cssi/SciSciGPT-SciSciNet huggingface dataset:
Political Bargaining and Democratic Transitions: A Comparison of Nicaragua and El Salvador

This article examines the relationship between pact-making and democratic transitions in Nicaragua (1988–1997) and El Salvador (1990–1997). We argue that the process of elite bargaining about regime change affects the prospects for the consolidation of democracy. We emphasise three factors: (1) the choices key actors make as they bargain about bargaining, (2) their willingness to ‘under-utilise’ their power and (3) the influence of historical and structural contingencies upon the key choices made. Essential to our discussion of historical and structural contingencies is the interrelation of domestic and international actors and the importance of demilitarisation and institutional reform. We argue that these three factors favoured El Salvador more than Nicaragua, although neither nation has overcome the political polarisation characteristic of transitional regimes.
Stochastic modeling of evaporating droplets polydispered in turbulent flows

Abstract Dispersion and polydispersity of evaporating droplets in turbulent flows are investigated through a newly proposed stochastic model. The model is based on a first-order time series analysis, addresses the anisotropy of turbulence, and adequately takes into account the temporal correlations. It predicts temperature and vapor mass fraction fluctuations as well as velocity fluctuations. A set of averaged equations are derived for the carrier phase in homogeneous turbulence while the interaction between the carrier phase and the droplet phase are considered through source terms. The performance of the model is assessed by conducting simulations of droplet-laden homogeneous shear flows. Good agreements are observed for various velocity, temperature and vapor mass fraction statistics with the DNS data.
Collaborating or Selling Patients? A Conceptual Framework of Between-Unit Handoff Negotiations

Handoffs of patients between healthcare providers are crucial enablers of coordination during transitions in a system that is highly specialized and greatly fragmented. In particular, between-unit ...
Quantitative phase microscopy with asynchronous digital holography

We demonstrate a new method of measuring quantitative phase in imaging of biological materials. This method, asynchronous digital holography, employs knowledge of a moving fringe created by acousto-optic modulators to execute phase-shifting interferometry using two near-simultaneous interferograms. The method can be used to obtain quantitative phase images of dynamic biological samples on millisecond time scales. We present results on a standard sample, and on live cell samples.
Septic Cerebral Vein Thrombosis and Abnormal Leptomeningitis as a Complication From a Periodontitis in a Hispanic Male: Case Report and Literature Review

Sinus vein thrombosis is a rare form of stroke that results from thrombosis of the dural vein sinus. Despite the variety of diagnostic procedures and treatment, septic thrombosis of the cavernous sinus can cause significant morbidity and mortality if not diagnosed and treated as an emergency. The clinical presentation of proptosis that occurs suddenly accompanied by erythema of the eyelid and limitation of ocular movement should alert the clinician of the possibility of cavernous sinus thrombosis. A 38-year old Hispanic male presented with pounding headache, mainly in the occipital region that began 1 week prior to hospital admission. During the hospitalization the patient subsequently developed a progressive worsening of proptosis, lacrimation and neck pain. The MRI and venography of the brain showed a cerebral venous thrombosis (CVT) with a reactive diffuse leptomeningitis. The underlying cause was a chronic dental infection. The patient was treated with course of antibiotics and discharged. A few weeks later the repeated imaging studies showed a resolution of the CVT and leptomeningitis. Although rare, septic vein thrombosis (SVT) remains a potentially lethal complication of infections that involve the sinuses, face, ears and oral cavity. The early recognition and differentiation from other diseases are keys to reducing mortality rates and long-term sequelae. Advances in imaging, especially CT and MRI have contributed substantially to the rapid diagnosis of the condition. J Med Cases. 2013;4(9):598-601 doi: http://dx.doi.org/10.4021/jmc1370w
The feeding behavior of Trichogramma brassicae: new evidence for selective ingestion of solid food

A descriptive study of the feeding behavior and structures of Trichogramma brassicae Bezdenko (Hymenoptera: Trichogrammatidae) was conducted. Based on direct observational and biochemical evidence, larvae feed predominantly on particulate materials, starting ca. 25 h post-oviposition. Feeding lasted for ca. 9 h, at 25 ± 1 °C. During this feeding period the shape of the larvae changed from vermiform to pyriform and then to sacciform, resulting in a ca. 40-fold increase in body size. Larvae used elaborate feeding behaviors as they pulled solid food particles to their oral opening, broke small particles from larger ones, and took the particles into the stomodaeum, which is a powerful pump. In the stomodaeum, peristaltic movement further macerated the particles, which eventually passed through the cardiac valve into the midgut. As indicated by changes in fluorescently labeled casein, digestive enzymes aid in the extra-oral chemical digestion of food. The contents of the gut, during and shortly after feeding, were almost entirely closely packed solid particles. The behavioral activity of feeding larvae centered almost exclusively on processing and ingesting solid food particles. The rapid larval growth is much more plausibly explained by their feeding on the highly concentrated nutrients found in solid foods, rather than the extensive concentration required if dilute liquids were the principal source of nutrients. The implications of these findings for the development of practical artificial diets are discussed.
Influence of thyroid states on stress gastric ulcer formation

