cssi/SciSciGPT-SciSciNet huggingface dataset:
Identification of Knowledge Gaps in Neurosurgery Using a Validated Self-Assessment Examination: Differences Between General and Spinal Neurosurgeons

Objective The practice of neurosurgery requires fundamental knowledge base. Residency training programs and continuing medical education courses are designed to teach relevant neurosurgical principles. Nevertheless, knowledge gaps exist for neurosurgeons and may be different between cohorts of neurosurgeons. The Self-Assessment in Neurological Surgery (SANS) General Examination and Spine Examination are online educational tools for lifelong learning and maintenance of certification. This study examines the gaps in knowledge of spinal neurosurgeons and general neurosurgeons taking SANS. Methods From 2008 to 2010, a total of 165 spinal neurosurgeons completed the 243 available questions of the SANS Spine Examination. Over that same time frame, 993 general neurosurgeons completed the SANS General Spine Examination. Mean scores were calculated and assessed according to 18 major neurosurgical knowledge disciplines. Statistical analysis was carried out to evaluate for significant knowledge gaps among all users and significant differences in performance between spinal neurosurgeons and their general neurosurgeon counterparts. Results The mean overall examination score was 87.4% ± 7.5% for spinal neurosurgeons and 71.5% ± 8.9% for general neurosurgeons ( P n = 165) answered questions incorrectly 15% or greater of the time in five of the categories. The categories of lower performance for spinal neurosurgeons were cerebrovascular, anesthesia and critical care, general clinical, tumor, and trauma. For general neurosurgeons ( n = 993), the five knowledge categories with lowest performance were cerebrovascular, epilepsy, peripheral nerve, trauma, and radiosurgery. Although spinal neurosurgeons and general neurosurgeons shared some areas of decreased performance including trauma and cerebrovascular, spine neurosurgeons relatively underperformed in general clinical, anesthesia andcritical care, and tumor. Conclusions The SANS Spine Examination demonstrated knowledge gaps in specific categories for spinal surgeons. The knowledge areas of diminished performance differed between spinal and general neurosurgeons. Identification of specific areas of deficiency could prove useful in the design and implementation of educational programs and maintenance of certification.
An economical design for a general purpose pH-Stat autotitrator

Abstract The design and construction of the comparator/control unit for a general purpose pH-Stat autotitrator, utilizing solid-state circuitry and readily available components, is described. Circuit values may be chosen so that the sharpness of regulation is adjustable from 0.003 to 0.4 pH units.
Sensor localization in concave environments

In sensor network localization, multihop based approaches have been proposed to approximate the shortest paths to Euclidean distances between pairwise sensors. A good approximation can be achieved when sensors are densely deployed in a convex area, where the shortest paths are close to straight lines connecting pairwise sensors. However, in a concave network, the shortest paths may deviate far away from straight lines, which leads to erroneous distance estimation and inaccurate localization results. To solve this problem, we propose an improved multihop algorithm that can recognize and filter out the erroneous distance estimation, and therefore achieve accurate localization results even in a concave network.
Ion exchange in amorphous alkali-activated aluminosilicates: Potassium based geopolymers

Abstract Ion exchange properties of pure potassium-based geopolymer ( pure K-GP) formulated with Si/Al = 2.1 and K/Al = 1.0 ± 0.02 atomic ratios have been studied. For pure K-GP, the maximum ion-exchange level of K + with respect to Na + and Cs + is 77 and 61%, respectively, as determined by exhausted exchange with 1 M solutions of appropriate nitrates at 22 ± 2 °C. The geopolymer shows a slight preference for K + over Cs + as indicated by the normalized Cs/K-GP isotherm obtained under noncompetitive exchange. Parent geopolymer yields a pure geopolymer when it is extensively washed with deionized water until neutral pH is obtained and equilibrated with aqueous solution of KNO 3 resulting in changing in composition and textural properties. As calculated from N 2 sorption–desorption isotherms, surface specific area and cumulative pore volume for parent K-GP are 5.5 m 2 g − 1 and 0.01 cm 3 g − 1 , respectively, whereas for pure K-GP surface specific area and cumulative pore volume are 270 m 2 g − 1 and 0.4 cm 3 g − 1 , respectively.
All-Optical Physical Layer NACK in AWGR-Based Optical Interconnects

This letter, proposes and experimentally demonstrates an all-optical physical layer negative acknowledgment (AO-NACK) technique to handle contention in array waveguide grating router (AWGR)-based optical interconnects. By using back-propagation in AWGR, the packets experiencing contention are reflected back to the senders in the optical domain to serve as a physical layer negative acknowledgement to trigger the retransmission. A host-switch distance of ≈ 20 m and a packet length of 204.8 ns are used in this proof-of-principle demonstration. Notification of AO-NACKs messages and successful packet retransmission and switching is demonstrated with error-free operation at 10 and 40 Gb/s.
Vertigo and rotational movement in cortical and subcortical lesions

