cssi/SciSciGPT-SciSciNet huggingface dataset:
Employee Dilemmas from Competing Organizational Objectives: Insights from Emergency Medical Services

Organizations face unique challenges when simultaneously pursuing conflicting organization-level objectives. We study how frontline employees deal with competing financial and social objectives within the context of Emergency Medical Services. Using data from 31 US states, we find that even in the absence of direct financial incentives, emergency crews are responsive to the financial objective of their agencies by providing differential service to patients based on their ability to pay. Private insurance and Medicare patients receive more procedures (6.1% and 1.9%) and have longer transport times (5.3% and 4.0%) than Medicaid patients after controlling for call and patient characteristics. Importantly, we also find evidence suggesting that EMS crews vacillate between the financial and social objectives between calls, depending on the relative salience of the objective.
Orthopaedic Group Practice Size Is Increasing

Purpose To analyze recent trends in orthopaedic surgery consolidation and quantify these changes temporally and geographically from 2012 to 2020. Methods We performed a retrospective cross-sectional analysis of orthopaedic surgeon practice size in the United States using 2012 and 2020 data obtained from the Physician Compare database. Results Although we observed an increase from 21,216 unique orthopaedic surgeons in 2012 to 21,553 in 2020 (1.6% increase), the number of practices experienced a large decrease from 7,299 practices in 2012 to 5,829 in 2020 (20.1% decrease). The proportion of orthopaedic surgeons working in solo practices decreased from 13.2% (2,790) in 2012 to 7.4% (1,595) in 2020, and the proportion of orthopaedic surgeons working in groups sized 2 to 24 decreased from 35.3% (7,482) in 2012 to 22.2% (4,775) in 2020. In contrast, groups sized 25 to 99 have grown from 20.7% (4,387) of all orthopaedic surgeons to 23.4% (5,048) in 2020. Groups sized 100 to 499 have increased from 16.9% (3,593) in 2012 to 24.1% (5,190) in 2020, whereas groups sized 500 or greater have grown from 14% (2,964) in 2012 to 22.9% (4,945) in 2020. The number of unique group practices showed a significant decrease in the number of solo groups, which comprised 43.8% (3,200) of the total number of individual practices in 2012, decreasing to 32% (1,886) in 2020. All other groups increased in number and proportionally from 2012 to 2020. Conclusions This study shows that over the period from 2012 to 2020, there has been a substantial trend of orthopaedic surgeons shifting to increasing practice sizes, potentially indicating that more orthopaedic surgeons are working for large health care organizations rather than small independent practices. Clinical Relevance The impact of these changes should be examined to determine large-scale effects on patient care, payment models, access, and outcomes, along with physician compensation, lifestyle, and satisfaction.
Essential functions of MLL1 and MLL2 in retinal development and cone cell maintenance

MLL1 (KMT2A) and MLL2 (KMT2B) are homologous members of the mixed-lineage leukemia (MLL) family of histone methyltransferases involved in epigenomic transcriptional regulation. Their sequence variants have been associated with neurological and psychological disorders, but little is known about their roles and mechanism of action in CNS development. Using mouse retina as a model, we previously reported the roles of MLL1 in retinal neurogenesis and horizontal cell maintenance. Here we determine roles of MLL2 and MLL1/MLL2 together in retinal development using conditional knockout (CKO) mice. Deleting Mll2 from Chx10+ retinal progenitors resulted in a similar phenotype as Mll1 CKO, but removal of both alleles produced much more severe deficits than each single CKO: 1-month double CKO mutants displayed null light responses in electroretinogram; thin retinal layers, including shorter photoreceptor outer segments with impaired phototransduction gene expression; and reduced numbers of M-cones, horizontal and amacrine neurons, followed by fast retinal degeneration. Despite moderately reduced progenitor cell proliferation at P0, the neurogenic capacity was largely maintained in double CKO mutants. However, upregulated apoptosis and reactive gliosis were detected during postnatal retinal development. Finally, the removal of both MLLs in fated rods produced a normal phenotype, but the CKO in M-cones impaired M-cone function and survival, indicating both cell non-autonomous and autonomous mechanisms. Altogether, our results suggest that MLL1/MLL2 play redundant roles in maintaining specific retinal neurons after cell fate specification and are essential for establishing functional neural networks.
Impact of Electromagnetic Stirring on Grain Structure of Electroslag Remelting Ingot

A transient, two-dimensional axisymmetric model was developed to understand the effect of the electromagnetic stirring (EMS) on the grain morphology of the electroslag remelting ingot. The cellular automaton-finite element technique was employed to describe the nucleation and growth of the grain. The Joule heating and Lorentz force created by the current of the furnace, as well as the Lorentz force induced by the EMS device, are included. The effect of the EMS current on the grain structure was investigated using the model. A reasonable agreement between the experiment and simulation was obtained. The growth direction of the upper grain without the EMS is approximately 45° with respect to the vertical axis, while changes to the radial were caused by EMS. The grain was considerably refined by the EMS, and the average area of the grain decreased from 9.381 × 10−7 m2 to 6.781 × 10−7 m2 with the current of the EMS ranging from 0 A to 500 A. Both the local solidification time and second dendrite arm spacing decreased with the increasing stirring intensity. The metal pool depth, however, increased with the EMS, which definitely contributed to the macrosegregation formation. The upper ingot with EMS was darker than that without EMS in the experiment. The EMS technique should be used with caution.
Uniqueness of the Mapping Degree for Elliptic Operators with Strong Zero Order Nonlinearities

