cssi/SciSciGPT-SciSciNet huggingface dataset:
Differences in health care quality for children and adults under managed care: justification for separate quality assessments?

Objective.—To assess reported results of health care quality for children and adults in managed systems of care and to determine if variations exist between reported quality results for adults and children within the same plan. Methods.—We utilized Consumer Assessment of Health Plan Survey results reported from 424 managed care plans to the National Committee for Quality Assurance in 1999. Responses from 218 530 adults (515 per plan, 424 plans) and 55 081 parents of children 0–12 years of age (304 per plan, 181 plans) were available. Restricting analyses to the 178 plans reporting both adult and child results, we performed matched-pairs analyses to test the hypothesis that child results would be the same as their adult counterparts within the same plan. Regression methods were employed to test for potential demographic differences explaining observed differences. Results.—Within the same plan, reported results for care provided by specialists and primary care physicians to adults and children in the same plan revealed marked variation, including rating of doctor (Spearman correlation coefficient, rS = .504) and rating of specialist (rS = .326). Conversely, assessments of activities related directly to health plan activities showed little variation, including rating of health plan (rS = .850) and claims processing (rS = .857). Differences in demographic characteristics between adults and child survey respondents do not appear to explain observed variations. Conclusions.—Separate quality of care assessments for adults and children within the same managed care system identify significant differences in reported quality. Having health plan quality information about adult care does not serve as a proxy for needed information on children, particularly the care related to primary care and specialist providers. Areas of health plan assessment common to both adults and children (eg, claims processing) could be replaced with more targeted assessments of importance to parents and purchasers (eg, children with chronic conditions).
The renin-angiotensin system: an old, newly discovered player in immunoregulation

Clinical and experimental studies that discuss the different immune functions of the renin-angiotensin system (RAS) in kidney diseases were reviewed, with emphasis on studies of kidney transplantation. The RAS has been shown to affect both the innate and adaptive immune responses and has a well-established role in fibrinogenesis. Of special clinical interest is the ability of the RAS to activate the transforming growth factor beta(1) and the Smad pathways leading to fibrinogenesis. In addition to the RAS enhancing effect on the activity of T cells, several components of the RAS have also been shown to be chemotactic to macrophages, T cells, and natural killer cells. Experimental studies have found that RAS blockade decreases the histologic lesions of chronic allograft nephropathy but can enhance acute graft vasculopathy. Although the blockade of RAS has been commonly practiced to reduce posttransplantation hypertension, proteinuria, and erythrocytosis, however, its role in prolonging graft survival is not well established.
Increasing the output of the free-electron laser by using dielectric effects

Abstract The effect of introducing an index of refraction into the single-mode analysis of the free-electron laser is examined. We show that the saturated output of the FEL may be increased by using a thin thermal plasma in the laser cavity. The small-signal gain may be increased by using a dielectric waveguide.
A Thomas-Fermi model of nuclei. Part I. Formulation and first results☆

We formulate a Thomas-Fermi model of average nuclear properties (i.e., of nuclear masses, deformation energies, density distributions, optical model potentials, etc.) by generalizing the momentum-dependent Seyler-Blanchard effective nucleon-nucleon interaction. In addition to reproducing the binding energy, density, symmetry energy, and surface energy of nuclear matter, the generalized model can be adjusted to reproduce the diffuseness of the nuclear density distribution, as well as theoretical estimates of the binding properties of neutron matter. The depth of the nuclear optical potential, including its energy and isospin dependences, can also be reproduced. The above properties of nuclei and of neutron matter determine quite firmly the seven adjustable parameters of the theory, yielding a model that, apart from shell effects and the discreteness of nucleons, is expected to be accurate for very small or very deformed systems and to be reliable for extrapolating to extremely large hypothetical nuclei, including systems with arbitrary neutron excess and arbitrary geometries, such as those that sometimes arise in astrophysical applications. A preliminary set of the model's parameters has been determined, and one of the predictions of the theory is that the measured values of the nuclear surface energy and surface diffuseness, taken together, place a significant constraint on the value of the compressibility coefficient of standard nuclear matter. This constraint will provide a useful estimate of this quantity once the final set of adjustable parameters has been determined. The present paper is the first part in a comprehensive application of the model to conventional as well as exotic aspects of nuclear physics.
It's eleven o'clock: do you know where your identity is?