Abstract The case histories of 7 patients with brain tumors, who experienced vertigo or rotational movements, have been presented as a basis for a discussion of the central origin of these symptoms. Six of the neoplasms were in the frontotemporal region and 1 in the parietal area. The value of activation of the EEG focus, and of electrocorticography and depth electrode studies in determining the location and extent of the lesions has been demonstrated. A discussion of the anatomical basis for the development of these symptoms and their relationship to neoplasms and traumatic lesions is included.
Metadesign as an Emergent Design Culture

The concept of metadesign was adopted in the 1980s regarding the use of information technologies in relation to art, cultural theories and design practices (from interactive art to biotechnological design). This article introduces theories and practices of metadesign and contributes to the unfolding of metadesign as an emergent design culture, calling for an expansion of the creative process in the new design space engendered by information technologies.
Community neurorehabilitation: A synthesis of current evidence and future research directions

Over the past decade, community neurorehabilitation has emerged as a promising extension of neurological rehabilitation. The goal of community neurorehabilitation is to maximize functional ability and quality of life through multidimensional rehabilitation that occurs while the individual is living in a home versus acute or transitory care setting. Because of its multidisciplinary focus, many variations of community neurorehabilitation teams have been implemented. Critical gaps exist, however, in understanding of the influence of structural and procedural differences among programs, as well as patient level variables such as social support, on recovery. This paper examines the current evidence of the effectiveness of community neurorehabilitation through a review of the findings of systematic reviews and meta-analyses of four neurological conditions: stroke, multiple sclerosis, traumatic brain injury, and Parkinson’s disease. It focuses in particular on the data regarding physical therapy and occupational therapy, which are two of the primary components of community neurorehabilitation, programs.
Evaluation of normal and abnormal sensing functions of demand pacemakers

Abstract The performance of demand (ventricular-inhibited) pacemakers may be evaluated by relatively simple techniques that greatly facilitate the interpretation of complex arrhythmias related to their sensing mechanism. Simple procedures to assess the demand function include the following: (1) Measurement of the QRS signal delivered to the pacemaker by recording unipolar and bipolar electrograms from the pacemaker catheter. (2) Measurement of the pacemaker refractory period after the emission of a pacing pulse and after sensing of a spontaneous beat by chest wall stimulation. The latter procedure may also demonstrate the capability of the pacemaker to sense spontaneous ventricular depolarization during apparent fixed-rate pacing. (3) Observation of QRS sensing during subthreshold ventricular stimulation. Arrhythmias related to the demand mechanism may be considered to originate from (1) apparent malfunction; (2) undersensing of the QRS complex, despite proper positioning of the catheter in the right ventricle, as a result of (a) delivery of a poor signal to a normally functioning pacemaker, or (b) the delivery of an adequate signal to a malfunctioning pacemaker; (3) oversensing of potentials such as (a) physiologic voltage of P and T waves, (b) interruption of the non-symmetrical biphasic wave form representing the return of energy to the pacemaker after delivery of its brief pacing pulse, (c) extra-corporeal voltages such as leakage of current from equipment in contact with the body or from distant radiofrequency or electromagnetic fields.
Histoplasma mechanisms of pathogenesis – one portfolio doesn't fit all

Histoplasma capsulatum is the leading cause of endemic mycosis in the world. Analyses of clinical isolates from different endemic regions show important diversity within the species. Recent molecular studies of two isolates, the Chemotype I NAm2 strain G217B and the Chemotype II Panamanian strain G186A, reveal significant genetic, structural, and molecular differences between these representative Histoplasma strains. Some of these variations have functional consequences, representing distinct molecular mechanisms that facilitate Histoplasma pathogenesis. The realization of Histoplasma strain diversity highlights the importance of characterizing Histoplasma virulence factors in the context of specific clinical strain isolates.
Late Pleistocene Glacial Stratigraphy and Chronology, Northeastern St Elias Mountains, Yukon Territory, Canada

Drift morphology and stratigraphic relations of drift sheets and weathering zones indicate four glaciations separated by three nonglacial intervals in the northeastern St. Elias Mountains, Yukon Territory, Canada. Ice of the two oldest glaciations (Shakwak and Icefield) flowed through Slims River valley into Shakwak Valley near Kluane Lake. Ice of the subsequent glaciation (Kluane) entered Shakwak Valley through valleys draining the Icefield Ranges, flowed northwest along Shakwak Valley with a thickness locally exceeding 3530 feet, and terminated in the vicinity of Snag near the Yukon-Alaska boundary. The last glaciation (Neoglaciation) was much more restricted. During the two oldest nonglacial intervals (Silver and Boutellier), Shakwak Valley was ice-free; during the third non-glacial interval (Slims), ice receded more than 13 miles upvalley from the present Kaskawulsh Glacier terminus. Twenty C 14 dates combine to give the following late Pleistocene chronology in the areas studied: Shakwak glaciation (>49,000 B.P.), Silver non-glacial interval (>49,000 B.P.), Icefield glaciation (start >49,000 B.P., end approximately 37,700 B.P.), Boutellier nonglacial interval (start approximately 37,700 B.P., end Comparison of C 14 -dated glacial events in Yukon-Alaska (as recorded in the St. Elias Mountains and in the Brooks Range) with glacial events in Washington and British Columbia, pluvial events at Searles Lake, California, and fluctuations of the Laurentide Ice Sheet in the Great Lakes region suggests, with reservations, that some major late Wisconsin climatic fluctuations in Yukon-Alaska and these other regions were broadly synchronous. However, sufficient detail is not yet available to make firm conclusions about correlation of minor climatic fluctuations during these times.
Prediction of the coronal structure for the solar eclipse of March 7, 1970.

