cssi/SciSciGPT-SciSciNet huggingface dataset:
Can Nonurgent Emergency Department Care Costs be Reduced? Empirical Evidence from a U.S. Nationally Representative Sample.

Abstract Background A well-functioning primary care system has the capacity to provide effective care for patients to avoid nonurgent emergency department (ED) use and related costs. Objective This study examined how patients' perceived deficiency in ambulatory care is associated with nonurgent ED care costs nationwide. Methods This retrospective cohort study used data from the 2010–2011 Medical Expenditure Panel Survey. This study chose usual source of care, convenience of needed medical care, and patient evaluation of care quality as the main independent variables. The marginal effect following a multivariate logit model was employed to analyze the urgent vs. nonurgent ED care costs in 2011, after controlling for covariates in 2010. The endogeneity was accounted for by the time lag effect and controlling for education levels. Sample weights and variance were adjusted with the survey procedures to make results nationally representative. Results Patient-perceived poor and intermediate levels of primary care quality had higher odds of nonurgent ED care costs (odds ratio [OR] = 2.22, p = 0.035, and OR = 2.05, p = 0.011, respectively) compared to high-quality care, with a marginal effect (at means) of 13.0% and 11.5% higher predicted probability of nonurgent ED care costs. Costs related to these ambulatory care quality deficiencies amounted to $229 million for private plans (95% confidence interval [CI] $100 million–$358 million), $58.5 million for public plans (95% CI $33.9 million–$83.1 million), and an overall of $379 million (95% CI $229 million–$529 million) nationally. Conclusions These findings highlight the improvement in ambulatory care quality as the potential target area to effectively reduce nonurgent ED care costs.
Retronasal Discrimination Between Vapor-Phase Long-Chain, Aliphatic Fatty Acids

Retronasal discrimination between vapor-phase fatty acids was tested in 40 participants. Linoleic, oleic, or stearic fatty acids were used in stimulus delivery containers (SDC) at concentrations previously determined to be detectable when presented vapor phase retronasally (Bolton and Halpern in Chem Senses 35:229–238, 2010). For each of these 18-carbon fatty acids, participants received, retronasally, 5 SDC on 2 trials, with 4 of the containers holding, in random order, 1 fatty acid, and the 5th container, a different fatty acid. In addition, for a “negative control”, on two trials, participants received very dilute linoleic acid (0.005%) versus mineral oil. For all trials, the task was to select the one different SDC. It was found that the one different SDC was selected on 83% of the stearic versus linoleic acid trials, 75% of stearic versus oleic acid trials, 58% of linoleic versus oleic acid trials, and 12% of very dilute linoleic acid versus mineral oil trials. An ANOVA found a difference between these distributions, p < 0.0001. Seventy percent of participants discriminated, i.e., selected the 1 different SDC on both trials (chance p = 0.04) between stearic and linoleic acids, 65% discriminated between stearic and oleic acids, and 38% discriminated between linoleic and oleic acids. No participants discriminated on “negative control” trials. These data suggest that retronasal vapor-phase stearic fatty acid is discriminated from vapor-phase linoleic or oleic fatty acids and that oleic and linoleic fatty acids, at concentrations known to be detectable, are discriminated from each other by a substantial minority of participants.
A critical site in the cell surface receptor for ecotropic murine retroviruses required for amino acid transport but not for viral reception.

Abstract The cell surface receptor (ecoR) for ecotropic host-range murine retroviruses is a Na + -independent transporter for cationic amino acids that is distantly related to yeast transporters for arginine, histidine, and choline. All members of this transporter family contain a conserved glutamic acid that occurs in a hydrophobic presumptive transmembrane region of ecoR at position 107. To address the function of this site, we conservatively mutated ecoR by substituting aspartic acid at this position. The mutant protein was processed to cell surfaces where it bound the ecotropic virus envelope glycoprotein and functioned as a viral receptor, but it lacked amino acid transport activity. Functional transporter cycling is not required for viral reception by ecoR.
Chemistry of the surface of hot-dipped galvanized steel and its relation to paint adherence☆

Abstract Auger spectroscopy studies of many samples of hot-dipped galvanized steel have revealed the presence in the surface of aluminum, antimony, barium, calcium, carbon, chlorine, iron, lead, magnesium, nitrogen, oxygen, phosphorus, potassium, sulfur, tin and zinc. Auger analysis and electron microprobe analysis yielded approximately the same results for aluminum, but Auger analyses for lead tended to be low under those conditions where carbonaceous matter was present on the surface after cleaning in isopropyl alcohol. The tightly bound carbonaceous material appeared to contain sulfur. The ability of the regular and minimized spangle galvanized steel to retain paint on severe deformation was a maximum on those panels with a low residuum of carbonaceous material after isopropyl alcohol cleaning and was a minimum for those panels with a high residuum of carbonaceous material. This relationship was explained in terms of the degree of (0001) preferred orientation since orientation is known to be related to paint adherence. Organic matter containing sulfur was more readily removed on those panels having crystallites whose (0001) planes were oriented parallel to the substrate.
Electrical resistivity of some directionally‐solidified aluminum‐based eutectic alloys

