cssi/SciSciGPT-SciSciNet huggingface dataset:
Inferior Vena Cava Filter - Appropriate Use and Retrieval

Inferior vena cava (IVC) filters, first introduced in 1998, have been utilized to reduce risk of pulmonary embolism (PE) in the setting of an inability to anticoagulate patients. The use of IVC filters has increased and continues to rise, especially with the introduction of retrievable IVC filters. Since their initial introduction, guidelines have been developed on the appropriate use of IVC filters. According to the American College of Chest Physicians (ACCP), the use of an IVC filter is limited to patients with an absolute contraindication to therapeutic anticoagulation or failure or complication of anticoagulation in the setting an acute proximal venous thrombus. Relative indications for IVC filter placement include high clot burden in setting of low cardiopulmonary reserve, high risk patients, or severe trauma without documented thrombosis. In 2010, the FDA announced a safety communication recommending removal of retrievable IVC filters due to reports of several adverse clinical outcomes associated with retained filters including thrombus formation, recurrent PE, filter migration, erosion or perforation through the IVC wall, and filter fracture with fragment embolization. In 2014, the FDA recommended removal of the IVC filter within 2 months after filter placement if the patient9s risk of thrombosis had passed. In this retrospective analysis of IVC filter management, we reviewed indications for placement according to current guidelines as set by the ACCP, initiation of appropriate anticoagulation, complication rates, and retrieval rates. In addition, we compared the data prior to the FDA recommendations in late 2014 and data after the recommendations to determine if there was a change in practice. After reviewing 179 patients, 89 patients in 2014 and 90 patients in 2015, who underwent IVC filter placement, only 81% (N=145) of patients had appropriate indications for IVC filter placement and 30% (N=54) of patients had inappropriate anticoagulation after IVC filter placement, given as prophylactic dosing of low molecular weight heparin. A comparison of retrieval rates prior to and after the FDA warning, showed a 19% (60% in 2014 vs 79% in 2015) improvement in IVC filter removals. There was an 11% complication rate, mainly related to IVC filter related acute DVT or IVC occlusion. A root cause analysis specifically for inappropriate IVC filter placement and appropriate anticoagulation and determined that familiarity of the guidelines and non-evidence based recommendations from consultants were major factors. Based on the analysis, we next plan to utilize the electronic health record system to help clinicians understand indications and when to initiate appropriate anticoagulation, with the opportunity for hematology consultants to be involved in situations that do not clearly fit within published guidelines. Disclosures No relevant conflicts of interest to declare.
Do Porous Tantalum Metaphyseal Cones Improve Outcomes in Revision Total Knee Arthroplasty

Abstract Background Some authors have advocated for use of porous tantalum metaphyseal cones to manage bone defects during revision total knee arthroplasty (TKA). The purpose of this study is to compare results with porous metaphyseal cones to results with traditional hybrid stem fixation in revision TKA. Methods Forty-nine patients undergoing revision TKA with femoral and/or tibial metaphyseal cones (39 tibial only, 3 femoral only, 7 both) were matched by surgical indication to 49 patients undergoing revision TKA with a traditional hybrid stem (non-cone) technique. Clinical and radiographic outcomes were compared at a minimum of two-year follow-up (mean 3.5 years) with adjustment for baseline characteristics. Results Pre-revision bone defects and most baseline demographics were similar between the cone and non-cone cohorts suggesting appropriate matching. Patients in the non-cone cohort had greater pre- to post-operative increases in Knee Society Score (37.2 ± 18.6 vs 28.4 ± 17.8, P = .010) and Knee Society Functional Score (30.4 ± 24.3 vs 13.1 ± 27.6, P = .003). The cohorts did not differ with respect to complications, subsequent reoperation, subsequent revision, patient satisfaction, tibial overhang, the presence of radio-sclerotic lines, cortical hypertrophy around the stems, or tibial subsidence. Conclusion In this series, metaphyseal cones were not associated with superior outcomes at short-term follow-up. Given the increased cost associated with use of cones compared to traditional techniques, this study cannot support the routine use of metaphyseal cones in revision TKA. Longer-term follow-up will be necessary to determine if construct durability differs over the long term.
Mixing methods in instructional research

Communication Education’s commitment to publishing rigorous instructional communication research with a diversity of methods is clear in its publication of quantitative, qualitative, and critical a...
Knowing Your (Relationship) Strengths: The Effect of Social Information Flow on Relational Acumen

The network activation literature has given us the insight that how networks are enacted matters -- important resources and information may not be accessed by individuals when they do not realize (...
Next Generation of Physical Training Environments: Bringing in Sensor Systems and Virtual Reality Technologies

Training on physical training ranges is immensely important to any military unit, as many aspects of individual and team skills still need to be trained there. Nevertheless, the overall cost of training on physical ranges, the required unit throughput, as well as a need to maximize the training potential that such precious environments have, are ever increasing, and leveraging emerging technologies to make the training more effective becomes a necessity. This paper reviews several novel efforts in the research domain that could be used as a guide to the types of emerging technical solutions that may be employed to augment the capabilities of physical training ranges, including the capabilities of humans engaged in orchestrating and executing the training events (range operators and instructors), and to support the global objective of acquiring more effective training solutions.
In-House Manufacture of Sterilizable, Scaled, Patient-Specific 3D-Printed Models for Rhinoplasty

