cssi/SciSciGPT-SciSciNet huggingface dataset:
Compliance with universal precautions among emergency department personnel caring for trauma patients.

Abstract Study objective: Emergency department personnel are at high risk of occupational infection with bloodborne pathogens. The objective of this study was to observe and analyze the use of barrier precautions among ED personnel caring for trauma patients. Methods: This observational study used videotapes of trauma cases seen at an urban Level I trauma center. Study participants were ED and trauma team personnel. Trained observers scored breaks in the use of barrier precautions during the first 15 minutes of 88 videotaped Level I trauma cases. "Major" breaks were scored when ED personnel performed invasive procedures without gloves, mask, gown, and adequate eye protection. "Minor" breaks were scored when ED personnel were adjacent to a trauma patient (within 1 m) without wearing these items. Results: We observed 1 or more major breaks in 33.6% of 304 invasive procedures. The most common major break was failure to wear a mask (32.2% of procedures), followed by inadequate eyewear (22.2%), no gown (5.6%), and no gloves (3.0%). We observed minor breaks during 55.5% of 752 patient encounters. Large and statistically significant variations were seen in use rates of barrier precautions among different groups of personnel; surgery residents were most likely to use precautions, whereas attending surgeons were least likely. Conclusion: Compliance with universal precautions is poor in this high-risk clinical setting. These data provide a baseline for measuring the effectiveness of interventions to improve compliance. Videotaped observations are a novel and effective tool in this setting. [Evanoff B, Kim L, Mutha S, Jeffe D, Haase C, Andereck D, Fraser V: Compliance with universal precautions among emergency department personnel caring for trauma patients. Ann Emerg Med February 1999;33:160-165.]
Osteoblast-specific expression of insulin-like growth factor-1 in bone of transgenic mice induces insulin-like growth factor binding protein-5

The activities of insulin-like growth factors (IGFs) in bone are modulated by a family of binding proteins (IGFBPs) whose physiological roles remain poorly understood. We have previously shown that targeted overexpression of IGF-I in osteoblasts of transgenic (OC-IGF-I) mice stimulates bone formation. In this model, bone formation is markedly but transiently increased in an age-dependent manner, raising the possibility that IGF-I may be influencing IGFBPs to in turn modulate its paracrine actions within bone. We sought to characterize the IGFBPs in normal mouse bone during development and to determine whether osteoblast-targeted overexpression of IGF-I influenced bone IGFBP abundance in vivo. Femoral bone IGFBP content was assessed in control nontransgenic and OC-IGF-I mice by I125-IGF-I ligand and immunoblotting. Bone IGFBP-5 and IGF-I mRNA abundance was determined using real-time reverse transcription (RT)-PCR. Ligand blot of bone extract showed a 30-kDa band, identified as IGFBP-5 by immunoblot, predominated. The abundance of IGFBP-5 declined with age in both control and transgenic bone. Ligand and immunoblot analysis revealed a 5-fold increase in IGFBP-5 protein levels at 3 weeks in transgenic bone (P<0.0001). The elevated IGFBP-5 protein levels were associated with a similar increase in IGF-I mRNA abundance (4-fold, P<0.01) and a significant increase in IGFBP-5 mRNA abundance (1.5-fold). Despite the age-related decline at 6 weeks, IGFBP-5 remained significantly (P<0.01) more abundant in transgenic bone compared to controls. In contrast, bone IGFBP-4 abundance was relatively unchanged by either age or IGF-I overexpression. These studies demonstrate a distinctive developmental pattern of IGFBP-5 content in mouse bone and show that osteoblast-derived IGF-I determines skeletal IGFBP-5 abundance, at least in part by inducing its synthesis. In that IGFBP-5 is thought to stimulate bone formation, directly or via IGF-I action, such changes in bone IGFBP-5 may be important to ensure robust bone acquisition in the early postnatal period.
Real-time rough refraction via LEAN mapping and Gaussian sum reduction

Rough refraction commonly occurs when light scatters on rough transparent surfaces. It presents a computational challenge, as every pixel's color depends on incoming light from numerous directions. De Rousiers et al. [2011] compute rough refraction interactively using a convolution of Gaussian normal and transmittance distribution functions (NDFs and BTDFs), but their work is limited to a constant roughness surfaces. We introduce two methods that allow for varying roughness by representing surface normals using LEAN mapping and Gaussian sum reduction (GSR).
A persymmetric multiband GLR algorithm

By exploring the covariance structure information to reduce the uncertainty in adaptive processing, a persymmetric generalized likelihood ratio algorithm (PGLR) is developed together with the closed-form expressions of probabilities of detection and false alarm. This multiband algorithm, which requires less computation, can significantly outperform the corresponding unstructured multiband GLR algorithm, especially in a severely nonstationary and/or nonhomogeneous interference environment. Simulation shows that the constant false alarm rate (CFAR) performance of the new algorithm is as insensitive as that of the unstructured multiband GLR to the departure of interference distribution from Gaussian. >
‘A Flower Is Your Brother!’: Holism, Nature, and the (Non-ironic) Enchantment of Modernity

