cssi/SciSciGPT-SciSciNet huggingface dataset:
Changes in Antiemetic Overuse in Response to Choosing Wisely Recommendations.

Importance Antiemetics are used to prevent chemotherapy-induced nausea and vomiting in patients with cancer. Newer antiemetic agents (serotonin and neurokinin-1 receptor antagonists) have increased efficacy but are expensive. The American Society of Clinical Oncology’s first guideline in the 2013 Choosing Wisely (CW) campaign discouraged overuse of expensive antiemetics in patients with low risk of chemotherapy-induced nausea and vomiting. However, little is known about patterns or trends in antiemetic overuse or whether any change has occurred with the publication of the CW recommendations. Objective To estimate the baseline prevalence, trends, determinants, and costs of antiemetic overuse from January 1, 2008, through March 31, 2015. Design, Setting, and Participants From January 1, 2008, through March 31, 2015, this observational study applied descriptive (univariate and bivariate) and multivariable logistic regression analyses to longitudinal health insurance enrollment and nationwide MarketScan insurance claims data for 678 220 privately insured patients receiving chemotherapy before and after the October 29, 2013, announcement of the CW guidelines. The baseline prevalence, trends, determinants, and costs of antiemetic overuse were estimated in cases stratified by risk for chemotherapy-induced nausea and vomiting. Main Outcomes and Measures Antiemetic use, overuse measure, and expenses before and after the publication of the CW recommendation, with adjustment for patient and health care professional characteristics. Results The sample included 678 220 adults who started chemotherapy during the observation period. The average age of the sample was 59.5 years, with 58.2% (n = 394 724) female. Antiemetic overuse occurred in 24.1% (n = 163 451) of patients, with highest rates among those receiving intravenous chemotherapy with high chemotherapy-induced nausea and vomiting risk (32.4% [n = 106 795]). Compared with baseline before the CW, patients had 7.0% lower odds of antiemetic overuse (95% CI, 4.4%-9.5%) during the 6 months after the CW, but this decrease was transitory: the odds of antiemetic overuse were 7.4% (95% CI, 4.6%-10.2%) higher than baseline at 6 months after the CW. Low-risk intravenous chemotherapy agents had overuse that continued to decrease 6 months after the CW. Antiemetic overuse was associated with higher costs. Reducing antiemetic overuse could have paid for 6.1% (95% CI, 5.8%-6.4%) of the chemotherapy drug costs. Conclusions and Relevance Antiemetic overuse is prevalent and results in unnecessary spending associated with systemic chemotherapy treatment. Short-term decreases in antiemetic overuse were associated with the CW recommendation, but sustained decreases occurred in only one risk group.
Fluidized Coal Combustion: The Effect of Sorbent and Coal Feed Particle Size Upon the Combustion Efficiency and NOx Emission

Measurements in the freeboard of a pilot scale fluidized bed coal combustor showed a substantial reduction in the levels of NOx with increasing elevation above the bed. This reduction could be well described by a model which takes into account the reaction between NOx and the carbonaceous particles entrained from the bed. The model was used to evaluate the impact of changing bed solid and coal feed size on both NOx reduction and carbon combustion efficiency in order to guide the selection of conditions which can maximize the reduction of NOx without incurring a significant penalty in combustion efficiency.
445. cGMP Compliant Production for Human Embryonic Stem Cell Derived Retinal Pigment Epithelial Cells on a Synthetic Substrate for the Treatment of Non-Neovascular Age-Related Macular Degeneration for Phase I Clinical Study

Non-neovascular age-related macular degeneration (dry AMD) is a leading cause of irreversible vision loss and is associated with retinal pigment epithelium (RPE) dystrophy. The RPE monolayer is integral for maintenance of healthy photoreceptors. Many studies have shown that AMD can be recovered by cellular therapy through transplantation of RPEs into the sub-retinal space to re-establish RPE functionality and halt neurological degeneration. Here we present a cGMP compliant manufacturing process to producing transplantable RPE cells on a synthetic substrate for clinical phase I study.
Adiponectin Deficiency Impairs Maternal Metabolic Adaptation to Pregnancy in Mice

Hypoadiponectinemia has been widely observed in patients with gestational diabetes mellitus (GDM). To investigate the causal role of hypoadiponectinemia in GDM, adiponectin gene knockout (Adipoq-/- ) and wild-type (WT) mice were crossed to produce pregnant mouse models with or without adiponectin deficiency. Adenoviral vector-mediated in vivo transduction was used to reconstitute adiponectin during late pregnancy. Results showed that Adipoq-/- dams developed glucose intolerance and hyperlipidemia in late pregnancy. Increased fetal body weight was detected in Adipoq-/- dams. Adiponectin reconstitution abolished these metabolic defects in Adipoq-/- dams. Hepatic glucose and triglyceride production rates of Adipoq-/- dams were significantly higher than those of WT dams. Robustly enhanced lipolysis was found in gonadal fat of Adipoq-/- dams. Interestingly, similar levels of insulin-induced glucose disposal and insulin signaling in metabolically active tissues in Adipoq-/- and WT dams indicated that maternal adiponectin deficiency does not reduce insulin sensitivity. However, remarkably decreased serum insulin concentrations were observed in Adipoq-/- dams. Furthermore, β-cell mass, but not glucose-stimulated insulin release, in Adipoq-/- dams was significantly reduced compared with WT dams. Together, these results demonstrate that adiponectin plays an important role in controlling maternal metabolic adaptation to pregnancy.
3D vision attack against authentication

