cssi/SciSciGPT-SciSciNet huggingface dataset:
A Respiratory Therapist Disease Management Program for Subjects Hospitalized With COPD

BACKGROUND: Patients with COPD often require repeated emergency department visits and hospitalizations for COPD exacerbations. Such readmissions increase health-care costs and expose COPD patients to the added risks of nosocomial infections and increased mortality. METHODS: To determine whether a respiratory therapist (RT) disease management program could reduce re-hospitalization and emergency department visits, a prospective, single-center, unblinded, randomized trial was performed. RESULTS: We enrolled 428 subjects (214 intervention, 214 control). The primary outcome (combined non-hospitalized emergency department visits and hospital readmissions for a COPD exacerbation during the 6-month follow-up) was similar for the study groups (91 vs 159, P = .08). When the 2 components of the primary end point were analyzed individually, the percentage of subjects with non-hospitalized emergency department visits for COPD exacerbations was similar between groups (15.0% vs 15.9%, P = .79). Readmission for a COPD exacerbation was significantly lower in the intervention group (20.1% vs 28.5%, P = .042). The median (interquartile range) duration of hospitalization for a COPD exacerbation was less for the intervention group (5 [3–11] d vs 8 [4–18.5] d, P = .045). In-patient hospital days (306 d vs 523 d, P = .02) and ICU days (17 d vs 53 d, P = .02) due to COPD exacerbations were significantly less for the intervention group. Mortality was similar for both groups (1.4% vs 0.9%, P > .99). CONCLUSIONS: Our RT disease management program was associated with less readmission, fewer ICU days, and shorter hospital stays due to COPD exacerbations. Further studies are needed to determine the optimal utilization of RT disease management teams for patients with COPD to optimize outcomes and prevent return hospital visits. (ClinicalTrials.gov registration NCT01543217.)
Between Public Management and Post-Modernism: The Future of Public Administration

(1999). Between Public Management and Post-Modernism: The Future of Public Administration. Administrative Theory & Praxis: Vol. 21, No. 4, pp. 520-522.
Tight performance bounds on the performance of a new compressed sensing algorithm

Compressed sensing refers to the recovery of high-dimensional but sparse vectors from a small number of measurements. The original and popular approach to compressed sensing is based on li-norm, popularly referred to as the LASSO formulation. A recent paper gives the "best possible" bounds on when the LASSO formulation is able to achieve compressed sensing. Over the years, the traditional LASSO formulation has been extended to others, such as the Sparse Group LASSO (SGL). In another paper, a special case of SGL called CLOT (Combined L-One and Two) was introduced, which in turn contains LASSO as a special case. It was shown that CLOT combines the best features of both LASSO and another popular approach called Elastic Net (EN). In the present paper, we analyze both the SGL and CLOT formulations, and derive sufficient conditions under which these formulations are able to achieve compressed sensing. When the sufficient conditions for CLOT are specialized to the LASSO formulation, we recover the known "best possible" bounds.
Spectral Representation of Proton NMR Spectroscopy for the Pattern Recognition of Complex Materials

Proton nuclear magnetic resonance (NMR) spectroscopy provides a powerful tool for chemical profiling, also known as spectral fingerprinting, because of its inherent reproducibility. NMR is now increasing in use for authentication of complex materials. Typically, the absorbance spectrum is used that is obtained as the phase-corrected real component of the Fourier transform (FT) of the free induction decay (FID). However, the practice discards half the information that is available in the dispersion spectrum obtained as the imaginary component from the FT. For qualitative analysis or quantitative analysis of small sets of absorbance peaks, the symmetric and sharp peaks of the real spectra work well. However, for pattern recognition of entire spectra, trading peak resolution for peak reproducibility is beneficial. The absolute value of the complex spectrum gives the length or magnitude of magnetization vector in the complex plane; therefore, the magnitude relates directly to the signal (i.e., induced magnetization). The magnitude spectrum is obtained as the absolute value from the real and imaginary spectral components after the FT of the FID. By breaking with tradition and using the magnitude spectrum the reproducibility of the spectra and consequent recognition rates can be improved. This study used a 500-MHz 1H NMR instrument to obtain spectra from 4 diverse datasets; 12 tea extracts, 8 liquor samples, 9 hops extracts, and 25 Cannabis extracts. Six classifiers were statistically evaluated using 100 bootstrapped Latin partitions. The classifiers were a fuzzy rule-building expert system (FuRES) tree, support vector machine trees (SVMTreeG and SVMTreeH), a regularized linear discriminant analysis (LDA), super partial least squares discriminant analysis (sPLS-DA), and a one against all support vector machine (SVM). All classifiers gave better or equivalent results for the magnitude spectral representation than for the real spectra, except for one case of the 24 evaluations. In addition, the enhanced reproducibility of the absolute value spectra is demonstrated by comparisons of the pooled within sample standard deviations. For pattern recognition of NMR spectra, the magnitude spectrum is advocated.
MODULATION OF THE STRUCTURE OF THE NUCLEOSOME CORE PARTICLE DURING DEVELOPMENT

