cssi/SciSciGPT-SciSciNet huggingface dataset:
Interpreting for california's insured deaf or hard of hearing population: Hmos' language access services, 2003-2008

Deaf or hard of hearing (DHOH) people experience significant health disparities in the United States; signed language interpretation services may increase their access to health care via health insurance plans. The authors’ objective is to describe signed language interpretation (SLI) services provided by California’s health maintenance organizations (HMOs) to their DHOH members. They conducted a descriptive review of an annual state-administered survey of California HMOs from 2003 through 2008 via retrospective analysis of annual or biennial survey responses to questions regarding SLI services and DHOH members. From 2003 through 2008, California HMOs increased efforts to inform DHOH members of SLI services while using more formal methods to assess the quality of those services. DHOH members were increasingly discouraged from using family members for medical SLI. California’s HMOs have improved efforts to promote and evaluate SLI services for the DHOH community.
Doped Bi-Se thin films for photovoltaic applications

Cu x Bi y Se z thin films with copper concentration x up to 29 mol. % are synthesized on glass substrates by chemical-bath deposition. Films with thickness in the range of 550–597 nm are fabricated by a multiple-dip process. Deposition parameters for a single-coating run are optimized to avoid re-dissolution of the particles, and to obtain large-area composition homogeneity in the films. Routine film composition Cu:Bi:Se and thickness are analyzed by X-ray fluorescence. To evaluate the doped Bi-Se thin films for potential use in photovoltaic devices, systematic investigations of the films' structural, morphological, optical, and electrical properties are performed. The physical properties of as-deposited and annealed films are analyzed by X-ray diffraction, scanning electron microscopy, UV-Vis-IR photospectroscopy, and Hall effect and Seebeck effect measurements.
Skeletal Mechanoresponsiveness: Effects of Sex Hormones

Sex hormones regulate bone mass, and their age-associated decline contributes to bone loss seen clinically with menopause and aging. Mechanical loading in surgical models of hormone deficiency has been examined extensively as a therapy to overcome the decreased bone mass associated with sex hormone deficiency. Exercise and controlled loading can overcome cancellous bone loss following ovariectomy and orchidectomy in rodent models. In addition, several signaling pathways associated with skeletal mechanotransduction have recently been shown to be regulated by sex hormones or, more specifically, their receptors. Deletion of hormone cellular receptors (estrogen receptors α and β, and androgen receptor) in mice suggests a critical role for estrogen in the response of bone tissue to mechanical stimuli. In this chapter we review the literature on skeletal adaptation to mechanical loading in surgical and genetic rodent models of sex hormone deficiency.
Statistical approach to MIMO capacity analysis in a fading channel

Theoretical analysis of the MIMO outage capacity distribution for an uncorrelated Rayleigh fading channel reveals that the Gaussian distribution is a good approximation, especially for large a number of antennas. The question as to whether the measured channel capacity distribution is close to the theoretical one has not been answered yet in a satisfactory way. We address this problem by developing a statistically-rigorous procedure (in terms of hypothesis testing) for the analysis of the mean and outage capacities of MIMO channels (both, theoretical models and measured) with the main goal being to compare the theoretical and measured capacity distribution, especially the validity of Gaussian approximation for the measured outage capacity. As we demonstrate, there is a tight lower bound on the amount of measured data necessary to provide a unique answer with high confidence probability. Additionally, based on the procedure above, we develop guidelines for future measurements and Monte-Carlo simulations in terms of accuracy.
Interaction between defects in ventilatory and thermoregulatory control in mice lacking 5-HT neurons

We have previously shown that mice with near-complete absence of 5-HT neurons (Lmx1bf/f/p) display a blunted hypercapnic ventilatory response (HCVR) and impaired cold-induced thermogenesis, but have normal baseline ventilation (), core body temperature (TCore) and hypoxic ventilatory responses (HVR) at warm ambient temperatures (TAmb; 30 degrees C). These results suggest that 5-HT neurons are an important site for integration of ventilatory, metabolic and temperature control. To better define this integrative role, we now determine how a moderate cold stress (TAmb of 25 degrees C) influences ventilatory control in adult Lmx1bf/f/p mice. During whole animal plethysmographic recordings at 25 degreesC, baseline , metabolic rate , and TCore of Lmx1bf/f/p mice were reduced (P < 0.001) compared to wild type (WT) mice. Additionally, the HCVR was reduced in Lmx1bf/f/p mice during normoxic (-33.1%) and hyperoxic (-40.9%) hypercapnia. However, in Lmx1bf/f/p mice was equal to that in WT mice while breathing 10% CO2, indicating that non-5-HT neurons may play a dominant role during extreme hypercapnia. Additionally, ventilation was decreased during hypoxia in Lmx1bf/f/p mice compared to WT mice at 25 degrees C due to decreased TCore. These data suggest that a moderate cold stress in Lmx1bf/f/p mice leads to further dysfunction in ventilatory control resulting from failure to adequately maintain TCore. We conclude that 5-HT neurons contribute to the hypercapnic ventilatory response under physiologic, more than during extreme levels of CO2, and that mild cold stress further compromises ventilatory control in Lmx1bf/f/p mice as a result of defective thermogenesis.
Liquid–liquid transition in supercooled water suggested by microsecond simulations

