cssi/SciSciGPT-SciSciNet huggingface dataset:
Online Machine Learning Audiometry.

Objectives A confluence of recent developments in cloud computing, real-time web audio and machine learning psychometric function estimation has made wide dissemination of sophisticated turn-key audiometric assessments possible. The authors have combined these capabilities into an online (i.e., web-based) pure-tone audiogram estimator intended to empower researchers and clinicians with advanced hearing tests without the need for custom programming or special hardware. The objective of this study was to assess the accuracy and reliability of this new online machine learning audiogram method relative to a commonly used hearing threshold estimation technique also implemented online for the first time in the same platform. Design The authors performed air conduction pure-tone audiometry on 21 participants between the ages of 19 and 79 years (mean 41, SD 21) exhibiting a wide range of hearing abilities. For each ear, two repetitions of online machine learning audiogram estimation and two repetitions of online modified Hughson-Westlake ascending-descending audiogram estimation were acquired by an audiologist using the online software tools. The estimated hearing thresholds of these two techniques were compared at standard audiogram frequencies (i.e., 0.25, 0.5, 1, 2, 4, 8 kHz). Results The two threshold estimation methods delivered very similar threshold estimates at standard audiogram frequencies. Specifically, the mean absolute difference between threshold estimates was 3.24 ± 5.15 dB. The mean absolute differences between repeated measurements of the online machine learning procedure and between repeated measurements of the Hughson-Westlake procedure were 2.85 ± 6.57 dB and 1.88 ± 3.56 dB, respectively. The machine learning method generated estimates of both threshold and spread (i.e., the inverse of psychometric slope) continuously across the entire frequency range tested from fewer samples on average than the modified Hughson-Westlake procedure required to estimate six discrete thresholds. Conclusions Online machine learning audiogram estimation in its current form provides all the information of conventional threshold audiometry with similar accuracy and reliability in less time. More importantly, however, this method provides additional audiogram details not provided by other methods. This standardized platform can be readily extended to bone conduction, masking, spectrotemporal modulation, speech perception, etc., unifying audiometric testing into a single comprehensive procedure efficient enough to become part of the standard audiologic workup.
11-Oxygenated C19 Steroids Do Not Decline With Age in Women.

CONTEXT The ovaries and adrenals are sources of androgens in women. Although dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), and testosterone (T) all decline with age, these C19 steroids correlate poorly with parameters of androgen action in postmenopausal women. OBJECTIVE To comprehensively compare the androgen profiles of pre- and postmenopausal women. METHODS We quantified 19 steroids-including DHEA; DHEAS; T; androstenedione (A4); and the following adrenal-specific 11-oxygenated C19 steroids (11oxyandrogens): 11β-hydroxytestosterone (11OHT), 11-ketotestosterone (11KT), 11β-hydroxyandrostenedione (11OHA4), and 11-ketoandrostenedione (11KA4)-using liquid chromatography-tandem mass spectrometry in morning serum obtained from 100 premenopausal (age 20 to 40 years) and 100 postmenopausal (age ≥ 60 years) women. Double immunofluorescence of 3β-hydroxysteroid dehydrogenase type 2 (HSD3B2) with cytochrome b5 (CYB5A) or sulfotransferase 2A1 (SULT2A1) was performed in normal adrenal glands obtained from eight premenopausal and eight postmenopausal women. RESULTS DHEA, DHEAS, A4, and T were significantly higher in pre- than in postmenopausal women (2.9, 2.8, 2.9, and 1.6-fold, respectively; P < 0.0001). In contrast, the 11-oxyandrogens did not decrease with aging, and the 11OHT/T and 11OHA4/A4 ratios showed strong positive correlations with age (r = 0.5 and 0.8, respectively; P < 0.0001). Double immunofluorescence analysis showed that with the involution of the zona reticularis in the old adrenals, the sharp zonal segregation of HSD3B2 and CYB5A becomes less distinct, and areas of HSD3B2 and CYB5A overlap are observed. CONCLUSIONS Unlike DHEA, DHEAS, A4, and T, the 11oxyandrogens do not decline in aging women. Structural changes within the adrenal cortex might explain the evolution of androgen profiles in aging women.
Abstraction, Coordination, and Situational Awareness: Implications for use Centered Design

Two strategies that scientists use to reduce the complexity of the natural world are reductionism and abstraction. Reductionism deals with complexity by describing the system in terms of a small number of fundamental elements. In physics the search for fundamental particles and in psychology the search for independent information processing stages or for local neural mechanisms reflect this strategy for attacking complexity. Abstraction deals with complexity by searching for global relational properties that exist somewhat independently of the elements whose behavior they govern. In physics, the idea of “fields” (e.g., gravitational or electromagnetic) are prototypical examples of the strategy of abstraction. In psychology, the cybernetic hypothesis, that human behavior may be constrained by the same kind of stability constraints as a servomechanism is an example of abstraction. This is an abstraction in the sense that within a closed-loop system stability is not associated with any particular element of the system. Rather, stability depends on global relations between forward loop gain (sensitivity to error) and time delays. Recent work using nonlinear dynamics to model phase transitions in rhythmic behaviors such as walking also reflect the strategy of abstraction (e.g., Kelso, 1995).
The Rise of the Islamic State and Changing Patterns of Cooperation in the Middle East

