cssi/SciSciGPT-SciSciNet huggingface dataset:
Effect of vital signs on triage decisions.

Abstract Study Objective: We sought to determine whether knowledge of vital signs changes nurse triage designations (TDs). We also sought to determine whether patient age and ability to communicate modify the effect of vital signs on triage decisions. Methods: We performed a prospective observational study, in 24 emergency departments, of nurse-assigned TDs of all ED patients undergoing triage. Nurses performed their typical triage routine, except that they chose 1 of 5 hypothetical TDs (call 911, ED Results: Six hundred twenty-five experienced triage nurses at 24 different EDs collected data on 14,285 patients. TDs were downgraded (decreased in urgency) in 2.4% of patients, and 5.5% were upgraded (increased in urgency) after vital signs were known. Changes were more likely to occur in the young (≤2 years old; 11.4%) and the elderly (≥75 years old; 9.9%) than in those 3 to 74 years of age (7.5%). When nurses reported a communication barrier, a change in post-vital signs TD was also more common (11.2% versus 7.7%). The post-vital signs TD better predicted patient ED disposition. Conclusion: In this sample, 92.1% of the nurses' TDs were not affected by the knowledge of patient vital signs. For the other 7.9%, including many patients from vulnerable populations, the vital signs changed the nurses' assessments of the patients' triage designation. Methods of triage that do not determine vital signs may not adequately reflect the urgency of the patient's presentation. [Cooper RJ, Schriger DL, Flaherty HL, Lin EJ, Hubbell KA. Effect of vital signs on triage decisions. Ann Emerg Med. March 2002;39:223-232.]
MUC1 splice variants in human ocular surface tissues: possible differences between dry eye patients and normal controls

Mucins are highly glycosylated proteins that are vital to the maintenance of healthy epithelial surfaces including the ocular surface. Mucins act as lubricants, protectants, and mediators of signal transduction. The majority of the O-glycosylation sites on the transmembrane mucin MUC1 are found in a highly polymorphic core region containing a variable number of tandem repeats (VNTR). MUC1 alleles can be divided into size classes that contain small (30-45) or large (60-90) numbers of repeats. Although at least 12 splice variants of MUC1 have been found in other tissues, no splice variants have been reported in human ocular surface tissues. We have used RT-PCR to identify MUC1 splice variants that were then confirmed by sequencing. We here report the presence in some samples of human cornea, conjunctiva, and lacrimal gland of MUC1/B which features canonical splicing between exons 1 and 2 and MUC1/A, a transcript that retains 27bp from the 3' end of intron 1 and is predicted to add 9 amino acids to the MUC1 sequence upstream of the tandem repeat region. Cornea and conjunctiva both contain the MUC1/SEC splice variant that lacks the transmembrane domain and, therefore, results in a soluble, secreted form of MUC1. Cornea and conjunctiva also contain MUC1/Y and MUC1/Z(X) variants that lack the tandem repeat region. Cornea, conjunctiva, and lacrimal gland also contain a previously undescribed MUC1 variant transcript, termed MUC1/YI, that retains 99bp from the 5' end and 27bp from the 3' end of the first intron, resulting in a frame shift and premature stop codon. This transcript is predicted to produce a novel 27 amino acid peptide after signal peptidase cleavage. Analysis of brush cytology samples revealed that the percentage of dry eye patients expressing the MUC1/A variant in the conjunctival epithelium is lower than in normal control donors. Western blotting confirmed that MUC1/A is associated with alleles containing the large size class of tandem repeats. Therefore, we propose that one factor in susceptibility to dry eye disease may be the lengths of the MUC1 VNTR in conjunctival epithelium based on the rationale that longer VNTR provide better lubrication and greater protection of the ocular surface against inflammation.
Presentation of the Mineralogical Society of America Dana Medal for 2004 to R. James Kirkpatrick

President Carpenter, members of the society, and guests: It is a special honor and pleasure to introduce to you today R. James Kirkpatrick, Professor in the Department of Geology at the University of Illinois and the 2004 Dana medalist of the Mineralogical Society of America. The Dana Medal recognizes “continued outstanding scientific contributions through original research in the mineralogical sciences by an individual in the midst of his or her career.” It is hard to think of a mineralogist who meets …
Use of periphyton assemblage data as an index of biotic integrity

AbstractPeriphyton assemblage data collected from 233 stream site-visits (49 in 1993, 56 in 1994, and 128 in 1995) throughout the Mid-Appalachian region were used to develop a periphyton index of biotic integrity (PIBI) based on 1) algal genera richness; 2) the relative abundances of diatoms, Cyanobacteria, dominant diatom genus, acidophilic diatoms, eutraphentic diatoms, and motile diatoms; 3) chlorophyll and biomass (ash-free dry mass) standing crops; and 4) alkaline phosphatase activity. Thirty-seven diatom genera and 38 non-diatom genera were collected. The relative richness and relative abundance (RA) of these genera were used to calculate the RA metrics of the PIBI. PIBI scores ranged from 48.0 to 85.1 among the 233 site-visits with an overall regional mean (±1 SE) of 66.1 ± 0.5. The 10 metrics and the PIBI were correlated with 27 chemical, 12 physical habitat, and 3 landscape variables. Overall, PIBI was inversely correlated with stream depth, stream water color, and Fe. Component metrics were sign...
LABORATORY MEASUREMENTS OF NiH BY INTRACAVITY LASER ABSORPTION SPECTROSCOPY

The visible electronic spectrum of the NiH B 2Δ5/2-X 2Δ5/2 transition has been recorded with rotational resolution by intracavity laser absorption spectroscopy. The gas-phase NiH molecules were produced in an electric discharge using a nickel cathode in a pure hydrogen atmosphere at 1-3 torr total pressure. Peak positions for the NiH isotopomers are presented. 58NiH and 60NiH have been observed in sunspots, and attempts to observe NiH in stellar spectra are underway.
Multiple HNPCC tumours: ask the family!

