cssi/SciSciGPT-SciSciNet huggingface dataset:
SU‐E‐T‐71: An Investigation of Measurement Techniques for Small Field Dosimetry Using Commercially Available Detectors

Purpose: To identify and quantify the pros and cons of currently available commercial detectors and measurement techniques for small fields. Methods: Measurements are made for a TrueBeam STX (Varian Medical System) for 6X, 6XFFF, and 15XFFF beams. Four ion chambers, Iba cc01, cc04, cc13, and Exradin A16, and two diodes, Iba stereotactic diode (SD) and photon diode (PD), are used with an IBA blue phantom. For ion chambers, the recombination and polarity effects are evaluated based on the PDDs, while the out‐of field doses are compared with the diode measurements. The effects of finite detector size on penumbra are compared for field sizes from 3×3 to 10×10, while PDD are compared down to 1x1 cm2. Results: Recombination affects the PDDs by up‐to 0.5% and 3.1% at deeper depths for cc04 and cc13, respectively. Polarity effects for cc04 and cc13 are 2.0% and 0.3%, respectively for 40x40 cm2, while both cc01 and cc04 are within 0.5% for 10x10 cm2.The 3x3 and 5x5 cm2 PDD of cc04, cc01, A16 and SD are within 1% of each other but cc01, A16 and diodes over‐respond by 1– 2% for 10×10 cm2 compared to cc04. At 1×1 cm2, A16, cc01 and PD remains within 1% of each other while cc04 and SD show 1.3% over‐respond and 3.0% under‐respond at d20 relative to cc01. Relative to cc04, the relative out‐of‐field dose difference for PD, SD, cc01 and A16 are −0.4%, +0.8%, +0.5% and +0.3% respectively at dmax and 10×10 cm2. The penumbras measured by all the small detectors are between 0.6 to 1.0 mm sharper than cc04. Conclusion: No single detector is accurate over the entire range of field size. The effects of detector size, recombination and polarity effects, and sensitivity to scatter can be minimized by appropriate mixes of detector and measurement techniques. Research grant from Varian Medical Systems
Bedside assessment of right atrial pressure in critically ill septic patients using tissue Doppler ultrasonography

Abstract Purpose Right atrial pressure (RAP) is considered a surrogate for right ventricular filling pressure or cardiac preload. It is an important parameter for fluid management in patients with septic shock. It is commonly approximated by the central venous pressure (CVP) either invasively using a catheter placed in the superior vena cava or by bedside ultrasound, in which the size and respiratory variations of the inferior vena cava (IVC) are measured from the subcostal view. Doppler imaging of the tricuspid valve from the apical 4-chamber view has been proposed as an alternative approach for the estimation of RAP. The tricuspid E/Ea ratio is measured, where E is the peak velocity of the early diastolic tricuspid inflow and Ea is the peak velocity of the early diastolic relaxation of the lateral tricuspid annulus. We hypothesized that the tricuspid E/Ea ratio may represent an alternative to IVC metrics, using invasive CVP as the criterion standard, for the assessment of RAP in critically ill septic patients. Materials and methods A convenience sample of 30 septic patients, both mechanically ventilated and non–mechanically ventilated, was enrolled. Using a portable ultrasound system, maximum velocity of tricuspid E and Ea was measured from the apical 4-chamber view; and IVC diameter and degree of collapse were measured from the subcostal view. Decision tree induction was used to determine the performance of each model compared with invasive CVP. Results Our results suggest that a tricuspid E/Ea ratio of greater than 4.7 can predict a CVP greater than 10 mm Hg in septic patients with sensitivity greater than 85% and specificity greater than 90%. Conclusions In this pilot study, Doppler imaging of the tricuspid valve provided a valuable alternative for noninvasive bedside estimation of RAP in septic patients.
Infective endocarditis in infants and children during the past 10 years: A decade of change

Abstract Infective endocarditis (IE) is closely associated with congenital heart diseases. 1–9 In major series done over several decades up to the early 1970s 2,6 and in a recent review 8 both the changing pattern of etiologic agents and the increasing incidence of IE overal has been stressed. In the last decade, the practice of pediatric cardiology has changed greatly. New diagnostic methods such as M-mode and two-dimensional echocardiography (2DE) have been developed. The rate of survival, particularly that of infants and of children with complex heart diseases, has greatly increased, coincident with improved surgery and intensive care of severely ill infants and children. Advances have also occurred in the antibiotic armamentarium. With these multiple recent developments it was questioned whether a change might have also taken place in the pattern of IE. Few reviews, however, dealing with the pattern of pediatric IE over the last decade are available. 8–10 This report is a review of our experience in diagnosis and treatment of pediatric IE during the last decade (1972 to 1982).
Unexpected induction of resistant Pseudomonas aeruginosa biofilm to fluoroquinolones by diltiazem: A new perspective of microbiological drug–drug interaction