ABSTRACT: Conservation of sequence is a hallmark feature of the inner nucleosomal histones in adult metazoans, as is conservation of structure of the nucleosomal core particle. In contrast, histone variants arise from post-synthetic modification or occur in sperm and early embryos of sea urchins. Ef fects of such altered histones on several static and dynamic features of core particle structure have been determined, using acetylated histones, s. purpuratus sperm, blastula and pluteus. For each case, significant modulation of core particle structure in terms of DNase I cutting site susceptibility, low ionic strength unfolding, and/or thermal denaturation, was observed. Histone variants have demonstrated effects on chromatin structure, even at the most basic level, the core particle; we suggest that these structural alterations likely have functional consequences in vivo.
“It is definitely not the priority”: A postcolonial inquiry of social studies education in the Commonwealth of the Northern Mariana Islands

Abstract This study employs a postcolonial lens to explore social studies education curriculum in the Commonwealth of the Northern Mariana Islands (CNMI). By using a web-based open-ended questionnaire and an exhaustive recruitment strategy, every middle and high school social studies teacher in the CNMI had an opportunity to participate in this study. Questionnaire responses and follow-up interviews reveal the ways in which social studies education in the CNMI is convergent and divergent with mainland iterations of social studies and the complexity of continual normative renegotiation of education given its colonial relationship with the United States.
Heart Failure and Sudden Cardiac Death.

The Centers for Diseases Control and Prevention estimates that 5.7 million adults in the United States suffer from heart failure and 1 in 9 deaths in 2009 cited heart failure as a contributing cause. Almost 50% of patients who are diagnosed with heart failure die within 5 years of diagnosis. Cardiovascular disease is a public health burden. The prognosis of patients with heart failure has improved significantly. However, the risk for death remains high. Managing sudden death risk and intervening appropriately with primary or secondary prevention strategies are of paramount importance.
UV light absorption parameters of the pathobiologically implicated bilirubin oxidation products, MVM, BOX A, and BOX B.

Abstract The formation of the bilirubin oxidation products (BOXes), BOX A ([4-methyl-5-oxo-3-vinyl-(1,5-dihydropyrrol-2-ylidene)acetamide]) and BOX B (3-methyl-5-oxo-4-vinyl-(1,5-dihydropyrrol-2-ylidene)acetamide), as well as MVM (4-methyl-3-vinylmaleimide) were synthesized by oxidation of bilirubin with H2O2 without and with FeCl3, respectively. Compound identity was confirmed with NMR and mass spectrometry (MS; less than 1 ppm, tandem MS up to MS4). UV absorption profiles, including λmax, and extinction coefficient (e; estimated using NMR) for BOX A, BOX B, and MVM in H2O, 15% CH3CN plus 10 mM CF3CO2H, CH3CN, CHCl3, CH2Cl2, and 0.9% NaCl were determined. At longer wavelengths, λmax's for 1) BOX A were little affected by the solvent, ranging from 295–297 nm; 2) BOX B, less polar solvent yielded λmax's of lower wavelength, with values ranging from 308–313 nm, and 3) MVM, less polar solvent yielded λmax's of higher wavelength, with values ranging from 318–327 nm. Estimated e’s for BOX A and BOX B were approximately 5- to 10-fold greater than for MVM.
Judicial Opinions and Journal Articles as 'Minefields of Misinformation'

According to Judge Richard Posner, judicial opinions may be a mine of misinformation, but this tends not to be recognized because rarely do "commentators get hold of the briefs and record to check the accuracy of the factual recitals in the opinion." By comparing several opinions with their underlying records, evidence is here adduced in support of Judge Posner's hypothesis. The practical import of such findings are described by Judge Posner: "All this would be of relatively little importance were it not that lawyers' and, particularly judges' knowledge of the world, or at least the slice of the world relevant to legal decision making, derives to a significant degree from judicial opinions." Given the multiplier effect generated by precedent, as increasing numbers of opinions (generally, unknowingly) come to rely on factually incorrect recitals provided in earlier opinions, the threat to the administration of justice becomes more widespread. This suggests the need for a system that would identify and make these errors known before their damaging impact becomes magnified.
Spezielle Untersuchungsmethoden: nichtinvasiv

Die speziellen kardiologischen Untersuchungsmethoden teilt man zweckmasigerweise in nichtinvasive und invasive Verfahren ein. Diese Trennung wird in allen nachfolgenden von den einzelnen Krankheitsbildern handelnden Abschnitten eingehalten. Die in den 2 folgenden Kapiteln gegebenen Beschreibungen beinhalten die allgemeinen Prinzipien, die den kardiologischen Untersuchungen zugrunde liegen. Sie zielen nicht darauf ab, dem Leser ausreichende technische Details zu vermitteln, um die Untersuchungsmasnahmen selbstandig vornehmen zu konnen. Vielmehr sollen sie helfen, die kardiologischen Untersuchungen verstehen und interpretieren zu lernen. Die technischen Fertigkeiten und Feinheiten eignet man sich am besten mit Hilfe eines erfahrenen Klinikers an, indem man bei der Durchfuhrung der Untersuchungen mitarbeitet und diese auf Patienten anwendet, die man selbst aufgenommen und korperlich untersucht hat.
"He told me it would be extremely selfish of me to even consider [having kids]": The importance of reproductive health to women with spina bifida and the lack of support from their providers.

