cssi/SciSciGPT-SciSciNet huggingface dataset:
Rehospitalization After Hip Fracture: Predictors and Prognosis from a National Veterans Study

OBJECTIVES: To estimate the risk and long-term prognostic significance of 30-day readmission postdischarge of a 4-year cohort of elderly veterans first admitted to Medicare hospitals for treatment of hip fractures (HFx), controlling for comorbidities. DESIGN: Retrospective, national secondary data analysis. SETTING: National Medicare and Veterans Health Administration (VHA) facilities. PARTICIPANTS: The study cohort was 41,331 veterans with a HFx first admitted to a Medicare eligible facility during 1999 to 2002. MEASUREMENTS: HFxs were linked with all other Medicare and VHA inpatient discharge files to capture dual inpatient use. Logistic regression was used to examine the relationship between 30-day readmission and age, sex, inpatient length of stay, and selected Elixhauser comorbidities. RESULTS: Approximately 18.3% (7,579/41,331) of HFx patients were readmitted within 30 days. Of those with 30-day readmissions, 48.5% (3,675/7,579) died within 1 year, compared with 24.9% (8,388/33,752) of those without 30-day readmissions. Readmission risk was significantly greater in the presence of specific comorbidities, ranging from 11% greater risk for patients with fluid and electrolyte disorders (95% confidence interval (CI)=1.04–1.20) to 43% for renal failure (95% CI=1.29–1.60). For this cohort, cardiac arrhythmias (24%), chronic pulmonary disease (28%), and congestive heart failure (16%) were common comorbidities, and all affected the risk of 30-day readmission. CONCLUSION: Patients with HFx with 30-day readmissions were nearly twice as likely to die within 1 year. Identification of several predictive comorbidities at discharge and examination of reasons for subsequent readmission suggests that readmission was largely due to active comorbid clinical problems. These comorbidity findings have implications for the current Centers for Medicare and Medicaid Services (CMS) pay-for-performance initiatives, especially those related to better coordination of care for patients with chronic illnesses. These comorbidity findings for elderly patients with HFx may also provide data to enable CMS and healthcare providers to more accurately differentiate between comorbidities and hospital-acquired complications under the current CMS initiative related to nonpayment for certain types of medical conditions and hospital acquired infections.
Structural insights into the molecular mechanism of Ca2+-dependent exocytosis

The fusion of vesicles with target membranes is controlled by a complex network of protein-protein and protein-lipid interactions. Recent structures of the SNARE complex, synaptotagmin III, nSec1, domains of NSF and its adaptor SNAP, along with Rab3 and some of its effectors, provide the framework for developing molecular models of vesicle fusion and for designing experiments to test these models. Ultimately, this knowledge of the structures of higher-order complexes and their dynamic behavior will allow us to obtain a full understanding of the vesicle fusion protein machinery.
The value relevance of pension accounting information : SFAS 87 vs. fair value

This study investigates the association between pension accounting information and both firm value and credit ratings. My findings indicate that fair-value-based pension accounting information is not more evaluation relevant (often termed value relevant in prior literature relating specifically to the equity valuation decision) than pension information recognized in the financial statements under SFAS 87. In fact, I find SFAS 87 information to be more evaluation relevant in models with composite pension variables. However, once I disaggregate the variables, the performance of fair-value data improves, which suggests that the loss in evaluation relevance is due mainly to the aggregation of transitory components (i.e. actuarial and investment gains and losses) with more persistent pension cost components. Similar to previous research, incremental evaluation relevance tests of pension cost component variables suggest that the market may overvalue pension components relative to regular earnings components. Moreover, my results suggest that financial statement users, particularly credit rating analysts, focus on pension income statement information, also indicative of overvaluation and weaker risk assessments. Should the U.S. continue to shift toward a fair-value based pension accounting standard, recognizing transitory elements of pension cost separately from net income (perhaps as part of comprehensive income) can mitigate any loss in evaluation relevance.
Modeling of macromolecule transfer in microvessel

Summary form only given. A one-dimensional unsteady-state model developed to describe the transfer of macromolecules across a microvascular wall and into the interstitial space is discussed. The model accounts for both molecular diffusion and convective transfer through the microvascular wall as well as in the interstitial space. The resulting partial-differential equations are coupled by the two boundary conditions at the wall-interstitial-space interface representing the equilibrium at the interface and the continuity of the mass flux leaving the microvascular wall and entering the interstitial space. A solution to the equations and an analytical expression for the total amount of mass which has accumulated in a portion of the interstitial space at any given time are also discussed. >
Recent developments in liver pathology.

Abstract Context.—Hepatocellular carcinoma is the sixth most common malignancy and the third leading cause of cancer deaths worldwide, making pathologic identification of precursor lesions essential. Recent molecular genetic, pathologic, and clinical data have led to the stratification of hepatic adenomas into subgroups with unique molecular profiles and varying potential for malignant transformation, as well as to the reclassification of telangiectatic focal nodular hyperplasia as telangiectatic adenoma. Clinical, morphologic, and molecular genetic studies have also established juvenile hemochromatosis and pediatric nonalcoholic steatohepatitis as entities distinct from their adult counterparts. Objective.—To review the recent molecular genetic characterization of telangiectatic hepatic adenomas and juvenile hemochromatosis, as well as the recent clinicopathologic characterization of pediatric nonalcoholic steatohepatitis. Data Sources.—Literature review, personal experience, and material from the Univer...
Functional valvular incompetence in decompensated heart failure: noninvasive monitoring and response to medical management.