BACKGROUND Rhinoplasty relies on clear patient communication and precise execution of a three-dimensional (3D) plan to achieve optimal results. As 3D imaging and printing continue to grow in popularity within the medical field, rhinoplasty surgeons have begun to leverage these resources as an aid to preoperative planning, patient communication, and the technical performance of this challenging operation. OBJECTIVES Utilizing departmentally available resources and open-access 3D imaging platforms, we have developed an affordable, reproducible protocol for rapid in-house virtual surgical planning (VSP) and subsequent manufacture of 3D-printed rhinoplasty models. METHODS Preoperative 3D photographic images underwent virtual rhinoplasty using a freely available 3D imaging and sculpting program (BlenderTM [Version 2.78, Amsterdam, The Netherlands]). Once the ideal postoperative result was digitally achieved, scaled, sterilizable, and patient-specific 3D models of the preoperative and ideal postoperative result were manufactured in-house using a departmentally owned 3D printer. RESULTS 3D-printed models have successfully been manufactured and employed for 12 patients undergoing rhinoplasty. The average time to prepare a set of pre- and postoperative models was 3 hours, while the printing process required 18 to 24 hours per model. Each set of surgical models can be manufactured at a total materials cost of approximately $5.00. CONCLUSIONS We describe an affordable means to construct sterilizable, scaled, patient-specific 3D-printed models for rhinoplasty. This technique may become of increasing interest to academic and cosmetic centers as hardware costs of 3D printers continue to fall. LEVEL OF EVIDENCE: 4
Venous Obstructions Due to Implanted Devices

Scientific advances over the past 30 years or so have also created new problems including those created when devices of several sorts are implanted into the subclavian and less often into the jugular veins [1, 2]. These include insertion of pacemaker leads to treat cardiac arrhythmias, defibrillator leads to treat and prevent sudden death due to ventricular fibrillation, catheters for dialysis [3] when IV fistulas either cannot be used or are being constructed, central venous catheters used for prolonged infusion of antibiotics or chemotherapeutic agents, and central intravenous alimentation lines. Whenever a catheter simply touches venous endothelium fibrotic reaction can occur and in the worst-case scenario may lead to total obliteration of the superior vena cava. These are obviously very complicated and difficult problems to treat, especially when total obstruction of the veins occurs. They may become overwhelming when venous sites of the opposite side are utilized transferring the problem to other veins which will be affected in the same manner.
Long Bone Structural Analyses and the Reconstruction of Past Mobility: A Historical Review

The use of long bone structural analysis to reconstruct past human behavior had its origins in the 1970s, although it was only in the last 30 years that true population-level comparisons began to be carried out. Since then, several dozen studies of archaeological and paleontological samples have been completed, illustrating the complexity as well as some consistencies in the relationship between bone morphology and mobility. Bone cross-sectional shape rather than relative size appears to be more clearly related to mobility differences. This is particularly true in comparisons between males and females within the same population. Terrain has a strong effect on relative strength of the lower limb bones. Body shape differences also have an effect on structural properties, and must be factored into comparisons. New methods of noninvasively acquiring structural properties promise even greater accessibility of information and larger samples in the future, although caution must be applied when extrapolating from approximations to true section properties.
Outcomes for Black Students in Team-Based Learning Courses:

Racial inequity in postsecondary education is a significant social problem. Black students’ academic success is often hindered by feelings of isolation, particularly at predominantly White institut...
Prolonged partial thromboplastin time: To mix or not to mix - is that the question?

Abstract Routine mixing studies are frequently used to evaluate patients presenting with prolonged partial thromboplastin times (PTT) and/or prothrombin times (PT). Unfortunately, mixing studies have a number of inherent limitations including lack of standardization in terms of what defines normal pooled plasma (NPP), the processing of a patient’s plasma for platelet removal (platelet poor plasma versus platelet-free plasma), performance of appropriate controls, conducting an incubation step to evaluate for a time and temperature dependent inhibitor, and finally interpretation of test results. Moreover, misinterpretation of study results can lead to a delayed or incorrect diagnosis or worse, inappropriate treatment. Within this manuscript, we present four cases illustrating the shortcomings associated with inappropriate utilization and interpretation of routine mixing studies; and present practical steps for managing abnormal PT or PTT results.
Non-pharmacologic Aspects of Management: “Asthma and Allergic and Immunologic Diseases During Pregnancy – A Guide to Management”

