cssi/SciSciGPT-SciSciNet huggingface dataset:
Implementation of the Vocera Communication System in a Quaternary Perioperative Environment

In the hospital, fast and efficient communication among clinicians and other employees is paramount to ensure optimal patient care, workflow efficiency, patient safety and patient comfort. The implementation of the wireless Vocera® Badge, a hands-free wearable device distributed to perioperative team members, has increased communication efficiency across the perioperative environment at Massachusetts General Hospital (MGH). This quality improvement project, based upon identical pre- and post-implementation surveys, used qualitative and quantitative analysis to determine if and how the Vocera system affected the timeliness of information flow, ease of communication, and operating room noise levels throughout the perioperative environment. Overall, the system increased the speed of information flow and eased communication between coworkers yet was perceived to have raised the overall noise level in and around the operating rooms (ORs). The perceived increase in noise was outweighed by the closed-loop communication between clinicians. Further education of the system's features in regard to speech recognition and privacy along with expected conversation protocol are necessary to ensure hassle-free communication for all staff.
The effect of Superstorm Sandy on salt marsh vascular flora in the New York Bight

Abstract On October 29, 2012, Superstorm Sandy crashed into the New York Bight as a post-tropical cyclone. This storm produced extensive damage to the New Jersey and New York coastal zone. Much of the damage was caused by the storm surge that accompanied Sandy and the shifting of sand and destruction of coastal dunes. Our study was concerned with the effects that this event had on the vascular flora of the salt marshes in the impact zone. We visited six New Jersey-New York marshes in the late summer and early fall of 2013 and compared, using parsimony analysis, the current state of the vascular flora of those marshes against a pre-Sandy database. Although we observed relatively minor variations in the vascular flora at these sites, that is, the loss of some species and gains in others, overall, most plant species post-Sandy was the same as those pre-Sandy. Thus, we conclude that the species composition of the vascular flora of these salt marshes showed a remarkable degree of stability in the face of this ...
Among opioid-naive patients receiving opioids, more intensive opioid prescribing in the first month is associated with transition to long-term opioid use

Commentary on: Deyo RA, Hallvik SE, Hildebran C, et al . Association between initial opioid prescribing patterns and subsequent long-term use among opioid-naive patients: a statewide retrospective cohort study. J Gen Intern Med 2017;32(1):21-7. A recent systematic review of long-term opioid use for chronic pain found that evidence is lacking to support benefit from long-term opioid therapy, and evidence supports a dose-dependent risk of opioid-related harms including overdose and death.1 Despite the evidence, an estimated 5 to 8 million Americans receive long-term opioid therapy.2 Understanding the transition from acute or episodic use of opioids to long-term opioid use may help design interventions to reduce the incidence of long-term opioid use. This study sought to analyse the association between prescribing patterns in the first 30 days of opioid receipt among formerly opioid-naive subjects and transitioning to long-term opioid use. …
Chapter 3 – Harnessing and Integrating Africa's Renewable Energy Resources

Africa’s long-term economic growth and competitiveness fundamentally depend on reliable access to energy services; yet, the population of Sub-Saharan Africa lags far behind the rest of the world in terms of access to electricity. Recent technological advancements as well as significant drops in associated costs present the African continent with a momentous opportunity to leapfrog to modern renewable energy. Although there is general recognition among African governments that renewable power provides huge opportunities given the continent's enormous resources, the lack of coherent, consistent policies, technical skills, institutional capacity, infrastructure and financial incentives remains a major barrier for wide-spread adoption. In this chapter we review i. the significant role of renewables in mitigating Africa's key energy challenges; and ii. the importance of coordinated efforts from all angles in guiding Africa towards a cleaner, more sustainable energy future.
Risk of hospitalization among survivors of childhood and adolescent acute lymphoblastic leukemia compared to siblings and a general population sample

Abstract Background Acute Lymphoblastic Leukemia (ALL) has a high survival rate, but cancer-related late effects in the early post-treatment years need documentation. Hospitalizations are an indicator of the burden of late effects. We identify rates and risk factors for hospitalization from five to ten years after diagnosis for childhood and adolescent ALL survivors compared to siblings and a matched population sample. Methods 176 ALL survivors were diagnosed at ≤22 years between 1998 and 2008 and treated at an Intermountain Healthcare facility. The Utah Population Database identified siblings, an age- and sex-matched sample of the Utah population, and statewide inpatient hospital discharges. Sex- and birth year-adjusted Poisson models with Generalized Estimating Equations and robust standard errors calculated rates and rate ratios. Cox proportional hazards models identified demographic and clinical risk factors for hospitalizations among survivors. Results Hospitalization rates for survivors (Rate:3.76, 95% CI = 2.22–6.36) were higher than siblings (Rate:2.69, 95% CI = 1.01–7.18) and the population sample (Rate:1.87, 95% CI = 1.13–3.09). Compared to siblings and population comparisons, rate ratios (RR) were significantly higher for survivors diagnosed between age 6 and 22 years (RR:2.87, 95% CI = 1.03–7.97 vs siblings; RR:2.66, 95% CI = 1.17–6.04 vs population comparisons). Rate ratios for diagnosis between 2004 and 2008 were significantly higher compared to the population sample (RR:4.29, 95% CI = 1.49, 12.32), but not siblings (RR:2.73, 95% CI = 0.54, 13.68). Survivors originally diagnosed with high-risk ALL did not have a significantly higher risk than siblings or population comparators. However, high-risk ALL survivors (Hazard ratio [HR]:3.36, 95% CI = 1.33–8.45) and survivors diagnosed from 2004 to 2008 (HR:9.48, 95% CI = 1.93–46.59) had the highest risk compared to their survivor counterparts. Conclusions Five to ten years after diagnosis is a sensitive time period for hospitalizations in the ALL population. Survivors of childhood ALL require better long-term surveillance.
Static Horizontal Positions Determined with a Consumer-Grade GNSS Receiver: One Assessment of the Number of Fixes Necessary

