cssi/SciSciGPT-SciSciNet huggingface dataset:
Monitoring prescribing patterns using regression and electronic health records

It is beneficial for health care institutions to monitor physician prescribing patterns to ensure that high-quality and cost-effective care is being provided to patients. However, detecting treatment patterns within an institution is challenging, given that medications and conditions are often not explicitly linked in the health record. Here we demonstrate the use of statistical methods together with data from the electronic health care record (EHR) to analyze prescribing patterns at an institution. As a demonstration of our method, which is based on regression, we collect EHR data from outpatient notes and use a case/control study design to determine the medications that are associated with hypertension. We also use regression to determine which conditions are associated with a preferential use of one or more classes of hypertension agents. Finally, we compare our method to methods based on tabulation. Our results show that regression methods provide more reasonable and useful results than tabulation, and successfully distinguish between medications that treat hypertension and medications that do not. These methods also provide insight into in which circumstances certain drugs are preferred over others. Our method can be used by health care institutions to monitor physician prescribing patterns and ensure the appropriateness of treatment.
The Influence of State Politics in Expanding Federal Power

In discussing this subject it will be necessary to refer to democratic principles of government. Unless it is understood distinctly just what is meant the statements made will not convey clear ideas. There are two senses in which the word democratic is used—one having respect primarily to means and the other to ends. From the one point of view, all institutions that pretend to put power in the hands of the people are democratic in their character. An instance of this assumption appears in last year's programme of this association, wherein the direct primary, the initiative, the referendum, and the recall are designated as “the newer institutional forms of democracy.” From the other point of view, the quality of institutions is not decided by the emotions and intentions with which they are created, but is to be discerned from their results, so that the democratic value of any institution is wholly contingent upon its usefulness in subjecting the operations of government to the control of the people. From this point of view, the classification quoted from last year's programme begs the very question that is to be determined.
Addressing the Stressful First Year in College: Could Peer Mentoring Be a Critical Strategy?:

Peer mentoring has emerged as a viable retention strategy to aid higher education institutions in their efforts to ensure freshmen students make it through that crucial first year and beyond and ob...
Noema and Essence

If a noema is an entity of some sort, what sort of entity is it? In Husserl’s ontology, there are just two kinds of entities: those that are real and those that are ideal. A noema clearly is not a real entity, it is not—as Husserl requires of everything that is real—spatio-temporally individuated. Is it then ideal? If a noema is an entity, it must be an ideal entity. An ideal entity is either an essence or belongs to the class of entities Husserl calls meanings. Is noema an essence?
Underdetermination of infinitesimal probabilities

A number of philosophers have attempted to solve the problem of null-probability possible events in Bayesian epistemology by proposing that there are infinitesimal probabilities. Hajek (Synthese 137:273–323, 2003) (more tentatively) and Easwaran (Philos Rev 123:1–41, 2014) (more definitively) have argued that because there is no way to specify a particular hyperreal extension of the real numbers, solutions to the regularity problem involving infinitesimals, or at least hyperreal infinitesimals, involve an unsatisfactory ineffability or arbitrariness. The arguments depend on the alleged impossibility of picking out a particular hyperreal extension of the real numbers and/or of a particular value within such an extension due to the use of the Axiom of Choice. However, it is false that the Axiom of Choice precludes a specification of a hyperreal extension—such an extension can indeed be specified. Moreover, for all we know, it is possible to explicitly specify particular infinitesimals within such an extension. Nonetheless, I prove that because any regular probability measure that has infinitesimal values can be replaced by one that has all the same intuitive features but other infinitesimal values, the heart of the arbitrariness objection remains.
Maternal obesity results in decreased syncytiotrophoblast synthesis of palmitoleic acid, a fatty acid with anti-inflammatory and insulin-sensitizing properties

The fetus is dependent on delivery of fatty acids (FAs) by the syncytiotrophoblast, the transporting epithelium of the human placenta. Obese pregnant women have dyslipidemia; however, whether obesity impacts placental lipid transport and metabolism remains to be fully established. Palmitoleic acid (POA), an FA with anti-inflammatory and insulin-sensitizing properties, is synthesized from palmitic acid (PA) catalyzed by stearoyl-coenzyme A desaturase (SCD) activity. We hypothesized that the uptake and incorporation of FAs and POA synthesis are reduced in primary human trophoblasts (PHTs) isolated from pregnancies complicated by maternal obesity. Villous cytotrophoblasts were isolated from 7 placentas of obese [body mass index (BMI) = 37.5 ± 1.9] and 12 normal (BMI = 23.6 ± 0.6) mothers. FA uptake and incorporation were assessed using uniformly labeled (U[13C])-FA mixtures of PA, oleic acid (OA), linoleic acid, and docosahexaenoic acid. Cellular [13C] FAs were quantified both in total cellular lipids and in lipid classes by GC-MS. Uptake and incorporation of [13C] FAs in total cellular lipids were not different in PHTs isolated from obese mothers compared with normal mothers. Only the concentration of OA was increased in the triglyceride fraction (P < 0.05) if the mother was obese. We found an isotopic enrichment of POA after U[13C]-PA treatment, demonstrating SCD activity in PHT cells. Labeled POA content and the POA:PA ratio were significantly lower in PHTs isolated from placentas of obese mothers compared with normal, healthy controls. Decreased syncytiotrophoblast POA synthesis may contribute to insulin resistance and low-grade inflammation in the mother, placenta, or fetus (or a combination of the 3) in pregnancies complicated by obesity.-Ferchaud-Roucher, V., Barner, K., Jansson, T., Powell, T. L. Maternal obesity results in decreased syncytiotrophoblast synthesis of palmitoleic acid, a fatty acid with anti-inflammatory and insulin-sensitizing properties.
5-Year Outcome of Photopheresis in Heart-Transplantation with Refractory/Persistent Rejection

