cssi/SciSciGPT-SciSciNet huggingface dataset:
Diagnosis and treatment of jugular foramen ectopic pituitary adenoma:case report and review of literature

Objective To explore the mechanism, clinical manifestation, pathological features, diagnosis and treatment of jugular foramen ectopic pituitary adenoma. Method The clinical data of a patient with jugular foramen ectopic pituitary adenoma were analyzed retrospectively. The clinical features were tinnitus of the left ear and headache. There was no endocrine disturbance. MR1 showed a long Tl, long T2 lesion with clear boundary in jugular foramen. The axial contrast - enhanced Tl - weighted image was non -uniform. Results The tumor was dissected under microscope through suboccipital retrosigmoidal approach. Postoperative recovery was well Pathological examination showed an adenoma with pituitary cells,and the endocrine examination showed that ACTH was 23.7pg/ml and others was normal. Conclusions Pituitary adenoma ectopic to jugular foramen was seldom. Its clinical features were disorder of neural function and endocrine disturbance. Its diagnosis mainly depends on pathological examination. Treatment strategy should be depended on the location and the classification of the endocrine types. The prognosis of operation is good. Total removal is recommended for its treatment Radiotherapy and drug treatment should be considered after surgery. Key words: Pituitary adenoma; Ectopic; Jugular foramen; Diagnosis; Treatment
Biological responses of the sea urchin, Arbacia punctulata, to lead contamination for an estuarine ecological risk assessment

An estuarine ecological risk assessment for thePortsmouth Naval Shipyard (PNS) Kittery, ME, wasconducted utilizing the U.S. EPA's Framework forEcological Risk Assessment (ERA). As part of theanalysis phase of the ERA, laboratory studies wereconducted to develop quantitative exposure-responserelationships for lead (Pb), a key contaminant ofconcern for PNS, in order to evaluate the role of Pbin the ecological stress observed near PNS, and toestimate the probability of ecological risk associatedwith Pb contamination at the site. Biological effectsof exposure to Pb via sediment or diet were evaluatedusing several life stages of the sea urchin, Arbacia punctulata. This strategy was employedbecause echinoderm species, including A.punctulata, are amenable to laboratory testing andhave been used frequently to assess the toxicity ofestuarine waters and sediments. In addition, lifestage-specific biological effects could be comparedand integrated into projections of population-levelresponses to Pb. Results indicated that adult seaurchins accumulated Pb in direct proportion toexposure medium Pb concentration, whether exposureoccurred via sediment or diet. High Pb concentrationsreduced survival and gamete production in females, buthad no effect on the viability of produced gametes. Aqueous Pb exposure concentrations that producedadverse effects on adult sea urchin survival andreproduction were also directly toxic to early lifestages. In addition to their utility for this ERA,these results have applicability for the prediction ofbiological effects or the retrospective analysis ofcausal relationships at other estuarine sites.
Association of Cannabis Use With All-Cause and Cause-Specific Mortality Among Younger- and Middle-Aged U.S. Adults

Introduction Cannabis is frequently used and increasingly legalized in the U.S., and 27.7 million Americans aged ≥12 years are currently using cannabis. However, the public health effects of cannabis use in the general population remain unclear. This study examines the associations of cannabis use with all-cause and cause-specific mortality in U.S. adults. Methods The study included 14,818 adults (aged 20–59 years) who participated in the National Health and Nutrition Examination Survey from 2005 to 2014 and were free of cardiovascular disease or cancer at baseline. Survey participants were linked to mortality records through December 31, 2015. The outcomes included all-cause mortality, cardiovascular disease mortality, and cancer mortality. All statistical analyses were conducted in 2019. Results During 86,453 person-years of observation, 304 deaths occurred, including 39 deaths from cardiovascular disease and 79 deaths from cancer. After adjustment for a variety of potential confounders, the hazard ratios for all-cause mortality, cardiovascular disease mortality, and cancer mortality among cannabis ever users, compared with the ratios among nonusers, were 1.14 (95% CI=0.81, 1.59), 2.29 (95% CI=1.10, 4.78), and 0.67 (95% CI=0.40, 1.14), respectively. The hazard ratios for cardiovascular disease mortality among cannabis users, compared with those among nonusers, were 1.65 (95% CI=0.57, 4.89) if the use was first initiated at age ≥18 years and 3.00 (95% CI=1.41, 6.38) if the use was first initiated before age 18 years. Conclusions Cannabis use was significantly associated with an increased risk of cardiovascular disease mortality among U.S. adults, especially among those who started using cannabis before age 18 years. The reasons and mechanisms underlying this association will require future research.
Adolescents’ relative position in school and educational attainment: The mediating role of educational expectations

Abstract This study examines whether and how adolescents' relative deprivation in school is associated with their years of education by incorporating the social comparison perspective into the Wisconsin status attainment model. Using Waves 1, 2, and 4 of the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study finds that adolescents who are positioned at the bottom of the economic hierarchy in school are likely to have up to one less year of education, compared to their counterparts positioned at the top of the hierarchy, when holding other variables constant. Also, by using causal mediation analyses, I find that educational expectations account for more than 20% of the relationship between adolescents' relative deprivation and educational attainment. The sensitivity analyses are conducted to examine how robust the main findings are to the violation of the assumption used in this study. These results provide evidence showing that adolescents’ educational outcomes do not only depend on their material resources but also on their relative standing in the economic hierarchy.
Practice Summary: Le Macaron Implements Ordering Optimization

