cssi/SciSciGPT-SciSciNet huggingface dataset:
Application of the International Classification of Functioning, Disability and Health system to symptoms of the Duchenne and Becker muscular dystrophies.

AbstractPurpose: Duchenne and Becker muscular dystrophies, collectively referred to as dystrophinopathies, are X-linked recessive diseases that affect dystrophin production resulting in compromised muscle function across multiple systems. The International Classification of Functioning, Disability and Health provides a systematic classification scheme from which body functions affected by a dystrophinopathy can be identified and used to examine functional health.Materials and methods: The infrastructure of the Muscular Dystrophy Surveillance, Tracking, and Research Network was used to identify commonly affected body functions and link selected functions to clinical surveillance data collected through medical record abstraction.Results: Seventy-one (24 second-, 41 third- and 7 fourth-level) body function categories were selected via clinician review and consensus. Of these, 15 of 24 retained second-level categories were linked to data elements from the Muscular Dystrophy Surveillance, Tracking, and Researc...
On passing an open access policy at Florida State University: From outreach to implementation

In February 2016, the Florida State University (FSU) Faculty Senate passed an institutional Open Access (OA) Policy by unanimous vote, 1 following the lead of many public and private universities across the United States. This was the culmination of many years of outreach and advocacy by OA champions at FSU, with a diverse, talented team of faculty and librarians making significant contributions along the way. This was also just one instance of a growing trend across North America and globally, with impressive growth in the number of OA policies and mandates adopted by research organizations and funders over the past decade. The adoption of an OA policy still presents many challenges with respect to policy compliance, 2 and there are open questions about the long-term impact of different OA policy requirements and implementation models. 3 At the same time, OA policy adoption remains an important goal for many institutions, a symbolic affirmation of faculty support for the principles of OA. An OA policy can help an institution raise the profile of its institutional repository (IR), invigorate outreach efforts and content recruitment, and, in the case of Harvard Model policies, safeguard the author rights of its faculty. 4
Definitions, Epidemiology and Prognostication of Liver Disease

Patients presenting to the intensive care unit with liver failure may be categorized into two main subtypes, those with acute liver failure and those with complications of chronic liver diseases, the former being a rare condition and the latter far more common. In both categories, patients presenting with liver failure have phenotypical features of multi-system failure, a deranged inflammatory response, and pose unique challenges for management in the intensive care unit. Differentiating acute liver failure from the liver failure associated with chronic liver disease is of critical diagnostic importance, as management strategies are distinctly different. The purpose of this chapter is to review the definitions of liver failure, the epidemiology of liver disease, and current tools to aid in prognosis of liver failure.
Almost Everywhere Convergence and SLLN Under Rearrangements

The almost everywhere (a.e.) convergence of trigonometric Fourier series for L 2(0, 1) functions was conjectured by Luzin (1922) and was partially solved by Kolmogorov and Silvestrov in (1925). The full solution was given by Carleson (1966). In the work of Garsia (1964), (see Garsia (1970)) almost everywhere convergence of a rearrangement of series of orthogonal functions was initiated using the so-called Garsia Inequality (GI). His convergence result was generalized by Nikishin (1967) who removed the assumption of orthogonality. We prove an inequality which generalizes GI using the technique introduced in Chobanyan (1990) (for other references see Chobanyan (1994)). As a consequence of this inequality we derive GI and a generalization of Nikishin’s result to a series of Banach space valued random variables.
Design, implementation, and evaluation of an intervention to improve referral to smoking cessation services in breast cancer patients.

Smoking is a risk factor for poor outcomes following breast reconstructive surgery. This project aimed to design and implement an intervention to consistently refer all breast cancer patients to tobacco treatment services. In formative work, a set of processes for providers to consistently refer patients to a tobacco treatment specialist at the Nicotine Dependence Center (NDC) was designed. Elements included consistent documentation of smoking status, provider advice specific to the benefits of quitting to cancer care, referral to NDC using an “opt-out” strategy that emphasized smoking cessation as a standard part of breast cancer treatment, and reinforcement of the importance of the referral by multiple personnel. The number of referrals to the NDC and number of patients who attended their scheduled NDC appointment were measured before and 1 year after implementation. Qualitative evaluation was performed using semi-structured interviews with participating providers and patients regarding acceptability. The proportion of smoking patients referred to the NDC increased from 29% (22/75) before the intervention to 74% (20/27) afterward. Among those referred, attendance at the consultation increased from 41% (9/22) to 75% (15/20). This occurred despite provider interviews revealing knowledge gaps about the referral process and evidence of provider adaptation to accommodate personal practice. Feasibility and acceptability of the intervention were high. These findings suggest that similar referral interventions for all cancer patients should be pursued with the aim of embedding tobacco dependence treatment seamlessly and consistently into the cancer treatment plan of every patient who smokes cigarettes.
Examining neurocognitive performance and heading in interscholastic female football players over their playing careers

The purpose of this study was to examine the effect of purposeful heading in football on measures of cognitive function in a large cohort of female interscholastic football players over the course ...
Expanding the Instrumentarium

The AO Instrumentarium was subjected to a continuous improvement cycle over the first 20 years of its use. The driving force of this continuous development was the AOTK, its Technical Commission, where all important decisions concerning the Instrumentarium and surgical methods were made. However, in parallel, there was important work taking place at the AO Research Center in Davos that, at times, was supporting the practice, while at other times also generated improvements in implants as a result of new scientific insights.
Evaluating the Effects of Fibrinogen αC Mutations on the Ability of Factor XIII to Crosslink the Reactive αC Glutamines (Q237, Q328, Q366).

