cssi/SciSciGPT-SciSciNet huggingface dataset:
What symptoms are important to patients? Developing a symptom burden measure for women with breast cancer.

The American Cancer Society predicted that 266,120 women would be diagnosed with breast cancer in 2018. Women experience significant symptom burden in response to tumor and treatment-related adverse effects, particularly in advanced disease. Use of valid and reliable patient-reported outcomes (PRO) symptom measures may assist clinicians in systematically monitoring and managing symptoms. The MD Anderson Symptom Inventory (MDASI) is a brief PRO measure of cancer symptom burden; specific symptoms can be added to the core symptoms to produce disease- and treatment-specific modules. The purpose of this study was to describe the patient symptom experience, define the content domain, and generate items for a breast cancer-specific MDASI module for measuring symptom burden in women with breast cancer. Women with breast cancer were qualitatively interviewed about their experiences of disease and treatment. Descriptive exploratory analysis identified symptoms and symptom interference to define the symptom burden of breast cancer. An expert panel rated the relevance of the identified symptoms to patients with breast cancer. A conceptual model of breast cancer symptom burden was developed from interviews with 36 women (mean age of 57.9 years, 86.1% had stages I–III, and 52.8% were on chemotherapy and/or radiation therapy) across the breast cancer disease and treatment trajectory. Thirty-six symptoms and 6 interference categories were identified. Symptoms specific to treatment modalities and breast cancer met the criteria for inclusion in the provisional instrument for psychometric testing. We generated an instrument with content validity for measuring symptom burden specific to women with breast cancer.
Flax Genome “Edits” in Response to the Growth Environment

The flax genome can be rapidly modified within a single generation in response to the growth environment. The variations that occur do not appear to be due just to either random mutations or the movement of transposable elements but rather that the genome appears to be able to switch between two well-defined, different sequences at many loci. The genomes of nine lines, the progenitor line (Pl) and eight derived lines (genotrophs), have been compared by whole genome sequencing, using the flax variety Bethune as the reference genome. The identified differences fall into two main classes: one where regions of the genome have insertions or deletions (indels) among the genotrophs compared to Pl and the second where Pl and the genotrophs have a large number of SNPs over a short region of the genome. Subsets of these indel variants have been assayed in the progeny from 19 individuals from 3 different nutrient regimes, from other flax accessions and the wild progenitor of flax, Linum bienne. In every case the same two alternative structures were seen. The source of these variants, since they are not present in an intact form in the progenitor genome, is intriguing. Such reproducible large-scale variation is unlikely to occur through multiple independent events, and therefore an “editing” mechanism by which long tracts of the genome can be replaced with an alternative structure has been proposed.
Autofluorescence Imaging to Monitor the Progression of Oral Potentially Malignant Disorders

Patients with oral potentially malignant disorders (OPMD) must undergo regular clinical surveillance to ensure that any progression to malignancy is detected promptly. Autofluorescence imaging (AFI) is an optical modality that can assist clinicians in detecting early cancers and high-grade dysplasia. Patients with OPMD undergoing surveillance for the development of oral cancer were examined using AFI at successive clinic visits. Autofluorescence images acquired at 133 clinical visits from sites in 15 patients who met inclusion criteria were analyzed quantitatively using an algorithm to calculate the red-to-green pixel intensity (RG ratio). A quantitative AFI threshold for high risk of progression was defined based on the RG ratio and was compared with expert clinical impression and with histopathology when available. Patients were divided into two groups based on their endpoint: surveillance (n = 6) or surgery (n = 9). In the surveillance group, 0 of 6 (0%) of patients were clinically identified as high risk for progression prior to the study endpoint, whereas 1 of 6 (17%) of patients were deemed at high risk for progression based on AFI during the same time period. In the surgery group, 9 of 9 (100%) of patients were clinically identified as high risk prior to the study endpoint, whereas 8 of 9 (89%) of patients were at high risk for progression based on AFI during the same time period. AFI results tracked over time were comparable with expert clinical impression in these patient groups. AFI has the potential to aid clinicians in noninvasively monitoring oral precancer and evaluating OPMDs that require increased surveillance.
Hardware-based approach to guarantee trusted system boot in embedded systems

Abstract In recent years, computer systems spread in our daily lives have been experiencing an increasing wave of attacks that disrupt their normal operation or leak sensitive data. Some of them, so-called I/O attacks, are performed by malicious peripherals that perform read or write accesses to DRAM memory through unauthorized DMA (Direct Memory Access) requests during the system boot. During this period the system is particularly vulnerable, which allows hackers to make use of peripherals to perform malicious accesses to DRAM memory. As consequence, it degrades system security. In this context, this paper presents a hardware-based secure-system boot sniffer (SBS) Watchdog to prevent I/O attacks during system boot. The SBS Watchdog is tightly connected to the PCIe communication bus to prevent peripherals from accessing DRAM memory during the BIOS execution and operating system loading, i.e., during the system boot. Compared to existing approaches, the proposed technique is fully transparent to the user, can be applied to any operating system, induces no performance degradation since the SBS Watchdog is turned-off after system boot, and cannot be unintentionally disabled by users during system configuration procedure. The proposed technique was implemented in a commercial FPGA. Practical experiments have demonstrated the high effectiveness of the proposed technique to prevent I/O attacks during system boot.
Pearls & Oy-sters: Dural defect repair as treatment for refractory headache from cerebrospinal fluid leak.

