cssi/SciSciGPT-SciSciNet huggingface dataset:
How important is disclosing surgeon experience when obtaining informed consent

Introduction The medical community has long debated the importance of disclosing surgeons' volumes/outcomes. Legal decisions are mixed on whether surgeons must disclose their volumes/outcomes when obtaining informed consent. We conducted surveys: (1) to determine what types of information, including a surgeon's volumes/outcomes, are essential for patients deciding whether to have surgery and (2) to compare patients' and surgeons' attitudes. Methods 85 attending surgeons and 383 adult post-operative outpatients completed surveys. Using a 6-point Likert scale (1 = completely unimportant, 6=extremely important, a patient could not decide without this information), participants rated the importance of discussing 16 types of information preoperatively for a hypothetical partial hepatectomy. Results For patients, the single most important type of information was whether the surgeon would be performing the procedure for the first time (mean Likert score 5.81). 79% considered this information essential to decision making. The second most important category of information to patients was their surgeon's volumes/outcomes, after risks/benefits (mean Likert scores 5.53 and 5.73 respectively, Wilcoxon signed-rank test p=0.0002). Around two-thirds of patients considered their surgeon's volumes/outcomes essential to decision making, while only one-quarter to one-third of surgeons considered this information essential (Pearson's chi-squared p Conclusions A large majority of patients placed great importance on surgeon experience, including their surgeon's volumes/outcomes and whether their surgeon would be performing the procedure for the first time. Fewer surgeons considered this information essential to patients. To promote informed decision making and patient autonomy, surgeons should discuss these topics with patients preoperatively.
Pathology of T-Cell Lymphomas: Diagnosis and Biomarker Discovery

T-cell lymphomas are a group of predominantly rare hematologic malignancies that tend to recapitulate different stages of T-cell development, in a similar way that B-cell lymphomas do. As opposed to B-cell lymphomas, the understanding of the biology and the classification of T-cell lymphomas are somewhat rudimentary, and numerous entities are still included as ‘provisional categories’ in the World Health Classification of hematolopoietic malignancies. A relevant and useful classification of these disorders have been difficult to accomplish because of the rarity nature of them, the relative lack of understanding of the molecular pathogenesis, and their morphological and immunophenotypical complexity. Overall, T-cell lymphomas represent only 15 % of all non-Hodgkin lymphomas. This review is focused on addressing the current status of the categories of mature T-cell leukemias and lymphomas (nodal and extranodal) using an approach that incorporates histopathology, immunophenotype, and molecular understanding of the nature of these disorders, using the same philosophy of the most recent revised WHO classification of hematopoietic malignancies.
Recombinant TIGR/MYOC Increases Outflow Resistance in the Human Anterior Segment

PURPOSE. To determine the effect of human recombinant TIGR/myocilin (MYOC) protein on outflow resistance in the human anterior segment. METHODS. A cDNA for MYOC was inserted into a bacterial expression system and purified with nickel ion affinity chromatography. The anterior segments of 12 pairs of human eyes were placed in perfusion organ culture. One eye received an anterior chamber exchange with partially purified recombinant MYOC (25 mg), whereas the other eye received either heat-denatured recombinant MYOC (25 mg), partially purified b-galactosidase (25 or 250 mg), or partially purified control proteins isolated from a null expression lysate (25 mg). Eyes were fixed up to 72 hours after infusion, and immunohistochemistry was performed using anti-MYOC polyclonal antibody. RESULTS. Recombinant MYOC caused an increase in IOP over 12 hours, increasing outflow resistance 94%, whereas the fellow eye infused with null expression sample increased 12% (n 5 7; P 5 0.0005). When compared with recombinant MYOC, neither heat-denatured MYOC, recombinant b-galactosidase, bovine serum albumin, nor fetal calf serum caused an increase in outflow resistance. MYOC IOP remained above baseline levels for 48 to 72 hours. Immunohistochemistry results confirmed the presence of recombinant MYOC in the trabecular meshwork. CONCLUSIONS. Recombinant MYOC increased outflow resistance in human anterior segments, whereas control proteins did not. MYOC may increase outflow resistance by specific interactions within the trabecular meshwork. (Invest Ophthalmol Vis Sci. 2000;41:4163‐ 4168)
Armed and Dangerous: Tort Liability for the Negligent Storage of Firearms

Overwhelming evidence shows that high percentages of American gun owners negligently store their firearms, leaving them easily accessible to unauthorized, dangerous users. Public health studies show that millions of guns are kept loaded and unlocked. More than 50 percent of all handguns are stored unlocked. Ammunition is stored unlocked in between 30–40 percent of gun-owning households. Millions of children live in homes with loaded, unlocked firearms. The author has argued in other articles for safe gun storage laws as a way to reduce accidental shootings, adolescent suicides, and intentional third-party shootings tied to stolen guns. This article makes a case that unsafe firearm storage constitutes an unreasonable risk and is negligent conduct under universally accepted principles of tort law.
Youth access to JUUL online: eBay sales of JUUL prior to and following FDA action

