cssi/SciSciGPT-SciSciNet huggingface dataset:
Outcome of surgical clipping of unruptured aneurysms as it compares with a 10-year nonclipping survival period.

Objective Recent studies on the natural history of unruptured intracranial aneurysms dictate that we reevaluate the risks and benefits of surgical intervention as it compares with the natural course. We analyzed the outcome of surgical clipping of a patient cohort with unruptured aneurysms as it compares with a 10 year nonclipping survival period on the basis of two previously published studies (International Study on Unruptured Intracranial Aneurysms and a study by Juvela et al. [36] from Helsinki). Methods Data on 148 unruptured aneurysms in 116 consecutive surgically treated patients were prospectively recorded and retrospectively analyzed. The overall majority were diagnosed with cerebral angiography. Data analyzed included aneurysmal properties and clinical outcomes including surgical related mortalities and morbidities. The observed outcomes were compared with the expected outcome of a 10 year nonclipping survival period if the patient cohort was included in recently reported studies on unruptured aneurysms. More than 1 year follow-up was available in 93.1% (108) of patients and follow-up cerebral angiography was performed in 80% (93) of patients. Results Mean age was 53.57 years. There were 25 (16.8%) small aneurysms (less than 7 mm), 70 (47.2%) aneurysms 7 to 12 mm in size, 41 (27.70%) large (13-24 mm), and 12 (8.10%) giant (>25 mm) aneurysms. Posterior circulation aneurysm comprised 13.51%. One hundred forty-three (96.62%) aneurysms were successfully clipped, and 3.37% were either wrapped or later coiled. Surgical-related mortality was 0.82% (1 patient because of air embolism). Surgical related permanent morbidity was 3.44% (4 patients) and transient surgical-related mild morbidities was 7.7% (9 patients). Immediate postsurgical good outcome (Glasgow Outcome Score = 4-5) was 87.93% (102 patients) and 95.68% in 3 months (111 patients). At 1 year, the modified Rankin scale scores were 0 to I = 102, II = 3, III = 2, IV = 1, and V = 0. Residual aneurysms were seen in none of the postoperative angiograms (93 patients). Using the chi method, the comparison of the expected to the observed mortality and morbidity revealed a statistically significant difference in the mortality in favor of surgical clipping (P = 0.034 when compared with the International Study on Unruptured Intracranial Aneurysms and P = 0.05 when compared with the Juvela et al. [36] study). There was no statistically significant difference in the permanent morbidity. Conclusion Studies on natural history of unruptured intracranial aneurysms suggest 10 year cumulative bleeding-related mortality and severe morbidity of no less than 7.5%. In our study, surgical clipping resulted in an 0.8% rate of mortality and 3.4% permanent morbidity. This suggests that surgical clipping has the potential of a superior outcome to the natural history of patients who have an estimated life expectancy of no less than 10 years.
An efficient approach to Aspidosperma alkaloids via [4 + 2] cycloadditions of aminosiloxydienes: stereocontrolled total synthesis of (+/-)-tabersonine. Gram-scale catalytic asymmetric syntheses of (+)-tabersonine and (+)-16-methoxytabersonine. Asymmetric syntheses of (+)-aspidospermidine and (-)-quebrachamine.

Described is a concise, highly stereocontrolled strategy to the Aspidosperma family of indole alkaloids, one that is readily adapted to the asymmetric synthesis of these compounds. The strategy is demonstrated by the total synthesis of (±)-tabersonine (rac-1), proceeding through a 12-step sequence. The basis for this approach was provided by a highly regio- and stereoselective [4 + 2] cycloaddition of 2-ethylacrolein with 1-amino-3-siloxydiene developed in our laboratory. Subsequent elaboration of the initial adduct into the hexahydroquinoline DE ring system was accomplished efficiently by a ring-closing olefin metathesis reaction. A novel ortho nitrophenylation of an enol silyl ether with (o-nitrophenyl)phenyliodonium fluoride was developed to achieve an efficient, regioselective introduction of the requisite indole moiety. The final high-yielding conversion of the ABDE tetracycle into pentacyclic target rac-1 relied on intramolecular indole alkylation and regioselective C-carbomethoxylation. Our approac...
How do foreign cosmetics companies align their supply chains and distribution channels in China

Backed by robust economic growth, China's cosmetics market has grown dramatically in recent years. As foreign cosmetics companies develop strategies for establishing or expanding their presence in China, they need to ensure proper alignment between their supply chain configurations and distribution channels. Because no public data is available, we use a case study approach to investigate the extent these foreign companies align their supply chains and distribution channels. In addition, we outline some current and future challenges and opportunities that foreign cosmetics companies need to face as they compete for growth.
Concordance between Mothers' Reports and Children's Self-Reports of Depressive Symptoms: A Longitudinal Study

