cssi/SciSciGPT-SciSciNet huggingface dataset:
The Stethoscope As a Potential Source of Transmission of Bacteria

To the Editor: Dr. Itzhak Brook's letter (1997;19:608) is of importance not only in showing that the stethoscope may be a vector for both aerobic and anaerobic bacteria but also in demonstrating that the stethoscope may be contaminated when used in physical examinations. The various textbook recommendations for cleaning before and after use are known commonly.1-3 However, these are not always adhered to, nor are adequate to prevent contamination of patients.4 Furthermore, hygiene rituals for stethoscopes often ignore the need for meticulous cleaning. The risk of contamination is high, especially in clinical settings and particularly for patients in the intensivecare unit or neonatal intensive-care unit.' In those very high-risk settings, the use of individual stethoscopes for each patient is known to be the most effective prevention. (Unfortunately, this makes doctors now a target of potential cross-infections via earpieces). To minimize this hazard, using single-use stethoscope-covers (Figure) would assure a high hygiene standard. Such covers could be used before physical examination and could be disposed of easily thereafter. We were able to detect 13 different patented devices designed to decrease stethoscope contamination, but only two seem to be feasible for real practice (Wurzburger, US Patent #5,538,004, 1996; Rothan-Tondeur, PCT #W0 96/38088, 1996). These devices involve a disposable cover that is attached to the diaphragm of the stethoscope prior to examination of the patient. After obtaining the desired clinical information, the cover can be removed easily. Application and disposal of these devices take 3 to 5 seconds. Because disposable stethoscopes are unrealistic, we believe these covers are a good alternative to disinfection procedures; but, as long as such covers are not available, meticulous disinfection of stethoscopes prior to use should be carried out.
Ectoparasites of the Striped Skunk, Mephitis mephitis, in Connecticut, U.S.A.

Abstract Seven species of ectoparasite were collected from 32 striped skunks, Mephitis mephitis, in south-central Connecticut, U.S.A., from July through September 2001. The most frequently collected ectoparasite was the chewing louse Neotrichodectes mephitidis, which was the only host-specific ectoparasite collected. Immature stages (larvae and nymphs) of 2 species of ticks, Ixodes cookei and the blacklegged tick, Ixodes scapularis, also were commonly collected. The remaining 4 species of ectoparasite consisted of 2 species of flea, Oropsylla arctomys and the cat flea, Ctenocephalides felis, the American dog tick, Dermacentor variabilis, and a macronyssid mite, Ornithonyssus wernecki, that normally parasitizes the Virginia opossum. Overall, the ectoparasite fauna of the striped skunk appears to be relatively depauperate. However, D. variabilis, I. cookei, I. scapularis, and C. felis are known to be vectors of zoonotic pathogens.
3D MPRAGE Improves Classification of Cortical Lesions in Multiple Sclerosis

Background—Gray matter lesions are known to be common in multiple sclerosis (MS), and are suspected to play an important role in disease progression and clinical disability. A combination of MRI techniques, double-inversion recovery (DIR) and phase-sensitive inversion recovery (PSIR), has been used for detection and classification of cortical lesions. We now demonstrate that highresolution three-dimensional (3D) magnetization-prepared rapid acquisition with gradient echo (MPRAGE) improves the classification of cortical lesions by allowing more accurate anatomic localization of lesion morphology. Methods—11 MS patients with previously identified cortical lesions were scanned using DIR, PSIR, and 3D MPRAGE. Lesions were identified on DIR and PSIR and classified as purely intracortical or mixed. MPRAGE images were then examined and lesions were re-classified based on the new information. Results—The high signal-to-noise ratio, fine anatomic detail, and clear gray-white matter tissue contrast seen in the MPRAGE images provided superior delineation of lesion borders and surrounding gray-white matter junction, improving classification. 119 lesions were identified as either intracortical or mixed on DIR/PSIR. In 89 cases, MPRAGE confirmed the classification by DIR/PSIR. In 30 cases, MPRAGE overturned the original classification. Conclusion—Improved classification of cortical lesions was realized by inclusion of high-spatial resolution 3D MPRAGE. This sequence provides unique detail into lesion morphology that is necessary for accurate classification.
Vitamin D and Dexamethasone Inversely Regulate Parathyroid Hormone-Induced Regulator of G Protein Signaling-2 Expression in Osteoblast-Like Cells