Le Macaron French Pastries is based in Sarasota, Florida. Its central commissary specializes in baking macarons, a small, French-style pastry. It has more than 60 retail franchises throughout the U...
Early Survivorship of Newly Designed Highly Porous Metaphyseal Tibial Cones in Revision Total Knee Arthroplasty

Abstract Background Metaphyseal cones provide durable fixation in revision total knee arthroplasty (TKA). However, there is a paucity of data on the outcomes of a new porous cone design. As such, the goal of this study was to analyze the early survivorship in patients undergoing revision TKA with this cone. Methods We retrospectively reviewed 163 revision TKAs with a newly designed porous tibial cone from 2016 to 2018. Mean age was 67 years, and mean body mass index was 33 kg/m2. Minimum follow-up duration was 2 years. Most patients were revised for aseptic loosening (46%), 2-stage periprosthetic joint infection (PJI) reimplantation (28%), or instability (15%). Most were varus-valgus constrained (65%) or hinged (32%) constructs. The majority had hybrid tibial stem fixation (74%). A multivariate Cox regression analysis was used to identify risk factors for reoperation. Results Survivorship free from re-revision for aseptic loosening, any nonmodular revision, and any reoperation was 100%, 96%, and 86% at 2 years, respectively. No patients were revised for aseptic loosening. Six (4%) tibial cones were removed for PJI, one of which was loose. There were 23 reoperations (14%), most commonly for PJI (10%). Multivariate analysis identified PJI reimplantation (hazard ratios [HR] = 4.2, P = .002), males (HR = 2.9, P = .02), and hinged constructs (HR = 2.7, P = .02) as significant risk factors for reoperation. Conclusions In a complex revision TKA cohort with a new highly porous tibial cone, in which most patients received hybrid stem fixation and nonlinked and linked constraint, there was 100% survival free from re-revision for aseptic loosening at 2 years. Longer term follow-up is required.
Online Retail Me Yes: E-Commerce and Employment during the COVID-19 Pandemic

The relationship between E-commerce and employment was largely ignored pre-COVID. This is likely because whether a worker's firm engages in E-commerce or not may not have any effect on an employee's likelihood of retaining their job. However, when COVID-19 hit the world economy in early 2020, a major determinant of whether a business stayed open for in-person shopping or not was whether it was able to continue selling online. Using data on the proportion of firms in a metropolitan area that engage in E-commerce from the Annual Survey of Entrepreneurs and CPS monthly data on employment, I run both a continuous difference-in-differences model and event study specification to see the effect a metropolitan area's connection to E-commerce had on employment in that city. Both models show that workers in metros with more E-commerce are no more likely to be employed prior to COVID, but are much more likely to retain their job once COVID hits. Results suggest that investing public or private money into moving firms to online platforms would make metro areas more resilient to the next pandemic.
Simulating Thermodynamic Stabilization in Nanocrystalline Binary Alloys Using a Novel Cellular Automaton Model

Predictive models for grain growth of nanocrystalline binary alloys are designed to select appropriate solutes and assess thermodynamic stabilization in nanoscale alloy systems. The available models incorporate concepts of free energy, solute segregation, size-misfit elastic strain energy, grain boundary energy and phase field framework. Besides the above factors, the present work proposes a novel cellular automaton model by considering normal grain boundary (GB) diffusion, triple junction GB kinetics and grain misorientation. The experimental data for two kinds of binary alloy system were used to validate the reasonability of the proposed model. For nanocrystalline Fe-4% Zr alloy with large atomic size mismatch and negative mixing enthalpy, compared with the available models, the proposed model shows a better fit to the experimental results for grain size as a function of annealing temperatures. For another binary alloy system with small atomic size mismatch and positive mixing enthalpy, the proposed model also captures well the measurements for grain size of nanocrystalline W-20% Ti alloy. The comparisons reveal that the proposed model has a wide application in addressing the thermal stabilization of nanocrystalline grain size.
Influence of Multimorbidity on New Treatment Initiation and Achieving Target Disease Activity Thresholds in Active Rheumatoid Arthritis: A Cohort Study Using the Rheumatology Informatics System for Effectiveness (RISE) Registry.