Thyroid hormones exert a critical developmental and regulatory role on the morphology and biochemistry of gastrointestinal mucosal cells. However, the relationship between thyroid function and stress gastric lesion formation remains undetermined. This study was designed to test the hypothesis that thyroid states may affect the acute development of gastric lesions induced by cold-restraint stress. Normal (euthyroid), hyperthyroid (200 micrograms of T4 i.p. x 7 days) and hypothyroid (thyroidectomized) rats were used. Gastric lesion incidence and severity was significantly (p less than 0.05) increased in hypothyroid rats, whereas in contrast hyperthyroid rats developed significantly less gastric lesions. As anticipated, plasma levels of thyroxin (T4) were significantly (p less than 0.01) elevated in hyperthyroid rats, and undetectable in hypothyroid rats. Acute pretreatment with i.p. cimetidine (100 mg/Kg), but not T4 (200 micrograms/Kg) 1 h prior to stress completely prevented gastric lesions formation in hypothyroid rats. Finally, binding of 3H-dihydroalprenolol to beta-adrenergic receptors on brain membranes prepared from frontal cortex was reduced by 20% in hypothyroid rats after 3 h of stress. These and other data contained herein suggest that thyroid hormones contribute to modulate the responsiveness of the gastric mucosa to stress. The increased rate of ulcerogenesis observed in hypothyroid rats appears to be mediated by gastric acid secretion. The central mechanism of this response may involve decreased brain nonadrenergic receptor function.
Patterns of sexual and erectile dysfunction and response to treatment in patients receiving androgen deprivation therapy for prostate cancer

OBJECTIVE To investigate the incidence of patient-reported erectile (ED) and sexual dysfunction and response to treatment in men after the induction of androgen deprivation therapy (ADT) for prostate cancer, as ADT-induced changes in serum testosterone can result in changes in libido and sexual function. PATIENTS AND METHODS We retrospectively reviewed patients receiving ADT for prostate cancer at our institution between January 1989 and July 2005; those receiving only neoadjuvant ADT were excluded. Variables included age, race, body mass index, prostate-specific antigen level before ADT, Gleason sum, clinical stage, ADT type (medical vs surgical) and schedule (continuous vs intermittent), previous treatment for prostate cancer, presence of pre-existing or new-onset diabetes mellitus (DM), and presence of ED before ADT. After ADT induction, charts were reviewed for reporting of ED, changes in libido, and initiation of ED therapy (medical or surgical). RESULTS In all, 395 patients (mean age of 71.7 years; 59.0% African-American, 41.0% Caucasian/other, at initiation ADT) were analysed. At mean follow-up of 87.4 months, 57 (14.4%) patients reported ED; 40 of these (70%) reported new-onset ED, while 17 (30%) reported ED before ADT. Response rates were 33–80% with medical therapy, including 44% receiving phosphodiesterase-5 inhibitor monotherapy. On multivariate analysis, age <70 years (P < 0.001) and the absence of DM (P = 0.024) were associated with reporting ED after ADT. CONCLUSIONS Patients receiving ADT for prostate cancer have variable degrees of ED. Successful outcomes are possible, particularly when implementing multimodal therapy. Younger patients and those with no DM are more likely to report ED after ADT induction.
“The Ennobling Unity of Science and Technology”: Materials Sciences and Engineering, the Department of Energy, and the Nanotechnology Enigma

The ambiguous material identity of nanotechnology is a minor mystery of the history of contemporary science. This paper argues that nanotechnology functioned primarily in discourses of social, not physical or biological science, the problematic knowledge at stake concerning the economic value of state-supported basic science. The politics of taxonomy in the United States Department of Energy’s Office of Basic Energy Sciences in the 1990s reveals how scientists invoked the term as one of several competing and equally valid candidates for reframing materials sciences in ways believed consonant with the political tenor of the time. The resulting loss of conceptual clarity in the sociology of science traces ultimately to the struggle to bridge the disjunction between the promissory economy of federal basic science and the industrial economy, manifested in attempts to reconcile the precepts of linearity and interdisciplinarity in changing socio-economic conditions over a half century.
Cardiac sodium channel structure and function.

The upstroke of the action potential in heart cells, as in nerve and skeletal muscle cells, is due to the movement of sodium ions through ion-selective channels in the surface membrane. Voltage-dependent sodium channels in the heart, while sharing many common electrophysiologic characteristics with sodium channels in nerve and skeletal muscle, are distinctive in that they also contribute current to the plateau phase of the action potential and have unique sensitivities to channel-active toxins and drugs, most notably the local anesthetic-type antiarrhythmic agents. With the recent cloning and functional expression of the rat and human cardiac sodium channel genes, we are now in a position to understand better the molecular mechanisms responsible for the unique characteristics of sodium channels in the heart.
Buruli Ulcer: A Review

Buruli ulcer (BU) is a severe necrotizing infection of skin and soft tissues caused by the fresh-water mycobacterium, Mycobacterium ulcerans . While it is rarely fatal, it can profoundly debilitate those it affects, resulting in extreme individual morbidity, as well as a profound financial, emotional and social burden for the families and communities affected. This review of Buruli ulcer details the history, pathogenesis, diagnosis and management of this neglected tropical disease.
All in the family: use of familial information in orthodontic diagnosis, case assessment, and treatment planning.