The PTH/PTHrP receptor stimulates both adenylate cyclase- and phospholipase C-dependent signaling pathways via different G proteins. The biological actions of PTH on bone are modified by steroid hormones. PTH induces expression of regulator of G protein signaling (RGS)-2, a putative preferential inhibitor of G(q)-mediated phospholipase C activation. We investigated whether steroid hormones interfere with PTH signaling by modulating PTH-induced RGS-2 expression in osteoblast-like UMR 106-01 cells. PTH (1-34) rapidly and transiently induced expression of RGS-2 mRNA and protein via the cAMP/protein kinase A pathway within 30 min, with maximal protein abundance after 2 h. PTH-induced RGS-2 preferentially bound to Galpha(q), compared with Galpha(s) protein. 1,25-(OH)(2)D(3) pretreatment enhanced PTH-induced RGS-2 mRNA and protein accumulation, whereas dexamethasone preincubation had an attenuating effect. These effects were due to modulation of the RGS-2 gene transcription rate, which increased by 35% with 1,25-(OH)(2)D(3) and decreased by 63% with dexamethasone pretreatment. RGS-2 mRNA half-life was not affected by either steroid. The transcriptional effects of dexamethasone and 1,25-(OH)(2)D(3) were independent of PTH/PTHrP receptor activation and were not explained by effects on cAMP accumulation, cAMP response element-binding protein expression or phosphorylation, or the abundance of the osteoblast-specific transcription factor core-binding factor alpha (CBFa1/Runx2), a known activator of RGS-2 expression. In conclusion, glucocorticoids and 1,25-(OH)(2)D(3) inversely modulate PTH-induced RGS-2 gene transcription. Regulation of RGS-2 may constitute a novel mechanism by which steroids modulate signaling via the PTH/PTHrP receptor and other G protein-coupled receptors in bone.
Simulated cytoskeletal collapse via tau degradation.

We present a coarse-grained two dimensional mechanical model for the microtubule-tau bundles in neuronal axons in which we remove taus, as can happen in various neurodegenerative conditions such as Alzheimers disease, tauopathies, and chronic traumatic encephalopathy. Our simplified model includes (i) taus modeled as entropic springs between microtubules, (ii) removal of taus from the bundles due to phosphorylation, and (iii) a possible depletion force between microtubules due to these dissociated phosphorylated taus. We equilibrate upon tau removal using steepest descent relaxation. In the absence of the depletion force, the transverse rigidity to radial compression of the bundles falls to zero at about 60% tau occupancy, in agreement with standard percolation theory results. However, with the attractive depletion force, spring removal leads to a first order collapse of the bundles over a wide range of tau occupancies for physiologically realizable conditions. While our simplest calculations assume a constant concentration of microtubule intercalants to mediate the depletion force, including a dependence that is linear in the detached taus yields the same collapse. Applying percolation theory to removal of taus at microtubule tips, which are likely to be the protective sites against dynamic instability, we argue that the microtubule instability can only obtain at low tau occupancy, from 0.06–0.30 depending upon the tau coordination at the microtubule tips. Hence, the collapse we discover is likely to be more robust over a wide range of tau occupancies than the dynamic instability. We suggest in vitro tests of our predicted collapse.
Comparing behavioral responses across multiple assays of stress and anxiety in zebrafish (Danio rerio)

Animals encounter stressful situations multiple times throughout their lives and often successfully cope with them. Individuals vary in the nature and intensity of their behavioral and physiological response to stressors, often representing correlated and qualitatively distinct coping styles (e.g., proactive and reactive). These alternative coping styles are ways an animal can overcome a variety of stressful situations, which ultimately can have important fitness consequences. Here we use zebrafish (Danio rerio) recently wild-derived and selectively bred for amount of stationary behavior (High and Low lines) and a classic domesticated strain (AB) to document the utility of these zebrafish strains in understanding coping mechanisms. The Low Stationary Behavior (LSB) line of zebrafish displayed significantly lower stress and anxiety-related behaviors than the High Stationary Behavior (HSB) across six stress and anxiety-related behavioral assays. In some assays, we observed strain differences in behavior within three minutes of the start of the trial. Males also showed reduced levels of anxiety-related behaviors relative to females in two assays. Comparing wild-derived and domesticated strains, the AB line displayed significantly lower levels of anxietyrelated behavior in half of the assays. This study demonstrates that our selectively bred lines from wild-caught zebrafish (HSB, LSB) exhibit consistent and divergent behavioral stress responses across multiple distinct assays. Hence these lines may prove useful in understanding the proximate and ultimate mechanisms of coping with stress and anxiety.
The Muir‐Torre syndrome in a black patient with AIDS: histopathology and molecular genetic studies

In 1981, a black man had adenocarcinoma of the colon. In 1986, he had a sebaceous adenoma and the diagnosis of the Muir-Torre syndrome was established. The patient was found to be HIV sero-positive in 1986, and 8 years later fulfilled the CDC criteria for AIDS. During 1989 to 1993 the CD4 count was > 200 cells/ml and the patient had 2 sebaceous tumors, 1 basal cell carcinoma and 1 keratoacanthoma. In 1994 to 1996, the CD4 count was < 200 cells/ml and the patient developed 18 sebaceous tumors and a poorly differentiated adenocarcinoma of the finger which metastasized to axillary lymph nodes. Microsatellite analysis of tumor DNA from a sebaceous adenoma and adenocarcinoma of the finger revealed widespread microsatellite instability. The interaction of AIDS with the behavior of the tumors in the Muir-Torre syndrome has not previously been reported. Although our patient had an increase in the number of new sebaceous tumors at the same time he experienced deterioration of the immune system, he is doing well 15 years after resection of adenocarcinoma of the colon and 16 months after metastatic poorly differentiated adenocarcinoma of the skin. This follows the previously observed tendency for cancers of the Muir-Torre syndrome, especially those displaying widespread microsatellite instability, to be less lethal than their histologically similar counterparts in people without Muir-Torre syndrome.
Neuroevolutionary sources of laughter and social joy: Modeling primal human laughter in laboratory rats