Interstate relations are highly interdependent: a change in relations between a pair of states can impact the relationship each of those states has with third parties, as well as relations among th...
The Wisconsin Substance Use Inventory (WSUI)

Considerable concern has appeared during the past few years with problems of “drug abuse” and its complex implications for the individual, his family, and the society at large. The research effort in this field is beset by confusion, methodological and conceptual flaws, absence of needed data, difficulty in obtaining such data, and a multitude of other problems. Research progress has been stymied, on one hand, by lack of standardized and operationalized definitions, terms, and concepts (Elinson and Nurco, 1975) and on the other hand, by the absence of a quantitative and standardized method of measurement (Walizer, 1975).
The Battle of the Atlantic: How the Allies Won the War

Jonathan Dimbleby’s new book on the six year-long “Battle of the Atlantic” brings a popular military historical approach to an important topic. This so-called “battle,” as Dimbleby emphasizes, was ...
Solar sailing technology challenges

Abstract Solar sailing technology has been demonstrated in the space environment over the past decade, in Earth orbit and on an interplanetary trajectory. These technology demonstration missions, along with a forty-year history of conceptual studies and laboratory development, have provided a foundation for a new era of missions where solar sailing provides the necessary propulsion to achieve space science and infrastructure goals. Numerous challenges remain on the path to flagship-class missions utilizing solar sails. This paper provides a survey of the current state of the art in solar sailing technology, including a taxonomy of solar sail design. A summary of solar sailing missions is provided, along with description of the larger-scale ground test programs. A set of representative next-generation solar sailing mission concepts is then presented, to establish driving requirements for future applications. To meet the objectives for these future missions, sail areas must increase by a factor of 50–500 relative to the largest solar sail flown to date. Sail loading, sailcraft areal density, characteristic acceleration and lightness number must improve by one to two orders of magnitude. Technology advancements required to meet the future solar sailing performance needs are described, providing a technology roadmap for solar sailing capability.
The classification of locally conformally flat Yamabe solitons

Abstract This paper addresses the classification of locally conformally flat gradient Yamabe solitons. In the first part it is shown that locally conformally flat gradient Yamabe solitons with positive sectional curvature are rotationally symmetric. In the second part the classification of all radially symmetric gradient Yamabe solitons is given and their correspondence to smooth self-similar solutions of the fast diffusion equation on R n is shown. In the last section it is shown that any eternal solution to the Yamabe flow with positive Ricci curvature and with the scalar curvature attaining an interior space–time maximum must be a steady Yamabe soliton.
What Enables Persistence

This chapter focuses on the complex and interrelated factors that contribute to students’ persistence in STEM majors. Like switching, persistence is a process for students that unfolds over time and involves many modifications and adjustments to their prior identities, practices, and habits. Students drew on an array of individual, social, cultural, and institutional resources to persist and succeed in STEM as no one approach or strategy was sufficient to ensure students’ success. Students with low math readiness were more likely to use a variety of means to ensure their survival in STEM. Persisters faced many of the same obstacles as switchers, such as poor grades, difficult coursework, heavy workloads, and poor instruction, yet they were able to shift or adapt their expectations and identities to accommodate and overcome these difficulties. From their interactions with peers, many persisters adjusted their perceptions of poor grades and came to a more sophisticated understanding of curved grading practices over time. Informal peer study groups also provided essential academic, social, and emotional support for many persisters. While formal institutional support and informal peer support factored heavily in students’ persistence, most persisters still viewed their STEM major as a “game” to play or a challenge to overcome.
Protecting Decision-Making in the Era of Neuromodulation

How humans make decisions is one of the primary domains of inquiry in psychology. Our ability to make decisions leads to direct consequences in our lives and defines one aspect of autonomous function. Among clinicians and researchers, the pursuit of effective cognitive enhancements and treatments that could directly or indirectly influence our decision processes has become widespread, since many of the neural circuits that we stimulate are involved in autonomous decision-making. Given rapid scientific developments, it is prudent to consider how neuromodulation could affect a person’s ability to make choices and manage trade-offs between decision outcomes. In light of this dilemma, we offer a framework based in decision neuroscience that separates brain networks into decision-making core, volitional action, and moderating systems. This framework bridges bioethics and cognitive neuroscience to provide heuristics for the neural basis of autonomous decision-making. In doing so, we provide a general call to predict and weight risks and benefits of different degrees and kinds with regard to decision-making as increasingly precise neuromodulation techniques emerge.
Social Contagion in Bullying: an Examination of Strains and Types of Bullying Victimization in Peer Networks