Identity theft continues to be a growing problem in our society. This paper describes a poster session that will give attendees the opportunity to consider identity issues related to campus life and how we might better educate our campus communities. We will describe what identity means, ways in which it might be abused in our campus environments, and how to balance risks and benefits. We will also provide tips on how faculty, staff, and students can better protect themselves and others. All attendees will be asked to complete an anonymous checklist to gauge how well we, as computer support professionals, protect our identities. The poster content is based on a symposium held in February 2004 on the UNC Chapel Hill campus.
Trophic ecology of two congeneric pipefishes (Syngnathidae) of the lower York River, Virginia

The northern pipefish, Syngnathus fuscus, and the dusky pipefish, S. floridae, co-exist in eelgrass beds in the lower York River. To compare the trophic ecology of both pipefishes, gut contents of 3488 northern pipefish, and 1422 dusky pipefish were examined and quantified by dry weight. Samples were taken with a dip net from May through November 1992. Syngnathus fuscus fed mainly on amphipods (Gammarus mucronatus, Amphithoe longimana, and Caprella penantis), and to a lesser degree on copepods, and isopods (Edotea spp. and Erichsonella attenuata). Syngnathus floridae fed mainly on grass shrimps (Palaemonetes pugio, P. vulgaris, and Palaemonetes eggs), and to a lesser degree on copepods, isopods, and mysids (Mysidopsis bigelowi). No seasonal trends were observed in the feeding habits of these pipefishes. Specimens of both species smaller than 100 mm TL fed mainly on copepods. Larger S. fuscus fed on amphipods, while larger S. floridae fed on grass shrimps. Schoener's diet overlap index revealed high consumption of the same prey type by both pipefish species only in July, but only for those specimens smaller than 110 mm TL. Food partitioning between both pipefish was associated with different snout sizes and shapes.
Crimean–Congo hemorrhagic fever virus genome L RNA segment and encoded protein

Sequence analysis of the L RNA genome segment and predicted encoded L polymerase protein of Crimean-Congo hemorrhagic fever (CCHF) virus (genus Nairovirus, family Bunyaviridae) demonstrates that they are approximately twice the size of those found in viruses of other bunyavirus genera. The CCHF virus L segment and encoded protein (12,164 nucleotides and 3944 amino acids, respectively) are similar in size and sequence to those of the nairovirus Dugbe virus (12,255/62% and 4036/62% nucleotide and amino acid length/identity, respectively). The identification of an ovarian tumor (OTU)-like protease motif in the L protein amino termini of the nairoviruses Dugbe, CCHF, and Nairobi sheep disease (NSD) indicates these proteins are members of the recently described OTU-like protease family and suggests that these large proteins may be polyproteins that are autoproteolytically cleaved or involved in deubiquitination.
Converging, pervasive technologies: chronic and emerging issues and policy adequacy.

This article is a thought piece with the expansive goal of identifying policy facilitators and barriers to the development of usable and accessible advanced information and communications technology for people with disabilities across the age span at the research and development and marketing stages. The working hypothesis is as follows: The lack of participation in and representation of the interests of people with disabilities in the technology resource system is a barrier to availability of affordable consumer goods that enable independence and community integration. Converging, pervasive computing technology, especially in housing applications, is used as a case example, drawing especially from research and development conducted by the National Science Foundation Quality of Life Technology Engineering Research Center. A critical theory approach is used to identify problems and seek solutions to the apparent lack of balance between the demand and needs of disabled users and the supply and availability ...
Analysis of failed aircraft wheel assembly

Abstract A failed wheel assembly from a Hawker 125-800XP corporate passenger jet was investigated to determine the root cause of the failure. Different levels of damage sustained by the 12 tie bolt/nut couples that had held the flange to the wheel showed that failure was a cascading sequence that began at one couple and spread to adjacent couples. The suspected initiating bolt/nut couple showed stepped threads on one side of the bolt, the characteristics of which suggested that the nut had cracked, disengaged, and induced the failures of the other bolt/nut couples. Since the nut was not available for examination, our conclusion that the root cause of failure was a cracked nut could not be confirmed. Somewhat later, however, a cracked nut was observed in another wheel assembly. Examination of the bolt showed similar thread deformation, supporting the initial conclusion. The nut fracture surfaces showed an intergranular region surrounded by a ductile field – most likely the crack initiation site where the grain boundaries were weak. In our expert opinion, the root cause of the wheel assembly failure was a cracked nut that may have been embrittled by hydrogen during cadmium plating.
Biradical spin dynamics with distance-dependent exchange interaction and electron transfer efficiency

Abstract The spin dynamics and reaction kinetics of photogenerated zwitterionic biradicals of the type 2A−(CH2)n2D+ (n = 8, 9, 10) are described for a model which assumes the same AD distance dependence for a “through space” exchange interaction and for the efficiency of electron back-transfer to the singlet ground state 1A(CH2)n1D and to a triplet excited state 3A*(CH2)n1D. The model is independent of the length n of the polymethylene chain and accounts well for the three type of observation on the biradicals: the mono-exponential character of the biradical decay, the life time associated with this decay, and the magnetic field dependence of the yield of the triplet excited state.
The real price of the dead past: a reply to Forrest and to Braddon‐Mitchell

