cssi/SciSciGPT-SciSciNet huggingface dataset:
An organizational analysis of the World Health Organization: Narrowing the gap between promise and performance

The World Health Organization's (WHO's) nearly half century amelioration of suffering stands as a singular achievement in international cooperation. But after 45 years, the Organization has grown into a complex bureaucracy with an outdated organizational structure. A multidisciplinary framework, which emphasizes organizational theory, yields some insights into these problems. Using this approach, this paper examines the structure, culture, mission, and rules of WHO, and adds a perspective, not otherwise found in the literature, to the growing debate on the future of the Organization. Previous studies of international organizations have explained their behavior as the consequence of the dominant external interests of powerful members. This perspective suggests that organizations like WHO have fewer options and less control of their policies and output. By contrast, there has been very little analysis explaining how international organizations function internally. This paper refutes an exclusively external perspective and shows that the internal organization is also important to understanding WHO. Several conclusions are drawn from this perspective. WHO's organizational myths, as a politically neutral technical agency staffed with uniquely qualified staff, need to be validated and enhanced to attract funding. A new organizational structure, based on an 'open systems' model, is proposed. This strategy would strengthen the WHO Representative Country Offices, redefine staff objectives, close the Regional Offices, and establish open, public elections of the Director General. Traditional WHO culture should only be used for health problems that are well matched to WHO's critical tasks. For more complex social and economic issues, newer, often non-medical, approaches are needed. The internal and external rules, which shape the incentives of WHO staff and leaders, need to be realigned to close the gap between WHO's myths and its day to day work. In the short run it is possible for WHO to do more with its limited budget if it changes its organizational structure; in the long run a reorganized WHO will be able to garner more funding and attract wider international participation.
The reactivity of the sulfhydryl groups of rhodopsin in rod outer segment membranes.

Abstract The number of light-exposed sulfhydryl groups observed in rod outer segment suspensions is greatly influenced by the specific reaction conditions used. If appropriate conditions are chosen, the same pattern of sulfhydryl group reactivity is observed in rod outer segment suspensions as previously reported for rhodopsin in digitonin solution. It is not clear whether the influence of the reaction conditions on the pattern of sulfhydryl reactivity reflects differences in the environment of the sulfhydryl groups, differences in the oxidation reactions, or some combination of these effects.
Mycobacterial Cell Wall Components

Although most of 50 known species of Mycobacterium are saprophytic species found in soil, a number are serious human health threats [1]. Prominent among these are M. tuberculosis and M. leprae, respectively, the causative agents of tuberculosis and leprosy. Also important are infections by “atypical” mycobacteria (M. avium, M. kansasii, and M. fortuitum) which cause opportunistic infections in patients with weakened immune systems [2]. It has been estimated that a third of the world’s population is infected with M. tuberculosis and that nearly three million deaths from tuberculosis occur each year, making it the single most lethal bacterial disease [3]. Other mycobacterial infections have a similarly high human toll: leprosy claims one million lives annually [4] and M. avium infections are increasingly the cause of death in AIDS patients [5], These infections have attracted renewed attention due to their increasing incidence in both the industrialized and the developing worlds, especially among immunocompromised and homeless populations [6]. Their resurgence has prompted interest in developing new antimycobacterial agents and the great urgency of this task has been underscored by the emergence of mycobacterial strains resistant to many of the drugs frequently used to treat these infections [7]. Furthermore, atypical mycobacteria are not sensitive to antibiotics active against M. tuberculosis and therefore combating these infections has been, and continues to be, difficult [8].
How To Choose a Capital Structure: Navigating the Debt-Equity Decision

In corporate offices as well as the classroom, there continues to be significant debate about the costs and benefits of debt financing. There is also considerable variation in corporate credit ratings, even among companies as large and successful as those that make up the SP and with the market's generally favorable response to recapitalizations and dividend increases, such financing issues are likely to receive even more attention. Underlying the diversity of corporate credit ratings is widespread disagreement about the “right” credit rating—a matter that is complicated by the fact that the cost of debt varies widely among companies with the same rating. Although credit ratings are clearly tied to measures of indebtedness such as leverage and coverage ratios, the most important factor in most industries is a company's size. For many mid-sized companies, an investment-grade rating can be attained only by making a large, equity-financed acquisition—or by making minimal use of debt. In this sense, the corporate choice of credit rating can be as much a strategic issue as a financial decision. Maintaining the right amount of financial fl exibility is a key consideration when determining the right credit rating for a given company (although what management views as value-preserving flexibility may be viewed by the market as value-reducing financial “slack”). A BBB rating will accommodate considerably more leverage (30–60%) in companies with fairly stable cash flows and limited investment requirements than in more cyclical or growth-oriented companies (10–20%). When contemplating taking on more leverage, companies should examine all major operating risks and view their capital structure in the context of an enterprisewide risk management framework.
Diode verification of routine electron-beam treatments.