Fibrinogen (Fbg) levels and extent of fibrin polymerization have been associated with various pathological conditions such as cardiovascular disease, arteriosclerosis, and coagulation disorders. Activated factor XIII (FXIIIa) introduces γ-glutamyl-e-lysinyl isopeptide bonds between reactive glutamines and lysines in the fibrin network to form a blood clot resistant to fibrinolysis. FXIIIa crosslinks the γ-chains and at multiple sites in the αC region of Fbg. Fbg αC contains a FXIII binding site involving αC (389-402) that is located near three glutamines whose reactivities rank Q237 >> Q366 ≈ Q328. Mass spectrometry and two-dimensional heteronuclear single-quantum correlation nuclear magnetic resonance assays were used to probe the anchoring role that αC E396 may play in controlling FXIII function and characterize the effects of Q237 on the reactivities of Q328 and Q366. Studies with αC (233-425) revealed that the E396A mutation does not prevent the transglutaminase function of FXIII A2 or A2B2. Other residues must play a compensatory role in targeting FXIII to αC. Unlike full Fbg, Fbg αC (233-425) did not promote thrombin cleavage of FXIII, an event contributing to activation. With the αC (233-425) E396A mutant, Q237 exhibited slower reactivities compared with αC wild-type (WT) consistent with difficulties in directing this N-terminal segment toward an anchored FXIII interacting at a weaker binding region. Q328 and Q366 became less reactive when Q237 was replaced with inactive N237. Q237 crosslinking is proposed to promote targeting of Q328 and Q366 to the FXIII active site. FXIII thus uses Fbg αC anchoring sites and distinct Q environments to regulate substrate specificity.
Efficient, divergence-free, high-order MHD on 3D spherical meshes with optimal geodesic meshing

There is a great need in several areas of astrophysics and space-physics to carry out high order of accuracy, divergence-free MHD simulations on spherical meshes. This requires us to pay careful attention to the interplay between mesh quality and numerical algorithms. Methods have been designed that fundamentally integrate high order isoparametric mappings with the other high accuracy algorithms that are needed for divergence-free MHD simulations on geodesic meshes. The goal of this paper is to document such algorithms that are implemented in the geodesic mesh version of the RIEMANN code. The fluid variables are reconstructed using a special kind of WENO-AO algorithm that integrates the mesh geometry into the reconstruction process from the ground-up. A novel divergence-free reconstruction strategy for the magnetic field that performs efficiently at all orders, even on isoparametrically mapped meshes, is then presented. The MHD equations are evolved in space and time using a novel ADER predictor algorithm that is efficiently adapted to the isoparametrically mapped geometry. The application of one-dimensional and multidimensional Riemann solvers at suitable locations on the mesh then provides the corrector step. The corrector step for the magnetic field uses a Yee-type staggering of magnetic fields. This results in a scheme with divergence-free update for the magnetic field. The use of ADER enables a one-step update which only requires one messaging operation per complete timestep. This is very beneficial for parallel processing. Several accuracy tests are presented as are stringent test problems. PetaScale performance is also demonstrated on the largest available supercomputers.
Retrospective analysis of eFAST ultrasounds performed on trauma activations at an academic level-1 trauma center.

Background Point-of-care ultrasound (POCUS) has become increasingly integrated into the practice of emergency medicine. A common application is the extended focused assessment with sonography in trauma (eFAST) exam. The American College of Emergency Physicians has guidelines regarding the scope of ultrasound in the emergency department and the appropriate documentation. The objective of this study was to conduct a review of performed, documented and billed eFAST ultrasounds on trauma activation patients. Methods This was a retrospective review of all trauma activation patients during a 10-month period at an academic level-one trauma center. A list comparing all trauma activations was cross-referenced with a list of all billed eFAST scans. Medical records were reviewed to determine whether an eFAST was indicated, performed, and appropriately documented. Results We found that 1,507 of 1,597 trauma patients had indications for eFAST, but 396 (27%) of these patients did not have a billed eFAST. Of these 396 patients, 87 (22%) had documentation in the provider note that an eFAST was performed but there was no separate procedure note. The remaining 309 (78%) did not have any documentation of the eFAST in the patient's chart although an eFAST was recorded and reviewed during ultrasound quality assurance. Conclusion A significant proportion of trauma patients had eFAST exams performed but were not documented or billed. Lack of documentation was multifactorial. Emergency ultrasound programs require appropriate reimbursement to support training, credentialing, equipment, quality assurance, and device maintenance. Our study demonstrates a significant absence of adequate documentation leading to potential revenue loss for an emergency ultrasound program.
Willingness to ride and perceptions of autonomous public transit