CSF leak should be considered in patients with suspected low-pressure, orthostatic headaches and a sacral canal fluid-intensity lesion demonstrated on imaging.
Cellular automata modeling suggests symmetric stem-cell division, cell death, and cell drift as key mechanisms driving adult spinal cord growth in teleost fish

Abstract Adult neurogenesis – the generation of neurons during adulthood – is intensively studied, yet little is known about its consequences at the tissue level. In the teleost fish Apteronotus leptorhynchus, morphometric analysis has revealed that the total number of cells in the spinal cord increases continuously throughout adulthood, driven by the activity of neurogenic stem/progenitor cells in both the ependymal layer at the central canal and in the radially located parenchyma. This net increase in cell numbers demonstrates cellular addition, as opposed to cellular turnover which appears to be the common outcome of adult neurogenesis in mammals. Grounded on a comprehensive set of quantitative data generated through high-resolution mapping of stem cells and their progeny, we constructed a cellular automata model of the stem-cell-driven growth of the spinal cord. Simulations based on this model suggest that three cellular mechanisms play a critical role for promoting sustained tissue growth and acquisition of correct form of the spinal cord, including the development of the ependymal layer and the parenchyma: the number of symmetric stem-cell divisions versus asymmetric divisions; the probability of the progeny of progenitor cells to undergo cell death; and the radial drifting of cells.
Rapidly fatal necrotizing soft tissue infection due to Clostridium sordellii in an injection drug user.

Abstract Clostridium sordellii infections are known to be associated with high morbidity and mortality. To date, only a small number of cases with necrotizing soft tissue infection due to C. Sordellii have been reported. We report a case presented with necrotizing soft tissue infection of the right upper extremity caused by C. sordellii in a patient with known use of injected heroin. Despite broad spectrum antibiotics and surgical debridement, the patient's clinical course became rapidly fatal, within 24 h of admission. C. sordellii necrotizing soft tissue infections are particularly virulent. Even in the context of appropriate surgical debridement, these infections can be rapidly fatal. This case highlights the importance of high suspicion for C. sordellii as potential pathogen of necrotizing soft tissue infection in injection drug users.
First-language influence on second language speech perception depends on task demands.

While listening to non-native speech, second language users filter the auditory input through their native language. We examined how bilinguals perceived second language (L2 English) sound sequence...
Wild mushroom exposures in Kansas, 2013–2018

Mushrooms exposures are uncommon, difficult to characterize, and occasionally cause serious morbidity and mortality. We describe mushroom exposures reported to the Kansas Poison Control Center (KSP...
CREG1 promotes lysosomal biogenesis and function.

CREG1 is a small glycoprotein which has been proposed as a transcription repressor, a secretory ligand, a lysosomal, or a mitochondrial protein. This is largely because of lack of antibodies for im...
Low-temperature high-frequency dynamic magnetic susceptibility of classical spin-ice Dy2Ti2O7.

Radio-frequency (14.6 MHz) AC magnetic susceptibility,χAC', of Dy2Ti2O7was measured using self-oscillating tunnel-diode resonator. Measurements were made with the excitation AC field parallel to the superimposed DC magnetic field up to 5 T in a wide temperature range from 50 mK to 100 K. At 14.6 MHz, a known broad peak ofχAC'(T)from kHz-range audio-frequency measurements around 15 K for both [111] and [110] directions shifts to 45 K, continuing the Arrhenius activated behavior with the same activation energy barrier ofEa≈ 230 K. Magnetic field dependence ofχAC'along [111] reproduces previously reported low-temperature two-in-two-out to three-in-one-out spin configuration transition at about 1 T, and an intermediate phase between 1 and 1.5 T. The boundaries of the intermediate phase show reasonable overlap with the literature data and connect at a critical endpoint of the first order transition line, suggesting that these features are frequency independent. An unusual upturn of the magnetic susceptibility atT→ 0 was observed in magnetic fields between 1.5 T and 2 T for both magnetic field directions, before fully polarized configuration sets in above 2 T.
Haller's Ansa: An Unrecognized Route of Facial Movement After Skull Base Surgery

