cssi/SciSciGPT-SciSciNet huggingface dataset:
Twin study confirms virtually identical prenatal alcohol exposures can lead to markedly different fetal alcohol spectrum disorder outcomes-fetal genetics influences fetal vulnerability.

Background: Risk of fetal alcohol spectrum disorder (FASD) is not based solely on the timing and level of prenatal alcohol exposure (PAE). The effects of teratogens can be modified by genetic differences in fetal susceptibility and resistance. This is best illustrated in twins. Objective: To compare the prevalence and magnitude of pairwise discordance in FASD diagnoses across monozygotic twins, dizygotic twins, full-siblings, and half-siblings sharing a common birth mother. Methods: Data from the Fetal Alcohol Syndrome Diagnostic & Prevention Network clinical database was used. Sibling pairs were matched on age and PAE, raised together, and diagnosed by the same University of Washington interdisciplinary team using the FASD 4-Digit Code. This design sought to assess and isolate the role of genetics on fetal vulnerability/resistance to the teratogenic effects of PAE by eliminating or minimizing pairwise discordance in PAE and other prenatal/postnatal risk factors. Results: As genetic relatedness between siblings decreased from 100% to 50% to 50% to 25% across the four groups (9 monozygotic, 39 dizygotic, 27 full-sibling and 9 half-sibling pairs, respectively), the prevalence of pairwise discordance in FASD diagnoses increased from 0% to 44% to 59% to 78%. Despite virtually identical PAE, 4 pairs of dizygotic twins had FASD diagnoses at opposite ends of the fetal alcohol spectrum—Partial Fetal Alcohol Syndrome versus Neurobehavioral Disorder/Alcohol-Exposed. Conclusion: Despite virtually identical PAE, fetuses can experience vastly different FASD outcomes. Thus, to protect all fetuses, especially the most genetically vulnerable, the only safe amount to drink is none at all.
Transformation of char carbon during bubbling fluidized bed gasification of biomass

Abstract This study focuses on the fate of carbon in the char generated by devolatilization of biomass during fluidized bed gasification. A carbon balance model was developed to distinguish between char transformed to carbon-bearing gases and its comminution and elutriation as fine char during gasification. The model accurately predicts the transient accumulation of char carbon in the reactor. Experiments revealed steady state reactor char carbon loadings were achieved after multiple hours of gasification. The model formed the basis of an experimental methodology that assesses the transformation of char carbon based on collection of elutriated solids from the reactor and assessment of the steady state char carbon loading in the reactor. Experiments were performed to distinguish the relative contributions of chemical reaction and physical comminution toward conversion of char to gaseous and solid products. The effects of equivalence ratio, gasification temperature, superficial gas velocity, biomass particle size, and the addition of steam on the partitioning of char carbon between gaseous and solid products during gasification of ground seed corn in a bubbling fluidized bed were investigated. This study revealed that char conversion during gasification of biomass was limited by elutriation of fine char particles arising from fragmentation or attrition of primary char product. Additionally, increased chemical reaction of char to form gases was usually accompanied by increased elutriation of fine char, which suggests that chemical reaction increased the porosity of the char and its susceptibility to fragmentation and attrition. Finally, decreasing superficial gas velocity, increasing equivalence ratio, and decreasing particle size led to increased carbon conversion, while increasing temperature and steam concentration in the reactor had negligible effect.
Comparing Self-Reported and Performance-Based Online Feedback on Early Childhood Teachers’ Implementation of Language Strategies

This professional development (PD) study examined the effect of feedback type on changing preschool teachers’ use of language enhancement strategies and language outcomes for children. We included 21 Head Start teachers and 107 children. We randomized classrooms to PD feedback condition: (a) self-reported or (b) observed use of strategies. All teachers completed online learning modules on language enhancement strategies (i.e. open-ended questions, self-talk, repetition, expansion, and narration) and teacher self-monitoring. After completing the PD, teachers were provided weekly, individualized feedback based on their submissions of: (a) self-reported, or (b) observed performance (via 10-min video) of their use of language enhancement strategies. Results suggested that the PD experience (less than 8 weeks, 1 h per week) increased teachers’ frequency in using language enhancement strategies (performance, Hedges’ g = 0.65; self-report, Hedges’ g = 1.43) across condition, with no significant differences by condition. Additionally, children demonstrated mean gains in expressive vocabulary and overall language skills. We believe that this brief, but targeted PD experience, warrants further research to explore the impact of using self-reported feedback with a larger sample. Determining more efficient and effective PD approaches will enable the field to better meet the needs of teachers and improve outcomes for children.
LBA-20 AUTOMATED CYSTOSCOPIC DETECTION OF BLADDER CANCER USING DEEP-LEARNING

INTRODUCTION AND OBJECTIVES:Over 1 million cystoscopies are performed annually in the United States for detection and surveillance of bladder cancer. Adequate identification of suspicious lesions i...
Quality Obfuscation for Error-Tolerant and Adaptive Hardware IP Protection

