cssi/SciSciGPT-SciSciNet huggingface dataset:
Myeloproliferative Neoplasms: A Contemporary Review.

Polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF) constitute the BCR-ABL1-negative myeloproliferative neoplasms and are characterized by mutually exclusive Janus kinase 2 (JAK2), calreticulin (CALR), and myeloproliferative leukemia virus oncogene (MPL) mutations; respective frequencies of these mutations are approximately 95%, 0%, and 0% in PV, 60%, 20%, and 3% in ET, and 60%, 25%, and 7% in PMF. These mutations might be accompanied by other mutations that are less specific to myeloproliferative neoplasms but are prognostically relevant, such as additional sex combs-like 1 (ASXL1). Characteristic bone marrow morphology is required for World Health Organization-compliant diagnosis, especially in distinguishing ET from prefibrotic PMF and masked PV. Survival is the longest in ET, although still inferior to that of the age- and sex-matched control population; median survivals for patients younger than 60 years are approximately 33 years for ET, 24 for PV, and 15 for PMF. Major disease complications include thrombosis and leukemic or fibrotic transformation. In PV and ET, risk factors for survival include older age, leukocytosis, and thrombosis, whereas JAK2 mutation in ET is associated with increased risk of thrombosis. In PMF, type 1 or type 1-like CALR mutations are associated with superior and ASXL1 with inferior survival. Prevention of thrombosis in PV is secured by phlebotomy (hematocrit target <45%) and in both PV and ET by low-dose aspirin therapy; high-risk patients derive additional antithrombotic benefit from cytoreductive therapy with hydroxyurea as first-line and interferon-alfa and busulfan as second-line drugs of choice. Although the JAK inhibitor ruxolitinib was recently approved for use in hydroxyurea-resistant PV, its role in routine clinical practice remains debatable. In myelofibrosis, stem cell transplant is the current treatment of choice for genetically or clinically high-risk disease; for all other patients requiring treatment, participation in clinical trials may be preferred because currently available drugs, including JAK inhibitors, are palliative and not shown to be disease modifying.
355 SEVERE AMEBIASIS IN EARLY INFANCY: A REPORT OF 3 CASES ASSOCIATED WITH HIGH PREVALENCE RATES AMONG FAMILY MEMBERS

Two infants died with extraintestinal amebiasis, one on March 23, 1976 in Ga. and the other on July 1, 1976 in S.C. One infant in Ca. recovered after a long illness. Case 1: A 7-wk-old male infant in suburban Atlanta died of amebic peritonitis and a liver abcess. Stool samples from 17 of 19 family members revealed that 4 (24%) were infected with Entamoeba histolytica. Serospecimens from all 19 family members revealed that 9 (47%) had elevated indirect hemagglutination (IHA) titers to E. histolytica. Case 2: An 8-wk-old male infant in S.C. died with amebic colitis, peritonitis and liver abcess. Of 34 extended family members. 10 (32%) had elevated titers by IHA and 6 (23%) of 26 had E. histolytica organisms on stool examination. Case 3: A 12-wk-old female infant in suburban Los Angeles developed amebic colitis, peritonitis and a hepatic abcess, but recovered following surgery and chemotherapy. Two (40%) of 5 family members were infected with amoebae on stool examination. No history of travel or job exposure to sources of amoebae could be elicited from the families and environmental studies revealed no infective sources. Thus, the source and route of spread of E. histolytica within these 3 families could not be traced; however, person-to-person transmission was suspected. Of significance is that all 3 mothers were passing E. histolytica organisms and that the infection in these otherwise healthy infants was severe.
Decision support and design evolution: integrating genetic algorithms, CFD and visualization

Abstract This paper describes a decision support evolution model using Genetic Algorithm (GA) as the evolution algorithm and Computational Fluid Dynamics (CFD) as the evaluation mechanism. The model is integrated with a visualization module to allow users to interact and select form instances as the design evolves. The advantages of such an evolutionary decision support design approach is that diverse instances of the state space can be investigated in relation to specific goal requirements which will enhance the possibility of discovering a variety of potential solutions. The model allows the user to explore and visualize the design evolution and its form generation in an attempt to stimulate the designer creativity that might contribute to their output. The process uses an iterative approach that allows design to be evaluated using CFD analysis automatically to maximize several thermal and ventilation criteria. Design change will then be performed, remeshed and displayed based on the evolutionary algorithms. The process allows the user to experience the morphing of the design based on its performance and continues until the designer has the opportunity to visualize the evolution of the final set of design alternatives.
Regulation of LIM-domain-binding 1 protein expression by ubiquitination of Lys134

