cssi/SciSciGPT-SciSciNet huggingface dataset:
Bridging the Gap: A 20-Year Experience with Vein Grafts for Free Flap Reconstruction. The Odds for Success.

Background Successful free tissue transfer requires tension-free microvascular anastomosis. Vein grafts are used when this cannot be obtained, which increases microsurgical complexity and the chance of vessel thrombosis. Previous studies on vein grafts are limited to low numbers and selected techniques, making it difficult to draw conclusions. Methods A retrospective chart review was performed for all patients who underwent vein grafts in free flap reconstruction from 1995 to 2015. Information on patient and flap characteristics, returns to the operating room, and flap loss was analyzed. Results Seventy-two free flap reconstructions requiring 122 vein grafts were performed in the genitourinary/perineal (49 percent) and head and neck (38 percent) regions. The majority were performed in the initial operation (82 percent) and, of those, the majority were planned (71 percent). The most common vein graft types used were transposition arteriovenous loops (57 percent) and interpositions (26 percent). Of the initial cases, 22 percent returned to the operating room, resulting in a 7 percent total flap loss rate and a 7 percent partial flap loss rate. On univariate analysis, graft timing/planning, gap type, vein graft type, and reconstruction location were significantly associated with take-backs and flap loss. However, gap type and location seem to be strongly associated with graft timing/planning and vein graft type. Graft type and planning/timing do not have as strong a relationship and seem to independently relate to flap loss. Conclusions Vein grafts are more successful when planned and when performing transpositions and arteriovenous loops over interpositions. These graft types should be considered over interpositions when possible. Clinical question/level of evidence Therapeutic, IV.
Microbial Ecology of Desert Soils

For many years, arid desert soils were considered economically unimportant, and any ecological research, including the examination of microbial characteristics, was sporadic. During the past two decades, however, the economic and agricultural utilization of arid lands has emerged as a critical element in maintaining and improving the world’s food supply; consequently, biological and environmental research on these soils has increased. The expansion of deserts (desertification process) due to human impact, often in combination with adverse climatic disasters, has reinforced the necessity of understanding biological processes in xeric environments. In comparison with the body of knowledge about physical processes and about floral and faunal aspects in marginally utilizable arid areas, relatively little detailed information about arid-soil biological properties exists. Although certain patterns of arid-soil biological properties have emerged from the examination of several desert ecosystems, it is still premature to generalize about soil biological characteristics on a global desert biome level. Considerably more information is available on subhumid and semiarid cultivated soils (Focht and Martin, 1979).
Going parallel with C++11

As hardware designers turn to multi-core CPUs and GPUs, software developers must embrace parallel programming to increase performance. No single approach has yet established itself as the "right way" to develop parallel software. However, C++ has long been used for performance-oriented work, and it's a safe bet that any viable approach involves C++. This position has been strengthened by ratification of the new C++0x standard, officially referred to as "C++11". This interactive workshop will introduce the new features of C++11 related to parallel programming, including type inference, lambda expressions, closures, and multithreading. The workshop will close with brief discussion of other technologies, in particular higher-level, Task-oriented abstractions such as Microsoft PPL.
Monoamine oxidase and oxidative stress at dopaminergic synapses

Increased oxidation of dopamine by monoamine oxidase (MAO) in the striatum is associated with an oxidant stress, expressed as a rise in the level of oxidized glutathione. Oxidation of glutathione is suppressed by MAO inhibitors, such as deprenyl and clorgyline. These observations relate to Parkinson’s disease and to the clinical trial of deprenyl as an agent that may retard progression of the disease.
Change in eating and body related behaviors during the first year of university.

Significant changes in BMI, disordered eating, and body image dissatisfaction occur during the first year of university. However, previous research has not yet isolated the key factors that lead to these changes. This study sought to add to the body of research in this area by investigating students’ eating attitudes, behaviors, body image, and weight at the beginning and the end of the first year of university. Participants were initially 64 male and female university students from two universities: one rural and one urban. Twenty-eight percent of the participants completed assessments at two time points. These included a series of questionnaires designed to measure disordered eating, body image dissatisfaction and weight. These changes were different for males and females. Substantial changes in eating behaviors, attitudes, body image and BMI occur during the first year of university. Concrete knowledge about these changes might help students adapt to university life.
Does clinical stage predict pathologic stage in pancreatic adenocarcinoma

4118Background: When faced with a diagnosis of pancreatic cancer, patients and providers rely upon stage of disease to formulate a treatment plan. The possibility of undertreatment of early-stage p...
Dissecting Pseudoaneurysms and Blister Aneurysms

