cssi/SciSciGPT-SciSciNet huggingface dataset:
Propensity score‐matched comparison of oncological outcomes between laparoscopic and open distal pancreatic resection

BACKGROUND Selected studies have reported improved outcomes in laparoscopic compared with open distal pancreatic resection. Concerns regarding failure to achieve proper oncological resection and compromised long-term outcomes remain. This study investigated whether postoperative outcomes and long-term survival after laparoscopic distal pancreatectomy are comparable to those after an open procedure. METHODS This retrospective case-control study included patients who underwent distal pancreatectomy for resectable pancreatic adenocarcinoma between 2010 and 2013, identified from the National Cancer Database. Propensity score nearest-neighbour 1 : 1 matching was performed between patients undergoing laparoscopic or open distal pancreatectomy based on all relevant co-variables. The primary outcome was overall survival. RESULTS Of 1947 eligible patients, 605 (31·1 per cent) underwent laparoscopic distal pancreatectomy. After propensity score matching, two well balanced groups of 563 patients each were analysed. There was no difference in overall survival at 3 years after laparoscopic versus open distal pancreatectomy (41·6 versus 36·0 per cent; hazard ratio 0·93, 95 per cent c.i. 0·77 to 1·12; P = 0·457). The overall conversion rate was 27·3 per cent (165 of 605). Patients who underwent laparoscopic distal pancreatectomy had outcomes comparable to those of patients who had an open procedure with regard to median time to chemotherapy (50 versus 50 days; P = 0·342), median number of nodes examined (12 versus 12; P = 0·759); 30-day mortality (1·2 versus 0·9 per cent; P = 0·562); 90-day mortality (2·8 versus 3·7 per cent; P = 0·403), 30-day readmission rate (9·6 versus 9·2 per cent; P = 0·838) and positive margin rate (14·9 versus 18·5 per cent; P = 0·110). However, median duration of hospital stay was shorter in the laparoscopic group (6 versus 7 days; P < 0·001). CONCLUSION Laparoscopic distal pancreatectomy is an acceptable alternative to open distal pancreatectomy with no detriment to survival.
Formation of chromium-iron carbide by carbon diffusion in AlXCoCrFeNiCu high-entropy alloys

Effect of the addition of carbon on phase formations in AlxCoCrFeNiCu (x = 0.3, 1.5, 2.8) high-entropy alloys (HEAs) was studied. Free diffusion of carbon from graphite crucible resulted in the par...
The Concept of the Social in Uniting the Humanities and Social Sciences

This book is a masterful accomplishment that deserves a large attentive audience. Readers will find an engagement with practically every category of thought in the social sciences and humanities th...
Parental Indifference and Children’s Digital Piracy in South Korea: Mediation Effects of Low Self-Control and Misconception

Digital piracy is a global concern for society. Although adolescents’ digital piracy in South Korea is pervasive, its cause has rarely been examined. Using data collected by the Korean Institute of Criminology (KIC) in 2009, this study conducted structural equation modeling to determine if low self-control and social learning theory accounted for digital piracy. This study found that parental indifference increased adolescents’ digital piracy through low self-control and misconception about digital piracy. However, there were no direct effects of parental indifference on the digital piracy behaviors. In particular, the mediation effect in the model combining low self-control and misconception was greater compared to other models. Overall, the combination of low self-control and social learning theory provided a more meaningful framework to explain adolescents’ digital piracy. Results of this study can offer ways to aid in the examination and remediation of this particular form of deviant behaviors on the Internet by adolescents.
Vulnerability Explored and Explained Dynamically

In this chapter we describe system dynamics, reveal how it has been used to refine and extend theory, and discuss an application showing how a system dynamics simulation model contributed to the disaster policy and planning process. Simulation models offer representations of community systems and give emergency managers and other decision makers the opportunity to ask “what if” questions about their policies and the conditions that exist in their communities. System dynamics can be used to explore ideas, describe situations, and to test hypotheses and explain situations. Modeling system causes and describing how the system changes over time provide explanations and offer the potential of identifying leverage points or strategic places to intervene in the system (Senge, 2006, p. 64). System dynamics models have the potential to refine vulnerability theory and contribute in direct, practical ways to the mitigation, preparedness, response, and recovery efforts carried out by emergency managers and human service professionals.
Disasters and the Frail Elderly

Disasters are characterized as random natural occurrences and as acute events affecting societies and individuals in unpredictable ways. In all disasters, there are components that are managed by humans that help determine the ability and capacity of communities and individuals to absorb the impact from any disasters. Frail older adults are particularly sensitive to changes in the interplay of these resources. This chapter presents the concept of the frail older adult and discusses the unique risks that arise during catastrophic events. General guidelines that should underlie all decision-making for disaster planning are presented.
Langmuir-Blodgett Films in Microelectronics

