cssi/SciSciGPT-SciSciNet huggingface dataset:
COVID-19 pneumonia: Guiding the decision to intubate based on independent assessment of oxygenation and work of breathing

With the emergence of COVID-19, healthcare worldwide is afflicted. While there is a spectrum of disease severity and presenting symptoms in infected patients, hypoxemic respiratory failure is the leading cause of mortality. Decision to intubate in rapidly deteriorating patients plays a significant role in determining patient outcome. In most patients, COVID-19 pneumonia initially causes worsening hypoxemia but minimal impairment of lung compliance which determines the work of breathing (WOB). Once adequate arterial oxygenation is established, a tool to determine WOB independent of oxygen needs can guide the decision to intubate for invasive mechanical ventilation (IMV). We monitored oxygen requirements and WOB in 14 patients admitted to our ICU with severe COVID-19 pneumonia. All patients had radiographic evidence of extensive lung disease, significant hypoxemia and multiple comorbidities. Hypoxemia was managed through non-invasive means, predominantly using highflow nasal cannula. To assess WOB, we used a scale developed by us assigning points to the respiratory rate and use of respiratory accessory muscles (range, 1 to 7) (Figure 1a). This was used at the time of initial evaluation and throughout the ICU stay. Out of 14 patients, 10 did not require intubation and recovered while 4 were intubated. We compared the maximum and average WOB of the non-intubated patients throughout their ICU stay with the WOB of intubated patients measured within 24 hours before intubation (Figure 1b). The maximal and the average WOB were higher in patients requiring intubation (mean ± SD, maximal 4.3 ± 0.9 vs 5.5 ± 1.0 pts, p = 0.028 and average 2.7 ± 0.6 vs 3.9 ± 0.5 pts, p = 0.002). Breakdown of the various WOB components demonstrated a statistically significantly higher maximal and average use of respiratory accessory muscles (assessed as their aggregate sum) and higher average respiratory rate in intubated patients. However, the maximal respiratory rate was not significantly higher. Our data illustrates the initial response to COVID-19 lung injury is tachypnea which can be sustained with adequate oxygenation. As lung injury progresses with more recruitment of respiratory accessory muscles, intubation for IMV becomes necessary. Our WOB scale becomes a useful tool to assist in the decision of when to intubate. It is simple to teach, apply and incorporate into routine patient assessment. We recommend routine and systematic WOB assessment to plan for orderly nonemergent intubations for IMV. Further refinement on the interventions recommended based on specific WOB level and other modifying factors is awaited.
A PICS-Free Future: What We Need to Address Now

Post-intensive care syndrome (PICS) is common, and its prevalence is increasing as the population of ICU survivors grows. To mitigate PICS, strategies presented within this textbook aim to improve care during and after critical illness. However, a PICS-free future will require that these strategies are successfully scaled across hospitals and sustained over time. Further, a PICS-free future requires averting the “asteroid strike” that is critical illness, when able. To accomplish this, strategies addressing PICS must align with the forces that motivate health system practices and shape healthcare delivery. In this chapter, we will describe the path toward a PICS-free future.
Impact of recurrent seizures on white matter in non-structural neonatal epilepsy (2494)

Objective: To determine the association between recurrent seizures in neonatal non-structural epilepsy and altered white matter diffusivity. Background: Increasing evidence demonstrates that myelin is often abnormal in epilepsy; seizures may alter white matter via the recently discovered process of activity-dependent myelination. If seizures alter white matter structure in neonates, the impact upon subsequent neurodevelopment could be pronounced. Neonates are in a period of rapid developmental myelination, making this population unique to study whether recurrent seizures are associated with abnormal white matter development. Design/Methods: This was a retrospective case-control study of term-born neonates who underwent brain MRI at a single institution from 2011–2018. Cases were neonates with non-structural epilepsy due to genetic/presumed genetic etiologies and no conditions present that are known to alter white matter. Controls were healthy neonates with normal MRI. White matter was assessed via mean diffusivity (MD) of the corpus callosum, cingulum, and internal capsules. A multivariable generalized linear model was utilized to determine the association of seizures with MD. Results: Of 1542 neonatal MRIs completed between 2011–2018, 20 neonates with non-structural epilepsy and 22 healthy controls were identified and included. MD was lower in the genu of the corpus callosum in cases compared to controls (77.1 ± 28.5, p=0.01). MD was also lower in the splenium of the corpus callosum, but this was non-significant (44.7 ± 23.9, p=0.069). There was no difference in the cingulum or internal capsule MD between groups. Conclusions: MD was lower in the corpus callosum of neonates with recurrent seizures due to non-structural epilepsy as compared to healthy controls. This difference in a major white matter association tract suggests there may be aberrantly increased myelination associated with seizures. Notably, pediatric imaging abnormalities suggestive of aberrantly increased callosal myelination are linked to cognitive dysfunction. Future work will evaluate the association between MD, seizure burden and developmental outcomes. Disclosure: Dr. Sandoval Karamian has nothing to disclose. Dr. Wusthoff has nothing to disclose. Dr. Yeom has nothing to disclose. Dr. Knowles has nothing to disclose.
Office Management of Genitourinary and Gastrointestinal Procedures.

