cssi/SciSciGPT-SciSciNet huggingface dataset:
Lapatinib activity in metastatic human epidermal growth factor receptor 2-positive breast cancers that received prior therapy with trastuzumab, pertuzumab, and/or ado-trastuzumab emtansine (T-DM1)

Lapatinib (L) is approved in combination with capecitabine or letrozole for patients with trastuzumab-resistant HER2-positive metastatic breast cancer (MBC). However, there is no efficacy data of L in patients who received prior pertuzumab (P) and ado-trastuzumab emtansine (T-DM1), now included as standard first- and second-line therapies, respectively. The goal of this study was to assess the efficacy of L in a contemporary patient population that received prior P and/or T-DM1. We identified patients with HER2-positive MBC who received L (n = 520) between 2003 and 2017 at MD Anderson Cancer Center and selected a target cohort who received L after prior P or T-DM1 (n = 43) with the remaining included in the comparison cohort (n = 477). We evaluated outcome measures including clinical benefit rate (CBR), best tumor response (BTR), duration on L, and time to progression (TTP). Survival analyses used Kaplan–Meier statistics. CBR was 28% (95% CI 10–32) for the target cohort and 40% (95% CI 36–45) for the comparison cohort. The median duration on L was 5 months (95% CI 3.0–9.0) in the target cohort and 6.7 months (5.9–8.0) in the comparison cohort. In both cohorts, the median time to progression (TTP) and overall survival (OS) were longer in patients with de novo metastatic disease compared to patients with disease recurrence. L-based therapy is an active therapeutic option and remains a viable option for HER2 + MBC after prior trastuzumab, P and/or T-DM1.
Clinical and immunological analyses of immune checkpoint inhibitor-associated neuromuscular (NM) toxicities.

e14118Background: A rare and often fatal spectrum of NM immune-related adverse events (irAEs) includes myositis, myocarditis, and myasthenia gravis (MG). A deeper understanding of their clinical an...
A review of the mechanism by which exploding bridge-wire detonators function.

An introduction to exploding bridge-wire (EBW) detonators is given followed by an extensive critical review of open source literature pertaining to these devices. The aim is to better establish the...
Effects of protocol on prevention of delirium in hospitalized hip fracture patients: A quality improvement project.

Abstract Background Delirium is a sudden change of consciousness experienced by hospitalized patients that results in negative outcomes. The incidence of delirium is under-reported and can be prevented in many patients. The purpose of this evidence-based study was to determine if the incidence of delirium decreased with the use of prevention interventions for hip fracture patients. Methods The project was a prospective quality improvement project. An audit of medical records using the CHART-DEL instrument was conducted pre- and post-implementation of an evidence-based protocol. Medical records were reviewed until discharge for the use of prevention interventions and the diagnosis of delirium. Results The sample included 90 hip fracture patients, 45 patients in both the pre- and post-implementation groups. The hip fracture protocol was used by admitting physicians in 31% of admissions and prevention interventions were documented by nurses in 75.6% of medical records. The incidence of delirium was similar in both groups; 11.1% in the pre-implementation group and 15.6% in the post-implementation group and was not statistically significant. Discussion Healthcare workers should take measures to reduce the incidence of delirium. There is a need for further studies on the use of protocols in the identification, prevention, and treatment of delirium in hospitalized patients.
The Absolute Indeterminacy of Karel Čapek’s Science Fiction

This article reintroduces readers to the science fiction novel The Absolute at Large (1922) by Karel Capek, one of the most influential but largely unacknowledged voices in early twentieth-century literature. I frame The Absolute at Large as a narrative about ‘free energy’, a term I have proposed to examine a range of relationships implicated in speculation about super-abundant or ‘virtually-limitless’ energy sources. I argue that Capek’s commentary emerges in the double meaning of the titular ‘Absolute’—a reference to both free energy and the divine—which foregrounds an inherent indeterminacy folded into the promise of abundance. This reading is made by examining Capek’s serious engagement with the philosophy of pragmatism, which has been consistently misrepresented in the existing literature on Capek’s legacy.
On the Definition of the Crime of Sea Piracy Revisited: Customary vs. Treaty Law and the Jurisdictional Implications Thereof

Crimes of piracy exist because the underlying purpose of defining the crime is to keep commercial lanes of navigation open to shipping. However, is the definition of sea piracy so all-inclusive so as to make it too vague in prosecution situations? And, can pirates on land be considered pirates only if they were first considered pirates on the high seas? A diversity of scholarly opinion exists surrounding the definition of the term, and has existed since the first articles on sea piracy appeared in the 1958 Geneva Convention on the High Seas. No prevailing definition of the word "piracy" is used when the crime occurs away from internal or territorial waters. Instead, piracy is called "armed robbery" in locations, primarily municipal, other than the high seas.This article sets out the different views of what constituted the crime of piracy historically, and how it evolved into its current usages. The author also discusses the "custom(s)" regarding the definition(s) of piracy and parses the international law definition provided in the Geneva Convention.
Evaluation of Point-of-Care Decision Support for Adult Acne Treatment by Primary Care Clinicians

