cssi/SciSciGPT-SciSciNet huggingface dataset:
Use of aromatherapy to promote a therapeutic nurse environment

Abstract Background Workplace stress can affect nurse satisfaction. Aroma therapy as a therapeutic use of essential oil can be beneficial in reducing stress. Purpose Assess perceived stress pre-post introduction of Essential Oil Lavender among registered nurses, charge nurses, and patient care technicians in a trauma intensive care unit, surgical specialty care unit and an orthopedic trauma unit. Methods Pre-post intervention with a quasi-experimental design. After a pre-survey, Essential Oil Lavender was diffused 24 h per day over 30 days in a designated nursing area that all nurses were not required to enter on each unit. Results Dependent sample t-test for “how often do nurses feel stressed a work in a typical week” revealed pre-survey mean 2.97 (SD = 0.99) which was significantly higher than post-survey mean 2.70 (SD = 0.92) with significance, t(69) = 2.36, p = 0.021, suggesting a difference in how often staff felt stressed at work in a typical week, trending down from “feeling stressed half of time” to “once in a while”. There were no statistically significant differences in pre-post survey scores for TICU, TOU, or SSC as separate units. Relevance Use of essential oils to decrease work-related stress among nursing staff may improve retention, workplace environment, and increase nurse satisfaction.
Wachovia Bank & Trust Company, N.A. (B): Piedmont Operations Center Scheduling

The manager of the bank's proof department has to decide how many part-time hours to schedule for the upcoming week. To do this, he must develop a forecast of the number of checks to be processed based on historical data, and then he must take into account the costs of under/overscheduling hours. The case is used to introduce exponential smoothing.
A novel technique for reference point generation to aid in intraoral scan alignment.

Objective When using a completely digital workflow on larger prosthetic cases it is often difficult to communicate to the laboratory or chairside Computer Aided Design and Computer Aided Manufacturing system the provisional prosthetic information. The problem arises when common hard tissue data points are limited or non-existent such as in complete arch cases in which the 3D model of the complete arch provisional restorations must be aligned perfectly with the 3D model of the complete arch preparations. In these instances, soft tissue is not enough to ensure an accurate automatic or manual alignment due to a lack of well-defined reference points. A new technique is proposed for the proper digital alignment of the 3D virtual model of the provisional prosthetic to the 3D virtual model of the prepared teeth in cases where common and coincident hard tissue data points are limited. Clinical considerations: A technique is described in which fiducial composite resin dots are temporarily placed on the intraoral keratinized tissue in strategic locations prior to final impressions. These fiducial dots provide coincident and clear 3D data points that when scanned into a digital impression allow superimposition of the 3D models. Conclusions Composite resin dots on keratinized tissue were successful at allowing accurate merging of provisional restoration and post-preparation 3D models for the purpose of using the provisional restorations as a guide for final CLINICAL SIGNIFICANCE Composite resin dots placed temporarily on attached tissue were successful at allowing accurate merging of the provisional restoration 3D models to the preparation 3D models for the purposes of using the provisional restorations as a guide for final restoration design and manufacturing. In this case, they allowed precise superimposition of the 3D models made in the absence of any other hard tissue reference points, resulting in the fabrication of ideal final restorations.
SynCAM in Formation and Function of Synaptic Specializations

SynCAM 1 (Synaptic Cell Adhesion Molecule 1), a member of the immunoglobulin (Ig) superfamily of proteins, is an intercellular adhesion molecule at synapses in the central nervous system (CNS). It mediates interactions that bridge the synaptic cleft between pre- and postsynaptic membranes. SynCAM 1 has an active role in synaptic differentiation and induces formation of new presynaptic terminals. In keeping with this activity, SynCAM 1 is expressed throughout the developing brain, indicating a general role in synaptogenesis. SynCAM 1 is a member of a family of four genes found solely in vertebrates. The domain structure of all SynCAM family members is well defined. Three Ig-like domains constitute their extracellular sequence, followed by a single transmembrane region and a short cytosolic tail. Their intracellular sequences display an interaction motif for PDZ domain-containing adaptor molecules and for components of the actin cytoskeleton. These cytosolic protein interaction motifs are highly conserved among all four SynCAM proteins, underscoring their important role in mediating membrane differentiation.
Process and rate of dedolomitization: Mass transfer and 14C dating in a regional carbonate aquifer: Extended interpretation and reply

No Abstract Available. The article being discussed and interpreted appeared in the Bulletin , v. 94, p. 1415–1429.
Rebuilding New Orleans with Affordable, Hurricane-Resistant Residential Construction

This article describes a project in which the overall objective was to provide information and designs for the rebuilding effort in New Orleans following the city’s destruction by Hurricane Katrina in August 2005. More than 250,000 houses were damaged in New Orleans - 100,000 beyond repair. The University of Nebraska-Lincoln teamed with Catholic Charities of the Archdiocese of New Orleans to work with residents in the Treme/Lafitte neighborhoods of Orleans Parish to rehabilitate, construct, and reconstruct their homes. Three objectives of the project were to (1) develop a rehabilitation manual; (2) design 10 new affordable house designs with 10 variations, for a total of 20 new designs; and (3) capture the designs of 10 houses to be demolished and rebuilt.
Model Combination for Event Extraction in BioNLP 2011