A direct communication between the glossopharyngeal and facial nerves known as Haller's ansa exists in a minority of patients. Clinical manifestations of this anastomosis are not commonly observed. We describe post-operative facial movement with swallowing after facial nerve sacrifice in two patients who underwent surgery for skull base tumors. Patient 1, a 49-year-old male, received a transcochlear approach for resection of endolymphatic sac tumor and intratemporal facial nerve sacrifice without nerve reconstruction. Patient 2, a 23-year-old female, underwent surgery for left jugular paraganglioma, requiring facial nerve sacrifice and cable graft. Both patients had preoperative facial weakness and intraoperative preservation of the glossopharyngeal nerve. A literature review related to Haller's ansa was performed using PubMed, EMBASE, and Scopus from 1920-2021. Post-operatively, both patients demonstrated oral commissure movement with swallowing, suggesting a communication between the glossopharyngeal nerve and the facial nerve (Haller's ansa). Although anatomical references to Haller's ansa exist, there are no reported clinical manifestations of this neural anastomosis. Glossopharyngeal-facial nerve communications may contribute to facial tone and movement. Pre- and post-operative assessment of facial nerve movement with swallowing may help assess for the presence of Haller's ansa. Better understanding of this neural anastomosis may have implications for facial reanimation surgery. Laryngoscope, 2021.
Assessing the social determinants of health in Tourette Syndrome (P4.8-041)

Objective: To examine sociodemographic differences among people living with Tourette Syndrome. Background: Tourette Syndrome (TS) occurs in all racial/ethnic groups. There is limited research related to racial/ethnic disparities in TS. This study analyzes racial/ethnic differences in outcomes among TS patients. Design/Methods: Data from 1,008 individuals with TS were extracted from the Tourette Association of America International Consortium for Genetics (TAAICG) database. To be included, individuals had to have completed sex, race, and ethnicity information. Statistical analyses explored the relationship between race/ethnicity and TS patients’ 1) time-to-diagnosis; 2) tic severity; and 3) comorbidity rates. Results: 870 individuals met inclusion criteria (N=195, 22.4% female; N=675, 77.6% male; mean age 20.2 years±14.5). TS symptom onset was 6.21±2.69 years, with time-to-diagnosis 5.43±8.09 years. OCD was present in 55.1% of TS individuals; ADHD was present in 46%. In gender-stratified analysis, time-to-diagnosis in TS (6.64±9.71 vs 5.08±7.54, p=0.058), ADHD (7.66±10.27 vs 4.34±6.75, p=0.06), and OCD (6.63±9.11 vs 5.73±8.30, p=0.51) was delayed in females compared to males. In analyses stratified by ethnicity (Non-Hispanic N=831, Hispanic N=39) and race (White N=802, Non-White N=56), time-to-diagnosis of TS, ADHD, and OCD was longer in non-Hispanic/White compared to Hispanic/Non-White groups (TS time-to-diagnosis: 5.40±8.29 in White vs. 4.42±3.87 in Non-White TS patients (p=0.107)). Comorbid ADHD rates were significantly increased in Hispanics compared to non-Hispanics (61.5% vs. 45.2%, p=0.04), but not in Non-White vs. White subjects (56.4% vs 45.9%, p=0.106). Rates of comorbid OCD were similar across racial and ethnic groups. Conclusions: Health care disparities appear to be present in TS patients, including delayed diagnoses in females compared to males, and higher rates of comorbid ADHD in Hispanic compared to non-Hispanic individuals. These analyses will be expanded to 3000 individuals in the TAAICG database. Further understanding of the pathways to disparities must be understood to eliminate potential inequities. Disclosure: Dr. Dy has nothing to disclose. Dr. Osiecki has nothing to disclose. Dr. Essa has nothing to disclose. Dr. Mathews has nothing to disclose. Dr. Mejia has nothing to disclose. Dr. Scharf has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Abide Therapeutics.
ERGOPEPTINE TOXINS AND PEPTIDE SYNTHETASE GENES IN CLAVICIPITACEOUS PATHOGENS AND SYMBIONTS OF PLANTS

Claviceps purpurea and Neotyphodium coenophialum are important fungi in agriculture due to their production of ergopeptine toxins, which are the products of a peptide synthetase. I have cloned fragments of three different peptide synthetase genes from N. coenophialum and fragments of four peptide synthetase genes from C. purpurea. All but one of the N. coenophialum genes, and two of the C. purpurea genes, are present in multiple copies in the genomes of the respective fungi. Functional analyses by gene disruption has been complicated by these multiple copies and by a low frequency of homologous recombination. All of the peptide synthetase genes are transcribed, and transcripts from most have been detected under conditions consistent with their potential involvement in ergopeptine biosynthesis. One peptide synthetase gene is common to N. coenophialum and C. purpurea and hybridizes with DNA from the putative ergopeptine-producing plant Calystegia sepium.
Recovery design pattern

This paper introduces the recovery design pattern. The pattern presents an abstract design model that helps in the designing the recovery problem independent of a specific application. This pattern has been developed based on the concepts of stable design patterns. Stable design patterns are built based on the concepts of software stability.
Phase relations in fluoroborate systems—II: The system NaFKFBF3

