cssi/SciSciGPT-SciSciNet huggingface dataset:
Spaced education in medical residents: An electronic intervention to improve competency and retention of medical knowledge

Background Spaced education is a novel method that improves medical education through online repetition of core principles often paired with multiple-choice questions. This model is a proven teaching tool for medical students, but its effect on resident learning is less established. We hypothesized that repetition of key clinical concepts in a "Clinical Pearls" format would improve knowledge retention in medical residents. Methods This study investigated spaced education with particular emphasis on using a novel, email-based reinforcement program, and a randomized, self-matched design, in which residents were quizzed on medical knowledge that was either reinforced or not with electronically-administered spaced education. Both reinforced and non-reinforced knowledge was later tested with four quizzes. Results Overall, respondents incorrectly answered 395 of 1008 questions (0.39; 95% CI, 0.36-0.42). Incorrect response rates varied by quiz (range 0.34-0.49; p = 0.02), but not significantly by post-graduate year (PGY1 0.44, PGY2 0.33, PGY3 0.38; p = 0.08). Although there was no evidence of benefit among residents (RR = 1.01; 95% CI, 0.83-1.22; p = 0.95), we observed a significantly lower risk of incorrect responses to reinforced material among interns (RR = 0.83, 95% CI, 0.70-0.99, p = 0.04). Conclusions Overall, repetition of Clinical Pearls did not statistically improve test scores amongst junior and senior residents. However, among interns, repetition of the Clinical Pearls was associated with significantly higher test scores, perhaps reflecting their greater attendance at didactic sessions and engagement with Clinical Pearls. Although the study was limited by a low response rate, we employed test and control questions within the same quiz, limiting the potential for selection bias. Further work is needed to determine the optimal spacing and content load of Clinical Pearls to maximize retention amongst medical residents. This particular protocol of spaced education, however, was unique and readily reproducible suggesting its potential efficacy for intern education within a large residency program.
Sorry I Don’t Dance: Why Men Refuse to Move, Maxine Leeds Craig. Oxford University Press, Oxford/New York (2013), 256 pp.

Reading Maxine Leeds Craig's Sorry I Don’t Dance (2013) caused me to reflect upon my own life. I recall spontaneous dancing to street corner bands as a small child, elementary school “dance parties...
Embedded systems and robotics

This workshop will demonstrate the content of a quarter length course that incorporates elements of both embedded systems and robotics. Attendees will get a handson introduction to such topics as basic electronics, assembling electronic components and electronic circuits, programming a computer chip with an embedded language specific to that chip and then using that chip and circuit board to give functionality to a small, wheeled robot. We will work through a few projects using the Stampworks Basic Stamp 2 computer chip, the PBasic programming software and the Boe-Bot robot all made by Parallex Inc.
An Introduction to Industrial Biocatalysis

Nature is extremely diverse in terms of the large number and many types of organic molecules required for life. This diversity is made possible solely due to the wide catalytic scope of enzymes. It is the ability to harness the catalytic power of enzymes and use it for the synthesis of commercially important products that represents the core technology of applied biocatalysis. This chapter provides an introduction into the field of applied biocatalysis. Specifically, the commercial use of biocatalysts in the food, medical (diagnostic), chemical, and pharmaceutical industries will be discussed along with the future potential for biocatalyst application in such areas. In addition, the advantages and disadvantages of using biocatalysts vs. chemical catalysts will be examined in order to rationalize the use of biocatalysts for processes that have traditionally been slow to utilize such a novel approach.
Pregnancy and cancer.

Cancer is the second most common cause of death in women of reproductive age, with the incidence of cancer in pregnancy ranging from 0.07 to 0.1% [1]. As cancer therapy is becoming more efficacious and women are waiting later to begin childbearing, cancer in pregnancy as well as pregnancy in cancer survivors are both increasing in prevalence. With the increasing survival of cancer patients, issues regarding the quality of life in cancer survivors are becoming progressively more important. Unfortunately, many of the successful treatment options for cancer lead to infertility. In a time of tragedy, while facing the new diagnosis of cancer, it is very difficult for patients to think about the implications of their therapies. As a healthcare provider, one must weigh a variety of considerations in such circumstances including but not limited to the clinical, biological, ethical, legal and psychosocial issues surrounding cancer and pregnancy.
Unfounded Fears About Pollution Trading and Hotspots

EPA emissions inventory and cancer risk data for criteria pollutants and air toxics show clearly that vehicles and small stationary sources emit a majority of the air pollution nationally and account for most of the cancer risks from air toxics. Industrial sources, by contrast, rarely account for more than 10% of cumulative cancer risks from all outdoor sources of air toxics. The observed pattern of emissions is replicated at spatial scales ranging from census tracts to the nation as a whole. The secondary status of industrial facilities as sources of air pollution largely neutralizes the potential for pollution trading programs to cause hotspots. In the vast majority of jurisdictions, industrial emissions are simply too low, and in the few jurisdictions in which disparities cannot be ruled out, targeted policies exist to prevent them without compromising market efficiency. These findings are generalizable to all market-based regulations.
A note on a tight lower bound for capacitated MNL-bandit assortment selection models