**The author would like to thank Kieko Matteson, Kevin Armitage, and the anonymous reviewers at Intellectual History Review for their careful reading and helpful suggestions.The idea that the moder...
Static Elastic Properties of the Left Coronary Circumflex Artery and the Common Carotid Artery in Dogs

Static elastic properties were studied in isolated segments of the left coronary circumflex artery (LCCA) and the right common carotid artery (CA) from 14 dogs at in-vivo values of pressure and length. A microscope with a Filar micrometer was used to measure radius and length. From these data it was possible to study the pressure-radius relationship and compute various anisotropic elastic moduli as well as the strain energy density (SED). Results indicate: (1) Both arteries exhibited hysteresis which could be minimized within two inflation-deflation cycles. (2) The pressure-radius relationship at constant length was essentially linear over a pressure range corresponding to the in-vivo pulse pressure. (3) The value of volume distensibility was 3.4 x 10-6 cm2/dyne for LCCA and 1.5 x 10-6 cm2/dyne for CA. (4) LCCA was more distensible than CA in the circumferential direction. (5) LCCA was stiffer in the longitudinal direction than in the circumferential direction; the reverse was true of CA. (6) SED values a...
Enhanced lung toxicity of intratracheally instilled cadmium chloride in selenium-deficient rats

Abstract In order to further characterize biochemical correlates of CdCl2-induced lung injury, CdCl2 lung toxicity was studied in Se-deficient rats. A solution of 0.5 μmol/kg of CdCl2 was intratracheally instilled into chronic respiratory disease-free 70-day-old rats fed a basal Se-deficient diet or a basal diet supplemented with 0.5 or 2.0 ppm of Se for 40 days. Within 3 days Se-deficient rats showed signs of marked respiratory distress and 25% had died, whereas rats from Se-supplemented groups all survived this time period. As evidenced by gross examination and lung water contents, Se-deficient rats exhibited a greater degree of inflammatory pulmonary edema than did rats from Se-supplemented groups. The results of the various enzymatic and biochemical determinations may be interpreted as being consistent with greater damage occurring in the Se-deficient rats.
Measurement of forward jets, forward energy flow and diffractive events with CMS

Abstract We report on a first measurement of forward jet production and forward energy flow in pp collisions up to highest energies of s = 7 TeV . Inclusive spectra of jets are presented with p t > 20 GeV in the region of 3 | η | 5 . The energy flow in the forward region is measured for minimum bias events and for events with a high p t dijet in the central region. In addition, the absence of energy deposition in the forward region is used to observe diffractive events. We compare our results with predictions from Monte Carlo event generators including a simulation of multi-parton scattering.
Tree scattering amplitudes of the spin-4/3 fractional superstring. II. The twisted sectors.

The spin-$\frac{4}{3}$ fractional superstring is characterized by a world-sheet chiral algebra involving spin-$\frac{4}{3}$ currents. The discussion of the tree-level scattering amplitudes of this theory presented in the preceding paper is expanded to include amplitudes containing two twisted-sector states. These amplitudes are shown to satisfy spurious state decoupling. The restriction to only two external twisted-sector states is due to the absence of an appropriate dimension-one vertex describing the emission of a single twisted-sector state. This is analogous to the "old covariant" formalism of ordinary superstring amplitudes in which an appropriate dimension-one vertex for the emission of a Ramond-sector state is lacking. Examples of tree scattering amplitudes are calculated in a $c=5$ model of the spin-$\frac{4}{3}$ chiral algebra realized in terms of free bosons on the string world sheet. The target space of this model is three-dimensional flat Minkowski space-time and the twisted-sector physical states are fermions in space-time. Since the critical central charge of the spin-4/3 fractional superstring theory is 10, this $c=5$ model is not consistent at the string loop level.
A concise XML binding framework facilitates practical object-oriented document engineering

Semantic web researchers tend to assume that XML Schema and OWL-S are the correct means for representing the types, structure, and semantics of XML data used for documents and interchange between programs and services. These technologies separate information representation from implementation. The separation may seem like a benefit, because it is platform-agnostic. The problem is that the separation interferes with writing correct programs for practical document engineering, because it violates a primary principle of object-oriented programming: integration of data structures and algorithms. We develop an XML binding framework that connects Java object declarations with serialized XML representation. A basis of the framework is a metalanguage, embedded in Java object and field declarations, designed to be particularly concise, to facilitate the authoring and maintenance of programs that generate and manipulate XML documents. The framework serves as the foundation for a layered software architecture that includes meta-metadata descriptions for multimedia information extraction, modeling, and visualization; Lightweight Semantic Distributed Computing Services; interaction logging services; and a user studies framework.
One- and two-dimensional coordination polymers of substituted tetrazoles with cadmium(II)

