cssi/SciSciGPT-SciSciNet huggingface dataset:
The effect of M&A advisors’ opinions on acquirer shareholder voting☆

Abstract Recent studies find that merger advisors, in particular those of the acquirer, often face conflicts of interest and present overly optimistic opinions about a deal. It is not clear, however, whether and how these opinions affect shareholders’ voting decisions regarding a deal. The main findings indicate that target advisors’ opinions but not those of acquirer advisors, significantly influence the acquirer shareholders’ approval rate. Acquirer advisors’ opinions tend to be more optimistic, especially when the deal announcement intrigues negative market reaction. However, these opinions are negatively related to the post-merger performance. This paper concludes that acquirer shareholders are able to discern the potential conflicts of interest of merger advisors and follow the advice of more conservative target advisors.
Neurilemmomatosis, NF2, and juvenile xanthogranuloma

The gene locus for neurilemmomatosis has been reported to lie within the neurofibromatosis type 2 gene region, suggesting that these 2 diseases may be identical. We describe an adolescent girl with multiple neurilemmomas and juvenile xanthogranulomas, who was found to have bilateral acoustic neuromas and multiple central nervous tissue tumors as seen in patients with a diagnosis of neurofibromatosis type 2. This case and recent genetic studies suggest that neurilemmomatosis and neurofibromatosis type 2 are the same disease.
A response by P. Benner to K. Cash, “Benner and expertise in nursing: a critique”

Articulating the knowledge, skill and ethos embedded in practice is the explicit goal of From Novice to Expert, in order to inform our science by raising new issues and questions. The work is not inherently conservative, since it does not assume a monolithic position in opposition to all other perspectives. It does not call for traditionalism, i.e. using tradition as the only source of authority and power. Instead, it attempts to articulate the best in our current practice while raising questions about the silences and hidden assumptions in the Cartesian tradition, a tradition which holds that there are, in principle, no limits to formalism, that skill is just a mechanistic following of formal propositions held as representations in the mind, that contrasts necessarily form oppositions and contradictions rather than discovery and dialogue, and that all perspectives are best understood from an objectivist point of view. Such a hegemonic epistemological stance may indeed be the most conservative position of all. If we continue to force our ways of knowing into one hegemonic mold for the sake of 'winning' in a power discourse, we may have 'lost' before we have begun, because our agenda will continue to be described and evaluated in terms of what it is not rather than in terms of what it is (Benner, 1994b).
Cytoplasmic suppression of tumor progression in reconstituted cells

This report details studies of whether mouse NIH/3T3 TGr karyoplasts that are exposed to benzo[a]pyrene epoxide(trans) (BPDE) can progress to tumorigenicity when they are rescued with either mouse B10mtJ CAPr tumorigenic (experiment 1) or nontumorigenic (experiment 2) cytoplasts. The mitochondrial DNA of the B10mtJ cells has restriction fragment length differences that allow distinction from the mitochondrial DNA of the NIH/3T3 cells. The reconstructed clones in experiment 1 were all tumorigenic, while those from experiment 2 were all nontumorigenic. The clones in both experiments were passaged for an equivalent time. These findings reflect the presence of factors in mouse cytoplasm capable of suppressing the tumor phenotype of NIH/3T3-BPDE treated karyoplasts when rescued at an early stage of progression.
Evidence against the nuclear in situ binding of arsenicals–oxidative stress theory of arsenic carcinogenesis

A large amount of evidence suggests that arsenicals act via oxidative stress in causing cancer in humans and experimental animals. It is possible that arsenicals could bind in situ close to nuclear DNA followed by Haber-Weiss type oxidative DNA damage. Therefore, we tested this hypothesis by using radioactive (73)As labeled arsenite and vacuum filtration methodology to determine the binding affinity and capacity of (73)As arsenite to calf thymus DNA and Type 2A unfractionated histones, histone H3, H4 and horse spleen ferritin. Arsenicals are known to release redox active Fe from ferritin. At concentrations up to about 1 mM, neither DNA nor any of the three proteins studied, Type II-A histones, histone H3, H4 or ferritin, bound radioactive arsenite in a specific manner. Therefore, it appears highly unlikely that initial in situ binding of trivalent arsenicals, followed by in situ oxidative DNA damage, can account for arsenic's carcinogenicity. This experimental evidence (lack of arsenite binding to DNA, histone Type II-A and histone H3, H4) does not rule out other possible oxidative stress modes of action for arsenic such as (a) diffusion of longer lived oxidative stress molecules, such as H(2)O(2) into the nucleus and ensuing oxidative damage, (b) redox chemistry by unbound arsenicals in the nucleus, or (c) arsenical-induced perturbations in Fe, Cu or other metals which are already known to oxidize DNA in vitro and in vivo.
The Use of Laser Altimetry in the Orbit and Attitude Determination of Mars Global Surveyor