Abstract A platinum doped n type commercial silicon electron diode/electrometer system was evaluated for use in our comprehensive external beam radiotherapy quality assurance program. Directional dependence of diode response was investigated by positioning the diode at the radiation isocenter and recording the response versus beam incident direction. Dose rate response was examined by testing for nonidealities in inverse square law behavior. Energy dependence of response was explored using 6–21 MeV beams. Dose response linearity was investigated from 50-800 cGy. Radiation perturbation was measured using localization film. Finally, the system was evaluated for initial treatment quality assurance in a number of clinical cases (N = 34). The diode response exhibited ±5% variation within ±20° of the detector’s marked “preferred” direction for the 6 MeV beam. Higher energy electron beams exhibited much less directional dependence. Dose rate response was found constant from 178-326 cGy/min (or 96-130 cm SSD). Energy dependence of response was constant within ±5.5% from 6-21 MeV. Dose response was linear (r2 = 0.999). Radiation field perturbation was significant at the depth of dose maximum (dmax). The maximum perturbation measured was −12.5% at dmax using the 6 MeV beam. Clinical trials of the system demonstrated that the diodes could be utilized for initial treatment quality assurance. The system proved effective for routine initial treatment electron beam in vivo dosimetry when the directional and energy dependent limitations of the system were respected.
Backbone Mutations in Transmembrane Domains of a Ligand-Gated Ion Channel: Implications for the Mechanism of Gating

Abstract An approach to identify backbone conformational changes underlying nicotinic acetylcholine receptor (nAChR) gating was developed. Specific backbone peptide bonds were replaced with an ester, which disrupts backbone hydrogen bonds at the site of mutation. At a conserved proline residue ( α Pro221) in the first transmembrane (M1) domain, the amide-to-ester mutation provides receptors with near-normal sensitivity, although the natural amino acids tested other than Pro produce receptors that gate with a much larger EC 50 than normal. Therefore, a backbone hydrogen bond at this site may interfere with normal gating. In the α M2 domain, the amide-to-ester mutation yielded functional receptors at 15 positions, 3 of which provided receptors with >10-fold lower EC 50 than wild type. These results support a model for gating that includes significant changes of backbone conformation within the M2 domain.
The volitional unit: a functional concept in cortico-motoneuronal connections in humans

We used the EMG precision decomposition technique to resolve complex EMG signals and derive information about the firing times of a family of motor units (MUs) and the force they produce. The active units shared a common behavior among their firing rates, a concept described by DeLuca et al. and termed the 'common drive'. This 'common' behavior was extracted as the average of the firing rates of MUs and found to track the subject's force trajectory. In this paper, we propose the existence of functional cortico-motoneuronal connections which provide for a large number of combinations between affector cortical motoneurons (CMNs) and effector spinal motoneurons (SMNs) for the generation of a purposeful movement. We argue that these connections provide the essential link between volition and movement and function as a 'volitional unit' which consists of the CMNs, the SMNs and the anatomical and interneuronal connections between them.
BETA COEFFICIENTS FOR CONVERTIBLE BONDS

WHEN THE STANDARD portfolio model is applied to convertible bonds, the changing relationship between the common stock conversion value and the straight bond value give the resulting betas a high degree of non-stationarity. It is the purpose of this note to take the valuation model of Poensgen [2], extend it to include the market portfolio of common stocks, and in so doing derive an expected value for beta for convertible bonds. This value is based on the historical value of the underlying common stock beta and the current relationship between the common stock conversion value and the straight bond value. The only nonstationarity difficulties with this approach are those inherent in the calculation of common stock betas. This derivation provides both theoretical proof that convertible bond beta coefficients are less than those of the corresponding common stocks, and a beta calculation which is more justifiable as a regression variable and input into simulation models. Poensgen's analysis and definition of convertible bond values gives the following equation for the expected value of a convertible bond (such as in Walter and Que's designation [3, p. 714]):
Conifer and angiosperm biomarkers in clay sediments and fossil plants from the Miocene Clarkia Formation, Idaho, USA

The aliphatic lipids and terpenoids of conifer and angiosperm macrofossils and the clay sediment from a new site (P-37) of the Miocene Clarkia Formation, Idaho, USA, were analyzed to evaluate the preservation of characteristic conifer and angiosperm biomarkers in the sediment. Series of aliphatic lipids, terpenoids and steroids similar to the biomarkers found in type locality Clarkia P-33 were the predominant compounds in the sediment and in the fossils. Long-chain aliphatic lipids were major compounds in the fossil plants and the sediment, but a differentiation of angiosperm and conifer sources is not possible due to their common distribution among all vascular plants. In addition to previously reported terpenoids, diterpenoids of a conifer origin and several angiosperm derived polar triterpenoids of the oleanane, lupane, ursane and friedelane classes are reported here for the first time from the Clarkia sediments. The conifer shoots (Taxodium, Glyptostrobus, Calocedrus) contained characteristic conifer biomarkers such as abietane type diterpenoids while characteristic angiosperm triterpenoids were predominant in the angiosperm leaves (Betula, Quercus, Lithocarpus). The biomarker compositions of the Taxodium and Glyptostrobus shoots match the terpenoid patterns previously reported from fossil seed cones of the same genera. Although conifer macrofossils contribute about 45% to the flora of site P-37, characteristic conifer biomarkers occurred in the sediment in only low amounts while the angiosperm derived triterpenoids were present in comparatively higher abundances. The results indicate that the conifers are under-represented compared to the angiosperms according to the terpenoid composition of the sediment extract. This may be due to the presence of small angiosperm derived particles (leaf detritus, wax) in the sediment and/or migration of leaf waxes from the angiosperm leaves into the sediment. In contrast, the diterpenoids are trapped in the resinous woody tissue of the conifers and are thus disseminated less into the sediment.
Uncertainty of Boundary Layer Heat Budgets Computed from Wind Profiler—RASS Networks

