cssi/SciSciGPT-SciSciNet huggingface dataset:
Local excision results in comparable survival to radical resection for early-stage rectal carcinoid

Abstract Background Controversy exists regarding current National Comprehensive Cancer Network guidelines, which recommend local excision for rectal carcinoids ≤2 cm and radical resection for tumors >2 cm. Given the limited data examining optimal surgical approach for these lesions, we queried a national database to determine the impact of extent of resection on survival. Methods Patients undergoing treatment for clinical stage I and II rectal carcinoid (RC) were identified from the National Cancer Data Base (1998-2012). The association between extent of surgery, tumor size, and the likelihood of pathologic lymph node positivity was examined. Kaplan–Meier analysis was used to compare overall survival. Results In total, 1900 patients were identified, of whom 1644 (86.5%) were treated with local excision, and 256 (13.5%) were treated with radical resection. A significant majority of patients with tumors ≤2.0 cm (89.0%) and nearly half with tumors 2.1-4.0 cm (44.8%) or >4.0 cm (45.8%) underwent local excision. Nodal positivity was correlated with tumor size (7.1% positivity with ≤2.0 cm tumors, 31.3% with 2.1-4.0 cm tumors, and 50.0% with >4 cm tumors). However, 5-y survival was equivalent between surgical approaches for tumors ≤2 cm (93.0% versus 93.0%) and tumors 2.1-4.0 cm (76.0% versus 76.0%). Conclusions We demonstrate in early-stage RC that nearly half of intermediate and large tumors are being treated with local excision outside National Comprehensive Cancer Network guidelines. In addition, radical resection does not appear to be associated with improved overall survival for tumors of any size. These findings suggest that the preferred approach to early-stage RCs without aggressive biological characteristics is local excision due to the decreased morbidity and mortality versus radical resection.
Ovarian derived prorenin-angiotensin cascade in human reproduction.

Objective To review the available literature concerning the renin-angiotensin system of the human and animal ovary and to outline the clinical relevance of this system. Design The location, function, and regulation of the components of the ovarian prorenin cascade are described. The possible functions of this system as well as its association with common gynecologic problems are also given. Conclusions The ovary contains a complete cascade whose end product is the formation of angiotensin II. Angiotensin II may have a role in steroid synthesis, oocyte maturation, ovulation, and corpus luteum formation. Further, aberrations in this system are associated with ovarian tumors, ectopic pregnancy, pre-eclampsia, and ovarian hyperstimulation syndrome.
Social distraction? Social media use and political knowledge in two U.S. Presidential elections

Abstract With increasing numbers of people using social media to get news and political information, whether social media helps users learn about politics has become an important question. Intrigued by the potential of social media to politically educate people, researchers have begun to explore the effects of social media on political knowledge. However, the findings from these studies have been far from conclusive. Drawing on both cross-sectional and panel data from two recent United States presidential elections, this study examines how political social media use and general social media use influence political knowledge. Overall, the results of the cross-sectional and panel analyses lead to the same conclusions. Both show that political social media use does not have a significant effect on political knowledge, while general social media use has a moderately negative effect on political knowledge. Thus, on balance, the overall impact of social media on political knowledge appears to be negative. Implications and directions for future research are discussed.
Increased Donor Age Leads to Greater Severity of Ocular Graft-Versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation

Introduction Ocular graft-versus-host disease (GVHD) is a common complication of allogeneic hematopoietic stem cell transplantation (HSCT), affecting 40-60% of patients within 3 years after transplant. While the most common clinical manifestation is dry eye disease (DED), ocular GVHD can result in epithelial changes in the cornea that contribute to ocular pain and vision loss. Objectives We sought to investigate potential risk factors for the development of ocular GVHD and for increased severity of disease. Methods This was a retrospective study analyzing the outcomes of patients who underwent allogeneic HSCT between 2014-2017. Patients with ocular symptoms were referred for eye exams, which included a slit lamp evaluation to assess the ocular surface. The ocular surface disease index (OSDI) survey was conducted to assess patient symptoms; results were scored from 0-100 with 100 being the most severe. Exams also monitored for the development of filamentary keratitis, a condition in which degenerated epithelial cells and mucus adhere to the corneal surface and cause pain and discomfort. Statistical analysis was performed using the Fisher Exact Probability Test with p-values Results A total of 26 patients who had previously undergone allogeneic HSCT were included in the study. The incidence of ocular symptoms was 30%, with the most common symptom being DED (73%) followed by light sensitivity (35%) and eye pain (31%). In patients with transplant donors of age >50 years compared to those with donors Conclusions Ocular GVHD is an important complication in patients undergoing allogeneic HSCT that contributes to patient morbidity and mortality. Cataracts is one previously documented risk factor for increased severity of disease, though further studies to investigate for other contributing factors are lacking. In our study, donor age >50 years was found to be a risk factor for a significantly higher OSDI score in allogeneic transplant patients. In addition, greater donor age also led to a higher incidence of filamentary keratitis in this patient population. These findings are important with regards to donor selection in allogeneic HSCT, as donors of age
Ability of normal hearing listeners to recognize vowels and musical instruments under spectrally-degraded conditions