Abstract The reactions of Cd(NO3)2·4H2O with derivatized tetrazolate ligands yielded a series of coordination polymers of the Cd(II)/iminetetrazolate/anion/solvent family. [Cd(4-Hpyrtet)2(OH)2] (1) (4-Hpyrtet = 4-pyridinetetrazole) is two-dimensional with the ligand in the protonated form with the tetrazole N3 site as the protonation location. The Co(II) and Cu(II) analogous [M(4-pyrtet)2(H2O)2] (M = Co (2), Cu (3)) are structurally similar to 1, but with the aqua ligands projecting to the intralamellar voids rather than into the interlamellar domains, as observed for the hydroxy groups of 1. The 2-pyridyltetrazolate derivative [CdCl(2-pyrtet)(DMF)] (4) is one-dimensional with chloride and DMF ligands projecting from a { Cd ( 2 -pyrtet ) } n n + ribbon. Compound 5, [Cd4Cl6(prytet)2(DMF)4], (prytet = pyrazinetetrazolate) is two-dimensional and exhibits {Cd4Cl6} secondary building units linked through tetrazolate groups and pyrazine units into the network structure. The azide derivative, [Cd3(N3)4(4-pyrtet)2(H2O)2 (6), is a “pillared” layer three-dimensional framework with {Cd3(N3)4(tetrazolate)2(H2O)2}n layers through the 4-pyrtet ligands.
High-frequency, Small-volume Ventilation during Thoracic Surgery

Surgical conditions during conventional mechanical ventilation (CMV) and pulmonary gas exchange were compared with those during high-frequency ventilation (HFV) in 24 patients undergoing anesthesia for intrathoracic surgery. HFV at an oscillatory frequency of 3 Hz and a delivered gas volume of 1.3-1.9 ml/kg provided excellent surgical conditions for peripheral lung procedures. However, surgical conditions for procedures on the major airways or mediastinal structures were unsatisfactory during HFV. Adequate pulmonary gas exchange was achieved with HFV when the chest was open. Further evidence is presented for expiratory flow limitation during HFV. Expiratory flow limitation seems to occur particularly in patients with chronic obstructive airway disease, leading to increased lung volume. Currently, the authors do not recommend HFV for routine use during anesthesia for thoracic surgery.
Triplet quenching by diacyl peroxides

Abstract Benzoyl and decanoyl peroxides are efficient quenchers of various triplet sensitizers: kinetic studies using laser photolysis techniques indicate that electronic energy transfer and charge transfer to the peroxide are important factors contributing to the quenching process.
Superior oblique myectomy and trochlear resection for superior oblique myokymia.

Purpose To describe our experience with myectomy of the superior oblique muscle combined with resection of the trochlea for recurrent or primary superior oblique myokymia (SOM). Design Retrospective, interventional case series. Methods We performed superior oblique myectomy combined with resection of the trochlea in 3 patients with SOM in whom medical management had failed. In 2 patients, the symptoms of myokymia were recurrent after previous superior oblique tenectomy, and in 1 patient, our procedure was the first surgery. Results All 3 patients have experienced complete symptomatic relief from SOM with follow-up ranging from 1 to 22 years. Iatrogenic superior oblique palsy has been managed in each patient. Dysesthesia in the infratrochlear and supratrochlear regions was judged by each patient to be much less bothersome than the symptoms of SOM. Conclusions We recommend myectomy of the superior oblique muscle combined with resection of the trochlea if symptoms of SOM recur after a prior superior oblique tenectomy. Based on this small series with long follow-up, the procedure also may be considered as the primary operation for SOM that fails medical management.
Wall‐protein antibodies as inhibitors of growth and of autolytic reactions of isolated cell wall

Antiserum raised against protein prepared from corn (Zea mays L. hybrid B73 X Mo17) seedling cell wall exhibits antigrowth activity and inhibits autolytic reactions of isolated cell wall. The growth of corn coleoptile segments pretreated in wall-protein antiserum was inhibited 35% compared to tissue which had been exposed to normal serum. Since the cuticle constituted a barrier to the entry of serum protein the coleoptile surface was abraded prior to exposure to the serum. Growth inhibition observed in nonabraded sections (8 to 10%) was apparently the result of the entry of serum protein via the cut ends of the tissue. Subsections recut from the central region of antiserum-treated, nonabraded coleoptiles responded normally in growth experiments. Antiserum brought in contact with isolated cell wall prior to its use with intact coleoptiles was less effective as a growth inhibitor, which suggested that the antibodies which impede growth responses bind to cell wall. Wall-protein antiserum also strongly inhibited autolytic reactions of isolated cell wall. Wall treated in normal serum or buffer liberated sugars at a rate of 8.6 μg- (mg wall dry-weight)−1·h−1 while antiserum-treated wall autolyzed at a rate of 2.6 μg·mg−1·h−1 representing a 70% reduction in autolytic potential. After 24 h yields from antiserum-treated wall were 50% lower than yields obtained from control wall. The antiserum had no effect on the molecular-weight distribution of the autolytically-liberated products, and direct assays of wall-bound and solubilized endo- and exo-β-d-glucanases involved in autolytic reactions demonstrated no significant impairment of their catalytic activity. However, the addition to antiserum-treated wall of a wall-protein preparation containing autolytic enzymes resulted in a significant enhancement (132%) in autolytic potential. The evidence suggests that enzyme mobility may be critical in the autolytic hydrolytsis of plant cell wall.
Controversies in the use of second generation antipsychotics as sleep agent

A growing number of patients present in clinics with complaints of insomnia. Over the past century, great advances have been made in our knowledge of mechanisms of sleep and wakefulness. Understanding sleep neurochemistry has led to better management of different types of insomnias with a variety of non-pharmacological and pharmacological treatments. Unfortunately, the increasing development and availability of second generation antipsychotics (SGA) have prompted their frequent use exclusively for insomnia. However, to date, no large randomized-controlled or placebo-controlled studies have shown the utility of SGAs in the realm of treating insomnia. Many clinicians use SGAs as "off-label" for sleep induction and maintenance, but this practice needs to be readdressed given their potential risks and the current lack of evidence base. This review will highlight the neurochemistry related to sleep, the mechanisms of action by which SGA may have some benefit in treating insomnia, and the risks associated with their utilization.
Effect of chronic ethanol administration on cholesterol and bile acid synthesis in vivo.

