cssi/SciSciGPT-SciSciNet huggingface dataset:
Supraglottoplasty in premature infants with laryngomalacia: does gestation age at birth influence outcomes?

PurposePrematurity is thought to be to be an independent risk factor for supraglottoplasty (SGP) failure. The purpose of this study was to compare the outcomes of supraglottoplasty in premature infants with congenital laryngomalacia (LM) with that of term infants.Study DesignCase series with chart review.SettingTertiary-care pediatric institution.MethodsAnalysis was performed on 325 consecutive patients undergoing SGP between 2004 and 2012. Patients older than 12 months age or with syndrome, neurologic, or cardiac comorbidities were excluded. Resolution of airway symptoms after SGP was considered successful while revision SGP and tracheostomy were considered failures. The rates of secondary airway lesions (SAL), dysphagia, and gastrostomy tube (GT) placement were also compared.ResultsA total of 176 infants (136 term, 40 preterm) were identified. SGP was successful in 92.7% term and 90% preterm infants with no significant difference (P = .5865). Incidence of revision SGP and tracheostomy was similar among ...
Conserved patterns of cortico-cortical connections define areal hierarchy in rat visual cortex.

The prevalence of reciprocal connections in the cerebral cortex indicates that they play a fundamental role in the processing of sensory information. We have investigated the laminar termination patterns of such paired connections between different visual cortical areas of the rat, and have found two basic projection types: one which includes layer 4 and a second which includes layer 1 and avoids layer 4. The projections from primary visual cortex (area 17) to extrastriate visual cortical targets in the cytoarchitectonical areas 18a and 18b, and from 18a to a site in 18b, are of the first type. In contrast, the return projections from 18a and 18b to area 17 and from 18b to 18a, are of the second type. Thus each pair of connections has one element of each type, giving every circuit a nearly identical asymmetric structure. These laminar patterns resemble those of forward and feedback connections in primate cortex, indicating that cortico-cortical connectivity patterns are highly conserved through evolution, and that, as in monkeys, these connections define a hierarchical organization of areas in rat visual cortex.
Advances in InSb Charge Injection Device (CID) Focal Planes

This paper reviews the status of two Indium Antimonide Charge Injection Device (CID) focal planes, one composed of multiple line arrays, the other made with an area array using random access addressing. After an introduction to CID operation, factors governing Performance Efficiency (PE) in both line and area arrays are considered and compared to experimental results. The charge sharing mode of operation of a two dimensional array is presented, along with its perform-ance implications. The linear focal plane consists of 48 linear arrays, each with 64 elements. Each InSb array is addressed by a silicon scanner chip. The scanner outputs are serviced by preamp chips mounted perpendicular to the focal plane. The 32x32 element area arrays have been coupled to combinatorial decoders permitting random selection of any site of the array. Focal planes consisting of a single 32x32 array with two silicon decoders mounted in sealed off glass dewars are described.© (1980) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
The influence of adhesive reinforcement on the Mode-I fracture toughness of a bonded joint

The influence of adhesive reinforcement on the Mode-I fracture toughness of a double-cantilever beam specimen has been investigated. An analytical model based on Reissner's variational theorem, which has previously been shown accurately to predict stress fields and energy release rates for cracked laminates, was used to model the test specimen. A plane-strain model was developed and used to determine the energy release rates for mid-plane cracks in aluminum-adherend bonded specimens with varying amounts of reinforcement in the adhesive. The energy release rates determined from the present model, which was used to determine fracture toughness for specimens in a systematic experimental program, compared favorably to results of closed-form analyses from the literature. The amount of reinforcement in the adhesive layer has been shown to have a significant effect on the Mode-I adhesive fracture toughness and cracking behavior.
Effusion cytology of malignant melanoma. A morphologic and immunocytochemical analysis including application of the MART-1 antibody.