LDB1 (LIM-domain-binding 1) is a cofactor that participates in formation of transcriptional regulatory complexes involving transcription factors containing LIM domains as well as other factors. The amount of LDB1 protein in cells has previously been shown to be modulated by RNF12 (RING finger protein 12). RNF12 is an E3 ubiquitin ligase that can target LDB1 for poly-ubiquitination and degradation via the proteasome. We find that in HEK (human embryonic kidney)-293 cells expression of RNF12 leads to mono-ubiquitination of LDB1 and increased levels of LDB1 protein. Mutagenesis studies identified Lys134 of LDB1 as the residue that is mono-ubiquitinated by RNF12. Mutation of Lys134 of LDB1 to arginine blocks the formation of mono-ubiquitinated LDB1 and surprisingly also increases LDB1 protein expression in HEK-293 cells. This leads to a model in which Lys134 of LDB1 can be either mono-ubiquitinated, leading to stabilization, or poly-ubiquitinated, leading to degradation by the proteasome pathway. We also find that ubiquitin-LDB1 fusion proteins are stabilized in HEK-293 cells, offering further evidence that mono-ubiquitination stabilizes LDB1 in these cells. Expression in Xenopus laevis embryos of an LDB1 protein in which Lys134 is replaced with arginine leads to enhanced expression of the mutant protein as compared with the wild-type protein. These findings provide evidence that modification of Lys134 can play a major role in regulating LDB1 expression.
Na4Mn9O18 as a positive electrode material for an aqueous electrolyte sodium-ion energy storage device

Abstract Here we demonstrate Na 4 Mn 9 O 18 as a sodium intercalation positive electrode material for an aqueous electrolyte energy storage device. A simple solid-state synthesis route was used to produce this material, which was then tested electrochemically in a 1 M Na 2 SO 4 electrolyte against an activated carbon counter electrode using cyclic voltammetry and galvanostatic cycling. Optimized Na 4 Mn 9 O 18 was documented as having a specific capacity of 45 mAh/g through a voltage range of 0.5 V, or an equivalent specific capacitance of over 300 F/g. With the proper negative:positive electrode mass ratio, energy storage cells capable of being charged to at least 1.7 V without significant water electrolysis are documented. Cycling data and rate studies indicate promising performance for this unexplored low-cost positive electrode material.
Swelling of nuclear graphite and high quality carbon fiber composite under very high irradiation temperature

Abstract The purpose of this experiment was to evaluate the dimensional change of newly proposed nuclear graphite material following high-temperature irradiation, and to compare the measured swelling with the historic nuclear graphite, H-451. Over the irradiation temperature range studied (∼850–1475 °C) and neutron dose range (2–10 × 10 25 n/m 2 ( E > 0.1 MeV)) the Graftech PCEA and SGL NBG-10 candidate nuclear graphite had similar densification to that of Great Lakes Carbon nuclear graphite H-451. In this temperature and dose range all materials remained in the densification stage. Additionally, the effect of high-temperature irradiation on the dimensional stability of high-quality carbon fiber composites was investigated. A high thermal conductivity three-dimensional carbon fiber composite, FMI-222, and a very high thermal conductivity one-dimensional carbon fiber composite MKC-1PH, were studied. Results indicate that a greater than anticipated dimensional change occurred for these composites. Moreover, the dimensional stability of the 3D composite appears to be a strong function of the sample size chosen, thus raising the question of the appropriate size sample to use to determine irradiation-induced dimensional change for these materials.
A survey of transfusion practices among anesthesiologists

Abstract. A survey of transfusion practices was conducted among anesthesiologists practicing in the United States to determine if significant variation exists and to identify those areas toward which research and educational efforts should be directed. Thirty-seven percent (389) of 1,043 active members of the American Society of Anesthesiologists who received the survey responded. The indications for transfusion as well as the types of components administered were found to vary considerably. Among the areas which need to be addressed are arbitrary preoperative hemoglobin requirements, indications for fresh frozen plasma administration, preoperative blood ordering and autologous transfusion.
A method for recording the arterial pressure pulse and blood pressure in man.

Abstract 1. 1. A method for recording arterial pressure pulse waves in man is presented which has certain practical advantages over techniques in current use. 2. 2. Cases are presented to demonstrate the utility of such an apparatus. 3. 3. The application of this method to experimental and clinical procedures provides the observer with an opportunity of investigating large numbers of subjects under a wide range of conditions. 12,13
Charge induction by thermal radiation

Abstract It is argued that precision measurements which rely on the use of conductive housings for electrical screening may well be subject to spurious error owing to charge induction within the housing. If the momentum transfer processes associated with the absorption of thermal radiation act selectively upon electrons, a residual charge may be induced on surfaces internal to the housing and held in place by radiation pressure. The effects of such action upon the measurement of G is discussed in relation to anomalies reported in such measurements. The phenomenon is supported by the existence of the charge on the Earth's surface. A method of testing for the presence of induced charge and eliminating its effects is indicated.
Livedo Reticularis and Bowel Ischemia after Carbon Dioxide Arteriography in a Patient with CREST Syndrome

Abstract For 30 years, CO 2 gas has been used as a safe alternative to iodinated contrast agents for angiography in patients with renal insufficiency or allergy to iodine. CO 2 angiography is well tolerated when performed properly, and serious complications are rare. However, severe complications may occur if the physical properties of CO 2 and the specific pathophysiology of an individual patient are not carefully considered. The present report describes a case in which diffuse livedo reticularis, bowel ischemia, and renal insufficiency developed following CO 2 angiography in a patient with CREST syndrome (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia).
113 11|[beta]|-HYDROXYLASE DEFICIENCY-CONGENITAL DEFECT OR TUMOR