Rats make abundant 50 kHz ultrasonic vocalizations (USVs) when they play and exhibit other positive social interactions. This response can be dramatically increased by tickling animals, especially when directed toward bodily areas toward which animals direct their own play solicitations (e.g., nape of the neck). The analysis of this system indicates that the response largely occurs in positive, playful social situations, and may index willingness for social engagement, similar to human infantile laughter, which may mature into productive adult socio-sexual behaviors. There are now enough formal similarities between rat 50 kHz USVs and human laughter, to realistically hypothesize that they are neurally and functionally homologous at the subcortical level of brain organization. To help contrast this behavior with human laughter, the available evidence concerning neural organization of human laughter is summarized from brain imaging and neuropsychological perspectives. Thus, a study of 50 kHz USVs in rats may offer an animal model for studying some of the fundamental properties of laughter circuitry in humans, and the brain mechanisms that facilitate positive social engagement, in the mammalian brain. It is proposed that further study of this phenomenon may provide a theoretical as well as empirical handle on the sources of social joy within the mammalian brain.
Some Applications of Ion Beams in III-V Compound Semiconductor Device Fabrication

Ion-beam-assisted etching of GaAs/AlGaAs and InP/GaInAsP, ion-beam disordering of GaAs/AlGaAs multiple-quantum-well structures, and ion implantation in InP are discussed.
An Influence-Cost Model of Organizational Practices and Firm Boundaries

This paper explores organizational responses to in‡uence activities - costly activities aimed at persuading decision makers. As Milgrom and Roberts (1988) argued, rigid practices that otherwise seem ine¢ cient can optimally arise. If more complex decisions are more susceptible to in‡uence activities, optimal selection may partially account for the observed correlation between …rm performance and management-practice quality reported in Bloom and Van Reenen (2007). Further, a …rm’s boundaries can be shaped by in‡uence-activity considerations, providing a theory of the …rm based on ex-post ine¢ ciencies. Finally, boundaries and rigid practices interact: rules under non-integration should be less restrictive than under integration. (JEL D02, D23, D73, D83)
Driver information and motorist aid hardware

The state of the art of three types of driver information and motorist aid hardware is presented: variable message signing (VMS), highway advisory radio (HAR), and motorist aid systems (MAS). The evolution of this hardware is discussed as well as the current practices and future direction. This is not intended to be an exhaustive discussion but rather a summary and critique of these hardware types. In conclusion, some interim steps are identified that are and can be taken before a total integrated driver information and motorist aid system can be implemented.
Average Competence, Variability in Individual Competence, and Accuracy of Statistically Pooled Group Decisions

We correct propositions advanced by Sattler in 1966 on the accuracy of group judgments as a function of the mean competence and distribution of competence of group members. We provide the special distributions which, for fixed total group competence, minimize/maximize group majority rule accuracy. We also show how group majority competence can be above/below that of group mean competence.
Fringe Compensation in Hologram Interferometry

A new quasi real-time method has been developed for the unambiguous determination of fractional value as well as algebraic sign of fringe orders in hologram interferemetry. Two reference beams are employed in this method. The first exposure is recorded with one reference beam while the second exposure is recorded with the other. In playback, both reference beams are used simultaneously. A calibrated phase shifting device in one reference beam allows for a uniform shifting of fringes and, hence, a means for determining fractional orders.
Control of auxin-regulated root development by the Arabidopsis thaliana SHY2/IAA3 gene

The plant hormone auxin controls many aspects of development and acts in part by inducing expression of various genes. Arabidopsis thaliana semidominant shy2 (short hypocotyl) mutations cause leaf formation in dark-grown plants, suggesting that SHY2 has an important role in regulating development. Here we show that the SHY2 gene encodes IAA3, a previously known member of the Aux/IAA family of auxin-induced genes. Dominant shy2 mutations cause amino acid changes in domain II, conserved among all members of this family. We isolated loss-of-function shy2 alleles including a putative null mutation. Gain-of-function and loss-of-function shy2 mutations affect auxin-dependent root growth, lateral root formation, and timing of gravitropism, indicating that SHY2/IAA3 regulates multiple auxin responses in roots. The phenotypes suggest that SHY2/IAA3 may activate some auxin responses and repress others. Models invoking tissue-specificity, feedback regulation, or control of auxin transport may explain these results.
Cross-talk between Receptor Tyrosine Kinase and Tumor Necrosis Factor-α Signaling Networks Regulates Apoptosis but not Proliferation