BACKGROUND Malignant effusions are complications of metastatic malignant melanoma (MM). Differential diagnosis often involves distinguishing MM from adenocarcinoma and reactive mesothelial cells. Descriptions in the literature of the morphologic and immunocytochemical (IM) staining characteristics of MM in effusions are sparse. A combination of morphology and immunocytochemistry should yield the most accurate diagnostic results. The MART-1 antigen, a transmembrane protein, is specifically expressed in melanocytes and MM. A recently developed monoclonal antibody to the MART-1 antigen may represent a useful marker for the identification of MM in effusions. METHODS The authors conducted a retrospective review of 32 effusion samples diagnosed as MM. The review consisted of morphologic and IM analyses of the effusion samples with antibodies to MART 1, HMB45, S-100, and cytokeratins (AE1/AE3).IM stains were performed on cell block or cytospin material, depending on availability. In the morphologic review, emphasis was placed on Diff Quik-stained material, due to its enhanced cytoplasmic volume and detail. RESULTS Predominant cytologic features noted were lack of cellular cohesion (in 100% of cases), large eccentric nuclei with prominent nucleoli (in 100%), multinucleation (in 84%), variable cytoplasmic vacuolization (in 75%), pigment (in 72%), and cell-in-cell engulfment (in 47%). All immunoreactive cases with sufficient material stained with at least one of the markers used. Tumor cells were positive with IM stains to MART-1 in 78% of cases, HMB45 in 81%, and S-100 in 81%. Coexpression of MART-1, HMB45, and S-100 was noted in 63% of cases. Of cases that showed expression for only 1 of the 3 antigens, the MART-1 was positive in 1 case, and HMB45 and S-100 were positive in 2 cases each. Three cases showed immunoreactivity for cytokeratins in the melanoma cells. CONCLUSIONS The diagnosis of MM in effusions can be made reliably through a combination of morphologic and IM features. Differential diagnosis often involves distinguishing MM from adenocarcinoma or reactive mesothelial cells. Cytoplasmic vacuolization, multinucleation, prominent nucleoli, and cell-in-cell engulfment are cytologic features common to all three. The lack of IM staining for cytokeratins alone cannot reliably distinguish MM; 11% of cases showed positive staining with this antibody in the melanoma cells. The use of a panel of antibodies increases the accuracy of diagnosing MM. In this study, MART-1 proved a useful adjunct to the HMB45/S-100/cytokeratin panel for the diagnosis of MM in effusions, staining 78% of the immunoreactive cases, with positivity in 1 case that was negative for HMB45 and S-100. Cancer 1997; 81:57-63. © 1997 American Cancer Society.
Security by Any Other Name: On the Effectiveness of Provider Based Email Security

Email as we use it today makes no guarantees about message integrity, authenticity, or confidentiality. Users must explicitly encrypt and sign message contents using tools like PGP if they wish to protect themselves against message tampering, forgery, or eavesdropping. However, few do, leaving the vast majority of users open to such attacks. Fortunately, transport-layer security mechanisms (available as extensions to SMTP, IMAP, POP3) provide some degree of protection against network-based eavesdropping attacks. At the same time, DKIM and SPF protect against network-based message forgery and tampering. In this work we evaluate the security provided by these protocols, both in theory and in practice. Using a combination of measurement techniques, we determine whether major providers supports TLS at each point in their email message path, and whether they support SPF and DKIM on incoming and outgoing mail. We found that while more than half of the top 20,000 receiving MTAs supported TLS, and support for TLS is increasing, servers do not check certificates, opening the Internet email system up to man-in-the-middle eavesdropping attacks. At the same time, while use of SPF is common, enforcement is limited. Moreover, few of the senders we examined used DKIM, and fewer still rejected invalid DKIM signatures. Our findings show that the global email system provides some protection against passive eavesdropping, limited protection against unprivileged peer message forgery, and no protection against active network-based attacks. We observe that protection even against the latter is possible using existing protocols with proper enforcement.
Detection of respiratory compromise by acoustic monitoring, capnography, and brain function monitoring during monitored anesthesia care

Episodes of apnea in sedated patients represent a risk of respiratory compromise. We hypothesized that acoustic monitoring would be equivalent to capnography for detection of respiratory pauses, with fewer false alarms. In addition, we hypothesized that the patient state index (PSI) would be correlated with the frequency of respiratory pauses and therefore could provide information about the risk of apnea during sedation. Patients undergoing sedation for surgical procedures were monitored for respiration rate using acoustic monitoring and capnography and for depth of sedation using the PSI. A clinician blinded to the acoustic and sedation monitor observed the capnograph and patient to assess sedation and episodes of apnea. Another clinician retrospectively reviewed the capnography and acoustic waveform and sound files to identify true positive and false positive respiratory pauses by each method (reference method). Sensitivity, specificity, and likelihood ratio for detection of respiratory pause was calculated for acoustic monitoring and capnography. The correlation of PSI with respiratory pause events was determined. For the 51 respiratory pauses validated by retrospective analysis, the sensitivity, specificity, and likelihood ratio positive for detection were 16, 96 %, and 3.5 for clinician observation; 88, 7 %, and 1.0 for capnography; and 55, 87 %, and 4.1 for acoustic monitoring. There was no correlation between PSI and respiratory pause events. Acoustic monitoring had the highest likelihood ratio positive for detection of respiratory pause events compared with capnography and clinician observation and, therefore, may provide the best method for respiration rate monitoring during these procedures.
Cisplatin-induced hair cell death requires STAT1 and is attenuated by epigallocatechin gallate.