Background The novel e-cigarette product JUUL has experienced rapid market growth. The online auction site eBay has been mentioned as a source of JUUL access for youth, and the US Food and Drug Administration (FDA) notified eBay to remove JUUL listings in April 2018. We sought to characterise the sale of JUUL products on eBay prior to the FDA’s request, document the impact of this request and explore ways in which eBay vendors bypassed this effort. Methods eBay was searched for JUUL-branded products sold by US vendors in March 2018, yielding a sample of 197 listings for devices and/or pods. Each listing was coded for product, listing and youth access content. Following FDA action, each listing was revisited to determine its status, and each vendor’s page was searched for JUUL and other vaping content. Data were analysed using descriptive statistics. Results Of 197 eBay listings, 189 were for JUUL kits and 13 were for pods. Prices were on average higher than those on the official JUUL store, and language about age restrictions was rare. Following FDA contact, most listings were no longer active. However, 3.4% of these vendors still sold JUUL devices or pods and 15.5% were selling other vaporisers or nicotine products. Conclusions Online platforms may lack the will or expertise to effectively monitor content for tobacco products, while vendors quickly adapt to minor changes with simple strategies such as spelling variations. Accurate identification of online e-cigarette vendors is essential to the enforcement of policy and may benefit from cross-sector partnerships.
Data-Loop-Free Self-Timed Circuit Verification

This paper presents a methodology for formally verifying the functional correctness of self-timed circuits whose data flows are free of feedback loops. In particular, we formalize the relationship between their input and output sequences. We use the DE system, a formal hardware description language built using the ACL2 theorem-proving system, to specify and verify finite-state-machine representations of self-timed circuit designs. We apply a link-joint paradigm to model self-timed circuits as networks of computations that communicate with each other with protocols. Our approach exploits hierarchical reasoning and induction to support scalability. We demonstrate our methodology by modeling and verifying several data-loop-free self-timed circuits.
Inhibition of Calcium/Calmodulin-Dependent Protein Kinase Kinase β Is Detrimental in Hypoxia⁻Ischemia Neonatal Brain Injury.

Neonatal hypoxia–ischemia (HI) is a major cause of death and disability in neonates. HI leads to a dramatic rise in intracellular calcium levels, which was originally thought to be detrimental to the brain. However, it has been increasingly recognized that this calcium signaling may also play an important protective role after injury by triggering endogenous neuroprotective pathways. Calcium/calmodulin-dependent protein kinase kinase β (CaMKK β) is a major kinase activated by elevated levels of intracellular calcium. Here we evaluated the functional role of CaMKK β in neonatal mice after HI in both acute and chronic survival experiments. Postnatal day ten wild-type (WT) and CaMKK β knockout (KO) mouse male pups were subjected to unilateral carotid artery ligation, followed by 40 min of hypoxia (10% O2 in N2). STO-609, a CaMKK inhibitor, was administered intraperitoneally to WT mice at 5 minutes after HI. TTC (2,3,5-triphenyltetrazolium chloride monohydrate) staining was used to assess infarct volume 24 h after HI. CaMKK β KO mice had larger infarct volume than WT mice and STO-609 increased the infarct volume in WT mice after HI. In chronic survival experiments, WT mice treated with STO-609 showed increased tissue loss in the ipsilateral hemisphere three weeks after HI. Furthermore, when compared with vehicle-treated mice, they showed poorer functional recovery during the three week survival period, as measured by the wire hang test and corner test. Loss of blood–brain barrier proteins, a reduction in survival protein (Bcl-2), and an increase in pro-apoptotic protein Bax were also seen after HI with CaMKK β inhibition. In conclusion, inhibition of CaMKK β exacerbated neonatal hypoxia–ischemia injury in mice. Our data suggests that enhancing CaMKK signaling could be a potential target for the treatment of hypoxic–ischemic brain injury.
Adaptive control for the IOS adaptive optics system

Future adaptive optics systems will require advanced predictive control algorithms that mitigate loop latency by forecasting disturbances. In many applications, such as laser communications terminals, synthesizing such controllers is challenging due to the non-stationary nature of the disturbance statistics over long periods. We present initial experimental results using a new, multichannel, adaptive control algorithm applied on the Integrated Optical System, an extreme AO system under development for the Laser Communications Relay Demonstration. The adaptive controller implicitly tracks disturbance statistics, and provides broadband wavefront control without the need for open loop downtime. The results illustrate the improved disturbance rejection capabilities of the controller compared to a traditional integrator, even when the exogenous disturbance statistics evolve.
PayFlow: Micropayments for Bandwidth Reservations in Software Defined Networks

We present PayFlow, a fine-granularity QoS micro-payment system that allows end devices in a software-defined network to make and pre-pay for guaranteed bandwidth reservations for their flows within the network for an arbitrary period of time. PayFlow combines payments using digital currency and storage of transaction records in a distributed ledger with queue-based QoS management using software-defined networks. While the PayFlow architecture is agnostic to the choice of digital currency, ledger technology and SDN platform used, we present a proof of concept implementation of PayFlow using OpenFlow and the IOTA cryptocurrency and distributed ledger, that we evaluate using the Mininet emulator.
Laparoscopy assisted ventriculoperitoneal shunt placement in children