Abstract Background As more women with spina bifida (SB) enter their reproductive years, the number having children is significantly increasing. However, little is known about their understanding of their ability to get pregnant or their experiences in considering, planning, or interacting with providers during a pregnancy. Objective We sought to determine what women have been told and understand about their reproductive health, their attitudes towards having children, and their experiences interacting with providers when seeking reproductive health care. Methods In this exploratory study employing qualitative research methods and following Grounded Theory, interviews with women with SB 16 years or older were transcribed verbatim and analyzed by three coders. Results Interviews of 25 women with SB ages 16–52 (median 26) revealed the following themes about their reproductive health perceptions and experiences: 1) poor understanding of reproductive health and potential, 2) interest in having a family, 3) facing provider's opposition to their reproductive goals, 4) going into pregnancy and delivery unprepared, 5) the importance of provider support for reproductive goals. Five women experienced an unintended pregnancy. Conclusions Although having children is important to most women with SB in this study, they report a poor understanding of their reproductive potential with several noting unintended pregnancies. They feel uninformed and unprepared during pregnancy and face discouragement from providers. Those experiencing supportive providers report a more positive experience. This demonstrates the urgent need to educate women with SB about their reproductive health and the providers who care for them how to support and counsel these women.
Preformulation Characterization and Stability Assessments of Secretory IgA Monoclonal Antibodies as Potential Candidates for Passive Immunization by Oral Administration.

Abstract Enterotoxigenic Escherichia coli (ETEC) is a major cause of diarrheal disease among children in developing countries, and there are no licensed vaccines to protect against ETEC. Passive immunization by oral delivery of ETEC-specific secretory IgAs (sIgAs) could potentially provide an alternative approach for protection in targeted populations. In this study, a series of physiochemical techniques and an in vitro gastric digestion model were used to characterize and compare key structural attributes and stability profiles of 3 anti–heat-labile enterotoxin mAbs (sIgA1, sIgA2, and IgG1 produced in CHO cells). The mAbs were evaluated in terms of primary structure, N-linked glycan profiles, size and aggregate content, relative apparent solubility, conformational stability, and in vitro antigen binding. Compared to IgG1 mAb, sIgA1 and sIgA2 mAbs showed increased sample heterogeneity, especially in terms of N-glycan composition and the presence of higher molecular weight species. The sIgA mAbs showed overall better physical stability and were more resistant to loss of antigen binding activity during incubation at low pH, 37°C with pepsin. These results are discussed in terms of future challenges to design stable, low-cost formulations of sIgA mAbs as an oral supplement for passive immunization to protect against enteric diseases in the developing world.
Ferroelectric FET Based TCAM Designs for Energy Efficient Computing

As Moore's law based device scaling and accompanying performance scaling trends slow down, there is increasing interest in new technologies and computational paradigms that enable faster and more energy-efficient information processing. Meanwhile, there is growing evidence that in the context of traditional Boolean circuits and/or von Neumann architectures, it will be challenging for beyond-CMOS devices to compete with the CMOS technology. Exploiting the unique characteristics of emerging devices – especially in the context of alternative circuits and architectural paradigms – has the potential to offer orders of magnitude improvement in terms of energy and/or performance. In this work, we show how our research work has leveraged the unique characteristics of emerging devices to build efficient circuits and architectures with significant improvements in energy and performance for various data-intensive applications. Specifically, we consider Ferroelectric FETs (FeFETs) which are nonvolatile and can function as both a transistor and a storage element. This unique property enables FeFETs to be used for building area efficient and low-power ternary content addressable memories (TCAMs). TCAMs are desirable in many applications including network routers and cognitive learning tasks. Using models calibrated by experimentally demonstrated ferroelectric material or device, as well as detailed circuit simulations, we show that the FeFET-based TCAMs we proposed can enable orders of magnitude improvements in energy efficiency and performance when considering array-level computing tasks in the IoT domain.
Cost-Effective High Torque Density Bi-Magnet Machines Utilizing Rare Earth and Ferrite Permanent Magnets

This paper proposes a novel Bi-Magnet machine design concept in which ferrite and rare earth magnet materials are both utilized for torque production. The proposed design aims to reduce the cost of permanent magnet machines by minimizing the use of expensive high-grade rare earth magnet materials without compromising the high performance associated with them. The decreased performance due to the reduced rare earth magnet content can be compensated by adding inexpensive ferrite magnets. The design was optimized to achieve maximum cost-savings by minimizing the rare earth magnet content and improving the saliency of the rotor structure. A comparative study was conducted to highlight the advantages of the proposed concept using the Camry 2007 model as the baseline design. The results show that the proposed design is capable of achieving the same torque and power density as the baseline design using 30% less rare earth magnet materials, resulting in 20% active material cost reduction. The Bi-Magnet machine concept is shown to maintain the superior performance of conventional rare earth permanent magnet machines at a lower cost.
Nonreciprocal Emissive and Absorptive Processes

Publisher Summary This chapter discusses the non-reciprocal emissive and absorptive processes. Two upper states of the same angular momentum radiatively decay to the same final level and are coupled through this decay. It has been shown that if two levels decay to an identical continuum, then this decay couples these levels and results in nonreciprocal emissive and absorptive profiles. When a photon is spontaneously emitted by an upper state, it has a probability of being instantaneously reabsorbed by the other upper state of the same atom. Therefore, the upper states are coupled. The decay rate of the cancelable channel is larger than the decay rate of the noncancelable channels. For this condition, the ratio of the stimulated emission cross section to the absorption cross section is equal to the ratio of the cancelable and noncancelable decay rates. A density matrix based computer model have been developed to include the effects of dephasing collisions, excitation and de-excitation rates, and non-cancelable decay channels and to study the large signal behavior. There are non-linear processes that will operate by virtue of the coupling to the continuum.
Inflammation-Induced Abnormal Expression of Self-molecules on Epithelial Cells: Targets for Tumor Immunoprevention.

