cssi/SciSciGPT-SciSciNet huggingface dataset:
Saline-filled breast implant safety and efficacy: a multicenter retrospective review.

Our center undertook an industry-funded, outcomes-based, multicenter, retrospective review to evaluate the safety and efficacy of saline-filled breast implants. Our review was part of a pre-market approval review process mandated by the U.S. Food and Drug Administration. The design of our review was modeled on a Plastic Surgery Educational Foundation outcomes study previously conducted by our center. For this study, several significant changes were made to our previous protocol, including improved patient tracking, stronger biostatistical support, and a mandatory 10-year minimum patient follow-up period. Physician-reported and patient-reported data on 450 patients with 882 saline-filled breast implants placed between January 1, 1980, and June 30, 1986, were obtained. Mean patient follow-up period was 13.0 years. Most implants (93.9 percent) were placed for breast augmentation. Seventy-four percent were placed in a submammary position; 25.6 percent, subpectorally; and 0.2 percent, subcutaneously. The overall complication rate was 20.2 percent. Reoperation for capsular contracture or implant deflation was necessary in 104 of 450 patients (23.1 percent). Deflation occurred in 73 implants (8.3 percent) and was underreported according to the physicians' record review alone. This deflation rate is higher than the 5.5 percent previously reported by our center. However, 26 of these 73 deflations (35.6 percent) occurred in a single cohort of patients at one center using Surgitek saline implants. If this cohort is excluded, the deflation rate drops to 5.8 percent, a figure more consistent with data published in the literature and found in our previous study. Of the 73 deflations, spontaneous deflation was reported for 50 (74.6 percent), and the remainder were iatrogenic. Actuarial survival of the non-Surgitek implants was 98.4 percent to 99.8 percent at 5 years and 96.9 percent to 98.9 percent at 10 years (95 percent confidence interval). Risk factors for implant deflation included the use of Surgitek saline-filled implants (odds ratio = 17.5, p < 0.01), use of Heyer-Schulte and Mentor model 1800 implants (odds ratio = 3.0, p < 0.01), and implant size greater than 450 cc (odds ratio = 1.01, p < 0.02). Risk factors for capsular contracture included submammary implant position (odds ratio = 2.05, p = 0.03) and implant size greater than 450 cc (odds ratio = 1.01, p < 0.01). Overall, satisfaction was high: 93 percent of patients were "satisfied" or "very satisfied" with their implants. As in our earlier study, risk factors for patient dissatisfaction were reconstruction after mastectomy (odds ratio = 7.6, p = 0.011), significant breast firmness (odds ratio = 6.2, p < 0.001), and patient desire for smaller implants (odds ratio = 3.0, p = 0.020). In conclusion, our review provides additional outcomes-based evidence that saline-filled breast implants remain a safe, effective alternative to silicone gel-filled models.
Grazing bifurcations of a harmonically excited oscillator moving on a time-varying translation belt

The criterion for grazing motions in a friction-induced oscillator with a time-varying transport belt is obtained. The three mappings for such a friction-induced oscillator are introduced for analytical prediction of the grazing motions. The sufficient and necessary conditions of grazing are expressed from mappings. With system parameter variations, the initial and final switching sets of grazing mapping are illustrated. Numerical illustrations of grazing motions are carried out from analytical predictions. This investigation provides a technique for how to determine the grazing on the time-varying boundary in discontinuous dynamical systems.
The Voting Behavior of Minority Judges in the U.S. Courts of Appeals Does the Race of the Claimant Matter

The diversification of the federal courts has led to a number of studies focusing on the voting behavior of African American and, to a lesser extent, Latino judges. Despite expectations that minority judges will vote differently from their White colleagues, extant research demonstrates mixed results. Perhaps one reason for this outcome is that they fail to account for the conditional role that coracial and coethnic claimants might have on behavior. This study examines the voting behavior of minority judges in the U.S. Courts of Appeals. Focusing on employment discrimination claims between 2001 and 2009, this analysis demonstrates that minority judges are not monolithic in their voting behavior. While African American judges are more likely to vote in favor of Black claimants, Latino judges are less likely to vote in favor of the claimant more generally. In all, the findings have important implications for substantive policy outcomes.
Production of spinal curvatures in rats by chemically dissimilar substances.

Starke Kyphoskoliosen werden in Ratten durch Futterung von osteolathyrogenischen Substanzen wie 2-Aminopropionitril, Aminoacetonitril, 2-Mercaptoethylamin, Cystamin, Semicarbazid und Acetonsemicarbazid induziert. Kyphosen konnen auch durchp-Hydrazinobenzoesaure, 4,4-Diphenylsemicarbazid, 1,5-Diphenylcarbazid, 1,3-Diathyl-2-thioharnstoff und Thiosemicarbazid hervorgerufen werden. Es wird vermutet, dass derselbe toxische Mechanismus dieser chemisch ungleichen Substanzen durch Bildung von Koordinationsverbindungen oder Chelaten bedingt ist.
Age and HIV Sexual Risk among Women in Methadone Treatment

This study examines the relationship between age and HIV sexual risk behaviors among a random sample of 372 women in methadone treatment in New York City. Logistic regression results indicate that women of all ages are at risk for HIV through inconsistent condom use. Exposure to intimate partner violence (IPV), alcohol use, and HIV-negative status are associated with inconsistent condom use during vaginal sex. Age (35-44), having a main sexual partner with an HIV risk factor, IPV, and alcohol use are associated with using crack or cocaine during sex. Similarly, age (35-44), having a main sexual partner with an HIV risk factor, IPV, and drug use are associated with consuming four or more drinks prior to sex. The findings highlight the importance of age-appropriate HIV prevention and intervention strategies, as well as the need to address intimate partner violence, mental health, polysubstance use, and relational factors associated with HIV sexual risk behaviors among women in methadone treatment.
Interferon pathway activation in systemic lupus erythematosus.