The potential application of Langmuir-Blodgett-deposited films in microelectronics is discussed. The application areas which appear most promising are those requiring near perfect and uniformly thick films in the thickness range 2.5–50 nm. Three areas are discussed: the use of Langmuir-Blodgett films as electron resists in submicron device fabrication; the use of these films as insulators in metal-insulator-semiconductor (MIS) structures in which the semiconductor is a compound one; and the use of Langmuir-Blodgett films as tunneling barriers in Josephson junction electronic circuits. It is pointed out that, while preliminary evidence indicates high potential payoff for these films, the amount of data and research is very limited.
Laser Action in Organic Semiconductors

Recent research progress in the area of organic laser action is summarized in this chapter, and major challenges are discussed with focus on photo-pumped lasing. A general introduction to the field of stimulated emission and laser action in organics, and organic gain materials is presented, along with recent highlights of potential applications that redefine the scope of the field. We provide an overview of organic laser action with particular emphasis on the five types of laser action, namely, amplified spontaneous emission, lasing in microcavities, superradiance, superfluorescence, and the newly discovered random lasing. Specific examples and applications of the various laser action processes are given, and the transient stimulated emission in each case is analyzed. In addition, we also show how a systematic study of organic lasing can bring traditional science and nanoscience together, as a crucial foundation for further developments in organic nanophotonics.
Rates of Synthetic Cannabinoid Use in Adolescents Admitted to a Treatment Facility.

Objective Many forms of synthetic marijuana are available in the United States for recreational use. Although the composition of these synthetic forms is unclear, consumption has been on the rise among adolescents. The objective of this study is to understand the usage rates and identify the reasons and risk factors for synthetic cannabinoid use. Methods We recruited 637 adolescents (aged 13 to 17 years) admitted to the Children's Recovery Center, Norman, Oklahoma, from August 11, 2014, to March 30, 2016, for the study. Descriptive statistics and Pearson χ² test were used to analyze the data. Logistic regression and adjusted odds ratio (OR) were performed to determine the risk factors for synthetic marijuana use. Results The mean age of synthetic cannabinoid users was 16 years. Increased prevalence of synthetic marijuana use was observed in 16- to 17-year-old adolescent males, in the white population, and in individuals living in urban areas. Synthetic marijuana was preferred by subjects over the regular form, as it is less expensive, produces a better high, is undetectable on drug tests, and is perceived as legal. Male sex (OR = 2.63, P < .0001), aged 16 to 17 years (OR = 1.99, P < .0001), and residing in an urban locality (OR = 1.57, P = .05) were identified as risk factors for consuming synthetic marijuana. Adolescents who use synthetic marijuana are more at risk of having substance use disorder (OR = 11.87, P < .0001) than those who do not. Conclusions Synthetic marijuana use is increasing in the adolescent age group and could potentially have a negative impact on the health of teenagers. Hence, enforcing strict laws against synthetic marijuana use and promoting awareness programs targeting adolescents would be beneficial.​.
Sexual Violence of Liberian School Age Students: An Investigation of Perpetration, Gender, and Forms of Abuse.

This study examined the perpetration of sexual violence within the institutional setting of primary schools in Liberia using secondary analysis of data collected from 811 Liberian school aged parti...
Development of Wet Process Mimic Device

Drainage and the fiber bleed-through (FBT) are very important variables for the wet process. While there are several methods that can be used to evaluate the drainage retention characteristics of p...
Abstract WP501: Stroke Code Quality Metrics and Functional outcomes: Advanced Practice Providers versus Neurology Residents

Background: Advanced Practice Providers (APPs) are important members of stroke code teams. However, the impact of APP involvement on quality metrics and functional outcomes is unclear. We sought to...
Engineering stem cell cardiac patch with microvascular features representative of native myocardium.

The natural myocardium is a highly aligned tissue with an oriented vasculature. Its characteristic cellular as well as nanoscale extracellular matrix (ECM) organization along with an oriented vascular network ensures appropriate blood supply and functional performance. Although significant efforts have been made to develop anisotropic cardiac structure, currently neither an ideal biomaterial nor an effective vascularization strategy to engineer oriented and high-density capillary-like microvessels has been achieved for clinical cardiovascular therapies. A naturally derived oriented ECM nanofibrous scaffold mimics the physiological structure and components of tissue ECM and guides neovascular network formation. The objective of this study was to create an oriented and dense microvessel network with physiological myocardial microvascular features. Methods Highly aligned decellularized human dermal fibroblast sheets were used as ECM scaffold to regulate physiological alignment of microvascular networks by co-culturing human mesenchymal stem cells (hMSCs) and endothelial cells (ECs). The influence of topographical features on hMSC and EC interaction was investigated to understand underlying mechanisms of neovasculature formation. Results Results demonstrate that the ECM topography can be translated to ECs via CD166 tracks and significantly improved hMSC-EC crosstalk and vascular network formation. The aligned ECM nanofibers enhanced structure, length, and density of microvascular networks compared to randomly organized nanofibrous ECM. Moreover, hMSC-EC co-culture promoted secretion of pro-angiogenic growth factors and matrix remodeling via metalloprotease-2 (MMP-2) activation, which resulted in highly dense vascular network formation with intercapillary distance (20 μm) similar to the native myocardium. Conclusion HMSC-EC co-culture on the highly aligned ECM generates physiologically oriented and dense microvascular network, which holds great potential for cardiac tissue engineering.
Selective Nerve Cuff Stimulation Strategies for Prolonging Muscle Output

