cssi/SciSciGPT-SciSciNet huggingface dataset:
Continuity and Change in Regional Planning and Policy: Scholarship in the Style of William Alonso

Commitment to regional policy analysis and counsel has long been a hallmark of leadership in regional science. In this article, the author traces the rise and disillusionment with development economics and its concern with backward regions, the emergence of deindustrialization as a regional challenge, opposing trends toward devolution and nation building, the rise of environmental concerns, and the resurgence of interest in metropolitan planning as successive high-water marks in regional policy making. Reflecting on the work of William Alonso, the author shows how a major theoretician in regional science bent his sights on the important policy issues of his times, evaluating options and forecasting new developments. While the objects of concern have changed, the author documents continuity in Alonso’s zest for the knottier policy issues in the field of regional analysis and his contributions to each.
Effects of rest-duration, time-of-day and their interaction on periodic leg movements while awake in restless legs syndrome

Abstract Background and purpose The diagnostic criteria for restless legs syndrome (RLS) indicate that both time-of-day and rest effects induce or aggravate symptoms. Periodic limb movements while awake (PLMW) provide an objective motor sign of RLS that can be measured during an awake suggested immobilization test (SIT). This study uses the SIT at different times of the day and analyzes time-of-day and duration-of-rest effects and their interaction on the PLMW. Patients and methods Twenty-eight RLS patients who were not on medications had SIT tests at 10 pm, 8 am and 4 pm on two consecutive days. PLMW for each 20-min period were analyzed for time-of-day and rest effects and their interaction. PLMW increase from the first to last 20-min SIT period assessed the rest-effects. Results Significant effects were found for rest, time-of-day and rest–time-of-day interaction. The rest-effect increased most from morning to afternoon while total PLMW increased more from afternoon to night. Males compared to females had significantly more PLMW and a larger rest-effect change with time-of-day. Conclusions Rest and time-of-day effects and their interaction all increase RLS symptoms. PLMW increase with rest may provide a sensitive measure of symptom severity.
Aroma Content of Fresh Basil (Ocimum basilicum L.) Leaves Is Affected by Light Reflected from Colored Mulches

Sweet basil (Ocimum basilicum L.) is an herb that is used to add a distinct aroma and flavor to food. Volatile compounds emitted from fully expanded fresh leaves grown in drip-irrigated plots that were covered with six colors of mulch were compared. The colors reflected a range of photosynthetic photon flux, far-red, red, and blue light from the soil surface to developing leaves. Our objective was to determine whether reflection from the different colors could influence concentrations of volatile compounds emitted from the fresh leaves. Volatile compounds were isolated by headspace sampling and quantified by gas chromatography. Twenty-six compounds were identified, of which the terpenoids linalool and 1,8-cineole comprised more than 50% of the total yield. Concentrations of volatile compounds from leaves that developed over green, blue, yellow, white, and red mulches followed the same patterns as they did for air-dried leaves of the same cultivar. However, the concentration of volatile compounds from fresh leaves was about 50-fold higher than those found in the previous study of air-dried leaves.
An approach to the allocation of common costs of multi‐mission systems

Many Naval systems, as well as other military and civilian systems, generate multiple missions. An outstanding problem in cost analysis is how to allocate the costs of such missions so that their true costs can be determined and resource allocation optimized. This paper presents a simple approach to handling this problem for single systems. The approach is based on the theory of peak-load pricing as developed by Marcel Boiteux. The basic principle is that the long-run marginal cost of a mission must be equal to its “price.” The implication of this is that if missions can cover their own marginal costs, they should also be allocated some of the marginal common costs. The proportion of costs to be allocated is shown to a function of not only the mission-specific marginal costs and the common marginal costs, but also of the “mission price.” Thus, it is shown that measures of effectiveness must be developed for rational cost allocation. The measurement of effectiveness has long been an intractable problem, however. Therefore, several possible means of getting around this problem are presented in the development of the concept of relative mission prices.
Emerging issues on multimedia distribution

This session has assembled expertise from both the industry and academia, addressing various interesting issues related to multimedia distribution. Two nicely written and well-covered overviews provide good pointers to readers on security and object-based encoding issues in streaming videos. A. Vetro and H. Sun provide a comprehensive overview of MPEG-4 object-based encoding algorithms which are readily being incorporated in emerging video products and systems. Security, the utmost concern for secured distribution and communications, has been nicely reviewed by E.J. Delp and his colleague. This session also includes two practical applications. S. Wilson and C.H. Chu develop a video system with GPS capability for environmental monitoring. F. Davoli and his colleagues at DIST-University of Genoa, Italy and CNIT, Italian National Telecommunications Consortium, present their LABNET Project, which will enable enhanced multimedia remote device control such as conducting on-line real-time experiments. Finally, H. Liu, N. Ansari and Y.Q. Shi present on-line dynamic bandwidth algorithms that are effective in reducing CLR and improving resource utilization.
Exploring subsets of standard cell libraries to exploit natural fault masking capabilities for reliable logic

