cssi/SciSciGPT-SciSciNet huggingface dataset:
Cancer Clusters in Delaware? How One Newspaper Turned Official Statistics into News

The flagship newspaper for the state of Delaware, the News Journal, has been instrumental in disseminating information from state-generated reports of cancer clusters to its readers over the past 7 years. The stories provide colorful maps of census tracts designated as clusters, often on the front page, and detail the types of elevated cancers found in these tracts and the purported relationship of elevated cancer rates to local industry pollution. Though the News Journal also provided its readers with advice about interpreting these data with caution, it uncritically presented these data. Using the state’s unusual definition and measurement of elevated cancer incidence as cancer clusters, it transformed questionable statistics into an alarming public issue. This article critically examines these news reports and the state-generated reports they utilized.
CSF somatostatin and abnormal response to dexamethasone administration in schizophrenic and depressed patients.

• Low levels of cerebrospinal fluid (CSF) somatostatin and abnormal response to dexamethasone are two neuroendocrine disturbances reported to appear in depression and other neuropsychiatric disorders. We measured the levels of CSF somatostatin in patients with schizophrenia (n = 44) and depression (n=19). In view of in vitro and animal evidence of the ability of somatostatin to inhibit stimulated corticotropin secretion, we also administered the dexamethasone suppression test to a subgroup of the patients with schizophrenia (n =16) and the total depressed group. Lower levels of CSF somatostatin were found in dexamethasone nonsuppressors regardless of diagnosis and were negatively correlated with maximum postdexamethasone cortisol level in the total and depressed patient groups. These data suggest a functional relationship between hypothalamic-pituitary-adrenal axis hyperactivity and reduced CSF somatostatin level.
Urodynamics and Massive Vesicoureteral Reflux

AbstractPurpose: Urodynamic studies are the key to management and reconstruction of bladder pathology. In the face of high grade vesicoureteral reflux measured pressures and volumes reflect the combined storage characteristics of the upper and lower tracts. We examined the influence of high grade reflux on measured volume and compliance (change in volume/change in pressure).Materials and Methods: A total of 18 children with high grade vesicoureteral reflux underwent urodynamic evaluation with and without ureteral occlusion. Occlusion was created in the operative suite using ureteral occlusion balloons. After fluoroscopic confirmation of the absence of reflux bladder pressure was measured during filling at a rate of 12.5 cc per minute. During ureteral occlusion bladder capacity was defined as leakage around the urethral catheter, bladder pressure greater than 40 cm. water or volume exceeding estimated bladder capacity for age, as determined by the formula, bladder capacity in ml. = (age - 2) × 30. The uret...
Optimal full motion video registration with rigorous error propagation

Optimal full motion video (FMV) registration is a crucial need for the Geospatial community. It is required for subsequent and optimal geopositioning with simultaneous and reliable accuracy prediction. An overall approach being developed for such registration is presented that models relevant error sources in terms of the expected magnitude and correlation of sensor errors. The corresponding estimator is selected based on the level of accuracy of the a priori information of the sensor’s trajectory and attitude (pointing) information, in order to best deal with non-linearity effects. Estimator choices include near real-time Kalman Filters and batch Weighted Least Squares. Registration solves for corrections to the sensor a priori information for each frame. It also computes and makes available a posteriori accuracy information, i.e., the expected magnitude and correlation of sensor registration errors. Both the registered sensor data and its a posteriori accuracy information are then made available to “down-stream” Multi-Image Geopositioning (MIG) processes. An object of interest is then measured on the registered frames and a multi-image optimal solution, including reliable predicted solution accuracy, is then performed for the object’s 3D coordinates. This paper also describes a robust approach to registration when a priori information of sensor attitude is unavailable. It makes use of structure-from-motion principles, but does not use standard Computer Vision techniques, such as estimation of the Essential Matrix which can be very sensitive to noise. The approach used instead is a novel, robust, direct search-based technique.
Indirect competitive effects of stemborers on a gall community

Interspecific competition between phytophagous insects using the same host plant occurs frequently and can strongly affect population densities of competing species. Competition between gallmakers and stemborers could be especially intense because both types of herbivore are unable to avoid competition by relocation during their immature stages. For apical meristem gallmakers the main result of competition is likely to be the interruption of resources to the gall by the stemborers' devouring of stem contents. The proximate effect of such competition could be to reduce gall size, thereby increasing the number of chambers per gall unit volume, and reducing the size and potential reproductive output of the gallformer. In addition, smaller galls may be more susceptible to attack from size-limited parasitoids, resulting in a second indirect effect of competition. Using a community of galling and stemboring insects on the saltmarsh shrub Iva frutescens L. (Asteraceae), we measured for indirect effects of competition. We examined the primary indirect effect of competition on gall midge crowding and the secondary effects on parasitism rates and parasitoid guild composition. Results indicated that galls co-occurring with stemborers were smaller, crowding of gall inhabitants was 22% greater, and the composition of the parasitoid guild was altered relative to galls on unbored stems. The overall parasitism rate was not different between galls on bored vs. unbored stems. These results show that competition resulting from the presence of stemborers has the potential to affect the gall midge Asphondylia borrichiae Rossi & Strong (Diptera: Cecidomyiidae) and secondarily to affect its guild of hymenopteran parasitoids.
Certain matters concerning scaling in the magnetron with special reference to the relative efficiency of magnetrons of different sizes