ON March 3, I made a prediction of the coronal structure of the March 7, 1970, eclipse of the Sun. The model employed is similar to that used for the prediction of the coronal structure at the eclipse of September 22, 1968, and details of the method are described in ref. 1. Observations of this eclipse seem to support2 the model: “there is a general similarity between the two drawings” (prediction and observation)3, and a sketch of the observations “agrees well with the prediction; had Schatten drawn his streamers more nearly radial, the agreement would have been almost perfect”4.
Deformation near a fault termination, part I: A fault in a clay experiment

Abstract Strike-slip faults were induced in a 5.5 cm-high clay cake by moving slowly half of the supporting base plate. The strain at 24 sample points near the termination of one of the faults was determined by measuring the preferred orientation of the basal planes of kaolinite crystals with an X-ray pole-figure goniometer and by calculating the strain according to the theory of March (1932). Each observed strain is the result of two consecutive strains. The first strain is due to the compaction of the clay under its own weight before the experiment. It is uniform throughout the clay cake and was sampled at points remote from faults. The second strain is variable and is due to the faulting. In order to separate the two strains and to find the “tectonic” strain alone, a strain with the orientations and magnitudes of the “pretectonic” strain was made, by calculation, to act on a hypothetical body that had first undergone the inverse of the observed strain. The result is the inverse of the “tectonic” strain, converted by an easy calculation into the “tectonic” strain itself. A contoured map of the shear strain (ϵ 2 –ϵ 3 )/2 shows great similarity with the maximum resolved shear stress distribution found by Chinnery and Petrak (1968) to exist theoretically in a semi-infinite elastic medium at the end of a dislocation surface representing a strike-slip fault. Unstraining the fault and superposing the unstrained configuration on the strained one allowed the construction of the displacement field. It resembles displacement fields determined near several natural strike-slip faults.
On the relation between V2 and the second position cliticization

Abstract Following the standardly adopted hypothesis of a uniform diachronic source of V2 in Germanic and second position cliticization (2P), the paper investigates both operations in order to verify common claims concerning the motivation for the V2 and 2P movement. It shows that neither of them can be analyzed as a PF-driven phenomenon, nor is it possible to attribute them to a uniform syntactic trigger, such as Tense or Illocutionary Force feature checking. Special attention is given to the 2P effect in Slavic, whose properties show that it is necessary to draw a distinction between the “generalized” 2P, which is a syntactic process but seems unrelated to any feature checking mechanism, and Force-related 2P, which occurs for Force/Operator feature checking. The findings concerning 2P are applied to draw conclusions about the trigger of V2 in Germanic. It is argued that V2 covers a number of unrelated cases of movement or base generation, whose only common property is the position of the verb after the first constituent. Therefore, it seems incorrect to attribute all cases of V2 to a uniform syntactic trigger, in particular to Force marking.
Infección por Cryptosporidium parvum en una mujer embarazada, inmunocompetente, con riesgo ocupacional

Cryptosporidioses is a parasitic zoonoses generated by diverse Cryptosporidium species. This coccidiosis affects multiple vertebrate species, including human beings. In Chile, as it happens in other countries, cryptosporidioses is a low frequency infection in immunocompetent individuals, acquiring a big relevance in immunocompromised ones. We present the following case: a recently graduated student from Veterinary medical school, with a 20 week pregnancy, living in “Laguna Verde” area in the Region of Valparaiso and who was infected with Cryptosporidium sp. Etiologic diagnosis was made by Ziehl Neelsen, and nested PCR followed by PCR product sequencing. During the same period, the infection was detected in her cats which were asymptomatic. In all of them, her and the cats, the species identifi ed was Cryptosporidium parvum. Her husband and her other pets were all asymptomatic and non infected. This is the fi rst report of a possible cryptosporidioses transmission between humans and cat.
Autonomic dysfunction in the Lambert-Eaton myasthenic syndrome Serologic and clinical correlates