Abstract Two quasi-binary systems were identified in the system formed by the compounds NaF, NaBF 4 , KBF 4 , and KF. The only part of the NaFKFBF 3 system that can be studied at atmospheric pressure contains a maximum of 50 mole % BF 3 . Differential thermal analysis and quenching data indicate that the high-temperature polymorphs of NaBF 4 and KBF 4 form a continuous series of solid solutions with a very shallow minimum, melting at 398°C, near the 90 mole % NaBF 4 composition. There is some evidence for the existence of a sub-solidus compound, 3NaBF 4 ·KBF 4 , which is stable between approximately 193° and 280°C. The compounds NaF and KBF 4 form a simple eutectic system containing 94 ± 1 mole % KBF 4 which melts at 539±2°C. The ternary system is dominated by a large NaF primary phase field. There is a shallow ternary minimum, corresponding to the NaBF 4 KBF 4 quasi-binary minimum, containing 3·5±1 mole % KF and 48±1 mole % BF 3 which has a liquidus temperature of 377±2°C. The ternary eutectic composition in the NaFKBF 4 KF triangle is very close to the KFKBF 4 binary eutectic in composition and it melts at 458°C only about 2° lower in temperature.
Divergent behavior of mucosal memory T cells

Memory CD4 T cells are strategically positioned at mucosal surfaces to initiate a robust adaptive immune response. The detection of specific antigen via the T-cell receptor causes these memory T cells to unleash a potent antimicrobial response that includes rousing local innate immune populations for tissue-specific defense. Paradoxically, these same memory T cells can also be stimulated by nonantigen-specific signals that are generated by the activity of local innate immune cells. This versatility of mucosal memory T cells in both the initiation and the sensing of local innate immunity could be a vitally important asset during pathogen defense but alternatively could be responsible for initiating and maintaining chronic inflammation in sensitive mucosal tissues.
Electron—Ion Collisions in High Temperature Plasmas

Several newly observed electron—ion collision phenomena that occur in high temperature plasmas containing electrons and ions of energies 10–104 eV, or temperature of 105–108 K, are reviewed. These are the phenomena of dielectronic recombination, excitation-autoionization, and electron energy-loss scattering as measured in crossed (90°) and merged electron—ion beam experiments.
Human pituitary growth hormone. XXII. The reduction and reoxidation of the hormone.

Abstract The two disulfide bridges in human pituitary growth hormone were reduced with dithiothreitol in the absence of denaturant. The reduced protein was allowed to autooxidize at pH 8.4, and a reoxidized monomer was obtained in good yield. The reoxidized hormone retained the full biological potency of the native hormone as a growth-promoting and lactogenic agent. Small differences between the native and reoxidized proteins were revealed by viscosity measurements and the rates of tryptic hydrolysis. However, these differences are much smaller than those found between the native hormone and a biologically active reduced tetra-S-carbamidomethylated derivative reported previously. The circular dichroism spectra of the reoxidized and native proteins at pH 8.2 were found to be identical between 205 and 300 mμ. The significance of these findings is discussed in terms of the role of the disulfide bonds in this protein.
Cohort mortality study of garment industry workers exposed to formaldehyde: Update and internal comparisons

Background To further evaluate the association between formaldehyde and leukemia, we extended follow-up through 2008 for a cohort mortality study of 11,043 US formaldehyde-exposed garment workers. Methods We computed standardized mortality ratios and standardized rate ratios stratified by year of first exposure, exposure duration, and time since first exposure. Associations between exposure duration and rates of leukemia and myeloid leukemia were further examined using Poisson regression models. Results Compared to the US population, myeloid leukemia mortality was elevated but overall leukemia mortality was not. In internal analyses, overall leukemia mortality increased with increasing exposure duration and this trend was statistically significant. Conclusions We continue to see limited evidence of an association between formaldehyde and leukemia. However, the extended follow-up did not strengthen previously observed associations. In addition to continued epidemiologic research, we recommend further research to evaluate the biological plausibility of a causal relation between formaldehyde and leukemia. Am. J. Ind. Med. 56:1027–1039, 2013. © 2013 Wiley Periodicals, Inc.
A study of 200 mb wind fields over the Indian Ocean region for the summer of 1972

Synoptic and dynamic aspects of the 200 mb wind field over the Indian Ocean region were investigated for the summer of 1972 when the monsoon circulation was delayed and much weaker than normal. The study was based on daily analyses of wind data obtained from conventional rawinsonde and aircraft observations. Vorticity and divergence values around the upper tropospheric anticyclones were computed in areas where the number of data were sufficiently dense. Comparisons of computational results were made with the distribution of convective clouds obtained from satellite brightness maps. Case studies for selected days as well as composite averages were prepared for circulation centers of various synoptic scale sizes. Also, the origin of unstable waves in the upper tropospheric easterlies along the equatorward side of the Tibetan anticyclone was investigated.
The monsoon as a self-regulating coupled ocean—atmosphere system

