cssi/SciSciGPT-SciSciNet huggingface dataset:
Managed care of chronically ill older people: the US experience

The continuing debate over changes in geriatric care in the United Kingdom could be informed by some difficult lessons learnt from recent developments in the United States.1 Medicare, created by US law in 1965, is a low cost health insurance programme that is available to most Americans aged 65 or older and to some disabled younger people. Medicare is a traditional indemnity insurance plan that reimburses physicians, hospitals, and other professionals for providing Medicare beneficiaries with acute healthcare services. The coverage does not include drugs or, with few exceptions, preventive or long term care services. #### Summary points The US Medicare health maintenance organisation industry has produced evidence on the cost effectiveness of new approaches to caring for elderly people Some innovations change how and where health care is provided; others focus on educating patients and adapting their behaviour Economic and organisational forces mean that most Medicare health maintenance organisations are reluctant to invest in new forms of care, even where programmes seem effective Purchasers of health care for chronically ill older people should offer capitation payments that reflect each older person's probable need for health resources in the future Purchasers should also facilitate the collection and public distribution of data about the quality and the outcomes of the care delivered by each provider In the mid-1980s Medicare began looking to “managed care” to help control its runaway expenditure. Under managed Medicare, an insurance company known as a health maintenance organisation accepts from the Medicare programme a fixed capitation payment for each person it enrolls, and it agrees to provide that person with at least the standard package of Medicare benefits. The amount of the capitation payment is based on the person's age, sex, income, type of residence (nursing home or independent dwelling), and geographical location. The health maintenance organisation may, at …
Principles of delta fractional calculus on time scales and inequalities

Here we develop the Delta Fractional Calculus on Time Scales. Then we produce related integral inequalities of types: Poincare, Sobolev, Opial, Ostrowski and Hilbert-Pachpatte. Finally, we give inequalities' applications on the time scale R.
Catamenial Pneumothorax in Sisters

Two sisters had documented pelvic endometriosis and catamenial pneumothoraxes. Both were typical of the 54 reported cases of catamenial pneumothorax in that pneumothoraxes were always on the right and occurred only at menses with onset in the fourth decade. One patient was asymptomatic during 11 months of menstrual suppression with hormones but subsequently required surgery where diaphragmatic perforations were found. The other patient was treated with isoxazole ethisterone with no pneumothoraxes while under suppression. These patients are unlike any of the previously reported cases of familial pneumothoraxes. We have not found a previous report of familial catamenial pneumothorax.
Sensing in the City

Citizens carrying or wearing sensors, and sensors embedded in the places they visit. The presence and flows of pedestrians on the streets of Bath using Bluetooth sensors. This paper discusses the city as a system that can sense. The Cityware project, funded through the EPSRC's WINES programme, has a goal of instrumenting the city as a system. (13 pages)
Determination of nonvolatile components in polar fractions of rice bran oils

High-oryzanol rice brain oil (HORBO), rice bran oil (RBO), and partially hydrogenated soybean oil (PHSBO) were used to prepare french fries. Polar fractions of the three oils were analyzed for nonvolatile components by high-performance size-exclusion chromatography (HPSEC) with ELSD. In all frying experiments, both HORBO and RBO yielded predominantly dimeric and monomeric materials. The concentrations of polymeric species in HORBO and RBO were greater than in PHSBO. The major degradation products from HORBO, RBO, and PHSBO were dimers (8.93 mg/100 mg oil), monomers (10.5 mg/100 mg oil), and DG (22.4 mg/100 mg oil), respectively. Thermal degradation via hydrolysis was much greater in PHSBO than in HORBO or RBO. Distribution data indicated that the extent of polymer formation from frying was in the order RBO>HORBO >PHSBO, consistent with the degree of lipid unsaturation and the oryzanol content in these oils. HPSEC-ELSD results from the two RBO showed that the amounts of various polymeric species, including trimers and higher polymers, were lower in HORBO than in RBO. The percentage of polar materials and the percentage of polymerized TG, which were used as indicators of oil quality and stability, decreased with increasing tocopherol and oryzanol contents in the order PHSBO>HORBO>RBO.
Hemoglobin glycation index: a robust measure of hemoglobin A1c bias in pediatric type 1 diabetes patients.