Altimetry from the Mars Observer Laser Altimeter (MOLA) which is carried on board Mars Global Surveyor (MGS) has been analyzed for the period of the MOS mission known as Science Phasing Orbit 1 (SPO-1). We have used these altimeter ranges to improve orbit and attitude knowledge for MGS. This has been accomplished by writing crossover constraint equations that have been derived from short passes of MOLA data. These constraint equations differ from traditional Crossover constraints and exploit the small foot print associated with laser altimetry.
Using knowledge in the world to improve patient safety: Designing affordances in health care equipment to specify a sequential “checklist”

Use of current health care equipment for medical procedures (e.g., central line insertions and central line care) is primarily dependent on the cognition of the health care worker. That is, the present design of equipment (typically numerous, separately packaged individual items) provides minimal information about the optimal order of procedure steps and no defenses against human error, such as omitting steps in procedure. In this article, we propose patient safety may be improved by redesigning equipment to integrate a “checklist” using sequencing, color coding, and visual icons. We hypothesize this reduces cognitive demand by off-loading knowledge into the world, creating affordances that provide guidance reducing the likelihood of errors and promoting adherence to best practices. © 2011Wiley Periodicals, Inc.
Valproic acid induced encephalopathy – 19 new cases in Germany from 1994 to 2003 – A side effect associated to VPA-therapy not only in young children

Valproic acid (VPA) is a broad-spectrum antiepileptic drug and is usually well-tolerated. Rare serious complications may occur in some patients, including haemorrhagic pancreatitis, bone marrow suppression, VPA-induced hepatotoxicity and VPA-induced encephalopathy. The typical signs of VPA-induced encephalopathy are impaired consciousness, sometimes marked EEG background slowing, increased seizure frequency, with or without hyperammonemia. There is still no proof of causative effect of VPA in patients with encephalopathy, but only of an association with an assumed causal relation. We report 19 patients with VPA-associated encephalopathy in Germany from the years 1994 to 2003, none of whom had been published previously.
Interferon-Free Regimens: The Near Future, the Likely and the Not So Likely

Remarkable progress has been achieved in the treatment of chronic hepatitis C virus (HCV) since interferon was first used to treat this pathogen more than 20 years ago. This article reviews the mechanisms through which interferon is believed to suppress HCV and lead to SVR. These observations are used to speculate as to whether an all-oral antiviral cocktail could "cure" HCV in the near future.
Versatile architecture for image recognition applications

Architectures for the development of image recognition algorithms must support the implementation of systematic procedures for solving image recognition problems. All too often, designers develop image recognition architectures in an ad hoc fashion which lacks the structure to meet long term needs. Vendors typically supply customers with standard image processing libraries and display tools. Combining these tools and formulating development strategies have remained stumbling blocks in the design of complete image recognition algorithm development environments. In this paper, an architecture is presented which provides a well defined framework, and at the same time is sufficiently flexible to accommodate images of multiple sensor and data types. The primary components of the architecture are: ground-truthing, preprocessing (which includes image processing and segmentation), feature extraction, classification, and performance analysis. Powerful and well defined data structures are exploited for each of the primary components. Groups of programs called tasks manipulate one or more of these data structures, each task belonging to one of the primary components. Multiple tasks can be executed in an unsupervised mode over an entire database of images. Results are then subjected to performance analysis and feedback. A description of the primary components and how they are integrated to facilitate the rapid prototyping and development of image recognition algorithms is presented.© (1992) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
The state of the "state" debate in hypnosis: a view from the cognitive-behavioral perspective.

Abstract For most of the past 50 years, hypnosis research has been driven by a debate about whether hypnotic phenomena can be best described and understood as the product of an altered state of consciousness. The meanings of some of the pivotal concepts in this debate and the nature of the phenomena that gave rise to them were ambiguous at the outset and led to misconceptions and surplus meanings that have obscured the debate through most of its history The nature of the posited hypnotic state and its assumed consequences have changed during this period, reflecting the abandonment of untenable versions of hypnotic state theory. Carefully conducted studies in laboratories around the world have refined our understanding of hypnotic phenomena and helped idenbfy the critical variables that hterad to elicit them. With the maturation of the cognitive-behavioral perspective and the growing refinement of state conceptions of hypnosis, questions arise whether the state debate is still the axis about which hypnosis...
Modeling of Droplet Evaporation and Coalescence for Direct Injection into an Argon Inductively Coupled Plasma

A numerical model has been developed to simulate the desolvation and coalescence rates and number densities of sample droplets directly injected into an argon inductively coupled plasma. Specific droplet processes considered include transport, heating, desolvation, and coalescence. The droplet-droplet interactions are computed with the direct simulation Monte Carlo method. The simulation is used to predict spatial maps of droplet number and mass densities within an argon ICP. An investigation into the overall importance of coalescence in various spray processes is also conducted.
An analysis of the effects of ground reflection in line-of-sight phase systems