Chronic administration of ethanol failed to stimulate the hepatic rate of cholesterol synthesis in meal-fed rats. In contrast, chronic ethanol feeding caused a 50% inhibition in the rate of incorporation of [4-14C] cholesterol to bile acids in the bile-duct cannulated rats. It is, therefore, suggested that the decreased rate of cholesterol degradation to bile acids may play an important role in ethanol-induced accumulation of cholesterol in liver.
Hyperthermic liver perfusion and release of lysosomal enzymes.

Abstract Perfused rat liver was used to study the relationship between the hepatotoxic effects of hyperthermia and the effects of heat on lysosomes. Livers from fed rats were perfused for 180 min at 37–43°C. Release of lysosomal enzymes into the perfusate during perfusion and lysosomal fragility at the end of perfusion were determined. Lysosomes were then incubated in vitro at 37–45°C with xanthine and xanthine oxidase to generate superoxide in order to study lipid peroxidation as a potential causative factor in heat-induced lysosomal lability. Perfusate lysosomal enzymes p -nitrophenyl phsophatase and β-glucuronidase increased significantly ( P P p -nitrophenyl phosphatase, but not when measuring β-glucuronidase activity. Xanthine oxidase acting on xanthine caused labilization of the lysosomes at all temperatures studied when compared to a control at each temperature. There was a temperature effect with an increase in the release of p -nitrophenyl phosphatase and β-glucuronidase from control lysosomes which became significant ( P P
Population-level differences in disease transmission: A Bayesian analysis of multiple smallpox epidemics

Abstract Estimates of a disease's basic reproductive rate R 0 play a central role in understanding outbreaks and planning intervention strategies. In many calculations of R 0 , a simplifying assumption is that different host populations have effectively identical transmission rates. This assumption can lead to an underestimate of the overall uncertainty associated with R 0 , which, due to the non-linearity of epidemic processes, may result in a mis-estimate of epidemic intensity and miscalculated expenditures associated with public-health interventions. In this paper, we utilize a Bayesian method for quantifying the overall uncertainty arising from differences in population-specific basic reproductive rates. Using this method, we fit spatial and non-spatial susceptible-exposed-infected-recovered (SEIR) models to a series of 13 smallpox outbreaks. Five outbreaks occurred in populations that had been previously exposed to smallpox, while the remaining eight occurred in Native-American populations that were naive to the disease at the time. The Native-American outbreaks were close in a spatial and temporal sense. Using Bayesian Information Criterion (BIC), we show that the best model includes population-specific R 0 values. These differences in R 0 values may, in part, be due to differences in genetic background, social structure, or food and water availability. As a result of these inter-population differences, the overall uncertainty associated with the “population average” value of smallpox R 0 is larger, a finding that can have important consequences for controlling epidemics. In general, Bayesian hierarchical models are able to properly account for the uncertainty associated with multiple epidemics, provide a clearer understanding of variability in epidemic dynamics, and yield a better assessment of the range of potential risks and consequences that decision makers face.
Duality between the webs of heterotic and type II vacua

We discuss how transitions in the space of heterotic K3×T 2 compactifications are mapped by duality into transitions in the space of Type II compactifications on Calabi–Yau manifolds. We observe that perturbative symmetry restoration, as well as non-perturbative processes such as changes in the number of tensor multiplets, have at least in many cases a simple description in terms of the reflexive polyhedra of the Calabi–Yau manifolds. Our results suggest that to many, perhaps all, four-dimensional N = 2 heterotic vacua there are corresponding type II vacua.
Decremental Response to High-Frequency Trains of Acetylcholine Pulses but Unaltered Fractional Ca2+ Currents in a Panel of “Slow-Channel Syndrome” Nicotinic Receptor Mutants

