cssi/SciSciGPT-SciSciNet huggingface dataset:
27 Using QI methodology to increase usage of seizure action plans for pediatric patients with seizures

Background Seizure Action Plans (SAP) have been proposed as an educational tool to help patients and caregivers be prepared for daily seizure care and emergencies. Meaningful clinical outcomes have been linked to the use of SAPs. Despite recognizing the importance of SAP use, 39% of patients seen by epilepsy providers within our outpatient epilepsy center at Nationwide Children’s Hospital received a SAP in 2016. Objectives Increase and sustain the percentage of outpatient epilepsy center patients with seizure rescue medications who receive SAPs, from 39% to 85%. Methods A multi-disciplinary QI team developed key drivers and implemented interventions, such as an imbedded clinical pharmacist in the neurology clinic to assist with SAPs, clinic nursing staff providing SAP education at discharge, SAP enhancements to ease completion within the Electronic Medical Record (EMR), utilizing clinical decision support via the EMR to remind providers to complete SAPs, and provider and nursing education (figure 1). The team created a monthly report to monitor provider compliance for creating clinically indicated SAPs. The first half of 2016 was used as the preliminary baseline data. Results From January 2016 to April 2021, the team increased the percentage of outpatient epilepsy center patients with an active SAP from 39% to an average of 85.6% (P Conclusions Using QI methodologies, the team successfully and substantially increased provider compliance in creating clinically indicated SAPs for outpatient epilepsy center patients by 120%. Through our efforts we have been able to develop and implement a standardized and customizable SAP completed within the EMR that is now provided to nearly 90% of epilepsy center patients. This project demonstrates that high SAP utilization rates can be achieved even amongst a large, diverse group of Neurology providers. Future work linking SAP usage to decreased healthcare utilization is ongoing.
Effectiveness of facemasks for pediatric populations against submicron-sized aerosols.

Background In the event of a public-health threat involving bioaerosols, such as a terrorist attack or pandemic, options for devices to protect the pediatric population are limited. One strategy involves deployment of facemasks meant for the pediatric population, although protection against bioaerosols was not an intended use of such masks and little is known about their effectiveness. Methods We chose 3 brands of facemasks for pediatric use for characterizing penetration. To validate our experimental technique, 2 N95 respirator brands were also tested. All barriers were subjected to neutralized polydispersed sodium chloride aerosols, and their intrinsic penetration was evaluated in the submicron size range at different flow rates. Results As expected, the N95 brands had low penetration (5% or less) at the highest flow rates. However, for the facemasks for pediatric use, penetration varied significantly amongst brands at the highest flow rates (∼15%->50%). Studies with isopropanol-dipped respirators and facemasks demonstrated that not all brands of facemasks for pediatric use have electret layers. Conclusions Our bench tests suggest that the intrinsic penetration through facemasks for pediatric use can be high in the submicron size range. These data can be used in risk-assessment models to determine the extent to which facemasks for pediatric use reduce the likelihood of infection in emergency situations.
Networking for Leadership, Inquiry, and Systemic Thinking: A New Approach to Inquiry-Based Learning

Recent changes in science education standards have mandated a prominent place for inquiry learning in science curricula. However, change from traditional teaching methods to a more inquiry-centered approach is difficult to enact. While research to date demonstrates a number of successful inquiry implementations, it also reveals a slow rate of change along with possible reasons for difficulty in adopting inquiry instructional methods. Further, inquiry reforms have failed in the past. The Networking for Leadership, Inquiry, and Systemic Thinking (NLIST) initiative, sponsored by the Council of State Science Supervisors and NASA, proposes to facilitate inquiry through systemic reform designed to avoid the mistakes of the past and incorporate new knowledge about teaching and learning. Systemic elements targeted for change include a standard conceptualization of science as inquiry, instructional materials, professional development, administrative support and leadership, facilities, community involvement, and technology infrastructure. To date, the initiative has created a detailed definition of inquiry learning and a rubric for evaluating instructional materials against this definition. This paper presents the theoretical and empirical foundations for the NLIST initiative, describes its progress, and outlines future goals.
Study of the Grain Boundary Effects in N-P Junction Polycrystalline Si Solar Cells

The effects of grain boundary, such as recombination velocity, grain size, and grain orientations have been studied on the efficiency of n-p junction polycrystalline Si solar cells. Numerical calculations have been made for the photocurrent, dark current and fill factor utilizing our previously developed theory in three dimension. The results of this study indicate that it is possible to produce an efficiency as high as 15% with fibrously grained samples of grain size 100μm, recombination velocity 100m/sec, and thickness 100μm.
The Science and Technology-Bereft Department of State

The Department of State, currently without focused management of Science and Technology (ST create a new ST establish a ST and ensure basic S&T literacy for all State personnel. Failure to ensure State9s S&T competence will lead to a gradual decline in the Department9s relevance to U.S. international interests.
Shallow normal fault slopes on Saturnian icy satellites