Insertion of urinary catheters (most often Foley catheters) can be performed in outpatient settings to manage acute urinary obstruction without referral to emergency services, as well as to obtain urine samples in patients not able to provide a clean catch urine sample. For patients with established suprapubic urinary catheters, routine exchange can also occur safely in primary care settings. Excision of a thrombosed external hemorrhoid can be performed in the office setting with local anesthesia. The procedure offers better clinical outcomes than symptomatic treatment if performed within the first 72 hours from the onset of symptoms.
ON THE PATH TO ECONOMIC GROWTH, DO REMITTANCES HELP? EVIDENCE FROM PANEL VARs

Despite the emergence of remittances studies, knowledge about their effect on economic development is still ambiguous. This paper investigates the impact of remittances at macroeconomic level in developing countries controlling for endogeneity problems with the use of panel vector autoregression (panel VAR). The findings suggest that remittances have a positive, albeit small, impact on economic growth even without considering the role of institutions. When institutions are included, the pattern of response remains unaltered. A distinction between low versus high remittances participation in economic activity evidences that, although the impact of remittances on growth is similar, appreciation of the exchange rate occurs in economies with high remittances participation. Finally, a distinction by geographical region reveals that Eastern European economies receive the greatest benefit from these flows, followed by the Americas and Asia; however, African economic growth does not appear to have a statistically significant impact.
Using process definitions to support reasoning about satisfaction of process requirements

This paper demonstrates how a precise definition of a software development process can be used to determine whether the process definition satisfies certain of its requirements. The paper presents a definition of a Scrum process written in the Little-JIL process definition language. The definition's details facilitate understanding of this specific Scrum process (while also suggesting the possibility of many variants of the process). The paper also shows how these process details can support the use of analyzers to draw inferences that can then be compared to requirements specifications. Specifically the paper shows how finite state verification can be used to demonstrate that the process protects the team from requirements changes during a sprint, and how analysis of a fault tree derived from the Little-JIL Scrum definition can demonstrate the presence of a single point of failure in the process, suggesting that this particular Scrum process may fail to meet certain process robustness requirements. A new Scrum process variant is then presented and shown to be more robust in that it lacks the single of point failure.
A Survey of DBMS Research Issues in Supporting Very Large Tables

A number of interesting problems arise in supporting the efficient and flexible storage, maintenance and manipulation of large volumes of data (e.g., >100 gigabytes of data in a single table). Very large tables are becoming common. Typically, high availability is an important requirement for such data. The currently-popular relational DBMSs have been very slow in providing the needed support. To make it possible for RDBMSs to be deployed for managing many large enterprises' operational data and to support complex queries efficiently, these features are very crucial. We discuss some of the issues involved in improving the availability and efficient accessibility of partitioned tables via parallelism, fine-granularity locking, transient versioning and partition independence. We outline some solutions that have been proposed. These solutions relate to algorithms for index building, utilities for fuzzy backups, incremental recovery and reorganization, buffer management, transient versioning, concurrency control and record management.
Second Class Citizen: The Point of Departure for Understanding Buchi Emecheta's Major Fiction

It has been said that "of all the women writers in contemporary African literature Buchi Emecheta of Nigeria has been the most sustained and vigorous voice of direct feminist protest." While there is no doubt about the validity of this statement, one thing that is questionable is the persistent attempt by some scholars (Katherine Frank and Eustace Palmer, for example) to read Emecheta's Second Class Citizen only within the feminist protest tradition. It would not make sense, of course, to suggest that in evaluating the works of a writer such as Emecheta (who in all of her novels deals quite seriously with the role of women in various societies), one can avoid the feminist question. It is something else, however, to imply that this is the only aspect worth examining in her oeuvre. In fact, Frank, in her essay, 'The Death of the Slave Girl: African Womanhood in the Novels of Buchi Emecheta," demonstrates the danger of focusing almost exclusively on Emecheta's feminist theme by making all kinds of sweeping and erroneous generalizations about the African woman's "bondage" and the Western woman's "freedom" in Emecheta's works. We can also say that because Second Class Citizen has often been seen as a somewhat flawed feminist novel, critics such as Lloyd W. Brown have failed to notice the novel's full generic potential. Brown comments that "the emphasis on individual growth and self-reliance is more fully developed in Second Class Citizen" than in Emecheta's first novel, In the Ditch;* however, he also consistently deplores the heroine, Adah, in those sections where she is obviously displaying naivete, immaturity, and ignorance—qualities commonly found among protagonists of the novel of personal development. One other critic does not even
Implementation of Real-Time MPEG-4 FGS Encoder

