cssi/SciSciGPT-SciSciNet huggingface dataset:
Flexure of a fluid-saturated cuboid

The flexure of a cuboid mixture of a nonlinearly elastic solid and an ideal fluid is considered in the context of the theory of interacting continua. The Helmholtz free energy function for the mixture is assumed to be of a “Neo-Hookean” type. The effect of flexure on the distribution of the fluid content and the radial stresses in the deformed, swollen, cylindrical configuration is investigated. Classical results for the flexure of a cuboid of an incompressible nonlinearly elastic material [1] are also derived by considering the special case of the mixture with zero fluid content. It is anticipated that the results presented herein will be valuable to practicing engineers, and also guide and motivate future experimental work.
Shear and compression buckling analysis for anisotropic panels with elliptical cutouts

An approximate analysis for buckling of biaxial- and shear-loaded anisotropic panels with centrally located elliptical cutouts is presented. The analysis is composed of two parts: a prebuclling analysis and a buckling analysis. The prebuckling solution is determined using Lekhnitskii's complex variable equations of plane elstostatics combined with a Laurent series approximation and a boundary collocation method. The buckling solution is obtained using the principle of minimum potential energy. A byproduct of the minimum potential energy equation is an integral equation that is solved using Gaussian quadrature
The Effects of the Laurentide Ice Sheet on North American Climate during the Last Glacial Maximum

A climate model, consisting of an atmospheric general circulation model coupled with a simple model of the oceanic mixed layer, is used to investigate the effects of the continental ice distribution of the last glacial maximum (LGM) on North American climate. This model has previously been used to simulate the LGM climate, producing temperature changes reasonably in agreement with paleoclimatic data. The LGM distribution of continental ice according to the maximum reconstruction of HUGHES et al. (1981) is used as input to the model. In response to the incorporation of the expanded continental ice of the LGM, the model produces major changes in the climate of North America. The ice sheet exerts an orographic effect on the tropospheric flow, resulting in a splitting of the midlatitude westerlies in all seasons but summer. Winter temperatures are greatly reduced over a wide region south of the Laurentide ice sheet, although summer cooling is less extensive. An area of reduced soil moisture develops in the interior of North America just south of the ice margin. At the same time, precipitation increases in a belt extending from the extreme southeastern portion of the ice sheet eastward into the North Atlantic. Some of these findings are similar to paleoclimatic inferences based on geological evidence.
Clinical and Biochemical Course of Alcoholic Liver Disease Following Sudden Discontinuation of Alcoholic Consumption

It has been our impression that clinical deterioration and worsening of liver tests of patients with alcoholic liver disease (ALD) is common immediately following hospitalization and cessation of ethanol intake. In order to determine the frequency of such deterioration and characterize features which may identify those patients who initially deteriorate, we analyzed the standard liver tests and clinical parameters of liver function following hospitalization of 273 cases of ALD, and correlated these with histologic patterns and hospital course. We found that moderate liver test worsening following hospitalization is frequent in patients with ALD, especially alcoholic hepatitis. The presence of alcoholic hyalin in patients with alcoholic hepatitis did not correlate with liver function or frequency of biochemical worsening, but did correlate with mortality. Biochemical deterioration did not correlate with clinical deterioration or mortality, unless complications such as bleeding, sepsis, or pancreatitis occurred. Spontaneous clinical deterioration of our patients in the absence of precipitating factors was rare. We conclude that worsening of liver tests following hospitalization frequently occurs in patients with ALD, does not necessarily imply presence of complications (e.g., biliary obstruction, sepsis, other liver injury), but should suggest the presence of alcoholic hepatitis.
Population programs: Measuring their impact on fertility and the personal distribution of their effects

Abstract Evaluating population programs involves statistically inferring how the interregional variation in subsidized family planning activity (or other program intervention) is related to fertility, holding constant for an array of initial endowments, prices, wages, and environmental factors that are determined independently of parents and are likely to exert an exogenous influence on desired and actual fertility. This paper illustrates how most family planning evaluation schemes are flawed because they focus analysis on measured contraceptive use rather than on the final fertility outcome. Furthermore, the choice of environmental determinants of fertility, other than the local activity of the family planning program, are rarely conceptualized as including only exogenous conditions influencing the reproductive goals and behavior of couples. Review of evidence from the early years of the Taiwan family planning program illustrates many of the issues discussed at the outset of the paper.
Composition of Vehicle Occupancy for Journey-to-Work Trips evidence of ridesharing from 2009 national household Travel Survey Vermont add-On Sample

