cssi/SciSciGPT-SciSciNet huggingface dataset:
Can Electronic Health Records Make Quality Measurement Fast and Easy

Electronic health records (EHRs) present key opportunities to improve the efficiency of quality reporting. An underappreciated aspect of quality measurement is the amount of effort that goes into acquiring and reporting quality data. From chart abstraction to formatting the data so it can be shared with payers, accreditation agencies, and clinical staff, health systems spend a tremendous amount of funds on tracking and reporting of metrics. Electronic quality measures (eQMs) have the potential to automate much of this data collection and reporting process. By freeing staff who have extensive familiarity with the metrics from time-consuming chart abstraction, these quality experts can partner with clinical staff to improve patient care. See Article by Bravata et al In this issue of Circulation: Cardiovascular Quality and Outcomes , Bravata et al1 developed and evaluated a series eQMs abstracted electronically from the medical record for patients with minor stroke and transient ischemic attack (TIA). The authors developed 31 eQMs encompassing 15 domains of care for patients with minor stroke and TIA that are aligned with national guidelines,2 clinical performance measures,3 and joint commission metrics.4 They then evaluated the agreement between these eQMs and the same measures abstracted manually in a random sample of 763 patients from 50 Veterans Health Administration hospitals. The authors found that for 16 of the 31 measures, electronic abstraction compared favorably with manual abstraction both for eligibility …
The Prevalence and Characteristics of E-Cigarette Users in the U.S

Studies have examined the characteristics of individuals who use e-cigarettes, including sociodemographic and smoking characteristics, and the relationship of e-cigarette use to tobacco control policies. While most studies consider a subset of these characteristics with weak measures of regular e-cigarette use, this study uses a large, recent U.S. survey to simultaneously consider the association of each of these factors with different use measures. Data from the May 2014 Tobacco Use Supplement-Current Population Survey is supplemented with information on tobacco control policies. The prevalence of ever, current (at least 1 of the last 30 days), and regular (at least 20 of the last 30 days) e-cigarette use were 7.7%, 2.1% and 0.9%, implying that 27.0% of ever users were current users of which 45.3% were regular users. E-cigarette use varied by socio-demographic characteristics and by smoking status, and depended on the measure of use adopted. However, regardless of measures, e-cigarette use was higher among those smokers who smoked more cigarettes. The association with policies was generally weak, but we found more regular use by smokers in low tax and low tobacco control spending states. The results indicate that the user characteristics differ depending on the e-cigarette use measure. The measure of use should be carefully considered in analyzing how e-cigarette use affects cigarette use.
Anesthetic Management for ECT

Depression in the elderly is a growing public health problem. Depression affects more than 6.5 million of the 35 million Americans aged 65 years or older. Depression in the older person can have significant impact including loss of function, social isolation, and even death; 20 % of all suicides occur in individuals over the age of 65 years. Older patients with primary depression have frequently experienced episodes of the illness during much of their lives. However, late-life depressive syndromes also arise secondary to medical and neurological disorders common to elderly patients. Unfortunately depression in elderly people can go undiagnosed and untreated because it is thought to be a normal part of aging or an “accepted” sign of chronic illness.
The Marginalisation of the High Court Under Indirect Rule, 1920–1944

This chapter examines the High Court between 1920 and World War II, arguing that as the system of indirect rule became more deeply entrenched in Tanganyika, colonial judges and professional magistrates were increasingly marginalised in the sphere of colonial justice by the administration. The Native Courts Ordinance of 1929 removed the Native Courts from the jurisdiction of the High Court and allowed the administration to prevent Africans from accessing it. This reduced the authority of judicial officials while enhancing the judicial powers of administrative officers. Though severely limited in their role in the administration of justice after 1929, colonial judges were nonetheless essential because they served both symbolic and practical functions, which facilitated the development of the territory and British rule.
Cardiovascular effects of intravenous anesthetic agents

The most commonly used anesthetic agents of this kind are the barbiturates. The duration of action of these agents is tied to their fat solubility. Since the thiobarbiturates are more fat soluble (classified as ultra-short acting), they provide a surgical plane of anesthesia for less time than the short acting agents such as pentobarbital sodium. Most of these drugs are, however, metabolized at about the same rate. If the ultra-short acting barbiturates are used and additional drug is given to achieve a longer duration of anesthesia, the pool of unmetabolized drugs is expanded and the recovery period can be very prolonged.
Minimum Hop vs. Minimum Edge Based Multicast Routing for Mobile Ad hoc Networks

The high-level contribution of this paper is to establish benchmarks for the minimum hop count per source-receiver path and the minimum number of edges per tree for multicast routing in mobile ad hoc networks (MANETs) and explore the tradeoffs between these two routing strategies with respect to hop count, number of edges and lifetime per multicast tree. Accordingly, we consider two categories of algorithms – Breadth First Search (for minimum hop trees) and minimum Steiner tree heuristic (for minimum edge trees). Extensive simulations of these two algorithms on centralized snapshots of the MANET topology, sampled for every 0.25 seconds, have been conducted for 1000 seconds under two different conditions of network density and three different multicast group sizes. Simulation results illustrate that minimum edge trees have 20-160% larger lifetime than the minimum hop trees. The tradeoff is that the minimum edge trees have 20-100% larger hop count per source-receiver path compared to the minimum hop trees. Similarly, the minimum hop trees have 13-35% more edges than the minimum edge trees.
Acing an Audit

