepartmental collaboration to create and preserve a digital collection documenting the Urban Native Relocation Program of the mid- to late-twentieth century in Grand Rapids, Michigan. Involving the Grand Valley State University Libraries, the Kutsche Office of Local History, and the university's Native American Advisory Board, the project serves as a model not just for collaborative collection development but also for community engagement and outreach. We find that process is as important as product in developing collaborative digital collections.
Air pollution and subclinical interstitial lung disease: the Multi-Ethnic Study of Atherosclerosis (MESA) air-lung study.

We studied whether ambient air pollution is associated with interstitial lung abnormalities (ILAs) and high attenuation areas (HAAs), which are qualitative and quantitative measurements of subclinical interstitial lung disease (ILD) on computed tomography (CT). We performed analyses of community-based dwellers enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) study. We used cohort-specific spatio-temporal models to estimate ambient pollution (fine particulate matter (PM 2.5 ), nitrogen oxides (NO x ), nitrogen dioxide (NO 2 ) and ozone (O 3 )) at each home. A total of 5495 participants underwent serial assessment of HAAs by cardiac CT; 2671 participants were assessed for ILAs using full lung CT at the 10-year follow-up. We used multivariable logistic regression and linear mixed models adjusted for age, sex, ethnicity, education, tobacco use, scanner technology and study site. The odds of ILAs increased 1.77-fold per 40 ppb increment in NO x (95% CI 1.06 to 2.95, p = 0.03). There was an overall trend towards an association between higher exposure to NO x and greater progression of HAAs (0.45% annual increase in HAAs per 40 ppb increment in NO x ; 95% CI −0.02 to 0.92, p = 0.06). Associations of ambient fine particulate matter (PM 2.5 ), NO x and NO 2 concentrations with progression of HAAs varied by race/ethnicity (p = 0.002, 0.007, 0.04, respectively, for interaction) and were strongest among non-Hispanic white people. We conclude that ambient air pollution exposures were associated with subclinical ILD.
Outdated Prescription Drug Labeling: How FDA-Approved Prescribing Information Lags Behind Real-World Clinical Practice

Background:Prescription drug labeling is an authoritative source of information that guides the safe and effective use of approved medications. In many instances, however, labeling may fail to be updated as new information about drug efficacy emerges in the postmarket setting. When labeling becomes outdated, it loses its value for prescribers and undermines a core part of the FDA’s mission to communicate accurate and reliable information to patients and physicians.Methods:We compared the number of drug uses indicated on product labels to the number of uses contained in a leading drug compendium for 43 cancer drugs approved between 1999 and 2011. We defined a “well-accepted off-label use” of a drug as one that was not approved by the FDA and received a category 1 or 2A evidence grade.Results:Of the 43 drugs reviewed in this study, 34 (79%) had at least one well-accepted off-label use. In total, 253 off-label uses were identified; 91% were well accepted, and 65% were in cancer types not previously represent...
Therapeutic Jurisprudence and American Elder Law

Throughout the world, modern legislative and regulatory entities have spawned an impressive body of law intended to protect and improve the rights and well-being of older persons and the quality of their lives (Eekelaar and Pearl 1989; Koff and Park 1999). This regulatory corpus takes the form of enactments establishing public benefit programs targeted exclusively or primarily toward the aged, directing the conduct of human service and commercial product providers vis-a-vis older clients, and authorizing governmental or private interventions into older persons’ lives, with or without the specific client’s permission. In the western legislative tradition, laws prohibit discrimination on the basis of a person’s chronological age. Elder law provisions in the United States are predicated upon society’s inherent police and parens patriae powers to, respectively, promote the general health, safety, welfare, and morals of the community and protect from harm those persons who lack sufficient capacity to fend successfully for themselves. Philosophically, some particular examples of American elder law (e.g., regulation prohibiting employers from discriminating against older workers) depend upon the premise that chronological age by itself ought to be considered irrelevant, while other examples embrace the opposite position that older individuals — solely by virtue of their age — require and deserve special governmental preferences. An example of the latter would be the Medicare program, which creates a universal entitlement to federal health care benefits for persons over age 65, an entitlement that the U.S. has not extended to any other segment of the population on the sole basis of age (Rothman 1997, 67–86).
Unraveling Photodimerization of Cyclohexasilane from Molecular Dynamics Studies.

Photoinduced reactions of a pair of cyclohexasilane (CHS) monomers are explored by time-dependent excited-state molecular dynamics (TDESMD) calculations. In TDESMD trajectories, one observes vivid reaction events including dimerization and fragmentation. A general reaction pathway is identified as (i) ring-opening formation of a dimer, (ii) rearrangement induced by bond breaking, and (iii) decomposition through the elimination of small fragments. The identified pathway supports the chemistry proposed for the fabrication of silicon-based materials using CHS as a precursor. In addition, we find dimers have smaller HOMO–LUMO gaps and exhibit a red shift and line-width broadening in the computed photoluminescence spectra compared with a pair of CHS monomers.
Greater naturally occurring expressive suppression is associated with poorer executive functioning and motor-sequence learning among older adults.

