cssi/SciSciGPT-SciSciNet huggingface dataset:
Customer Experience and Service Design

While services already dominate economic activity in all major economies in the world, there has been curiously little investigation into many aspects of service management. For example, while product design and development have received a great deal of attention, the subject of service design has not been very visible in the research literature. There are many individual designers and design firms famous for their contributions to product design, but the same cannot be said for services. Undoubtedly many examples of outstanding service design exist and we will mention some later in this work. But recognition of service design as a discipline, as a management function or a job description, still seems to be rare.
Diagnosis and treatment of polyglandular autoimmune syndrome

Polyglandular autoimmune syndromes (PAS) comprises a wide spectrum of autoimmune disorders for autoimmune inflammatory to invade.According to age of presentation,characteristic patterns of disease combinations,and different modes of inheritance,PAS are classified into four subtypes.Actual diagnosis of PAS involves clinical syndromes,serological measurement of organ-specific autoantibodies and subsequent functional testing.Principles of treatment included comprehensive assessment,hormone replacement,general consideration. Key words: Polyglandular; Autoimmune; Diagnosis; Treatment
Predictive Value of RAPID Assessed Perfusion Thresholds on Final Infarct Volume in SWIFT PRIME (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment).

Background and Purpose— Computed tomography perfusion imaging can estimate the size of the ischemic core, which can be used for the selection of patients for endovascular therapy. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) thresholds chosen to identify ischemic core influence the accuracy of prediction. We aimed to analyze the accuracy of various rCBV and rCBF thresholds for predicting the 27-hour infarct volume using RAPID automated analysis software from the SWIFT PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment) data. Methods— Patients from the SWIFT PRIME study who achieved complete reperfusion based on time until the residue function reached its peak >6 s perfusion maps obtained at 27 hours were included. Patients from both the intravenous tissue-type plasminogen activator only and endovascular groups were included in analysis. Final infarct volume was determined on magnetic resonance imaging (fluid-attenuated inversion recovery images) or computed tomography scans obtained 27 hours after symptom onset. The predicted ischemic core volumes on rCBV and rCBF maps using thresholds ranging between 0.2 and 0.8 were compared with the actual infarct volume to determine the most accurate thresholds. Results— Among the 47 subjects, the following baseline computed tomography perfusion thresholds most accurately predicted the actual 27-hour infarct volume: rCBV=0.32, median absolute error (MAE)=9 mL; rCBV=0.34, MAE=9 mL; rCBF=0.30, MAE=8.8 mL; rCBF=0.32, MAE=7 mL; and rCBF=0.34, MAE=7.3. Conclusions— Brain regions with rCBF 0.30 to 0.34 or rCBV 0.32 to 0.34 thresholds provided the most accurate prediction of infarct volume in patients who achieved complete reperfusion with MAEs of ≤9 mL. Clinical Trial Registration— URL: . Unique identifier: [NCT01657461][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01657461&atom=%2Fstrokeaha%2F48%2F4%2F932.atom
A survey of current state of training of plastic surgery residents

Plastic surgery training is undergoing major changes however there is paucity of data detailing the current state of training as perceived by plastic surgical trainees. Our aim was to determine the quality of training as perceived by the current trainee pool and their future plans. A 25-item anonymous survey with three discrete sections (demographics, quality of training, and post-graduate career plans) was developed and distributed to plastic surgery residents during the academic year 2013. With the confidence interval of 95% and margin of error of 10%, our target response rate was 87 responders. We received a total of 114 respondents with all levels of Post Graduate Year in training represented. Upon comparison of residents with debt of 250,000, those with higher debt were significantly less interested in fellowship training (p value 0.05) and were more likely to pursue private practice (p value <0.01). Disciplines within plastic surgery least offered as a separate rotation were microsurgery (45%) followed by aesthetic surgery (33%). 53.7% of the residents felt that they were least trained in aesthetic surgery followed by burn surgery 45.4%. Of note 56.4% intended to seek additional training after residency. Moreover residents with an average of 6.4 months of experience in an individual subspecialty were more likely to feel comfortable with that specialty. This survey highlights the areas and subspecialties that deserve attention as perceived by the current trainee pool.
Tumor Targeting-Retargeted Adenovirus

Adenovirus (Ad) has been applied for gene therapy in various applications. The current Ad vector system has two critical problems; low transduction of the target cancer cells and high transduction of nontarget normal organs. To address these issues, we have been working on “retargeting” of Ad vectors via transductional or transcriptional targeting. Transductional targeting has been achieved with application of various bridging moieties, genetical modification of vector capsid, or chemically coating viral particles. On the other hand, transcriptional targeting has been performed by employing natural or artificial transcriptional control elements with desired selectivity profile. In the field of cancer gene therapy, such retargeting has achieved augmented infectivity in the cancers that have been difficult to transduce with conventional Ad vector, as well as cancer specific transgene expression for avoiding toxicity. Success in cancer gene therapy requires vector design reflecting the pathological/physiological profile of the target disease, such as conditionally replicative adenovirus with combined retargeting mechanisms incorporated. In addition, we must continue to seek new targeting modalities because different tumor context always imposes unique challenges with respect to disease targeting. While reliable preclinical/clinical studies are necessary to establish a legitimate role of adenoviral retargeting in the field of cancer gene therapy, it is obvious that better vector targeting should leads to more potent and safe adenovirus based cancer therapeutics.
Home, Bittersweet Home