Abstract In this short note we consider a dynamic assortment planning problem under the capacitated multinomial logit (MNL) bandit model. We prove a tight lower bound on the accumulated regret that matches existing regret upper bounds for all parameters (time horizon T , number of items N and maximum assortment capacity K ) up to logarithmic factors. Our results close an O ( K ) gap between upper and lower regret bounds from existing works.
A novel glycoproteomics workflow reveals dynamic O-GlcNAcylation of COPγ1 as a candidate regulator of protein trafficking

O-linked β-N-acetylglucosamine (O-GlcNAc) is an abundant and essential intracellular form of protein glycosylation in animals and plants. In humans, dysregulation of O-GlcNAcylation occurs in a wide range of diseases, including cancer, diabetes, and neurodegeneration. Since its discovery more than 30 years ago, great strides have been made in understanding central aspects of O-GlcNAc signaling, including identifying thousands of its substrates and characterizing the enzymes that govern it. However, while many O-GlcNAcylated proteins have been reported, only a small subset of these change their glycosylation status in response to a typical stimulus or stress. Identifying the functionally important O-GlcNAcylation changes in any given signaling context remains a significant challenge in the field. To address this need, we leveraged chemical biology and quantitative mass spectrometry methods to create a new glycoproteomics workflow for profiling stimulus-dependent changes in O-GlcNAcylated proteins. In proof-of-principle experiments, we used this new workflow to interrogate changes in O-GlcNAc substrates in mammalian protein trafficking pathways. Interestingly, our results revealed dynamic O-GlcNAcylation of COPγ1, an essential component of the coat protein I (COPI) complex that mediates Golgi protein trafficking. Moreover, we detected 11 O-GlcNAc moieties on COPγ1 and found that this modification is reduced by a model secretory stress that halts COPI trafficking. Our results suggest that O-GlcNAcylation may regulate the mammalian COPI system, analogous to its previously reported roles in other protein trafficking pathways. More broadly, our glycoproteomics workflow is applicable to myriad systems and stimuli, empowering future studies of O-GlcNAc in a host of biological contexts.
Change in Children's Physical Activity: Predictors in the Transition From Elementary to Middle School.

Introduction Interventions to promote physical activity in children should be informed by knowledge of the factors that influence physical activity behavior during critical developmental transitions. The purpose of this study is to identify, from a comprehensive, multidomain set of factors, those that are associated with change in objectively measured physical activity in children as they transition from elementary to middle school. Methods The study used a prospective cohort design, with children observed in fifth, sixth, and seventh grades. Growth curve analyses were used to examine associations between exposure variables measured at baseline and children's physical activity across three observations. A total of 828 children, aged 10.6 (SD=0.5) years at baseline provided physical activity data in fifth grade and at one or both follow-ups. Exposure variables assessed child characteristics, parent characteristics, home characteristics, social factors, school environment, and community characteristics. Physical activity was measured via accelerometry. Data were collected in two school districts in South Carolina in 2010–2013 and analyzed in 2017. Results Variables measured within the child, parent/home, and community domains were positively associated with children's physical activity as they transitioned from fifth to seventh grade. These included parent encouragement of physical activity, parental support for physical activity, child sports participation, parent's report of the child's physical activity level, the child's time spent outdoors, social spaces for physical activity in the community, and the number of physical activity facilities that were proximal to the child's home. Conclusions Interventions designed to increase children's physical activity should include strategies that target multiple domains of influence.
Recent increases in tropical cyclone intensification rates.

Tropical cyclones that rapidly intensify are typically associated with the highest forecast errors and cause a disproportionate amount of human and financial losses. Therefore, it is crucial to understand if, and why, there are observed upward trends in tropical cyclone intensification rates. Here, we utilize two observational datasets to calculate 24-hour wind speed changes over the period 1982–2009. We compare the observed trends to natural variability in bias-corrected, high-resolution, global coupled model experiments that accurately simulate the climatological distribution of tropical cyclone intensification. Both observed datasets show significant increases in tropical cyclone intensification rates in the Atlantic basin that are highly unusual compared to model-based estimates of internal climate variations. Our results suggest a detectable increase of Atlantic intensification rates with a positive contribution from anthropogenic forcing and reveal a need for more reliable data before detecting a robust trend at the global scale. Tropical cyclones that rapidly intensify are associated with the highest forecast errors and the strongest storms. This study shows that the proportion of tropical cyclones that rapidly intensify recently increased in the Atlantic basin, and that this trend is likely due to anthropogenic forcing.
Hydrops fetalis in a cohort of 3,137 stillbirths and second trimester miscarriages

