cssi/SciSciGPT-SciSciNet huggingface dataset:
Concurrent presentation of brain arteriovenous malformation, peripheral arteriovenous malformation, and cerebellar astrocytoma: Case report.

Author(s): Gautam, Ayushi; Sun, Zhengda; Winkler, Ethan; Su, Hua; McCalmont, Timothy H; Kim, Helen; Tihan, Tarik; Hoffman, William Y; Dowd, Chris F; Frieden, Ilona J; Cooke, Daniel L | Abstract: BackgroundWe report a rare case of a 19-year-old female progressively affected by a peripheral arteriovenous malformation (pAVM), a midline cerebellar astrocytoma, and a brain arteriovenous malformation (bAVM).Case descriptionShe presented with a pulsatile mass on her left cheek, which was classified as a pAVM through angiography. Following treatment with embolization and surgical resection, she returned with enlargement of the mass and imaging incidentally identified a cerebellar astrocytoma. Suboccipital craniotomy, C1 laminectomy, and endoscopic third ventriculostomy were subsequently performed. She was later treated again for growth of her pAVM, and angiography revealed the presence of a left temporal bAVM, which was resected via a pterional craniotomy.ConclusionsPathological staining identified activation of mTOR and RAS/MAPK pathway in the patient's pAVM and bAVM tissue samples. Furthermore, genetic sequencing demonstrated an activating MAPK21 (K57N) mutation in the pAVM and a gain of distal chromosome 7q in the pilocytic astrocytoma. No germline mutation was identified to explain all pathologies. This case demonstrates the need for continued development and further integration of multi-disciplinary genetic, radiological, and neurological treatment teams to effectively care for such complex presentations.
Residential Load Management Using System Frequency and Grid Voltage as Price Indicators

Demand Response is a key component of the Smart Grid, enabling energy savings through load scheduling and reducing the stress on the grid. During peak consumption periods, utilities require a way of communicating with their consumers and sending signals to reduce their load. Setting up a dedicated communication channel for this purpose can be expensive and resource intensive. This project explores the possibility of generating relative price signals locally, i.e. at the consumer node by sensing physical grid quantities such as voltage and frequency and taking action at the household level. A low power prototype is built in order to demonstrate the approach. The experimental results show that using this method results in a lower total cost of electricity usage for the consumer when compared to a base case where loads are not scheduled intelligently.
A Sparse Conjugate Gradient Adaptive Filter

In this letter, we propose a novel conjugate gradient (CG) adaptive filtering algorithm for online estimation of system responses that admit sparsity. Specifically, the Sparsity-promoting Conjugate Gradient (SCG) algorithm is developed based on iterative reweighting methods popular in the sparse signal recovery area. We propose an affine scaling transformation strategy within the reweighting framework, leading to an algorithm that allows the usage of a zero sparsity regularization coefficient. This enables SCG to leverage the sparsity of the system response if it already exists, while not compromising the optimization process. Simulation results show that SCG demonstrates improved convergence and steady-state properties over existing methods.
Idiopathic acute mesenteric venous thrombosis causing ischemic enteritis: A case report

Abstract Introduction Though mesenteric venous thrombosis (MVT) causes bowel ischemia far less frequently than arterial thrombosis, it still has the potential to cause life-threatening bowel infarction. Presentation of case Presented here is a case of idiopathic MVT of the superior mesenteric vein and multiple distal venous branches causing diffuse peritonitis secondary to small bowel infarction in a 64 year old male. History and physical exam demonstrated severe persistent abdominal pain, hematochezia, and diffuse abdominal tenderness to palpation with guarding. Venous filling defects and segmental enteritis were noted on CT. The patient was treated with immediate IV heparin therapy with subsequent laparotomy and excision of 45 cm of ischemic ileum. The patient had an uncomplicated recovery. Post-operative thrombophilia screen was negative. The patient was discharged on indefinite warfarin therapy. Discussion MVT is often idiopathic in nature, with up to 49% having no identifiable cause. Risk factors include abdominal inflammation and systemic thrombophilias. Importantly, bowel infarction is more common with occlusion of more distal, smaller caliber mesenteric vessels. The standard of diagnosis is contrast-enhanced abdominal CT, and management is prompt anticoagulation with surgical intervention if severe. If the cause remains unclear, outpatient anticoagulation is continued indefinitely. Conclusion This case provides a valuable demonstration of several important MVT concepts – specifically the high rate of idiopathic etiology, the need for indefinite anticoagulation in idiopathic cases, and the increased risk of infarction in occlusion of smaller, more distal mesenteric veins.
A Global Temporal Genetic Program for Neural Circuit Formation

