cssi/SciSciGPT-SciSciNet huggingface dataset:
Hemodynamic attenuation and the nitrate-free interval: Alternative dosing strategies for transdermal nitroglycerin

Various dosing strategies to determine therapeutic effects of nitroglycerin (NTG) preparations are reviewed. The importance of individual patient titration in establishing an effective NTG dosage is emphasized by reviewing a nitroglycerin ointment study and a crossover study. Studies reporting the development of hemodynamic attenuation ("tolerance") with longterm nitrate therapy are also discussed. The results of these and other studies suggest that the magnitude of the hemodynamic response to NTG or isosorbide dinitrate diminishes over time, with acute or first-dose effects far exceeding those obtained during long-term therapy. However, patients on long-term therapy continue to respond to sublingual NTG, which suggests that this phenomenon is not true NTG tolerance. The effect of a nitrate-free interval as a mechanism for avoiding hemodynamic attenuation of NTG therapy is reviewed. The results of 4 studies discussed found that intermittent nitrate protocols were not associated with the attenuated hemodynamic effect observed during chronic therapy. Two possible mechanisms for the vasodilatory effects of nitroglycerin are discussed. The first relates to the production of cyclic guanosine monophosphate in the smooth muscle cells of arteries and veins; the second to the synthesis of prostaglandin I2 by vascular endothelial cells. A mechanism by which nitrate receptors could be manipulated to increase vascular responsiveness is theorized, as well as a means by which a nitrate-free interval might avoid the development of hemodynamic attenuation in terms of cellular mechanisms and receptors.
Understanding and Comprehending.

Schools should be instructing students in formal thought and expression—what we call “comprehending”—rather than in everyday or “home” thought and language—what we call “understanding.” In this essay we suggest general changes in the standard reading and writing curricula. Finally, we examine the language of writing instruction, in college-level individual writing conferences, to take a close look at issues involved in implementing the curricula for higher and lower achieving students.
Causal models of literacy acquisition

Abstract Since 1984, a number of reading researchers have turned to path analysis as a powerful tool for confirming theoretical models of reading, literacy acquisition, and the reading‐writing relationship. This review examines seven articles which employed path analysis to test causal models of the acquisition of literacy or the reading‐writing relationship. A comparative analysis of these studies revealed that while such analysis holds promise for a better understanding of the components of literacy, several potential difficulties remain for those who attempt to synthesize this body of literature. First, there appears to be little agreement between researchers about terms used to describe constructs or the measures used to assess them. Second, the reliability and validity of certain measures used in these studies may be questionable. Third, statistical assumptions of path analysis techniques are sometimes violated. One finding that emerged from the studies is that phonological awareness, however defined...
Virtue, Law and Chinese Political Tradition: Can the Past Predict the Future?

This paper intends to build a case for a third alternative that can reconcile the two opposing views of democracy, i.e., the consensual vs. the adversarial, through a reexamination and reconstruction of Chinese traditional theories of political governance. The paper links the rule of virtue with consensual politics, and the rule of law with adversary politics, By focusing on the roles of virtue and law, and their importance to the acquisition and maintenance of original and utilitarian dimensions of political legitimacy, the paper proposes a hybrid version of democracy that will continue the dualist political tradition while enabling necessary political modernization.
Separation of different receptor-mediated effects of a prostaglandin H2 analogue (U46619) on human platelets by means of human granulocytic elastase and chymotrypsin.

Abstract Previous investigations indicated two classes of thromboxane A 2 /prostaglandin H 2 (TXA 2 /PGH 2 ) receptors on human platelets and suggested that shape change and myosin light chain phosphorylation correlated with the occupancy of high affinity receptors while serotonin release was related to a putative low affinity binding component (Morinelli TA et al. , Am J Physiol 253 : H1035–H1043, 1987). The current study shows that chymotrypsin destroyed three receptor-mediated responses of platelets to U46619 (a TXA 2 /PGH 2 agonist), i.e. shape change, myosin light chain phosphorylation and serotonin release. Human granulocyte elastase selectively inactivated platelet ability to release serotonin following stimulation with U46619, but it did not affect significantly shape change and myosin light chain phosphorylation. In conclusion, it is possible to separate different receptor-mediated effects of U46619 on human platelets by means of human granulocytic elastase and chymotrypsin.
Factors influencing the accumulation of sediment-sorbed hexachlorobiphenyl by midge larvae.

The continued occurrence of PCBs in the biota indicates that sediment remains a source of hydrophobic organic compounds long after the initial source of contamination has been alleviated. Bioaccumulation of organic compounds by aquatic organisms is believed to be the result of equilibrium partitioning of the residues between the environment and biota. This study was undertaken to elucidate the importance of abiotic and biotic factors to the bioaccumulation of sediment-sorbed hydrophobic organic compounds by benthic organisms. Hexachlorobiphenyl was chosen as the model substrate because it is extremely stable and shows no indication of being biodegradable, and thus is representative or organic compounds which pose the greatest ecological hazard. Factors examined were substrate type, organic content of substrate, concentration, temperature, and biological viability.
Family study of the inheritance of pectus excavatum.