Ahstract-Various attacks on hardware intellectual properties (IPs) have been successful in obtaining design information that can be used to reverse engineer a system, create counterfeits, or insert hardware Trojans. Key-based hardware obfuscation is an attractive solution that helps prevent such attacks. In this paper, for the first time, we propose a key error tolerant obfuscation approach that achieves graceful degradation in output Quality of Service (QoS) as the bit error rate (BER) in obfuscation key increases. The approach, which we refer to it as, “Quality Obfuscation”, is applicable to a large variety of IPs, including digital signal processing (DSP) and approximating computing IPs, which are resilient to output QoS degradation. We present a complete obfuscation framework that can be adapted to any error tolerance rate. To demonstrate its robustness, we obfuscate several common DSP IP blocks and observe the performance under various percentages of bit-flips in the key. We show that our approach provides controllability of system quality, as well as the strong protection at low overhead, e.g., average 15% area and 5.9% power overhead to tolerate 10% BER.
Chronic Pancytopenia and Increased Bone Density Due to TBXAS1 Deficiency

Abstract Non-dysmorphic 32-year old Caucasian female developed malaise, fluctuating body aches and progressive transfusion-dependent pancytopenia with peripheral blood morphology consistent with myelodysplastic syndrome (MDS). Reportedly, she had an episode of "low blood counts" of unclear etiology 23 years prior. Multiple attempts at bone marrow biopsy were unsuccessful due to technical difficulties with penetrating the bone, necessitating surgical biopsy by an orthopedic surgeon. Bone densitometry revealed increased bone density with Z-score of 4.5, consistent with mild thickening of long bone diaphysis noted via x-ray. Strikingly, the bone marrow biopsy revealed haphazard ossification, immature cartilage formation and thickened trabeculae replacing hematopoiesis within the marrow cavity. Next-generation sequencing revealed two novel biallelic mutations within the thromboxane synthase gene TBXAS1 (c.266T>C; c.989T>C). Both mutations affected conserved amino acid residues and were predicted to be disruptive to the protein function by two independent bioinformatics algorithms (Provean and PolyPhen-2). Thromboxane cascade regulates pathways of inflammation, coagulation and osteoclast activation, suggesting a mechanistic explanation of how thromboxane synthase malfunction causes abnormal bone remodeling and bone marrow failure. TBXAS1 disruption had been described in a rare autosomal recessive syndrome Ghosal hematodiaphyseal dysplasia (GHDD) associated with increased bone density and bone marrow failure. GHDD due to TBXAS1 mutations was genetically confirmed only in four families of Northern African and Middle Eastern descent (Nat Genet 2008; 40: 284-286). To our knowledge, this is the first genetically validated case of TBXAS1-/- Ghosal syndrome in the Caucasian population. Consistent with the well-established role of thromboxane in platelet function, our patient's platelets displayed impaired aggregation in response to arachidonic acid and structural abnormalities by transmission electron microscopy, revealing a functional platelet defect. Steroid therapy rendered the patient transfusion-independent and alleviated chronic pain and inflammation. A long-term follow-up will be needed to determine whether steroid treatment will result in stable improvement in hematopoiesis and decreased bone density, similar to other GHDD patients. This case illustrates how establishing the diagnosis of an underlying rare inherited bone marrow failure syndrome allows personalized, evidence-based treatment with lower risk of morbidity compared to cytotoxic chemotherapy and hematopoietic stem cell transplantation. Download : Download high-res image (223KB) Download : Download full-size image Disclosures No relevant conflicts of interest to declare.
30-Day unanticipated healthcare encounters after prolapse surgery: impact of same day discharge.

Abstract Background Same day discharge is becoming increasingly common in gynecologic surgery but data is limited for frequency, setting and severity of unanticipated healthcare visits for women discharged on day of surgery after major prolapse repair. Objective To evaluate if discharge on the day of surgery (POD0) is associated with increased 30-day unanticipated healthcare encounters after major pelvic organ prolapse (POP) surgery compared to discharge on or after post-operative day 1 (POD1). Study Design This is a retrospective analysis of women who underwent POP surgery by 8 FPMRS surgeons from 1/2016 - 10/2017. Unanticipated healthcare encounter was a composite variable of any visit to the office, emergency department (ED) or hospital readmission. Number of visits, visit diagnoses, and complication severity (Clavien-Dindo classification) were compared by day of discharge using χ2 tests. Multivariable analyses were performed. Results Of 405 women, 258 (63.7%) were discharged POD0 and 147 (36.3%) POD1 or later. Mean age was 66 (± 11) years, body mass index was 27.9 (± 4.8) kg/m2. Most had Stage III prolapse (n=273, 67.4%). Procedures included laparoscopic or robotic sacrocolpopexy, (n=163, 40.2%), vaginal apical suspensions (n=115, 28.4%), obliterative (n=105, 25.9%), and concomitant hysterectomy (n=229, 56.5%). There was no increase in number of women with at least one unanticipated healthcare encounter within 30 days of surgery based on discharge on POD0 compared to POD1, (24.0% vs 26.5%, p= .572). Majority of visits occurred in the office (17.8% vs 19.0%, p=.760). There was no increase in 30-day readmissions (3.5% vs 4.8%, p=.527). The most common visit diagnosis was pain and accounted for 31.5% of all visits, followed by urologic and GI symptoms. Diagnoses and complication severity did not vary by day of discharge, except women discharged POD0 were more likely to have a superficial wound separation (11.3% v 0%, p=.011) and less likely to experience Grade II complications (7.4% v 15.6%, p=.009). Few women had more than one unscheduled visit and rates were similar between the two groups (6.2% vs 6.8%, p=.810). On multivariable regression, younger women (aOR 1.03, 95%CI [1.001, 1.05]), those with lower BMI (aOR 1.07, 95%CI [1.13, 1.01]), and higher initial PACU pain scores (aOR 1.11, 95%CI [1.02-1.21]) were more likely to have an unanticipated healthcare encounter. Pain complaints were most often evaluated in the office compared to ED (41.1% vs 13.0%) while medical complications such as cardiac (15.6% vs 0%) and respiratory (6.5% vs 0%) were more likely to be evaluated in the ED. Higher Grade complications (II/III) were more likely to present to the ED (78.2% vs 27.1%, p Conclusion Same-day discharge after prolapse surgery did not result in an increase in 30-day unanticipated healthcare encounters.
Radicals in the Heartland: The 1960s Student Protest Movement at the University of Illinois