See article on page 664 Hereditary non-polyposis colorectal cancer (HNPCC) is one of the most common conditions predisposing to colorectal cancer (CRC). Affecting less than 1% of the general population, HNPCC confers a lifetime risk of CRC estimated at over 80%; the risk to age 40 may exceed 30%.1 It can be caused by inherited mutations in one of the several DNA mismatch repair (MMR) genes. The resulting DNA MMR deficiency in neoplastic tissue gives rise to microsatellite alterations, a reflection of genomic instability.2Patients with HNPCC are at increased risk of cancers other than CRC, including cancers of the endometrium, ovary, stomach, small bowel, and the upper urinary tract (renal pelvis and ureter).3 Despite recent advances in the understanding of the molecular genetic basis of HNPCC, we are still far from the clinical ideal of being able to identify patients with this disorder among the population we serve. Tests for mutations in MMR genes are problematic. There are classic HNPCC families with clear linkage to one of the MMR genes which have been exhaustively but fruitlessly searched for mutations, indicating some types of HNPCC associated mutations are not identifiable by current technologies. Even when an inherited alteration of an MMR gene is discovered, its causal role …
Biochemical characterization of the GTP:adenosylcobinamide-phosphate guanylyltransferase (CobY) enzyme of the hyperthermophilic archaeon Methanocaldococcus jannaschii.

Cobamides are ancient cofactors that are widely distributed in nature (1). With the exception of plants, cells of all domains of life have enzymes that require a cobamide as their coenzyme, yet only some bacteria and archaea synthesize cobamides de novo (2–4). Although not all cobamide producers synthesize the corrin ring de novo, some can salvage pre-formed, incomplete precursors [e.g., cobinamide (Cbi), cobyric acid (Cby)] from their environments using a high- affinity ATP-binding cassette transporter (5–10). Precursors such as Cbi and Cby are then converted to cobamides by two distinct branches of the pathway. One of these branches, known as the corrinoid adenosylation pathway, attaches the upper axial ligand to the corrin ring via a labile C-Co bond (11). The second branch assembles the nucleotide loop that tethers the lower ligand base to the corrin ring; this branch is known as the nucleotide loop assembly pathway (Fig. 1). The latter can be further broken down into two sub-branches, one of which activates adenosyl-Cbi (AdoCbi) to AdoCbi-guanosine diphosphate (AdoCbi-GDP) (12), and a second one that activates the lower ligand base to its nucleotide (2) (Fig. 1). Figure 1 Nucleotide loop assembly pathway In bacteria, the activation of AdoCbi to AdoCbi-GDP is catalyzed by the bifunctional CobU enzyme (EC 2.7.1.156, EC 2.7.7.62) via an AdoCbi-P intermediate (13). Archaea, however, use a different strategy for the synthesis of AdoCbi-GDP (2). These organisms do not synthesize CobU; instead, they use CobY, a GTP:AdoCbi-P guanylyltransferase enzyme that lacks the NTP:AdoCbi-P kinase activity of CobU (Fig. 1) (14). The cobY gene was identified in extreme halophilic and thermophilic, methanogenic archaea as a non-orthologous replacement for cobU (14, 15). In this work we identified the locus encoding the CobY enzyme in the hyperthermophilic methanogenic archaeon Methanocaldococcus jannaschii. Recombinant protein was expressed in E. coli cells, the order of substrate binding was determined, and the interactions between substrate and enzyme were quantified.
Stochastic learning paths in a knowledge structure

Abstract This paper presents a stochastic process describing the progress of subjects (for example, students learning a particular field) over a period of time. Typical data involve a fixed sample of subjects tested repeatedly. At the core of the model is a knowledge structure, that is, a possibly large collection Q of items, together with a family of its subsets representing the possible knowledge states. The basic prediction concerns the joint probabilities P ( R t1 = R 1 , …, R ta = R n ) of observing sets of correct responses R 1 , …, R n at times t 1 t n (Thus, R t 1 , …, R t n are jointly distributed random variables taking their values in 2 Q , for any choice of the times t 1
Radiatively Driven Winds and the Shaping of Bipolar Luminous Blue Variable Nebulae

Nebulae around luminous blue variable (LBV) stars are often characterized by a bipolar, prolate form. In the standard interpretation of the generalized interacting stellar winds model, this bipolar form is attributed to an asymmetry in the density structure of the ambient medium. However, there is limited observational evidence to suggest that such an asymmetric medium is present in most LBV nebulae. In this work we use scaling relations derived from the theory of radiatively driven winds to model the outflows from LBV stars, taking account of stellar rotation and the associated latitudinal variation of the stellar flux due to gravity darkening. We show that, for a star rotating close to its critical speed, the decrease in effective gravity near the equator and the associated decrease in the equatorial wind speed results naturally in a bipolar, prolate interaction front, even for a spherically symmetric ambient medium. Moreover, when gravity darkening is included, the resulting density of the outburst is also strongest over the prolate poles. We discuss the implications of these results for the formation of windblown nebulae in general.
Radial rearrangement, harmonic measures and extensions of Beurling's shove theorem