While computers become faster than they used to be, software implementation of the latest video codec in real time is still a challenging topic. This paper presents our techniques in optimizing the speed of MPEG-4 Fine Granularity Scalability (FGS) video encoders. First, zigzag scans are slow processes in video encoding and decoding. While state-of-the-art processors utilize hardware data prefetchers to reduce memory latency, nonsequential addresses in the zigzag scan may destroy the trackability of hardware prefetching. The problem is even more serious in MPEG-4 FGS where we need multiple scans in bit-plane coding. More than 30% of CPU time is for bit-plane encoding in an MPEG-4 FGS encoder (including base layer and enhancement layer). In this work, we rearrange the layout of the image structure so that zigzag scans are in sequential memory locations. After the rearrangement, there are prefetch reads and we see 80% speed-up in bit-plane encoding. Second, variable length encoder (VLC) incurs a huge number of unpredictable conditional branches. While modern processors can execute tens of instructions in their pipeline, a mis-predicted branch will decrease the efficiency of the pipeline. The problem is severer in MPEG-4 FGS where we need multiple bit-plane VLC's. More than half of the CPU time for MPEG-4 FGS enhancement layer encoder is on bit-plane VLC's. In this work, we also design a bit-plane VLC algorithm, which has fewer unpredictable branches. The new design reduces mis-predicted branches by 2.4x. After these changes, overall speed-up in our MPEG-4 FGS software encoder is 1.4x without any assembly and MMX technology optimization.
Care of HIV-exposed and HIV-infected neonates.

South Africa has implemented a successful prevention-of-mother-to-child-transmission (PMTCT) intervention programme. Important milestones achieved in 2012 include: (1) an estimated 83% of all pregnant women living with HIV in South Africa received antiretrovirals (ARVs) for PMTCT, (2) early vertical transmission of HIV in infants ≤ 2 months of age declined to 2.4% and (3) early infant HIV diagnosis coverage (i.e. coverage in infants < 2 months of age) reached 72.6%.
Healthy Immigrant Effect: Preterm Births Among Immigrants and Refugees in Syracuse, NY.

Objectives The healthy immigrant effect is the phenomenon by which immigrants experience more positive health outcomes than the native-born population in developed countries. The strength of this effect appears to be related to country of origin, health outcome, healthcare and integration policies of receiving countries, as well as immigration class. This secondary analysis of birth records examines whether immigrants and mothers from refugee countries have lower adjusted risk of preterm births than US-born mothers in Syracuse, NY, a preferred refugee resettlement area. Methods This secondary analysis included 6354 electronic birth records for residents in the city of Syracuse, NY who gave birth to singleton infants between 2009 and 2011. Multivariate log-binomial regression was used to calculate the adjusted relative risk for preterm birth among foreign-born mothers and mothers from refugee countries, compared to US-born mothers. Results Infants born to both foreign-born women and to women from refugee countries had decreased risks of being born preterm compared to infants born to US mothers, controlling for race, late/no prenatal care, maternal age less than 18 years and smoking. Conclusion Our findings support a healthy immigrant effect for preterm births both among all foreign-born immigrants and among the subsample of women from refugee countries. Mother’s nativity is likely a proxy for unmeasured factors (e.g., prenatal stress, maternal diet, etc.) that may explain the relationship between mother’s nativity and preterm births. Additional research is needed to better understand the underlying factors.
Copper metabolism in metallothionein-null mice fed a high-zinc diet

Abstract Humans and animals develop low copper (Cu) status when fed diets containing large amounts of zinc (Zn) for an extended period. Current theory states that Zn-induced metallothionein (MT) in the intestinal mucosa binds Cu and prevents its absorption. We tested this theory by using a mouse model with a disruption in the MT gene that renders it incapable of producing functional MT-I and MT-II (MT-null). If the theory is true, then the MT-null mouse should not develop low Cu status when fed a high Zn diet. For 1 week, groups of 4-week-old MT-null and control mice were fed a diet that contained 35 mg Zn and
575 CHILDHOOD SARCOIDOSIS

A wide range of clinical and laboratory manifestations have been reported in childhood sarcoidosis. We are presenting the findings from a review of the largest series reported to date. Sixty patients were diagnosed with sarcoidosis by biopsy (47) or chest x-ray (CXR) and clinical course (13). Fifty-four percent were male, 72% black, 88% lived on the coastal plain of N.C., 75% presented in the winter or spring, and the average age was 13.3 yrs. Common symptoms were weight loss (54%), cough (53%), and fatigue (48%). Common physical findings included peripheral lymphadenopathy (58%), eye changes (54%), and skin changes (42%). All but 1 had an abnormal CXR. Frequently abnormal laboratory tests included an elevated ESR (74%), eosinophilia (45%), increased gamma-globulins (88%), hypercalcemia (31%), hypercalciuria (67%), and pulmonary function tests (50% with restrictive changes). Distinctive features not emphasized fully in the past were the prominence of eye involvement, hypercalcemia/hypercalciuria, skin involvement and the multisystem involvement. After an average of 4.7 yrs, of follow-up, there was considerable improvement in clinical manifestations, CXR findings, and pulmonary function; however, there was 1 death, 35% had continued physical abnormalities, and 47% had CXR findings. Because children treated with adrenocorticosteroids had more severe disease, evaluation of therapy could not be done. Due to the larger number of children in this series, the clinical manifestations are clarified and knowledge of the distinctive features should improve the management of childhood sarcoidosis.
Reaction paths in donor solvent coal liquefaction