Publisher Summary This chapter discusses the uniqueness of the mapping degree for elliptic operators with strong zero order nonlinearities. The chapter presents the examples for the mappings f with domain in a reflexive Banach space X and values in its conjugate space X . The chapter proves that by a degree theory on a class F of mappings f , corresponding to a class of permissible homotopies H , that is, an integer-valued function that for every mapping f in the class and each bounded open set G in X . The chapter also shows that for each target point in X, an integer-valued function is defined having three basic properties—namely, normalization, additivity on the domain, and invariance under homotopies in H .
Technological Hazards, Risk, and Society: A Perspective on Risk Analysis Research

In recent years government support for the study of technological hazards and risks has substantially increased. Much of the research effort has been carried out through grants and contracts to statisticians, physicists, biologists, chemists, engineers, decision analysts, economists, and psychologists, although researchers from other disciplines have also made major contributions. Largely due to these efforts, there is now a significant body of knowledge on methods for identifying estimating, and evaluating risks; on institutional, political, and legal constraints associated with the risk management process; and on public perceptions of risk. It would be no exaggeration to say that as a result of these efforts a new and lively field of research has been created almost overnight.
Production and Provenance of Sand

In this chapter we consider two problems. One has to do with how sand is formed and the other deals with the source or place where sand is produced. In the first, we are concerned with the processes involved in the production of sand, how sand grains come into being. In the second, we wish to know what the source rocks were and where the source area was. It is presumed that a sand body or formation itself contains much of the information needed to answer these questions. We might ask about each and every sand grain — how did it form and where did it come from? This in a nutshell is the theme of this chapter.
Regulation of Phosphatidylcholine Biosynthesis by the Methylation Pathway in Saccharomyces cerevisiae

Abstract The labeling of the methylated phospholipids of Saccharomyces cerevisiae has been studied with methionine-methyl-14C, serine-3-14C, and choline-1,2-14C as precursors. It was found that inclusion of 1 mm choline in the growth media greatly lowered the rate of labeling of the methylated phospholipids by methionine and serine; sterol labeling was unaffected. It is suggested that this is a result of repression of synthesis of the specific N-methyl transferases involved in the biosynthesis of phosphatidylcholine. A study in vitro with methyl-14C-S-adenosylmethionine as methyl donor showed that particles prepared from cells grown in the absence of choline had a much higher rate of phospholipid methylation than the particles prepared from choline-grown cells. Incorporation rates of choline in vivo into phosphatidylcholine were not greatly altered by the presence of choline in the growth medium.
Lithographic measurement of EUV flare in the 0.3-NA micro exposure tool optic at the Advanced Laser Source

The level of flare present in a 0.3-NA EUV optic (the MET optic) at the Advanced Light Source at Lawrence Berkeley National Laboratory is measured using a lithographic method. Photoresist behavior at high exposure doses makes analysis difficult. Flare measurement analysis under scanning electron microscopy (SEM) and optical microscopy is compared, and optical microscopy is found to be a more reliable technique. In addition, the measured results are compared with predictions based on surface roughness measurement of the MET optical elements. When the fields in the exposure matrix are spaced far enough apart to avoid influence from surrounding fields and the data is corrected for imperfect mask contrast and aerial image proximity effects, the results match predicted values quite well. The amount of flare present in this optic ranges from 4.7% for 2 mm features to 6.8% for 500 nm features.
Do We Still Need Cities? Evidence on Rates of Innovation from Count Data Models of Metropolitan Statistical Area Patents

Evidence of the importance of urban agglomeration and the offsetting effects of congestion are provided in a number of studies of productivity and wages. Little attention has been paid to this evidence in the economic growth literature, where the recent focus is on technological change. We extend the idea of agglomeration and congestion effects to the area of innovation by empirically looking for a nonlinear link between population density and patent activity. A panel data set consisting of observations on 302 USA metropolitan statistical areas (MSAs) over a 10-year period from 1990 to 1999 is utilized. Following the patent and R&D literature, models that account for the discreet nature of the dependent variable are employed. Strong evidence is found that agglomeration and congestion are important in explaining the vast differences in patent rates across US cities. The most important reason cities continue to exist, given the dramatic drop in transportation costs for physical goods over the last century, is probably related to the forces of agglomeration as they apply to knowledge spillovers. Therefore, the empirical investigation proposed here is an important part of understanding the viability of urban areas in the future.
Chapman’s Orthopaedic Surgery. 3rd edition, volumes 1 through 4 and CD-ROM.

