cssi/SciSciGPT-SciSciNet huggingface dataset:
Costs of Two Health Insurance Plan Programs to Mail Fecal Immunochemical Tests to Medicare and Medicaid Plan Members

BeneFIT is a 4-year observational study of a mailed fecal immunochemical test (FIT) program in 2 Medicaid/Medicare health plans in Oregon and Washington. In Health Plan Oregon's (HPO) collaborative model, HPO mails FITs that enrollees return to their clinics for processing. In Health Plan Washington's (HPW) centralized model, FITs are mailed directly to enrollees who return them to a centralized laboratory. This paper examines model-specific Year 1 development and implementation costs and estimates costs per screened enrollee. Staff completed activity-based costing spreadsheets. Non-labor costs were from study and external data. Data matched each plan's 2016 development and implementation dates. HPO development costs were $23.0K, primarily administration (eg, clinic recruitment). HPW development costs were $37.3K, 38.8% for FIT selection and mailing/tracking protocols. Year 1 implementation costs were $51.6K for HPO and $139.7K for HPW, reflecting HPW's greater outreach. Labor was 50.4% ($26.0K) of HPO's implementation costs, primarily enrollee eligibility and processing returned FITs, and was shared by HPO ($17.0K) and 6 participating clinics ($9.0K). Labor was 10.5% of HPW's implementation costs, primarily administration and enrollee eligibility. HPO's implementation costs per enrollee were 12.3% higher ($18.36) than for HPW ($16.34). Similar proportions of completed FITs among screening-eligibles produced a 15% lower cost per completed FIT in HPW ($89.75) vs. HPO ($105.79). Implementation costs for HPO only (without clinic costs) were $15.16/mailed introductory letter, $16.09/mailed FIT, and $87.35/completed FIT, comparable to HPW. Results highlight cost implications of different approaches to implementing a mailed FIT program in 2 Medicaid/Medicare health plans.
Is Net Zero Carbon 2050 Possible

John Deutch is an emeritus Institute Professor at the Massachusetts Institute of Technology where he has been a member of the faculty since 1970. He has served as Chairman of the Department of Chemistry, Dean of Science, and Provost. In the Carter Administration, he served as Director of Energy Research (1977–1979), Acting Assistant Secretary for Energy Technology (1979), and Undersecretary (1979–1980) in the U.S. Department of Energy. He has been a member of the President’s Nuclear Safety Oversight Committee (1980– 1981), the White House Science Council (1985–1989), the President’s Committee of Advisors on Science and Technology (1997–2001), and the Secretary of the Energy Advisory Board (2008–2016). John Deutch has published widely on technical and policy aspects of energy and the environment and has been a member of the board of directors or of the technical advisory committees of several energy companies.
Outcomes of Airway Management in Micrognathia and Retrognathia Patients Born at Fetal versus Nonfetal Centers.

Objectives There is a paucity of evidence to guide the perinatal management of difficult airways in fetuses with micrognathia. We aimed to (1) develop a postnatal grading system based on the extent of airway intervention required at birth to assess the severity of micrognathic airways and (2) compare trends in airway management and outcomes by location of birth [nonfetal center (NFC), defined as a hospital with or without an NICU and no fetal team, versus fetal center (FC), defined as a hospital with an NICU and fetal team]. Methods We retrospectively reviewed the prenatal and postnatal records of all neonates diagnosed with micrognathia from January 2010 to April 2018 at a quaternary children's hospital. We developed a novel grading scale, the Micrognathia Grading Scale (MGS), to grade the extent of airway intervention at birth from 0 (no airway intervention) to 4 (requirement of EXIT or advanced airway instrumentation for airway securement). Results We identified 118 patients with micrognathia. Eighty-nine percent (105/118) were eligible for grading using the MGS. When the MGS was applied, the airway grades were as follows: grade 0 (30%), grade 1 (10%), grade 2 (9%), grade 3 (48%), and grade 4 (4%). A quarter of micrognathic patients with grade 0-2 airways had postnatal hospital readmissions for airway obstruction after birth, of which all were born at NFC. Over 40% of patients with grade 3-4 micrognathic airways required airway intervention within 24 h of birth. Overall, NFC patients had a readmission rate of (27%) for airway obstruction after birth compared to FC patients (17%). Conclusions Due to the high incidence of grade 3-4 airways on the MGS in micrognathic patients, fetuses with prenatal findings suggestive of micrognathia should be referred to a comprehensive fetal care center capable of handling complex neonatal airways. For grade 0-2 airways, infants frequently had postnatal complications necessitating airway intervention; early referral to a multidisciplinary team for both prenatal and postnatal airway management is recommended.
Pediatric Craniofacial Fractures From Canine Bites.