Ridesharing serves to mitigate pollution and congestion with minimal investment of public capital while also increasing the efficiency of the transportation system. This research addresses the gaps in the literature on the structure and formation of ridesharing by identifying individual, household, and physical-environment characteristics that correspond with an individual’s choice to rideshare instead of drive alone. For a fuller understanding of ridesharing behavior, there first must be a better understanding of who is in the vehicle, not just how many. A distinction is made between intrahousehold (internal) and interhousehold (external) ridesharing. With the Vermont add-on sample of the 2009 National Household Travel Survey, a multinomial logit model and nested logit model were developed to examine the determinants of ridesharing. The analysis in this research stresses the importance of the way ridesharing behavior is extracted from survey data. Further, a new method for calculating household vehicle availability is presented; the method places less importance on drivers who are not full-time workers. Results indicate that employment density, longer distance traveled to work, and working in a small urban area have positive influences on the likelihood of ridesharing. Higher vehicle availability in the household, age, sex (male), and a longer time spent per trip on the journey to work were all found to influence the propensity to rideshare negatively. Cost of travel does not significantly affect ridesharing. Continuing growth in vehicle ownership and sprawl has led to dramatic increases in automobile use. The resulting air pollution, energy expenditure, time consumption, and congestion are significant concerns. Furthermore, the popularity of single-occupant vehicle (SOV) trips propagates these problems. Commuting in America III: The Third National Report on Commuting Patterns and Trends indicates that the average daily one-way commute trip increased by approximately 3 min between 1990 and 2000, and 13 million solo drivers were added to the U.S. transportation system (1). This preference can also be seen in the steady loss of the ridesharing market share to driving alone (2). Multiple-occupant vehicle (MOV) trips, or ridesharing, are one way to increase the efficiency of our transportation system, yet little is known about ridesharing behaviors. Even less is available in the literature about the structure and formation of rideshares.
Separation Algorithms for Classes of STSP Inequalities Arising from a New STSP Relaxation

The problem ofseparating a class of inequalities that are valid for the symmetric traveling salesman problem (STSP) consists of devising an efficient method that, given a fractional pointx*. for a relaxation of the STSP, either finds an inequality in the given class of STSP inequalities that is violated byx*. or determines that there are no such violated inequalities. We can define important classes of STSP inequalities by performing Naddef's and Rinaldi's (1993)node-lifting operation on STSP inequalities defined on small graphs.We present efficient methods forexactly separating large classes of STSP inequalities that arise from an STSP relaxation related to node lifting. In particular, we show how to find efficiently the most-violated inequality in the class of STSP inequalities having abackbone set with a constant numberk of vertices, and thus separate in polynomial time the class of all STSP inequalities whose backbone set has at mostk vertices.
Short-term outcomes of inguinal hernia repair in octogenarians and nonagenarians

The objective of this study is to report the 30-day outcomes following inguinal hernia repair in octogenarians (80–89 years of age) and nonagenarians (≥90 years) using a large, prospective, multi-institutional database and to identify the individual risk factors associated with increased morbidity and mortality. Patients aged 80 and above undergoing inguinal hernia repair were identified from the American College of Surgeons’ National Surgical Quality Improvement Program (2007–2008). Univariate analysis was performed using chi square, Fisher’s exact test and t test. Multivariate logistic regression analysis was carried out to assess factors associated with increased postoperative complications and mortality. Of 2,377 patients above 80 years of age, 226 (9.5 %) were nonagenarians. Men accounted for 81.4 % (1,936) of patients. There were significantly more female patients in the nonagenarian group (29.2 vs. 17.4 %, p < 0.0001). Laparoscopic repair was performed in 210 (9.9 %) patients. Emergency repair was more frequent in nonagenarians than octogenarians (12 vs. 4.4 %, p < 0.0001). The 30-day overall complication rate was significantly increased in nonagenarians compared to octogenarians (6.1 vs. 3.2 %, p = 0.03). Mortality is increased tenfold in elective inguinal hernia repair in nonagenarians compared to octogenarians (3 vs. 0.3 %, p < 0.0005). On multivariate analysis, preoperative variables found to be significantly associated with morbidity included totally dependent functional status, congestive heart failure and emergent nature of procedure, while higher age, emergency repair and open wound are associated with increased mortality. Elective inguinal hernia repair can be safely performed in octogenarians with low morbidity and mortality but is increased in nonagenarians. More vigilant postoperative care is required after emergent hernia repairs due to the increased risk of morbidity and mortality, and effort should be made to electively repair inguinal hernias early in this elderly population.
TRANSLATING (AND INTERPRETING) THE MENGZI: VIRTUE, OBLIGATION, AND DISCRETION

The essay focuses on two aspects of the translation and interpretation of Mengzi in Bryan Van Norden’s new translation. First, I argue that Van Norden’s explanation of virtues in terms of obligations is potentially problematic, and show instances in which this unusual understanding of virtue influences the translation itself. Second, I highlight the ways in which Van Norden’s translation and commentary have effectively thematized the role of “discretion (quan 權)” in Mengzi’s text, and make some suggestions for how we can arrive at an even deeper understanding of this important concept. Author’s Contact Information: Professor Stephen C. Angle Department of Philosophy Wesleyan University 350 High Street Middletown, CT 06459, USA E-mail: sangle@wesleyan.edu Tel: (860) 685-3654 Fax: (860) 685-3861
Write-Once Read-Many Oblivious RAM