O r t h o d o n t i c s has never been a quiet, settled specialty, but the current controversy, touching as it does upon the very scientific bases of orthodontic diagnosis, case assessment, and t reatment p lanning--not to mention a number of complex ethical issues--has commanded an unusual amount of attention, both at the meetings of our societies and in the pages of our journals. Computers / large data bases, 2 and service agencies ~ are used to provide the clinician with norms, standards, growth projections and even appropriate t reatment strategems. Morphometrics, computerized cephalometrics, and clinical deviations are all catchwords and phrases coined, in keeping with the best of advertising tradition, to divert attention from the intrinsic values of the product and focus on the packaging. In selling the concept of a "norm," for example, it is suggested that data generated by a computer is afortiori scientifically acceptable. What remains unspoken is the tacit assumption that the extent of the individual patient 's depar ture f rom such norms is a reliable indication of his growth potential. Some have, of course, recognized--and re jected-this assumption. The result of the ensuing dialogue has been a bipolarization of opinion among orthodontis ts--
Planned neck dissection following primary chemoradiation for advanced-stage head and neck cancer

OBJECTIVES: To determine the prevalence of residual cancer in planned neck dissection specimens for advanced-stage squamous cell carcinoma following chemoradiation. STUDY DESIGN: A case series. SETTING: A single-surgeon community-based head and neck practice. SUBJECTS AND METHODS: Twenty-six patients were identified during 2000 to 2007. All patients were treated with external beam radiation; the average dose to the neck was 60 Gy (range 50-72 Gy). Concurrent chemotherapy was given with cisplatin and 5-fluorouracil. Patients presenting with greater than N2 cervical disease and at least one node greater than 3 cm were considered advanced. Post-chemoradiation physical examinations were performed by the primary surgeon and oncologist. Absence of physical evidence of disease was deemed a complete clinical response. RESULTS: Fourteen of 21 (67%; 95% confidence interval [CI], 0.449-0.854) patients were found to have carcinoma in their neck specimens. Seven patients were noted to have a clinically complete response, and two of seven (29%; 95% CI, 0.053-0.659) patients with a clinically complete response were found to have carcinoma in their neck specimens. Fourteen patients were noted to have an incomplete response to therapy. Two of these 14 (14%; 95% CI, 0.026-0.419) patients had negative pathology in their neck dissection specimens. Three patients had local recurrence and succumbed to their disease. CONCLUSION: Planned neck dissection in the setting of advanced neck disease following chemoradiation should remain an important consideration when counseling patients presenting with advanced cervical metastasis from squamous cell head and neck cancer.
Slowing the brain drain: FAIMER education programs.

Migration of physicians has produced serious shortages in many developing countries. The Foundation for Advancement of International Medical Education and Research (FAIMER) is attempting to show this international brain drain through creation of faculty development programs for medical school faculty from developing countries in order to strengthen medical education and help build a sustainable discipline of medical education. The goals of these programs are to allow Fellows to acquire basic skills in medical education, skills in leadership and management, and build a strong community of practice. Acquisition of these skills will improve medical education in their home country, stimulate growth of the field of medical education, and improve opportunities for professional advancement. Three programs currently exist: the FAIMER Institute, a two year fellowship with residential and distance learning components; International Fellowships in Medical Education, which funds selected Institute alumni to obtain ma...
Pulmonary function and dyspnea/suffocation theory of panic

This article presents a brief discussion of pulmonary function and panic attacks in the context of respiratory psychophysiology. Ley's (Behaviour Research and Therapy, 27, 549-554, 1989) earlier dyspnea/suffocation theory of panic is contrasted with Klein's (Archives of General Psychiatry, 50, 306-316, 1993) later false suffocation alarm theory. The distinction between "dyspnea" (the sensation of difficulty in breathing) and "suffocation" (a condition that sometimes gives rise to dyspnea) is emphasized. The brief discussion is followed by a critical comparison of two recent studies on pulmonary function and panic. Asmundson and Stein (Journal of Anxiety Disorders, 8, 63-69, 1994) reported an association between forced expiratory flow rate (a measure of pulmonary function) in panic disorder patients and the severity of panic-related symptoms. They interpreted their findings as support for the dyspnea/suffocation theory of panic since severity of dyspnea is a consequence of pulmonary function. Spinhoven et al. (Behaviour Research and Therapy, 33, 457-460, 1995) failed to replicate the findings of Asmundson and Stein. The present paper provides a critical analysis of the study by Spinhoven et al. and concludes that the failed attempt to replicate may have been a consequence of a flawed methodology (the subjects of the two studies are not comparable on a crucial pulmonary test) and a statistical anomaly (disproportionately small differences between means that exceed predictions based on sampling error). A recommendation is made that future attempts to replicate should pay special care to avoid the possibility of experimenter-demand effects.
Spontaneous passivation observations during scale formation on mild steel in CO2 brines

