cssi/SciSciGPT-SciSciNet huggingface dataset:
A Learning Curve for Laparoscopic Splenectomy at an Academic Institution

Abstract Background.Laparoscopic splenectomy is emerging as the standard for treatment of benign splenic disorders. Since splenectomy is indicated relatively infrequently, issues arise concerning training of surgeons to perform laparoscopic splenectomy. Our experience with 50 laparoscopic splenic procedures is reported with emphasis on the learning curve at an academic institution. Materials and methods.Data were prospectively collected on 50 consecutive patients undergoing attempted or successful laparoscopic surgical procedures on the spleen at Northwestern Memorial Hospital or The Chicago Health Care System, Lakeside Division, from April 1993 to April 1998, and on 5 patients undergoing open splenectomy from April 1993 to October 1995. Outcomes including conversion rate, operative time, day feedings were tolerated, and length of hospital stay was examined and correlated with the number of attempted cases. Results.Laparoscopic splenectomy progressed from an operation requiring two advanced laparoscopic surgeons to one performed by carefully supervised senior residents. Success rates increased from 60% initially to greater than 95% recently. Likewise, operative time decreased significantly from 195 to 97 min, while length of stay declined from 2.5 to 1.5 days. High success rates, low operative times, and short length of stays were achieved during the last 20 patients while surgical residents were taught to perform the procedures. The reasons for improvement are multifactorial including use of the harmonic scalpel, a change to the lateral position, and increasing experience with the procedure. Conclusions:Laparoscopic splenectomy is a safe and effective procedure that reduces postoperative length of hospital stay. It can be performed successfully in most patients with operative times comparable to those of open splenectomy. Moreover, the procedure can (and should) be taught to residents once they master basic and advanced laparoscopic skills.
Animal Model Evaluation Within Herd Linked to National Evaluations

Abstract Computer programs with modest computational requirements were developed to calculate animal model evaluations on a herd basis. Evaluations are connected to the national system through parents with national evaluations and parents assigned to unknown-parent groups. The programs can be used to compute evaluations of animals in herds not included in national evaluations or to update evaluations between semiannual national evaluations for herds that are included. Computer memory requirements are reduced dramatically from those of the national system, because only data for animals with records or progeny in the herd are in memory at any time. Computational requirements also are reduced by processing only lactation records initiated after an adjustable date; earlier lactation records are replaced by management group deviations. For older animals, processing is reduced further by not updating the animal's evaluation. When progeny evaluations no longer are updated, the animal's evaluation no longer is required. Solutions for management group, permanent environmental, and herd-sire effects are by Gauss-Seidel iteration and for animal effects by approximate successive over-relaxation.
Political Parties and Presidential Oversight

The intimate, and often underappreciated, relationship between political parties, the presidency, and the administrative state has profound consequences for the functioning of these three institutions at the heart of American political life. Failure to draw out and illuminate this connection has led to an incomplete understanding of administrative law — both descriptively in what the law does and can do, and normatively in what it should do. In particular, courts and commentators have not grappled with the fundamental shift experienced by political parties over the past several decades — from traditional party organizations that were locally focused and ideologically diverse to today’s high-tech, polarized, and nationally oriented parties. This transformation was strongly influenced by the growth of administrative agencies and the modern presidency, and has important implications for the practical realities of presidential control over agencies, for the normative justifications supporting the President’s prominent role in the administrative state, and for the struggle over control of agencies between the President and Congress. This Article maps out the intersection of President, administration, and contemporary parties and proposes “responsible party administration” as a normative framework to evaluate how well institutional arrangements and judicial doctrines forward administrative values such as expertise, coherence, and legality while accommodating a system of regulated rivalry in which two programmatically distinct parties compete for the reins of the administrative state.
The transient distribution of allele frequencies under mutation pressure.

The transient distribution of allele frequencies in a finite population is derived under the assumption that there are k possible alleic states at a locus and mutation occurs in all directions. At steady state this distribution becomes identical with the distribution obtained by Wright, Kimura and Crow when k = ∞. The rate of approach to the steady state distribution is generally very slow, the asymptotic rate being 2v + 1/(2N), where v and N are the mutation rate and effective population size, respectively. Using this distribution it is shown that when population size is suddenly increased, the expected number of alleles increases more rapidly than the expected heterozygosity. Implications of the present study on testing hypotheses for the maintenance of genetic variability in populations are discussed.
Fully Codon-Optimized luciferase Uncovers Novel Temperature Characteristics of the Neurospora Clock

We report the complete reconstruction of the firefly luciferase gene, fully codon optimized for expression in Neurospora crassa. This reporter enhances light output by approximately 4 log orders over that with previously available versions, now producing light that is visible to the naked eye and sufficient for monitoring the activities of many poorly expressed genes. Time lapse photography of strains growing in race tubes, in which the frq or eas/ccg-2 promoter is used to drive luciferase, shows the highest levels of luciferase activity near the growth front and newly formed conidial bands. Further, we have established a sorbose medium colony assay that will facilitate luciferase-based screens. The signals from sorbose-grown colonies of strains in which the frq promoter drives luciferase exhibit the properties of circadian rhythms and can be tracked for many days to weeks. This reporter now makes it possible to follow the clock in real time, even in strains or under conditions in which the circadian rhythm in conidial banding is not expressed. This property has been used to discover short, ca. 15-h period rhythms at high temperatures, at which banding becomes difficult to observe in race tubes, and to generate a high-resolution temperature phase-response curve.
Advertising in the USA

