cssi/SciSciGPT-SciSciNet huggingface dataset:
Development of a Postprocessing Methodology for Studying Thermal Stratification in an HCCI Engine

Naturally occurring thermal stratification significantly impacts the characteristics of HCCI combustion. The in-cylinder gas temperature distributions prior to combustion dictate the ignition phasing, burn rates, combustion efficiency, and unburned hydrocarbon and CO emissions associated with HCCI operation. Characterizing the gas temperature fields in an HCCI engine and correlating them to HCCI burn rates is a prerequisite for developing strategies to expand the HCCI operating range.To study the development of thermal stratification in more detail, a new analysis methodology for post-processing experimental HCCI engine data is proposed. This analysis tool uses the autoignition integral in the context of the mass fraction burned curve to infer information about the distribution of temperature that exists in the cylinder prior to combustion. An assumption is made about the shape of the charge temperature profiles of the unburned gas during compression and after combustion starts elsewhere in the cylinder. Secondly, it is assumed that chemical reaction rates proceed very rapidly in comparison to the staggering of ignition phasing from thermal stratification. The autoignition integral is then coupled to the mass fraction burned curve to produce temperature-mass distributions that are representative of a particular combustion event. Due to the computational efficiency associated with this zero-dimensional calculation, a large number of zones can be simulated at very little computational expense.The temperature-mass distributions are then studied over a coolant temperature sweep. The results show that very small changes to compression heat transfer can shift the distribution of mass and temperature in the cylinder enough to significantly affect HCCI burn rates and emissions.Copyright © 2012 by ASME and General Motors
ELECTORAL BEHAVIOR AND ELECTORAL BEHAVIOUR: A NOTE ON CERTAIN RECENT DEVELOPMENTS IN ELECTORAL GEOGRAPHY∗

(1969). ELECTORAL BEHAVIOR AND ELECTORAL BEHAVIOUR: A NOTE ON CERTAIN RECENT DEVELOPMENTS IN ELECTORAL GEOGRAPHY. The Professional Geographer: Vol. 21, No. 6, pp. 398-400.
Greedy Algorithms andM-Term Approximation with Regard to Redundant Dictionaries

We study the efficiency of greedy type algorithms with regard to redundant dictionaries in Hilbert space and we prove a general result which gives a sufficient condition on a dictionary to guarantee that the pure greedy algorithm is near best in the sense of power decay of error of approximation. We discuss also some important examples. It is already known (see DeVore and Temlyakov,Adv. Comput. Math.5(1996), 173?187) that the Pure Greedy Algorithm for some dictionaries has a saturation property. We construct an example which shows that a natural generalization of the Pure Greedy Algorithm also has a saturation property. Next we discuss some new phenomena which occur in approximation by a greedy type algorithm with regards to a highly redundant dictionary.
Comparison of Calculated Detection Limits in Molecular Absorption, Molecular Luminescence, Raman, Molecular Ionization, and Photothermal Spectrometry

Detection limits for absorption, luminescence, photoionization, Raman, and photothermal molecular spectrometric methods are calculated from signal-to-noise expressions. The detection limits (in m−3) represent the best possible values by the various methods, since the limiting noises in each case were chosen. Molecular luminescence methods, with laser excitation, approach 1 species/cm3. Methods relying upon two (or more) laser wavelengths generally have much poorer detection limits than the simpler single-wavelength methods.
Plasma Control of a Turbulent Shock Boundary-Layer Interaction

The Navier–Stokes equations were solved using a high-fidelity time-implicit numerical scheme and an implicit large-eddy simulation approach to investigate plasma-based flow control for supersonic flow over a compression ramp. The configuration included a flat-plate region to develop an equilibrium turbulent boundary layer at Mach 2.25, which was validated against a set of experimental measurements. The fully turbulent boundary-layer flow traveled over a 24 deg ramp and produced an unsteady shock-induced separation. A control strategy to suppress the separation through a magnetically-driven surface-discharge actuator was explored. The size, strength, and placement of the model actuator were based on recent experiments at the Princeton University Applied Physics Group. Three control scenarios were examined: steady control, pulsing with a 50% duty cycle, and a case with significant Joule heating. The control mechanism was very effective at reducing the time-mean separation length for all three cases. The ste...
Caffeine and Theobromine Levels in Cocoa and Carob Products

Seventy-nine cocoa or chocolate products and eighteen carob products were analyzed by HPLC for caffeine and theobromine content. After extraction into boiling water, the methylxanthines were identified and quantified with the use of a reverse phase column. Mean theobromine and caffeine levels respectively, were 0.695 mg/g and 0.071 mg/g in cocoa cereals; 1.47 mg/g and 0.152 mg/g in chocolate bakery products; 1.95 mg/g and 0.138 mg/g in chocolate toppings; 2.66 mg/g and 0.208 mg/g in cocoa beverages; 0.621 mg/g and 0.032 mg/g in chocolate ice creams; 0.226 mg/g and 0.011 mg/g in chocolate milks; 74.8 mg/serving and 6.5 mg/serving in chocolate puddings. Theobromine and caffeine levels in carob products ranged from 0-0.504 mg/g and 0-0.067 mg/g, respectively.
Biomonitoring of heavy metals in the pacific basin using avian feathers

