cssi/SciSciGPT-SciSciNet huggingface dataset:
High Performance Development for High End Computing With Python Language Wrapper (PLW)

This paper presents a design and implementation of a system that leverages interactive scripting environment to the needs of scientific computing. The system allows seamless translation of high level script codes to highly optimized native language executables that can be ported to parallel systems with high performance hardware and potential lack of the scripting language interpreter. Performance results are given to show various usage scenarios that differ in terms of invested programmer's effort and resulting performance gains.
Future management opportunities for minorities in managed care.

Current proposals for health care reform emphasize managed care in an effort to achieve universal coverage and access to health care for all Americans. One of the many strategies to achieve this goal is to create a new health care workforce by supporting the recruitment and education of health professionals from population groups underrepresented in health care. To help insure that the managed care industry will be adequately prepared to face the challenges of reform, the Group Health Foundation of the Group Health Association of America, Inc., has crafted an innovative Minority Training Program—a management training program in the field of managed care. The program involves resident fellows who will train in select health maintenance organizations (HMOs) in the Washington, DC/Baltimore metropolitan area. To augment training, the fellows will simultaneously participate in a comprehensive didactic program especially designed to prepare each fellow for a first or middle-management position in an HMO or a similar managed care organization. Following successful completion of the first years in Washington, DC, the program will be broadened to other geographical areas.
Fungal symbionts maintain a rare plant population but demographic advantage drives the dominance of a common host

Summary 1. A potential driver of species abundance that remains understudied is the interaction between host species and their microbial symbionts. Beneficial symbionts could promote the dominance of common host species by increasing their population growth rates more than they do for rare species, and symbiont benefits could be important for maintaining rare species in communities. Alternatively, intrinsic differences in demography, independent of interactions with symbionts, could be the main driver of species’ relative abundances. 2. Here, we used demographic modelling with 5 years of data from experimental host populations to compare how symbiotic fungal endophytes, which are vertically transmitted from parent plant to offspring, influenced the population dynamics of one pair of co-occurring, congeneric rare versus common host grasses (genus Poa). 3. The common plant species achieved higher population growth than the rare species. Endophyte symbiosis increased the geometric population growth rate (k) of rare and common species by 18% and 32%, respectively, but only the rare species was predicted to decline (k < 1) in the absence of the endophyte, demonstrating that symbiosis was essential to maintain this species in the community. 4. Endophyte symbiosis differentially affected the demographic transitions of the two hosts, increasing survival and growth for the common host, Poa sylvestris, and increasing survival but decreasing the probability of flowering for the rare host, Poa alsodes. The total contribution of the endophyte effects on host demographic rates to the overall difference in population growth between host species was small compared to the plants’ intrinsic differences in demography. However, low rates of vertical transmission in P. sylvestris lessened its advantage in intrinsic demography over P. alsodes and thus decreased the projected difference in population growth between host plants. 5. Synthesis. Our results highlight the importance of plant–symbiont interactions in the persistence of a rare plant population, as well as the utility of demographic models in teasing apart the relative importance of plant demographic rates versus host–symbiont interactions on the regional abundance of rare and common host plant species.
Wide area power system transient stability assessment using catastrophe theory method and synchrophasors

This paper presents a real time power system transient stability assessment method using synchrophasor data and the catastrophe theory. It is designed to satisfy the requirement of real time stability assessment in the wide area power system. Different from conventional approaches the proposed method does not consider the process of system operation by certain parameter values but by the concept of continuity of system operation. The stability margin is defined by discontinuity boundary. This feature can greatly simplify the complicity of defining the stability margin for different cases. In this paper the discontinuity of the maximum swing angle has been studied for the power system TSA. The operation trajectory of the maximum swing angle is obtained via different fault clearing angles. Then the stability condition is determined by the continuity of maximum swing angle. The value of fault clearing angle, which correlated to the intersection of the operational trajectory and the discontinuity boundary, is equal to the critical clearing angle. The synchrophasor has been applied here to provide the initial condition of the disturbance and to obtain the center of inertia with the rotor angle as a reference.
Port wine stain coagulation experiments with a 540-nm continuous wave dye-lase

Treatment of port wine stains with a continuous wave dye laser at 540 nm was performed in three patients. Coagulation of the capillary blood plexus without damaging the epidermis and superficial dermis was shown to be possible for laser energy densities between 5 J/cm2 and 6.5 J/cm2. Vascular destruction was realised up to about 0.3 mm dermal depth. After 5 months the skin was perfectly normal. A comparison with argon laser treatment was made.
Multifactorial analyses in the diagnosis of pneumonia arising in the surgical intensive care unit.