Purpose Extracorporeal photopheresis (ECP) is an apheresis and photodynamic therapy that uses 8-methoxy-psolaren and ultraviolet light to modulate T-cell activity. Research has shown that ECP is an effective treatment for patients (pts) with recurrent acute cellular rejection (ACR) and antibody-mediated rejection (AMR) post-heart transplantation (HTx). We sought to assess the long-term outcome of pts placed on ECP at our single center. Methods Between 2010-2012, we assessed 235 HTx pts, 10 of which were initiated on ECP. ECP was administered for 2 days, weekly x 4 and once monthly x 5 for 6 months total therapy. Endpoints included subsequent 5-year survival, 5-year freedom from cardiac allograft vasculopathy (CAV) as defined by stenosis ≥ 30% by angiography, 5-year freedom from non-fatal major adverse cardiac events (NF-MACE: defined as myocardial infarction, congestive heart failure, percutaneous cardiac intervention, placement of pacemaker/defibrillator, stroke), 5-year freedom from any-treated rejection (ATR), ACR, and AMR. A control group that was not treated with ECP (n=225) was included. Results The average time to ECP initiation was 1.6 years post-transplant. The ECP group had an average LVEF of 40% (range 23% to 63%) pre-treatment. 8/10 patients were sensitized with a PRA ≥ 10% (range 13% to 90%). The ECP group compared to the control group had a significantly lower subsequent 5-year survival (40.0% vs 79.0%, p=0.001). 6 out of 10 pts on ECP died within 5 years. There was no difference in subsequent 5-year freedom from CAV, NF-MACE, ATR, ACR, and AMR between the groups (see table). Conclusion Heart transplant pts treated with ECP due to high risk factors have reduced long-term survival. It is not clear how much ECP benefited these pts or whether earlier treatment may have been of more benefit. The selection of pts for ECP may be key to improved outcome. Further studies are needed.
The Influence of Environmental Growth Conditions on Salmonella Spectra Obtained from Hyperspectral Microscope Images

Salmonella causes illness in millions of people each year with severe cases resulting in death. Traditional detection methods are well established but are associated with disadvantages such as time or reoccurring sample cost. Hyperspectral microscope imaging (HMI) has shown potential as an early and rapid detection method, identifying bacteria based on spectral signatures unique to the microorganism. Bacteria undergo physiological changes when introduced to environmental stresses. Understanding how these physiological changes impact the resulting cellular spectra is critical to developing robust HMI methodologies for early and rapid detection of bacteria. Salmonella Enteritidis (SE) and Salmonella Typhimurium (ST) were incubated on plate agars of brilliant green sulfa, tryptic soy agar, xylose lysine deoxycholate, and xylose lysine tergitol 4, at incubation pH ranging from 4.7 to 8.3, and at incubation temperatures between 27 and 47 °C. All samples were incubated for 24 h. A principal component analysis (PCA) was performed for each experiment, with Mahalanobis distances (MD) calculated for each sample to its respective cluster’s center, quantifying intraclass variation. One-way ANOVA of MD values showed no significant difference for SE and ST grown on four agars (P > 0.05), or at varying incubation temperatures (P > 0.05). SE and ST incubated at five pH values showed significantly different spectra (P < 0.01). Results suggest that future HMI tools for identifying Salmonella can be developed regardless of the growth media or temperature but should take into consideration acidic growth environments.
A Robust Self-Learning Framework for Cross-Lingual Text Classification

Based on massive amounts of data, recent pretrained contextual representation models have made significant strides in advancing a number of different English NLP tasks. However, for other languages, relevant training data may be lacking, while state-of-the-art deep learning methods are known to be data-hungry. In this paper, we present an elegantly simple robust self-learning framework to include unlabeled non-English samples in the fine-tuning process of pretrained multilingual representation models. We leverage a multilingual model’s own predictions on unlabeled non-English data in order to obtain additional information that can be used during further fine-tuning. Compared with original multilingual models and other cross-lingual classification models, we observe significant gains in effectiveness on document and sentiment classification for a range of diverse languages.
A Retrospective Review of Angiotensin II Use in Adult Patients With Refractory Distributive Shock

Purpose:Catecholamines are first-line vasopressors for hemodynamic support in distributive shock but are associated with adverse effects, which may be mitigated with noncatecholamine vasopressors. ...
Description and Comparison of Health Behaviors to Fitness Measures Among Boy Scouts.