Abstract Observational studies have shown that the Asian-Australasian monsoon system exhibits variability over a wide-range of space and timescales. These variations range from intraseasonal (20–40 days), annual, biennial (about 2 years), longer-term interannual (3 to 5 years) and interdecadal. However, the amplitude of the interannual variability of the South Asian monsoon (at least as described by Indian precipitation) its summer pluvial phase is smaller than variability exhibited in other climate systems of the tropics. For example, drought or flood rarely extend to multiple years, with rainfall oscillating biennially from slightly above average to slightly below average precipitation. We argue that variability of the monsoon is regulated by negative feedbacks between the ocean and the atmosphere. The annual cycle of the heat balance of the Indian Ocean is such that there is an ocean heat transport from the summer hemisphere to the winter hemisphere resulting principally from wind-driven Ekman transport. Given the configuration of the low-level monsoon winds, the Ekman transport is in the opposite sense to the lower tropospheric divergent wind. The cross-equatorial ocean heat transport is large with amplitudes varying between +2 PW (northward) in winter and −2 PW (southward) in summer. Thus, the wind-induced heat transport works to cool the summer hemisphere upper ocean while warming the winter hemisphere. Similar regulation occurs on interannual timescales. For example, during anomalously strong Northern Hemisphere monsoon summers (typically a La Nina), strong winds induce a stronger than average southward flux of heat. When the monsoon is weak (typically an El Nino), the wind-driven ocean heat flux is reduced. In this manner, the monsoon regulates itself by reducing summer hemisphere sea-surface temperatures during strong monsoon years and increasing it during weak years. In this manner, the monsoon is self regulating. It is noted, however, that the ocean heat transport theory of monsoon regulation does not necessarily insist that heat anomalies persist from one year to the next. Furthermore, the theory does not include the Indian Ocean dipole as a dynamic entity. Finally, we develop a more general theory in which the slow dynamics of the dipole are integral components of a sequence of processes that regulate the monsoon, thus minimizing radical year-to-year departures of the monsoon from climatology.
High and low intensity slot discharge

The author describes some of the work in the area of slot discharges undertaken at the CERL-CEGB Research Laboratories (now National Grid R&D Centre) since 1980. Slot discharge mechanisms are considered, and results of laboratory studies using bar and sheet samples are examined. Slot discharge damage is a problem encountered with epoxy micapaper systems used in large machine windings. The main insulation system has been developed to be resistant to partial discharge attack. However, research has shown that slot discharge can include other types of gas discharge such as surface discharge and a sustained discharge which is probably a glow-to-arc transition. >
Steroids in egg yolk

Abstract Daily intravenous injection of 17β-estradiol-6,7-H3 or progesterone-7α-H3 into laying hens led to the deposition of radioactive steroids in the egg yolk. The transfer of radioactivity to yolk reached a steady state, representing approximately 0.04% of the injected dose, within 4–7 days. Following E2-H3 injection, estrone, estradiol, and a polar conjugate of estrone, probably estrone sulfate, were isolated from yolk extracts. The nature of the radioactive material in yolk following P-H3 injection was not determined.
A demand-driven method for scheduling optimal smooth production levels

This paper is concerned with demand-driven production scheduling in a commercial environment where smoothed production plans generation over a rolling horizon is desirable as new observations of demand are received through time. Demands are assumed to be normally distributed and dependent on the previous observed levels. The method of chance constraint of Charnes and Cooper is extended to multi-product production planning with variable workforce, back-ordered inventory, and nonstationary stochastic demand process. Bayesian procedures for revising the chance constraints and several variants of linear-programming-based production planning models are presented. In all cases the proposed methodology ensures that demands are satisfied, at a given level of confidence, while achieving smooth production.
The Life Cycle of Northern Hemisphere Downward Wave Coupling between the Stratosphere and Troposphere

AbstractThe life cycle of Northern Hemisphere downward wave coupling between the stratosphere and troposphere via wave reflection is analyzed. Downward wave coupling events are defined by extreme negative values of a wave coupling index based on the leading principal component of the daily wave-1 heat flux at 30 hPa. The life cycle occurs over a 28-day period. In the stratosphere there is a transition from positive to negative total wave-1 heat flux and westward to eastward phase tilt with height of the wave-1 geopotential height field. In addition, the zonal-mean zonal wind in the upper stratosphere weakens leading to negative vertical shear.Following the evolution in the stratosphere there is a shift toward the positive phase of the North Atlantic Oscillation (NAO) in the troposphere. The pattern develops from a large westward-propagating wave-1 anomaly in the high-latitude North Atlantic sector. The subsequent equatorward propagation leads to a positive anomaly in midlatitudes. The near-surface tempera...
An exactly solvable model for quantum communications

Information theory establishes the ultimate limits on performance for noisy communication systems. Accurate models of physical communication devices must include quantum effects, but these typically make the theory intractable. As a result, communication capacities--the maximum possible rates of data transmission--are not known, even for transmission between two users connected by an electromagnetic waveguide with Gaussian noise. Here we present an exactly solvable model of communication with a fully quantum electromagnetic field. This gives explicit expressions for all point-to-point capacities of noisy quantum channels, with implications for quantum key distribution and fibre-optic communications. We also develop a theory of quantum communication networks by solving some rudimentary models including broadcast and multiple-access channels. We compare the predictions of our model with the orthodox Gaussian model and in all cases find agreement to within a few bits. At high signal-to-noise ratios, our simple model captures the relevant physics while remaining amenable to exact solution.
Financial policy issues for HIV pre-exposure prophylaxis: cost and access to insurance.