In this chapter we follow the Van der Waerden’s home to Holland and empathise with their hardships.
Sjogren's Syndrome: Cytokine and Epstein-Barr Viral Gene Expression Within the Conjunctival Epithelium

Purpose. In primary Sjogren's syndrome (SS), ocular surface changes within the conjunctival epithelium include lymphocytic infiltration, squamous cell metaplasia, and a reduction in goblet cell number. These changes may be the simple result of increased mechanical abrasion secondary to dryness. Alternatively, they may represent a local response to ocular and/or systemic inflammatory processes, perhaps in response to Epstein-Barr viral (EBV) infection, an agent recently implicated in the etiology of SS. To determine whether inflammatory processes or local infection by EBV contribute to the ocular surface pathology of SS, we examined the expression of inflammatory cell surface markers, cytokines, and EBV gene products within the ocular conjunctiva of patients with SS. Methods. Ocular conjunctival tissue was isolated from patients with primary SS and nondry eye control patients by impression cytology or direct biopsy. These specimens were examined by immunofluorescence microscopy and reverse-transcriptase polymerase chain reaction (RT-PCR) for the expression of various markers. Results. The authors found the frequency of expression of HLA-DR (P < 0.0001), ICAM-1 (P < 0.035), and IL-6 (P < 0.0001) to be significantly elevated in patients with primary SS versus nondry eye control patients. The IL-2 receptor and cytokines IL-1/5 and IL-8 were each found to be expressed with relatively high frequency in both patient populations, whereas mRNAs encoding cytokines IL-2, IFN-y, GM-CSF, and TGF-/3 were not reproducibly detectable in either population. Messenger RNA encoding a marker for passive-latent EBV infection (EBNA-1) was detected with high frequency in both SS and normal populations. The EBV IL-10 analog BCRF-1 was expressed with low frequency in the SS population; however, these levels were not significantly different from the control population. The expression of two other markers of EBV infection, latent membrane protein (LMP, a lytic and latent marker), and BZLF-1 (putative latent-lytic switch gene) was undetectable in either study population. Conclusion. Based on the increased expression of the cell surface molecules HLA-DR and ICAM-1, and the inflammatory cytokine IL-6, the authors propose that local inflammatory processes contribute to the ocular surface changes and ocular surface dryness associated with primary SS. Invest Ophthalmol Vis Sci. 1994;35:3493-3504.
THE CONTROL OF GLYCOLYSIS IN YEAST

Publisher Summary This chapter focuses on control of glycolysis in yeast. In a study described in the chapter, the behavior of ADP was typical of that expected of a control component because on changing to anaerobic conditions, it rose to a new steady state level within the time taken for the glycolytic rate to increase. On addition of 1,3-diphosphoglycerate, reduction of pyridine nucleotide was inhibited as compared to the control where the system displayed a full oscillation cycle leading first to a strong reduction until the system turned to the oxidation phase of the period. It was observed that the addition of glucose partly restored respiration after a slight lag, which could be attributed to the formation of α-glycerophosphate. It is possible that the relationship between G-6-P levels and glucose utilization is secondary to a change in some intermediate or effect that varies directly with G-6-P, such as F-6-P or phosphofructokinase activity.
Technical Evaluation and Its Ethics for New Interventional Treatment

Technical innovation presents a major ethical challenge for the practicing physician. Conflicts of interest, both academic and financial, need to be identified and addressed on the institutional, professional, and patient level. On the institutional and professional level, regulations regarding the investigation of new devices and disclosure of physician-industrial relationships can help insure physician propriety. On the patient level, there is general agreement that patients should be informed of physician-industrial relationships. However, the best strategy for disclosing such conflicts of interest to patients is unclear. When evaluating his or her relationships with industry, the best interests of the patient should always guide the physician. In years to come, the ethics for new interventional treatment will probably involve disclosing potential conflicts of interest to patients, colleagues, and institutions to a greater degree than in years past.
Deictic Adaptation in a Virtual Environment.

As human-computer interfaces become more sophisticated, people expect computational agents to behave more like humans. However, humans interacting make assumptions about mutual conceptual understanding that they may not make when interacting with a computational agent, where spatial cues in the environment affect their assumptions about the agent’s knowledge. In this paper, we examine an interaction between human subjects and a virtual embodied avatar displayed on a screen, wherein a surface displayed on the screen is either “continued” in the real world by a physical surface or not. Subjects are, with minimal instruction, asked to indicate objects displayed in the shared environment to the agent in the course of a collaborative task. We then examine the subjects’ adaptations, in aggregate, to the different configurations.
Passive flight in density-stratified fluids