Electrical resistivity of directionally-solidified Al-based eutectic composites containing Al3Ni, Al6Fe, and Al9Co2 are measured as a function of temperature between 77 and 300 K. These measurements are made with electric current being parallel and perpendicular to the fibers. Various theories are applied to the measured longitudinal and transverse electrical resistivities to obtain the resistivities of the components. This approach gives good results for the electrical resistivity of the matrix. However, the resistivity of the dispersed phase is very sensitive to the experimental error of measurements. It is found that interface effects play a very important role in the composite electrical resistivities. Der elektrische Widerstand von richtungsverfestigten eutektischen Legierungen auf Al-Basis, die Al3Ni, Al6Fe und Al9Co2 enthalten, werden als Funktion der Temperatur zwischen 77 und 300 K gemessen. Diese Messungen werden mit Stromrichtung parallel und senkrecht zur Faser durchgefuhrt. Um die Widerstande der Komponenten zu berechnen, werden mehrere Theorien fur die gemessenen longitudinalen und transversalen elektrischen Widerstandswerte benutzt. Dieses Verfahren liefert gute Ergebnisse fur die elektrische Leitfahigkeit der Matrix. Jedoch ist der Widerstand der dispergierten Phase sehr empfindlich gegenuber Mesfehlern. Es wird gefunden, das Grenzflacheneffekte eine sehr wesentliche Rolle fur die elektrischen Widerstande von Legierungen spielen.
A placebo-controlled multicenter trial of Limbitrol versus its components (amitriptyline and chlordiazepoxide) in the symptomatic treatment of depressive illness

In a multicenter, placebo-controlled, clinical trial, the efficacy of Limbitrol was compared with that of its components, amitriptyline and chlordiazepoxide. All patients had a diagnosis of primary depression. Data from 279 patients were evaluated using the Hamilton depression scale, the Beck depression inventory, and physician and patient global change measures. Statistically significant differences favoring Limbitrol occurred after 1 week of treatment, and a trend in favor of Limbitrol continued throughout the remaining 3 weeks. In most efficacy comparisons, the combination was as good as, or better than, amitriptyline alone. It was superior to chlordiazepoxide alone after 2 and 4 weeks of treatment. Each component produced an independent contribution to the total therapeutic effect: the chlordiazepoxide effect was more prominent in the first 2 weeks and the amitriptyline effect in the latter 2 weeks. A trend favoring amitriptyline over chlordiazepoxide was evident by week 4. The overall incidence of side effects was comparable in both Limbitrol- and amitriptyline-treated groups. Limbitrol-treated patients exhibited more sedation, but significantly fewer Limbitrol patients discontinued treatment prematurely because of side effects.
128 INHERITED SUSCEPTIBILITY TO AUTOIMMUNE ADDLSON'S DISEASE IS LINKED TO HLA-DR3 AND DR4

Inherited susceptibility to Addison's disease has been linked to the leukocyte antigen (HLA)-B8 allele, and by inference because of linkage disequilibrium between B8 and DR3, this susceptibility should be primarily to that of the DR3 antigen. Twenty four patients who had presented with overt Addison's disease, and another 28 patients who had been found to have adrenocortical autoantibodies, were HLA typed. Six of the Addisonian patients and 22 of the adrenal autoantibody positive patients had co-existing insulin dependent diabetes (IDD). In relation to HLA typing data from 253 Caucasian controls, Addison's disease was significantly associated with DR3 (X2 6.0 ; p = 0.014), DR4 (X2 7.4; p = 0.007) and DR3/DR4 heterozygosity (X2 25.4; p 0.0001). Of the 6 Addison's patients who lacked DR3 and DR4 alleles in their HLA phenotype, 3 had type I autoimmune polyglandular syndrome.
Soft indexing of speech content for search in spoken documents

The paper presents the Position Specific Posterior Lattice (PSPL), a novel lossy representation of automatic speech recognition lattices that naturally lends itself to efficient indexing and subsequent relevance ranking of spoken documents. This technique explicitly takes into consideration the content uncertainty by means of using soft-hits. Indexing position information allows one to approximate N-gram expected counts and at the same time use more general proximity features in the relevance score calculation. In fact, one can easily port any state-of-the-art text-retrieval algorithm to the scenario of indexing ASR lattices for spoken documents, rather than using the 1-best recognition result. Experiments performed on a collection of lecture recordings-MIT iCampus database-show that the spoken document ranking performance was improved by 17-26% relative over the commonly used baseline of indexing the 1-best output from an automatic speech recognizer (ASR). The paper also addresses the problem of integrating speech and text content sources for the document search problem, as well as its usefulness from an ad hoc retrieval-keyword search-point of view. In this context, the PSPL formulation is naturally extended to deal with both speech and text content for a given document, where a new relevance ranking framework is proposed for integrating the different sources of information available. Experimental results on the MIT iCampus corpus show a relative improvement of 302% in Mean Average Precision (MAP) when using speech content and text-only metadata as opposed to just text-only metadata (which constitutes about 1% of the amount of data in the transcription of the speech content, measured in number of words). Further experiments show that even in scenarios for which the metadata size is artificially augmented such that it contains more than 10% of the spoken document transcription, the speech content still provides significant performance gains in MAP with respect to only using the text-metadata for relevance ranking.
Prediction of Imagined Single-Joint Movements in a Person With High-Level Tetraplegia

