cssi/SciSciGPT-SciSciNet huggingface dataset:
Cost Awareness of Common Supplies Is Severely Impaired Among All Members of the Surgical Team.

Abstract Background Increased health care spending concerns have generated interest in reducing operating room (OR) costs, but the cost awareness of the surgical team selecting intraoperative supplies remains unclear. This work characterizes knowledge of supply cost among surgeons and OR staff in a large academic hospital and seeks to examine the role of experience and training with regards to cost insight. Methods This work is a cross-sectional study of surgeons, trainees, nurses, and surgical technicians (n = 372) across all surgical specialties at a large academic hospital. Participants completed a survey reporting frequency of use and estimated cost for 11 common surgical supplies as well as opinions on access to cost information in the OR. Cost estimation error was expressed as the ratio of estimated-to-actual cost, and groups were compared with one-way analysis of variance and chi-squared testing. Spearman correlation (ρ) was used to describe the relationship between monotonic variables. Results Overestimation error was universal and ranged widely (3.80-49.79). There was no significant difference in estimation accuracy when stratified by role or years of experience. Less expensive items had higher rates of estimation error than more expensive items (P Conclusions Price knowledge of common supplies is globally impaired for entire surgical team but coexists with a strong desire to augment cost awareness. Improved access to cost information has a high potential to inform surgical decision-making and decrease OR waste.
Missed opportunities: Arrest and court touchpoints for individuals who fatally overdosed in Philadelphia in 2016.

Abstract Background Many studies document high risk of fatal overdose after incarceration. Few explore earlier touchpoints in criminal justice processes, like arrests and court hearings. Understanding these touchpoints is important for several reasons. Arrest and adjudicatory processes are harmful even when not resulting in incarceration. Arrests and criminal hearings also may reflect changes in overdose-related risk factors like transitions in employment and housing stability. Moreover, knowledge about these touchpoints contextualizes debate about the implementation of court-based programs like Drug Treatment Courts. This study described the incidence and accumulation of touchpoints for people who fatally overdosed in Philadelphia in 2016, and depicted how touchpoint incidence and characteristics interface with court-program eligibility. Methods Criminal court documents were obtained for all individuals who fatally overdosed in Philadelphia in 2016 from the Philadelphia Medical Examiner's Office. The characteristics of arrests and court hearings were abstracted to compile lifetime criminal histories. Latent class analysis was performed to identify whether these histories followed observably distinct patterns. Results In 2016, 907 people fatally overdosed in Philadelphia. Of these, 605 had at least one or more of 3,926 arrests and 3,822 hearings over their lifetime. There were 488 arrests and 533 hearings in the two years before death, with public disorder charges especially common closer to death. Less than 20% of these hearings resulted in custodial sentences. Of individuals with touchpoints, only nine participated in Drug Treatment Court, consistent with findings that most individuals were ineligible. Latent class analysis suggested five distinguishable patterns in age, timing, and characteristics of touchpoints. Conclusions The type and frequency of touchpoints preceding fatal overdose reflect a period of complex vulnerability. Few individuals qualified for court-based programming, underscoring the limitations of supporting this population in specialized court settings. Reducing incidence and improving the health impact of criminal justice touchpoints remain important public health priorities.
High prevalence of injection drug use and blood-borne viral infections among patients in an urban emergency department.

Background The opioid epidemic has led to an increase in the number of persons who inject drugs, and this population accounts for 12% of new human immunodeficiency virus (HIV) and 60% of new hepatitis C virus (HCV) infections in the United States annually. While persons who inject drugs disproportionately utilize the emergency department (ED), accurate data is lacking on the prevalence and patterns of injection drug use, and prevalence of co-occurring HIV and HCV infections among ED patients. Objective The primary outcome was to assess the prevalence of injection drug use and co-occurring HIV and HCV infection among patients presenting to an urban ED. Methods This was a cross sectional study conducted at an urban ED, with an annual census of 65,000 visits. A closed-response questionnaire was developed based on publicly available validated surveys to assess patterns of injection drug use and HIV and HCV infection status, and administered by trained research assistants to all registered adult patients during 4-hour blocks of time. Results Of the 2,319 eligible patients, 2,200 (94.9%) consented and completed the survey. 241 (11.0%) had ever used injection drugs, 103 (4.7%) currently used injection drugs, and 138 (6.3%) formerly used injection drugs. White patients age 25 to 34 years and white patients age 55 to 64 years had the highest prevalence of current (25.6%) and former (27.1%) injection drug use, respectively. Persons who use injection drugs had a higher prevalence of HCV infection (52.7% vs. 3.4%) and HIV infection (6.2% vs. 1.8%) than the rest of the population. Conclusion A high prevalence of ED patients report injection drug use, and this population self-reports a high prevalence of HIV and HCV infection. Emergency departments are in a unique position to engage with this population with regards to substance use treatment and linkage to care for HIV and HCV infection.
Seeking to be serviceable some reflections on Hayes and Fryling (2019)