The increase of multi-drug resistant Pseudomonas aeruginosa infections is a worldwide dilemma. At the heart of the problem is the inability to treat established P. aeruginosa biofilms with standard antibiotic therapy, including fluoroquinolones. We address a previously unstudied question as to the effect of a commonly prescribed calcium channel blocker (CCB) diltiazem on the biofilm growth. Real-time monitoring of the overall growth and killing of P. aeruginosa biofilm during fluoroquinolones therapy in the presence and absence of diltiazem was performed. In this study, we demonstrate that for P. aeruginosa biofilms, resistance to the first-line fluoroquinolones may be induced by the commonly prescribed calcium channel blocker diltiazem.
Synthesis of an optimal wastewater reuse network

Process and manufacturing plants usually consume huge amounts of water in various cleaning and rinsing operations. Wastewater contains pollutants that are frequently environmentally regulated. An effective way to minimize wastewater is to design a wastewater reuse network (WWRN) such that the used water can be reused to a maximum extent in the same plant. In this paper, a mathematical approach is introduced to design an optimal network when multiple pollutants are contained in water streams. The approach is general, systematic, and easy to use. Its applicability is demonstrated by designing WWRN's for both papermaking and electroplating processes.
Deformation and failure of thin brazed joints—microscopic considerations

Experimental data are presented on the microscopic aspects of the strength and deformation of thin brazed joints. Determination of the shear stress distribution at the braze interface revealed that the interfacial shear intensity increases as the thickness to diameter ratio,t/d, increases. The contribution of geometrical constraint (triaxiality) to joint strengthening was found to increase drastically ast/d decreases whereas the role of strain hardening in joint strengthening was found to change from one of delaying macroscopic instability in thick joints to the microscopic role of delaying microvoid coalescence in thin joints. Stress-strain measurements of both the braze metal and adjacent layers of the base metal showed that increasing triaxiality (lowert/d) results in lower axial strains within the joint for any given axial stress. In addition, base metal yielding was found to cause large increases in plastic strain within the brazed joint.
Basic experiments in thin‐layer chromatography–fourier transform Raman spectrometry

In some basic experiments, the feasibility is demonstrated of obtaining artifact- and fluorescence-free spectra by in situ (Fourier transform (FT)) Raman spectrometry of TLC spots. In addition, the high sensitivity enhancement by using TLC–FT-SERS of silver colloid-activated chromatographic spots is shown.
Changes in Severity Distribution after Subsequent Fires on the North Rim of Grand Canyon National Park, Arizona, USA

Understanding the distribution of fire severity patches across a landscape is of critical importance to managers and researchers. Of particular interest are those areas that burn multiple times. Understanding the complexity of these “multiple entry, mixed severity” patches is an important component of managing the landscape. We investigated the role that initial fire severity might play on subsequent fire severity (for a given re-burned area) to assess whether high severity patch distribution was impacted by initial burn conditions. In our study area, the North Rim of Grand Canyon National Park, USA, the fire severity patch distribution of one fire had little influence on the fire severity distribution of a subsequent fire and second entry severity patches were distributed on top of the first entry severity patches in a close to random distribution. Of all areas that burned twice between 2000 and 2011 on the North Rim of Grand Canyon National Park, 48 % burned with equal severity, 26 % burned with a lower severity, and 26 % burned with a higher severity in the second fire. The majority of the agreement can be attributed to a similarity in the proportions of each severity class and not to a match in the spatial allocation of the equal severity patches on first and second entry fires. The distribution of high severity patches showed little change when comparing post-first entry and post-second entry distributions. The mean and the standard deviation of the high severity patch size did not change after a second fire entry. The total area of high severity did increase; this was due to both the addition of new patches as well the growth of existing patches. These findings can help to inform land managers about the roles that fire-on-fire events play on the landscape and how those interactions may impact management goals and decisions.
Green Tea as a Nutraceutical: The Latest Developments

Green tea processed from Camellia sinensis leaves is a common beverage with enormous medicinal importance. The accumulating evidences derived from in vitro, animal studies and human trials say loud for its diverse therapeutic potentials. The polyphenol rich tea extract has been validated to offer benefits as cancer prevention, amelioration of diabetes side-effects, cardiovascular safety, cognitive boost, promotion of weight loss, skin care, allergy suppression, protection from osteoarthritis, prebiotics etc. The flavanols, epigallocatechin gallate (EGCG) and epigallocatechin (EGC) have been identified to confer most of the biological effects. This review has been composed to keep track of the recent breakthroughs in this rapidly evolving area of dietary supplements. Mechanisms of functionality have been mentioned where ever deemed essential.
Inflammation and Tumor Microenvironment in Lymph Node Metastasis

In nearly all human cancers, the presence of lymph node (LN) metastasis increases clinical staging and portends worse prognosis (compared to patients without LN metastasis). Herein, principally reviewing experimental and clinical data related to malignant melanoma, we discuss diverse factors that are mechanistically involved in LN metastasis. We highlight recent data that link tumor microenvironment, including inflammation (at the cellular and cytokine levels) and tumor-induced lymphangiogenesis, with nodal metastasis. Many of the newly identified genes that appear to influence LN metastasis facilitate general motility, chemotactic, or invasive properties that also increase the ability of cancer cells to disseminate and survive at distant organ sites. These new biomarkers will help predict clinical outcome and point to novel future therapies in metastatic melanoma as well as other cancers.
Sexual Assault, Overweight, and Suicide Attempts in U.S. Adolescents.