Michael W. Chapman, editor. Philadelphia: Lippincott Williams and Wilkins; 2001. 5152 pages. $425.00. The second edition of this text has been a standard and heavily used reference in our residents’ library for years. This new edition is indeed welcome. Dr. Chapman has selected an outstanding group of new section editors and chapter authors who represent the most active and influential contributors to the broad field of orthopaedics today. The …
Intestinal Mucosal Mast Cell Immune Response and Pathogenesis of Two Eimeria acervulina Isolates in Broiler Chickens

Four experiments were conducted comparing intestinal immune responses to 2 isolates of Eimeria acervulina (EA), EA1 and EA2. In experiments 1 and 2, broiler chicks of 2 commercial breeds were divided into control (nonchallenged), EA1-, or EA2-challenged groups. On d 6 postchallenge (PC), changes in BW were determined, intestinal lesions were scored, and duodenal tissue was evaluated for morphometric alterations and mucosal mast cell numbers. EA1 produced classical duodenal lesions and reduced villus height to crypt depth ratios compared with controls; however, no differences were found in mast cell counts. EA2 produced different results, and observed data were suggestive of an anaphylactic-like intestinal secretory response compared with EA1 or controls. In experiment 3, tissues were analyzed from d 2 through 6 PC. Villus atrophy and crypt hyperplasia were increased on d 5 PC in both challenged groups. Mast cell counts were significantly greater on d 3 and 4 PC in EA1-challenged birds. In experiment 4, EA2 oocysts were cleaned with 5.25% sodium hypochlorite to evaluate the possibility of a bacterial contaminant contributing to the pathogenesis of intestinal alterations. No evidence of a bacterial contaminant contributing to the pathology was observed. These data are indicative of differential host response and immunovariability between different isolates of the same Eimeria species in 2 breeds of commercial broiler chickens.
Molecular characterization of pezizalean ectomycorrhizas associated with pinyon pine during drought.

Recent studies using molecular analysis of ectomycorrhizas have revealed that ascomycete fungi, especially members of the order Pezizales, can be important members of ectomycorrhizal (EM) fungal communities. However, little is known about the ecology and taxonomy of many of these fungi. We used data collected during a wet and a dry period to test the hypothesis that pezizalean EM fungi associated with pinyon pine (Pinus edulis) responded positively to drought stress. We also assessed the phylogenetic relationships among six, unknown pezizalean EM fungi, common to our study sites, using rDNA sequences from the internal transcribed spacer and large subunit (LSU) regions of the ribosomal DNA. Sequences of these fungi were then compared to sequences from known taxa to allow finer-scale identification. Three major findings emerged. First, at two sites, pezizalean EM were 44–95% more abundant during a dry year than a wetter year, supporting the hypothesis that pezizalean EM fungi respond positively to dry conditions. Second, four of the six unknown pezizalean EM fungi associated with P. edulis separated from one another consistently regardless of site or year of collection, suggesting that they represented distinct taxa. Third, comparison with LSU sequences of known members of the Pezizales indicated that these four taxa grouped within the genus Geopora of the family Pyronemataceae. Our results provide further evidence of the importance of pezizalean fungi in the ectomycorrhizal symbiosis and demonstrate high local abundance of members of the genus Geopora in drought-stressed pinyon–juniper woodlands.
Matrix-assisted laser desorption/ionization mass spectrometry of collected bioaerosol particles.

A method was developed for collection and analysis of bioaerosols by matrix-assisted laser desorption/ionization (MALDI) time-of-flight mass spectrometry using a modified Andersen N6 bioaerosol collector. The overall goal of the study was to develop methods for obtaining mass spectra with minimal reagents and treatment steps for potential use in remote collection and analysis systems. Test bioaerosol particles were generated from a nebulized E. coli bacterial suspension and collected on MALDI targets placed in an Andersen N6 single-stage aerosol impactor. The bioaerosols were mixed with matrix either by deposition on a bare target with the matrix solution added later, or by deposition on a target pre-coated with matrix. The matrix compounds α-cyano-4-hydroxycinnamic acid (CHCA) and sinapic acid (SA) were tested and the SA matrix was found to give the best results in number of peaks, resolution, and signal-to-noise ratio. Deposition of bioaerosol particles onto the matrix pre-coated target did not produce signal in the m/z region above 1000, but the signal could be recovered with the addition of a 1:1 (v/v) acetonitrile/water solvent. Addition of solvent by pipette to the pre-coated targets after particle deposition recovered signal comparable to the dried-droplet sample preparations, whereas solvent sprayed into the impactor recovered fewer peaks. Deposition on pre-coated targets with post-collection solvent addition was superior to deposition on bare target followed by post-collection addition of matrix solution. Copyright © 2005 John Wiley & Sons, Ltd.
Public administration, executive power, and constitutional confusion

