cssi/SciSciGPT-SciSciNet huggingface dataset:
Nonabsorbable Corticosteroids Use in the Treatment of Gastrointestinal Graft-versus-Host Disease

For over a decade, nonabsorbable corticosteroids have been employed in the treatment of gastrointestinal graft-versus-host-disease (GVHD) in hematopoietic stem cell transplant (HSCT), as monotherapy or in combination with systemic corticosteroids. The majority of the evidence showing a favorable outcome consisted of case series, small phase II trials and a large randomized phase III trial. The 2 most commonly studied molecules were oral budesonide and beclomethasone diproprionate. Although these reports hint at some benefit with the local treatment strategy, their methodologic inconsistencies preclude meaningful adoption to everyday clinical practice. This review evaluates the current evidence of nonabsorbable corticosteroids in HSCT and sets forth recommendations for future trials with these agents.
The unrecognized danger of a new transportation mechanism of injury - Pedicabs

OBJECTIVE: Pedicabs are a new and controversial transportation innovation for tourists in congested areas in several U.S. cities. Scant literature on this trauma mechanism exists. The purpose of this study is to identify the incidence, demographics, morbidity, mortality, and potential for injury prevention of pedicab incidents amongst major trauma admissions at an urban, academic Level I Trauma Center. PATIENTS & METHODS: Researchers conducted a retrospective review of the Trauma Registry from 2000 to 2009. All patients identified as being injured in a pedicab incident were reviewed. Demographics, diagnoses, toxicology, treatments, and injury severity scale (ISS) were collected. Outcomes included mortality, ICU, and hospital length of stay (LOS), discharge disposition, and hospital charges. A photographic survey of 50 local pedicabs was examined for the presence and use of safety equipment. RESULTS: During the period of January 2000 to July 2009 there were 15 major trauma victims from identified pedicab incidents. Falling from the pedicab was the mechanism of injury in 14 of 15 cases. There were two fatalities in victims following severe traumatic brain injury. Traumatic brain injury, skull fracture, or loss of consciousness was seen in 11/15 victims. Ethanol ingestion was detected in blood tests of 10 of the 14 adult victims. Median charges of hospitalization due to a pedicab related injury was US$29,956±77,482. A photographic survey of 50 local pedicabs reveals very limited use of safety belts by passengers despite existing city ordinances. CONCLUSIONS: Major trauma victims of pedicab incidents in the United States suffer significant injuries and death. Most cases occurred in passengers falling from the pedicab at night after alcohol ingestion. There is an opportunity for implementation of strategies toward improved injury prevention with this new form of transport. Language: en
Segmental Dynamics and Density Fluctuations in Polymer Networks during Chemical Vitrification

Molecular dynamics of network-forming reactive polymers were examined as a function of the advancement of chemical reaction as the materials structure undergoes a transition from liquid to amorphous solid. The accompanying changes in the segmental relaxation time (α process) are a signature of the materials state (within the liquid to amorphous solid spectrum of physical properties). Both broad-band dielectric relaxation spectroscopy (DRS), which probes the α process via dipolar reorientational mobility, and dynamic light scattering (DLS), which probes the α process via density fluctuations, were used to monitor the system under reaction conditions in the reaction bath (to our knowledge, the first study of its kind). An excellent agreement was found between DRS and DLS for the α process characteristic parameters: relaxation time and KWW, the stretched exponential parameter (characterizing the relaxation breadth). That dipole dynamics exhibit the same α relaxation characteristics as time dependent density...
Recent Developments in the Epidemiology of Prostate Cancer

The purpose of this review is to examine the implications of recent trends in prostate cancer incidence and mortality and to consider recent progress of epidemiological research on this disease. The incidence and mortality rates for prostate cancer are changing throughout the world at an accelerating pace. Much of the increase in incidence is related to changes in detection technology, but increases in mortality rates suggest other factors are involved. Recent research has focused on race-related difference, diet and related lifestyle exposures, the aetiologic significance of vasectomy and, patterns of familial aggregation. Continued monitoring of trends in incidence and mortality will be important as prostate cancer becomes a greater public health burden worldwide. Epidemiological research has identified several possible risk factors which may be useful for prostate cancer prevention and targeting high-risk individuals for early detection intervention. Additional research may confirm and refine understanding of prostate cancer aetiology.
The scale transformation in physics

Abstract Some criteria are established to test whether invariance under a continuous transformation will lead to a conservation law. The scale transformation is examined as a special case, and shown not only to lead to no general conservation law, but also in fact to be of a trivial nature. This is due to the rather artificial way in which scale invariance is usually introduced. A theory is then constructed by introducing an internal coordinate of dimension (length) in order to allow only the dimensionless ratio of lengths to enter, and by exploiting the gaugelike structure of the scale transformation. In this theory the scale transformation does lead to a new conserved current (as well as to an “almost conserved” one), and the internal coordinate is shown to play the same role for the scale transformation as the internal coordinate spin plays for the case of rotations, and allows the theory to treat massive particles.
Human gamma- to beta-globin gene switching in transgenic mice

Previous studies demonstrated correct tissue- and temporal-specific expression of human gamma- and beta-globin genes in transgenic mice; however, expression was extremely low. When the erythroid-specific DNase I super-hypersensitive (HS) sites that are normally located upstream of the human beta-globin locus were fused individually to gamma- or beta-globin genes, expression increased to endogenous mouse globin levels but temporal specificity was lost. In contrast, when the HS sequences were combined with fragments containing both gamma- and beta-globin genes, correct developmental regulation was restored. We suggest that human gamma- to beta-globin gene switching during development results from competition of individual globin gene family members for interaction with the HS sequences and that factors influencing these competitive interactions determine temporal specificity.
Satisfaction?: The Psychological Impact of Gender Segregation on Women at Work