Autonomic dysfunction is a recognized feature of the Lambert-Eaton myasthenic syndrome (LES). However, the characteristic pattern of dysautonomia has not been clearly documented and its pathophysiologic basis is not known. We therefore abstracted autonomic symptomatology and results of quantitative tests for salivation, and vasomotor, cardiovagal, and sudomotor reflexes from records of 30 LES patients. Dry mouth (77%) and impotence (45% of men) were the most common symptoms. Composite Autonomic Scoring Scale results were abnormal in 93% of patients, and autonomic failure was severe in 20%. The frequency of specific test abnormalities were the following: sudomotor function, 83%; cardiovagal reflexes, 75%; salivation, 44%; and adrenergic function, 37%. Although voltage-gated N-type calcium (Ca2+) channels are implicated in autonomic transmission, the low frequency of serum antibodies to N-type Ca2+ channels found in the patients of this study (31% positive) argues against a pathogenic role in mediating LES-related dysautonomia. In contrast, 93% of the patients were seropositive for P/Q-type Ca2+ channel antibodies. A subset of these antibodies is thought to impair neuromuscular transmission. Autoantibodies of thyrogastric or glutamic acid decarboxylase specificity (markers of predisposition to type 1 diabetes mellitus) were found in 45% of patients, and type 1 antineuronal nuclear antibody (or anti-Hu, a marker of autoimmune neuropathy associated with small-cell lung carcinoma) was found in 3%. No autoantibody correlated with autonomic dysfunction severity. Sensorimotor neuropathy was documented in five patients, and was not significantly associated with autonomic neuropathy. Autonomic failure was most severe in older subjects with cancer (p = 0.02, age by cancer interaction).
User Evaluations of Adaptive Scanning Patterns in the CASA Spring Experiment 2007

The Engineering Research Center for Collaborative Adaptive Sensing of the Atmosphere (CASA) is creating a new paradigm for weather observation based on low cost, densely spaced networks of X-band radars. These networks adapt their scanning strategy based on the evolving weather and user needs for data. This paper presents the results of an evaluation by National Weather Service forecasters and academic researchers of the dynamically reconfigurable radar scanning patterns that operated in CASA's prototype test bed in southwest Oklahoma in spring 2007. The evaluation demonstrates that a pilot group of users were satisfied overall with CASA's scanning patterns. The evaluation also uncovered needed improvements to the scanning strategy that have been subsequently implemented. Through this iterative cycle of design, implementation, evaluation, we have demonstrated the flexibility of the system architecture and our ability to modify existing and add new capabilities to increase the benefits of CASA radar systems.
A demo search engine for products

Most product search engines today build on models of relevance devised for information retrieval. However, the decision mechanism that underlies the process of buying a product is different than the process of locating relevant documents or objects. We propose a theory model for product search based on expected utility theory from economics. Specifically, we propose a ranking technique in which we rank highest the products that generate the highest surplus, after the purchase. We instantiate our research by building a demo search engine for hotels that takes into account consumer heterogeneous preferences, and also accounts for the varying hotel price. Moreover, we achieve this without explicitly asking the preferences or purchasing histories of individual consumers but by using aggregate demand data. This new ranking system is able to recommend consumers products with "best value for money" in a privacy-preserving manner. The demo is accessible at http://nyuhotels.appspot.com/
Respiratory morbidity in a coffee processing workplace with sentinel obliterative bronchiolitis cases.

Rationale Obliterative bronchiolitis in former coffee workers prompted a cross-sectional study of current workers. Diacetyl and 2,3-pentanedione levels were highest in areas for flavoring and grinding/packaging unflavored coffee. Methods We interviewed 75 (88%) workers, measured lung function, and created exposure groups based on work history. We calculated standardized morbidity ratios (SMRs) for symptoms and spirometric abnormalities. We examined health outcomes by exposure groups. Results SMRs were elevated 1.6-fold for dyspnea and 2.7-fold for obstruction. The exposure group working in both coffee flavoring and grinding/packaging of unflavored coffee areas had significantly lower mean ratio of forced expiratory volume in 1 s to forced vital capacity and percent predicted mid-expiratory flow than workers without such exposure. Conclusion Current workers have occupational lung morbidity associated with high diacetyl and 2,3-pentanedione exposures, which were not limited to flavoring areas. Am. J. Ind. Med. 58:1235–1245, 2015. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.
EFFECT OF STAPHYLOCOCCUS INFECTION ON ACID AND ALKALINE PHOSPHATASE IN BRUISED POULTRY TISSUE

SUMMARY increasing severity of trauma elicited marked differences in both acid and alkaline phosphatases. The former is a lysosomal enzyme; whereas, the latter is a nonlysosomal enzyme. The magnitude of enzymatic responses as a result of trauma was not the same for each enzyme. Acid phosphatase activity increased in the bruised tissue while alkaline phosphatase activity decreased. The bound form of acid phosphatase increased in the bruised tissue, a form of the enzyme absent in normal tissue. The following factors seem to play an important role on the activities of these enzymes in poultry tissues: age of trauma, severity of the bruise and staphylococcal infection. Rates of changes in the enzymatic activities after infection were directly related to the number of organisms in the infecting dose and induced an alteration in the activities of alkaline phosphatase in the bruised tissue from a decreased to an increased value compared to normal level.
Procedural Headache Medicine in Neurology Residency Training: A Survey of US Program Directors