Previous study revealed localized corrosion in CO2 environments was driven by a galvanic cell established between pit surfaces and scaled surrounding area. In order to underpin the understanding of the galvanic mechanism of localized corrosion, the root cause of potential differences between these two surfaces, passivation of mild steel, in CO2 environments was investigated using transmission electron microscopy technique and electrochemical techniques including potentiodynamic polarization, cyclic polarization and open circuit potential techniques. Potentiodynamic polarization experiments showed that the passivation of the carbon steel surface favorably occurred at pH > 7 and facilitated with the presence of FeCO3 scale. Cyclic polarization tests showed that polarization rate had an important influence on passivation behavior. At a slower polarization rate, lower passivation potential and current density were observed. Spontaneous passivation was evidenced by a significant increase of corrosion resistance and an open circuit potential without any externally applied current or potential during electrode immersion. This process is affected by pH, temperature, presence of CO2 and iron carbonate. Nevertheless, iron carbonate film is not the only one responsible for passivation, as demonstrated from depassivation tests where passivity was lost without losing the existing iron carbonate film. Transmission electron microscopy technique was used to determine the structure of the passive layer. An extra phase, most likely magnetite, was observed to be beneath the iron carbonate scale and at the crystal grain boundaries which passivated the mild steel.
Credit Card Use and Abuse: A Veblenian Analysis

(2007). Credit Card Use and Abuse: A Veblen ian Analysis. Journal of Economic Issues: Vol. 41, Papers From The 2007 AFEE Meeting, pp. 567-574.
RASSF1A and NORE1A methylation and BRAFV600E mutations in thyroid tumors

We analyzed RASSF1A and NORE1A methylation and BRAF mutation in 89 thyroid tumors, 42 non-neoplastic thyroid tissues and three thyroid tumor cell lines using polymerase chain reaction (PCR), methylation-specific PCR, Western blotting and DNA sequencing in order to study thyroid tumor pathogenesis and progression. RASSF1A promoter methylation was present in all three thyroid cell lines and in 27/78 (35%) of benign and malignant thyroid tumors. We showed for the first time that there was generally good agreement between RASSF1A methylation status and RASSF1A protein expression. We also examined for the first time NORE1A promoter region methylation in thyroid cell lines and primary tumors and showed that two of three thyroid cell lines were methylated in the NORE1A promoter region, while all primary thyroid tumors analyzed (n=51) were unmethylated. BRAF mutation was present in 38% of papillary thyroid carcinomas (PTC), including 20% of PTC with a follicular variant pattern and 67% of the tall cell variant of PTC. Hyalinizing trabecular tumors (n=23), which had nuclear features similar to PTC, did not have BRAF mutations, indicating that the presence of BRAF mutations can help to separate these two tumor types. Phospho-MEK expression was increased in the NPA cell line, which had a BRAF mutation, supporting the importance of the BRAF pathway alterations in PTC pathogenesis. These results indicate that RASSF1A epigenetic changes are an early event in thyroid tumor pathogenesis and progression and that NORE1A methylation is uncommon in primary thyroid tumors. BRAF mutation occurs later in thyroid tumor progression and is restricted mainly to PTC and anaplastic thyroid carcinoma.
Sudden Death Related to Myocardial Infarction

Sudden death as it relates to myocardial infarction (not necessarily acute) is discussed on the premise that most such deaths are due to a lethal electrical disturbance of the heart. The three sections of the first part deal with the rhythm of the heart, conduction in the heart, and neural control of the heart. In these sections consideration is made of those factors which stabilize cardiac electrical performance, and conversely how these factors may be deranged into electrical instability. In the second part a practical discussion is organized to interrelate the principles presented on maintenance and derangement of electrical stability of the heart; the electrical reserve of the heart, some unstabilizing factors, and clinical considerations are the subjects for this integrating synthesis. The entire review is designed to provide the clinical cardiologist a framework of reference in which logical decisions can be made in caring for the patient who has coronary disease and in whom myocardial infarction wi...
INCIDENCE OF RADIATION FIBROSIS AFTER USE OF A STANDARDIZED TECHNIQUE OF RADIOTHERAPY FOR BREAST CANCER