Associations between overweight, sexual assault history, and suicide attempts were examined among 31,540 adolescents from the combined 2009 and 2011 nationally representative Youth Risk Behavior Surveys samples. These variables have not previously been studied concurrently. It was hypothesized that overweight and sexual assault, together, would interact and result in increased suicide attempts. Findings across analyses included (a) no significant associations between sexual assault and overweight in females or males (p = .65 and p = .90, respectively), (b) statistically significant associations between female (but not male) overweight status and suicide attempts (p = .001), (c) a strong association between sexual assault and suicide risk in males (p < .001) and females (p < .001), and (d) an elevated risk for suicide in overweight males with co-occurring sexual assault, with over 33% of males with such histories attempting suicide. Preliminary findings have powerful implications for research and secondary prevention.
A Model for Timing Errors in Processors with Parameter Variation

Parameter variation in integrated circuits causes sections of a chip to be slower than others. To prevent any resulting timing errors, designers have traditionally designed for the worst case. Unfortunately, this approach has the potential to nullify much of the upcoming gains of shrinking technologies. To help understand this problem, we introduce a novel high-level and easy-to-apply model of how parameter variation affects timing errors in microprocessors. The model successfully predicts the probability of timing errors under different process and environmental conditions for both SRAM and logic units. Circuit designers can apply the model at design time to improve yield, and computer architects can use it to design processors that improve performance
Enriched Finite Elements for Regions with Multiple, Interacting Singular Fields

Enriched two-dimensional finite elements are formulated for analysis of solids with interacting singular points. These elements contain both the order and the angular variation of all singular stress fields emanating from each singular point so that the possible interaction of stress states present in such regions is represented. The order and distribution of the singular fields are determined with a separate finite element eigenanalysis. These field characterizations and the subsequent enrichment are carried out numerically rather than analytically for ease of extension of the technique to complex geometries for which analytical solutions would be difficult to obtain. Generalized stress intensity factors as well as the stresses and displacements result directly from models incorporating enriched elements. Enriched-element models can be applied not only to crack problems but also to singular stress states not involving cracks and crack growth, and are thus more versatile than J-integral and virtual crack-closure techniques used for calculating energy release rates. In addition, the proper angular distribution of the displacement fields leading to each singular stress state is used in formulating the element, an advantage not shared by formulations such as the quarter-point elements. The advantages of using enriched elements containing information from interacting singular points are demonstrated with an example having two interacting singular points. This tensile groove specimen is modeled using these new elements as well as enriched elements that do not take interaction into consideration. Attention is given to modeling issues when using interactive enriched elements.
Innate and adaptive determinants of host susceptibility to medically important fungi

The host response is the outcome of an interplay between innate immunity, adaptive immunity (Th1, Th2, T regulatory cells, B cells and antibodies) and fungal virulence factors. Dendritic cells are the gatekeepers between innate and adaptive immunity and have been the intense focus of recent studies on innate immunity to fungi because of their ability to distinguish between different forms of a fungal species, to drive Th1 versus Th2 versus T regulatory responses, and potentially be modulated by fungal products. New mechanisms have been described by which anti-fungal antibodies can modulate infection and augment T cell immunity. Th1 responses are central to limiting infection with many fungi; thus, a great deal of attention has been focused recently on the antigen(s) that trigger such a response.
Interventions Improve Gait Regularity in Patients with Peripheral Neuropathy While Walking on an Irregular Surface Under Low Light

Objectives: To determine which, if any, of three inexpensive interventions improve gait regularity in patients with peripheral neuropathy (PN) while walking on an irregular surface under low-light conditions. Design: Observational. Setting: University of Michigan Biomechanics Research Laboratory. Participants: Forty-two patients with PN (20 women), mean age±standard deviation=64.5±9.7. Interventions: A straight cane, touch of a vertical surface, or semirigid ankle orthoses. Measurements: Step-width variability and range, step-time variability, and speed. Results: Subjects demonstrated significantly less step-width variability (mean=41.0±1.5, 36.9±1.6, 37.2±1.3, and 35.9±1.5?mm for baseline, cane, orthoses, and vertical surface, respectively; P<.0001) and range (182.7±7.4, 163.7±8.3, 164.3±7.4, 154.3±6.9?mm for baseline, cane, orthoses and vertical surface, respectively; P=.0006) with each of the interventions than under baseline conditions. Step-time variability significantly decreased with use of the orthoses and vertical surface but not the cane (P=.0001). Use of a cane, but not orthoses or vertical surface, was associated with decreased speed (0.79±0.03, 0.73±0.03, 0.79±0.03, 0.80±0.03 m/s for baseline, cane, orthoses, and vertical surface, respectively; P=.0001). Conclusion: Older patients with PN demonstrate improved spatial and temporal measures of gait regularity with the use of a cane, ankle orthoses, or touch of a vertical surface while walking under challenging conditions. The decreased speed and stigma associated with the cane and uncertain availability of a vertical surface suggest that the ankle orthoses may be the most practical intervention. Keywords: neuropathy; gait; balance; orthoses; assistive device
Foreign trade and innovation in domestic labor relations