Objective To survey neurology residency program directors (PDs) on trainee exposure, supervision, and credentialing in procedures widely utilized in headache medicine. Background Clinic-based procedures have assumed a prominent role in headache therapy. Headache fellows obtain procedural competence, but reliance on fellowship-trained neurologists cannot match the population eligible for treatments. The inclusion of educational modules and mechanisms for credentialing trainees pursuing procedural competence in residency curricula at individual programs is not known. Methods A web-based survey of US neurology residency PDs was designed by the American Headache Society (AHS) procedural special interest section in collaboration with AHS and American Academy of Neurology's Headache and Facial Pain section leadership. The survey addressed exposure, training, and credentialing in: (1) onabotulinumtoxinA (onabotA) injections, (2) extracranial peripheral nerve blocks (PNBs), and (3) trigger point injections (TPIs). Results Fifty-five PDs (42.6%) completed the survey. Compared to noncompleters, survey completers were more likely to feature headache fellowships at their institutions (38.2% vs 10.8%, P=0.0002). High exposure (onabotA=90.9%, PNBs=80.0%, TPIs=70.9%) usually featured hands-on patient instruction (66.2%) and lectures (55.7%). Supervised performance rates were high (onabotA=65.5%, PNBs=60.0%, TPIs=52.7%), usually in continuity clinic (60.0%) or headache elective (50.9%). Headache specialists (69.1%) or general neurology (32.7%) faculty most commonly trained residents. Formal credentialing was uncommon (16.4-18.2%), mostly by documenting supervised procedures (25.5%). Only 27.3% of programs permitted trainees to perform procedures independently. Most PDs felt procedural exposure (80.0-90.9%) and competence (50.9-56.4%) by all trainees was important. Conclusions Resident exposure to procedures for headache is high, but credentialing mechanisms, while desired by most PDs, are not generally in place. Implementation of a credentialing process may ensure trainees enter practice with the ability to perform procedures safely and effectively.
Monitoring and verification of the Comprehensive Nuclear Test‐Ban Treaty

The Comprehensive Nuclear Test‐Ban Treaty prohibits the testing of nuclear weapons and establishes an international monitoring system to collect data for international verification of the treaty. The objective of verification is to discriminate between nuclear explosions and all other events detected by the monitoring system. Monitoring is performed through a network of seismological, radionuclide, hydroacoustic and infrasound stations. The data will be collected and analyzed at the International Data Center in Vienna, and the results of the analyses will be used to verify compliance or detect non‐compliance. For all the simplicity of the concept, there are questions about the effective operation of the international verification regime. The treaty establishes an elaborate system for collecting and processing the data from the monitoring stations, but it is ambiguous on the decision‐making process for ascertaining non‐compliance. This paper describes the objectives and architecture of the International Monitoring System and its relationship to the verification goals of the treaty.
BORROWING TO COPE WITH ADVERSE HEALTH EVENTS: LIQUIDITY CONSTRAINTS, INSURANCE COVERAGE, AND UNSECURED DEBT

This article uses data from the Health and Retirement Study for 1998–2010 to investigate whether households respond to the financial stress caused by health problems by increasing their unsecured debt. Results show both the probability of having unsecured debt and the amount of debt increase after an adverse health event among households with low financial assets, who are uninsured, or who have less generous health insurance. The effect of health problems on borrowing is caused by both medical expenditures and disruptions to the income stream. Unsecured debt seems to remain on some households' balance sheets for an extended period. Copyright © 2012 John Wiley & Sons, Ltd.
Controller Synthesis from LSC Requirements

Live Sequence Charts (LSCs) is a visual requirements language for specifying reactive system behavior. When modeling and designing open reactive systems, it is often essential to have a guarantee that the requirements can be satisfied under all possible circumstances. We apply results in the area of controller synthesis to a subset of the LSC language to decide the realizability of LSC requirements. If realizable, we show how to generate system responses that are guaranteed to satisfy the requirements. We discuss one particular implementation of this result which is formulated as an extension of smart play-out, a method for direct execution of scenario-based requirements.
THE EFFECTS OF OXIDATION AND PARTIAL HYDROGENATION OF DIETARY SOY OIL ON RAT LIVER MICROSOMAL FATTY ACID DISTRIBUTION AND THE RESULTING INFLUENCE ON THE MIXED FUNCTION OXIDASE SYSTEM

Abstract The lipid content and fatty acid composition of liver microsomes from rats fed 5% or 20% fresh or oxidized soy oil and from rats fed 20% fresh or oxidized partially hydrogenated soy oil were determined. Dietary inducers, namely, phenobarbitone (PB) and β-naphthofavone (NF) were also included in similar diets that contained 20% levels of oil. The results indicated (1) that the microsomal fatty acid distributions reflected that of the dietary oil but was modulated by dietary inducers; (2) that there was a threshold for the microsomal incorporation of 18:3 fatty acids; (3) that NF promoted or allowed chain lengthening of 18:2 and 18:3 to their longer chained homologues 20:4 and 22:6, respectively while PB inhibited such lengthening; (4) that de novo synthesis of microsomal phospholipid was due to incorporation of dietary 18:2 and 18:3 and/or the subsequent chain lengthening to 20:4 and 22:6, respectively; (5) that the non-enzymatic ascorbate mediated uptake of oxygen by liver microsomes was modulated by dietary induced changes in microsomal phospholipid composition and that PB acted as a pro-oxidant and NF behaved like an antioxidant and (6) that enzymatic mediated uptake of oxygen by microsomes or a hydroperoxide was substrate dependent and that oxygen uptake could be modulated by dietary lipid induced changes in the phospholipid moiety (fatty acid composition) and/or changes in the rate of synthesis of varying species of cytochrome P-450.
The impact of hematocrit drop on long-term survival after cardiac catheterization: insights from the Dartmouth Dynamic Registry.