ABSTRACT Craniofacial fractures from canine bites are rare, but can be devastating events that lead to complex surgical management, long-term functional deficits, and psychological sequelae. The objective of this case-control study was to identify risks associated with craniofacial fractures in pediatric dog bite victims. From 2008 to 2019 at our quaternary center, all children with craniofacial fractures from dog bites were included in this study. Controls were obtained in a 2:1 ratio via a random sample of all dog bite encounters. Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Of 3602 dog bite encounters, 114 children were included in the study with an average age of 4.8 years (interquartile range = 2.4-9.1 years) and 51 patients (45%) were female. Seventy-four children (65%) were bitten by a family-owned dog. Thirty-eight patients with 60 craniofacial fractures were identified. The following factors were significantly associated with increased risk for craniofacial fractures: Caucasian race (OR 7.3, CI 1.6-16.7), age under five (OR 4.1, CI 1.6-10.7), rural location (OR 3.9, CI 1.3-12.3), child location on the floor (OR 6.2, CI 2.4-16.2), and dogs weighing over 30 pounds (OR 19.6, CI 5.8-82.3). Nine patients (12%) required multiple reconstructive operations, and four patients (5%) developed post-traumatic stress disorder. In conclusion, toddlers in rural households with large dogs are at high risk for sustaining craniofacial fractures from bite injuries. Craniofacial surgeons, pediatricians, and emergency department physicians should use these data to lead prevention efforts in the community.
Carbapenem Resistance in Acinetobacter baumannii, and their Importance in Hospital-acquired Infections: A Scientific Review

Carbapenem is an important therapy for serious hospital-acquired infections and for the care of patients affected by multidrug-resistant organisms, specifically Acinetobacter baumannii; however, with the global increase of carbapenem-resistant Ac. baumannii, this pathogen has significantly threatened public health. Thus, there is a pressing need to better understand this pathogen in order to develop novel treatments and control strategies for dealing with Ac. baumannii. In this review, we discuss an overview of carbapenem, including its discovery, development, classification and biological characteristics, and its importance in hospital medicine especially in critical-care units. We also describe the peculiarity of bacterial pathogen, Ac. baumannii, including its commonly reported virulence factors, environmental persistence and carbapenem resistance mechanisms. In closing, we discuss various control strategies for overcoming carbapenem resistance in hospitals and for limiting outbreaks. With the appearance of strains that resist carbapenem, the aim of this review is to highlight the importance of understanding this increasingly problematic healthcare-associated pathogen that creates significant concern in the field of nosocomial infections and overall public health.
Frailty assessment of older adults, first-time applicants of public home care service in Norway

Early detection of frailty is essential to prevent or delay disability. The most appropriate screening tool for frailty among home-dwelling older adults is under debate. The present study estimates...
The Incorporation of Standardized Patients into a Continuing Education Conference on Child Abuse

Standardized Patients (SPs) have played a significant role as an adjunct to medical education over the last 30 years. Issues of Child Abuse demand a multidisciplinary approach to the child and family. Three SPs, 10 years of age, were used to portray a clinical case of a 10 year-old abused child. The SPs were utilized for discussions on the medical, legal, and social aspects of child abuse. To evaluate the use of SPs in this setting, a questionnaire was completed by participants at the end of the conference. The results are reported.
Amine oxidase: XV. The sulfhydryl groups of beef liver mitochondrial amine oxidase

Abstract Beef liver mitochondrial amine oxidase components 1 and 2 contain about 28 and 86 sulfhydryl groups per mole of enzyme or 7 sulfhydryl groups per 100,000 g of protein. The rate of reaction of p -chloromercuribenzoate with the enzyme was complete in about 30 min and 8 m urea had no effect on the rate of reaction. After reaction of all the sulfhydryl groups with p -chloromercuribenzoate, the enzyme was not completely inhibited and removal of the excess sulfhydryl reagent led to reactivation of the enzyme. At higher p -chloromercuribenzoate concentrations, the enzyme was inhibited noncompetitively. Iodoacetic acid and iodoacetamide did not inhibit the enzyme appreciably even at a concentration of 1 × 10 −3 m . Certain heavy metal salts inhibited the enzyme noncompetitively. The sulfhydryl groups probably are required for conformational stability rather than being required for catalysis.
Crassulacean Acid Metabolism in Submerged Aquatic Plants

CO2-fixation in the dark is known to occur in various organs of many plants. However, only in species possessing crassulacean acid metabolism (CAM) does dark CO2-fixation contribute substantially to the carbon economy of the plant. Until very recently CAM was known only from terrestrial species, largely drought adapted succulents. The discovery of CAM in the submerged aquatic fern ally Isoetes howellii (Isoetaceae)(Keeley 1981) adds a new dimension to our understanding of crassulacean acid metabolism. In this paper I will summarize 1) the evidence of CAM in Isoetes howellii, 2) the data on the distribution of CAM in aquatic species, and 3) the work to date on the functional significance of CAM in aquatic species.
Peroral Jejunoscopy and Duodenoscopy: Endoscopy Of the Uppermost Small Intestine after Total Gastrectomy

Instrumental visualization of the upper jejunum or duodenum following the suturing of either of these segments to the esophagus upon removal of the entire stomach is designated as jejunoscopy or duodenoscopy, respectively. The elucidation of problems in medical managementl-5 following total gastrectomy accounts for the introduction and development of this procedure. It has been found to be of importance especially since the impetus given this operation by Pack6 and by Lahey7 and its re-introduction with a low mortality rate at The Johns Hopkins Hospital by Longmire8 and by Scott and Longmire. 9 The work of these men followed after a long lapse that of Finney and Rienhof£. 10 As far as can be ascertained, there is no reference to a like study. The method is to be used complementary to roentgenography.
Zollinger-Ellison syndrome. Relation to Helicobacter pylori-associated chronic gastritis and gastric acid secretion.