Neural stimulation systems are often limited by rapid muscle fatigue. Selective nerve cuff electrodes can target independent yet synergistic motor unit pools (MUPs), which can be used in duty-cycle reducing stimulation paradigms to prolong joint moment output. Objective: This study investigates waveform parameters within moment-prolonging paradigms and determines strategies for their optimal implementation. Methods: Composite flat-interface nerve cuff electrodes (C-FINEs) were chronically implanted on feline proximal sciatic nerves. Cyclic stimulation tests determined effects of stimulation period and duty cycle in different MUP types. Ideal parameters were then used in duty-cycle reducing carousel stimulation. Time to 50% reduction in moment (T50), moment overshoot, and moment ripple were determined for constant, open-loop carousel, and moment feedback-controlled closed-loop carousel stimulation. Results: A stimulation period of 1 s best maintained joint moment for all MUPs. Low (25%) duty cycles consistently improved joint moment maintenance, though allowable duty cycle varied among MUPs by gross muscle and fiber type. Both open- and closed-loop carousel stimulation significantly increased T50 over constant stimulation. Closed-loop carousel significantly decreased moment overshoot over the other conditions, and significantly decreased moment ripple compared with open-loop stimulation. Conclusion: Selectivity-enabled carousel stimulation prolongs joint moment over conventional constant stimulation. Appropriate waveform parameters can be quickly determined for individual MUPs and stimulation can be controlled for additional performance improvements with this paradigm. Significance: Providing prolonged, stable joint moment and muscle output to recipients of motor neuroprostheses will improve clinical outcomes, increase independence, and positively impact quality of life.
Effect of Particle Size on the Deep HDS Properties of Ni2P Catalysts

Nickel phosphide nanoparticles encapsulated in mesoporous silica (Ni2P@mSiO2) were used to probe particle size effects in the deep hydrodesulfurization (HDS) of 4,6-dimethyldibenzothiophene (4,6-DM...
Long-Term Outcomes of 125 Patients With Metastatic Pheochromocytoma or Paraganglioma Treated With 131-I MIBG

Context Prognosis of metastatic pheochromocytoma/paraganglioma following 131-Iodine metaiodobenzylguanidine (MIBG) is incompletely characterized due to small samples and shorter follow-up in these rare, often indolent tumors. Objective To describe long-term survival, frequency, and prognostic impact of imaging, biochemical, and symptomatic response to 131-I MIBG. Design Retrospective chart and imaging review at a tertiary referral center. Patients Six hundred sixty-eight person-years of follow-up in 125 patients with metastatic pheochromocytoma/paraganglioma with progression through prior multimodal treatment. Intervention Median 18 800 MBq 131-I MIBG. Main outcome measures Overall survival, Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST) imaging response, symptomatic response per chart review, and biochemical response (20% change over 2 consecutive assays of catecholamines, vanillylmandelic acid, metanephrines, or chromogranin A). Results Median survival standard deviation [SD] from diagnosis was 11.5 years [2.4]; following metastasis, 6.5 years [0.8]; post treatment, 4.3 years [0.7]. Among 88 participants with follow-up imaging, 1% experienced complete response, 33% partial response, 53% stability, and 13% progression. Fifty-one percent showed subsequent progression, median progression-free survival [SD] of 2.0 years [0.6]. Stability/response vs progression at first imaging follow-up (3-6 months) predicted improved survival, 6.3 vs 2.4 years (P = 0.021). Fifty-nine percent of 54 patients demonstrated biochemical response. Fifty percent of these relapsed, with median time to laboratory progression [SD] of 2.8 years [0.7]. Biochemical response did not predict extended survival. Seventy-five percent of 83 patients reported improvement in pretreatment symptoms, consisting primarily of pain (42%), fatigue (27%), and hypertension (14%). Sixty-one percent of these patients experienced subsequent symptomatic progression at median [SD] 1.8 years [0.4]. Symptomatic response did not predict extended survival. Conclusions Imaging, symptomatic, and laboratory response to multimodal treatment including high-dose 131-I MIBG were achieved on long-term follow-up in metastatic pheochromocytoma or paraganglioma. Imaging response at 3 to 6 months was prognostic.
Working with Families in Bilingual Mathematics: Supporting a Leadership Space for Latina Mothers