Nacrtak Over the course of a year, a consumer-grade GNSS receiver was used to collect data in three forest types in northeastern Georgia (USA). During each visit, fifty position fixes were collected to estimate a horizontal position. Since there has been a significant amount of debate regarding the appropriate number of position fixes to collect to determine a position, this analysis was conducted to understand whether the static horizontal position error (a) changed over the collection period of fifty position fixes, (b) was significantly different than a single position fix collected to estimate the positions, and (c) was a function of forest type. We failed to reject the hypothesis that static horizontal position accuracy does not significantly change with increasing numbers of position fixes collected to determine a position, yet we favor rejecting the hypothesis that trends do not differ by forest type or by density of trees per unit area. The results are not entirely conclusive, and the time (season) of year may influence the results observed within certain forest types (e.g., young coniferous forests). We observed a trend that the static horizontal position accuracy in a young coniferous forest, on average, improved from a position determined by a single position fix to a position determined from the average of fifty position fixes. A much less relevant trend in accuracy was observed in a deciduous forest, and no trend at all was observed in an older coniferous forest.
Offsetting Justice: Protecting Federally-Exempt Benefits from Garnishment and Bank Set-Offs

For the millions of Americans who rely on direct deposit for receipt of their monthly federal benefits, section 207 of the Social Security Act provides a necessary protection against creditors. This federal law protects federal benefits from garnishment, attachment and other legal processes, but the courts, federal agencies, consumer groups and other stakeholders are in disagreement over its scope. This Note serves as a comprehensive review of the exemption, discussing its policy and history as well as case law that highlights the difficulty of applying its provisions to modern day banking practices. This Note concludes by advocating legislative and administrative actions to protect recipients of federal benefits
Subtotal Resection of a Thalamic Glioblastoma Multiforme through Transsylvian Approach

Glioblastoma multiforme (GBM) is a malignant brain tumor with an ominous prognosis. The standard treatment includes maximal safe resection plus adjuvant therapy. Thalamic GBMs, however, are unfavorable for microsurgical removal because of deep location and proximity to critical structures. We present a patient presenting with progressive hemiparesis and decreased consciousness with a large thalamic GBM who underwent subtotal resection through a transsylvian approach. His clinical and neurologic condition improved after surgery and he survived nine months after surgery. This may propose that in selected cases, more aggressive microsurgery for debulking of tumors might have some impact in the final outcome.​​​.
Environmental exposure to manganese in air: Tremor, motor and cognitive symptom profiles

Abstract Background Excessive exposure to manganese (Mn) may cause parkinsonian-like motor and tremor symptoms and adverse cognitive effects, including problems with executive functioning (EF), resembling those found in later-stage Parkinson’s disease (PD). Studies seeking to differentiate PD patients into subgroups with associated cognitive and functional outcomes using motor and tremor symptoms identified tremor-dominant (TD) and non-tremor dominant (NTD) subtypes. It is unclear whether differing patterns of pathophysiology and symptoms exist in Mn neurotoxicity, as they do in PD. Methods Residents of East Liverpool (n = 83) and Marietta, OH (n = 99) exposed to chronic (>10 years) environmental Mn through industrial pollution were administered neuropsychological measures and a physician-rated scale of movement-disorder symptoms. Two-step cluster analysis was used to group residents based on tremor symptoms, bradykinesia/rigidity symptoms, gait disturbance, and executive function. Cluster membership was validated using modeled air-Mn exposure and a computerized tremor measure. Results Elevated tremor and motor symptoms and executive dysfunction were observed, and TD and NTD symptom clusters were identified. Two additional clusters were also identified: Executive Dysfunction and Normal Functioning. The NTD residents, with elevated levels of gait disturbance and other movement disorder symptoms, did not evidence EF impairment, as predicted. Instead, residents with EF impairment formed their own cluster, and were relatively free of movement disorder symptoms. Conclusions Results resemble reports in the PD literature with TD and NTD clusters identified, but executive dysfunction did not cluster with NTD symptoms. PD and Mn exposure likely have differing pathophysiology and developmental courses, and therefore different symptom patterns, even when similar symptoms are present.
Embodiment, sociality, and the life shaping thesis

