cssi/SciSciGPT-SciSciNet huggingface dataset:
Dyspnea in cancer patients: Etiology, resource utilization, and survival‐Implications in a managed care world

BACKGROUND Dyspnea is the fourth most common symptom of patients who present to the emergency department (ED) at The University of Texas M. D. Anderson Cancer Center and may, in some patients with advanced cancer, represent a clinical marker for the terminal phase of their disease. This retrospective study describes the clinical characteristics of these patients, the resource utilization associated with the management of dyspnea, and the survival of patients with this symptom. METHODS The authors randomly selected 122 of 1068 patients presenting with dyspnea for a retrospective analysis. The median age of the patients was 58 years (range, 23-90 years) and 53% were female. Underlying malignancies were breast cancer (30%), lung cancer (37%), and other cancers (34%). Approximately 94% of the patients had received prior cancer treatment and the majority (69%) had uncontrolled, progressive disease. RESULTS The most common treatments administered in the ED were oxygen (31%), beta-2 agonists (14%), antibiotics (12%), and narcotics (11%). Approximately 60% of patients were admitted to the hospital from the ED for further treatment of dyspnea and the underlying malignancy, and the median length of stay was 9 days. The median overall survival after the ED visit for dyspnea was 12 weeks. Specific diagnoses were associated with different median survival rates: lung cancer patients: 4 weeks; breast cancer patients: 22 weeks (P = 0.0073, vs. lung cancer); and other cancer diagnoses: 27 weeks (P = 0.0027, vs. lung cancer). CONCLUSIONS Lung cancer patients presenting to the ED with dyspnea have much shorter survival than patients with other malignancies. For some patients, the presence of dyspnea requiring emergency treatment may indicate a phase in their illness in which resources should be shifted from acute intervention with hospitalization to palliative and supportive care measures. Cancer 1996;78:1314-9.
Localization of some enzymes of beta-oxidation of fatty acids in the peroxisomes of Tetrahymena.

SYNOPSIS Mitochondria and peroxisomes were prepared from homogenates of Tetrahymena pyriformis by sedimentation through sucrose gradients. Catalase and isocitrate lyase served as peroxisomal markers; lactic dehydrogenase and glutamic dehydrogenase as mitochondrial markers. Acetyl-CoA synthetase, octanoyl-CoA synthetase, palmitoyl-CoA synthetase, 3-β hydroxyacyl CoA dehydrogenase, and thiolase activities were found in both the peroxisomes and the mitochondria. It is suggested that β-oxidation of fatty acids accurs in both organelles in Tetrahymena.
Genome-wide approach to identify risk factors for therapy-related myeloid leukemia

Using a target gene approach, only a few host genetic risk factors for treatment-related myeloid leukemia (t-ML) have been defined. Gene expression microarrays allow for a more genome-wide approach to assess possible genetic risk factors for t-ML. We assessed gene expression profiles (n=12 625 probe sets) in diagnostic acute lymphoblastic leukemic cells from 228 children treated on protocols that included leukemogenic agents such as etoposide, 13 of whom developed t-ML. Expression of 68 probes, corresponding to 63 genes, was significantly related to risk of t-ML. Hierarchical clustering of these probe sets clustered patients into three groups with 94, 122 and 12 patients, respectively; 12 of the 13 patients who went on to develop t-ML were overrepresented in the latter group (P<0.0001). A permutation test indicated a low likelihood that these probe sets and clusters were obtained by chance (P<0.001). Distinguishing genes included transcription-related oncogenes (v-Myb, Pax-5), cyclins (CCNG1, CCNG2 and CCND1) and histone HIST1H4C. Common transcription factor recognition elements among similarly up- or downregulated genes included several involved in hematopoietic differentiation or leukemogenesis (Maz, PU.1, ARNT). This approach has identified several genes whose expression distinguishes patients at risk of t-ML, and suggests targets for assessing germline predisposition to leukemogenesis.
Gender Stereotypes in Advisors' Clinical Judgments of Financial Risk Tolerance: Objects in the Mirror Are Closer than They Appear

A sample of 183 financial advisors and 290 advisory clients was used to determine the degree of correspondence between advisors' subjective clinical judgments about their clients' financial risk tolerance and the clients' actual financial risk tolerance. The correlation between the estimates and the actual measures was 0.41. It was further determined that advisors overestimated the risk tolerance of men and underestimated the risk tolerance of women. This distortion could not be attributed to income or wealth differences between the males and females.
Parenting Attitudes and Adjustment Among Custodial Grandparents

