cssi/SciSciGPT-SciSciNet huggingface dataset:
State Variability in Assisted Living Residents' End-of-Life Care Trajectories.

Abstract Objective A growing and increasingly vulnerable population resides in assisted living. States are responsible for regulating assisted living and vary in their requirements. Little is known about how this variability translates to differences in the dying experiences of assisted living residents. The objective of this study is to describe assisted living residents’ end-of-life care trajectories and how they vary by state. Design Observational retrospective cohort study. Setting and Participants Using Medicare data and a methodology developed to identify beneficiaries residing in larger assisted living communities (25+ beds), we identified a cohort of 40,359 assisted living residents in the continental United States enrolled in traditional Medicare and who died in 2016. Methods We used Medicare data and the Residential History File to examine assisted living residents’ locations of care and services received in the last 30 days of life. Results Nationally, 57% of our cohort died outside of an institutional setting, that is, hospital or nursing home (n = 23,165), 18,396 of whom received hospice at the time of death. Rates of hospitalization and transition to a nursing home increased during the last 30 days of life. We observed significant interstate variability in the adjusted number of days spent in assisted living in the month before death [from 13.6 days (95% confidence interval [CI] 11.8, 15.4) in North Dakota to 24.0 days (95% CI 22.7, 25.2) in Utah] and wider variation in the adjusted number of days receiving hospice in the last month of life, ranging from 2.1 days (95% CI 1.0, 3.2) in North Dakota to 13.8 days (95% CI 12.1, 15.5) in Utah. Conclusions and Implications Findings suggest that assisted living residents’ dying trajectories vary significantly by state. To ensure optimal end-of-life outcomes for assisted living residents, state policy makers should consider how their regulations influence end-of-life care in assisted living, and future research should examine factors (eg, state regulations, market characteristics, provider characteristics) that may enable assisted living residents to die in place and contribute to differential access to hospice services.
Intrinsic connectome organization across temporal scales: New insights from cross-modal approaches

The discovery of a stable, whole-brain functional connectivity organization that is largely independent of external events has drastically extended our view of human brain function. However, this d...
Response to: 'Antimalarial use and arrhythmias in COVID-19 and rheumatic patients: a matter of dose and inflammation?' by Erre et al .

We read the comment by Erre et al to our correspondence about hydroxychloroquine (HCQ) use during the COVID-19 with great interest.1 2 As also highlighted by others, antimalarial use such as HCQ during the COVID-19 pandemic has the potential for cardiotoxicity.3 4 Patients with COVID-19 and those with rheumatic disease represent distinct populations with different dosing strategies. We agree that the potential for cardiotoxicity from antimalarials may also be different related to these issues. The authors present interesting data on QTc intervals in patients with rheumatoid arthritis (RA) on maintenance HCQ, drawn from an established cohort of patients without known significant underlying cardiovascular disease. While these patients had statistically significant higher QT intervals on HCQ compared with those on other disease-modifying antirheumatic drugs (DMARDs), the mean remained within normal limits so this difference is unlikely to have a …
Where I Can Be Myself: Helga Crane’s Quest for Home in Quicksand

In this chapter, I advocate applying Homi Bhabha’s concept of the “unhome” to teaching Nella Larsen’s novel Quicksand in a study abroad course to Copenhagen, Denmark. This chapter connects Helga Crane’s biracial identity to her feeling of “unhome” as the catalyst for her journey from the south, to Chicago, to Harlem, to Copenhagen, and ultimately the United States again. Finally, the text exposes how travel does not fully offer solutions for characters struggling with racism in the United States and foreshadows the difficulties later writers experience trying to navigate America’s complex racial milieu.
Fast neutron mutagenesis in soybean creates frameshift mutations

The mutagenic effects of ionizing radiation have been used for decades to create novel variants in experimental populations. Fast neutron (FN) bombardment as a mutagen has been especially widespread in plants, with extensive reports describing the induction of large structural variants, i.e., deletions, insertions, inversions, and translocations. However, the full spectrum of FN-induced mutations is poorly understood. We contrast small insertions and deletions (indels) observed in 27 soybean lines subject to FN irradiation with the standing indels identified in 107 diverse soybean lines. We use the same populations to contrast the nature and context (bases flanking a nucleotide change) of single nucleotide variants. The accumulation of new single nucleotide changes in FN lines is marginally higher than expected based on spontaneous mutation. In FN treated lines and in standing variation, C→T transitions and the corresponding reverse complement G→A transitions are the most abundant and occur most frequently in a CpG local context. These data indicate that most SNPs identified in FN lines are likely derived from spontaneous de novo processes in generations following mutagenesis, rather than from the FN irradiation mutagen. However, small indels in FN lines differ from standing variants. Short insertions, from 1 - 6 base pairs, are less abundant than in standing variation. Short deletions are more abundant and prone to induce frameshift mutations that should disrupt the structure and function of encoded proteins. These findings indicate that FN irradiation generates numerous small indels, increasing the abundance of loss of function mutations that will impact single genes.
Permian millipedes from the Fort Sill fissures of southwestern Oklahoma, with comments on allied taxa and millipedes preserved in karstic environments