Abstract Background Placement of ventriculoperitoneal shunts (VPS) can be challenging in children with previous VPS, previous abdominal surgery, or complex abdominal pathology. Laparoscopy can help identify intra-abdominal adhesions and determine the optimal site for insertion of the distal VPS catheter. We analyzed the feasibility and safety of laparoscopy assisted VPS placement (lapVPS) in children. Methods A retrospective review from January/2015 to December/2018 was performed. Laparoscopy was performed via a 5 mm trans-umbilical port. Once the optimal entry site was identified, the distal end of the VPS was inserted by Seldinger technique under direct laparoscopic guidance. Results One hundred ten lapVPS procedures were reviewed. Median age was 1 (IQR 0.3–9.37) year. Fifty-five (50%) patients were Conclusion Laparoscopy is a valuable tool to assess the suitability of the peritoneal cavity to accommodate a VPS. LapVPS is safe and can be performed in children of all ages. Level of Evidence Level IV.
Distributed Data Fusion for On-Scene Signal Sensing With a Multi-UAV System

This article presents an algorithmic framework for distributed data fusion using a network of multiple unmanned aerial vehicles (UAVs). Each UAV in the network is capable of sensing signals, performing computational tasks, and exchanging information with its immediate neighbors. Based on the limited local measurement and exchanged information only from neighbors, we aim to propose a fully distributed algorithm to integrate information from various measurements of individual UAVs. As an important building block of the distributed data fusion algorithm, a novel sum consensus scheme is also developed with only assuming row-stochastic weight matrices. Consequently, through the proposed distributed algorithm, each UAV is able to obtain a more reliable fused sensing result with higher accuracy, compared to the local measurement collected by the UAV itself. The effectiveness of the proposed algorithmic framework is validated by both theoretical analysis and numerical simulations.
Pseudosymmetric layers in high-Z′ and P1 structures of organic molecules

Layers having obvious approximate symmetry higher than that of the overall 3-D crystal are present in 20–25% of the Z′ > 4 and P1 organic structures archived in the Cambridge Structural Database (Groom et al., Acta Crystallogr., Sect. B: Struct. Sci., Cryst. Eng. Mater., 2016, 72, 171–179). Such layers were found in 72 of ca. 300 organic structures having more than four crystallographically independent formula units. In roughly a third of the 72 the approximate layer symmetry is broken by offsets perpendicular to the layer normal. In another third some of the independent layers are related by a local rotation, glide, or inversion operation. In the final third there are two or more layer types that differ in packing arrangement, pattern of strong interactions (e.g., H bonds), or even composition. If layers are related by simple offsets only, symmetry lowering could have taken place after crystal nucleation, perhaps as a consequence of cooling. If, however, alternating layers differ substantially in arrangement or orientation then the pattern would have had to be established at the time of nucleation. Layers of obvious approximate symmetry were also found in 136 members (22%) of a validated subset containing 615 (43%) of the 1422 (as of May 2019) organic, P1, 2 ≤ Z′ ≤ 4 structures having R ≤ 0.050. The layers in 129 of the 136 are related by a simple shift, which is the only possibility if Z′ = 2 or if the order of the approximate layer group is four. For those 129, a modulation during crystal growth or cooling probably lowered the symmetry of the original crystal nucleus.
Data-Driven Predictive Flexibility Modeling of Distributed Energy Resources

The potential of distributed energy resources (including, flexible electrical loads) in providing grid services can be maximized with the recent advancements in demand side control. Effective coordination of the flexible loads for grid services, while satisfying end-user preferences and constraints, requires the knowledge of aggregated predictive flexibility of the distributed energy resources (DERs). Recent works have shown that the aggregated predictive flexibility of DERs can be modeled as a virtual battery (VB) whose state evolution is governed by a first-order dynamics including self-dissipation rate and energy capacity. Identifying the VB model parameters for a collection of DERs, however, is challenging primarily due to the following reasons: (1) the composition of DERs is time-varying and uncertain, with the device availability determined by uncertain end-user behavior, (2) the underlying device models and parameters are mostly unknown and uncertain, and (3) lack of available behind-the-meter sensing and measurements (partly due privacy concerns). As such, data-driven deep learning based frameworks have been proposed in this work to identify aggregated predictive flexibility models of a collection of DERs, using front-of-the-meter data (such as net power consumption, etc.). The effectiveness of the proposed frameworks is demonstrated on an ensemble of residential air conditioners and electric water heaters.
Stress Testing, Nuclear Imaging, CT Angiography, and Cardiac MRI

Non-invasive imaging plays a pivotal role in modern-day medicine from diagnosis to management of disease. It is crucial to have a solid understanding of the various indications and limitations of these techniques to be able to best utilize the different modalities in risk assessment and clinical decision-making. Through this chapter, we will go through the fundamentals of the different modalities and selection of an image modality based on the disease being investigated and individual patient characteristics. A multimodality approach to patient evaluation is needed more times than not, and it is important to choose modalities that complement each other rather than repeating the same evaluation.
Pseudo-subarachnoid hemorrhage and gadolinium encephalopathy following lumbar epidural steroid injection.