In marketing, the first and most important element of advertising is the audience who are the potential buyers of the product. Without an audience of potential buyers, there would be no reason for the other elements of advertising, which are the advertisement or message, the medium or more typically media by which the message is carried, the advertiser or firm whose product or service is advertised, and the advertising agency or other similar firm that usually creates the message and places it on the media.
Management of Seizure Disorders in Infancy, Childhood and Adolescence

The approach of the clinician to the management of seizures remains largely symptomatic and pragmatic. The many publications about the epilepsies and the continuing need to develop modes of anticonvulsant treatment more effective than those available bear witness to the gap between the base provided by experiments such as reported in this Symposium and the exigencies of the clinical situations. Guidelines may be given on how to bridge the gap, but not a set of rules; knowing one’s patient and experience with a drug or drugs are among the prime ingredients of good seizure management.
Holocene Climate Changes Recorded in an East Antarctica Ice Core

Ice core derived proxy climate records from Antarctica suggest that decadal, century and possibly even millennial-scale temperature variations in East and West Antarctica may be temporally asynchronous. For example, records from the Antarctic Peninsula indicate a strong 20th century warming in which the high plateau of East Antarctica has not participated. Similarly, a recent Neoglacial cooling, the “Little Ice Age”, was prominent in East Antarctica, but absent in the Peninsula region. A new history of oxygen isotopic ratios (δ18O) and atmospheric dust concentrations from central East Antarctica suggests that the high inland plateau has been dominated by a cooling trend for the last 4000 years. Superimposed upon this isotopically-inferred cooling were a number of warmer events, the largest and most persistent of which occurred ≈ 3600 yr. BP and lasted several centuries. The most prominent event is a prolonged cold phase around 2200 yr. BP which is correlative with a mid-Neoglacial advance on South Georgia Island (Clapperton et al, 1989). Most intriguing are several shorter-term (multi-centennial scale) δ18O oscillations which are similar in magnitude to the glacial-interglacial transition in Antarctic ice cores. Although it is impossible to discount the effect of wind scouring and re-deposition in this low snow accumulation region, this 4000-year history raises important questions about the climate history on the high inland plateau during the last half of the Holocene. Certainly, a better spatial distribution of high resolution δ18O records from East Antarctica are necessary to determine the extent to which the Plateau Remote record is spatially representative.
A Perspective on the Global Pandemic of Waterborne Disease

Waterborne diseases continue to take a heavy toll on the global community, with developing nations, and particularly young children carrying most of the burden of morbidity and mortality. Starting with the historical context, this article explores some of the reasons why this burden continues today, despite our advances in public health over the past century or so. While molecular biology has revolutionized our abilities to define the ecosystems and etiologies of waterborne pathogens, control remains elusive. Lack of basic hygiene and sanitation, and failing infrastructure, remain two of the greatest challenges in the global fight against waterborne disease. Emerging risks continue to be the specter of multiple drug resistance and the ease with which determinants of virulence appear to be transmitted between strains of pathogens, both within and outside the human host.
Dissecting the Control of Flowering Time in Grasses Using Brachypodium distachyon

The timing of flowering is a critical life history trait that has been shaped over evolutionary time to maximize the ability to flower at a time that optimizes reproductive success. Furthermore, timing of flowering is one of many traits that has been manipulated by humans for increased crop productivity. It can be difficult to determine the molecular underpinnings controlling flowering in cereals due to their large complex genomes and larger stature. However, many attributes of Brachypodium distachyon makes it a useful model grass system to accelerate understanding of the genetic basis of flowering time in grasses. Here we will first discuss what is currently known about flowering in temperate grasses, which largely comes from studies of natural variation for flowering in wheat and barley, followed by some of the progress made in B. distachyon. We will then discuss practical considerations of flowering behavior when growing different accessions of B. distachyon for studies of other traits of interest.
Nobody Can Harm You, Nobody Can Charm You: Efik Nnabo Society Masquerades of Calabar, Nigeria

