cssi/SciSciGPT-SciSciNet huggingface dataset:
Characteristics of Good Software Design

Six characteristics of good software design—simplicity, coupling, cohesion, information hiding, performance, and security—are described. This is followed by a description of abstraction as the art of software design. Two common approaches to describing software abstractions—software design models and software design patterns—are introduced.
Modified twin-incision thoracoscopic Nuss procedure for pectus excavatum: a report of 50 cases

Objective To explore the clinical efficacy of modified twin-incision thoracoscopic Nuss procedure for pediatric pectus excavatum. Methods A retrospective review was performed for the clinical data of 50 cases of pectus excavatum from July 2017 to May 2016. There were 30 boys and 20 girls with an average age of 6.5( 3.3-16.0) years. All of them underwent modified twin-incision thoracoscopic Nuss procedure.Average haller index was 3.0-6.9. Pectus excavatum 35 cases , asymmetric pectus excavatum 15 cases. Results 50 cases procedures were successfully completed. Operative duration was( 60±15) min, intraoperative blood loss( 5±2) ml, without serious complications during and after operation, and the average postoperative hospitalization stay(6±1) days, the postoperative effect was successfully, during follow-up from 7 months to 17months after the operation. Conclusion Modified twin-incision thoracoscopic Nuss procedure with is both safe and effective for pediatric pectus excavatum. With the advantages of shorter operative duration, mini-invasiveness, fewer complications and excellent cosmetics, it is worthy of wider popularization. Key words: Pectus excavatum; Twin-incision thoracoscopic; Thoracoscopy; Nuss Procedure
Swine producer willingness to pay for Tier 1 disease risk mitigation under multifaceted ambiguity

Understanding producers' risk perceptions of foreign animal diseases and their willingness to participate in prevention efforts is crucial for effective policymaking and communication strategies, yet there is limited empirical evidence to support initiatives. Using results from a 2017 survey of U.S. swine producers, we test whether producers' subjective risk perceptions affect their willingness to pay for interventions that could reduce potential foreign animal disease losses. Then, controlling for subjective risk perceptions, we determine the relative and total impacts of different representations of ambiguity on willingness to pay. Our results indicate that producers have a mean willingness to pay of $0.581 per pig per year. We find no difference in willingness to pay under alternative representations of ambiguity characterized by probability of occurrence, damage, and damage duration. Rather, a producer with a higher subjective belief in the probability of a foreign animal disease outbreak in the U.S. swine industry, a higher level of formal education, operating as a contractor or integrator, and owning a truck‐wash has a higher willingness to pay. Also, the number of market hogs sold annually is an important determinant of willingness to pay for foreign animal disease risk mitigation. [EconLit citations: D81, Q11, Q18]
Reflections on surface morphology

Electrochromic windows can reduce buildings’ energy demand and improve occupants’ comfort, yet they struggle to fully meet market needs. Now, researchers demonstrate that polymer additives improve light and solar heat modulation of reflective electrochromic windows, with potential for durable, large-scale and low-cost manufacturing.
Gadamer, German Idealism, and the Hermeneutic Turn in Phenomenology

Gadamer’s philosophical hermeneutics is important to phenomenology for a number of reasons. One chief reason is that Gadamer describes his philosophical hermeneutics as an attempt to advance beyond the early Heidegger’s introduction of a “hermeneutics of facticity” that would break from the transcendental idealism of Husserl’s phenomenology. This chapter argues that Gadamer attempts to clarify his advance beyond Heidegger’s hermeneutical turn in phenomenology, at least in part, in reference to Hegel’s philosophy. While Gadamer remains critical of German Idealism generally and Hegel’s notion of “absolute” spirit in particular, Gadamer nevertheless embraces Hegel’s approach to “objective” spirit in order to elucidate historical and linguistic conditions of facticity that the early Heidegger appears to discount.
On-time, late, or never: Incorporating intersectionality to predict age-specific probabilities of initiating the HPV vaccine series.

Abstract The HPV vaccine's effectiveness in protecting against the human papillomavirus (HPV) is dependent on both the timing of vaccine initiation (by age 12) and number of vaccine doses. This study used an intersectional approach to examine how gender and its intersection with race/ethnicity predict age-specific probabilities of initiating HPV vaccinations for boys/men and girls/women across four racial/ethnic groups: non-Latinx (NL) white, NL-Black, Latinx, and NL-Asian American. Multinomial logistic regression models—with on-time vaccination as the base outcome—examined the timing of initiating HPV vaccinations (never or late) in the 2011–2016 National Health and Nutrition Examination Survey (NHANES). This study finds that the multiplicative interaction term between gender and race/ethnicity produces significant results in the likelihood of initiating HPV vaccine uptake: NL-Asian American boys/men have the highest risk of not vaccinating on time. This finding would have been hidden with a one-dimensional analysis.
In Structural Glycobiology, Deuterium provides the Details.