Permian millipedes are rare, especially so considering the relative abundance of millipedes in Carboniferous rocks. We report an early Permian millipede fauna containing three new genera and species of millipedes (Oklahomasoma richardsspurense new genus new species, Karstiulus fortsillensis new genus new species, and Dolesea subtila new genus new species) found in fossil-producing pockets of the Fort Sill fissures exposed in the Dolese Quarry near Richards Spur, southwest Oklahoma, USA. These are the first new genera of invertebrates to be described from this site, one of the most prolific fossil-vertebrate sites in the world. We also comment on taxa with morphological similarities and note previously described occurrences of Permian millipedes as well as occurrences of fossil myriapods (millipedes and centipedes) in karst deposits (caves and fissure fills) in Europe, Africa, Asia, North America, and the Caribbean. In contrast with the forms found at Richards Spur, most of these previous accounts of millipedes found in caves and fissure fills are of Pleistocene forms that are closely allied to modern taxa. The taxa from Richards Spur bear some similarities to Pennsylvanian forms. Karst (cave and fissure) faunas should be ranked with concretion faunas, cannel coals, and amber faunas as a major source of fossil myriapods. UUID: http://zoobank.org/5d58e1fb-4e5b-4597-9cd9-5cc9e2096b4d
Psoriatic arthritis: the role of the nonphysician clinician in the diagnosis and treatment of patients with psoriasis

Psoriatic arthritis is a clinically heterogeneous, chronic, and progressive disease that develops in up to 30% of patients with psoriasis and is characterized by multiple and increasing joint defects caused by persistent immune-mediated inflammation. Several treatment options are available, including multiple biologic agents that inhibit specific cellular mediators of inflammation either directly or indirectly. Early detection and intervention are critical to preventing severe joint damage and pain, necessitating increased awareness and education about this disease for primary providers and nonphysician clinicians. Physician assistants and nurse practitioners, given their role in the primary care setting and within multiple specialty areas such as dermatology and rheumatology, are often the first to see patients who may have psoriatic arthritis. These healthcare providers are increasingly important in the early diagnosis and treatment of this disease. In this review, we provide an overview of psoriasis and psoriatic arthritis and discuss the multiple treatment options that are available for these patients. We also discuss ways to help recognize early joint involvement in the clinic and emphasize the role that nonphysician clinicians play in the care of patients with psoriatic arthritis.
Faster Deterministic Approximation Algorithms for Correlation Clustering and Cluster Deletion

Correlation clustering is a framework for partitioning datasets based on pairwise similarity and dissimilarity scores, and has been used for diverse applications in bioinformatics, social network analysis, and computer vision. Although many approximation algorithms have been designed for this problem, the best theoretical results rely on obtaining lower bounds via expensive linear programming relaxations. In this paper we prove new relationships between correlation clustering problems and edge labeling problems related to the principle of strong triadic closure. We use these connections to develop new approximation algorithms for correlation clustering that have deterministic constant factor approximation guarantees and avoid the canonical linear programming relaxation. Our approach also extends to a variant of correlation clustering called cluster deletion, that strictly prohibits placing negative edges inside clusters. Our results include 4-approximation algorithms for cluster deletion and correlation clustering, based on simplified linear programs with far fewer constraints than the canonical relaxations. More importantly, we develop faster techniques that are purely combinatorial, based on computing maximal matchings in certain auxiliary graphs and hypergraphs. This leads to a combinatorial 6-approximation for complete unweighted correlation clustering, which is the best deterministic result for any method that does not rely on linear programming. We also present the first combinatorial constant factor approximation for cluster deletion.
Physical Appearance, Grooming, and Fitness

Appearance plays a pivotal role in an individual's career success. This chapter focuses on the importance of physical appearance, grooming, and fitness. One should do the most with what one is born with. Slim, fit, well-groomed, and tastefully dressed people enjoy advantages. A person's attire is an expression of culture with accents of individuality. Slim and fit individuals dressed casually, tastefully, and elegantly send a powerful message. Dress, weight, and general appearance have a double effect; one feels better about oneself and this then radiates and is perceived by others with whom one comes into contact. Certain aspects of appearance are inherited and one can do nothing about it, but other aspects can be worked on for better career prospects. The chapter also mentions the common problems related to appearance that are faced by most men and women. A sloppy and obese person has fewer chances of being successful compared with a smart, slim, and well-groomed individual. The chapter specifies how these things can be worked on.
Conduct disorder in girls: A review of the literature.