The recognition that a multitude of interferon (IFN)-inducible genes are coordinately expressed in peripheral blood cells of patients with systemic lupus erythematosus (SLE) has contributed to considerable interest in the IFN pathway as a therapeutic target in lupus. Together with data that have accumulated over the past four decades implicat-ing IFN-a in SLE, the gene expression data have resulted in emergence of this cytokine pathway as a focal point for understanding mechanisms of autoimmunity and inflamma-tion in systemic autoimmune diseases. Assays that measure IFN-inducible gene expression in patient cells and tissues and plasma assays that quantify IFN-a protein are providing tools for identification of patients with active disease and who may be responsive to inhibition of the innate immune system component of the altered immune response in SLE. In addition, investigations of the mecha-nisms of induction of IFN pathway activation are suggesting clues to the triggers of autoimmunity in SLE.
Some Relations between Altitude and the Distribution of Acrididae in Colorado

It is a well known fact that mountain ranges extending in a north-south direction carry boreal species far south of their latitudinal range at sea-level. That altitude is of pronounced effect in a very limited area is not so widely known. Such an effect was, however, clearly demonstrated in a series of studies, undertaken during the summer of 1932 by a graduate class in Animal Ecology at this institution. The results here reported are due to the cooperation of Mr. Lawrence Jones, my assistant, and Miss Nora O'Mara and Messrs. H. B. Perrin, A. L. Oder, R. E. Rodock, and D. F. Crain, members of the class, all of whom assisted in the collection of data.
Students' Attitudes Towards and Engagement in Self-Disclosure: Implications for Supervision

Social work students were surveyed to ascertain their attitudes toward and engagement in two types of self-disclosure (SD), transparency and self-involving. In general, trainees reported being prepared by their classroom education to engage in SD with clients. Students' use of self-disclosure was consistent with what has been found to be helpful to clients, even though they often were unsure of their actions. Of particular concern was the finding that students generally were not comfortable discussing SD with their field supervisor. Yet, the results suggest that the field supervisor plays an important role in encouraging students' appropriate use of self-disclosure. Suggestions for how the supervisor can assist trainees in making informed decisions regarding self-disclosure in their work with clients are provided.
On the numerical computation of laminar boundary layers at a phase‐changing, gas‐liquid interface

The two-dimensional, laminar boundary-layer equations of heat, mass and momentum at a smooth, phase-changing, gas-liquid interface are solved numerically by the Keller Box method. The gas and liquid regimes are embedded in a single marching scheme which computes interfacial parameters implicitly. Results of both self-similar and non-similar boundary-layer computations are presented and effects of mild pressure gradient, a mean current in the liquid, and free-stream vapour concentration on the interfacial parameters are analysed. In order to assess the accuracy of the method, several self-similar problems are solved by Runge-Kutta integration and results are compared to those obtained by the finite-difference scheme. Agreement is excellent in all cases.
Improved ARMA spectral estimation

The autoregressive (AR) spectral estimator has been studied by several authors, Parzen [10], Burg [3], and Marple [7] to name but a few. Even though the results of Burg and later results of Nuttal [9], Ulrych and Clayton [14] and also Marple [7] significantly improved the AR spectral estimator, it still is somewhat disappointing for narrow band signals or for nearly noninvertible auroregressive moving average (ARMA) data. To circumvent the difficulties, while at the same time introducing a more robust estimator, several authors have suggested the use of the ARMA spectral estimator (e.g. Morton and Gray [8] and Cadzow [4]). In this paper, a new ARMA spectral estimator is introduced which, using a recent result of Tiao and Tsay [12], makes use of dynamic prefiltering. It seems to perform better than previously defined ARMA spectral estimators and the AR spectral estimators of Burg or Marple. Examples are given which include data which is ARMA and data which is not ARMA. Several references to work in this area are included.
The Great Salt Lake's monimolimnion and its importance for mercury bioaccumulation in brine shrimp (Artemia franciscana)