Abstract For the most part, neoclassical trade theory has restricted its concerns to the effect that trade has on the production and distribution of commodities. It implicitly assumes that international trade leaves unchanged the institutional structure of domestic economies. The empirical evidence presented here supports the claim that international trade induces innovation in the institutions regulating the capital-labor relationship. Existing trade theories, neoclassical or otherwise, that assume away such changes give only a partial answer to one of the central questions a theory of trade must answer: What are the effects of trade, and are these effects beneficial?
Study of the Durability of Faceted Pt3Ni Oxygen–Reduction Electrocatalysts

The durability of truncated octahedral Pt3Ni (t,o-Pt3Ni) electrocatalysts in the oxygen–reduction reaction (ORR) was investigated by using an accelerated-durability-testing procedure. The Pt3Ni/C catalyst lost 21 % of its initial electrochemical surface area (ECSA) and 40 % of the mass-current density (0.55 to 0.33 A mgPt−1) after 30 000 potential cycles under acidic conditions. In comparison, the reference commercial Pt/C catalyst lost 44 % of its initial ECSA and had a final mass-specific activity of only 0.09 A mgPt−1 under identical testing conditions. This study shows the potentials of this class of Pt3Ni/C nanostructures as highly active and durable ORR catalysts.
Authoritarianism, democracy and psychiatric reform in Argentina, 1943-83.

From 1955 through the early 1970s a group of Argentine psychiatrists, influenced by psychoanalysis and the mental health movement, and supported by military and civilian governments alike, began attempts to transform psychiatric care by replacing large asylums with day hospitals, general hospital clinics and therapeutic communities. Their goals included integrating psychiatry into the mainstream of medicine, improving medical and social services to patients, improving the relationship between doctors and patients, and eliminating patients' social isolation. The military coup of March 1976 ushered in a period of unchecked repression and led to the evaporation of what had often been a tenuous alliance between progressive psychiatry and the state.
Vision based hand modeling and tracking for virtual teleconferencing and telecollaboration

The authors present a hand model that simultaneously satisfies both the synthesis and analysis requirements of model based compression. The model can be fitted to any person's hand and can be done using a single camera. Once the model is fitted to a real human hand, it is then used in several tracking scenarios in order to verify its effectiveness. With successful tracking achieved, the model is ready to be incorporated into a virtual environment or model based compression scheme such as sign language communication over telephone lines or virtual teleconferences over computer networks at very low bit rates and at very high image quality. >
Hybrid Modeling and Experimental Cooperative Control of Multiple Unmanned Aerial Vehicles

Abstract : Recent years have seen rapidly growing interest in the development of networks of multiple unmanned aerial vehicles (UAVs), as aerial sensor networks for the purpose of coordinated monitoring, surveillance, and rapid emergency response. This has triggered a great deal of research in higher levels of planning and control, including collaborative sensing and exploration, synchronized motion planning, and formation or cooperative control. In this paper, we describe our recently developed experimental testbed at the University of Pennsylvania, which consists of multiple, fixed-wing UAVs. We describe the system architecture, software and hardware components, and overall system integration. We then derive high-fidelity models that are validated with hardware-in-the-loop simulations and actual experiments. Our models are hybrid, capturing not only the physical dynamics of the aircraft, but also the mode switching logic that supervises lower level controllers. We conclude with a description of cooperative control experiments involving two fixed-wing UAVs.
MEMBRANE INSERTION, PROCESSING, AND TOPOLOGY OF CYSTIC FIBROSIS TRANSMEMBRANE CONDUCTANCE REGULATOR (CFTR) IN MICROSOMAL MEMBRANES

Cystic fibrosis transmembrane conductance regulator (CFTR) is a cAMP-regulated C1(-) channel. Malfunction of CFTR causes cystic fibrosis (CF). CFTR belongs to an ATP-binding cassette (ABC) transporter superfamily which includes P-glycoprotein (Pgp), the molecule that is responsible for multidrug resistance in cancer cells. P-glycoprotein molecules have been suggested to have more than one topology and function. In this study, we analysed the early stages of membrane insertion, processing, and topology of human CFTR using rabbit reticulocyte lysate and wheat germ extract translation systems supplemented with canine pancreatic microsomal membranes. Our results suggest that CFTR contains an uncleavable signal sequence and its membrane targeting and insertion may depend on the signal recognition particle (SRP) and SRP receptor. The topology of CFTR in microsomal membranes is the same as the one predicted based on hydropathy plot analysis. These results, together with our previous findings on Pgp, indicate that (1) the topologies of mammalian ABC transporters can be dissected and studied using protein fusion chimeras in a cell-tree system; and (2) the membrane targeting and insertion of CFTR and Pgp may take the same pathway, i.e., the SRP-dependent pathway, but the membrane folding mechanism of these two proteins in microsomal membranes is probably different.
Is integration of communication and technical instruction across the SE curriculum a viable strategy for improving the real-world communication abilities of software engineering graduates?