In this paper, we introduce a computer vision-based attack using stereo cameras against authentication approaches for touch-enabled devices. In the attack, an attacker uses a stereo camera (such as one on the HTC Evo 3D smartphone) and takes a video of a victim entering passwords on the touch screen of the victim's mobile device. We focus on challenging scenarios where the victim holds the device up and the attacker cannot see the victim's fingertip or the device screen. Since the stereo camera provides depth and distance information of objects in video frames, we can build a 3D scene to analyze the victim's hand movement and automatically recover the victim's passcode. The 3D vision attack is stealthy in daily settings like a classroom or a coffee shop since the attacker does not need to take a suspicious angle and see the touch screen of the victim. Without loss of generality, we use graphical passwords as an example and perform extensive experiments to demonstrate the effectiveness of the attack. The success rate of the 3D vision attack reaches 90% when the camera is across a table from a victim in a typical gathering scene.
Freeze-cast yttria-stabilized zirconia pore networks: Effects of alcohol additives

Freeze casting yttria-stabilized zirconia (YSZ) can be useful in making electrodes for solid oxide fuel cells (SOFCs) by introducing hierarchical porosity to increase triple-phase boundary (TPB) area while maintaining adequate fuel flow. In this study the influence of alcohol additives on pore structure of aqueous YSZ freeze-cast samples was investigated. Slurries with ethanol, iso-propyl alcohol, or methanol as additives were compared to a control sample. Pore characteristics along sample lengths were measured using X-ray computed tomography reconstructions. The control sample showed significant changes in pore size along sample length, whereas pore size of the alcohol additive samples remained similar, indicating that freezing rates of the additive samples remained constant during solidification. Ice lens formation and interactions between alcohols and slurry functional additives (dispersant, surfactant, and binder) resulted in complex pore structures which show promise in increasing SOFC TPB area.
P211 A roadmap for successful robotic automation of next generation sequencing based HLA typing

Aim DNA library preparation for next generation sequencing (NGS) consists of several hundred material transfer and wash steps, which are time consuming, labor intensive, and increase the risk of repetitive strain injury. Robotic liquid handlers can automate and standardize library preparation, but few HLA laboratories have experience with high-complexity robotic platforms. We sought to evaluate the use of robotics for library preparation in conjunction with a NGS based HLA typing assay. Methods A Beckman Coulter Biomek NXp Span-8 robotic liquid handler was acquired along with the vendor supplied robotics method for the Illumina TruSight HLA v2 sequencing panel. The robotics method was first optimized with a series of runs using water, 50% glycerol, 85% ethanol, and AMPure beads. Next, DNA and reagents were run to identify sample viscosity and reagent issues. After each run, issues were communicated to the vendor for method improvement. The finalized method was run on 78 DNA samples over seven runs to assess the quality of normalization, pooling, sequencing, and reproducibility of results. Results Robotic issues were encountered with pipette calibration, labware definitions, proper labware selection, and efficiency. To add complexity, these issues had subtle compounding effects on the overall success of the method, which required that each be addressed individually and in detail. Eleven versions of the method were subsequently produced and tested to ensure robustness and consistency. The finalized method produced consistent high quality sequencing metrics on the NGS typing platform which agreed with the known HLA typing results. Conclusions Detailed documentation of issues by lab staff and clear communication with the vendor allowed for a rapid and iterative improvement of the robotics method. The lessons learned during the implementation process formed a roadmap that allowed for successful implementation of a robotics platform for NGS based HLA typing.
Investigation of α-MnO2 Tunneled Structures as Model Cation Hosts for Energy Storage

ConspectusFuture advances in energy storage systems rely on identification of appropriate target materials and deliberate synthesis of the target materials with control of their physiochemical properties in order to disentangle the contributions of distinct properties to the functional electrochemistry. This goal demands systematic inquiry using model materials that provide the opportunity for significant synthetic versatility and control. Ideally, a material family that enables direct manipulation of characteristics including composition, defects, and crystallite size while remaining within the defined structural framework would be necessary. Accomplishing this through direct synthetic methods is desirable to minimize the complicating effects of secondary processing.The structural motif most frequently used for insertion type electrodes is based on layered type structures where ion diffusion in two dimensions can be envisioned. However, lattice expansion and contraction associated with the ion movement a...
Experimental observations of the three-dimensional wake structures and dynamics generated by a rigid, bioinspired pitching panel

The wake created by a trapezoidal pitching panel displays a variety of dynamics and behaviors. Results show that a chain of highly three-dimensional, alternating vortex rings is shed from the trailing edge. These rings interact with each other in a manner that is dependent on Strouhal number.
Stem Cell–Based Immunomodulation After Stroke: Effects on Brain Repair Processes