Abstract Uncertainties in the evaluation of the atmospheric heat budget, in which the turbulent heat flux divergence term is calculated as a residual, are investigated for a triangular array of 915-MHz wind profilers—radio acoustic sounding systems (RASS) using a surface-integral method. A scaling analysis of the residual error heat budget equation reveals the basic characteristics and magnitudes of the uncertainties. These values are verified with a Monte Carlo simulation technique for synthetic datasets in which the triangle size is of the order of 30 km (meso-γ scale). The uncertainties depend on measurement errors, atmospheric stability, mean wind speed, triangle size, and averaging time. In addition, we estimate the effects of baroclinity and mean wind divergence on the accuracy of the calculation of the heat budget. Idealized, barotropic, and divergence-free conditions are studied to investigate the influence of various instrument accuracies on profiles of the turbulent virtual potential temperature...
Experimental Study of Shear-Layer/Acoustics Coupling in Mach 5 Cavity Flow

Simultaneous planar laser imaging and e uctuating-pressure measurements were made in a high-Reynolds- number, Mach 5 cavity e ow, with cavity length-to-depth ratios of 3, 4, 5, 6, and 7. Instantaneous planar laser scattering images show no evidence for coherent structures that are induced by the cavity acoustics. Furthermore, both the pressure measurements and imaging suggest that the rear-wall shock is caused by the impingement of shear-layer turbulent structures. Analysis of the e uctuating-pressure data suggests that the shock frequencies and the duration of the impingement shock are not sensitive to cavity length-to-depth ratio. Ensemble-average velocity proe les in the shear layer, conditioned on the front-wall pressure, suggest that the dee ection of the shear layer is not measurably correlated with the cavity oscillation cycle. In addition, spectral analysis of the e uctuating pressures shows that the cavity oscillation frequencies are accurately predicted using simple closed-box acoustic theory. These results suggest that the present cavity e ow exhibits substantially less coupling between the cavity pressure e uctuations and the shear-layer e uid dynamics as compared to similar e ows at lower Mach numbers.
Distributed Lifetime and Data Rate Optimization with Dynamic Approximation in Wireless Networks

In this paper, we study the problem of jointly maximizing network lifetime and data rate in wireless networks. For this problem, we introduce a general network utility maximization (NUM) cross-layer formulation that accommodates routing, scheduling and stream control from different layers of network with relevant constraints. In particular, based on both Lagrangian approach and Markov Chain Monte Carlo method, we extend our programming model to distributed algorithms that can dynamically approximate the optimal solution to this problem. Finally, we present computational results for the insight that can be gained from the cross-layer optimization and the distributed algorithms.
The Strengths of Fiber Reinforced Composite Bends

An analysis is presented for calculating the stresses and strains in bends made of fiber reinforced composites and for estimating the strengths of bends. The stress field is calculated by a finite element method. The strength is predicted using the Tsai-Hill criterion for inplane failure and the Chang-Springer criterion for out of plane failure. Results are presented which illustrate the effects of geometry and ply orientation on the strength and on the mode of failure.
The Impact of CHIP Coverage on Children With Asthma in Alabama

This study evaluates the impact of coverage in ALL Kids, the Alabama Child Health Insurance Program (CHIP), by examining asthma-related utilization and outcomes among children continuously enrolled for 3 years (N = 1954)with persistent asthma at enrollment. Outcomes and costs were compared for the first, second, and third years of enrollment using repeated measures analysis of variance and controlling for age, gender, and year fixed-effects. Compared with subsequent years, first year enrollment utilization was higher for asthma-related hospitalizations (6% vs 2% vs 2%; P < .0001) and emergency visits (10% vs 3% vs 2%; P < .0001). Also decreasing were asthma-related outpatient visits (1.46 vs 1.12 vs 0.94; P < .0001), quick-relief prescriptions (2.6 vs 2.2 vs 2.1; P < .0001), and long-term control prescriptions (5.8 vs 5.2 vs 4.4; P < .0001). As a result, significant declines in the mean costs per child were observed. Ongoing ALL Kids coverage is associated with improved disease-management and lower costs ...
Prevalence of Pain-Predominant Functional Gastrointestinal Disorders and Somatic Symptoms in Patients with Anxiety or Depressive Disorders

