cssi/SciSciGPT-SciSciNet huggingface dataset:
The erector spinae plane (ESP) block: A pooled review of 242 cases.

Abstract Study objective The erector spinae plane block (ESPB) was first described in 2016 as a regional block for thoracic neuropathic pain. Given its short history, there are a paucity of controlled clinical trials, yet an abundance of case reports. The primary aim of this review is to examine pooled clinical data from published literature to gain an understanding of ESPB characteristics. Design A PubMed search was conducted to identify all ESPB related publications. Inclusion criteria included reports of ESP single shot, continuous infusion, intermittent bolus, human and cadaveric studies. Only publications obtained in English were included. Measures included type of publication, year and country of publication, journal of publication, block technique, anatomic location, age, opioid and adjunct pain medication use, sensory and motor changes, side effects and adverse events. Qualitative statistics were used. Main results The initial search yielded 201 publications. After application of inclusion and exclusion criteria, 85 publications from 21 journals were included in the pooled review which yielded 242 reported cases between 2016 and 2018. The majority of publications reported single shot techniques (80.2%), followed by intermittent boluses (12.0%) and continuous infusions (7.9%). 90.9% reported use of multimodal analgesia in addition to the ESPB and 34.7% reported sensory changes from ESPB. A reduction in opioid use was reported in 34.7% of cases. One adverse event involving a pneumothorax was reported. Conclusions To our knowledge, this is the first review providing a pooled review of ESPB characteristics. The ESPB appears to be a safe and effective option for multiple types thoracic, abdominal, and extremity surgeries.
Correlation of tumor-derived circulating cell free DNA (cfDNA) measured by digital PCR (DigPCR) with tumor burden measured radiographically in patients (pts) with BRAFV600E mutated melanoma (mel) treated with RAF inhibitor (RAFi) and/or ipilimumab (Ipi).

9085 Background: We hypothesized that tumor-derived cfDNA in plasma may reflect accurately total tumor burden. DigPCR is a quantitative technique that carries out individual PCR reactions simultane...
A Breath of Fresh Air: BCG Prevents Adult Pulmonary Tuberculosis

Abstract Objectives The efficacy of childhood BCG vaccination in the prevention of adult pulmonary tuberculosis is not universally accepted. Methods We reviewed the published literature and summarized studies of BCG vaccination reporting long-term protection against pulmonary TB. Results We identified 15 papers reporting prospective studies and their long-term follow up, retrospective studies or systematic reviews. Conclusions Good quality evidence supports the efficacy of BCG vaccination in the prevention of adult pulmonary tuberculosis.
The impact of e-cigarette price changes on vaping and smoking behaviors

Background: Understanding the relations between e-cigarette prices and e-cigarette/cigarette use may shed light on the possible impact of e-cigarette regulations on public health. Objectives: This ...
Early case ascertainment and prospective multidisciplinary review for management of new melanoma diagnoses within an integrated healthcare system: The Kaiser Permanente Northern California experience.

6523Background: Appropriate surgical treatment of early-stage melanoma yields a high cure rate, but this management can be nuanced. In particular, surgical management, including sentinel lymph node...
Privacy-Preserving Predictive Model Using Factor Analysis for Neuroscience Applications

The purpose of this article is to present an algorithm which maximizes prediction accuracy under a linear regression model while preserving data privacy. This approach anonymizes the data such that the privacy of the original features is fully guaranteed, and the deterioration in predictive accuracy using the anonymized data is minimal. The proposed algorithm employs two stages: the first stage uses a probabilistic latent factor approach to anonymize the original features into a collection of lower dimensional latent factors, while the second stage uses an optimization algorithm to tune the anonymized data further, in a way which ensures a minimal loss in prediction accuracy under the predictive approach specified by the user. We demonstrate the advantages of our approach via numerical studies and apply our method to high-dimensional neuroimaging data where the goal is to predict the behavior of adolescents and teenagers based on functional magnetic resonance imaging (fMRI) measurements.
Towards Auto-tuning of Kalman Filters for Underwater Gliders based on Consistency Metrics

Underwater gliders are often used to perform in-situ measurements of oceanographic systems. In particular, there have been a number of recent efforts to use their state estimation capabilities in order to infer physical oceanographic process dynamics, such as modeling currents and eddies. Such inference requires that the dead-reckoning systems used on the vehicles, typically hand-tuned Extended Kalman Filters (EKFs), to be tuned consistently, which can be tedious and burdensome, especially across large numbers of trials. In this work, we describe a method to automatically tune state estimation hyper-parameters used in underwater glider EKFs, that does not require ground truth estimates. This automation is achieved by taking advantage of the normalized innovation squared (NIS) metric, which can be used inside of the objective function of various optimization methods. In this paper, we demonstrate its validity in simulated environments and provide initial results for its use on fielded glider data.
Butch-femme dynamics in Exodus 2–6 and 14: a lesbian-focused character study

This article assesses Exodus’ Egypt as lesbian bar culture of the 1940s and 1950s, treating the main characters of Moses, Pharaoh, Yhwh as competing butches for the femme, Israel. The article utili...
County-level factors underlying opioid mortality in the United States.