We introduce WORM-ORAM, a first mechanism that combines Oblivious RAM (ORAM) access privacy and data confidentiality with Write-Once Read-Many (WORM) regulatory data retention guarantees. Clients can outsource their database to a server with full confidentiality and data access privacy, and, for data retention, the server ensures client access WORM semantics. In general simple confidentiality and WORM assurances are easily achievable, e.g., via an encrypted outsourced data repository with server-enforced read-only access to existing records (albeit encrypted). However, this becomes hard when also access privacy is to be ensured-when client access patterns are necessarily hidden and the server cannot enforce access control directly. WORM-ORAM overcomes this by deploying a set of zero-knowledge proofs to convince the server that all stages of the protocol are WORM-compliant.
Multicore garbage collection with local heaps

In a parallel, shared-memory, language with a garbage collected heap, it is desirable for each processor to perform minor garbage collections independently. Although obvious, it is difficult to make this idea pay off in practice, especially in languages where mutation is common. We present several techniques that substantially improve the state of the art. We describe these techniques in the context of a full-scale implementation of Haskell, and demonstrate that our local-heap collector substantially improves scaling, peak performance, and robustness.
The evidence for non-invasive ventilation in the preterm infant.

Non-invasive ventilation was among the earliest forms of respiratory support used in infants with respiratory failure in the early seventies.1 Its use in preterm infants, however, subsided to the use of nasal continuous positive airway pressure (N-CPAP). Continuous distending pressure provided by N-CPAP improves oxygenation by stabilising lung volume in infants with respiratory distress syndrome (RDS), reduces apnoea of prematurity and attenuates distortion of the chest wall during inspiration. The use of N-CPAP as a primary mode of respiratory support to avoid invasive ventilation and facilitate weaning from the ventilator has become standard practice. Although successful in a large proportion of infants, N-CPAP is not always effective in avoiding the need for intubation or preventing extubation failure.2–5 This is most evident in the more immature infants who are the ones at a higher risk of developing complications associated with invasive mechanical ventilation. Nasal intermittent positive pressure ventilation (N-IPPV) is being increasingly used in preterm infants with respiratory failure in lieu of or to facilitate removal from invasive mechanical ventilation. N-IPPV consisting of positive pressure cycles delivered on top of the continuous distending pressure delivered by N-CPAP is used as an intermediate mode of respiratory support between N-CPAP and invasive mechanical ventilation. Several investigations have explored the physiological and clinical effects of N-IPPV in preterm infants. This manuscript describes the evidence provided by these studies and discusses the areas where further research is needed. The proposed mechanisms by which N-IPPV may enhance the support provided by N-CPAP include increased ventilation, higher mean airway pressure, washout of the upper airway anatomical dead space and a possible stimulatory effect of intermittent cycling on the respiratory drive. Although it is difficult to determine what portion of the positive pressure is transmitted to the distal airways during N-IPPV, physiological data from studies involving …
30.3: An Enhanced Analog Video Interface Standard

With the de-facto standard “VGA” connector nearing the end of its useful life, no obvious candidate for its replacement has appeared. The recent digital interface standards have failed to gain widespread acceptance, due to their increased cost and lack of compatibility with the VGA installed base. This paper will describe a proposed new standard interface which effectively duplicates the performance of the current digital standards while retaining full backward compatibility with the VGA system.
A planar multipolar antenna for MIMO applications

In this paper, a planar multipolar antenna consists of four elements is proposed for MIMO application. The size of the antenna is compactly confined in a 0.22lambdao x 0.22lambdao square. With the concept of multipolar radiation and the introduction of the mode decomposition network, we can generate the desired multipolar pattern with a fully decoupled benefit. Although the bandwidth performance is significantly reduced for higher order multipolar mode, we can always make a tradeoff between bandwidth and compactness of the multi-element antenna.
Holiday Greeting Rituals as Expressions of Ambivalence and Indifference Toward Social Change

Social change often is positioned as the gradual acceptance of one set of dominant ideas over another. Ambivalence and indifference, however, also play an important role in the development of social change. Participants in this study discussed their use of common holiday greeting rituals and their reasons for using one greeting over another. Through constant comparative analysis, it was revealed that practicing American Christians undesirably challenge social change, desirably support it, see it as inevitable and therefore regard it with ambivalence, or see social change as irrelevant and meet it with indifference. Importantly, the way individuals experience social change has direct and observable implications on patterns of talk, thus affecting the nature of social change over time.
Property measurement utilizing atomic/molecular filter-based diagnostics