ABSTRACT Custodial grandparents (CGPs; n = 42), parents (n = 39), and noncustodial grandparents (GPs; n = 44) completed measures of parenting attitudes (e.g., belief in the use of corporal punishment) and parental adjustment (e.g., parenting stress). Moreover, half of the actively parenting participants were caring for a (grand)child with emotional or behavioral problems. While CGPs and parents differed in their self-reported levels of empathy toward children's needs and opinions about appropriate parent-child role responsibilities, with CGPs scoring in the less adaptive direction compared to parents, these two groups did not differ in their attitudes about corporal punishment or on any measure of parental adjustment. The caregivers in this sample who were raising (grand)children with emotional or behavioral problems, however, reported significantly lower levels of parental adjustment than CGPs and parents whose (grand)children did not have clinically significant emotional or behavioral problems. A multip...
901–88 Rapid Genetic Screen for Common β-Myosin Heavy Chain Mutations Causing Familial Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM), an autosomal dominant disease and the most common cause of sudden death in the young, is diagnosed by echocardiographic detection of cardiac hypertrophy. Unfortunately, the hypertrophy is usually not detectable until adolescence, which may be too late since sudden death often occurs as the first symptom. The availability of a clinical genetic assay to detect mutations would provide a definitive diagnosis, independent of clinical features and can be made at or before birth. Computer analysis showed most of the known mutations in the βMHC gene involve a restriction enzyme recognition site which can be exploited as a rapid genetic screening test. Accordingly, we employed polymerase chain reaction (PCR) to amplify the involved region of the gene followed by enzyme restriction digestion for 15 known mutations in 122 families with HCM. Fourteen families were positive and 108 negative. Ten families carried one of the three mutations known to have a high incidence of sudden death with 26 offspring having the mutation and at risk for sudden death while 49 did not have the mutation and are not at risk of developing HCM. Four families had one of the three known benign mutations with 23 offspring having the mutation and 21 without. The mutations were confirmed by sequencing and shown to be co-inherited with the disease. This test provides for a definitive genetic diagnosis and identifies those with the mutation and at risk for HCM and those without who will not develop HCM. Genetic counseling can be given prior to development of symptoms and those with mutations having a high incidence of sudden death are candidates for electrophysiology testing and possible implantation of cardiac defibrillators or amiodarone therapy. The test requires only a blood sample, is simple to perform and results are available in 48 hours. Over 25 of the βMHC mutations have now been shown to be amenable to rapid genetic diagnosis using PCR and restriction enzyme digestion. Mutation Prognosis No. of Families Arg 719 Trp malignent 4 (3.3% of total) Arg 403 Gln malignent 3 (2.5% of total) Arg 453 Cys malignent 3 (2.5% of total) Leu 908 Val benign 2 (1.6% of total) Val 606 Met benign 1 (0.8% of total) Gly 741 Arg benign 1 (0.8% of total)
Predictors of extraventricular drain-associated bacterial ventriculitis☆

Abstract Purpose Bacterial ventriculitis (BV) may develop in patients requiring external ventricular drains (EVDs). The purpose of this study was to determine predictors of EVD-associated BV onset. Materials and Methods A retrospective review of Duke University Hospital patients with EVD device placement between January 2005 and May 2010 was conducted. Subject data were captured for predefined variables. Outcomes included in-hospital mortality, length of stay, and neurologic status at discharge. Results In 410 subjects with 420 EVDs, the BV rate was 10.2%. Univariate analysis indicated that age, sex, positive blood culture, duration of EVD placement, and the number of cerebrospinal fluid (CSF) samples taken were associated with BV. Of these, the number of CSF samples and sex retained significance in multivariable modeling (female: odds ratio, 0.47 [confidence interval, 0.23-0.97]; CSF samples: odds ratio, 1.08 [confidence interval 1.01-1.17]; P = .04; c index = 0.69). In this model, each CSF sample taken expanded the likelihood of BV by 8.3%. The most common pathogens were Staphylococcus or proprioniobacter (n = 26). Bacterial ventriculitis was associated with an increase in hospital length of stay (33 ± 22.9 days vs 24.6 ± 20.4 days; P = .04) but not mortality. Conclusion An association exists between CSF sampling frequency and the development of EVD-associated BV. Larger prospective studies should be aimed at identifying causal relationships between these variables.
Obsessive-compulsive disorder in youth with and without a chronic tic disorder

The goal of this study was to discriminate subtypes of pediatric obsessive-compulsive disorder (OCD) among youth with and without a comorbid tic disorder. Seventy-four youth (Mage=9.7±2.3 years) with a principal diagnosis of OCD, with (n=46) or without (n=28) a comorbid tic disorder, were assessed with a semi-structured diagnostic interview and the Children's Yale Brown Obsessive-Compulsive Scale (CY-BOCS). The CY-BOCS Symptom Checklist was used to categorize obsessions and compulsions. Group differences were analyzed by t tests, χ2, and discriminant function analyses. Results suggested that subjects without tics had significantly more contamination obsessions, sexual obsessions, and counting compulsions than youth with comorbid tics. Generally speaking, however, youth with and without tics had similar symptom presentations. These data suggest that pediatric OCD patients with and without comorbid tics may have some aspects of symptom presentation that differ, but generally have more OCD symptoms in common than different. Implications of these findings on clinical presentation and treatment efficacy are highlighted. Depression and Anxiety. © 2007 Wiley-Liss, Inc.
Recalcitrant space: modeling variation in humanistic geography

In the past decade humanistic geography has been roundly criticized by influential geographers for offering essentialist conceptions of place. In this paper it is argued that essentialism is not intrinsic to these conceptions, and a model of ‘recalcitrant space’ is presented to show how amenable humanistic geographies are to constructivist adaptations that foreground variation in subjective encounters with place.
Clinicopathologic correlations of ABO and rhesus blood type in colorectal cancer

