cssi/SciSciGPT-SciSciNet huggingface dataset:
52 Impact of ERAS program implementation in gynecologic surgery on healthcare costs

Objectives To evaluate differences in hospital charges and healthcare service utilization for gynecologic surgery patients managed before and after ERAS implementation. Methods We retrospectively reviewed women undergoing open gynecologic surgery before and after ERAS implementation. Consecutive patients from 5/2014–10/2014 and 11/2014–11/2015 comprised the pre-ERAS and ERAS cohorts, respectively. Patients were excluded if they had a multidisciplinary surgical team or underwent minimally invasive surgery. All technical and professional charges were ascertained for healthcare services from procedure date until postoperative day 30. Adjuvant treatment charges were excluded. Charges were categorized by the type of clinical service provided. The primary outcome was the difference in total charges between the two groups. Results A total of 271 patients were included with 58 and 213 patients in the pre-ERAS and ERAS cohort, respectively. 70,177 technical charges and 6,775 professional charges were identified and classified. The median hospital charge decreased 15.6% from the pre-ERAS to ERAS groups [95% CI 0–39%; p=0.008]. ERAS patients had lower charges for laboratory services [20% decrease; 95% CI 0–39%; p=0.04], pharmacy services [30% decrease; 95% CI 14–41%; p Conclusions Hospital charges and healthcare service utilization were lower for ERAS patients compared with patients receiving conventional perioperative care. ERAS may be considered high value as it provides improved outcomes while lowering resource utilization.
High-content screening in zebrafish identifies perfluorooctanesulfonamide as a potent developmental toxicant.

Per- and polyfluoroalkyl substances (PFASs) have been used for decades within industrial processes and consumer products, resulting in frequent detection within the environment. Using zebrafish embryos, we screened 38 PFASs for developmental toxicity and revealed that perfluorooctanesulfonamide (PFOSA) was the most potent developmental toxicant, resulting in elevated mortality and developmental abnormalities following exposure from 6 to 24 h post fertilization (hpf) and 6 to 72 hpf. PFOSA resulted in a concentration-dependent increase in mortality and abnormalities, with surviving embryos exhibiting a >12-h delay in development at 24 hpf. Exposures initiated at 0.75 hpf also resulted in a concentration-dependent delay in epiboly, although these effects were not driven by a specific sensitive window of development. We relied on mRNA-sequencing to identify the potential association of PFOSA-induced developmental delays with impacts on the embryonic transcriptome. Relative to stage-matched vehicle controls, these data revealed that pathways related to hepatotoxicity and lipid transport were disrupted in embryos exposed to PFOSA from 0.75 to 14 hpf and 0.75 to 24 hpf. Therefore, we measured liver area as well as neutral lipids in 128-hpf embryos exposed to vehicle (0.1% DMSO) or PFOSA from 0.75 to 24 hpf and clean water from 24 to 128 hpf, and showed that PFOSA exposure from 0.75 to 24 hpf resulted in a decrease in liver area and increase in yolk sac neutral lipids at 128 hpf. Overall, our findings show that early exposure to PFOSA adversely impacts embryogenesis, an effect that may lead to altered lipid transport and liver development.
Checks and Balances: Publics, Interests, and the Development of Electronic Fund Transfers in 1970s US

This article examines the work of the National Commission on Electronic Fund Transfers to understand the emergence of electronic banking in 1970s US. Reviewing reports and papers prepared by the Commission and analyzing them in light of an influx of letters it received from the general public, this article explores how public interests were defined in debates over electronic banking, providing perspectives from both consumers and policymakers. Building on literature on the binding of collectives in relation to and through information technologies, including payment technologies, I demonstrate how certain visions of the public are formed to cohere with economic and technological desirable futures. I argue that the Commission reworked a number of public concerns—about automation, loss of privacy to the “databank,” and the “checkless” society—into technical matters, resulting in a new vision of the “public interest” in a time of electronic connectivity.
Myocarditis and Inflammatory Cardiomyopathy

Myocarditis is an inflammatory process of the heart, which can be acute or chronic, and caused by a diverse spectrum of infectious agents, autoimmune processes, toxins, and drugs. Myocarditis, which results in injury to the cardiac myocytes, may cause cardiac dysfunction (called inflammatory cardiomyopathy), and exhibit protean signs and symptoms, spanning subacute heart failure, severe bradyarrhythmias and ventricular tachyarrhythmias, and cardiogenic shock. The cardiologist must be aware of the types of myocarditis and inflammatory cardiomyopathy, and maintain a high index of suspicion in diagnosing myocarditis, noting that specific treatment and prognosis in myocarditis depends on the underlying etiology.
Spontaneous Intracranial Hypotension in the Critical Patient.