We describe the FAUST entry to the BioNLP 2011 shared task on biomolecular event extraction. The FAUST system explores several stacking models for combination using as base models the UMass dual decomposition (Riedel and McCallum, 2011) and Stanford event parsing (McClosky et al., 2011b) approaches. We show that using stacking is a straightforward way to improving performance for event extraction and find that it is most effective when using a small set of stacking features and the base models use slightly different representations of the input data. The FAUST system obtained 1st place in three out of four tasks: 1st place in Genia Task 1 (56.0% f-score) and Task 2 (53.9%), 2nd place in the Epigenetics and Post-translational Modifications track (35.0%), and 1st place in the Infectious Diseases track (55.6%).
Visualizing Software Ecosystems as Living Cities

Several groups visualize software systems using ”city” metaphors, mapping software onto features such as buildings and roads. This abstract introduces a “living city” metaphor, where programs are visualized as a city populated by users, data structures, threads of execution, and bugs. A living city is a 3D, multi-user virtual world in which the visible artifacts are software and data.
Progress in Pollution Prevention through Precision Process Modeling, Design, and Operation

In order to have a broad impact on pollution prevention at the source in the chemical process industries (CPI), one must have a multifaceted approach to the underlying fundamental problems. There is obviously important work that must be undertaken to develop totally new processes involving new chemistry, new catalysts, and new process designs so as to prevent or greatly reduce the production of pollutants during chemical synthesis and processing. However, this long-term approach requires the construction of new plants and necessarily involves huge new capital investments in order to affect even a fraction of the pollutants produced by the CPI today. With many trillions of dollars invested in existing chemical and oil refining plants around the world, it will be many years before research directed at totally new processes will have widespread impact on pollution reduction. In order to have an important effect in reducing the production of pollutants in the next 10–20 years, one must develop focused process revamps which require modest capital investments and maximize the impact on pollution reduction. These approaches, while complementing important research on totally new processes, can have enormously greater impact in the next two decades because they require the least investment and produce the greatest benefits. In this context, an essential requirement for success is in identifying good candidates for process modification and then to use fundamental tools for precision process modeling, design, and operation in order to achieve the desired pollution reduction goals. The engineering approach described in this lecture is directed towards developing new basic engineering tools for analyzing and designing processes so as to make modifications for pollution prevention, and then demonstrating the tools and the underlying principles on real problems from the CPI.
Tame vs. Wild

In this chapter we will compare two classical structures: the field of complex numbers \(({\mathbb {C}},+,\cdot )\) and the standard model of arithmetic \(({\mathbb {N}},+,\cdot )\). The former is vast and mysterious, the latter deceptively simple. As it turns out, as far as the model-theoretic properties of both structures are concerned, the roles are reversed, the former is very tame while the latter quite wild, and those terms have well-understood meanings. In recent years, tameness has become a popular word in model theory. Tameness is not defined formally, but a structure is considered tame if the geometry of its definable sets is well-described and understood. Tameness has different levels. The most tame structures are the minimal ones. All parametrically definable unary relations in a minimal structure are either finite or cofinite. The examples of minimal structures that we have seen so far are the structures with no relations on them—the trivial structures—and \(({\mathbb {N}},<)\). It is somewhat surprising that the ultimate number structure—the complex numbers, is also minimal. It is a fascinating example.
1,2,4-Triazolo[1,5-a]pyrimidines in Drug Design

The 1,2,4-triazolo[1,5-a]pyrimidine (TP) heterocycle, in spite of its relatively simple structure, has proved to be remarkably versatile as evidenced by its use in many different applications reported over the years in different areas of drug design. For example, as the ring system of TPs is isoelectronic with that of purines, this heterocycle has been proposed as a possible surrogate of the purine ring. However, depending on the choice of substituents, the TP ring has also been described as a potentially viable bio-isostere of the carboxylic acid functional group and of the N-acetyl fragment of e-N-acetylated lysine. In addition, the metal-chelating properties of the TP ring have also been exploited to generate candidate treatments for cancer and parasitic diseases. In the present review article, we discuss recent applications of the TP scaffold in medicinal chemistry, and provide an overview of its properties and methods of synthesis.
Activation of vitamin D in the gingival epithelium and its role in gingival inflammation and alveolar bone loss