This study examined risk and protective factors for four types of bullying victimization – physical, verbal, relational, and cyber bullying – while assessing the influence of vicarious, anticipated, and experienced strains from General Strain Theory. In this study, experienced strain was operationalized as exposure to negative stimuli, such as rejection. Vicarious strain was operationalized as witnessing or being aware of other people’s negative experiences, such as peer victimization, and anticipated strain occurred when an individual had negative expectations about the future, such as a fear of harm. Using a sample of Southeastern high school students, this study found that individuals who experienced vicarious strain (peer victimization) had a higher likelihood of experiencing the same type of victimization as their peers. Previous bullies were also likely to experience the same type of bullying that they initiated. Anticipated strain (fear of attack) was associated with an increased likelihood of experiencing verbal and cyber bullying. Adult support was associated with an increased likelihood of verbal bullying but decreased likelihood of relational bullying victimization. Peer support was associated with an increased likelihood of experiencing relational and cyber bullying victimization. The results support Agnew’s (2006) proposal that experienced, vicarious, and anticipated strains are correlated with antisocial behavior and victimization (Zavala & Spohn, 2013). Policy implications and directions for future research are discussed.
Retiming for high-performance superconductive circuits with register energy minimization

Retiming, which is a circuit transformation whereby registers are relocated to optimize performance, area, or energy consumption, has reached a high level of maturity in CMOS designs. However, the recent emergence and rapid rise of non-CMOS technologies are introducing new and important variants of the standard retiming problems. This paper presents a path-balancing retiming transformation, taking superconductive designs as an evaluation case study, where the retiming solution must achieve full path balancing of the circuit while simultaneously minimizing the energy consumption of inserted registers with performance constraints. This optimization problem, which is called a constrained register energy minimization (CREM) problem, is precisely formulated and polynomially solved. Next, the CREM problem formulation is extended to retime the circuit under a dual clocking architecture requiring partially (bounded depth difference) path balanced (PPB) characteristics only. It is shown that the PPB-CREM problem is NP-complete. We thus propose a polynomial-time approximation algorithm with a bounded error to solve this retiming variant. Compared to prior work, our approach reduces 38% of register count and 50% of register energy consumption of 14 benchmark circuits on average. Moreover, the competitive ratio of the register energy consumption between our approximate solution and the optimal solution is on average only 1.08.
Assessing Ease of Delivering Emergency Care for Patients with Autism Spectrum Disorders.

OBJECTIVE The aim of this study was to develop a method for objectively assessing the delivery of care to children with autism spectrum disorder (ASD) in the emergency department (ED). METHODS A case-control study of patients ages 2 to 18 years admitted to the hospital from January 2016 to January 2018. Cases were defined as patients with an International Classification of Diseases, Tenth Revision diagnosis of ASD or other pervasive developmental disorder (F84) in their medical record and were matched 1:1 with neurotypical controls. The primary outcome was ability to complete several core tasks clinically necessary within an ED visit and summarized into a Task Completion Index (TCI). RESULTS Overall, children with ASD had higher median TCIs of 0.25 (interquartile range [IQR] 0-0.45) versus 0 (IQR 0-0.25) when compared with children without ASD (p < 0.01). Children with ASD were 5 times more likely to have difficulty with triage vitals, 3 times more likely to require additional staff for peripheral intravenous placement, and 4 times more likely to experience delays or disruptions to their plan of care. The TCI was also associated with 8-fold increased odds of receiving pharmacologic or physical restraint. CONCLUSIONS The TCI reflects difficulty accomplishing core tasks necessary to complete an ED visit. Children with ASD have higher TCIs than neurotypical controls, which puts them at higher risk for care disruptions. Evaluation of initiatives to improve quality of care for children with ASD should focus not only on metrics of overall experience and satisfaction but also how these initiatives affect the ability to effectively administer care.
Short-Term RCT of Increased Dietary Potassium from Potato or Potassium Gluconate: Effect on Blood Pressure, Microcirculation, and Potassium and Sodium Retention in Pre-Hypertensive-to-Hypertensive Adults

Increased potassium intake has been linked to improvements in cardiovascular and other health outcomes. We assessed increasing potassium intake through food or supplements as part of a controlled diet on blood pressure (BP), microcirculation (endothelial function), and potassium and sodium retention in thirty pre-hypertensive-to-hypertensive men and women. Participants were randomly assigned to a sequence of four 17 day dietary potassium treatments: a basal diet (control) of 60 mmol/d and three phases of 85 mmol/d added as potatoes, French fries, or a potassium gluconate supplement. Blood pressure was measured by manual auscultation, cutaneous microvascular and endothelial function by thermal hyperemia, utilizing laser Doppler flowmetry, and mineral retention by metabolic balance. There were no significant differences among treatments for end-of-treatment BP, change in BP over time, or endothelial function using a mixed-model ANOVA. However, there was a greater change in systolic blood pressure (SBP) over time by feeding baked/boiled potatoes compared with control (-6.0 mmHg vs. -2.6 mmHg; p = 0.011) using contrast analysis. Potassium retention was highest with supplements. Individuals with a higher cardiometabolic risk may benefit by increasing potassium intake. This trial was registered at ClinicalTrials.gov as NCT02697708.
Healthcare utilization and outcomes in cervical cancer with and without HIV: National inpatient sample analysis.

e17522Background: Cervical cancer (CC) is an AIDS-defining malignancy and is the most common cancer in women with HIV who have a six times higher risk of developing CC than women without HIV. Compa...
Fast and Accurate Craniomaxillofacial Landmark Detection via 3D Faster R-CNN.