Fault dips are a function of the coefficient of internal friction, μi, of the lithospheric material. Laboratory deformation experiments of H2O ice at conditions applicable to icy bodies yield 0 ≤ μi ≤ 0.55 such that normal faults dip between 45° and 59°. We tested the hypothesis that normal faults on icy bodies reflect these values by using digital elevation models to examine geometries of large extensional systems on three Saturnian satellites. Analyzed faults within Ithaca Chasma on Tethys and Avaiki Chasmata on Rhea all exhibit shallower-than-predicted topographic slopes across the fault scarp, which we term ‘fault slopes’. A scarp of Padua Chasmata within Dione's Wispy Terrain also has a shallow fault slope, although three others that make up Palatine Chasmata exhibit steeper slopes as predicted. We infer that viscous relaxation is the most viable explanation for these shallow fault slopes, and we model the potential role of viscous relaxation in creating shallow fault slopes. Our modeling results support formation of these normal faults with steep dips consistent with deformation experiments, followed by their relaxation due to lithospheric heating events related to radionuclide decay. The steepest fault slopes in this terrain yield 0 ≤ μi ≤ 0.73 for Dione's lithospheric ice, which overlaps the dip range predicted from experiments. Results of this work suggest that viscous relaxation substantially affected fault slopes on Tethys, Rhea, and Dione. By implication, these processes may have also affected fault geometries on other icy satellites.
Collectives on two-tier direct networks

Collectives are an important component of parallel programs, and have a significant impact on performance and scalability of an application. To obtain best performance, platform specific implementations of various parallel programming frameworks, such as MPI and Charm++, are done. As a result, when systems with new network topologies are built, new topology aware algorithms for collectives are added to these frameworks that also contain the topology oblivious algorithms. In this paper, we propose topology aware algorithms for collectives performed on two-tier direct networks such as IBM PERCS and Dragonfly. We observe that, for large message operations, significant performance gains can be made by taking advantage of large number of links in a two-tier direct network. We evaluate proposed algorithms using an analytical model based on link utilization.
Neutrophil defects and host-parasite interactions in the pathogenesis of localized juvenile periodontitis.

Through the study of host responses in periodontal diseases, the role of the neutrophil as an important protective cell in the pathogenesis of disease has become apparent. In this report, we examine the neutrophil defects associated with localized juvenile periodontitis to include defects of cell surface protein expression, defects of signal transduction, and defects of bactericidal activity. We report that LJP neutrophils are deficient in chemotactic factor receptors and a chemotaxis-related glycoprotein (GP110). There is a deficit of signal transduction, resulting in a decrease in leukotriene B4 production, and the LJP neutrophil is deficient in its ability to kill the periodontal pathogen, Actinobacillus actinomycetemcomitans. The study of neutrophil biology in the LJP model and the application of these studies to the more prevalent disease, adult periodontitis, are discussed.
Efficient reformulation for 0-1 programs: methods and computational results

Abstract We introduce two general methods for 0–1 program reformulation. Our first method generalizes coefficient reduction, our second method generalizes lifting. Together they provide a unifying interpretation of many previously described automatic reformulation methods. The particular model structures that we consider are individual knapsack constraints, pairs of knapsack constraints, clique and cover induced inequalities, variable upper bounding constraints and capacity expansion constraints. We describe several easy applications of our reformulation procedures. Some computational experience is reported, including the currently best known results on a well-known 147 × 2655 benchmark problem.
Expression of interleukin-1 receptor antagonist in human cornea.

Abstract The purpose of this study was to confirm the expression of interleukin-1 receptor antagonist (IL-1 Ra) in the human cornea. Four samples of human ex vivo corneal epithelium were obtained from patients undergoing photorefractive keratectomy. RT-PCR was performed using mRNA isolated from the corneal epithelium and oligo-dT primers. PCR was performed on the cDNA products using primers specific for human IL-1 Ra. The PCR products were subcloned and sequenced. Human cornea sections were prepared from eyes enucleated for choroidal melanoma. Immunocytochemistry was performed using goat anti-mouse polyclonal IL-1 Ra IgG and NL-577 conjugated donkey anti-goat IgG. IL-1 Ra mRNA was expressed in all ex vivo corneal epithelium samples as confirmed by sequencing of the PCR products. Immunofluorescence studies revealed strongest expression of IL-1 Ra in the superficial apical layer of corneal epithelium. Expression of IL-1 Ra may represent an endogenous mechanism of down-regulating the effects of epithelial- and tear-derived IL-1α and IL-1β on the intact epithelium in the unwounded cornea and stromal cells after injury.
Health through three life stages: A longitudinal study of urban black adolescents

Abstract This is a study of life stage coherence and change in perceived health status and morbidity reports over a 15 year interval bounding adolescence. Data were obtained through personal home interviews with a representative sample ( N = 426) of urban black youths who were interviewed at three successive life stages: first when they were adolescents ages 12–17, 6–8 years later when they were ages 18–23, and 7–8 years after that when they were ages 26–31. Results showed that health decline was neither continuous nor progressive over the three life stages. Instead, a dramatic increase in morbidity reports occurring between adolescent and post adolescent measurement was succeeded by stabilization in the following 7 year interval. One interpretation of these findings is that they reflect the stressfulness of the adolescent life stage in the urban black youth cohort. The congruence of this interpretation with Mechanic and Angel's theory of differential health synchrony over the life course and also with Antonovsky's theory of sense of coherence in explaining variations in perceived health is discussed. The study, finally, pointed up a serious methodological impediment to attempting comparative life span health studies such as this, namely, the difficulty in arriving at equivalently comprehensive and sensitive health symptom indicators at different life stages.
Comparison of the Surface Activity and Bulk Aggregation of Ferrocenyl Surfactants with Cationic and Anionic Headgroups

