cssi/SciSciGPT-SciSciNet huggingface dataset:
Sonographically guided botulinum toxin injections in patients with neurogenic thoracic outlet syndrome: correlation with surgical outcomes

We examined the role of botulinum toxin (BTX) injections of anterior scalene (AS) and pectoralis minor (PM) muscles in patients undergoing surgery for neurogenic thoracic outlet syndrome (NTOS). We hypothesized that symptomatic improvement from BTX injections correlates with favorable long-term response to surgery for NTOS. This Health Insurance Portability and Accountability Act compliant study was approved by the institutional review board and prior informed consent requirement was waived. We retrospectively analyzed prospectively acquired data in NTOS patients who underwent sonographically guided chemodenervation of AS and PM using BTX type A followed by scalenectomy and first rib resection. Overall responses to BTX injections and surgery were recorded after each procedure. Statistical analyses were performed to determine correlation between responses to BTX injections and surgery. In 157 patients, 178 BTX injections followed by surgery were identified (114 females; mean age 38 ± 13 years). Responders and non-responders to BTX injections and surgery had similar preoperative symptom duration and age (P > 0.14). Better response to BTX injections correlated positively with better response to surgery (P = 0.003), persisting after adjustment for age, gender, and symptom duration (P = 0.03). A high proportion of responders to BTX injections also responded to surgery (positive predictive value of 99%), and BTX injections showed high specificity (90%). BTX injections were moderately sensitive (66%) and accurate (67%) to determine surgical response and had low negative predictive value (14%). Response to BTX injections correlates positively with long-term surgical outcome in subjects with NTOS, potentially playing an important role in patient management.
Lefamulin (Xenleta) for the Treatment of Community-Acquired Bacterial Pneumonia

Lefamulin may be considered for patients hospitalized with community-acquired bacterial pneumonia.
Three-Wave Mixing Kinetic Inductance Traveling-Wave Amplifier with Near-Quantum-Limited Noise Performance

A high gain, high power handling, broadband amplifier with simultaneous near-quantum-limited performance is demonstrated.
Remote Proctoring: Expanding Reliability and Trust

Online learning is becoming an essential pillar of today's education system. As reliance on this mode of education grows, so does the need for security in remote examinations and remote proctoring. One obstacle to remote proctoring is the difficulty in establishing a secure environment. Remote and automated proctoring services use several safeguards to discourage potential cheating. This work intends to build on the technologies used by proctoring services to investigate a profile (side) camera arrangement. While a front-facing camera captures only the examinee's head and shoulders, a profile-angle provides a view of the examinee and their environment by capturing the upper body, hands, and desk. As a result, this setup may discourage dishonest behaviors. Our exploratory pilot investigates this camera arrangement to provide insight into the use of profile cameras, providing guidance for instructors considering remote examinations and a foundation for future work on remote proctoring.
75561 Association of childhood hypertension with early adulthood obesity and hypertension

ABSTRACT IMPACT: This study establishes the association between childhood hypertension and health outcomes in early adulthood, identifying the need to understand blood pressure during early life for primary prevention of hypertension and cardiovascular disease. OBJECTIVES/GOALS: There is evidence that blood pressure level in early life can influence hypertension and other cardiovascular risk factors later in life. We examined whether hypertension before the age of 18 is associated with higher odds of obesity and hypertension after the age of 18. METHODS/STUDY POPULATION: We studied 19,367 children and adolescents from the Vanderbilt University Medical Center’s Synthetic Derivative, a de-identified version of the electronic medical record. Childhood hypertension was defined as systolic blood pressure (SBP) ≥130 mmHg or diastolic blood pressure (DBP) ≥80 mmHg at three or more outpatient visits before the age of 18. Obesity and hypertension in early adulthood were the primary outcomes. Obesity was defined as being above normal weight for adulthood height at age 30 based on the NIH’s body mass index tables. Hypertension was defined as SBP ≥130 mmHg or DBP ≥80 mmHg at three or more outpatient visits after the age of 18. Odds ratios and 95% confidence intervals (CIs) were computed from logistic regression models adjusted for demographics, medication use, and childhood weight. RESULTS/ANTICIPATED RESULTS: Most subjects were female (63%) and white (80%). During childhood, 17% of participants had hypertension. Approximately 58% of this group were obese at age 30, and 38% had hypertension as adults. Compared to females with no childhood hypertension, females with childhood hypertension had 1.35 times higher odds of being obese at age 30 (95% CI: 1.15, 1.58) and 3.56 times higher odds of having hypertension over the age of 18 (95% CI: 3.09, 4.09). Males with childhood hypertension, compared to males without, had 1.28 times higher odds of being obese at age 30 (95% CI: 1.08, 1.52) and 2.74 times higher odds of having hypertension over the age of 18 (95% CI: 2.35, 3.20). Associations between childhood hypertension, early adulthood obesity, and hypertension significantly differed by gender (p-for-interaction for both: <0.01). DISCUSSION/SIGNIFICANCE OF FINDINGS: Childhood hypertension is associated with obesity and hypertension in early adulthood. Understanding blood pressure levels in childhood and adolescence may help target efforts to reduce early adulthood cardiovascular risk factors.
Association of COA1 with Patellar Tendonitis: A Genome-wide Association Analysis