Abstract L. J. Hayes and Fryling (2019) defend Interbehaviorism against criticisms that it represents Descriptive Contextualism and present an argument for how Interbehaviorism might be more serviceable than Functional Contextualism and Radical Behaviorism. This commentary explores ways in which Interbehaviorism might be serviceable to both the current-day and future science of behavior. We discuss similarities between Interbehaviorism and other perspectives, justify the need for an updated perspective on dualism, explore pragmatism in light of the authors’ criticisms of truth criteria, and share applications of Interbehaviorism with potential utility for improving the human condition.
An Exploratory Analysis of a Subjective Well-Being Model for Chinese University Students

College students experience great stress due to many factors, such as an uncertain future, academic responsibilities, and pressures imposed by social communication. Many institutions of higher education are focusing on how to mediate stressful situations and increase the subjective well-being (SWB) of students to sustain a lifestyle focused on wellness. The online survey used for this study focused on testing an exploratory SWB model by implementing partial least squares structural equation modeling (PLS-SEM) techniques. The participants were 470 college-aged students enrolled in seven different institutions in six cities across China. Findings yielded a good model fit (the Standardized Root Mean Squared Residual [SRMR] = .054) with the validity of manifest variables, reliability of the latent variables (LVs), and overall SWB model indicating moderate predictiveness (GoF R2 = .476) by the LVs. Additionally, all of the direct path coefficients and indirect path coefficients that consisted of four partial mediators and one full mediator yielded statistically significant results via bootstrapping. Furthermore, path coefficients for utilization of emotion to life satisfaction for the cognitive exercise group were significantly higher than for the non-cognitive exercise group. The findings illustrated a good model fit for an exploratory SWB model that can predict an individual’s SWB, and cognitive and non-cognitive exercises had different effects on the individuals’ SWB.
Closed-form representations of iterated Darboux transformations for the massless Dirac equation

It is shown that first-order Darboux transformations for the two-dimensional massless Dirac equation with scalar potential and for the Schrodinger equation are the same up to a change of coordinate...
Predictive factors of outcomes in patients with AL amyloidosis treated with daratumumab.

Daratumumab as a single agent (sDARA) or in combination with chemotherapies (cDARA) leads to impressive hematologic and organ responses in AL amyloidosis. However, predictive factors associated with outcomes, and optimal duration of therapy remain unclear. We analyzed 107 patients with AL amyloidosis treated with daratumumab between 2017 and 2020. The median overall survival (OS) was not reached while the median major organ deterioration progression free survival (MOD-PFS) was 36 months in the sDARA cohort and not reached in the cDARA cohort, respectively. Hematologic response > VGPR was achieved in 81% of patients receiving sDARA and 86% of patients treated with cDARA. Several predictive factors were identified on a univariate analysis, including NTproBNP >8500 pg/mL but only achievement of at least VGPR and presence of 1q21 gain were independently associated with MOD-PFS and OS on a multivariate analysis. Finally, patients receiving > 12 cycles had significantly longer MOD-PFS (30 vs.13 months; (p = .0018) and OS (NR vs. 15 months; p 8500 pg/mL, presence of 1q21 gain and shorter duration of therapy (≤ 12 cycles) are strong negative predictive factors for outcomes with daratumumab therapy in AL amyloidosis.
Radiological evaluation of small-size solitary intraductal papilloma

Detection of intraductal papilloma can be difficult; however, conventional ductography, MRI, ultrasound, and ductoscopy play important roles in the diagnostic process. Intraductal papilloma is usually benign in nature, with a small parentage being malignant. When evaluating the average size of a papilloma, which is between 1 and 3 cm, both conventional ductography and MRI have high sensitivity in detection. However, MRI has slightly better sensitivity and less invasiveness in comparison with conventional ductography and is considered the state of art in evaluation of normal-size intraductal papilloma. A 40-year-old female patient presented with a history of clear nipple discharge from the left breast. Left breast had no palpable mass, and there were no skin changes. From the center part of the nipple, there was watery clear discharge (serous) from a single duct. No bloody nipple discharge was expressed from either nipple. Mammography was negative for masses or nipple retraction. Ultrasound demonstrated dilated duct with no intraductal mass. Conventional ductogram demonstrated dilated duct with abrupt cutoff and no filling defect. MRI did not demonstrate any mass except dilated duct. Owing to concavity seen in the ductogram, mammography-guided wire placement was done for the dilated duct and then surgically removed. Pathology revealed 2-mm intraductal papilloma, with no atypia or carcinoma in situ. Neither the conventional ductogram nor the MRI ductography proves to be a better method of diagnosing miniscule intraductal papilloma. Individually, both methods have the potential to emphasize various aspects of the ducts in a way that would be valuable to the reader.
Single Incision Laparoscopic Right Colectomy

Single incision laparoscopic colectomy (SILC), like single incision surgery in other specialities, has developed in a continuing quest to decrease the points of abdominal access of laparoscopic surgery. Decreased number of trocar sites likely correlates with less trauma to the abdominal wall, and therefore less postoperative pain for the patient compared to multiport laparoscopic colectomy (MPLC). It may also correlate with shorter length of postoperative stay. In SILC, all laparoscopic instruments are inserted through one incision, most commonly at the umbilicus, to perform the operation. Usually an access device is used to place all trocars through one fascial incision. Right-sided procedures are especially amenable to the technique given the relatively focused colonic target, fewer operative steps and the option to perform an exterior anastomosis. Appendectomy, extended appendectomy or partial cecetomy and right hemicolectomy are excellent initial cases when adopting the SILC technique.
Preassembly and transport of nerve terminals: a new concept of axonal transport.