Abstract The diagnosis of ventilator-associated pneumonia in the surgical intensive care unit continues to be problematic. The majority of intensive care units use clinical criteria based on chest x-ray; fever; leukocytosis; alterations in the pulse oximeter observations; the need to alter modes and amounts of ventilatory support; and more specific microbiologic studies, such as appropriate sputum, Gram stain, and culture to identify pneumonia. Diagnosing pneumonia based on clinical criteria alone is often difficult and inaccurate, which may lead to inappropriate use and choice of antibiotics. Invasive diagnostic techniques, such as protected specimen brush and bronchoalveolar lavage, provide an important microbiologic diagnosis. However, the cost and inconvenience limit broad usage. Furthermore, those results that return positive are often too late to dictate the need for, or direction of, therapy. Our use of a “pneumonia grid” may help identify patients likely to have a poor outcome. Until a readily available and cost-effective diagnostic study for pneumonia is developed, clinical criteria remain vital in routine practice.
High-Dose Urokinase Therapy in Newborn Infants with Major Vessel Thrombosis

The effectiveness of urokinase therapy for thrombosis in children, particularly in newborn infants, has not been established. We report our experience with the local administration of high-dose intrathrombus urokinase in two newborn infants. One infant had aortic thrombosis and the other, thrombosis of the right femoral artery. The known abnormalities in the newborn's fibrinolytic mechanism provide the rational basis for the therapeutic use of high doses of plasminogen activators. No significant abnormalities of our patients' fibrinolytic systems were found, and effective thrombolysis was achieved. A literature review of the use of urokinase therapy for thrombosis in children reveals great disparities in dosage and outcome. We believe that fixed-dose regimens should be replaced by individually adjusted thrombolytic therapy and that the need for higher doses of urokinase in newborns should be studied further.
The use of electric multipole lenses for bending and focusing polar molecules, with application to the design of a rotational-state separator

The dipole interaction (Stark effect) of a polar molecule allows one to use an inhomogeneous electric field to bend and focus a neutral beam in a transport line. The dependence of the optics on the Stark potential energy is discussed and we describe the type of multipole-field lenses that are needed. The special features that differ from charged particle optics are discussed. The RMS envelope equations are used to design a rotational-state separator to be built at LBNL. Its performance is simulated using the non-linear trajectory equations (with off-energy molecules included) and we find good state selection.
The Binding Selectivity of ADAR2's dsRBMs Contributes to RNA-Editing Selectivity

ADAR2 is an RNA editing enzyme that deaminates adenosines in certain duplex structures. Here, we describe the role of its RNA binding domain, consisting of two copies of a common dsRNA binding motif (dsRBM), in editing site selectivity. ADAR2's dsRBMs bind selectively on a duplex RNA that mimics the Q/R editing site in the glutamate receptor B-subunit pre-mRNA. This selectivity is different from that of PKR's dsRBM I, indicating that dsRBMs from different proteins possess intrinsic binding selectivity. Using directed hydroxyl radical cleavage data, molecular models were developed that predict important recognition surfaces on the RNA for identified dsRBM binding sites. Blocking these surfaces by benzyl modification of guanosine 2-amino groups impeded RNA-editing, demonstrating a correlation between deamination efficiency by ADAR2 and selective binding by its dsRBMs. In addition, the editing activity of a mutant of ADAR2 lacking dsRBM I on N(2)-benzylguanosine-modified RNA suggests the location of the dsRBM I binding site that leads to editing at the GluR-B Q/R site.
IT value contingencies: moderating effects of market responsiveness and business strategy

The fundamental questions regarding whether and how information technology (IT) contributes to firm performance have been answered in different ways, with some studies reporting negative impacts, some finding no overall effect, and some finding positive impacts. To reconcile these findings, several studies suggest that contextual effects moderate IT’s performance effects. Firm effects reportedly account for roughly half the productivity benefits attributed to IT—i.e., firm capabilities may leverage investments in IT. Our research question is, "To what extent do market responsiveness and business strategy moderate the relationship between IT infrastructure and firm performance?" We will test these ideas using moderated regression analysis with data from the latest Global Manufacturing Research Group (GRMG) survey.
Phenomenological Electromagnetic Modeling of Laminated-Containment Launchers

Electromagnetic launchers typically feature a containment structure around the rails that is fabricated using high-strength stainless steel laminations. Eddy currents induced in these laminations reduce the propulsive force in the launcher, leading to a reduction in incremental inductance-a fundamental railgun design parameter. Thus, designers need a method to simulate the effect of the laminated containment structure on this parameter. Using finite-element (FE) analysis to model individual laminations is likely to be counterproductive; an impossibly large number of elements would be required to model the laminations, and the insulating layers between them, for the entire railgun. Instead of modeling the physical structure of the laminated containment, it is more productive to model the effect it has on magnetic fields around the armature. The basic idea is to replace the laminated containment material with anisotropic material with different properties in the longitudinal and transverse directions. Both electrical conductivity and magnetic permeability of the containment structure will affect the magnetic field around the armature, and both these properties can be represented by an anisotropic model for the bulk. The phenomenological model discussed in this paper is designed to find the magnetic fields and currents at the sliding armature, so that L' can be calculated using readily available commercial FE codes
Two Models for Conceptualizing the Attitude-Behavior Relationship