Abstract Objective Developmental factors and maternal depression were examined for their impact on mother-child and clinician-child agreement concerning children's internal depressive symptoms. Method Data were derived from a clinically referred, racially mixed sample of school-age boys and girls ( n = 113), with a study entry diagnosis of depression. Measures of agreement were based on parallel items from the self-rated Children's Depression Inventory, mother-rated Child Behavior Checklist, and clinician-rated, semistructured psychiatric interview with both the child and mother. Repeated measures of agreement were modeled longitudinally over a maximum of 7 years as a function of age, social-cognitive development, and maternal depression. Additional covariates were maternal psychopathology (excluding depression), socioeconomic status, and child's gender and verbal ability. Results Mother-child and clinician-child agreement increased as a function of the child's age during the follow-up and was consistently attenuated by maternal depression. Depressed mothers overrated their children's symptomatology as compared with the children's self-reports. Conclusions Clinicians should consider the young patient's age and level of maternal depression when weighing the relative merits of self-report and parental report of the child's depressive symptoms. Additional research is necessary to understand the mechanisms of change in parent-child agreement.
A study of the polymorphic transformations in Co2SiO4

The olivine-beta phase transformation in Co2SiO4 has been studied in a large-volume high-pressure apparatus (USSA-2000). The experimental conditions straddle the univariant phase boundaries due to the presence of a substantial temperature gradient (150–200° C over the 3-mm length of the sample). At conditions close to equilibrium, the transformation mechanism is one of limited nucleation with rapid growth of large crystals of the beta phase. Transmission electron microscopy (TEM) analysis shows that the cation stacking faults in Co2SiO4-spinel are identical to those seen in numerous spinels. The 010 faults in beta-Co2SiO4 are found to be identical to those seen in beta-(Mg,Fe)2SiO4 found in shocked veins in meteorites.
Multicultural identification and treatment of stuttering: A continuing need for research

Abstract This article presents one view of the past, present, and future of multicultural studies of stuttering. Historical issues are reviewed, and current issues about the multicultural or cross-cultural identification and treatment of stuttering are then considered in light of that history. It appears from this combined analysis of historical and current trends that many multicultural discussions about stuttering continue to be based on ethnocentric speculation and on ideas related to diagnosogenic theory, rather than on dependable empirical or clinical knowledge. Suggestions are provided in the form of issues to be considered and, more importantly, in the form of areas that will need considerably more research if this disorder is to be approached from a truly multicultural perspective.
Dental implications of pharmacological management of the Alzheimer's patient.

Medications used for the management of the Alzheimer's patient are of two types: agents prescribed for treatment of cognitive disorders and agents used for symptomatic relief of mood disorders. This article reviews the mechanisms of action and side-effects of the more common of these agents. In addition, dental management of the Alzheimer's patient is discussed in relation to specific medications being taken.
Usefulness of Echocardiographic Dyssynchrony in Patients With Borderline QRS Duration to Assist With Selection for Cardiac Resynchronization Therapy

Objectives To test the hypothesis that echocardiographic dyssynchrony may assist in the selection of patients with borderline QRS duration for cardiac resynchronization therapy (CRT). Background Although echocardiographic dyssynchrony is currently not recommended to select patients with QRS duration widening for CRT, its utility in patients with borderline QRS widening is unclear. Methods Of 221 consecutive heart failure patients with an ejection fraction (EF) ≤35% referred for CRT, 86 had a borderline QRS duration of 100 to 130 ms (115 ± 8 ms) and 135 patients had wide QRS >130 ms (168 ± 26 ms). Dyssynchrony was assessed using interventricular mechanical delay, tissue Doppler imaging longitudinal velocity opposing wall delay, and speckle tracking radial strain for septal to posterior wall delay. Response to CRT was defined as ≥15% increase in EF, and reverse remodeling as ≥10% decrease in end-systolic volume. Results There were 201 patients with baseline quantitative echocardiographic data available, and 187 with follow-up data available 8 ± 5 months after CRT. A smaller proportion of borderline QRS duration patients (53%) were EF responders compared with 75% with widened QRS (p Conclusions Radial dyssynchrony by speckle tracking strain was associated with EF and reverse remodeling response to CRT in patients with borderline QRS duration and has the potential to assist with patient selection.
Quantitative Determination of Carbohydrates in Solution via a Reduction/Permethylation Technique

Abstract A reduction/permethylation technique has been developed for the quantitative gas Chromatographie analysis of anhydrosugars, monosaccharides, and disaccharides. All derivatizations are carried out in the same vial, and transfers are not necessary until recovery of the permethylated derivatives. The reaction scheme is extremely simple and offers improved accuracy over standard GC carbohydrate analysis protocols. Emphasis is placed on quantitative compound recovery, and relative response factors are presented for several carbohydrates. The sodium hydroxide/methyl iodide permethylation reaction has also been shown to be a viable replacement for standard dimsyl anion procedures utilized for methylation analysis of polysaccharides. Application of the reduction/permethylation sequence to the analysis of the hydrolyzate resulting from the dilute sulfuric acid hydrolysis of cellulose demonstrates that reversion products account for a considerable amount of the glucose losses, with levoglucosan, 1, 6-anhyd...
Rational design and evaluation of improved o-phthalaldehyde-like fluorogenic reagents.