Pregnancy represents a unique physiologic state that makes management of allergic disease challenging, particularly when considering use of pharmacologic therapies in the context of risk for possible teratogenicity and poor maternal-fetal outcomes. Non-pharmacologic approaches to management of atopic disorders in pregnancy need to be a key part of any allergic disease state management plan. Allergic rhinitis, asthma, and atopic dermatitis represent the three main allergic diseases that can be expected to be encountered during pregnancy. The avoidance of known irritants and allergens is a cornerstone of allergic rhinitis and allergic asthma therapeutic strategy, and non-pharmacologic interventions for atopic dermatitis are critical components of standard management. In some instances, adequate relief may be achieved solely with non-pharmacologic interventions, and in many cases, the need for pharmacologic therapy can be reduced by concurrent use of non-pharmacologic approaches. This chapter focuses on effective avoidance strategies and other non-pharmacologic approaches to the management of common allergic disease in the pregnant patient, allowing for better outcomes while at the same time limiting exposure to unnecessary medical therapy.
Natural algorithms

We provide further evidence that the study of complex self-organizing systems can benefit from an algorithmic perspective. The subject has been traditionally viewed through the lens of physics and control theory. Using tools typically associated with theoretical computer science, we settle an old question in theoretical ecology: bounding the convergence of bird flocks. We bound the time to reach steady state by a tower-of-twos of height linear in the number of birds. We prove that, surprisingly, the tower-of-twos growth is intrinsic to the model. This unexpected result demonstrates the merits of approaching biological dynamical systems as "natural algorithms" and applying algorithmic techniques to them.
Glecaprevir/pibrentasvir-associated acute liver injury in non-cirrhotic, chronic HCV infection without HBV co-infection.

The combination of glecaprevir and pibrentasvir was recently approved for chronic hepatitis C virus (HCV) infection with recommended treatment duration of 8–12 weeks depending on previous treatments, viral genotype and cirrhosis status. Although liver injury was reported with other protease inhibitors in the presence of cirrhosis or hepatitis B virus (HBV) co-infection, glecaprevir/pibrentasvir treatment is not known to cause liver injury. We report a patient with chronic HCV infection who despite the absence of cirrhosis and HBV co-infection developed acute liver injury that completely resolved after glecaprevir/pibrentasvir withdrawal. Interestingly, sustained HCV virologic response was achieved after only 3 weeks of glecaprevir/pibrentasvir treatment.
Space Constrained Stereoselective Geometric Isomerization of 1,2-Diphenylcyclopropane and Stilbenes in an Aqueous Medium

Confinement provided by the reaction space alters the photostationary state isomer distribution during the geometric isomerization of excited 1,2-diphenylcyclopropane and stilbenes. The selectivity in 1,2-diphenylcyclopropane is suggested to result from the supramolecular steric hindrance exerted by the medium for the rotational motion. The alteration in the selectivity between a dimethyl and n-propyl substituted stilbenes is attributed to the medium influence on the location of the transition state on the ground state surface.
Precise coordination of three-dimensional rotational kinematics by ventral tegmental area GABAergic neurons

Summary The ventral tegmental area (VTA) is a midbrain region implicated in a variety of motivated behaviors. However, the function of VTA GABAergic (Vgat+) neurons remains poorly understood. Here, using three-dimensional motion capture, in vivo electrophysiology, calcium imaging, and optogenetics, we demonstrate a novel function of VTAVgat+ neurons. We found three distinct populations of neurons, each representing head angle about a principal axis of rotation: yaw, roll, and pitch. For each axis, opponent cell groups were found that increase firing when the head moves in one direction and decrease firing in the opposite direction. Selective excitation and inhibition of VTAVgat+ neurons generate opposite rotational movements. Thus, VTAVgat+ neurons serve a critical role in the control of rotational kinematics while pursuing a moving target. This general-purpose steering function can guide animals toward desired spatial targets in any motivated behavior.
Neurophysiological Findings and Brain Injury Pattern in Patients on ECMO

Introduction. Brain injury is a major determinant of outcomes in extracorporeal membrane oxygenation (ECMO). Neurologic prognostication in ECMO has not been established. Absent electroencephalogram (EEG) reactivity and absent N20 on somatosensory evoked potential (SSEP) are associated with poor outcome in other types of brain injuries, especially following cardiopulmonary arrest. It is currently known if the same criteria are applicable in patients on ECMO. Methods. Continuous EEG (cEEG) was performed for patients with a Glasgow Coma Scale (GCS) <8 and SSEP data were performed for patients with a motor GCS < 4 in a prospective observational cohort undergoing ECMO at a tertiary center. EEG variables including reactivity were collected. SSEPs were categorized into absence, delay, or presence of N20. Poor outcome was defined as cerebral performance category 3 to 5 at discharge. Results. We present 13 consecutive patients who underwent both cEEG and SSEP. The median time from cannulation to EEG and SSEP were 3 (interquartile range [IQR] = 1-6) and 5 (IQR = 2-7) days, respectively. All patients were in coma and 12 (92%) had poor outcomes. Ten (77%) underwent brain computed tomography, the findings of which explained coma in only 2. Patients (n = 12) with poor outcome had poor variability, absent reactivity, and lack of sleep features with diffusely slow theta-delta background on the EEG. Despite poor outcomes, all had relatively preserved or normal N20 responses. One patient with preserved reactivity and sleep features on the EEG and intact SSEP had a good outcome. Conclusions. Absent EEG reactivity with the preservation of SSEP N20 was associated with poor outcome in comatose ECMO patients. We advise caution in interpreting electrophysiological tests in prognosticating ECMO patients until the patterns and outcomes are better understood.
PD-L1 Expression in Pediatric Low-Grade Gliomas Is Independent of BRAF V600E Mutational Status