Abstract Background The most common congenital deformity of the chest wall is pectus excavatum, a malformation that is present in between 1 in 400 and 1 in 1000 live births and causes the body of the sternum to be displaced, producing a depression. There are many different shapes of the pectus, and multiple factors probably contribute to the final form. The etiology of pectus excavatum is uncertain, but a familial tendency has been found in clinical experience, where it may be seen in more than one sibling. Pectus excavatum is commonly associated with connective tissue disorders such as Marfan and Ehlers Danlos syndromes. Extensive literature review failed to identify articles documenting families with multiple affected members. Purpose The purpose of this study was to collect evidence that pectus excavatum is familial and may be an inherited disorder. Methods Using the Children's Surgical Specialty Group database at Children's Hospital of The King's Daughters, families with more than one affected individual were selected. With Institutional Review Board–approved informed consent, 34 families agreed to participate. Family histories were obtained, and a 4-generation pedigree was constructed for each family. Forty questions were asked about each individual's medical history, and comprehensive systems review included features of connective tissue-related problems. Inheritance patterns for each family were determined by pedigree analysis. Results A total of 14 families suggested autosomal dominant inheritance, 4 families suggested autosomal recessive inheritance, and 6 families suggested X-linked recessive inheritance. Ten families had complex inheritance patterns. Pectus excavatum occurred more frequently in males than in females (1.8:1). Long arms, legs, and fingers; high-arched palate; mitral valve prolapse; heart arrhythmia; scoliosis; double jointedness; flexibility; flat feet; childhood myopia; poor healing; and easy bruising were commonly associated with pectus excavatum. Conclusions Pedigree analysis of 34 families provides evidence that pectus excavatum is an inherited disorder, possibly of connective tissue. Although some families demonstrate apparent Mendelian inheritance, most appear to be multifactorial.
Relaxation of the D center in amorphous silicon and how this accounts for the observed energy distributions of deep defects within the mobility gap

Abstract Transient capacitance measurements disclose that the mobility gap energy of the D defect in a-Si:H relaxes following a change in its charge state. Using the relaxation parameters thus determined, we solve the resulting dynamical equation to obtain the steady-state energy distributions of both the D − and D 0 sub-bands. These results agree with the experimental distributions determined by modulated photocurrent and steady-state junction capacitance measurements.
Double Whammy? Rural Youth With Serious Emotional Disturbance and the Transition to Adulthood

ABSTRACT: Context:All youth, especially those with serious emotional disturbances (SED), face challenges as they transition to adulthood. Little is known about rural youth at risk for transition problems. Purpose: To examine transition-age youth who use publicly funded services in rural and urban/suburban locations in Tennessee in order to describe youth at risk for transition difficulties who need policy and service planning. Methods: Using Medicaid enrollment and claims/encounter data, youth at high risk for transition difficulties were identified in the following groups: SED, at risk of or in foster care/state custody, intensive or frequent mental health services users, or diagnosed with major mental disorders, behavior disorders, mental retardation, or substance use. Membership in these groups was compared between youth living in rural and urban/suburban counties. Multivariate regression was used to examine factors related to multiple group membership. Findings: Rural youth were more likely to be in groups at high risk for problems transitioning to adulthood, and enrolled in Medicaid as uninsured/uninsurable, compared to their urban counterparts. The strongest factors associated with multiple risk group membership were being in state custody/foster care and receiving Supplemental Security Income (SSI). Conclusions: Services are needed to support the transition to adulthood for youth at high risk of behavioral and adjustment problems. Systems to support coordinated planning and accountability are needed, including data on populations and services, and research on transition-age youth.
Characterization of antibodies induced by paternal lymphocyte immunization in couples with recurrent spontaneous abortion

Abstract This study was designed to identify and characterize the allo- and autoantibodies induced following successful paternal lymphocyte immunization to prevent recurrent spontaneous abortion. Firstly the titers of maternal anti-paternal antibodies in women with successful pregnancies as determined by the flow cytometry crossmatch (FCXM) were highly variable; however, in all cases, the initial pre-immunization titers were negative and the post-immunization titers were positive by the FCXM in successfully treated women. Secondly, the specificities of maternal alloantibodies to paternal HLA antigens (immunogen) were evaluated. Not all predicted antibodies to mismatched paternal HLA antigens were found by microlymphocytotoxicity (MCX) assays and the specificities varied. Thirdly, antibodies in post- but not pre-immunization sera reacted with two lymphoid cell lines, SupT1 and SB; in addition, the rise and fall of the titers of these sera with paternal cells seemed to be reflected with the cell lines by the FCXM. Fourthly, autoantibodies to activated lymphocytes were detected and seemed to correlate with successful immunization since women who had another abortion following immunotherapy lacked these autoantibodies.
Aquatic environmental nanoparticles

Researchers are now discovering that naturally occurring environmental nanoparticles can play a key role in important chemical characteristics and the overall quality of natural and engineered waters. The detection of nanoparticles in virtually all water domains, including the oceans, surface waters, groundwater, atmospheric water, and even treated drinking water, demonstrates a distribution near ubiquity. Moreover, aquatic nanoparticles have the ability to influence environmental and engineered water chemistry and processes in a much different way than similar materials of larger sizes. This review covers recent advances made in identifying nanoparticles within water from a variety of sources, and advances in understanding their very interesting properties and reactivity that affect the chemical characteristics and behaviour of water. In the future, this science will be important in our vital, continuing efforts in water safety, treatment, and remediation.
Midwifery across the generations: a modernizing midwife in Guatemala.

