cssi/SciSciGPT-SciSciNet huggingface dataset:
Set-valued optimization in welfare economics

This paper mainly concerns applications of advanced techniques of variational analysis and generalized differentiation to nonconvex models of welfare economics with finite-dimensional and infinite-dimensional commodity spaces. We pay special attention to establishing new relationships between necessary conditions in multiobjective/set-valued optimization and appropriate extensions of the second fundamental theorem of welfare economics to nonconvex economies with general preference relations. The variational approach developed in this paper allows us to obtain new necessary conditions for various types of local optimal solutions to constrained multiobjective problems and to derive from them new versions of the second welfare theorem applied to Pareto as well as weak, strict, and strong Pareto optimal allocations of nonconvex economies under certain qualification conditions developed in the paper. We also establish relationships of the latter conditions with some versions of Mas-Colell’s uniform properness.
Left Ventricular Mechanical Dyssynchrony in Acute Onset Cardiomyopathy: Association of Its Resolution With Improvements in Ventricular Function

Objectives The purpose of this study was to evaluate mechanical dyssynchrony in patients with acute onset cardiomyopathy with narrow QRS interval, and its association with improvements in left ventricular (LV) function. Background LV dyssynchrony has been usually studied in patients with chronic heart failure and wide QRS in the context of cardiac resynchronization therapy. Methods We studied 201 patients enrolled in the IMAC-2 (Inflammatory Mediators in Acute Cardiomyopathy) trial with recent onset nonischemic cardiomyopathy and ejection fraction Results Although mean QRS was narrow (98 ± 21 ms), 108 (54%) acute cardiomyopathy patients had significant LV dyssynchrony at presentation: opposing wall delay 89 ± 51 ms, versus 35 ± 11 ms in controls, and 12-site standard deviation 43 ± 23, versus 24 ± 8 ms in controls (p Conclusions Mechanical dyssynchrony was observed in a significant number of patients with acute onset cardiomyopathy, despite having a narrow QRS interval. Resolution of dyssynchrony associated with improvements in LV function occurred in the large majority of these patients.
On Consensus-Disagreement Tradeoff in Distributed Optimization

Distributed optimization has been a significantly important topic in recent multi-agent networked systems research for a variety of real-life applications. Most of the previous works are focused on how to find the globally optimal solution under certain assumptions on the objective functions as well as the agent interaction characteristics. However, in many practical problems (specifically, where agents form multiple sub-groups smaller than the overall multi-agent system based on commonalities of objective functions or nature of connectivity), globally optimal solution may not be very useful and quite difficult to achieve. Achieving multiple local optimal solutions for different sub-groups may be more useful in these cases. In this context, this paper presents a new distributed optimization problem formulation by introducing a modified cost function involving a parameter that controls the tradeoff between consensus and disagreement enabling realization of the entire spectrum of globally optimal solution to multiple locally optimal solutions. A distributed generalized consensus-based gradient (DGCG) algorithm is proposed to solve such an optimization problem for strongly convex objective functions. We show the convergence analysis of the proposed algorithm and two illustrative numerical examples for validating the methodology.
Freeze-casting porous chitosan ureteral stents for improved drainage

As a new strategy for improved urinary drainage, in parallel to the potential for additional functions such as drug release and self-removal, highly porous chitosan stents are manufactured by radial, bi-directional freeze-casting. Inserting the porous stent in to a silicone tube to emulate its placement in the ureter shows that it is shape conforming and remains safely positioned in place, also during flow tests, including those performed in a peristaltic pump. Cyclic compression tests on fully-hydrated porous stents reveal high stent resilience and close to full elastic recovery upon unloading. The drainage performance of the chitosan stent is evaluated, using effective viscosity in addition to volumetric flow and flux; the porous stent's performance is compared to that of the straight portion of a commercial 8 Fr double-J stent which possesses, in its otherwise solid tube wall, regularly spaced holes along its length. Both the porous and the 8 Fr stent show higher effective viscosities, when tested in the silicone tube. The performance of the porous stent improves considerably more (47.5%) than that of the 8 Fr stent (30.6%) upon removal from the tube, illustrating the effectiveness of the radially aligned porosity for drainage. We conclude that the newly-developed porous chitosan ureteral stent merits further in vitro and in vivo assessment of its promise as an alternative and complement to currently available medical devices. STATEMENT OF SIGNIFICANCE: No papers, to date, report on porous ureteral stents, which we propose as a new strategy for improved urinary drainage. The highly porous chitosan stents of our study are manufactured by radial, bi-directional freeze casting. Cyclic compression tests on fully-hydrated porous stents revealed high stent resilience and close to full recovery upon unloading. The drainage performance of the chitosan is evaluated, using effective viscosity in addition to volumetric flow and flux, and compared to that of the straight portion of a commercial 8 Fr double-J stent. The performance of the porous stent improves considerably more (47.5%) than that of the 8 Fr stent (30.6%) upon removal from the tube, illustrating the effectiveness of the radially aligned porosity for drainage. While further studies are required to explore other potential benefits of the porous stent design such as antimicrobial behavior, drug release, and biodegradability, we conclude that the newly-developed porous chitosan ureteral stent has considerable potential as a medical device.
Query Ambiguity Revisited: Clickthrough Measures for Distinguishing Informational and Ambiguous Queries