In this issue of Structure, Gadjos et al. (2021b) determine the structure of a bacterial lectin in complex with L-fucose by neutron diffraction of both perdeuterated protein and carbohydrate ligand. The structure provides insight into lectin-ligand interactions, opening avenues for drug design targeting bacterial lectins for intervention in infectious disease.
27 Radiochemistry and radiopharmaceuticals

The radiochemistry section of Annual Reports has, this year, been expanded to include a review of recent progress in the use of radiochemical procedures for imaging in nuclear medicine. The usual fields will also be considered: isotopes, their production and purification, the preparation of labelled molecules and environmental aspects of radiochemistry. The following topics are excluded: radiation chemistry (except as it impinges on the stability of labelled molecules), the general chemistry of elements that happen to be radioactive, the use of radioisotopes as tracers and nuclear activation analysis.
On-Site Computerization: A Case Study in Historic Archaeology

Since 1979 I have been involved with the analysis of archaeological remains from Mission San Antonio de Padua, in the former Spanish Province of Alta California. We have been focusing our attention at the Mission on two behavioral areas. The first of these is the neophyte quarters. The second is the soldiers' barracks, The data retrieved from these excavations have been used to test a micro-computer system for on-site analysis.
Microelectronics to Nanoelectronics : Materials, Devices & Manufacturability

Moore's Law: Technology Scaling and Reliability Challenges, T. Nigam, K.-Y. Yiang, and A. Marathe Scaling and Radiation Effects in Silicon Transistors, A.H. Johnston and L.Z. Scheick Hewlett-Packard's MEMS Technology: Thermal Inkjet Printing and Beyond, J. Stasiak, S. Richards, and P. Benning Silicon MEMS Resonators for Timing Applications, B. Kim, M.A. Hopcroft, and R.N. Candler Nanoscale Electromechanical Devices Enabled by Nanowire Structures, P. X.-L. Feng Silicon Etching and Etch Techniques for NEMs and MEMs, M.D. Henry and A. Scherer Learning from Biology: Viral-Templated Materials and Devices, E.D. Haberer Principles and Methods for Integration of Carbon Nanotubes in Miniaturized Systems, A.J. Hart, S.J.Park, M. F.L. de Volder, S.H. Tawfick, and E.R. Meshot Heterogeneous Integration of Carbon Nanotubes on Complementary Metal Oxide Semiconductor Circuitry and Sensing Applications, C.-L. Chen, S. Sonkusale, M. Chen, and M.R. Dokmeci NEMS-Based Ultra Energy-Efficient Digital ICs: Materials, Device Architectures, Logic Implementation, and Manufacturability, H.F. Dadgour and K. Banerjee Carbon Nanotube Y-Junctions, P.R. Bandaru Nanoscale Effects in Multiphase Flows and Heat Transfer, N. Singh, D. Shin, and D. Banerjee Nanoengineered Material Applications in Electronics, Biology, and Energy Harnessing, D.S. Choi, Z. Zhang, and N. Pachauri
Problems and needed directions in the profession of educational technology

Finn’s 1953 assessment added up, in his opinion, “to the simply stated fact that the audiovisual field is not yet a profession” (p. 16).
Stochastic approximation with biomedical applications

Stochastic approximation is a method for approximating the root of the equation M(θ) = m0, when the function M(.) is not directly observable but can be cast as the expectation of a suitably defined regression function. The method was introduced by Robbins and Munro in 1951 and has since been extensively refined and extended. It has found application in many areas of biostatistics and in the application of neural networks. Keywords: approximation methods; convergence; neural networks; optimization; simulation methods
Ribosomal DNA in Drosophila melanogaster. I. Isolation and characterization of cloned fragments.

Abstract Fragments of rDNA‡ from Drosophila melanogaster produced by the restriction endonuclease Eco RI were cloned in the form of recombinant plasmids in Escheriehia coli . Maps were prepared showing the location of the coding regions and of several restriction endonuclease sites. Most rDNA repeats have a single Eco RI site in the 18 S gene region. Thus, 19 of 24 recombinant clones contained a full repeat of rDNA. Ten repeats with continuous 28 S genes and repeats containing insertions in the 28 S gene of 0.5, 1 and 5 kb were isolated. The 0.5 and 1 kb insertion sequences are homologous to segments of the 5 kb insertions; because of this homology they are grouped together and identified as type 1 insertions. Four recombinant clones contain an rDNA fragment that corresponds to only a portion of a repeating unit. In these fragments the 28 S gene is interrupted by a sequence which had been cleaved by Eco RI. The interrupting sequences in these clones are not homologous to any portion of type 1 insertions and are therefore classified as type 2. In one of the above clones the 28 S gene is interrupted at an unusual position; such a structure is rare or absent in genomic rDNA from the fly. Another unusual rDNA fragment was isolated as a recombinant molecule. In this fragment the entire 18 S gene and portions of the spacer regions surrounding it are missing from one repeat. A molecule with the same structure has been found in uncloned genomic rDNA by electron microscopic examination of RNA/DNA hybrids.
Absorptance of Thermal Radiation by Cryodeposit Layers

The problems associated with the presence of condensed gases on low-temperature surfaces are receiving much attention in connection with basic studies of cryopumping, simulation of the solar space environment, and the storage of cryogenic fluids. Atgthis laboratory, a general program of inquiry is being pursued into the optical properties of low-temperature surfaces. As part of that program, the transport of energy within a cryodeposit layer which is subjected to thermal radiation was investigated.
WW14: MAKING MODELS BETTER

