cssi/SciSciGPT-SciSciNet huggingface dataset:
Comparison of the Antimicrobial Efficacy of 1.3% NaOCl/BioPure MTAD to 5.25% NaOCl/15% EDTA for Root Canal Irrigation

The purpose of this study was to compare the antimicrobial efficacy of 1.3% NaOCl/BioPure MTAD to 5.25% NaOCl/15% EDTA for root canal irrigation. Twenty-six bilaterally matched pairs of human teeth were collected. The teeth were incubated with Enterococcus faecalis for 4 weeks. The teeth were divided into two experimental groups and one positive control group. The canals were instrumented and irrigated with either 5.25% NaOCl/15% EDTA or 1.3% NaOCl/BioPure MTAD. Bacterial samples were collected after instrumentation/irrigation and after additional canal enlargement. Statistical analysis of the data using the Wilcoxon Signed Rank test showed significant differences between the experimental groups. The first bacterial samples revealed growth in 0 of 20 samples with 5.25% NaOCl/15% EDTA irrigation and in 8 of 20 samples with 1.3% NaOCl/BioPure MTAD irrigation. Samples taken after additional canal enlargement revealed growth in 0 of 20 samples in 5.25% NaOCl/15% EDTA and in 10 of 20 samples in 1.3% NaOCl/BioPure MTAD group. This investigation showed consistent disinfection of infected root canals with 5.25% NaOCl/15% EDTA. The combination of 1.3% NaOCl/BioPure MTAD left nearly 50% of the canals contaminated with E. faecalis.
Allomothering in a captive colony of Hanuman langurs (Presbytis entellus)

Abstract Quantitative data on infants in a stable troop of Hanuman langurs ( Presbytis entellus ) at the San Diego Zoo were collected to determine the identity and competence of their allomothers. Most allomothering (67.1%) was directed at infants less than three months old and 53.6% of it was done by juvenile females. Yearling females and juvenile males were gentle, solicitous allomothers, whereas older juvenile and adult females were often rough and inconsistent in their treatment of infants. The prevalence of juvenile allomothers suggests that allomothering did not evolve because of its adaptive value to mothers and infants, and the apparent lack of improvement in the skills of juvenile allomothers casts doubt on the theory that allomothering is adaptive as a learning experience for allomothers. Thus allomothering may not have adaptive value of its own, but rather may have evolved as part of a total behavioral complex.
An Interprofessional Study of the Effects of Topical Pilocarpine on Oral and Visual Function

INTRODUCTION In light of expanding use of pilocarpine for numerous systemic disorders over the past decades, it is important to understand its effects on visual and oral function. OBJECTIVE To study the adverse effects of topical pilocarpine on visual and oral function in healthy volunteers via interprofessional collaboration. METHODS Thirty-six subjects, 21 years and older, were enrolled for the study. The study was designed to have each subject undergo tests for oral and visual function before and 20 minutes after a topical dose (2% ophthalmic solution), so the subjects served as their own controls. RESULTS The sample included 24 females and 11 males with a mean of 22 years. The pupil diameter was significantly reduced post treatment with pilocarpine. The effect was larger in dim light than in bright light. Distance and near visual acuity were significantly reduced by pilocarpine treatment. Distance visual acuity under low contrast illumination and automated perimetry were significantly reduced with pilocarpine. Remarkably, salivary volume was significantly increased. CONCLUSION In young normal subjects, pilocarpine adversely affects the visual acuity, contrast sensitivity, visual field and thus the overall visual function, but it positively increases salivary volume.
Hybrid theory calculation of electron-N2 scattering at 5 and 10 eV

Hybrid theory results pertaining to e–N2 scattering have been evaluated for differential elastic and first vibrational excitation cross sections at 5 and 10 eV. Comparison with the recent experiment of Chutjian, Srivastava, and Trajmar is good, although there is an indication that the calculated nonresonant (adiabatic‐nuclei) contribution is somewhat too small. A short discussion engendered by this point is given.
Simulation of welding flows in a slit. Part I: Kinematics

The kinematics of ideal welding flows generated by a thin-plate divider, a cylinder, or a slab in a slit channel are studied by using a finite element analysis. The analysis includes simulations of Newtonian and Carreau fluids. There are two flow configurations. First, a single plate-divider or an obstacle was positioned symmetrically in a slit channel with no-slip at the walls. In the second, an infinite number of plate-dividers or obstacles were positioned in parallel, and the boundary walls were infinitely far away. It was found that extensional flow dominates the region near the stagnation points of obstacles and plate-dividers, and that the fluid elements near the weld interfaces have a strain history of both high stretching and shearing. The thickness of the elongated region is reduced as the thickness of the plate-divider increases. Shear-thinning tends to increase the rate of extension. However, its influence on the flow field tends to lessen as the width of the flow channel or the obstacle size increases. A no-slip condition at walls causes slightly stronger elongational flow in the weld interface than does the symmetric condition of perfect slip at walls.
Analysis of Two Forms of the Molybdate- Stabilized Estrogen Receptor*

