cssi/SciSciGPT-SciSciNet huggingface dataset:
First-year medical students’ calibration bias and accuracy across clinical reasoning activities

To be safe and effective practitioners and learners, medical professionals must be able to accurately assess their own performance to know when they need additional help. This study explored the metacognitive judgments of 157 first-year medical students; in particular, the study examined students’ self-assessments or calibration as they engaged in a virtual-patient simulation targeting clinical reasoning practices. Examining two key subtasks of a patient encounter, history (Hx) and physical exam (PE), the authors assessed the level of variation in students’ behavioral performance (i.e., effectiveness and efficiency) and judgments of performance (i.e., calibration bias and accuracy) across the two subtasks. Paired t tests revealed that the Hx subtask was deemed to be more challenging than the PE subtask when viewed in terms of both actual and perceived performance. In addition to students performing worse on the Hx subtask than PE, they also perceived that they performed less well for Hx. Interestingly, across both subtasks, the majority of participants overestimated their performance (98% of participants for Hx and 95% for PE). Correlation analyses revealed that the participants’ overall level of accuracy in metacognitive judgments was moderately stable across the Hx and PE subtasks. Taken together, findings underscore the importance of assessing medical students’ metacognitive judgments at different points during a clinical encounter.
Assessment of anxiety in older adults: psychometric properties and relationships with self-reported functional impairment.

OBJECTIVE The current study aimed to examine the psychometric properties of two geriatric anxiety measures: the Geriatric Anxiety Inventory (GAI) and the Geriatric Anxiety Scale (GAS). This study also aimed to determine the relationships of these measures with two measures of functional ability and impairment: the Barkley Functional Impairment Scale (BFIS) and the Everyday Cognition Scale (E-Cog). DESIGN Confirmatory factor analyses (CFA) were used to analyze the factor structures of the GAI and GAS in older adults. Tests for dependent correlations were used to examine the relationship between anxiety scales and functioning. SETTING Amazon's Mechanical Turk. PARTICIPANTS 348 participants (aged 55-85, M= 62.75 (4.8), 66.5% female) with no history of psychosis or traumatic brain injury. RESULTS CFAs supported the previously demonstrated bifactor solution for the GAI. For the GAS, the previously demonstrated three-factor model demonstrated a good-to-excellent fit. Given the high correlation between the cognitive and affective factors (r =.89), a bifactor solution was also tested. The bifactor model of the GAS was found to be primarily unidimensional. Tests for dependent correlations revealed that the GAS demonstrated stronger relationships with measures of self-reported functional impairment than the GAI. CONCLUSIONS The current study provides further psychometric validation of the factor structure of two geriatric anxiety measures in an older adult sample. The results support previous work completed on the GAI and the GAS. The GAS was more strongly correlated with self-reported functional impairment than the GAI, which may reflect differences in content in the two measures.
Allogeneic Transplantation after an Alemtuzumab-Containing Myeloablative Conditioning Regimen for CD52 Positive Acute Lymphoblastic Leukemia (ALL).

Alemtuzumab is an effective agent in the treatment of various B- and T-cell malignancies that express CD52. Patients with advanced or refractory ALL have poor outcome after allogeneic stem cell transplantation (SCT). We investigated whether the addition of alemtuzumab to a standard myeloablative conditioning regimen would have any additional therapeutic effect and improve outcome after SCT in CD52+ ALL. Patients and Methods: Patients were eligible if their disease expressed CD52 in >20% blasts by flow cytometry. The conditioning regimen consisted of cyclophosphamide (Cy, 60 mg/kg daily x 2 doses) and total body irradiation (TBI, 12 Gy in four daily fractions). Alemtuzumab at 10 mg was intravenously administered daily on days -6 to -2 prior to day of stem cell infusion. Patients received additional graft versus host disease (GVHD) prophylaxis with tacrolimus and methotrexate. Results: Fifteen patients (9 M/6 F) with median age 33 years (range 22–57) were studied. Twelve patients had B-lineage and 3 had T-lineage disease. Cytogenetic data were available for 12 patients; all had high-risk cytogenetics, including 5 with Ph+ disease. The median number of prior chemotherapy regimens was 3 (range 1–6). At time of study entry, 3 patients were in CR1, 3 were in ≥ CR1, and 9 were in primary or refractory relapse. Five patients received a matched related donor transplant and 10 received an unrelated donor graft. The source of stem cells was bone marrow (n=7) or peripheral blood (n=8). The median CD34+ cell dose infused was 4.67 x 10 6 /kg (range 1.85–6.43). Median time to ANC ≥ 0.5 x 10 9 /L was 15 days (range 11–20). Median time to platelet count ≥ 20 x 10 9 /L was 19 days (range 13–34). The cumulative incidence of non-relapse mortality at 2 years was 13% (95% CI, 4%–43%). The incidence of grade II-IV acute GVHD was 7% (95% CI, 1%–38%); no grade III/IV acute GVHD was observed. The incidence of chronic extensive GVHD was 20%. Overall survival at 2 years was 16% (95% CI, 3%–40%). Failure was related mainly to progression; thirteen of 15 patients had disease progression at a median time of 4 months (range 1–22). Conclusion: These data suggest that alemtuzumab can be safely added to the standard transplant conditioning regimen for ALL without delayed engraftment or increased regimen-related toxicity. However, any potential direct antileukemia effect in CD52+ ALL patients with advanced disease appears to be negated by in-vivo T-cell depletion of the donor graft. Strategies to restore the graft-versus-leukemia effect in this setting are needed.
Measuring innovation using firm-level surveys: Evidence from developing countries✰