The putative liquid–liquid phase transition in supercooled water has been used to explain many anomalous behaviors of water. However, no direct experimental verification of such a phase transition has been accomplished, and theoretical studies from different simulations contradict each other. We investigated the putative liquid–liquid phase transition using the Water potential from Adaptive Force Matching for Ice and Liquid (WAIL). The simulation reveals a first-order phase transition in the supercooled regime with the critical point at ∼207 K and 50 MPa. Normal water is high-density liquid (HDL). Low-density liquid (LDL) emerges at lower temperatures. The LDL phase has a density only slightly larger than that of the ice-Ih and shows more long-range order than HDL. However, the transformation from LDL to HDL is spontaneous across the first-order phase transition line, suggesting the LDL configuration is not poorly formed nanocrystalline ice. It has been demonstrated in the past that the WAIL potential provides reliable predictions of water properties such as melting temperature and temperature of maximum density. Compared with other simple water potentials, WAIL is not biased by fitting to experimental properties, and simulation with this potential reflects the prediction of a high-quality first-principle potential energy surface.
Effect of haemin on enzyme activity and cytotoxin production by Bacteriodes gingivalis W50

Bacteriodes gingivalis W50 was grown in a chemostat at pH 7.5 under haemin-limited and haemin excess conditions in order to provide cells with a known high or low inefectivity and virulence for mice, respectively. The activities of enzymes and formation of cytotoxic fermentation products by these cells were compared. No significant differences in chymotrypsin activity or in the ability to degrade hyaluronic acid were found; neither were there any significant differences in the production of butyrate, propionate or succinate. At pH 7.5, trypsin activity was 3.5-fold higher in cells grown under haemin excess conditions whereas collagenolytic activity was nearly 3-fold higher in haemin-limited cells. Although collagenolytic activity may be important in tissue damage, a high ratio of trypsin to collagen breakdown activities was associated with virulent cells grown under an excess of haemin.
Three-dimensional nonlinear magnetic field boundary value problem and its numerical solution

An accurate solution to the nonlinear magnetic field boundary value problem which results when ferromagnetic materials are present is generally very difficult to obtain. Several computer codes based on a magnetic vector potential have been published in the literature. While those codes can be used to solve 2-dimensional problems, difficulties arise in their application to 3-dimensional problems. One difficulty is the complexity of the resulting differential equations which must be solved. This paper treats the more complex 3-dimensional solutions as derived from the concept of a scalar magnetic potential. The most desirable feature of this approach is that the magnetic material characteristics are incorporated directly into one second order nonlinear partial differential equation which can be solved on a digital computer using standard finite difference schemes. In order to add credence to the validity of the technique presented, a simple 3-dimensional magnetic field boundary value problem is posed and solved.
The Asymmetric Tonic Neck Reflex Its Presence and Significance in the Newborn

Asymmetric tonic neck reflex (ATNR) is an easily elicited reflex in the immediate newborn period and should not be considered pathologic unless it is obligatory. Although bidirectional responses are normally encountered, unidirectional responses are not uncommon. The majority of infants display the complete reflex, however, the lower extremities are the most consistent participants.
Enhancing student innovation: Physical models in the idea generation process

Innovation and engineering creativity are highly sought after skills. Unfortunately, little guidance exists for developing and teaching these critical skills. Physical representations ranging from simple, very rough models to full working prototypes are common within the design process and are a likely tool for supporting innovation. There are varied and conflicting recommendations on when physical models should be employed. Some studies suggest physical models cause design fixation. Design fixation is when designers think of a particular concept and it limits the ideas they are able to generate. The effects of physical models in the idea generation process were explored through a controlled experiment comparing participants who sketched, built, or built & tested their concepts. Results show that physical models overcome gaps in designers' mental models thus producing a greater number of functional ideas that solve the design problem. In addition, physical models appear to not cause design fixation but a larger sample size is required to verify this result. Similar levels of novelty and variety are observed across the conditions.
Logging and recovery in a highly concurrent database

This thesis addresses the problem of fault tolerance to system failures for database systems that are to run on highly concurrent computers. It assumes that, in general, an application may have a wide distribution in the lifetimes of its transactions. Logging remains the method of choice for ensuring fault tolerance, but this thesis proposes new ways of managing a database's log information that are better suited for the conditions described above. The disk space reserved for log information is managed according to the extended ephemeral logging (XEL) method. XEL segments a log into a chain of fixed-size FIFO queues and performs generational garbage collection on records in the log. Log records that are no longer necessary for recovery purposes are "thrown away" when they reach the head of a queue; only records that are still needed for recovery are forwarded from the head of one queue to the tail of the next. XEL does not require checkpoints, permits fast recovery after a crash and is well suited for applications that have a wide distribution of transaction lifetimes. The cost of XEL is more main memory space and possibly a slight increase in the disk bandwidth required for log information. XEL can significantly reduce the disk bandwidth required for log information in a system that has been augmented with a non-volatile region of main memory. When bandwidth requirements for log information demand an arbitrarily large collection of disks, they can be grouped into separate log streams. Each log stream consists of a small fixed number of disks and operates largely independently of the other streams. XEL manages the storage space of each log stream. Load balancing amongst the log streams is an important issue. This thesis evaluates and compares three different distribution policies for assigning log records to log streams. Simulation results demonstrate the effectiveness of the implementation techniques proposed in this thesis for a highly concurrent database system in which transactions may have a wide distribution in lifetimes. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.)
Half—off-shellt-matrix elements for ΛNS-wave energy-dependent potentialsS-wave energy-dependent potentials