Abstract Evidence was presented suggesting that the fluorescent isoindole produced by reaction of o-phthalaldehyde (OPA), ethanethiol, and primary amine was formed by initial imine formation follwed by conversion to an α-alkylaminobenzylsulfide and subsequent ring closure to form the isoindole nucleus. This mechanism suggested that the minimum structural requirement for condensation to an isoindole was an o-diacyl benzene in which one of the carbonyl groups was aldehydic. A major drawback of OPA as an analytical reagent is the limited stability of the fluorescent 1,2-disubstituted isoindole. Since isoindole instability is related to autoxidation at C-3, the use of o-(formyl) arylketones as alternatives to OPA is attractive in increasing the lifetime of the fluorescent species in that such reagents would form 1,2,3-trisubstituted isoindoles. Two compounds, o-acetylbenzaldehyde (OAB) and o-benzoylbenzaldehyde (OBB), were synthesized and evaluated as potential fluorogenic reagents. Both formed fluorescent products. The rate of formation of isoindole from the latter was too slow to make it of practical analytical value; however, OAB formed isoindoles with t 1 2 s and offered markedly improved stability over that observed with OPA.
Prediction of prepyrolysis temperature rise in dead forest fuels

The heat transfer rate to forest fuels ahead of a flaming fire front is highly variable over the interval of time required to preheat the fuels. An analytical function was derived which permitted inclusion of this varying transfer rate in the calculation of temperature rise for forest fuels.
Pulsed laser ignition thresholds of energetic multilayer foils

Ignition thresholds for energetic multilayer foils comprised of aluminum (Al) and platinum (Pt) layers are presented as a function of foil properties for laser pulse durations of 100 femtosecond (fs) and 30 nanosecond (ns).
Chan-Vese Segmentation

While many segmentation methods rely heavily in some way on edge detection, the “Active Contours Without Edges” method by Chan and Vese [7, 9] ignores edges completely. Instead, the method optimally fits a two-phase piecewise constant model to the given image. The segmentation boundary is represented implicitly with a level set function, which allows the segmentation to handle topological changes more easily than explicit snake methods. This article describes the level set formulation of the Chan-Vese model and its numerical solution using a semi-implicit gradient descent. We also discuss the Chan–Sandberg–Vese method [8], a straightforward extension of Chan–Vese for vector-valued images.
Emergency medicine and the public's health : Emerging infectious diseases

In recent years, multiple global forces have contributed to the emergence and widespread distribution of previously unknown disease entities. This article discusses Ebola virus, West Nile virus, and Hantavirus as representative emerging infectious diseases. Smallpox is discussed along with concerns about the safety of the smallpox vaccine, given the uncertain risk of bioterrorism and smallpox exposure. ED physicians must become familiar with the presentation, management, and public health impact of all of these entities, as well as understand the potential impact of other emerging infectious diseases.
The Compilation of Loop Induction Expressions

In an optimizing compiler, it is often desirable to compile subscript expressions such as Abase-2 + I*2 so that the value of the expression is available in a register and is simply incremented whenever I is incremented, thus avoiding the multiplication inside the loop. This change is effected by a standard optimization called strength reduction. Program loops often contain several such expressions stemming perhaps from references to operands A(I), A(I+1), B(I), and C(K,J,I,L). Under what circumstances can we do better than keeping four addresses in four separate registers or temporaries? A general technique is presented which minimizes the number of registers needed to hold such values, while simultaneously minimizing the amount of computation inside the loop. In the above collection, it is possible to use as few as two registers for the four I-dependent values.
WE-E-18C-01: Multi-Energy CT: Current Status and Recent Innovations

Conventional computed tomography (CT) uses a single polychromatic x-ray spectrum and energy integrating detectors, and produces images whose contrast depends on the effective attenuation coefficient of the broad spectrum beam. This can introduce errors from beam hardening and does not produce the optimal contrast-to-noise ratio. In addition, multiple materials can have the same effective attenuation coefficient, causing different materials to be indistinguishable in conventional CT images. If transmission measurements at two or more energies are obtained, even with polychromatic beams, more specific information about the object can be obtained. If the object does not contain materials with k-edges in the spectrum, the x-ray attenuation can be well-approximated by a linear combination of two processes (photoelectric absorption and Compton scattering) or, equivalently, two basis materials. For such cases, two spectral measurements suffice, although additional measurements can provide higher precision. If K-edge materials are present, additional spectral measurements can allow these materials to be isolated. Current commercial implementations use varied approaches, including two sources operating a different kVp, one source whose kVp is rapidly switched in a single scan, and a dual layer detector that can provide spectral information in every reading. Processing of the spectral information can be performed in themore » raw data domain or in the image domain. The process of calculating the amount of the two basis functions implicitly corrects for beam hardening and therefore can lead to improvements in quantitative accuracy. Information can be extracted to provide material specific information beyond that of conventional CT. This additional information has been shown to be important in several clinical applications, and can also lead to more efficient clinical protocols. Recent innovations in x-ray sources, detectors, and systems have made multi-energy CT much more practical and improved its performance. In addition, this is a very active area of research and further improvements are expected through further technological improvements. Learning Objectives: Basic principles of multi-energy CT Current implementations of mutli-energy CT Data and image analysis methods in multi-energy CT Current clinical applications of dual energy CT5. recent innovations and anticipated advances in multi-energy CT.« less
Ewing’s Sarcoma: Standard and Experimental Treatment Options