Music perception requires greater spectral resolution than speech perception [Shannon, Int. Rev. Neurobiol. 70, 121 (2005)]. However, conclusions from these metadata are problematic given that they aggregate results from several different studies using diverse methodologies and paradigms. In particular, methodologies generally tapped into different perceptual dimensions, namely word recognition for speech and melody recognition for music. The present study aims to develop a paradigm to compare speech and music recognition based on similar perceptual dimensions, namely timbre. Stimuli consisted of naturally-spoken vowels and notes played on musical instruments as well as 32-, 8-, and 4- channel noise-vocoded versions. Listeners discriminated either instruments from vowels or vowels from instruments using a go/no-go task. The discrimination paradigm offered insight as to how available spectral information influenced perception between stimulus sound categories. Reaction times and accuracy were measured and organized as a function of signal degradation level to consider potential differences in how normal hearing listeners utilize spectral fine structure information when distinguishing vowels and musical instruments. In general, listeners’ ability to discriminate vowels from instruments under degraded conditions was similar to their ability to discriminate instruments from vowels. The results suggest that the perception of vowels and musical instruments rely on similar mechanisms.
Evolutionary games on the torus with weak selection

Abstract We study evolutionary games on the torus with N points in dimensions d ≥ 3 . The matrices have the form G = 1 + w G , where 1 is a matrix that consists of all 1’s, and w is small. As in Cox Durrett and Perkins (2011) we rescale time and space and take a limit as N → ∞ and w → 0 . If (i) w ≫ N − 2 / d then the limit is a PDE on R d . If (ii) N − 2 / d ≫ w ≫ N − 1 , then the limit is an ODE. If (iii) w ≪ N − 1 then the effect of selection vanishes in the limit. In regime (ii) if we introduce mutations at rate μ so that μ / w → ∞ slowly enough then we arrive at Tarnita’s formula that describes how the equilibrium frequencies are shifted due to selection.
Rate of gadoxetate disodium (Eovist®) induced transient respiratory motion in children and young adults.

Gadoxetate disodium (Eovist®, Bayer Healthcare, Wayne, NJ) is the preferred MR contrast agent for pediatric hepatobiliary imaging. A known limitation of this contrast agent is transient severe respiratory artifacts during arterial phase imaging, and some adult studies have raised caution against its use for evaluation of arterial enhancing lesions. The reported rate of transient severe breathing motion is 5–22% in adult studies. This study seeks to evaluate the frequency of transient severe respiratory motion secondary to gadoxetate disodium in a pediatric cohort. This is a retrospective, IRB-approved study with informed consent waiver. The radiology information system of a children’s hospital was searched to identify all MRI studies performed with gadoxetate disodium during January 2016–June 2018. Two readers independently evaluated all phases of a dynamic liver protocol for respiratory motion artifact on a 5-point scale (1 none, 2 mild, 3 moderate, 4 severe—still diagnostic, 5 extreme—not diagnostic). Average scores of the 2 readers for each phase were used for analyses. Transient severe respiratory motion was defined as an increase in artifact score of ≥ 1.5 from pre-contrast to arterial phase that returned to < 3 in equilibrium phase of imaging. The study cohort consisted of 140 cases (60% female), age range: 1 month–23 years (median 13 years). 102/140 scans were performed non-sedated. Mean respiratory motion score for each phase of scan for the entire cohort were pre-contrast: 2.23, arterial: 2.56, portal venous: 2.39, and equilibrium: 2.31. Transient severe respiratory motion was seen in 8 non-sedated cases and in 0 sedated cases. The rate of transient severe respiratory motion in a non-sedated pediatric cohort was estimated at 7.84% (8/102 cases). The rate of transient severe respiratory motion in the non-sedated pediatric population is in the lower end of the range reported in adults. Transient severe respiratory motion is not observed in sedated patients.
Rheology of supercooled Se-Te chain liquids: Role of Te as an interchain cross-linker

Abstract The shear relaxation behavior of supercooled SexTe100-x (70 ≤ x ≤ 95) liquids are studied using oscillatory parallel plate rheometry. The difference in the relaxation timescales of the slow bond scission/renewal dynamics and the fast segmental chain motion that coexist in Se decreases monotonically with progressive addition of Te, until only one relaxation process can be identified in the Se70Te30 liquid. This evolution of the relaxation dynamics mimics the rheological behavior of Ge/As-Se liquids, when traditional chain crosslinkers such as Ge/As is added to Se. This finding suggests that the Te atoms serve as pseudo-crosslinkers via secondary bonding interactions between adjacent [Se,Te]n chains. This interchain interaction results in a lowering of the motional degrees of freedom of the constituent chains in SexTe100−x liquids in the supercooled region. However, the compositional invariance of the superliquidus viscosity of these liquids suggests that the interchain interaction constraint can be lifted at high temperatures.
Promotional Space or Public Forum: Protest Coverage and Reader Response in Team-Operated Media:

As sports reemerge as a site for social protest, league- and team-controlled media are a new forum for the spread and consideration of political messages. In-house sites challenge established bound...
Keeping students in by sending them out: Retention and service-learning

This review of recent literature examines the research on the impact of service-learning on student retention. The theoretical framework of the review draws on both Tinto’s model of student attrition and Knowles’s theory of adult learning, which together suggest that academic and social integration, active participation and engagement in learning, and application and relevancy of the subject-matter under study are key factors in student success. The role of these factors has been confirmed in a growing body of research around learning experiences in general and, as this review shows, particularly in service-learning experiences. Suggestions are made for how future research might expand and critically deepen this evidence and offers some implications for service-learning as a means of improving student retention. DOI: 10.18870/hlrc.v4i2.177
AMPA Receptors: Disease

α-Amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors (AMPARs) mediate fast synaptic transmission at excitatory synapses in the central nervous system. Proper AMPAR function and regulation are critical to neuronal development, synaptic plasticity, and structural remodeling. Excessive activation of AMPARs is thought to play a role in a number of neurological disorders and diseases. Ca2+ permeation through AMPARs lacking the glutamate receptor (GluR)-2 subunit is thought to play a critical role in the cell death associated with ischemia, seizure, and amyotrophic lateral sclerosis. While in many brain regions AMPARs are impermeable to calcium under physiological conditions, AMPAR subunit composition and Ca2+ permeability are dynamically regulated in response to neuronal insults. Recent studies now demonstrate that these changes arise, not only from activity-mediated alterations in gene expression, but also from trafficking of AMPARs, RNA editing, and local dendritic protein synthesis. This article reviews new insights into the role of Ca2+-permeable AMPARs in neurological diseases and disorders.
E-116 Long-term mortality after carotid stenting

Background Carotid artery stenting (CAS) is an established procedure for the treatment of atherosclerotic disease affecting the extracranial internal carotid artery. Recent population-based studies have suggested that long-term survival after CAS may be limited, thereby questioning its efficacy in a real-world scenario. Methods We retrospectively reviewed outcomes of patients undergoing CAS for asymptomatic or symptomatic carotid stenosis by a neurosurgeon or interventional neuroradiologist at our institution between 2008 and 2018. Patient and disease characteristics were recorded, as was the incidence of peri-procedural and overall ischemia and mortality after CAS. Risk factors for recurrent ischemia and mortality were identified using a Cox proportional hazards model. Results There were 238 patients who met inclusion criteria. Mean age was 69.7 years and the majority of patients were male (69.7%). Most patients had one or two major comorbidities (52.9%), and 21.4% had more than two major comorbidities. 62.2% underwent CAS for symptomatic carotid stenosis. Fourteen patients (5.9%) experienced new or recurrent ipsilateral ischemia during follow-up, with eight (3.4%) experiencing a stroke with permanent neurologic deficit. 59 patients (24.8%) died during follow-up with a median to time to death of 111.3 months (95% CI: 95.1 – 133.6) on Kaplan-Meier analysis. Increasing age at time of CAS (Unit Risk ratio (1.06, 95% CI 1.02–1.10, p=0.005) and more than two major comorbidities (RR 3.82, 95% CI 1.28–11.49, p=0.02) were independent risk factors for mortality during follow-up. Conclusion Unlike population-based studies, our results indicate acceptable long-term survival rates after CAS in adequately selected patients. Disclosures L. Rinaldo: None. A. Bhargav: None. C. Arnold Fiebelkorn: None. G. Lanzino: None.
‘I want to record and share my wonderful journey’: Chinese Millennials’ production and sharing of short-form travel videos on TikTok or Douyin

Seeking to understand how involvement with social media influences travel experiences, the current investigation explores the reasoning and social justifications of tourists’ engagement with travel...
Predicting Positive Margins in Pancreatic Head Adenocarcinoma After Neoadjuvant Therapy: Investigating Disparities in Quality Care Using the National Cancer Database