Objectives: Unusually high engagement in expressive suppression (i.e., purposeful regulation of overt affect) has been associated with poorer performance on executive functioning (EF) and motor-sequence learning tasks. As such, expressive suppression represents one possible source of fluctuations in executive test performance. However, the relationship between expressive suppression and EF and motor performance has not yet been examined in older adults, who are more prone to EF and motor fluctuations than are younger adults. The purpose of this study was to test whether greater self-reported, naturally occurring expressive suppression is related to poorer EF performance and motor-sequence learning in older adults.Method: One hundred and ten community-dwelling older adults completed a self-report measure of expressive suppression, a battery of EF tests, and a computer-based measure of motor-sequence learning.Results: As expected, higher self-reported burden of expressive suppression in the 24 hours...
Edge Computing with ParaDrop Tutorial

This half-day tutorial will explore edge computing through hands-on development activities using a physical edge computing platform. With the recent trends in the networking ecosystem-the rise of IoT devices, high bandwidth wireless, and powerful, energy-efficient, and inexpensive computation-edge computing is a promising technology for highly interactive and immersive environments. This tutorial aims to promote awareness of the possibilities of edge computing in general and introduce attendees to the tools that they can use to begin exploring this space. The tutorial's activities will give attendees hands-on experience with the ParaDrop edge computing platform developed at the University of Wisconsin-Madison. We hope to impart working knowledge about edge computing and our vision for its future. Recent developments in home wireless networks such as the proliferation of connected devices (e.g. Internet-of-Things) and gigabit wireless (e.g. 802.11ac) create an environment where edge computing can truly enhance applications. The availability of low latency and high bandwidth at the network edge but not necessarily end-to-end to the cloud, can enable interesting new applications involving video (e.g. augmented reality), low latency sensor-actuator coordination, and other public safety or educational applications. However, before such applications emerge, there needs to be a platform available for them. We argue that the availability of widespread platforms and standards for edge computing will unleash a new wave of innovation much like the creation of app markets for mobile devices. The hardware exists, e.g. in the form of millions of always-on Wi-Fi routers in homes and businesses, but it is not very programmable. With our tutorial, we aim to foster awareness of the possibilities that exist with edge computing and promote the advancement of research toward good standards for its realization. We introduce the ParaDrop platform as an open source demonstration of our vision for edge computing. We have been single-mindedly focused on researcher and developer needs in creating the ParaDrop platform. As such, applications that are already written to be run as cloud services can be easily modified to run on the ParaDrop platform in order to benefit from running at the network edge. Applications are not required to be written in a highly specialized language, and applications are able to leverage the rapidly growing software ecosystem surrounding Docker. Our tutorial will give researchers a hands-on experience with the platform and knowledge that they will be able to use beyond the workshop.
Case series of adolescents with stroke-like symptoms following head trauma

Abstract Background Studies cite the incidence of pediatric blunt cerebrovascular injuries (BCVI) ranges from 0.03% to 1.3%. While motor vehicle incidents are a known high-risk mechanism, we are the first to report on football injuries resulting in BCVI. Case Report Case 1 is a 14-year-old male football player who presented with slurred speech and facial droop 16 h after injury that had resulted in unilateral stinger on the field. The patient had a negative brain computed tomography (CT) at the onset of symptoms. Given progression of symptoms over the next 24 h, re-evaluation with CT angiography (CTA) of brain and neck showed left internal carotid artery (ICA) dissection, and magnetic resonance imaging of the brain showed left middle cerebral artery infarct. Case 2 is a 16-year-old male football player who presented with headache and right hemiparesis immediately following a tackle injury. CT brain and neck were negative at an outside hospital, but he was transferred to us for progressive symptoms, and then CTA showed a left ICA dissection with distal emboli, including occlusive involvement of the intracranial left ICA. Why Should an Emergency Physician Be Aware of This? The diagnosis of BCVI requires a high level of suspicion. Focal neurologic deficits are consistently a risk factor across all screening criteria, including the Denver, Utah, Memphis, and Eastern Association for the Surgery of Trauma. These current screening criteria, however, may not be sufficient to diagnosis BCVI in children. The addition of the mechanism of injury and attention to the patient's clinical presentation and examination are important to prevent missed diagnosis and poor neurologic outcomes.
Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) was a term introduced in the literature in 2005 and has become a focus of research for both clinical investigators and basic scientists.
Understanding the host-pathogen interaction saves lives: lessons from vaccines and vaccinations.