Two models were outlined for conceptualizing the relationship between attitudes and behaviors. Model I describes the process of influencing attitudes and predicting behaviors. Model II describes the process of influencing behaviors and predicting attitudes. Conclusions from research on the enhancement of the attitude-behavior relationship were integrated into the frameworks of the two models. Researchers interested in influencing attitudes were challenged to complete the link between attitude change -attitude measure - behavior. Researchers interested in influencing behaviors were challenged to complete the link between behavior change -attitude measure - future behavior. A paradigm shift was noted from attribution theories to the use of causal models for elucidating the attitude-behavior relationship.
Reciprocal Induction of IL-10 and IL-12 from Macrophages by Low-Density Lipoprotein and Its Oxidized Forms

Atherosclerosis is a chronic inflammatory disease. Several lines of evidence indicate that altered or modified lipoproteins contribute to plaque formation and lesion progression in atherogenesis. In this study we examined if lipoproteins and their oxidized forms can exert an immunomodulatory effect, thereby potentially influencing atherogenesis. We demonstrate that LDL, upon binding to its receptor, induces interleukin (IL)-10 production from macrophages and biases naive T cells to become Th2-like. In contrast, oxLDL induces IL-12 from macrophages and accordingly favors differentiation of naive T cells along a Th1 pathway. IL-10 is a potent anti-inflammatory cytokine with a number of potential effects that could dampen inflammation at sites of vascular wall damage, including downregulation of MHC and adhesion molecules and biasing of adaptive immune responses toward the anti-inflammatory, humoral immune-promoting Th2 T cell subset. These studies assign a new immunomodulatory role to LDLs and offer a potential means to upregulate IL-10 production and prevent arterial inflammation.
Live music, social media and participatory metadata

This project examines the metadata practices of YouTube users who take and share videos of live music events. Situated within library and information science scholarship addressing the utility of and applications for harnessing participatory metadata (also called user-generated metadata), it is argued that taking a qualitative approach to this phenomenon allows for a more complex understanding of individual information practices. In turn, this understanding can lead to important improvements in application design and provide valuable insight on the viability of incorporating participatory metadata into institutional archives and catalogs.
Magnetic Resonance Imaging at Ultrahigh Fields

Since the introduction of 4 T human systems in three academic laboratories circa 1990, rapid progress in imaging and spectroscopy studies in humans at 4 T and animal model systems at 9.4 T have led to the introduction of 7 T and higher magnetic fields for human investigation at about the turn of the century. Work conducted on these platforms has demonstrated the existence of significant advantages in SNR and biological information content at these ultrahigh fields, as well as the presence of numerous challenges. Primary difference from lower fields is the deviation from the near field regime; at the frequencies corresponding to hydrogen resonance conditions at ultrahigh fields, the RF is characterized by attenuated traveling waves in the human body, which leads to image nonuniformities for a given sample-coil configuration because of interferences. These nonuniformities were considered detrimental to the progress of imaging at high field strengths. However, they are advantageous for parallel imaging for signal reception and parallel transmission, two critical technologies that account, to a large extend, for the success of ultrahigh fields. With these technologies, and improvements in instrumentation and imaging methods, ultrahigh fields have provided unprecedented gains in imaging of brain function and anatomy, and started to make inroads into investigation of the human torso and extremities. As extensive as they are, these gains still constitute a prelude to what is to come given the increasingly larger effort committed to ultrahigh field research and development of ever better instrumentation and techniques.
The importance of assessing climate change vulnerability to address species conservation

Abstract Species conservation often prioritizes attention on a small subset of “special status” species at high risk of extinction, but actions based on current lists of special status species may not effectively moderate biodiversity loss if climate change alters threats. Assessments of climate change vulnerability may provide a method to enhance identification of species at risk of extinction. We compared climate change vulnerability and lists of special status species to examine the adequacy of current lists to represent species at risk of extinction in the coming decades. The comparison was made for terrestrial vertebrates in a regionally important management area of the southwestern United States. Many species not listed as special status were vulnerable to increased extinction risk with climate change. Overall, 74% of vulnerable species were not included in lists of special status and omissions were greatest for birds and reptiles. Most special status species were identified as additionally vulnerab...
The delivery of bad news in organizations