Abstract The paper concerns the comparison of the behavior of two magnetron systems of different sizes, all apparatus from the input terminals of the magnetron to the final radiation antenna being contemplated in the picture. The mathematical comparison of the two systems assumes a specially simple form when the electrical conductivities of the corresponding parts of the systems in the two cases are adjusted to values in the inverse ratio of the scaling in linear dimensions. A scaling of this kind is therefore studied. The conclusions reached are as follows: For an assigned potential applied to the two models, the power input is the same, the power radiated from the antenna is the same, the power dissipated in Ohm's law heating in all parts is the same, and the power dissipated in back-bombardment or at the anode is the same. As a corollary to the foregoing, it is inferred that if the corresponding parts of the two models have the same electrical conductivity, then in so far as Ohm's law heating is an important factor at all, it is more important in the small model than in the large one.
Exploring 3D navigation: combining speed-coupled flying with orbiting

We present a task-based taxonomy of navigation techniques for 3D virtual environments, used to categorize existing techniques, drive exploration of the design space, and inspire new techniques. We briefly discuss several new techniques, and describe in detail one new techniques, Speed-coupled Flying with Orbiting. This technique couples control of movement speed to camera height and tilt, allowing users to seamlessly transition between local environment-views and global overviews. Users can also orbit specific objects for inspection. Results from two competitive user studies suggest users performed better with Speed-coupled Flying with Orbiting over alternatives, with performance also enhanced by a large display.
Breeding alfalfa cultivars resistant to the alfalfa weevil

A ten-year study consisting of nine field experiments was conducted to evaluate alfalfa (Medicago sativa L.) for resistance to larval feeding by the alfalfa weevil (Hypera posticaGyllenhal). The results were consistent over years and experiments. Only one source of alfalfa germplasm, designated Starnes, showed resistance to larval feeding in the field under natural infestations of the weevil. The cultivars Team, Arc, and Liberty have been developed from this germplasm source. The only effective method of selection for field resistance to the weevil was field selection under natural weevil infestations. Selection was based on low larval feeding on spaced plants. After six generations of such selection the Starnes germplasm showed only one-third as much defoliation as did the check cultivars. The heritability of the weevil resistance was moderately high. Field resistance was transferred to other strains through hybridization; hybrids were intermediate to the resistant and susceptible parents. Resistance was stable.
Two new tapeworms from the goblin shark Mitsukurina owstoni off Australia

Internal parasites are reported from the goblin shark Mitsukurina owstoni for the first time. The shark examined was a 190 kg male collected off of Ulladulla, New South Wales, Australia and deposited at the Australian Museum in Sydney. What appear to be 4 different species of tapeworms were recovered from the spiral intestine. These included two new species, Litobothrium amsichensis n. sp. (order Litobothridea) and Marsupiobothrium gobelinus n. sp. (order Tetraphyllidea), as well as one specimen of a trypanorhynch and one scolex of a second tetraphyllidean. The latter two species are unidentifiable without further material. The generic placement of the new tetraphyllidean is somewhat problematical; this genus was thought to be the most appropriate placement at present. The most conspicuous difference between the new litobothridean and the five other species in the order is that it possesses dorso-ventral projections on five rather than four or three anterior segments. The discovery of a litobothridean parasitising the goblin shark is consistent with the systematic placement of the Mitsukurinidae within the Lamniformes, and may preliminarily indicate close affinities between the Alopidae, Odontaspidae and Mitsukurinidae. The phyllobothriid differs from the five other species of Marsupiobothrium in its possession of extremely long bothridial peduncles, its lack of an arcuate cylindrical pad on the posterior bothridial margins and its possession of a marginal, distinct apical sucker rather than a submarginal, diffuse apical sucker on each bothridium. Four detached specimens of the new phyllobothriid retained tips of mucosal villi within their bothridia. From these specimens it appears that the peduncles allow this species to stretch its scolex for attachment to up to four villi simultaneously.
Molecular and Cellular Actions of Galantamine: Clinical Implications for Treatment of Organophosphorus Poisoning

There have been continued efforts to develop effective antidotal therapies against poisoning with organophosphorus (OP) compounds, including nerve agents and pesticides. We reported recently that galantamine, a drug used to treat Alzheimer's disease, administered before (up to 3 h) or soon after (up to 5 min) an exposure of guinea pigs to 1.5-2 x LD50 soman or sarin effectively counteracted the acute toxicity and lethality of the nerve agents provided that the animals were also post-treated with atropine. Here, we demonstrate that administered to guinea pigs at 30 min before or up to 15 min after an acute challenge with 1 x LD50 soman, galantamine (8 mg/kg, intramuscular) alone is sufficient to counteract the lethality and acute toxicity of the nerve agent. Evidence is also provided that 100% survival can be attained when the association of appropriate doses of galantamine and atropine is administered 30-45 min after the challenge of the guinea pigs with 1 x LD50 soman. Galantamine counteracts the neurodegeneration and the changes in the nicotinic cholinergic system that result from an acute exposure of guinea pigs to 1 x LD50 soman. The results presented herein corroborate that galantamine is an effective antidote against OP poisoning.
Sensors for Detecting Molecular Hydrogen Based on Pd Metal Alloys