Review of: Radicals in the Heartland: The 1960s Student Protest Movement at the University of Illinois, by Michael V. Metz.
Poppin’ the Prophylactics: an Analysis of Antibiotics in Aquaculture

This paper will focus on the problems associated with the use of prophylactic and therapeutic antibiotics used in aquaculture internationally. Aquaculture can, in theory, be a beneficial way of sustainably harvesting fish—but only if done correctly. This paper will provide a background of scientific analysis as to how and why antibiotics are used and detail the problems associated with excessive use, including antibiotic resistance, residues found in human food and accumulation of antibiotics in the environment. Current use and regulation of antibiotics in differing nations will be analyzed, with an emphasis on the countries of Norway and Chile. Norway has proven to be a successful model by decreasing antibiotic usage drastically while still maintaining plentiful yields, as opposed to Chile, a nation that uses an abundance of antibiotics. Alternative approaches will be explored, such as vaccination to prevent disease outbreaks and the use of probiotics and bacteriophages. Finally, proposed policy recommendations and solutions will be examined.
Reflections on empathic design: a K-16 perspective

This paper offers a response to the article entitled, “Empathic design: imagining the cognitive and emotional learner experience” (Tracey and Hutchinson, Educational Technology Research and Development 67(5):1259–1272, 2019). This review examines the recent published study on empathic design in consideration of practical applications for K-16 settings. The case study explores the alignment of the designers’ sensitivities with the learner perceptions of a web-based collaborative tool, the Virtual Hospital, developed for health professionals. Aspects of the study and empathic design can be useful in the development and evaluation of similar tools across all educational levels. The noted flexibility in the design discussions and the continued focus towards student affect are two facets which could support the development of educational technology tools. One noted limitation when applying the findings to K-16 students is that the collaborative program in the study was designed for health professionals with advanced degrees. Two suggestions are offered to make a comparable project more suitable for the K-16 environment. First, build an evaluative piece that contains an objective assessment to measure collaboration and second, include the teacher perspective in the design and evaluative process. The reviewed study offers an excellent blueprint for further work with empathic design.
Racial Matching Among African-American and Hispanic Physicians and Patients

It is widely known that minority doctors have more patients of their same race and ethnicity than would be predicted by random distribution, but most measures of racial matching do not control for physician specialty, practice setting, or location. When we control for these variables, differences by doctor's race are much smaller and, in many cases, not statistically significant, suggesting that simply increasing the supply of minority physicians may not be the best way to increase access for under-served populations. However, we do find some evidence of culture-specific human capital (in the form of language ability) for Hispanics.
Measuring Faculty Viewpoints to Optimize Success for Faculty Researchers: Does Creativity Matter?

Researchers in higher education seek understanding of techniques to optimize success and produce insightful solutions that make positive impacts on society. We sought to establish howfaculty view c...
LID Study: Plasma lidocaine levels following airway topicalisation for paediatric microlaryngobronchoscopy (MLB).

BACKGROUND A dose of 5mg/kg lidocaine is considered appropriate for paediatric airway topicalisation. Existing literature suggests younger children are susceptible to toxic lidocaine plasma levels and achieve this at a faster rate. AIMS The primary outcome of this study was to ascertain peak plasma lidocaine levels after topicalisation for airway endoscopy. Secondary endpoints included: time to peak lidocaine plasma levels, signs of lidocaine toxicity (restricted to ECG changes or seizures when under anaesthesia) and clinical adverse events of laryngospasm, coughing or desaturation during the procedure. METHODS Data was collected prospectively over 18 months at Royal Manchester Children's Hospital. Children aged 0-8 years undergoing elective diagnostic or therapeutic airway endoscopy were included within the study. Standardised 2% lidocaine was used for airway topicalisation. Dose varied depending upon practitioner usual practice. Venous blood sampling occurred at 5, 10, 15 and 20 minutes post administration and plasma lidocaine levels (ng/ml) analysed. RESULTS A significant relationship exists between higher peak plasma levels and ages <18 months (p=0.00973). Strong linear correlation exists between body weight and age for our cohort (r=0.88). Higher peak plasma lidocaine levels occur with total dose volumes between 2 and 3mls of 2% lidocaine local anaesthetic (p=0.03) compared with <2ml total dose volumes. Data suggests a potential relationship of lower body weights achieving higher peak plasma levels (p=0.0516). Reduced IQR variation of peak plasma lidocaine levels exists when lidocaine dosing is <5mg/kg. CONCLUSIONS Age and total dose volume of topicalised lidocaine have a significant relationship with plasma lidocaine levels. A dose of 5mg/kg topicalised lidocaine for paediatric airway endoscopy is safe and provides good operating conditions. Lower patient body weights trend toward higher peak lidocaine plasma concentrations and require further investigation.
Early Readmission following NICU Discharges among a National Sample: Associated Factors and Spending.