What Kyselo calls the “body-social problem” concerns whether to individuate the human self in terms of its bodily aspects or social aspects. In her view, either approach risks privileging one dimension while reducing the other to a mere contextual element. However, she proposes that principles from enactivism can help us to find a middle ground and solve the body-social problem. Here Kyselo looks to the notions of “needful freedom” and "individuation through and from a world" and extends them from the realm of biological individuation to an individuation in terms of social interactions. However, I will argue that because Kyselo’s solution to the body-social problem downplays the role of the living body, it actually is in tension with the enactivist framework. First, while enactivism places the living body at the center of selfhood and subjectivity, Kyselo’s account treats the living body as mere means and mediator. Second, her claim that the self is socially enacted and individuated is in tension with the enactivist conception of autonomous agency, which centers on the autonomous organization of the living body. However, suppose we grant Kyselo’s claim that we are necessarily social beings, but claim that the mind of a minded human animal constitutively extends to the limits of its living organismic body, but no further. My proposed “life shaping” thesis says that the self is not just essentially embodied, but also partially causally determined or shaped by social interactions, and thoroughly influenced by social norms and values. The life shaping thesis can explain how the self is individuated biologically, in terms of the autonomous organization of the living body, but nonetheless deeply embedded in the social world.
Materials for Orthopedic Applications

Orthopaedic devices come in different shapes, sizes, and forms, varying in accordance to their respective applications, sites of usage, load-bearing and non-load-bearing capacities, patient anatomy and physiology, and design requirements of medical device companies and orthopaedic surgeons. Most of these devices have geometrical features in the millimeters scale or greater. In materials science and engineering, structures like these that are relatively large have two distinct components with different energy properties namely, bulk and surface materials. Bulk components occupy a majority of the implant’s volume and determine the strength properties of the device while surface materials comprise a tiny fraction but usually dictate the biocompatibility and tissue-integration capacities of the exogenous construct.
Thermal Conductivity in Two Regions of a Neutron Star

Recent X-ray observational results1 put fairly stringent upper limits on the blackbody temperatures of compact sources in supernova remnants. For a few seconds during the collapse of a supernova the single star may become as luminous as an entire galaxy containing a trillion stars. One class of highly condensed objects that are believed to be left behind in a supernova collapse are neutron stars. If born in this violent fashion, neutron stars are extremely hot initially, although they cool down quickly due to the profuse emission of energetic neutrinos. Once they are produced in collisions of nucleons or electrons, the weakly-interacting neutrinos have little problem escaping from the star (except perhaps in the first few hundred seconds2). Neutrinos thus lead to a direct local cooling of the interior stellar matter in contrast to cooling due to photons, which is diffusive and radiative from the surface.
“Government Surveillance: Racism and Civic Virtue in the United States”

This chapter is concerned with the rise in exclusionary practices, racism, and xenophobia in twenty-first century United States (US) surveillance. In particular, this chapter seeks to understand how surveillance technologies, especially drone surveillance within US boundaries, seek to control communities of colour manifest in society and are sanctioned or commissioned by the US government as part of an evolving regime of white supremacy within a structurally racist government apparatus. Typically, drone surveillance enables federal agencies such as the CIA to monitor suspected terrorist activities in targeted countries such as Iraq or Afghanistan. Now, drone surveillance is breaking new ground. Local law enforcement entities use the same technology on US soil to detect and monitor citizen-led protests. The chapter explores how surveillance and race advance the theories of violence and subjugation in American life.
Petromylidenes A–C: 2-Alkylidene Bile Salt Derivatives Isolated from Sea Lamprey (Petromyzon marinus)

Three novel bile acid derivatives, petromylidenes A⁻C (1⁻3), featuring uncommon alkylidene adductive scaffolds, were isolated from water conditioned with sexually mature male sea lampreys (Petromyzon marinus). Their structures were elucidated by mass spectrometry and NMR spectroscopy, and by comparison to spectral data of related structures. The identification of compounds 1⁻3, further illustrates the structural diversity of the 5α bile salt family. Compounds 1⁻3 exhibited notable biological properties as well, including high olfactory potencies in adult sea lampreys and strong behavioral attraction of ovulated female sea lampreys. Electro-olfactogram recordings indicated that the limit of detection for 1 was 10-9 M, 2 was 10-11 M, and 3 was less than 10-13 M. These results suggested 1⁻3 were likely male pheromones, which guide reproductive behaviors in the sea lamprey.
A Simple and Mild Microwave-Based Synthesis of Novel Functionalized Benzofulvenes

Benzofulvenes and their derivatives are useful molecular entities having applications as biologically active molecules, polymer precursors, and optoelectronic devices. We have developed a simple and mild synthetic method for the formulation of a variety of these interesting compounds. Using carbonyl coupling techniques combined with microwave heating, a wide variety of functionalized benzofulvenes can be accessed rapidly in good yield. Furthermore, we have obtained five crystal structures further expanding a limited number of benzofulvene structures available.
Nursing Education: Review of Assessment, Clinical Care, and Implications for Practice Regarding Older Adult Patients With Cancer.