The slow-channel congenital myasthenic syndrome (SCCMS) is a disorder of the neuromuscular junction caused by gain-of-function mutations to the muscle nicotinic acetylcholine (ACh) receptor (AChR). Although it is clear that the slower deactivation time course of the ACh-elicited currents plays a central role in the etiology of this disease, it has been suggested that other abnormal properties of these mutant receptors may also be critical in this respect. We characterized the kinetics of a panel of five SCCMS AChRs (αS269I, βV266M, eL221F, eT264P, and eL269F) at the ensemble level in rapidly perfused outside-out patches. We found that, for all of these mutants, the peak-current amplitude decreases along trains of nearly saturating ACh pulses delivered at physiologically relevant frequencies in a manner that is consistent with enhanced entry into desensitization during the prolonged deactivation phase. This suggests that the increasingly reduced availability of activatable AChRs upon repetitive stimulation may well contribute to the fatigability and weakness of skeletal muscle that characterize this disease. Also, these results emphasize the importance of explicitly accounting for entry into desensitization as one of the pathways for burst termination, if meaningful mechanistic insight is to be inferred from the study of the effect of these naturally occurring mutations on channel function. Applying a novel single-channel–based approach to estimate the contribution of Ca2+ to the total cation currents, we also found that none of these mutants affects the Ca2+-conduction properties of the AChR to an extent that seems to be of physiological importance. Our estimate of the Ca2+-carried component of the total (inward) conductance of wild-type and SCCMS AChRs in the presence of 150 mM Na+, 1.8 mM Ca2+, and 1.7 mM Mg2+ on the extracellular side of cell-attached patches turned out be in the 5.0–9.4 pS range, representing a fractional Ca2+ current of ∼14%, on average. Remarkably, these values are nearly identical to those we estimated for the NR1-NR2A N-methyl-d-aspartate receptor (NMDAR), which has generally been considered to be the main neurotransmitter-gated pathway of Ca2+ entry into the cell. Our estimate of the rat NMDAR Ca2+ conductance (using the same single-channel approach as for the AChR but in the nominal absence of extracellular Mg2+) was 7.9 pS, corresponding to a fractional Ca2+ current of 13%.
Small coupled double loop antennas for dual band GPS arrays

Small footprint coupled double loop (CDL) antennas are presented for dual band anti-jam GPS arrays. Miniaturization is achieved by employing a readily available e r =9.8 substrate and lumped coupling capacitors. A CDL GPS antenna prototype having 1″×1″ (λ 0 /9.6×λ 0 /9.6 at L2 band) footprint over a 0.5″ thick 1.6″×1.6″ substrate is shown to operate with 3.8dB and 3.3dB measured gains at the L2 and L1 bands, respectively. To realize the smallest possible GPS array, the performance parameters of the CDL antenna are investigated in detail as a function of its substrate size.
IP quality: a new model that faces methodology and management challenges

Summary form only given. The promised value and productivity from re-aggregating the IC design chain is not always delivered, in part because of isolated IP product development/quality related practices, and in part because of an inability, from a design management perspective, to see "big picture" issues in the IP marketplace. However these challenges are not insurmountable. The concern over IP quality has rightfully grown over the past years as the future growth of the IC industry depends on two factors; (a) achieving higher levels of design productivity; and (b) shifting internal resources towards creating and delivering value-added user benefits that stimulate increased end-product consumption. While the second factor is not discussed in this presentation, there is a presumption that higher IP quality and productivity enables a shift of resources to more application-oriented design. A pre-requisite to achieving the productivity gains is substantial improvements in the level of IP quality, coupled with increased forethought during product development. This presentation describes a methodology to evaluate IP for SoC integration. The focus is on development and quality verification practices that also account for the issues of IP integration. Additionally, the long-term growth of the semiconductor industry may be limited by the lack of value placed on collaboration, support, quality verification, and due diligence between SoC design teams and their IP partners. This presentation also describes improvements in the hard IP business relationship between these groups that enable dramatic growth through slight changes in communications models. By developing reasonable expectations and focusing on open discussion between each group, perspective begins to shift. The true value of the design team and IP partnership is a function of successful collaborations - not when the user squeezes the last drop out of NRE, royalty, per-use, or other financing models. And the value-add of the partnership is realized when that collaboration includes additional real, shared incentives that more fully value the IP industry, rather than focus on purely lowest cost.
Depression, self-esteem, suicide ideation, and GPAs of high school students at risk.

131 subjects completed the Beck Depression Inventory, Coopersmith's Self-esteem Inventory--Short Form, the first 11 questions of the Beck Scale of Suicide Ideation, and gave some background information. The students receiving free or reduced-cost lunches scored lower on self-esteem, while students who had been absent more than 15 times scored higher on depression and suicide ideation and had lower GPAs than students who were not absent as often but had similar scores on self-esteem. Students who were below the 25th percentile on the SRA Composite score had lower GPAs. 9 students in special education in Learning Disabilities and Behavioral Disordered categories had scores similar to those of 121 regular education students on depression, self-esteem, suicide ideation, and GPA. Indicators for children at-risk provide clues about how children think about themselves, others, and the world in which they live. Language: en
Concomitant polymorphism and supramolecular isomerism in 1,3,5-tris(4-cyanobenzoyl)benzene

The title compound, 1,3,5-tris(4-cyanobenzoyl)benzene, exhibits the phenomenon of concomitant polymorphism. Two distinct isomeric solid-state networks, honeycomb and ladder, were obtained upon crystallization from acetone–water solution. Conformational flexibility of the molecule appears to facilitate polymorph formation. Each network is maintained via formation of multiple C–H⋯N and C–H⋯O hydrogen bonds.
Long-term management of the tunneled venous catheter

