cssi/SciSciGPT-SciSciNet huggingface dataset:
Consistent differences in medical unit fall rates: implications for research and practice.

Objectives To determine the proportion of variation in long-term fall rates attributable to variability between rather than within hospital units and to identify unit- and hospital-level characteristics associated with persistently low- and high-fall units. Design Retrospective study of administrative data on inpatient falls. Eighty low-fall and 74 high-fall units were identified based on monthly rankings of fall rates. Unit- and hospital-level characteristics of these units were compared. Setting U.S. general hospitals participating in the National Database of Nursing Quality Indicators. Participants Nonsubspecialty medical units (n = 800) with 24 consecutive months of falls data. Measurements Monthly self-reported unit fall rates (falls per 1,000 patient-days). Results An estimated 87% of variation in 24-month fall rates was due to between-unit differences. With the exception of patient-days, a proxy for unit bed size, low- and high-fall units did not differ on nurse staffing or any other unit or hospital characteristic variable. Conclusion There are medical units with persistently low and persistently high fall rates. High-fall units had higher patient volume, suggesting patient turnover as a variable for further study. Understanding additional factors underlying variability in long-term fall rates could lead to sustainable interventions for reducing inpatient falls.
Erythrocytes as controllers of perfusion distribution in the microvasculature of skeletal muscle

In 1929, August Krogh identified the matching of oxygen (O2) supply with demand in skeletal muscle as a fundamental physiological process. In the intervening decades, much research has been focused on elucidating the mechanisms by which this important process occurs. For any control system to be effective, there must be a means by which the need is determined and a mechanism by which that information is coupled to an appropriate response. The focus of this review is to highlight current research in support of the hypothesis that the mobile erythrocyte, when exposed to reduced O2 tension, releases ATP in a controlled manner. This ATP interacts with purinergic receptors on the endothelium producing both local and conducted vasodilation enabling the erythrocyte to distribute perfusion to precisely match O2 delivery with need in skeletal muscle. If this is an important mechanism for normal physiological control of microvascular perfusion, defects in this process would be anticipated to have pathophysiological consequences. Individuals with either type 2 diabetes (DM2) or pre-diabetes have microvascular dysfunction that contributes to morbidity and mortality. DM2 erythrocytes and erythrocytes incubated with insulin at levels similar to those seen in pre-diabetes fail to release ATP in response to reduced O2 tension. Knowledge of the components of the signal transduction pathway for low O2-induced ATP release suggest novel therapeutic approaches to ameliorating this defect. Although the erythrocyte may be but one component of the complex O2 delivery process, it appears to play an important role in distributing oxygen within the microvasculature.
Cache Coherence in Multiprocessors: A Survey

Abstract Shared-memory multiprocessor systems use private (or per processor) caches to enhance system performance by reducing average memory access time. In-cache modification of shared data in such systems leads to a data inconsistency problem referred to as the cache coherence problem. A solution to the cache coherence problem must ensure that any read access to shared data is satisfied with the most recent version of that data item. Both hardware-based and software-assisted solutions have been developed, reported in the literature, and implemented in multiprocessors. This paper surveys the impact of cache coherence on multiprocessor architecture design. First, general hardware approaches to dealing with cache coherence in shared-memory multiprocessors are presented. The approaches presented are interconnection medium-dependent, as follows: bus-based, multistage interconnection network (MIN)-based, and crossbarbased. The possibility of implementing protocols in hypercubes is also discussed. Software solutions to cache coherence are also dealt with. Coherency requirements and correctness of protocols are later described. Finally, a performance analysis summary is included.
Complete Bilateral Cleft Lip and Palate

Management of the prominent premaxilla in bilateral cleft lip and palate remains challenging, and consequently, many different approaches have been tried. Surgical setback at time of lip repair is one approach that provides immediate resolution of the excessive midfacial prominence. However, follow-up studies have demonstrated severe deleterious effects on midface growth resulting from this treatment (see Chap. 7).
Turning Out Unlikely Voters? A Field Experiment in the Top-Two Primary

Those who turn out in American primary elections are a small and unrepresentative subset of the population. Why do citizens forgo participation in nominating contests yet vote in general elections? We argue that limited contact lowers participation in primary elections. We present results from a randomized field experiment with near 150,000 letters in California’s 2014 primary. Each letter went to one of the four million Californians who had participated in recent general elections but not in primaries. We find that a single letter increased turnout by 0.5 points from a base rate of 9.3 percent. This increase is more than twice the average effect calculated in a recent meta-analysis and represents a proportional increase of 5.4 percent. Our experiment shows that registrants who typically abstain from primaries—and who are thus often ignored by campaigns—can be effectively mobilized.
A derivation of the radar cross section of an iceberg for a pulsed high frequency radar

The radar cross section (RCS) of an iceberg is derived in the context of a monostatic high frequency surface wave radar with a vertical dipole source driven by a pulsed waveform. The starting point of this derivation is the backscattered electric field equation as found in previous work. This equation is simplified by restricting the iceberg size to fit within the radar system's patch width. After simplification, the power received by the radar is calculated using the electric field equation. Comparing the received power with the standard radar range equation results in a general expression for the iceberg RCS.
Recovery of the slow action potential is hastened by the calcium slow channel agonist, Bay-K-8644.