Although many of the signaling networks activated by receptor tyrosine kinases (RTKs) and cytokine receptors are well understood, how these networks interconnect is much less clear. We set out to determine how cells respond to simultaneous exposure to opposing signals and how their downstream networks process this information. Using six isogenic cell lines, each stably transfected with a different RTK, we found that, in each case, the cognate growth factor induced proliferation, whereas TNFα induced apoptosis. Surprisingly, when the cells were treated simultaneously with growth factor and TNFα, the growth factor enhanced, rather than antagonized, TNFα-induced cell death. In contrast, TNFα had no effect on growth factor-induced proliferation, suggesting that cross-talk between these networks is unidirectional. A quantitative, system-wide study of signaling at early and late time points corroborated this observation: proteins in the RTK networks were not affected by TNFα treatment, but proteins in the TNFα network were affected by growth factors. These studies also highlighted the stress mitogen-activated protein kinase proteins p38 and c-Jun N-terminal kinase as the key nodes of signal integration, and their activation states at an early time point correlated well with subsequent measurements of apoptosis. Knocking down cRaf reduced the growth factor enhancement of TNFα-induced apoptosis, highlighting its role as a regulator of network cross-talk upstream of p38 and c-Jun N-terminal kinase. Overall, we found that when cells encounter conflicting stimuli, their phenotypic response is determined not by the sum of isolated processes, but by how their signaling networks interconnect. This underscores the need to build mechanistic models of network integration as a first step in predicting cellular behavior in complex settings and in rationally designing combination therapies.
Response of jejunal mucosa to fractionated doses of neutrons or γ-rays

Abstract The RBE n + γ/γ of fast neutrons produced by the 9 Be( d,n ) 9 B reaction ( E d = 50 MeV) relative to 60 Co γ-rays for killing of jejunal crypt stem cells has been measured over a wide range of doses beginning at 400 rad of γ-rays, and extending to doses as high as 1600 rad. Dose-equivalent values for recovery as a function of the size of the dose-per-fraction have been measured. When γ-ray doses up to about 400 rad are given, about 60% of the dose is “recovered”. With neutron doses of 100–200 rad, the recovered dose amounts to only about 13% of the given dose.
Enhanced contrast ratio of an electrochromic window (ECW) based on a V2O5-TiO2 composite thin film as a counter electrode

An Electrochromic window (ECW) is a strong candidate for an optical shutter. An ECW is composed of the conductive polymer as a working electrode and V2O5 as a counter electrode. The ECW technology switches between colored and bleached stages. In this paper the modification of a V2O5 thin film as a counter electrode is studied to increase contrast ratio of ECWs by adding TiO2 into V2O5. The dependence of the intercalation properties and transmissivity of V2O5-TiO2 composite films on various chemical compositions, a preparation and characterization of the films for use as a transparent ion storage layer in organic ECWs are focused on in this paper. A V2O5-TiO2 composite film was synthesized with sol-gel electrophoresis deposition method. Indium Tin Oxide (ITO) coated glass was used as an electrically conductive and transparent substrate. A V2O5-TiO2 composite film with V/Ti ratio of 70/30 in the reduced state showed 6 to 13% improvement of transmissivity between 380 nm and 800 nm wavelengths as compared to a V2O5 thin film in the same state. Li+ intercalation rate was also observed to be higher. The composite film exhibited twice of capacitance than that of the V2O5 film. An ECW with the composite film exhibited 6% higher contrast ratio than that with the V2O5 film. The contrast ratio of the ECW, measured as Δ%T, was equal to 56%, and ranged from 2% to 58% between the colored and bleached state measured at 580 nm wavelength. The color change response speed was also faster, i.e., only two seconds between fully colored and bleached stages. Key words: electrochromic window (ECW), V2O5-TiO2 composite film, contrast ratio, transmissivity, Li+ intercalation rate
The Green Sulfur and Nonsulfur Bacteria of Hot Springs

Hot springs are inhibited primarily by prokaryotes and provide habitats where nearly monospecific populations of phototrophs occur in a recognizable pattern. There is a great diversity of hot springs with regard to chemistry, but within the array, some species of almost all groups of photosynthetic bacteria may be found.
H/sup /spl infin//-optimal control for singularly perturbed systems. II. Imperfect state measurements

For pt.I, see ibid., vol. 29, no. 2, p 401-423 (1993). In this paper we study the H/sup /spl infin//-optimal control of singularly perturbed linear systems under general imperfect measurements, for both finite- and infinite-horizon formulations. Using a differential game theoretic approach, we first show that as the singular perturbation parameter (say, /spl epsiv/>0) approaches zero, the optimal disturbance attenuation level for the full-order system under a quadratic performance index converges to a value that is bounded above by (and in some cases equal to) the maximum of the optimal disturbance attenuation levels for the slow and fast subsystems under appropriate "slow" and "fast" quadratic cost functions, with the bound being computable independently of E and knowing only the slow and fast dynamics of the system. We then construct a controller based on the slow subsystem only and obtain conditions under which it delivers a desired performance level even though the fast dynamics are completely neglected. The ultimate performance level achieved by this "slow" controller can be uniformly improved upon, however, by a composite controller that uses some feedback from the output of the fast subsystem. We construct one such controller, via a two-step sequential procedure, which uses static feedback from the fast output and dynamic feedback from an appropriate slow output, each one obtained by solving appropriate /spl epsiv/-independent lower dimensional H/sup /spl infin//-optimal control problems under some informational constraints. We provide a detailed analysis of the performance achieved by this lower-dimensional /spl epsiv/-independent composite controller when applied to the full-order system and illustrate the theory with some numerical results on some prototype systems. >
Sarcoma of the uterus. A clinical and pathologic study of 177 cases.