Cisplatin is a chemotherapy drug that frequently causes auditory impairment due to the death of mechanosensory hair cells. Cisplatin ototoxicity may result from oxidative stress, DNA damage, and inflammatory cytokines. The transcription factor STAT1, an important mediator of cell death, can regulate all of these processes in other cell types. We used cultured utricles from mature Swiss Webster mice to investigate the role of STAT1 in cisplatin-induced hair cell death. We show that STAT1 phosphorylation is an early event in both hair cells and support cells after exposure of utricles to cisplatin. STAT1 phosphorylation peaked after 4 h of cisplatin exposure and returned to control levels by 8 h of exposure. The STAT1 inhibitor epigallocatechin gallate (EGCG) attenuated STAT1 phosphorylation in cisplatin-treated utricles and resulted in concentration-dependent increases in hair cell survival at 24 h postexposure. Furthermore, we show that utricular hair cells from STAT1-deficient mice are resistant to cisplatin toxicity. EGCG failed to provide additional protection from cisplatin in STAT1-deficient mice, further supporting the hypothesis that the protective effects of EGCG are due to its inhibition of STAT1. Treatment with IFN-γ, which also causes STAT1 activation, also induced hair cell death in wild-type but not STAT1-deficient mice. These results show that STAT1 is required for maximal cisplatin-induced hair cell death in the mouse utricle and suggest that treatment with EGCG may be a useful strategy for prevention of cisplatin ototoxicity.
Explaining Nonratification of the Genocide Convention: A Nested Analysis

What explains the large variation in the time taken by states to ratify the 1948 Genocide Convention? The costs of ratification would appear to be relatively low, yet many states have waited several decades before ratifying this symbolically important treaty. This study employs a “nested analysis” that combines a large-n event history analysis with a detailed study of an important outlying case in order to explain the main sources of this variation. Surprisingly, the results of our event history analysis suggest that states do not become more likely to ratify once the treaty has become widely adopted by others. We use the case of Japan to examine this relationship in more detail. We argue that once the norm embodied in a human rights treaty develops a “taken-for-granted” character, the rate of ratification can slow down because the marginal costs of additional ratifications begin to outweigh the expected benefits.
Structural-functional correlates in the transendothelial exchange of water-soluble macromolecules.

Abstract The transport of water-soluble macromolecules across the capillary wall is currently explained by assuming the existence of two pore systems: one of small pores with diameters of 90 A and relatively high frequency, and the other of large pores with diameter of up to 700 A and considerably lower frequency. There is at present general agreement concerning the structural equivalent of the two pore systems in the fenestrated capillaries, and the large pores in muscular capillaries. But the location of the small pores in the continuous endothelium of muscle capillaries is still an unsettled question: two hypothesis have been advanced, one favoring the intercellular junctions, another the plasmalemmal vesicles as structural equivalent for this system. Recent work with intravenously injected tracers of low molecular dimensions (Hemeundecapeptide, mol. wt. 1,900; mol. diam. 17–20 A and Hemeoctapeptide, mol. wt. 1,550) showed that such molecules cross the endothelium via vesicles, only. The latter can function either as isolated units shuttling, in revolvable phases, between the two endothelial fronts, or can fuse to form patent transendothelial channels made up by 1, or more connecting vesicles. Their size-limiting structures are represented either by strictures of 100 A diameter, or by diaphragms. The general geometry of the transendothelial channels could explain the physiological data, but their frequency remains to be established. Similar results were obtained by back-diffusion experiments in which the tracers were injected into the interstitial spaces. In both types of experiments, the endothelial junctions were not permeable to the tracers, but they may be permeated by molecules smaller than 20 A.
A convergent algorithm for quantile regression with smoothing splines

An important practical problem is that of determining a nonparametric estimate of the conditional quantile of y given x. If we balance fidelity to the data with a smoothness requirement, the resulting quantile function is a smoothing spline. We reformulate this estimation procedure as a quadratic programming problem, with associated optimality conditions. A recently developed interior point algorithm with proven convergence is extended to solve the quadratic program. This solution characterizes the desired nonparametric conditional quantile function. These methods are illustrated in a study of audiologic performance following cochlear implants.
Household health expenditures in Morocco: implications for health care reform

Using the 1995 Morocco Demographic and Health Survey which included a special supplement on health care costs this paper presents a descriptive analysis of health care utilization and expenditures. Descriptive statistics are presented on utilization of and out-of-pocket expenditures for antenatal and obstetric care chronic care and non-chronic care associated with illness and injury by urban/rural status and by socioeconomic status. Overall the results indicate that utilization of modern health care is substantially higher among individuals living in better-off and urban households than among their poorer counterparts. In addition government health care providers appear to be an important source of modern health care not only for poor households but for better-off households as well. While individuals who use private health care providers incur substantially higher costs than those who use public providers an unexpected finding of the study is the degree to which public clients pay for health care services despite the fact that public care is nominally priced in the country. Based on these findings it is suggested that carefully designed financing strategies may be effective in achieving a higher level of cost recovery and efficiency within the public sector.
Sensor/actuators placement on civil structures using a real coded Genetic algorithm