A variety of atomic/molecular filter diagnostic techniques have been under development for qualitative and quantitative flow diagnostic tools since their introduction in the early 1990s. This class of techniques utilizes an atomic or molecular filter, which is basically a glass cell containing selected vapor-phase species (e.g., I2, Hg, K, Rb). In filtered Rayleigh scattering (FRS), and techniques derived from it, the atomic/molecular filter is placed in front of the detector to modify the frequency spectrum of radiation scattered by flow-field constituents (i.e., molecules/atoms and/or particles) when they are illuminated by a narrow linewidth laser. The light transmitted through the filter is then focused on a detector, typically a CCD camera or photomultiplier tube. The atomic/molecular filter can be used simply to suppress background surface/particle scattering, and thereby enhance flow visualizations, or to make quantitative measurements of thermodynamic properties. FRS techniques have been developed to measure individual flow properties, such as velocity (when the scattered light is from particles) or temperature (when the scattered light is from molecules), and measure multiple flow properties simultaneously such as pressure, density, temperature, and velocity. This manuscript summarizes the background needed to understand FRS techniques, and gives example measurements that have been used to develop FRS, demonstrate its capabilities, and investigate flow fields (both non-reacting and combustion) of research interest utilizing the unique capabilities of FRS. In addition, FRS has been used in conjunction with other diagnostics to improve the technique or measure properties simultaneously such as temperature and velocity (measured with PIV), or temperature and species concentration (measured by Raman scattering or laser-induced fluorescence). Also, a brief discussion is given of similar techniques being developed which utilize atomic/molecular filters and Thomson scattering from electrons to measure the electron number density and electron temperatures in plasmas.
A Large-Scale Multidimensional Test of the Effect of Prison Education Programs on Offenders' Behavior:

This study examined the prison behavior and postrelease recidivism of more than 14,000 inmates released from Texas prisons in 1991 and 1992. Comparisons were made between participants and nonpartic...
A SIMULTANEOUS‐EQUATIONS MODEL OF WHITE AND NONWHITE MIGRATION AND URBAN CHANGE

Utilizing color-specific data relating to the 100 largest Standard Metropolitan Statistical Areas (SMSA's), this study develops a simultaneous-equations model of migration and urban change for white and nonwhite civilian labor force members. For both the white and nonwhite groups significant own-group interactions are uncovered between migration and urban change. Significant interactions between the groups are also apparent. White civilian labor force members are found to be more responsive to the growth of (destination) Job opportunities than nonwhite civilian labor force members, while nonwhites are more responsive than whites to high (destination) income levels and income growth.
Structure of human rhinovirus 3C protease reveals a trypsin-like polypeptide fold, RNA-binding site, and means for cleaving precursor polyprotein

The structure of human rhinovirus-14 3C protease (3Cpro) has been determined at 2.3 A resolution and refined to an R factor of 0.22. This cysteine protease folds into two topologically equivalent six-stranded beta barrels and in this sense is similar to trypsin-like serine proteases. However, there are differences in the lengths and positioning of individual beta strands as well as in loops connecting elements of secondary structure. The catalytic residues Cys-146, His-40, and Glu-71 are positioned as in serine proteases, but the oxyanion hole is moved 1-1.2 A away. Residues that bind to the 5' noncoding region of rhinovirus genomic RNA are located on the opposite side of the molecule from the active site. Interactions between individual 3Cpro molecules in the crystal lattice suggest a model for intermolecular proteolytic cleavage of the 3CD polyprotein.
To sink or swim: The use of dream material in addiction treatment

An individual's dream is a unique production that offers insight into the conversation that occurs between the conscious and unconscious ‘mind’. Dreams are important as they allow insight into the transference, countertransference, dissociated aspects of the self, and the nature of the therapeutic alliance. In the treatment of addicted individuals, psychodynamically oriented addiction specialists have offered techniques and understanding in working with dream material. This paper offers the shared analysis of a dream by a patient in recovery and her therapist The dream's meaning is explored from an interpersonal perspective.
Risk of Female Human Papillomavirus Acquisition Associated with First Male Sex Partner

To quantify the risk of human papillomavirus (HPV) acquisition associated with a first male sex partner and to identify associated risk factors, we analyzed data from women who were enrolled before or within 3 months of first intercourse with a male partner and were censored at the report of a second partner. The 1-year cumulative incidence of first HPV infection was 28.5% (95% confidence interval, 20.6%-38.6%) and increased to almost 50% by 3 years. The risk was increased when the first male partner was sexually experienced. Our results indicate a high risk of HPV infection in young women who have had just 1 male sex partner.
A new hypothesis about the origin of uterine fibroids based on gene expression profiling with microarrays

This article will discuss some recent insights based on our microarray studies that have emphasized the role the extracellular matrix, transforming growth factor beta, and collagen structure in fibroid formation. These studies led to appreciation of molecular similarities between fibroids and keloids. Collectively, these observations suggest a model of fibroid development based on an abnormal response to tissue repair, resulting in disordered healing and formation of an altered extracellular matrix.
Guidelines for Quality Standards for Immunization