Importance Acne is a common reason for referral to dermatologists from primary care clinicians. We previously modeled the impact of algorithm-based acne care in reducing dermatology referrals, missed appointments, and treatment delays. Objective To prospectively evaluate the downstream outcomes following a real-time, algorithm-based electronic decision-support tool on the treatment of patients referred for acne. Design, Setting, and Participants This prospective cohort study included 260 treatment-naive patients referred to a dermatologist for the chief concern of acne, as well as the referring primary care clinicians, at 33 primary care sites affiliated with Brigham and Women’s Hospital from March 2017 to March 2018. Interventions We developed and implemented a decision-support tool into the electronic medical record system at an academic medical center. The algorithm identified patients referred to a dermatologist who had not previously been treated for acne and offered guideline-based recommendations for treatment via a real-time notification. Main Outcomes and Measures Treatment modification by referring clinicians. Results Of 260 patients referred for acne, 209 (80.4%) were women, 146 (56.1%) were non-Hispanic white, and 236 (90.8%) listed English as the preferred language. Patients had a median (quartile 1-quartile 3) age of 28.8 years (24.4-35.1 years) and 185 of 260 had private insurance (71.1%). In total, the algorithm was associated with cancellation of the initial referral in 35 of 260 (13.5%) instances and treatment initiation by the referring clinician in 51 of 260 (19.6%) instances. Conclusions and Relevance This decision-support algorithm was associated with a modest reduction in rates of acne-related referrals to dermatologists, and an increased likelihood of treatment initiation by the referring clinician.
Electrocatalytic valorization into H2 and hydrocarbons of an aqueous stream derived from hydrothermal liquefaction

Electrocatalytic oxidation is an attractive process for valorizing the organic compounds and removing the nitrogen in aqueous waste streams at ambient conditions. We evaluated the electrocatalytic oxidation reaction as a function of applied potential over Pt electrodes of an aqueous stream generated via hydrothermal liquefaction. We quantified the conversion of particular organic compounds (e.g., carboxylic acids, alpha hydroxyacids, alcohols, ketones, and amides) and the removal of carbon, nitrogen, sulfur, and chemical oxygen demand. Organic nitrogen and sulfur were oxidized to nitrates and sulfates. The main reaction products from the electrocatalytic oxidation at the anode were short chain volatile hydrocarbons (i.e., olefins, and paraffins) and CO2, while H2 was generated at the cathode. Unidentified compounds were converted to short chain carboxylic acids, alcohol and ketones, while ammonia was oxidized into N2. Studies with model compounds showed that amides and alpha hydroxyacids yielded carboxylic acids that convert further via (non-)Kolbe chemistry. Simultaneous denitrification, valorization of organic compounds, and H2 generation from the aqueous stream can potentially simplify the unit operations currently used in a hydrothermal process. The cost of the electricity required to drive the electrocatalytic operation can be partially mitigated by selling the excess H2 produced.
Low Superior Pubic Ramus Screw Failure Rate With Combined Anterior and Posterior Pelvic Ring Fixation.

OBJECTIVES To determine whether fracture pattern, implant size, fixation direction, or the amount of posterior pelvic ring fixation influences superior ramus medullary screw fixation failure. DESIGN Retrospective cohort review. SETTING Regional Level 1 trauma center. PATIENTS/PARTICIPANTS After exclusion criteria, 95 patients with 111 superior ramus fractures with 3 months minimum follow-up were included. INTERVENTION All patients underwent anterior and posterior pelvic ring fixation. MAIN OUTCOME MEASUREMENTS Comparison of immediate postoperative radiographs and/or computer tomography scan with the latest postoperative image to calculate interval fracture displacement and implant position. Postoperative fracture displacement or implant position change greater than 1 cm were considered fixation failures. RESULTS Five screws were defined as failures (4.5%), including 3 retrograde, 3 with bicortical fixation, 4 with a 4.5-mm screw, and 1 with a 7.0-mm screw. Fracture patterns included 2 oblique and 3 comminuted fractures. Based on the Nakatani classification, there were 3 zone II, 1 zone I, and 1 zone III. Failure modes included 3 with cut-out along the screw head and 1 cut-out and 1 cut-through at the screw tip. CONCLUSIONS Our incidence of superior pubic ramus intramedullary screw fixation failure was 4.5%. Even with anterior and posterior fixation along with precise technique, failures still occur without a common failure predictor. The percutaneous advantages and proven strength provided by an intramedullary implant make it desirable to help reestablish global pelvic ring stability. Biomechanical and clinical studies are needed to further understand intramedullary superior ramus screw fixation. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Andean or Caribbean? Nine Books on Colombia