This article examines the ambiguity in the meaning of executive power in both the text of the U.S. Constitution and in subsequent judicial interpretations. This ambiguity has had a profound impact on the constitutional position of the public administration. In the recent independent counsel case, the U.S. Supreme Court offered a restrictive interpretation of the President's constitutional powers to remove subordinate officers. This new interpretation could lead to increased congressional control over administrative agencies. The proper place and function of the public administration, unfortunately for the public administration, have been and remain inherently ambiguous because of the longstanding confusion about executive power in the Constitution of the United States. Richard Neustadt captured this ambiguity nicely when he noted that the two great themes that have characterized the American presidency have been “clerkship” and “leadership.”(1) There is no easy formula to bring clerks and leaders together...
Cerebral vasculopathy secondary to leptomeningeal gliomatosis: angiography

We describe a young woman with a glioblastoma multiforme in whom angiography showed multiple intracranial stenoses. The resected tumour was found to be invading cerebral vessels.
From the Luxembourg Compromise to Codecision: Decision Making in the European Union

Abstract The process of European integration today is significantly affected by the legislative procedures that apply to different policy areas. In the high politics areas still governed by vestiges of the Luxembourg compromise, that is by unanimity voting in the Council of Ministers, the pace of integration is determined by most recalcitrant member government. All other policy areas under the European Union's jurisdiction are now subject to qualified majority voting in the Council, but outcomes can be expected to vary across procedures. The position of the Commission is strongest—and hence the pace of integration is likely to be fastest—under the consultation procedure. The Commission must share agenda setting power with the Parliament under the cooperation procedure. This will not slow the pace of integration, however, unless the Parliament comes to be more responsible to the citizens of Europe. Finally, the new codecision procedure of the Maastricht treaty significantly weakens the Commission and strengthens the Council of Ministers by transferring agenda setting power from the Commission to the Council. The Parliament's agenda setting power was replaced with veto power. As a result, the likely policy consequence of codecision will be to slow the pace of integration in areas under its jurisdiction.
Magnetic resonance imaging of pancreatitis: An update

Magnetic resonance (MR) imaging plays an important role in the diagnosis and staging of acute and chronic pancreatitis and may represent the best imaging technique in the setting of pancreatitis due to its unmatched soft tissue contrast resolution as well as non-ionizing nature and higher safety profile of intravascular contrast media, making it particularly valuable in radiosensitive populations such as pregnant patients, and patients with recurrent pancreatitis requiring multiple follow-up examinations. Additional advantages include the ability to detect early forms of chronic pancreatitis and to better differentiate adenocarcinoma from focal chronic pancreatitis. This review addresses new trends in clinical pancreatic MR imaging emphasizing its role in imaging all types of acute and chronic pancreatitis, pancreatitis complications and other important differential diagnoses that mimic pancreatitis.
The Branched-Chain Amino Acid Aminotransferase Encoded by ilvE Is Involved in Acid Tolerance in Streptococcus mutans

ABSTRACT The ability of Streptococcus mutans to produce and tolerate organic acids from carbohydrate metabolism represents a major virulence factor responsible for the formation of carious lesions. Pyruvate is a key metabolic intermediate that, when rerouted to other metabolic pathways such as amino acid biosynthesis, results in the alleviation of acid stress by reducing acid end products and aiding in maintenance of intracellular pH. Amino acid biosynthetic genes such as ilvC and ilvE were identified as being upregulated in a proteome analysis of Streptococcus mutans under acid stress conditions (A. C. Len, D. W. Harty, and N. A. Jacques, Microbiology 150:1353–1366, 2004). In Lactococcus lactis and Staphylococcus carnosus, the ilvE gene product is involved with biosynthesis and degradation of branched-chain amino acids, as well as in the production of branched-chain fatty acids (B. Ganesan and B. C. Weimer, Appl. Environ. Microbiol. 70:638–641, 2004; S. M. Madsen et al., Appl. Environ. Microbiol. 68:4007–4014, 2002; and M. Yvon, S. Thirouin, L. Rijnen, D. Fromentier, and J. C. Gripon, Appl. Environ. Microbiol. 63:414–419, 1997). Here we constructed and characterized an ilvE deletion mutant of S. mutans UA159. Growth experiments revealed that the ilvE mutant strain has a lag in growth when nutritionally limited for branched-chain amino acids. We further demonstrated that the loss of ilvE causes a decrease in acid tolerance. The ilvE strain exhibits a defect in F1-Fo ATPase activity and has reduced catabolic activity for isoleucine and valine. Results from transcriptional studies showed that the ilvE promoter is upregulated during growth at low pH. Collectively, the results of this investigation show that amino acid metabolism is a component of the acid-adaptive repertoire of S. mutans.
Appearance-space texture synthesis

The traditional approach in texture synthesis is to compare color neighborhoods with those of an exemplar. We show that quality is greatly improved if pointwise colors are replaced by appearance vectors that incorporate nonlocal information such as feature and radiance-transfer data. We perform dimensionality reduction on these vectors prior to synthesis, to create a new appearance-space exemplar. Unlike a texton space, our appearance space is low-dimensional and Euclidean. Synthesis in this information-rich space lets us reduce runtime neighborhood vectors from 5x5 grids to just 4 locations. Building on this unifying framework, we introduce novel techniques for coherent anisometric synthesis, surface texture synthesis directly in an ordinary atlas, and texture advection. Remarkably, we achieve all these functionalities in real-time, or 3 to 4 orders of magnitude faster than prior work.
Responses of Arctic Tundra to Experimental and Observed Changes in Climate