Objective We hypothesized that functional mitral and tricuspid valvular incompetence (MR and TR, respectively) are reversible causes of reduced cardiac output in decompensated heart failure (DF) that accompanies systolic dysfunction in ischemic or nonischemic cardiomyopathy. Background DF, defined as signs and symptoms of heart failure at rest, is rooted in a salt-avid state transduced by neurohormonal activation secondary to impaired renal perfusion. Functional MR and TR are reversible causes of reduced systemic blood flow. Their impact on cardiac output, thoracic fluid content, cardiac chamber dimensions, and valvular apparatus function can be monitored noninvasively, before and after optimized medical management. Methods Fourteen male subjects (66 +/- 8 years old) with reduced ejection fraction (24 +/- 5%) secondary to ischemic (71%) or nonischemic (29%) cardiomyopathy, who developed DF with clinical evidence of mitral (MR) and tricuspid (TR) valvular incompetence, were each assessed by bioimpedance and echocardiography before and 1 week after optimized medical management restored compensated failure. Results Pharmacologic elimination of DF was accompanied by a reduction in body weight (P Conclusions In DF, functional MR and TR contribute to reduced cardiac output, increased thoracic fluid content, and systemic vascular resistance, together with enlarged atria and valvular orifice size, which can be improved by medical management. Bioimpedance and echocardiography provide for serial noninvasive assessments of hemodynamic status and valvular function in such cases.
Delivering the evidence – skill mix and education for elder care

Objectives To review the current status of dental curricula on elder care, and the current curricula regarding elder care, and it's effect on altering practitioner behaviors while addressing the needs of a growing North American elder population. Background An impending crisis is looming over the oral healthcare of our aging population. At the same moment that life expectancy is being extended through increasingly complex healthcare improvements, the numbers of trained dental providers capable and interested in delivering the needed care is failing to grow at an adequate rate. Discussion The skills necessary to manage these increasingly complex patients require an interprofessional approach capable of delivering care to sicker patients, in a variety of living accommodations, while managing a variety of care givers. The dental skills necessary to treat these elderly are modifications of skills students routinely learn in dental school. As a matter of fact, the skills students acquire to treat an adult patient population may be contrary to the basic skills necessary to manage the elderly dependent adult patient. Teaching students the nuance differences needed to properly diagnose and care for this population is a difficult task that must be taught in a contextual environment. Conclusion Significant changes in the teaching of dental management of the elderly are critical within much of the education community. Just as teaching students to care for the pediatric population as general dentists, the clinical education must involve a sufficient number of quality experiences to address issues of both competency, that of the graduate to perform care independently, and attitudes, the actually willingness to treat the elderly.
Stabilization of Thermomonospora curvata beta‐glucosidase by a low molecular weight intracellular factor

The beta-glucosidase in Thermomonspora curvata was stabilized against thermal denaturation by a soluble intracellular factor. This factor had an apparent molecular weight of 6kD, was resistant to proteolytic digestion, stable to boiling but was inactivated by autoclaving. It had little effect on beta-glucosidase maximal velocities or substrate affinity but it reduced the enzyme inactivation rate five-fold at 63°C.
Contrast Enhancement of Medical Images Using Multiscale Decomposition

Each image acquired from a medical imaging system is often part of a two-dimensional (2-D) image set whose total presents a three-dimensional (3-D) object for diagnosis. Unfortunately, sometimes these images are of poor quality. These distortions cause an inadequate object-of-interest presentation, which can result in inaccurate image analysis. Blurring is considered a serious problem. Therefore, "deblurring" an image to obtain better quality is an important issue in medical image processing. In our research, the image is initially decomposed. Contrast improvement is achieved by modifying the coefficients obtained from the decomposed image. Small coefficient values represent subtle details and are amplified to improve the visibility of the corresponding details. The stronger image density variations make a major contribution to the overall dynamic range, and have large coefficient values. These values can be reduced without much information loss.
Role of Diffusion and Perfusion MRI in Selecting Patients for Reperfusion Therapies

After onset of ischemic stroke, potentially viable tissue at risk (ischemic penumbra) may be salvageable. Currently, intravenous alteplase is approved for up to 4.5 hours after symptom onset of acute ischemic stroke. Increasing this time window may allow many more patients to be treated. The ability to use MRI to help define the irreversibly damaged brain (infarct core) and the reversible ischemic penumbra shows great promise for stroke treatment. Recent advances in penumbral imaging technology may enable a phase III trial of an intravenous thrombolytic to be performed beyond 4.5 hours using techniques to select patients with penumbral tissue.
Mutants in Saccharomyces lactis controlling both -glucosidase and -galactosidase activities.