Effects of the positive inotropic drug, Bay-K-8644, were studied on the slow action potential (AP) parameters and diastolic recovery of Vmax in K+ (22 mM)-depolarized rabbit papillary muscles. Bay-K-8644 (10−6 M) increased the amplitude, maximum rate of rise (Vmax) and duration of the slow APs. Diastolic recovery of Vmax, examined by a paired-pulse protocol, was approximated by a single exponential function,both in control and in drug-treated muscles. The time constant of the recovery for drug-treated preparations was 171 ± 20 ms (n = 9), and was significantly smaller than that for control: 414 ± 45 ms (n = 12) (P < 0.001) The diastolic intervals which allow 90% recovery of Vmax (T90%) were: 752 ± 106 ms (n = 12) for control and 364 ± 53 ms (n = 9) in the presence of drug, the latter being significantly shorter (P < 0.01). The extent of the reductions in Vmax, at driving frequencies higher than 0.5 Hz, was minimal in the presence of the drug compared to the control. It was concluded that Bay-K-8644 not only enhanced the slow inward current, but also accelerated the reactivation process of the slow inward current and Ca2+ slow channel.
Temporal and spatial patterns of phytoplankton production in Tomales Bay, California, U.S.A.

Primary productivity in the water column was measured 14 times between April 1985 and April 1986 at three sites in Tomales Bay, California, USA The conditions at these three stations encompassed the range of hydrographic conditions, phytoplankton biomass, phytoplankton community composition, and turbidity typical of this coastal embayment. Linear regression of the measured daily carbon uptake against the composite parameter B Zp Io (where B is the average phytoplankton biomass in the photic zone; Zp is the photic depth; and Io is the daily surface insolation) indicates that 90% of the variability in primary productivity is explained by variations in phytoplankton biomass and light availability. The linear function derived using Tomales Bay data is essentially the same as that which explains more than 80% of the variation in productivity in four other estuarine systems. Using the linear function and measured values for B, Zp, and Io, the daily photic-zone productivity was estimated for 10 sites at monthly intervals over the annual period. The average daily photic-zone productivity for the 10 sites ranged from 0·2 to 2·2 g C m−2. The bay-wide average annual primary productivity in the water column was 400 g C m−2, with most of the uptake occuring in spring and early summer. Spatial and temporal variations in primary productivity were similar to variations in phytoplankton biomass. Productivity was highest in the seaward and central regions of the bay and lowest in the shallow landward region.
The role of surgery in children with neurofibromatosis.

Abstract Background/Purpose: Neurofibromatosis frequently is complicated by the development of symptomatic lesions such as optic gliomas and plexiform neurofibromas that require operative resection. Although characteristically benign, these neoplasms have often devastating functional and cosmetic effects and must be monitored for malignant transformation. The purpose of this study is to identify and describe the surgical considerations in the care of children with neurofibromatosis. Methods: The authors reviewed the charts of all children ( Results: A total of 249 patients with either neurofibromatosis 1 or 2 were identified. Of these, 50 (20%) underwent a total of 93 operations. The average age at operation was 9.4 years (1.2 to 21 years). There were 40 soft tissue procedures, 21 intracranial, and 32 miscellaneous. The soft tissue masses typically were treated with wide local excision, and in 8 of these procedures multiple resections were performed. Fourteen of the 50 patients had malignancies. Five of the tumors were soft tissue sarcomas, and 9 were intracranial malignancies. Three patients died, 2 from malignancy and 1 from acute, obstructive hydrocephalus after operation. There were 3 patients alive with malignancy and 8 others living with varying levels of disability. Conclusions: Neurofibromatosis in the pediatric patient frequently requires surgical intervention, often because of symptoms such as pain or cosmetic deformity, or for malignancy. Children should be watched carefully for signs of malignant transformation and undergo biopsy for neurofibromas that exhibit rapid growth. Management of sarcomas should be aggressive with consideration given to re-excision, placement of brachytherapy catheters, metastectomy, and limb salvage with adjuvant therapy when possible. Preoperatively, children should receive clinical and radiographic (computed tomography or magnetic resonance imaging) evaluation for hydrocephalus. J Pediatr Surg 36:25-29. Copyright © 2001 by W.B. Saunders Company.
The energetics of New Zealand's ducks.