Automatic craniomaxillofacial (CMF) landmark localization from cone-beam computed tomography (CBCT) images is challenging, considering that 1) the number of landmarks in the images may change due to varying deformities and traumatic defects, and 2) the CBCT images used in clinical practice are typically large. In this paper, we propose a two-stage, coarse-to-fine deep learning method to tackle these challenges with both speed and accuracy in mind. Specifically, we first use a 3D faster R-CNN to roughly locate landmarks in down-sampled CBCT images that have varying numbers of landmarks. By converting the landmark point detection problem to a generic object detection problem, our 3D faster R-CNN is formulated to detect virtual, fixed-size objects in small boxes with centers indicating the approximate locations of the landmarks. Based on the rough landmark locations, we then crop 3D patches from the high-resolution images and send them to a multi-scale UNet for the regression of heatmaps, from which the refined landmark locations are finally derived. We evaluated the proposed approach by detecting up to 18 landmarks on a real clinical dataset of CMF CBCT images with various conditions. Experiments show that our approach achieves state-of-the-art accuracy of 0.89±0.64 mm in an average time of 26.2 seconds per volume.
The Dynamics of Development: Innovation and Reallocation

This paper proposes a quantitative model of firm dynamics with endogenous innovation to study growth acceleration episodes triggered by reforms. The authors find that reforms removing barriers to firm entry lead to persistent growth in TFP and declining average firm size, as in the experience of successful post-communist transitions. Reforms that reverse resource misallocation result in more protracted paths of TFP and rising average firm size, as in the experience of non-communist growth accelerations. When calibrating the reforms to data from Chile's and China?s growth accelerations, the model can replicate the macro and firm-level features of these episodes.
Bioreactors for Vocal Fold Tissue Engineering.

It is estimated that almost one-third of the United States population will be affected by a vocal fold (VF) disorder during their lifespan. Promising therapies to treat VF injury and scarring are m...
Cell therapy for nonischemic dilated cardiomyopathy: A systematic review and meta-analysis of randomized controlled trials

Cell therapy involves transplantation of human cells to promote repair of diseased or injured tissues and/or cells. Only a limited number of mostly small-scale trials have studied cell therapy in nonischemic cardiomyopathy (NICM). We performed a meta-analysis of randomized clinical trials (RCTs) to assess the safety and efficacy of cell therapy in NICM. Electronic databases were searched for relevant RCTs from inception until August 2020. Outcomes assessed were left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter or volume (LVEDD), quality of life (QoL) indices, and major adverse cardiac events (MACEs). Weighted mean differences (MDs) and standardized mean differences (SMDs) were calculated using random-effects methods. Eleven RCTs with 574 participants were included in the analysis. There was a significant increase in mean LVEF (MD, 4.17%; 95% confidence interval [CI] = 1.66-6.69) and modest decrease in LVEDD (SMD, -0.50; 95% CI = -0.95 to -0.06) in patients treated with cell therapy compared with controls. Cell therapy was also associated with improvement in functional capacity, as assessed by the 6-minute walking distance (MD, 72.49 m; 95% CI = 3.44-141.53). No significant differences were seen in MACEs and QoL indices between treated and control groups. This meta-analysis suggests that cell therapy may improve LV systolic function and may be associated with improvement in LVEDD and functional capacity compared with maximal medical therapy. Cell therapy was safe, with no significant difference in MACEs between treatment and control groups. However, given the limitations of current studies, larger well-designed RCTs are needed to evaluate the efficacy of cell therapy in patients with NICM.
Does Word-Problem Performance Maintain? Follow-Up One Year After Implementation of a Word-Problem Intervention

We conducted a randomized control trial assessing the effects of two variants of word-problem intervention with third graders (n = 304) experiencing mathematics difficulty. Students were assigned t...
Six Themes on Variation

Calculus of variations: What does "variations" mean? by F. Jones How many equilibria are there? An introduction to Morse theory by R. Forman Aye, there's the rub. An inquiry into why a plucked string comes to rest by S. J. Cox Proof of the double bubble conjecture by F. Morgan Minimal surfaces, flat cone spheres and moduli spaces of staircases by M. Wolf Hold that light! Modeling of traffic flow by differential equations by B. L. Keyfitz.
Continuation of Periodic Solutions

In the last chapter, some local results about periodic solutions of Hamiltonian systems were presented. The systems contain a parameter, and the conditions under which a periodic solution can be continued in the parameter were discussed. Since Poincare used these ideas extensively, it has become known as Poincare’s continuation method. By Lemma V.E.2, a solution o(t, ξ′) of an autonomous differential equation is T-periodic if and only if o(T’) = o is the general solution. This is a finite-dimensional problem since is a function defined in a domain of ℝm+1 into ℝm. Thus, periodic solutions can be found by the finite-dimensional methods, i.e., the finite-dimensional implicit function theorem, the finite-dimensional fiixed point theorems, the finite-dimensional degree theory, etc. This chapter will present results which depend only on the finite-dimensional implicit function theorem. Chapter X will present a treatment of fixed point methods as they apply to Hamiltonian systems. In this chapter the periodic solutions vary continuously with the parameter (“can be continued”), but Chapter VII will discuss the bifurcations of periodic solutions.
Neuropeptides and Diabetic Wound-Healing