Ewing sarcoma family tumors (EWS), which include classic Ewing’s sarcoma in addition to primitive neuroectodermal tumor and Askin tumor, are the second most common variety of primary bone cancer to afflict adolescents and young adults. Multi-disciplinary care incorporating advances in diagnosis, surgery, chemotherapy, and radiation has substantially improved the survival rate of patients with localized Ewing sarcoma to nearly 70%. Unfortunately, those advances have not significantly changed the long-term outcome for those with metastatic or recurrent disease; 5-year survival remains less than 25%. This apparent therapeutic plateau exists despite extensive effort during the last four decades to optimize the efficacy of cytotoxic chemotherapy through combination of chemotherapies of mechanistically diverse action, dose-dense scheduling (provided as frequently as every 2 weeks), increased adjuvant treatment duration, and higher dosage per cycle (facilitated with parallel strides in supportive care incorporating growth factors). As has already occurred for malignancies such as breast or colon cancer, the “-omics-based” revolution has enhanced our understanding of the molecular changes responsible for Ewing’s tumor formation and identified a number of potential targets (such as IGF-1R or mTOR) amenable to biological therapy. It has also created both a challenge and an opportunity to develop predictive biomarkers capable of selecting patients most likely to benefit from targeted therapy. In this review, we discuss current standard-of-care for patients with Ewing’s sarcoma and highlight the most promising experimental therapies in early-phase clinical trials.
The results of surgical treatment of cancer of the colon at the Cleveland Clinic from 1965–1975: classification of the spread of colon cancer and long-term survival

Between the years 1965–1975, 564 patients underwent surgical treatment for cancer of the colon. The primary tumour was removed in 502 patients (89%) in all cases with a “no touch isolation” technique. The 5-year survival rate corrected for age was 64% in 546 operative survivors, and 82% in 413 patients operated with intent to cure. Survival analyses are presented classifying the spread of the tumour by (1) the clinico-pathological method of Turnbull, (2) the TNM method, (3) the Astler-Coller method, (4) Dukes' method. The results suggest that (a) the Astler-Coller classification offers no advantage over that of Dukes' when predicting survival for patients after operation for cure, and (b) that separating those patients considered to have evidence of invasion of an adjacent organ at operation (Turnbull's classification) from those patients without evidence of contiguous growth, is only justified if invasion of cancer is confirmed by histological examination of the resected specimen.
Singularity-free electrodynamics for point charges and dipoles: a classical model for electron self-energy and spin

It is shown how point charges and point dipoles with finite self-energies can be accommodated in classical electrodynamics. The key idea is the introduction of constitutive relations for the electromagnetic vacuum, which actually mirrors the physical reality of vacuum polarization. Our results reduce to conventional electrodynamics for scales large compared to the classical electron radius r0 ≈ 2.8 × 10−15 m. A classical simulation for a structureless electron is proposed, with the appropriate values of mass, spin and magnetic moment.
Molecular characterization of hydrocarbon degradative plasmids in Pseudomonas putida

Summary Plasmids detected in soil Pseudomonas species allow growth on complex organic compounds including CAM (camphor), SAL (salicylate), and OCT (octane), plus a fertility factor K or P. The double stranded, covalently closed circular DNA was isolated from Oct + , Cam + , Sal + , and K + strains, purified on cesium chloride-ethidium bromide gradients and converted into open circular form for electron microscopy. Their contour lengths in μm were: OCT, 14; fertility factor, 31; CAM, 78; SAL, 18, 26, 31.3, and 48.8. The Oct + K + (Oct + P + ) strains always contained two autonomous circular duplex DNA molecules, 14 and 31 μm.
Theory for particle collection under london and gravity forces

Abstract Theoretical predictions of particle capture from suspensions flowing around spherical, rotating disc and cylindrical collectors are presented. These results are intended to describe collection of non-Brownian particles under negligible double layer forces from water, primarily for application to deep bed filtration. The predictions are obtained from numerical solutions of the trajectory equations of Spielman and Goren for motion of a small particle near a much larger collector with hydrodynamic, gravitational and London-van der Waals forces considered simultaneously. Electrical double layer forces are introduced only to establish a criterion for their neglect. Comparison with experiment is presented in a subsequent paper.
A Model for Low-Resistivity TiSi2 Formation on Narrow Polysilicon Lines.

The sheet resistance of TiSi2 films formed on patterned sub-half micron n+ polysilicon lines has been observed to be higher than the sheet resistance of unpatterned blanket TiSi2 films. We have investigated this phenomenon, and determined that the TiSi2 thickness is not a function of linewidth, and that the resistivity increase in narrow n+ lines is caused primarily by incomplete phase transformation to the low-resistivity C54 phase. We have determined a physical model for the kinetics of this phase transformation, based on an Arrhenius-type atomic re-arrangement process, and we have determined an activation energy (Ea) of phase transformation for different linewidths. We have observed that this Ea increases non-linearly as a function of decreasing linewidth, contrary to conventional belief. We have hypothesized that this increase is due to increasing dominance of edge-related phenomena such as contaminant segregation, strain etc. Finally, we have demonstrated that by supplying this Ea through a high temperature (825°C) anneal, even applied for a short time (15 s), low sheet resistances (<4 Ω/u) can be obtained down to 0.35 μ m lines.
Teaching African American English Forms to Standard American English-Speaking Teachers: Effects on Acquisition, Attitudes, and Responses to Student Use.