Tumor-associated antigens (TAA) are self-molecules abnormally expressed on tumor cells, which elicit humoral and cellular immunity and are targets of immunosurveillance. Immunity to TAAs is found in some healthy individuals with no history of cancer and correlates positively with a history of acute inflammatory and infectious events and cancer risk reduction. This suggests a potential role in cancer immunosurveillance for the immune memory elicited against disease-associated antigens (DAA) expressed on infected and inflamed tissues that are later recognized on tumors as TAAs. To understand probable sources for DAA generation, we investigated in vitro the role of inflammation that accompanies both infection and carcinogenesis. After exposure of normal primary breast epithelial cells to proinflammatory cytokines IL1β, IL6, and TNFα, or macrophages producing these cytokines, we saw transient overexpression of well-known TAAs, carcinoembryonic antigen and Her-2/neu, and overexpression and hypoglycosylation of MUC1. We documented inflammation-induced changes in the global cellular proteome by 2D difference gel electrophoresis combined with mass spectrometry and identified seven new DAAs. Through gene profiling, we showed that the cytokine treatment activated NF-κB and transcription of the identified DAAs. We tested three in vitro–identified DAAs, Serpin B1, S100A9, and SOD2, and found them overexpressed in premalignant and malignant breast tissues as well as in inflammatory conditions of the colon, stomach, and liver. This new category of TAAs, which are also DAAs, represent a potentially large number of predictable, shared, immunogenic, and safe antigens to use in preventative cancer vaccines and as targets for cancer therapies.
(Invited) 3D-NAND Reliability: Review of key mechanisms and mitigations

As scaling of 2D-NAND reached severe limitations several years ago, the industry has transitioned to 3D-NAND array architectures that are enabling continued scaling through stacking of cells in the vertical dimension. While 3D-NAND cells have inherent capability advantages due to the larger cell size and gate all-around structure, there are also several unique and particularly severe reliability mechanisms at play. Here, we will briefly review the physical model understanding of some of the key mechanisms impacting reliability on 3D-NAND, arising from the polysilicon channel with its grain boundaries, floating body, new block architecture, silicon nitride charge-trap layer, and virtual source/drain.
Teasing Apart the Effect of Depression Specific and Anxiety Specific Symptoms on Academic Outcomes

Research shows that adolescents' performance in school can be negatively affected by depression and anxiety. However, past studies have used nonspecific measures of depression and anxiety that preclude researchers from understanding their unique effects. The current study addressed this gap in the literature by teasing apart the effects of depression specific and anxiety specific symptoms on end of semester grade point average (GPA) and the likelihood of dropping a course. We used a 3-month longitudinal design with a sample of 130 United States (U.S.) undergraduates. Results showed that only cumulative GPA and ACT score predicted end of semester GPA. However, high levels of anxiety specific (anxious arousal), but not depression specific (anhedonia), symptoms predicted whether or not a student dropped a course. These results suggest that targeting anxiety specific symptoms in schools may be effective in improving academic outcomes.
Rhetorical Vessels: Public Womanhood as Visual Warrant in World War II Venereal Disease Campaigns

This article considers how venereal disease campaigns during World War II offered a warrant through public health discourse for the mass incarceration of American women in an era of shifting gender...
Default priors and predictive performance in Bayesian model averaging, with application to growth determinants

Bayesian model averaging (BMA) has become widely accepted as a way of accounting for model uncertainty, notably in regression models for identifying the determinants of economic growth. To implement BMA the user must specify a prior distribution in two parts: a prior for the regression parameters and a prior over the model space. Here we address the issue of which default prior to use for BMA in linear regression. We compare 12 candidate parameter priors: the unit information prior (UIP) corresponding to the BIC or Schwarz approximation to the integrated likelihood, a proper data-dependent prior, and 10 priors considered by Fernandez et al. (Journal of Econometrics 2001; 100: 381–427). We also compare two model priors: the uniform model prior and a prior with prior expected model size 7. We compare them on the basis of cross-validated predictive performance on a well-known growth dataset and on two simulated examples from the literature. We found that the UIP with uniform model prior generally outperformed the other priors considered. It also identified the largest set of growth determinants. Copyright © 2009 John Wiley & Sons, Ltd.
Review of Pharmacist Driven Penicillin Allergy Assessments and Skin Testing: A Multi-Center Case-Series:

Objective: To describe the impact of pharmacy driven penicillin allergy assessments on de-labeling penicillin allergies and antibiotic streamlining opportunities for hospitalized patients. Design: ...
Outdoor and indoor concentrations of size-resolved particulate matter during a wildfire episode in interior Alaska and the impact of ventilation

Residential areas are being increasingly impacted by wildfire smoke that causes hazardous local ambient air quality conditions. Poor outdoor air quality also exacerbates the quality of indoor air as smoke particles penetrate the building envelope or the heating, ventilation, and air-conditioning (HVAC) filtration systems. In this work, we investigate the impact of wildfire-affected poor ambient air quality on indoor air particulate matter during a wildfire episode in June 2015 in interior Alaska. We measured size-resolved (0.3–10 μm) particle number counts (PNC; numbers/cm3) and calculated particle mass concentrations (PMC; μg/m3) outside and inside of three buildings in Fairbanks, Alaska, during this summer wildfire event. For comparison, the measurements were repeated during a no-wildfire period in summer 2017. Our results show that the fire episode increased the total PNC by factors of 189.4–244 in the outdoor air and by 19.5–150 in the indoor air compared to the total PNC measured during a non-fire season. The PNC was primarily dominated by particles in the size range 0.3–1 μm (> 99%) at all locations during the fire season, whereas the PMC was dominated by particles in the size range from 2.5 to 10 μm (40–67%). The indoor to outdoor ratio (I/O) of PNC during the fire season was significantly lower for an unventilated building (I/O = 0.13 ± 0.001) as compared to those with active (filtered) ventilation (I/O = 0.76 ± 0.11 and 0.62 ± 0.02), suggesting that lower efficiency filters (< Minimum Efficiency Reporting Value or MERV rating 11) often used in residential and public buildings may not control the infiltration of smaller smoke particles during a wildfire event. Although this study had a small sample size, the limited data collected here indicates that sheltering in a closed, non-ventilated building may be an effective strategy to reduce exposure to particulate matter during wildfires, given that there are no significant indoor source(s) of particulates and that the air leakage is insignificant. Finally, this study also shows that particulate mass concentrations (μg/m3) may not fully describe the relative differences between indoor and outdoor air quality especially during wildfire episodes.
Ultraviolet-Induced Immune Suppression and its Relationship to Statospheric Ozone Depletion

Ultraviolet radiation-B (280–320nm) is linked directly to skin cancer formation and is also associated with significant immunological alterations leading to local and systemic immunosuppression in mammals. The mechanism as well as the short or long-term effects of such immunological perturbations is largely unknown. This mechanism may, however, play a critical role in human skin cancer development and other UVB-related disorders.
Floer Homotopy Theory, Realizing Chain Complexes by Module Spectra, and Manifolds with Corners

In this paper we describe and continue the study begun in Cohen et al. (Progress in Mathematics, vol. 133, Birkhauser, Boston, 1995, pp. 287–325) of the homotopy theory that underlies Floer theory. In that paper the authors addressed the question of realizing a Floer complex as the cellular chain complex of a CW-spectrum or pro-spectrum, where the attaching maps are determined by the compactified moduli spaces of connecting orbits. The basic obstructions to the existence of this realization are the smoothness of thesemoduli spaces, and the existence of compatible collections of framings of their stable tangent bundles. In this note we describe a generalization of this, to show that when these moduli spaces are smooth, and are oriented with respect to a generalized cohomology theory E*, then a Floer E*-homology theory can be defined. In doing this we describe a functorial view point on how chain complexes can be realized by E-module spectra, generalizing the stable homotopy realization criteria given in Cohen et al. (Progress inMathematics, vol. 133, Birkhauser, Boston, 1995, pp. 287–325). Since these moduli spaces, if smooth, will be manifolds with corners, we give a discussion about the appropriate notion of orientations of manifolds with corners.
Brenner, Sydney (1927–)

First page of article Keywords: Brenner, Sydney (molecular genetics development); Caenorhabditis elegans
Evaluation of a Measure of Engagement for Group Work

ObjectiveThis study examines the psychometric properties of a measure of engagement for group work, the Groupwork Engagement Measure (GEM).MethodThe measure's properties were tested at two differen...
A View Selection Tool for Multidimensional Databases

Materialized views speed up query response time at the cost of view maintenance and data duplication. However, for some systems, the use of materialized views is restricted by factors like space availability and query response time. Not all possible views for a multidimensional cube can be materialized because the number of views grows exponential to the number of cube dimensions. The system must decide which subset of materialized views produce the maximum benefit in terms of some constraints. There are many algorithms in the literature that address this problem, BPUS and PBS algorithms address the problem of view selection in multidimensional database using a benefit metric based on space availability. This paper presents a design and implementation of a tool for view selection for multidimensional databases.
Stroke and Critical Care Seizures