The study of Conduct Disorder (CD) has primarily been limited to boys. The lack of research resulted from a premise that CD in girls was rare. However, CD in girls is a relatively common psychiatric diagnosis, and appears to be associated with several serious outcomes, such as Antisocial Personality Disorder and early pregnancy. Understanding gender differences in the course and severity of CD may lead to important information about etiology. Empirical studies on precursors, developmental course, risk factors and treatment for CD in girls are reviewed, while highlighting similarities and differences between girls and boys. Generally, CD symptoms in girls are stable. Precursors to CD in girls probably include Oppositional Defiant Disorder and temperamental factors, but also may include certain negative cognitions. What distinguishes CD in girls is the high risk they have to develop comorbid conditions, especially internalizing disorders. Risk factors for CD in girls partly overlap with those known for boys, but some factors appear to be highly salient for girls. Finally, there may be some significant effects of gender on treatment efficacy. Implications of these findings for future etiologic research are discussed.
Abstract P2-01-12: Impact of the ASOCOG Z0011 trial on a multi-institutional mixed practice setting

Background The ASOCOG Z0011 trial is widely considered to be practice changing, but reports to date on the adoption of Z0011 are largely confined to tertiary academic institutions with breast cancer surgical specialty services. The aim of this study was to assess the impact of Z0011 on the care of breast cancer patients in a mixed academic/ non-academic practice setting. Methods All patients who underwent surgical treatment for breast cancer in the Vidant Healthcare System, a multi-county network, between the years January 1, 2009 and September 20, 2013 were identified. Patients with Stage IV disease and ductal carcinoma in situ were excluded. Results One thousand six hundred four patients met initial inclusion criteria, 661 in the pre-Z0011 period and 973 in the post-Z0011 period. The majority of patients were female (99%) and Caucasian (65%). Infiltrating ductal cancer (67%) was the most common tumor type. Tumors on average were 23mm in size with the majority being ER (74%), PR (63%) positive and Her2 (82%) negative. Most patients had node negative disease (73%). Table 1 summarizes the characteristics of the pre- and post-Z0011 study populations. A total of 142 patients met Z0011 criteria, with T1-2 disease, underwent partial mastectomy and had a positive SNB. There were a similar number of patients who met Z00111 criteria in the pre- (n=63) and post-Z0011 (n=79) periods, p>0.05. In the post-Z0011 period, patients were more likely to undergo SNB alone (56 vs. 19%, p Conclusion In this mixed practice setting there was an overall decrease in ALND in T1/T2 patients with low metastatic axillary burden following publication of Z0011. Immediately post-Z0011 the non-academic practices more rapidly adopted SNB alone, however these differences were no longer apparent two years following Z0011. Continued longitudinal studies will further assess the variability in the incorporation of Z0011 among various surgical practices. Citation Format: Swapnil D Kachare, Nasreen A Vohra, Kathyrn M Verbanac, Timothy L Fitzgerald, Emmanuel E Zervos, Jan H Wong. Impact of the ASOCOG Z0011 trial on a multi-institutional mixed practice setting [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-01-12.
Introduction to Quantum Mechanics

In Chapter 0 we saw that classical mechanics was incapable of explaining the optical spectra emitted by atoms or even the existence of atoms. Bohr developed a model for the atom of hydrogen by assuming the quantization of the angular momentum, which was an introduction to wave or quantum mechanics. Quantum mechanics is a more precise approach to describe nearly all physical phenomena which reduces to classical mechanics in the limit where the masses and energies of the particles are large or macroscopic.
Regulatory roles of the NMDA receptor GluN3A subunit in locomotion, pain perception and cognitive functions in adult mice

Since the discovery of the glutamate NMDA receptor subunit 3A (GluN3A), the functional role of this unique inhibitory subunit has been largely obscure. GluN3A expression is high in the neonatal brain but declines to a low level in the adult brain; it is thus commonly believed that GluN3A does not have a major functional impact in adulthood. Using wild-type (WT) and GluN3A knockout (KO) mice, we show here that deletion of GluN3A affected multiple behavioural functions in adult animals. GluN3A KO mice showed impaired locomotor activity on a variety of motor function tests, and increased sensitivity to acute and sub-acute inflammatory pain. GluN3A KO mice also showed enhanced recognition and spatial learning and memory functions. Hippocampal slices from juvenile and adult GluN3A KO mice showed greater long-term potentiation (LTP) compared with WT slices. GluN3A deletion resulted in increased expression of Ca(2+)/calmodulin-dependent kinase II (CaMKII) in the forebrain, and the phosphorylated CaMKII level upon LTP induction was significantly higher in the GluN3A KO hippocampus compared with WT controls. CaMKII inhibition abrogated the enhanced LTP in GluN3A KO slices. These data reveal for the first time that the presence of GluN3A may have profound impacts on several functional/behavioural activities in adult animals, and could be a therapeutic target for neurological disorders associated with NMDA receptor functions.
Associations among Depressive Symptoms, Dating Violence, and Relationship Power in Urban, Adolescent Girls

ABSTRACT Objective To explore the associations among dating violence (DV), aggression, relationship power, and depressive symptoms. Design A cross‐sectional survey secondary analysis. Setting An urban, school based health center, October, 2009 through May, 2009. Participants Low income, adolescent girls ( n = 155), ages 14–18. Methods Descriptive and bivariate analyses were conducted to illustrate patterns and associations among variables. Key variables included depressive symptoms, DV victimization and aggression, and relationship power. We used mediation analyses to determine the direct and indirect effects among variables. Results Both DV victimization and aggression were reported frequently. Furthermore, DV victimization had a significant direct effect on depression and an indirect effect through relationship power. Depressive symptoms and relationship power were associated with DV aggression. Although relationship power did have a significant inverse effect on depressive symptoms, it was not through DV aggression. Conclusions Complex associations remain between mental health and DV; however, relationship power partially accounts for DV victimization's effect on depressive symptoms. Depressive symptoms are associated with DV victimization and aggression; therefore, nurses should address relationship power in clinical and community interventions.
Design of a Web-based Symptom Management Intervention for Cancer Patients