This essay reviews the following works: An Aqueous Territory: Sailor Geographies and New Granada’s Transimperial Greater Caribbean World. By Ernesto Bassi. Durham, NC: Duke University Press, 2016. Pp ix + 360. $26.95 paperback. ISBN: 9780822362401. Marijuana Boom: The Rise and Fall of Colombia’s First Drug Paradise. By Lina Britto. Berkeley: University of California Press, 2020. Pp. 352. $29.95 paperback. ISBN: 9780520325470. Crafting a Republic for the World: Scientific, Geographic, and Historiographic Inventions of Colombia. By Lina del Castillo. Lincoln: University of Nebraska Press, 2018. Pp. 402. $30.00 paper back. ISBN: 9781496205483. Guerrilla Marketing: Counterinsurgency and Capitalism in Colombia. By Alexander L. Fattal. Chicago: University of Chicago Press, 2018. Pp. 304. $27.50 paperback. ISBN 9780226590646. 1892: Un ano insignificante; Orden policial y desorden social en la Bogota de fin de siglo. By Max S. Hering Torres. Bogota: Critica y Universidad Nacional de Colombia, 2018. Pp. 245. COP$50.000 hardcover. ISBN: 9789584266606. Makers of Democracy: A Transnational History of the Middle Classes in Colombia. By A. Ricardo Lopez-Pedreros. Durham, NC: Duke University Press, 2019. Pp. 360. $28.95 paperback. ISBN: 9781478002857. Sorting Out the Mixed Economy: The Rise and Fall of Welfare and Developmental States in the Americas. By Amy C. Offner. Princeton, NJ: Princeton University Press, 2019. Pp. 400. $39.95 hardcover. ISBN: 9780691190938. No Limits to Their Sway: Cartagena’s Privateers and the Masterless Caribbean in the Age of Revolutions. By Edgardo Perez Morales. Nashville: Vanderbilt University Press, 2018. Pp. xi + 248. $27.95 paperback. ISBN: 9780826521927. The Politics of Taste: Beatriz Gonzalez and Cold War Aesthetics. By Ana Maria Reyes. Durham, NC: Duke University Press, 2019. Pp. 328. $27.95 paperback. ISBN: 9781478003977.
Acknowledging and assessing implicit bias among healthcare professionals: A randomized controlled trial

Abstract Background Implicit bias, defined as the attitudes or stereotypes that affect understanding, actions, and decisions in an unconscious manner, results in substandard health care and propagates health disparities. The extent of implicit bias among healthcare professionals is unknown but could break down the cohesive team dynamic required for providing optimal patient care. Objective and Outcomes: This randomized controlled trial sought to evaluate implicit bias of pharmacists toward other health professionals (HP) and develop a positive framing intervention to reduce implicit bias toward the most biased HP. The primary outcome was the level of implicit bias of pharmacists towards physicians, nurses, and other pharmacists as a group. Secondary outcomes included the change in implicit bias levels from baseline to after the framing intervention. Methods Pharmacist participants recruited from a pharmacy practice listserv completed a baseline Implicit Attitudes Test (IAT) and explicit attitude questionnaire. A positively framed passage was written about the HP with the most negative bias as identified from the baseline IAT. After a 16-week washout, participants were randomized to read the positively framed passage (intervention) or neutral passage (control) and retake the IAT. Comparison of standardized difference in reaction times of the IAT (D-score) between HP groups was done using a linear fixed model. Results Fifty-seven pharmacists completed the full study. Pharmacists had statistically higher D-scores toward physicians (0.26, SD 0.41, p = 0.002) and nurses (0.2, SD 0.34, p = 0.03) than toward other pharmacists (0.09, SD 0.36). A positive framing passage was written about pharmacists as the HP with the least positive attitudes. Pharmacist implicit attitudes towards other pharmacist grew more positive between the phases in the intervention group compared to other HPs (p = 0.03). Conclusion Pharmacists’ implicit attitudes toward other pharmacists, physicians, and nurses is more positive than toward the general public, but it is lower towards pharmacist colleagues than physicians or nurses. Positively framed passages can improve subconscious bias among healthcare professionals and contribute to a cohesive interprofessional team dynamic.
Genetic Evaluation of Inpatient Neonatal and Infantile Congenital Heart Defects: New Findings and Review of the Literature.

The use of clinical genetics evaluations and testing for infants with congenital heart defects (CHDs) is subject to practice variation. This single-institution cross-sectional study of all inpatient infants with severe CHDs evaluated 440 patients using a cardiovascular genetics service (2014–2019). In total, 376 (85.5%) had chromosome microarray (CMA), of which 55 (14.6%) were diagnostic in syndromic (N = 35) or isolated (N = 20) presentations. Genetic diagnoses were made in all CHD classes. Diagnostic yield was higher in syndromic appearing infants, but geneticists’ dysmorphology exams lacked complete sensitivity and 6.5% of isolated CHD cases had diagnostic CMA. Interestingly, diagnostic results (15.8%) in left ventricular outflow tract obstruction (LVOTO) defects occurred most often in patients with isolated CHD. Geneticists’ evaluations were particularly important for second-tier molecular testing (10.5% test-specific yield), bringing the overall genetic testing yield to 17%. We assess these results in the context of previous studies. Cumulative evidence provides a rationale for comprehensive, standardized genetic evaluation in infants with severe CHDs regardless of lesion or extracardiac anomalies because genetic diagnoses that impact care are easily missed. These findings support routine CMA testing in infants with severe CHDs and underscore the importance of copy-number analysis with newer testing strategies such as exome and genome sequencing.
Police Tactics and Their Effects on Democracy