To evaluate a potential relationship between BRAF V600E mutation and PD-L1 expression, we examined the expression of PD-L1 in pediatric high- and low-grade glioma cell lines as well as a cohort of pediatric low-grade glioma patient samples. Half of the tumors in our patient cohort were V600-wildtype and half were V600E mutant. All tumors expressed PD-L1. In most tumors, PD-L1 expression was low (<5%), but in some cases over 50% of cells were positive. Extent of PD-L1 expression and immune cell infiltration was independent of BRAF V600E mutational status. All cell lines evaluated, including a BRAF V600E mutant xenograft, expressed PD-L1. Transient transfection of cell lines with a plasmid expressing mutant BRAF V600E had minimal effect on PD-L1 expression. These findings suggest that the PD-1 pathway is active in subsets of pediatric low-grade glioma as a mechanism of immune evasion independent of BRAF V600E mutational status. Low-grade gliomas that are unresectable and refractory to traditional therapy are associated with significant morbidity and continue to pose a treatment challenge. PD-1 pathway inhibitors may offer an alternative treatment approach. Clinical trials will be critical in determining whether PD-L1 expression indicates likely therapeutic benefit with immune checkpoint inhibitors.
Explantation of an Infected TEVAR with an Extra-Anatomic Arch Reconstruction along the Right Heart

This case represents the disease progression and workup of an infected thoracic endovascular aortic repair (TEVAR) graft that initially manifested as an aortic arch pseudoaneurysm. The patient underwent a 2-stage operation to resect the infected TEVAR and to reconstruct flow via an extra-anatomic aortic bypass paralleling the right heart. This is one of the few documented cases of TEVAR explantation with an extra-anatomic aortic bypass to re-establish flow.
Increasing Assessment, Diagnosis, and Intervention of Overweight and Obesity Among College Students: A Quality Improvement Project.

Background Approximately 66% of college students gain weight in their first year of college and continue to gain weight at a higher rate than the general population. On-campus clinics are often the only contact this generally healthy population has with healthcare providers. Objective The aim of this quality improvement project was to increase screening, diagnosis, and intervention of overweight (OW) and obesity by healthcare providers in a university-based student health center. Methods Manual audits of electronic health records were conducted 6 weeks before and 14 weeks after two educational seminars to increase provider awareness of evidence-based practice recommendations and available online and on-campus resources related to OW and obesity of young adult college students. Two hundred and forty-one pre-intervention and 520 post-intervention EHRs were reviewed to collect data on screening, diagnosis, and intervention by providers in the health center. Results Assessment of OW and obesity, diagnosis, and intervention all significantly (p = .00) increased following nurse practitioner (NP) education. Conclusions Following two continuing education seminars, provider adherence to evidence-based guidelines in the health center significantly increased. Implications for practice Education on evidence-based recommendations and available resources may increase health promotion, screening, diagnosis, and intervention of OW and obesity by healthcare providers in university-based health centers.
Addressing the needs of parents with advanced cancer: Attitudes, practice behaviors, and training experiences of oncology social workers.

Objective Advanced cancer patients who are parents of minor children experience heightened psychosocial distress. Oncology social workers (OSWs) are essential providers of psychosocial support to parents with advanced cancer. Yet, little is known about the experiences and approaches of OSWs in addressing these patients’ unique needs. The purpose of this study was to characterize the attitudes, practice behaviors, and training experiences of OSWs who provide psychosocial care for advanced cancer patients with minor children. Method Forty-one OSWs participated in a cross-sectional survey addressing multiple facets of their psychosocial care for parents with advanced cancer. The five assessed domains of psychosocial support were communication support, emotional support, household support, illness and treatment decision-making support, and end-of-life planning. Results Participants reported greatest confidence in counseling patients on communication with children about illness and providing support to co-parents about parenting concerns. OSWs reported less confidence in counseling parents on end-of-life issues and assisting families with non-traditional household structures. The majority of participants reported needing more time in their clinical practice to sufficiently address parents’ psychosocial needs. Nearly 90% of participants were interested in receiving further training on the care of parents with advanced cancer. Significance of results To improve the care of parents with advanced cancer, it is critical to understand how the psychosocial oncology workforce perceives its clinical practice needs. Study findings suggest an opportunity for enhanced training, particularly with respect to end-of-life needs and in response to the changing household structure of American families.
Directed Test Generation for Activation of Security Assertions in RTL Models