Background: Mortality from overdoses involving opioids in the United States (U.S.) has reached epidemic proportions. More research is needed to examine the underlying factors contributing to opioid...
Evaluation of outputted and leaked power for a micro-cavity laser in the terahertz region

Terahertz wave is generally an electromagnetic wave at the wavelength of 0.1-10 THz (30-3000 μm). The terahertz laser is a new type of radiation source with many unique advantages and has broad applications. Generally, the size of a normal laser cavity is from a few of to several hundred millimeters, and the size of a micro-cavity is mainly from a few of to several hundred micrometers in the wavelength region of ultraviolet, visible, and near-infrared. However, if the wavelength increases to the terahertz region, the wavelength is of the order of the micro-cavity size. The power distributions inside and outside the cavity of a terahertz laser are significantly different from those for a conventional laser cavity. In this paper, a theoretical model is established to study the outputted and leaked power of a micro-cavity in the terahertz band. We assume that the wavelength of an emission terahertz source is 240 μm and simulate the output features of a micro-cavity laser with the Finite-Difference Time-Domain (FDTD) algorithm. The output characteristics of a micro-cavity have been analyzed by using two types of material and different thicknesses of the sidewall. It has been found that when the thicknesses of both silver and aluminum sidewalls are reduced to around 16 μm, the power leaking from the micro-cavity begins to increase with the decrease of the sidewall thickness. In this way, the sidewall no longer restrains terahertz radiation inside the cavity. The simulation results might be referred for the design of a terahertz laser with the micro-cavity.
Crush Injury-induced Finger Compartment Syndrome: A Case Report and Literature Review.

Isolated finger compartment syndrome is an uncommon condition and is not well-documented. It is usually associated with pain, decreased sensation, and intra-compartmental swelling. We present the case of a finger fracture after a crush injury that developed compartment syndrome, which responded well after surgical fixation and midline skin incision for digital decompression. A 20-year-old male with a history of a 200 lb crush-injury to the left index finger 24 hours prior presented to the emergency department with decreased sensation and range of motion, deformity, increasing pallor, and severe pain. Radiographs demonstrated a middle phalanx fracture of the index finger. Digital decompression of the index finger through a radial approach, along the middle line, and open reduction internal fixation of the middle phalanx improved perfusion almost immediately. The patient continued to improve at his one-week, 12-week, and six-month follow-up appointments, with a normal neurovascular exam, a capillary refill of less than two seconds, and, ultimately, he was able to make a full composite fist. Though finger compartment syndrome is uncommon, it should be suspected in cases where the patient demonstrates hallmark clinical signs and symptoms. Compartment syndrome is a clinical diagnosis that requires urgent diagnosis and intervention and must be suspected regardless of the anatomic location of the injury.
Solriamfetol for Excessive Sleepiness in Narcolepsy and Obstructive Sleep Apnea.

Objective:The purpose of this article is to review the available clinical trial data that led to the Food and Drug Administration (FDA) approval of solriamfetol as well as its role in clinical prac...
Real-world on-treatment and initial treatment absolute risk differences for dabigatran vs warfarin in older US adults.

Purpose Trials and past observational work compared dabigatran and warfarin in patients with atrial fibrillation, but few reported estimates of absolute harm and benefit under real-world adherence patterns, particularly in older adults that may have differing benefit-harm profiles. We aimed to estimate risk differences for ischemic stroke, death, and gastrointestinal bleeding after initiating dabigatran and warfarin in older adults (a) when patients adhere to treatment and (b) under real-world adherence patterns. Methods In a 20% sample of nationwide Medicare claims from 2010 to 2015, we identified beneficiaries aged 66 years and older initiating warfarin and dabigatran. We followed individuals from initiation until death or October 2015 (initial treatment, IT) and separately censored individuals' follow-up after drug switches and gaps in supply (on-treatment, OT). We applied inverse probability of treatment and standardized morbidity ratio weights, as well as inverse probability of censoring weights, to estimate two-year risk differences (RDs) for dabigatran vs warfarin. Results We identified 10,717 dabigatran and 74,891 warfarin initiators. Weighted OT RDs suggested decreased ischemic stroke risk for dabigatran vs warfarin; IT RDs indicated increased or no change in ischemic stroke risk. Regardless of follow-up approach and weighting strategy, risk of death appeared lower and risk of gastrointestinal bleeding appeared higher when comparing dabigatran vs warfarin. Conclusions Dabigatran use was associated with lower risks of mortality and ischemic stroke in routine care when older adults stayed on treatment. IT analyses suggested that these benefits may be diminished under real-world patterns of switching and discontinuation.
Feeding Outcomes Following Infant Tracheostomy

Background: While need for technology-assisted feedings is common among infants who have received tracheostomy, long-term feeding outcomes for this medically population have not been well described. Improved knowledge about the expected feeding needs over time for these infants may be beneficial for family counseling, medical decision-making, and advocating for related services. Objectives: 1) Characterize feeding methods in infants after tracheostomy at time of initial hospital discharge and during subsequent follow up 2) Identify factors associated with long term achievement of full oral feedings in infants after tracheostomy Methods: We conducted a large retrospective review of all …
Multimodal imaging of recurrent cystoid macular edema associated with POEMS Syndrome responsive to intravitreal dexamethasone implant.