Background As the population of older adults continues to increase, the healthcare system must adapt to respond to their unique and complicated health needs. More than half of all patients diagnosed with cancer in America are aged 65 years or older. The appropriate care for older adult patients with cancer requires a holistic approach with careful coordination of interprofessional providers. Objectives This article aims to describe the components of the comprehensive geriatric assessment, summarize the importance of exercise in older adults, discuss the harms of polypharmacy, and evaluate the initiatives to improve geriatric nursing education. Methods The literature was reviewed and summarized to provide information on comprehensive geriatric assessment, exercise, polypharmacy, and geriatric nursing education. Findings Numerous assessment tools can help guide the care of older adult patients with cancer. Because many nurses have little formal geriatric-specific training, there is a growing need for targeted education to ensure best practices.
Eugene J. Koay: Translating promising new radiation technologies to patients with gastrointestinal cancers

Gastrointestinal (GI) cancer refers to the group of cancers that affect the digestive system. This includes cancers of the oesophagus, stomach, liver, pancreas, gallbladder and biliary tract, small intestine, colon, rectum and anus. GI cancers are regarded as a highly virulent neoplasm with both high morbidity and mortality. Collectively, they are a major cause of morbidity and mortality worldwide (1). Over the past half century, modern radiation therapy has been established and slowly evolved to treat different kinds of GI cancers. However, challenges remain in giving accurate and safe radiation delivery.
Web-based patient portal access in an orthopedic adult reconstruction patient population.

Abstract Background We surveyed patients in an adult reconstruction practice as to their use of the Web-based portal provided by our electronic health record, seeking to reveal patterns of use and helpfulness. Methods A total of 150 completed surveys were received. The survey queried demographics, the number of clinic visits, Internet access, portal activation, portal use frequency, and portal information questions and how patients answered them. Helpfulness was rated from 1 (not helpful) to 5 (very helpful). Statistical analysis included bivariate analysis and logistic regression, with odds ratio (OR) and 95% confidence interval (CI) reported. Results The mean age was 67.6 years. Most were females (n = 97, 65.1%). Most (68.7%) patients used the portal. Younger age (OR, 0.94; CI, 0.90-0.99) and access to Internet (OR, 31.8; CI, 8.5-119.4) predicted portal use (P .373). Of all, 47.5% of patients were unclear about online chart information. Older age indicated being unclear of portal information (68.5 vs 66, P = .0002). Of those who clarified doubts regarding information (n = 67), 23 used the Internet (34.3%), 32 (47.7%) called the physician, and 12 (17.9%) asked a friend and/or family member. Most (90.3%) patients felt the portal was helpful in gathering health information. Conclusions Age and Internet access affected portal usage; ability to understand chart information decreased with age. Most patients used the Internet or a family member to clarify doubts regarding portal information. The use of portal data resulted in 32 extra communications to the physician.
How do particle number, surface area, and mass correlate with toxicity of diesel particle emissions as measured in chemical and cellular assays?

Abstract Increasingly stringent particulate matter (PM) emission standards have brought forth engine design improvements, cleaner-burning fuels, and aftertreatment technologies. Reductions in tailpipe PM mass have concomitantly reduced accumulation-mode particle emissions. However, some strategies promote the emission of nucleation-mode particles, which are typically quantified on a number (PN) basis. We previously demonstrated that PN emissions from heavy-duty diesel vehicles equipped with various aftertreatment systems were inversely correlated, and gravimetric PM mass was positively correlated, with two in vitro assays. This present work expands on the analysis of PM mass and PN with in vitro assays to also include four additional PM metrics: suspended PM mass, active particle surface area, aggregate particle surface area, and accumulation-mode particle number. This new analysis shows that like gravimetric PM mass, suspended particle mass and accumulation mode particle number are well correlated with dithiothreitol consumption rate (DTT) and macrophage reactive oxygen species consumption rate (ROS) assays (R2 = 0.61–0.96). Data suggest that PM mass emissions dominated by nucleation-mode particles induce equal or slightly greater toxicity compared to PM mass dominated by accumulation-mode particles. Data also show that among all PM metrics, those used for regulating PM in the United States and Europe, namely gravimetric mass and solid PN are overall most correlated with in vitro toxicity. Moreover, continued exploration of alternative, low-cost, and more appropriate PM metrics is warranted to better understand the reproducibility of these findings on other engine applications, fuel types, and aftertreatment platforms.
Patient-reported cognitive complaints in older adults with gastrointestinal malignancies at diagnosis– Results from the Cancer & Aging Resilience Evaluation (CARE) study