We manipulated light, temperature, and nutrients in moist tussock tundra near Toolik Lake, Alaska to determine how global changes in these parameters might affect community and ecosystem processes. Some of these manipulations altered nutrient availability, growth—form composition, net primary production, and species richness in less than a decade, indicating that arctic vegetation at this site is sensitive to climatic change. In general, short—term (3—yr) responses were poor predictors of longer term (9—yr) changes in community composition. The longer term responses showed closer correspondence to patterns of vegetation distribution along environmental gradients. Nitrogen and phosphorus availability tended to increase in response to elevated temperature, reflecting increased mineralization, and in response to light attenuation, reflecting reduced nutrient uptake by vegetation. Nutrient addition increased biomass and production of deciduous shrubs but reduced growth of evergreen shrubs and nonvascular plants. Light attenuation reduced biomass of all growth forms. Elevated temperature enhanced shrub production but reduced production of nonvascular plants. These contrasting responses to temperature increase and to nutrient addition by different growth forms "canceled out" at the ecosystem level, buffering changes in ecosystem characteristics such as biomass, production, and nutrient uptake. The major effect of elevated temperature was to speed plant response to changes in soil resources and, in the long term (9 yr), to increase nutrient availability through changes in N mineralization. Species within a growth form were similar to one another in their responses to changes in resources (light or nutrients) but showed no consistent response to evelated temperature. Species richness was reduced 30—50% by temperature and nutrient treatments, due to loss of less abundant species. Declines in diversity occurred disproportionately in forbs, which are important for animal nutrition, and in mosses, which maintain soil thermal regime. There was no increased abundance of initially rare species in response to any treatment. During our 9—yr study (the warmest decade on record in the region), biomass of one dominant tundra species unexpectedly changed in control plots in the direction predicted by our experiments and by Holocene pollen records. This suggests that regional climatic warming may already be altering the species composition of Alaskan arctic tundra.
Holmium laser prostatic resection for patients presenting with acute urinary retention

OBJECTIVE To compare the outcomes of patients presenting with and without acute urinary retention (AUR) who were treated with 100-W holmium laser resection of the prostate (HoLRP), as laser therapies, including HoLRP, have been used for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH), but the effectiveness of HoLRP for patients with AUR has not been fully elucidated. PATIENTS AND METHODS The medical records of 87 patients who had HoLRP were reviewed, and prospective questionnaires aimed at determining patients’ American Urologic Association Symptom Index (AUA-SI) and Quality-of-Life (QoL) scores and medication usage were also obtained. Statistical analyses were used to compare the clinical characteristics and outcomes between patients with and with no AUR for up to 2 years after HoLRP. RESULTS All patients had the catheter removed successfully by 1 month after surgery; those presenting with AUR tended to have a greater improvement in clinical outcomes than those with no AUR, including a mean AUA-SI score decrease by ≈13 and ≈8 points, and a QoL score decrease by ≈2 and ≈1.4 points, respectively. These decreases were maintained throughout the study period. Patients with AUR had significantly greater decreases in their postvoid residual urine volume than those with no AUR. Serum prostate-specific antigen levels also had a modest but sustained decrease (14%) in both groups. There were no significant decreases in the reported use of BPH-related medications after surgery in either group. CONCLUSIONS HoLRP (100 W) is a safe and effective surgical therapy for patients presenting with AUR. The present results suggest that the short- and long-term outcomes of these patients are similar between men presenting with and with no AUR.
Psychophenomenology of the postpsychotic adjustment process.

A clinical phenomenological study with nine adults with schizophrenia explored the postpsychotic adjustment stage of recovery from a psychotic episode to map a psychological recovery trajectory. Participants (ages 21–37 years) were actively involved in an early psychosis outpatient treatment program. Psychophenomenological analysis of interview data resulted in 458 descriptive expressions reflecting four structural elements. Cognitive dissonance involved achieving pharmacological efficacy and cognitive efforts to “sort out” the experience. Insight was distinguished by mastery of autonomous performance of reality checks. Cognitive constancy was marked by resuming interpersonal relationships and age-appropriate activities. Ordinariness involved consistent engagement in daily activities reflective of prepsychosis functioning.
Treatment of diencephalic syndrome with chemotherapy: growth, tumor response, and long term control.