In contrast to “true” aneurysms, which have walls that contain intima, media, and adventitia, “false” or pseudoaneurysms no longer have all layers of the normal mural components. The precise mechanisms of pseudoaneurysm formation remain unclear but are believed to result either from a tear of the intima with blood dissecting into the wall or rupture of vasa vasorum. The classic angiographic appearance of a dissecting pseudoaneurysm is a fusiform dilatation with or without adjacent stenosis. Once ruptured there is a high rate of re-rupture during the first week. Symptomatic, ruptured or large pseudoaneurysms warrant treatment. Depending on the location of the pseudoaneurysm and clinical scenario, deconstructive or reconstructive approaches can be utilized, while endovascular reconstructive techniques are more commonly employed for intracranial lesions.
A Culturally Competent Phenotypic Evaluation / Obesity Assessment in African and African American Populations: Pilot Study

BMI, a ratio of weight over height, is a culturally-biased tool imposed upon the scientific, academic and medical communities as an errant measure of obesity across ethnicity. Body Mass Index (BMI) relates mass (g) to a relative fat distribution with regards to height. Its genesis is from the actuarially derived and ethnically exclusive height and weight tables that promote the fictional notion of inter-ethnic ideal weights that would be later adopted by the National Institutes of Health (NIH) as a competent measure of adiposity. Best practice, movement towards individualized medicine and deployment of effective models that impact the diabetes epidemic and its related precursors like insulin resistance and the metabolic syndrome, requires terminal use of BMI, a biologically meaningless and crude indicator of obesity, in favor of effective and culturally competent non-relative body composition evaluation of genetically determined adiposity that untenably compares values among groups. African Americans are among the increasingly affected groups for diabetes and posses unique composition variation requiring proper intra-cultural evaluation independent of inter-ethnic Eurocentric assumptions that over assesses obesity risk. Incorporating use of 4C models to evaluate adiposity and assess risk for diabetic predisposition and onset provides an effective unbiased assessment of the cultural components inherent within body composition variation among ethnicity, age, gender. Obesity and type II diabetes onset and pre-disposition is assessed phenotypically, in creation of a body mass profile among African and African American groups, using 4C model, photography, anthropometry, somatotype and genetic evaluation. Environmental obeseogenic cultural factors are also explored.
Why Ricardo’s Theory of Comparative Advantage Regarding Foreign Trade Doesn’t Work in Today’s Global Economy

This article first analyzes Ricardo’s theorem, not just his argument in favor of comparative advantage, but also the conditions that are necessary for the theory to work, namely, that capital is loyal to the country of origin and that currencies will adjust to level out imbalances in trade. It then traces the flow of foreign direct investment into China and the basis for that flow – cheap labor. It then analyzes China’s manipulation of the yuan and the changes in the relative valuation of currencies. The next section of the article addresses China’s entry into the World Trade Organization and its failure to live up to its agreement to move to a market-based economy. China’s reliance on state owned enterprises, its subsidization of export and high-tech industries, and its direct and indirect coercion of technological transfer and know-how from the U. S. and other countries – all stand in opposition to the principles to which other countries have agreed in connection with their participation in the World Trade Organization. A critical factor that is not been understood in connection with global trade is that the transfer of dual-use technology to China also carries with it national security implications. The next sections look at forced technology transfer and China’s military goals, including its policy to be both industrially and militarily self-sufficient, something United States needs to be likewise. This leads to a discussion of industrial policy. China has clearly articulated its industrial policy and the steps that it will take to implement it. The United States cannot afford, either from the standpoint of providing good paying jobs for its citizens, or from the standpoint of being a leader in research and development, or from the standpoint of national security, to be dependent upon products originating from, or supply chains running through, other countries – particularly when such countries are hostile to the United States. The conclusion asserts that Sen. Rubio’s “Made in China 2025 and the Future of American Industry” may be the opening of a critically necessary dialogue on the need for, and nature of, an industrial policy for the United States. Just relying upon the mantra that free trade benefits all, and supporting such mantra on the basis that it is “proved” by Ricardo’s theorem of comparative advantage, is to put our head in the sand and ignore the evidence set forth in this article.
Affinity Partitioning of Receptor-Rich Membrane Fractions and Their Purification

The study of the molecular properties of membrane bound receptors is greatly facilitated by their solubilization and purification. An excellent example of this is the nicotinic acetylcholine receptor, which can be solubilized by the use of nonionic detergents and purified by affinity chromatography (15, 20). Initial studies indicated that the binding properties of the nicotinic receptor remain intact in the presence of nonionic detergents. Such fortuitous circumstances do not occur in the study of other receptors. For example, the muscarinic acetylcholine receptor has proved rather labile to treatment with nonionic detergents (7), resulting in considerable loss of binding properties. Even when binding properties of a receptor are intact after solubilization, questions often remain concerning the in situ structure of the receptor and its associated activities. For example, functional coupling between receptor and enzymatic activities and ionophores may be disrupted or altered upon solubilization. Even in the case of the nicotinic receptor, differences in the binding properties of solubilized and membrane bound receptors have been detected (5).
Bronchiectasis and Chronic Rhinosinusitis