The Nnabo society is an institution of the Efik people of Calabar, Cross River State, Nigeria. Formerly charged with martial duties, Nnabo masquerades today serve various functions— including spiritual protection and public performances to honor deceased members and the Efik Obong, or paramount ruler—while offering a visually rich display of heritage that speaks to a larger complex of masquerade societies previously found throughout the Cross River basin. Here, we address the lacuna in published sources about Nnabo by introducing the primary masquerade characters and their roles based on interviews with society members in Calabar. Nowadays Nnabo highlights the warriorlike prowess displayed by energetic young men in their attempts to intimidate and frighten onlookers during public performances. That the masquerades seek to inspire fear is no surprise, considering their former roles among the Efik, which included warfare (Figs. 1, 5, 7). Hence, Nnabo connotes the fearlessness and steady vigilance required to protect the dignity and integrity of the Efik people. While a few members in Calabar today might still desire to regain its former power, Nnabo long ago ceded its martial function to government and now performs primarily to honor fellow members during events such as commemorative funerals, or the installation of a new Obong. Nnabo also provides public entertainment at the holidays (e.g., the annual Christmas carnival of masquerades in Calabar), and may perform during private functions. We were repeatedly told that, prior to the colonial period, Nnabo led the way onto the battlefield during times of confrontation or war. Its masquerades were charged with intimidating the enemy and removing any malignant spiritual forces they may have incurred. In times of peace, certain members—the Nsibidi Nnabo—carried out the executions of condemned persons ordered by the Obong. The Efik phrase nedseo nsibidi refers to the act of execution. The origin of Nnabo is shrouded in history, although Efik oral history traces it to the region of the Ejagham peoples of the upper Cross River region. According to members of the Owanese group, Nnabo is not an Efik term, but rather is Qua/ Ejagham, because they “owned” the word.1 However, the precise meaning was not proffered because it’s “nsibidi”—that is, a secret. Apart from its general connotation as a “war dance,” members noted that Nnabo also means, “Everybody knows that something happens” or, more succinctly, “Action!” It may be that the group originated with, or was inspired by, a Qua/Ejaham or Efut source, as was the men’s Leopard Society, known as Ekpe amongst the Efik of Calabar (Latham 1973:36; Leib and Romano 1984:48). The institution of Nnabo is not limited to the Calabar region. A Nnabo masquerade costume seen by the authors at the Oron Museum in 2004 indicates the group is widespread throughout the southern Cross River region. Its label read:
Therapeutic trials with thyroid hormones in chemically euthyroid patients with myofascial pain and complaints suggesting mild thyroid insufficiency.

OBJECTIVE To determine why patients with normal function of the pituitary-thyroid axis, myofascial pain, and other symptoms resembling those of hypothyroidism respond to a slightly supraphysiological dose of levothyroxin administration. DESIGN Review and analysis of author's records drawn from a data base of therapeutic trials. INTERVENTION Oral administration of levothyroxin, 0.2 mg daily for at least 3 months. MAIN OUTCOME MEASURES Patient interviews and physical examinations by author. Measurement of differences in paired BMR, serum cholesterol, and subjective response after 3 or more months of thyroid hormone administration, using each patient as his or her own control. SUMMARY Fifty-seven chemically euthyroid adults of both sexes with myofascial pain and hypothyroid-like symptoms were treated with a slightly supraphysiological dose, 0.2 mg, of levothyroxin daily. Cases were selected recently from a database of 367 therapeutic trials performed by the author between 1954 and 1983. All patients had a normal thyroid profile, and a serum TSH measurement before initiating levothyroxin replacement. BMRs and serum cholesterol determinations before and after at least 3 months of thyroid hormone therapy were compared. A graph was constructed in which each point displayed three responses for each patient: change in resting oxygen consumption, following a 12-h fast (BMR); change in serum cholesterol; and symptom response score. Thirteen TSH levels were slightly elevated. Analysis of the graph suggests that almost all patients with: (1) normal function of the pituitary thyroid axis; (2) non-inflammatory myofascial pain refractory to physical medicine and trigger point therapy; and (3) symptoms and signs resembling hypothyroidism, responded to thyroid hormone therapy. The responses suggest correction of a peripheral block to thyroid hormone in patients with normal pituitary thyrotroph function.
"To Feel like a Man": Black Seamen in the Northern States, 1800-1860

"Those beautiful vessels, robed in white, and so delightful to the eyes of freemen," remembered Frederick Douglass of the sailing ships he saw daily during his boyhood along the Chesapeake Bay, "were to me so many shrouded ghosts." Douglass contrasted the ships, "loosed from [their] moorings, and free," with his own condition "fast in my chains, and . . . a slave!" And he swore, as he later recollected, "This very bay shall yet bear me into freedom."1 As it turned out, Douglass employed a seafaring subterfuge instead of a ship to escape his chains. Rigging himself out in "a red shirt and tarpaulin hat and black cravat, tied in sailor fashion, carelessly and loosely about my neck," he borrowed a seaman's protection certificate from a bona fide black sailor and brazenly struck out for Philadelphia by train. He succeeded that September day in 1838 largely because free black seamen were then so common as to cause few second looks.2 Frederick Douglass never went to sea. Yet as a skilled ship caulker he worked on the wharves in Baltimore (and later did odd jobs in New Bedford, Massachusetts) shoulder to shoulder with black and white sailors and, in his own words, "knew a ship from stem to stern, and from keelson to crosstrees, and could talk sailor like an 'old salt."' No stranger to waterfront tales of hardship, brutality, and deprivation at sea, Douglass nonetheless persisted in his metaphorical view of ships as "freedom's swift-winged angels" because, unlike the white men who spoke movingly of the "slavery" aboard ship, Douglass knew real slavery firsthand.3 Whether ex-slave like Frederick Douglass or freeborn, all northern black men rec-
Environmental Influences on Cardiovascular Health