Vaccines are one of the most successful and cost-effective public health tools employed to date, yet these benefits are only realized when the life-saving intervention reaches each and every targeted individual. Vaccine development is prioritized based on a number of factors such as health burden, feasibility, and determination of potential target populations. But only through an arduous process of pre-clinical development and progressive clinical trials does a vaccine become licensed and recommended for use. Once used in a wider and more diverse population safety issues, long-term impact and other unintended outcomes may become apparent, influencing policy modification. This commentary explores the role host–pathogen interaction plays in vaccine development and the operational and policy considerations that may impact vaccine success post-licensure.
Qualitative investigation of the speech-language therapy experiences of individuals who covertly stutter.

Abstract Purpose Individuals who covertly stutter have a unique experience of stuttering that involves concealing the core behaviors of stuttering (e.g., repetitions, prolongations, and blocks). From the listener’s perspective, covert stuttering results in minimum typical, overt stuttering behaviors. However, from the speaker’s perspective, covert stuttering often increases the cognitive and emotional impact of stuttering. This study explores the speech-language therapy experiences of individuals who covertly stutter in order to improve treatment recommendations and best practice. Methods This investigation is a qualitative analysis of individuals’ speech-language therapy experiences as persons who covertly stutter. Real-time video interviews were conducted with the use of open-ended phenomenological interview questions. Interviews were transcribed and thematic analysis of interview transcripts was conducted to investigate the speech-language therapy experiences of the participants. Results The participants indicated that stuttering therapy was most impactful when it included explicit goals and activities, personalized selection of therapy techniques or strategies beyond fluency techniques, encouraged self-education, and educated those in the person’s environment. Conclusion The evidence suggests individualized therapy based on each client’s unique manifestation of covert stuttering is beneficial; while, fluency-focused stuttering therapy is often incongruent with the needs of persons who covertly stutter. Therapeutic implications and recommendations for speech-language pathologists are discussed.
Threshold measurements of a nonresonant continuous wave Raman laser in H2

High finesse cavities have recently been used to produce an optically pumped, non-resonant cw Raman laser at 683 nm (Stokes) with a threshold of less than 5 mW pump power.
Elucidating Thermally Induced Structural and Chemical Transformations in Kaolinite Using Reactive Molecular Dynamics Simulations and X-ray Scattering Measurements

The lack of reliable predictive modeling methods and robust experimental techniques has hindered the rational design of hierarchical materials with desired structure–property–performance attributes...
Risk Perception of Rare Catastrophic Events in Housing Markets: Evidence from Jet Crash Risk

We present evidence of differential effects of risk perception in the housing market. We use housing transaction data near military bases to examine capitalization of potential military jet accident risk in house prices. We find that properties in accident potential zones (APZs) transact at lower prices. In addition, we find that the perceived effect is much more pronounced following a jet crash in the area and mitigates over passage of time. Thus, we highlight the role of recency in asset pricing as market participants differentially account for relevant information.
Pinpointing the neural signatures of single-exposure visual familiarity

Memories of the images that we have seen are thought to be reflected in the reduction of neural responses in high-level visual areas such as inferotemporal (IT) cortex, a phenomenon known as repetition suppression (RS). We challenged this hypothesis with a task that required rhesus monkeys to report image familiarity while ignoring variations in contrast, a stimulus attribute that is also known to modulate the overall IT response. The monkeys9 behavior was largely contrast-invariant, contrary to the predictions of the RS encoding scheme, which could not distinguish response familiarity from changes in contrast. However, the monkeys9 behavioral patterns were well predicted by a linearly decodable variant in which the total spike count is corrected for contrast modulation. These results suggest that the IT neural activity pattern that best aligns with single-exposure visual familiarity behavior is not RS but rather "sensory referenced suppression (SRS)": reductions in IT population response magnitude, corrected for sensory modulation.
Back to peripheries based on remoteness. Human capital in the peripheral municipalities of South Bohemia

Abstract Peripheral municipalities are defined in the article based on their substantial time remoteness from higher settlement centres. Inside the catchment region of these centres, on the continuum: higher settlement centre – periphery, the zone of the remote peripheral municipalities, and zone of semi-peripheral and suburban municipalities can be distinguished. The human capital of municipalities in these zones is evaluated and compared subsequently in the article. This is necessary because the low human capital of peripheral municipalities is often due to their remoteness. In addition, the remoteness and low level of human capital require different mitigating and stimulating instruments and measures. The assumption of low level of human capital in peripheral municipalities can only be partially confirmed – only one third of the peripheral municipalities in South Bohemia report significantly unfavourable values of human capital indicators. The level of the human capital in some peripheral municipalities improves thanks to tourism, counter-urbanization, quality municipality management and government instruments and measures specified in the article.
Parameterized Pseudo-Differential Operators for Graph Convolutional Neural Networks