OBJECTIVES: In this workshop, we will (1) lay out the set of conditions for assessing the quality of models, (2) provide examples from the Duke Stroke Policy Model of how these conditions may be met, and (3) engage participants in a discussion of cases in other clinical areas. PARTICIPANTS WHO WOULD BENEFIT: Those who develop and use decision/cost-effectiveness models. In an ideal world all clinical decisions would be based on evidence from large comprehensive scientific studies. In the complex world of actual practice—the world of pharmacoeconomics—such evidence is often impractical or impossible to obtain. Models are used to help decision-makers make plausible and useful inferences in the absence of perfect information. Despite the broad application of models in this context, the process and conclusions of modeling exercises are frequently suspect. Concerns include: (1) failure to use the best available data; (2) inaccessibility of the model code; (3) lack of validation; and (4) difficulty interpreting the results of technical analyses. Despite recommendations from the US Preventive Services Task Force intended to address these concerns, models are still held in low regard. As part of the Stroke PORT project, a simulation model of stroke development and outcomes was developed. This model has since been expanded to accommodate a variety of potential interventions and data sources and is currently designated the Duke Stroke Policy Model (DSPM). One of the major objectives of the DSPM has been to address the above concerns. Our approach has been to (1) use the best data; (2) vigorously promote an open-code public-use application, available on the Internet; (3) perform rigorous validation; and (4) develop user-friendly applications based on the validated core code, tailored to different user groups. Researchers, teachers and public health professionals are encouraged to use the DSPM for academic and other non-commercial applications, and to engage with the developers to promote the continuing improvement of the model. In this workshop, we will (1) lay out the set of conditions for assessing the quality of models, (2) provide examples from the DSPM of how these conditions may be met, and (3) engage participants in a discussion of cases in other clinical areas.
RURAL DEVELOPMENT, PRIVATIZATION AND PUBLIC CHOICE: SUBSTANCE DEPENDS UPON PROCESS: DISCUSSION

I intend to accomplish three things with my discussion of this paper. First, I offer a summary of Jim’s basic line of reasoning, as I understand it, and then suggest what I believe to be the most important contributions his paper makes. Second, I use his paper as a jumping off point to offer my assessment of a likely shift to privatization in the provision of one traditionally “public” service in rural communities, with which I am particularly interested. Third, I comment briefly on the possible role of an intermediate institutional arrangement-public, but with market type incentives--for that same public service.
Emittance growth analysis of electon beams due to nonlinear focusing fields of PPM magnets

Emittance increasingly becomes an issue for high-frequency RF amplifiers as dimensions become minute. This is currently an active area of research with articles being published in 2014 to address designing emittance dominated beams for linear RF amplifiers.1 Emittance growth, on the other hand, has never been thought to be an issue for RF amplifiers. We present a method for determining the emittance growth that can be caused by PPM focusing lattices. This can be used as a tool for determining important beam related design issues in RF amplifiers.
Benefits of Surfing for Children with Disabilities: A Pilot Study

The purpose of this study was to assess the effectiveness of an eight-week surfing intervention for 16 children with disabilities. The assessment procedure consisted of pre and post physical fitness measures to determine the benefits of this intervention. Our results showed an overall improvement in upper body strength (right: P = 0.024, left: P = 0.022), core strength (P = 0.002) and cardiorespiratory endurance (P = 0.013). This research is the first of its kind, illustrating the feasibility and effectiveness of a surfing intervention on improving the physical fitness of children with disabilities.
The surgical technique of bilateral sequential lung transplantation

Since the first successful lung transplant performed three decades ago, the technique of lung transplantation has evolved with acceptable short- and long-term outcomes such that it has become the standard for those with end stage pulmonary disease. Herein, we describe our current favored approach and discuss some of the current areas in need of further investigation as they relate to the technical aspects of the operation.
FVIII/VWF ratio is not a reliable predictor of VWD in children

Adults with von Willebrand Disease (VWD) are known to have a ratio of factor VIII activity (FVIII:C) to von Willebrand factor antigen (VWF:Ag) greater than 1. We, however, noted healthy children with ratios that are unexpectedly high. Though the FVIII:C/VWF:Ag ratio differs significantly between healthy children and VWD patients in some age groups, the substantial overlap of observed ranges suggests that a ratio threshold-based screening approach alone cannot reliably discriminate between these groups. The diagnostic performance of this ratio is poor for VWD in children, which may decrease its value as a screening tool in the pediatric population.
Granzyme B Binds to Target Cells Mostly by Charge and Must Be Added at the Same Time as Perforin to Trigger Apoptosis

Perforin (PFN) delivery of granzymes (Gzm) into the target cell at the immunological synapse is the major pathway for inducing apoptosis of virus-infected cells and tumors. A validated model for how PFN delivers Gzm into the cytosol is still lacking. PFN was originally thought to work by forming pores in the target cell plasma membrane that allow Gzm entry. This model was questioned when it was shown that GzmB is endocytosed without PFN. Moreover, apoptosis could be triggered by adding PFN to washed cells that have previously endocytosed GzmB. In this study, we show that GzmB binds to the plasma membrane mostly via nonspecific charge interactions. Washing in saline does not remove bound Gzm. However, if externally bound GzmB is completely removed, subsequent addition of PFN does not release previously endocytosed GzmB and does not trigger apoptosis. Therefore, PFN must be coendocytosed with GzmB to deliver it into the cytosol.
Estudos de cetáceos no Oceano Atlântico Sul Ocidental e a falta de uma política de conservação e manejo no Brasil

