cssi/SciSciGPT-SciSciNet huggingface dataset:
Outcomes of Guideline-Directed Concomitant Annuloplasty for Functional Tricuspid Regurgitation.

Background Despite guideline recommendations, rates of concomitant tricuspid valve repair are suboptimal, possibly due to fear of complications. We reviewed morbidity, mortality, recurrent tricuspid regurgitation, and right ventricular remodeling after guideline-directed concomitant tricuspid valve repair. Methods We performed guideline-directed concomitant tricuspid valve repair on 171 consecutive patients who underwent left-sided valve surgery (degenerative mitral surgery or aortic valve replacement) between May 2012 and March 2016. Exclusion criteria included functional mitral regurgitation, rheumatic disease, active endocarditis, and concomitant coronary artery bypass grafting or complex aortic surgery. Results Mean age was 68 ± 12 years, and 47% (81 of 171) were women. Preoperative atrial fibrillation was present in 57% (98 of 171), and preoperative tricuspid regurgitation was moderate or higher in 64% (108 of 171). The rate of de novo pacemaker placement was 4.1% (7 of 171), and the 30-day mortality rate was 0.6% (1 of 171). Estimated survival was 95% ± 4% at 1 year and 92% ± 5% at 5 years. Freedom from moderate or worse residual/recurrent tricuspid regurgitation was 93% ± 6% at 6 months and 89% ± 8% at 3 years. Quantitative echocardiography found no significant increase in right ventricular dimensions or area at 1 year in subgroup analysis. Mean echocardiographic follow-up was 14.1 months, and mean clinical follow-up was 33.9 months. Conclusions Guideline-directed concomitant tricuspid valve repair resulted in excellent safety end points and survival. At 14 months, freedom from moderate or worse tricuspid regurgitation was high, right ventricular performance did not worsen, and the pacemaker rate was comparable to rates after isolated mitral repair. Given these findings, adherence to current guidelines regarding functional tricuspid regurgitation should be encouraged.
Calibration of matrix-dependent biases in isotope and trace element analyses of carbonate minerals

The timing of important events in the early history of the solar system can be established by using the decay of the short-lived radionuclide 53Mn to stable 53Cr. Carbonate minerals found in meteorite samples can be dated using this system provided that an accurate and precise value for the Mn/Cr ratio can be established. However, the ion yields of Mn and Cr vary substantially based upon the elemental composition of the matrix and require calibration using standards of known Mn and Cr concentrations to relate the measured Mn/Cr ratio to the true ratio with a “relative sensitivity factor.” The authors implant 52Cr+ into a suite of terrestrial calcite and dolomite samples of varied elemental compositions to produce matrix-matched standards for 53Mn-53Cr analysis. Depth profiling of the implanted carbonates reveals variation in the relative sensitivity factors between carbonates low in Fe and Mn and dolomite rich in Fe and Mn. For carbonates with FeCO3 > 8 mol. %, the relative sensitivity factor is constant at 0.88 ± 0.08 (2SD). For carbonates with FeCO3 < 2 mol. %, the relative sensitivity factor is approximately 1.1. The authors also show that the use of an inappropriate relative sensitivity factor can lead to systematic errors in the age determined for meteoritic carbonate.
The Research-Practice Gap in Music Education: Applying Brokerage Structures to Guide Future Inquiry:

The research-practice gap in music education has been discussed for decades. Many attempts have been made to explain the gap and offer recommendations for bridging it. However, few systematic exami...
Primary Aneurysmal Bone Cyst of the Spine in Children: Updated Outcomes of a Modern Surgical Technique.

ABSTRACT Objective Aneurysmal bone cysts (ABC) are benign but locally aggressive lesions. Treating children with spinal ABC poses risks due to the proximity of the lesion to the spinal cord and the need to preserve spinal stability after surgery. This study reports the updated outcomes of a uniform aggressive initial surgical technique for the treatment of spinal ABC in children. Methods Twenty-nine cases of spinal ABC were collected from a tertiary pediatric tumor center over a 24-year period (January 1990–September 2014). The study patients were divided into 2 groups based on the performed procedure: a traditional approach consisting of curettage and bone grafting (group 1) and a 4-step approach consisting of intralesional curettage, high-speed bur, electrocautery, and bone grafting (group 2). Results The study population was composed of 12 males and 17 females with a mean age of 12.2 years at the time of diagnosis and a mean postoperative follow-up of 4.03 years. Twenty-one patients underwent the 4-step approach, while 8 patients were treated with the traditional technique. The recurrence rate was 50% (4/8 patients) with the traditional technique (group 1) and 19% (4/21) in the 4-step technique (group 2) (P = .164). Regardless of the technique used, the presence of sensory symptoms at the time of presentation was a statistically significant factor for recurrence (P = .016). Conclusions We suggest that addressing spinal ABC in pediatric patients with a 4-step approach is a safe technique that may decrease long-term recurrence and reoperation rates compared to the traditional technique of intralesional curettage and bone grafting. Level of Evidence 4.
Does methionine enhance immunity in Mycoplasma gallispeticum F strain vaccinated broiler breeder pullets