Understanding query ambiguity in web search remains an important open problem. In this paper we reexamine query ambiguity by analyzing the result clickthrough data. Previously proposed clickthrough-based metrics of query ambiguity tend to conflate informational and ambiguous queries. To distinguish between these query classes, we introduce novel metrics based on the entropy of the click distributions of individual searchers. Our experiments over a clickthrough log of commercial search engine demonstrate the benefits of our approach for distinguishing informational from truly ambiguous queries.
Preexisting Commensal Dysbiosis Is a Host-Intrinsic Regulator of Tissue Inflammation and Tumor Cell Dissemination in Hormone Receptor–Positive Breast Cancer

It is unknown why some patients with hormone receptor-positive (HR+) breast cancer present with more aggressive and invasive disease. Metastatic dissemination occurs early in disease and is facilitated by cross-talk between the tumor and tissue environment, suggesting that undefined host-intrinsic factors enhance early dissemination and the probability of developing metastatic disease. Here, we have identified commensal dysbiosis as a host-intrinsic factor associated with metastatic dissemination. Using a mouse model of HR+ mammary cancer, we demonstrate that a preestablished disruption of commensal homeostasis results in enhanced circulating tumor cells and subsequent dissemination to the tumor-draining lymph nodes and lungs. Commensal dysbiosis promoted early inflammation within the mammary gland that was sustained during HR+ mammary tumor progression. Furthermore, dysbiosis enhanced fibrosis and collagen deposition both systemically and locally within the tumor microenvironment and induced significant myeloid infiltration into the mammary gland and breast tumor. These effects were recapitulated both by directly targeting gut microbes using nonabsorbable antibiotics and by fecal microbiota transplantation of dysbiotic cecal contents, demonstrating the direct impact of gut dysbiosis on mammary tumor dissemination. This study identifies dysbiosis as a preexisting, host-intrinsic regulator of tissue inflammation, myeloid recruitment, fibrosis, and dissemination of tumor cells in HR+ breast cancer. SIGNIFICANCE: Identification of commensal dysbiosis as a host-intrinsic factor mediating evolution of metastatic breast cancer allows for development of interventions or diagnostic tools for patients at highest risk for developing metastatic disease.See related commentary by Ingman, p. 3539.
Gamma Knife Radiosurgery of Arteriovenous Malformations: Long-Term Outcomes and Late Effects

Gamma Knife radiosurgery (GKRS) of cerebral arteriovenous malformations (AVM) is an accepted treatment option that has been performed for more than 40 years. The goal of AVM GKRS is nidus obliteration to eliminate the risk of intracranial hemorrhage while minimizing the risk of short- and long-term adverse radiation effects (ARE). Nidus obliteration typically occurs between 1 and 5 years after GKRS. The most important factor associated with nidus obliteration is the prescribed radiation dose. The chance of obliteration ranges from 60 to 70% for margin doses of 15-16 Gy to 90% or more for margin doses of 20-25 Gy. Neurologic decline after GKRS can occur from either hemorrhage or ARE. Numerous studies have shown that the risk of AVM bleeding is either unchanged or decreased following GKRS. Advances in neuroimaging and dose-planning software have reduced the incidence of early ARE to <4%. Volume-staged procedures can be safely performed for large-volume AVM that were previously considered too large for GKRS. Late ARE (generally cyst formation) are common in patients who develop early MRI imaging changes (areas of high T2 signal) after GKRS, but most cases can be managed with either observation or resection of the thrombosed AVM.
Towards high Voc, thin film, homojunction WS2 solar cells for energy harvesting applications

Transition metal dichalcogenides (TMDs) are great candidates for thin film photovoltaic cells due to their high absorption coefficient. WS2, with a band gap of 1.57 eV, is specifically attractive for applications where high open-circuit voltage (Voc) is required. However, due to strong Fermi level pinning at the contacts, Voc is nearly zero if a standard metal contact scheme is used on intrinsic WS2. In this work, for the first time, we achieve a record high Voc of 335 mV by using AlOx and MoOx for n and p doping of WS2, respectively.
Compensatory growth offsets poor condition in native trout populations