Chronic rhinosinusitis (CRS) and bronchiectasis are alike in features of chronic mucosal inflammation and excess mucus output. While a spectrum of lower airway dysfunctions may be seen with CRS, concurrent bronchiectasis and CRS lead to more frequent lower airway exacerbations and a significant reduction in quality of life. While the concept of unified airway disease may explain this coexistence, there remains no clear link of causality. Surgical optimization of the upper airway has demonstrated significant improvement in both quality of life and pulmonary function in patients with asthma and cystic fibrosis. However, in patients with bronchiectasis, the irreversible nature of structural damage appears to limit pulmonary function improvement, although it has shown to improve quality of life and reduce the frequency of pulmonary exacerbations.
The growing gap in pedestrian and cyclist fatality rates between the United States and the United Kingdom, Germany, Denmark, and the Netherlands, 1990–2018

Using official national data for each country, this article calculates trends in walking and cycling fatalities per capita and per km in the USA, the UK, Germany, the Netherlands, and Denmark. From...
How Can We Help Alleviate the Financial Concerns of Non-Directed (Altruistic) Living Kidney Donors?

Introduction:The recent increase in non-directed donors (NDDs) in the United States (U.S.) may help reduce the overwhelming number of patients on the waitlist. However, non-directed donation may be...
Automatic detection of head and neck squamous cell carcinoma on pathologic slides using polarized hyperspectral imaging and machine learning

The aim of this study is to incorporate polarized hyperspectral imaging (PHSI) with machine learning for automatic detection of head and neck cancer on H&E stained tissue slides. A polarized hyperspectral imaging microscope had been developed in our group. The preliminary results showed that the spectral curves of the Stokes vector parameters (S0, S1, S2, S3) on the H&E stained tissue slides with squamous cell carcinoma (SCC) from the larynx are different from normal tissue in certain wavelength range. In this paper, we imaged 20 H&E stained tissue slides from 10 patients with SCC of the larynx by the PHSI microscope. Several machine learning algorithms (support vector machine, random forest, Gaussian naive Bayes, logistic regression) were applied to the collected image data for the automatic detection of SCC on the H&E stained tissue slides. The performance of these methods was compared among the collected polarized hyperspectral imaging dataset of tissue slides, the pseudo RGB images generated from the polarized hyperspectral imaging dataset, and the principle component analysis (PCA) transformation of the polarized hyperspectral imaging dataset. The results suggest that SVM is a superior classifier for the classification task based on polarized hyperspectral data cubes compared to the other three types of classifiers. Furthermore, the incorporation of the four Stokes vector parameters improved the classification accuracy. Finally, the PCA transformed image data did not improve the accuracy as it might lose some important information from the original polarized hyperspectral data cube. Polarized hyperspectral imaging can have many potential applications in digital pathology.
Cardiovascular Risk of Concomitant Use of Atypical Antipsychotics and Stimulants Among Commercially Insured Youth in the United States.

Objectives: To investigate the risk of cardiovascular events associated with concomitant use of stimulants and atypical antipsychotics (AAPs) among youth and evaluate whether AAP dose and duration of concomitant use modifies the risk. Methods: We used IQVIA PharMetrics® Plus data from 2006 to 2015 to construct a retrospective cohort of commercially-insured youth aged 5-17 years old who initiated a stimulant medication. Time-varying concomitant stimulant/AAP use was defined as current, past and no concomitant use based on person months. The primary time-varying Cox proportional hazard regression analysis evaluated the risk of cardiovascular events comparing current concomitant use with past and no concomitant use, adjusted for baseline cardiovascular risk. A secondary analysis assessed the risk of cardiovascular events comparing AAP daily doses ( 2 mg) and duration ( 6 months) of current concomitant use to no concomitant use. Cardiovascular outcomes included severe (i.e., stroke, acute myocardial infarction, ischemic heart disease) and less severe (i.e., angina pectoris, cardiac dysrhythmias, transient cerebral ischemia, hypertensive disease, tachycardia, palpitations, syncope). Results: For this cohort of 61,438 youths, the incidence rate of severe cardiovascular events was 0.18 per 10,000 person-months, and all events occurred in no concomitant use months. The risk of less severe cardiovascular events was significantly higher in current concomitant users compared with no [HR: 2.59 (95%CI: 1.72, 3.90)] and past [HR: 1.89 (95%CI: 1.10, 3.24)] concomitant users. Compared to no concomitant use, the risk of less severe cardiovascular events was significantly higher at all AAP daily doses [HR: 2 mg: 2.65 (95%CI: 1.50, 4.71)]. The risk of less severe cardiovascular events significantly elevated for all duration of use and was higher for 6 months: 2.61 (95%CI: 1.59, 4.30)]. Conclusions: Severe cardiovascular events are rare. Concomitant stimulant/AAP use elevates the risk of less severe cardiovascular events. Periodic heart rate or blood pressure monitoring for youth on stimulant/AAP treatment may be warranted.
The Interactive Effects of Coworker and Supervisor Support on Prenatal Stress and Postpartum Health: a Time-Lagged Investigation