SinceHelicobacter pylori infects the gastric mucosa in most patients with chronic duodenal ulcer, infection with this organism has been implicated in the pathogenesis of this common disease. We postulated that ifH. pylori is pathogenic in the usual type of duodenal ulcer, it should be less common when duodenal ulcer has another, specific etiology, such as Zollinger-Ellison syndrome. Gastric mucosa was compared from 18 patients with proven Zollinger-Ellison syndrome (17 of whom had had duodenal ulcer disease) and 18 controls with chronic duodenal ulcer without such a diagnosis. All subjects, who were matched for age and sex, had undergone elective gastric resections. Gastric tissues were stained by hematoxylin-eosin and Giemsa and were reviewed by an experienced pathologist who was unaware of the diagnosis. The frequency ofH. pylori in patients with Zollinger-Ellison syndrome (8/18) was lower than in controls with duodenal ulcer (16/18;P<0.02). Moreover, chronic antral gastritis scores were higher in patients with duodenal ulcer (P<0.01). In Zollinger-Ellison syndrome, peak acid output was lower in patients positive (median 22 meq/30 min) compared to those negative forH. pylori (median 32 meq/30 min;P<0.02) but serum gastrin was correspondingly lower in patients positive forH. pylori (P<0.05).H. pylori infection appears to be more frequent when duodenal ulceration is not associated with another etiology, such as acid hypersecretion in Zollinger-Ellison syndrome.H. pylori infection in Zollinger-Ellison syndrome may also be associated with decreased gastric acid secretion.
Evaluation of a new method for measurement of minute ventilation recovery time.

PURPOSE: To determine if the measurement of minute ventilation recovery time (V˙ERT), a recently proposed predictor of extubation outcome, can be reproduced using a more practical, simpler method. METHODS: A case series with convenience sampling was performed in the surgical intensive care unit of a tertiary-care hospital. Nineteen patients were enrolled during weaning from mechanical ventilation, prior to the initial extubation attempt. Within-subject comparisons of V˙ERT were performed, using 2 alternative methods for measuring baseline V˙E and one alternative method for determining the threshold for recovery of V˙E during the final spontaneous breathing trial prior to extubation. Comparison methods for baseline V˙E included an 8-hour average and the last V˙E measurement prior to the spontaneous breathing trial. The alternative threshold for defining recovery of V˙E was 100% of the baseline value (vs 110% in the original method). RESULTS: The study subjects were primarily cardiac surgery patients (63%) and were ventilated for a median of 5 days prior to extubation. V˙ERT calculated using the 8-hour average or the last V˙E measurement prior to the spontaneous breathing trial as baseline, and a threshold of 100% of baseline V˙E to define recovery most closely approximated V˙ERT obtained by the original method and similarly classified patients at high risk for reintubation (kappa statistic = 0.78 ± 0.2). CONCLUSIONS: V˙ERT can be determined using a simpler method for measuring both baseline V˙E and the recovery threshold. These methodological modifications may increase the feasibility of measuring V˙ERT, while reproducing the results obtained by the original method.
Prediction in dynamic models with time-dependent conditional variances

Abstract This paper considers forecasting the conditional mean and variance from a single-equation dynamic model with autocorrelated disturbances following an ARMA process, and innovations with time-dependent conditional heteroskedasticity as represented by a linear GARCH process. Expressions for the minimum MSE predictor and the conditional MSE are presented. We also derive the formula for all the theoretical moments of the prediction error distribution from a general dynamic model with GARCH(1, 1) innovations. These results are then used in the construction of ex ante prediction confidence intervals by means of the Cornish-Fisher asymptotic expansion. An empirical example relating to the uncertainty of the expected depreciation of foreign exchange rates illustrates the usefulness of the results.
Shortcomings in Wilson’s Chronicle of Higher Education Article on the State of Black Studies Programs

This article criticizes Robin Wilson’s Chronicle of Higher Education article of April 22, 2005, on Black studies titled, “After 35 Years on Campuses, Black-Studies Programs Struggle to Survive.” It contends that Wilson’s article presents a blend of truths, half-truths, and outright distortions. Contrary to Wilson’s insinuations, Black studies is a liberal arts degree program open to and meant for any interested student of whatever background. The creation of Black studies was not meant to preclude Black students from pursuing degrees in scientific areas. A Black studies major tends to “jell” with and also serves as an important background for a variety of other careers. The fact that some traditional disciplines have now found it worthwhile to introduce peripheral courses on the Black experience, in their quest to be inclusive, cannot serve as a substitute for a holistic, systematic, and coherent approach to the study of that experience.
Sports-related injuries of the elbow : An approach to MRI interpretation