Studies on cetaceans at Argentina, Uruguay and Brazil can be divided in three periods. During the first one (1861-1963), studies of the Argentines Burmeister, Gallardo, Lahille and Marelli were done on dolphin and porpoise osteology, occasionally on whales, these wire followed by those of Miranda Ribeiro and Carvalho in Brazil. The second period (1969-1976) begins with the studies of the North American Gilmore (1969) in Patagonia. From this year on, numerous forcing expeditions came to Argentina and Uruguay, to study the right whale, Eubalaena australis behavior in Patagonia and the La Plata river dolphin. Pontoporia blainvillei biology at Punta del Diablo, Uruguay. These expeditions have contributed to a better knowledge of whales and dolphins, not only in South if not also, abroad. During thin period studies on bekzvior, bioacustics, population dynamics and bio-ecological studies ; began. Simultaneously it is observed that Latin Americm researches, specially those of Uruguay and Brazil, become interested ind doing cetological research on systematic aspects. The third period (1976- ) it is characterized by an increased effort on this field and also by a better exchange of information between the three S. W. Atlantic countries. In Brazil, during the last two years, a gret interest on the minke whale conservation problem has developed, not only at the public opinion, but also at the government level.
The histochemical and microscopical differentiation of the respiratory glands around the maxillary sinus of the rat.

To investigate the histochemical and microscopical characteristics of the lateral and maxillary glands, as well as their topographical relationship with the maxillary sinus, 25 adult specimens were used. The tissues were fixed in neutral buffered formalin and serial sections were stained with hematoxylin and eosin, trichrome, Sudan black B, ninhydrin-Schiff, PAS, alcian blue, and mucicarmine. The objectives were to ascertain: (1) the general morphology of the lateral nasal wall and of the maxillary sinus, (2) the topographical relation between the glands and the maxillary sinus, (3) the microscopical and histochemical characteristics of the maxillary gland, and (4) the microscopical and histochemical characteristics of the lateral nasal gland. In all specimens, the sinus was surrounded by glandular tissue. The lateral gland occupied the submucosa anterior and inferior to the sinus, the maxillary gland extended from the anterior to the posterior recess superior to the sinus. The maxillary gland showed the typical morphology characteristic of a serous gland. The gland drained into the sinus by numerous excretory ducts. The epithelium of the proximal ducts was simple columnar and in the distal ducts, pseudostratified columnar ciliated. The latter type of epithelium, without goblet cells, was found in the maxillary sinus. The lateral gland showed a morphology characteristic of mucous glands. Although the gland contained neither free lipids nor proteins, it was PAS-positive. A high concentration of acid glucoproteins was detected in the lateral gland. The excretory system of this gland was lined throughout by either a simple columnar or a simple cuboidal epithelium. The possible contribution of the glands to the functioning of the upper part of the respiratory system was discussed.
Mechanical Properties of Intermetallic Compounds in the Au–Sn System

The mechanical properties of intermetallic compounds in the Au–Sn system were investigated by nanoindentation. Measurements of hardness and elastic modulus were obtained for all of the confirmed room-temperature intermetallics in this system as well as the β phase (8 at.% Sn) and AuSn4. Overall, it was found that the Au–Sn compounds have lower hardness and stiffness than common Cu–Sn compounds found in solder joints. This finding is in contrast to common knowledge of “Au embrittlement” due to the formation of either AuSn4 or (Au,Ni)Sn4 intermetallic compounds. This difference in understanding of mechanical properties of these phases and the resulting joint strength is discussed in terms of reliability and possible failure mechanisms related to interface strength or microstructural effects. Indentation creep measurements performed on Au5Sn, Au–Sn eutectic (29 at.% Sn) and AuSn indicate that these alloys are significantly more creep resistant than common soft solders, in keeping with typical observations of actual joint performance.
Quantification of abnormal EEG spike characteristics.

Abstract A digital computer technique is presented whereby abnormal scalp EEG transients are magnified and processed so that detailed characteristics of their morphology can be precisely quantified. A set of six parameters describing these characteristics is proposed, and data from a quantitative analysis of abnormal spikes chosen from three human epileptics are presented. Finally, the advantages of the presented method are discussed.
The optimal spread and offering price for underwritten securities

Abstract The paper develops the net proceeds maximization theory explaining how the spread and offering price are determined in all underwritten offerings in the U.S. The theory yields solutions for the optimal spread and offering price for all underwritten securities and it yields comparative statics that explain the cross-sectional variation in actual spreads and initial returns across different types of underwritten securities. The theory also suggests two alternative explanations to the ones offered by Chen and Ritter (J. Finance 55 (2000) 1105) for the clustering of unseasoned equity offerings spreads at 7%.
Foodservice Design: Assessing the Importance of Physical Features to Older Consumers

The purpose of this study was to identify the issues Baby Boomers and other older consumers have with many of the physical aspects in foodservice settings. Of particular concern were accessibility and comfort, the importance of certain physical factors that might affect the choice of restaurant by seniors, and the service encounter. It was a follow-up to a previous study. The data were analyzed primarily by age and gender. Booth seats were the most preferred seating types. Overall means of restaurant design issues in 2012 were significantly lower than those in 1998.
Reactions of Acetaldehyde on CeO2 and CeO2-Supported Catalysts