Abstract Clinical and pathologic features of 177 cases of sarcoma of the uterus have been reviewed. Twenty-five of 60 patients with leiomyosarcoma and 17 of 53 patients with endometrial sarcoma who received their primary definitive therapy at the Mayo Clinic were known to be living at least 5 years later. Clinical features were not diagnostic, but suggested other more common neoplasms. Treatment of choice was total abdominal hysterectomy. Radiation therapy was of questionable value. The grade and extent of the sarcomas were the most significant prognostic factors.
Elevated Blood Lead Levels in Children Associated With the Flint Drinking Water Crisis: A Spatial Analysis of Risk and Public Health Response

Objectives. We analyzed differences in pediatric elevated blood lead level incidence before and after Flint, Michigan, introduced a more corrosive water source into an aging water system without adequate corrosion control. Methods. We reviewed blood lead levels for children younger than 5 years before (2013) and after (2015) water source change in Greater Flint, Michigan.We assessed the percentage of elevated blood lead levels in both time periods, and identified geographical locations through spatial analysis. Results. Incidence of elevated blood lead levels increased from 2.4% to 4.9% (P<.05) after water source change, and neighborhoods with the highest water lead levels experienced a 6.6% increase. No significant change was seen outside the city. Geospatial analysis identified disadvantaged neighborhoods as having the greatest elevated blood lead levelincreases andinformed response prioritization during the now-declared public health emergency. Conclusions. The percentage of children with elevated blood lead levels increased after water source change, particularly in socioeconomically disadvantaged neighborhoods. Water is a growing source of childhood lead exposure because of aging infrastructure. (Am J Public Health. 2016;106:283–290. doi:10.2105/AJPH.2015.303003)
An efficient structure for run-time configuration of synthesis and channelizer filter banks

The ability to change frequency and adjust bandwidth in a digital receiver is a fundamental property of Software Defined Radios (SDRs). FPGAs are ideal candidates for handling the high computational load required for high sampling rates. In this paper an efficient method for either combining or channelizing varying bandwidth signals within a single filter structure in hardware is presented. The two methods are a synthesis polyphase filter bank (PFB) and a channelizer PFB. The synthesis PFB is implemented as an M-point inverse Discrete Fourier Transform (DFT) followed by an M-path polyphase filter bank, which is modified to oversample the input channel, limiting aliasing between channels. The channelizer PFB is implemented as the reverse process: a D-path PFB followed by a D-point inverse DFT. The channelizer structure is similarly modified to produce output channels that are 2x oversampled. This structure can accommodate a large number signals with large variations in bandwidth, and allows them to be combined or channelized efficiently.
EpiAssist: Service-learning in public health education.

Background: Although public health degree programs typically require practica and other field experiences, service-learning courses, with a focus on civic engagement and the application of classroom learning in real world settings, can go beyond these requirements and provide benefits to students and community-based practice partners. The goal of this paper is to assess potential benefits of service-learning programs for both graduate-level public health students and state and local public health agency partners. Methods: EpiAssist is a new service-learning program developed at the School of Public Health of the Texas A and M University Health Science Center, USA, in January 2015. EpiAssist was integrated into a new course, Methods in Field Epidemiology. The integration of service-learning was guided by a partnership with the Texas A and M Center for Teaching Excellence. Results: State, regional, and local public health partners requested EpiAssist via email or telephone. A listserv was used to recruit student volunteers to meet requests. 54 of 86 registered EpiAssist students (63%) participated in at least one of ten service-learning and three training activities between January and June, 2015. Service-learning activities included questionnaire development, in-person and telephone data collection, and data analysis. Training topics for students included the Epi Info™ software, community assessment and communicable disease reporting. Students and partner organizations provided generally positive assessments of this service learning program through an online evaluation. Discussion: Service-learning provides students with enhanced classroom learning through applied public health experience in state, regional and local health departments. These experiences provide both needed surge capacity to public health departments and valuable hands-on field experience to students.
Studies on terpenes—7: A Short route to a pentalenolactone e precursor

Abstract The bicyclic enone 6 was converted into the adduct 13 by photochemical addition of aliene, and then elaborated through a fragmentation sequence into the α-methylene ketone 17.
The Effects of Atrial Fibrillation on Myocardial Blood Flow and Energetics