MRI is a valuable tool for evaluating the athlete with elbow pain, particularly in those with nonlocalizable pain. MRI also is helpful in sorting out the cause of pain in athletes who may have acute trauma superimposed on tendinopathy or other chronic injuries from repetitive microtrauma. Even in athletes in whom the cause of pain confidently can be diagnosed clinically, MRI can document the injury severity, which can be helpful for estimating recovery time or in preoperative planning. By contributing to an accurate early diagnosis, MRI also can help minimize the time that athletes are away from their sports. The authors describe their approach to the MRI interpretation of elbow injuries in athletes, including osteochondral lesions, epicondylitis, and tears of the medial collateral ligament.
Foulkes characters for complex reflection groups

Foulkes discovered a marvelous set of characters for the symmetric group by summing Specht modules of certain ribbon shapes according to height. These characters have many remarkable properties and have been the subject of many investigations, including a recent one [2] by Diaconis and Fulman, which established some new formulas, a conjecture of Isaacs, and a connection with Eulerian idempotents. We widen our consideration to complex reflection groups and find ourselves equipped from the start with a simple formula for (generalized) Foulkes characters which explains and extends these properties. In particular, it gives a factorization of the Foulkes character table which explains Diaconis and Fulman’s formula for the determinant, their link to Eulerian idempotents, and their formula for the inverse. We present a natural extension of a conjecture of Isaacs, and then use properties of Foulkes characters which resemble those of supercharacters to establish the result. We also discover a remarkable refinement of Diaconis and Fulman’s determinantal formula by considering Smith normal forms. Classic type A Foulkes characters have connections with adding random numbers, shuffling cards, the Veronese embedding, and combinatorial Hopf algebras [2, 7]. Our formula brings Orlik–Solomon coexponents from [12] the cohomology theory of [10] complements into the picture with the geometry of the Milnor fiber complex [8], and it gives rise to a curious classification at the end of the paper. The paper is structured as follows. Section 1 introduces Foulkes characters for Shephard and Coxeter groups. Key properties are quickly gathered, including our main formula. In Section 2, properties of type A Foulkes characters are explained and extended from the symmetric group to the infinite family of wreath products. In Section 3, Isaacs’ type A conjecture is sharpened for the Coxeter–Shephard–Koster family. Diaconis and Fulman’s type A determinantal formula is also extended here. Lastly, we determine exactly when the Foulkes characters are a basis for the space of class functions .g/ that depend only on the dimension of the fixed space of g.
Low-temperature optical photon detectors for quantum information applications

There is increasing interest in using high-performance cryogenic optical photon detectors in a variety of applications in quantum information science and technology. These applications require detectors that have extremely low dark count rates, high count rates, high quantum efficiency, and moderate energy resolution for IR to optical photons. We describe three applications, quantum key distribution, quantum optics with spontaneous parametric down converters, and linear optical quantum computing. We also describe preliminary results using a superconducting tungsten transition-edge sensor in a quantum key distribution system and a quantum optics experiment with spontaneous parametric down converters.
Normalization of pre-ASCT, FDG-PET imaging with second-line, non-cross resistant, chemotherapy programs improves event-free survival in patients with Hodgkin lymphoma

We previously reported that remission duration 80%, versus 28.6% for patients with a positive scan (P < .001). This prospective study provides evidence that the goal of SLT in patients with Hodgkin lymphoma should be a negative FDG-PET scan before HDT/ASCT.
Validation of radiometric standards for the laboratory calibration of reflected-solar Earth-observing satellite instruments

Historically, the traceability of the laboratory calibration of Earth-observing satellite instruments to a primary radiometric reference scale (SI units) is the responsibility of each instrument builder. For the NASA Earth Observing System (EOS), a program has been developed using laboratory transfer radiometers, each with its own traceability to the primary radiance scale of a national metrology laboratory, to independently validate the radiances assigned to the laboratory sources of the instrument builders. The EOS Project Science Office also developed a validation program for the measurement of onboard diffuse reflecting plaques, which are also used as radiometric standards for Earth-observing satellite instruments. Summarized results of these validation campaigns, with an emphasis on the current state-of-the-art uncertainties in laboratory radiometric standards, will be presented. Future mission uncertainty requirements, and possible enhancements to the EOS validation program to ensure that those uncertainties can be met, will be presented.
Analytical solutions for the electromagnetic fields of tightly focused laser beams of arbitrary pulse length

The analytical solution for a monochromatic focused laser beam was recently published [Opt. Lett.31, 1447 (2006)]. The effect of introducing bandwidth by including a finite-length temporal pulse envelope is included exactly. This is done formally first in the frequency domain for an arbitrary pulse shape, and the specific case of a cosine-squared envelope is then solved analytically for all pulse lengths, thereby decreasing the computation time by 2 orders of magnitude. The inclusion of longer wavelengths reduces the fraction of laser energy in the focus from 86.5% to 83.5% for a 5 fs Ti:sapphire laser and 72.7% in a single-cycle pulse.
Preparation and control of surface properties of monodisperse micrometer size beads by dispersion copolymerization of styrene and butyl methacrylate in polar media