Abstract The reactions of acetaldehyde were investigated on the surfaces of CeO 2 , 3 wt% Pd/CeO2, 3 wt% Co/CeO 2 , and 3 wt% Pd-3 wt% Co/CeO 2 by temperature programmed desorption (TPD) and infrared spectroscopy (FT-IR). The surface and bulk compositions of these catalysts were studied by X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD), and CO chemisorption. XRD patterns indicated that the fluorite structure of CeO 2 was maintained in all catalysts (calcined and H 2 -reduced) and that there were no apprediable differences in particle dimension between CeO 2 alone (96 A) and metal/CeO 2 catalysts (84-98 A). Reduced catalysts were investigated by XPS: Ce (3 d ) spectra indicated the precence of Ce 3+ cations, evidenced by V′ and U′ peaks at 885.0 and 903.7 eV, together with Ce 4+ species. Co 2 p spectra indicated the presence of Co 2+ cations, evidenced by the Co 2 p 3/2 line at 781.0 eV (and its satellite at about 788 eV) and Co 2 p 1/2 at 797.0 eV (and its satellite at about 804 eV). Pd metal was detected on Pd/CeO 2 and Pd-Co/CeO 2 . Several reactions of acetaldehyde were observed; they can be classified as oxidation, reduction, or carbon-carbon bond formation reactions. Oxidation to acetates and reduction to ethanol were observed on all catalysts; acetate species were identified by their IR bands at 1560-1540, 1451, 1400, 1343, and 1020 cm −1 at room temperature, and ethanol was observed to desorb at ca, 400 K during acetaldehyde TPD. Several other adsorbed species were observed (on hydrogen reduced catalysts) by IR: acetyl, fingerprinted by a 1684 cm −1 band on metal/CeO 2 , η 2 (C, O) acetaldehyde (bands at 1220-1268, 1175-1156, 950-940 cm −1 ) on Pd/CeO 2 and Pd-Co/CeO 2 , and CO adsorbed by its carbon to metal (Pd, Co) and by its oxygen to reduced Ce, giving rise to bands at 1730, 1739, and 1750 cm −1 . Four C-C bond formation reactions were observed: (1) β-aldolization to crotonaldehyde and crotyl alcohol (most prominent on CeO 2 alone), (2) acetate ketonization to acetone and CO 2 on CeO 2 and Co/CeO 2 , (3) acetyl reaction with methyl species to give acetone on Pd/CeO 2 , Co/CeO 2 , and Pd-Co/CeO 2 (this acetone desorption was coincident with propane desorption on Pd/CeO 2 and Co/CeO 2 ), (4) reductive coupling of two molecules of acetaldehyde to butene and butadiene (on CeO 2 and Co/CeO 2 ). Pd-Co/CeO 2 adsorbed four times more CO than did Pd/CeO 2 or Co/CeO 2 and was the most active for acetaldehyde conversion.
Preservation of glucose tolerance and insulin secretory response to repeated glucose loads by the feeding of minimal glucose during prolonged fasting

Abstract The facilitation of glucose disposal (Staub-Traugott effect) and potentiation of serum insulin (IRI) concentration normally occurring after closely spaced intravenous glucose loads, are known to disappear after prolonged starvation. To study the effects of minimal amounts of glucose during fasting upon the insulin response and disposal of repeated intravenous glucose tolerance tests, obese volunteers were fasted for a mean of 25 ± 2 days, while receiving either 8 or 16 gm of oral glucose every 6 hr, and compared to totally fasted subjects without glucose supplementation. Weight loss rate and the fall in basal IRI and glucose levels were similar to those of totally fasted subjects. However, the Staub-Traugott effect and insulin secretory dynamics after stimulation by repetitive intravenous glucose loading were preserved by this glucose modified fast, while baseline serum glucagon levels (IRG) were significantly lower, and the basal IRI/IRG ratios were thus unchanged from the fed state. IRG and free fatty acid suppression were similar in the fed and glucose modified fasted states. Lactic acid levels increased as expected after the repeated glucose injections in the fed state, but failed to do so after the prolonged modified fast until the second and third repetitive glucose loads, in which a significant rise coincided with accelerated glucose disposal. It is suggested that minimal amounts of carbohydrate during fasting preserve the insulin potentiating action of glucose, preferentially sparing a delayed releasable pool of insulin, while protecting the glucose utilization mechanisms, including increased glycolysis, responsible for the Staub-Traugott effect.
Reinventing Emergency Department Flow via Healthcare Delivery Science

Healthcare system flow resulting in emergency departments (EDs) crowding is a quality and access problem. This case study examines an overcrowded academic health center ED with increasing patient volumes and limited physical space for expansion. ED capacity and efficiency improved via engineering principles application, addressing patient and staffing flows, and reinventing the delivery model. Using operational data and staff input, patient and staff flow models were created, identifying bottlenecks (points of inefficiency). A new flow model of emergency care delivery, physician-directed queuing, was developed. Expanding upon physicians in triage, providers passively evaluate all patients upon arrival, actively manage patients requiring fewer resources, and direct patients requiring complex resources to further evaluation in ED areas. Sustained over time, ED efficiency improved as measured by near elimination of "left without being seen" patients and waiting times with improvement in door to doctor, patient satisfaction, and total length of stay. All improvements were in the setting on increased patient volume and no increase in physician staffing. Our experience suggests that practical application of healthcare delivery science can be used to improve ED efficiency.
t(X;18) reverse transcriptase-polymerase chain reaction demonstrating a variant transcript.

