cssi/SciSciGPT-SciSciNet huggingface dataset:
Needle and guidewire visualization in ultrasound-guided internal jugular vein cannulation

Abstract Study objective Reimbursement for ultrasound-guided central lines requires documenting the needle entering the vessel lumen. We hypothesized that physicians often successfully perform ultrasound-guided internal jugular (IJ) cannulation without visualizing the needle in the lumen and that guidewire visualization occurs more frequently. Methods This prospective, observational study enrolled emergency physicians performing ultrasound-guided IJ cannulations over an 8-month period. Physicians reported sonographic visualization of the needle or guidewire and recorded DVD images for subsequent review. Outcome measures were the proportion of successful procedures in which the operator reported seeing the needle or guidewire in the vessel lumen and the proportion of successful, recorded procedures, in which a reviewer noted the same findings. Procedures were deemed successful when functioning central venous catheters were placed. Fisher exact test was used for comparisons. Results Of 41 attempted catheterizations, 35 (85.4%) were successful. Eighteen of these were recorded on DVD for review. The operator reported visualizing the needle within the vessel lumen in 23 (65.7%) of 35 successful cannulations (95% confidence interval [CI], 47.7%-80.3%). In 27 cases, the operator attempted to view the guidewire and reported doing so in 24 cases (88.9%; 95% CI, 69.7%-97.1%). On expert review, the needle was seen penetrating the vessel lumen in 1 (5.6%) of 18 cases (95% CI, 0.3%-29.4%). Among recorded procedures in which the operator also attempted wire visualization, the reviewer could identify the wire within the vessel lumen in 12 (75.0%) of 16 cases (95% CI, 47.4%-91.7%). Conclusions During successful ultrasound-guided IJ cannulation, physicians can visualize the guidewire more readily than the needle.
Reduced Insulin-like Growth Factor I Receptor and Altered Insulin Receptor Isoform mRNAs in Normal Mucosa Predict Colorectal Adenoma Risk

Background: Hyperinsulinemia resulting from obesity and insulin resistance is associated with increased risk of many cancers, but the biology underlying this risk is unclear. We hypothesized that increased mRNA levels of the insulin-like growth factor I receptor (IGFIR) versus the insulin receptor (IR) or elevated ratio of IR-A:IR-B isoforms in normal rectal mucosa would predict adenoma risk, particularly in individuals with high body mass index (BMI) or plasma insulin. Methods: Biopsies from normal rectal mucosa were obtained from consenting patients undergoing routine colonoscopy at University of North Carolina Hospitals (Chapel Hill, NC). Subjects with colorectal adenomas were classified as cases ( n = 100) and were matched to adenoma-free controls ( n = 98) based on age, sex, and BMI. IGFIR and IR mRNA levels were assessed by qRT-PCR, and IR-A:IR-B mRNA ratios by standard PCR. Plasma insulin and crypt apoptosis were measured by ELISA and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL), respectively. Logistic regression models examined relationships between receptor mRNAs, BMI, plasma insulin, and adenoma risk. Results: Unexpectedly, cases were significantly more likely to have lower IGFIR mRNA levels than controls. No overall differences in total IR mRNA or IR-A:IR-B ratios were observed between cases and controls. Interestingly, in patients with high plasma insulin, increased IR-A:IR-B ratio was associated with increased likelihood of having adenomas. Conclusions: Our work shows novel findings that reduced IGFIR mRNA and, during high plasma insulin, increased IR-A:IR-B ratios in normal rectal mucosa are associated with colorectal adenoma risk. Impact: Our work provides evidence supporting a link between IGFIR and IR isoform expression levels and colorectal adenoma risk. Cancer Epidemiol Biomarkers Prev; 23(10); 2093–100. ©2014 AACR .
Fluorodeoxyglucose positron emission tomography studies in the diagnosis and staging of transitional cell carcinoma.

The introduction of positron emission tomography (PET) has allowed scientists and clinicians to measure biochemical and physiological processes in vivo. Although PET has been in existence since the 1960s, it did not gain complete clinical acceptance until roughly a decade ago. At that time, Di Chiro et al demonstrated the ability of PET to differentiate between recurrent brain tumor and radiation necrosis.5 This prompted the recognition of PET as a valid method of tumor imaging.
Processing and Characterization of Multiphase Ceramic Composites Part I: Duplex Composites Formed In Situ from Solution