The dispersion copolymerization of styrene and butyl methacrylate in ethanol-water medium to afford micrometer-size monodisperse beads has been investigated. Hydroxypropyl cellulose, poly(acrylic acid), and poly(vinylpyrrolidone) have been used as steric stabilizers, benzoyl peroxide and azobisisobutyronitrile as initiators. A novel steric stabilizing system consisting of a mixture of poly(acrylic acid) and hydroxypropyl cellulose has also been shown to lead to monodisperse beads for which the surface charge can be controlled by the relative ratio of steric stabilizers. The effect of several variables, such as the solvency of the medium, the concentration of co-monomers, the reaction temperature, and the type of steric stabilizer and initator used on the bead size and size distribution are discussed.
Rhetoric, the sophists, and the possible

This essay argues that the rhetoric of the Sophists exhibits a distinct preference for the world of possibility. As such, it is different from Aristotle's rhetoric, which privileges the world of actuality. After showing how this is so, the essay compares the sophistical and the Aristotelian versions of rhetoric by discussing their respective implications for language and persuasion. The conclusion reached is that the Aristotelian version, although textually and topically more complete, is not superior to but merely different from the sophistical.
Improved seismic fragility modeling from empirical data

The improved empirical fragility model addresses statistical dependence among observations of seismic performances, which arises from common but unknown factors influencing the observations. The proposed model accounts for this dependence by explicitly including common variables in the formulation of the limit state for individual components. Additionally, the fact that observations of the same component during successive earthquakes are correlated is considered in the estimation of the model parameters. As demonstrated by numerical examples considering the fragility of electrical substation equipment, the improved formulation can lead to significantly different fragility estimates than those obtained with the conventional assumption of statistical independence among the empirical observations. Furthermore, the conventional approach underestimates the statistical uncertainty associated with the resulting fragility estimates. The paper concludes with an investigation of the effects of statistical uncertainty and component statistical dependence on the system fragility. Numerical examples demonstrate that these effects are significant and must be addressed in the analysis of redundant systems.
Relation of High Heart Rate Variability to Healthy Longevity

The population's aging underscores the need to understand the process and define the physiologic markers predictive of healthy longevity. The findings that aging is associated with a progressive decrease in heart rate variability (HRV), an index of autonomic function, suggests that longevity might depend on preservation of autonomic function. However, little is known about late life changes. We assessed the relation between autonomic function and longevity by a cross-sectional study of HRV of 344 healthy subjects, 10 to 99 years old. The HRV was determined from 24-hour Holter records, using 4 time domain measures of HRV (the root mean square of the successive normal sinus RR interval difference [rMSSD], percentage of successive normal sinus RR intervals >50 ms [pNN50], standard deviation of all normal sinus RR intervals during a 24-hour period [SDNN], and standard deviation of the averaged normal sinus RR intervals for all 5-minute segments [SDANN]). Autonomic modulation of the 4 measures differs, permitting distinctions between changes in HRV–parasympathetic function, using rMSSD and pNN50, and HRV–sympathetic function using SDNN and SDANN. Decade values were compared using analysis of variance and t-multiple comparison testing. The HRV of all measures decreases rapidly from the second to fifth decades. It then slows. The HRV–sympathetic function continues to decrease throughout life. In contrast, the decrease in HRV–parasympathetic function reaches its nadir in the eighth decade, followed by reversal and a progressive increase to higher levels (p
Diallel Analysis of Resistance to Fusarium Ear Rot and Fumonisin Contamination in Maize

The fungus Fusarium verticillioides infects maize (Zea mays L.) ears and kernels, resulting in Fusarium ear rot disease, reduced grain yields, and contamination of grain with the mycotoxin fumonisin. Hybrid maize breeding programs involve selection for both inbred and hybrid performance; the emphasis placed on inbred versus hybrid selection depends on heritability of and the genetic correlation between resistance in the different generations. The objectives of this study were to assess the importance of general combing ability (GCA) and specifi c combining ability (SCA) for resistance to Fusarium ear rot and fumonisin contamination and to estimate the correlation between resistance measured in inbred and hybrid generations. We evaluated a diallel mating of 18 inbred lines from different heterotic groups with different levels of resistance. Hybrids had 27% less ear rot and 30% less fumonisin content than their inbred parents, demonstrating the importance of hybrid vigor to disease resistance. Both GCA and SCA were signifi cant for yield and disease resistance, and inbred performance per se and corresponding GCA in hybrids were signifi cantly correlated (r ≥ 0.78). Genetic variation for resistance was greater in inbred lines than among hybrids, however. These results suggest that the most effi cient way to improve Fusarium ear rot and fumonisin contamination resistances in hybrids is to evaluate and select among inbred lines before using resources to create and evaluate hybrids.
Periprocedural safety of Pipeline therapy for unruptured cerebral aneurysms: Analysis of 279 Patients in a multihospital database