There is no specific association established between colorectal cancer and blood group type. In this study, the distribution of ABO and Rh blood groups was studied in 838 patients with colorectal cancer. There was no difference in distribution of ABO blood groups between patients who were Rh+ and Rh-. There was no difference in ABO blood group or Rh factor and tumor location. The highest A/O ratio was found in rectal cancer. Although there was no difference in stage distribution for each ABO blood group, there was a significant difference between the Rh+ and Rh-groups (P<0.037).It is not clear, however, whether the prognosis is different between the two groups since there were more early tumors as well as incurable tumors in the Rh-group. All patients with synchronous cancer were Rh+. Further studies on blood group antigens are needed to elucidate the relationship between these antigens and colorectal cancer.
A Place of Opportunity: Black Male Student Athletes’ Experiences at a Historically Black University

The purpose of this study was to identify key factors associated with the academic achievement and positive college experiences among Black male student athletes at a Historically Black University (HBU) in the Southeastern United States (U.S.). A concurrent triangulation exploratory design allowed both qualitative and quantitative data to be collected simultaneously and converged during the analysis phase (Creswell, 2009). Participants in this study included current Black male student athletes who participated in football and men’s basketball at a HBU in the Southeastern U.S. Using aspects of the grounded theoretical approach for analysis (Glaser & Strauss, 1967), the following emergent themes were identified: “You Got a Chance,” “An Opportunity,” “Not Just a Number,” “It’s Hard, But It’s Not Impossible” and “As An Athlete It Makes Your Social Life a Little Easier.” Implications for policy and practice are discussed.
Comparing perceptions of the important environmental characteristics of the places people engage in consumptive, non-consumptive and spiritual activities

Managers, risk assessors, tribal leaders, public policy makers, and the public are increasingly interested in the characteristics of natural habitats where people like to engage in recreational, subsistence, or spiritual activities. Such data are critical for making decisions about human and ecological risk deriving from contaminants, as well as resource protection and land use. In this study we examined the perceptions of Native Americans and Caucasians about the natural places they prefer to engage in consumptive, non-consumptive, and spiritual activities which might expose them to contamination or other stressors. Subjects were interviewed at Post Falls and Fort Hall in Idaho, Cookeville in Tennessee, and at two sites in Long Island, New York, and northern New Jersey. Our objectives were to determine differences in perceptions as a function of category of activity, type of activity, location, and ethnicity. The data indicate that: (1) the highest rated characteristics were unpolluted water, lack of rad...
Structure-preserving model reduction

A general framework for structure-preserving model reduction by Krylov subspace projection methods is developed. The goal is to preserve any substructures of importance in the matrices L, G, C, B that define the model prescribed by transfer function H(s)=L*(G +sC)−−1B. Many existing structure-preserving model-order reduction methods for linear and second-order dynamical systems can be derived under this general framework.
The Active Voice: Narrative in Applied and Activist Anthropology

Applied anthropology strives to support accessible writing, especially in journals that publish the work of nonacademic anthropologists. In this, narrative must be concise and clear, as it reports on active projects that form the basis of research and practice. As such, the resulting texts can neither be jargon filled or excessively interpretive, especially when the production involves the participation of community collaborators. The challenges of writing applied and activist ethnography begin well before the research itself and continue throughout. We must seek informed permission for projects; carry out work in conjunction with the community; obtain preapproval for written products; and work to find a mode of expression that meets complex criteria: to be creative while also being concrete, to present theory to a general audience, and to share the ethnographic endeavor on all levels. This article addresses narrative and ethical dilemmas of applied practice and writing. Illustrations from a number of recent ethnographies supplement text and case studies from Chiapas, Mexico. An examination of the experience of collaborative research and writing that resulted in Duncan Earle and Jeanne Simonelli's book Uprising of Hope: Sharing the Zapatista Journey to Alternative Development (2005) illustrates the process of doing and writing ethnography for and with the community.
On the Geometry of Convex Reflectors, II. Polar Reflectors

This paper is a part of a series [4, 5] in which we study geometric properties of reflectors. Here we study the notion of geometric polarity for reflectors extending the classical polarity for convex bodies [1, 6, 7].
Acceptance patterns of retaliatory aggression among adjudicated youth by sex and race.

This study investigates sex and race differences in normative beliefs about the acceptability of aggression across dimensions of severity of provocation (weak versus strong) and sex of provoker (male versus female). Students in the sample of 311 included those required to attend three Department of Youth Services schools after placement by the juvenile court system from across the state of Alabama (N=392). Results show that males were significantly more likely than females to approve of retaliation to weak provocation and against females. There were no significant differences between males and females for retaliation with strong provocation and against males. Results also show the Black group was significantly more likely than the White group to approve of retaliation to weak provocation, strong provocation, and against females. Language: en
Sphingosine-1-phosphate, FTY720, and sphingosine-1-phosphate receptors in the pathobiology of acute lung injury