This article examines change and continuity in midwifery knowledge and practice by comparing a mother and daughter, both of whom are local mid‐wives, or comadronas, on a Guatemalan plantation. The daughter apprenticed with the mother, who died in 1997. Like her mother, she received a government midwifery license after attending an official training course. I discuss the applicability of the concept of “postmodern midwifery” as I trace how both mother and daughter adapted to the pressures of medicalization and modernization. The daughter negotiates with biomedical personnel and copes with increasing government regulations, and she tends to accept biomedical authority more readily than did her mother. Unlike her mother, she sometimes uses this authority to enhance her own status. Nevertheless, her acceptance of the biomedical model is not complete, for she recognizes the practical constraints of poverty, under which both she and her clients live, and she also insists upon the superiority of such practices a...
Apparatus for contour-clamped homogeneous electric fields

These notes and diagrams describe the construction of a simple hexagonal electrode array contour-clamped homogeneous electric field (CHEF) apparatus (1, 2). Included are a number of improvements on the original design. The circuit is shown in modules so that the investigator can upgrade an existing device as desired. The modules represent modifications of a second-generation device with vertical electrodes (2). One module replaces the original mechanical relay with an electronic switching circuit, which is (blissfully) silent and more reliable and permits faster switch times. The other module inserts transistor circuits to provide more accurate voltage clamping. However, it should be noted that the clamping is still not as precise as it is in commercial devices available from Bio-Rad or BRL. We have also developed a new system with electrodes in a square array that produces precise voltage clamping with operational amplifiers and is capable of arbitrary reorientation angles. That device is described elsewhere (3). Nevertheless, the circuits shown here are inexpensive, are easy to construct, are adaptable to older generation devices, and give good results for most applications. The circuits can be followed by anyone with a rudimentary training in electronics.
Sinonasal adenoid cystic carcinoma: the M. D. Anderson Cancer Center experience.

BACKGROUND. Adenoid cystic carcinoma of the sinonasal tract is a rare cancer that accounts for 10% of all malignancies at this site. The objective of the current study was to evaluate prognostic factors, treatment outcomes, recurrence patterns, and survival rates for sinonasal adenoid cystic carcinoma. METHODS. A retrospective chart review was performed at an academic tertiary referral center. Between 1990 and 2004, 105 patients were evaluated for adenoid cystic carcinoma of the sinonasal tract at a single institution. Demographics, presentation, anatomic site, Tumor, Lymph Node, Metastasis (TNM) classification, pathology, treatment, recurrences, and survival were evaluated. RESULTS. One hundred five patients with adenoid cystic carcinoma were evaluated, including 58 women and 47 men. Their median age was 50 years, and the mean follow-up was 47 months. The maxillary sinus (47%) and the nasal cavity (30%) were the most common primary tumor sites. The majority of patients presented with T3/T4 (76.7%), N0 (98%), M0 (97%) disease. Eighty-four percent of patients underwent surgery and received postoperative radiation as treatment for their primary disease. The local recurrence rate was 30%, and the distant metastases rate was 38%. The 5-year overall survival and disease specific survival rates were 62.9% and 70.9%, respectively. CONCLUSIONS. Adenoid cystic carcinoma of the paranasal sinuses is a rare disease, and the ideal treatment paradigm has yet to be defined. The current data suggested that surgical resection with postoperative radiation therapy offers durable local control and compares favorably with historic data. Although local recurrences develop in a significant percentage of patients, survival from this disease exceeds that of other sinonasal malignancies. Cancer 2007. © 2007 American Cancer Society.
Treatment with B-type natriuretic peptide for chronic decompensated heart failure : Insights learned from the follow-up serial infusion of nesiritide(FUSION) trial