Despite their propensity for significant complications, tunneled central venous catheters have become a common means of vascular access in the United States for patients requiring maintenance hemodialysis for end-stage renal disease (ESRD). Reasons for their use include advanced patient age, peripheral vascular disease (arterial and venous), late referral for creation of vascular access, and more importantly, the lack of an interdisciplinary service line on vascular access among vascular surgeons, radiologists, and nephrologists. This review article summarizes complications commonly encountered in dialysis patients who use tunneled central venous catheters for vascular access-mainly thrombosis, stenosis, and infection. Special attention is given to novel approaches for the prevention of catheter-associated infections. Effective prevention and timely treatment of common catheter-associated complications can reduce the substantial morbidity associated with the use of these devices. However, these measures should not detract from the goal of avoiding or limiting the long-term use of catheters, thereby optimizing vascular access management by ensuring the timely availability of functioning arteriovenous fistulas.
Caucasian lesbians' use of psychotherapy: A matter of attitude?

Evidence suggests that a high proportion of lesbians seek psychological counseling. This study represents an empirical investigation of the disproportionate use of mental health services by lesbians, focusing on the hypothesis that lesbians place a greater value on psychotherapy than do nonlesbian women. Participants (100 lesbians and 309 nonlesbian women, 97% Caucasian) completed Surgenor's revision of the Attitudes Toward Seeking Professional Psychological Help Scale. Results indicate that the lesbian group had a significantly more positive attitude toward seeking psychological counseling than did the nonlesbian sample, regardless of whether or not they had experienced psychological counseling.
Discrete and differential two-view constraints for general imaging systems

The recent popularity of catadioptic and multi-camera imaging systems indicates a need to create formal models for general, non-perspective camera geometries. Development of algorithmic tools for interpreting images from a generalized camera model will lead to a better understanding of how to design camera systems for particular tasks. Here we define the corollary to epi-polar constraints for standard cameras-the relationship between two images of a scene taken by generalized cameras from viewpoints related by discrete or differential motions.
The roles of interleukin 2 and interferon‐γ in human B cell activation, growth and differentiation

The roles of interleukin 2 (IL 2) and interferon-gamma (IFN-gamma) in human peripheral blood B cell activation, growth and differentiation were examined. Highly purified B cells stimulated with Cowan I Staphylococcus aureus (SA) proliferated minimally and generated no immunoglobulin-secreting cells (ISC) without the addition of T cell supernatants (T sup) produced by mitogen-activated T cells. Recombinant IL 2 (rIL 2) alone was able to promote maximum proliferation and generation of ISC in cultures of highly purified SA-stimulated B cells when present from the initiation of the incubation. IFN-gamma, by contrast, could not support either response alone. When a two-step culture system was employed to determine the effect(s) of T cell influences during both initial activation and in propagating the response following activation, it was found that B cells activated by SA alone subsequently responded maximally to T sup but only minimally to IL 2 and not at all to IFN-gamma. However, the presence of T sup, rIL 2, or rIFN-gamma during initial activation with SA was found to facilitate greatly the subsequent capacity of the activated B cells to proliferate and differentiate in response to either T sup or IL 2. These data suggest two distinct pathways of human B cell responsiveness. Activities in T sup other than IL 2 or IFN-gamma can support the growth and differentiation of B cells initially activated with SA alone, whereas rIL 2 is capable of promoting these responses maximally only when B cells have been initially activated by SA in the presence of T cell lymphokines, such as IL 2 or IFN-gamma. The results emphasize the role of specific T cell factors in determining the outcome of humoral immune responses.
THE MANY FACES OF PREDATION: HOW INDUCTION, SELECTION, AND THINNING COMBINE TO ALTER PREY PHENOTYPES

Populations in nature face a number of factors that can alter their traits and subsequent performance. Predation is one factor that can have widespread effects on the mean trait value in a prey population because predators can impact prey traits through a number of processes. Predators can directly induce prey phenotypes through visual and chemical cues, predators can indirectly alter prey phenotypes by thinning the prey population (thereby reducing competition), and predators can cause selection on prey phenotypes through nonrandom killing. Ecologists are beginning to understand each of these three processes in isolation, but these processes act on prey phenotypes simultaneously, and we lack information on the relative importance of these processes in determining the final phenotype of prey. I used a system of gray treefrog tadpoles ( Hyla versicolor) and dragonfly predators (Anax longipes) to determine the separate and combined impacts of induction, thinning, and selection on the behavior, morphology, and growth of tadpoles reared in aquatic me- socosms. Using combinations of hand thinning, cues emitted from caged predators, and lethal predators, I demonstrated that the impact of lethal predators on growth was mediated primarily through thinning, the impact on morphology was primarily through induction, and the impact on behavior was affected similarly through thinning and induction. Sur- prisingly, while we know from numerous studies that the dragonflies kill tadpoles nonran- domly, selection did not have a significant impact on the final phenotypes of the tadpoles. This work appears to be the first study that identifies the relative magnitudes of the three predatory processes on a suite of prey phenotypes. The three processes can have opposing or supporting effects, the relative magnitudes of which likely differ among systems, illus- trating why we often observe contradictory results when we examine the impact of lethal predators on prey phenotypes. Thus, it is important that we identify the mechanisms un- derlying the outcomes of predation, rather than simply observing the outcomes and then inferring which processes are responsible.
Plea bargaining and appraisals of eyewitness evidence by prosecutors and defense attorneys