Many U.S. students speak nonstandard forms of English, yet dialect issues are slighted in teacher education programs and literacy courses. In this study, classroom teachers who spoke Standard American English (SE) were familiarized with seven syntactic features characterizing African American English (AAE). Three approaches to instruction based on a cognitive view of self-regulated learning were compared: exposure to the features by reading AAE text (E); exposure plus explanation of dialect transformation strategies (ES); and exposure, strategy explanation, and guided practice transforming sentences from SE to AAE (ESP). On posttests, all forms of instruction improved teachers’ knowledge and positive attitude toward AAE. However, ESP instruction proved more effective in teaching teachers how to translate sentences into AAE and to use AAE in writing stories. Results support the value of implementing self-regulated learning theory and reveal effective ways to teach dialect features to teachers so they can h...
ALPHA-1 ADRENERGIC RECEPTOR mRNA EXPRESSION IN THE RAT CNS AFTER FOCAL ISCHEMIA. † 2246

Adrenergic receptors mediate tissue responses to catecholamines. Multiple subtypes of adrenergic receptors are expressed in the CNS, each with a unique pattern of distribution. Little is known of the functional significance of these multiple subtypes. Pharmacologic studies after brain injury have suggested that alpha-1 adrenergic receptors may be involved in improved recovery of function. In order to evaluate the subtype of adrenergic receptors that may be involved, alpha-1D and alpha-1B mRNA expression was evaluated by in situ hybridization after CNS focal ischemia in the adult rat.
IGF-1-induced lipid accumulation impairs mesangial cell migration and contractile function.

IGF-1–induced lipid accumulation impairs mesangial cell migration and contractile function. Background Chronic treatment of mesangial cells with insulin-like growth factor-1 (IGF-1) results in intracellular lipid accumulation. These mesangial cells resemble foam cells. Methods To determine whether this phenotype affects cell function, lipid-laden mesangial cells were tested for their ability to migrate in response to IGF-binding protein-5 (IGFBP-5) and to contract in response to angiotensin II (Ang II). IGFBP-5 binding and subsequent activation of the signal transduction cascade for migration were examined. To confirm that lipid accumulation was responsible for impaired contractility, lipid was removed from lipid-laden mesangial cells and the cells were re-tested for contractile response to Ang II. Results In comparison to control mesangial cells, lipid-laden cells failed to migrate in response to IGFBP-5. Although cellular binding of IGFBP-5 was not altered by lipid accumulation, IGFBP-5 failed to activate cdc42, a Rho GTPase required for IGFBP-5-mediated mesangial cell migration. These data indicate that lipid accumulation within the mesangial cell interferes with the signal transduction response to IGFBP-5. In addition, mesangial cells treated with IGF-1 had reduced contraction to Ang II. When lipid accumulation was exaggerated by adding cholesteryl esters to the culture medium, mesangial cells failed to contract in response to Ang II. Following removal of excess lipid from these mesangial cells, the contractile response to Ang II was restored. Conclusions IGF-1 induces lipid accumulation in mesangial cells, which impairs their ability to respond to specific migratory and contractile stimuli. These observations are relevant to understanding functional abnormalities in diseases where mesangial foam cells occur, such as focal and segmental glomerulosclerosis and diabetic nephropathy.
Nuclear line spectroscopy of solar flares

A large nuclear-line-rich solar flare which occurred near the west limb on April 27, 1981 has been analyzed. Three intense and isolated gamma-ray lines observed have been identified as the deexcitation lines of Ne-20(1.634 MeV), C-12(4.438 MeV), and O-16(6.129 MeV). The elemental abundances of the ambient gas at the site of gamma-ray line production in the solar atmosphere deduced using the observations are found to be different from local Galactic abundances.
The Coffin-Siris Syndrome

• We present the sixth reported case of the Coffin-Siris syndrome. This disorder is characterized by the absence of the nails of the fifth fingers and toes, severe mental and developmental retardation, and postnatal growth deficiency. Feeding and respiratory problems are prominent features. The Dandy-Walker malformation was found at autopsy in our patient. This malformation was also present in the only other patient with this syndrome whose autopsy has been reported. (Am J Dis Child132:393-395, 1978)
The electrical noise of a cell: correlations between resistance noise and voltage noise

Abstract A theory is developed for explaining the very low-frequency stochastic fluctuations of both the membrane voltage and the membrane conductance of a cell. It is shown that these fluctuations need not be correlated. However, in cells where the dominant transport mechanism is a potassium conductance, the theory predicts a significant negative correlation between the two with the relative fluctuations of the membrane conductance being much larger than those of the membrane voltage; this is in accord with previously published measurements.
Tamm-Horsfall glycoprotein binds IgG with high affinity

