cssi/SciSciGPT-SciSciNet huggingface dataset:
Emergency Department Point-of-Care Ultrasonography Can Reduce Length of Stay in Pediatric Appendicitis: A Retrospective Review.

OBJECTIVES Appendicitis is the most common pediatric surgical emergency. Ultrasonography is recommended as first-line imaging for appendicitis in children; however, this is often followed by more advanced imaging. Our goal was to determine if point-of-care ultrasonography (POCUS) could reduce cost and length-of-stay (LOS) in suspected pediatric appendicitis. METHODS We performed a chart review of patients presenting to our pediatric emergency department (ED) from August 1, 2017 to June 30, 2019 who had imaging for appendicitis. We compared cost and LOS for patients who received POCUS to those who had magnetic resonance imaging (MRI) as first-line imaging, which is standard at our institution. RESULTS We identified 695 visits of 685 unique patients. Patients who received POCUS (n = 209) had a significantly shorter mean LOS (274 minutes) in the ED compared to patients who did not (317 minutes, P <.001). This was true regardless of the month of their visit. The POCUS group was younger, less likely to have right lower quadrant pain/tenderness, less likely to be admitted, and less likely to have appendicitis than the MRI group. Average appendix imaging cost per patient was lower in the POCUS group at $1308 compared to the MRI group at $1371 (P <.001), although patients who had both POCUS and MRI (n = 102) had the highest average imaging costs ($2010). CONCLUSION POCUS can reduce LOS and imaging cost in suspected pediatric appendicitis. Further study is warranted to determine which patients benefit the most from POCUS and whether the results are applicable in other settings.
Percutaneous cryoneurolysis of the lateral femoral cutaneous nerve for analgesia following skin grafting: a randomized, controlled pilot study.

Burn pain includes not only the burn itself but also the pain associated with procedures such split thickness skin graft (STSG) harvesting.[1][1] Opioid analgesics, conventionally the first-line agent for burn analgesia, are associated with hyperalgesia in burn patients.[2][2] Peripheral nerve
Comparing the CamBlobs2 contrast sensitivity test to the near Pelli-Robson contrast sensitivity test in normally-sighted young adults.

PURPOSE Contrast sensitivity (CS) has been proposed as a potential method for patients to assess their vision at home. The CamBlobs2 contrast sensitivity test is meant to be performed easily in the clinic or at home. The purpose of this study was to determine the intra-visit coefficient of repeatability of the CamBlobs2 compared with the near Pelli-Robson test, and the limits of agreement between these two tests on normally-sighted subjects. METHODS Twenty-two normally-sighted subjects (mean age 28 ± 4 years) completed two trials of the near Pelli-Robson and CamBlobs2 contrast sensitivity tests within a single visit. Tests were performed monocularly on each eye in random order. Pelli-Robson tests were scored as 0.05 logCS for each letter read correctly after deducting the first triplet. CamBlob2 tests were scored as the highest line where two or fewer blobs were marked correctly. The coefficient of repeatability was determined as 1.96 times the standard deviation of the difference between the two measurements using the same type of chart on the same eye. The limits of agreement between the two tests were evaluated using Bland-Altman analysis. RESULTS The mean difference between intra-visit measurements for both the near Pelli-Robson and CamBlobs2 was less than 0.05 logCS and the coefficient of repeatability was within ±0.20 log CS for both left and right eyes. The mean ± standard deviation differences between near Pelli-Robson and CamBlobs2 scores was -0.08 ± 0.08 (limits of agreement: -0.24 to 0.09) for right eyes and -0.05 ± 0.10 (limits of agreement: -0.23 to 0.14) logCS for left eyes based on average measurements. CONCLUSIONS The intra-visit repeatability of CamBlobs2 was consistent with the near Pelli-Robson contrast sensitivity test (±0.20 logCS). With a 0.05 correction, the CamBlobs2 scores showed excellent agreement with the near Pelli-Robson contrast sensitivity test.
Resurrecting and Appending Identities: The Role of Nonprofits in Managing Stigmatized Identity:

Homelessness is an issue that impacts more than half a million people in the United States every day. Nonprofits are often on the front lines of efforts to aid individuals without homes. In this st...
Tunable and Recyclable Polyesters from CO2 and Butadiene

Carbon dioxide is inexpensive and abundant, and its prevalence as waste makes it attractive as a sustainable chemical feedstock. Although there are examples of copolymerizations of CO2 with high-energy monomers, the direct copolymerization of CO2 with olefins has not been reported. Herein, an alternate route to tunable, recyclable polyesters derived from CO2 and butadiene via an intermediary lactone, 3-ethyl-6-vinyltetrahydro-2H-pyran-2-one, is described. Catalytic ring-opening polymerization of the lactone by 1,5,7-triazabicyclo[4.4.0]dec-5-ene yields polyesters with molar masses up to 13.6 kg/mol and pendent vinyl sidechains that can undergo post-polymerization functionalization. The polymer has a low ceiling temperature of 138 oC, allowing for facile chemical recycling. These results mark the first example of a well-defined polyester derived solely from CO2 and olefins, expanding access to new feedstocks that were once considered unfeasible.
Generalizability of Randomized Controlled Trials in Rectal Cancer.