The discipline of Human-Computer Interaction design has potential for significant benefit to the field of health informatics. This paper describes the design approach used to develop a web-based interface to help cancer patients manage their chemotherapy side effects. Previous versions of this intervention utilizing telephone technology had been efficacious, but limited. The paper discusses the design decisions made in order to leverage the potential benefits of the Internet in supporting patients while avoiding the potential pitfalls that the patients may encounter with a web-based approach.
Degrees of captivity and aggressive behavior in domestic Norway rats

Six categories of aggressive behaviors were studied in groups of domestic rats observed for 3 months and in three settings of varying degrees of captivity. In the least captive situation, a large outdoor pen, aggression frequently took a wild-type form (aggressive side postures, biting attacks) and infrequently took a “playful” form (pins, aggressive grooms) relative to aggression shown by rats in the most captive situation, laboratory cages. Rats housed in an intermediate degree of captivity showed intermediate levels of both serious and playful types of aggression. Male and female intruders were attacked by residents of all three settings, most seriously in the outdoor pen. These results indicate that captivity may have a powerful effect on the form of aggression shown by domestic rats.
Widespread expression of corticotropin-releasing factor messenger RNA and immunoreactivity in the rat olfactory bulb.

Abstract Immunohistochemical, in situ hybridization histochemical, and Northern blot methods were used to demonstrate and charaterize the distribution of corticoptropin-releasing immunoreactivity (CRF-IR) and mRNA in the rat olfactory system. Northern analysis demonstrated the presence of an mRNA species in the olfactory bulb indistinguishable from, and in greater abundance than, CRF and mRNA isolated from whole hypothalamus. Results from hybridization histochemical and immunohistochemical studies converged to indicate tha CRF is expressed in a majority of mitral and tufted in the main accessory bulbs, and in subsets of granule and periglo3erular cells. Consistent with cellular localization in primary output neurons, a dense network of fine CRF-immunoreactive varicosities was demonstrated in the external plexiform layer of the olfactory bulb and in layer Ia of piriform cortex. Other acknowledged terminal fields of the projection neurons of the main and accessory bulbs also displayed CRF-IR. The results suggest that CRF is the most broadly distributed neuroactive agent yet charted in olfactory bulb somata. This peptide may serve as a modulator or co-transmitter of importance in several cell types in the main and accessory olfactory bulbs, including the principal output neurons.
40.3: Distinguished Student Paper: Dual Mode Reflective Cholesteric Display

We developed a dual mode reflective cholesteric display which works in the traditional bistable mode as well as in a monostable mode. In the bistable mode, it is operated between the reflecting planar state and non-reflecting focal conic state, both of which are stable at zero voltage. The bistable mode is suitable to display static images. In the monostable mode, it is operated on all the intermediate states between the planar and focal conic states. It is fast and has low driving voltage, and can exhibit gray levels of reflectance determined by the applied voltage. The monostable mode is suitable to display video rate dynamic images.
Cross section measurements for neutron-induced reactions in Ti, Fe and Ni at several neutron energies ranging from 70.7 to 151.6 MeV

Abstract Cross sections for neutron-induced reactions producing relatively short-lived radionuclides were measured in natural targets of Ti, Fe and Ni using quasi-monoenergetic neutron beams at several different neutron energies between 70.7 and 151.6 MeV. Comparisons of these new measurements were made with energy integrated cross section measurements and reported data measured at low neutron energies as well as with MC-ALICE calculations. These cross section measurements are part of a systematic study to measure relevant cross sections needed to better understand cosmic ray interactions with extraterrestrial materials.
Plasma post-heparin lipolytic activity in hyperchylomicronemia (fat-induced lipemia)☆

Abstract 1. 1. Low levels of plasma post-heparin lipolytic activity, assayed in vitro , were observed in three siblings with hyperchylomicronemia, a heritable disorder characterized by markedly increased levels of serum triglyceride transported as chylomicrons ( S f > 5000). Although no evidence of inhibitors was observed in pre- or post-heparin plasma from these hyperchylomicronemic siblings, in vitro studies with esterase and lipase inhibitors demonstrated that plasma post-heparin lipolytic activity in these siblings was relatively less inhibited by NaCl, sodium deoxycholate, Triton, or sodium dodecyl sulfate than was the post-heparin lipolytic activity in plasma from subjects with other types of hyperglyceridemia or from subjects with normal serum triglyceride concentrations. 2. 2. The lipolytic activity in post-heparin plasma was measured using individual triglycerides containing C 4 through C 18 fatty acids as substrates. The plasma tributyrinase activity was normal in the siblings with hyperchylomicronemia, whereas the rates of lipolysis for triglycerides containing C 8 through C 18 fatty acids were low. Lipolytic activity in the plasma of these hyperchylomicronemic siblings had a relative substrate specificity (the ratio of the rate of lipolysis of an individual triglyceride to that of tricaprin) for triglycerides containing longer-chain fatty acids similar to that for subjects with other types of hyperglyceridemia. The K m value of the lipolytic activity in post-heparin plasma differed several-fold between the siblings with hyperchylomicronemia and the other subjects studied. 3. 3. It is suggested that subjects with hyperchylomicronemia have a genetically determined structural abnormality of the lipolytic enzyme or enzymes resulting in a lessened hydrolysis of triglycerides containing longer-chain fatty acids.
Structural Control of Poly(Methyl Methacrylate)-g-poly(Lactic Acid) Graft Copolymers by Atom Transfer Radical Polymerization (ATRP)