Tamm-Horsfall glycoprotein binds IgG with high affinity. Tamm-Horsfall protein (THP), a monomelic glycoprotein (M r 80 to 100 kDa), is produced by the mammalian kidney's thick ascending limb of Henle cells and excreted into the urine. The function of THP is uncertain. Here we report that a high molecular weight contaminant in sheep THP (sTHP) preparations was identified as sheep IgG by its positive reaction with donkey anti-sheep IgG antibody and with protein G. To answer the question of whether sTHP and sheep IgG co-purified because of a physical interaction between the two proteins, an enzyme-linked immunosorbent assay (ELISA) using immobilized sTHP and soluble sheep IgG was performed. Analysis of the ELISA data identified the presence of two sets of binding sites: a high affinity site (K d 10 -12 to 10 -13 M) and a lower affinity site (K d 10 -10 to 10 -11 M). The ELISA detected a similar high affinity interaction between human THP (hTHP) and human IgG. The binding of sheep IgG to immobilized sTHP was inhibited by soluble sTHP. These observations suggest an additional factor to be considered in studies addressing THP's potential immuno-regulatory function.
Small Angle Neutron Scattering Study of Mixed AOT + Lecithin Reverse Micelles

The structures formed in a four-component water-in-oil microemulsion consisting of deuterated water added to sodium bis(2-ethylhexyl) sulfosuccinate (AOT) and phosphatidycholine (lecithin) in 2,2,4-trimethylpentane (isooctane) have been probed by small-angle neutron scattering (SANS). The total surfactant concentration in each of the five samples studied is fixed at 0.01 M in isooctane. The water content is fixed at Wt = 20 (Wt = moles water/moles total surfactant). The molar ratios of lecithin to AOT are 0, 1:7, 1:3, 3:5, and 1:1 in the five samples, respectively. The experimental SANS data from all five samples are fit well by a model containing polydispersed spheres. The mean size of the spheres increases, whereas the polydispersity decreases as the lecithin content is increased. The different packing parameters for AOT and lecithin drive the observed changes in droplet size, whereas the reduction in polydispersity is a consequence of the increased rigidity of the interface as lecithin is added. An alt...
Relating domain shape to growth velocity anisotropy: Inherent symmetry of the Wulff construction

The Wulff construction relates the equilibrium shape of a crystal to its anisotropic surface tension profile, and, in a formally equivalent way, relates the shape of an evolving domain to its anisotropic growth velocity profile. We demonstrate explicitly the underlying complementarity and symmetry between these real space shapes and their generating profiles. By exploiting this symmetry, we have developed a simplified method for determining velocity profiles from the shapes of growing domains, demonstrated here for polarization reversal domains in ferroelectric liquid crystals.
Why cardiology fellows should not give up on practicing internal medicine.

As a fellow, beginning one’s training in cardiology represents a major life event. Having gone through seemingly countless years of training in medical school and, subsequently, in internal medicine, we were finally allowed to narrow our focus of study to something about which we were all
Coverage problems in wireless ad-hoc sensor networks

Wireless ad-hoc sensor networks have recently emerged as a premier research topic. They have great long-term economic potential, ability to transform our lives, and pose many new system-building challenges. Sensor networks also pose a number of new conceptual and optimization problems. Some, such as location, deployment, and tracking, are fundamental issues, in that many applications rely on them for needed information. We address one of the fundamental problems, namely coverage. Coverage in general, answers the questions about quality of service (surveillance) that can be provided by a particular sensor network. We first define the coverage problem from several points of view including deterministic, statistical, worst and best case, and present examples in each domain. By combining the computational geometry and graph theoretic techniques, specifically the Voronoi diagram and graph search algorithms, we establish the main highlight of the paper-optimal polynomial time worst and average case algorithm for coverage calculation. We also present comprehensive experimental results and discuss future research directions related to coverage in sensor networks.
Perspective on Animal Models: Chronic Intracellular Infections

Systemic human disease caused by organisms of the Mycobacterium avium-Mycobacterium intracellularecomplex (MAC) represent a chronic intracellular infection in human hosts who are usually immunocompromised. To develop improved treatment and prophylaxis, and to obtain a better understanding of pathogenesis, we studied the beige mouse (C57 beige + /beige + ) challenged orally or intravenously with a human isolate that causes lethal disease in patients with AIDS (MAC 101, serovar 1). Encouraging anti-MAC studies in animals, as reviewed here, should provide the basis for considering human trials with a promising agent. The ability of an antimicrobial agent to achieve high intracellular concentrations has correlated with the in vivo activity of several specific compounds.
Mycotic aneurysms of the suprarenal abdominal aorta: prolonged survival after in situ aortic and visceral reconstruction.