Scholars have long wondered whether the intersection of crime, justice, and local elections are correlated. Recently, multiple deaths of African-American citizens during encounters with police have become highly-publicized and have consequently catalyzed discussions around police misconduct and police reform. Based on the increased exposure of police misconduct, this study explores how contact with the criminal justice system and perceptions of police legitimacy shape political behavior in the modern era, with specific emphasis on the aggressiveness of police tactics and voting behavior in local elections. This study has attempted to control for neighborhood context by using the municipalities with similar ecological factors to highlight the correlation between specific police tactics and voting behavior in local elections. This study also will look at how specific police tactics either promote or obstruct the requirements of a participatory democracy set forth by Robert Dahl. Those requirements are as follows: meaningful and extensive competition, sufficient inclusiveness in national and local elections, and a high level of civil and political liberties. Due to this study’s focus on voting behavior in local election, the analysis will concentrate on the second requirement of participatory democracy. The results of this study show that perceptions of police legitimacy through the use of specific policing tactics are likely to be highly influential in the prediction of candidate selection as well as the likelihood of a citizen’s participation in local elections. Municipalities that have less aggressive police tactics turn out to have a higher voter turnout, as well are to be more likely to vote for a Democratic candidate, while those municipalities that institute more aggressive police tactics will have a lower voter turnout and will also more likely vote for a Democratic candidate but will have larger amount or residents vote for a Republican or Independent candidate.
Equality for Inegalitarians

This book offers a new and compelling account of distributive justice and its relation to choice. Unlike luck egalitarians, who treat unchosen differences in people's circumstances as sources of unjust inequality to be overcome, Sher views such differences as pervasive and unavoidable features of the human situation. Appealing to an original account of what makes us moral equals, he argues that our interest in successfully negotiating life's ever-shifting contingencies is more basic than our interest in achieving any more specific goals. He argues, also, that the state's obligation to promote this interest supports a principled version of the view that what matters about resources, opportunity, and other secondary goods is only that each person have enough. The book opens up a variety of new questions, and offers a distinctive new perspective for scholars of political theory and political philosophy, and for those interested in distributive justice and luck egalitarianism.
Criminal Jurisdiction and the Nation-State: Toward Bounded Pluralism

Should nation-states fight to maintain their traditional monopoly on criminal jurisdiction, or should they accommodate themselves to supra-national and sub-national prosecutors and courts? Here in the United States, we face difficult questions about how to engage with the supra-national International Criminal Court in The Hague and how much criminal jurisdiction to cede to sub-national Native American tribes at home. Legal commentators interested in criminal jurisdiction tend to fall into one of three categories: (1) Nationalists such as John Yoo who want to strengthen nation-state criminal justice systems against all jurisdictional challengers, (2) Internationalists such as Anne-Marie Slaughter who promote robust international institutions like the International Criminal Court, and (3) Pluralists such as Paul Berman who champion greater autonomy for sub-national communities to run their own criminal justice systems. This article lays out a new approach to the relationship between criminal justice and the nation-state – the approach of Bounded Pluralism. Bounded Pluralism stands for the proposition that a nation-state may, where appropriate, cede some elements of its criminal jurisdiction to sub-national or supra-national entities, but that it should maintain supervisory jurisdiction to ensure that the exercise of such jurisdiction conforms to fundamental national norms, such as Constitutional guarantees. On this basis, the United States ought to be open to recognizing the functional criminal jurisdiction of Indian tribes and of the International Criminal Court, but it should insist on retaining supervisory jurisdiction to confirm that those entities respect the fundamental due process rights embedded in the U.S. Constitution. Bounded Pluralism thus allows the nation-state to remain faithful to its core national values, while recognizing the legitimacy of certain supra-national and sub-national jurisdictional claims. The article details the implications of Bounded Pluralism for how the federal government should approach contemporary issues in tribal criminal jurisdiction and in international criminal law.
The Ratio of the Nuclear Moments of 99Ru and 101Ru from NMR Studies of Ferromagnetic Alloys

NMR investigations of Ru as an impurity in Fe, Co, and Ni hosts yield a resonance frequency ratio for the isotopes 99 Ru and 101 Ru, ν 101 /ν 99 =1.121±0.002 Interpreting this as the ratio of nuclear moments and using the best available date for µ 99 gives µ 101 =0.698±0.024 µ N .
PCR with arbitrary primers: approach with care.