The relative safety of unruptured aneurysm treatment with coiling versus flow diversion therapy is unknown. Most data available on flow diversion reflect highly focused patient groups and very experienced operators. We evaluated a national, multihospital patient database to examine periprocedural morbidity and mortality in patients treated with endovascular flow diversion therapy. The Premier Perspective database was used to identify patients hospitalized between May 2011 and March 2013 for unruptured aneurysm who underwent flow diversion therapy with a Pipeline embolization device. The risk of in-hospital mortality and morbidity was determined using ICD 9 codes. A total of 279 unruptured aneurysm patients at 18 medical centers underwent endovascular therapy with a Pipeline device. Adverse outcomes included in-hospital mortality in two cases (0.7%), discharge to long-term care in 22 cases (7.9%), ischemic complications in 14 cases (5.0%), hemorrhagic complications in four cases (1.4%), and postoperative neurological complications in nine cases (3.2%). This study of a large cohort of patient hospitalizations in the United States provides preliminary data on flow diversion in a "real world" scenario and demonstrates that the periprocedural morbidity and mortality is not negligible and must be considered in the context of the natural history of the aneurysms that are being treated.
Deformation Mechanisms in Nanoindentation of Bone

Cortical bone is a hierarchical, composite material composed of mineralized collagen fibrils organized into lamellae and osteons as classically described by Lakes [1]. The inherent heterogeneity and hierarchy of bone tissue makes it an interesting material to study at various size scales using a range of spherical tip sizes in nanoindentation. Further, the prevalence of pointed, Berkovich nanoindenter tips enable researchers to readily generate nanoindentation data. However, other tip geometries and sizes may provide an advantage over the Berkovich tip by enabling a more elastic contact and testing over a range of contact areas and structures.Copyright © 2010 by ASME
Synergistic Action of Hepatocyte Nuclear Factors 3 and 6 onCYP2C12 Gene Expression and Suppression by Growth Hormone-activated STAT5b PROPOSED MODEL FOR FEMALE-SPECIFIC EXPRESSION OFCYP2C12 IN ADULT RAT LIVER

Growth hormone (GH) exerts sexually dimorphic effects on liver gene transcription through its sex-dependent temporal pattern of pituitary hormone secretion. CYP2C12 encodes a female-specific rat liver P450 steroid hydroxylase whose expression is activated by continuous GH stimulation of hepatocytes. Presently, we investigated the role of liver-enriched and GH-regulated transcription factors in the activation of CYP2C12 gene expression in GH-stimulated liver cells. Transcription of a CYP2C12 promoter-luciferase reporter gene in transfected HepG2 cells was activated 15–40-fold by the liver-enriched hepatocyte nuclear factor (HNF) 3α, HNF3β, and HNF6. Synergistic interactions leading to an ∼300-fold activation of the promoter by HNF3β in combination with HNF6 were observed. 5′-Deletion analysis localized the HNF6 response to a single 5′-proximal 96-nucleotide segment. By contrast, the stimulatory effects of HNF3α and HNF3β were attributable to five distinct regions within the 1.6-kilobase CYP2C12 proximal promoter. GH activation of the signal transducer and transcriptional activator STAT5b, which proceeds efficiently in male but not female rat liver, inhibited CYP2C12 promoter activation by HNF3β and HNF6, despite the absence of a classical STAT5-binding site. The female-specific pattern of CYP2C12 expression is thus proposed to reflect the positive synergistic action in female liver of liver-enriched and GH-regulated transcription factors, such as HNF3β and HNF6, coupled with a dominant inhibitory effect of GH-activated STAT5b that is manifest in males.
Measuring a year of child pornography trafficking by U.S. computers on a peer-to-peer network.

We used data gathered via investigative "RoundUp" software to measure a year of online child pornography (CP) trafficking activity by U.S. computers on the Gnutella peer-to-peer network. The data include millions of observations of Internet Protocol addresses sharing known CP files, identified as such in previous law enforcement investigations. We found that 244,920 U.S. computers shared 120,418 unique known CP files on Gnutella during the study year. More than 80% of these computers shared fewer than 10 such files during the study year or shared files for fewer than 10 days. However, less than 1% of computers (n=915) made high annual contributions to the number of known CP files available on the network (100 or more files). If law enforcement arrested the operators of these high-contribution computers and took their files offline, the number of distinct known CP files available in the P2P network could be reduced by as much as 30%. Our findings indicate widespread low level CP trafficking by U.S. computers in one peer-to-peer network, while a small percentage of computers made high contributions to the problem. However, our measures were not comprehensive and should be considered lower bounds estimates. Nonetheless, our findings show that data can be systematically gathered and analyzed to develop an empirical grasp of the scope and characteristics of CP trafficking on peer-to-peer networks. Such measurements can be used to combat the problem. Further, investigative software tools can be used strategically to help law enforcement prioritize investigations. Keywords: Human trafficking Language: en
Characterization of placenta accreta using transvaginal sonography and color Doppler imaging