We present a novel graph convolutional layer that is fast, conceptually simple, and provides high accuracy with reduced overfitting. Based on pseudo-differential operators, our layer operates on graphs with relative position information available for each pair of connected nodes. We evaluate our method on a variety of supervised learning tasks, including superpixel image classification using the MNIST, CIFAR10, and CIFAR100 superpixel datasets, node correspondence using the FAUST dataset, and shape classification using the ModelNet10 dataset. The new layer outperforms multiple recent architectures on superpixel image classification tasks using the MNIST and CIFAR100 superpixel datasets and performs comparably with recent results on the CIFAR10 superpixel dataset. We measure test accuracy without bias to the test set by selecting the model with the best training accuracy. The new layer achieves a test error rate of 0.80% on the MNIST superpixel dataset, beating the closest reported rate of 0.95% by a factor of more than 15%. After dropping roughly 70% of the edge connections from the input by performing a Delaunay triangulation, our model still achieves a competitive error rate of 1.04%.
A machine learning risk score predicts mortality across the spectrum of left ventricular ejection fraction.

Aims Heart failure (HF) guideline recommendations categorize patients according to left ventricular ejection (LVEF). Mortality risk, however, varies considerably within each category and the likelihood of death in an individual patient is often uncertain. Accurate assessment of mortality risk is an important component in the decision-making process for many therapies. In this report, we assess the accuracy of MARKER-HF, a recently described machine learning-based risk score, in predicting mortality of patients in the three guideline-defined HF categories and its ability to distinguish risk of death for patients within each category. Methods and results MARKER-HF was used to calculate mortality risk in a hospital-based cohort of 4064 patients categorized into groups with reduced, mid-range, or preserved LVEF. MARKER-HF was substantially more accurate than LVEF in predicting mortality and was highly accurate in all three HF categories, with c-statistics ranging between 0.83 to 0.89. Moreover, MARKER-HF accurately discriminated between patients at high, intermediate and low levels of mortality risk within each of the three categories of HF used by guidelines. Conclusions MARKER-HF accurately predicts mortality in patients within the three categories of HF used in guidelines for management recommendations and it discriminates between magnitude of risk of patients in each category. MARKER-HF mortality risk prediction should be helpful to providers in making recommendations regarding the advisability of therapies designed to mitigate this risk, particularly when they are costly or associated with adverse events, and for patients and their families in making future plans.
Integration of Advanced Health Technology Within the Healthcare System to Fight the Global Pandemic: Current Challenges and Future Opportunities

The COVID-19 pandemic presents a significant challenge for providing adequate healthcare services in the context of patient isolation. DISCUSSION: The ability of our current healthcare system to cope with the current situation is mainly dependent on advanced health technology, such as telehealth, chatbots, virtual reality (VR), and artificial intelligence (AI). Telehealth can be a novel tool for improving our current healthcare system and allowing for greater delivery of healthcare services during global crises (i.e., the COVID-19 pandemic). Technology, such as chatbots, VR, and AI, could be utilized to reduce the burden of both communicable and noncommunicable diseases, as well as to build a patient-centered decision-making healthcare system. OBJECTIVES: Understanding the various methods of enhancing healthcare services using advanced health technology will help to develop new applications that can be integrated into regular healthcare and in time of healthcare crises. CONCLUSION: Advanced health technology is a main tool to face a pandemic that decreased the burden on physicians and patients as well as the entire healthcare system.
Thrombolytic Therapy for ST-Elevation Myocardial Infarction Presenting to non-Percutaneous Coronary Intervention Centers During the COVID-19 Crisis.

Purpose of review The purpose of this review is to offer a discussion on the existing data for the use of thrombolytic therapy for the treatment of ST-elevation myocardial infarction (STEMI) as well to present an evidence-based approach regarding the treatment for STEMI patients presenting to non-percutaneous coronary intervention (PCI)-capable hospitals during the ongoing COVID-19 pandemic. Recent findings There have been tremendous advances in the care of STEMI patients over the past two decades with primary (PCI) being the standard of care. However, many hospitals do not have interventional cardiology services available, and either have to expeditiously transfer patients for primary PCI, or use the strategy of fibrinolysis therapy with facilitated or rescue PCI. The current COVID-19 crisis has created an unprecedented paradigm shift with regard to the decision-making algorithm for STEMI patients especially in non-PCI-capable hospitals. Depending on regional transfer systems and potential delay in primary PCI, a strategy of thrombolysis first could be entertained at certain regional systems of care. The COVID-19 pandemic has caused a dramatic decline in the number of patient seeking care for myocardial infarction as well as a reduction in the accessibility of cardiac catheterization services. Regardless, professional societies continue to recommend PCI as the primary means of treatment for STEMI through the COVID-19 pandemic, and early multicenter data suggests the benefit of this therapy remains. Future research will be necessary and holds the key to proving this benefit persists beyond the immediate hospitalization time period both in the current era and in the context of possible future pandemics.
Iron-Storage Disorder Presenting as Chronic Diarrhea