Purpose To describe the multimodal imaging findings of cystoid macular edema (CME) in POEMS syndrome and to demonstrate the effectiveness of the dexamethasone intravitreal implant in this condition METHODS:: Case report of a patient with POEMS syndrome. Multimodal imaging, including optical coherence tomography (OCT) and ultra-wide field fluorescein angiography (UWFA), was used to evaluate the CME and its response to treatment. Results A 66-year-old male with history of POEMS syndrome in clinical remission after chemotherapy presented with blurry vision in the left eye. Vitreomacular traction and CME were noted on OCT. After pars plana vitrectomy, the patient had persistent CME in the left eye and developed new CME in the right eye, which worsened over the next year. Visual acuities (VA) at this time were 20/60 OU. The CME was unresponsive to topical ketorolac and prednisolone acetate and intravitreal bevacizumab but partially response to intravitreal and sub-Tenon's triamcinolone acetate injections. Intravitreal dexamethasone implant was given bilaterally with full resolution and VA improvement to 20/40 OD and 20/30 OS. However, CME recurred after three months. UWFA demonstrated bilateral CME and diffuse peripheral vascular leakage. Serum vascular endothelial growth factor (VEGF) levels were normal. Conclusion CME may develop in POEMS syndrome in the absence of systemic findings, elevated serum VEGF, or optic nerve edema. Previously unreported peripheral vascular leakage was demonstrated on UWFA. Dexamethasone implant was the most effective of utilized therapies to treat CME.
Comparison of immediate hypersensitivity reactions to preoperative antibiotics in patients labeled as penicillin allergic.

Abstract Background Cefazolin is routinely recommended as the first-line agent for surgical antibiotic prophylaxis because it prevents more surgical site infections than second-line antibiotics. Clinicians often avoid administering cefazolin to patients who are labeled as penicillin allergic due to concerns of cross-reactivity. The aim of this study was to compare the incidence of hypersensitivity reactions between cefazolin and the second-line antibiotics vancomycin and clindamycin. Methods This retrospective study included patients who were labeled as penicillin allergic and received either cefazolin, clindamycin, or vancomycin as preoperative antibiotics. The primary outcome was intraoperative hypersensitivity reactions. Results A total of 734 surgical procedures in 690 patients were included. Fifteen immediate hypersensitivity reactions were identified. Probable hypersensitivity reactions occurred in 3 (0.9%) patients in the cefazolin group, 4 (1.4%) in the clindamycin group, and 1 (1.1%) in the vancomycin group. Seven of 8 patients reported allergies to additional medications beyond penicillin. There were seven cases of possible hypersensitivity reactions, 3 (0.9%) in the cefazolin group, 1 (1.1%) in the vancomycin group, and 3 (1.0%) in the clindamycin group. Conclusion Our data suggest that perioperative hypersensitivity reactions are uncommon in patients labeled as penicillin allergic. The frequency of immediate hypersensitivity reactions was not different between patients receiving cefazolin, clindamycin, or vancomycin. Avoiding cefazolin in patients labeled as penicillin allergic may not be warranted.
A bivariate zero-inflated negative binomial model and its applications to biomedical settings

Summary The zero-inflated negative binomial (ZINB) distribution has been widely used for count data analyses in various biomedical settings due to its capacity of modeling excess zeros and overdispersion. When there are correlated count variables, a bivariate model is essential for understanding their full distributional features. For this purpose, we develop a Bivariate Zero-Inflated Negative Binomial (BZINB) model that has a simple latent variable framework and parameters with intuitive interpretations. Using this model, we examine two biomedical data examples where the counts are zero-inflated—single cell RNA sequencing (scRNA-seq) data and dental caries count indices. In scRNA-seq data example, a correlation between a pair of genes is estimated after adjusting for the effects of dropout events represented by excess zeros. In the dental caries data, we analyze how the treatment with Xylitol mints affects the marginal mean and other patterns of response manifested in the two dental caries traits. An R package ‘bzinb’ is available on CRAN.
Alkylating Derivatives of Oxotremorine Have Irreversible Actions on Muscarinic Receptors