Stroke is a major cause of death and disability worldwide. The inflammatory response is pivotal to the pathophysiology of ischemic stroke. It begins in the vasculature directly after arterial occlusion, continues in the brain, and systemically throughout all disease stages. Immune responses are tightly regulated and have both beneficial and detrimental properties after stroke; inflammation can result in considerable brain damage and inhibition of brain repair, including neurogenesis.1 Variability in different inflammatory processes render the immune response a strong determinant of brain restoration and patient survival after stroke.2 Directed modulation of the immune response could, therefore, be designed as a potential therapeutic approach to induce stroke recovery. Modulation can be achieved with stem cell (SC) therapy and is now a widely investigated approach with multiple clinical trials for different diseases, including stroke (www.clinicaltrials.gov).3,4 Certain types of SCs are pluri- or multipotent and have the potential to create many neural cells, which may be important after stroke-based neuronal loss. Exogenous SC transplantations, primarily with neural stem/precursor cells (NSPCs) and mesenchymal-derived SCs (MSCs), have been examined using different administration routes in various stroke animal models; increased functional recovery was often observed.5–8 Besides NSPCs and MSCs, mixed adult SC populations from bone marrow or umbilical cord blood have been examined, showing improved outcomes as well.9–11 However, the therapeutic time window of these mixed cell populations seems to be narrower, restricting their use to the acute and subacute stages after stroke as compared with the NSPCs and MSCs, which can be used in chronic stroke as well.12 Therefore, the focus of this Topical Review lies on NSPC and MSC therapy in stroke. Despite many studies, their exact mechanisms behind the brain restoring effects are not completely understood. It is thought that …
Splanchnic tissue energy use in ruminants that consume forage-based diets ad libitum.

The effects that characteristics of forage-based diets on gut and liver energy use in sheep with ad libitum consumption were discussed, and practical consequences of diet and animal effects on splanchnic energy use were projected. Explained variation in portal-drained viscera (PDV) and hepatic energy use by sheep in recent experiments increased when independent variables were included in regressions on DE intake (DEI) (PDV: R 2 = 33 vs 22%; liver: R 2 = 48 vs 25%). The regression equations used were the following: PDV energy use, Mcal/d = -.0194 + (.1207-DEI, Mcal/d) + (1.1173-fecal NDF excretion, kg/d) - (.2860-DEI-fecal NDF excretion) and hepatic energy use, Mcal/d =.0014 + (.0266-DEI, Mcal/d) + (.3325-PDV energy use, Mcal/d) + (.0745-urea N hepatic net flux, mol/d) + (.0016-BW, kg). Thus, gut digesta, as implied by fecal NDF excretion, seemed to influence PDV energy use in addition to the effect of DEI, and energy consumption by the liver seemed affected by PDV energy use and hepatic ureagenesis. A regression equation (R 2 = 49%) for splanchnic bed energy use, expressed as a percentage of DEI, was 43.61 - (9.531-DEI, Mcal/d) + (15.914-fecal NDF excretion, kg/d) + (6.057-urea N hepatic net flux, mol/ d). If physiological control of feed intake with effect of efficiency of energy metabolism is assumed, and if whole-body efficiency of energy metabolism with ad libitum intake is constant, then efficiency of energy metabolism in extrasplanchnic tissues decreases as level of ad libitum intake and the ratio of splanchnic bed energy use to DEI decrease. Therefore, animal characteristics (e.g., maturity, body condition, and biological type) and grazing conditions (e.g., forage mass) may affect feed intake by influencing heat production by peripheral tissues. In conclusion, an increased understanding of dietary influences on efficiency of splanchnic tissue metabolism may lead to enhanced efficiency of forage utilization and ruminant production systems.
Morphological stability of steady-state passive oxide films

Abstract Understanding the kinetics of passive oxide formation and breakdown has been an ongoing problem for corrosion scientists for several decades. Here, we present a model for the formation of a passive oxide film on a metal that is an extension of the Point Defect Model (PDM) by Macdonald and coworkers. We replace the potential description of the PDM with a boundary value problem and ensure that Gauss's law is satisfied at the oxide-solution interface by considering the presence of the Helmholtz layer in solution. Our model predicts the observed linear variation of the steady-state film thickness with anode potential, and an increasing film thickness with increasing pH. We perform a linear stability analysis of the model and show that, depending on the parameters, the passive film may be unstable to morphological perturbations of the film interfaces, leading to nonplanar films and potentially the formation of a pit in the oxide. This also implies that one-dimensional models, which assume planar interfaces, can be inapplicable in broad classes of corrosion processes. The analysis shows that a morphological instability exists if the oxide dissolution mechanism is such that an increasing Helmholtz layer potential drop leads to an increasing dissolution rate. The instability behavior is consistent with the literature on breakdown of passivity in the presence of chloride ions. The theory provides insights on the initiation of passivity breakdown leading to pitting corrosion and the role that interfacial energy plays in determining stability.
Rhizosphere microbial biomass is affected by soil type, organic and water inputs in a bell pepper system