Deep submicron technology is expected to be plagued by many reliability issues including soft errors in logic. To address this, we demonstrate how exploiting the natural fault masking characteristics of logical functions can be achieved by exploring the design space for selecting subsets of cells from within a cell library prior to synthesis. Subset selection alone is shown to improve the reliability of combinational logic circuits by more than 35%. We compare how subset libraries effect the trade-offs between reliability, area, power, and performance. Further, we show that added benefits of reduced cell library size can benefit the design.
Proteolytic Pathways of Activation and Degradation of a Bacterial Phospholipase C during Intracellular Infection by Listeria monocytogenes

Listeria monocytogenes is a facultative intracellular bacterial pathogen that spreads cell to cell without exposure to the extracellular environment. Bacterial cell-to-cell spread is mediated in part by two secreted bacterial phospholipases C (PLC), a broad spectrum PLC (PC-PLC) and a phosphatidylinositolspecific PLC (PI-PLC). PI-PLC is secreted in an active state, whereas PC-PLC is secreted as an inactive proenzyme (proPC-PLC) whose activation is mediated in vitro by an L. monocytogenes metalloprotease (Mpl). Analysis of PI-PLC, PC-PLC, and Mpl single and double mutants revealed that Mpl also plays a role in the spread of an infection, but suggested that proPC-PLC has an Mpl-independent activation pathway. Using biochemical and microscopic approaches, we describe three intracellular proteolytic pathways regulating PCPLC activity. Initially, proPC-PLC secreted in the cytosol of infected cells was rapidly degraded in a proteasome-dependent manner. Later during infection, PCPLC colocalized with bacteria in lysosome-associated membrane protein 1–positive vacuoles. Activation of proPC-PLC in vacuoles was mediated by Mpl and an Mpl-independent pathway, the latter being sensitive to inhibitors of cysteine proteases. Lastly, proPC-PLC activation by either pathway was sensitive to bafilomycin A1, a specific inhibitor of vacuolar ATPase, suggesting that activation was dependent on acidification of the vacuolar compartment. These results are consistent with a model in which proPC-PLC activation is compartment specific and controlled by a combination of bacterial and host factors.
Insulin Blockade of Epinephrine

The effect of insulin on tachycardia induced by epinephrine and isoproterenol, and on hyperglycemia induced by epinephrine, was studied in dogs. Insulin was injected (a) before epinephrine or isoproterenol, (b) with epinephrine or isoproterenol, and (c) after epinephrine, with and without continuous infusion of 10% glucose. In all 3 types of experiments insulin blockaded the positive chronotropic response to epinephrine. Isoproterenol was blockaded only when insulin was injected in advance. The effect of insulin on the cardioaccelerator effect of epinephrine is independent of a fall in blood glucose and is not related to the hypoglycemic effect of the hormone. (Endocrinology 87: 186, 1970) WE HAVE previously shown that epinephrine injected into dogs 5 min after treatment with insulin does not evoke the typical hyperglycemia and tachycardia (1). The purpose of the present investigation was to study in more detail the antagonism of these 2 hormones and to establish that insulin itself, rather than a metabol...
Vaccinia Virus L1 Protein Is Required for Cell Entry and Membrane Fusion

Genetic and biochemical studies have provided evidence for an entry/fusion complex (EFC) comprised of at least eight viral proteins (A16, A21, A28, G3, G9, H2, J5, and L5) that together with an associated protein (F9) participates in entry of vaccinia virus (VACV) into cells. The genes encoding these proteins are conserved in all poxviruses, are expressed late in infection, and are components of the mature virion membrane but are not required for viral morphogenesis. In addition, all but one component has intramolecular disulfides that are formed by the poxvirus cytoplasmic redox system. The L1 protein has each of the characteristics enumerated above except that it has been reported to be essential for virus assembly. To further investigate the role of L1, we constructed a recombinant VACV (vL1Ri) that inducibly expresses L1. In the absence of inducer, L1 synthesis was repressed and vL1Ri was unable to form plaques or produce infectious progeny. Unexpectedly, assembly and morphogenesis appeared normal and the noninfectious virus particles were indistinguishable from wild-type VACV as determined by transmission electron microscopy and analysis of the component polypeptides. Notably, the L1-deficient virions were able to attach to cells but the cores failed to penetrate into the cytoplasm. In addition, cells infected with vL1Ri in the absence of inducer did not form syncytia following brief low-pH treatment even though extracellular virus was produced. Coimmunoprecipitation experiments demonstrated that L1 interacted with the EFC and indirectly with F9, suggesting that L1 is an additional component of the viral entry apparatus.
Maximizing the swing of a human-operated wrecking ball

A common use of mobile cranes is swinging a wrecking ball into structures to knock them down. This process is typically achieved by an experienced operator who moves the crane back and forth to increase the payload swing, thereby increasing the force at impact. This is a very challenging process, even for a highly-experienced crane operator. This paper analyzes a controller designed to aid the operator in achieving large-amplitude payload swings. The proposed controller is obtained by following a design method similar to input shaping. Usually, input shaping intercepts the operator's commands and modifies them so that they do not induce large oscillations. However, a similar method can be used to create commands that increase the oscillation. This paper illustrates the design process, then presents a series of operator studies that test the effectiveness of the controller in a small-scale wrecking application.
All the way up or all the way down?: Some historical reflections on theories of psychological continuity.