The introduction of a β-chloroethylamino group into the structure of a drug has proven to be a successful means of developing irreversible ligands for α-adrenergic (10), muscarinic (6) and opiate receptors (2). Muscarinic agents would appear to be ideally suited for this type of chemical modification since the cationic aziridinium ring derived from a β-chloroethylmethylamino compound is structurally very similar to the trimethyl ammonium group of acetylcholine. This has been born out by the irreversible antagonist benzilylcholine mustard (6) which has proven to be a useful investigational tool in muscarinic receptor pharmacology. Recently, we and our colleagues have described some β-chloroethylamine derivatives of oxotremorine that are potent muscarinic agonists that bind irreversibly to the muscarinic receptor (3, 13, 14). The compounds, N-[4-(2-chloroethylmethylamino)-2-butynyl] -2-pyrrolidone (BM 123) and N-[4-(2-chloromethylpyrrolidino)-2-butynyl]-2-pyrrolidone (BM 130) (see Figure 1), cyclize spontaneously in neutral aqueous solutions to form aziridinium ions, which are responsible for their pharmacological effects (3, 13, 14). BM 123 and BM 130 stimulate contractions of the guinea pig ileum, and these effects are blocked by atropine, but not by hexamethonium (3, 13, 14). When injected into rats, BM 123 and BM 130 produce typical muscarinic effects including chromodacryorrhea, diarrhea, hypothermia, lacrimation, salivation and tremor. In this report, we describe some irreversible muscarinic receptor binding characteristics of BM 123 and BM 130, as well as the persistent inhibitory effect of BM 123 on acetylcholine release from the myenteric plexus of the guinea pig ileum.
Crossability between cultivated and wild tuber-and non-tuber-bearing Solanums

The cultivated potato has over 200 extant wild relatives many of which contain genes valuable for disease resistance, hardiness, processing and agronomic traits. Crossability of these wild species directly with the cultivated potato is complicated by several reproductive phenomena such as stylar and ploidy barriers and Endosperm Balance Numbers (EBN). However, a systematic analysis of crossability with many of these wild relatives has never fully been examined. Reciprocal crosses were made between cultivated potato and over 400 wild potato accessions; stylar barriers and 2n gamete production were examined as was the fertility of many of the putative hybrids. Generally, the seed/fruit ratio increased the more closely related the species were to the cultivated potato. However, a few crosses were successful in spite of predicted failure due to ploidy or EBN differences.
Comparing the Canadian and US Systems of Health Care in an Era of Health Care Reform

The purpose of this article is to provide an informed comparison of health care in the United States and Canada along multiple dimensions. Specifically this article looks at coverage, access, cost, health outcomes, satisfaction, and underlying ideology. Canada fares better than the United States with regard to coverage, cost, and health outcomes. While overall access is better in Canada, patients are sometimes required to endure longer wait times than in the United States. Reports of satisfaction levels vary across studies, but most evidence points toward comparable levels of satisfaction in Canada and the United States. Strong ideological differences underlie the Canadian and American systems, making the acceptance and implementation of certain reforms difficult. The potential impact of the US Patient Protection and Affordable Care Act (PPACA), as well as recent Canadian health care reforms on coverage, access, cost, and health outcomes are also discussed.
Comparison of creatinine and specific gravity for hydration corrections on measurement of the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in urine.

Background Tobacco-specific carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) was measured in all participants aged 6 years and older from the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey 2007–2008. The suitability of using creatinine or specific gravity for urinary NNAL correction in exposure assessment is examined in this study. Methods Effects of both specific gravity and creatinine correction on urinary NNAL among smokers were investigated with multiple linear regression models using either normalization or the fitting of creatinine and specific gravity in the model as covariates. Results When log-scaled NNAL was normalized by either creatinine or specific gravity, R2 was slightly higher for creatinine than for specific gravity (R2 = 0.1694 and 0.1439, for creatinine and specific gravity, respectively). When log-scaled NNAL was normalized by both factors, the R2 was improved (R2 = 0.2068). When specific gravity or creatinine was included as a covariate separately in the models, they were highly significant factors (P < 0.001, R2 = 0.2226 and 0.1681 for creatinine and specific gravity, respectively). However, when both were included in the model as covariates, creatinine remained highly significant (P < 0.001), whereas the significance of specific gravity was eliminated (P = 0.4294). Conclusion This study confirms significant relationships between NNAL concentrations and both urine creatinine and specific gravity. We conclude that creatinine is the more influential and preferred variable to account for urine dilution in tobacco-specific nitrosamine exposure assessment.
Who is afraid of a black Spider(-Man)?