Atom transfer radical copolymerization of methyl methacrylate (MMA) and (meth)acrylate-terminated poly(lactic acid) (PLA) macromonomers was investigated. The relative reactivity of methacrylate-terminated macromonomer (1/rMMA = 1.75) and acrylate-terminated macromonomer (1/rMMA = 0.61) was close to that of 2-hydroxyethyl methacrylate and 2-hydroxyethyl acrylate, respectively. The difference in reactivity in ATRP and conventional radical polymerization is discussed in terms of the diffusion control effect. A mixture of methacrylate-terminated macromonomer and acrylate-terminated macromonomer was copolymerized with MMA by ATRP to give a homogeneously branched PMMA-g-PLA graft copolymer with low polydispersity (Mw/Mn = 1.15).
Beyond the Entrepreneurial City: Municipal Capitalism in San Diego

Over the last several decades the public sector has become much more innovative and entrepreneurial when pursuing downtown redevelopment, embracing characteristics previously restricted to the priv...
Ski Regulates Muscle Terminal Differentiation by Transcriptional Activation of Myog in a Complex with Six1 and Eya3

Overexpression of the Ski pro-oncogene has been shown to induce myogenesis in non-muscle cells, to promote muscle hypertrophy in postnatal mice, and to activate transcription of muscle-specific genes. However, the precise role of Ski in muscle cell differentiation and its underlying molecular mechanism are not fully understood. To elucidate the involvement of Ski in muscle terminal differentiation, two retroviral systems were used to achieve conditional overexpression or knockdown of Ski in satellite cell-derived C2C12 myoblasts. We found that enforced expression of Ski promoted differentiation, whereas loss of Ski severely impaired it. Compromised terminal differentiation in the absence of Ski was likely because of the failure to induce myogenin (Myog) and p21 despite normal expression of MyoD. Chromatin immunoprecipitation and transcriptional reporter experiments showed that Ski occupied the endogenous Myog regulatory region and activated transcription from the Myog regulatory region upon differentiation. Transactivation of Myog was largely dependent on a MEF3 site bound by Six1, not on the binding site of MyoD or MEF2. Activation of the MEF3 site required direct interaction of Ski with Six1 and Eya3 mediated by the evolutionarily conserved Dachshund homology domain of Ski. Our results indicate that Ski is necessary for muscle terminal differentiation and that it exerts this role, at least in part, through its association with Six1 and Eya3 to regulate the Myog transcription.
In-Plane Stiffness and Yield Strength of Periodic Metal Honeycombs

In-plane mechanical properties of periodic honeycomb structures with seven different cell types are investigated in this paper. Emphasis is placed an honeycambs with relative density between 0.1 and 0.3, such that initial yield is associated with short column compression or bending, occurring prior to elastic buckling. Effective elastic stiffness and initial yield strength of these metal honeycombs under in-plane compression, shear, and diagonal compression (for cell structures that manifest in-plane anisotropy) are reported as functions of relative density. Comparison among different hancycomb structures demonstrates that the diamond cells, hexagonal periodic supercells composed of six equilateral triangles and the Kagome cells have superior in-plane mechanical properties among the set considered.
Extraction of Th(IV) as a mixed complex, nitrate or chloride, by 2-ethylhexyl hydrogen 2-ethylhexyl phosphonate

Abstract The extraction of Th(IV) from aqueous perchlorate, chloride and nitrate aqueous phases into a solution of an acidic phosphonate, generally represented as (GO)(G)PO(OH), dissolved in a carrier diluent is reported for the first time. Specifically, 2-ethylhexyl hydrogen 2-ethylhexyl phosphonate, (EHO)(EH)PO(OH), dissolved in toluene has been employed as the extractant phase. From a nitrate phase, Th(IV), in tracer level concentration, is extracted as two mono-nuclear species containing one and two nitrate groups per atom of Th(IV), respectively. The extraction of the two-nitrate entity is favoured, with respect to that of the one-nitrate entity, as the acidity of the aqueous phase increases. The K for each of these species appears to be third-power dependent upon the concentration of the (EHO)(EH)PO(OH), which is dimeric in the diluent employed. The extraction of a nitrate-free entity is negligible under the conditions of the investigation. In saturation experiments, the empirical composition of the extract, as determined by gross analyses, is Th(NO 3 ) 1·9 (EH[EHP]) 2·2 . From a chloride phase, the extract in tracer-level studies contained a chloride-free and a one-chloride species. The K values for these two species are third-power and 2·5-power extractant dependent, respectively. In saturation experiments, the empirical composition of the extract, as determined by gross analyses, is Th(Cl) 0·9 (EH[EHP]) 2·9 . The perchlorate behaviour parallels that of the chloride system, except that the extractant dependency is third-power. The empirical composition of the extract, in saturation experiments, is Th(ClO 4 ) 0·4 (EH[EHP]) 3·7 .
Ischaemia-induced negative U waves in electrocardiograms (an experimental study in canine hearts)