Spontaneous intracranial hypotension typically manifests with orthostatic headaches and is caused by spinal dural tears, ruptured meningeal diverticula, or CSF-venous fistulas. While most patients ...
Educational Opportunity and the Limits of Legal Obligation

It is often thought that a fundamental right to education should be recognized under the federal Constitution. The courts, however, have generally been less than fully receptive to this idea. This Article offers reasons for courts to reconsider this position. Crucially, the Article points out an important implication of denying basic educational opportunity. Specifically, failing to provide a minimally sufficient opportunity for basic education undermines any claim to any morally binding general legal authority over those persons denied such opportunity. That is, persons denied basic educational opportunity typically have no moral obligation to obey the dictates of the established legal regime. For such persons, the regime is, on mainstream theories, illegitimate. This conclusion should provoke a reconsideration of whether it is justifiable, overall, to fail to acknowledge and enforce a federal constitutional right to an educational opportunity that is minimally sufficient for broad regime legitimacy.
Enterprise resource planning success: An exploratory study of the financial executive perspective

Purpose – To explore the views of top corporate financial executives on the success of implementation of enterprise resource planning (ERP) systems as well as the variables associated with ERP project success. Specifically, relationships between dependent variables cost and budget performance on the independent variable overall project success are studied. Variables influencing cost and time performance are also explored.Design/methodology/approach – An analysis of secondary data obtained from the 2003 financial executives international comprehensive survey‐based research on technology issues for financial executives. Multiple regression analysis and other statistical methods are used.Findings – The findings indicate that ERP implementations are generally viewed as moderately successful by top financial executives. In addition, both cost and time were significantly correlated with an overall view of success with cost performance holding higher influence. Several variables were found to significantly corre...
Evaluation of Child Maltreatment in the Emergency Department Setting: An Overview for Behavioral Health Providers

Emergency providers are confronted with medical, social, and legal dilemmas with each case of possible child maltreatment. Keeping a high clinical suspicion is key to diagnosing latent abuse. Child abuse, especially sexual abuse, is best handled by a multidisciplinary team including emergency providers, nurses, social workers, and law enforcement trained in caring for victims and handling forensic evidence. The role of the emergency provider in such cases is to identify abuse, facilitate a thorough investigation, treat medical needs, protect the patient, provide an unbiased medical consultation to law enforcement, and provide an ethical testimony if called to court.
A Matchmaking Component for the Discovery of Agreement and Negotiation Spaces in Electronic Markets

This paper presents the design of an extended matchmaking component for electronic markets, which is able to identify negotiable agreements and the issues that are subject to the negotiation, in the case where basic matchmaking fails to find agreements that satisfy the constraints of the seller and the buyer. The foundation for this functionality is the introduction of negotiable constraints within the offer specification process. The extended matchmaking component complements our SilkRoad design and implementation framework for electronic negotiations. This framework also features other negotiation service components such as a mediation service, which may use the feedback from the extended matchmaking operation on agreement candidates and negotiation spaces, to suggest fair agreements on the basis of the Adjusted Winner algorithm for dispute resolution.
Inducers of Small Heterodimer Partner Expression Lead to Decreased CYP2D6 Expression and Activity

Studies have shown that differential transcriptional regulation of CYP2D6 may contribute to large interindividual variability in CYP2D6-mediated drug metabolism. However, factors governing CYP2D6 t...
Experience with sham feeding as a test for vagotomy.

Abstract Sham feeding is thought to stimulate gastric acid secretion solely via vagal pathways. We evaluated whether sham feeding can be used as a test for vagotomy. From results in 50 nonvagotomized subjects (28 unoperated duodenal ulcer patients and 22 healthy controls), a ratio of sham feeding-stimulated acid output to peak acid output of 0.10 or less was defined as abnormally low (with 95% confidence). The ratio of sham feeding to peak acid output was abnormally low in 28 of 41 (68%) vagotomized duodenal ulcer patients without clinical evidence of recurrent ulcer, suggesting that most of these patients had indeed had an effective reduction in vagal innervation of the stomach. On the other hand, 11 of 15 (73%) vagotomized duodenal ulcer patients with symptomatic, recurrent ulcers had normal ratios of sham feeding to peak acid secretion. That a normal ratio represented an incomplete vagotomy was independently suggested in 5 of these patients; in 1 an intact vagal trunk was confirmed at a second operation; in the other 4, acid secretion fell strikingly after transthoracic vagotomy, which would not have been expected to happen if vagotomy had initially been complete. In 5 vagotomized patients tested on two occasions, the ratio was reasonably reproducible. We conclude that a ratio of sham feeding-stimulated to peak acid output greater than 0.10 after an attempted vagotomy suggests persistent vagal innervation, whereas a ratio of 0.10 or less suggests, with at least 95% confidence, that vagotomy has been successful.
Roadside memorial policies in the United States

Roadside memorials in memory of a fatality dot the landscape of the nation's highways. The appearance of memorials varies as much as the policies and practices states employ to manage them. The purpose of this research is to ascertain whether or not the states of the US have policies regarding roadside memorials and, if so, what the policies are. A postal questionnaire survey was sent to the director of the Department of Transportation in each of the 50 states of the US. Only the state of Alaska did not respond. Twenty-three states have policies regarding roadside memorials; some states' policies are more specific than others. Though sometimes controversial, roadside memorials typically do not bring complaints, yet most states remove the memorial if complaints occur. Overall, the nation's states are sensitive to the role roadside memorials play in expressing survivors' grief, balancing those needs with any safety hazards that memorials may pose.
On the bondage number of planar and directed graphs