Hydrops fetalis was diagnosed in 277 (9%) of 3,137 fetuses referred to the Wisconsin Stillbirth Service Program (WiSSP) for etiologic evaluation of stillbirth or second trimester miscarriage. Hydrops was clinically recognized at delivery in only about half the cases, while the remainder were diagnosed at autopsy or during evaluation of records, photographs, and radiographs. The peak incidence of hydrops was at 20-28 weeks. Hydropic fetuses were also frequent before 20 weeks but became increasingly rare toward term. The most frequent identifiable underlying cause was chromosomal (29%), followed by other syndromes (14%), and more distantly by cardiac (6%) and other single system disorders. While the overall prevalence of hydrops and chromosomal causes was comparable to other autopsy series, the frequency of nonchromosomal syndromes was higher, reflecting increased attention to syndrome identification. Lethal multiple pterygium syndrome (LMPS) was identified retrospectively in 17 cases, accounting for 6% of all hydrops; 3/17 had a previous affected sib, emphasizing the importance of accurate diagnosis and counseling. Depending on the underlying cause, hydropic fetuses may be either small (if the cause is chromosomal or LMPS) or large (in cases with other syndromes or cardiac causes) for gestational age. The relatively large number in the "idiopathic" group in WiSSP (104/277; 38%) is probably due to variability of autopsies at local hospitals and limited laboratory data. Improved recognition of hydrops and testing directed at diagnosis of specific underlying causes can lead to improved counseling for families.
Spatial-temporal dynamics of hunter effort for wild turkeys in Michigan

Wild turkeys (Meleagris gallopavo; hereafter turkeys) are an important game animal whose popularity among hunters has increased in recent decades. Yet, the number of hunters pursuing turkeys appears to be in flux, patterns of hunter abundance have primarily been described at broad spatial scales, and the ability of management to impact hunter numbers in the post-restoration era of management through opportunity for quality hunting is unclear. We used county-scale estimates of turkey hunter numbers collected over a 14-year period (2001-2014) and time-series analyses to evaluate the spatial scales at which spring and fall turkey hunter populations fluctuate, and also used generalized linear mixed models to evaluate whether attributes related to quality turkey hunting explain recent patterns in hunter abundance. We found heterogeneity in turkey hunter population growth at finer spatial scales than has been previously described (i.e., counties and management units), and provide evidence for spatial structuring of hunter population dynamics among counties that did not always correspond with existing management units. Specifically, the directionality of hunter population change displays spatial structure along an east-west gradient in southern Michigan. We also found little evidence that factors providing opportunity for quality turkey hunting had meaningful impacts on recent spatial-temporal patterns of hunter numbers. Our results imply that providing quality turkey hunting opportunities alone may be insufficient for sustaining populations of turkey hunters in the future, and that modern determinants of hunter participation extend beyond the availability of abundant turkey populations. Moreover, our results demonstrate that interpretation of harvest data as indices of abundance for turkey populations is difficult in the absence of hunter effort data, as changes to turkey harvest are a function of potentially fine-scaled changes in populations of hunters, not simply changes to turkey populations.
Global Contributions and Trends in Research within the Top-ranked Plastic Surgery Journal.

Background We aimed to longitudinally study the relative research contributions of US and international plastic surgeons by evaluating publications within the premier plastic surgery journal over the last 2 decades. We hypothesized that even with an increased pressure to publish in this journal, the relative research contributions from American plastic surgeons will continue to be the largest overall and in all subspecialties. Methods Data for the surgical subspecialty, corresponding author's country of origin, and region were extracted from all original articles in 2 randomly selected monthly issues of Plastic & Reconstructive Surgery (PRS) from the last 2 decades to evaluate longitudinal trends. Data were also extracted from all of the original articles published in PRS for the last 3 years to analyze the recent distribution of research output. Results During the last 2 decades, the relative proportion of total original articles written by US authors has increased. They have published proportionally more articles in the Reconstructive and Breast field while publishing relatively less in the hand/peripheral nerve field. From the first decade of analysis, US authors wrote relatively fewer articles in the hand/peripheral nerve field, whereas in the second decade, the US authors wrote relatively fewer articles in the Experimental field. In the last 3 years, US authors published relatively fewer articles in the Experimental and Cosmetic fields. Conclusions Each country's scientific productivity in PRS is related to funding, interest, patients' demand, and healthcare market pressure. In this study, we see that these factors influence trends within research publications over the last 2 decades.
Electron beam irradiation induces DNA endoreplication in holometabolous juvenile insects: a rapid flow cytometry-based diagnosis