Half—off-shellt-matrix elements for a variety of ΛNS-wave energy-dependent central potentials and for the potential of Dalitz, Herndon and Tang are presented. On the basis of a comparison of these matrix elements and the corresponding values ofD, the Λ binding energy in nuclear matter, it is concluded that the relation between the half—off-shellt-matrix elements and the values ofD is not a trivial one.
A meta-analysis of work sampling studies pre- and post-implementation of bedside computer charting in intensive care units.

The purpose of this meta-analysis was to integrate the findings of unpublished work sampling studies to determine (1) the effect of bedside computers on the distribution of time nurses spend in direct patient care, indirect patient care, charting, and communication, and (2) the relationship between the effects of bedside computers and methodological characteristics of the primary studies. The sample included three work sampling studies that measured the impact of bedside computers on the distribution of time that nurses spend in various activities in the intensive care units (ICUs). Analyses began by coding the observations recorded in the primary studies and combining them into the four activity subsets of interest to this meta-analysis. Percent change in time that nurses spent in each activity after computer installation was converted to an effect size through probit transformation techniques. Obtained effects sizes were weighted for sample size and then combined to create a weighted mean effect size for each activity subset across studies. Findings revealed that bedside computers had no real effect on the time that nurses spent in direct patient care, indirect patient care, charting, and communication activities when effect sizes were compared to Cohen's guidelines for effect size interpretation. There was an average increase of 2.1% in time spent in direct patient care activities and an average decrease of 2.7% in time spent in charting. The methodological characteristics considered in this study were (a) prior use of computers, (b) computer applications, (c) length of time between pre- and post-study, and (d) quality of the primary studies. After coding the primary studies, only length of time between the pre- and post-study was found to vary across studies. A Pearson Product-Moment correlational analysis was conducted to determine the relationship between length of time between the pre- and post-studies and the weighted effect sizes for direct patient care and charting activities. There was found to be no significant relationship between length of time between the pre- and post-study and the weighted effect sizes for direct patient care or charting.
Why Women Join the Military: Enlistment Decisions and Postdeployment Experiences of Service Members and Veterans

Over the past three decades women's enlistment has continued to increase. In an effort to help social workers better meet the needs of female veterans, this study sought to learn women's enlistment motivations and postdeployment experiences. This qualitative study was nested within the Women Veterans Cohort Study. Using a semistructured interview guide, authors interviewed 18 enlisted female service members and veterans. The themes that emerged, based on grounded theory, included not only opportunity and calling, but also outcomes. Unexpectedly, enlistment resulted in a professional military career, with over half of the participants making the military their life's work. Further study on the motivation, retention, and the reintegration needs of women postmilitary is necessary, particularly with military recruitment targets of 20 percent women by the year 2020 and the increased awareness of the military as a potentially hostile work environment for women.
Effect of Solvent on Surface Ordering of Poly(3-hexylthiophene) Thin Films.

Enhancement of charge transport in organic polymer semiconductors is a crucial step in developing optimized devices. A variety of sample preparation conditions, such as film fabrication method, solvent species, and annealing, were found to influence the hole mobility of organic polymers. Despite the fact that many factors can influence their performance, it is believed that polymer surface ordering plays a key role in determining organic polymer function. Here, sum frequency generation (SFG) vibrational spectroscopy was used to nondestructively map the surface/interfacial ordering of poly(3-hexylthiophene) (P3HT) films prepared using different solvents; we believe that solvent interactions determine the degree of surface/interfacial ordering. Both X-ray diffraction (XRD) spectroscopy and scanning electron microscopy (SEM) were used to supplement SFG to systematically study bulk crystallinity and surface morphology. We conclude that SFG is a powerful tool to elucidate the surface/interfacial structural inf...
Combination therapy for rheumatoid arthritis: new paradigms of treatment.