We report the synthesis and aqueous solution properties of a novel redox-active surfactant, Fc(CH2)11SO3-Na+, where Fc is ferrocene. Electrochemical oxidation of Fc to the ferrocenium cation (Fc+) reversibly transforms the anionic surfactant (Fc(CH2)11SO3-) into a zwitterionic species (Fc+(CH2)11SO3-). When dissolved at concentrations between 0.15 and 0.4 mM in aqueous solutions containing 10 mM Li2SO4, oxidation is accompanied by the reversible transformation of a solution of monomeric species of Fc(CH2)11SO3- into vesicle-like (Dh = 70 ± 8 nm, Rg/Rh = 1.0 ± 0.3) surfactant assemblies of Fc+(CH2)11SO3-. In contrast, at concentrations above 0.4 mM, oxidation reversibly transforms a solution of globular (Dh = 6 ± 2 nm) micelles into vesicle-like assemblies of Fc+(CH2)11SO3-. These various oxidation-induced changes in aggregation are reflected in the interfacial properties of this surfactant system, which are substantially different from those of ferrocenyl surfactants with cationic headgroups (Fc(CH2)11N+(...
Allelic loss of 8p sequences in prostatic intraepithelial neoplasia and carcinoma

Abstract Objectives Previous work has suggested that prostatic intraepithelial neoplasia (PIN) may be a premalignant lesion important in tumorigenesis of the prostate. However, to adequately test this hypothesis at the genetic level, it is necessary to determine whether lesions in close proximity demonstrate similar genetic alterations and, hence, whether an "evolutionary" relationship might exist between PIN and tumor in the same prostate. Therefore, the purpose of this study was to examine at least two PIN lesions per prostate (one adjacent to and another distant from malignant lesions in the same prostate) for similarities or differences in the types and frequencies of genetic alterations. Methods To accomplish this goal, DNA was extracted from microdissected PIN, tumor and normal epithelial tissue samples from 48 radical prostatectomies and amplified using polymerase chain reaction techniques at highly polymorphic microsatellite repeat sequences at proximal ( D8S87 , 8p12) and distal ( NEFL , 8p21) loci on the short arm of chromosome 8. PIN specimens were either adjacent to (within one high-power microscopic field [HPF]) or distant from (separated by two or more HPFs) tumor specimens from the same patients. Results Similar fractional allelic loss frequencies were observed for informative tumor (10 [35%] of 29) and PIN (6 [21%] of 29) samples at the NEFL locus, but allelic loss at the D8S87 locus was observed only in tumors (8 [22%] of 36 informative samples). Moreover, allelic loss at the NEFL locus involved the same allele in 4 cases and different alleles in 3 cases. Interestingly, all 4 cases with the same allele loss were from adjacent PIN and tumor tissues and all 3 with different allele loss were from distant PIN and tumor. Conclusions These results suggest that PIN and invasive cancer share common genetic events (eg, deletion at the NEFL locus) along the same pathway of development in the prostrate.
Case Study: The Engineering Economics of RFID in Specialized Manufacturing

Calibrated tools are essential to producing highly specialized, defect-free parts. These tools are used in many processes in specialty manufacturing operations. Personnel could use the improper tool if the calibrated tool has been lost or stolen. This results in reduced business productivity and increased cost due to poor quality. This study demonstrates the cost effectiveness of using a radio frequency identification (RFID) system to track calibrated tools throughout a production facility. The costs of RFID tool tracking are described and return on investments of plausible scenarios are determined. Also, sensitivity analysis is performed utilizing spider plot and tornado diagrams.
Extrapolating programmed gas chromatographic data from one set of conditions to another

Abstract Programmed temperature retention indices can be extrapolated from one set of conditions to another by a simple logarithmic relation. A similar relation for retention temperatures is less successful, but Giddings' approximation works well.
Internal Fixation Techniques for Midfoot Charcot Neuroarthropathy in Patients with Diabetes

Charcot neuropathic osteoarthropathy (CN) of the foot and ankle is a poorly understood destructive process that poses a great clinical challenge to foot and ankle specialists. Neuropathic fractures or dislocations in the foot and ankle predispose patients to increased morbidity, premature mortality, and can greatly decrease quality of life. Early recognition and treatment of CN is imperative to prevent the development of permanent deformities. The purpose of this article is to review the history, cause, and classification of CN and to discuss commonly used internal fixation techniques and their indications.
Grooming behavior of spider monkeys (Ateles geoffroyi) on Barro Colorado Island, Panama