Chemically compatible 50 vol% Al2O3–50 vol% YAG (yttrium aluminum garnet, Y3Al5O12), 50 vol% Al2O3–50 vol% mullite, and 50 vol% Al2O3–50 vol% NiAl2O4, in situ, duplex composite powders were fabricated by a chemical synthesis method. Both amorphous and crystalline powders were synthesized. The physical and mechanical properties of YAG and in situ, solution derived composites made using these powders were analyzed. Mechanically mixed, composite powders were made by a conventional, ball-milling technique. The properties of the composites made from in situ versus mechanically mixed powders were studied. Compared with pellets made from crystalline powder, amorphous powder-derived pellets had about a twofold higher sintering shrinkage. The crystalline powder-derived YAG pellet sintered at 1650°C for 10 h had a three-point bending strength of 244±3 MPa. A 50 vol% Al2O3–50 vol% YAG in situ composite achieved an average bending strength of 361±19 MPa after sintering at 1700°C for 5 h. Grain size measurements indicated a mutual grain growth retardation effect of alumina and YAG phases in the composites. The better properties of in situ composites compared with mechanically mixed composites were attributed to the intimate mixing, at a molecular level, during the processing of in situ composites. The possible formation of a glassy phase in the Al2O3-mullite in situ composite heat treated at higher temperatures was discussed. The physical and mechanical properties of alumina–mullite and Al2O3–NiAl2O4in situ composites were investigated.
Seasonal variability in the dynamics of marine-terminating outlet glaciers in Greenland

Recent studies indicate that the dynamics of fast-flowing, marine-terminating outlet glaciers of the Greenland ice sheet may be sensitive to climate and ocean forcing on sub-annual timescales. Observations of seasonal behavior of these glaciers at such high temporal resolution, however, are currently few. Here we present observations of front position, flow speed, near-surface air temperature and ocean conditions for six large marine-terminating glaciers in the Uummannaq region of West Greenland, to investigate controls on short-term glacier dynamics. As proposed by other studies, we find that seasonal front advance and retreat correlates with the formation and disappearance of an ice melange. Our data suggest that high sea-surface temperature, anomalously low sea-ice concentration and reduced melange formation in early 2003 have triggered multi-year retreat of several glaciers in the study area, which is consistent with other regions in Greenland. Of the stable glaciers, only Rink Isbrae exhibits a seasonal speed variation that correlates with variations in front position, with the others undergoing mid-summer deceleration that indicates the effects of subglacial meltwater discharge and drainage system evolution. Drainage of supraglacial lakes and water-filled crevasses results in substantial decreases in speed (40-60%) on fast-flowing glaciers. Our results demonstrate that attempts to model ice-sheet evolution must take into account short-timescale flow dynamics resulting from drainage events and oceanographic conditions.
Infection of the choroid plexus by feline immunodeficiency virus

The human, simian, and feline immunodeficiency viruses rapidly penetrate into the brain and trigger an inflammatory process that can lead to significant neurologic disease. However, the mechanisms that permit efficient trafficking of macrophage-tropic and the more neurotoxic lymphocytotropic isolates are still poorly understood. One potential source of virus entry may be the blood-CSF barrier provided by the choroid plexus. Infected cells are often detected within the choroid plexus but it is unclear whether this reflects trafficking cells or infection of the large macrophage population within the choroidal stroma. To address this issue, we cultured fetal feline choroid plexus and evaluated the ability of feline immunodeficiency virus (FIV) to establish a primary infection. Significant provirus was detected in macrophage-enriche d choroid plexus cultures as well as in the choroid plexus of cats infected in vivo. FIV p24 antigen production in vitro was very low but detectable. Addition of a feline T-cell line to macrophages inoculated with FIV resulted in a dense clustering of the T cells over macrophages with dendritic cell-like morphologies and a robust productive infection. The direct infection of choroid plexus macrophages with FIV, the efficient transfer of the infection to T cells indicate that the choroid plexus can be a highly efficient site of viral infection and perhaps trafficking of both macrophage-tropic and T-cell-tropic viruses into the CNS.
Prevention of Catheter Associated Urinary Tract Infections in Stroke Patients (P1.009)

Objective: To evaluate the effectiveness of reduction of inappropriate catheterization of stroke patients to prevent CAUTI. Background: Urinary tract infections (UTIs) are a common complication in stroke patients and have been shown to cause an increased risk of death or disability at 3 months. Urinary catheters are responsible for most UTIs in hospitalized patients. Their inappropriate use has been brought into focus by various national quality organizations. CAUTI has been designated as a preventable and non- reimbursable condition by CMMS with direct costs running to several thousand dollars. They also significantly affect length of stay by several days. Few studies have evaluated CAUTI in stroke patients. Design: A protocol was developed to reduce inappropriate catheterization on stroke patients and implemented on November 1, 2013. CAUTI was defined per CDC guidelines. Patients admitted to the stroke service from January 2013 to July 2014 were included in this retrospective pilot study. CAUTI rates per 1000 catheter days and catheter utilization rates during the pre- intervention and post- intervention periods were calculated. Results: 1405 patients (ICH n= 209, CVA n= 1196) were included in the study period. Mean age was 64.7 and mean NIHSS score was 7.2 The mean CAUTI rate was 6.86 per 1000 catheter days during the 9 months pre-intervention and 3.32 during the 8 months post- intervention. The pre-intervention average catheter utilization rate in the stroke ward was 17.3 vs 12.8 post-intervention. The total number of CAUTIs pre-intervention was 12(6 Ischemic, 3 ICH and 3 stroke mimics). Post-intervention , CAUTI was detected in 3 ischemic strokes. Conclusion: Steps taken to reduce unnecessary catheterization resulted in reduced rates of CAUTI. The study could prove to be a useful pilot for a prospective study for the prevention of CAUTI in stroke patients and may help reduce comorbidities in this population. Disclosure: Dr. Aroor has nothing to disclose. Dr. Branson has nothing to disclose. Dr. Turner has nothing to disclose. Dr. Lee has nothing to disclose.
When Popular Religion Becomes Elite Heritage: Tensions and Transformations at the Shrine of St. Padre Pio of Pietrelcina