Abstract Effects of environmental and management factors on the diversity and abundance of rhizosphere microbes in unmanaged ecosystems are well established. However, there is limited information about these interactions in vegetable cropping systems. In this two-year field study, we used organic amendments (humic substances, HS) and water supply (deficit irrigation) as soil management factors to characterize changes in bell pepper rhizosphere microbial population under two distinct soil types (clay and sandy). Path analysis revealed that soil type was the main factor constructing the microbial population. Clay soil indirectly increased bacterial biomass through the changes in root length, soil pH, P and K contents, while increased fungal biomass was linked with the enhanced above-ground plant yield. As organic inputs, HS had long-term positive influences on soil microbial activity through improvements in soil organic carbon content, which was also positively correlated with bacterial population. Water input became a less influential factor – deficit irrigation indirectly decreased fungal biomass but increased soil respiration through the reduction in pepper yield. These findings provide a better understanding of external factors controlling the abundance of rhizosphere microbiota under intensively managed cropping systems, and potential strategies to improve beneficial microbial diversity and soil health.
Island Girl in a Rock-and-Roll World: An Interview with June Millington by Theo Gonzalves and Gayle Wald

The following text collects edited excerpts from a 30 July 2018 interview with musician June Millington (b. 1948, Manila, the Philippines) conducted by Theo Gonzalves, curator in the Division of Culture and the Arts at the National Museum of American History, and Gayle Wald, Professor of English and
THE HEALTHCARE CHALLENGE FOR AN AGING POPULATION: THE ROLE OF TECHNOLOGY

Although many older adults enjoy relatively good health into their later years, many have one or more chronic conditions, diseases, or disabilities, and need help with disease management activities or activities important to independent living. With the increase in numbers of aging adults there is a concomitant strain on the healthcare system. Models of healthcare are also changing and moving towards a more partnership model where consumers are supposed to assume a more collaborative role in health decision making and a more active role in health management. This presentation will discuss the continuing and increasing role of technology in meeting the healthcare challenges for an aging population. The discussion will focus on technology applications to support the health and well-being of older adults as well as family caregivers. Challenges and barriers that currently limit the full potential of technology to be realized for these populations will also be discussed.
Deja Vu and the Gendered Origins of the Practice of Immigration Law, 1907-1940

Donald Trump’s administration has provoked crisis after crisis regarding the United States’ immigration policy, laws, and their enforcement. This has drastically affected millions of immigrants in the U.S. and those hoping to immigrate. Stemming from this, immigration lawyers and immigrant advocacy organizations are challenging such policies and providing an extraordinary amount of direct pro bono legal services to immigrants in need. Yet the history of the practice of immigration law has been largely understudied. This article seeks to address this history by closely examining Chicago’s Immigrants’ Protective League between 1910 and 1940. The League provided free counsel to tens of thousands of poor immigrants facing a multitude of immigration-related legal issues during a time when Congress passed increasingly strict immigration laws often spawned by xenophobia and racism. The League, always headed by women social workers, created a robust model of immigration advocacy. Overtime, it combined the everyday legal representation of immigrants, the production of social science research and scholarship about immigration and immigrants, the lobbying of immigration officials and the federal government for better and less restrictive immigration laws, and the provision of a variety of social services to immigrants. It also did so during an era when only a handful of women were professionally trained lawyers. A close and thick reading of the League’s archival documents, manifests how the events of Trump’s immigration policies have a long and painful history. U.S. immigration law and its enforcement have consistently been cruel, inhumane, arbitrary, and capricious. Told from the ground up and focusing upon the day-to-day problems that immigrants brought to the League, one dramatically sees how immigration laws and practices were (and still are) like quicksand – changing and unstable— thwarting the legitimate expectations of migrants, at times, leaving people in a legal limbo, and at other times, destroying lives. The League, in response, participated in creating what would become the practice of immigration law. In doing so, it continually engaged in legal improvisation as it quickly responded to changing laws, rules, policies, and the needs of those trying to immigrate.
Systematic sensitivity analysis of cuttings transport in drilling operation using computational fluid dynamics approach

Abstract Hole cleaning and cuttings transport play a vital role in the drilling operation. Various drilling problems such as a reduction in penetration rate, an increase in the torque and drag, and an increase in the potential of differential sticking are often related to poor cuttings transport from a wellbore. Multiple parameters, including the fluid rheology, mud velocity, cuttings size, and drill pipe inclination generally influence the cuttings transport performance. Although several experimental and modelling research works have been conducted in this area, the interactions among the parameters during cuttings transport have not been adequately investigated. This study focuses on interactions between the drilling parameters. Cuttings transport in the wellbore represents a solid-liquid multiphase flow phenomenon. In this research work, Computational Fluid Dynamics (CFD) model was employed to simulate the cuttings transport behaviours in a horizontal wellbore. The Eulerian-Eulerian multiphase flow model was adopted to describe the flow characteristics in the wellbore annular section. Design of Experiment (DoE) was used to systematically study the sensitivity and interactions among the operating parameters. It was observed that the mud viscosity, mud velocity, and drill pipe rotation have a positive impact, whereas an increase in cuttings size and eccentricity in annular clearance show a significant adverse effect on cuttings transport performance. According to the results, the cuttings between 1 mm to 2 mm are difficult to clean, compared to larger cuttings. The study also revealed important interaction effects between the parameters. Although both drilling mud viscosity and velocity show a positive effect, the interaction among them exhibits a negative influence on cuttings transport.
Parental Perceptions of the Nutritional Quality of School Meals and Student Meal Participation: Before and After the Healthy Hunger-Free Kids Act.