Background: The long-term prognostic implication of post-procedural hematocrit drops in patients undergoing cardiac catheterization outside the clinical trial setting is not well defined. Methods: Data was prospectively collected from 12,661 patients undergoing diagnostic or interventional cardiac catheterization between July 1998 and July 2006. Patients were divided into three cohorts based upon the degree of hematocrit change: drop greater than 6, drop between 3 and 6, and drop less than 3. In-hospital major adverse events, 30-day mortality, and long-term all-cause mortality were recorded. Results: Patients with larger reductions in hematocrit were more likely to be older, female, and have a higher baseline hematocrit, present with acute myocardial infarction, develop cardiogenic shock, require emergent catheterization, develop retroperitoneal bleeds and large hematomas, receive transfusions, have longer index hospitalizations, develop subacute stent thrombosis, and have higher 30-day and long-term mortality. An increase in long-term mortality was observed with progressive hematocrit drop. This finding is largely driven by early (30 day) mortality, as trends were no longer significant after rezeroing mortality. Hematocrit drop was not an independent risk factor for 30-day mortality. Transfusion and low baseline hematocrit were identified as independent predictors of near and long-term mortality. Conclusions: Periprocedural bleeding, defined by hematocrit drop, is associated with increased near-term and long-term mortality in patients undergoing diagnostic and therapeutic cardiac catheterization procedures. Long-term mortality is largely driven by up front 30-day mortality. Hematocrit drop was not an independent predictor for near-term mortality. Transfusion and low baseline hematocrit were independent predictors for near and long-term mortality. © 2009 Wiley-Liss, Inc.
Anger and post-traumatic stress disorder in female crime victims

This study examined feelings of anger among female victims of crime and the relation of anger to the development of post-traumatic stress disorder (PTSD). One hundred and sixteen women who had been victims of sexual or nonsexual criminal assaults were compared to a matched comparison group of 50 nonvictimized women on measures of anger and anger expression. Results indicate that victims were angrier than nonvictims. The level of anger was related to various aspects of the assault, such as the use of a weapon and the victim's response to the attack. In addition, the results indicate that elevated anger is positively related to the development of PTSD. Results are discussed in relation to a cognitive/behavioral conceptualization of PTSD.
Contralateral effect of topical β-adrenergic antagonists in initial one-eyed trials in the Ocular Hypertension Treatment Study

Abstract PURPOSE: To evaluate the magnitude of the contralateral effect of topically administered β-blockers on intraocular pressure. METHODS: The Ocular Hypertension Treatment Study enrolled 1,636 subjects. Of these, 817 subjects were randomized to receive topical ocular hypotensive medication and 819 subjects were randomized to close observation (i.e., no topical medication). We compared the intraocular pressure of the contralateral eye of subjects at the baseline visit and after an initial one-eyed therapeutic trial of topical β-blockers. We examined differences between baseline and follow-up intraocular pressure in untreated eyes of subjects randomized to close observation. RESULTS: The mean reduction in intraocular pressure in the β-blocker–treated eyes was −5.9 ± 3.4 mm Hg (−22% ± 12%; Student t test, P P CONCLUSIONS: The contralateral effect is important in clinical practice and in clinical trials when the hypotensive effect of a topical β-blocker is evaluated by means of a one-eyed therapeutic trial.
FRACTAL TRANSITION STEPS TO FRACTAL STAGES: THE DYNAMICS OF EVOLUTION, II

Successful applications of hierarchical complexity to the behaviors of organisms, animals and humans, and social entities evidence the scaling properties of self-similarity, thus the bounded fractal characteristics of orders of hierarchical complexity. The theory specifies an identical sequence of discrete-state transition steps required from each stage of performance to the next. It repeats at all scales. Tasks nested within the step sequence evidence self-similarity with the orders of complexity. This model introduces questions about noise categories when system tasks are fully accounted for, dependent, self-similar, and measurable. Ubiquitous transition steps are inherent dynamics of evolution.
Predicting Everyday Functional Abilities of Dementia Patients With the Mini-Mental State Examination

The Mini-Mental State Exam (MMSE) is a widely used cognitive screening measure. The purpose of the present study was to assess how 5 specific clusters of MMSE items (i.e., subscores) correlate with and predict specific areas of daily functioning in patients with dementia. Sixty-one patients with varied forms of dementia were administered the MMSE and an observation-based daily functional test (the Direct Assessment of Functional Status; DAFS). The results revealed that the orientation and attention subscores of the MMSE correlated most significantly with nearly all of the functional domains. The MMSE language items correlated with all but the DAFS shopping and time orientation tasks, while the MMSE recall items correlated with the DAFS time orientation and shopping tasks. Stepwise regression analyses found that among the MMSE subscores, orientation was the single, best independent predictor of most of the DAFS functional domains, with language, attention and recall subscores accounting for additional variance on DAFS functional tasks. These results indicate that the MMSE is not only a good cognitive screening tool, but its specific subsores can predict functional disabilities in patients with dementia.
COMBUSTION OF SOLIDS IN AN ACOUSTIC FIELD