Summary This experiment was conducted to assess a protocol combining 20% excess dietary methionine above the modern breeder pullet's requirement and AviPro MGF vaccine in controlling Mycoplasma gallispeticum (MG) infection. In a complete randomized design, a total of 276 6-wk-old breeder pullets, of the Ross 308 strain were allocated into 4 treatments, each with 3 floor pen replicates of 23 birds/pen: 1) nonvaccinated with adequate methionine (NVAM), 2) nonvaccinated with 20% excess methionine (NVEM), 3) Vaccinated with adequate methionine (VAM), 4) Vaccinated with 20% excess methionine (VEM). Vaccination with AviPro MGF at 6 wk of age was performed via drinking water. Results indicated that the rate of depictable growth and tracheal colonization of MGF vaccine strain is 6 wk postvaccination. Sera Elisa titers showed that an 8-wk-postvaccination period was required for the vaccine to stimulate the humoral immunity response against MG. The 20% excess methionine numerically increased the IgG titer against MG in comparison to other groups, yet this increase was not enough to generate protective titer count. Furthermore, the addition of 20% excess methionine above the recommended levels hindered the tracheal colonization rate and log10 values of AviPro MGF vaccine colony forming units from 5.9/mL of tracheal swab suspension in VAM group to 0.82/mL of tracheal swab suspension in VEM group (P ˂ 0.05). In conclusion, the 20% excess methionine above the modern requirements reduced the tracheal colonization of F-strain MG. Further research is needed to confirm the ability of excess dietary methionine to enhance the adaptive and acquired immunity of broiler breeder pullets.
Some quantitative characteristics of error covariance for Kalman filters

Some quantitative characteristics of error covariance are studied for linear Kalman filters. These quantitative characteristics include the peak value and location in the matrix, the decay rate fro...
Effects of pellet quality to on-farm nutrient segregation in commercial broiler houses varying in feed line length

Summary Improving pellet quality (PQ) by increasing the percentage of pellets in finished feed is complicated. The hurdles of feed manufacturing are well documented. Researchers continue to investigate the effects of PQ on various performance parameters, yet additional PQ benefits must be presented to stimulate change in feed manufacturing practices. Therefore, the aim of this study was to investigate the effects of PQ on nutrient segregation in commercial broiler houses differing in feed line length. Four experiments (Exp) were performed, each including 4 replicate feed lines segmented into 8 regions. A commercial broiler finisher diet was manufactured using techniques to create either poor pellet quality (PPQ) or improved pellet quality (IPQ) feeds. Exp1 and Exp2 were conducted to investigate how PPQ and IPQ feed contributes to nutrient segregation in a 152-m feed line, respectively. Exp3 and Exp4 used the same PPQ and IPQ feed but were carried out in a 152-m house with split feed lines, 76-m long. Feed samples were taken from each feed pan per Exp. Pellets and fines were analyzed separately to determine pellet-to-fine ratio (P:F), pellet survivability, and nutrient concentrations. Segregation of amino acids and phytase were apparent in Exp1 (PPQ-152m), demonstrated by varying concentrations of amino acids and phytase activity across the 8 regions of the feed line (P 0.05). Threonine and phytase segregation occurred in Exp3 (PPQ-76m) (P 0.05). These data suggest that investing in PQ improvements provides a more uniform distribution of nutrients throughout the house.
HIV-1 gp120-Induced Endolysosome de-Acidification Leads to Efflux of Endolysosome Iron, and Increases in Mitochondrial Iron and Reactive Oxygen Species

The HIV-1 coat protein gp120 continues to be implicated in the pathogenesis of HIV-1 associated neurocognitive disorder (HAND); a condition known to affect ~50% of people living with HIV-1 (PLWH). Autopsy brain tissues of HAND individuals display morphological changes to mitochondria and endolysosomes, and HIV-1 gp120 causes mitochondrial dysfunction including increased levels of reactive oxygen species (ROS) and de-acidification of endolysosomes. Ferrous iron is linked directly to ROS production, ferrous iron is contained in and released from endolysosomes, and PLWH have elevated iron and ROS levels. Based on those findings, we tested the hypothesis that HIV-1 gp120-induced endolysosome de-acidification and subsequent iron efflux from endolysosomes is responsible for increased levels of ROS. In U87MG glioblastoma cells, HIV-1 gp120 de-acidified endolysosomes, reduced endolysosome iron levels, increased levels of cytosolic and mitochondrial iron, and increased levels of cytosolic and mitochondrial ROS. These effects were all attenuated significantly by the endolysosome-specific iron chelator deferoxamine, by inhibitors of endolysosome-resident two-pore channels and divalent metal transporter-1 (DMT-1), and by inhibitors of mitochondria-resident DMT-1 and mitochondrial permeability transition pores. These results suggest that oxidative stress commonly observed with HIV-1 gp120 is downstream of its ability to de-acidify endolysosomes, to increase the release of iron from endolysosomes, and to increase the uptake of iron into mitochondria. Thus, endolysosomes might represent early and upstream targets for therapeutic strategies against HAND.
Socioculturally Mediated Academic Advising: A GYO Approach for Supporting Bilingual/Bicultural Paraprofessionals:

This case study examined how the academic advising (hence, advising) component of a Grow Your Own (GYO) teacher program can be tailored to honor bilingual/bicultural paraprofessionals’ (hence, BL/B...
New drugs for difficult bugs: management of multidrug-resistant gram-negative infections in solid organ transplant recipients.