Objective To determine whether multimorbidity is associated with treatment changes and achieving target disease activity thresholds in patients with active rheumatoid arthritis (RA). Methods We conducted a retrospective cohort study of adults with active RA within the Rheumatology Informatics System for Effectiveness (RISE) registry. Multimorbidity was measured using RxRisk, a medication-based index of chronic disease. We used multivariable logistic regression models to assess the associations of multimorbidity with the odds of initiating a new DMARD in active RA and, among those initiating a new DMARD, the odds of achieving low disease activity or remission. Results We identified 15,626 (RAPID3 cohort) and 5,733 (CDAI cohort) patients with active RA, of which 1,558 (RAPID3) and 834 (CDAI) initiated a new DMARD and had follow-up disease activity measures. Patients were middle aged, female and Caucasian predominant, and on average received medications from 6-7 RxRisk categories. Multimorbidity was not associated with new DMARD initiation in active RA. However, a greater burden of multimorbidity was associated with lower odds of achieving treatment targets (per 1-unit RxRisk OR 0.95 [95% CI 0.91-0.98] RAPID3 cohort; OR 0.94 [95% CI 0.90-0.99] CDAI cohort). Those with the highest burden of multimorbidity had the lowest odds of achieving target RA disease activity (OR 0.54 [0.34-0.85] RAPID3 cohort; OR 0.65 [0.37-1.15] CDAI cohort). Conclusions These findings from a large, real-world registry illustrate the potential impact of multimorbidity on treatment response and indicate that a more holistic management approach targeting multimorbidity may be needed to optimize RA disease control in these patients.
Prime-time abortion on Grey's Anatomy: What do US viewers learn from fictional portrayals of abortion on television?

CONTEXT Entertainment television can impact viewers' knowledge, attitudes, and reproductive health behaviors, yet little research has examined the impact of scripted abortion plotlines on viewers' abortion knowledge or social supportiveness for those having abortions. We examined the impact of an abortion storyline from Grey's Anatomy on US-based viewers. METHOD We conducted an online survey of likely Grey's Anatomy viewers prior to the episode's airing, assessing abortion ideology, knowledge, and support. After airing, we resurveyed respondents (including both those who had and had not viewed the target episode). We tested three hypotheses: episode exposure would (1) improve abortion knowledge and (2) increase support for medication abortion and decrease support for self-induced abortion, and (3) the effects on knowledge and supportive intention would be moderated by state support for abortion. We used independent samples t tests to examine hypotheses 1 and 2 and PROCESS macro to test the moderated effects (hypothesis 3). RESULTS The results of the pretest/posttest analysis indicated that exposure to the episode significantly improved medication abortion knowledge. Increases in medication abortion knowledge were tied to explicit educational dialogue and did not translate into an increase in general abortion knowledge or social supportiveness. Notably, abortion-related state policy significantly moderated the influence of exposure for respondents in states with policies favorable to abortion access. CONCLUSIONS These findings suggest that entertainment television can contribute to meaningful increases in viewers' knowledge about abortion, but that the potential for impact of entertainment-education is closely linked to episode content and moderated by state-level abortion policy.
PAST AND FUTURE OF CONSTRUCTION EQUIPMENT-PART III

To predict the construction equipment of the future, it is divided into equipment of the near future and that of the distant future. Equipment of the near future can best be decribed by extrapolating from present machines. New equipment must now be designed under the constraints of OSHA, EPA, and the labor unions. It will be safer, have less noise, and provide more comfort for the operator. Equipment in the distant future will incorporate new systems of excavation, concrete mixing and placing, and use of new materials. Use of automation, electronic controls, and new devices will increase productivity and decrease labor requirements.
Behavioral Disinhibition and Underlying Processes in Adolescents with Disruptive Behavior Disorders

A decade ago, we offered some reflections on the research underlying the construct of impulsivity (Milich & Kramer, 1984). We noted that there was widespread agreement that problems in disinhibition played a crucial role in the major externalizing disorders of childhood, especially attention-deficit hyperactivity disorder (ADHD) and conduct disorder (CD). In addition, many secondary problems of childhood, including peer and academic difficulties, were at least in part attributed to poor impulse control. Nevertheless, despite the recognized role that impulsivity played in explaining these difficulties, the research investigating this construct was quite discouraging. Numerous problems were identified that would preclude making meaningful advances in our understanding of the role of impulsivity in accounting for childhood behavior problems.
Test Problems for Inviscid Transonic Flow

This paper will briefly discuss some of the results obtained in the process of solving the test problems for the GAMM Workshop on “Numerical Methods for the Computation of Inviscid Transonic Flow with Shock Waves” with the TRANDES program. Briefly, this method, 1–5 utilizes the full, inviscid, perturbation-potential flow equation in a Cartesian grid system that is stretched to infinity. This equation is represented by a non-conservative system of finite difference equations that includes at supersonic points a rotated difference scheme and is solved by column relaxation. The solution usually starts from a zero perturbation potential on a very coarse grid (typically 13 × 7) followed by several grid halvings until a final solution is obtained on a fine grid (97×49). Occasionally, for cases having high local Mach numbers, the solution must be started on the coarse grid (25 × 13). Since the airfoil does not coincide with the grid points, the surface boundary conditions are represented as two-term Taylor series about dummy points inside the airfoil. On the outer boundaries, the exact infinity conditions are used. This method can, if desired, include the effects of weak viscous interaction or be used in the design mode. 2–6
Blogging in the Classroom: Using WordPress Blogs with BuddyPress Plugin as a Learning Tool:

In an effort to speak the social media language of our students, better prepare them for today's advertising jobs and seek the helpful learning aspects of social media, three professors used WordPr...
Photoprotection and vitamin D: a review

The topic of vitamin D is at the forefront of discussions due to evidence suggesting its role in extra-skeletal health. It is already established that vitamin D plays a key role in skeletal health in young and elderly adults. This vitamin is obtained mainly through sunlight; various factors such as skin pigmentation and seasons affect cutaneous synthesis. Debates about the effects of sunscreen use on cutaneous synthesis of vitamin D have arisen in recent years. An updated review of the literature emphasizes that adequate levels of vitamin D are needed to prevent osteoporosis, falls and fractures in the elderly population. Emerging data also point to its role in cardiovascular disease, auto-immune conditions and cancers. Normal usage of sunscreen by adults has not shown to decrease cutaneous synthesis of vitamin D. Recommended Daily Allowance for vitamin D, released in 2010, was based on studies examining skeletal effects of this vitamin. Oral intake with vitamin d-enriched foods or vitamin D supplements is recommended over prolonged ultraviolet exposure to maintain proper serum levels. Patients should not be discouraged from normal usage of sunscreens due to their well-established photoprotective effects.
The Stereochemistry of Pyridoxal Phosphate Enzymes THE ABSOLUTE STEREOCHEMISTRY OF COFACTOR C'4 PROTONATION IN THE TRANSAMINATION OF HOLOSERINE HYDROXYMETHYLASE BY d-ALANINE

Abstract Serine hydroxymethylase catalyzes the reversible cleavage of several β-hydroxy-α-amino acids to glycine and the appropriate aldehyde. With d-alanine as substrate, the α-hydrogen is labilized and a slow transamination to pyruvate and the pyridoxamine phosphate enzyme occurs. The absolute stereochemistry of this transamination has been determined by using pyridoxamine pyruvate transaminase to analyze the pyridoxamine phosphate product of the serine hydroxymethylase transamination. These two enzymes were found to protonate the cofactor C'4 from the same face. Thus, all five pyridoxal phosphate enzymes so far examined show the same absolute stereochemistry of cofactor protonation, adding the proton from the si face of C'4, so that the labile proton occupies the pro-S position of the pyridoxamine methylene group.
Proacrosin Gene Expression in Rat Spermatogenic Cells

Mammalian proacrosin gene expression was considered to be exclusively postmeiotic until recent studies detected the presence of proacrosin mRNA in mouse pachytene spermatocytes. To determine if rat proacrosin gene expression was initiated during meiosis, a 314-bp proacrosin cDNA fragment was amplified from rat round spermatid RNA, using proacrosin-specific primers, for use as a probe. Sequence analysis of the round spermatid 314-bp cDNA fragment confirmed > 99% identity with the rat proacrosin cDNA sequence. This 314-bp fragment was subsequently used for Northern blot analysis of RNA isolated from testicular germ cells. A 1.6-kb transcript was detected in pachytene spermatocytes, round spermatids, and a mixed population of condensing spermatids/residual bodies, with the highest level of expression in round spermatids. Northern blot analysis of testicular RNA during development revealed the earliest timepoint of expression to be at 24 days of age, further demonstrating the association of proacrosin mRNA with spermatocytes. These data demonstrate diploid expression of the rat proacrosin gene, in agreement with mouse proacrosin gene expression but in contrast to the apparent haploid expression of proacrosin described for the bull and the boar. These studies provide evidence that, in the rat, the process of acrosome biogenesis begins during meiosis.
Abstract 3522: A novel BAP1 mutation is associated with melanocytic neoplasms and thyroid and pancreatic cancers

BRCA1 associated protein-1 (BAP1) functions as a tumor suppressor gene by modulating fundamental cellular mechanisms such as cell cycle progression and cell growth. Inactivating germline mutations of BAP1 predispose to multiple cancers including uveal and cutaneous melanoma as well as malignant mesothelioma. In the present study we document a family with a novel germline mutation of BAP1 (g.1777C>T) that results in expression of a truncated BAP1 protein. Family members with this mutation demonstrated a primary clinical phenotype of autosomal dominant, early-onset melanocytic neoplasms with immunohistochemistry (IHC) of these tumors demonstrating lack of BAP1 protein expression. In addition, family members harboring the BAP1 germline mutation developed other neoplastic disease such as thyroid cancer and pancreatic cancer. IHC analysis of these cancers also demonstrated loss of BAP1 protein expression. Our investigation identifies a new BAP1 mutation, further underscores the relevance of BAP1 as a clinically important tumor suppressor gene and broadens the range of cancers associated with BAP1 inactivation. Further study will be required to understand the full scope of BAP1-associated neoplastic disease. Citation Format: Gregory T. Gallanis, Kathleen A. Heller, Eleni-Marina Melas, Stephen B. Gruber. A novel BAP1 mutation is associated with melanocytic neoplasms and thyroid and pancreatic cancers. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3522. doi:10.1158/1538-7445.AM2014-3522
Intuitive intraoperative ultrasound guidance using the Sonic Flashlight: a novel ultrasound display system.