In this investigation, the effects of acoustic oscillations on the combustion of solid fuel were studied. Burning rates and pollutant emissions were measured while burning 'cardboard samples with and without pulsations in cold and preheated combustion air. The burning can be divided into two phases: a luminous, gas flame phase, followed by a smoldering, surface reaction phase. In the work reported here, acoustic oscillations significantly reduced flaming and smoldering combustion times in both cold and preheated combustion air experiments. The reduced combustion times can be attributed to increased heat transfer(to the pyrolyzing sample surface) and mass transfer(of oxygen to and combustion products from the burning surface respectively) by pulsations. Flaming combustion time was also reduced, to a lesser degree, by increasing the combustion chamber temperature, both with and without pulsations present. This reduction was mainly due to reduced ignition time at higher temperature. Total CO and NOX emissions were affected by both the combustion chamber temperature and the presence of oscillations. In cold flow tests, total pollutant emissions were independent of pulsations. During combustion with preheated air, however, less CO and more NOX were emitted than in cold flow tests. This effect was further amplified by adding acoustic oscillations.
Perception of clusters in statistical maps

SUMMARY Two experiments observed performance on a cluster identification task across a variety of common statistical maps. Stimulus maps displayed mortality rates for several diseases and subjects had to identify regions of the map that were perceived to form a cluster of particularly high (or low) mortality. Subjects marked the perceived centroid of each cluster, and analyses focused on the dispersion of centroid location across subjects. Under these circumstances, monochrome classed choropleth maps were found to minimize dispersion, compared to a two opposing colours scheme, a dot density map, a pie map, and a categorical (hue-based) colour scheme. Maps using a famiUar geographical unit (i.e. a U.S. state) supported better recall of the information than maps using less familiar and smaller geographical units. The results were found to be interpretable within current cognitive theory.
The irritable uterus: A risk factor for preterm birth?

Abstract OBJECTIVE: Our aim was to determine the incidence and preterm delivery rate along with the indication for delivery in patients with uterine irritability. STUDY POPULATION: In this retrospective, descriptive study, 17,186 patients with well-defined high-risk factors were compared with 2637 women with uterine irritability. RESULTS: The incidence of preterm labor in patients with uterine irritability was 18.7%, significantly less than in those with other high-risk factors (odds ratio 0.35, 0.31 CONCLUSIONS: The incidence of preterm labor in women with uterine irritability is not as frequent as in patients with other high-risk factors. However, preterm labor does occur in patients with uterine irritability at a rate higher than that in the general obstetric population (18.7% vs 11.0%). Because it appears that women with uterine irritability have more resistance to conventional tocolytic therapy, this condition should prompt the physician to use more aggressive perinatal assessment.
Filling the gap: Developing health economics competencies for baccalaureate nursing programs

Abstract Background The need for greater involvement of the nursing profession in cost containment efforts has been documented extensively. More thorough education of nurses in the subject of health economics (HE) is one of the factors that could contribute toward achievement of that goal. Purpose The project's main contribution is the development of the unique list of essential HE competencies for baccalaureate nursing students. Methods The proposed competencies were developed and validated using the protocol by Lynn (1986) for two-stage content validation of psychometric instruments. An additional validation step that included a nationwide survey of nurse administrators was conducted to measure the value they place on the health economics–related skills and knowledge of their employees. Results A set of six HE competencies was developed. Their validity was unanimously approved by the panel of five experts and additionally supported by the survey results (with individual competencies' approval rates of 67% or higher). Conclusions The incorporation of economic thinking into the nationwide standards of baccalaureate nursing education, and professional nursing competencies, will enhance the capacity of the nursing workforce to lead essential change in the delivery of high-value affordable health care nationwide.
Effect of incorporating controlled-release fertilizer on adventitious rooting and growth of Artemisia, Gaura, and Nepeta.

Controlled-release fertilizer was incorporated into the rooting substrate to determine its effect on adventitious rooting and subsequent growth of three herbaceous perennials: Artemisia ludoviciana ‘Valerie Finnis,’ Gaura lindheimeri ‘Whirling Butterflies,’ and Nepeta x faassenii ‘Six Hills Giant.’ Nutrient treatments consisted of a control, and four treatments each of Nutricote® 13–13–13 Type 180 and 18–6–8 Type 180 at 3, 6, 9, and 12 g/liter (5, 10, 15, and 20 lbs/cu yd) incorporated into the rooting substrate. These treatments equate to N rates of 0, 0.38, 0.77, 1.16, 1.54, 0.53, 1.07, 1.6, and 2.13 g/liter (N at 0, 0.65, 1.3, 1.95, 2.6, 0.9, 1.8, 2.7, and 3.6 lbs/cu yd), respectively. Incorporating controlled-release fertilizer into the rooting substrate at levels equal to or greater than 0.77 g/liter (1.3 lbs/cu yd) increased shoot dry weights, but had no effect on adventitious rooting and little influence on root number or root dry weight. This in turn influenced shoot:root ratios and potentially plant quality. There was no difference between the two formulations. Index words: vegetative propagation, herbaceous perennials, Nutricote®, controlled-release fertilizer. Species used in this study: white sage (Artemisia ludoviciana Nutt.‘Valerie Finnis’), white gaura (Gaura lindheimeri Engelm. & Gray ‘Whirling Butterflies’), and catmint (Nepeta x faassenii Bergmans ex Stearn. ‘Six Hills Giant’).
Extranuclear-initiated estrogen signaling and cancer

