cssi/SciSciGPT-SciSciNet huggingface dataset:
Validation of Smartphone Based Heart Rate Tracking for Remote Treatment of Panic Attacks

Panic attacks are an impairing mental health problem that affects 11% of adults every year [1] . Those who suffer from panic attacks often do not seek psychological treatment, citing the inability to receive care during their attacks as a contributing factor. A digital medicine solution which provides an accessible, real-time mobile health (mHealth) biofeedback intervention for panic attacks may address this problem. Critical to this approach are methods for capturing physiological arousal during an attack. Herein, we validate an algorithm for capturing physiological arousal using smartphone video of the fingertip. Results demonstrate that the algorithm is able to estimate heart rates that are highly correlated with ECG-derived values (r > 0.99), effectively reject low-quality data often captured outside of controlled laboratory environments (AUC > 0.90), and resolve the physiological arousal experienced during a panic attack. Moreover, patient reported measures indicate that this measurement modality is feasible during panic attacks, and the act of taking the measurement may stop the attack. These results point toward the need for future development and clinical evaluation of this mHealth intervention for preventing panic attacks.
An Experimental Apparatus for Two-phase Cooling of High Heat Flux Application using an Impinging Cold Plate and Dielectric Coolant

Increasing heat transfer rates over smaller area and volumetric footprints are a challenge to electronics cooling. Conventional air-based cooling solutions require larger space for heatsink fins and impose challenges on chassis design. Those challenges of air cooling encourage a shift to a more efficient liquid cooling solution. The more efficient heat transfer performance in a small volume is attributed to high specific heat and latent heat associated with a liquid coolant. In this research, a bench level two-phase experimental setup was built to study the heat transfer and hydraulic performance of a jet impinging cold plate using a dielectric coolant HFE 7000. A copper block heater arrangement was used to mimic a computer chip with a footprint of 1“ × 1” (6.45 cm2). Heat transfer performance and pressure drop were compared in single- and two-phase operation at three volumetric flow rates 1.0, 1.25, and 1.75 LPM corresponding to mass fluxes 2005, 2506, and 3509 kg/m2s respectively. The tests were carried out for heat fluxes ranging from 5 to 70 W/cm2. It is found that thermal resistance remains unchanged in the single-phase regime at lower heat fluxes but then decreases significantly when boiling occurs at high heat fluxes. At lower heat fluxes and high heat fluxes, thermal resistance decreases with flow rate. However, at moderate heat fluxes (27–58 w/cm2), the thermal resistance is independent on flow rate. This behavior is attributed to the dominance of nucleate boiling at moderate heat fluxes. Therefore, thermal performance at moderate heat fluxes depends on cold plate design (nucleate site density) rather than flow rate. Pressure drop decreases slightly (less than 7 %) in single phase regime due to the reduction of viscosity with temperature. When two-phase boiling occurs, pressure drop is observed to rise considerably (over 70 %). A high power of 450 $\mathrm{w}$ was dissipated at operable base temperature (31 to 85°C) and pressure drop (7 to 24 kpa).
Anti-capsular immunity to Streptococcus pneumoniae serotype 22F prevents bacterial transmission in murine colonization and influenza virus co-infection models.

We evaluated the effectiveness of anti-22F serotype immunity in the prevention of Streptococcus pneumoniae (Spn) bacterial transmission during colonization and influenza virus co-infection. Mice were immunized with 22F formulation and later colonized with Spn or co-infected with Spn and influenza virus. The 22F antisera exhibited strong reactivity to 22F bacteria and promoted the opsonic uptake of Spn by the neutrophils. The 22F vaccination led to a significant reduction of bacterial densities in the nasopharynx and prevented bacterial transmission during colonization and co-infection. The transfer of 22F antisera to infant mice resulted in reduced bacterial transmission in colonization and co-infection models.
Use of High-Dose Influenza and Live Attenuated Influenza Vaccines by US Primary Care Physicians

Several different types of influenza vaccine are licensed for use in adults in the USA including high-dose inactivated influenza vaccine (HD-IIV) and live attenuated influenza vaccine (LAIV). HD-IIV is licensed for use in adults ≥ 65 years, and recommendations for use of LAIV have changed several times in recent years. We sought to examine family physicians’ (FPs) and general internal medicine physicians’ (GIMs) perceptions, knowledge, and practices for use of HD-IIV and LAIV during the 2016–2017 and 2018–2019 influenza seasons. E-mail and mail surveys conducted February–March 2017, January–February 2019. Nationally representative samples of FPs and GIMs. Surveys assessed HD-IIV practices (2017), knowledge and perceptions (2019), and LAIV knowledge and practices (2017, 2019). Response rates were 67% (620/930) in 2017 and 69% (642/926) in 2019. Many physicians believed HD-IIV is more effective than standard dose IIV in patients ≥ 65 years (76%) and reported their patients ≥ 65 years believe they need HD-IIV (67%). Most respondents incorrectly thought ACIP preferentially recommends HD-IIV for adults ≥ 65 years (88%); 65% “almost always/always” recommended HD-IIV for adults ≥ 65 years. Some physicians incorrectly thought ACIP preferentially recommends HD-IIV for adults < 65 years with cardiopulmonary disease (38%) or immunosuppression (48%); some respondents recommended HD-IIV for these groups (25% and 28% respectively). In 2017, 88% of respondents knew that ACIP recommended against using LAIV during the 2016–2017 influenza season, and 4% recommended LAIV to patients. In 2019, 63% knew that ACIP recommended that LAIV could be used during the 2018–2019 influenza season, and 8% recommended LAIV. Many physicians incorrectly thought ACIP had preferential recommendations for HD-IIV. Physicians should be encouraged to use any available age-appropriate influenza vaccine to optimize influenza vaccination particularly among older adults and patients with chronic conditions who are more vulnerable to severe influenza disease.
Espacios marítimos y proyecciones culturales