The authors used avian feathers to biomonitor heavy-metal distribution in several areas in the Pacific Basin including Papua New Guinea, Australia, New Zealand, China, Johnston Atoll, Hawaii, and Costa Rica. This paper is a preliminary synthesis of data gathered by the Pacific Basin Biomonitoring Project. They examined levels of mercury, lead, cadmium, selenium, chromium, and manganese. For sooty terns (Sterna fuscata) and brown noddy (Anous stolidus) mercury levels were lower in the Pacific than in Puerto Rico in the Atlantic, but his was reversed for lead and cadmium. Adult birds had higher metal levels in their feathers than did young birds of the same species from the same area. Cadmium levels were higher in terrestrial species; lead, chromium, and manganese were highest in coastal species; and mercury and selenium were highest in marine species. Mercury levels were lowest in forest species, intermediate in species that eat insects and small vertebrates, and highest in species that eat intermediate to large fish. Lead levels were highest in species feeding in industrialized estuaries of Hong Kong.
Deep-Water Running: A Practical Review of the Literature with an Emphasis on Biomechanics

Deep-water running (DWR) is used as an adjunct to training and conditioning, and as an injury-rehabilitation technique. It is important for the physician or sports medicine practitioner to focus on the underlying physics and biomechanics of running in water in order to better produce the desired physiological, metabolic, and psychological outcomes. Deep-water running maximal heart rate and oxygen consumption values have been consistently shown to be lower than those found during treadmill running. However, recent evidence reveals that there is less of a difference between these maximal values relative to treadmill running and DWR with increased DWR experience. Submaximal values have been shown to be strikingly similar. The skill level of DWR technique, psychological comfort, perception of work, muscular recruitment patterns, and running kinematics are all affected by the physics (ie, temperature, buoyancy, hydrostatic pressure, specific gravity, and drag) of running in water. Therefore, the relationship between the biomechanics and the corollary practical physiological indicators of workload found in DWR must be factored into the appropriate prescription of training and conditioning workloads and rehabilitation protocols.
Creatine Kinase and Intermediate Filaments in Cultured Mammalian Cells

Creatine kinase catalyzes the Lohmann reaction—the conversion of ADP and phosphorylcreatine to ATP and creatine. This reaction, essential in vertebrate muscle, has not been studied extensively in tissue other than muscle and brain. In this chapter, we summarize our immunofluorescence localization studies (Eckert et al.,1980) that show the association of creatine kinase with intermediate filaments in cultured rat kangaroo kidney epithelial cells (PTK1) and in cultured mouse uterine fibroblast cells (BALB/3T3). We also discuss the association of creatine kinase with the mitotic spindle of dividing cells (Koons et al., 1980, 1981).
Silvicultural systems and biological nitrogen fixation

Biological nitrogen fixation occurs in most, probably all, forest ecosystems (Chap. 2), and thus is a factor in all silvicultural systems. Silvicultural systems are defined here as purposeful attempts to derive benefits for humans from forested (or afforested) lands. Such attempts vary from minimal efforts to protect wild ecosystems from catastrophic fire to the establishment of artificial stands of exotic trees which are then vigorously managed for specific products. Although ‘forest products’ are commonly thought of as wood in its various fuelwood and manufactured forms, of equal or greater importance in many places are clean water, stabilized soil, enhanced wildlife populations, improved grazing for domestic livestock, and enhanced recreational opportunities. Thus, this discussion of nitrogen fixation as a silvicultural tool will emphasize, but will not be limited to, silvicultural systems with wood production as their objective. Also, since all silvicultural systems probably contain some nitrogen-fixing organisms, this discussion is limited to 1) those in which naturally-occurring fixation is recognized as particularly important and is a factor in silvicultural decisions (passive systems) and 2) those in which fixation is enhanced through species introduction or silvicultural practices, or both (active systems).
Self-seeded multicasting of 320 Gb/s data in a 2-pump parametric amplifier

We report first experimental demonstration of single stage, self-seeded 2-pump fiber optic parametric amplifier for simultaneous wavelength conversions. 320 Gb/s single channel OTDM signal was successfully copied to 5 wavelengths with ≪3 dB Q-factor penalty.
Self-injurious behavior

Self-injurious behavior (SIB) has been around for a long time. Many caves in Southern France contain hand imprints on their walls and in one cave, at Gargas the 20,000 year old imprints display the absence of all tips except for the thumb. The 5th century B.C.E. historian Herodotus described the actions of a probably psychotic Spartan leader, Cleomenes, who mutilated him by slicing his flesh into strips with a knife; starting with his shins he worked upwards to his thighs, hips, and sides until he reached his abdomen which he chopped into mincemeat. The Gospel of Mark 5∶5 describes a repetitive self-injurer, a man who “night and day would cry aloud among the tombs and on the hillsides and cut himself with stones.”
Treg stability: to be or not to be