Background and objective Both chronic and aggressive periodontal disease are associated with vitamin D deficiency. The active form of vitamin D, 1,25(OH)2 D3 , induces the expression of the antimicrobial peptide LL-37 and innate immune mediators in cultured human gingival epithelial cells (GECs). The aim of this study was to further delineate the mechanism by which vitamin D enhances the innate defense against the development of periodontal disease (PD). Materials and methods Wild-type C57Bl/6 mice were made deficient in vitamin D by dietary restriction. Cultured primary and immortalized GEC were stimulated with 1,25(OH)2 D3 , followed by infection with Porphyromonas gingivalis, and viable intracellular bacteria were quantified. Conversion of vitamin D3 to 25(OH)D3 and 1,25(OH)2 D3 was quantified by ELISA. Effect of vitamin D on basal IL-1α expression in mice was determined by topical administration to the gingiva of wild-type mice, followed by qRT-PCR. Results Dietary restriction of vitamin D led to alveolar bone loss and increased inflammation in the gingiva in the mouse model. In primary human GEC and established human cell lines, treatment of GEC with 1,25(OH)2 D3 inhibited the intracellular growth of P. gingivalis. Cultured GEC expressed two 25-hydroxylases (CYP27A1 and CYP2R1), as well as 1-α hydroxylase, enabling conversion of vitamin D to both 25(OH)D3 and 1,25(OH)2 D3 . Topical application of both vitamin D3 and 1,25(OH)2 D3 to the gingiva of mice led to rapid inhibition of IL-1α expression, a prominent pro-inflammatory cytokine associated with inflammation, which also exhibited more than a 2-fold decrease from basal levels in OKF6/TERT1 cells upon 1,25(OH)2 D3 treatment, as determined by RNA-seq. Conclusion Vitamin D deficiency in mice contributes to PD, recapitulating the association seen in humans, and provides a unique model to study the development of PD. Vitamin D increases the activity of GEC against the invasion of periodontal pathogens and inhibits the inflammatory response, both in vitro and in vivo. GEC can convert inactive vitamin D to the active form in situ, supporting the hypothesis that vitamin D can be applied directly to the gingiva to prevent or treat periodontal disease.
A practical guide to episode groupers for cost-of-illness analysis in health services research:

Despite the prominence of episode groupers for analysis and reimbursement in US payer settings, peer-reviewed articles using episode groupers for cost-of-illness analysis that informs public health research and decision-making are uncommon. This article provides a brief practical guide to episode-based cost analysis and offers some examples of episode grouper products. It is intended for an audience of health services researchers and managers in public health settings who perform or commission cost-of-illness studies with the US healthcare claims fee-for-service data but lack familiarity with episode groupers.
Searching and Citing the Literature

Medical students are expected to take a scholarly approach to their work. Learning to identify the key questions raised by the case and performing a thorough but focused literature search can help students to optimize their patients’ care. There are many ways to search the literature, including straightforward web searches and MEDLINE searches using the MeSH (Medical Subject Headings) database. Although web searches are sometimes sufficient, a properly conducted MeSH search will generally narrow the focus to the most relevant and highest-quality articles. When presenting patients on rounds, medical students should make the literature search an integral part of their assessment. Finding the best evidence will help students to learn, excel, and provide outstanding care for their patients.
Descriptions of diabetes burnout from individuals with Type 1 diabetes: an analysis of YouTube videos.

Aim The purpose of the study was to analyse self-descriptions of diabetes burnout in individuals with Type 1 diabetes via YouTube videos. Methods In this qualitative descriptive study, a systematic approach was used to search YouTube videos with a title, description or content specifically about diabetes burnout dated between 2007 and 2017. Irrelevant or duplicated videos were excluded using eligibility criteria. All videos meeting inclusion criteria (n = 32) from individuals with Type 1 diabetes were transcribed verbatim and analysed using a qualitative content analysis approach. Descriptive statistics were used to analyse video characteristics. Results The four major themes associated with diabetes burnout were: (i) feeling mentally drained and physically tired of dealing with self-care; (ii) experiencing a detachment from self, diabetes care and support system; (iii) being powerless and paralysed to 'climb out' of diabetes burnout; and (iv) contributing potential factors to diabetes burnout. Conclusions Self-descriptions of diabetes burnout suggest that it is a combination of emotions and behaviours on a spectrum from exhaustion to detachment accompanied by an overwhelming sense of powerlessness. More studies are needed to further clarify diabetes burnout and its distinction from, or overlap with, other related psychosocial concepts in diabetes care.
A Plasma-Arc Technique for the Spectrochemical Determination of Titanium and Zirconium in Molybdenum

A plasma-arc technique has been developed for the spectrochemical determination of titanium and zirconium in molybdenum alloys. Titanium is determined in the 0.25–1.5% range and zirconium in the 0.05–0.4% range with an overall precision of about ±5% and an accuracy which approaches the precision. Sensitivity for the zirconium determination is achieved by using high gas flow and high amperage. Molybdenum is used as the internal standard and a background correction is necessary to produce a straight-line analytical curve for zirconium over the concentration range of interest.
Linear Programming Based Near-Optimal Pricing for Laminar Bayesian Online Selection