Purpose of review Multidrug-resistant Gram-negative bacteria remain a significant threat to patient and allograft survival. Management of these infections in solid organ transplant (SOT) recipients remains challenging due to a limited antimicrobial pipeline and reliance on novel agents, which have not been systematically evaluated in the transplant population. Recent findings Novel antimicrobials, including the second-generation β-lactam/β-lactamase inhibitors, cefiderocol, plazomicin and eravacycline, have been developed to combat infections due to multidrug-resistant Gram-negative infections, but each has microbiologic and therapeutic niches and warrant further study in SOT recipients. Summary This review summarizes therapeutic options for extended-spectrum β-lactamase-producing Enterobacterales, carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa with difficult-to-treat resistance in SOT recipients and emphasizes recently approved antimicrobial agents.
Relationship Between Cognitive Performance and Lower Extremity Biomechanics: Implications for Sports-Related Concussion

Background:Collegiate athletes with prior sports-related concussion (SRC) are at increased risk for lower extremity (LE) injuries; however, the biomechanical and cognitive mechanisms underlying the...
Unfolding Semiotics: The Field of Mediated Activity

Grounded in process philosophy and with a focus on language activity, the contribution explores the intricate entanglement of languaging processes with their concrete reality. This brings the old-established notion of field to the fore that serves to anchor language activity, against its pervasive mentalization, dis-embodying, and de-temporalization in psychology. The feature of movement is seen as key to semiosis and is first addressed through the pragmatic and dialogic accounts of the language sign in Buhler, Volosinov, and Vygotsky. It shows the language sign’s specific movements as linked to forms of contact and otherness and characterized by embodied-symbolic qualities. Second, the way language activity is anchored in concrete reality is explored. An actual language activity constructs an own, new symbolic reality unto a given semiotized field, the unfolding language activity intertwines itself in a certain way with an established field creating an actual field of mediated activity.
An uncertain trumpet: Developing archival and special collections in the electronic era

Summary In the era of electronic information, it is important that the leaders in the larger community connect, or reconnect, with the leaders of all of the specialties that fall within the archives, rare books, and manuscript sector.
Can Crude Oil Futures Predict Spot Retail Unleaded Gasoline Prices

The motivation for this paper began with casual empiricisms regarding the brief distributed lag of retail gasoline prices behind crude oil futures. We developed a model consistent with our hypothesis and tested it with econometrics using statistical data that include the sharp decrease in crude oil price futures in late summer 2008. We found that our model is a consistent and efficient estimator of the actual gasoline prices over most of our sample period. However, random shocks to gasoline prices, like Hurricane Ike in 2008, cause the model to have problems accurately predicting gas prices. We conclude that our estimated model and simulations provide reasonable support for our hypothesis that crude oil price futures can predict spot retail unleaded gasoline prices.
Pan-Africanism and the Politics of History

Africa is not a country! It is neither a homogenous socio-cultural group nor a unanimous ethno-political sovereign. How then could we speak of Pan-Africanism without generating an ambiguous vernacular mode of identity formation deeply rooted in questionable intellectual claims grounded in politics of history? To make sense of our discourse, therefore, is to localize it within the context of its emergence. These context(s) are the Trans-Atlantic era and colonial historicity with their associative epochs of subjective domination and shared responses of African peoples to this condition. Among other things, colonialism thrived through a denial of historical culture to non-Western people(s) with a false promise of “civilizing” the barbarian – a strategy that evacuates all possibility of human enterprise. In Africa and in the African Diaspora, the “uncivilized” is also a non-historical being of no consequence; an imposed misrecognition that enabled his/her objectification and domination. Pan-Africanism emerged as a restorative agency in this struggle for freedom and dignity by offering a new pose of repudiation grounded in historical unity of the African experience.
A Farewell to Freshmen

Abstract The arrival of underprepared freshmen to a high school presents a host of challenges for all stakeholders. West High School in Bakersfield, California, responded to a problem of academic failure of a significant number of freshmen by developing and implementing a Freshman Academy for underprepared students entering the 9th grade. During two years of this intervention, the school experienced improvement in the matriculation rate, an increase in literacy skills, and a reduction in student suspensions. The Freshman Academy identified students’ academic and nonacademic needs and provided a supportive learning environment to help address these needs in a way that led to successful promotion through high school. Two critical attributes of this approach are teacher efficacy and teacher collaboration.
Rationale of Design of Anti-HIV Drugs

The acquired immunodeficiency syndrome disease, abbreviated AIDS, is caused by the retrovirus, human immunodeficiency virus subtype1 (HIV-1). Infection with the virus leads to severe suppression of the immune system and potential exposure to the so-called opportunistic infections such as pneumonia, which could be fatal. Most of the currently available anti-AIDS medications are inhibitors for the reverse transcriptase and protease enzymes. The growing resistance to the currently available drugs requires developing new agents that act by different mechanisms beyond transcriptase and protease inhibition. Treatment of AIDS and development of anti-HIV agents to stop the virus replication requires acquaintance with various steps of the virus life cycle and the mechanism of how it reproduces itself. The present chapter describes the molecular aspects of the AIDS virus including its structure, molecular biology, and life cycle. Approaches to design anti-HIV drugs are presented with update on the status of anti-HIV therapeutic agents in the light of the continuous growing viral mutation. Keywords: AIDS; HIV-1; HIV entry inhibitors; HIV replication inhibitors; HIV transcriptase inhibitors; HIV protease inhibitors; HIV life cycle; therapeutic targets of HIV therapy
The National Retail Sales Tax: What Would the Rate Have To Be?