LetI be a union of finitely many closed intervals in [−1, 0). LetI↞ be a single interval of the form [−1, −a] chosen to have the same logarithmic length asI. LetD be the unit disc. Then, Beurling [8] has shown that the harmonic measure of the circle ∂D at the origin in the slit discD/I is increased ifI is replaced byI↞. We prove a number of cognate results and extensions. For instance, we show that Beurling's result remains true if the intervals inI are not just one-dimensional, but if they in fact constitute polar rectangles centred on the negative real axis and having some fixed constant angular width. In doing this, we obtain a new proof of Beurling's result. We also discuss a conjecture of Matheson and Pruss [25] and some other open problems.
Effect of the Interparticle Pair Potential on the Rheological Behavior of Zirconia Powders: I, Electrostatic Double Layer Approach

Aqueous slurries containing 20 vol% ZrO2 powder doped with 3 mol% Y2O3 were prepared by first dispersing the powder at pH 11, then adding 0.1M to 1.0M tetramethylammonium chloride (TMACl), or 1.0M of TPACl, CsCl, and LiCl to produce different, weakly attractive particle networks. The particle pair potentials in the slurries were investigated by viscosity versus shear rate measurements. Slurries exhibited increasing viscosities (at a given shear rate) with increasing salt concentration and decreasing (unhydrated) counterion size. The viscosities for these weakly attractive networks were intermediate to dispersed (pH 11 without added salt) and flocced (isoelectric point, pH 7.5) slurries. Cylindrical bodies were consolidated from these slurries by pressure filtration at different applied pressures. The bodies consolidated from slurries formulated with TMACl had the highest packing densities relative to those consolidated from a flocculated slurry, but the relative densities were much lower than those achieved from bodies consolidated from a dispersed slurry. The plastic or brittle nature of these bodies was determined in uniaxial compression. Powder compacts consolidated from flocced slurries and slurries coagulated with 1M TMACl, CsCl, and LiCl showed plastic behavior for filtration pressures ≤7.5 MPa. Results for ZrO2 will be compared with those previously obtained for Al2O3, which produces plastic, consolidated bodies over a much broader range of slurry conditions.
Substantia nigra and ventral tegmental area projections to cortex: topography and collateralization

The substantia nigra and ventral tegmental area of the rat were examined by retrograde transport methods to determine the topography and collateralization patterns of projections to cortex and certain subcortical sites. The topographical relationships between cells and their terminal fields were confirmed and clarified by the horseradish peroxidase retrograde transport technique. The collateralization of axons was analyzed by the use of multiple fluorescent tracers. These experiments indicated that individual ventral tegmental area cells do not collateralize extensively to either subcortical or cortical terminal fields. Substantia nigra cells, however, give rise to more highly collateralized axons and single cells may simultaneously innervate different regions of cortex as well as subcortical sites. Substantia nigra cells can be divided with respect to their cortical collateralization patterns into three groups: (1) those that innervate cingulate cortices, (2) those that project to prefrontal and suprarhinal cortices, and (3) those that innervate entorhinal cortex.
Reversal of Obesity- and Diet-Induced Insulin Resistance with Salicylates or Targeted Disruption of Ikkβ

We show that high doses of salicylates reverse hyperglycemia, hyperinsulinemia, and dyslipidemia in obese rodents by sensitizing insulin signaling. Activation or overexpression of the IkappaB kinase beta (IKKbeta) attenuated insulin signaling in cultured cells, whereas IKKbeta inhibition reversed insulin resistance. Thus, IKKbeta, rather than the cyclooxygenases, appears to be the relevant molecular target. Heterozygous deletion (Ikkbeta+/-) protected against the development of insulin resistance during high-fat feeding and in obese Lep(ob/ob) mice. These findings implicate an inflammatory process in the pathogenesis of insulin resistance in obesity and type 2 diabetes mellitus and identify the IKKbeta pathway as a target for insulin sensitization.
MODERATION BY ORGANIZATION-BASED SELF-ESTEEM OF ROLE CONDITION-EMPLOYEE RESPONSE RELATIONSHIPS

Behavioral plasticity theory is offered as an explanation for the moderating effects of self-esteem on role perception-employee response relationships. According to this theory, because individuals...
Effects of Maternal Oxygen Administration on the Ductus Arteriosus and Pulmonary Circulation in Fetal Sheep. 129