Objectives To examine (1) parental perceptions of school meals and (2) student meal participation before and after the implementation of the Healthy Hunger-Free Kids Act (HHFKA). Design Data were collected from telephone surveys of 2 independent cross-sectional panels in New Jersey (2009–2010 and 2016–2017). Participants Households with children aged 7–18 years (pre-HHFKA: n = 1,027; post-HHFKA: n = 324). Main Outcome Measures Parental perception of school meals and parental reports of student participation in school meals. Analysis Multivariable logistic regression models were developed to examine outcome variables. For school meal participation, nested models were analyzed first controlling for sociodemographic variables, followed by parental perception, and then the interaction between perception and time. Results Parental perceptions of school meals did not change significantly after the HHFKA. At both time points, school meal participation rates were significantly higher for children of parents who perceived school meals as healthy compared with children whose parents perceived meals to be unhealthy (pre-HHFKA: 89.9% vs 75.1%, P Conclusion and Implications Because higher perception of school meal quality is associated with higher participation, it is important for school food programs to inform parents about the improved nutritional quality of school meals.
Genetic and Physical Localization of the Gene Controlling Leaf Pigmentation Pattern in Medicago truncatula

In Medicago truncatula, some ecotypes form a black or purple stain in the middle of adaxial leaf surface due to accumulation of anthocyanins. However, this morphological marker is missing in some other ecotypes, although anthocyanin biosynthesis pathway is not disrupted. Genetic analysis indicated that the lack of the leaf spot of anthocyanins accumulation is a dominant trait, which is controlled by a single gene, LPP1. Genetic mapping indicated that the LPP1 gene was delimited to a 280 kb-region on Chromosome 7. A total of 8 protein-coding genes were identified in the LPP1 locus through gene annotation and sequence analysis. Of those, two genes, putatively encoding MYB-transcriptional suppressors, were selected as candidates for functional validation.
Design and performance evaluation of inerter-based tuned mass dampers for a ground acceleration excited structure

Abstract This paper investigates the design and performance of three configurations of inerter–based tuned mass dampers (TMDs) for the control of undamped single-degree-of-freedom structures subjected to ground acceleration. Inerter-based TMDs utilize the mass effects provided by an inerter in combination with spring and damping elements in otherwise conventional TMDs. The three configurations of inerter-based TMDs investigated have been developed by replacing the dashpot in traditional TMDs with different configurations connecting together a spring, a damper and an inerter. H2 and H-infinity optimum design values are presented through an exact optimization and a numerical optimization, respectively. Each device is also optimally designed considering 44 individual earthquake records. Utilizing individual, average, H2, and H-infinity designs, the performance evaluation of the devices is presented. Similar performance for the three inerter-based TMDs is observed. Compared to the TMD, the inerter-based TMDs can provide a 7% reduction in RMS response to a white noise ground motion, a 25% reduction in the maximum dynamic magnification factor, and an average 7% reduction in the RMS of the primary structure's displacement subjected to earthquake records.
Systematic review of hemostatic agents used in vascular surgery

Abstract Background Hemostatic agents are routinely used in vascular surgery to complement proper suture techniques and decrease the risk of perioperative bleeding. A relative lack of comparative research studies have left surgeons with the option of choosing hemostatic agents based on their personal experience. The present review has highlighted the efficacy and safety of hemostatic agents and categorized them according to their primary mechanism of action and cost. Methods A systematic search strategy encompassing hemostatic agent products was deployed in the PubMed database. Single-center and multicenter, randomized, controlled trials with >10 patients were included in the present study. Results We reviewed 12 studies on the efficacy and safety of hemostatic agents compared with manual compression or other hemostatic agents. Using the time to hemostasis as the primary end point, all studies had found hemostatic agents to be significantly more efficient than manual compression. Likewise, adhesives (high pressure sealants) and dual agents (containing biologically active and absorbable components) were found to be more efficient, but costlier, than agents with either biologically active or absorbable components only. Agents with porcine or bovine constituents were found to trigger anaphylactic reactions in rare cases. Additionally, the absence of fibrin stabilizing factor XIII in a brand of fibrin sealant was speculated to reduce the affinity of the fibrin sealant for the expanded polytetrafluoroethylene graft. The cost of agents varied greatly depending on their active ingredient. Conclusions Hemostatic agents appear to be highly effective at decreasing the risk of bleeding during surgical procedures. Although some hemostatic agents were demonstrated to achieve hemostasis faster than others, most are able to control bleeding within
History Evaluation of the Child or Adolescent with Back Pain Including Ten Red Flags