The generalizability of outcomes from randomized controlled trials (RCTs) in oncology is a frequent concern. Given the prevalence and multidisciplinary management of rectal cancer, understanding the generalizability of rectal cancer RCTs is critical to surgical oncologists. An exhaustive literature review identified 100 non-metastatic rectal cancer RCTs published in English over the past 10 years investigating surgery, chemotherapy, or radiotherapy. In order to evaluate the representativeness of these RCTs compared to the USA and each continent’s rectal cancer populations, demographic characteristics were stratified by surgical versus chemoradiotherapy (CRT) trial and by continent then compared with the National Cancer Database and CANCER TODAY using chi-squared and Welch’s t-tests. Of the 100 trials identified, 65% enrolled significantly younger patients, and 38% enrolled a significantly greater proportion of males than the US rectal cancer population. These demographic differences were more prominent among CRT trials than surgical trials. Half of all trials enrolled patients who were on average more than 7 years younger and enrolled a 5% greater proportion of males than their respective continental rectal cancer populations. Patients enrolled in trials had more advanced cancers than their corresponding continental populations. Sociodemographic data was rarely reported. Patients enrolled in trials were younger, predominantly male, and had advanced stage cancer when compared to the rectal cancer population. Sociodemographic variables are underreported, further limiting equal participation in clinical trials. Future rectal cancer RCTs should strive to recruit representative samples. To enhance recruitment of women and underrepresented minorities, tailored recruitment strategies must be implemented.
The Role of the Interface in Refractory Metal Alloy Composites

Tungsten fiber reinforced niobium alloy metal matrix (W/Nb) composites were evaluated in creep‐rupture and tensile tests. Thoriated tungsten wires were chosen as the reinforcement material, and composite specimens were hot isostatically pressed using arc‐sprayed monotape in sealed in situ cans produced by hot pressing. An order of magnitude increase in composite strength was observed over the matrix strength in both short term and long term tests. The effect of the fiber/matrix interface on this strength increase is examined.
Sparse decomposition of gene expression data to infer transcriptional modules guided by motif information

An important topic in computational biology is to identify transcriptionalmodules through sequence analysis and gene expression profiling. Atranscriptional module is formed by a group of genes under control of one orseveral transcription factors (TFs) that bind to cis-regulatory elements in thepromoter regions of those genes. In this paper, we develop an integrative approach,namely motif-guided sparse decomposition (mSD), to uncover transcriptionalmodules by combining motif information and gene expression data.The method exploits the interplay of co-expression and co-regulation to findregulated gene patterns guided by TF binding information. Specifically, a motif-guided clustering method is first developed to estimate transcription factorbinding activities (TFBAs); sparse component analysis is then followed to furtheridentify TFs' target genes. The experimental results show that the mSD approachcan successfully help uncover condition-specific transcriptional modulesthat may have important implications in endocrine therapy of breast cancer.
Stochastic k-Coverage in Wireless Sensor Networks

Sensor scheduling is a critical issue in the design of wireless sensor networks (WSNs) with a goal to achieve certain coverage degree of a field. In this paper, we focus on the sensor scheduling problem to guarantee sensing k-coverage , where each point in a field is covered by at least k sensors, while maintaining network connectivity . Precisely, we propose a global framework that considers both deterministic and stochastic sensing models of the sensors. For each of these sensing models, we decompose the sensor scheduling problem for k -coverage in WSNs into two sub-problems: k -coverage characterization problem and k-coverage-preserving scheduling problem . Our solution to the first problem is based on Helly's Theorem and the analysis of a geometric structure, called Reuleaux triangle . To solve the second problem, we propose a distributed approach that enables each sensor to run a k-coverage candidacy algorithm to check whether it is eligible to turn itself on . We find a perfect match between our simulation and analytical results.
Increased erythrocyte osmotic fragility in pregnancy

An unexpected increase in erythrocyte osmotic fragility during pregnancy in two healthy women prompted a study of the effects of pregnancy on osmotic fragility. The incubated glycerol lysis time, a rapid, sensitive measure of osmotic fragility, was determined in 100 pregnant women and 50 nonpregnant control subjects. Twenty-two of the pregnant women (22%) showed abnormal results when compared to normal nonpregnant women (p less than 0.0005). Increased erythrocyte fragility was observed primarily in the last trimester of pregnancy. Twenty-one of 65 women in the last trimester (32.3%) had abnormal incubated glycerol lysis time values, but only one of 34 (2.9%) showed increased fragility during early pregnancy. Physiologic shifts in erythrocyte osmotic fragility may create a problem in the diagnosis of hereditary spherocytosis during the last trimester of pregnancy.
Catalytic Membrane Reactors

Membrane reactors combining reaction and membrane separation provide numerous advantages over conventional reactors, including retaining expensive catalysts, in situ purification, enhancing reaction rate, and reducing postprocessing of the reaction (by) products. In this article, two different ways were used to classify the various types of membrane reactors. One is based on whether the membrane is catalytic or noncatalytic, selective or nonselective, and whether or not a packed bed or a fluidized bed of catalysts is being used. The second classification is based on the membrane role: the extractor-type, the distributor-type, and the contactor-type membrane reactors. This article presents the key features of these three types of reactors and the various classes of reactions these reactors have been applied, with emphasis on conventional (i.e., nonbiochemical) reaction systems. Keywords: catalytic membrane reactors; catalytic dehydrogenation; pervaporation membrane reactors; Fischer–Tropsch synthesis; syngas production
Thermal analysis of selected illite and smectite clay minerals. Part II. Smectite clay minerals