A simple process using a shadow mask is described to fabricate Nd/Ni resistors for detecting H{sub 2}. The performance of the resistive sensors is studied in relation to annealing the devices at different temperatures in 2% H{sub 2} in N{sub 2} for 2 h. The Pd/Ni film surface morphology is also examined in relation to the resistor response when exposed to H{sub 2}. The detailed information learned about the performance of the prototype resistors is used to fabricate wide-range-hydrogen microsensors, which combine a Pd/Ni chemiresistor and metal-oxide semiconductor capacitor along with a thin film metal heater and temperature sensor. These studies provide an important step for improving the reliability of microsensors used to detect H{sub 2} over concentrations ranging from 1 mTorr to 700 Torr.
Applicability of some infiltration formulae to rangeland infiltrometer data

Abstract Three algebraic infiltration equations (Kostiakov's, Horton's and Philip's) were examined to determine which one would best fit infiltrometer data collected from a variety of mostly semi-arid rangeland plant communities from both Australia and the United States. Approximately 1,100 infiltrometer plots were included in the analysis. Results indicated that, in every instance, Horton's equation best fit the infiltrometer data. Variability of “point” measures of short-term infiltration rates were never satisfactorily accounted for by using either Kostiakov's or Philip's equation. Though Horton's equation provided a best fit to the overall infiltration data, R 2 values indicated a potential usefulness of this equation only under the certain conditions that were sampled in several rangeland plant communities in the Northern Territory, Australia. The equation could not be considered consistently useful under conditions sampled on rangelands in the United States.
Polarizability dyadics of small chiral ellipsoids

Abstract An integral-equation method has been used to derive the polarizability dyadics of small chiral ellipsoids immersed in an achiral fluid. These polarizabilities have been used to obtain the effective properties of a dilute suspension consisting of randomly oriented, ellipsoidal, chiral particles suspended in an achiral fluid. Finally, the optical rotation and the circular dichroism of the suspension have been obtained.
The Role of Bisphosphonates in Multiple Myeloma

Multiple myeloma is a difficult and frustrating disease to treat. Although bisphosphonates are clearly not a panacea, they represent an advance in skeletal benefit and symptom control that is meani...
Porphyromonas gingivalis enhances FasL expression via up-regulation of NFκB-mediated gene transcription and induces apoptotic cell death in human gingival epithelial cells

The interaction between epithelial cells and micro-organisms is often a crucial initiating event in infectious diseases. Infection with Porphyromonas gingivalis, a Gram-negative anaerobe, is strongly associated with severe periodontal disease. This bacterium possesses an array of virulence factors, some of which can induce apoptosis. The tumour necrosis factor (TNF) receptor family is involved in the regulation of cellular homeostasis, cell surface molecules involved in phagocytosis, Fas ligand (L) expression and activation of the caspase cascade resulting in DNA fragmentation and cell blebbing. The current study examined the role of nuclear factor-κB (NFκB) in FasL-mediated apoptotic cell death in primary human gingival epithelial cells (HGEC) induced by heat-killed P. gingivalis, probably through TLR signalling pathways. A marked up-regulation of TLR2 and Fas–FasL was detected in HGEC stimulated with P. gingivalis. Activation of NFκB by P. gingivalis in HGEC was demonstrated by an NFκB promoter luciferase assay as well as by phosphorylation of p65 as detected by Western blotting. Activation of cleaved caspase-3 and caspase-8 resulted in apoptotic cell death of HGEC. The survival proteins c-IAP-1/c-IAP-2 were decreased in HGEC exposed to P. gingivalis. HGEC apoptosis induced by P. gingivalis was inhibited by an anti-human FasL monoclonal antibody. Blockade of NFκB by helenalin resulted in down-regulation of FasL whereas a caspase-8 inhibitor did not decrease FasL. Taken together, these studies show that P. gingivalis can induce epithelial cell apoptosis through Fas–FasL up-regulation and activation of caspase-3 and caspase-8.
Echocardiography in heart failure: beyond diagnosis.