In this paper I chart the history of the development of theories of psychological continuity in the modern period, beginning with the contrasting positions of Rene Descartes and Julian Offrey de la Mettrie during the period of the scientific revolution in Europe. In providing the logical geography of competing positions, I distinguish between two forms of strong psychological continuity and discontinuity, between theories of strong continuity and discontinuity between cognitive and associative processes and between theories of strong continuity and discontinuity between human and animal psychology and behavior. I note that both forms of strong continuity and discontinuity have tended to be affirmed or denied together, and have only rarely and recently been decoupled, opening up a new theoretical position in the debate, which affirms strong discontinuity between cognitive and associative processes but strong continuity between human psychology and some forms of animal psychology. Although the historical trend in the late 19th and early 20th century was to extend explanations in terms of association "all the way up" to the highest human cognitive processes, some contemporary theorists have tried to extend cognitive explanations "all the way down" to associative processes in both humans and nonhuman animals. I draw some tentative conclusions about the theoretical options in contemporary research on psychological continuity. (PsycINFO Database Record.
Assessing and Understanding Teacher Candidates' Dispositions toward and Knowledge of Parent Involvement.

To maximize children's opportunities for success in school, teacher preparation programs need to support preservice teachers in developing strong knowledge, experiences, and dispositions toward working with diverse families. Yet, it is challenging for programs to assess their candidates' knowledge and dispositions in this area. In this study we utilize case scenarios to uncover preservice teacher candidates' dispositions toward working with diverse families and strategies that they identify for working with diverse families. We report the ways the scenarios can be utilized to build this understanding as well as describe what we learned about our candidates' knowledge and dispositions. Overall, candidates identified the problematic negative teacher attitudes depicted in the scenario and shared a number of alternative strategies that could be utilized. Findings indicate that candidates' knowledge and dispositions were influenced by their coursework, field experiences, and personal experiences.
Vagus nerve stimulation for electrographic status epilepticus in slow-wave sleep

Abstract Background Electrographic status epilepticus in slow sleep or continuous spike and waves during slow-wave sleep is an epileptic encephalopathy characterized by seizures, neurocognitive regression, and significant activation of epileptiform discharges during nonrapid eye movement sleep. There is no consensus on the diagnostic criteria and evidence-based optimal treatment algorithm for children with electrographic status epilepticus in slow sleep. Patient Description We describe a 12-year-old girl with drug-resistant electrographic status epilepticus in slow wave sleep that was successfully treated with vagus nerve stimulation. Her clinical presentation, presurgical evaluation, decision-making, and course after vagus nerve stimulator implantation are described in detail. Findings After vagus nerve stimulator implantation, the girl remained seizure free for more than a year, resolved the electrographic status epilepticus in slow sleep pattern on electroencephalography, and exhibited significant cognitive improvement. Conclusion Vagus nerve stimulation may be considered for electrographic status epilepticus in slow sleep.
Implications of Comprehensive Mental Health Services Embedded in an Adolescent Obstetric Medical Home

Purpose Mental health issues in perinatal adolescents are well documented and studies have shown high rates of depressive disorders among this population. Treatment is challenging because pregnant adolescents are poorly adherent with mental health services. We describe a novel integrated mental health care program for pregnant and parenting adolescent mothers and their children. Methods The Colorado Adolescent Maternity Program (CAMP) is a comprehensive, multidisciplinary teen pregnancy and parenting medical home program serving an ethnically diverse and low socioeconomic status population in the Denver metro area. We describe the Healthy Expectations Adolescent Response Team (HEART), an embedded mental health care program focused on improving identification of mental health symptoms and increasing rates mental health treatment in adolescent mothers. Results From January 1, 2011–January 16 2014, 894 pregnant adolescents were enrolled in CAMP and 885 patients were screened for mental health issues. Prior to HEART’s inception, 20 % of patients were identified as having mood symptoms in the postpartum period. Successful referrals to community mental health facilities occurred in only 5 % of identified patients. Following the creation of HEART, 41 % of patients were identified as needing mental health services. Nearly half of the identified patients (47 %) engaged in mental health treatment with the psychologist. Demographic factors including age, parity, ethnicity, and parent and partner involvement did not have a significant impact on treatment engagement. Trauma history was associated with lower treatment engagement. Conclusion Our findings suggest that an embedded mental health program in an adolescent obstetric and pediatric medical home is successful in improving identification and engagement in mental health treatment. Key components of the program include universal screening, intensive social work and case management involvement, and ready access to onsite mental health care providers. Limitations of the program are discussed as well directions for future research.
James Fitzjames Stephen, John Stuart Mill, and the Victorian Theory of Toleration