H.R. 25 would replace federal taxes with a 23 percent tax-inclusive (30 percent tax-exclusive) sales tax on private consumption, household interest payments, and government spending, and give households payments to offset taxes on consumption up to the poverty line. This paper shows that even if there were no avoidance or evasion, setting the rate at 23 percent (tax-inclusive) would reduce revenues by $7 trillion relative to current law. The required tax rate to hold the government and revenue constant would be 31 percent tax-inclusive (44 percent tax-exclusive) if there were no evasion or avoidance and much higher under less optimistic assumptions. [&copy Brookings Institution]
Sublattices of regular elements

Let L be an r-lattice, i.e., a modular multiplicative lattice that is compactly generated, principally generated, and has greatest element 1 compact. We consider certain subsets of L consisting of “regular elements”: \(L_f = \left\{ 0 \right\} \cup \left\{ A \right. \in \left. L \right|\left. {(0:A) = 0} \right\},L_{sr} = \left\{ 0 \right\} \cup \left\{ A \right. \in \left. L \right|\) there is a compact element \(X \leqslant A\) with \(\left. {(0:X) = 0} \right\},L_r = \left\{ 0 \right\} \cup \left\{ A \right. \in \left. L \right|\) there is a principal element \(X \leqslant A{\text{ with }}\left. {(0:X) = 0} \right\},{\text{ and }}L_{rg} = \left\{ 0 \right\} \cup \left\{ A \right. \in \left. L \right|A = \bigvee _\alpha X_\alpha {\text{ where each }}X_\alpha \) is a principal element with (0:X_{\alpha })=0\} . The first three subsets L_{f}, L_{sr}, and L_{r} are augmented filters \(\mathcal{L}^0 \) on L, i.e., \(\mathcal{L}^0 = \mathcal{L} \cup \left\{ 0 \right\}{\text{ where }}\mathcal{L}\) is a multiplicatively closed subset of $L$ with $A\in \(\mathcal{L}\) and $B\geq A$ with $B\in L$ implies $B\in \(\mathcal{L}\) and hence are sublattices of $L$ closed under multiplication. We first consider the more general situation of augmented filters on $L.$ These results are then applied to study the four previously defined subsets for $L$ an $r$-lattice or Noether lattice (i.e., an $r$-lattice with ACC). Finally, we give a brief discussion of how the results for augmented lattices can be applied to subsets of $L$ which are “regular” with respect to an $L$-module.
Psychologic and Behavioral Effects of Antiepileptic Drugs in Children: A Double-Blind Comparison Between Phenobarbital and Valproic Acid

Traditional clinical monitoring of children with epilepsy does not appear to be sufficiently sensitive to cognitive functioning and behavioral problems. Although subtle, these changes may alter a child's ability to perform well in school and in society. Physicians must prevent seizures without producing intolerable side effects, and ways of more appropriately assessing these side effects must be developed. In this double-blind, counter-balanced, crossover study of 21 children, the effects of phenobarbital and valproic acid on cognitive functioning and behavior were measured. There was no difference in seizure control between the drugs, and each medication was maintained in the therapeutic range for 6 months (mean phenobarbital level, 21.2 micrograms/mL; mean valproic acid level, 94.1 micrograms/mL). Children were treated with each drug for 6 months. Differences between the drugs were seen on measurements of cognitive function and behavior. On four tests of neuropsychologic function, children performed significantly less well while receiving phenobarbital (P less than .01). There was no evidence that the patients were sedated or less able to perform continuous performance tasks while receiving phenobarbital. Parental assessment of behavior indicated significantly worse behavior with the phenobarbital regimen for three items (P less than .01) and children were measurably more "hyperactive" (P less than .05). Routine clinical assessment of the patients did not reveal differences between the drugs with respect to routine laboratory measurements or side effects as assessed by history or physical examination. Although children may appear to tolerate a medication without clinically apparent problems, subtle but significant changes in intellectual function and behavior may be occurring. Additional, more sensitive, methods of monitoring patients while receiving these drugs is necessary.
The Use of Lidocaine Containing Cardioplegia in Surgery for Adult Acquired Heart Disease.

Background Del Nido cardioplegia, a crystalloid-based solution with lidocaine as a key element, is given as a single dose and has been used successfully in congenital cardiac surgery. Hypothesis We retrospectively compared a lidocaine containing “modified del Nido” solution with our standard whole blood cardioplegia to investigate its safety and efficacy in adult cardiac surgery. Methods From June 1, 2013 to December 30, 2013, we used a single dose of lidocaine containing cardioplegia (LC group) in 92 consecutive operations. Propensity matching analysis was undertaken to compare the outcomes of such patients with those who underwent their surgery by the same surgeon using standard whole blood cardioplegia (WB group), n = 396. Propensity score matching yielded 79 pairs of patients. Results After propensity matching, LC and WB groups were similar in baseline operative characteristics including cross-clamp time (LC: 65 minutes [range 54 to 89] vs. WB: 70 minutes [54 to 86], p = 0.993). Postoperative outcomes were similar including inotropic requirements (30.4% [24/72] vs. 25.3% [20/72], p 0.798). Conclusions Lidocaine containing cardioplegia appears to be safe in adults undergoing cardiac procedure when administered for the first 60 minutes of aortic cross clamping. Higher CK-MB levels did not translate into adverse clinical outcomes. doi: 10.1111/jocs.12597 (J Card Surg 2015;30:677–684)
Remembering with Joy