he costs and access issues related to pre-exposure prophylaxis (PrEP) for HIV prevention have not been adequately explored in health services re- search or in health policy circles. The dearth of informa- tion about the financial aspects of PrEP is a reflection of the unsettled state of this recent HIV prevention strategy. The U.S. Food and Drug Administration (FDA) has ap- proved a drug label change that brings the first antiretro- viral combination medication to market for HIV preven- tion. 1 Prior to this decision, there were anecdotal reports that the tenofovir- emtricitabine (TDF-FTC) combina- tion pill Truvada ® was already being prescribed and used "off label" as PrEP and that some insurers may have been willing to reimburse PrEP in limited circumstances. 2 Although PrEP now has a small impact on HIV pre- vention, its near- to long-term implications could be pro- found. As healthcare leaders begin to deal with PrEP for mainstream prevention, financial policy issues will be- come increasingly important. This article highlights the practical aspects of cost and access to insurance related to PrEP for HIV prevention in the U.S. First, the cost drivers of PrEP for HIV prevention strategies are identified. Then, the factors that influence the availability of health insurance coverage for PrEP in the U.S. today are dis- cussed. The conclusion includes key policy issues for healthcare leaders to consider going forward.
Changes in densities and kinetics of delayed rectifier potassium channels during neuronal differentiation

Single-channel K+ currents were recorded from young and mature spinal neurons cultured from Xenopus embryos to examine the bases of the developmental increases in density and in rate of activation of the macroscopic voltage-dependent delayed rectifier K+ current (IKv). K+ channels of three conductance classes (integral of 80, 30, and 15 pS) are present at both ages, but only the intermediate and small conductance classes are voltage-dependent and thus underlie IKv. The increase in the density of IKv is due to increases in the numbers of intermediate and small channels per cell, but not to changes in their open probabilities. The increase in rate of activation of IKv results from a change in the activation kinetics of the intermediate channel class alone.
Physical and psychological causality as determinants of culpability in sexual harassment cases

In this study a hierarchical legal model was presented to explain how observers arrive at decisions regarding culpability and disciplinary action in cases of alleged sexual harassment. Subjects read a vignette describing a sexual advance. Information about the flagrance of the request, the victim's response, and the frequency of similar encounters were manipulated in order to examine their impact on dimensions of culpability. Subjects then completed a series of Likert-type scales designed to assess the critical dimensions in the model. The findings provided support for the model, suggesting that subject's decisions regarding physical causality and psychological causality are critical factors in attribution of responsibility and that these attributions impact subsequent disciplinary decisions.
Use of Mesh and Materials in Pelvic Floor Surgery

The complex issues regarding the use of mesh and materials in pelvic floor dysfunction are discussed. The various types of grafts available for use and the outcomes of the case series and comparative studies of graft repairs used in the treatment of stress urinary incontinence and pelvic organ prolapse are examined.
Confusion in Reperfusion Problems in the Clinical Development of Antithrombotic Drugs

A paradoxical effect of the administration of thrombolytic drugs, such as recombinant tissue plasminogen activator (rTPA) and streptokinase, is marked platelet activation in vivo.1 2 Multiple experiments in animal models attest to the functional importance of this observation.3 4 However, perhaps the most convincing evidence is that the effects of aspirin, which inhibits thromboxane (Tx) A2–dependent platelet activation, and streptokinase are roughly additive in reducing 30-day mortality in patients presenting with myocardial infarction.5 The data supporting the concomitant use of heparin with therapeutic thrombolysis in this disease are somewhat less convincing.6 7 However, this may reflect such variables as the timing and route of heparin administration.8 Comparable efficacy of unfractionated and low-molecular-weight heparins has recently been established in the treatment of unstable angina.9 However, irrespective of the quality of the evidence, heparins are commonly administered to patients with myocardial infarction in combination with thrombolytic drugs and aspirin. Given the multiple pathways by which platelets may be activated, it seems surprising that a drug such as aspirin should exhibit clinical efficacy in the prevention of thrombosis. Perhaps this reflects its role in blocking formation of TxA2, an amplification signal for other platelet agonists.10 However, the quest for a more potent but well-tolerated platelet inhibitor continues. This has proven to be no easy task, as exemplified most recently by the outcome of the CAPRIE trial of clopidogrel.11 This drug, a thienopyridine, like ticlopidine, predominantly inhibits platelet activation induced by ADP, although the precise molecular basis of action of these compounds remains to be defined.12 Ticlopidine is perhaps marginally superior to aspirin in the prevention of strokes in patients presenting with transient ischemic attacks13 but is associated with some unpleasant side effects, including profound neutropenia in up to 2% …
Spiny lobsters stick and slip to make sound

These crustaceans can scare off predators even when their usual armour turns soft. Many arthropods are able to produce pulsed sounds by rubbing a hard pick over stiff macroscopic ridges1, rather like dragging a stick over a washboard. Spiny lobsters (Palinuridae) also make pulsed sounds, and here I show that they generate these by virtue of a frictional 'stick-and-slip' mechanism that is more usually associated with bowed stringed instruments. By using this technique rather than a 'hard-washboard' mechanism, lobsters can produce strident warning sounds against predators throughout their moult cycle, including the period when their exoskeleton is softened and they are most susceptible to predation.
Coping effectiveness training for men living with HIV: results from a randomized clinical trial testing a group-based intervention.