Cortical neuroprostheses for movement restoration require developing models for relating neural activity to desired movement. Previous studies have focused on correlating single-unit activities (SUA) in primary motor cortex to volitional arm movements in able-bodied primates. The extent of the cortical information relevant to arm movements remaining in severely paralyzed individuals is largely unknown. We record intracortical signals using a microelectrode array chronically implanted in the precentral gyrus of a person with tetraplegia, and estimate positions of imagined single-joint arm movements. Using visually guided motor imagery, the participant imagined performing eight distinct single-joint arm movements, while SUA, multispike trains (MSP), multiunit activity, and local field potential time (LFPrms), and frequency signals (LFPstft) were recorded. Using linear system identification, imagined joint trajectories were estimated with 20-60% variance explained, with wrist flexion/extension predicted the best and pronation/supination the poorest. Statistically, decoding of MSP and LFPstft yielded estimates that equaled those of SUA. Including multiple signal types in a decoder increased prediction accuracy in all cases. We conclude that signals recorded from a single restricted region of the precentral gyrus in this person with tetraplegia contained useful information regarding the intended movements of upper extremity joints.
The Development of Islamic Law and Society in the Maghrib: Qād⪽īs, Muftīs, and Family Law

The development of Islamic law and society in the Maghrib: Qād⪽ī s, Muftī s, and family law, by David S. Powers, Burlington VT, Ashgate, 2011, xii and 342 pp., $149.95, ISBN 978-1-4094-0370-8 David...
Study of neutrino background to proton decay search using K2K 1kt detector data

Backgrounds for proton decay searches at Super-Kamiokande are summarized. A study of the background using the K2K 1kt detector data is described.
The resistivity of dilute magnetic alloys

Abstract The resistivity of dilute magnetic alloys is discussed in terms of a model which assumes an exchange energy only between magnetic atoms which are nearest neighbours. The perturbing potential produced by the magnetic atoms is assumed to consist of a spin-independent and a spin-dependent part. It is shown that the elastic scattering resulting from nearest-neighbour pairs of magnetic atoms contains a temperature-dependent term. It is suggested that this model might explain the occurrence of a maximum followed by a minimum in the resistivity versus temperature curve observed for some alloys.
Numerical Simulation of Magnetic Induction Heating of Tumors with Ferromagnetic Seed Implants

Calculations based on the bioheat transfer equation have been carried out to determine the temperature distributions to be expected from the use of inductively heated ferromagnetic implants to heat deep-seated tumors. Two types of ferromagnetic implants are considered: constant power seeds, for example, those constructed from Type 430 stainless steel; and constant temperature seeds which pass through a Curie transition to the nonmagnetic state at a specified temperature. The temperature distributions are studied as a function of the size of the implant array, its geometrical relationship to the tumor, the density of implants within the array, and the blood perfusion characteristics of the tumor and its surrounding normal tissue. Two tumor models are considered: a uniformly perfused model which is indistinguishable from the surrounding normal tissue, and an annular perfusion model with a necrotic core surrounded by intermediately and highly perfused shells. Temperature distributions are considered acceptable if the minimum temperature in the tumor is greater than 42°C and the maximum temperature does not exceed a maximum allowable value (either 48 or 60°C). The results of over 200 combinations of the above parameters are presented in a compact format. General conclusions drawn are that the tumor should lie entirely within the implanted array if the tumor periphery is to be heated adequately, and that the constant temperature seeds, which are self-regulating in temperature, give better tumor temperature distributions.
Chemical and sensory properties of gas‐purged, minimum‐refined, extruded‐expelled soybean oil

Developing low-cost oil refining methods is critical to business that use low-cost extrusion-expelling (E-E) to crush soybeans so they can capture the full value-added potential by marketing finished oils. Normal commodity (CO) and high-oleic (HO) E-E soybean oils were minimum-refined, gas-purged, and evaluated in frying applications. Degummed commodity oil (DCO) and minimum-refined (degummed and deacidified by Magnesol® adsorption) CO and HO oils were gas-purged with N2 for 1 h at 150°C. For DCO, gas purging did not affect PV, oxidative stability index (OSI), FFA, color, and total tocopherol content, but p-anisidine value (AV) increased. For CO, the minimum-refined, gas-purged oil did not differ from degummed, gas-purged oil in terms of p-AV, OSI, tocopherol content, and color. PV and FFA were lower in minimum-refined, gas-purged oil. Minimum-refined, gas-purged HO had much higher OSI, tocopherol, and FFA levels than did minimum-refined, gas-purged CO. The oils were used to fry bread cubes at 185°C. Fried bread cubes were stored under various conditions and evaluated for flavor attributes. These oils were different in toasty/nutty, beany/grassy, and oxidized flavors, as well as overall flavor intensity and desirability. Minimum-refined, gas-purged oils produced fried bread cubes having initial flavor profiles similar to those fried in commercial oil; however, when fresh oils were used they were less stable to oxidation. Longer heating times of the minimum-refined, gas-purged oils produced bread cubes with better oxidative stabilities than those produced with commercial oil.
Colorimetric bio-barcode amplification assay for cytokines.