Abstract Patients with imaging findings concerning for subarachnoid hemorrhage, however, with no evidence of hemorrhage following autopsy or cerebrospinal fluid testing are diagnosed with having pseudo-subarachnoid hemorrhage. A 73-year-old female presented to the emergency department with altered mental status one day after undergoing a lumbar epidural steroid injection at an outside hospital; a noncontrast computed tomography scan of the head revealed evidence of diffuse hyperdensity within the subarachnoid space concerning for subarachnoid hemorrhage. The patient underwent magnetic resonance imaging which demonstrated diffuse opacification of the cerebrospinal fluid spaces with gadolinium and the diagnoses of pseudo-subarachnoid hemorrhage and gadolinium encephalopathy were made. The combination of the neurologic symptoms related to gadolinium encephalopathy and the radiographic findings of pseudo-subarachnoid hemorrhage can create a clinical presentation nearly identical to ruptured aneurysmal subarachnoid hemorrhage. Patient history, magnetic resonance imaging findings, and temporal changes in computed tomography provide vital tools in establishing a diagnosis of pseudo-subarachnoid hemorrhage, especially after an iatrogenic intrathecal contrast administration.
Three-dimensional bluff evolution in response to seasonal fluctuations in Great Lakes water levels

Abstract Effects of lake level fluctuations on coastal bluff erosion in the Great Lakes are pervasive and of significant concern to policy-makers and property owners. Previous studies of bluff erosion have primarily estimated two-dimensional bluff recession rates over years to decades. However, bluff erosion is an irregular process in time and space so averaging coarse resolution observations over long time periods may neglect important processes driving erosion. To address this we use photogrammetric surveys of a Lake Michigan bluff to create four high resolution (10 cm) digital elevation models (DEMs) that span one year with images collected from small unoccupied aerial systems (sUAS). The elevation models were differenced to compare variations in sediment loss to modelled time-series of wave data, atmospheric temperature and lake level. The sub-annual erosion rates calculated from sUAS surveys were compared to long-term recession rates obtained by digitizing historic aerial imagery. The rate of erosion of the bluffs is a time dependent function of two factors: (1) the supply of sediment to lower regions on the bluffs from mass wasting and (2) increased wave erosion resulting from above-average lake levels and intensified onshore wave energy. These factors combine in the early spring when wave energy is elevated and atmospheric temperatures increase, causing reduction in bluff sediment strength by thawing, as well as an increase in porewater pressure from snow melt. Most importantly, above-average lake levels sustained in the longer term (multiple years) are required for the combination of (1) and (2) to result in substantial bluff erosion.
Academic Satisfaction and Career Preparedness: An Exploratory Study on the Perceptions of Construction Management Graduates

When students graduate from higher education, their objective is to gain employment in a field of study where they can utilize the skills they have obtained. Many Construction Management programs are designed to encompass within four years, as much academic knowledge and training pertaining to the construction industry the program is designed around. However, there is often a disconnect between what is taught in the curriculum and the skills that is valued in the workplace. Many higher education programs want to know whether their program provides the necessary skills for their students’ success. Students’ satisfaction is one major indicator of their success and by conducting a survey of the students’ satisfaction level in relation to their education and job, programs often define areas that need improvement so they can create the best possible learning environment for the students. The objective of this research is to discover whether the Construction Management program is meeting the needs of its students. With this knowledge, the Construction Management program can address the areas that may require further development, making the program more satisfying for current and future students.
Towards Private Data-driven Control

Control as a Service (CaaS) is becoming a reality– particularly in the case of building automation and smart grid management. Often, the control algorithms in CaaS focus on controlling the client’s system directly from input-output data, since the system’s model might be private or unavailable. Therefore, large quantities of data collected from the client need to be uploaded to a cloud server. This data can be used by a malevolent cloud service provider to infer sensitive information about the client and mount attacks. In this paper, we co-design a solution that interlaces control and privacy. Our goal is to perform online data-driven control on encrypted input-output data, while maintaining the privacy of the client’s uploaded data, desired setpoint and control actions. We design our control algorithm based on results from the behavioral framework, which is more encryption-friendly compared to other classical frameworks. We obtain privacy by using a leveled homomorphic encryption scheme to enable the cloud to perform complex computations on the client’s encrypted data. Finally, we achieve efficiency by manipulating the tasks required by the control algorithm such that they only involve arithmetic circuits, as well as by leveraging parallelization and ciphertext packing.
The Impact of Multiple Sclerosis Disease Status and Subtype on Hematological Profile