The bondage number b(G) of a nonempty graph G is defined to be the cardinality of the smallest set E of edges of G such that the graph G-E has domination number greater than that of G. In this paper we present a simple, intuitive proof that b(G)=
Effect of sequestration on PAH degradability with Fenton’s reagent: roles of total organic carbon, humin, and soil porosity

The phenomenon of contaminant sequestration-and the physicochemical soil parameters which drive this process-has recently been studied by several authors with regard to microbial contaminant degradation. Very little work has been done to determine the effects of contaminant sequestration on the chemical treatability (oxidizability) of soil contaminants; the current study was conducted to address this data gap. A suite of six model soils, ranging in organic matter content from 2.32 to 24.28%, were extensively characterized. Measured parameters included: (1) levels of total organic carbon (TOC); (2) contents of humic acid (HA); fulvic acid (FA) and humin; and (3) total porosity and surface area. Each soil was then spiked with coal tar and, after varying periods of aging/sequestration, subjected to slurry-phase Fenton's reagent oxidation. Percent recoveries of 12 PAHs, ranging from 3 to 6 aromatic rings, were determined. Results indicated that the susceptibility of each PAH to chemical oxidation was a function of TOC in four of the soils (those with TOC greater than approximately 5%), but was strongly dependent on soil porosity for low-TOC soils. The importance of these two parameters changed with increasing sequestration time, with the relative contribution of porosity-mediated sequestration becoming more important over time. Porosity-mediated effects were more rapid and significant with lower-molecular-weight PAHs (e.g. those with three or four aromatic rings) than with higher-molecular-weight, more hydrophobic compounds. These observations are discussed in light of current physicochemical models of the contaminant sequestration process.
Parental response to elevated begging in a high predation, tropical environment

Interactions among parents, offspring and the environment are a critical aspect of parental care. Begging by offspring usually results in increased parental provisioning. Yet, parents also vary their behaviours to reduce offspring predation. Both begging sounds and provisioning activity can increase risk of nest predation. We predicted in a high nest-predation environment, parents would satiate young and reduce begging by increasing food load but maintaining the same provisioning rates. We also assessed whether increased begging was beneficial to offspring and whether parents changed the allocation of food to particular nestlings. We increased whole-brood begging via playbacks at nests of a tropical passerine bird, the western slaty antshrike, Thamnophilus atrinucha. We observed that parents increased provisioning rates and reduced food load in response to elevated begging. Selection may therefore favour feeding hungry nestlings even when predation risk is elevated, or begging sounds may place offspring at a higher risk than increased activity. Parents reduced the time between arrival to the nest and feeding of nestlings, potentially to reduce begging sounds. Exaggerated begging did not appear to be beneficial to offspring since parents did not deliver more food. Parents switched to preferentially feed the closest offspring during the begging treatment. This suggests that, under elevated begging, parents either allowed sibling competition to influence feeding decisions, or fed the closer nestling to reduce the time between arrival to the nest and feeding. Studying species in different environments provides insight into how ecological factors such as nest predation influence parental behaviour.
Neural systems underlying spatial language in American Sign Language.

A [(15)O]water PET experiment was conducted to investigate the neural regions engaged in processing constructions unique to signed languages: classifier predicates in which the position of the hands in signing space schematically represents spatial relations among objects. Ten deaf native signers viewed line drawings depicting a spatial relation between two objects (e.g., a cup on a table) and were asked either to produce a classifier construction or an American Sign Language (ASL) preposition that described the spatial relation or to name the figure object (colored red). Compared to naming objects, describing spatial relationships with classifier constructions engaged the supramarginal gyrus (SMG) within both hemispheres. Compared to naming objects, naming spatial relations with ASL prepositions engaged only the right SMG. Previous research indicates that retrieval of English prepositions engages both right and left SMG, but more inferiorly than for ASL classifier constructions. Compared to ASL prepositions, naming spatial relations with classifier constructions engaged left inferior temporal (IT) cortex, a region activated when naming concrete objects in either ASL or English. Left IT may be engaged because the handshapes in classifier constructions encode information about object type (e.g., flat surface). Overall, the results suggest more right hemisphere involvement when expressing spatial relations in ASL, perhaps because signing space is used to encode the spatial relationship between objects.
Immunization of Fishes: a Review

Immune response in fishes, which are ectothermic animals, depends on temperature. The optimum response is at the optimum temperature for the species. It is, however, slower in coldwater fishes, such as salmonids, and faster in warmwater fishes. Serum of fishes contains proteins very similar, but not identical, with those of mammals. Immune bodies are contained in gamma, beta, and alpha globulins. Gamma globulin is absent in some fishes. Fishes can be effectively immunized by injection of antigens, however, this is not a practical method. For this reason oral immunization has been attempted repeatedly but the effectiveness is variable.
Primitive and definitive blood share a common origin in Xenopus: a comparison of lineage techniques used to construct fate maps.