Abstract Understanding innovation in developing countries has been substantially constrained by the lack of comparable and reliable data. Collecting data on firm-level innovation is challenging because of the difficulties to operationalize the definition of innovation, the subjective judgement calls that respondents are required to make because of this, and because what constitutes innovation may be considered differently across different country contexts. These challenges may lead to serious issues in innovation measurement. This paper contributes to the literature on measurement of innovation by uncovering significant differences in self-reporting innovation rates likely to result in mismeasurement. The first finding is that measures of innovation varies across survey instruments. Second, key elements explaining these differences are related to both framing issues and cognitive issues. Minimizing differences and potentially mismeasurement issues, therefore, requires ensuring good quality interviews but also facilitating good and consistent understanding of what is an innovation. Adding questions that collect more details describing innovation is critical to identifying inconsistencies in responses. While, the focus is on developing countries; the results of the study are also relevant to other countries and the overall literature on innovation survey design.
Restoring Names, Stories, and Voices for Cinematographic Maids: Toward a New Poetics of Domestic Service in Recent Argentine Films

Traditionally deprived of subjectivity or complexity, servants become mere carcasses for the purposes of their masters or creators. Some recent Argentine films that challenge this idea of utilitarian functionality are La cienaga / The Swamp (Lucrecia Martel 2001) and El nino pez / The Fish Child (Lucia Puenzo 2009), in which the female servants awaken sexual desires within their employers’ households. Nosilatiaj. La belleza / Beauty (Daniela Seggiaro 2012), and Reimon / Reimon (Rodrigo Moreno 2014) experiment further with these characters, organizing their narratives around servant protagonists to explore their identity, subjectivity, and, ultimately, agency. Focusing on four female servant characters and recognizing what is innovative in these depictions, Rossi argues a new poetics of servants is taking place in Argentine cinema.
Co-registration of pre- and post-stent intravascular OCT images for validation of finite element model simulation of stent expansion

Intravascular optical coherence tomography (IVOCT) provides high-resolution images of coronary calcifications and detailed measurements of acute stent deployment following stent implantation. Since pre- and post-stent IVOCT image “pull-back” acquisitions start from different locations, registration of corresponding pullbacks is needed for assessing treatment outcomes. In particular, we are interested in assessing finite element model (FEM) prediction of lumen gain following stenting, requiring registration. We used deep learning to segment calcifications in corresponding pre- and poststent IVOCT pullbacks. We created 1D representations of calcium thickness as a function of the angle of the helical IVOCT scans. Registration of two scans was done by maximizing the cross correlation of these two 1D representations. Registration was accurate, as determined by visual comparisons of 2D image frames. We used our pre-stent calcification segmentations to create a lesion-specific FEM, which took into account balloon size, balloon pressure, and stent measurements. We then compared simulated lumen gain from FEM analysis to actual stent deployment results. Actual lumen gain across ~200 registered pre and post-stent images was 1.52 ± 0.51, while FEM prediction was 1.43 ± 0.41. Comparison between actual and FEM results showed no significant difference (p < 0.001), suggesting accurate prediction of FEM modeling. Registered image data showed good visual agreement regarding lumen gain and stent strut malapposition. Hence, we have developed a platform for evaluation of FEM prediction of lumen gain. This platform can be used to guide development of FEM prediction software, which could ultimately help physicians with stent treatment planning of calcified lesions.
Abstract P253: Blood Pressure Status Among Current Cigarette, E-cigarette, And Marijuana Users In The United States: An Analysis Of The National Health And Nutrition Examination Surveys, 2013-2016

Introduction: Tobacco and marijuana have been associated with abnormal blood pressure (BP). Yet, little is known about differences in BP status among individuals who smoke cigarettes, e-cigarettes,...
The duration of intrapartum supplemental oxygen administration and umbilical cord oxygen content.

Background Maternal oxygen (O2) administration is a commonly performed intrauterine resuscitation technique though to improve fetal oxygenation. However, hyperoxygenation is known to be harmful in both neonates and adults. Currently, there are no formal recommendations on whether a certain dose or duration of O2 may be most helpful in improving umbilical cord gases or neonatal outcomes. Objective We tested the hypothesis that prolonged supplemental O2 exposure during labor is associated with increased umbilical cord O2 concentrations. Study Design This was a planned secondary analysis of a randomized noninferiority trial comparing O2 with room air in laboring patients. Patients were randomized to receive either 10 L/min O2 or room air at any point during active labor when they developed a category II fetal heart tracing that would otherwise require resuscitation. The primary outcome variable for this analysis was partial pressure of O2 in the umbilical vein. The secondary outcome variable was partial pressure of O2 in the umbilical artery. These outcome variables were compared between patients with short durations of O2 exposure and those with long durations of O2 exposure, defined as Results Among the 99 patients with paired and validated cord gases who were included in this analysis, the partial pressure of O2 in the umbilical vein was significantly lower in patients who received O2 supplementation for longer durations than in those who received O2 for shorter durations (median interquartile range 25.5 [21.5–33] vs 32.5 [26.5–37.5] mm Hg; P Conclusion Longer durations of O2 exposure are not associated with a higher partial pressure of O2 in the umbilical cord. In fact, patients with longer durations of O2 exposure had lower partial pressure of O2 in the umbilical vein, suggesting impaired placental O2 transfer with prolonged O2 exposure.
Guidelines for Evaluating the Feasibility of Recruitment in Pilot Studies of Diverse Populations: An Overlooked but Important Component