In the Bayesian online selection problem, the goal is to design a pricing scheme for a sequence of arriving buyers that maximizes the expected social-welfare (or revenue) subject to different types of structural constraints. Inspired by applications in operations management, the focus of this paper is on the cases where the set of served customers is characterized by a laminar matroid. We give the first Polynomial-Time Approximation Scheme (PTAS) for the problem when the laminar matroid has constant depth. Our approach is based on rounding the solution of a hierarchy of linear programming relaxations that approximate the optimum online solution with any degree of accuracy plus a concentration argument that shows the rounding incurs a small loss. We also study another variation, which we call the production constrained problem, for which the allowable set of served customers is characterized by a collection of production and shipping constraints forming a certain form of laminar matroid. Using a similar LP-based approach, we design a PTAS for this problem even when the depth of the laminar matroid is not constant. The analysis exploits the negative dependency of the optimum selection rule in the lower-levels of the laminar family. Finally, we conclude with a discussion of the linear programming based approach employed in the paper and re-derive some of the classic prophet inequalities known in the literature.
Breaking the exclusionary boundary between user experience and access: steps toward making UX inclusive of users with disabilities

This research paper points out that we as Designers have failed to come up with a model of UX that would proximate a satisfying user experience for users with disabilities. It underscores the gaps in designer knowledge about disabled bodies. The research paper also draws the attention of the designer community to the limited understanding we presently possess of the disabled people's notions of, and expectations from, satisfying user experiences. It proposes a multi-step process for shifting the focus of design activity from a "medical model of accessibility design" that retrofits normative designs to the needs of users with disabilities to developing an "accessible user experience model (AUX)" of design that counts these users as design collaborators, possessors of special knowledge about disabled bodies, and untapped sources of innovative designs that might offer additional design features for all users.
Actionable Exomic Secondary Findings in 280 Lebanese Participants

The expanded use of NGS tests in genetic diagnosis enables the massive generation of data related to each individual, among which some findings are of medical value. Over the last three and a half years, 280 unrelated Lebanese patients, presenting a wide spectrum of genetic disorders were referred to our center for genetic evaluation by WES. Molecular diagnosis was established in 56% of the cases, as was previously reported. The current study evaluates secondary findings in these patients in 59 genes, linked to conditions mostly responsive to medical interventions, as per the ACMG guidelines. Our analysis allowed us to detect 19 pathogenic/likely pathogenic variants in 24 individuals from our cohort. Dominant actionable variants were found in 17 individuals representing 6% of the studied population. Genes associated with dominant cardiac diseases were the most frequently mutated: variants were found in 2.1% of our cohort. Genetic predisposition to cancer syndromes was observed in 1.07% of the cases. In parallel to dominant disease alleles, our analysis identified a recessive pathogenic disease allele in 2.5% of the individuals included in this study. Of interest, some variants were detected in different patients from our cohort thus urging the study of their prevalence in our population and the implementation, when needed, of specific genetic testing in the neonatal screening panel. In conclusion, here we report the first study estimating the actionable pathogenic variant load in the Lebanese population. Communicating current findings to the patients will enable them to benefit from a multi-disciplinary approach. Furthermore, tailoring the ACMG guidelines to the population is suggested, especially in highly consanguineous populations where the information related to recessive alleles might be highly beneficial to patients and their families.
CHAPTER 12 – Discrete Probability

Publisher Summary This chapter focuses on discrete probability. The product of the probabilities of two individual letter occurrences does not match the probability of occurrence of the pair of letters. The order of occurrence of words affects the probability of co-occurrence. The computation of large binomial coefficients and factorials is a recurring problem in combinatorial work. The numbers involved are so large and require so many multiplications that even with double precision arithmetic; the result is not very accurate. In quality control, variations from the distribution can indicate a malfunction in an assembly line. In insurance, the distribution is used to set insurance rates. In stylistic analysis, word and sentence distributions are used to determine authorship. While the variety of distributions is infinite, most natural distributions can be closely approximated by a few standard types of distribution. The chapter also discusses the important types of these distributions.
Determine the Electrode Configuration and Sensitivity of the Enclosure Dimensions when Performing Arc Flash Analysis

Arc flash hazard prediction methods have become more sophisticated because the knowledge about arc flash phenomenon has advanced since the publication of IEEE Std. 1584-2002 [17]. The IEEE Std. 1584-2018 [13] has added parameters for more accurate arc flash incident energy, arcing current and protection boundary estimation. The parameters in the updated estimation models include electrode configuration, open circuit voltage, bolted fault current, arc duration, gap width, working distance, and enclosure dimension. The sensitivity and effect changes of other parameters have been discussed the previous literatures [8] [9] [11] [2] [12] [15], this paper explains the fundamental theory on the selection of electrode configurations and performs sensitivity analysis of the enclosure dimension, that have been introduced in the IEEE Std. 1584-2018. According to the newly published model for incident energy (IE) estimation, the IE between VCB (Vertical Electrodes inside a metal Box) and HCB (Horizontal Electrodes inside a metal Box) can differ by a factor of two with other parameters constant. Using HCB as the worst-case scenario to determine the personal protection requirements [7] [10] may not be the best practice in all circumstances. This paper provides guidance for electrode configuration selection and a sensitivity analysis for determining a reasonable engineering margin when actual dimension is not available.
Safety, Tolerability, and Pharmacokinetics of PF-06823859, an Anti-Interferon β Monoclonal Antibody: A Randomized, Phase I, Single- and Multiple-Ascending-Dose Study.