Diabetes impairs wound-healing, which in turn predisposes patients to develop nonhealing foot ulcers and amputations. Vascular dysfunction, peripheral neuropathy, and immune dysregulation are among the known contributors to nonhealing foot ulcers. In recent years, research efforts have been initiated towards deciphering the role of neuropeptides in wound-healing. In particular, Substance P, neuropeptide Y, and calcitonin gene-related peptide are known to have physiological roles in pain transmission, satiety, and maintenance of vascular tone. Cytokine secretion, immune cell trafficking, and growth factor signaling are some of the mechanisms modulated by peripheral autonomic and sensory neuropeptides through which they affect inflammation and proliferation. Thus, neuropeptides released by cutaneous nerves can directly participate in the healing process by affecting the inflammatory and proliferative phases of wound-healing. We therefore believe that, in diabetic patients with peripheral neuropathy, impaired wound-healing could be a result of neuropeptide dysregulation. The present chapter gives a broad overview of different neuropeptides that could play a fundamental role in the wound-healing process. Additionally, we have discussed different in vivo models that could further help delineate the role of neuropeptides in diabetic wound-healing.
Lacosamide in status epilepticus: Update on the TRENdS study

Many patients with critical illness have been noted to have nonconvulsive seizures (NCSs) and nonconvulsive status epilepticus (NCSE). How aggressively these seizures should be treated is unclear. Many investigators feel that the morbidity of NCSs and NCSE is different from that of generalized convulsive status epilepticus (GCSE), so treatment should be less urgent. Consequently, many nonsedating AEDs have been used to treat NCSs and NCSE in patients with critical illness. Randomized, controlled trials demonstrating the efficacy of AEDs in NCSs and NCSE are lacking. The Treatment of Recurrent Electrographic Nonconvulsive Seizures (TRENdS) study compared lacosamide to fosphenytoin in the treatment of NCSs. An update of the study is presented. This article is part of a Special Issue entitled "Status Epilepticus".
Dynamic compilation for reducing energy consumption of i/o-intensive applications

Tera-scale high-performance computing has enabled scientists to tackle very large and computationally challenging scientific problems, making the advancement of scientific discovery at a faster pace. However, as computing scales to levels never seen before, it also becomes extremely data intensive, I/O intensive, and energy consuming. Amongst these, I/O is becoming a major bottleneck, impeding the expected pace of scientific discovery and analysis of data. Furthermore, the applications are becoming increasingly dynamic in terms of their computation patterns as well as data access patterns to cope with larger problems and data sizes. Due to the complexities of systems and applications and their high energy consumptions, it is, therefore, very important to address research issues and develop dynamic techniques at the level of run-time systems and compilers to scale I/O in the right proportions. This paper presents the details of a dynamic compilation framework developed specifically for I/O-intensive large-scale applications. Our dynamic compilation framework includes a set of powerful I/O optimizations designed to minimize execution cycles and energy consumption, and generates results that are competitive with hand-optimized codes in terms of energy consumption.
A study of 111 cystograms for diagnosis of placenta previa

Abstract The purpose of this paper is to present a comprehensive study of the use of the cystogram in the diagnosis of placenta previa and to point out certain failures of the method. The work was first undertaken about May, 1937. A preliminary report covering 19 cases was prepared by me in collaboration with Dr. John A. McGeary and read before the Section on Obstetrics, at the New York Academy of Medicine, Nov. 23, 1937. The present report includes those cases and others collected during the intervening peroid up to October, 1938. During this time a total of 111 cystograms were done on 105 patients in the third trimester of pregnancy. Until 1934 various methods 7 were used in conjunction with the x-ray for the diagnosis of placenta previa. Since all of these methods involved the injection of foreign materials directly or indirectly into the uterine cavity, they entailed the dangers of intrauterine infection, premature rupture of the membranes, premature induction of labor, fetal death in utero, intrauterine hemorrhage, or perforation of maternal (occasionally fetal) viscera. Snow and Powell 8 in 1934 wrote that with careful study one could locate the placental site in the ordinary anteroposterior or lateral films of the abdomen. Other authors pointed out that calcifications in the mature placenta could be visualized in the usual films of the abdomen. In the same year Ude, Weum, and Urner 12 suggested the use of the cystogram, and in 1935 Ude and Urner 9, 10 reported its use in 35 cases of third trimester bleeding. In the present series the technique of Ude and Urner has been followed. There were 105 patients upon whom 111 cystograms were done. The discrepancy is accounted for by repetition on those few cases which were admitted to the hospital more than once during the same pregnancy, or who were kept under observation for longer than usual. For the purposes of this paper the cases are divided into three groups: 1.1. Patients proved not to have had placenta previa at the time of parturition. 2.2. Patients in whom placenta previa was demonstrated at the time of delivery. 3.3. Patients with presentations other than vertex.
Regression to the Mean in Clinical Trials