A morphological study suggests a new view of synapse formation by demonstrating that presynaptic elements are assembled into ‘prototerminals’ before being transported down axons by fast, saltatory movement. These structures stop moving when the axon contacts a dendrite.
Catholic Revival in the Age of the Baroque: Religious Identity in Southwest Germany, 1550–1750

List of maps Acknowledgements List of abbreviations Introduction 1. The Counter-Reformation offensive, 1550-1650 2. The sacral landscape and pilgrimage piety 3. Religious practice 4. Clericalism in the villages 5. The communal church in German Catholicism 6. Reformers and intermediaries, 1650-1750 Conclusion Bibliography Index.
Inhibitors of histamine metabolism in vitro and in vivo: correlations with antitrypanosomal activity

Abstract The effects of antimalarial and antitrypanosomal drugs on the activity of histamine N -methyl transferase and diamine oxidase in vitro , as well as diamine oxidation and histamine levels in vivo , were examined. Diamidine antitrypanosomal drugs which interfere with polyamine metabolism were found to be potent inhibitors both in vitro and in vivo . Antrycide (quinapyramine) and isometamidium were the best inhibitors of both enzymes. K i values for histamine N -methyl transferase were 3 × 10 −8 M for both compounds, and the inhibition was competitive for histamine. Antrycide and isometamidium were both non-competitive inhibitors of diamine oxidase, having K i values of 6 × 10 −9 M and 3 × 10 −9 M respectively. Isometamidium elevated histamine levels in rat kidney 2-fold and produced a long-term inhibition of putrescine oxidation in vivo . Among the compounds examined, only known active antitrypanosomal agents inhibited both histamine N -methyl transferase and diamine oxidase in vitro as well as putrescine oxidation in vivo . These observations suggest that the enzymes acting on histamine and putrescine as substrates can be used to select compounds which interfere with polyamine metabolism and that persistence of such compounds in vivo , as indicated by inhibition of putrescine oxidation, correlates with favorable chemotherapeutic properties as antitrypanosomal agents.
Comparison of power system simulation tools with load flow study cases

Power system in its normal operating condition is analyzed and investigated by load flow studies. A typical electric power system has a large number of buses and that can only be analyzed with computational tools. A variety of computational tools are available for load flow analysis. This paper provides a qualitative comparison and evaluation of four power system analysis tools NEPLAN, PowerWorld, PSAT and MATPOWER, for load flow analysis of IEEE 9-bus and IEEE 14-bus systems.
Cluster Variation and Cluster Statics

Ever since its early formulation by Ryoichi Kikuchi in 1951, the Cluster Variation Method (CVM) has become a versatile tool for Ising Model applications, particularly in complex situations such as those required by phase diagram calculations. Now that first-principles approaches are becoming feasible, the CVM has become virtually indispensable: the deficiencies of the Bragg-Williams can no longer be masked by fudging adjustable interaction parameters. Thanks to delightful tutorials given to us by Ryo Kikuchi at UCLA in the 70’s, Juan Miguel Sanchez was soon able to develop a remarkable “Cluster Algebra” which has proved to be the formalism of choice for ab initio alloy thermodynamics. I shall review this formalism and its possible applications to alloy phase stability.
Secular studies come of age

In this essay I review three important volumes for the field of secular studies: Varieties of Secularism in a Secular Age, Rethinking Secularism, and The Power of Religion in the Public Sphere. All three volumes explore the nature of the secular and the status, role, and possible futures of religion in our late modern, globalized world. The volumes present 34 essays by 30 authors representing seven disciplines, and at least six end games. For some, questions of religion-secular entanglement are a historical matter and the task is to map intellectual and ideological trajectories. A second purpose is to empirically document the complexities of particular religion-secular entanglements in particular socio-cultural locations. For others, the remit is theoretical, to discern a conceptual agenda for the ongoing study of religion-secular entanglements. Others are more philosophical, chasing the existential consequences of secularity. A fifth end game is applied in nature: reflections on how political actors migh...
The preparation and properties of a series of olefinic tin compounds

Abstract A series of allyl- and β-methallyltin compounds have been prepared by the action of the olefinic Grignard reagent on the appropriate tin halide and their infrared spectra recorded. The compounds prepared include (C 2 H 5 ) 3 SnR; ( n -C 4 H 9 ) 3 SnR; (C 6 H 5 ) 2 SnR; ( p -CH 3 C 6 H 4 ) 2 SnR; (C 2 H 5 ) 2 SnR 2 ; ( n -C 4 H 9 ) 2 SnR 2 (R = allyl); (C 2 H 5 ) 3 SnR; ( n -C 4 H 9 ) 3 SnR′; (C 6 H 5 ) 3 SnR′; ( p -CH 3 C 6 H 4 ) 3 SnR′ and ( n -C 4 H 9 ) 2 SnR′ 2 (R′ = β-methallyl).
Prescriptive models for nonstructural floodplain planning