Sobre Flor Trejo Rivera y Guadalupe Pinzon Rios (coords.), Espacios maritimos y proyecciones culturales.
Breakthrough Bleeding in Transgender and Gender Diverse Adolescents and Young Adults on Long-Term Testosterone.

ABSTRACT Study Objective Amenorrhea is a goal of many transgender and gender diverse adolescent and young adult (TGD AYA) patients on testosterone gender-affirming hormone therapy (T-GAHT). Breakthrough bleeding can contribute to worsening gender dysphoria. Our objective was to evaluate breakthrough bleeding in TGD AYA on T-GAHT. Design Institutional review board−approved retrospective cohort. Setting Tertiary-care children's hospital. Participants TGD AYA on T-GAHT >1 year. Interventions None; observational. Main Outcome Measures Presence of, and risk factors for, breakthrough bleeding. Results Of the 232 patients who met inclusion criteria, one-fourth (n = 58) had 1 or more episodes of breakthrough bleeding, defined as bleeding after more than 1 year on T-GAHT. In comparing patients with breakthrough bleeding to those without, there were no significant differences between age of initiation, body mass index (BMI), race/ethnicity, testosterone type used, use of additional menstrual suppression, serum testosterone, or estradiol levels. Patients with breakthrough bleeding patients were on T-GAHT longer (37.3 ± 17.0 vs 28.5 ± 14.6 months, P Conclusion Breakthrough bleeding is relatively common (25%) on T-GAHT despite early amenorrhea. Most cases do not have an identifiable cause. Our data did not show superiority of any 1 method for managing breakthrough bleeding on T-GAHT.
Theory of radiative processes in GaN-based laser structures

GaN and related compounds are challenging materials for UV and visible semiconductor lasers. While stimulated emission from photopumped GaN-based structures was relatively easy to achieve [1], only very recently has the first diode laser been announced [2]. In spite of their importance for design and further studies of GaN-based lasers, investigations of radiative recombination and emission processes in GaN are still at their infancy. In this paper, we consider radiative processes in GaN and calculate the radiative recombination coefficient and optical gain as functions of excess carrier density and injection current density. We then predict the theoretical limit for the threshold current density in optimized double-heterostructure (DH) lasers emitting in the near-UV spectral range.
Reconciling Imbalanced Transition State Effects with Nonadiabatic CPET Reactions

Recently there have been several experimental demonstrations of how concerted proton electron transfer (CPET) reaction rates are affected by off-main-diagonal energies, namely the stepwise thermodynamic parameters ΔG°PT and ΔG°ET. Semi-classical structure-activity relationships have been invoked to rationalize these asynchronous linear free energy relation-ships despite the widely acknowledged importance of quantum effects such as nonadiabaticity and tunneling in CPET reactions. Here we report variable temperature kinetic isotope effect data for the asynchronous reactivity of a terminal Co-oxo complex with C–H bonds and find evidence of substantial quantum tunneling which is inconsistent with semi-classical models even when including tunneling corrections. This indicates substantial nonadiabatic tunneling in the CPET reactivity of this Co-oxo complex and further motivates the need for a quantum mechanical justification for the in-fluence of ΔG°PT and ΔG°ET on reactivity. To reconcile this dichotomy, we include ΔG°PT and ΔG°ET in nonadiabatic models of CPET by having them influence the anharmonicity and depth of the proton potential energy surfaces, which we approximate as Morse potentials. With this model we independently reproduce the dominant trend with ΔG°PT + ΔG°ET as well as the subtle effect of ΔG°PT − ΔG°ET (or η) in a nonadiabatic framework. The primary route through which these off-diagonal energies influence rates is through vibronic coupling. Our results reconcile predictions from semiclassical transition state theory with models that treat proton transfer quantum mechanically in CPET reactivity and suggest that similar treatments may be possible for other nonadiabatic processes.
Medicine and the arts. Morning Song by Marcia F. Brown. Commentary.