David Braddon-Mitchell's recent paper begins, 'Many philosophers have found a theory of time that shares features of four dimensionalism with an account of the genuine passage of time to be attractive' (2004: 199). I was once one such philosopher. But then I read the rest of BraddonMitchell's paper and was convinced that this combination of views is untenable.' It implies that it is almost certainly not now now.2 Braddon-Mitchell's particular target is the Growing Block Theory, according to which the past is real, the future is not, and the present is to be identified with that hyperplane of space that is the leading edge of the growing four-dimensional block that is our universe. If the Growing Block Theory is true, then we have no reason to think that this moment, the moment we are all in right now, is the present moment. For all we know, some moment in the thirty-seventh millennium is currently at the leading edge, and so it is the real present, you and I being ancient history. Our evidential situation is no better than the current one of Caesar, crossing the Rubicon in 49 Bc, believing falsely that he is doing so in the present. But (to conclude the argument) scepticism about whether one exists in the present is absurd. Any view that allows such scepticism is unacceptable. Braddon-Mitchell considers a way, due to Peter Forrest (forthcoming), for the Growing Block Theorist to stop this argument: the Dead Past Hypothesis. According to the Dead Past Hypothesis, life and consciousness are 'by-product[s] of the causal frisson that takes place on the borders of being and non-being' (Braddon-Mitchell 2004: 201). On this view, only those beings on the leading edge of the universe, and so in the objective present, can be conscious and living. The Growing Block Theorist can then block the road to scepticism by deriving knowledge that one is in the present from knowledge that one is conscious. We are different from Caesar because he's now a Zombie and we're not.
Sensitivity and permeability of the anthramycin producing organism Streptomyces refuineus to anthramycin and structurally related antibiotics.

Streptomyces refuineus, the microorganism which produces the DNA reactive antibiotic anthramycin, has been shown to possess a quite specific mechanism to survive and grow in the presence of this antibiotic. Stationary phase cells are insensitive to anthramycin since the antibiotic is prevented from entering these cells. However, cells in early log phase are inhibited by concentrations of anthramycin that are later produced by these same cells. Significantly, sibiromycin, a closely related antibiotic, is taken up by cells of S. refuineus independent of the age of the culture. Anthramycin reacts in vitro equally as well with DNA isolated from S. refuineus and other procaryotic and eucaryotic cells. When S. refuineus has reached the production phase the anthramycin is probably biosynthesized outside the cell membrane which also becomes specifically impermeable to anthramycin.
HAPLOIDENTICAL BONE MARROW TRANSPLANTATION OF CHILDREN WITH X-LINKED SCID USING BONE MARROW DEPLETED OF T-CELLS BY CENTRIFUGAL ELUTRIATION. •69

HAPLOIDENTICAL BONE MARROW TRANSPLANTATION OF CHILDREN WITH X-LINKED SCID USING BONE MARROW DEPLETED OF T-CELLS BY CENTRIFUGAL ELUTRIATION. • 69
Radiation-induced Damage in Vegetative Tissues of Pinus rigida Mill

Epicormic sprouts were collected from Pinus rigida trees growing at different levels of chronic Cesium-137 radiation (1.6-13.5R/day) in the Ecology Forest, located on Long Island.Cytological examination of the meristematic area at the base of developing needles showed that the frequency of nuclear damage of all types was rather high at low levels of exposure, and increased with increasing exposure. Average diameters of resin ducts in irradiated sprouts were twice the average found in control material; a physiological indication of injury or damage to the irradiated trees.The high degree of radiosensitivity during the mitotic process is in agreement with previous reports of the radiosensitivity of P. rigida during meiosis.
A malonic ester-type synthesis with 4-chloroquinoline utilizing highly acidic enols

A synthetic method of attaching carbon-chain substituents to the 4-position of the quinoline ring was developed. In our approach enolate anions were generated from highly acidic enols under conditions in which the 4-chloroquinoline can be N-acylated or N-protonated. Isopropylidene alkyl(4-quinolyl)malonates or 5-alkyl-5-(4-quinolyl)barbituric acids were obtained from the reaction of 4-chloroquinolines with isopropylidene alkylmalonates in acetic anhydride or with 5-alkylbarbituric acids by heating in the absence of solvent. Some of the products were hy-drolyzed and decarboxylated to give the corresponding 4-alkylated quinolines.
Afrotarsius chatrathi , first tarsiiform primate (? Tarsiidae) from Africa