This double-blind, randomized, placebo-controlled, dose-ascending, first-in-human study (NCT02766621) assessed the safety, tolerability, and pharmacokinetics (PK) of PF-06823859, an anti-interferon β monoclonal antibody. Healthy subjects were randomized to single ascending doses (SADs) of intravenous PF-06823859 30, 100, 300, 900, or 2000 mg or placebo; to multiple ascending doses (MADs) of subcutaneous PF-06823859 100 or 300 mg or placebo (once every 2 weeks for a total of 3 doses); or to MAD of intravenous PF-06823859 600 mg or placebo (once every 3 weeks or once every 4 weeks for a total of 2 doses). The incidence, severity, and causal relationship of adverse events (AEs) were assessed, along with immunogenicity and PK. In total, 62 subjects were randomized to treatment (SAD, n = 35; MAD, n = 27). There were 76 treatment-emergent all-causality AEs in the SAD (PF-06823859: n = 25; placebo: n = 4) and MAD (PF-06823859: n = 40; placebo: n = 7) cohorts. In the SAD cohorts, all treatment-emergent all-causality AEs were mild in severity; 4 AEs of moderate severity were identified in the MAD cohorts. No dose-limiting AEs, serious AEs, treatment-related discontinuations, dose reductions, or deaths occurred. PF-06823859 exposure increased dose-proportionally, with half-life values ranging between 23 and 35 days. The estimated subcutaneous bioavailability was 43% to 44%. Immunogenicity incidence rates were low (antidrug antibodies, 12.5%; neutralizing antibodies, 2.1%). No immunogenically related clinical responses of concern were observed. In conclusion, PF-06823859 demonstrated an acceptable safety, tolerability, and PK profile that supports clinical development for treating disorders associated with increased interferon β levels, such as dermatomyositis or systemic lupus erythematosus.
Validity of echocardiography for detection of left ventricular thrombus with surgical validation in patients awaiting durable left ventricular assist device.

Objective Unrecognized left ventricular thrombi (LVT) can have devastating clinical implications and precludes patients with end-stage heart failure from undergoing left ventricular assist device (LVAD) implantation without cardiopulmonary bypass assistance. We assessed the reliability of an echocardiogram to diagnose LVT in patients with end-stage heart disease who underwent LVAD implantation. Methods A single-center retrospective study evaluated 232 consecutive adult patients requiring implantation of durable LVADs between 2005 and 2019. The validity of preoperative transthoracic echocardiogram (TTE) and intraoperative transesophageal echocardiogram (TEE) for diagnosing LVT was compared to direct inspection at the time of LVAD implantation. Results There were 232 patients that underwent LVAD implantation, with 226 patients (97%) receiving a preoperative TTE. Of those 226 patients, 32 patients (14%) received ultrasound enhancing agents (UEA). Intraoperative TEE images were available in 195 patients (84%). The sensitivity of TTE without UEA was 22% and specificity was 90% for detecting LVT, compared to 50% and 86%, respectively, for TTE with UEA. For intraoperative TEE, the sensitivity and specificity were 46% and 96%, respectively. The false omission rate ranged from 4% to 8% for all modalities of echocardiography. Conclusion Among patients undergoing LVAD implantation, preoperative TTE and intraoperative TEE had poor sensitivity for LVT detection. Up to 8% of echocardiograms were incorrectly concluded to be negative for LVT on surgical validation. The low sensitivity and positive predictive value for diagnosing LVT suggest that echocardiography has limited reliability in this cohort of patients who are at high risk of LVT formation and its subsequent complications.
Successful pregnancy with left ventricular assist device failure in the setting of peripartum cardiomyopathy

Pregnancy is contraindicated for women with left ventricular dysfunction due to high maternal and fetal mortality. We present a case of a pregnant 31-year-old woman with a history of heart failure ...
Limited Toxicity of Hypofractionated Intensity Modulated Radiation Therapy (H-IMRT) for Head and Neck Cancer.