In 3 children with low renin hypertension and virilism, the hormonal profile distinguished the patient with an adrenal tumor producing DOC and androgens from the other 2 patients who had a genetic deficiency of steroid 11β-hydroxylase (11β-OHD). Clinical presentations were remarkably similar as were the baseline serum concentrations of deoxycorticosterone (DOC). The major difference in the baseline hormones consisted of very high DHEA levels in the tumor patient in contrast to very high androstenedione (Δ4) levels in the patients with the genetic defect of 11β-hydroxylation. The stimulation and suppression tests also distinguished the tumor patient. DOC did not stimulate with ACTH nor suppress with dexamethasone (dex). The PRA rose with dex suppression only in the patients with the genetic defect. Serum aldosterone was undetectable in all 3 patients in the baseline period.
Fus3 controls Ty1 transpositional dormancy through the invasive growth MAPK pathway

Fus3, the mitogen-activated protein kinase (MAPK) of the mating pheromone response pathway, inhibits a post-translational step of Ty1 retrotransposition. Fus3 also inhibits haploid invasive growth by blocking cross-activation of invasive growth gene expression by the pheromone response signal cascade. Here, we show that Fus3 kinase activity and dosage co-ordinately regulate Ty1 transposition and invasive growth. A chromosomal copy of the kinase-defective fus3-K42R allele fails to inhibit either Ty1 transposition or invasive growth. When overexpressed, kinase-defective Fus3 weakly inhibits both Ty1 transposition and invasive growth, but is much less inhibitory than wild-type Fus3 expressed at the same level. Moreover, increasing the dosage of wild-type Fus3 intensifies the inhibition of both Ty1 transposition and invasive growth. To demonstrate that Fus3 regulates Ty1 transposition via its negative regulation of the invasive growth pathway, we show by epistatic analysis that the invasive growth pathway transcription factors Ste12 and Tec1 are both required for Fus3-mediated inhibition of Ty1 transposition. When haploid invasive growth is stimulated by high-copy expression of TEC1, by expression of the dominant hypermorphic allele STE11-4 or by deletion of HOG1, Ty1 transposition is concomitantly activated. In summary, these results demonstrate that the haploid invasive growth pathway activates Ty1 transposition at both transcriptional and post-transcriptional levels and that Fus3 inhibits Ty1 transposition by inhibiting the invasive growth pathway.
Mode of Action: Developmental Thyroid Hormone Insufficiency—Neurological Abnormalities Resulting From Exposure to Propylthiouracil

Because thyroid hormone is essential for normal brain development before and after birth, environmental chemicals that interfere with thyroid hormone signaling can adversely affect brain development. Adverse consequences of thyroid hormone insufficiency depend both on severity and developmental timing, indicating that environmental antithyroid factors may produce different effects at different developmental windows of exposure. Mechanistic studies can provide important insight into the potential impact of chemicals on human thyroid function, but relevance to humans must be systematically evaluated. This kind of analysis depends on data sets that include information about animals and humans. The drug 6-n-propyl-2-thiouracil (PTU) is used in animals to experimentally manipulate serum thyroid hormone levels, and in humans to treat patients, including pregnant women, with Graves' disease. A systematic analysis of the mode of action (MOA) of PTU in rats and in humans discloses similar modes of action. While the analysis predicts that PTU doses that produce thyroid hormone insufficiency in humans would adversely affect the developing brain, careful monitoring of PTU administration in pregnant and lactating humans keeps infant serum thyroid hormone levels within the normal range.
Pseudomultidimensional NMR by spin-state selective off-resonance decoupling.

An alternate technique for accurately monitoring the chemical shift in multidimensional NMR experiments using spin-state selective off-resonance decoupling is presented here. By applying off-resonance decoupling on spin S during acquisition of spin I, we scaled the scalar coupling J(I,S) between the spins, and the residual scalar coupling turns out to be a function of the chemical shift of spin S. Thus, the chemical shift information of spin S is indirectly retained, without an additional evolution period and the accompanying polarization transfer elements. The detection of the components of the doublet using spin-state selection enables an accurate measurement of the residual scalar coupling and a precise value for the chemical shift, concomitantly. The spin-state selection further yields two subspectra comprising either one of the two components of the doublet and thereby avoiding the overlap problems that arise from off-resonance decoupling. In general, spin-state selective off-resonance decoupling can...
When not to restore

It’s tough, in the strictest sense, to back into an assignment from the editor of this journal, who has taken the naive stance that maybe we are treating more teeth than need be treated; and, that perhaps the patients’ needs and welfare ought to come first, before our economic needs.
Contemporary hair transplantation

BACKGROUNDThe field of hair transplantation has evolved considerably over the last quarter century. Performed correctly, the cosmetic results of contemporary hair transplantation are virtually undetectable in women and men. Large, pluggy “punch grafts” have been replaced with natural-appearing folli
Expression of the Androgen Receptor Gene in Rat Penile Tissue and Cells during Sexual Maturation