Software engineering educators and trainers are acutely aware that software engineering graduates need strong real-world communication abilities. The National Science Foundation is supporting a three-year project in which industry professionals, CS/SE faculty, and communication-across-the-curriculum specialists are collaborating to develop curricula and teaching resources designed to improve communication abilities of CS/SE graduates by integrating communication instruction and assignments with the technical work in courses across the students' four years of study. Our panelists — an industry practitioner, a CS/SE educator, and a communication specialist — will describe what has been learned in the project's first half and invite comments, insights and advice from the audience.
NK cells: New issues and challenges

NK cells are innate lymphocytes crucial for surveillance against pathogens and tumors. Although the basic mechanisms through which NK cells operate have been established, many questions are still unresolved. Are all NK cells equal or can we identify subsets with distinct developmental origin and function? How do NK cells interact with other components of the immune system, such as DC, effector T cells, and Treg cells to elicit effective immune responses? How do NK cells become tolerant to self and preclude autoimmunity? Finally, can we design novel therapeutic avenues for cancer treatment based on NK cells? The editorial team of the European Journal of Immunology asked the opinion of some of the leading experts in the NK-cell field regarding the new challenges and opportunities facing this area of research and the thoughts of the experts are presented in this viewpoint series. This introduction to the series brings together some of the novel concepts emerging from the experts' discussions.
Arthroscopic and Endoscopic Spinal Surgery: Text and Atlas, ed 2

Kambin P, ed. Totowa, NJ 07512, Humana Press Inc, 2005, hardcover (with DVD), 383 pp, illus, ISBN: 1-58829-522-2 $157.50. The phrase “minimally invasive spine surgery” and the establishment of 2 related international societies closely followed publication of the first edition of this book ( Arthroscopic Microdiscectomy: Minimal Intervention in Spinal Surgery ) in 1990. In the 15 years since, this relatively young subspecialty has witnessed the evolution of endoscopic fragmentectomy, decompression of lateral recess stenosis, forminoplasty, and spinal stabilization, to name a few procedures. The purposes of this second edition are to (1) describe and illustrate the current minimally invasive surgical techniques and approaches that may be able to prevent the development of postsurgical “failed back” syndrome and (2) discuss evidence regarding treatment effectiveness. The text is organized into 19 chapters, the first 7 of which were written by the editor, …
Doppelganger: Better browser privacy without the bother

We introduce Doppelganger, a novel system for creating and enforcing fine-grained, privacy preserving browser cookie policies with low manual effort. Browser cookies pose privacy risks, since they can be used to track users' actions in detail, but some cookies also enable useful functionality, like personalization features. Web browsers currently lack an effective cookie management mechanism. Users must choose between two unpalatable options: a permissive, privacy-compromising policy for every site they visit, or a seemingly endless series of questions to which they must supply underinformed opinions. Doppelganger takes a big step forward: it makes automated determinations of cookies' value to enable a cost-benefit analysis, and offers an automated recovery system when that mechanism---or the user---makes an incorrect judgment. Doppelganger leverages client-side parallelism to automatically and simultaneously explore multiple cookie policies, enabling each user to create her ideal cookie policy. We tackle important and difficult subproblems along the way: mechanisms for recording and replaying web sessions; improved handling of third-party cookies; and enforcing fine-grained, per-site cookie mediation. We implemented Doppelganger as a Firefox extension; we discuss experimental results comparing it to various browser settings, as well as lessons learned from the real-world engineering challenges we faced in our implementation.
The Influence of Open versus Periodic Alongshore Boundaries on Circulation near Submarine Canyons

Abstract It is impractical to create gridded numerical models of coastal circulation with sufficient resolution around small topographic features, such as submarine canyons, and still have the alongshore boundaries placed beyond the decay distance of coastal trapped waves. Two solutions to this problem are to make the alongshore boundaries either open or periodic. Numerical simulations were performed with upwelling and downwelling winds to compare the effects of these different choices for boundary conditions. Several open boundary formulations were tried and three are discussed in detail. The offshore boundary was specified as “no gradient” for all variables with no serious effect. The “modified” Orlanski radiation condition is used for all variables at the alongshore boundaries, except the vertically integrated flow that has the strongest effect on the model solution. An alongshore pressure gradient, opposing the wind, develops in the model if the modified Orlanski radiation condition is applied to the ...
Face Detection with a 3D Model

Abstract This chapter presents a part-based face detection approach where the spatial relationship between the face parts is represented by a hidden 3D model with six parameters. The computational complexity of the search in the six-dimensional pose space is addressed by proposing meaningful 3D pose candidates by image-based regression from detected face keypoint locations. The 3D pose candidates are evaluated using a parameter sensitive classifier based on difference features relative to the 3D pose. A compatible subset of candidates is then obtained by nonmaximal suppression. Experiments on the Face Detection Database (FDDB) and Annotated Faces in the Wild (AFW) face detection datasets show that the proposed 3D model-based approach obtains results comparable to the Cascade-CNN [ 17 ].
Ethical Issues in Forensic Settings