Purpose/objective(s) Hypofractionated intensity modulated radiation therapy (H-IMRT) is uncommonly used in head and neck cancers due to concern for toxicity. This study reviews our experience using H-IMRT for head and neck cancers and explores its tolerability and efficacy. Materials/methods This single institution IRB approved retrospective study includes patients with head and neck cancers treated with definitive or post-operative H-IMRT from 2011-2020. Patients treated with ≥50Gy in 20 fractions to the primary tumor site and/or neck with at least 3 months of follow up were included. Patients treated to a superficial target only without proximity to mucosal surfaces or coverage of the elective neck (e.g., scalp; skin only targets) were excluded. Patients undergoing re-irradiation were excluded. Toxicity was scored using CTCAE v4.0. Acute toxicity included events occurring within 90 days of H-IMRT completion. Late toxicities occurred any time thereafter. Multiple toxicities in the same patient were scored separately. Results Fifty-nine patients with a median follow up of 10.9 months (range 3.0-111.5) were included. The majority of patients were white (93%) and male (78%) with a median age of 79.1. The most common primary tumor sites were skin (42%), major salivary glands (22%), and oral cavity (9%). The most frequent histologies included squamous cell carcinoma (66%) followed by thyroid cancer (7%), melanoma (5%), and Merkel cell carcinoma (5%). Treatment was delivered post-operatively in 80% and definitively in 20% of patients. All patients were treated with ≥50 Gy in 20 fractions, with the most common dose being 50 Gy (53%) followed by 55 Gy (44%). In 64% of patients a secondary elective dose of 45-50 Gy was used. Site treated included primary tumor site/bed with unilateral neck (54%), primary tumor site/bed with bilateral neck (19%), primary tumor site/bed alone (14%), unilateral neck (8%), and bilateral neck (5%). Five patients (8%) experienced a locoregional failure at a median time of 5.4 months (range 2.8-13.9). There were no grade 4 or 5 toxicities. Ten patients (17%) experienced acute grade 3 toxicity including mucositis (12%) and dermatitis (5%). Forty-six patients (78%) had an acute grade 2 toxicity, most commonly dermatitis (41%), pain (32%), fatigue (32%), dysgeusia (31%) and xerostomia (22%). Five patients (8%) experienced grade 2 late complications including neck fibrosis in three patients and trismus, aspiration pneumonia, and osteoradionecrosis in one patient each. No patient experienced grade 3 or higher late toxicity. No patients required the placement of a feeding tube or tracheostomy. Conclusion Hypofractionated IMRT in the definitive or post-operative treatment of head and neck cancers using ≥50Gy in 20 fractions appears safe and well tolerated with modest toxicity. Prospective studies comparing the safety and efficacy of H-IMRT to conventionally fractionated IMRT are warranted.
Return to an Event-Based Analysis

Neither the analysis of Lasersohn (1988, 1990) nor that of Schwarzschild (1992b) seems entirely satisfactory. Ideally, what we would like is an analysis which generalizes to as many of the readings of together as possible, which does not give wrong results for examples involving downward entailing contexts or related problems, which maintains a collective/distributive ambiguity of the sort argued for in Part One of this book, and which does not require an unintuitive semantics for negation.
Orientalism, Modernism, and the American Poem: Seeing the World without Language: Gary Snyder and Chinese as American Speech

I grew up with the poetry of twentieth-century coolness, its hard edges and resilient elitism. Ezra Pound introduced me to Chinese poetry, and I began to study classical Chinese. When it came to writing out of my own experience, most of modernism didn't fit, except for the steer toward Chinese and Japanese. I n a brief text directly reminiscent of the earth-beating song in Canto 49, Gary Snyder brings together several characteristic features of his work – directness, economy, clarity of expression – which he shares particularly with the Pound of the imagist manifesto and Cathay : When creeks are full The poems flow When creeks are down We heap stones. What most carries over from Pound's earth-beating song here, of course, is the short, sharply accentual line and the elemental quality of the language, which is closely related to the connection in the poem between natural events and human acts. Like the speaker of Pound's poem, the speaker here is the spokesperson for a community and a way of life that are highly naturalized, governed by natural events. In “The Etiquette of Freedom,” an essay which can be read in part as a revisionary updating of Emerson's Nature , and which aims to dismantle the civilized definition of nature as the opposite of culture, Snyder characterizes such a community as a “primary culture,” a society “whose economic system is in a close and sustainable relation to the local ecosystem,” and he gives a distinctly Fenollosan cast to his description of all “social organization” and “order in government” as “a set of forms that have been appropriated by the calculating mind from the operating principles in nature.”
Tenuazonic Acid, a Toxin Produced by Alternaria alternata

Fifty-seven of 87 isolates of Alternaria alternata (Fr) Keissler grown on autoclaved, moist corn-rice substrate and fed to rats were lethal. The major toxin produced was isolated and characterized as tenuazonic acid. Twenty of 23 toxigenic Alternaria isolates examined produced tenuazonic acid. No tenuazonic acid could be detected in either of the field samples of sorghum or blackeyed peas, which were heavily invaded by Alternaria.
Technology insight: Proton beam radiotherapy for treatment in pediatric brain tumors.

Tumors of the central nervous system are the most common solid tumor in childhood. Treatment options for childhood brain tumors include radiation therapy, surgery and chemotherapy, often given in combination. Radiation therapy regularly has a pivotal role in treatment, and technological advancements during the past quarter of a century have dramatically improved the ability to deliver radiation in a more focused manner. Improvements in imaging and computing ability led to better targeting of tumor tissue using conventional X-ray therapy. These advances have been harnessed for proton radiation therapy. Proton radiotherapy has special physical characteristics that allow normal tissues to be spared better than even the most conformal photon radiation, and it will reduce the complications from treatment. This review discusses the characteristics of proton radiation, and describes examples of pediatric brain tumor patients who would benefit most from this form of treatment. Advances in imaging and computing technology have improved the targeting of tumor tissue using conventional X-ray therapy, especially for the treatment of childhood brain tumors. Proton radiotherapy allows better sparing of normal tissues than the most conformal photon radiation. The characteristics of this technology and examples of who would benefit most from this treatment are discussed.
Unternehmenswachstum und Internationalität als Qualitätssignale