OBJECTIVE Infants admitted to the neonatal intensive care unit (NICU) are at increased likelihood of hospital readmission when compared with non-NICU admitted infants, resulting in appreciable financial and emotional burdens. Early readmission, days to weeks, following NICU discharge, may be preventable. Population-based data identifying potentially modifiable factors and spending associated with early readmission are lacking. STUDY DESIGN We conducted a secondary data analysis of privately insured infants in the IBM MarketScan Research Database born from 2011 to 2017 in all 50 states and admitted to the NICU. We examined demographic and clinical characteristics of early readmission within 7 days and between 8 and 30 days following NICU discharge and the payments of NICU and readmission care. Data were analyzed using univariate and multivariable logistic regression. RESULTS Of the 86,741 NICU survivors analyzed, 3,131 infants (3.6%) were readmitted by 7 days and 2,128 infants (2.5%) between 8 and 30 days. Preterm infants had reduced odds of readmission by 7 days compared with term infants. Infants transferred to a step-down facility (vs. discharge home) and those with congenital anomalies had higher independent odds of readmission by 7 and 8 to 30 days. A higher percentage of NICU infants within the lowest quartile of initial NICU length of stay (LOS) were readmitted by 7 days compared with NICU infants in the middle and highest LOS quartiles (64 vs. 36%, p < 0.01). Median payments of readmissions at 7 and 8 to 30 days was $12,785 and 14,380, respectively. CONCLUSION Being term, being transferred to a step-down facility, and having a congenital anomaly were risk factors for early readmission. Shorter initial NICU LOS may be a contributing factor to readmission by 7 days, especially among term infants. These findings identify factors associated with readmission with the hope of preventing early readmission, minimizing spending, and optimizing ideal timing of NICU discharge. KEY POINTS · Preterm infants were less likely than term infants to be readmitted within 7 days after discharge.. · Transferred infants had higher odds of readmission versus those who were discharged home.. · Payments for an average single NICU day were $1,000 less than for an average day of readmission..
Impacted publics’ perceptions of crisis communication decision making

Abstract This study focused on qualitative analysis utilizing the grounded theory approach to explore how impacted publics connected to an organization’s business interests perceive the complexities of crisis communication decision making. Referencing the Boeing 737 MAX 8 crashes in October 2018 and March 2019, respectively, the researcher conducted interviews with participants either affiliated with Boeing publics or affiliated with an organization within the same industry that could conceivably be connected in a similar hypothetical context. Coding resulted in the emergence of Publics’ Expectations, which are those expectations that an impacted public has in an organizational crisis situation where it is affected by the crisis communication of a central organization, as the core category. This was further subcategorized into Cognitive Empathy (impacted public empathizes or understands elements that introduce central organization reluctance to communicate), Crisis Communication (impacted public expectations of central organization communication), and Decision Making (impacted public expectations of complicated decision making), with corresponding components for each subcategory. Although the findings support many of the prevailing notions in Situational Crisis Communication Theory (SCCT) and other crisis communication theories, this study found that impacted publics might have higher levels of empathy for organizational realities than previously understood that reframes culpability as responsibility for the plight of your publics, not necessarily immediate outright responsibility for the crisis. This offers insights for a practical approach to crisis communication that is inclusive of publics, yet still fair to the organization that has to also represent its own interests.
My How Things Have Changed! Strategic Organization Development and the Transformation of Human Resource Management

The purpose of this book Strategic Organization Development is to report a metasynthesis research study focusing on a human resources management approach Strategic Organizational Development. The book is written by Sharadindu Pandey who conducted a meta synthesis research study that is the focus of the book. The book is organized by chapters in which each is devoted to a step in the metasynthesis process. Pandey details the many decisions that must be made by the researcher employing this method as well as discussing the importance of the use of strategic organization development to build actionable knowledge. Valuable feature s of this book include the provision of a unique view of evolving metasynthesis research and the perspective of understanding the e merging use of the ‘Strategic Business Model’ of an organization being aligned with the Organizational Development of a company. This is not a book for light reading; rather this book would be most meaningful for those readers that are informed on the subjects of metasynthesis, qualitative research, business management, and strategic organization development.
Race/ethnicity and Americans' experiences with treatment decision making.