Patients with hemorrhagic stroke are usually admitted for observation to an intensive care unit (ICU). A smaller percentage of patients with ischemic stroke are also admitted, as well as patients with cerebral venous thrombosis or those who have undergone carotid endarterectomy. All these patients are at risk for seizures. Those with hemorrhagic stroke are usually at two to three times higher risk than those with ischemic stroke, but several characteristics of the stroke modify the risk for having a seizure. In most cases an early seizure (within the first few days after the ictus) has a different significance from a late seizure (after the patient has been discharged from the ICU or the hospital). In addition, a significant role is played by the treatment offered to these patients, either medical, surgical, or endovascular. Despite an abundance of studies examining the incidence and characteristics of poststroke seizures, there are several questions still to be answered regarding the institution and duration of the appropriate treatment.
Cardiac Ultrastructural and Electrophysiological Abnormalities in Postweanling Copper-Restricted and Copper-Repleted Rats in the Absence of Hypertrophy

Cardiac ultrastructural and functional characteristics were determined in copper-depleted and copper-repleted rats. Male weanling rats were randomized into five groups that were fed either copper-adequate or copper-deficient diets. After 5 wk, one group fed each diet was studied to obtain baseline values. At this time, one copper-adequate postweanling group continued to receive the adequate diet as control, one deficient postweanling group was fed the adequate diet to evaluate the effect of copper repletion and one postweanling adequate group was fed the deficient diet to evaluate copper depletion in relatively older rats. These dietary treatments were continued for six additional weeks. Copper-depleted rats of both ages exhibited significant cardiac ultrastructural pathology and electrocardiogram abnormalities and the postweanling copper-depleted rats exhibited these abnormalities in the absence of hypertrophy and anemia. Increased mitochondrial volume density, disarranged cristae, and nonaligned myofibrils with disturbances at Z-bands were displayed. Additionally, all copper-depleted rats demonstrated fragmented basal laminae at capillary-myocyte interface. Increased QRS amplitude and notching and greater QT intervals were displayed. Copper-repleted rats exhibited some, but not total, reversal of these abnormalities. These results suggest that capillary-myocyte interface changes may play an important role in the developing pathology of copper depletion.
Race and age at menarche.

2 silk purse-string sutures were placed around its base. Then the cul-de-sac was obliterated by concentric sutures of 2-O silk beginning at the bottom of the cul-de-sac and proceeding upward (Moschowitza operation). The abdominal incision was then closed. The postoperative course was uncomplicated, and she was discharged five weeks after admission. Examination four years after repair shows no recurrence of the enterocele, and she is in good health.
Nanomedicine based approaches for the delivery of siRNA in cancer

Small interfering RNA (siRNA) technology holds great promise as a therapeutic intervention for targeted gene silencing in cancer and other diseases. However, in vivo systemic delivery of siRNA-based therapeutics to tumour tissues/cells remains a challenge. The major limitations against the use of siRNA as a therapeutic tool are its degradation by serum nucleases, poor cellular uptake and rapid renal clearance following systemic administration. Several siRNA-based loco-regional therapeutics are already in clinical trials. Further development of siRNAs for anti-cancer therapy depends on the development of safe and effective nanocarriers for systemic administration. To overcome these hurdles, nuclease-resistant chemically modified siRNAs and variety of synthetic and natural biodegradable lipids and polymers have been developed to systemically deliver siRNA with different efficacy and safety profiles. Cationic liposomes have emerged as one of the most attractive carriers because of their ability to form complexes with negatively charged siRNA and high in vitro transfection efficiency. However, their effectiveness as potential therapeutic carriers is limited by potential for pulmonary toxicity. Recently, our laboratories described the use of neutral 1,2-dioleoyl-sn-glycero-3-phosphatidylcholine based nanoliposomes in murine tumour models. We found this approach to be safe and 10- and 30-fold more effective than cationic liposomes and naked siRNA, respectively, for systemic delivery of siRNA into tumour tissues. Here, we review potential approaches for systemic delivery of siRNA for cancer therapy.
BLOCK OF THE N-METHYL-D-ASPARTATE RECEPTOR BY REMACEMIDE AND ITS DES-GLYCINE METABOLITE

The anticonvulsant and neuroprotective properties of remacemide [(+/-)-2-amino-N-(1-methyl-1,2-diphenylethyl)acetamide] and its active des-glycine metabolite [(+/-)-1-methyl-1,2-diphenylethylamine] may result in part from blockade of N-methyl-D-aspartate (NMDA) receptors. The blocking actions of the remacemide enantiomers and their des-glycinates were investigated in whole cell voltage-clamp recordings from cultured rat hippocampal neurons and in binding studies with [3H]dizocilpine in rat forebrain membranes. (+/-)-Remacemide caused a rapid and reversible inhibition of NMDA-evoked current; the R(+)- and S(-)-enantiomers were roughly equipotent (IC50 values at -60 mV, 67 and 75 microM, respectively). In contrast, the block by the S(+)- and R(-)-des-glycine analogs was slower, more potent and occurred in a stereoselective fashion (IC50 values, 0.7 and 4 microM). The block by S(+)-des-glycine remacemide was strongly use- and voltage-dependent, and, in addition, could be occluded by Mg++, indicating that it occurs by an open channel mechanism. In contrast, the block by R(+)-remacemide was only partially voltage-dependent, suggesting that it occurs by both channel blocking and nonchannel blocking (allosteric) mechanisms. Support for an allosteric mechanism was obtained in nonequilibrium [3H]dizocilpine binding studies where it was observed that 100 microM R(+)-remacemide slowed the dissociation of the radioligand [whereas 10 microM S(+)-des-glycine remacemide did not]. Neither R(+)-remacemide nor S(+)-des-glycine remacemide inhibited currents evoked by kainate, alpha-amino-3-hydroxy-5-methyl-4-isoxazoleproprionate or gamma-aminobutyric acid. We conclude that des-glycine remacemide is a potent and selective channel blocking NMDA receptor antagonist, whereas remacemide is weaker and inhibits NMDA receptors by both channel blocking and nonchannel blocking actions.
Cytokine Diversity in the Th1-Dominated Human Anti-Influenza Response Caused by Variable Cytokine Expression by Th1 Cells, and a Minor Population of Uncommitted IL-2+IFNγ- Thpp Cells