Background: In health disparities research, studies often fall short of their recruitment goals. Conducting a pilot feasibility study of recruitment in which data are collected systematically on recruitment processes can help investigators refine methods for the larger study. However, there are few guide­lines for conducting pilot feasibility studies, and recruitment methods are seldom the focus. Feasibility indicators differ from traditional reports of recruitment results by focusing on the extent to which recruitment goals are met. Methods: We present an organizing frame­work for assessing the feasibility of recruit­ment that includes eight steps, briefly: 1) specify recruitment goals; 2) specify recruit­ment processes; 3) establish a tracking sys­tem for each individual; 4) establish a track­ing database for monitoring processes and results; 5) implement recruitment and track each individual’s progress; 6) summarize re­cruitment results; 7) calculate and interpret feasibility measures - were goals met; and 8) if goals were not met, utilize tracking data to modify methods for the larger study. We describe methods within each step, with added details for steps 2-5 (the specific pro­cesses). The framework draws from a small literature on recruitment feasibility with a focus on health disparities populations. The guidelines blend well-known methods of recruitment with additional information on calculating feasibility indicators. Conclusion: These guidelines provide a first step in thinking systematically about recruitment feasibility, to advance the field of measuring feasibility. Feasibility indicators also can be used to track the effectiveness of innovative recruitment strategies as part of building the science of recruitment, es­pecially in disparities populations. Ethn Dis. 2020; 30(Suppl 2):745-754; doi:10.18865/ed.30.S2.745
In vivo evaluation of combination therapy targeting the isoprenoid biosynthetic pathway

Geranylgeranyl diphosphate synthase (GGDPS), an enzyme in the isoprenoid biosynthetic pathway (IBP), produces the isoprenoid (geranylgeranyl pyrophosphate, GGPP) used in protein geranylgeranylation reactions. Our prior studies utilizing triazole bisphosphonate-based GGDPS inhibitors (GGSIs) have revealed that these agents represent a novel strategy by which to induce cancer cell death, including multiple myeloma and pancreatic cancer. Statins inhibit the rate-limiting enzyme in the IBP and potentiate the effects of GGSIs in vitro. The in vivo effects of combination therapy with statins and GGSIs have not been determined. Here we evaluated the effects of combining VSW1198, a novel GGSI, with a statin (lovastatin or pravastatin) in CD-1 mice. Twice-weekly dosing with VSW1198 at the previously established maximally tolerated dose in combination with a statin led to hepatotoxicity, while once-weekly VSW1198-based combinations were feasible. No abnormalities in kidney, spleen, brain or skeletal muscle were observed with combination therapy. Combination therapy disrupted protein geranylgeranylation in vivo. Evaluation of hepatic isoprenoid levels revealed decreased GGPP levels in the single drug groups and undetectable GGPP levels in the combination groups. Additional studies with combinations using 50% dose-reductions of either VSW1198 or lovastatin revealed minimal hepatotoxicity with expected on-target effects of diminished GGPP levels and disruption of protein geranylgeranylation. Combination statin/GGSI therapy significantly slowed tumor growth in a myeloma xenograft model. Collectively, these studies are the first to demonstrate that combination IBP inhibitor therapy alters isoprenoid levels and disrupts protein geranylgeranylation in vivo as well as slows tumor growth in a myeloma xenograft model, thus providing the framework for future clinical exploration.
A brief review of the stony coral (Cnidaria: Anthozoa: Scleractinia) papers published by Zootaxa in its first 20 years

In the 20 year history of Zootaxa, thirty-two papers have been published having Scleractinia as its primary focus. Twenty-four of the 32 scleractinian papers deal with Recent taxa, most of which belonging to shallow-water, reef corals. The 8 publications dealing with fossil Scleractinia include 3 monographic works, three papers discussing nomenclatural issues of individual taxa, and 2 papers deal with various aspects of select genera.
Undue Conservatism in Random Vibration Design Loads

– Dynamic loads specified as static loads are unduly conservative as applied (statically)• A recently retired MSFC vibro-acoustic engineer has been heard to say (numerous times) “it’s a dynamic load, if you want to apply it statically, be my guest”– At “higher frequencies” the effect of vibrations on structures is minimal – this of course begs the ques tion, how high is high?
Therapy for α1-Antitrypsin Deficiency