The Great Salt Lake (Utah) is divided by a railroad causeway that causes the lake's south arm to be chemically stratified, when saltier, denser water from the north underflows into the south, creating an anoxic, sulfide-rich deep brine layer that accumulates high levels of total mercury (Hg; 59 ng L−1) and methylmercury (33 ng L−1). Approximately 40% of this water is advected into the upper mixed layer annually. High mercury levels of brine shrimp (Artemia franciscana) in the mixed layer are passed to waterfowl, creating a human health hazard. We hypothesized that high mercury levels in Artemia are due to exposure when mercury is mixed into the upper layer or when they feed on mercury-rich organic matter in the chemocline separating the two layers. Surprisingly, in aquaria growth experiments with 0%, 10%, or 25% deep brine water, Artemia exposed to progressively higher concentrations of mercury had significantly less mercury. In column experiments simulating a lake with a deep brine layer, Artemia grazed in the chemocline, but they also had lower mercury concentrations than Artemia in controls without a deep brine layer. This was due to detrital dilution of the mercury because the deep brine layer has very high particulate organic carbon (POC; 11.0 mg C L−1), which reduced the Hg : POC ratio of food 7-fold compared to that in the overlying mixed layer. Consequently, although Artemia are exposed to the high concentrations of methylmercury generated in the deep layer, the detrimental effect is partially ameliorated by detrital dilution of the mercury.
Projected changes in the physical climate of the Gulf Coast and Caribbean

As the global climate warms due to increasing greenhouse gases, the regional climate of the Gulf of Mexico and Caribbean region will also change. This study presents the latest estimates of the expected changes in temperature, precipitation, tropical cyclone activity, and sea level. Changes in temperature and precipitation are derived from climate model simulations produced for the Fourth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC AR4), by comparing projections for the mid- and late-21st century to the late 20th century and assuming a “middle-of-the-road” scenario for future greenhouse gas emissions. Regional simulations from the North America Regional Climate Change Program (NARCCAP) are used to corroborate the IPCC AR4 rainfall projections over the US portion of the domain. Changes in tropical cyclones and sea level are more uncertain, and our understanding of these variables has changed more since IPCC AR4 than in the case of temperature and precipitation. For these quantities, the current state of knowledge is described based on the recent peer-reviewed literature.
The fine structure of the perigeniculate nucleus in the cat

The fine structure of the cat's perigeniculate nucleus has been analyzed and compared to that of dorsal thalamic relay nuclei. Golgi preparations and electron micrographs of perigeniculate cells commonly show somatic spines. The most common presynaptic elements for these spines and for the adjacent perikaryal surfaces are relatively large axon terminals containing round synaptic vesicles and making multiple asymmetric contacts. These "RLD" terminals (so termed for their round vesicles, large average size of the terminals, and dark mitochondria) are also presynaptic to dendritic spines and shafts of proximal and secondary dendrites. Comparisons with adjacent parts of the dorsal lateral geniculate nucleus show that these RLD terminals are cytologically distinct from retinogeniculate terminals and that small numbers of RLD terminals also occur in the geniculate A laminae. Three other major classes of perigeniculate synaptic terminals, resemble major classes of terminals in the dorsal lateral geniculate nucleus. These include two types of terminal with flat or ovoid synaptic vesicles and dark mitochondria, "FD1" and "FD2" terminals, and a class of small terminal with densely clustered round vesicles and dark mitochondria, "RSD" terminals. RSD terminals, which resemble corticogeniculate axon terminals, represent the only class of perigeniculate terminal that does not contact perikarya. FD2 terminals resemble lateral geniculate presynaptic dendrites and participate in serial and triadic synaptic contacts, being both pre- and postsynaptic; however, in contrast to the arrangement characteristic of thalamic relay nuclei, these contacts do not occur within synaptic glomeruli. A fifth major class of perigeniculate presynaptic terminal has large flat or polymorphic synaptic vesicles and pale mitochondria. These "FP" terminals are seen infrequently in the lateral geniculate A laminae. Similarities between perigeniculate and lateral geniculate fine structure may relate in part to common sources of afferent input to the two nuclei.
Modeling of filler retention in compressible fibrous media

Abstract Filler retention is an important issue at the wet-end of the paper machine. Filler is added to improve the printing and mechanical properties of paper. Filler retention in sheets has long been studied using elements of depth filtration theory ignoring the compressibility of the media. The objective of this work is to develop a theoretical model for depth filtration that accounts for compressibility of fibrous media. The model development is based on principles of volume averaged continuum theory. Material parameters as required by the model are estimated from experimental data of filtration experiments. Filtration experiments are done with Prince Albert softwood pulp fibers and titanium dioxide as filler. For the depth filtration study the fiber bed is formed first, conditioned and then used as media for retaining filler particles. All filtration experiments are performed at constant flow rate conditions. Numerical simulation of the model predicts the cake compression and filler retention profiles within the fibrous mat. Porosity profiles indicate that the reduction in volume fraction at the end of filler filtration is mostly due to compression of the cake, than due to the physical volume of the retained filler. Retention of filler is highest at the entrance of the cake and lowest at the exit. This is due to high concentration of filler in slurry at the top of the cake, which decays exponentially towards the bottom due to retention on fibers. Filler concentration in the fluid phase at the exit of the bed follows a typical `S' shaped breakthrough curve.
Characteristic patterns of word association responses in institutionalized elderly with and without senile dementia