Abstract Objective Despite widespread documentation of racial/ethnic disparities in medical care, population-wide variation in Americans’ experiences with care are not well understood. We examined whether race/ethnicity is associated with information received from physicians regarding treatment recommendations. Methods We conducted a secondary analysis of cross-sectional survey data from a nationally representative sample (N = 1238). We assessed patients’ personal experiences of receiving information about the rationale for treatment recommendations from their physicians. Results Overall, respondents of minority race/ethnicity received less information from their doctors about the rationale for treatment recommendations. After adjustment for possible confounders, doctors talked less often with patients of ‘other’ race/ethnicity about reasons for treatment recommendations. Both Blacks’ and Hispanics’ doctors less often cited their own experiences, or scientific research as a reason for treatment recommendations. Conclusion Americans’ experiences with information communicated by physicians regarding treatment rationale varies significantly on some dimensions by race/ethnicity, suggesting that differences in key elements of shared decision making are evident in the care of racial/ethnic minorities. Practice implications Physicians should evaluate the extent to which their communication with patients varies by patient race/ethnicity, and make efforts to ensure that they share equally with all patients regarding the rationale for treatment recommendations.
Shootout-89, An Evaluation of Knowledge-Based Weather Forecasting Systems

Abstract During the summer of 1989, the Forecast Systems Laboratory of the National Oceanic and Atmospheric Administration sponsored an evaluation of artificial-intelligence-based systems that forecast severe convective storms. The evaluation experiment, called Shootout-89, took place in Boulder, and focussed on storms over the northeastern Colorado foothills and plains. (Moninger, et al., 1990) Six systems participated in Shootout-89. These included traditional expert systems, an analogy-based system, and a system developed using methods from the cognitive science/judgment analysis tradition. Each day of the exercise, the systems generated 2 to 9 hour forecasts of the probabilities of occurrence of: nonsignificant weather, significant weather, and severe weather, in each of four regions in northeastern Colorado. A verification coordinator working at the Denver Weather Service Forecast Office gathered ground-truth data from a network of observers. Systems were evaluated on the basis of several measures of forecast skill, and on other metrics such as timeliness, ease of learning, and ease of use. Systems were generally easy to operate, however the various systems required substantially different levels of meteorological expertise on the part of their users–reflecting the various operational environments for which the systems had been designed. Systems varied in their statistical behavior, but on this difficult forecast problem, the systems generally showed a skill approximately equal to that of persistence forecasts and climatological (historical frequency) forecasts. The two systems that appeared best able to discriminate significant from nonsignificant weather events were traditional expert systems. Both of these systems required the operator to make relatively sophisticated meteorological judgments. We are unable, based on only one summer's worth of data, to determine the extent to which the greater skill of the two systems was due to the content of their knowledge bases, or to the subjective judgments of the operator. A follow-on experiment, Shootout-91, is currently being planned. Interested potential participants are encouraged to contact the author at the address above.
Autonomy and networking challenges of future underwater systems

In the last decade, the use of underwater systems of all kinds has seen a steady increase. In this publication, we advocate the use of such systems in a complementary, collective, and networked manner. Even though today's achievements of such systems look impressive, the level of autonomy and networking required for tomorrow's needs remains deficient. After reviewing current trends and limitations, we formulate challenges pertaining to research areas that are key for future employments of underwater systems. We conclude by discussing future research efforts, especially those at the DRDC Atlantic Research Centre.
Combined emission and economic dispatch incorporating demand side resources

In this paper, a unique formulation for combined emission and economic dispatch (CEED) incorporating demand side resources (CEED-DSRs) is presented. Herein, the target of a generation company is minimizing total cost including power generation cost, penalty cost due to carbon emissions, and cost of demand response program (DRP) implementation. In solving the CEED-DSRs problem, one of the voluntary and incentive-based programs of DRPs, that is, emergency demand response program (EDRP) is chosen, and then different strategies are defined for implementing EDRP. The strategies are prioritized based on minimum cost of the CEED-DSRs problem. Potential benefits of the proposed CEED-DSRs include reduced total cost of problem, diminished carbon emission level of thermal power plants, and improved system load factor.
Oncogenic Mutations of PIK3CA in Human Cancers

The involvement of the PIK3CA gene product p110α, the catalytic subunit of phosphatidylinositol 3-kinase (PI3K), in human cancer has been suggested for over 15 years, and support for this proposal had been provided by both genetic and functional studies, including most recently the discovery of common activating missense mutations of PIK3CA in a wide variety of common human tumor types. This chapter will focus on the discovery of these mutations and describes their relevance to a wide range of common human tumor types.
Dr. Strangelove Moves Mountains

Proving Grounds . Project Plowshare and the Unrealized Dream of Nuclear Earthmoving. By Scott Kirsch . Rutgers University Press, New Brunswick, NJ, 2005. 272 pp. $39.95. ISBN 0-8135-3666-9. The author explores the two-decades-long efforts of Edward Teller and others to promote the use of nuclear explosions to construct canals, dams, harbors, and quarries.
Mechanical behavior of solid oxide fuel cell (SOFC) seal glass-boron nitride nanotubes composite