The delivery of bad news is at the center of many organizational processes. Despite the variety of organizational processes involving the delivery of bad news, there is no integrative framework that guides its study. Based on a literature review of professionals who deliver bad news as part of their occupations, this article presents a framework that conceptualizes the delivery of bad news as a process involving a variety of activities in three different, but interrelated, phases—preparation, delivery, and transition. This three-phase model is the guiding framework for the literature review. The article identifies the strategic functions served by different bad news management activities and highlights many dilemmas facing managers in the delivery of bad news. The article concludes with identifying new directions for research on the delivery of bad news in organizations.
3D facial feature detection using iso-geodesic stripes and shape-index based integral projection

Research on 3D face models relies on extraction of feature points for segmentation, registration, or recognition. Robust feature point extraction from pure geometric surface data is still a challenging issue. In this project, we attempt to automatically extract feature points from 3D range face models without texture information. Human facial surface is overall convex in shape and a majority of the feature points are contained in concave regions within this generally convex structure. These "feature-rich" regions occupy a relatively small portion of the entire face surface area. We propose a novel approach that looks for features only in regions with a high density of concave points and ignores all convex regions. We apply an iso-geodesic stripe approach to limit the search region, and apply the shape-index integral projection to locate the features of interest. Finally, eight individual features (i.e., inner corners of eye, outer corners of eye, nose sides, and outer lip corners) are detected on 3D range models. The algorithm is evaluated on publicly available 3D databases and achieved over 90% accuracy on average.
Futile cardiopulmonary resuscitation and physician authority for unilateral do not resuscitate orders

Abstract There is an emerging consensus today that specific case profiles exist in which in-hospital cardiopulmonary resuscitation (CPR) would be futile care and in which a do not resuscitate (DNR) order is medically appropriate. The physician's affirmative decision to perform CPR usually is made without involvement of the patient or the patient's family. On the other hand, DNR orders seldom are issued without consent of the patient or the patient's family, even though the patient is not likely to survive CPR. The concept of patient autonomy, however, does not extend to the patient and/or family a legal, ethical, or social right to futile care, particularly CPR that is futile. As such, the treating physician is not required to obtain the patient's and/or family's informed consent prior to issuing a DNR order, but has the unilateral authority to enter such an order.
Communication With Significant Others About Weight Management: The Role of Confirmation in Weight Management Attitudes and Behaviors

The current study employed a confirmation perspective to examine the relationship between communication with significant others and individuals’ weight management. Confirmation was conceptualized as consisting of two components—acceptance and challenge. In Study 1, 413 participants (aged 18-66) completed a survey assessing their diet and exercise behaviors as well as interactions with a significant other about weight management. As predicted, the combination of acceptance and challenge from significant others was related to the highest levels of body self-esteem, eating and exercise self-efficacy, and healthy eating behaviors beyond the individual effects of acceptance and challenge. In Study 2, 161 participants (aged 18-62) rated the effectiveness of messages varying in acceptance and challenge. Messages higher in both acceptance and challenge were rated as more effective in motivating healthy behaviors than messages primarily higher in either acceptance or challenge or lower in both. Overall, both studi...
Hydraulic and carbohydrate changes in experimental drought- induced mortality of saplings in two conifer species

Global patterns of drought-induced forest die-off indicate that many forests may be sensitive to climate-driven mortality, but the lack of understanding of how trees and saplings die during drought hinders the projections of die-off, demographic bottlenecks and ecosystem trajectories. In this study, we performed a severe controlled drought experiment on saplings of Pinus edulis Engelm. and Juniperus osteosperma (Torr.) Little, two species that both experienced die-off in a recent ‘climate change-type’ drought. We examined the roles of carbohydrate and hydraulic changes in multiple tissues as the saplings died. We found that saplings of both species exhibited large degrees of loss of hydraulic conductivity prior to death. Neither species exhibited significant changes in carbohydrate concentrations in any tissue during the relatively short and severe imposed drought. Native hydraulic conductivity successfully predicted the degree of canopy mortality in both species, highlighting the importance of drought characteristics and tree attributes in influencing physiological pathways to mortality. The relationships elucidated here, as well as the differences between our results and previous findings in adult trees, can help inform mortality mechanisms in climate–vegetation models, especially for young trees, and to understand species response to severe drought across ontogeny.
Human ecology in pathogenic landscapes: two hypotheses on how land use change drives viral emergence

The emergence of novel viral diseases is driven by socioeconomic, demographic and environmental changes. These include land use changes such as deforestation, agricultural expansion and habitat degradation. However, the links between land use change and disease emergence are poorly understood and probably complex. In this review, we propose two hypotheses for the mechanisms by which land use change can lead to viral emergence: firstly, by perturbing disease dynamics in multihost disease systems via impacts on cross-species transmission rates (the 'perturbation' hypothesis); and secondly, by allowing exposure of novel hosts to a rich pool of pathogen diversity (the 'pathogen pool' hypothesis). We discuss ways by which these two hypotheses might be tested using a combination of ecological and virological approaches, and how this may provide novel control and prevention strategies.
Intrinsic fast neutron sensitivity of imaging plates