Ionizing radiation including electron beam (eBeam) technology has been used as a quarantine measure around the world for transboundary shipment of agricultural products. Since the treatment goal of this technology is not to instantly kill insects but to cause them to be sterile, an apparent challenge is how to ensure that the agricultural commodities have been exposed to ionizing radiation if live insects are found. Because irradiation affects DNA synthesis and cell division, we investigated the feasibility of using flow cytometry detection of eBeam irradiation-induced ploidy change as a diagnostic tool. All eBeam-treated holometabolous insects tested including cowpea bruchid (Callosobruchus maculatus), corn earworm (Helicoverpa zea) and fruit fly (Drosophila melanogaster) displayed significantly higher proportions of polyploid cells than their respective unirradiated controls. However, such increased DNA ploidy was mostly absent in irradiated hemimetabolous sand field cricket (Gryllus firmus), green peach aphid (Myzus persicae) and potato/tomato psyllid (Bactericera cockerelli). Further studies with representative holometabolous insects revealed that the eBeam-triggered DNA endoreplicative response was strong in larvae, but became weaker as insects continued to develop into pupae and was even diminished in adults. Therefore, the flow cytometry-based method has the potential to be developed into a diagnostic tool to determine whether juvenile insects found on agricultural shipments, particularly those that undergo complete metamorphosis, have received irradiation as a quarantine treatment. This simple and rapid detection method could potentially resolve the dilemma that occurs in border control and domestic movement of plant material and products from areas under quarantine.
Subclavian Artery to Internal Carotid Artery Interpositional Bypass for Carotid Artery Occlusion: Technical Case Report.

Background and importance Conventional microsurgical treatment for symptomatic internal carotid artery (ICA) occlusion is revascularization with superficial temporal artery (STA) to middle cerebral artery bypass. However, in rare cases where the common carotid artery, external carotid artery (ECA), or both are also occluded, other microsurgical treatment options must be considered. Clinical presentation We present the case of a 52-yr-old woman with common carotid artery occlusion and weak ICA flow from collateral connections between the vertebral artery, occipital artery, and ECA. She had ischemic symptoms and a history of stroke. The patient's STA was unsuitable as a donor vessel due to its small caliber and poor flow, and we instead performed an interpositional bypass from the subclavian artery to the ICA using a radial artery graft. Conclusion This case illustrates the successful use of the subclavian artery to ICA bypass technique with an interpositional radial artery graft. The surgical anatomy of the subclavian arteries is reviewed, and the technical details of subclavian artery to radial artery graft to ICA interpositional bypass are presented.
Age-adjusted and Expanded Lactate Thresholds as Predictors of All-Cause Mortality in the Emergency Department.

Author(s): Cannon, Chad M.; Miller, Ross T.; Grow, Krista L.; Purcell, Seth; Nazir, Niaman | Abstract: Introduction: While numerous studies have found emergency department (ED) lactate levels to be associated with increased in-hospital mortality, little information is available on the role age plays in this association. This study investigates whether age is a necessary variable to consider when using lactate levels as a marker of prognosis and a guide for management decisions in the ED.Methods: This was a retrospective cohort study in an urban, tertiary-care teaching hospital. A total of 13,506 lactate levels were obtained over a 4.5-year period. All adult patients who had a lactate level obtained by the treating provider in the ED were screened for inclusion. The main outcome measure was in-hospital mortality using age-adjusted cohorts and expanded lactate thresholds with secondary outcomes comparing mortality based on the primary clinical impression.Results: Of the 8796 patients in this analysis, there were 474 (5.4%) deaths. Mortality rates increased with both increasing lactate levels and increasing age. For all ages, mortality rates increased from 2.8% in the less than 2.0 millimoles per liter (mmol/L) lactate level, to 5.6% in the 2.0-2.9 mmol/L lactate level, to 8.0% in the 3.0-3.9 mmol/L lactate level, to 13.9% in the 4.0-4.9 mmol/L lactate level, to 13.7% in the 5.0-5.9 mmol/L lactate level, and to 39.1% in the 6.0 mmol/L or greater lactate level (p l0.0001). Survivors, regardless of age, had a mean lactate level l2.0 whereas non-survivors had mean lactate levels of 6.5, 4.5, and 3.7 mmol/L for age cohorts 18-39, 40-64, and ≥ 65 years, respectively.Conclusion: Our findings suggest that although lactate levels can be used as a prognostic tool to risk stratify ED patients, the traditional lactate level thresholds may need to be adjusted to account for varying risk based on age and clinical impressions.
Guide for protein fold change and p-value calculation for non-experts in proteomics

Proteomics studies generate tables with thousands of entries. A significant component of being a proteomics scientist is the ability to process these tables to identify regulated proteins. Many bioinformatics tools are freely available for the community, some of which within reach for scientists with limited or no background in programming and statistics. However, proteomics has become popular in most other biological and biomedical disciplines, resulting in more and more studies where data processing is delegated to specialists that are not lead authors of the scientific project. This creates a risk or at least a limiting factor, as the biological interpretation of a dataset is contingent of a third-party specialist transforming data without the input of the project leader. We acknowledge in advance that dedicated scripts and software have a higher level of sophistication; but we hereby claim that the approach we describe makes proteomics data processing immediately accessible to every scientist. In this paper, we describe key steps of the typical data transformation, normalization and statistics in proteomics data analysis using a simple spreadsheet. This manuscript aims to demonstrate to those who are not familiar with the math and statistics behind these workflows that a proteomics dataset can be processed, simplified and interpreted in software like Microsoft Excel. With this, we aim to reach the community of non-specialists in proteomics to find a common language and illustrate the basic steps of -omics data processing.
Inductive Reasoning with Equality Predicates, Contextual Rewriting and Variant-Based Simplification