An Internet post asking about Spider-Man's race in a film turned into an Internet campaign about an actor that led fans to interact with each other as well as with the actor, which in turn led to the attention of media producers, which resulted in a change in Spider-Man's race in a print comic book.
Rate variation in parasitic plants: correlated and uncorrelated patterns among plastid genes of different function

The analysis of synonymous and nonsynonymous rates of DNA change can help in the choice among competing explanations for rate variation, such as differences in constraint, mutation rate, or the strength of genetic drift. Nonphotosynthetic plants of the Orobanchaceae have increased rates of DNA change. In this study 38 taxa of Orobanchaceae and relatives were used and 3 plastid genes were sequenced for each taxon. Phylogenetic reconstructions of relative rates of sequence evolution for three plastid genes (rbcL, matK and rps2) show significant rate heterogeneity among lineages and among genes. Many of the non-photosynthetic plants have increases in both synonymous and nonsynonymous rates, indicating that both (1) selection is relaxed, and (2) there has been a change in the rate at which mutations are entering the population in these species. However, rate increases are not always immediate upon loss of photosynthesis. Overall there is a poor correlation of synonymous and nonsynonymous rates. There is, however, a strong correlation of synonymous rates across the 3 genes studied and the lineage-speccific pattern for each gene is strikingly similar. This indicates that the causes of synonymous rate variation are affecting the whole plastid genome in a similar way. There is a weaker correlation across genes for nonsynonymous rates. Here the picture is more complex, as could be expected if there are many causes of variation, differing from taxon to taxon and gene to gene. The distinctive pattern of rate increases in Orobanchaceae has at least two causes. It is clear that there is a relaxation of constraint in many (though not all) non-photosynthetic lineages. However, there is also some force affecting synonymous sites as well. At this point, it is not possible to tell whether it is generation time, speciation rate, mutation rate, DNA repair efficiency or some combination of these factors.
Seemingly Unrelated Regressions

When asked “How did you get the idea for SUR ?” Zellner responded: “On a rainy night in Seattle in about 1956 or 1957, I somehow got the idea of algebraically writing a multivariate regression model in single equation form. When I figured out how to do that, everything fell into place because then many univariate results could be carried over to apply to the multivariate system and the analysis of the multivariate system is much simplified notationally, algebraically and, conceptually. “ Read the interview of Professor Arnold Zellner by Rossi (1989, p. 292).
A new derivation of the logistic distribution

Logistic distribution is widely used in describing biological, engineering, industrial, and various other types of data. In this paper it is shown that this distribution is a special case of a compound generalized extreme value distribution which is derived by compounding a generalized extreme value distribution with a gamma distribution. The paper contains several useful results relevant to these distribution functions.
Hα Emission from HVCS and Ionization Sources in the Galactic HALO

Faint, diffuse optical line emission has been detected from ∼ 20 high velocity clouds (HVCs), the Magellanic Stream (MS), and HI gas projected near the Sculptor dwarf spheroidal. Only one HVC is undetected at < 20 milli-Rayleighs; all others are brighter than expected from metagalactic UV ionization alone, implying that HVCs are not extragalactic nor Local Group objects. If the Hα emission is produced by photoionization from the Galaxy, HVC distances are generally tens of kpc, placing them in the Galactic halo. However, photoionization by the Galaxy is too weak to power the Magellanic Stream Hα. The MS Ha, and the O VI which FUSE has discovered in HVCs and the MS, imply a source of collisional ionization, but its cause remains undetermined.
Transformation-defective mutant of adenovirus type 5 containing a single altered E1a mRNA species.

Abstract A mutant of adenovirus type 5 containing an octanucleotide insert in region E1a of the viral genome was constructed. The insert was present in only one (13s) of the three overlapping mRNA's synthesized from this region. The insert was within the sequences removed by RNA splicing during the production of the other two nRNA's. The insertion resulted in a shift in the translational reading frame of the 13s mRNA and the probable premature termination of translation. The mutant was defective for viral DNA replication in HeLa cells and the transformation of rat embryo and baby rat kidney cells, indicating that a product encoded by the 13s nRNA is required for these two processes. Other early regions of the genome were expressed in HeLa cells infected by this mutant although in some cases the expression was decreased as compared with wild-type-infected cells.
Medicine under socialism : Some observations on Yugoslavia and China

Abstract Based on fieldwork in Yugoslavia and China, we compare medicine in two societies which are attempting to construct their own unique paths to socialism. After a brief description of each country and its sociopolitical system, we sketch the broad outlines of the health care system which has evolved. We then discuss certain constraints on achieving the socialist objectives of equality of access to health care and democratization of the patient-clinician relationship. In a concluding section, we summarize some of the similarities and differences in medicine under Yugoslav and Chinese socialism, respectively.
Dental hygienists' knowledge and opinions of oral-systemic connections: implications for education

Although associations between periodontal and systemic health have been well established, there is little evidence regarding dental hygienists' knowledge of the oral-systemic connection. The purpose of this study was to determine the knowledge levels of North Carolina dental hygienists regarding oral-systemic connections and their attitudes and confidence about incorporating this knowledge into clinical practice. A survey was developed, pilot tested, revised, and mailed to 1,665 licensed dental hygienists in North Carolina. After three mailings, the response rate was 62 percent, with 52 percent (N=859) meeting the inclusion criteria. The majority (>80 percent) of the respondents correctly identified risk factors for diabetes and cardiovascular disease (CVD), but were less knowledgeable about risk factors for osteoporosis and adverse pregnancy outcomes. Most knew that there is strong evidence linking periodontal disease with CVD (77 percent) and diabetes (70 percent). The majority felt that dental hygienists should be trained to identify risk factors for oral-systemic disease (94 percent) and to actively manage patients with systemic disease (78 percent). Eighty-eight percent felt that dental and medical professionals should be taught to practice collaboratively. These dental hygienists had a high level of knowledge in some areas of oral-systemic disease but could improve their confidence levels and knowledge through expanded content in their educational programs and continuing education. Inter-professional education and collaboration would also assist in integration of knowledge into clinical practice.
Histologic, surgical, and imaging correlations of adnexal masses.