Maureen J. O’Sullivan’s current address is the Department of Pathology, Edinburgh University Medical School, Edinburgh, Scotland.
Statistical thermodynamics of bulk polymers: A unified approach

Abstract The methodology of a molecular theory encompassing the three states of melt, crystal and glass, and results are reviewed. The distinctions between monomeric-type and chain molecular ensembles reside in the obvious geometric restraints and in a dynamic factor, i.e., the spectrum of “soft” and “hard” modes in a flexible chain. The introduction of a flexibility parameter which is to be independent of temperature and pressure, consistent with the earlier proposal of Prigogine et al. reduces the polymer to a monomer problem. Here cell theory, intended originally by Lennard-Jones and Devonshire as a description of the liquid state, yields the equation of state for the crystal. The distinction between the two states resides in a vacancy fraction in the quasilattice which serves as a structural disorder function. At equilibrium it is derived by the minimization of a configurational free energy. The quantitative success of the liquid state theory is briefly illustrated by comparisons with low and high pre...
Iron oxide nanoparticles as drug delivery agents in MIA PaCa-2 pancreatic cells

Oleic acid (OA)-Pluronic-coated iron oxide nanoparticles were synthesized and characterized by Fourier Transform Infrared Spectroscopy (FT-IR) and Atomic Force Microscopy (AFM). FT-IR confirmed the bonding of oleic acid and Pluronic (surfactant) to the nanoparticles. AFM measurements on these nanoparticles indicated a root mean square (RMS) roughness, a measure of nanoparticle size of (50 ± 20) nm. The efficiency of these functionalized nanoparticles was investigated by loading with 5-Fluorouracil (5-FU) in aqueous solution. AFM measurements were used to characterize modified iron oxide nanoparticles and pancreatic MIA PaCa-2 cells, including size distribution, stability and cellular uptake. Nanoparticles were added to MIA PaCa-2 cells and assayed for their cytotoxic effects after 24 and 48 hours. The outcome of this study demonstrated the effectiveness of oleic acid (OA)-Pluronic-coated iron oxide nanoparticles as a non-toxic drug delivery agent for pancreatic cancer.
Conformational changes of DNA in chromatin and the nucleosome sub-unit.

Conformation of the DNA in a salt-soluble chromatin and in the nucleosome sub-unit was studied in a variety of ionic environments. Precipitation with Mg2+ was used as one kind of a probe to indicate the arrangement of the proteins in the complex. Parallel circular dichroic measurements were also made. Three types of DNA conformation have been described: (1) an extended configuration. (2) an intermediate type as observed in the high mol. wt, salt-soluble chromatin and (3) the type seen in the nucleosome sub-unit. Both the chromatin and the nueleosome are pictured as flexible complexes iheir structure being highly dependent on the ionic environment.
Sucrose crystallization kinetics in thin films at elevated temperatures and supersaturations

Sucrose crystal growth from stagnant sucrose syrups in thin films was monitored by videomicroscopy at different temperatures and concentrations in order to obtain sucrose crystal growth rates as a function of sucrose total solids at four temperatures (40, 55, 70, and 82 °C). Total solids were varied from 70% to 95%, creating supersaturation values (based on concentration units in weight percent) of 1.02−1.3 at each temperature. Growth rates for individual crystals at each temperature under stagnant growth conditions in thin films were monitored by an image analysis system for up to 30 min. Additionally, theoretical growth rates based on diffusion-limited sucrose growth models were obtained at the same temperatures. A concentration gradient model was compared to a model based on chemical potential differences. At 40, 55, and 70 °C, growth rates decreased at very high supersaturation values, whereas at 82 °C growth rates continued to increase with supersaturation (within experimental limits). The diffusion-...
Evidence for a new phase of matter measured with the STAR experiment at RHIC

I will show recent results of the STAR experiment measured in p-p, d-Au and Au-Au collisions at RHIC energies. Evidence for collective behavior of a new phase of matter is shown based on bulk properties. The characterization of the new matter, using high momentum particles produced in the same collisions, indicates that partons are indeed the relevant degrees of freedom in the produced state. Surprisingly the medium exhibits strong coupling, though, and seems to behave more like an ideal fluid than a weakly interacting plasma. Unique features such as strong partonic flow and jet quenching will be discussed in detail.
Comparison of flow cytometry- and microscopy-based methods for measuring micronucleated reticulocyte frequencies in rodents treated with nongenotoxic and genotoxic chemicals