Tarsiiform primates have long been regarded as a Laurasian group, with an extensive fossil record in the Eocene of North America and Europe1–4 and two important but less well-known records from Asia5,6. The only living genus is Tarsius (Tarsiidae), whereas all of the fossil tarsier-like primates are usually placed in the extinct family Omomyidae3. We now report the discovery of Afrotarsius chatrathi from early Oligocene rocks of Fayum Province, Egypt. This is the first known tarsiiform primate from Africa. Compared with fossil primates, the molar tooth morphology of this diminutive prosimian is most similar to that of the European Eocene microchoerine Pseudoloris; however, the closest similarity is to the molars of Tarsius. Because the phylogenetic relationships among living Tarsius and the omomyids remain unclear7,8 and because of the fragmentary nature of the only known specimen of this new primate, allocation of Afrotarsius to either Omomyidae or Tarsiidae is necessarily provisional. As we believe that its molar teeth are more like those of Tarsius than of any omomyids (including Pseudoloris), we tentatively assign the new genus to the extant family Tarsiidae as its only known fossil representative. Recovery of a Tarsius-like primate from Africa suggests that it or its ancestors might have been immigrants from Europe, may have been derived from an unknown Asian stock related to the ancestry of Tarsius, or may have originated in Africa.
Triangular current-sweep chronopotentiometry at rotating disk and stationary, planar electrodes

Abstract A convenient series solution is presented for the evaluation of reactant and product concentrations during triangular current-sweep chronopotentiometry at a rotating disk electrode and at a stationary, planar electrode in the absence of free convection. The advantages of controlled-current processes, relative to controlled-potential processes, for otaining kinetic, thermodynamic, and transport information are elucidated. Theoretical predictions are compared with results obtained for the deposition of cadmium from a dilute, aqueous, cadmium sulfate + potassium sulfate electrolyte. A multidimensional optimization routine, the Levenberg-Marquardt algorithm, is used to evaluate physicochemical parameters.
Social Capital, Volunteering, and Charitable Giving

This paper explores the impact of social capital—measured by social trust and social networks—on individual charitable giving to religious and secular organizations. Using United States data from the national sample of the 2000 Social Capital Community Benchmark Survey, we find that social trust, bridging social network, and civic engagement increase the amount of giving to both religious and secular causes. In contrast, organizational activism only affects secular giving. Volunteering activity, and human and financial capital indicators positively affect both religious and secular giving. Finally, those who are happy about their lives and those who are religious give more to religious causes, but these factors do not affect secular giving. We find evidence of important differences in the determinants of religious and secular giving, suggesting the need to distinguish these two types of charitable giving in future work.
Receptor targeting and heterogeneity at interneuronal nicotinic cholinergic synapses in vivo

Within a single neuron the correct targeting of the diverse neurotransmitter receptor types to discrete synaptic regions is crucial for proper function. However, the molecular mechanisms that underlie neuronal receptor clustering and targeting are still largely undefined. Here we report advances in defining the mechanisms that mediate nicotinic acetylcholine receptor (nAChR) targeting to interneuronal synapses. Recent in vivo studies have demonstrated that one subunit plays a critical role in the differentiation of nicotinic cholinergic synapses on vertebrate autonomic neurons. The major cytoplasmic loop of the α3 subunit targets specific nAChR subtypes to the synapse. In contrast, nAChR complexes that lack the α3 targeting domain are excluded and are perisynaptic. Additional studies have demonstrated a greater complexity to α3-nAChR targeting due to a unique postsynaptic receptor microheterogeneity – under one presynaptic terminal, α3-nAChR clusters are separate, but proximal to, glycine receptor (GlyR) clusters in discrete postsynaptic membrane microregions. The surprising coexistence under one nerve ending of separate clusters of receptors that respond to different fast-acting transmitters with opposing functions may represent a novel mechanism for modulating synaptic activity. Overall, the receptor targeting and clustering studies reviewed in this issue suggest that a common mechanism underlies the formation of the diverse types of interneuronal synapses but differs from that responsible for neuromuscular junction assembly in vertebrates.
Serial sections of vaccinia virus examined at one stage of development in the electron microscope

Abstract Two clusters of intracytoplasmic viral particles are illustrated in eight consecutive serial sections. The sections average 30–33 mμ in thickness. The viral particles are spherical with diameters varying from 200–240 mμ. They possess a dense, limiting membrane 9–12 mμ thick. All particles sectioned five or more times can be shown to contain a nucleoid at one stage of development.
Medical costs in community subjects with irritable bowel syndrome.