Compensatory growth—when individuals in poor condition grow rapidly to catch up to conspecifics—may be a mechanism that allows individuals to tolerate stressful environmental conditions, both abiotic and biotic. This phenomenon has been documented fairly widely in laboratory and field experiments, but evidence for compensatory growth in the wild is scarce. Cutthroat trout (Oncorhynchus clarkii subsp.) are cold‐water specialists that inhabit montane streams in western North America where seasonal conditions can be harsh and growth rates vary greatly among seasons. Understanding if individuals compensate for periods of reduced growth and body condition will improve understanding of the requirements of fish throughout their life‐cycle and across freshwater habitats. We quantified compensatory growth of juvenile cutthroat trout using extensive mark–recapture data from 11 stream populations (1,125 individuals) and two subspecies inhabiting a wide range of ecological settings in the northern Rocky Mountains, U.S.A. Our objectives were to determine how growth was linked across seasons and whether individuals behaviourally compensated for depressed body condition via emigration. Fish in relatively poor condition consistently demonstrated compensatory growth in mass during subsequent seasons. In contrast, fish in relatively better condition responded with positive growth in length during the summer signalling these fish may be better suited to headwater environments; no compensatory growth in length was found during the winter. Furthermore, there was no evidence that individual condition mediated migration tendencies of fish to seek more favourable habitat. Across a wide range of environmental conditions, we found consistent empirical support for compensatory growth in mass in the wild. A critical next step is to quantify how changing abiotic and biotic conditions influence the ability of stream fishes to compensate for locally or seasonally challenging conditions, thereby affecting long‐term resiliency, viability, and adaptation in the face of changing environmental conditions.
Enforcing access restrictions to fishery zones

Fisheries conservation requires restricting access to countries’ exclusive economic zones (EEZs), which is costly to monitor and enforce. A new analysis shows that unauthorized foreign fishing is indeed substantially lower just inside the EEZ boundary compared with just outside.
Tongue pellet tracking by ultrasound: development of a reverberation pellet

Abstract: Using a water bath phantom designed to simulate the tongue, various substances were scanned to determine their usefulness as a point marker during ultrasound scanning of the oral cavity. The “comet-tail” reverberation artifact was visible when generated from stainless steel pellets placed at the water–air interface of the phantom. This reverberation artifact was also visible projected over the air in the oral cavity when these pellets were placed on the tongue surface of a normal volunteer. Using the reverberation artifact as a point indicator, it was possible to track the excursions during speech of two pellets placed on the tongue surface and one pellet placed on the anterior floor of the mouth. It is now possible, using ultrasound imaging of the tongue during speech, to display simultaneously in real-time, the change in configuration of the tongue surface, the alteration in position of the oral cavity internal musculature and, with the development of this reverberation pellet, movement of selected points on the tongue.
Hedonic eating behaviors and food preferences associated with medication-assisted treatment for opioid use disorder.

Objective: To characterize hedonic eating behaviors such as sugar cravings, food preferences, and appetitive responsiveness for sweet and hyper-palatable foods, and to determine the prevalence of addictive like eating behaviors and food addiction (FA) in individuals receiving medication-assisted treatment (MAT) for opioid use disorder (OUD) . Design: Quasi-experimental . Setting: Outpatient MAT center . Participants: Nonpregnant adult patients undergoing MAT (n = 116) receiving either buprenorphine/naloxone or methadone for at least 6 months . Main outcome measures: Hedonic eating, FA, and food craving . Results: Of the aggregate sample, 13.3 percent met criteria for FA. More than onethird of all subjects endorsed consuming larger amounts of highly palatable food than intended, unsuccessful attempts to quit or cut down on eating such foods, and a great deal of time spent on consuming or recovering from consuming such foods. Both medication groups demonstrated greatest cravings for sweets and fast foods followed by carbohydrates and fats (p < 0.001). Similarly, subjects reported “giving in” most frequently to sweets and fast foods followed by carbohydrates then fats (p < 0.001). Greater appetitive responsiveness was noted in the presence of hyper-palatable foods. No group differences were found. Weight change was not associated with addictive like eating, food craving, or appetitive responsiveness . Conclusions: Individuals receiving MAT exhibit preferences for sweet and fast foods that appear to be influenced by the proximity of such foods. FA was present. Collectively, such eating behaviors and food preferences may pose additional adverse health consequences and associated co-morbidities. This underlies the importance of comprehensive healthcare for patients with OUD, including nutrition education and evaluation of eating behaviors and food preferences .
Cullin 4-DCAF Proteins in Tumorigenesis

Cullin-RING ligase 4 (CRL4), a member of the cullin-RING ligase family, orchestrates a variety of critical cellular processes and pathophysiological events. Recent results from mouse genetics, clinical analyses, and biochemical studies have revealed the impact of CRL4 in development and cancer etiology and elucidated its in-depth mechanism on catalysis of ubiquitination as a ubiquitin E3 ligase. Here, we summarize the versatile roles of the CRL4 E3 ligase complexes in tumorigenesis dependent on the evidence obtained from knockout and transgenic mouse models as well as biochemical and pathological studies.
Denoising Wearable Armband ECG Data Using the Variable Frequency Complex Demodulation Technique