It is a great honor for me to deliver this year's Euro Echo Lecture in this beautiful city of Florence and I appreciate the European Association of Echocardiography for the invitation and this opportunity to discuss the role of echocardiography in systolic and diastolic heart failure as the single most useful test, not only in diagnosis, but also as a tool to provide insights into the pathophysiological mechanism of various etiologies of heart failure, as a tool to monitor patient's response to various treatment options, and as a tool to help us develop innovative new therapies for heart failure. According to the ESC guidelines published in 2005, heart failure is defined as “a complex clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of ventricles to fill with or eject blood” which includes diastolic as well as systolic heart failure.1 ACC/AHA guidelines as well as ESC guidelines state that echocardiography is the single most useful test in the diagnosis of heart failure since structural abnormality, systolic dysfunction, diastolic dysfunction, or a combination of these abnormalities needs to be documented in patients who present with resting or/and exertional symptoms of heart failure to establish a definitive diagnosis of heart failure.1,2 It is important to demonstrate an objective evidence of structural or functional abnormalities to explain patient's symptoms of heart failure since symptoms of heart failure are not specific and more than a third of patients with a clinical diagnosis of heart failure may not actually have heart failure. It is also interesting to note from the SHAPE study that only 3% of more than 7000 subjects surveyed from nine European countries recognized breathlessness, fatigue, and edema as symptoms of heart failure.3 Moreover, even when someone presents with typical symptoms of heart …
Battling tumors with magnetic nanotherapeutics and hyperthermia: turning up the heat.

Using nanotherapeutics in combination withmagnetic fields is an attractive therapeuticapproach. Magnetic fields are used alone or incombination with other treatment modalities,such as surgery, chemotherapy and hyperther-mia. Phase I clinical reports confirm that the useof alternating magnetic fields (AMF) is safeenough for clinical applic ation, although optimi-zation for the best clinical results is still needed.Nanomedicine might represent the greatestopportunity to apply magnetic fields for cancertherapy; however, we must also understand,which properties of early formulations requireadditional characterization and optimization.The development of magnetite cationic lipo-somes (MCLs) is an example of a relatively newnanotreatment with clinical potential based onearly formulation studies and preclinical reports.MCLs are taken up by ta rget cells when adminis-tered by local injection; when target cells inter-nalize magnetite they become highly susceptibleto hyperthermia-inducing effects. When MCLsare loaded with chemotherapeutic agents, cancercells are even more susceptible to selective heatinduction (or hyperthermia). An example is seenwith 4-
The steady state characteristics of a StatCom with energy storage

The integration of energy storage systems (ESS) such as batteries, SMES, super-capacitors, or flywheels, into a FACTS device can expand the functionality of the FACTS device. The expanded functionality can potentially lead to a more economical and flexible transmission controller. In this paper, the authors compare the steady state characteristics of the traditional StatCom to an integrated StatCom/ESS. Two operational characteristic curves (voltage and power) are developed. From the characteristic curves, the advantages of the integrated StatCom/ESS over the traditional StatCom are presented. The steady state model used in this paper is derived directly from the dynamic model of the StatCom, so the power-electronic-induced high frequency effects are included in the analysis.
Reading challenging barcodes with cameras

Current camera-based barcode readers do not work well when the image has low resolution, is out of focus, or is motion-blurred. One main reason is that virtually all existing algorithms perform some sort of binarization, either by gray scale thresholding or by finding the bar edges. We propose a new approach to barcode reading that never needs to binarize the image. Instead, we use deformable barcode digit models in a maximum likelihood setting. We show that the particular nature of these models enables efficient integration over the space of deformations. Global optimization over all digits is then performed using dynamic programming. Experiments with challenging UPC-A barcode images show substantial improvement over other state-of-the-art algorithms.
Evaluating the Potential for a Helicobacter pylori Drinking Water Guideline

Helicobacter pylori is a microaerophilic, gram-negative bacterium that is linked to adverse health effects including ulcers and gastrointestinal cancers. The goal of this analysis is to develop the necessary inputs for a quantitative microbial risk assessment (QMRA) needed to develop a potential guideline for drinking water at the point of ingestion (e.g., a maximum contaminant level, or MCL) that would be protective of human health to an acceptable level of risk while considering sources of uncertainty. Using infection and gastric cancer as two discrete endpoints, and calculating dose-response relationships from experimental data on humans and monkeys, we perform both a forward and reverse risk assessment to determine the risk from current reported surface water concentrations of H. pylori and an acceptable concentration of H. pylori at the point of ingestion. This approach represents a synthesis of available information on human exposure to H. pylori via drinking water. A lifetime risk of cancer model suggests that a MCL be set at <1 organism/L given a 5-log removal treatment because we cannot exclude the possibility that current levels of H. pylori in environmental source waters pose a potential public health risk. Research gaps include pathogen occurrence in source and finished water, treatment removal rates, and determination of H. pylori risks from other water sources such as groundwater and recreational water.
Bootstrap Methods: Another Look at the Jackknife

We discuss the following problem given a random sample X = (X 1, X 2,…, X n) from an unknown probability distribution F, estimate the sampling distribution of some prespecified random variable R(X, F), on the basis of the observed data x. (Standard jackknife theory gives an approximate mean and variance in the case R(X, F) = \(\theta \left( {\hat F} \right) - \theta \left( F \right)\), θ some parameter of interest.) A general method, called the “bootstrap”, is introduced, and shown to work satisfactorily on a variety of estimation problems. The jackknife is shown to be a linear approximation method for the bootstrap. The exposition proceeds by a series of examples: variance of the sample median, error rates in a linear discriminant analysis, ratio estimation, estimating regression parameters, etc.
A high-speed reconfigurable architecture for heterogeneous multimodal packet traffic generation