Objective The purpose of this study was to quantify, categorize, and illustrate discrepancies between preoperative radiologic, surgical, and pathologic diagnoses and to assess the potential impact of discrepancies on clinical care. Methods Adnexal masses reported by pathology during a 16-month period were included if prior imaging at our institution had been performed. Up to 3 sonographic, computed tomographic, and magnetic resonance imaging examinations were reviewed by a gynecologic sonographer and compared with the reported pathologic findings. Cases in which ambiguities were not resolved by consulting the surgical notes were reviewed by a gynecologic pathologist, who confirmed or modified the diagnosis and assigned a score to the pathology quality assurance issue: 0, no pathology quality assurance error; 1, differences in terminology; 2, discrepancy of diagnostic interpretation, benign findings; or 3, discrepancy of diagnostic interpretation, malignant findings. Results Of 418 total masses, there was a discrepancy between imaging and pathology in 73 (17%) masses and 68 (21%) pathology reports. Twenty-five (6%) had pathology discrepancies resolved by correlation with the surgical notes alone (eg, torsion seen during surgery but not evident on pathologic examination). Histologic review was performed for 48 (11%) of 418 masses, with pathology errors identified in 34 (71%) of 48. Quality assurance scores were 0 (n = 14), 1 (n = 14), and 2 (n = 20), with no cases receiving a score of 3. Examples of pathology errors included gross (complex versus simple) and microscopic (neoplastic versus functional versus mesothelial) characterization of cysts, sizes of lesions not being described, characterization of fibrous lesions (cystadenofibroma versus cystadenoma), and lack of correlation with imaging (lesions not described). Conclusions This study illustrates the importance of imaging, surgical, and histologic correlation in assessing the diagnostic accuracy of sonography of adnexal masses.
The development of a knowledge-based software fault localization system

A multifaceted approach to automation of the software fault localization process is proposed. The facets include the development of a conceptual process model derived from empirical studies; the implementation of a blackboard-based fault localization tool built on model underpinnings, and tool integration in a computer-aided software engineering (CASE) environment that will provide long term support for its functionality and expandability. The authors report on the progress in modeling studies and development of the tool architecture. >
Multi‐dimensional spectroscopy of polymer films; surface and interfacial interactions

Behavior of macromolecules near surfaces and interfaces of polymeric thin films and coatings may play a vital role in numerous applications. Therefore, understanding of molecular level processes responsible for durability, adhesion, and many other macroscopic processes is of a particular importance. This presentation will focus on stratification processes in multi-component polymeric films, with particular emphasis to polymer-surfactant interactions in latexes, responsiveness of individual components during coalescence of water-borne polyurethanes, and behavior of thermoplastic olefins (TPO). The presence of macromolecular arrange-ments and interactions among various components near the film-air (F-A) and the film-substrate (F-S) interfaces can be effectively monitored using attenuated total reflectance (ATR) and step-scan photoacoustic (SSPA) Fourier transform infrared (FT-IR) spectroscopy. Both approaches are capable of obtaining infonnation from various surface depths and complement each other if one seeks molecular level infonnation from 0 -150 μm into the film. If one combines ATR and PA information with IR and/or Raman surface imaging, it is possible to obtain a 3-dimensional representation of polymeric films.
Development and Installation of 138 KV Cable Systems for Tests at EEI Waltz Mill Station: Cable 23

This paper covers the General Electric Company's development, testing and installation at the Waltz Mill Station of a 138 kV solid dielectric power cable and associated splice. The cable described is unique in the industry in that (1) it utilizes a new insulation with higher breakdown strength, (2) is the only cable at Waltz Mill to use a mineral filled cross- linked polyethylene, and (3) has its insulation shield intimately bonded to the insulation.
Topographical distribution of a membrane-inserted fluorescent phospholipid analogue during cell fusion

Potential alterations in the transbilayer distribution of lipid molecules during cell-cell fusion were studied, using the fluorescent phospholipid analogue 1-acyl, 2-(N-4-nitrobenzo-2-oxa-1,3-diazole)-aminocaproyl phosphatidylcholine (C6-NBD-PC). The fluophore was inserted into the outer leaflet of the plasma membrane of Chinese hamster fibroblasts from an exogenous source and cell-cell fusion was induced either with Sendai virus or polyethylene glycol (PEG). After fusion, the cells were examined under a fluorescence microscope and the pool of tagged lipid molecules in the external monolayer was determined quantitatively. The results showed that in contrast to PEG-induced cell fusion, substantial redistribution of the lipid marker occurred when cell fusion was induced by Sendai virus and it was estimated that approx. 40% of exogenously supplied lipid was internalized. The possible mechanism causing lipid redistribution in the case of Sendai virus-induced cell fusion is discussed.
Factor analysis of small group leadership behavior.