OBJECTIVE The Sonic Flashlight (SF) is a new handheld ultrasound (US) display device being developed at our institution. It replaces the standard monitor on a conventional ultrasound (CUS) system with a miniature monitor and half-silvered mirror to reflect real-time US images into the body. With the SF, the imaged body part appears translucent, with the US image appearing to float below the surface of the anatomy, exactly where it is being scanned. The SF merges the patient, US image, instrument, and operator's hands into the same field of view, allowing the user to operate directly on the US image using normal hand-eye coordination. In contrast, CUS procedures result in displaced hand-eye coordination when the operator looks away from the patient to view the CUS monitor. Intraoperatively, the SF may make localizing and accessing tumors, foreign bodies, hematomas, vascular malformations, and ventricles easier and more accurate, especially for those without extensive CUS training. METHODS In this cadaver study, the SF was used to visualize the brain and guide a needle into an implanted simulated tumor. The needle was inserted both in the US plane and outside of the US plane. INSTRUMENTATION Sonic Flashlight fifth generation research prototype. CONCLUSION The needle was easily and intuitively visualized and guided into the lesion, both within and outside of the US plane. By having the US image appear directly beneath the brain surface, the surgeon can easily and quickly guide the needle or surgical instrument to the lesion. The operator's eyes never have to leave the surgical field, as they do with CUS technology. The impact of this device on neurosurgical procedures could be significant. The ease of use, intuitive function, and small instrument size allow the surgeon to quickly localize lesions, confirm surgical positioning, and assess postoperative results.
LARUELLE DOES NOT EXIST

In the beginning there is Black – Man and Universe, rather than a philosopher and the World.[…]Man, who carries the Universe with him, is condemned, without knowing why, to the World and to the Ear...
Multi-level administrative structure and the distribution of social service expenditures: A Nebraska example

Abstract During the decade of the 1980s Nebraska restructured its social service (welfare) delivery system. Prior to the change, administrative responsibility for many social service programs was shared between the state and county governments. The restructuring brought the entire program under state administration. A primary reason for this policy change was to eliminate administrative inconsistencies evident in the decentralized structure. This article utilizes 1980 and 1990 data on the distribution of Food Stamp and AFDC program expenditures in Nebraska to analyze the impact of the restructuring on expenditure distribution. The results indicate that expenditures were more equally distributed and that arbitrary decision making was reduced when social service administration was centralized.
Irritable bowel syndrome: The role of psychosocial factors.

The irritable bowel syndrome (IBS) is a very common disorder of intestinal function characterized by variable symptoms of abdominal pain, diarrhea, constipation and bloating. The spectrum of severity ranges from mild symptoms, not worthy of clinical attention, to intense and continuous symptoms associated with impaired health-related quality of life and high health care use. Psychosocial disturbance is commonly found among patients with irritable bowel, but until recently, its precise role in the disorder was uncertain. The data now suggest that irritable bowel is not a psychiatric disorder per se, but psychosocial factors including life stress, psychiatric comorbidity and abnormal illness behavior, among others, influence how the illness is experienced and acted upon. Patients with mild symptoms usually respond to education, reassurance, dietary modification and, when needed, antimotility agents. However, patients with more severe symptoms, who usually have greater psychosocial disturbance, will also require behavioral interventions, and possibly psychopharmacological agents. In sum, a graduated, multicomponent plan of care that includes dietary, behavioral and pharmacological treatments is recommended.
A model of respiratory airway motion for real-time tracking of an ultrathin bronchoscope

Deformable registration of chest CT scans taken of a subject at various phases of respiration provide a direct measure of the spatially varying displacements that occur in the lung due to breathing. This respiratory motion was studied as part of the development of a CT-based guidance system for a new electromagnetically tracked ultrathin bronchoscope. Fifteen scans of an anesthesized pig were acquired at five distinct lung pressures between full expiration to full inspiration. Deformation fields were computed by non-rigid registration using symmetric "demons" forces followed by Gaussian regularization in a multi-resolution framework. Variants of the registration scheme were tested including: initial histogram matching of input images, degree of field smoothing during regularization, and applying an adaptive smoothing method that weights elements of the smoothing kernel by the magnitude of the image gradient. Registration quality was quantified and compared using inverse and transitive consistency metrics. After optimizing the algorithm parameters, deformation fields were computed by registering each image in the set to a baseline image. Registration of the baseline image at full inspiration to an image at full expiration produced the maximum deformation. Two hypotheses were made: first, that each deformation could be modeled as a mathematical sub-multiple of the maximum deformation, and second, that the deformation scales linearly with respiratory pressure. The discrepancy between the deformation measured by image registration and that predicted by the linear model was 1.25 mm on average. At maximum deformation, this motion compensation constitutes an 87% reduction in respiration-induced localization error.
SU-E-T-535: Proton Dose Calculations in Homogeneous Media.