Pregnancy represents a critical time during which women are increasingly susceptible to challenges that can shape maternal health postpartum. Given the increasing number of women who are working through the duration of their pregnancies, in this study, we examine the extent to which both maternal psychological and physical health are influenced by social support received at work during pregnancy. Specifically, we examine 118 pregnant employees’ perceptions of coworker support, supervisor support, and stress over the course of 15 working days. We then link prenatal stress levels with postpartum maternal health outcomes following women’s return to work. At the within-person level, coworker support predicted next-day decreases in stress during pregnancy; however, stress did not predict next-day change in coworker support. There was no relationship between supervisor support and next-day change in stress during pregnancy or vice versa. At the between-person level, an interactive effect between coworker support and supervisor support emerged in predicting prenatal stress, such that women who benefitted from supportive coworkers and supportive supervisors during pregnancy reported the lowest levels of prenatal stress which were, in turn, associated with lower incidence of postpartum depression and quicker recovery times from birth-related injuries. Significant indirect effects suggested that when perceptions of supervisor support were higher (but not lower), coworker support during pregnancy predicted lower incidence of postpartum depression and quicker recovery times through reduced prenatal stress. Taken together, our findings provide novel insight into how specific aspects of the workplace environment may interact to shape maternal psychological and physical health during pregnancy and postpartum.
Takes Two to Tango: Cognitive Impairment and Sexual Activity in Older Individuals and Dyads.

OBJECTIVES This paper examines the association between cognitive impairment, including mild cognitive impairment (MCI) and early dementia (ED), and sexual activity in a large, longitudinal sample of community-dwelling older adults. We focus here on sexual activity, which includes both sexual activity with a partner and masturbation. METHODS We analyzed 3777 older individuals and members of 955 intimate dyads using the National Social Life, Health and Aging Project (2010 and 2015). We used ordered-probit regression, cross-lagged panels models, and probit regression. RESULTS We find that older adults with cognitive limitations, either MCI or early dementia, are about as likely to be sexually active with a partner as those with normal cognitive function. This is the case both in the cross section and longitudinally. Both men and women with early dementia are less likely to have masturbated, however. Among married and cohabiting couples, we find no association between cognitive impairment in either the husband, the wife, or in both partners and their joint sexual activity. Women whose measured cognitive function is lower than their husband's are less likely to report any masturbation. DISCUSSION Sex with a partner, a fundamentally social activity, seems to be conserved in the face of cognitive limitation but masturbation, a solitary activity, does not. We argue that the intimate dyad plays an important role in conserving partnered sexual activity. Results can inform strategies to maintain sexual well-being of older adults with cognitive impairment and their partners as part of overall strategies to improve quality of life.
Burnout and Perceptions of Stigma and Help-Seeking Behavior Among Pediatric Fellows.

BACKGROUND AND OBJECTIVES Although burnout has been studied extensively among students and residents, in few studies have researchers examined burnout among fellowship trainees. We measured burnout among fellows in our freestanding children’s hospital and evaluated fellows9 perceptions of stigma around (and willingness to seek treatment for) psychological distress. The objectives are as follows: to (1) measure burnout among pediatric fellows, (2) assess fellows9 perceptions of stigma around help seeking for mental illness, and (3) examine the relationship between burnout and willingness to seek behavioral health counseling. METHODS We distributed a 48-item inventory to all 288 fellows in our pediatric center. Items included the Maslach Burnout Inventory and Likert-type matrices to assess attitudes toward behavioral health treatment and associated stigma. We used 2-sampled t-tests to associate burnout with willingness to seek mental health treatment. RESULTS A total of 152 fellows (52%) responded, of whom 53% met the threshold for burnout. Most reported believing that their program directors (78%), attending physicians (72%), and patients (82%) hold negative attitudes about mental illness and its treatment; 68% believed that employers would reject their application if they knew they sought counseling. Fellows with burnout were more likely to believe that others in the clinical learning environment hold negative views of help seeking for behavioral health (odds ratio 1.2–1.9). CONCLUSIONS Just over one-half of the pediatric fellows in our center meet the threshold for burnout. They also experience significant workplace-based stigma around help seeking for psychological distress. Fellows with burnout are more likely than their peers to perceive significant stigma around help seeking for their distress, making them a particularly at-risk learner population.
Injection of Micronized Human Amnion/Chorion Membrane Results in Increased Early Supraspinatus Muscle Regeneration in a Chronic Model of Rotator Cuff Tear

Surgical repair of severe rotator cuff tear often results in retear due to unaddressed muscle degeneration. The objective of this study was to test the regenerative potential of micronized dehydrated Human Amnion/Chorion Membrane (dHACM), in a clinically relevant delayed reattachment model of rotator cuff repair. Micronized dHACM was injected into rat supraspinatus muscle during tendon re-attachment surgery, three weeks after original tendon injury. One week after material injection, inflammatory and mesenchymal stem cell infiltration into supraspinatus muscles was assessed via flow cytometry. Histological methods were utilized to assess structural and regenerative changes in muscle one and three weeks after material injection. Micronized dHACM injection resulted in increased M1-like macrophages (17.1 [Formula: see text] fold change over contralateral controls) and regenerating muscle fibers (4.3% vs 1.7% in saline treated muscles) one week after injection compared to saline treated muscles. Tendon reattachment itself exhibited intrinsic healing in this model, demonstrated by a general return of muscle weight and reduced fibrosis. Our results indicate that injection of micronized dHACM may initiate an inflammatory response in degenerated muscle that promotes early muscle regeneration, and that our animal model may be a suitable platform for studying treatments in muscle at early timepoints, before intrinsic healing occurs.
People helping people: examining the relationship between the support provider and the support recipient in an IS environment

