cssi/SciSciGPT-SciSciNet huggingface dataset:
Generalist and Subspecialist Care for Children With Chronic Conditions

Objective.—To determine, among Medicaid-enrolled children with chronic conditions, associations of indicators of morbidity and expenditures with different patterns of generalist, subspecialist, and pediatric subspecialist use. Design and Setting.—Cross-sectional analysis of Medicaid claims, enrollment, and provider data from 4 states (California, Georgia, Michigan, and Tennessee). Sample.—All children enrolled in Supplemental Security Income (aged 0–21 years) and a sample of other Medicaid-enrolled children matched for age and gender. We included 11 chronic conditions, including both uncommon conditions (eg, spina bifida, hemophilia) and common ones (eg, asthma, attention deficit hyperactivity disorder). Main Outcome Measures.—We determined the number of visits per year to generalists and subspecialists (pediatric and other), using only subspecialists relevant to that condition. We categorized patterns of care as generalist only, predominantly generalist, or predominantly subspecialist, and examined patterns by condition and an indicator of morbidity. Among children seeing subspecialists, we also compared morbidity by pediatric and other subspecialists. We used linear regression to determine per-year total expenditures, controlling for demographic characteristics and morbidity. Results.—Most children (60.7%) saw generalists only. Twenty-eight percent were in predominantly generalist arrangements, and 11% were in predominantly subspecialist arrangements. Children in predominantly generalist arrangements had higher morbidity than children in generalist-only or predominantly subspecialist arrangements. Among children seeing subspecialists, those seeing pediatric subspecialists had generally higher morbidity than those seeing other subspecialists. Mean yearly expenditures varied from $1306 (attention deficit hyperactivity disorder) to $11 633 (acquired immunodeficiency syndrome). Children who saw only generalists had significantly lower expenditures for 6 of the 11 conditions, after adjusting for morbidity. Conclusions.—Medicaid-enrolled children in predominantly generalist arrangements appear to have more complicated conditions than children in generalist-only or predominantly subspecialist arrangements, engendering also higher expenditures. Although children who saw generalists only had lower expenditures than those seeing subspecialists, this finding may reflect unmeasured variations in morbidity.
Structural Effects of Methionine Oxidation on Isolated Subdomains of Human Fibrin D and αC Regions

Oxidation of key methionine residues on fibrin leads to altered fibrin polymerization producing severely altered fibrin gel structure and function. This is important because fibrinogen and its modification by oxidative stress have been implicated as key contributors to both pathological thrombotic and hemorrhagic diseases ranging from cardiovascular thrombosis to the acute coagulopathy of trauma. However, how oxidation leads to altered fibrin polymerization remains poorly understood at the molecular level. We have applied a powerful and novel well-tempered ensemble parallel tempering (PT-WTE) technique along with conventional molecular dynamics (MD) simulation to investigate the molecular-level consequences of selective methionine oxidation of fibrinogen. We offer new insights into molecular mechanisms of oxidation-induced changes in fibrin polymerization, while focusing on the D region knob ‘B’ and hole ‘b’ interaction and αC-domain interactions, both of which are hypothesized to contribute to the lateral aggregation mechanism of fibrin fibrils. Methionine oxidation did not alter the native state or the stability of a bound knob ‘B’ surrogate when interacting with hole ‘b’ in the D region. However, applying PT-WTE simulation to a human homology model of the bovine N-terminal subdomain fragment from the αC-domain revealed that methionine oxidation altered the conformation of the hairpin-linking region to favor open rather than closed hairpin structures. We attribute this alteration to the disruption of the hairpin-linking region's conformation, with oxidation increasing the radius of gyration for this segment. This result is in agreement with experimental data demonstrating decreased fibrin protofibril lateral aggregation when methionine oxidation is present in the same αC-domain fragment. Therefore, single methionine oxidation within the αC-domain is a likely molecular mechanism.
ANATOMIC VARIATIONS IN THE NUTRIENT FORAMINA OF THE EQUINE THIRD METATARSAL BONE IN TWO HORSES

An unusual presentation of the nutrient foramen of the third metatarsal bone (Mt-3) is described in two horses. In the first horse, the nutrient foramen was located ectopically in the dorsolateral cortex of Mt-3. The metatarsal nutrient foramina of the second horse were in the usual plantar location, but one was atypical in configuration. Clinical signs did not appear to be associated with these findings in either horse. The possibility of misdiagnosing a fracture rather than an ectopic nutrient foramen is discussed.
Extrinsic coronary artery obstruction by chronic aortic dissection.