Regulatory T cell (T(reg)) stability has been primarily determined by the maintained expression of the transcription factor Forkhead box P3 (Foxp3). However, T(regs) can exhibit instability while maintaining Foxp3 expression, requiring a re-examination of what defines T(reg) stability. Recent work suggests that the establishment and stability of T(regs) is mediated by a number of mechanisms besides Foxp3 expression, such as epigenetic modifications, Foxo1/3a localization, expression of Eos and signaling via Neuropilin-1. Additional studies may help to define approaches that can undermine T(reg) stability in cancer or enhance T(reg) stability in transplantation, autoimmune or inflammatory diseases and therefore have substantial therapeutic utility. In this review, we will discuss how T(reg) stability is defined and the mechanisms utilized to maintain stability.
The p- and h-p versions of the finite element methods in solid mechanics

Applications of p- and h-p extension procedures in solid mechanics are discussed. Error estimation and quality control procedures made possible by p-extensions are described and illustrated by examples.
Saliva DNA quality and genotyping efficiency in a predominantly elderly population

The question of whether DNA obtained from saliva is an acceptable alternative to DNA from blood is a topic of considerable interest for large genetics studies. We compared the yields, quality and performance of DNAs from saliva and blood from a mostly elderly study population. Two thousand nine hundred ten DNAs from primarily elderly subjects (mean age ± standard deviation (SD): 65 ± 12 years), collected for the Primary Open-Angle African-American Glaucoma Genetics (POAAGG) study, were evaluated by fluorometry and/or spectroscopy. These included 566 DNAs from blood and 2344 from saliva. Subsets of these were evaluated by Sanger sequencing (n = 1555), and by microarray SNP genotyping (n = 94) on an Illumina OmniExpress bead chip platform. The mean age of subjects was 65, and 68 % were female in both the blood and saliva groups. The mean ± SD of DNA yield per ml of requested specimen was significantly higher for saliva (17.6 ± 17.8 μg/ml) than blood (13.2 ± 8.5 μg/ml), but the mean ± SD of total DNA yield obtained per saliva specimen (35 ± 36 μg from 2 ml maximum specimen volume) was approximately three-fold lower than from blood (106 ± 68 μg from 8 ml maximum specimen volume). The average genotyping call rates were >99 % for 43 of 44 saliva DNAs and >99 % for 50 of 50 for blood DNAs. For 22 of 23 paired blood and saliva samples from the same individuals, the average genotyping concordance rate was 99.996 %. High quality PCR Sanger sequencing was obtained from ≥ 98 % of blood (n = 297) and saliva (n = 1258) DNAs. DNA concentrations ≥10 ng/μl, corresponding to total yields ≥ 2 μg, were obtained for 94 % of the saliva specimens (n = 2344). In spite of inferior purity, the performance of saliva DNAs for microarray genotyping was excellent. Our results agree with other studies concluding that saliva collection is a viable alternative to blood. The potential to boost study enrollments and reduce subject discomfort is not necessarily offset by a reduction in genotyping efficiency. Saliva DNAs performed comparably to blood DNAs for PCR Sanger sequencing.
Tylosin for Control of American Foulbrood Disease in Honey Bees

Gorging colonies of Apis mellifera L. with sugar sirup or dusting them with dry powdered sugar containing tylosin lactate or sodium sulfathiazole controlled most cases of American foulbrood disease when the treatments were repeated once a week for at least 3 weeks. Gorging was more effective than dusting in controlling the disease. Less disease appeared among larvae individually inoculated with the disease spores and then reared in colonies treated with Tylosin than in colonies treated with sulfathiazole. Tylosin tartrate also effectively controlled American foulbrood disease.
Quality-of-life advancements in the treatment of adolescent and pediatric patients with gynecologic malignancies

Adolescent and pediatric gynecologic oncology patients represent a subgroup of patients afflicted with malignancies in which significant improvement has been noted. In this article we discuss the specific factors which led to improvement in survival of these patients, but most importantly, how these improvements paralleled the improvements in quality-of-life issues for patients who only two decades ago were sentenced to a poor prognosis, a dismal outlook, and a miserable limited human existence.
Large Eddy Simulation of Supercritical Mixing and Combustion for Rocket Applications

We report on the implementation of the real fluid capabilities to CharlesX, the in-house, unstructured, large eddy simulation code used at the Center for Turbulence Research at Stanford University. A conceptually distinct implementation was needed for the puremixing and the flamelet/progress-variable (FPV) model combustion case. For the nonreacting simulations, a Newton-Raphson based iterative algorithm is used to determine the temperature from the transported density and energy. For the reacting simulations, an extended flamelet table is used that tabulates the departure functions as well as the compressibility factor. These tabulated parameters are used to correct the transported thermodynamic properties. The real fluid extension to CharlesX was used to investigate a non-reacting and a reacting case. In both of these cases, a second-order essentially nonoscillatory (ENO) schemes is locally applied to the flux computation on the faces identified with a dual-threshold relative density sensor. This avoids spurious oscillations of the numerical solution with limited numerical dissipation. This preliminary work illustrates the capability CharlesX to capture the important physics in a typical rocket engine configuration.
Large Prostatic Utricles and Related Structures, Urogenital Sinus and Other Forms of Urethrovaginal Confluence