Multiple sclerosis (MS) is an immune-mediated, demyelinating disease of the central nervous system. In this study, an MS cohort and healthy controls were stratified into Caucasian and African American groups. Patient hematological profiles-composed of complete blood count (CBC) and complete metabolic panel (CMP) test values-were analyzed to identify differences between MS cases and controls and between patients with different MS subtypes. Additionally, random forest models were used to determine the aggregate utility of common hematological tests in determining MS disease status and subtype. The most significant and relevant results were increased bilirubin and creatinine in MS cases. The random forest models achieved some success in differentiating between MS cases and controls (AUC values: 0.725 and 0.710, respectively) but were not successful in differentiating between subtypes. However, larger samples that adjust for possible confounding variables, such as treatment status, may reveal the value of these tests in differentiating between MS subtypes.
The Utility of Inpatient Electromyography/Nerve Conduction Studies: Quality Over Quantity Saves Quite a Quota (134)

Objective: To predict the utility of changing inpatient management with EMG/NCS by admission criteria, EMG/NCS indication, duration of symptoms prior to testing, presence of artifacts, and location of testing. Background: Inpatient EMG/NCS cost more than outpatient studies at our center due to facility fees. Professional opinion suggests inpatient studies have more artifacts, are performed too early from symptom onset, and often are irrelevant to admission criteria, prompting this retrospective cross-sectional study. Design/Methods: Charts (n=83) were examined for admission criteria, EMG/NCS indication, duration of symptoms prior to EMG/NCS, location of testing, and presence of artifact (edema, 60 hertz interference, or cold limbs). “Change in management” occurred if medications were started/stopped, workup was broadened/narrowed, or early discharge occurred. Cost was compared with t-testing, and categorical variables were studied with Chi-Squared statistics. Results: Cost was less for outpatient EMG/NCS (μ=$124.69±$40.12) compared to inpatient tests (μ=$519.17±$174.37) statistically (T=1.98, p=1.6E-37). Matching indications for admission and EMG/NCS positively predicted change in management (OR=9.4,χ2=6.19, p=0.013). Presence of symptoms ≥3 weeks prior to testing positively predicted change in management (OR=3.7,χ2=4.99, p=0.025). Artifact was less likely with ward EMG/NCS than PCU/ICU testing (OR=0.18,χ2=5.15, p=0.023). The presence of artifacts did not negatively affect inpatient management (χ2=0.085, p =0.77), though studies were often repeated due to artifacts. Results of EMG/NCS being normal or abnormal favored abnormal tests changing inpatient management only slightly (OR=1.04,χ2=4.82, p=0.028). Conclusions: Inpatient EMG/NCS are more expensive than outpatient tests at our center. To optimize quality of data and chances of changing management, the admission criteria should match the EMG/NCS indication, the patient’s symptoms should be present for ≥3 weeks prior to testing, and testing should be performed in a ward to reduce artifacts. While artifacts did not statistically negatively impact changing inpatient management in this study, artifacts resulted in repeat testing. Neither normal nor abnormal testing predicted change in management appreciably over the other without appropriate clinical context. Disclosure: Dr. Miller has nothing to disclose. Dr. Bodkin has received research support from Mallinkrodt Pharmaceuticals, Alexion Parmaceuticals and Amicus therapeutics..
Effective Diffusivity Tensors of Point-Like Molecules in Anisotropic Porous Media by Monte Carlo Simulation

Monte Carlo simulations of random walks in anisotropic structured media are performed to determine the dependence of effective diffusivities on geometrical properties. The anisotropic media used in this study are periodic systems, which are generated by extending primitive, face-centered, and body-centered unit cells indefinitely in all axial directions. Results of simulations compare well with published experimental data and the calculations by the volume averaging method. In addition, these results suggest that if the 2D media with percolation thresholds subtantially differ from those of 3D, 2D approximations of 3D media are not satisfactory. When percolation thresholds are the same, the effective diffusivity tensors depend solely on the porosity. This fact has been suggested for isotropic media and it seems to hold for anisotropic media.
Computer-assisted analysis of flagellar structure.

Publisher Summary The identification of polypeptides as subunits of specific axonemal structures has arisen because of analysis of flagellar mutants of Chlamydomonas reinhardtii by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). This approach has been particularly useful in sorting out the complexity of the inner dynein arms. Methods such as cross-correlation analysis and rotational averaging of structures possessing ninefold axial-symmetry have been used to average transverse sections of insect sperm flagella. Averages of doublet cross sections have been obtained to make qualitative comparisons between inner and outer dynein arm mutants in Chlamydomonas . Described in this chapter are the steps involved in obtaining averages of axonemal components and the methods for making statistical comparisons between them. There is illustration of specimen preparation and electron microscopy. There is image analysis; the programs involve digitization, display, and quantitative analysis of images. The hardware used for the analysis includes a Dage MTI video camera. Images of axonemes containing outer doublets in cross section are found relatively quickly and easily in sections of pellets. Axonemes are chosen for analysis if they have a complete set of nine outer-doublet microtubules, an intact central pair, and protofilaments that are visible in at least one outer-doublet microtubule. The individual doublets at each position are aligned, averaged, and normalized, and statistical comparisons made to determine if there are doublet-specific differences in dynein structure in a mutant strain. There is analysis of longitudinal sections. Statistical comparisons of different samples are performed by a nested analysis of variance, using the sums of squared deviations computed from the means, standard deviations, and sample number for each individual sample, then test is done for the significance of differences in specified areas of the dynein arms or at each pixel in a given pair of images by taking into account the intra- and inter-sample variability.
On the role of the south Atlantic atmospheric circulation in tropical Atlantic variability