Purpose It is unknown why some athletes develop patellar tendinopathy and others do not, even when accounting for similar workloads between individuals. Genetic differences between these two populations may be a contributing factor. The purpose of this work was to screen the entire genome for genetic markers associated with patellar tendinopathy. Methods Genome-wide-association (GWA) analyses were performed utilizing data from the Kaiser Permanente Research Board (KPRB) and the United Kingdom (UK) Biobank. Patellar tendinopathy cases were identified based on electronic health records from KPRB and UK Biobank. Genome-wide association analyses from both cohorts were tested for patellar tendinopathy using a logistic regression model adjusting for sex, height, weight, age, and race/ethnicity using allele counts for single nucleotide polymorphisms (SNPs). The data from the two GWA studies (KPRB abd UK Biobank) were combined in a meta-analysis. Results There were a total of 1,670 cases of patellar tendinopathy and 293,866 controls within the two cohorts. Two SNPs located in the intron of the Cytochrome C Oxidase Assembly Factor 1 (COA1) gene showed a genome-wide significant association in the meta-analysis. Conclusions Genetic markers in COA1 appear to be associated with patellar tendinopathy and are potential risk factors for patellar tendinopathy that deserve further validation regarding molecular mechanisms.
Semi-supervised sequence modeling for improved behavioral segmentation

A popular approach to quantifying animal behavior from video data is through discrete behavioral segmentation, wherein video frames are labeled as containing one or more behavior classes such as walking or grooming. Sequence models learn to map behavioral features extracted from video frames to discrete behaviors, and both supervised and unsupervised methods are common. However, each approach has its drawbacks: supervised models require a time-consuming annotation step where humans must hand label the desired behaviors; unsupervised models may fail to accurately segment particular behaviors of interest. We introduce a semi-supervised approach that addresses these challenges by constructing a sequence model loss function with (1) a standard supervised loss that classifies a sparse set of hand labels; (2) a weakly supervised loss that classifies a set of easy-to-compute heuristic labels; and (3) a self-supervised loss that predicts the evolution of the behavioral features. With this approach, we show that a large number of unlabeled frames can improve supervised segmentation in the regime of sparse hand labels and also show that a small number of hand labeled frames can increase the precision of unsupervised segmentation.
Boundaries, communities and state-making in West Africa: the centrality of the margins (Vol. 144)

Boundaries, Communities and State-Making in West Africa is the kind of book that geographers would dream about writing and political scientists ought to read. Building on a comparative history of S...
Evaluating and predicting design performance

Partial table of contents: THEORY Computational Framework for Supporting Creative Architectural Design (G. Carrara, et al.) Design Inquiry and Resource Allocation (R. Johnson) FRAMEWORKS FOR INTEGRATION Design for Performance (G. Schmitt) Multiple Operative and Interactive Modes in Knowledge-Based Design Systems (R. Oxman) MULTICRITERIA EVALUATION Performance Evaluation in an Integrated Software Environment for Building Design and Construction Planning (S. Fenves, et al.) Architecture and Software for Interactive Learning About Total Building Performance (V. Hartkopf, et al.) MULTILEVEL EVALUATION A Preliminary to Development of Expert Systems for Total Design of Entire Buildings (P. Manning & S. Mattar) Multilevel Analysis and Optimization of Design (R. Liggett, et al.) ENERGY EVALUATION Evaluation of Designs for Energy Performance Using a Knowledge-Based System (B. Jog) HUMAN FACTORS EVALUATION Towards Artificial Users (E. Steinfeld) Predicting Wayfinding Behavior in Buildings: A Schema-Based Approach (M. Gross & C. Zimring) Conclusion: Evaluating and Predicting Design Performance (Y. Kalay).
Evaluation of an Aerator Control Strategy Utilizing Time Varying Mathematical Model Simulations

A mechanistic mathematical model of the aerated stabilization basin process utilized in the pulp and paper industry is presented. The time variable model is calibrated for a paper mill wastewater treatment system and is used to develop and test a control scheme for the optimization of aeration intensity. The control scheme is shown to reduce aerator usage on an annual basis by seventeen to thirty percent compared to the case of no control. The aerator usage reduction percentage was found to be inversely related to the organic loading rate per aerator horsepower. Savings in aerator usage under the control scheme were equivalent to the existing practice of seasonal aeration control. However, modest improvements in effluent quality variability were observed under the control scheme.
Leader as a Ship’s Captain