We propose a novel electrocardiogram (ECG) denoising technique using the variable frequency complex demodulation (VFCDM) algorithm. We used VFCDM to perform the sub-band decomposition of the noise-contaminated ECG to remove the noise components so that accurate QRS complexes could be identified. The ECG quality was further improved by removing baseline drift and smoothing via adaptive mean filtering. The proposed method was validated on the MIT-BIH arrhythmia database (MITDB) and wearable armband ECG data. For the former, we added Gaussian white noise to the ECG signals at different signal-to-noise ratios and the denoising performance of the proposed method was compared with other denoising techniques. The proposed approach showed superior denoising performance compared to the other methods. We compared the QRS complex detection performance of the noisy to the denoised armband ECG. The performance of the proposed denoising method on the armband ECG resulted in comparable QRS complex detection as that obtained when using Holter monitor ECG signals. This demonstrates that the proposed algorithm can significantly increase the amount of usable armband ECG data, which would otherwise have been discarded due to electromyogram contamination especially during arm movements. Hence, the proposed algorithm has the potential to enable long-term monitoring of atrial fibrillation using the armband without the discomfort of skin irritation often experienced with Holter monitors.Clinical Relevance— The proposed ECG denoising method can significantly increase the ECG quality of wearable ECG devices, which are more susceptible to muscle and motion artifacts.
Modeling Atlantic herring fisheries as multiscalar human-natural systems

Abstract Fisheries contribute to food and nutrition security, livelihoods, and poverty alleviation for billions of people globally. However, human-environmental interactions in fisheries are rarely assessed locally, regionally, and globally at the same time, limiting social-ecological resilience in fisheries management. We evaluated worldwide catches of a keystone forage fish (Atlantic herring, Clupea harengus) over 65 years (1950–2014); modeled local, regional, and global interactions among industrial, artisanal, subsistence, and recreational fishing sectors; and predicted future catches using a multifaceted and multilayered human-nature coupling framework for assessing social-ecological interactions within and across adjacent and distant fisheries (termed “metacouplings”). Across 17 exclusive economic zones (EEZs), catches by nations in their own EEZs (7.1 × 107 metric tons [MT]) outweighed those in adjacent EEZs (5.3 × 107 MT). However, adjacent-EEZ fishing was the largest-tonnage fishing type in more EEZs (53 %), reflecting the proximity of Northern/Western European fishing nations and regulations conducive to fishing in neighboring waters. Catches in distant (non-adjacent) EEZs were relatively small (1.2 × 107 MT). Fishing-sector interactions were generally positive but notably negative for artisanal fishing, which declined with increasing industrial and recreational catches in five EEZs (29 %). Combined with projected declines in artisanal and subsistence catches in parts of Germany, Norway, and Sweden, metacoupling interactions could elicit harmful financial, food-supply, and food/nutrition security outcomes for small-scale fishers if metacouplings remain absent from management programs. However, quantitative and conceptual tools developed herein enable fisheries managers to identify where, when, and how to maximize positive and minimize negative metacoupling interactions and thereby ensure continued ecological, economic, nutritional, and sociocultural benefits for fisheries stakeholders, locally to globally.
An Arbitration Agenda for the Biden Administration

In recent decades, increased use of forced arbitration provisions has blunted the impact of regulatory schemes that are enforced through private civil litigation. The major institutional driver of expansions in arbitration law has been the Supreme Court. But federal administrative agencies and executive departments can play an important, if underappreciated, role in addressing harmful uses of arbitration. This essay - prepared for the University of Illinois Law Review's symposium on the Biden administration’s first 100 days - highlights the tools available to agencies and executive departments to address the effects of forced arbitration and offers suggestions for how they might be used. Executive branch action alone cannot undo all of the arbitration’s effects on private regulatory enforcement; but it can do much to restore this engine of the U.S. legal system.
Advances in the Conceptualization and Measurement of Critical Consciousness

This article reviews three emergent measures of critical consciousness (CC), which refers to marginalized or oppressed people’s critical reflection on oppressive social, economic, or political conditions, the motivation to address perceived injustice, and action taken to counter such injustice in a liberatory manner (Freire in Education for critical consciousness. Continuum, New York, 1973; Watts et al. in New Dir Child Adolesc Dev 134:43–57, 2011). Until recently, no instruments were explicitly designed to measure CC, resulting in fragmented approaches to its conceptualization and measurement. The concurrent development and validation of three measures—the Measure of Adolescent Critical Consciousness (McWhirter and McWhirter 2016), the Critical Consciousness Inventory (Thomas et al. in J Res Adolesc 24(3):485–496, 2014), and the Critical Consciousness Scale (Diemer et al. in press)—represents a significant scholarly advance. We argue that these new measures provide a ‘conceptual anchor’ for subsequent CC inquiry, useful for both quantitative and qualitative studies. We also recommend mixed-methods approaches to research aimed at understanding how CC develops and operates. We conclude by raising a number of questions to guide future research, the answers to which will further refine scholars’ conceptualization and measurement of CC.
The Role of Ethnopharmacology in Drug Development