The cessation of rat and human penile growth at completion of sexual maturation appears to be related to a tissue-specific decrease in the number of androgen receptors (AR) in the penis. To find out whether this is due to either transcriptional or translational regulation of the AR gene, we determined the levels of AR mRNA by Northern blots in the corpora cavernosa from groups of 16-, 19-, 22-, 27-, 52-, and 90- day-old rats. The AR mRNA rapidly decreases with age and is nearly undetectable in the 52- and 90-day-old rats, paralleling the decline in AR number. The persistence of a low amount of AR mRNA in the adult penis was confirmed by reverse transcription/ polymerase chain reaction amplification of total RNA, and its level was estimated by a semiquantitative modificationof this procedure at less than l/25th of that found in the youngest rats. Smooth muscle cells derived from the 16- and 90- day-old corpora cavernosa express the AR gene in vitro in approximately the same levels, suggesting that there ar...
Antigen Presentation in Protein-Energy Malnutrition

Abstract Protein-energy malnutrition is associated with intrinsic defects in macrophage (MO) microbicidal function, but effects on MO-CD4+ cell interaction are unclear. This study examined the effect of protein-energy malnutrition on components of Ag presentation (AP) by peritoneal macrophages (PMO) and splenocyte responses (MLR) in the naive (resident) and infected state (mycobacterium-BCG), and assessed the potential role of prostaglandin (PGE2) and L-arginine-derived nitric oxide (NO') as regulatory mechanisms in these immune interactions. Mice were randomized to receive either a control (24% casein, RD) or low-protein (2.5% casein, LPD) diets for 8 weeks. PMO and splenocytes were harvested and AP function and MLR assessed ±NG-monomethyl-L-arginine (NMMA; competitive inhibitor of NO' synthesis) or indomethacin (PGE2 inhibitor). PMO components of AP were evaluated, including phagocytic function, MHC-class II (Ia) expression, and interleukin-1 (IL-1) and interleukin-6 (IL-6) production. PGE2 production and NO' (measured as NO-2) synthesis were also assessed. AP and MLR were preserved in protein-energy malnutrition in both resident and activated states, BCG infection in RD was associated with PMO activation as measured by increased O-2 and NO-2 release, but impaired AP and MLR responses. NMMA and indomethacin enhanced AP and MLR in RD groups only. Individual components of PMO AP (phagocytosis, IL-1 and IL-6 production) were defective during protein-energy malnutrition, as were NO-2 and PGE2 production. Thus, AP and MLR were preserved in LPD groups which may be related to a loss of prostaglandin- and L-arginine-mediated suppressor mechanisms.
Coronary assessment before noncardiac surgery: current strategies are flawed.

The preoperative evaluation of patients scheduled for elective noncardiac surgery is a conspicuous component of the practice of cardiology and general internal medicine and has become a standard content area in general internal medicine training.1 In particular, clinicians are expected to address coronary risk in such patients because the stress of surgery, induction of anesthesia, postoperative pain, and other complications may induce coronary ischemia through mismatch between coronary oxygen supply and demand or through rupture of vulnerable plaque.2 Preoperative evaluation may involve estimation of the probability of perioperative cardiac events3 and application of algorithms that guide patients to stress testing or β-blocker therapy.4–6 Although these algorithms are informed by clinical research, their ultimate configuration is influenced substantially by expert opinion. Response by Gregoratos p 3151 The most visible and widely cited guideline during the past decade, published initially in 1996 and updated in 2002 and 2006, is that of the American College of Cardiology (ACC) and the American Heart Association (AHA).4,5 The decision-making algorithm in the 2002 guideline exists as a pocket manual for easy reference7 and has been reprinted in popular clinical references such as the Washington Manual of Medical Therapeutics 8 and UpToDate .9 Because studies published during the past several years raised questions about recommendations that flowed from the 2002 algorithm, an updated ACC/AHA guideline was published in October 2007.6 In my view, the new guideline represents an improvement but still embodies ambiguity, fails to account fully for recent relevant medical literature, and remains problematic for clinicians. In this article, I begin with a critique of the 2002 ACC/AHA guideline because it provides historical context for the recent revision. I will then review recently published data that render the guidelines problematic. Finally, I will offer a critique of the …
Congestion theory and transport demand

A general theorem for the analysis of transport modal choices is derived and applied to a representative bus- versus-auto modal choice. Other applications of the model are also discussed, including analysis of the demand for freeways versus local streets, choices between jitneys and taxis, and interurban travel by air versus rail. Comparisons are drawn between cross-elasticities of demand in American and European communities. /HRIS/
Seasonal patterns of water relations and enzyme activity of the facultative CAM plant Portulacaria afra (L.) Jacq.