One dominant manifestation of tropical Atlantic variability (TAV) takes place in March-April-May in the form of a strong inter-hemispheric sea surface temperature gradient coupled to a cross-equatorial near surface atmospheric flow. The variability of this circulation pattern affects the position of the intertropical convergence zone and the regional climate in the surrounding areas. In this study, we investigated the effect of the South Atlantic atmospheric variability on this phenomenon. We found that southern summer atmospheric variability (and to a lesser extent winter variability) can play a preconditioning role in the onset of inter-hemispheric anomalies in the deep tropics during the following austral fall. It does so by inducing a sea surface temperature anomaly in the southern tropics that initiates local thermodynamic air-sea feedbacks. This remote influence of the Southern Hemisphere on TAV is contrasted with the remote influence of El Nino-Southern Oscillation (ENSO) and the North Atlantic Oscillation (NAO) during austral summer. The results suggest that to fully understand TAV and its predictability it is necessary to consider not only the remote influences from ENSO and NAO, but also the influence from the South Atlantic atmospheric circulation.
Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Part A: vitamins.

Even though in the Western world there is almost no limitation to a wide variety of food supply, nutritional deficiencies can be found in both normal-weight population and in the obese population. In this review, we examine the prevalence and manifestations of various mineral deficiencies in obese patients.
The effect of syntropan on the motor activities of the human gastrointestinal tract and on gastric acidity.

Summary 1.The effects of syntropan on the motor activities of the gastrointestinal tract of 63 patients and on the gastric acid secretion in 19 of them are described. 2.Its intravenous administration, in doses of 10–25 mg., decreased tonus and abolished waves for short periods of time in the stomach, duodenum, jejunum, ileum and colon, and also retarded transport of the balloon through the stomach and intestine. 3.No effect on the motor function of the intestine was demonstrated by subcutaneous injection or by intestinal infusion of the drug. 4.Undesirable side effects were encountered in all patients given the drug intravenously in doses of 10–25 mg., in 8 of 13 who received it subcutaneously in doses of 10–50 mg. 5.Equivocal results were obtained in a clinical trial of the. drug administered orally in 17 patients with roentgenological evidence of gastrointestinal hypermotility or spasm. Intraluminal infusion was not accompanied by any significant effect not obtained by the introduction of tap water. 6.No effects on the volume or acidity of the gastric secretion were observed.
Calculation of three dimensional permeance for structures containing nonlinear magnetic material

A method is presented for computing the upper and lower bounds to the permeance of three-dimensional electric machine regions containing nonlinear magnetic materials. Techniques for integrating the permeance integrals and for handling magnetic nonlinearity are described. Integrals that yield lower and upper bounds to the region permeance are derived from Ampere's and Gauss's laws. A parametric transformation is used to facilitate the calculation of the permeance. speed, accuracy, and the geometric insight into the field distribution make it useful for design analysis of electromechanical devices. >
Hints of R-parity violation in B decays into τν

In this article we show that the recently observed enhanced semi-leptonic and leptonic decay rates of the B meson into τν modes can be explained within the frame work of R-parity violating (RPV) MSSM. In particular, RPV contributions involving the exchange of right-handed down-type squarks can give a universal contribution to the B + → τν, B→Dτν and the B→D * τν decaysinthemodelwepropose. Wefindthatthemasses and couplings that explain the enhanced B decay rates are phenomelogically viable and the squarks can possibly be observed at the LHC.
Toxicity of Treated Seed Corn in Rations for Chicks

Abstract ORGANIC seed protectants are applied to nearly all commercially produced seed corn. Two such compounds are Arasan and Orthocide. These are known chemically as tetramethyl thiuram disulphide and N-trichloromethylthiotetra-hydrophthalimide. In practice it usually happens that the requirement for seed is overestimated. This leaves substantial dealer stocks which are often salvaged by sale as feed after washing to remove the protectant. The question of toxicity of stocks which escape washing then arises and inquiries on this point led to the investigation of the effect of Arasan and Orthocide on the growth of young chicks. The toxicity of dithiocarbamates, including tetramethyl thiuram disulphide was studied by Brieger and Hodes (1948) who found the LD 50 for rabbits to be 0.21 g./kg. of the latter compound. A release (1952) by the Committee on Pest Control states that Orthocide used as a wettable powder has a low order of toxicity for warm blooded animals… .
Parathyroid pathology in an intrathyroidal position