Abstract The classic studies of Sol Weller and his collaborators 1,2 provided the working model for most American investigations of donor solvent coal liquefaction. The investigations, particularly at what is now the Pittsburgh Energy Research Centre of ERDA, at what is now Conoco Coal Development Company, at Pittsburg and Midway Coal Company and at the University of Utah, added notably to Weller's picture. Recently, however, new details have emerged that contradict the common interpretation of Weller's model, viz. that oils appear only after the coaly matter has traversed a sequence of reactions, coal → asphaltenes → oil. University of Utah studies at short residence times showed that coal can sometimes be converted very quickly to oil species, whereas asphaltenes hydrogenate to oils only slowly. 3 With interest in the conversion of coal to a clean ‘solvent refined coal’ for electricity generation, 4 researchers have taken interest in the portion of liquefaction product that is not soluble in benzene. Earlier, this portion had been implicitly regarded as ‘unreacted coal’ and held little interest, but it was found to be soluble in pyridine 5 and, as we shall see, differs from coal in important respects. We owe the new information to a sharp increase in research activity, both at the older, established centres and at newly recruited institutions which have responded to opportunities afforded by the RANN Program (‘Research Applied to National Needs’) of the US National Science Foundation, by the Energy Research and Development Administration (ERDA) and by the Electric Power Research Institute (EPRI). The increased activity has led to greater, in some cases pioneering, applications to coal science of sophisticated new tools for examining materials, such as advanced chromatographic separation procedures and pulsed Fourier transform 1 H and 13 C nuclear magnetic resonance spectroscopy. To a large extent, the recent additions of knowledge arise from new attention to the first few minutes of the sequence of reactions by which a donor solvent solubilises coal.
Robust controller design for multivariable nonlinear systems via multi-model H2/H∞ synthesis

Input/output (I/O) linearization via state feedback provides a convenient framework for designing controllers for multivariable nonlinear systems. However this approach does not account for parametric uncertainty which may lead to loss of stability and performance degradation. In this paper, a multi-model H2/H∞ approach is utilized to design a robust controller for minimum phase multivariable nonlinear systems that are subject to parametric uncertainty. It is first shown that a state feedback (inner loop) based on nominal parameters introduces nonlinear perturbations to the linear sub-system and results in loss of decoupling. The uncertain system is characterized in a form that provides a framework for robust controller design. Recent results from linear robust control theory are utilized to design an outer-loop controller to account for the parametric uncertainty. This methodology is illustrated via simulation of a regulation problem in a continuous stirred tank reactor.
FENESTRATION OF PORENCEPHALIC CYSTS TO THE LATERAL VENTRICLE: EXPERIENCE WITH A NEW TECHNIQUE FOR TREATMENT OF SEIZURES. † 2238

Unilateral porencephalic cysts are brain cavities resulting from perinatal vascular occlusion, most often in the territory of the middle cerebral artery. Severe neurological deficits such as hemiparesis are commonly associated with porencephalic cysts as well as intractable seizures. Between 1978 and 1992 we treated 37 children with medically intractable epilepsy and porencephalic cysts by uncapping and fenestration of these cysts to the lateral ventricle. We retrospectively reviewed the outcome of these patients with regard to seizures, paresis, and neurosurgical complications.
Variation in the miRNA-433 Binding Site of FGF20 Confers Risk for Parkinson Disease by Overexpression of α-Synuclein

Parkinson disease (PD) is a common neurodegenerative disorder caused by environmental and genetic factors. We have previously shown linkage of PD to chromosome 8p. Subsequently, fibroblast growth factor 20 (FGF20) at 8p21.3–22 was identified as a risk factor in several association studies. To identify the risk-conferring polymorphism in FGF20, we performed genetic and functional analysis of single-nucleotide polymorphisms within the gene. In a sample of 729 nuclear families with 1089 affected and 1165 unaffected individuals, the strongest evidence of association came from rs12720208 in the 3′ untranslated region of FGF20. We show in several functional assays that the risk allele for rs12720208 disrupts a binding site for microRNA-433, increasing translation of FGF20 in vitro and in vivo. In a cell-based system and in PD brains, this increase in translation of FGF20 is correlated with increased α-synuclein expression, which has previously been shown to cause PD through both overexpression and point mutations. We suggest a novel mechanism of action for PD risk in which the modulation of the susceptibility gene's translation by common variations interfere with the regulation mechanisms of microRNA. We propose this is likely to be a common mechanism of genetic modulation of individual susceptibility to complex disease.
Resonance and direct reaction interference in 12C(d, n)13N