The safe use of transvaginal sonography in patients with placenta previa has been confirmed, and has revolutionized precise placental localization. The aim of our study was to evaluate the efficacy of transvaginal sonography and color-coded blood flow in the prediction of placenta accreta. Twenty-one patients with persistent placenta previa were scanned using transvaginal sonography and color-coded flow. Suspicion for placenta accreta consisted of total placenta previa at term with several placental lacunae exhibiting marked or turbulent blood flow, as seen with color Doppler transvaginal sonography from within the placenta, extending into the surrounding tissues. Five of the patients exhibited sonographic placental patterns suspicious for placenta accreta and one patient exhibited placental and cervical blood flow described as lacunar. Five Cesarean hysterectomies were performed for placenta accreta. Every placenta accreta was correctly diagnosed sonographically by the use of color flow studies. One patient with suspicion of placenta accreta delivered at another institution, a Cesarean hysterectomy was performed, and the pathology was confirmed. The one placenta previa exhibiting turbulent lacunar flow in the cervical area only was not confirmed to be an accreta at Cesarean section, although hemostasis was difficult at the placental bed. The remaining 15 patients with placenta previa and who on sonography were not suspicious for placenta accreta underwent uncomplicated Cesarean section. Transvaginal sonography and color Doppler imaging improve the diagnostic accuracy in the prediction of placenta accreta in patients with persistent placenta previa. A pattern of turbulent blood flow extending from the placenta into the surrounding tissues should alert the physician to the possibility of placenta accreta.
Walking symmetry and energy cost in persons with unilateral transtibial amputations: matching prosthetic and intact limb inertial properties.

Abstract Mattes SJ, Martin PG, Royer TD. Walking symmetry and energy cost in persons with unilateral transtibial amputations: matching prosthetic and intact limb inertial properties. Arch Phys Med Rehabil 2000;81:561-8. Objectives: To investigate the hypothesis that increasing the mass and moment of inertia of the prosthetic limb of people with unilateral, transtibial amputations to match the mass and moment of inertia of the intact limb improves walking symmetry without increasing energy cost. Design: Gait symmetry and metabolic energy cost of walking for six subjects with unilateral, transtibial amputations were evaluated under three prosthesis loading conditions. Setting: University research laboratory. Subjects: Six ambulatory individuals with unilateral, transtibial amputations. Interventions: Subjects walked at 1.34m/sec under three prosthetic limb loading conditions: (1) no added load; (2) loading that produced a match of prosthetic shank and foot mass and moment of inertia with those of the intact limb (100% load); and (3) a load that was half that of the 100% condition (50% load). Main Outcome Measures: Step length, swing time, stance time, and metabolic energy expenditure. Results: As mass and moment of inertia of the prosthetic limb became more closely matched to the intact limb, step length, swing time, and stance time became less symmetrical. Energy cost for the 100% load condition was significantly greater (6% to 7%) than the baseline and 50% conditions. Conclusions: The loading configuration required to produce a match in the moments of inertia of the prosthetic and intact lower legs resulted in greater gait asymmetry and higher energy cost. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
Pain Management in Patients with Pancreatic Carcinoma

Pancreatic cancer has a very poor prognosis and is often associated with severe pain. A variety of pain syndromes and pain pathophysiologies can be identified. Information about the analgesic efficacy of available oncological treatments is very limited, but the available data suggest that pharmacological and non-pharmacological approaches can be effective in the majority of cases. Guidelines have been developed for drug administration that emphasize indications, selection of routes, optimal dosing, and side effect treatment. Celiac plexus block can be considered for a subgroup of patients who fail to benefit from drug therapy. Optimally, pain management should be provided within a broader model of palliative care, which can address the many problems associated with this challenging disease.
The two-atom model in enhanced ion backscattering near 180° scattering angles☆

Abstract The recent discovery by Pronko et al. of an unusual enhancement of the yield of ions backscattered through angles close to 180° from the near surface regions of solids is investigated using a two-atom scattering model. The model predicts an enhancement effect in amorphous solids whose physical origin arises from the tolerance of path for those ions whose inward and outward trajectories lie in the vicinity of the critical impact parameter. Predictions are given of the dependence of the yield enhancement on the following parameters: ion energy, backscattering depth, exit angle, scattering potential, atomic numbers of projectile and target, and atomic density of target.
Atmospheric monitoring of volatile organic compounds using a Fourier transform near-infrared spectrometer

The feasibility has been demonstrated for using a Fourier transform near-infrared spectrometer for atmospheric monitoring of volatile organic compounds.
On temporal characteristics of behavior in certain complex systems.