Abstract Autonomous vehicles (AVs) hold great promise to contribute to global sustainability by expanding access to mobility. The introduction of autonomous buses and shuttles could be a turning point for public mobility in the USA, but how autonomous public transit is perceived remains largely unknown. To fill this gap, this study analyzes the willingness to use autonomous buses and shuttles based on two surveys conducted in Michigan. These surveys were a phone-based random-sampling survey of the general public and an on-board intercept survey of public transit riders. We found that autonomous buses might increase willingness to use public transit. 15% of people, who occasionally ride or do not ride public transit, embrace the idea of using autonomous bus service, while fixed-route riders were more likely to accept AVs than demand-response transit riders. However, about half of the public transit riders were hesitant about riding in autonomous buses citing concerns over safety, no human, and distrust in technology. Willingness to ride was higher among younger males than it was for females, seniors, and people with mobility disabilities. In addition, our data suggests that riders’ satisfaction with their drivers - be it skill, professionalism, or friendliness - had no impact on willingness to ride in AVs. As AVs become ready for deployment, policymakers and public transportation service providers should consider AV acceptance among vulnerable individuals to bring AV benefits to all.
TRIPS in the Field of Copyright

This chapter reviews the copyright law-specific contributions of TRIPS, including its substantive copyright law provisions and the interpretations that WTO panel reports have provided for some of the provisions. The chapter further explores how copyright law has developed outside of TRIPS; it focuses on international copyright law negotiations that resulted in the conclusion of WIPO treaties and on other international negotiations that led to the conclusion of numerous free trade agreements. Finally, the chapter offers an outlook on the current copyright law landscape; it presents the structural and substantive issues that have arisen in the landscape since the TRIPS negotiations and suggests the paths that international copyright law might take in the future.
Cognitive fusion potentiates the effect of maladaptive posttraumatic cognitions on posttraumatic stress symptoms

Abstract Maladaptive posttraumatic cognitions are considered an important factor in conceptualizing posttraumatic stress disorder (PTSD). Specifically, negative beliefs about self, the world, and self-blame regarding the traumatic event are all associated with more severe PTSD symptoms and are targets of cognitive treatments of PTSD (e.g., cognitive processing therapy). However, there may be important, related psychological constructs to consider when examining the relationship between maladaptive posttraumatic cognitions and PTSD. Cognitive fusion, or the entanglement with one's thoughts such that they are interpreted literally, may be one such construct. The current study examined the moderating role of cognitive fusion on the relationship between maladaptive posttraumatic cognitions (i.e., negative beliefs about self, world, and self-blame) and posttraumatic stress (PTS) symptoms in a trauma-exposed sample of community adults (N = 812). Hierarchical regression with simple slopes analysis was used to assess four proposed interactions. The only difference between models is that a different posttraumatic cognition variable served as the predictor variable in each model (i.e., using a posttraumatic cognitions total score and also examining the three domain-specific factors). Results indicated that cognitive fusion moderated the relationship between maladaptive posttraumatic cognitions (i.e., the total score and two of three domain-specific factors) and PTS such that the deleterious relationship between maladaptive posttraumatic cognitions and PTS symptoms was stronger for those who were more highly fused to their cognitions.
Differences in Medical Expenditures for Men and Women with Diabetes in the Medical Expenditure Panel Survey, 2008-2016.

Abstract Background: Evidence suggests that women have increased health care costs; however, little is known about expenditures for women with diabetes compared with men with diabetes. The objectiv...
Association of basophil to lymphocyte ratio (BLR) with clinical outcomes in metastatic hormone sensitive prostate cancer.

e17049Background: There is limited biomarker data available for metastatic hormone sensitive prostate cancer (mHSPC). Inflammatory markers found on routine clinical lab data, including leukocyte to...
Higher Ultra-Processed Food Consumption Is Associated with Increased Risk of Incident Coronary Artery Disease in the Atherosclerosis Risk in Communities Study.

Background Higher ultra-processed food intake has been linked with several cardiometabolic and cardiovascular diseases. However, prospective evidence from US populations remains scarce. Objectives To test the hypothesis that higher intake of ultra-processed foods is associated with higher risk of coronary artery disease. Methods A total of 13,548 adults aged 45-65 y from the Atherosclerosis Risk in Communities study were included in the analytic sample. Dietary intake data were collected through a 66-item FFQ. Ultra-processed foods were defined using the NOVA classification, and the level of intake (servings/d) was calculated for each participant and divided into quartiles. We used Cox proportional hazards models and restricted cubic splines to assess the association between quartiles of ultra-processed food intake and incident coronary artery disease. Results There were 2006 incident coronary artery disease cases documented over a median follow-up of 27 y. Incidence rates were higher in the highest quartile of ultra-processed food intake (70.8 per 10,000 person-y; 95% CI: 65.1, 77.1) compared with the lowest quartile (59.3 per 10,000 person-y; 95% CI: 54.1, 65.0). Participants in the highest compared with lowest quartile of ultra-processed food intake had a 19% higher risk of coronary artery disease (HR: 1.19; 95% CI: 1.05, 1.35) after adjusting for sociodemographic factors and health behaviors. An approximately linear relation was observed between ultra-processed food intake and risk of coronary artery disease. Conclusions Higher ultra-processed food intake was associated with a higher risk of coronary artery disease among middle-aged US adults. Further prospective studies are needed to confirm these findings and to investigate the mechanisms by which ultra-processed foods may affect health.
Reflections on and Implications of Systems Analysis as a Sociological Phenomenon

