cssi/SciSciGPT-SciSciNet huggingface dataset:
Have Hospice Costs Increased After Implementation of the Hospice Quality-Reporting Program?

Abstract Context The Centers for Medicare & Medicaid Services Hospice Quality–Reporting Program introduced the requirement that hospices nationwide begin collecting and submitting standardized patient-level quality data on July 1, 2014. Objectives This study examined whether this requirement has increased hospice total costs, general costs, and visiting services costs. Methods We conducted a cross-sectional study using data from the 2012 and 2014 Medicare hospice cost reports linked to hospice claims. We measured total costs per patient day (PPD), general costs PPD, and visiting services costs PPD for freestanding hospices. We estimated the incremental costs of operating in 2014 vs. 2012 using hierarchical random effects models and adjusting for year, wage index, care volume, case-mix, and hospice and market characteristics, stratified by hospice ownership type. Results Both for-profit and nonprofit hospices reported higher total costs PPD and general services costs PPD in 2014 than 2012. Nonprofit hospices also reported higher general costs PPD in 2014 than 2012. In adjusted models, the total costs PPD in 2014 were $10.55 higher than in 2012 for nonprofit hospices and $6.43 higher for for-profit hospices. The increase in general costs PPD and visiting services costs PPD ranged from $3.15 to $5.87 by ownership and type of costs. Both for-profit and nonprofit hospices showed lower costs PPD for all types associated with more patients and longer length of stay. Conclusion Hospice costs increased after the Centers for Medicare & Medicaid Services Hospice Quality–Reporting Program quality data collection/submission requirement. Complementary studies need to understand whether increased costs brought additional benefits.
Viewing Telugu Inscriptions at Ahobila

One of the important pilgrimage centers (tīrtha) in South India, dedicated to the incarnation (avatāra) of Viṣṇu as Narasiṃha, the man-lion, is located at Ahobila, in the state of Andhra Pradesh. T...
On Semi-Stochastic Model for Multi-Stage Decision Making Under Uncertainty

We propose a (seemingly) new computationally tractable model for multi-stage decision making under stochastic uncertainty.
Between Prophecy and Apocalypse: Buber, Benjamin, and Socialist Eschatology

Martin Buber’s political thought has enjoyed renewed attention lately, particularly his concept of “theopolitics,” a type of political practice that recognizes God as the ultimate political authori...
Improving the Efficiency and Equity of Highway Funding and Management: The Role of Vmt Charges

Congestion problems that are becoming more serious, along with deteriorating roads and bridges, raise questions about the viability of the existing system for funding roads and highways in the United States. Using economic theory and evidence from the literature, this paper explores the role that vehicle mile charges could play in reforming highway funding and management. It discusses the advantages of such a system in comparison to the status quo as well as obstacles that might prevent the adoption or implementation of a system of charges for vehicle miles traveled. It also discusses options for addressing drivers' privacy concerns. Replacing fuel taxes with a comprehensive system of vehicle mile charges, especially if accompanied by a greater role for private firms in owning or managing roads, is a promising approach for achieving a more efficient and equitable solution for funding surface transportation infrastructure.
Sex Differences in Huntington's Disease: Evaluating the Enroll-HD Database.

Background Identifying sex-related differences is critical for enhancing our understanding of factors that may impact prognosis and advance treatments in Huntington's disease (HD). Objectives To investigate if sex-related differences exist in clinical HD. Methods Longitudinal study of the Enroll-HD database. Manifest HD patients were included in the analysis (N = 8401). Linear mixed models were used to assess motor, behavioral, and cognitive functioning over a series of four annual visits, and compared male and female HD gene carriers. Results HD patients showed significant sex-dependent differences in motor, cognitive, and behavioral symptoms. Both sexes had worsened motor symptoms over the course of four visits, but there was a significant disparity between sexes, with females consistently presenting with more symptoms than males. For behavioral symptoms, specifically depressive symptoms, females had significantly more depressive symptoms, although self-reported symptoms in both sexes became less severe throughout time. Conclusions Our analyses suggest that women have worse symptoms than men during the course of HD.
Precise Cache Profiling for Studying Radiation Effects

Increased access to space has led to an increase in the usage of commodity processors in radiation environments. These processors are vulnerable to transient faults such as single event upsets that may cause bit-flips in processor components. Caches in particular are vulnerable due to their relatively large area, yet are often omitted from fault injection testing because many processors do not provide direct access to cache contents and they are often not fully modeled by simulators. The performance benefits of caches make disabling them undesirable, and the presence of error correcting codes is insufficient to correct for increasingly common multiple bit upsets. This work explores building a program’s cache profile by collecting cache usage information at an instruction granularity via commonly available on-chip debugging interfaces. The profile provides a tighter bound than cache utilization for cache vulnerability estimates (50% for several benchmarks). This can be applied to reduce the number of fault injections required to characterize behavior by at least two-thirds for the benchmarks we examine. The profile enables future work in hardware fault injection for caches that avoids the biases of existing techniques.
Unwriting the Father