We recently reported that the calf uterine estrogen receptor prepared in 10-mm molybdate elutes as two components (peaks I and II) from DEAE-Sephadex columns with a linear KC1 gradient. We have extended these studies and report that unoccupied cytosol receptors also elute as two peaks (0.21 and 0.25 m KC1), as determined by postlabeling experiments with [3H]estradiol. Since molybdate-stabilized cytosol estrogen receptors incubated in the presence of 0.3 m KC1 as well as estrogen receptors in peaks I and II did not demonstrate receptor binding to DNA-cellulose, we conclude that both receptor forms are nonactivated. Also, [3H]estradiol-receptor complexes from cytosol prepared in 10 mm molybdate sediment as 6.7S in 5–20% sucrose density gradients containing 0.3 m KC1, whereas receptor complexes from cytosol prepared without molybdate sediment as 4.5S. Both peaks I and II were eluted from DEAESephadex columns prepared with either 10 mm molybdate or 10 mm tungstate, with both phosphatase inhibitors having effe...
Future directions in national health policy for the United States.

Abstract Unlike other countries which have established some form of national health insurance, the United States is debating this profound social program in facing all problems of financing and managing personal health services simultaneously: elimination of cost at time of service, sharing this cost equitably through the tax system, distributing the services equitably geographically, controlling rapidly rising costs and managing the organizational structure of services. Originally in other countries the primary objectives were to free citizens of the burden of costly illnesses, improve access across income groups, and share the costs more or less equally. Now other countries are expressing the problems found simultaneously by the United States. It is argued that universal and comprehensive national health insurance spreads money and resources so thinly that specific and important problems such as pockets of high infant mortality or curable diseases are obscured and ignored. The United States should set up a health program which targets specific problems and mitigates high cost episodes rather than indulge itself in a comprehensive and universal national health insurance. This proposal is not politically feasibis, however, and predictions are made as to what will happen in the United States within the politically and culturally determined range of debatable options.
DSPP effects on in vivo bone mineralization

Abstract Dentin sialophosphoprotein has been implicated in the mineralization process based on the defective dentin formation in Dspp null mice (Dspp−/−). Dspp is expressed at low levels in bone and Dspp−/− femurs assessed by quantitative micro-computed tomography (micro-CT) and Fourier transform infrared spectroscopic imaging (FTIRI) exhibit some mineral and matrix property differences from wildtype femurs in both developing and mature mice. Compared to wildtype, Dspp−/− mice initially (5 weeks) and at 7 months had significantly higher trabecular bone volume fractions and lower trabecular separation, while at 9 months, bone volume fraction and trabecular number were lower. Cortical bone mineral density, area, and moments of inertia in Dspp−/− were reduced at 9 months. By FTIRI, Dspp−/− animals initially (5 months) contained more stoichiometric bone apatite with higher crystallinity (crystal size/perfection) and lower carbonate substitution. This difference progressively reversed with age (significantly decreased crystallinity and increased acid phosphate content in Dspp−/− cortical bone by 9 months of age). Mineral density as determined in 3D micro-CT and mineral-to-matrix ratios as determined by 2D FTIRI in individual cortical and trabecular bones were correlated (r2 = 0.6, p
Can I be of assistance? The intelligence behind an assistive robot

The social interaction, guidance and support that a socially assistive robot can provide a person can be very beneficial to patient-centered care. However, there are a number of conundrums that must be addressed in designing such a robot. This work addresses two main limitations in the development of intelligent task-driven socially assistive robots: (i) recognition and identification of human gesticulation as a source of determining the affective state of a person, and (ii) robotic control architecture design and implementation with explicit social and assistive task functionalities. In this paper, the development of a unique task-driven robotic system capable of quantitatively interpreting human body language and in turn, effectively responding via task-driven behavior during assistive social interaction is presented. In particular, a novel gesture identification and classification technique is proposed capable of interpreting human gestures as semantically meaningful commands for inputs into a multi-layer decision making control architecture. The learning-based control architecture is then utilized to determine the effective and appropriate assistive behavior of the robot.
Optimizing ACTH-stimulated steroid secretion by cultured adrenocortical tumor cells.

If 1 mM supplemental Ca++, or 1.6 mg hemoglobin (Hb)/ml medium (23.5 uM, a concentration comparable to that in 1 ml mouse blood), was added to Eagle's mimimum essential medium (MEM) (which contains 1 mM Ca++), basal and maximally stimulated 20-dihydroprogesterone (20-DHP) secretion by cultured Y-1 mouse adrenal tumor cells [49 - 65th passages] could be measured by radioimmunoassay after a 0.5 hr incubation. ACTH-stimulated, but not basal, 20-DHP secretion increased after 1 mM Ca++ treatment. 5 mM EGTA significantly reduced basal and stimulated 20-DHP secretion, although significant ACTH stimulation still remained. Basal and stimulated secretion significantly increased when Hb was present. Although O2 involvement in the Hb effect was tested by bubbling medium with 100% O2 for 10 minutes, basal and stimulated secretion was unaffected. Since proteins, such as Hb, non-specifically bind free steroids, enhancing secretion, albumin (A1) was compared to Hb. A1 enhanced unstimulated, but not ACTH-stimulated, 20-DH...
Evidence That Personal Genome Testing Enhances Student Learning in a Course on Genomics and Personalized Medicine