Wiring a complex brain relies on cell-type and temporal specific expression of genes encoding cell recognition molecules regulating circuit formation1−3. Though genetic programs driving cell type specificity have been described4−6, how precise temporal control is achieved remains unknown. Here, we describe a global program for the temporal regulation of cell type specific wiring genes in the Drosophila visual system. We show that the Ecdysone Receptor induces a synchronous cascade of transcription factors in neurons throughout the visual system in a highly stereotyped fashion. Single cell RNA seq analysis of neurons lacking transcription factors in the cascade revealed that targets are cell type dependent and these are enriched for wiring genes. Knock down of different transcription factors in this cascade led to defects in sequential steps in wiring. Taken together, this work identifies a synchronous, global program for temporal control of different sets of wiring genes in different neurons. We speculate that this global program coordinates development across cell types to choreograph specific steps in circuit assembly.
TRADER: trace divergence analysis and embedding regulation for debugging recurrent neural networks

Recurrent Neural Networks (RNN) can deal with (textual) input with various length and hence have a lot of applications in software systems and software engineering applications. RNNs depend on word embeddings that are usually pre-trained by third parties to encode textual inputs to numerical values. It is well known that problematic word embeddings can lead to low model accuracy. In this paper, we propose a new technique to automatically diagnose how problematic embeddings impact model performance, by comparing model execution traces from correctly and incorrectly executed samples. We then leverage the diagnosis results as guidance to harden/repair the embeddings. Our experiments show that TRADER can consistently and effectively improve accuracy for real world models and datasets by 5.37% on average, which represents substantial improvement in the literature of RNN models.
An Improved Online Penalty Parameter Selection Procedure for $\ell_1$-Penalized Autoregressive with Exogenous Variables.

Many recent developments in the high-dimensional statistical time series literature have centered around time-dependent applications that can be adapted to regularized least squares. Of particular interest is the lasso, which both serves to regularize and provide feature selection. The lasso requires the specification of a penalty parameter that determines the degree of sparsity to impose. The most popular penalty parameter selection approaches that respect time dependence are very computationally intensive and are not appropriate for modeling certain classes of time series. We propose enhancing a canonical time series model, the autoregressive model with exogenous variables, with a novel online penalty parameter selection procedure that takes advantage of the sequential nature of time series data to improve both computational performance and forecast accuracy relative to existing methods in both a simulation and empirical application involving macroeconomic indicators.
A Review of “Forensic Dentistry”

This compact 158-page, nine-chapter text presents a collection of various topics of or related to forensic dentistry. The authors and contributors are composed of several persons who have published numerous articles concerning the field in the world literature. The book is definitely intended for a person with a dental background and represents a rather thorough coverage of particular areas within the field of forensic dentistry. The subject material is handled in excellent academic fashion with complete supporting bibliographic references. In review of the text as a whole, a broad overall continuous presentation of the scope of forensic dentistry fails to come across. Perhaps this is due to the fact that multiple contributors are involved. At any rate, one receives the impression that the book is one of a collection of isolated treatises upon selected topics within or related to forensic dentistry. For this reason, the work is best suited for one who already possesses some experience in forensic dentistry. For the latter individual, the publication represents a special treat, especially in the subject matter dealing with tooth and age estimation and radiological identification. The presentation of these two chapters alone makes the book well worth its modest price. The chapter on bite marks is also concise and well organized. The book does not fulfill the statement “. . . the book is as invaluable as Gustafson's original guide to the subject” as included in the foreword and upon the front coverleaf. Nevertheless, the text does possess several areas of great merit and interest as indicated, and should be a permanent fixture in the library of any dentist with an interest in forensic dentistry.
Good for what? Social rank, character, and moral judgment

The person-centered account of moral judgment suggests an evolutionary explanation for two puzzling findings from moral psychology: that people judge an act that had bad side effects as more intent...
La formación endógena de acuerdos sostenibles de comercio

Este articulo se refiere a la formacion de acuerdos endogenos de libre comercio en un modelo de competencia imperfecta entre tres paises. Teniendo en cuenta que la literatura ha ignorado en ocasiones el requisito de sostenibilidad en las areas de libre comercio, el articulo propone una estructura para predecir que acuerdos comerciales se forman cuando la sostenibilidad es explicitamente incluida como una restriccion en la formacion de acuerdos cooperativos. Se encuentra que la introduccion de un requisito de auto-ejecucion reduce el alcance general de los acuerdos comerciales y que las areas comerciales preferenciales pueden ser puntos de apoyo o impedimentos, dependiendo de la demanda relativa entre los paises.
School Leadership Burnout and Job-Related Stress: Recommendations for District Administrators and Principals

Principals are critical to improving schools, but job-related stress and burnout are factors that can limit principal effectiveness and lead to untimely turnover. Extant literature, leadership prep...
Optimization of Tape Casting for Fabrication of Li6.25Al0.25La3Zr2O12 Sheets

Tape casting is an attractive technology for the scalable manufacturing of thin lithium garnet electrolyte (LLZO) layers for solid state battery applications. Processing of LLZO is complicated by m...
Point-of-care program in HIV, tuberculosis, and associated conditions: A virtual global technical assistance platform to strengthen HIV and tuberculosis workforce capacity.

Abstract A global multi-disciplinary faculty was established to work collaboratively and provide virtual technical assistance, using a point-of-care continuing education model, to clinicians across the world engaged in the care of patients with either HIV infection or tuberculosis. Ancillary offerings included live or virtual lectures, case-based conferences, and courses. In spite of the considerable disruption of the program due to the COVID-19 pandemic, we engaged and assisted a substantial number of clinicians across the world and provided meaningful contributions to their continuous professional development and patient care. In light of the ongoing pandemic, virtual technical assistance models such as this should be scaled to continue essential high-quality HIV/TB services.
Big Data in Nephrology.