Abstract This study examined the responses of 91 institutionalized elderly persons to the Goldfarb-Halpern Word Association Test (1981), Journal of Speech and Hearing Research, 24, 233–246 . Subjects with senile dementia evidenced a characteristic pattern of responses which included marked reduction of paradigmatic responses, no decrease in syntagmatic responses, and a marked increase in unclassifiable and multiword responses not previously reported in the literature. The declines and increases appeared linear and progressive with severity of dementia. The pattern was distinct from that of any other adult group previously tested with this tool. Institutionalized elderly subjects without senile dementia performed similarly to previously tested noninstitutionalized elderly. Theoretical and clinical implications are discussed.
BALLISTIC WAVES IN HIGH-SPEED WATER ENTRY

Abstract The generation and propagation of pressure waves (ballistic waves) by a body impacting and penetrating into water at high speed are investigated both analytically and numerically. An analytical model is, in principle, applicable for predicting ballistic waves by any projectiles of practical interest. The theory is general enough to handle oblique and/or multiple penetrations, and is valid for impacts at subsonic and supersonic velocities with respect to water. The ballistic waves radiated by a projectile are expressed as a convolution between the vertical component, which represents the response of a moving point source, and the horizontal component, which represents the response of the cross-section of the source. Diffraction effects resulting from the finite size are accounted for by including the horizontal pressure component. A time inversion phenomenon which can occur during supersonic penetration is also considered. The approach provides valuable insight into the pressure field generated by the penetration mechanisms. Numerical results are obtained by using a nonlinear wave-code, and these are in good agreement with the analytical predictions.
Children's bite size and intake of an entrée are greater with large portions than with age-appropriate or self-selected portions.

Background: Whether large portion sizes affect children’s eating behavior has rarely been studied. Objectives: Our objectives were 1) to determine the effects of repeated exposure to a large portion of an entree on preschoolaged children’s awareness of portion size, self-selected portion size, and food intake and 2) to evaluate associations of children’s responsiveness to portion size with weight status and overeating. Design: Energy intake, bite size, and comments about portion size were evaluated among 30 children at 2 series of lunches in which either an age-appropriate portion or a large portion of an entree was served. On separate occasions, the children’s self-served portions, weight, height, and tendency to overeat were assessed. Results: Doubling an age-appropriate portion of an entree increased entree and total energy intakes at lunch by 25% and 15%, respectively. Changes were attributable to increases in the average size of the children’s bites of the entree without compensatory decreases in the intake of other foods served at the meal. These increases were seen even though observational data indicated that the children were largely unaware of changes in portion size. Greater responsiveness to portion size was associated with higher levels of overeating. The children consumed 25% less of the entree when allowed to serve themselves than when served a large entree portion. Conclusions: Large entree portions may constitute an “obesigenic” environmental influence for preschool-aged children by producing excessive intake at meals. Children with satiety deficits may be most susceptible to large portions. Allowing children to select their own portion size may circumvent the effects of exposure to large portions on children’s eating. Am J Clin Nutr 2003;77:1164‐70.
Differentiation of arrhythmias in the dog by measurement of activation sequence using an atrial and two ventricular electrodes.

Timing of atrioventricular activation and ventricular dispersion identifies and discriminates between beats of different origin. In eight dogs, three bipolar epicardial electrodes recorded left atrial and left and right ventricular depolarizations simultaneously during arrhythmias induced by programmed electrical stimulation and coronary artery occlusion and release. The interval between the left atrial and left ventricular intrinsic deflections (V1-V2) and between the left ventricular and right ventricular intrinsic deflections (V1-V2) of each heat was measured. Recordings were of normal sinus rhythm (NSR) (mean of five beats in 8/8 dogs), atrial flutter (AFL) (five beats of one episode), atrial fibrillation (AF) (144 beats in 29 episodes in 7/8), monomorphic ventricular tachycardia (MVT) (24 beats with six morphologies in 2/8), polymorphic ventricular tachycardia (PVT) (63 beats in 15 episodes in 5/8) and premature ventricular contractions (PVC) (29 beats with 29 morphologies in 5/8). Supraventricular rhythms can be differentiated from ventricular rhythms by V1-V2 timing. The mean difference in V1-V2 during AFL and AF vs NSR was 1 ms (range of 0–3 ms). The change from sinus during MVT ranged from 38 to 43 ms (m 31 ms) and during PVC 10 to 75 ms (m 38 ms). Thirty-five of 35 of these ectopic ventricular morphologies exhibited 10 ms or more timing difference compared to corresponding beats of NSR. PVT was consistently distinguished from supraventricular rhythms and MVT by the variability of V1-V2,A-V1 intervals can be used to distinguish supraventricular arrhythmias from sinus rhythm; a 32 ms difference existed for AFL. AF could be detected by the variability in AV1. One atrial and two ventricular leads can provide a means of differentiating normal sinus rhythm from supraventricular and ventricular arrhythmias that may be applicable to implantable antitachycardia devices.
Cooperativity within and among Pten, p53, and Rb Pathways Induces High-Grade Astrocytoma in Adult Brain