α1-Antitrypsin (A1AT) deficiency is inherited as an autosomal codominant disorder characterised by reduced levels of A1AT in the serum. Low levels of A1AT in blood perfusing the lung cause low levels in the lung interstitium, making it susceptible to proteolytic damage from resident neutrophil elastase. A ‘protective threshold’ serum A1AT level of 11 μmol/L has been identified by epidemiological studies as a minimum value below which there is an increased risk of emphysema. Intravenous augmentation therapy for patients with severe deficiency of A1AT has been shown to have biochemical efficacy. Although the clinical efficacy of intravenous augmentation therapy has not been demonstrated in a randomised clinical trial, available studies suggest that augmentation therapy is associated with a slowed rate of decline of lung function and enhanced survival. The criteria for patient selection include: age >18 years, serum A1AT level ≤11 μmol/L, a high-risk phenotype (usually PI*ZZ), and documented fixed airflow obstruction (consistent with chronic obstructive pulmonary disease). Although intravenous augmentation is currently the only form of specific therapy approved in the US, active research in the fields of aerosol and gene therapy promise to offer new treatment prospects. In this article, we review the available literature on A1AT augmentation therapy and discuss our recommendations.
Are kissing gourami specialized for substrate-feeding? Prey capture kinematics of Helostoma temminckii and other anabantoid fishes.

The Kissing gourami, Helostoma temminckii, has an unusual jaw morphology, which is used in a peculiar way: two individuals will "flare" the upper and lower jaws, in both the mediolateral and dorsoventral planes, and press the tips of their jaws against one another. This eponymous "kissing" behavior is an intraspecific, agonistic behavior. In fact, the distinctive oral jaw morphology of Helostoma was interpreted by the late Professor Karel Liem as an adaptation for this kissing behavior (Liem, '67). A key feature of the distinctive oral jaw morphology of Helostoma is an additional joint within the mandible—between the dentary and articular—known as the intramandibular joint ABSTRACT Helostoma temminckii are known for a "kissing" behavior, which is often used in intraspecific interactions, and an unusual cranial morphology that is characterized by an intramandibular joint (IMJ). The IMJ is located within the lower jaw and aids in generating the eponymous kissing movement. In other teleost linages the IMJ is associated with the adoption of a substrate-grazing foraging habit. However, because of anatomical modifications of the gill-rakers, Helostoma has been considered a midwater filter-feeding species. We offered midwater, benthic, and attached food to Helostoma, Betta, and two "true" osphronemid gouramis, to ask: (1) how do food capture kinematics differ in different foraging contexts; and (2) are Helostoma feeding kinematics distinct when compared with closely related anabantoids that lack an IMJ? For all anabantoid species except Helostoma, benthic prey were captured using a greater contribution of effective suction relative to midwater prey, though Helostoma was rarely willing to feed in the midwater. Helostoma individuals produced relatively less suction than other species regardless of the food type. Helostoma produced a much larger gape and more premaxillary protrusion than other species, but also took longer to do so. We suggest that the jaw morphology of Helostoma facilitates an extremely large mouth-gape to enhance substrate-scraping. The large amplitude mouth-opening that characterizes substrate-feeding may represent a functional trade-off, whereby the enhanced ability to procure food from the substrate is accompanied by a concomitant reduction in the ability to produce suction. J. Exp. Zool. 317A:571-579, 2012. © 2012 Wiley Periodicals, Inc. How to cite this article: Ferry LA, Konow N, Gibb AC. 2012. Are kissing gourami specialized for substrate-feeding? Prey capture kinematics of Helostoma temminckii and other anabantoid fishes. J. Exp. Zool. 317A:571-579. J. Exp. Zool. 317A:571-579, 2012
Enthalpies of dilution of aqueous solutions of HCl, MgCl2, CaCl2, and BaCl2 at 300, 325, and 350°C

Dilution enthalpies, measured using isothermal flow calorimetry, are reported for aqueous solutions of BaCl2 at 300°C and 11.0 MPa, MgCl2, CaCl2, and BaCl2 at 325°C and 14.8 MPa, and at 350°C and 17.6 MPa. Previously collected dilution enthalpies for aqueous solutions of MgCl2 and CaCl2 at 300°C and 10.3 MPa and for aqueous solutions of HCl at 250, 275, and 300°C at 10.3 MPa and 320°C at 12.8 MPa were included with the new data at 300°C and 11.0 MPa and at 350°C and 17.6 MPa when fitting the Pitzer parameters. The concentration range of the chloride solutions was 0.5 to 0.02 molal. Parameters for the Pitzer excess Gibbs ion–interaction equation were determined from the fits of the experimental heat data. Equilibrium constants, enthalpy changes, entropy changes, and heat-capacity changes for the association of alkaline earth metal ions and H+ with chloride ion were estimated from the heat data. For all systems, the enthalpy and entropy changes are positive and show accelerating increases with temperature. The resulting equilibrium constants show significant, but smaller, increases with temperature.
Transport of diamino acids into the Ehrlich cell.