In pancreatic cancer, surgical resection with neoadjuvant therapy improves survival, but survival relies significantly on the margin status of the resected tissue. This study aimed to develop a model that predicts margin positivity, and then to identify facility-specific factors that influence the observed-to-expected (O/E) ratio for positive margins among facilities. This retrospective review analyzed patients in the National Cancer Database (2004–2016) with pancreatic head adenocarcinoma [tumor-node-metastasis (TNM) stage 1 or 2] who received neoadjuvant therapy for a pancreaticoduodenectomy. Logistic regression was used to develop a model that predicts margin positivity. This model then was used to identify outlier facilities with regard to the O/E ratio. Hospital volume was defined as the total number of pancreaticoduodenectomies per year. The study enrolled 4085 patients, and 16.8% of these patients had positive margins. Most of the patients (64%) had a tumor size of 2 to 4 cm, and approximately 51% of the patients did not have positive lymph nodes at resection. A logistic regression model showed that the predictors of positive margins after resection with neoadjuvant therapy were male sex, larger tumor size, and positive lymph nodes. This model was validated to yield a bootstrap-corrected concordance index of 0.632. The study calculated O/E ratios with the model, identifying 12 low- and 17 high O/E-ratio outlier facilities among 401 studied hospitals. The outlier hospitals did not differ in facility type (i.e., academic vs integrated network), but did differ significantly in terms of yearly hospital volume (low outlier of 20.6 vs high outlier of 10.7; p = 0.008). An association of lower-volume facilities with higher than expected rates of positive margins was found to indicate a disparity in care. This disparity was identified via an O/E ratio as a quality indicator for facilities. Facilities can gauge the efficiency of their own practices by referencing their O/E ratios, and they also can improve their practices by analyzing the framework of low O/E-ratio facilities.
Vector Deformations of Script N = 4 Super-Yang-Mills Theory, Pinned Branes, and Arched Strings

We study a deformation of = 4 super-Yang-Mills theory by a dimension-5 vector operator. There is a simple nonlocal ``dipole'' field-theory that realizes this deformation. We present evidence that this theory is realized in the setting of ``pinned-branes''. The dipoles correspond to open strings that arch out of the brane. We find the gravitational dual of the theory at large N. We also discuss the generalization to the (2,0) theory.
Multidisciplinary design optimization of distributed energy generation systems: The trade-offs between life cycle environmental and economic impacts

Abstract Distributed energy systems (DES) are the focus of increasing attention because they have the potential to enhance the sustainability performance of energy generation. Previous DES researches evaluated various distributed energy technologies and systems from different aspects. However, there is still a research gap to evaluate and compare the multiple technology combinations and sizes for finding optimal energy solutions under various scenarios. This study aims to determine the best combination of technologies and their corresponding sizes for DES for various building types and climate zones in terms of life cycle environmental and economic impact. We developed parametric models (which considers dynamic hour by hour energy demand) for six commercially available distributed energy technologies and simulated the performance of them under various conditions. Then, we used a novel approach – multidisciplinary design optimization (MDO) to examine the billions of options (e.g., technologies, sizes, climate zone, Etc.) and identified the Pareto front with the optimal environmental and economic impact. According to MDO simulations, the microturbine-solar PVs-lithium ion battery and solid oxide fuel cells-solar PVs-lithium ion battery are two optimal combinations of technologies for three commercial building types for five climate zones. The DES can primarily reduce the environmental impact compared to conventional centralized energy production (CCEP) by 16–61% in all scenarios. However, the life cycle cost of DES is higher than CCEP, especially for SOFC-based DES. The microturbine-based DES is more cost-competitive and economical (about 65%, 32%, and 64% lower than SOFC-based DES for the small, medium, and large office, respectively).
Relationship Distress Among Pediatric Intensive Care Nurses in the United States

Purpose: To assess the prevalence of relationship distress among Pediatric Intensive Care Unit (PICU) nurses in the United States. Method: In 2016, an online survey of PICU nurses throughout North America was conducted. Approximately 254 PICU nurses responded to the survey. The survey gathered demographic data, practice and personal characteristics, Revised Dynamic Adjustment Scale (RDAS), and revised Maslach Burnout Inventory (MBI). RDAS is a validated measure of relationship …
Circadian Rhythms and the Transcriptional Feedback Loop (Nobel Lecture)

Circadian rhythms are present in most if not all animals, plants, and even photosynthetic cyanobacteria. These cyanobacterial clocks as well as plant clocks are very different from those of animals, with no credible homology between the different clock proteins. Therefore circadian rhythms probably emerged multiple times in evolution, which underscores their importance.
Interaction diversity explains the maintenance of phytochemical diversity

The production of complex mixtures of secondary metabolites is a ubiquitous feature of plants. Several evolutionary hypotheses seek to explain how phytochemical diversity is maintained, including the synergy hypothesis, the interaction diversity hypothesis, and the screening hypothesis. We experimentally tested a set of predictions derived from these hypotheses by manipulating the richness and structural diversity of phenolic metabolites in the diets of eight plant consumers. Across 3940 total bioassays, there was clear support for the interaction diversity hypothesis over the synergy or screening hypotheses. The number of consumers affected by a particular phenolic composition increased with increasing richness and structural diversity of compounds. Furthermore, the bioactivity of phenolics was consumer-specific. All compounds tested reduced the performance of at least one consumer, but no compounds affected all consumers. These results show how phytochemical diversity may be maintained in nature by a complex selective landscape exerted by diverse communities of plant consumers.
College student’s attitudes about SCD carrier screening

Sickle Cell Disease (SCD) is an inherited blood disorders that leads to several health problems ranging from delayed growths, recurrent infections, vision problems, chronic hemolysis, kidney diseas...
Capillary Ion Electrophoresis in Forensic Science