Leaves falling in air and marine larvae settling in water are examples of unsteady descents due to complex interactions between gravitational and aerodynamic forces. Understanding passive flight is relevant to many branches of engineering and science, ranging from estimating the behaviour of re-entry space vehicles to analysing the biomechanics of seed dispersion. The motion of regularly shaped objects falling freely in homogenous fluids is relatively well understood. However, less is known about how density stratification of the fluid medium affects passive flight. In this paper, we experimentally investigate the descent of heavy discs in stably stratified fluids for Froude numbers of order 1 and Reynolds numbers of order 1000. We specifically consider fluttering descents, where the disc oscillates as it falls. In comparison with pure water and homogeneous saltwater fluid, we find that density stratification significantly enhances the radial dispersion of the disc, while simultaneously decreasing the vertical descent speed, fluttering amplitude and inclination angle of the disc during descent. We explain the physical mechanisms underlying these observations in the context of a quasi-steady force and torque model. These findings could have significant impact on the design of unpowered vehicles and on the understanding of geological and biological transport where density and temperature variations may occur.
A Nursing Dashboard to Communicate the Evaluation of Program Outcomes.

BACKGROUND Schools of nursing pursue accreditation to convey the quality of their program. Communication of their process for continuous quality improvement and ability to produce competent nurse graduates are common program goals. PURPOSE This article describes the implementation of a nursing dashboard as an innovative approach to examine and communicate program outcomes. METHODS A comprehensive evaluation document in the form of a dashboard was created in a user-friendly format to monitor and convey outcomes to stakeholders. This visual evaluation document was crafted in congruence with a utilization-oriented evaluation model incorporating accreditation standards. RESULTS Stakeholders, including alumni, faculty, and students, conveyed satisfaction with the dashboard graphic of program evaluation data. Participant responses were greater than 4.3/5.0 on a Likert scale, indicating satisfaction with the dashboard communication of outcomes. CONCLUSIONS The nursing dashboard provides an innovative approach to the review of program outcomes with meaningful data for strategic planning and program decisions.
Activity of Paricutin Volcano from July 1 to December 31, 1951

Continuous observation of activity at Paricutin Volcano during the second half of 1951 was carried on mainly by Celedonio Gutierrez and partly by Jesus Saldanna. The senior author was at Paricutin July 10–12, August 24–27, November 14–15 and 19–22, and December 27–30, for a total of 17 days during the period. Observatory data of Gutierrez and Saldana are presented in the diagrams of eruptive characteristics in Figures 1–3, and their records of weather conditions, rainfall, and ashfall are summarized in Table 1. Gutierrez also mapped the monthly advance of the lava during the period, as shown in Figure 6. The senior author prepared the summaries in Table 2 and measured the changes in horizontal distances and elevations of points on the cone, as given in Table 3, besides interpreting the data, formulating the report, and commenting on the progress of the activity.
Mixed-phenotype acute leukemia with t(4;11)(q21;q23) KMT2A-AFF1-rearranged.

![Figure][1] A 12-year-old girl had marked leukocytosis (white blood cell count, 692 000/µL), severe anemia (hemoglobin, 5.9 g/dL), and thrombocytopenia (platelet count, 13 000/µL). Peripheral blood (PB) and bone marrow (BM) smears appeared similar with numerous small to large blasts (
Other 'routes in'? Has the 'fast' in the fast mapping concept led us astray?

The notion of fast mapping originated in an effort to explain the remarkable adeptness and acceleration with which toddlers learn new words. Yet, by abstracting selected elements of fast mapping aw...
Risk of coronary artery disease in patients with ankylosing spondylitis: a systematic review and meta-analysis.

Objective: To investigate the association between coronary artery disease (CAD) and ankylosing spondylitis (AS). Methods: We conducted a systematic review and meta-analysis of observational studies that reported relative risks, hazard ratios, standardized prevalence ratio or standardized incidence ratios with 95% confidence comparing CAD risk in patients with AS versus non-AS controls. Pooled risk ratios and 95% confidence intervals (CI’s) were calculated using a random-effect, generic inverse variance of DerSimonian and Laird. Results: Out of 229 potentially relevant articles, ten studies (five retrospective cohort studies and five cross-sectional studies) were identified and included in our data analysis. The overall pooled risk ratio of CAD in patients with AS was 1.41 (95% CI: 1.29-1.54). The pooled risk ratios for cross-sectional and cohort studies were 2.08 (95% CI: 1.28-3.40) and 1.36 (95% CI: 1.31-1.41), respectively. The statistical heterogeneity of this meta-analysis was moderate with an I2 of 56%. Conclusions: Our study demonstrated a statistically significant increased CAD risk among patients with AS with 41% excess risk.
Dupilumab-Associated Acquired Hemophilia A in an Elderly Male With Severe Eczema