New techniques have recently been described that employ the polymerase chain reaction (PCR) to amplify arbitrary regions of a genome using a single primer. The techniques reveal polymorphisms in insect taxa that lack allozyme variation and, for the first time, permit genetic polymorphisms to be rapidly analysed in small arthropods (e.g. mites, endoparasitic wasps). The methods have been used in identification of sub-species and cryptic species, and have applications in population genetics and genetic fingerprinting. They are fairly inexpensive, do not require the use of radioactivity, are relatively simple to learn and can easily be adapted to most laboratories. However, their application is not without technical problems and practical limitations. The purpose of this note is to indicate the critical factors to consider before launching into their use. We chiefly emphasize that most polymorphisms revealed by these methods segregate as dominant markers. Furthermore, application of these techniques requires extensive standardization and may not prove to be reproducible among various laboratories especially those employing different types of thermal cyclers. There are some unique features of these polymorphisms to consider when using them in genetic fingerprinting. In addition, because the techniques amplify arbitrary regions of genomes, similarly sized fragments amplified between two species may not be homologous. This argument and empirical observations suggest that PCR with arbitrary primers will have limited application in molecular systematics above the intraspecific level.
Effects of nonionic micelles on dephosphorylation and aromatic nucleophilic substitution.

Abstract Terminal hydroxyl groups of micellized dodecyl (10) and (23) polyoxyethylene glycol (C 12 E 10 and C 12 E 23 , respectively) are deprotonated by OH − , and the alkoxide ions react with 2,4-dinitrochlorobenzene (DNCB) giving ethers, but do not react with p -nitrophenyl dimethyl and diethyl phosphate ( p NPDMP and p NPDEP, respectively), which react wholly with OH − . These substrates have similar hydrophobicities and should locate similarly in the micellar interfacial regions. These differences in reactivities are due to differences in relative nucleophilicities of OH − and alkoxide ions in aromatic nucleophilic substitution and dephosphorylation in micelles. Reactivities of DNCB and the related ethers indicate that local concentrations of OH − are similar in the aqueous and micellar interfacial regions but those of the alkoxide ions are higher in C 12 E 10 than in C 12 E 23 micelles due to differences in the molar volumes of the interfacial regions. With time the initially formed ethers react at similar rates with OH − generating 2,4-dinitrophenoxide ion.
Popular Reception of Classical German Drama in New York 1945–1965

THE PROPER CARE AND FEEDING OF THE MIND doesn't admit the rule that the better the mind the greater its need for a good diet. (The mind is of the same essential nature in all the children of man.) "Any language," writes Edmund Wilson, "that has once borne the impress of the masters of thought and art is impregnated forever after with the genius and authority of these masters." Language is shaped in the response of spirit to the possibilities and necessities of existence. It is possible to study a great language only linguistically, but given half a chance its literature will out, and in its literature its humanity.
A correction in nomenclature

In the second edition of the Species Plantarum in 1763, Linnaeus described a fungus which he called Hydnum parasiticum as follows: "acaule arcuato-rugosum tomentosum. Habitat in Europae arboribus." This appears to be the original publication of the species and Linnaeus never furnished any more complete account of the plant. It seems practically impossible from so meager a characterization to identify the plant thus named. In later editions of the Species Plantarum the name and description are continued unchanged. In 1769, a plant was figured in Flora Danica pl. 465, which was supposed to be the Linnaean species. The figure, however, fails to give any more definite characters of the plant. In the same year Weigel quotes the Linnaean species and appends a more elaborate description.* The fact that he states that the plant described by him is at first gelatinous raises the question whether he really had the Linnaean plant. In 1787, Willdenow described a plantt which he doubtfully referred to Hydnum parasiticum L. and the next year he repudiated his determination by figuring and describing his plant as a new species with the name Agaricus decipiens.$ It seems evident, therefore, that even the earlier botanists were more or less in doubt as to the identity of the Linnaean plant. About I8oo, Olof Swartz sent to Persoon a specimen from Sweden which he affirmed to be the true Hydnum parasiticum L. This plant Persoon figured and fully described under the Linnaean name in his Icones et Descriptiones Fungorum 2: 55. pl. I4, f. 2. I8oo. The figure is so well executed that it leaves no doubt as to the plant represented. Soon after this was published Swartz wrote Persoon, according to the latter, that the plant was not the Hydnum parasiticum of Linnaeus. Persoon now did a
Willingness to Self-Disclose to Female and Male Friends as a Function of Social Anxiety and Gender

Research indicates that women's and men's willingness to self-disclose to others about themselves varies as a function of the characteristics of the disclosure recipient and the disclosure topic. The present investigation was conducted to examine the self-presentational impact of social anxiety on women's and men's willingness to discuss the instrumental-masculine and expressive-feminine aspects of themselves with their male and female friends. Multivariate results demonstrated that high-social-anxiety women were more willing to discuss expressive-feminine behavioral information with their female friends and less willing to discuss instrumental-masculine behavioral information with their male friends, whereas high-social-anxiety men were more willing to self-disclose about their instrumental-masculine behaviors with their male friends and less willing to self-disclose about their expressive-feminine behaviors with their female friends. These findings suggest that high-social-anxiety males and females may ...
Dielectrophoresis-Based Assembly and High-Frequency Characterization of Carbon Nanotube Bundles