There are 119 drugs of known structure that are still extracted from higher plants and used globally in allopathic medicine. About 74% of these were discovered by chemists who were attempting to identify the chemical substances in the plants that were responsible for their medical uses by humans. These 119 plant-derived drugs are produced commercially from less than 90 species of higher plants. Since there are at least 250,000 species of higher plants on earth, it is logical to presume that many more useful drugs will be found in the plant kingdom if the search for these entities is carried out in a logical and systematic manner. The first and most important stage in a drug development programme using plants as the starting material should be the collection and analysis of information on the use(s) of the plant(s) by various indigenous cultures. Ethnobotany, ethnomedicine, folk medicine and traditional medicine can provide information that is useful as a 'pre-screen' to select plants for experimental pharmacological studies. Examples are given to illustrate how data from ethnomedicine can be analysed with the aim of selecting a reasonable number of plants to be tested in bioassay systems that are believed to predict the action of these drugs in humans. The ultimate goal of ethnopharmacology should be to identify drugs to alleviate human illness via a thorough analysis of plants alleged to be useful in human cultures throughout the world. Problems and prospects involved in attaining this goal are discussed.
The Micro-Economics of 'Surplus Labor

This paper examines the apparent conflict between the classical assumption of a bargaining agricultural sector wage and the neoclassical assumption of a competitive wage in the context of a labor surplus developing economy. It concludes that the relatively inelastic supply of labor hours offered by low income small or landless farmers in the static micro-economic leisure/work context is perfectly consistent with the persistence for some time of an institutional real wage offered to the non-agricultural sector of the dual economy. Empirical evidence is brought to bear in support of that position.
To Whom Do We Refer When We Speak of Obligations to "Future Generations"? Reproductive Rights and the Intergenerational Community

for granted that there will be future generations to have interests. It is, in other words, wrong to despoil the environment or fail to keep the social security system solvent because our children, grandchildren, and their descendants will inhabit this earth and have basic needs that will go unfulfilled if we do not maintain our world in habitable condition. As long as people continue to exist, there are things they will need to survive and thrive, and it is generally understood to be our obligation—as current inhabitants of the planet—to live in a manner consistent with their survival and thriving.
Statistical parsing with a context-free grammar and word statistics

We describe a parsing system based upon a language model for English that is, in turn, based upon assigning probabilities to possible parses for a sentence. This model is used in a parsing system by finding the parse for the sentence with the highest probability. This system outperforms previous schemes. As this is the third in a series of parsers by different authors that are similar enough to invite detailed comparisons but different enough to give rise to different levels of performance, we also report on some experiments designed to identify what aspects of these systems best explain their relative performance.
Signaling eco-certification: Implications for service coproduction and resource efficiency

Purpose – The purpose of this paper is to use an eco-friendly service concept framework to demonstrate the effect of credible eco-certification signaling. Design/methodology/approach – The authors examine a cross-sectional data set consisting of 2,481 hotel sites across the US. The authors measure the performance of the operations component of eco-friendly service by operations-driven resource efficiency (ODF), and the performance of the marketing component by customer-driven resource efficiency (CDF). A series of multivariate regressions compare these two resource efficiency measures between credibly eco-certified hotel sites and others. Findings – The results indicate that credible eco-certifications achieve the signaling effect. Eco-certified hotels outperform others in both ODF and CDF measures; and eco-certified hotels still achieve higher CDF after controlling for ODF. Practical implications – The findings suggest that eco-friendly service design requires not only eco-friendly operations but also a ...
Analysis of the role of membrane polarity in polycystic kidney disease of transgenic SBM mice

Altered membrane polarity has been proposed as an important pathogenetic factor in the development of renal cysts in polycystic kidney disease. To determine whether this alteration in epithelial phenotype is a primary or secondary phenomenon, we examined the epithelial membrane polarity of SBM transgenic mice, in which epithelial proliferation mediated by the c-myc oncogene is an established primary event. Kidneys from 32 transgenic mice and 10 age-matched controls from fetal to adult age were immunostained with antibodies to Na,K-ATPase, fodrin, ankyrin, E-cadherin, and tubule segment-specific lectins. In normal control mice, Na,K-ATPase localization was apical in fetal kidneys but became translocated to the basolateral membrane at maturity. Early microcysts in fetal transgenic kidneys displayed similar (95 to 100%) apical Na,K-ATPase. In young and newborn transgenic mice (1 to 8 days of age), Na,K-ATPase localization was extremely heterogeneous. Noncystic tubules demonstrated either apical (mean 23 to 28%), basolateral (mean 48 to 58%), mixed (mean 4 to 15%), or absent (mean 10 to 13%) staining for Na,K-ATPase. Apical Na,K-ATPase was more frequently observed in early cysts (mean 55%) in young transgenic mice but became less prevalent in adult mice (mean 22%), where 30% of cysts had basolateral staining, 39% mixed patterns, and 9% absent staining. Macrocysts typically lost all Na,K-ATPase reactivity. At all ages, Na,K-ATPase colocalized well with cytoskeletal proteins ankyrin and fodrin. These heterogeneous patterns of Na,K-ATPase staining indicate that although altered cell polarity is frequent in early cystic epithelium of SBM mice, it is not a prerequisite to cystogenesis or progressive cyst enlargement. In conclusion, our results support the view that altered cystic membrane polarity is not a primary process, but represents the persistence of an immature epithelial phenotype characteristic of proliferative polycystic kidney disease epithelia.
Nursing, System Design, and Health Care Quality