This is a case of an 80-year-old Caucasian male with no personal or family history of coagulopathy, who was admitted for new onset painless hematuria followed by skin and significant deep soft tissue hemorrhage, with resultant anemia requiring blood transfusions. The hematuria started 1 week after he received an initial dose of subcutaneous injection of dupilumab for the treatment of refractory eczema. Few days later, he had spontaneous bruising on the tongue, anterior neck, right arm and entire left lower extremity in the absence of trauma and strenuous physical activity. His hemoglobin dropped to 7.2 g/dL from a baseline of 15.0 g/dL. Laboratory tests revealed a prolonged partial thromboplastin time, reduced factor VIII activity, and presence of factor VIII inhibitors. Three units of packed red blood cells were transfused and oral prednisone 1 mg/kg daily was initiated. His hemoglobin stabilized. No further bleeding was noted and the ecchymoses gradually resolved. J Med Cases. 2019;10(7):206-208 doi: https://doi.org/10.14740/jmc3336
Convergent ablation for persistent atrial fibrillation: Single center experience

Background Endocardial catheter ablation has been shown to be effective in patients with paroxysmal atrial fibrillation (AF), and significantly less effective in patients with persistent AF (PAF). Lately, there is a trend toward a hybrid approach in the treatment of PAF that may be a more durable treatment for patients with PAF. In this manuscript we report our experience with the convergent ablation procedure in a PAF cohort. Methods This is a single center retrospective analysis of 31 patients with PAF who underwent the convergent procedure. All patients underwent surgical epicardial ablation of the posterior left atrial through a subxiphoid approach, followed by radiofrequency endocardial ablations on the same day. Patients were followed at 6 months intervals with static electrocardiograms or implanted devices. Results Sinus rhythm was achieved intraoperatively in all patients. Recurrence was defined according to Hearlt Rhythm Society definitions. At a median follow up of 17.7 months (IQR 11-24), the recurrence of atrial tachyarrhythmia (AF and atrial flutter) by Kaplan-Meier event free survival analysis occurred in 9 (29%) patients at 1-year follow up and 15 (48%) patients at 2-year follow up with or without the use of antiarrhythmic drugs. Recurrence of AF alone occurred in 4 (13%) patients at 1-year follow up and 9 (29%) patients at 2-year follow up patients. Complication rate in perioperative period was 12.9%. Conclusion Our experience showed the hybrid procedure is a relatively safe and effective option for patients with PAF. Further studies are needed to better determine its long-term outcomes.
CHEMICAL MODIFICATION OF SUPERCOILED DNA: EFFECT ON THE RATE OF TRANSCRIPTION

ABSTRACT Superhelical SV40 DNA I can be modified with the single strand specific reagent N-cyclohexyl-N′-β(4, methylmorpholinium) ethylcarbodiimide (CMC). A limited reaction, less than 2% of the base pairs, results in almost total inhibition of in vitro transcription by DNA-dependent-RNA polymerase from E. coli . The inhibition is shown to be primarily a loss of the ability to the enzyme to bind to the super-coiled DNA.
Optimization Methods for Evaluating PV Hosting Capacity of Distribution Circuits

As today’s distribution grid is experiencing increased rooftop solar installations, there is growing interest in evaluating the PV hosting capacity (HC) of the grid. Since, predicting the exact size and location of potential PV installations is not feasible at the distribution grid planning phase, a stochastic method is employed to choose a finite number of combinations of possible PV size and location. As a result, the calculated PV HC is a range of total PV capacity in MW that a circuit can accommodate and not a single value. Additionally, the calculated PV HC range is not unique; it varies with the PV distribution considered for the analysis. This paper proposes an optimal power flow based formulation to find the maximum PV capacity in MW that can be accommodated in a given distribution grid. The PV HC values are evaluated for IEEE 123 bus circuit by the proposed method and the results are compared with the conventional approach. It is observed that the results of the optimal power flow method is unique and can act as the upper bound for the stochastic PV HC analysis.
Long-term economic change: Craft extensification in the Mesoamerican cotton textile industry

Abstract Mesoamerican cotton textile production shows a long-term process of craft extensification (the geographic and social expansion of cotton processing and weaving without a notable increase in productivity per person). Few economies of scale, high labor input, restrictions in the environments in which cotton can be grown, and increasing social demand for textiles contributed to craft extensification. The western lower Papaloapan basin in south-central Veracruz provides a case study showing the inception of craft extensification by the Early Classic period, CE 300–600. Production was not concentrated at elite residences and was widespread in commoner households and environmental zones. Environmental variation in the basin and related agricultural techniques raise the possibility of selection for annualized traits in cotton. Annualized varieties were important in the spread of cotton cultivation to more upland environments from the tropical coastal areas to which the plant was initially adapted. Craft extensification contributed strongly to regional and community specialization and trade, which are traits relevant to monitor long-term economic change and growth.
False-positive very long-chain fatty acids in a case of autoimmune adrenal insufficiency