To confirm the clinical impression that negative U waves are a sign of myocardial ischaemia, and to study their possible mechanism, we performed open chest experiments on dogs with the following results. (1) A negative U-wave tended to appear at the peripheral rather than the central portion of the cyanotic zone following coronary artery occlusion; (2) it also appeared temporarily at the central ischaemic area after release of coronary artery occlusion; (3) it became apparent or accentuated with augmentation of left ventricular performance at a postextrasystolic beat; and (4) it was eliminated by infusion of K+-free Tyrode solution, but appeared after an infusion of high K+-Tyrode solution into the regional coronary artery. These results indicate that negative U waves are a sign of myocardial ischaemia, which may be related not only to simple myocardial stretching but also to contraction and external high K+ in the ischaemic area.
Antibiotics for simple upper respiratory tract infections: a survey of academic, pediatric, and adult clinical allergists

Background The Centers for Disease Control and Prevention (CDC), the American Academy of Family Practice, and the American Academy of Pediatrics published guidelines for judicious antibiotic use: antibiotics are injudicious for the treatment of short-term purulent rhinorrhea, otitis media with effusion, and acute wheezy bronchitis. Objective To determine how academic, pediatric, and adult clinical allergists differed in use of antibiotics for upper respiratory tract infections (URIs). Methods Surveys were sent to 424 allergists in private clinical practice and 156 allergists in academic settings. Three clinical pediatric vignettes were described. Questions about possible antibiotic use followed. Vignettes were as follows: simple URI in a toddler, the same child with short-duration green rhinorrhea, and the same child with otitis media with effusion. Results Of 580 mailed surveys, 358 were returned, for an overall response rate of 61.7%. Thirty-nine of these surveys did not meet inclusion criteria, reducing the response rate to 55.0%. Of these, 47.0% (n = 150) were familiar with the guidelines: 85.3% answered that they usually adhered to them in practice. The academic allergist respondents demonstrated the best adherence to the guidelines for the 3 vignettes, followed closely by the clinical pediatric allergist respondents. For the population surveyed, adult clinical allergists were more likely than the other 2 groups to prescribe antibiotics for a simple URI ( P P = .004). Conclusions Academic allergists adhered to the CDC guidelines more closely than did adult allergists. Pediatric allergists in clinical practice were in agreement with the academic allergists. Despite self-reported knowledge of the CDC guidelines, many adult allergists in clinical practice did not adhere to them in their answers to the questions after several vignettes.
Motivational and Volitional Variables Associated with Stages of Change for Exercise in Multiple Sclerosis: A Multiple Discriminant Analysis.

The main objective of this study was to determine whether motivational and volitional variables identified in the health action process approach (HAPA) model can be used to successfully differentia...
Genomic structure, mapping, activity and expression of fibroblast growth factor 17.

Fibroblast growth factors are essential molecules for development. Here we characterize Fgf17, a new member of the fibroblast growth factor (FGF) family. The Fgf17 gene maps to mouse chromosome 14 and is highly conserved between mouse and human (93% identity). It exhibits 60% amino acid identity with Fgf8 and 50% identity with Fgf18. Both Fgf8 and Fgf17 have a similar structure and a similar pattern of alternative splicing in the 5′ coding region. When expressed in 3T3 fibroblasts, mouse FGF17 is transforming, indicating that it can activate the ‘c’ splice form of either FGF receptor (FGFR) one or two. During midgestation embryogenesis, in situ hybridization analysis localized Fgf17 expression to specific sites in the midline structures of the forebrain, the midbrain-hindbrain junction, the developing skeleton and in developing arteries. Comparison to Fgf8 revealed a striking similarity in expression patterns, especially in the central nervous system (CNS), suggesting that both genes may be important for CNS development, although Fgf17 is expressed somewhat later than Fgf8. In the developing skeleton, both genes are expressed in costal cartilage while Fgf8 is preferentially expressed in long bones. In the developing great vessels Fgf17 is preferentially expressed, suggesting that it may have a more prominent role in vascular growth.
Post-Colonial Reformation? Hybridity in 16th-Century Christianity:

The author considers the utility of post-colonial theory, specifically Homi Bhabha’s notion of hybridity, for its conceptualization of religious diversity and transformation in the German Reformation. She argues that an explicit discourse on the respective ‘‘purity’’ of the confessions should be read in the context of cultural practices that draw not on signs of difference and purity but on cultural commonalities and thus constitute hybridities. This process can be seen in the commemoration of Luther’s death, which relies on traditional Catholic notions of the good Christian death to support its evangelical claims. Using ‘‘hybridity’’ may be a way to circumvent diffculties in the confessionalization paradigm.
Determination of diffusion coefficients from instantaneous current measurements and the kloutecky equation