Abstract Measurements on rates of metabolism and temperature regulation are presented from nine populations of seven species of ducks resident in New Zealand. An analysis of these data and those from 18 additional species obtained from the literature indicates that basal rate of metabolism in anatids correlates with body mass and restriction to the Australian–New Zealand region: these ‘southern’ species have basal rates that average 70% of those from the Northern Hemisphere. The low basal rates of southern anatids may reflect reduced pectoral muscle masses in association with the absence of migratory habits and/or life on land masses without eutherian predators. New Zealand flightless teal (Anas aucklandica nesiotis, Anas aucklandica aucklandica) do not have mass-independent basal rates that differ from those found in flighted ducks living in the same region, although flightless teal have lower total basal rates than most ducks as a result of small masses. Minimal thermal conductance in this sample is determined by body mass alone. Regulated body temperature is negatively correlated with body mass.
The network simplex method on a multiprocessor

We compare several implemented approaches to parallelizing the network simplex method on the SEQUENT shared memory multiprocessor. The experiments underscore the importance of parallel pricing and show that specialized processes and single pivots are more efficient than are uniform processes with parallel pivots. We describe the PARNET implementation that combines the best features of the experimental codes. In its least parallel version, PARNET outperforms NETFLO, a standard sequential code, by a factor of 12. The total execution time (including i/o and statistics) for any problem with 5000 nodes and 25,000 arcs taken from a standard set of NETGEN benchmark problems is less than 25 sec wall clock time on the Sequent Symmetry S-81 using six processors. The incremental speedup is linear up to six processors on the test set and improves with the problem size and the density of the underlying graph. For a problem with 1000 nodes and 500,000 ares, PARNET achieves incremental linear speedup up to 12 processors.
Generality of creativity across performance domains

The existence of general creative‐thinking skills was investigated. In the first study, 50 eighth‐grade students wrote poems, stories, mathematical equations, and mathematical word problems, all of which were rated for creativity by experts. When the effects of IQ reading achievement, and math achievement were controlled through multiple regression analyses, creativity scores on the four tasks were not correlated. This suggests that general creative‐thinking skills did not contribute to creative performance in these different tasks. Subjects also responded to a brief verbal fluency test. Scores on this test correlated significantly with story‐writing creativity (r = .34) but not with the other three tasks. Three follow‐up studies were conducted with second‐, fourth‐, and fifth‐grade students, and adults. These studies also produced no significant correlations among creativity ratings of various products.
Dermatan disulfate (Intimatan) prevents complement-mediated myocardial injury in the human-plasma-perfused rabbit heart.

Intimatan (dermatan 4,6-O-disulfate), a heparin cofactor II agonist, is a highly sulfated negatively charged semisynthetic polysaccharide. The present study examined the hypothesis that Intimatan reduces complement-mediated myocardial injury. The rabbit isolated heart was perfused with 4% normal human plasma (NHP) as a source of complement in the absence or presence of Intimatan (5 μM). Heat-inactivated human plasma (HIHP) was used as a negative control. Previous studies demonstrated that contact of rabbit tissue with human plasma results in activation of the alternative pathway of the human complement system, leading to irreversible myocardial injury. In the presence of NHP, left ventricular end-diastolic pressure (LVEDP) was increased significantly to 61.8±11.7 mm Hg compared to a value of 17.2±6.1 mm Hg in hearts perfused in the presence of HIHP. Left ventricular developed pressure (LVDP) was reduced significantly upon exposure to NHP, 19.3±10.2 (NHP) vs. 54.0±8.0 mm Hg (HIHP). Functional impairment in the presence of NHP was accompanied by a significant release of cardiac troponin I (cTnI; 131.8±20.3 ng/ml) as compared to hearts exposed to HIHP (0.8±0.8). Intimatan treatment improved cardiac function and maintained viability of cardiac myocytes (LVEDP 14.6±5.6, LVDP 58.0±8.1 mm Hg and cTnI 6.7±5.2 ng/ml). Immunohistochemical staining demonstrated that Intimatan pretreatment prevented deposition of the human membrane attack complex (MAC) in hearts exposed to NHP. The results indicate that Intimatan, a glycosaminoglycan (GAG), can reduce tissue injury and preserve organ function that otherwise would be compromised during activation of the human complement cascade.
Enzyme-linked immunosorbent assay for LY163502, a potent dopamine agonist.

A rapid and sensitive enzyme-linked immunosorbent assay (ELISA) for the potent selective dopaminergic receptor (D2) agonist, LY163502, is described. The ELISA is a competitive assay in which peroxidase-labeled LY163502 competes with unlabeled LY163502 for binding to solid-phase antibodies specific for LY163502. The limit of detection is 8 pg/mL; intra- and interassay coefficients of variation are 7.2 and 12.3%, respectively, for human plasma determinations. Recovery of LY163502 from plasma and urine is quantitative. We found two potential metabolites of LY163502, despropyl-LY163502 and N-oxide LY163502, to be 44 and 0.5% cross-reactive at the ED50 level, respectively. However, LY163502 levels measured by the ELISA and by a specific gas-liquid chromatography (GLC) assay are highly correlated [Pearson's correlation coefficient, r = 0.964]. This suggests that the ELISA assay of biological fluids is not affected by cross-reactivity due to LY163502 metabolites. Application of the ELISA to the measurement of LY163502 in biological fluids is demonstrated.
Thermodynamics of melting and freezing in small particles

The properties of small particles can be markedly different from the bulk. A classical thermodynamic treatment of the melting and freezing of small particles, including the effects of surface-induced order, predicts an energy barrier between a surface melted state and the liquid droplet. The requirement of homogeneous nucleation over the barrier on laboratory time scales predicts melting and freezing temperatures that vary from the bulk temperatures and from each other. For very small particles the energy barrier is so small that the melting and freezing temperatures are the same. However, above a few nanometers in radius the melting and freezing temperatures are different. This approach also predicts a low temperature region where a disordered particle would stay disordered for extended periods of time. This model only applies to the situation where the melt wets the solid.
Correlation of the dermal microvasculature morphology with the epidermal and the endothelial population changes produced by single X ray fractions of 1649, 2231 and 2619 rad in swine.