To determine whether the use of a standardized technique of radiotherapy for breast cancer was followed by roentgenographic evidence of pulmonary fibrosis, a survey was made of the serial chest roentgenograms of 42 patients with breast cancer who had received such radiotherapy 2 1/2 years previously. Also reviewed, to aid in identification of roentgenographic changes caused by other disease, were their clinical notes, hospital records and, in 5 instances, autopsy protocols. Evidence of slight pulmonary fibrosis appeared on the chest roentgenograms of 6 patients as one or more fibrotic strands, 2 or 3 cm long, in the lung underlying x-irradiated regions of the thoracic wall. The affected lungs were not retracted or distorted. Evidence of radiation fibrosis did not appear on the serial chest roentgenograms of the other 36 patients. Among these 42 disparate patients with breast cancer observed for at least 2 1/2 years this standardized technique of radiotherapy did not cause roentgenographic evidence of significant pulmonary fibrosis.
METEX—An expert system for machining planning

Optimal selection of process parameters is an important problem faced by most process planners and NC programmers. Computerized systems and mathematical models are available in literature for machining parameter selection. These systems are usually constructed with compiled handbook data. The machining process is non-linear and exhibits piecewise behaviour within different cutting ranges. If this piecewise behaviour can adequately be represented in machinability parameter selection systems, more insightful selection of cutting conditions can be achieved. The present paper provides a comprehensive survey of existing literature on machinability parameter selection systems, followed by a literature-based analysis of the anomalies of machining and the process and material effects in machining. A justification of expert systems for qualitative modelling is provided. A prototype system (METEX) for machining parameter selection is then discussed. This system uses production (FF-THEN rules to qualify machining at...
Pellagra, Sex and Gender: Biocultural Perspectives on Differential Diets and Health

Pellagra is generally characterized as a niacin deficiency disease. Symptoms include the four “D's” - dermatitis, diarrhea, dementia, and death. Historically, it has been linked to high maize and low protein diets. The “plague of com” was rampant in southern Europe for centuries and prevalent among U.S. Southerners in the early 1900s. Pellagra's social history is extensive and stands as a classic in the study of vitamins and nutrient deficiencies. However, to date none of this work has focused on the fact that mortality rates for women have been double that of men. This paper calls for a biocultural perspective that investigates the clear difference in both morbidity and mortality rates related to sex and gender. To do so, one must discuss diet and digestion by integrating the role of estrogen during the female lifecycle (from menarche to menopause) with differential gender-based food consumption patterns.
Nickel Particle Size Effects on Cyclohexane Dehydrogenation: A Combined Reaction Kinetics and Surface Science Study

The kinetics of cyclohexane dehydrogenation was studied under near atmospheric pressure (25 Torr) at 600 K on Ni/SiO2/Mo(110) model catalysts prepared under ultrahigh vacuum conditions. The supported Ni model catalysts were characterized by Auger electron spectroscopy, temperature programmed desorption (TPD) and polarization modulation infrared reflection absorption spectroscopy (PM-IRAS). The average Ni particle sizes and particle size distributions were acquired by scanning tunneling microscopy. The kinetics results show that, for Ni particles below 2.5 nm in diameter, the specific rates (turnover frequency of benzene or TOF) increase with a decrease in particle sizes, while for Ni particles larger than 2.5 nm, the TOF is particle size independent. H2- and CO-TPD experiments as well as CO PM-IRAS spectroscopy confirm the change of Ni particles’ surface structures as a function of particle size. The particle size effect on reaction kinetics is explained by the sharp increase in the fraction of low coordinated Ni atoms on the surface of particles below 2.5 nm in diameter.
Why Vote-seeking Parties May Make Voters Miserable

This paper explores an unexpectedly hard question for representative democracy, which is usually thought to be enhanced when political parties compete with each other for the support of voters in free and fair elections. Defining optimal representation in terms of the probability that a voter will find a party to support at election time that promotes a policy position close to his/her ideal point, it transpires that vote-seeking parties do not deliver optimal representation. They tend to locate ‘too close’ to the centroid of voter ideal points to minimize the aggregate distance between party positions and voter ideal points. Instead, optimal representation in this sense will be delivered if parties set policy positions using ‘aggregator’ rules, which seek to represent the views of current party supporters, but not to attract new supporters. One policy implication is that the representativeness of inter-party politics is increased by enhancing the representativeness of intra-party politics.
State-of-the-art screening for lung cancer (part 1): the chest radiograph☆

A series of studies performed primarily in the 1970s have been interpreted to show that the chest radiograph (CXR) is not an effective method for reducing mortality from lung cancer. While a stage shift was seen for the detected cancers, compared with current or historic controls, mortality was not shown to decrease. Since the 1970s, when these studies were performed, there have been substantial improvements in the technologies for CXRs and for the detection of small nodules on these radiographs. New developments include computed radiography (CR), direct digital radiography (DDR), image processing, energy subtraction (ES), temporal subtraction of serial radiographs (TS), and computer-aided detection (CAD). In this article the term digital radiography (DR) will be used to include CR and DDR. Examples of DR, ES, and CAD are shown in Figs. 1 and 2.
Use of human rocombinant erythropoietin to correct severe preoperative anemia

The risks of homologous blood transfusion are well known. Herein, we describe the successful preoperative use of human recombinant erythropoietin to correct severe anemia in a patient refusing transfusion. This case report emphasizes the important perioperative role human recombinant erythropoietin may play in the future.
Aligning economic and social value creation through pay-what-you-want pricing