Abstract A mathematical programming model is developed to assist in selecting those floodplain management plans which will reduce the damage due to inundation, and, at the same time, be economically prudent. These techniques are intended to be used for relatively inexpensive screening of floodplain management alternatives before carrying out a plan-by-plan search with more detailed and expensive methods of analysis. Viewing the floodplain as a land use allocation problem in three dimensions, this formulation permits a direct assessment of expected flood damage on the basis of location and elevation. The model discretizes time, flood losses, topography, and building heights. Decision variables include changes in the land use allocation on the floodplain. Hence, in addition to determining which activities should be located in undeveloped regions, shifts in the activity schema of developed basins can be handled, a situation probably encountered with greater frequency than the undeveloped case. In addition, the effects of the floodwater displaced by various activities can be explicitly measured, and, if desired, included as a component of flood risk.
The pharmacokinetics of digoxin in newborn and adult sheep

The pharmacokinetics of digoxin were determined in 12 ewes and 13 newborn sheep after bolus drug administration and under steady state drug conditions. After death, tissue distribution of digoxin was determined and normalized to plasma drug concentrations at steady state. Volume of distribution and total drug clearance were lower at steady state than the comparable variables calculated from bolus drug administration. No significant difference between ewes and newborns was shown for drug distribution half-life (0.72 vs. 0.76 hr), drug elimination halflife (15.2 vs. 13.7), or renal drug clearance (0.86 vs. 0.89 liters/kg/hr). Total drug clearance as well as the area derived and steady state volumes of distribution were higher in newborns than in ewes. Digoxin secretion into the urine was limited in newborns, as evidenced by a lower renal digoxin clearance to creatinine clearance ratio in newborns than in ewes (371 vs. 600%). The plasma concentration of digoxin at steady state correlated well with myocardial drug concentrations. Drug distribution was similar in both age groups; however, the tissue to plasma digoxin ratio in kidney was higher in newborns than in ewes (mean 469 vs. 263, respectively). Although agerelated differences in drug clearance and distribution volume existed, intersubject variation was substantial, and the demonstrated variations were not large enough to account for the high doses of digoxin used to treat congestive heart failure in immature subjects.
Automated Duffy Typing Using a Multichannel Blood Grouping Machine

Successful Fya blood typing has been achieved by using a multichannel automated blood grouping machine with a filter-paper readout. The Fya channel was modified by increasing the temperature of incubation and by using a selected Fya antibody in an alkaline polyvinylpyrrolidone-methyl cellulose reagent.
Nitrogen Controls on Fine Root Substrate Quality in Temperate Forest Ecosystems

Nitrogen controls on fine root substrate quality (that is, nitrogen and carbon-fraction concentrations) were assessed using nitrogen availability gradients in the Harvard Forest chronic nitrogen addition plots, University of Wisconsin Arboretum, Blackhawk Island, Wisconsin, and New England spruce-fir transect. The 27 study sites encompassed within these four areas collectively represented a wide range of nitrogen availability (both quantity and form), soil types, species composition, aboveground net primary production, and climatic regimes. Changes in fine root substrate quality among sites were most frequently and strongly correlated with nitrate availability. For the combined data set, fine root nitrogen concentration increased (adjusted R 2 = 0.46, P < 0.0001) with increasing site nitrate availability. Fine root “extractive” carbon-fraction concentrations decreased (adjusted R 2 = 0.32, P < 0.0002), “acid-soluble” compounds increased (adjusted R 2 = 0.35, P < 0.0001), and the “acid-insoluble” carbon fraction remained relatively high and stable (combined mean of 48.7 ± 3.1% for all sites) with increasing nitrate availability. Consequently, the ratio of acid-insoluble C–total N decreased (adjusted R 2 = 0.40, P < 0.0001) along gradients of increasing nitrate availability. The coefficients of determination for significant linear regressions between site nitrate availability and fine root nitrogen and carbon-fraction concentrations were generally higher for sites within each of the four study areas. Within individual study sites, tissue substrate quality varied between roots in different soil horizons and between roots of different size classes. However, the temporal variation of fine root substrate quality indices within specific horizons was relatively low. The results of this study indicate that fine root substrate quality increases with increasing nitrogen availability and thus supports the substrate quality component of a hypothesized conceptual model of nitrogen controls on fine root dynamics that maintains that fine root production, mortality, substrate quality, and decomposition increase with nitrogen availability in forest ecosystems in a manner that is analogous to foliage.
Pliocene−Pleistocene incision of the Green River, Kentucky, determined from radioactive decay of cosmogenic 26Al and 10Be in Mammoth Cave sediments

Cosmogenic 26Al and 10Be in sediments washed into Mammoth Cave, Kentucky, record the history of 3.5 m.y. of water-table position, governed by incision and aggradation of the Green River, a tributary of the Ohio River. Upper levels of the cave formed during a period of slow river incision and were later filled with sediment due to river aggradation at 2.3–2.4 Ma. A brief surge of river incision ca. 2 Ma was followed by river stability and cave-passage formation at a lower level. Rapid incision through 15 m of bedrock ca. 1.5 Ma was prompted by repositioning of the Ohio River to its present course along an ice-sheet margin. Renewed incision ca. 1.2 Ma and aggradation at 0.7–0.8 Ma correlate with major ice advances in the Ohio River basin. Measurements of 26Al and 10Be also indicate that sandstone-capped uplands have maintained slow erosion rates of 2–7 m/m.y. for the past 3.5 m.y., despite accelerated Pleistocene river incision rates of ∼30 m/m.y.
The S Helix Mediates Signal Transmission as a HAMP Domain Coiled-Coil Extension in the NarX Nitrate Sensor from Escherichia coli K-12