In Saccharomyces lactis, a class of mutants isolated for low β-glucosidase activity are reduced in activity for β-galactosidase as well. Genetic studies indicate that their properties are the result of a single mutation in a nuclear gene. In diploide containing a wild-type and mutant β-galactosidase allele, the mutant phenotype is partially dominant. The two enzymes can be separated physically and under appropriate conditions are induced independently in wild-type strains.
Cultural Therapy and the Explicitness of Our Intentions

L'auteur se charge ici de relater ses experiences professionnelles dans le domaine de l'anthropologie de l'education, en developpant la notion de therapie culturelle, notamment dans une mission au Bresil.
Axial histidyl imidazole non-exchangeable proton resonances as indicators of imidazole hydrogen bonding in ferric cyanide complexes of heme peroxidases

Abstract Proton NMR spectra of a model of low-spin cyanide complexes of ferric hemoproteins indicate that two broad single-protein resonances from the axial imidazole can be resolved outside the diamagnetic spectral region. Upon deprotonation of the imidazole in the model, the upfield resonance shifts dramatically to higher field, suggesting that its position may reflect the degree of hydrogen bonding or proton donation of the imidazole. Met-cyano myoglobin reveals a pair of such broad peaks in the regions expected for an essentially neutral axial imidazole. In the cyano complexes of horseradish peroxidase and cytochrome c peroxidase, a pair of single-proton resonances are located which are assigned to the same imidazole protons on the basis of their linewidth and shift changes upon altering the heme substituents. The upfield proton, however, is found at much higher field than in metMbCN. The upfield bias of this resonance is taken as evidence for appreciable imidazolate character for the axial ligand in these heme peroxidases.
Translocation of 3-deoxy-D-arabino-heptulosonate 7-phosphate synthase precursor into isolated chloroplasts.

A cDNA encoding 3-deoxy-D-arabino-heptulosonate 7-phosphate (DAHP) synthase (EC 4.1.2.15) from potato (Solanum tuberosum L.) presumably specifies a chloroplast transit sequence near its 5′-end. In order to show the function of this transit sequence, we constructed a plasmid that contains the entire coding region of the cDNA downstream from a T7 promoter. Using this plasmid as template, DAHP synthase mRNA was synthesized in vitro with T7 RNA polymerase. The resulting mRNA served as template for the in vitro synthesis of a 59-kDa polypeptide. This translation product was identified as the DAHP synthase precursor by immunoprecipitation with a monospecific polyclonal antibody raised against pure tuber DAHP synthase and by radiosequencing of the [3H]leucine-labeled translation product. Incubation of the 59-kDa polypeptide with isolated spinach (Spinacia oleracea L.) chloroplasts resulted in a 53-kDa polypeptide that was resistant to protease treatment. Fractionation of chloroplasts, reisolated after import, showed the mature DAHP synthase in the stroma fraction. Incubation of the 59-kDa polypeptide with a chloroplast precursor-processing enzyme cleaved the precursor between Ser49 and Ala50, generating a mature DAHP synthase of 489 residues. The uptake of the DAHP synthase precursor into isolated chloroplasts was inhibited by anti-DAHP synthase, and the precursor was not processed cotranslationally by canine microsomal membranes. We conclude that the transit sequence is able to direct DAHP synthase into chloroplasts.
Lactose Maldigestion, Calcium Intake and Osteoporosis in African-, Asian-, and Hispanic-Americans

Dietary calcium is critical for the development of the human skeleton and likely plays an important role in the prevention of osteoporosis. Dairy products provide approximately three-fourths of calcium consumed in the diet and are the most concentrated sources of this essential nutrient. One obstacle that likely interferes with calcium consumption among many ethnic groups is lactose maldigestion. The real or perceived occurrence of intolerance symptoms after dairy food consumption may cause maldigesters to avoid dairy products. Several investigators have observed a relationship between lactose maldigestion, dietary calcium and osteoporosis in Caucasian populations. Research on ethnically diverse populations is necessary to better understand how lactose maldigestion influences the risk for osteoporosis. Low calcium intakes, a greater than previously thought potential for low bone density and extensive lactose maldigestion among Hispanic-American and Asian-American populations may create an elevated risk for osteoporosis. Dietary management strategies for lactose maldigesters to increase calcium consumption include consuming (1) dairy foods with meals, (2) yogurts, (3) calcium-fortified foods, (4) using lactose digestive aids and (5) including dairy foods daily in the diet to enhance colonic metabolism of lactose.
Computer-assisted electron paramagnetic resonance spectroscopy

Abstract An inexpensive, versatile Varian E-109 Century Series EPR spectrometer computer interface has been constructed. This interface, which is designed around the Octagon System 1-A single-board computer, is controlled by an IBM System 9000 computer utilizing a RS-232C communication bus. The interface is programmed in machine language to speed operation, while the IBM System 9000 programs, which control data acquisition and processing, are written in BASIC. The data acquisition program allows for control of the interface, and the data processing program provides display, baseline corrections, integration, and additional manipulations of the digitized spectrum. An overview of the hardware specifications and data acquisition and processing software is presented.
Realistic quark masses and mixing angles without scalars