AbstractThe main objective of social ventures is the creation of social value. However, these organizations must also generate and appropriate economic value to fund their social value-creating activities. Mechanisms that enable the alignment of these seemingly contradicting goals are necessary. The authors propose that a participative pricing mechanism known as pay-what-you-want (PWYW) is capable of aligning a venture's economic and social value creation goals. This mechanism allows customers to determine the price they are willing and able to pay. The authors explain that this mechanism enables social ventures to generate social value through their commercial activities by serving more beneficiaries in need, reducing the stigma of receiving help, allowing non-disadvantaged customers to show support for the social venture, and aligning commercial activities with the social mission, all while ensuring that sufficient economic value is captured to sustain operations.
Predicting change in functional status over quarterly intervals for older adults enrolled in the PACE community-based long-term care program.

Background and aims: Many frail older adults experience multiple changes in activities of daily living (ADL) functioning over the course of a year. Accurate predictions of ADL status over quarterly intervals may improve the precision of care planning for older adults who seek long-term care in the community. The study sought to develop and validate a model that predicts older adults’ ADL status over quarterly intervals. Methods: The study included 3127 enrollees from 11 Program of All Inclusive Care for the Elderly (PACE) sites. Nurses assessed ADL status quarterly. Potential predictors included baseline assessment of age, sex, race, and living situation and quarterly assessments of prior functioning, co-morbidities, prior hospitalizations, and mental status. Results: Change in level of functioning occurred for 30% of quarterly observations. Predictors of functioning at the end of a quarter were prior ADL change, prior hospitalization, living with others, impaired mental status, cancer, dementia, coronary artery disease, congestive heart failure and chronic obstructive pulmonary disease. When the model was applied to the validation observations, 93% of predictions were within one level and 72% of the predictions were the same level of ADL functioning observed at the end of the quarter. Conclusions: In a sample of community-living ADL-disabled older adults, changes in functional status over a quarter were common and associated with functional and health status at the beginning of the quarter. Further validation of the model may result in an index that helps clinicians better predict future ADL needs of community-living older adults who need long-term care.
1.54 mu m electroluminescence in MeV ion implanted Er-doped GaAs

Er3+ electroluminescence at 1.54 μm has been observed from p-n junction diodes fabricated from ≈ 1 μm Er doped GaAs layers produced by high energy ion implantation. These unique junctions are formed directly by the p-type conversion of the n-type substrate material within the implantation profile. The low efficiencies observed in these devices ( n ≈ 10−6) are believed to be related to the small fraction of the implanted Er in the Er3+ state.
Mechanism of cytochrome c oxidase-catalyzed reduction of dioxygen to water: evidence for peroxy and ferryl intermediates at room temperature.

The reaction between bovine heart cytochrome oxidase and dioxygen was investigated at room temperature following photolysis of the fully reduced CO-bound enzyme. Time-resolved optical absorption di...
Selectively silicided vertical power DMOSFETs for high-frequency power conversion

A 50 V, 056mΩcm2 vertical power DMOSFET fabricated using selectively silicided gate and source contact regions is reported. The gate-source isolation was provided by anisotropically etched oxide sidewall spacers. This new device structure lowers the source contact resistance considerably by providing a larger contact area and improves the distributed gate RC propagation delay by lowering the gate sheet resistance compared with the conventional heavily doped n+-polysilicon gates. Devices with cell density as high as 8 million cells/inch2 and die size as large as 200 mil × 220 mil and capable of conducting more than 160 A of current have been successfully fabricated with excellent gate yield. These results represent the highest reported forward conductivities for any type of power FET in the 50 V reverse blocking range
Regulation of damage-inducible genes in Escherichia coli.

Abstract The expression of the dinA, dinB, dinD and dinF genes of Escherichia coli is stimulated by certain agents that either damage DNA or block DNA replication. These agents induce the complex SOS response. Genetic evidence is presented to show that the expression of each of these genes is blocked in uninduced cells by the same repressor, the lexA protein. In addition, the regulatory regions of the dinA and dinB genes were cloned, and the approximate positions of the promoters were determined. Purified lexA protein was found to block transcription of these genes in vitro.
Conditioned and unconditioned drug effects in relapse to opiate and stimulant drug self-administration