Remember me when I am gone away, Gone far away into the silent land; When you can no more hold me by the hand, Nor I half turn to go, yet turning stay. Remember me when no more, day by day You tell...
An optimized 850 degrees C low-pressure-furnace reoxidized nitrided oxide (ROXNOX) process

The electrical characteristics of thin (10 nm) MOS gate dielectrics formed at 850 degrees C by low-pressure furnace nitridation of SiO/sub 2/ followed by an oxygen anneal (reoxidation) are described. The ROXNOX process is demonstrated to be readily scalable from 950 degrees C to 850 degrees C through the use of higher partial pressures in the nitridation and reoxidation steps, resulting in the same quality dielectric formed with a lower D/sub t/ product. Electrical characterization results of capacitors and transistors with the 850 degrees C ROXNOX dielectric are presented. Reliability of the 850 degrees C ROXNOX dielectric is demonstrated through Fowler-Nordheim and channel hot-electron stressing results. >
Intensity of attack, displacement and verbal aggression

One hundred-fifty male college students participated in a laboratory study of verbal aggression in which they competed against confederates (Cs) while assembling a formboard. The Ss or Cs verbally attacked one another while their opponent was assembling the formboard. Intense verbal attack by a C led to a higher outburst of aggression than did mild verbal attack or no prior attack by a C. Retaliatory verbal attack against a C who had previously attacked the S led to higher peak aggression than conditions in which the S was attacked by one C but displaced his attack to a second C.
Context and the Measurement of Moral Judgement

This study explored the role of context in moral judgement measurement by addressing a recent contention that moral dilemmas are not essential for the successful assessment of moral judgement. We e...
DIRAC--SCHWINGER COVARIANCE CONDITION IN CANONICAL THEORIES.

The simplest form of the Dirac-Schwinger condition for covariance of field theories relates the equal-time commutator of the energy density to the momentum density; this form has been shown by Schwinger to hold for a large class of theories. We present two new proofs of this theorem for "canonical theories," i.e., theories in which canonical commutation relations may be assumed consistently with the constraint equations. The first new proof, which is valid for all canonical theories to lowest order in $\ensuremath{\hbar}$, shows that the theorem holds for canonical theories because (1) all field components transform (under Lorentz transformations) explicitly as tensors or spinors and (2) the simplicity of the commutation relations prevents additional terms from appearing in the energy-density commutator. The second new proof, which is valid to all orders in $\ensuremath{\hbar}$, consists of the direct evaluation of the energy-density commutator; this proof is given for a "preferred subclass" of canonical theories; in order for the theorem to apply (to all orders in $\ensuremath{\hbar}$) to canonical theories outside this subclass, one must set ${\ensuremath{\partial}}_{i}{\ensuremath{\delta}}^{3}(0)=0$ on symmetry grounds. In an Appendix, we show the close relationship between the Dirac-Schwinger condition and the integrability condition required for consistency of the Schwinger-Tomonaga covariant formulation of field theory in the interaction picture.
The normal foot.

The term "normal foot" has many different interpretations. This article reviews some of the ways in which the word "normal" has been used historically to describe the foot. Also discussed are the problems of attempting to determine what should constitute a normal foot and proposed criteria for distinguishing between the normal and the pathological.
A prospective study of widowhood and changes in symptoms of depression in a community sample of the elderly.

This survey examines changes in depressive symptomatology (CES-D) during bereavement in 1046 elderly subjects, of whom 139 became widowed during follow-up. Depression scores increased during the first year of bereavement, but generally returned to pre-widowhood levels thereafter. However, depression scores remained elevated among young-old widows (65–74year-olds) well after the first year of widowhood. Using cut-off scores, rates of high depressive symptoms remained somewhat elevated over baseline levels. Increases in depression scores during bereavement were not explained by socio-economic variables, health habits and health status. It is concluded that particularly young-old widows are at risk of developing chronic depressive symptomatology during bereavement that may warrant clinical attention.
Nonverbal acoustic communication in human-computer interaction

Nonverbal communication helps to compensate many hidden meanings omitted from spoken language. In some situations, nonverbal communication may even take the place of verbal communication. In this paper, we introduce how nonverbal acoustic communication can be utilized in human-computer interaction. We first overview acoustic techniques for nonverbal communication. Then we provide a design framework of nonverbal communication based intelligent agents. We demonstrate an example of the design using an experimental iPad game.
Cardiopulmonary Resuscitation and Do-Not-Resuscitate Orders: A Guide for Clinicians