A huge array of data in nephrology is collected through patient registries, large epidemiological studies, electronic health records, administrative claims, clinical trial repositories, mobile health devices and molecular databases. Application of these big data, particularly using machine-learning algorithms, provides a unique opportunity to obtain novel insights into kidney diseases, facilitate personalized medicine and improve patient care. Efforts to make large volumes of data freely accessible to the scientific community, increased awareness of the importance of data sharing and the availability of advanced computing algorithms will facilitate the use of big data in nephrology. However, challenges exist in accessing, harmonizing and integrating datasets in different formats from disparate sources, improving data quality and ensuring that data are secure and the rights and privacy of patients and research participants are protected. In addition, the optimism for data-driven breakthroughs in medicine is tempered by scepticism about the accuracy of calibration and prediction from in silico techniques. Machine-learning algorithms designed to study kidney health and diseases must be able to handle the nuances of this specialty, must adapt as medical practice continually evolves, and must have global and prospective applicability for external and future datasets. Application of big data in nephrology could lead to new insights into kidney diseases, facilitate personalized medicine and improve patient care. This Review discusses the major sources of big data in nephrology and how they could be utilized in research and clinical practice.
Spatial relationships of intra-lesion heterogeneity in Mycobacterium tuberculosis microenvironment, replication status, and drug efficacy

A hallmark of Mycobacterium tuberculosis (Mtb) infection with critical impact on disease development and outcome is the marked heterogeneity that exists, spanning differences in lesion types to changes in microenvironment as the infection progresses1-7. A mechanistic understanding of how this heterogeneity affects Mtb growth and treatment efficacy necessitates single bacterium-level studies in the context of intact host tissue architecture; however, such an evaluation has been technically challenging. Here, we exploit fluorescent reporter Mtb strains and the C3HeB/FeJ murine model in an integrated imaging approach to study microenvironment heterogeneity within a single lesion in situ, and analyze how these differences relate to non-uniformity in Mtb replication state, activity, and drug efficacy. We show that the pH and chloride environments differ spatially in a caseous necrotic lesion, with increased acidity and chloride levels in the lesion cuff versus the necrotic core. Conversely, a higher percentage of Mtb in the necrotic core versus the lesion cuff were in an actively replicating state, and correspondingly active in transcription and translation. Finally, examination of three first-line anti-tubercular drugs showed that efficacy of isoniazid was strikingly poor against bacteria in the lesion cuff. Our study reveals spatial relationships of intra-lesion heterogeneity, sheds light on important considerations in the development of anti-tubercular treatment strategies, and establishes a foundational framework for Mtb infection heterogeneity analysis at the single cell level in situ.
The Bearing of Prognosis on the Ethics of Medicine: Congenital Anomalies, the Social Context and the Law

In their retrospective evaluation of clinical rounds in medical ethics at Children’s Hospital Medical Center in Boston, Melvin Levine, Lee Scott and William Curran surveyed the most frequently recurring issue which emerged in these sessions over a five-year period. Among some 17 issues and topics the question ‘Who should decide?’ emerged most frequently (37%). ‘Acting on uncertain prognosis’ involved only 6% of the cases and ranked in the 16th position ([24], p. 204). The point of interest here is the tendency of the researchers to qualify the topic of prognosis with the term ‘uncertain’. The underlying assumption is clear: prognostications are typically uncertain since they are based on what Dr. Mark Siegler calls ‘subjective appraisals’ ([43], p. 857). There is a tendency to assume that prognoses are in principle highly uncertain. This prevailing attitude perhaps accounts for the fact that many physicians consider prognoses as not really helpful and at times even harmful. This latter view is supported by arguments in Dr. Siegler’s essay “Pascal’s Wager and the Hanging of Crepe” [43].
LINE-1 DNA Methylation, Smoking and Risk of Parkinson's Disease

Background Long interspersed nucleotide element-1 (LINE-1) retrotransposons are located throughout the human genome. Those retaining an intact 5' promoter can copy and insert themselves into the DNA of neural progenitor cells that express tyrosine hydroxylase, which may influence differentiation and survival of these cells. LINE-1 promoter methylation is associated with decreased LINE-1 propagation. Objective To investigate whether LINE-1 promoter methylation is associated with Parkinson's disease (PD). Methods We compared LINE-1 methylation profiles in blood mononuclear cells between 292 newly diagnosed PD cases and 401 unrelated, neurologically normal controls, all non-Hispanic Caucasians in western Washington state. Results Overall, PD was not associated with percent methylation of the LINE-1 promoter. However, the predictable inverse association between PD and ever smoking tobacco was strongest for men and women with the lowest LINE-1 promoter methylation, and less apparent as LINE-1 methylation increased. Underlying this possible interaction, ever regularly smoking tobacco was associated with decreased LINE-1 methylation in controls (age- and sex-adjusted linear regression β = -0.24, 95% confidence interval [CI] -0.43, -0.04), but not in cases (β = 0.06, 95% CI -0.17, 0.28, interaction p = 0.06). Conclusion PD cases may have innate differences in their ability to respond to tobacco smoke.
Effect of Nippostrongylus brasiliensis infection on anti-hapten IgE antibody response in the mouse. I. Induction of carrier specific helper cells.