This is an update of the 1997 Quality Standards for Immunization, which is one of a series of guidelines commissioned by the Infectious Diseases Society of America (IDSA) through its Practice Guidelines Committee. This information is presented as a standard-of-care rather than practice guidelines because the evidence for following these recommendations is so strong that they should be implemented with rare exceptions. The purpose of these standard-of-care guidelines is to provide assistance to clinicians who make decisions on providing immunizations to infants, children, adolescents, and adults. This document is a summary of evidence-based guidelines previously developed by national organizations. A standard ranking system was used to determine the strength of the recommendations, and the quality of evidence cited in the literature was reviewed for each guideline. The targeted health care professionals are pediatricians, family practitioners, internists (including specialists), obstetricians, and others who provide immunizations. The panel members are experts in the field of adult and pediatric infectious diseases. The document has been subjected to external review by peer reviewers as well as by the Practice Guidelines Committee, and it was approved by the IDSA Council. Indicators for measuring compliance with the standards are included. The document will be posted on the IDSA home page at http://www.idsociety.org/.
Bionomics of the Anthocoridae.

▪ Abstract The family Anthocoridae (Hemiptera:Heteroptera) contains between 400 and 600 species distributed worldwide, chiefly on the continents but also on oceanic islands. They are small (1.4–4.5 mm) and common to a wide variety of habitats. Many are found in cryptic habitats such as galls, several widespread genera are surface feeders on small arthropods (Anthocoris, Orius, and Tetraphleps), and others can be found in ant nests and, especially, under bark. Wing polymorphism is common in this family, often associated with the cryptic habit. Most known species are predaceous, though some take plant food as well (e.g. Orius insidiosus, Orius pallidicornis). A few of these are believed to be entirely phytophagous (Paratriphleps laeviusculus). Their small size and often generalized feeding habits have resulted in about 30 introduced species, mostly accidental. A few have been introduced deliberately as biological control agents (Anthocoris spp., Montandoniola moraguesi, O. insidiosus, Orius tristicolor, and...
Depression and life satisfaction among people ageing with post-polio and spinal cord injury

Purpose and background: Attention has recently begun to focus on the ageing of individuals with disability, not only as a longterm follow-up issue but as a unique developmental issue itself. The ma...
Beneath the Seven Seas: Shipwrecks, Seafaring, and Archaeology

Beneath the Seven Seas: Adventures with the Institute of Nautical Archaeology. Edited by George F. Bass. Thames and Hudson, London. 2005. ISBN-13 978-0500051368 (Hardback GB £24.95; US $39.95), 256...
High mercury seafood consumption associated with fatigue at specialty medical clinics on Long Island, NY.

We investigated the association between seafood consumption and symptoms related to potential mercury toxicity in patients presenting to specialty medical clinics at Stony Brook Medical Center on Long Island, New York. We surveyed 118 patients from April–August 2012 about their seafood consumption patterns, specifically how frequently they were eating each type of fish, to assess mercury exposure. We also asked about symptoms associated with mercury toxicity including depression, fatigue, balance difficulties, or tingling around the mouth. Of the 118 adults surveyed, 14 consumed high mercury seafood (tuna steak, marlin, swordfish, or shark) at least weekly. This group was more likely to suffer from fatigue than other patients (p = 0.02). Logistic regression confirmed this association of fatigue with frequent high mercury fish consumption in both unadjusted analysis (OR = 5.53; 95% CI: 1.40–21.90) and analysis adjusted for age, race, sex, income, and clinic type (OR = 7.89; 95% CI: 1.63–38.15). No associations were observed between fish intake and depression, balance difficulties, or tingling around the mouth. Findings suggest that fatigue may be associated with eating high mercury fish but sample size is small. Larger studies are needed to determine whether fish intake patterns or blood mercury tests warrant consideration as part of the clinical work-up in coastal regions.
Formation and Decay of Shock Waves

In the previous five chapters, the close analogy between one-dimensional conventional gas dynamics and the particular class of hydromagnetic flows under consideration has been utilized to extend a rather large part of the linearized theory of the former to the magnetic case. The analogy may be exploited in yet another problem of interest, namely, the formation and decay of weak shock waves. This is due to the fact that in common with conventional gas dynamic shock waves, the entropy change across magnetohydrodynamic shock waves involves only terms of the third and higher order in the shock strength [1]. With this fact as a basis and because of the existence of generalized Riemann invariants and simple normal shock relations, it is possible to extend the Friedrichs theory [46] of the formation and decay of shock waves to the magnetic case with little difficulty. Since the generalized Riemann invariants and an exact solution for simple wave flow are known explicitly for a monatomic fluid, the discussion will be limited to a monatomic fluid in order to simplify the expository analysis of this chapter.
A 10-year retrospective analysis of risk factors, patterns of cancer recurrence, and survival after liver transplant for cirrhosis and hepatocellular carcinoma

4617 Introduction: Determining eligible patients who are likely to have better outcomes following orthotopic liver transplant (OLT) for cirrhosis and hepatocellular carcinoma (HCC) is an ongoing ch...
Implementation of an Inpatient Pediatric Sepsis Identification Pathway.