Religious sites seem to have always been viewed as profitable and popular loci for heritage and heritage tourism as they are highly affective mediators (between people, places, and the divine) deeply implicated in a society’s cosmology and values, and often attest to important syncretisms and networks of socio-cultural exchange. However, this chapter argues that extreme tensions may arise at the popular level when heritage practitioners attempt to transition a site from a locus of popular religion—with its own specific style of embodied devotion practices—to one of modern heritage and tourism. Tracing the theological and philosophical turns of thought underlying both (pre-Tridentine) popular devotion and (post-Enlightenment) heritage tourism, and based on long-term ethnographic research in Italy, this chapter examines the contemporary difficulties religious site managers in the Italian pilgrimage town of San Giovanni Rotondo have encountered in turning their shrine to twentieth century stigmatic and saint Padre Pio of Pietrelcina into a modern cultural heritage site akin to Assisi, which, in the popular imaginary, is more famous for its UNESCO-designated art and architecture than it is of its extremely influential saint, Francis of Assisi. The author argues that, to mitigate such tensions, more ethnographic attention should be paid to the divergent goals and values of popular religion and popular heritage, and to the oft-conflicting ways in which pilgrims and heritage tourists and practitioners discipline their bodies and senses to achieve these objectives.
Analysis of the Soluble and Membrane‐bound Immobilization Antigens of Ichthyophthirius multifiliis

The immobilization antigens (i-antigens) are a class of highly abundant surface membrane proteins found on a number of holotrich ciliates. In Ichthyophthirius multifiliis (an obligate parasite of fish) these antigens appear to be targets of the host immune response. While the i-antigens of Ichthyophthirius are predominantly membrane-associated proteins, we now find that they are released into the water surrounding the parasite in a highly enriched form. The membrane-associated and water soluble proteins appear indistinguishable by antigenic means, as well as by several biochemical criteria including peptide mapping, mobility in reducing and non-reducing SDS-polyacrylamide gels, and relative glycosylation. Antibodies raised against the membrane-associated antigens react with the water soluble proteins on Western blots. Not surprisingly, immunocytochemical localization studies show binding of these antibodies to surface membranes of the cell. In addition, however, antibody binding is also detectible on the membranes of secretory organelle (that is, mucocysts) present in the cortical cytoplasm. The significance of these findings with regard to the potential role of the i-antigens in infection and immunity is discussed.
Public Land Grazing in California: Untapped Conservation Potential for Private Lands?

June 2007 The growing interest in conservation of working landscapes and the attention paid to ranchland protection refl ects a growing recognition of the environmental values of production landscapes, dissatisfaction with what sometimes appears to be gridlocked, under-funded public lands management, and decreasing public funding for fee title acquisition. Yet productive private rangelands are often linked to public land leases. In this research, we examined the relationship between the accessibility and management of these leases and ranch sustainability in 2 areas of California. Findings suggest that an overlooked tool for the conservation of working landscapes is the use of public land grazing for stabilizing livestock operations. Public land grazing could be the glue holding many ranching communities together in the face of strong pressures to convert private rangeland to more intensive uses.
Effect of ocean surface currents on wind stress, heat flux, and wind power input to the ocean

[1] The effect of ocean surface currents on bulk algorithm calculations of wind stress and heat flux in a 1/5° resolution model of the North Pacific is investigated. Two year-long model runs are performed, one with wind speed modified by ocean surface velocities and one without. Basin averaged heat flux and wind stress differences between the models were only 1–2%, but localized flux reductions of ∼10% were found in the tropics and in the Kuroshio current system. Basin average power input by the wind to the general circulation was reduced by 27% when the effect of surface currents was included. Tropical surface currents were reduced by 10%, tropical surface temperature warmed by 0.1°C, and equatorial upwelling was reduced by 15% due to the changed velocity field.
A new approximation to three-dimensional electromagnetic scattering

We introduce a new source-dependent but diagonal scattering tensor to approximate the electromagnetic fields internal to a scatterer. The approximate analytical expressions for the three diagonal scattering components are derived. Numerical tests show that the new approximation has favorable accuracy and wider range of applicability than the existing approximations such as the widely used extended Born approximation and the quasi-analytical approximation.
Aglycones and Sugar Moieties Alter Anthocyanin Absorption and Metabolism after Berry Consumption in Weanling Pigs