Objective To determine whether children with symptoms of internalizing psychiatric disorders have a greater prevalence of pain-predominant functional gastrointestinal disorders (FGIDs) and migraine-like headaches. Study design Children and adolescents aged 6-18 years were recruited from a behavioral health center (n = 31) and a primary care center (n = 36). Subjects completed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition –based symptom inventory questionnaires to screen for internalizing psychiatric disorders, the Questionnaire on Pediatric Gastrointestinal Symptoms, and a somatic distress assessment interview. Results Thirty-three subjects (19 of 31 from the behavioral health center and 14 of 36 from the primary care center) screened positive for symptoms of anxiety or depressive disorders. The remainder screened negative and served as controls. Pain-predominant FGIDs were more common in the group with symptoms of anxiety or depression compared with controls (prevalence, 51.5% vs 8.8%; P = .0002). Migraine headaches occurred in 57.6% of the subjects with internalizing psychiatric disorders vs 23.5% of the control group ( P = .006). The prevalence of functional constipation did not differ significantly between the 2 groups. The data remained essentially unchanged when analyzed within each center of recruitment. Conclusion Youths with anxiety or depressive symptoms are more likely to suffer from pain-predominant FGIDs and migraine-like headaches, but not from functional constipation. The lack of an association between functional constipation and internalizing psychiatric symptoms suggests that FGIDs associated with pain may bear a specific relationship to emotional disorders.
Hierarchical coherency management for shared virtual memory multicomputers

Abstract For many applications of scalable multicomputers with distributed memory it is desirable to provide transparent shared virtual memory. For such applications, the hardware and system software must maintain coherency among the local memories. Most existing coherency schemes for multicomputers manage memory uniformly at a single granularity of fixed size pages or cache blocks, leading to unnecessarily high storage overhead and poor performance. Coherency management at the granularity of pages (thousands of bytes) results in unnecessary network traffic. At the granularity of cache blocks (tens of bytes), unacceptably large mapping tables are needed for large systems. We propose a solution to this problem using hierarchical management, where mapping and transfer at the block level are done only when necessary—during the time that the page is actually shared. When pages are not shared, they do not require more space for mapping tables than uniform page-level schemes. A detailed description of the scheme is presented, together with an evaluation of its performance and area overheads. The results of trace-driven simulations of the hierarchical coherency scheme are reported. It is shown that the hierarchical scheme makes it possible to achieve the performance advantage of uniform block-based schemes without their large storage overhead.
Treatment strategies of testicular cancer in the United States.

The treatment of testicular cancer has dramatically improved during the past decade. Combination chemotherapy with PVB was instituted at Indiana University in 1974. Subsequent studies demonstrated that: (1) post PVB, surgery can cure patients; (2) vinblastine dosage can be lowered from 0.4 to 0.3 mg/kg without sacrificing cure potential: (3) maintenance vinblastine is not necessary; (4) VP-16 can be substituted for vinblastine with equivalent cure rates and decreased neuromuscular toxicity.
Specific serological relationships among partially purified DNA polymerases of avian leukosis-sarcoma viruses, reticuloendotheliosis viruses, and avian cells.

Abstract Specific serological relationships were found among the partially purified DNA polymerases of the two groups of avian viruses whose virions contain RNA and a DNA polymerase—the avian leukosis-sarcoma viruses and the reticuloendotheliosis viruses—and three avian species which are natural hosts for these viruses: chickens, turkeys, and Pekin ducks. No relationships were found to DNA polymerases of HeLa cells or Escherichia coli. These results are consistent with the hypothesis that RNA viruses with a DNA polymerase originated from normal cellular components.
Selecting Observations against Adversarial Objectives

In many applications, one has to actively select among a set of expensive observations before making an informed decision. Often, we want to select observations which perform well when evaluated with an objective function chosen by an adversary. Examples include minimizing the maximum posterior variance in Gaussian Process regression, robust experimental design, and sensor placement for outbreak detection. In this paper, we present the Submodular Saturation algorithm, a simple and efficient algorithm with strong theoretical approximation guarantees for the case where the possible objective functions exhibit submodularity, an intuitive diminishing returns property. Moreover, we prove that better approximation algorithms do not exist unless NP-complete problems admit efficient algorithms. We evaluate our algorithm on several real-world problems. For Gaussian Process regression, our algorithm compares favorably with state-of-the-art heuristics described in the geostatistics literature, while being simpler, faster and providing theoretical guarantees. For robust experimental design, our algorithm performs favorably compared to SDP-based algorithms.
THE SMILE CALIBRATION PROBLEM SOLVED

Following previous work on calibration of multi-factor local stochastic volatility models to market smiles (7), we show how to calibrate exactly any such models. Our approach, based on McKean's particle method, extends to hybrid models, for which we provide a Malliavin representation of the eective local volatility. We illustrate the eciency of our algorithm on hybrid local stochastic volatility models.
Floodplain ecosystem restoration: commodity markets, environmental services, and the farm bill.