Several evidence-based treatment regimens are modestly effective in patients with moderately severe to severe heart failure, but truly effective therapies that improve symptoms, reduce hospitalizations, and extend meaningful survival do not exist for these patients. Only ventricular replacement therapy, with either heart transplantation or left ventricular assist devices, has been shown to significantly improve outcomes. Nesiritide, a recombinant B-type natriuretic peptide, is associated with significant reductions in filling pressure, with corresponding relief of symptoms, and diminished neurohormonal levels and has no inotropic effects and no evidence of proarrhythmia when given to patients with decompensated acute heart failure. Results of the Follow-Up Serial Infusion of Nesiritide (FUSION) trial suggest that a regimen incorporating nesiritide can be accomplished with a reasonable assurance of safety and tolerability; pre-study concerns regarding hypotension were not realized. A qualified look at outcomes data within FUSION I suggests that further study of this paradigm is reasonable, especially if the studied patient population includes patients with a low left ventricular ejection fraction and New York Heart Association (NYHA) class III disease with renal insufficiency, or patients with low left ventricular ejection fraction and NYHA class IV heart failure. Therefore, FUSION II, a double-blind, placebo-controlled trial, will randomly assign approximately 900 such patients to treatment with usual care plus nesiritide or usual care plus placebo and will use mortality/cardiorenal hospitalization as a composite end point. If positive data emerge from FUSION II that either confirm or strengthen the data in FUSION I, a new therapeutic option may be available for patients with chronic decompensated heart failure.
HIPAA Compliant HIS in J2EE Environment

This article presents the design and architecture of a health information system that takes into account various requirements posed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The recommendations made, primarily address Health Care Provider and Health Plansâ€™ needs. It introduces the reader to common HIPAA terminology, then picks a specific enterprise technology stack, i.e. Java Enterprise Edition (J2EE) and delves into some of its relevant artifacts. The article makes recommendations for tools, techniques and design guidelines to facilitate the architecture of a HIPAA compatible information system. We focus primarily on Health-care Providers and a subset of Health Plans. These entities have one thing in common: they process or store health information, hence they fall under HIPAAâ€™s purview. The architecture model that we are proposing will attempt to present a unified security model (e.g. security in client, application and database layers).
Bariatric surgery was cost-effective at 2 years for management of type 2 diabetes in obese patients

Source Citation Keating CL, Dixon JB, Moodie ML, et al. Cost-efficacy of surgically induced weight loss for the management of type 2 diabetes: a randomized controlled trial. Diabetes Care. 2009;32:...
The use of occupancy as a surrogate for particle concentrations in recirculating, zoned cleanrooms

Abstract The substantial energy demands of today's cleanroom environmental-maintenance systems provide large opportunities for energy conservation. However, cleanroom environments are subject to much more stringent standards and operate with much smaller tolerances, and therefore simple application of industrial/commercial controls is not sufficient. We conducted a set of measurements in a Class 1000 cleanroom to confirm that humans are the predominant source of particles in a cleanroom, supporting that occupancy can be used as an effective surrogate for particle concentrations. Our data suggest that people release approximately 1.7 × 104 particles per minute into the cleanroom and raise the local concentration of particles by 1742 ± 481 particles m−3 person−1. Furthermore, our timescale analysis on control system and ventilation unit responses indicates that a predictive-occupancy system is required for implementing demand-controlled ventilation.
K+ channels in the secretory membrane of the parietal cell. focus on "Gastric parietal cell secretory membrane contains PKA- and acid-activated Kir2.1 K+ channels".

physiologists generally accept the H+-K+-ATPase as the principal gastric proton pump, and a mechanism of membrane recruitment and recycling of the pump as the primary means for regulating the activity of gastric HCl secretion. One of the major challenges in gastric HCl secretory physiology is the
Spectral signatures of hydrilla from a tank and field setting

The invasion of hydrilla in many waterways has caused significant problems resulting in high maintenance costs for eradicating this invasive aquatic weed. Present identification methods employed for detecting hydrilla invasions such as aerial photography and videos are difficult, costly, and time consuming. Remote sensing has been used for assessing wetlands and other aquatic vegetation, but very little information is available for detecting hydrilla invasions in coastal estuaries and other water bodies. The objective of this study is to construct a library of spectral signatures for identifying and classifying hydrilla invasions. Spectral signatures of hydrilla were collected from an experimental tank and field locations in a coastal estuary in the upper Chesapeake Bay. These measurements collected from the experimental tank, resulted in spectral signatures with an average peak surface reflectance in the near-infrared (NIR) region of 16% at a wavelength of 818 nm. However, the spectral measurements, collected in the estuary, resulted in a very different spectral signature with two surface reflectance peaks of 6% at wavelengths of 725 nm and 818 nm. The difference in spectral signatures between sites are a result of the components in the water column in the estuary because of increased turbidity (e.g., nutrients, dissolved matter and suspended matter), and canopy being lower (submerged) in the water column. Spectral signatures of hydrilla observed in the tank and the field had similar characteristics with low reflectance in visible region of the spectrum from 400 to 700 nm, but high in the NIR region from 700 to 900 nm.
Factored Items for Appraising Classroom Effectiveness of Teaching Assistants