AbstractThe urethrograms and clinical records of 106 children with a large prostatic utricle or related structures, urogenital sinus in intersex disorders and other types of urethrovaginal confluence were reviewed. There were 27 boys with normal external genitalia, 19 cases of male hypospadias, 1 case of male pseudohermaphroditism, 7 cases of mixed gonadal dysgenesis, 1 case of true hermaphroditism, 32 cases of female pseudohermaphroditism, 11 normal girls with urethrovaginal confluence and 8 cases of cloacal malformation. Among the patients of the first 2 groups 10 had an imperforate anus, 7 the prune belly syndrome, 6 Down’s syndrome and 2 posterior urethral valves.
Late type II endoleaks after endovascular aneurysm repair require intervention more frequently than early type II endoleaks

Abstract Objective Type II endoleaks (T2ELs) are commonly observed after endovascular aneurysm repair (EVAR). We sought to determine whether time at onset of T2ELs correlated with the need to intervene based on sac expansion or rupture. Methods Between 1998 and 2015, 462 EVARs performed at our institution had duplex ultrasound surveillance in our accredited noninvasive vascular laboratory. Computed tomography and arteriography were reserved for abnormal duplex ultrasound findings. The need for intervention for T2ELs was classified according to time at onset after EVAR. Interventions for T2ELs were performed only for sac expansion >5 mm or rupture. We defined early-onset T2ELs as 1 year of follow-up. Results Of the 462 EVARs, 96 patients (21%) developed T2ELs after implantation. Of these, 65 (68%) had early and 31 (32%) had late onset (mean, 12 months; range, 1-112 months). Early T2ELs resolved without treatment in 75% (49/65) of cases compared with only 29% (9/31) of late T2ELs ( P P P = .922). Conclusions Less than one-third (29%) of T2ELs that develop after 1 year will resolve spontaneously and about half (55%) will require intervention for sac growth or rupture. T2ELs that develop >1 year after EVAR should be followed up with a more frequent surveillance protocol and perhaps with a lower threshold to intervene.
Correct author citations for some upper rank names of liverworts (Marchantiophyta)

Documentation is provided to support the correct author citation for ten upper rank names of liverworts that have hitherto been cited incorrectly. In addition, the use of parenthetical author citations is clarified.
Time dependent junction degradation in FinFET

A systematic study of time dependent source/drain junction degradation (TDJD) for extremely scaled FinFETs is conducted. It is verified that junction degradation can be attributed to the increase in band to band tunneling due to generation of new traps upon application of stress. Impact of varying stress conditions, drain engineering and junction area on TDJD is also studied. It is shown for the first time that TDJD follows 1/E model based on the long-term stress data.
Drug helplines and adult marijuana users: An assessment in Washington, Colorado, Oregon, and Alaska.

Drug helplines are well-known and widely utilized resources for those seeking help with managing their substance use. Using “secret shoppers,” a preliminary assessment of the drug helplines in 4 st...
Dissociating two sources of variability using a safety-margin model

Neurological trauma can have a devastating effect on activities of daily living. One of the consequences is an increased amount of variability in the system, which can challenge individuals to stay within safe and stable regions of operation. There are multiple sources of movement variability; two of these are neuromotor noise and action-tolerance variability. The amount of neuromotor noise that is uncontrollable can impose limitations on reshaping variability. Action-tolerance variability, which can be reshaped through experience, and neuromotor noise, a certain amount of which cannot be altered, are often conflated when discussing motor variability. We attempted to disambiguate the two using an adaptive model, producing distinct “signatures” of neuromotor noise and action-tolerance variability within a task and compare with experimental data on stroke and healthy. Not all stroke survivors could adapt to the task, as predicted for those with greater neuromotor noise. Possible applications of this model can inform us of potential to influence distributions in stroke survivors and other individuals who have had a neurological injury. Additionally, we could design new training environments specifically tailored to the needs of the individual. This technique may also help disambiguate the type of brain injury suffered by stroke survivors.
The effect of a multi-axis suspension on whole body vibration exposures and physical stress in the neck and low back in agricultural tractor applications.

Whole body vibration (WBV) exposures are often predominant in the fore-aft (x) or lateral (y) axis among off-road agricultural vehicles. However, as the current industry standard seats are designed to reduce mainly vertical (z) axis WBV exposures, they may be less effective in reducing drivers' exposure to multi-axial WBV. Therefore, this laboratory-based study aimed to determine the differences between a single-axial (vertical) and multi-axial (vertical + lateral) suspension seat in reducing WBV exposures, head acceleration, self-reported discomfort, and muscle activity (electromyography) of the major muscle of the low back, neck and shoulders. The results showed that the multi-axial suspension seat had significantly lower WBV exposures compared to the single-axial suspension seats (p' < 0.04). Similarly, the multi-axial suspension seat had lower head acceleration and muscle activity of the neck, shoulder, and low back compared to the single-axial suspension seat; some but not all of the differences were statistically significant. These results indicate that the multi-axial suspension seat may reduce the lateral WBV exposures and associated muscular loading in the neck and low back in agricultural vehicle operators.
Market share and costs of biologic therapies for inflammatory bowel disease in the USA