A growing body of evidence indicates that the respiratory system is not the only target organ that may be injured by the inhalation of airborne particulate matter. Increased attention is now focused on research showing a link between particulate matter air pollution and cardiovascular morbidity and mortality, raising complex questions about the mechanism by which dirty air affects the heart. At the same time, the population at risk of cardiovascular continues to grow, including the obese, overweight, hypertensive and senior citizens. This pervasive and growing public health and medical care issue elevates into sharp relief the need for physicians and other healthcare practitioners to understand the clinical consequences exposure to particulate air pollution. This review is designed to further that understanding.
The Mutual Evolutions between the Modal System and the Tense-aspect System

There is evolvement relationship between the time deixis system and the modal system in the human languages.Thus,the sentence-final particles(SFP)as modal markers in Chinese have potentiality to be related to tense/aspect markers.The dispute about whether "le" "de" ave SCPs or not,and the fact that SCPs "ne,laizhe,zhene,la,a" ave used to express the tense-aspect meanings,actually reflects the universal phenomenon among the human languages.In Chinese there exists mutual evolutions between the time deixis system and the modal system.Being a word class,the SCP is also a prototypical category which has typical members and non-typical members.
Lightning spectroscopy-photographic techniques. 2.

Some spectroscopic studies of lightning from 1901 to the present are reviewed, with special emphasis on slitless techniques—time-integrated and time-resolved. Some of the best examples of the authors’ time-integrated spectra are reproduced to display and identify emission and absorption features from 3000 A to almost 9000 A on a nearly uniform scale approximating 20 A/mm. Time-resolved spectra in the visible region are reproduced in the range of milliseconds for a continuing-current luminosity, and microseconds for a return stroke and a stepped leader.
Behavioral adaptations in larvae of brachyuran crabs: A review

Abstract Larval development in brachyuran crabs includes a number of zoeal stages followed by a single megalopal stage. Zoeae and megalopae are relatively strong swimmers, and movement up or down in the water column takes advantage of vertical shear in ambient currents with consequent transport in the horizontal dimension. For some species, this process is important in controlling the dispersal of early-stage larvae away from spawning sites and in maintaining the supply of late-stage larvae to juvenile nursery habitat. For other species it enables retention near spawning sites throughout the larval period. Vertical position in the water column also modulates predator-prey interactions, which impact growth and survival of larvae. Swimming behavior in larval crabs is regulated by both external cues detected in the water column and endogenous rhythms entrained by external oscillators. Gravity, hydrostatic pressure, and light are the primary external cues because of their predictability in the environment. Light is also the most common external oscillator entraining swimming rhythms. Secondary cues include salinity, temperature, turbulent kinetic energy, and feeding state. Crab larvae also respond to chemical and tactile cues that facilitate settlement in juvenile habitat. This paper presents a review of the physical and chemical characteristics of these cues, the behavioral responses of crab larvae to the cues, and the patterns of larval transport that emanate from these responses.
Dexmedetomidine for the treatment of hyperactive delirium refractory to haloperidol in non-intubated patients

Delirium is reported to occur in up to 89% of patients admitted to the intensive care unit (ICU) (1), and delirium is an independent risk factor for increased costs, longer hospital stays, neuropsychological dysfunction, and mortality (2-4). As such, the effective treatment of delirium represents a way to not only improve patient safety and outcomes but also to decrease costs and increase hospital throughput. Multiple modalities, including both typical and atypical anti-psychotics, are available as off-label use to treat the symptoms of delirium. These agents do not treat the underlying condition, and data are conflicting on whether they can prevent delirium or decrease its duration (5-7). A promising therapy that can not only treat delirium symptoms but may also prevent the development of delirium is the alpha-2 agonist dexmedetomidine. Several studies have shown that dexmedetomidine, when used for sedation of patients on mechanical ventilation, can reduce the incidence and duration of delirium (8-11) and hasten extubation of patients with hyperactive delirium (12,13). There is little data, however, on its effectiveness in non-intubated patients. This represents an important patient population because the consequences of over-sedation are potentially catastrophic in the absence of a secure airway. In their current work, Carrasco et al. (14) show that the use of dexmedetomidine in non-intubated patients who failed treatment with haloperidol resulted in reduced time with symptoms of agitated delirium, more time at the target sedation level, and decreased overall costs of the patient stay.
The Status-Achievement Process: Insights from Genetics