Abstract The role of the dermal microvasculature in the production of skin changes has not been specified. The healing moist reaction observed between 21 and 36 days following X ray exposures of 1649, 2231, and 2619 rad results from the loss and repopulation of the epidermal basal cells. The second breakdown occurring between 36 and 70 days results from the loss of endothelial cells in vessels of the papillary plexus. The epidermal population in swine skin decreases linearly to a nadir at 23 days and returns to control levels (and beyond) exponentially at 28–32 days. During this period, the endothelial cell density remains at control levels. At 28–36 days there is an abrupt decrease to 50% of control levels following administration of 1649 rad and a further decrease to 0 after 2231 and 2619 rad by 70 days. The qualitative morphology of the microvasculature remains unchanged until 32–36 days following irradiation. At that time there is increased endothelial cell pyknosis and loss of endothelial cells. A decrease in the vascular lumen cross-section profile density occurs by 43–49 days. This is accompanied by a progressive vascular dilatation. Interstitial edema becomes marked, with an inflammatory infiltrate of varying amount. Micro thrombi are found after 2619 rad, but are nearly absent after 1649 rad.
Determining the relative amounts of positional isomers in complex mixtures of triglycerides using reversed-phase high-performance liquid chromatography-tandem mass spectrometry

A reversed-phase HPLC-tandem mass spectrometry (RP-HPLC-MS-MS) method was refined for the positional analysis of complex mixtures of TAG. This method has the advantages of speed, ease of automation, and specificity over traditional digestion-based methods for the positional analysis of TAG. Collision-induced dissociation (CID) of ammoniated TAG in an ion-trap mass spectrometer produced spectra that were dependent on the FA position. Dominant DAG fragments were formed from the loss of a FA moiety from the ammoniated TAG species. The loss of FA in the outer positions was favored over their loss in the central position. The combination of RP-HPLC and CID produced spectra that were free of the isotope effects that can complicate spectral interpretation in existing methods. The combination also provided selectivity based on the chromatographic fractionation of TAG, in addition to the selectivity inherent in the CID process. Proof-of-concept experiments were performed with binary mixtures of TAG from the SOS/SSO, OSO/OOS, and the PSO/POS/SPO positional isomer systems (where S is 18∶0, stearic acid; O is 18∶1 (cis-9), oleic acid; and P is 16∶0, palmitic acid). Plots of fractional DAG fragment intensities vs. fractional composition of the binary mixtures were linear. These plots were used to determine the fractional composition of each of these isomeric systems in a variety of vegetable oils and animal fats. Current limitations, future developments, and applications of this method are discussed.
Multiplying messages LRRK beneath parkinson disease

Parkinson Disease (PD) is a progressive neurodegenerative disorder with limited therapeutic options. In this issue of Cell, Martin et al. link PD protein leucine-rich repeat kinase 2 (LRRK2) to abnormalities of translational control, a pathogenic mechanism implicated in an increasing number of CNS neurodegenerative diseases, as well as in normal aging.
Vocabulary Instruction for the Struggling Reader

ABSTRACT Children's acquisition of vocabulary is essential for gains in reading comprehension and reading development. Struggling readers often do not make gains in their reading comprehension because they have a limited reading vocabulary. Enhancing the vocabulary development and growth for children who are experiencing reading difficulties enables them to better identify key concepts in text that they read, make inferences within and between texts, and increase their abilities to comprehend. Teaching vocabulary and the incidental learning of words should not be viewed as competitive forces that create a good/bad dichotomy. Instead, it should be acknowledged that learners develop vocabularies through both approaches, and that teachers need to know when students would benefit from explicit instruction that initially teaches word meaning by application in meaningful narrative and expository text (McKeown, 1993).
Long-Term, Non-Nightly Administration of Zolpidem in the Treatment of Patients With Primary Insomnia