Background X-linked adrenoleukodystrophy (ALD) affects up to 25% of boys diagnosed with adrenal insufficiency in childhood. Because early identification of these individuals can be lifesaving, all boys with new-onset primary adrenal insufficiency should be tested for ALD with a plasma very long-chain fatty acid (VLCFA) level. While plasma VLCFA is a diagnostic test with high sensitivity and specificity, false-positive results have been reported in individuals on a ketogenic diet. Case presentation We present a case of an 11-year-old boy with new-onset primary adrenal insufficiency due to autoimmune adrenalitis who was initially found to have elevated VLCFA levels, suggestive of ALD, that normalized on repeat testing. Conclusions As advances in gene therapy and newborn screening for ALD expand, VLCFA testing may increase, and clinicians should be aware that testing during the initial presentation of primary adrenal insufficiency may lead to false-positive results and associated psychosocial distress.
Findings from Cardiovascular Evaluation of NCAA Division I Collegiate Student-Athletes after Asymptomatic or Mildly Symptomatic SARS-CoV-2 Infection

ABSTRACT Objectives The risk of myocardial damage after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been controversial. There is an urgent need for data to support the appropriate level of cardiovascular screening for safe return-to-play. The purpose of this study is to report the incidence of abnormal cardiovascular findings in National Collegiate Athletic Association (NCAA) Division I student-athletes with a history of SARS-CoV-2 infection. Methods This is a case series of student-athletes at a single NCAA Division I institution who tested positive for SARS-CoV-2 by polymerase chain reaction (PCR) or antibody testing (IgG) from 4/15/2020 to 10/31/2020. From 452 athletes who were screened, 5,124 PCR and 452 antibody tests were completed. Student-athletes were followed through 12/31/2020 (median 104 days, range 64-182 days). Cardiac work-up included clinical evaluation, troponin level, electrocardiogram (ECG), and echocardiogram. Additional work-up was ordered as clinically indicated. Results 55 student-athletes tested positive for SARS-CoV-2. Of these, 38 (69%) had symptoms of Coronavirus Disease (COVID-19), 14 (26%) had a positive IgG test, and 41 (74%) had a positive PCR test. Eight abnormal cardiovascular screening evaluations necessitated further testing including cardiac magnetic resonance imaging (cMRI). Two athletes received new cardiac diagnoses, one probable early cardiomyopathy and one pericarditis, while the remaining six had normal cardiac MRIs. Conclusion These data support recent publications which recommend the de-escalation of cardiovascular testing for athletes who have recovered from asymptomatic or mildly symptomatic SARS-CoV-2 infection. Continued follow-up of these athletes for sequelae of SARS-CoV-2 is critical.
Safety of Inpatient Dofetilide Initiation per Cardiology Services: A Retrospective Review.

Introduction:Dofetilide is an antiarrhythmic medication that has the potential to cause life threatening arrhythmias, such as Torsade de pointes. The 2014 ACC/AHA/HRS guidelines for the management ...
The Association of Medicaid Insurance and Affordable Care Act Expansions with Survival among Patients with Testicular Cancer

AbstractIntroduction:Following passage of the Affordable Care Act, Medicaid access was expanded in several states beginning in 2014. We sought to determine the oncologic implications by comparing o...
Exploring the Ethics of Stature Lengthening as Treatment for Height Dysphoria.

Aim To promote a discussion on the ethics and justifications of stature lengthening in patients without skeletal deformity. Background Stature lengthening for height gain in patients without skeletal deformity has stirred controversy within the orthopedic community. However, current literature does not delineate the ethical issues surrounding this procedure. Improvements in the techniques, technology, and safety profile of stature lengthening warrant an ethical discussion to challenge, justify, and guide the use of this surgical procedure. Review results Examination of ethical issues leads to the distinction between the dual roles of stature lengthening as a treatment vs an enhancement. The primary focus on stature lengthening as treatment allows for exploration of "height dysphoria"-a psychological burden caused by a dissatisfaction with one's height-as the primary pathology that may justify surgical intervention. Conclusion In our opinion, additional work is required to establish "height dysphoria" as a true pathology in order to ethically justify stature lengthening as a legitimate form of treatment. Further discussion is needed to address the ethics of stature lengthening as an enhancement. Clinical significance This paper addresses salient ethical issues of stature lengthening in patients without skeletal deformity by exploring historical, contemporary, and comparative contexts. How to cite this article Lee RC, Aulisio M, Liu RW. Exploring the Ethics of Stature Lengthening as Treatment for Height Dysphoria. Strategies Trauma Limb Reconstr 2020;15(3):163-168.
Maintenance Therapy in First-Line Gastric and Gastroesophageal Junction Adenocarcinoma: A Retrospective Analysis.

Background Fluoropyrimidine with platinum-based chemotherapy has become the standard of care for advanced gastric and gastroesophageal (GEJ) cancer. Trials in colon cancer show that induction chemotherapy followed by maintenance chemotherapy is an efficacious strategy to maximize clinical response while minimizing toxicity. The current retrospective study aims to evaluate the efficacy and tolerability of maintenance versus continuous treatment in advanced GEJ malignancy. Methods A retrospective analysis of patients with metastatic gastric/GEJ adenocarcinoma treated with fluoropyrimidine and platinum chemotherapy between 2007-2017 was performed. Patients who achieved at least stable disease after initial induction treatment were included. After 16 weeks of induction chemotherapy, patients were categorized into the continuous group if induction chemotherapy was continued and the maintenance group if chemotherapy was switched to maintenance fluoropyrimidine monotherapy or observed off treatment. Endpoints were progression-free survival (PFS), overall survival (OS), and toxicities. Results In total, 90 patients met the criteria, 48 received continuous therapy, and 42 received maintenance. Baseline characteristics were comparable. No difference in PFS (9.9 vs 8.4 months p = .28) or in OS (16.1 vs 21.3 months p = .75) was observed, including after controlling for the best response on induction therapy and other variables. In patients on continuous induction therapy, there was a higher prevalence of grade three neuropathy (42.6% vs 9.8% p = .001) and neutropenic fever (13% vs 0% p =.03). Conclusions Maintenance therapy following induction fluoropyrimidine and platinum-based therapy is associated with an improved toxicity profile and appears to have comparable efficacy to continuous treatment in metastatic gastric/GEJ cancer.
A coupled geomechanics and reservoir simulator with a staggered grid finite difference method