Soros AA, Chalew SA, McCarter RJ, Shepard R, Hempe JM. Hemoglobin glycation index: a robust measure of hemoglobin A1c bias in pediatric type 1 diabetes patients. Background: The hemoglobin glycation index (HGI) assesses biological variation in A1c after accounting for the effect of mean blood glucose (MBG). Previous studies minimized analytical variation that could mask biological variation and showed that HGI was consistent within individuals over time and positively associated with risk for microvascular complications. We tested the hypothesis that biological variation in A1c can be assessed by HGI calculated using routine MBG and A1c data obtained from a typical diabetes clinic. Methods: Self-monitored MBG and A1c were collected from charts of 202 pediatric type 1 diabetes patients attending 1612 clinic visits over 6 yr. Predicted A1c was calculated from the linear regression equation of A1c on MBG in the study population. HGI was calculated by subtracting predicted A1c from observed A1c. Patients were divided into low, moderate, and high HGI tertile groups. Results: Patients used 12 models of glucose meters. Download protocols varied with clinical practice over time. A1c was measured by multiple assays and laboratories. Despite this analytical heterogeneity, HGI was significantly different between individuals and correlated within individuals. MBG (mean ± SD, mg/dL) was similar in the low (186 ± 31), moderate (195 ± 28), and high (199 ± 42) HGI groups. A1c (%) was significantly different (p < 0.0001) in the low (7.6 ± 0.7), moderate (8.4 ± 0.7), and high (9.6 ± 1.1) HGI groups. Conclusion: Biological variation in A1c is a robust quantitative trait that can be assessed using HGI calculated from routine clinic data. This suggests that HGI could be used clinically for more personalized assessment of complications risk.
Competition from the Curb: Survey of Passengers on Discount Curbside Bus Operators in Eastern and Midwestern U.S. Cities

To foster a greater understanding of the composition and preferences of travelers served by discount curbside bus operators, this study summarizes the results of a survey of such passengers. The study compares the characteristics of passengers using the two largest operators, Bolt-Bus and Megabus, with those using conventional bus lines such as Greyhound. Surveys were administered in the three most heavily served curbside bus markets in the East and Midwest of the United States—six cities in total—and the result was a cumulative sample of 1,025 responses. Curbside bus service was shown to have generated much new travel, with newly generated trips accounting for 22.0% of all passengers. In the East, however, curbside bus service is taking many travelers from passenger trains. More than a third of those surveyed (34.0%) report that they would have ridden trains had curbside buses not been available. In all markets surveyed, ridership heavily comprised passengers in the group 18 to 25 years of age and was ov...
"Ad Infinitum": how to make a fractal

"Ad Infinitum" has been featured in film festivals in the US, Canada, and Ireland, and was an award winner at the Moondance International Film Fest in Boulder, CO.
Genetic Differences in Drug Disposition

Genetic polymorphisms of drug metabolizing enzymes are well recognized. This review presents molecular mechanisms, ontogeny and clinical implications of genetically determined intersubject variation in some of these enzymes. Included are the polymorphic enzymes N-acetyl transferase, cytochromes P4502D6 and 2C, which have been well described in humans. Information regarding other Phase I and Phase II polymorphic pathways, such as glutathione and methyl conjugation and alcohol and acetaldehyde oxidation continues to increase and are also discussed. Genetic factors effecting enzyme activity are frequently important determinants of the disposition of drugs and their efficacy and toxicity. In addition, associations between genetic differences in these enzymes and susceptibility to carcinogens and teratogens have been reported. Ultimately, the application of knowledge regarding these genetic factors of enzyme activity may guide medical therapy and minimize xenobiotic-induced disease.
Computation Of Flows with Shocks Using Spectral Dierence Scheme with Articial Viscosity

The current work focuses on applying an arti cial viscosity approach to the Spectral Di erence (SD) method to enable high-order computation of compressible uid ows with discontinuities. The study modi es the arti cial viscosity approach proposed in the earlier work. Studies show that a dilatation sensor for arti cial viscosity, combined with a dilatation-based switch and lter for smoothing, works well for curvilinear and unstructured grids. The arti cial viscosity model is found to stabilize numerical calculations and reduce oscillations near discontinuities. Promising results are demonstrated for 2-D test problems. Adaptive mesh re nement is used in conjunction with arti cial viscosity to obtain improved shock pro les. A mortar element method is used to handle the non-conforming interfaces generated from mesh-re nement of quadrilateral elements.
Criteria for assessing the environmental behavior of chemicals: selection and preliminary quantification.

Abstract The following criteria were found to be of prime importance for assessing the environmental behavior of chemicals: quantity (entering the environment), mobility, accumulation, persistence, and noxious effects (direct or toxic effects and indirect, e.g., meteorological, effects). These criteria were used in interdisciplinary “evaluation sessions” in order to assess retrospectively a number of well-known, “old” organic chemicals. The criteria were quantified using production volumes, physicochemical data, results of degradation and accumulation experiments, and toxicity values. The sum of the quantified criteria for each substance was related to the results of the evaluation sessions, using appropriate weighting factors. The criteria persistence and accumulation are the most important ones. Mutagenicity and carcinogenicity have to be strongly weighted in estimating the noxious effects. Mobility, although indispensable for estimating the distribution and persistence of a chemical, does not enter into the final assessment, since a high mobility can have beneficial as well as adverse effects. With the assessment of old chemicals being quite satisfactory, the method may now be extended to the more difficult case of new chemicals. Some suggestions for this procedure are presented.
7.6: Presentation session: Poster session and reception: “Seizure prediction: One step closer. Graphical user interface for fast EEG review and statistical validation of PSDM”