Assertions are widely used for functional validation as well as coverage analysis for both software and hardware designs. Assertions enable runtime error detection as well as faster localization of errors. While there is a vast literature on both software and hardware assertions for monitoring functional scenarios, there is limited effort in utilizing assertions to monitor System-on-Chip (SoC) security vulnerabilities. We have identified common SoC security vulnerabilities and defined several classes of assertions to enable runtime checking of security vulnerabilities. A major challenge in assertion-based validation is how to activate the security assertions to ensure that they are valid. While existing test generation using model checking is promising, it cannot generate directed tests for large designs due to state space explosion. We propose an automated and scalable mechanism to generate directed tests using a combination of symbolic execution and concrete simulation of RTL models. Experimental results on diverse benchmarks demonstrate that the directed tests are able to activate security assertions non-vacuously.
The Next Normal: Business Cycles, Innovation Theory, and Reactive Destruction

The COVID-19 pandemic brought with it a sharp economic contraction. Worldwide stay-home orders and calls for quarantine disrupt employment and commercial business activities are limited to those considered “essential.” Once closure rules are somewhat relaxed, citizens, companies, and independent business owners recalibrate and adapt to new ways of reassuring a safe way to obtain and deliver services and goods. That said, this “new normal” so far has proven more challenging for some industries and sectors than others. Much uncertainty as to life beyond the pandemic still remains. Forecasts predict the world will have to deal with Covid-related disruptions in years to come. Business cycle theory predicts expansion under certain periods of contraction, recession, or depression. Innovation theorists point to new discoveries and knowledge as the engine of such movements of contraction and expansion. Alas, these theories focus on internal innovation mechanisms that drive such changes. Although the current recession follows an idiosyncratic health crisis rather than new technological discoveries—a cause unrelated to innovation theory—we have already witnessed many scientific and business innovations since the onset of the COVID-19 pandemic. Could these pandemic-related novelties be a prerequisite to be able to attain the capstone of the current business cycle? Can external (rather than internal technological) dynamics be a catalyst to boost the next cycle of innovation and economic growth? This essay hopes to provide a missing piece of the puzzle and a deeper understanding of the business cycle and innovation theories. It demonstrates via the case studies of health-related shocks that such external factors should be factored into economic recession and growth models. As a normative solution, we propose to make certain laws more flexible to allow not only endogenic innovations to drive expansion and recovery but adopt rules that stifle change to increase preparedness and handle crisis.
News Media as Artifacts of Loss: Journalism History in the 9/11 Museum

With the passage of two decades, the story of September 11, 2001, is moving out of living memory and into recorded history. This essay considers the place of journalism within this transition, focu...
Francis King Carey, The Beet Sugar Industry and the Roots of Mexican Contract Labor Imperialism

This essay examines the role of entrepreneur Francis King Carey in the establishment of the World War I Mexican contract agricultural labor program in the beet sugar industry of Colorado.
Transfer facilitation effects of morphological awareness on multicharacter word reading in Chinese as a foreign language

This study examined the transfer facilitation effects from English morphological awareness on Chinese multicharacter word reading in English-speaking adult learners of Chinese as a foreign language (CFL). Fifty English-speaking American university CFL learners participated in our study who measured their English morphological awareness, Chinese morphological awareness, Chinese linguistic knowledge, Chinese word reading, and working memory. There were three major findings: (1) with approximately three years of formal Chinese instruction and limited Chinese print input, English-speaking adult learners of Chinese developed sensitivity to the internal morphological structure of multicharacter words in Chinese. (2) English morphological awareness did not directly contribute to Chinese bimorphemic three-character pseudoword reading yet contributed indirectly via the joint serial mediation by Chinese morphological awareness and Chinese monomorphemic two-character real word reading. (3) There was no additional influence from Chinese linguistic knowledge on Chinese word reading. And, English morphological awareness explained about 3.64% of the variance in second language Chinese bimorphemic three-character pseudoword reading. Discussion is provided regarding the transfer facilitation mechanism through which first language morphological awareness contributes to adult second language reading acquisition.
Quantifying Retinal Microvascular Morphology in Schizophrenia Using Swept-Source Optical Coherence Tomography Angiography.

BACKGROUND Retinovascular changes are reported on fundus imaging in schizophrenia (SZ). This is the first study to use swept-source optical coherence tomography angiography (OCT-A) to comprehensively examine retinal microvascular changes in SZ. METHODS This study included 30 patients with SZ/schizoaffective disorder (8 early and 15 chronic) and 22 healthy controls (HCs). All assessments were performed at Beth Israel Deaconess Medical Center and Massachusetts Eye and Ear. All participants underwent swept-source OCT-A of right (oculus dextrus [OD]) and left (oculus sinister [OS]) eye, clinical, and cognitive assessments. Macular OCT-A images (6 × 6 mm) were collected with the DRI Topcon Triton for superficial, deep, and choriocapillaris vascular regions. Microvasculature was quantified using vessel density (VD), skeletonized vessel density (SVD), fractal dimension (FD), and vessel diameter index (VDI). RESULTS Twenty-one HCs and 26 SZ subjects were included. Compared to HCs, SZ patients demonstrated higher overall OD superficial SVD, OD choriocapillaris VD, and OD choriocapillaris SVD, which were primarily observed in the central, central and outer superior, and central and outer inferior/superior, respectively. Early-course SZ subjects had significantly higher OD superficial VD, OD choriocapillaris SVD, and OD choriocapillaris FD compared to matched HCs. Higher bilateral (OU) superficial VD correlated with lower Positive and Negative Syndrome Scale (PANSS) positive scores, and higher OU deep VDI was associated with higher PANSS negative scores. CONCLUSIONS AND RELEVANCE These results suggest the presence of microvascular dysfunction associated with early-stage SZ. Clinical associations with microvascular alterations further implicate this hypothesis, with higher measures being associated with worse symptom severity and functioning in early stages and with lower symptom severity and better functioning in later stages.
Scientific Method (Scientific Methodology)