In the nitrate-responsive, homodimeric NarX sensor, two cytoplasmic membrane alpha-helices delimit the periplasmic ligand-binding domain. The HAMP domain, a four-helix parallel coiled-coil built from two alpha-helices (HD1 and HD2), immediately follows the second transmembrane helix. Previous computational studies identified a likely coiled-coil-forming alpha-helix, the signaling helix (S helix), in a range of signaling proteins, including eucaryal receptor guanylyl cyclases, but its function remains obscure. In NarX, the HAMP HD2 and S-helix regions overlap and apparently form a continuous coiled-coil marked by a heptad repeat stutter discontinuity at the distal boundary of HD2. Similar composite HD2-S-helix elements are present in other sensors, such as Sln1p from Saccharomyces cerevisiae. We constructed deletions and missense substitutions in the NarX S helix. Most caused constitutive signaling phenotypes. However, strongly impaired induction phenotypes were conferred by heptad deletions within the S-helix conserved core and also by deletions that remove the heptad stutter. The latter observation illuminates a key element of the dynamic bundle hypothesis for signaling across the heptad stutter adjacent to the HAMP domain in methyl-accepting chemotaxis proteins (Q. Zhou, P. Ames, and J. S. Parkinson, Mol. Microbiol. 73:801-814, 2009). Sequence comparisons identified other examples of heptad stutters between a HAMP domain and a contiguous coiled-coil-like heptad repeat sequence in conventional sensors, such as CpxA, EnvZ, PhoQ, and QseC; other S-helix-containing sensors, such as BarA and TorS; and the Neurospora crassa Nik-1 (Os-1) sensor that contains a tandem array of alternating HAMP and HAMP-like elements. Therefore, stutter elements may be broadly important for HAMP function.
1001-28 Stenotic Lesions Reliably Form in Porcine Coronary Arteries Using Copper Stents or Intracoronary Heating

The capability of creating stenotic lesions in an animal model is essential to testing new interventional devices. We developed a coronary stenosis model in domestic swine using either heated balloon angioplasty (heat) at high-temperature (80 °C for 15 seconds) or copper stents (copper). Animals were sacrificed 14–47 days after artery injury. Morphometric and histologic study of the stenoses created by heat (14 pigs, 33 arteries) and copper (9 pigs, 18 arteries) was performed. Measurement of lumen area and area circumscribed by the internal elastic lamina (IEL) was used to calculate stenosis by l-(lumen/IEL). Mean stenosis from heat was 66.9 ± 27% and copper 80.7 ± 22%. Stenoses exceeding 50% were produced by heat 78.8% and copper stents 87.5% of the time. Histologically, the heat group was notable for concentric intimal hyperplasia, intact elastic laminae, necrosis of medial cells, calcific deposits in the media, and mild adventitial inflammation and fibrosis. Copper stent lesions demonstrated severe diffuse inflammation, destruction of the elastic laminae, neovascularization, and mild intimal calcification around stent tines. Percent of Arteries with Histologic Feature Inflammation Calcification Neovascular Fibrosis Necrosis H C H C H C H C H C Intima 3% 90% ‡ 3% 50% ‡ 3% 65% ‡ 3% 50% ‡ 11% 5% Media 25% 95% ‡ 22% 5% 11% 63% ‡ 8% 74% ‡ 69% 26% * Adventitia 69% 70% 11% 5% 17% 40% ‡ 64% 55% 11% 5% Fisher's Exact Test, two-sided: * p ≤ 0.05, ‡ p ≤ 0.0001 H = Heat C = Copper Conclusion Heated balloon angioplasty or deployment of copper stents into swine coronary arteries reliably creates severe stenoses suitable for testing new interventional devices. Copper stents in particular create very tight and complicated lesions that would challenge new devices. The histopathology differs with copper demonstrating destructive inflammatory lesions vs. orderly intimal hyperplasia and medial calcification observed in heat lesions.
The Role of Screening for Sudden Cardiac Death in Young Competitive Athletes: A Critical Review

The purpose of this review is to examine the evidence surrounding the recommendations for cardiovascular screening in young competitive athletes. Sudden cardiac death (SCD) is the leading medical cause of death in athletes. There is widespread agreement that the primary purpose of the pre-participation cardiovascular screening examination is to identify athletes with conditions that predispose them to SCD. This can help inform the athlete of risks associated with exercise, define which athletes should pursue medical management for their condition, determine eligibility for competition, and delineate first-degree relatives who may need additional cardiac testing. Current cardiovascular screening with a traditional history and physical examination does not detect the majority of athletes at risk and provides false reassurance for those with silent underlying cardiovascular conditions. The addition of an electrocardiogram (ECG) enhances disease detection capabilities and modern athlete-specific ECG interpretation standards provide low false positive rates and improved cost efficiency. Future efforts should focus on physician education of ECG interpretation criteria, the development of an infrastructure to optimize cardiovascular screening, and providing evidence-based management strategies for athletes diagnosed with cardiac disorders. The goal of pre-participation screening is to identify athletes at risk for SCD. Advanced cardiovascular screening protocols have the potential to improve the health and safety of sport and should be considered in young competitive athletes, especially those deemed high risk.
Economic Growth and World Food Insecurity: A Parametric Approach