The do-not-resuscitate order, introduced nearly a half century ago, continues to raise questions and controversy among health care providers and patients. In today's society, the expectation and availability of medical interventions, including at the end of life, have rendered the do-not-resuscitate order particularly relevant. The do-not-resuscitate order is the only order that requires patient consent to prevent a medical procedure from being performed; therefore, informed code status discussions between physicians and patients are especially important. Epidemiologic studies have informed our understanding of resuscitation outcomes; however, patient, provider, and institutional characteristics account for great variability in the prevalence of do-not-resuscitate orders. Specific strategies can improve the quality of code status conversations and enhance end-of-life care planning. In this article, we review the history, epidemiology, and determinants of do-not-resuscitate orders, as well as frequently encountered questions and recommended strategies for discussing this important topic with patients.
Hormonal therapy of endometrial cancer

Hormonal therapy of advanced or recurrent endometrial cancer is a well-established therapeutic option. Patients most likely to respond have lower grade tumours and possess progesterone receptors on the surface of their cancer cells.
Excitotoxicity in the embryonic chick spinal cord

Recent evidence implicates excitatory amino acids (EAAs), acting as excitotoxic agents, in the pathogenesis of neurological disorders involving the spinal cord. In this study, we used the chick embryo spinal cord as an in vitro model for studying the sensitivity of spinal neurons to the excitotoxic effects of EAA agonists. Compounds tested include the prototypic receptor-specific agonists, N-methyl-D-aspartate (NMDA), quisqualic acid (Quis), and kainic acid (KA), and the plant-derived excitotoxic food poisons, beta-N-oxalylamino-L-alanine, beta-N-methylamino-L-alanine, and domoic acid. Each agonist induced concentration-dependent acute degeneration of neurons distributed throughout the spinal cord. These cytopathological changes consisted of acute edematous degeneration of dendrosomal structures in the dorsal horn and intermediate zone, and dark cell changes with intracytoplasmic vacuolization of motor neurons; this damage is identical to that induced by excitotoxin agonists in other regions of the central nervous system. The NMDA receptor-specific antagonist MK-801 completely blocked toxicity of NMDA, and the nonNMDA antagonist CNQX preferentially blocked the toxicity of Quis- and KA-type agonists in the spinal cord. Our findings suggest that (1) the majority of spinal neurons have all three subtypes of EAA receptors, making them acutely vulnerable to excitotoxin exposure; and (2) EAA antagonists are effective in preventing excitotoxin-induced damage of the spinal cord.
Biodegradation of low concentrations of 1,2-dibromoethane in groundwater is enhanced by phenol

The lead scavenger 1,2-dibromoethane (EDB), a former additive to leaded gasoline, is a common groundwater contaminant, yet not much knowledge is available for its targeted bioremediation, especially under in situ conditions. The study site was an aviation gas spill site, which, although all hydrocarbons and most of the EDB were remediated in the mid-1990s, still exhibits low levels of EDB remaining in the groundwater (about 11 μg EDB/l). To evaluate the effect of phenol on biostimulation of low concentration of EDB, microcosms were established from an EDB-contaminated aquifer. After 300 days at environmentally relevant conditions (12 ± 2 °C, static incubation), EDB was not significantly removed from unamended microcosms compared to the abiotic control. However, in treatments amended with phenol, up to 80 % of the initial EDB concentration had been degraded, while added phenol was removed completely. Microbial community composition in unamended and phenol-amended microcosms remained unchanged, and Polaromonas sp. dominated both types of microcosms, but total bacterial abundance and numbers of the gene for phenol hydroxylase were higher in phenol-amended microcosms. Dehalogenase, an indicator suggesting targeted aerobic biodegradation of EDB, was not detected in either treatment. This finding suggests phenol hydroxylase, rather than a dehalogenation reaction, may be responsible for 1,2-dibromoethane oxidation under in situ conditions. In addition, biostimulation of EDB is possible through the addition of low levels of phenol in aerobic groundwater sites.
Tax Refunds and Microbusinesses: Expanding Family and Community Wealth Building in the Borderlands

The Earned Income Tax Credit (EITC) is the largest antipoverty fiscal policy program for working families administered by the Internal Revenue Service (EITCs totaled $42 billion in 2003). For the 2004 tax season, U.S.-Mexico border county EITC refunds reached $1.9 billion while total tax refund amounts for low-income borderlands families topped $2.6 billion. Questionnaires administered during the tax-filing season to working families in Texas, New Mexico, Arizona, and California border counties collected more than forty-five hundred surveys that canvassed respondents on a variety of financial behaviors and tax refund expenditures. Additionally, researchers recorded data on tax filers using their tax refunds to capitalize microbusinesses and respondents' desires to know more about operating a microbusiness. Empirical analysis employing logistic regression produces results that parallel previous findings in the literature and suggests actionable policy prescriptions that may support family and community ent...
The effectiveness of visitation proxy variables in improving recreation use estimates for the USDA Forest Service

In estimating recreation visitation at the National Forest level in the US, annual counts of a number of types of visitation proxy measures were used. The intent was to improve the overall precision of the visitation estimate by employing the proxy counts. The precision of visitation estimates at sites that had proxy information versus those that did not is examined. Results show that using visitation proxy information reduces sampling needs by about 25%. Characteristics of the types of visitation proxy information that performed best and worst are discussed.
Future evolution of cosmic structure in an accelerating universe