In this paper, the application of the techniques of differential thermal analysis (DTA), thermogravimetry (TG) and derivative thermogravimetry (DTG) to the characterization of smectite clay minerals is presented. Several specimens including both dioctahedral and trioctahedral types of smectite clay mineral are included here. The use of DTA to separate the mineral montmorillonite into two subtypes is demonstrated. A unique industrial example of the use of TG to follow the cleaning of a raw bentonite clay and its subsequent conversion into an organo-clay product is demonstrated. The thermal analysis of both raw and processed hectorite clay specimens which was originally performed by the author is reviewed.
Pressure dependence of the superconducting and Néel temperatures in a La2CuO4+ delta crystal.

We have measured the temperature dependence of the resistance for a ${\mathrm{La}}_{2}\mathrm{Cu}{\mathrm{O}}_{4+\ensuremath{\delta}}$ single crystal at pressures from 1 bar to 18 kbar. The effects of pressure on the antiferromagnetic transition temperature ${T}_{N}$ and the superconducting transition temperature ${T}_{c}$ are compared to those of oxygen doping.
The SAS-3 X-ray observatory

The experiment section of the Small Astronomy Satellite-3 (SAS-3) launched in May 1975 is an X-ray observatory intended to determine the location of bright X-ray sources to an accuracy of 15 arc-seconds; to study a selected set of sources over a wide energy range, from 0.1 to 55 keV, while performing very specific measurements of the spectra and time variability of known X-ray sources; and to monitor the sky continuously for X-ray novae, flares, and unexpected phenomena. The improvements in SAS-3 spacecraft include a clock accurate to 1 part in 10 billion, rotatable solar panels, a programmable data format, and improved nutation damper, a delayed command system, improved magnetic trim and azimuth control systems. These improvements enable SAS-3 to perform three-axis stabilized observations of any point on the celestial sphere at any time of the year. The description of the experiment section and the SAS-3 operation is followed by a synopsis of scientific results obtained from the observations of X-ray sources, such as Vela X-1 (supposed to be an accreting neutron star), a transient source of hard X-ray (less than 36 min in duration) detected by SAS-3, the Crab Nebula pulsar, the Perseus cluster of galaxies, and the Vela supernova remnant.
Energy Absorption of Thin Walled Members Under Axial Compressive Loading

This study was conducted to investigate the effects of cross-sectional geometry on thin wall axial crushing members for the purpose of improved energy absorption. A total of five geometrically equivalent shapes (same wall thickness area, material, and length) were analyzed namely, triangle, rectangle, square, pentagon, and circle. The deformation modes and energy absorption of the members were studied under compressive loads and compared using ABAQUS/Explicit module, finite element analysis software. The simulations revealed that for the five geometrically equivalent cross sections under equal loading conditions, the pentagon shaped member absorbed the highest amount of energy. As compared to baseline rectangle member, the pentagon member absorbed approximately 25–28% more energy.Copyright © 2014 by ASME
Safety of coronary reactivity testing in women with no obstructive coronary artery disease: results from the NHLBI-sponsored WISE (Women's Ischemia Syndrome Evaluation) study.

Objectives This study evaluated the safety of coronary reactivity testing (CRT) in symptomatic women with evidence of myocardial ischemia and no obstructive coronary artery disease (CAD). Background Microvascular coronary dysfunction (MCD) in women with no obstructive CAD portends an adverse prognosis of a 2.5% annual major adverse cardiovascular event (MACE) rate. The diagnosis of MCD is established by invasive CRT, yet the risk of CRT is unknown. Methods The authors evaluated 293 symptomatic women with ischemia and no obstructive CAD, who underwent CRT at 3 experienced centers. Microvascular function was assessed using a Doppler wire and injections of adenosine, acetylcholine, and nitroglycerin into the left coronary artery. CRT-related serious adverse events (SAEs), adverse events (AEs), and follow-up MACE (death, nonfatal myocardial infarction [MI], nonfatal stroke, or hospitalization for heart failure) were recorded. Results CRT-SAEs occurred in 2 women (0.7%) during the procedure: 1 had coronary artery dissection, and 1 developed MI associated with coronary spasm. CRT-AEs occurred in 2 women (0.7%) and included 1 transient air microembolism and 1 deep venous thrombosis. There was no CRT-related mortality. In the mean follow-up period of 5.4 years, the MACE rate was 8.2%, including 5 deaths (1.7%), 8 nonfatal MIs (2.7%), 8 nonfatal strokes (2.7%), and 11 hospitalizations for heart failure (3.8%). Conclusions In women undergoing CRT for suspected MCD, contemporary testing carries a relatively low risk compared with the MACE rate in these women. These results support the use of CRT by experienced operators for establishing definitive diagnosis and assessing prognosis in this at-risk population. (Women's Ischemia Syndrome Evaluation [WISE]; NCT00832702 )
Direct stimulation of Vav guanine nucleotide exchange activity for Ras by phorbol esters and diglycerides.