Little is known about the behavior of dynamic systems with many intricately interacting parts, and about the factors which tend to affect their behavior in general, rather than detailed, ways. This paper describes a study of such systems built up out of unit elements which compute recursive logical functions.
Outward stabilization of the voltage sensor in domain II but not domain I speeds inactivation of voltage-gated sodium channels

To determine the roles of the individual S4 segments in domains I and II to activation and inactivation kinetics of sodium current (INa) in NaV1.5, we used a tethered biotin and avidin approach aft...
Automatic segmentation and analysis of fibrin networks in 3D confocal microscopy images

Fibrin networks are a major component of blood clots that provides structural support to the formation of growing clots. Abnormal fibrin networks that are too rigid or too unstable can promote cardiovascular problems and/or bleeding. However, current biological studies of fibrin networks rarely perform quantitative analysis of their structural properties (e.g., the density of branch points) due to the massive branching structures of the networks. In this paper, we present a new approach for segmenting and analyzing fibrin networks in 3D confocal microscopy images. We first identify the target fibrin network by applying the 3D region growing method with global thresholding. We then produce a one-voxel wide centerline for each fiber segment along which the branch points and other structural information of the network can be obtained. Branch points are identified by a novel approach based on the outer medial axis. Cells within the fibrin network are segmented by a new algorithm that combines cluster detection and surface reconstruction based on the α-shape approach. Our algorithm has been evaluated on computer phantom images of fibrin networks for identifying branch points. Experiments on z-stack images of different types of fibrin networks yielded results that are consistent with biological observations.
A Reply to Yvonne M. Johnson

I appreciate the opportunity to respond to Yvonne M. Johnson’s critique of my Social Service Review article, “Reinterpreting Abraham Flexner’s Speech, ‘Is Social Work a Profession?’: Its Meaning and Influence on the Field’s Early Professional Development” (Morris 2008). My article presents findings from a Gadamerian hermeneutic inquiry that explores various topics: the meaning of Flexner’s criteria of a profession, his assessment of social work’s professional standing, the field’s multiple interpretations of his criteria and assessment throughout the 90 years since his speech, and the speech’s influence on the field’s early professional development. Contrary to Johnson’s critique, my interpretation of Flexner’s text (1915) is based on a sound methodology derived from a philosophical perspective. It is unclear what methodology, if any, Johnson uses in deriving either her understanding of the text or her critique of my interpretation. Instead, Johnson falls into the very trap that my article identifies; she seems to interpret his meaning through a contemporary lens. For example, she uses recent editions of Merriam-Webster’s Collegiate Dictionary and the Oxford English Dictionary. Since ancient times, scholars have used hermeneutics to interpret religious, legal, historical, and literary texts. Interpretations sometimes differ because they are often guided by varying philosophical and methodological principles. My inquiry is guided by Hans-Georg Gadamer’s seminal work, Truth and Method (1989). Five principles guide the inquiry:
Access to care – what can the United States learn from other countries?*

This paper briefly describes the US system for dental care services; asserts that there is much to be learned by considering the experience of other countries; identifies a few lessons that may be learned from comparisons with England, Australia, and other nations; and encourages the monitoring of outcomes associated with innovations in financing and delivery of services elsewhere. Oral health is affected by more factors than access to dental care. Because so many factors at the individual, environmental, and delivery system levels affect oral health, interpreting the findings from international studies is difficult. Furthermore, the findings of these international studies are confounded by significant intra-country variation in outcomes and expectations. While public funding and the public provision of services (such as programs in schools or community health centers) can be powerful instruments of change, they have their limitations. Examination of all types of public subsidization of dental care may reveal inadvertent distributions that may increase disparities. The discovery of best practices and lessons learned in the financing and organization of dental care may begin by comparing US experiences with those of other countries.
Orthodoxy, cultural compatibility, and universals in education

Are western psychological and educational theory and practice truly applicable to a range of diverse settings around the world? We demonstrate that there is a globally dominant pedagogical orthodoxy—not exclusively western—for which there is little supportive theory nor evidence of efficacy. There is an alternative—Standards for Effective Pedagogy—that aspires directly and by design toward universalism. We describe this pedagogical system’s nearly forty‐year developmental history, as well as its methods, disciplines, and evidence for efficacy. Examples and prospects for application in a variety of cultures are discussed, as well as the political and philosophical limits of a universalist approach.
Crystal structure of tetrakis(diacetamide) monoaquostrontium(II) perchlorate

Abstract A new compound, tetrakis(diacetamide)monoaquostrontium(II) perchlorate, Sr(CH3CONHCOCH3)4 H2(ClO4)2 has been synthesized and its structure determined from three dimensional X-ray diffraction data using monochromatic CuKα radiation. The unit cell is monoclinic, space group P21/m with dimensions a = 8.642(.9) A, b = 21.833(2), c = 8.652(.9), β = 78°41′ (1′) and Z = 2. Three dimensional intensity data were collected on the Enraf Nonius CAD-4 automated diffractometer. The crystal structure was determined by the heavy atom method and refined anisotropically by block diagonal least squares to a conventional unweighted R-factor of 0.083 The complex forms the nine-coordinate monocapped square antiprism (C4v), rather than the lower energy symmetrically tricapped trigonal prism (D3h). Eight of the coordinated oxygens are contributed by the four bidentate diacetamides and the ninth by the water. Two of the diacetamides bridge the equatorial planes while a third spans an edge of one equatorial plane and the fourth bridges the cap position and an equatorial plane. Two types of hydrogen bonding are present: (1) OH⋯O between water and perchlorate and (2) NH⋯O between amide and perchlorate. Strontium-oxygen bond distances fall within the range 2.54A to 2.69A.