The optimal design and placement of controllers at discrete locations on civil engineering structures is an important control problem that will have impact on the earthquake engineering community. Though algorithms exist for the placement of sensor/actuator systems on continuous structures, the placement of controllers on discrete civil structures is a very difficult problem. Because of the nature of civil structures, it is not possible to place sensors and actuators at any location in the structure. This usually creates a nonlinear constrained mixed integer problem that can be very difficult to solve. However, genetic algorithms have been found to be a powerful too in solving such problems. The introduction of algorithms based on genetic search procedures should increase the rate of convergence and thus reduce the computational time for solving the difficult control problem. In this research task, a real coded genetic algorithm will be used to simultaneously place and design a control system for a civil engineering structure. The proposed method of simultaneously placing and designing sensor/actuators will be compared to a similar work that used a hybrid method. The hybrid method involves using a genetic algorithm to place the sensor/actuators, followed by a gradient-based method to determine the optimal controller gains. The proposed method is more convenient, in that both placement and design is done in the same algorithm, and as such it has a better convergence rate than the hybrid method.
Blood prothrombin levels and hippuric acid excretion liver function test in liver disease.

ConclusionThere was no correlation between the blood prothrombin level and a single estimation of the urinary excretion of hippuric acid after ingestion of known amounts of sodium benzoate in 12 patients with liver disorders after treatment with synthetic vitamin K analogues.
Reminiscing with different children: Relating maternal stylistic consistency and sibling similarity in talk about the past.

This study explored patterns of consistency and change in maternal reminiscing style across conversations with different children in the same family. Twenty-three White, middle-class mothers engaged in separate memory conversations with their younger (M age = 40 months) and older (M age = 68 months) children. Mothers evidenced striking stylistic consistency. Analyses of bidirectional relations revealed that for different elements of style, mothers' use of a stylistic dimension with one of the children predicted mothers' use of the same dimension with the other child in the family, above the variance accounted for by the siblings' participation. The results address questions concerning the strategic and responsive nature of maternal reminiscing style and the similarity of environments for learning autobiographical memory skills for different children within families.
Persistent right superior vena cava in a patient with dextrocardia: Case report and review of the literature

Introduction Systemic venous circulation anomalies are uncommon; they are often incidental findings during echocardiography.
Cohomology equations near hyperbolic points and geometric versions of sternberg linearization theorem

We prove that if two germs of diffeomorphisms preserving a voiume, symplectic, or contact structure are tangent to a high enough order and the linearization is hyperbolic, it is possible to find a smooth change of variables that sends one into the other and which, moreover, preserves the same geometric structure. This result is a geometric version of Sternberg’s linearization theorem, which we recover as a particular case. An analogous result is also proved for flows.
Systematic construction of upper and lower bounds to the ground state energy of the Schrödinger equation

For the multidimensional Schrodinger equation, we develop a technique based on the moment problem formulation of this equation. The method provides systematic and rapidly converging upper and lower bounds to the ground state energy, and it enjoys the following features: 1 The bounds are insensitive to the strength of the perturbation; that is, the method applies even to the most singular perturbation. 2 The method does not require the potential to be semibounded. It applies directly to potentials whose spectrum extends from minus to plus infinity, as is the case for the Zeeman effect in hydrogenic atoms. 3 The presence of continuum spectrum does not affect the method: no information coming from the continuum is needed.
β-Blockers in Chronic Heart Failure: Considerations for Selecting an Agent

Patients with chronic heart failure have increased sympathetic nervous system activity that contributes to deterioration of cardiovascular function over time. Long-term β-blocker therapy prevents such deterioration through inhibition of this neurohormonal pathway. The impressive survival data collected from several large studies have made β-blockers a component of standard therapy for New York Heart Association class II to III heart failure. Although there are differences in the pharmacological properties of the β-blockers shown to improve morbidity and mortality in heart failure, there is little evidence to suggest that such properties constitute any major advantages in clinical outcome. Carvedilol and extended-release metoprolol succinate are 2 β-blockers currently approved in the United States for the treatment of patients with heart failure. Both agents have shown similar risk reductions in overall and cause-specific mortality; however, no outcome data from a comparative trial are available to support the use of one agent over the other. Regardless of the agent chosen, appropriate dosing and titration of β-blockers are essential for successful therapy.
Finite momentum at string endpoints

We argue that classical strings, both bosonic and supersymmetric, can have finite energy and momentum at their endpoints. We show that in a general curved background, string endpoints must propagate along null geodesics as long as their energy remains finite. Finite endpoint momentum allows strings with a fixed energy to travel a greater distance in a five-dimensional anti--de Sitter Schwarzschild background than has been possible for classical solutions considered previously. We review the relevance to heavy ion phenomenology of the dependence of this distance on energy, and we propose a scheme for determining the instantaneous rate of energy loss.
The cancer family caregiving experience: an updated and expanded conceptual model.