Abstract Background & Aims: Costs of management of irritable bowel syndrome (IBS) are unknown. The direct medical charges in community subjects with IBS were estimated. Methods: An age- and sex-stratified random sample of residents of Olmsted County, Minnesota, ranging in age from 20 to 95 years, was mailed a valid self-report questionnaire. Subjects were categorized as having IBS, having some symptoms but inadequate criteria for IBS, and controls. All charges (in 1992 U.S. dollars) for health services rendered in the year before completing the survey were obtained (except outpatient medications). Results: A total of 88% of subjects with IBS, 86% of subjects with some symptoms of IBS, and 83% of controls incurred direct medical charges during the study year. The odds of incurring charges were 1.6 times greater in subjects with IBS relative to those without symptoms (P
Effects of Moist Convection on Hurricane Predictability

This study exemplifies inherent uncertainties in deterministic prediction of hurricane formation and intensity. Such uncertainties could ultimately limit the predictability of hurricanes at all time scales. In particular, this study highlights the predictability limit due to the effects on moist convection of initial-condition errors with amplitudes far smaller than those of any observation or analysis system. Not only can small and arguably unobservable differences in the initial conditions result in different routes to tropical cyclogenesis, but they can also determine whether or not a tropical disturbance will significantly develop. The details of how the initial vortex is built can depend on chaotic interactions of mesoscale features, such as cold pools from moist convection, whose timing and placement may significantly vary with minute initial differences. Inherent uncertainties in hurricane forecasts illustrate the need for developing advanced ensemble prediction systems to provide event-dependent probabilistic forecasts and risk assessment.
Ritual Male Infant Circumcision and Human Rights

Opponents of male circumcision have increasingly used human rights positions to articulate their viewpoint. We characterize the meaning of the term "human rights." We discuss these human rights arguments with special attention to the claims of rights to an open future and to bodily integrity. We offer a three-part test under which a parental decision might be considered an unacceptable violation of a child's right. The test considers the impact of the practice on society, the impact of the practice on the individual, and the likelihood of adverse impact. Infant circumcision is permissible under this test. We conclude that infant circumcision may be proscribed as violating local norms, even though it does not violate human rights.
Toward meaningful computing

Computer science can revolutionize the humanities as it has the hard sciences by revealing and contextualizing the meaning hidden in digital libraries.
Testing mode of inheritance of a candidate mutation at a quantitative trait locus.

Here is presented an approach to testing whether the effect of a candidate gene on a quantitative trait is dominant and for testing whether the effect is recessive. The approach uses parental genotype information in nuclear families to adjust for bias due to population admixture. The approach is applicable regardless of the nature of the sampling. The results of an application of the methods to a candidate mutation for diabetic nephropathy are used for illustration.
Enhancing the Validity and Utility of Randomized Clinical Trials in Addictions Treatment Research: III. Data Processing and Statistical Analysis

Purpose This is the third paper in a series that reviews strategies for optimizing the validity and utility of randomized clinical trials (RCTs) in addictions treatment research. Whereas the two previous papers focused on design and implementation, here we address issues pertaining to data processing and statistical analysis. Scope Recommendations for enhancing data quality and utility are offered in sections on data coding and entry; and data format, structure and management. We discuss the need for preliminary data analyses that examine statistical power; patterns of attrition; between-group equivalence; and treatment integrity and discriminability. We discuss tests of treatment efficacy, as well as ancillary analyses aimed at explicating treatment processes. Conclusions Safeguards are necessary to protect data quality, and advance planning is needed to ensure that data formats are compatible with statistical objectives. In addition to treatment efficacy, statistical analyses should evaluate study internal and external validity, and investigate the change mechanisms that underlie treatment effects.
Jolly fat rats? The effects of diet-induced obesity on territorial fighting

In experiment 1, pairs of young male rats became obese on a palatable and complex diet high in fat, sucrose, and protein. The obese pairs exhibited greater within-group weight variability and, when tested as adults, were significantly more aggressive toward an unfamiliar conspecific than chow-fed controls. The increased aggressivity of obese males was not due to the relatively larger resident-intruder weight disparities in these pairs, since weight-matched pairs of unfamiliar animals were as aggressive toward each other as pairs not matched in body weight (experiment 2). The complex and calorically dense diet may have accelerated the development of the experimental animals, producing subjects whose aggressivity was comparable to that of much older animals.
Phase textures induced by dc-current pair breaking in weakly coupled multilayer structures and two-gap superconductors.

We predict the current-induced formation of equilibrium phase textures for a multicomponent superconducting order parameter. Using the two-component Ginzburg-Landau and Usadel equations, we show that, for weakly coupled comoving superconducting condensates, the dc current $I$ first causes the breakdown of the phase-locked state at $Ig{I}_{c1}$ followed by the formation of intrinsic phase textures well below the depairing current ${I}_{d}$. These phase textures can manifest themselves in multilayer structures, atomic Bose condensate mixtures in optical lattices, and two-gap superconductors, particularly ${\mathrm{MgB}}_{2}$, where they can result in oscillating and resistive switching effects.
Organizational Policy Communication Research: Challenges, Discoveries, and Future Directions

This article reports a review of empirical research on policy, organizations, and communication. Ninety-nine articles were coded in four emergent research themes that included constitutive topics: (1) framing, with process and perceptions; (2) identity management, with organizational identity and individual identity; (3) multiple stakeholder decision-making, with structure/process and voice/power; and (4) contradictions, with intrasystem and intersystem contradictions. The discussion offers implications for research and practice.
Patriotic Education in Russia: Stylistic Move or a Sign of Substantive Counter-Reform?