We present an inductive inference system for proving validity of formulas in the initial algebra \(T_{\mathcal {E}}\) of an order-sorted equational theory \(\mathcal {E}\) with 17 inference rules, where only 6 of them require user interaction, while the remaining 11 can be automated as simplification rules and can be combined together as a limited, yet practical, automated inductive theorem prover. The 11 simplification rules are based on powerful equational reasoning techniques, including: equationally defined equality predicates, constructor variant unification, variant satisfiability, order-sorted congruence closure, contextual rewriting and recursive path orderings. For \(\mathcal {E} = (\varSigma , E \uplus B)\), these techniques work modulo B, with B a combination of associativity and/or commutativity and/or identity axioms.
Convergence in Distribution

Tightness and relative compactness, convergence and tightness in function spaces, convergence of continuous and rcll processes, functional central limit theorem, moments and tightness, optional equi-continuity and tightness, approximation of random walks, tightness and convergence of random measures, existence via tightness, vague and weak convergence, Cox and thinning continuity, strong Cox continuity, measure-valued processes, convergence of random sets and point processes.
Hemodynamics and Clinical Implications of Occult Left Ventricular Dysfunction in Adults Undergoing Ebstein Anomaly Repair

Background: Left ventricular global longitudinal strain (LVGLS) can detect early phases of LV systolic dysfunction, but its application has not been studied in Ebstein anomaly. We hypothesized that...
Florid Bacillus cereus Infection of the Placenta Associated With Intrauterine Fetal Demise.

Bacillus cereus is a gram-positive, rod-shaped bacterium that is commonly implicated in foodborne illness but has also become increasingly recognized as a source of serious non-gastrointestinal inf...
Wealth and Hours

In the United States, market hours worked are approximately flat across the wealth distribution. Accounting for this phenomenon is a standing challenge for standard heterogeneous-agent macro models. In these models, wealthier households consume more, enjoy more leisure, and work less. We propose a theory that generates the cross-sectional wealth-hours relation as in the data. We quantify this theory in the context of a new general-equilibrium heterogeneous-agent incomplete-markets model with three key features: a quality choice in consumption, non-homothetic preferences, and a multi-sector production structure. As external validation, we show that the model produces expenditure patterns that are consistent with the data, as well as realistic "quality Engel curves."
Appropriateness of psychiatric advance directives facilitated by peer support specialists and clinicians on Assertive Community Treatment teams.

Psychiatric advance directives (PADs) are used to document a person’s treatment preferences for a future mental health crisis. Peer support specialists have been proposed to facilitate PADs, but li...
A novel Streptococcus species causing clinical mastitis in a pregnant donkey.

An 8-y-old jenny was presented because of anorexia and mild depression. The jenny had weaned her colt 10 d before the admission. Upon arrival at the University of Illinois Veterinary Teaching Hospi...
Immune Checkpoint Inhibitor-Related Pulmonary Toxicity: A Comprehensive Review, Part II

The development of immune checkpoint inhibitors (ICIs) has changed the treatment paradigm for cancer. The ICIs nivolumab, pembrolizumab, and cemiplimab target programmed cell death protein 1, and durvalumab, avelumab, and atezolizumab target programmed death ligand 1. Ipilimumab targets cytotoxic T lymphocyte-associated antigen-4. Used as monotherapy or in combination, they have shown remarkable efficacy in melanoma, lung cancer, and many other solid tumors, and indications continue to evolve. These checkpoint inhibitors are typically well tolerated; however, they may cause immune-mediated adverse effects, resulting in inflammation of any organ system. Pulmonary toxicity is vital to recognize, and it can be more challenging to diagnose in patients with lung cancer, given the nature of the disease course and treatment.
Vacuole dynamics in growth cones: correlated EM and video observations