Abstract Inoculation of infective larvae of Nippostrongylus brasiliensis into A/J, BALB/c, and SJL mice primed intraperitoneally (ip) 3 weeks before infection with 1 μg of dinitrophenylated keyhole limpet hemocyanin (DNP-KLH) mixed with 1 mg Al(OH)3 induced a carrier effect on anti-DNP IgE and IgG1 antibody responses when the experimental mice were secondarily immunized with an ip injection of 1 μg of DNP-coupled N. brasiliensis extract (DNP-Nb) plus alum 2 weeks after infection. The magnitude of the hapten specific antibody response did not correlate rigidly with the number of larvae in the inoculum. Thus, a dose of 100 larvae was as effective in inducing the carrier effect as a dose of 800 larvae. Kinetic studies in A/J and BALB/c mice revealed that the anti-DNP IgE antibody response reached a maximum titer 7 days after the secondary immunization. These studies also showed that the enhanced IgE antibody response persisted for more than 40 days, while the response in all control groups terminated prior to that time. Using the adoptive transfer system, it was demonstrated that lymphoid cells obtained from the spleens or the mesenteric lymph nodes of infected mice cooperated with DNP-KLH primed cells to produce hapten specific IgE and IgG, antibodies when the challenge was made with DNP-Nb but not when it was made with 1 μg DNP-ovalbumin, clearly indicating carrier specificity. The helper activity of the cells obtained from infected mice was completely abolished or greatly reduced by the in vitro treatment with anti-θ serum and complement. The helper cells with maximum activity were present as early as 14 days after inoculation. The level of helper activity gradually decreased after 14 days. The results indicate that N. brasiliensis infection is effective in inducing carrier specific helper cells of thymic origin (T cells) in anti-DNP antibody responses. These results confirm those obtained by other investigators and add the new observation that N. brasiliensis infection elicits special helper T cells which induce an enhancement as well as a prolongation of anti-DNP IgE antibody response.
SOME RECENT DEVELOPMENTS IN TECHNIQUE FOR MONITORING HIGH-ENERGY ACCELERATOR RADIATION

Abstract In order to accurately evaluate the exposures received by individuals working near high-energy accelerators it is necessary to measure the separate components in the radiation field and to determine their energy spectrum. Since no single instrument or detector will do this, a variety of different detectors and instruments must be used. Three recent developments in technique for monitoring particulate radiation above 20 MeV use nuclear emulsion, elemental mercury, and Be7 production in light elements; below 20 MeV, the use of moderated foils of In, Au, and Co has been extended to include Ta. When emulsion is used, the number of stars formed by high-energy inelastic collisions is counted, together with the number of gray prongs. The ratio of gray prongs per star was previously found to be linearly related to the energy of the neutron which formed the star, over the energy range 20 to 300 MeV. This technique is used to measure average neutron energy and to estimate spectrum shape for neutron energies above 20 MeV. A second technique makes use of the spallation of Hg to Tb149, an alpha-emitter of 4.12-hr half-life. The threshold for this reaction is near 500 MeV, and it therefore extends the use of threshold detectors for the estimation of spectrum shape to a higher energy domain and gives additional confidence in previous estimates of spectrum shape made with Bi fission, C12(n, 2n)C11, and A127(n, a)Na24. Thirdly, production of Be7 from C12, N14, and O16 has been studied; it offers a method of high-energy neutron threshold detection with practical thresholds extending from 30 to 40 MeV for carbon to 45 to 55 MeV for oxygen. The practical sensitivity can be arbitrarily high without making the extraction process either too lengthy or unwieldy. Another recent development involves the inclusion of Ta in the class of detectors which use a thermal-neutron-sensitive activation element inclosed in a Cd-clad hydrogenous moderator to allow an integration period of a few months and a sensitivity considerably greater than with Co. Finally, recent improvements in the performance of our large parallel-plate Bi fission chamber are discussed.
Arachidonic acid inhibits myosin light chain phosphatase and sensitizes smooth muscle to calcium

Abstract Arachidonic acid (AA) increased, at constant Ca2+, the levels of force and 20-kDa myosin light chain (MLC20) phosphorylation in permeabilized smooth muscle, and slowed relaxation and MLC20 dephosphorylation. The Ca(2+)-sensitizing effect of AA was not inhibited by inhibitors of AA metabolism (indomethacin, nordihydroguaiaretic acid, or propyl gallate), of protein kinase C (pseudopeptide) or by guanosine-5'-O-(beta-thiodiphosphate) and was abolished by oxidation of AA in air. A non-metabolizable AA analog, 5,8,11,14-eicosatetraynoic acid) also had Ca(2+)-sensitizing effects. Extensive treatment with saponin abolished the Ca(2+)-sensitizing effects of phorbol 12,13-dibutyrate and guanosine-5'-O-(gamma-thiotriphosphate), but not that of AA. A purified, oligomeric MLC20 phosphatase isolated from gizzard smooth muscle was dissociated into subunits by AA, and its activity was inhibited toward heavy meromyosin but not phosphorylase. We conclude that AA may act as a messenger-promoting protein phosphorylation through direct inhibition of the form of protein phosphatase(s) that dephosphorylate MLC20 in vivo.
Mechanical forces and their second messengers in stimulating cell growth in vitro