Mutations in the PTEN, TP53, and RB1 pathways are obligate events in the pathogenesis of human glioblastomas. We induced various combinations of deletions in these tumor suppressors in astrocytes and neural precursors in mature mice, resulting in astrocytomas ranging from grade III to grade IV (glioblastoma). There was selection for mutation of multiple genes within a pathway, shown by somatic amplifications of genes in the PI3K or Rb pathway in tumors in which Pten or Rb deletion was an initiating event. Despite multiple mutations within PI3K and Rb pathways, elevated Mapk activation was not consistent. Gene expression profiling revealed striking similarities to subclasses of human diffuse astrocytoma. Astrocytomas were found within and outside of proliferative niches in the adult brain.
Nightside flow enhancement associated with solar wind dynamic pressure driven reconnection

[1] Over the past few years the prominent role of solar wind dynamic pressure in enhancing dayside and nightside reconnection and driving enhanced ionospheric convection has been documented by both ground and spaceborn instruments. Super Dual Auroral Radar Network (SuperDARN) observations show that solar wind pressure fronts induce significantly enhanced ionospheric convection in the dayside ionosphere. In parallel, Defense Meteorological Satellite Program (DMSP) precipitating particle measurements and POLAR Ultra-Violet Imager (UVI) images have demonstrated that sudden solar wind pressure increases also significantly reduce the size of the polar cap, especially on the nightside, suggesting an enhancement of magnetotail reconnection. MHD models of the interaction of the magnetosphere with solar wind pressure fronts have reproduced the enhancement of dayside reconnection but have failed so far to account for the observed closing of the polar cap on the nightside and the suggested magnetotail reconnection increase. We use SuperDARN measurements of ionospheric convection within the nightside polar ionosphere, including near the magnetic separatrix, to evaluate the strength of the observed nightside reconnection enhancement after an abrupt increase in solar wind dynamic pressure on 6 November 2000 and compare it with similar observations on the dayside. We show that an enhancement of nightside convection occurs after a sudden increase in solar wind pressure, delayed by about 40 min compared with the observed dayside convection enhancement. The nightside enhanced flows are observed crossing the open-closed boundary determined by POLAR UVI data, indicating an enhancement of tail reconnection that is possibly due to the pressure increase and is, in addition to the tail reconnection, associated with the more immediate closing of the polar cap.
Watchtower -- A service oriented sensor web framework for educational and academic purposes

The idea of creating world-wide networks for the dissemination of sensor data has been driven by the increasing availability and widespread installation of low-cost, networked sensor systems. It can be expected that these type of networks, which are often referred to as sensor Webs, will play an important role in the future of information technology. It has therefore been our intention to create a software platform, which supports teaching and research activities in this field. By preferring ease of use and under standability to completeness and large-scale applicability, we envision a system that provides a platform for advanced high school and undergraduate college students to experiment with sensor Webs and to learn about the relevant technologies. We have chosen a modular, three-tier system approach, where a central Web service, the Watchtower, establishes the connection between sensor adaptors, so-called Scouts, and application adaptors, so-called Sentries. While Watchtower is written in Ruby, utilizing the Ruby on Rails framework, Scouts and Sentries can be programmed in any language. This should make it possible for anyone with some knowledge of a contemporary programming language to make use of the proposed framework.
Factors contributing to dropping out from and returning to HIV treatment in an inner city primary care HIV clinic in the United States

Although advances in pharmacotherapy have enabled people living with HIV/AIDS to live longer, fuller lives, some leave medical care, resulting in sub-optimal treatment and increased health risk to themselves and others. Forty-one patients who dropped out of an urban, publically funded primary care HIV clinic were contacted and encouraged by outreach staff to return. Participants were interviewed within two weeks of returning, and themes associated with dropping out and returning were elicited and content analyzed. Dropping out was associated with drug/alcohol use, unstable housing/homelessness, psychiatric disorders, incarceration, problems with HIV medications, inability to accept the diagnosis, relocation, stigma, problems with the clinic, and forgetfulness. Returning was associated with health concerns, substance abuse treatment/recovery, stable housing, incarceration/release, positive feelings about the clinic, spirituality, and assistance from family/relocation. Because a large number of patients reported substance abuse, depression, and past suicide attempts. Clinic staff should assess substance use, depression, and suicidal ideation at each primary care visit and encourage patients to obtain substance abuse treatment and mental health care. Future interventions could include providing SBIRT and/or onsite mental health and substance abuse treatment, all of which may boost retention.
A comparative texture classification study based on generalized cooccurrence matrices

A comparative study of generalized cooccurrence texture analysis tools is presented. A generalized cooccurrence matrix (GCM) reflects the shape, size and spatial arrangement of texture features. The particular texture features considered in this paper are: 1) pixel-intensity, for which generalized cooccurrence reduces to traditional cooccurrence; 2) edge-pixel; and 3) extended-edges. The best classification results, using pairs of descriptors computed from GCM's, were obtained using edge-pixel. This is consistent with the results reported in [4]. In addition, results are reported based on first-order statistics of edge-pixels and extended-edges.
A relational dual of the fuzzy possibilistic c-means algorithm