Proc Amer Assoc Cancer Res, Volume 46, 2005 SY14-2 Estrogen action through estrogen receptors (ER) in the nucleus transcribes genes that contribute to the cellular biological actions of estrogen, actions that participate in the biology of breast and uterine cancer. Another pool of ER localizes to the plasma membrane of breast cancer cells. This ER pool acts as atypical G protein coupled receptor proteins, resulting in downstream signaling through kinases that impact the proliferation and survival of breast cancer cells. Existing evidence favors the idea that the membrane-localized receptor is the nuclear receptor, translocated to the cell membrane. In breast cancer, the ability of membrane-localized ER to signal is dependent on a cross-talk activation of the EGF or ErbB2 receptors, or in some instances, the IGF1R. Activation of the growth factor tyrosine kinase receptors results in signaling through ERK and PI3 kinases to G1/S and G2/M cell cycle progression. This occurs through activating key cell cycle kinases such as CDK4 and CDC2, and through the upregulation of cyclins D1 and B transcription. All these events, activated by estradiol, EGF, or IGF1, are significantly inhibited by intact BRCA1, as a novel tumor suppressor function. In contrast, mutant BRCA1 found in women with this neoplasm does not restrain proliferative signaling from the membrane, a potential contributant to neoplastic transformation. Another pool of ER has been recently localized to the mitochondria of several cell types including breast cancer cells (MCF-7). We have recently found that estradiol can act at this receptor pool to inhibit key events for radiation-induced apoptosis. This occurs through estrogen preventing activation of the intrinsic mitochondrial death pathway, providing an additional mechansism by which the sex steroid unfortunately acts as a survival factor for breast cancer.
Teams or Communities? Organizational Structures for Knowledge Management

Organizations are looking for new organizational structures in order to improve their knowledge management. Knowledge management is a general umbrella concept that covers many different processes, but here we limit ourselves to three specific knowledge management processes: knowledge creation, knowledge legitimization, and knowledge sharing. With this purpose in mind, we examine and define two types of group structures: teams and communities; and we elaborate propositions on their advantages and disadvantages for creating, legitimizing, and sharing knowledge in organizations.
Conflicts of Interest? The Ethics of Usury

Social attitudes toward usury (here defined using the archaic meaning as the taking of interest on loans) have changed dramatically over the centuries. From antiquity until the Protestant Reformation, usury was regarded as an inherently evil activity. Today, with few exceptions, usury is met with moral indifference. Modern objections to usury are limited to protest against "excessive" interest rates rather than interest per se. With this change in focus, the very meaning of the term "usury" has also changed. Many early pronouncements against the taking of interest emphasized the plight of the poor, but ironically, the poor actually pay the highest rates of interest in the modern American economy. Despite the universality of usury, some socio-economic subcultures still manage to avoid the taking or giving of interest. Orthodox branches of both Judaism and Islam have maintained bans on usury throughout the centuries and up to the present time. This is especially interesting in the case of Judaism, given the popular cultural image of the Jew as usurer. Jewish free loan systems may actually offer a model for modern loan programs that can be designed to aid poor borrowers, who are frequently shut out of mainstream financial services.
Sustainability in a Hospital-Based Biobank and University-Based DNA Biorepository: Strategic Roadmaps

Sustainability in the biobanking community has recently become an important and oft-discussed issue as biorepositories struggle to balance limited external funding and complex cost recovery models with high operating costs and the desire to provide the highest quality materials and services to the research community. A multi-faceted view of biobanking sustainability requires consideration of operational and social sustainability in addition to the historical focus exclusively on financial sustainability. Planning and implementing this three pillar model creates a well-rounded biorepository that meets the needs of all the major stakeholders: the funders, the patients/depositors, and the researcher recipients. Often the creation of a detailed business plan is the first step to develop goals and objectives that lead down a path towards sustainability. The definition of sustainability and the complexity of a sustainable business plan may differ for each biorepository. The DNASU Plasmid Repository at Arizona State University stores and distributes DNA plasmids to researchers worldwide, and the Biobank Core Facility at St. Joseph's Hospital and Barrow Neurological Institute consents patients and collects, stores, and distributes human tissue and blood samples. We will discuss these two biorepositories, their similar and different approaches to sustainability and business planning, their challenges in creating and implementing their sustainability plan, and their responses to some of these challenges. From these experiences, the biobanks share lessons learned about planning for sustainability that are applicable to all biorepositories.