Economic and cultural values, the same forces that led people to alter floodplain ecosystems, will be the forces that determine the extent of their restoration. Landowner investment in agricultural production and forest and hydrologic restoration will reflect perceived economic returns from investments, as well as personal preferences for the environmental services each land use provides. Conservation programs and emerging environmental markets can encourage floodplain restoration, but will be effective only if they improve economic returns from bottomland management relative to other land uses. Over the past three years, prices for corn, soybeans, wheat, and other agricultural commodities have increased sharply, increasing returns to crop production and decreasing the amount of marginally profitable cropland, land most likely to be restored to bottomland hardwoods. Understanding commodity price dynamics is critical for understanding the potential for retiring cropland into bottomlands. Often Farm Bill conservation title provisions attract the greatest attention regarding bottomland hardwood restoration. However, the commodity title, which sets commodity price supports, and energy policy, need to be considered because commodity and energy policy effect returns from bottomland hardwood restoration.
The use of in situ and airborne fluorescence measurements to determine UV absorption coefficients and DOC concentrations in surface waters

We compared the fluorescence (λ eX = 355 nm, λ em = 450 nm) of chromophore-containing dissolved organic matter (CDOM) determined in the laboratory to that determined with a shipboard fluorometer and an airborne laser fluorosensor off the U.S. mid-Atlantic coast. Fluorescence was highly correlated with CDOM absorption at the excitation wavelength despite the presence of multiple sources of CDOM and a changing contribution of CDOM to the total dissolved organic C (DOC) pool, both in surface waters and down the water column. The mean quantum yield (0.8±0.1%) fell within the narrow range of yields previously determined for U.S. east coast and south Florida waters. These results show that CDOM absorption can be reliably determined from in situ or airborne fluorescence over wide areas of the ocean and that it may be possible to estimate DOC concentration from fluorescence or absorption measurements.
Bed nonhomogeneity in turbulent gas‐solid fluidization

Bed dynamic behavior in a gas-solid fluidization system is measured in real time using ECT based on the NNMOIRT recently developed. The ECT results reveal the time-averaged and transient characteristics of the bubble/void phase and the emulsion phase, which is of value to the verification of the 3-D computation codes with real physical systems. In the turbulent regime, the time-averaged solids holdup distribution exhibits radial symmetry, which is not the case for the bubbling regime. The standard deviations of the fluctuations of the cross-sectional, averaged bubble/void phase fraction, and the cross-sectional, averaged solids holdups in the bubble/void phase and in the emulsion phase, all peak at the transition velocity from the bubbling to the turbulent regimes Uc. The addition of 10% fine particles decreases the solids holdup in the emulsion phase due to the breakup of large bubbles. The ECT study indicates that optical fiber probe measurement of the bubble/void phase fraction may yield significantly different results depending on the threshold level selected for the measured solids holdup distribution. The bubble/void phase fraction measured by the optical fiber probe does not vary with bed temperature up to 400°C; the emulsion phase voidage is observed to increase as the bed temperature increases.
Enduring Illusions: The Social Organization of Secrecy and Deception

Sociologists theorize that people comply with the dictates of states and other organizations out of self-interest or because of the perceived legitimacy of those in authority. Some organizations, however, are based on lies, or secrets, and it would seem that these should be very short-lived, given how easy it is for the truth to escape. This article lays the foundations of a sociology of deception, focusing on lies and secrets successfully maintained for years or even decades. The ideas of Goffman and Simmel provide a theoretical starting point. Then Bernard Madoff’s Ponzi scheme is considered as a case study. Drawing on that and other examples, the article culminates in a theory that distinguishes between barriers to knowing, barriers to asking, barriers to telling, barriers to perceiving, barriers to believing, and barriers to acting. Together, these may counter the natural entropic tendency for information to leak and diffuse, in part because the effectiveness of one sort of barrier may offset imperfections in others.
Photo-oxidation of dissolved organic matter in river water and its effect on trace element speciation

To investigate the effect of photodegradation of fluvial dissolved organic matter (DOM) on dissolved trace element distributions, we performed a 3-week incubation of water from the lower Pearl River (Mississippi). The experiment was performed in natural light (with dark controls) and examined both the changes in DOM and changes in physical–chemical speciation of a suite of trace metals. During the incubation, dissolved organic carbon (DOC) decreased in the light by about 20%, whereas ultraviolet light absorbance decreased by nearly 40%; dark controls showed no significant change in DOC. For the trace elements, a variety of behaviors were observed. Some elements (alkali and alkaline earth metals, Mo, Mn, Cd, and Zn) showed no change in concentration or speciation. A number of elements, however, did show significant changes in the light. For example, there was a significant, continuous decrease in dissolved (,0.02-mm) Fe in the light samples during the experiment. This and other speciation results indicate that organically complexed Fe was released during photo-oxidation of the lowmolecular-weight DOM; this was followed by subsequent precipitation of the released Fe as additional colloidal FeOOH. Other elements (Ce, Cu, Cr, Pb, V, and U) also showed decreases in the dissolved (,0.02-mm) fraction with time. Some of these elements, as well as Co and Ni, also showed decreases in their retention by an anion exchange column, likewise implying a decrease in their organically complexed forms.
Predicting the Restenosis Benefit of Drug-Eluting Versus Bare Metal Stents in Percutaneous Coronary Intervention