The support of computer users is one key issue facing organizations who wish to expand their use of computers. If organizations want to be effective, they must build a support structure that is able to adapt to the changing needs of the user community. It has been well documented that computer users seek the assistance of their colleagues before they seek the assistance of the IS professionals that have been placed in the company's Information Center. Researchers suggest many possible reasons for this. Chief among these is physical proximity and professional familiarity. This research examined other reasons why users sought the assistance of their colleagues before they sought the assistance of IS experts. A classification scheme was devised for coding the relationship between a Support Provider and a Support Recipient. It consists of nine attributes: Guidance, Knowledge, Personal Familiarity, Professional Familiarity, Assurance, Communication, Emotional Support, Peer Similarities and Proximity. Administrative Computer users at eight colleges were surveyed. They were asked to identify individuals who they most recently sought for advice and to rate these individuals on each attribute. Finally, they were asked to identify how likely they were to seek help from the individual, and how satisfied they were with the help they had received. These answers were used as a measure for the success of the relationship. All nine of the attributes had significantly positive correlations to the success measures. A factor analysis grouped the attributes into four different factors. The Counseling Factor (Assurance, Guidance, Emotional Support and Communication) was identified as the one that had the most significant impact on the success of the Provider/Recipient Relationship. The Knowledge Factor (Knowledge) also had a significant but lesser effect. The Friendship Factor (Peer Similarities and Personal Familiarity) and the Professional Factor (Professional Familiarity and Physical Proximity) had no significant effect. The results suggest that IS Managers should give more attention to developing the Counseling Factor attributes in IS support Providers. The results also suggest that researchers in End-user Computing should examine more closely the effect of the Counseling Factor on the success of IS Support functions in particular and IS departments in general.
Union Wage Effect: New Evidence From Matched Employer-Employee Data

This paper estimates a union wage effect, using matched employer- employee data and estimation models that control an association between a worker's union status and an employer's characteristics. Failure to control this association may cause previous studies' estimates of the union wage effect to be biased. As long as a worker is more likely to become a union worker in a firm that offers her a higher potential for better pay, the union status is (positively) associated with employer characteristics. The empirical finding of this paper verifies this possibility. Estimates of the union wage effect are shown to be upward-biased in the estimation models without control of the employer characteristics. The estimated union wage effect of this study (in an approximate range of 0.2"3.2 percent) is less than a quarter of cross-sectional estimates, and half of individual panel estimates with unobservable person effects.
Meta‐analysis: the effects of placebo treatment on gastro‐oesophageal reflux disease

Aliment Pharmacol Ther 2010; 32: 29–42 Summary Background There appears to be a significant placebo response rate in clinical trials for gastro-oesophageal reflux disease. Little is known about the determinants and the circumstances associated with placebo response in the treatment of gastro-oesophageal reflux disease (GERD). Aims To estimate the magnitude of the placebo response rate in randomized controlled trials for GERD and to identify factors that influence this response. Methods A meta-analysis of randomized, double-blind, placebo-controlled trials, published in English language, which included >20 patients with GERD, treated with either a proton pump inhibitor or H2-receptor antagonist for at least 2 weeks. Medline, Cochrane and EMBASE databases were searched, considering only studies that reported a global response for ‘heartburn’. Results A total of 24 studies included 9989 patients with GERD. The pooled odds ratio (OR) for response to active treatment vs. placebo was 3.71 (95% CI: 2.78–4.96). The pooled estimate of the overall placebo response was 18.85% (range 2.94%–47.06%). Patients with erosive oesophagitis had a non-significantly lower placebo response rate than patients without it (11.87% and 18.31%, respectively; P = 0.246). Placebo response was significantly lower in studies of PPI therapy vs. studies of H2 RAs (14.51% vs. 24.69%, respectively; P = 0.05). Conclusions The placebo response rate in randomized controlled trials for GERD is substantial. A lower placebo response was associated with the testing of PPIs, but not the presence of erosive oesophagitis.
Motion near a Hopf bifurcation of a three-dimensional system

Analyse du systeme autonome tridimensionnel de Rand. Developpement asymptotique de l'amplitude et de la frequence du cycle limite proche de la bifurcation Hopf par la methode multiechelle. Domaine de validite des calculs evalue par une analyse de stabilite et des simulations numeriques
Persistence of tetrachlorophenol and pentachlorophenol in exposed woodworkers