Summary The purposes of this study were to identify the major dimensions of leaders' verbal behavior in small groups and then to compare the identified dimensions with those logically derived during the course of developing the Bales Category System. Ninety-six groups of four, one leader per group, served as subjects. During the course of a case discussion problem the leader's verbal behavior was recorded by means of the Bales system. Following a factor analysis it was concluded that a leader's verbal behavior could be described by four major dimensions, only two of which were similar to the four major categories derived on logical grounds by Bales.
Ethics and disciplinary procedures

My theme is the importance of recog­ nizing the legal principles and economic consequences that may complicate any component society disciplinary action against a member. For example, the member who is summoned to defend him­ self against a charge of unethical conduct has the legal right to a fair hearing by an impartial group of his colleagues. This is so even where the evidence shows a clear violation of professional ethics. Again, the member may also be in a position to show that his right to con­ duct the business side of his practice supersedes any ethical provision which conflicts with his mode of practice. Thus, any ethic which has principally an eco­ nomic rather than a professional signif­ icance is vulnerable. Component society members may criticize the dentist who has evening practice hours; but the so­ ciety would not be justified in expelling him from membership.
An automated FORTRAN documenter

We have written a set of programs designed to help R and D programmers document their FORTRAN programs more effectively. The central program reads FORTRAN source code and asks the programmer questions about things it has not heard of before. It inserts the answers to these questions as comments into the FORTRAN code. The comments, as well as extensive cross-reference information, are also written to an unformatted file. Other programs read this file to produce printed information or to act as an interactive document.
Chiral quarks and the non-relativistic quark model

We study some of the consequences of an effective lagrangian for quarks, gluons and goldstone bosons in the region between the chiral symmetry breaking and confinement scales. This provides an understanding of many of the successes of the non-relativistic quark model. It also suggests a resolution to the puzzle of the hyperon non-leptonic decays.
Polymorphic family of injected pseudokinases is paramount in Toxoplasma virulence

Toxoplasma gondii, an obligate intracellular parasite of the phylum Apicomplexa, has the unusual ability to infect virtually any warm-blooded animal. It is an extraordinarily successful parasite, infecting an estimated 30% of humans worldwide. The outcome of Toxoplasma infection is highly dependent on allelic differences in the large number of effectors that the parasite secretes into the host cell. Here, we show that the largest determinant of the virulence difference between two of the most common strains of Toxoplasma is the ROP5 locus. This is an unusual segment of the Toxoplasma genome consisting of a family of 4–10 tandem, highly divergent genes encoding pseudokinases that are injected directly into host cells. Given their hypothesized catalytic inactivity, it is striking that deletion of the ROP5 cluster in a highly virulent strain caused a complete loss of virulence, showing that ROP5 proteins are, in fact, indispensable for Toxoplasma to cause disease in mice. We find that copy number at this locus varies among the three major Toxoplasma lineages and that extensive polymorphism is clustered into hotspots within the ROP5 pseudokinase domain. We propose that the ROP5 locus represents an unusual evolutionary strategy for sampling of sequence space in which the gene encoding an important enzyme has been (i) catalytically inactivated, (ii) expanded in number, and (iii) subject to strong positive selection. Such a strategy likely contributes to Toxoplasma’s successful adaptation to a wide host range and has resulted in dramatic differences in virulence.
Ultrastructural changes in tobacco undergoing the hypersensitive reaction caused by plant pathogenic bacteria

Abstract The hypersensitive reaction induced by either Erwinia amylovora or Pseudomonas pisi is indicative of widespread damage to membranes of subcellular organelles and particulate cellular components in tobacco leaf tissue. Plasmalemma, tonoplast, as well as the bounding and internal membranes of chloroplasts and mitochondria and the external membrane of microbodies, are profoundly deranged in 7 h. Cytoplasm, groundplasm of chloroplasts, mitochondria and microbodies and membrane-attached and free ribosomes are similarly affected. The damage coincides with and is probably the cause of the observed tissue collapse and rapid loss of electrolyte-laden water. The presence of few bacterial cells (not more than 4 × 106 cells/leaf disk 1 cm in diameter) cause the observed symptoms which appear, at the ultrastructural level, to be unique.
Tree recruitment and growth on 20-year-old, unreclaimed surface mined lands in West Virginia