Abstract The mediated uptake of lysine by the Ehrlich cell shows a heterogeneity in its accessibility to inhibition by other amino acids: a portion of about 60% that can be eliminated by the presence of phenylalanine in excess; a minor portion that can be eliminated by various neutral amino acids, although not by phenylalanine; and another minor saturable portion that cannot be inhibited by neutral amino acids. The latter component shows a doubling of its rate on the removal of the sodium ion from the medium. The described heterogeneity of lysine transport might be explained in either of two ways. First, one might propose three independent transport-mediating systems for lysine, none of them identical with any serving for the neutral amino acids. Alternatively, the leucine-preferring and lysine-preferring receptor sites may lie on a common transport-mediating system, the phenomena of partial inhibition of lysine transport by neutral amino acids and of neutral amino acid transport by lysine arising from the handicap that filling of one of the sites presents to the operation of the other. A parallelism in the loss of countertransport by leucine and lysine on treatment with dinitrofluorobenzene indicates at least a common feature if not a common step for two of the processes concerned. The entry of α-N-methyl-l-lysine, which was unreactive with the above transport agencies, showed a first order rate constant of 0.003 min-1, providing a maximal value for entry by simple diffusion. At least two of these three components contribute to the uptake of α,γ-diaminobutyric acid, but its intense uptake at high concentration (and that of its lower homologue) is produced by an atypical use of the usual alanine-preferring (A) system. Possible bases for that atypical operation of the A system are discussed.
Regulation of Inducible Nitric Oxide Synthase Expression by Macrophage Purinoreceptors and Calcium

Macrophage activation is central to the progression of multiple diseases via the release of inflammatory mediators such as cytokines and nitric oxide. Despite the recognized overlap in the regulatory mechanisms involved in mediator production, little formation exists regarding receptor-initiated signaling pathways that coordinately control multiple end points, such as tumor necrosis factor-alpha (TNF-alpha) and nitric oxide production. In this study, the expression of inducible nitric oxide synthase (iNOS) in macrophages is shown to be regulated by calcium and by a purinoreceptor signaling system. The P2Y purinoreceptor partial agonist, 2-methylthio-ATP (2-MeS-ATP), inhibits the expression of iNOS induced by lipopolysaccharide (LPS) plus interferon-gamma (IFN-gamma) in primary macrophages. Additionally, 2-MeS-ATP attenuates the expression of iNOS in macrophages isolated from CD-1 mice challenged with LPS, and it inhibits LPS-induced TNF-alpha and interleukin-1 alpha (IL-1 alpha) release, thereby preventing endotoxic death. Thus, purinoreceptors and calcium are likely to be critical for macrophage activation and the production of inflammatory mediators stimulated by LPS.
Re-housing and a preliminary evaluation of conservation treatment methods for scraperboard artworks

This article provides an introduction to the artist's medium scraperboard, also known as scratchboard. Research into the development of the medium and its constituent materials informed a preliminary evaluation of possible conservation treatments and the re-housing of scraperboard artworks in the collection of The National Archives. The treatment evaluation used visual examination, surface depth, gloss and colour measurements to assess the impact of surface cleaning and consolidation techniques, both individually and in combination, on the surface of scraperboard samples. Results showed that the surface cleaning methods tested were unsuitable, but found that gelatine used with the aerosol generator caused the least changes to the surface of the scraperboard and proved the most successful consolidant of those tested. However, further testing was suggested before its use could be recommended as a treatment. Condition assessments of artworks determined types of damage encountered with scraperboard and assist...
A shock spectra and impedance method to determine a bound for spacecraft structural loads

A method to determine a bound of structural loads for a spacecraft mounted on a launch vehicle is developed. The method utilizes the interface shock spectra and the relative impedance of the spacecraft and launch vehicle. The method is developed for single-degree-of-freedom models and then generalized to multidegree-of-freedom models.
Endobronchial Metastases from Prostatic Carcinoma

Prostatic carcinoma presenting with pulmonary symptoms is unusual. We describe the case of a 59-year-old man whose disseminated prostate cancer was diagnosed with bronchoscopy. To our knowledge, this represents the second reported case of prostate cancer that manifested with endobronchial symptoms. The importance of this entity and clinical and therapeutic aspects are also discussed.
Variability of sea-surface temperature in the South Atlantic bight as observed from satellite: Implications for offshore-spawning fish