Abstract For a stress-sensitive reservoir, the constant rock compressibility term used in a conventional reservoir simulator (CRS), does not account for change of porosity and permeability. This paper develops a coupled geomechanics and reservoir simulator (CGRS) which accounts for changes in porosity and permeability related to deformation. The simulator in this paper adopts a staggered grid finite difference method for fluid flow and displacements. Displacements and pore pressures are placed at centers of faces and grid blocks, which increases numerical accuracy. Four types of nonlinear, coupled equations (porosity, permeability, displacements, and pressure equations) have been derived for use in CGRS. The Newton-Raphson method requires solving all the unknowns simultaneously, a computationally intensive procedure. An alternative is to use the Macro Gauss-Seidel method, which divides a huge nonlinear matrix into several smaller matrices, thus speeding up computations. Solutions from CGRS have been validated using two analytical solutions: a one-dimensional consolidated reservoir and an idealized reservoir. This validated simulator is used to simulate a 3D reservoir with multiple vertical and horizontal wells. The comparison between CRS and CGRS shows that pressure depletes faster in CRS as compared to CGRS. CGRS results in higher bottom-hole pressure for a constant rate well. Constant rate wells yield a result of 1–1.26 times higher bottom-hole pressure than CRS. This shows that neglecting geomechanics effects in CRS can lead to an under prediction of reservoir/bottom hole pressures and production rates. Another powerful function of CGRS is the output of 3D displacements, which cannot be predicted by CRS. After producing for 1000 days, the maximum vertical displacement reaches 0.34 ft. (0.085% of reservoir thickness). Maximum displacements in the x and y directions (lateral displacements) are 4 × 10 − 4 ft. and 0.015 ft., both of which are smaller than vertical displacement because of fixed lateral boundary conditions. Unlike traditional iterative coupled (IC) methods, fluid flow and geomechanics share the same mesh, which solves the problem of numerical instability in two discretization methods used in traditional IC. Also, the change of volumetric strain with respect to time (usually neglected in traditional IC) has been included in the fluid flow equation to better characterize the effects of solids movement on fluid flow. The Macro Gauss-Seidel method was adopted to increase computation efficiency of the simulations. The simulator introduced in this paper has its own data structure for geomechanics analysis which can be incorporated in single-phase, two-phase, three-phase or compositional reservoir simulators.
An essential role for Birc5 in innate lymphocyte development (HEM5P.223)

NK cells and innate lymphoid cells (ILCs) are two important classes of innate lymphocytes, and both have essential roles in early immune responses. NK cells provide systemic protection against viruses and cancer, while ILCs defend against a broad range of pathogens, including viruses, helminths, and bacteria, particularly at barrier organs such as the lung, gut, and skin. The molecular pathways that regulate innate lymphocyte development and function are an area of active investigation. Here we show that the inhibitor of apoptosis (IAP) protein, Birc5, is essential for the development of NK cells and ILC subsets. We observed high expression of Birc5 in NK cell and ILC precursor populations in the bone marrow, and consistent with a non-redundant role for Birc5 in innate lymphocyte development, steady-state populations of NK cells and ILCs were severely reduced in mice with cell-specific deletions of the Birc5 gene. BrdU-labeling experiments indicated an important role for Birc5 in cell cycle progression in developing innate lymphocytes in the bone marrow. Moreover, Birc5-deficient NK cells in the peripheral organs of these mice exhibited a maturation defect. Together, these findings highlight a new and crucial role for Birc5 in the proliferation and maturation of developing innate lymphocytes.
Scholarship and the two Sudans: an interview with Professor Samson Wassara

Over a period of several months in late 2013 I had the pleasure of carrying on a long-distance conversation with Samson Samuel Wassara, Vice Chancellor of the University of Bahr al-Ghazal and forme...
High sigma measurement of random threshold voltage variation in 14nm Logic FinFET technology

Random variation of threshold voltage (Vt) in MOSFETs plays a central role in determining the minimum operating voltage of products in a given process technology. Properly characterizing Vt variation requires a large volume of measurements of minimum size devices to understand the high sigma behavior. At the same time, a rapid measurement approach is required to keep the total measurement time practical. Here we describe a new test structure and measurement approach that enables practical characterization of Vt distributions to high sigma and its application to 14nm Logic FinFET technology. We show that both NMOS and PMOS single fin devices have very low random Vt variation of 19mV and 24mV respectively, normally distributed out to +/−5σ.
Spatio-temporal histograms