Mechanical forces play an important role in modulating the growth of a number of different tissues including skeletal muscle, smooth muscle, cardiac muscle, bone, endothelium, epithelium, and lung....
IMOUTA: a proposal for patient care handoffs.

Objectives/Hypothesis An increased frequency of patient handoffs has occurred as a result of the new resident work-hour restrictions that have recently been instituted. Inadequate handoff of patient care has been associated with adverse patient events due to residents being unprepared for events that happen during cross cover periods. The objective of our study was to develop and test the effectiveness of a patient handoff method in an otolaryngology residency program. Study Design Single-blinded controlled clinical trial. Methods A standardized, anonymous questionnaire was developed that scored on-call residents' understanding of their patients' diagnoses, hospital courses, active concerns, and treatment plans. For the first 45 days, residents used their traditional handoff. This handoff was prepared by the residents, relaying relevant patient information without any structured format. For the next 45 days, the residents followed the acronym of IMOUTA for handoffs. This mnemonic was developed to help residents identify data (I), medical course (M), outcomes possible tonight (OU), responsibilities to do tonight (T), and opportunity to ask questions and give morning feedback in the AM (A). The questionnaires were then compared at the end of the study. Results The residents who used the IMOUTA acronym scored significantly higher on their perceived knowledge of patients diagnoses (P = 0.001), hospital courses (P <0.001), active concerns (P <0.001), and treatment plans (P <0.001). Conclusion Residents felt significantly better prepared for call duties when using the IMOUTA acronym. This standardized system of patient handoff may also be valuable to other residency programs. Level of Evidence N/A. Laryngoscope, 123:2649–2653, 2013
Concentration dependence of the magnetic properties in amorphous Fe-P-B alloys

The concentration dependence of the magnetic properties of amorphous Fe-P-B alloys obtained by splat-cooling is discussed. For a given Fe concentration, the magnetic moment \bar{\mu} averaged over all atoms of material and the Curie temperature T c both increase with the substitution of B for P. We observed for the variation of \bar{\mu} and T c as a function of the B content the same discontinuity as that occurring between the two phases \varepsilon and \varepsilon_{1} of the crystalline Fe 3 P 1-x B x compounds. We studied also the variation of \bar{\mu} and T c when one metalloid (P or B) substitutes for Fe, the other metalloid remaining constant. \bar{\mu} was found to decrease when the P (or B) content is increased, as expected from a rigid band model. For the same concentrations, T c increases. The different behaviours of \bar{\mu} and T c are tentatively explained by assuming that the amorphous Fe has two magnetic states (ferro and antiferromagnetic) as already suggested for crystalline Fe in a fcc environment.
Cavitation as a mechanism of substrate discrimination by adenylosuccinate synthetases

Adenylosuccinate synthetase catalyzes the first committed step in the de novo biosynthesis of AMP, coupling L-aspartate and IMP to form adenylosuccinate. Km values of IMP and 2'-deoxy-IMP are nearly identical with each substrate supporting comparable maximal velocities. Nonetheless, the Km value for L-aspartate and the Ki value for hadacidin (a competitive inhibitor with respect to L-aspartate) are 29-57-fold lower in the presence of IMP than in the presence of 2'-deoxy-IMP. Crystal structures of the synthetase ligated with hadacidin, GDP, and either 6-phosphoryl-IMP or 2'-deoxy-6-phosphoryl-IMP are identical except for the presence of a cavity normally occupied by the 2'-hydroxyl group of IMP. In the presence of 6-phosphoryl-IMP and GDP (hadacidin absent), the L-aspartate pocket can retain its fully ligated conformation, forming hydrogen bonds between the 2'-hydroxyl group of IMP and sequence-invariant residues. In the presence of 2'-deoxy-6-phosphoryl-IMP and GDP, however, the L-aspartate pocket is poorly ordered. The absence of the 2'-hydroxyl group of the deoxyribonucleotide may destabilize binding of the ligand to the L-aspartate pocket by disrupting hydrogen bonds that maintain a favorable protein conformation and by the introduction of a cavity into the fully ligated active site. At an approximate energy cost of 2.2 kcal/mol, the unfavorable thermodynamics of cavity formation may be the major factor in destabilizing ligands at the L-aspartate pocket.
Early aggressive DMARD therapy: the key to slowing disease progression in rheumatoid arthritis.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation, joint destruction, progressive disability, and premature death. Patients at risk for poor prognoses can be identified by a variety of prognostic indicators. These include sociodemographic factors (e.g., older age, female sex), clinical indicators (e.g., higher joint counts), laboratory variables (e.g., higher erythrocyte sedimentation rate, high rheumatoid factor titer), and radiographic indicators (e.g., the presence of bone erosions). Patients with a poor prognosis, as evidenced by the presence of one or more indicators of poor outcome, should be treated promptly and aggressively with disease-modifying antirheumatic drugs (DMARDs) or combination DMARD therapy to limit or prevent further disease progression. Limiting the severity of RA with early and aggressive treatment is the best way to minimize the dire consequences of untreated or inadequately treated disease.
CARDIAC SIZE AND FUNCTION IN SCHOOL ATHLETES AT REST AND AFTER EXERCISE