Epilepsy is one of the most widely occurring and costly neurological disorders. The CDC has named developing a prediction method for seizures as its top priority in epileptic research because the unpredictability of seizures causes immense psychological stress on persons with lifetime epilepsy. In order to reduce these stresses, Hively et al have designed an algorithm to provide forewarning of epileptic events from scalp EEG data. To help in the development of this algorithm for clinical application, we have designed a graphical user interface (GUI) to allow experts to rapidly characterize electroencephalogram (EEG) datasets to be used to train the forewarning algorithm. We have also performed a statistical validation of the forewarning results to date. Both of these aspects of this project contribute to the overall goal of realizing reliable seizure prediction for people with epilepsy
Stable Isotopes in Pharmacology Studies: Present and Future

Stable-isotope techniques offer advantages over older methods in safety, sensitivity, specificity, and reduction in numbers of subjects required and analytic determinations for some types of pharmacology studies. In addition to their use as internal standards in gas chromatography-mass spectrometry analytic methods, stable isotopes have been successfully employed in studies of absorption, bioavailability, distribution, biotransformation, excretion, metabolite identification, time-dependent and dose-dependent pharmacokinetic changes, drug interactions, pharmacologic changes during pregnancy, mutagenicity, and teratogenicity.
A 3D mechanistic model for brittle materials containing evolving flaw distributions under dynamic multiaxial loading

Abstract We present a validated fully 3D mechanism-based micromechanical constitutive model for brittle solids under dynamic multiaxial loading conditions. Flaw statistics are explicitly incorporated through a defect density, and evolving flaw distributions in both orientation and size. Interactions among cracks are modeled by means of a crack-matrix-effective-medium approach. A tensorial damage parameter is defined based upon the crack length and orientation development under local effective stress fields. At low confining stresses, the wing-cracking mechanism dominates, leading to the degradation of the modulus and peak strength of the material, whereas at high enough confining stresses, the cracking mechanism is completely shut-down and dislocation mechanisms become dominant. The model handles general multiaxial stress states, accounts for evolving internal variables in the form of evolving flaw size and orientation distributions, includes evolving anisotropic damage and irreversible damage strains in a thermodynamically consistent fashion, incorporates rate-dependence through the micromechanics, and includes dynamic bulking based on independent experimental data. Simulation results are discussed and compared with experimental results on one specific structural ceramic, aluminum nitride. We demonstrate that this 3D constitutive model is capable of capturing the general constitutive response of structural ceramics.
Clinical considerations related to victimization dynamics and post-traumatic stress in the group treatment of sexually abused boys

Clinical considerations inherent in the development of a boy's time-limited psychoeducational sexual abuse trauma group are described. The sexually abused boy's impact struggles are divided into two categories: victimization dynamics and post-traumatic stress. Within each category, five impact-specific dynamics are presented. The victimization dynamics are: victim/victimizer identity struggle; abandonment fear; accelerated sexual arousal; body conflict and shame. The post-traumatic stress dynamics are: psychophysiological dysregulation; post- sexual abuse re-enactment potential; post- sexual abuse triggers; intrusion and numbing. These dynamics are central to the group's development and purpose. Within this framework, group structure, confidentiality limitations, role of caretakers, role of group therapists, and impact-specific group activities are also examined.
A Theory of Social Structure and the Quality of Life

The demographic and social structure of the community/society provide the basis for interactions that lead to satisfactions, subjective well being and the quality of life. Studies are cited that employ elements of social structure in identifying satisfying aspects of the quality of life. Ten propositions are offered that identify theoretical relationships between social structural features and well-being. To improve the quality of life, suggestions for altering the social structure are presented.
Structure characterization of AlN buffer layers grown on (0 0 0 1) sapphire by magnetron sputter epitaxy

Abstract AlN layers grown by magnetron sputter epitaxy (MSE) are effective buffer layers for the growth of high quality GaN materials and devices. The structural and morphological properties of AlN layers with two different thicknesses (20 and 200 nm) grown by this technique were analyzed by atomic force microscopy and X-ray diffraction measurements. The root-mean-square surface roughness of the MSE AlN layers was 0.625 nm for the 20 nm thick AlN layer, and 0.249 nm for the 200 nm thick one. In the latter, however, scattered hexagonal plateaus (up to 200 nm in diameter and 10 nm in height) were found embedded in the otherwise atomically smooth surface. The MSE AlN layers were found to be single crystalline epilayers in c -axis orientation, with crystalline quality better or comparable to AlN layers grown by ammonia-molecular-beam epitaxy (MBE) with similar thicknesses. Compared with the MBE counterparts, the MSE AlN layers showed smaller compressive strain at the 20 nm thickness, and crossed into tensile strain at the 200 nm thickness.
SELECTED CHEMICAL and PHYSICAL CHARACTERISTICS of CHICKEN BROTH FROM BROILER DEBONING BY-PRODUCTS

The characteristics of chicken broths from broiler breast frames (BF), mechanically-deboned bone residue (BR) and whole carcasses (WC) were investigated. Cooking times were for 1, 2, and 3 h. Increasing cooking times increased nitrogenous constituents, specific gravity, total soluble solids, turbidity and viscosity regardless of the type of raw material used. Broth pH was not affected by the length of cooking time. Broth viscosity was inversely related to broth temperature (25-65C). Chicken broths from BF and BR had equivalent or higher nitrogenous constituents when compared to those from WC. the main amino acids of chicken broths from BF and BR were similar to chicken flesh. Results of this study indicated that BF and BR are potential raw material alternatives in the processing of chicken broth.
Black Prisoners and Their World, Alabama, 1865-1900

This study draws on a variety of sources, including the reports and correspondence of prison inspectors and letters from prisoners and their families, to explore the history of the African-American men and women whose labour made Alabama's prison system the most profitable in the country.
Exhibits facilitate histology laboratory instruction: student evaluation of learning resources.