The research study team may be notified about an impending audit by telephone or in writing. In turn, the research site should notify all involved parties, including the sponsor, CRO, and IRB. Sponsor audits are done to be certain that the site is collecting accurate information which may be crucial for FDA approval. IRB audits instead focus on subject safety, welfare, privacy, and confidentiality. An FDA audit can occur randomly or be triggered if the site is a top enrolling site, if the site is recommended to the FDA by the sponsor or CRO, if the site has had prior quality issues, or if there are public health issues concerning that research. An FDA audit, also called an inspection, follows very specific protocols of which the site should be informed. An audit is a time to hone the clinical research skills and appreciate the clarity that an audit can bring.
Assessing the localization accuracy and clinical utility of electric and magnetic source imaging in children with epilepsy.

Abstract Objective To evaluate the accuracy and clinical utility of conventional 21-channel EEG (conv-EEG), 72-channel high-density EEG (HD-EEG) and 306-channel MEG in localizing interictal epileptiform discharges (IEDs). Methods Twenty-four children who underwent epilepsy surgery were studied. IEDs on conv-EEG, HD-EEG, MEG and intracranial EEG (iEEG) were localized using equivalent current dipoles and dynamical statistical parametric mapping (dSPM). We compared the localization error (ELoc) with respect to the ground-truth Irritative Zone (IZ), defined by iEEG sources, between non-invasive modalities and the distance from resection (Dres) between good- (Engel 1) and poor-outcomes. For each patient, we estimated the resection percentage of IED sources and tested whether it predicted outcome. Results MEG presented lower ELoc than HD-EEG and conv-EEG. For all modalities, Dres was shorter in good-outcome than poor-outcome patients, but only the resection percentage of the ground-truth IZ and MEG-IZ predicted surgical outcome. Conclusions MEG localizes the IZ more accurately than conv-EEG and HD-EEG. MSI may help the presurgical evaluation in terms of patient’s outcome prediction. The promising clinical value of ESI for both conv-EEG and HD-EEG prompts the use of higher-density EEG-systems to possibly achieve MEG performance. Significance Localizing the IZ non-invasively with MSI/ESI facilitates presurgical evaluation and surgical prognosis assessment.
Level III Evidence: A Case-Control Study

Case-control studies are used to retrospectively determine the role of an exposure in the etiology of an outcome or condition of interest that is rare or takes a long time to develop. Because of the retrospective nature, case-control studies can be completed relatively quickly and at a smaller cost than a prospective observational study. However, the retrospective nature may introduce multiple types of bias into the data set, and results must be considered in light of the limitations of the retrospective study. This chapter outlines approaches to selecting cases and controls, designing studies to minimize bias, and basic approaches to statistical analysis.
Implementations of a text-message intervention to increase linkage from the emergency department to outpatient treatment for substance use disorders.

Abstract Aim To determine acceptability and explore potential usefulness of a text messaging (SMS) program aimed at increasing attendance at outpatient treatment for substance use disorders (SUD) after emergency department (ED) referral. Method A retrospective analysis of 377 adult patients from 2 urban EDs seeking treatment for SUD (opioids (n = 168), alcohol (n = 188), benzodiazepines (n = 21)) referred to outpatient treatment and offered an SMS program which included daily (1) motivational messages focused on positive thinking, (2) ecological momentary assessments (EMA) related to craving with tailored behavioral strategy messages, (3) EMA of drug use with tailored feedback to reduce abstinence violation effects, and (4) reminders about treatment location and phone number. We assessed acceptability by examining opt-in rates, EMA completion rates over the first week and end-of-program qualitative feedback. We assessed how individuals who opt in differ in outcomes from those who opt out by examining rates of outpatient SUD treatment attendance recorded from the medical record. Results 167 patients (44%) opted in to the SMS program. Over 7 days, around 33% of EMA were completed. Median helpfulness score was 8 (IQR 6 to 10) out of 10 and 84% would recommend the SMS program to someone else. Individuals who opted in to the SMS program had higher rates of SUD treatment initiation than individuals who did not opt-in (70.7% vs. 40.9%). Conclusions We found evidence supporting acceptability and potential usefulness of an automated text message program to assist treatment attendance for some individuals with SUDs discharged from the ED. A controlled trial is needed to examine whether SMS program exposure is associated with improved treatment attendance compared to standard care.
Building a Better Innovation System: Combining Facially Neutral Patent Standards With Regulation of End Product Therapeutics