Abstract Primitive blood constitutes the ventralmost mesoderm in amphibians, and its cleavage-stage origin reveals important clues about the orientation of the dorsal/ventral axis in the embryo. In recent years, investigators employing various lineage-labeling strategies have reported disparate results for the origin of primitive blood in Xenopus [W. D. Tracey, Jr., M. E. Pepling, G. H. Thomsen, and J. P. Gergen (1998). Development 125, 1371–1380; M. C. Lane W. C. Smith (1999). Development 126, 423–434; K. R. Mills, D. Kruep, and M. S. Saha (1999). Dev. Biol. 209, 352–368; A. Ciau-Uitz, M. Walmsley, and R. Patient (2000). Cell 102, 787–796]. These discrepancies must be resolved in order to elucidate early embryonic patterning mechanisms in vivo. We directly compared two of the techniques used to determine the origin of the ventral blood islands and primitive blood, injection of either β-galactosidase mRNA or conjugated dextrans, by coinjecting both tracers simultaneously into individual blastomeres in cleavage-stage embryos. We find that dextrans label progeny efficiently, while β-galactosidase activity is not present in many of the progeny of an injected blastomere, suggesting that mRNA fails to diffuse throughout a blastomere. This result demonstrates that β-galactosidase mRNA fails to meet the criterion for a true lineage label, namely efficient detection of the progeny of a blastomere, and raises questions about interpretations based on mapping the ventral blood islands using Lac Z mRNA as a tracer. We examined the origins of the ventral blood islands and primitive blood from the vegetal region of the marginal zone in regularly cleaving embryos by coinjecting both reporters into C-tier blastomeres. Our results demonstrate that both the ventral blood islands and primitive blood routinely arise from all C-tier blastomeres. Our data, in combination with published mapping results for the dorsal aorta, demonstrate that primitive and definitive blood do not have separate origins at the 32-cell stage in Xenopus. In addition, these results support a proposal to align the dorsal/ventral axis of the mesendoderm with the animal/vegetal axis in pregastrula Xenopus.
Stress concentration due to a hemispherical surface inclusion

Fatigue cracks often initiate at surface inclusions, and sometimes appear at inclusions within the bulk. To clarify the relative efficiency of these crack sources, an approximate solution for the elastic stress of a hemispherical surface inclusion is provided and compared with the existing result of a spherical interior inclusion. The approximate solution is obtained from the Eshelby solution for the elastic field of an ellipsoid inclusion by introducing the Green's function of an elastic half-space. The numerical calculated results indicate that the stress concentration of a surface inclusion is higher when the inclusion is harder than the matrix, while that of an embedded inclusion is higher when the inclusion is softer than the matrix.
Brain pH measurements using a diffusible, lipid soluble pH sensitive fluorescent indicator.

— Brain tissue pH was measured in cats at normocapnia hypocapnia, hypercapnia, and death from anoxia using a pH sensitive fluorescent indicator (umbelliferone) with both molecular and ionic fluorophors. A ratio analysis of the indicator's calibrated 450 nm fluorescent tissue washout curves from 340 and 370 nm excitation permitted direct determinations using a nomogram. Possible errors in these measurements related to differential quenching, absorption, and changes in the redox state of the indicator were investigated in vitro and in vivo for brain tissue and blood. In animals with preserved autoregulation, brain pH varied linearly with arterial pH (art pH 7.0, brain pH 6.98: art pH 7.4, brain pH 7.24). Brain pH at death fell to 6.68. An analysis of the indicator clearance curves suggests these measurements reflect a component of the intracellular space and the lipid solubility of the indicator suggests this is a membranous component.
Thrombolysis Versus Primary Angioplasty in Older Patients with Acute Myocardial Infarction

Although it is effective for appropriate older patients with acute myocardial infarction (AMI), only about 25% of patients 65 years and older are eligible for thrombolytic therapy. Primary percutaneous transluminal coronary angioplasty (PTCA) may be a suitable alternative reperfusion therapy, particularly for older patients with high risk of intracerebral haemorrhage or cardiogenic shock. Randomised trials of primary PTCA versus thrombolytic therapy have demonstrated better efficacy for primary PTCA, whereas the 2 therapies produced comparable results in observational studies. In subset analyses in 2 randomised trials, there were trends toward better outcomes with primary PTCA, although these studies had small numbers of older patients. Results from 3 AMI registries (the Cooperative Cardiovascular Project, the Myocardial Infarction Triage and Intervention Registry, and the National Registry of Myocardial Infarction 2) indicated trends toward improved hospital or 30 day death rates in patients 75 years and older receiving primary PTCA. Older patients who are at high risk of bleeding complications may do better with primary PTCA, although for others with moderate or minimal risk, the 2 therapies are equivalent. More data about long term follow-up and the association between outcomes and hospital and operator volumes for primary PTCA in older patients are needed before a definitive recommendation can be made.
Postpartum psychoses in female and male bipolar manic-depressive patients.