Abstract The 12 C(d, n) 13 N reaction has been studied in the region of the 4 MeV resoance. Measured excitation and angular distribution curves have been analysed on the assumption that the reaction proceeds principally in two modes, one resonant, the other non-resonant. The total reaction amplitude is written as the sum of a stripping theory and a amplitude resonnance amplitude having a Breit-Wigner denominator. Satisfactory fits to the experimental data are obtained with a resonance energy of 4.02 MeV and a level width of about 235 keV. The analysis shows that the resonant state probably has spin 1 with even parity. The relationship of these results to others bearing on this level and the possible nature of the level are both discussed.
The influence of micro-topography on cellular response and the implications for silicone implants

Tissue attachment to substratum surfaces is of central importance to the in vivo performance of prosthetic implant materials. It is not yet understood why connective tissue does not attach to the surface of silicone or any other polymeric material. Recently the authors have conclusively demonstrated that micro-range surface roughness modifies cellular responses in cell culture and modifies biocompatibility and tissue attachment in vivo significantly. In order to better understand the basic interactions between living cells or tissues on one hand and man-made substratum surfaces on the other hand, the germane literature is reviewed here. Cells adhere to substratum surfaces mainly through focal adhesions which are a complex of intracellular, transmembrane and extracellular proteins. Adhesion is facilitated and modified by proteins adsorbed to the substratum surface. Protein adsorption in turn is modified by the underlying substratum surface properties including surface chemistry, charge, and free energy. Wh...
TH-C-17A-03: Dynamic Visualization and Dosimetry of IMRT and VMAT Treatment Plans by Video-Rate Imaging of Cherenkov Radiation in Pure Water

Purpose: A novel optical dosimetry technique for the QA and verification of intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) radiotherapy plans was investigated for the first time by capturing images of the induced Cherenkov radiation in water. Methods: An intensified CCD camera (ICCD) was used to acquire a two-dimensional (2D) projection image of the Cherenkov radiation induced by IMRT and VMAT plans, based on the Task Group 119 C-Shape geometry. Plans were generated using the Varian Eclipse treatment planning system (TPS) and delivered using 6 MV x-rays from a Varian TrueBeam Linear Accelerator (Linac) incident on a water tank. The ICCD acquisition was gated to the Linac, operated for single pulse imaging, and binned to a resolution of 512×512 pixels. The resulting videos were analyzed temporally for regions of interest (ROI) covering the planning target volume (PTV) and organ at risk (OAR) and summed to obtain an overall light distribution, which was compared to the expected dose distribution from the TPS using a gammaindex analysis. Results: The chosen camera settings resulted in data at 23.5 frames per second. Temporal intensity plots of the PTV and OAR ROIs confirmed the preferential delivery of dose to the PTV versus the OAR, and the gamma analysis yielded 95.2% and 95.6% agreement between the light distribution and expected TPS dose distribution based upon a 3% / 3 mm dose difference and distance-to-agreement criterion for the IMRT and VMAT plans respectively. Conclusion: The results from this initial study demonstrate the first documented use of Cherenkov radiation for optical dosimetry of dynamic IMRT and VMAT treatment plans. The proposed modality has several potential advantages over alternative methods including the real-time nature of the acquisition, and upon future refinement may prove to be a robust and novel dosimetry method with both research and clinical applications. NIH R01CA109558 and R21EB017559.
Halothane Decreases the Release of Neuropeptide Y and 3,4-Dihydroxyphenylglycol from Superfused Segments of Dog Pulmonary Artery

Neuropeptide Y (NPY), norepinephrine (NE), and 3,4-dihydroxyphenylglycol (DOPEG), the metabolite of NE that arises intraneuronally, were measured in superfusates before, during, and after nerve stimulation and in extracts of dog pulmonary artery after superfusion and electrical stimulation (ES) at 12, 6, and 1 Hz. NE and DOPEG were quantified by high-pressure liquid chromatography with electrochemical detection; peptides were quantified by radioimmunoassay. The rate of overflow of NPY, NE, and DOPEG into superfusate was measured over time. The overflow of DOPEG into superfusate during basal conditions was 3.0 times that of NE. Efflux of DOPEG and NPY increased during ES; peak effluxes were not reached, however, until after cessation of stimulation. NE efflux peaked during ES. Effluxes of NE, NPY, and DOPEG were frequency-dependent at 12 and 6 Hz; at 1 Hz efflux of only NE was greater than basal. Halothane decreased significantly the rates of NPY and DOPEG efflux during and after 12 Hz ES; DOPEG efflux evoked by 6 Hz stimulation was also decreased by halothane. The percentage of the total tissue content of NPY that overflowed was decreased by halothane. Halothane did not affect the molar ratios of NE:DOPEG or NE:NPY during basal conditions or ES. These studies provide evidence that halothane slows efflux of NPY that is released along with NE from dog pulmonary artery during high frequencies of stimulation. Halothane also reduces the metabolism of NE to DOPEG.
Development of an objective structured assessment of technical skills for obstetric and gynecology residents.

