cssi/SciSciGPT-SciSciNet huggingface dataset:
Medical Student Mobilization During A Crisis: Lessons From A COVID-19 Medical Student Response Team.

Problem: On March 17, 2020, the Association of American Medical Colleges recommended the suspension of all direct patient contact responsibilities for medical students because of the COVID-19 pandemic. Given this change, medical students nationwide had to grapple with how and where they could fill the evolving needs of their schools' affiliated clinical sites, physicians, and patients and the community. Approach: At Harvard Medical School (HMS), student leaders created a COVID-19 Medical Student Response Team to: (1) develop a student-led organizational structure that would optimize students' ability to efficiently mobilize interested peers in the COVID-19 response, both clinically and in the community, in a strategic, safe, smart, and resource-conscious way; and (2) serve as a liaison with the administration and hospital leaders to identify evolving needs and rapidly engage students in those efforts. Outcomes: Within a week of its inception, the COVID-19 Medical Student Response Team had more than 500 medical student volunteers from HMS and had shared the organizational framework of the response team with multiple medical schools across the country. The HMS student volunteers joined any of the 4 virtual committees to complete this work: Education for the Medical Community, Education for the Broader Community, Activism for Clinical Support, and Community Activism. Next steps: The COVID-19 Medical Student Response Team helped to quickly mobilize hundreds of students and has been integrated into HMS's daily workflow. It may serve as a useful model for other schools and hospitals seeking medical student assistance during the COVID-19 pandemic. Next steps include expanding the initiative further, working with the leaders of response teams at other medical schools to coordinate efforts, and identifying new areas of need at local hospitals and within nearby communities that might benefit from medical student involvement as the pandemic evolves.
Effect of Gate-Oxide Degradation on Electrical Parameters of Silicon Carbide MOSFETs

Although gate-oxide degradation occurs in both silicon (Si) and silicon carbide (SiC) MOSFETs, it requires a special attention in SiC MOSFETs. This is because the gate oxide in SiC MOSFETs is comparatively thinner than the gate oxide in Si MOSFETs, and thus, a higher electric field that appears across it could push the gate oxide to its reliability limit. While several electrical parameters have been identified as precursors (indicators) for monitoring the gate-oxide degradation process in Si MOSFETs, very few have been identified for their SiC counterparts. The purpose of this article is twofold. The first objective is to demonstrate that the three gate-oxide degradation precursors identified for Si MOSFETs: 1) threshold voltage, 2) gate-plateau voltage, and 3) gate-plateau time can also be extended to SiC MOSFETs. The second objective is to demonstrate analytically and experimentally that all three precursors increase in a linear-with-log-stress-time manner during gate-oxide degradation in both planar and trench-gate SiC MOSFETs. The increasing trends of precursors and their associated logarithmic time responses were experimentally verified by inducing accelerated gate-oxide degradation in two different commercial SiC MOSFETs (650-V, 70-A trench-gate MOSFETs and 1200-V, 19-A planar MOSFETs) under high temperatures of 150 and 125 °C, respectively.
Sticks and Stones…: Embracing Discomfort to Enhance Learning

In The Coddling of the American Mind: How Good Intentions and Bad Ideas are Setting Up a Generation for Failure, Lukianoff and Haidt contend that an atmosphere of “safetyism” threatens the universi...
SAPIEN S3 valve deployment in the pulmonary position using the gore DrySeal sheath to protect the tricuspid valve

Background Tricuspid valve injury can occur during implantation of a SAPIEN valve in the pulmonary position. We describe our experience using a long Gore DrySeal (GDS) sheath to protect the tricuspid valve during advancement of the Commander delivery system. Methods Retrospective single center review of all patients who underwent placement of a SAPIEN valve in the right ventricular outflow tract between January 2016 and April 2020. Patients were divided into two groups: delivery of the valve using standard technique (Group I), and with the use of a GDS (Group II), for comparison. Results There were 48 patients in total: 25 in Group I and 23 in Group II. In Group II, the first 10 patients had a 29 mm S3 placed through a 26 French (Fr), 65 cm GDS. We then performed additional crimping of the S3 onto the balloon after the balloon catheter was withdrawn to position the valve on the balloon outside the body. Subsequently, seven had a 29 mm S3 placed through a 24 Fr GDS, and four had a 26 mm S3 placed through a 22 Fr GDS including one weighing 16 kg. Two had a 23 mm S3 placed through a 22Fr GDS as the 20Fr GDS was not available in our lab. Severe tricuspid valve injury occurred in 2/25 (8%) of Group I patients and 0/23 of Group II patients. Conclusion Use of a long GDS may protect the tricuspid valve from injury during implantation of the S3 valve in the pulmonary position, and is technically feasible in smaller patients.
Analytical sensitivity and efficiency comparisons of SARS-CoV-2 RT-qPCR primer-probe sets.

The recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for accurate and rapid diagnostic assays to prompt clinical and public health interventions. Currently, several quantitative reverse transcription–PCR (RT–qPCR) assays are being used by clinical, research and public health laboratories. However, it is currently unclear whether results from different tests are comparable. Our goal was to make independent evaluations of primer–probe sets used in four common SARS-CoV-2 diagnostic assays. From our comparisons of RT–qPCR analytical efficiency and sensitivity, we show that all primer–probe sets can be used to detect SARS-CoV-2 at 500 viral RNA copies per reaction. The exception for this is the RdRp-SARSr (Charite) confirmatory primer–probe set which has low sensitivity, probably due to a mismatch to circulating SARS-CoV-2 in the reverse primer. We did not find evidence for background amplification with pre-COVID-19 samples or recent SARS-CoV-2 evolution decreasing sensitivity. Our recommendation for SARS-CoV-2 diagnostic testing is to select an assay with high sensitivity and that is regionally used, to ease comparability between outcomes. This is a comparative analysis of the performance of the primer–probe sets from four open-source molecular diagnostic assays for SARS-CoV-2 recommended by the World Health Organization.
A non-parametric control chart for high frequency multivariate data

Support Vector Data Description (SVDD) is a machine learning technique used for single class classification and outlier detection. A SVDD based K-chart was first introduced by Sun and Tsung [4]. K-chart provides an attractive alternative to the traditional control charts such as the Hotelling's T2 charts when the distribution of the underlying multivariate data is either non-normal or is unknown. But there are challenges when the K-chart is deployed in practice. The K-chart requires calculating the kernel distance of each new observation but there are no guidelines on how to interpret the kernel distance plot and draw inferences about shifts in process mean or changes in process variation. This limits the application of K-charts in big-data applications such as equipment health monitoring, where observations are generated at a very high frequency. In this scenario, the analyst using the K-chart is inundated with kernel distance results at a very high frequency, generally without any recourse for detecting presence of any assignable causes of variation. We propose a new SVDD based control chart, called a k T chart, which addresses the challenges encountered when using a K-chart for big-data applications. The k T charts can be used to track simultaneously process variation and central tendency.
Implementing Electronic Check-In/Check-Out to Reduce Challenging School Bus Behavior:

The purpose of this study was to explore the efficacy of an electronic check-in, check-out (eCICO) intervention. The district’s case manager (i.e., guidance counselor) implemented the eCICO interve...
Flow over closely packed cubical roughness

Cube arrays are one of the most extensively studied types of surface roughness, and there has been much research on cubical roughness with low-to-moderate surface coverage densities. In order to help populate the literature of flow over cube arrays with high surface coverage densities, we conduct direct numerical simulations (DNSs) of flow over aligned cube arrays with coverage densities . The roughness are in the d-type roughness regime. Essential flow quantities, including the mean velocity profiles, Reynolds stresses, dispersive stresses and roughness properties, are reported. Special attention is given to secondary turbulent motions in the roughness sublayer. The spanwise-alternating pattern of the thin slots between two neighbouring cubes gives rise to spanwise-alternating regions of low- and high-momentum pathways above the cube crests. We show that the strength and spanwise location of these low- and high-momentum pathways depend on the surface coverage density, and that the high-momentum pathways are not necessarily located directly above the roughness elements. In order to determine the physical processes responsible for the generation and the destruction of these secondary turbulent motions, we analyse the dispersive kinetic energy (DKE) budget. The data shows that the secondary motions get their energy from the DKE-specific production term and the wake production term, and lose energy to the DKE-specific dissipation term.
Latinx adolescents facing multiple stressors and the protective role of familismo.

OBJECTIVE In this study, we cumulatively examined how a number of cultural and general stressors as well as familismo differentially related to Latinx adolescents' psychological well-being as measured by depressive symptoms, anxiety, and future orientation. In addition, we examined whether familismo buffered Latinx adolescents from the negative psychological outcomes associated with both cultural and general stressors. METHOD Two hundred and twenty-four low-income, Latinx 9th graders (Mage = 14.5) attending three high schools in the Northeastern United States were surveyed. RESULTS Findings demonstrated that family-based cultural stressors were associated with increased depressive symptoms whereas familismo was associated with fewer depressive symptoms. Language conflicts and racial discrimination were also positively associated with anxiety. However, when both cultural and general stressors were accounted for, only greater material need was associated with increased depressive symptoms and a less positive future orientation. Moreover, familismo protected adolescents from depressive symptoms linked to material hardship. CONCLUSIONS Cultural stressors may be less distressing to Latinx adolescents than more general stressors, like financial hardship, and familismo helps buffer the stress of material hardship. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Influence of Particle Shape on Microstructure of Granular Materials under Gravity

AbstractThe paper presents a study of particle shape effect on microstructure within granular materials in gravitational environments using samples acquired from three-dimensional (3D) discrete ele...
Endoscopic Screening for Squamous Cell Carcinoma of the Esophagus

Although the relative incidence of esophageal squamous cell carcinoma (SCC) has been declining steadily in the United States and Europe compared to that of adenocarcinoma (1,2); esophageal SCC continues to be the more common form of esophageal malignancy worldwide (3). There are approx 6000 new cases of esophageal SCC diagnosed in the United States annually (4). The global incidence and gender ratio vary widely according to geographic region, likely reflecting environmental and dietary factors more than genetic predisposition. Several risk factors for esophageal SCC have been identified, making screening a potential option for specific populations. This chapter outlines conditions or behaviors that are strongly associated with this malignancy, describes methods for improving the endoscopic detection of early squamous cell dysplasia, and suggests specific instances in which screening for esophageal SCC may be appropriate.
L-Dopa and the treatment of extrapyramidal disease.