To investigate the absorption and metabolism of anthocyanins (ACNs) with different aglycones and sugar moieties, weanling pigs (11.4 +/- 3.8 kg) were fed, in a single meal, a freeze-dried powder of chokeberry, black currant, or elderberry at a single dose of 229, 140, or 228 mumol total ACN/kg body weight (BW), respectively. These berries provided ACNs with differences in aglycone as well as some unique differences in the sugar moieties. The relative proportions of the different metabolites depended upon concentrations, quantities consumed, and types of glycoside of ACNs in the berry. Delphinidin ACNs were not metabolized to any measurable extent. Cyanidin ACNs were metabolized via methylation and glucuronidation as well as by formation of both derivatives on the same ACN molecule. ACNs with either a di- or trisaccharide attached to them were excreted in the urine primarily as the intact form. Over 80% of the ACN compounds containing rutinose or sambubiose, which were excreted in the urine from black currant, elderberry, or Marion blackberry, were excreted as the intact molecule. The limited metabolism of these ACNs that did occur was via methylation. ACN monoglycosides other than the glucoside were metabolized via methylation and/or glucuronide formation. The monoglucuronide that formed represented a small proportion of the metabolites relative to the methylated or the mixed methylated and glucuronide forms of ACNs. The data clearly demonstrate that the aglycone and the sugar moieties can alter the apparent absorption and metabolism of ACNs.
Exploration of Theoretical Models: Postpartum Weight Retention in African American Adolescents

Obesity presents a public health challenge and is a serious chronic medical condition, associated with multiple co-morbidities and reduced survivability and longevity. Obesity accounts for about 300,000 deaths each year and is expected to cost the United States healthcare system almost 237 million dollars within the next decade. African American adolescents who retain weight after pregnancy are at the highest risk of becoming obese adults with the potential to develop chronic diseases or serious illnesses. The author explores non-nursing and nursing theories that could guide needed research to help understand the barriers that prevent weight loss and raise the risk of obesity among postpartum adolescents. After the exploration, Orem’s self-care theory was selected for the proposed study based on nursing interventions that could facilitate postpartum adolescents’ self-care and weight control behaviors.
Security performance of optical CDMA Against eavesdropping

Enhanced security has often been cited as an important benefit of optical CDMA (O-CDMA) signaling. However, the quality and degree of security enhancement has not been closely examined in the literature. This paper examines the degree and types of security that may be provided by O-CDMA encoding. A quantitative analysis of data confidentiality is presented for O-CDMA encoding techniques that use both time spreading and wavelength hopping. The probability of successful data interception is calculated as a function of several parameters, including signal-to-noise ratio and fraction of total available system capacity. For reasonable choices of system and encoding parameters, it is shown that increasing code complexity can increase the signal-to-noise ratio (SNR) required for an eavesdropper to "break" the encoding by only a few dB, while the processing of fewer than 100 bits by an eavesdropper can reduce the SNR required to break the encoding by up to 12 dB. The overall degree of confidentiality obtainable through O-CDMA encoding is also compared with that obtainable through standard cryptography. time-spreading/wavelength-hopping in particular, and O-CDMA in general, are found to provide considerably less data confidentiality than cryptography, and the confidentiality provided is found to be highly dependent on system design and implementation parameters.
State knowledge representation in the Mission Data System

The possible states of a system, be it a spacecraft, rover or ground station, are what system engineers identify and specify, what software engineers design for, and what operators monitor and control. Many activities inside mission software are directly concerned with state, whether planning it, estimating it, controlling it, reporting it or simulating it. The cause of several mission failures can be traced to inadequate or inconsistent representations of state. Consequently, the concept of 'state' and its representation occupy a prominent role in mission software architecture. The Mission Data System (MDS), presently under development by NASA to provide multi-mission flight and ground software for the next generation of deep space systems, addresses this fundamental need. This paper describes the MDS approach to state knowledge representation, covering state variables, state functions, state estimates and state constraints, emphasizing design patterns that reduce sources of human error.
Gaussian Quadrature Formulae for Arbitrary Positive Measures

We present computational methods and subroutines to compute Gaussian quadrature integration formulas for arbitrary positive measures. For expensive integrands that can be factored into well-known forms, Gaussian quadrature schemes allow for efficient evaluation of high-accuracy and -precision numerical integrals, especially compared to general ad hoc schemes. In addition, for certain well-known density measures (the normal, gamma, log-normal, Student’s t, inverse-gamma, beta, and Fisher’s F) we present exact formulae for computing the respective quadrature scheme.
Human preembryo development on autologous endometrial coculture versus conventional medium

Abstract Objective: To evaluate the effect of autologous endometrial coculture versus conventional medium on preembryo development. Design: Controlled systematic clinical study. Setting: University-based IVF center. Patient(s): Women with a history of failed IVF-ET with poor preembryo quality. Intervention(s): Patients underwent a luteal phase endometrial biopsy. The tissue then was digested enzymatically, and the stromal and glandular cells were separated by differential sedimentation rates. These cells were cultured to confluence, released, and then cryopreserved until the patient's IVF-ET cycle. All normally fertilized oocytes then were allocated systematically to growth on autologous endometrial coculture or conventional medium until transfer on day 3. Main Outcome Measure(s): Preembryo blastomere numbers and cytoplasmic fragmentation rates were measured. Result(s): Forty-two women underwent 44 cycles of IVF-ET. In the morning on day 3, the mean (±SD) number of blastomeres and cytoplasmic fragments per preembryo on coculture compared with conventional medium was 5.9 ± 1.5 versus 5.5 ± 1.4 and 21% ± 13% versus 24% ± 11. At transfer the mean (±SD) number of blastomeres per preembryo on coculture was 7.4 ± 1.3 versus 6.7 ± 1.9 on conventional medium. Conclusion(s): There was a significant improvement in the mean (±SD) number of blastomeres per preembryo and decrease in the fragmentation rate for preembryos on autologous endometrial coculture compared with noncocultured preembryos from the same patient.
CellSort: high performance sorting on the cell processor