Abstract Objective: To develop an objective structured assessment for evaluating surgical skills of obstetrics and gynecology residents and to evaluate the reliability and validity of the assessment. Methods: A seven-station, objective, structured assessment of technical skills was administered to 24 residents. The test included laparoscopic procedures (port placement, salpingostomy, suturing, vessel ligation) and open abdominal procedures (hypogastric ligation, repair of enterotomy, salpingo-oophorectomy.) All surgical tasks were done on pigs. Residents were timed and assessed at each station using three methods of scoring, a task-specific checklist, global rating scale, and pass-fail grade. Results: Assessment of construct validity (the ability of the test to discriminate among residency levels) found significant differences on the checklist and the global rating scale by residency level. Reliability indices calculated with Cronbach’s α were 0.89 for the global rating scale and 0.89–0.95 for the individual skills checklists. Interrater reliability was 0.87 for the global rating scale and 0.78–0.98 for the checklists. Conclusion: Objective, structured assessment of technical skills can assess residents’ surgical skills with high reliability and validity. These assessments have possible application for identifying residents who need additional training and might provide a mechanism to ensure competence of surgical skills.
The limitations of high-index resists for 193-nm hyper-NA lithography

This paper will investigate the potential benefits and limitations of increasing the refractive index of the photoresist for water and high-index immersion based lithography. The primary potential benefits are increased exposure latitude due to restoration of the TM polarization component and improved depth of focus due to a delay in the onset of image-induced top-loss. After first understanding the physical origins of these effects, a series of simulation studies will probe the level of impact they may have for the 32nm and 22nm technology nodes. It is concluded that, although they may provide some process latitude relief, the benefits are minimal for 1.35NA water immersion, especially when weighed against the likely required development effort and cost. The benefits are slightly more compelling for high-index immersion (>1.5 NA), but a high index resist does not appear to be critical, provided the resist is at least as large as the immersion fluid index. A comparable benefit can be achieved with a conventional resist by using polarized illumination (a trend already happening for various reasons) and thinning the resist by ~9% for 1.35NA water immersion and ~15% for 1.55NA high-index immersion. Additionally, increasing the refractive index is typically accompanied by a corresponding increase in absorption. This will be addressed, concluding the limitations of absorption are likely chemical and not optical in nature. High absorption is likely tolerable, provided the chemistry can be engineered to account for exponential intensity decay. The level of difficulty in doing so is addressed.
Maze training effects on dendritic branching in occipital cortex of adult rats.

Dendritic branching in occipital cortex was compared in Golgi-stained neurons from adult rats subjected to 26 days of Hebb-Williams maze training (24 trials per day) and littermates subjected to deprivation and daily handling procedures. Distal regions (beyond 250 μm) of the apical dendritics of Layer IV and V pyramidal neurons were more extensively branched in the trained animals, as revealed by both a concentric ring intersection analysis and by measures of the numbers and lengths of oblique branches from the apical dendrite. There were no statistical differences in basal dendritic branching of pyramidal cells or in dendritic branching of Layer IV stellate neurons between the two groups, nor were there consistent differences in the proximal region of apical dendrites. These results are among the first to indicate anatomical plasticity at the neuronal level in adult animals.
Assessing the impact of an oil import fee

Abstract We examine the impact of an oil-import fee on the United States economy. For a general equilibrium model, we estimate the effect that a $5.00 per barrel import fee would have on producing sectors, consuming sectors, households, and the government. Over the period 1984–1990 with such an import fee (as compared to the absence of a crude oil import fee), the results suggest that there will be a reduction in output by all producing sectors (except the crude oil industry) by about $8.6 billion, there will be a fall in the consumption of goods and services by about $318 million and there will be a decline in aggregate social welfare (measured as utility) by about $208 million. The government will realize an increase in revenue of about $3.41 billion.
Discussion of 'Conditional and Unconditional Conservatism: Concepts and Modeling'

Beaver and Ryan (Beaver, W. H., Ryan S. G. (2005). Review of Accounting Studies 10: (2/3)) algebraically model, simulate and graph the effects of various factors on the nonlinear earnings-return relation induced by conditional conservatism. Their analysis clarifies how conditional and unconditional conservatism are inter-related. I discuss why unconditional and conditional conservatism are more than mere substitutes, and provide evidence from the historical record. I then highlight a few areas for future modeling, before moving on to discuss potential empirical tests of their predicted relations. I identify some research questions and opportunities for future investigation.
Arterial-ventricular coupling: mechanistic insights into cardiovascular performance at rest and during exercise