Publisher Summary This chapter discusses the L-dopa and the treatment of extrapyramidal disease. Although the systemic administration of L-dopa elevates intraneuronal concentrations of both dopa and DA, dietary tyrosine serves as the natural precursor of these catechols in the central nervous system. L-Tyrosine is hydroxylated in the meta-position to L-dopa by tyrosine hydroxylase. The enzyme requires molecular oxygen, ferrous iron, and a reduced pteridine. It is specific for the hydroxylation of L-tyrosine or L-phenylalanine, but ineffective for D isomers or m-tyzosine and thus, differs from the rather nonspecific phenol-oxidizing enzyme, tyrosinase. Tyrosine and phenylalanine each inhibits the hydroxylation by tyrosine hydroxylase of the other amino acid. Dopa decarboxylase that is found in the soluble portion of cell homogenates catalyzes the conversion of dopa to DA. This pyridoxal phosphate-requiring enzyme has been thought to act on all aromatic 1-amino acids including phenylalanine, tryptophan, 5-hydroxytryptophan, and histidine. The distribution of dopa decarboxylase is ubiquitous both outside and within the central nervous system, including high concentrations in the gut mucosa and the walls of brain capillaries.
Listening to Older Adults: Elderly Patients' Experience of Care in Residency and Practicing Physician Outpatient Clinics

The population of people aged 65 and older is rapidly growing. Research has demonstrated significant quality gaps in the clinical care of older patients in the United States, especially in training programs. Little is known about how older patients' experience with care delivered in residency clinics compares with that delivered by practicing physicians. Using patient surveys from the American Board of Internal Medicine Care of the Vulnerable Elderly Practice Improvement Module, the quality of care provided to adults aged 65 and older by 52 internal medicine and family medicine residency clinics and by a group of 144 practicing physicians was studied. The residency clinics received 2,213 patient surveys, and the practicing physicians received 4,204. Controlling for age and overall health status, patients from the residency clinic sample were less likely to report receiving guidance and interventions for important aspects of care for older adults than patients from the practicing physician sample. The largest difference was observed in providing ways to help patients prevent falls or treat problems with balance or walking (42.1% vs 61.8%, P<.001). Patients from the residency clinic sample were less likely to rate their overall care as high (77.5% vs 88.8%, P<.001). Patient surveys reveal important deficiencies in processes of care that are more pronounced for patients cared for in residency clinics. Quality of patient experience and communication are vital aspects of overall quality of care, especially for older adults. Physician education at all levels, faculty development, and practice system redesign are needed to ensure that the care needs of older adults are met.
An ecological perspective of science and math academic achievement among African American students

viii CHAPTER ONE. INTRODUCTION 1 CHAPTER TWO. BACKGROUND 7 CHAPTER THREE. METHODS 46 CHAPTER FOUR. RESULTS 67 CHAPTER FIVE. DISCUSSION 92 APPENDIX A. STUDY ITEMS 103 APPENDIX B. ADDITIONAL TABLE AND FIGURE 110 WORKS CITED 113
Beyond the Business Case: Strategic IT Investment

Traditionally, most firms' IT capital investment decisions have been based on business cases estimating financial returns on individual applications. Infrastructure costs were often bundled with applications, although disruptive technologies, such as desktop computing and Internet protocols, led to occasional large lump sum investments. In this paper, we argue that firms should make four distinct types of IT investments: transformation, renewal, process improvements, and experiments. Transformation initiatives create significant, long-term infrastructure that enables major changes in organizational processes. Renewal initiatives improve the efficiency or effectiveness of existing shared IT platforms. Business process improvement initiatives increase the net value of business activities, products or services by leveraging, not building, shared infrastructure. Experiments are business applications focused on identifying and developing opportunities afforded by IT. We describe these four types of initiatives and illustrate them using evidence from field research and case studies. We conclude that firms should be investing in all four types of initiatives in order to address both short-term profitability and longer-term survival and growth and to develop the robust IT environment and business applications that are needed to support their desired business model.
Why Dominant Parties Lose: Mexico's Democratization in Comparative Perspective

Part I. The Macro Perspective: 1. A theory of single-party dominance and opposition party development 2. Dominant party advantages and opposition party failure, 1930s-90s Part II. The Micro Perspective: 3. Why participate? A theory of elite activism in dominant party systems 4. The empirical dynamics of elite activism Part III. Implications: 5. Constrained to the core: opposition party organizations, 1980s-90s 6. Dominance defeated: voting behavior in the 2000 elections 7. Extending the argument: Italy, Japan, Malaysia, and Taiwan.
Kinetic Explanation for Accumulation of Nitrite, Nitric Oxide, and Nitrous Oxide During Bacterial Denitrification