The current logjam over legislative reform might lead to the pessimistic conclusion that patent reform efforts are likely to be either: 1) ineffectual (the current situation); 2) zero sum (one set of industry interests is able to garner more votes than its opponent and override the legitimate interests of the other); or 3) founded in disparate treatment of different industries (a departure from the much-heralded "unitary" nature of the patent system). This Essay argues that such a conclusion would be premature. One important counter to the pessimistic view is the example of the Supreme Court's recent judicial reform. Although the biopharmaceutical industry has been quite opposed to this judicial reform, the available evidence thus far suggests that the Court's decisions will have only a limited impact on the legitimate interests of the industry. Specifically, although the Court's decisions adopt a facially neutral approach, this approach is likely to have a disparate impact that leaves relatively untouched the patent law that surrounds end product therapeutics. Two other counters to the pessimistic view bear emphasis. First, to the extent that the outlier set of inventions appears to be biopharmaceutical end products, these end products are embedded in a web of non-patent-based regulatory and market structures that do much of the heavy lifting in terms of setting up barriers to entry and influencing price. These non-patent structures are narrowly tailored to the peculiar economic questions raised by end product therapeutics. Second, in those situations where neither existing patent law standards nor existing regulation specific to end product therapeutics is sufficiently sensitive to relevant considerations of economic policy, additional facially neutral standards (and tweaks to FDA and health insurance regulation) could be implemented.
Versatile biomimetic medical device surface: hydrophobin coated, nitric oxide-releasing polymer for antimicrobial and hemocompatible applications

In medical device design, there is a vital need for a coating that promotes treatment of the patient and simultaneously prevents fouling by biomacromolecules which in turn can progress to infections, thrombosis, and other device-related complications. In this work, hydrophobin SC3 (SC3), a self-assembling amphiphilic protein, was coated on a nitric oxide (NO) releasing medical grade polymer to provide an antifouling layer to work synergistically with NO's bactericidal and antiplatelet activity (SC3-NO). The contact angle of SC3 samples were ∼30% lesser than uncoated control samples and was maintained for a month in physiological conditions, demonstrating a stable, hydrophilic coating. NO release characteristics were not adversely affected by the SC3 coating and samples with SC3 coating maintained NO release. Fibrinogen adsorption was reduced over tenfold on SC3 coated samples when compared to non-SC3 coated samples. The viable cell count of adhered bacteria (Staphylococcus aureus) on SC3-NO was 79.097 ± 7.529% lesser than control samples and 49.533 ± 18.18% lesser than NO samples. Platelet adherence on SC3-NO was reduced by 73.407 ± 14.59% when compared to control samples and 53.202 ± 25.67 when compared to NO samples. Finally, the cytocompatibility of SC3-NO was tested and proved to be safe and not trigger a cytotoxic response. The overall favorable results from the physical, chemical and biological characterization analyses demonstrate the novelty and importance of a naturally-produced antifouling layer coated on a bactericidal and antiplatelet polymer, and thus will prove to be advantageous in a multitude of medical device applications.
Mechanical and Corrosion Properties of Additively Manufactured CoCrFeMnNi High Entropy Alloy

Abstract This study investigates the mechanical and corrosion properties of as-built and annealed equiatomic CoCrFeMnNi alloy produced by laser-based directed energy deposition (DED) Additive Manufacturing (AM). The high cooling rates of DED produced a single-phase, cellular microstructure with cells on the order of 4 μm in diameter and inter-cellular regions that were enriched in Mn and Ni. Annealing created a chemically homogeneous recrystallized microstructure with a high density of annealing twins. The average yield strength of the as-built condition was 424 MPa and exceeded the annealed condition (232 MPa), however; the strain hardening rate was lower for the as-built material stemming from higher dislocation density associated with DED parts and the fine cell size. In general, the yield strength, ultimate tensile strength, and elongation-to-failure for the as-built material exceeded values from previous studies that explored other AM techniques to produce the CoCrFeMnNi alloy. Ductile fracture occurred for all specimens with dimple initiation associated with nanoscale oxide inclusions. The breakdown potential (onset of pitting corrosion) was similar for the as-built and annealed conditions at 0.40 VAg/AgCl when immersed in 0.6 M NaCl. Pit morphology/propagation for the as-built condition exhibited preferential corrosion of inter-cellular Ni/Mn regions leading to a tortuous pit bottom and cover, while the annealed conditions pits resembled lacy pits similar to 304 L steel. A passive oxide film depleted in Cr cations with substantial incorporation of Mn cations is proposed as the primary mechanism for local corrosion susceptibility of the CoCrFeMnNi alloy.
Cost-Related Medication Nonadherence in Adults With Atherosclerotic Cardiovascular Disease in the United States, 2013 to 2017.