When a person is selected for having an extreme measurement (e.g., high blood pressure), a second measure of the variable will, on average, be closer to the mean of the population distribution. This function is called regression to the mean. It is used as a justification for a randomized control group in clinical trials. It may also affect recruitment in clinical trials in which potential participants are selected because they hold an extreme value on some variable. Keywords: regression; selection; within person variability
Lymphocyte stimulation with Fc fragments: II. Requirement for mature B lymphocytes

Abstract Fc fragments of Ig induce blastogenesis, proliferation, and polyclonal antibody production in murine B lymphocytes. Enrichment for complement receptor-bearing (CR+) spleen cells from normal mice consistently results in a threefold increase of the proliferative response (measured by [ 3 H]thymidine incorporation). In contrast, spleen cells or CR+ spleen cells from young adult mutant CBA/N mice cannot be triggered by Fc fragments while they are capable of responding to LPS. However, this defect is overcome in aging (1-year-old) CBA/N mice. In normal mice (A/J, CBA/Caj) responsiveness in spleen cells is absent at birth and gradually develops between 5 days and 8 weeks of age. This process also occurs, but is greatly delayed, in the mutant CBA/N strain. The findings suggest that the Fc signal for proliferation acts on B cells at a late stage of maturation.
An X-Ray Microprobe Beam Line for Trace Element Analysis

The application of synchrotron radiation to a x-ray microprobe for trace element analysis is a complementary and natural extension of existing microprobe techniques using electrons, protons, and heavier ions as excitation sources for x-ray fluorescence. This was first recognized by HOROWITZ and HOWELL [1] in their development of the first synchrotron radiation microprobe at the Cambridge Electron Accelerator. SPARKS, et al. [2] used a miniprobe beam at the Stanford Synchrotron Radiation Laboratory in an attempt to find natural occurring superheavy elements by x-ray fluorescence of characteristic L-lines. The ability to focus charged particles leads to electron microprobes with spatial resolutions in the sub-micrometer range and down to 100 ppm detection limits and proton microprobes with micrometer resolution and ppm detection limits. The characteristics of synchrotron radiation that prove useful for microprobe analysis include a broad and continuous energy spectrum, a relatively small amount of radiation damage compared to that deposited by charged particles, a highly polarized source which reduces background scattered radiation in an appropriate counting geometry, and a small vertical divergence angle of ~ 0.2 mrad which allows for focussing of the light beam into a small spot with high flux. The features of a dedicated x-ray microprobe beam line developed at the National Synchrotron Light Source (NSLS) are described.
Coadsorption of electropositive and electronegative elements: II. Cs and O2 on W (100)

Abstract A systematic experimental study of Cs and CsH 2 adsorption on W (100) surfaces by LEED and work function measurements has been made. It was found that at high coverages the electropositive and electronegative adsorbates formed a double layer. The arrangement of the adsorbates was independent of the sequence of deposition. The two adsorbates affected the structures of each other: a Cs layer caused an increase in ordering and binding energy of H on W and the existence of H on W(100) caused an increase in the maximum density of Cs atoms that can be deposited on the surface. This increase in Cs density was accompanied by an increase in work function. The coverage of Cs at the work function minimum was also shifted to a smaller value with increasing amount of initially adsorbed H 2 . The work function result was compared with a recent non-uniform electron gas theory of work function. The adsorption of H 2 on Cs-covered W was found to be an activated process and the sticking coefficient decreased exponentially with increasing Cs coverage. It appears that adsorption of Cs did not form a duolayer on W (100), as reported by MacRae et al., rather it formed a single layer on top of some patches of hydrogen impurity. The small amount of H impurity was not ordered unless there was a layer of Cs on top.
The Effects of Synthetic Estrogen Exposure on the Sexually Dimorphic Liver Transcriptome of the Sex-Role-Reversed Gulf Pipefish

Species exhibiting sex-role reversal provide an unusual perspective on the evolution of sex roles and sex differences. However, the proximate effects of sex-role reversal are largely unknown. Endocrine disruptors provide an experimental mechanism to address hormonal regulation of sexually dimorphic gene expression in sex-role-reversed taxa. Here, we investigate gene expression patterns in the liver of the sex-role-reversed Gulf pipefish, because the liver is known to be sexually dimorphic and estrogen-regulated in species with conventional sex roles. Using next-generation RNA-sequencing technology (RNA-seq), we detected sexually dimorphic hepatic gene expression patterns, with a total of 482 differentially expressed genes between the sexes in Gulf pipefish. Two-thirds of these genes were over-expressed in females, and the sex-specific transcriptomes of this sex-role-reversed pipefish's liver were superficially similar to those of fishes with conventional sex-roles. We exposed females, pregnant males, and non-pregnant males to 17α-ethinylestradiol (EE2) at ecologically relevant concentrations of 5ng/L and compared gene expression patterns in the livers of exposed fish to control fish. Several genes that were up-regulated in EE2-exposed males relative to control males were also found to be female-biased in control animals. These genes included several of the classic estrogen biomarkers, such as vitellogenin, choriogenin, and zona pellucida. Thus, estrogen exposure induced feminization of the male liver transcriptome in a sex-role-reversed pipefish. These results suggest that the ancestral state of estrogen-regulated female reproductive physiology has been retained in all sex-role-reversed vertebrates thus far studied, despite substantial evolution of the hormonal regulation of ornamentation and mating behavior in these interesting taxa.
Nanoscale Boundary Lubrication Studies