The purpose of this study is to describe, compare, and correlate self-reported health behaviors (HB) to fitness test (FT) measures among boy scouts initiating the Personal Fitness Merit Badge (PFMB) requirements. A descriptive study recruited scouts ages 11-17 years using a sample of convenience. A survey of self-reported responses to physical activity, weight and nutrition, and PFMB required FTs were assessed. Descriptive statistics reported age and survey responses. A pairwise comparison examined the differences in negative and positive survey responses to FT measures; whereas the Spearman Rank correlation analyzed physical education (PE) classes and sports team participation with FT performance. Ninety-nine scouts, age 12.6 (SD 1.4) years, met inclusion criteria. Positive responses to being at a recommended weight and engaging in less screen time demonstrated significantly better performance on pull-ups, push-ups, sit-ups, and one mile run (1MR) tests; whereas scouts reporting to have been physically active at least five times in the past week performed better on the push-ups, sit-ups, and 1MR tests. Improved sit and reach flexibility and sit-up tests were correlated to more days in PE; whereas team sport participation correlated to better 1MR and sit-up test performance. Nutritional practices and reduced screen time demonstrated favorable trends among scouts compared to all-male adolescence nationally; however, weight and physical activity behaviors suggest targeted interventions are warranted. Scouts initiating the requirements of the PFMB may be well-positioned to embark on targeted health behavior changes aimed at achieving long-term healthful lifestyles.
Exploring the Multiplication Table and beyond.

An exploration of the multiplication table for patterns and relationships provides students with an opportunity to increase their understanding of mathematics. In the process, they are reinforcing their knowledge of number facts and practicing their computational skills. But perhaps more important, in their search for patterns and relationships children are not only learning to verbalize their discoveries and to make generalizations about their findings, but also they are developing critical and creative thinking skills.
A review of polymethyl methacrylate (PMMA) as a versatile lithographic resist – With emphasis on UV exposure

Abstract This review describes the utility of polymethyl methacrylate (PMMA) as a resist for several types of lithographic processes. Ordinarily, PMMA is only considered an electron beam resist but in fact it can be used as a resist material with exposure systems based on both particle beams and electromagnetic radiations. In each case, both positive tone and negative tone resist action can be realized with appropriate process design. We first describe and review the mechanisms that bring about lithographic pattern formation in this acrylic polymer. This is followed by descriptions of processes for using PMMA in different ways as a lithographic resist. Use of PMMA at both long and short UV wavelengths is treated in more detail as this aspect is less well-known for lithography with PMMA. We also describe several new findings from own work here, such as cross-linking PMMA with Michler's ketone (MK), use of resist reflow for three-dimensional structure fabrication and lithographic tone switching with change in UV exposure dose. The aim of this exposition is to emphasize the great versatility of PMMA as a resist for micro- and nano-electronic device fabrication.
Deep Brain Stimulation Lead Implantation Using a Customized Rapidly Manufactured Stereotactic Fixture with Submillimetric Euclidean Accuracy

Background The microTargetingTM MicrotableTM Platform is a novel stereotactic system that can be more rapidly fabricated than currently available 3D-printed alternatives. We present the first case series of patients who underwent deep brain stimulation (DBS) surgery guided by this platform and demonstrate its in vivo accuracy. Methods Ten patients underwent DBS at a single institution by the senior author and 15 leads were placed. The mean age was 69.1 years; four were female. The ventralis intermedius nucleus was targeted for patients with essential tremor and the subthalamic nucleus was targeted for patients with Parkinson's disease. Results Nine DBS leads in 6 patients were appropriately imaged to enable measurement of accuracy. The mean Euclidean electrode placement error (EPE) was 0.97 ± 0.37 mm, and the mean radial error was 0.80 ± 0.41 mm (n = 9). In the subset of CT scans performed greater than 1 month postoperatively (n = 3), the mean Euclidean EPE was 0.75 ± 0.17 mm and the mean radial error was 0.69 ± 0.17 mm. There were no surgical complications. Conclusion The MicrotableTM platform is capable of submillimetric accuracy in patients undergoing stereotactic surgery. It has achieved clinical efficacy in our patients without surgical complications and has demonstrated the potential for superior accuracy compared to both traditional stereotactic frames and other common frameless systems.
Risk of Stroke and Bleeding in Atrial Fibrillation Treated with Apixaban Compared with Warfarin.

A previous FDA study reported a favorable benefit risk for apixaban compared with warfarin for stroke prevention in older non-valvular atrial fibrillation (NVAF) patients (≥ 65 years). However, it remains unclear whether this favorable benefit risk persists in other populations including younger users. We examined if a similar benefit risk was observed in the Sentinel System and if it varied by age group. To examine the risk of ischemic stroke, gastrointestinal (GI) bleeding, and intracranial hemorrhage (ICH) in apixaban users compared with warfarin users in Sentinel Distributed Database (SDD). A retrospective new user cohort study was conducted among patients, 21 years and older initiating apixaban and warfarin for NVAF, between December 28, 2012, and June 30, 2018, in the SDD. Cox proportional hazard regression was used to estimate the hazard ratios (HR) and 95% confidence intervals (95% CI) for each outcome (ischemic stroke, GI bleeding, and ICH) in propensity score matched apixaban users compared with the warfarin users. Subgroup analyses by age (21–64, 65–74, and 75+ years) were conducted. After matching, 55.3% and 58.4% (n = 55,038) of the apixaban and warfarin users were included in the main analysis. GI bleeding was the most common outcome. The HR (95% CI) for GI bleeding, ICH, and ischemic stroke in apixaban users compared with warfarin users were 0.57 (0.50–0.66), 0.53 (0.40–0.70), and 0.56 (0.45–0.71) respectively. The reduced risk of these outcomes in apixaban compared with warfarin users persisted across age groups. In NVAF patients of all ages initiating either apixaban or warfarin for stroke prevention in the Sentinel System, apixaban was associated with a decreased risk of GI bleeding, ICH, and ischemic stroke compared with warfarin. Among patients less than 65 years of age, apixaban use was associated with a decreased risk of GI bleeding and ischemic stroke.
In Vitro Characterization of Ertugliflozin Metabolism by UDP-Glucuronosyltransferase and Cytochrome P450 Enzymes.