Barium calcium aluminosilicate glass composites reinforced with about 4 weight percent of BN nanaotubes (BNNTs) were fabricated by hot pressing. Flexure strength and fracture toughness of the glass-BNNT composites were determined at ambient temperature. The strength of the composite was higher by as much as 90 % and fracture toughness by as much as 35 % than those of the unreinforced G18 glass. Pullout of the BNNTs was observed from fracture surfaces of the composite. Elastic modulus, density, and microhardness of the composite were lower than those of the unreinforced glass.
Factors Influencing the Reliability of Hepatic Turbidity and Flocculation Tests in the Differential Diagnosis of Obstructive Jaundice

To distinguish obstructive from hepatocellular jaundice often requires laboratory aid to supplement clinical judgment. The turbidity and flocculation tests are recognized as being particularly useful for this purpose. As newer techniques of this type have been introduced, for example the zinc turbidity method and the substitution of pH 7.55 buffer for pH 7.S in thymol tests, their sensitivity in detecting slight liver damage has increased. Several studiesl 3 have shown the superiority of these modifications for diagnosing subclinical hepatitis and for screening blood donors to detect possible virus carriers. It has been suggested4 that in obstructive jaundice, which often is associated with some degree of secondary liver cell damage, these highly sensitive tests might also give abnormal results more often than some of the older turbidity and flocculation methods. If this proved to be so, it might make the newer techniques less useful than the older ones as aids in differentiating between obstructive and hepatocellular jaundice. To answer this question the present study was undertaken. In 154 patients with obstructive jaundice the results of six hepatic turbidity and flocculation tests were compared with one another. These findings were contrasted with results reported for these tests in other studies of patients with hepatocellular jaundice. The effect of such factors as the duration and intensity of jaundice on the test responses also was analyzed. It was found that the more sensitive turbidity and flocculation tests are as effective as the older, less sensitive ones for differentiating jaundice caused by obstruction from that caused by liver disease.
Effect of an automated, nursing unit-based drug-dispensing device on medication errors.

The effect of an automated drug-dispensing system on medication error rates was studied. Disguised observations were made on nursing units just before (phase 1) and two months after (phase 2) the implementation of Medstation Rx (Pyxis, San Diego, CA) at a 600-bed hospital. Information gathered included the time of drug administration, the time the medication as ordered to be given, a description of what happened during administration of the dose, and the type of medication error, if any. During phase 1 there were 873 observations and 148 medication errors, for an error rate of 16.9%. During phase 2 the error rate was 10.4% (97 errors in 929 observations). In both study phases, most of the errors were wrong-time errors. The mean +/- S.D. difference between actual and scheduled administration times was 34.5 +/- 48.9 minutes in phase 1 and 30.1 +/- 31.6 minutes in phase 2. Both the decrease in the error rate and the decrease in the departure from scheduled administration times were statistically significant. Medstation Rx was associated with a reduction in the rate of medication errors at a large hospital.
Techniques and applications of in vivo diffusion imaging of articular cartilage.

Early in the process of osteoarthritis (OA) the composition (water, proteoglycan [PG], and collagen) and structure of articular cartilage is altered leading to changes in its mechanical properties. A technique that can assess the composition and structure of the cartilage in vivo can provide insight in the mechanical integrity of articular cartilage and become a powerful tool for the early diagnosis of OA. Diffusion tensor imaging (DTI) has been proposed as a biomarker for cartilage composition and structure. DTI is sensitive to the PG content through the mean diffusivity and to the collagen architecture through the fractional anisotropy. However, the acquisition of DTI of articular cartilage in vivo is challenging due to the short T2 of articular cartilage (∼40 ms at 3 Tesla) and the high resolution needed (0.5–0.7 mm in plane) to depict the cartilage anatomy. We describe the pulse sequences used for in vivo DTI of articular cartilage and discus general strategies for protocol optimization. We provide a comprehensive review of measurements of DTI of articular cartilage from ex vivo validation experiments to its recent clinical applications. J. Magn. Reson. Imaging 2015;41:1487–1504. © 2015 Wiley Periodicals, Inc.
Photodynamic Therapy for Non-Melanoma Skin Cancer

Photodynamic therapy (PDT) involves the administration of a photosensitizing drug and its subsequent activation by light at wavelengths matching the absorption spectrum of the photosensitizer. Because the skin is readily accessible to light-based therapies, PDT with systemic and particularly with topical agents has become important in treating cutaneous disorders. Topical PDT is indicated for treating actinic keratosis, superficial or thin non-melanoma skin cancer, including some cases of nodular basal cell carcinoma, and some cutaneous lymphomas. Advantages of aminolevulinic acid/methyl aminolevulinate PDT include the possibility of simultaneous treatment of multiple tumors and large surface areas, good cosmesis, and minimal morbidity, such as bleeding, scarring, or infection.
Measurement of the angular distribution of 4He(p, d)3He, 4He(p, 3He)pn and 4He(p, t)pp reactions