An emerging debate in academic medical centers is not about the need for providing trainees with fundamental education on genomics, but rather the most effective educational models that should be deployed. At Stanford School of Medicine, a novel hands-on genomics course was developed in 2010 that provided students the option to undergo personal genome testing as part of the course curriculum. We hypothesized that use of personal genome testing in the classroom would enhance the learning experience of students. No data currently exist on how such methods impact student learning; thus, we surveyed students before and after the course to determine its impact. We analyzed responses using paired statistics from the 31 medical and graduate students who completed both pre-course and post-course surveys. Participants were stratified by those who did (N = 23) or did not (N = 8) undergo personal genome testing. In reflecting on the experience, 83% of students who underwent testing stated that they were pleased with their decision compared to 12.5% of students who decided against testing (P = 0.00058). Seventy percent of those who underwent personal genome testing self-reported a better understanding of human genetics on the basis of having undergone testing. Further, students who underwent personal genome testing demonstrated an average 31% increase in pre- to post-course scores on knowledge questions (P = 3.5×10−6); this was significantly higher (P = 0.003) than students who did not undergo testing, who showed a non-significant improvement. Undergoing personal genome testing and using personal genotype data in the classroom enhanced students' self-reported and assessed knowledge of genomics, and did not appear to cause significant anxiety. At least for self-selected students, the incorporation of personal genome testing can be an effective educational tool to teach important concepts of clinical genomic testing.
Biodegradation of three azaarene congeners in river water

The biodegradability of three structurally related azaarenes (pyridine, quinoline, and acridine) at various concentrations (which gave 0 to 100% lethality to embryo-larval stages of an indigenous frog species) was determined using a river water die-away test and water collected from the Green River (Newton, KY). HPLC analyses of the amended river water during the 6- to 11-d study revealed rapid removal of pyridine and quinoline at the lower substrate concentrations; however, no change in the acridine concentrations was detected during the 11-d study. Except for the lowest quinoline concentration, the turnover times and latent periods for pyridine and quinoline increased with higher initial concentrations, but the kinetics of microbial oxidation were constant at all but the highest concentrations. The adaptation of previously exposed river flora was determined by respiking degraded waters. When the flora were reexposed to the substrates there was no latent period and the kinetics were superimposable. By tracking the metabolites of quinoline, sequential oxidation of the parent compound to more polar species was demonstrated. It was determined by co-culturing quinoline and acridine that acridine nondegradability was not due to any inhibitory effect that acridine may have on the river flora.
Immunology in Dentistry

Implications of immunology in dental treatment are explained through discussion of the basic scientific principles of allergy, autoimmunity, immunization, immune dysfunction, tumor immunology, immunosuppression, and transplantation immunobiology.
Comparative anatomical and developmental analysis of dry and fleshy fruits of Solanaceae.

UNLABELLED PREMISE OF THE STUDY An anatomical examination of dry and fleshy fruits within the Solanaceae was carried out to identify comparable stages throughout development as well as features exclusive to each type of fruit. We studied fruit development of Nicotiana and Petunia, which have the plesiomorphic capsular fruit; Solanum and Iochroma, characterized by a derived fleshy berry; Cestrum, an independent origin of a fleshy fruit; and Datura, a reversion to a dry fruit. • METHODS Pre- and postanthesis carpels and fruits of all species were collected, sectioned, stained, and examined using light microscopy. • KEY RESULTS Comparable stages of carpel and fruit development were identified in all species. Furthermore, anatomical and developmental features were identified that characterize capsules in Solanaceae, including lack of increase in the number of pericarp cell layers, formation of a sclerified endocarp, and elongation of the epidermal cells of the placenta. Pericarps of fleshy fruits of the Solanoideae are characterized by abundant collenchyma, an increase in the number of cell layers, and a parenchymatous endocarp often expanding into the locules. Anatomical data show that early developmental stages of the fruit of Cestrum, a berry, are similar to the capsular fruits of Petunia and Nicotiana; similarly, Datura, one of the few capsular members of the Solanoideae, shares several anatomical features with closely related berried taxa. • CONCLUSIONS Ontogenetically, all fleshy or all dry fruits do not necessarily share a common developmental ground plan. Independent evolution of fleshiness, sclerification, dryness, and dehiscence are discussed in a phylogenetic context.
Evaluating implementation of a rapid response team: considering alternative outcome measures