Quantitative grooming data are presented for free-ranging black-handed spider monkeys (Ateles geoffroyi) on Barro Colorado Island, Republic of Panama. A total of 126 grooming sessions was recorded, with an average session length of 2.0 min (range, 0.1 to 10.0 min). Grooming was an infrequent behavior; on average, individuals allocated only 2.5% of their daily activity to grooming. Two daily peaks of grooming activity were observed, one near midday and another in the late aftermoon between 1600 and 1700. Adult females groomed most frequently, followed by males and then juveniles. Juveniles were the most frequent recipients of grooming, followed by females and then males. Individual preferences were observed primarily between mother-offspring, male-male, and juvenile-male grooming partners in this male-bonded fission-fusion, species. Grooming interactions reflect many of the social characteristics of spider monkey societies: intraclass grouping preferences, long period of juvenile dependence, male philopatry, and female dispersal.
Stabilization of an archaeal DNA-sliding clamp protein, PCNA, by proteasome-activating nucleotidase gene knockout in Haloferax volcanii

Many details of structure, function and substrate specificity of eukaryotic proteasomal systems have been elucidated. This information far-exceeds that available for the archaeal and bacterial counterparts. While structural and functional studies have provided some insight into the workings of prokaryotic proteasomes, the question of substrate targeting and global cellular influence remain largely unaddressed. In this communication, we report an over 720-fold increase in the half-life of the DNA-sliding clamp protein proliferating cell nuclear antigen after knockout of the panA gene, encoding a proteasome-activating nucleotidase A, on the chromosome of the halophilic archaeon Haloferax volcanii. This discovery marks the first identification of a protein stabilized by an archaeal proteasome mutation and provides a starting point for investigations into substrate recognition mechanisms. The findings also begin to address the functional role of proteasomal systems within the scope of the archaeal cell.
The African-American Labor Supply after Reconstruction: Added Worker Effects in Urban Families

Econometric analysis of a hitherto unused 1896 survey of African-American families in American cities, mostly located in the South, reveals the classic added worker effect: Longer intervals of husbands' unemployment—not counting work missed on account of illness—led to a greater share of wives taking paid employment outside the home. The analysis also shows that household structure and composition, as well as the health of husbands, influenced the decision of wives to enter the labor force. The data and analysis provide some of first econometric evidence about the labor-force decisions of urban-dwelling blacks in late nineteenth-century America.
Photobiological effects of metal ions. Photosensitizing action of uranyl acetate on Escherichia coli K-12.

— The Uranyl acetate sensitized killing of Escherichia coli K-12 by a light source approximating sunlight in both intensity and wavelength distribution is demonstrated to occur at a concentration of 5.0 × 10O-4M uranyl acetate (pH 7.0). The photosensitized killing was evident after 150 min and almost complete within 320 min. Auxotrophic mutants were isolated from cultures incubated in both light and dark for 160 min at this concentration of uranyl acetate. Binding of UO22+ to E. coli is shown to occur with 82% of the UO22+ ions in a 5 × 10-4M solution (pH 7.0) being bound to the cell wall. In the dark as well as at other pH values the extent of binding was much less. Most of the binding occurred in a time less than 30 min. The observation of rapid binding but delayed photosensitization is attributed to the necessity for penetration of uranyl ions into the cells' interior to effect photosensitization.
Type decomposition for von Neumann algebra embeddings

This paper establishes a type decomposition theory for embeddings of a von Neumann algebra A into a von Neumann algebra M, by studying projections in A that are semifinite (resp. abelian) relative to M. An application of this theory is a complete characterization of the subalgebras A of M that have an n-equipartition of the identity, i.e., I = ∑k = 1npk with projections pk ϵ A which are equivalent in M. From this follows R. V. Kadison's result (Amer. J. Math.106, 1984, 1451–1468) that masas of M always have equipartitions and hence that normal operator valued matrices are diagonalizable. A second application is an answer to a question by G. K. Pedersen and E. Stormer (Indiana Univ. Math. J.23, 1973, 121–129) on the characterization of ~G-finite projections in discrete crossed products.
Electromagnetic interaction of ultrarelativistic heavy ions

The validity of a delta-function approximation for the electromagnetic interaction of relativistic heavy ions is investigated. The production of e+e- pairs, with electron capture, is used as a test of the approximation.
Teaching style and the application of adult learning principles by police instructors

Purpose – The purpose of this research is to describe the teaching style of the faculty of a Police Officer Standards and Training (POST) organization in a Midwestern state and the degree and method of application of adult learning principles by the POST faculty. The move of law enforcement to community‐oriented policing (COP) requires that police officers develop communication and problem‐solving skills. The application of adult learning principles in law enforcement education can help prepare officers for their role in COP.Design/methodology/approach – In this mixed method/descriptive study, 85 instructors completed the Principles of Adult Learning Scale (PALS) and 21 instructors participated in in‐depth interviews.Findings – Major findings in the study related to POST instructors' strong preference for a teacher‐centered style of teaching as measured by PALS and a disconnect between what instructors do in the classroom and what they feel is effective instruction.Practical implications – Offers suggesti...
Clinical pharmacological studies with 6-azidomorphine.