Abstract We examined full-resolution (1 × 1 km) satellite images of sea-surface temperature (SST) over five consecutive years (1981–1986) covering the Atlantic menhaden (Brevoortia tyrannus) recruitment period (November–April) in the SABRE (South Atlantic Bight recruitment experiment) study site. The results of our image time series indicated two processes which could be possible mechanisms for the onshore transport of fish larvae into coastal regions. One is the influx of warm Gulf Stream water that oscillates in and out of the Carolina Bays. These oscillations occurred throughout the study period over distances of 20–40 km and on time-scales as short as two days. The other is a tongue of relatively cold water located adjacent to the Virginia coast that moved southward and penetrated into Onslow Bay between January and March. Previous studies showed that Atlantic menhaden preferentially spawn in 18–22°C waters on the outer shelf. On the assumption that the 18°C isotherm (18DI) indicates where high larval abundance may occur, we used AVHRR-SST imagery to track the onshore-offshore movement of the 18DI along a transect extending onshore-offshore in Onslow Bay. Owing to seasonal warming and cooling, this isotherm was always found closest to the coast in early November, reached maximum offshore displacement by January/March, and then moved onshore again in April/May. Our results also showed that the position of this isotherm can move offshore or onshore in a matter of a few days. An important influence and possibly the major cause of the higher frequency displacements of the 18DI are Gulf Stream meanders or filaments moving through Onslow Bay. Our estimates of onshore isotherm speeds as determined from satellite SST ranged from 2 to 25 cm s−1 and are within the same order as those calculated by physical models or larval age determinations. If the onshore pulses of warm Gulf Stream water are indeed a mode by which menhaden larvae are transported cross-shelf, then the use of satellite-based observations to determine their frequency and onshore extent, as done in the present study, is a useful tool to study variations in fish recruitment.
Herbivore responses to a seasonally fluctuating food supply: Growth potential of two temperate intertidal fishes based on the protein and energy assimilated from their macroalgal diets

Abstract The protein and energy assimilated from eight main dietary algae by the stichaeid fishes Cebidichthys violaceus (Girard) and Xiphister mucosus (Girard) were calculated using bimonthly data on the chemical compositions (carbohydrate, protein, lipid) of these algae and the stomach contents and assimilation efficiencies of the two fish species. The effects of food choice on diet quality were estimated by comparing the amounts of energy and protein determined to be assimilated from the actual (selective) diets with those that would be assimilated from hypothetical (nonselective) diets based on algal availability. Both fishes consumed carbohydrate-rich, protein-poor algae in the winter and protein-rich, carbohydrate-poor algae during the rest of the year. Thus, contrary to an expectation from optimal diet theory, energy intake was increased by selection only during winter, whereas protein intake was increased at the expense of energy intake at all other times. Growth rates of the two fishes predicted by a growth curve based on the relative amounts of protein and energy assimilated from their diets were at or just above maintenance levels in winter and higher during other times of the year. The additional species of algae and the small amounts of animal material in the diets of the two fishes appeared not to alter substantially the predicted annual growth pattern. Although Cebidichthys violaceus and Xiphister mucosus seem to be able to grow during most times of the year on a completely algal diet, their rates of energy consumption, which in turn regulate protein intake, are unknown and must be examined before more definite conclusions can be drawn about the growth of these fishes.
Crystal Structure of NC1 Domains. Structural Basis for Type IV Collagen Assembly in Basement Membranes

Type IV collagen, which is present in all metazoan, exists as a family of six homologous alpha(IV) chains, alpha1-alpha6, in mammals. The six chains assemble into three different triple helical protomers and self-associate as three distinct networks. The network underlies all epithelia as a component of basement membranes, which play important roles in cell adhesion, growth, differentiation, tissue repair and molecular ultrafiltration. The specificity of both protomer and network assembly is governed by amino acid sequences of the C-terminal noncollagenous (NC1) domain of each chain. In this study, the structural basis for protomer and network assembly was investigated by determining the crystal structure of the ubiquitous [(alpha1)(2).alpha2](2) NC1 hexamer of bovine lens capsule basement membrane at 2.0 A resolution. The NC1 monomer folds into a novel tertiary structure. The (alpha1)(2).alpha2 trimer is organized through the unique three-dimensional domain swapping interactions. The differences in the primary sequences of the hypervariable region manifest in different secondary structures, which determine the chain specificity at the monomer-monomer interfaces. The trimer-trimer interface is stabilized by the extensive hydrophobic and hydrophilic interactions without a need for disulfide cross-linking.
Assessing correlations between lingual movements and formants

First and second formant histories have been used in studies of both normal and disordered speech to indirectly measure the activity of the vocal tract. The purpose of the present study was to determine the extent to which formant measures are reflective of lingual movements during diphthong production. Twenty native speakers of American English from the western United States produced four diphthongs in a sentence context while tongue movement was measured with a magnetic tracking system. Correlations were computed between the vertical tongue movements and the first formant, as well as between the anteroposterior movements and the second formant during the transition phase of the diphthong. In many instances the acoustic measures were clearly reflective of the kinematic data. However, there were also exceptions, where the acoustic and kinematic records were not congruent. These instances were evaluated quantitatively and qualitatively in an effort to understand the cause of the discrepancy. Factors such as coarticulation, motor equivalence (including the influence of structures other than the tongue), and nonlinearities in the linkage between movement and acoustics could account for these findings. Recognizing potential influences on the acoustic-kinematic relationship may be valuable in the interpretation of articulatory acoustic data on the individual speaker level.
Rapid sequence intubation for pediatric emergency patients: higher frequency of failed attempts and adverse effects found by video review