The kinetics of denitrification and the causes of nitrite and nitrous oxide accumulation were examined in resting cell suspensions of three denitrifiers. An Alcaligenes species and a Pseudomonas fluorescens isolate characteristically accumulated nitrite when reducing nitrate; a Flavobacterium isolate did not. Nitrate did not inhibit nitrite reduction in cultures grown with tungstate to prevent formation of an active nitrate reductase; rather, accumulation of nitrite seemed to depend on the relative rates of nitrate and nitrite reduction. Each isolate rapidly reduced nitrous oxide even when nitrate or nitrite had been included in the incubation mixture. Nitrate also did not inhibit nitrous oxide reduction in Alcaligenes odorans, an organism incapable of nitrate reduction. Thus, added nitrate or nitrite does not always cause nitrous oxide accumulation, as has often been reported for denitrifying soils. All strains produced small amounts of nitric oxide during denitrification in a pattern suggesting that nitric oxide was also under kinetic control similar to that of nitrite and nitrous oxide. Apparent Km values for nitrate and nitrite reduction were 15 μM or less for each isolate. The Km value for nitrous oxide reduction by Flavobacterium sp. was 0.5 μM. Numerical solutions to a mathematical model of denitrification based on Michaelis-Menten kinetics showed that differences in reduction rates of the nitrogenous compounds were sufficient to account for the observed patterns of nitrite, nitric oxide, and nitrous oxide accumulation. Addition of oxygen inhibited gas production from 13NO3− by Alcaligenes sp. and P. fluorescens, but it did not reduce gas production by Flavobacterium sp. However, all three isolates produced higher ratios of nitrous oxide to dinitrogen as the oxygen tension increased. Inclusion of oxygen in the model as a nonspecific inhibitor of each step in denitrification resulted in decreased gas production but increased ratios of nitrous oxide to dinitrogen, as observed experimentally. The simplicity of this kinetic model of denitrification and its ability to unify disparate observations should make the model a useful guide in research on the physiology of denitrifier response to environmental effectors.
The pathogenesis of H3N8 canine influenza virus in chickens, turkeys and ducks.

Please cite this paper as: McKinley et al. (2010) The pathogenesis of H3N8 canine influenza virus in chickens, turkeys and ducks. Influenza and Other Respiratory Viruses 4(6), 353–356. Background Canine influenza virus (CIV) of the H3N8 subtype has emerged in dog populations throughout the United States where it has become endemic in kennels and animal shelters in some regions. It has not previously been determined whether the canine-adapted H3N8 influenza virus can be transmitted to chickens, turkeys or ducks which are economically important animals that are susceptible to type A influenza virus from numerous species. Methods Four-week-old specific pathogen–free (SPF) chickens, 3-week-old SPF turkeys and 2-week-old commercial Pekin ducks were inoculated with 105·2 50% tissue culture infectious doses of CIV per bird by the intra-choanal route. The birds were observed daily, and at 2 and 4 days post-inoculation (DPI), two inoculated birds and one sham-inoculated control bird were euthanized and necropsied to evaluate gross lesions and to collect tissues for microscopic examination. Cloacal and oral swabs were collected at 2, 4 and 7 DPI to evaluate virus shed by real-time RT-PCR (rRT-PCR). Two weeks post-infection, sera were collected from all remaining birds for type A influenza antibody detection by hemagglutination inhibition assay. Results Clinical signs and gross lesions were not observed in any of the birds of any species nor did any seroconvert. Oral and Cloacal swab material was negative for virus by rRT-PCR. Conclusions Chickens, turkeys and Pekin ducks are not susceptible to infection with CIV by simulated respiratory exposure route with the dose administered.
Hypoxia, Effects on Animal Cells

Introduction Cell Responses to and Hypoxia Growth, Viability, and Differentiation Antioxidants and ROS Stress-Related Proteins Cell Metabolism Protein Synthesis Growth Factors and Their Receptors Molecular Mechanisms Mediating Oxygen Effects Oxygen Sensing Signal Transduction Gene Expression Acknowledgment Bibliography Keywords: antioxidants; gene expression; metabolism; O2-sensing; pO2; reactive oxygen species; stress proteins
Fear Extinction in Rodents

Pavlovian conditioning paradigms have become important model systems for understanding the neuroscience of behavior. In particular, studies of the extinction of Pavlovian fear responses are yielding important information about the neural substrates of anxiety disorders, such as phobias and post-traumatic stress disorder (PTSD) in humans. These studies are germane to understanding the neural mechanisms underlying behavioral interventions that suppress fear, including exposure therapy in anxiety disorders. This unit describes detailed behavioral protocols for examining the nature and properties of fear extinction in laboratory rodents.
Estimate of the potential impact of folic acid fortification of corn masa flour on the prevention of neural tube defects.