Electrolyte concentrations can be determined in biological specimens by a number of analytical techniques including flame emission spectrophotometry, atomic absorption spectrometry, high-performance liquid chromatography (HPLC), and potentiometry with an ion-specific electrode. Capillary ion electrophoresis (CIE) is an adaptation of free zone capillary electrophoresis to a particular electrophoretic analysis of highly mobile low-molecular-weight ions. Vitreous humor electrolyte and nitrogenous compound concentrations are often used to determine potential antemortem disease states or the time interval between time of death and time of autopsy (postmortem interval). Potassium ion concentration in the vitreous humor increases after death, and determination of its concentration in vitreous humor is often used to estimate the postmortem interval. Lithium ion is considered valuable in the treatment of certain types of mania and major endogenous depression and is even used in the treatment of cluster headaches. The optimum dosage is best determined by monitoring serum lithium concentrations. Lithium toxicity can occur with elevated serum lithium concentrations and repeated measurement every 3 h of serum lithium concentrations is recommended for intoxicated patients to differentiate acute poisoning from chronic toxicity and to determine the best course of therapy. The development of the CIE methodology reported herein offers a different qualitative and quantitative analytical technique to detect these ions in biological fluids and tissues. Application of CIE analysis for detection and quantitation of potassium and lithium ions in biological fluids and tissues commonly collected and analyzed in clinical and forensic toxicology is described.
The interaction of proteins with hydroxyapatite. III: Mechanism

The mechanism of protein binding to and elution from hydroxyapatite (HA) has been established. Binding occurs both by nonspecific attraction between protein positive charges and HA and by specific complexing of protein carboxyls with calcium loci on the mineral. Elution can take place either as the result of the nonspecific ion screening of charges or by the specific displacement of protein groups from sites on the column with which they had complexed.
Fishing for Development? Tuna Resource Access and Industrial Change in Papua New Guinea

Papua New Guinea (PNG) is an island state with sovereign rights over valuable tuna resources. Historically, PNG captured value from tuna only by charging licensing fees to foreign fishing fleets, which relegated PNG as a source of raw material for the global tuna industry. To capture more value from tuna – including much-needed jobs and infrastructure – the PNG government now offers firms that invest in domestic tuna processing plants strategic, long-term fishing licences. This strategy of ‘obligating embeddedness’ enables PNG to reorder the international division of labour in the canned tuna sector, but socio-economic outcomes are shaped by competition within the global tuna industry, the core business strategies of foreign firms and domestic conditions in PNG. Ultimately, a state's right to control the terms of access to tuna is not synonymous with its ability to shape the local-level consequences that emerge as firms comply. These findings reveal the peculiar nature of state sovereignty over pelagic marine resources and the complications of exploiting them to achieve domestic economic and social objectives.
A Time-dependent solution for the cluster concentrations in homogeneous nucleation

Publisher Summary This chapter discusses a time-dependent model for homogeneous nucleation and derives a time-dependent solution to the coupled growth-rate equations for molecular cluster concentrations; this yields expressions for the time evolution of individual embryo populations and the currents between them. The condensation rate used considers all embryos to be in motion, rather than assuming that only the monomers move. A correction to the monomer concentration growth-rate equation is applied, which accounts for the gain and loss of molecules by cluster populations of all sizes. By converting the growth-rate equations to a matrix differential equation, a solution is obtained in the form of a matrix exponential. Gibbs free energy expressions from other theoretical approaches, such as steady-state theories, can be substituted into this model to obtain the corresponding time-dependent cluster concentrations. This provides the corresponding time-dependent currents between cluster concentrations. Free energy expressions from recent semiphenomenological models are applied and excellent agreement with their nucleation rates is found. Agreement with experimentally measured nucleation rates for water is within one order of magnitude.
Cenas cotidianas: cultura de consumo e mídia em contos de André Sant'Anna

Este artigo propoe uma analise da representacao da cultura de massas e da cultura de consumo em relatos de Sexo e amizade, do escritor brasileiro Andre Sant'Anna. Situamos estes relatos no fluxo de um extenso dialogo da literatura brasileira com a cultura de massas, o qual tem se efetivado desde o inicio do seculo XX e atraves do qual a literatura brasileira tem, com frequencia, elaborado uma critica a cultura de consumo. Argumentamos que, nos textos em questao, Sant'Anna representa a cultura de consumo como uma forca intrinsecamente presente nas relacoes sociais e na forma de pensar dos personagens. Afastando-se do que Lidia Santos chama de estetica da dificuldade, uma marca comum da literatura brasileira que se engaja com esse tema entre os anos 1960 e 1980, Andre Sant'Anna articula uma critica da presenca da cultura de consumo no cotidiano brasileiro a partir de uma linguagem predominantemente midiatica e acessivel, retratando individuos oriundos de diferentes classes sociais.
Structure and Evolution of Baroclinic Waves as Inferred from Regression Analysis.