Maternal oxygen administration combined with fetal ultrasound is used for testing fetal activity. To evaluate the effects of maternal oxygen administration on the ductus arteriosus (DA) and pulmonary circulation, we studied 8 near-term fetal sheep. During fetal surgery, catheters were inserted into the main pulmonary artery and the ascending aorta to measure pressures. An ultrasonic flow transducer was placed around the DA and the left pulmonary artery (LPA) to measure blood flow simultaneously. In 3 fetuses, the DA was formalinized in order to prevent its constriction. We performed 11 studies in 8 fetuses: 6 studies in 5 fetuses without and 5 studies in 3 fetuses with DA formalinization. 100% oxygen was administered for 30 minutes via a face mask to the maternal sheep. Hemodynamic data were measured continuously and the pressure gradient and resistance across the DA were calculated. Arterial blood gas samples were obtained before and after maternal oxygen administration. Hemodynamic changes were analyzed statistically within the group, and compared between the two groups with and without DA formalinization. Maternal oxygen administration increased fetal arterial oxygen tension from 21.0 ± 3.5 to 25.4 ± 3.3 mmHg in total. In the fetuses without DA formalinization, DA blood flow decreased significantly from 907 ± 123 to 647 ± 217 ml/min, while the LPA blood flow increased significantly from 33 ± 21 to 153 ± 61 ml/min. The pressures in the main pulmonary artery and the ascending aorta did not change significantly. The calculated resistance across the DA did not change significantly (from 0.003 ± 0.002 to 0.005± 0.002 [mmHg*min/ml]). In the fetuses with DA formalinization, hemodynamic changes were quite similar to those without formalinization. There were no significant differences in changes between the two groups. These data suggest that maternal oxygen administration decreases the DA blood flow and increases LPA blood flow in fetal sheep and that this redistribution of blood flow is due not to DA constriction, but to diversion of blood flow into pulmonary circulation as a result of pulmonary vasodilatation.
Stochastic relaxation algorithm for improved vector quantiser design

An easily implementable stochastic relaxation algorithm for vector quantisation design is given. It generalises the usual Lloyd iteration in codebook design by perturbing the computed entroids with independent multidimensional noise, whose variance diminishes as the algorithm progresses. A significant improvement is often achieved.
Classical Irreversibility and Mapping of the Isosceles Triangle Billiard

Mapping of the two-dimensional isosceles triangle billiard onto the circular one-dimensional motion of two mass points is described. The singular nature of trajectories directly incident on an acute vertex is discussed in the framework of the present mapping. For an obtuse-angled isosceles triangle, dynamical equations in two-particle space applied to an orbit along a hypotenuse incident on the obtuse vertex suggests irreversible behavior at the critical angle ψ=2π/3. Thus it is found that the nonsingular motion of a finite smooth-walled disk on this trajectory exhibits irreversibility. A finite spherical smooth-walled particle moving in a uniform right cylinder whose cross section includes this critical vertex angle likewise exhibits irreversibility. Each such example comprises an irreversible orbit for a single-particle Hamiltonian.
Change in muscle strength explains accelerated decline of physical function in older women with high interleukin-6 serum levels

OBJECTIVES: To test whether accelerated sarcopenia in older persons with high interleukin (IL)-6 serum levels plays a role in the prospective association between inflammation and disability found in many studies. DESIGN: Cohort study of older women with moderate to severe disability. PARTICIPANTS: Six hundred twenty older women from the Women's Health and Aging Study in whom information on baseline IL-6 serum level was available. MEASUREMENTS: Self-report of functional status, objective measures of walking performance, and knee extensor strength were assessed at baseline and over six semiannual follow-up visits. Potential confounders were baseline age, race, body mass index, smoking, depression, and medical conditions. RESULTS: At baseline, women with high IL-6 were more often disabled and had lower walking speed. After adjusting for confounders, women in the highest IL-6 tertile (IL-6>3.10 pg/mL) were at higher risk of developing incident mobility disability (risk ratio (RR) = 1.50, 95% confidence interval (CI) = 1.01–2.27), disability in activities of daily living (RR = 1.41, 95% CI = 1.01–1.98), and severe limitation in walking (RR = 1.61, 95% CI = 1.09–2.38) and experienced steeper declines in walking speed (P < .001) than women in the lowest IL-6 tertile (IL-6 ≤1.78 pg/mL). Decline in knee extensor strength was also steeper, but differences across IL-6 tertiles were not significant. After adjusting for change over time in knee extensor strength, the association between high IL-6 and accelerated decline of physical function was no longer statistically significant. CONCLUSIONS: Older women with high IL-6 serum levels have a higher risk of developing physical disability and experience a steeper decline in walking ability than those with lower levels, which are partially explained by a parallel decline in muscle strength.
Recurrent Pulmonary Embolism Associated With Klippel-Trenaunay-Weber Syndrome

Klippel-Trenaunay-Weber syndrome (KTWS) is a rare, congenital disorder characterized by the triad of varicose veins, cutaneous hemangiomas, and hypertrophy of soft tissue and bone. We present the case of a woman with KTWS, cor pulmonale, and death due to recurrent pulmonary embolism (PE). The risk of deep venous thrombosis and PE in patients with KTWS is evaluated, and treatment recommendations are made with emphasis on the role of early, aggressive management in the subset of patients with KTWS known to have thromboembolic disease.
Induction of alkali labile links in cellular DNA by camptothecin.