The bio-barcode amplification assay has become a powerful tool in detecting tens to hundreds of biological targets such as proteins and nucleic acids in the entire sample. However, current bio-barcode detection schemes still require many experimental steps including microarrayer-based immobilization of oligonucleotides on a glass chip, silver enhancement of immobilized gold nanoparticles on a chip, and light-scattering measurement. Here, we report a colorimetric bio-barcode method that minimizes the above requirements while detecting 30 aM concentrations of cytokines (∼3 orders of magnitude more sensitive than conventional nonenzymatic cytokine detection assays). The assay is based on porous microparticles, which enable loading of a large number of barcode DNA per particle, and gold nanoparticle-based colorimetric barcode detection method.
Improving caretakers' knowledge of fever management in preschool children: Is it possible?

Abstract Introduction. The purpose of this study was to investigate caretakers knowledge of the implications of fever, the appropriate method of fever management, and the effectiveness of an educational intervention directed toward improving caretakers' ability to manage their child's fever. Method. A descriptive, comparative study was conducted with a convenience sample of 86 caretakers. Follow-up data were obtained for 50 caretakers. Data were collected with an investigator-developed open-ended questionnaire. Results. A fever of 104° F was considered to be harmful by 31 subjects. However, fever as low as 100° F was perceived to be harmful by eight subjects. Administration of acetaminophen was the most frequent method of treatment (84 [98%] of 86). No significant improvement in caretaker knowledge in terms of the level of fever at which to administer medication was demonstrated (chi-squared analysis, .012; df, 1; p = 0.91). Accuracy of antipyretic medication dosage was improved (chi-squared analysis, 13.13; df, 6; p = 0.04). Discussion. Caretakers continue to perceive even marginal fevers can cause harm. Improvement was noted in dose accuracy after the intervention. The lack of significant improvement in caretaker knowledge regarding some aspects of fever management after the educational intervention suggests that more than a one-time educational intervention is required.
The carboxy-terminal F domain of the human estrogen receptor: role in the transcriptional activity of the receptor and the effectiveness of antiestrogens as estrogen antagonists.

Of the steroid hormone receptor family members, the estrogen receptor (ER) is notable in containing a sizable (42-amino acid) C-terminal region, denoted domain F. This F region differs from its adjacent hormone-binding domain, domain E, in that it is not well conserved among different vertebrate ER species, and its role in the biological activity of the ER is not well defined. We report an important role for the F domain of the ER in modulating the magnitude of gene transcription by estrogen and antiestrogen, and in determining the effectiveness of antiestrogens in suppressing estrogen-stimulated gene transcription. Using transient transfections, we have examined, in several cell types, the transcriptional activity of the full-length wild type human ER and ER lacking the carboxy-terminal F domain (delta F ER, containing amino acids 1-554) or ER altered in the F domain by point mutations. In some cells, namely Chinese hamster ovary (CHO) cells and MDA-MB-231 human breast cancer cells expressing wild type E...
Risk-adjusted prolonged length of stay as an alternative outcome measure for pediatric congenital cardiac surgery.

Background Morbid events after pediatric congenital cardiac surgery are increasingly used for better outcome measurement and quality comparisons. This study was undertaken to evaluate the relationship between a hospital's risk-adjusted prevalence of prolonged postoperative length of stay (PLOS) and its risk-adjusted mortality rate to investigate whether PLOS can serve as an appropriate quality measure for pediatric congenital cardiac surgery. Methods Risk-adjusted prevalence of prolonged PLOS for 12 programs in New York State was estimated using data from 4,776 operations in the New York State pediatric Cardiac Surgery Reporting System (2006–2009). We used logistic regression analysis to adjust for case mix and patient risk factors. The hospital-level correlation between risk-adjusted prolonged PLOS and risk-adjusted mortality rates was examined using Spearman correlation coefficient analysis. Results Risk-adjusted prevalence of prolonged PLOS ranged from 7.48% to 36.52% for pediatric cardiac programs in New York State during the study period. The Spearman correlation test showed a strong positive relationship between a hospital's risk-adjusted prolonged PLOS and mortality rate ( r = 0.83; p = 0.0008). Conclusions Prolonged PLOS can be used in lieu of risk-adjusted mortality rates when it is not practical to use mortality rates owing to low case volume or decreasing mortality rates of some procedures.
Placental transfer of diphenylhydantoin in the goat