The mainstream status achievement model of sociology and economics views individual careers as sequences of causally linked status-related traits and outcomes such as ability, educational attainment, and occupational status. The variance decomposition models of quantitative genetics interpret variation in these traits and status outcomes as produced by latent factors summarizing genetic, shared environmental and nonshared environmental sources of influence. This article proposes that the two approaches can be combined and together provide valuable insights into core issues of social stratification research. The argument is illustrated with respect to three issue areas: (1) Nature of family environmental influences in educational attainment; (2) Sources of associations among successive status-related outcomes; (3) Implications of the combined status achievement / quantitative genetic model for the relative strengths of opportunities for mobility versus social forces of reproduction facing individuals in different social positions and in different societies.
Stats Don't Tell the Whole Story: Using Qualitative Data Analysis of Chat Reference Transcripts to Assess and Improve Services

ABSTRACTIn the five years following implementation of a chat reference service at James Madison University (JMU), the service proved very popular but was not closely assessed for quality of service. Using grounded theory and qualitative data analysis techniques, a comprehensive assessment effort was begun in earnest and is in progress. Preliminary results indicate several patterns and difficulties that will inform the staffing model and training for this service and will potentially be generalizable to other similar libraries. Other libraries may find high value in assessing the transcripts of their chat reference interactions to gauge specific trends in their individual libraries.
Cancer Stem Cells: Metastasis and Evasion From the Host Immune Responses

Metastasis is the leading cause of cancer-related deaths. Cancer stem cells (CSCs) have the distinct ability of self-renewal and proposed capacity to metastasize to distant locations. CSCs are more resistant to radiation and chemotherapeutic agents compared to other cancer cells and, therefore, survive conventional therapies, resulting in local and distant relapse of the disease. This chapter reviews the current knowledge of the metastatic potential of CSCs, termed as metastatic CSCs (MCSCs). Limited evidence has also led to the hypothesis that CSCs may evade host immune responses. This chapter describes the immunosuppressive approaches that cancer cells, including CSCs and MCSCs, employ to evade the host immune system. In addition, the types of immune and inflammatory cells that may be utilized to support tumor progression and promote metastasis are illustrated. Understanding these mechanisms may provide new insights and aid in the development of novel strategies to target the “Achilles’ heel” of CSCs and MCSCs.
Challenging the “jolly fat” hypothesis among older adults: High body mass index predicts increases in depressive symptoms over a 5-year period:

Several investigators have observed lowered risk of depression among obese older adults, coining the "jolly fat" hypothesis. We examined this hypothesis using baseline and a 5-year follow-up body mass index, depressive symptoms, and covariates from 638 community-based older adults. High objectively measured body mass index and functional limitations predicted increased future depressive symptoms. However, symptoms did not predict future body mass index. Self-reported body mass index showed similar associations despite underestimating obesity prevalence. Results did not differ on the basis of gender. Results for this study, the first longitudinal reciprocal risk analysis between objectively measured body mass index and depressive symptoms among older adults, do not support the "jolly fat" hypothesis.
A 23-mW 24-GS/s 6-bit Voltage-Time Hybrid Time-Interleaved ADC in 28-nm CMOS

This paper presents a power- and area-efficient 16-way time-interleaved (TI) analog-to-digital converter (ADC) achieving 24-GS/s conversion speed and 6-bit resolution in 28-nm CMOS. A voltage-time hybrid pipeline technique exploiting the comparator input-voltage-output-time dependency is reported to enhance the throughput of successive-approximation-register (SAR) ADCs. A reference-buffer-free capacitive digital-to-analog (CDAC) converter is utilized to mitigate the crosstalk problem in TI-ADCs. Timing mismatches between individual sub-ADCs are estimated with a reference-ADC dithering technique and corrected by digitally controlled delay lines (DCDL). The techniques collectively enabled a very compact design, obviating any input buffer or hierarchical sampling structures. The ADC core consumes 23 mW and occupies an area of 0.03 mm2. A signal-to-noise plus distortion ratio (SNDR) of 35 dB and a spurious-free dynamic range (SFDR) of 54 dB were measured for a 40-MHz input. For a Nyquist input, the prototype measured an SNDR of 29 dB and an SFDR of 41 dB with all timing mismatch spurs suppressed below −50 dBc after skew calibration.
In vivo transport of three radioactive [18F]-fluorinated deoxysucrose analogs by the maize sucrose transporter ZmSUT1.