BACKGROUND Hispanics in the US have a higher prevalence of neural tube defect (NTD) -affected pregnancies than non-Hispanic whites, and lower median total folic acid (FA) intake. FA fortification of corn masa flour (CMF) is a policy-level intervention for NTD prevention; however, the impact on NTD prevalence has not been estimated. METHODS We developed a model to estimate the percentage reduction in prevalence of spina bifida and anencephaly (NTDs) that could occur with FA fortification of CMF. Model inputs included estimates of the percentage reduction in United States NTD prevalence attributed to FA fortification of enriched cereal grain products (1995–1996 vs. 1998–2002), the increase in median FA intake after enriched cereal grain product fortification, and the estimated increase in median FA intake that could occur with CMF fortification at the same level as enriched cereal grain products (140 μg/100 g). We used Monte Carlo simulation to quantify uncertainty. We stratified analyses by racial/ethnic group and rounded results to the nearest 10. RESULTS We estimated CMF fortification could prevent 30 Hispanic infants from having spina bifida (95% uncertainty interval: 0, 80) and 10 infants from having anencephaly (95% uncertainty interval: 0, 40) annually. The estimated impact among non-Hispanic whites and blacks was smaller. CONCLUSION CMF fortification with FA could prevent from 0 to 120 infants, with the most likely value of approximately 40, from having spina bifida or anencephaly among Hispanics, the population most likely to benefit from the proposed intervention. While this estimated reduction is unlikely to be discernible using current birth defect surveillance methods, it still suggests an important benefit to the target population. Birth Defects Research (Part A) 97:649–657, 2013. © 2013 Wiley Periodicals, Inc.
Sums and products in finite fields: an integral geometric viewpoint

We prove that if $A \subset {\Bbb F}_q$ is such that $$|A|>q^{{1/2}+\frac{1}{2d}},$$ then $${\Bbb F}_q^{*} \subset dA^2=A^2+...+A^2 d \text{times},$$ where $$A^2=\{a \cdot a': a,a' \in A\},$$ and where ${\Bbb F}_q^{*}$ denotes the multiplicative group of the finite field ${\Bbb F}_q$. In particular, we cover ${\Bbb F}_q^{*}$ by $A^2+A^2$ if $|A|>q^{{3/4}}$. Furthermore, we prove that if $$|A| \ge C_{size}^{\frac{1}{d}}q^{{1/2}+\frac{1}{2(2d-1)}},$$ then $$|dA^2| \ge q \cdot \frac{C^2_{size}}{C^2_{size}+1}.$$ Thus $dA^2$ contains a positive proportion of the elements of ${\Bbb F}_q$ under a considerably weaker size assumption.We use the geometry of ${\Bbb F}_q^d$, averages over hyper-planes and orthogonality properties of character sums. In particular, we see that using operators that are smoothing on $L^2$ in the Euclidean setting leads to non-trivial arithmetic consequences in the context of finite fields.
Fatigue Behavior of Axial and Pressure Cycled Butt and Girth Welds Containing Defects

This paper presents the results of a study directed at developing a data base for establishing fitness-for-purpose defect acceptance criteria for welds with defects. The study focused on A106 Grade B steel pipe. Data are presented for flat plate, wall segment, and vessel specimens and actual pipe sections containing either artificial or natural planar or volumetric defects. Defect acceptance criteria developed from the test data are discussed.
Economic Factors in the Decline of the Byzantine Empire

It is now five hundred years since the Byzantine empire was brought to an end by the Ottoman Turks, Scholars today quite justly reject Gibbon's assumption that the Byzantine empire was, throughput its entire existence, in a state of decline. They have come to rank it, instead, as one of the great empires in history. And this for good reasons. It endured for over a thousand years. Down to about the middle of the eleventh century it was the center of civilization in Christendom. It preserved the thought and literature of antiquity; it developed new forms of art; it held back the barbarians. It produced great statesmen, soldiers, and diplomats as well as reformers and renowned scholars. Its missionaries, aided by its diplomats and sometimes by its armies, spread the gospel among the pagan tribes, especially the Slavs, which dwelt along its frontiers and beyond. As a Czech historian has put it, Byzantium “molded the undisciplined tribes of Serbs, Bulgars, Russians, Croats even, and made nations out of them; it gave to them its religion and institutions, taught their princes how to govern, transmitted to them the very principles of civilization—writing and literature.” Byzantium was a great power and a great civilizing force.
Interleaver-based method for full utilization of the bandwidth of fiber optical parametric amplifiers and wavelength converters

We present a method using two parallel fiber optical parametric amplifiers (OPAs) and two interleavers, which allow one to either amplify or spectrally invert a broad spectrum. This permits the utilization of the full bandwidth of OPAs and wavelength converters.
Asthma care community program focusing on primary care (PC) education: Train the trainer

Objectives: To determine if asthma education intervention aimed at primary care practices can improve asthma care for children in a community and if the results vary by intervention duration of 6 or 12 months. Methods: Ten practices were selected and were randomly assigned to one of 2 intervention groups. Group 1 (12 month intervention) and Group 2 (6 month intervention). Both groups included 5 pediatric PC practices. Inclusion criteria: voluntary participation, ability to identify one specialized non-physician designee for asthma care provider/practice. Program included visits from asthma educator every 2 weeks. Group 1 received early intervention for 12 months and was then monitored for 6 additional months and Group 2 was observed for 12 months and then intervention for 6 months and then monitoring for 6 additional months. Baseline survey and blinded chart review determined adequacy of documentation. Targeted questionnaire was done at 6 month intervals. Results: In group 1, 6 month, 12 month and 18 month data (mean and exact 95% binomial confidence intervals) revealed significant improvement in documentation of asthma severity level, education, action plan, management according to NIH guidelines, day time and exercise related symptoms compared to baseline. Improvement was significant compared to group 2 at 6 and 12 month interval. In group 2, intervention started at 12 months and improvement in all of the above endpoints was noted at 18 months. At end of intervention and end of the follow-up evaluation, there was no significant difference in any end point between group 1 and 2. Conclusion: In- office support for asthma education improves asthma care during and following the intervention.
Different Strokes of Different Folks: Searching for Health Narratives in Weblogs