Some professional schools have replaced microscopes for histology laboratory instruction with printed and electronic media. It is recognized that these media cannot replace experience with the microscope and that there is a cognitive dissonance of completely replacing microscope study. In addition, students believe that their time is not optimally used in the traditional histology laboratory. Therefore, at Loma Linda University, nine weekly microscope exhibits consisting of 10–15 slides each were prepared. For each exhibited slide, a one page “atlas” is provided, consisting of labeled low- and high-power color micrographs taken from that slide and an informative legend. By referring to the atlas, the student can easily identify the exact field and the labeled features with little help from an instructor. A live or taped video demonstration of the microscope exhibit is available on the first day of the exhibit. During the eighth week of the quarter, students were asked to evaluate the various learning resources available to them. No resource was valued significantly more than the microscope exhibits, but the video demonstrations were valued significantly more than the printed black and white atlas or the color atlas on CD. These exhibits have been used for 2 years to instruct a class of 90 dental students. Advantages are (1) students' time is used efficiently, (2) only one slide set and a fourth as many microscopes need be maintained compared with a traditional laboratory, and (3) one-of-a-kind slides derived from research activities provide for high impact learning. Anat Rec (New Anat) 265:222–227, 2001. © 2001 Wiley-Liss, Inc.
Distant Publics: Development Rhetoric and the Subject of Crisis

In discussions about urban development, gentrification is frequently a reviled topic. Jenny Rice identifies herself as an advocate for development (6), despite the image of anti-development protest...
Asparagine uptake in rat hepatocytes: resolution of a paradox and insights into substrate-dependent transporter regulation.

Extracellular asparagine has previously been shown to markedly stimulate both ornithine decarboxylase and System N-mediated glutamine transport activities in hepatocytes by a transport-dependent mechanism. However, as a weak substrate of its inferred transporter System N, the specific route of asparagine uptake has remained enigmatic. In this study, asparagine transport was studied in detail and shown to be Na+-dependent, Li+-tolerant, stereospecific, and inhibited profoundly by glutamine and histidine. Coupled with competitive inhibition by glutamine (Ki = 2.63 ± 1.11 mM), the data indicated that asparagine was indeed slowly transported by System N in rat hepatocytes, albeit at rates an order of magnitude less than for glutamine. The differential substrate transport velocities were shown to be attributable to a low transporter asparagine affinity (Km = 9.3 − 17.5 mM) compared to glutamine (Km∼ 1 mM). Consistent with its slow uptake, asparagine accumulated to a fivefold lesser degree than glutamine after 60 min, yet stimulated System N activity to the same extent as glutamine. The transaminase inhibitor aminooxyacetate and starvation of the donor animal each enhanced asparagine uptake twofold and augmented subsequent transporter activation. Conversely, asparagine-dependent System N stimulation was abrogated by hyperosmotic media and blunted 30%–40% by phosphatidylinositol 3-kinase (PI3K) inhibitors wortmannin and LY294002. Collectively, the data suggest that System N-mediated asparagine uptake serves an autostimulatory role, mediated by cellular swelling and in part by a PI3K-dependent signal transduction pathway.
INTRODUCTION: (RE)READING STUDENTS' DIFFICULTIES WITH READING AND WRITING

(2003). INTRODUCTION: (RE)READING STUDENTS' DIFFICULTIES WITH READING AND WRITING. Reading & Writing Quarterly: Vol. 19, No. 3, pp. 199-204.
Generalized sweeping-out and probability

Abstract In this paper, in further confirmation of the close relation between potential theory and probability, generalized sweeping-out (balayage) will be investigated from a probabilistic point of view. The key concept is that of a supermartingale with values in a compact space K . A specified reference family S of functions from K to the reals determines a partial ordering of measures on K ; a measure following a measure is a balayage of the latter. It is shown that under appropriate hypotheses on S an ordered (totally ordered) family of measures is the family of marginal distributions of a supermartingale with state space K . If the measure family is maximal in the order, if K is metrizable and if the supermartingale is chosen properly, the supermartingale sample paths are right-continuous paths to the Choquet boundary of K relative to S . The functions in S are generalized superharmonic functions and the supermartingale paths to the Choquet boundary of K are analogs of Brownian paths to the Martin boundary of a Green space in the classical potential theoretic context.
Du Nagra au caméscope : questions de synchronisation image/son