Abstract Constant blood levels of diphenylhydantoin (DPH) were maintained in pregnant goats by an intravenous infusion. Venous blood was sampled simultaneously from the conscious, unanesthetized mother and fetus during the infusion. Maternal serum levels of DPH were maintained at 14·8 mean, 0·82 S.E. μg/ml. At equilibration, the corresponding fetal level of DPH was 7·6 (0·44 S.E.) μg/ml. When the maternal and fetal sera were equilibrated against each other for 18 hr in vitro , the corresponding levels were found to be 13·2 mean, 1·9 S.E. and 6·9 mean, 1·6 S.E. μg/ml respectively. Differences in plasma protein concentration and binding affinity account for the observed maternal-fetal distribution of DPH. Maternal plasma binds more DPH than fetal plasma even when diluted to the same protein concentration as fetal plasma. Antipyrine, which is not appreciably bound to plasma protein at the concentrations studied, distributes equally between maternal and fetal plasma in vivo .
Designing and implementing a comprehensive learner-centered regional anesthesia curriculum.

Education experts have suggested that many doctors know what to teach, but few know how to teach.1 This statement stems from the fact that most physicians do not receive formal instruction in education theory or methodology during their own medical training. As a result, apprenticeship models of education have prevailed as the primary mode of teaching regional anesthesia to residents in-training for the past several decades. Limitations to this style of teaching include inconsistent learning experiences and limited case numbers. Recently, Richman et al2 demonstrated that a dedicated regional anesthesia rotation may increase the number of blocks performed by residents by concentrating their learning experiences into a focused period. Although this approach represents an educational step forward, most regional anesthesia curricula continue to revolve around an apprenticeship style of training. The Accreditation Council for Graduate Medical Education (ACGME) has also made attempts to improve resident education by implementing standardized education performance objectives (ie, competencies) and establishing minimum regional block numbers for anesthesia residents during the past decade (for complete explanation of ACGME competencies, see http://www.acgme.org/acWebsite/ home/home.asp). However, it has been estimated that 40% of residents lack adequate exposure or proficiency in peripheral nerve blockade. Finally, the introduction of ultrasound-guided regional anesthesia (UGRA) and the national spotlight on patient safety and quality care initiatives have introduced new challenges for regional anesthesia educators. In an effort to address these and many other concerns, we recently redesigned and implemented a new regional anesthesia curriculum within our institution. This curriculumVwhich describes a single institution’s approach to resident educationVis reviewed within this special article.
Stress-pain relationship in MPD syndrome patients and non-MPD syndrome patients

1 ff’lt o e ective y reat myofascial pain-dysfunction (MPD) syndrome, it is important to understand its etiology. Malocclusion’-” and psychologic traits’.’ have been identified as causal factors. The present study will focus on the MPD syndrome patient’s stress perception and relationship of this perception to pain assessment. Such information should be of use to dentists and other health professionals who treat MPD patients. Laskin,” for example, indicates the importance of psychophysiologic theory in the treatment of MPD syndrome. He reported that, “Initiating factors for the MPD syndrome are generally emotional, rather than physical, (and) treatment must be directed toward this aspect of the problem. . . ” syndrome patients were classified by a psychiatrist as neurotic. The remaining six patients were either psychotic or healthy. These authors note that the number of patients was too small to provide statistical evidence for clusters of these findings.
Monitoring the U.S. legal unit of resistance via the quantum Hall effect

The quantum Hall effect is being used to monitor the resistances of the five 1-Ω Thomas-type resistors which define the U.S. legal unit of resistance, the ohm maintained at the National Bureau of Standards (Ω NBS ). Typically, the total one-standard-deviation (1σ) accuracy for the transfer between three different GaAs quantum Hall devices and the five 1-Ω resistors is ±0.05 ppm. Measurements to date provide the first direct evidence that the value of Ω NBS is decreasing by about (0.05 ± 0.02) ppm per year.
Translation of unspliced transcripts after heat shock

Severe heat shocks block the splicing of intervening sequences from messenger RNA precursors. The RNA's that accumulate after a severe heat shock have normal transcription start sites and are uncut at both their 5' and 3' splice junctions. Some of these unspliced transcripts leave the nucleus and enter the pool of cytoplasmic messenger RNA. Translation of these RNA's proceeds into their intervening sequences, resulting in the production of abnormal proteins. Thus, the repression of normal transcription, which usually accompanies the heat shock response, may protect the cell from the large-scale synthesis of abnormal RNA's and aberrant proteins.
The Psychology of Residential Developers: Lessons from Behavioral Economics and Additional Explanations for Satisficing

Researchers have repeatedly observed satisficing by residential developers. The phenomenon has been attributed to their bounded rationality. In response, policy makers have designed policies that reduce risks to assist developers in overcoming bounds on their rationality. However, after decades of such policies, there is little evidence that developers have stopped satisficing. This article argues that bounded rationality is an insufficient explanation for satisficing by small developers. Lessons from behavioral economics suggest additional reasons for satisficing by developers. Satisficing is common because developers bracket projects one at a time, bracket each investment decision in isolation of others, create nonfungible investment accounts, establish self-imposed liquidity constraints, and temporally space projects. Policies that group risks to developers are likely to be the most effective. However, additional land-market-specific research is required to design policies that address these psychologi...
The dance between attending physicians and senior residents as teachers and supervisors.