Objective This randomized clinical trial was designed to compare the effects of a theory-based coping effectiveness training (CET) intervention with an active informational control (HIV-Info) condition and a waiting-list control (WLC) condition on psychological distress and positive mood in HIV-seropositive gay men. Materials and methods The authors recruited 149 self-identified gay or bisexual men who were 21 to 60 years of age, reported depressed mood, and had CD4 levels of 200 to 700 cells/mm(3). CET and HIV-Info participants attended 10 90-minute group sessions during the 3-month intervention phase and six maintenance sessions over the remainder of the year. Participants were assessed at baseline and at 3, 6, and 12 months. Data were collected 1992 to 1994, before the introduction of HAART. Analyses were based on the 128 participants who completed the 3-month assessment. Results After the 3-month intervention phase, when compared with HIV-Info, CET participants showed significantly greater decreases in perceived stress and burnout, and regression analyses indicated that significant increases in coping self-efficacy mediated the improvements in perceived stress and burnout. Compared with WLC, CET participants also showed significantly greater decreases in anxiety, and regression analyses indicated that significant increases in positive states of mind mediated the improvements in anxiety. Significant treatment group differences for positive morale were maintained at 6 and 12 months. In addition, optimism continued to increase in the CET and HIV-Info treatment groups during the maintenance phase. Conclusions CET can be an effective strategy for managing psychological distress and improving positive psychological states in patients confronting chronic illness.
The relative energy variable in covariant nuclear wave functions

Abstract The roles of the relative time variable and its conjugate, the relative energy, are examined in three model bound states of two scalar nucleons, corresponding to different binding energies and different masses of exchanged scalar mesons. Solutions to the ladder Bethe-Salpeter equation are compared to those of three-dimensional equations in which the relative energy variable is fixed by the form of reduction. These three-dimensional solutions are also used to approximate four-dimensional functions which are compared to the Bethe-Salpeter solutions in the region of the first meson production threshold.
Correspondence bias and attitude toward abortion: Effects of information from others

This study investigated the influence of information from others on the correspondence bias in the attribution of attitudes. Participants were presented with an essay either for or against the legalization of abortion. They also received either no information, an argument mentioning the target person’s constraint, or behavior-inconsistent prior information about the target from a “fellow classmate.” Participants then estimated the constrained target person’s actual attitude. Results showed that the correspondence bias (CB) was substantially attenuated by the constraint argument and was reversed by the prior information. These findings demonstrate that arguments from others may prompt perceivers to make an inferential adjustment to take into account the target’s situational constraint, and that behavior-inconsistent prior information from others may lead perceivers to assign greater inferential weight to that information relative to the behavior.
Sources of failures and yield improvement for VLSI and restructurable interconnects for RVLSI and WSI: Part II&#8212;Restructurable interconnects for RVLSI and WSI

In a companion paper [34], sources of failures and yield improvement through the use of redundancy for MOS, VLSI, and WSI were discussed. It was shown that interconnection density and complexity determines the effectiveness of the use of redundancy for yield improvement for RVLSI and WSI. The key issue in the use of redundancy is the development of interconnection technologies for restructuring. In this paper, interconnect technologies which can be used to facilitate restructuring of VLSI and WSI are discussed. Although electron-beam and laser-programmed technologies are favored for yield improvement, a combination of these (permanent) and electrically programmable interconnections are required for efficient utilization of WSI using new schemes involving self-testing and self-diagnosis with special-purpose architectures.
Macrophage cathepsin K promotes prostate tumor progression in bone

Bone marrow macrophages (BMMs) share common progenitors with osteoclasts and are critical components of bone–tumor microenvironment; however, their function in prostate tumor growth in the skeleton has not been explored. BMMs are the major source of inflammatory factors and proteases, including cysteine protease cathepsin K (CTSK). In this study, utilizing mice deficient in CTSK, we demonstrate the critical involvement of this potent collagenase in tumor progression in bone. We present the evidence that tumor growth and progression in the bone are impaired in the absence of CTSK. Most importantly, we show for the first time that BMM-supplied CTSK may be involved in CCL2- and COX-2-driven pathways that contribute to tumor progression in bone. Together, our data unravel novel roles for CTSK in macrophage-regulated processes, and provide evidence for close interplay between inflammatory, osteolytic and tumor cell-driven events in the bone–tumor microenvironment.
Functional changes in white blood cells after microsonation.