Abstract We recently identified Vav as a Ras-activating guanine nucleotide exchange factor (GEF) stimulated by a T-cell antigen receptor-coupled protein tyrosine kinase (PTK). Here, we describe a novel, protein kinase-independent alternative pathway of Vav activation. Phorbol ester, 1,2-diacylglycerol, or ceramide treatment of intact T cells, Vav immunoprecipitates, or partially purified Vav generated by in vitro translation or COS-1 cell transfection stimulated the Ras exchange activity of Vav in the absence of detectable tyrosine phosphorylation. GEF activity of gel-purified Vav was similarly stimulated by phorbol myristate acetate (PMA). Stimulation was resistant to PTK and protein kinase C inhibitors but was blocked by calphostin, a PMA and diacylglycerol antagonist. In vitro-translated Vav lacking its cysteine-rich domain, or mutated at a single cysteine residue within this domain (C528A), was not stimulated by PMA but was fully activated by p56lck. This correlated with increased binding of radiolabeled phorbol ester to COS-1 cells expressing wild-type, but not C528A-mutated, Vav. Thus, Vav itself is a PMA-binding and -activated Ras GEF. Recombinant interleukin-1 alpha stimulated Vav via this pathway, suggesting that diglyceride-mediated Vav activation may couple PTK-independent receptors which stimulate production of lipid second messengers to Ras in hematopoietic cells.
Recent progress on the quantum-dot avalanche photodiode (QDAP)

Mid-infrared sensors in the 3–25 µm range are very important devices in applications such as medical imaging, night vision, fire-fighting equipment, and defense and security applications. Among the different technologies available, the quantum dot infrared photodetectors (QDIPs) and the quantum dots-in-a-well (DWELL) photodetectors are among the promising alternatives for high background threshold applications due to their beneficial characteristics, which include normal absorption of the incident radiation and low dark current. In addition, QDIP and DWELL detectors benefit from a mature growth and processing technology of III-V semiconductors, making it possible to produce devices with good spatial uniformity over a large area. This characteristic is essential for fabricating large area focal plane arrays (FPAs).
Persistence and habitat associations of Purple Martin roosts quantified via weather surveillance radar

Weather surveillance radars (WSR) have been used to locate roost sites used by Purple Martins (Progne subis) for decades. Improvements in radar data processing and accessibility now make it possible to monitor roosts over a broad spatial scale. We sought to locate all of the Purple Martin roosts in North America and to use the data to evaluate (1) the land cover types associated with roosts (2) relationships among roost persistence, land cover type, and regional population trends. We used mosaicked images of radar reflectivity based on the NEXRAD WSR network to locate 234 Purple Martin roosts that were active between 2009 and 2014. Of these roosts, we ground-truthed a subset of 57 with site visits and reports from citizen scientists. We assigned roosts to different classes based on local land cover, and used a variety of statistical and spatial analyses to address the objectives listed above. Roosts were mainly associated with forest, cropland, urban, and water land cover types, with cropland being the most common. There was an apparent preference for urban sites, and urban roosts were associated with the high year-to-year persistence. We found no correlation between roost persistence and regional population trends in data from the North American Breeding Bird Survey (BBS). Although they use a diverse array of roosting habitats, urban roosting areas appear to be increasingly important for Purple Martins. Persistence of urban roosts was high, which aligns with the species’ unique natural history and its association with human societies.
Design of Sustainable Biofuel Processes and Supply Chains: Challenges and Opportunities

The current methodological approach for developing sustainable biofuel processes and supply chains is flawed. Life cycle principles are often retrospectively incorporated in the design phase resulting in incremental environmental improvement rather than selection of fuel pathways that minimize environmental impacts across the life cycle. Further, designing sustainable biofuel supply chains requires joint consideration of economic, environmental, and social factors that span multiple spatial and temporal scales. However, traditional life cycle assessment (LCA) ignores economic aspects and the role of ecological goods and services in supply chains, and hence is limited in its ability for guiding decision-making among alternatives—often resulting in sub-optimal solutions. Simultaneously incorporating economic and environment objectives in the design and optimization of emerging biofuel supply chains requires a radical new paradigm. This work discusses key research opportunities and challenges in the design of emerging biofuel supply chains and provides a high-level overview of the current “state of the art” in environmental sustainability assessment of biofuel production. Additionally, a bibliometric analysis of over 20,000 biofuel research articles from 2000-to-present is performed to identify active topical areas of research in the biofuel literature, quantify the relative strength of connections between various biofuels research domains, and determine any potential research gaps.
Candidate positioning and responsiveness to constituent opinion in the U.S. House of Representatives

In this paper, I develop a survey-based measure of district ideology for the House of Representatives. I use this index to document and study ways in which patterns of candi- date positioning depart from perfect representation. These findings help distinguish between competing theories of candidate positioning. My findings present evidence against theories that attribute divergence to the preferences of voters and the locations of primary constituen- cies. My findings are potentially consistent with the policy-motivation and resource theories, which attribute divergence to the polarization of political elites.
Sequential interactions with Sec23 control the direction of vesicle traffic