INTRODUCTION While it is common practice that hypnotics are used on a non-nightly basis, few investigations have been undertaken to evaluate the efficacy of the intermittent dosing strategy. The present study was designed to further evaluate this issue within a large scale, double-blind, placebo-controlled, long-term trial. METHOD Patients who met DSM-IV criteria for primary insomnia participated in the study from January 2000 through October 2001. Patients were randomly assigned to 1 of 2 treatment groups (zolpidem 10 mg or placebo) for a period of 12 weeks. Ten pills were provided in foil packs on an every-other-week basis, and patients were instructed to take no fewer than 3 and no more than 5 pills per week. Sleep was evaluated daily with sleep diaries. Pill use was recorded in the sleep diaries. RESULTS 199 patients (mean +/- SD age = 41.0 +/- 12.8 years; 71% female) were randomly assigned to treatment. On mean, patients receiving zolpidem exhibited (vs. baseline) a 42% decrease in sleep latency, a 52% reduction in number of awakenings, a 55% decrease in wake time after sleep onset, and a 27% increase in total sleep time. These positive clinical gains did not diminish with time and were not associated with dose escalation. There was also no evidence of rebound insomnia. CONCLUSIONS Over a period of 12 weeks of intermittent treatment with zolpidem, sleep continuity was significantly improved, the clinical gains were sustained, and there was no evidence of subjective rebound insomnia between doses or increases in the amount of medication used during the study interval.
Structural requirements for VanA activity of vancomycin analogues

We have prepared several sets of glycopeptide analogues in order to probe the molecular basis for the activity of derivatives that overcome vanA resistance. The results described in this paper provide compelling evidence that good vanA activity is due to a mechanism of action that does not involve peptide binding. Hypothesizing that this mechanism of action involves an interaction of the disaccharide portion of vancomycin analogues with bacterial transglycosylases, we have prepared a compound in which the vancomycin aglycone is coupled to a known transglycosylase inhibitor that is structurally unrelated to the disaccharides that have been previously investigated. The activity of this compound is excellent. This work provides a clear prescription for the design of better glycopeptide analogues.
Higher levels of sex chromosome heteromorphism are associated with markedly stronger reproductive isolation

The two 'rules of speciation', Haldane's rule and the large X-effect, describe the genetic basis of postzygotic isolation, and have led to the realization that sex chromosomes play an important role in this process. However, a range of sex determination mechanisms exists in nature, not always involving sex chromosomes. Based on these 'rules of speciation', I test the hypothesis that the presence of sex chromosomes will contribute to a faster evolution of intrinsic postzygotic isolation. I show that taxa that do not have sex chromosomes evolve lower levels of postzygotic isolation than taxa with sex chromosomes, at a similar amount of genetic divergence. Taxa with young homomorphic sex chromosomes show an intermediate pattern compared to taxa with heteromorphic sex chromosomes and taxa without sex chromosomes. These results are consistent with predictions from the two 'rules of speciation', and emphasize the importance of sex chromosomes for the evolution of intrinsic postzygotic isolation.
Collective Excitations in Strong-Coupling Superconducting Alloys

The mean-free-path dependence of collective excitations in strong-coupling superconducting alloys is investigated by extension of the Fermi-liquid theory, which was developed by Larkin and Migdal for pure strong-coupling superconductors. Numerical results, which are presented, show that the dependence of the energy of transverse collective excitations on mean free path is large enough to suggest that the precursor in the infrared absorption spectrum of lead alloys is not due to collective excitations.
Balance in children with otitis media with effusion

Abstract To determine the presence of balance disorders in young children who had otitis media with effusion (OME), 25 subjects, aged 13–57 months, diagnosed by pediatric otolaryngologists, were tested on the gross motor subtest of the Peabody Developmental Motor Scales, a standardized test of motor development with established norms. Parents also filled out questionnaires about their children's balance skills. Subjects with unilateral disease did not differ significantly from normals. Subjects with bilateral disease, however, were significantly impaired compared to normals on balance, locomotion and total score and they were significantly impaired compared to unilateral subjects on all scores. Parental perceptions of their children's balance correlated poorly with the test results. These data suggest that young children with bilateral otitis media with effusion are delayed in developing motor skills that require dynamic balance. Therefore, in spite of a negative history for balance problems physicians should consider balance performance when developing a treatment plan. Children with balance impairments might benefit from more aggressive intervention.
Improving Quality Improvement Using Achievable Benchmarks For Physician Feedback: A Randomized Controlled Trial

ContextPerformance feedback and benchmarking, common tools for health care improvement, are rarely studied in randomized trials. Achievable Benchmarks of Care (ABCs) are standards of excellence attained by top performers in a peer group and are easily and reproducibly calculated from existing performance data.ObjectiveTo evaluate the effectiveness of using achievable benchmarks to enhance typical physician performance feedback and improve care.DesignGroup-randomized controlled trial conducted in December 1996, with follow-up through 1998.Setting and ParticipantsSeventy community physicians and 2978 fee-for-service Medicare patients with diabetes mellitus who were part of the Ambulatory Care Quality Improvement Project in Alabama.InterventionPhysicians were randomly assigned to receive a multimodal improvement intervention, including chart review and physician-specific feedback (comparison group; n = 35) or an identical intervention plus achievable benchmark feedback (experimental group; n = 35).Main Outcome MeasurePreintervention (1994-1995) to postintervention (1997-1998) changes in the proportion of patients receiving influenza vaccination; foot examination; and each of 3 blood tests measuring glucose control, cholesterol level, and triglyceride level, compared between the 2 groups.ResultsThe proportion of patients who received influenza vaccine improved from 40% to 58% in the experimental group (P<.001) vs from 40% to 46% in the comparison group (P = .02). Odds ratios (ORs) for patients of achievable benchmark physicians vs comparison physicians who received appropriate care after the intervention, adjusted for preintervention care and nesting of patients within physicians, were 1.57 (95% confidence interval [CI], 1.26-1.96) for influenza vaccination, 1.33 (95% CI, 1.05-1.69) for foot examination, and 1.33 (95% CI, 1.04-1.69) for long-term glucose control measurement. For serum cholesterol and triglycerides, the achievable benchmark effect was statistically significant only after additional adjustment for physician characteristics (OR, 1.40 [95% CI, 1.08-1.82] and OR, 1.40 [95% CI, 1.09-1.79], respectively).ConclusionUse of achievable benchmarks significantly enhances the effectiveness of physician performance feedback in the setting of a multimodal quality improvement intervention.
Sodium-coupled neutral amino acid (System N/A) transporters of the SLC38 gene family