To determine the effect of high school athletics on cardiac structure and function, we performed 2-D directed M-Mode echos on students involved in isometric (IM) and isotonic (IT) sports and compared them to non-athletic controls (C). Measurements were made at rest and immediately after stage 4 treadmill exercise. Twenty students were included in each group. LV mass was greater in both in and IT compared to C (C 111±4, IM 132±3, IT 130±4 g/M2, p . In IT LV diastole volume (LVDV) was increased with normal wall thickness/radius ration (t/r), whereas, in IM, LVDV was normal but, t/r was increased. Stroke index (SI) was increased in IT (C 44±1.7, IM 46±1.6, IT 52.3±2.0 ml/M2, p<0.02). Cardiac index (CI) and shortening fractions were similar among the three groups. After exercise LVDV and systolic volume decreased in both C and IT but, remained unchanged in IM. CI increased with exercise in all groups. Although resting systolic (S), diastolic (D), and mean (M), blood pressures (BP) were similar in all groups, after exercise both C and IT had an increase in SBP, (C 39%, IT 32%) and a fall in DBP, (C-26%), IT-27%) HBP remained unchanged. In IM, SBP rose less, 22%, and DBP fell less, −18%. These data suggest that students engaged in ordinary school sports can develop either eccentric or concentric LVH depending upon the type of sport. The IM athlete appears to have a thicker, less compliant LV and demonstrates less change in blood pressure with exercise.
Decrepitation and thermal decomposition of dolomite

Abstract A commercially available dolomite was split into six different particle size ranges and thermogravimetric and differential thermal analysis was performed on each of these samples. XRD was performed on each size range before TGA with no differences found. Chemical analysis was performed only on the bulk material. The particle size was found to affect the shape but not necessarily the position of the DTA curve. Decrepitation was found to be most affected by particle size. These data were evaluated in an effort to explain the decrepitation and thermal decomposition of dolomite
Isolating the Information Content of Equity Analysts' Recommendation Changes, Post Reg FD

We investigate the information content of equity analysts' recommendation changes subsequent to the passage of Regulation Fair Disclosure. We find that analyst upgrades (downgrades) are associated with positive (negative) abnormal returns. Overall, stock prices tend to react significantly more strongly to recommendation changes accompanied by news events than to those that are not. Even so, returns around recommendation changes not accompanied by news are significantly different from zero. This result holds after controlling for firm-specific variables and the incidence of multiple simultaneous recommendation changes. We conclude that analyst recommendation changes, in and of themselves, are informative.
Determination of mixing parameters from tracer distributions in deep-sea sediment cores

Abstract Computer optimization and approximate analytical procedures are developed for the determination of the depth of bioturbation mixing, d , and the mixing coefficient, D , for instantaneous tracer inputs. The methods have been applied to observations of microtektites, volcanic ash and pumice in sixteen deep-sea sediment cores. The values for d are well determined, generally with confidence intervals of a few centimeters or less and with an average value of d = 11 cm for the sixteen cores. The values for D are determined to first figure accuracy, at best, with values of around 10 cm 2 ka −1 or greater.
Automated protein resonance assignments of magic angle spinning solid-state NMR spectra of β1 immunoglobulin binding domain of protein G (GB1)

Magic-angle spinning solid-state NMR (MAS SSNMR) represents a fast developing experimental technique with great potential to provide structural and dynamics information for proteins not amenable to other methods. However, few automated analysis tools are currently available for MAS SSNMR. We present a methodology for automating protein resonance assignments of MAS SSNMR spectral data and its application to experimental peak lists of the β1 immunoglobulin binding domain of protein G (GB1) derived from a uniformly 13C- and 15N-labeled sample. This application to the 56 amino acid GB1 produced an overall 84.1% assignment of the N, CO, CA, and CB resonances with no errors using peak lists from NCACX 3D, CANcoCA 3D, and CANCOCX 4D experiments. This proof of concept demonstrates the tractability of this problem.
Evidence for a genetic aetiology in reading disability of twins