Imaging plate (IP) is a phosphor which has image storage capability. Because of its immunity to electric-magnetic-interference, IP's have been used in various laser-plasma experiments as a detector for x-ray imaging and electron spectroscopy. IP's are sensitive to most of ionizing radiations. Response of IP's to x-ray, gamma-ray, and charged particle exposure has been reported. However its intrinsic response to neutron exposure has not been understood clearly. In order to assess expected performance of IP's in harsh neutron background environment of the National Ignition Facility, it is crucial to understand IP's sensitivity to 14MeV neutrons. We exposed absolutely calibrated IP's to known neutron flux at OMEGA laser facility. Comparison of experimental results and Monte Carlo simulations will be reported.
Proteinuria in a placebo-controlled study of basic fibroblast growth factor for intermittent claudication

Intermittent claudication is the most common symptom of peripheral arterial disease (PAD), in part due to an inadequate rise in limb blood flow with exercise. Claudication causes a severe impairment in functional capacity and quality of life in over 3 million Americans. Basic fibroblast growth factor (bFGF) stimulates angiogenesis in vivo and improves limb blood flow in several animal models of hindlimb ischemia. However, the relative safety and efficacy of angiogenic molecules in the treatment of claudication has not been fully evaluated in prospective, blinded clinical trials. In this study, a randomized, double-blind, placebo-controlled, phase II trial of recombinant human bFGF for the treatment of intermittent claudication was performed. bFGF was administered weekly by intravenous infusions of 2 microg/kg for 6 sequential weeks (total dose 12 microg/kg). The primary efficacy endpoint was change in peak walking time (PWT) on a graded exercise treadmill protocol. Secondary efficacy endpoints included changes in functional status as measured by validated questionnaires. The study was stopped prematurely after treatment of the first 24 subjects due to proteinuria in five of the 16 subjects who received systemic bFGF, which exceeded 1000 mg/24 h in four of these five subjects. The small sample size limited evaluation of the predefined efficacy endpoints; however, there was no significant difference between the treatment and control groups for any of the measures of efficacy. In conclusion, intravenous administration of bFGF delivered at low doses weekly for 6 weeks was associated with a high rate of severe proteinuria. It is speculated that bFGF-related proteinuria in this study was primarily related to the systemic route of administration and the frequent dosing schedule. Future clinical trials of bFGF protein should carefully monitor renal function and consider alternative dosing schedules and drug administration routes.
A Method for the Simultaneous Passage of many Paraffin Sections Through the more Difficult Stains

Numerous attempts have been made to find means whereby serial paraffin sections, or duplicate preparations intended for class-work, may be stained simultaneously; and, so far as regards stains that demand merely a transfer of the sections from one solution to another, these attempts have had success. Thus the Schmorl "celloidinplate" method, by which the paraffin sections are incorporated in a film of celloidin and then manipulated, fulfils all the requirements for hematoxylin and eosin or other simple staining and counterstaining technic. When it is inadmissible?as, for instance, in clearing by turpentine, which affects celloidin?one may employ a glass or metal rack, such as that of Neumayer, to carry many slides on which the preparations have previously been fixed, or may, as recommended by Apathy, space the slides by means of bits of glass rod between each two, unite them all with rubber bands, and carry them through as one piece. But beyond the reach of these there remain a" number of the processes for differential staining?Gram's stain, that of Weigert for fibrin, the amyloid and mucin stains, etc.?which, since they involve a careful differentiation of the dyes, blotting, and other detailed attention, have seemed to forbid the collective handling of many sections. To meet the conditions for simultaneous staining here involved some new method is needed. I have therefore devised the one that follows:
Time-resolved laser-induced fluorescence measurement of ion and neutral dynamics in a Hall thruster during ionization oscillations

The paper presents spatially and temporally resolved laser-induced fluorescence (LIF) measurements of the xenon ion and neutral velocity distribution functions in a 400 W Hall thruster during natural ionization oscillations at 23 kHz, the so-called “breathing mode.” Strong fluctuations in measured axial ion velocity throughout the discharge current cycle are observed at five spatial locations and the velocity maxima appear in the low current interval. The spatio-temporal evolution of the ion velocity distribution function suggests a propagating acceleration front undergoing periodic motion between the thruster exit plane and ∼1 cm downstream into the plume. The ion LIF signal intensity oscillates almost in phase with the discharge current, while the neutral fluorescence signal appears out of phase, indicating alternating intervals of strong and weak ionization.
VII.—On the Neonatus of Callimico gœldii (Thomas) *