Ertugliflozin is primarily cleared through UDP-glucurosyltransferase (UGT)–mediated metabolism (86%) with minor oxidative clearance (12%). In vitro phenotyping involved enzyme kinetic characterization of UGTs or cytochrome P450 enzymes catalyzing formation of the major 3-O-β-glucuronide (M5c) and minor 2-O-β-glucuronide (M5a), monohydroxylated ertugliflozin (M1 and M3), and des-ethyl ertugliflozin (M2) metabolites in human liver microsomes (HLMs). Fractional clearance (fCL) from HLM intrinsic clearance (CLint) indicated a major role for glucuronidation (fCL 0.96; CLint 37 µl/min per milligram) versus oxidative metabolism (fCL 0.04; CLint 1.64 µl/min per milligram). Substrate concentration at half-maximal velocity (Km), maximal rate of metabolism (Vmax), and CLint for M5c and M5a formation were 10.8 µM, 375 pmol/min per milligram, and 34.7 µl/min per milligram and 41.7 µM, 94.9 pmol/min per milligram, and 2.28 µl/min per milligram, respectively. Inhibition of HLM CLint with 10 µM digoxin or tranilast (UGT1A9) and 3 µM 16β-phenyllongifolol (UGT2B7/UGT2B4) resulted in fraction metabolism (fm) estimates of 0.81 and 0.19 for UGT1A9 and UGT2B7/UGT2B4, respectively. Relative activity factor scaling of recombinant enzyme kinetics provided comparable fm for UGT1A9 (0.86) and UGT2B7 (0.14). Km and Vmax for M1, M2, and M3 formation ranged 73.0–93.0 µM and 24.3–116 pmol/min per milligram, respectively, and was inhibited by ketoconazole (M1, M2, and M3) and montelukast (M2). In summary, ertugliflozin metabolism in HLMs was primarily mediated by UGT1A9 (78%) with minor contributions from UGT2B7/UGT2B4 (18%), CYP3A4 (3.4%), CYP3A5 (0.4%), and CYP2C8 (0.16%). Considering higher ertugliflozin oxidative metabolism (fCL 0.12) obtained from human mass balance, human systemic clearance is expected to be mediated by UGT1A9 (70%), UGT2B7/UGT2B4 (16%), CYP3A4 (10%), CYP3A5 (1.2%), CYP2C8 (0.5%), and renal elimination (2%). SIGNIFICANCE STATEMENT This manuscript describes the use of orthogonal approaches (i.e., enzyme kinetics, chemical inhibitors, and recombinant enzymes) to characterize the fraction of ertugliflozin metabolism through various UDP-glucuronosyltransferase (UGT) and cytochrome P450 (CYP) enzyme-mediated pathways. Phenotyping approaches routinely used to characterize CYP hepatic fractional metabolism (fm) to estimate specific enzymes contributing to overall systemic clearance were similarly applied for UGT-mediated metabolism. Defining the in vitro metabolic disposition and fm for ertugliflozin allows risk assessment when considering potential victim-based drug-drug interactions perpetrated by coadministered drugs.
Aducanumab and the FDA - where are we now?

The amyloid antibody aducanumab is currently undergoing review by the FDA. The treatment would be the first disease-modifying drug to be approved for Alzheimer disease; however, a medical advisory committee recently convened by the FDA did not recommend approval, raising questions about whether the existing evidence of efficacy is sufficient.
Longer Operative Time Associated with Prolonged Length of Stay, Non-Home Discharge and Transfusion Requirement after Anterior Cervical Discectomy and Fusion: an Analysis of 24,593 Cases

Abstract BACKGROUND Prolonged operative time of single-level ACDF has been associated with adverse postoperative outcomes. The current literature does not contain a comprehensive quantitative description of these associations PURPOSE This study characterized the associations between single-level anterior cervical discectomy and fusion(ACDF) operative time and (1)30-day postoperative healthcare utilization, and (2)the incidence of local wound complications, need for transfusion and mechanical ventilation. DESIGN/SETTING Retrospective database analysis PATIENT SAMPLE The American College of Surgeons National Surgical Quality Improvement Program(ACS-NSQIP) database was queried for single-level ACDF cases(2012–2018) using current procedural terminology codes. A total of 24,593 cases were included. OUTCOME MEASURES Primary outcomes included healthcare utilization(lengths of stay[LOS], discharge dispositions, 30-day readmissions, and reoperations) per operative time category. The secondary outcome was the incidence of wound complications, blood transfusion and need for ventilation per operative time category. METHODS Multivariate regression determined operative time categories associated with increased risk while adjusting for patient demographics and comorbidities. Predictive spline regression models visualized the associations. RESULTS Compared to the reference operative time of 81-100-minutes, the 101-120-minute category was associated with higher odds of LOS >2 days(OR:1.36,95%CI(1.18–1.568);p 2 days(OR:3.367,95%CI(2.719-4.169); p 2 days(OR:4.838,95%CI(4.032–5.804);p 2 days, non-home discharge disposition, reoperation and bleeding requiring transfusion events began to rise, starting at 94, 91.6, 91.6, and 93.3 minutes of operative time, respectively. CONCLUSION This study demonstrated that prolonged operative time is associated with increased odds of healthcare utilization and transfusion after single-level ACDF. Operative times greater than 91 minutes may carry higher odds of postoperative complications.
Seasonal variability in the diet of juvenile European catfish, Silurus glanis, in the Arno River (Italy) in Florence

