cssi/SciSciGPT-SciSciNet huggingface dataset:
The association between glaucoma prevalence and supplementation with the oxidants calcium and iron.

Glaucoma is a chronic and irreversible optic neuropathy, characterized by the progressive loss of retinal ganglion cells.1,2 The only confirmed modifiable risk factor for glaucoma is intraocular pressure (IOP); consequently, the goal of all current medical and surgical therapies for this disease is to reduce IOP. The identification of modifiable risk factors other than IOP may provide additional therapeutic targets that would be valuable in the management of patients, particularly those who continue to show substantial progression despite significant lowering of IOP. A body of research has focused on elucidating the role of oxidative stress in the pathogenesis of neuronal death as well as aqueous humor outflow,3 with particular interest in the role that oxidants such as calcium and iron may play in disease pathogenesis. Iron is a potent oxidant that accumulates with aging and catalyzes the creation of highly reactive hydroxyl radicals, which can cause oxidative damage to DNA and adjacent lipids and proteins. In vitro studies have suggested that iron regulation plays a role in glaucoma's pathogenesis both in retinal ganglion4 and trabecular meshwork (TM)5 cells. Dysregulation of calcium homeostasis has also been implicated in some neurodegenerative diseases,6 including glaucoma.7 One study found that human TM cells from donors with glaucoma were defective in mitochondrial function, resulting in abnormal sensitivity to calcium-induced stress.8 Impaired calcium regulation and calcium overload have been found in lamina cribrosa cells of donors with glaucoma,9 and intriguing yet controversial evidence suggests that treatment of glaucoma patients with a calcium channel blocker may slow loss of visual fields.10 These previous animal and preliminary human studies have offered potential roles that calcium and iron may play in oxidative stress and the pathogenesis of glaucoma. However, there have been no epidemiologic studies investigating the relationship of calcium or iron consumption with glaucoma. The National Health and Nutrition Examination Survey (NHANES) is an annual national population study conducted by the Centers for Disease Control and Prevention (CDC) designed to assess the health status of the U.S. population. It not only includes an extensive interview related to a variety of health conditions and medication use, but a physical examination component as well, which includes a visual acuity examination and objective refraction. In addition, the 2007–2008 data release of NHANES included a calculated intake of a variety of nutrients from a detailed interview of participants' use of dietary supplements. We have used this extensive, nationally representative sample to study the association between glaucoma and the consumption of calcium and iron through dietary supplements.
Aspect diversity in moths revisited.

Abstract: Ricklefs and O’Rourke compared the diversity of appearance (aspect diversity) in samples of moths attracted to ultraviolet lights in Colorado, Arizona, and Panama. The more species‐rich Panamanian assemblage of moths exhibited proportionately greater diversity of color and form, which supported stronger frequency‐dependent selection by predators to diversify the strategies that moths adopt to achieve crypsis in an ecological space composed of resting backgrounds. Comparable analyses of 15 additional samples obtained from Ecuador to Canada fail to support Ricklefs and O’Rourke’s original result. In the present analysis, two measures of the volume of aspect space were unrelated to the number of species per sample and did not differ between temperate and tropical localities. Either frequency‐dependent (apostatic) selection is not a powerful force in diversifying moth appearance, or it does not vary with latitude, or potential resting backgrounds and cryptic strategies are similarly constrained in t...
GROUP 2 COMPLEXES OF 2,4,6-TRIMERCAPTOTRIAZINE (TMT)

The 2,4,6-trimercaptotriazine (TMT) ligand system is currently being used as a complexing agent for divalent metals although little is known about its chemistry. This report entails a description of the syntheses and structures of TMT complexes having the formula M(TMTH2)2·nH2O (M = Ca (1), Sr (2), and Ba (3), where n = 11, 11, and 4.5, respectively). In 1 and 2, the structures consist of alternating layers of hydrated metal cations and π-stacked TMT groups. A wide range of hydrogen-bonding interactions connect these layers. Compound 3 forms as a polymeric molecule with covalent bonds between the Ba atoms and TMT ligands. Each of the compounds was structurally characterized. X-ray data: 1, C24H104Ca4N24O44S24, triclinic, P1, a = 12.9622(7) A, b = 15.9874(9) A, c = 24.516(1) A, α = 81.191(1)°, β = 89.560(1)°, γ = 72.433(1)°, Z = 2; 2, C6H26N6O11S6Sr, triclinic P1, a = 8.7454(5) A, b = 11.7545(6) A, c = 13.7292(7) A, α = 66.529(1)°, β = 73.201(1)°, γ = 77.034(1)°, Z = 2; 3, C12H18Ba2N12O9S12, monoclinic,...
Vaccination with Alum-Precipitated Recombinant Ancylostoma-Secreted Protein 1 Protects Mice against Challenge Infections with Infective Hookworm (Ancylostoma caninum) Larvae