Acute lung injury (ALI) attributable to sepsis or mechanical ventilation and subacute lung injury because of ionizing radiation (RILI) share profound increases in vascular permeability as a key element and a common pathway driving increased morbidity and mortality. Unfortunately, despite advances in the understanding of lung pathophysiology, specific therapies do not yet exist for the treatment of ALI or RILI, or for the alleviation of unremitting pulmonary leakage, which serves as a defining feature of the illness. A critical need exists for new mechanistic insights that can lead to novel strategies, biomarkers, and therapies to reduce lung injury. Sphingosine 1–phosphate (S1P) is a naturally occurring bioactive sphingolipid that acts extracellularly via its G protein–coupled S1P1–5 as well as intracellularly on various targets. S1P-mediated cellular responses are regulated by the synthesis of S1P, catalyzed by sphingosine kinases 1 and 2, and by the degradation of S1P mediated by lipid phosphate phospha...
Methotrexate for refractory Crohn's disease: preliminary answers to definitive questions.

Encyclopedic in scope , the article in this issue of the Mayo Clinic Proceedings (pages 69 to 80) by Egan and Sandborn reviews the pharmacologic propert ies of methotrexate, its potential in the treatment of disparate inflammatory pro­ cesses, mechanisms of action, potential toxicity related to short-term and long-term use, and the limited published data utilizing this 50-year-old medic ation for refractory inflam­ matory bowel disease (IBD). Synopsizing three uncon­ trolled and two placebo-controlled studies,':' the authors conclude that "this agent can [now] be recommended for induction of remission and steroid sparing in refractory and corticosteroid-dependent Crohn 's disease." I concur with this assessment. Nonetheless, as one of the original investi­ gators who has utilized methotrexate for refractory IBD since 1987, I am chagrined by the gaps in our knowledge regardin g not only the definit ive mechanism of drug action in IBD but also by more basic clin ical questions. For in­ stance, what role does this drug have, if any, in chron ic ulcerative colitis? Our data have previously demon strated efficacy in inducing remission in chronic ulcerati ve colitis, but substantial relapse has occurred at 1 year.' Nevertheless, I have multiple patients in my practice who have maintained remissions for up to 5 years by taking only this drug. How can we better select those patients who will respond initially , and how long should they be treated? Dose and Route of Administration.-From the stand­ point of Crohn's disease, was the initial dosage of 25 mg given intramuscularly once a week the correct dose and route of administration? Addition al experience with this drug throughout the years suggests a higher side effect profile when the drug is administered orally, and a third of my patients either are intolerant of oral therap y or experience relapse with this route of administration. Con sequentl y, most continue to admini ster their own shots on a weekly basis. From a dosage standpoint, 25 mg was selected be­ cause it was a higher dosage than that conventionally used for rheum atoid arthriti s (7.5 to 15 mg weekly) but was lower than that usually associated with severe toxicity. In simple terms, we did not want to undertake a trial that may have yielded negative results because of an inadequate medication dose. Apparently, 25 mg was a reasonable choice for indue
The senescence-accelerated prone mouse (SAMP8): A model of age-related cognitive decline with relevance to alterations of the gene expression and protein abnormalities in Alzheimer's disease

The senescence-accelerated mouse (SAM) is an accelerated aging model that was established through phenotypic selection from a common genetic pool of AKR/J strain of mice. The SAM model was established in 1981, including nine major senescence-accelerated mouse prone (SAMP) substrains and three major senescence-accelerated mouse resistant (SAMR) substrains, each of which exhibits characteristic disorders. Recently, SAMP8 have drawn attention in gerontological research due to its characteristic learning and memory deficits at old age. Many recent reports provide insight into mechanisms of the cognitive impairment and pathological changes in SAMP8. Therefore, this mini review examines the recent findings of SAMP8 mice abnormalities at the gene and protein levels. The genes and proteins described in this review are functionally categorized into neuroprotection, signal transduction, protein folding/degradation, cytoskeleton/transport, immune response and reactive oxygen species (ROS) production. All of these processes are involved in learning and memory. Although these studies provide insight into the mechanisms that contribute to the learning and memory decline in aged SAMP8 mice, higher throughput techniques of proteomics and genomics are necessary to study the alterations of gene expression and protein abnormalities in SAMP8 mice brain in order to more completely understand the central nervous system dysfunction in this mouse model. The SAMP8 is a good animal model to investigate the fundamental mechanisms of age-related learning and memory deficits at the gene and protein levels.
Serum Magnesium and Plasma Sodium Levels in Essential Vascular Hypertension

The mean serum magnesium concentration in 26 uncomplicated hypertensive patients was found to be significantly lower than that in 43 normal individuals. The mean plasma sodium concentration in these patients was significantly higher than that in a normal group. The mean plasma potassium levels were not significantly different. It is suggested that a possible explanation for these electrolyte changes is excessive adrenal cortical activity.
An ultra-shallow buried-channel PMOST using boron penetration

A novel process using controlled boron penetration to form an ultrashallow buried-layer for a sub-half-micrometer channel-length n/sup +/ polysilicon-gate PMOS device is presented. Experimental results coupled with two-dimensional process and device simulation are used to examine the impact of the buried-channel design on the drain-induced barrier lowering effects. Using a sacrificial 125-AA gate oxide and a BF/sub 2/-implanted polysilicon layer, the boron penetration profile is formed prior to the actual gate oxidation. This process is suitable for sub-half-micrometer channel-length n/sup +/ poly-gated CMOS technologies which require gate oxide thicknesses of less than 100 AA. >
Algorithmic study of single-layer bus routing for high-speed boards