Recent evidence from long-term studies contradicts the perception that rheumatoid arthritis is slowly progressive, relatively benign, and readily controlled with monotherapy.
Ultra-Low Resistance Ni-Based Contacts to n-InP: the Dependence of Contact Resistivity on the Condition of the Metal-Semiconductor Interface

Near-theoretical-minimum values of specific contact resistivity, ρc (in the mid-to-low E-8 Ω-cm2 range) have been achieved for Ni-based contacts to moderately doped (2E18 cm−3) n-type InP. In each case these values are an order of magnitude lower than those previously achieved. These ultra-low resistivities are shown to result when the metallurgical interaction rate between the contact metal and the semiconductor is sufficiently reduced. Several methods of reducing the metal-InP reaction rate and thus achieving lowered resistivity values are demonstrated. We show, for instance, that the introduction of a thin (100A) Au layer at the metal-InP interface retards metal-semiconductor intermixing during sintering and results in a ten-fold reduction in ρc. Another method consists of ensuring the perfection of the near-surface InP lattice prior to and during contact deposition process. Use of this technique has enabled us to fabricate, for the first time, Ni-only contacts with ρc values in the low E-8 Ω-cm2 range. We present an explanation for these observations that is based upon the magnitude of the In-to-P atomic ratio at the metal-InP interface.
The impact of gastroparesis on diabetes control: Patient perceptions.

Abstract The impact of gastroparesis on diabetes management and control from the patient perspective has not been well characterized. The aim of this study was to identify patient perceptions regarding the impact of gastroparesis on managing their diabetes. Methods Patients with diabetes being referred for gastroparesis were enrolled in this prospective study. Gastroparetic symptom severity was assessed with the Patient Assessment of Upper GI Symptoms (PAGI-SYM). A questionnaire examined the impact of gastroparesis on diabetes related symptoms and control. Results 54 diabetic gastroparesis patients (36 T1DM, 18 T2DM) participated. Duration of diabetes averaged 17.4±1.4years and gastroparetic symptoms 5.1±1.1years. Patients rated their most severe symptoms as postprandial fullness, early satiety, and nausea. Two thirds of diabetic subjects identified that since their diagnosis of gastroparesis, their diabetes was more difficult to control (44 of 54 patients) and that extra time and effort were required for care of their diabetes (45 of 54). Patients with T1DM, compared to those with T2DM, more often expressed that since developing gastroparesis, their blood sugars have been higher, they have had more frequent episodes of hypoglycemia, and they found that their gastroparetic symptoms worsened if blood sugars were too high. Conclusions Gastroparesis has a significant impact on patients' perceived ability to self-manage and control their diabetes. T1DM patients, in particular, associate their gastroparesis with episodes of hyper- and hypo-glycemia, and find their gastroparetic symptoms worsen with poor control. Future research should focus on strategies to support self-management of patients with diabetic gastroparesis.
Social Enterprise in Mental Health: An Overview

ABSTRACTThis article provides an overview of the models and concepts of social enterprise utilized for and by people with serious mental illness histories. Although social enterprise in mental health is not new, the naming of it as social enterprise and the attention these efforts have garnered is new. This article will provide a brief history of social enterprise in formal social services; review some conceptual issues and differences between social enterprise in Europe and North America—the two major current centers of its activity; and conclude with some observations of the ways in which mental health social enterprises are developing.
Study on Static Aero-elastic Characteristics of Aircraft Wing

In this thesis,the aerodynamic characteristic of wing is achieved by solving 3D unstructured Euler equations,and by using the flexibility matrix the elastic deformations is calculated,the method of 3D unstructured elastic mesh is introduced to modify the deformed mesh.Simulation of the static aero-elastic characteristics of wing is finished after coupling three forenamed approaches.The static aero-elastic characteristics of wing is analyzed and studied through developing our codes.The results are help to analyzing the static aero-elastic characteristics of wing.
Creation and Practice of Diversified Teaching Methods in Higher Vocational Education——Taking Legal Major for Example

Legal major in Vocational education is one that combining theory together with capacity-building,but traditional teaching methods which focus on the theory indoctrination are not conducive to cultivate students' abilities.To realize the objectives of training applied talents majoring in Legal,certain principles must be based on,and combining with natures of different courses and curriculum goals,the reform of teaching methods should be carried out,and to select and apply to flexible and diverse teaching methods.
Product Quality Control Contract Model in a Two-Echelon Supply Chain

Based on game theory and principal-agent theory,how to design quality control contract in the two-echelon supply chain is studied.The producer's and buyer's expected profits function model is set up,in which the producer makes investment level decision in production process and decides the product quality prevention level,and the buyer makes quality evaluation decision and decides the product quality inspection level.It the producer has the moral hazard of reducing product quality investment level and it reduces the investment,the buyer will pay for the information rents in order to incentive producer improve investment level.The buyer may have the moral hazard of exaggerating product quality defects.The optimization theory is used to solve the producer's optimal investment level,product quality prevention level,price rebates and the buyer's optimal quality inspection level and apportionment ratio of external failure cost.Results of a numerical example show that when producer improve the investment level,the product quality prevention level will increase and the buyer's quality inspection level will decrease.With the improvement of the buyer's product quality inspection level,the producer's price rebates will firstly increase and then decrease,the external failure cost undertook by the producer will decrease,and expected profits will increase,the buyer's expected profits will decrease,and the supply chain's joint expected profits are inverse U-shaped.The maximum expected profits and contract parameters are solved and the results,demonstrate that the quality control contract model is effective.
The problem of exploiting charity and the conclusion