There is growing recognition that instructional planning and evaluation play an important role in faculty development programs ( 4 ) . Various forms of intervention are being tried out to upgrade the quality of teaching; special attention is directed toward the graduate-level teaching assistant (1, 3, 5 ) . The purpose of the present study was to identify a set of ratings useful for appraising the performance of graduate teaching assistants. Subjects were 2332 undergraduates enrolled in 108 social sciences and humanities sections at the University of Hawaii. Classes convened 1 hr./wk. over a 15-wk. semester; sessions were led by a graduate student who was the teaching assistant (TA) . A special evaluative instrument had 17 5-point rating scales; 12 items from the work of Meredith and Bub ( 3 ) . four items concerned communication behaviors of the teaching assistant . . . and an over-all rating of effectiveness in the classroom.' Scores for each subject were intercorrelated and yielded a positive matrix; average r = .46 ( p < .001). The 17 X 17 Pearson s matrix was analyzed through Iterative Principal Axis Solution (2 ) . An inspection of the eigenvalues indicated one factor with roots greater than 1.0. Squared multiple Rs were inserted in the principal diagonal as comrnunality (h2) estimates, and a single factor extracted; rotation was unnecessary. All 17 items exhibited loadings greater than k . 5 0 and the factor was labeled, "Teaching Assistant Impact." The salient ordered markers were: considering everything, how would you rate the over-all effectiveness of this Teaching Assistant ( .87), the TA broadened my understanding and grasp of the subject ( .78) , the TA stimulated a sense of challenge, insight and discovery in students (.75), the TA was helpful when asked questions about the material ( .75) , the TA was able to explain difficult concepts in terms I could understand ( .75), the TA made clear the aim of each session ( .72) , the TA appeared to be interested in the students and their progcess ( .69), the TA was well organized and prepared for each session ( .68), the TA was effective in leading group discussions ( .68), the TA listened attentively to what students had to say ( .66), the TA was helpful in reviewing tests and assignments ( .64) , the T A clarified the assigned readings ( .64), the TA made good use of examples and illustrations ( .64) , the TA had a positive attitude toward the subject ( .62) , the T A encouraged discussion and conversation rather than lecturing ( .57), the TA was easy to talk to outside of class ( .56), and the TA frequently asked students what they thought about issues (.56). Split-half reliability for the 17 ratings was .94 ( f i < ,001) with Spearman-Brown correction for length. An abbreviated scale may be used with the first 10 items (split-half corrected reliability = .93) or the first eight items (split-half corrected reliability = .90) .'
Protests of engagement : Dignity, false love, and self-love in Mexico during 1968

A few thousand young Mexicans were standing together in large groups in the Plaza de las Tres Culturas at Tlatelolco in downtown Mexico City to remember the massacre which had brought the student movement of 1968 to a sudden end ten years before. Many turned their heads upward to the balcony of a residential building that faced the plaza to hear Carlos Monsivais, a well-known intellectual who had savored the protests, tell them that they “no longer saw the state as a tyrannical and omnipresent father.” Still another ten years later, many of them, and others as well, read the words of Hugo Hiriart, a promising young journalist in 1968, who claimed that the students had “dared to lead in a frontal and uncompromising opposition to the paternal and authoritarian Mexican state.”
RELATIVE EFFECTIVENESS OF TEACHER ATTENTION AND THE “GOOD BEHAVIOR GAME” IN MODIFYING DISRUPTIVE CLASSROOM BEHAVIOR1

A variety of behavioral procedures have been employed in recent years to modify disruptive classroom behavior. Such methods have been developed with the belief that curtailing disruptive behavior would strengthen positive classroom performance. In this study, two procedures, the good behavior game and the teacher-attention method, were compared to determine short-run effectiveness. Four teachers (two fourth-grade and two fifth-grade) implemented both methods in their classrooms over a five-week period. Presentation of methods was alternated in a counterbalanced design to control for order effects. Each of the four classrooms consisted of 25 students. A time-sampling procedure was used to record the presence or absence of disruptive behavior within 15-second intervals. Disruptive behavior was defined as any talking-out or out-of-seat behavior without permission. The results indicated that both procedures were effective in modifying disruptive classroom behavior, but that the good behavior game reduced disruptive behavior significantly better than the teacher-attention method. In addition, all teachers preferred the game to the teacher-attention procedure. This reaction seemed related to the effort involved in initiating the two activities. The good behavior game required less effort on the teacher's part. However, use of the game alone raises certain ethical considerations. One such issue involves abuse of peer pressure. Also, there is a possibility that negative rules may tend to promote resentment. Positively stated rules would ameliorate that problem. Another relates to the possibility that some teachers might be carried away by the ease of the game's implementation to the extent that behavior control becomes the primary objective in the classroom. As a result, one might consider use of the game to maximize short-term change, but then phase out this procedure in favor of another method (e.g., teacher attention) for long-run effects.
Development of a new thermal feature in Yellowstone National Park

Norris Geyser Basin in Yellowstone National Park is characterized by great variations in location and activity of thermal features. A new and popular “geyser” developed in the center of a paved parking area, in the spring of 1946. Observations on the types and changes of activity of this feature are recorded for a three month period. Late phases of activity appear to be directly related to the frequency of local rainfall and the resultant effect upon ground water circulation.
Torque measurements on single crystal DyxTb1−xFe2 compounds

Abstract Torque measurements on single crystal Dy x Tb 1− x Fe 2 compounds reveal continuous spin reorientations along nonprincipal crystallographic directions in the (110) plane. A comparison of the experimental results with single ion model calculations suggest that the crystal field parameters for this system may be about 30% lower than those measured for ErFe 2 .
The Relationship between Preoperative Wound Classification and Postoperative Infection: A Multi-Institutional Analysis of 15,289 Patients.