Abstract The structure of transient disturbances with periods shorter than a week is documented an the basis of one-point regression maps and longitude–height sections derived from the National Meteorological Center (NMC) operational analyses for nine winter seasons. The reference time series for the regression coefficients is highpass filtered, normalized 500-mb height at a grid point in the Pacific stormtrack. The field variables that were regreesed on the reference time series were not filtered. The regression statistics yield quantitative estimates of the amplitudes of the high-frequency fluctuations in the geopotential height, temperature, wind, ageostrophic wind, vorticity, divergence, vertical velocity, and outgoing longwave radiation fields. The observed high-frequency fluctuations exhibit a vertical and meridional structure suggestive of baroclinic waves evolving through the mature phase of their life cycle. Most of the results are in qualitative agreement with previous studies, but the ageostrop...
Effluent for Irrigation — A Need for Caution?a

Most municipal waste treatment systems receive, treat, and eventually discard to some segment of the environment storm runoff and liquid wastes from all industrial, commercial, and domestic areas and establishments in the community. At any given time these wastes may contain viruses, antibiotics, hormones, nutrients, weedkillers, fungicides, pesticides, trace metals, and an almost countless number of toxic chemical compounds. Present treatment by the old, ineffectual sewage treatment methods and facilities still employed generally does not remove nor reduce to a harmless state all of the hazardous materials contained in the waste streams entering the plant. Some are more concentrated when they leave the plant in effluent and sludge than they were upon entry. Existing pollution protection laws prohibit surface-water dilution of these effluents and sludges. Drying, burning, or distilling them is very costly, causes air pollution, and produces potentially hazardous chemical residues which still must be disposed of in some nonpolluting fashion. There are no “technologically feasible, economically reasonable” alternative methods of effectively treating these wastes to an acceptable quality level for discharge to streams. For these reasons, land disposal of sewage effluent and sludges now is being widely promoted and employed as the best available method of treatment. It is estimated that as many as 300 municipalities have gone to the land to solve their sewage plant waste problems in recent months. Many of these have been at least partially funded with State and Federal grants. If similar permits and financial assistance continue to be granted in the future, it is anticipated that several thousand municipalities will follow suit within the next few years.
The Development of Underground Musicians in a Honolulu Scene, 1995-1997

fliers for obscure local rock band performances adorn telephone poles. The sounds of a practicing rock band blast out of someone’s garage. Who are these bands? Who supports them? Where did they come from? Where are they going? Who are the band musicians? And what exactly is the connection, if any, between these bands and the bands we see on MTV and hear on the radio, and whose CDs we see in the music stores? This study examines bands and their musicians in a local underground scene. The material I have accumulated over a two-year period of fieldwork on local rock bands in Hawaii is restricted to original bands: bands that create and play their own music. Cover bands that play renditions of pop hits from the big charts in bars and clubs are excluded from the study. The term “underground” means that these bands are hidden and inaccessible to people who are not “hooked into” the scene. Without good venues for playing before an audience and commercial promotion, they reach their audience mainly by fliers on telephone poles or by word of mouth. The study emphasizes the connections that form both among members within the scene, and between scene members and outsiders. One way of looking at such connections is to view them as elements of an underground social movement. The scene is not an organized group with a clear goal that dictates its actions, as is the case with many other social movements. It is also not an aggressive group of individuals who have a grievance against established institutions, although some aspects of the lives and attitudes of those in the scene are anti-establishment. Gusfield (64–66) argues that even though a movement may not necessarily be geared towards changing the institutionalized rules and procedures of an organization, social movement action can be going on at a more micro, less public level of everyday interaction. A movement can be oriented toward establishing alternative lifestyles or norms rather than engaging in direct conflict with established institutions. Gusfield notes that each member of such a movement feels that he is not an isolated individual, but that the ideas behind the movement are socially shared. The interaction among band members and among bands reflects their involvement in an alternative lifestyle. Besides the interaction within the local scene, bands also have ties to other bands on the mainland. CDs and tapes, radio, music
Bench to Bedside Tumor Necrosis Factor‐alpha: From Inflammation to Resuscitation

Proinflammatory mediators such as tu- mor necrosis factor-alpha (TNF) have been implicated in the pathophysiology in a number of acute disease states. Tumor necrosis factor-alpha can contribute to cell death, apoptosis, and organ dysfunction. Tumor necrosis factor-alpha can be generated with sepsis or ischemia-reperfusion by activation of cell mitogen-ac- tivated protein kinases and nuclear factor kappa B, leading to TNF production. A number of strategies to modulate TNF have been recently explored, including factors directed toward mitogen-activated protein ki- nases, TNF transcription, anti-inflammatory ligands, heat shock proteins, and TNF-binding proteins. How- ever, TNF may also play an important role in the adaptive response to injury and inflammation. Con- trol of the deleterious effects of TNF and other proin- flamatory cytokines represents a realistic goal for clinical emergency medicine. The purpose of this ar- ticle is to provide a background of relevance to emer- gency medicine academicians on the production and regulation of TNF, the acute effects of TNF on path- ophysiology, and the rationale for therapeutic inter- ventions directed toward TNF and the clinical expe- rience with these strategies. Key words: sepsis; shock; ischemia and reperfusion; therapy; trauma; emergency; review; tumor necrosis factor. ACA- DEMIC EMERGENCY MEDICINE 2000; 7:930-941
Medical Malpractice for Critical Care

