cssi/SciSciGPT-SciSciNet huggingface dataset:
Surgeon Attitudes Toward Physiotherapeutic Scoliosis-Specific Exercises in Adult Patients With Spinal Deformities.

ABSTRACT Background: Physiotherapeutic scoliosis-specific exercise (PSSE) has proven to be an important treatment for patients with adolescent idiopathic scoliosis. However, there is a lack of understanding of the role of PSSE in older adults with spinal deformity. Methods: An electronic, 14-question survey with questions regarding the use of physical therapy (PT) and PSSE for adult spinal deformity was administered to all Scoliosis Research Society members. Physician location, age, specialty, years in experience, and management preferences were quantified using descriptive analyses. Results: Of the 98 surgeons who participated in this study, the majority of respondents were from North America (71.1%), and the mean age was 51.87 ± 10.93 years; approximately 98% of respondents were orthopedic surgeons, and 48.0% had been in practice for more than 21 years. Sixty-four percent reported they prescribed PT in their practice, with 52% of respondents often using PT as nonoperative treatment; 21.4%, preoperative; and 40.8% postoperative. The primary reason for PT referral was persistent pain (40.3%), followed by impairments to the patient9s balance or gait (34.3%) and difficulty with daily living activities (25.4%). The primary indications for not referring postoperative patients to PT were lack of perceived value from PT (50%), lack of evidence supporting the benefits from PT (31.3%), and a lack of physical therapists appropriately trained for scoliosis (18.8%). Of the respondents, 74% were familiar with PSSE and 66% were comfortable prescribing PSSE postoperatively. In addition, 28% of respondents agreed that >12 weeks postoperation was the ideal time for PSSE referral, followed by 6 to 8 weeks postoperation (26.2%) and immediately postoperation (18%). Conclusions: The results show that the majority of respondents prescribed PSSE solely for nonoperative treatment. Respondents who did not prescribe PSSE reported skepticism due to a lack of perceived value. This suggests the need for further research into the benefits of PSSE. Level of Evidence: 5. Clinical Relevance: Physiotherapeutic Scoliosis Specific Exercises (PSSE) is an important non-operative treatment for patients with Adolescent Idiopathic Scoliosis (AIS) but is understudied in Adult Spinal Deformity (ASD) patients, suggesting further clinical research. This study demonstrates that only two-thirds of the respondents familiar with PSSE were comfortable prescribing PSSE postoperatively suggesting the need for further research into the effectiveness and benefits of PSSE in ASD patients.
Capturing Fluctuations in Pathogen Avoidance: the Situational Pathogen Avoidance Scale.

Pathogen avoidance is an important motive underlying human behavior and is associated with numerous psychological processes—including biases against social groups heuristically associated with illness. Although there are reliable measurement scales to assess chronic dispositional levels of pathogen avoidance, no measurement scale currently exists to directly assess moment-to-moment fluctuations in pathogen avoidance. This paper presents the Situational Pathogen Avoidance (SPA) scale, which assesses situational variability in pathogen avoidance, especially as it pertains to avoidance of social stimuli. Across six studies, we demonstrate the reliability and validity of the SPA scale, show that the scale is influenced by situational activation of pathogen avoidance motives, and demonstrate that it mediates the association between pathogen avoidance motives (both chronic and situational) and social biases against obese and foreign targets. The SPA scale provides a valuable measurement tool for researchers who study pathogen avoidance and to those who study social biases more generally.
Using Assistive Technology to Support Science Instruction in the Inclusive Elementary Classroom

In 2004, the Individuals with Disabilities Education Act outlined specific considerations for students with individual education programs in relation to their needs and application of assistive tec...
Global status of violence against children and how implementation of SDGs must consider this issue.

Abstract The 30th anniversary of the Convention on the Rights of the Child (CRC) is a historic commemoration to recommit for children and with children. Thirty years ago, the Convention recognized children as rights holders and transformed the way we understand the rights, the agency and power of children. Children went from being passive recipients of services and charities to human rights holders with a voice. The Convention is one of the most comprehensive human rights instruments that have reached almost universal ratification. However, progress towards ending all forms of violence against all children is slow and we need to act better, faster and further in bringing violence against children to an end by 2030 as per the commitment in SDG 16.2.
A Deep On-Policy Learning Agent for Traffic Signal Control of Multiple Intersections

Reinforcement Learning (RL) is being rapidly adopted in many complex environments due to its ability to leverage neural networks to learn good strategies. In traffic signal control (TSC), existing work has focused on off-policy learning (Q-learning) with neural networks. There is limited study on on-policy learning (SARSA) with neural networks. In this work, we propose a deep dueling on-policy learning method (2DSARSA) for coordinated TSC for a network of intersections that maximizes the network throughput and minimizes the average end-to-end delay. To describe the states of the environment, we propose traffic flow maps (TFMs) that capture head-of-the-line (HOL) sojourn times for traffic lanes and HOL differences for adjacent intersections. We introduce a reward function defined by the power metric which is the ratio of the network throughput to the average end-to-end delay. The proposed reward function simultaneously maximizes the network throughput and minimizes the average end-to-end delay. We show that the proposed 2DSARSA architecture has a significantly better learning performance compared to other RL architectures including Deep Q-Network (DQN) and Deep SARSA (DSARSA).
Public Insurance Status Negatively Affects Access to Care in Pediatric Patients With Meniscal Injury.