As the clock frequencies used in industrial applications increase, the timing requirements on routing problems become tighter, and current routing tools cannot successfully handle these constraints any more. In this paper, the authors focus on the high-performance single-layer bus routing problem, where the objective is to match the lengths of all nets belonging to each bus. An effective approach to solve this problem is to allocate extra routing resources around short nets during routing, and use those resources for length extension afterwards. First, a provably optimal algorithm for routing nets with minimum-area maximum-length constraints is proposed. Then, this algorithm is extended to the case where minimum constraints are given as exact length bounds, and it is also proven that this algorithm is near-optimal. Both algorithms proposed are shown to be scalable for large circuits, since the respective time complexities are O(A) and O(AlogA), where A is the area of the intermediate region between chips.
Adaptive power control for server clusters

Power control is becoming a key challenge for effectively operating a modern data center. In addition to reducing operation costs, precisely controlling power consumption is an essential way to avoid system failures caused by power capacity overload or overheating due to increasing high- density. Control-theoretic techniques have recently shown a lot of promise on power management thanks to their better control performance and theoretical guarantees on control accuracy and system stability. However, existing work oversimplifies the problem by controlling a single server independently from others. As a result, at the cluster level where multiple servers are correlated by common workloads and share common power supplies, power cannot be shared to improve application performance. In this paper, we propose a cluster-level power controller that shifts power among servers based on their performance needs, while controlling the total power of the cluster to be lower than a constraint. Our controller features a rigorous design based on an optimal multi-input-multi-output control theory. Empirical results demonstrate that our controller outperforms a state-of-the-art controller, by having better application performance and more accurate power control.
Pride, shame and stigma in private spaces

Private spaces are one locus of public faces. Those who do not wish to be judged by others may close off their homes from observation. Conversely, those who wish intensely to be judged by others may open up their homes to scrutiny by all. In this ethnography of a wealthy ‘marina’ community in Southern California, private homes, boats and automobiles are the sites of pride, shame and stigma on the part of owners and residents, in ways that reflect gender, class, ethnicity, sexuality and age as well as enduring, general cultural norms (pride goeth before a fall).
Effect of a slot on the buckling load of a cylindrical shell with a circular cutout.

The results are discussed of a study of the effect of slots on the buckling of cylinders with circular holes of systematically varied circularity. The results obtained suggest that the substantial increase in the buckling loads of cylindrical shells resulting from increases in slot length is due to a relief of the bending stress field.
Kinetic studies of HIV-1 and HIV-2 envelope glycoprotein-mediated fusion.

Background HIV envelope glycoprotein (Env)-mediated fusion is driven by the concerted coalescence of the HIV gp41 N-helical and C-helical regions, which results in the formation of 6 helix bundles. Kinetics of HIV Env-mediated fusion is an important determinant of sensitivity to entry inhibitors and antibodies. However, the parameters that govern the HIV Env fusion cascade have yet to be fully elucidated. We address this issue by comparing the kinetics HIV-1IIIB Env with those mediated by HIV-2 from two strains with different affinities for CD4 and CXCR4.
Objective measures of the efficacy of noninvasive positive-pressure ventilation in amyotrophic lateral sclerosis

The impact of noninvasive positive-pressure ventilation (NIPPV) on pulmonary function studies, quality of life, and survival was assessed in patients with amyotrophic lateral sclerosis. NIPPV did not change the rate of decline of the forced vital capacity (FVC) and forced expiratory volume in the first second (FEV(1)) (2.31 and 2.09 percent-predicted points per month, respectively). NIPPV resulted in a drop of FEV(1) by 5.94 percent-predicted points (P = 0.07), and of maximal inspiratory pressure by 6.33 percent-predicted points (P = 0.11). The change in FEV(1) and FVC pre- and postintervention correlated with the corresponding change in maximal inspiratory pressure. Fatigue and mastery scores were improved by NIPPV. Median survivals in patients intolerant and tolerant of NIPPV were 5 and 20 months, respectively (P = 0.002). Although NIPPV has no impact on the rate of decline of lung function and may have deleterious effects on spirometric measures, it may improve quality of life and survival.
More honors for Horton Winner

The first grand slam in hydrogeology has been achieved by John Cherry (University of Waterloo, Waterloo, Canada). This year's Horton Award recipient, AGU's most prestigious award for hydrologists, (see “John Cherry Wins Horton Award,” p. 91), has also received the O.E. Meinzer Award from the Geological Society of America and has been selected the first Henry Darcy Distinguished Lecturer for the National Water Well Association. The Meinzer Award was given for a “significant body of work” on aquifer contamination that was published in volume 63 of the Journal of Hydrology.
Sound Intensity and Noise Evaluation in a Critical Care Unit