RITICAL CARE malpractice means care that does not meet the standard expected by all practitioners of critical care, regardless of specialty. That care should not be judged differently regardless of the practitioner's primary specialty. We obviously presume that the physicians involved willingly participated in the care of critically ill patients. Furthermore, such care does not necessarily have to be delivered in the intensive care unit (ICU) itself but at any location in the hospital where a patient may be critically ill The standard does not change by geographic location or hospital. Perhaps the only exceptions would be situations in which general practitioners or other non-critical care providers would find themselves caring for sick patients in isolated circumstances with no other competent medical help available. No doubt, the standards would be lowered in such cases.
Managing Capacity and Flow at Theme Parks

The growth of service industries and their impact on the U.S. economy have attracted considerable attention in recent years. While some service sectors, most notably airline and telecommunication industries, have been in the forefront of model development, the industry is rather fragmented, and similar rigor is lacking in most other sectors. This paper describes an application of a model-based approach to some of the short-term ride capacity and visitor flow issues faced by the Six Flags Magic Mountain SFMM, a major national theme park. Specifically, we consider daily operations at the theme park and focus on the generation and evaluation of alternative strategies for managing ride capacities and visitor flow. Management of demand involves two aspects: a understanding customer preferences as revealed by routing behavior, and b using the model to evaluate the implications of changes in transition-behavior. A crucial component of the study relates to the empirical data collected. Besides verifying the validity of the models, these data provide several insights for developing schemes to manage the day-to-day operations of the park. The SFMM management was actively involved in various phases of this study and as a result has been introducing the proposed models in a phased manner.
19 Deficiency in GATA-4 or GATA-6 Diminishes Definitive Hematopoiesis in Murine Embryonic Stem Cell Derived Embryoid Bodies.

Formation of mesoderm derived blood islands in the mouse embryonic yolk sac requires the presence of visceral endoderm (VE) and VE derived factors. Murine embryonic stem (ES) cells can be differentiated into embryoid bodies (EBs) which serve as an in vitro model recapitulating many embryonic developmental processes, including formation of early hematopoietic cells. Previous investigators have reported that differentiation of ES cells deficient in either GATA-4 or GATA-6 results in EBs with disrupted differentiation of visceral endoderm and defective blood island formation. In the current study, we have compared GATA-4 and GATA-6 null ES cell derived EBs to wild-type EBs in their ability to commit to early hematopoietic lineages using hematopoietic progenitor colony assays, and used RT-PCR to assess the expression of endoderm genes. As expected, we observed differences in expression of endoderm genes in wild-type and GATA-4 or GATA-6 null EBs. Blast colony forming cell assays from day 2 and day 3 EBs revealed no difference between the ability of wild-type and GATA-4 or GATA-6 null EBs to differentiate into hemangioblasts. Analysis of primitive erythroid progenitors from day 4, 5, 6 and 7 wild-type and homozygous deficient EBs also showed similar numbers of primitive erythroid progenitor colonies. In contrast, comparisons of definitive hematopoietic progenitor colonies from day 8, 9 and 10 GATA-4 and GATA-6 null EBs revealed a significant reduction in colony numbers at day 8 (p-values < 0.05) compared to wild-type. Strikingly, definitive progenitor colony numbers are rescued nearly to wild-type levels after the addition of visceral endoderm derived factors during EB differentiation. These results suggest that GATA-4 and GATA-6 transcription factors and/or visceral endoderm are not necessary for hemangioblast, primitive erythroid, or definitive progenitor emergence from EBs but play a role in definitive progenitor expansion in EBs.
Comparative study of courtship in twelve phycitine moths (Lepidoptera: Pyralidae).