Background:Non- and underinsured individuals experience poor access to care and treatment delays. Meniscal injury is a common reason for surgical intervention in the pediatric population, and delay...
Risk assessment of inhaled diacetyl from electronic cigarette use among teens and adults

Abstract Diacetyl (C4H6O2) is a toxicant commonly found in electronic cigarettes (e-Cigs) as a flavoring component and an enhancer of e-juices. Lung injury in current and former workers in popcorn manufacturing suggests a possible association with diacetyl inhalation exposure. Although the number of e-Cig users continues to rise steadily among the teens and adults, the potential risk of pulmonary disease has not been characterized. A systematic review of the open literature identified bronchiolitis obliterans—a pathological inflammation resulting in fibrosis of the bronchioles leading to an irreversible limitation to airflow in lungs—as the primary outcome of diacetyl exposures. Following the deterministic United States National Research Council/Environmental Protection Agency's risk assessment framework, that consists of four key steps: hazard identification, dose-response assessment, exposure assessment and risk characterization, we estimated noncarcinogenic (systemic) risks using a Hazard Quotient (HQ) approach upon exposure to diacetyl among teens and adults who use e-Cigs. Based on the NIOSH Benchmark Dose (BMD; 0.0175 mg/kg-day) and modelled Average Daily Doses (ADDs; range 0.11–5.2 mg/kg-day), we estimated 12 different HQ values—a measure of non-carcinogenic risk for diacetyl inhalation exposures—all of which were greater than 1 (range 6.2875–297.1429), suggesting a significantly higher non-carcinogenic risk from diacetyl exposures among the teens and adults who use e-Cigs. These results underscore the need to regulate e-Cigs to protect teens and adults from diacetyl exposures and risk of developing lung injuries, including bronchiolitis obliterans.
Laptop-Administered NIH Toolbox and Cogstate Brief Battery in Community-Dwelling Black Adults: Unexpected Pattern of Cognitive Performance between MCI and Healthy Controls

Objective Black adults are approximately twice as likely to develop Alzheimer's disease (AD) than non-Hispanic Whites and access diagnostic services later in their illness. This dictates the need to develop assessments that are cost-effective, easily administered, and sensitive to preclinical stages of AD, such as mild cognitive impairment (MCI). Two computerized cognitive batteries, NIH Toolbox-Cognition and Cogstate Brief Battery, have been developed. However, utility of these measures for clinical characterization remains only partially determined. We sought to determine the convergent validity of these computerized measures in relation to consensus diagnosis in a sample of MCI and healthy controls (HC). Method Participants were community-dwelling Black adults who completed the neuropsychological battery and other Uniform Data Set (UDS) forms from the AD centers program for consensus diagnosis (HC = 61; MCI = 43) and the NIH Toolbox-Cognition and Cogstate batteries. Discriminant function analysis was used to determine which cognitive tests best differentiated the groups. Results NIH Toolbox crystallized measures, Oral Reading and Picture Vocabulary, were the most sensitive in identifying MCI apart from HC. Secondarily, deficits in memory and executive subtests were also predictive. UDS neuropsychological test analyses showed the expected pattern of memory and executive functioning tests differentiating MCI from HC. Conclusions Contrary to expectation, NIH Toolbox crystallized abilities appeared preferentially sensitive to diagnostic group differences. This study highlights the importance of further research into the validity and clinical utility of computerized neuropsychological tests within ethnic minority populations.
Implementation and evaluation of a virtual objective structured clinical examination for pharmacy students

Introduction: The University of California, San Francisco (UCSF) School of Pharmacy employs Objective Structured Clinical Examinations (OSCEs) to assess students' skills. The Coronavirus disease 2019 (COVID-19) pandemic made in-person OSCEs infeasible. This article describes the implementation and evaluation of a two-station virtual OSCE (vOSCE) for first-year pharmacy students. Methods: A summative vOSCE was conducted in June 2020 using Zoom and ExamSoft. Faculty and residents served as standardized patients (SPs) and evaluated student performance. Students and SPs were surveyed on their perceptions post-vOSCE. A mixed methods analysis was conducted, incorporating thematic analysis of survey responses and quantitative analyses of student performance on the virtual vs in-person OSCE. Results: Ninety-six (75%) students and 17 SPs (94.4%) completed the survey. Students and SPs (69% vs 88%, P =.10) felt that vOSCEs were acceptable alternatives for demonstrating knowledge, communication, and telehealth skills. SPs felt that in-person OSCEs were more effective to assess communication skills and ability to conduct in-person encounters (P 0.05). Discussion: The virtual environment did not seem to negatively impact student performance. However, students and SPs felt vOSCEs may be less effective to demonstrate and assess nonverbal communication. To address these limitations, future implementation of vOSCEs may include providing students with instruction on nonverbal telehealth skills and SP training on virtual assessment of nonverbal communication skills.
Mutant PPM1D and TP53 populate the hematopoietic compartment after peptide receptor radionuclide therapy (PRRT) exposure.