Abstract Chronic type A aortic dissection due to cannulation injury is an unusual entity which in this patient was seen as extrinsic left main coronary artery obstruction four years following valve operation. This is an unusual manifestation of coronary artery involvement by dissection, and successful management did not require simultaneous myocardial revascularization. The clinical and pathological characteristics of this condition are presented, and the spectrum of lesions associated with iatrogenic dissection is reviewed.
Methodological issues in the interpretation of constituent order in Early East Slavonic sources

The material for this paper is drawn from Early East Slavonic sources of the eleventh to late fourteenth centuries, all from the city of Novgorod and its environs. The sources attest a diverse range of language use: they comprise items of correspondence, both private and public, and extracts from the Novgorod First Chronicle in the Synodal copy. The paper argues for an approach to the analysis of constituent order in such sources which gives priority to pragmatic rather than syntactic concepts. In the course of the article, three approaches which have been taken to the study of constituent order in Contemporary Standard Russian are discussed, with the aim of assessing their usefulness in relation to the language of pre-modern texts. These approaches are: the configurational approach found in King (1995), the transactional model of discourse set forth in Yokoyama (1986), and functional sentence perspective,1 as originally proposed by linguists of the Prague School and later developed with reference to Russian in works such as Adamec (1966) and Kovtunova (1969, 1976, 1980). Crucial to the argument of the paper is a distinction between theory and methodology. The latter is the principal focus of interest. The nature of the source material makes it impossible to construct a comprehensive and testable theory of clause organization in Early East Slavonic which is framed in pragmatic terms. However, the limitations imposed by the sources do not inevitably compromise the usefulness of pragmatic concepts and categories for elucidating the order of major clause constituents. Provided that the limitations are recognized and that the assumptions which must be made in order to circumvent them are acknowledged, a cogent methodology of pragmatic analysis can be developed. Although such an approach will necessarily leave many aspects of clause organization unaccounted for, it nevertheless has many advantages over analyses which proceed on a purely syntactic basis. The areas of difficulty which are discussed in sections 3-5 should not, it is argued, be allowed to overshadow the valuable insights into fundamental principles influencing clause organization in pre-modern texts which can be attained through the application of a careful and consistent methodology.
Evaluation of a Novel Statistical Method for EMG-to-Moment Estimation During Gait

Neuromusculoskeletal models have the potential to improve the design of clinical interventions for disorders such as stroke and osteoarthritis that affect walking function. Application of such models to clinical problems will likely require model customization to the unique anatomical and neurological conditions of each patient. Unfortunately, current modeling methods make model customization to patient data difficult, especially for model parameter values related to muscle-tendon models and musculoskeletal geometry [1]. Improved methods are needed so that patient-specific neural control capabilities and limitations can be easily incorporated into predictive gait optimizations to be used for intervention planning purposes.© 2012 ASME
Design of the commercial data masking facility data privacy algorithm

This paper presents the details of the new Commercial Data Masking Facility (CDMF) data privacy algorithm1. When implemented appropriately, products containing the CDMF algorithm can, in general, be freely exported from the United States. A short discussion of the requirements and rationale of the new algorithm is given.This paper is an abbreviated version of a paper scheduled to be published in the March 1994 issue of the IBM Journal of Research and Development. The full paper will include a more extensive discussion of the requirements and rationale as well as a discussion of its strength under various threat scenarios and testcases to help ensure a correct implementation.
Transcutaneous oximetry and skin surface temperature as objective measures of pressure ulcer risk.

OBJECTIVE To determine if transcutaneous oximetry and skin surface temperature could measure differences in skin perfusion between 2 groups of hospitalized patients: (1) those who made gross or subtle movements in bed, and (2) those who could not move. DESIGN A quasi-experimental design was used. SETTINGS AND PATIENTS A convenience sample of 38 subjects (17 males, 21 females) was selected from patients admitted to a neurological/neurosurgical critical care and step-down unit in a university health sciences center hospital. MAIN OUTCOME MEASURES Prepressure and postpressure oximetry and temperature readings were taken over the sacrum and recorded every minute for 15 minutes. Pressure was applied by positioning subjects on their backs for 2 hours; subjects were observed for gross or subtle movement. Oximetry measurements were taken and recorded every minute. RESULTS Paired t tests showed subjects who moved (n = 24) had a statistically significant difference between prepressure and postpressure temperature means over subjects who could not move (n = 14). Postpressure transcutaneous carbon dioxide (TcPCO2) mean levels were lower at all time-points and transcutaneous oxygen (TcPO2) mean levels were higher at most time-points in subjects who moved. Analysis of variance between the 2 groups during pressure showed a statistically significant difference in TcPCO2 levels, but not TcPO2 levels. CONCLUSIONS Both methods identified statistically significant differences in moving and nonmoving patients and may prove to be useful tools in assessing pressure ulcer risk. Further research with both methods across various patient populations is needed.
Depression and immune function

Clinical studies have demonstrated that measures of cell-mediated immune function are altered in bereaved persons and depressed patients. This review article focuses on our recent observations of changes in T cell subpopulations and natural killer cytotoxicity in women undergoing adverse life events including conjugal bereavement. A reduction in natural cytotoxicity has also been found in depressed patients. The mechanism by which psychologic states might influence immune function is discussed.
Electricity production from laser-driven fusion reactors: technological aspects of power conversion chambers