Medicine and the Arts Morning Song By Marcia F. Brown Here, I place a blue glazed cup where the wood is slightly whitened. Here, I lay down two bright spoons, our breakfast saucers, napkins white and smooth as milk. I am stirring at the sink, I am stirring the amount of dew you can gather in two hands, folding it into the fragile quiet of the house. Before the eggs, before the coffee heaving like a warm cat, I step out to the feeder— one foot, then the other, alive on wet blades. Air lifts my gown—I might fly— This thistle seed I pour is for the tiny birds. This ritual, for all things frail and imperiled. Wings surround me, frothing the air. I am struck by what becomes holy. A woman who lost her teenage child to an illness without mercy, said that at the end, her daughter sat up in her hospital bed and asked: What should I do? What should I do? Into a white enamel bath I lower four brown eggs. You fill the door frame, warm and rumpled, kiss the crown of my head. I know how the topmost leaves of dusty trees feel at the advent of the monsoon rains. I carry the woman with the lost child in my pocket, where she murmurs her love song without end: Just this, each day: Bear yourself up on small wings to receive what is given. Feed one another with such tenderness, it could almost be an answer. “Morning Song” by Marcia F. Brown. What on Earth. Westbrook, ME: Moon Pie Press; 2010. Copyright © Marcia F. Brown. Reprinted with permission. Academic Medicine, Vol. 87, No. 11 / November 2012
Aspen leaf miner ( Phyllocnistis populiella ) oviposition site selection mediated by aspen ( Populus tremuloides ) extrafloral nectaries

By impacting performance of individual offspring, oviposition site choice can have a large influence on female fitness; however, a female’s fitness is also impacted by her own survival and future reproductive potential. Factors influencing oviposition site selection include a female’s own predation risk and nutritional needs, as well as the performance of offspring. Trade-offs may occur when oviposition sites differ in their favorability for these fitness-related functions. Adults of the leaf-mining moth, Phyllocnistis populiella, forage at the extrafloral nectaries (EFNs) of quaking aspen, Populus tremuloides. Females are synovigenic and likely rely on adult nutrition for egg production; however, proximity to EFNs may be associated with reduced offspring survival. In a controlled experiment, when given the choice of oviposition on either a leaf with or without EFNs, P. populiella preferred leaves lacking EFNs. Seven years of field survey data revealed significantly higher oviposition and lower egg predation on leaves lacking EFNs. Aspen shoots with a higher proportion of leaves expressing EFNs experienced higher oviposition but no difference in egg predation. At the leaf level, eggs were overdispersed when at low to moderate densities, likely to decrease interference competition. Females mated multiply, and the acquisition of spermatophores through repeated matings may decrease P. populiella’s reliance on EF nectar for egg production. P. populiella appears to balance the trade-off between resource rich and high offspring performance sites by ovipositing in neighborhoods with a high proportion of leaves bearing EFNs, while preferring leaves lacking EFNs which experience lower egg predation.
Preconditioning the Neurovascular Unit: Tolerance in the Brain’s Nonneuronal Cells

Hypoxia has challenged the homeostatic physiology and survival of cells, tissues, and species over many millennia of evolutionary time. As such, it is not surprising that a brief hypoxic “challenge” serves as a powerful preconditioning stimulus to induce a wide variety of epigenetic changes that promote a transient, robust period of enhanced resistance to injury. Evidence for such “tolerance” is particularly strong in the central nervous system, with hypoxic preconditioning (HPC) paradigms affording both the adult and pediatric brain powerful protection from ischemia and other pathologic insults. In this chapter, we review in vivo and in vitro HPC models and what is currently understood regarding the molecular-genetic basis for the observed protective effects, from the signaling pathways inducing the gene expression changes in response to the hypoxic stress to the effectors that account for the injury-tolerant phenotype. Despite relatively intensive investigation, and the identification of several “hypoxia-mimetic” approaches to pharmacologically induce cerebral ischemic tolerance, the precise mechanisms and mediators of this phenomenon still require considerably more elucidation. We close with a translational perspective highlighting the identified strengths and weaknesses that characterize HPC-induced tolerance, the target subpopulations of patients that could potentially benefit from HPC, and the preclinical studies still needed going forward to help propel HPC-based stroke therapeutics from bench to bedside.
ENDOR and ELDOR on Iron-Sulfur Proteins

It is fitting that a book of this nature should include a chapter on the application of double resonance techniques to the study of iron-sulfur proteins. Magnetic resonance techniques have permitted a detailed study of the nature of the active sites of many proteins that had not been possible previously. Among these is the whole class of iron-sulfur proteins. These proteins have been implicated, primarily as electron carriers, in the mediation of a wide variety of biochemical reactions in plants, bacteria, and mammals. They are involved in photosynthesis, oxidative phosphorylation, nitrogen fixation, and many hydroxylations, to name but a few important functions.
Blood chemistry and renal function in abruptio placentae