Boundary films are formed by physisorption, chemisorption, and chemical reaction. With physisorption, no exchange of electrons takes place between the molecules of the adsorbate and those of the adsorbant. The physisorption process typically involves van der Waals forces, which are relatively weak. In chemisorption, there is an actual sharing of electrons or electron interchange between the chemisorbed species and the solid surface. The solid surfaces bond very strongly to the adsorption species through covalent bonds. Chemically reacted films are formed by the chemical reaction of a solid surface with the environment. The physisorbed film can be either monomolecularly or polymolecularly thick. The chemisorbed films are monomolecular, but stoichiometric films formed by chemical reaction can have a large film thickness. In general, the stability and durability of surface films decrease in the following order: chemically reacted films, chemisorbed films, and physisorbed films. A good boundary lubricant should have a high degree of interaction between its molecules and the sliding surface. As a general rule, liquids are good lubricants when they are polar and, thus, able to grip solid surfaces (or be adsorbed). In this chapter, we focus on perfluoropolyethers (PFPEs). We first introduce details of the commonly used PFPE lubricants; then present a summary of nanodeformation, molecular conformation, and lubricant spreading studies; followed by an overview of nanotribological properties of polar and nonpolar PFPEs studied by atomic force microscopy (AFM) and some concluding remarks.
William Osier and Jacob Mendez Da Costa: Philadelphia Medicine, 1884–1889

When William Osler (1849-1919), at the age of 35, moved from Montreal to Philadelphia (the leading medical centre in the United States) in 1884, Jacob Mendez Da Costa (1833-1900) was 51, and Chair of Practice at Jefferson Medical College. During Osler's five frenetic years in Philadelphia, he and Da Costa shared medical and professional experiences, interactions with friends and colleagues, and participation in the leading medical organizations in the United States. The shared experiences reflect Philadelphia in the 1880s, the traditions, the times and the individuals. Although Da Costa was considered the greatest clinical teacher of his day, his career embodied Quaker Philadelphia and his legacy does not reflect the stature of the clinician and the man. In time, Osler became Sir William Osler, a man for the ages.
Effect of alcohol and exercise on postprandial lipemia and triglyceride clearance in men

Abstract Alcohol intake and exercise have both been found to be related to increased plasma levels of high density lipoprotein cholesterol (HDLC). Exercise training results in decreased postprandial lipemia, and clearance rate of infused lipids is related to plasma lipoprotein levels in physically active men. The effect of alcohol intake on plasma triglyceride (TG) clearance has not been studied in relation to the exercise status of subjects. Plasma TG change over 8 h was determined following a liquid fatty meal in 14 male habitual runners (R) and 13 physically inactive men (I) after 3 weeks of alcohol abstinence and 3 weeks of drinking ∼41 g(1.44 oz) of ethanol per day. Fasting total cholesterol and apolipoprotein A-1 (apo A-1) were not different between groups, but TG was lower and HDLC, HDL 2 C, and HDL3C were higher in the runners. After abstinence, I had slower TG clearance ( P = 0.07) compared with R; with alcohol, TG clearance was unchanged in R, but was significantly retarded in I. With alcohol, both groups had increased HDLC levels, but this mainly was due to an increase in HDL 3 C in R and HDL 2 C in I; apo A-1 increased similarly in both groups and fasting TG increased significantly only in I. Alcohol-induced increases in postprandial lipemia and retardation of TG clearance appear to occur in inactive, but not exercise-trained subjects and the effect of alcohol on plasma HDL subfractions may differ between these groups.
Cooperating G6PD mutations associated with severe neonatal hyperbilirubinemia and cholestasis.

We report a novel glucose-6-phosphate dehydrogenase (G6PD) mutation, which we propose to name G6PD Cincinnati (c.1037A>T, p.N346I), found in combination with G6PD Gastonia (c.637G>T, p.V213L) in an infant who presented with neonatal cholestasis. The G6PD Cincinnati mutation results in a non-conservative amino acid substitution at the tetramer interface disturbing its formation, as seen by native gel electrophoresis and immunoblotting. G6PD Gastonia disrupts dimerization of the enzyme and by itself causes chronic non-spherocytic hemolytic anemia. The G6PD Cincinnati mutation may have aggravated the clinical picture of G6PD Gastonia with the result of severe perinatal hemolysis causing cholestasis and associated liver injury.
Flow Measurements in a First Stage Nozzle Cascade Having Endwall Contouring, Leakage, and Assembly Features