Partant du postulat du glissement progressif des dispositifs cinematographiques vers un paradigme electrique, l’auteur questionne l’impact de l’enregistrement synchrone filmique et video sur nos conceptions de la technique audiovisuelle. Utilisant plusieurs exemples provenant en particulier du fonds de l’ONF, l’article decrit les difficultes liees a l’etablissement d’une synchronisation son/image fiable au cinema, pour ensuite analyser les principales differences esthetiques induites par l’utilisation des deux supports (pellicule et bande magnetique). L’asservissement de l’image et du son etant une donnee « ontologique » du medium video, la desynchronisation devient un choix esthetique produisant un changement dans la perception de la temporalite des images et des sons.
Predictive Morphometric Relationships for Estimating Fecundity of Sea Lampreys from Lake Champlain and Other Landlocked Populations

Abstract Landlocked populations of sea lamprey Petromyzon marinus are a nuisance in the Great Lakes and other lakes in the northeastern United States. In an effort to optimize control efforts, recent research has focused on creating population models to test various control scenarios. Accurate population parameters, such as fecundity, are an important component of these models. To determine the fecundity of sea lampreys in Lake Champlain, we sampled 29 female sea lampreys (mean length = 456 mm [range = 364–550 mm]; mean total wet weight = 173.8 g [range = 96.5–321.4 g]). The estimated fecundity of our sample was 67,660 ± 6,870 eggs/female (95% confidence interval around the mean). To determine the best morphometric indices to estimate fecundity, we examined the relationships between fecundity and length, weight, length and gonadosomatic index (GSI), weight and GSI, and several additional morphological measures. Regression analyses were also conducted on length, weight, and GSI data from previously publish...
Bleeding complications associated with peritoneal dialysis catheter insertion.

ObjectiveTo identify the incidence of bleeding complications associated with peritoneal dialysis catheter insertion.DesignRetrospective review at a tertiary-care center of all double-cuffed Tenckho...
An Axial-Flow Cyclone for Aircraft-Based Cloud Water Sampling

Abstract A new aircraft-based cloud water collection system has been developed to provide samples of cloud water for chemical analysis. The collection system makes use of centrifugal separation in an axial-flow cyclone to remove cloud drops from the airstream. An automated sample storage system allows up to seven independent samples to be obtained during a single research flight. The entire collection system is housed in a Particle Measurement Systems (PMS) canister to permit the collector to be used on a range of research aircraft without extensive modification to the collector or the aircraft structure. Computational fluid dynamics (CFD) analysis was used extensively throughout the development of the new collector for component design and to predict internal flow dynamics. CFD-based cloud drop trajectory simulations provided an estimate of collection efficiency as a function of drop size. Based on the numerical modeling, the 50% cut diameter was predicted to be 8 μm. Through a quantitative laboratory ca...
Geochemistry of a Sedimentary Process, Golfo San Matias: ABSTRACT

End_Page 791------------------------------Geochemical analyses of marginal basin sediments (Golfo San Matias, Argentina) for Ca, Mg, Sr, Co, Ni, V, Ti, Cr, Fe, Cu, Zn, and Mn in the total sediments and their carbonate fractions have yielded distinct halistases, the areal dispositions of which must be controlled by processes operating within the basin. One of the most important of these processes is derived from hydrodynamic forces moving the sedimentary particles and depositing them in rather distinct (at the 1-phi interval) granulometric zones. For the total sample analyses, there are covariant relations between the dominant granulometric fractions and certain elements (for example, Zn with clay size, Ti with fine-sand size). For other elements, correlations are less definitive (for example, Fe). Fragmented biogenic material is ubiquitous in the basin sediments but shows strong accumulations in some zones as a result of localized sources and dominant current activity; there is an expected positive correlation between Ca, Mg, and Sr, and the quantity of carbonate material in the sediments, and the distribution of Co appears to be directly influenced by biogenic components. In the study basin, the disposition and shape of the plotted halistases are determined by the mode of migration of the elements, in solution, as hydrolysates, as resistates, and as biodates. Although homogenization drives exist, localized conditions have been more influential in controlling detrital and elemental distributions and dispersions. Selected elements are examined for their utility in serving as discriminants better to interpret similar data from the geologic column. End_of_Article - Last_Page 792------------
Interventions for sarcopenia and muscle weakness in older people

Objective: three major strategies have been tested for combating the losses in muscle mass and strength that accompany ageing. Those strategies are testosterone replacement for men, growth hormone replacement and resistance exercise training. This review will cover the risks and benefits associated with each of these interventions. Methods: searches of PubMed and Web of Science through May 2004 yielded 85 relevant citations for the following descriptors: sarcopenia, aging/ageing, elderly, testosterone, hormone replacement, growth hormone, resistance training, exercise, muscle mass, nutrition and strength. Results and conclusions: testosterone replacement in elderly hypogonadal men produces only modest increases in muscle mass and strength, which are observed in some studies and not in others. Higher doses have not been given for fear of accelerating prostate cancer. Growth hormone replacement in elderly subjects produces a high incidence of side-effects, does not increase strength and does not augment strength gains resulting from resistance training. Some alternate strategies for stimulating the growth hormone/insulin-like growth factor (IGF) pathway continue to hold promise. The latter include growth hormone releasing hormone (GHRH) and the complex of IGF-I with its major circulating binding protein (IGF-I/IGFBP-3). Resistance training remains the most effective intervention for increasing muscle mass and strength in older people. Elderly people have reduced food intake and increased protein requirements. As a result, adequate nutrition is sometimes a barrier to obtaining full benefits from resistance training in this population.
Total surface replacement of the hip joint.