BACKGROUND The diencephalic syndrome (DS), which is manifested by progressive emaciation and failure to thrive in an apparently alert, cheerful infant, usually is due to a low grade hypothalamic glioma. Treatment with aggressive surgery and/or radiotherapy is variably successful in controlling disease and may result in severe neurologic sequelae. Chemotherapy recently has been shown to be effective in patients with low grade gliomas of childhood, but it is used infrequently in those with DS. METHODS The authors evaluated the efficacy of a regimen of carboplatin and vincristine on improving weight, causing tumor shrinkage, and delaying the need for alternative therapies in seven children (ages 9-20 months; median age, 11 months) with DS. Five patients weighed less than the 5th percentile for their age at the start of the study, one weighed within the 10th percentile, and one weighed within the 25th percentile. RESULTS At follow-up (range, 6-54 months; median, 28 months), the patients' weights had increased by 66-95% (median, 80%). On magnetic resonance imaging, four patients had a >50% reduction in tumor mass, one had a 25-50% reduction, and two had stable disease. In those patients with radiographic response to treatment, weight gain was accomplished with oral feedings in four of five patients, whereas those with stable disease required nasogastric, nasojejunal, or gastrostomy tube supplementation to maintain weight. Disease progression occurred at a median of 24 months after initiation of chemotherapy, and two patients remained free of progressive disease at last follow-up. Five patients were alive a median of 59 months from diagnosis. The need for radiation or other therapies was delayed in six of seven children. Therapy was tolerated without significant toxicities. CONCLUSION The authors conclude that treatment of DS with a carboplatin and vincristine regimen results in demonstrable weight gain, may result in tumor shrinkage, and in some cases, significantly delays the need for alternative therapies. Cancer 1998;83:166-172. © 1998 American Cancer Society.
Bradykinin B1 receptor antagonists : An α-hydroxy amide with an improved metabolism profile

Abstract A series of carbo- and heterocyclic α-hydroxy amide-derived bradykinin B1 antagonists was prepared and evaluated. A 4,4-difluorocyclohexyl α-hydroxy amide was incorporated along with a 2-methyl tetrazole in lieu of an oxadiazole to afford a suitable compound with good pharmacokinetic properties, CNS penetration, and clearance by multiple metabolic pathways.
GLUCURONYL TRANSFERASE INHIBITION BY STEROIDS.

Several steroids including hydrocortisone, estriol, and pregnanediol glucuronide are inhibitory to the enzyme glucuronyl transferase when tested in an in vitro microsome system with the use of o-aminophenol as the glucuronide acceptor. In view of the steroid hormones which are cross-placentally transferred to the newborn infant, the possible physiologic implications of these findings are discussed.
Floating the raft hypothesis: the roles of lipid rafts in B cell antigen receptor function.

The initiation of antibody responses to foreign antigens requires that B cells receive and integrate a variety of signals through an array of cell surface receptors including the B cell antigen receptor (BCR) as well as a number of essential coreceptors. Recent evidence indicates that cholesterol-rich plasma membrane microdomains, referred to here as lipid rafts, serve as platforms for BCR signaling and trafficking in B cells. The existence of rafts suggests a previously unappreciated level of organization at the B cell surface that may explain, at least in part, how BCR signaling is coordinated. Here the current evidence that lipid rafts play a key role in B cell responses is reviewed.
Fixed Membership Groups: The Locus of Culture Processes

ANTHROPOLOGISTS, in dealing with culture changes, have usually limited themselves to contrasting newer and older patterns of behavior. Only recently have there been attempts to deal with the process of culture change (Bennett and Despres 1960; d'Azevedo 1959; Geertz 1957; Maher 1960; Vogt 1960). The present paper explores that process by locating the kinds of social groupings that may facilitate culture changes but does not try to suggest what culture changes might occur or even to assert that any will occur. The present thesis employs the Gemeinschaft-Gesellschaft distinction originally set by Tonnies and used for various purposes by Weber and others. It will serve here to contrast social groups that tend to permit cultural changes among their members with those that do not. The cohesion of a Gemeinschaft, or communal group, is based largely on emotional ties. Its members regard their relations to one another as lasting indefinitely or at least for a very long time. Kinship groups, tribes, national communities are all examples of the Gemeinschaft or what will hereafter be called "fixed-membership" groups, each at its own level of integration. A Gesellschaft, or associative group, on the other hand, has as its formative principle a cultural determination. That is, its members are and remain members because of their continued support of the basic values or ideologies of the group. Examples of the Gesellschaft are religious sects, armies, political parties, voluntary associations, and business firms. These will be referred to as "flexible-membership" groups, and we shall try to justify the use of the terms "fixed membership" and "flexible membership." For the moment we may note that an enduring social group based primarily on the emotional ties of its members is better suited structurally to making shifts in its ideologies or values than one in which membership is retained by manifest support-or, at least, with no overt rejection-of the cultural beliefs held by the group.2 In dealing with culture changes it seems advantageous to differentiate culture and social structure, as Kroeber (1948: 7, 8, 10, 847), Parsons (1951:15 ff., 327, and passim), Merton (1957:esp. Parts I and II), Nadel (1957:149), and others have done. This distinction will help to direct our attention to those groups in which the process of cultural change is more likely to occur, and to avoid confusing social structural changes with cultural ones. The definitions of culture and social structure used here accord with those offered by the abovementioned authors. Culture is thus regarded as an ideational system, consisting of learned and shared symbols, technical skills, prescriptions for correct
Management Capacity and State Municipal Bond Ratings Evidence With the GPP Grades