The development of automated flow cytometric (FCM) methods for evaluating micronucleus (MN) frequencies in erythrocytes has great potential for improving the sensitivity, reproducibility, and throughput of the traditional in vivo rodent MN assay that uses microscopy-based methods for data collection. Although some validation studies of the FCM evaluation methods have been performed, a comprehensive comparison of these two data collection methods under routine testing conditions with a variety of compounds in multiple species has not been conducted. Therefore, to determine if FCM evaluation of MN frequencies in rodents was an acceptable alternative to traditional manual scoring methods in our laboratory, we conducted a comparative evaluation of MN-reticulocyte (MN-RET) frequencies determined by FCM- and microscopy-based scoring of peripheral blood and bone marrow samples from B6C3F1 mice and Fisher 344 rats. Four known inducers of MN (cyclophosphamide, ethyl methanesulfonate, vincristine sulfate, acrylamide) were assayed in bone marrow and peripheral blood of both mice and rats. In addition, MN-RET frequencies were measured in bone marrow (microscopy) and peripheral blood (FCM) of mice treated with five nongenotoxic chemicals (S-adenosylmethionine chloride, cefuroxime, diphenolic acid, 3-amino-6-methylphenol, pentabromodiphenyl oxide). No significant differences were observed between results obtained by the two methods in either species. These results support the use of FCM for determining MN-RET frequency in rodents after chemical exposure.
Oxygen Therapy in Chronic Obstructive Pulmonary Disease

Since the introduction of oxygen as a therapeutic agent 70 years ago, much has been learned regarding the detrimental effects of hypoxemia and the beneficial impact of oxygen therapy. It is projected that there are close to 800,000 patients receiving long-term oxygen therapy (LTOT) in the United States, at a cost of approximately $1.8 billion annually. The large numbers of patients receiving supplemental oxygen as treatment and the high costs incurred in providing oxygen therapy necessitate the practitioner to know the indications for LTOT as well its effects on survival, pulmonary hemodynamics, sleep, and exercise capacity. It is now recognized that the basis for LTOT prescription for all patients is founded on data that are over 25 years old and that only involve a very select cohort of patients. It is clear that further studies are required to assess the effects of oxygen on patients with chronic obstructive pulmonary disease with only mild hypoxemia, not only survival but also on neurocognitive function, quality of life, exercise physiology, and sleep quality. In addition, although proven to be safe when prescribed long term to individuals with lung disease, there are some concerns about worsening carbon dioxide retention and increased oxidant injury. The goals of this article are to briefly describe the indications for chronic oxygen administration, the physiologic effects of treatment, and potential toxicities, as well as its effect on morbidity and mortality.
Chemical effects of CF3H in extinguishing counterflow CO/air/H2 diffusion flames

The relative importance of introducing CF3H as a fire suppressant with the oxidizer or the fuel stream, and its chemical and thermal effects on the extinction condition of counterflow CO/air/H2 diffusion flames, are investigated both experimentally and numerically. In experiments, the extinction strain rate is evaluated by measuring the jet exit velocities at extinction and the jet separation distance. In numerical calculations, the potential flow approximation is introduced to describe the outer flow field and the strain rate at extinction is determined from the axial velocity gradient on the oxidizer side. By employing mixture fraction concepts, the shift in flame location within the mixing layer caused by increasing the CF3H mole fraction or switching CF3H from air to fuel stream is shown to affect the measured and predicted extinction strain rates significantly. Flame structure and reaction pathway analyses have been used to identify the ratecontrolling reactions and the influence of introducing the supressing agent from the oxidizer or fuel side on the finite-rate chemistry. Subsequent sensitivity analysis has shown that two alternate CF3-consumption reaction pathways can either increase or decrease the extinction strain rate, similar to the sensitivities found in a recent premixed burning velocity study. Finally, based on the numerical calculations, the overall chemical and thermal effects of CF3H are demonstrated by freezing the CF3H chemistry and by replacing the heat capacity of CF3H with that of N2 for the frozen case.
Patterns of blood flow through filaments and lamellae of isolated-perfused rainbow trout (Salmo gairdneri) gills

Abstract 1. 1. Individual gill arches of rainbow trout ( Salmo gairdneri ) were prepared surgically and were perfused, at constant pressure, with solutions containing indian ink. The inflow and collection pressures were 40 and 15 mm Hg respectively. 2. 2. The routes for blood flow through filaments and lamellae of isolated, perfused gills are described and our observations confirm those made by Steen & Kruysse (1964) using isolated non-perfused gills. 3. 3. The effects of atropine indicate that there may be some tonic cholinergic regulation of gill blood flow, but significant changes in filamental and lamellar flow patterns appear to be controlled adrenergically. 4. 4. Regulation of filamental and lamellar blood flow by vasoconstriction and vasodilation of sinus vessels and lamellar arterioles is suggested.
Calculation of uncertainties of U-Pb isotope data

Abstract Equations are derived for the estimation of errors and error correlations for various types of U-Pb isotope data, taking into account ion-beam instabilities, run-to-run variability in mass-discrimination, uncertainties in Pb and U concentrations, and uncertainties in initial-Pb and blank-Pb amount and isotopic composition. Equations are also given for the calculation of concordia intercept errors.
Monitoring performance: longterm impact of trauma verification and review.