Understanding the performance of the left ventricle (LV) requires not only examining the properties of the LV itself, but also investigating the modulating effects of the arterial system on left ventricular performance. The interaction of the LV with the arterial system, termed arterial-ventricular coupling (EA/ELV), is a central determinant of cardiovascular performance and cardiac energetics. EA/ELV can be indexed by the ratio of effective arterial elastance (EA; a measure of the net arterial load exerted on the left ventricle) to left ventricular end-systolic elastance (ELV; a load-independent measure of left ventricular chamber performance). At rest, in healthy individuals, EA/ELV is maintained within a narrow range, which allows the cardiovascular system to optimize energetic efficiency at the expense of mechanical efficacy. During exercise, an acute mismatch between the arterial and ventricular systems occurs, due to a disproportionate increase in ELV (from an average of 4.3 to 13.2, and 4.7 to 15.5 mmHg·ml−1·m−2 in men and women, respectively) vs. EA (from an average of 2.3 to 3.2, and 2.3 to 2.9 mmHg·ml−1·m−2 in men and women, respectively), to ensure that sufficient cardiac performance is achieved to meet the increased energetic requirements of the body. As a result EA/ELV decreases from an average of 0.58 to 0.34, and 0.52 to 0.27 in men and women, respectively. In this review, we provide an overview of the concept of EA/ELV, and examine the effects of age, hypertension, and heart failure on EA/ELV and its components (EA and ELV) in men and women. We discuss these effects both at rest and during exercise and highlight the mechanistic insights that can be derived from studying EA/ELV.
Nonbudgetary constraints in consumer demand for gasoline

This paper develops a conceptual framework for taking into account nonbudgetary constraints in economic analysis of consumer demand for gasoline. The individual's need for gasoline is defined and the process of satisfying the need is recognized. Thus, nonbudgetary factors are used to restrict the consumption space to a relevant subset in the commodity space. The restriction of the consumption space enables nonbudgetary factors to be included in a theoretical model of utility maximization. This formulation implies the dependency of income and price elasticities on nonbudgetary factors. In studies of the demand for gasoline, as in many other empirical studies, researchers are frequently confronted with the considerable gap existing between empirical relationships and economic theory. This gap underlies the comment by Henderson and Quandt (1980) that ‘theorists would provide examples that were of little aid for empirical work, and econometricians would estimate relations that had little connection with utili...
The Acute Toxicopathy of Intravenous Diacetoxyscirpenol (Anguidine) Administration in Swine

Diacetoxyscirpenol (DAS, anguidine) was given intravenously to swine at 0.0, 0.5, and 1.0 mg/kg body wt. In mitotically and metabolically active tissues such as gastrointestinal epithelium and lymphoid aggregates the effects of DAS mimicked radiation poisoning. A quadratic dose-response relationship between the cytotoxicity of DAS and damage to enterocytes was found. Enterocytes in different anatomical regions of the bowel had differing susceptibilities to the toxic effects of DAS. In lymphoid tissues, DAS was preferentially cytotoxic to B-lymphocyte-rich tissues as compared to T-lymphocyte-rich tissues. In all pigs dosed with DAS the bone marrow was void of hemopoietic elements. DAS was cytotoxic to cells with specialized ion pumps, namely, renal tubular, gastric parietal, and salivary ducts. Cell damage in the exocrine and endocrine pancreas and adrenal gland accounted for changes in blood glucose. Endothelial necrosis and hemorrhage were observed in the brain. These findings were compared with those reported for other 12,13-epoxytrichothecenes and ionizing radiation and we concluded that a similar mechanism of cytotoxicity could exist.
Estimation of significant wave height using reflected digital communication signals

This paper presents a semi-empirical relationship between the coherence time of ocean-reflected digital satellite radio signals and significant wave height (SWH). An experiment was conducted on Platform Harvest, a petrochemical exploration platform located in the Pacific Ocean off the coast of Southern California. Raw data were recorded from both directly-received and ocean-reflected signals from the XMradio (S-bandwith center frequency 2.342 GHz), and DirecTV (Ku-Band with center frequency 12.239 GHz) from antennas located at an approximate altitude of 27 meters above the ocean surface. Using a technique first developed for Global Navigation Satellite Systems (GNSS) signals, the coherence time of the Interferometric Complex Field (ICF) is computed by cross-correlating the direct and reflected signals. A relationship is developed between the ICF and SWH. This is done by first developing a model showing a relationship between ICF, correlation time of the sea surface and SWH. A Monte Carlo simulation of the ocean surface is used to show that empirical relationship between correlation time of the sea surface and SWH takes a quadratic form. The coefficients of this empirical model are finally determined from fitting experimental data of S-band signals and a limited amount of Ku-band signals, from the XM radio and DirecTV transmission, respectively. The retrievals of SWH from experimental data through inverting this relationship are then compared to the in-situ recordings from the nearest buoy (8 km away). S-band measurements are found to have a standard deviation of 0.51 meters over a range of SWH from 1 to 5.6 meters.
Effectively Measuring Student Leadership

With a worldwide sample of students (N = 77, 387), this paper reviews and analyses the psychometric properties of the Student Leadership Practices Inventory [1]. Modest to strong internal reliability coefficients are found across a number of different dimensions. Predictive validity of the instrument is supported, with the instrument being able to differentiate between effective and ineffective leaders using both self-reported and observer (constituent) data. Few significant differences are found on the basis of respondent gender, ethnicity, nationality, or institutional level (high school versus college). Implications for developing student leaders and future research are offered.
Finite Strain Plasticity and Damage in Constitutive Modeling of Metals With Spin Tensors