An account is provided of the external and skeletal features of a four-days old Callimico gœldii, one of twins born in captivity. Bodily proportions are compared with those of other newborn marmosets and tamarins. Diffeiences in pelage from the adult are outlined. Data are provided on the regional external anatomy. The state of skeletal ossification and dental development are discussed. The taxonomic position of Callimico within the Hapalidae is confirmed.
A "Painting Master of the Time":the Zenith of Classical Landscape-(On the painting art of Wang Shigu)

A "Master" in the history of Chinese arts and literature indicates three meanings: firstly synthesizing all that is good,secondly having profound influence and thirdly according with lineal the Confucian view of arts and literature.Classical landscapes needed artists to balance the three forms: of landscape of reality,the landscape of ideal and fu bi mo as a representative.Paintings by Wang Shigu accord with the taste of landscapes,and with all that a master requires.Thus his paintings were highly praised at that time and in the following 200 years.
Decision Making in Lower Extremity Deformity Correction

Indications for the correction of lower extremity deformities in children are somewhat nebulous. Relative indications include patient symptoms such as pain; mechanical axis deviation at the knee; coronal and sagittal malalignment of the hip, knee, and ankle on radiographs; and rotation deformities observed on physical exam. The formation of a problem list and a comprehensive treatment plan are essential for an accurate, well-performed correction. The involvement of the patient and caretakers in the decision-making process is essential and the inability of the patient or family to comply with the postoperative protocol is a contraindication to surgical intervention.
Renal considerations in the injured patient.

This article is concerned with the renal homeostatic response to trauma and hypovolemic shock and the identification and treatment of the acute renal failure that occurs when the insult exceeds the capacity of the normal protective homeostatic response to shock and trauma.
OBLITERATION OF THE PRINCIPAL ORIFICE OF THE STENOTIC MITRAL VALVE: A RARE FORM OF "RESTENOSIS".

SUMMARY In classical rheumatic mitral stenosis, the principal orifice for the flow of blood through the valve lies between the two papillary muscles. Two cases are presented in which this orifice had become obliterated some time after mitral commissurotomy. In each case, an opening created by a commissurotomy was the only orifice through which blood could flow from the left atrium into the left ventricle. It is assumed that closure of the principal orifice of the mitral valve resulted either from thrombosis in situ or from lodgment of an embolus which had originated in the left atrium.
MENSTRUAL DYSFUNCTION IN ATHLETES : HOW TO IDENTIFY AND TREAT PATIENTS AT RISK FOR SKELETAL INJURY

Preview As more and more women participate in competitive sports, disorders of menstrual function and the resultant risk of skeletal injury have become significant concerns. Primary care physicians can have a key role in identifying patients at risk and helping them to stay active while avoiding serious morbidity. Dr DiFiori discusses the relationship between menstrual dysfunction and loss of bone mineral density and offers a practical approach to evaluation and treatment.
Positive Predictive Value of a Single Assessment of Estimated GFR in the Diagnosis of Chronic Kidney Disease.

OBJECTIVES The positive predictive value (PPV) of a single assessment of estimated glomerular filtration rate (eGFR) in the diagnosis of chronic kidney disease (CKD) is not known. Our objective was to determine the PPV of a single assessment of eGFR among adults with at least one eGFR <60 mL/min in their lifetime, using the Distributed Area Research and Therapeutics Network CKD natural history dataset. METHODS In all, 47,104 adults who were cared for by 113 practices in the United States were included. Proportions of patients in eGFR categories at baseline were calculated using the following categories: <15 mL/min, 15 to 29.99 mL/min, 30 to 44.99 mL/min, and 45 to 59.99 mL/min. Comparisons were then made between the baseline and the endpoint to identify patients who had a follow-up eGFR that remained at <60 mL/min. The proportions of patients in each eGFR category were compared baseline to endpoint using cross-tabulations. To test the proposed cutpoint, the proportions of patients who had an eGFR that remained at <60 mL/min were measured, using the cutpoints that included the highest cumulative proportion of patients. The sensitivity and specificity of that cutpoint were calculated. RESULTS A cutpoint of <45 mL/min was identified, yielding a PPV of 93% with a sensitivity of 28% and a specificity of 94%. CONCLUSIONS A valid cutpoint to screen for CKD was identified. This cutpoint may prove important to early screening for CKD while reducing the burden on the healthcare system and patients suspected of having CKD.
Reflections on the Evolution of Algorithmic Language

Publisher Summary This chapter focuses on the interpretation of the existing history regarding algorithmic languages. Algorithmic language before computers was essentially textual with a liberal sprinkling of examples and three dots. There are four areas of language in which structure plays a prominent role: (1) program organization, (2) program control, (3) data, and (4) expression notation. Progress toward common algorithmic language has been made in all four areas, with particular signs of convergence relative to program control and, to a lesser extent, to data. In regard to abstraction, there are three areas mentioned in the chapter: (1) subroutines and procedures, (2) set-theoretic symbolism, and (3) algorithm-data-representation independence. It is observe that in spite of the seeming proliferation of programming languages at present, the various features are being sorted out, and in fact general-purpose languages are converging toward everyday algorithmic language. The chapter discusses that progress has been made relative to the design and use of procedures, while set-theoretic notation and data abstraction are just beginning to come into prominence.
Adaptation of Augmented Berlin-Frankfurt-Munster (ABFM) Therapy in Adolescents and Young Adults with Acute Lymphoblastic Leukemia (ALL).