The presence of a reflected component in a line-of-sight radio system influences the phase variability resulting from atmospheric changes along and near the path. An analysis is made of a simple case showing the general nature of this effect and the parameters upon which it depends. A method is presented for calculating the phase behavior of the resultant signal, in terms of that expected from a single direct component, and the relevant system parameters.
A Multifunctional Region of the Shigella Type 3 Effector IpgB1 Is Important for Secretion from Bacteria and Membrane Targeting in Eukaryotic Cells

Type 3 secretion systems are complex nanomachines used by many Gram–negative bacteria to deliver tens of proteins (effectors) directly into host cells. Once delivered into host cells, effectors often target to specific cellular loci where they usurp host cell processes to their advantage. Here, using the yeast model system, we identify the membrane localization domain (MLD) of IpgB1, a stretch of 20 amino acids enriched for hydrophobic residues essential for the targeting of this effector to the plasma membrane. Embedded within these residues are ten that define the IpgB1 chaperone-binding domain for Spa15. As observed with dedicated class IA chaperones that mask hydrophobic MLDs, Spa15, a class IB chaperone, promotes IpgB1 stability by binding this hydrophobic region. However, despite being stable, an IpgB1 allele that lacks the MLD is not recognized as a secreted substrate. Similarly, deletion of the chaperone binding domains of IpgB1 and three additional Spa15-dependent effectors result in alleles that are no longer recognized as secreted substrates despite the presence of intact N-terminal secretion signal sequences. This is in contrast with MLD-containing effectors that bind class IA dedicated chaperones, as deletion of the MLD of these effectors alleviates the chaperone requirement for secretion. These observations indicate that at least for substrates of class IB chaperones, the chaperone-effector complex plays a major role in defining type 3 secreted proteins and highlight how a single region of an effector can play important roles both within prokaryotic and eukaryotic cells.
Circulation in Enewetak Atoll lagoon1

Currents at Enewetak Atoll, Marshall Islands, were measured on the reef margins, in the channels, and in the lagoon. Lagoon circulation is dominated by wind-driven downwind surface flow and an upwind middepth return flow. This wind-driven flow has the characteristics of an Ekman spiral in an enclosed sea. Lagoon flushing is accomplished primarily by surf-driven water input over the windward (eastern) reefs and southerly drift out the South Channel. Mean water residence time is 1 month, while water entering the northern portion of the atoll takes about 4 months to exit.
Avoidant personality disorder, generalized social phobia, and shyness: Putting the personality back into personality disorders.

With increasing recognition of social phobia as a common and often debilitating disorder, interest is developing in its boundaries with other disorders such as avoidant personality disorder and temperamental constructs such as shyness. Such interest reflects the more general debate concerning Axis I disorders, personality disorders, and what is considered normal personality variance. This review summarizes the available literature comparing avoidant personality disorder (APD), generalized social phobia (GSP), and shyness. In studies comparing APD and GSP, comorbidity rates have varied from approximately 25% to numbers high enough that the ability to diagnose one disorder without the other was questioned. Comparisons of the characteristics of APD and GSP have yielded few qualitative differences, although some studies have shown evidence that APD may represent a more severe form of GSP with respect to levels of symptoms, fear of negative evaluation, anxiety, avoidance, and depression. Personality dimensions...
Emerging no more: Do emerging market economies owe their success to globalisation?

The influential weekly The Economist recently proclaimed that emerging economies have reached a milestone by producing more than half the world's GDP. The Economists' argument suggests that emerging economies have embraced globalisation and integrated them into the international economic and trade systems. The implications for developed economies are ominous – slower growth, higher inflation, and lower wage growth. The enigma of globalisation and emerging economies are explored by decomposing them into economic, social, and political factors. We engage the globalisation literature by testing common assumptions of globalisation in emerging economies.
Raman Spectroscopy At Very High Pressures

In this review article technical aspects of high-pressure Raman spectroscopy are discussed. With the advancements-in the diamond anvil cell (DAC) technology and spectroscopic instrumentation, high-pressure Raman spectroscopy has made tremendous advances. It has become possible to study vibrational spectra of micron size (~5μ) samples of solids, liquids and gases to very high pressures--approaching the megabar range--in the 0°, 90°, 135° and 180° scattering geometries. The advantages and problems of Raman measurements in various scattering geometries in the DAC are examined by comparing: (i) the high-pressure spectra of normal deuterium (n-D2) fluid in 0° and 90° scattering geometries, and (ii) micro-Raman spectra of diamond anvils at high pressures in 135° and 180° scattering geometries. It is found that the 90° and 135° scattering modes of high-pressure Raman measurements in the DAC provide better signal-to-noise ratio and less interference from diamond-anvil fluorescence. In addition, the results of high-pressure Raman measurements of Ge02 and Si02 glasses and of crystalline polymorphs of a number of materials, including Ge02, Si02, and TiO2 are summarized.
Significance of distal false lumen after type A dissection repair