Traffic modeling plays a key role in the study of packet switching systems, such as Internet routers. As line rates increase towards tens of gigabits per second, the duration of individual packets decreases, rendering real-time traffic generation a fundamental engineering challenge. In evaluation of these systems, it is critical to reproduce traffic conditions that approximate the target environment. Additionally, the ability to generate traffic flows that establish the limitations of a given algorithm or architecture is highly desirable. To address these issues, we propose a reconfigurable high-speed hardware architecture for heterogeneous multimodal packet generation. FPGA results demonstrate the scalability and flexibility of the proposed framework
A Methodological Study Comparing the Audio-Lingual Habit Theory and the Cognitive Code-Learning Theory-A Continuation.

ADESCRIPTION of the first year of this study and the obtained results were previously reported in these pages.' In general, the students who had studied under the cognitive method, as defined in the report, had scores which were significantly higher in reading while doing as well as if not better than the audiolingual students in the other skill areas. The only significant difference in favor of the audiolingual classes was the ability of the students to repeat after a native speaker, i.e., to participate in echo activities. The progress of these same students was followed as they continued in second-year Spanish classes. The concern was to examine the
Music as a memory enhancer: Differences between healthy older adults and patients with Alzheimer's disease.

Simmons-Stern, Budson, and Ally (2010) were the first to demonstrate that visually presented song lyrics were better remembered by patients with Alzheimer’s disease (AD) when accompanied by those lyrics sung rather than spoken at encoding. Surprisingly, healthy older adults showed no benefit of these musical mnemonics. Healthy older adults performed significantly better in both the sung and spoken conditions than the patients with AD. Perhaps, whenever discrimination is sufficiently high, musical mnemonics do not further aid performance. To test this possibility, we introduced a 1-week delay between study and test in a paradigm otherwise identical to the one used by Simmons-Stern et al. We successfully matched the overall discrimination performance of healthy older adults to the levels of the patients with AD in the original study but still did not find a benefit of musical mnemonics. The results of this study suggest that there may be a fundamental difference in musical encoding between patients with AD—whose memory is enhanced by musical encoding—and healthy older adults—whose memory is not—even when the two groups are matched for overall performance.
Strong asymmetric interspecific aggression between two sympatric New Guinean robins

Interspecific aggression is predicted to be common in diverse tropical avifaunas but is seldom tested experimentally. I conducted two playback experiments to measure interspecific aggression between two sympatric Australo-Papuan robin species that inhabit the understorey of montane New Guinean forests: Slaty Robin Peneothello cyanus and Ashy Robin Heteromyias albispecularis. The first experiment, at a location where both species were present, demonstrated strong asymmetric interspecific aggression; the larger Ashy Robin responded as aggressively to Slaty Robin playback as to conspecific playback, but Slaty Robins did not respond to Ashy Robin playback. In contrast, in the second experiment, which took place at a nearby site where Slaty Robins were absent, Ashy Robins did not respond aggressively to Slaty Robin playback. Thus, Ashy Robin interspecific aggression appears to be a learned response to the presence of Slaty Robins, and may reflect resource competition between these two sympatric species.
Radiotherapy dose–response analysis for diffuse large B-cell lymphoma with a complete response to chemotherapy

Objective: To examine the efficacy of different radiation doses after achievement of a complete response to chemotherapy in diffuse large B-cell lymphoma (DLBCL). Methods: Patients with stage I-IV DLBCL treated from 1995–2009 at Duke Cancer Institute who achieved a complete response to chemotherapy were reviewed. In-field control, event-free survival, and overall survival were calculated using the Kaplan-Meier method. Dose response was evaluated by grouping treated sites by delivered radiation dose. Results: 105 patients were treated with RT to 214 disease sites. Chemotherapy (median 6 cycles) was R-CHOP (65%), CHOP (26%), R-CNOP (2%), or other (7%). Post-chemotherapy imaging was PET/CT (88%), gallium with CT (1%), or CT only (11%). The median RT dose was 30 Gy (range, 12–40 Gy). The median radiation dose was higher for patients with stage I-II disease compared with patients with stage III-IV disease (30 versus 24.5 Gy, p<0.001). Five-year in-field control, event-free survival, and overall survival for all patients was 94% (95% CI: 89-99%), 84% (95% CI: 77-92%), and 91% (95% CI: 85-97%), respectively. Six patients developed an in-field recurrence at 10 sites, without a clear dose response. In-field failure was higher at sites ≥10 cm (14% versus 4%, p=0.06). Conclusion: In-field control was excellent with a combined modality approach when a complete response was achieved after chemotherapy without a clear radiation dose response.
Why We Need Better Ethics for Emerging Technologies