Background—Drug-eluting stents (DES) for percutaneous coronary intervention decrease the risk of restenosis compared with bare metal stents. However, they are costlier, require prolonged dual antiplatelet therapy, and provide the most benefit in patients at highest risk for restenosis. To assist physicians in targeting DES use in patients at the highest risk for target vessel revascularization (TVR), we developed and validated a model to predict TVR. Methods and Results—Preprocedural clinical and angiographic data from 27 107 percutaneous coronary intervention hospitalizations between October 1, 2004, and September 30, 2007, in Massachusetts were used to develop prediction models for TVR at 1 year. Models were developed from a two-thirds random sample and validated in the remaining third. The overall rate of TVR was 7.6% (6.7% with DES, 11% with bare metal stents). Significant predictors of TVR included prior percutaneous coronary intervention, emergency or salvage percutaneous coronary intervention, prio...
An empirical approach to model selection through validation for censored survival data

Medical prognostic models can be designed to predict the future course or outcome of disease progression after diagnosis or treatment. The existing variable selection methods may be precluded by full model advocates when we build a prediction model owing to their estimation bias and selection bias in right-censored time-to-event data. If our objective is to optimize predictive performance by some criterion, we can often achieve a reduced model that has a little bias with low variance, but whose overall performance is enhanced. To accomplish this goal, we propose a new variable selection approach that combines Stepwise Tuning in the Maximum Concordance Index (STMC) with Forward Nested Subset Selection (FNSS) in two stages. In the first stage, the proposed variable selection is employed to identify the best subset of risk factors optimized with the concordance index using inner cross-validation for optimism correction in the outer loop of cross-validation, yielding potentially different final models for each of the folds. We then feed the intermediate results of the prior stage into another selection method in the second stage to resolve the overfitting problem and to select a final model from the variation of predictors in the selected models. Two case studies on relatively different sized survival data sets as well as a simulation study demonstrate that the proposed approach is able to select an improved and reduced average model under a sufficient sample and event size compared with other selection methods such as stepwise selection using the likelihood ratio test, Akaike Information Criterion (AIC), and lasso. Finally, we achieve better final models in each dataset than their full models by most measures. These results of the model selection models and the final models are assessed in a systematic scheme through validation for the independent performance.
Effect of digital radiography on emergency department radiographic examinations

The purpose of this paper is to determine the time-savings realized as a result of conversion from film-based radiography to digital radiography (DR) in emergency department patients receiving multiple radiographic examinations. We retrospectively reviewed the computer records of 69 patients from the preconversion group (January 2004) and 62 patients from the postconversion group (January 2005), calculated the mean examination time per image from each group, and used a one-tailed t test to compare the two means. The preconversion (a mix of screen-film and computed radiography) group had a mean examination time of 3.27±1.50 min per image. The postconversion (DR) group had a mean examination time of 2.51±1.16 min. The p value between the two means is 0.000822 with a standard error of 0.330 min. DR reduces radiographic examination time by 23% when compared to conventional screen-film radiography.
Taenia solium (Linnaeus 1758)

Taenia solium is distributed throughout the world and coincides with the raising of pigs, especially in areas where human feces are used as fertilizer. In parts of Southeast Asia, Micronesia, the Philippines, Mexico, Central America (particularly Guatemala), South America (particularly Ecuador), and eastern Europe, the infection is endemic. In the United States, the highest prevalence of adult T. solium infection is in southern California, probably reflecting the large number of immigrants from endemic areas.1,2 T. solium is a large tapeworm, more than 6 m in length. It lives attached to the wall of the small intestine. Although the presence of the adult tapeworm in the intestine usually does not result in any clinical disease, infection with the larval form, referred to as cysticercosis (see Chap. 16), can be a serious, even fatal disease.
Hemodynamics and baroreflex function in rats with nephrotic syndrome.