Fifty-eight patients underwent repair of acute type A dissection between 1986 and 1992. Follow-up aortogram, computed tomographic scan with contrast, magnetic resonance imaging scan, or a combination of these tests was available in 38 patients with preoperatively patent distal false lumens. All distal anastomoses were constructed with the open technique during a period of circulatory arrest. There were 25 suture and 13 intraluminal graft anastomoses. Patency of the distal false lumen was found in 47.3%. Use of the intraluminal graft for the distal anastomosis decreased patency, although not significantly (4/13, 30% versus 14/25, 56%; p = 0.14). The direction of flow into the false lumen was antegrade in 11 of 24 (45.8%) of sutured anastomoses and 0 of 9 intraluminal graft anastomoses (p < 0.01). Actuarial survival at 5 years for patients with closed distal false lumen was 95% +/- 4.8% versus 76% +/- 15% for patients with patency of the distal false lumen (p = not significant). Event-free survival at 5 years for both groups was 84% +/- 8.3% (closed false lumen) and 63% +/- 13.5% (patency of distal false lumen; p = not significant). This experience indicates that in the treatment of acute type A dissections, operative strategy and anastomotic technique play a role in reducing the incidence of patency and related complications of the distal false lumen.
A recurrent dynamic neural network approach and implementation, for noise-contaminated signal representation

This paper presents a new Recurrent Dynamic Neural Network (RDNN) approach and its implementation in order to solve noisy signal representation, processing, and compression. Essentially, the neural net solves, in a systematic recurrent way, simultaneous sets of uncertain and even noise corrupted linear or nonlinear equations, by seeking a corresponding minimum energy state. The VLSIC hardware design and implementation are built around asymmetric Cellular Neural Network (CNN) architecture. Digital semi-custom circuit design is used to implement each CNN building block, using CMOS 2-/spl mu/m n-well technology, and employing available standard cell library. The overall dimensions of the implemented CNN is 3.1/spl times/2.5 mm/sup 2/. Time domain simulation using IRSIM, gave an expected throughput rate of 33 M operations per second. The perceived advantages over traditional approaches are: robustness of computation, ability to confront dynamic (time-varying), as well as noisy signals, flexibility in implementation, and quick turn-around design time.
Copper-64-alloyed gold nanoparticles for cancer imaging: improved radiolabel stability and diagnostic accuracy.

Gold nanoparticles, especially positron-emitter- labeled gold nanostructures, have gained steadily increasing attention in biomedical applications. Of the radionuclides used for nanoparticle positron emission tomography imaging, radiometals such as 64 Cu have been widely employed. Cur- rently, radiolabeling through macrocyclic chelators is the most commonly used strategy. However, the radiolabel stability may be a limiting factor for further translational research. We report the integration of 64 Cu into the structures of gold nanoparticles. With this approach, the specific radioactivity of the alloyed gold nanoparticles could be freely and precisely controlled by the addition of the precursor 64 CuCl2 to afford sensitive detection. The direct incorporation of 64 Cu into the lattice of the gold nanoparticle structure ensured the radiolabel stability for accurate localization in vivo. The superior pharmacoki- netic and positron emission tomography imaging capabilities demonstrate high passive tumor targeting and contrast ratios in a mouse breast cancer model, as well as the great potential of this unique alloyed nanostructure for preclinical and transla- tional imaging. Nanoparticles have been widely used in biomedical research, including drug delivery and molecular imaging. (1) Of the various diagnostic applications, radiolabeled nano- particles for positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging have received special attention owing to their high sensitivity, unlimited tissue penetration, and translational capability. (2) The desirable nuclear properties and straightforward radio- labeling chemistry make 64 Cu (t1/2 = 12.7 h, b + , 0.653 MeV
Optimal Transmission Policy for Renewable Sensor Networks

We consider optimized transmission policies for sensors with renewable energy sources. Depending on the reward for successfully transmitting a message and the energy status of a sensor itself, we will prove the existence of optimal thresholds that maximize the average reward rate. Our results are quite general since the reward values can be made application-specific. Compared with the unconditional "transmit-all" policy, which transmits every message as long as the battery energy is nonzero, we will show that the proposed optimal transmission policy can achieve significant gains in the average reward rate.
Homogeneous immunosubtraction integrated with sample preparation enabled by a microfluidic format.

Immunosubtraction is a powerful and resource-intensive laboratory medicine assay that reports both protein mobility and binding specificity. To expedite and automate this electrophoretic assay, we report on advances to the electrophoretic immunosubtraction assay by introducing a homogeneous, not heterogeneous, format with integrated sample preparation. To accomplish homogeneous immunosubtraction, a step-decrease in separation matrix pore-size at the head of a polyacrylamide gel electrophoresis (PAGE) separation channel enables ‘subtraction’ of target analyte when capture antibody is present (as the large immune-complex is excluded from PAGE), but no subtraction when capture antibody is absent. Inclusion of sample preparation functionality via small pore size polyacrylamide membranes is also key to automated operation (i.e., sample enrichment, fluorescence sample labeling, and mixing of sample with free capture antibody). Homogenous sample preparation and assay operation allows on-the-fly, integrated subtraction of one to multiple protein targets and reuse of each device. Optimization of the assay is detailed which allowed for ~95% subtraction of target with 20% non-specific extraction of large species at the optimal antibody-antigen ratio, providing conditions needed for selective target identification. We demonstrate the assay on putative markers of injury and inflammation in cerebrospinal fluid (CSF), an emerging area of diagnostics research, by rapidly reporting protein mobility and binding specificity within the sample matrix. We simultaneously detect S100B and C-reactive protein, suspected biomarkers for traumatic brain injury (TBI), in ~2 min. Lastly, we demonstrate S100B detection (65 nM) in raw human CSF with a lower limit of detection of ~3.25 nM, within the clinically relevant concentration range for detecting TBI in CSF. Beyond the novel CSF assay introduced here, a fully automated immunosubtraction assay would impact a spectrum of routine but labor and time-intensive laboratory medicine assays.
An efficient, global resource-directed approach to exploiting instruction-level parallelism