Summary of Phases 1 and 2 In summary, the results of phases 1 and 2 indi-cated that the LCpk values of alarms measured inthe patient room were higher than the values inthe adjacent room for all equipment alarms investi-gated and that closing the door to the adjacent roomfurther decreased the LCpk measured for the venti-lator system but not for the cardiac monitoring sys-tem. Data were not available to make this comparisonfor the infusion pump. Of interest, for all equipment,changing alarm output settings altered the LCpklevels measured in the patient room but not in theadjacent room. Ambient Noise In phase 3, data were collected for 24 hours.Because of variations in ICU census, the durationof recording time and the start and end of recordingtimes varied across recording sessions, and equalsets of data for the door open and the door closedcould not be obtained. Specifically, 8 sets of datafor the door open and 4 sets for the door closedwere available. For the analyses, all data for thedoor open were averaged, as were all data for thedoor closed.Figures 5 and 6 show LAeq and LCpk levelsmeasured over time with the door open and thedoor closed, respectively. Table 2 gives the meanLAeq and LCpk levels and the results of ANOVAcomparing the two. The minimum value shown onthese figures (and in Figure 7) is 39 dB(A). Duringdata collection with the door open, the SLM wasinadvertently set incorrectly such that any LAeq lessthan 40 dB(A) was stored as 39 dB(A). In order tomake comparisons across the door-open and door-closed conditions, all LAeq readings less than 40dB(A) were coded as 39 dB(A).LAeq values were higher when the door to thepatient room was open, but LCpk levels were simi-lar whether the door was open or closed. In otherwords, closing the door to a patient room decreasesthe mean noise level in that room but not the peaknoise level.Figure 7 shows a histogram of the LAeq valuesmeasured throughout the 24-hour surveillanceperiod, and Figure 8 shows the LCpk data. Analysesindicated that 83% of LAeq values were less than 45dB(A). LCpk values were considerably higher; 6%with the door closed and 9% with the door openwere greater than 90 dB(C).
Spatial Stochastic Models and Metrics for the Structure of Base Stations in Cellular Networks

The spatial structure of base stations (BSs) in cellular networks plays a key role in evaluating the downlink performance. In this paper, different spatial stochastic models (the Poisson point process (PPP), the Poisson hard-core process (PHCP), the Strauss process (SP), and the perturbed triangular lattice) are used to model the structure by fitting them to the locations of BSs in real cellular networks obtained from a public database. We provide two general approaches for fitting. One is fitting by the method of maximum pseudolikelihood. As for the fitted models, it is not sufficient to distinguish them conclusively by some classical statistics. We propose the coverage probability as the criterion for the goodness-of-fit. In terms of coverage, the SP provides a better fit than the PPP and the PHCP. The other approach is fitting by the method of minimum contrast that minimizes the average squared error of the coverage probability. This way, fitted models are obtained whose coverage performance matches that of the given data set very accurately. Furthermore, we introduce a novel metric, the deployment gain, and we demonstrate how it can be used to estimate the coverage performance and average rate achieved by a data set.
Automated Ptosis Measurements From Facial Photographs

Importance Measurements of the margin reflex distances 1 and 2 are crucial for the surgical planning of ptosis repair and blepharoplasty. Facial photographs annotated with automated measurements of eyelid position could provide objective, accurate, and reproducible documentation of these features. Objectives To describe a software algorithm for determining the margin reflex distances 1 and 2 from facial photographs and to evaluate its agreement with manual measurements of the margin reflex distances 1 and 2. Design, Setting, and Participants Observational study at a single-surgeon oculoplastic private practice among 55 eyes of 28 adult volunteers. The study dates were July 30, 2014, to September 12, 2014. The dates of our analysis were October 12, 2014, to June 18, 2015. Main Outcomes and Measures Agreement between manual and automated measurements of the margin reflex distances 1 and 2. Results Among 55 eyes of 28 participants, automated margin reflex distance 1 measurements were strongly correlated with manual measurements (r = 0.97; 95% CI,r = 0.95 tor = 0.98;P Conclusions and Relevance Automated ptosis measurements produced by our software algorithm compare favorably with manually performed clinical measurements. An automated, photography-based system could provide an archival and highly reproducible means for obtaining the margin reflex distances 1 and 2 and other facial morphometric data.
Effects of Phenolic Monomers on Rat Performance and Metabolism

Phenolic monomers identified in common roughages were included in diets fed to rats both as mixtures, to mimic phenolic composition of roughages, and individually at various levels. Three performance and digestion/metabolism trials were conducted. Dry matter, protein, total carbohydrate, cellulose, and soluble carbohydrate (dextrose plus starch) digestibilities were measured. Urine and fecal samples were an alyzed for phenolic monomers in trial 1. Inclusion of phenolic monomers (p-coumaric, ferulic, protocatechuic and salicylic acids, and vanillin) in rat diets resulted in reduced feed intake with a linear trend toward decreased intake with increasing dietary phenolic (p-coumaric and ferulic acids) concentrations. Average daily gain also exhibited a similar negative linear relationship. p-Coumaric and ferulic acids did not differ from one an other in their effects, whereas salicylic acid had greater negative effects and vanillin was not different from the phenolic-free control. Some differences in digestibility of individual nutrients were observed, but were small in magnitude and did not correlate well with the altered growth responses. Analysis of urine and feces revealed low re coveries of phenolic monomers, suggesting extensive metabolism of phenolics by rats after intestinal absorption. Potential exists for phenolic monomers to be intake- and growth-depressing agents in both animal and human diets. J. Nutr. 113: 546-556,
Coagulopathy following peritoneovenous shunting.