Surface mining in West Virginia has disturbed large tracts of forested land. In the 1930s to 1960s, reclamation generally involved replanting of trees on mined sites, but revegetation practices gradually evolved into seeding of forages for erosion control as federal and state laws were enacted in the 1970s. Reforestation of mined lands has recently become an important issue and both federal and state regulatory agencies are returning to forestry as a preferred post-mining land use. This study evaluated tree species recruitment and growth on three, 20-year-old, surface mined areas that were not transplanted with trees. Three transects of 150 m at each site extended across three positions: (1) the flat top after coal removal; (2) the outslope down from the flat top where soil and weathered rock materials had been pushed down the hill; (3) the undisturbed forest. Tree canopy cover and herbaceous cover were determined at 1.5 m intervals along the transect line, and tree density and diameter at breast height w...
Compiler-directed application mapping for NoC based chip multiprocessors

The problem attacked in this paper is one of automatically mapping an application onto a Network-on-Chip (NoC) based chip multi-processor architecture in a locality-aware fashion. The proposed compiler approach has four major steps: task scheduling, processor mapping, data mapping, and packet routing. Our experimental result clearly shows that the proposed framework reduces energy consumption of our applications significantly (27.41% on average over a pure performance oriented application mapping strategy) as a result of improved locality of data accesses.
On the local convergence of Fliess operators driven by L 2 -Itô random processes

Fliess operators, which are a type of functional series expansion, have been used to describe a broad class of nonlinear input-output maps driven by deterministic inputs. But in most applications, a system's inputs have noise components. It has been shown that the notion of a Fliess operator can be generalized to admit a class of L 2 -Ito stochastic input processes, and that they converge absolutely over an arbitrarily large but finite time interval when a certain coefficient growth condition is met. However, a significant number of systems fail to meet this condition. In this paper, the methodology is extended by considering instead an interval of convergence with a random length. It results in a less restrictive sufficient condition for convergence, and thus, is applicable to a larger class of systems.
Peptide antagonists of lh-rh: Large increases in antiovulatory activities produced by basic d-amino acids in the six position

It has been assumed, usually with good reason, that D-amino acids with large aromatic side-chains must be present in position 6 of both LH-RH superagonists and antagonists for the highest levels of biological activity to be reached. However, using one of a recent generation of potent lH-RH inhibitory analogs as a model, we have found that the insertion of D-lysine or, better still, D-arginine in this position results in greater antiovulatory activity in the rat over corresponding D-phenylalanine6- and D-tryptophan6-analogs. For instance, [Ac-D-p-Cl-Phe1,2,D-Trp3,D-Arg6,D-Ala10]-LH-RH exhibits antiovulatory activity at a dose of 750 ng per animal and appears to be the first competitive antagonist with activity in the nanogram region in vivo. This effect seems to be highly dependent on the degree of basicity of the amino acid side-chain since D-amino acids with neutral or acidic groups produced far less active compounds.
Real-time numerical peak detector

Abstract A very simple and effective peak detector is proposed. The system gives in real-time the position and amplitude of a peak in a digital signal to a precision better than one pixel. An FIR filter is first used to average and differentiate the signal and a linear interpolator to increase the precision of the peak position. A simulated comparison with other techniques is also given. Finally, experimental results with the use of CCD devices are presented.
Gapex-5, a Rab31 Guanine Nucleotide Exchange Factor that Regulates Glut4 Trafficking in Adipocytes

Insulin stimulates glucose uptake by promoting translocation of the Glut4 glucose transporter from intracellular storage compartments to the plasma membrane. In the absence of insulin, Glut4 is retained intracellularly; the mechanism underlying this process remains uncertain. Using the TC10-interacting protein CIP4 as bait in a yeast two-hybrid screen, we cloned a RasGAP and VPS9 domain-containing protein, Gapex-5/RME-6. The VPS9 domain is a guanine nucleotide exchange factor for Rab31, a Rab5 subfamily GTPase implicated in trans-Golgi network (TGN)-to-endosome trafficking. Overexpression of Rab31 blocks insulin-stimulated Glut4 translocation, whereas knockdown of Rab31 potentiates insulin-stimulated Glut4 translocation and glucose uptake. Gapex-5 is predominantly cytosolic in untreated cells; its overexpression promotes intracellular retention of Glut4 in adipocytes. Insulin recruits the CIP4/Gapex-5 complex to the plasma membrane, thus reducing Rab31 activity and permitting Glut4 vesicles to translocate to the cell surface, where Glut4 docks and fuses to transport glucose into the cell.
Medicine: Interfering with bone remodelling

As they mature, bone-resorbing cells trigger the production of their own 'off-switch' — the interferon-β protein — to prevent the runaway bone loss that is seen in diseases such as osteoporosis.
The relationship of fractals in geophysics to “the new science”

Abstract Many phenomena in geophysics satisfy fractal statistics, examples range from the frequency–area statistics of earthquakes to the time series of the earth’s magnetic field. Solutions to classical differential equations cannot give this type of behavior. Several “cellular automata” models have successfully reproduced the observed statistics. For example, the slider-block model for earthquakes. Stephen Wolfram’s recent book A New Kind of Science sets forth a “new science” based on cellular automata. This paper discusses the role of cellular automata in geophysics.