The hard, fuzzy and possibilistic c-means clustering algorithms are widely used for partitioning a set of n objects into c groups. There are cases, however, when more than one type of partition is necessary to correctly describe the belongingness of an object to a group. Previously, Pal, Pal and Bezdek listed some of these cases and proposed a method to simultaneously produce both memberships and typicalities for a set of vectorial object data: the fuzzy possibilistic c-means (FPCM) clustering algorithm. However, FPCM is not directly applicable when the data are represented by object-object relationships. In this paper, we reformulate FPCM so that it can work with A-norm relational data. Extensions and properties of the relational clustering algorithm are also considered.
Clinical Importance of Delays in the Initiation of Appropriate Antibiotic Treatment for Ventilator-Associated Pneumonia

Study objectives: To determine the influence of initially delayed appropriate antibiotic treatment (IDAAT) on the outcomes of patients with ventilator-associated pneumonia (VAP). Setting: Medical ICU of Barnes-Jewish Hospital, St. Louis, a university-affiliated urban teaching hospital. Patients: One hundred seven consecutive patients receiving mechanical ventilation and antibiotic treatment for VAP. Interventions: Prospective patient surveillance and data collection. Measurements and results: All 107 patients eventually received treatment with an antibiotic regimen that was shown in vitro to be active against the bacterial pathogens isolated from their respiratory secretions. Thirty-three patients (30.8%) received antibiotic treatment that was delayed for > 24 h after initially meeting diagnostic criteria for VAP. These patients were classified as receiving IDAAT. The most common reason for the administration of IDAAT was a delay in writing the antibiotic orders (n 25; 75.8%). The mean time ( SD) interval from initially meeting the diagnostic criteria for VAP until the administration of antibiotic treatment was 28.6 5.8 h among patients classified as receiving IDAAT, compared to 12.5 4.2 h for all other patients (p < 0.001). Forty-four patients (41.1%) with VAP died during their hospitalization. Increasing APACHE (acute physiology and chronic health evaluation) II scores (adjusted odds ratio, 1.13; 95% confidence interval, 1.09 to 1.18; p < 0.001), presence of malignancy (adjusted odds ratio, 3.20; 95% confidence interval, 1.79 to 5.71; p 0.044), and the administration of IDAAT (adjusted odds ratio, 7.68; 95% confidence interval, 4.50 to 13.09; p < 0.001) were identified as risk factors independently associated with hospital mortality by logistic regression analysis. Conclusion: These data suggest that patients classified as receiving IDAAT are at greater risk for hospital mortality. Clinicians should avoid delaying the administration of appropriate antibiotic treatment to patients with VAP in order to minimize their risk of mortality. (CHEST 2002; 122:262–268)
Role of microRNA-155 at early stages of hepatocarcinogenesis induced by choline-deficient and amino acid-defined diet in C57BL/6 mice.

MicroRNAs are conserved, small (20–25 nucleotide) noncoding RNAs that negatively regulate expression of mRNAs at the post-transcriptional level. Aberrant expression of certain microRNAs plays a causal role in tumorigenesis. Here, we report identification of hepatic microRNAs that are dysregulated at early stages of feeding C57BL/6 mice choline deficient and amino acid defined (CDAA) diet that is known to promote nonalcoholic steatohepatitis (NASH)-induced hepatocarcinogenesis after 84 weeks. Microarray analysis identified 30 hepatic microRNAs that are significantly (P≤0.01) altered in mice fed CDAA diet for 6, 18, 32 and 65 weeks compared to those fed choline sufficient and amino acid defined diet. Real-time RT-PCR analysis demonstrated upregulation of oncogenic miR-155, miR-221/222 and miR-21 and downregulation of the most abundant liver specific miR-122 at early stages of hepatocarcinogenesis. Western blot analysis showed reduced expression of hepatic PTEN and C/EBPβ respective targets of miR-21 and miR-155, in these mice at early stages. DNA binding activity of NF-kB that transactivates miR-155 gene was significantly (P=0.002) elevated in the liver nuclear extract of mice fed CDAA diet. Further, the expression of miR-155, as measured by in situ hybridization and real-time RT-PCR, correlated with diet-induced histopathological changes in the liver. Ectopic expression of miR-155 promoted growth of HCC cells whereas its depletion inhibited cell growth. Notably, miR-155 was significantly (P=0.0004) upregulated in primary human HCCs with concomitant decrease (P=0.02) in C/EBPβ level compared to matching liver tissues. Conclusion Temporal changes in microRNA profile occur at early stages of CDAA diet-induced hepatocarcinogenesis. Reciprocal regulation of specific oncomirs and their tumor suppressor targets implicate their role in NASH-induced hepatocarcinogenesis and suggest their use in the diagnosis, prognosis and therapy of liver cancer.
Numerical study of acoustic radiation due to a supersonic turbulent boundary layer

Direct numerical simulations are used to examine the pressure fluctuations generated by fully developed turbulence in a Mach 2.5 turbulent boundary layer, with an emphasis on the acoustic fluctuations radiated into the free stream. Single- and multi-point statistics of computed surface pressure fluctuations show good agreement with measurements and numerical simulations at similar flow conditions. Consistent with spark shadowgraphs obtained in free flight, the quasi-homogeneous acoustic near field in the free-stream region consists of randomly spaced wavepackets with a finite spatial coherence. The free-stream pressure fluctuations exhibit important differences from the surface pressure fluctuations in amplitude, frequency content and convection speeds. Such information can be applied towards improved modelling of boundary layer receptivity in conventional supersonic facilities and, hence, enable a better utilization of transition data acquired in such wind tunnels. The predicted acoustic characteristics are compared with the limited available measurements. Finally, the numerical database is used to understand the acoustic source mechanisms, with the finding that the supersonically convecting eddies that can directly radiate to the free stream are confined to the buffer zone within the boundary layer.
Prevalence rates for constipation and faecal and urinary incontinence