The involvement of the endocrine pancreas leading to bronze diabetes is well studied. However, little is known about the pathophysiology of iron dysregulation involving the exocrine pancreas. We present a unique association between the exocrine pancreas and iron dysregulation. A 45-year-old female presented with chronic diarrhea and low fecal elastase indicative of pancreatic exocrine dysfunction. MRI of the abdomen/pelvis showed iron deposition in the pancreas, suggesting an associated iron-storage disorder without features suggesting chronic pancreatitis. Association of an iron-storage disorder with pancreatic exocrine dysfunction has been reported only in one other case report. Pancreatic exocrine dysfunction can be directly associated with an iron-storage disorder that involves the pancreas. This should be included in the differential and diagnostic work-up of chronic diarrhea of unclear etiology. Based on the literature, we have highlighted the potential pathophysiology relevant to the case.
Is There a Link Between Hormone Use and Diabetes Incidence in Transgender People? Data from the STRONG Cohort.

BACKGROUND Risk of type 2 diabetes mellitus (T2DM) in transgender and gender diverse (TGD) persons, especially those receiving gender affirming hormone therapy (GAHT) is an area of clinical and research importance. METHODS We used data from an electronic health record-based cohort study of persons 18 years and older enrolled in three integrated health care systems. The cohort included 2869 transfeminine members matched to 28,300 cisgender women and 28,258 cisgender men on age, race/ethnicity, calendar year, and site, and 2133 transmasculine members matched to 20,997 cisgender women and 20,964 cisgender men. Cohort ascertainment spanned 9 years from 2006 through 2014 and follow up extended through 2016. Data on T2DM incidence and prevalence were analyzed using Cox proportional hazards and logistic regression models, respectively. All analyses controlled for body mass index. RESULTS Both prevalent and incident T2DM was more common in the transfeminine cohort relative to cisgender female referents with odds ratio and hazard ratio (95% confidence interval) estimates of 1.3 (1.1-1.5) and 1.4 (1.1-1.8), respectively. No significant differences in prevalence or incidence of T2DM were observed across the remaining comparison groups, both overall and in TGD persons with evidence of GAHT receipt. CONCLUSION Although transfeminine people may be at higher risk for T2DM compared to cisgender females the corresponding difference relative to cisgender males is not discernable. Moreover, there is little evidence that T2DM occurrence in either transfeminine or transmasculine persons is attributable to GAHT use.
Ionic Mechanisms and Behavioral Functions of Presynaptic Facilitation and Presynaptic Inhibition in Aplysia: A Model System for Studying the Modulation of Signal Transmission in Sensory Neurons

During the last decade a variety of pharmacological and physiological studies have indicated that receptors to chemical transmitter substances are located not only on the cell body and dendrites, but also on presynaptic terminals of neurons (Fig. 1). The finding of receptors on presynaptic terminals is interesting and important for three reasons.
On the accuracy of high-order finite elements in curvilinear coordinates

The governing equations for shallow water flow on the sphere are formulated in generalized curvilinear coordinates. The various analytic expressions for the differential operators are all mathematically equivalent. However, numerical approximations are not equally effective. The accuracy of high-order finite element discretizations are evaluated using the standard test problems proposed by Williamson et al (1992). The so-called strong conservation formulation is far more accurate and results in standard error metrics that are at least two orders of magnitude smaller than the weak conservation form, Jorgensen (2003), Prusa and Smolarkeiwicz (2003). Moreover, steady state solutions can be integrated much longer without filtering when time-stepping the physical velocities.
Floaters and decreased vision as initial symptoms of acute lymphoblastic leukaemia

Patients might present to their eye care providers with minimal visual symptoms and no observable external physical signs, yet display ocular findings from potentially life‐threatening conditions t...
Hierarchical Markov Chain Monte Carlo (MCMC) for Bayesian System Reliability

Hierarchical models are one of the central tools of Bayesian analysis. They offer many advantages, including the ability to borrow strength to estimate individual parameters and the ability to specify complex models that reflect engineering and physical realities. Markov chain Monte Carlo (MCMC) is a set of algorithms that allow Bayesian inference in a variety of models. We illustrate hierarchical models and MCMC in a Bayesian system reliability example. Keywords: hierarchical model; system reliability; Markov chain Monte Carlo
Risk factors for early cytologic abnormalities after loop electrosurgical excision procedure