While approaches for assessing the impact of invasive species are advancing, fundamental autoecological information such as feeding preferences is often unavailable for many invasive species. The European catfish, Silurus glanis, is a well-known, high-impact invasive predator; however, there remain considerable gaps in knowledge about its feeding preferences and biotic interactions that limit ecological impact predictions for this predator. This study is an investigation of seasonal variability in this predator’s diet during the juvenile life stage using the Arno River, Italy as a model system. This study identified significant differences across seasons, provided further information on the dietary spectrum of this species, and raised important questions for further study.
Intraosseous Access Techniques

Clinicians commonly face frustration when working to gain access to a patient’s circulation during emergency situations. Frequently, traditional attempts to establish peripheral intravenous access are complicated by the decreased venous flow seen in patients in shock or cardiac arrest. First described in 1922, intraosseous infusions offer a safe and rapid alternative method of vascular access during emergent resuscitations and carry less risk than accessing larger veins through blind or ultrasound-guided central venous catheterization. Intraosseous access is indicated in patients who are unlikely to have traditional vascular access initiated in a safe or timely manner and is recommended and taught during numerous training programs including Advanced Cardiac Life Support, Advanced Trauma Life Support, Pediatric Advanced Life Support, and Tactical Combat Casualty Care. Clinicians are often reluctant to place an intraosseous needle for fear of causing the patient pain. However, this fear is misplaced as patients report that intraosseous needle placement is less painful than other commonly performed emergent procedures. Pain associated with infusions of large volumes of fluids can be mitigated with the use of intravenous lidocaine. It is important to note that any medication or fluid that can be given through traditional intravenous access may also be delivered through intraosseous access. Infectious complications are rare and are minimized through the use of aseptic technique.
Elevation of fasting serum lipids in patients treated with low-dose cyclosporine for severe plaque-type psoriasis: An assessment of clinical significance when viewed as a risk factor for cardiovascular disease

Background: Hyperlipidemia has received little attention as a side effect of cyclosporine therapy for severe psoriasis. Objective: We report changes in fasting serum lipids in patients treated with low-dose oral cyclosporine for psoriasis and discuss their significance. Methods: Twenty-two patients with severe, recalcitrant, plaque-type psoriasis were treated with cyclosporine, 5 mg/kg/day, for 12 to 16 weeks. Fasting serum lipid levels (triglycerides, cholesterol, and high-density lipoproteins) were measured at 2-week intervals. Results: The mean serum triglyceride level increased from 117.8 ± 11.7 mg/dl before initiation of therapy to 183.9 ± 31.4 mg/dl after 2 weeks of treatment, without further significant change during the remainder of the study ( p p p Conclusion: Serum lipids should be closely monitored in psoriasis patients receiving intermediate or long-term therapy with cyclosporine, especially in the presence of elevated baseline values.
Minimizing blood loss during hepatectomy: A literature review

There are numerous techniques surgeons employ to reduce blood loss during partial hepatectomy. In this literature review, prospective studies from the last 20 years are examined to determine the techniques that are best supported by the literature. Some of the techniques include vascular control, multiple parenchymal transection techniques, various hemostatic agents, low central venous pressure, and hemodilution. The strategies supported most convincingly by the literature include low CVP and total hepatic inflow occlusion.
Transfected human neuropeptide Y cDNA expression in mouse pituitary cells. Inducible high expression, peptide characterization, and secretion.

An expression vector was constructed that placed the cDNA for human neuropeptide Y (NPY) under the control of the mouse metallothionein promoter and was used to transfect the AtT-20 mouse anterior pituitary corticotrope cell line. AtT-20 cells normally process the pro-ACTH/endorphin precursor but do not produce detectable levels of NPY. The resulting AtT-20/NPY cell line (Mt.NPY1a) was used to study the ability of the corticotrope cells to synthesize, process, and secrete the foreign proNPY-related peptide products. The stable cell line created contains approximately 40 copies of proNPY cDNA per cell. NPY mRNA levels and proNPY synthesis were increased at least 35-fold when maximally induced with cadmium; proNPY synthesis was also induced by glucocorticoids. Upon induction the NPY secretion rate was equimolar to that of the endogenous peptides. ProNPY, NPY, and the COOH-terminal peptide produced by this cell line had molecular weight and amino acid-labeling pattern predicted from cDNA sequence data and from previous isolation of NPY-related molecules from NPY-producing cells. The structures of secreted proNPY, NPY, and COOH-terminal peptide, as well as determination of the site of proteolytic cleavage between NPY and the COOH-terminal peptide, were determined by tryptic mapping and Edman degradation of secreted biosynthetically labeled peptide products. The proNPY molecule appears to be processed in the same pathway responsible for cleavage of the endogenous pro-ACTH/endorphin precursor. Secretion of proNPY-derived peptides paralleled secretion of endogenous pro-ACTH/endorphin-derived products, under both basal and stimulated conditions. With induction proNPY expression there is a dose-dependent inhibition of both proNPY and pro-ACTH/endorphin proteolytic processing.
Patient Misconceptions and Ethical Challenges in Radioactive Iodine Scanning and Therapy