Although long committed to his marriage, a father’s distancing from it as well as the writing process itself of the experience help the author understand that his straight father’s refusal to reunite the family is not unlike a queer son’s refusal to support traditional practices of marriage. Despite wanting to believe in the heteronormative family and expecting his father to remain loyal to its roles, commitments, and moral obligations, Baros himself must reject family tradition given his own sexuality. Ultimately, the author understands a father’s promise to comply with whatever it takes to be a father may not always involve free will or capture the silences in the construction and telling of family narratives. Father/son ideals, Baros finds, necessitate rethinking and renewed practices and tolerances.
Superconducting properties of BaBi3

We report the superconducting properties of single crystals of the intermetallic compound BaBi3, whose crystal structure is perovskite related. The superconducting transition temperature ( K) was obtained from heat capacity measurements. Using the measured values for the critical fields , and the specific heat C, we estimate the thermodynamic critical field H c (0), coherence length ξ(0), Debye temperature and coupling constant λep. and λep suggest that BaBi3 is a weakly coupled superconductor. Electronic band structure calculations show a complex Fermi surface and a moderately high DOS at the Fermi level. Further analysis of the electronic specific heat shows that the superconducting properties are dominated by s-wave gap.
GWAS analysis to compute genetic markers of progression to Alzheimer's disease

Prediction of conversion from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD) is a challenging task due to involvement of many genetic and environmental factors leading to neurodegeneration. Several Genome Wide Association Studies (GWAS) have been conducted to understand genetic risk factors of AD, however, there are not many GWAS studies that find the genetic factors of conversion from MCI to AD. In this study, we aim to find potential genetic markers causing conversion from MCI to AD and build a machine learning model to predict the conversion. To this end, we used genetic variation data of 809 patients in Alzheimer's Disease Neuroimaging Initiative (ADNI). We processed the genetic data by merging SNPs information of all patients into a single set of PLINK files, which served as input for the GWAS analysis. SNPs were filtered based on call rate, minor allele frequency and Hardy-Weinberg equilibrium cut-off. Samples were also filtered to remove any linkage using sample call rate, inbreeding coefficient, kinship coefficient and linkage disequilibrium cut-off. After the filtration, we calculated negative log p-value for the remaining SNPs in association with the phenotype (i.e., converter vs. non-converter). We repeated this step for other traits such as ventricle size, hippocampus size, and Tau protein concentration to record different loci on chromosomes influencing each trait. The presence or absence of significant SNPs will be used to create a deep learning model to predict the progression of AD in a patient using only genetic information.
Linear Complexity Entropy Regions

A great many problems in network information theory, both fundamental and applied, involve determining a minimal set of inequalities linking the Shannon entropies of a certain collection of subsets of random variables. In principle this minimal set of inequalities could be determined from the entropy region, whose dimensions are all the subsets of random variables, by projecting out dimensions corresponding to the irrelevant subsets. As a general solution technique, however, this method is plagued both by the incompletely known nature of the entropy region as well as the exponential complexity of its bounds. Even worse, for four or more random variables, it is known that the set of linear information inequalities necessary to completely describe the entropy region must be uncountably infinite. A natural question arises then, if there are certain nontrivial collections of subsets where the inequalities linking only these subsets is both completely known, and have inequality descriptions that are linear in the number of random variables. This paper answers this question in the affirmative. A decomposition expressing the collection of inequalities linking a larger collection of subsets from that of smaller collections of subsets is first proven. This decomposition is then used to provide systems of subsets for which it both exhaustively determines the complete list of inequalities, which is linear in the number of variables.
Operations Research Applications