Within overall Th1-like human memory T cell responses, individual T cells may express only some of the characteristic Th1 cytokines when reactivated. In the Th1-oriented memory response to influenza, we have tested the contributions of two potential mechanisms for this diversity: variable expression of cytokines by a uniform population during activation, or different stable subsets that consistently expressed subsets of the Th1 cytokine pattern. To test for short-term variability, in vitro-stimulated influenza-specific human memory CD4+ T cells were sorted according to IL-2 and IFNγ expression, cultured briefly in vitro, and cytokine patterns measured after restimulation. Cells that were initially IFNγ+ and either IL-2+ or IL-2- converged rapidly, containing similar proportions of IL-2-IFNγ+ and IL-2+IFNγ+ cells after culture and restimulation. Both phenotypes expressed Tbet, and similar patterns of mRNA. Thus variability of IL-2 expression in IFNγ+ cells appeared to be regulated more by short-term variability than by stable differentiated subsets. In contrast, heterogeneous expression of IFNγ in IL-2+ influenza-specific T cells appeared to be due partly to stable T cell subsets. After sorting, culture and restimulation, influenza-specific IL-2+IFNγ- and IL-2+IFNγ+ cells maintained significantly biased ratios of IFNγ+ and IFNγ- cells. IL-2+IFNγ- cells included both Tbetlo and Tbethi cells, and showed more mRNA expression differences with either of the IFNγ+ populations. To test whether IL-2+IFNγ-Tbetlo cells were Thpp cells (primed but uncommitted memory cells, predominant in responses to protein vaccines), influenza-specific IL-2+IFNγ- and IL-2+IFNγ+ T cells were sorted and cultured in Th1- or Th2-generating conditions. Both cell types yielded IFNγ-secreting cells in Th1 conditions, but only IL-2+IFNγ- cells were able to differentiate into IL-4-producing cells. Thus expression of IL-2 in the anti-influenza response may be regulated mainly by short term variability, whereas different T cell subsets, Th1 and Thpp, may contribute to variability in IFNγ expression.
Organizational Pitfalls of Reengineering

Abstract Ironically, some of the reasons business process reengineering efforts fail have their roots in the very factors considered essential to the success of BPR initiatives. the primary pitfalls of successful BPR – considering a BPR effort as a massive, new strategy that requires a leader – can be avoided through proactive management and specific guidelines based on past efforts.
Effects of intracellular structural associations on degradation of algal chloropigments in natural oxic and anoxic seawaters

To understand the effects of intracellular structural associations on degradation of algal chloropigments, we conducted a series of microcosm experiments by incubating Emiliania huxleyi cells (a marine haptophyte) in natural oxic and anoxic seawaters collected from a stratified water column in the Cariaco Basin. The incubated cell detritus were sequentially treated with two buffer solutions to separate pigment components into soluble and insoluble fractions. By using non-denaturing gel electrophoresis, several chlorophyll-complexes, free chlorophyll, and another unknown chlorophyll-containing component were further separated from the soluble fraction. The chlorophyll-complexes included those bound with high molecular weight core-proteins (CP-I and CP43+CP47) and low molecular weight polypeptides (LHC-I and LHC-II) in the cellular photosystems PS-I and PS-II. Overall pigment recovery from these fractions and gel bands was well equivalent to the total amount from direct acetone extraction of the cells. We followed the time-dependent concentration changes of chlorophyll-a (Chl-a), phaeophorbide-a (Ppb-a), and phaeophytin-a (Ppt-a) in all fractions and complexes to estimate the degradation rate constants of chloropigments in natural oxic and anoxic seawaters. Our experimental results demonstrated that the intracellular structural associations had important influences on degradation of chloropigments under different redox conditions. In general, total Chl-a degraded faster (∼4X) in oxic seawater than in anoxic seawater. However, the rate differences between oxic and anoxic conditions varied among the fractions and complexes. Degradation rate constants of Chl-a in soluble fraction were much higher (>10X) than those in insoluble fraction under both oxic and anoxic conditions. Chl-a bound with the complexes in PS-II appeared to be more reactive (∼2X) than that in PS-I under oxic conditions but the difference in degradation rate constants between two photosystems became indistinguishable under anoxic conditions. Variations of Ppb-a in different fractions and complexes during incubation showed different patterns, implying that cellular Chl-a could degrade through two different pathways: (1) internal degradation into Ppb-a within insoluble pool and polypeptide complexes; and (2) release first from protein complexes and followed by external degradation.
Which consumers are ready for consumer-directed health plans?