10605Background: Mutations in TP53 and PPM1D are putative drivers associated with therapy related-myeloid neoplasm (T-MN) and have been identified in pre-treatment blood samples obtained at the tim...
Measurement of unnecessary psychiatric readmissions in the context of care transition interventions: a scoping review.

Objective The objective of this study was to examine how published studies of inpatient to outpatient mental healthcare transition processes have approached measuring unnecessary psychiatric readmissions. Design Scoping review using Levac et al’s enhancement to Arksey and O’Malley’s framework for conducting scoping reviews. Data sources Medline (Ovid), Embase (Ovid), PsycINFO, CINAHL, Cochrane and ISI Web of Science article databases were searched from 1 January 2009 through 28 February 2019. Eligibility criteria for selecting studies We included studies that (1) are about care transition processes associated with unnecessary psychiatric readmissions and (2) specify use of at least one readmission time interval (ie, the time period since previous discharge from inpatient care, within which a hospitalisation can be considered a readmission). Data extraction and synthesis We assessed review findings through tabular and content analyses of the data extracted from included articles. Results Our database search yielded 3478 unique articles, 67 of which were included in our scoping review. The included articles varied widely in their reported readmission time intervals used. They provided limited details regarding which readmissions they considered unnecessary and which risks they accounted for in their measurement. There were no perceptible trends in associations between the variation in these findings and the included studies’ characteristics (eg, target population, type of care transition intervention). Conclusions The limited specification with which studies report their approach to unnecessary psychiatric readmissions measurement is a noteworthy gap identified by this scoping review, and one that can hinder both the replicability of conducted studies and adaptations of study methods by future investigations. Recommendations stemming from this review include (1) establishing a framework for reporting the measurement approach, (2) devising enhanced guidelines regarding which approaches to use in which circumstances and (3) examining how sensitive research findings are to the choice of the approach.
Deep brain stimulation for depression informed by intracranial recordings

Abstract The success of deep brain stimulation (DBS) for treating Parkinson’s disease has led to its application to several other disorders, including treatment-resistant depression (TRD). Results with DBS for TRD have been heterogeneous, with inconsistencies largely driven by incomplete understanding of the brain networks regulating mood, especially on an individual basis. We report results from the first subject treated with DBS for TRD using an approach that incorporates intracranial recordings to personalize understanding of network behavior and its response to stimulation. These recordings enabled calculation of individually optimized DBS stimulation parameters using a novel “inverse solution” approach. In the ensuing double-blind randomized phase incorporating these bespoke parameter sets, DBS led to remission of symptoms and dramatic improvement in quality of life. Results from this initial case demonstrate the feasibility of this personalized platform, which may be used to improve surgical neuromodulation for a vast array of neurological and psychiatric disorders.
Mycophenolate Mofetil as an Immunomodulatory Agent in the Treatment of Chronic Ocular Inflammatory Disorders

Purpose: To evaluate the outcomes of patients with chronic ocular inflammatory disease treated with mycophenolate mofetil as an immunosuppressive and steroid-sparing agent. Design: Retrospective noncomparative interventional case series. Participants: All patients with ocular inflammatory disease treated with mycophenolate mofetil at a single institution between 1998 and 2001. Methods: Charts of patients seen on the Ocular Immunology and Uveitis Service at the Massachusetts Eye and Ear Infirmary were reviewed. Patients with chronic ocular inflammatory disease were included in the study. Main Outcome Measures: Control of inflammation, steroid-sparing effect, visual acuity, and adverse reactions were measured. Results: A total of 54 patients were evaluated. Control of ocular inflammation with mycophenolate mofetil as monotherapy was achieved in 35 patients (65%) and in 67 eyes (62%), and a steroid-sparing effect was achieved in 29 (54%) patients. Visual acuity was maintained or improved in 51 patients (94%) and in 97 eyes (90%). Side effects requiring discontinuation of medication occurred in 10 patients (18%). There was neither long-term morbidity nor mortality due to mycophenolate mofetil. Conclusions: Mycophenolate mofetil is effective in the treatment of patients with steroid-dependent or -resistant chronic ocular inflammatory disorders that fail to respond to conventional steroid treatment. It is a safe and effective steroid-sparing immunomodulatory agent and can be considered an important addition to our armamentarium in the care of patients with ocular inflammatory disease. Ophthalmology 2003;110:1061–1065 © 2003 by the American Academy of Ophthalmology.
Mertens v. Hewitt Associates, and the ERISA Liability of the Professional Service Provider