Abstract We have measured the angular distribution of the reaction 4 He(p, d) 3 He at 47 MeV over the center-of-mass angular range of 12–166°. We have also measured the angular distributions of the reactions 4 He(p, 3 He)pn and 4 He(p, t)pp in the region of the nucleon-nucleon final state interaction at the same bombarding energy over an angular range of 7.5° to 50.0° in the laboratory. The 3 He and triton energy spectra are also presented and Watson-Migdal fits to these data in the region of the nucleon-nucleon final state interaction are shown.
A Modified Procedure for the Purification of Clostridial Collagenase

Abstract A method is described for the purification of clostridial collagenase from a crude enzyme preparation employing cation exchange chromatography on SP Sephadex, anion exchange chromatography on DEAE cellulose and gel filtration on Sephacryl S-200. Emphasis was placed on purity using continuous shallow gradients for the ion exchange separations to increase resolution and monitoring eluates both with respect to ultraviolet light absorption at 230 nm and analytical disc gel acrylamide electrophoresis. In addition, protein fractions were assayed for collagenolytic and non-specific proteolytic activity. The purity of the final preparation was assessed by acrylamide electrophoresis, gel filtration and amino acid analysis. The isolated enzyme hydrolyzed between 30 and 40% of rat tail tendon collagen in 1 h at 37° C and lacked measurable trypsin or elastase-like activity.
Discovery of the Wonder Drug: From Cows to Cortisone

Featured Article: Hench PS, Kendall EC, Slocumb CH, Polley HF. The effects of the adrenal cortical hormone 17-hydroxy-11-dehydrocorticosterone (Compound E) on the acute phase of rheumatic fever; preliminary report. Mayo Clin Proc 1949;24:277–97.2 A passage in the New Testament describes a paralyzed man miraculously regaining the ability to stand and walk. In a small town in southeast Minnesota on the morning of September 21, 1948, a similar miracle began to unfold. A 29-year-old woman was hospitalized at the Mayo Clinic (Rochester, MN) for severe rheumatoid arthritis that caused debilitating joint immobility. She was injected with a small amount of an experimental new drug, at the time named Compound E, which was discovered and investigated in tandem by Edward C. Kendall and Philip S. Hench. Two days and 2 more injections later the patient could walk and left the hospital to enjoy a 3-hour shopping spree. Just 2 short years later Kendall and Hench shared the Nobel Prize in Physiology or Medicine with Tadeus Reichstein, a Swiss scientist who independently isolated hormones of the adrenal cortex (1). The …
Parathyroid preservation during thyroid surgery

Purpose: Even though thyroid surgery is generally quite safe, permanent hypoparathyroidism is a very distressing complication. The incidence of hypoparathyroidism is directly proportional to the extent of thyroidectomy, and inversely proportional to the experience of the surgeon. It is also related to the extent of invasion of thyroid cancer and of the degree of dissection in the tracheo-esophageal groove. The incidence reported in the literature varies between 1 % to 29%. Total thyroidectomy results in a higher incidence of hypoparathyroidism. Materials and Methods: This report describes experiences with 600 thyroidectomies over a period of 11 years. The major indications for surgery included suspicion or proof of malignancy, compression symptoms, and substernal goiters. Twenty-six patients underwent surgery for Graves' disease. There were 221 men and 379 women, ranging in age from 16 to 89 years; 88% of the patients had benign disease, whereas 12% of the patients had malignant pathology. The surgical procedures included 62 total thyroidecotmies, 188 subtotal thyroidectomies, and lobectomy and isthmectomy in 350 patients. Results: Meticulous tracheo-esophageal groove dissection, identification of parathyroids and their preservation, including the blood supply, was routine in each case. Even in patients undergoing unilateral lobectomy, every effort was made to preserve the parathyroids. If any of the parathyroids or its blood supply was injured, it was autotransplanted in the sternomastoid muscle. Only two patients developed temporary hypoparathyroidism. Conclusion: Parathyroid autotransplantation is performed whenever one or more of the parathyroids are damaged. Parathyroid preservation during thyroid surgery is crucial in the overall management of thyroid diseases.
EXTRATHYROIDAL IODINE METABOLISM1,2

IODINE HAS BEEN IDENTIFIED with the physiology of the thyroid gland since the findings of Coindet (I) and Chatin (2). The studies of Baumann (3) Marine (4), Kendall (5) and recently many others have contributed to our knowledge of io-dine metabolism. These studies have focused attention on the intimate relation that exists between iodine and the thyroid. The effects of either the administration or re-striction of iodine, hitherto observed are, for the most part, effects on the thyroid gland or those which imply the participation of thyroid tissue. Recently the extra-thyroidal production of thyroxine or thyroxine-like substances from the iodization of protein has been accomplished. In view of this finding, a study of the effect of iodine on the completely thyroidectomised animal should be significant.
Chronic mucocutaneous candidiasis

Summary The pathophysiology, diagnosis, and treatment of chronic mucocutaneous candidiasis are discussed and a case is presented that was eventually treated successfully with clotrimazole and ketoconazole.
Land Price Impacts of the Adirondack Park Land Use and Development Plan