Viele Unternehmen verzeichnen aufgrund von Fusionen oder Ubernahmen ein exogenes oder in Folge von Umsatzerfolgen ein endogenes Wachstum oder erweitern ihr Absatzgebiet auf Lander, in denen sie ihre Produkte noch nicht vertrieben haben. Die Frage, die in diesem Beitrag diskutiert wird, lautet, ob Konsumenten Informationen uber solche Ereignisse als Signale fur die Qualitatder Produkte dieser Unternehmen verwenden. Zunachst werden klassische Theorienvorgestellt, die erklaren, warum Nachfrager bestimmte Informationen zur Qualitatsbewertung heranziehen. Die Uberlegungen werden auf das “Unternehmenswachstum” und die “Internationalitat” eines Unternehmens ubertragen und experimentell getestet.
Comment on ‘The precursor state to dissociation of CO adsorbed on the W(110) surface by J.E. Houston’: Some aspects of CO adsorption on W(110) at low coverage

Abstract The work function change versus exposure for CO on W(110) at various temperatures has been measured via the Kelvin method. We find essentially linear rise with coverage at T s ≤2 200 K in agreement with a previous determination by Wang and Gomer [C. Wang and R. Gomer, Surf. Sci. 74 (1978) 389] but in disagreement with a recent measurement by Houston [J.E. Houston, Surf. Sci. 225 (1991) 303] based on changes in secondary electron emission with CO coverage for 2000 eV incident electrons. We have also measured the ratio of 4σ to (5σ + 1π) peaks in UPS at 21.2 and 40.8 eV photon energies at relative CO coverages of 1 of 0.3–0.25. For 21.2 eV photons the 4σ peak virtually disappears at θ = 0.3, but at 40.8 eV 4σ/(5σ + 1π) is greater at θ = 0.25 than at θ =1. The present results do not contradict the tilted CO configuration at low coverage suggested by Houston's CO stretch results, but do not lend it direct support.
CARATHEODORY-TOEPLITZ AND NEHARI PROBLEMS FOR MATRIX VALUED ALMOST PERIODIC FUNCTIONS

In this paper the positive and strictly contractive extension problems for almost periodic matrix functions are treated. We present nece ssary and sufficient conditions for the existence of extensions in terms of Toeplit;z and Hankel operators on Besicovitch spaces and Lebesgue spaces. Furthermore, when a solution exists a special extension (the band extension) is constructed which enjoys a maximum entropy property. A linear fractional parameterization of the set of all extensions is also provided. The techniques used xn the proofs include factorizations of matrix valued almost periodic functions and a general algebraic scheme called the band method.
Storm-Induced Cyclic Effects On Seafloor Soils

This paper presents a proposed procedure for evaluating the impact of storm waves on the movements and stability of seafloor soils. This new procedure can be used to predict the magnitude and the rate of cyclic degradation and/or excess pore-water pressure build-up in soft clays by first estimating the dissipated strain energy. The proposed procedure accounts for the impact of rotation of stress points due to wave loading. The proposed procedure should serve as a simple and rational alternative to existing methods for evaluating the seafloor stability against storm-wave loading.
Giant quadrupole resonance in Ni isotopes.

Inelastic scattering of 129 MeV alpha particles has been used to excite the giant quadrupole resonance in {sup 58,60,62,64}Ni. The resonance was found to exhaust 58{plus minus}12 %, 76{plus minus}14 %, 78{plus minus}14 %, and 90{plus minus}16 % of the {ital E}2 energy-weighted sum rule, respectively, for {sup 58,60,62,64}Ni.
Stochastic model for metastable wetting of roughness-induced superhydrophobic surfaces

A stochastic model for metastable wetting of roughness-induced hydrophobic surfaces is proposed. For a rough surface, increased solid–liquid interface area results in increased interface energy, and increases the contact angle (for non-wetting liquids) or decreases it (for wetting liquids). For a very rough surface, a composite solid–liquid–air interface may form with air pockets trapped in the valleys between asperities, as opposed to the homogeneous solid–liquid interface. Both the homogeneous and composite interface configurations correspond to local energy minima of the system and therefore, there are stable states associated with different energy levels. The system may transform from one stable state to the other due to small perturbations, such as capillary waves. Different probabilities are associated with these different stable states, depending on the energy levels. The contact zone consists of a large number of asperities and valleys, which may be in the homogeneous or composite state. The overall contact angle is calculated based on the statistical model. The model may be used for design of roughness-induced superhydrophobic surfaces.
Slow crack growth in blends of HDPE and model copolymers

The resistance to slow crack growth (SCG) was measured in binary blends of high density polyethylene (HDPE) and 5-10% concentrations of model ethylene-butene random copolymers by measuring the time to failure (t f ) under a constant stress intensity. An increase of t f with the addition of the copolymer if the copolymer could crystallize and the increase was greater the higher branch density. The copolymer with 117 branches/1000C could not crystallize and therefore its blend had a t f that was less than that of the HDPE. The fracture energies of the blends as determined by their resistance to SCG were compared with the energy by rapid fracture, J c , as previously measured by Rhee and Crist. It is concluded that SCG is more sensitive to variations in the microstructure than is rapid fracture and that the differences in SCG behavior can be qualitatively explained in terms of the differences in microstructure of the blends
Perturbed γ−γ angular correlations: A spectroscopy for point defects in metals and alloys