The courtship behavior of 12 phycitine moths (Lepidoptera: Pyralidae) was studied using frame-by-frame analysis of video recordings. Behavioral transitions during courtship were quantified for selected species and kinematic diagrams of courtship sequences were constructed. Interspecific similarities in courtship behaviors were measured by calculating Euclidean distances between species based on 12 courtship characters and by clustering species according to UPGMA (unweighted pair-group method using arithmetic averages). The resulting phenogram revealed two major behavioral patterns in courtship: (1) interactive and (2) simple. The former was characterized by a complex sequence in which, typically, a male approached a pheromoneemitting female, engaged in a head- to- head posture with the female, and then brought his abdomen over his head and struck the female on the head and thorax. This action brought male abdominal scent structures into close proximity with the female antennae. The male then attempted copulation from the head- to- head position by a dorsolateral thrust of the abdomen toward the female genitalia. Males of these species possessed scent structures located either on the eighth abdominal segment, or in a costal fold of the forewing, or both. Courtship in the second group was much more prosaic. After locating the female by response to her sex pheromone, the male simply attempted copulation by lateral abdominal thrusts under the female wing, without behavioral embellishments. Males of species exhibiting simple courtship had either no scent structures or structures that appeared vestigial. The grouping of species based on courtship characters was poorly correlated with taxonomic relationships, suggesting that the selective pressures governing the evolution and maintenance of courtship and male pheromones were distinct from those involved in the evolution of other morphological characters. While we argue that the primary force molding the evolution of courtship was an adaptive response to interspecific mating mistakes, we do not believe that isolation is brought about by the sequence of courtship behaviors themselves, due to the striking similarity in the sequence across several diverse species. Rather, these behaviors act to deliver more efficiently the male pheromonal message, which mayhave evolved for reproductive isolation.
Redescription of Stentorceps Quinlan, 1984 (Hymenoptera: Figitidae), with a Description of Five New Species

The Afrotropical eucoiline genus Stentorceps, described in 1984, has remained monotypic until now. Stentorceps is herein redescribed using recent field collections from Kenya and Madagascar. Stentorceps tubicen Quinlan is redescribed, and the new species S. abbotti, S. heimdalli, S. vuvuzela, S. weedlei and S. zuparkoi are described. Stentorceps heimdalli, S. weedlei and S. zuparkoi extend the range of Stentorceps to Nigeria, Madagascar, Rwanda, Somalia and South Africa. The descriptions and keys provide a foundation for future taxonomic and biological investigations.
DISTANCE LEARNING AND CULTURAL DIVERSITY: POTENTIAL USERS' PERSPECTIVE

This study examined the impact of cultural differences (individualism‐collectivism) on potential users' receptivity towards distance learning. Using a sample of 424 students enrolled in two northeastern universities, we addressed three research questions: Would an individual's culture affect his or her receptivity towards distance learning? Would an individual's culture affect his or her preference for particular distance learning media? Would an individual's culture affect his or her preference for distance learning in a particular course type? Findings reveal that an individual's culture affects his or her overall attitude towards distance learning. Specifically, we found that individualists' motives and communication patterns are in synch with distance learning as a medium of instruction or communication; whereas collectivists' motives and communication patterns shun any form of mediated instruction or communication as in distance learning. Implications and direction for future studies are discussed.
Standard states for the adsorbed-solution theory

Abstract The thermodynamic basis for the adsorbed-solution theory is examined within the context of the two definitions of Gibbs energy for nonideal adsorbed solutions. We invoke three assumptions: (i) that an ideal adsorbed solution is defined in a way analogous to an ideal liquid solution with a pure-component standard state used to define a standard chemical potential and Gibbs energy of mixing, (ii) that the system has a linear Henry's law region, and (iii) that the Gibbs isotherm holds. Based on these, we show that the only pure-component standard state for mixed gas adsorption is one at the spreading pressure (or surface potential) of the mixture. Thus, the ideal adsorbed-solution theory of Myers and Prausnitz is formally derived.
Surface solar ultraviolet radiation for paleoatmospheric levels of oxygen and ozone.

Many investigators have concluded that the level of solar ultraviolet radiation (200-300 nm) reaching the surface was a key parameter in the origin and evolution of life on earth. The level of solar ultraviolet radiation between 200 and 300 nm is controlled primarily by molecular absorption by ozone, whose presence is strongly coupled to the level of molecular oxygen. In this paper, a series of calculations is presented of the solar ultraviolet radiation reaching the surface for oxygen levels ranging from 0.0001 the present atmospheric level to the present level. The solar spectrum between 200 and 300 nm has been divided into 34 spectral intervals. For each spectral interval, the solar ultraviolet radiation reaching the earth's surface has been calculated by considering the attenuation of the incoming beam due to ozone and oxygen absorption. A one-dimensional photochemical model of the atmosphere was used for these calculations.
The many factors that affect the success of regulatory mechanisms designed to foster investments in energy efficiency

A utility’s profit-maximizing level of investment in energy efficiency or demand-side management (DSM) programs and mix of programs is affected by natural load growth, the frequency of rate cases, program costs, and the structure of any mechanism designed to either compensate the utility for foregone profits or sever the link between sales and profits. Under a range of reasonable assumptions, decoupling can incent a utility to invest in DSM. However, a utility experiencing high natural load growth and little inflation is likely to resist the imposition of a decoupling mechanism, as it would tend to lower profits. A utility with low growth in per-customer sales will tend to favor decoupling, as it will tend to lead to higher profits than under traditional regulation. The results presented here are quite sensitive to the assumptions made regarding natural load growth, regulatory lag, the frequency of price changes, price elasticity of demand, and other factors. This suggests that there is not a single approach to promoting energy efficiency without penalizing utility profits that will work in all situations for all utilities.