SummaryBackground Real-world data quantifying the costs of increasing use of biologics in inflammatory bowel disease (IBD) are unknown. Aim To determine the outpatient IBD drug utilization trends, relative market share, and costs in the USA during a 9-year period. Methods The Truven MarketScan® Database was analysed for patients with Crohn's disease (CD) and ulcerative colitis (UC) during 2007-2015. National drug codes were used to identify prescription drugs; Healthcare Common Procedure Coding System J-codes were used to capture biologic out-patient infusions. Proportion of drug usage, relative market share and per-member per-year (PMPY) costs were analysed for biologics, immunomodulators, 5-ASAs and corticosteroids. Results In 415 405 patients (188 842 CD; 195 183 UC; 31 380 indeterminate colitis; 54.67% female), utilization trends show a consistent rise in the market share of biologics during the 9-year study period. The proportion of patients using biologics increased from 21.8% to 43.8% for CD and 5.1%-16.2% for UC. This contrasts a small decrease in immunomodulator and 5-ASA use for CD and relative constancy of other classes including corticosteroids-only use as primary IBD medication from 2007 to 2015. The average biologic-taking patient accounted for $25 275 PMPY in 2007 and $36 051 PMPY in 2015. The average paediatric biologic-taking patient accounted for $23 616 PMPY in 2007 and $41 109 PMPY in 2015. In all patients, the share of costs for biologics increased from 72.9% in 2007 to 85.7% in 2015 (81.7% in 2007 to 94.9% in 2015 in paediatrics). Conclusion The vast majority of costs allocated to out-patient IBD medications in the USA is attributed to increasing use of biologic therapies despite the relative minority of biologic-taking patients.
Bortezomib in combination with dose-adjusted EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) induces long-term survival in patients with plasmablastic lymphoma: a retrospective analysis

Plasmablastic lymphoma (PBL) is a rare and aggressive form of B-cell non-Hodgkin lymphoma. This subtype of lymphoma has a post-germinal center cell-of-origin called the plasmablast, and the immunophenotype is more consistent with that of a plasma cell than a lymphocyte. Because of these unique features, PBL is notoriously difficult to treat. Case reports and small reviews have evaluated the addition of agents directed against plasma cell disorders in combination with traditional lymphoma-directed regimens. We describe the largest case series to date, with the longest follow-up, evaluating bortezomib in combination with etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin (V-EPOCH) for the treatment of PBL. Our results show that this is a safe and effective regimen with an overall and complete response rate of 100% and 2-year overall survival of 50%.
Enhancement of vegetation-rainfall feedbacks on the Australian summer monsoon by the Madden–Julian Oscillation

A regional climate modeling analysis of the Australian monsoon system reveals a substantial modulation of vegetation-rainfall feedbacks by the Madden Julian Oscillation (MJO), both of which operate at similar sub-seasonal time scales, as evidence that the intensity of land–atmosphere interactions is sensitive to the background atmospheric state. Based on ensemble experiments with imposed modification of northern Australian leaf area index (LAI), the atmospheric responses to LAI anomalies are composited for negative and positive modes of the propagating MJO. In the regional climate model (RCM), northern Australian vegetation feedbacks are characterized by evapotranspiration (ET)-driven rainfall responses, with the moisture feedback mechanism dominating over albedo and roughness feedback mechanisms. During November–April, both Tropical Rainfall Measuring Mission and RCM data reveal MJO’s pronounced influence on rainfall patterns across northern Australia, tropical Indian Ocean, Timor Sea, Arafura Sea, and Gulf of Carpentaria, with the MJO dominating over vegetation feedbacks in terms of regulating monsoon rainfall variability. Convectively-active MJO phases support an enhancement of positive vegetation feedbacks on monsoon rainfall. While the MJO imposes minimal regulation of ET responses to LAI anomalies, the vegetation feedback-induced responses in precipitable water, cloud water, and rainfall are greatly enhanced during convectively-active MJO phases over northern Australia, which are characterized by intense low-level convergence and efficient precipitable water conversion. The sub-seasonal response of vegetation-rainfall feedback intensity to the MJO is complex, with significant enhancement of rainfall responses to LAI anomalies in February during convectively-active MJO phases compared to minimal modulation by the MJO during prior and subsequent calendar months.
Organizational Module Design and Architectural Inertia: Evidence from Structural Recombination of Business Divisions

The modular organization has been found to be particularly effective in exploring and adapting to changing environments. One powerful means of exploration has been argued to be structural recombination—that is, the splitting and merging of modules. Once undertaken, structural recombination can lead to novel architectural opportunities that enable greater innovation and long-term performance. However, little research exists that explores whether and to what extent a focal module may be readily available for recombinatory opportunities in the first place. In this paper, I investigate the design hierarchy choices related to visibility and information hiding in organizational module designs (i.e., business divisions). In a longitudinal sample of 222 divisions in 18 of the largest European universal banks, I find support for modularity-informed predictions in which visibility and information hiding affect module recombination decisions. In a post hoc analysis, I explore a complementary theoretical explanation ...
A case of mistaken identity, limbus annulare mimics fracture.