Background: Medication nonadherence is associated with worse outcomes in patients with atherosclerotic cardiovascular disease (ASCVD), a group who requires long-term therapy for secondary preventio...
Prosthetic valve endocarditis from Mycobacterium chimaera infection causing granulomatous interstitial nephritis

Mycobacterium chimaera is a rare infection associated with cardiopulmonary bypass. We describe a case of granulomatous interstitial nephritis caused by M. chimaera in a patient with prosthetic aortic valve endocarditis. A 63-year-old female with a mechanical aortic valve replacement developed fatigue, 20 lbs. weight loss, anemia, and an elevated creatinine. Fat pad aspirate at an outside hospital was suspicious for amyloidosis which prompted hematology referral at our institution. Bone marrow biopsy revealed a single granuloma, negative for amyloid or acid fast bacillus (AFB). She was admitted to our hospital for worsening kidney function refractory to intravenous fluid challenge. Transesophageal echocardiogram showed aortic root abscess and valve vegetation with negative blood cultures at seven days. Renal biopsy showed granulomatous interstitial nephritis and negative AFB stain. Prednisone 40 mg was started and renal function partially improved. Blood cultures obtained before biopsy subsequently grew M. chimaera. Three-drug antimicrobial therapy was initiated and prednisone discontinued. One month later, creatinine improved and follow up echocardiogram showed no lesion. Our case highlights this rare infection inducing granulomatous interstitial nephritis despite lack of positive AFB or gram stains on renal biopsy.
Anatomic resolution of neurotransmitter-specific projections to the VTA reveals diversity of GABAergic inputs

The ventral tegmental area (VTA) is important for reward processing and motivation. The anatomic organization of neurotransmitter-specific inputs to the VTA remains poorly resolved. In the present study, we mapped the major neurotransmitter projections to the VTA through cell-type-specific retrograde and anterograde tracing. We found that glutamatergic inputs arose from a variety of sources and displayed some connectivity biases toward specific VTA cell types. The sources of GABAergic projections were more widespread, displayed a high degree of differential innervation of subregions in the VTA and were largely biased toward synaptic contact with local GABA neurons. Inactivation of GABA release from the two major sources, locally derived versus distally derived, revealed distinct roles for these projections in behavioral regulation. Optogenetic manipulation of individual distal GABAergic inputs also revealed differential behavioral effects. These results demonstrate that GABAergic projections to the VTA are a major contributor to the regulation and diversification of the structure. Soden et al. use cell-type-specific retrograde tracing to identify neurotransmitter-specific inputs to the ventral tegmental area, uncovering an underappreciated number of GABAergic inputs with diverse innervation patterns and behavioral functions.
Association of four-factor prothrombin complex concentrate with subsequent plasma transfusion: A retrospective cohort study

OBJECTIVE To assess whether patients prescribed four-factor prothrombin complex concentrate (4FPC) received less plasma during the following 24-hour period than those treated for the same indications who received only plasma. INTRODUCTION It is unclear whether 4FPC is associated with a reduction in subsequent plasma transfusion. This is important for minimising transfusion-associated risks and for inventory management. MATERIALS AND METHODS We retrospectively studied patients treated for bleeding or coagulopathy. Individuals receiving 4FPC were matched by indication to patients treated with only plasma. Blood products received during 24-hour follow up were compared between 4FPC and plasma-only patients. RESULTS There was no difference in the number of patients receiving additional plasma (19 (21%) 4FPC patients vs 31 (34%) plasma-only patients, P = .07) nor in the median number of additional plasma units received (0 units for both groups, interquartile range [0, 0] for 4FPC patients vs [0, 1] for plasma-only patients, P = .09). Subgroup analysis comparing patients who received 4FPC for on-label vs off-label indications found no difference in the number of patients receiving plasma nor in the median number of plasma units received. CONCLUSION 4FPC was prescribed to a diverse set of patients, and administration was not associated with reduced plasma transfusion at our institution.
Antimicrobial use data collection in animal agriculture

Antimicrobial drug use can contribute to the emergence of antimicrobial drug-resistant organisms; therefore, judicious use of this important category of drugs is critical in both human and animal medicine to slow the development and spread of resistance. The US Food and Drug Administration (FDA) Center for Veterinary Medicine (CVM) is committed to advancing efforts to implement good antimicrobial stewardship practices in veterinary settings as part of our mission to protect human and animal health. In order to understand the drivers of resistance in veterinary settings and assess the impact of interventions designed to slow the development and spread of resistance, it is vital to have access to scientifically sound data on antimicrobial use and resistance. In 2016, FDA awarded funds in the form of cooperative agreements to support pilot projects for the collection of farm-level antimicrobial use data in animal agriculture. These funded data collection efforts are intended to provide needed information on antimicrobial use practices in various animal production settings and to inform the development of long-term strategies for collecting and reporting such data in a sustainable and nationally representative manner. Data were collected from records of participating dairy and feedlot cattle operations, swine companies, and broiler and turkey companies. Information from the first 2 years of the pilot projects is presented in this special issue, along with discussions related to challenges of collecting and reporting antimicrobial use data.
No Free Lunch? Welfare Analysis of Firms Selling Through Expert Intermediaries

We study how firms target and influence expert intermediaries. In our empirical context, pharmaceutical manufacturers provide payments to physicians during promo- tional interactions. We develop an identification strategy based on plausibly exogenous variation in payments driven by differential exposure to spillovers from academic med- ical centers’ conflict-of-interest policies. Using a detailed case study of an important class of cardiovascular drugs, we estimate heterogeneous effects of payments on pre- scribing, with firms targeting highly responsive physicians. Our model of supply and demand allows us to quantify how oligopoly prices reduce drug prescribing, and how payments move prescribing closer to the optimal level, but at great financial cost to patients and payers. In our estimated model, consumers are worse off with payments, unless there is substantial underprescribing due to behavioral or other frictions. In a final exercise, we calibrate such frictions using clinical data. We estimate that, in this case study, payments benefit consumers.
Pheromonal enrichment in the zoo: An empirical approach with Asian elephants (Elephas maximus)