Introduction A formidable barrier to the acceptance of the reading of 2 Thessalonians' eschatological problem proposed in the preceding chapters is the assumption of most scholars in the nineteenth and twentieth centuries that the false eschatological claim of 2:2c underlies the problem of ‘idleness’ in 3:6–15. Indeed, it has been argued that 2 Thess. 3:6ff. reveals why the eschatological problem of ‘the Thessalonians’ needed to be addressed. Disagreement exists regarding whether ‘Paul’ is suggesting that the eschatology intensified the community members' perception of the parousia's imminence, with the consequence that they concluded there was no point in working, perhaps feeling that proclamation of the nearness of the eschaton was more important and urgent; or whether he is assuming that excited anticipation of the parousia so seized ‘the Thessalonians’ that they felt unable to carry out their tasks. Some scholars question whether the false eschatology was the primary causative factor, preferring to see it as one contributing ingredient in a larger problem or merely as a pretext. Others view the ἄτακτοι as the originators of the erroneous eschatological claim referred to in 2:2c. Difficulties of reading 2 Thess. 3:6–15 as an eschatological problem The most striking difficulty of reading the idleness of 2 Thess. 3:6–15 as an eschatological problem is the silence of 2, and indeed 1, Thessalonians regarding any explicit link between the idleness and eschatology. Not only is there no reference to eschatology in 2 Thess. 2:1ff. (or 1 Thess. 4:13–5:11) had direct ethical consequences.
Theology and Political Doctrine in Church and Dissent

It has lately been argued by Jonathan Clark that theological heterodoxy, in particular the Socinian heresy, is “conceptually basic to radicalism in the ancien regime sense”: If Christ were not a person of the Trinity, the Catholic doctrine of the Atonement, held Socinians, was meaningless; if man was not in need of redemption, original sin did not descend by inheritance, and man must be assumed to be both fundamentally benevolent and capable of ordering his own affairs in all respects … A consequence of a denial that Christ exercised divine authority was that He could not institute a priesthood descending by apostolic succession and exercising its mediatory powers by virtue of that divine right: the Anglican clergy were thus on a par, in point of authority, with Dissenting clergy (or even with the private individual.) If even the Church could not claim divine institution, the State was still more obviously secular. “No bishop, no king” was once more a relevant challenge, if mankind was free to amend or reject its ecclesiastical and political hierarchy in the name of reason, conscience or utility.1
Aligning organizational priorities with ARC to improve youth mental health service outcomes.

Objective The Availability, Responsiveness, and Continuity (ARC) organizational intervention is designed to improve community-based youth mental health services by aligning organizational priorities with 5 principles of effective service organizations (i.e., mission driven, results oriented, improvement directed, relationship centered, participation based). This study assessed the effect of the ARC intervention on youth outcomes and the mediating role of organizational priorities as a mechanism linking the ARC intervention to outcomes. Method Fourteen community-based mental health agencies in a midwestern metropolis along with 475 clinicians and 605 youth (ages 5-18) served by those agencies were randomly assigned to the 3-year ARC intervention or control condition. The agencies' priorities were measured with the ARC Principles Questionnaire (APQ) completed by clinicians at the end of the intervention. Youth outcomes were measured as total problems in psychosocial functioning described by their caregivers using the Shortform Assessment for Children (SAC) at 6 monthly intervals. Results The rate of improvement in youths' psychosocial functioning in agencies assigned to the ARC condition was 1.6 times the rate of improvement in agencies assigned to the control condition, creating a standardized difference in functioning of d = .23 between the 2 groups at the 6-month follow-up. The effect on youth outcomes was fully mediated by the alignment of organizational priorities described in the 5 ARC principles (d = .21). Conclusion The ARC organizational intervention improves youth outcomes by aligning organizational priorities with the 5 ARC principles. The findings suggest that organizational priorities explain why some community mental health agencies are more effective than others. (PsycINFO Database Record
Cardiac tamponade as a manifestation of severe dermatomyositis

In connective tissue disorders, the incidence of pericardial disease and pericardial effusion can be up to 58%, and if untreated, it can lead to cardiac tamponade which can be fatal. Physicians must have a high index of suspicion for this disease as diagnosis can be delayed while evaluating more common causes of tachycardia and hypotension in the immunosuppressed (ie, sepsis). We present a 55-year-old woman with a severe case of dermatomyositis, marked by significant weight loss, a bedridden state and hallmark cutaneous findings. On evaluation of interstitial lung disease, a pericardial effusion was incidentally noted. Serial examination revealed increasing fluid accumulation and progressive tachycardia, and diagnosis of cardiac tamponade was made on echocardiography. After initial pericardiocentesis, the effusion rapidly re-accumulated requiring a pericardial window. In severe presentations of rheumatic disease, cardiac tamponade should be considered as a cause of tachycardia, with or without associated hypotension.
The cGMP signaling pathway in retinal photoreceptors and the central role of photoreceptor phosphodiesterase (PDE6).