Abstract Objectives Patient-reported cognitive complaint (CI) is poorly described in older adults with cancer. The purpose of this study was to quantify the prevalence and examine the associations of patient-reported CI in older adults with gastrointestinal (GI) malignancies at diagnosis. Materials and Methods Using participants ≥60 years with GI malignancies from the Cancer & Aging Resilience Evaluation (CARE) Registry that underwent a Geriatric Assessment (GA), we examined CI using the Patient-Reported Outcomes Measurement Information System (PROMIS®) Short Form 4a Cognitive Function. Cognition scores were dichotomized into normal (scores of 15–20) and impaired (4–14), and bivariate and multivariate analyses were used to examine associations. Results A total of 264 participants with GI malignancy were included, mean age of 70.0 ± 7.1, 55.7% male, pancreatic cancer was the most common cancer (24.2%) and majority were stage III/IV (68.2%). 29.3% of participants endorsed CI. CI was not associated with demographic and clinical domains, but was associated with many GA impairments including instrumental Activities of Daily Living (iADL) impairment (adjusted odds ratio [aOR] 6.0, 95% confidence interval 3.0–11.8), falls (aOR 2.7, 1.4–5.4), anxiety (aOR 10.3, 5.2–20.4), and depression (aOR 10.2, 5.2–20.4). CI was also associated with reduced global mental (aOR 18.7, 8.1–42.2) and physical (aOR 4.7, 2.4–8.9) quality of life, and prior hospitalizations (aOR 2.4, 1.2–4.8). Conclusion We found a high prevalence of patient-reported CI in older adults with GI malignancies that was associated with increased GA impairments, reduced health-related quality of life, and increased healthcare utilization.
Unemployment during the Great Recession and large-for-gestational age births.

Background Several studies have suggested that record high unemployment during the Great Recession was associated with deleterious changes in diet and weight-related health. However, studies have yet to explore whether the Great Recession was also associated with obesity-related health in utero. Methods We investigated whether increasing county-level unemployment was associated with large-for-gestational age (LGA) births, using repeated cross-sectional data from California birth records between 2008 and 2011 (n = 1,715,052). LGA was defined as >90th percentile, using the Oken reference. We use the annual 1-year lagged value for county-level unemployment (2007-2010) and limit our analyses to singleton, term births. Linear probability models, with county and year fixed-effects were used to examine the unemployment-LGA association. All models control for county-level foreclosure rates, child gender, and maternal age, parity, education, and race/ethnicity. Results An increase in county-level unemployment was not statistically significantly associated with the prevalence of LGA (percentage point [PP]: 0.12; 95% CI: -0.02, 0.25). But, over the period of observation, for every one standard deviation increase in unemployment, LGA prevalence increased by 5% and p = 0.08. Conclusions These results cautiously suggest some deleterious effects of the Great Recession on obesity-related health in utero.
Effects of weight loss during a very low carbohydrate diet on specific adipose tissue depots and insulin sensitivity in older adults with obesity: a randomized clinical trial.

Insulin resistance and accumulation of visceral adipose tissue (VAT) and intermuscular adipose tissue (IMAT) place aging adults with obesity at high risk of cardio-metabolic disease. A very low carbohydrate diet (VLCD) may be a means of promoting fat loss from the visceral cavity and skeletal muscle, without compromising lean mass, and improve insulin sensitivity in aging adults with obesity. To determine if a VLCD promotes a greater loss of fat (total, visceral and intermuscular), preserves lean mass, and improves insulin sensitivity compared to a standard CHO-based/low-fat diet (LFD) in older adults with obesity. Thirty-four men and women aged 60–75 years with obesity (body mass index [BMI] 30-40 kg/m2) were randomized to a diet prescription of either a VLCD ( 65% energy from CHO:protein:fat) or LFD diet (55:25:20) for 8 weeks. Body composition by dual-energy X-ray absorptiometry (DXA), fat distribution by magnetic resonance imaging (MRI), insulin sensitivity by euglycemic hyperinsulinemic clamp, and lipids by a fasting blood draw were assessed at baseline and after the intervention. Participants lost an average of 9.7 and 2.0% in total fat following the VLCD and LFD, respectively (p < 0.01). The VLCD group experienced ~ 3-fold greater loss in VAT compared to the LFD group (− 22.8% vs − 1.0%, p < 0.001) and a greater decrease in thigh-IMAT (− 24.4% vs − 1.0%, p < 0.01). The VLCD group also had significantly greater thigh skeletal muscle (SM) at 8 weeks following adjustment for change in total fat mass. Finally, the VLCD had greater increases in insulin sensitivity and HDL-C and decreases in fasting insulin and triglycerides compared to the LFD group. Weight loss resulting from consumption of a diet lower in CHO and higher in fat may be beneficial for older adults with obesity by depleting adipose tissue depots most strongly implicated in poor metabolic and functional outcomes and by improving insulin sensitivity and the lipid profile. NCT02760641 . Registered 03 May 2016 - Retrospectively registered.
DETERMINATION OF SKIN BLOOD FLOW DURING TRANSCUTANEOUS MONITORING

Publisher Summary This chapter discusses the determination of skin blood flow during transcutaneous monitoring. The transcutaneous measurement of the partial pressure of oxygen in arterial blood represents a new, noninvasive method for clinical use. The technique suffers because the accuracy of the measurement is not assured for all clinical situations. This is because of the dependence of many of the variables involved in transcutaneous oxygen sensing on skin blood flow and on skin temperature. The chapter presents two mechanisms that have been proposed to counter the temperature effect on the hemoglobin saturation curve. Oxygen consumption by the electrode can be significant if large electrodes are used. However, microelectrodes that consume negligible amounts of oxygen have been designed. It is found that diffusion gradients through the skin are insignificant. Skin respiration results in the consumption of some of the oxygen before it reaches the sensor and is believed to vary with temperature of the sensor. To find the significant variables involved in transcutaneous oxygen sensing and quantify the effect of each on the final measurement, a means of directly measuring skin blood flow is necessary.
Endogenous Networks and Legislative Activity