Study objective Using video review, we seek to determine the frequencies of first-attempt success and adverse effects during rapid sequence intubation (RSI) in a large, tertiary care, pediatric emergency department (ED). Methods We conducted a retrospective study of children undergoing RSI in the ED of a pediatric institution. Data were collected from preexisting video and written records of care provided. The primary outcome was successful tracheal intubation on the first attempt at laryngoscopy. The secondary outcome was the occurrence of any adverse effect during RSI, including episodes of physiologic deterioration. We collected time data from the RSI process by using video review. We explored the association between physician type and first-attempt success. Results We obtained complete records for 114 of 123 (93%) children who underwent RSI in the ED during 12 months. Median age was 2.4 years, and 89 (78%) were medical resuscitations. Of the 114 subjects, 59 (52%) were tracheally intubated on the first attempt. Seventy subjects (61%) had 1 or more adverse effects during RSI; 38 (33%) experienced oxyhemoglobin desaturation and 2 required cardiopulmonary resuscitation after physiologic deterioration. Fewer adverse effects were documented in the written records than were observed on video review. The median time from induction through final endotracheal tube placement was 3 minutes. After adjusting for patient characteristics and illness severity, attending-level providers were 10 times more likely to be successful on the first attempt than all trainees combined. Conclusion Video review of RSI revealed that first-attempt failure and adverse effects were much more common than previously reported for children in an ED.
Calcium Absorption from Three Salts and CaSO4-Fortified Bread in Premenopausal Women

Two studies were conducted to measure calcium absorption from calcium sulfate fortified bread and three salts (calcium lactate, calcium carbonate, and calcium sulfate) in healthy premenopausal women using a crossover design. In study I, calcium fractional absorption levels from the three salts labeled with a stable isotope, 44Ca, were not significantly different (0.039−0.47) as determined by the fecal recovery method. In a second study, absorption of 45Ca from CaSO4-fortified labeled bread or labeled milk was measured in serum exactly 5 h postingestion. Fractional calcium absorption was slightly but significantly greater from fortified bread than from milk (mean within subject difference = 0.0675 ± 0.016). Calcium sulfate is a bioavailable fortificant for white bread that compares favorably with milk and two other salts. Keywords: Calcium; stable isotope; absorption; bread; fortification
The effect of allopurinol on the degree of early myocardial ischemia.

Abstract The effect of allopurinol on the size of ischemic injury was evaluated following ligation of the left anterior descending coronary artery (LAD) in 37 open-chest dogs. Heart rate, aortic blood pressure, left ventricular pressure, cardiac ouptut, and total peripheral resistance were continuously monitored. Arterial blood was obtained and analyzed for electrolytes, enzymes, uric acid, total inorganic phosphates, lactate, and pyruvate before and after two hours of LAD ligation. At two hours, the hearts were perfused with fluorescein dye to delineate the flow/no flow areas of the excised cross-section myocardium. Planimetry and section thickness were used to calculate the volume of ischemic myocardium. Heart rate and cardiac output were higher and peripheral resistance was lower at baseline and two hours after ligation in the allopurinol intravenously pretreated dogs than in controls. Uric acid was significantly lower at baseline and two hours after LAD ligation and lower levels of total inorganic phosphate, calcium, and magnesium were present at two hours after ligation. The stained cross-sectioned hearts showed that the control and postligation allopurinol treated animals had respective ischemic areas of 19.42% and 21.56% of the total myocardium below the section of the LAD ligation obtained perpendicular to the long axis of the heart. In contrast, animals pretreated with allopurinol, whether orally or intravenously, showed 14.19% and 12.28% ischemic areas, respectively. The latter represented 36.74% less (p The study suggests that allopurinol pretreatment has a protective effect on the ischemic myocardium. This is probably due to opening of coronary collaterals either by direct vasodilatory action or by maintaining locally high levels of adenosine by enzyme inhibition which in turn acts as a vasodilator.
Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes

Aims/hypothesis Red blood cell distribution width (RDW) has been reported to be a risk marker of morbidity and mortality for cardiovascular disease in various study populations. However, no studies have investigated the relationship between RDW and diabetes complications. We therefore evaluated RDW as a marker of macrovascular and microvascular complications in a nationally representative sample of the adult diabetes population in the USA.
Engaging a Global Community of Learners and Practitioners in the Care of the Critically Ill Child

The traditional methods of education, while once revolutionary, are failing to keep pace in the 21 st Century. OPENPediatrics TM has created an interactive, virtual training and knowledge exchange platform to enhance the quality of pediatric critical care. It revolutionizes the existing post-graduate medical education model. Designed by experienced physicians at Boston Children's Hospital, in collaboration with IBM Interactive, it offers asynchronous interactive learning and various avenues for knowledge sharing outside the walls of individual institutions. It is creating a digital, global community, based on adult learning principles, provided at no cost to the user.
Retardation of cerebellar and motor development in rats by focal X-irradiation beginning at four days.

Abstract The cerebellum of rats was irradiated daily from four to thirteen days of age. This resulted in subtotal elimination of the postnatally-formed interneurons, with minimal distortion of the lobular and laminar organization of the cerebellar cortex. The population of Purkinje and Golgi cells was slightly reduced, and Purkinje cells were found in various pathological states. The motor development of these animals was observed between 14–30 days of age by recording various spontaneous activities, and were tested on a vertical rope on which they had to descend to the ground, and a vertical rod on which they had to climb up to a landing platform. The irradiated animals tended to be more active than the controls in locomotion, but they displayed severe coordination difficulties which gradually imporved in some tests as they became older. They fell more while in motion or at rest and displayed difficulty in transferring their body from a rod on which they had climbed up, to a landing platform, because of the inability of the hindlimbs to support the body.
Low energy tandem mass spectrometry of deoxynucleoside adducts of polycyclic aromatic hydrocarbon dihydrodiol-epoxides.