Abstract The intravenous (i.v.) administration of 4 μg/kg 6-deoxy-6-dihydro-azido-isomorphine (6-AM) base to healthy, young adult male volunteers caused no circulatory and relatively little, short-lasting respiratory depres sion. Of the ten volunteers all felt lightheaded, two became euphoric and when they became ambulatory at the end of the experiment, three vomited and two others became nauseated. The intramuscular (i.m.) administration of the same dose of 6-AM had considerable analgesic effect against various types of experimental pain. It was more effective against ischemic pain, than against pain induced by electrical stimulation of the earlobe or the tooth pulp and it effected severe pain more than mild or moderate pain. In the six subjects investigated, 6-AM produced significant myosis. Of the 16 subjects who received 4 μg/kg 6-AM i.m. five experienced mild euphoria, two felt lightheaded, six became pale and sweaty in the course of the experiments carried out in the sitting position. When they became ambulatory after the completion of the experiments, two subjects vomited and six others became nauseated. The findings of this study indicate that 6-AM causes less circulatory and respiratory depression than is to be expected from equianalgetic doses of morphine. Its other side effects (e.g., nausea, vomiting) are also less frequent and severe than those encountered after the administration of comparable doses of morphine to ambulating volunteers.
Oxidized lipids formed non-enzymatically by reactive oxygen species.

The evolution of living organisms in an oxidizing atmosphere has resulted in a complex array of antioxidation mechanisms within cells to protect critical biomolecules from oxidative modifications. Despite this, oxidation of biomolecules as a result of exposure to reactive oxygen species is a constant biochemical battle. Because lipids present themselves often as initial barriers to the free diffusion of reactive oxygen species into the cell, they themselves become targets of oxidation reactions. By and large, the resulting structures are not controlled by enzymatic mechanisms and thus are not programmed by the human genome. Their formation is controlled by chemical reaction mechanisms, and a diverse array of products are made, depending upon the reactive oxygen species as well as the nature of the lipid target. In most cases, these molecules are readily degraded and recycled into the essential building blocks of the cell, but there are some oxidized lipids that escape such protective mechanisms and can exert profound, deleterious effect on cells.
Fundoplication in 160 children under 2 years of age

Abstract The natural history of fundoplication in young children with gastroesophageal reflux (GER) had not been analyzed previously. The authors reviewed the charts of 160 children who underwent gastric fundoplication (GF) before the age of 2 years (mean age [±SD], 9 ± 7 months; range, 1 week to 2 years), from 1974 to 1992. Reflux was documented by upper gastrointestinal series in 124 patients, by 24-hour pH probe monitor in 98 patients, and by both in 68 patients. Clinical indications for GF included failure to thrive (FTT) in 68%, emesis (Ems) in 58%, and aspiration pneumonia (Asp) in 53%. Neurological impairment (NI) was present in 47% of all patients, and 13% had esophageal atresia (EA). The type of GF used was a Nissen fundoplication in 79% and an anterior fundoplication (AF) in 21%. Of the 160 patients, 24 (15%) died of unrelated causes. Of the remaining 136, follow-up of at least 2 years was obtained for 96 (mean follow-up period, 5.3 ± 3.0 years; range, 2 to 15 years). Clinical resolution of symptoms/findings after GF occurred in 87% of children with FTT, 92% with Ems, 70% with Asp, and 71% overall. A second fundoplication was required for 15 children (16%) because of documented recurrent reflux. The type of GF, the age of the patient, and the presence of EA or NI did not significantly affect the success of GF. This experience demonstrates that (1) in young children there is no inordinate increase in recurrence after GF, (2) GF (AF or Nissen) is an effective means of treating GER in children under 2 years of age, even those with EA or NI.
Sensory receptors on the adult labial and maxillary palpi and galea of Cicindela sexguttata (Coleoptera: Cicindelidae).

Five types of sensilla are situated on the apical area of the labial and maxillary palpi and galea of Cicidela sexguttata. Large, conical, and peg-like sensilla are in rows on the central region of each palpus. These sensilla have a hollow cuticular peg, with an apical pore and multi-innervation. This central region of palpal sensilla is surrounded by campaniform sensilla that are disc-shaped and small conical peg sensilla. A similar type of conical sensillum as the found in the palpal central region is situated around the periphery of the palpal apex and apex of the galea. This conical peg sensillum is located in a shallow depression and is structurally similar to the other peg sensilla, but it has a mechanoreceptor neuron attached to the cuticular base of the sensillum. A long, single, trichoid sensillum is situated in the center of the galea and is hollow, thick-walled, porous, and multi-innervated. The apices of the palpi and galea have a large number of dermal gland openings that actively secrete a substance during the feeding process of the tiger beetle. © 1995 Wiley-Liss, Inc.
The impact of menopause and lifestyle factors on blood and bone lead levels among female former smelter workers: the Bunker Hill Study.