How the directionality of vesicle traffic is achieved remains an important unanswered question in cell biology. The Sec23p/Sec24p coat complex sorts the fusion machinery (SNAREs) into vesicles as they bud from the endoplasmic reticulum (ER). Vesicle tethering to the Golgi begins when the tethering factor TRAPPI binds to Sec23p. Where the coat is released and how this event relates to membrane fusion is unknown. Here we use a yeast transport assay to demonstrate that an ER-derived vesicle retains its coat until it reaches the Golgi. A Golgi-associated kinase, Hrr25p (CK1δ orthologue), then phosphorylates the Sec23p/Sec24p complex. Coat phosphorylation and dephosphorylation are needed for vesicle fusion and budding, respectively. Additionally, we show that Sec23p interacts in a sequential manner with different binding partners, including TRAPPI and Hrr25p, to ensure the directionality of ER-Golgi traffic and prevent the back-fusion of a COPII vesicle with the ER. These events are conserved in mammalian cells.
Intraoperative high-dose-rate brachytherapy using dose painting technique: Evaluation of safety and preliminary clinical outcomes

Abstract Purpose Intraoperative radiation therapy (IORT) allows delivery of tumoricidal doses of radiation to areas of potential residual microscopic disease while minimizing doses to normal tissues. IORT using high-dose-rate (HDR) brachytherapy allows dose modulation and delivery of concomitant boosts to high-risk areas. This study describes a novel technique of HDR-IORT with dose painting (DP) (HDR-IORT-DP) and evaluates the clinical outcomes. Methods and Materials Sixteen patients with recurrent cancers received HDR-IORT-DP at the time of radical resection. Of these patients, 13 had colorectal cancer, 2 had head and neck cancer, and 1 had a gynecologic malignancy. All received external beam radiation previously. Negative margin (R0) was obtained in 12 patients (75%) and microscopically positive margins (R1) in 4 patients (25%). Results The median total target and boost area were 45 and 8.5 cm2, and HDR-IORT and boost dose were 1500 and 1750 cGy, respectively. Median followup was 14.9 months. The 2-year local control and overall survival were 80% and 20%, respectively. Eleven patients (69%) developed distant metastasis and were deceased at the time of the last followup. A total of 13 patients (19%) developed Grade 3 toxicity related to HDR-IORT; no grade 4+ toxicities were observed. Conclusions HDR-IORT-DP technique is feasible, safe, and allows for dose escalation in locally advanced or recurrent previously irradiated tumors. To our knowledge, this is the first clinical report on HDR-IORT-DP. Further studies are warranted to evaluate efficacy in a larger patient cohort. Local control was encouraging in our patients.
REVISION TOTAL HIP ARTHROPLASTY WITH CORRECTIONAL FEMORAL OSTEOTOMY IN PAGET'S DISEASE

Varus alignment of the femoral component is associated with femoral component loosening in total hip arthroplasty performed for Paget's disease. Irregular and hemorrhagic bone, along with angular femoral deformity, was encountered during revision total hip arthroplasty in three pagetic patients. A diaphyseal femoral osteotomy facilitated cement removal and provided an opportunity for correction of the deformity. The step-cut configuration of the osteotomy provided intrinsic rotational stability of the femoral segments around a modular, long-stem cementless implant. Excellent clinical and radiographic results were achieved, but moderate blood loss and delayed healing of the osteotomy site were observed.
Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for advanced gastric cancer

Peritoneal carcinomatosis is a common and universally fatal sequelae of gastric carcinoma. Treatment of peritoneal carcinomatosis from appendiceal and colorectal sources with intraperitoneal hyperthermic chemotherapy (IPHC) combined with aggressive cytoreductive surgery has been shown to be effective. There are few data on this treatment modality for carcinoma of the stomach. This study evaluates cytoreductive surgery and IPHC with peritoneal carcinomatosis from gastric carcinoma. Thirty-four patients with peritoneal carcinomatosis due to gastric carcinoma underwent gastric resection with cytoreductive surgery followed by IPHC with mitomycin C. A control group consisting of 40 contemporaneous patients, who underwent radical gastrectomy without extended nodal resection, was identified through the tumor registry. Despite more advanced disease in the IPHC group compared to the control group (P < 0.001), overall survival in the two groups was similar. Proportional-hazards regression analysis shows that only resection status is significantly correlated with improved survival (P = 0.0068). Within the IPHC group, patients who underwent an R0/R1 resection had increased survival times (11.2 vs. 3.3 months, P = 0.015) vs. those who underwent R2 resection. The group who had an R0/R1 resection had 1- and 2-year survival rates of 45% and 45% compared to 16% and 8%, respectively, in the R2 group. Cytoreductive surgery and IPHC is a modality with limited potential for the treatment of peritoneal carcinomatosis from gastric carcinoma. Careful patient selection for this procedure is imperative, and patients in whom an R0/R1 resection can be achieved are the best candidates.
Path analysis of the relationship between market share, business-level conduct and risk