OBJECTIVE: To examine how attending physicians and senior residents negotiated shared responsibilities for teaching and supervising on clinical work rounds. METHODS: As part of a larger ethnographic field study, we observed clinical work rounds on a General Pediatrics ward over 8 months, and interviewed 14 of 18 attending physicians and 9 of 11 senior residents whom we observed. Struck by the frequency of 2 codes in that data set (“stand back” and “step up”), we used the metaphor of a dance as an analytic strategy for understanding the dynamic relationship between attending physicians and senior residents. RESULTS: Like a traditional dance with a priori choreography, and consistent with the traditional premise in graduate medical education, attending physicians frequently “stood back” and senior residents, accordingly, “stepped up” and took on teaching and supervising responsibilities. Less often, both attending physicians and senior residents assumed the lead, or attending physicians stepped up rather than entrust senior residents. The complex clinical context sometimes changed the choreography. Attending physicians and senior residents understood their mutual responsibilities but were not bound by them; they improvised to maintain high-quality patient care. CONCLUSIONS: The metaphor of a dance enabled us to better understand not only how attending physicians and senior residents negotiate shared responsibilities for teaching and supervision on clinical work rounds, but also how the clinical context impacts this negotiation. A better understanding of this negotiated relationship may help to clarify assumptions and set realistic expectations for what it might take for senior residents to assume progressive responsibility for these responsibilities in today’s clinical context. * Abbreviations: GME — : graduate medical education
The uptake of purines by rat brain in vivo and in vitro.

— The uptake of [14C]guanine and some of its [14C]-labelled derivatives into rat brain was studied in vivo and in vitro. In vivo guanine, guanosine, and hypoxanthine penetrated the brain of adult rats to a very small extent. Inosine was taken up somewhat better. In young animals, also, guanosine was taken up poorly, but guanine was taken up fairly well. When guanine was administered to adult animals, only guanine was found in the brain. In young animals, by contrast, radioactivity from guanine appeared in guanosine and in guanine nucleotides, but no free guanine was found. In vitro guanine was taken up much better and, in fact, remained mostly as guanine in slices from 10-day-old rats. The in vitro conversion of guanine to GMP and its incorporation into RNA was unimpaired by the addition of unlabelled guanosine, an indication that guanine was converted directly to GMP. The uptake of guanine in vitro was not subject to competitive inhibition or influenced by the presence of dinitrophenol. This finding suggested that guanine entered the slice by simple diffusion.
Effect of mating on terminating aggregation during host colonization in the bark beetle,Ips paraconfusus.

Attraction of maleIps paraconfusus to male-infested ponderosa pine logs was inhibited by volatiles from logs infested with mated males and females over an 8-day period in the field. The response of females during this time was not significantly inhibited by these volatiles. Synthesis of the male-specific pheromones, ipsenol and ipsdienol, appeared negligible after 8 days in males allowed to mate with 3 females in these logs while males alone contained levels of these pheromones at about half their maximum rate. The decline in pheromone production in mated males appears to result, at least in part, from a reduction in the activity of the biosynthetic system that converts the host monoterpene, myrcene, to ipsenol and ipsdienol. Mating and feeding have apparently no effect on the biosynthetic system that converts the host monoterpene, (−)-α-pinene, to the pheromone,cis-verbenol in either males or females. The reduced production and release of pheromones by males after mating appears to play a major function in the process of terminating the aggregation phase of host colonization.
Soluble phosphorus release from organic soils

Abstract Soluble P release during soil organic matter decomposition was measured under fluctuating seasonal temperatures in several of Florida's organic soils. Natural soil profiles obtained from seven locations in central and south Florida were used in the study. Soil columns were leached once every 25 days, followed by applying a suction of 100 cm. Soil columns were flooded for 25 days in the months of July and August (between 14 and 21 weeks after initiation of the study for central Florida organic soils and between 11 and 18 weeks for south Florida organic soils) to simulate normal agronomic practice. The amounts of P released into effluent from Florida's organic soils were in the range of 2.9–26.2 μg P/cm 3 of soil per year (16–168 kg P ha −1 year −1 ). This represents 2.2–20% of the total soil P for central Florida organic soils and 0.75–1.1% of total soil P for south Florida organic soils. Soluble ortho-P accounted for about 70–89% of total effluent P for central Florida organic soils and 54–57% of effluent P for south Florida organic soils. Estimated soil P mineralization during organic matter decomposition was about 38–185 kg P ha −1 year −1 for central Florida organic soils and 16–23 kg P ha −1 year −1 for south Florida organic soils. Seasonal temperature fluctuations had minimal influence on the P release into effluent. Flooding the organic soils, however, increased P release into drainage effluent by about 4–8 times, compared with drained conditions.
Role of the Family in Case Management of the Mentally Ill