As discussed in the previous chapter, Peter Senge in the Fifth Discipline pointed out that the most “powerful” position on a ship might not be the captain, but rather the ship’s architect. While this view is indeed useful, in the realm of distributed innovation leadership, captaining the ship is a critical piece of the leadership puzzle as well. Otherwise, an innovation leader with poor captaining skills will soon ground her ship upon the shoals of the three principles of escalation of expectations, exchange, and providential behavior.
Cervical mucus: Problems and opportunities for drug delivery via the vagina and cervix

Abstract The vagina has been targeted as the site for delivery of a variety of drugs, and several different delivery systems have been utilized for this purpose. The compounds have almost exclusively been delivered to the vaginal epithelium. The presence of a mucus-laden cervix in women provides an opportunity as an alternative, or conjoint site for such drug delivery. An obvious application is the delivery of drugs that destroy, or render dysfunctional, spermatozoa and pathogens such as viruses and bacteria. In principle, a reservoir of a compound in the cervical mucus could achieve other physiological goals, as well. This article reviews the biology of human cervical mucus and its interaction with spermatozoa. It then focuses upon the critical problem of understanding the mechanisms of drug entry and permeation through the cervical mucus. This problem is only partially understood at present, and salient biophysical concepts are presented which will aid in its further study. It is concluded that there are good prospects for improved utilization of the cervical mucus for drug delivery, but that their realization will require improved understanding of the mechanisms of drug transport and bioactivity within the mucus.
Children, Agency and Violence: In and beyond the United Nations study on violence against children

This paper examines the role of child agency as it relates to child protection. The focus arises from recognition that child protection approaches can be ineffective, and even counterproductive, when local context is not given sufficient attention (Bissell et al., 2007). The prevailing child protection models - child rescue, social services and medical models - commonly neglect local community assets, including the role of children themselves. Yet in many cases these assets may play a critical role, particularly when family and community are the primary line of defence to protect children from violence and exploitation. Rethinking child protection from a rights perspective requires building on empirical and theoretical understandings of child agency and child development, and the interactions between them.
Coercive Heterosexual Sexuality in Dating Relationships of College Students

Summary Although it has generally been assumed that most instances of coercive sexual acts involve male coercion against female targets, recent data (appearing in the literature beginning in the late 1980s) suggest that the reverse experience is also common. In the present investigation, the Ross and Allgeier Sexual Experience Questionnaire was administered to 214 university students (113 women and 101 men) who reported past interactions in which they engaged in sexual coercion, were the targets of such coercion, both, or neither. The findings (p<.001) were consistent with widely held assumptions that men often coerce, whereas women are more often the targets of these acts. It also appears that, although men behave more coercively than women, both genders report coercing and being coerced, when investigatiors ask the appropriate questions of being coerced when investigators ask the appropriate questions of both men and women. Empirical reports indicating to methodological variations involving the specific...
Expression of acetylcholine receptor isoforms at extraocular muscle endplates

Purpose. To determine the expression of fetal and adult acetylcholine receptor (AChR) iso-forms among extraocular muscle (EOM) en plaque and en grappe endplates.Methods. Antibodies against peptide fragments of the y- and e-subunits of the fetal and adultAChRs and a-bungarotoxin were used in immunofluorescence experiments to stain rat neona-tal leg, adult diaphragm, and extraocular rectus muscle endplates.Results. Anti-e antibodies intensely stained diaphragm endplates and weakly stained rare neona-tal endplates. Anti-y antibodies stained neonatal, but not diaphragm, endplates. Anti-e anti-bodies bound to all en plaque and en grappe endplates of extraocular muscle. Anti-7 antibod-ies bound to global and orbital en grappe endplates. All en plaque endplates of the orbitalregion and a subset of endplates in the global region stained with anti-y antibodies.Conclusions. All en grappe endplates and certain en plaque endplates of EOM are the onlymature endplates that coexpress the adult and fetal AChR isoforms. The expression of bothisoforms may be important to determine contractile properties, protein expression regulation,and EOM susceptibility to myasthenia gravis. Invest Ophthalmol Vis Sci. 1996;37:345-351.Jlixtraocular muscle (EOM) is the only mature, inner-vated skeletal muscle to express gene transcripts spe-cific for adult and fetal isoforms of the acetylcholinereceptor (AChR).
Health care charges for youth with newly diagnosed epilepsy

Objectives: To estimate first-year health care charges for youth with newly diagnosed epilepsy seen within an interdisciplinary pediatric epilepsy team and examine demographic, clinical, and psychosocial predictors of annual charges. Methods: Retrospective chart review was conducted to extract medical, hospital, and physician billing data from the year following an epilepsy diagnosis for 258 patients (aged 2–18 years) seen in a New Onset Seizure Clinic between July 2011 and December 2012. Descriptive statistics were used to estimate per-patient total first-year charges and health care utilization patterns (e.g., hospitalizations, emergency department visits, outpatient visits). Univariate analyses examined differences in health care charges between demographic, clinical, and psychosocial factors. Predictors of health care charges were examined using hierarchical multiple regression analysis. Results: The estimated per-patient total first-year health care charge was $20,084 (95% confidence interval [CI] $16,491–$23,677). Charges were higher for patients who reported having seizures since diagnosis ($25,509; 95% CI $20,162–$30,856) and were associated with more antiepileptic drug side effects ( r = 0.18; 95% CI 0.03–0.32). Controlling for demographic and clinical factors, poorer baseline health-related quality of life was associated with higher per-patient health care charges (B = −445.40; 95% CI −865 to −25). Conclusions: The economic impact of pediatric epilepsy in the year following diagnosis is substantial. Cost reduction efforts would be optimized by improving seizure control and targeting health-related quality of life, an outcome amenable to behavioral intervention.
Hardware assisted real-time rollback in the advanced fault-tolerant data processor