All eukaryotic cells utilize cyclic nucleotides—specifically cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP)—as intracellular messengers in a wide variety of cell signaling pathways. In addition to the visual signaling pathway (the focus of this review), cGMP is involved in numerous other physiological processes, including vascular smooth muscle relaxation, natriuresis, platelet function, neutrophil adhesion, sperm motility, neuronal signaling, and other sensory transduction systems [1]. The metabolism of cGMP is controlled by the synthetic enzymes, guanylate cyclases (GCs), and hydrolytic enzymes, cyclic nucleotide phosphodiesterases (PDEs). Cytoplasmic levels of cGMP may also be modulated nonenzymatically by sequestration by cGMP-binding proteins [2] or by transport mechanisms that cause cGMP efflux from the cell [3]. Changes in cytoplasmic cGMP concentration affect cGMP signaling pathways by changing the extent of binding to specific cGMP-binding proteins (receptors). Targets of cGMP action include cGMPdependent protein kinases (PKGs), cyclic nucleotide-gated (CNG) ion channels, and cGMP-binding PDEs, all of which are allosterically regulated by cGMP binding to noncatalytic regulatory sites on these proteins.
Predicting survival after acute civilian penetrating brain injuries The SPIN score

Objective: To identify predictors associated with survival in civilian penetrating traumatic brain injury (pTBI) utilizing a contemporary, large, diverse 2-center cohort, and to develop a parsimonious survival prediction score for pTBI. Methods: Our cohort comprised 413 pTBI patients retrospectively identified from the local trauma registries at 2 US level 1 trauma centers, of which one was predominantly urban and the other predominantly rural. Predictors of in-hospital and 6-month survival identified in univariate and multivariable logistic regression were used to develop the simple Surviving Penetrating Injury to the Brain (SPIN) score. Results: The mean age was 33 ± 16 years and patients were predominantly male (87%). Survival at hospital discharge as well as 6 months post pTBI was 42.4%. Higher motor Glasgow Coma Scale subscore, pupillary reactivity, lack of self-inflicted injury, transfer from other hospital, female sex, lower Injury Severity Score, and lower international normalized ratio were independently associated with survival (all p Conclusions: The SPIN score, a logistic regression–based clinical risk stratification scale estimating survival after pTBI, was developed in this large, diverse 2-center cohort. While this preliminary clinical survival prediction tool does not include radiologic factors, it may support clinical decision-making after civilian pTBI if external validation confirms the probability estimates.
Critical Shortage of Neurologists in the Management of Cerebrovascular Accidents in Developing Countries: The Role of Telemedicine (P6.032)

Objective Over the past few decades, there has been a steady rise in the incidence of cerebrovascular events in the developing world, and it is likely to worsen based on the World Health Organization projections. Given the shortcomings of health resource management in developing countries, neuro-critical care is inadequate, resulting in significant morbidity and mortality. This review examines deficiencies in stroke management in resource-limited settings with a bid to inform targeted recommendations, and subvert adverse socioeconomic effects. Methods Literature search on CVA in developing countries was done via Pubmed, MEDLINE, and Research Gate, using strict selection criteria. Qualitative analysis of original research studies was conducted, and significant findings synthesized. Findings A critical shortage of trained neurologists and other allied healthcare workers exists. There is a wide gap in the ratio of trained neurologists/patients between lesser developed and more developed countries (5.2 neurologists/100,000 people in the United States; 1.4 neurologists/100,000 people in Spain; while up to twelve other developing nations with a total population of 25,939,273 report having no neurologists). Also, very few healthcare facilities are equipped with adequate diagnostic capabilities. Specialized multidisciplinary stroke units are yet to be implemented in many developing countries. While these healthcare systems are not well-positioned to meet the demand for a holistic approach to stroke management, recent advances in technology and mobile health provide a sliver of hope, through which existing challenges can be addressed cost-effectively. Telemedicine, with the use of mobile devices may aid in enhancing public awareness and training of healthcare professionals. Additionally, its applicability as supplementary tools can be implemented in the assessment and evaluation of acute stroke, and in tele-rehabilitation for post-stroke patients. Conclusion Rising CVA incidence in developing countries needs focused attention for improved outcome. Tele-neurology application is a vital tool for provision of multidisciplinary stroke care. Disclosure: Dr. Asemota has nothing to disclose.
Assistive Intelligent Robotic Wheelchairs

In a world where technological achievements and breakthroughs are astonishing and where computers and all kinds of electronic devices have become one with their users, there are still people that need assistance. This type of aid often has to come through technology and the implementation of ideas. People with disabilities and the elderly usually require diligent monitoring and help to complete their daily tasks.
Consuming a Ketogenic Diet while Receiving Radiation and Chemotherapy for Locally Advanced Lung Cancer and Pancreatic Cancer: The University of Iowa Experience of Two Phase 1 Clinical Trials