This study presents a prospective evaluation of intravascular coagulation occurring in patients undergoing insertion of a LeVeen peritoneovenous shunt for ascites. In 15 patients, platelets, jbrinogen, prothrombin time (PT), thrombin time (TT), partial thromboplastin time (PTT), jbrinogenlfibrin split products (FSPlfsp), andfactors V, VII, and VIII were measured before operation and on postoperative days I, 3, and 7. FSPIf p s were measured in ascitic Juid collected at operation. A consumption coagulopathy was demonstrated in I I of 15 patients during the postoperative period. The mean peritonealjuid FSPIfsp was 552 pg/ml. Two patients (13%) h a serum FSP/fsp demonstrated before operation. After shunting, serum d FSPlfsp was present on day I injve of six patients (83%), on day 3 in nine of nine patients evaluated (lOO%), and in seven of eight patients on day 7 (88%). The mean platelet count fell from 240,000/ cu mm before operation to lO4,OOO/cu mm (P < 0.05) on day I, 99,OOO/cu mm (P < 0.005) on day 3, and 95,OOO/cu mm (P < 0.005) on day 7. Values as low as 31,OOO/cu mm were demonstrated after operation. Plasma jbrinogen decreased from 298 mgldl before operation to 186 mg/dl on day I (P -=c 0.05), 154 mg/dl on day 3 (P < 0.005), and 158 mgldl on day 7 (P < 0.005). The PT increasedfrom 15.3 seconds before operation to 17.7 seconds (P -C 0.05) on day 1, 19.4 seconds (P < 0.005) on day 3, and 17. I seconds (P < .05) on day 7. The TT increased from 20.0 seconds before operation to 24.0 seconds (P < 0.05) on day 3. Four patients died after operation. We postulate that the consumption coagulopathy is a result of direct and rapid intravenous infusion of a procoagulant substance(s) in asciticjluid.
Interview with Ron Wasserstein

(2014). Interview with Ron Wasserstein. Journal of Statistics Education: Vol. 22, No. 1, pp. null.
The Difficulties of Informed Consent in Stem Cell Transplant

Informed consent is the process by which a competent patient is provided with a sufficient amount of relevant information to make an educated decision about a procedure. The process of informed consent is designed to prioritize patients' autonomy. Stem cell transplant (SCT) is a complicated process with many possible results and requirements for on-going decision-making depending on outcomes and complications. While understanding basic theories of decision science will help the physician provide improved information at the time of consent, experiential learning by the patients as they proceed through SCT may have the strongest influence in continued patient decision-making that may or may not align with their initial informed consent.
The Land Aesthetic

SOCRATES: By Hera, it is a charming resting place. For this plane tree is very spreading and lofty, and the tall and shady willow is very beautiful, and it is in full bloom, so as to make the place most fragrant; then, too, the spring is very pretty as it flows under the plane tree, and its water is very cool, to judge by my foot.... Then again, if you please, how lovely and perfectly charming the breeziness of the place is! And it resounds with the shrill summer music of the chorus of cicadas. But the most delightful thing of all is the grass, as it grows on the gentle slope, thick enough to be just right when you lay your head on it, so you have guided the stranger most excellently, dear Phaedrus.
Microstructural Analysis of Porcine Skull Bone Subjected to Impact Loading

Skull fracture can be a complex process involving various types of bone microstructure. Finite element analysis of the microscopic architecture in the bone allows for a controlled evaluation of the stress wave interactions, micro-crack growth, propagation and eventual coalescence of trabecular fracture. In this paper, the microstructure and mechanics of small-volume sections of a 6-month-old Gottingen Minipig skull were analyzed. MicroCT scans were used to generate finite element models. Various computational methods were investigated for modeling the intricacies contained within the porous microstructure of the trabecular bone. Pores were explicitly meshed in one method, whereas in the second, a mesh was created from a microCT image-informed mapping algorithm that mapped the trabecular porosity from an image stack to a solid volume mesh of the model. From here, all models were subject to uniaxial compression simulations. The output of the simulations allowed for a detailed understanding of the failure mechanics of the skull structure and allowed for comparison between the methods. Fracture typically occurs in the weakest areas where the bone is highly porous and forms a fracture surface throughout the material, which causes the bone to collapse upon itself.Copyright © 2015 by ASME
Estimation of aortic valve leaflets from 3D CT images using local shape dictionaries and linear coding