Ancylostoma-secreted protein 1 (ASP-1) is the major protein secreted by infective hookworm larvae (Ancylostoma caninum). The Escherichia coli-expressed recombinant protein was evaluated as a vaccine antigen in a mouse model of ancylostomiasis. A. caninum larvae migrate through mouse lungs, with maximal migration occurring 48 - S4 h after oral infection. Quantitative larval recovery from the lungs at this time was used as an end point for vaccine evaluation. All mice developed antibodies to recombinant ASP-1 (rASP-1) after immunization and boosting with the alum-precipitated protein. The immunized mice had their worm burden reduced 79% (P < .0001) compared with controls. Immunization with rASP-1 in the presence of Corynebacterium parvum adjuvant also showed a vaccine effect (63% protection; P < .0001). The possibility that this protective effect resulted from delayed larval lung entry was excluded. rASP-l offers promise as a hookworm vaccine antigen. Hookworm disease is a leading cause of anemia and malnu­ trition in the less-developed countries of the tropics [I]. Be­ cause patients in endemic areas reacquire hookworm infections within months after receiving antihelmintic drug therapy [2], there is a need for alternative control methods. We have pro­ posed prevention of hookworm disease through vaccination with genetically engineered molecules derived from the infec­ tive larval stage of the parasite [3]. Our rationale for focusing on antigens from this life history stage is based on a body of previous investigative work showing that laboratory animals can be partially vaccinated by successive inoculations of infec­ tive larvae [4]. Our goal is to develop a recombinant vaccine that achieves or surpasses the protective effect obtained with previously described live attenuated larval vaccines. The lead candidate vaccine antigen is a molecule known as Ancylo­ stoma-secreted protein (ASP), which we have renamed ASP­ I because we have since discovered that it belongs to a family of related molecules.
An Analysis of Vocational Rehabilitation Services for Consumers with Hearing Impairments Who Received College or University Training.

The purpose of this study was to determine the predictive ability of vocational rehabilitation services for deaf and hard of hearing consumers who received college and university training. The RSA-...
Studying physician effects on patient outcomes: Physician interactional style and performance on quality of care indicators

Many prior studies which suggest a relationship between physician interactional style and patient outcomes may have been confounded by relying solely on patient reports, examining very few patients per physician, or not demonstrating evidence of a physician effect on the outcomes. We examined whether physician interactional style, measured both by patient report and objective encounter ratings, is related to performance on quality of care indicators. We also tested for the presence of physician effects on the performance indicators. Using data on 100 US primary care physician (PCP) claims data on 1,21,606 of their managed care patients, survey data on 4746 of their visiting patients, and audiotaped encounters of 2 standardized patients with each physician, we examined the relationships between claims-based quality of care indicators and both survey-derived patient perceptions of their physicians and objective ratings of interactional style in the audiotaped standardized patient encounters. Multi-level models examined whether physician effects (variance components) on care indicators were mediated by patient perceptions or objective ratings of interactional style. We found significant physician effects associated with glycohemoglobin and cholesterol testing. There was also a clinically significant association between better patient perceptions of their physicians and more glycohemoglobin testing. Multi-level analyses revealed, however, that the physician effect on glycohemoglobin testing was not mediated by patient perceived physician interaction style. In conclusion, similar to prior studies, we found evidence of an apparent relationship between patient perceptions of their physician and patient outcomes. However, the apparent relationships found in this study between patient perceptions of their physicians and patient care processes do not reflect physician style, but presumably reflect unmeasured patient confounding. Multi-level modeling may contribute to better understanding of the relationships between physician style and patient outcomes.
Anomalous stark effects in the millimetre wave spectrum of formyl fluoride

Measurements of Stark effects in the rotational spectra of formyl andd-formyl fluoride show the presence of anomalous components that vary in strength with the field. They occur predominantly at high fields and may possibly be a molecular polarisability effect. In addition the normal molecular dipole moment is found to be (1.99±0.03)D, oriented almost parallel to the C-H bond and at an angle of 79° to the C-F bond. This is discussed in connection with the molecular structure.
Evidence for Helically Kinked Magnetic Flux Ropes in Solar Eruptions

Images of the X-ray corona near the solar disk's center were examined for large, transient brightenings of the type known to be associated with Hα filament eruptions and coronal mass ejections. Many of the brightenings were sigmoid (S-shaped). The measured ratios of length to width of the sigmoid features are shown to be consistent with ratios predicted by a simple model based on a kinked and twisted magnetic flux rope. Many of the studied sigmoid brightenings evolved into arcades of bright loops. Such arcades are often associated with coronal mass ejections, and it is suggested that the cause of the ejections is an MHD helical kink instability in the Hα filament/coronal arcade complexes. Reverse-S brightenings outnumbered forward-S brightenings by six to one in the northern hemisphere. Forward-S brightenings were similarly predominant in the south. This hemispherical segregation suggests that the magnetic fields in the transient features are systematically twisted. Globally, the implied distribution of magnetic helicity is similar to the distribution that Martin et al. discovered in quiescent Hα filaments.
Two internal thoracic artery grafts are better than one.