Sucrose transporter (SUT) proteins translocate sucrose across cell membranes; however, mechanistic aspects of sucrose binding by SUTs are not well resolved. Specific hydroxyl groups in sucrose participate in hydrogen bonding with SUT proteins. We previously reported that substituting a radioactive fluorine-18 [18F] at the C-6' position within the fructosyl moiety of sucrose did not affect sucrose transport by the maize (Zea mays) ZmSUT1 protein. To determine how 18F substitution of hydroxyl groups at two other positions within sucrose, the C-1' in the fructosyl moiety or the C-6 in the glucosyl moiety, impact sucrose transport, we synthesized 1'-[F18]fluoro-1'-deoxysucrose and 6-[F18]fluoro-6-deoxysucrose ([18F]FDS) analogs. Each [18F]FDS derivative was independently introduced into wild-type or sut1 mutant plants, which are defective in sucrose phloem loading. All three (1'-, 6'-, and 6-) [18F]FDS derivatives were efficiently and equally translocated, similarly to carbon-14 [14C]-labeled sucrose. Hence, individually replacing the hydroxyl groups at these positions within sucrose does not interfere with substrate recognition, binding, or membrane transport processes, and hydroxyl groups at these three positions are not essential for hydrogen bonding between sucrose and ZmSUT1. [18F]FDS imaging afforded several advantages compared to [14C]-sucrose detection. We calculated that 1'-[18F]FDS was transported at approximately a rate of 0.90 ± 0.15 m.h-1 in wild-type leaves, and at 0.68 ± 0.25 m.h-1 in sut1 mutant leaves. Collectively, our data indicated that [18F]FDS analogs are valuable tools to probe sucrose-SUT interactions and to monitor sucrose transport in plants.
Bargaining Power and Background Law

Power in contract law typically refers to the bargaining strength of each contracting party in relation to the other. In assessing the relative bargaining power of each party, courts and commentators often consider factors specific to the parties, such as socio-economic status and education level. In this Essay, I suggest another factor that affects the power of the parties in negotiating or modifying their agreement, one that I refer to as the “background law.” The background law is the substantive law that governs the subject matter of the contract. This Essay focuses specifically on the background law of copyrights and the way it alters and affects the allocation of power between contracting parties. In certain circumstances, the background law of copyright has the potential to create or exacerbate two kinds of power imbalance – knowledge power and market power. In this Essay, “knowledge power” refers to the advantage that a superior understanding of the background law confers upon a contracting party. I use the term “market power” to refer to the ability of a contracting party to establish and dictate business norms in a particular segment of the economy or within a particular industry. This Essay focuses on three bargaining pairs in order to explore how copyright law as background law can create knowledge and market power imbalances: (1) independent artist and hiring party, (2) employee and employer, and (3) software company and consumer. The first two bargaining pairs involve the work-made-for-hire doctrine. The third bargaining pair involves innovative contracting forms and the freedom to contract. Part I examines knowledge power imbalances using as examples the first two bargaining pairs. Part II analyzes market power imbalances using as an example the third bargaining pair.
Staphylococcus lugdunensis Infections of the Skin and Soft Tissue: A Case Series and Review

Staphylococcus lugdunensis (S. lugdunensis) is a coagulase-negative, Gram-positive bacterium that can be isolated as a component of normal skin flora in humans. However, more recently, it has also been documented as a culprit in skin and soft tissue infections. We describe the clinical features of five individuals with S. lugdunensis-associated skin infections. We review the characteristics of other patients that were previously described with this organism as the causative agent of skin infection. Staphylococcus lugdunensis was correlated with the development of significant skin and soft tissue infections in five patients. The Pubmed database was used to search for the following terms: “abscess,” “cellulitis,” “cutaneous,” “lugdunensis,” “paronychia,” “skin,” “soft,” “staphylococcus,” and “tissue.” The relevant and reference papers generated by the search were reviewed. One woman and four men developed S. lugdunensis-related skin infections from February 19, 2015 to May 30, 2017. The patients’ ages at the onset of the infection ranged from 30 to 82 years; the median age was 70 years. Four patients were older than 65 years. The back was the most common location for the infection, followed by digits. The infection presented as cystic lesions with cellulitis or periungual abscesses. The lesions were incised or spontaneously ruptured. Patients were empirically treated with oral antibiotics; if necessary, the management was adjusted based on the culture-derived sensitivities of the organisms. The infections resolved within 10–30 days after commencing treatment. Staphylococcus lugdunensis has previously been considered as a nonpathogenic organism and to be a component of normal skin flora. However, S. lugdunensis can result in significant skin and soft tissue infections, perhaps more frequently in older individuals. Its antibiotic sensitivities appear to be similar to those of methicillin-susceptible Staphylococcus aureus.
Free gracilis muscle transfer for smile reanimation after treatment for advanced parotid malignancy.

Background The purpose of this study was to characterize the outcomes of free gracilis muscle transfer for delayed smile reanimation after radical parotidectomy. Methods A retrospective chart review of patients who underwent free gracilis muscle transfer for smile reanimation after radical parotidectomy between 2003 and 2016 was performed. Patient-reported quality of life (Facial Clinimetric Evaluation Scale [FaCE]), physician-reported facial function ("eFACE" facial grading scale), and oral commissure excursion were compared preoperatively and postoperatively. Results Twelve patients were identified with prior surgery and adjuvant therapy (radiotherapy in 6 cases and chemoradiotherapy in 6 cases). Significant postoperative improvements were demonstrated for ipsilateral commissure excursion with smile (preoperatively: -2.2 mm [SD 2.3 mm] vs postoperatively: 7.9 mm [SD 2.5 mm]; P = .002), with meaningful smile achieved in 11 of 12 cases (91.7%). The average duration of facial paralysis before intervention was 72 months (range 12-204 months). Conclusion Free gracilis muscle transfer is an option for dynamic smile reanimation in select patients who have undergone treatment for advanced parotid malignancy.
Embedded thermocouples for CMC engine components