Abstract In recent times, few aspects of moral education have drawn the attention of Russian officials as has patriotic education. The new steps in patriotic education demonstrate the revival of the policy of State Patriotism that had been challenged for a short period at the beginning of educational reforms in the 1990s. The revitalization of traditionalist paradigms in moral education calls into question initially declared efforts to build democratic non-totalitarian schools in Russia.
Composite laminated shells under internal pressure

A theoretical study is conducted of the response of filament-wound composite shells under internal pressure; a system of sixth-order ordinary differential equations is obtained by means of the cylindrically anisotropic elasticity field equations and Lekhnitskii's (1963) stress functions. The general expressions for the stresses and displacements in the laminated composite shells under internal pressure are discussed. Attention is given to the influence of the degree of material anisotropy and fiber orientation on the axial and induced twisting deformation.
The Mindset of Teachers Capable of Fostering Resilience in Students

The assumptions educators possess about themselves, their role as teachers, and their students' capabilities play a significant role in determining expectations, teaching practices, and ultimately student happiness and success. This article provides an overview of the application of resilience principles in the classroom from the perspective of the mindset of effective educators. In their efforts to nurture resilience in their students, effective educators appreciate the life-long impact they have on students, acknowledge that all students want to be successful, and appreciate that the foundation for successful learning in a safe and secure classroom climate is the relationship they forge with students. Ideas and strategies are offered to assist teachers in developing a mindset capable of fostering resilience in students.
Does the use of new intracoronary interventional devices prolong radiation exposure in the cardiac catheterization laboratory

Abstract Objectives . The aim of this study was to the duration of radiation exposure associated with new percutaneous coronary interventional devices with that associated with convention balloon angioplasty. Background . Radiation exposure levels has been documented to be higher with coronary balloon angioplasty than with routine diagnostic coronary angiography. However, the effect of new interventional devices on radiation exposure has not been studied. Methods . Fluoroscopic and cineangiographic data from the Mayo Clinic cardiac catheterization laboratory data base of patients having single-segment coronary intervention during a recent 46-month period were retrospectively analyzed. Of 897 patients studied, 646 underwent balloon angioplasty, 138 directional coronary atherectomy (42 with adjunctive balloon angioplasty), 76 excimer laser angioplasty (50 with adjunctive balloon angioplasty) and 37 placement of an intracoronary stent (16 emergencies). Results . Duration of fluoroscopy during balloon angioplasty was 24 ± 18 min, which was longer than with directional atherectomy (18 ± 8 min; p = 0.001). Fluoroscopy time was 25 ± 17 min with laser angioplasty and 29 ± 15 min with elective stent placement (neither time was significantly different from that with balloon angioplasty). When atherectomy or laser angioplasty was performed with adjunctive balloon angioplasty or if emergency intracoronary stent placement was performed, the duration of fluoroscopy was significantly prolonged compared with balloon angioplasty alone. Conclusions . Fluoroscopy duration is not prolonged with the use of new interventional coronary devices compared with conventional angioplasty unless adjunctive balloon angioplasty is used or emergency stent placement is required.
The effects of varying doses of delta 9-tetrahydrocannabinol on the human visual and somatosensory evoked response.

Abstract The present study was designed to determine the effects of varying oral doses of Δ 9 -THC on the human visual and somatosensory evoked response. Two groups of 10 subjects were studied. One group reported smoking marijuana at least twice a week (frequent user group) while subjects in the second group reported their marijuana use did not exceed twice per month (occasional user group). Δ 9 -THC was extracted from raw marijuana plant material and administered orally on sugar cubes in doses of 0.2, 0.4 and 0.6 mg/kg. All subjects received each dose of Δ 9 -THC and a placebo in a randomized sequence. Recording sessions were separated by at least one week. Data are reported for visual and somatosensory evoked responses recorded from frontal, central and occipital scalp 4 h after drug administration. For each response recorded under drug and placebo conditions amplitudes and latencies of consistently identifiable wave components were calculated and analyzed. No consistent evoked response differences were found between the frequent and occasional user groups. The most prominent finding was the consistency with which Δ 9 -THC slowed the latency of evoked response waves while producing relatively little change in amplitude. In contrast, most drugs have been found to exert their main effects on evoked response amplitude with only slight alterations of latency. It was thus hypothesized that Δ 9 -THC acts to increase the threshold of cortical and subcortical neurons or neural networks involved in producing the evoked response rather than to selectively inhibit brain-stem centers. Δ 9 -THC administration produced no evidence of an excitatory action on the central nervous system. In those infrequent instances in which Δ 9 -THC did produce a change in evoked response amplitude it was always a decrease. Unlike alcohol, Δ 9 -THC did not alter amplitude hemispheric asymmetry.
Characterization of phospholipase C-mediated phosphatidylinositol degradation in rat heart ventricle.