Abstract Objective: Does the use of bilateral internal thoracic artery (ITA) grafts provide incremental benefit relative to the use of a single ITA graft? Methods: We conducted a retrospective, nonrandomized, long-term (mean follow-up interval of 10 postoperative years) study of patients undergoing elective primary isolated coronary bypass surgery who received either single (8123 patients) or bilateral ITA grafts (2001 patients), with or without additional vein grafts. Multiple statistical methods including propensity score matching, and multivariable parsimonious and nonparsimonious risk factor analyses were used to address the issues of patient selection and heterogeneity. Results: In-hospital mortality was 0.7% for both the bilateral and single ITA groups. Survival for the bilateral ITA group was 94%, 84%, and 67%, and for the single ITA group 92%, 79%, and 64% at 5, 10, and 15 postoperative years, respectively ( P Conclusions: Patients who received 2 ITA grafts had decreased risks of death, reoperation, and angioplasty. (J Thorac Cardiovasc Surg 1999;117:855-72)
Regional anesthesia and pain medicine: residency training--the year 2000.

Background and Objectives A survey of anesthesiology training programs in 1980 reported the use of a regional anesthetic technique in 21.3% of cases. A similar survey of anesthesiology training programs in 1990 reported that the use of regional anesthetic techniques had increased to 29.8%. Over the ensuing 10 years, additional changes have occurred in the field of anesthesiology and its United States residency training programs. This manuscript reports the impact these changes have had on the use of regional anesthesia techniques in residency training programs in the year 2000. Methods Blinded cumulative data about regional anesthetic techniques performed by anesthesiology residents were obtained from all annual training report forms submitted to the Residency Review Committee for Anesthesiology. Exposure to obstetric (OB) anesthesia, pain management, and a resident’s year-in-training were analyzed as independent factors expected to influence the use of regional anesthesia. Results Aneswthesiology trainees used a regional anesthesia technique in 30.2% of cases in the year 2000. This represents an insignificant change from 1990 and a marked slowing in the growth of regional anesthesia techniques compared with the 1980 to 1990 period. The use of regional anesthesia remains strongly correlated with a resident’s exposure to OB anesthesia and pain consultations. Variability in exposure to regional anesthesia techniques among individual residents has decreased. Conclusions Anesthesiology training programs now appear to provide a satisfactory exposure to regional anesthesia for a majority of resident trainees, although 40% of residents may still be deficient in nerve block anesthesia. The growth in the use of regional anesthesia during residency has plateaued over the past decade, but the discrepancy between individual resident experience has improved.
"One-way-out": contraflow freeway operation for hurricane evacuation

Over the past 20 years, the coastal population of the southeastern United States that is vulnerable to hurricanes has increased significantly. Much of the recent planning and construction of infrastructure in these regions has taken place during a two-decade lull in hurricane activity. It is now apparent that these areas are not all suitably equipped to deal with the threat of severe hurricanes. As a result, a significant percentage of the coastal population is forced to evacuate under the threat of major hurricanes. This has been demonstrated recently during Hurricane Floyd in 1999 and during Hurricane Georges in 1998. One method suggested to meet the need to evacuate large numbers of people in a rapid and efficient manner is to contraflow segments of interstate freeway. Under contraflow operation, some or all inbound lanes of a freeway are used for outbound evacuation. While the concept is simple, implementation is complex. This paper discusses the advantages and disadvantages of contraflow operation on freeways during hurricane evacuations, including the capacity benefits, critical planning, design, and operational issues, and current contraflow operation plans from threatened states. The paper also provides a list of recommendations and needs that should be considered in the planning and implementation of contraflow evacuations.
Sterile, caseous mitral anular abscess

Echocardiography identified three patients with a mitral anular mass. Fluoroscopy demonstrated a faint, homogeneous intracardiac calcific density in each patient. Cardiac catheterization and angiography were performed and showed no left ventricular inflow or outflow obstruction. One patient died suddenly and two patients had cardiac surgery (one for mitral regurgitation and another for constrictive pericarditis). Examination demonstrated that each mass was nonencapsulated, sterile and acellular and contained cholesterol, calcium and fatty acids. The clinical significance and cause of these masses are unclear at present.
Evidence that NPY-containing neurons in the brainstem project into selected hypothalamic nuclei: implication in feeding behavior.

Abstract Recent studies show that bilateral neural transections (NT) at the level of dorsal tegmentum in the mesencephalon significantly increase food intake and decrease latency to onset of feeding behavior in response to neuropeptide Y (NPY). The increased responsiveness to NPY may be due to denervation-induced hypersensitivity to NPY in hypothalamic sites that mediate feeding behavior in rats. To test this hypothesis we have studied the effect of NT on NPY concentrations in 7 neural sites of male rats. Two weeks after NT, NPY levels in 3 hypothalamic nuclei—suprachiasmatic nucleus, arcuate nucleus and ventromedial hypothalamus—were not altered by NT thereby suggesting that NPY innervations in these nuclei may be derived mainly from NPY perikarya in the ARC and elsewhere in the diencephalon. On the other hand, NPY concentrations were markedly decreased (50–60%) in the medial preoptic area, paraventricular nucleus, median eminence and dorsomedial nucleus indicating that a substantial number of neurons in the brainstem, which show coexistence of NPY and adrenergic transmitters, project into these 4 diencephalic nuclei. These findings indicate that NPY-containing neurons in the brainstem may project into selected hypothalamic sites and the reduction in the NT rats of NPY levels, especially in the paraventricular nucleus, may be responsible for the reported increase in sensitivity of the NPY-induced feeding response.
Coupling kinetics of the photorefractive hologram