Abstract The use of odors is a popular form of sensory enrichment, yet few studies have investigated the longer lasting effects of biologically relevant chemical signals like pheromones. Asian elephants (Elephas maximus) are unique because they are commonly held in zoos and utilize two single-compounds to synchronize reproduction: frontalin (a pheromone produced by male elephants in musth) and (Z)-7-dodecenyl acetate (Z7-12:Ac, a pheromone produced by female elephants around ovulation). While Asian elephant chemical signaling dynamics have been well-studied, no reports exist on the broader behavioral effects (i.e., primer effects) of either of these pheromones. The purpose of this study was to describe the primer effects of both frontalin and Z7-12:Ac for potential enrichment applications. We bioassayed 50 elephants at 10 zoos using synthetic versions of these two pheromones that replicated the concentrations at which they are produced naturally. We found that behavioral diversity in response to these pheromones was influenced both by the degree of exposure to the chemicals and by properties of the receiver, such as sex, sexual experience, age, and social access, with models that included all or most of these factors explaining much of the variation in the bioassay data for frontalin (R2(c) = 0.42) and Z7-12:Ac (R2(c) = 0.59). Furthermore, both males and females exhibited distinct changes in activity levels in the presence of frontalin or Z7-12:Ac, with specific behavioral differences noted. For instance, frontalin stimulated increased activity (and decreased inactivity) among female elephants (P
Impact of the Ready to Learn and Play Framework on Occupational Performance for Students with Autism in the School Setting: A Pilot Study

Individuals with autism spectrum disorder (ASD) often have sensory processing difficulties, which impact their participation in daily occupations. This pilot study investigated a newly developed Re...
Moving Patients Out of Hospitals—In Whose Interest?

No one would argue that state mental hospitals in the United States have fulfilled any kind of promise of providing a therapeutic atmosphere for the mentally ill. Or is it their purpose to provide a therapeutic atmosphere? Does furnishing a custodial milieu provide sufficient benefits for some patients who would be worse off without the hospital so that their commitment seems justifiable? Until recently no one could be found to say a good word for the state mental hospital system; now that we are beginning to see the results of new policies that restrict the use of state hospitals, many people are beginning to see the state hospital system as preferable to moving disturbed and incompetent people out into the community.
S3-R1: the IBM smart surveillance system release 1

Summary form only given. One of the key components of tele-presence systems is automatic awareness of the remote environment. This very same capability of automatic situation awareness is currently being developed and deployed in the context of the next generation smart surveillance systems. Smart surveillance systems use a number of automatic video analysis techniques like object detection, tracking and classification in conjunction with database and Web application servers to provide users with the capability of distributed smart surveillance. The IBM smart surveillance system is one of the few advanced surveillance systems which provides not only the capability to automatically monitor a scene but also the capability to manage the surveillance data, perform event based retrieval, receive real time event alerts thru standard web infrastructure and extract long term statistical patterns of activity.
Recombination and Complementation Between Temperature-Sensitive Mutants of a Bunyavirus, Snowshoe Hare Virus

Complementation and recombination have been observed with temperature-sensitive mutants of Bunyavirus snowshoe hare virus.
Non-intrusive debug technique for embedded programming

Trace debugging is a software diagnostic technique for embedded real-time systems. It is developed to give embedded software developers the ability to trace the activity of the processor even when it is operating out of cache. This ability is lost on many high performance processors and in real-time systems. Tools for debugging real-time systems are scarce (Lee, E., 2000; Zhang, L. and Yuan, P., 1999). This paper describes work that was performed on a new method of trace debugging that can be used to aid in real-time debugging of embedded software. The technique described uses non-intrusive measurements that are supplemented with deductive algorithms. The technique developed in the study differs from traditional debuggers by utilizing the a-priori information that is available. The study utilized a Motorola 68020 as a model of a high performance processor, but the processes are applicable to many "high performance" processors.
A systematic method for determining soft-failure robustness of a subsystem

A systematic method for evaluating soft fail robustness of a DUT subsystem is presented and demonstrated on a camera MIPI interface. Two different mobile phone platforms are studied under TLP injection while various methods for extracting failure thresholds and localization are applied. The root cause for the soft-failure threshold discrepancy is left for future work.
Repression of Staphylococcus aureus by Food Bacteria: I. Effect of Environmental Factors on Inhibition