Abstract 1. 1. Patients with abruptio placentae may be divided into a toxemic, hypertensive, or vascular disease group and a nontoxemic group. In the former the majority of the cases are associated with a persistent hypertension, which may have been initiated or intensified by the pregnancy rather than with a true preeclampsia and eclampsia. The nontoxemic group is associated with local conditions in the uterus. These may be subinvolution due to multiparity or infection, abnormal implantation, faulty contractions of the uterus, etc. 2. 2. The hemoglobin, hematocrit and serum protein concentrations are lowered proportionately to the hemorrhage. If the loss of these substances is great enough, death may occur as a result of tissue anoxemia and improper interchange of water and electrolysis. 3. 3. The determination of the hemoglobin and serum protein concentration on admission does not, as a rule, give a true index of the volume of the hemorrhage or of the patient's condition. 4. 4. The systolic blood pressure on admission may be 100 mm. or more, and yet the patient may be in shock. 5. 5. The blood fibrin may also be reduced to a concentration which predisposes to bleeding from mucous surfaces, incisions, and the uterus. 6. 6. The renal function is impaired in many cases but returns to normal after an interval of several months. These tests demonstrate that a chronic nephritis is not present. 7. 7. The prevention or cure of the associated phenomena is the prompt, adequate, and continued administration of blood and parenteral fluids.
Subband coding of video using adaptive quantization

An adaptive video coder is presented. The coder is based on motion compensation and subband coding. The probability distributions of the subband signals are modeled by generalized Gaussian distributions. Quantizer design, bit allocation, and entropy coding are then based on these distribution models. The video coder adapts to changes in signal characteristics by updating the distribution models and redesigning the quantizers and entropy codes. >
Miranda Revisited: Broadening the Right to Counsel During Custodial Interrogation-- Commonwealth v. Sherman

The judicially created Miranda protections require law enforcement officials to inform criminal suspects of their right to counsel prior to proceeding with custodial interrogation. In Commonwealth v. Sherman, the Supreme Judicial Court of Massachusetts considered whether a criminal defendant validly waived his right to counsel when a police officer failed to inform him that an attorney, appointed to represent him in an unrelated case, had requested to be present during his interrogation. Concluding that, under the peculiar circumstances of the case, the defendant did not voluntarily waive his right to counsel, the court suppressed the defendant's in-custody statements to police. Commonwealth v. Sherman strengthens procedural safeguards in the early, but vital, stages of the criminal justice process. The Sherman court decisively balanced the delicate relationship of attorneys, police, and criminal suspects by supplying a standard of conduct, beyond mere formality and procedural aquiescence, to include an element of personal responsibility. Fully realizing that criminal defendants facing custodial interrogation cannot meaningfully exercise their right to counsel without knowing all salient information, the court took precautions to protect a criminal defendant's rights. Commonwealth v. Sherman thus succeeds in maintaining a symmetry between the conflicting interests of law enforcement institutions and individual rights.
Responses to Symptoms of Acute Myocardial Infarction: Reasons for Delay and Bystanders'Role

Significance of the study. Acute myocardial infarction (AMI) is a major cause of death in Korea. Delay in seek- ing treatment may cause unnecessary exacerbation of the disease and early mortality from AMI. Patientsifl recognition of symptoms of an AMI and response to those symptoms may influence the delay time. Bystanders' role in patients' seeking treatment after AMI has not been studied in previous research. Understanding reasons for delay in seeking treatment is important in developing interventions for reducing these delays and increasing survival rate from AMI. Results. The mean of overall pre-hospital delay time was 13.64 (21.86) hours and it consisted of patients' delay of 13.64 (22.32) hours and transportation time of 24.86 (19.41) minutes. People living in rural area delayed longer than people living in urban area. Pre-hospital delay time was associated with the bystander: patients delayed longer when they were with their spouse, family and friends than when with colleagues at work. Calling 119 saved transportation time, but did not reduce overall pre-hospital delay time. Conclusion and suggestions.Patients delay longer than the time window for a successful reperfusion therapy when they experience symptoms of AMI; and calling 119 does not diminish this delay. Bystanders' ade- quate response to the patients' symptom may reduce the delay time in seeking treatment. Findings from this study may suggest that health education and public campaigns are needed to increase people' s recognition of symptoms of an AMI and to promote adequate response from bystanders to the AMI symptoms. In addi- tion, public campaigns urging car operators to yield to the emergency vehicle are needed in order to reduce transportation time.
A Deep Redshift Survey of Field Galaxies

A spectroscopic survey of over 400 field galaxies has been completed in three fields for which we have deep UBVI photographic photometry. The galaxies typically range from B = 20 to 22 and possess redshifts z from 0.1 to 0.5 that are often quite spiky in distribution. Little, if any, luminosity evolution is observed up to redshifts z ≃ 0.5. By such redshifts, however, an unexpectly large fraction of luminous galaxies has very blue intrinsic colors that suggest extensive star formation; in contrast, the reddest galaxies still have colors that match those of present-day ellipticals.
Water-module interaction studies

Mechanisms by which moisture enters photovoltaic modules and techniques for reducing such interactions are reported. Results from a study of the effectiveness of various module sealants are given. Techniques for measuring the rate and quantity of moisture ingress are discussed. It is shown that scribe lines and porous frit bridging conductors provide preferential paths for moisture ingress and that moisture diffusion by surface/interfacial paths is considerably more rapid than diffusion by bulk paths, which implies that thin-film substrate and supersubstrate modules are much more vulnerable to moist environments than are bulk-encapsulated crystalline-silicon modules. Design approaches that reduce moisture entry are discussed. >
Transactions costs as an obstacle to fisheries self-governance in New Zealand.