How we became Pooh-Bears, how this has affected life in the latter half of the twentieth century, how this could shape the future — these are matters of sociological interest, for systems analysis, its components and derivatives, are, in essence, a sociological phenomenon reflecting our Zeitgeist. In T.S. Rutin’s terminology, they constitute our “dominant paradigm”.2 In order to ascertain how this came about, we must understand the attribution and continual re-attribution as well as the social process through which re-affirmation of the methodology has occurred. Important, and demanding review in the social context, are the essential elements of the methodology, especially as they emerge in and impinge on present and future planning. Finally, we must consider the social consequences of the continued domination of this technical paradigm.
Radial pn junction nanorod solar cells: device physics principles and routes to fabrication in silicon

We have developed quantitative device-physics models for a radial pn junction nanorod solar cell, that is, a cell which consists of densely packed nanorods attached to a conducting substrate, each nanorod with a pn junction in the radial direction. It is found that this novel design shows large improvements over the planar geometry so long as two conditions are satisfied: a) a planar solar cell made from the same material is collection limited, i.e. the diffusion length of minority carriers is too low to allow for collection of most or all of the light-generated carriers in the conventional planar geometry, and b) recombination in the depletion region is not too high, or, equivalently, the lifetime of carriers in the depletion region is not too short. In order to experimentally validate this concept, the vapor-liquid-solid (VLS) growth of silicon (Si) nanorods has been explored using metal catalyst particles that are not as deleterious to the minority carrier lifetime of Si as gold (Au), the most commonly used wire growth catalyst.
Blood bilirubin in ectopic pregnancy

Abstract 1. 1. There is probably a local formation of bilirubin from hemoglobin in the hemorrhagic extravasations of some cases of ectopic pregnancy. 2. 2. It has not been determined how quickly this bilirubin is formed, or how rapidly it is absorbed. 3. 3. The normal liver promptly removes any excess of bilirubin from the circulating blood, by excreting it into the biliary passages. 4. 4. In cases of ruptured ectopic pregnancy, icterus may be simulated because of the anemia. 5. 5. Hyperbilirubinemia, in the absence of biliary, hepatic, or hemolytic disease, is not infrequent. 6. 6. Blood bilirubin values are no different in ectopic pregnancy cases than in other gynecologic patients.
An abstract theory for the domain reduction method

The domain reduction method uses a finite group of symmetries of a system of linear equations arising by discretization of partial differential equations to obtain a decomposition into independent subproblems, which can be solved in parallel. This paper develops a theory for this class of methods based on known results from group representation theory and algebras of finite groups. The main theoretical result is that if the problem splits into subproblems based on isomorphic subdomains, then the group of symmetries must be commutative. General decompositions are then obtained by nesting decompositions based on commutative groups of symmetries.
Abstract W MP36: The Phenomenon of Delayed Pipeline Embolization Device Migration: Technical Considerations, Complication Avoidance, and Management.

Introduction: The Pipeline Embolization Device (PED) is a dedicated flow diverter designed to treat intracranial aneurysms. New safety concerns are emerging as neurointerventionalists accumulate experience with the device. In this study, we describe the phenomenon of spontaneous delayed migration of the PED and discuss important technical considerations for prevention and management of this complication. Methods: A total of 155 patients were treated with the PED at our institution from November 2010 to January 2013. Patients who had spontaneous delayed migration of their devices during the study period were prospectively identified. Results: Five patients (3.2%) were found to have spontaneous delayed migration of their PEDs. All 5 cases occurred late during the study period (second half of the cohort). The PED migrated proximally in 4 patients and distally in 1 patient. The migration distance was 11 mm on average (range, 5-20 mm). Mismatch in arterial diameter between inflow and outflow vessels was a cons...
Insights into the pharmacological relevance of lysophospholipid receptors

The discovery of lysophospholipid (LP) 7-transmembrane, G protein-coupled receptors (GPCRs) that began in the 1990s, together with research into the functional roles of the major LPs known as lysophosphatidic acid (LPA) and sphingosine 1-phosphate (S1P), have opened new research avenues into their biological processes and mechanisms. Major examples of LP signalling effects include embryogenesis, nervous system development, vascular development, uterine implantation, immune cell trafficking, and inflammatory reactions. LP signalling also influences the pathophysiology of many diseases including cancer, autoimmune and inflammatory diseases, which indicate that LP receptors may be attractive targets for pharmacological therapies. A key example of such a therapeutic agent is the S1P receptor modulator FTY720, which upon phosphorylation and continued drug exposure, acts as an S1P receptor functional antagonist. This compound (also known as fingolimod or Gilenya) has recently been approved by the FDA for the treatment of relapsing forms of multiple sclerosis. Continued basic and translational research on LP signalling should provide novel insights into both basic biological mechanisms, as well as novel therapeutic approaches to combat a range of human diseases.
Mixed-bundling auctions with reserve prices