SUMMARYDue to his famous conflict with John Stuart Mill, James Fitzjames Stephen is often assumed to have been an opponent of toleration and intellectual freedom and a defender of authoritarian or reactionary principles. These assumptions are misleading. Stephen was, and was known in his time to have been, a champion of toleration. This essay provides a comprehensive overview of his writing on these themes, drawing from a wider array of texts than is usually considered in the study of the Stephen-Mill controversy. Contrary to popular belief, Stephen had a deep and multi-faceted argument in favor of toleration. As a critic of contending theories of toleration and freedom of discussion (especially Mill’s), Stephen was concerned to defeat what he saw as the resurgence of a priori principles in Victorian political philosophy and to combat the expansion of a proper notion of toleration to include a cluster of beliefs and attitudes of which he disapproved. In his approach to these issues Stephen was, arguably, ...
PERSONALITY CORRELATES OF PREDISPOSITION TO FASHION: DOGMATISM AND MACHIAVELLIANISM

Fashion is a form of social behavior offering security to some individuals and differentiation to others. A person's reaction to fashion or his predisposition to fashion may be influenced by or reflective of underlying personality structures. Adherence to fashion may be functionally dependent upon more conforming personalities, as more dogmatic individuals wore clothing which conformed to either mass fashion or trends in the fashion industry (3). Individuals with lower dogmatism scores tended to wear clothing which was nonconformist or "hippie." Theoretically, fashion-related behaviors may reflect a Machiavellian personality structure. Some persons use an attractive appearance as a manipulative tactic (7). Fashion may be used in the same way. Others may resist fashion because they are cynical of the social structure in general. The present study assessed dogmatism and Machiavellianism as correlates of predisposition to fashionable dothing. Based upon theoretical rationale and empirical evidence, it was predicted rhat individuals with high predisposition to fashion would be higher in dogmatism, higher in Machiavellian tactics, and lower in Machiavellian cynicism than individuals kib low predisposition. To 202 undergraduate female volunteers enrolled in various majors at a large midwestern university were administered a questionnaire, introduced as a survey of srudenrs' attitudes. This was composed of two scales. One scale which measures predisposition to fashionable clothing (6) assesses willingness to spend rime, energy, and money on fashionable clothing. In a pilot study the internal consistency of the 14-item Likerttype scale was .86 for a separate group of 110 college women not included in the final sample. Using a test-retest procedure, the reliability over a 3-wk. period for 16 college women not included in the final sample was .91. Evidence for validity was reported by Sharpe (6). A 10-item short form (8) of the Rokeach (5) dogmatism scale was used to measure dogmatism. Evidence of reliability and validity was reported (8). A revision (2) of the original Machiavellianism scale (1) which divided Machiavellianism into factors was used. The Machiavellian tactics factor measures the extent to which flattery, lying, or deception are endorsed. A high score in the Machiavellian cynicism factor reflects a distrust of people and a belief in the rigidity of society. Evidence of reliability and validity was given (2). Based on fashion scores, subjects were split into two groups at the median point of 45; scores ranged from 14 to 68. There was a significant over-all difference (t = 4.25, p < ,001, two-tailed test) in dogmatism scores between the two groups. Significant
Survivin in glioblastomas. Protein and messenger RNA expression and comparison with telomerase levels.

c Context.—Survivin is a novel inhibitor of apoptosis that acts via a pathway independent of bcl-2. Little is known about its distribution in brain tumors or how it correlates with other biomarkers of malignancy, such as telomerase, an enzyme that plays a critical role in cellular immortalization and cancer biology. Objectives.—To assess survivin protein expression in gliomas and to compare expression with that of telomerase. Design.—Immunohistochemical staining for survivin protein expression was performed using an antibody developed in our laboratory. Quantitative survivin messenger RNA (mRNA) levels were assessed by reverse transcriptasepolymerase chain reaction. In selected cases, survivin results were compared with quantitative telomerase values analyzed by polymerase chain reaction‐based telomerase repeat amplification protocol (TRAP) assay. Twenty-five tumor tissue samples from 16 cases of glioblastoma multiforme (GBM; including multiple tissue samples in 6 patients), 2 grade II gliomas, 4 grade III gliomas, and 3 control temporal lobectomy specimens were studied. Results.—Nuclear immunoreactivity for survivin protein and survivin mRNA were detectable in most glioma samples, regardless of grade. Glioblastoma multiforme demonstrated moderate protein expression and survivin mRNA levels compared to epithelial malignancies previously tested in our laboratory. Although the association of survivin mRNA with the levels of telomerase within the GBM cases did not reach statistical significance, most GBMs also expressed survivin. The quantitative score for survivin mRNA was higher in GBMs than in grade II and III gliomas (P 5 .02), after accounting for multiple specimens per patient. Conclusions.—Quantitative survivin mRNA analysis, but not immunohistochemistry, distinguished GBMs from lower grade gliomas. Mechanisms that promote both cell proliferation (telomerase expression) and cell survival (survivin expression) are often activated in GBMs. (Arch Pathol Lab Med. 2003;127:826‐833)
Rapid Bioorthogonal Chemistry Turn-on through Enzymatic or Long Wavelength Photocatalytic Activation of Tetrazine Ligation