The limbus annulare is of practical importance as a radiographic finding. Its proper identification will lead to an accurate diagnosis and eliminate the need for hospitalization and unnecessary diagnostic studies. This is a report of a patient with a limbus annulare misdiagnosed as a fracture of L-4. A review of the literature and possible explanations as to the etiology of the limbus are also presented. Language: en
Demographic variation in the rate of knee replacement: A multi-year analysis

Abstract OBJECTIVE. The aim of this study is to describe the practice variation of knee replacements (KRs) in the elderly ( > or = 65) over time from 1985-1990 in terms of the number of primary, bilateral, and revision KRs; the extent of large area variation in performance rates; and the degree to which demographic variables are the determinants of area rates. DATA SOURCES/STUDY SETTING. Data analyzed are from every hospital in the United States that performed a KR on a Medicare patient during the study period. Data were obtained from the MEDPAR, HISKEW, and denominator files of the Medicare Statistical System. STUDY DESIGN. This is a cohort study of all Medicare beneficiaries who received a KR between 1985 and 1990. The dependent variable in the analyses was the count of the KRs performed in each area. DATA COLLECTION/EXTRACTION METHODS. This is a population-based sample of Medicare enrollees in the United States. All hospitalizations for Medicare-reimbursed KRs were included in the initial data set. Exclusion criteria were used to identify the Medicare covered population with a definite KR. These criteria resulted in 7.3 percent exclusions and a final set of 414,079 KR hospitalizations. PRINCIPAL FINDINGS. The number of Medicare-funded KRs increased in each of the study years corresponding to an annual rate of increase of 18.45 percent. The likelihood of receiving a KR was a function of age, gender, and race. For each year, KRs were almost-twice as likely to be performed on women than on men. The odds of whites getting the surgery were over 1.5 times greater than for blacks. Even after adjusting for demographic factors, significant regional variation remained. CONCLUSIONS. Much about area variation and the rate of growth in KR rates remains unexplained. For answers to emerge, better data and different types of studies are required.
Food, Chemical Feedstocks and Energy from Biomass

The Oxford Concise Dictionary (1976) defines biomass as “the total quantity or weight of organisms.” The root of the word “bio” comes from the Greek bios which means life and mass has it origin from the old French and Latin meaning “a lump.” The term biomass has been used during the last few years to refer to all materials of recent plant and animal origin. The definition of biomass can encompass oil, natural gas, tar sands and coal, but these materials are usually excluded.
Clinician Utilization of Rapid Antibiotic Susceptibility Data: A Prospective Study

The University of Iowa Hospitals is a 1,000 bed tertiary care center which serves as a regional hospital for hematology-oncology, cystic fibrosis and a variety of chronic disease patients. It also houses diverse transplantation patients, ranging from kidney, heart, liver-pancreas, to bone marrow. Thus a fair percentage of our patient load is compromised by immunosuppression or chronic disease which influences the demand for rapid testing and equally rapid reporting systems. In the areas of bacterial identification and susceptibility tests (MICs), we utilize the Vitek System as the mainstay of the laboratory due to its rapid turnaround time and reproducible accuracy. If we encounter isolates not in the Vitek database we use the manual API for idents and B-D Sceptor for MICs. I’ll try to detail this as we follow a specimen through our work-flow pattern. To fully appreciate the Iowa System of rapid testing and reporting, one must understand that we are one of the most automated and instrumented laboratories in the country. All steps of specimen handling from admit or rejection, to final report, are computer mediated which gives us reproducibility as well as rapid, accurate test results. When the specimen is received in the lab and entered into our system via the lab computer, a work-flow card listing the media and stain, etc., required for that specific type of specimen is printed out. This will vary with specimen types, e.g., a wound would get routine culture and Gram stain only, however an abscess would also get anaerobic culture, while a BAL would demand all of these plus culture and stains for fungi or TB, if from the appropriate patient load.
Testing Daily Associations between Impulsivity, Affect, and Alcohol Outcomes: A Pilot Study

Background Considerable research has examined impulsivity between individuals, but less research has focused on whether impulsivity fluctuates within a person. Although previous research supports trait levels of impulsivity as a risk factor for increased alcohol involvement, it is unclear whether daily (i.e., state) fluctuations in impulsivity coincide with same-day drinking behaviors. The present pilot study tested (1) the extent to which impulsivity fluctuates within-person; (2) the influence of daily impulsivity on alcohol use outcomes across all days (i.e., whether drinking occurred, the number of drinks consumed, and intentions to drink) and on drinking days only (i.e., whether heavy episodic drinking occurred and the number of problems experienced); and (3) daily affect as moderators of these relationships. Method Participants were 24 young adult drinkers without postsecondary education who completed a baseline plus 14 follow-up daily surveys. Each day, participants reported their impulsivity, affect, and drinking behavior. Results Multilevel modeling revealed that 42.5% of the variability in daily impulsivity was due to within-person differences. Impulsivity was related to greater odds of heavy episodic drinking and more alcohol-related problems on drinking days. Positive affect moderated the relationship between impulsivity and alcohol-related problems, and the relationship between impulsivity and drinking intentions. Conclusions Findings suggest that changes in positive affect and impulsivity may be a risk factor for alcohol problems in a daily context. Future research examining within-person impulsivity and negative outcomes may benefit from considering positive affect.
CS-31 Safety of hydroxychloroquine withdrawal in older adults with systemic lupus erythematosus