This study evaluated the impact of market share on three measures of business-level risk: ROI variation, share instability and the difference between growth in price and growth in cost. The analysis also included conduct variables which might bear upon these relationships. The sample was drawn from the PIMS data base and consisted of mature industrial businesses separated into three types of market environments. Path analysis was employed and yielded partial support for the risk-reduction benefits of market share.
Data-based restructuring of a surgery residency: efficient data acquisition through electronic evaluation forms

Abstract Purpose To evaluate a new electronic evaluation system that was developed to increase compliance in returning faculty and rotation evaluation forms. Methods Compliance rates of returned evaluation forms were compared in 4 phases. Phase I was paper, baseline. Phase II was paper, with increased administrative enforcement. Database-driven evaluation forms were distributed to residents via e-mail in phase III and via the Internet in phase IV. Results Evaluation return rates are shown in Table 1 , Table 2 . Table 1 . Compliance rates for return of evaluations: comparison of phases I and II Evaluation form Phase I Phase II p value Rotation 35% 54% 0.001 Faculty 24% 55% 0.026 Table 2 . Compliance rates for return of evaluations: comparison of phases II and III Evaluation form Phase II Phase III p value Rotation 54% 91% Faculty 55% 91% Table 1 shows a comparison of phases I and II and Table 2 shows a comparison of phases II and III. In phase IV, residents who had not completed evaluations by e-mail did so via the Internet. Conclusions: Completion of electronic evaluation forms by residents represents a superior approach to Residency Review Committee–mandated evaluations. Improved compliance rates produced more complete samples than the paper forms, increasing the confidence of using the data for re-engineering the clinical teaching services and improving the educational experience offered by the residency, which is the ultimate goal of evaluations. The advantage of database-driven evaluations is that the responses can be tallied electronically, whereas returned paper forms (raw data) require manual examination. Web-based evaluations simplified data management and increased compliance further.
Lateral femoral scan: an alternative method for assessing bone mineral density in children with cerebral palsy.

Background. Children with cerebral palsy (CP), often nonambulatory and/or on anticonvulsants, are at increased risk for fractures. Bone mineral density (BMD) measured by the conventional techniques of dual-energy X-ray absorptiometry (DXA) often cannot be reliably or easily measured in these patients. Objective. To find an alternative site to whole body, spine and hip that can be conveniently used to measure BMD in CP patients. Materials and methods. Having observed that CP patients prefer to lie on their sides, we explored measuring BMD at the distal femur in the lateral projection. A total of 92 scans were performed without sedation in 34 children and adolescents with CP, aged 4–19 years. Four femoral shaft subregions were created: two trabecular and two cortical. Results. The coefficients of variation (CV %) were generally higher for opposite-side comparisons (n = 12 patients) than for same-side comparisons (n = 16 patients). For intra- and interobserver analyses, CV % were higher for cortical regions than for trabecular regions. Overall, the CV % were similar to those for hip and spine. Conclusion. This peripheral site in the femur should be considered as an alternative for patients with CP when whole-body, hip and spine DXA are not practical.
Cross-validation of a heroin addiction (He) scale in a treatment setting.

An He (Heroin Addiction) scale has been developed from the MMPI for differentiating incarcerated addicts from nonaddicts. Its clinical utility has not been tested among addicts seeking treatment in hospital-based treatment programs. In this cross-validation study, the He scale did not differentiate heroin users (n = 336) from polydrug users (n = 179). Further, White heroin users scored significantly higher than Black heroin users. Findings were similar in both analysis of variance and co-variance designs, both when potentially-confounding covariates were controlled and uncontrolled (i.e., the covariates age, education, socioeconomic status, and admission status). Although the scale showed promise for differentiating compulsive users of proscribed drugs categorized generally (but not heroin users specifically), nevertheless additional refinement of the scale is needed before it can be applied in hospital settings. Race, age, and admission status emerged as subject background characteristics meriting system...
Approximations for interactive Markov chains in discrete and continuous time

A class of models called interactive Markov chains is studied in both discrete and continuous time. These models were introduced by Conlisk and serve as a rich class for sociological modeling, because they allow for interactions among individuals. In discrete time, it is proved that the Markovian processes converge to a deterministic process almost surely as the population size becomes infinite. More importantly, the normalized process is shown to be asymptotically normal with specified mean vector and covariance matrix. In continuous time, the chain is shown to converge weakly to a diffusion process with specified drift and scale terms. The distributional results will allow for the construction of a likelihood function from interactive Markov chain data, so these results will be important for questions of statistical inference. An example from manpower planning is given which indicates the use of this theory in constructing and evaluating control policies for certain social systems.
Ionization Energy of Methylene Revisited: Improved Values for the Enthalpy of Formation of CH2 and the Bond Dissociation Energy of CH3 via Simultaneous Solution of the Local Thermochemical Network