The coupling kinetics of a reflection-type photorefractive hologram are studied, and we have found that the coupling between the adjacent channels increases as the reading time is prolonged. Our study-shows that the reading beam is modulated by the grating in another channel for which it produces a weak backscattered light. As the backward-scattered light interacts with the reading beam, a new grating is formed; it in turn amplifies the backscattered light. Therefore the coupling increases rapidly compared with the normal fanning process. We have used Kukhtarev’s charge-transport model to evaluate the time evolution of coupling. The calculated results are consistent with the experimental observation.
Further Evaluation of the Skin Test for Filariasis in Man, based on Results obtained in British Guiana.

by us in comparative tests with antigens of different dilutions. The particular features of our test as finally recommended and the conditions under which it was conducted were that: (1) a dose of 0.02 ml of a 1:100,000 dilution of Dirofilaria immitis antigen was employed; (2) a corresponding concentration of dog serum was used as a control; (3) early and doubtful cases of filariasis, and individuals who had been in endemic areas, constituted the test group; and (4) a large number of persons, most of whom were allergic to various substances, but none of whom had ever lived in an endemic area, constituted the control group. It was concluded that a dilution of 1:100,000 of D. immitis in saline, in a dose of 0.02 ml, was a suitable antigen for the diagnostic test for filariasis.
Hematologic complications of primary immune deficiencies

Primary immune deficiencies have an estimated overall incidence of 1 in 10,000 individuals. These disorders are diverse, depending on the specific immune functions involved, and lead to chronic or recurrent infections, inflammatory conditions, and a variety of autoimmune diseases. The most common autoimmune disorder is immune thrombocytopenic purpura (ITP), followed by autoimmune hemolytic anemia (AHA). While cytopenias are common in all the congenital immune diseases, they are particularly common in the antibody defects, common variable immunodeficiency and selective immunoglobulin A deficiency. In common variable immunodeficiency, ITP occurred in 7.6% of the patients and AHA in 4.8%. Treatment options include corticosteroids, intravenous immunoglobulin (i.v.Ig), anti-D, and splenectomy. Although the association between cytopenias and congenital immune deficiency is unclear, defects in T-cell regulation, cytokine defects, abnormal apoptosis, and abnormal production of immunoglobulins with autoimmune features are potential mechanisms.
Antagonistic interactions among nephrotoxic polycyclic aromatic hydrocarbons.

Although the liver and pulmonary toxicity of polycyclic aromatic hydrocarbons (PAHs) has been extensively characterized, limited data concerning the nephrotoxic potential of these chemicals are available. The present studies were conducted to define the kidney cell-specific toxic responses to anthracene (ANTH), benzo[a]pyrene (BaP), and chrysene (CHRY). Given that exposure to environmental chemicals from a specific source is rarely limited to a single compound, a second goal was to evaluate the nephrotoxic potential of binary and ternary mixtures of these chemicals. Cultured rat glomerular mesangial cells (rGMCs) and porcine cortico-tubular epithelial kidney cells (LLCPK-1) were challenged with hydrocarbon concentrations ranging from 0.03 to 30 µ M for up to 24 h and were processed for measurements of mitochondrial membrane permeability, trypan blue dye exclusion, cytoplasmic enzyme leakage, and protein synthesis. BaP induced a threefold increase in mitochondrial fragility, a modest increase in cellular d...
Clonal Analysis of Sacrococcygeal “Teratomas”

Congenital masses of the sacrococcygeal region commonly contain multiple tissues and have variously been subclassified as neoplasms or congenital hamartomas based on clinicopathological and embryological observations. We have used a polymerase chain reaction-based assay for nonrandom X chromosome inactivation to infer the clonality of three congenital sacrococcygeal tumors previously diagnosed as teratomas. One solid immature teratoma was monoclonal, and a predominantly cystic histologically mature mass was polyclonal. A third immature teratoma was noninformative because of baseline asymmetry of polyclonal tissue X inactivation. We confirm that immature teratomas at this site appear to be monoclonal neoplasms and suggest that at least some histologically mature “teratomas” are more appropriately classified as hamartomas.
Morphology and synaptic connections of unmyelinated primary axons in the border zone of rat trigeminal nucleus oralis

This anterograde horseradish peroxidase study examines the morphology and synaptic connections of a population of primary axons which terminate in the dorsal one-half of the border zone (BZ) of rat trigeminal nucleus oralis. Unmyelinated parent fibers in the spinal V tract enter BZ directly and each terminate by continuing as a sparsely branched, long caudally directed strand containing several axonal endings. Primary endings lie in glomeruli where each forms an asymmetrical synapse on a central dendrite. Other glomerular components include two types of non-primary endings. One contains flattened synaptic vesicles, and forms a symmetrical synapse on either the primary ending or the central dendrite, while the other contains pleomorphic synaptic vesicles and establishes a symmetrical synapse on the central dendrite.
Continuous separation of biomolecules by the laterally asymmetric diffusion array with out‐of‐plane sample injection