A model in which the three family quark mass matrices M/sup U/ and M/sup D/ is related to the extended technicolor vector boson mass matrix is presented. A phenomenological mass matrix is consistent with the model when the u-quark mass is about 50 MeV.
The Fatality of Romanticism vs. the Metaphysics of Sexual Love: Wagner's Love Letter to Schopenhauer and the Break-Up with Nietzsche

The issue of whether chastity or sexual union leads to transcendence in Richard Wagner’s final opera Parsifal (1882) was one of the precipitating factors in Friedrich Nietzsche’s break with him. But an unfinished and unsent 1858 letter to the composer’s hero Arthur Schopenhauer, entitled “Original Konzept: Metaphysik der Geschlechtsliebe,” sheds light on how Wagner’s views of immanence and transcendence changed from the late 1850s to the early 1880s. His Grail knight, who is both a holy fool and a pure-blooded warrior, suffers from the contradictory impulse to surpass his material form and yet be an exemplar for a degenerating Europe. Wagner’s fusion of Eschenbach, Schopenhauer, and Gobineau creates a racialized metaphysics that is only theorized, though. Parsifal becomes the leader of the Grail knights, but how he will re-connect with those of us who are “all-too-human” to help us heal our spiritual lives remains to be seen. (RC)
Characterization of flax fiber reinforced soy protein resin based green composites modified with nano-clay particles

Abstract In this research, fully environment-friendly, sustainable and biodegradable ‘green’ composites were fabricated using modified soy protein concentrate (SPC) resins and flax yarns and fabrics. The modified SPC resin was prepared by blending SPC with nano-clay particles, and then cross-linked using glutaraldehyde. The modified SPC resin showed significantly improved mechanical properties. Flax fiber was used as the reinforcement, in both yarn and fabric forms, individually, to fabricate ‘green’ composites. The unidirectional flax yarn reinforced SPC resin composites showed longitudinal tensile failure stress of 298 MPa and Young’s Modulus of 4.3 GPa. These ‘green’ composites also exhibited excellent flexural properties in the longitudinal direction. The flexural stress was 117 MPa and the flexural modulus was 7.6 GPa. Flax fabric reinforced composites had failure stress of 62 MPa and 82 MPa in the warp and weft directions, respectively. The Young’s Modulus values, in both directions, were around 1.2 GPa.
Rate of acetylcholine hydrolysis affects the phase dependency of cardiac responses to vagal stimulation

The influence of the rate of acetylcholine hydrolysis on the magnitude and phase dependency of the cardiac chronotropic response to vagal stimulation was studied in anaesthetised dogs. In one group of animals the chronotropic response to tonic vagal stimulation varied directly with the dose of physostigmine. In a second group of animals one brief stimulus burst was delivered to the right vagus nerve during each cardiac cycle, and the timing (phase) of the stimulus was varied within the cycle. Before physostigmine was given the phase of the stimulus had a substantial influence on the chronotropic response. When each stimulus burst contained 6 pulses the response was changed from its minimum to its maximum value (mean (SEM) change 0.338(0.081) s) when the phase was shifted by a mean value of 0.091(0.031) s. After physostigmine (0.3 mg X kg-1) was given the change in response produced by a phase shift was much less pronounced. A mean shift in phase of 0.593(0.052) s was required to change the chronotropic response from its minimum to its maximum value, and the mean difference between the minimum and maximum response was only 0.140(0.032) s. Hence the rate of acetylcholine hydrolysis in the cardiac tissues is an important determinant of the phase dependency of the chronotropic response to repetitive vagal stimulation-that is, the slower the rate of hydrolysis the less the change in the chronotropic response elicited by a given change in stimulus timing.
An evaluation of transfer function models for the transient growth response of microbial cultures

Abstract Experiments were conducted to evaluate the ability of transfer function models to characterize the transient-state growth response of Pseudomonas putida grown in l -lysine minimal media. The results indicated that, while transfer function models could be used to characterize individual transient responses, the values of the parameters in the models varied with the pre-transient growth conditions (i.e. the steady-state specific growth rate prior to the transient) and the type of transient (shift-up or shift-down). Thus, the models were not very useful for predicting transient responses. It is suggested that this poor predictive power is the result of a complex physiological adaptation which is not adequately accounted for in simple transfer function models.
Dynamic mechanical and thermogravimetric analyses of the effect of ferric oxide on the thermaloxidative degradation of silicone rubber

Abstract The thermaloxidative degradation of hydrosilation formed dimethylsiloxane rubber networks containing ferric oxide in amounts of 0 to 60% (w/w) was investigated by dynamic mechanical analysis (DMA) and thermogravimetry (TG). Scanning work showed that the key weight loss event from TG and the key stiffening event on DMA correlated, showing maximum temperatures at 40% ferric oxide content. Isothermal work showed TG and DMA to be of a very complementary nature. Under isothermal decomposition three chemistry regions were identified—one dominated by thermal decomposition, one dominated by oxidative crosslinking, and a transition region. From Arrhenius kinetics, apparent activation energies, pre-exponential factors, and rate constants were calculated.
Anatomical and electrophysiological demonstration of tectotectal pathway in the golden hamster