The surface replacement hip prosthesis reported represents an attempt to improve upon some aspects of the present design of total hip. The prosthesis comprises a cap fitted over the femoral head and a liner fixed into the socket, both being cemented with methyl methacrylate. The chief advantage of this design is preservation of bone stock. The prostheses were inserted bilaterally into six dogs, and whilst ten joints failed, one case was strikingly successful at two years follow-up. It was concluded that the design showed sufficient advantages over current total hips and that there was sufficient possibility of success in some application, to merit further study.
Is Sierra Nevada at acid threshold

Three University of California, Santa Barbara, scientists have reported that even though rain and snowmelt with elevated levels of acidity have been found in California's Sierra Nevada mountains, acid has not yet harmed the lakes and streams. The researchers warn, though, that the same lakes and streams appear to be vulnerable to future increases in acid levels. The study, reported August 17 at the Davis, Calif., meeting of the American Institute of Biological Sciences, was conducted at Emerald Lake in Sequoia National Park. The lake is considered representative of lakes in the region and has a pH in the low end of the neutral range (6.2–6.5), so it is more susceptible to acidification.
Measurement of organ blood flow with coloured microspheres in the rat

Objective: The aim was to establish a method for measuring organ blood flow in rats using commercially available, coloured, dye extraction microspheres. Methods: A mixture of radiolabelled and dye extraction microspheres was infused into rats at rest (basal) and during intravenous administration of either angiotensin II (0.5 μg·kg−1·min−1) or isoprenaline [12.5 ng·(g0.74)−1·min−1]. Tissues were removed and placed in test tubes, counted for radioactivity, then digested with 2N sodium hydroxide. Within the same tube, microspheres were isolated using centrifugation and the dye was extracted with dimethylformamide. The dye was quantified by spectrophotometry. Results: Recovery of microspheres averaged greater than 95% for all tissues studied; larger reagent volumes were required to achieve this level of recovery from white adipose tissue. Statistical analyses showed excellent correlations between blood flow values obtained by the dye extraction and radiolabelled microsphere techniques. Blood flow values obtained with the radioactive technique tended to be slightly higher. There were no differences in the results obtained with the two techniques when they were simultaneously used to measure changes in organ blood flow induced by angiotensin II or isoprenaline. Conclusions: The coloured, dye extraction microsphere technique accurately measures organ blood flow in rats. This technique is potentially useful for estimating blood flow in any animal, even if tissue sample size is limited.
Effects of face plates on surface displacement profile in 2-2 piezoelectric composites

A simple model is developed to describe the inhomogeneous surface deformation profile of face plated 2-2 type piezocomposites. The contribution of face plate to the equilibrium condition is approximated by simple elastic bending of the plate. Analytical solutions were obtained for the inhomogeneous surface displacement profile. From these solutions one can predict the variation of the nonuniform surface displacement in a 2-2 composite with respect to material and geometry parameters. It is shown that the surface displacement uniformity depends on several factors: the ceramic aspect ratio, the spacing between ceramic plates, the thickness of face plate, the Young's modulus of the polymer and of the face plate. The calculated results indicate that stiffer face plates, softer polymer resin, and closer ceramic spacing could make the piezocomposite transducers have more uniform surface displacement. >
Low-dose α-interferon treatment of chronic myeloid leukemia

We treated 29 patients with chronic-phase and accelerated chronic myeloid leukemia (CML) with alpha-interferon in a dose of 2 mU/m2 given subcutaneously daily for 30 days and then three times per week. Most had received prior treatment. Three patients have had sustained hematologic and karyotypic remissions after a median of 22 months of treatment. Three further patients have had complete hematologic and partial karyotypic remissions. At a median follow-up of 48 months, the median survival has not been reached. This dose of alpha-interferon may induce sustained remissions even in pretreated patients and may prolong survival in CML.
Trail Making Test errors in normal aging, mild cognitive impairment, and dementia

The objective of the present study was to provide normative data for Trail Making Test (TMT) time to completion and performance errors among cognitively normal older adults, and to examine TMT error rates in conjunction with time scores for pre-clinical and clinical Alzheimer's disease (AD) diagnostic decision-making. A sample of 526 individuals was classified into three diagnostic groups (normal controls, N=269; mild cognitive impairment, MCI, N=200; AD, N=57) by a multidisciplinary consensus conference. Results indicated that performance differed among the three groups for TMT A and B time scores as well as TMT B error rate. Diagnostic classification accuracy (i.e., sensitivity, specificity, and positive and negative predictive powers) is described for various combinations of the diagnostic groups. The findings show that TMT B time and errors are independently meaningful scores, and both therefore have clinical utility in assessing individuals referred for dementia evaluations.
Ozone profiles at McMurdo Station, Antarctica, The austral spring of 1990