The changes produced by atrial fibrillation on myocardial blood flow and energetics are unclear. Accordingly, the effects of atrial fibrillation on myocardial blood flow and oxygen consumption were studied in 18 anesthetized dogs. With atrial fibrillation cardiac output and mean aortic pressure declined. Although average myocardial blood flow and oxygen consumption did not change, the alterations in these variables correlated strongly (r = 0.95, P less than 0.01). Moreover, myocardial blood flow changes correlated with those of tension time index and peak dp/dt (r = 0.64, P less than 0.05). Distribution of left ventricular regional flow remained uniform irrespective of the directional changes in blood flow. However, average left ventricular inner to outer wall flow ratio declined and myocardial oxygen extraction increased. Thus, with atrial fibrillation, myocardial blood flow does not change in a consistent fashion, although myocardial blood flow still reflects myocardial oxygen demand. Relative hypoperfusion of subendocardium and an increase in myocardial oxygen extraction suggest that with atrial fibrillation the myocardial blood flow response is abnormal.
Kikuchi-Fujimoto disease: unusual presentation of rare disease

Kikuchi-Fujimoto disease (KFD) is a rare, benign disorder that typically follows a selflimiting natural course and was initially described in young females of Asian descent. Its clinical presentation may mimic lymphoproliferative disorders, connective tissue disorders, and chronic infections. This often leads to misdiagnosis and inappropriate treatment. The exact cause of this condition remains unknown although autoimmune processes and certain infectious agents have been associated with the disease. The diagnosis of KFD is made histopathologically. Treatment is supportive and long-term follow-up is recommended due to increased risk of future development of systemic lupus erythematosus. Here we are presenting a case of a patient with an unusual presentation of KFD.
Adverse events of medical devices and the role of the government

The concept of medical devices adverse events is introduced in the paper. The contents of surveillance of adverse events are discussed and the government's role in the surveillance is presented as well.
Conservative Kinetic Models

In the previous chapter we studied boundary value problems in half space geometry of the type with A strictly positive.
II—Arrogance, Silence, and Silencing

Alessandra Tanesini’s insightful paper ([2016][1]) explores the moral and epistemic harms of arrogance, particularly in conversation. Of special interest to her is the phenomenon of arrogance-induced silencing, whereby one speaker’s arrogance either prevents another from speaking altogether or else undermines her capacity to produce certain speech acts such as assertions ([Langton 1993][2], [2009][3]). I am broadly sympathetic to many of Tanesini’s claims about the harms associated with this sort of silencing. In this paper I propose to address what I see as a lacuna in her account. I believe (and will argue) that the arrogant speaker can put those he silences in the morally outrageous position in which their own silence contributes to their oppression . While nothing in Tanesini’s account would predict or explain this, the wrinkle I propose will aim to do so in a way that is in the spirit of her account. To do so, I will need to expand the focus of discussion: instead of concentrating on (arrogance-induced) silencing , I will consider the phenomenon of (arrogance-induced) silence . When one is silent in the face of a mutually observed assertion (whatever the cause of this silence), one’s silence will be interpreted by others. I argue that (1) under certain widespread conditions, a hearer’s silence in the face of the arrogant speaker’s assertions is likely to be falsely interpreted as indicating her assent to the assertion, and (2) such an interpretation of the hearer’s silence will bring new harms in its wake—in particular, harms to the hearer who was silenced, and also harms to the community at large. When we combine these new harms with the ones Tanesini identified in her paper, we reach the further conclusion that (3) the harms of silencing (whether arrogance-induced or otherwise) are potentially far worse than many have imagined. [1]: #ref-17 [2]: #ref-10 [3]: #ref-9
Assessment of the Value of Scintigraphic Procedures: A Case Study

Over the past 15 years, nuclear medicine techniques have grown at nearly a logarithmic rate. In view of increasing concern over rising health care expenditures, the proper evaluation of new scintigraphic tests becomes increasingly important. In this context “proper evaluation” must be clearly defined so that accurate quantification of results is possible. Any overall evaluation of new scintigraphic procedures rests first upon evaluation of improvements in diagnostic accuracy, that is, the sensitivity and specificity of the test, and then upon evaluation of the impact of these improvements on health outcomes. The first point can be approached directly through studies designed to assess the ability of a test to detect patients with disease and to separate them from patients without disease or with other diseases. The second point is more difficult because it requires selection of an appropriate measure for assessing health outcomes.
Ample and Nef Vector Bundles

This chapter is devoted to the basic theory of ample and nef vector bundles. We start in Section 6.1 with the “classical” material from [274]. In Section 6.2 we develop a formalism for twisting bundles by Q-divisor classes, which is used to study nefness. The development parallels - and for the most part reduces to - the corresponding theory for line bundles. The next two sections constitute the heart of the chapter. In the extended Section 6.3 we present numerous examples of positive bundles arising “in nature,” as well as some methods of construction. Finally, we study in Section 6.4 the situation on curves, where there is a close connection between amplitude and stability: following Gieseker [224] one obtains along the way an elementary proof of the tensorial properties of semistability for bundles on curves.
Relational categories are more mutable than entity categories

Across three experiments, we explore differences between relational categories—whose members share common relational patterns—and entity categories, whose members share common intrinsic properties....
Adaptive stochastic convex optimization over networks