BACKGROUND AND OBJECTIVE: Early identification and treatment of severe sepsis and septic shock improves outcomes. We sought to identify and evaluate children with possible sepsis on a pediatric medical/surgical unit through successful implementation of a sepsis identification pathway. METHODS: The sepsis identification pathway, a vital sign screen and subsequent physician evaluation, was implemented in October 2013. Quality improvement interventions were used to improve physician and nursing adherence with the pathway. We reviewed charts of patients with positive screens on a monthly basis to assess for nursing recognition/physician notification, physician evaluation for sepsis, and subsequent physician diagnosis of sepsis and severe sepsis/septic shock. Adherence data were analyzed on a run chart and statistical process control p-chart. RESULTS: Nursing and physician pathway adherence of >80% was achieved over a 6-month period and sustained for the following 6 months. The direction of improvements met standard criteria for special causes. Over a 1-year period, there were 963 admissions to the unit. Positive screens occurred in 161 (16.7%) of these admissions and 38 (23.5%) of these had a physician diagnosis of sepsis, severe sepsis, or septic shock. One patient with neutropenia and septic shock had a negative sepsis screen due to lack of initial fever. CONCLUSIONS: Using quality improvement methodology, we successfully implemented a sepsis identification pathway on our pediatric unit. The pathway provided a standardized process to identify and evaluate children with possible sepsis requiring timely evaluation and treatment.
Host and Environmental Factors Influencing the Peripheral Blood Leukocyte Count

The peripheral leukocyte count is an important predictor of mortality. Hence, host and environmental factors influencing the peripheral leukocyte count are of interest. The authors studied 8,635 subjects, aged 30-74 years, who were seen as part of the National Health and Nutrition Examination Survey II in 1976-1980, and sought to assess the relation of age, sex, obesity (body mass index), alcohol use, and various parameters of cigarette smoking to the peripheral leukocyte count using multiple regression analysis. Various parameters of cigarette smoking were statistically significant independent predictors of the peripheral leukocyte count with higher leukocyte counts seen among current smokers, relative to former or never smokers. Among current smokers, a dose-response relation was seen for cigarettes/day and total pack-years smoked. A dose-response relation with pack-years and years since quitting was seen in former smokers. Other variables that were statistically significant independent predictors of a higher peripheral blood leukocyte count were younger age, male sex, increased body mass index, and decreased alcohol consumption. Although the specific cell or cells responsible for these relations are not defined by this analysis, the results support the suggestion that a number of host and environmental factors can influence cellular markers of inflammation.
Food Frequency Questionnaire-Based Estimates of Compliance to ATP III (National Cholesterol Education Programme) Recommended Diets in a Middle-Class Adult Population of Bangalore City

Objective: To assess the extent of compliance to recommended diets of the ATP III (National Cholesterol Education Programme) in adults across a wide age range. Methods: A cross-sectional survey of dietary intake assessed by a 108 item food frequency questionnaire (FFQ) in a convenience middle-class adult population sample (n=302) of Bangalore city. The FFQ was tested for repeatability and validated against multiple 24 hour dietary recalls in a smaller sample (n=55). Results: Repeatability of nutrient estimates was high with correlations between two FFQ administrations of r=0.529 to r=0.732, all P < 0.01. Relative validity of nutrient estimation was also high (correlations 0.43 to 0.753, all P <0.05; FFQ vs 24 hour recalls). The percentage of people across age stratified groups who had adverse dietary intakes in relation to recommended norms were 3.7% to 28.9% for total fat, 94.1% to 100% for saturated fat, 36.3% to 49.1% for cholesterol and 67.6% to 88.9% for fibre. Conclusions: The FFQ that was developed has comparable repeatability and relative validity with other published FFQs. A large proportion of middle-class individuals across a wide age range have adverse dietary profiles. There is a need to develop effective strategies to tackle this.
Assessing differences in intimate partner obligations based on relationship status, gender, and parental status

The purpose of this study was to explore the effects of relationship status (i.e., cohabiting or married), gender, and parental status on perceptions about intimate partner obligations. In vignettes depicting various aspects of couple relationships, we measured the effects of relationship status, gender, and parental status on partner obligations, obtaining quantitative and qualitative data. Married couples were perceived to have greater obligations to one another than cohabitors when issues involved potential relationship transitions. Women were perceived to be more obligated than men to support a partner's career change. Open-ended responses indicated that marriage is an important factor in shaping perceived intimate partner obligations, but love, commitment, and intimacy also are important in motivating relationship-enhancing behaviors.
Detection and Diagnosis of Insulator Condition Based on Infrared Thermal Image Techniques