Abstract OBJECTIVE: To evaluate risk factors for early cytologic abnormalities and recurrent cervical dysplasia after loop electrosurgical excision procedure (LEEP). METHODS: A retrospective analysis was performed of all pathology records for LEEPs performed at our institution from January 1996 through July 1998. Follow-up cytology from 2 through 12 months after LEEP was reviewed. Patients with abnormal cytology were referred for further colposcopic evaluation. Statistical analysis using χ2 test for trend, proportional hazards model test, Fisher exact tests, and life table analysis were performed to identify risk factors for early cytologic abnormalities after LEEP and to determine relative risk of recurrent dysplasia. RESULTS: A total of 298 women underwent LEEP during the study period, and 29% of these had cytologic abnormalities after LEEP. Grade of dysplasia, ectocervical marginal status, endocervical marginal status, and glandular involvement with dysplasia were not found to be independent risk factors for early cytologic abnormalities. However, when risk factors were analyzed cumulatively, the abnormal cytology rate increased from 24% with no risk factors to 67% with three risk factors present (P = .037). Of patients with abnormal cytology after LEEP, 40% developed subsequent dysplasia, and the mean time to diagnosis was approximately 6 months. The relative risk of subsequent dysplasia ranged from a 20% increase to twice the risk if post-LEEP cytology was low-grade squamous intraepithelial lesion or high-grade squamous intraepithelial lesion, respectively. CONCLUSION: Based on these results, consideration should be given for early colposcopic examination of patients who have evidence of marginal involvement or endocervical glandular involvement with dysplasia. These patients are at increased risk for abnormal cytology and recurrent dysplasia. This initial visit should occur at 6 months, as the mean time to recurrence of dysplasia was 6.5 months.
Components of instruction toward a theoretical tool for instructional design

This article defines primary knowledgecomponents for entities, actions, andprocesses. It also defines primaryinstructional strategy components. It proposesthat a different combination of strategy andknowledge components is required for differentkinds of instructional goals. It furtherproposes that if these fundamentalstrategy-knowledge component combinations arenot present that there will be a decrement inthe student's effective and efficientacquisition of the desired knowledge and skill.It further proposes that the underlyingarchitecture of an instructional strategy is acombination of primary strategy components andprimary knowledge components appropriate for,and consistent with, a given instructionalgoal. Instructional components are a theoreticaltool. They are not a method or developmentprocedure. These instructional strategy andknowledge components can be imbedded in a widevariety of different instructionalarchitectures based on a variety of differentphilosophical orientations. It is hoped thatone of the primary benefits of instructionalcomponents is to provide a common vocabularythat will enable designers, theorists, andinstructional developers to more clearlydescribe their products and procedures.
On shock in premature children; preliminary report.

Summary. The author discusses the conflicting opinions which, from the literature (e.g. Ylppo, Peiper), appear to prevail in respect of the cause of death in the premature, or in the debile who die immediately after birth or during the “new-born period”. The hypothesis is advanced that the low condition which often precedes death for a longer or shorter period, is a state of shock. The clinical picture tallies well with that typical of shock. As, for various reasons, the special investigations usually made for the purpose of verifying the diagnosis of shock (e. g. examinations of the blood pressure and pulse, of changes in the erythrocyte concentration in the blood) cannot be employed in the case of the new-born and the premature, the author has tried to find support for the shock hypothesis in the anatomical findings. In autopsies on the premature the most typical and constant finding is a strong macroscopic and microscopic hyperaemia in the liver, and, usually, extremely wide intra-acinous capillaries. Other internal organs also exhibit at times, but by no means regularly, a certain, but generally not high degree of hyperaemia. Thus the anatomical findings appear to support the shock hypothesis. The physiological hemoconcentration which makes its appearance during the period immediately after birth in the full-term newborn — as also in the premature — speaks in favour of there being a special disposition to shock during the “new-born period”. A number of anatomical data from the literature can also be adduced to support the assumption of a functional inferiority or deficient development of the capillary system in the premature, likely to favour the appearance of shock. Finally, a short description is given of some therapeutic experiments with suprarenal cortex hormone in cases of lowered conditions in the premature. These experiments have exhibited promising results and will be continued.
The boundless spaces of expanded multimedia

Back in 1970 Gene Youngblood published his book “Expanded Cinema”, undoubtedly one of the major milestones in the world of media theory. In the book he argues that during the late 1960 cinema and the whole complex of audiovisual media, reached a tipping point when the boundaries of the world of moving images broke down and a new visual reality emerged. That was the time when the videosphere appeared and the intermedia where born. Today, forty years later, we see another, somewhat similar event. The intermedia, which in the meantime evolved in multimedia, reached another “Seldon crisis point”, and we can witness how the whole complex of multimedia creation, processing, distribution and consumption is undergoing a radical change. That change shall profoundly modify the world of mass media communications. The boundaries that until now separated different mass media are becoming progressively blurred and in a not so distant future they might completely disappear creating thus just one big media industry. In a surrogate social environment lonely media consumers will exchange interaction for communication and try to escape the harsh reality by immersing themselves in infinite virtual worlds of the boundless expanded multimedia.
Total cardiac output response during four minutes of exercise.