In Mertens v. Hewitt Associates, the United States Supreme Court held that money damages cannot be recovered as "appropriate equitable relief" under section 502(a)(3) of the Employee Retirement Income Security Act of 1974 (ERISA) when the liability of professional service providers who are not fiduciaries under ERISA is in question. Nonetheless, the author main tains, Mertens is not the last word on ERISA liability of the professional providing services to ERISA plans. The 5-4 decision reflects a sharp split among members of the Court as to the appropriate construction to be given ERISA's remedial provisions. In both the discussion of the money damages issue and the undecided issue of whether the "knowing participation" claim underlying Mertens is available at all, the Court was divided. The dissent ing Justices held that the statute commands a broad construction consistent with its remedial purpose and its foundation in the common law of trusts. The majority, on the other hand, rejected any interpretation which lay outside the statute's text. Mertens is important to the employee benefits practitioner, the author writes, not only because its holding reduces the risk that the professional will be subject to tenuous suits aimed primarily at the "deep pocket, " but also because it raises new questions in connection with the theories most favored by ERISA plaintiffs seeking to recover from in dependent service providers: the "knowing participation " cause of action and the claim that the service provider is liable as an ERISA fiduciary for plan losses.
Planning accelerated destructive degradation tests with initiation time

For some products, their reliability information can only be collected via destructive degradation tests where only one measurement can be taken for each test specimen. To expedite data collection, it is also quite common to conduct accelerated destructive degradation tests (ADDT) by exposing test units to harsher-than-normal conditions. One challenge in such tests is that some products start degrading only after a random de gradation initiation time that is sometimes not even observable. This paper addresses a problem of planning ADDT for a product with random degradation initiation time. The objective is to improve the statistical efficiency of the estimator of the product's reliability index obtained from the designed ADDT. The maximum likelihood estimation method and an expectation-maximum algorithm are used to estimate the model parameters and the p-quantile of failure time under the normal operating condition. In planning the ADDT, the optimal unit allocations for those accelerated stress levels are determined under the sample size and testing time constraints. To solve this problem, a nonlinear integer programming problem is formulated. As a main step, a simulation-based method is used to minimize the asymptotic variance of the estimator of the interested p-quantile. To the best of our knowledge, this is the first attempt that focuses on planning of ADDT involving random degradation initiation time. The experimental design method will facilitate the implementations of ADDT in various industry applications.
The warship as the ultimate guarantor of Britain's freedom in 1940*

This article undermines a prop supporting the popular belief that Britain was directly saved from invasion in 1940 because the R.A.F. held control of the air in the Battle of Britain. Primary source evidence shows that even without adequate air cover, warships retained considerable potential to resist bombing attacks. While weaknesses in the system of air defence are acknowledged, the Luftwaffe possessed significant shortcomings when operating against the Royal Navy. Germany achieved temporary local air superiority over Kent and Sussex in September 1940 and it is suggested that German leaders were disinclined to recognize this because they expected that warships would smash the invasion anyway.
Question-Answer Cards for an Inclusive Micro-tasking Framework for the Elderly

Micro-tasking (e.g., crowdsourcing) has the potential to help “long-tail” senior workers utilize their knowledge and experience to contribute to their communities. However, their limited ICT skills and their concerns about new technologies can prevent them from participating in emerging work scenarios. We have devised a question-answer card interface to allow the elderly to participate in micro-tasks with minimal ICT skills and learning efforts. Our survey identified a need for skill-based task recommendations, so we also added a probabilistic skill assessment model based on the results of the micro-tasks. We also discuss some scenarios to exploit the question-answer card framework to create new work opportunities for senior citizens. Our experiments showed that untrained seniors performed the micro-tasks effectively with our interface in both controlled and realistic conditions, and the differences in their skills were reliably assessed.
Relationship Marketing at Volkswagen

The development of stable relationships with customers is an increasingly important goal for Volkswagen, since the company is part of a global car industry suffering from clear over-capacity. Knowing your customers and addressing their needs is a major prerequisite for the successful establishment of such long-term relationships, but this is a difficult process in an industry focused on mass production. In this chapter, the author describes the development of a relationship marketing approach at Volkswagen and shows how this approach manifests itself in terms of products and services. Building on the crucial role of information in developing stable relationships with customers, he provides an overview of both the Volkswagen club & card concept and the underlying advanced database management system.
Someone to live for: social well-being, parenthood status, and decision-making in oncology.

PURPOSELittle is known about the influence of social factors on treatment preferences and desire for aggressive cancer therapy. The present study assessed subjective and objective social indicators in patient preferences for treatment.METHODSCancer patients (N = 296) with diverse diagnoses and stages read sets of hypothetical vignettes describing patients with early-stage and advanced disease. In the first set, patients made decisions about treatment acceptance given varying levels of either increasing cure or extending survival. In the second set, the point at which patients shifted preferences from mild to severe treatment to improve likelihood of 1-year survival (switch point) was the dependent measure. We assessed the impact of quality-of-life (QL) domains measured by the Functional Assessment of Cancer Therapy-General (FACT-G), having children, marital status, and living arrangements on treatment preferences and switch points.RESULTSThe Social Well-Being (SWB) subscale of the FACT-G predicted both tr...
Improved I/O pad assignment for sea-of-gates placement algorithm

A new method to improve the input/output (I/O) pad positioning assignment for a placement algorithm based on a resistive network optimization model is proposed. In the sea-of-gates placement program, the preplaced I/O pads are used as boundary conditions in solving sparse linear equations to obtain the module placement. The objective of the pad assignment is to assign I/O pad positions, based on connectivity information, so that the resulting optimized module arrangement will minimize the cost function defined in this case as the total wire length. The pad assignment program is used as a processor for the sea-of-gates placement package PROUD. The results have revealed excellent improvement. >
The identification and distribution of the carboxylic esterases in the American cockroach, Periplaneta americana (L.)