Bipolar manic-depressive women are considered a special risk for recurrence of a childbirth-related affective episode. In a chart study of 40 fathers who are former bipolar patients, 21 had histories of an affective episode in proximity to a wife's pregnancy. When these bipolar fathers were compared with the 19 for whom no such episodes were recorded, differences were found on several parameters. Therapeutic implications of the findings are considered, and recommendations for further study are offered.
COGNITIVE RESPONSES TO IDEALIZED MEDIA IMAGES OF WOMEN: THE RELATIONSHIP OF SOCIAL COMPARISON AND CRITICAL PROCESSING TO BODY IMAGE DISTURBANCE IN COLLEGE WOMEN

This study explored college women’s cognitive processing of print advertisements featuring images of highly attractive female models. The relationship of counterarguing (critical processing) and social comparison in response to these images with a number of body image–related variables was examined. Participants were 202 undergraduate females. Research was conducted in two phases. In one phase, participants wrote their thoughts in response to three advertisements taken from recent women’s magazines. In the second phase, women completed a number of self–report measures focusing on body image, along with a number of distracter measures. Results suggest that making negative outcome, upward social comparisons in response to such images is significantly associated with greater internalization of the thin ideal and decreased satisfaction with one’s own appearance. Despite predictions that counterarguing might act as a protective factor, the tendency to generate counterarguments in response to these images was not related to appearance–related dissatisfaction, internalization of the media ideal, or importance of appearance.
Differential effects of cyclic adenosine-3',5'-monophosphate on phosphorylation of rat liver nuclear acidic proteins.

Abstract The effects of cyclic AMP on the phosphorylation of different acidic proteins of rat liver nuclei were examined in vivo and in vitro. N6,O2′-dibutyryl cyclic AMP selectively stimulated in vivo phosphorylation of specific nuclear proteins more than twofold within 15 min after injection. Cyclic AMP caused only a small stimulation of phosphorylation of acidic proteins in isolated nuclei but the stimulation was selective for specific proteins. When isolated nuclear acidic proteins were incubated with a soluble cyclic AMP-dependent protein kinase, the cyclic nucleotide stimulated total phosphorylation about 1.7-fold. These results support the view that the regulatory effects of cyclic AMP may involve phosphorylation of acidic proteins associated with DNA in the chromatin.
Carotid stump syndrome: A colour-coded Doppler flow study

Colour-coded Doppler flow imaging (angiodynography) was performed on 29 patients with 30 internal carotid artery occlusions. Large internal carotid stumps were revealed as intravascular cul-de-sacs demonstrating vortices of blue flow reversal. Large carotid stumps or significant external carotid stenoses were present in nine patients (9 arteries). Such patients were significantly more likely to develop symptoms of cerebral ischaemia during follow up which averaged 18 months (P = 0.016; Fisher exact). These results support the concept of embolisation from the carotid bifurcation (residual stump or external stenosis) as a cause of episodic cerebral ischaemia following internal carotid occlusion. Angiodynography may prove to be a useful tool for selecting appropriate patients for treatment.
Adult liver transplantation in the USA.

Purpose of reviewTo provide the nontransplant clinician with a basic understanding of the liver transplant process.Recent findingsSince its inception, the technique of liver transplantation and patient management has evolved considerably. We present an up-to-date overview of the evaluation of the tr
Exonerating Bernoulli? On evaluating the physical and biological processes affecting marine seepage meter measurements

Seepage meters, like most benthic flux chamber techniques, come with inherent concerns about how their presence may alter the environment and flow regimen of the benthic boundary layer and underlying sediments. Flow due to wave and current movement across topographic features induces a downward and upward flow field within the sediments surrounding the feature. We found this Bernoulli-induced flow is a real, but maybe minor, component of measured advection using seepage meters. This study was conducted in a Florida coastal lagoon to test the physical forcing mechanisms that may influence seepage measurements from sediments. Calculated Bernoulli seepage was within the measured background (~1 to 2 cm day−1) expected from seepage meters when a plastic barrier beneath the device is used to inhibit natural seepage contributions. Nearby seepage measurements made with Lee-type seepage meters placed directly in the sediments ranged from 1 to 12 cm day−1. Thus, when seepage flow is very slow from sediments, Bernoulli-induced seepage may obscure the measurement. However, this study demonstrates that seepage in the Indian River Lagoon must be driven by forces other than Bernoulli-induced (pumped) flow. Suggestions for these forcing mechanisms highlight the uncertainty of the water source(s) in seepage measurements. In these Florida lagoon sediments, bioirrigation and terrestrial groundwater inputs are the most likely drivers, depending on distance from shore, benthic community composition, and continental recharge. Seepage measurements can be an excellent measure of advection in shallow-water marine sediments if Bernoulli-induced seepage is taken into account either experimentally or calculated based on local hydrographic and meteorological data.
Magnitude and Frequency of Wind Speed Shears from 3 to 150 Meters

An analysis is presented of high resolution wind profile measurements recorded at the NASA 150-m ground winds tower facility, showing wind speed shear frequency and magnitude distributions for six vertical layers of the atmosphere and one vertical distance. Vertical wind shear is defined as the change of wind speed with height, and its magnitudes were derived by algebraically subtracting lower level wind speeds from those of higher levels and dividing the distance between levels. Horizontal wind shear is understood to be change of wind speed with horizontal distance, and its magnitudes were derived by algebraically subtracting the wind speed at a short tower from that at a tall one and dividing by the distance between towers.
Is Fecal Incontinence a Risk Factor for Institutionalization in the Elderly