This paper analyzes the work developed with a group of Latina mothers in a mathematics afterschool program for a period of 3 ½ years. The analysis of the productive patterns of interaction of this group of mothers with a group of bilingual participants shows that the program’s participation and activity structure closely determines the quality of the mothers’ participation. We present a sequence of attempts developed to alter this structure in order to successfully capitalize on mothers’ leadership roles and knowledge during intergenerational and bilingual mathematical activity. We further discuss key social processesâ€”acknowledging mothers as facilitators, focusing on communication rather than on a specific language, and supporting mathematics performance through social interactionsâ€”that opened up a space for Latina mothers’ leadership and dynamic participation during bilingual mathematical activity.
Laparoscopic parastomal hernia repair delays recurrence relative to open repair

Mesh repair of parastomal hernia is widely accepted as superior to non-mesh repair, yet the most favorable surgical approach is a subject of continued debate. The aim of this study was to compare the clinical outcomes of open versus laparoscopic parastomal hernia repair. An IRB-approved retrospective review was conducted comparing laparoscopic (LPHR) or open (OPHR) parastomal hernia repair performed between 2009 and 2017 at our facilities. Patient demographics, preoperative characteristics, operative details, and clinical outcomes were compared by surgical approach. Subgroup analysis was performed by location of mesh placement. Repair longevity was measured using Kaplan–Meier method and Cox proportional hazards regression. Intention to treat analysis was used for this study based on initial approach to the repair. Sixty-two patients (average age of 61 years) underwent repair (31 LPHR, 31 OPHR). Patient age, gender, BMI, ASA Class, and comorbidity status were similar between OPHR and LPHR. Stoma relocation was more common in OPHR (32% vs 7%, p = .022). Open sublay subgroup was similar to LPHR in terms of wound class and relocation. Open “Other” and Sublay subgroups resulted in more wound complications compared to LPHR (70% and 48% vs 27%, p = .036). Operative duration and hospital length of stay were less with LPHR (p < .001). After adjustment for prior hernia repair, risk of recurrence was higher for OPHR (p = .022) and Open Sublay and Other subgroups compared to LPHR (p = .005 and p = .027, respectively). Laparoscopic repair of parastomal hernias is associated with shorter operative duration, decreased length of stay, fewer short-term wound complications, and increased longevity of repair compared to open repairs. Direct comparison of repair longevity between LPHR and OPHR with mesh using Kaplan–Meier estimate is unique to this study. Further study is warranted to better understand methods of parastomal hernia repair associated with fewer complications and increased durability.
Antenatal corticosteroids for pregnant women with COVID-19 infection and preterm prelabor rupture of membranes: a decision analysis.

Background: While antenatal corticosteroids are routinely used to decrease adverse neonatal outcomes following preterm delivery, corticosteroids are also associated with worse outcomes in patients with viral respiratory infections. Currently in the setting of the COVID-19 pandemic, it is unclear whether antenatal corticosteroids for infant benefit outweigh the potential harm to a pregnant woman with a COVID-19 infection.Objective: To determine at which gestational ages administering antenatal corticosteroids is the optimal management strategy for hospitalized women with preterm prelabor rupture of membranes (PPROM) who have a COVID-19 infection.Methods: We designed a decision-analytic model to assess the maternal and infant outcomes associated with antenatal corticosteroid administration for risk of preterm delivery following rupture of membranes in the setting of a COVID-19 infection. We used a theoretical cohort of 10,000 women at each gestational age between 24 and 32 weeks who were hospitalized with PPROM and found to be COVID-19 positive. Maternal outcomes included intensive care unit admission and death related to COVID-19 infection. The infant outcomes of interest included respiratory distress syndrome, intraventricular hemorrhage, neurodevelopmental delay, and death, and were assessed along with maternal and infant quality-adjusted life years (QALYs). Deterministic and probabilistic sensitivity analyses were used to evaluate model assumptions.Results: In our theoretical cohort of 10,000 women with COVID-19 infection and preterm prelabor rupture of membrane between 24 and 32 weeks, corticosteroid administration resulted in 2,200 women admitted to the ICU and 110 maternal deaths at each gestational age. No antenatal corticosteroid use resulted in 1,500 ICU admissions and 75 maternal deaths at each gestational age. Antenatal corticosteroid administration also resulted in fewer cases of respiratory distress syndrome, intraventricular hemorrhage, and infant death. Overall, we found that between 24 and 30 weeks of gestation, administering antenatal corticosteroids was the optimal management strategy as it resulted in higher combined QALYs than no corticosteroid use. For 31 and 32 weeks of gestation, antenatal corticosteroid administration resulted in lower combined QALYs. On sensitivity analyses, we found that with increasing gestational age, the probability which antenatal corticosteroids was the optimal management strategy decreased.Conclusion: Administration of antenatal corticosteroids was an effective management strategy compared to no corticosteroid administration at gestational ages less than 31 weeks. These results provide data for clinicians to utilize when counseling pregnant patients hospitalized with PPROM and have a COVID-19 infection.
High Bundled Payment Costs Following Total Hip and Knee Arthroplasty in African Americans.