The use and nature of radioactive iodine (RAI) are complex topics for patients with thyroid conditions to understand. Fear and anxiety over its use, misinformation in patient advocacy books and on the Internet, medical jargon, confusion regarding postscanning and posttreatment procedures, patient literacy, thyroid health status, and several other socioeconomic factors can create serious barriers to genuine informed consent in RAI scanning and treatment. The following discussion will review the origins of patient misconceptions and misinterpretations, including international differences in physician attitudes regarding RAI usage. Next, this article will present the core ethical duties, problems, and moral dilemmas that can arise in the RAI setting. Upon completion of this article, the reader should be able to describe the core ethical principles of respect for persons (patient autonomy), beneficence, nonmaleficence, and justice; describe the 3 components of informed consent; identify common barriers to informed consent and describe how such barriers can lead to misconceptions, misinformation, and refusal of treatment with RAI; and summarize where RAI candidates and patients first look for information and identify the common ways in which misinformation surfaces.
A gendered perspective on organizational creation

Literature on the creation of organizations is often cast within a masculine gender framework. This paper draws from three theoretical perspectives to develop a new perspective that broadens the vi...
Presence of an unusual methanogenic bacterium in coal gasification waste.

Methanogenic bacteria growing on a pilot-scale, anaerobic filter processing coal gasification waste were enriched in a mineral salts medium containing hydrogen and acetate as potential energy sources. Transfer of the enrichments to methanol medium resulted in the initial growth of a strain of Methanosarcina barkeri, but eventually small cocci became dominant. The cocci growing on methanol produced methane and exhibited the typical fluorescence of methanogenic bacteria. They grew in the presence of the cell wall synthesis-inhibiting antibiotics d-cycloserine, fosfomycin, penicillin G, and vancomycin as well as in the presence of kanamycin, an inhibitor of protein synthesis in eubacteria. The optimal growth temperature was 37°C, and the doubling time was 7.5 h. The strain lysed after reaching stationary phase. The bacterium grew poorly with hydrogen as the energy source and failed to grow on acetate. Morphologically, the coccus shared similarities with Methanosarcina sp. Cells were 1 μm wide, exhibited the typical thick cell wall and cross-wall formation, and formed tetrads. Packets and cysts were not formed. Images
It's on me! the benefit of altruism in BAR environment

Cooperation, a necessity for any peer-to-peer (P2P) cooperative service, is often achieved by rewarding good behavior now with the promise of future benefits. However, in most cases, interactions with a particular peer or the service itself eventually end, resulting in some last exchange in which departing participants have no incentive to contribute. Without cooperation in the last round, cooperation in any prior round may be unachievable. In this paper, we propose leveraging altruistic participants that simply follow the protocol as given. We show that altruism is a simple, necessary, and sufficient way to incentivize cooperation in a realistic model of a cooperative service's last exchange, in which participants may be Byzantine, altruistic, or rational and network loss is explicitly considered. By focusing on network-level incentives in the last exchange, we believe our approach can be used as the cornerstone for incentivizing cooperation in any cooperative service.
Meteorites, Ice, and Antarctica

Bill Cassidy has led meteorite recovery expeditions in the Antarctic for many years. His searches have resulted in the collection of thousands of meteorite specimens from the ice. This fascinating story is a first-hand account of his field experiences on the US Antarctic Search for Meteorites Project, which he carried out as part of an international team of scientists. Cassidy describes this hugely successful field program in Antarctica and its influence on our understanding of the moon, Mars and the asteroid belt. In this 2003 book, he describes the hardships and dangers of fieldwork in a hostile environment, as well as the appreciation he developed for the beauty of the place. In the final chapters he speculates on the results of the trips and the future research they might lead to.
Stimulation of adenylate cyclase in homogenates of isolated intestinal epithelial cells from hamsters. Effects of gastrointestinal hormones, prostaglandins, and deoxycholic and ricinoleic acids.

Abstract The mechanism by which intestinal secretagogues evoke fluid secretion in the small bowel and colon has been suggested to involve mucosal adenylate cyclase. Adenylate cyclase activity was assayed by conversion of [ 32 P]ATP to [ 32 P]cyclic AMP in a system of pure epithelial cells isolated from the small intestine of the hamster by vibration in buffer. Several gastrointestinal hormones were tested for their capacity to stimulate adenylate cyclase; vasoactive intestinal peptide and impure cholecystokinin-pancreozymin (but not the 99% pure preparation or pure cholecystokinin octapeptide) were potent stimuli, but pentagastrin, glucagon, secretin, and gastric inhibitory peptide were impotent. Two prostaglandins, PGE 1 and PGE 2 , were potent stimuli of adenylate cyclase. Two other compounds that provoke intestinal secretion of fluid, deoxycholic acid and ricinoleic acid (castor oil), were ineffective stimuli of adenylate cyclase. These experiments do not support a clear-cut relationship between a compound's ability to stimulate adenylate cyclase and its activity as an intestinal secretagogue.
A Comparison of the Respiratory Function of the Haemocyanins of Vertically Migrating and Non-Migrating Pelagic, Deep-Sea Oplophorid) Shrimps