As the size of integrated circuit elements decreases, the properties of carbon nanotubes (CNTs) become increasingly attractive for interconnect applications. To be used by industry, full characterization of the electronic properties of CNT aggregates is essential. Dielectrophoresis from CNTs suspended in liquid has been demonstrated as a simple route to bundles of aligned parallel nanotubes. We describe a method by which circuits including such bundles may be fabricated, and provide some high-frequency measurements of their electrical properties. The contributions of the contacts can be separated from those of the bundle itself.
Updates on the Evaluation and Management of Caustic Exposures

In 2004, the American Association of Poison Control Centers' Toxic Exposure Surveillance System documented over 200,000 exposures to caustic substances, in both household and industrial products. Although the most commonly affected body areas are the face, eyes, and extremities, all reported fatalities were as a result of ingestion. Little controversy exists in patient management following dermal or ocular caustic exposure. Immediate water irrigation of the site of caustic exposure, followed by routine burn care, analgesia, intravenous fluids, and electrolyte replacement are standards of care. In this manuscript, a thorough review of the management of gastrointestinal caustic exposure is explored, not only because of the high rates of morbidity and mortality associated with these exposures, but also because there remains controversy regarding appropriate management of such exposures. Hydrofluoric acid, a weak acid in its aqueous form, requires special consideration and specific antidotes, and as such, is addressed separately.
Statistical Significance of Geographic Heterogeneity Measures in Spatial Epidemiologic Studies

Assessing geographic variations in health events is one of the major tasks in spatial epidemiologic studies. Geographic variation in a health event can be estimated using the neighborhood-level variance that is derived from a generalized mixed linear model or a Bayesian spatial hierarchical model. Two novel heterogeneity measures, including median odds ratio and interquartile odds ratio, have been developed to quantify the magnitude of geographic variations and facilitate the data interpretation. However, the statistical significance of geographic heterogeneity measures was inaccurately estimated in previous epidemiologic studies that reported two-sided 95% confidence intervals based on standard error of the variance or 95% credible intervals with a range from 2.5th to 97.5th percentiles of the Bayesian posterior distribution. Given the mathematical algorithms of heterogeneity measures, the statistical significance of geographic variation should be evaluated using a one-tailed P value. Therefore, previous studies using two-tailed 95% confidence intervals based on a standard error of the variance may have underestimated the geographic variation in events of their interest and those using 95% Bayesian credible intervals may need to re-evaluate the geographic variation of their study outcomes.
The relationship of abuse and witnessing violence on the Child Abuse Potential Inventory with black adolescents

A number of social and psychological factors present in most adolescent parents place them at high risk for abusive behavior toward their children. However, current child abuse potential measures do not include adolescent samples as part of the psychometric data base. Consequently, the purpose of this study was twofold: (1) to investigate whether a Black adolescent sample would perform differently than an adult nonabusing sample on the Child Abuse Potential Inventory (CAP), and (2) to examine the relationship between history of abuse or witnessing violence to scores on the CAP. Results revealed that Black adolescents scored significantly higher than the adult normative sample on the CAP; consequently, cutoff scores need to be empirically established for adolescents. Additional analyses indicated that a history of abuse, as well as a history of witnessing violence, are associated with a high potential for abuse.
Axisymmetric grazing-incidence focusing optics for small-angle neutron scattering

Abstract We propose and design novel axisymmetric focusing mirrors, known as Wolter optics, for small-angle neutron scattering instruments. Ray-tracing simulations show that using the mirrors can result in more than an order-of-magnitude increase in the neutron flux reaching detectors, while decreasing the minimum wave vector transfer. Such mirrors are made of Ni using a mature technology. They can be coated with neutron supermirror multilayers, and multiple mirrors can be nested to improve their flux-collection ability. Thus, these mirrors offer simple and flexible means of significantly improving existing and future SANS instruments. In addition, short SANS instruments might become possible, especially at compact neutron sources, when high-resolution detectors are combined with Wolter optics.
AIDS and the social sciences: review of useful knowledge and research needs

This paper reviews several areas of social science research that are relevant to the critical social dimensions of the AIDS crisis. These dimensions include how to effect changes in behavior so as to break the chain of transmission, how best to inform the public about risks so as to develop reasonable and nondiscriminatory policies and practices based on the best available scientific information, and how to organize health care and social services so as to treat persons with AIDS effectively, humanely, and at reasonable cost. Relevant research in the social sciences includes studies of behavioral risk modification, risk perception, communication and persuasion, attitudes toward civil liberties, and the organization of health care. This work suggests useful avenues for research on AIDS that could provide the understanding necessary to develop effective ways of approaching the problems presented by this devastating disease. Since AIDS was first identified in 1981, a great deal has been learned about the genetic structure of the virus, the route of viral transmission, and the course of the disease. However, AIDS is far more than a
Supporting worker independence in collaboration transparency

Conventional collaboration-transparency systems are inefficient in their use of network resources and lack support for key groupware principles: concurrent work, relaxed WYSIWIS, and group awareness. We present an alternative implementation approach to collaboration transparency that provides many features previously seen only in collaboration-aware applications. Our approach is based on an object-oriented replicated architecture where selected single-user interface objects are dynamically replaced by multi-user extensions. The replacement is transparent to the single-user application and its developer. As an instance of this approach, we describe its incorporation into a new Java-based collaboration-transparency system, called Flexible JAMM. We conducted an empirical study to evaluate the effectiveness of Flexible JAMM versus a representative conventional collaboration-transparency system, NetMeeting. Completion times were significantly faster in a loosely-coupled task using Flexible JAMM, and were not adversely affected in a tightly-coupled task. Accuracy was unaffected by the system used. Participants greatly preferred Flexible JAMM. The evaluation validates our aim of supporting multiple styles of collaboration.
An MR imaging method for simultaneous measurement of gaseous diffusion constant and longitudinal relaxation time.