The infrared thermal image detection is one of the most important methods for the real-time online detection of insulation state of insulators. The discriminant methods of infrared thermal image diagnosis for insulators were analyzed and discussed. On this basis, taking the porcelain insulator strings as investigated subjects, the laboratory simulation tests and field measurements of the insulator infrared thermal image diagnosis were carried out. This paper expatiated on the difference between the thermal image characteristics of different inferior insulator strings with different types of defects. The results show that, the general thermal image characteristic of porcelain insulator is that the temperature of the steel cap is higher than that of the porcelain plate. As to the porcelain plate, the farther the position is from the insulator string axis, the lower the temperature is. Compared with the normal insulator string, for the inferior insulator string, the maximum temperature difference along the insulator string obviously increases. As to different inferior insulator strings with different types of defects, the thermal image characteristic may be different. There is possibly a blind detection zone near the lowest point of the voltage distribution curve.
THE MANAGEMENT OF ILIOTIBIAL BAND SYNDROME WITH A MULTIFACETED APPROACH: A DOUBLE CASE REPORT

Background and purpose Iliotibial Band Syndrome (ITBS) has commonly been thought of as an overuse injury in runners. The exact etiology of ITBS is not well understood and there is no consensus on how to properly manage it. The purpose of this case series is to present a comprehensive model that utilizes a review of the current literature and the concept of regional interdependence as a foundation for the treatment of ITBS in runners. Case descriptions The first subject was a 36-year old female, referred from an orthopedic physician with the diagnosis of left iliotibial band friction syndrome. She reported a 9/10 stabbing pain on a visual analog scale (VAS) in the left lateral knee at mile two while running. The second subject was a 41-year old female with a referral to physical therapy from an orthopedic surgeon for left iliotibial band tendinitis. She reported the symptoms beginning one month prior to her presentation to therapy, and that she would get an 8/10 stabbing pain on a VAS in the left lateral knee at mile three while running. Both subjects complained of the onset of lateral knee pain at a consistent mileage that forced them to stop running. Neither of them initially reported pain in adjoining regions, but did recall some low back stiffness from time to time when questioned further. The concept of regional interdependence, as well as neuromuscular re-education, and strengthening interventions in conjunction with addressing the contributing factors of training errors, shoe wear, running surface, and program design were utilized. Outcomes At a six-month follow-up, subject one had successfully completed a half marathon without knee pain. At a nine-month follow-up, subject two was able to run five miles, twice weekly and 10 miles once weekly without pain or symptoms. Discussion These case reports demonstrate the successful management of ITBS in two subjects using a multifaceted approach based on the current literature and the concept of regional interdependence.
Representations of the Gypsy in the Romantic Period

Gypsies are notoriously hard to catch at their doings, even if one is an authentic Romantic poet like William Wordsworth or John Clare, presumably endowed with superior insight into gypsy lore by a...
A Journey of Cytolethal Distending Toxins through Cell Membranes.

The multifunctional role of lipids as structural components of membranes, signaling molecules and metabolic substrates makes them an ideal partner for pathogens to hijack host cell processes for their own survival. The properties and composition of unique membrane micro-domains such as membrane rafts make these regions a natural target for pathogens as it affords them an opportunity to hijack cell signaling and intracellular trafficking pathways. Cytolethal distending toxins (Cdts), members of the AB2 family of toxins are comprised of three subunits, the active, CdtB unit, and the binding, CdtA-CdtC unit. Cdts are cyclomodulins leading to cell cycle arrest and apoptosis in a wide variety of cell types. Cdts from several species share a requirement for membrane rafts, and often cholesterol specifically for cell binding and CdtB mediated cytotoxicity. In this review we focus on how host–cell membrane bilayer organization contributes to the cell surface association, internalization, and action of bacteria derived cytolethal distending toxins (Cdts), with an emphasis on Aggregatibacter actinomycetemcomitans Cdt.
Variations in Strategies to Prevent Ventriculostomy-Related Infections: A Practice Survey

Background and Purpose:The ideal strategy to prevent infections in patients with external ventricular drains (EVDs) is unclear.Methods:We conducted a cross-sectional survey of members of the Neuroc...
Coal, Confederate Mines, and the CSS Virginia

Sunday, March 9, 1862, ushered in a new era of naval history as two of the strangest warships the world had yet seen clashed on the waters of Hampton Roads, Virginia (Fig. 12.1). That benchmark day witnessed the initial battle between ironclad vessels when the USS Monitor and the CSS Virginia fought to a draw after pounding each other relentlessly for several hours. One account of the duel noted that “…the Federals were at a loss to know what was propelling the Virginia when it ventured out on the first day of the battle, as they thought that the only coal the Confederates had was bituminous coal which gives off a dense black smoke” [181]. The answer to the Union seamen’s befuddlement very likely lay in the kind of coal firing the Virginia’s boilers. Emitting thick clouds of black smoke, bituminous coal or wood typically did in fact drive most Southern steam engines, but a cleaner burning semi-anthracite may well have powered the Confederate vessel that day.
Sartorius Muscle Flaps: Perioperative Outcomes Based on Surgical Specialty