Ketogenic diets are low in carbohydrates and high in fat, which forces cells to rely more heavily upon mitochondrial oxidation of fatty acids for energy. Relative to normal cells, cancer cells are believed to exist under a condition of chronic mitochondrial oxidative stress that is compensated for by increases in glucose metabolism to generate reducing equivalents. In this study we tested the hypothesis that a ketogenic diet concurrent with radiation and chemotherapy would be clinically tolerable in locally advanced non-small cell lung cancer (NSCLC) and pancreatic cancer and could potentially exploit cancer cell oxidative metabolism to improve therapeutic outcomes. Mice bearing MIA PaCa-2 pancreatic cancer xenografts were fed either a ketogenic diet or standard rodent chow, treated with conventionally fractionated radiation (2 Gy/fraction), and tumor growth rates were assessed daily. Tumors were assessed for immunoreactive 4-hydroxy-2-nonenal-(4HNE)-modfied proteins as a marker of oxidative stress. Based on this and another previously published preclinical study, phase 1 clinical trials in locally advanced NSCLC and pancreatic cancer were initiated, combining standard radiation and chemotherapy with a ketogenic diet for six weeks (NSCLC) or five weeks (pancreatic cancer). The xenograft experiments demonstrated prolonged survival and increased 4HNE-modfied proteins in animals consuming a ketogenic diet combined with radiation compared to radiation alone. In the phase 1 clinical trial, over a period of three years, seven NSCLC patients enrolled in the study. Of these, four were unable to comply with the diet and withdrew, two completed the study and one was withdrawn due to a dose-limiting toxicity. Over the same time period, two pancreatic cancer patients enrolled in the trial. Of these, one completed the study and the other was withdrawn due to a dose-limiting toxicity. The preclinical experiments demonstrate that a ketogenic diet increases radiation sensitivity in a pancreatic cancer xenograft model. However, patients with locally advanced NSCLC and pancreatic cancer receiving concurrent radiotherapy and chemotherapy had suboptimal compliance to the oral ketogenic diet and thus, poor tolerance.
False data attack models, impact analyses and defense strategies in the electricity grid

Abstract The injection of false data is a type of cyber-attack that targets the data and measurements in power systems to disrupt their normal operation. This article presents a comprehensive review of such attacks against modern power systems from three perspectives: attack models, their operational impacts and defense strategies. Also discussed are future research directions in this field and existing technical challenges.
ZAFFARONI, Eugenio Raúl: La cuestión criminal. Planeta, Buenos Aires, 2012, 2ª Edición. 400 páginas.

ZAFFARONI, Eugenio Raul: La cuestion criminal . Planeta, Buenos Aires, 2012, 2a Edicion. 400 paginas.
A coastal surface seawater analyzer for nitrogenous nutrient mapping

Abstract Satellite-data-based modeling of chlorophyll indicates that ocean waters in the mesosphere category are responsible for the majority of oceanic net primary productivity. Coastal waters, which frequently have surface chlorophyll values in the mesosphere range and have strong horizontal chlorophyll gradients and large temporal variations. Thus programs of detailed coastal nutrient surveys are essential to the study of the dynamics of oceanic net primary productivity, along with land use impacts on estuarine and coastal ecosystems. The degree of variability in these regions necessitates flexible instrumentation capable of near real-time analysis to detect and monitor analytes of interest. This work describes the development of a portable coastal surface seawater analyzer for nutrient mapping that can simultaneously elucidate with high resolution the distribution of nitrate, nitrite, and ammonium - the three principal nitrogenous inorganic nutrients in coastal systems. The approach focuses on the use of pulsed xenon flash lamps to construct an analyzer which can be adapted to any automated chemistry with fluorescence detection. The system has two heaters, on-the-fly standardization, on-board data logging, an independent 24 volt direct current power supply, internal local operating network, a 12 channel peristaltic pump, four rotary injection/selection valves, and an intuitive graphical user interface. Using the methodology of Masserini and Fanning (2000) the detection limits for ammonium, nitrite, and nitrate plus nitrite were 11, 10, and 22 nM, respectively. A field test of the analyzer in Gulf of Mexico coastal waters demonstrated its ability to monitor and delineate the complexity of inorganic nitrogen nutrient enrichments within a coastal system.
Type B Hemophilus Influenzae Epididymo-Orchitis in the Prepubertal Boy

The ninth pediatric case of type B Hemophilus influenzae epididymo-orchitis is reported and the literature is reviewed. This is a manifestation of systemic infection and these children often are toxic at presentation. Scrotal fluid cultures may be sterile if inappropriate culture media are used. The urinary tract is not the primary source of infection and radiographic correlation has not proved to be valuable. Antibiotic therapy may need to be prolonged in selected cases. Testicular atrophy has not been noted in these children at followup.
Relapse of porphyria cutanea tarda after treatment with phlebotomy or 4-aminoquinoline antimalarials: a meta-analysis.