Most state governments issue general obligation (GO) bonds in the financial market to borrow money. Assigned by credit agencies, state GO bond ratings reflect states’ perceived credit quality and affect their borrowing costs. Despite many studies on the determinants of municipal bond ratings, little has been known about the association between state management capacity and bond ratings because management capacity is generally difficult to quantify. However, state governments’ performance grades assigned by the Government Performance Project (GPP) provide a great opportunity to study how people perceive and respond to state governments’ management capacity. This study finds that states with higher GPP grades tend to have higher state GO bond ratings, but the relationship may be nonlinear as people are more sensitive to the extremes of perceived performance. In particular, we observe a “performance premium” scenario in which S&P bond ratings grow at an increasing rate as state GPP grades improve.
Presidential and Media Leadership of Public Opinion on Iraq

Much research disputes the president's ability to lead public opinion and shows media to have influenced public opinion concerning the war in Iraq. We argue that although news tone is likely to have affected public support for the war, presidential rhetoric could be influential for two reasons. First, heightened presidential attention to the war increases the public's accessibility to the president's perspective on the war. Second, a survey question that cues the respondent to consider the president explicitly in their evaluation of the Iraq war is likely to encourage responsiveness to presidential rhetoric. To assess these arguments, we simultaneously examine the impact that presidential tone and media tone have on public support for the war in Iraq by analyzing an original dataset of presidential speeches, news coverage, and public support for the war and the president's handling of it from 2002 to 2008. Our findings reveal that although media tone drives public support for the war in Iraq, presidential tone influences the public's view of President Bush's handling of it.
A differential effect of adenosine 3′,5′-cyclic monophosphate on the synthesis of functional enzymes from two different cistrons of the lac operon

Abstract A temperature sensitive mutant of Escherichia coli that fails to synthesize functional β-galactosidase at the non-permissive temperature unless exogenous cAMP (adenosine 3′,5′-cyclic monophosphate) is added does synthesize almost normal levels of thiogalactoside transacetylase and a β-galactosidase-like protein in the absence of cAMP. This protein can complement in vitro , deletion mutants in the β-galactosidase ( z ) gene. In the parental strain the synthesis of transacetylase but not of β-galactosidase is increased when cAMP is added. This phenomenon cannot be explained as an effect of cAMP on initiation of transcription at the initial promoter of the lac operon. Thus in E. coli cAMP can apparently affect lac mRNA in two different ways, one of which seems to be the promotion of initiation of transcription outside of the regular promoter site.
Introduction to the local enhancement of underwater imagery

Image-based detection of submerged objects is frequently confounded by optical distortions in the aqueous medium. For example, scattering can severly degrade contrast and resolution in underwater (UW) images when illumination systems and cameras are not range-gated. Prior to the development of range-gated imaging, much research emphasis was placed upon the analysis of greyscale imagery acquired under incoherent illumination. Primarily as a result of current emphasis on coherent optical technologies, the progress of image processing (IP) research that pertains to UW imagery has lagged IP hardware and software development. In this paper, we summarize methods for the digital clarification of images that portray actively illuminated UW scenes, i.e., images of floodlit objects. We model the primary UW image components as: a) contrast degradation resulting from illuminant backscattering from the water column, b) a return signal that results from backscattering of the illuminant from the object of regard, and c) resolution loss, due to forward scattering of the return signal. Letting items a) and c) consititute error sources, one can locally apply the appropriate filters to reduce the contribution of such errors. Our technique emphasized local enhancement, as opposed to the global methods used in previous imaging practice. Our enhancement filters are based upon image-algebraic templates that are designed to compensate for the effects of single and multiple scattering as well as absorption within the water column. Discussion is based upon image clarity, algorithmic complexity, and computational efficiency.
Family Structure and Children's Success: A Comparison of Widowed and Divorced Single-Mother Families

Compared with children raised in single-mother families created by the death of the father, children raised in divorced single-mother families have significantly lower levels of education, occupational status, and happiness in adulthood. Yet divorced single mothers are not significantly different than their widowed counterparts in child rearing, gender role, and family values and in religiosity, health-related behaviors, and other dimensions of lifestyle. However, relative to widowed single mothers, divorced single mothers hold lower occupational positions, are more financially stressed, and have a higher rate of participation in the paid labor force. We speculate that the contrasting positions in the social structure of different types of single-mother families may account for observed differences in child outcomes.
Can a school-based hand hygiene program reduce asthma exacerbations among elementary school children?