Abstract.Portulacaria afra (L.) Jacq. is a perennial facultative CAM species showing a seasonal shift from C3 to CAM photosynthesis. The shift to CAM during the summer occurs despite continued irrigation of the plants. The authors examined the hypothesis that the seasonal shift to CAM occurred because of low transient water potentials. They measured changes in whole leaf water, osmotic and pressure potentials over the course of the shift. They also studied changes in enzyme activity to ascertain if PEP carboxylase and PEP carboxykinase were induced during the seasonal shift to CAM. Water potentials were high, from -0.1 to -0.5 MPa, predawn and midday, when the C3 pathway of photosynthesis was utilized. Osmotic potentials were constant, from -0.7 to - 0.8 MPa, indicating very little change in turgor. P. afra shifted to CAM indicated by large diurnal acid fluctuations (300 400 meq m−2) despite C3-like predawn water potentials. Midday water potentials usually decreased 0.2-0.7 MPa, while the osmotic potential remained unchanged or decreased slightly. Thus, a midday loss of turgor was associated with the use of the CAM pathway. The results support the hypothesis that the induction of CAM occurred due to low transient water potentials and may be partially mediated through the loss of turgor. The shift to CAM is only a partial induction with PEP carboxykinase showing high activity all year round while PEP carboxylase increases three-to five-fold over C3 levels. Relatively high levels of CAM enzyme activity enables the utilization of the CAM pathway in the winter and spring in response to high daytime temperatures and increased evaporative demand. These results would lead to an increase in water use efficiency during such periods when compared to other inducible CAM species.
Mitotic blockage following laser micro-irradiation of prosphase chromosomes

Abstract An argon laser microbeam was used to irradiate prophase chromosomes of the salamander ( Taricha ) and the established cell of the rat kangaroo (PTK1, Potorous ). In both cell types mitosis was significantly blocked when irradiation occurred in early prophase regardless of whether or not the irradiated chromosomes were nucleola-associated. It was also determined that with identical irradiation conditions, the salamander cells were more susceptible to mitotic inhibition than the kangaroo cells. The results are compared with earlier studies performed with lower energy densities.
Discriminative stimulus effects of dextromethorphan in the rat

This study was performed to characterize pharmacologically the discriminative stimulus effects of dextromethorphan, an antitussive that binds with high affinity to a subtype ofsigma site in the brain. Dextrorphan, a metabolite of dextromethorphan, has phencyclidine (PCP)-like effects. Therefore, training was conducted with dextromethorphan injected by the SC route, which minimizes dextrorphan formation compared to the IP route. The training dose used, 30 mg/kg, by the SC route did not occasion selection of the PCP-appropriate choice lever in rats discriminating IP injections of 2.0 mg/kg PCP from saline. (In contrast, by the IP route the ED50 of dextromethorphan for PCP-appropriate lever selection was 21.7 mg/kg). In rats discriminating 30 mg/kg (SC) of dextromethorphan from distilled water, dextromethorphan was slightly more potent SC than it was IP (ED50s for dextromethorphan-appropriate lever selection: 8.5 and 14.9 mg/kg, respectively). These animals generalized dose-dependently and completely to PCP and to other PCP-receptor ligands, but selected the vehicle-appropriate choice lever when tested withsigma-site ligands,mu-opioid agonists, and naltrexone. Concurrent administration of naltrexone orsigma-site ligands with 30 mg/kg dextromethorphan did not block dextromethorphan-appropriate responding. These results show that the discriminative effects of SC dextromethorphan are PCP-like and are not mediated by the high-affinity dextromethorphan binding site or by themu-opioid receptor. Because little dextrorphan is formed when dextromethorphan is given SC and because dextromethorphan itself has low affinity for the PCP receptor, the discriminative effects of SC dextromethorphan probably are mediated by a recognition site related closely to but different from the PCP receptor.
Discriminative probabilistic models for passage based retrieval

The approach of using passage-level evidence for document retrieval has shown mixed results when it is applied to a variety of test beds with different characteristics. One main reason of the inconsistent performance is that there exists no unified framework to model the evidence of individual passages within a document. This paper proposes two probabilistic models to formally model the evidence of a set of top ranked passages in a document. The first probabilistic model follows the retrieval criterion that a document is relevant if any passage in the document is relevant, and models each passage independently. The second probabilistic model goes a step further and incorporates the similarity correlations among the passages. Both models are trained in a discriminative manner. Furthermore, we present a combination approach to combine the ranked lists of document retrieval and passage-based retrieval.An extensive set of experiments have been conducted on four different TREC test beds to show the effectiveness of the proposed discriminative probabilistic models for passage-based retrieval. The proposed algorithms are compared with a state-of-the-art document retrieval algorithm and a language model approach for passage-based retrieval. Furthermore, our combined approach has been shown to provide better results than both document retrieval and passage-based retrieval approaches.
On the limitation of generalized Welch-bound equality signals

This correspondence characterizes the performance limitation of the well-acclaimed generalized Welch-bound equality (WBE) signals under linear minimum mean-squared error (MMSE) detection. It is analytically proven, and experimentally verified, that when users in an overloaded but finite-size code-division multiple-access (CDMA) system are allocated such signals, the error rate of at least one user "floors" (i.e., it cannot be driven to zero even in the absence of additive noise), independently of the symbol energies. If, in addition, all users are received with equal energy, then the error rate of every user "floors".
Integrating clinical and managerial activities of health care units