Purpose: To develop a pencil beam dose calculation algorithm for scanned proton beams that improves modeling of scatter events. Methods: Our pencil beam algorithm (PBA) was developed for calculating dose from monoenergetic, parallel proton beams in homogeneous media. Fermi‐Eyges theory was implemented for pencil beam transport. Elastic and nonelastic scatter effects were each modeled as a Gaussian distribution, with root mean square (RMS) widths determined from theoretical calculations and a nonlinear fit to a Monte Carlo(MC) simulated 1mm × 1mm proton beam, respectively. The PBA was commissioned using MC simulations in a flat water phantom. Resulting PBA calculations were compared with results of other models reported in the literature on the basis of differences between PBA and MC calculations of 80–20% penumbral widths. Our model was further tested by comparing PBA and MC results for oblique beams (45 degree incidence) and surface irregularities (step heights of 1 and 4 cm) for energies of 50–250 MeV and field sizes of 4cm × 4cm and 10cm × 10cm. Agreement between PBA and MC distributions was quantified by computing the percentage of points within 2% dose difference or 1mm distance to agreement. Results: Our PBA improved agreement between calculated and simulated penumbral widths by an order of magnitude compared with previously reported values. For comparisons of oblique beams and surface irregularities, agreement between PBA and MC distributions was better than 99%. Conclusions: Our algorithm showed improved accuracy over other models reported in the literature in predicting the overall shape of the lateral profile through the Bragg peak. This improvement was achieved by incorporating nonelastic scatter events into our PBA. The increased modeling accuracy of our PBA, incorporated into a treatment planning system, may improve the reliability of treatment planning calculations for patient treatments. This research was supported by contract W81XWH‐10‐1‐0005 awarded by The U.S. Army Research Acquisition Activity, 820 Chandler Street, Fort Detrick, MD 21702‐5014. This report does not necessarily reflect the position or policy of the Government, and no official endorsement should be inferred.
Response of a tactical missile to convected aerodynamic excitation

A tactical missile instrumented with pressure and acceleration sensors was flown on a fighter aircraft to help characterize the in-carriage flight environment. The pressure data associated with a throttle chop at a high angle of attack have been analyzed with two techniques to determine whether a simple, yet appropriate, model can be used to model forces applied to a structural finite element model. Analysis has revealed a nearly uniform convection of narrow-band random forces along the missile, indicating a highly coherent aerodynamic structure. The circumferential distribution of the standard deviation of measured pressures, which tend to swirl along the missile, seems to indicate the existence of shed-vortex-related swirl of the aerodynamic excitation. Lateral vibration of the missile has been analyzed using the finite element method, both with and without allowing for correlation (convection and swirl) within the aerodynamic excitation. In some frequency ranges these effects may be extremely important.
Stress intensity factors of a radial crack in a compound disk subjected to concentrated forces

Abstract A compound disk or compound cylinder containing a radial crack, subjected to general concentrated forces, is studied and the stress intensity factors of the crack are calculated. In the approach, the uncracked compound disk solution is sought first using Muskhelishvili's complex variable method, and then by superposition with the uncracked geometry solution, the crack problem may be reduced to a perturbation case. By integrating the corresponding dislocation solution, the stress intensity factors of the crack can be formulated in terms of the solution of a singular integral equation, and evaluated accurately by virtue of a collocation technique. Extensive results are given in tabular form. For crack tip contact cases, the contact lengths are also calculated.
Improvements in pulmonary and general critical care reduces mortality following ventilator-associated pneumonia.

BACKGROUND Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection in the intensive care unit, with substantial subsequent mortality. The mortality following VAP declined in the 1980s and 1990s. Experts suggest that little progress has been made in the outcomes from VAP since several novel interventions have failed. We nonetheless hypothesized that mortality following VAP has continued to decrease owing to advances in pulmonary critical care. METHODS We identified all adult patients with Centers for Disease Control and Prevention-defined, intensive care unit-acquired VAP between January 1, 1997, and December 31, 2008, from a prospectively collected database. RESULTS A total of 793 cases of VAP occurred in the study period. Cases were divided into four periods (1997-1999, 2000-2002, 2003-2005, or 2006-2008) to compare outcomes over time. Acute Physiology and Chronic Health Evaluation II scores were stable, while mortality was significantly lower in Period 4 when compared with Periods 1 and 2 (p = 0.004 and 0.009, respectively). A logistic regression model predicting death (c statistic = 0.871) revealed age (odds ratio, 1.03; 95% confidence interval, 1.02-1.05), Acute Physiology and Chronic Health Evaluation II score (1.09, 1.05-1.14), white blood cell count (1.03, 1.00-1.06), transplant recipient (3.45, 1.40-8.53), transfusions (3.25, 1.37-7.68), and pulmonary disease (3.01, 1.67-5.45) were independent predictors of death, as was the presence of trauma (0.10, 0.06-0.18), chronic steroid therapy (0.39, 0.17-0.91), and patient length of stay (0.99, 0.98-0.99), with odds ratios less than 1.0. In addition, those patients treated in Period 1 (2.23, 1.16-4.29) or Period 2 (2.13, 1.12-4.06) had twice the risk of death following an episode of VAP when compared with those treated in the most recent period. CONCLUSION We have shown that mortality following an episode of VAP continues to decrease over time and attribute this to advancements in pulmonary and general critical care rather than any specific interventions. LEVEL OF EVIDENCE Prognostic study, level II.
Synthesis of a single-molecule nanotruck