We present resource-directed loop pipelining (RDLP), a new approach that attempts to retain much of the advantages of resource-constrained software pipelining (RCSP) while minimizing the expense. It does so by allowing the availability of target resources to in some sense guide the application of parallelism exposing and parallelizing transformations. One of the key features of RDLP is the separation of control heuristics from transformations that allows the loop pipelining to be as general as the underlying system of code motion transformations. Results are presented that show that even with very unsophisticated heuristics, RDLP achieves roughly the same performance as RCSP, while providing a 4-fold decrease in space/time cost.
Interaction between HIV protease inhibitors (PIs) and hepatic transporters in sandwich cultured human hepatocytes: implication for PI‐based DDIs

Although HIV protease inhibitors (PIs) produce profound metabolic interactions through inactivation/inhibition of CYP3A enzymes, their role as victims of transporter-based drug-drug interactions (DDIs) is less well understood. Therefore, this study investigated if the PIs, nelfinavir (NFV), ritonavir (RTV), lopinavir (LPV) or amprenavir (APV) were transported into sandwich-cultured human hepatocytes (SCHH), and whether OATPs contributed to this transport. The findings showed that, except for (3) H-APV, no significant decrease in the total hepatocyte accumulation of the (3) H-PIs was detected in the presence of the corresponding unlabeled PI, indicating that the uptake of the other PIs was not mediated. Further, hepatocyte biliary efflux studies using (3) H-APV and unlabeled APV confirmed this decrease to be due to inhibition of sinusoidal influx transporter(s) and not the canalicular efflux transporters. Moreover, this sinusoidal transport of APV was not OATP-mediated. The results indicate that the hepatic uptake of NFV, RTV or LPV was primarily mediated by passive diffusion. The hepatic uptake of APV was mediated by an unidentified sinusoidal transporter(s). Therefore, NFV, RTV or LPV will not be victims of DDIs involving inhibition of hepatic influx transporters; however, the disposition of APV may be affected if its sinusoidal transport is inhibited.
Potential Vorticity Structure across the Gulf Stream: Observations and a PV-Gradient Model

Abstract Potential vorticity (PV) structure across a baroclinic front is a property that determines the stability characteristics of that front, cross-frontal exchange, and the behavior of the vortical waves that this front enables. Hence, there has been much interest in estimating PV across the Gulf Stream (GS). However, PV estimations have typically encountered two problems—the horizontal resolution of sampling has been inadequate, and noise in measurements gets amplified by differentiation when estimating PV. This paper’s approach addresses both of these problems. The authors have used a unique set of highly resolved, simultaneous density and direct velocity measurements across the Gulf Stream, first to calculate the PV structure, and then to obtain its idealization within density layers using a PV-gradient (PVG) model. The PVG model inverts an input PV in layers to determine the isopycnal depths and velocities in isopycnal layers. By comparing the observed and PVG-modeled velocities and isopycnal posi...
Predictors and outcomes of endoleaks in the Veterans Affairs Open Versus Endovascular Repair (OVER) Trial of Abdominal Aortic Aneurysms.

Objective The Veterans Affairs Open Versus Endovascular Repair (OVER) Trial of Abdominal Aortic Aneurysms study was a randomized controlled trial comparing open vs endovascular repair (EVAR) in standard-risk patients with infrarenal aortic aneurysms. The analysis reported here identifies characteristics, risk factors, and long-term outcome of endoleaks in patients treated with EVAR in the OVER cohort. Methods The OVER trial enrolled 881 patients, of whom 439 received successful EVAR. Logistic regression analysis was used to identify predictors for endoleaks and secondary interventions. Kaplan-Meier survival analysis, longitudinal plots, and generalized linear mixed models methods were used to describe time to endoleak detection, resolution, or death. Results During a mean follow-up of 6.2 ± 2.4 years, 135 patients (30.5%) developed 187 endoleaks. Four patients with EVAR went on to rupture; these four patients did not all have an endoleak. Mortality between patients who did and did not develop endoleaks was not significantly different. The 187 endoleaks included 12% type I, 76% type II, 3% type III, 3% type IV, and 6% indeterminate. Patient demographics and vascular risk factors were not associated with endoleak development. The presence of endoleaks resulted in an increase in aneurysm diameter over time ( P P 1 year after EVAR) were associated with aneurysm enlargement compared with the early counterpart. There was no difference in aneurysm size or length of survival between type II and other types of endoleak. Conclusions We present one of the most comprehensive and longest follow-up analyses of patients treated with aortic endografts. Endoleaks were common and negatively affected aneurysm diameter reduction. Delayed type II endoleaks were associated with late aneurysm diameter enlargement. Endoleaks and aneurysm diameter enlargement were not associated with excess mortality compared with those without these features.
Abstract 86: Accuracy of Emergency Medical Services Dispatcher and Provider Recognition of Stroke in Clinical Practice