Abstract A magnetic resonance imaging method for simultaneous and accurate determination of gaseous diffusion constant and longitudinal relaxation time is presented. The method is based on direct observation of diffusive motion. Initially, a slice-selective saturation of helium-3 (3He) spins was performed on a 3He/O2 phantom (9 atm/ 2 atm). A time-delay interval was introduced after saturation, allowing spins to diffuse in and out of the labeled slice. Following the delay interval a one-dimensional (1-D) projection image of the phantom was acquired. A series of 21 images was collected, each subsequent image having been acquired with an increased delay interval. Gradual spreading of the slice boundaries due to diffusion was thus observed. The projection profiles were fit to a solution of the Bloch equation corrected for diffusive motion. The fitting procedure yielded a value of D3He = 0.1562 ± 0.0013 cm2/s, in good agreement with a measurement obtained with a modified version of the standard pulsed-field gradient technique. The method also enabled us to accurately measure the longitudinal relaxation of 3He spins by fitting the change of the total area under the projection profiles to an exponential. A value of T1 = 1.67 s (2 T field) was recorded, in excellent agreement with an inversion recovery measurement.
Significance of site of origin of premature ventricular contractions.

Abstract One hundred and sixty-five inpatients with premature ventricular contractions (PVC's) were clinically evaluated in regard to the presence (130 patients) or absence (35 patients) of organic heart disease. PVC's were classified based on QRS morphology (bundle branch block pattern) in Lead V 1 as being either left ventricular (66 patients), right ventricular (71 patients), or of both ventricles (28 patients). The incidence of organic heart disease was significantly greater in patients with left ventricualr PVC's 60 of 66 (91 per cent) and biventricular PVC's 25 of 28 (89 per cent) than in patients with right ventricular PVC's 45 of 71 (63 per cent) (p These data suggest the following conclusions regarding inpatients with PVC's: (1) Organic heart disease is frequent in patients with right ventricular PVC's and almost universally present in patients with left ventricular and biventricular PVC's. (2) Patients without organic heart disease primarily have PVC's of right ventricular origin. The mechanism of the latter association is unknown.
US retailers' cooperation with manufacturer promotional support

Promotional support, as a push strategy, that manufacturers use to encourage retailers to carry their products needs retailers' cooperation. This study investigates the effects of retailers' fashion and price orientations on manufacturers' offerings of and retailers' cooperation with promotional support. Twenty‐one promotional support items applicable to the apparel retailing were studied. Questionnaires completed by 137 US apparel retail buyers via a modified national mail survey were analyzed. A factor analysis determined four factors: sales support, ad/display materials, monetary support, and selling aid samples. MANCOVAs revealed that the effects of price orientation on both offering frequency and cooperation level were significant. The effects of fashion orientation were not significant. For sales support and selling aid samples, the differences in offering frequency and cooperation levels were found among the different levels of price orientation groups. Monetary support was found most favorably accepted by retailers, regardless of price orientation or fashion orientation.
Anthropometric Analysis of the Velopharynx and Related Craniometric Dimensions in Three Adult Populations Using MRI.

Objective: The purpose of this study is to examine effects of sex, race, and craniometry among three distinct racial groups of adults with normal velopharyngeal anatomy and to determine whether craniofacial structures could be used to predict velopharyngeal structures. Methods: A total of 88 adults across three racial groups including white, black, and Asian (Japanese) participated. Magnetic resonance images were obtained using a high-resolution, three-dimensional anatomical scan. Measurements were obtained on the levator veli palatini muscle, velum, and craniofacial structures. Results: Head circumference was used as a covariate to control the effect of overall cranial size on the analyses. Palate height, linear cranial base, and face height and width vary based on sex, with men demonstrating larger values compared with women. Linear base values, cranial base angle, and face width vary significantly based on race, with Japanese subjects showing the smallest anterior to posterior measures and larger f...
Gold(I)-catalyzed Claisen rearrangement of allenyl vinyl ethers: missing transition states revealed through evolution of aromaticity, Au(I) as an oxophilic Lewis acid, and lower energy barriers from a high energy complex.