In this work, we study the task of distributed optimization over a network of learners in which each learner possesses a convex cost function, a set of affine equality constraints, and a set of convex inequality constraints. We propose a distributed diffusion algorithm based on penalty methods that allows the network to cooperatively optimize a global cost function, subject to all constraints and without using projection steps. We show that when sufficiently small step-sizes are employed, the expected distance between the optimal solution vector and that obtained at each node in the network can be made arbitrarily small.
32. Lawrence’s the Rocking-Horse Winner

(1973). 32. Lawrence’s the Rocking-Horse Winner. The Explicator: Vol. 31, No. 5, pp. 69-70.
Strategies for Building Peer Surgical Coaching Relationships.

Importance Peer surgical coaching is a promising approach for continuing professional development. However, scant guidance is available for surgeons seeking to develop peer-coaching skills. Executive coaching research suggests that effective coaches first establish a positive relationship with their coachees by aligning role and process expectations, establishing rapport, and cultivating mutual trust. Objective To identify the strategies used by peer surgical coaches to develop effective peer-coaching relationships with their coachees. Design, Setting, and Participants Drawing on executive coaching literature, a 3-part framework was developed to examine the strategies peer surgical coaches (n = 8) used to initially cultivate a relationship with their coachees (n = 11). Eleven introductory 1-hour meetings between coaching pairs participating in a statewide surgical coaching program were audiorecorded, transcribed, and coded on the basis of 3 relationship-building components. Once coded, thematic analysis was used to organize coded strategies into thematic categories and subcategories. Data were collected from October 10, 2014, to March 20, 2015. Data analysis took place from May 26, 2015, to July 20, 2016. Main Outcomes and Measures Strategies and potentially counterproductive activities for building peer-coaching relationships in the surgical context to inform the future training of surgical coaches. Results Coaches used concrete strategies to align role and process expectations about the coaching process, to establish rapport, and to cultivate mutual trust with their coachees during introductory meetings. Potential coaching pitfalls are identified that could interfere with each of the 3 relationship-building components. Conclusions and Relevance Peer-nominated surgical coaches were provided with training on abstract concepts that underlie effective coaching practices in other fields. By identifying the strategies used by peer surgical coaches to operationalize these concepts, empirically based strategies to inform other surgical coaching programs are provided.
Development and Validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: The ED Prevention Quality Indicators for General Health Conditions.

Objective To develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health. Data Sources Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project 2008–2010 State Inpatient Databases and State Emergency Department Databases. Study Design Empirical analyses and structured panel reviews. Methods Panels of 14–17 clinicians and end users evaluated a set of ED Prevention Quality Indicators (PQIs) using a Modified Delphi process. Empirical analyses included assessing variation in ED PQI rates across counties and sensitivity of those rates to county-level poverty, uninsurance, and density of primary care physicians (PCPs). Principal Findings ED PQI rates varied widely across U.S. communities. Indicator rates were significantly associated with county-level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density. A clinical and an end-user panel separately rated the indicators as having strong face validity for most uses evaluated. Conclusions The ED PQIs have undergone initial validation as indicators of community health with potential for use in public reporting, population health improvement, and research.
Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Case Report and Review of the Literature.

Breast implant–associated anaplastic large T-cell lymphoma has recently been recognized as an entity, with few reports describing the two common subtypes: in situ (indolent) and infiltrative. Recently, the infiltrative subtypes have been shown to be more aggressive requiring adjuvant chemotherapy. We report a rare case of breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) in a 65-year-old Caucasian female following silicone breast implantation and multiple capsulectomies. We discuss the rare presentation of this disease, histopathologic features of the indolent and infiltrative subtypes of ALCL, and their clinical significance. We also review the literature for up-to-date information on the diagnosis and clinical management. Treatment modalities including targeted therapy are also discussed. Although BIA-ALCL is rare, it should always be considered as part of the differential diagnosis especially in women with breast implants. Given the increasing rate of breast reconstruction and cosmetic surgeries, we anticipate a continuous rise in incidence rates of this rare disease; thus, caution must be taken to avoid misdiagnosis.
Certain applied electrical signals during EPG cause negative effects on stylet probing behaviors by adult Lygus lineolaris (Hemiptera: Miridae).