Reading disability (dyslexia) is a major social, educational, and mental health problem. Although estimates of prevalence vary, up to 10-15% of school-age children have severe reading deficits in spite of average intelligence and adequate educational opportunity. That reading disability may have a constitutional basis has long been recognized, and results of twin and family studies suggest that one or more of its forms may be heritable; however, definitive evidence for a genetic aetiology has not been reported. Establishing a heritable basis for reading disability could suggest possible causes, give improved risk estimates, facilitate early diagnosis, and provide validity tests for ostensible subtypes. In this report, we apply a recently developed multiple regression analysis to data collected from a sample of 64 pairs of identical twins and 55 pairs of fraternal twins, in which at least one member of the pairs is reading disabled, and present evidence for a significant genetic aetiology.
Communication and Collaboration: Creating a Culture of Teamwork Through the Use of TeamSTEPPS Strategies

Professional Issues Poster Presentation Purpose for the Program To improve patient safety and satisfaction by implementing an evidence‐based system to enhance communication and teamwork skills among healthcare professionals. Proposed Change TeamSTEPPS is an innovative program that works to solidify collaboration among the healthcare team to achieve the best outcomes for patients. A multidisciplinary group committed to changing the culture of the department attended the TeamSTEPPS master training course. The team identified communication as a recurring problem that threatened patient safety and satisfaction. The team then developed the department‐wide "snapshot" as an intervention to improve communication. Implementation, Outcomes, and Evaluation The women's services department consists of high‐risk labor and delivery (L&D), well‐baby nursery, level II and level III neonatology units, mother–baby couplet unit, and perinatal special care unit. Direct patient care providers from the departmental units attended the TeamSTEPPS fundamentals 4‐hour interactive workshop. This workshop provided hands‐on learning experience of the TeamSTEPPS philosophy as well as an opportunity to practice the TeamSTEPPS behaviors. At 8 a.m. and 8 p.m. daily, the obstetric (OB) faculty member on duty conducts the interdisciplinary department‐wide "snapshot." The snapshot is a scripted report that begins with the OB faculty giving L&D staff the big picture report. Next, the L&D team lead nurse reports on inductions, surgeries, expected patients, antepartum unit census and concerns, OB triage status, and patients waiting for beds and staffing. The OR nurse discusses concerns about scheduled cases and the mother–baby team lead nurse reports census, discharges, and concerns. The nurse–midwife and family medicine resident report on admitted patients and bring to light any concerns they may have. Next, staff from the anesthesia department discuss the OR cases, epidurals infusing, problem epidurals, and anticipated high‐risk cases. The staff from the neonatology department then has an opportunity to discuss any concerns. To close the snapshot, the OB faculty clearly states, "If any team member sees anything unsafe or not in the best interests of our patients, we expect you to speak up. If you are unable to get a timely or effective response, call me, OB faculty, Dr. _______." Improved communication has been evidenced by expediting safe mother–baby discharges during periods of increased census, improved operating room productivity, timely and effective neonatology consultations, and accessibility and accountability of the OB faculty member on duty. Implications for Nursing Practice Effective collaboration and communication are essential elements of professional nursing. The department‐wide snapshot encourages nurses to be actively involved in the multidisciplinary healthcare team and make valuable, evidence‐based contributions to patient safety and satisfaction.
A most stubborn bias: No adjustment method fully resolves confounding by indication in observational studies

Abstract Objective To evaluate the effectiveness of methods that control for confounding by indication, we compared breast cancer recurrence rates among women receiving adjuvant chemotherapy with those who did not. Study Design and Setting In a medical record review-based study of breast cancer treatment in older women ( n =1798) diagnosed between 1990 and 1994, our crude analysis suggested that adjuvant chemotherapy was positively associated with recurrence (hazard ratio [HR]=2.6; 95% confidence interval [CI]=1.9, 3.5). We expected a protective effect, so postulated that the crude association was confounded by indications for chemotherapy. We attempted to adjust for this confounding by restriction, multivariable regression, propensity scores (PSs), and instrumental variable (IV) methods. Results After restricting to women at high risk for recurrence ( n =946), chemotherapy was not associated with recurrence (HR=1.1; 95% CI=0.7, 1.6) using multivariable regression. PS adjustment yielded similar results (HR=1.3; 95% CI=0.8, 2.0). The IV-like method yielded a protective estimate (HR=0.9; 95% CI=0.2, 4.3); however, imbalances of measured factors across levels of the IV suggested residual confounding. Conclusion Conventional methods do not control for unmeasured factors, which often remain important when addressing confounding by indication. PS and IV analysis methods can be useful under specific situations, but neither method adequately controlled confounding by indication in this study.
An algorithmic approach to error localization and partial recomputation for low-overhead fault tolerance

The increasing size and complexity of massively parallel systems (e.g. HPC systems) is making it increasingly likely that individual circuits will produce erroneous results. For this reason, novel fault tolerance approaches are increasingly needed. Prior fault tolerance approaches often rely on checkpoint-rollback based schemes. Unfortunately, such schemes are primarily limited to rare error event scenarios as the overheads of such schemes become prohibitive if faults are common. In this paper, we propose a novel approach for algorithmic correction of faulty application outputs. The key insight for this approach is that even under high error scenarios, even if the result of an algorithm is erroneous, most of it is correct. Instead of simply rolling back to the most recent checkpoint and repeating the entire segment of computation, our novel resilience approach uses algorithmic error localization and partial recomputation to efficiently correct the corrupted results. We evaluate our approach in the specific algorithmic scenario of linear algebra operations, focusing on matrix-vector multiplication (MVM) and iterative linear solvers. We develop a novel technique for localizing errors in MVM and show how to achieve partial recomputation within this algorithm, and demonstrate that this approach both improves the performance of the Conjugate Gradient solver in high error scenarios by 3x-4x and increases the probability that it completes successfully by up to 60% with parallel experiments up to 100 nodes.
Mass density inferred from toroidal wave frequencies and its comparison to electron density