The neuronal growth cone is a major site of surface membrane dynamics associated with uptake and release of materials, motility, and axon extension. Although intracellular membrane organelles are thought to mediate surface membrane addition and retrieval at the growth cone, membrane events are fleeting and therefore difficult to study directly. In an effort to capture transient interactions between intracellular membrane organelles and the plasmalemma at the growth cone, embryonic rat sympathetic neuron cultures were prepared for whole-mount electron microscopy (EM) by rapid freezing and freeze substitution. We identified a set of vacuole-like organelles (> or = 150 nm in diameter) that appeared to interact directly with the plasmalemma. In stereo-pair EM images the bounding membrane of some of these vacuoles had an orifice at sites where the organelle was adjoining the plasmalemma, suggesting that the organelle and surface membranes were confluent. Since this population of organelles could be labeled with cationized ferritin or HRP when added to living cultures just prior to freezing or chemical fixation, they were probably derived from the plasmalemma. Combined light microscopy and EM of individual growth cones showed that these same vacuoles had a conspicuous reverse shadowcast appearance in differential interference contrast images. Thus, we used real-time video microscopy to follow these organelles in living growth cones. Many of these vacuoles spontaneously appeared, remained visible for several minutes, and then disappeared. Reverse shadowcast vacuoles were formed at various sites throughout the growth cone, including surface membrane ruffles at the leading edge [P (peripheral)-domain] as well as quiescent and retracting regions at the growth cone base [C (central)- domain]. Vacuoles in the P-domain moved centripetally and rarely grew in size. In contrast, those in the C-domain exhibited Brownian-like movements and sometimes appeared to increase in size, raising the possibility that new membrane may be added to these organelles. Vacuoles within both the P- and C-domains shrank before rapidly disappearing, but rarely vesiculated, suggesting that they had fused with the plasmalemma. The results indicate that vacuoles are a highly dynamic population of organelles that directly communicate with the plasma membrane at the growth cone; they provide a major route of surface membrane uptake and may also play a role in membrane recycling.
Practicing neonatology in a blackout: the University Hospital NICU in the midst of Hurricane Katrina: caring for children without power or water.

August 26: 3 Days Before Landfall: Like most Friday afternoons, our 12-person neonatology group went through the weekend sign-out process of patients divided among the 9 area hospitals for which we provide NICU coverage. I was assigned to University Hospital for the weekend. University Hospital is a state-run public hospital in downtown New Orleans, Louisiana, that serves primarily indigent patients as part of the campus of the old Charity Hospital. It has a level 3 NICU and is a full-service teaching hospital for the medical schools at Louisiana State University and Tulane University. I was aware of Hurricane Katrina, then a category 1 storm in south Florida, and all indications were that the storm was targeting the coast of the Florida panhandle. By evening, as the storm's predicted path had dramatically changed westward, I began to review our available on-call neonatologists and plan for hospital coverage in the event that this new prediction held true. I also began to make plans for the evacuation of my wife and 5 children but hoped, as had been the case in recent years with other hurricanes, that Katrina would steer clear of New Orleans. As the predictions for the storm passing over or near New Orleans remained consistent, plans for covering each of our hospitals with an in-house neonatologist for the duration of the hurricane threat were finalized. Dating back to at least Hurricane Andrew in 1992, our division had gone through this process multiple times. Although several hurricanes during this time threatened to hit New Orleans, our city had managed to avoid any direct hit. Despite many doomsday scenarios, New Orleans had not experienced a direct hit since Hurricane Betsy in September 1965. In recent years, there were increasing efforts to evacuate the city with such threats. Hospital evacuation had been discussed, … Address correspondence to Brian M. Barkemeyer, MD, FAAP, Children’s Hospital NICU, 200 Henry Clay Ave, New Orleans, LA 70118. E-mail: bbarke{at}lsuhsc.edu
Long Term Complete Circulatory Exclusion of the Right Side of the Heart Hemodynamic Observations

Abstract Long-term, complete circulatory exclusion of the right side of the heart was achieved in dogs by: (1) performing an end-to-side anastomosis between the left subclavian and left pulmonary artery as a preliminary procedure, (2) transplanting the inferior caval vein into the left atrium, (3) draining the superior vena cava into the pulmonary artery, and (4) ligating the previously established subclavian-pulmonary artery anastomosis. Sixteen out of 76 animals survived the third stage of the procedure; 9 dogs lived for two weeks or longer after the completion of the procedure. Five of the animals survived one year or longer following complete circulatory exclusion of the right heart. Except for some cyanosis of the mucous membranes and exertional dyspnea, the animals appeared to be and behaved like normal dogs. Hemodynamic observations one year after the completion of the experiment were characterized by the following findings: (1) Normal pressures in the left heart and systemic arteries. (2) Moderately increased pressure in the inferior caval area in some animals. (3) More pronounced pressure elevation in the superior caval area in most animals. (4) “Respiratory” characteristics of the pressure curve in the right pulmonary artery. (5) Desaturation of the arterial blood due to the right-to-left shunt. (6) Increase in the circulating blood volume.
Property Taxes and Polycentricity

Elinor and Vincent Ostrom have dedicated their professional careers to understanding polycentric forms of public administration. From a public finance perspective, the Ostrom-polycentric system represents a number of challenges. America’s answer to the public financing of polycentric public administration has been the real property tax, which has characteristics that are unique among taxes. This essay describes these unique characteristics as they pertain to the permissibility of multiple, decentralized, and overlapping polycentric nodes of public administration that each maintain a financial independence necessary for local autonomy. We conclude that reforms aimed at eliminating the property tax will ultimately undermine polycentric public administration as well.
Ports and complications for intraperitoneal chemotherapy delivery

Intraperitoneal access ports are essential to the delivery of chemotherapy agents into the peritoneal cavity of women with ovarian cancer, but their malfunction and adverse effects are frequently responsible for the failure to complete planned therapy. Complications, such as obstruction of the catheter, infection, leakage, rotation, retraction, and pain, together with bowel and vaginal perforation, cause delays in treatment, patient suffering and the expenditure of medical resources. A wide variety of ports have been used, including vascular access devices and intraperitoneal access devices. This paper reviews the development and use of ports for intraperitoneal chemotherapy, their complications and reported methods of prevention.
Novel integrated shock protection for MEMS