The decline in urinary concentrations of pentachlorophenol (PCP) and 2,3,4,6-tetrachlorophenol (TCP) were observed for a group of woodworkers chronically exposed to Permatox 100 (3% PCP, 21% TCP) during a 16 day vacation and plant shutdown. The group was monitored annually for two years, with sampling occurring on the last working day prior to shutdown and on the first day after the shutdown. Among those workers with the highest pre-shutdown levels, uniform TCP reductions of 90 +/- 6% were observed, indicating elimination rates similar to those reported for PCP in a single dose human exposure study. Four workers were sampled on alternate days during the shutdown in the second year. Of these, two workers had significant pre-shutdown levels, and showed declines in urine TCP levels over this period consistent with simple one-compartment first order decay. The possible effect of environmental PCP exposure on observed biological decay rates when occupational PCP exposures are low was indicated by the wide variation in urinary PCP reduction and slight decreases or actual increases observed over the shutdown period.
Double Photoionization of excited Lithium and Beryllium

We present total, energy-sharing and triple differential cross sections for one-photon, double ionization of lithium and beryllium starting from aligned, excited P states. We employ a recently developed hybrid atomic orbital/ numerical grid method based on the finite-element discrete-variable representation and exterior complex scaling. Comparisons with calculated results for the ground-state atoms, as well as analogous results for ground-state and excited helium, serve to highlight important selection rules and show some interesting effects that relate to differences between inter- and intra-shell electron correlation.
Ultrafast and Nonlinear Spectroscopy of Semiconductors with Small Energy Photons

Abstract Ultrashort pulses of intense, coherent, and tunable far-infrared and mid-infrared radiation, achievable with free-electron lasers and optical parametric amplifiers, provide unique opportunities to investigate low energy dynamics in solids. This paper reviews our recent experiments on bulk and quantum-confined semiconductors using such radiation. These experiments include: far-infrared spectroscopy of transient plasmas, picosecond time-resolved cyclotron resonance, terahertz sideband generation, and the dynamic Franz-Keldysh effect. PACS codes: 78J0.-e, 78.30. Fs, 78.20. Jq, 78.20. Ls
LIMIT THEOREMS FOR TRANSIENT MARKOV CHAINS

Abstract An investigation of the asymptotic behavior, for large n, of the quantities P x ( n V B r ∞ ; X V B r = y ) where VBr is the time of the r-th visit to a finite, non-empty set B of states in a countable state space transient Markov chain Xn. These results are shown to yield information on the asymptotic behavior for solutions to the exterior Dirichlet problem for B, and on the error in approximating Px(Nn(B) N ( B ) = lim ⁡ n N n ( B ) Applications are given to several specific classes of Markov chains.
Advances in Kawasaki disease.

Recent studies have increased our understanding of the etiopathogenesis of Kawasaki disease (KD). The inflammatory infiltrate in KD coronary artery aneurysms has been shown to consist of CD8 T lymphocytes, macrophages, and IgA plasma cells, consistent with an immune response to an intracellular pathogen with a mucosal portal of entry. The identification of an oligoclonal IgA response in the vascular wall and the detection of a KD-associated antigen in inflamed KD tissues using a synthetic antibody derived from KD oligoclonal IgA antibodies have provided new approaches to identification of the etiologic agent. Highly effective therapy has evolved for KD, even in the absence of identification of the etiologic agent. The existence of incomplete KD cases remains a significant diagnostic dilemma for the clinician. Conclusion: the development of a diagnostic test, more specific therapy, and ultimate prevention of this potentially fatal illness of childhood are dependent upon continued advances in determining the etiopathogenesis of this fascinating disorder.
Lateral auxin transport in stems and roots.

The lateral movement of auxin has been sttudied with bioassays and also by application of '4C-IAA. Both techniques have demonstrated that the upper half of a horizontally positioned stem or root contains at least 30( to 45 % of the total auxin present in the tissue (2). However, such an auxin gradient is difficult to reconcile with the Cholodny-Weit theory of root geotropism because it is too small to account for the growth inhibition which occurs in the underside of a root experiencing a geotropic curvatture (2). We shall present evidence that the auxin differential actulally is considerably larger than these experiments indicate, and discuss several problems which have obscured this fact and hindered the measurement of lateral auixin transport. Previously we reported (3) that in 8 experiments, each using 20 sections and 1 ,um 14C-IAA, the specific activity of the upper half of horizontally positioned etiolated pea stem segments was 37.5 + 2.7 % that of the lower half. In an equal number oif experiments the specific activities of the upper quarter, middle half, and lower quarter relative to that of the intact section were 0.58 ? 0.07, 0.99 + 0.07, and 1.46 + 0.10 respectively (3). From these values the distribution of 14C-IAA across the diameter of the stem has been calculated (fig 1). The data show the specific activity to be fairly uniform throughout the middle of the stem, only rising or falling markedly at the ouiter suirfaces. Apparently each cell passes the auxin it receives to the next lower cell so that IAA is displaced from the upper to the lower surface with little change in concentration in the center of the section where most of the tissuie mass resides. Consequently when sections are halved the large differential between the upper and lower suirfaces is obscured by the lack of a gradient in the central builk of tisstue included in each sample. The magnitude of the gradient between the surfaces can be es-timated by extrapolating the curves (dotted lines, fig 1) and may be as large as 10:1. The problem of the central tissue mass can be circumvented by utilizing hollow cylinders such as Avena an(l corn coleoptiles, but this approach introduces new difficulties. It is well established that auxin does not spread laterally in these tissues exceept under the influence of gravity; otherwise the Avena and corn -curvature tests would not work. Consequently when coleoptiles are positioned horizontally, IAA should only migrate at the flanks from the upper to the lower half of the coleoptile (see fig 2). In addition a net movement of IAA from U1 to U2 and L1 to Lo would be expected, giving rise to the final distribution illtistrated in fi'gure 2. If this interpretation is correct the lower half of a split coleoptile must contain a mass of flank cells in which there is no gradient as well as a zone (,1) partially depleted of auxin, whereas the upper half shotuld contain an auxin rich zone (U,). Therefore, we believe that auxin gradients U1 :U9 an( I1 :L2 are greater than the differential measured between the upper and lower halves of sulit coleoD-
Efficacy of concomitant chemoradiation and surgical salvage for N3 nodal disease associated with upper aerodigestive tract carcinoma.