The laterally asymmetric diffusion array, a biomolecule sorting device, was used to continuously separate a mixture of T2 and T7 coliphage DNA molecules into its constituents. A two-dimensional array of obstacles (in the presence of an average flow v) can be used to rectify the Brownian motion of particles (in this case DNA molecules) so that they diffuse preferentially in one direction, and perpendicular to the direction of the applied field (in this case an electric field). This type of device had not yet been used for actual fractionation of biomolecules, due to difficulties in injection of the sample. Here we show that with a new injection strategy a well-defined, narrow and continuous stream of molecules can be injected into the separation channel, thus enabling this separation technique to be used in a working device. We expect this type of device could now be employed for separation of a variety of different biomolecules, ranging from long dsDNA to small proteins.
Recombination experiments on the odontogenic roles of mouse dental papilla and dental sac tissues in ocular grafts.

Abstract First molar tooth germs were dissected from mandibles of mouse embryos 16, 17, 18 and 19 days of gestational age. The tooth rudiments were separated into dental papilla, dental sac and enamel organ after enzymic digestion. These embryonic dental tissues were recombined and grown for 4 weeks in anterior chambers of eyes of homologous adult mice. The removal of the dental sac from recombinations of only dental papillae and enamel organs did not significantly alter the proportion of grafts which formed teeth when compared with those grafts which consisted of all 3 dental tissues. Both groups of recombinants formed teeth in 50–80 per cent of the grafts cultured. The dental papilla and dental sac tissues showed the same inductive activity with the enamel organ with the 16-day-old tissues. However, the dental papilla cells maintained their inductive capacity for a longer period. Whereas 70 per cent of the 16-day-old tissue recombinations of dental sac and enamel organ formed teeth, only 15 per cent of the recombinations of older ages of the same tissues formed teeth.
Learner Characteristics and Feedback in Tutorial Dialogue

Tutorial dialogue has been the subject of increasing attention in recent years, and it has become evident that empirical studies of human-human tutorial dialogue can contribute important insights to the design of computational models of dialogue. This paper reports on a corpus study of human-human tutorial dialogue transpiring in the course of problem-solving in a learning environment for introductory computer science. Analyses suggest that the choice of corrective tutorial strategy makes a significant difference in the outcomes of both student learning gains and self-efficacy gains. The findings reveal that tutorial strategies intended to maximize student motivational outcomes (e.g., self-efficacy gain) may not be the same strategies that maximize cognitive outcomes (i.e., learning gain). In light of recent findings that learner characteristics influence the structure of tutorial dialogue, we explore the importance of understanding the interaction between learner characteristics and tutorial dialogue strategy choice when designing tutorial dialogue systems.
A network design criterion for estimating selected attributes of the semivariogram

The semivariogram plays a central role in a geostatistical analysis of spatially correlated environmental data. A valid semivariogram model is selected, and the parameters of that model are estimated, before kriging (spatial prediction) of environmental variables is performed. These inference procedures are generally based upon examination of the empirical semivariogram, which consists of average squared differences of data taken at sites lagged the same distance apart in the same direction. In some situations, the investigator may wish to estimate some attributes of the semivariogram more precisely than others. The efficient estimation of such attributes is affected significantly by the spatial configuration of the network of sites where measurements are taken. In this paper, an approach to network design is proposed that emphasizes the utility of the network for estimating selected attributes of the semivariogram. Details are given as to how the approach can be applied to precisely estimate (a) the ratio of nugget effect to sill, (b) a set of compatibility-determining attributes, and (c) a geometric anisotropy. Acid deposition data taken from a sampling network in the eastern United States are used to further illustrate the approach.
Forensic GPR: finite-difference simulations of responses from buried human remains

Abstract Time domain 2.5-D finite-difference simulations of ground-penetrating radar (GPR) responses from models of buried human remains suggest the potential of GPR for detailed non-destructive forensic site investigation. Extraction of information beyond simple detection of cadavers in forensic investigations should be possible with current GPR technology. GPR responses are simulated for various body cross-sections with different depths of burial, soil types, soil moisture contents, survey frequencies and antenna separations. Biological tissues have high electrical conductivity so diagnostic features for the imaging of human bodies are restricted to the soil/skin interface and shallow tissue interfaces. A low amplitude reflection shadow zone occurs beneath a body because of high GPR attenuation within the body. Resolution of diagnostic features of a human target requires a survey frequency of 900 MHz or greater and an increment between recording stations of 10 cm or less. Depth migration focuses field GPR data into an image that reveals accurate information on the number, dimensions, locations and orientations of body elements. The main limitation on image quality is attenuation in the surrounding soil and within the body. 3-D imaging is also feasible.
Multidisciplinary head and neck cancer clinic and adherence with speech pathology.