Abstract Camptothecin has been reported to rapidly introduce single strand breaks into the DNA of cells exposed to the drug. The breaks are apparent when drug-treated cells are layered on alkaline-sarcosyl and released DNA sedimented in an alkaline gradient. In this report, we show that the DNA breaks are not found when formamide denaturation is substituted for high pH. Furthermore, if cells are lysed in neutral sarcosyl and the DNA then sedimented in alkali, no camptothecin-induced breaks are apparent. These results suggest that the DNA breaks induced by the drug result from alkali labile links in the DNA. The DNA fragmentation apparently only occurs if the DNA is exposed to high pH while the drug or some derivative is still present.
Post-copulatory storage of sperm in the seminal bursa of the acoel flatworm Otocelis luteola

Summary Copulation in the acoel Otocelis luteola may result in mutual or one-sided insemination. Fifty specimens cultured with a species of Navicula were allowed to mate in pairs for a period of 6 h, 50 were allowed to mate in pairs for 24 h, and nine were allowed to mate freely for 24 h. All wows were then isolated in separate containers that were examined at frequent intervals in order to record the number of eggs and young. The number of progeny produced by worms that had been inseminated ranged from 1 to 65, and one worm had progeny as late as 55 days after mating. This study shows that O. luteola is able to store viable sperm in its seminal bursa for several weeks.
Incidence of gastric involvement in patients with nongastrointestinal extranodal marginal zone lymphoma.

BACKGROUND: The current study was conducted to determine the incidence of gastric involvement in patients presenting with extranodal marginal zone lymphoma (MZL) outside the gastrointestinal (GI) tract and to identify clinical or laboratory parameters that predict gastric involvement in such cases. METHODS: The records of 121 consecutive patients who presented with non-GI extranodal MZL and had undergone esophagogastroduodenoscopy (EGD) as part of their initial workup were retrospectively reviewed. The authors assessed the presence of occult gastric MZL in these patients and possible associations with demographic characteristics; anatomic site of initial presentation; Helicobacter pylori (H. pylori) infection; Zubrod score; International Prognostic Index (IPI); B symptoms; and serum lactate dehydrogenase, hemoglobin, albumin, and β2-microglobulin levels. RESULTS: The median age at diagnosis of non-GI MZL was 59 years. The most common primary tumor sites were the salivary/parotid gland (32 patients), ocular adnexa (26 patients), skin (19 patients), and lung (17 patients). Twenty-two patients (18%) were found to have gastric involvement on EGD. Using logistic regression analysis, factors found to be associated with gastric involvement included: high IPI score (odds ratio [OR], 3.70; P = .03), female sex (OR, 6.50; P = .02), serum β2-microglobulin level of ≥2.5 mg/L (OR, 3.69; P = .02), and involvement of the aerodigestive mucosal/glandular tissue (OR, 4.50; P = .004). On multivariate logistic analysis, aerodigestive mucosal/glandular sites, H. pylori infection, and an elevated β2-microglobulin level were found to be associated with gastric involvement. CONCLUSIONS: Routine EGD is recommended for patients with non-GI MZL, particularly those with primary aerodigestive mucosal/glandular tissue involvement or those with a high IPI, female sex, elevated serum β2-microglobulin level, or H. pylori infection regardless of the primary tumor site. Cancer 2011. © 2010 American Cancer Society.
Human Tibiofemoral Joint Displacements Determined by Displacement-Encoded MRI

Articular cartilage and surrounding soft tissues in the knee are important to normal joint function. Osteoarthritis (OA) is highly prevalent in the United States [1] and features precocious degeneration of articular cartilage. Effective OA treatments require the ability to detect early degeneration, including mechanical and biochemical changes. Magnetic resonance imaging has shown promise for the detection of early degenerative changes, including various quantitative MRI techniques [2]. Displacement-encoded MRI has the ability to detect changes in mechanical behavior, and such techniques have previously been used in cartilage explants [3] and intact juvenile animal joints [4]. However, the authors are aware of no studies with displacement-encoded MRI of human articular cartilage. Tissue-level displacement patterns could be key to revealing early degeneration in articular cartilage. This study demonstrates for the first time displacement encoding with stimulated echoes (DENSE) in an adult human tibiofemoral joint.Copyright © 2011 by ASME
Allergic reactions to peanuts, tree nuts, and seeds aboard commercial airliners

Background Minimal data exist on the prevalence and characteristics of in-flight reactions to foods. Objectives To characterize reactions to foods experienced by passengers aboard commercial airplanes and to examine information about flying with a food allergy available from airlines. Methods Telephone questionnaires were administered to individuals in a peanut, tree nut, and seed allergy database who self-reported reactions aboard aircraft. Airlines were contacted to obtain information on food allergy policies. Results Forty-one of 471 individuals reported allergic reactions to food while on airplanes, including 4 reporting more than 1 reaction. Peanuts accounted for most of the reactions. Twenty-one individuals (51%) treated their reactions during flight. Only 12 individuals (29%) reported the reaction to a flight attendant. Six individuals went to an emergency department after landing, including 1 after a flight diversion. Airline personnel were notified of only 3 of these severe reactions. Comparison of information given to 3 different investigators by airline customer service representatives showed that inconsistencies regarding important information occurred, such as whether the airline regularly serves peanuts. Conclusions In this group of mainly adults with severe nut/seed allergy, approximately 9% reported experiencing an allergic reaction to food while on board an airplane. Some reactions were serious and potentially life-threatening. Individuals commonly did not inform airline personnel about their experiences. In addition, the quality of information about flying with food allergies available from customer service departments is highly variable and, in some cases, incomplete or inaccurate.
Multiobjective optimization in pavement management using genetic algorithms and efficient surfaces