The effects of environmental factors on the inhibition of an enterotoxin-producing strain of Staphylococcus aureus by food bacteria were investigated. Type of medium and temperature of incubation were important factors in determining the amount of inhibition. The pH range of maximal inhibition was found to be 7.4 to 6.2. Availability of oxygen was not a factor. As the ratios of inhibitor to staphylococcus were increased from 1:1 to 10:1 and 100:1, the amount of inhibition was markedly increased. Inhibition occurred in custard, where it increased with increasing ratios of effector to staphylococcus. The repression of the staphylococcus in all media usually was sufficient to be of practical significance.
Earthquake Prediction and Forecasting

Prospects for earthquake prediction and forecasting, and even their definitions, are actively debated. Here, forecasting means estimating the future earthquake rate as a function of location, time, and magnitude. Forecasting becomes prediction when we identify special conditions that make the immediate probability much higher than usual and high enough to justify exceptional action. Proposed precursors run from aeronomy to zoology, but no identified phenomenon consistently precedes earthquakes. The reported prediction of the 1975 Haicheng, China earthquake is often proclaimed as the most successful, but the success is questionable. An earthquake predicted to occur near Parkfield, California in 1988±5 years has not happened. Why is prediction so hard? Earthquakes start in a tiny volume deep within an opaque medium; we do not know their boundary conditions, initial conditions, or material properties well; and earthquake precursors, if any, hide amongst unrelated anomalies. Earthquakes cluster in space and time, and following a quake earthquake probability spikes. Aftershocks illustrate this clustering, and later earthquakes may even surpass earlier ones in size. However, the main shock in a cluster usually comes first and causes the most damage. Specific models help reveal the physics and allow intelligent disaster response. Modeling stresses from past earthquakes may improve forecasts, but this approach has not yet been validated prospectively. Reliable prediction of individual quakes is not realistic in the foreseeable future, but probabilistic forecasting provides valuable information for reducing risk. Recent studies are also leading to exciting discoveries about earthquakes.
Integrating object and relational technologies

A precondition for integrating object-oriented and relational technologies is an integration of their respective models. A general approach to unifying the models is outlined. The essential features of the resulting model are that abstract data types (ADTs) provide the sole mechanism for encapsulating data and operations, an inheritance ordering on ADTs reflects common abstract interfaces and supports static typechecking, and there is a distinction between value and object ADT instances. Primitive data types provided by the model include atomic data and data structures. Instances of primitive data types are always values. An ADT is implemented using a primitive data type to store its state. What is normally in object-oriented terminology called a class, is called an ADT in the model discussed. Object-oriented databases (OODBs) often make use of class extents, which provide a useful indexing technique for objects. In the model discussed, extents appear as instances of ADTs whose state includes a set of objects plus a set of sub-extents. >
Artificial neural network-based pharmacodynamic population analysis in chronic renal failure

An artificial neural network (ANN)-based approach to pharmacodynamic population analysis presented. In pursuit of an optimal and cost-effective strategy for drug dosing in patients with renal failure, an ANN is applied to perform drug-dose-effect modeling. Such a model allows for versatile prediction of the response to the drug at the effect site and, subsequently, for adjusting the dosing regimen.
Patient-Reported Sexual Function After Staged Penile Urethroplasty

Objective To evaluate sexual function after staged penile urethroplasty with oral mucosal graft (OMG). Methods We identified men with completed staged penile urethroplasty with OMG from the Trauma and Urologic Reconstruction Network of Surgeons database between January 1, 2010 and May 1, 2014. Our primary outcome was change in total Sexual Health Inventory for Men (SHIM) and total Male Sexual Health Questionnaire Ejaculatory Domain (MSHQ-EjD) Short Form at baseline vs after the second stage of the procedure. Second, we assessed subjective changes in penile curvature, length, and sensation. Results Thirty-three patients were included with a mean age of 45 years and mean body mass index of 27.6 kg/m2. Urethral strictures arose from failed hypospadias repair in 52% and lichen sclerosus in 27%. Fifty-two percent of patients reported a previous urethroplasty. The median follow-up time between the second stage procedure and postoperative questionnaires was 6.3 months (interquartile range: 3.5-13.3). There was no significant change in the total SHIM (Δ0.64, 95% confidence interval [CI]: −3.00∼1.72) and MSHQ-EjD (Δ1.55, 95% CI: −1.53∼4.63) scores preoperatively vs postoperatively. In addition, 32% reported improved and 52% no change in satisfaction with sexual intercourse (SHIM Q5). Forty percent of patients reported reduced and 45% no change in bother with ejaculation after surgery (MSHQ-EjD Q4). Men reported new penile curvature (23%), loss of penile length (55%), and altered penile sensitivity (45%) after surgery. Conclusion Patients undergoing staged penile urethroplasty with OMG are likely to have minimal changes in erectile and ejaculatory function postoperatively, although many may experience new penile curvature, reduced penile length, and/or reduced penile sensitivity.
The trial and crucifixion of Jesus: A modest proposal