Objective The Bunker Hill mine in Idaho operated from 1886 to 1981. In the 60’s and 70’s it provided approximately 25% of the primary lead in the United States. Women first began working on the production and maintenance lines in 1972. This study examines the impact of menopause and several occupational and lifestyle factors as determinants of blood and bone lead levels among 73 female former smelter workers. Methods Blood lead levels were analyzed using graphite furnace atomic absorption spectroscopy. The 109 Cd K X-ray fluorescence system was used to measure calcaneus and tibia bone lead content. Information was obtained on reproductive history, alcohol and cigarette consumption, education, and hormone replacement therapy (HRT). Results Postmenopausal women (n ¼ 47) had significantly (P 10 or � 10 cigarettes/day), natural menopause, technical or community college education, manager or technical worker, and past or present use of HRT. The best predictors of calcaneus bone lead levels (P 10 cigarettes/day; level of education; 1–2 pregnancies; and age (>60 years). Conclusions Lead exposure results in higher blood lead levels especially during menopause. Am. J. Ind. Med. 49:143–152, 2006. Published 2006 Wiley-Liss, Inc. {
Type 1 diabetes and glucose monitoring.

Perspectives on the News commentaries are now part of a new, free monthly CME activity. The Mount Sinai School of Medicine, New York, New York, is designating this activity for 2.0 AMA PRA Category 1 credits. If you wish to participate, review this article and visit www.diabetes.procampus.net to complete a posttest and receive a certificate. The Mount Sinai School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This is the third in a series of articles based on presentations at the American Diabetes Association’s 67th Scientific Sessions, 22–26 June 2007, in Chicago, discussing aspects of type 1 diabetes and new approaches to glucose monitoring. George King (Boston, MA) discussed the Joslin award for documented type 1 diabetes of at least 50 years duration. The program, which began in 1970, has awarded more than 2,100 medals so far, comprising 0.05% of individuals with type 1 diabetes in the U.S. Of the medalists, 14 have had diabetes for at least 75 years. The mean age is 71 years for males and 68 years for females, with diabetes for 58 and 57 years, respectively; mean ages of onset are 14 and 12 years, respectively. Their average A1C levels are 7% and 7.2% for men and women, and 45 and 48%, respectively, have no significant evidence of eye, kidney, or nerve disease. Of the 211 who were more closely evaluated, at mean age 67 years, age was 11 years at diagnosis, their mean BMI was 25 kg/m2, and triglycerides 66, HDL 62, and LDL 84 mg/dl. Of this group, 44% have no to mild nonproliferative retinopathy, with <2 microaneurisms, 7% have moderate-to-severe nonproliferative retinopathy, and 49% have proliferative diabetic retinopathy. Complications did not correlate with C-peptide or HLA type, and …
The production and replacement of soldiers in incipient Colonies ofReticulitermes Hesperus Banks

1. Only a small percentage of incipient colonies ofReticulitermes hesperus produce a soldier during the first year. 2. In some colonies the soldier is derived from the first eggs and in other colonies the soldier develops from later eggs. 3. Not more than one soldier was present in any one colony during the first year. 4. If the initial soldier, produced from the first group of young was removed, a second or replacement soldier was produced from the second group of young in 50% of an experimental series of 12 colonies.
Bone Mineral Density of Wild Turkey (Meleagris gallopavo) Skeletal Elements and its Effect on Differential Survivorship

Zooarchaeologists recognize that density-mediated attrition is a bias that demands consideration in the analysis of archaeofaunal samples. This paper presents bone mineral density values (aereal and volumetric) for the wild turkey (Meleagris gallopavo) and represents the first application of Dual-energy X-ray Absorptiometry (DEXA) to birds. The relationship between density and the survivorship of avian skeletal elements and portions is demonstrated by examining 20 assemblages from the archaeological record of the northeastern United States. The results suggest that density may account for the differential survivorship of least 35% of the samples tested. Further analysis of a single site demonstrates the importance of examining bone mineral density when interpreting past bird hunting and use.
Drug metabolism by the human hepatoma cell, Hep G2

Abstract The human liver-derived cell line, Hep G2, has aryl hydrocarbon hydroxylase and 7-ethoxycoumarine o-deethylase activities. Partial purification of cytochrome P-450 from Hep G2 cells provided spectral evidence of this hemeprotein in the purified fraction. These results suggest that Hep G2 cells will be useful for the study of cytochrome P-450 and the regulation of mixed function oxidase activities in liver cells of human origin.
The Correlation of the Φ Function of the Difference Score with Performance and its Relevance to Laterality Experiments

Summary It is shown that there is a generic correlation between the Φ functions of differences in pairs of scores and the averages of pairs of scores. This correlation can be approximated extremely accurately given only the means, variances, and covariance of the two scores in the sample data. Thus, even when difference scores are transformed into their Φ equivalents, these are still not independent of performance level.
Flash Pulmonary Edema and the Diagnostic Suspicion of Occult Renal Artery Stenosis

A NUMBER OF different patterns of pres entations of ischemic renal disease exist. I These presentations include acute renal failure, often in association with use of an angiotensinconverting enzyme (ACE) inhibitor;2 progressive renal dysfunction in a patient with previously identified renovascular hypertension; progressive renal dysfunction in an elderly patient with refractory hypertension; and unexplained progressive renal dysfunction in an elderly patient. I We describe here three patients with a clinical presentation of long-standing hypertension, renal dysfunction, and episodes of abrupt-onset pulmonary edema that rapidly resolved ("flash" pulmonary edema) and were out of proportion to the degree of myocardial dysfunction subsequently determined by invasive and/or noninvasive diagnostic testing. These patients underwent successful renal artery bypass grafting without further recurrence of flash pulmonary edema, as well as an improvement in renal function. Flash pulmonary edema constitutes an important new pattern of clinical presentation in patients with renal artery stenosis.
Rapid expression of neuronal and inducible nitric oxide synthases during post-ischemic reperfusion in rat brain