Abstract Introduction Concerns exist that minorities who utilize more resources in an episode-of-care following total hip (THA) and knee arthroplasty (TKA) may face difficulties with access to quality arthroplasty care in bundled payment programs. The purpose of this study is to determine if African American patients undergoing TKA or THA have higher episode-of-care costs compared to Caucasian patients. Methods We queried Medicare claims data for a consecutive series of 7,310 primary TKA and THA patients at our institution from 2015 to 2018. We compared patient demographics, comorbidities, readmissions, and 90-day episode-of-care costs between African American and Caucasian patients. A multivariate regression analysis was performed to identify the independent effect of race on episode-of-care costs. Results Compared to Caucasians, African Americans were younger, but had higher rates of pulmonary disease and diabetes. African American patients had increased rates of discharge to a rehabilitation facility (20% vs. 13%, p Conclusion African American patients have increased episode-of-care costs following THA and TKA when compared to Caucasian patients, mainly due to increased rates of home health and rehabilitation utilization. Further study is needed to identify social variables that can help reduce post-acute care resources and prevent reduction in access to arthroplasty care in bundled payment models.
The Longer They Are, the More Citations They Receive: How Impact Factor Punishes Concise Scholarship

One does not need to be a highly cited legal scholar to conclude that — since impact factor is measured per article and longer articles are more likely to garner citations — impact factor incentivizes the publication of longer articles. And for anyone unable to make the connection, none other than the Washington & Lee Law Journal Rankings (W&LLJR) website explicitly spells this out. The second sentence of the impact factor methodology page explains, “Impact Factor rankings should be considered with caution, as they are biased against journals that publish a larger number of concise articles, such as book reviews.” The relationship between article length and impact factor — despite being significant and salient — receives no coverage in the literature on citation-count criticism. This Article first explains the significance of impact factor not only to law journal rankings but also to law school rankings. It then chronicles existing criticism of citation-count metrics. The Article provides a practical demonstration of the effects of article size on impact factor using two Stanford Law journals. Next the Article considers likely objections to calls to reform the impact factor. Finally, the Article concludes by calling for future research on the subject.
Development and initial validation of the diabetes family conflict scale (revised)‐short form in a racially and income diverse sample

Objective The purpose of the study was to develop a short form of the revised Diabetes Family Conflict Scale (DFCS) in a racially and income diverse sample while retaining strong psychometric properties. Methods 179 youth with type 1 diabetes (ages 12-18 years) and caregivers completed the DFCS-Revised as well as assessments of adherence, psychosocial functioning, and diabetes-related stress. Hemoglobin A1c was also obtained. The sample was split at random into a development sample and validation sample. Results Confirmatory factor analyses in the validation sample supported the use of a six-item diabetes family conflict scale short form (DFCS-SF) either as a total score (6-items) or a direct (3-item) and indirect (3-item) score. Variations of the DFCS-SF (three items of the 6-item short form) also had acceptable model fit. The short-form questionnaires had acceptable internal consistency and convergent validity (6-item: Cronbach's a = 0.865, full scale DFCS r = 0.954; 3-item: Cronbach's a = 0.757, full scale DFCS r = 0.912). The DFCS-SF showed measurement invariance across both youth and caregiver respondents. Greater report of the DFCS-SF by both youth and caregivers was significantly associated with higher HbA1c, more diabetes-related stress, and more psychosocial concerns. Conclusions The DFCSȁ0SF developed in the present study shows psychometric integrity in a diverse population of youth and can be utilized by providers to rapidly assess and potentially implement interventions to reduce diabetes family conflict, a psychosocial concern which is associated with elevated HbA1c, non-optimal adherence, diabetes-related stress, and psychological distress. This article is protected by copyright. All rights reserved.
Treatments that are perceived to be helpful for non-neuropathic pain after traumatic spinal cord injury: a multicenter cross-sectional survey.

Study design Cross-sectional survey. Objectives The objective of the study was to identify the treatments that people with traumatic spinal cord injury (SCI) used for their non-neuropathic pains (nonNeuPs) and how they subjectively rated the helpfulness of those treatments. Setting Six centers from the Spinal Cord Injury Model Systems. Methods Three hundred ninety one individuals who were at least 1-year post-traumatic SCI were enrolled. A telephone survey was conducted for pharmacologic and non-pharmacologic treatments utilized in the last 12 months for each participant's three worst pains and the perceived helpfulness of each treatment for each pain. Results One hundred ninety (49%) participants reported at least one nonNeuP (Spinal Cord Injury Pain Instrument score Conclusions Results of the study may help guide clinicians in selecting pain-specific treatments for nonNeuPs. The self-reported helpfulness of heat therapy, exercise, and massage suggests a possible direction for clinical trials investigating these treatments of nonNeuP while limiting the side effects accompanying pharmacologic treatments.
A Systematic Review of the Use of the Implicit Relational Assessment Procedure (IRAP) to Assess Implicit Biases Held by Professionals Toward Client Populations

Implicit biases held by professionals, functioning outside conscious awareness, can negatively affect client outcomes and professional well-being.Purpose:This systematic review evaluated evidence i...
A Cross-Sectional Analysis of American Insurance Coverage of Prominauris Otoplasty.