Abstract No less than twelve separate esterolytic enzymes were disclosed by the electrophoretic analysis of the supernatant fraction from whole cockroach homogenates. These isolated enzymes exhibited definite substrate preferences, and the effect of various inhibitors indicated the presence of five different organophosphorus resistant esterases and six separate ali-esterases in addition to cholinesterase. The dissected tissues of the cockroach were assayed colorimetrically for esterase activity with alpha-naphthyl acetate as substrate. The nerve cord and the brain were the sites of greatest activity. The other tissues in the order of decreasing enzyme activity were: midgut, Malpighian tubules, fat body, foregut, hindgut, haemolymph, reproductive system, and muscle. The largest number and the major concentration of the organophosphorus resistant esterases were found in the alimentary tract and the haemolymph, while the most abundant number and amount of the aliesterases were observed in the nerve cord, brain, fat body, and integument. Cholinesterase appeared to be restricted to the nervous system. The results of injection studies revealed that TOCP is not a selective inhibitor for aliesterases in vivo .
Solution conformational preferences of glutaric, 3‐hydroxyglutaric, 3‐methylglutaric acid, and their mono‐ and dianions

Conformational preferences of glutaric, 3-hydroxyglutaric and 3-methylglutaric acid, and their mono- and dianions have been investigated with the aid of NMR spectroscopy. In contrast to succinic acid, glutaric acid displays essentially statistical conformational equilibria in polar and non-polar solutions of high and low hydrogen-bonding ability with no clear evidence for intramolecular hydrogen-bonding interactions. The acid ionization constant ratios, K_1/K_2, in D_2O and DMSO of glutaric, 3-hydroxyglutaric, and 3-methylglutaric acids also indicate that intramolecular interactions are much less important than, or indeed insignificant, for shorter-chain acids. FTIR studies on 3-methylglutaric acid indicate some preference for either association with solvent or dimerization, depending on the solvent, rather than intramolecular hydrogen bonding.
Abstract 4825: Metabolic factors and hepatocarcinogenesis in steatohepatitis.

Proceedings: AACR 104th Annual Meeting 2013; Apr 6-10, 2013; Washington, DC Background: With the rising prevalence in the US of alcoholism, obesity, and metabolic syndrome and better treatments for hepatitis B and C, steatohepatitis is projected to become the leading cause of end-stage liver disease and hepatocellular carcinoma (HCC) by 2025. Objective, Setting, and Design: Using a prospectively collected database, we analyzed clinical and pathologic features of HCC in patients who underwent liver transplantation (LT) for steatohepatitis due to non-alcoholic (NASH) and alcoholic causes (ALD) between 1/1/02 and 12/31/11 in a large urban transplant center. We further compared patients with HCC due to NASH (N-HCC) and ALD (A-HCC). Results: HCC was present in 80 of 317 patients who underwent LT for steatohepatitis with equivalent distribution in NASH and ALD patients (24% vs 26%;P=0.8). On multivariate analysis, age and diabetes were associated with HCC in the explant but not BMI, hypertension, or smoking; hyperlipidemia was protective (Table). Among patients with HCC, N-HCC patients were more likely than A-HCC patients to be female (58% vs 4%;P<0.0001) and have metabolic syndrome (27% vs 9%;P=0.025). On pathology, N-HCC patients were also more likely to have steatosis (76% vs 34%;P<0.001), steatohepatitis (67% vs 19%;P<0.0001), or nuclear grade 1 or 2 (89% vs 67%;P=0.03). Five-year survival was similar in N-HCC and A-HCC (67% vs 68%;P=1). Conclusions: We report the largest series of liver transplantation for HCC in steatohepatitis. Metabolic factors such as diabetes and hyperlipidemia appear to play large and independent promoting and protective roles in hepatocarcinogenesis. Modulation of causative factors may be important in management of this increasingly common obesity-related disease. Table. Multivariate Predictors of HCC Presence in Explant View this table: Table. Multivariate Predictors of HCC Presence in Explant Citation Format: Ali Zarrinpar, Vatche Agopian, Jonathan Hiatt, Ronald Busuttil. Metabolic factors and hepatocarcinogenesis in steatohepatitis. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4825. doi:10.1158/1538-7445.AM2013-4825 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.
Respiratory Retraining of Refractory Cough and Laryngopharyngeal Reflux in Patients With Paradoxical Vocal Fold Movement Disorder