To the Editor: It has been hypothesized that fecal incontinence (FI) increases the risk of nursing home (NH) referral, but direct evidence is lacking. We read with great interest the study by AlAmeel et al. (1) that is a secondary analysis of 9,000 community dwelling participants aged 65 years enrolled in the Canadian Study of Health and Aging. These authors report a significant association between FI and institutionalization, independent of age and sex. However, on including mental status as a covariate, statistical significance was lost. The authors concluded that the effects of FI on institutionalization are likely explained by cognitive impairment.
Radioactive and other medical waste and their implications to medical technology

The current crisis in radioactive waste disposal coupled with increased regulatory control over medical and hazardous waste has a definite impact on medical research. In addition to increased costs, the unavailability of disposal sites has resulted in the inability to perform standard research protocols in some institutions. The system implemented at a major research medical center is discussed focusing on the methods used to collect, transport, store, and dispose of radioactive and hazardous waste. Problems faced by research scientists include, increased costs, space, staff and time spent to meet ever increasing regulatory requirements.© (1994) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Mouse strain differences in the chemokine response to acute lung infection with a murine gammaherpesvirus.

Numerous mouse strain-based differences in the immune response and in susceptibility to numerous pathogens have been described, but it is not known if these differences extend to chemokine responses to viral infection of the lungs. To define mouse strain-based differences in the host chemokine response and susceptibility to infection with murine gammaherpesvirus-68 (MHV-68), we compared the induced chemokine response to MHV-68 infection in the lungs of BALB/c and C57BL/6 mice at 1-15 days post-infection. CC and CXC chemokines were induced in both BALB/c and C57BL/6 following infection but the level of chemokine induction was significantly higher in the BALB/c mice for all chemokines measured. In addition, interferon-γ (IFN-γ) was also induced to a significantly higher level in the lungs of BALB/c infected mice compared to C57BL/6 mice. Interestingly, viral gene expression was lower in the lungs of C57BL/6 mice during the acute phase of replication. Titers of infectious virus were also greater in BALB/c lu...
Combating Sloth as Well as Gluttony: The Role of Physical Fitness in Mortality among Men with Type 2 Diabetes

Wei and colleagues' findings, reported in this issue, remind us that a comprehensive exercise program should be an integral part of diabetes care.
Fluxes of dissolved organic carbon from California continental margin sediments

Abstract Fluxes of dissolved organic carbon (DOC) from marine sediments represent a poorly constrained component of the oceanic carbon cycle that may affect the concentration and composition of DOC in the ocean. Here we report the first in situ measurements of DOC fluxes from continental margin sediments (water depths ranging from 95 to 3,700 m), and compare these fluxes with measured benthic fluxes from 20 other coastal and continental margin sediments. With this combined data set data we have estimated that benthic DOC fluxes are less than ∼10% of sediment carbon oxidation rates, and that the integrated DOC flux from sediments in water depths less than 2,000 m is ∼180 Tg C/yr. These fluxes are roughly equivalent to the riverine DOC flux, and the organic carbon burial rate in marine sediments. Benthic DOC fluxes therefore represent an important net source of DOC to the oceans. We also note that: (1) benthic DOC fluxes represent a loss of organic carbon from sediments; (2) in many sediments these fluxes appear to be controlled by molecular diffusion (i.e., by pore water concentration gradients); (3) pore water DOC may be an important intermediate in sediment carbon burial and preservation. These observations therefore suggest a linkage between benthic DOC fluxes and sediment carbon preservation that may be mediated by pore water DOC concentrations and cycling. The magnitude and fate of DOC effluxing from marine sediments is thus important to understanding carbon cycles and budgets in the marine environment.
Soil Organic Carbon and Nitrogen After Application of Nine Organic Amendments

The amount and type of C-containing amendments applied to soil can have an influence on soil organic carbon (SOC) levels. To test the hypothesis that amendment type is more important than amount, we applied 250 g C m⁻² as manure, legume foliage, wheat (Triticum aestivum L.) residue, municipal biosolid, wood sawdust, brassica (Brassica napus L.) residue, composted wheat residue, sucrose, and cotton linters to both fallow soil and an annual winter wheat crop for five consecutive years. After an additional 3.5 yr with no inputs and all plots being fallow, the SOC of biosolid, manure, and wood amended plots were significantly (P < 0.0001) greater than the unamended check. The application of biosolid increased SOC 492 g m⁻², and manure increased SOC 316 g m⁻², over the fallow check plots in the top 300 kg m⁻² of soil (approximately 0–25 cm). The increase in SOC relative to the check ranged from 0 to 39% of the amendment C applied. The SOC content was 482 g m⁻² greater under continuous winter wheat than under fallow. The amendment and wheat crop effects on soil C and N changed little during the 3.5 yr after treatments ended, indicating that decomposition occurred soon after application. Wood sawdust was unique in that it increased SOC even though it was low in N content, and it changed the soil C/N ratio from 12.3 to 13.4. This field research demonstrated that amendments applied at the same C rate can have variable effects on SOC accretion.
Tailored domain decomposition

Abstract We developed a biased domain decomposition clustering algorithm designed for use in parallel processing for the numerical solution of partial differential equations. The biased clustering algorithm is designed to work on a distributed memory parallel computer. To date, the algorithm has been on the simulated Cray-2 shared memory multiprocessor.
Applying MAR analysis to identify human and non-human fecal sources in small Kentucky watersheds.