Background Although hydroxychloroquine (HCQ) is a mainstay of treatment for patients with Systemic Lupus Erythematosus (SLE), ocular toxicity can result from accumulated exposure. The introduction of highly sensitive tools has engendered even more concern. As the longevity of patients with SLE improves, additional data will help physicians accurately balance the risk of ocular toxicity and the risk of disease flare, especially in older patients who have stable/quiescent disease. Accordingly, this study was initiated to examine the safety of HCQ withdrawal in older SLE patients. Methods Data were obtained by retrospective chart review at three lupus centers. Twenty-seven patients met the following inclusion criteria:≥4 ACR criteria, disease duration ≥5 years, HCQ use of 200–400 mg per day ≥5 years, and discontinuation of hydroxychloroquine at ≥age 55 years. The comparator group comprised 39 age, gender and racial/ethnic matched patients who remained on HCQ. The primary outcome was a clinically meaningful flare within one year of HCQ withdrawal, defined as moderate or severe, using a revised version of the SELENA-SLEDAI Flare composite that separates mild from moderate flares, evaluates each organ system separately, and incorporates increases in corticosteroid dose and/or addition of immunosuppressive agents. Mild flares were considered secondary outcomes. Results Demographics are provided in table 1. There was a trend toward longer disease duration in the HCQ withdrawal group but no difference in prevalence of prior lupus nephritis between the groups. The reasons for HCQ withdrawal were maculopathy (n=13), presumed/biopsy proven cardiomyopathy (n=2), patient request (n=4), and miscellaneous other reasons (n=8). There was no difference in the primary or secondary outcomes between the groups (table 1). Two patients had a moderate flare after discontinuing HCQ, of whom one had arthritis treated with methotrexate and one had thrombocytopenia (>30K) and proteinuria of 2 grams/d (baseline 700 mg). Three patients had severe flares while continuing HCQ, of whom two were hospitalized, one for seizures and one for pericarditis; the third had worsening nephritis (urinary protein >4 g/d, requiring treatment). Two patients had moderate flares while remaining on HCQ, one of whom had a rash and arthritis treated with tofacitinib and one a rash treated with prednisone. Conclusions In this retrospective study of older patients with SLE on long-term HCQ, withdrawal did not increase the risk of moderate or severe flares. These data provide reassurance regarding the safety of withdrawing HCQ in stable older SLE patients.
Otosyphilis: Resurgence of an Old Disease

Objectives To describe the clinical characteristics of patients presenting with a new diagnosis of otosyphilis over the past 10 years in a large, urban, safety-net hospital affiliated with a large county sexually transmitted disease clinic. Methods Retrospective case series. A chart review was performed of all patients who presented to an adult otolaryngology clinic with a new diagnosis of syphilis and hearing loss from January 2008 to December 2017. Results Twelve patients met the criteria for "suspected" or "likely" otosyphilis based on Centers for Disease Control and Prevention definitions. The average age was 48 years (range 19-59). All were male. Nine (75%) were men who have sex with men. Eight (67%) were positive for human immunodeficiency virus. One (8%) presented with primary, nine (75%) with secondary, and two (17%) with early latent syphilis. Seven (58%) presented with bilateral audiogram-confirmed hearing loss, two (17%) with unilateral hearing loss, and three (25%) with suspected hearing loss based on fluctuating symptoms. Nine (75%) presented with tinnitus and two (17%) with vertigo. The median duration of otologic symptoms prior to presentation was 2 weeks (range: 0-16 weeks). All presented within the last 2 years surveyed. Conclusion We have seen an increase in the number of otosyphilis cases in our clinic. We suspect otosyphilis may be underdiagnosed and emphasize the importance of screening for syphilis in patients with new audiologic symptoms of vertigo, tinnitus, or hearing loss. Level of evidence 4 Laryngoscope, 129:1680-1684, 2019.
Injury-Related Deaths according to Environmental, Demographic, and Lifestyle Factors

Background. Environmental, demographic, and lifestyle variables have been associated with injury-related deaths. The current study identifies the simultaneous association of selected environmental, demographic, and lifestyle variables with deaths from homicide, unintentional injuries, and suicide. Materials and Methods. Analyses are based on county-level mortality data in the contiguous United States, 2011–15. Basic summary statistics and Poisson regression were used to evaluate the data. Results. The selected causes of death were impacted differently by age, sex, and race: for homicide, mortality rates were greater in ages 20–39, males, and blacks; for unintentional injuries, the rates increased with age, most noticeably in the oldest age group, and were highest among males and whites; and for suicide, the rates tended to increase with age and were greater in males and whites. Mortality rates from homicide were positively associated with poverty, cigarette smoking, air temperature, and leisure-time physical inactivity. They were negatively associated with precipitation and sunlight. Mortality rates from unintentional injuries were positively associated with altitude, cigarette smoking, air temperature, poverty, obesity, and precipitation. They were negatively associated with population density. Mortality rates from suicides were positively associated with altitude, cigarette smoking, obesity, air temperature, and precipitation and negatively associated with population density. Conclusion. The results confirm and extend previous research in which death from homicide, unintentional injuries, and suicide are distinctly associated with a combination of environmental, demographic, and lifestyle variables. The findings may be useful in developing strategies for reducing injury-related deaths.
When Is a Child Too Young for Juvenile Court? A Comparative Case Study of State Law and Implementation in Six Major Metropolitan Areas:

There is a dearth of knowledge concerning statutes and practices designed to protect younger children from formal juvenile court petitions. This case study examines minimum age laws and related sta...
Detection of Galactic Dark Matter by GLAST

The mysterious dark matter has been a subject of special interest to high energy physicists, astrophysicists and cosmologists for many years. According to theoretical models, it can make up a significant fraction of the mass of the Universe. One possible form of galactic dark matter, Weakly Interacting Massive Particles (WIMPs), could be detected by their annihilation into monoenergetic gamma-ray line(s). This paper will demonstrate that the Gamma-ray Large Area Space Telescope (GLAST), scheduled for launch in 2005 by NASA, will be capable of searching for these gamma-ray lines in the energy range from 20 GeV to ~500 GeV and will be sufficiently sensitive to test a number of models. The required instrument performance and its capability to reject backgrounds to the required levels are explicitly discussed.
Tool wear and resulting surface finish during micro slot milling of polycarbonates using uncoated and coated carbide tools

A growing application of polycarbonates is in the microfluidic disks and DNA detection devices, where surface finish of the micro-channels plays an important role. This study intends to investigate...
S100A10 Is a Critical Mediator of GAS6/AXL-Induced Angiogenesis in Renal Cell Carcinoma.

Angiogenesis is a hallmark of cancer that promotes tumor progression and metastasis. However, antiangiogenic agents have limited efficacy in cancer therapy due to the development of resistance. In clear cell renal cell carcinoma (ccRCC), AXL expression is associated with antiangiogenic resistance and poor survival. Here, we establish a role for GAS6/AXL signaling in promoting the angiogenic potential of ccRCC cells through the regulation of the plasminogen receptor S100A10. Genetic and therapeutic inhibition of AXL signaling in ccRCC tumor xenografts reduced tumor vessel density and growth under the renal capsule. GAS6/AXL signaling activated the expression of S100A10 through SRC to promote plasmin production, endothelial cell invasion and angiogenesis. Importantly, treatment with the small molecule AXL inhibitor cabozantinib or an ultra-high affinity soluble AXL Fc fusion decoy receptor (sAXL) reduced the growth of a pazopanib-resistant ccRCC patient-derived xenograft. Moreover, the combination of sAXL synergized with pazopanib and axitinib to reduce ccRCC patient-derived xenograft growth and vessel density. These findings highlight a role for AXL/S100A10 signaling in mediating the angiogenic potential of ccRCC cells and support the combination of AXL inhibitors with antiangiogenic agents for advanced ccRCC.
Modeling pulse-cleaning plasma mirrors from dielectric response to saturation: A particle-in-cell approach

Pulse-cleaning plasma mirrors are widely employed to improve ultraintense laser contrast, but much of the literature concerning their effect on the reflected pulse is empirical. A simulation study of pulse-cleaning plasma mirrors using the particle-in-cell code large scale plasma is presented. The importance of capturing initial ionization from neutral atoms, collisional effects, and simulation dimensionality is considered. Excellent agreement with experimental data is obtained when a multiphoton ionization model is employed. Furthermore, a series of 2D simulations is shown to accurately replicate both the reflected light intensity and mode obtained from full 3D simulations at significantly reduced computation cost.
Cold Abscesses and Lymphadenopathy

Treatment of hyper IgE syndrome (HIES) is directed towards prevention and management of infections by using sustained systemic antibiotics and antifungals
2608. Restriction of Rhinovirus Infection Depends on Virus Sensing and Early IFN Induction

Background Human rhinovirus (RV) infections are ubiquitous, underestimated, and costly. RV causes 3–12 infections per year per individual with a wide range of clinical presentations from mild upper respiratory infections to severe viral pneumonias (1). The virus-host interactions that control RV infection are poorly understood. Thus, there are no vaccines or antiviral medications available. RV infection begins at the airway epithelial surface where the virus first encounters the host cell immune defenses, including type I and III interferon (IFN). IFN actions are critical for defense against RV infection wherein interferon-stimulated genes (ISG)s direct antiviral actions to limit RV infection.
Theology in the Reformation period ( c. 1400–1700)

THE LATE MEDIEVAL CONTEXT OF CHURCH AND SOCIETY When Martin Luther famously published his Ninety-five Theses in Wittenberg, he did not intend to create a new church or denomination, but set out to spur on the reform of the Catholic Church of his day. That his attempt at reformation in fact produced the Reformation cannot, however, be comprehended by the sheer force of his theological ideas. Like all major epochs in church history, the Reformation was occasioned by a range of social, political, and cultural forces, in addition to ecclesiastical and theological concerns. Before examining the key issues in the theology of the Reformation, we will briefly survey the harrowed landscape of the church and society of Luther's day that readied his world for major ecclesiastical and theological change. In Chapter 17, we reviewed the rise of the so-called via moderna , associated above all with the name of William of Ockham, which undermined the Thomistic synthesis between nature and grace, and placed a greater emphasis on human works in justification than did previous theologies. The theological flux stirred by the via moderna was one key factor that helped to destabilize the medieval church. While Luther's Reformation project would continue the via moderna 's skepticism concerning the ability of human reason to discern God through the natural world, he reacted vociferously against an Ockhamist construal of justification, in part because of how its emphasis on human works in salvation encouraged other abuses in the church.