When faced with opportunities for greater self-governance, the New Zealand fishing industry managed to make only limited progress. Why industry was unable to progress self-management more effectively remains an interesting question. This paper argues that the benefits of greater self-governance were probably less than the significant transactions costs to self-organise. The benefits were probably smaller in New Zealand than elsewhere, because reform had already reduced the costs of fisheries administration. And the transactions costs confronting industry were substantial. First, unanimous agreement was required for self-governance, which created high transactions costs. Second, the tools for private enforcement were limited. Third, policy failed to specify clearly the expectations of self-governance, so the investments in self-governance are unusually risky. The government had unrealistic expectations that self-governance would solve third-party environmental externalities as well as fishing externalities. This implied high transactions costs to negotiate with third parties, such as environmental groups. Fourth, the standards for accountability were difficult to specify. This experience identifies four key policies if devolved fisheries governance is to be promoted: non-unanimous decision-making; private enforcement; clarity on areas for self-governance; and clarity on accountability standards.
How to Address Standardless Discretion after Jones

The Supreme Court held in United States v. Jones that prolonged GPS tracking infringes upon a Fourth Amendment interest, but left for another day whether that means that a warrant is required for all such surveillance activity. Building on Supreme Court precedent that directly addresses the problem of "standardless and unconstrained discretion," we propose that courts test the constitutionality of police action of this kind by examining the adequacy of procedural safeguards and actual police compliance therewith. Accordingly, in a range of settings involving new technologies, the state would need to craft reasonable safeguards against standardless discretion, and then comply with those safeguards in order for state action to be deemed constitutional.
Distinct Subpopulations of Nucleus Accumbens Dynorphin Neurons Drive Aversion and Reward

The nucleus accumbens (NAc) and the dynorphinergic system are widely implicated in motivated behaviors. Prior studies have shown that activation of the dynorphin-kappa opioid receptor (KOR) system leads to aversive, dysphoria-like behavior. However, the endogenous sources of dynorphin in these circuits remain unknown. We investigated whether dynorphinergic neuronal firing in the NAc is sufficient to induce aversive behaviors. We found that photostimulation of dynorphinergic cells in the ventral NAc shell elicits robust conditioned and real-time aversive behavior via KOR activation, and in contrast, photostimulation of dorsal NAc shell dynorphin cells induced a KOR-mediated place preference and was positively reinforcing. These results show previously unknown discrete subregions of dynorphin-containing cells in the NAc shell that selectively drive opposing behaviors. Understanding the discrete regional specificity by which NAc dynorphinerigic cells regulate preference and aversion provides insight into motivated behaviors that are dysregulated in stress, reward, and psychiatric disease.
Body weight changes and subsequent lambing rates of western whiteface ewes grazing winter range

Abstract The objective was to describe body weight change (BWC) and subsequent lambing performance of Columbia, Polypay, Rambouillet, and Targhee ewes that grazed shrub-dominated range in winter of 1989, 1990, and 1991. In December (winter), after breeding each year (yr; October to December), ewes were moved to range. Depending upon severity of climatic conditions and vegetation accessibility, ewes grazed winter range for 30 to 60 days (d). Body weights were measured 2 d before grazing commenced (initial) and 2 to 7 d after ewes were transported off range (exit). Total BWC was calculated by subtracting finial BW from initial BW. All data were analyzed within each breed, as repeated measures using mixed models with age and year included in the model. For all breeds, 2-yr-old ewes were lightest going on to winter range and had the lowest lambing rate. Ewes lost weight while grazing winter range, but mature BW, once achieved, was restored annually with the exception of the 7-yr-old Columbia and Targhee ewes. Regardless of breed or age, ewes were able to achieve lambing rates > 1.5 lambs following early- and mid-pregnancy weight loss. Lambing rates were greater in older ewes, which generally experienced substantial negative BWC during winter grazing.
Assessing the Relationship between Cognitive Load and Cervicobrachial Muscle Response during a Typing Task

Workers in office environments often have to deal with high cognitive workload due to the coordination of multiple work tasks. The objective of this research was to use a dual-task paradigm to exam...
Evaluating personal alcohol feedback as a selective prevention for college students with depressed mood.

Abstract Objective This research evaluated a brief mailed intervention for alcohol use as an adjunct to a brief treatment for college students with depression symptoms. The intervention aimed to correct normative misperceptions and reduce students' drinking and related consequences. Method One hundred seventy seven college students (70% Female) with elevated scores on the Beck Depression Inventory were randomly assigned to intervention or control group. Participants in the intervention were mailed feedback and information detailing their reported alcohol use, moderation strategies, and accurate normative information regarding student drinking. Results Results indicated no main effects of the intervention on drinking or related problems but students receiving feedback showed significant reductions in their perception of drinking norms compared to the control group. Furthermore, students whose normative perceptions reduced showed significant reductions in total drinks per week and total alcohol related problems compared to those whose norms did not reduce. Conclusions Results support the importance of correcting normative perceptions and provide direction for selective prevention of alcohol use and related problems among college students with depressed mood.
Emergency department resource use by supervised residents vs attending physicians alone.