Abstract Objective The decade from 2000 to 2010 was an era of tremendous growth in family caregiving research specific to the cancer population. This research has implications for how cancer family caregiving is conceptualized, yet the most recent comprehensive model of cancer family caregiving was published ten years ago. Our objective was to develop an updated and expanded comprehensive model of the cancer family caregiving experience, derived from concepts and variables used in research during the past ten years. Methods A conceptual model was developed based on cancer family caregiving research published from 2000 to 2010. Results Our updated and expanded model has three main elements: 1) the stress process, 2) contextual factors, and 3) the cancer trajectory. Emerging ways of conceptualizing the relationships between and within model elements are addressed, as well as an emerging focus on caregiver-patient dyads as the unit of analysis. Conclusions Cancer family caregiving research has grown dramatically since 2000 resulting in a greatly expanded conceptual landscape. This updated and expanded model of the cancer family caregiving experience synthesizes the conceptual implications of an international body of work and demonstrates tremendous progress in how cancer family caregiving research is conceptualized.
1X deep-UV lithography with chemical amplification for 1-micron DRAM production

This paper describes methods used and results obtained in the production of 1-megabit (Mb) DRAM chips, using a chemically amplified tertiary-butoxy carhonyl hydroxystyrene (t-BOC) resist and 1X lithography. 'Flie internally developed resist provided high sensitivity and contrast, for I rn resolution on a Perkin Elmer Micralign model 500 (PE 500) in the deep UV. Characterization, and modification of the PE 500 were required for this first application in the deep UV. The manufacturing process had photo limited yield in excess of 95% with throughput of 100 wafers per hour.
Response interference between functional and structural actions linked to the same familiar object

Viewing objects with the intention to act upon them may activate task-irrelevant motor responses. Many manufactured objects are associated with two action classes: grasping in accordance with object structure and skillful use consistent with object function. We studied the potential for within-object competition during action selection by comparing initiation latencies for “conflict” objects (with competing structure and function responses) to “non-conflict” objects (with a single response). We demonstrated a novel pattern of within-object interference wherein actions involving conflict objects were slowed when participants skillfully used those objects (grasp-on-use interference) as well as a second pattern of interference when conflict objects were grasped after skillfully using the same objects in previous blocks (long-term use-on-grasp interference). These data suggest that actions to common objects are influenced by competition between rapid but briefly maintained grasp responses and slower but longer-lasting use responses, and advance our understanding of the process and neural substrates of selection for action.
Thermo-mechanical characterization of forged coated products during water quench

The thermo-mechanical response of coated and uncoated forgings during warm water quench is investigated using experimental and FE modeling techniques. Two coating application methods are examined: in the first method, the forging surface is fully coated, while in the second one, the part is partially coated at selected sections of the workpiece. The thermal response during quench is recorded at various locations of the forgings and residual stresses are obtained using the hole drilling method. The study demonstrates that the coating applications proposed herein significantly enhance the surface heat removal rates during quenching and therefore offer the potential to increase mechanical properties. Based on the results, it is also concluded that no significant differences exist between the thermal responses of the partially and fully coated forgings.
Radio Frequency sputtered Si1−xGex and Si1−xGexOy thin films for uncooled infrared detectors

Abstract Thin films of Si1−xGex and Si1−xGexOy were deposited by radio frequency (rf) magnetron sputtering at room temperature from a single target of Si1−xGex in the Ar or Ar:O2 environment. The silicon and oxygen concentrations were varied in a parametric investigation of the dependence of the electrical and optical characteristics of the thin films on composition. As Si concentration was increased in the Si1−xGex films, the temperature coefficient of resistance (TCR) was decreased. For Si1−xGexOy films, the addition of oxygen to the Si1−xGex, increased the activation energy and TCR. The TCR was measured to vary from − 2.27% to − 8.69%/K. The optical bandgap was increased with the increasing concentration of oxygen in Si1−xGexOy. A suitable atomic composition of Si1−xGexOy for uncooled infrared detector applications was found to have a TCR of − 5.10%/K.
Democracy and Maturity: Deciphering Conditional Effects on Levels of Dispute Intensity

A good deal of recent research has focused on the possible dangers associated with young democracies that are trying to weave their way through modern interstate relations for the first time. Democratic transitions, and their immediate aftermath, have been isolated as periods plagued by all sorts of potential conflict. Further, some studies implicitly suggest that the maturity of the regime may matter at least as much as the type of regime. This research directly examines the interactive effects of both joint democracy and joint maturity on the levels of intensity reached in militarized conflict. The findings reveal the conditional importance of both factors. Joint democracy imparts disparate effects on the hostility intensification of disputes, in terms of direction and magnitude, depending on maturity levels. Similarly, the magnitude of the joint maturity impact is contingent on democracy levels, although the direction of its influence remains unchanged across varying degrees of democracy. These findings signal the necessity of explicitly considering linkages between the effects of regime type and regime maturity in theories and tests of dyadic conflict dynamics.
Staggered In Time Coupling of Reservoir Flow Simulation and Geomechanical Deformation: Step 1 - One-Way Coupling