The enactment of any ambitious land use control system raises a variety of concerns about the effects of the system on land values. Restrictions on allowable use typically are opposed by the affected landowners in that such controls may depress market value. Owners of land not encumbered by controls may be far more sanguine, believing the demand for developable parcels will be enhanced. These concerns are likely to be expressed whenever land use controls are imposed. A particularly strong reaction followed the legislation that created the Adirondack Park Agency in New York State. The 1973 enactment of the Adirondack Land Use and Development Plan by the agency introduced sophisticated land use controls where virtually no regulation on private land had existed previously. One key policy issue that arises is the impact of this new set of controls on property values. The need for empirical answers to this issue is prompted by concerns over the equity of the program. Land value changes determine, in part, who pays and who benefits from the program. This concern is certainly not unique to the Adirondack land use control case, but has been raised in the context of economic evaluation of land use controls in other regions as well (Kneisel). This paper addresses the issue of land price impacts. Specifically, a technique is described for measuring the price impacts of land use control systems and is applied to the Adirondack Park Land Use and Development Plan. New York's Adirondack Park contains some six million acres, three-fifths of which are now in private ownership and two-fifths in state ownership. Although efforts to manage this collection of private and public holdings of mountains, lakes, forests, and villages date at least to the creation of the State Forest Commission in the 1800s, a fully comprehensive plan was not enacted until 1973. In that year the Adirondack Land Use and Development Plan (hereinafter referred to as "the Plan") was signed into law. The Plan separated the park into several land use intensity zones. These were, ranging from lowest to highest permitted intensity of development: resource management, rural, low intensity, moderate intensity, hamlet, and industrial. The most critical restriction on residential development is the intensity guideline for each of these classes. In general, moderate intensity land cannot be developed with a density greater than 1.28 acres per house; low intensity land must allow 2.3 acres per house; rural land 8.5 acres per house; and resource management 42.0 acres per house. No in ensity guidelines apply in the industrial and hamlet areas.
On the growth of single crystals of ReO3 by chemical vapour transport

Abstract This paper reports the growth of single crystals of ReO3 using chemical vapour transport. Hydrogen chloride and iodine were used as transporting agents. It is found that crystal growth can occur at temperatures far in excess of the temperature at which ReO3 decomposes in vacuo, and a considerable increase in the growth rate is hereby achieved.
SU-E-J-65: Feasibility Study of Backscatter Imaging for Image-Guided Radiotherapy

Purpose: Tracking tumor motion during external beam radiation therapy is a major factor limiting the treatment of lung tumors. Several tracking techniques have been previously reported; however, these are limited to 2D motion, fail to capture image data during treatment delivery (e.g., patient setup imaging), fail to capture motion along the beam axis (MV CineMode), or increase patient dose (kV fluoroscopy). Creating images from radiation that is naturally scattered from the patient during treatment could overcome the limitations of other techniques. This study investigated the feasibility of using photon scatter to create images during external beam radiation delivery. Methods: A prototype imager was created using a Trilogy Linac, pinhole collimator, and computed radiography(CR) plate. Two small cylinders (solid water and cerrobend) were placed in the path of a 6MV beam. The collimator/CR plate was placed at 45° and 90° from the gantry head and 2000MU was delivered. Optically‐stimulated luminescent (OSLD) detectors were placed on the surface of the CR plate to measure photondose. Contrast‐to‐noise ratios (CNR) were calculated for each peg to assess image quality. Results: At 45°, OSLD dose was 1.3±0.2cGy and the CNRs were 1.5 and 5.3 for water and cerrobend, respectively. OSLD dose increased to 2.6±0.3cGy and CNR increased to 14.8 and 18.3 at 90°. Scatter from the gantry head and the pinhole collimator are the major sources of noise which limit image quality. The measured CNR satisfied the Rose criteria for detectability (CNR > 3–5) for the 90° gantry orientation. Further, scatter imaging should satisfy the Rose criteria if output is reduced from 2000MU to 200MU. Conclusions: Preliminary results confirm the feasibility of using scatter imaging for in situ treatment monitoring. Future work will investigate creation of tomosynthesis images and improving image quality using increased shielding and a multi‐pinhole collimator.
Management of Global Risk Across the Continuum of Hypertensive Heart Disease

Identification and management of cardiovascular (CV) risk factors are essential to help prevent CV disease and slow its progression. Long-term epidemiologic data show that hypertension is associated with a two- to four-fold increase in CV morbidity and mortality; moreover, antihypertensive therapy has been proven to significantly reduce the risk of CV events. Clinical trial data also suggest that different antihypertensive agents generally provide similar reductions in CV risks and outcomes. Beta blockers have historically played an integral role in hypertension treatment, particularly among patients at high CV risk; however, a recent meta-analysis, based primarily on the use of atenolol, found that β blockers may provide less clinical benefit as initial therapy than other classes of antihypertensive agents. Beta blockers are heterogeneous, and atenolol data may not be representative of other β blockers. Newer β blockers, which provide both cardioselective β2-adrenergic receptor blockade and endothelium-dependent vasodilation, may prove to be more effective in reducing CV morbidity and mortality. Intensive strategies to control global CV risk have been shown to significantly reduce CV events. The challenge remains to develop effective risk assessment tools to identify at-risk patients who often go undetected.