The utility of storytelling in the interaction between healthcare providers and patients is now firmly established, but the potential use of large-scale story collections for health-related inquiry has not yet been explored. In particular, the enormous scale of storytelling in personal web logs offers investigators in health-related fields new opportunities to study the behavior and beliefs of diverse patient populations outside of clinical settings. In this paper we address the technical challenges in identifying personal stories about specific health issues from corpora of millions of web log posts. We describe a novel infrastructure for collecting and indexing the stories posted each day to English-language web logs, coupled with user interfaces designed to support targeted searches of these collections. We evaluate the effectiveness of this search technology in an effort to identify hundreds of first person and third person accounts of strokes, for the purpose of studying gender differences in the way that these health emergencies are described. Results indicate that the use of relevance feedback significantly improves the effectiveness of the search. We conclude with a discussion of sample biases that are inherent in web log storytelling and heightened by our approach, and propose ways to mitigate these biases.
A novel model of chronic sleep restriction reveals an increase in the perceived incentive reward value of cocaine in high drug-taking rats

Substance abuse and sleep deprivation are major problems in our society. Clinical studies suggest that measures of poor sleep quality effectively predict relapse to substance abuse. Previously, our laboratory has shown that acute sleep deprivation increases the rate and efficiency (i.e., the goal-directed nature of responding) of cocaine self-administration using a progressive ratio (PR) schedule of reinforcement. However, the problem of sleep deprivation in our nation is largely one of chronicity. Therefore, the current study used a rodent model of chronic sleep restriction more akin to that experienced by humans (approximately 25% reduction in baseline sleep over the course of 8 days) to assess the impact of chronic sleep deprivation on cocaine-seeking and cocaine-taking behaviors in rats early during acquisition of self-administration. While low drug-taking rats were unaffected by chronic sleep restriction, high drug-takers in the chronic sleep restriction (CSR) group exhibited enhanced fixed ratio (FR) responding by the fourth day of FR training and significantly higher PR breakpoints than their non-sleep restriction (NSR) counterparts. This study is the first to directly assess the impact of chronic sleep deprivation on drug self-administration. These results show that chronic sleep deprivation early during acquisition of self-administration has a significant effect on the perceived incentive reward value of cocaine in high drug-takers, as indicated by both increased FR responding and an increased willingness to work for drug. Thus, it is important to be mindful of such factors in clinical settings designed for treatment of addiction and relapse prevention.
The Potential for Clinical Guidelines to Impact Appropriate Antimicrobial Agent Use

The problem of antimicrobial resistance has been widely described in the medical literature and is reviewed extensively elsewhere in this issue of Infectious Disease Clinics of North America. 2,3,26 Misuse of antimicrobial agents among physicians is neither a new nor insignificant finding. 35 Health care practitioners' knowledge of appropriate indications, selection, dose, adjustment of dose with renal and liver failure, and age and duration of therapy is often lacking. 10 Is the situation hopeless? Are the infectious disease clinician, microbiology laboratory director, infection control practitioner, and clinical pharmacist helpless in the face of the scourge of antimicrobial resistance? Are there ways that they can intervene individually or as a team to reduce the impact of antimicrobial resistance? There are, in fact, numerous ways to deal with this rapidly evolving problem. Guidelines, standards, and performance measures are tools that can improve antimicrobial use. The Infectious Disease Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the Centers for Disease Control and Prevention (CDC), and the American Society for Microbiology (ASM) have guideline programs that address the appropriate use of antimicrobial agents. 1,4,15,44
Copper-chelatin: purification and properties of a copper-binding protein from rat liver.

Abstract A cytoplasmic copper-binding protein present in livers of rats injected with CuCl 2 has been purified by Sephadex gel filtration and acetone fractionation. The protein, termed copper-chelatin, shows a single band after electrophoresis in polyacrylamide gels at pH 3.2 or 8.9. Cu-chelatin has an apparent molecular weight of about 8,000 and is characterized by a low content of aromatic amino acids and a cysteine content of 14.6 mol%. The amino acid composition and anion exchange chromatography behavior distinguish this protein from metallothionein. As purified, the chelatin has a copper content of 4.2% which corresponds to about six atoms per protein molecule. Epr studies show that the copper is present in a diamagnetic state in the native protein but is released in a paramagnetic form by incubation of the protein with a variety of thiol-reactive and oxidizing reagents. Concomitant with the release of copper in the presence of oxidizing agents the sulfhydryl groups of the Cu-free apoprotein from disulfide bonds. Rapid anaerobic addition of reduced apoprotein to sodium acetate buffer containing Cu 2+ leads to apparent reconstitution of Cu-chelatin. Reconstituted Cu-chelatin exhibits the same epr properties as native Cu-chelatin. Reconstitution is totally abolished by previous treatment of apochelatin with iodoacetate. These studies indicate that sulfhydryl groups serve as ligands for copper in Cu-chelatin.
Teenage cervical screening in a high risk American population.