A sample of defense attorneys and prosecutors from matched California counties participated in a two-part study. Study 1A reports the results of a survey regarding how influential each of the 17 eyewitness factors is in affecting the accuracy of real eyewitness identifications. Generally, both attorney groups considered all eyewitness factors to be influential; on only 6 of the 17 factors were defense attorneys more likely than prosecutors to provide higher importance ratings. In Study 1B, the attorneys answered questions regarding their willingness to plea bargain after reading each of four scenarios in which (1) same- versus cross-race identification and (2) whether the perpetrator was familiar were experimentally manipulated. Both eyewitness factors influenced plea bargaining decisions, and effects were generally consistent for both attorney groups. Results confirm that plea bargaining decisions at least by defense attorneys are made ‘in the shadow of the trial,’ and that appraisals of the strength of ...
Critical points in charged membranes containing cholesterol.

Epifluorescence microscopy is used to determine phase diagrams for lipid monolayers containing binary mixtures of cholesterol or dihydrocholesterol and dimyristoylphosphatidylserine, as well as ternary mixtures that also contain ganglioside GM1. The phase diagrams are unusual in that they show multiple critical points: two upper miscibility critical points and one lower miscibility critical point. These critical points all are associated with the formation of condensed complexes between these lipids and cholesterol (or dihydrocholesterol). The miscibility critical pressures depend on subphase pH and ionic strength. Changes in critical pressures due to changes in subphase composition are closely related to changes in membrane electrostatic pressure and surface ionization.
Generation of Pairwise Test Sets Using a Genetic Algorithm

Pairwise testing is a combinatorial technique used to reduce the number of test case inputs to a system in situations where exhaustive testing with all possible inputs is not possible or prohibitively expensive. Given a set of input parameters where each parameter can take on one of a discrete set of values, a pairwise test set consists of a collection of vectors which captures all possible combinations of pairs of parameter values. The generation of minimal pairwise test sets has been shown to be an NP-complete problem and there have been several deterministic algorithms published. This paper presents the results of an investigation of generating pairwise test sets using a genetic algorithm. Compared with published results for deterministic pairwise test set generation algorithms, the genetic algorithm approach produced test sets which were comparable or better in terms of test set size in 39 out of 40 cases. However, the genetic algorithm approach required longer processing time than deterministic approaches in all cases. The results demonstrate that the generation of pairwise test sets using a genetic algorithm is possible, and suggest that the approach may be practical and useful in certain testing scenarios.
Adaptive Randomized Study of Idarubicin and Cytarabine Versus Troxacitabine and Cytarabine Versus Troxacitabine and Idarubicin in Untreated Patients 50 Years or Older With Adverse Karyotype Acute Myeloid Leukemia

Purpose: Troxacitabine has activity in refractory myeloid leukemia, either as a single agent or when combined with cytarabine (ara-C) or with idarubicin. A prospective, randomized study was conducted in patients aged 50 years or older with untreated, adverse karyotype, acute myeloid leukemia (AML) to assess troxacitabine-based regimes as induction therapy. Patients and Methods: Patients were randomized to receive idarubicin and ara-C (IA) versus troxacitabine and ara-C (TA) versus troxacitabine and idarubicin (TI). A Bayesian design was used to adaptively randomly assign patients to treatment. Thus, although there was initially an equal chance for randomization to IA, TA, or TI, treatment arms with a higher success rate progressively received a greater proportion of patients. Results: Thirty-four patients were treated. Randomization to TI stopped after five patients and randomization to TA stopped after 11 patients. Defining success as complete remission (CR) that occurred within 49 days of starting treat...
Commentary on: Rhinoplasty: The Nasal Bones – Anatomy and Analysis

The authors undertake a cadaver study whose purpose is to provide increasingly precise anthropometric and clinical measurements to remove some of the ambiguities that currently exist in the medical literature.1 For example, the terms “nasion” and “sellion” are often confused. We have been guilty ourselves of referring to the nasion as the deepest point of the concavity of the cephalic end of the nasal bone where it merges into the glabella. In fact, the sellion is the deepest point of that concavity. The authors carefully define their terms and proceed to perform detailed measurements of the bony structure of the nose. They remove ambiguities whenever possible. For example, they remind us not to confuse surface (skin) landmarks with …
In vitro cross-allergenicity of major aeroallergenic pollens by the radioallergosorbent technique

Abstract Cross-reactivity between major classes of aeroallergenic pollens has been estimated by comparing the inhibitory effects of selected allergens upon the reaginic activity of other native and non-native varieties, as measured by the radioallergosorbent technique (RAST). Common allergenic determinants were demonstrated in indigenous and nonindigenous ragweed species. Although patterns of inhibitory capacity were less uniform among grass pollens, endemic species tended to have more common allergenic properties than nonendemic species. Tree pollens exhibited the greatest degree of heterogeneity, confirming the previous view that these pollens tend to be less cross-reactive. Concomitant skin test threshold studies utilising the same groups of pollens were in general agreement with in vitro results. Because threshold skin testing was affected by a number of uncontrollable variables, however, the current modification of RAST in estimating cross-allergenicity was more accurate and reliable than data based upon cutaneous tests. It was concluded that reagin neutralization by the RAST method is the best currently available method of assessing cross-allergenic properties of pollens.
The rheology of non-dilute dispersions of highly deformable viscoelastic particles in Newtonian fluids