This work supports new gas turbine designs for improved performance by evaluating the use of endwall contouring in a cascade that is representative of a first stage stator passage. Contouring accelerates the flow, reducing the thickness of the endwall inlet boundary layer to the turbine stage and reducing the strength of secondary flows within the passage. Reduction in secondary flows leads to less mixing in the endwall region. This allows improved cooling of the endwall and airfoil surfaces with injected and leakage flows. The present paper documents component misalignment and leakage flow effects on the aerodynamic losses within a passage having one contoured and one straight endwall. Steps on the endwall and leakage flows through the endwall can lead to thicker endwall boundary layers, stronger secondary flows and possibly additional vortex structures in the passage. The paper compares losses with steps of various geometries and leakage of various flow rates to assess their importance on aerodynamic losses in this contoured passage. In particular, features associated with the combustor-to-turbine transition piece and the slashface gap, a gap between two vane segments on the vane platform, are addressed. An n-factorial study is used to quantify the importance of such effects on aerodynamic losses.Copyright © 2005 by ASME
Remembering Trauma revisited

David Spiegel's review of my book, Remembering Trauma (Nat. Med. 9, 1251−1252; 2003), contains serious errors. First, Spiegel wrongly states, "McNally insists elsewhere that clinicians' judgments of the veracity of trauma memories are completely unreliable." Never have I made such an absurd, sweeping generalization.
Steady-state kinetics of the hypoxanthine phosphoribosyltransferase from Trypanosoma cruzi.

Abstract The kinetic mechanism for the reaction catalyzed by the hypoxanthine phosphoribosyltransferase (HPRT) from Trypanosoma cruzi was analyzed to determine the feasibility of designing a parasite-specific mechanism-based inhibitor of this enzyme. The results show that the HPRT from T. cruzi follows an essentially ordered bi–bi reaction, and like its human counterpart also likely forms a dead end complex with purine substrates and the product pyrophosphate. Computational fitting of the kinetics data to multiple initial velocity equations gave results that are consistent with the dead end complex arising when the hypoxanthine- or guanine-bound form of the enzyme binds pyrophosphate rather than the phosphoribosylpyrophosphate substrate of the productive forward reaction. Limited proteolytic digestion was employed to provide additional support for formation of the dead end complex and to estimate the K d values for substrates of both the forward and reverse reactions. Due to similarities with the kinetic mechanism of the human HPRT, the results reported here for the HPRT from T. cruzi indicate that the design of a mechanism-based inhibitor of the trypanosomal HPRT, that would not also inhibit the human enzyme, may be difficult. However, the results also show that a potent selective inhibitor of the trypanosomal HPRT might be achieved via the design of a bi-substrate type inhibitor that incorporates analogs of moieties for a purine base and pyrophosphate.
Pain, Fatigue, Family Functioning, and Attitude Toward Illness in Children with Juvenile Rheumatic Diseases

Pain and fatigue adversely affect the physical and psychosocial functioning of children with Juvenile Rheumatic Diseases (JRDs). Research investigating relations among disease severity and family functioning has produced mixed results. There is scant research examining the relations among illness attitudes and disease severity. Children (50 girls and 32 boys) with a JRD and their parents participated in this study. Parents completed a scale assessing family functioning and children completed information about their experience of pain and fatigue and attitude toward their illness. Regression analyses indicated that children experiencing more pain and fatigue were apt to hold negative attitudes toward their illness, and that parents reported lower family functioning when children were experiencing higher levels of fatigue. Research examining relations among child and reports of family functioning and children’s attitudes toward their illness will provide information for health care teams serving these children and their families.
Nurse management for hypertension. A systems approach.

Background Standard office-based approaches to controlling hypertension show limited success. Such suboptimal hypertension control reflects in part the absence of both an infrastructure for patient education and frequent, regular blood pressure (BP) monitoring. We tested the efficacy of a physician-directed, nurse-managed, home-based system for hypertension management with standardized algorithms to modulate drug therapy, based on patients’ reports of home BP. Methods We randomized outpatients requiring drug therapy for hypertension according to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) criteria to receive usual medical care only (UC, n = 76) or usual care plus nurse care management intervention (INT, n = 74) over a 6-month period. Results Patients receiving INT achieved greater reductions in office BP values at 6 months than those receiving UC: 14.2 ± 18.1 versus 5.7 ± 18.7 mm Hg systolic (P < .01) and 6.5 ± 10.0 versus 3.4 ± 7.9 mm Hg diastolic, respectively (P < .05). At 6 months, we observed one or more changes in drug therapy in 97% of INT patients versus 43% of UC patients, and 70% of INT patients received two or more drugs versus 46% of UC. Average daily adherence to medication, measured by electronic drug event monitors, was superior among INT subjects (mean ± SD, 80.5% ± 23.0%) than among UC subjects (69.2 ± 31.1%; t113 = 2.199, P = .03). There were no significant adverse drug reactions in either group. Conclusions Telephone-mediated nurse management can successfully address many of the systems-related and patient-related issues that limit pharmacotherapeutic effectiveness for hypertension.