Objectives: To determine the effect of referral patterns on compliance with speech–language pathology (SLP) treatment of voice and swallowing difficulties in patients with head and neck cancer (HNCA). Study Design: Retrospective cohort study. Methods: Patients with newly diagnosed oropharyngeal HNCA referred for pretreatment SLP evaluation comprised the study population. Compliance was measured by participation in SLP therapy during and after head and neck treatment, as well as by the number of missed and completed visits. Outcomes were compared between patients who were initially evaluated through the multidisciplinary clinic and those evaluated outside of the multidisciplinary clinic format. Results: The final study sample included 118 individuals with oropharyngeal tumors. All patients were treated with primary radiotherapy with or without chemotherapy. Patients evaluated initially through the multidisciplinary clinic had more SLP visits than those who did not participate in the multidisciplinary clinic (mean ¼ 1.8 vs. 0.2, P <.0001). Participation in SLP treatment was significantly greater for patients � 60 years of age (odds ratio [OR] ¼ 2.4, P ¼.032) and for patients who participated in the multidisciplinary clinic (OR ¼ 19.3, P <.0001). Tumor stage, sex, race, marital status, and insurance status were not associated with patient compliance. Multivariate analysis revealed that participation in a multidisciplinary clinic was the only significant variable associated with SLP treatment compliance (OR ¼ 12.9, P <.0001), after controlling for all other variables. Conclusions: Patients evaluated in a multidisciplinary clinic are more likely to comply with SLP treatment recommendations.
Alveolar surfactant subfractions differ in their lipid composition

Alveolar surfactant consists of subfractions which are generated during normal lung function. Although subfractions obtained by differential centrifugation of lung lavage differ in structure, function and protein content, the phospholipid-pattern shows only minor differences. To correlate possible differences in composition between subfractions to their functional properties we did a more detailed analysis of lipid pattern. Subfractions of lung lavages from Wistar rats were obtained by differential centrifugation, lipid classes were separated by thin layer chromatography (TLC). Fatty acids and plasmalogens were determined as methylester and dimethylacetals by gas chromatography, respectively. Cholesterol and vitamin E were determined enzymatically and by HPLC, respectively. The patterns of fatty acids of total lipids and of the molecular species of phosphatidylcholine and phosphatidylethanolamine were very similar among the subfractions. The distribution of individual lavage lipids varied considerably. Three types of subfractions can be distinguished: The two dense subfractions (1000 g and 60,000 g) contain 70-88% of total phospholipids, dipalmitoylphosphatidylcholine, polyunsaturated phospholipids and polyunsaturated fatty acids present in lung lavage. The less dense subfraction (100,000 g) contains 44-60% of total cholesterol, choline plasmalogen, ethanolamine plasmalogen and vitamin E. The 100,000 g supernatant contains 40-50% of total tri-, diacylglycerols and free fatty acids. Our results support the concept that the 1000 g subfraction contains freshly secreted surfactant. The 60,000 g subfraction likely contains the monolayer and freshly secreted surfactant. The 100,000 g pellet probably contains material "squeezed out" from the monolayer at expiration. Most likely, the supernatant contains material destined for removal from the airspace.
The influence of visual feedback and register changes on sign language production: A kinematic study with deaf signers

Speakers monitor their speech output by listening to their own voice. However, signers do not look directly at their hands and cannot see their own face. We investigated the importance of a visual perceptual loop for sign language monitoring by examining whether changes in visual input alter sign production. Deaf signers produced American Sign Language (ASL) signs within a carrier phrase under five conditions: blindfolded, wearing tunnel-vision goggles, normal (citation) signing, shouting, and informal signing. Three-dimensional movement trajectories were obtained using an Optotrak Certus system. Informally produced signs were shorter with less vertical movement. Shouted signs were displaced forward and to the right and were produced within a larger volume of signing space, with greater velocity, greater distance traveled, and a longer duration. Tunnel vision caused signers to produce less movement within the vertical dimension of signing space, but blind and citation signing did not differ significantly on any measure, except duration. Thus, signers do not “sign louder” when they cannot see themselves, but they do alter their sign production when vision is restricted. We hypothesize that visual feedback serves primarily to fine-tune the size of signing space rather than as input to a comprehension-based monitor.
Rate distortion bounds for speech coding based on a perceptual distortion measure (PESQ-MOS)

We develop practical rate distortion bounds for speech coding based on composite source models and the PESQ-MOS distortion measure. Specifically, the bounds and formulated using composite source models for speech, the rate distortion function for Gaussian autoregressive sources, the classical reverse water-filling result, and conditional rate distortion theory, along with a recently devised MSE-to-PESQ_MOS mapping. The resulting rate distortion bounds are shown to lower bound the performance of the AMR, G.729, and G.718 standardized codecs, and based on the tightness of these bounds, to indicate how the performance of voice codecs might be improved.
Perspective: riddles wrapped in enigma.