Abstract Objective: To determine whether neuronal and inducible nitric oxide synthase (nNOS and iNOS) isoforms are expressed within cortical neurons during early reperfusion after focal cerebral ischemia. Methods: Male spontaneously hypertensive rats underwent occlusion of the left middle cerebral artery for 2 h. Coronal brain sections with normal and ischemic cortex were obtained after 15 min or 1, 6 or 24 h of reperfusion. Immunohistochemical and double-label immunofluorescent techniques were used to confirm cellular identity and localize nNOS and iNOS. Results: Immunoreactive nNOS was identified within isolated neurons in layer V of normal cortex. However, the number of nNOS-immunoreactive neurons in ischemic cortex rose markedly at 15 min and persisted for 24 h (P≤0.001 at each time point when compared to normal cortex). Cells that were immunoreactive for nNOS appeared in perivascular clusters within ischemic brain at all sampling times. Immunoreactive iNOS was also expressed within neurons in ischemic cortex, peaking after 15 min of reperfusion (P≤0.01). Although nNOS-immunoreactive neurons were observed in random numbers within normal tissue throughout reperfusion, iNOS-immunoreactive neurons increased steadily in the same region (P≤0.05). Conclusions: Ischemic neurons become immunoreactive for both nNOS and iNOS during early reperfusion. Expression of iNOS immunoreactivity in unaffected neurons may reflect transcription of immediate early genes in response to stimulatory neurotransmission from ischemic cortex.
Binding and activation of small molecules by three-coordinate Cr(I).

[(i-Pr2Ph)2nacnacCr]2(μ-η2:η2-N2) (2) has been prepared and structurally characterized; it contains a bridging side-on bonded dinitrogen ligand with a N−N distance of 1.249(5) A. Reactions of this reactive Cr(I) synthon with various small molecules resulted in a series of unusual molecules and transformations; thus CO yielded the binuclear isocarbonyl [(i-Pr2Ph)2nacnacCr]2(CO)(μ-η1:η1-CO)2, ethylene gave [(i-Pr2Ph)2nacnacCr]2(μ-η2:η2-C2H4), O2 oxidatively added to produce (i-Pr2Ph)2nacnacCr(O)2, and azobenzene afforded the product of NN bond cleavage [(i-Pr2Ph)2nacnacCr]2(μ-NPh)2. 2 can be prepared in good yield and affords a facile entry to low-coordinate Cr(I) coordination chemistry.
Direct Insertion of MODIS Radiances in a Global Aerosol Transport Model

Abstract In this paper results are presented from a simple offline assimilation system that uses radiances from the Moderate Resolution Imaging Spectroradiometer (MODIS) channels that sense atmospheric aerosols over land and ocean. The MODIS information is directly inserted into the Goddard Chemistry and Aerosol Radiation Transport model (GOCART), which simulates the following five aerosol types: dust, sea salt, black carbon, organic carbon, and sulfate. The goal is to produce three-dimensional fields of these aerosol types for radiative forcing calculations. Products from this assimilation system are compared with ground-based measurements of aerosol optical depth (AOD) from the Aerosol Robotic Network (AERONET). Insertion of MODIS radiances draws the GOCART model closer to the AERONET AOD. However, there are still uncertainties with surface reflectivity over moderately bright surfaces and with the amount of absorbing aerosol. Also described is the assimilation cycle. The forward model takes the aerosol ...
Conservation of a Triple-Helix-Forming RNA Stability Element in Noncoding and Genomic RNAs of Diverse Viruses

Abundant expression of the long noncoding (lnc) PAN (polyadenylated nuclear) RNA by the human oncogenic gammaherpesvirus Kaposi's sarcoma-associated herpesvirus (KSHV) depends on a cis-element called the expression and nuclear retention element (ENE). The ENE upregulates PAN RNA by inhibiting its rapid nuclear decay through triple-helix formation with the poly(A) tail. Using structure-based bioinformatics, we identified six ENE-like elements in evolutionarily diverse viral genomes. Five are in double-stranded DNA viruses, including mammalian herpesviruses, insect polydnaviruses, and a protist mimivirus. One is in an insect picorna-like positive-strand RNA virus, suggesting that the ENE can counteract cytoplasmic as well as nuclear RNA decay pathways. Functionality of four of the ENEs was demonstrated by increased accumulation of an intronless polyadenylated reporter transcript in human cells. Identification of these ENEs enabled the discovery of PAN RNA homologs in two additional gammaherpesviruses, RRV and EHV2. Our findings demonstrate that searching for structural elements can lead to rapid identification of lncRNAs.
Stability of the Shuttle on-orbit flight control system for a class of flexible payloads