Abstract Both the retrograde transport of horseradish peroxidase (HRP) and extracellular single unit recording have been employed to demonstrate the existence of an intertectal pathway in the golden hamster. The cells of origin of this projection are located primarily in the stratum griseum intermediale and stratum griseum profundum of the anterior one-half of the colliculus and respond, in most cases, only to somatosensory stimuli. These findings cast doubt on the recently proposed generalization [13] that this pathway may be rudimentary or even absent in animals with limited collicular binocularity or a small ipsilateral hemifield representation in the colliculus.
Effects of nonparabolicity on collective intersubband excitations.

We have used inelastic light scattering to study the collective charge- and spin-density excitations associated with electronic intersubband transitions in GaSb-AlSb superlattices. The density of the photoexcited two-dimensional electron-hole plasma was controlled by varying the incident laser power. A comparison of experiment with detailed calculations of the response functions shows that the noparabolicity of the conduction band must be properly included in order to yield quantitative agreement. It is found that nonparabolicity, in addition to decreasing the resonance energies of the collective excitations, provides a mechanism for observing single-particle excitations at q=0.
PUVA therapy for psoriasis: comparison of oral and bath-water delivery of 8-methoxypsoralen.

A direct clinical comparison has been made of the efficacy of oral 8-methoxypsoralen with bath-water delivery of 8-methoxypsoralen during psoralen ultraviolet A (PUVA) phototherapy for a group of forty patients with stable plaque-type psoriasis vulgaris. The 8-methoxypsoralen concentration was 3.7 mg/liter in the bath water. The efficacy of these treatments was assessed by their ability to improve or clear the psoriasis. The skin of eight of the twenty patients with oral psoralen cleared, and another eight showed good improvement. Of the twenty patients who received 8-methoxypsoralen in bath water, eight patients had clearing of the skin, whereas nine patients had good improvement during the initial 8-week treatment period. Administration of 8-methoxypsoralen in bath water required much lower ultraviolet A irradiance to achieve maximum improvement. There were no systemic side effects in the patients treated by bath-water delivery; however, some patients did develop phototoxic erythema. Minimal phototoxic doses were also studied in patients and in volunteers using both routes of psoralen delivery. The minimal phototoxic dose threshold after psoralen bath delivery gradually declined over five treatments from 5.3 ± 0.6 joules/cm 2 to 2.8 ± 0.3 joules/cm 2 , suggesting an accumulation of psoralen in the skin with this method of drug delivery. Bath-water delivery of 8-methoxypsoralen was therefore found to be as effective as oral administration of 8-methoxypsoralen and yet required smaller amounts of ultraviolet A radiation and yielded fewer side effects. It would thus seem to be confirmed as a useful alternative means of 8-methoxypsoralen administration in PUVA therapy.
Weighted integral and integro-differential inequalities

A general weighted integral inequality for two continuous functions on an interval [a,b] is presented. The equality conditions are given. This result implies the new inequalities for the incomplete beta and gamma functions as well as the related estimates for the confluent hypergeometric function, error function, and Dawson's integral. Also it implies various weighted integro-differential inequalities, those of the Opial type included, and some inequalities which involve the Erdelyi-Kober and Riemann-Liouville fractional integrals.
Multi-wavelength view of the interstellar medium in the large Magellanic cloud

The Large Magellanic Cloud (LMC) has been surveyed in optical emission lines, X-rays, radio continuum, HI, and CO lines. These surveys provide views of the interstellar medium (ISM) in the LMC of unprecedented clarity, allowing us to study astrophysical processes and to examine the relationship among the different phases of the ISM. Multi-wavelength images are used to illustrate the physical structures of supernova remnants, superbubbles, and supergiant shells, as well as the global interstellar structure of the LMC.
The use of long-acting opioids in chronic pain management