Objective Determine the prolonged effect of rapid response team (RRT) implementation on failure to rescue (FTR). Design Longitudinal study of institutional performance with control charts and Bayesian change point (BCP) analysis. Setting Two academic hospitals in Midwest, USA. Participants All inpatients discharged between 1 September 2005 and 31 December 2010. Intervention Implementation of an RRT serving the Mayo Clinic Rochester system was phased in for all inpatient services beginning in September 2006 and was completed in February 2008. Main Outcome Measure Modified version of the AHRQ FTR measure, which identifies hospital mortalities among medical and surgical patients with specified in-hospital complications. Results A decrease in FTR, as well as an increase in the unplanned ICU transfer rate, occurred in the second-year post-RRT implementation coinciding with an increase in RRT calls per month. No significant decreases were observed pre- and post-implementation for cardiopulmonary resuscitation events or overall mortality. A significant decrease in mortality among non-ICU discharges was identified by control charts, although this finding was not detected by BCP or pre- vs. post-analyses. Conclusions Reduction in the FTR rate was associated with a substantial increase in the number of RRT calls. Effects of RRT may not be seen until RRT calls reach a sufficient threshold. FTR rate may be better at capturing the effect of RRT implementation than the rate of cardiac arrests. These results support prior reports that short-term studies may underestimate the impact of RRT systems, and support the need for ongoing monitoring and assessment of outcomes to facilitate best resource utilization.
Munificent Compensations as Disincentives: The Case of American CEOs:

We review the scholarly literature and report that there exists no convincing link between CEO compensation on the one hand and either CEO performance or company performance on the other. We report further that neither market processes nor a lottery-like process account for the systematic difference between the remunerations of CEOs in the US and in other industrialized countries. Based on the observation that CEO mega-compensations are not taxed out of existence although they seem to violate common social norms of equity, we speculate that such compensations must serve a mythical social function. We propose that, baffled by the non-hierarchical nature of our economic system, Americans use high CEO compensation as evidence that someone is in charge. Finally, we argue that the current very high levels of CEO compensation may be counterproductive because they protect CEOs from the material consequences of their bad performance.
All-Optical Label Switching Routers for Scalable High-Performance Photonic Internet

This paper discusses all optical label switching router architecture, technologies, and systems integration in support of ultralow latency, peta-scale services for the future photonic Internet.
Bias and efficiency loss due to misclassified responses in binary regression

SUMMARY Methods that ignore errors in binary responses yield biased estimators of the associations of covariates with response. This paper derives general expressions for the magnitude of the bias due to errors in the response and shows that, unless both the sensitivity and specificity are very high, ignoring errors in the responses will yield highly biased covariate effect estimators. When the true, error-free response follows a generalised linear model and misclassification probabilities are known and independent of covariate values, responses observed with error also follow such a model with a modified link function. We describe a simple method to obtain consistent estimators of covariate effects and associated errors in this case, and derive an expression for the asymptotic relative efficiency of covariate effect estimators from the correct likelihood for the responses with errors with respect to estimates based on the true, error-free responses. This expression shows that errors in the response can lead to substantial losses of information about covariate effects. Data from a study on infection with human papilloma virus among women and simulation studies motivate this work and illustrate the findings.
Thermoregulatory behaviour affects prevalence of chytrid fungal infection in a wild population of Panamanian golden frogs

Predicting how climate change will affect disease dynamics requires an understanding of how the environment affects host-pathogen interactions. For amphibians, global declines and extinctions have been linked to a pathogenic chytrid fungus, Batrachochytrium dendrobatidis. Using a combination of body temperature measurements and disease assays conducted before and after the arrival of B. dendrobatidis, this study tested the hypothesis that body temperature affects the prevalence of infection in a wild population of Panamanian golden frogs (Atelopus zeteki). The timing of first detection of the fungus was consistent with that of a wave of epidemic infections spreading south and eastward through Central America. During the epidemic, many golden frogs modified their thermoregulatory behaviour, raising body temperatures above their normal set point. Odds of infection decreased with increasing body temperature, demonstrating that even slight environmental or behavioural changes have the potential to affect an individual's vulnerability to infection. The thermal dependency of the relationship between B. dendrobatidis and its amphibian hosts demonstrates how the progression of an epidemic can be influenced by complex interactions between host and pathogen phenotypes and the environments in which they are found.
Numerical Investigation of the Generalized Pinch-Diffusion Equations in the Edge Pedestal

AbstractThe presence of a large pinch velocity in the edge pedestal of high-confinement (H-mode) tokamak plasmas implies that particle transport in the plasma edge must be treated by a generalized pinch-diffusion theory, rather than a pure diffusion theory. An investigation of extending the numerical solution methodology of the standard diffusion theory to the solution of the generalized pinch-diffusion theory has been carried out. It is found that in the edge pedestal, where the inward pinch velocity is large in H-mode plasmas, a finer mesh spacing will be required than is necessary for similar accuracy farther inward, where the pinch velocity diminishes. An expression for the numerical error in various finite-differencing algorithms is presented.
The detection and identification of birds in flight, using coherent and noncoherent radars

The monitoring of bird movements and flight characteristics by radar can contribute to an understanding of radar clutter and bird migration, can help to alleviate the hazard of collisions between birds and aircraft, and may constitute a useful form of environmental monitoring. Most conventional surveillance radars can detect birds readily but are very much limited in their ability to identify birds. The recording of amplitude and Doppler signatures, however, may allow identification as to size and type and has the potential for increasing knowledge concerning bird flight.
Language and African Americans: Movin on up a Lil Higher