Background: The new 2009 ACOG guideline for cervical cytology screening changed the starting age to 21 years regardless of the age of onset of sexual intercourse. However, many recent studies have shown a dramatic increase in the incidence of cervical epithelial abnormalities among adolescents within the past two decades. Materials and Methods: For this study, the reports of 156,342 cervical cytology were available of which 12,226 (7.8%) were from teenagers. A total of 192 teenagers with high grade intraepithelial lesion (HSIL) cervical cytology were identified. The ages ranged from 13 to 19 years with a mean of 17.7 years and a median of 18 years. Among them, 31.3% were pregnant, 12.0% were postpartum, and 13.5% were on oral contraceptive. Ninety-eight had prior cervical cytology. Results: The teenagers had statistically significant higher detection rates of overall abnormal cervical cytology (23.6% vs. 6.6%, P = 0), with 15.4% vs. 3.2% (P = 0) of low grade intraepithelial lesion (LSIL) and 1.8% vs. 1.0% (P = 2.56 Χ 10 -13 ) of HSIL compared to women ≥20 years. The teenage group had the highest abnormal cytology among all age groups. The LSIL/HSIL ratio was 8.5:1 for teenagers and 3.1:1 for women ≥20 years. A total of 131 teenagers had cervical biopsies within 12 months of the HSIL cytology, with diagnoses of 39 CIN 3, 1 VAIN 3, 15 CIN 2, 62 CIN 1, and 14 had a negative histology (CIN 0). Only in 19 of these 39 women, the CIN 2/3 lesion proved to be persistent. Conclusion: We conclude that cytology screening of high risk teenagers is effective in detecting CIN 2/3 lesions. Moreover, treatment and careful follow-up can be realized.
Performance and Energy Consumption Analysis of a Delay-Tolerant Network for Censorship-Resistant Communication

Delay Tolerant Networks (DTNs) composed of commodity mobile devices have the potential to support communication applications resistant to blocking and censorship, as well as certain types of surveillance. We analyze the performance and energy consumption of such a network, and consider the impact of random and targeted denial-of-service and censorship attacks. To gather wireless connectivity traces for a DTN composed of human-carried commodity smartphones, we implemented and deployed a prototype DTN-based micro-blogging application, called 1am, in a college town. We analyzed the system during a time period with 111 users. Although the study provided detailed enough connectivity traces to enable analysis, message posting was too infrequent to draw strong conclusions based on user-initiated messages, alone. We therefore simulated more frequent message initiations and used measured connectivity traces to analyze message propagation. Using a flooding protocol, we found that with an adoption rate of 0.2% of a college town's student and faculty population, the median one-week delivery rate is 85% and the median delivery delay is 13 hours. We also found that the network delivery rate and delay are robust to denial-of service and censorship attacks eliminating more than half of the participants. Using a measurement-based energy model, we also found that the DTN system would use less than 10.0% of a typical smartphone's battery energy per day in a network of 2,500 users.
Impact of Reaction Conditions on MnO2 Genesis during Permanganate Oxidation

To enhance the understanding of the behavior and effects of the precipitation of MnO2 particles in the subsurface generated during in situ chemical oxidation (ISCO) using permanganate, laboratory batch experiments were completed to examine the influence that varied reaction matrix conditions have on the generation and properties of manganese oxides. The conditions examined include organic material type and concentration, permanganate concentration, pH, and the presence of calcium (as a representative divalent cation) in solution. Experimental studies included: (1) spectrophotometric examination of permanganate depletion and manganese oxides generation over time during reactions with trichloroethene; (2) scanning electron microscopy analyses of manganese particle morphology; (3) particle size distribution (filtration) characterization studies; and (4) optical particle sizing and numeration studies. Bench-scale, batch experiments were conducted to focus on fundamental chemical properties affecting particle ...
Study on Work and the Workplace: Implications of the Psychological Aspects for Health Education and an Occupational Health and Safety Program on a University Campus

Abstract The purpose of the present study is to examine social and psychological factors accounting for satisfaction and dissatisfaction at work and to relate levels of job satisfaction to physical and psychological well-being. Eight hundred eighty-seven male and female employees at all job levels at a large mid-Atlantic university completed the questionnaire, responding to questions on job satisfaction, health characteristics (chronic conditions and physical symptoms) and psychological well-being. Job satisfaction was a function of those variables associated with occupational status, particularly the intrinsic dimension of challenge. Overall satisfaction was highest among the occupational group with highest status — faculty/administration — and lowest among the secretarial/clerical group. Health status appeared also to be related to occupational group; secretarial/clerical, the group with the lowest job satisfaction, also reported significantly more physical symptoms than faculty/administration. Faculty/...
Virtual Refrigerant Pressure Sensors for Use in Monitoring and Fault Diagnosis of Vapor-Compression Equipment