Rollback recovery offers an efficient method of recovering from transient faults and permanent faults when rollback is combined with spare resource reconfiguration. The hardware macro-rollback technique presented has been implemented in the advanced fault-tolerant data processor (AFTDP), which is a high-performance fault-tolerant shared memory multiprocessor. The architecture discussion focuses on the unique problems of achieving both low overhead and fast recovery in high-throughput cached multiprocessors. Macro-rollback recovery from transient faults and hard macro-rollback from permanent faults are examined. In addition, deadline analysis based on a semi-Markov model is presented. >
Torts Compendium, Volume One (Version 1.0)

Casebook on American tort law covering intentional torts, strict liability, products liability, safety regulation, oblique torts (such as defamation, invasion of privacy, and intentional interference), and issues relating to parties, actions, and remedies.
A fluoroacetamidine-based inactivator of protein arginine deiminase 4: design, synthesis, and in vitro and in vivo evaluation

Protein arginine deiminase 4 (PAD4) is a calcium-dependent transcriptional corepressor that has been implicated in the onset and progression of rheumatoid arthritis. Herein we describe the synthesis and in vitro evaluation of a fluoroacetamidine-containing compound, N-α-benzoyl-N5-(2-fluoro-1-iminoethyl)-l-ornithine amide, 1, hereafter referred to as F-amidine, that is the most potent PAD4 inhibitor ever described. Additional studies described herein indicate that F-amidine can also inhibit PAD4 activity in vivo. The bioavailability of this compound suggests that F-amidine will be a powerful chemical probe of PAD4 function that can be used to dissect the roles of this enzyme in both rheumatoid arthritis and transcriptional control. The fact that inhibition is of an irreversible nature suggests that, with appropriate functionalization, F-amidine analogues will be robust activity-based protein-profiling and proteomic capture reagents.
Routine laboratory tests in adolescent psychiatric inpatients: their value in making psychiatric diagnoses and in detecting medical disorders.

Psychiatric patients have a high rate of medical problems. Several authors have suggested that laboratory screening procedures can aid in the detection of medical problems that cause or contribute to psychiatric illness. A review of 100 cases of adolescents hospitalized for an approximately 4–6-week period indicated that numerous “routine” laboratory tests were obtained. The results of these tests did not seem to change psychiatric diagnoses from those that were “functional” in nature to those that were “organic” in nature. The benefits of this screening approach from a medical standpoint were also uncertain. For the most part, while numerous abnormalities were detected, they were generally minor, felt to be clinically inconsequential, and not followed up. Careful attention to the particular tests ordered, the goals of a screening program, and follow-up of abnormal results seem essential if a screening program is to be a valuable aspect of psychiatric hospitalization.
The Global Reorganization and Revitalization of the Asbestos Industry, 1970–2007

The intent of this essay is to highlight the global reorganization of the asbestos industry over the period 1970–2007. Descriptive analysis illustrates that asbestos consumption in the industrializ...
Dicarboxylic acids and glucose utilization in humans: effect of sebacate

Dicarboxylic acids have been proposed as an alternate lipid energetic substrate for total parenteral nutrition. No data are yet available on the possible effect of dicarboxylic acids on glucose metabolism in humans. Thus, we examined the effect of a continuous intravenous infusion of the sodium salt of the 10-carbon atom alyphatic dicarboxylic acid, sebacate (Sb), on insulin-dependent glucose metabolism in four control subjects, four patients with insulin-dependent diabetes mellitus, and four obese subjects. All subjects received a constant 5-hour infusion of saline or sebacate (6.6 g/h), in a randomized order on two different days. After 3 hours of infusion, a 120-minute euglycemic, hyperinsulinemic clamp procedure was performed (insulin infusion rate = 40 mU/m2 per minute). Glucose uptake, plasma sebacate, insulin, glucagon, C-peptide, and ketone bodies were measured. No significant differences in insulinemia were found among groups either during the saline infusion or the sebacate infusion. On the contrary, glucose uptake (molar) was significantly reduced during the sebacate vs the saline day in all three groups: 6.7 +/- 0.04 vs 3.7 +/- 1.3 in control subjects (p < .001), 4.6 +/- 0.4 vs 2.5 +/- 1.2 in patients with insulin-dependent diabetes mellitus (p < .001), and 4.8 +/- 0.5 vs 2.7 +/- 0.2 mg/kg per minute in obese subjects (p < .001). In conclusion, Sb administration was associated with a glucose-sparing effect as shown by the reduced glucose uptake in all patients studied. Sebacate did not stimulate insulin secretion, inasmuch as no modification of C-peptide plasma levels was observed after 3 hours of Sb infusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Bis-histidine-coordinated hemes in four-helix bundles: how the geometry of the bundle controls the axial imidazole plane orientations in transmembrane cytochromes of mitochondrial complexes II and III and related proteins.