One of the most important considerations for laser driven fusion power plants is the safe and efficient operation of the chamber that contains the thermonuclear energy released from the target. Several approaches to the design of such a chamber are described in this paper and the critical issues associated with protection of the first wall, the performance of the structural materials, and the cost are discussed. Presently, the need for direct drive illumination of the cryogenic targets makes the use of liquid first wall protection problematical at best. The use of dry first walls protected with a few torr of an inert gas seems to hold the most promise.
R-Primary L-Representations of L-Ideals

We examine the basic properties of prime L-ideals, primary L-ideals, and R-radicals of L-ideals where L is a completely distributive lattice. We determine to what extent every L-ideal has an R-primary L-representation.
Chemically activated formation of organic acids in reactions of the Criegee intermediate with aldehydes and ketones

Reactions of the Criegee intermediate (CI, ˙CH2OO˙) are important in atmospheric ozonolysis models. In this work, we compute the rates for reactions between ˙CH2OO˙ and HCHO, CH3CHO and CH3COCH3 leading to the formation of secondary ozonides (SOZ) and organic acids. Relative to infinitely separated reactants, the SOZ in all three cases is found to be 48–51 kcal mol−1 lower in energy, formed via 1,3-cycloaddition of ˙CH2OO˙ across the CO bond. The lowest energy pathway found for SOZ decomposition is intramolecular disproportionation of the singlet biradical intermediate formed from cleavage of the O–O bond to form hydroxyalkyl esters. These hydroxyalkyl esters undergo concerted decomposition providing a low energy pathway from SOZ to acids. Geometries and frequencies of all stationary points were obtained using the B3LYP/MG3S DFT model chemistry, and energies were refined using RCCSD(T)-F12a/cc-pVTZ-F12 single-point calculations. RRKM calculations were used to obtain microcanonical rate coefficients (k(E)) and the reservoir state method was used to obtain temperature and pressure dependent rate coefficients (k(T, P)) and product branching ratios. At atmospheric pressure, the yield of collisionally stabilized SOZ was found to increase in the order HCHO < CH3CHO < CH3COCH3 (the highest yield being 10−4 times lower than the initial ˙CH2OO˙ concentration). At low pressures, chemically activated formation of organic acids (formic acid in the case of HCHO and CH3COCH3, formic and acetic acid in the case of CH3CHO) was found to be the major product channel in agreement with recent direct measurements. Collisional energy transfer parameters and the barrier heights for SOZ reactions were found to be the most sensitive parameters determining SOZ and organic acid yield.
Should I advertise on the interstate

Abstract The highway logo signing program has existed for over 20 years. Since its inception, most motorists have become accustomed to relying on these blue signs to provide information on services available at each highway exit. However, there is little, if any, literature that examines the program as an advertising source, and no formal literature that addresses the signing program from the perspective of the independent business owner. This paper provides service business owners with information about the highway logo signing program, and is directed toward independent owners who are considering the signing program as an advertising source. A five step process is described that owners can follow to first determine if the venue is viable, and then if the investment is value-added for them.
Beta-endorphin chimeric peptides: transport through the blood-brain barrier in vivo and cleavage of disulfide linkage by brain.

Water soluble peptides are normally not transported through the brain capillary wall, i.e. the blood-brain barrier (BBB). Chimeric peptides may be transportable through the BBB and are formed by the covalent coupling of a nontransportable peptide, e.g. β-endorphin, to a transportable peptide vector, e.g. cationized albumin, using disulfide-based coupling reagents such as iV-succinimidyl 3-[2-pyridyldithio(propionate)] (SPDP). The transcytosis of peptide into brain parenchyma, as opposed to vascular sequestration of blood-borne peptide, was quantified using an internal carotid artery perfusion/capillary depletion method. It is shown that [125I]β-endorphin is not transported through the BBB, but is rapidly cleaved to free [125I] tyrosine via capillary peptidase. Therefore, chimeric peptide was prepared using [125I] [D-Ala2]β-endorphin (DABE), owing to the resistance of this analogue to peptidase degradation. The [125I] DABE-cationized albumin chimeric peptide is shown to enter brain parenchyma at a rate com...
A statistical approach to model simplification and multiobjective analysis

Abstract Evolving national energy supply/demand distribution systems rely, at least in part, on quantifiable factors such as local and national environmental restrictions, resource availability (type, price, and quantity) and the associated transportation infrastructure, the amount and price of capital available to consumers and suppliers of energy, total annualized system cost, including the annualized cost of end-use devices, and the demands for energy and their price/supply responsiveness. The evolution also depends on nonquantifiable factors such as personal, regionally aggregated, or even national “utility functions” and institutional or social barriers. Many models have been formulated which attempt to simulate these complex interactions. This paper describes a systematic statistical methodology for capturing, both visually and quantitatively, the trade-offs between competing quantifiable, differentiable objective functions in a model of the national energy system (Brookhaven Energy System Optimization Model). The aim is to provide decision makers with a more easily understood tool and a more easily defensible methodology on which trade-offs between certain sensitive and competing energy issues can be based. The methodology has the additional advantage of providing insights into the inherent structural relationships of the model (model simplification).
Availability of phosphorus from feedstuffs fed to rainbow trout, Oncorhynchus mykiss