The analysis of damage and plastic deformation in metals is very important towards the full understanding of the various damage mechanisms in these materials. A coupled theory of damage mechanics and finite strain plasticity is proposed. The theory is based on a sound mathematical and mechanical background and is thermodynamically consistent. It is formulated using spatial coordinates utilizing a von Mises type yield criterion with both isotropic and kinematic hardening. The derivation is based on the concept of effective stress that was originally proposed by Kachanov for the case of uniaxial tension. The plasticity model is first formulated in a fictitious undamaged configuration of the body. Then certain transformation equations are derived to transform this model into a damage-plasticity model in the damaged configuration of the body. Certain assumptions are made in order to make this transformation possible. These assumptions include small elastic strains and the hypothesis of elastic energy equivalence. 39 refs., 6 figs.
Three-dimensional finite-element modeling of wave propagation in a transversely isotropic medium

In this research, the authors present the numerical results of three-dimensional finite element modeling of elastic wave propagation in a half space of a transversely isotropic medium. The input physical parameters are taken from the physical model used by Chang and Gardner (1992). The synthetic seismograms of the three displacement components along the axis at an azimuth of 45{degree} to the fracture orientation on the surface are shown. Snapshots taken on the free surface are illustrated which are the displacement fields with polarization in the direction perpendicular to the fracture orientation. These snapshots show clearly the elliptical patterns demonstrating the effects of anisotropy on wave propagation. Four waves, namely, the fast and slow S-waves and the fast and slow P-waves, can be clearly observed.
Impact of race on early treatment termination and outcomes in posttraumatic stress disorder treatment.

Objective:The present study investigated the influence of race on posttraumatic stress disorder (PTSD) treatment among 94 African American and 214 Caucasian female victims of interpersonal violence participating in 2 studies of cognitive-behavioral treatment for PTSD that were conducted sequentially and continuously. Method:In each study, participants were randomized into 1of 3 conditions. The first study compared cognitive processing therapy with prolonged exposure and a delayed treatment condition. In the second study, cognitive processing therapy was compared with its constituent components: cognitive therapy only and written accounts. Participants were assessed with the Clinician Administered PTSD Scale and the Structured Clinical Interview for DSM-IV, as well as through self-report measures of PTSD. Results:Analyses revealed that African Americans were significantly less likely to complete treatment compared with Caucasians (45% vs. 73%, respectively, p Language: en
Quantitative nuclear DNA analysis of human ovarian adenocarcinoma: Compared before and after chemotherapy and correlated with clinical response

Abstract Quantitative DNA measurements on 18 human ovarian adenocarcinomas were made by computerized image analysis. The DNA content of the tumor cells was measured on specimens of tumor obtained at the initial diagnostic surgery and at second-look surgery after treatment with chemotherapy. The mean DNA content of the specimens and the ploidy pattern of the tumor cells were determined. With the exception that borderline tumors had near normal ploidy patterns and mean DNA content, there was no consistent correlation between the stage of disease, grade, or histiologic character of the tumor and either the DNA content or ploidy pattern. But it was noteworthy that all three of the patients who had complete responses (negative second-looks), also had tumors with DNA content and ploidy patterns near triploid. When the ratio of mean DNA content before and after chemotherapy was determined for each ploidy group, there was an apparent correlation between this ratio and clinical status of the patient 10 month after chemotherapy. That is, patients with low ploidy tumors and high DNA content ratio (>1.25) had a better prognosis than patients with high ploidy tumors and lower DNA content ratios (
Dental caries prevalence in children and adolescents with cystic fibrosis: a qualitative systematic review and recommendations for future research.

Background Children and adolescents with cystic fibrosis (CF) are believed to be at low risk for dental caries, but this paradigm has not been critically evaluated. Aims To conduct a qualitative systematic review of the international literature on dental caries prevalence in children and adolescents with CF and make recommendations on future CF-related oral health research priorities. Design The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was used to identify relevant studies published between 1960 and 2013. Results The search resulted in 696 studies. Fifteen publications were included in the qualitative systematic review. Ten studies concluded that children with CF had significantly lower caries prevalence than control children, three studies reported that children with CF had higher caries prevalence, and two studies found no difference by CF status. Of the seven studies including age-based subgroup analyses, only one study supported the current paradigm. All studies had limitations that may bias study results. Conclusions While children with CF may be a lower risk for dental caries, adolescents with CF may not be at lower caries than those without CF. Additional research is needed to evaluate a potentially flawed paradigm regarding caries risk in children and adolescents with CF.
On Type-II Singularities in Ricci Flow on ℝ N

In each dimension N ≥ 3 and for each real number λ ≥1, we construct a family of complete rotationally symmetric solutions to Ricci flow on ℝ N , which encounter a global singularity at a finite time T. The singularity forms arbitrarily slowly with the curvature blowing up arbitrarily fast at the rate (T − t)−(λ+1). Near the origin, blow-ups of such a solution converge uniformly to the Bryant soliton. Near spatial infinity, blow-ups of such a solution converge uniformly to the shrinking cylinder soliton. As an application of this result, we prove that there exist standard solutions of Ricci flow on ℝ N whose blow-ups near the origin converge uniformly to the Bryant soliton.