At the outset of the APA Code of Ethics, there were no items that dealt exclusively with forensic issues. However, in 1981, the Code, following a case called Tarasoff, adopted a section called limits of confidentiality. The issue of whether or not psychologists could advertise their services was taken up in the 1980s. It was not until 1992 that we see in the Code a clear section dealing with forensic activities, as well as distinctions between aspirational principles and enforceable standards. Further, definitions of what was meant by competence were spelled out and these had clear reference to the qualification of expert witnesses. Issues regarding conflicts between the Code of Ethics and court orders were starting to be discussed. Clarification regarding the nature of multiple relationships to be avoided was set out, and the need for complete documentation of how a clinician reached their opinions, conclusions, and recommendations was also discussed. The section about avoiding harm was expanded, and restrictions regarding the release of records were also discussed. The next version of the Code of Ethics had several changes including the elimination of the section dealing with forensic activities and a marked shift, pursuant to HIPAA, about the need to release records to a patient upon request. The Forensic Specialty Guidelines expanded on several of these points and provided more specific guidelines for dealing with record release, for reconciling court orders with ethical constraints, and for defining what activities were forensic in nature.
Abstract 42: Use of the Kansas City Cardiomyopathy Questionnaire to assess acute heart failure patients

Background: Patient reported health status outcomes are becoming increasingly important. While disease-specific measures exist for chronic heart failure (HF), there is not a well-validated instrument for acute HF. We sought to assess the feasibility of using the KCCQ during hospitalization and to examine whether acute changes were associated with early emergency department (ED) revisits or readmission for HF. Methods: A prospective cohort pilot study of a convenience sample of chronic HF patients presenting to the ED with worsening HF were enrolled who met the following inclusion criteria: >18 years old, BNP>400, primary admission for HF (dyspnea at rest or on minimal exertion, and at least 2 of following: CXR consistent with HF, JVD, peripheral edema, rales), and treated with IV loop diuretics in pre-hospital or ED. Exclusion criteria were ongoing ACS, current or recent pregnancy, non-English speaking, unable to consent, terminal illness with life expectancy <6 months. Consenting patients were enrolled within 12 hours of presentation and administered the KCCQ by interview on presentation, at discharge (or hospital day 7, whichever came first), and 30 days post-discharge by phone. Primary analysis was a description of mean differences in the KCCQ Overall Summary score over time, and hospital-based changes stratified by early ED revisit or readmission were compared. Changes in summary scores between assessments were evaluated using paired t-test. Associations between summary scores, changes in scores, and ED revisits and readmissions were evaluated using t-tests for bivariate comparison and logistic regression to control for baseline scores. Results: Among the 53 enrolled patients (mean age 64±15, 56.6% male; 46.3% white, 29.6% black, 7.4% Hispanic, 16.7% other) assessments 2 and 3 were each completed by 92% (49). Within each domain and summary score, mean scores were lowest on admission, improved on assessment 2, and highest on assessment 3. The mean change in the KCCQ Summary score between admission and discharge was +11.5±26.5 (p=0.007) and between discharge and 30 days was +19.1±17.7 (p<0.001). Within the 30-day follow-up period, 8 patients re-visited the ED for HF, and 10 were readmitted for HF (6 through the ED). Patients with ED revisits versus those without had no difference in scores on discharge, but had significantly less improvement in summary scores during hospitalization (mean KCCQ score change -6.5 points vs. +17.6 points, p=0.03). There were no significant differences between patients with HF readmissions versus those without when comparing summary scores or changes in summary scores from presentation to discharge. Conclusion: The KCCQ is feasible to use during acute hospitalization for HF, and changes in summary score during hospitalization may predict ED revisits, but not readmissions for HF. Further validation of the instrument in the acute setting will be required.
Effects of Flow Separation on a Highly Loaded, Low-Pressure Gas Turbine Blade at Low Reynolds Numbers

Current gas turbine engines experience a loss in performance due to the low Reynolds number flow in the low-pressure turbine. This low flow speed can result in separation of the air from the blade surface, reducing the efficiency of the engine. The Baylor University Cascade wind tunnel (BUC) is being used to study this flow separation. A cascade wind tunnel contains a row of turbine vanes that simulates a turbine wheel. The BUC is capable of simulating the environment seen by the low-pressure turbine at high altitudes by producing Reynolds numbers varying from 25,000 to 400,000. The L1A blade profile is currently being tested. Coefficient of pressure (Cp) plots show a less than 1% difference between surface pressure locations when comparing the most inboard and outboard test blades. This agreement demonstrates the flow uniformity in the tunnel. Cp plots also compared favorably to the literature, validating the BUC operation and providing insight into how Reynolds numbers and free stream turbulence intensity (FSTI) affect flow separation. The literature and this study showed the size and reattachment of the separation bubble was highly dependent on the FSTI for lower Reynolds numbers (25,000 to 200,000). This comparison also showed that the size of the separation bubble and the location was not heavily impacted by FSTI for Reynolds numbers above 200,000. Tests in the future will be conducted to determine the actual FSTI of the BUC. Once completely validated, future studies with the BUC may include use of particle image velocimetry (PIV) to visualize the flow, a gold foil steady state technique using liquid crystals to measure heat transfer, and a series of deposition tests using surface roughness (sandpaper or textured sprays) to measure performance loss under these conditions. The ultimate goal of this research is to improve blade design in the low pressure turbine for all commercial and military aircraft.Copyright © 2015 by ASME
Determination of anisotropy-dependent inelastic collision cross sections in atomic sodium using linear polarization spectroscopy