Project Management, A.B. Badiru Introduction Critical Path Method PERT Network Analysis Statistical Analysis of Project Duration Precedence Diagramming Method Software Tools for Project Management Conclusion Quality Control, Q. Feng and K.C. Kapur Introduction Quality Control and Product Life Cycle New Trends and Relationship to Six Sigma Statistical Process Control Process Capability Studies Advanced Control Charts Limitations of Acceptance Sampling Conclusions Reliability, L.M. Leemis Introduction Reliability in System Design Lifetime Distributions Parametric Models Parameter Estimation in Survival Analysis Nonparametric Methods Assessing Model Adequacy Summary Production Systems, B.L. Foote and K.G. Murty Production Planning Problems Demand Forecasting Models for Production Layout Design Scheduling of Production and Service Systems Energy Systems, C.R. Hudson and A.B. Badiru Introduction Definition of Energy Harnessing Natural Energy Mathematical Modeling of Energy Systems Linear Programming Model of Energy Resource Combination Integer Programming Model for Energy Investment Options Simulation and Optimization of Distributed Energy Systems Point-of-Use Energy Generation Modeling of CHP Systems Economic Optimization Methods Design of a Model for Optimization CHP System Capacities Capacity Optimization Implementation of the Computer Model Other Scenarios Airline Optimization, J.L. Snowdon and G. Paleologo Introduction Schedule Planning Revenue Management Aircraft Load Planning Future Research Directions and Conclusions Financial Engineering, A.R. Heching and A.J. King Introduction Return Estimating an Asset's Mean and Variance Diversification Efficient Frontier Utility Analysis Black-Litterman Asset Allocation Model Risk Management Options Valuing Options Dynamic Programming Pricing American Options Using Dynamic Programming Comparison of Monte Carlo Simulation and Dynamic Programming Multi-Period Asset Liability Management Conclusions Supply Chain Management, D.P. Warsing Introduction Managing Inventories in the Supply Chain Managing Transportation in the Supply Chain Managing Locations in the Supply Chain Managing Dyads in the Supply Chain Discussion and Conclusions E-Commerce, S. Sadagopan Introduction Evolution of E-Commerce OR/MS and E-Commerce OR Applications in E-Commerce Way Forward Summary Water Resources, G.V. Loganathan Introduction Optimal Operating Policy for Reservoir Systems Water Distribution Systems Optimization Preferences in Choosing Domestic Plumbing Materials Stormwater Management Groundwater Management Summary Military Application, J.D. Weir and M.U. Thomas Introduction Background on Military OR Current Military Applications of OR Concluding Remarks Future of OR/MS Applications: A Practitioner's Perspective, P. Balasubramanian Past as a Guide to the Future Impact of the Internet Emerging Opportunities
Microwave Noninvasive Sensing of Physiological Signatures

Knowledge of the physiologic or pathophysiologic status of the heart and vessels as a transportation system for blood, and lungs as the site of gas exchange are factors that can greatly assist medical practitioners in the management of cardiovascular and pulmonary diseases. In light of prevalence of mortality and morbidity associated with heart, vascular and lung diseases, considerable efforts have been devoted to the development of noninvasive diagnostic techniques which not only are safe, but also offer the possibility of earlier detection as well as quantification of these disease states. Most recently, the advantage afforded by non-contact and remote sensing has engendered a great deal of excitement regarding the use of such technologies for monitoring patients with critical burns and premature developments, and personnel fell prey to such hazardous environments as fire, chemical or nuclear contamination and natural or man-caused disasters.
Major Depressive Disorder

Major depressive disorder (MDD) is characterized by depressed mood or a lack of interest or pleasure in once-enjoyable activities, and associated symptoms (e.g., sleep disturbance; appetite/weight disturbance; difficulty concentrating; feelings of worthlessness or exaggerated guilt). To receive a diagnosis of MDD, at least five symptoms must be present most of the day, nearly every day, for at least two weeks (American Psychiatric Association [APA], 2000). Keywords: major depression; relapse; recurrence
Oral Histories of Education and the Relevance of Theory: Claiming New Spaces in a Post‐Revisionist Era

Almost forty years since the publication of Cutler's landmark “Oral history—its nature and uses for educational history,” growing numbers of historians of education have adopted oral interviews as the basis for historical analysis. Furthermore, questions about the objectivity of oral sources in view of memory's fallibility have been more productively redirected toward exploring, in light of credibility standards borrowed from the social sciences and literary theory, the many hues of subjectivity of oral historical testimonies, and their implications for understanding same past events from multiple perspectives. As Portelli aptly states, “the first thing that makes oral history different, is that it tells us less about events than about their meaning” He boldly asserts that “what informants believe is indeed a historical fact “that is, the fact that they believe it”, as much as what really happened.” Oral historians not only reproblematized memory for historians by focusing attention on understanding the subjectivity of memory as a manifestation of historical consciousness, but they also brought to our attention how memories are gendered, racialized, and class based. They brought to our attention the importance of examining why different individuals and groups experience the same event in very different ways. Today, oral sources, particularly since the 1990s when historians began investigating the construction of identities, are compared less pejoratively with documentary sources by academic disciplinarians. And oral historians continue to break down “boundaries between the educational institution and the world, between the [history] profession and ordinary people.” However, they also continue to be faced with the challenge of articulating “the connection between individual and social historical consciousness.”
Compact ambient pressure pyroelectric ion source for mass spectrometry.

We present the construction and implementation of a compact, low-power ambient pressure pyroelectric ionization source. The source comprises a z-cut lithium niobate or lithium tantalate crystal with an attached resistive heater mounted in front of the atmospheric pressure inlet of an ion trap mass spectrometer. Positive and negative ion formation alternately results from thermally cycling the crystal over a narrow temperature range. Ionization of 1,1,1,3,3,3−hexafluoro-2-propanol or benzoic acid results in the observation of the singly deprotonated species and their clusters in the negative ion mass spectrum. Ionization of triethylamine or triphenylamine with the source results in observation of the corresponding singly protonated species of each in the positive ion mass spectrum. Although processes in which ion formation occurs directly on the highly charged crystal surface may contribute to the observed signal, ion formation appears to result mainly from electrical discharges occurring on the surface of the crystal, from one z face to another. This dielectric breakdown originates from the high electric fields generated at the surface of pyroelectric crystals when they are thermally cycled by as little as 30 K from ambient temperature. Ion formation is largely unaffected by contamination of the crystal faces. This robust source might prove particularly useful in applications where unattended operation in harsh environments, long service lifetimes, and durability are desirable characteristics.
Simple, Robust, and Memory-Efficient FastICA Algorithms Using the Huber M-Estimator Cost Function