Abstract Comparisons of survival of adolescents up to age 21 years of age treated on either pediatric or adult ALL protocols so far show improved survival for patients (pts) treated with pediatric therapies. ABFM therapy has been shown to be effective therapy for teen-aged pts up to age 21, and is the standard therapy arm of the current Children's Oncology Group high-risk ALL trial. We have initiated a trial of ABFM based therapy for pts up to the age of 30 with lymphoblastic leukemia. Pts receive four drug induction with prednisone 60 mg/m2 daily for 28 days, daunorubicin 25 mg/m2 weekly for four doses, vincristine 2 mg weekly for four doses, and a single dose of intravenous pegylated asparaginase (PEG-asp) in week one of therapy. Intrathecal (IT) cytarabine is given on day one, and IT methotrexate is given on days 8 and 29. IT therapy is intensified depending on the presence of spinal fluid blasts. Induction is extended by two weeks for patients who do not acheive a bone marrow morphologic remission (MR) by day 29. Pts that are in MR by day 15 are rapid early responders; they receive one phase of delayed intensification. Pts who are not in MR by day 15 but enter MR by day 29 or 42 are slow early responders; they receive two delayed intensifications. Upon completion of induction, pts continue with intensive phases of chemotherapy for approximately 6 months. They then start 24 months of maintenance therapy. 13 patients with newly diagnosed ALL have been enrolled with a planned enrollment of 80. The median age is 20 (range 14–28). 10(77%) have pre-B ALL and 3(23%) have T-ALL. 12(92%) are rapid early responders. All pts are in MR by day 29. Minimal residual disease (MRD) status is evaluated at day 29 and day 84 by four-color flow cytometry. 8(62%)pts are MRD negative by day 29. All pts so far are MRD negative by day 84. One pt has relapsed. There are no treatment related deaths. Treatment delays for bone marrow suppression are common. There has been 1 allergic reaction to PEG-asp and 2 cases of clinical pancreatitis. 2 pts have had stroke-like symptoms with MRI findings compatible with treatment toxicity; complete clinical resolution has occurred in both. 4 pts have had grade (Gr) 3–4 hyperglycemia. 2 pts have had Gr 3–4 hyperbilirubinemia. 2 patients have been non-compliant. One pt has had Gr 4 sepsis. Other infectious complications are not common. Early evaluation indicates that ABFM therapy is effective in inducing rapid MR in young adults with ALL. The regimen appears tolerable, but morbidity is frequent. Gr 3–4 toxicity occurs more often than recently reported for similar therapy in adults with ALL (Douer D, et al. Blood , 1 Apr 2007, 2744050).
e-Learning in the Age of Betsy DeVos

Betsy DeVos is the new U.S. Secretary of Education, having been confirmed by not just a razor-thin measure, but rather by a tie-breaking vote by Vice President Mike Pence that was unprecedented for a presidential cabinet appointment. What are the likely potentials and possibilities for e-learning in the new era of Donald Trump and Betsy DeVos? It's worth exploring what we might be able to anticipate for e-learning in the coming era.
Quantifying electrical impacts on redundant wire insertion in 7nm unidirectional designs

In nano-meter scale Integrated Circuits, via fails due to random defects is a well-known yield detractor, and via redundancy insertion is a common method to help enhance semiconductors yield. For the case of Self Aligned Double Patterning (SADP), which might require unidirectional design layers as in the case of some advanced technology nodes, the conventional methods of inserting redundant vias don’t work any longer. This is because adding redundant vias conventionally requires adding metal shapes in the non-preferred direction, which will violate the SADP design constraints in that case. Therefore, such metal layers fabricated using unidirectional SADP require an alternative method for providing the needed redundancy. This paper proposes a post-layout Design for Manufacturability (DFM) redundancy insertion method tailored for the design requirements introduced by unidirectional metal layers. The proposed method adds redundant wires in the preferred direction - after searching for nearby vacant routing tracks - in order to provide redundant paths for electrical signals. This method opportunistically adds robustness against failures due to silicon defects without impacting area or incurring new design rule violations. Implementation details of this redundancy insertion method will be explained in this paper. One known challenge with similar DFM layout fixing methods is the possible introduction of undesired electrical impact, causing other unintentional failures in design functionality. In this paper, a study is presented to quantify the electrical impacts of such redundancy insertion scheme and to examine if that electrical impact can be tolerated. The paper will show results to evaluate DFM insertion rates and corresponding electrical impact for a given design utilization and maximum inserted wire length. Parasitic extraction and static timing analysis results will be presented. A typical digital design implemented using GLOBALFOUNDRIES 7nm technology is used for demonstration. The provided results can help evaluate such extensive DFM insertion method from an electrical standpoint. Furthermore, the results could provide guidance on how to implement the proposed method of adding electrical redundancy such that intolerable electrical impacts could be avoided.
Acute Pain Management in Hospitalized Adult Patients with Opioid Dependence: A Narrative Review and Guide for Clinicians.