Rapid bioorthogonal reactivity can be induced by controllable, catalytic stimuli using air as the oxidant. Methylene blue (4 μM) irradiated with red light (660 nm) catalyzes the rapid oxidation of a dihydrotetrazine to a tetrazine thereby turning on reactivity toward trans-cyclooctene dienophiles. Alternately, the aerial oxidation of dihydrotetrazines can be efficiently catalyzed by nanomolar levels of horseradish peroxidase under peroxide-free conditions. Selection of dihydrotetrazine/tetrazine pairs of sufficient kinetic stability in aerobic aqueous solutions is key to the success of these approaches. In this work, polymer fibers carrying latent dihydrotetrazines were catalytically activated and covalently modified by trans-cyclooctene conjugates of small molecules, peptides, and proteins. In addition to visualization with fluorophores, fibers conjugated to a cell adhesive peptide exhibited a dramatically increased ability to mediate contact guidance of cells.
The Effect of Auxin on the Polyadenylated RNA of Soybean Hypocotyls

Studies with several plant systems have demonstrated that environmental or developmental changes may cause an altered level of specific mRNAs. For example, and considering only products of the nuclear genome, it is known that leghaemoglobin synthesis and mRNA levels increase during early soybean root nodule development (Auger et al, 1979), that light stimulates production of phenylalnine ammonia lyase (PAL) and the level of PAL mRNA in parsley leaves (Ragg et al., 1977), and that gibberellic acid induced synthesis of α amlase in barley aleurone cells is a result of an increased level of a amylase mRNA (Higgins et al., 1976). It is not yet clear, however, to what extent the whole spectrum of gene expression may shift during developmental or environmental changes. In order to investigate this problem further we have examined the effect of auxin (2,4-D) on the polyadenylated RNA populations of soybean hypocotyls using nucleic acid hybridisation and in vitro translation.
Mitochondrial oxygen consumption is a unique indicator of stallion spermatozoal health and varies with cryopreservation media

Abstract Mitochondrial oxygen consumption is a sensitive indicator of spermatozoal health in the context of cryopreservation. We investigated oxygen consumption of equine sperm mitochondria during incubation in four commercially available sperm cryopreservation extenders: modified INRA 96, BotuCrio, EZ Freezin–“LE” and “MFR5”, in addition to several other parameters including motility, reactive oxygen species (ROS) production and viability. All experimental endpoints, with the exception of average path velocity, were affected significantly by freezing extender type after freezing and thawing. Sperm in INRA 96 had the lowest average progressive motility after thawing (24 ± 4.8%, P
Analysis of etiological factors and diagnostic methods of pediatric neuromuscular disease

Objective To evaluate the diagnostic value and the application of different methods of pediatric neuromuscular disease.Methods A retrospective analysis was made on the clinical data of 258 cases of children in muscle biopsy and/or genetic test in the Department of Neurology,Children's Hospital of Hebei Province.Results The etiology for 258 cases involved two categories and nine kinds,including 177 cases of congenital myopathy,accounted for68.5%(177/258),among which pediatric muscular disorder(DMD)was the most,accounted for 48.8%(126/258);65cases of spinal muscular atrophy,accounted for 25.2%(65/258);14cases of inflammatory myopathy,accounted for5.4%(14/258).A total of 185 cases of creatine kinase(CK)increased in different degrees,of which 28 cases exceeded the upper limit of normal value a hundred times;60.0%(145/258)patients showed abnormal electromyography.There were 174 cases who underwent muscle biopsy,of which 122 cases were diagnosed;182patients were detected with genetic test,of which 136 cases were diagnosed;44cases were examined with combined detection,of which 8cases had the diagnosis significance. Conclusion Muscular dystrophy, spinal muscular atrophy, mitochondrial encephalomyopathy and polymyositis are the main etiological factors of the children with neuromuscular disease etiology in the hospital.Diagnosis needs comprehensive analysis based on clinical biochemical,electrophysiological,muscle biopsy pathology,gene detection,muscle biopsy pathology and genetic test.The muscle biopsy pathology and genetic test are the main basis to make definite diagnosis,comprehensive diagnostic information may be provided through combined detection.
Immunohistochemistry of thyroid gland carcinomas: clinical utility and diagnostic pitfalls