The first step in understanding information systems in health care units (HCUs) is to develop a conceptual model of HCU able to gather data and knowledge used by the management staff in order to plan, execute, control and evaluate the patient care process. An approach to HCU management modelling is presented in the paper. Our approach is centred on the use of guidelines for all activities which are carried out in HCU environments. Various guidelines may exist. Some of them are clinical, others are managerial. Among the most important managerial guidelines are the communication guidelines. They govern all communication activities inside or between HCUs. A model of guideline-based inter-HCUs communication is presented.
An in vivo and in vitro trial of aclarubicin in metastatic breast cancer: a novel approach to the study of analogs

Aclarubicin is an anthracycline antibiotic that differs from doxorubicin in its structure, mechanism of action, and preclinical toxicity profile, especially its reduced cardiotoxicity. We therefore conducted a side-by-side in vivo and in vitro trial of this agent in metastatic breast-cancer patients and their biopsied tumor specimens, respectively. Aclarubicin (100 mg/m2) was given by intravenous infusion every 3 weeks to 22 patients with objectively measurable metastatic breast cancer, 15 of whom had not previously received doxorubicin. The dose-limiting toxicity consisted primarily of leukopenia and severe nausea and vomiting. No objective response was observed in the 19 evaluable patients. After disease progression, 10 of the 15 doxorubicin-naive patients were treated with doxorubicin; 6 patients achieved a partial response, including 4 who responded to doxorubicin alone and 2 who responded to doxorubicin in combination with thiotepa and vinblastine. Tumor specimens were obtained from 14 of the 22 patients prior to the start of therapy and were tested for in vitro sensitivity to aclarubicin and doxorubicin using a soft agar colony-forming assay. Adequate colony growth occurred in 9 of 14 cultured tumor specimens. All 9 specimens, including 3 obtained from doxorubicin-naive patients, demonstrated in vitro resistance to aclarubicin. In all, 1 of 3 specimens taken from doxorubicin-naive patients demonstrated in vitro sensitivity to doxorubicin, whereas 6 tumor specimens obtained from patients who had undergone prior doxorubicin therapy demonstrated in vitro resistance. The patient whose tumor demonstrated in vitro doxorubicin sensitivity responded to a doxorubicin regimen after failing aclarubicin treatment; in vitro doxorubicin resistance correlated with clinical resistance in all cases. We conclude that aclarubicin is inactive in metastatic breast cancer at the dose and schedule used. Side-by-side in vivo and in vitro trials are feasible and could be useful in the development of investigational agents with activity greater than that of aclarubicin and, particularly, in the evaluation of analogs of clinically active drugs.
Unitary Interpretation of Quantum Theory

This Anti-Copenhagen interpretation [compare with N. R. Hanson, Am. J. Phys. 27, 1 (1959)-I submits that the doctrine of an inherent double nature of matter (and of light) is a most uneconomical hypothesis which would never have been proposed (except for heuristic purposes) had it not been for an oversight of the mechanical particle theory of diffraction by Duane (1923), later incorporated into the quantum mechanics of 1926 in Born’s unitary statistical interpretation of wavelike phenomena. Bohr’s indeterminacy view comes from a verbal translation of a legitimate wave feature; it is contrasted to the uncertainty of prediction of exact results. The latter is supported by the experiment, the former is not, so that various “epistemological lessons” drawn from Bohr’s view stand on brittle ground, which can hardly be reinforced by pointing to the transformation from the first to the second quantization, i.e., from one to another form of a complete and unitary theory. The simple quantum rules of the particle theory (first quantization) can be reduced to general postulates of symmetry and invariance.
Uniformly Diophantine numbers in a fixed real quadratic field

The field Q( √ 5) contains the infinite sequence of uniformly bounded similar patterns can be found in Q( √ d) for any d > 0. This paper studies the broader structure underlying these patterns, and develops related results and conjectures for closed geodesics on arithmetic manifolds, packing constants of ideals, class numbers and heights.
Reintegration after bone marrow transplantation.

objectives: This study examines the problems of bone marrow transplantation (BMT) survivors in returning to “normal” life in the community after BMT. materials and methods: Before being released from The Johns Hopkins Oncology Center, 84 recipients of BMT were interviewed regarding their quality of life and psychosocial adaptation. Survivors were reinterviewed at 6 months, and at 1 year post-BMT, producing considerable qualitative data regarding their problems in living. Eighty-four patients who had received BMT completed qualitative interviews and standardized measures before treatment, before the return home, and at 6 and 12 months post-BMT. The interviews were subjected to a content analysis methodology to establish units and categories to examine the body of material. results: Content analysis of these interviews from the first year after BMT identified three areas of psychosocial morbidity: 1) physical problems, which included fatigue, appearance, troubles in eating, and physical restrictions; 2) psychological problems, which included fears about the future, sense of loss of control, anxiety, and depression; and 3) community reintegration problems, which included difficulty in returning to former social roles, separation from home, family, and friends, difficulty in resuming social relations, dealing with stigmatization, problems with family and children, and financial and employment difficulties. conclusions: Identification of these problems for BMT survivors can be used to guide the development of specific materials and services to prepare recipients of BMTs and their families for life after the transplant. These qualitative results can also be used to direct the development of assessment tools to identify potential patient and family problems.
On an Irrelevant Regress