Humans and laboratory animals given access to opiate and stimulant drugs frequently become compulsive users of these drugs, and often, in spite of prolonged periods of abstinence, persist in drug-seeking behavior and relapse to drug-taking. Evidence suggests that such drugs act on positive appetitive systems of the brain to maintain drug-taking and that, in the absence of drugs, stimuli previously associated with the drug state might acquire the ability to arouse motivational states similar to those activated by the drugs themselves. In rats previously trained to self-administer cocaine or heroin intravenously, noncontingent 'priming' intravenous infusions of cocaine or heroin lead to reinstatement of drug-taking behavior. Priming infusions of pharmacologically related drugs and drugs with similar stimulus properties also reinstate responding. Application of morphine to the cell body region of dopaminergic neurons of the ventral tegmental area (VTA), a site known to support morphine self-administration, reinstates both heroin and cocaine self-administration behavior. Reinstatement is blocked by pretreatment with naltrexone. Morphine applied to several other brain areas rich in opiate receptors does not reinstate the behavior. Application of morphine to the VTA, a site known to support conditioned place preferences as well as self-administration, causes increased locomotion that is naloxone reversible. This locomotor activity shows sensitization upon repeated administration, an effect that is specific to the environment in which morphine is administered. Conditioned increases in activity are observed in the same environment. Neither conditioning nor sensitization develops when animals are pretreated with pimozide.(ABSTRACT TRUNCATED AT 250 WORDS)
Multiple Outcomes and Multiple Sources of Evidence Best Statistical Practices

This issue contains 2 articles in our planned Statistical Primer on Methods or Interpretation Series. The goals of our series are to (1) familiarize cardiovascular outcomes researchers with design and analytic problems encountered in outcomes research, (2) point to potential solutions, and (3) introduce modern analytic approaches. The series' inaugural article1 discussed approaches for handling missing data—approaches that have existed for several decades but have not been fully embraced by outcomes researchers. The second article2 focused on the “landmark analysis, an analytic approach in which patients having treatment-censoring events before a “landmark” time are excluded from analysis. In this issue, Teixeira-Pinto and Mauri3 address the problem of multiple outcomes, and Kwok and Lewis4 discuss the use of Bayesian hierarchical models. What is “the problem” of multiple outcomes? Many readers of Circulation: Cardiovascular Quality and Outcomes will be familiar with multiplicity adjustments used in a hypothesis testing setting. Here, researchers control the overall risk of making a mistake, such as rejecting the null hypothesis when it is true, through the use of an “adjustment.” If the effects of an intervention of four different outcomes need to be tested …
Primordial hypermagnetic knots

Topologically non-trivial configurations of the hypermagnetic flux lines lead to the formation of hypermagnetic knots (HK) whose decay might seed the Baryon Asymmetry of the Universe (BAU).HK can be dynamically generated provided a topologically trivial (i.e. stochastic) distribution of flux lines is already present in the symmetric phase of the electroweak (EW) theory. In spite of the mechanism generating the HK, their typical size must exceed the diffusivity length scale. In the minimal standard model (MSM) (but not necessarily in its supersymmetric extension) HK are washed out. A classical hypermagnetic background in the symmetric phase of the EW theory can produce interesting amounts of gravitational radiation.
Adenosine stress CMR with variable density spiral pulse sequences accurately detects CAD with minimal dark-rim artifacts

Background Adenosine stress CMR perfusion imaging has numerous advantages over competing modalities for assessing CAD demonstrating high diagnostic and prognostic utility. However, adenosine stress CMR perfusion imaging is limited by motion-induced dark-rim artifacts (DRA) which may be mistaken for true perfusion abnormalities. We have previously demonstrated that a high-resolution variable-density spiral pulse sequence with a novel density compensation strategy reduces ringing artifacts in firstpass perfusion imaging. The purpose of this study was to assess the clinical performance of this new technique to detect obstructive coronary artery disease (CAD).
The Paradox of Credit Ratings

Credit ratings pose an interesting paradox. On one hand, credit ratings are enormously valuable and important. Rating agencies have great market influence and even greater market capitalization. Credit rating changes are major news; 2 rating agencies play a major role in every sector of the fixed income market. Credit ratings purport to provide investors with valuable information they need to make informed decisions about purchasing or selling bonds, and credit rating agencies seem to have impressive reputations. The market value of credit ratings was confirmed on September 30, 2000, when Moody’s Corp. became a free-standing publicly-traded entity. The market capitalization of Moody's as of April 2002 was more than $6 billion.
Why do pertussis vaccines fail

* Abbreviations: DTaP — : pediatric diphtheria and tetanus toxoids and acellular pertussis vaccine DTP — : pediatric diphtheria and tetanus toxoids and whole-cell pertussis vaccine FHA — : filamentous hemagglutinin FIM — : fimbriae PCR — : polymerase chain reaction PRN — : pertactin PT — : pertussis toxin WHO — : World Health Organization During the 2010 pertussis epidemic in California, there was considerable concern in the press and in public health communications about the possible contribution of vaccine failures to the problem.1,2 In this commentary, I examine why pertussis vaccines fail and Table 1 lists 8 possible reasons. View this table: TABLE 1 Possible Reasons Why DTP, DTaP, and Adolescent- and Adult-Formulated Tetanus and Diphtheria Toxoids and Acellular Pertussis Vaccines Fail The first reason, and perhaps the most important one, is that our estimates of vaccine efficacy have been inflated because of case definition.3–11 At the time of the pediatric diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine efficacy trials in the early 1990s, it was hoped that a universal case definition could be developed so that the results of the various trials could be compared. To this end, the World Health Organization (WHO) case definition was developed.3 The primary case definition required laboratory confirmation and ≥21 days of paroxysmal cough. I was a member of the WHO committee and disagreed with the primary case definition because it was clear at that time that this definition would eliminate a substantial number of cases and therefore inflate reported efficacy values.4–11 Nevertheless, the Center for Biologics Evaluation and Research of the Food and Drug Administration accepted this definition, and package inserts of the US-licensed DTaP vaccines reflect this. For example, Infanrix (containing 25 μg pertussis toxin [PT], 25 μg filamentous hemagglutinin [FHA], and 8 μg pertactin [PRN]) and Daptacel (containing 10 μg PT, 5 μg FHA, 5 μg fimbriae [FIM]-2/3, and 3 μg … Address correspondence to James D. Cherry, MD, MSc, Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, MDCC 22-442, Los Angeles, CA 90095-1752. E-mail: jcherry{at}mednet.ucla.edu
Overview of Screening: Where We Are and Where We May Be Headed