The goal of blind source separation is to separate multiple signals from linear mixtures without extensive knowledge about the statistical properties of the unknown signals. The design of separation criteria that achieve accurate and robust source estimates within a simple adaptive algorithm is an important part of this task. The purpose of this paper is threefold: (1) We introduce the Huber M-estimator cost function as a contrast function for use within prewhitened blind source separation algorithms such as the well-known and popular FastICA algorithm of Hyvarinen and Oja. The resulting algorithm obtained from this cost is particularly simple to implement. We establish key properties regarding the local stability of the algorithm for general non-Gaussian source distributions, and its separating capabilities are shown through analysis to be largely insensitive to the cost function's single threshold parameter. (2) We illustrate the use of the Huber M-estimator cost as a criterion within the winning algorithm entry for the blind source separation portion of the first Machine Learning for Signal Processing Workshop Data Analysis Competition, describing the key features of the algorithm design for successful separation of large-scale and ill-conditioned signal mixtures with reduced data set requirements. (3) We show how the FastICA algorithm can be implemented without significant additional memory resources by careful use of sequential processing strategies.
Multi-language service literature program

Effective multi-language service literature depends on accurate conversion of thought and meaning-not direct translation of individual words. Such conversion is best accomplished by those who speak the customer's language as their native tongue and whose educational background encompasses the scope of the subject matter. In addition, the publication format, e.g., parallel or sequential arrangements of translated units of text, may be usefully varied according to the information content. The result is a more direct and understandable communication between the manufacturer and the user of his product.
Statewide Vessel Collision Design for Bridges

Design Method II for vessel collision design is recommended by AASHTO specifications for most bridges. With its required resources more elaborate than Method I, Method II classifies vessel traffic passing under a specific bridge into different categories. To achieve an economical vessel collision design, a strategy is proposed to perform design Method II analysis on a statewide basis. In association with the waterways of Florida, the vessel traffic data are collected from available resources and a synthesizing methodology is developed to statistically process these data by vessel types, sizes, and loading condition. This study provides statewide input data ready for vessel collision analysis adopting Method II. As a numerical example, an illustrative bridge with multiple piers is designed in accordance with Method II. Waterborne traffic data from Indian River in Florida are utilized as input data. Comparison among annual frequencies of collapse due to various vessel categories indicates that barge trains are statistically significant in the collision design. Future traffic growth is considered using two different approaches and the possible difference is studied.
Corneal impression test for the diagnosis of acute rabies encephalitis.

Purpose: This study aimed to alert ophthalmologists as to their role in the diagnosis of rabies. Methods: A 13-year-old girl was admitted with acute encephalitis of unknown etiology. Bacterial and viral cultures and test results for Lyme disease and tuberculosis were negative. Initial cerebrospinal fluid, serum, skin, and saliva specimens were negative for rabies. A corneal impression test was performed. Results: Immunofluorescent antibody staining of the epithelial cells on the corneal impression test was positive for rabies. Subsequently, the diagnosis was confirmed by serum serologic analysis and saliva testing. Conclusion: Ophthalmologists can assist in the diagnosis of rabies by using the corneal impression test. Corneal smears should be part of the routine antemortem work-up for presumptive rabies.
Internal or shape coordinates in the n-body problem.

The construction of global shape coordinates for the n-body problem is considered. Special attention is given to the three- and four-body problems. Quantities, including candidates for coordinates, are organized according to their transformation properties under so-called democracy transformations (orthogonal transformations of Jacobi vectors). Important submanifolds of shape space are identified and their topology studied, including the manifolds upon which shapes are coplanar or collinear, and the manifolds upon which the moment of inertia tensor is degenerate.
Effects of a glyphosate-based herbicide on mate location in a wolf spider that inhabits agroecosystems.

Abstract Chemical communication is important to many arthropod species but the potential exists for anthropogenic chemicals to disrupt information flow. Although glyphosate-based herbicides are not acutely toxic to arthropods, little is known regarding their effects on natural chemical communication pathways. The wolf spider, Pardosa milvina, is abundant in agroecosystems where herbicides are regularly applied and uses air- and substrate-borne chemical signals extensively during mating. The aim of this study was to examine effects of a commercial formulation of a glyphosate-based herbicide on the ability of males to find females. In the field, virgin females, when hidden inside pitfall traps with herbicide, attracted fewer males than females with water. Likewise females in traps with a ring of herbicide surrounding the opening were less likely to attract males than those in traps surrounded by water. We explored the reaction of males to any airborne component of the herbicide in a laboratory two-choice olfactometer experiment. When no female pheromones were present, males were equally likely to select herbicide or water treated corridors and they all moved through the apparatus at similar speeds. When female pheromones were present, the males that selected control corridors moved more slowly than those that selected herbicide and, if we control for the initial decision time, more males selected the control corridors over the herbicide. These data suggest that glyphosate-based herbicides are “info-disruptors” that alter the ability of males to detect and/or react fully to female signals.
Sounding a wake-up call: improving the lives of adults with autism.