The recurrence of reports citing water quality impairments in watersheds is evidence that tools are needed to identify pollution sources and facilitate restoration efforts such as implementing total maximum daily limits (TMDLs) or best management practices (BMPs). Fecal bacteria in surface waters are one of the most commonly cited impairments to water quality. This study evaluated microbial source tracking (MST), specifically multiple antibiotic resistance (MAR) analysis, as a management tool to differentiate nonpoint source pollution into source groups. A library containing Escherichia coli (E. coli, EC) and fecal streptococci (FS) isolates from poultry (EC n = 282, FS n = 650), human (EC n = 152, FS n = 240), wildlife (EC n = 17, FS n = 43), horse (EC n = 79, FS n = 82), dairy cattle (EC n = 38, FS n = 42), and beef cattle (EC n = 49, FS n = 46) sources was created. The MAR analysis was conducted on the isolates using a profile of seven antibiotics. The antibiotic signatures of unknown source isolates from Elkhorn and Hickman Creek watersheds were evaluated against the library to determine the contributions of potential fecal inputs from the respective sources. Correct classification was >60% when analyzed at the human and non-human-level of classification. On a watershed basis, both watersheds produced similar results; inputs from non-human sources were the greatest contributors to nonpoint source pollution. The results from the multiple antibiotic resistance (MAR) analysis revealed that the information produced, coupled with knowledge of the watershed and its associated land uses, would be helpful in allocating resources to remediate impaired water quality in such watersheds.
Increased Distraction Rates Influence Precursor Tissue Composition Without Affecting Bone Regeneration

The effect of increased distraction rate on bony tissue differentiation was studied using a paired bilateral model of rat femur lengthening. After a 6-day latency period, one randomly selected femur for each rat was distracted at 0.5 mm/day (normal rate) for 12 days, and the contralateral femur was distracted at 1.5 mm/day (increased rate) for 4 days. Femoral lengthening for each side was 6.0 mm, leaving the increased rate leg with an extra 8 days of consolidation compared with the normal rate limb. Group I rats (n = 9) were killed at day 18 postsurgery and analyzed for cartilage tissue composition and distribution. Group II rats (n = 7) were killed on day 36 postsurgery and analyzed by three-dimensional microcomputed tomography (MCT) for changes in new bone volume. Digital color analysis of slides stained with type II collagen antibody showed increases in cartilaginous tissue formation on the increased rate side (1.51 mm2 vs. 0.83 mm2; p = 0.10). No differences in new bone volume were detected between increased rate limbs and their contralateral controls (46.13 mm3 vs. 42.69 mm3; p = 0.63). These findings suggest that intermediate distraction rates may influence precursor tissue composition without affecting the final amount of new bone formed. Because damage to the tissue was not detected at either time point, these changes in chondrogenesis may reflect sensitivity of the pluripotential gap tissue to tension accumulation during lengthening. Future work with this in vivo model is focused on improving our understanding of the mechanisms behind this strain sensitivity. (J Bone Miner Res 2000;15:982–989)
Public health impact of antiviral therapy for hepatitis C in the United States

Despite dramatic improvements in antiviral therapy for hepatitis C, there is reason to believe that the uptake of antiviral therapy remains limited. The aims of this study were to determine the number of patients being treated with antiviral therapy in the U.S., to estimate the public health impact of these treatment patterns, and to identify barriers to treatment for patients with hepatitis C. Data on the number of new patient pegylated interferon prescriptions each year, from 2002–2007, was obtained from Wolters Kluwer Inc., which maintains an electronic audit of pharmacies nationwide. A Markov model was created of the population with chronic hepatitis C in the U.S. from 2002 to 2030, and was used to estimate the number of liver-related deaths caused by hepatitis C that will be prevented by current treatment patterns. The National Health and Nutrition Evaluation Survey (NHANES) Hepatitis C Follow-Up Questionnaire was used to investigate reasons for lack of treatment and to identify strategies for improving access. Approximately 663,000 patients received antiviral therapy between 2002 and 2007, and treatment rates appear to be declining. If this trend continues, only 14.5% of liver-related deaths caused by hepatitis C from 2002–2030 will be prevented by antiviral therapy. Results from the NHANES questionnaire suggest that the primary barrier to treatment is lack of diagnosis, with 69/133 (adjusted proportion 49%) of respondents previously unaware that they had hepatitis C. Conclusion: Efforts to improve rates of diagnosis and treatment will be required if the future public health burden of hepatitis C is to be ameliorated. (HEPATOLOGY 2009.)
Re(CO)3 Complexes Synthesized via an Improved Preparation of Aqueous fac-[Re(CO)3(H2O)3]+ as an Aid in Assessing 99mTc Imaging Agents. Structural Characterization and Solution Behavior of Complexes with Thioether-Bearing Amino Acids as Tridentate Ligands