Importance Few studies have evaluated the common assumption that graduate medical education is associated with increased resource use. Objective To compare resources used in supervised vs attending-only visits in a nationally representative sample of patient visits to US emergency departments (EDs). Design, Setting, and Participants Cross-sectional study of the National Hospital Ambulatory Medical Care Survey (2010), a probability sample of US EDs and ED visits. Exposures Supervised visits, defined as visits involving both resident and attending physicians. Three ED teaching types were defined by the proportion of sampled visits that were supervised visits: nonteaching ED, minor teaching ED (half or fewer supervised visits), and major teaching ED (more than half supervised visits). Main Outcomes and Measures Association of supervised visits with hospital admission, advanced imaging (computed tomography, ultrasound, or magnetic resonance imaging), any blood test, and ED length of stay, adjusted for visit acuity, demographic characteristics, payer type, and geographic region. Results Of 29 182 ED visits to the 336 nonpediatric EDs in the sample, 3374 visits were supervised visits. Compared with the 25 808 attending-only visits, supervised visits were significantly associated with more frequent hospital admission (21% vs 14%; adjusted odds ratio [aOR], 1.42; 95% CI, 1.09-1.85), advanced imaging (28% vs 21%; aOR, 1.27; 95% CI, 1.06-1.51), and a longer median ED stay (226 vs 153 minutes; adjusted geometric mean ratio, 1.32; 95% CI, 1.19-1.45), but not with blood testing (53% vs 45%; aOR, 1.18; 95% CI, 0.96-1.46). Of visits to the sample of 121 minor teaching EDs, a weighted estimate of 9% were supervised visits, compared with 82% of visits to the 34 major teaching EDs. Supervised visits in major teaching EDs compared with attending-only visits were not associated with hospital admission (aOR, 1.15; 95% CI, 0.83-1.58), advanced imaging (aOR, 1.21; 95% CI, 0.96-1.53), or any blood test (aOR, 1.02; 95% CI, 0.79-1.33), but had longer ED stays (adjusted geometric mean ratio, 1.32; 95% CI, 1.14-1.53). Conclusions and Relevance In a sample of US EDs, supervised visits were associated with a greater likelihood of hospital admission and use of advanced imaging and with longer ED stays. Whether these associations are different in EDs in which more than half of visits are seen by residents requires further investigation.
5-Minute Clinical Consults.

5-Minute Clinical Consults (5MCC) is a commercial program for personal digital assistants (PDAs). It is the handheld version of the 2003 Griffith's 5-Minute Clinical Consult textbook, which is edited by Mark Dambro, MD, and published by Lippincott Williams and Wilkins. The PDA version of 5MCCs is powered by Skyscape.
Multigrid algorithms for solving structural mechanics problems on supercomputers

Abstract Multigrid methods are described for solving linear and non-linear structural mechanics problems. The algorithms combine relaxation on a fine mesh with the computation of a coarse mesh correction. Both linear matrix equations and symmetric eigenvalue problems are considered. History-dependent non-linear problems are solved by combining the linear matrix solver with the Newton-Raphson iteration algorithm. Special attention is paid to implementing the multigrid methods on vector and coarse grained parallel computers. The basic approach adopted is to perform all the matrix-vector multiplications on the element level. This results in code that requires a low amount of storage. Several large-scale problems are solved on a Convex C240, an Alliant FX/8, and a CRAY Y-MP to demonstrate the speed and storage requirements of the methods. Speed-ups of up to 3.41 are observed on four processors of the CRAY Y-MP.
Liquid velocity in upward and downward air–water flows

Abstract Local characteristics of the liquid phase in upward and downward air–water two-phase flows were experimentally investigated in a 50.8-mm inner-diameter round pipe. An integral laser Doppler anemometry (LDA) system was used to measure the axial liquid velocity and its fluctuations. No effect of the flow direction on the liquid velocity radial profile was observed in single-phase liquid benchmark experiments. Local multi-sensor conductivity probes were used to measure the radial profiles of the bubble velocity and the void fraction. The measurement results in the upward and downward two-phase flows are compared and discussed. The results in the downward flow demonstrated that the presence of the bubbles tended to flatten the liquid velocity radial profile, and the maximum liquid velocity could occur off the pipe centerline, in particular at relatively low flow rates. However, the maximum liquid velocity always occurred at the pipe center in the upward flow. Also, noticeable turbulence enhancement due to the bubbles in the two-phase flows was observed in the current experimental flow conditions. Furthermore, the distribution parameter and the void-weighted area-averaged drift velocity were obtained based on the definitions.
What Is the "Drug User Community"?: Implications for Public Health

Through an exploration of a group that is beginning to be labeled in the public health and drug research literature “the drug user community,” this paper engages the challenges of achieving a shared research definition of the oft used term “community.” While this term has been a central concept in public health since the international Alma Alta conference of 1978, it remains “slippery” and hard to pin down, however useful. While drug users commonly are disparaged as a threat to community—indeed, the very embodiment of such threats, as a result of the AIDS epidemic, postmodernism, and the harm reduction movement—illicit drug users are now increasingly being accorded community status among drug interventionists and researchers alike. This paper examines the development of this trend, the community (and anti-community) features of drug users based on research in Hartford, CT, and the public health implications of conceiving (or failing to conceive) of drug users in this way.
A better prognosis for genetic association studies in mice.