For many years, philosophers of science including Feyeraband (1975), Bauer (1994) and Gjertsen (1989) have asked the question “is there a scientific method?” The answer is “yes” and “no.” Yes, because there are things that most scientists do most of the time so these might be called scientific methods or methodology.
Bilateral laparoscopic nephrectomy for significantly enlarged polycystic kidneys: a technique to optimize outcome in the largest of specimens

OBJECTIVE To present our experience with bilateral laparoscopic nephrectomy (BLN) for symptomatic autosomal-dominant polycystic kidney disease (ADPKD), as surgical management of massively enlarged polycystic kidneys can be a daunting task. PATIENTS AND METHODS The study was a retrospective chart review of all patients undergoing BLN for ADPKD. Patient demographics, indications for the procedure, perioperative data, and pathological data were analysed. RESULTS In all, 12 patients underwent BLN at our institution; eight were performed before transplant, three after transplant, and one with a concomitant kidney transplant. Indications for surgery included abdominal pain, fullness and early satiety, recurrent urinary tract infections, and need for space for future transplant. The mean patient age was 49.6 years, with a body mass index of 27.0 kg/m2. The mean operative duration was 214 min, estimated blood loss was 169 mL, and the hospital stay was 4 days. There were no conversions to open surgery. The mean (range) pathological kidney mass was 2243 (656–4200) g on the left and 2379 (789–5042) g on the right. No patients with a previous renal transplant had deterioration in postoperative renal function. There was one minor intraoperative complication, one postoperative complication, and one patient with preoperative anaemia required a blood transfusion. CONCLUSIONS Symptomatic patients with ADPKD due to massively enlarged kidneys should be considered for BLN when performed by an experienced laparoscopic surgeon. This includes patients with an existing renal allograft and candidates for concomitant transplantation. The approach should be tailored to avoid injury to adjacent structures secondary to displacement from the mass effect of these kidneys.
Problems and issues in designing hypertext/hypermedia for learning

The growth in interest in hypertext and hypermedia (hereafter referred to by the more generic term, hypermedia) in recent years has been staggering. Hypermedia systems are being used extensively in software engineering and collaborative problem solving applications, for online documentation and information retrieval and help systems, as writing aids, and more recently as authoring tools for instruction and learning. Although hypermedia promises great potential for instruction, its efficacy is neither established nor without likely problems. Hypermedia learning systems will place more responsibility on the learner for accessing, sequencing and deriving meaning from the information. This added responsibility will entail added cognitive processing requirements on the learners. In many ways, this increased processing load appears consistent with constructive conceptions of learning and therefore desirable. Yet, it is not clear whether users will be able to assume this additional responsibility and processing load. The issues that this Advanced Research Workshop considered were how the hypermedia information and environment should be organized and displayed and how the information processing requirements specific to learning outcomes can be facilitated by hypermedia.
Molecular phenotypes in cultured maple syrup urine disease cells. Complete E1 alpha cDNA sequence and mRNA and subunit contents of the human branched chain alpha-keto acid dehydrogenase complex.

The activity of the branched-chain α-keto acid dehydrogenase complex is deficient in patients with the inherited maple syrup urine disease (MSUD). To elucidate the molecular basis of this metabolic disorder, we have isolated three overlapping cDNA clones encoding the E1 α subunit of the human enzyme complex. The composite human E1 α cDNA consists of 1783 base pairs encoding the entire human E1 α subunit of 400 amino acids with calculated Mr = 45,552. The human E1 α and the previously isolated human E2 cDNAs were used as probes in Northern blot analysis with cultured fibroblasts and lymphoblasts from seven unrelated MSUD patients. The results along with those of Western blotting have revealed five distinct molecular phenotypes according to mRNA and protein-subunit contents. These consist of type I, where the levels of E1 α mRNA and E1 α and E1 β subunits are normal in cells, but E1 activity is deficient; Type II, where the E1 α mRNA is present in normal quantity, whereas the contents of E1 α and E1 β subunits are reduced; Type III, where the level of E1 α mRNA is markedly reduced with a concomitant loss of E1 α and E1 β subunits; Type IV, where the contents of both E2 mRNA and E2 subunits are markedly reduced; and Type V, where the E2 mRNA is normally expressed, but the E2 subunit is markedly reduced or completely absent. Type V includes thiamin-responsive (WG-34) and certain classical MSUD cells. These molecular phenotypes have demonstrated the complexity of MSUD and identified the affected gene in different patients for further characterization.
Novel processes for anaerobic sulfate production from elemental sulfur by sulfate-reducing bacteria.