Nickel-based super alloys have been the mainstay for gas turbine components comprising the hot section. However, due to their superior thermomechanical properties, SiC-SiC ceramic matrix composites (CMC) are replacing nickel-based superalloy components. This requires that the CMC components be instrumented to determine structural integrity. Traditional wire thermocouples report reliable data but are not suited for the conditions in the gas turbine engine since they affect gas flow and vibrational modes during operation. Thin-film thermocouples provide a true surface temperature measurement but there are reliability issues with thin-film thermocouples such as selective oxidation, dewetting, and metallurgical changes as well as small diffusional distances. Sensors utilizing the bulk semiconducting properties of SiC in the CMC have been developed. High purity sputtered platinum is coupled with SiC in the base CMC to form a new class of thermocouples which produced thermoelectric powers of 250uV/°K at ∼1000°C. These thermocouples are able to survive high temperature by using sputtered diffusion barrier coatings. Performance of this new class of thermocouples will be presented and the potential for embedded thermocouples for advanced CMC will be discussed.
An analysis of South Carolina fish kills in relation to human population density and measures of water quality.

This correlational analysis attempts to describe the relationships between fish kill reports, measures of water quality, biological indicators, atmospheric variations, agricultural activities, and human population variables within the state of South Carolina. Generally, agricultural activities are negatively correlated with the frequency of fish kill events. Biochemical oxygen demand, pH, and conductivity are correlated with both the frequency of fish kills and human population variables. Similarly, conductivity, pH, and decreases of dissolved oxygen are correlated with the frequency of fish kills and temperature changes. No correlation is observed between anthropogenic nutrient disruptions and fish kill incidents. However, when nitrogen and phosphorous levels are compared to reference standards, it is evident that the failure to correlate these variables with fish kills is likely related to the wide distribution of eutrophic conditions. Property managers in the area are advised to consult with available resources to mitigate or prevent these conditions.
Glacial-Marine and Subglacial Sedimentation Upper Proterozoic Mineral Fork Formation, Utah

The Upper Proterozoic Mineral Fork Formation of northern Utah is a well-preserved ancient example of facies that accumulated in a glacial-marine environment and beneath an ice sheet that at times was grounded below sea level. The rocks were deposited in erosional troughs as deep as 850 m on a continental platform east of the Cordilleran miogeocline, and were partly disrupted by east-directed thrusts during the Mesozoic and early Cenozoic.
Emergency Physicians' Perceived Influence of EHR Use on Clinical Workflow and Performance Metrics

Objective Over the last decade, electronic health records (EHRs) have shaped clinical practice. In this article, we investigated the perceived effects of EHR use on clinical workflow and meaningful use (MU) performance metrics. Materials and Methods Semistructured interviews were conducted with 20 (n = 20) physicians at two urban emergency departments. Interview questions focused on time spent on EHR use, changes in clinical practices with EHR use, and the effect of MU performance metrics on clinical workflow. Qualitative coding using grounded theory and descriptive analyses were performed to provide descriptive insights. Results Physicians reported that EHRs improved their clinical workflow, especially on MU-related activities including door-to-doctor time and admit decision time. EHR use also affected physicians work efficiency, quality of care provided, and overall patient safety. Conclusion Physicians' perception of EHRs is likely to influence their practices. With negative perceptions of EHR usability problems, positive aspects of EHR use, including the influence on MU performance metrics, may be overridden.
Center for Health Administration Studies (CHAS) at the University of Chicago School of Social Service Administration.

The Center For Health Administration Studies (CHAS) is an interdisciplinary health policy and services research center located at the University of Chicago School of Social Service Administration. ...
Skin sympathetic nerve activity and the temporal clustering of cardiac arrhythmias

BACKGROUND. Simultaneous noninvasively recorded skin sympathetic nerve activity (SKNA) and electrocardiogram (neuECG) can be used to estimate cardiac sympathetic tone. We tested the hypothesis that large and prolonged SKNA bursts are associated with temporal clustering arrhythmias. METHODS. We recorded neuECG in 10 patients (69 ± 10 years old) with atrial fibrillation (AF) episodes and in 6 patients (50 ± 13 years old) with ventricular tachycardia (VT) or fibrillation (VF) episodes. Clustering was defined by an arrhythmic episode followed within 1 minute by spontaneous recurrences of the same arrhythmia. The neuECG signals were bandpass filtered between 500–1000 Hz to display SKNA. RESULTS. There were 22 AF clusters, including 231 AF episodes from 6 patients, and 9 VT/VF clusters, including 99 VT/VF episodes from 3 patients. A total duration of SKNA bursts associated with AF was longer than that during sinus rhythm (78.9 min/hour [interquartile range (IQR) 17.5–201.3] vs. 16.3 min/hour [IQR 14.5–18.5], P = 0.022). The burst amplitude associated with AF in clustering patients was significantly higher than that in nonclustering patients (1.54 μV [IQR 1.35–1.89], n = 114, vs. 1.20 μV [IQR 1.05–1.42], n = 21, P < 0.001). The SKNA bursts associated with VT/VF clusters lasted 9.3 ± 3.1 minutes, with peaks that averaged 1.13 ± 0.38 μV as compared with 0.79 ± 0.11 μV at baseline (P = 0.041). CONCLUSION. Large and sustained sympathetic nerve activities are associated with the temporal clustering of AF and VT/VF. FUNDING. This study was supported in part by NIH grants R42DA043391 (THE), R56 HL71140, TR002208-01, R01 HL139829 (PSC), a Charles Fisch Cardiovascular Research Award endowed by Suzanne B. Knoebel of the Krannert Institute of Cardiology (TK and THE), a Medtronic-Zipes Endowment, and the Indiana University Health-Indiana University School of Medicine Strategic Research Initiative (PSC).
Spending on World Health Organization essential medicines in Medicare Part D, 2011-15: retrospective cost analysis