Although inbred mouse strains have been the premier model organism used in biomedical research, multiple studies and analyses have indicated that genome-wide association studies (GWAS) cannot be productively performed using inbred mouse strains. However, there is one type of GWAS in mice that has successfully identified the genetic basis for many biomedical traits of interest: haplotype-based computational genetic mapping (HBCGM). Here, we describe how the methodological basis for a HBCGM study significantly differs from that of a conventional murine GWAS, and how an integrative analysis of its output within the context of other ‘omic' information can enable genetic discovery. Consideration of these factors will substantially improve the prognosis for the utility of murine genetic association studies for biomedical discovery.
Relationship between the Charge Distribution and Dipole Moment Functions of CO and the Related Molecules CS, SiO, and SiS

The dipole moment functions of the titled molecules are written as the sum of a charge and induced atomic dipole contribution and the distance dependence interpreted in terms of these components. These two contributions have opposite signs over a large range of internuclear distances, and when they have equal magnitudes, the dipole moment vanishes. This happens with CO near the equilibrium bond length and is responsible for its small dipole moment. The dipole moment of CS is 0.770(ea0), rather large for a diatomic in which the two atoms have essentially the same electronegativities; this is because for CS, the two components of the dipole moment have the same sign at equilibrium and reinforce one another.
Perceived Holographic Image Distortions

The use of holography for the storage and retrieval of metric information in close range applications offers two distinct advantages over conventional photographic techniques. Since a hologram contains a three dimensional image, multiple perspectives are available for information retrieval. Also the hologram is capable of a larger depth of field.© (1974) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
miR-221 silencing blocks hepatocellular carcinoma and promotes survival

Patients with advanced hepatocellular carcinoma (HCC) face a dismal prognosis because of a lack of any effective therapies. To address this situation, we conducted a preclinical investigation of the therapeutic efficacy of oligonucleotides directed against the oncogenic microRNA miR-221, which has been implicated in HCC. Of 9 chemistries evaluated, we determined that a 2'-O-methyl phosphorothioate-modified anti-miR-221 oligonucleotide was most effective at reducing proliferation in vitro. A cholesterol-modified isoform of anti-miR-221 (chol-anti-miR-221) exhibited improved pharmacokinetics and liver tissue distribution compared with unmodified oligonucleotide. Chol-anti-miR-221 significantly reduced miR-221 levels in liver within a week of intravenous administration and in situ hybridization studies confirmed accumulation of the oligonucleotide in tumor cells in vivo. Within the same period, chol-anti-miR-221 reduced tumor cell proliferation and increased markers of apoptosis and cell-cycle arrest, elevating the tumor doubling time and increasing mouse survival. Taken together, our findings offer a preclinical proof of efficacy for chol-anti-miR-221 in a valid orthotopic mouse model of HCC, suggesting that this targeted agent could benefit treatment for patients with advanced HCC.
Expression of a cosmid containing the LCR, Aγ, Δ, and β globin genes in mouse erythroleukemia cells

A novel method involving the packaging of phage particles was used to introduce cosmids containing components of the human beta-globin locus control region (LCR) and the human (A)gamma, delta, and beta globin genes into mouse erythroleukemia (MEL) cells. After stable transfection, MEL clones were selected and analyzed for expression of human genes. Both (A)gamma and beta globin mRNA were expressed in these clones, indicating that MEL cells do not suppress transcription of the human gamma globin gene. The variability of human (A)gamma vs. beta globin expression from clone to clone prevents a clear delineation of differences in the expression of these two genes with a cosmid in which a region potentially involved in gamma-to-beta switching has been deleted. The results suggest that MEL cells are capable of supporting human gamma expression, despite their predominantly adult phenotype.
Cultural Attitudes of Romanian Youth

A variation of the Bogardus scale on social distance was implemented to examine the cultural attitudes of Romanian youth about minorities in Romania. The results indicated that the greatest social distance was reported towards members of the Rroma minority with members of the Hungarian minority following. The least social distance was, not surprisingly, associated with members of the Romanian majority. The findings of this study are examined in light of their implications for teacher education, in the continuously changing sociopolitical landscape of Romania. Keywords : Cultural attitude, Romania, Pre-service teacher, Bogardus scale, Contact theory
An evaluation of fiber-reinforced titanium matrix composites for advanced high-temperature aerospace applications

The current capabilities of continuous silicon-carbide fiber-reinforced titanium matrix composites (TMCs) are reviewed with respect to application needs and compared to the capabilities of conventional high-temperature monolithic alloys and aluminides. In particular, the properties of a first-generation titanium aluminide composite, SCS-6/Ti-24Al-11Nb, and a second-generation metastable beta alloy composite, SCS-6/TIMETAL 21S, are compared with the nickel-base superalloy IN100, the high-temperature titanium alloy Ti-1100, and a relatively new titanium aluminide alloy. Emphasis is given to life-limiting cyclic and monotonic properties and to the influence of time-dependent deformation and environmental effects on these properties. The composite materials offer a wide range of performance capabilities, depending on laminate architecture. In many instances, unidirectional composites exhibit outstanding properties, although the same materials loaded transverse to the fiber direction typically exhibit very poor properties, primarily due to the weak fiber/matrix interface. Depending on the specific mechanical property under consideration, composite cross-ply laminates often show no improvement over the capability of conventional monolithic materials. Thus, it is essential that these composite materials be tailored to achieve a balance of properties suitable to the specific application needs if these materials are to be attractive candidates to replace more conventional materials.
Secretion of trans-zeatin by Agrobacterium tumefaciens: A function determined by the nopaline Ti plasmid