Sulfate reducers and related organisms which had previously been found to reduce Fe(III) with H2 or organic electron donors oxidized S0 to sulfate when Mn(IV) was provided as an electron acceptor. Organisms catalyzing this reaction in washed cell suspensions included Desulfovibrio desulfuricans, Desulfomicrobium baculatum, Desulfobacterium autotrophicum, Desulfuromonas acetoxidans, and Geobacter metallireducens. These organisms produced little or no sulfate from S0 with Fe(III) as a potential electron acceptor or in the absence of an electron acceptor. In detailed studies with Desulfovibrio desulfuricans, the stoichiometry of sulfate and Mn(II) production was consistent with the reaction S0 + 3 MnO2 + 4H+→SO42- + 3Mn(II) + 2H2O. None of the organisms evaluated could be grown with S0 as the sole electron donor and Mn(IV) as the electron acceptor. In contrast to the other sulfate reducers evaluated, Desulfobulbus propionicus produced sulfate from S0 in the absence of an electron acceptor and Fe(III) oxide stimulated sulfate production. Sulfide also accumulated in the absence of Mn(IV) or Fe(III). The stoichiometry of sulfate and sulfide production indicated that Desulfobulbus propionicus disproportionates S0 as follows: 4S0 + 4H2O→SO42- + 3HS- + 5 H+. Growth of Desulfobulbus propionicus with S0 as the electron donor and Fe(III) as a sulfide sink and/or electron acceptor was very slow. The S0 oxidation coupled to Mn(IV) reduction described here provides a potential explanation for the Mn(IV)-dependent sulfate production that previous studies have observed in anoxic marine sediments. Desulfobulbus propionicus is the first example of a pure culture known to disproportionate S0.
Nucleotide sequence and expression of cheF, an essential gene for chemotaxis in Bacillus subtilis.

The cheF gene, which is involved in chemotaxis in Bacillus subtilis, has been cloned, expressed, and sequenced. This gene is contained in a 0.7-kilobase PstI DNA fragment that was isolated from a lambda Charon 4A B. subtilis chromosomal DNA library. This fragment was subcloned into the expression vector pSI-1 and shown to complement the cheF mutation both for chemotaxis and for methanol production in response to the addition of attractants. Plasmid-encoded DNA expression in B. subtilis maxicells indicated that a membrane-associated polypeptide of 20-kilodaltons was expressed from this 0.7-kilobase DNA. The nucleotide sequence of this DNA fragment was determined, and an open reading frame capable of encoding a putative 175-amino-acid protein (Mr 20,002) was identified. In an effort to understand the function of the cheF protein, the dosage of the cheF gene product was varied by altering the concentration of IPTG (isopropyl-beta-D-thiogalactopyranoside) during growth. In the presence of high concentrations of IPTG, chemotaxis was inhibited and methanol production was impaired. Images
FILAMENT FORMATION IN RADIORESISTANT MUTANTS OF ESCHERICHIA COLI S AFTER TREATMENT WITH ULTRAVIOLET LIGHT AND RADIOMIMETIC AGENTS

Curry, Janet (Stanford Research Institute, Menlo Park, Calif.) and Joseph Greenberg. Filament formation in radioresistant mutants of Escherichia coli S after treatment with ultraviolet light and radiomimetic agents. J. Bacteriol. 83:38-42. 1962.-The effect of ultraviolet light and of five radiomimetic compounds on cell division, growth in liquid medium, and growth in solid medium of Escherichia coli S and four of its radioresistant mutants was examined. All of the agents, including ultraviolet light, induced filaments in the parent S and in at least one of its radioresistant mutants; two of the agents, azaserine and mitomycin C, induced filaments in three of the mutants; in only one mutant were no filaments induced by any agent. Growth in solid medium was more sensitive to the agents than was growth in liquid medium. The mutants differed among each other in their degree of resistance to most of the chemical agents, when inhibition of growth in agar was used as the criterion. There was no difference among the mutants in the dose of any agent required to inhibit overnight growth in liquid medium.
Intermodulation product statistics in multi-carrier radio systems

The authors study the probability distribution function (PDF) and cumulative probability distribution function (CPDF) of the IM (intermodulation) products in several nonlinearly amplified systems by computer simulations and hardware measurements. The statistics of the in-band and out-of-band IM products are found. Particular emphasis is given to the study of the CPDF of out-of-band IM products since it is shown that these can be the major cause of adjacent-channel-interference (ACI). It is demonstrated that the PDF of the out-of-band IM interference is not necessarily Gaussian and that this out-of-band IM noise may lead to more frequent peaks and to higher peaks or crest factors than practical Gaussian noise sources. Thus the BER (bit error rate) will be worse than that in the WGN (white Gaussian noise) case. On the contrary, in the case of in-band IM noise, the BER performance is better than that of the WGN case when C/N (carrier/noise ratio) is high enough. >
Political Bias and War

We examine the incentives for countries to go to war as they depend on the comparison between how much their pivotal decision-makers have at risk and how much they stand to gain from a war. How this ratio compares to the country at large is what we term "political bias." If there is no political bias, then there are always payments that one country would like to make to the other that will avoid a war in the presence of commitment or enforceability of peace treaties. If there is a bias on the part of one or both countries, then war can result and in some cases cannot be prevented by any transfer payments. We examine how war technology and relative wealth levels interact with political bias in determining whether countries make transfers, go to war, and form alliances. Our results shed some new light on the uneven contender paradox and the interpretation of the "democratic peace".
Time-resolved studies of CN radical reactions and the role of complexes in solution.