Background Viral upper respiratory tract infections have been implicated as a major cause of asthma exacerbations among school-aged children. Regular hand washing is the most effective method to prevent the spread of viral respiratory tract infections, but effective hand-washing practices are difficult to establish in schools. Objectives This randomized controlled trial evaluated whether a standardized regimen of hand washing plus alcohol-based hand sanitizer could reduce asthma exacerbations more than schools' usual hand hygiene practices. Methods This was a 2-year, community-based, randomized controlled crossover trial. Schools were randomized to usual care and then intervention (sequence 1) or intervention and then usual care (sequence 2). Intervention schools were provided with alcohol-based hand sanitizer, hand soap, and hand hygiene education. The primary outcome was the proportion of students experiencing an asthma exacerbation each month. Generalized estimating equations were used to model the difference in the marginal rate of exacerbations between sequences while controlling for individual demographic factors and the correlation within each student and between students within each school. Results Five hundred twenty-seven students with asthma were enrolled among 31 schools. The hand hygiene intervention did not reduce the number of asthma exacerbations compared with the schools' usual hand hygiene practices ( P = .132). There was a strong temporal trend because both sequences experienced fewer exacerbations during year 2 compared with year 1 ( P Conclusions Although the intervention was not found to be effective, the results were confounded by the H1N1 influenza pandemic that resulted in substantially increased hand hygiene behaviors and resources in usual-care schools. Therefore these results should be viewed cautiously.
Team-Based Interaction in the Foodservice Instructional Laboratory: An Exploratory Model of Team Composition, Team-Member Interaction, and Performance

This exploratory investigation of organizational behavior, communication, marketing, and education concepts resulted in a test model of team influence, process, and outcomes. Both individual and aggregate team scores led to the same conclusions and suggested that the team characteristics, processes, and outcomes appear best suited to team level interpretation.
Ocular Phenomena in Acromegaly

The ocular findings and their relation to the sella turcica in fifty cases of acromegaly are here reported in tabular form. The principal points observed are also discussed, with the cases arranged in four groups. The paper is based on observations made in the section on Ophthalmology of the Mayo Clinic, Rochester, Minn.
β-blocker therapy for prophylaxis of initial variceal hemorrhage: Has its time come?

In a double-blind randomized trial, the hemodynamic events following the administration of propranolol (n = 51) or a placebo (n = 51) were prospectively studied in cirrhotic patients with esophageal varices. The hepatic venous pressure gradient, heart rate, and variceal size were determined at the baseline and 3, 12, and 24 months after the beginning of therapy. Baseline values were similar in both groups. At 3 months, the hepatic venous pressure gradient decreased significantly in propranolol-treated patients (from 18.1 ± 4.2 to 15.7 ± 3.4 mm Hg; P 12 mm Hg. In 21 patients (14 propranolol-, 7 placebo-treated) the hepatic venous pressure gradient decreased to ⩽12 mm Hg; none of them bled from esophageal varices, and their mortality rate also decreased. Because most of the bleeding events occurred during the first year (10 placebo-, 1 propranololtreated; P < 0.01), propranolol seems to have its protective effect during the period associated with the largest reduction in the hepatic venous pressure gradient. Because a reduction in the hepatic venous pressure gradient to < 12 mm Hg protects from variceal bleeding and increases the rate of survival, this should be the aim of the pharmacological therapy of portal hypertension.
Transformations in quasimelting

The structural fluctuations in small particles in the presence of an electron beam has been investigated using real time video recordings. The acquired images have been analyzed frame by frame in order to probe the exact nature of the quasimolten state. This analysis demonstrates that quasimelting, as experimentally observed in a high resolution microscope is a mixture of rapid rotations of the particle and much slower structural transformations. In addition, no evidence is found for an amorphous state.
Temporal–Spatial Scales of Observed and Simulated Precipitation in Central U.S. Climate

Abstract Precipitation intensity spectra for a central U.S. region in a 10-yr regional climate simulation are compared to corresponding observed spectra for precipitation accumulation periods ranging from 6 h to 10 days. Model agreement with observations depends on the length of the precipitation accumulation period, with similar results for both warm and cold halves of the year. For 6- and 12-h accumulation periods, simulated and observed spectra show little overlap. For daily and longer accumulation periods, the spectra are similar for moderate precipitation rates, though the model produces too many low-intensity precipitation events and too few high-intensity precipitation events for all accumulation periods. The spatial correlation of simulated and observed precipitation events indicates that the model's 50-km grid spacing is too coarse to simulate well high-intensity events. Spatial correlations with and without very light precipitation indicate that coarse resolution is not a direct cause of excessi...
Effect of pedal rate, brake load and power on metabolic responses to bicycle ergometer work.

Abstract In earlier investigations of the energy cost of bicycle ergometer work, pedal rate and brake load have been varied simultaneously while maintaining a constant power, thus confounding the effects of these factors. A two-way factorial design was used to isolate the effects of rate and load upon metabolic responses during ergometer work while also determining any interaction of effects (a power effect). Nine men performed bicycle ergometer tests at five pedal rates (20-100 r.p.m.) with five brake loads at each rate (0-4 kp). Steady-state V˙O2 was found to be a quadratic function of pedal rate when brake load was held constant, and to be a quadratic function of brake load when pedal rate was held constant. There was a significant interaction between the effects of rate and load which resulted in a shifting of the most efficient rate-load combination as the power changed. Significant differences (10-29%) were found between rate-load combinations at a constant power. It was concluded that the energy co...