This paper presents and structurally estimates a model of endogenous network formation and legislative activity of career-motivated politicians. Employing data on socialization and legislative effort of members of the 105th-110th U.S. Congresses, our model reconciles a set of empirical regularities, including: recent trends in Congressional productivity; the complementarity of socialization processes and legislative activities in the House of Representatives; substantial heterogeneity across legislators in terms of effort and success rate in passing specific legislation. We avoid taking the social structure of Congress as exogenously given and instead embed it in a model of endogenous network formation useful for developing relevant counterfactuals, including some pertinent to the congressional emergency response to the 2008-09 financial crisis. Our counterfactual analysis further demonstrates how to empirically identify the specific equilibrium at play within each Congress among the multiple equilibria typically present in this class of games.
Paraneoplastic Syndrome Masking as Peripheral Vertigo. (P4.235)

OBJECTIVE: Paraneoplastic syndromes are rare but can present as the first signs of malignancy. In our case, vertigo was the presenting symptom ultimately leading to the diagnosis of cerebellar degeneration in the setting of paraneoplastic syndrome secondary to underlying Hodgkin’s lymphoma. BACKGROUND: 69 year old gentleman who presented with persistent and intractable vertigo for over a year. At initial presentation he had nausea, vomiting and positive mild right nystagmus on dix-hallpike maneuver and was thought to have peripheral vertigo, especially in the presence of negative brain MRI/MRA imaging. He had an otherwise benign exam including cranial nerve examination, motor and sensory exam, reflexes and coordination. Evaluation with a neuro-otologist supported the diagnosis of peripheral vertigo with otolith dysfunction. One year later he presented with a month history of progressive dysarthria, diplopia and fast beating horizontal nystagmus accompanied by severe limb and gait ataxia. Repeat imaging with brain MRA was unrevealing. RESULTS: CSF studies showed pleocytosis and was positive for anti PCA Tr-1 antibodies. Further neoplastic workup discovered mediastinal lymphadenopathy, which on biopsy led to the diagnosis of Hodgkin’s lymphoma. CONCLUSIONS: Cerebellar dysfunction has a broad differential diagnosis. A small percentage of cerebellar dysfunction is caused by tumors or brain lesions that generally can be detected on routine brain imaging. As our case demonstrates, something more insidious etiology such as a paraneoplastic syndrome may be the culprit for cerebellar signs that are not readily obvious on imaging or other basic workup. This is especially true when symptoms are persistent without a clear etiology. Disclosure: Dr. Nguyen has nothing to disclose. Dr. Knipe has nothing to disclose. Dr. Raheja has nothing to disclose. Dr. Lowden has nothing to disclose.
COMMON BLOOD TESTS FOR LIVER DISEASE : WHICH ONES ARE MOST USEFUL ?

Preview Detection of clinicaHy silent liver disease and determination of the causes of acute and chronic liver disease often require a panoply of blood tests and, occasionally, liver biopsy. Knowing when to order tests and which tests to order not only facilitates diagnosis but also leads to earlier intervention with appropriate therapy. This article reviews the most common blood tests for detecting liver disease, including viral hepatitis.
Expression of autoimmunity by NZB/NZW marrow.

Abstract Bone marrow from NZB NZW mice, treated in vitro with anti-θ (anti-Thy-1.2) serum and complement to remove T cells, was found to transfer autoimmune disease to nonautoimmune recipients. Such recipients had elevated anti-DNA titers, increased proteinuria, and decreased survival when compared with recipients of bone marrow from nonautoimmune donors. Nevertheless, recipients of NZB NZW bone marrow had retarded disease relative to untreated NZB NZW mice. These studies confirm and extend transfer studies in NZB mice which suggest that marrow B cells or stem cells carry an autoimmune potential. They leave open the possibility that there is an additional abnormality predisposing to autoimmunity, such as a regulatory T-cell defect.
Mitogenic factor from inbred guinea pigs. II. Properties of the factor.

Abstract Properties of a mitogenic factor from lymphocytes of inbred guinea pigs were investigated. Experiments in which the antigen was removed from supernatant fractions containing mitogenic factor (MF) indicate conclusively that MF activity does not depend on the presence of antigen. Also, under the conditions tested, MF did not potentiate the response of immune cells to antigen. Highly purified lymphocytes were able to respond to MF, indicating a lack of a requirement for other cell types in the response to MF as well as in its production. Studies of the kinetics of stimulation of nonimmune lymph node cells by MF showed that MF induces DNA synthesis and mitosis starting approximately 24 to 36 hr after the beginning of incubation. Supernatants containing MF stimulate blast transformaion in a subpopulation of lymphocytes; only a small fraction of these transformed cells synthesize DNA and undergo mitosis. About 10% of the cell population was induced by MF to undergo blast transformation. These findings distinguish MF from factors such as lymphocyte-activating material and potentiating factor and provide a basis for further studies of its properties.
Type I interferon modulates the battle of host immune system against viruses.