Abstract Disagreements between experimental polarographic currents and those predicted by the Koutecký equation often arise from failure to consider depolarizer concentration depletion and the influence of back pressure on the time-dependent flow rate of mercury from the dropping mercury electrode. The magnitudes of these effects have been made negligible by measuring maximum currents on first drops and by adjusting the capillary constants. With proper consideration of the assumptions implicit in the mathematical model and careful experimental measurements, the use of the Koutecký current-time relationship has yielded polarographic diffusion coefficients for lead(II), zinc(II), and thallium(I) which agree with tracer values within 2%. The use of all three terms in the equation is shown to be justified. A computer program which utilized the Bolzano bisection reduced tedious calculations.
BATH TUB NEAR-DROWNING AS A MANIFESTATION OF THE CHILD NEGLECT SYNDROME: CLINICAL, BIOCHEMICAL AND SOCIAL ASPECTS

BATH TUB NEAR-DROWNING AS A MANIFESTATION OF THE CHILD NEGLECT SYNDROME: CLINICAL, BIOCHEMICAL AND SOCIAL ASPECTS
Gaussian effective potential: Quantum mechanics

We advertise the virtues of the Gaussian effective potential (GEP) as a guide to the behavior of quantum field theories. Much superior to the usual one-loop effective potential, the GEP is a natural extension of intuitive notions familiar from quantum mechanics. A variety of quantum-mechanical examples are studied here, with an eye to field-theoretic analogies. Quantum restoration of symmetry, dynamical mass generation, and "quantum-mechanical resuscitation" are among the phenomena discussed. We suggest how the GEP could become the basis of a systematic approximation procedure. A companion paper will deal with scalar field theory.
Crystal growth of alkaline earth fluorides in a reactive atmosphere. Part II

Abstract Crystal growth of MF2 (M = Ca, Sr, and Ba) is carried out under two different reactive atmospheres, HF and HF + CF4, with the same carrier gas (He). The effect of processing is seen in a comparison of the optical transparency in the near infrared of the single-crystal specimens.
Measurement of sexual arousal in male homosexuals: effects of instructions and stimulus modality.

Erections were measured in 20 male homosexual subjects under three instructional conditions and within three stimulus modalities. The three conditions were arousal (e.g., imagine yourself involved and get aroused), suppression (e.g., imagine yourself involved but suppress erection responses), and rearousal (e.g., imagine yourself involved and get aroused). The three stimulus modalities studied were video tapes, slides or pictures, and audio tapes of homosexual cues. The results show that video tape generates the highest level of arousal, audio tape the lowest level of arousal, and slides an intermediate level. Both video tape and slides show substantial voluntary suppression effects. During suppression, video tape continues to elicit relatively high levels of arousal in contrast to slides and audio tapes, which are equally low.
The ADP/ATP translocator is not essential for the mitochondrial permeability transition pore

A sudden increase in permeability of the inner mitochondrial membrane, the so-called mitochondrial permeability transition, is a common feature of apoptosis and is mediated by the mitochondrial permeability transition pore (mtPTP). It is thought that the mtPTP is a protein complex formed by the voltage-dependent anion channel, members of the pro- and anti-apoptotic BAX-BCL2 protein family, cyclophilin D, and the adenine nucleotide (ADP/ATP) translocators (ANTs)1,2. The latter exchange mitochondrial ATP for cytosolic ADP and have been implicated in cell death. To investigate the role of the ANTs in the mtPTP, we genetically inactivated the two isoforms of ANT3,4,5 in mouse liver and analysed mtPTP activation in isolated mitochondria and the induction of cell death in hepatocytes. Mitochondria lacking ANT could still be induced to undergo permeability transition, resulting in release of cytochrome c. However, more Ca2+ than usual was required to activate the mtPTP, and the pore could no longer be regulated by ANT ligands. Moreover, hepatocytes without ANT remained competent to respond to various initiators of cell death. Therefore, ANTs are non-essential structural components of the mtPTP, although they do contribute to its regulation.
Coagulation and activation of inflammatory pathways in the development of functional decline and mortality in the elderly.

Abstract Purpose This study was performed to determine the effects of markers of inflammation (interleukin 6) and coagulation (D-dimer) on mortality and functional status in older persons. Methods Subjects were selected for the Duke Established Populations for Epidemiologic Studies of the Elderly. In 1992, 2569 subjects (age >71 years) were interviewed, of whom 1723 had interleukin-6 and D-dimer measurements. Values of interleukin 6 and D-dimer were categorized into quartiles. Outcomes were mortality (through 5 years) and functional status (through 4 years). Relative risks were estimated with proportional hazards models that adjusted for potential confounders. Results The relative risk of mortality was 1.28 (95% confidence interval [CI]: 0.98 to 1.69; P = 0.06) for those with only interleukin-6 levels in the highest quartile, 1.53 (95% CI: 1.18 to 1.97; P = 0.001) for subjects with only D-dimer levels in the highest quartile, and 2.00 (95% CI: 1.53 to 2.62; P = 0.0001) for those with levels of both in the highest quartile, as compared with those who were not in either of the highest quartiles. Those with high interleukin-6 and high D-dimer levels had the greatest declines in all measures of function. Conclusion Activation of the coagulation and inflammatory pathways is associated with mortality and decline in function, and may be part of the explanation for the development of a frailty phenotype in the elderly.
Time course of improved neuromuscular function following plasma exchange alone and plasma exchange with prednisone/azathioprine in myasthenia gravis.