A systematic approach based on the embryology of the parathyroid glands should allow for the appropriate identification of both normal and abnormal glands at the time of parathyroidectomy. The exact role of subtotal thyroidectomy as part of this approach remains in question because of the low incidence of intrathyroidal adenomas reported in the past. From 1978 to 1992, 97 cervical explorations were performed in 96 patients (mean age: 56 years) with hyperparathyroidism. Four patients (4%) were found to have intrathyroidal parathyroid adenomas and were cured by ipsilateral partial or subtotal thyroid lobectomy on the side of a missing gland. One parathyroid adenoma completely replaced the right lobe of the thyroid, whereas two inferior and one superior intrathyroidal adenomas were found in the remaining three patients. The 4% incidence of intrathyroidal adenomas is higher than that reported in most series and suggests that this entity may be a more common cause of failed parathyroid explorations than is currently thought. Ipsilateral thyrotomy or subtotal thyroid lobectomy continues to be a potentially curative procedure for hyperparathyroidism when there is a missing and presumably diseased superior or inferior gland.
A neural set point for the long-term control of arterial pressure: beyond the arterial baroreceptor reflex.

Arterial baroreceptor reflex control of renal sympathetic nerve activity (RSNA) has been proposed to play a role in long-term control of arterial pressure. The hypothesis that the “set point” of th...
Emergency Department Patient Preferences for Boarding Locations When Hospitals Are at Full Capacity

Study objective Admitted patients are frequently boarded in emergency departments (EDs) when hospitals are at full capacity, which lessens the ED's ability to treat new patients. One alternative is to board admitted patients in inpatient hallways. We assess ED patient preferences for boarding location. Methods We surveyed adult ED patients during a 4-week period on preferences for boarding location. Patients were eligible if they were currently being admitted through the ED and had experienced at least 1 previous hospital admission to ensure knowledge of both the ED and inpatient locations. Patients were asked to choose whether they would rather board in an ED hallway or an inpatient hallway or whether they had no preference. Survey responses were hypothetical and did not affect care or bed placement. We tested whether patient demographics, survey location (ED room or ED hallway), admission service, timing to room placement, time to admission request, and time to survey administration were associated with survey responses. Results A total of 565 patients were approached; 87% consented to be interviewed. Of those consented, 88% of patients had been previously admitted, leaving 431 patients in the study group. A total of 64% (95% confidence interval [CI] 59% to 69%) had a preference for boarding location: 59% (95% CI 52% to 65%) preferred inpatient hallways and 41% (95% CI 35% to 48%) preferred ED hallways. Survey location, admission service, time to room placement, admission request, and survey administration were not associated with survey responses. Conclusion When hospitals are at full capacity, patients would rather board in inpatient hallways than ED hallways.
The Nitric Oxide Synthase Inhibitor l-NAME (Nω-Nitro-L-Arginine Methyl Ester) Does Not Produce Discriminative Stimulus Effects Similar to Ethanol.

N-methyl-D-aspartate (NMDA) antagonists substitute for the discriminative stimulus effects of ethanol, indicating that a component of ethanol's behavioral activity is produced via blockade of NMDA receptor/channel function. Recently, it has been reported that ethanol inhibits NMDA-stimulated nitric oxide synthase (NOS) activity in cortical neurons, thereby decreasing the formation of nitric oxide (NO) in the brain. These findings suggest that some of the behavioral effects of ethanol may be mediated by inactivation of NOS. The present study examined the role of NO formation in mediating the discriminative stimulus effects of ethanol. To address this hypothesis, an NOS inhibitor, N omega-nitro-L-arginine methyl ester (L-NAME) and an NMDA competitive antagonist, (D)-4-(3-phosphonoprop-2-enyl) piperazine-2-carboxylic acid (CPPene), were administered to two groups of rats trained to discriminate 1.5 g/kg of ethanol (n = 6) or 2.0 g/kg (n = 7) of ethanol from water. After training, dose ranges of CPPene (3 to 17 mg/kg, ip) and L-NAME (100 to 780 mg/kg, ip) were tested for ethanol-like effects. L-NAME was also tested under a range of pretreatment times (20, 60, 90, and 120 min). An additional group of rats trained to discriminate 2.0 g/kg (n = 7) of ethanol from water was also tested with CPPene (10 mg/kg, ip) and L-NAME (100 and 300 mg/kg, ip) to verify data gathered from the original 2.0 g/kg of ethanol group tested with L-NAME after a 20-minute pretreatment. Although overall, 17 of 20 animals trained to discriminate ethanol from water exhibited complete substitution of CPPene for ethanol, L-NAME, without affecting response rates, did not consistently substitute for either 1.5 g/kg or 2.0 g/kg of ethanol. These results indicate that inhibition of NO formation is less effective than direct NMDA receptor antagonism in producing ethanol-like discriminative stimulus effects.
Measuring stewardship in public relations: A test exploring impact on the fundraising relationship

Abstract Though scholars have explored the impact symmetrical relationship maintenance strategies from interpersonal and marketing communication in public relations contexts, they have largely ignored stewardship. Explicated by Kelly [Kelly, K. S. (2001a). Stewardship: The fifth step in the public relations process. In R. L. Heath (Ed.), Handbook of public relations (pp. 279–289). Thousand Oaks, CA: Sage] as a core component of the ROPES process of public relations, the “S” or stewardship proposes four elements that foster relationship growth when incorporated into organization's strategic efforts. This study created original scales to measure the impact of reciprocity, responsibility, reporting, and relationship nurturing in the fundraising setting. Results indicate that donors favor these strategies, and path analysis demonstrates they have significant impact on how donors evaluate the nonprofit organization–donor relationship.
Prevention of local recurrence after surgical debulking of nodal and subcutaneous melanoma deposits by hypofractionated radiation.