Objectives/Hypothesis: The objective was to describe a case series of patients with refractory cough and paradoxical vocal fold movement disorder treated with respiratory retraining therapy. Study Design: Retrospective review of a case series in a tertiary medical care center. Methods: Five patients with laryngopharyngeal reflux were identified with refractory cough and paradoxical fold movement disorder on transnasal fiberoptic laryngoscopy by a greater than 50% reduction in airway during inspiration. The were four women and one man (age range, 42–67 y). All patients had normal forced vital capacity and forced expiratory flow but decreased ratio of forced inspiratory volume at 0.5 seconds (FIV0.5) to forced inspiratory vital capacity (FIVC) before starting therapy. All patients were treated with more than 6 months of twice-daily proton pump inhibitor therapy with improvement in reflux symptoms but persistent and severe daytime cough. They were subsequently treated with respiratory retraining therapy. Patients were asked to rate subjectively the severity of cough at the onset and conclusion of therapy. All patients underwent pulmonary function testing before and after therapy. Long-term follow-up ranged from 5 to 17 months. Results: Patients received two to seven sessions of respiratory retraining therapy. The mean severity score changed from 9.2 before therapy to 1.3 after therapy. All patients subjectively described an improvement in the severity of their cough. Transnasal flexible laryngoscopy demonstrated improvement in paradoxical vocal fold movement, and pulmonary function testing showed improvement in the FIV0.5/FIVC ratio. Conclusion: Patients with laryngopharyngeal reflux and refractory cough in the absence of pulmonary disease should be evaluated for paradoxical vocal fold movement disorder. Respiratory retraining therapy may represent an effective therapy for cough in the absence of relief from standard management of laryngopharyngeal reflux.
Quality factors in exported peanuts from agrentina, China and the united states

In three crop years (1986–1988), peanuts exported from Argentina, China and the United States were evaluated for biochemical composition relative to flavor and shelf-life quality potentials and physical size conformity. Relationships were consistent in that oil stability was associated with high tocopherol and oleic/linoleic acid ratio, and with low free fatty acid, peroxide, carbonyl, and copper and iron content. Peanuts from specific origins had recurring component patterns, with highest indications for shelf life and flavor potential in United States samples. Although no single factor or group of factors can be relied on completely as predictors of flavor or quality, these data establish a significant positive relationship between oil quality factors and roasted peanut flavor quality potential. Argentina and United States peanuts were the most consistently sized, and China peanuts generally had the lowest count/weight.
Hormones and the aging process.

For more than a century, it has been suggested that failure of the secretions of the ductless glands leads to aging. Replacement of these hormones has been suggested as a method of slowing the aging process. Clearly, modern research has demonstrated that the concept of a “hormonal fountain of youth” is predominantly mythology. The best evidence for hormonal replacement is vitamin D and estrogen replacement to prevent hip fractures. Other than that, treatment should be limited to hormone replacement in persons who have endocrine disease.
An electron and light microscope study of the caecal tonsil: The basic unit of the caecal tonsil

Abstract The caecal tonsil (CT) develops in the initial 4–18 mm of each of the chicken's caecal pouches. Utilizing scanning and transmission electron microscopy and light microscopy we identified the basic unit of the CT. The basic unit contains a central crypt with several primary branches, dense lymphoid tissue and germinal centers. The main structural design of the CT appears to correspond to the mammalian palatine and lingual tonsils.
Acid-induced expression of an LPS-associated gene in Helicobacter pylori

Summary To investigate urease-independent mechanisms by which Helicobacter pylori resists acid stress, subtractive RNA hybridization was used to identify H. pylori genes whose expression is induced after exposure to acid pH. This approach led to the isolation of a gene that encoded a predicted 34.8 kDa protein (WbcJ), which was homologous to known bacterial O-antigen biosynthesis proteins involved in the conversion of GDP-mannose to GDP-fucose. An isogenic wbcJ null mutant strain failed to express O-antigen and Lewis X or Lewis Y determinants and was more sensitive to acid stress than was the wild-type strain. Qualitative differences in LPS profiles were observed in H. pylori cells grown at pH 5 compared with pH 7, which suggests that H. pylori may alter its LPS structure in response to acidic pH. This may be an important adaptation facilitating H. pylori colonization of the acidic gastric environment.
Occurrence and persistence of Escherichia coli O157:H7 in water

Escherichia coli O157:H7 has been associated with water related outbreaks. It has been isolated from surface and ground waters. It is capable of survival in water for days to weeks
Detection of Data Flow Anomaly Through Program Instrumentation

A data flow anomaly in a program iB an indication that a programming error might have been committed. This paper descibes a method for detecting such an anomiay by means of program instrumentation. The method is conceptually simple, easy to use, easy toimplement on a computer, and can be applied in conjunction with a conventional program test to achieve increased error-detection capability.
Between Cram-School and Career in Tokyo