Objective: To evaluate the prevalence rates for constipation and faecal and urinary incontinence in children attending primary care clinics in the United States. Methods: Retrospective review of case records of all children, 4–17 years of age, seen for at least one health maintenance visit during a 6 month period and followed from birth or within the first 6 months of age in our clinics. We reviewed all charts for constipation, faecal incontinence and urinary incontinence. Results: We included 482 children in the study, after excluding 39 children with chronic diseases. The prevalence rate for constipation was 22.6% and was similar in boys and girls. The constipation was functional in 18% and acute in 4.6%. The prevalence rate for faecal incontinence (⩾1/week) was 4.4%. The faecal incontinence was associated with constipation in 95% of our children. The prevalence rate for urinary incontinence was 10.5%; 3.3% for daytime only, 1.8% for daytime with night-time and 5.4% for night-time urinary incontinence. Faecal and urinary incontinence were significantly more commonly observed in children with constipation than in children without constipation. Conclusion: The prevalence rates were 22.6% for constipation, 4.4% for faecal incontinence and 10.5% for urinary incontinence in a US primary care clinic. Children with constipation had higher prevalence rates for faecal and urinary incontinence than children without constipation. Boys with constipation had higher rates of faecal incontinence than girls with constipation.
Interaction testing of highly-configurable systems in the presence of constraints

Combinatorial interaction testing (CIT) is a method to sample configurations of a software system systematically for testing. Many algorithms have been developed that create CIT samples, however few have considered the practical concerns that arise when adding constraints between combinations of options. In this paper, we survey constraint handling techniques in existing algorithms and discuss the challenges that they present. We examine two highly-configurable software systems to quantify the nature of constraints in real systems. We then present a general constraint representation and solving technique that can be integrated with existing CIT algorithms and compare two constraint-enhanced algorithm implementations with existing CIT tools to demonstrate feasibility.
Distributed Adaptive Quantization for Wireless Sensor Networks: From Delta Modulation to Maximum Likelihood

We consider distributed parameter estimation using quantized observations in wireless sensor networks (WSNs) where, due to bandwidth constraint, each sensor quantizes its local observation into one bit of information. A conventional fixed quantization (FQ) approach, which employs a fixed threshold for all sensors, incurs an estimation error growing exponentially with the difference between the threshold and the unknown parameter to be estimated. To address this difficulty, we propose a distributed adaptive quantization (AQ) approach, which, with sensors sequentially broadcasting their quantized data, allows each sensor to adaptively adjust its quantization threshold. Three AQ schemes are presented: (1) AQ-FS that involves distributed delta modulation (DM) with a fixed stepsize, (2) AQ-VS that employs DM with a variable stepsize, and (3) AQ-ML that adjusts the threshold through a maximum likelihood (ML) estimation process. The ML estimators associated with the three AQ schemes are developed and their corresponding Cramer-Rao bounds (CRBs) are analyzed. We show that our 1-bit AQ approach is asymptotically optimum, yielding an asymptotic CRB that is only pi/2 times that of the clairvoyant sample-mean estimator using unquantized observations.
Methyl chlorophyllide a as a probable intermediate in the chlorophyll a pathway.

Although the enzyme chlorophyllase has been long known (13) only recently has evidence been presented for its probable function in chlorophyll a (chl a) biogenesis, namely, the demonstration that methyl chlorophyllide a (me chlide a) was transesterified with phytol in the presence of chlorophyllase yielding chl a (2). However, no evidence has been presented that would indicate the presence of me chlide a in green plants, a finding that would strongly support the above as the function of chlorophyllase in chl a biosynthesis. This report describes the isolation and partial characterization of minor quantities of me chlide a from extracts of expanding wheat (Triticum aestivum) or passion flower leaves (Passiflora X alatocaerulea). This finding together with that described above suggests that the final steps in chl a biogenesis
Characterization and Expression of the Short Neuropeptide F Receptor in the African Malaria Mosquito, Anopheles gambiae

A short neuropeptide F (sNPF) precursor and a sNPF receptor (sNPFR) were characterized for the mosquito, Anopheles gambiae. The sNPFR was expressed in CHO-K1 cells, and it exhibited high affinity binding, IC(50) approximately 3-5 nM, for specific sNPFs. sNPF1 potently inhibited forskolin-stimulated cAMP production by transfected cells, suggesting sNPFR acts via G(i/o). Transcripts for sNPF and sNPFR were present in all body regions of larvae, pupae, and adults, and immunoblots for sNPFR confirmed this distribution in females. Membranes from female heads and thoraces exhibited prototypical high affinity binding for radiolabeled sNPF, indicating sNPFR is a bona fide endogenous receptor.
The Impact of an Interactive Web-Based Module on Residents’ Knowledge and Clinical Practice of Injury Prevention