Six decades of studies on healthcare quality have persisted in rendering the subject difficult to understand or explain to health researchers and policymakers. This article advances three hypotheses about why quality in healthcare is such an enigma. The first concerns problems with the conceptualization of quality. Issues of uncertainty embedded in quality are discussed in the second hypothesis. Finally, difficulties in understanding quality are discussed within a model offered by the sociology of deviance. The article highlights the contribution of each hypothesis and integrates them into a plausible explanatory framework for quality's elusive compre-hensibility.
Estimation of overall survival in an ‘illness–death’ model with application to the vertical transmission of HIV‐1

We derive a nonparametric maximum likelihood estimate of the overall survival distribution in an illness-death model from interval censored observations with unknown status of the nonfatal event. This expanded model is applied to the re-analysis of data from a randomized trial where infants, born to women infected with HIV-1 that were randomly assigned to breastfeeding or counseling for formula feeding, were followed for 24 months for HIV-1 positivity, HIV-1-free survival, and overall survival. HIV-1 positivity, assessed by postpartum venous blood tests, is the interval censored nonfatal event, and HIV-1 positivity status is unknown for a subset of infants due to periodic assessment. The analysis demonstrates that estimation of the overall and the pre- and post-nonfatal event survival distributions with the proposed methods provide novel insights into how overall survival is influenced by the occurrence of the nonfatal event. More generally, it suggests the usefulness of this expanded illness-death model when evaluating composite endpoints as potential surrogates for overall survival in a given disease setting.
Uniform Convergence and the Hahn-Schur Theorem

Let E be a vector space, F as et,G be a locally convex space, b : E × F → G a map such that b(·,y ): E → G is linear for every y ∈ F; we write b(x,y )= x · y for brevity. Let λ be a scalar sequence space and w(E,F) the weakest topology on E such that the linear maps b(·,y ): E → G are continuous for all y ∈ F .A series P j xj in X is λ multiplier convergent with respect to w(E,F) if for each t = {tj} ∈ λ ,t he series P∞=1 tjxj is w(E,F) convergent in E. For multiplier spaces λ satisfying certain gliding hump properties we establish the following uniform convergence result: Suppose P j xij is λ multiplier convergent with respect to w(E,F) for each i ∈ N and for each t ∈ λ the set { P∞=1 tjxij : i} is uniformly bounded on any subset B ⊂ F such that {x · y : y ∈ B} is bounded for x ∈ E .T hen for each t ∈ λ the series P∞=1 tjxij · y converge uniformly for y ∈ B,i ∈ N. This result is used to prove a Hahn-Schur Theorem for series such that limi P∞=1 tjxij · y exists for t ∈ λ,y ∈ F. Applications of these
Treatment of prosthetic tricuspid valve thrombosis with low-dose tissue plasminogen activator

Reprint requesta: Mark L. Cohen, MD, Cardiovascular Division, Box 8086, Washington University School of Medicine, 660 South Euclid Ave., St. Louis, MO. 63110. 4/4/22910 Thrombosis of a prosthetic valve usually is life-threatening and generally requires emergency surgical intervention. Recently, there have been reports of nonsurgical treatment with tissue plasminogen activators (t-PA). In these reports, the doses employed invariably resulted in systemic fibrinogenolysis, and up to a 25 % incidence of bleeding has been reported.‘F2 To investigate the possibility that very low doses of t-PA would be equally efficacious, and by avoiding fibrinogenolysis would be potentially safer, we treated a patient with a thrombus on a St. Jude’s Medical mechanical tricuspid valve prosthesis (St. Jude Medical Inc., St. Paul, Minn.) with small doses of t-PA titrated by careful monitoring of clinical, echocardiographic, and coagulation parameters. The patient was a 30-year-old woman who underwent
Evidence for indirect effects of plant diversity and composition on net nitrification

Abiotic controls on net nitrification rates are well documented, but the potential effects of plants on this important ecosystem process are poorly understood. We evaluated four structural equation models to determine the relative importance of plant community composition, aboveground herbaceous production, and plant species richness on nitrifier abundance and net nitrification following restoration treatments in a ponderosa pine forest. Model selection criteria indicated that species richness was the best predictor of nitrifier abundance, but a model that included community composition effects also had some support in the data. Model results suggest that net nitrification was indirectly related to plant species richness via a positive relationship between species richness and nitrifier abundance. Community composition was indirectly related to nitrifier abundance through its relationship with species richness. Our model indicates that species-rich plant communities dominated by C3 graminoids and legumes are associated with soils that have high abundances of nitrifiers. This study highlights the complexity of deciphering effects of ecological treatments on a system response when multiple interacting factors are simultaneously affected. Our results suggest that plant diversity and composition can both respond to forest thinning, prescribed fire and fuel manipulations, and can be factors that might indirectly influence an ecosystem process such as nitrification. Ecological restoration treatments designed to increase plant diversity and alter community composition may have cascading effects on below-ground processes.
APW-Xα Compton profiles in crystalline rare gases☆

Abstract Augmented Plane Wave, local exchange ( APW - X α) one-electron wave functions have been used to calculate Compton profiles for crystalline Ne at three different lattice constants for two values of the local exchange parameter. Some results for Ar, Kr, and Xe are also presented. The impulse approximation is used. The crystalline calculations are little different from the isolated atom results. A variety of difficulties, primarily due to the energy-dependent nature of the APW basis, are explored. A translational symmetry restriction that is particularly severe for APW calculations of Compton profiles is studied. In all, it is concluded that the APW scheme is ill-suited to the computation of the sort of non-energy quantity represented by a Compton profile.
Intrathecal "microdosing": reality or artifact?