The consensus statement from the American Pain Society and American Academy of Pain Medicine states that the undertreatment of pain is unjustified [6]. It has been suggested that opioid therapy can be used effectively to treat noncancer pain in a subset of patients [26], and this is becoming more acceptable [3]. Providing sustained analgesia is an important aspect of therapy, and medications should be administered on an around-the-clock basis, because regular administration of doses maintains a constant level of drug in the body and helps prevent recurrence of pain. Ideal treatment for persistent pain is a long-acting opioid administered around the clock to prevent baseline pain, with the use of short-acting opioids as supplemental agents for breakthrough pain. Controlled-release formulations can lessen the inconvenience associated with around-the-clock administration of short-acting opioids. Sustained analgesia also can be achieved with transdermal fentanyl, which combines a strong opioid with a 72-hour release profile and the benefits of a parenteral route, avoiding first-pass metabolism. Controlled-release formulations of morphine and oxycodone are available in the United States, and hydromorphone preparations are being reviewed for approval. Clinical experience with these formulations and transdermal fentanyl indicates that these agents are equally effective in controlling pain. Studies have demonstrated improved quality of life with the transdermal route and with controlled-release morphine and oxycodone. Because of patch reapplication every 72 hours, the transdermal route also enhances compliance. Use of an opioid without the need for oral or intravenous administration and the opportunity to improve compliance are among the advantages of the transdermal route in clinical practice. The nurse has an important role in the management of patients receiving long-acting opioids for chronic noncancer pain, Facilitation of the conversion from short-acting to long-acting opioids may be the initial step. Individualization of therapy to determine which route and product best suits the patient's needs and lifestyle can be accomplished through a comprehensive nursing assessment. Titration of dose along with institution of a short-acting opioid for break-through pain may require frequent interventions that a nurse familiar with the patient can provide. Prevention and management of opioid-related adverse events are essential for effective opioid therapy. Providing patient and family education regarding administration, monitoring, and management of opioid therapy is an important nursing role. Lastly, documentation of pain level, functional status, and opioid-related adverse events is required for each contact with the patient, to make this information available to all who assist in the management of the patient's pain. Chronic noncancer pain is an experience that affects all aspects of a patient's life. Effective pain management with long-acting opioids may help the patient to focus on the positive aspects of life, decreasing the focus on pain.
Megakaryocyte-derived microparticles: direct visualization and distinction from platelet-derived microparticles

Platelet microparticles are a normal constituent of circulating blood. Several studies have demonstrated positive correlations between thrombotic states and platelet microparticle levels. Yet little is known about the processes by which platelet microparticles are generated in vivo. We now characterize microparticles derived directly from megakaryocytes. Video microscopy of live mouse megakaryocytes demonstrated that microparticles form as submicron beads along the lengths of slender, unbranched micropodia. These microparticles are CD41+, CD42b+, and express surface phosphatidylserine. Megakaryocyte microparticle generation is resistant to inhibition of microtubule assembly, which is critical to platelet formation, and augmented by inhibition of actin polymerization. To determine whether circulating microparticles are derived primarily from activated platelets or megakaryocytes, we identified markers that distinguish between these 2 populations. CD62P and LAMP-1 were found only on mouse microparticles from activated platelets. In contrast, full-length filamin A was found in megakaryocyte-derived microparticles, but not microparticles from activated platelets. Circulating microparticles isolated from mice were CD62P−, LAMP-1− and expressed full-length filamin A, indicating a megakaryocytic origin. Similarly, circulating microparticles isolated from healthy volunteers were CD62P− and expressed full-length filamin A. Cultured human megakaryocytes elaborated microparticles that were CD41+, CD42b+, and express surface phosphatidylserine. These results indicate that direct production by megakaryocytes represents a physiologic means to generate circulating platelet microparticles.
Are ejection fraction measurements by echocardiography and left ventriculography equivalent

Background Left ventricular ejection fraction (EF) is an important parameter in the diagnosis and treatment of patients with coronary heart disease. Previous studies comparing echocardiography and contrast left ventriculography (CVG) for the measurement of EF have shown considerable variation in results, yet, in clinical practice, EF measurements are used interchangeably. The purpose of this study was to assess the concordance between echocardiography and CVG for the determination of EF in routine clinical practice and to identify factors associated with variation in test results. Methods We reviewed the medical records of 5,385 patients hospitalized for acute myocardial infarction between 1997 and 2005 as part of a community-based surveillance project. Of these, 741 patients had EF measurements recorded by both echocardiography and CVG during hospitalization. Results While good correlation ( r = 0.73) and no systematic bias were noted between the measurement of EF by echocardiogram compared to CVG, there was wide variation between the 2 methods for any given patient. In approximately one third of patients with acute myocardial infarction, the measurement of EF by echocardiography and CVG differed by >10 points, while in approximately 1 in 20 patients, EF measurements by echocardiography and CVG differed by >20 points. The number of days between tests to measure EF, level of EF, temporal order of EF testing, and patient-related factors made only a minor contribution to the variation in test results. Conclusions Our results demonstrate that, in routine clinical practice, EF determinations obtained by echocardiography and CVG may vary widely, with potentially important clinical implications.
Pareto sampling: choosing the right weights by derivative pursuit

The convex weighted-sum method for multi-objective optimization has the desirable property of not worsening the difficulty of the optimization problem, but can lead to very nonuniform sampling. This paper explains the relationship between the weights and the partial derivatives of the tradeoff surface, and shows how to use it to choose the right weights and uniformly sample largely convex tradeoff surfaces. It proposes a novel method, Derivative Pursuit (DP), that iteratively refines a simplicial approximation of the tradeoff surface by using partial derivative information to guide the weights generation. We demonstrate the improvements offered by DP on both synthetic and circuit test cases, including a 22 nm SRAM bitcell design problem with strict read and write yield constraints, and power and performance objectives.
The human liver and reticulocyte cytochrome b5 mRNAs are products from a single gene.