Back pain in the child or adolescent patient is one of the most common reasons for physician assessment and referral. Back pain prevalence in the teenage years has been purported in the literature as high as 35% (Joergensen et al., Eur J Pediatr 178:695–706, 2019). Although the majority of time it is musculoskeletal in nature and self-remitting, it still necessitates a thorough evaluation to rule out disorders that can result in significant disability, such as infection or tumor. Back pain itself should not be construed as a diagnosis, but rather a symptom of some underlying process. The physician should be able to take a thorough and detailed history to help direct for further diagnostic modalities as part of the workup. Activity modifications, exercises, rehabilitation, and management of emotional stressors can prevent recurrent episodes for most cases of musculoskeletal back pain. However, in cases of severe and persistent back pain, a thorough history combined with a detailed physical exam and appropriate imaging studies is necessary to determine if serious underlying pathology is to blame.
Local Industry Employment Share and the Experiences of Displaced Workers

This paper examines how industries' share of employment in local labor markets affects displaced workers' re-employment, industry switching and earnings losses. A key result is that workers displaced from industries with low employment shares are more likely to switch industries after displacement. Earnings loss estimates indicate that for most workers, displacement from an industry that employs a smaller share of the local labor force is associated with larger earnings losses.
Introduction: Symposium on the 10th Anniversary of the Health Law Certificate Program , University of Pittsburgh School of Law

In his introduction to the University of Pittsburgh School of Law symposium recognizing the 10th anniversary of its Health Law Certificate Program, Alan Meisel, program founder, Professor of Law and Dickie, McCamey and Chilcote Professor of Bioethics, considers the evolution of the medical profession, modern medicine, and modern hospitals in America. Prof. Meisel also reflects on the array of topics each speaker addressed at the event, including: the role of the modern charitable tax-exempt hospital; whether it’s time to modify the IRS “community benefit” standard for granting tax exemptions to hospitals; the effect of charitable sector scandals and abuses on public trust in and donations to charitable organizations; current and coming changes in IRS treatment of non-profit hospitals and other health care providers; and existing and emerging questions that result as non-profit and for profit hospitals become more and more alike.
383. Die Behandlung ausgedehnter Knochendefekte am Unterschenkel durch Ilizarov-Osteotomie

Posttraumatische Knochendefekte am Unterschenkel konnen durch Ilizarov-Osteotomie therapiert werden. Dabei wird eine Osteotomie in der proximalen Metaphyse der Tibia durchgefuhrt und ein Segment mit einem Zugmechanismus in den Defekt gezogen. Danach kommt es zur spontanten Knochenneubildung im Bereich der distrahierten Osteotomie und zum Ausheilen des ursprunglichen Defektes, der mit dem heruntergezogenen Tibiasegment ausgefullt ist. Dadurch ist der biomechanisch geforderte Rohrenknochen wieder hergestellt.
Differential Stimulation of Phosphorylation of Initiation Factors eIF-4F, eIF-4B, eIF-3, and Ribosomal Protein S6 by Insulin and Phorbol Esters

Exposure of quiescent, serum-starved 3T3-L1 cells to insulin promotes phosphorylation of initiation factors eIF-4F, eIF-4B, and eIF-3 p120, as well as ribosomal protein S6. Phosphorylation of both the p25 and p220 subunits of eIF-4F is stimulated typically by 2.5-5-fold, with a 2-4-fold increase in phosphorylation of eIF-4B and eIF-3 p120. Optimal stimulation is observed by 10(-9) M insulin. A similar pattern of stimulation is seen upon treatment of 3T3-L1 cells with 1 x 10(-6) M phorbol 12-myristate 13-acetate (PMA). Two-dimensional phosphopeptide mapping of p25, isolated from quiescent, insulin- or PMA-stimulated cells, results in a single tryptic phosphopeptide, indicating a single phosphorylation site identical to that obtained with protein kinase C. A more complex phosphopeptide map is observed with the p220 subunit. Following PMA-stimulation of 3T3-L1 cells, phosphopeptide mapping of p220 results in a pattern similar to that observed in vitro with Ca2+/phospholipid-dependent protein kinase (protein kinase C). Following insulin stimulation, mapping of p220 results in the appearance of novel peptides. Upon prolonged exposure to PMA, the cells are no longer responsive to this mitogen and no stimulation of phosphorylation of eIF-4F, eIF-4b, eIF-3 p120, or S6 via a protein kinase C-dependent mechanism is observed. Addition of insulin to these down-regulated cells leads to stimulation of phosphorylation of eIF-4F p220, ribosomal protein S6, and to a lesser extent, eIF-4B; little or no stimulation of phosphorylation of eIF-4F p25 and eIF-3 p120 is observed. Thus, eIF-4F p220, eIF-4B and ribosomal protein S6 are phosphorylated via PMA-dependent and insulin-dependent pathways, whereas phosphorylation of eIF-4F p25 and eIF-3 p120 is stimulated only upon activation of protein kinase C. Phosphopeptide maps of eIF-4F p220 and ribosomal protein S6 suggest that protease-activated kinase II is one of the protein kinases involved in the insulin-stimulated response in protein kinase C-depleted cells.
CD1-restricted T-cell responses and microbial infection