Early investigation of the electron paramagnetic resonance spectra of bis-histidine-coordinated membrane-bound ferriheme proteins led to the description of a spectral signal that had only one resolved feature. These became known as “highly anisotropic low-spin” or “large g max” ferriheme centers. Extensive work with small-molecule model heme complexes showed that this spectroscopic signature occurs in bis-imidazole ferrihemes in which the planes of the imidazole ligands are nearly perpendicular, Δφ = 57–90°. In the last decade protein crystallographic studies have revealed the atomic structures of a number of examples of bis-histidine heme proteins. A frequent characteristic of these large g max ferrihemes in membrane-bound proteins is the occurrence of the heme within a four-helix bundle with a left-handed twist. The histidine ligands occur at the same level on two diametrically opposed helices of the bundle. These ligands have the same side-chain conformation and ligate heme iron on the bundle axis, resulting in a quasi-twofold symmetric structure. The two non-ligand-bearing helices also obey this symmetry, and have a conserved small residue, usually glycine, where the edge of the heme ring makes contact with the helix backbones. In many cases this small residue is preceded by a threonine or serine residue whose side-chain hydroxyl oxygen acts as a hydrogen-bond acceptor from the Nδ1 atom of the heme-ligating histidine. The Δφ angle is thus determined by the common histidine side-chain conformation and the crossing angle of the ligand-bearing helices, in some cases constrained by hydrogen bonds to the serine/threonine residues on the non-ligand-bearing helices.
Humeral blade plate fixation of intercalary allografts and segmentally comminuted proximal humeral fractures: a preliminary report

The AO 90° humeral blade plate is a relatively new device, whose primary indication and previously described use is for proximal humeral fracture non-union. This study describes the use of the humeral blade plate for extended indications-fixation of segmentally comminuted proximal humeral fractures in two patients and fixation of humeral intercalary allografts after primary humeral neoplasm resection in three patients. A mean follow-up of 20 months revealed union in both fractures and five of the six allograft-host junctions. One patient required subsequent bone grafting for non-union at a proximal allograft-host junction. Functional results were excellent in three patients, good in one, and fair in one. Problems encountered intraoperatively were directly related to the limited array of implants. The long plates which were needed had blades which were too long and required intra-operative trimming in three cases. In four cases, additional plates were used to supplement the blade plate for distal fixation. In conclusion, the humeral blade plate is a useful device for fixation in these extended indications, but longer plates with 30.0 and 40.0-mm blade lengths should be made available.
Mixed algebras and quivers related to cell complexes

In this paper we study finite dimensional algebras arising from categories of perverse sheaves on finite regular cell complexes (cellular perverse algebras). We prove that such algebras are quasi-hereditary and have finite global dimension. We discuss some restrictions, under which cellular perverse algebras are Koszul. We also study the relationship between Koszul duality functors in the derived categories of categories of graded and non-graded modules over an algebra and its quadratic dual.
Radiation induced precipitation in 9 MeV Al ion irradiated Ti-6A1-4V

Abstract The dominant irradiation response of several titanium alloy systems is the production of different phases. Previous studies have shown that a thermally unstable bcc,β, phase precipitates out in the hcp matrix during irradiation. In this paper, the extent of this phase separation in Ti-6A1-4V is examined as a function of temperature for low dose ion irradiations. The alloy Ti-6A1-4V was irradiated with 9 MeV Al ions to 2 dpa at a 2 μ depth over a 500–700°C temperature range. The densities of the radiation-induced β precipitates were found to decrease at high temperatures while the size increased. The original grain boundary β phase shows no radiation effect until 650°C when it undergoes a transformation to a Widmanstatten morphology. An EDS analysis of the radiation-induced β phase indicates it is 50% higher in vanadium when compared to the thermally predicted vanadium concentration. The total fraction of bcc phase present in the irradiated region is drastically altered.
Is the growth in laparoscopic surgery reproducible with more complex procedures