Revenue maximization in multi-item settings is notoriously elusive. This paper studies a class of two-item auctions which we call a mixed-bundling auction with reserve prices (MBARP). It calls VCG on an enlarged set of agents by adding the seller---who has reserve valuations for each bundle of items---and a fake agent who receives nothing nor has valuations for any item or bundle, but has a valuation for pure bundling allocations, i.e., allocations where the two items are allocated to a single agent. This is a strict subclass of several known classes of auctions, including the affine maximizer auction (AMA), λ-aution, and the virtual valuations combinatorial auction (VVCA). As we show, a striking feature of MBARP is that its revenue can be represented in a simple closed form as a function of the parameters. Thus, we can solve first-order conditions on the parameters and obtain the optimal MBARP. The optimal MBARP yields significantly higher revenue than prior auctions for which the revenue-maximizing parameters could be solved for in closed form: separate Myerson auctions, pure-bundling Myerson auction, VCG, and mixed-bundling auction without reserve prices. Its revenue even exceeds that obtained via simulation within broader classes: VVCA and AMA.
Blood and blood substitutes for treating hemorragic shock

Blood substitute products for the treatment of hemorrhagic shock are discussed with regard to their composition, physical and therapeutic characteristics, adverse effects, cost, and market availability. Commercially available plasma expanders discussed include blood derivatives (whole blood, packed red blood cells, plasma, normal human serum albumin, and plasma protein fraction), synthetic colloids (dextrans 40 and 70) and a balanced salt solution (lactated Ringer's injection). Plasma substitutes alone are administered until the hematocrit falls below 30% of coagulation difficulties develop. Normal serum albumin 5% and plasma protein fraction 5% are excellent colloidal plasma expanders without the potential hazard of hepatitis. Lactated Ringer's injection is the fluid of choice to replace lost blood up to 10% of the vascular volume.
Automatic recognition and assignment of missile pieces in clutter

The ability to discriminate a reentry vehicle (RV) from booster parts and other debris is critical to theater ballistic missile defense (TBMD). As it travels along its trajectory, a threat missile separates into a reentry vehicle (RV) and clutter. The latter consists of several tanks, separation debris and fragments of hot fuel. Interception of the RV requires discrimination of the RV from the clutter. The required discrimination must be performed no later than 30 seconds before intercept. A time-delay neural network (TDNN) is proposed for discrimination of the RV from other missile parts debris. The rate of change of the IR signature over several seconds is used as a discriminant. The performances of two different approaches are compared: 1) A TDNN that employs backpropagation weight updates is used to calculate activation levels for output nodes. The RV is selected via winner-take-all. A TDNN that updates weights using a cross-entropy error function with a softmax activation function is used to estimate assignment probabilities. The RV is subsequently selected via a probabilistic assignment algorithm that imposes the constraint that there can only be a single RV. We found that the TDNN employing backpropagated softmax learning performed better than the TDNN employing backpropagated least mean square learning.
Magnetic and optical properties of Ga1−xMnxN grown by metalorganic chemical vapour deposition

Epitaxial layers of Ga1−xMnxN with concentrations of up to x = 0.015 have been grown on c-sapphire substrates by metalorganic chemical vapour deposition. No ferromagnetic second phases were detected via high-resolution x-ray diffraction. Crystalline quality and surface structure were measured by x-ray diffraction and atomic force microscopy, respectively. No significant deterioration in crystal quality and no increase in surface roughness with the incorporation of Mn were detected. Optical measurements show a broad emission band attributed to a Mn-related transition at 3.0 eV that is not seen in the underlying GaN virtual substrate layers. Room temperature ferromagnetic hysteresis has been observed in these samples, which may be due to either Mn-clustering on the atomic scale or the Ga1−xMnxN bulk alloy.
SCHOOLS OF EXCELLENCE AND EQUITY? USING EQUITY AUDITS AS A TOOL TO EXPOSE A FLAWED SYSTEM OF RECOGNITION

The purpose of this article is to demonstrate how equity audits can be used as a tool to expose disparate achievement in schools that, on the surface and to the public, appear quite similar. To that end, the researcher probed beyond surface-level performance composite scores into deeper, more hidden data associated with state-recognized "Honor Schools of Excellence." How is "excellence" defined and operationalized in these schools? Are these schools "excellent" for all students? Can a school really be classified by the state as "excellent" and yet still have significant "gaps" and disparities? If so, is the state's formula used to identify exemplary schools too simple, dogmatic, and institutionally flawed? Through the use of equity audits, quantitative data was collected to scan for systemic patterns of equity and inequity across multiple domains of student learning and activities within 24 elementary schools. The intent was to document and distinguish between schools that are promoting and supporting both academic excellence (small gap schools; SGS) and systemic equity and schools that are not (large gap schools; LGS). Results reveal that although demographic, teacher quality, and programmatic audits all indicated a fair amount of equity between SGS and LGS, the achievement audit between both types of schools indicated great disparities. By controlling for or eliminating some of the external variables and internal factors often cited for the achievement gaps between white middle-class children and children of color or children from low-income families, the findings from this study raise more questions than answers. Results do indicate that equity audits are a practical, easy-to-apply tool that educators can use to identify inequalities objectively.
Adjustments in energy expenditure and substrate utilization during late pregnancy and lactation