Abstract Necrotizing infection of the arterial wall causes rupture and false ("mycotic") aneurysm formation, with a very poor prognosis if untreated. Cure can be achieved by surgical drainage and debridement, with restoration of arterial continuity through uncontaminated tissues. The dilemma of applying these principles to the treatment of mycotic aneurysms of the suprarenal aorta is that no remote or extraanatomic routes are available to maintain perfusion to the viscera. We report the first case of Klebsiella suprarenal mycotic aortic aneurysm successfully treated with in situ prosthetic reconstruction of the aorta and visceral arteries, and we have reviewed the 21 other suprarenal mycotic aortic aneurysms reported in the English-language literature. Repair was performed in 20 of the 22 cases, with in situ prosthetic reconstruction performed in 18. Prolonged survival has been achieved in 16 patients after in situ repair. No long-term survival has been reported after extraanatomic reconstruction of the aorta and visceral arteries in patients with such aneurysms. We conclude that in situ prosthetic reconstruction, accompanied by thorough drainage and debridement, prolonged parenteral antibiotic therapy, and permanent suppressive oral antibiotics, offers the best chance for survival in these patients. (J Vasc Surg 1989;10:635–41.)
Carbon coatings produced by high temperature chlorination of silicon carbide ceramics

Carbon coatings are widely used to modify surfaces of materials and improve their tribological properties. In this work, carbon layers were formed on various types of sintered and CVD silicon carbide (SiC) using a novel technique involving a reaction with chlorine and chlorine-hydrogen gas mixtures at 1000 °C. Following the work done on powders and fibers, this method successfully produced adherent coatings on SiC ceramics, which could be grown to thickness above 200 µm. Highly disordered carbon with contributions from nanocrystalline graphite was identified by Raman spectroscopy, x-ray diffraction, and energy dispersive spectroscopy. The kinetics of the chlorination reaction at 1000 °C for different gas mixtures fit to a linear reaction rate equation. Coatings produced in pure Cl2 are graphitic and demonstrate a low hardness (1.8 GPa), Young’s modulus (18 GPa), low wear rate, and a friction coefficient of ∼0.1, which is almost constant for any testing conditions in dry or humid air. Coatings produced in Cl2/H2 mixtures have microhardness up to 50 GPa and Young’s modulus up to 800 GPa. Although the presence of hydrogen had little effect on the Raman spectrum of the carbon layers, its presence changed the structure and permeability of the carbon film.
A simple ergometer modification can expand the exercise options for wheelchair clients.

Purpose. Wheelchair users are by necessity, limited to upper body exercise and have fewer exercise options. An ergometer found in many homes and fitness facilities can be simply adapted for use by those with lower extremity disabilities. This article outlines a novel modification using polyvinyl chloride(PVC) tubing to an existing exercise ergometer. Method. This adapted device was metabolically tested using 9 paraplegics and 8 healthy controls (mean age of 29 years; mean body mass index BMI of 23.5 kg/m 2 ) and found to allow for the attainment of peak exercise by both groups. Results. The mean peak oxygen consumption was VO2peak ¼ 22 ml/kg/min (6.3 METS). The mean maximal power output was 103 W and the peak heart rate averaged 157 beats per min. Conclusions. A simple modification to a fitness ergometer (dual action exercise bicycle) can allow for its use by the wheelchair mobile client. The potential impact of this work is that it can expand the exercise options for the wheelchair client who is at risk for many lifestyle-induced chronic diseases.
Aubrey O. Hampton Lecture. Can radiology save managed care? Preserving quality in the face of managed competition.

T he 1990s have been a roller-coaster ride for those of us practicing medicine in America, especially in those states where managed care has made its most aggressive inroads. The changes in health care have altered the relationship between doctors and patients and among members of the health care team. But we have to be careful to distinguish between traditional managed care and managed competition. Managed care in the form of nonprofit staff model health maintenance organizations (HMOs) has been with us for decades. It began in the l930s and 40s, providing relatively low-cost, prepaid health benefits for a segment of the workforce that could not afford indemnity insurance. As late as 1981, 82% of HMOs were nonprofit but, by 1995, the number had fallen to 29% [1]. With the emergence of for-profit HMOs and managed competition, the way providers and payers relate to each other has changed drastically. So far, we in Massachusetts have been spared the excesses of managed competition because our environment is dominated by nonprofit HMOs. But the for-profits are coming, and the not-for-profits are changing to compete. I would like to raise two questions: Can quality be preserved in the current health care system? What is our responsibility as radiologists to preserve that quality? To answer these questions, I will explore three issues: What got us to managed competilion? What went wrong? And how do we fix it?
Clement of Alexandria on The Generation of The Logos

At the time of Clement of Alexandria there existed two theories with regard to the generation of the Logos. They may be described as the twofold stage theory and the single stage theory. According to the twofold stage theory, which reflects a similar conception in Philo, 1 the Logos at first existed from eternity in God and then, prior to the creation of the world, it was generated from the essence of God as a distinct personal being. Representatives of this view are, among the Greek Fathers, Justin Martyr, Tatian, Athenagoras, Theophilus, and Hippolytus, and among the Latin Fathers, Tertullian, Novatian, Lactantius, and as late as the fourth century, Zeno of Verona. According to the single stage theory, the generation of the Logos from God was from eternity. The first to introduce this view were Irenaeus and Origen and it is this view which ultimately prevailed. Now with regard to Clement of Alexandria, who was a contemporary of both Irenaeus and Origen, it is the general opinion of students of the history of doctrine that he is to be included among those who introduced the single stage theory, though Zahn finds that Clement “always makes a sharp distinction between the only Unbegotten God the Father and the Son or Logos who was begotten or created before the rest of creation.” 2 It is this general opinion which I wish to question in this paper.
Phi-predication for light-weight if-conversion