It was nearly a generation between Martin Luther King Junior Elementary School Children, et al., v. Ann Arbor School District Board (l979) and Oakland, California, Unified School District Board’s “...
Correlation of random urine protein creatinine (P-C) ratio with 24-hour urine protein and P-C ratio, based on physical activity: a pilot study

Quantification of proteinuria is usually predicated upon 24-hour urine collection. Multiple factors influence urine collection and the rate of protein and creatinine excretion. Urine collection is often incomplete, and therefore creatinine and protein excretion rates are underestimated. A random urine protein-creatinine (P-C) ratio has been shown over the years to be a reliable alternative to the 24-hour collection for detection and follow up of proteinuria. However, urine protein excretion may be influenced by physical activity. We studied 48 patients with proteinuria and varying levels of physical activity to determine the correlation between the measures of urine protein excretion. The correlation coefficient (r) between 24-hour urine total protein and random urine P-C ratio was 0.75 (P 3500 mg/day) and non-nephrotic (<3500 mg/day) range proteinuria, respectively. The correlation appeared to be stronger between random urine and 24-hour urine P-C ratio for the overall study population (r = 0.84; P < 0.001), and when stratified according to the level of proteinuria and physical activity: r = 0.99 (P < 0.001) and r = 0.92 (P < 0.01) in bedridden patients; r = 0.61 (P = NS) and r = 0.54 (P = NS) in semiactive patients; and r = 0.64 (P < 0.02) and r = 0.52 (P < 0.05) in active patients with nephrotic and non-nephrotic range proteinuria, respectively. We conclude that the random urine P-C ratio is a reliable and practical way of estimating and following proteinuria, but its precision and accuracy may be affected by the level of patient physical activity.
Perception of Success Questionnaire: Preliminary Validation in An Adolescent Population:

Summary.-The purpose of this study was a preliminary examination of the psychometric properties of the Perception of Success Questionnaire among adolescents. The questionnaire was developed to assess dispositional achievement goal orientation. Responses of 96 adolescents (M = 11.3 yt) suggest that the questionnaire has a stable factor structure and acceptable internal consistency. Analysis assessing the discriminative validity of the task and ego subscales suggests a coherent relationship between the subjects' goal orientation and their beliefs bout sport. In contrast to the findings from education, however, where differences in individuals' task orientation appear key, present results suggest that differences in ego orientation may be important in sport. Although various explanations have been proposed to account for the motivational determinants of children's achievement in sport, recent research stemming from achievement goal theory (Ames, 1992; Dweck, 1986; Nicholls, 1984, 1989) has focused on the goal-directed nature of behavior. Although not extensive, research in sport settings has also shown that goals organize achievement beliefs (Duda, 1987; Treasure & Roberts, 1994). Two achievement goal orientations, termed task and ego (Nicholls, 1984), have been shown to predominate. When a task orientation is exhibited, perceived ability is self-referenced and dependent on learning or improvement on the task. In contrast, when an ego orientation is displayed, perceived ability is other-referenced and dependent on subjective assessment of one's ability relative to that of others. To assess individuals' disposition toward task and ego achievement goal orientations, Nicholls (1989) suggested that individuals should be asked what makes them feel successful in a given situation. In line with research in the classroom setting (Nicholls, Patashnick, & Nolen, 1985), research in sport has been directed toward developing measures of task and ego goal orientations. Duda and her colleagues (Duda, 1989; Duda & Nicholls, 1989) have developed the Task and Ego Orientation in Sport Questionnaire, while Roberts and Balague (1989) have been developing the Perception of Success Questionnaire. '
Improved Formulas for the Q of Antennas With Highly Lossy Dispersive Materials

Formulas obtained by Yaghjian and Best [ IEEE Trans. Antennas Propagat., vol. 53, pp. 1298-1324, Apr. 2005] for the quality factor (Q) of antennas containing linear passive media that is not too highly lossy and dispersive are generalized to hold in highly lossy dispersive media as well. The generalization is obtained by means of a straightforward, though ad hoc, definition of nonnegative energy densities that determine a Q which is approximately equal to twice the inverse of the matched VSWR half-power fractional impedance bandwidth of the antenna. The Q for a straight-wire antenna embedded in highly lossy dispersive media is computed using the generalized energy densities and is shown to agree closely with twice the inverse of the half-power fractional bandwidth of the antenna. Other antennas modeled by resonant RLC series and parallel circuits with the inductors and capacitors filled with lossy dispersive material further confirm the improvement in the inverse-bandwidth accuracy of the Q computed from the generalized energy densities
Carbon retention in YBa2Cu3O7–δ and its effect on the superconducting transition