Background Metabolic adjustments occur during pregnancy and lactation to support fetal growth and milk synthesis; however, the effect of body composition and hormonal milieu on these changes is poorly understood. Objective We hypothesized that energy metabolism changes during pregnancy and lactation to support fetal growth and milk synthesis, and that body composition and hormonal milieu influence these alterations. Design We measured energy expenditure, body composition, and hormone, metabolite, and catecholamine concentrations in 76 women (40 lactating, 36 nonlactating) at 37 wk gestation and 3 and 6 mo postpartum. Total energy expenditure (TEE), basal metabolic rate (BMR), sleeping metabolic rate (SMR), and minimal SMR (MSMR) were measured with room calorimetry. Fat-free mass (FFM) and fat mass were estimated with a 4-component model. Results TEE, BMR, SMR, and MSMR were 15-26% higher during pregnancy than postpartum after being adjusted for FFM, fat mass, and energy balance. TEE, SMR, and MSMR were higher in lactating than in nonlactating women. Fasting serum insulin, insulin-like growth factor I, fatty acids, and leptin, and 24-h urinary free norepinephrine, epinephrine, and dopamine correlated positively with TEE, BMR, SMR, and MSMR. In nonlactating women, the respiratory quotient decreased over time, carbohydrate oxidation decreased, and fat oxidation increased. Substrate utilization was not influenced by body composition, fasting serum hormones, or 24-h urinary catecholamines. Conclusions These results indicate increased energy expenditure and preferential use of carbohydrates during pregnancy and lactation. Elevated respiratory quotient and carbohydrate utilization during pregnancy continue during lactation, consistent with preferential use of glucose by the fetus and mammary gland.
Gay Gifted Adolescent Suicide and Suicidal Ideation Literature Research Barriers and Limitations

Little empirical research has been conducted regarding suicide and suicidal ideation about gay gifted adolescents, so most of what is presented in the literature is based on theories and assumption...
The Bayesian Approach to Causality Assessment: An Introduction

This paper outlines an approach to causality assessment that is based on the logic of uncertainty, Bayesian probability theory. The goal of causality assessment is taken to be the calculation of the posterior odds in favor of drug causation, given all available background and case information. There are two stages to the Bayesian approach: collecting the facts and evaluating the evidence. The evaluation proceeds by a series of probability assessments that decompose the overall causality assessment into a series of component evaluations, each of which focuses on one factor or source of information. The solutions to these component problems are then combined according to the rules of probability theory to give a solution to the overall causality assessment.
Use of multiple CT scans to accommodate large objects and stretch dynamic range of detectability

Rotate-only X-ray CT scanners are preferred for their speed and dose utilization, but suffer from the restriction that the scanned object must fit within the radiation beam. In addition, the ratio of signals unattenuated by air paths to those penetrating thick, dense objects often exceeds the dynamic range of conventional X-ray detectors. Both of these disadvantages can be removed for objects larger than the X-ray beam by taking multiple scans, each of which exposes only part of the object. These partial data sets can then be merged to produce a complete data set. For most objects, it is also possible to separately expose regions in which the ratios between the extremes of attenuation are much lower than that between air and the maximum path length. It is therefore possible to use a higher flux to image denser regions, improving signal-to-noise ratios and yielding images superior to those of larger scanners having the same dynamic range,
Patients with bladder and lung cancer: a long‐term outcome analysis

OBJECTIVES To report on patient characteristics, stage of disease and long-term outcome and prognosis of patients with dual bladder and lung cancers, as there is an established increased risk of smoking-related second primary cancers, especially lung cancer, developing in patients with bladder cancer. PATIENTS AND METHODS We reviewed our hospital tumour registry database from 1990 to 2002, and identified 27 patients who had both bladder and lung cancers among 1038 with bladder cancer and 2427 with lung cancer. Seventeen patients had bladder cancer detected before lung cancer (group 1), and the remaining 10 had lung cancer diagnosed first (group 2). RESULTS Group 1 and 2 were comparable in terms of patients’ characteristics, mean interval between cancer detection and their use of tobacco. Group 1 patients had a tendency towards more invasive lung cancer at diagnosis than had group 2 patients (11/17 vs 2/10 stage ≥ IIB, respectively; P = 0.082). The mean follow-up was 49.8 and 64.5 months for groups 1 and 2, respectively (not significant). The mean (sd) interval to death from the date of diagnosis of lung cancer was 18 (17) months for group 1 and 65 (42) months for group 2 (P < 0.05). CONCLUSIONS Patients with bladder and lung cancer who have lung cancer detected first have a lower lung cancer stage and higher overall survival rate than patients diagnosed with bladder cancer first.
Exciton-polariton mediated universal quantum computing

We propose a scheme for universal quantum computation with electron spin qubits. The scheme requires electrical control and manipulation of single spin qubit, along with exciton-polariton mediated two-qubit operation and single shot quantum non-demolition (QND) readout.
Fat hormones pull their weight in the CNS.