Abstract Using a combination of standard cDNA library screening techniques and the Polymerase Chain Reaction (PCR) we have isolated and sequenced DNA fragments corresponding to the human reticulocyte cytochrome b 5 mRNA. The reticulocyte specific sequence codes for amino acids 97 and 98 only, with a TAA stop codon. The reticulocyte specific 3′non-translated sequence has 15 new nucleotides then utilizes the liver mRNA sequence from amino acid 97 onward. This indicates that the reticulocyte specific exon has 24 base pairs (bp). In addition, we have isolated sequences that are derived from a transcribed cytochrome b 5 pseudogene. This transcript contains multiple mutations which prevent the synthesis of any functional protein.
Bayesian Quantiles of Extremes

Extreme value distributions are increasingly being applied in biomedical literature to model unusual behavior or rare events. Two popular methods that are used to estimate the location and scale parameters of the type I extreme value (or Gumbel) distribution, namely, the empirical distribution function and the method of moments, are not optimal, especially for small samples. Additionally, even with the more robust maximum likelihood method, it is difficult to make inferences regarding outcomes based on estimates of location and scale parameters alone. Quantile modeling has been advocated in statistical literature as an intuitive and comprehensive approach to inferential statistics. We derive Bayesian estimates of the Gumbel quantile function by utilizing the Jeffreys noninformative prior and Lindley approximation procedure. The advantage of this approach is that it utilizes information on the prior distribution of parameters, while making minimal impact on the estimated posterior distribution. The Bayesia...
Optimal design of a medical staple using shape memory alloy

This paper presents the mechanical design of a medical staple using shape memory alloy (SMA) material. The design problem was formulated as an optimization problem minimizing an energy functional. The constraints were the length of wire, the properties of the SMA material, and the required clamping force. The Euler-Lagrange equation of this isoperimetric calculus of variation problem was derived, which was a fourth order two-point boundary value problem. An analytical solution was constructed and verified. A numerical optimization technique was applied to generate other possible solutions for the boundary value problem. The objective was to minimize the error of the solution for specific boundary conditions. The sequential quadratic programming algorithm was applied with Runge-Kutta integration to solve the boundary value problem. The design procedure described in this paper could be applied to the design of other mechanical components of wire form using SMA material.
The dehydrogenation of ethane over chromium catalysts

Abstract The nature of the active sites for ethane dehydrogenation over chromium supported on silica gel has been studied by infrared spectroscopy, together with kinetic measurements. Low nuclearity A-type chromium(II) ions are believed to be the active sites for ethane dehydrogenation on Cr/SiO 2 catalysts. Higher dehydration temperatures increased the concentration of active A-type chromium(II) ions. The apparent activation energy was the same for different dehydration temperatures, which indicates that the number but not the type of site changed upon dehydration at elevated temperatures. The active A-type chromium(II) sites were selectively poisoned by carbonaceous deposits during the dehydrogenation of ethane. Turnover frequencies, based on the calculated number of surface chromium atoms, were similar for Cr/SiO 2 , Cr/Al 2 O 3 , and α-Cr 2 O 3 , but a CrY zeolite was essentially inactive since chromium ions remain in the +3 oxidation state.
A dosimetric evaluation of using a single treatment plan for multiple treatment fractions within a given applicator insertion in gynecologic brachytherapy.

Abstract Purpose To evaluate the dosimetric impact of using one treatment plan for multiple fractions from a single tandem and ring applicator insertion of high-dose-rate brachytherapy for cervical cancer. Methods and Materials Thirteen cervical cancer patients undergoing high-dose-rate brachytherapy were followed. Patients received the total dose from a single applicator insertion in two fractions, given with at least 6 hours apart within 24 hours. The treatment plan was based on a CT scan taken before the first treatment fraction. A second CT was obtained before the second treatment fraction. The co-registered image series were used to evaluate the dosimetric impact of using a single treatment plan for both fractions. Applicator and catheters were measured to quantify interfraction displacement. Results When the Day 1 plan was applied to the Day 2 images, high-risk clinical target volume (HR-CTV) coverage was reduced by as much as 17.4 percentage points. The mean decrease was 9.4 ± 5.0 percentage points (p Conclusions When the Day 1 plan was used on the Day 2, the HR-CTV coverage decreased significantly (p
Attitudes and Behavior toward Hippies: a Field Experiment Accompanied by Home Interviews*

It was hypothesized that subjects who exhibit high social distance toward a hippie-target will be more likely to report a hippie shoplifter than subjects low on social distance. This hypothesis is derived from the theoretical literature in deviant behavior and social psychology and examines two issues: (1) the relationship between social distance and the severity of reaction to deviance, and (2) the extent of congruence between verbal scale scores and overt actions. The hypothesis was tested using observational data collected during a field experiment in which rigged shoplitting events were enacted and self-report data collected during follow-up interviews. The data support our hypothesis and increases our confidence in the congruence of attitudes and behavior.
The Carrot vs. the Stick in Work Team Motivation