Background Porphyria cutanea tarda (PCT) is the most common human porphyria. It is caused by hepatic deficiency of uroporphyrinogen decarboxylase activity, which is acquired in the presence of multiple susceptibility factors. PCT presents clinically with cutaneous blistering photosensitivity and is readily treatable with either repeated phlebotomy or 4-aminoquinoline antimalarials. Objectives To perform a systematic review and meta-analysis to compare the effectiveness of these quite different treatment approaches, especially on relapse rates (RRs) after achieving remission. Methods Published studies that included follow-up for at least 1 year after treatment of PCT were included. The primary study outcome was PCT relapse. Pooled data are reported as the RRs per person-year of follow-up with 95% confidence intervals (CIs). Results Of 375 articles identified as pertaining to PCT treatment, 12 were eligible for analysis. Of these, five used high-dose 4-aminoquinoline regimens (two combined with phlebotomy and three without phlebotomy), five used low-dose 4-aminoquinoline regimens and three used phlebotomy. RRs during the year after treatment were similar for the high- and low-dose 4-aminoquinoline groups (35-36%) and lower in the phlebotomy group (20%). The pooled RRs with their 95% CIs were 8·6 (3·9-13·3) per 100 person-years in the high-dose 4-aminoquinoline group, 17·1 (8·9-25·3) per 100 person-years in the low-dose 4-aminoquinoline group and 5·1 (0·5-10·6) per 100 person-years in the phlebotomy group. Subgroup and sensitivity analyses showed similar results. Conclusions Clinical or biochemical RRs ranged from 5 to 17 per 100 person-years after remission of PCT. Relapses were somewhat more frequent after remission with 4-aminoquinoline regimens than after remission following phlebotomy. Prospective studies are needed to define better how often relapses occur with these treatments after documenting both clinical and biochemical remission of PCT.
Digital health intervention as an adjunct to a workplace health program in hypertension

Abstract Background Hypertension is a common and difficult-to-treat condition; digital health tools may serve as adjuncts to traditional pharmaceutical and lifestyle-based interventions. Using a retrospective observational study we sought to evaluate the effect of a desktop and mobile digital health intervention (DHI) as an adjunct to a workplace health program in those previously diagnosed with hypertension. Methods As part of a workplace health program, 3330 patients were identified as previously diagnosed with hypertension. A DHI was made available to participants providing motivational and educational materials assisting in the management of hypertension. We evaluated changes in blood pressure, weight, and body mass index (BMI) between users and nonusers based on login frequency to the DHI using multivariate regression through the five visits over the course of 1 year. Results One thousand six hundred twenty-two (49%) participants logged into the application at least once. DHI users had significant greater improvements in systolic blood pressure (SBP; −2.79 mm Hg), diastolic blood pressure (−2.12 mm Hg), and BMI (−0.23 kg/m2) at 1 year. Increased login frequency was significantly correlated with reductions in SBP, diastolic blood pressure, weight, and BMI (P ≤ .014). Discussion This large, observational study provides evidence that a DHI as an adjunct to a workplace health program is associated with greater improvement in blood pressure and BMI at 1 year. This study adds to the growing body of evidence that DHIs may be useful in augmenting the treatment of hypertension in addition to traditional management with pharmaceuticals and lifestyle changes.
NEUROTRANSMITTER FUNCTION | Consequences of Diminished Function of the Glutamine Cycle on Inhibitory Function in the Epileptic Brain

Synapses regulate their own neurotransmitter supply. Once released, neurotransmitter is recycled, both through direct reuptake and by processing through the astrocytic glutamate–glutamine cycle. Inhibitory synapses exhibit tight, activity-dependent coupling of the GABA supply to the activity of the glutamate–glutamine cycle. Interrupting the glutamine cycle rapidly depletes GABA supply at active inhibitory synapses – which in turn may mediate synaptic scaling, allowing the inhibitory efficacy to ramp up during periods of high excitatory synaptic activity, thus maintaining circuit regulation. In epileptogenic foci in hippocampus resected from patients with temporal lobe epilepsy, the keystone enzyme in the glutamine cycle, glutamine synthetase, is significantly downregulated in reactive astrocytes. GABA supply will also be deficient in this tissue, causing disinhibition and a lack of circuit regulation. This condition could contribute to seizure initiation and/or propagation. Therefore, therapeutic intervention strategies targeted towards restoring the glutamine cycle and GABA levels in epileptic brain appear promising.
Transient Surface Temperature Behavior in the Film Boiling Region

An array of miniature thin-film thermometers was used to measure local, transient boiler-surface temperatures in the film-boiling region of saturated nitrogen. The data recordings were made at selected power levels throughout the region – including the condition of minimum heat flux – and are related to the conventional steady-state heat flux vs. excess temperature boiling behavior. The transient temperature signals illustrate features indicative of liquid impingement on the boiler surface. Additional experiments were performed to simulate liquid impingement on the same boiler surface and thermometer array, and the results substantially confirm the liquid-solid contact hypothesis. A computer-based data recording and processing system made possible both temperature and time expansions of the data for visual analyses. Progressive changes in the local, transient surface temperature characteristics with decreasing power levels – ultimately leading to the collapse of the vapor film at the minimum heat flux – a...