Background: Local recurrence (LR) after surgical debulking of nodal or subcutaneous melanoma deposits defeats the purpose of operation and may worsen prognosis if the procedure was performed for stage III disease. To decrease LR rates in this setting, we extended the previously described role of hypofractionated radiation for melanoma deposits of the neck to all situations where the patient was felt to be at high risk for postoperative relapse after resection of bulky disease. Methods: Hypofractionated external beam radiation was administered in 6-Gy doses for 5 fractions (total dose 30 Gy, given over a median of 15 elapsed days) to 42 resected melanoma deposit sites in 41 patients. Results: Stages of the 41 patients at the time of treatment were: 22 stage III and 19 stage IV. All patients had complete gross resection of disease at the radiation site before radiation. Mean time between operation and initiation of radiation was 4 weeks. The 42 sites of treatment included 27 neck, 9 axilla, 3 groin, and 3 subcutaneous deposits. There were no treatment-related deaths; side effects were minimal and self-limited. Transient erythema, desquamation, fibrosis, telangiectasias, and mucositis, parotiditis, and xerostomia (for head and neck radiation) were reported, but no patient required interruption of therapy for these events. Of the 42 treated sites, only 2 recurred in the treatment field (one neck, one axilla) during the mean follow-up time of 22.4 months, for a treatment failure rate of 4.8%. This represents improved local control compared with patients treated with surgery alone at our institution and with published recurrence rates. Conclusions: The addition of hypofractionated radiation therapy after resection of nodal and subcutaneous melanoma deposits at a variety of sites is a rapid and well-tolerated method of providing excellent local control.
Function word erosion which is not a frequency effect: On exemplars and prosodic paradigm levelling

The notion of ‘erosion’, a universal diachronic process affecting the phonetic content of certain language forms, has held a place in historical linguistics for almost two centuries now. Recently it has been argued that the erosion of high frequency words can be derived as a consequence of normal language use within a theory of phonology based on exemplars. Focusing on discrete changes to function words, this paper argues that types of erosion exist which cannot be derived in this manner. Instead, erosion as well as other less celebrated, but well attested, irregular changes to function words can be accounted for by a species of paradigm levelling. Prosodic paradigm levelling (PPL) is much like its familiar morphological cousin only it plays out over paradigms whose cells contain word forms selected for by prosodic, not morphological, features. While PPL can account for data which exemplar models cannot, it is maintained nevertheless that exemplar models can offer a reasonable account of much of the data, provided that the model incorporates a discrete level of phonological representation, in addition to exemplars. Arguments presented have implications for phonological representation in general, as well as for the explanation of discrete, irregular change to function words.
A usability evaluation of four commercial dental computer-based patient record systems

Background The usability of dental computer-based patient record (CPR) systems has not been studied, despite early evidence that poor usability is a problem for dental CPR system users at multiple levels.
Proofreading: A Must in Word Processing

(1976). Proofreading: A Must in Word Processing. The Journal of Business Education: Vol. 52, No. 2, pp. 60-63.
Quantum-defect parametrization of perturbative two-photon ionization cross sections

A multichannel quantum-defect theory (MQDT) parametrization of two-photon ionization (2PI) of atoms, suitable for use with ab initio calculations of perturbative 2PI amplitudes in the presence of intermediate- and/or final-state Rydberg resonances is developed. The rapid energy variation of such amplitudes is extracted in terms of elementary functions of energy and a set of MQDT parameters, which are ``smooth'' functions of energy. As an example, results of numerical computations of MQDT parameters for 2PI of atomic hydrogen (1s, 2s, and 3s) by circularly polarized light are presented. MQDT parameters for the many-channel case are derived, and an analysis of their energy dependence across Rydberg thresholds is given. The two-channel case is analyzed using phase-shifted Coulomb functions, and simple analytic formulas are given for the energy dependence of the amplitude as a function of a small set of physical parameters.
Clinical, hemodynamic, electrocardiographic, and vectorcardiographic observations in progressive muscular dystrophy of 34 years' duration

Abstract A 47-year-old man with proven muscular dystrophy was observed closely for 24 years after the initial diagnosis of his disease. X-ray films and electrocardiograms during this period revealed progressive abnormalities prior to the onset of the first clinical manifestations of congestive heart failure when he was 43 years old. During the period of congestive heart failure, catheterization of the right side of the heart revealed left ventricular failure. A vectorcardiogram confirmed the scalar electrocardiographic findings of severe, widespread myocardial disease. The sequence of clinical events in the 34-year course of this patient's disease, with particular attention directed to the cardiac manifestations, is described.