Abstract In this study, we determined both apparent and true availability of phosphorus (P) from feedstuffs fed to rainbow trout. Feedstuffs evaluated were anchovy meal, sardine meal, menhaden meal, herring meal, spray dried blood meal, flame dried blood meal, poultry by-product meal, canola meal, solvent-extracted soybean meal, full-fat soybeans, heat processed soybean meal, peanut meal, corn gluten meal and cottonseed meal. Barium carbonate was used as the indicator and fecal samples were collected by dissection. One of the diets containing canola meal and the diet containing cottonseed meal were poorly accepted and precluded calculation of a realistic P availability value. Both diets containing blood meal contained insufficient P concentrations for distinguishing between dietary and endogenous P. Apparent phosphorus availability (APA) values ranged from 19.5 to 50.5% for fish meals and as high as 30.7% for the plant protein sources. Endogenous P excretion averaged 225 mg kg −1 body weight and was used to correct APA values to true phosphorus availability (TPA). True P availability ranged from 21.5 to 55.4% for fish meals and 9.7 to 48.4% for the plant feedstuffs. Supplementation of plant protein sources with phytase significantly increased APA values to 46.2 to 75.6%. Endogenous secretions of P decreased over time, but clinical signs of P inadequacy did not occur until between 6 and 10 days of feeding a P-deficient diet.
Low-energy solution to the μ problem in gauge mediation

In the gauge-mediation framework the soft supersymmetry breaking mass parameters of the supersymmetric standard model are induced by the gauge interactions of some messenger fields. The parameters exhibit flavor universality which is dictated by the gauge interactions and which efficiently eliminates new dangerous contributions to flavor changing neutral currents. However, the Higgs potential in this framework typically contains an unacceptable hierarchy between its dimensionful parameters (the $\ensuremath{\mu}$ problem of gauge mediation). We show that the problem can be resolved if the Higgs potential arises dynamically once an intermediate ${U(1)}^{\ensuremath{'}}$ sector is integrated out rather than arising radiatively from some Yukawa interactions at the messenger scale. As an added benefit, such models may naturally avoid new contributions to $\mathrm{CP}$ violating amplitudes. The proposed framework is described, explicit examples are given and its phenomenology is explored. The $\ensuremath{\mu}$ problem is resolved in this case by the low-energy ${U(1)}^{\ensuremath{'}}$ dynamics which could be tested in future collider experiments.
Effect of Extended Surfactant Structure on Interfacial Tension and Microemulsion Formation with Triglycerides

In this work, the impacts of extended surfactant structure (number of polypropylene oxide PO groups and branching nature of the hydrocarbon chain) on microemulsion formation and IFT values were examined with triglyceride oils. The results show that branching of the hydrocarbon tail of extended surfactants lowers optimum salinity and IFT values. The results also show that for the surfactants studied ultralow IFTs and microemulsion formation with vegetable oils can be achieved using extended surfactants with at least eight PO groups.
Active site control of myosin cross-bridge zeta potential.

The electrical properties of contractile proteins contribute to muscle structure and perhaps function but have not been characterized adequately. Electrophoretic mobility, mu(e), is sensitive to the net electric charge and hydrodynamic size of a molecule in solution. Zeta potential, zeta, particle charge, Q(e), and particle charge-to-mass ratio are proportional to mu(e). We measured mu(e) for nucleotide complexes of skeletal muscle heavy meromyosin (HMM) and subfragment 1 (S1). The results indicate that mu(e) for HMM changes depending on the ligand bound in the active site. The changes in electric charge appear to occur mainly on the S1 moieties. For HMM(MgATPgammaS)(2) and HMM(MgADP.P(i))(2) the values of mu(e) are -0.077 and -0.17 (microm/s)/(V/cm), respectively. For these complexes, mu(e) is independent of [ATP], [ADP], and [P(i)]. When P(i) dissociates from HMM(MgADP.P(i))(2) to form HMM(MgADP)(2), mu(e) decreases to -0.61 (microm/s)/(V/cm). This large decrease in mu(e) is independent of free [ADP] or [ATP]. Increasing [P(i)], on the other hand, increases mu(e) for HMM(MgADP)(2) to values near those observed for the steady-state intermediate. For HMM, mu(e) = -0.34 and is independent of P(i). MgADP binding to HMM decreases mu(e) to -0.57 (microm/s)/(V/cm), and the dissociation constant is 9 microM. Taken together, these data indicate that mu(e) and, thus, zeta are controlled by ligand binding to the active site. The magnitudes of the particle charge-to-mass ratios for the HMM complexes are all in a range that falls within published values determined for a variety of other proteins. Possible roles that the observed nucleotide-dependent changes in cross-bridge electric charge might have in the contractile cycle in muscle are considered.
Does negative pressure wound therapy have a role in preventing poststernotomy wound complications