fter making the initial diagnosis of autistic disorder in a child younger than 3 years, A the examination room is often silent and filled with sadness. I have learned to sit quietly with the parents, often as tears run down their cheeks. After a few minutes, one of the parents, usually the mother, asks me if their child will go to college and get married. Because there are sparse data to guide my response, I base it on my experience caring for adults with autism during the past 25 years. My answer is not one the parents hope to hear. It has been unusual for one of my patients with autistic disorder to “go away” to a 4-year college and be successful, at least in the manner that one of their typical peers might. The individual may have the intellect to master the coursework, but the lack of structure and social demands are often too much to overcome. The young adult may live in a single room in the dormitory and the parents may continue to function as the person’s external ego, calling to wake him up and telling him when to take his medication, go to class, and go to bed. The individual may become preoccupied with a particular video game or have the need to watch and rewatch each episode of a television series from the 1960s in sequence. Although this may sound like the experience of many college freshmen, there are usually roommates, friends, hall monitors, and residence assistants to help the person get back on track. Fortunately, many colleges and universities have begun to develop support services to assist those with autism. I have treated only 2 adults with autistic disorder who were married. One man with an IQ in the low average range was not married long, in part because of his difficulties managing his anger and impulsivity. In the other case, the marriage had been “arranged” by grandmothers doing what they hoped would make their adult grandchildren happy. My patient, a higher-functioning man with autistic disorder,
A hypothesis of synergism: the interrelationship of T3 and insulin to disturbances in metabolic homeostasis.

While the role of abnormal insulin homeostasis in the pathogenesis of Type-2 diabetes mellitus is well established, the importance of the canonical role of T(3) on Type-2 diabetes or the homeostasis of glucose, lipid, and energy balance has not been addressed. Based on the available evidence from molecular biology, the pivotal regulatory role of T(3) in major metabolic pathways and glycemic control can be delineated by mapping the specific action sites of T(3) and insulin on the metabolic pathways of the glucose-lipid cycle. The current paper presents an integrative hypothesis of the synergistic relationship of T(3) and insulin in metabolic homeostasis and abnormalities.
Positron emission tomographic scan investigations of Huntington's disease: Cerebral metabolic correlates of cognitive function

Fifteen drug-free patients with early to mid-stage Huntington's disease (HD) were evaluated with positron emission tomographic (PET) scans of 18F-2-fluoro-2-deoxy-D-glucose uptake and quantitative measures of neurological function, learning, memory, and general intelligence. In comparison with a group of normal volunteers, the HD patients showed lower metabolism in both caudate (p less than 0.001) and putamen (p less than 0.001) on PET scans. A significant and positive relationship was found between neuropsychological measures of verbal learning and memory and caudate metabolism in the patient group but not in the normal group. Visual-spatial learning did not reflect a similar pattern, but performance intelligence quotient was positively related to both caudate and putamen metabolism in the HD group. Vocabulary level was unrelated to either brain structure. Discussion focuses on these and other observed brain-behavior relationships and on the implications of these findings for general behaviors such as those involved in coping and adaptation.
The Potential of Grid-Enabled Learning for High Impact Weather with LEAD

Linked environments for atmospheric discovery (LEAD) is a bold and revolutionary paradigm that through a Web-based service oriented architecture (SOA) exposes the user to a rich environment of data, models, data mining and visualization/analysis tools, enabling the user to ask science questions of applications while the complexity of the software and middleware managing these applications is hidden from the user. The LEAD education initiative has focused on making available to students the same data, tools, and services used by researchers but with an authentic and contextualized environment for teaching and learning.
Gestational weight gain and hypertensive disorders: MacDonald-Wallis et al

See related article, page 327 ypertensive disorders of pregH nancy (HDP), which include gestational hypertension, preeclampsia, and chronic hypertension, affect up to 10% of all pregnancies. Manifestations range from mild elevations in blood pressure with minimal or no systemic effects to severe increases and organ damage. Several studies investigating modifiable risk factors found that HDP is more likely to develop in women with greater gestational weight gain (GWG). However, edema could not be excluded as a confounder because researchers looked at weight gain throughout the pregnancy. MacDonald-Wallis and colleagues avoided this statistical dilemma by looking at weight gain only up to 18 weeks’ gestation as a risk factor for development of HDP. Their work was discussed in this month’s meeting of the Journal Club.
Effect of the selective kappa-opioid receptor antagonist JDTic on nicotine antinociception, reward, and withdrawal in the mouse.

Rationale Several lines of evidence support a role for the endogenous opioid system in mediating behaviors associated with drug dependence. Specifically, recent findings suggest that the kappa-opioid receptor (KOR) may play a role in aspects of nicotine dependence, which contribute to relapse and continued tobacco smoking.
Effects of subcutaneous verapamil on the duration of local anesthetic blockade.