Vertical profiles of ozone and temperature were measured on 40 occasions during the austral spring of 1990 at McMurdo Station, Antarctica, and once again near record levels of ozone depletion were observed. Total ozone decreased from 260 DU in late August to its minimum value of 145 DU on 9 October, when the ozonesonde was at it's lower detection limit from 15 to 16.5 km. Ozone reductions were observed almost exclusively between 12 and 20 km, with a half life of 20 days. This is similar to previous years. Although McMurdo was within the polar vortex for most of the period, there were several occasions when the edge of the vortex was over McMurdo. During these periods, ozone above 20 km approximately doubled, but below 20 km remained relatively unchanged.
Liberalism, Catholicism, and the Abbé Grégoire*

With the convening and accomplishments of the Second Vatican Council liberal Catholicism seems triumphant in the Catholic Church. Despite continuing controversy over such agonizing problems as birth control, it would appear that the Church has forthrightly and definitely decided to reconcile itself as fully as possible to modern society. From this present perspective, the historian may well need to reexamine certain aspects of the rise of liberal Catholicism and to reassess the work of certain of its pioneers and the frustrating obstacles they encountered. No longer on the defensive, the partisans of liberal Catholicism may want to reclaim those they have ignored or rejected. One curious figure who seldom if ever has been given credit for his role in the emergence of liberal Catholicism is the Abbe Henri Gregoire, priest and politician during the French Revolution and patriarch of the schismatic Constitutional Church.Liberal Catholic historians have tended to shy away from too much attention to this puzzling and perhaps embarrassing figure, leaving him to the attacks of conservative Catholics or the enthusiastic devotion of neo-Jansenist sectarians. Secular liberals who have generally preferred to face a Catholic Church which was unequivocally reactionary have pretended to see Gregoire as an excentric of little significance.
Partially-time-ordered Schwinger-Keldysh loop expansion of coherent nonlinear optical susceptibilities

A compact correlation-function expansion is developed for $n$-order optical susceptibilities in the frequency domain using the Keldysh-Schwinger loop. By not keeping track of the relative time ordering of bra and ket interactions at the two branches of the loop, the resulting expressions contain only $n+1$ basic terms, compared to the ${2}^{n}$ terms required for a fully-time-ordered density matrix description. Superoperator Green's function expressions for ${\ensuremath{\chi}}^{(n)}$ derived using both expansions reflect different types of interferences between pathways. These are demonstrated for correlation-induced resonances in four-wave-mixing signals.
Chronic Creatine Kinase Elevation Not Associated with HMG-CoA Reductase Inhibitor Treatment:

OBJECTIVE:To report a case of chronically elevated creatine kinase (CK) concentration that is possibly associated with renal insufficiency and prostatic carcinoma. The goal is to raise awareness among clinicians who monitor CK concentrations in patients receiving hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors.CASE SUMMARY:Because of an elevated CK concentration, a 64-year-old African-American man with a history of chronic heart disease and renal insufficiency was assessed for possible myositis relating to his treatment with HMG-CoA reductase inhibitors. However, an association between the elevated enzyme concentration and drug treatment could not be clearly established. The patient was subsequently diagnosed with prostatic cancer and underwent a radical retropubic prostatectomy. The CK enzyme concentration declined following the surgery despite continuation of the drug therapy.DISCUSSION:CK is relatively nonspecific because of its wide distribution in human tissues. Although several findi...
External-beam radiotherapy for localized extrahepatic cholangiocarcinoma

Purpose: The role of radiation therapy (RT) in extrahepatic cholangiocarcinoma (EHCC) is not clear and only limited reports exist on the use of this modality. We have reviewed our institutional experience to determine the pattern of failure in patients after potentially curative resection and the expected outcomes after adjuvant RT and in unresectable patients. Methods and Materials: After institutional review board approval, 81 patients diagnosed with EHCC (gallbladder 28, distal bile duct 24, hilar 29) between June 1986 and December 2004 were identified and their records reviewed. Twenty-eight patients (35%) underwent potentially curative resection with R0/R1 margins. Fifty-two patients (64%) were unresectable or underwent resection with macroscopic residual disease (R2). All patients received three-dimensional planned megavoltage RT. The dose for each patient was converted to the equivalent total dose in a 2 Gy/fraction, using the linear-quadratic formalism and α/β ratio of 10. The median dose delivered was 58.4 Gy (range, 23–88.2 Gy). 54% received concomitant chemotherapy. Results: With a median follow-up time of 1.2 years (range, 0.1–9.8 years) 75 patients (93%) have died. Median overall survival (OS) and progression-free survival (PFS) were 14.7 (95% CI, 13.1–16.3) and 11 (95% CI, 7.6–13.2) months, respectively. There was no difference among the three disease sites in OS (p = 0.70) or PFS (p = 0.80). Complete resection (R0) was the only predictive factor significantly associated with increase in both OS and PFS (p = 0.002), and there was no difference in outcomes between R1 and R2 resections. The first site of failure was predominantly locoregional (68.8% of all failures). Conclusion: Local failure is a major problem in EHCC, suggesting the need for more intense radiation schedules and better radiosensitizing strategies. Because R1 resection appears to convey no benefit, it appears that surgery should be contemplated only when an R0 resection is likely. Borderline-resectable patients might be better served by neoadjuvant therapy.
Changes in TRMM Rainfall due to the Orbit Boost Estimated from Buoy Rain Gauge Data