Magnetic susceptibility measurements are used to show that the superconducting transition temperature of yttrium barium cuprate is lowered by carbon trapped in the microstructure of dense polycrystalline materials during sintering. We show that carbon is retained in the material as a result of the porosity closing off during the sintering process. X-ray photoelectron spectroscopy and electron energy loss spectroscopy are used to show that the retained carbon forms a solid solution with YBa2Cu3O7–δ and resides in a barium carbonate-like configuration in the crystal structure. The origin of the lowering of the superconducting transition temperature and processing strategies for preventing carbon retention are discussed.
Recreation Students' Attitude Toward Intramural Sports

This study explored the attitude toward intramural sports of students who were taking recreation classes, (2) scores for athletic team members taking recreation classes compared to students taking ...
Mandatory laboratory consultation: How one hospital's program reduced overuse of cardiac tests

We retrospectively analyzed test use patterns during a 4-year period before and after institution of a mandatory laboratory approval program for lactate dehydrogenase isoenzyme analysis. In the first month after institution of the program, requests for lactate dehydrogenase isoenzymes declined from about 2,000 per month to 7 per month (greater than 99% decrease) and remained stable for 2 years. The decrease in lactate dehydrogenase isoenzyme requests did not result in any significant change in requests for creatine kinase or creatine kinase MB isoenzyme, and total lactase dehydrogenase requests (relative to creatine kinase requests) were reduced. Of the remaining lactate dehydrogenase isoenzyme tests that were performed, most were normal or nondiagnostic.
The asteroid cometh: Whether IPO ‘underpricing’ is being exploited by hedge funds

Underperformance of initial public offerings (IPOs) – a minuscule return following initial period of drastic appreciation after their issuance – is one of the remaining mysteries of quantitative finance. The size of the implied underpricing of new issues arguably should attract many a hedge fund to participate. On the contrary, the fraction of hedge funds investing in IPOs is rather small; their longevity is short and their performance decent, but hardly spectacular. In this article, I use a Markov growth-collapse model to explain the phenomenon of the finite growth of an asset, which may exhibit explosive returns punctuated by a rare devastating event. The proposed reason for the fact that hedge funds investing in IPOs never achieve the performance implied by alleged astronomical IPO underpricing is that one especially large and unsuccessful investment can obliterate the bulk of the gains.
Economists, Public Provision, and the Market: Changing Values in Policy Debate

Among health services researchers, an "economizing model" of health care has eclipsed two traditional models, "social conflict" and "collective welfare." The older models emphasized social solidarity and distributive justice, but the newer one focuses on improving efficiency, minimizing risks borne by third-party payers, constraining cost increases, and improving the functioning of markets. This article examines one source of the economizing model, the work of several early and persistently prominent economists of health care, especially Mark Pauly, Martin Feldstein, and Joseph Newhouse and his colleagues at the Rand Corporation. In particular, it explores their role in transforming perceptions of health care from a set of special services into an ordinary commodity, in giving currency to apparently dispassionate as opposed to overtly value-laden analysis, and in according priority, among health services researchers and policy makers, to economists' traditional interest in fostering smoothly functioning markets. It exhibits their principal policy recommendation-income-graduate cost sharing-the sources and character of their modes of analysis, and the character of their influence on policy makers. The article concludes that the supposedly value-free economic analysis of health care rests on a cluster of values that inhibit the expression of social solidarity and the formulation of policies intended to foster distributive justice.
Commentary: The Heuristics and Psychology of Bile Duct Injuries

During cholecystectomy, common bile duct injury (CBD) isn’t part of the operative plan and is rarely an accident. Most CBDs are cut deliberately.
Calculating Method for Thermal Equilibrium Temperature of Traditional DC TV

Capacitance-resistance divider is used for transducer of traditional direct current potential transformer. Due to resistance dissipation,the capacitance-resistance divider will heat itself seriously at rated voltage. The capacitance-resistance divider will also be affected easily by air temperature. It is significant that knowing about the temperature distribution and heat dissipation of the capacitance-resistance divider. Based on the classical heat transfer theory,a heat transfer model of the capacitance-resistance divider was established,and the heat transfer process of the capacitance-resistance divider was analyzed at thermal equilibrium. An iterative method was described to calculate the temperature distribution and heat dissipation of the capacitance-resistance divider at thermal equilibrium. The temperature distribution and heat dissipation of a capacitance-resistance divider which had typical size was calculated. The results of the temperature distribution and heat dissipation were researched,and these influential factors for oil temperature just as air temperature and the power of divider were researched too. Calculation results reveal that:(a)more than 96% of heat is dissipated by insulating bushing,and the heat dissipated by metal cover is less than 1/3 of that by metal base. (b)20°C,500 W at thermal equilibrium,the oil temperature is 43.04°C and the difference in temperature between the wall and ektexine of insulating busing is 3.61°C. (c)at the oil temperature of 40°C,the temperature at 1000 W is 17°C higher than that at 500W. (d)at 500 W,the oil temperature at 40°C is 20°C higher than that at 20°C.
Prescribing for Older Patients With Cancer