Current cosmological data indicate that our universe contains a substantial component of dark vacuum energy that is driving the cosmos to accelerate. We examine the immediate and longer term consequences of this dark energy (assumed here to have a constant density). Using analytic calculations and supporting numerical simulations, we present criteria for test bodies to remain bound to existing structures. We show that collapsed halos become spatially isolated and dynamically relax to a particular density profile with logarithmic slope steeper than -3 at radii beyond r200. The asymptotic form of the spacetime metric is then specified. We develop this scenario further by determining the effects of the accelerating expansion on the background radiation fields and individual particles. In an appendix, we generalize these results to include quintessence.
The second-order theory of electromagnetic hot ion beam instabilities

The present investigation is concerned with the application of a second-order theory for electromagnetic instabilities in a collisionless plasma to two modes which resonate with hot ion beams. The application of the theory is strictly limited to the linear growth phase. However, the application of the theory may be extended to obtain a description of the beam at postsaturation if the wave-beam resonance is sufficiently broad in velocity space. Under the considered limitations, it is shown that, as in the cold beam case, the fluctuating fields do not gain appreciable momentum and that the primary exchange of momentum is between the beam and main component.
Population pharmacokinetic meta-analysis of denosumab in healthy subjects and postmenopausal women with osteopenia or osteoporosis.

Background and Objective: Inhibition of the receptor activator of nuclear factor k-B ligand (RANKL) is a therapeutic target for treatment of bone disorders associated with increased bone resorption, such as osteoporosis. The objective of this analysis was to characterize the population pharmacokinetics of denosumab (AMG 162; Prolia®), a fully human IgG2 monoclonal antibody that binds to RANKL, in healthy subjects and postmenopausal women with osteopenia or osteoporosis. Methods: A total of 22944 serum free denosumab concentrations from 495 healthy subjects and 1069 post-menopausal women with osteopenia or osteoporosis were pooled. Denosumab was administered as either a single intravenous dose (n = 36), a single subcutaneous dose (n = 469) or multiple subcutaneous doses (n= 1059), ranging from 0.01 to 3 mg/kg (or 6–210 mg as fixed mass dosages), every 3 or 6 months for up to 48 months. An open, two-compartment pharmacokinetic model with a quasi-steady-state approximation of the target-mediated drug disposition model was used to describe denosumab pharmacokinetics, using NONMEM Version 7.1.0 software. Subcutaneous absorption was characterized by the first-order absorption rate constant (ka), with constant absolute bioavailability over the range of doses that were evaluated. Clearance and volume of distribution parameters were scaled by body weight, using a power model. Model evaluation was performed through visual predictive checks. Results: The subcutaneous bioavailability of denosumab was 64%, and the ka was 0.00883 h−1. The central volume of distribution and linear clearance were 2.49 L/66 kg and 3.06 mL/h/66 kg, respectively. The baseline RANKL level, quasi-steady-state constant and RANKL degradation rate were 614ng/mL, 138 ng/mL and 0.00148 h−1, respectively. Between-subject variability in model parameters was moderate. A fixed dose of 60 mg provided RANKL inhibition similar to that achieved by equivalent body weight-based dosing. The effects of age and race on the area under the serum concentration-time curve of denosumab were less than 15% over the range of covariate values that were evaluated. Conclusions: The non-linearity in denosumab pharmacokinetics is probably due to RANKL binding, and denosumab dose adjustment based on the patient demographics is not warranted.
Possible role of hypercoagulability in calciphylaxis: Review of the literature

Background The role of a hypercoagulable state in the pathogenesis of calciphylaxis has yet to be determined. Objective We sought to find evidence of an association between hypercoagulability and calciphylaxis. Methods We reviewed the primary literature for review articles, studies, and case reports that discussed or demonstrated a possible relationship between calciphylaxis and a hypercoagulable state. Results Review of the primary literature showed that in cases of calciphylaxis with reported levels of protein C and S, 38% of the patients had decreased protein C levels and 43% had decreased levels of protein S. From review of case reports, 3 cases of improvement of skin lesions with low molecular weight heparin treatment, and a fourth case of healing of skin lesions with tissue plasminogen activator treatment, were found. Calciphylaxis was also found in a patient with antiphospholipid antibody syndrome, and a patient with cryofibrinogenemia had clinical and histologic findings consistent with possible calciphylaxis. Limitations A limited number of reports were available for review. Conclusion Our review of the literature found sufficient evidence to suggest a possible role of a hypercoagulable state in the pathogenesis of calciphylaxis. A prospective study with serial testing of all relevant clotting factors in patients with calciphylaxis is needed to more definitively establish this role.
Glacier Peak tephra in the North Cascade Range, Washington: Stratigraphy, distribution, and relationship to late-glacial events