This dissertation describes a new method of finding near optimal maintenance and rehabilitation strategies for road pavements, at both the project and network levels, using genetic algorithms and multi-objective optimization. A strategy, in this case, is defined as a set of decisions (for instance what maintenance action to take in each year of an analysis period). The methodology differs from other similar methods in a number of important respects. Unlike many methods which optimize or prioritize based on a single objective (resulting in a single optimal strategy), this method allows generation of efficient sets of strategies which are optimal or near optimal for various combinations of user defined multiple objectives. These strategies can then be plotted, based on their objective values, to form surfaces in as many dimensions as there are objectives. Thereafter, users may visualize the tradeoffs between their objectives and choose strategies accordingly. The generation of efficient sets at project level is also shown to allow decomposition of restricted cases of the network optimization problem into project level sub-problems. This insight allows solution of these network problems, while retaining location information, for large networks. It is believed that this is a new accomplishment. However, the common network optimization problem involving annual budget restrictions is not accommodated. Because of the flexibility of genetic algorithms, almost any optimization criteria and prediction models can be used in the optimization. Criteria can thus include different distresses, costs, user delays or safety considerations. The only necessity is that criterion values can be predicted for any project or network strategy. It is also possible to define different models for each specific project level section. The specific criteria and prediction models used as examples in this dissertation are linked to deterioration of the pavement and costs. General prediction models for these criteria are thus developed and discussed. A new type of deterioration/restoration modeling method termed ‘interactivity modeling’ is introduced, as well as methods to generalize this ‘point’ modeling to distress extent and severity distributions over the pavement. A chapter on cost modeling also introduces a method of incorporating economies of scale into the optimization system.
The Alexandria digital earth prototype

This note summarizes the system development activities of the Alexandr ia Digital Earth Prototype (ADEPT) Project.5 ADEPT and the Alexandria Digital Library (ADL) are, respectively, the research and operational components of the Alexandria Digital Library Project. The goal of ADEPT is to build a distributed digital library (DL) of personalized collections of geospatially referenced information. This DL is characterized by: (1) services for building, searching, and using personalized collections; (2) collections of georeferenced multimedia information, including dynamic simulation models of spatially distributed processes; and (3) user interfaces employing the concept of a “Digital Earth”. Important near-term objectives for ADEPT are to build prototype collections that support undergraduate learning in physical, human, and cultural geography and related disciplines, and then to evaluate whether using such resources helps students learn to reason scientifically. Collections and services developed by ADEPT researchers will migrate to ADL as they mature.
Reinterpretation of the exposed record of the last two cycles of Lake Bonneville, Western United States

A substantially modified history of the last two cycles of Lake Bonneville is proposed. The Bonneville lake cycle began prior to 26,000 yr B.P.; the lake reached the Bonneville shoreline about 16,000 yr B.P. Poor dating control limits our knowledge of the timing of subsequent events. Lake level was maintained at the Bonneville shoreline until about 15,000 yr B.P., or somewhat later, when catastrophic downcutting of the outlet caused a rapid drop of 100 m. The Provo shoreline was formed as rates of isostatic uplift due to this unloading slowed. By 13,000 yr B.P., the lake had fallen below the Provo level and reached one close to that of Great Salt Lake by 11,000 yr B.P. Deposits of the Little Valley lake cycle are identified by their position below a marked unconformity and by amino acid ratios of their fossil gastropods. The maximum level of the Little Valley lake was well below the Bonneville shoreline. Based on degree of soil development and other evidence, the Little Valley lake cycle may be equivalent in age to marine oxygenisotope stage 6. The proposed lake history has climatic implications for the region. First, because the fluctuations of Lake Bonneville and Lake Lahontan during the last cycle of each were apparently out of phase, there may have been significant local differences in the timing and character of late Pleistocene climate changes in the Great Basin. Second, although the Bonneville and Little Valley lake cycles were broadly synchronous with maximum episodes of glaciation, environmental conditions necessary to generate large lakes did not exist during early Wisconsin time.
Effects of Industrial Respirator Wear During Exercise in Subjects With Restrictive Lung Disease

Few studies have examined the response of individuals with restrictive lung disease (RLD) to respirator wear. Such information should be of theoretical and practical interest when the need to determine fitness to wear respirators is considered. Seventeen females performed progressive submaximal treadmill exercise. Twelve control subjects with total lung capacity (TLC)=5.71±.19 L (mean±SEM) and DLCO=25.8±1.0 mL/min/mmHg were compared to five RLD subjects with TLC=3.70±0.22 and DLCO=14.5±0.7. Mean age, height and weight were similar. Separate exercise trials were performed with no added resistance (NAR), and with 5 cm H2O/L/sec inspiratory and 1.5 cm H2O/L/sec expiratory resistance (R2) to simulate widely used respiratory masks. Comparisons of exercise data were made at an oxygen consumption of 0.8 L/min. With NAR, RLD subjects had significantly higher minute ventilation ([Vdot]E) (29.0 vs. 21.2 L/min for controls), higher respiratory rate (RR), and lower tidal volume (VT). Heart rate, end-tidal PCO2 (PETCO...
Mechanisms by which T7 lysozyme specifically regulates T7 RNA polymerase during different phases of transcription.