Background Complicated groin wounds often require repair by sartorius muscle flap (SMF). Operating surgical specialty differs based on SMF indication, hospital, and operating surgeon preference. We aim to assess the effect of operating surgical specialty, indication for SMF, and other patient-level factors on 30-day outcomes. Methods We collected data on all patients undergoing SMF performed at our institution from 2005 to 2015, including age, sex, body mass index, comorbidity index (hypertension, diabetes, dyslipidemia, peripheral arterial disease, coronary artery disease), smoking status, history of malignancy, indication for SMF (infection, noninfectious complication, prophylaxis), and operating surgeon's specialty (vascular, plastic, general, other). Primary outcome was any 30-day complications (wound infection, seroma, dehiscence, or bleeding). Secondary outcome included 30-day surgical reintervention rate. Univariate analysis and multivariate logistic regression modeling were used to evaluate primary outcomes. Results A total of 170 SMFs were performed during the study period (mean patient age 58 years; 49% male). Primary indication for SMF was prophylaxis in 116 cases (68%), followed by infection in 36 cases (21%) and noninfectious complications in 18 cases (11%). General surgeons performed the highest proportion of SMF (45%) followed by vascular surgeons (26%), “other specialties” (15%), and plastic surgeons (14%). Compared with all specialties, vascular surgeons operated on the severely ill patients (77% of vascular patients had ≥3 comorbidities, P < 0.001). Surgical reintervention within 30 days was required in 7 patients (4.1%): 3 by vascular surgeons (6.8% of total cases by vascular surgery) and 4 by plastic surgeons (17.4% of total cases by plastic surgery, P < 0.001). Any 30-day complications occurred in 47 patients (28%): 30 general surgery cases (39%), 7 plastic surgery cases (30%), 7 other specialty cases (27%), and 3 vascular surgery cases (7%) (P < 0.001). Of all vascular disease–related cases (56), plastic surgeons performed 21% of SMF, while vascular surgeons performed 79%. On logistic regression correcting for baseline differences between groups, vascular surgeon SMF outcomes were compared favorably with those done by other specialties. Conclusions Overall, SMFs have low perioperative reintervention rates but high complication rates. Vascular surgeons perform SMF on high-risk patients with more comorbidities compared with other specialties. Although overall morbidity associated with this procedure is high, perioperative outcomes for SMF performed by vascular surgeons are favorable.
Performance characteristics of magnetic resonance imaging without contrast agents or sedation in pediatric appendicitis

Magnetic resonance imaging (MRI) has emerged as a promising modality for evaluating pediatric appendicitis. However optimal imaging protocols, including roles of contrast agents and sedation, have not been established and diagnostic criteria have not been fully evaluated. To investigate performance characteristics of rapid MRI without contrast agents or sedation in the diagnosis of pediatric appendicitis. We included patients ages 4–18 years with suspicion of appendicitis who underwent rapid MRI between October 2013 and March 2015 without contrast agent or sedation. After two-radiologist review, we determined performance characteristics of individual diagnostic criteria and aggregate diagnostic criteria by comparing MRI results to clinical outcomes. We used receiver operating characteristic (ROC) curves to determine cut-points for appendiceal diameter and wall thickness for optimization of predictive power, and we calculated area under the curve (AUC) as a measure of test accuracy. Ninety-eight MRI examinations were performed in 97 subjects. Overall, MRI had a 94% sensitivity, 95% specificity, 91% positive predictive value and 97% negative predictive value. Optimal cut-points for appendiceal diameter and wall thickness were ≥7 mm and ≥2 mm, respectively. Independently, those cut-points produced sensitivities of 91% and 84% and specificities of 84% and 43%. Presence of intraluminal fluid (30/33) or localized periappendiceal fluid (32/33) showed a significant association with acute appendicitis (P<0.01), with sensitivities of 91% and 97% and specificities of 60% and 50%. For examinations in which the appendix was not identified by one or both reviewers (23/98), the clinical outcome was negative. Rapid MRI without contrast agents or sedation is accurate for diagnosis of pediatric appendicitis when multiple diagnostic criteria are considered in aggregate. Individual diagnostic criteria including optimized cut-points of ≥7 mm for diameter and ≥2 mm for wall thickness demonstrate high sensitivities but relatively low specificities. Nonvisualization of the appendix favors a negative diagnosis.
Investigation on bio-oil yield and quality with scrap tire addition in sugarcane bagasse pyrolysis

Abstract The study investigated potential of scrap tire and sugarcane bagasse as co-pyrolysis feedstock with a focus on liquid yield. Two raw materials were fed to fixed-bed reactor in various mixing ratios. The experiments were carried out at 500 °C with heating rate of 20 °C/min and Nitrogen (flowrate: 50 mL/min) was used as carrier gas. Sugarcane bagasse/scrap tire 1:3 produced highest liquid yield (49.7 wt% against 42.1 wt% of pure sugarcane bagasse), which was then characterized for physical and chemical properties using different chromatographic and spectroscopic analytical techniques. Significant synergistic effects were indicated by the quality and quantity of the co-pyrolysis liquid yield. The optimum feedstock mix produced oil with calorific value of 41 MJ/kg with lesser viscosity as compared to pure sugarcane bagasse pyrolysis oil. Co-pyrolysis oil showed high potential to be used as feedstock for fuel production after required processing.