The sodium-coupled neutral amino acid transporters (SNAT) of the SLC38 gene family resemble the classically-described System A and System N transport activities in terms of their functional properties and patterns of regulation. Transport of small, aliphatic amino acids by System A subtypes (SNAT1, SNAT2, and SNAT4) is rheogenic and pH sensitive. The System N subtypes SNAT3 and SNAT5 also countertransport H(+), which may be key to their operation in reverse, and have narrower substrate profiles than do the System A subtypes. Glutamine emerges as a favored substrate throughout the family, except for SNAT4. The SLC38 transporters undoubtedly play many physiological roles including the transfer of glutamine from astrocyte to neuron in the CNS, ammonia detoxification and gluconeogenesis in the liver, and the renal response to acidosis. Probing their regulation has revealed additional roles, and recent work has considered SLC38 transporters as therapeutic targets in neoplasia.
Artificial neural networks: a tutorial

Artificial neural nets (ANNs) are massively parallel systems with large numbers of interconnected simple processors. The article discusses the motivations behind the development of ANNs and describes the basic biological neuron and the artificial computational model. It outlines network architectures and learning processes, and presents some of the most commonly used ANN models. It concludes with character recognition, a successful ANN application.
Structuring parallel algorithms in an MIMD, shared memory environment

Abstract This paper discusses the class of algorithms having global parallelism, i.e. those in which parallelism is introduced at the top of the program structure hierarchy. Such algorithms have performance advantages in a shared-memory. MIMD computational model. A programming environment consisting of FORTRAN, enhanced by some pre-processed macros, has been built to aid in writing programs for such algorithms for the Denelcor HEP multiprocessor. Applications of from tens to hundreds of FORTRAN statements have been written and tested in this environment. A few parallelism constructs suffice to yield understandable programs with a high degree of parallelism. The automatic generation of programs with global parallelism seems to be a promising possibility.
Effects of Formalin and Freezing on Length, Weight and Condition Factor of Cisco and Yellow Perch

Abstract Preservation of cisco (Coregonus artedii) and yellow perch (Perca flavescens) for 72 hr in 10% formalin or by freezing reduced median total length by 0.7–2.1% for both species and increased median condition factor by 6.3–9.4% for cisco and 4.8–8.8% for yellow perch. Formalin increased median weight by 1.8% for cisco and 5.0% for yellow perch; freezing and thawing reduced weight by 1.7–2.0% for each species. Changes in length, weight, and condition factor were not significant for unpreserved fish remeasured after 72 hr, suggesting that the above changes were not entirely due to errors in measurement. The study revealed that even small changes in length or weight due to preservation can produce large errors in condition factor.
A small-area voltage regulator with high-bandwidth supply-rejection using a regulated replica in 45nm CMOS SOI

We present a low dropout voltage regulator which uses a regulated replica in the loop in order to achieve small area, excellent power supply rejection over a wide frequency range, and high loop stability. The regulated replica provides accurate matching of the gm/gds ratio in the current source transistors for the replica and the load path. Power supply rejection of >22 dB was measured up to 1 GHz for a circuit operating at 0.8 V from a 1.0 V supply.
Gradual anisometric-isometric transition for human-machine interfaces

Human-machine interfaces (HMIs) are widely used in biomedical applications, from teleoperated surgical systems to rehabilitation devices. This paper investigates a method of control that allows an HMI to transition from anisometric to isometric mode, shifting the control input from position to force as the user's movement is gradually reduced. Two different approaches for achieving this transition are discussed: one is based on the natural system dynamics, whereas the other involves selecting and controlling dynamics. The two approaches were implemented on a custom haptic device in a targeting task. Anisometric to isometric transitioning can potentially be used for training purposes, enabling transfer of what was learned in one mode to the other, as well as novel studies of the human sensorimotor system.
Chemical Tracers of Particle Transport

Particles represent important agents of transport in global ocean cycles of many trace elements, of carbon, and of other substances. Once introduced into the oceans, many trace elements are removed from seawater by scavenging (sorption, complexation, and other forms of surface reactions) to particles. Scavenging and burial in marine sediments represents the principal loss process influencing the biogeochemical cycle of many trace elements in the ocean. Vertical transport processes are primarily considered when examining the fate of biogenic particles formed in surface waters. Lateral transport processes influence the dispersion into the ocean interior of particulate material eroded from continents. Much of this dispersion occurs by eddy mixing, but advection by ocean currents plays an important role in transport of marine particles as well. A complete understanding of the cycling of material within the oceans relies on an accurate knowledge of particle transport.
Altered white matter integrity in temporal lobe epilepsy: association with cognitive and clinical profiles.