CD1, a conserved family of major histocompatibility (MHC)-like glycoproteins in mammals, specializes in capturing lipid rather than peptide antigen for presentation to T lymphocytes. The principles and mechanisms of this newly discovered immune strategy differ markedly from those governing classical MHC–peptide presentation. They might be exploited for the design of new lipid-based microbial vaccines and adjuvants.
Wave Propagation Across Muddy Seafloors

Abstract : The long-term goal is to develop field-verified models for the evolution of surface-gravity waves, allowing more skillful predictions of wave fields on continental shelves and enabling the estimation of characteristics of the seafloor from wave observations. The objective of the Wave Propagation Across Muddy Seafloors project is to develop, test, and improve models for mud-induced dissipation of waves in shallow water. Specific goals are to: (1) Observe waves along a cross-shore transect spanning several km of the Louisiana inner shelf between about 5- and 1-m water depth; (2) Extend existing wave models to account for damping by mud; (3) Use the observations and models to test hypotheses for mud-induced damping, and (4) Calibrate, test, and improve the models by comparing their predictions with the observations. Additional objectives in FY07 included analysis of waves, currents, and morphological change onshore of complex shallow-water bathymetry dominated by two submarine canyons that extend nearly to the shoreline (the Nearshore Canyon Experiment, NCEX).
Uniform Subtree Mutation

The traditional genetic programming crossover and mutation operators have the property that they tend to affect smaller and smaller fractions of a solution tree as the tree grows larger. It is generally thought that this property contributes to the 'code bloat' problem, in which evolving solution trees rapidly become unmanageably large, and researchers have investigated alternate operators designed to avoid this effect. We introduce one such operator, called uniform subtree mutation (USM), and investigate its performance--alone and in combination with traditional crossover--on six standard problems. We measure its behavior usingb oth computational effort and size effort, a variation that takes tree size into account. Our tests show that genetic programming using pure USM reduces evolved tree sizes dramatically, compared to crossover, but does impact solution quality somewhat. In some cases, however, a combination of USM and crossover yielded both smaller trees and superior performance, as measured both by size effort and traditional metrics.
On the Overuse and Misuse of Mediation Analysis: It May Be a Matter of Timing

Kenny (2008) credited Hyman (1955) with originally discussing mediation analysis under the name elaboration. Of importance, Hyman's elaboration required a time-ordered relationship among variables,...
Does Moral Ignorance Exculpate

Non-moral ignorance can exculpate: if Anne spoons cyanide into Bill's coffee, but thinks she is spooning sugar, then Anne may be blameless for poisoning Bill. Gideon Rosen argues that moral ignorance can also exculpate: if one does not believe that one's action is wrong, and one has not mismanaged one's beliefs, then one is blameless for acting wrongly. On his view, many apparently blameworthy actions are blameless. I discuss several objections to Rosen. I then propose an alternative view on which many agents who act wrongly are blameworthy despite believing they are acting morally permissibly, and despite not having mismanaged their moral beliefs.1
Biophysical basis, stability, and directional response characteristics of multiplicative lateral inhibitory neural networks

Summary form only given, as follows. A directionally selective nonlinear lateral inhibitory neural network is proposed. The network originates from the biophysical mechanism of shunting inhibition. Its stability and some of its directional response characteristics are examined. The most significant property of this network is its differential response to stimuli moving in opposite directions. This directional response is found to vary with the mean input strength level, the size and speed of moving objects, as well as with coupling among elements of the network. >
The rates of plate creation and consumption

Summary. An alternative vector derivation of the expression for the rates of plate creation and consumption is given, from which it can be seen that the rates are proportional to the scalar product of the edges of the geohedron and plate polyhedron corresponding to the same boundary. The plate polyhedron is defined by the set of triple junction vectors. This is used, together with a recent determination of the angular velocity vectors and a number of auxiliary plate boundary vectors, to revise the rates of plate creation and consumption along sections of plate boundaries. All plates which have a substantial proportion of their boundary connected to a downgoing slab are found to be decreasing in area. The total rate of plate generation is used in estimates of the area of the ocean floor and the total heat loss from the oceans. The rate of consumption within a relatively small area around New Guinea implies a large mass flux away from this region. Knowledge of the rates of plate creation and consumption is used in a number of different areas: calculating the contribution of plate creation to the total heat loss of the Earth; calculating geochemical fluxes out of the mantle, such as for the rare gases and other volatiles, and return fluxes back into the mantle resulting from reactions between sea-water and the ocean crust during hydrothermal circulation; calculating the area of the ocean floor as a function of age. Mass fluxes related to the distribution of the rates of creation and destruction along the plate boundaries are important boundary conditions on the flow pattern in the mantle. Previous estimates of these rates (Deffeyes 1970; Chase 1972; Garfunkel 1975) have applied a simple expression derived for spreading ridges (Deffeyes 1970), using angular distances from the poles of rotation measured graphically on a globe. An alternative derivation of the expression for rates of plate creation and consumption, which is independent of assumptions about the nature of the boundary, is given below in terms of the framework used to describe plate motions by McKenzie & Parker (1967, 1974). This derivation emphasizes that the rates depend on two sets of vectors - one the instantaneous rotation vectors defining the relative plate motions, the other a set of triple junction and auxiliary vectors defining the plate boundaries.
Model-free simulations of turbulent reactive flows