Background Despite advances in surgical techniques, sterile protocols, and perioperative antibiotic regimens, surgical site infections (SSIs) remain a significant problem. We investigated the relationship between wound classification (i.e., clean, clean/contaminated, contaminated, dirty) and SSI rates in plastic surgery. Methods We performed a retrospective review of a multi-institutional, surgical outcomes database for all patients undergoing plastic surgery procedures from 2006-2010. Patient demographics, wound classification, and 30-day outcomes were recorded and analyzed by multivariate logistic regression. Results A total of 15,289 plastic surgery cases were analyzed. The overall SSI rate was 3.00%, with superficial SSIs occurring at comparable rates across wound classes. There were similar rates of deep SSIs in the clean and clean/contaminated groups (0.64%), while rates reached over 2% in contaminated and dirty cases. Organ/space SSIs occurred in less than 1% of each wound classification. Contaminated and dirty cases were at an increased risk for deep SSIs (odds ratios, 2.81 and 2.74, respectively); however, wound classification did not appear to be a significant predictor of superficial or organ/space SSIs. Clean/contaminated, contaminated, and dirty cases were at increased risk for a postoperative complication, and contaminated and dirty cases also had higher odds of reoperation and 30-day mortality. Conclusions Analyzing a multi-center database, we found that wound classification was a significant predictor of overall complications, reoperation, and mortality, but not an adequate predictor of surgical site infections. When comparing infections for a given wound classification, plastic surgery had lower overall rates than the surgical population at large.
Inculturation and Theology in Africa

In this article James C. Okoye first speaks about inculturation as the mutual transformation of culture and understandings of the gospel. He then outlines some aspects of the inculturation process as it has been employed in Africa in the last four decades.. In a brief historical overview, Okoye speaks of three stages of inculturation in Africa: the stage of indigenization and adaptation, the stage of inculturation and liberation and the stage of contextualization. The rest of the article is devoted to outlining inculturation efforts in two crucial areas for African theology: salvation and christology. Salvation for Africans is more physical and ecclesial than spiritual and individualistic. A plurality of christological approaches exist in African and perhaps can be characterized as comparative, as systematic, as formed by the theology of liberation, and as arising from communal experience. Professor Okoye concludes with a brief overview of the Kairos Document from South Africa.
Dobutamine stress echocardiography identifies hibernating myocardium and predicts recovery of left ventricular function after coronary revascularization.

BACKGROUND The identification of hibernating myocardium is important in selecting patients who will benefit from coronary revascularization. This study was performed to determine whether dobutamine stress echocardiography (DSE) could identify hibernating myocardium and predict improvement in regional systolic wall thickening after revascularization. METHODS AND RESULTS DSE was performed in 49 consecutive patients with multivessel coronary disease and depressed left ventricular function. Contractile reverse during DSE was defined by the presence of two criteria: (1) improved systolic wall thickening in at least two adjacent abnormal segments and (2) > or = 20% improvement in regional wall thickening score. Postoperative echocardiograms were evaluated for improved regional wall thickening in 25 patients at least 4 weeks after successful coronary revascularization. All studies were read in blinded fashion. Contractile reserve during DSE was present in 24 (49%) of 49 patients. The presence or absence of contractile reserve on preoperative DSE predicted recovery of ventricular function in the 25 patients who underwent successful revascularization. Thus, 9 of 11 patients with contractile reserve had improved systolic wall thickening after revascularization (hibernating myocardium), whereas 12 of 14 patients without contractile reserve did not improve (P = .003). CONCLUSIONS Dobutamine stress echocardiography provides a simple, cost-effective, and widely available method of identifying hibernating myocardium and predicting improvement in regional left ventricular wall thickening after coronary revascularization. This technique may be clinically valuable in the selection of patients for coronary revascularization.
Supporting lock-free synchronization in Pfair-scheduled real-time systems

We consider the use of lock-free techniques for implementing shared objects in real-time Pfair-scheduled multiprocessor systems. Lock-free objects are more economical than locking techniques when implementing relatively simple objects such as buffers, stacks, queues, and lists. However, the use of such objects on real-time multiprocessors is generally considered impractical due to the need for analytical real-time guarantees. In this paper, we explain how the quantum-based nature of Pfair scheduling enables the effective use of such objects on real-time multiprocessors and present analysis specific to Pfair-scheduled systems. In addition, we show that analytical improvements can be obtained by using such objects in conjunction with group-based scheduling techniques. In this approach, a group of tasks is scheduled as a single entity (called a supertask in the Pfair literature). Such grouping prevents tasks from executing simultaneously, and hence from executing in parallel. Consequently, grouping tasks can improve the worst-case scenario with respect to object contention. Grouping also enables the use of less costly uniprocessor algorithms when all tasks sharing an object reside within the same group. We illustrate these optimizations with a case study that focuses on shared queues. Finally, we present and experimentally evaluate a simple heuristic for grouping tasks in order to reduce object contention. Though the analysis presented herein focuses specifically on Pfair-scheduled systems, the observations and techniques should be applicable to other quantum-scheduled systems as well.
Filter-based chemical sensors for hazardous materials