This paper presents a framework for building and continuously maintaining spatio-temporal histograms (ST-Histograms, for short). ST-Histograms are used for selectivity estimation of continuous pipelined query operators. Unlike traditional histograms that examine and/or sample all incoming data tuples, ST-Histograms are built by monitoring the actual selectivities of the outstanding continuous queries. ST-Histograms have three main features: (1) The ST-Histograms are built with (almost) no overhead to the system. We use only feedback (i.e., the actual selectivity) from the existing continuous queries. (2) Rather than wasting system resources in maintaining accurate histograms for the whole spatial space, we only maintain accurate histograms for that part of the space that is relevant to the current existing queries. The rest of the space has less accurate histograms. (3) The ST-Histograms are equipped with a periodicity detection procedure that predicts the future execution of the continuous queries. Hence, the query processing engine can continuously adapt the continuous query pipeline to reflect this prediction. Experimental results based on a real implementation inside a data stream management system show a superior performance of ST-Histograms in terms of providing accurate operator selectivity estimations with no extra overhead.
The role of serine/threonine phosphorylation in hematopoietic cytokine receptor signal transduction.

The hematopoietic cytokine receptors rapidly activate tyrosine phosphorylation after ligand engagement. In addition, however, serine/threonine phosphorylation of important effector molecules also icreases. Interleukins 2-5 and granulocyte-macrophage colony stimulating factor all activate protein kinase C. This results in serine/threonine phosphorylation of such important regulatory molecules as Raf-1 kinase, myristoylated alanine-rich C kinase substrate, and SOS. These phosphorylated effector molecules are regulators of important genes related to cell survival and proliferation. In addition, as yet uncharacterized serine/threonine kinases associate directly with the hematopoietic receptor subunits themselves. These kinases may contribute to the phosphorylation of the STAT family of transcription factors that is important in regulating cytokine-specific gene inductions. Thus, it is time to begin integrating serine/threonine kinases into the postulated signaling pathways activated by hematopoietic cytokine ...
Cross-layer protocol interactions in heterogeneous data networks

Modern data networks are heterogeneous in that they often employ a variety of link technologies, such as wireline, optical, satellite and wireless links. As a result, internet protocols, such as Transmission Control Protocol (TCP), that were designed for wireline networks, perform poorly when used over heterogeneous networks. This is particularly the case for satellite and wireless networks which are often characterized by high bandwidth-delay product and high link loss probability. This thesis examines the performance of TCP in the context of heterogeneous networks, particularly focusing on interactions between protocols across different layers of the protocol stack. First, we provide an analytical framework to study the interaction between TCP and link layer retransmission protocols (ARQ). The system is modelled as a Markov chain with reward functions, and detailed queueing models are developed for the link layer ARQ. The analysis shows that in most cases implementing ARQ can achieve significant improvement in system throughput. Moreover, by proper choice of protocols parameters, such as the packet size and the number of transmission attempts per packet, significant performance improvement can be obtained. We then investigate the interaction between TCP at the transport layer and ALOHA at the MAC layer. Two equations are derived to express the system performance in terms of various system and protocol parameters, which show that the maximum possible system throughput is 1/e. A sufficient and necessary condition to achieve this throughput is also presented, and the optimal MAC layer transmission probability at which the system achieves its highest throughput is given. Furthermore, the impact of other system and protocol parameters, such as TCP timeout backoff and MAC layer retransmissions, are studied in detail. The results show that the system performance is a balance of idle slots and collisions at the MAC layer, and a tradeoff between packet loss probability and round trip time at the transport layer. Finally, we consider the optimal scheduling problem with window service constraints. Optimal policies that minimize the average response time of jobs are derived and the results show that both the job lengths and the window sizes are essential to the optimal policy. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.)
Getting Involved in Transition Planning

This article gives attention to the physical education teacher's role in transition planning for students with disabilities.
Introduction to an Overview of Pediatric Patient Education

Today9s physicians must deal with a public that is both informed and misinformed on children9s health care. Adult school and college courses, magazine articles, film and television documentaries, and a host of books offer parents readily available information on pediatric health care, but some of these sources are inaccurate or biased, or both. Erroneous information is also disseminated by a variety of nonmedical practitioners and special-interest groups. They publicize their theories and methods by using authoritative-sounding statements and impressive, if meaningless, letters after their names. The profession of pediatrics is faced with the challenge of being the single most important source that parents can turn to for accurate information concerning their children9s health. The challenge extends beyond that goal: pediatricians must also be willing to utilize educational methods and materials with which they may currently have little or no familiarity. Some of these techniques and tools will be presented in the following papers. As a first step in achieving these goals, pediatricians must recognize that patient education is a critical function of their practices. Next, they must become sufficiently motivated to act on this recognition of responsibility for patient education. Pediatricians must learn what patients need to know, what the best and most practical methods are to deliver that information, and what types of materials are available or need to be developed to assist in the educational process. Practices should be structured so as to enable sustained patient education while allowing for future innovations in either methods or materials. The goal of this conference is to strengthen individual patient education efforts and to convince pediatricians and the American Academy of Pediatrics that an organized, chapter-centered program should be established.
S-Layer Similarity in Matrix and Mineral Structure of a Leptotrix Species (Bacteria)

The uniquely shaped mineral coat reported in the literature for a Leptotrix species [1] is shown to have an organic matrix with an identical morphology. The same structural design is found among the crystalline cell surface layers of many bacteria. Hence presentation of the Leptotrix data is prefaced by pertinent information on similarly shaped crystalline surface layers.
Virtual interaction profiles of proteins.