BACKGROUND Prominent ears affect up to 5% of the population and can lead to social and psychological concerns at a critical time of social development. It can be addressed with an otoplasty, which is often considered a cosmetic procedure. The authors assessed insurance coverage of all indications of otoplasty and their medical necessity criteria. METHODS A cross-sectional analysis was conducted of 58 insurance policies for otoplasty. The insurance companies were selected based on their state enrolment and market share. A web-based search and telephone interviews were utilized to identify the policies. Medically necessary criteria were then abstracted from the publicly available policies. RESULTS Of the 58 insurance policies assessed, 25 (43%) provide coverage of otoplasty. There were 2 indications for coverage: hearing loss (n = 20, 80%) and normal approximation (n = 14, 56%), which would encompass prominent ears. Normal approximation was a covered indication for significantly fewer insurers than hearing loss (56% versus 80%, P = 0.0013). Of all the otoplasty policies which covered normal approximation, 21% (n = 3) addressed protruding ears as an etiology. Prominent ears were not included in any policies which covered hearing loss. All policies inclusive of prominent ears required a protrusion of >20 mm from the temporal surface of the head (n = 3, 100%). CONCLUSIONS There is a great discrepancy in insurance coverage of otoplasty. A greater proportion of policies cover hearing loss compared to normal approximation. The authors encourage plastic surgeons to advocate for the necessity and coverage of normal approximation by insurers.
Surveillance for Metastatic Disease

Approximately half of patients with uveal melanoma will go on to develop metastatic disease at some point following diagnosis. Efficacy of systemic therapies (including immunotherapies) for widely metastatic uveal melanoma is poor. In contract, there appears to be some survival benefit when locally directed therapies, such as surgical metastasectomy or hepatic chemoembolization, are applied. However, these local therapies are generally only applicable when disease is regionally confined and less extensive. Thus, some have argued in favor of routine surveillance for metastatic disease, to maximize the likelihood of identifying disease earlier, when local therapies are feasible. However, prospective trials to establish optimized surveillance imaging schedules are lacking. When considering available evidence, most physicians choose a surveillance paradigm based primarily on the prognostic risk stratification of a specific patient’s disease, and taking into account environment-related factors such as cost, radiation dose, and local expertise. In this chapter, available data on surveillance for metastatic uveal melanoma, including the use of peripheral blood testing and imaging modalities such as chest X-ray, computed tomography, ultrasound, and magnetic resonance imaging, is explored. The goal is to provide insight into the available evidence and the need for larger prospective trials to fully elucidate optimal surveillance methods in uveal melanoma.
STM studies of single-walled carbon nanotubes

This topical review summarizes scanning tunneling microscopy investigations of the electronic properties of single-walled carbon nanotubes (SWNTs). First, the unique relationship between the atomic structure and electronic properties of SWNTs is reviewed. Second, the one-dimensional electronic band structure of SWNTs is introduced, and a comparison of tunneling spectroscopy to tight-binding calculations is presented. Third, localized structures in nanotubes, such as intramolecular junctions and ends, are addressed. Fourth, quantum size effects in SWNTs are discussed. Lastly, the effects of external perturbations, specifically magnetic impurities, on the low energy properties of metallic SWNTs are discussed. Prospects for future research directions are considered.
Human Tear Serotonin Levels Correlate with Symptoms and Signs of Dry Eye.

Purpose Serotonin, a neurotransmitter known to be involved in nociceptor sensitization, is present in human tears. The purpose of this study was to correlate tear serotonin levels, as a marker of nociceptor sensitization, to facets of dry eye (DE), including symptoms and signs. Design Cross-sectional study. Participants A total of 62 patients with normal eyelid and corneal anatomy were prospectively recruited from a Veterans Administration Ophthalmology Clinic over 11 months. Methods Dry eye symptoms (Ocular Surface Disease Index [OSDI]), signs (tear break-up time [TBUT], corneal staining, and Schirmer's score), and clinical descriptors of neuropathic ocular pain (NOP) (sensitivity to light or sensitivity to wind) were assessed. For tear analysis, each patient's tears were collected after instilling 50 μl of sterile saline to the lower cul-de-sac of each eye and using capillary action microcaps to collect the ocular wash. Tear serotonin levels were measured using enzyme-linked immunosorbent assay. Main Outcome Measures Correlations between tear serotonin concentrations and DE symptoms and signs. Results The mean age of the population was 61±14 years, and 84% (n = 52) of the patients were male. Serotonin concentrations negatively correlated with Schirmer's scores ( r = −0.28; P = 0.02) but did not correlate with other DE parameters, such as OSDI scores, sensitivity to light or wind, TBUT, and staining. According to our hypothesis, we divided patients into groups based on both DE symptoms and aqueous tear production; serotonin concentrations were significantly higher in DE group 1 (OSDI ≥6 and Schirmer's Conclusions Patients with DE symptoms and aqueous tear deficiency had higher tear serotonin levels compared with those with DE symptoms but normal tear production and those without DE symptoms.
Many-fold Moment Method