Aortic valve (AV) disease is a significant cause of morbidity and mortality. The preferred treatment modality for severe AV disease is surgical resection and replacement of the native valve with either a mechanical or tissue prosthetic. In order to develop effective and long-lasting treatment methods, computational analyses, e.g., structural finite element (FE) and computational fluid dynamic simulations, are very effective for studying valve biomechanics. These computational analyses are based on mesh models of the aortic valve, which are usually constructed from 3D CT images though many hours of manual annotation, and therefore an automatic valve shape reconstruction method is desired. In this paper, we present a method for estimating the aortic valve shape from 3D cardiac CT images, which is represented by triangle meshes. We propose a pipeline for aortic valve shape estimation which includes novel algorithms for building local shape dictionaries and for building landmark detectors and curve detectors using local shape dictionaries. The method is evaluated on real patient image dataset using a leave-one-out approach and achieves an average accuracy of 0.69 mm. The work will facilitate automatic patient-specific computational modeling of the aortic valve.
To the maximum extent appropriate: determining success and the least restrictive environment for a student with autism spectrum disorder

ABSTRACTThis case study uses an institutional ethnography approach to investigate the experiences of the parents of a son who has autism spectrum disorder (ASD) as they engaged in meetings related to his progress and placement with school personnel over the course of one school year. Through an analysis of the discourse used in these meetings and documents generated by the district and the parents, the researcher highlights how administrators managed and controlled meetings and decision-making when there was disagreement over the least restrictive environment for this child. Analyses of these meetings show how the structure and wording of behavioural plans and other formal documents reinforce common stereotypes about children with ASD – even when information is presented to suggest that such stereotypes are incorrect.
Recombinant IgG Fc Fragments Effectively Suppress Experimental Myasthenia Gravis (S35.002)

Objective: To investigate the therapeutic effects of intravenous administration of fully recombinant forms of polyvalent IgG Fc fragments in murine experimental myasthenia gravis. Background Intravenous immune globulin (IVIg) has been shown to have broad therapeutic application in the treatment of autoimmune diseases, including myasthenia gravis (MG). The anti-inflammatory activities of IVIg are now generally attributed to the immunoglobulin G (IgG) Fc domains. Interestingly, soluble immune aggregates bearing intact Fc fragments have been shown to be effective in the treatment of a variety of autoimmune disorders in mice. To study the mechanisms by which soluble Fc containing immune complexes can suppress autoimmunity, a series of fully recombinant forms of polyvalent IgG2a Fc were created by linking the hinge-CH2-CH3 regions of murine IgG2a Fc to one or more multimerization domains (MD). Design/Methods: Recombinant polyvalent IgG2a fusion proteins (400µg) were administered via tail vein to mice with well-established experimental myasthenia gravis (EAMG) on five consecutive days. Control EAMG mice received a) IVIg (0.4 g/kg) X 5 days or b) PBS. Effectiveness of treatment was assessed by improvement in myasthenic weakness as determined by a standard clinical scoring protocol, circulating serum levels of anti-AChR antibodies, and immunological evaluation of lymph nodes and spleens. Results: Treatment of EAMG mice with recombinant polyvalent IgG2a Fc fusion proteins produced a significant improvement in myasthenic weakness, and an equivalent magnitude of beneficial effect compared to IVIg. Results of anti-AChR antibody levels and immunological studies of splenocytes and lymph node cells will be presented. Conclusions: Recombinant polyvalent IgG2a Fc fusion proteins were equally effective in ameliorating EAMG compared to IVIg, and may represent a feasible alternative, offering the advantages of being completely recombinant, of unlimited supply, free of infectious risks, and effective at doses 1 -2 log orders lower than IVIg. Supported by: The NIH (National Institute of Neurologic Disorders and Stroke, K08NS058800, and the Muscular Dystrophy Association (MDA) MNM and JRS; and National Institute of Allergy and Infectious Diseases, RO1 AI 058190, BSP. Study material (Recombinant IgG2a Fc fusion proteins (stradomersTM) was provided by Gliknik, Inc. Disclosure: Dr. Meriggioli has received personal compensation for activities with Athena Diagnostics, Talecris Biotherapeutics, Gliknik, and Celegene Corporation. Dr. Meriggioli receives patent payments for a patent on bispecific antibody coated dendritic cells. Dr. Meriggioli has received research support from the NIH/NINDS and the Muscular Dystrophy Association. Dr. Sheng has nothing to disclose. Dr. Li has nothing to disclose. Dr. Muthusamy has nothing to disclose. Dr. Prabhakar has received personal compensation for activities with Gliknik Inc. as a consultant.Dr. Prabhakar has received research support from NIH.
Mapping the Specific Amino Acid Residues That Make Hamster DPP4 Functional as a Receptor for Middle East Respiratory Syndrome Coronavirus.

UNLABELLED The novel emerging coronavirus Middle East respiratory syndrome coronavirus (MERS-CoV) binds to its receptor, dipeptidyl peptidase 4 (DPP4), via 14 interacting amino acids. We previously showed that if the five interacting amino acids which differ between hamster and human DPP4 are changed to the residues found in human DPP4, hamster DPP4 does act as a receptor. Here, we show that the functionality of hamster DPP4 as a receptor is severely decreased if less than 4 out of 5 amino acids are changed. IMPORTANCE The novel emerging coronavirus MERS-CoV has infected >1,600 people worldwide, and the case fatality rate is ∼36%. In this study, we show that by changing 4 amino acids in hamster DPP4, this protein functions as a receptor for MERS-CoV. This work is vital in the development of new small-animal models, which will broaden our understanding of MERS-CoV and be instrumental in the development of countermeasures.