Background: Sternal wound infection (SWI) remains a devastating complication after cardiac surgery, decreasing long-term and short-term survival. In treating documented SWI, negative pressure wound therapy (NPWT) reduces wound edema and time to definitive closure and improves peristernal blood flow after internal mammary artery (IMA) harvesting. The authors evaluated NPWT as a form of “well wound” therapy in patients at substantial risk for SWI based on existing risk stratification models. Methods: Records of 57 adult cardiac surgery patients (September 2006 to April 2008) were reviewed. After preoperative risk assessment, NPWT was instituted on the clean, closed sternotomy immediately after surgery and continued 4 days postoperatively. Adverse postoperative events, including SWI, need for readmission, and other complications, were documented. Results: Mean age was 60.4 ± 10 years, and 89.5% were male; 77.2% were obese (mean body mass index 35.3 ± 6.7), 54.4% were diabetic, and 29 (50.9%) were both obese ...
The optimal property tax with mobile nonresidential capital

Abstract Implications of the dynamic nature of mobile nonresidential capital for community fiscal behavior are examined using the median voter framework. The representative voter's control rule calls for the community to lower its current public service demand in order to retain or attract taxable capital. The model predicts a positive short-run and a negative long-run income effect on public good demand. Incorporating intergovernmental aid into the model, asymmetry between effects of the unconditional aid and of the voter income is demonstrated.
Association of school nutrition policy and parental control with childhood overweight.

BACKGROUND: Schools and parents may play important roles in preventing childhood obesity by affecting children’s behaviors related to energy balance. This study examined how school nutrition policy and parental control over children’s eating and physical activity habits are associated with the children’s overweight/obesity (hereafter overweight) status. METHODS: Data were analyzed from a total of 246 pairs of children and parents who were recruited in the 2008-2009 academic year from 10 randomly selected public secondary schools in Indiana (school response rate = 66.7%; participant response rate = 73.5%). Logistic regression analyses were performed to examine odds ratios of different levels of school nutrition policies and parental control with and without adjusting for sociodemographic characteristics. RESULTS: Children who attended schools where soda pop (OR = 3.79, p <. 01) and non-low-fat salty snacks (OR = 2.46, p = .05) could be purchased were more likely to be obese than those at schools where such items were not sold. Children whose parents rarely or never ensured that their child was avoiding eating too many sweets (OR = 2.33, p = .08), avoiding spending too much time watching TV (OR = 2.24, p = .06), or engaging in physical activity (OR = 2.35, p = .09) were more likely to be obese than children whose parents did so always or most of the time. CONCLUSIONS: School nutrition policy and parental control over children’s eating and physical activity habits are associated with the children’s overweight status.
Catechol oxidase of red delicious apple peel

Abstract Catechol oxidase has been solubilized from the particulate fraction of apple peel using Triton X-100, dialysis and butanol extraction. The partially purified enzyme retained activity during lyophilization in the presence of mercaptobenzothiazole. The substrate specificity and pH optima of the enzyme are reported.
Crystallization and premelting in thin films of weakly interacting molecules: A study of pyridine films on ag by optical second harmonic generation

It is shown that second harmonic generation from a thin molecular film can be used for characterizing the crystallization and premelting kinetics of the crystallites in the film. The new observations provide a model understanding of the growth and crystallization mechanism in thin films made of molecules, such as pyridine, with very weak intermolecular interactions. The amorphous pyridine films, with thickness less than 100 nm, deposited at 82 K under UHV conditions on Ag(111) are found to crystallize via a diffusion-limited process at temperatures above 120 K, forming polycrystallites through a cylindrical-plate shape. This shape suggests that film thickness is an important factor in determining the crystallization mechanism. The boundary of the polycrystallites in the annealed pyridine film is found to crystallize or melt reversibly with decreasing/increasing temperature in a temperature range (80-135 K) much lower than the bulk melting temperature and the film desorption temperature.
Strength in more than numbers.

Theory suggests that cerebellar granule cells combine sensory and motor signals originating from different sources. An unexpected logic governing how granule cells process different input sources may enhance computational power.
GLOMERULAR ALTERATIONS IN THE RAT PRODUCED BY HOMOLOGOUS KIDNEY, STREPTOCOCCUS AND INCOMPLETE ADJUVANT.

Abstract Rats were given a single subcutaneous injection containing various combinations of homologous kidney, nephritogenic streptococcus and incomplete adjuvant. Only animals receiving the complete mixture (streptococcus, kidney, and adjuvant) developed proteinuria and hematuria and lesions in the kidneys similar to latent, subacute and chronic nephritis in humans.
Successful Long-Term Treatment of Cushing Disease with Mifepristone (RU486)