Objective: It is imperative that prehospital providers accurately recognize stroke. We assessed the sensitivity of stroke recognition by emergency medical services (EMS) in clinical practice in a major US city, and assessed variables associated with failure to recognize stroke. Methods: Data from the Philadelphia EMS system was linked with data from a single comprehensive stroke center to identify patients diagnosed with transient ischemic attack, ischemic stroke, or intracerebral hemorrhage by EMS dispatchers, EMS providers, or at hospital discharge between September 2009 and October 2012. Sensitivity and positive predictive value (PPV) were calculated. Multivariable logistic regression was used to identify variables associated with EMS recognition of stroke. Results: There were a total of 709 cases, 400 of which were cerebrovascular events (38% infarct, 10% ICH, and 8% TIA). Of these cases, 80 (20%) were not recognized by EMS dispatcher or EMS provider, 90 (23%) were recognized by dispatcher alone, 87 (22%) by EMS provider alone, and 143 (36%) by both. EMS providers recognized stroke with a sensitivity of 58%, PPV 69%. Dispatchers or EMS providers recognized stroke with a sensitivity of 80%, PPV 51%. In a multivariable model, EMS providers were more likely to miss a stroke when NIHSS was low (compared to NIHSS 10+, NIHSS 5-9 OR=1.6, 95% CI 0.9-3.0 & NIHSS 270 minutes (OR=2.4, 95% CI 1.5-3.8). Medics correctly recognized 81% of stroke patients with NIHSS>4 and symptom duration <270 minutes, and dispatcher or EMS providers correctly recognized 90% of these patients. Conclusions: EMS recognized stroke with limited sensitivity, resulting in a high proportion of missed stroke cases. When added to the EMS provider impression, dispatcher impression meaningfully improves the sensitivity for recognizing stroke. Maximizing sensitivity is critical to prehospital interventions which may improve overall stroke care, such as transportation to designated stroke centers or EMS prenotification of receiving hospitals.
Interactive Influences on Health and Adult Education.

This chapter examines multiple convergent forces affecting health, relates these to social determinants of health and critical adult health learning, and closes with discussion of opportunities for adult educators to contribute to human health at the individual, community, health provider, policy/regulatory agency, and international levels.
The Actions of Exogenous Dehydroepiandrosterone in Experimental Animals and Humans

Dehydroepiandrosterone (DHEA) is the major adrenal steroid of young adults; however, its physiologic functions, if any, are not known. The purpose of this review is to evaluate the current literature in which DHEA was administered to either humans or experimental animals to discern what these functions might be. Reports are divided into five areas: neurologic, immunologic, cardiovascular, oncologic, and metabolic. Particular attention is paid to the dosage and route of administration. This type of analysis shows that at the lowest doses, DHEA has effects on neurologic and immunologic tissues, suggesting that these two sites may be physiologic targets. DHEA also affects cardiologic and metabolic functions as well as tumor growth, but such actions require higher doses and may reflect 'pharmacologic' activities. It is proposed that DHEA's pattern of activity represents a new class of steroid hormones, the "Regnantoids." Further progress in the endocrinology of this family of steroids may only come when synthetic, long-acting analogs of DHEA are available for in vitro studies to allow correlations between hormone action and receptor binding.
Goldilocks black holes.

Astronomers are investigating middleweight, or intermediate-mass, black holes to understand how black holes found at the center of large galaxies from which nothing, not even light, can escape formed so rapidly. The research suggests that middleweight black holes formed by the collapse of primordial gas clouds in the early universe that bypassed the star stage rather than early stars providing small seeds that merged together. Additional clues about middleweight holes may come from studying bulgeless galaxies which conceal middleweight holes behind dust. INSETS: What Were the Seeds of Supermassive Black Holes?;Early Evidence Favors Gas Collapse over Star Mergers.
Psychology of computer use: III. Accessing the BIOSIS PREVIEWS database in clinical psychology.