Background. Laparoscopic (LAP) surgery has experienced significant growth since the early 1990s and is now considered the standard of care for many procedures like cholecystectomy. Increased expertise, training, and technological advancements have allowed the development of more complex LAP procedures including the removal of solid organs. Unlike LAP cholecystectomy, it is unclear whether complex LAP procedures are being performed with the same growth today. Methods. Using the Nationwide Inpatient Sample (NIS) from 1998 to 2006, patients who underwent elective LAP or open colectomy (n = 220, 839), gastrectomy (n = 17,289), splenectomy (n = 9,174), nephrectomy (n = 64,171), or adrenalectomy (n = 5,556) were identified. The Elixhauser index was used to adjust for patient comorbidities. To account for patient selection and referral bias, a matched analysis was performed using propensity scores. The main endpoints were adjusted for in-hospital mortality and prolonged length of stay (LOS). Results. Complex LAP procedures account for a small percentage of total elective procedures (colectomy, 3. 8 %; splenectomy, 8. 8 %; gastrectomy, 2. 4 %; nephrectomy, 7. 0 %; and adrenalectomy, 14.2 % These procedures have been performed primarily at urban (94 %) and teaching (64 %) centers. Although all LAP procedures trended up, the growth was greatest in LAP colectomy and nephrectomy (P < . 001 ). In a case-controlled analysis, there was a mortality benefit only for LAP colectomy (hazard ratio [HR] = 0.53; 95 % confidence interval [Cl] = 0.34-0.82) when compared with their respective open procedures. All LAP procedures except gastrectomy had a lower prolonged LOS compared with their open counterparts. Conclusion. Despite the significant benefits of complex LAP procedures as measured by LOS and in-hospital mortality, the growth of these operations has been slow unlike the rapid acceptance of LAP cholecystectomy. Future studies to identify the possible causes of this slow growth should consider current training paradigms, technical capabilities, economic disincentive, and surgical specialization.
Discussing Depression with Vietnamese American Patients

Background Asian patients preferentially seek mental health care from their primary care providers but are unlikely to receive it. Primary care providers need culturally-informed strategies for addressing stigmatizing illnesses. Methods 11 Vietnamese American community members participated in semi-structured interviews. Interviews were audio-taped and transcribed. The grounded theory approach was used for qualitative coding and thematic analysis. Results Vietnamese community members describe experiences with depression under four themes: (1) Stigma and face; (2) Social functioning and the role of the family; (3) Traditional healing and beliefs about medications; and (4) Language and culture. Based on this data, we offer suggestions for improving culturally-informed care for Vietnamese Americans. Disucssion Our study adds to the research aimed at improving communication and health care relationships between physicians and Vietnamese American patients. Physicians should learn to tailor their interviewing style to the increasingly diverse patient population.
Mass Defect Curve and Nuclear Constitution

In the discussion before the Royal Society on the constitution of the atomic nucleus held on February 7, 1929,* I proposed a simple model of a nucleus built from α-particles in a way very similar to a water-drop held together by surface tension. A certain number of protons (not more than three) and electrons can be bound to such an α-aggregate without forming a new α-particle. † Such additional units of nuclear constitution, usually bound less strongly than those involved in the α-particles, we shall term free nuclear protons and electrons. Their presence will, of course, affect the form of the nuclear energy curve (mass defect curve), not changing, however, its general shape. In the present paper I shall attempt to treat the problem more closely, analysing from the theoretical point of view the experimental facts concerning the nuclear energy.
Hierarchy of organization in eukaryotic chromosomes (a review)

Several models of macromolecular arrangements in eukaryotic chromosomes have been proposed during the past fifteen years. Many of the models are consistent with physical and chemical data on the molecular components of chromosomes, and a few have the appearance of meeting the requirements for cytological organization in chromosomes. However, one of the most frustrating problems in developing a working model is to provide a scheme that fits genetic function while satisfying the structural parameters. This has not yet been achieved. Although emphasis in this review has been placed on uninemic and polynemic models, alternatives, such as a bineme, for example, remain. It is clear, moreover, that the issue can be resolved only through continued efforts to make direct observations of chromosomes with light and electron microscopy coupled with the additional tools ofX-ray analysis and analytical biochemistry. A recent analysis byWray andStubblefield (1969) has led to a rather innovative model of the chromosome, and exemplifies the kind of approach needed to clarify the phenomenon. Furthermore, analyses of meiotic chromosomes may provide valuable insight for relating organization to genetic function (cf Maguire, 1966 andBraselton, pers. comm). Of particular interest are mutation events as related to subchromatid organization, and the reorganization of chromosomal fibrils during early meiotic stages. At present, and as a generalization, the evidence points more strongly toward at least a binemic arrangement of chromosomal subunits than toward a uninemic one.
PhysioNet: Physiologic signals, time series and related open source software for basic, clinical, and applied research

PhysioNet provides free web access to over 50 collections of recorded physiologic signals and time series, and related open-source software, in support of basic, clinical, and applied research in medicine, physiology, public health, biomedical engineering and computing, and medical instrument design and evaluation. Its three components (PhysioBank, the archive of signals; PhysioToolkit, the software library; and PhysioNetWorks, the virtual laboratory for collaborative development of future PhysioBank data collections and PhysioToolkit software components) connect researchers and students who need physiologic signals and relevant software with researchers who have data and software to share. PhysioNet's annual open engineering challenges stimulate rapid progress on unsolved or poorly solved questions of basic or clinical interest, by focusing attention on achievable solutions that can be evaluated and compared objectively using freely available reference data.
Consecutive intravenous infusions: Simulation of two compartment pharmacokinetic drugs