The current computational methods for solving transport equations of turbulent reacting single-phase flows are critically reviewed, with primary attention given to those methods that lead to model-free simulations. In particular, consideration is given to direct numerical simulations using spectral (Galerkin) and pseudospectral (collocation) methods, spectral element methods, and Lagrangian methods. The discussion also covers large eddy simulations and turbulence modeling.
Treatment for aspiration related to dysphagia: An overview

Aspiration of food during ingestion is the entry of material into the airway below the true vocal folds. It may occur as the result of a number of anatomical and physiological disturbances in deglutition in the oral, pharyngeal, or esophageal stages. In order for aspiration to be treated effectively and efficiently, it should be defined according to its etiology and timing in relation to the reflexive swallow, i.e., before, during, or after the swallow. Each physiological or anatomical etiology for aspiration requires a different management strategy. Treatment may involve compensatory strategies, such as postural changes or diet restraints, which alter the way food flows through the oral cavity or pharynx and usually have an immediate effect on aspiration. Or treatment may consist of exercise programs designed to have a long-term effect on neuromuscular control during the swallow and that require a longer time to take effect. Both compensatory techniques and exercise programs may be instituted simultaneously in some patients. Treatment procedures for the most frequently occurring physiological disorders of deglutition are described.
Status of the Amphipod Diporeia spp. in Lake Superior, 1994–2000

The amphipod Diporeia spp. is the dominant component of the Great Lakes benthic macroinvertebrate fauna, and plays an important role in the ecosystem. The Great Lakes Water Quality Agreement of 1978 (GLWQA) calls for the use of Diporeia as an indicator of ecological condition, with a goal of 220 to 320/m2 at depths less than 100 m, and 30-160/m2 at greater depths. To ascertain the status of Diporeia in Lake Superior, a probability-based survey of 27 sites representing the U.S. nearshore (10 to 110 m) waters of Lake Superior was conducted in 1994, and again in 2000. During 1995 to 1998, ten nearshore non-depositional sites and five sites in major depositional basins in the western half of the lake were revisited yearly to examine variability of Diporeia abundance. In 1994, nearshore Diporeia abundance ranged from 550 to 5500/m2, and the entire nearshore area met or exceeded the GLWQA ecosystem objective. In 2000, abundance ranged from less than 10 to 2,800/m2, and 11% of the nearshore area did not meet the GLWQA objective. The area that did not meet the GLWQA objective was located in the eastern half of the lake. Examination of yearly abundance data in the western half of Lake Superior did not reveal a significant trend at nearshore or offshore sites. Although Diporeia abundance in the eastern half of the lake was lower in 2000 than 1994, the severe declines in Diporeia populations that have been observed in the lower Great Lakes are not evident in Lake Superior. Abundances of Diporeia observed in the present study are higher than those reported in the 1970s by a factor of seven.
History, despotism, public opinion and the continuity of the radical attack on monarchy in the French revolution, 1787–1792

Propagation de la philosophie politique des Lumieres dans le discours pamphletaire pre-revolutionnaire
Fractionated cyclophosphamide, vincristine, liposomal daunorubicin, and dexamethasone plus rituximab and granulocyte‐macrophage–colony stimulating factor (GM‐CSF) alternating with methotrexate and cytarabine plus rituximab and GM‐CSF in patients with Richter syndrome or fludarabine‐refractory chronic lymphocytic leukemia

BACKGROUND Therapy for patients with Richter syndrome (RS) or fludarabine-refractory chronic lymphocytic leukemia (CLL) is unsatisfactory. A Phase II study was conducted to evaluate an alternating combination cytotoxic regimen given with rituximab and granulocyte-macrophage–colony stimulating factor (GM-CSF) in these patients. METHODS Fludarabine-refractory CLL was defined as failure to respond to most recent prior fludarabine-containing regimen. Patients received up to six cycles of fractionated cyclophosphamide, vincristine, liposomal daunorubicin, and dexamethasone (hyper-CVXD) plus rituximab and GM-CSF alternating with methotrexate and cytarabine plus rituximab and GM-CSF. Response, toxicity, and survival data were compared with data from prior therapy with hyper-CVXD alone in this patient group. RESULTS Forty-nine patients with RS (n = 30 patients) or refractory CLL (n = 19 patients) were treated on study. Nine patients (18%) achieved a complete remission, and 11 patients achieved a partial remission (22%), for an overall objective response (OR) rate of 41%. With a median follow-up of 7.5 months and a maximum follow-up of 15.2 months, the 12-month failure free survival (FFS) rate was 27%, and the overall survival (OS) rate was 39%. Nine patients (18%) died during the first cycle of therapy, and two patients (4%) died during the second cycle. There were no significant differences between the rates of OR, OS, and FFS in the current study and those obtained with hyper-CVXD alone on a prior study. CONCLUSIONS The study regimen had activity and significant toxicity in patients with RS or fludarabine-refractory CLL. It was not clearly better compared with hyper-CVXD alone in this patient population. Cancer 2003;97:1711–20. © 2003 American Cancer Society. DOI 10.1002/cncr.11238