This paper reports on the use of carrot (positive) and stick (negative) incentives as methods of increasing effort among members of work teams. We study teams of four members in a laboratory environment in which giving effort towards the team goal is simulated by eliciting voluntary contributions towards the provision of a public good. We test the efficiency-improving properties of four distinct environments: monetary prizes given to high contributors versus monetary fines assessed to low contributors, where high/low contributor is defined first in terms of absolute contributions and then in terms of contributions relative to abilities—which we call handicapping. Our results show that both carrot and stick can increase efficiency (i.e., contributions) levels by 10–28%. We find that handicapped incentives promise the highest efficiency levels, and when handicapping is not used penalties may be more effective than prizes. The implications for work teams and suggestions for practical implementation are discussed.
Chemorheology of Phenylboronate−Salicylhydroxamate Cross-Linked Hydrogel Networks with a Sulfonated Polymer Backbone

Hydrogel networks crosslinked with polymer-bound phenylboronic acid (PBA) and salicylhydroxamic acid (SHA) demonstrate pH-reversible gel behavior due to the pH-dependent equilibrium of the crosslinking moieties that form the gel network. Furthermore, the pH at which gels behave dynamically can be controlled by use of a polyelectrolyte backbone. Here we report on the frequency-dependent chemorheological characterization of PBA-SHA crosslinked hydrogel networks with a sulfonated polymer backbone. Our results suggest that the anionic nature of the polymers allows reversible crosslinking at neutral pH that an otherwise neutral-backboned PBA-SHA crosslinked network cannot, and that these charge-induced dynamics can be effectively screened by ions in solution. Moreover, moduli-frequency data can effectively be reduced into a single master curve with a neutral-backboned PBA-SHA gel data set as the reference condition.
Recent developments in the study of presolar grains

Abstract Studies of presolar grains have provided a wealth of data that are relevant to astrophysics. Their isotopic ratios are especially informative for understanding stellar nucleosynthesis and mixing in stars and stellar ejecta. In the past few years, isotopic ratios of heavy elements in single presolar grains have been analyzed with resonant ionization mass spectrometry. Molybdenum, Zr, and Ba isotopic patterns of SiC grains of a supernova origin agree with patterns predicted for a neutron burst. A new type of ion microprobe, the NanoSIMS, with its high sensitivity and small beam diameter, makes isotopic analyses of submicron grains possible.
Approaching the physiological functions of penicillin-bindingproteins in Escherichia coli

A rigid shell of peptidoglycan encases and shapes bacteria and is constructed and maintained by a diverse set of enzymes, among which are the penicillin-binding proteins (PBPs). Although a great deal has been learned about how these proteins synthesize and modify peptidoglycan, the physiological functions of the multitude of bacterial PBPs remain enigmatic. We approached this problem by combining PBP mutations in a comprehensive manner and screening for effects on biochemical processes involving the passage of proteins or nucleic acids across the cell wall. The results indicate that the PBPs or their peptidoglycan product do have significant biological functions, including roles in determination of cell shape, in phage resistance, in induction of capsule synthesis, and in regulation of autolysis.
Regulation of Transducin GTPase Activity by Human Retinal RGS

The intrinsic GTPase activity of transducin controls inactivation of the effector enzyme, cGMP phosphodiesterase (PDE), during turnoff of the visual signal. The inhibitory gamma-subunit of PDE (Pgamma), an unidentified membrane factor and a retinal specific member of the RGS family of proteins have been shown to accelerate GTP hydrolysis by transducin. We have expressed a human homologue of murine retinal specific RGS (hRGSr) in Escherichia coli and investigated its role in the regulation of transducin GTPase activity. As other RGS proteins, hRGSr interacted preferentially with a transitional conformation of the transducin alpha-subunit, GtalphaGDPAlF4-, while its binding to GtalphaGTPgammaS or GtalphaGDP was weak. hRGSr and Pgamma did not compete for the interaction with GtalphaGDPAlF4-. Affinity of the Pgamma-GtalphaGDPAlF4- interaction was modestly enhanced by addition of hRGSr, as measured by a fluorescence assay of GtalphaGDPAlF4- binding to Pgamma labeled with 3-(bromoacetyl)-7-diethylaminocoumarin (PgammaBC). Binding of hRGSr to GtalphaGDPAlF4- complexed with PgammaBC resulted in a maximal approximately 40% reduction of BC fluorescence allowing estimation of the hRGSr affinity for GtalphaGDPAlF4- (Kd 35 nM). In a single turnover assay, hRGSr accelerated GTPase activity of transducin reconstituted with the urea-stripped rod outer segment (ROS) membranes by more than 10-fold to a rate of 0.23 s-1. Addition of Pgamma to the reconstituted system reduced the GTPase level accelerated by hRGSr (kcat 0.085 s-1). The GTPase activity of transducin and the PDE inactivation rates in native ROS membranes in the presence of hRGSr were elevated 3-fold or more regardless of the membrane concentrations. In ROS suspensions containing 30 microM rhodopsin these rates exceeded 0.7 s-1. Our data suggest that effects of hRGSr on transducin's GTPase activity are attenuated by Pgamma but independent of a putative membrane GTPase activating protein factor. The rate of transducin GTPase activity in the presence of hRGSr is sufficient to correlate it with in vivo turnoff kinetics of the visual cascade.