The excess renal sodium retention leading to edema formation in the nephrotic syndrome (NS) is substantially dependent on increased efferent renal sympathetic nerve activity (RSNA). This study examined whether the hypoalbuminemia in NS is reflected as a decrease in cardiac output or cardiac function and whether the increased RSNA in NS is due to alterations in arterial and/or cardiopulmonary baroreflex function. NS was induced in rats with adriamycin (3.5 mg/kg i.v.), and they were studied 4 wk after injection. Mean arterial pressure (MAP) was similar in control (C) and NS rats. Cardiac indexes (CIs; cardiac output/body wt) were 29 +/- 1 and 26 +/- 1 ml.min-1.100 g-1 in C and NS rats, respectively. Total peripheral resistance indexes were significantly greater in NS than in C rats (4.7 +/- 0.2 vs. 4.1 +/- 0.1 mmHg.100 g.min.ml-1). Cardiac function during increases in cardiac filling pressure was not different between C and NS rats. The afferent limb of the arterial baroreflex was assessed by measuring aortic depressor nerve activity (ADNA) while the efferent limb was assessed by measuring RSNA in C and NS rats during increases in MAP. The central component of the arterial baroreflex was assessed from plots of RSNA (output) vs. ADNA (input). Comparisons between C and NS rats before and after vagotomy revealed no differences in the gains of any component of the arterial baroreflex. The cardiopulmonary baroreflex was assessed in a similar manner by measuring afferent vagus nerve activity (VGNA) and efferent RSNA during volume expansion before and after sinoaortic denervation (SAD). Before SAD, gains were similar in C and NS rats. After SAD, gains of the total (-1.59 +/- 0.44 vs. -3.64 +/- 0.65%/mmHg) and the central/efferent limb (-0.26 +/- 0.07 vs. -0.67 +/- 0.14 %/%) were significantly reduced (P < 0.05) in NS compared with C rats while the gain of the afferent limb of the reflex was similar in C and NS rats. These results indicate that NS rats with significant hypoalbuminemia maintain an arterial pressure similar to C rats by increasing total peripheral resistance, which serves to offset the tendency to a lower CI. Arterial baroreflex function in NS does not differ from that in C, but decreased cardiopulmonary baroreflex inhibition of RSNA in NS may contribute to the increased RSNA.
Bankruptcy Prediction Using Neural Networks

This study is an extension of prior studies that have used artificial neural networks to predict bankruptcy. The incremental contribution of this study is threefold. First, we use only financially stressed firms in our control sample. This sampling enables the models to more closely approximate the actual decision processes of auditors and other interested parties. Second, we develop a more parsimonious model using qualitative “bad news” variables that prior research indicates measure financial distress. Past research has focused on the “usefulness” of accounting numbers and therefore often ignored non-accounting variables that may contribute to the classification accuracy of the distress prediction models. In addition, rather than use multiple financial ratios, we include a single variable of financial distress using the Zmijewski distress score that incorporates ratios measuring profitability, liquidity, and solvency. Finally, we develop and test a genetic algorithm neural network model. We compare its predictive ability to that of a backpropagation neural network and a model using multiple discriminant analysis.
A Cross-Course Investigation of Integrative Cases for Evolution Education

Evolution is a cornerstone theory in biology, yet many undergraduate students have difficulty understanding it. One reason for this is that evolution is often taught in a macro-scale context without explicit links to micro-scale processes. To address this, we developed a series of integrative evolution cases that present the evolution of various traits from their origin in genetic mutation, to the synthesis of modified proteins, to how these proteins produce novel phenotypes, to the related macro-scale impacts that the novel phenotypes have on populations in ecological communities. We postulated that students would develop a fuller understanding of evolution when learning biology in a context where these integrative evolution cases are used. We used a previously developed assessment tool, the ATEEK (Assessment Tool for Evaluating Evolution Knowledge), within a pre-course/post-course assessment framework. Students who learned biology in courses using the integrative cases performed significantly better on the evolution assessment than did students in courses that did not use the cases. We also found that student understanding of evolution increased with increased exposure to the integrative evolution cases. These findings support the general hypothesis that students acquire a more complete understanding of evolution when they learn about its genetic and molecular mechanisms along with macro-scale explanations.
Extrapleural pneumonectomy, chemotherapy, and radiotherapy in the treatment of diffuse malignant pleural mesothelioma.

Malignant pleural mesothelioma has been considered a uniformly fatal disease associated with a median survival of 4 to 18 months. Extrapleural pneumonectomy alone has proved disappointing in the treatment of this disease, as have chemotherapy and radiotherapy. From 1980 to 1990, 31 patients with pleural mesothelioma underwent multimodality therapy that included extrapleural pneumonectomy with resection of the pericardium and diaphragm. The age of the patients was 53.4 ± 8.6 years; 26 were male. All patients had the pathologic diagnosis reviewed before treatment. At thoracotomy six patients had residual (unresectable) gross disease, and in 23 there was histologic evidence of disease at the resection margin. The perioperative morbidity and mortality rates were 19% and 6%, respectively. The mean length of hospital stay for the 29 patients who survived the operation was 10.9 ± 3.5 days. Postoperatively 26 patients received cyclophosphamide, doxorubicin, and cis-platinum chemotherapy with or without radiotherapy. The survival rates were 70% at 1 year and 48% at 2 years. Trends toward improved survival in the patients with complete resections approached but did not reach statistical significance. These data suggest that this multimodality protocol can be administered with acceptable morbidity and mortality. Prospective trials are justified to further clarify the role of this approach.
A scalable framework for the global offline community land model ensemble simulation