Abstract Objectives To characterize the trends, drivers, and potential modifiers of increased spending by US Medicare beneficiaries on medicines deemed essential by the World Health Organization. Design Retrospective cost analysis of Medicare Part D Prescriber Public Use File, detailing annual generic and brand name drug prescribing and spending from 2011 through 2015 by Medicare Part D participants who filled prescriptions for WHO essential medicines. Setting US Medicare System. Main outcome measures Total and per beneficiary Medicare spending, total and per beneficiary out-of-pocket patient spending, cumulative beneficiary count, claim count, and per unit drug cost. All spending measures were adjusted for inflation and reported in 2015 US dollars. Results Medicare Part D expenditures on 265 WHO essential medicines between 2011 and 2015 was $87.2bn (£68.4bn; €76.5bn), with annual spending increasing from $11.9bn in 2011 to $25.8bn in 2015 (116%). Patients’ out-of-pocket spending for essential medicines over the same period was $12.1bn. Total annual out-of-pocket spending increased from $2.0bn to $2.9bn (47%), and annual per beneficiary out-of-pocket spending on these drugs increased from $20.42 to $21.17 (4%). Total prescription count increased from 376.1m to 498.9m (33%), and cumulative beneficiary count grew from 95.9m to 135.8m (42%). Of the essential medicines included in the study, the per unit cost of 133 (50%) agents increased faster than the average inflation rate during this period. Overall, approximately 58% of the increase in total spending during this period can be attributed to the introduction of novel agents. Conclusions Spending associated with essential medicines grew substantially from 2011 to 2015, driven largely by the increased use of two expensive novel drugs used in treating hepatitis C. Approximately 22% of increased total spending during this period can be attributed to increases in per unit cost of existing drugs. These trends may limit patients’ access to essential drugs while also increasing healthcare system costs.
Psychological mislabelling in chronic pain: reducing the risk.

GPs devote much of their clinical time to chronic pain. Back, joint, and musculoskeletal pain consistently rank among the top five reasons for visiting a doctor.1 One of the pitfalls in treating chronic pain is the tendency to over-psychologise, a practice I call psychological mislabelling.2 Psychological mislabelling occurs when anxiety, depression, and stress are routinely assumed to play a major role in cases of back pain, headache, fibromyalgia, and other poorly understood chronic conditions. When we invoke the biopsychosocial model (BPSM) — particularly the psychological component — selectively in chronic pain, we are likely mislabelling. When we think of the BPSM only when confronted with patients we find difficult, inconsistent symptoms, or failed therapies, we perpetuate the misconceptions of a discredited …
Whose Citizens, What Rights? Roles and Responsibilities in Addressing Displacement and Forced Migration in Haiti

Over the past 10 years, a new impetus in addressing statelessness and protecting the stateless population led to stronger state commitments, and improved mechanisms at the national and international levels, to address/eliminate statelessness. The most recent such development is embodied by the 10-year UNHCR’s Global Action Plan to End Statelessness. Yet, the Dominican Republic (DR) is a stark exception from this rule. Although the tension between the DR and Haiti is not new, in 2010, and respectively, 2013, the DR’s shift in legal requirements for citizenship and nationality sharply increased statelessness, adding an estimated 210,000 people to the stateless population. The legal decisions leading to this situation contributed to statelessness and displacement—with thousands of Haitian people in the DR migrating back to Haiti in 2015 and 2016. This paper presents the context of legal and political constraints affecting the situation of displaced Haitians, and the findings of an initial assessment conducted in 2015 of the stateless living situations in two of the camps set at the southern border between the Dominican Republic and Haiti. We particularly focus our analysis on migrants’ perception of government and international organizations, their expectations and claims to protection and support, and the elements contributing to either helplessness or resilience. The findings of this study indicate that participants had minimum support and lacked housing, food security, access to latrines, and water sources. A large number of participants reported significant level of trauma and very low levels of trust in any of the official stakeholders involved in the migration and relocation processes.