Background This study documents how the verification process at a Level I pediatric trauma center affected patient care through changes in care indicators (CIs) from predesignation through four postverification time frames. An important component of any verification program is its effectiveness, not only at the time of verification but during the time between "examinations." To date, few data exist describing the interval periods and the progression and maturation of a trauma program after initial verification. Study design Forty-seven distinct CIs were monitored monthly through data generated from the trauma registry. Six distinct time periods were identified. PRE (January, June, October 1997), trauma care without monitoring; VER (November 1999 to September 2000), preparation for verification; and four postverification periods: P1 (January to June 2001), P2 (July to December 2001), P3 (January to June 2002), and P4 (July to September 2002). Results Between 1997 and 2002, trauma admissions increased from 200 per year to 313 per year. Mortality rate and Injury Severity Score distributions remained unaltered. Statistically significant (p Conclusions Statistically significant changes in patient care indicators were noted to improve during the trauma center designation process, and other key deficiencies were identified and addressed. Maintaining these improvements requires constant monitoring or performance may revert below accepted levels.
Design of broadband filters and antennas for SAMBA

We present a design for multipixel, multiband submillimeter instrument: SAMBA (Superconducting Antenna coupled, Multi-frequency, Bolometric Array).
The Effects of Work and Community Resources and Demands on Family Integration

This paper uses interviews with 1,156 married dual-earner parents of children aged 10–17 from the 1992–1994 National Survey of Families and Households to examine relationships between work and community resources and demands and two aspects of family integration: activities with adolescents and family cohesion. The results indicate that mothers' shorter paid work hours and fathers' lower participation in community-professional organizations and moderate and high levels of informal helping are positively related to activities with adolescents, whereas moderate and high levels of participation in organized youth activities are positively related to family integration. Community-based subjective resources are positively related to family integration, whereas work-based subjective demands are negatively related to family cohesion. The findings generally are similar for mothers and fathers.
Production of Ultra-Thin Metal Films Using Neutral Cluster Beams

Gold clusters (diam. = 1.0 ± .5 nm) are prepared in a gas aggregation source (MECS), expanded into a vacuum chamber to form a neutral cluster beam, and deposited at low impact velocity on room temperature substrates. When several monolayers of these clusters are deposited on clean substrates (nitrocellulose, glass, mica, NaCl), they form smooth ultra-thin films. These cluster-assembled films appear to be similar in quality to those produced by the Takagi-Yamada ion cluster beam process. They exhibit finite electrical conductivity at thicknesses much smaller than is the case with atomically evaporated films. They are extremely uniform and smooth with a surface height that typically varies less than 1 nm across the entire film.
Vitamin D metabolites stimulate phosphatidylcholine transfer to renal brush-border membranes

The phosphatidylcholine content of both the intestinal and renal brush-border membranes and ion transport are affected by 1,25-dihydroxycholecalciferol (1,25(OH)2D3). To investigate the mechanism of this effect, liposomes were prepared containing self-quenching concentrations of fluorescent phospholipid derivatives. When these liposomes were incubated with rat renal brush-border membrane vesicles, an immediate increase in the relative fluorescence of N-4-nitrobenz-2-oxa-1,3-diazole phosphatidylcholine (NBD-PC) was detected, indicating transfer of NBD-PC into a non-quenched membrane. Addition of 1,25(OH)2D3 to the liposomes produced a dose-dependent stimulation of NBD-PC transfer to the acceptor brush-border membrane vesicles. Peripheral fluorescence was visible when the brush-border membrane vesicles were viewed with a fluorescent microscope. Using brush-border membrane vesicles from kidneys of vitamin D-deficient animals, quantitation of lipid transfer revealed a 1,25(OH)2D3 (10−7 M) stimulation of NBD-PC transfer from 1.38 ± 0.27 to 2.07 ± 0.26 μg/h, and of PC transfer, assessed by vesicle phosphatidylcholine content, from 49.7 ± 12 to 57.3 ± 12 μg/mg protein per h (P < 0.05). There was no significant transfer of N-(lissamine rhodamine B sulfonyl)dioleoylphosphatidylethanolamine (N-Rh-PE). In the absence of hormone, the amount of NBD-PC transferred to brush-border membrane vesicles prepared from normal rats was significantly greater than that transferred to brush-border membrane vesicles prepared from vitamin D-deficient animals (2.12 ± 0.02 vs. 1.39 ± 0.27 μg of NBD-PC/h, P < 0.05). Both physiologic and pharmacologic concentrations of 1,25(OH)2D3 stimulated NBD-PC transfer with maximum response at 10−14 M (2.98 ± 0.15 μg/h). 24,25-Dihydroxycholecalciferol and 25-hydroxycholecalciferol (25(OH)D3) also stimulated transfer, although dose-response curves were less effective than for 1,25(OH)2D3. Cortisol and vitamin D-3 did not stimulate transfer. 1,25(OH)2D3 did not stimulate NBD-PC transfer between liposome populations.
Predictors of Asthma Medication Nonadherence

Background The purpose of this study was to describe asthma medication adherence behavior and to identify predictors of inhaled corticosteroid (ICS) underuse and inhaled beta-agonist (IBA) overuse. Methods Self-reported medication adherence, spirometry, various measures of status, and blood for immunoglobulin E measurement were collected on 158 subjects from a larger cohort of adults with asthma and rhinitis who were prescribed an ICS, an IBA, or both. Results There was a positive association between ICS underuse and higher forced expiratory volume in one second percent (FEV1%) predicted ( P = .01) and a negative association with lower income ( P = 0.04). IBA overuse was positively associated with greater perceived severity of asthma ( P = 0.004) and negatively with higher education level ( P = 0.02). Conclusions Nonadherence to prescribed asthma therapy seems to be influenced by socioeconomic factors and by perceived and actual severity of disease. These factors are important to assess when trying to estimate the degree of medication adherence and its relationship to clinical presentation.