Author(s): Riley, Jeffrey D; Franklin, David L; Choi, Vicky; Kim, Ronald C; Binder, Devin K; Cramer, Steven C; Lin, Jack J | Abstract: PurposeDiffusion tensor imaging (DTI) studies have reported substantial white matter abnormalities in patients with temporal lobe epilepsy (TLE). However, limited data exist regarding the extent of white matter tract abnormalities, cognitive effects of these abnormalities, and relationship to clinical factors. The current study examined these issues in subjects with chronic TLE.MethodsDTI data were obtained in 12 TLE subjects and 10 age-matched healthy controls. Voxel-wise statistical analysis of fractional anisotropy (FA) was carried out using tract-based spatial statistics (TBSS). White matter integrity was correlated with cognitive performance and epilepsy-related clinical parameters.ResultsSubjects with TLE, as compared to healthy controls, demonstrated four clusters of reduced FA, in anterior temporal lobe, mesial temporal lobe, and cerebellum ipsilateral, as well as frontoparietal lobe contralateral to the side of seizure onset. Mean FA was positively correlated with delayed memory, in anterior temporal lobe; and immediate memory, in mesial temporal lobe. Lower FA values in the posterior region of corpus callosum were related to earlier age of seizure onset.ConclusionTLE is associated with widespread disturbances in white matter tracts and these changes have important cognitive and clinical consequences.
Twin-twin transfusion with abrupt onset of microcephaly in the surviving recipient following spontaneous death of the donor twin

We describe a case in which twin-twin transfusion with fetal death of the donor at 23 weeks was complicated by suspected intracranial embolic insult of the surviving recipient twin. Dynamic transient intracranial ultrasonographic findings were noted with complete resolution by 28 weeks. Subsequent severe microcephaly of the survivor with no further growth of any of the cranial parameters beyond 25 weeks was thought to be a result of this very unusual pathophysiologic mechanism.
Are emotions more than learned behaviors

To ‘explain’ emotions, we must empirically envision how mammalian brains were designed, through evolution, to cope with many archetypal survival needs. In raw form, emotions probably reflect ancestral neuro-genetic memories that link up with capacities to learn about environmental contingencies. In this amplification and updating of his 1999 book, Edmund Rolls heeds some criticisms of his earlier efforts [1] but remains committed to his central thesis – that external rewards and punishments create emotional states.
Evidence for dysregulation of axonal growth and guidance in the etiology of ASD

Current theories concerning the cause of autism spectrum disorders (ASDs) have converged on the concept of abnormal development of brain connectivity. This concept is supported by accumulating evidence from functional imaging, DTI, and high definition fiber tracking (HDFT) studies which suggest altered microstructure in the axonal tracts connecting cortical areas may underly many of the cognitive manifestations of ASD. Additionally, large-scale genomic studies implicate numerous gene candidates known or suspected to mediate neuritic outgrowth and axonal guidance in fetal and perinatal life. Neuropathological observations in postmortem ASD brain samples further support this model and include subtle disturbances of cortical lamination and subcortical axonal morphology. Of note is the relatively common finding of poor differentiation of the gray-white junction associated with an excess superficial white matter or “interstitial” neurons (INs). INs are thought to be remnants of the fetal subplate, a transient structure which plays a key role in the guidance and morphogenesis of thalamocortical and cortico-cortical connections and the organization of cortical columnar architecture. While not discounting the importance of synaptic dysfunction in the etiology of ASD, this paper will briefly review the cortical abnormalities and genetic evidence supporting a model of dysregulated axonal growth and guidance as key developmental processes underlying the clinical manifestations of ASD.
The alloreactivity of human colostral T lymphocytes. II. Specific control of maternal anti-fetal mixed lymphocyte reactivity

Lymphocytes in human colostrum were examined for evidence of alloreactivity specifically directed against the paternal HLA haplotype. Such reactivity was detected using umbilical cord blood leukocytes as stimulator cells in the mixed lymphocyte reaction, but the responses were reduced when compared to those of the same patient's blood lymphocytes. Analysis of this defect determined that only colostral lymphocyte responses to neonatal alloantigens were impaired and that the phenomenon apparently depended on a non-adherent fetal leukocyte for its expression. Attempts to demonstrate directly colostrum or cord blood-derived cell-mediated suppression failed, and the results suggest that a classical T suppressor cell is probably not involved. These findings indicate that human colostrum contains anti-paternal T cell clones but their reactivity is specifically abrogated when cultured with fetal leukocytes.
Amino Acid Composition of Chromatographically Separated β-Casein A3

Abstract Polyacrylamide gel electrophoresis or starch gel electrophoresis at pH 3 demonstrates that the β -casein type A, as classified at pH 9, actually consists of three species, A 1 , A 2 , and A 3 . Chromatography on cellulose phosphate has been used to separate an A 3 /B β -casein into its constituents. Amino acid analyses and end group analyses of β -caseins A 3 were compared with those of the other genetic variants, A 1 and A 2 β -caseins. The three variants, A 1 , A 2 , and A 3 , have 6, 5, and 4 histidine residues per molecule of ∼24,000 Daltons. The analytical data indicate a substitution of proline for histidine.
Facilitated phospholipid flip-flop using synthetic steroid-derived translocases.