Objective: We describe a girl with Cushing disease for whom surgery and radiation treatments failed and the subsequent clinical course with mifepristone therapy.Methods: We present the patient's clinical, biochemical, and imaging findings.Results: A 16-year-old girl presented with classic Cushing disease. After transsphenoidal surgery, Cyberknife radiosurgery, ketoconazole, and metyrapone did not control her disease, and she was prescribed mifepristone, which was titrated to a maximal dosage of 1200 mg daily with subsequent symptom improvement. Mifepristone (RU486) is a high-affinity, nonselective antagonist of the glucocorticoid receptor. There is limited literature on its use as an off-label medication to treat refractory Cushing disease. Over her 8-year treatment with mifepristone, her therapy was complicated by hypertension and hypokalemia requiring spironolactone and potassium chloride. She received a 2-month drug holiday every 4 to 6 months to allow for withdrawal menstrual bleeding with medroxyprog...
A novel method for simulating laser-solid interactions in semiconductors and layered structures

Abstract We have developed a new implicit finite difference method to simulate the interaction of intense nanosecond laser beams with semiconductors and metal-coated ceramic structures. This method is based upon a higher order implicit finite difference scheme with a smaller truncation error and is not restricted by any stability criterion, thereby allowing faster convergence to the exact solution. The temperature-dependent optical and thermal properties of the irradiated material as well as the temporal variation in the laser intensity have been taken into account. Finite difference equations have been set up for accurate determination of the temperature gradients at the liquid-solid interface, which control the melt-in and resolidification velocities. A new formulation is introduced to accomodate the effect of pulsed laser irradiation on layered composite structures (e.g. metal-coated ceramics) by incorporating the boundary conditions at the composite interface. Using this method, the thermal histories of laser-irradiated materials were predicted. The effects of variation in the pulse energy density, pulse duration and substrate temperature on the maximum melt depths, solidification velocities and surface temperatures were computed. The calculations on the depth of melting were found to be in good agreement with experimental results where complete annealing of the ion implantation damage was used as a measure of the melt depth. The surface temperatures and melt lifetimes in metal-coated ceramics were determined in order to understand the laser mixing process. Simple energy balance considerations were applied to calculate some of the effects of laser irradiation on materials. From these energy considerations, the maximum melt depths as a function of energy density, pulse duration and substrate temperature were obtained and compared with the exact solutions. The maximum surface temperatures, solidification velocities and melt lifetimes were also determined by this analytical method and compared with the detailed calculations. A good agreement between the analytical relations and the detailed numerical calculations provides an excellent guide to researchers in this field.
A spatial model of engagement for a social robot

Even if a socially interactive robot has perfect information about the location, pose, and movement of humans in the environment, it is unclear how this information should be used to enable the initiation, maintenance, and termination of social interactions. We review models that have been developed to describe social engagement based on spatial relationships and describe a system developed for use on a robotic receptionist. The system uses spatial information from a laser tracker and head pose information from a camera to classify people in a categorical model of engagement. The robot's behaviors are determined by the presence of people in these different levels. We evaluate the system using observational behavioral analysis of recorded interactions between the robot and humans. This analysis suggests improvements to the current system: namely, to put a stronger emphasis on movement in the estimation of social engagement and to vary the timing of interactive behaviors
Metachromatic Leukodystrophy (MLD): VIII. MLD in Adults; Diagnosis and Pathogenesis

ADULTS, as well as children, develop metachromatic leukodystrophy (MLD). Does the adult with MLD also have a sulfatase A deficiency? If he does, can this enzyme deficiency really explain his illness? For example, if one presumes that the enzymic defect is inborn, why did his symptoms not begin when he was a child? Are different mechanisms involved in the delayed demyelination of adult MLD than in the form of MLD which affects young children?1-3Answers to questions posed in the MLD model may help explain why other neurological disorders, though "inborn," appear clinically only later in life. The purpose of the present report is threefold: (1) to note sulfatase studies and other laboratory data in a 62-year-old adult with MLD; (2) to review the pertinent literature and to comment on some special clinical features and pathogenic mechanisms of adult MLD; (3) to synthesize from this information a working
Using Epstein-Barr Viral Load Assays To Diagnose, Monitor, and Prevent Posttransplant Lymphoproliferative Disorder

Summary: Epstein-Barr virus (EBV) DNA measurement is being incorporated into routine medical practice to help diagnose, monitor, and predict posttransplant lymphoproliferative disorder (PTLD) in immunocompromised graft recipients. PTLD is an aggressive neoplasm that almost always harbors EBV DNA within the neoplastic lymphocytes, and it is often fatal if not recognized and treated promptly. Validated protocols, commercial reagents, and automated instruments facilitate implementation of EBV load assays by real-time PCR. When applied to either whole blood or plasma, EBV DNA levels reflect clinical status with respect to EBV-related neoplasia. While many healthy transplant recipients have low viral loads, high EBV loads are strongly associated with current or impending PTLD. Complementary laboratory assays as well as histopathologic examination of lesional tissue help in interpreting modest elevations in viral load. Circulating EBV levels in serial samples reflect changes in tumor burden and represent an effective, noninvasive tool for monitoring the efficacy of therapy. In high-risk patients, serial testing permits early clinical intervention to prevent progression toward frank PTLD. Restoring T cell immunity against EBV is a major strategy for overcoming PTLD, and novel EBV-directed therapies are being explored to thwart virus-driven neoplasia.
Implementing enterprise resource planning systems: organizational performance and the duration of the implementation