The development of new techniques for the detection of homemade explosive devices is an area of intense research for the defense community. Such sensors must exhibit high selectivity to detect explosives and/or explosives related materials in a complex environment. Spectroscopic techniques such as FTIR are capable of discriminating between the volatile components of explosives; however, there is a need for less expensive systems for wide-range use in the field. To tackle this challenge we are investigating the use of multiple, overlapping, broad-band infrared (IR) filters to enable discrimination of volatile chemicals associated with an explosive device from potential background interferants with similar chemical signatures. We present an optical approach for the detection of fuel oil (the volatile component in ammonium nitrate-fuel oil explosives) that relies on IR absorption spectroscopy in a laboratory environment. Our proposed system utilizes a three filter set to separate the IR signals from fuel oil and various background interferants in the sample headspace. Filter responses for the chemical spectra are calculated using a Gaussian filter set. We demonstrate that using a specifically chosen filter set enables discrimination of pure fuel oil, hexanes, and acetone, as well as various mixtures of these components. We examine the effects of varying carrier gasses and humidity on the collected spectra and corresponding filter response. We study the filter response on these mixtures over time as well as present a variety of methods for observing the filter response functions to determine the response of this approach to detecting fuel oil in various environments.
Synthesis of 14C and 35S labelled carbonyl sulfide

Carbonyl sulfide (COS) was prepared by a replacement reaction from potassium thiocyanate (KSCN) in 50% sulfuric acid. 14C-COS or 35S-COS can be prepared by the same method, depending on the position of the label in the starting KSCN. The yield of the final product is in excess of 60%, and radiochemical purity was 99.5%.
MORE THAN PLAYING HOUSE: A Developmental Perspective on the Strengths in Teenage Motherhood

Historically, the literature on adolescent pregnancy and motherhood has focused primarily on negative outcome. A review of current research reveals that outcomes for many teenage mothers and their children are not necessarily bleak. Indeed, becoming a parent can stimulate positive change in the adolescent's life. It is suggested that developmental level interacts with psychological, sociocultural, economic, family, and health variables to create a context in which teenage pregnancy can be an inhibitor or an enhancer of maturation.
Endothelium-Derived Hyperpolarizing Factor Determines Resting and Stimulated Forearm Vasodilator Tone in Health and in Disease

Background—We assessed the contribution of endothelium-derived hyperpolarizing factors to resting and agonist-stimulated vasodilator tone in health and disease. Tetraethylammonium chloride (TEA) was used to inhibit K+Ca channel activation and fluconazole was used to inhibit cytochrome P450 2C9–mediated epoxyeicosatrienoic acid synthesis. We hypothesized that endothelium-derived hyperpolarizing factors contribute to resting vascular tone by K+Ca channel activation and epoxyeicosatrienoic acid release and that endothelium-derived hyperpolarizing factors compensate for reduced nitric oxide bioavailability at rest and with endothelium-dependent vasodilators. Methods and Results—In 103 healthy subjects and 71 nonhypertensive subjects with multiple risk factors, we measured resting forearm blood flow (FBF) using venous occlusion plethysmography before and after intra-arterial infusions of NG-monomethyl-l-arginine (L-NMMA), TEA, fluconazole, and their combination. The effects of these antagonists on resting FBF ...
Regulation of enzyme synthesis by slime mold cell assemblies embarked upon alternative developmental programs

Abstract Depending on specified environmental conditions, the developing multi-cellular aggregate of Dictyostelium discoideum can either immediately begin to construct a fruiting body in situ or can transform into a migrating slug and move to a more suitable location. At any time thereafter the latter can be induced to stop migrating and construct a fruiting body. The patterns of accumulation and disappearance of two enzymes have been studied in cell assemblies engaged in either of the developmental programs described above. The enzymes are: uridine disphosphate glucose pyrophosphorylase (EC 2.7.7.9) and uridine diphosphate galactose epimerase (EC 5.1.3.2). In cell assemblies engaged in fruit construction both enzymes accumulate rapidly, the pyrophosphorylase several hours in advance of the epimerase. They reach peaks of specific activity at a given morphogenetic stage, and then disappear, the former partially, the latter completely. In cell assemblies engaged in slug migration the pyrophosphorylase accumulates very slowly to the same activity peak as in assemblies that had fruited directly but does not disappear. The epimerase does not accumulate at all. When migrating slugs are induced to stop moving and start fruiting while this slow round of pyrophosphorylase accumulation is under way, they complete it but in the rapid fashion characteristic of cells which had fruited directly without ever becoming slugs and this is followed by the characteristic sudden disappearance of part of the activity. However, if the slugs are allowed to migrate long enough to have already completed the slow round of pyrophosphorylase accumulation and then are induced to stop moving and start fruiting, they initiate a second rapid round of pyrophosphorylase synthesis while accomplishing the usual first round of epimerase accumulation and disappearance. The fundamental control of these events appears to be at the level of genetic transcription.
Bile Duct Perforation in a Newborn With Stenosis of the Ampulla of Vater