Abstract A program is presented to simulate the blood concentrations which result from multiple, consecutive, constant rate intravenous infusions of drugs displaying two compartment kinetics. The program utilizes the principle of superposition and was developed for a Hewlett-Packard model 97 programmable calculator. The program can handle from 1–8 consecutive infusions, each with its own infusion rate and duration. Post-infusion blood concentrations can also be readily obtained. A modification of the main program is also presented which enables the simulation of blood concentration — time data pairs without operator assistance. A desired increment of time is specified, and the program will provide concentration — time data pairs between specified starting and ending times.
End-of-Life Care Decisions: Importance of Reviewing Systems and Limitations After 2 Recent North American Cases

Two recent and unfortunate North American cases involving end-of-life treatment highlight the difficulties surrounding medical futility conflicts. As countries have explored the greater influence that patients and their representatives may play on end-of-life treatment decisions, the benefits and struggles involved with such a movement must be appreciated. These 2 cases are used to examine the present systems existing in the United States and Canada for resolving end-of-life decisions, including the difficulty in defining medical futility, the role of medical ethics committees, and controversies involving surrogate decision making.
Effects of attitude-similarity and success-failure upon attitude toward other persons.

Summary An experiment tested the hypothesis that when a person is attitudinally similar to other, liking for other will be less affected by whether they both succeed or he succeeds and other fails at the same task than whether he fails and other succeeds or they both fail, and that when a person is attitudinally dissimilar to other, liking for other will not be differentially affected by comparative performances. College students were asked to form an impression of another person from questionnaires supposedly filled out by the other person. The questionnaires contained answers designed to make them think that the other person was either attitudinally similar or dissimilar to them. Subsequently, both the subject and the other person performed a learning task in which the success-failure of self and the success-failure of other were varied orthogonally. The results of the experiment provided good support for the hypothesis.
A clinical application of expert system methodology

In recent years, several expert systems have been developed for practical applications in applied statistical methodologies. Existing expert systems in statistics have explored several areas, e.g. the determination of appropriate statistical tests, regression analysis, and determination of the ‘best’ experimental design for industrial screening experiments. We present here the DESIGN EXPERT which is a prototype expert system for the design of complex statistical experiments. It is intended for scientific investigators and statisticians who must design and analyze complex experiments, e.g. multilevel medical experiments with nested factors, repeated measures, and both fixed and random eflects. This system is ‘expert’ in the sense that it is capable of the following:(i) recognize specific types of complex experimental designs, based on the application of inference rules to non-technical information supplied by the user; (ii) encode the obtained and inferred information in a flexible general-purpose internal...
Forecast of Tsunamis from the Japan–Kuril–Kamchatka Source Region

This paper describes an investigation of the subfault distribution along the Japan–Kuril–Kamchatka subduction zone for the implementation of a far-field tsunami forecast algorithm. Analyses of seismic data from 1900 to 2000 define the subduction zone, which in turn is divided into 222 subfaults based on the fault characteristics. For unit slip of the subfaults, a linear long-wave model generates a database of mareograms at water-level stations along the subduction zone and at warning points in the North Pacific. When a tsunami occurs, an inverse algorithm determines the slip distribution from near-source water-level records and predicts the waveforms at the warning points using the pre-computed mareograms. A jackknife resampling scheme uses combinations of input water-level records to provide a series of waveform predictions for the computation of the confidence-interval bounds. The inverse algorithm is applied to hindcast two major tsunamis generated from the Japan–Kuril–Kamchatka source and the computed tsunami heights show good agreement with recorded water-level data.
Serotonin transporter null male mouse pups have lower ventilation in air and 5% CO2 at postnatal ages P15 and P25

In Wild Type (WT) and serotonin transporter (5HTT) null mice, we studied oxygen consumption, ventilation and heart rate in air and 5% CO(2) at postnatal (P) days P5, P15, and P25 using either a head-out (younger mice) or whole body plethysmograph (older mice). Body weight and temperature did not differ between the groups. Oxygen consumption differed significantly only in females at P15 when it was reduced in 5HTT nulls (P<0.01). Heart rate similarly differed only in female 5HTT nulls at P15 being decreased in both air and CO(2) (P<0.01). Ventilation in air and 5% CO(2) was significant reduced via an effect on tidal volume at P15 (P<0.02) and P25 (P<0.05) but only in males. Ventilation in air and 5% CO(2) was greater in 5HTT null females at P25. We conclude that the gender specific effect (male predominant) on the CO(2) response reported in 5HTT null adult mice (Li and Nattie, 2008, J. Physiol. 586.9, 2321-2329, 2008) appears to have origins in early postnatal life (P15) when ventilation in both air and 5% CO(2) is reduced.
Optical binary coded ternary arithmetic and logic.