This paper reports the design and analysis of two novel concepts for shock protection of MEMS devices using nonlinear springs and soft coatings. Hard shock stops have conventionally been used for shock protection for MEMS devices, but their operation generates secondary impacts and unwanted device oscillations. The two concepts described herein aim to improve shock protection by reducing secondary impacts and dissipating energy. We analyze the merits and demerits of each concept using simulation methods and also suggest ranges of shock stop design parameters to enhance performance. Doing so reveals that the nonlinear spring shock stops are capable of reducing impulses by over 90% while soft coatings may reduce impulses by 40%.
Evaluating dementia screening tests: Methodologic standards to rate their performance

Dementia is a major public health challenge that is becoming more common as the aged population grows. Over the next 20 years, the aging of the “baby boomers” will change the composition of the US population so that one person in every five will be older than 65 years. Adequate care of dementia patients requires that they be recognized as having memory impairment, identified as having a dementia syndrome, and evaluated for the specific cause of the dementia. Currently, nearly 75% of patients with moderate to severe dementia are unrecognized by primary care clinicians as having cognitive impairment. In one study, 97% of patients with mild cognitive impairment were not recognized as being in an early phase of a dementia syndrome.1 The identification of demented individuals is critically important, particularly if new therapies are developed. Agents that alter disease course are most effective if administered early in progressive disorders such as AD. Thus, there is an imperative need for a widely applicable screening test for dementia. Several screening tests for dementia have been developed,2-5 but no single test is the established standard.5-6 Many tests that showed promise have proven inaccurate, performing poorly in mild dementia and varying in accuracy depending on the patient’s age and educational level.2,4 Initial evaluation of dementia screening tests, like most diagnostic tests, does not adhere to established methodologic standards.7-9 In this issue of Neurology , Buschke et al. evaluate a new screening test for dementia—the Memory Impairment Screen (MIS).10 Before adopting the MIS, we should ask: “How does their study measure up to the methodologic standards6-8 necessary for evaluating a screening test for dementia?” A screening test differs from a diagnostic test. A screening test—such as a questionnaire, …
The association between knee airbag deployment and knee-thigh-hip fracture injury risk in motor vehicle collisions: A matched cohort study.

Abstract Introduction In the U.S. alone, an estimated 30,000 knee–thigh–hip (KTH) injuries occur annually in frontal motor vehicle collisions. These fractures typically occur through occupant contact with the vehicle's knee bolster. Research has suggested that knee airbags (KABs) can mitigate the forces sustained during this contact, resulting in decreased injury risk; however, previous research has been limited by small sample sizes or by occurring in a controlled setting. The objective of the current study is to determine the effectiveness of KABs on KTH fracture risk using nationally representative, real-world data. Methods Using combined data from the Crash Injury Research and Engineering Network and the National Automotive Sampling Survey, a matched cohort study was conducted among front-seat occupants of vehicles involved in a frontal collision occurring from 2000 to 2009. Occupants exposed to a KAB deployment were matched to occupants with no KAB deployment based on age ±5 years, sex, seatbelt use, vehicle seating position (i.e., driver or front passenger), car vehicle body type, collision impact, and sampling weight. A Cox proportional hazards model was used to calculate risk ratios (RRs) and associated 95% confidence intervals (95% CI) to estimate the association between KAB deployment and lower extremity fracture risk. Results There was no association between KAB deployment and risk of lower extremity fracture (RR 0.83, 95% CI 0.52–1.31). A notable pattern in fracture risk, though not statistically significant, was observed, with a decreased risk of hip (RR 0.72, 95% CI 0.26–1.97) and thigh fracture (RR 0.81, 95% CI 0.32–2.05), and an increased risk of tibia/fibula (RR 1.23, 95% CI 0.52–2.90) and foot fracture (RR 1.96, 95% CI 0.72–5.32). Conclusions The results of the current study suggest that KABs are not associated with the risk of lower extremity fractures. However, given the small sample size of the current study, it is difficult to definitively say whether the observed injury pattern is representative of the true pattern.
Line-of-sight pointing accuracy/stability analysis and computer simulation for small spacecraft

This paper presents a case study where a comprehensive computer simulation is developed to determine the driving factors contributing to spacecraft pointing accuracy and stability. The simulation is implemented using XMATH/SystemBuild software from Integrated Systems, Inc. The paper is written in a tutorial manner and models for major system components are described. Among them are spacecraft bus, attitude controller, reaction wheel assembly, star-tracker unit, inertial reference unit, and gyro drift estimators (Kalman filter). THe predicted spacecraft performance is analyzed for a variety of input commands and system disturbances. The primary deterministic inputs are desired attitude angles and rate setpoints. The stochastic inputs include random torque disturbances acting on the spacecraft, random gyro bias noise, gyro random walk, and star-tracker noise. These inputs are varied over a wide range to determine their effects on pointing accuracy and stability. The results are presented in the form of trade-off curves designed to facilitate the proper selection of subsystems so that overall spacecraft pointing accuracy and stability requirements are met.
Effects of norepinephrine infusion (IV) on microvascular pressures and capillary blood flow in the mesentery.