N 8-wk-old female infant was referred with jaundice, acholic stools, and abdominal swelling of 2-wk duration. On admission the patient was icteric and abdominal palpation showed a positive fluid wave. The liver was enlarged 2 finger breadths and the spleen was palpable. Significant laboratory data included bilirubin 6.0 mg/ 100 ml total, 4.9 direct, and 1.1 indirect; alkaline phosphatase 19.9 Bodansky U; 5 nucleotidase 16 Bodansky U. Evaluation for sepsis and metabolic disorders was negative. Liver biopsy was normal. Rose Bengal excretion was 8%. An upper GI series (Fig. 1) demonstrated extrinsic compression of the first portion of the duodenum. Exploration was performed with an uncertain preoperative diagnosis, possibly choledochal cyst. The pathology could not be visualized at preliminary laparoscopy. Laparotomy disclosed an encapsulated collection of bile beneath the liver. After dissecting away a thick green peel overlying the portahepatis and duodenum, a pinpoint perforation of the anterior wall of the dilated common duct was found at the junction of the cystic and hepatic ducts. Sludge was aspirated from the common duct. Cholangiogram (Fig. 2) showed severe stenosis of the distal common duct with proximal dilatation. The common duct was explored through the site of perforation, but a small probe would not pass into the duodenum. Duodenotomy was performed. There was severe stenosis of the ampulla which was relieved by sphincteroplasty (Fig. 3). Cholecystectomy and closure of the common duct perforation completed the procedure. The patient has done well since, now 18 mo postoperatively. DISCUSSION Perforation of the common bile duct is a rare but dramatic clinical entity. In 52 previously reported cases’ rarely is the diagnosis made preoperatively. Johnston2 suggested that the clinical picture of variable jaundice and acholic stools in a patient with failure to thrive and progressive ascites should suggest the diagnosis. Another clue is a disproportionate elevation of ascitic bilirubin compared to serum bilirubin.3 Laparoscopy was not possible because an inflammatory mass obscured the structures in the right upper quandrant. Foaming which occurred when CO, was introduced into the peritoneal cavity may have been caused by the presence of bile salts, a natural detergent. Laparoscopy was not helpful in this case. Perforation occurred in the anterior wall of the common bile duct at the level
Dependence of Proteasome Processing Rate on Substrate Unfolding

Protein degradation by eukaryotic proteasomes is a multi-step process involving substrate recognition, ATP-dependent unfolding, translocation into the proteolytic core particle, and finally proteolysis. To date, most investigations of proteasome function have focused on the first and the last steps in this process. Here we examine the relationship between the stability of a folded protein domain and its degradation rate. Test proteins were targeted to the proteasome independently of ubiquitination by directly tethering them to the protease. Degradation kinetics were compared for test protein pairs whose stability was altered by either point mutation or ligand binding, but were otherwise identical. In both intact cells and in reactions using purified proteasomes and substrates, increased substrate stability led to an increase in substrate turnover time. The steady-state time for degradation ranged from ∼5 min (dihydrofolate reductase) to 40 min (I27 domain of titin). ATP turnover was 110/min./proteasome, and was not markedly changed by substrate. Proteasomes engage tightly folded substrates in multiple iterative rounds of ATP hydrolysis, a process that can be rate-limiting for degradation.
Modeling flow and transport in saturated fractured rock to evaluate site characterization needs

Using regional geographic, geologic, surface and subsurface hydrologie, and geophysical data for the Tono area in Gifu, Japan, we develop a numerical model to simulate subsurface flow and transport in a 4 km x 6 km x 3 km thick fractured granite rock mass overlain by sedimentary layers. Individual fractures are not modeled explicitly. Rather, large-scale features such as lithologic layering and major fault zones are assigned deterministically, and continuum permeability and porosity distributions are assigned stochastically, based on well-test data and fracture density measurements. The model simulates the steady-state groundwater flow through the site, and then stream trace analysis is used to calculate travel times to the model boundary from specified points. The study is being conducted as a part of the site characterization effort for the Mizunami Underground Research Laboratory in Japan. Predicted travel times range from 1 to 25 years. Several other research groups also developed models based on the ...
The viscous catenary

A filament of an incompressible highly viscous fluid that is supported at its ends sags under the influence of gravity. Its instantaneous shape resembles that of a catenary, but evolves with time. At short times, the shape is dominated by bending deformations. At intermediate times, the effects of stretching become dominant everywhere except near the clamping boundaries where bending boundary layers persist. Finally, the filament breaks off in finite time via strain localization and pinch-off.