Abstract Type I interferon (IFN), as its name implies, ‘interferes’ with virus replication by activating numerous genes. Further, virus-induced type I IFN regulates the magnitude and functions of cells directing the host immune system. Importantly, recent exploration into how type I IFN operates following virus infection has advanced our understanding of its role with respect to modulation of host innate and adaptive immune responses. Such activities include the activation of antigen-presenting dendritic cells and the localization, expansion or differentiation of virus-specific T lymphocytes and antibody-producing B lymphocytes. However, type I IFN not only benefits the host but can also induce unnecessary or extremely pathogenic immune responses. This review focuses on such interactions and the manner in which type I IFN induces dynamic changes in the host immune network, particularly adaptive immune responses to viral invasion. Manipulating the type I IFN-mediated host immune response during virus infections could provide new immunotherapeutic interventions to remedy viral diseases and implement more effective and sustainable type I IFN therapy.
Are diagrams always helpful tools? Developmental and individual differences in the effect of presentation format on student problem solving

Background. High school and college students demonstrate a verbal, or textual, advantage whereby beginning algebra problems in story format are easier to solve than matched equations (Koedinger & Nathan, 2004). Adding diagrams to the stories may further facilitate solution (Hembree, 1992; Koedinger & Terao, 2002). However, diagrams may not be universally beneficial (Ainsworth, 2006; Larkin & Simon, 1987). Aims. To identify developmental and individual differences in the use of diagrams, story, and equation representations in problem solving. When do diagrams begin to aid problem-solving performance? Does the verbal advantage replicate for younger students? Sample. Three hundred and seventy-three students (121 sixth, 117 seventh, 135 eighth grade) from an ethnically diverse middle school in the American Midwest participated in Experiment 1. In Experiment 2, 84 sixth graders who had participated in Experiment 1 were followed up in seventh and eighth grades. Method. In both experiments, students solved algebra problems in three matched presentation formats (equation, story, story + diagram). Results. The textual advantage was replicated for all groups. While diagrams enhance performance of older and higher ability students, younger and lower-ability students do not benefit, and may even be hindered by a diagram's presence. Conclusions. The textual advantage is in place by sixth grade. Diagrams are not inherently helpful aids to student understanding and should be used cautiously in the middle school years, as students are developing competency for diagram comprehension during this time.
Do you know how to care for older adults

As many oncology clinicians can attest, the number of older adults diagnosed with cancer is increasing. On a daily basis, inpatient and outpatient oncology data show that patients aged 65 years and older are now being treated with complex chemotherapeutic regimens for various types of cancer.
Design of a robust power system stabilizer over a wide range of load characteristics

The authors present a novel method for designing a power system stabilizer to improve the dynamic stability of AC power systems. the static load is modeled as a nonlinear function of load bus voltage and the dynamic load is modeled by an equivalent induction motor load. The rotor speed and angle deviations of the synchronous generator are used as a stabilizing signal to the power system stabilizer (PSS). The stabilizer gains are selected based on the eigenvalue sensitivity of electromechanical mode of the closed loop system with respect to the load characteristics. Eigenvalue analysis and simulation results show that the proposed PSS improves the system response over a wide range of load characteristics. >
Embedded-atom-method functions for the fcc metals Cu, Ag, Au, Ni, Pd, Pt, and their alloys.

A consistent set of embedding functions and pair interactions for use with the embedded-atom method [M.S. Daw and M. I. Baskes, Phys. Rev. B 29, 6443 (1984)] have been determined empirically to describe the fcc metals Cu, Ag, Au, Ni, Pd, and Pt as well as alloys containing these metals. The functions are determined empirically by fitting to the sublimation energy, equilibrium lattice constant, elastic constants, and vacancy-formation energies of the pure metals and the heats of solution of the binary alloys. The validity of the functions is tested by computing a wide range of properties: the formation volume and migration energy of vacancies, the formation energy, formation volume, and migration energy of divacancies and self-interstitials, the surface energy and geometries of the low-index surfaces of the pure metals, and the segregation energy of substitutional impurities to (100) surfaces.
Bioluminescent stem-loop probes for highly sensitive nucleic acid detection

Here, we report the first bioluminescent stem-loop probe, which is 50 times more sensitive and able to achieve a LOD 25 times lower than fluorescent stem-loop probes. Chemical generation of a signal from Renillaluciferase reduces background noise for improved quantitative utility in nucleic acid biomarker detection.
Strategic directions in concurrency research