This study investigated the efficacy of using the database BIOSIS PREVIEWS as an online retrieval tool in clinical psychology. Considering the vast information store (53 million records) of this underutilized database, the authors demonstrated the productivity of BIOSIS versus PsycINFO citation output. Several illustrated examples were offered, and the implications of the results attest to the usefulness of accessing BIOSIS as an adjunct bibliographic retrieval strategy when searching the professional literature.
From Upper Canal to Lower Manhattan: Memorialization and the Politics of Loss

The New Orleans Katrina Memorial is located at the upper end of Canal Street, an inexpensive and relatively short trolley car ride from the city's tourist hub in the French Quarter. Despite its ease of access, and close proximity to the more famous cemeteries to which tourists regularly make pilgrimage, the memorial is little visited and largely unknown, even to many of the city's own residents. In this it stands in stark contrast to the National September 11 Memorial in Lower Manhattan, which drew its millionth visitor less than four months after its opening on September 12, 2011. Recent work in political theory on memory, mourning, and memorialization—as well as Ancient Greek concerns about the same—point to the ways in which the manner of remembrance, grieving, and commemoration employed by a democratic polity help to shape political outcomes. In what follows, I trace the history and design of the New York City and New Orleans memorials to suggest the ways in which they embody and perpetuate national strategies of remembrance and forgetting, in which injustices perpetrated against the polity are prioritized over injustices perpetrated within it. Drawing on John Bodnar's distinction between national and vernacular commemoration, I nevertheless conclude with a counter-intuitive suggestion: that while on a national level the public's relative ignorance of the Katrina Memorial is indeed indicative of a polity more concerned with injustices perpetrated against it than within it; on a local level the erection and subsequent forgetting of the Katrina Memorial is a manifestation of a mode of vernacular memory, mourning and commemoration with far more democratically-productive potential than its counterpart in New York City. In particular, I argue that it cultivates, and historically has cultivated, a more forward-looking, progressive, and polyphonic response to loss than the type of dominant national narratives embodied by the 9/11 Memorial. Whereas the latter continually replays the loss in ways that rob the polity of its capacity to move beyond its initial response, the former acknowledges and incorporates the loss while steeling the community for the challenges ahead.
Reactive silver inks for patterning high-conductivity features at mild temperatures

Reactive silver inks for printing highly conductive features (>10(4) S/cm) at room temperature have been created. These inks are stable, particle-free, and suitable for a wide range of patterning techniques. Upon annealing at 90 °C, the printed electrodes exhibit an electrical conductivity equivalent to that of bulk silver.
Overview of the Energy-saving Potential of the Large Capacity and High Parameters Pumps in Thermal Power Units

This paper describes the development of thermal power units,and presents detail application characteristics and economic indicators of feed water pumps,condensate pumps,circulating pumps in large thermal power plant. According to analysis on existing problems of the pumps which have been put into operation and the economic impacts of power plant,there is a large energy saving potential in the design,manufacturing and processing,operation mode. it is crucial for improving the economy of thermal power plants and reducing the cost of power generation.
Effects of yield and quality of hybrid rice Tianyou huazhan and their parents under nitrogen fertilization application

Effects of different nitrogen application(N 0 and 202.5 kg/hm2) on rice yield,quality and nitrogen absorption were studied using three rice cultivars,Tianyou huazhan and their parents(Huazhan and Tianfeng),in a field experiment.The results showed that:nitrogen fertilizer could raise Tianyou huazhan and their parents yield and the reason was effective panicles increased,the reason of Tianyou huazhan yield higher than the other two varieties was effective panicle number and grain weight higher;The application of nitrogen fertilizer could increase dry matter accumulation of Tianyou huazhan and its parents;under the same treatment,stem sheath dry matter output rate and contribution rate of Tianyou huazhan was the biggest;nitrogen fertilizer could increase Tianyou huazhan and parents rice grain length and protein content,decrease chalky grain rate;When harvest different parts of nitrogen accumulation in all varieties positively corrected with nitrogen fertilization,and nitrogen accumulation in different organs of Tianyou huazhan was significantly higher than that of Huazhan and Tianfeng.
Choice of technologies and dynamic-physical order of efficiency

From the analysis of the foregoing Chapter, we came up with some key variables in studying the dynamic process; namely, the techniques A(h), the derived compound technologies, the internal growth rate of each technique, and the residuals that could emerge from the increasing technological dimension.
Machine Arithmetic and Related Matters

The questions addressed in this introductory chapter are fundamental in the sense that they are relevant in any situation that involves numerical machine computation, regardless of the kind of problem that gave rise to these computations. In the first place, one has to be aware of the rather primitive type of number system available on computers.
Tools and strategies for discovering novel enzymes and metabolic pathways