[1] We have estimated the magnetospheric local mass density using the frequency of the toroidal standing Alfven waves detected with the magnetic (B) and electric (E) field experiments on the Combined Release and Radiation Effects Satellite (CRRES), which had a low-latitude elliptical orbit (6.3 RE apogee and 18° inclination). A 73-day period in 1991, which included several geomagnetic storms, was chosen for analysis because the spacecraft was located on the afternoon sector where toroidal waves are routinely excited. Dynamic spectra of the B and E fields were generated for each CRRES orbit for visual identification of toroidal mode ULF waves excited at a number of harmonics. The fundamental mode is the most persistent feature in the spectra, and this mode appears more clearly in the electric field than in the magnetic field. For statistical analysis we determined the fundamental frequency f1 from a separate set of electric field spectra that were computed in a moving 20-min time window with 10-min overlap. The frequency is in the range of 1.7–14.2 mHz. The local mass density consistent with f1 was obtained by numerically solving a magnetohydrodynamic wave equation that incorporated the Tsyganenko magnetic field model and an analytical form of field-line mass density variation that was derived from a recent study of toroidal harmonics. We combined the estimated mass density with the local electron number density ne derived from the plasma wave spectra at CRRES to obtain the local average ion mass M (=ρ/ne). A total of 1094 M samples were obtained, with the majority (95%) coming from the plasmatrough region (ne 100 cm−3).
Supercurrent and the Adler-Bardeen theorem in coupled supersymmetric Yang-Mills theories

We construct the supercurrent and a supersymmetric current which satisfies the Adler-Bardeen theorem in supersymmetric Yang-Mills theory coupled to non-self-interacting chiral matter. Using the formulation recently developed by Grisaru, Milewski, and Zanon, supersymmetry and gauge invariance are maintained with supersymmetric background-field theory and regularization by dimensional reduction. We verify the finiteness of the supercurrent to one loop, and the Adler-Bardeen theorem to two loops by explicit calculations in the minimal-subtraction scheme. We then demonstrate the subtraction-scheme independence of the one-loop Adler-Bardeen anomaly and prove the existence of a subtraction scheme in which the Adler-Bardeen theorem is satisfied to all orders in perturbation theory.
Transthyretin Pro 36 associated with familial amyloidotic polyneuropathy in an Ashkenazic Jewish kindred

Mutations in the serum protein transthyretin (TTR) cause amyloidosis involving the peripheral nerves, heart, and other organs. In Ashkenazic Jews, the only TTR variant described to date has been TTR Ile 33. We have studied DNA from another Ashkenazic Jewish kindred with familial amyloidotic polyneuropathy. Singlestrand conformation polymorphism analysis, DNA sequencing, and restriction analysis indicated that this kindred has the TTR Pro 36 variant, previously described only in a Greek kindred.
N-scaling algorithm for density-functional calculations of metals and insulators.

An algorithm for minimization of the density-functional energy is described that replaces the diagonalization of the Kohn-Sham Hamiltonian with block diagonalization into explicit occupied and partially occupied (in metals) subspaces and an implicit unoccupied subspace. The progress reported here represents an important step toward the simultaneous goals of linear scaling, controlled accuracy, efficiency, and transferability. The method is specifically designed to deal with localized, [ital nonorthogonal] basis sets to maximize transferability and state-by-state iteration to minimize any charge-sloshing instabilities. It allows the treatment of metals, which is important in itself, and also because the dynamics of semiconducting'' systems can result in metallic phases. The computational demands of the algorithm scale as the particle number, permitting applications to problems involving many inequivalent atoms.
Information requirements assessments of the Humphrey Institute

Extensive assessments of the information requirements of the Humphrey Institute were conducted. The purposes of these assessments were to describe the current information environment of the Institute and to identify the kinds of supports that the proposed IIC could provide to facilitate the information processing activities of the Institute
Spatial-bisection acuity in infantile nystagmus

This study measured spatial bisection acuity for horizontally and vertically separated line targets in five observers with infantile nystagmus syndrome (INS) and no obvious associated sensory abnormalities, and in two normal observers during comparable horizontal retinal image motion. For small spatial separations between the line targets, bisection acuity for both horizontally and vertically separated lines is worse in the observers with IN than normal observers. In four of the five observers with IN, bisection acuity for small target separations is poorer for horizontally compared to vertically separated lines. Because the motion smear generated by the retinal image motion during IN would be expected to influence horizontally separated targets, the degradation of bisection acuity for both vertical and horizontally separated lines indicates that a sensory neural deficit contributes to impaired visual functioning in observers with idiopathic IN.