OCTOBER 2009, VOL 90, NO 4 • AORN JOURNAL • 581 he consequences of medical errors and poor health care quality affect our lives directly and indirectly. Most physicians, nurses, and other health care workers have had firsthand experiences with near errors, adverse events, or care of such poor quality that it should never have been delivered to a patient. Adverse events, in particular, can be traumatic for the caregiver as well as for the patient and his or her family. Unfortunately, when errors occur or the quality of care is poor, a natural instinct is to look for someone to blame. Oftentimes, the blame falls to a nurse, despite the fact that system design factors, not human factors, actually comprise the majority of errors and poor quality care. System design factors are often to blame for errors and poor quality in the OR. Unfortunately for those who work in the OR, this setting is often less visible than other care settings. To many observers, the OR remains a place of mystery—even to those who work in other health care settings. The doors are closed, the patient is anesthetized, and there are no visitors. No one is watching. If the perioperative nurse does not speak up on behalf of the patient, it is quite possible that nobody will. This places tremendous responsibility and stress on perioperative nurses. Nurses protect patients in so many ways. In the OR, this responsibility can include maintaining the sterile field to guard against infection, speaking up during a procedure to prevent an error, and assessing and managing pain. These are duties of enormous importance that ultimately place nurses at the “sharp end” of patient care; thus, they bear the responsibility to intercept an error. This position is untenable unless systems are put in place to lessen the likelihood that human error—which is inevitable—will turn into medical error, which is not. System design factors present the potential for many errors; therefore, we must work diligently to improve system design. To prevent adverse events and ensure higher quality care, the systems in which we work need to be adapted to reflect our human strengths and weaknesses. They also should be designed to ameliorate the effects of whatever human error occurs.
TASK PROTOCOL SPECIFICATION: A WORKSTATION INDEPENDENT SPECIFICATION TECHNIQUE FOR HUMAN-COMPUTER INTERACTION

Methods of specification for human-computer interfaces (HCI) are diverse. Commonly used methods include (augmented) transition networks, BNF grammars, event-based descriptions, and the command language grammar [Moran81]. The latter is especially useful for its task-based description of the conceptual model as well as the dialogue. The Command Language Grammar (CLG) begins with a task analysis, and proceeds to model the HCI structurally through a process of step-wise refinement. The result is a detailed specification or representation of the system.
The effects of hemispatial and asymmetrically focused attention on dichotic listening with normal and learning-disabled children.

Abstract The effects of hemispatial and focused attention were examined with 50 normal and learning-disabled children to determine the extent of these two attentional strategies influenced perceptual laterality as reflected by the dichotic listening right-ear advantage (REA). Twenty-five children (8 females, 17 males, mean age 9.10 yr) matched with 25 learning-disabled children (8 females, 17 males, mean age 10.1 yr) were administered a dichotic consonant-vowel (CV) and consonant-vowel-consonant (CVC) syllable task. The two types of stimuli were compared across focused attention (free report, focused left, focused right) and hemispatial (central, left hemispace, right hemispace) conditions implemented independently and in systematic combinations. A four-factorial analysis of variance (groups x stimuli x conditions x ears) resulted in a significant REA for normal children across all attentional conditions whereas learning-disabled did not produce a consistent REA across all attentional conditions, and in several instances, produced equivalent left and right hemisphere processing. Right hemispatial orientation increased the magnitude of the REA (i.e., left hemisphere processing) for both groups, whereas left hemispatial orientation increased the magnitude of the left ear report (i.e., right hemisphere processing) only in learning-disabled subjects. Focused attention to the right ear also increased left hemisphere efficiency for both groups of children; however, focused attention to the left ear produced symmetrical functioning by learning-disabled subjects. Congruent combinations of focused attention and hemispatial orientation were not found to enhance the REA beyond its magnitude when each strategy was assessed independently. When focused attention and hemispatial conditions were employed in opposing directions, normal children were more susceptible to the “rightward” direction regardless of the strategy whereas learning-disabled subjects were more susceptible to the “verbal” nature of the strategy. Higher overall processing performance was exhibited for CVC stimuli when compared to CV stimuli. These findings lend support to the hypothesis that hemispatial and asymmetrically focused attention strategies interact with structural mechanisms in producing the observed REA in dichotic listening and do so differentially for normal and learning-disabled children.
The Temporal-Interactive Influence of Reading Achievement and Reading Attitude.