Abstract This study is the first to fully evaluate whether electrical signals applied to large insects during electropenetrography (EPG; also called electrical penetration graph) negatively affect insect behavior. During EPG, electrical signals are applied to plants, and thus to the gold-wire-tethered insects feeding on them. The insect completes an electrical circuit whose changes in voltage reflect the insect’s stylet probing/penetration behaviors, recorded as waveform output. For nearly 50 years of EPG science, evidence has supported that there are no or negligible effects on tiny insects from applied electricity during EPG. Recently however, EPG studies of large-bodied hemipterans such as heteropterans and sharpshooter leafhoppers have been published. The wider stylet diameters of such large insects cause them to have lower inherent resistances to applied signals compared with smaller insects, conveying more electrical current. The present study asked whether such increased currents would affect insect stylet probing, by comparing Lygus lineolaris behaviors on pin-head cotton squares using an AC-DC electropenetrograph. Effects of AC or DC applied signals were separately examined in two factorial studies, each comparing four input resistor (Ri) levels (10 6 , 10 7 , 10 8 and 10 9 Ω) and four applied voltage levels (2, 60, 150 and 250 mV). Results showed that changes in both probing and non-probing behaviors were indeed caused by changing signal type, Ri level, or applied voltage. Negative effects on feeding were numerically greater overall for DC than AC applied signals, perhaps due to muscular tetany from DC; however, AC versus DC could not be statistically tested. Results strongly support the need for flexible Ri and applied voltage levels and types, to tailor instrument settings to the size and special needs of each insect subject. Our findings will facilitate further EPG studies of Lygus spp., such as host plant resistance or insecticidal assays/bioassays to assess mode of action and appropriate dosage. It is hoped that this study will also inform EPG studies of similar, large heteropterans in the future.
On self-concordant barriers for generalized power cones

In the study of interior-point methods for nonsymmetric conic optimization and their applications, Nesterov (Optim Methods Softw 27(4–5): 893–917, 2012) introduced a 4-self-concordant barrier for the power cone, also known as Koecher’s cone. In his PhD thesis, Chares (Cones and interior-point algorithms for structured convex optimization involving powers and exponentials, PhD thesis, Universite catholique de Louvain, 2009) found an improved 3-self-concordant barrier for the power cone. In addition, he introduced the generalized power cone, and conjectured a “nearly optimal” self-concordant barrier for it. In this paper, we prove Chares’ conjecture. As a byproduct of our analysis, we derive a self-concordant barrier for a nonnegative power cone.
PHONETIC PATTERNS OF NASALIZATION AND IMPLICATIONS FOR FEATURE SPECIFICATION

Publisher Summary This chapter presents the studies that reveal complex relation between phonological representations and their phonetic realization. The studies provide a variety of views of the spatial and temporal regularities associated with the realization of linguistic feature specifications, and they identify some phonetic patterns of nasalization which, instead of being characterized by phonological feature specifications, are more appropriately handled within the domain of phonetic representations and processes. Consequently, these new data have resulted in a refinement in views regarding phonetic implementation and thus, the way phonetic data may be used to investigate phonological feature specification. The chapter presents Keating's view of the phonetic implementation of segmental features. The chapter discusses the results of recent studies that have focused on the implementation of [nasal] and the refinements which they suggest to Keating's approach.
Colorectal cancer screening among users of county health centers and users of private physician practices.

OBJECTIVE We examined use of colorectal cancer (CRC) screening exam modalities among county health centers and private physician offices, where both were located in the same geographic area. METHODS We surveyed 500 county health center registrants and 570 private physician patients, aged 52-75 years. We administered telephone surveys during 2004 to examine relationships among sociodemographic characteristics; perceived barriers to screening with fecal occult blood test (FOBT), sigmoidoscopy, and colonoscopy; and self-reported receipt of each exam. RESULTS FOBT was more frequent among county health center registrants; sigmoidoscopy and colonoscopy were more frequent among private physician patients (p < 0.001). County health center registrants less frequently cited no physician recommendation as a barrier to FOBT, but more frequently cited no recommendation as a barrier to sigmoidoscopy and colonoscopy, compared with private physician patients (p < or = 0.02). Among county health center registrants, better health insurance coverage was associated with lower odds of FOBT and higher odds of screening endoscopy; perceived barriers were associated with lower odds of screening (p < 0.02). Among private physician patients, we noted an association between perceived barriers to screening and lower odds of any screening (p < 0.001). CONCLUSIONS Overall, CRC screening among county health center and private physician patient samples compared favorably with overall New York and U.S. rates. Although prior studies using national data suggested that screening rates were equivalent in county health center and private physician primary care settings, we found exam-specific differences in patient-reported screening endoscopy among our two patient samples. Understanding factors that contribute to differences in CRC screening between primary care settings is important for ensuring equal access to CRC screening options for all patients.
Toward a Sustainable More Electrified Future: The Role of Electrical Machines and Drives

In the past few decades, electrical machines and drives have played a key role in electrification across a wide range of applications. Several initiatives have been introduced to supplant mechanical and hydraulic systems with electrical systems and move toward advanced variable-speed drives (VSDs) when necessary. In terms of performance, reliability, efficiency, and robustness, electrical systems offer significant advantages, while "more electric" systems have become an industry trend for many applications, e.g., traction, aerospace, actuation, mining, oil and gas, and industrial applications. The broad topic of renewables and how to integrate them into the grid ties into the deployment of smart grids, microgrids, and distributed generation. This shift toward more electrification presents significant challenges, especially to the performance requirements of electrical machines and drives. It is now clear that there is a critical need for state-of-the-art electrical machines and drives to meet the demands of various applications including harsh environments, high power density, high efficiency, and fault tolerance in safety-critical applications.