An isothermal, implicit, mixed finite element black oil reservoir simulator from the University of Texas is coupled to an explicit, quasistatic, nonlinear finite element solid mechanics code from Sandia National Laboratories. Both codes are 3d and parallel. The former models (in a locally conservative manner) the flow of oil, gas, and water fluid phases in the reservoir while the latter has been specialized to solve large-scale geomechanics problems involving significant inelastic deformations. In this paper we illustrate a uni-directional coupling of the two codes in which flow simulation output (pore pressures) from a 10-year test case based on the Belridge Field in California drives the geomechanics simulation for the same time period. The highporosity, low-permeability Belridge diatomite undergoes significant compaction including 6 feet of vertical displacement at the top of the reservoir.
The Effects of Frequency and Temperature on Water Tree Degradation of Miniature XLPE Cables

This paper presents results of water treeing aging tests on miniature crosslinked polyethylene cables. To produce the water trees, the cables were immersed in water and subjected to HV at frequencies of 600, 400, and 1000 Hz. The times to breakdown and ac ramp breakdown voltages after preset times of aging were measured. The effect of temperature cycling was also examined. The ac ramp voltage was found to be a good indicator of the severity of water tree degradation at room temperature as the time to breakdown distributions correlated well with a reduction in the ac ramp breakdown voltage. Temperature cycling of the cables increased the number and the lengths of bow-tie trees compared to room temperature aged cables but decreased the number of vented trees. Correlation between ramp breakdown voltages and times to breakdown was poor for temperature-cycled cables. Microscopic examinations of some of the breakdown channels and possible causes of the different mechanisms of breakdown as the final stage of aging are discussed.
A Care Management Model for Enhancing Physician Practice for Alzheimer Disease in Primary Care

Previous research has indicated that passive distribution of educational material by itself has little impact on physician behavior. In this paper, a collaborative care management program for the treatment and management of dementia in primary care (The PREVENT Study) is described. The essential components of the integrated program are: 1) a comprehensive screening and diagnosis protocol; 2) a multidisciplinary team approach coordinated by a geriatric advance practice nurse; and 3) a proactive longitudinal tracking system. The key role of the geriatric nurse practitioner is emphasized. While the clinical trial is still on-going, we can report that the intervention has been well received by primary care physicians, patients and their families.
Managing the paradox of inter‐firm learning: the role of governance mechanisms

Organizational learning in inter‐firm exchange relationships poses a double‐edged sword. On one hand, inter‐firm learning is a desirable extension of organizational learning, developing a firm’s knowledge base, and providing fresh insights into strategies, markets, and relationships. On the other hand, inter‐firm learning can lead to unintended and undesirable skills transfer, resulting in the potential dilution of competitive advantage. This risk can be exacerbated by disparities in inter‐firm learning, resulting in uneven distribution of benefits and risks in the collaborative relationship. This paper articulates these two different views on inter‐firm learning, and second, develops a framework for the role of governance in regulating knowledge transfer. In particular, appropriate governance mechanisms must be crafted which match the learning intentions of the partners, the type of knowledge sought, and the designed duration for the collaboration, so as to maximize the benefits of learning while minimizing the risks. Implications for strategy and future research are offered.
Habitat‐independent spatial structure in populations of some forest birds in eastern North America

Summary The extent to which populations fill available ecological space is critical to evaluating niche-based theories of community assembly, but habitat suitability for populations is difficult to assess. The absence of a species from areas of otherwise suitable habitat might indicate localized species-specific influences, including biological interactions with competitors, consumers or pathogens, on local population persistence. I used Bray–Curtis ordination axis scores, based on the distributions of forest birds across census plots in eastern North America, as proxies of general features of habitat suitability to predict local abundances of each species of small land bird. I then applied spatial analysis to identify significant spatial structure (Moran's I) in residuals (positive or negative) from predicted local densities, which would indicate localized species-specific influences on population size. Fifty-eight of 79 species exhibited no significant spatial structure in residual abundances, indicating that the ordination axes reflect most of the spatial variation in environmental conditions and habitat characteristics that influence population distribution and density or that samples were too small to detect significant spatial variation. Twenty-one species exhibited significant habitat-independent spatial structure of residuals within distances of 100 km. Aggregations of residuals for these species were independently located, for the most part, and thus probably unrelated to general features of the environment that affect many species. Among factors considered as potential causes of spatial anomalies, positive density dependence (Allee effects), intraspecific social aggregation and area sensitivity in response to forest fragmentation find little support in this analysis. Because of the species-specific nature of these clustered residuals, specialized pathogens are potential candidates to drive spatial anomalies in host abundance.
Analytical characterization of the divided-chamber combustion process