Abstract This paper focuses on the feasibility of reducing the number of individuals that are food insecure to about 700 million by 2015. A sufficient statistic to characterize the level and distribution of income in 134 countries is developed and regressed on variables hypothesized to be its major determinants. A global general equilibrium model is then calibrated to data and experiments performed that change the levels of these variables. The results show that attaining the 700 million target is feasible, but unlikely. Growth in economy-wide total factor productivity, agricultural factor productivity and labor productivity is analyzed.
Carcinoma ex Pleomorphic Adenoma of the Nasal Cavity

Background Carcinoma ex pleomorphic adenoma (CXPA) is a malignant epithelial neoplasm arising in a benign mixed tumor (i.e., pleomorphic adenoma or PA); it accounts for approximately 3–4% of all salivary gland neoplasms. CXPA is exceedingly rare in the nasal cavity, with only three cases previously documented.
Interaction of alkanes with unsaturated metal centres: The complex W(CO)5C2H6 in the gas phase☆

Abstract The complex W(CO) 5 C 2 H 6 has been observed in the gas phase by time-resolved infrared spectroscopy following 308 nm laser photolysis of W(CO) 6 in the presence of C 2 H 6 . The complex is shown to be in equilibrium with its precursor, W(CO) 5 , at room temperature and to have a C 2 H 6 binding energy of 9.7±3 kcal mol −1 .
Man-Vehicle Systems Research Facility - Design and operating characteristics

This paper describes the full-mission flight simulation facility at the NASA Ames Research Center. The Man-Vehicle Systems Research Facility (MVSRF) supports aeronautical human factors research and consists of two full-mission flight simulators and an air-traffic-control simulator. The facility is used for a broad range of human factors research in both conventional and advanced aviation systems. The objectives of the research are to improve the understanding of the causes and effects of human errors in aviation operations, and to limit their occurrence. The facility is used to: (1) develop fundamental analytical expressions of the functional performance characteristics of aircraft flight crews; (2) formulate principles and design criteria for aviation environments; (3) evaluate the integration of subsystems in contemporary flight and air traffic control scenarios; and (4) develop training and simulation technologies.
Multiple points in the sample paths of a Lévy process

We obtain a sufficient condition for the sample paths of a Levy process to contain multiple points. Our condition is close to one conjectured by Hendricks and Taylor.
Factors influencing pregnancy rate and calving date in four breeds of beef cows on an Ozark mountain range

Abstract Observations from 4928 matings made over 17 years were used to evaluate the influence of year, exposure class, cow weight, average daily gain (ADG) before and during the breeding season on pregnancy rate (PR) and calving date (CD) in four breeds of beef cows maintained on an Ozark mountain range. Pregnancy rate was the percentage of cows exposed to natural mating that were checked pregnant in the fall. Calving date was the number of days from a base date of 1 January. Pregnancy rate and CD were analyzed separately for each breed by least-squares analysis of variance. A model including the above factors accounted for 10 to 12% of the variation in PR and 3 to 23% of the variation in CD. Variation among years significantly affected PR and CD. Cows being bred for their first lactation had the lowest PR and the latest CD. Mature cows had the highest PR and the earliest CD. Partial regression coefficients of PR and CD on cow weight ranged from 2.9% and −3.2 days to 7.4% and 2.3 days/100 kg. Partial regression coefficients of PR and CD on ADG prior to the breeding season ranged from 3.4% and −14.5 days to 24.9% and −2.8 days/kg. Partial regression coefficients for PR and CD on ADG during the breeding season ranged from 10.4% and −18.2 days to 41.6% and −6.1 days/kg. A second analysis was performed on the adjusted data in which cows were nested within sires and offspring were nested within cows. The major source of variance for the two traits was among offspring within dams, which accounted for 78.7 to near 100% of the variation in PR and 50.6 to 84.6% of the variation in CD.
Same-decision probability: A confidence measure for threshold-based decisions

We consider in this paper the robustness of decisions based on probabilistic thresholds. To this effect, we propose the same-decision probability as a query that can be used as a confidence measure for threshold-based decisions. More specifically, the same-decision probability is the probability that we would have made the same threshold-based decision, had we known the state of some hidden variables pertaining to our decision. We study a number of properties about the same-decision probability. First, we analyze its computational complexity. We then derive a bound on its value, which we can compute using a variable elimination algorithm that we propose. Finally, we consider decisions based on noisy sensors in particular, showing through examples that the same-decision probability can be used to reason about threshold-based decisions in a more refined way.
Role of Solvent and Secondary Doping in Polyaniline Films Doped with Chiral Camphorsulfonic Acid: Preparation of a Chiral Metal

We present the first study of chirality from the UV to the IR region for a conducting polymer, thereby probing the motion of the metallic “free carriers.” Through study of chiral and achiral campho...
Enhancing the Career Exploration and Job-Seeking Skills of Secondary Students with Disabilities:

This study examined student outcomes from a career exploration and job-seeking skills instructional program designed and validated for use in special education programs in secondary education settings. Instruction was designed to address specific behaviors associated with (a) career exploration (vocational self-awareness, vocational decision-making confidence, and career decisiveness) and (b) job-seeking (completing job application forms and performing in a job interview). A state special education department, a university rehabilitation research and training center, and special education programs from two school districts coordinated resources to develop and evaluate the instructional program. Study results provide support for utilization of the program with secondary students with disabilities. Experimental group students demonstrated better vocational decision-making confidence and career decisiveness, and performed better completing a job application and in a simulated employment interview.
Perioperative management of anticoagulation in patients on warfarin therapy undergoing surgery for cardiac implantable electronic devices

Many patients on chronic warfarin therapy are undergoing surgery for permanent pacemakers and implantable defibrillators, collectively known as cardiac implantable electronic device (CIED). The perioperative management of anticoagulation in these patients is a challenging clinical situation that requires balance between the risk of acute thrombosis and perioperative hemorrhage. This issue however, is inadequately addressed in the guidelines published by professional organizations. Increasing evidence suggests that temporarily interrupting anticoagulation is associated with a small but real thromboembolic risk, whereas cessation of warfarin with heparin bridging anticoagulation frequently leads to a higher incidence of pocket hematoma. Continuing warfarin with a therapeutic international normalized ratio appears to be a safe and cost-effective approach for CIED surgery in most patients with moderate to high thromboembolic risk. An algorithm is proposed for the practical management of anticoagulation and antiplatelet therapy in these patients during the perioperative period.
Enhanced induction of tissue-type plasminogen activator in normal human cells compared to cancer-prone cells following ionizing radiation.

Abstract Normal human fibroblast (i.e., GM2936B, GM2907A, and IMR-90) and cancer-prone human fibroblast (i.e., Fanconi's anemia, Bloom's syndrome, and Ataxia telangiectasia) cells demonstrated the induction of intracellular and extracellular levels of tissue-type plasminogen activator (t-PA) at 6 and 12 hr, respectively, following ionizing radiation. Induced t-PA enzymatic activities following ionizing radiation were blocked by actinomycin D treatments. t-PA enzymatic activities were induced over 14-fold in Ataxia telangiectasia cells, over 9-fold in Bloom's syndrome cells, and over 6-fold in Fanconi's anemia cells, as compared to normal human fibroblasts. Similarly, the induction of t-PA mRNA levels in cancer-prone cells were between 5- to 10-fold higher than those observed in normal cells following equitoxic doses of ionizing radiation. Temporal induction of t-PA mRNA levels for normal and cancer prone human cells were consistent with quantifiable enzymatic activities. The elevated induction of an intracellular protease (i.e., t-PA) in cancer-prone human cells is reminiscent of an “SOS”-like response observed in yeast and bacteria.
Prevalence of Spontaneous Portosystemic Shunts in Patients With Portopulmonary Hypertension and Effect on Treatment

Background & Aims We documented the frequency of large spontaneous portosystemic shunts in patients with moderate or severe portopulmonary hypertension (POPH) and determined the association between large shunts and response to treatment. Methods We performed a retrospective case-control study of data from patients with mild (mean pulmonary artery pressure [MPAP], 25–35 mm Hg; n=18), moderate (MPAP, 35–50 mm Hg; n=45), and severe POPH (MPAP, >50 mm Hg; n=16). Data were compared with those from controls (normal echocardiography with estimated right ventricular systolic pressure, 50 mm Hg). Results The frequency of spontaneous shunts did not differ significantly between groups of subjects with severe (n = 14 of 16), moderate (n = 38 of 45), or mild POPH (n = 11 of 18) or normal echocardiograms (controls, n=86 of 122) ( P = .77). Large shunts were associated with severe (14 of 16) and moderate POPH (32 of 45), compared with mild POPH (6 of 18) or controls (30 of 122) ( P Conclusions Large spontaneous portosystemic shunts are associated significantly with moderate and severe POPH, and with lack of response to treatment.
Oxidatively Induced Reductive Elimination from (tBu2bpy)Pd(Me)2: Palladium(IV) Intermediates in a One-Electron Oxidation Reaction

This communication describes studies of oxidatively induced C-C bond-forming reductive elimination from ((t)Bu(2)bpy)Pd(II)(Me)(2). With the outer-sphere oxidant ferrocenium, the data are consistent with a mechanism involving Pd(III) and Pd(IV) intermediates, with C-C bond formation occurring from the latter. The reaction with Ag(+) appears to proceed via a Pd-Ag(+) adduct, which then undergoes inner sphere electron transfer to generate Pd(III). In contrast, the slower benzoquinone reaction forms ethane by a different pathway that does not involve methyl group scrambling and generates Pd(0) products.
Characterization of a tunable optical parametric oscillator laser system for multielement flame laser excited atomic fluorescence spectrometry of cobalt, copper, lead, manganese, and thallium in buffalo river sediment.