Objectives/Hypothesis To determine whether an aggressive approach using trimodality therapy would improve the outcome in head and neck cancer patients with advanced (N3) nodal disease. Study Design In this retrospective, nonrandomized review, we analyzed a subset of patients who were treated in a targeted chemoradiation therapy protocol, consisting of 31 patients who received treatment between June 1993 and June 1997. Methods Patients received selective intra-arterial infusions of cisplatin (150 mg/m2/wk for 4 weeks) and concomitant radiation therapy (2 Gy/fraction × 35 daily fractions over a 7-wk period) to the primary and clinically positive nodal disease. The patients were re-evaluated 2 months later and underwent salvage neck dissections if there was any residual disease. Results Classification of disease in the primary site was as follows: T1 in 2 patients, T2 in 6 patients, T3 in 14 patients, and T4 in 9 patients. Among the 31 patients who were assessed for response at the nodal site, 4 of 31 (13%) had a complete response, 21 of 31 (68%) had a partial response, and 1 of 31 (3%) had no response. Excluding the 5 patients who could not be evaluated, 4 of 26 patients (15%) had a complete response, 21 of 26 (81%) had a partial response, and 1 of 26 (4%) had no response. Nineteen patients subsequently underwent neck dissection, and five patients had histological evidence of residual disease. The remaining seven patients included four who had a complete response in their necks and three who died of intercurrent disease before re-staging. Among the 23 patients who were rendered disease free, there were no recurrences within the neck, whereas 1 patient had recurrence at the primary site and 11 patients had recurrence at distant sites. With a median follow-up of 15 months (range, 4–41 mo), the 3-year overall survival and disease-specific survival were 41% and 43%, respectively. Conclusions Targeted chemoradiation therapy followed by surgical salvage is a highly effective approach for regional control of patients with N3 nodal disease, whereas additional strategies are required to address the problem of distant metastases.
The EEG of the early premature

EEGs were taken of 33 premature babies of 27-32 weeks of conceptional age who were considered normal for their conceptional age by clinical criteria. The EEGs were divided into epochs of 1 min each and their characteristics of temporal and spatial organization as well as amount and distribution of special patterns were coded and analyzed. The records were mostly discontinuous, with synchronous and symmetric bursts. There was much rhythmic activity in all frequencies and some patterns were consistently asymmetric. At least one pattern, the sawtooth, seems to be characteristic of this early conceptional age. Follow-up EEGs and clinical examinations were done on 17 children at 6-8 months of age post term. Three more died before 6 months and on one a telephone report was obtained from the mother. The characteristics of the neonatal EEGs were compared with those published on smaller groups of early prematures and those on later premature babies.
Neural network architectures for efficient modeling of FX futures options volatility

The importance of volatility modeling is evidenced by the voluminous literature on temporal dependencies in financial market assets. A substantial body of this literature relies on explorations of daily and lower frequencies using parametric ARCH or stochastic volatility models. In this research we compare the model performance of alternate neural network models against that of the (G)ARCH framework when applied to hourly volatility of FX futures options. We report that the results obtained from the application of a closed-form Bayesian regularization radial basis function neural network are considerably more efficient than those produced by alternate neural network topologies and the (G)ARCH model formulation.
The role of a 40-megadalton plasmid in the adherence and hemolytic properties of Aeromonas hydrophila