Concurrency is concerned with the fundamental aspects of systems of multiple, simultaneously active computing agents that interact with one another. This notion is intended to cover a wide range of system architectures, from tightly coupled, mostly synchronous parallel systems, to loosely coupled, largely asynchronous distributed systems. We refer to systems exhibiting concurrency as concurrent systems, and we call computer programs written for concurrent systems concurrent programs. Concurrency has emerged as a separate area of research in response to the intrinsic difficulties experienced by designers of concurrent systems in diverse fields within computer science. These difficulties stem in general from two main sources. The first is that the presence of multiple threads of control can lead to subtle and often unanticipated interactions between agents—in particular, issues such as interference, race conditions, deadlock, and livelock are peculiar to concurrent programming. The second arises from the fact that many concurrent systems, such as operating systems and distributed databases, are reactive, meaning that they are designed to engage in an ongoing series of interactions with their environments. Unlike traditional sequential programs, reactive systems should not terminate, and consequently traditional notions of correctness that rely on relating inputs to expected outputs upon termination no longer apply. Developing mathematical frameworks that accurately and tractably account for these phenomena has been a major goal of researchers in concurrency.
Severity of Aortic Regurgitation Assessed by Digital Image Processing of Doppler Spectral Recordings.

Visual estimates of the intensity of the regurgitant signal (RS) obtained by continuous-wave (CW) Doppler has been used as an indicator of the severity of aortic regurgitation (AR). This study was designed to test this concept quantitatively using digital image processing methods. Twenty-one patients with AR were studied, 14 of whom had concomitant mitral valve disease. Patients with aortic stenosis were excluded. By angiography, 10 patients had mild (grade 1 or 2), 5 had moderate (grade 3), and 6 severe (grade 4) AR. We digitized three well-defined AR envelopes and calculated the mean pixel intensity (MPI) of the RS and the systolic flow signal (SFS) using an offline computer analysis system developed in our laboratory. To negate the effects of different gain settings, the ratio of RS to SFS (RS/SFS ratio) was compared to angiographic grade of AR. Thus, each patient served as his own control. The mean RS/SFS ratio was 0.54 +/- 0.42 SD (range 0.46-0.59) for mild AR, 0.76 +/- 0.71 SD (range 0.65-0.82) for moderate AR, and 0.84 +/- 0.52 (range 0.77-0.92) for severe AR. This RS/SFS ratio correlated well with angiographic severity of AR (r = 0.9). A ratio of 0.6 correlated with moderate-to-severe AR. We conclude that the ratio of the regurgitant to systolic flow CW Doppler signal is an accurate noninvasive indicator of AR severity. (ECHOCARDIOGRAPHY, Volume 13, May 1996)
Accelerated imidization reactions using microwave radiation

Microwave radiation has been clearly shown to result in enhancement of the rate of reaction for an imidization reaction. Analysis of the kinetic parameters showed that the apparent activation energy for the reaction was reduced from 105 to 55 kJ/mol, under the conditions of this experiment. The mechanism which has been proposed to explain this enhancement is based on the concept of a nonuniform temperature on a molecular scale, rather than a true reduction in the activation energy. © 1992 John Wiley & Sons, Inc.
Public Finance and Wisconsin Institutionalism, 1892-1929

This paper examines the development of public finance as a subfield of study at the University of Wisconsin from 1892 through 1929. Considered is the historical evolution of faculty and course work in public finance at Wisconsin, with comparisons offered to Harvard, Chicago and Columbia. While Wisconsin economists made notable contributions to both the theory and practice of public finance in the United States during this period, we conclude that the failure to develop a particularly "Wisconsin Institutionalist" version was due to (1) the absence of a dominant proponent/advocate during a pivotal time, (2) the necessity to differentiate graduate programs, (3) the number of competing subject areas providing contemporary economics problems to study, and (4) the co-opting of the department of economics at Wisconsin to serve Commons's labor research program.
The influence of type and severity of mental illness on receipt of screening mammography

BACKGROUND: Women with mental illness may be at risk for failure to receive recommended preventive services such as mammography. Little is known about whether the type or severity of mental illness influences receipt of preventive services. OBJECTIVE: To measure the influence of type and severity of mental illness on receipt of mammography. DESIGN: Retrospective study of administrative claims data, 1996 to 2001. SUBJECTS: Privately insured women age 40 to 64 years, with and without claims for mental illness, and who were eligible for mammography between 1996 and 2001. MEASUREMENT: Odds ratios (OR) for receipt of screening mammography, any mammography, and follow-up mammography, adjusted for age, rural location, utilization of nonmental health services, and severity and type of the mental disorder. Severity measures were based on utilization of outpatient and inpatient mental health services and presence of comorbid substance use disorder. RESULTS: Women with any mental disorder were significantly less likely to receive mammography than controls. This was strongly influenced by severity of mental illness (any mammography: moderate severity OR 0.62; confidence interval [CI] 0.59 to 0.66: high severity OR 0.38; CI 0.33 to 0.43). Whereas severity contributed to lower receipt of mammography among women with mood and anxiety disorders, women with psychotic, alcohol, and substance abuse disorders had decreased odds for receipt of mammography regardless of severity. CONCLUSIONS: Women with mental disorders are at risk for failure to receive mammography, a recommended preventive service. Women with severe mental illness or psychotic and substance abuse disorders should be targeted to ensure delivery of mammography.