Predicated execution can eliminate hard to predict branches and help to enable instruction level parallelism. Many current predication variants exist where the result update is conditional based upon the outcome of the guarding predicate. However, conditional writing of a register creates a naming problem for an out-of-order processor, and can stall the issuing of instructions. This problem arises from potential multiple predicated definitions reaching a use, which is unresolved until the prior predicate values are computed.In this paper we focus on a light-weight form of predication, Phi-Predication, where all predicated instructions write a result value to their register regardless of the predicate value (i.e. even if it is false). Therefore, the predicate does not guard the writing of the result register; it instead acts as a form of selection between two input registers. This eliminates the naming problem for an out-of-order processor. Our Phi-Predicated ISA is derived from the predicated features of the Multiflow ISA, with extensions to efficiently predicate complex control flow. Our compiler modifications also expand upon prior techniques to provide efficient code generation. We examine the use of Phi-Predication for an in-order and out-of-order architecture and compare its performance to using select-op and IA64 ISA predication.
DISEASE RECURRENCE AND PROGRESSION IN UNTREATED PATHOLOGIC STAGE T3 PROSTATE CANCER: SELECTING THE PATIENT FOR ADJUVANT THERAPY

ABSTRACTPurpose: Optimal management of pathologic T3 prostate cancer is poorly defined. We conducted a prospective study of untreated pT3 patients to improve understanding of the natural history of this disease and to identify clinical parameters useful in patient selection for adjuvant therapy.Materials and Methods: Of 583 consecutive patients with clinical stage T1 to 2 disease managed by total prostatectomy, 206 had pT3 disease. Excluding patients requesting immediate adjuvant treatment or neoadjuvant therapy, 156 subjects were eligible for the study, including 34 with pT3a, 80 pT3b, 22 pT3c, and 20 pT3N + disease. Patients were followed for prostate-specific antigen (PSA) recurrence of greater than 0.2 ng./ml. and biopsy proved local or distant tumor progression demonstrated by imaging studies.Results: After a median of 45 months, PSA recurrence was seen in 29.4% of pT3a (10/34), 30% of pT3b (24/80), 27.3% of pT3c (6/22), and 80% of pT3N+ (16/20 cases). Local or distant progression was seen in 2.9% of...
Cultures of Work-Life Balance in Higher Education: A Case of Fragmentation

In response to demographic shifts, colleges and universities implemented new policies, adopted new practices, and created professional development opportunities to gain support for work–life balance. Research on work–life balance reveals gender disparities, lack of policy usage, and a lack of cultural change with little understanding of the ways to bring about a campus culture that understands, promotes, and has established norms that support work–life balance. Research often recommends that cultural change be established to support policy usage and reduce stigma from work–life balance. This research study examined 2 institutions of higher education to challenge the notion that organizational change can be simply created and to examine the impact of fragmented cultures and individual identity on change. The 2 major themes—symbolic meaning of policies and children and discontinuity of symbols and policies—that emerged in this study provide evidence of the need for campuses to contend with organizational culture and, in particular, on symbols and discourses intentionally presented to reflect work– life balance acceptance. This study concludes with recommendation of how leaders, faculty, and policymakers can support work–life balance within higher education despite the ambiguity and complexity of organizational life.
Woman's role in society in the 1980s

American women will face opportunities, challenges, and sizeable hurdles throughout the decade of the 1980s. Political, economic, and international forces will weigh heavily on women in the United ...
Implantable cardioverter-defibrillator deactivation at the end of life: A physician survey

Background Among older adults, implantable cardioverter-defibrillator (ICD) use is increasing. ICD shocks can occur at end of life (EOL) and cause substantial distress, warranting consideration of ICD deactivation discussions. This nationwide physician survey sought to (1) determine if physicians discuss ICD deactivation at the EOL, (2) identify predictors of those discussions, and (3) ascertain physicians' knowledge/attitudes about ICD use. Methods We surveyed 4,876 physicians stratified by specialty (cardiologists, electrophysiologists, general internists, and geriatricians). The mailed survey presented 5 vignettes (eg, end-stage chronic obstructive pulmonary disease, advanced dementia) wherein ICD deactivation might be considered and 17 Likert-scaled items. Results Five hundred fifty-eight (12%) physicians returned surveys. Respondents were largely men (77%) and white (69%). Most physicians (56%-83%) said they would initiate deactivation discussions in all 5 vignettes, whereas significantly more (82%-94%) would discuss advance directives and do not resuscitate status. In logistic regression analyses, a history of prior deactivation discussions was an independent predictor of willingness to discuss deactivation (adjusted OR range, 2.8-8.8) in 4 of the 5 vignettes. General internists and geriatricians were less likely than electrophysiologists to agree that ICD shocks are painful and to distinguish between the ICD's pacing and defibrillator functions. Finally, most physicians believed that informed consent for ICD implantation should include information about deactivation (77%) and endorsed the need for expert guidance in this area (58%). Conclusions Most physicians would discuss ICD deactivation at EOL. The strongest predictor of this was a history of prior discussions. Knowledge about ICDs varies by specialty, and most expressed a desire for more expert guidance about ICD management at EOL.