The stability of the Space Shuttle on-orbit flight control system is determined for a class of payloads for which the payload is tilted out of the orbiter bay and the bending can be modeled as localized at a pivot. Examples are the Inertial Upper Stage or the Centaur with attached spacecraft during deployment. The many inertial, geometric, and jet option parameters are reduced to a smaller set which allows the determination of stability or instability as a function of bending frequency and the other elements of the set. The resulting stability charts, which are presented, can be used by payload designers and misssion planners to predict possible instability without elaborate analysis or simulation.
Implementing clinical practice guidelines about health promotion and disease prevention through shared decision making

Clinical practice guidelines aim to improve the health of patients by guiding individual care in clinical settings. Many guidelines specifically about health promotion or primary disease prevention are beginning to support informed patient choice, and suggest that clinicians and patients engage in shared discussions to determine how best to tailor guidelines to individuals. However, guidelines generally do not address how to translate evidence from the population to the individual in clinical practice, or how to engage patients in these discussions. In addition, they often fail to reconcile patients’ preferences and social norms with best evidence. Shared decision making (SDM) is one solution to bridge guidelines about health promotion and disease prevention with clinical practice. SDM describes a collaborative process between patients and their clinicians to reach agreement about a health decision involving multiple medically appropriate treatment options. This paper discusses: 1) a brief overview of SDM; 2) the potential role of SDM in facilitating the implementation of prevention-focused practice guidelines for both preference-sensitive and effective care decisions; and 3) avenues for future empirical research to test how best to engage individual patients and clinicians in these complex discussions about prevention guidelines. We suggest that SDM can provide a structure for clinicians to discuss clinical practice guidelines with patients in a way that is evidence-based, patient-centered, and incorporates patients’ preferences. In addition to providing a model for communicating about uncertainty at the individual level, SDM can provide a platform for engaging patients in a conversation. This process can help manage patients’ and clinicians’ expectations about health behaviors. SDM can be used even in situations with strong evidence for benefits at the level of the population, by helping patients and clinicians prioritize behaviors during time-pressured medical encounters. Involving patients in discussions could lead to improved health through better adherence to chosen options, reduced practice variation about preference-sensitive options, and improved care more broadly. However, more research is needed to determine the impact of this approach on outcomes such as morbidity and mortality.
Variation in the risk of readmission among hospitals: the relative contribution of patient, hospital and inpatient provider characteristics.

BACKGROUND The risk of readmission varies among hospitals. This variation has led the Centers of Medicare and Medicaid services to reduce payments to hospitals with excess readmissions. The contribution of patient characteristics, hospital characteristics and provider type to the variation in risk of readmission among hospitals has not been determined.
The marine osmium isotope record

Over the past decade the marine osmium isotope record has been developed into a new tracer in palaeoceanographic research. Several analytical developments, particularly in the past few years, have significantly increased our ability to study the behaviour of osmium in the surficial environment. The 187Os/188Os and osmium concentration of seawater, river water, rain, and hydrothermal vent fluids have been measured directly. Recently, the behaviour of osmium in estuaries–critical for estimating the marine residence time of osmium–has been studied. Our knowledge of the surficial osmium cycle has thus significantly improved. In addition, reconstructions of past variations in the marine 187Os/188Os recently have been extended back into the Mesozoic. This review attempts to summarize our current understanding of the marine osmium system–present and past. The 187Os/188Os of seawater during the Cenozoic to first order mimics the marine 87Sr/86Sr record. It is therefore tempting to interpret both records as reflecting increased input of radiogenic osmium and strontium resulting from enhanced continental weathering regulated by climatic/tectonic processes. However, the marine osmium isotope system differs fundamentally from the marine strontium isotope system. This review emphasizes three important differences. First, large impacts are capable of resetting the 187Os/188Os to unradiogenic values without significantly affecting the marine strontium system. Second, organic-rich sediments are characterized by high 187Re/188Os; resulting 187Os/188Os ingrowth-trajectories are similar to the average slope of the Cenozoic 187Os/188Os seawater record. Trends towards more radiogenic 187Os/188Os seawater therefore can be caused by weathering of organic-rich sediments at a constant rate. Third, the marine residence time of osmium is sufficiently short to capture short-periodic (glacial-interglacial) fluctuations that are inaccessible to the buffered marine strontium isotope system. This offers the opportunity to discriminate between high-frequency (climatic) and low-frequency (tectonic) forcing.
Synthesis and Diversification of 1,2,3-Triazole-Fused 1,4-Benzodiazepine Scaffolds

A substituted heterocyclic scaffold comprising a 1,4-benzodiazepine fused with a 1,2,3-triazole ring has been synthesized and diversified via a variety of refunctionalizations. The strategy features the rapid assembly of the scaffold by combining 3-4 reactants in an efficient multicomponent assembly process, followed by an intramolecular Huisgen cycloaddition.
Self-organization of spatial solitons

We present experimental results on the transverse modulation instability of an elliptical beam propagating in a bulk nonlinear Kerr medium, and the formation and self-organization of spatial solitons. We have observed the emergence of order, self organization and a transition to an unstable state. Order emerges through the formation of spatial solitons in a periodic array. If the initial period of the array is unstable the solitons will tend to self-organize into a larger (more stable) period. Finally the system transitions to a disordered state where most of the solitons disappear and the beam profile becomes unstable to small changes in the input energy.