This volume of Epidemiologic Reviews continues a discussion about screening within the evidence community that has been going on for many years. From various perspectives, the authors of these reviews consider the benefits and harms of screening for multiple conditions; the balance between benefits and harms (and costs) is often not clear. With few exceptions, the contribution of screening to improving the health of the public is small, yet it has become a popular and growing form of prevention. It may be that we are learning that the magnitude of benefit from screening is less than we hoped, and the harms may be greater than we thought. Perhaps we should not think of screening as our primary prevention strategy but rather use screening to make a real, but limited contribution to population health for a few conditions. We might target screening to smaller subpopulations with the highest potential benefit and the lowest potential harm. The payoff for population health could be greater if we shifted some resources we now devote to screening to developing, testing, and implementing alternative approaches to preventing the important threats to population health. There needs to be a wider discussion about these issues with the public.
Prescription drug coverage, utilization, and spending among Medicare beneficiaries

ABSTRACT: Outpatient prescription drugs are not a covered benefit under Medicare. There have been proposals in the past to expand Medicare benefits to include drug coverage, and current discussions...
Thyroid Cancer among Persons Given X-ray Treatment in Infancy for an Enlarged Thymus Gland

A cohort of 2,657 infants in Rochester, New York, who were given x-ray treatment for a purported enlarged thymus gland, along with 4,833 siblings, have been followed by mail surveys through about 1986, which represents an average of 37 years of follow-up, to determine their incidence of thyroid cancer. Estimated thyroid doses ranged from 0.03 to > 10 Gy, with 62% receiving > 0.5 Gy. There were 37 pathologically diagnosed thyroid cancers in the irradiated group and five in the sibling controls. The dose-response relation was essentially linear, with no evidence of an additional dose-squared component. The estimated relative risk at 1 Gy was 10 (90% confidence interval 5-23). Thyroid cancer rates were elevated even at low doses; i.e., a dose-response analysis over the range of 0-0.3 Gy showed a significant positive slope. The risk ratio was declining over time but was still highly elevated to at least 45 years after irradiation. An examination of potential risk factors showed that older age at first childbirth was significantly associated with thyroid cancer risk. An evaluation of interactions between possible risk factors and radiation suggested that Jewish subjects and women with older ages at menarche or at first childbirth were at greater risk for radiogenic thyroid cancer.
Dual-wedge scanning confocal reflectance microscope

A confocal reflectance microscope has been developed that incorporates a dual-wedge scanner to reduce the size of the device relative to current raster scanning instruments. The scanner is implemented with two prisms that are rotated about the optical axis. Spiral and rosette scans are performed by rotating the prisms in the same or opposite directions, respectively. Experimental measurements show an on-axis lateral resolution of 1.6 μm and optical sectioning of 4.7 μm, which compares with a diffraction-limited resolution of 0.8 and 1.9 μm, respectively.
IBM RISC System/6000: architecture and performance

The IBM RISC System/6000, a superscalar microprocessor, is presented. The architecture of this processor has its instruction set specifically designed for a superscalar machine containing three independent units-branch, fixed-point, and floating-point. The design also emphasizes high-performance floating-point operations. The design principles are to offer maximum overlap of the three functional units, avoid dead cycles, and define instructions that can (for the most part) be completed at a rate of one per cycle. The branch cycle, fixed- and floating-point units, cache management, and performance are described. Benchmark results are given. >
SOME GENERALIZATIONS CONCERNING PRIMATE CITIES1

Six hypotheses are formulated and tested on the conditions under which primate cities occur. Using worldwide data, it was found that high urban primacy occurs most frequently in countries with small areal extent of dense population, low per capita income, export-oriented and agricultural economies, a colonial history, and rapid rates of population growth.
The Capiox RX05 oxygenator: pediatric clinical observations.

Terumo Cardiovascular Systems has released the X-Coated™ Capiox® RX05 or Baby RX™ oxygenator. This oxygenator is designed for neonate and infant patient populations. The device was integrated into ...