Bacteriophage T7 lysozyme binds to T7 RNA polymerase (RNAP) and regulates its transcription by differentially repressing initiation from different T7 promoters. This selective repression is due in part to a lysozyme-induced increase in the KNTP of the initiation complex (IC) and to intrinsically different NTP concentration requirements for efficient initiation from different T7 promoters. While lysozyme represses initiation, once the enzyme has left the promoter and formed an elongation complex (EC) it is generally resistant to the effects of lysozyme. The mechanism by which the inhibitory effects of lysozyme are largely restricted to the initiation phase of transcription is not well understood. We find that T7 lysozyme destabilizes initial transcription complexes (ITCs) and increases the rate of release of transcripts from these complexes but does not destabilize ECs. However, if the RNA:RNAP interaction proposed to be important for EC stability is disrupted by proteolysis of the RNA-binding domain or use of templates which interfere with establishment of this RNA:RNAP interaction, the EC becomes sensitive to lysozyme. Comparison of the X-ray structures of T7RNAP and of a T7RNAP:T7 lysozyme complex reveals that lysozyme causes the C terminus of the polymerase to flip out of the active site. Experiments in which carboxypeptidase A is used to probe the lysozyme-induced exposure of the C terminus reveal a large decrease in carboxypeptidase sensitivity following transcription initiation, suggesting that interactions with the 3'-end of the RNA help stabilize the active site in a functional (carboxypeptidase protected) conformation. Thus, the resistance of the EC to lysozyme appears to be due to the consecutive establishment of two sets of RNA:RNAP interactions. The first is made with the 3'-end of the RNA and helps stabilize a functional conformation of the active site, thereby suppressing the effects of lysozyme on KNTP. The second is made with a more upstream element of the RNA and keeps the EC from being destabilized by lysozyme binding.
A query-based cross-language diagnosis tool for distributed decision making support

A query translation-based Korean-English cross-language diagnosis (Q-KE-CLD) tool for assisting Korean users diagnosing print defects was developed and then evaluated as a case study of distributed decision making support for nonnative English users. The first step in developing the Q-KE-CLD tool involved collecting and analyzing print defect descriptions in Korean and English. A fuzzy Bayesian model was obtained from the descriptions and the Q-KE-CLD tool was developed. The tool was then experimentally evaluated in four different universities in South Korea. Results showed that Korean subjects generated Korean queries faster (p=0.008) when entering Korean queries. In addition, the subjects rated Korean queries as being easier to generate (p=0.004). Untrained subjects reported that use of the Korean language made it easier to generate queries and identify print defects. The overall results suggested that query translation-based cross-language diagnosis is a feasible approach for localizing troubleshooting websites.
Atrial fibrillation and cardiac surgery.

PURPOSE OF REVIEW: To discuss the pathophysiology, risk factors, and treatments for atrial fibrillation occurring after cardiac surgery. RECENT FINDINGS: Atrial fibrillation occurs frequently after cardiac surgery and it may lead to patient morbidity. Many variables have been suggested to be associated with this arrhythmia, but only advanced patient age can consistently identify risk for this complication. Immediate electrical cardioversion is indicated when the arrhythmia leads to hemodynamic instability or myocardial ischemia. Otherwise treatment is aimed at heart rate control, elective cardioversion with drugs or electrical means, and anticoagulation when the arrhythmia persists. Multiple investigations have evaluated methods for preventing postoperative atrial fibrillation, but only beta-adrenergic receptor blocking drugs have been consistently shown to be effective, and then not in all patients. Surgical treatments are increasingly being considered as a therapeutic means for ameliorating chronic atrial fibrillation. The use of these procedures has been simplified with the development of devices that can generate linear scars in the atrium and around the pulmonary vein orifices. These simplifications will allow for broader application of these techniques to patients undergoing other cardiac surgery (e.g. mitral valvular surgery). SUMMARY: Atrial fibrillation is one of the most common complications of cardiac surgery. There are three major aims for treating atrial fibrillation: conversion to sinus rhythm, heart rate control, and anticoagulation. Only beta-blockers can be recommended for prophylaxis against postoperative atrial fibrillation. Further refinements in surgical treatments for atrial fibrillation may allow for wider applications of this therapy with lower rates of complications.
Cuffed Inner Cannula and Flexible Outer Cannula Trachesotomy Device: Ensuring a Stable Airway

Tracheostomy tubes (TTs) are used to provide a direct airway to a patient’s trachea when natural respiration is no longer possible. A TT generally includes an elongate outer cannula as well as a smaller inner cannula formed so as to have a gradual curve to facilitate insertion into a patient’s trachea. In order seal the airway around the tube, a conventional TT generally has an inflatable cuff attached to the perimeter of the outer cannula. When inflated, the cuff seals the airway around the cannula, thereby, requiring air to pass through only the cannula. In order to retain the distal end of the device in its operative position, the TT generally includes a neck plate or other fixation device, which is attached to the proximal end of the outer cannula. There are many potential drawbacks with current TTs, which can range in effect from minor irritation to death. Varying sizes of individuals and differences in anatomical dimensions leads to discomfort from TTs that fit poorly. The rigid ends of the outer cannula often put pressure on the walls of the trachea, which can cause irritation and ulceration. Cuffed inner cannulas are required to be replaced with uncuffed inner cannulas as soon as possible, after placement, to avoid pressure necrosis and allow for vocalization. The process of switching TTs may also be very hazardous, especially when treating obese patients. The stoma can easily be lost among layers of fat and skin, as well as the trachea, which all move independently of one another. Losing the stoma may cause suffocation and possibly death. Our novel device is a TT for use with a neck plate having an aperture. The TT comprises an elongate outer cannula having a lumen and configured to extend through the aperture. An elongate inner cannula having a lumen and an inflatable cuff and configured to extend through the lumen of the outer cannula such that the cuff extends beyond a distal end of the outer cannula and an interlocking mechanism configured to releasably secure a proximal end of the inner cannula to a proximal end of the outer cannula. This superior TT has the potential for wide application with a special emphasis on application within the obese population. Such patients experience the most difficulty with current devices. There is no single device in the market today that packages the numerous features of this particular design.
Fail-Safe Logic Elements for Use with Reactor Safety Systems