During the first three-and-a-half years of the Tropical Rainfall Measuring Mission (TRMM), the TRMM satellite operated at a nominal altitude of 350 km. To reduce drag, save maneuvering fuel, and prolong the mission lifetime, the orbit was boosted to 403 km in August 2001. The change in orbit altitude produced small changes in a wide range of observing parameters, including field-of-view size and viewing angles. Due to natural variability in rainfall and sampling error, it is not possible to evaluate possible changes in rainfall estimates from the satellite data alone. Changes in TRMM Microwave Imager (TMI) and the precipitation radar (PR) precipitation observations due to the orbit boost are estimated by comparing them with surface rain gauges on ocean buoys operated by the NOAA/Pacific Marine Environment Laboratory (PMEL). For each rain gauge, the bias between the satellite and the gauge for pre- and postboost time periods is computed. For the TMI, the satellite is biased 12% low relative to the gauges during the preboost period and 1% low during the postboost period. The mean change in bias relative to the gauges is approximately 0.4 mm day 1 . The change in TMI bias is rain-rate-dependent, with larger changes in areas with higher mean precipitation rates. The PR is biased significantly low relative to the gauges during both boost periods, but the change in bias from the pre- to postboost period is not statistically significant.
Chapter 5 Implementation theory

Abstract The implementation problem is the problem of designing a mechanism (game form) such that the equilibrium outcomes satisfy a criterion of social optimality embodied in a social choice rule. If a mechanism has the property that, in each possible state of the world, the set of equilibrium outcomes equals the set of optimal outcomes identified by the social choice rule, then the social choice rule is said to be implemented by this mechanism. Whether or not a social choice rule is implementable may depend on which game-theoretic solution concept is used. The most demanding requirement is that each agent should always have a dominant strategy, but mainly negative results are obtained in this case. More positive results are obtained using less demanding solution concepts such as Nash equilibrium. Any Nash-implementable social choice rule must satisfy a condition of “monotonicity”. Conversely, any social choice rule which satisfies monotonicity and “no veto power” can be Nash-implemented. Even non-monotonic social choice rules can be implemented using Nash equilibrium refinements. The implementation problem can be made more challenging by imposing additional requirements on the mechanisms, such as robustness to renegotiation and collusion. If the agents are incompletely informed about the state of the world, then the concept of Nash equilibrium is replaced by Bayesian Nash equilibrium. Incentive compatibility is a necessary condition for Bayesian Nash implementation, but in other respects the results closely mimic those that obtain with complete information.
Abstract 146: Demographic and Clinical Characteristics Associated with Patient Perceptions of Being Cured Following Hospitalization for Acute Coronary Syndromes: Preliminary Results from TRACE-CORE and TRACE-CARE

Background: Recent decades have seen improvements in treatment for acute coronary syndromes (ACS), reduced mortality, and shortened hospital stays. Limited evidence suggests that some patients may leave the hospital with the perception that they are cured. Objective: To describe demographic and clinical characteristics associated with patient perceptions that their heart condition is cured at one week following hospitalization for ACS. Methods: We analyzed data from 397 patients interviewed during hospitalization for ACS in 2011-2013 as part of the Transitions, Risks, and Actions in Coronary Events: Centers for Outcomes Research and Education (TRACE-CORE), and again at one week post-discharge as part of an ancillary study, TRACE-CARE. At one week, patients were asked “How true or false is this statement for you: My heart condition is cured. Would you say that this is definitely true, mostly true, neutral, mostly false, or definitely false?” We considered patients who responded “definitely true” or “mostly true” to perceive that their heart condition was cured. We calculated 6-month GRACE risk scores using clinical data from medical records. We used multivariable logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations with cure perceptions. Results: Participants were 26% (n=105) female and 89% (n=350) non-Hispanic white with mean age 60.7±11.0 years. Sixteen percent (n=63) were hospitalized with unstable angina, 69% (n=266) with NSTEMI, and 14% (n=55) with STEMI; 31% (n=124) had a history of CHD; and the average GRACE risk score was 93.6 (SD: 26.6). Seventy-three percent (n=289) received PCI during hospitalization and 11% (n=43) CABG. Discharge occurred the same or next day for 19% (n=76) and within 2-3 days for 54% (n=214). One week post-discharge, 30% (n=120) perceived their heart condition was cured. In a multivariable model, male sex, unstable angina, no history of CHD, and receipt of CABG were associated with greater odds of perceiving oneself cured (Table). Conclusions: One week post-discharge for ACS, 3 in 10 patients perceived their heart condition was cured. Future research should examine additional patient factors related to cure perceptions, and whether these perceptions influence engagement in recommended secondary prevention strategies. ![][1] [1]: /embed/graphic-1.gif