In a series of studies (including interviews, observations, surveys and focus groups), we explored the leisure practices of young adults in Tokyo. After initial fieldwork with a wide age-range of participants, we narrowed our focus to 19-25 year olds, who have more leisure time and for whom leisure activities hold greater significance. In this paper, we briefly characterize these transitional “golden years” between cram school and career in Japan, and illustrate how a grounded understanding of leisure preferences and patterns can help suggest issues and opportunities for design.
Deuterium isotope effects and product studies for the oxidation of N(ω)-allyl-L-arginine and N(ω)-allyl-N(ω)-hydroxy-L-arginine by neuronal nitric oxide synthase

The nitric oxide synthases (NOS), which require heme, tetrahydrobiopterin, FMN, FAD, and NADPH, catalyze the O2-dependent conversion of L-arginine to L-citrulline and nitric oxide. N(omega)-Allyl-L-arginine, a mechanism-based inactivator of neuronal NOS, also is a substrate, producing L-arginine, acrolein, and H2O (Zhang, H. Q.; Dixon, R. P., Marletta, M. A.; Nikolic, D.; Van Breemen, R.; Silverman, R. B. J. Am. Chem. Soc. 1997, 119, 10888). Two possible mechanisms for this turnover are proposed, one initiated by allyl C-H bond cleavage and the other by guanidino N H cleavage, and these mechanisms are investigated with the use of N(omega)-allyl-L-arginine (1), N(omega)-[1,1-(2)H2]allyl-L-arginine (7), N(omega)-allyl-N(omega)-hydroxy-L-arginine (2) and N(omega)-[1,1-(2)H2]allyl-N(omega)-hydroxy-L-arginine (8) as substrates. Significant isotope effects on the two kinetic parameters, kcat and kcat/Km, are observed in case of 1 and 7 during turnover, but not with 2 and 8. No kinetic isotope effects are observed for either compound in their role as inactivators. These results support a mechanism involving initial C-H bond cleavage of N(omega)-allyl-L-arginine followed by hydroxylation and breakdown to products.
Short-duration shock-wave initiation of solid explosives

Abstract In the study of the initiation of solid, polycrystalline explosives by short-duration (thin) shock waves, several investigators have found that the relationship between initial pressure (P) and shock duration (τ) can be described with the equation P2τ = const. Different mechanisms have been proposed to explain this relationship. However, the possibility that the relationship arises from the hydrodynamics of the overtake of the shock wave by a rarefaction from the rear has not been considered. I have investigated five simple models, three analytic and two numerical models, to examine the relationship between the entry time of the rarefaction and the time of its overtaking the initiating shock wave in a solid explosive. The purpose of this study is not to define a new quantitative model, but is to explore what effects changes in the wave profile and sustained-shock parameters have on the interaction of the rarefaction and the shock front. One of the analytic models fits the experimental data for the explosive PBX 9404 exceptionally well, but the very simplicity of the analytic model argues that transit time data on fixed-length samples are not sufficient to verify a proposed model for the initiation of solid explosives by thin shock waves. The analytic models show, in a simple manner, how the sustained-shock initiation parameters can influence the thin-shock initiation. The two numerical models, neither of which are intended to model reality, could be forced to fit the experimental sustained- and thin-shock data. They also illustrate some of the additional data that will be required before a realistic model can be developed. Given a more realistic model for the hydrodynamic conditions behind the shock front, this study indicates that a model based on rarefaction overtake is apparently adequate to describe thin-shock initiation.
Hemodynamic resistance to intravenous nitroglycerin in severe congestive heart failure and restored response after diuresis.

A wide variety of organic nitrate preparations are often used in the management of congestive heart failure (CHF). This class of drugs exerts a vasodilatory action, predominantly on the venous capacitance vessels, that leads to a reduced ventricular filling pressure and usually without an increase in cardiac output. 1,2 Two major problems exist that deter its widespread acceptance as an effective drug in CHF: the development of tolerance and hemodynamic resistance or primary drug failure. Tolerance is responsible for the loss of hemodynamic and clinical benefits after nitrate therapy has been initiated.3–5 An absent or feeble hemodynamic response to nitrates, a relatively common occurrence, has been reported to occur in approximately ≥50% of treated patients.6,7 However, nitrate resistance is not always apparent when intravenous nitroglycerin is used without hemodynamic monitoring. This study was designed for 2 purposes: (1) to substantiate previously described hemodynamic and clinical correlates of CHF predictive of resistance to intravenous nitroglycerin,6,7 and (2) to determine whether hemodynamic modification using alternate drug therapy might restore responsiveness to nitroglycerin.
Bladder Injury after LAVH: A Prospective, Randomized Comparison of Vaginal and Laparoscopic Approaches to Colpotomy During LAVH

Abstract Study Objective To compare results of a vaginal approach to colpotomy (type IA) and laparoscopic-assisted abdominal colpotomy (type ID) in performing a laparoscopic-assisted vaginal hysterectomy (LAVH). Design Prospective, randomized study (Canadian Task Force classification I). Setting Tertiary teaching hospital. Patients Five hundred forty-one women, 274 in group 1 (type 1D) and 267 in group 2 (type 1A). Intervention LAVH with follow-up for 3 months to 5 years. Measurements and Main Results There were no statistically significant differences in age, preoperative and postoperative hemoglobin values, or postoperative hospital stay between groups. Operating time and estimated blood loss were significantly reduced in group 2 (p Conclusion LAVH type IA achieved better results than type ID in preventing bladder injury.
Factors that determine the occurrence of arrhythmias during acute myocardial ischemia