Abstract Cardiac output was monitored continuously during 4 minutes of steady-state exercise in 34 human subjects, of whom 16 were normal volunteers, 9 had heart disease with a cardiac index within normal limits during the fourth minute of exercise, and 9 had subnormal levels of cardiac output during the same period of timed exercise. The linear flow velocity in the ascending aorta was computed using the time derivative of the aortic pressure as the input to a circuit providing approximate solution to a modification of the Navier-Stokes equation. The proportionality constant necessary to express the output as volume flow was derived by comparison of the integral of the flow curves in systole with a simultaneously determined cardiac output by the Fick or dye dilution methods with the subject at rest. The cardiac output was examined each 30 seconds throughout the 4 minute period of exercise as a percentage of the level attained during the fourth minute. Striking differences between the three groups were seen 30 seconds after the start of exercise. The normal subjects had achieved 88.4 per cent of the maximal level at 30 seconds. The patients with a subnormal steady-state cardiac output had achieved only 77.9 per cent of their final value at this time while the patients with normal steady state levels were intermediate at 30 seconds. The differences in the groups were still present but diminished at one and two minutes of exercise. The output was cumulated for the entire four minute exercise period in each patient and plotted as a function of work load (i.e., 3 to 4 minute V O 2 ). Considered in this manner, a wide separation of the patients with low steady-state cardiac output and the normal subjects was achieved without overlap. These data suggest that patients with a subnormal cardiac output during the steady state phase of exercise tend to increase their cardiac outputs more slowly in response to a given exercise than do normal subjects or patients with less severe heart disease.
Characteristics of Sleep Disturbance in Patients with Carpal Tunnel Syndrome

Background Sleep disturbance is common in carpal tunnel syndrome (CTS), and we hypothesize that it has an important impact on the quality of life of CTS patients. The characteristic of sleep problems associated with CTS has not been evaluated.
The X-Ray Afterglow of Dark GRB 970815: A Common Origin for Gamma-Ray Bursts and X-Ray Flashes?

GRB 970815 is a well-localized gamma-ray burst (GRB) detected by the All-Sky Monitor (ASM) on the Rossi X-Ray Timing Explorer (RXTE) for which no afterglow was identified despite follow-up ASCA and ROSAT pointings and optical imaging to limiting magnitude R > 23. Although an X-ray source, AX/RX J1606.8+8130, was detected just outside the ASM error box, it was never associated with the GRB because it was not clearly fading and because no optical afterglow was ever found. We recently obtained an upper limit for this source with Chandra that is at least a factor of 100 fainter than the ASCA detection. We also made deep optical observations of the AX/RX J1606.8+8130 position, which is blank to limits V > 25.2 and I > 24.0. In view of these extreme limits, we conclude that AX/RX J1606.8+8130 is indeed the afterglow of GRB 970815, which corresponds to an optically "dark" GRB. AX/RX J1606.8+8130 can therefore be ruled out as the counterpart of the persistent EGRET source 3EG J1621+8203. The early light curves from BATSE and the RXTE ASM show spectral softening between multiple peaks of prompt emission. We propose that GRB 970815 might be a case in which the properties of an X-ray flash and a "normal" GRB coincide in a single event.
The Use of Psychoactive Medications in Children with Cancer

Serious psychopathology is sometimes encountered in the prolonged treatment of childhood cancer. The child psychiatrist is asked to see children who have not responded to other psychotherapeutic interventions, including individual therapy, family therapy, play therapy, hypnosis, and relaxation techniques. Often, psychoactive medications are required to treat anxiety, depression, pain, and psychotic-organic brain syndromes. In general, the most familiar psychoactive medication, prescribed at the minimal effective dose, should be used for short-term relief of symptoms. Psychoactive medications may be most useful in conjunction with other forms of therapy. Consideration of the child's physically compromised status is essential, as is a knowledge of the potential toxic effects of psychoactive medications. The psychiatric consultation is an increasingly important environment in which to explore the relationship between the biomedical and psychosocial aspects of behavior.
Right heart catheterization measuring central hemodynamics in cystic fibrosis during exercise.