A cured strain of Aeromonas hydrophila, MS-2PC, was examined for phenotypic changes in antibiotic resistance, adherence, and hemolysis. Parental strain MS-2 was resistant to ampicillin, novobiocin, and carbenicillin; MS-2PC, which lacked a 40-MDa plasmid, was also resistant to ampicillin but was sensitive to novobiocin and carbenicillin. The adherence of these isolates to CaCo-2 and HeLa cells was examined. MS-2PC demonstrated greater attachment to both cell lines than did strain MS-2 (p < 0.05). MS-2PC also demonstrated greater hemolysis activity than did MS-2 (p < 0.01). The 40-Mda plasmid was isolated and reintroduced into MS-2PC. The resulting transformant, 20T, regained resistance to carbenicillin and novobiocin. The attachment ability of 20T was equal to that of MS-2, and both strains demonstrated significantly lower attachment ability than that of MS-2PC (p < 0.01). Strains MS-2 and 20T exhibited the same hemolysis pattern, which was markedly less than that of strain MS-2PC. These results indicate that the 40-Mda plasmid which codes for antibiotic resistance also controls other functions of A. hydrophila MS-2.
Efficiently locating photographs in many panoramas

We present a method for efficient and reliable geo-positioning of images. It relies on image-based matching of the query images onto a trellis of existing images that provides accurate 5-DOF calibration (camera position and orientation without scale). As such it can handle any image input, including old historical images, matched against a whole city. On such a scale, care needs to be taken with the size of the database. We deviate from previous work by using 360° panoramas to simultaneously reduce the database size and increase the coverage. To reduce the likelihood of false matches, we restrict the range of angles for matched features. Furthermore, we enhance the RANSAC procedure to include two phases. The second phase includes guided feature matching to increase the likelihood of positive matches. Hence, we devise a matching confidence score that separates between true and false matches. We demonstrate the algorithm on a large scale database covering a whole city in order to show its usefulness for a vision-based augmented reality system.
MO-C-BRD-01: SBRT I: Overview of Simulation, Planning, and Delivery

SBRT is having a dramatic impact on radiation therapy of early-stage, locally advanced cancers. Treatment planning of SBRT is characterized by precise target volume delineation, highly conformal dose distribution, sharp dose gradient outside the target volume, and meticulous tumor motion management. Stringent dose volume constraints of SBRT require the treatment planning to be highly personalized. Not only the complete patient's medical information (anatomy, tumor size/shape/location/motion, breathing pattern, health status) should be taken into consideration during planning, but also a wide range of factors including imaging techniques (imaging modality, breathing control, immobilization, patient position, etc.), treatment planning techniques (3D-conformal, dynamic conformal arcs, IMRT, VMAT, etc.), image guidance techniques (CBCT, orthogonal X-Ray, fiducial marker tracking, fluoroscopy, etc.), and delivery techniques (FFF, gating, tracking, etc.). In addition, potential pitfalls may exist in SBRT techniques and processes, such as target volume error in 4DCT and image registration error in image guidance. How to manage these affecting factors to achieve optimal, personalized SBRT treatment plans remains a great challenge. In this proposal, we will review technologies, share experiences, and discuss strategies concerning SBRT simulation, planning, and delivery. Learning Objectives: Understand requirements and challenges of SBRT treatment planning Discuss information-driven strategies of developing optimal SBRT plansmore » Discuss practical considerations and potential pitfalls of SBRT treatment planning.« less
752 Should Advanced Age Be a Contra-Indication to LVAD Implant: A Community Hospital Experience

with refractory Stage D heart failure. Methods and Materials: MEDAMACS (n 168) enrolled adult patients with CHF on optimal therapy, LVEF 30%, and 2 hospitalizations in the past year or 1 hospitalization and 1 high risk feature. Echo-determined severity of TR (none, mild, moderate, severe) was reported in 166 of 168 patients. With an endpoint of survival free of inotrope dependence, mechanical circulatory support (MCS), or heart transplantation, we tested the predictive value of at least moderate TR in adjusted analyses. Results: Moderate TR was present in 30% and severe TR in 15% of the study cohort. The presence of greater than moderate TR was associated with right atrial pressure (p 0.0006), pulmonary artery mean pressure (p 0.03), TR velocity (p 0.01), inspiratory collapse of the inferior vena cava (p 0.01), RVD(p 0.04), peripheral edema (p 0.0003), hepatosplenomegaly (p 0.01), low platelets (p 0.05), and total bilirubin (p 0.03). Over a mean follow-up of 154 days, 64 events were recorded including long term inotropic support (9), MCS (16), cardiac transplantation (17), and mortality (22). In univariate analysis, at least moderateTR was associated with increased risk (OR 3.1; 95% CI 1.6, 6.0; p 0.0006). After multivariate adjustment, tricuspid regurgitation remained independently associated with survival free of transplant, MCS, or inotropic dependence (OR 3.5; 95% CI 1.5, 8.6; p 0.004). Conclusions: Tricuspid regurgitation is common and carries prognostic import in Stage D Heart Failure. Given the importance of TR when considering left ventricular assist device support, future studies should investigate the reversibility of this lesion.
Site of the biosynthesis of CDP-diglyceride in plant mitochondria.

Abstract The site of synthesis of CDP-diglyceride in purified plant mitochondria has been found to be located on the inner membrane.