Abstract There are several settings in which immunohistochemistry could be employed in thyroid pathology. Ancillary immunohistochemistry can aid in differentiating tumour types and has also been used to support a diagnosis of malignancy in equivocal follicular lesions. Theoretically, immunostains could serve as prognostic markers as well. Here, we focus on the role of immunohistochemistry as a diagnostic tool mainly in less well-differentiated carcinomas, to confirm cell lineage. In this setting, it is important to perform a panel of immunostains and interpret them in the context of the tumour morphology and the clinical picture, since staining patterns can overlap with other non-thyroid tumour types. We also address the controversial use of immunostains to separate malignant from benign follicular lesions. Lastly, the potential for immunohistochemistry as prognostic markers will be considered. This review emphasizes the application of immunohistochemistry to thyroid histopathology rather than cytology.
Abstract ES5-1: Predictive gene expression profiles in breast cancer, where are we?

Successful sequencing of the entire human genome offered an enormous potential for improving human health, especially in oncology. Nearly 20 years after successful completion of the human genome project, the Cancer Genome Atlas (TCGA) has catalogued the most common mutations in most cancers, including breast. Further, the technical advances that facilitate the ability to fully analyze both germline and somatic DNA and RNA has resulted in rapid ( However, arguably, the most clinically useful product of the Human Genome Project to date has been the emergence of multiparameter gene expression assays that can be used to direct cancer care, particularly in breast cancer. The 21-gene assay was the first of these to be shown to have sufficiently high analytical validity and clinical utility to be used to identify patients with node negative, ER positive early stage breast cancer who, assuming adequate adjuvant endocrine therapy, could be spared the toxicity of adjuvant chemotherapy based on prognosis alone. Subsequently, several other assays have now been reported to be equally satisfactory for this same use context. The Oxford Overview has suggested that adjuvant chemotherapy reduces the odds of distant recurrence and death by approximately 1/3, regardless of initial prognosis. However, many retrospective correlative studies over the last 4 decades have suggested that chemotherapy may have differing relative activities within distinct biological, or more recently designated “intrinsic,” subtypes, based mostly on expression of estrogen receptor and proliferation genes. Preliminary, prospective retrospective studies by the NSABP in B20 and SWOG in S8814 have, indeed, suggested that patients with ER positive breast cancer with low recurrence scores, as determined by the 21-gene assay, not only have better prognosis than those with intermediate or higher RS, but that chemotherapy may simply not work in this category. However, these studies were both confounded by a number of biases. Therefore, before potentially life-saving chemotherapy is with-held from node positive breast cancer patients based on prediction alone, a prospective clinical trial, SWOG S1007 (the RxPonder Trial), was initiated. The primary objective of the RxPonder trial is to determine if women with node positive, ER positive breast cancer with RS Citation Format: Hayes DF. Predictive gene expression profiles in breast cancer, where are we?. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr ES5-1.
The health care 'iron triangle' and the Patient Protection and Affordable Care Act.

There is no way to increase access, improve quality, and decrease costs all at the same time.
Abstract 260: Risk Factors for Readmission from Medical Cardiology Services. A Medication Reconciliation Perspective.

BACKGROUND: Hospital readmissions for cardiac diseases have a strong socio-economic impact. Medication reconciliation is one of the current interventions intended to improve quality of care, in which pharmacists play an important role. We aimed to determine risk factors and identify patients who are at risk of re-hospitalization by gathering data from the medication reconciliation process. METHODS: We included adults from our local community admitted to a medical cardiology service from September 2011 to August 2012. Two pharmacists led interviews within 48 hours of presentation. In addition to a rigorous medication reconciliation evaluation at admission and discharge, we assessed medication handling habits, adherence, familiarity with prescriptions, health literacy and reading impairment. We determined Potential Adverse Drug Events (PADE) by assessing discrepancies within medication records. Multivariate analyses were performed to look for association among factors and outcomes. RESULTS: We included 258 patients, mean age 70.5, 52 % male, 19% received help with medications, 83 % were adherent, 14% reported reading impairment, 40% heart failure (HF). The mean number of prescriptions was 7.5 and the mean Charlson comorbidity index 3.5. Medication errors reached 39% of patients on admission and 20% at discharge; no clinical complications were detected. The number of prescriptions was associated with PADEs at admission (p=0.0001) and discharge (p=0.03). Presence of PADE on admission or discharge did not affect the readmission rate. At 30 days 18% of 258 patients were readmitted, 9% visited the Emergency Department (ED) and 2.3% died; meanwhile at 6 months 38% were hospitalized, 46% went to the ED and 5.8% died. We identified a diagnosis of HF and the need for help handling medications at home as the strongest predictors of readmission at both 1 and 6 months. Other factors associated with higher readmissions rates and ED visits were the number of prescriptions, number of hospitalizations within the prior year, lack of familiarity with medical regimen and reading impairment. HF was associated with lower adherence (p=0.025); more admissions in the previous year (p=0.002), higher number of medications (p=0.001), reading impairment (p=0.02), higher readmissions at 1 and 6 months (p=0.003 and 0.0008 respectively) as well as ED visits (p=0.016) at 6 months compared with non-HF subjects. CONCLUSION: We found several characteristics, key examples being presence of HF and receipt of help with medications, that may warrant formal assessment during medication reconciliation as they seem associated with re-hospitalization. These patients may benefit from close follow-up during and post hospitalization.
Thermal shock and related properties of dielectric ceramics