Present address and address for correspondence: Bamfield Marine Station, Bamfield, B.C. V0R 1B0, Canada. The effects of temperature and pH on haemocyanin oxygen-binding were compared for three species of diurnally vertically migrating and two species of non-migrating, pelagic oplophorid shrimps from the deep sea off the Hawaiian island of Oahu. The effects of L-lactate were also measured for three of these species. Haemocyanin concentrations were higher in the haemolymphs of oplophorids that migrate vertically (39.4, 46.8 and 57.6 mg ml−1) than in those of non-migrators (26.0 and 36.4 mg ml−1). Moderately high Bohr effects were found for vertically migrating and non-migrating oplophorids at all temperatures examined (5–25°C,φ=−0.46 to −0.80, and −0.55 to −0.88, respectively). The vertically migrating species had temperature-sensitive haemocyanins (ΔH=−23.1 to −41.2 kJ mol−1) across the normal temperature range (5–25°C) encountered during diurnal vertical migration. This results in haemocyanins that have relatively high affinities (P50=0.80-1.06 kPa at pH 7.8,5°C) at the low temperatures and low O2 partial pressures (approximately 2.66 kPa O2 at 5°C) found at depth, and low affinities (P50=4.00-4.66 kPa at pH 7.5, 25°C) at the higher temperatures and higher O2 partial pressures (approximately 13.33-17.50 kPa at 25°C) found in the near-surface waters. In contrast, the non-migrating species, which live within a narrower temperature range (3–6°C) and at a constant, low partial pressure of O2 (2.66-4.00 kPa), have haemocyanins with a high affinity for oxygen (P50=0.67-0.93 kPa at pH 7.8, 5°C) and lower sensitivity to temperature (ΔH=−4.2 to −21.6 kJ mol−11). The effects of temperature on the haemocyanin oxygen-affinities of the vertical migrators appear to be highly adaptive, enabling these haemocyanins to be functional across the entire depth (and thus, temperature and oxygen partial pressure) range encountered.
Using ConceptGrid as an easy authoring technique to check natural language responses

ConceptGrid provides a template-style approach to check natural language responses by students using a model-tracing style intelligent tutoring system. The tutor-author creates, using a web-based authoring system, a latticestyle structure that contains the set of required concepts that need to be in a student response. The author can also create just-in-time feedback based on the concepts present or absent in the student's response. ConceptGrid is integrated within the xPST authoring tool and was tested in two experiments, both of which show the efficacy of the technique to check student answers. The first study tested the tutor's effectiveness overall in the domain of statistics. The second study investigated ConceptGrid's use by non-programmers and non-cognitive scientists. ConceptGrid extends existing capabilities for authoring of intelligent tutors by using this template-based approach for checking sentence-length natural language input.
Fusion to C3d Enhances the Immunogenicity of the E2 Glycoprotein of Type 2 Bovine Viral Diarrhea Virus

The use of DNA and protein subunit vaccines in animals provides an opportunity to introduce vaccines that are arguably the safest that can be developed. For that reason, considerable effort is under way to devise methods of enhancing the immunogenicity of such vaccines. Seven years ago it was shown that fusing complement fragment C3d to hen egg lysozyme (HEL) enhanced the immunogenicity of HEL 10,000-fold. Based on this observation, we decided to evaluate the effect of C3d on the immunogenicity of the E2 protein of bovine viral diarrhea virus (BVDV). E2 is the major target of neutralizing antibody during BVDV infection. To test the effect of C3d on E2 immunogenicity, expression cassettes encoding a secreted form of E2 alone (E2s) or E2 fused to three copies of murine C3d (E2s-C3d) were constructed. The proteins were purified from the supernatants of transfected cells and used to immunize mice. The immune response was monitored by an enzyme-linked immunosorbent assay (ELISA) for E2s-specific antibody and by a virus neutralization test. The ELISA results indicated that the E2s-C3d protein is 10,000-fold more immunogenic than the E2s protein alone. The maximum primary immune response was elicited with <0.1 μg of E2s-C3d protein without an adjuvant. In addition, we have shown for the first time that high levels of anti-E2s and neutralizing antibodies can be elicited when this same low concentration of E2s-C3d is used to both prime and boost the immune response. We conclude that the E2s-C3d fusion protein has significant potential as a subunit vaccine against BVDV infection.
Number of active slip systems in polycrystalline brass: Implications for ductility in other structures

Abstract Etching of freshly cut surfaces in deformed polycrystalline brass allows the number of active slip planes to be counted and limits to be placed on the number of active slip systems in interior grains. For all strains and grain sizes tested, fewer than 5 independent slip systems were active in about 40% of the grains; therefore the von Mises demand for 5 slip systems for uniform deformation does not apply. The interpretation here is that deformation is nonuniform even within confined grains in a polycrystal. The implications for polycrystalline deformation in other crystal structures are briefly considered.
The Handedness of Rhesus Monkeys: II. Concurrent Reaching