Abstract We have developed a new method for the prediction of peptide sequences that bind to a protein, given a three-dimensional structure of the protein in complex with a peptide. By applying a recently developed sequence prediction algorithm and a novel ensemble averaging calculation, we generate a diverse collection of peptide sequences that are predicted to have significant affinity for the protein. Using output from the simulations, we create position-specific scoring matrices, or virtual interaction profiles (VIPs). Comparison of VIPs for a collection of binding motifs to sequences determined experimentally indicates that the prediction algorithm is accurate and applicable to a diverse range of structures. With these VIPs, one can scan protein sequence databases rapidly to seek binding partners of potential biological significance. Overall, this method can significantly enhance the information contained within a protein-peptide crystal structure, and enrich the data obtained by experimental selection methods such as phage display.
Sorptive reconstruction of CuMCl4 (M = Al and Ga) upon small-molecule binding and the competitive binding of CO and ethylene.

Carbonyl adducts to CuMCl4 (M = Al and Ga) have been characterized by single-crystal and/or powder X-ray diffraction, IR and diffuse reflectance UV/vis spectroscopy. Up to two equivalents of carbon monoxide (∼200 cm3/g relative to stp) are sorbed at room temperature, with equilibrium binding pressures of below 0.5 atm of CO. The carbonyl bonding is shown to be nonclassical, implicating the dominance of σ-bonding and absence of π-back-bonding. Analysis of the crystalline structures of the parent and adduct phases provides an atomistic picture of the sorptive reconstruction reaction. Comparison of the reactivity of CO and ethylene with these CuMCl4 materials, as well as other copper(I) halide compounds that exhibit classical and nonclassical modes of bonding, demonstrates the ability to tune the reactivity of the crystalline frameworks with selectivity for carbon monoxide or olefins, respectively.
Fate of Inhaled Hexachlorocyclopentadiene in Albino Rats and Comparison to the Oral and IV Routes of Administration

Abstract Hexachlorocyclopentadiene (C56) is extremely toxic when inhaled by rats, but only moderately toxic when administered orally. The difference in toxicity as a function of route of exposure was studied by determining the absorption, distribution, and ultimate fate of C56 following acute oral, inhalation, and iv exposure. For rats treated with a single oral dose (5 μg/kg) of 14C-C56, radiocarbon was primarily excreted in the 0–72 hr feces (68.2%). Animals treated with equivalent inhaled and iv doses eliminated 23.1 and 31.4% of the dose in the 0–72 hr feces, respectively. Urinary radiocarbon was equivalent to 24.4, 23.1, and 31.4% of the dose for oral, inhalation and iv treatments, respectively. Biliary excretion following all exposure routes was between 9 and 18% of the dose, indicating that the large amount of radiocarbon in the feces of orally treated rats was due to poor absorption of C56 from the gastrointestinal tract. For all exposure routes, the lungs appeared to be a major site of C56 toxicity upon post-mortem examination. This study suggests that the direct damage to lung tissue by inhaled C56 and low bioavailability of orally administered C56 contribute substantially to the difference in toxicity between oral and inhalation exposure to C56. A recently developed inhalation exposure system which allows quantitative administration of toxicant vapors to rats is also described in this report.
Covalent modification of the active site threonine of proteasomal β subunits and the Escherichia coli homolog HslV by a new class of inhibitors

The proteasome is a multicatalytic protease complex that plays a key role in diverse cellular functions. The peptide vinyl sulfone, carboxybenzyl-leucyl-leucyl-leucine vinyl sulfone (Z-L3VS) covalently inhibits the trypsin-like, chymotrypsin-like and, unlike lactacystin, also the peptidylglutamyl peptidase activity in isolated proteasomes, and blocks their function in living cells. Although described as a class of mechanism-based inhibitors for cysteine proteases, the peptide vinyl sulfone Z-L3VS and a 125I-labeled nitrophenol derivative (125I-NIP-L3VS) covalently modify the active site threonine of the catalytic β subunits of the proteasome. Modification of Thermoplasma proteasomes demonstrates the requirement for a hydroxyl amino acid (threonine, serine) as nucleophile at the β subunit’s NH2 terminus. 125I-NIP-L3VS covalently modifies the HslV subunit of the Escherichia coli protease complex HslV/HslU, a reaction that requires ATP, and supports a catalytic mechanism shared with that of the eukaryotic proteasome.