Two ternary, an ordinary ternary (OT) and a binary balance ternary (BT), number representations to be used for optical computing are discussed. An unsigned OT number is represented by a string of symbols (0, 1, 2), while for the BT, the three logic symbols take on the set (−1, 0, +1). The BT symbols can represent a signed number. Using a particular binary encoding method, the three ternary symbols are converted to a pair of binary symbols. The binary coded ternary (BCT) representation has two advantages. First, it allows use of the well-developed binary optical components. Second, compared with other optical multiple-valued number encoding schemes, it reduces the number of input–output channels and thus is able to conserve the optical space–bandwidth product. As an example for arithmetic operations, BCT full addition algorithms are given. As examples for multiple-valued logic computing, BCT Post, Webb, and residue logic elements are discussed. Using the two-port Sagnac interferometric switches, optical implementations of various BCT arithmetic and logic operations are described.
C-peptide and zinc delivery to erythrocytes requires the presence of albumin: implications in diabetes explored with a 3D-printed fluidic device

People with type 1 diabetes (T1D) must administer insulin exogenously due to the destruction of their pancreatic β-cells. Endogenous insulin is stored in β-cell granules along with C-peptide, a 31 amino acid peptide that is secreted from these granules in amounts equal to insulin. Exogenous co-administration of C-peptide with insulin has proven to reduce diabetes-associated complications in animals and humans. The exact mechanism of C-peptide's beneficial effects after secretion from the β-cell granules is not completely understood, thus hindering its development as an exogenously administered hormone. Monitoring tissue-to-tissue communication using a 3D-printed microfluidic device revealed that zinc and C-peptide are being delivered to erythrocytes by albumin. Upon delivery, erythrocyte-derived ATP increased by >50%, as did endothelium-derived NO, which was measured downstream in the 3D-printed device. Our results suggest that hormone replacement therapy in diabetes may be improved by exogenous administration of a C-peptide ensemble that includes zinc and albumin.
Experimental and Numerical Study of the Effect of Geometric Parameters on Liquid Single-Phase Pressure Drop in Micro-Scale Pin-Fin Arrays

The purpose of this project was to study experimentally and numerically the effects of changing geometrical parameters on water single-phase pressure drop across arrays of micro-scale pin-fin heat sinks. An experimental study was performed on a cylindrical pin-fin heat sink at various flow rates and temperatures. Computational analysis was also performed on a cylindrical pin-fin array to study the effects of changing certain geometric parameters and to compare these results with previous experimental and numerical results. The results for the experimental method were not as expected due to malfunctioning equipment and the numerical results had to be compared to existing experimental data in order to validate the numerical model.
The Modern United States Senate: What is Accorded Respect

The modern U.S. Senate is often seen as being hopelessly personalistic and little concerned with such quaint standards as party discipline, loyalty to the institution, and improving public policy. In this paper, by determining the specific behaviors and traits that are associated with respect, we attempt to test the veracity of these widely-held beliefs. Our measure of respect was obtained from a survey of top-level staffers, and our efforts to explain variations in respect for senators were based on such variables as use of the frank, number of trips home, support for the president, support for the party, ideology (as displayed in roll call behavior), legislative specialization, success in moving legislation, seniority, and presidential ambitions. The results support the notion that respect, for the most part, is accorded to senators who are involved with substantive legislative activities and who are not overly preoccupied with external actors such as constituents and the president. More surprisingly, perhaps, rather than being viewed with suspicion, senators who are media-savvy and interested in seeking the presidency are accorded additional respect in the modern Senate.
An engagement with Marilyn McCord Adams's Horrendous Evils and the Goodness of God

I may have agreed to review this work under false pretenses. In a book I wrote called The Domestication of Transcendence, and elsewhere, I raised two sorts of objections to many of the contemporary discussions of the problem of evil among Anglo-American philosophers of religion. First, they often defend an abstract philosophical theism which I think has quite different implications from Christianity, or for that matter from Judaism or Islam or any other major world religion. So, as a Christian theologian, I find myself doubting that their detailed analysis of the strengths and weaknesses of the arguments they consider is really worth the trouble, given that the results may not have much to do with what religious folk actually believe.
Psychobiological Responses to Social Self Threat: Functional or Detrimental?

A growing body of research suggests that threats to the social self, or threats to one's social esteem, acceptance, or status, can elicit a coordinated response, including increases in self-conscious emotion, cortisol, and proinflammatory cytokine activity. These psychobiological changes may have important benefits under certain acute contexts, including providing a signaling function for detecting social threat, initiating biological processes to adequately respond to the threat, and supporting behavioral patterns of submission or disengagement, which may be adaptive in this context. However, prolonged or chronic experiences of social self threat could have damaging mental and physical health consequences; situational and individual characteristics may render some more vulnerable to these negative effects.