Abstract Production of the plant cytokinin, trans -zeatin, by a number of strains of Agrobacterium tumefaciens was measured by a combination of traceenrichment, HPLC and radioimmunoassay and confirmed by mass spectrometry. Secretion of trans -zeatin into a culture medium is a constitutive function of those strains which harbor a nopaline Ti plasmid. Strains cured of the nopaline Ti plasmid and those which harbor octopine or agropine plasmids are non-producers. Reacquisition of nopaline plasmids by cured strains restores production.
Low-temperature isotopic exchange in obsidian: Implications for diffusive mechanisms

Abstract While a great deal is known about the interaction between water and rhyolitic glasses and melts at temperatures above the glass transition, the nature of this interaction at lower temperatures is much more poorly understood. This paper presents the results of a series of isotopic exchange experiments aimed at further elucidating this process and determining the extent to which a point-by-point analysis of the D/H or 18O/18O isotopic composition across the hydrated rim on a geological or archaeological obsidian sample can be used as a paleoclimatic monitor. Experiments were performed by first hydrating the glass for 5 days in water of one isotopic composition, followed by 5 days in water of a second composition. Because waters of near end-member compositions were used (nearly pure 1H216O, 1H218O, and D216O), the relative migration of each species could be ascertained easily by depth-profiling using secondary ion mass spectrometry (SIMS). Results suggest that, during hydration, both the isotopic composition of the waters of hydration, as well as that of intrinsic water remaining from the initial formation of the glass vary dramatically, and a point-by-point analysis leading to paleoclimatic reconstruction is not feasible.
Changes, perturbations, and responses in geomorphic systems:

In recent decades views of change, disturbance, response, and recovery in geomorphology have expanded considerably. Conceptual frameworks emphasizing single-path, single-outcome trajectories of change have been supplemented — not replaced — by multi-path, multi-outcome perspectives. Geomorphology has also seen a transition from the idea of normative standards such as characteristic, (steady-state) equilibrium, zonal, and mature forms to the recognition that some systems may have multiple potential characteristic or equilibrium forms — and that some may have no particular normative state at all. These trends are not presented as a replacement of outmoded ideas, but rather as a broadening of approaches. The single-path single-outcome frameworks can generally be viewed as special cases of the broader pluralistic analytical structures. In this context, two perspectives — an adaptation of White's hazards matrix, and the landscape sensitivity concept — are suggested which lend themselves to studies of recent an...
Globalization, Welfare and `Social' Partnership

This article stresses that, in today's European Union, a nationally or regionally based neo-corporatist revival would not bridge the democratic deficit in welfare governance. Using the example of employment, it describes trends that point at the changing character of `social Europe' as the site of multiple vulnerabilities. Such transformation would require speedy assessments of, and tailored policies towards, excluded social categories. It argues that work-centred institutional expressions of yesterday's welfare state, such as the traditional `social partners', cannot be expected to represent welfare demands and perspectives of hitherto politically isolated sectors. Further, issues of representation and democracy in the European context are reviewed.
Metaphors and user interfaces in the 21st Century

"Fast Forward" is a new column that the editors of interactions have kindly permitted me to write. It presents an opportunity for me to think about where our profession of user-interface design has been over the past three-and-a-half decades in which I have worked and about its future. I hope you will enjoy and benefit from joining me in this discussion. Your feedback is welcome.
Adolescent Drug Abuse and Alcoholism: Directions for the School and the Family.

Misuse of alcohol and drugs is a general problem, particularly severe among adolescents and youth, and particularly in the city.
Surface instabilities in finitely strained solids under static loading

Abstract Surface bifurcation in a quasistatically loaded solid is an important instability phenomenon occurring at high levels of strain. After a discussion of theoretical as well as experimental work done in this area, a general formulation for the surface buckling of an incrementally linear three dimensional halfspace is presented and corresponding necessary conditions for the onset of this instability are derived.
Adenomyoma (pancreatic heterotopia) of the duodenum producing common bile duct obstruction

Because gastroenteric anastomoses may not be adequately defined by conventional barium studies and there is no specific roentgenographic appearance to differentiate anastomotic ulcerations unrelated but proximate to sutures from those causally related to sutures, endoscopy has become the most reliable means to make the differential diagnosis. , 6, 7 At endoscopy, suture material protrudes into the lumen at the anastomosis and appears as shiny black strands or loops sometimes encrusted with a greenish exudate. Frequently, the suture is surrounded by ulceration or edema. The extent of the lesion is variable and the reaction may involve only one suture or the entire