Summary The number of entries in the sequence databases continues to increase exponentially – the UniProt database is increasing with a doubling time of ∼4 years (2% increase/month). Approximately 50% of the entries have uncertain, unknown, or incorrect function annotations because these are made by automated methods based on sequence homology. If the potential in complete genome sequences is to be realized, strategies and tools must be developed to facilitate experimental assignment of functions to uncharacterized proteins discovered in genome projects. The Enzyme Function Initiative (EFI; previously supported by U54GM093342 from the National Institutes of Health, now supported by P01GM118303) developed web tools for visualizing and analyzing (1) sequence and function space in protein families (EFI-EST) and (2) genome neighbourhoods in microbial and fungal genomes (EFI-GNT) to assist the design of experimental strategies for discovering the in vitro activities and in vivo metabolic functions of uncharacterized enzymes. The EFI developed an experimental platform for large-scale production of the solute binding proteins (SBPs) for ABC, TRAP, and TCT transport systems and their screening with a physical ligand library to identify the identities of the ligands for these transport systems. Because the genes that encode transport systems are often co-located with the genes that encode the catabolic pathways for the transported solutes, the identity of the SBP ligand together with the EFI-EST and EFI-GNT web tools can be used to discover new enzyme functions and new metabolic pathways. This approach is demonstrated with the characterization of a novel pathway for ethanolamine catabolism.
Ethylenediaminedisuccinic acid (EDDS) enhances phytoextraction of lead by vetiver grass from contaminated residential soils in a panel study in the field.

Phytoextraction is a green remediation technology for cleaning contaminated soils. Application of chelating agents increases metal solubility and enhances phytoextraction. Following a successful greenhouse experiment, a panel study under field weather elucidated the efficiency of the chelating agent ethylenediaminedisuccinic acid (EDDS) on phytoextraction of lead (Pb) by vetiver grass, a hyperaccumulator of Pb, and a nonaccumulator fescue grass from residential soils contaminated with Pb-based paint from Baltimore, MD and San Antonio, TX. Three soils from each city with Pb content between 1000 and 2400 mg kg-1 were chosen for the panel study. Sequential extraction revealed that Fe-Mn oxide (60-63%) and carbonate (25-33%) fractions of Pb dominated in Baltimore soils, whereas in San Antonio soils, Pb was primarily bound to the organic fraction (64-70%) because organic content was greater and, secondarily, to the Fe-Mn oxide (15-20%) fraction. Vetiver and fescue grasses were transplanted and grown on wood panels in the field with EDDS applied after 3 months and 13 months. Soil and leachate results indicated that EDDS applications increased Pb solubility in soils. Plant tissues results indicated enhanced the uptake of Pb by vetiver and showed that EDDS application promoted translocation of Pb from root to shoot. Average Pb concentration increased by 53% and 203% in shoots and by 73% and 84% in roots of vetiver after the first and second applications of EDDS, respectively. Concentrations in roots and shoots increased in all tested soils, regardless of soil pH or clay content. After the second application, average Pb concentrations in vetiver were higher than those in fescue by 3.6x in shoots and 8.3x in roots. Visual phytotoxic symptoms from increased bioavailable Pb from EDSS applications were observed in fescue but not in vetiver. This study demonstrated the potential of a chemically-catalyzed phytoremediation system as a cleanup method for lead-contaminated soils.
Annual Facility Treatment Volume and Patient Survival for Mycosis Fungoides and Sézary Syndrome.

Abstract Background Management of mycosis fungoides and Sezary syndrome (MF/SS) is complex, and randomized evidence to guide treatment is lacking. The institutional treatment volumes for MF/SS might vary widely nationally and influence patient survival. Patients and Methods Using the National Cancer Database, we identified patients with a diagnosis of MF/SS from 2004 to 2011 in the United States who had received treatment at a reporting facility. The patients were grouped into quintiles according to their treatment facility's average annual treatment volume (ATV). The characteristics associated with ATV were identified and compared using χ 2 tests. Overall survival (OS) was compared among the ATV quintiles using the Kaplan-Meier method with log-rank tests and multivariable Cox regression with hazard ratios (HRs). OS was also analyzed using the annual patient volume as a continuous variable. Results A total of 2205 patients treated at 374 facilities were included for analysis. The ATV quintile cutoffs were 1, 3, 6, and 9 patients. With a median follow-up period of 59 months, the 5-year estimated OS survival increased with ATV from 56.7% in the lowest quintile (≤ 1 patient annually) to 83.8% in the highest quintile (> 9 patients annually; P P Conclusion The present national database analysis demonstrated that higher facility ATV is associated with improved OS for patients with MF/SS. Further study is needed to determine the underlying reasons for improved survival with higher facility ATV.
Stabilization and expectations in a state space model of interconnected economies, a dynamic panel study

Carlin and Soskice (2005) advocate a 3-equation model of stabilization policy, the IS-PC-MR model. Their third equation is the monetary reaction rule MR derived by assuming that governments have performance objectives, but are constrained by an augmented Phillips curve PC. Central banks achieve their preferred outcome by setting interest rates along an IS curve. We simplify their model to 2 equations (PC and MR), developing a state space econometric specification of this solution, and adding a random walk model of unobserved potential growth. Applying this model to a panel of North Atlantic countries, we find it historically consistent with an inflation target of about 4%. Significant interdependence is found in the between-country covariance of inflation and growth shocks, but not of potential output. Beginning with the approximation that expected inflation is the most recent observation, we extend the model to introduce alternative assumptions about expectations with mixed results, support for the sticky-price model, but doubts about activist policy.