This article provides a systematic discussion and assessment of the actual and potential contributions that families of the chronic mentally ill can make to the case management of their patient-relatives. It examines family members' involvement with six major case management functions including assessment, linkage, monitoring, assistance with daily problems, crisis intervention, and advocacy. For each function, the authors consider the potential of family members to make a contribution, specific activities that are more appropriately assumed by professional staff, and any limitations or caveats about family members' involvement with the given case management activity. The article points out that family members are clearly quite capable of making significant contributions in almost all aspects of managing their patient-relatives and that their potential contributions are too frequently ignored or underused by professionals. The authors recommend that professionals give greater acknowledgment to the case management efforts of family members, work to integrate the contributions of these natural helpers with formal case management systems, and provide family members with the encouragement and support they need to enhance their caring contributions.
Some propositions regarding the role of information technology in the organization of economic activity

Industrial organization literature provides a comprehensive treatment of the many factors that affect the costs and risks of transacting to obtain goods and services. The authors discuss how information technology (IT) can reduce the costs and risks associated with these exogenous factors, thereby facilitating the adoption of economically efficient organizational forms. It is suggested that the firm's choice of governance structure to deal with the transactions cost stemming from various exogenous factors has been significantly altered by the increasing use of IT. IT promotes long-term cooperative relationships with the firm's business partners as a viable choice, and in fact the preferred choice, of governance structure in many cases where this was not previously the case. Except in the cases of relationship-specific investments or a small number of suppliers, IT allows the firm to deal with transaction costs in a more efficient manner than typically requires a smaller commitment of capital. >
Immunogenic Properties of Human Gamma Globulin Free of Endotoxin Contamination

SummaryHuman gamma globulin (HGG) was separated into three fractions following ultracentrifugation: (A) aggregate-free supernatant, (B) heat aggregated supernatant, and (C) sediment. The aggregate-free material proved tolerogenic in rabbits. The aggregated material was immunogenic in all rabbits tested, and the sedimented material was immunogenic in four of seven rabbits. None of these fractions were pyrogenic and therefore considered to be free of contaminating endotoxins.
Sex Differences in the Metabolic Syndrome: Implications for Cardiovascular Health in Women

BACKGROUND: The metabolic syndrome is a clinical condition characterized by the presence of multiple interrelated risk factors for type 2 diabetes and cardiovascular disease. Component features include dysglycemia, increased blood pressure, increased triglycerides, decreased HDL cholesterol concentrations, and obesity (in particular, abdominal obesity). The underlying biology, optimal diagnostic criteria, and clinical implications, once diagnosed, have been matter for intense debate. Despite these areas of controversy, there is now general consensus that the observed risk factor clustering signifies heightened cardiovascular risk. CONTENT: The influence of sex on the clinical expression and pathophysiology of the syndrome is underrecognized, and is an issue of increasing importance given the alarming increase in prevalence among young women. This minireview will highlight sex differences in the epidemiology, etiology, biology, and clinical expression of the metabolic syndrome. In particular, key sex differences include distinctions in (a) prevalence of dysglycemia, (b) body fat distribution, (c) adipocyte size and function, (d) hormonal regulation of body weight and adiposity, and (e) the influence of estrogen decline on risk factor clustering. SUMMARY: Accumulated and emerging data convincingly demonstrate that significant heterogeneity exists between men and women developing the metabolic syndrome, in large part related to hormonal regulation of body fat distribution and attendant metabolic abnormalities.
Urban Damage Estimation Using Statistical Processing of Satellite Images

Remotely sensed satellite imagery of an earthquake-affected region can significantly assist in estimating the severity of infrastructure damage. Modern high-resolution satellite systems have been launched to provide users optical imagery with submeter accuracy, which enable the possibility of sensing damage for individual structures by means of pre- and postevent imagery. Recognizing these advancements, herein, we focus our study on the region of Bam, Iran, which was devastated by a moment magnitude Mw =6.6 earthquake on December 26, 2003, causing approximately 43,200 lives lost. The recognition of urban structures within the Bam region is obtained by performing morphological filtering and intensity thresholding, which is further optimized through a statistical procedure. By overlaying the recognized structures with the pre- and postevent images, three object-based change detection methods are presented. The performance of change indices resulting from the three change detection methods is evaluated by me...
Polarization and Piezoelectric Properties of a Nitrile Substituted Polyimide

This research focuses on the synthesis and characterization of a piezoelectric (Beta-CN)-APB/ODPA polyimide. the remanent polarization and piezoelectric dsub{31}and gsub{33} coefficients are reported to assess the effect of synthesis variations. Each of the materials exhibits a level of piezoelectricity which increases with temperature. the remanent polarization is retained at temperatures close to the glass transition temperature of the polyimide.
Eating habits of elderly Vietnamese in the United States

A sample of 62 elderly from the Vietnamese Senior Citizens Association responded to a 24-hour dietary recall interview regarding their eating habits and food preferences in order to examine their health status. Results indicated that one-fifth of those sampled had milk at breakfast. The majority of elderly still consumed rice at both lunch and supper, and 94 percent did not snack. Thirty-one percent took vitamin supplements. The health problems most frequently mentioned were anemia, arthritis, hypertension, and diabetes. Research on food habits and diet in relation to diseases of this ethnic group is much needed.
Screening for Gene Regulation Mutants by Bioluminescence Imaging