In a recent article, Wilson argues that Cartesian Scepticism leads to a vicious regress that can only be stopped by rejecting Cartesian Scepticism. If she is right, Wilson has solved one of philosophy's enduring problems. However, her regress is irrelevant to Cartesian Scepticism. This is evident once the proposition that we should have doubts, the person who has doubts, and the person who thinks that we should have doubts are carefully distinguished.
Measuring the Impact of Outreach and Enrollment Strategies for Public Health Insurance in California

Objective and Study Setting. To evaluate the effectiveness of different approaches to outreach on public health insurance enrollment in 25 California counties with a Children's Health Initiative. Data Source. Administrative enrollment databases. Study Design. The use of eight enrollment strategies were identified in each quarter from 2001 to 2007 for each of 25 counties (county quarter). Strategies were categorized as either technology or nontechnology. New enrollments were obtained for Medi-Cal, Healthy Families, and Healthy Kids. Bivariate and multivariate analyses assessed the link between each strategy and new enrollments rates of children. Data Collection. Methods Surveys of key informants determined whether a specific outreach strategy was used in each quarter. These were linked to new enrollments in each county quarter. Principal Findings. Between 2001 and 2007, enrollment grew in all three children's health programs. We controlled for the effects of counties, seasons, and county-specific child poverty rates. There was an increase in enrollment rates of 11 percent in periods when technology-based systems were in use compared with when these approaches were inactive. Non-technology-based approaches, including school-linked approaches, yielded a 12 percent increase in new enrollments rates. Deploying seven to eight strategies yielded 54 percent more new enrollments per 10,000 children compared with periods with none of the specific strategies. Conclusions and Implications. National health care reform provides new opportunities to expand coverage to millions of Americans. An investment in technology-based enrollment systems will maximize new enrollments, particularly into Medicaid; nontechnological approaches may help identify harder-to-reach populations. Moreover, incorporating several strategies, whether phased in or implemented simultaneously, will enhance enrollments.
Concentration-dependent patterning of the Xenopus ectoderm by BMP4 and its signal transducer Smad1

Morphogens are thought to establish pattern in early embryos by specifying several cell fates along a gradient of concentration; a well-studied example is the Drosophila protein decapentaplegic (DPP) acting in the wing disc. Recent work has established that bone morphogenetic protein 4 (BMP4), the vertebrate homologue of DPP, controls the fundamental choice between neural and epidermal fates in the vertebrate ectoderm, under the control of antagonists secreted by the organizer region of the mesoderm. We now show that BMP4 can act as a morphogen, evoking distinct responses in Xenopus ectodermal cells at high and low concentrations, in a pattern consistent with the positions of the corresponding cell types in the embryo. Moreover, this complex cellular response to extracellular BMP4 concentration does not require subsequent cell-cell communication and is thus direct, as required of a classical morphogen. We also show that the same series of cell types--epidermis, cement gland and neural tissue--can be produced by progressively inhibiting endogenous BMP signaling with specific antagonists, including the organizer factor noggin. Finally, expression of increasing doses of the signal transduction molecule Smad1 accurately reproduces the response to BMP4 protein. Since Smads have been shown to act in the nucleus, this finding implies a direct translation of extracellular morphogen concentration into transcription factor activity. We propose that a graded distribution of BMP activity controls the specification of several cell types in the gastrula ectoderm and that this extracellular gradient acts by establishing an intracellular and then nuclear gradient of Smad activity.
A multiple associative model to support branches in data parallel applications using the manager-worker paradigm

ASC (associative computing model) and MASC (multiple associative computing model) have long been studied in the Department of Computer Science at Kent State University. While the previous studies provide the background and the basic definition of the model, the description of the interactions between the instruction streams (ISs) is very brief, high level, and incomplete. One change here is that we specify the interaction between ISs and consider that all of the ISs operate on the same clock in order to support predictable worst case computation times, while earlier the ISs were assumed to interact in a MIMD type fashion. This paper provides a detailed explanation as to how these interactions can be supported in the case where only a few ISs are supported.
Parallel multiplier designs utilizing a non-binary logic scheme

The paper presents a novel approach for CMOS low-power, high performance parallel multiplier design, utilizing a recently proposed non-binary shift switch logic scheme. Compared with the existing well-known parallel multiplier designs, the new approach requires fewer partial product bit reduction stages, and improves performance in speed, VLSI area as well as power dissipation. SPICE simulations with a 0.25 micron, 2.5 volt supply process on critical paths have demonstrated the superiority of the approach.
The application and evaluation of a two-concept diagnostic instrument with students entering college general chemistry