Fat cells secrete the hormone adiponectin, which regulates glucose metabolism through actions on peripheral tissues. It is now apparent that adiponectin also acts on the brain to reduce body weight and improve glucose metabolism ( pages 524–529 ).
Chloride Masks Effects of Opposing Positive Charges in Hb A and Hb Hinsdale (β139 Asn → Lys) that can Modulate Cooperativity as well as Oxygen Affinity

Abstract In the human hemoglobin variant Hb Hinsdale, lysine is substituted for asparagine at position β139 (H17), which lies in the water-filled cavity that runs through the center of the molecule. This substitution adds two extra cationic residues to the excess of four cationic residues normally lining this cavity. Moo-Penn and colleagues who discovered this hemoglobin, found its oxygen affinity in 0·5 M bis-Tris buffer to be lower than that Hb A. Their finding conflicted with our prediction that additional cationic groups lining the central cavity would destabilize the T-structure by increased electrostatic repulsion and thereby increase the oxygen affinity. We have, therefore, remeasured the ligand-binding properties of Hb Hinsdale. In chloride-free Hepes buffer, Hb Hinsdale has greatly increased oxygen affinity and lower cooperativity than Hb A. A comparison of the properties of Hb A, Hb Hinsdale, Hb Deer Lodge (β2 His→ Arg) and Hb Abruzzo (β143 His→ Arg) in 0·05 M Hepes versus 0·05 M bis-Tris buffers shows that very low chloride concentrations can significantly alter cooperativity as well as oxygen affinity. The apparent conflict between the findings of Moo-Penn and colleagues and our prediction arises from the enhanced chloride effects exhibited by Hb Hinsdale. On going from 0·05 M Hepes to 0·05 M bis-Tris at pH 7·0, log P 50 values for Hb A and Hb Hinsdale are increased by 0·28 and 1·12, respectively. The Bohr effect, the kinetics of oxygen dissociation, the second-order rate constant of CO binding and the rate of CO recombination after flash photolysis were also determined for Hb Hinsdale. The enhanced chloride sensitivity of Hb Hinsdale is consistent with the allosteric mechanism of chloride interactions proposed by Perutz et al. in the accompanying paper.
Pain education at the University of Washington School of Medicine.

Contemporary medical education is inadequate to prepare medical students to competently assess and design care plans for patients with acute and chronic pain. The time devoted to pain education in most medical school curricula is brief and not integrated into case-based clinical experiences, and it is frequently nonexistent during clinical clerkships. Medical student pain curricula have been proposed for over 30 years and are commonly agreed upon, though rarely implemented. As a consequence of poor undergraduate pain education, postgraduate trainees and practicing physicians struggle with both competency and practice satisfaction; their patients are similarly dissatisfied. At the University of Washington School of Medicine, a committee of multidisciplinary pain experts has, between 2009 and 2011, successfully introduced a 4-year integrated pain curriculum that increases required pain education teaching time from 6 to 25 hours, and clinical elective pain courses from 177 to 318 hours. It is expected that increased didactic and case-based multidisciplinary clinical training will increase knowledge and competency in biopsychosocial measurement-based pain narrative and risk assessment, improve understanding of persistent pain as a chronic complex condition, and expand the role of patient-centered interprofessional treatment for medical students, residents, and fellows, leading to better prepared practicing physicians.
POLARIZED EMISSION FROM SiO MASERS IN IK Tauri

We present high spatial and frequency resolution images of the SiO masers in Stokes I, Q, U, and V around the asymptotic giant branch star IK Tau and describe and exploit a new technique for making accurate calibration of Stokes V. This technique also resulted in improved images of Stokes I. An evaluation of the results suggests that the circular polarization is neither the result of Zeeman splitting nor an alternate propagation effect. The pattern of circular and linear polarization across the maser lines shows no tendency toward that expected for simple Zeeman splitting. The fractional circular polarization greatly exceeds that expected from the alternate mechanism. The overall shape of the masing ring has changed from the elliptical form repeatedly observed over the last decade and a half.
Physician versus computer knowledge of potential drug interactions in the emergency department.