In this paper we describe the design and implementation of CellSort - a high performance distributed sort algorithm for the Cell processor. We design CellSort as a distributed bitonic merge with a data-parallel bitonic sorting kernel. In order to best exploit the architecture of the Cell processor and make use of all available forms of parallelism to achieve good scalability, we structure CellSort as a three-tiered sort. The first tier is a SIMD (single-instruction multiple data) optimized bitonic sort, which sorts up to 128KB of items that cat fit into one SPE's (a co-processor on Cell) local store. We design a comprehensive SIMDization scheme that employs data parallelism even for the most fine-grained steps of the bitonic sorting kernel. Our results show that, SIMDized bitonic sorting kernel is vastly superior to other alternatives on the SPE and performs up to 1.7 times faster compared to quick sort on 3.2GHz Intel Xeon. The second tier is an in-core bitonic merge optimized for cross-SPE data transfers via asynchronous DMAs, and sorts enough number of items that can fit into the cumulative space available on the local stores of the participating SPEs. We design data transfer and synchronization patters that minimize serial sections of the code by taking advantage of the high aggregate cross-SPE bandwidth available on Cell. Results show that, in-core bitonic sort scales well on the Cell processor with increasing number of SPEs, and performs up to 10 times faster with 16 SPEs compared to parallel quick sort on dual-3.2 GHz Intel Xeon. The third tier is an out-of-core bitonic merge which sorts large number of items stored in the main memory. Results show that, when properly implemented, distributed out-of-core bitonic sort on Cell can significantly outperform the asymptotically (average case) superior quick sort for large number of memory resident items (up to 4 times faster when sorting 0.5GB of data with 16 SPEs, compared to dual-3.2GHz Intel Xeon).
19F NMR of trifluoroacetyl-labeled cysteine mutants of myoglobin: structural probes of nitric oxide bound to the H93G cavity mutant.

Nitric oxide (NO) binds to the myoglobin (Mb) cavity mutant, H93G, forming either a 5- or 6-coordinate Fe-NO heme complex. The H93G mutation replaces the proximal histidine of Mb with glycine, allowing exogenous ligands to occupy the proximal binding site. In the absence of the covalently attached proximal ligand, NO could bind to H93G from the proximal side of the heme rather than the typical diatomic binding pocket on the distal side when the 5-coordinate complex forms. The question of whether NO binds on the distal or proximal side was addressed by 19 F NMR. Site-directed mutagenesis was used to introduce unique cysteine residues at the protein surface on either the distal (S58C) or proximal (L149C) side, approximately equidistant from and perpendicular to the heme plane of both wild-type and H93G Mb. The cysteine thiols were alkylated with 3-bromo-1,1,1-trifluoroacetone to attach a trifluoroacetyl group at the mutation site. 19 F NMR spectra of 5-coordinate, NO bound S58C/H93G and L149C/H93G double mutants depict peaks with line widths of 100 and 23 Hz, respectively. As fluorine peaks broaden with increasing proximity to paramagnetic centers, such as 5-coordinate Fe-NO, the 19 F NMR data are consistent with NO binding in the distal heme pocket of H93G, even in the absence of a sixth axial ligand. Additionally, 19 F NMR spectra are reported for deoxy, oxy, CO, met CN, and met H2O forms of the labeled cysteine mutants. These results demonstrate that the fluorine probes are sensitive to subtle conformational changes in the protein structure due to ligation and oxidation state changes of the heme iron in Mb.
Euthanasia and the Administration of Neuromuscular Blockers without Ventilation: Should Physicians Fear Prosecution?:

A common dilemma among physicians who treat the dying is whether pharmacological paralysis should be reversed prior to removal of mechanical ventilation. But what if a physician were to administer ...
Antenna performance predictions of a radio telescope subject to thermal perturbations

Antenna performance predictions and calibration times are estimated on a 37 m diameter radio telescope subject to thermal perturbations. The telescope is designed to operate at frequencies up to 325 GHz with a one-way performance requirement of 1 dB loss in gain accounting for fabrication, alignment, gravity and thermal errors. Thermal gradients acting over the antenna structure due to diurnal air temperature variations are a significant contributor to degradations in antenna performance. Integrated thermal-structural-optical analyses were performed to predict antenna performance as a function of the diurnal variations. Based on the results, design requirements were imposed on the radome thermal control system and the rate of calibration of the hexapod mounted subreflector.
Medicaid Expansion Did Not Result In Significant Employment Changes Or Job Reductions In 2014