Abstract Phosphoinositide-speciflc phospholipase C (PI-PLC) activity was investigated in the rat heart ventricle. Incubation of ventricle homogenate or 100,000g supernatant fraction with [3H]myoinositol or [3H]arachidonate-labeled phosphatidylinositol in the presence of Ca2+ resulted in a decrease in phosphatidylinositol with a concomitant increase in water-soluble [3H]inositol phosphate or [3H]diglyceride, respectively. Total overt homogenate PI-PLC activity could be accounted for in the supernatant fraction. Neutral, zwitterionic, cationic, or anionic detergents did not unmask membrane-associated activity. While cytosolic phospholipase C was active against a pure phosphatidylinositol substrate in the presence of Ca2+, no hydrolytic activity was detected when phosphatidylinosito was presented as a component (4–5%) of a mixture of phospholipids. However, addition of deoxycholate to the incubation mixture (pH 6.5, Ca2+10−3 m ) containing mixed phospholipids resulted in the exclusive hydrolysis of inositol phospholipids. Ventricular supernatant phospholipase C-mediated phosphatidylinositol degradation has a sharp pH optimum at 5.5 and a specific requirement for Ca2+. Activity is maximal at 1 to 2 × 10−3 m Ca2+, with inhibition occurring at higher levels. Under optimized conditions phosphatidylinositol is hydrolyzed at a rate of 20–25 nmol/min/mg protein. Multivalent cations inhibit Ca2+-dependent PI-PLC activity while monovalent cations and anions have no effect. There is no apparent selectivity for specific fatty acid moieties on phosphatidylinositol. Soluble PI-PLC is inhibited by sulfhydryl reagents, neomycin, mepacrine, trifluoperazine, and propranolol. Chlorpromazine, dibucaine, and tetracaine exert a biphasic influence, stimulating at lower and inhibiting at higher concentrations.
Impact of electronic medical record integration of a handoff tool on sign-out in a newborn intensive care unit

Impact of electronic medical record integration of a handoff tool on sign-out in a newborn intensive care unit
On mode mixing effects in absorption-emission spectra and resonance Raman excitation profiles

Abstract The Dushinsky effect is studied in absorption and fluorescence spectra and in resonance Raman excitation profiles of totally-symmetric fundamentals, overtones and combination bands. It is demonstrated that even for strong mode mixing the absorption or emission spectrum of a strongly allowed electronic transition can be analyzed in terms of displaced harmonic oscillators, but in that case the displacement parameters for the two spectra will be quite different. If no emission spectrum can be obtained, Raman excitation profiles of combination bands provide a sensitive probe of mode mixing.
The thermal denaturatlon of DNA: average length and composition of denatured areas

Abstract A spectral study of melting curves of DNA ranging from 73 to 32% AT indicates that the base ratio of sequences melting within DNA are a linear function of temperature. A study of partially denatured DNA by electron microscopy, reversible renaturation and fractionation on hydroxylapatite suggests that the melting curve of DNA represents the melting of sequences which average 3-4 million daltons in length. These sequences appear to be a combination of two areas, one which is high in AT and denatures in the first three-quarters of the melting curve, and one which is high in GC and denatures in the final quarter. The length of these sequences appears to vary between 1.5-6 million daltons.
An asynchronous solver for systems of ODEs linked by a directed tree structure

Abstract This paper documents our development and evaluation of a numerical solver for systems of sparsely linked ordinary differential equations in which the connectivity between equations is determined by a directed tree. These types of systems arise in distributed hydrological models. The numerical solver is based on dense output Runge–Kutta methods that allow for asynchronous integration. A partition of the system is used to distribute the workload among different processes, enabling a parallel implementation that capitalizes on a distributed memory system. Communication between processes is performed asynchronously. We illustrate the solver capabilities by integrating flow transport equations for a ∼17,000 km2 river basin subdivided into 305,000 sub-watersheds that are interconnected by the river network. Numerical experiments for a few models are performed and the runtimes and scalability on our parallel computer are presented. Efficient numerical integrators such as the one demonstrated here bring closer to reality the goal of implementing fully distributed real-time flood forecasting systems supported by physics based hydrological models and high-quality/high-resolution rainfall products.
Successful Short-Term Suppression of Clarithromycin-Resistant Mycobacterium avium Complex Bacteremia in AIDS