Refrigerant pressures are critical measurements for monitoring, control, diagnostics, and optimization of vapor compression cycle equipment. Direct refrigerant pressure measuring practices are expensive and more than often problematic. This paper describes a method, termed virtual pressure sensing, wherein refrigerant pressure values are indirectly derived from low-cost temperature sensors that can be surface-mounted. In this manner, physical pressure sensors are eliminated and pressure sensing can be achieved at a much lower cost and in a non-invasive way. Five virtual pressure sensors are developed to obtain the five most important pressures in vapor compression cycle equipment: compressor discharge line pressure, condensing pressure, liquid line pressure, evaporating pressure, and suction line pressure. The performance of the proposed virtual pressure sensors, in terms of accuracy in estimating pressures and inferring liquid line subcooling, suction superheat, compressor power consumption, and refriger...
Self-Efficacy in Incarcerated Adolescents: The Role of Family and Social Supports

This research investigated the role of general and specific self-efficacy factors in positive family relationships and perceived social support within an U.S. incarcerated adolescent population. One hundred African American and Hispanic male adolescent participants, randomly selected from a southern California Probation Department, were included in the archival dataset used in this study. Self-efficacy beliefs were found to be significantly and positively correlated with family supportiveness and social support from peers. The results have implications for preventative treatment and policy approaches for youth and families at risk for incarceration and confirm self-efficacy models with a multicultural adolescent population.
Practice-based evidence informs environmental health policy and regulation: a case study of residential lead-soil contamination in Rhode Island.

Abstract Prior to 1978, the exteriors of Rhode Island's municipal water towers were painted with lead-containing paint. Over time, this lead-containing paint either flaked-off or was mechanically removed and deposited on adjacent residential properties. Residents challenged inconsistencies across state agencies and federal requirements for collecting and analyzing soil samples. The purpose of this case study was to evaluate the efficacy of Rhode Island Department of Health (RIDOH) soil sampling regulations in determining the extent of lead contamination on residential properties using real world data. Researchers interviewed key government personnel, reviewed written accounts of events and regulations, and extracted and compiled lead data from environmental soil sampling on 31 residential properties adjacent to six municipal water towers. Data were available for 498 core samples. Approximately 26% of the residential properties had lead soil concentrations > 1000 mg/kg. Overall, lead concentration was inversely related to distance from the water tower. Analysis indicated that surface samples alone were insufficient to classify a property as “lead safe”. Potential for misclassification using RIDOH regulations was 13%. For properties deemed initially “lead free”, the total number of samples was too few to analyze. Post-remediation lead‐soil concentrations suggest the extent of lead contamination may have been deeper than initially determined. Additional data would improve the ability to draw more meaningful and generalized conclusions. Inconsistencies among regulatory agencies responsible for environmental health obfuscate transparency and erode the public's trust in the regulatory process. Recommendations for improvement include congruency across departmental regulations and specific modifications to lead‐soil sampling regulations reflective of lowered CDC reference blood lead value for children 1 to 5 years old (5 μg/dL). While scientific research informed the initial development of these environmental health policies and regulations, practice-based evidence did not support their efficacy in context of real world practice.
Distribution and relevance of insulin-like growth factor-I receptor in metanephric development

Distribution and relevance of insulin-like growth factor-I receptor in metanephric development. During embryogenesis, various ligand-recep-tor interactions take place to modulate the development and growth of various mammalian organs. During these interactions, a critical concentration of a given receptor is needed to elicit a ligand-induced biologic response at a defined gestational stage of the fetus. In this study, the distribution and the relevance of insulin-like growth factor-I receptor (IGF-IR) in metanephric development was investigated. Kidneys were harvested from mouse embryos at days 13 to 19 of fetal gestation, and maintained in a metanephric culture system. Immunofluorescence studies, using anti-IGF-IR, revealed a high expression of IGF-IR at day 13, which declined during the later stages of gestation through neonatal life. To study the relevance of IGF-IR expression in metanephric development, antisense-oligodeoxynucleotide (ODN) experiments were carried out. Antisense-ODN 43 mer probes were synthesized utilizing rat IGF-IR cDNA selected nucleotide sequences which are highly conserved in other mammalian species. Southern blot analyses of various restriction fragments of the rat and mice genomic DNA yielded similar bands when hybridized with the antisense-ODN or rat IGF-IR cDNA, suggesting a high degree of homology in the region of the gene selected for the synthesis of antisense-ODN. Also, the antisense-ODN hybridized with the appropriate murine fetal kidney mRNA species, as ascertained by S 1 nuclease protection assay. Inclusion of antisense-ODN in the culture medium resulted in an inhibition of the growth of the kidney, reduction in the population of the nephrons and disorganization of the ureteric bud branches. Effectivity of the antisense-ODN was reduced during the later stages of development when the expression of IGF-IR is decreased. Immunoprecipitation studies revealed a reduction in the IGF-IR associated radioactivity, indicating a specific translational arrest. These studies suggest that IGF-IR is relevant in the modulation of various developmental events during the early midgestational period, the time when it is highly expressed in the metanephric tissues.