To the Editor, Hamza and colleagues merit commendation for conducting a prospective study on non-cancer-pain patients receiving intrathecal (IT) therapy ⇓ using the concept of “microdosing”—the practice of weaning patients off systemic opioids prior to implanting an IT drug delivery system (IDDS) using very low opioid dosage. A number of elements, however, remain unresolved and unexplained in relation to hypothesis, design, and execution of the current study. The unproven theory of “microdosing” deserves a close look. The premise of placing an IDDS traditionally centered on providing better analgesia with lesser side effects compared with systemic opioids ⇓. However, patients who require higher IT opioid doses at the trial stage receive significantly higher IT opioid amounts after implant than patients needing lower IT trial opioid doses ⇓ and report worse pain scores ⇓. A small retrospective study suggested that “microdosing” results in sustained pain relief without the need for supplemental oral opioid dosages ⇓. Similar findings were encountered in the current study by Hamza and colleagues ⇓. While these findings are significant, it remains unclear why patients who could tolerate being weaned off systemic opioids would need to have an implanted IDDS infusing low-dose IT morphine. Weaned patients may just be managed off …
CONTAMINATION OF BEEF TISSUE SURFACES BY ARTIFICIALLY INOCULATED LOW‐MOISTURE MENSTRUA

Salmonella typhimurium was inoculated into prepared dirt (moisture content 8.8%), sand (moisture content 0.06%) and phosphate buffer, and these menstrua were used to contaminate beef tissue. Fewer bacteria adhered to the tissue surface from the low moisture menstrua when compared to contamination by buffer. Determination of SR values, an estimate of the total population associated with the surface which was physically attached, indicated that more bacteria remained in the soil menstrum than adhered to the surface, when compared to buffer and sand menstrua. Contrary to expectations, bacteria which contaminated the surface from the low moisture menstrua were not more sensitive to organic acids than those which originated from the buffer.
Combinatorial Data Analysis

Combinatorial data analysis (CDA) as a generic term can be discussed within the framework of two distinct tasks of data analysis: exploratory and confirmatory. A confirmatory CDA approach compares some given data set to a specific structure that is conjectured for it a priori; the empirically observed degree of correspondence is evaluated by reference to what could be observed using all possible structures of the same form that could have been conjectured (for example, one-way analysis-of-variance can be viewed as comparing a given structure defined by a partitioning of subjects into groups, to all possible partitions that could have been formed). Alternatively, an exploratory strategy would seek one possible structure from some given class that best fits the given data set. In both cases, the data and the various structures considered are typically coded as matrices; thus, a confirmatory task usually involves an assessment of similar patterning across matrices; an exploratory task seeks to optimize such a pattern of correspondence by locating the most appropriate matrix reorganization.
Angiotensin mediates renal fibrosis in the nephropathy of glycogen storage disease type Ia

Patients with glycogen storage disease type Ia (GSD-Ia) develop renal disease of unknown etiology despite intensive dietary therapies. This renal disease shares many clinical and pathological similarities to diabetic nephropathy. We studied the expression of angiotensinogen, angiotensin type 1 receptor, transforming growth factor-β1, and connective tissue growth factor in mice with GSD-Ia and found them to be elevated compared to controls. While increased renal expression of angiotensinogen was evident in 2-week-old mice with GSD-Ia, the renal expression of transforming growth factor-β and connective tissue growth factor did not increase for another week; consistent with upregulation of these factors by angiotensin II. The expression of fibronectin and collagens I, III, and IV was also elevated in the kidneys of mice with GSD-Ia, compared to controls. Renal fibrosis was characterized by a marked increase in the synthesis and deposition of extracellular matrix proteins in the renal cortex and histological abnormalities including tubular basement membrane thickening, tubular atrophy, tubular dilation, and multifocal interstitial fibrosis. Our results suggest that activation of the angiotensin system has an important role in the pathophysiology of renal disease in patients with GSD-Ia.
THE BIOLOGY OF HARVEYELLA MIRABILIS (CRYPTONEMIALES, RHODOPHYCEAE). VI. TRANSLOCATION OF PHOTOASSIMILATED 14C122

Pulse-chase labelling experiments demonstrate that photoassimilated 14C-bicarbonate is translocated from the host red alga Odonthalia floccosa (Esper) Falkenberg to the parasite Harveyella mirabilis (Reinsch) Schmitz & Reinke. The primary path of translocation is from host cortical cells (the site of photoassimilation) to the erumpent parasite pustule via the zone of interdigitation. The latter is a tissue region in which rhizoidal cells of Harveyella grow between, and establish secondary pit plugs with medullary cells of Odonthalia. A secondary translocation pathway occurs from isolated host cells dispersed in the pustule of Harveyella to adjacent parasite cells.