Technological revolutions are dissected into three stages: the introduction stage, the permeation stage, and the power stage. The information revolution is a primary example of this tripartite model. A hypothesis about ethics is proposed, namely, ethical problems increase as technological revolutions progress toward and into the power stage. Genetic technology, nanotechnology, and neurotechnology are good candidates for impending technological revolutions. Two reasons favoring their candidacy as revolutionary are their high degree of malleability and their convergence. Assuming the emerging technologies develop into mutually enabling revolutionary technologies, we will need better ethical responses to cope with them. Some suggestions are offered about how our approach to ethics might be improved.
The Housestaff Incentive Program: improving the timeliness and quality of discharge summaries by engaging residents in quality improvement

Background Quality improvement has become increasingly important in the practice of medicine; however, engaging residents in meaningful projects within the demanding training environment remains challenging. Methods We conducted a year-long quality improvement project involving internal medicine residents at an academic medical centre. Resident champions designed and implemented a discharge summary improvement bundle, which employed an educational curriculum, an electronic discharge summary template, regular data feedback and a financial incentive. The timeliness and quality of discharge summaries were measured before and after the intervention. Residents and faculty were surveyed about their perceptions of the project; primary care providers were surveyed about their satisfaction with hospital provider communication. Results With implementation of the bundle, the average time from patient discharge to completion of the discharge summary fell from 3.5 to 0.61 days (p<0.001). The percentage of summaries completed on the day of discharge rose from 38% to 83% (p<0.001) and this improvement was sustained for 6 months following the end of the project. The percentage of summaries that included all recommended elements increased from 5% to 88% (p<0.001). Primary care providers reported a lower likelihood of discharge summaries being unavailable at the time of outpatient follow-up (38% to 4%, p<0.001). Residents reported that the systems changes, more than the financial incentive, accounted for their behaviour change. Conclusions Our discharge summary improvement project provides an instructive example of how residents can lead clinically meaningful quality improvement projects.
Cutting Edge: Nitrogen Bisphosphonate-Induced Inflammation Is Dependent upon Mast Cells and IL-1

Nitrogen-containing bisphosphonates (NBPs) are taken by millions for bone disorders but may cause serious inflammatory reactions. In this study, we used a murine peritonitis model to characterize the inflammatory mechanisms of these agents. At dosages comparable to those used in humans, injection of NBPs into the peritoneum caused recruitment of neutrophils, followed by an influx of monocytes. These cellular changes corresponded to an initial increase in IL-1α, which preceded a rise in multiple other proinflammatory cytokines. IL-1R, IL-1α, and IL-1β were required for neutrophil recruitment, whereas other MyD88-dependent signaling pathways were needed for the monocyte influx. Mice deficient in mast cells, but not mice lacking lymphocytes, were resistant to NBP-induced inflammation, and reconstitution of these mice with mast cells restored sensitivity to NBPs. These results document the critical role of mast cells and IL-1 in NBP-mediated inflammatory reactions.
Hypoplasia of the cerebellar vermis and corpus callosum in thrombocytopenia with absent radius syndrome on MRI studies

Thrombocytopenia with absent radius (TAR) syndrome is infrequently (7%) associated with mental retardation. In those cases, the mental deficiency is presumed to be a consequence of intracranial hemorrhage due to the thrombocytopenia. We report on 2 infants with TAR syndrome. One had developmental delay with evidence of cerebral dysgenesis by magnetic resonance imaging (MRI). Such findings have not been noted in the literature, but may not have been investigated in most cases. The other infant with TAR syndrome, who has had normal psychomotor development, has a normal brain on MRI scan. Detailed neuroimaging studies, preferably MRI, should be considered in the evaluation of patients with TAR syndrome, especially when there are documented signs of developmental delay, with or without a history of intracranial hemorrhage.
Earthquake Response of Elastic Single-Degree-of-Freedom Systems with Nonlinear Viscoelastic Dampers

Investigated are the steady-forced and earthquake responses of single-degree-of-freedom (SDF) systems with a nonlinear viscoelastic damper (VED), which consists of a nonlinear fluid viscous damper (FVD) connected in series to a linear elastic bracing element (chevron or inverted V-shaped braces). For a wide range of bracing stiffness, nonlinear dampers are advantageous because they achieve essentially the same reduction in system responses but with a significantly reduced force. Damper nonlinearity has little influence on the structural response in the velocity-sensitive region of the spectrum even if the bracing is fairly flexible, but differences up to 16% were observed in other spectral regions. As expected, supplemental damping reduces structural response and the response reduction depends on the bracing stiffness, with this dependence varying with the spectral regions. For practical applications, a procedure is presented to estimate the design values of structural deformation, structural force, foundation shear, and damper force directly from the earthquake design (or response) spectrum. Finally, a procedure is presented to determine the damper and bracing properties necessary to limit the structural deformation to some design value or to the structural capacity.
Onset of Celiac Disease after Treatment of Chronic Hepatitis C with Interferon Based Triple Therapy.