We report on the measurement of the linear polarization degree of the $3s{\phantom{\rule{0.16em}{0ex}}}^{2}\phantom{\rule{-0.16em}{0ex}}{S}_{1/2}$ $\ensuremath{\rightarrow}$ $3p{\phantom{\rule{0.16em}{0ex}}}^{2}\phantom{\rule{-0.16em}{0ex}}{P}_{3/2}$ $\ensuremath{\rightarrow}$ $5s{\phantom{\rule{0.16em}{0ex}}}^{2}\phantom{\rule{-0.16em}{0ex}}{S}_{1/2}$ transition in atomic sodium. A linearly polarized pump laser creates an alignment in the excited ${}^{23}$Na $3p{\phantom{\rule{0.16em}{0ex}}}^{2}\phantom{\rule{-0.16em}{0ex}}{P}_{3/2}$ level. From the spectra, we extracted the inelastic collision cross section for the disalignment of the excited atoms by collisions with ground-level argon or xenon atoms. Measurements were done by monitoring the intensity of the cascade fluorescence from the $4p{\phantom{\rule{0.16em}{0ex}}}^{2}\phantom{\rule{-0.16em}{0ex}}{P}_{1/2}$ $\ensuremath{\rightarrow}$ $3s{\phantom{\rule{0.16em}{0ex}}}^{2}\phantom{\rule{-0.16em}{0ex}}{S}_{1/2}$ transition at 330.29 nm, in the presence of Ar and Xe for pressures ranging from 5.3 to 146.6 mbar. We demonstrated that the polarization measurement can provide important information about the alignment-dependent inelastic process in alkali-metal\char21{}rare-gas collisions. A depolarization cross-section value of 196 (22) \AA{}${}^{2}$ for Na-Ar and 357 (21) \AA{}${}^{2}$ for Na-Xe are obtained.
Effect of Early-Season Infestations of the Tobacco Flea Beetle (Coleoptera: Chrysomelidae) on the Growth and Yield of Flue-Cured Tobacco

The effect of Epitrix hirtipennis (Melsheimer) on the yield and growth of flue-cured tobacco was investigated in Virginia during 1981. Beetles (0, 5, 10, 15, and 20 per plant) were confined to individual tobacco plants in sleeve cages for a 3-week period immediately after transplant. Cages were then removed, and the plants were protected from other insects for the rest of the season. All populations caused significant ( P = 0.05) reductions in fresh- and cured-leaf yield, plant height, leaf area, and root weight. Cured-leaf yield was reduced by 18, 25, 38, and 38% for tobacco infested with 5, 10, 15, and 20 beetles per plant, respectively. Fresh-leaf yield was reduced by 21 g per beetle plant.
Cholesteatoma of the Renal Pelvis: A Case with Long-Term Followup

AbstractWe report a case of cholesteatoma of the renal pelvis with a 56-year followup. Quiescence of the disease with remission of symptoms, stabilization of the lesion and absence of further anatomical change was related temporally to treatment with vitamin A. The disease in our patient was idiopathic and no causative or predisposing factors were demonstrated.
Show Me the Money: Part Two Monetizing the 'Value Added' of Attorneys Who Serve as Mediators and Arbitrators

This column discusses how lawyers who serve as mediators and arbitrators might more accurately and ethically monetize “the value added” they bring to parties through creative fee structures, beyond traditional hourly or daily fees. To engage in this discussion, dispute resolution practitioners are encouraged to adopt a more realistic and nuanced perspective about what mediator and arbitrator impartiality actually means in the context of ethical billing paradigms and forgo our long-held, unattainable concept of mediator and arbitrator impartiality.
Does the NBME Surgery Shelf exam constitute a “double jeopardy” of USMLE Step 1 performance?

Abstract Background Scores from the NBME Subject Examination in Surgery (Surgery Shelf) positively correlate with United States Medical Licensing Examination Step 1 (Step 1). Based on this relationship, the authors evaluated the predictive value of Step 1 on the Surgery Shelf. Methods Surgery Shelf standard scores were substituted for Step 1 standard scores for 395 students in 2012–2014 at one medical school. Linear regression was used to determine how well Step 1 scores predicted Surgery Shelf scores. Percent match between original (with Shelf) and modified (with Step 1) clerkship grades were computed. Results Step 1 scores significantly predicted Surgery Shelf scores, R 2 = 0.42, P Conclusion Replacing Surgery Shelf scores with Step 1 scores did not have an effect on the majority of final clerkship grades. This observation raises concern over use of Surgery Shelf scores as a measure of knowledge obtained during the Surgery clerkship.
Dendritic GIRK Channels Gate the Integration Window, Plateau Potentials, and Induction of Synaptic Plasticity in Dorsal But Not Ventral CA1 Neurons.