Of 171 monkeys tested for handedness, 60 were found to make occasional bilateral concurrent reaches. These reaches accounted for only 1.3% of the total of 600 reaches observed for each animal. Younger animals were observed to make such reaches more frequently than older animals. Concurrent reaching was characterized by a lower degree of preference for the overall preferred hand than unilateral reaches made by the same animals at comparable periods of testing.
Strategic management and public organizations: Lessons from the past and prescriptions for the future

The 1990s have become a decade of reflection and rethinking of foundational concepts in the field of public administration. Public adminstrationists are attempting to bring the best of management approaches to bear on the problems facing public organizations. Strategic management has been widely used in the private sector since the 1960s, and has gained increased acceptance in the public sector since the 1980s. It is a management approach that synthesizes much of what management theorists have long recognized as essential to effective management practice. This article traces the development of strategic management and examines what has been learned from the past that will improve future implementation efforts in public organizations.
Does pathologic node status affect local control in patients with carcinoma of the head and neck treated with radical surgery and postoperative radiotherapy

Purpose: To evaluate the effect of pathologic lymph node status and nodal stage on local control at the primary -patients with advanced squamous cell carcinomas of the head and neck, treated with radical surgery and postoperative irradiation. Methods and Materials: Fifty-seven patients with advanced squamous cell carcinomas of the oral cavity, oropharynx, hypopharn~, larynx, and supraglottic larynx were analyzed. All patients underwent resection of the primary lesion, neck dissection, and postoperative radiotherapy. Minimum follow-up was 2 years. The median dose to the primary tumor bed was 60.4 Gray (range 39.7-72.0). Besides pathologic nodal status (pN0 vs. pN+) and nodal stage, the following factors were analyzed for their impact on local control: age, gender, T stage, tumor grade, resection margins, interval from surgery to irradiation, dose to the primary site, and overall treatment time. Results: The 3-year actuarial local control rate was 78%. When all patients were analyzed, nodal status (pN0 vs. pN+)id not affect control at the primary site (71% vs. 82%, p = 0.42). Nodal stage (pNO-N2a va. pN2bN2e) was also not a significant factor for local control (74% vs. 82%, p = 0.57). When only patients with negative margins were analyzed, nodal status again did not impact on local control (79% vs. 90% for pN0 vs. pN+, p = 0.39). On univariate analysis, only tumor grade, margin status, and elapsed days were signifi~nt factors for local control. Local control was 85% for patients with negative margins vs. 60% for those with positive margins (p = 0.016). For patients with moderately and poorly differentiated tumors, local control was 86% as compared to 50% for patients with well~ifferentiated tumors (p = 0.007). When radiotherapy was completed within 50 days, local control was 93% as opposed to 63% for SO days (p = 0.016). On muitivariate analysis, only margin status (p = 0.002) and tumor grade (p = 0.007) remained significant. Conclusion: We conclude that neither the presence of patholo~~lly positive nodes nor nodal stage is a pr~nosti~lly significant factor for local control in patients who have undergone radical surgery and postoperative radiotherapy for advanced squamous cell carcinomas of the head and neck. We do not recommend a change in treatment philosophy, such as an increase in dose to the primary site, based on the pathologic status of the neck. Head and neck carcinomas, Lymph node status, Local control, Combined modality therapy, Radiotherapy.
Normal and shearing contact stresses in indented strips and slabs

Abstract A numerical method is developed for finding the distributions of contact stresses between two and three-dimensional elastic bodies which are pressed together, the area of contact either being free from or subjected to frictional forces. The method is first applied to the plane-stress problem of a strip which is compressed by a rigid, axially-loaded, flat-ended indenter where the contact surfaces are either free to slide over one another (zero friction coefficient) or locked together (large friction coefficient). Numerical values of the contact stresses and displacements are computed in each case for several indenter width vs. strip depth ratios. Corresponding values for a finite-depth slab compressed by an axially-loaded and flat-ended cylindrical indenter are also calculated. Finally, the method is extended to a case where the indentation area varies with the load, and numerical values are calculated for a strip compressed by a rigid circular roller.
Activity of vaccinia virus-neutralizing antibody in the sera of smallpox vaccinees.

Individuals vaccinated against smallpox maintain substantial antiviral antibody responses for many years after vaccination. In this study, we examined the ability of antiviral antibodies from 104 unique serum samples to neutralize the two infectious forms of vaccinia virus, intracellular mature virus (IMV) and extracellular enveloped virus (EEV). While we found direct correlations between antiviral antibody titers and the ability to neutralize IMV and EEV, correlation with EEV neutralization was weaker. To determine factors that may influence more varied EEV neutralization within a vaccinated population, we asked the following questions. (1) Does vaccinia virus-neutralizing ability remain constant over time? (2) Do multiple vaccinations boost IMV and EEV neutralization activity? We found that serum from vaccinated individuals retained ability to neutralize EEV for a relatively long time, but there was a significant drop in EEV neutralization ability in the third decade after vaccination. While all vaccinees maintained some ability to neutralize IMV, a number of individuals lost the capacity to neutralize EEV. Interestingly, the ability to neutralize either virus form was not altered by the number of vaccinations received. Since it is likely that neutralizing antibodies against both IMV and EEV are required for maximal protective immunity, a loss of anti-EEV-neutralizing ability may warrant the revaccination of individuals who have been vaccinated > 20 years ago, should widespread pre-event smallpox vaccination be instituted.