Abstract White-cell-rich canine plasma was subjected to the field of a microvibrator at 20 kHz, in order to obtain information on the vulnerability of blood elements to ultrasonically produced shearing stresses. Destruction of the white cells occurs at amplitudes above a critical threshold value; the latter is less than the corresponding threshold for red cells. Functional characteristics, measured by indices of phagocytic, bacteriocidal and metabolic activities, are altered at amplitudes much lower than the critical value for cell destruction. The results have implications for possible bio-effects in ultrasonic fields when gaseous pockets or bubbles of optimum size are present.
Discussant's Response to “Implications from Studies of Foot and Mouth Disease”*

T he three papers presented in this session on the "Implications from Studies of Foot and Mouth Disease" illustrate the interdependence of economics and livestock-disease control and the importance of good quality, integrated economic and epidemiological information to support decision and policy making. The paper by Randolph, Morrison, and Poulton extends the traditional evaluation of the benefits and costs of disease-control programs to include poverty-alleviation objectives. A key feature of the analysis is the integration of the economic framework with a stochastic epidemiological model to allow simulating future Foot and Mouth Disease (FMD) outbreaks. Uncertainty is important in simulating disease outbreaks as the efficacy of control measures and the course of any particular epidemic can vary greatly. Epidemiological analyses frequently incorporate stochastic elements to address these and other uncertainties. Incorporating these disease-related uncertainties into economic analysis is a methodological area deserving of exploration. The paper by Rich, Winter-Nelson, and Brozovik, also illustrates the variance in the efficacy of control measures. The focus in this analysis is on spatial spillovers of FMD virus and the divergent behavior of neighbors in disease control efforts.
Viruses and the type I interferon antiviral system: induction and evasion.

The type I interferon (IFN) system responds to viral infection and induces an "antiviral state" in cells, providing an important first line of defense against virus infection. Interaction of type I IFNs (IFNα and IFNβ) with their receptor induces hundreds of cellular genes. Of the proteins induced by IFN, the antiviral function of only a few is known, and their mechanisms of action are only partly understood. Additionally, although viral-encoded mechanisms that counteract specific components of the type I IFN response have been known for some time, it has recently become clear that many (if not most) viruses encode some form of IFN-antagonist. Understanding the interplay between viral-encoded IFN antagonists and the interferon response will be essential if the therapeutic potential of IFNs is to be fully exploited.
R-matrix theory for electron-atom and electron-molecule collisions using analytic basis set expansions

Abstract A formulation of R-matrix theory based on analytic basis set expansions of the internal wavefunction is presented which has several advantages over the more conventional approach. Integral evaluation is simple even for diatomic molecules, the R-matrix boundary condition is incorporated into the hamiltonian not the basis functions and single-center expansions are eliminated for non-spherical targets. Results for electron-He scattering are presented and compared with other calculations to illustrate the technique.
Safe, rapid, and effortless femoral nail removal using a new third-generation universal femoral nail extraction tool.

Intramedullary nails used for fixation of femoral fractures may require removal for a variety of reasons. Some recommend that all such nails be removed after fracture healing,1,2 whereas others prefer to remove only those that cause symptoms.3,4 Regardless of the reason, removal of an intact femoral nail can be difficult and time-consuming. Husain et al.,3 in a review of 45 femoral nail removals, noted that an average of 110min was required for removal of titanium nails and 84 min for removal of stainless steel nails. They attributed the longer removal times for titanium nails to the removal of more locking screws than in the stainless steel nails. Femoral nails also frequently require removal of a heterotopic bone cap. Although specific retrieval difficulties are difficult to quantitate, we have found that a new universal extraction tool (Smith-Nephew, Memphis, TN, USA) allows quick, easy, and predictable removal of unbroken antegrade and retrograde femoral nails. The tool is a conical, threaded extraction device that can be attached to a bar for impaction with a slotted mallet. The extraction head is cannulated for a standard 3.2-mm guide pin or guidewire, which is used to penetrate the nail core to guide the extraction device into place.
Power extraction from aeroelastic limit cycle oscillations

Abstract Nonlinear limit cycle oscillations of an aeroelastic energy harvester are exploited for enhanced piezoelectric power generation from aerodynamic flows. Specifically, a flexible beam with piezoelectric laminates is excited by a uniform axial flow field in a manner analogous to a flapping flag such that the system delivers power to an electrical impedance load. Fluid–structure interaction is modeled by augmenting a system of nonlinear equations for an electroelastic beam with a discretized vortex-lattice potential flow model. Experimental results from a prototype aeroelastic energy harvester are also presented. Root mean square electrical power on the order of 2.5 mW was delivered below the flutter boundary of the test apparatus at a comparatively low wind speed of 27 m/s and a chord normalized limit cycle amplitude of 0.33. Moreover, subcritical limit cycles with chord normalized amplitudes of up to 0.46 were observed. Calculations indicate that the system tested here was able to access over 17% of the flow energy to which it was exposed. Methods for designing aeroelastic energy harvesters by exploiting nonlinear aeroelastic phenomena and potential improvements to existing relevant aerodynamic models are also discussed.