During a randomized study of clarithromycin plus clofazimine with or without ethambutol in patients with AIDS and Mycobacterium avium complex (MAC) bacteremia, eight participants received additional antimycobacterial drugs following the detection of a clarithromycin-resistant isolate (MIC, > 8 micrograms/mL). A macrolide (seven received clarithromycin, one azithromycin) and clofazimine were continued; additional treatment included various combinations of ethambutol, ciprofloxacin, amikacin, and rifabutin. After the detection of a resistant isolate and before receipt of additional antimycobacterials, the median peak MAC colony count in blood was 105 cfu/mL (range, 8-81,500 cfu/mL). After additional antimycobacterials, the median nadir MAC colony count was 5 cfu/mL (range, 0-110 cfu/mL). Five (63%) of eight patients had a > or = 1 log10 decrease, including two who achieved negative blood cultures; all of these responses occurred in patients originally assigned to clarithromycin plus clofazimine. Treatment of clarithromycin-resistant MAC bacteremia that emerges during clarithromycin-based treatment can decrease levels of bacteremia and transiently sterilize blood cultures.
An introduction to fault tolerant parallel simulation with EcliPSe

The paper presents an overview of the ACES parallel software system and, in particular, an introduction to the EcliPSe layer of the system. The ACES system is a fault tolerant, layered software system for heterogeneous network based cluster computing. The EcliPSe toolkit, which resides on an upper layer, was constructed specifically for replication based and domain decomposition based simulation applications. It is not, however, restricted to simulations and supports any message passing form of parallel processing. By taking advantage of networks of heterogeneous machines, generally "idle" workstations, EcliPSe programs can achieve supercomputer level performance with little programming effort-that is, low programming effort was a motivating factor in EcliPSe's design. We present an overview of key application level features in EcliPSe, support for fault tolerant simulation, and performance results for three simple but large scale and representative experiments.
Evolving Accounting Systems Research with Business Measurement Practice— A Letter from the Editor

Accounting, the science of organization measurement, is at a threshold of change. It either substantially changes or becomes irrelevant as an external corporate measurement. While external reporting has remained rather stationary and consequently has lost much of its relevance internal reporting with the adoption of ERPs, and the substantive computerization of business processes has become dynamic and creative. While instruction in Management Accounting still has some of its traditional cost emphasis, corporate practices related to the measurement of business processes have evolved fundamentally: (1) from the financial area to a wide scope of non-financial measurements, (2) in timing from quarterly to very rapid reporting, and in type from manual transaction processing to transaction, business process and account monitoring.
Direct field-feedback control for multi-DOF spherical actuators

This paper presents an alternative control strategy for permanent magnet (PM) based spherical actuators capable of multi-DOF precision manipulation. Unlike existing control methods which rely on separate sensing systems, this direct approach utilizes magnetic field measurements for feedback and eliminates the complicated multi-DOF orientation detection in closed-loop control which may cause time-delay and affect system sampling rate. By capitalizing on the rotor magnetic field implicit dependence on orientation, the control law derivation and torque coefficient estimation can be obtained simultaneously and directly from field measurements without explicit determination of the rotor orientation, thereby improving computational efficiency and eliminating error accumulation. The control method is simulated in 2-DOF motion with a CAD model of a spherical actuator.
How personal and standardized coordination impact implementation of integrated care

Integrating health care across specialized work units has the potential to lower costs and increase quality and access to mental health care. However, a key challenge for healthcare managers is how to develop policies, procedures, and practices that coordinate care across specialized units. The purpose of this study was to identify how organizational factors impacted coordination, and how to facilitate implementation of integrated care. Semi-structured interviews were conducted in August 2009 with 30 clinic leaders and 35 frontline staff who were recruited from a convenience sample of 16 primary care and mental health clinics across eight medical centers. Data were drawn from a management evaluation of primary care-mental health integration in the US Department of Veterans Affairs. To protect informant confidentiality, the institutional review board did not allow quotations. Interviews identified antecedents of organizational coordination processes, and highlighted how these antecedents can impact the implementation of integrated care. Overall, implementing new workflow practices were reported to create conflicts with pre-existing standardized coordination processes. Personal coordination (i.e., interpersonal communication processes) between primary care leaders and staff was reported to be effective in overcoming these barriers both by working around standardized coordination barriers and modifying standardized procedures. This study identifies challenges to integrated care that might be solved with attention to personal and standardized coordination. A key finding was that personal coordination both between primary care and mental health leaders and between frontline staff is important for resolving barriers related to integrated care implementation. Integrated care interventions can involve both new standardized procedures and adjustments to existing procedures. Aligning and integrating procedures between primary care and specialty care requires personal coordination amongst leaders. Interpersonal relationships should be strengthened between staff when personal connections are important for coordinating patient care across clinical settings.