The appearance energy of the CH{sub 2}{sup +} fragment from CH{sub 2}CO has been carefully remeasured and fitted by a model curve, producing EA{sub 0}(CH{sub 2}{sup +}/CH{sub 2}CO) = 13.743 {+-} 0.005 eV. This value can be sequentially propagated through selected thermochemical cycles to yield individual values for El(CH{sub 2}), D{sub 0}(H-CH{sub 2}), {Delta}H{sup o}{sub f 0}(CH{sub 2}CO). A set of values with a statistically larger weight is produced by analyzing a local thermochemical network, which combines the present measurement with thirteen other experimental determinations from the literature and encompasses the enthalpies of formation of CH{sub 3}, CH{sub 3}{sup +}, CH{sub 2}, CH{sub 2}{sup +}, and CH{sub 2}CO. The recommended simultaneously adjusted thermochemical values are: {Delta}H{sup o}{sub f 0}(CH{sub 3}) = 35.86 {+-} 0.07 kcal/mol (35.05 {+-} 0.07 kcal/mol at 298 K), {Delta}H{sup o}{sub f 0}(CH{sub 3}{sup +}) = 262.73 {+-} 0.06 kcal/mol (261.83 {+-} 0.06 kcal/mol at 298 K), {Delta}H{sup o}{sub f 0}(CH{sub 2}) = 93.18 {+-} 0.20 kcal/mol (93.31 {+-} 0.20 kcal/mol at 298 K), {Delta}H{sup o}{sub f 0}(CH{sub 2}{sup +}) = 332.92 {+-} 0.19 kcal/mol (333.04 {+-} 0.19 kcal/mol at 298 K), {Delta}H{sup o}{sub f 0}(CH{sub 2}CO) = -11.10 {+-} 0.21 kcal/mol (-11.85 {+-} 0.21 kcal/mol atmore » 298 K), as well as D{sub 0}(H{sub 3}C-H) = 103.42 {+-} 0.03 kcal/mol (104.99 {+-} 0.03 kcal/mol at 298 K), D{sub 0}(H{sub 2}C-H) = 108.95 {+-} 0.20 kcal/mol (110.35 {+-} 0.20 kcal/mol at 298 K), D{sub 0}(H{sub 2}C{double_bond}CO) = 77.08 {+-} 0.02 kcal/mol (78.73 {+-} 0.02 kcal/mol at 298 K), El(CH{sub 3}) = 9.3830 {+-} 0.0005 eV, and El(CH{sub 2}) = 10.3962 {+-} 0.0036 eV. These values are in excellent agreement with current and several previous experimental measurements. The recommended enthalpy of formation of CH{sub 2} implies that the reaction of singlet methylene with water is essentially thermoneutral (to within {+-}0.2 kcal/mol) at 0 and 298 K, and slightly endothermic (0.5 {+-} 0.2 kcal/mol) at 1000 K.« less
Asymptotic Cycles on Non-Compact Spaces

The notion of an asymptotic cycle is extended to flows on non-compact spaces, and it is proved that for a suitable class of flows on manifolds it is true that the set of points with asymptotic cycles defined has measure one with respect with every invariant probability measure.
Dasein Versus Design: The Problematics of Turning Making Into Thinking

Building on suggestions from the work of Martin Heidegger, a distinction is made between two ways of being in the world. One is associated with the unplanned particularity and care of Dasein, another with the planning and thinking-out of design; the former is characteristic of a more traditional way of life, the latter of contemporary life. Included are brief etymologies of `Dasein' and `design', along with some reflections on the two-fold history of design of internal structure and surface appearance (that is, of engineering and aesthetic design, respectively). The conclusion sketches out a problematics of engineering design as involving a disengagement from fundamental human experience, and suggests the need to discriminate between authenticity and inauthenticity in the world of design.
An Eocene Primate from California.

Recognition of a primate in the mammalian assemblage now being recorded from one of the faunal stages of the Sespe, north of the Simi Valley, California, comes with startling abruptness, yet is not wholly unexpected. No fewer than five fragments of jaws, probably representing as many individuals, have been found recently. The sudden appearance of this material in the collections of fossil mammalian remains obtained at Locality 150 Calif. Inst. Tech. Vert. Pale. commands attention when it is stated that excavations at this site have been in progress more or less continuously during the past two years.
Ultrafast experiments on intermolecular electron transfer in the benzene - bromine atom charge transfer complex

Abstract Ultrafast pump - probe measurements have been made on the benzene - bromine atom charge transfer (CT) complex in CCl4 and cyclohexane solutions. Ultrafast optical excitation of the CT band of the complex yields an ion pair, which is comprised of a benzene cation and a bromide anion. The rate of charge recombination between the bromide and the benzene cation in the ion pair has been observed to be much faster than the rate of diffusion apart. The charge recombination rate is accelerated at high benzene concentrations as a result of the formation of a benzene dimer cation - bromide ion pair which undergoes much faster charge recombination than the benzene cation - bromide ion pair.
The Kinetics of Nascent Protein Folding upon Release from the Ribosome