Although the relationship between attitudes toward reading and reading achievement has been well documented, the causal relationship between these constructs remains unclear.Using longitudinal covariance structure modeling, this study tested the hypothesis that 3 reading-related constructs in the primary grades (2nd-3rd grade) – reading attitude, behavior, and achievement – would predict reading achievement in the 7th grade. Results showed that primary attitude was not correlated with primary achievement yet both had causal paths to 7th-grade achievement, described as a “temporal-interaction” model. The resulting model suggests that while reading attitude and achievement may appear unrelated at the early stages of reading they become more closely linked over time, developing into important causal determinants of reading achievement by early adolescence.
Birth weight and the risk of testicular cancer: A meta-analysis

The high incidence of testicular cancer in young males indicates a potential role of events during early life. Birth weight has been identified as a factor possibly associated with the risk of cancers later in life. To investigate the association between birth weight and testicular cancer, we conducted a Systematic Review and Meta-Analysis of published studies investigating the association between birth weight and testicular cancer. Data were combined using a fixed-effects model. Thirteen epidemiologic studies, published between 1983 and 2004, were included in the analysis, encompassing 5,663 patients with testicular cancer. Men weighing less than 2,500 grams at birth had a higher risk for developing testicular cancer later in life than those with normal birth weight (2,500-4,000 g) (OR = 1.18; 95% confidence interval (CI) 1.01-1.38). A similar trend was found for men with a birth weight above 4,000 g, (OR = 1.12; 95% CI 1.02-1.22). When seminoma and nonseminoma testicular cancer cases were considered separately, low birth weight was a risk factor specifically for seminomas (OR = 1.44; 95% CI 1.11-1.88). A U-shaped association was observed between birth weight and the risk for testicular cancer. The underlying biological mechanisms for this phenomenon remain to be elucidated.
The Online STEM Classroom—Who Succeeds? An Exploration of the Impact of Ethnicity, Gender, and Non-traditional Student Characteristics in the Community College Context

Objective:This study analyzes how ethnicity, gender, and non-traditional student characteristics relate to differential online versus face-to-face outcomes in science, technology, engineering, and mathematics (STEM) courses at community colleges.Method:This study used a sample of 3,600 students in online and face-to-face courses matched by course, instructor, and semester from a large urban community college in the Northeast. Outcomes were measured using rates of successful course completion (with a “C−” or higher). Multilevel logistic regression and propensity score matching were utilized to control for unobserved heterogeneity between courses and for differences in student characteristics.Results:With respect to successful course completion, older students did significantly better online, and women did significantly worse (although no worse than men) online, than would be expected based on their outcomes in comparable face-to-face courses. There was no significant interaction between the online medium a...
Children of fathers with phenylketonuria: An international survey

Although considerable data are available regarding the outcome of children born to mothers with phenylketonuria, less is known about the effect of paternal PKU. Fischet al. ~ found an inverse relationship between the sperm count and semen volume in male subjects with PKU and their serum phenylalanine levels. Published data on children of fathers with PKU are limited. 29 Therefore an international survey was carried out among metabolic clinics to study the status of children of fathers with PKU. The purpose of this study was threefold: first, to determine the outcome of children of fathers with PKU; second, to establish the ability of men with PKU to produce children; and finally, but not least important, to compare the children of PKU fathers and the children of PKU mothers to examine whether genetic as well as metabolic factors are responsible for the high incidence of abnormalities among the offspring of mothers with PKU.
Patient Registration Using Intraoperative Stereovision in Image-guided Open Spinal Surgery

Despite its widespread availability and success in open cranial neurosurgery, image-guidance technology remains more limited in use in open spinal procedures, in large part, because of patient registration challenges. In this study, we evaluated the feasibility of using intraoperative stereovision (iSV) for accurate, efficient, and robust patient registration in an open spinal fusion surgery. Geometrical surfaces of exposed vertebrae were first reconstructed from iSV. A classical multistart registration was then executed between point clouds generated from iSV and preoperative computed tomography images of the spine. With two pairs of feature points manually identified to facilitate the registration, an average registration accuracy of 1.43 mm in terms of surface-to-surface distance error was achieved in eight patient cases using a single iSV image pair sampling 2–3 vertebral segments. The iSV registration error was consistently smaller than the conventional landmark approach for every case (average of 2.02 mm with the same error metric). The large capture ranges (average of 23.8 mm in translation and 46.0° in rotation) found in the iSV patient registration suggest the technique may offer sufficient robustness for practical application in the operating room. Although some manual effort was still necessary, the manually-derived inputs for iSV registration only needed to be approximate as opposed to be precise and accurate for the manual efforts required in landmark registration. The total computational cost of the iSV registration was 1.5 min on average, significantly less than the typical ∼30 min required for the landmark approach. These findings support the clinical feasibility of iSV to offer accurate, efficient, and robust patient registration in open spinal surgery, and therefore, its potential to further increase the adoption of image guidance in this surgical specialty.
Neurodegenerative disease: cut to the chase.