Time-resolved studies using 100 fs laser pulses generate CN radicals photolytically in solution and probe their subsequent reaction with solvent molecules by monitoring both radical loss and product formation. The experiments follow the CN reactants by transient electronic spectroscopy at 400 nm and monitor the HCN products by transient vibrational spectroscopy near 3.07 μm. The observation that CN disappears more slowly than HCN appears shows that the two processes are decoupled kinetically and suggests that the CN radicals rapidly form two different types of complexes that have different reactivities. Electronic structure calculations find two bound complexes between CN and a typical solvent molecule (CH2Cl2) that are consistent with this picture. The more weakly bound complex is linear with CN bound to an H atom through the N atom, and the more strongly bound complex has a structure in which the CN bridges Cl and H atoms of the solvent. Fitting the transient absorption data with a kinetic model contain...
Optical Digital Recording

An optical information storage system based on direct binary bit imaging is described. The recorded bit diameters are about one micron, and a density of about 5 x 107 bits/cm2 has been demonstrated. Color television program material has been encoded in a differential PCM format, recorded and played back in real time. The system uses a stationary rec-ord, and a scanned optical aperture that is smaller than usual for these bit densities. The present work has been directed toward a low cost video player/recorder for home use. Optical digital recording is a technique for high density storage of binary information. Each information bit is stored as a discrete, direct image in contrast to the more usual holo graphic transform images. By the use of short focal length lenses and a mechanical scanner a data density of 5 x 1 07 bits per square centimeter and data rates of 3 x 107 bits per second have been demonstrated. For comparison, the information on a typical reel of computer tape (2600 ft at 1600 BPI) could be stored in roughly one square inch on this optical record. This technology was developed for several applications. The first, consumer prerecorded TV, is reported here. This choice was made because a video record would require the highest densities and the simplest, lowest cost player of all the applications considered. In effect, the results of this work would help define those applications that are commercially feasible. Color TV material has been successfully re corded in real time and played back with basically no degredation of the signal. The luminance bandwidth is 3.5 MHz plus the .6 MHz color components. The playback device is simple and probably inexpensive in quantity. Holographic data storage techniques were not used for this work because the inherent advantages of holographic systems can be had with properly designed direct bit systems, while the playback equipment for direct systems appears less expensive. Scanner In contrast to much previous work, the record element is held stationary during re
The praxis assignment: experiential learning in a large social-community psychology class.

In this article, a faculty member, a graduate student teaching assistant, and four undergraduates describe their experiences with a “Day of Social Justice Praxis Assignment” as a form of experiential learning in a 120-person social-community psychology course. The faculty member lays out the goals of the course and her hopes for the specific assignment. The undergraduates reflect on their experience with the assignment, and the graduate student contextualizes how their work is reflective or not reflective of the work produced in the class and course concepts. The article ends with a critical and frank discussion of the benefits and drawbacks of the assignment.
An Insane Way to Behave? Sources of Confusion Under the Criminal Procedure (Insanity and Unfitness to Plead) Act 1991

Abstract A case is reported under the Criminal Procedure (Insanity and Unfitness to Plead) Act 1991, where a finding of unfitness to plead was made incorrectly and unintentionally; where this was followed by a successful plea of not guilty by reason of insanity on the basis of little medical evidence, and where the court confused the CP(I)A 1991 with the Mental Health Act 1983. The issues raised are discussed and their implications considered and explored.
An attempted synthesis of tricyclo[8.21,10.01,7.04,10]-1(7),4(10)-dodecadiene

Abstract Titanium-induced cyclization of diketone 4 yields diene 12, presumably by Cope rearrangement of the desired tricyclo[8.21,10.01,7.04,10]-1(7),4(10)-dodecadiene (1). Molecular mechanics calculations support the belief that the rearrangement should be rapid.
How do users respond to voice input errors?: lexical and phonetic query reformulation in voice search

Voice search offers users with a new search experience: instead of typing, users can vocalize their search queries. However, due to voice input errors (such as speech recognition errors and improper system interruptions), users need to frequently reformulate queries to handle the incorrectly recognized queries. We conducted user experiments with native English speakers on their query reformulation behaviors in voice search and found that users often reformulate queries with both lexical and phonetic changes to previous queries. In this paper, we first characterize and analyze typical voice input errors in voice search and users' corresponding reformulation strategies. Then, we evaluate the impacts of typical voice input errors on users' search progress and the effectiveness of different reformulation strategies on handling these errors. This study provides a clearer picture on how to further improve current voice search systems.