I model an attempt by radical parties to topple a modus vivendi between a ruling government and a moderate opposition group. Cooperation between the regime and the moderate opposition is possible if each player prefers mutual cooperation to mutual confrontation. If each player also prefers mutual confrontation to cooperating while the other defects then radical parties have a chance at breaking up this accord. Radical parties can succeed in bringing the government and opposition to mutual confrontation if they can agree on power-sharing arrangements after regime change. This paper also resolves central questions surrounding the trial and crucifixion of Jesus Christ. I use an institutional approach to infer player preferences from historical and biblical sources and then use game theory to model the interactions between participants in these events. In so doing, I clarify aspects of the Gospel narrative that have puzzled readers for the past 2000 years.
Tracking with asynchronous binary readings and layout information in RFID systems with sense-a-tags

This paper addresses the problem of real-time indoor tracking of tagged objects in Ultra High Frequency Radio Frequency IDentification (RFID) systems with layout information and asynchronous readings. The method is based on binary detections and the model for the probability of detection is a function of both distance and angle between a tag and a reader and accounts for the possibility of a tag being in a dead-zone. A newly developed RFID component, called sense-a-tag, is used to improve the tracking performance, especially in areas with intersections and at portals, where the estimation of the direction of movement is important. A multi-hypothesis particle filtering method is applied for the tracking and its performance is demonstrated by computer simulations.
Regime Transitions of Cross-Equatorial Hadley Circulations with Zonally Asymmetric Thermal Forcings

Observed nonlinearities in the seasonal evolution of monsoons have been previously explained using theories for Hadley circulations driven by zonally symmetric thermal forcings, even though monsoonal forcings deviate strongly from the assumption of zonal symmetry. Here, an idealized model of a dry, threedimensional atmosphere is used to compare the response to zonally symmetric and asymmetric off-equatorial thermal forcings. For symmetric forcings, the zonal-mean, cross-equatorial mass flux increases more rapidly with the amplitude of the forcing once the forcing becomes strong enough to reduce the upper-tropospheric absolute vorticity to near zero, consistent with previous studies of the transition to angular momentum‐ conserving flow. For zonally asymmetric forcings, the zonal-mean cross-equatorial flow exhibits a similar dependence on forcing strength and a similar reduction of the zonal-mean upper-level vorticity, but asymmetric forcings also produce strong zonal overturnings with subsidence west of the heating, as in the wellknown linear response to off-equatorial heatings. The mass flux in these zonal overturnings increases linearly with forcing strength until its rate of increase tapers off for the strongest forcings; the total upward mass flux (i.e., the zonal-mean plus zonally asymmetric components) increases linearly with the strength of zonally asymmetric forcings and exhibits no abrupt or nonlinear dependence on forcing amplitude. These results indicatetheimportanceofconsideringthezonallyasymmetricpartofthedivergent responsetooff-equatorial forcings and suggest that theories based on zonally symmetric forcings need further examination before they can be assumed to describe observed monsoons.
NRC Quantum Hall Devices for National Measurement Institutes

At CPEM'02 in Ottawa the NRC Electrical Standards Group undertook to fabricate a batch of Hall devices suitable for use at National Measurement Institutes as resistance standards. One wafer has been fabricated to date and testing of the electrical parameters of devices has commenced. The paper described the fabrication parameters, and preliminary test results
pH Variation of midpoint potential for three photosynthetic bacterial cytochromes c′. A link between physical and functional properties

Abstract Midpoint redox potential (EM) versus pH curves are reported over the pH range 5 to 10 for the cytochromes c′ from three species of purple photosynthetic bacteria: Rhodospirillum rubrum, Rhodopseudomonas palustris and Chromatium vinosum. In each case, theoretical curves are fitted to the data and pK values for the reduced (pH 5–5.5) and oxidized (pH 8–8.5) forms of the protein are found to influence the midpoint redox potentials. The oxidized form pK values in each case are found to correlate with previously determined pK values for variation in physical and/or spectroscopic properties. This correlation of functional and physical observables is discussed in terms of a possible mechanism of control of midpoint redox potential through heme iron-ligand bonding as moderated by the protein conformation in response to solution conditions. The reduced form pK values are discussed in terms of a mechanism which would alter the polarity of the heme environment, thereby influencing redox potentials.
Electrochemical equilibrium diagrams for sulphidization of oxide copper minerals

Abstract The Eh-pH diagrams of systems CuSH 2 O, CuCSH 2 O, CuSiSH 2 O are constructed and analyzed to study the sulphidization of oxide copper minerals of economic importance such as chrysocolla, malachite, azurite, brochantite and tenorite. The results show that for all of the minerals, the areas of CuS and Cu 2 S stable domains, where sulphidization is expected to take place, depend only on the sulphur concentration. At the same sulphur concentration, the domains are the same for the different minerals. As sulphur concentration increases, CuS domains expands and Cu 2 S domain shrinks. It is suggested that instead of constructing the Eh-pH diagrams for more complicated systems such as CuCSH 2 O, CuSiSH 2 O systems, the Eh-pH diagrams of the simple CuSH 2 O system are sufficient to help designing sulphidization experiments and predicting sulphidization products for various oxide copper minerals. The stability of the minerals in acqueous solution has also been discussed.
Nonuremic calciphylaxis precipitated by teriparatide [rhPTH(1–34)] therapy in the setting of chronic warfarin and glucocorticoid treatment