. Introduction: Proliferation of Food and Drug Administration—approved drugs makes it impossible for emergency medicine (EM) faculty to stay current on potential interactions between drugs, and with diseases, laboratory tests, and ethanol. A computer database may augment physician knowledge. Objectives: To compare the performance of EM faculty and an “expert” emergency physician (EP) with that of a criterion standard computer database in identifying potential drug interactions, and to report the incidence of drug—ethanol and drug—laboratory test interactions. Methods: This was a retrospective review of 276 emergency department charts for drug, ethanol, lab, and medical history. Evaluation by both EM faculty and an “expert” EP of patient history was done to identify potential interactions, and comparison with the Micromedex Drug-Reax database for potential interactions (graded minor, moderate, or major) was made. Clinical significance of potential interactions was judged by a second EM faculty member. Results: Seventeen percent of the patients had potential drug—drug interactions, and 25% of these were judged to be clinically significant. Up to 52% of the patients had potential drug—ethanol interactions, while 38% of the patients could have potential drug—lab interactions. Sensitivity, specificity, and positive and negative predictive values of the EM faculty for potential drug—drug interactions compared with the computer were poor, at 14%, 58%, 6%, and 23%, respectively. The corresponding values for the “expert” EP were 25%, 86%, 26%, and 85%. The “expert” EP was statistically better than the EM faculty, but still less sensitive and predictive than the computer. Conclusions: A computer can aid the physician in avoiding potential drug interactions. Prospective validation of these findings should be done.
Estimating F-statistics for the analysis of population structure.

This journal frequently contains papers that report values of F-statistics estimated from genetic data collected from several populations. These parameters, FST, FIT, and FIS, were introduced by Wright (1951), and offer a convenient means of summarizing population structure. While there is some disagreement about the interpretation of the quantities, there is considerably more disagreement on the method of evaluating them. Different authors make different assumptions about sample sizes or numbers of populations and handle the difficulties of multiple alleles and unequal sample sizes in different ways. Wright himself, for example, did not consider the effects of finite sample size. The purpose of this discussion is to offer some unity to various estimation formulae and to point out that correlations of genes in structured populations, with which F-statistics are concerned, are expressed very conveniently with a set of parameters treated by Cockerham (1 969, 1973). We start with the parameters and construct appropriate estimators for them, rather than beginning the discussion with various data functions. The extension of Cockerham's work to multiple alleles and loci will be made explicit, and the use of jackknife procedures for estimating variances will be advocated. All of this may be regarded as an extension of a recent treatment of estimating the coancestry coefficient to serve as a mea-
Feasibility of using the national hospital discharge survey to estimate the prevalence of selected birth defects.

BACKGROUND: Nationally representative data on the prevalence of certain birth defects are largely unavailable. We evaluated the feasibility of using data from the National Hospital Discharge Survey (NHDS) to describe the prevalence of selected birth defects. METHODS: All live births recorded in the NHDS during 1999–2001 were included. The prevalence for selected birth defects was calculated using weighted ratio estimators. Prevalence ratios comparing the NHDS estimates to published national estimates from the National Birth Defects Prevention Network (NBDPN) were calculated. RESULTS: With the exception of common truncus, the NHDS prevalence for the selected defects was consistently lower than the NBDPN estimates. The prevalence ratios ranged from 0.38 for trisomy 18 and anopthalmia/micropthalmia to 1.16 for common truncus. The NHDS prevalence estimates for spina bifida without anencephaly (PR 0.89, 95% CI: 0.57–1.22) and gastroschisis/omphalocele (PR 0.94, 95% CF: 0.48–1.40) most closely approximated the NBDPN estimates. CONCLUSIONS: NHDS data underestimate the prevalence of most birth defects. Additional research is needed to determine whether NHDS estimates may be useful for evaluating trends in certain conditions. Surveillance systems employing active case-finding continue to provide more accurate estimates of birth defects prevalence. Birth Defects Research (Part A) 76:757–761, 2006. © 2006 Wiley-Liss, Inc.
Rapid estradiol modulation of neuronal connectivity and its implications for disease.

Estrogens have multiple actions in the brain including modulating synaptic plasticity, connectivity and cognitive behaviours. While the classical view of estrogens are as endocrine signals, whose effects manifest via the regulation of gene transcription, mounting evidence has been presented demonstrating that estrogens have rapid effects within specific areas of the brain. The emergence that 17 β-estradiol can be produced locally in the brain which can elicit rapid (within minutes) cellular responses has led to its classification as a neurosteroid. Moreover, recent studies have also begun to detail the molecular and cellular underpinnings of how 17 β-estradiol can rapidly modulate spiny synapses (dendritic spines). Remodelling of dendritic spines is a key step in the rewiring of neuronal circuitry thought to underlie the processing and storage of information in the forebrain. Conversely, abnormal remodelling of dendritic spines is thought to contribute to a number of psychiatric and neurodevelopmental disorders. Here we review recent molecular and cellular work that offers a potential mechanism of how 17 β-estradiol may modulate synapse structure and function of cortical neurons. This mechanism allows cortical neurons to respond to activity-dependent stimuli with greater efficacy. In turn this form of plasticity may provide an insight into how 17 β-estradiol can modulate the rewiring of neuronal circuits, underlying its ability to influencing cortically based behaviours. We will then go on to discuss the potential role of 17 β-estradiol modulation of neural circuits and its potential relevance for the treatment of psychiatric and neurodevelopmental disorders.