Consumer Directed Health Plans (CDHPs) are new and increasingly popular insurance products in the United States that aim to increase consumer involvement in health care decision-making. Using quantitative and qualitative methods, we examine characteristics of employees in a large firm that voluntarily enroll in CDHPs. We find salaried and hourly high deductible CDHP enrollees to be substantially healthier and have higher educational attainment than Preferred Provider Organizations (PPO) enrollees. There was less favorable selection into a more popular, lower deductible CDHP.
Sciatic Nerve Lipoprotein Lipase Is Reduced in Streptozotocin-Induced Diabetes and Corrected by Insulin

The metabolic abnormalities underlying the cause of diabetic neuropathy have been the subject of much debate. Lipoprotein lipase (LPL) is a 56-kDa enzyme produced by several tissues in the body and has recently been shown in vitro to be expressed in cultured Schwann cells, where it is important in phospholipid synthesis. This suggests a role for LPL in myelin biosynthesis in the peripheral nervous system. The aim of this study was to determine if acute streptozotocin (STZ)-induced diabetes reduces the expression and regulation of sciatic nerve LPL in vivo. Adult Sprague Dawley rats were rendered diabetic via an sc injection of STZ. A decrease in sciatic nerve LPL activity was observed in the STZ-treated rats after just 2 d of diabetes and remained significantly reduced for at least 35 d. The decrease in LPL activity coincided temporally with a drop in motor nerve conduction velocity. Treatment with insulin for 4 d showed a normalization of sciatic nerve LPL activity. These results show that STZ-induced diabetes causes a decrease in LPL activity in the sciatic nerve that, as in other tissues, is reversible with insulin treatment. These data may suggest a role for LPL in the pathophysiology of diabetic neuropathy. (Endocrinology 143: 1213–1217, 2002)
Evanescent detection of adsorbed protein concentration-distance profiles: fit of simple models to variable-angle total internal reflection fluorescence data

Total internal reflection fluorescence spectroscopy (TIRF) is an established technique for following the course of interfacial reactions. Theoretically, by gathering TIRF data as a function of observation angle, one can obtain the density of fluorophores with respect to distance away from a solid/liquid interface. In order that the practical application of the theory might be explored, variable observation angle data from solutions of fluorescein and from adsorbed layers of fluorescein isothiocyanate labeled immunoglobulin have been analyzed in terms of simple concentration-distance profiles. In all cases the general shape of the data curves was found to conform to the theoretical expectation. Layer thickness determinations varied over a range of 20 to 100 nm, with concentrations in the layer ranging from 12 to 61 mg/mL. The theoretical background, sources of error, and system improvements are also discussed.
Persistent ST-segment elevation and left ventricular wall abnormalities: a 2-dimensional echocardiographic study

Twenty-three patients with an anterior wall myocardial infarction (MI) and persistent ST-segment elevations (Group I) were examined for wall motion abnormalities using 2-dimensional (2-D) echocardiography. Twenty-two (96%) had dyskinetic wall motion of the infarcted area and 10 (43%) had a left ventricular aneurysm. Among 15 patients who had a chronic anterior wall MI without ST-segment elevation (Group II), 13 (86%) had akinesia of the infarcted segment. To document that dyskinetic wall motion caused the persistent electrocardiographic ST-segment elevations, 15 patients with an acute anterior wall MI (Group III) were followed by serial 2-D echocardiography for 2 to 24 months (mean 8). Of the 10 patients who had dyskinetic wall motion abnormalities on their initial 2-D echocardiogram, persistent ST-segment elevation developed in 9. All 5 patients with akinetic or severely hypokinetic wall motion abnormalities on their first 2-D echocardiogram did not show ST-segment elevation on late follow-up surface electrocardiograms. Infarct size as determined by peak creatine kinase levels for the former subgroup was greater than that for the latter subgroup (2243 +/- 429 vs 899 +/- 320 IU, respectively, p less than 0.01). In conclusion, persistent ST-segment elevation after an acute anterior wall MI is indicative of dyskinetic wall motion rather than aneurysm formation. Dyskinesia precedes the appearance of ST-segment elevation and is probably responsible for these changes on the surface electrocardiogram. Infarct size is larger in persons in whom dyskinetic wall motion abnormalities are likely to develop.
Transient chemical reaction analysis by orthogonal collocation

Abstract Models of packed-bed chemical reactors most frequently account for the diffusion of mass and energy within catalyst particles. The orthogonal collocation method is developed for transient, nonlinear problems of this type. A sequence of approximate solutions is proved to converge to the exact solution. A stability criterion is presented for estimating the maximum step size to use in the integration. The orthogonal collocation method is applied to linear transient diffusion and gives accuracy to six significant figures for dimensionless times greater than 0·1 using six expansion functions. The method is then applied to nonlinear diffusion and reaction problems which have multiple solutions. Eight to twelve expansion functions are required to give temperatures with accuracies from 0·03% to 0·1% and heat flux at the boundary of the catalyst pellet within 1%. Jacobi polynomials are preferred expansion functions for boundary conditions of the first kind and Legendre polynomials are recommended for boundary conditions of the third kind. Comparison to two finite difference methods indicates that the collocation method is from four to forty times as fast for comparable accuracy.