Objective. To determine the effectiveness of an interactive Web-based module on knowledge acquisition, retention, and clinical practice by residents. Methods. Residents were randomized to complete an interactive Web-based module on injury prevention or a noninteractive Web-based module of identical content. Acquisition and retention of medical knowledge were measured by pretest, posttest, and long-term test scores, and change in clinical practice was measured by videotaped clinical encounters. Results. Fifty-seven residents completed the modules. The control group had higher posttest scores than the intervention group (P = .036). Thirty-seven residents completed the long-term test with scores that were significantly higher than pretest scores (P = .00). Thirty-six residents had videotaped encounter scores (232 visits), with no difference in these scores after the intervention (P = .432). Conclusion. The noninteractive module was more effective in promoting knowledge acquisition. Residents successfully dem...
Cost-efficiency in Medicaid long-term support services: the role of home and community based services

Growth in home and community based services (HCBS) has been implicated in rising long-term care expenditure in the Medicaid program. Its efficiency impact has not been tested. Using Stochastic Frontier Analysis (SFA) and panel data methods, we evaluated the cost efficiency of long-term support services (LTSS) provided by state Medicaid agencies and examined its association with intensity of HCBS use. We compared the efficiency of state funded HCBS programs with federal waiver programs. We found substantial variation in cost efficiency of LTSS programs by states, but all showed improvement over time related to increased HCBS use. Higher participation in federal waivers programs yielded additional improvements in cost-efficiency. Results indicate that increasing HCBS services targeted at “high need” population and developmentally disabled individuals would improve efficiency in LTSS delivery. These results reveal the importance of measuring and comparing efficiencies across Medicaid funded LTSS programs, as we introduce reforms in the LTSS delivery system. We recommend that Medicaid agencies invest in the development of improved data sources for the estimation of cost efficiencies of their programs.
High intakes of choline and betaine reduce breast cancer mortality in a population-based study

Choline and betaine provide methyl groups for one-carbon metabolism. Humans obtain these nutrients from a wide range of foods. Betaine can also be synthesized endogenously from its precursor, choline. Although animal studies have implied a causal relationship between choline deficiency and carcinogenesis, the role of these two nutrients in human carcinogenesis and tumor progression is not well understood. We investigated the associations of dietary intakes of choline and betaine and breast cancer risk and mortality in the population-based Long Island Breast Cancer Study Project. Among the 1508 case-group women, 308 (20.2%) deaths occurred, among whom 164 (53.2%) died of breast cancer by December 31, 2005. There was an indication that a higher intake of free choline was associated with reduced risk of breast cancer (P(trend)=0.04). Higher intakes of betaine, phosphocholine, and free choline were associated with reduced all-cause as well as breast cancer-specific mortality in a dose-dependent fashion. We also explored associations of polymorphisms of three key choline- and betaine-metabolizing genes and breast cancer mortality. The betaine-homocysteine methyltransferase gene (BHMT) rs3733890 polymorphism was associated with reduced breast cancer-specific mortality (hazard ratio, 0.64; 95% confidence interval, 0.42-0.97). Our study supports the important roles of choline and betaine in breast carcinogenesis. It suggests that high intake of these nutrients may be a promising strategy to prevent the development of breast cancer and to reduce its mortality.
Retrospective processing of DTI tractography to compensate for partial volume effects

Partial volume effects are one of the most common sources of error in diffusion tensor imaging (DTI) tractography. For example, in data from older subjects or Alzheimer's disease probable subjects, the situation is especially exacerbated around the dilated ventricle, which causes erroneous merging of tracts. Rescanning the subject at higher resolution is the best solution, but often times unattainable. We offer a retrospective filtering algorithm, which is purely subtractive, based on a region of interest (ROI) filtering methodology that filters tracts by their shape and seed points. The ROIs are defined using both anatomic images and fractional anisotropy (FA) maps in normalized space allowing for consistency across all subjects. Our algorithm helps correct the partial volume effects by reducing the overestimation of tract length, giving a more accurate regional tract count. The objective of our retrospective algorithm is reclamation of data sets from partial volume effects.
Rational design of novel cathode materials in solid oxide fuel cells using first-principles simulations

The search for clean and renewable sources of energy represents one of the most vital challenges facing us today. Solid oxide fuel cells (SOFCs) are among the most promising technologies for a clean and secure energy future due to their high energy efficiency and excellent fuel flexibility (e.g., direct utilization of hydrocarbons or renewable fuels). To make SOFCs economically competitive, however, development of new materials for low-temperature operation is essential. Here we report our results on a computational study to achieve rational design of SOFC cathodes with fast oxygen reduction kinetics and rapid ionic transport. Results suggest that surface catalytic properties are strongly correlated with the bulk transport properties in several material systems with the formula of La0.5Sr0.5BO2.75 (where B = Cr, Mn, Fe, or Co). The predictions seem to agree qualitatively with available experimental results on these materials. This computational screening technique may guide us to search for high-efficiency cathode materials for a new generation of SOFCs.