Cholate esters with phenylurea groups at the 7α- and 12α-positions are highly effective promoters of phosphatidylcholine translocation across vesicle and cell membranes. The urea groups are essential for strong binding of the highly polar phosphate portion of the phosphocholine headgroup and apparently cannot be replaced by simple amide, alcohol, or amine moieties. NMR and UV studies show that these synthetic translocases have very weak affinity for phosphatidylethanolamine and phosphatidylserine.
A TM Tasseled Cap equivalent transformation for reflectance factor data

A transformation of TM-waveband reflectance-factor data which provides features related as directly as possible to the corresponding TM Tasseled Cap brightness, greennes, and wetness features is presented. The reflectance factor transformation is based on spectrometer data integrated over the prelaunch composite-detector response functions of the Landsat-4 Thematic Mapper. A description, in general terms, of the approach for adjusting the transformation matrix to other types of reflectance factor data (different instrument or band response) is given.
Disparities in the care of chest pain

Improving medical care for patients with chest pain is an intimidating task because of the complexity of the systems used to deliver care. Each step in the delivery of care can be seen as a potential mishap. To improve quality of care, each step in this process needs to be understood, which often
SU‐E‐J‐185: Comparison of Iodine‐Labeled Sc‐Fv‐Fc Protein Biodistributions to Indium‐Labeled Biodistributions in Nude Mice

Purpose: Animal biodistributions (BDs) are necessary to demonstrate radiopharmaceutical targeting. Radioiodine labeling requires considerably less novel agent material as compared to radiometal labeling. Yet iodine BDs show uptakes that are reduced in magnitude due to tissue metabolism and dehalogenation. It is important to measure the magnitude of this effect and thereby determine whether an iodine‐BD could be converted mathematically into the comparable metal‐BD. Methods: LS174T human colon tumors were implanted in nude mice. Simultaneous (I‐125 and In‐111) BDs were obtained using the H310A single‐chain Fv‐Fc antibody (105 kDa) fragment against CEA. Animals were sacrificed at 0, 2, 4, 6, 12, 24, 48 and 72 h post injection. Excised organs, tumor and blood were assayed for percent injected dose per gram of tissue (%ID/g). Curves were generated of %ID/g vs. time for liver, kidney, spleen, lungs, tumor and whole blood. In analogy with radiodecay, ratios of the iodine/indium BDs were fitted with single‐exponential functions to determine initial halftimes of organ loss of iodine. Results: For solid tissues at time > 0, iodine‐125 BD values were lower than the simultaneous In‐111 BD. Hepatic results were the most dramatic with losses of nearly 90% of the iodine by 12 h into the study. For the colon tumor, there was a moderate decrease (approx. 50%) in the iodine BD as compared to the In‐111 BD over 24 h. Blood showed no significant clearance difference between labels. Conclusions: Iodine losses for liver, kidneys, spleen and lungs could be described by initial T1/2 values of 1.3, 3.6, 3.5 and 10 h respectively. Tumor clearance (7 h) was comparable to lung. Liver was the most effective organ in removing iodine with similar but reduced effects seen in other solid tissues. No dehalogenation appeared in the blood out to 72 h. Dept of the Army grants DAMD 17‐00‐1‐203 and 17‐00‐1‐0150 for Anna Wu
Effects of data limitations when modeling fatal occupational injury rates.

BACKGROUND: Occupational fatal injury rate studies are often based upon uncertain and variable data. The numerator in rate calculations is often obtained from surveillance systems that can understate the true number of deaths. Worker-years, the denominator in many occupational rate calculations, are frequently estimated from sources that exhibit different amounts of variability. METHODS: Effects of these data limitations on analyses of trends in occupational fatal injuries were studied using computer simulation. Fatality counts were generated assuming an undercount. Employment estimates were produced using two different strategies, reflecting either frequent but variable measurements or infrequent, precise estimates with interpolated estimates for intervening years. Poisson regression models were fit to the generated data. A range of empirically motivated fatality rate and employment parameters were studied. RESULTS: Undercounting fatalities resulted in biased estimation of the intercept in the Poisson regression model. Relative bias in the trend estimate was near zero for most situations, but increased when a change in fatality undercounting over time was present. Biases for both the intercept and trend were larger when small employment populations were present. Denominator options resulted in similar rate and trend estimates, except where the interpolated method did not capture true trends in employment. CONCLUSIONS: Data quality issues such as consistency of conditions throughout the study period and the size of population being studied affect the size of the bias in parameter estimation.