This paper examines the impact of the duration of ERP implementation on firm performance both during and after implementation. Organizations choose either an accelerated implementation approach or a traditional (longer) implementation approach. The former approach gives the organization the advantage of speed, but the disadvantage of fitting its processes to that of a packaged (thus, undifferentiated from competitors) ERP. The latter approach allows the organization to redesign strategy and processes, and thus, search for ways to be unique from its competition. The study uses a regression model to capture the changes in various performance measures during and after implementation between firms that implemented the ERP, using the performance measure of a matched group of firms that did not implement an ERP as a benchmark/control sample, on the basis of the duration of the implementation. Financial data from Compustat, and data on start date and end date of ERP implementation between 1990 and 2005 for firms in the Oil and Gas industry was collected from an ERP vendor. Results show that measures such as return on sales improved after implementation. However, measures such as inventory turnover, which reflect operational benefits, improve during implementation. We find that accelerated implementation confers both operational and strategic benefits. This study highlights the strategic consequences of the different choices of implementation.
The Internal Morality of Clinical Medicine: A Paradigm for the Ethics of the Helping and Healing Professions

The moral authority for professional ethics in medicine customarily rests in some source 'external' to medicine, i.e., a pre-existing philosophical system of ethics or some form of social construction, like consensus or dialogue. Rather, 'internal' morality is grounded in the phenomena of medicine, i.e., in the nature of the clinical encounter between physician and patient. From this, a philosophy of medicine is derived which gives moral force to the duties, virtues and obligations of physicians qua physicians. Similarly, an ethic specific to the other healing professions, law, teaching or ministry, can be derived from the specific ends to telos of each of these professions, which like medicine, are focused on a special type of human relationship.
A potential role for human UDP-glucuronosyltransferase 1A4 promoter single nucleotide polymorphisms in the pharmacogenomics of tamoxifen and its derivatives.

Tamoxifen (Tam) is a selective estrogen receptor modulator used to inhibit breast tumor growth. Tam can be directly N-glucuronidated via the tertiary amine group or O-glucuronidated after cytochrome P450–mediated hydroxylation. In this study, the glucuronidation of Tam and its hydroxylated and/or chlorinated derivatives [4-hydroxytamoxifen (4OHTam), toremifene (Tor), and 4-hydroxytoremifene (4OHTor)] was examined using recombinant human UDP-glucuronosyltransferases (UGTs) from the 1A subfamily and human hepatic microsomes. Recombinant UGT1A4 catalyzed the formation of N-glucuronides of Tam and its derivatives and was the most active UGT enzyme toward these compounds. Therefore, it was hypothesized that single nucleotide polymorphisms (SNPs) in the promoter region of UGT1A4 have the ability to significantly decrease the glucuronidation rates of Tam metabolites in the human liver. In vitro activity of 64 genotyped human liver microsomes was used to determine the association between the UGT1A4 promoter and coding region SNPs and the glucuronidation rates of Tam, 4OHTam, Tor, and 4OHTor. Significant decreases in enzymatic activity were observed in microsomes for individuals heterozygous for −163G/A and −217T/G. These alterations in glucuronidation may lead to prolonged circulating half-lives and may potentially modify the effectiveness of these drugs in the treatment of breast cancer.
Cosolvent Effects on Protein Stability

Proteins are marginally stable, and the folding/unfolding equilibrium of proteins in aqueous solution can easily be altered by the addition of small organic molecules known as cosolvents. Cosolvents that shift the equilibrium toward the unfolded ensemble are termed denaturants, whereas those that favor the folded ensemble are known as protecting osmolytes. Urea is a widely used denaturant in protein folding studies, and the molecular mechanism of its action has been vigorously debated in the literature. Here we review recent experimental as well as computational studies that show an emerging consensus in this problem. Urea has been shown to denature proteins through a direct mechanism, by interacting favorably with the peptide backbone as well as the amino acid side chains. In contrast, the molecular mechanism by which the naturally occurring protecting osmolyte trimethylamine N-oxide (TMAO) stabilizes proteins is not clear. Recent studies have established the strong interaction of TMAO with water. Detailed molecular simulations, when used with force fields that incorporate these interactions, can provide insight into this problem. We present the development of a model for TMAO that is consistent with experimental observations and that provides physical insight into the role of cosolvent-cosolvent interaction in determining its preferential interaction with proteins.
Trucking Industry Adoption of Information Technology: A Structural Multivariate Discrete Choice Model

Modern panel surveys frequently suffer from high and likely non-ignorable attrition, and transportation surveys suffer from poor travel time estimates. This paper examines new methods for adjusting forecasts and model estimates to account for these problems. The methods we describe are illustrated using a new panel survey of 1500 commuters in San Diego, California. These data are being collected to evaluate a federally-funded “Congestion Pricing” experiment investigating the impacts of allowing solo drivers to pay to use freeway carpool lanes. The panel survey, begun in Fall 1997, collects data on travel behavior and attitudes at six-month intervals through telephone interviews. The panel sample is refreshed with new respondents at each wave to counteract the attrition between waves. Both the original and refreshment samples are stratified on commuters’ mode choice (solo drive in free lanes, pay to solo drive in the carpool lanes, or carpool for free in carpool lanes) to insure sufficient sample size for estimating our models.
Simulation of human microDopplers using computer animation data