Current earth system models have a large range of uncertainty, owing to differences in the simulation of feedbacks and insufficient information to constrain model parameters. Parameter disturbance experiment provides a straightforward method to quantify the variation uncertainty outputs caused by model inputs. Owing to the software complexity and computational intensity of earth system models, a large-scale simulation framework is needed to support ensemble simulation required by parameter disturbance experiment. This paper presents a parallel framework for the community land model ensemble simulation. After a software structure review of the community land model simulation, a single factor parameter disturbance experiment of a reference computational experiment design is used to demonstrate the software design principles, computational characteristics of individual application, parallel ensemble simulation implementation, as well as the weak scalability of this simulation framework on a high-end computer. Finally, the paper discusses some preliminary diagnostic analysis results of the single factor parameter disturbance experiments. The framework design considerations and implementation details described in this paper can be beneficial to many other research programmes involving large scale, legacy modelling system.
Multi-criteria Routing in Networks with Path Choices

Typical routing algorithms use a single criterion, such as hop count or link weight, to calculate paths. As the requirement of flexible routing arises, there are circumstances where multiple criteria are needed for routing. Though there are proposed solutions to the multi-criteria optimal path selection problem for quality-of-service routing, they usually combine all criteria into a single path optimization metric a priori. However, this approach is not feasible in scenarios where the path consumers' weightings of criteria is not known at compute time. Such circumstances require finding all the Pareto-optimal paths, i.e., all the paths that are not dominated by other paths. In this paper, we present the algorithmic foundations for efficiently computing Pareto-optimal paths. We present ParetoBFS, a variant of a breadth-first search that uses branch-and-bound techniques to find all the Pareto-optimal paths while effectively limiting the potentially very large search space. We present several sampling techniques to further increase the speed of the search while degrading the quality of the results only marginally. Our simulation results show that existing multi-criteria combinatorial optimization approaches can only search a small fraction of all the Pareto-optimal paths while ParetoBFS can obtain the whole path set in shorter time. We also present results from an implementation of ParetoBFS on a software-defined network prototype.
Antibody responses to influenza a H1N1 vaccine compared to the circulating strain in influenza vaccine recipients during the 2013/2014 season in North America

Abstract Background Influenza strain A/California/07/2009 H1N1 (H1N1-09) reemerged in 2013/2014 as the predominant cause of illness. We sought to determine if antigenic drift may have contributed to the decreased responses to influenza vaccine. Methods Fifty adults who received trivalent inactivated influenza vaccine (IIV3) and 56 children who received live attenuated quadrivalent influenza vaccine (LAIV4) had hemagglutination inhibition (HAI) and microneutralizing (MN) antibodies measured in plasma against H1N1-09 and H1N1 2013/2014 (H1N1-14) influenza. Partial sequencing of the hemagglutinin gene (nt 280–780) was performed on 38 clinical isolates and the vaccine prototype. Results In IIV3 recipients, HAI and MN titers against H1N1-14 were significantly lower than against H1N1-09 (p Conclusions 2013/2014 IIV3 and LAIV4 recipients had consistently lower MN antibody titers against H1N1-14 compared with H1N1-09. The HA K166Q mutation, located in a neutralizing epitope, probably contributed to these findings.
No accounting for taste: Palatability of variably defended Caribbean sponge species is unrelated to predator abundance

Abstract The antipredatory chemical ecology of Caribbean reef sponges has been well studied, with two distinct ecological strategies described: chemically defended species use secondary metabolites to deter fish predators, while palatable species lack chemical defenses, but grow, reproduce, or recruit fast enough to persist despite predation. While most palatable sponge species are consistently undefended from fish predators in laboratory feeding assays, there are some species that exhibit individual inter- and intra-site variation ranging from palatable to defended. The objective of this study was to better document the extent of chemical defense variability for 7 of these species over a wider geographic range and to test the dual hypotheses that variably defended sponge species would be (1) more palatable, and (2) exhibit greater variability in chemical defenses from reefs without sponge predators than from reefs where predators are abundant. Laboratory feeding assays using the bluehead wrasse confirmed intraspecific variability of chemical defenses for Clathria virgultosa, Cribrochalina vasculum, Desmapsamma anchorata, Dragmacidon reticulata, Iotrochota birotulata, Niphates digitalis, and Xestospongia muta for sites across the Caribbean. Surprisingly, logistic regression models relating levels of sponge chemical defense to a site-specific index of spongivorous fish abundance offered little support for the hypothesis that predator abundance alters palatability for any of these variably defended sponge species. The presence of symbiotic zoanthids in the tissue of I. birotulata and N. digitalis did not alter palatability. While the selective effect of predation has segregated most species of Caribbean reef sponges into chemically defended and undefended categories, this study concludes that the situation is more complex for variably defended sponge species, and suggests that automimicry is a possible explanation for this alternative strategy.