Abstract The purpose of these studies was to characterize the effects of intravenous infusion of norepinephrine on pressure and flow adjustments within the mesenteric microcirculation of the rat. The servo-null method of Wiederhielm was used to measure pressures within selected arterioles and venules and the dual-slit photometric method of Wayland and Johnson was used to measure RBC velocity in mesenteric capillaries during iv infusion of 4 μg/Kg/min of norepinephrine for periods of 5–7 min. Systemic arterial pressure increased over the first 2–3 min of infusion following which pressure gradually declined towards preinfusion levels. At the microvascular level the effects of norepinephrine were evident but highly variable among single vessels. However, pooling of the data showed that average pressure at all levels of the mesenteric vasculature and average mesenteric capillary RBC velocity paralleled the systemic pressure response. Pressure to velocity ratios (an index of vascular resistance) indicated little change in net mesenteric vascular resistance throughout norepinephrine infusion.
Repetitive vocalizations evoked by local electrical stimulation of avian brains. I. Awake chickens (Gallus Gallus).

Electrical stimulation of the brain (ESB) through 1178 chronically-implanted electrodes in 128 chickens consistently yielded repetitive vocalizations from 414 sites. Active points were concentrated in two areas, one ventro-medial to the inferior colliculus, and one apparently in tractus occipitomesencephalicus just ventral to nucleus ovoidalis. Call duration, interval between calls, and frequency structure of individual notes all varied continuously both within and between sites. Simultaneous stimulation of two sites yielded facilitation, summation, and occlusion with increasing stimulus intensity. Results are interpreted to suggest a single set of neural mechanisms controlling repetitive vocalizations. Correlation between sites active in awake and anaesthetized birds was 0·996.
Religion, plausibility structures, and education's effect on attitudes toward elective abortion

This study tests three hypotheses derived from Berger's (1967) plausibility theory. The first hypothesis states that among people who attend church frequently, education's liberalizing effect on attitudes toward elective abortion is weakest among conservative Protestants and Catholics, intermediate among moderate Protestants, and strongest among liberal Protestants and Jews. Hypotheses 2 states that education's effect is weaker among frequent than infrequent attenders in all religious groups except liberal Protestants and Jews, and Hypothesis 3 states that education's effect does not vary by religious group among infrequent attenders. Using General Social Survey data, I found strong support for Hypotheses I and 2 and partial support for Hypothesis 3. I discuss the implications of the findings for plausibility theory.
Life-steps: Applying cognitive behavioral therapy to HIV medication adherence

New medication treatments for HIV have recently improved so that survival over long periods is now possible, but these treatment gains are wholly dependent on proper use of the medications. Improper use of medications, missed or delayed doses, or drug holidays from part of the treatment regimen may be as deleterious as no medications at all. Despite its importance, the number of medications, complex dosage schedules, and significant side-effect profiles of these medications makes adherence to HIV medications difficult. This paper describes a new cognitive-behavioral intervention in which education, problem solving, and rehearsal strategies are used to help patients develop better skills for adhering to HIV treatment.
Effect of the 2.37 MeV oxygen antiresonance in a fast neutron filter

Abstract Calculations of fast neutron through a liquid oxygen slab are presented, with a view as to their applicability in the design of an oxygen filter to produce a 2.37 MeV monoenergetic neutron beam. It is found that, while an oxygen filter is possible, exceedingly large amounts of oxygen would be required if a large fraction of the transmitted flux is to be in the 2.37 MeV energy region.
PRODUCT DEVELOPMENT CYCLE TIME FOR BUSINESS-TO-BUSINESS PRODUCTS

Abstract For a number of years, firms have been implementing changes in the way they develop new products, changes that are targeted at reducing overall product development cycle times. And over the years, a number of academics have conducted research trying to understand the factors that are related to reducing new product development (NPD) times. But the question remains — just how long does product development generally take in absolute numbers? Information on how long product development takes is helpful to firms for planning and controlling the flow of products into the marketplace and in determining resource needs for NPD. Other than anecdotal data pertaining to particular projects that have been commercialized by particular firms, very little hard data have been reported on this topic. This article analyzes data to quantify average cycle times for physical goods commercialized by business-to-business (B2B) firms. The data are a subset of a much larger data set from the Product Development & Management Association's (PDMA) Best Practices research. The analysis presents average product development cycle times for four different types of projects (new-to-the-world, new-to-the-firm, next generation improvements and incremental improvements), presents evidence of the lack of a relationship between cycle time and success and looks at factors that are associated with differences in the length of product development cycle times.