A complete fail-safe trip circuit is described which utilizes fail-safe logic elements. The logic elements1 used are analog multipliers and active bandpass filter networks. These elements perform Boolean operations on a set of AC signals from the output of a reactor safety-channel trip comparator.
Response inhibition is impaired by developmental methylmercury exposure: Acquisition of low-rate lever-pressing ☆

Developmental methylmercury (MeHg) exposure produces response perseveration on discrimination reversal procedures, disrupts sensitivity to reinforcement, and enhances sensitivity to dopamine agonists - a profile suggesting a deficit in behavioral inhibition. To examine inhibition, we examined MeHg's effects on the acquisition and persistence of low-rate lever-pressing following a history of high-rate responding. Additionally, we examined whether chronic exposure to selenium protects against MeHg's developmental neurotoxicity. Female rats were exposed in utero via maternal exposure to drinking water containing 0ppm, 0.5ppm or 5ppm of Hg as MeHg, producing approximately 0μg/kg/day, 40μg/kg/day, or 400μg/kg/day of Hg. The mothers (during gestation) and the offspring (throughout life) consumed a purified diet containing 0.06ppm or 0.6ppm of Se (as sodium selenite), forming a 2 (lifespan diet)×3 (developmental MeHg) factorial design. Adult offspring lever-pressed under two schedules of reinforcement. A differential reinforcement of high-rate (DRH) schedule imposed rigid response requirements that remained constant through the study. A high-rate percentile schedule (PCNT-H) incorporated a flexible criterion that reinforced short interresponse times using an adjusting criterion that was sensitive to recent performance. After high-rate responding stabilized, the PCNT-H schedule was abruptly inverted by reinforcing long interresponse times. Acquisition of low-rate responding was impaired in the MeHg-exposed rats because of intrusions of high-rate response bursts. DRH response rates did not change. Dietary selenium did not influence MeHg's effects. High-rate operant behavior perseverated, suggesting that gestational MeHg exposure impairs response inhibition - an effect that extends results previously reported using choice procedures or spatial and visual discrimination reversals.
Active tremor cancellation by a “Smart” handheld vitreoretinal microsurgical tool using swept source optical coherence tomography

Abstract: Microsurgeons require dexterity to make precise and stable maneuvers to achieve surgical objectives and to minimize surgical risks during freehand procedures. This work presents a novel, common path, swept source optical coherence tomography-based “smart” micromanipulation aided robotic-surgical tool (SMART) that actively suppresses surgeon hand tremor. The tool allows enhanced tool tip stabilization, more accurate targeting and the potential to lower surgical risk. Freehand performance is compared to smart tool-assisted performance and includes assessment of the one-dimensional motion tremor in an active microsurgeon’s hand. Surgeon hand tremor—the ability to accurately locate a surgical target and maintain tool tip offset distances—were all improved by smart tool assistance.
Cytosolic Alkalinization of Vascular Endothelial Cells Produced by an Abrupt Reduction in Fluid Shear Stress

Abstract—Reductions in fluid shear stress produce endothelium-dependent vasoconstriction and promote neointimal hyperplasia, but the intracellular signaling mechanisms involved in these processes are poorly understood. To examine whether decreases in fluid shear stress affect endothelial cytosolic pH, carboxy-seminaphthorhodafluor-1–loaded rat aortic endothelial cells were cultured in glass microcapillary tubes and examined during abrupt reductions in laminar flow. After a 30-minute exposure to a shear stress of 2.7 dyne/cm2 in bicarbonate buffer, the acute reduction of fluid shear stress from 2.7 to 0.3 dyne/cm2 transiently increased cytosolic pH from 7.20±0.02 to 7.47±0.07 (mean±SEM, P<.05 versus control). This was not affected by prior inhibition of the Na+-H+ exchanger with 10 μmol/L ethylisopropylamiloride but was abolished in bicarbonate-free buffer. Recovery from an ammonium chloride prepulse–induced acid load occurred more rapidly when fluid shear stress was abruptly reduced from 2.7 to 0.3 dyne/c...
Recent advances in the treatment of eosinophilic esophagitis

First described nearly 20 years ago, eosinophilic esophagitis (EoE) is an inflammatory disease of the esophagus characterized by eosinophilic infiltration of the esophageal epithelium. Over 50% of the current literature on EoE has been published in the last 3 years, signaling both a rising incidence and increased recognition of this disorder. Treatment options available for patients with EoE include dietary management and/or pharmacologic therapy. An individualized approach to treatment is preferred, with an emphasis on patient–parental preference. The objective of this article is to discuss the current and future treatment options for EoE.