Theoretical analysis of the divided-chamber, two-stage combustion process has demonstrated the effect of several design and operating variables on engine-exhaust emissions. The divided combustion-chamber design, which has been described in several recent publications, produces a timed staging of the combustion process. The basis for pollutant reduction is division of the combustion space into two regions, a primary chamber to which a fuel—air mixture is supplied and a secondary chamber containing only air. Combustion products issuing from the primary chamber into the secondary chamber are quenched by the low-temperature secondary air with consequent suppression of nitric oxide formation reactions. The present work has involved digital computer analysis of the divided-chamber-combustionprocess. The analysis has been based on a two-system thermodynamic model in which the primary and secondary chambers are represented as separate thermodynamic systems coupled by mutual mass flow. Stepwise solution of the time-dependent mass- and energy-conservation equations together with associated gasdynamic and chemical rate equations yields the histories of primary and secondary chamber thermodynamic properties and chemical compositions. The results demonstrate major effects of relative primary chamber volume and of dividing orifice area on exhaust emission of nitric oxide.
Parallel immunoassays on HydroGel biochips using microspot arrays

Parallel immunoassay enable simultaneous detection of many analytes forma small volume of sample fluid. The use of exceedingly small quantities of capture antibody immobilized in microspots facilitates ambient analyte assay conditions. Under these assy conditions, the fractional occupancy of capture antibody is independent of sample volume. Analyte concentrations are thus measured with greater sensitivity and potentially greater speed. The small drop size delivered by the Packard BioChip Arrayer, a non-contact piezoelectric robotic dispenser, enables the production of arrays consisting of high reproducible microspots of antibodies. The Packard HyrdoGel coated slide is a porous substrate based on a polymer matrix that provides a 3D hydrophilic environment similar to free solution suitable for biomolecular interactions. This substrate has been used to develop fluorescence-based detection immunoassay in multiplex with high sensitivity and offers advantages of increased probe capacity, functionality and accessability for other biomolecular screening applications. Images are captured with the ScanArray confocal laserscanner, which offers the use to choose from a wide range of fluorescent dyes with high resolution and sensitivity, and analyzed with QuantArray microarray analysis software, which enables researchers to easily and accurately visualize and quantitate gene expression and proteomics data.
The early definitive diagnosis of patients with congenital heart disease

Summary Five reasons have been presented to support the concept of early definitive diagnosis of patients with congenital heart disease: 1. The high morbidity and mortality rates for such patients during the infancy period. 2. The early age at which certain operable lesions reach the stage of inoperability by present methods. 3. The apparent increased tolerance of the young patient's heart for corrective or palliative surgery. 4. The psychological advantages in early amelioration of cardiovascular signs and symptoms. 5. The greater potential for return of the cardiac status toward the normal with early surgery.
Safe Use of Opioids in Individuals with Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a chronic breathing disorder that contributes to many other health problems (Epstein et al., 2009). It is present but undiagnosed in a large percentage of the population (Adesanya, Lee, Grilich, & Joshi, 2010). Pain is recognized as a public health problem in the United States, affecting millions of people of all ages (Committee on Advancing Pain Research, Care, and Education Board on Health Sciences Policy, 2011). Because of the high prevalence of both OSA and pain, it is very likely that an individual will have both conditions. Opioid analgesics used to treat pain may cause sedation and respiratory depression by themselves. When administered to individuals with OSA, the risk for harmful respiratory events increases. This article reviews the assessment and monitoring needed to administer opioids safely to individuals with OSA and identifies best practices from a review of the literature.
The Role of Policy in the Prevention of Personal Health Record (PHR) Market Failure

ABSTRACT The Personal Health Record market in the U.S. is in a precarious state. Personal Health Records represent an innovative new way for consumers to manage personal medical records and health information, especially as the healthcare market moves towards a patient-centric model, but major Personal Health Record policy deficiencies in the areas of privacy, value appropriation, and interoperability may lead to market failure if not proactively addressed. We analyze and discuss the Personal Health Record market and related polices and suggest that a balanced social contract represents an optimal solution to current market inefficiencies.
Utility of punch biopsy for lesions that are hard to aspirate by conventional fine‐needle aspiration