Abstract Ten patients with myasthenia gravis (MG) were treated with weekly plasma exchange (PE) in combination with prednisone and azathioprine; 4 of the patients were treated with 3–6 PE alone, before instituting prednisone/azathioprine. Four clinico-physiological parameters of neuromuscular function as well as the anti-acetylcholine receptor antibody (anti-AChRAb) titrs were measured 1–3 times per week. Evidence of improved neuromuscular function (NMF) was based on: (1) reduced % decrement of the maximum muscle compound potential following 2/s supramaximal nerve stimulation; (2) increased maximum force; (3) increased outstretched arm time, and (4) increased vital capacity. An early improvement in NMF occurred within the first 2 weeks (sometimes as early as 1–2 days), which was quantitatively comparable in patients treated with PE alone and PE plus prednisone/azathioprine. This early improvement reached a plateau, and was subsequently maintained for 3–4 weeks, followed by a later substantial improvement after 8–12 weeks of combined PE plus prednisone/azathioprine.
Summary of International Progress on Superconducting Magnets

Superconducting pulsed magnets for use in high field synchrotrons and storage rings and dc dipoles and quadrupoles for use in beam transport lines are reviewed. Operating and construction plans for the immediate future are presented.
Posterior urethral valves masquerading as prune belly syndrome

Abstract Posterior urethral valves associated with bilateral cryptorchidism may simulate the prune belly syndrome. A case is presented to emphasize this diagnostic pitfall.
A SENSITIVE, HIGH RESOLUTION MAGIC ANGLE TURNING EXPERIMENT FOR MEASURING CHEMICAL SHIFT TENSOR PRINCIPAL VALUES

A sensitive, high-resolution ‘FIREMAT’ two-dimensional (2D) magic-angle-turning experiment is described that measures chemical shift tensor principal values in powdered solids. The spectra display spinning-sideband patterns separated by their isotropic shifts. The new method's sensitivity and high resolution in the isotropic-shift dimension result from combining the 5π magic-angle-turning pulse sequence, an extension of the pseudo-2D sideband-suppression data rearrangement, and the TIGER protocol for processing 2D data. TPPM decoupling is used to enhance resolution. The method requires precise synchronization of the pulses and sampling to the rotor position. It is shown that the technique obtains 35 natural-abundance 13C tensors from erythromycin in 19 hours, and high quality natural-abundance 15N tensors from eight sites in potassium penicillin V in three days on a 400 MHz spectrometer.
On the obituary for George E. Schreiner.

To the Editor: Drs Robert Rubin and Christopher Blagg have brought to my attention an error in my obituary for George E. Schreiner where I wrote ‘He is credited with demonstrating a patient on dialysis to a Senate Select Subcommittee.’1 In fact, he opposed this move, which he considered reckless, but was persuaded to supply a dialysis machine and the assistance of one of his nephrology fellows. A full account of this can be read in the chapter on ‘Origins of the Medicare Kidney Disease Entitlement: The Social Security Amendments of 1972’ by Retting2 and Schreiner.3
The effects of frontal EMG biofeedback and progressive relaxation upon hyperactivity and its behavioral concomitants

Hyperactive children (N = 15) and nonhyperactive children (N = 15) were compared. Hyperactive children were found to possess significantly higher (p less than .002) muscular tension levels and, in addition, presented more behavioral problems and had lower test scores. Both electromyographic (EMG) biofeedback and progressive relaxation exercises were successful in the significant reduction of muscular tension, hyperactivity, distractability, irritability, impulsivity, explosiveness, aggressivity, and emotionality in hyperactive children. The greatest improvement was seen in the area of "emotionality-aggression" (irritability, explosiveness, impulsivity, low frustration tolerance, aggresion). No differences were seen in the EMG improvement of drug and nondrug hyperactive children; both made progress under these self-control techniques. However, nondrug children made greater improvements in the behavioral area. Both EMG biofeedback and progressive relaxation resulted in improvements on the test scores of hyperactive subjects (Bender-Gestalt, Visual Sequential Memory, Digit Span, Coding). The therapy would appear to be improved by the inclusion of mental relaxation, concentration, meditation, and mind-blanking exercises for mental control.
Recurrent respiratory papillomatosis: Management with cidofovir

Recurrent respiratory papillomatosis (RRP) remains a difficult and challenging disease to treat. Cidofovir, when administered intralesionally for severe RRP, has shown effective control in early trials. Appropriate patient selection and technique of administration will be reviewed.
The effectiveness of multi-layer insulation as meteoroid and orbital debris shielding

This paper presents the results of a study of the penetration resistance of Type I Multi-Layer Insulation (MLI) to meteoroid and orbital debris particles. Hypervelocity impact tests on MLI were performed and the collected data was compared to data and empirical equations developed for aluminum. The study results indicate that MLI can be an effective shield from meteoroids and orbital debris for short duration missions and for non-critical elements. However, long missions which require high levels of protection cannot rely on MLI without a thorough investigation of the overall system reliability.