Pharmacotherapy in the elderly is very complex owing to age-related physiologic changes, the presence of multiple comorbidities, the use of multiple medications, the involvement of multiple prescribers and pharmacies, and an increased prevalence of cognitive deficits. The treatment of cancer and the manage - ment of symptoms related to therapy-induced toxicity significantly add to this complexity, with an increased risk of drug interactions, using potentially inappropriate medications (PIMs), and adverse drug reactions. There are several ways to evaluate inappropriate prescribing, with various levels of support for their use. We review the most widely used. Older adults are more susceptible than younger ones to chemotherapy toxicity, and may require dose modifications. Before starting therapy, the goals of care should be clearly defined and the general state of the patient should be assessed using some form of geriatric evaluation. Changes in the pharmacokinetics of the drugs related to aging and the possibil- ity of end-organ dysfunction must be taken into consideration, particularly the age-related decline of glomerular filtration rate that is not always reflected by an increase in serum creatinine. The treatment plan for the older adult needs to be carefully defined in order to prevent adverse events, and allow the patient to benefit from treatment without a major impact on quality of life.
Education, training, and evaluation of hospital compounding personnel

Many practicing pharmacists who graduated in the past 20 years have little or no compounding education, training, or experience. With the change to the entry-level PharmD degree now underway in schools of pharmacy, the primary emphasis is on clinical practice instead of traditional pharmacy practice. Little or no compounding education is offered or required, even though demand for pharmacy compounding is steadily increasing. Since compounding is a specialized division of the hospital pharmacy department, the compounding staff is held to a higher in-house standard than the rest of the pharmacy department. According to the United States Pharmacopeia Chapter 795, any pharmacist or licensed healthcare professional who is responsible for preparing compounds is a "compounder." This definition includes compounding pharmacy technicians. Although compounding has always been part of hospital pharmacy practice, few hospital pharmacies have dedicated laboratories or staff for the specialized tasks of nonsterile compounding, high-risk sterile compounding, or unit-dose packaging. Since both the American Society of Health-System Pharmacists and the Joint Commission on Accreditation of Healthcare Organizations mandate that hospital personnel be properly educated and trained according to applicable legal and regulatory requirements and oranizational policy in order to fulfill their assigned tasks and responsibilities, the education, training, and evaluation of hospital compounding personnel is crucial.
MMTV/N-ras Transgenic Mice as a Model for Altered Capacitation Male Sterility and Tumorigenesis

Infertility is generally defined as a failure to conceive following one year of unprotected intercourse; it affects about 10% to 15% of couples attempting a pregnancy for the first time (Romeny et al., 1975). Abnormalities in the male partner contribute to infertility in about 40% of these couples (Speroff et al., 1983).
Spectral measurements of asymmetrically irradiated capsule backlighters

Capsule backlighters provide a quasi-continuum x-ray spectrum over a wide range of photon energies [J. F. Hansen et al., Rev. Sci. Instrum. 79, 013504 (2008)]. Ideally one irradiates the capsule backlighter symmetrically, however, in complex experimental geometries, this is not always possible. In recent experiments we irradiated capsule backlighters asymmetrically and measured the x-ray spectrum from multiple directions. We will present time-integrated spectra over the photon energy range of 2-13 keV and time-resolved spectra over the photon energy range of 2-3 keV. We will compare the spectra from different lines of sight to determine if the laser asymmetry results in an angular dependence in the x-ray emission.
Hospitals Should Help Communities Prepare for Climate Change

The article focuses on the role hospitals should play through community health needs assessments (CHNA) in helping communities prepare for climate change. It states CHNAs provide hospitals with a strong vehicle for collaborating with public health and environmentalists in identifying local health needs that are associated with climatic conditions. It suggests many local hospitals fail to provide support for environmental projects despite the obvious impacts on community health.
Proton range verification in homogeneous materials through acoustic measurements

Clinical proton beam quality assurance (QA) requires a simple and accurate method to measure the proton beam Bragg peak (BP) depth. Protoacoustics, the measurement of the pressure waves emitted by thermal expansion resulting from proton dose deposition, may be used to obtain the depth of the BP in a phantom by measuring the time-of-flight of the pressure wave. Rectangular and cylindrical phantoms of different materials (aluminum, lead, and polyethylene) were used for protoacoustic studies. Four different methods for analyzing the protoacoustic signals are compared. Data analysis shows that, for Methods 1 and 2, plastic phantoms have better accuracy than metallic ones because of the lower speed of sound. Method 3 does not require characterizing the speed of sound in the material, but it results in the largest error. Method 4 exhibits minimal error, less than 3 mm (with an uncertainty ⩽1.5 mm) for all the materials and geometries. Psuedospectral wave-equation simulations (k-Wave MATLAB toolbox) are used to understand the origin of acoustic reflections within the phantom. The presented simulations and experiments show that protoacoustic measurements may provide a low cost and simple QA procedure for proton beam range verification as long as the proper phantoms and calculation methods are used.
Benign and malignant odontogenic neoplasms of the jaws show a concordant nondiscriminatory p63/p40 positive immunophenotype