Medicaid expansion undertaken through the Affordable Care Act (ACA) is already producing major changes in insurance coverage and access to care, but its potential impacts on the labor market are also important policy considerations. Economic theory suggests that receipt of Medicaid might benefit workers who would no longer be tied to specific jobs to receive health insurance (known as job lock), giving them more flexibility in their choice of employment, or might encourage low-income workers to reduce their hours or stop working if they no longer need employment-based insurance. Evidence on labor changes after previous Medicaid expansions is mixed. To view the impact of the ACA on current labor market participation, we analyzed labor-market participation among adults with incomes below 138 percent of the federal poverty level, comparing Medicaid expansion and nonexpansion states and Medicaid-eligible and -ineligible groups, for the pre-ACA period (2005–13) and the first fifteen months of the expansion (Ja...
The Art of Anger

AbstractThe importance of anger management and nonviolent conflict resolution are discussed and related to therapeutic practice. Additionally, the results of two studies concerning the imagery and expression of anger are presented. In both studies, college students completed a drawing representing anger and Spielberger's State-Trait Anger Expression Inventory (STAXI). Findings included a significant positive correlation between intensity of anger imagery and State Anger (r = .26, p < .05, one-tailed test N = 46) and a significant chi-square value for a test of independence between imagery themes and STAXI scores (χ2 = 9.73, p < .05, N = 92). The results support clinical experience and suggest an art therapy approach to anger management for further development.
Computational Simulation of Surface Formation in Solid Continua

The formation of new free surface by such phenomena as fracture, cutting, and penetration requires that a curve propagate through the continuum, along which the kinematical fields are singular (i.e. no single-valued limit exists). This singular curve leaves newly-created free surfaces in it wake. In conventional fracture mechanics, a local constitutive description is assumed to hold in the neighborhood of the singular curve, with the fracture criterion itself involving a length scale. A different approach is proposed that is thought to be applicable not only to “fracture-type” problems, but also to, e.g., metal-cutting, wherein the presence of large deformations and nonproportional and nonlinear material behavior render asymptotic solutions difficult, or impossible, to obtain. The approach involves identification of an exclusion region surrounding the singular curve, within which neither a constitutive model is available, nor a requirement made that equilibrium hold pointwise. The exclusion region takes the form of a small-diameter tube of material around the singular curve, in which the radius is a material parameter. The kinematical fields within the exclusion region are given by assumed functional forms that involve a small number of free parameters. These parameters are determined so that the exclusion region is in overall equilibrium. The surface tractions on the region are obtained from the constitutive model for the bulk continuum. The separation criterion involves suitably-defined normal and shearing forces that act on the boundary of the exclusion region. This criterion may be put into correspondence with the familiar critical stress-intensity factors of LEFM in the case of linear elasticity. Results from a preliminary, two-dimensional finite element implementation of these ideas are presented.
A 51-year-old woman with dyspnea.

Her symptoms began 4 days ago. She appears uncomfortable and anxious, her pulse is over 160, and her respirations are 40. What is going on?
Erasure or partitioning in short-term memory

The possibility of erasure or partitioning in short-term memory was studied by instructing Ss to retrieve by free recall only 10 relevant letters embedded in a sequence of 20 visually presented letters. In the pre-cuing condition, irrelevant letters were indicated by a preceding blank, while in the post-cuing condition, irrelevant letters were indicated by a following blank. There was no difference in free recall under pre-cuing and post-cuing conditions, although free recall in both was better than chance. Free recall in a cueless control condition with irrelevant letters removed was better than in either pre- or post-cuing conditions. Analysis of errors suggests that irrelevant items were treated by partitioning or tagging in both cuing conditions, rather than by erasure, because cued-out letters occurred as errors of commission significantly more often than did letters which were not presented.
Q04 Impact of tetrabenazine on balance and gait in individuals with Huntington's disease

Background Chorea may contribute to balance problems and walking difficulties that lead to higher fall rates in individuals with Huntington9s disease (HD). Few studies have examined the effects of anti-choreic drugs on functional abilities. We noted that patients report decreased falls on stable dose of tetrabenazine, and we observed declines in gait and functional mobility when the drug was abruptly stopped. Aims The purpose of this study is to compare: (1) spatiotemporal gait measures in forward and backward walking, (2) performance on functional mobility measures, and (3) amount of daily walking activity before and after administration of tetrabenazine in individuals with HD. It is hypothesised that the use of tetrabenazine to decrease chorea will improve gait, transfers and stair climbing. Methods Evaluation of eight individuals on stable doses of tetrabenazine while off medication for >18 h and again 2 h following medication resumption. Individuals walked on the GAITRite and completed functional testing of UHDRS motor scores, Tinetti Mobility Test, Timed Sit-to-Stand Test and Timed Stair climbing. Results As shown in prior studies, UHDRS motor scores showed significant improvement on drug vs off drug (p Conclusions The improvement of patients on gait measures as well as the Tinetti Mobility Test when on drug indicates that functional mobility is positively impacted by the use of tetrabenazine. Additional data collection is ongoing, including daily activity and fall data on subjects before and after starting tetrabenazine.
223 COMPLIANCE WITH ACC/AHA GUIDELINES FOR RIGHT-SIDED ELECTROCARDIOGRAPHIC LEADS IN PATIENTS WITH INFERIOR WALL ST ELEVATION MYOCARDIAL INFARCTION.