Studies comparing neuronal activity at the dorsal and ventral poles of the hippocampus have shown that the scale of spatial information increases and the precision with which space is represented declines from the dorsal to ventral end. These dorsoventral differences in neuronal output and spatial representation could arise due to differences in computations performed by dorsal and ventral CA1 neurons. In this study, we tested this hypothesis by quantifying the differences in dendritic integration and synaptic plasticity between dorsal and ventral CA1 pyramidal neurons of rat hippocampus. Using a combination of somatic and dendritic patch-clamp recordings, we show that the threshold for LTP induction is higher in dorsal CA1 neurons and that a G-protein-coupled inward-rectifying potassium channel mediated regulation of dendritic plateau potentials and dendritic excitability underlies this gating. By contrast, similar regulation of LTP is absent in ventral CA1 neurons. Additionally, we show that generation of plateau potentials and LTP induction in dorsal CA1 neurons depends on the coincident activation of Schaffer collateral and temporoammonic inputs at the distal apical dendrites. The ventral CA1 dendrites, however, can generate plateau potentials in response to temporally dispersed excitatory inputs. Overall, our results highlight the dorsoventral differences in dendritic computation that could account for the dorsoventral differences in spatial representation. SIGNIFICANCE STATEMENT The dorsal and ventral parts of the hippocampus encode spatial information at very different scales. Whereas the place-specific firing fields are small and precise at the dorsal end of the hippocampus, neurons at the ventral end have comparatively larger place fields. Here, we show that the dorsal CA1 neurons have a higher threshold for LTP induction and require coincident timing of excitatory synaptic inputs for the generation of dendritic plateau potentials. By contrast, ventral CA1 neurons can integrate temporally dispersed inputs and have a lower threshold for LTP. Together, these dorsoventral differences in the threshold for LTP induction could account for the differences in scale of spatial representation at the dorsal and ventral ends of the hippocampus.
Repurposing Leflunomide for Multiple Myeloma Treatment

Background: Despite recent advances in treatment that have improved the prognosis for patients with multiple myeloma (MM), the disease remains incurable. There is a need for MM treatments with new mechanisms of action. Leflunomide, a commercially available oral immunosuppressive agent that has been FDA-approved since 1998 for the treatment of rheumatoid arthritis (RA) was evaluated as a potential MM therapy. The primary mechanism of action is de novo inhibition of pyrimidine synthesis by targeting dihydroorotate dehydrogenase (DHODH), and thus achieving an anti-proliferative effect in B- and T-lymphocytes. A secondary mechanism of action is inhibition of cytokine and growth factor receptor-associated tyrosine kinase activity. Methods and Results: Pre-clinical studies of teriflunomide, the active metabolite of leflunomide, showed that it inhibited cell growth and induced apoptosis in MM cell lines (MM.1S, MM.1R, U266, H929, RPMI-8226) and primary MM patients9 (CD138+) plasma cells at clinically achievable concentrations (50-200 uM) in a time- and dose-dependent manner. We also found that teriflunomide induces cell-cycle arrest in both, glucocorticoid-sensitive (MM.1S) and resistant (MM.1R) MM cell lines at Conclusions: Leflunomide and its analogues demonstrated anti MM effects in vitro as well as synergy with dexamethasone. Based on our promising pre-clinical results we have initiated a single-agent phase I/II clinical trial in patients with relapsed/refractory MM. Disclosures No relevant conflicts of interest to declare.
Coronary Artery Disease and Myocardial Infarction

Coronary artery disease (CAD) and its primary complication, myocardial infarction, is a polygenic disease that remains a leading cause of death and disability worldwide. Recent progress in genomics has provided us with a golden opportunity to dissect the genetic basis of this condition paving the way for the development of novel methods to prevent, diagnose, and treat this condition. In this chapter, we review the evidence supporting the heritable nature of CAD, the recent findings from genome-wide association studies including insights on the pathophysiology of CAD through pleiotropy and pathway analyses, the role of Mendelian randomization studies in deciphering causal from noncausal risk factors of CAD, the utility of genetic risk scores in managing subjects at risk of CAD, and the identification of novel lipoprotein metabolism related drug targets for the treatment of CAD through recent large-scale sequencing projects of the exome.
Economic activity and patterns of infant growth in a high altitude district of Peru.

Objectives Changing economic activities bring significant cultural, epidemiological, and nutritional transitions. Infancy represents a critical period when rapid growth and metabolic programming occur, making infants particularly vulnerable to long-lasting biological changes due to such transitions. This paper examines the relationship between residence in distinct economic production zones (urban, herding, and dairy) and early growth in a highland district of Peru. Methods The length, weight, body mass index, and triceps skinfold of 93 infants (55 boys and 38 girls, aged 2 to 24 months) from 3 economic zones were measured at two time points 6 months apart. z-scores were calculated based on the WHO Growth Reference for children under 5 years of age. Comparisons were made to the reference group and between economic zones to examine the impacts of different economic activities on infant growth. Results Female infants had significantly higher height-for-age z-scores (HAZ) than males (P < 0.05). Across zones, dairying infants had the highest HAZ scores and the lowest prevalence of stunting. There was a significant association between zone and HAZ at baseline. While these associations were attenuated in measurements, taken 6 months later, longitudinal growth monitoring revealed differential patterns of weight gain and adiposity deposition across the zones with herding infants showing consistent high adiposity and urban infants gaining both weight and adiposity between rounds. Discussion Changes in economic activity are bringing about nutritional and epidemiological transitions in the Nunoa district. Economic activity is a key factor influencing early growth with distinct longitudinal growth patterns in each economic zone.