An extension of Yvon's method to two-dimensional transport theory is given. The detailed formalism in P1 approximation is presented. Some pilot calculations on two-dimensional critical sizes perfor...
Domain Shuffling Has Been the Main Mechanism Forming New Hominoid Killer Cell Ig-Like Receptors

The killer cell Ig-like receptor (KIR) gene family encodes MHC class I-specific receptors, which regulate NK cell responses and are also expressed on subpopulations of T cells. KIR haplotypes vary in gene content, which, in combination with allelic polymorphism, extensively diversifies the KIR genotype both within and between human populations. Species comparison indicates that formation of new KIR genes and loss of old ones are frequent events, so that few genes are conserved even between closely related species. In this regard, the hominoids define a time frame that is particularly informative for understanding the processes of KIR evolution and its potential impact on killer cell biology. KIR cDNA were characterized from PBMC of three gorillas, and genomic DNA were characterized for six additional individuals. Eleven gorilla KIR genes were defined. With attainment of these data, a set of 75 KIR sequences representing five hominoid species was assembled, which also included rhesus monkey, cattle, and rodent KIR. Searching this data set for recombination events, and phylogenetic analysis using Bayesian methods, demonstrated that new KIR were usually the result of recombination between loci in which complete protein domains were shuffled. Further phylogenetic analysis of the KIR sequences after removal of confounding recombined segments showed that only two KIR genes, KIR2DL4 and KIR2DL5, have been preserved throughout hominoid evolution, and one of them, KIR2DL4, is also common to rhesus monkey and hominoids. Other KIR genes represent recombinant forms present in a minority of species, often only one, as exemplified by 8 of the 11 gorilla KIR genes.
Physical and chemical transformations of highly compressed carbon dioxide at bond energies.

Carbon dioxide exhibits a richness of high-pressure polymorphs with a great diversity in intermolecular interaction, chemical bonding, and crystal structures. It ranges from typical molecular solids to fully extended covalent solids with crystal structures similar to those of SiO2. These extended solids of carbon dioxide are fundamentally new materials exhibiting interesting optical nonlinearity, low compressibility and high energy density. Furthermore, the large disparity in chemical bonding between the extended network and molecular structures results in a broad metastability domain for these phases to room temperature and almost to ambient pressure and thereby offers enhanced opportunities for novel materials developments. Broadly speaking, these molecular-to-non-molecular transitions occur due to electron delocalization manifested as a rapid increase in electron kinetic energy at high density. The detailed mechanisms, however, are more complex with phase metastabilities, path-dependent phases and phase boundaries, and large lattice strains and structural distortions – all of which are controlled by well beyond thermodynamic constraints to chemical kinetics associated with the governing phases and transitions. As a result, the equilibrium phase boundary is difficult to locate precisely (experimentally or theoretically) and is often obscured by the presence of metastable phases (ordered or disordered). This paper will review the pressure-induced transformations observed in highly compressed carbon dioxide and present chemistry perspectives on those molecular-to-non-molecular transformations that can be applied to other low-Z molecular solids at Mbar pressures where the compression energy rivals the chemical bond energies.
Anaphylactic shock induced by intraurethral use of chlorhexidine.

Chlorhexidine, a widely used antiseptic, may cause life-threatening anaphylactic shock, even when introduced intraurethrally.
Changes in corneal topography after excimer laser photorefractive keratectomy for myopia

Abstract Computer-assisted analysis of corneal topography was performed in 17 normally sighted human eyes during the first year after excimer laser photorefractive keratectomy (PRK) for myopia. Laser ablation of the central cornea produced an optical zone with a smooth power transition to the peripheral cornea. Decentration of the ablation was noted in some eyes (
EBV-associated, extranodal NK-cell lymphoma, nasal type of the breast, after heart transplantation.

Post-transplantation lymphoproliferative disorders (PTLDs) are predominantly Epstein–Barr virus (EBV)-associated B-cell lymphoproliferations. PTLDs of T-cell lineage are rare, mostly reported after renal transplantation and show less frequent association with EBV. NK-cell lymphomas after transplantation (NK-cell PTLDs) are very rare; only five cases are reported so far in the English literature, all developed after renal transplantation. We describe a case of EBV-associated, extranodal NK-cell lymphoma of nasal type, involving the breast in a cardiac allograft recipient 5 years after transplantation. The neoplastic cells are positive for CD2, cytoplasmic CD3, CD7, CD43, CD56, TIA-1 and p53; and negative for surface CD3 and CD57. Analysis of T-cell receptor beta and gamma genes fails to show clonal rearrangement. EBV studies show clonal episomal integration of EBV and latency II pattern (EBER-1+, LMP-1+, EBNA-1+, EBNA-2-). In conclusion, NK-cell PTLDs are rare complications that arise relatively late after solid organ transplantation, show strong association with EBV, and can follow an aggressive clinical course. To the best of our knowledge, we present the first reported case of NK-cell PTLD after cardiac transplantation and the unifying clinical and diagnostic features of NK-cell PTLDs occurring after solid organ transplantation.
Neurolinguistic characteristics of language production in Huntington's disease: A preliminary report