Curtin–Hammett analysis of four alternative mechanisms of the gold(I)-catalyzed [3,3] sigmatropic rearrangement of allenyl vinyl ethers by density functional theory calculations reveals that the lowest energy pathway (cation-accelerated oxonia Claisen rearrangement) originates from the second most stable of the four Au(I)-substrate complexes in which gold(I) coordinates to the lone pair of oxygen. This pathway proceeds via a dissociative transition state where the C–O bond cleavage precedes C1–C6 bond formation. The alternative Au(I) coordination at the vinyl π-system produces a more stable but less reactive complex. The two least stable modes of coordination at the allenyl π-system display reactivity that is intermediate between that of the Au(I)–oxygen and the Au(I)–vinyl ether complexes. The unusual electronic features of the four potential energy surfaces (PESs) associated with the four possible mechanisms were probed with intrinsic reaction coordinate calculations in conjunction with nucleus independ...
Analysis of Transient Coolant Void Formation During a Guillotine-Type HX Tube Rupture Event in the STAR-LM System Employing a Supercritical CO2 Brayton Cycle

One proposed concept for the STAR-LM Lead Fast Reactor (LFR) incorporates a supercritical CO2 gas turbine Brayton cycle to achieve high cycle efficiency and reduced plant footprint. In this design, 100+% of core full power is transferred by natural circulation from the core, located at the bottom of the reactor vessel, to in-vessel heat exchangers (HXs) located at the top of the vessel in the annulus between the core shroud and vessel inner wall. Although this approach extremely simplifies the plant design, the presence of the HX’s within the vessel raises concerns regarding the potential rupture of a HX tube that would initiate a high-pressure blowdown of CO2 into the lead coolant. The principal issue is to what extent, if any, is void entrained downwards with the coolant and then upwards through the core where adverse reactivity effects or degraded heat removal could result. To address this question, a scoping analysis of transient void formation during a guillotine-type HX tube rupture event in the STAR-LM employing a supercritical CO2 Brayton cycle has been performed. The void formation process is evaluated by solving a coupled set of ordinary differential equations describing: i) the supercritical CO2 blowdown, ii) bubble center-of-mass trajectory, iii) bubble growth rate, iv) bubble gas internal energy, and v) discrete bubble formation rate due to Taylor instability at the bubble/coolant interface. The results indicate that for thermal hydraulic conditions consistent with the current STAR-LM design, the peak blowdown rate from a single tube rupture is ∼ 2.5 kg/sec. The void formation process is dominated by large coherent gas bubbles that penetrate minimally downwards into the coolant due to the large coolant density. Rather, the gas pockets are predicted to periodically rise due to buoyancy and vent to the core cover gas region, as opposed to being swept downwards with the coolant. Moreover, the total CO2 fraction that is rendered in the form of discrete bubbles during blowdown is found to be small (∼ 3%), and the bubbles are of fairly large diameter (≥ 0.7 cm). Thus, these discrete bubbles are also calculated to benignly rise to the cover gas region since the terminal rise velocity for the bubbles exceeds the average lead coolant down flow velocity below the HX.Copyright © 2004 by ASME
Regional alterations in rat brain neurotransmitter systems following chronic lithium treatment.

: Chronic, but not acute, consumption of lithium leads to a significant decrease in serotonin and GABA receptor binding in selected regions of the rat brain, with no changes noted in P-adrenergic or cholinergic muscarinic receptor binding. In addition, the concentration of β-methoxytyramine, a dopamine metabolite, in the corpus striatum was increased in the animals treated chronically with lithium, suggesting a possible enhancement in dopamine release, or inhibition of uptake, in this brain area. In contrast, chronic consumption of rubidium had no effect on any of the parameters studied. The results suggest that lithium administration causes selective changes in brain neurotransmitter receptor systems and that the net result of these changes may be a decrease in GABAergic and serotoninergic activity. The fact that these alterktions are noted only after chronic administration suggests that they may be related to the therapeutic action of lithium in the prophylactic treatment of recurrent manic- depressive psychosis.
Ice releasing block-copolymer coatings

The ice releasing characteristics of a series of polydimethylsiloxane-polycarbonate block-copolymers films have been investigated. The abhesion is not only a function of the hydrophobic nature of the surface of the films but is also dpendent of the polysiloxane content, its block chain length and the glass temperature of the polymer, i. e. it is dependent on the rheological properties of the films telative to ice. Addition of some silicone oil to the films only improves the abhesion of the optimum block-copolymers which have a suitable polydimethylsiloxane composition. The oil acts as plasticizer and lubricant. Attenuated infrared reflectance measurements show that the polydimethylsiloxane blocks lie preferentially in the polymer/air interface, i. e. the methyl groups are located uppermost.
Perspectives on self-scaling variable metric algorithms

Recent attempts to assess the performance of SSVM algorithms for unconstrained minimization problems differ in their evaluations from earlier assessments. Nevertheless, the new experiments confirm earlier observations that, on certain types of problems, the SSVM algorithms are far superior to other variable metric methods. This paper presents a critical review of these recent assessments and discusses some current interpretations advanced to explain the behavior of SSVM methods. The paper examines the new empirical results, in light of the original self-scaling theory, and introduces a new interpretation of these methods based on anL-function model of the objective function. This interpretation sheds new light on the performance characteristics of the SSVM methods, which contributes to the understanding of their behavior and helps in characterizing classes of problems which can benefit from the self-scaling approach.