Purpose To determine compliance with the 2004 ACC/AHA Class I recommendations for right-sided electrocardiographic leads in patients with inferior wall ST elevation myocardial infarction. Such screening is advised to exclude coexisting right ventricular infarction. Methods Lectures regarding the above recommendations were provided by cardiovascular fellows to housestaff at a large university-affiliated community hospital and at a Veterans Affairs Medical Center. Additionally, the ACC/AHA class I recommendations that nitrates not be administered to patients with right ventricular infarction was emphasized. Following such lectures, a prospective study was undertaken to determine compliance with the guidelines. Results During a 21-month period, 62 patients with inferior wall ST elevation myocardial infarction were identified at the community hospital and 12 at the Veterans Affairs Medical Center. When the frequency of right ventricular leads at the community hospital and Veterans Affairs Medical Center were compared there was a highly significant difference (community hospital 95% CI: 0.004-0.112; Veterans Affairs Medical Center 95% CI: 0.779-1.00; p Conclusion Despite instructions regarding right ventricular leads to housestaff at both institutions, there was minimal application of right-sided leads at the community hospital compared with the Veterans Affairs Medical Center. Reasons for the difference appear to be greater use of early echocardiography and percutaneous coronary intervention at the community hospital and aggressive cardiovascular fellow-driven guideline implementation at the Veterans Affairs Medical Center.
Forecast of Energy Storage Applied in Wind Power Integration

Now,the wind power in China develops quite rapidly and the installation of wind power is accounting more and more in power generating installation. Wind power,as a typical kind of renewable energy,is intermittent and unstable so it causes concerns about the damage to power grid when integrate the large- scale wind power. Based on the mentioned- above,the integration is the main restraint for China to develop wind power. Energy storage,as an emerging technology,has been applied,tested and operated for a few years. It can solve integration problem efficiently and improve the efficiency of wind power integrating with the power grid. Hence,there is a large demand of energy storage on the wind power market.The paper chooses gray forecast method and trend extrapolation method to predict the installation of wind power in the near future. Then based on the forecast result,the paper selects energy storage ratio of the wind power system that is under operation now,and finally predicts the demand of energy storage in the wind power integration felid in the future. The paper provides quantitative number and makes it possible to plan further development.
Bone disease in primary hyperparathyroidism.

The classic bone disease of primary hyperparathyroidism, osteitis fibrosa cystica, was characterized by subperiosteal bone resorption, osteopenia, and "brown tumors." Since the description of this skeletal disorder, the clinical profile of primary hyperparathyroidism has evolved markedly. The disease today is often characterized by no more than asymptomatic hypercalcemia, and severe bone disease is a distinct rarity. Newer and more sensitive techniques show significant evidence of the effect of excess parathyroid hormone on the skeleton. Bone density as measured by photon absorptiometry and bone histomorphometry show a deficit of cortical bone and a preservation of or increase in cancellous bone elements in mild primary hyperparathyroidism with no clinical evidence of skeletal disease.
Matrix Isolation Study of the Reaction of TiCl4 with CH3OH: Synthesis and Characterization of Cl3TiOCH3

The initial steps of the reaction of TiCl4 with CH3OH and its isotopomers have been investigated using matrix isolation with infrared spectroscopic detection of the reaction intermediates. When twin jet deposition was employed, a substantial yield of a 1:1 adduct was observed. However, when merged jet deposition was employed with a 15 cm merged reaction region, no traces of the precursors or the 1:1 complex were observed. Rather, very intense bands due to previously unreported monomeric Cl3TiOCH3 were observed, as well as bands due to HCl. Band assignments were assisted by extensive isotopic labeling and supported by density functional calculations. In subsequent experiments, heating the merged region to as high as 350 °C led to complete destruction of the bands to Cl3TiOCH3 while bands due to CH3Cl and the complex of CH3Cl with HCl were observed to grow.
Three-dimensional graphene enhanced heat conduction of porous crystals

We present functionalized three-dimensional graphene as a promising thermal additive to increase the effective thermal conductivity of porous crystal adsorbents. Due to the percolation and high porosity of three-dimensional graphene, the thermal conductivity of the adsorbent-graphene composite was enhanced up to 500 % with a minimal reduction in adsorption capacity of approximately 2 %. The functionalization demonstrated to be an effective way to implement a hydrophobic carbon network with hydrophilic porous crystals. The functionalized three-dimensional graphene can be applicable to numerous types of porous crystals including zeolites and metal organic frameworks to overcome their intrinsic low thermal conductivity. This work provides insights for the development of binders for enhanced thermal performance of porous materials in various adsorption systems.
Designing—or Redesigning—Middle Schools for a Student-Sensitive, Technological Future