Parallel studies of the preparation of Re and 99mTc agents aid in interpreting the nature of tracer 99mTc radiopharmaceuticals. Aqueous solutions of the fac-[99mTc(CO)3(H2O)3]+ cation are gaining wide use and are readily prepared, but such solutions of the fac-[Re(CO)3(H2O)3]+ cation (1) are not so easily accessible. Herein we describe a new, reliable, and straightforward preparation of aqueous solutions of 1, characterized by HPLC and ESI-MS. Treatment of solutions of 1 with thioether-bearing amino acids, AAH = S-methyl-l-cysteine (MECYSH), S-propyl-l-cysteine (PRCYSH), and methionine (METH), gave high yields of fac-Re(CO)3AA complexes. X-ray crystallographic and NMR analyses indicated that MECYS-, PRCYS-, and MET- were bound in fac-Re(CO)3AA complexes as tridentate monoanionic ligands through amino, thioether, and α-carboxyl groups. In CD3OD, 1H NMR spectra have broad signals but have two sets of signals at −10 °C, consistent with two isomers with different configurations at the pyramidal sulfur; these ...
A Memory of Color

We see a veiled woman standing in the warm light of the desert sun. Her emotion is unreadable, hidden despite the steady gaze of her eyes. Our attention slips beyond the woman to the stultifying desert landscape that takes shape in the curtained window behind her. A solitary leaf and a palm tree emerge, followed by two distant hills and, perhaps, a road. ‘‘Arab Song’’ is an oil-on-burlap piece by the celebrated painter Paul Klee. Though he completed the piece in 1932, Klee was likely painting under the spell of a 1914 trip to Tunisia. Klee’s mastery of color is the point of reference for most art enthusiasts. Consider his stunning ‘‘Red Balloon,’’ or the depth and vibrancy of ‘‘Ad Parnassum.’’ Indeed, Klee’s Bauhaus lectures on form and design have become classics on color theory (Klee 1999). However, color did not come easily to him. Early in his career, Klee wrote of the ‘‘realization that a long struggle [lay] in store for me in this field [of color]’’ (Klee and Klee 1964). His early paintings lack dramatic impact. That all changed in 1914, when Klee sailed from Marseilles to Tunis with painters August Macke and Louis Moulliet. In the clear light of North Africa, among the brilliant colors of the city and the millennium-old traditional cloth dyes used on the carpets, blankets, and tunics of the souk, Klee experienced the longdesired moment of artistic epiphany. ‘‘Color possesses me, I don’t have to pursue it,’’ Klee wrote. ‘‘Color and I are one. I am a painter’’ (Klee and Klee 1964). Klee returned from Tunisia with that bright, clear image of the landscape imprinted in his mind. He also returned with the ability to use color beyond physical description; he had achieved abstraction. Many of his following works evoked the dramatic geometry and geography of North Africa, in the form of ‘‘shifting horizontals’’ or ‘‘overlapping color squares’’ (Phillips Collection 2011). In ‘‘Arab Song,’’ we see a vivid moment at the turning point of his career, the moment of realization that color had arrived. The tonality and shape are more simplistic than in many of Klee’s other works, but the layers shift and flutter like a curtain in a hot desert wind. We simultaneously see distant hills and gazing eyes, a landscape and a woman, so that one cannot exist without the other. This is a portrait and a landscape, a ‘non-portrait’ and a ‘nonlandscape’ (Heath 2008). It evokes the mystery and power of women as seen in the mind of the artist. It also reminds us of the crucial part that women play in shaping landscapes and lives in the developing world. They preserve traditional roles as they manage crop-planting and livestock-raising, yet they act as the most critical agents of effective and sustainable change in local communities. For Klee, his trip to Tunisia stayed with him throughout his life, stamped into his art with a daring to push color to the limits while maintaining the subtlety of form. In this way, his work mirrors the Tunisian landscapes Correspondence to: Sara E. Howard, e-mail: howard@ecohealthalliance.org; Peter Daszak, e-mail: daszak@ecohealthalliance.org; EcoHealth DOI: 10.1007/s10393-011-0733-7
Organizational Slack and Information Technology Innovation Adoption in SMEs

This study explores the relevant dimensions of organizational slack in small and medium enterprises (SMEs) and investigates their impact on adoption of different types of information technology (IT) innovations. Using recent data from a representative sample of 2,296 U.S. SMEs, we find that the slack-innovation relationships previously described in larger firms do not hold well for SMEs. Our results show potential slack (measured as access to external credit) to be a strong predictor of technology adoption in SMEs. By contrast, available slack appeared not to be a significant factor in SME innovation adoption. Moreover, the direction of the effects of potential slack was moderated by the capital-intensity of the innovation. In particular, e-commerce, which required lesser financial resources for SME adoption, was found to be pursued by those with lesser potential slack. We argue that, in some cases, innovation adoption may represent a form of â€œbricolageâ€ by resource constrained SMEs.