A family of enzymes called caspases — best known for their involvement in programmed cell death — now seems to be pivotal in the progression of two neurodegenerative diseases.
Cystic dysplasia of the rete testis : A benign congenital lesion associated with ipsilateral urological anomalies

AbstractPurpose: Cystic dysplasia of the rete testis is a benign congenital lesion that can mimic testicular cancer. We report 6 cases, review the literature, discuss the embryological etiology and make management recommendations.Materials and Methods: The records and pathology reports of 6 boys presenting with cystic dysplasia of the rete testis at 5 institutions were reviewed, as was the relevant literature.Results: Of the 6 cases 5 presented as scrotal masses in previously healthy boys and 1 as an abdominal mass in a newborn with multiple congenital anomalies. One patient had been followed from birth for a multicystic dysplastic kidney and 4 were found to have an ipsilateral absent kidney during evaluation. Development of the contralateral side was normal in most cases.Conclusions: Cystic dysplasia of the rete testis is an unusual, benign congenital lesion that can mimic testicular cancer in presentation. The presence of ipsilateral renal anomalies, particularly renal agenesis, can suggest cystic dyspl...
Salmon heart triglycerides during spawning migration

Abstract 1. 1. Triglycerides (TG) were substantially elevated in heart lipids of pre-spawning Pacific salmon as compared to other marine fish sampled in the waters of British Columbia, Canada. 2. 2. Tracer studies with 14 C-palmitate showed that FFA was largely converted into TGFA in the heart of migrating salmon. 3. 3. In spawned-out salmon a striking reduction of TG in heart lipids revealed another facet of metabolic collapse of this species during the reproductive cycle. It is suggested that triglycerides occupy a more important function in heart metabolism than generally ascribed to them.
The effect of roentgen ray irradiation on normal, hypothyroid and hyperthyroid rats.

BLOUNT and Smith (1949) reported that the feeding of thyroid extract to normal mice increased the mortality rate after roentgen ray irradiation while thiouracil feeding decreased the rate under similar circumstances. They concluded that the increased mortality was the result of an increased metabolic rate rather than an increased body temperature. Brophy and McEachern (1949) have shown that thyroxin not only increases the basal metabolic rate of the intact animal, but also the oxygen consumption of isolated tissues from such an animal. It appears, therefore, that the hyperthyroid animal is more susceptible to roentgen ray irradiation damage because of an increased oxygen consumption. The production of a hypothyroid animal with thiouracil is complicated by the fact that thiouracil has a potential sulfhydryl group in its molecule, and thus any protective effect observed may result by virtue of the mechanism of sulfhydryl group protection postulated by Patt et al. (1949) for the cysteine protection of roentg...
Congenitally Corrected Transposition of the Great Arteries (CCTGA) Initially Presenting in the Sixth Decade

Adult congenital heart disease (ACHD) has become increasingly important in adult cardiology. A 54-year-old female presented with symptoms and signs of new onset heart failure. Echocardiography showed congenitally corrected transposition of the great arteries (CCTGA) with systolic dysfunction of the systemic right ventricle, ejection fraction was 15 to 20% and no other associated abnormalities. CCTGA is often missed in cardiology practice due to failure to recognize the abnormal position of the ventricles and the associated AV valves. One percent of patients with CCTGA are uncomplicated without VSD, PS or Ebstein's anomaly of the systemic AV valve; this was the case for our patient. Most patients present in early adulthood. The mechanism of systemic ventricular failure has been related to fibrosis due to oxygen supply and demand mismatch.
Dysphagia and associated respiratory considerations in cervical spinal cord injury.

Dysphagia, swallowing dysfunction, following traumatic cervical spinal cord injury (SCI) is an under-recognized complication that can lead to significant medical complications and morbidity. In a prospective study by Shem et al, the incidence of dysphagia in individuals with tetraplegia was as high as 40%.1 It is imperative to diagnose dysphagia early to initiate timely evaluation and treatment by speech pathologists and to prevent possible secondary pulmonary complications that can result from aspiration, which is a sequelae of dysphagia. The most common pulmonary complications of dysphagia are airway obstruction, chemical pneumonitis, and pneumonia. 2 Swallowing serves 2 important roles. It serves an alimentary role for nutrition. A vital, but likely underappreciated, function involves clearing the nasopharynx and oropharynx and the subsequent coordination to close the nasopharynx and larynx to prevent aspiration.3,4 Aspiration is the entry of material (such as oral secretions, food or drink, or stomach contents) from the oropharynx or gastrointestinal (GI) tract into the respiratory tract. The act of normal swallowing involves the extraordinary coordination and sequencing of more than 25 pairs of muscles in the mouth, pharynx, larynx, and esophagus.5 As classically described by Logemann et al,6 there are 3 phases to the swallowing process: oral, pharyngeal, and esophageal. The oral preparatory phase is under voluntary control and involves the formation of an alimentary bolus from the food consumed. The pharyngeal and esophageal phases, once initiated, are involuntary and irreversible. The pharyngeal phase is the shortest but most complex phase of swallowing, with several key events occurring simultaneously. This phase is initiated when the tongue and suprahyoid muscles propel the food bolus from the oral cavity into the pharynx. Soft palate elevation occurs to prevent nasopharyngeal regurgitation. The larynx moves to an elevated position, with an excursion approximately the distance of 1 cervical vertebra and half the length of the jaw. The epiglottis moves to a retroflexed position. The upper esophageal sphincter dilates to receive the food bolus, which transitions to the esophageal phase. The food bolus is propelled via peristalsis from cricopharyngeus to lower esophageal sphincter. Upon reflex relaxation of the lower esophageal sphincter, food enters the stomach.