Background. Patients treated with interferon (IFN) based therapies may develop exacerbation of autoimmune disease. We herein present the case of a 53-year-old female patient who developed celiac disease (CD) as a result of triple therapy (interferon, ribavirin, and boceprevir) for chronic HCV. Case. 53-year-old Caucasian female with past medical history of IV drug abuse was referred for abnormal LFTs. Laboratory data showed HCV RNA of 4,515,392 IU/mL, HCV genotype 1a, with normal LFTs. She was treated with 4 weeks of pegylated interferon alfa-2a plus ribavirin, followed by triple therapy using boceprevir for a total of 28 weeks. Approximately 4 weeks after initiation of triple therapy patient developed loose nonbloody bowel movements and was also found to have anemia. Biopsies from first and second portions of the duodenum were consistent with CD. The patient was treated with a gluten-free diet. Her intestinal symptoms improved and the hemoglobin returned to normal. Conclusion. Chronic HCV patients being treated with interferon alfa can develop celiac disease during or after therapy. For patients with positive autoantibodies, all-oral-IFN-free regimens should be considered. Celiac disease should be considered in patients who develop CD-like symptoms while on and shortly after cessation of interferon alfa therapy.
Breastmilk from obese mothers has pro-inflammatory properties and decreased neuroprotective factors

Breastmilk from obese mothers has pro-inflammatory properties and decreased neuroprotective factors
Characterizing best isotone approximations in L p spaces, 1 ≤ p ∞

Abstract We characterize best approximations in L p ( 1 ≤ p ∞ ) from a class of convex subcones of the convex cone of nonnegative functions and the convex cone of increasing functions; in particular, from the convex cones themselves. These subcones arise naturally in applications of constrained or shape-preserving approximation.
Density Dependence of the Dielectric Properties of Wheat and Whole-Wheat Flour

Etablissement d'equations pour le calcul de la constante dielectrique d'un materiau pulverulent ou d'un materiau particulaire a densite donnee : on utilise les mesures effectuees sur grain de ble et sur farine de ble a teneurs en eau de 8,5 a 14,7 %
Application of Microbial Risk Assessment to the Development of Standards for Enteric Pathogens in Water Used To Irrigate Fresh Produce

Microbial contamination of the surfaces of cantaloupe, iceberg lettuce, and bell peppers via contact with irrigation water was investigated to aid in the development of irrigation water quality standards for enteric bacteria and viruses. Furrow and subsurface drip irrigation methods were evaluated with the use of nonpathogenic surrogates, coliphage PRD1, and Escherichia coli ATCC 25922. The concentrations of hepatitis A virus (HAV) and Salmonella in irrigation water necessary to achieve a 1:10,000 annual risk of infection, the acceptable level of risk used for drinking water by the U.S. Environmental Protection Agency, were calculated with a quantitative microbial risk assessment approach. These calculations were based on the transfer of the selected nonpathogenic surrogates to fresh produce via irrigation water, as well as previously determined preharvest inactivation rates of pathogenic microorganisms on the surfaces of fresh produce. The risk of infection was found to be variable depending on type of crop, irrigation method, and days between last irrigation event and harvest. The worst-case scenario, in which produce is harvested and consumed the day after the last irrigation event and maximum exposure is assumed, indicated that concentrations of 2.5 CFU/100 ml of Salmonella and 2.5 x 10(-5) most probable number per 100 ml of HAV in irrigation water would result in an annual risk of 1:10,000 when the crop was consumed. If 14 days elapsed before harvest, allowing for die-off of the pathogens, the concentrations were increased to 5.7 x 10(3) Salmonella per 100 ml and 9.9 x 10(-3) HAV per 100 ml.
Recent Advances in the Literature: Asia–Pacific Derivative Markets

Although most researchers trace the origin of modern futures markets to the creation of the Chicago Board of Trade in the 1840s, Hamori et al. (Journal of Futures Markets, 2001, 21, 861) argue that modern futures markets originated with the establishment of the Dojima Rice Exchange in Osaka in the early 1700s. Yet, derivative markets based in the Asia–Pacific region have only recently become important from a global perspective as measured by relative trading volume. Not surprisingly, the recent sharp growth in trading volume has stimulated much research on derivatives traded on Asia–Pacific markets as well. This study discusses some of that recent research.
II. Cross-Cultural Perspectives on Management Principles

The article presents information on a survey of management problems among groups of businessmen from Rio Grande do Sul, Brazil and Michigan. The author presents a comparison of the problems perceiv...
Advance in type II InAs/GaSb superlattice photodiodes for LWIR detection and imaging

Recent effort has lifted the Quantum Efficiency of Type-II InAs/GaSb superlattice photodetectors to 54%, comparable to the state-of-the-art MCT technology. High quality Type II Superlattice Focal Plane Array with a 12μm cut-off wavelength was demonstrated.
Determination of thiocyanate content in dairy products by ion chromatography

[Objective]To establish a method for determination of thiocyanate content in dairy products by using ion chromatography.[Methods]After precipitating the dairy protein by using acetonitrile,and removing fat over the RP column,the test was carried out with ICS-3000 ion chromatograph,the AS16 as separation column,at a flow rate of 1.0 ml /min.And it also involved sample injection volume of 25 μL and was under the condition of conductivity detector.[Results]The determination content of thiocyanate was between 0.1-2.0 mg /L,which showed a good linear relationship with peak area.The correlation coefficient γ = 0.999 8,the detection limit was 0.1 mg /L.The recoveries ranged from 90.7% to 108.6%.RSD 3.7%.[Conclusion]This method is simple,rapid and accurate with high reproducibility and recovery rate as well as low detection limit,which is worth popularizing and applying.
The changing technological environment and the future of behavioural research in accounting