The thermal shock resistance of ceramic dielectric insulation is affected by many factors, among them size and shape. These two factors vary so radically that most thermal shock resistance studies have merely been qualitative. The object of this work is to quantitatively determine the thermal shock resistance of ceramic dielectric insulation and the effect of certain physical properties. This is only part of a program sponsored by the U. S. Army Signal Corps on the development of ceramic dielectric insulation possessing high thermal shock resistances.
Wavelength-normalized spectroscopic analysis of Staphylococcus aureus and Pseudomonas aeruginosa growth rates

Optical density (OD) measurements are the standard approach used in microbiology for characterizing bacteria concentrations in culture media. OD is based on measuring the optical absorbance of a sample at a single wavelength, and any error will propagate through all calculations, leading to reproducibility issues. Here, we use the conventional OD technique to measure the growth rates of two different species of bacteria, Pseudomonas aeruginosa and Staphylococcus aureus. The same samples are also analyzed over the entire UV-Vis wavelength spectrum, allowing a distinctly different strategy for data analysis to be performed. Specifically, instead of only analyzing a single wavelength, a multi-wavelength normalization process is implemented. When the OD method is used, the detected signal does not follow the log growth curve. In contrast, the multi-wavelength normalization process minimizes the impact of bacteria byproducts and environmental noise on the signal, thereby accurately quantifying growth rates with high fidelity at low concentrations.
Interdepartmental Team Health Services

(1954). Interdepartmental Team Health Services. Journal of the American Association for Health, Physical Education, and Recreation: Vol. 25, No. 9, pp. 21-21.
Computer integrated manufacturing systems and insulation analysis

Modern manufacturing entered a revolutionary phase approximately 10 years ago with the introduction of the computer to the workplace. The first state of this still-devolving process was labeled computer-aided design (CAD) and computer-aided manufacturing (CAM). This early technology is now strongly established in some industries, including segments of the plastics processing industry. CAD-CAM is now giving way to a more advanced concept, known as CIMS (Computer Integrated Manufacturing Systems), in which all operations within a manufacturing complex, from accounting to inventory control, are controlled to obtain the most efficiency from the system. These developments will inevitably influence the manufacture of electrical insulation systems.
Computational fluid dynamic modeling of a medium-sized surface mine blasthole drill shroud.

The Pittsburgh Mining Research Division of the U.S. National Institute for Occupational Safety and Health (NIOSH) recently developed a series of models using computational fluid dynamics (CFD) to study airflows and respirable dust distribution associated with a medium-sized surface blasthole drill shroud with a dry dust collector system. Previously run experiments conducted in NIOSH’s full-scale drill shroud laboratory were used to validate the models. The setup values in the CFD models were calculated from experimental data obtained from the drill shroud laboratory and measurements of test material particle size. Subsequent simulation results were compared with the experimental data for several test scenarios, including 0.14 m3/s (300 cfm) and 0.24 m3/s (500 cfm) bailing airflow with 2:1, 3:1 and 4:1 dust collector-to-bailing airflow ratios. For the 2:1 and 3:1 ratios, the calculated dust concentrations from the CFD models were within the 95 percent confidence intervals of the experimental data. This paper describes the methodology used to develop the CFD models, to calculate the model input and to validate the models based on the experimental data. Problem regions were identified and revealed by the study. The simulation results could be used for future development of dust control methods for a surface mine blasthole drill shroud.
Reconsidering Unique Invulnerability in the Context of Sexual Behavior

Unique invulnerability has been defined as the perception that one is less vulnerable than the average person to negative events. This study examined positive outcomes of risky behaviors with respect to unique invulnerability, taking into consideration an individual's knowledge and experience of a given risk. If the phenomenon is truly one of unique invulnerability, then we would predict either no self–other differences for positive outcomes or even an enhanced belief that more desirable outcomes would happen to oneself. We found quite the opposite. Subjects estimated that they would be less likely than others to experiencebothpositive and negative outcomes. These findings invite not only a reconsideration of unique invulnerability, but also provide important new information about risk perception within a sexual context.
Breast Cancer Profile among Patients with a History of Chemoprevention