The Particulate Nature of Matter and Chemical Bonding Diagnostic Instrument (Othman J., Treagust D. F. and Chandrasegaran A. L., (2008), Int. J. Sci. Educ., 30(11), 1531–1550) is used to investigate college students' understanding of two chemistry concepts: particulate nature of matter and chemical bonding. The instrument, originally developed for secondary school students, is a two-tier diagnostic test. In this study, the instrument was given as a paper and pencil test to college students enrolled in General Chemistry I during the second week of class in Spring 2010. General Chemistry I students were divided into three groups for analysis: (A) with preparatory chemistry, (B) repeating general chemistry (without preparatory chemistry); and (C) first time in general chemistry (without preparatory chemistry); Groups B and C are expected to have taken at least one year of secondary school chemistry. However, Group A had little or no exposure to high school chemistry. Regardless of their pathway into the course, students in General Chemistry I are expected to have a fair understanding of the two concepts. Furthermore, students' responses were used to think about the role of a preparatory chemistry course in promoting deep understanding of chemistry concepts. An ANCOVA analysis was performed. Preparatory Chemistry was found to have a statistically significant but small effect on students’ scores after controlling for prior math achievement. Confirmatory factor analysis and reliability studies were performed and are presented here. Analysis also revealed alternative conceptions.
Biomechanical Consequences of Sequential Plantar Fascia Release

Plantar fascia release has long been a mainstay in the surgical treatment of persistent heel pain, although its effects on the biomechanics of the foot are not well understood. With the use of cadaver specimens and digitized computer programs, the changes in the medial and lateral columns of the foot and in the transverse arch were evaluated after sequential sectioning of the plantar fascia. Complete release of the plantar fascia caused a severe drop in the medial and lateral columns of the foot, compared with release of only the medial third. Equinus rotation of the calcaneus and a drop in the cuboid indicate that strain of the plantar calcaneocuboid joint capsule and ligament is a likely cause of lateral midfoot pain after complete plantar fascia release.
Cohesin-Dockerin Interactions of Cellulosomal Subunits of Clostridium cellulovorans

The cellulosome of Clostridium cellulovorans consists of three major subunits: CbpA, EngE, and ExgS. The C. cellulovorans scaffolding protein (CbpA) contains nine hydrophobic repeated domains (cohesins) for the binding of enzymatic subunits. Cohesin domains are quite homologous, but there are some questions regarding their binding specificity because some of the domains have regions of low-level sequence similarity. Two cohesins which exhibit 60% sequence similarity were investigated for their ability to bind cellulosomal enzymes. Cohesin 1 (Coh1) was found to contain amino acid residues corresponding to amino acids 312 to 453 of CbpA, which contains a total of 1,848 amino acid residues. Coh6 was determined to contain amino acid residues corresponding to residues 1113 to 1254 of CbpA. By genetic construction, these two cohesins were each fused to MalE, producing MalE-Coh1 and MalE-Coh6. The abilities of two fusion proteins to bind to EngE, ExgS, and CbpA were compared. Although MalE-Coh6 could bind EngE and ExgS, little or no binding of the enzymatic subunits was observed with MalE-Coh1. Significantly, the abilities of the two fusion proteins to bind CbpA were similar. The binding of dockerin-containing enzymes to cohesin-containing proteins was suggested as a model for assembly of cellulosomes. In our examination of the role of dockerins, it was also shown that the binding of endoglucanase B (EngB) to CbpA was dependent on the presence of EngB9s dockerin. These results suggest that different cohesins may function with differing efficiency and specificity, that cohesins may play some role in the formation of polycellulosomes through Coh-CbpA interactions, and that dockerins play an important role during the interaction of cellulosomal enzymes and cohesins present in CbpA.
Development of High-Speed Gas Bearings for High-Power-Density Micro-Devices

A 4.2 mm diameter silicon rotor has been operated in a controlled and sustained manner at rotational speeds greater then 1.3 million rpm and power levels approaching 5 W. The rotor, supported by hydrostatic journal and thrust gas bearings, is driven by an air turbine. This turbomachinery/bearing test device was fabricated from single crystal silicon wafers using micro-fabrication etching and bonding techniques. We believe this device is the first micro-machine to operate at a circumferential tip speed of over 300 meters per second, comparable to conventional macro-scale turbomachinery, and necessary for achieving high levels of power density in micro-turbomachinery and micro-electrostatic/ electromagnetic devices.To achieve this level of peripheral speed, micro-fabricated rotors require stable, low friction bearings for support. Due to the small scale of these devices as well as fabrication constraints that limit the bearing aspect ratio, the design regime is well outside that of more conventional devices. This paper focuses on bearing design and test, and rotordynamic issues for high-speed high-power micro-fabricated devices.Copyright © 2001 by ASME
Husserl and ptsd: The Traumatic Correlate

The present paper contributes to the analysis and understanding of post-traumatic stress disorder ( PTSD ) from the perspective of Husserlian phenomenology. The particular approach taken integrates the experience of a PTSD trigger into Husserl’s descriptive framework of noematic constitution. By analyzing the constituent makeup of a particular object that acts as a trigger for PTSD symptoms, a descriptive account of how an ordinary noematic correlate becomes a pathological traumatic correlate is provided. This is done in three steps. First, the traumatic correlate is shown to emerge by way of a judgment. Then, the role of the Ego will be examined to identify the point where the intentional relation between sufferer and traumatic correlate becomes pathological. Third, a phenomenological description of belief characteristics indicates the mechanism by which this pathology is maintained. I conclude by showing the connection between a phenomenological account of PTSD triggers and the current therapeutic practice of prolonged exposure therapy.