Objectives Antibody p40, which recognizes exclusively ΔNp63 but not TAp63, has shown diagnostic utility in salivary gland and sinonasal tract malignancies. Although p63 immunophenotypic characterization of odontogenic lesions has been reported, p40 expression has not been previously studied. We aimed to study p40 immunoreactivity in odontogenic tumors (OTs) and odontogenic cysts (OCs) and to investigate possible discriminatory properties of the combined p63/p40 immunoprofile in OTs and OCs. Study Design Fourteen ameloblastomas, 7 adenomatoid odontogenic tumors, 6 calcifying epithelial odontogenic tumors, 1 squamous odontogenic tumor, 4 primary intraosseous odontogenic carcinomas, 5 calcifying odontogenic cysts, 4 glandular odontogenic cysts, 3 odontogenic keratocysts, 3 dentigerous cysts, and 1 each radicular and orthokeratinized cysts were stained for p63 (4A4) and p40 (BC28) antibodies. Results Ameloblastoma, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, squamous odontogenic tumor, and primary intraosseous odontogenic carcinoma demonstrated concordant p63+/p40+ immunophenotype. P40, similar to p63, highlighted almost all lesional cells of OTs and, overall, the full thickness of the epithelial lining of the cystic areas of OCs and ameloblastoma. The keratin layer of OKC and the adluminal ductal and mucous cells of GOC were p63–/p40–. Conclusions Both ΔNp63 and TAp63 isoforms are present in neoplastic and developmental odontogenic lesions; and p63/p40 immunophenotype is nondiscriminatory pertaining to benign and malignant OTs and OCs.
Effects of Na+ and K+ Exchange in Interlayers on Biotite Dissolution under High-Temperature and High-CO2-Pressure Conditions.

Cations in formation brine can affect CO2-induced dissolution of minerals during geologic CO2 sequestration (GCS), affecting the GCS performance. This study investigated the dissolution of biotite with 0–4 M Na+ and 0–10 mM K+ under high temperature and high CO2 pressure (i.e., 95 °C and 100 bar CO2). At 0.5 M Na+, however, the enhancing effect of Na+ was mitigated by an inhibition caused by competing sorption between Na+ and protons. With 0.5 M Na+ concentration, coexisting K+ significantly inhibited the biotite dissolution with high sensitivity at even lower K+ concentrations, such as 0.1–0.5 mM. In this study, we also reported the dissolution of Na-treated biotite, mimicking biotite naturally equilibrated with Na+-abundant brine. Na-treated biotite dissolved faster than natural K-containing biotite, and during the dissolution, it transformed to vermiculite. Aqueous Na+ inhibited the dissolution...
Gender Differences in Adolescent Opioid Misuse and Major Depressive Episodes

The opioid crisis is a public health emergency in the United States, with staggering financial and social costs to society. Nonmedical prescription opioid use (NMPOU) disproportionately impacts adolescents, with opioid-related mortality rates increasing for female adolescents. Past research has linked opioid misuse to mental health problems, and adolescents have the highest prevalence of substance use and mental health disorders compared with other age cohorts. This study examined the relationship of adolescent NMPOU with having a major depressive episode (MDE), stratified by gender. This study used data from the 2016 National Survey on Drug Use and Health (NSDUH), and included 11,489 respondents aged 12 to 17. Multivariate logistic regression analyses using survey design weights were used to examine the effect of past-year NMPOU with the odds of having a past-year major depressive episode. Results indicated a higher prevalence of past-year MDE among adolescents who used NMPOU (34.0%), compared to those who did not (12.7%). Adolescent opioid misuse was associated with increased 60% higher odds for having a past-year MDE (OR = 1.60, 95% CI [1.11, 2.32], p < 0.05). Subgroup analysis found that NMPOU was associated with increased odds for having a past-year MDE for adolescent females (OR = 1.99, 95% CI [1.24, 3.17], p < 0.01), while the association of NMPOU with past-year MDE was not statistically observed for adolescent males. Results indicated that opioid misuse is a leading factor associated with having a major depressive episode among adolescent females. Adolescent females were at a higher risk for poor mental health outcomes compared to adolescent males. Social workers in collaboration with other professionals can play a central role by coordinating substance use and mental health prevention and recovery services.
Methodological standards for qualitative and mixed methods patient centered outcomes research

The Patient-Centered Outcomes Research Institute’s (PCORI) methodology standards for qualitative methods and mixed methods research help ensure that research studies are designed and conducted to generate the evidence needed to answer patients’ and clinicians’ questions about which methods work best, for whom, and under what circumstances. This set of standards focuses on factors pertinent to patient centered outcomes research, but it is also useful for providing guidance for other types of clinical research. The standards can be used to develop and evaluate proposals, conduct the research, and interpret findings. The standards were developed following a systematic process: survey the range of key methodological issues and potential standards, narrow inclusion to standards deemed most important, draft preliminary standards, solicit feedback from a content expert panel and the broader public, and use this feedback to develop final standards for review and adoption by PCORI’s board of governors. This article provides an example on how to apply the standards in the preparation of a research proposal.