Pain management is a core competency of hospital medicine, and effective acute pain management should be a goal for all hospital medicine providers. The prevalence of opioid use in the United States, both therapeutic and non-medical in origin, has dramatically increased over the past decade. Although nonopioid medications and nondrug treatments are essential components of managing all acute pain, opioids continue to be the mainstay of treatment for severe acute pain in both opioid-naive and opioid-dependent patients. In this review, we provide an evidence-based approach to appropriate and safe use of opioid analgesics in treating acute pain in hospitalized patients who are opioid-dependent. Journal of Hospital Medicine 2017;12:375-379.
Emerging Therapies for Diffuse Low Grade Glioma

Because of the intractable nature of diffuse low grade gliomas, which always progress into higher grade, malignant gliomas, there is increased interest in the use of newer and alternative approaches in addition to conventional approached including surgery, chemotherapy, and radiotherapy. These emerging treatments include several technologies for thermal ablation and improved drug delivery as well as immunotherapy and nutritional or “alternative” therapies.
How do generations on the workfloor really perceive each other? A bizarre love triangle (WITHDRAWN)

Recent reviews of literature on a multigenerational workforce have agreed on the following. The findings concerning intergenerational differences are shattered and there is little consensus among s...
21 The Ubiquitous Role of Preparation

A preparation-theory hypothesis of the psychological refractory period was supported by a step function relating RT (reaction time) to ISI (intersignal interval) for constant ISIs with adequate controls. The contribution of probability effects was demonstrated with varied ISIs. Preparation theory proposes that RT is an inverse function of available preparation capacity, which is apportionable but which may be shared. Equations derived from preparation models for the effect of number of alternatives, both equally and unequally probable, fit existing data reasonably well. Experiments on the aged support the distinction between preparatory ability and its control.
Qualitative evaluation of the Saleema campaign to eliminate female genital mutilation and cutting in Sudan.

Female genital mutilation and cutting (FGM/C, herein FGM) is a widespread and harmful practice. The Government developed a national campaign in Sudan, called Saleema, to change social norms discouraging FGM. Saleema translates to being “whole”, healthy in body and mind, unharmed, intact, pristine, and untouched, in a God-given condition. An interim evaluation was conducted using focus groups among Sudanese adults. The primary aim was to explore perceptions of the Saleema poster exemplars and to assess if the desired themes were being communicated. Secondary aims were to understand more about participants’ information sources, values, and suggestions for the campaign broadly. The Saleema campaign evaluation included four focus groups from each of the 18 states in Sudan (72 total). Participants were presented with three poster stimuli from the Saleema campaign and asked about the content and their reactions. Themes were coded inductively by concepts that arose through content in the transcripts. Codes were also reviewed in conjunction with themes from the broader Saleema evaluation framework. Participants reported the most common source of information or admiration was from local leaders who are responsive to a community, media-based outlets, and discussions among community members. Participants held high value for education, community solidarity, and/or religious devotion. Participants had positive opinions of Saleema and responded positively to the branding elements in the posters and the campaign as a whole. The most common suggestion was continued awareness. Advocacy, training, and posters were suggested to highlight the harms of FGM through leaders or in community settings. Individuals suggested that these activities target older women and individuals in rural villages. There was also a burgeoning theme of targeting youth for support of the campaign. The results of this focus group analysis demonstrate support for future Saleema campaign efforts promoting awareness and community engagement. The campaign could capitalize on partnerships with young people and those who are respected in the community (e.g., religious leaders) or continue promoting common values aligning with the support of education and community solidarity. Continuing campaign efforts have promise to decrease the harms of FGM in Sudan.
Montane-breeding Bird Distribution and Abundance Across National Parks of Southwestern Alaska

Abstract Between 2004 and 2008, biologists conducted an inventory of breeding birds during May–June primarily in montane areas (>100 m above sea level) of Aniakchak National Monument and Preserve (...