The capability to detect, track and monitor human activities in non-line-of-sight environments is an important component of security and surveillance operations. The movement of the human body and limbs result in unique microDoppler features which can be exploited for identification and classification of different types of human motions. In this paper, a method to simulate the microDoppler signatures of complex human motions from virtual reality animation data is presented. The simulation method is tested on three types of human motions - walking, running and crawling. The simulated Doppler spectrograms are compared with measurement results. Additional simulation data are presented to show patterns over a long time duration and the effect of frequency and viewing angle.
Nonpalpable Breast Cancer in Women Aged 40-49 Years: A Surgeon's View of Benefits From Screening Mammography

While mammography screening among women aged 50 years or older has proven to reduce breast cancer mortality, screening in younger women has been repeatedly scrutinized. To test the effect of screening among younger women, we examined 84 consecutive patients aged 40‐49 at the time of breast cancer diagnosis: 27 (32.1%) were diagnosed solely by mammography, and 57 (67.9%) had a palpable mass. The mean tumor sizes were 1.3 cm and 3.6 cm for the two groups respectively. While 68.8% nonpalpable invasive tumors were classified as Stage I cancer, only 34% of patients with palpable breast cancer had Stage I disease. None of the patients with nonpalpable breast cancer had disease beyond Stage II. In contrast, 28.3% of the patients with palpable invasive breast cancer presented with advanced disease. In addition, 6.3% versus 41.5% of patients with nonpalpable and palpable breast cancer respectively had nodal metastases. The five-year survival rates for the two groups were 100% and 73% respectively, favoring breast cancer detected mammographically. Screening of women aged 40‐49 also resulted in more breast-conserving surgery and less chemotherapy. We conclude that screening in this age group should be continued, although individual assessment is needed. [Monogr Natl Cancer Inst 1997:22:145‐149]
Field theory and educational practice: Bourdieu and the pedagogic qualities of local field positions in educational contexts

Bourdieu’s version of field theory has had an impressive impact on the ways that sociologists of education conceptualize educational practices. These accounts tend to focus on the varying levels of ontological complicity established between students’ cultural dispositions and educational institutions. In this paper, the wisdom of these accounts is acknowledged but it is also suggested that Bourdieu’s field theory does not go far enough to detail the ways that positions in local educational fields embody pedagogic qualities and action trajectories. Drawing on insights from social psychology and relational sociology, a field theory for local educational action is outlined that more adequately accounts for the ways that students and educators directly experience and act upon curricular and pedagogic qualities in educational settings. An empirical example is then offered of the authors’ claims within the context of curricular tracking/streaming, and the article concludes by considering the practical and polit...
NATIONWIDE STUDY OF THE STREAMFLOW DATA PROGRAM

During 1970 the Geological Survey conducted a study to evaluate the surface-water data collection program. Objectives were formulated, specific goals were set, a massive analysis of available data was made to determine the extent to which the present system enables the goals to be met, alternatives were considered for meeting the remaining goals, and finally, specific elements were identified for inclusion in the future program. The results of the evaluation will be used in planning the future streamflow data program. Less productive elements in the present program can be weeded out, and the effort devoted to more critically needed water data. The study provides the groundwork for redirection of efforts towards a more efficient system for satisfying present and future needs.
Activation Peaking during the Acquisition of a Motor Task under High and Low Contextual-Interference Conditions

Summary.-The purpose of this study was to assess the effect of high and low contextual-interference conditions on physiologic activation levels during the acquisition of a simple positioning task. 29 subjects, over 192 acquisition trials, learned to move to four positions in either a random (high interference) or blocked (low interference) sequence. Data on movement information, heart rate, and skin conductance were collected and analyzed. The movement data showed typical effects of contextual interference for acquisition that conformed to previously published findings. Heart rate was sensitive to the demands of movement extent. The high contextual-interference condition showed slower acquisition rates and higher activation levels as measured by skin conductance. It was concluded that changes in activation levels during practice may contribute or provide a sensitive index of contextual interference.
On the number of negative eigenvalues for a Schrödinger operator with magnetic field

We consider the Schrodinger operator with magnetic field $$H = \sum\limits_{j = 1}^n {\left( {\frac{1}{i}\frac{\partial }{{\partial x_j }} - a_j } \right)^2 + Vin\mathbb{R}^n .} $$ Under certain conditions on the magnetic fieldB=curla, we generalize the Fefferman—Phong estimates (Bull. A. M. S.9, 129–206 (1983)) on the number of negative eigenvalues for −Δ+V to the operatorH. Upper and lower bounds are established. Our estimates incorporate the contribution from the magnetic field. The conditions onB in particular are satisfied if the magnetic potentialsaj(x) are polynomials.