Study Objectives: To determine whether a subcutaneous injection of verapamil will provide local anesthesia and whether a mixture of lidocaine and verapamil will prolong the anesthetic effect of lidocaine alone. Design: Randomized, double-blind, placebo-controlled study. Setting: Preanesthetic area of a large metropolitan teaching hospital. Patients: 20 volunteers. Interventions: All volunteers received 4 injections of normal saline, verapamil, lidocaine, and lidocaine-verapamil at the volar aspect of the forearm. The sites were tested with a 26-gauge needle to be sure the sensation of sharp could be appreciated. The injections were performed in a randomized, double-blind fashion using a sterile technique. The 4 areas were tested at 1-minute intervals using a 26-gauge needle until the sensation of sharp was again perceived. Measurements and Main Results: Injection sites were examined for the presence and degree of erythema. Volunteers were asked to rate the degree of pain felt during and immediately after injection. The time elapsed until the person was again able to perceive sharp from a 26-gauge needle prick was measured at all 4 sites. When compared with the effects of normal saline, subcutaneous verapamil provided local anesthesia to pinprick. The mixture of verapamil and lidocaine also provided anesthesia to pinprick, but the duration of effect was less than that provided by lidocaine alone. The use of verapamil alone and in combination with lidocaine was associated with a marked degree of erythema and edema. Conclusions: Verapamil injected subcutaneously provides a degree of local anesthesia. However, this effect is hampered by a local reaction at the injection site and a short duration of action. The mixture of lidocaine and verapamil provides a shorter duration of action than does lidocaine alone.
PROPERTIES OF MICROCYSTIS AERUGINOSA AND M. FLOS–AQUAE (CYANOPHYTA) IN CULTURE: TAXONOMIC IMPLICATIONS

Cultures were cloned from a sample containing Microcystis aeruginosa, M. flos-aquae and a few morphological intermediates. The M. aeruginosa cultures remained distinct from the M. flos-aquae cultures in (a) cell size, (b) cell aggregation pattern, (c) width of the mucilage surrounding the multicellular colonies, (d) sharpness of the mucilage boundary, (e) efect of 0.1–1.0 μM calcium chloride on the disaggregation of multicellular colonies, (f) frequency of mucilage mutants and (g) colony morphology on agar media. No M. flos-aquae culture produced morphs resembling M. aeruginosa, inconsistent with proposals that M. flos-aquae is a developmental stage or environmentally-induced variant of M. aeruginosa. After longterm cultivation, but not soon after origanal isolation, several M. aeruginosa cultures contained mutants with diminished mucilage production and an altered colony shape.
Low‐resolution Raman spectroscopy: instrumentation and applications in chemical analysis

It is shown that low-resolution Raman spectroscopy (LRRS) satisfies the need for a highly useful, low-cost spectroscopic approach to both qualitative and quantitative analyses of organic systems. Until now, the disadvantage of using Raman spectroscopy has been the cost of the instrumentation. It is shown that when the application does not require high spectral resolution for analysis, LRRS can be used and implemented with low-cost multimode lasers and miniature low-resolution spectrometers, thus lowering the size, weight and cost of the instrumentation by an order of magnitude. First the implementation of LRRS is discussed, emphasizing a small portable instrument, then four applications are presented, each representative of a wide range of applications where LRRS is applicable. These results show that the use of LRRS provides the potential to bring Raman analyses out of the laboratory to the process floor and into the field for near real-time, on-site and, in many cases, in situ measurements, monitoring and identification. Copyright © 1999 John Wiley & Sons, Ltd.
Code Red in the OR—Implementing an OR Fire Drill

ABSTRACT • KNOWLEDGE OF FIRE PREVENTION and fire safety is essential for every OR staff member. In the event of a surgical fire, the quick and knowledgeable response of surgical team members will affect their own safety and that of their patients. • A NEW FIRE SAFETY PLAN was developed at Peninsula Regional Medical Center, Salisbury, Md. To update staff members' knowledge of the facility's fire plan and special instructions for the OR, a comprehensive educational program on fire safety was presented, and an OR fire drill was conducted. • THIS ARTICLE describes the facility's quest to improve knowledge of fire safety by providing multiple educational opportunities. AORN J 79 (April 2004) 797–805.
Exposure to Concentrated Ambient Air Particles Alters Hematologic Indices in Humans

Descriptions of changes in hematological indices have contested the premise that the biological effects of suspended particulate matter (PM) are restricted to the lung. Employing approximately 40 hematologic parameters reflecting blood cells, chemistries, mediators, and coagulation factors, we tested the hypothesis that exposure to concentrated ambient air particles (CAPs) can be associated with changes in hematologic indices in normal humans. Twenty healthy young volunteers were exposed to either filtered air (n = 5) or CAPs (n = 15) with a mean PM mass of 120.5 ± 14.0 µg/m3 and a range from 15.0–357.6 µg/m3. Hematologic indices were measured. Changes in all parameters are expressed as the absolute value either immediately after or 24 h after exposure. Differences between responses of those individuals exposed to filtered air and CAPs were tested using the T-test of independent means. If significant differences between the two groups were suggested by the T-test (p < .10), the relationship was further ev...
Genetics on a WHIM