How can we know when it makes sense to remodel an existing facility, or when it is more cost effective to build a new one? What does research tell us about how the design of a school affects learning? How will the Americans with Disabilities Act and new networking technologies be taken into account in designing and remodeling classrooms and library media centers? The ERIC documents and journal articles in this col umn address these questions and more. For more infor mation on designing school facilities, contact the ERIC Clearinghouse on Educational Management, University of Oregon, 1787 Agate Street, Eugene, OR 97403-5207; telephone: (503) 346-5043, (800) 438-8841; fax: (503) 346-2334; Internet: ppiele@oregon.uoregon.edu.
Zika Virus Targets Different Primary Human Placental Cells, Suggesting Two Routes for Vertical Transmission.

Summary Zika virus (ZIKV) infection during pregnancy is linked to severe birth defects, but mother-to-fetus transmission routes are unknown. We infected different primary cell types from mid- and late-gestation placentas and explants from first-trimester chorionic villi with the prototype Ugandan and a recently isolated Nicaraguan ZIKV strain. ZIKV infects primary human placental cells and explants—cytotrophoblasts, endothelial cells, fibroblasts, and Hofbauer cells in chorionic villi and amniotic epithelial cells and trophoblast progenitors in amniochorionic membranes—that express Axl, Tyro3, and/or TIM1 viral entry cofactors. ZIKV produced NS3 and E proteins and generated higher viral titers in amniotic epithelial cells from mid-gestation compared to late-gestation placentas. Duramycin, a peptide that binds phosphatidylethanolamine in enveloped virions and precludes TIM1 binding, reduced ZIKV infection in placental cells and explants. Our results suggest that ZIKV spreads from basal and parietal decidua to chorionic villi and amniochorionic membranes and that targeting TIM1 could suppress infection at the uterine-placental interface.
DISTRIBUTED DECISION MAKING IN SUPPLY CHAIN NETWORKS

Abstract The supply chain system is modeled as a “Value Added Network” (VAN) which performs the following tasks: assembly, storage, routing, processing and transportation. Many activities interact and complexity increases as the number of business activities and links in the VAN increase. In order to develop a model which can deal with changing market conditions and evolving technology it is necessary to adapt as the supplier and demand structures change. Recent developments focus on decentralized business structures and software solutions to reduce complexity and maintain scalability. It has been claimed that decentralized decisions lead to sub-optimal solutions. We show that this is not necessarily so. We present novel abstraction of an integrated system of decision makers, software and physical devices which allows for optimal decentralized decision making. The objective function captures the idea that investment and resource use decisions in a VAN (capacity expansion expansion, how much inventory to carry, which markets to address and which technology to use) carries value. The decentralized decision making processes we cover may be quite complex and may include local feedback corrections as well as decentralized, optimal (model predictive) strategies.
Raven: A Street Robot to Address Homelessness

With the difficulties that the homeless face in meeting their basic needs of safety and comfort, and with widespread misconceptions about their capabilities by the settled population, the homeless are often unable to keep routines and to find jobs. Raven is an interactive robotic object (IRO) that addresses the needs of the homeless by creating engagement between the homeless and the settled population in a city. With the IRO placed on busy streets, requests of funds, services, food, etc. made by the homeless at local community centers are shared with passersby, who can fulfill these requests either by themselves or collectively on social media. The project goal is to support the needs of the homeless by creating a systemic shift in the way we understand homelessness.
Psychical Research and the Outer Limits of Science

We examine here the peripheries of science where the scientific method reaches its limits, but where anomalous events suggest a wider reality that exceed, for now, our perceptive abilities. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman",serif; mso-ansi-language:EN-US; mso-fareast-language:EN-US;}
Reconstruction of Lateral Tip and Ala

A 44-year-old woman developed melanoma of the left alar groove. This was resected by her referring dermatological surgeon, and the patient was referred for wider surgical margins. She was in excellent health and did not have other cutaneous malignancies. Examination of the nose revealed a 0.8-cm ulcer in the anterior portion of the alar groove where the wound had been left open following her resection. A chest radiograph revealed no evidence of metastases. Pathological examination of the excised specimen showed a melanoma of a Breslow level of 2.13 mm. The recommended treatment was full-thickness resection of the tumor with a 1.5-cm wide soft-tissue margin (Fig. 23.1). The tumor was excised by removing the entire ala, lateral tip, and caudal portion of the sidewall to the level of the base of the pyriform aperture. The lateral crus and upper lateral cartilage were included in the specimen. Resection left a 3.0 × 2.75 cm full-thickness defect of the left nose (Fig. 23.2).
Drugs, Bugs, and Cancer: Fusobacterium nucleatum Promotes Chemoresistance in Colorectal Cancer

The tumor microenvironment has recently been shown to play decisive roles in chemotherapeutic response. In this issue of Cell, Yu et al. add to these findings by identifying the bacterium Fusobacterium nucleatum as a previously unrecognized chemoresistance mediator in colorectal cancer, thereby establishing the microbiota as a potential therapeutic target.