Atomic defects which migrate and trap at impurity probe atoms can be labelled by the changes they induce in the hyperfine interactions of the probe nuclei. Many studies have been made using perturbed γ−γ angular correlations (PAC) and the111In probe because of the excellent resolution of different sites. Identification of the bound states is the key problem in applying hyperfine interactions methods to point defects studies. In this study three structure-sensitive methods are applied to help identify the atomic structures of various multivacancy complexes in Pt and Au: (1) Quadrupole interaction parameters are compared with results of point-charge calculations of electric-field gradients for 20 structures containing 1–4 vacancies in the fcc lattice. (2) Hyperfine interactions induced by decorating vacancy complexes with hydrogen atoms are measured and interpreted with the assistance of point-charge calculations. (3) Transformations between complexes observed by annihilation of vacancies by mobile self-interstitials are used to test the consistency of the identifications. Using these methods in conjunction with analysis of the trapping behavior which occurs during annealing of damaged samples, structural models are presented for divacancy (2V), 3V and 4V complexes in Pt, and 3V and 4V complexes in Au. The activation temperatures of the 3V defect in Au and Pt are determined to be 162 K and 390 K, respectively, and activation temperatures of defects in Ni, Cu, Pt and Au are compared. For Pt, trapping of H at 1V and 2V complexes is observed to lead to small changes in the quadrupole interactions, consistent with well shielded protonic charges. However, trapping at 3V and 4V complexes leads to very large changes which we attribute to atomic restructuring to the defect complexes. Finally, the application of the same methodology to interpret recent experiments on NiAl, an ordered alloy, is described.
Montefiore Medical Center in The Bronx, New York: improving health in an urban community

The author calls on academic medical centers that serve urban communities to go beyond the traditional mission of patient care, teaching, and research by accepting responsibility to build community-based care systems that are capable of improving the health of underserved populations within their reach. The experience of Montefiore Medical Center in the Bronx, New York, is presented to illustrate the nature, scope, and complexity of the undertaking that is required. Eight initiatives are described: expanding the primary care network, creating The Children's Hospital at Montefiore and the Child Health Network, responding to the needs of other high-risk populations, integrating the network with health information technology, using care-management systems to improve quality, reinforcing ethical allocation of resources, building teaching and research into the network, and preserving community vitality. The author believes that the current health care environment offers opportunities that may help to stimulate change in the direction of community-based systems. Managed care provides financial incentives to academic centers that are willing to accept risk and responsibly manage the care of a defined community, and advanced information technologies can support them in that endeavor. The author concludes that for academic medical centers with the proper systems in place, accepting responsibility for the community is not only the right thing to do, it is the strategic thing to do.
How to clear a block: A theory of plans

Problems in commonsense and robot planning are approached by methods adapted from program synthesis research; planning is regarded as an application of automated deduction. To support this approach, we introduce a variant of situational logic, called plan theory, in which plans are explicit objects. A machine-oriented deductive-tableau inference system is adapted to plan theory. Equations and equivalences of the theory are built into a unification algorithm for the system. Frame axioms are built into the resolution rule. Special attention is paid to the derivation of conditional and recursive plans. Inductive proofs of theorems for even the simplest planning problems, such as clearing a block, have been found to require challenging generalizations.
Home-to-job spillover for generation X, boomers, and matures : A comparison

Home-to-job spillover, a source of stress for employed men and women, can be exacerbated by factors that deplete personal time and energy. Household responsibilities and caring for children or the elderly are stressors that may differentially impact employed adults based on lifecycle stage. The present study identified time, satisfaction, and demographic variables significantly associated with negative home-to-job spillover for three generational groups: generation Xer’s, boomers, and matures. Matures spent significantly more time caring for the elderly whereas boomers and generation Xer’s spent more time caring for children. Significantly more boomers reported home-to-job spillover, and there were more predictors of spillover for this group than for members of the younger or older generations.
What We Can Learn from the First Digital Generation: Implications for Developing Twenty-First Century Learning and Thinking Skills in the Primary Grades.

There is a growing body of research that provides evidence that today's late adolescents and college-age students have been affected in many ways, some adversely, by growing up in the ever-increasing technology-driven world – one in which they have been living, playing and communicating. The purpose of this article is to present recent research findings to assess what twenty-first century learning and thinking skills should be developed in young children to prepare them for the digital demands of daily life as they grow into pre-adolescence.
ACR Appropriateness Criteria® on Suspected Small-Bowel Obstruction

With no one generally accepted approach to evaluate patients with suspected small-bowel obstruction (SBO), standard CT has emerged as the preeminent imaging modality and should be considered in the initial evaluation of patients with suspected high-grade SBO. Playing less significant roles in the diagnosis of acute SBO are barium enemas and the small-bowel examination.