We initially described the WHIM syndrome based on the combination of Warts, Hypogammaglobulinaemia, Infections and Myelokathexis (neutrophil retention in the bone marrow). Translational research led to the discovery that this rare immunodeficiency disease is caused by a heterozygous mutation in the CXCR4 gene. Recently, Plerixafor has been suggested as a treatment for WHIM syndrome due to its efficacy as a CXCR4 antagonist, closing the translational research loop. In this review, we will focus on the clinical manifestations, pathophysiology, diagnosis and possible therapies for this rare entity.
Suicide and violence assessment in psychiatry

Psychiatrists are increasingly expected to predict and prevent the suicidal and violent/homicidal impulses of their clients. This article reviews the current literature and research in these areas. While the debate continues on whether the clinician can successfully predict either violence or suicidal behavior in their patients, the preponderance of studies weighs in that predicting suicide and violence in the individual may not be possible currently given present knowledge. To compensate for forecasting limitations, conservative clinicians deliberately overpredict suicide or violence to help insure the safety of their patients and the greater communities in which they reside. In addition, clinicians need to perform thorough assessments and make logical clinical decisions that are in line with the perceived risks. Preventive measures for violence remain complex, but clinicians can maximize treatment effects by following specific intervention guidelines. Minimally, documentation concerning violence needs to focus on the rationale for why treatment interventions were or were not implemented. The chart does not require lengthy notations but should include a reasonable assessment of risk and the delineation of a prudent course of action.
Comfort in a Decidedly Uncomfortable Time: Hunger, Collective Memory, and the Meaning of Soul Food in Gee's Bend, Alabama

Between 1979 and 1981, journalist Kathryn Tucker Windham conducted approximately 30 interviews of the residents of Gee's Bend—an African American community isolated in the “Black Belt” region of Alabama. The interviews provide a rare first-hand account of the lives of African Americans in Alabama between 1910 and 1981 as they discuss, among other things, food traditions. Remembered by nearly every interviewee is a catastrophic incident during which the family of a deceased white merchant, who had been lending Gee's Benders agricultural supplies, collected (with force) all of their agricultural property. Lacking any means to support themselves, residents were required to eat what they had hidden away, share their food with each other, and find comfort in the familiar foods that had become a part of the community's cuisine. The incident left a lasting community-wide association between food, ownership, and freedom, conveyed in the interviews through a collective narrative. The narrative reinforces the idea ...
Temperament and schooling: meaning of "goodness of fit"?

The fit between temperament and behavior demands in the classroom may influence cognitive and social performance.
Silicon defect and impurity studies using float-zone crystal growth as a tool

Abstract The float-zone (FZ) method for silicon crystal growth produces very high purities and low defect levels because no crucibles or other heated components are used, and the melt is only in contact with solid silicon. FZ growth is thus a useful tool for the study of defect and impurity effects on material properties such as minority charge carrier lifetime τ or photovoltaic efficiency η using controlled samples in which specific defects or impurities are deliberately introduced into the high-purity, low-defect baseline material, as desired. We have used this tool for defect studies on grain size, dislocations, silicon self interstitial clusters, and fast-cooling defects, as well as for impurity studies on H, N, Fe, p-type dopants, and interactions between Fe and Ga. Float zoning was conducted in vacuum or pure argon using induction heating at 2 MHz. The ASTM F28-91 photoconductive decay method was used to measure τ after growth. Arrays of isolated diagnostic solar cell devices were used to characterize defect and impurity effects on photovoltaic parameters.
Free kappa light chains in multiple sclerosis spinal fluid

Based on prior reports of free light chains of immunoglobulin G (IgG) in the cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS), we quantitated free kappa and lambda chains and whole IgG concentrations using sensitive and specific radioimmunoassays (RIAs). The RIA for free kappa chains had a sensitivity of 0.25 micrograms/ml and was capable of specifically measuring free kappa chains in whole CSF or serum even in the presence of a 4-log excess of whole IgG. By RIA, free kappa chains were detected in CSF samples from 33 (84%) of 39 MS patients but in only 1 (2.4%) of 42 controls. The control patients included 10 with noninfectious inflammatory diseases and 9 with central nervous system infections. The concentration of free kappa chains in the CSF of the MS patients was 1.40 +/- 1.21 micrograms/ml. Free kappa chains were concentrated in the CSF 71- to 120-fold relative to reference proteins. In contrast, increased levels of free lambda chains or of whole IgG were nonspecific; abnormalities were seen in controls with infections or inflammatory diseases as often as in MS patients. These studies suggest that the measurement of free kappa light chains may have important diagnostic usefulness, since the specificity of the finding for MS appears to be high.
Effect of fluphenazine on the stimulation of calcium-sensitive phospholipid-dependent protein kinase by 12-0-tetradecanoyl phorbol-13-acetate