Pumiceous tephra, resulting from multiple eruptions of Glacier Peak volcano in late-glacial time, mantles much of the landscape in the eastern North Cascade Range and extends eastward beyond the Columbia River as a thinner discontinuous deposit. Within about 25 km of the source, the tephra is divisible into as many as nine layers, distinguishable in the field on the basis of color, grain size, thickness, and stratigraphic position. Three principal layers, designated G (oldest), M, and B, are separated from one another by thinner, finer layers. Layer G has been found as far east as Montana and southern Alberta, whereas layer B has been identified as far as western Wyoming. By contrast, layer M trends nearly south, paralleling the crest of the Cascade Range. Available 14C dates indicate that the tephra complex was probably deposited between about 12,750 and 11,250 years ago. Glacier Peak tephra overlies moraines and associated outwash east of the Cascade Crest that were deposited about 14,000 years ago. Unreworked tephra occurs within several kilometers of many valley heads implying that major valley glaciers had nearly disappeared by the time of the initial tephra fall. Distribution of tephra indicates that the southern margin of the Cordilleran Ice Sheet had retreated at least 80 km north of its terminal moraine on the Waterville Plateau by the time layer G was deposited. Late-glacial moraines of the Rat Creek advance lie within the fallout area of layer M but lack the tephra on their surface implying that they were built subsequent to the eruption of this unit. Moraines of the Hyak advance at Snoqualmie Pass, which are correlated with the Rat Creek moraines farther north, were constructed prior to 11,000 14C years ago. The late-glacial advance along the Cascade Crest, therefore, apparently culminated between about 12,000 and 11,000 14C years ago and was broadly in phase with the Sumas readvance of the Cordilleran Ice Sheet in the Fraser Lowland which occurred between about 11,800 and 11,400 14C years ago.
Ability and motivation: Assessing individual factors that contribute to university retention.

The current study explored individual differences in ability and motivation factors of retention in first-year college students. We used discrete-time survival mixture analysis to model university retention. Parents' education, gender, American College Test (ACT) scores, conscientiousness, and trait affectivity were explored as predictors of retention. Results indicate gender, ACT scores, and conscientiousness are significant predictors of retention, but parents' education level was not a significant predictor. Positive affectivity and negative affectivity also were significant predictors of university retention when added to the model. Interestingly, once affectivity was added to the model, conscientiousness was no longer a significant predictor, indicating conscientiousness may be an amalgamation of motivation and ability. Implications for research and theory are discussed.
Stimulation of myosin light-chain kinase by Cd2+ and Pb2+.

The effect of Cd2+ on myosin light chain kinase (MLCK) reported in the literature is controversial, apparently because the level of Ca2+ contaminating the reaction mixture could not be accurately controlled by the addition of a metal chelator when Cd2+ was also present. In the present study, we have reduced the contaminating Ca2+ to a trace level that did not interfere with the enzyme activity; thus the use of a metal chelator was not necessary. We showed that Cd2+, or Pb2+ had a biphasic effect on MLCK isolated from chicken gizzard: stimulation at low and inhibition at high concentrations. (The stimulatory effect of on the enzyme activity isolated from chicken gizzard: stimulation at low and inhibition at high concentrations). The stimulatory effect of Cd2+ or Pb2+ on MLCK activity was not seen in the absence of calmodulin, and was abolished by trifluoperazine, a calmodulin antagonist, indicating that the heavy metals exert their activation via calmodulin. The inhibition of the enzyme activity by Cd2+ or Pb2+ at higher concentrations was also seen with the calmodulin-independent catalytic fragment of MLCK, suggesting that the inhibition is probably through their binding to sulfhydryl groups that are essential for catalytic activity. Pb2+ was more effective than Cd2+ in stimulating the enzyme activity, but less potent in inhibition. The extent of stimulation by heavy metals most likely resulted from a combination of the biphasic effects. Dithiothreitol and N,N,N′,N′-tetrakis (2-pyridylmethyl) ethylenediamine selectively chelated Cd2+ and Pb2+ over Ca2+, and reversed their stimulatory or inhibitory effect on MLCK. Thus, they are useful agents to discriminate between the action of Ca2+ from that of these heavy metal cations. Cd2+ and Pb2+ not only activited MLCK in vitro, but also triggered smooth muscle contraction in an isolated rabbit aortic strip.
Soil nitrogen conditions approach preinvasion levels following restoration of nitrogen-fixing Black locust (Robinia pseudoacacia) stands in a pine-oak ecosystem.

Restoring native plant communities on sites formerly occupied by invasive nitrogen-fixing species poses unique problems due to elevated soil nitrogen availability. Mitigation practices that reduce available nitrogen may ameliorate this problem. We evaluated the effects of tree removal followed by soil preparation or mulching on native plant growth and soil nitrogen transformations in a pine–oak system formerly occupied by exotic nitrogen-fixing Black locust (Robinia pseudoacacia) trees. Greenhouse growth experiments with native grasses, Andropogon gerardii and Sorghastrum nutans, showed elevated relative growth rates in soils from Black locust compared with pine–oak stands. Field soil nutrient concentrations and rates of net nitrification and total net N-mineralization were compared 2 and 4 years since Black locust removal and in control sites. Although soil nitrogen concentrations and total net N-mineralization rates in the restored sites were reduced to levels that were similar to paired pine–oak stands after only 2 years, net nitrification rates remained 3–34 times higher in the restored sites. Other nutrient ion concentrations (Ca, Mg) and organic matter content were reduced, whereas phosphorus levels remained elevated in restored sites. Thus, 2–4 years following Black locust tree removal and soil horizon mixing achieved through site preparation, the concentrations of many soil nutrients returned to preinvasion levels. However, net nitrification rates remained elevated; cover cropping or carbon addition during restoration of sites invaded by nitrogen fixers could increase nitrogen immobilization and/or reduce nitrate availability, making sites more amenable to native plant establishment.