In an era where the pace of change continues to escalate, behavioural research provides an ongoing avenue for explaining the likely effects of emergent changes on decision-making by providers, users and assurers of accounting information, and for providing ex ante enlightenment for policy-makers. The purpose of this discussion is to identify contemporary changes affecting the accounting environment, discuss the potential impact to individual and organisational decision-making, and explore how behavioural research can be utilised to examine these changes. Specifically, this discussion focuses on the impact that technological changes have had on financial reporting, external auditing and managerial accounting, with an eye towards the potential for these changes to radically alter the future of accounting and auditing research.
Comparison of bisoprolol and carvedilol in antihypertensive effects and reversion of left ventricular hypertrophy in patients with essential hypertension

Objectives To compare the effects of anti-hypertension and reverse left ventricular hypertrophy by bisoprolol or carvedilol in patients with essential hypertension (EH). Methods One hundred and six EH patients with ventricular hypertrophy were divided into bisoprolol group (n=49) and carvedilol group (n=46) in random. Blood pressure,heart rate,left ventricular diastolic diameter (LVDd),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction (LVEF),cardiac output(CO) and A peak / E peak ratio(A / E ratio) were measured before treatment and 3,6 and 12 months after treatment. Results Blood pressure and heart rate significantly decreased after treatment in the two groups (P0.05); heart rate of bisoprolol group was lower than carvedilol group after treatment and the difference was significant (P0.05). LVEF and CO of the two groups had no significant difference,but A / E ratio significantly decreased before and after treatment in the two groups (P0.05). Left ventricular mass index (LVMI),LVDd,IVST and LVPWT were decreased remarkably in both groups and they were changed more significantly in bisoprolol group than in carvedilol group. Conclusions Bisoprolol and carvedilol may improvol left ventricular diastolic function and significantly reduce left ventricular hypertrophy and at the same time reduce blood pressure. Comparing with carvedilol,bisoprolol reducing left ventricular hypertrophy and heart rate is more effective.
Using Portable Transducers to Measure Tremor Severity

Background: Portable motion transducers, suitable for measuring tremor, are now available at a reasonable cost. The use of these transducers requires knowledge of their limitations and data analysis. The purpose of this review is to provide a practical overview and example software for using portable motion transducers in the quantification of tremor. Methods: Medline was searched via PubMed.gov in December 2015 using the Boolean expression “tremor AND (accelerometer OR accelerometry OR gyroscope OR inertial measurement unit OR digitizing tablet OR transducer).” Abstracts of 419 papers dating back to 1964 were reviewed for relevant portable transducers and methods of tremor analysis, and 105 papers written in English were reviewed in detail. Results: Accelerometers, gyroscopes, and digitizing tablets are used most commonly, but few are sold for the purpose of measuring tremor. Consequently, most software for tremor analysis is developed by the user. Wearable transducers are capable of recording tremor continuously, in the absence of a clinician. Tremor amplitude, frequency, and occurrence (percentage of time with tremor) can be computed. Tremor amplitude and occurrence correlate strongly with clinical ratings of tremor severity. Discussion: Transducers provide measurements of tremor amplitude that are objective, precise, and valid, but the precision and accuracy of transducers are mitigated by natural variability in tremor amplitude. This variability is so great that the minimum detectable change in amplitude, exceeding random variability, is comparable for scales and transducers. Research is needed to determine the feasibility of detecting smaller change using averaged data from continuous long-term recordings with wearable transducers.
Improving Start-Up Contact Distribution Between Railgun Armature and Rails

Contact pressure between the armature and rails of a railgun is critical to rail lifetime, armature acceleration, and consistent shot behavior. A zero-velocity contact is provided by the mechanical strain of the armature flange in interference with the rails. The contacting surfaces of the armature typically have unpredictable, localized concentrations of contact pressure and areas with no contact pressure at all. A method to improve contact distribution and maintain control of the total contact force magnitude is introduced in this paper. This technique, called the predicted displacement method (PDM), showed promising results on simple model geometries and successfully demonstrated its ability to improve the design of a solid C-shaped railgun armature. The simulation results also illustrated the PDM’s ability to scale contact force magnitude while preserving the improved pressure distribution.
Baptism, Gender, and Family Redefined in Caribbean Pentecostalism

This chapter examines the political and cultural significance that the established colonial churches in the British West Indian slave colonies attached to Christian baptism. In the twentieth and twenty-first centuries, Pentecostalism rejects infant baptism as a path to salvation. Instead, Pentecostalism’s strong theological emphasis on the conversion experience and the ‘baptism of the Holy Spirit’ confirms and welcomes large numbers of poor Caribbean women and their families.