Summary Background Although pulmonary arterial hypertension (PAH) is a potential co-morbidity in cystic fibrosis (CF), right heart catheterization (RHC) is not commonly performed in this patient population until referral for lung transplantation. Material and methods An non-randomized observational pilot study was performed after an exercise protocol with an upright stationary bicycle was added to RHC performed in patients with CF undergoing evaluation for lung transplantation (LT). Results Twelve consecutive patients with advanced lung disease due to CF referred for LT completed RHC with exercise protocol. Transthoracic echocardiography (TTE) prior to the RHC did not identify evidence of PAH or significant structural abnormalities; right and left ventricular systolic function were normal. non-randomized RHC in this same cohort found 75% (9/12) had PAH with an elevation of the mean pulmonary artery pressure (PAP) at rest with a mean (±SD) of 27.8 ± 4.9 mmHg that significantly increased during exercise to 47.2 ± 5.4 mmHg, p = 0.0025. For the last 6 patients, pulmonary vascular resistance was calculated during exercise, with a significant increase from 3.15 ± 0.3 to 12.8 ± 0.6 Wood Units (p = 0.0313) comparing measurements at rest to exercise. Conclusion RHC at rest and during exercise was safely and effectively performed in patients with CF referred for LT. Furthermore, central hemodynamic measurements found significant worsening of PAH during exercise in a small cohort of CF patients with advanced lung disease.
Hard Metal-Induced Disease: Effects of Metal Cations in Vitro on Guinea Pig Isolated Airways☆

Abstract Inhalation of dust from hard metal (HM), a mixture of tungsten carbide, cobalt, and other metals, can cause interstitial alveolitis, fibrosis, and asthma in the workplace. Some effects of HM could occur after the metals dissolve in the lung. We examined whether chloride salts of metals in HM alloys can elicit responses or modify reactivity to methacholine (MCh) or responses to electric field stimulation (EFS) in guinea pig tracheal strips. In unstimulated strips, Co 2+ , Cd 2+ , and Ni 2+ evoked contractions (>3 × 10 −6 M), while Ta 5+ , Zn 2+ , Cr 2+ , and Cr 3+ caused weak relaxations (>10 −5 M). In strips contracted with MCh (3 × 10 −7 M), Co 2+ and Ni 2+ also caused relaxation in lower concentrations while the other metals caused weak relaxation only in high concentrations (>10 −4 M). The metals were generally without effect on reactivity to MCh, except that Cd 2+ inhibited and Ni 2+ potentiated some responses. The effects of selected metals (10 −6 M; Cr 3+ , Ni 2+ , Cd 2+ , and Co 2+ ) on EFS-induced contractile and relaxant responses were examined (±MCh; ±10 −6 M indomethacin (Indo), 30 min). No metal had any effect on the excitatory nonadrenergic, noncholinergic-mediated contraction phase. Cd 2+ and Ni 2+ inhibited cholinergically mediated contractions of unstimulated strips (+Indo), whereas Cr 3+ both inhibited (−MCh, −Indo) and potentiated (−Indo,+MCh; +Indo, +MCh) contractile responses. Cr 3+ was the only metal to inhibit the inhibitory nonadrenergic, noncholinergic-mediated relaxation phase (±MCh; −Indo). Co 2+ had no effect at all. The results suggest that smooth muscle tone and nerves in the airways could be targets of cationic metals after they dissolve in the lung.
The Monoamine Neurons of the Rat Brain Preferentially Express a Splice Variant of α1B Subunit of the N-Type Calcium Channel

The N-type voltage-dependent calcium channels play a significant role in neurotransmitter release. The alpha1B subunit of the N-type calcium channel functions as the primary subunit that forms the pore and contains the structural motifs that mediate the pharmacological and gating properties of the channel. We report on an isoform of the alpha1B subunit that is preferentially expressed by the monoaminergic neurons of the rat brain. This isoform contains a 21-amino acid cassette in the synprint site present in the cytoplasmic loop between domains IIS6 and IIIS1. RT-PCR of micropunched tissue was used to show preferential expression of this isoform in regions of the brain containing monoaminergic neurons and to a lesser extent in the cerebellum. Double-label in situ hybridization was used to show expression of this isoform mRNA in dopaminergic neurons of the ventral mesencephalon. The expression of two distinct N-type calcium channels containing these alpha1B subunit isoforms by the monoaminergic neurons may provide for synapse-specific regulation of neurotransmitter release.
A Robust Algorithm for the Detection of Vehicle Turn Signals and Brake Lights

Robust and lightweight detection of alert signals of front vehicle, such as turn signals and brake lights, is extremely critical, especially in autonomous vehicle applications. Even with cars that are driven by human beings, automatic detection of these signals can aid in the prevention of otherwise deadly accidents. This paper presents a novel, robust and lightweight algorithm for detecting brake lights and turn signals both at night and during the day. The proposed method employs a Kalman filter to reduce the processing load. Much research is focused only on the detection of brake lights at night, but our algorithm is able to detect turn signals as well as brake lights under any lighting conditions with high accuracy rates.
Competitive bidding with entry costs

Abstract This paper presents a simple model of competitive procurement, in which potential bidders incur non-recoverable resource costs in preparing bids. The main findings are that equilibrium entry achieves a welfare optimum but that expected procurement cost need not decline with increases in the number of potential bidders.