BACKGROUND Fine-needle aspiration (FNA) is a fast, reliable, and cost-efficient technique for diagnosing palpable masses. However, when the lesion is small, dermal in location, shallow in depth, or fibrotic, the cellular yield by FNA may be limited and thus hinder an accurate diagnosis. The authors examined the value of punch biopsy (PB) in diagnosing such hard-to-aspirate lesions. METHODS The authors reviewed 49 PB specimens from 47 patients who presented in their FNA clinic from June 1994 to July 1997. RESULTS The lesions were typically described as ill-defined erythematous skin lesions or as papules or small, firm, subcutaneous nodules (average size, 0.7 cm). Patients' previous history included breast carcinoma (in 36 cases), nonmammary carcinoma (in 3 cases), melanoma (in 2 cases), squamous carcinoma of the skin (in 2 cases), cutaneous T-cell lymphoma (in 2 cases), small lymphocytic lymphoma (in 1 case), and no history of malignancy (in 1 case). PB sites included chest wall, breast, extremities, abdominal wall, neck, back, scalp, and forehead. Of the 37 cases in which FNA was performed before PB, 21 aspirates (57%) were nondiagnostic because of scant cellularity, 11 aspirates (31%) were positive (9) or suspicious/atypical (2) for malignancy, and 5 aspirates (14%) were negative for malignancy. Seventeen (81%) of the 21 nondiagnostic aspirates and 10 of the 11 suspicious/atypical aspirates were positive for malignancy on PB specimens. Twelve PBs were done without prior FNA, 8 (67%) were positive for malignancy, and 4 (33%) were negative. In 7 patients, the findings from the PB specimens (new diagnosis of malignancy in 5 cases and recurrence of disease in 2 cases) led to surgical excision of the lesion. CONCLUSIONS PB is a valuable adjunct to FNA for diagnosing hard-to-aspirate lesions. Cancer (Cancer Cytopathol) 1999;87:149–54. © 1999 American Cancer Society.
Rapid incorporation of carbon from fresh residues into newly formed stable microaggregates within earthworm casts

Summary Earthworms play an important role in protecting carbon in the soil, but the exact influence of their activity on the distribution and protection of C is still poorly understood. We investigated the effect of earthworms on the formation of stable microaggregates inside newly formed macroaggregates and the distribution of C in them. We crushed ( 250 µm) formed. The 13C in fine particulate organic matter between and within the microaggregates was determined. Earthworms helped to form large macroaggregates (> 2000 µm). These large macroaggregates contained four times more stable microaggregates than those from samples without earthworms. There was more particulate organic matter within and between microaggregates in macroaggregates in the presence of earthworms. The larger amounts of organic matter inside stable microaggregates in casts than in bulk soil after 12 days of incubation (140 mg 13C kg−1 soil compared with 20 mg 13C kg−1 soil) indicates that these microaggregates are formed rapidly around freshly incorporated residues within casts. In conclusion, earthworms have a direct impact on the formation of stable microaggregates and the incorporation of organic matter inside these microaggregates, and it seems likely that their activity is of great significance for the long-term stabilization of organic matter in soils.
Race/ethnicity and depressive symptoms: a cross-cultural/ethnic comparison among university students in East Asia, North and South America.

Abstract To examine manifestations of depressive symptomatology among undergraduate students in East Asia, North and South America, responses to the Center for Epidemiologic Studies Depression Scale (CES-D) were compared across Japanese ( n =310), Anglo-American ( n =377), Native American ( n =353), and Argentinean ( n =110) undergraduate students. Japanese reported a significantly higher level of low positive affect, leading to significantly higher total CES-D scores, whereas their negative symptoms score was comparable to scores of Anglo-Americans and Argentineans. Although Native Americans were more likely to endorse negative symptoms, their low positive affect score was comparable to those of Argentineans. Argentineans appear to suffer less from depressive symptoms. Results from a Differential Item Functioning analysis, using Anglo-Americans as the reference group, indicated that: (1) the manifestation of depressive symptoms seemed to be similar for Anglo-Americans and Argentineans, except for low positive affect; (2) Native Americans tended to favor somatic symptoms over affective (depressive) symptoms; (3) responses to positive affect questions could possibly be biased not only for Japanese but also for people in North America; i.e., the expression of positive affect might be enhanced in North American culture, while inhibited in Japanese culture.
New feel for new phyla.

According to the dictionary, the Latin term ‘phylum’ comes from Greek phylon (ϕũλov), which means ‘race, tribe or clan’ and is unrelated to either philia (ϕiλiα) meaning ‘love, affection’ or to the ‘feel’, which comes from Old English felan ‘to touch’. These similarly sounding words illustrate a key problem of systematic microbiology: How can we extract useful information from short sequence fragments and not be swayed by superficial similarities? One of the most useful approaches has been binning together sequences from related microorganisms, even if the nature of these organisms remained unknown. This resulted in a number of candidate microbial phyla that still have no cultivated representatives (Hugenholtz et al., 1998). Extensive sequencing has been the only way to get a ‘feel’ of these organisms, find out at least some information about their physiology and distribution in the environment. The ultimate goal, of course, is to get a complete genome sequence of the previously uncharacterized organism and use the power of comparative genome analysis to deduce its features.