The use of fast-atom bombardment ionization-tandem mass spectrometry approaches, with collision energies on the order of 30–50 eV, was developed for the analysis of low picomole quantities of polycyclic aromatic hydrocarbon dihydrodiol-epoxide deoxynucleoside adducts. This strategy combines three experimental techniques: (1) product ion scans, (2) constant neutral loss scans, and (3) precursor ion scans. Product ion scans of the protonated molecule or the BH2+ ion that results from loss of the deoxyribose were dominated by fragments associated with cleavage of the sigma bond between the dihydrodiol-epoxide moiety and the nucleobase. Constant neutral loss scans were based upon the loss of deoxyribose (116 u) or the combined loss of the deoxynucleoside, water, and carbon monoxide (313 u); precursor ion scans utilized the latter fragment. The formation of trimethylsilyl derivatives increased the sensitivity of analysis, which allowed the simultaneous detection of DNA adducts in a mixture.
Analysis of a staging assessment system for prediction of surgical interval in recurrent respiratory papillomatosis

Summary Introduction: A staging system for assessment of recurrent respiratory papillomatosis (RRP) has been in use over the last 3 years for 17 patients at our children's hospital. Objective: To evaluate a staging system for assessment of RRP on the basis of the predictive value on the surgical interval of: anatomic staging system score, urgency of intervention, voice quality, and stridor. To assess effect on surgical interval of the age of patient at time of surgery and use of adjuvant therapy. To develop a model based on the staging criteria to predict need for adjuvant therapy. Design: Validation cohort. Setting: Academic children's hospital. Results: Estimated time to surgery decreased by “ x days”: “independent variable” “(95% CI)” as follows. Four days: each 1 point in total anatomical score (0.2, 8); 120 days: total anatomical score >20 (37,203); 143 days: urgent versus scheduled surgery (42, 243); 100 days: aphonic versus normal voice (−211, 343); 31 days: abnormal versus normal voice (−281, 343); 125 days: stridor at rest versus no stridor (−31, 281); 109 days: stridor with activity versus no stridor (19, 198); 26 days: each 1 year decrease in age (22, 30). Adjuvant therapy delays next surgery by 32 days (−4, 69) and average scores decreased while on adjuvant therapy. Conclusions: Elements of our proposed staging system are effective in prediction of surgical interval with statistical significance achieved for total anatomical scores, urgency of intervention and stridor with activity versus no stridor. This study is pilot in nature and provides a framework upon which future studies can be based. The analysis of a larger, more severity diverse population could yield results which lead to a model capable of effectively predicting future surgical interval based on a weighted prediction score calculated from age, comorbidities, anatomic staging score, and clinical staging score.
Strategies for coping with chronic low back pain: Relationship to pain and disability

Seventy-four chronic low back pain patients in a study assessing the effectiveness of group outpatient cognitive-behavioral and operant behavioral treatment completed the Coping Strategy Questionnaire (CSQ) and measures of pain, depression, and functional disability pre- and post-treatment. The previously reported factor structure of the CSQ was generally replicated, and significant associations were found between use of ignoring and reinterpretation strategies and downtime, between use of attention diversion strategies and pain intensity, and between tendency to catastrophize and physical and psychosocial impairment. Both treatments resulted in significant changes in types of coping strategies used to deal with pain. Increased use of praying and hoping strategies was significantly related to decreases in pain intensity. Decreased catastrophizing was also significantly related to decreases in pain intensity, as well as to decreases in physical and psychosocial impairment.
An endothelial cell compatible biosensor fabricated using optically thin indium tin oxide silicon nitride electrodes.

Abstract This study describes the fabrication and performance of an endothelial cell compatible, optically thin, indium tin oxide (ITO) microimpedance biosensor. The biosensor was constructed by sputtering a thin insulating layer of silicon nitride (Si3N4) onto a 100 nm thick ITO layer. Indium tin oxide electrodes were formed by chemically etching 250 or 500 μm diameter holes through the Si3N4 insulating layer. The exposed ITO electrode was electrically connected to an ITO counter electrode, approximately 2 cm2 in area, via a 400 μL well containing cell culture media. A lock-in amplifier circuit monitored the impedance of porcine pulmonary artery endothelial cells (PPAECs) cultivated on the electrodes as a function of frequency, between 10 and 100 kHz, and as a function of time, at 5.62 kHz. The ITO–Si3N4 microelectrodes provided consistent and repeatable impedance measurements to the attachment and spreading of PPAECs. In addition, the ITO–Si3N4 electrodes were recyclable, robust, resistant to ethanol sterilization, and had a high optical transmittance. Most importantly, the ITO–Si3N4 electrodes allowed optical access for dynamic cellular attachment imaging. The 5.62 kHz time dependent cellular impedance response to the drug Cytochalasin D further demonstrated the feasibility of using this electrode configuration for dynamic cellular impedance studies.