Calciphylaxis occurs rarely in the absence of end stage renal disease. Predisposing factors for nonuremic calciphylaxis (NUC) include hyperparathyroidism, coagulopathies, connective tissue disease, liver disease, glucocorticoid use, and malignancy. Warfarin can facilitate vascular calcification by reducing vitamin K-dependent carboxylation of matrix-Gla proteins. An 86-year-old Caucasian woman with a history of polymyalgia rheumatica, two spontaneous deep venous thromboses (DVTs) and multiple fractures was treated with calcium, vitamin D, prednisone, and warfarin. The patient's low bone density was treated initially with estrogen, then oral bisphosphonate, which was discontinued due to upper gastrointestinal symptoms. Nasal calcitonin was initiated. After 10 years of calcitonin treatment, she was changed to teriparatide. Two months after initiating teriparatide, she developed lower extremity edema and painful erythematous nodular lesions on her calves bilaterally, that progressed to necrotic ulcers despite antibiotic therapy. Biopsy of the lesions showed calcification in the media of small blood vessels and subcutaneous fat with fat necrosis, consistent with calciphylaxis. Teriparatide was discontinued. Aggressive wound care, antibiotics, and intravenous zoledronic acid were initiated. With cessation of teriparatide therapy and intensive wound care, the patient's lesions resolved over 8 months. We report the first case of NUC precipitated by teriparatide therapy. Our patient had multiple underlying predisposing factors including a connective tissue disorder, glucocorticoid therapy, warfarin use, and possible underlying coagulopathy given her history of multiple DVTs. In such patients, alternative osteoporosis therapies may be preferred.
Performance of invariant face recognition techniques

In this paper we present a comparison between four invariant face recognition techniques: synthetic discriminant function (SDF) based recognition, projection-slice SDF based recognition, optoelectronic correlator based neural network, and pose estimation based recognition. The pose estimation technique does not involve composite image generation and is most successful of these techniques mainly due to its success in maintaining a low interclass crosscorrelation. The optoelectronic fringe-adjusted joint transform correlator (JTC) is used to provide correlation. A description of the optoelectronic system and the simulation results are provided.
Maintaining steady state arterial alcohol levels in rats by using a physiologically based pharmacokinetic model

An intravenous method of alcohol administration that maintains arterial alcohol concentrations (AACs) in rats at a prescribed level for a prolonged period was previously described. This method produced steady state AACs between 30 and 180 min after the start of the infusion, but it resulted in substantial overshoots in AAC initially. The present study was designed to achieve target AACs close to steady state more quickly while minimizing any overshoot. A physiologically based pharmacokinetic (PBPK) model of alcohol distribution and elimination was developed for male Wistar rats. Body weight was used to compute individualized infusion rate profiles that would achieve steady state AACs of 75, 150, and 250 mg%. Rats were chronically implanted with cannulae in the jugular vein (for alcohol infusion) and carotid artery (for blood sampling). Alcohol was administered according to the individualized infusion rate profiles. Blood was collected at intervals for AAC determination. The PBPK model-based infusion profiles achieved target AACs 5 min after the start of the infusion and maintained the AACs for 2 h. The AACs deviated an average of 4.9%, 5.1%, and 5.9% from target at the 75, 150, and 250 mg% levels, respectively. Through the application of a PBPK model, it is possible to achieve target AACs close to steady state more quickly in male Wistar rats and to minimize any overshoot in AAC. The PBPK model-based method seems to be improved over the earlier method. Maintaining steady state AACs in rats is useful for studies in which fluctuating alcohol levels may confound experimental results.
Effect of trimethyltin on chemically-induced seizures

The effect of trimethyltin (TMT; 4.26 mg/kg i.p.), at 1 and 14 h following administration, on chemically-induced seizures in mice is reported. At 1 h following administration, TMT decreased seizure responsiveness and protected animals from bicuculline, isonicotinic acid hydrazide (INH) and pentylenetetrazol (PTZ) induced seizures. At 14 h following administration, TMT provided little protection against bicuculline, INH or PTZ induced seizures. Only slight decreases in seizure responsiveness were observed with strychnine induced seizures at either 1 or 14 h. By 16 h following administration, animals exhibited spontaneous tremors and convulsions. The results indicate that TMT exerts a biphasic effect on central nervous system excitability.
Molecular surface generation using marching tetrahedra

A method is presented to generate and triangulate molecular surfaces rapidly. It is based on the ‘marching tetrahedra’ approach. The method is fast, simple and easy to implement. Our approach is not analytical in nature. Hence no special treatment is required for complications with singularity, degeneracy, or with self-intersecting re-entrant surfaces. A quick test for determining the solvent accessibility of a point in space forms an important part of the method. This test has potential use outside of the surface generation algorithm such as in molecular field analysis where the solvent accessibility of a point needs to be determined. The triangulated surface generated is suitable for molecular graphics display as well as boundary element continuum dielectric calculations. © 1998, Government of Canada. Exclusive worldwide publication rights in the article have been transferred to John Wiley & Sons, Inc. in perpetuity. J Comput Chem 19: 1268–1277, 1998