We report the synthesis of a new nanovehicle, a porphyrin-based nanotruck. The porphyrin inner core was designed for possible transportation of metals and small molecules across a surface.
The speaking of Roy Wilkins

This article describes, interprets, and evaluates the rhetorical workmanship of Roy Wilkins, Executive Secretary of the NAACP. It is based on examination of eighteen speech manuscripts, tape recordings, film clips, TV and live observations, correspondence, and interviews. A paper on the speaking of Roy Wilkins was presented by the author at the CSSA Convention in April, 1964.
Vascular surgery training trends from 2001-2007: A substantial increase in total procedure volume is driven by escalating endovascular procedure volume and stable open procedure volume.

Background Endovascular procedure volume has increased rapidly, and endovascular procedures have become the initial treatment option for many vascular diseases. Consequently, training in endovascular procedures has become an essential component of vascular surgery training. We hypothesized that, due to this paradigm shift, open surgical case volume may have declined, thereby jeopardizing training and technical skill acquisition in open procedures. Methods Vascular surgery trainees are required to log both open and endovascular procedures with the Accreditation Council for Graduate Medical Education (ACGME). We analyzed the ACGME database (2001-2007), which records all cases (by Current Procedural Terminology [CPT] code) performed by graduating vascular trainees. Case volume was evaluated according to the mean number of cases performed per graduating trainee. Results The mean number of total major vascular procedures performed per trainee increased by 174% between 2001 and 2007 (from 298.3 to 519.2). Endovascular diagnostic and therapeutic procedures increased by 422% (from 63.7 to 269.1) and accounted for 93.0% of the increase in total procedures. The number of open aortic procedures (aneurysm, occlusive, mesenteric, renal) decreased by 17.1% (from 49.7 to 41.2), while the number of endovascular aortic aneurysm repair procedures increased by 298.8% (from 16.9 to 50.5). Specifically, open aortic aneurysm procedures decreased by 21.8%, aortobifemoral bypass increased by 3.2%, and open mesenteric or renal procedures decreased by 13%. Infrainguinal bypass procedures remained relatively constant (from 37.6 to 36.5, 2.9% decrease), and the number of carotid endarterectomy procedures performed did not change significantly (from 43.6 to 42.2, 3.2% decrease). Conclusion Vascular surgery trainees are performing a vastly increased total number of procedures. This increase in total procedure volume is almost entirely attributable to the recent increase in endovascular procedures. Aside from a small decline in open aortic procedures, the volume of open surgical procedures has largely remained stable. It is essential that vascular surgery training programs continue to focus on both endovascular and open surgical skills in order for vascular surgeons to remain the premier specialists to care for patients with vascular disease.
Wandering spleen presenting as acute pancreatitis in pregnancy.

Abstract Background Wandering spleen most frequently presents clinically with gastrointestinal bleeding and thrombocytopenia. Case A 24-year-old multiparous patient at 36 weeks’ gestation presented with pancreatitis. Incidental thrombocytopenia was discovered. A 2722-g female neonate was delivered by repeat cesarean from a breech presentation. The spleen was observed at the left margin of the incision. An evaluation of the pancreatitis included a computed tomography study demonstrating an enlarged spleen twisted on its pedicle and displaced inferiorly. Esophagogastric duodenoscopy performed in evaluation of gastrointestinal bleeding showed persistent gastric varices. Multiple transfusions were required. A splenectomy was performed. The recovery was uncomplicated. Conclusion In this case of a wandering spleen, pancreatitis resulted from torsion and obstruction of the tail of the pancreas within the splenic pedicle and was effectively treated with splenectomy. Thrombocytopenia occurred as a result of sequestration of platelets in the enlarged spleen. Persistent gastric varices and subsequent gastrointestinal bleeding occurred secondary to splenic vein obstruction.
Distribution of substance P-like immunoreactivity in the central nervous system of the rat--II. Light microscopic localization in relation to catecholamine-containing neurons.