We present a model for the rheological behaviour of non-dilute suspensions of initially spherical viscoelastic particles in viscous fluids under uniform Stokes flow conditions. The particles are assumed to be neutrally buoyant Kelvin–Voigt solids undergoing time-dependent finite deformations and exhibiting generalized neo-Hookean behaviour in their purely elastic limit. We investigate the effects of the shape dynamics and constitutive properties of the viscoelastic particles on the macroscopic rheological behaviour of the suspensions. The proposed model makes use of known homogenization estimates for composite material systems consisting of random distributions of aligned ellipsoidal particles with prescribed two-point correlation functions to generate corresponding estimates for the instantaneous (incremental) response of the suspensions, together with appropriate evolution laws for the relevant microstructural variables. To illustrate the essential features of the model, we consider two special cases: (i) extensional flow and (ii) simple shear flow. For each case, we provide the time-dependent response and, when available, the steady-state solution for the average particle shape and orientation, as well as for the effective viscosity and normal stress differences in the suspensions. The results exhibit shear thickening for extensional flows and shear thinning for simple shear flows, and it is found that the volume fraction and constitutive properties of the particles significantly influence the rheology of the suspensions under both types of flows. In particular, for extensional flows, suspensions of particles with finite extensibility constraints are always found to reach a steady state, while this is only the case at sufficiently low strain rates for suspensions of (less realistic) neo-Hookean particles, as originally reported by Roscoe (J. Fluid Mech., vol. 28, 1967, pp. 273–293) and Gao et al. (J. Fluid Mech., vol. 687, 2011, pp. 209–237). For shear flows, viscoelastic particles with high viscosities can experience a damped oscillatory motion of decreasing amplitude before reaching the steady state.
Analysis of Morbidity and Mortality Outcomes in Postoperative Clostridium difficile Infection in the Veterans Health Administration

Importance This study analyzes and reports Clostridium difficile infection (CDI) rates, risk factors, and associations with postoperative outcomes in the Veterans Health Administration (VHA). Objective To report 30-day postoperative CDI rates and outcomes and identify associated risks by surgical procedures and preoperative patient demographics in a large integrated health care system. Design, Setting, and Participants In a retrospective observational study conducted from September 2014 to April 2015, the Veterans Affairs Surgical Quality Improvement Program database and the Decision Support System pharmacy database were linked to analyze the association of postoperative CDI with patients’ demographics, preoperative comorbidities, operative characteristics, and preoperative medications. The Veterans Affairs Surgical Quality Improvement Program assessments from October 1, 2009, to September 30, 2013, were investigated. The study was conducted at 134 VHA surgery programs, and the study population represents 12 surgical specialties: general, gynecological, neurosurgical, oral, orthopedics, otolaryngologic, plastic, podiatric, thoracic, transplant, urologic, and peripheral vascular. Main Outcomes and Measures Thirty-day postoperative CDI rates, risk factors of CDI, and association of CDI with postoperative morbidity and mortality. Results Among 468 386 surgical procedures, the postoperative CDI rate was 0.4% per year and varied by the VHA Surgery Program (0.0% to 1.4%) and surgical specialty (0.0% to 2.4%). Thirty-day CDI rates were higher in emergency procedures, procedures with greater complexity and higher relative value units, and those with a contaminated/infected wound classification. Patients with postoperative CDI were significantly older, more frequently hospitalized after surgery (59.9% vs 15.4%), had longer preoperative hospital stays (9.1 days vs 1.9 days), and had received 3 or more classes of antibiotics (1.5% vs 0.3% for a single antibiotic class) (all P Conclusions and Relevance The number and class of antibiotics administered after surgery, preoperative length of stay, procedural characteristics, surgical program complexity, and patient comorbidities are associated with postoperative CDI in the VHA.
Time-Interleaved Noise-Coupling Delta-Sigma Modulator Using Modified Noise-Shaped Integrating Quantizer

This paper presents an efficient noise coupling scheme in time-interleaved delta-sigma modulators (DSMs). The traditional voltage domain quantization error extraction is replaced with time domain method which is inherently available in the noise-shaped integrating quantizers (NSIQs). Thus, no digital-to-analog converter is required for the noise-coupling. A modified NSIQ scheme is proposed, which not only allows the use of the NSIQ with an even number of time-interleaving, but also increases the overall noise transfer function (NTF) order. Along with an additional order of NTF in the NSIQ, a higher order NTF can be achieved by interleaving and noise-coupling multiple channel NSIQs and DSMs. The proposed time-interleaved noise-coupling NSIQ can be used as a stand alone analog-to-digital converter, or as a quantizer in time-interleaved DSMs. Mathematical analysis and MATLAB simulation results are provided to prove the efficiency of the proposed scheme.