Because plants cannot move, they have evolved complex sensing and response systems to cope with the physical environment. Adverse environmental conditions, such as those causing abiotic stress, often cause significant losses in crop productivity and quality. Because of a paucity of well-defined visible phenotypes, conventional genetic screens have not been very successful in isolating abiotic stress signal transduction mutants of plants. Here, we describe a reporter gene-based strategy to screen for mutants affected in abiotic stress-regulated gene transcription. Our genetic screen uses the firefly luciferase reporter gene driven by the cold, drought, salt, and abscisic acid (ABA)-responsive RD29A promoter (RD29A::LUC). Arabidopsis plants transformed with the RD29A::LUC reporter emit bioluminescence in response to cold, drought, salt, or ABA treatment. After mutagenesis of these plants with ethyl methanesulfonate (EMS), mutants can be screened from the M2 population by monitoring the level of stress-inducible bioluminescence with a high-throughput, low-light imaging system. This protocol describes in detail the procedures for this luciferase reporter-based genetic screen for Arabidopsis mutants defective in abiotic stress signaling.
Evidence-based approach to treatment of febrile neutropenia in hematologic malignancies

Applying the principles of evidence-based medicine to febrile neutropenia (FN) results in a more limited set of practices than expected. Hundreds of studies over the last 4 decades have produced evidence to support the following: (1) risk stratification allows the identification of a subset of patients who may be safely managed as outpatients given the right health care environment; (2) antibacterial prophylaxis for high-risk patients who remain neutropenic for ≥7 days prevents infections and decreases mortality; (3) the empirical management of febrile neutropenia with a single antipseudomonal beta-lactam results in the same outcome and less toxicity than combination therapy using aminoglycosides; (4) vancomycin should not be used routinely empirically either as part of the initial regimen or for persistent fever, but rather should be added when a pathogen that requires its use is isolated; (5) empirical antifungal therapy should be added after 4 days of persistent fever in patients at high risk for invasive fungal infection (IFI); the details of the characterization as high risk and the choice of agent remain debatable; and (6) preemptive antifungal therapy in which the initiation of antifungals is postponed and triggered by the presence, in addition to fever, of other clinical findings, computed tomography (CT) results, and serological tests for fungal infection is an acceptable strategy in a subset of patients. Many practical management questions remain unaddressed.
The Dirichlet-Gamma-Poisson Model of Repeated Events

A new multivariate statistical model of repeated events, the Dirichlet-gamma-Poisson model, is shown to account accurately for the multivariate distribution of four types of victimizations reported in city samples of the National Crime Survey. The lifestyle theory of victimization is used to interpret the compounding that defines the model. Parameter estimation, interpretation, and the prediction of future events based on past events are discussed. The model appears to be applicable to a variety of repeated events data.
Myosin Cross-Bridge Dynamics in Patients With Hypertension and Concentric Left Ventricular Remodeling

Background—Hypertension (HTN) causes concentric left ventricular remodeling, defined as an increased relative wall thickness or overt left ventricular hypertrophy, and associated diastolic dysfunction. HTN and concentric remodeling are also common precursors to heart failure with a preserved ejection fraction. It is not known whether the myofilament contributes to diastolic dysfunction in patients with concentric remodeling. Methods and Results—Intraoperative myocardial biopsies were obtained in 15 male patients undergoing coronary bypass grafting, all with normal left ventricular ejection fraction and wall motion. Eight patients had a history of HTN and concentric remodeling. Seven without HTN or remodeling served as controls. Myocardial strips were dissected and demembranated with detergent. Isometric tension was measured and sinusoidal length perturbation analysis performed at sarcomere length 2.2 μm and pCa 8 to 4.5. Sinusoidal analysis provides estimates of cross-bridge dynamics, including rate const...
Optimum Receiver structures for Phase-Multiplexed Modulations

The problem of deriving "optimum" receiver structures for synchronization of BPSK, QPSK, and unbalanced QPSK (UQPSK) modulations has been addressed by many authors starting with the wellknown maximum a posteriori (MAP) estimation technique as motivation. In general, the closed loop structures which result from application of this theory are impractical because of the difficulty of implementing the hyperbolic tangent nonlinearity which is suggested by using the gradient of the likelihood function as an error control signal in the loop. To arrive at practical realizations, one ordinarily approximates this nonlinearity with simpler, more easily implementable functions. This paper reexamines some of these approximations and the optimum structures which result. Using a slightly more sophisticated approximation of the nonlinearity, new and interesting structures are presented which overcome some of the deficiencies posed by MAP receiver structures for QPSK and UQPSK suggested by authors in the past. The equivalence of the QPSK structure with the well-known quadriphase Costas loop is discussed. Furthermore, it is argued that the new UQPSK structure allows carrier reconstruction at all ratios of data rates and powers in the two channels even in the limit of balanced QPSK.