Samples of spontaneous and descriptive speech were obtained from 12 patients with Huntington's disease (HD) and 24 at risk (AR) controls. The data were assessed according to a neurolinguistic protocol. HD was identified with a significant reduction in number of words produced, a diminished level of syntactic complexity, reductions of melodic line, phrase length, articulatory agility, and grammatical form, and increases in paraphasic errors and word-finding difficulty. The data were interpreted in support of the hypothesis that neostriatal pathology affects linguistic processing.
Bilateral eye formation in the eyeless mutant Mexican salamander following unilateral, partial excision of neural fold tissues: A quantitative study

Previous results showed that ectopic neural fold grafts, performed unilaterally during neurulation on eyeless mutant axolotl embryos, frequently stimulated eye formation bilaterally. The analysis of the eyeless mutant was expanded in order to obtain quantitative data on the effect of various types of neural fold grafts. While performing these experiments, significant eye formation occurred in controls. Larvae in which neural fold tissues were not grafted but only partially removed at neurula stages formed eyes in some experiments, but not in others. In those cases that eyes did form, partial removal of the posterior neural fold of the prospective ear region stimulated eyes to differentiate more frequently than partial removal of the anterior neural fold of the prospective nose area. In both cases, unilateral neural fold ectomy frequently resulted in bilateral eye formation. There was a positive correlation between the amount of posterior neural fold tissues excised and the frequency of cases in which eyes formed. This increase was roughly 10% if the posterior neural fold excision was performed bilaterally instead of unilaterally. A comparison of eye formation between neural fold excision experiments and ectopic neural fold grafts was performed. There was a statistically significant different between anterior and posterior neural fold operations, but not between grafting and excision experiments. I interpret these results to suggest that there is a signal in the posterior neural fold of the eyeless mutant that prevents eye formation. This signal can be neutralized most efficiently by wounding of the posterior neural folds. In addition, the results provide strong evidence that the effect of wounding propagates from posterior to anterior regions, as well as from one side of the developing neuroepithelium to the other. © 1993 Wiley-Liss, Inc.
Embodying Deep Throat: Mark Felt and the Collective Memory of Watergate

On May 31, 2005, a long-running journalistic secret came to an end when Vanity Fair revealed Deep Throat, Bob Woodward and Carl Bernstein's famous Watergate unnamed source, to be W. Mark Felt, the associate director of the FBI under President Nixon. While the announcement bought to a close 30 years of speculation and accusations concerning Deep Throat's identity, it created new complications in promoting Watergate as a marker of journalistic success. With stroke-afflicted Felt unable to speak on his own behalf, other speakers came forward to question Felt's character and his motives for surreptitiously working with journalists. In struggling to interpret the past, journalists and critics competed publicly to define acceptable news practices in the present. This paper uses the conceptual framework offered by collective memory to examine public discourse around Felt's revelation to demonstrate how discussions of Deep Throat expanded into a larger competition to define what the correct role of journalism sho...
A yeast protein with homology to the β-subunit of G proteins is involved in control of heme-regulated and catabolite-repressed genes

Abstract The product of the Saccharomyces cerevisiae AER2 gene is responsible for maintaining repression of at least two distinct regulatory pathways: heme activation/repression and catabolite repression. Mutations in the gene caused an eightfold increase in the expression of the heme-activated CYC1 gene in the absence of heme, a substantial increase in the expression oftheheme-repressed ANB1 gene in the presence of heme, and a 13-fold increase in the expression of the catabolite-repressed GAL1 gene in the presence of glucose. Lesser or no increases in the expression of these genes were observed under derepressed or activation conditions. The aer2 mutations also caused a large increase in CYC7 gene expression under all conditions; this gene is subject to heme activation/repression, as well as catabolite repression. The AER2 gene was cloned and the sequence determined. The large open reading frame contiguous with the transcript from the complementing region encoded a 713-amino acid polypeptide chain with extensive homology to the β-subunit of G proteins. The sequence revealed that AER2 is the TUP1 gene. A deletion mutation was constructed and the null phenotype was the same as the original mutants. The aer2 null mutant was shown to have increased aerobic and anaerobic levels ofRNA encoding the ROX1 repressor, normally expressed only aerobically and responsible for the aerobic repression of ANB1 expression. The increase in both ROX1 and ANB1 RNAs aerobically in this mutant suggests that the repressor is nonfunctional in the mutant.