Abstract The addition of the tumor-promoting phorbol ester 12-0-tetradecanoyl phorbol-13-acetate resulted in activation of calcium-sensitive phospholipid-dependent protein kinase which was dependent on the presence of phospholipid but was essentially independent of calcium. Fluphenazine, which is an effective inhibitor of the ability of this phorbol ester to stimulate proliferation in calcium-deprived non-neoplastic cells, inhibited the enzyme in the absence or presence of the phorbol ester (K i = 16 μ M). Fluphenazine inhibition was competitive with phospholipid but non-competitive with 12-0-tetradecanoyl phorbol-13-acetate.
Baryons and the QCD phase transition

Abstract Lattice simulations in full QCD have shown that the baryon susceptibility rises rapidly near the high temperature phase transition. This rise is a possible consequence of the restoration of chiral symmetry. Supporting evidence from numerical simulations with a Skyrme-like model is given. The results obtained further support the idea that the cooling of the quark plasma results in copious antibaryon production. They also provide a natural bridge between the high temperature and high density phase transitions.
Pneumomediastinum from nasal insufflation of cocaine

Chest pain is a common presenting symptom of cocaine users to the emergency department that requires a thorough work up. Pneumomediastinum is an uncommon complication of cocaine abuse that occurs more commonly when cocaine is smoked, but can also occur when cocaine is nasally insufflated. Our case report presents a patient with pneumomediastinum secondary to cocaine insufflation and reviews the necessary diagnostic tests that must be performed to rule out secondary pneumomediastinum, a severe life-threatening condition. Our case is unique, as it is one of a few reported cases of pneumomediastinum occurring after the use of intranasal cocaine.
Failure of Systemic Hypoxia to Blunt α‐Adrenergic Vasoconstriction in the Human Forearm

Systemic hypoxia in humans evokes forearm vasodilatation despite significant reflex increases in sympathetic vasoconstrictor nerve activity and noradrenaline spillover. We sought to determine whether post-junctional α-adrenergic vasoconstrictor responsiveness to endogenous noradrenaline release is blunted during systemic hypoxia. To do so, we conducted a two-part study in healthy young adults. In protocol 1, we measured forearm blood flow (FBF; venous occlusion plethysmography) and calculated the vascular conductance (FVC) responses to brachial artery infusions of two doses of tyramine (evokes endogenous noradrenaline release) in 10 adults during normoxia and mild systemic hypoxia (85 % O2 saturation; pulse oximetry of the earlobe). Systemic hypoxia evoked significant forearm vasodilatation as indicated by the increases in FBF and FVC (∼20–23 %; P < 0.05). The low and high doses of tyramine evoked significant reductions in FVC (vasoconstriction) that were similar in magnitude during normoxia (−29 ± 3 and −53 ± 4 %) and mild hypoxia (−35 ± 4 and −58 ± 3 %; P= 0.33). In protocol 2, forearm vasoconstrictor responses to the high dose of tyramine were determined in eight young adults during normoxia and during graded levels of systemic hypoxia (85, 80 and 75 % O2 saturation). The reductions in FVC were similar during normoxia (−59 ± 2 %) and the three levels of hypoxia (85 % O2 saturation, −64 ± 3 %; 80 % O2 saturation, −62 ± 1 %; 75 % O2 saturation, −61 ± 3 %; P= 0.37). In both protocols, the tyramine-induced increases in deep venous noradrenaline concentrations were similar during normoxia and all levels of hypoxia. Our results demonstrate that post-junctional α-adrenergic receptor vasoconstrictor responsiveness to endogenous noradrenaline release is not blunted during mild-to-moderate systemic hypoxia in healthy humans.
Platinum-catalyzed oxidations of organic compounds by ferric sulfate : use of a redox fuel cell to mediate complete oxidation of ethylene glycol by dioxygen at 80°C

A number of alcohols, aldehydes, and carboxylic acids were oxidized under mild conditions (60-80{degrees}C, 3 M H{sub 2}SO{sub 4} in water) by Fe(III) using a catalytic amount of Pt black to generate Fe(II) and protons. The extent of oxidation depended on the structures of the organic reductant and on reaction conditions. A redox fuel cell that catalyzed the complete oxidation of ethylene glycol by dioxygen at 80{degrees}C was assembled. Fe(II) generated by oxidation of ethylene glycol was reoxidized to Fe(III) at the anode of the cell. A V(V)/V(IV)/HNO{sub 3}/O{sub 2} redox system was used to catalyze the electrochemical reduction of dioxygen. Both the anode and cathode consisted of WDF graphite felt, the surface of which had been oxidized by boiling concentrated nitric acid for 15 min. A maximum power density of 9.9 mW/cm{sup 3} of graphite felt was obtained at a cell voltage of 197 mV. 19 refs., 3 figs., 1 tab.