A pulsed (10 Hz) optical parametric oscillator (OPO) laser system based on β-barium borate (BBO) crystals and equipped with a frequency-doubling option (FDO) was characterized for use in laser excited atomic fluorescence spectrometry (LEAFS). This all-solid-state laser has a narrow spectral line width, a wide spectral tuning range (220-2200 nm), and a rapid, computer-controlled slew scan of wavelength (0.250 nm s -l in the visible and infrared, and 0.125 nm s -1 in the ultraviolet). The output power characteristics (15-90 mJ/pulse in the visible, 1-40 mJ in the infrared, and 1- 11 mJ in the ultraviolet), laser pulse-to-pulse variability (3-13% relative standard deviation, RSD, of the laser pulses), conversion efficiency of the FDO (2-17%), and spectral bandwidth in the visible spectrum (0.1-0.3 cm -l ) were measured. The laser was used as the excitation source for a flame LEAFS instrument for which rapid, sequential, multielement analysis was demonstrated by slew scan of the laser. The instrument allowed about 640 measurements to be made in about 6 h, with triplicate measurements of all solutions and aqueous calibration curves, which yielded accurate analyses of a river sediment (National Institute of Standards and Technology, Buffalo River Sediment, 2704) for five elements with precisions <5% RSD. Comparable or improved flame LEAFS detection limits over literature values were obtained for cobalt (2 ng mL -1 ), copper (2 ng mL -l ), lead (0.4 ng mL -1 ), manganese (0.2 ng mL -1 ), and thallium (0.9 ng mL -1 ) by flame LEAFS.
A note on selection of spaces in computation of viscoelastic flows using the hp-finite element method

Abstract The stability, accuracy, and computational efficiency of higher order Galerkin (hp-type) finite elements for steady flow of viscoelastic fluids past square arrays of cylinders and through a corrugated tube with two different polynomial approximating spaces, namely truncated and product, have been investigated. It has been shown that both spaces produce a stable discretization with an exponential convergence rate toward the exact solution without an upper Weissenberg number limitation. Based on global deviation from mass and momentum conservation, it is shown that the truncated space provides a better quality solution at a reduced computational cost for a given number of degrees of freedom. In addition, the restrictions on the relative order of approximating polynomials for stresses and velocities have been examined. It has been shown that without splitting of the stress into purely viscous and elastic components the most cost efficient solution is obtained when the stresses and velocities are approximated by the same order polynomial, while with this splitting the best computational performance is obtained when the stresses are discretized with a polynomial order of one less than the velocities.
The use of the Shelhigh porcine valve conduit in infants

For comparison, we reviewed 20 infants (mean age, 98 days)who received cryopreserved homografts during a similar timeperiod. Five patients were less than 30 days old, and 9 patientswere less than 90 days old. The average size homograft was12 mm (8–15 mm), 7 of which were 12 mm or less. During a meanfollow-up of 21 months (4–50 months), 3 conduits were replacedat 7 months (size 13), 12 months (size 13), and 35 months (size 10)for obstruction in 2 patients and severe regurgitation in 1patient. Only one of 7 homografts (12 mm or less) requiredreplacement during a mean follow-up of 12.5 months. Onepatient had moderate stenosis with a gradient of 36 mm Hg.In contrast to the Shelhigh conduit, the cryopreserved ho-mograft appears to have superior longevity and a lower inci-dence of stenosis. Surprisingly, pathology of our three explantedShelhigh conduits demonstrated relatively preserved valve tis-sue without calciﬁcation, but marked pseudo-intimal peel for-mation with an intense inﬂammatory reaction in the conduititself (Fig 1). Currently, we cannot recommend the ShelhighNo-React Porcine valve conduit in infants less than 6 months ofage or sizes smaller than 13 mm.
The Professional Development Course as a Natural Extension of the Postsecondary Freshman Seminar

Abstract For decades the freshman seminar has been instrumental in facilitating student transition from high school to college and in improving retention and graduation rates. With their experience working in the affective, cognitive, and psychomotor domains, business education faculty have been involved in delivering freshman experiences. The professional development course, a natural extension of the freshman seminar, should be developed and delivered by business education faculty to help business majors develop a commitment to their profession. Suggestions for professional development course content are offered, and teaching-learning strategies are provided that facilitate a high level of student involvement in the learning process.
Transferring Management Technology: Healthcare Quality Improvement Education in Central and Eastern Europe

The newly independent nations of the former Soviet Union continue to restructure and refine their political and economic environments. Competition for scarce of dwindling economic resources within these nations and between the nations of an expanding global community necessitates that they adopt more efficient and effective management methods to provide essential public services. As a result, organizational management concepts developed and used in the West (i.e., in the United States and the countries of the European Union) are eagerly sought for incorporation into new administrative systems. This is an opportune time for healthcare service management educators to develop and present total quality management (TQM) programs, stressing continuous quality improvement (CQI) methods specifically targeted and adapted to the organizational needs of these countries, as they restructure their societies from centrally planned to market-driven economies. In general, educators in healthcare service management, acting as information consultants, can play a pivotal role in guiding strategies for healthcare organizational change and in helping to stabilize transitional organizational processes, by providing guidelines that can improve utilization of healthcare resources and monitoring of healthcare service outcomes. Most of the observations and recommendations presented in this article are derived from the author's experiences in conducting healthcare management improvement projects in Bulgaria in 1993 and in Lithuania since 1991.
Rnd-ing up RhoA Activity to Link Neurogenesis with Steps in Neuronal Migration

Neurogenesis is integrated with neuronal migration to ensure proper development of the cerebral cortex. Reporting in Neuron, Pacary et al. (2011) demonstrate that proneural factors activate atypical Rho GTPases Rnd2 and Rnd3 in newborn cortical neurons, leading to compartmentalized modulation of RhoA signaling and differential control of neuronal migration stages.