Abstract To elucidate the determinants of arrhythmias during acute myocardial ischemia, a 25-minute coronary artery occlusion was performed in 101 open-chest dogs. Heart rate correlated positively with the number of premature ventricular complexes (PVCs) and the occurrence of ventricular tachycardia (VT) and fibrillation (VF). The size of the occluded coronary bed was positively correlated with the occurrence of VF, but exhibited only a weak association with PVCs and VT. Coronary collateral flow exhibited a strong negative correlation with all forms of arrhythmias. Importantly, a sensitive coupling was present, whereby small differences in flow were associated with large differences in rhythm disorders. VT occurred in all ranges of occluded bed size examined, but within any given range, its incidence was inversely related to collateral flow. Thus, VT is relatively independent of occluded bed size, and is determined primarily by the degree of myocardial hypoperfusion. In contrast, even in the presence of low flows, VF did not develop with occluded beds
A Quadratic Model for Combining Quantitative Diagnostic Assessments from Radiologist and Computer in Computer-Aided Diagnosis

Rationale and Objectives Some computer-aided diagnosis (CAD) methods produce a quantitative diagnostic assessment (eg, likelihood of malignancy) based on computer image analysis that a radiologist who uses the computer aid must combine with his or her own assessment. Observer studies show that although CAD helps radiologists improve diagnostic performance, ad hoc use of computer aid can produce performance inferior to that of computer alone, indicating that radiologists are unable to incorporate computer assessment optimally into their final assessment. We describe a mathematical model for combining two correlated diagnostic assessments that may provide a basis for merging radiologists’ ratings with computer assessments in a way that yields greater diagnostic accuracy than ad hoc merging by radiologists. Materials and Methods We calculate a likelihood ratio from the bivariate binormal model that describes joint probability density functions of latent decision variables of two correlated diagnostic assessments. To the extent that the bivariate binormal model is valid and that the model’s parameters can be estimated reliably, results obtained in this way will be optimal because the likelihood ratio is the decision variable used by the ideal observer in any two-group classification task. We evaluated this method on two observer study datasets and in Monte Carlo simulations. Results This method produced better performance than achieved by radiologists when they incorporated computer assessment in an ad hoc way. Simulations show that with a large number of cases, this method can produce results indistinguishable from the ideal observer performance. Conclusions This method can potentially help radiologists use quantitative computed diagnostic assessments optimally, thereby surpassing the computer in accuracy.
Petroleum hydrocarbon toxicity studies. IX. Animal and human response to vapors of "80 thinner.".

Abstract The suggested hygienic standard for human inhalation of “80 Thinner”, based upon the results of inhalation studies with rats and dogs and the sensory response of human subjects, is 0.45 mg/liter (100 ppm). The LC50 for rats that inhaled “80 Thinner” for 4 hr was 27 (24 to 30) mg/liter or 6200 (5500 to 6900) ppm. Rats tolerated 3.5 mg/liter (810 ppm) and dogs 2.1 mg/liter (480 ppm) for 4 hr without visible discomfort. Four cats that inhaled 24.0 mg/liter (5500 ppm) for 4 hr had signs suggestive of central nervous system effect, became prostrate in 41 to 65 min, but recovered and survived the 14-day observation period. After inhaling a concentration of 1.7 mg/liter (390 ppm) for 6 hr/day, 5 days per week, neither rats nor dogs were statistically significantly different from their controls in any criterion of effect after 14 weeks of inhalation. The oder threshold, as determined by a sniff test involving six human subjects, is approximately 0.004 mg/liter (0.9 ppm). Only slight, transitory eye irritation was reported by one of six human subjects immediately following a 15-min period in 0.45 mg/liter (100 ppm) and variable responses as to comfort at about 1.0 mg/liter (230 ppm). It is anticipated that 0.45 mg/liter (100 ppm) would be tolerable for continuous inhalation in the workroom atmosphere.
Fascist food politics: Mussolini’s policy of alimentary sovereignty

Fascist food policies were based on the notion of alimentary sovereignty, or total self-sufficiency with regard to food supplies. Although the regime was unsuccessful in achieving complete self-sufficiency, alimentary sovereignty had a significant impact on everyday life and today challenges us to reconsider the authoritarian nature of Italian fascism. Fascist food policies reversed important trends in food habits and nutritional levels from the era before and during World War I, by holding down imports and encouraging the consumption of an austere diet based on bread, polenta, pasta, fresh produce and wine. Using archival sources, scientific writings and other printed materials on food consumption, this article traces the development of alimentary sovereignty as the guiding principle of fascist food policies, from the early years of fascist rule through World War II. This article argues that the history of food policies reveals the peculiar nature of fascist attitudes towards the Italian population, give...