Very little is known about the way proteins attain their native structure within the context of the living cell. In addition to the ribosome's well-established role in peptide bond formation, recent studies suggest that ribosomes play an important role in the early stages of protein folding in the cell and may be crucial for the production of folded bioactive proteins. Importantly, little is known about the impact of the mechanism of protein release from the ribosome on the attainment of a correctly folded conformation. Here, we present a kinetic study on the release time-course of fully synthesized ribosome-bound nascent proteins upon addition of the antibiotic puromycin. We focus these studies on the E. coli globin ApoHmpH. By time-resolved gel electrophoresis, we are able to follow puromycin's hydrolysis of the ester bond linking nascent polypeptides to the 3’ end of tRNA. Steady-state fluorescence anisotropy allows us to follow the escape and folding of ApoHmpH from the ribosome. Finally, time decay fluorescence anisotropy analysis in the frequency domain complements the above techniques by providing insights into the local motions experienced by the nascent protein before and after release from the ribosome. Under experimental conditions where puromycin reacts at rates comparable to the naturally occurring release factors, we show that protein release from the ribosome is rate-limited by the C-terminal ester bond cleavage, and that escape from the ribosome and completion of folding occur quickly following this step. This result shows that the ribosomal context promotes a particularly “temporally efficient” folding upon nascent protein release. An important consequence of this phenomenon is the prevention of undesirable diffusion- and concentration-dependent phenomena such as aggregation.
A budget of inversions

Two problems of inversion are considered. First are the inverses in a stand ard circle of curves based on two fixed points, i.e., Circles of Apollonius, Conic Sections and Ovals of Cassini; then the inverses of lines not passing through the center of inversion while using ''circles'' based on the City Block Metric.
Key Microwave-Photonics Technologies for Next-Generation Cloud-Based Radio Access Networks

Several key enabling techniques are introduced for next-generation wireless communication systems. Small-cell and cloud-RAN systems have been considered as promising solutions to meet the capacity demand of the future wireless access networks. In addition, utilization of high radio frequency (e.g., millimeter-wave band) is another dimension to expand the spectrum to enhance the throughput. From the network perspective, a high capacity, low latency, and reliable backhaul/fronthaul network is important to support the advanced wireless access techniques. Therefore, microwave-photonics techniques can play an important role in the integrated optical-wireless access systems for next-generation wireless communications. In this paper, we first review several key features and enabling techniques for next-generation 5G wireless communications. Then, we introduce a multiservice small-cell wireless access architecture based on microwave-photonics technologies (cloud radio-over-fiber networks). By combining small-cell cloud-RAN concept with multiband delivery capability in an integrated optical-wireless access system, the proposed architecture can realize high-speed multiservice data transmission in a simplified and flexible way. An in-building cloud radio-over-fiber testbed was demonstrated with real-time WiMAX traffic. Two different approaches of delivering conventional services and future-proof high-data-rate millimeter-wave services in a converged platform are also analyzed and summarized.
Unilateral subthalamic nucleus deep brain stimulation improves sleep quality in Parkinson's disease.

Background Sleep disturbances are common in Parkinson’s disease (PD). Bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) is superior to best medical therapy in the treatment of motor symptoms in advanced PD, and observational studies suggest that bilateral STN DBS improves sleep in these patients as well. Unilateral STN DBS also improves motor function in PD, but its effects on sleep have not been extensively investigated.
Amyloidosis associated bleeding diatheses in the surgical patient.

The coagulopathies associated with amyloidosis have not been widely appreciated. We encountered a patient with amyloidosis and mildly abnormal coagulation studies who presented for an emergency laparotomy for acute bowel obstruction. Upon gentle manipulation of the bowel, an unexpected bleeding diathesis was manifested by the formation of several large haematomas resulting in a large amount of blood loss (≈800 ml). Numerous defects of platelet function and coagulation have been associated with amyloidosis, including abnormal platelet aggregation, increased vascular fragility, factor IX and X deficiencies, decreased levels of alpha-2-plasmin inhibitor, and increased levels ofplasminogen. Intraoperative therapy for our patient included the rapid administration of four units of fresh frozen plasma and ten units of platelet concentrate. A review of the pathology and therapeutic modalities for this potentially life-threatening complication is presented.
Fostering the work motivation of individuals and teams

Solid evidence supports claims that motivational programs can increase the quality and quantity of performance from 20 to 40 percent. Motivation can solve three types of performance problems: 1) people are refusing to change; and/or 2) allowing themselves to be distracted and not persist at a key task; and/or 3) treating a novel task as familiar, making mistakes but not investing mental effort and taking responsibility because of overconfidence. Everyone is motivated to do or value whatever they believe will make us effective or successful. The challenge is to find ways to support the great variety of different individual and cultural beliefs held by different people about success and what makes them effective at work. However, there are universal demotivators and positive strategies that tend to motivate everyone, despite our different beliefs and values. After describing a number of general strategies for fostering individual motivation, the article focuses on the unique motivational issues faced by teams and how to overcome them.
Postures and Motions Library Development for Verification of Ground Crew Human Factors Requirements

Spacecraft and launch vehicle ground processing activities require a variety of unique human activities. These activities are being documented in a primitive motion capture library. The library will be used by human factors engineering analysts to infuse real to life human activities into the CAD models to verify ground systems human factors requirements. As the primitive models are being developed for the library, the project has selected several current human factors issues to be addressed for the Space Launch System (SLS) and Orion launch systems. This paper explains how the motion capture of unique ground systems activities is being used to verify the human factors engineering requirements for ground systems used to process the SLS and Orion vehicles, and how the primitive models will be applied to future spacecraft and launch vehicle processing.