Abstract A comparison of the distribution of material reacting with antisera to substance P and tyrosine hydroxylase, respectively, was made on adjacent sections of the central nervous system of untreated rats using Coon's indirect immunofluorescence technique. In some cases correlations between the two antisera were made on the same section. Tyrosine hydroxylase was used as a marker for catecholamine-containing neurons. All catecholamine-containing cell groups (A1–A15) were surrounded by substance P-positive nerve terminals. A very high or high density of substance P-containing fibers was observed around the A9 dopaminergic cells and their dendrites in the substantia nigra and around the A2 catecholamine-containing cells in the nucleus commissuralis, the nucleus tractus solitarii and the nucleus originis dorsalis nervi vagi. Only occasional substance P-immunoreactive fibers were observed around tyrosine hydroxylase-positive cells in the area postrema and around the periglomerular dopamine cells in the olfactory bulb. The remaining catecholamine-containing groups of cells were surrounded by substance P-networks of a low or medium density. The relation of catecholamine-con-taining nerve terminals to substance P-immunoreactive cell bodies has not been analysed. There are certain areas where both substance P and tyrosine hydroxylase immunoreactive terminal networks were seen including the medial frontal cortex, the amygdaloid complex, particularly the central nucleus, the caudate nucleus, the nucleus accumbens, the lateral septal nucleus, the nucleus interstitialis striae terminalis, various hypothalamic nuclei, the periaqueductal central gray, the parabrachial nucleus, the nucleus tractus solitarii, the nucleus originis dorsalis nervi vagi and the spinal cord. Although overlap between the two systems occurred, a close analysis sometimes revealed differential distribution patterns. The results suggest that interaction of at least two types may occur between the two systems. Firstly, substance P-containing nerve terminals may innervate catecholamine-containing cells and, secondly, substance P-containing and catecholamine-containing nerve terminals may together influence neuronal activity in certain brain regions. The morphological relations between these two systems can, however, only be fully understood after ultrastructural investigations.
Studies on the intracellular synthesis of reovirus-specified proteins.

Abstract All reovirus capsid polypeptides are formed in measurable amounts in mouse L fibroblasts. Five of them (λ1, λ2, μ1, σ2 and σ3) are formed more or less abundantly; one (σ1) is formed in very small amounts. Capsid polypeptide μ2, the major constituent of the virion, is not a primary gene product, but is derived from polypeptide μ1 by removal of 10% of its mass. The synthesis of all capsid polypeptides appears to start synchronously. During much of the infection cycle (from 3 to 9 hours) only minor, though significant, changes in their relative rates of synthesis occur. No evidence was obtained for the synthesis of any virus-specified noncapsid polypeptides. The extent to which the ten individual species of reovirus mRNA are transcribed within the cell was also measured. The pattern of transcription differs markedly from the uncontrolled pattern exhibited by cores in vitro . Some mRNA species are clearly translated frequently, others very infrequently. Both transcription and translation of reovirus message is thus controlled. The incorporation of capsid polypeptides formed at various times during the infection cycle into virions was determined. Core polypeptide molecules which are formed early in the cycle tend to be incorporated to a greater extent than such molecules which are formed later on, while the reverse is true for polypeptide molecules comprising the outer shell. The kinetics of synthesis of capsid polypeptides was studied as a function of the multiplicity of infection and the temperature of incubation and the effect of reovirus infection on host protein synthesis was determined; host protein synthesis does not decrease until late during the infection cycle.
Comparison of candidate methods to distinguish noise modes from system modes in structural identification

In modal identification, nonphysical noise or computation modes always appear to help match the input-output data. This paper studies the ability of four criteria to distinguish which modes in a model are noise modes: (1) modal amplitude coherency, (2) the relative contribution of each mode to the pulse response indicated by the mode singular value, (3) the variances of the mode frequencies and damping factors produced by a chosen measurement noise level, and (4) identification of the backward-time in order to let the shift from positive to negative damping of the true system modes distinguish these modes from noise modes. Both simulated and experimental data are used to study the four criteria.
Trauma Counsellors’ Quality of Life

Mental health professionals working with trauma survivors often experience both psychological costs (e.g., compassion fatigue) and benefits (e.g., compassion satisfaction). In this study, trauma counsellors’ individual characteristics as well as workplace conditions were examined to determine their relative influence on compassion fatigue and compassion satisfaction. Lack of control over workplace, over-involvement with clients, and secondary exposure to clients with serious trauma symptoms were significantly related to compassion fatigue. Counsellors’ perceived control of the workplace, personal trauma history, and years of clinical experience were significantly related to compassion satisfaction.
Subunit conformations and assembly states of a DNA-translocating motor: the terminase of bacteriophage P22.

Abstract Bacteriophage P22, a podovirus infecting strains of Salmonella typhimurium , packages a 42-kbp genome using a headful mechanism. DNA translocation is accomplished by the phage terminase, a powerful molecular motor consisting of large and small subunits. Although many of the structural proteins of the P22 virion have been well characterized, little is known about the terminase subunits and their molecular mechanism of DNA translocation. We report here structural and assembly properties of ectopically expressed and highly purified terminase large and small subunits. The large subunit (gp2), which contains the nuclease and ATPase activities of terminase, exists as a stable monomer with an α/β fold. The small subunit (gp3), which recognizes DNA for packaging and may regulate gp2 activity, exhibits a highly α-helical secondary structure and self-associates to form a stable oligomeric ring in solution. For wild-type gp3, the ring contains nine subunits, as demonstrated by hydrodynamic measurements, electron microscopy, and native mass spectrometry. We have also characterized a gp3 mutant (Ala 112 → Thr) that forms a 10-subunit ring, despite a subunit fold indistinguishable from wild type. Both the nonameric and decameric gp3 rings exhibit nonspecific DNA-binding activity, and gp2 is able to bind strongly to the DNA/gp3 complex but not to DNA alone. We propose a scheme for the roles of P22 terminase large and small subunits in the recruitment and packaging of viral DNA and discuss the model in relation to proposals for terminase-driven DNA translocation in other phages.