Purpose. This study identifies women with breast cancer who utilized chemoprevention agents prior to diagnosis and describes their patterns of disease. Methods. Our database was queried retrospectively for patients with breast cancer who reported prior use of chemoprevention. Patients were divided into primary (no history of breast cancer) and secondary (previous history of breast cancer) groups and compared to patients who never took chemoprevention. Results. 135 (6%) of 2430 women used chemoprevention. In the primary chemoprevention group (n = 18, 1%), 39% had completed >5 years of treatment, and fully 50% were on treatment at time of diagnosis. These patients were overwhelmingly diagnosed with ER/PR positive cancers (88%/65%) and were diagnosed with equal percentages (44%) of IDC and DCIS. 117 (87%) used secondary chemoprevention. Patients in this group were diagnosed with earlier stage disease and had lower rates of ER/PR-positivity (73%/65%) than the nonchemoprevention group (84%/72%). In the secondary group, 24% were on chemoprevention at time of diagnosis; 73% had completed >5 years of treatment. Conclusions. The majority of patients who used primary chemoprevention had not completed treatment prior to diagnosis, suggesting that the timing of initiation and compliance to prevention strategies are important in defining the pattern of disease in these patients.
Unreliable Machine Learning

Neural networks have been widely lauded for their success in handling specific tasks. But as humans deploy neural networks to perform under more complex and diverse parameters, with larger decisions and responsibilities at stake, what are their blind spots? How might those affect the ways in which neural networks interact with complex systems?
Phenotype-Genotype Correlation in Hypertrophic Cardiomyopathy: Less Signal, More Noise?

Identification of a genetic basis for hypertrophic cardiomyopathy (HCM) has proven to be more complex than originally postulated. Early reports in the 1950s and 1960s of clusters of patients within families with left ventricular hypertrophy (LVH), cardiac myocyte disarray, and fibrosis, as well as symptoms of heart failure and sudden cardiac death, with what seemed to be caused by an autosomal dominant pattern of inheritance, led to initial excitement regarding genetic testing in the 1990s.1 Although initial attempts to identify candidate genes led to the seminal discoveries of discrete mutations in the MYH7 (β-myosin heavy chain), which segregated within affected individuals in families,2 these mutations were not present in all families with HCM. Further analysis of affected families led to the identification of mutations in genes for other sarcomere proteins including other thick filaments (MYL2 [regulatory myosin light chain] and MYL3 [essential myosin light chain]), thin filaments (TNNT2 [cardiac troponin T], TNNI3 [cardiac troponin I], TNNC1 [cardiac troponin C], TPM-1 [α-tropomyosin], and ACTA [α-cardiac actin]), MYBPC3 (cardiac myosin-binding protein c), and z-disc proteins (ACTN2 [α-actinin 2] and MYOZ2 [myozenin 2]).1 At this point, >1400 mutations in 11 sarcomere protein genes have been identified, although ≈50% of identified mutations are in MYH7 or MYBPC3.3 Although the majority of mutations are private mutations within a family or as a de novo mutations, there are some HCM gene mutations referred to as founder mutations, which are highly conserved within populations that often have been historically geographically or culturally isolated. These occur almost exclusively in the MYBPC3 gene resulting in a truncated protein and delayed penetrance until after the reproductive years.1,4 At present, genetic testing identifies a known pathogenic or presumed pathogenic mutation in ≈30% to 40% of patients with phenotypic HCM. Both the Toronto Genotype score …
Confidence intervals for a two-parameter exponential distribution: One- and two-sample problems

The problems of interval estimating the mean, quantiles, and survival probability in a two-parameter exponential distribution are addressed. Distribution function of a pivotal quantity whose percen...
Skin in the game: Does paying for obesity treatment out of pocket lead to better outcomes compared to insurance coverage?

Objective To determine whether insurance coverage for medical weight loss treatment was associated with different program engagement and weight loss outcomes compared to those who paid out of pocket. Methods One-year outcomes from an academic medical weight management program were used to compare two groups: employees (n = 480) with insurance coverage (“covered”) versus nonemployees (n = 463) who paid out of pocket (“self-pay”). Demographics and weight were abstracted from medical records. Socioeconomic status was estimated using neighborhood demographics. Group differences in weight were analyzed using generalized linear modeling adjusted for age, baseline BMI, sex, program type, and neighborhood socioeconomic status. Results Covered patients were younger (46.5 ± 10.6 vs. 51.6 ± 12.5) with a lower BMI (38.5 ± 7.5 vs. 41.3 ± 9.9) compared to self-pay (P < 0.001). Self-pay patients resided in higher annual per capita income neighborhoods (+$4,545, P < 0.001). Program dropout was lower for covered patients (12.7% vs. 17.6%, P = 0.03). There was no significant difference in 12-month weight loss between groups in adjusted models; covered patients lost 13.4%, compared to 13.6% for self-pay. Conclusions Data from an academic medical weight management program suggest that individuals with access to insurance coverage for nonsurgical obesity treatment have lower levels of attrition and similar levels of participation and outcomes as those who pay out of pocket.