This study analyzes 1973 Quality of Employment Survey data to examine how work-place gender composition affects women's work-related psychological well-being. With individual, job, and organization...
Investor yield and gross underwriting spread comparisons among U.S. dollar domestic, Yankee, Eurodollar, and global bonds

Abstract The characteristics and features of domestic, foreign, Eurobonds, and global bonds differ from one another, as do their regulation. We develop regression models to compare investor yield differences that should logically exist at issuance for these bond market segments for U.S. dollar denominated bonds. Our empirical results show that, ceteris paribus, both privately placed and Rule 144A Eurodollar issues yield more than publicly placed bonds; Yankee bonds yield insignificantly more than domestic bonds; and, the bearer feature common to Eurodollar bonds is not prized enough by institutional investors for them to accept a lower yield relative to domestic or Yankee bonds. We do not find a statistically significant difference between the investor yield spread on U.S. dollar global bonds and U.S. domestic bonds, or Yankee bonds, or Eurodollar bonds. We also study underwriting costs of publicly traded bonds and find, ceteris paribus, that Eurodollar bonds are far more costly for the firm to issue than domestic bonds, Yankee bonds, or global bonds; domestic and Yankee bonds are more expensive than global bonds; and, there is no significant cost difference between domestic and Yankee bonds.
The long-term impact of dialysis discontinuation on families.

Background: Little is known about the long-term psychological impact of stopping life support treatments on surviving loved ones. Objective: The authors sought to determine if there was an increase...
A model study for the synthesis of the hexahydrobenzofuran fragment of the milbemycins and avermectins.

Abstract An INOC based approach to the hexahydrobenzofuran portion of the milbemycins and the avermectins is described in which a high level of π-facial selectivity has been observed in a six-membered ring forming reaction.
Sodic soil reclamation: Modelling and field study

Reclamation of sodic soils has traditionally been undertaken using calculation of gypsum or Ca requirement assuming 100% exchange efficiency and neglect of the contribution of calcium carbonate in the profile. The UNSATCHEM model is reviewed and then evaluated for its ability to predict field reclamation of a sodic saline soil. The 40-ha field site was initially at an electrical conductivity (EC) of 50 dS/m and a sodium absorption ratio (SAR) of 144 in the top 30 cm. After installation of a drainage system, 24 Mg/ha of gypsum was applied to a depth of 15 cm in the soil. Subsequently, 114 cm of water was applied by almost continuous ponding for 3 months. Model simulations were made based on infiltration of 70–80 cm of water, correcting for the estimated evaporation of 41 cm of water. These infiltration estimates are consistent with the good fit between the measured Cl concentrations after reclamation and the model predicted values after 70–80 cm of infiltrated water. Model predictions of EC and SAR after reclamation gave a satisfactory fit to the measured values. The effectiveness of mixing gypsum to various depths was evaluated in terms of the predicted SAR profiles. Alternative management practices of green manuring in presence of calcite were simulated and appeared feasible. In this instance it appears likely that the field could have been reclaimed either with less water or without the addition of gypsum.
Competitive interactions between related clades : evolutionary implications of overgrowth interactions between encrustin cyclostome and cheilostome bryozoans

Overgrowth interactions between encrusting cyclostome (eight species) and cheilostome (over 50 species) colonies were examined in subtidal communities in the northern Adriatic Sea off Rovinj, Croatia, in May–June 1988 and September–October 1990. Cheilostome colonies occupied ca. 80% of the available substrate space, whereas the cyclostome colonies occupied <5%. Out of 210 recorded interactions, cheilostomes overlapped cyclostomes in 164, while cyclostomes overlapped cheilostomes in only 16; 30 encounters resulted in mutual overlap or at least temporary growth termination along the line of contact. Most of the recorded interactions were for the cyclostomes Diplosolen obelia (Johnston) and Plagioecia patina (Lamarck). Both species elevated their colony margins on contact with a cheilostome in some instances, but D. obelia only overgrew competing cheilostomes in 12/120 encounters, and P. patina never prevailed. I propose that the cheilostomes have a key evolutionary innovation, lacking in cyclostomes, consisting of more rapid ontogenetic development of zooids along colony margins so that encrusting cheilostomes have substantially higher colony margins. This results in an outflow of filtered water along the edge of encrusting cheilostome colonies, while cyclostomes take water in at colony margins. These contrasting feeding currents apparently give a competitive advantage to the cheilostomes where colony margins approach and make contact with those of cyclostomes.
An alternative to foster care for victims of child abuse/neglect: A university-based program☆

Abstract Two central forces dominated the conception and development of the Parents and Children Together (PACT) project: the need for provision of an in-home alternative to foster care for abuse and/or neglect families and the prevention of further abuse and/or neglect in the family. Wayne State University in Detroit is the site for Parents and Children Together (PACT) project, a contractual service of the Michigan Department of Social Services (DSS). Graduate students provide in-home services to referred families who, due to child abuse or neglect, would otherwise have their child(ren) removed from the home. This family-based work is a one-year cooperative education experience for students interested in professions in the human services. This report discusses the PACT project as a grant operated through the university, the specification of course work associated, and the attraction of students to graduate study with “hands-on” experience. All of these program attributes, as well as the resource of the project for research, make it an important effort for the university. Further, the university has an additional meaningful role with community residents. Beyond university and student opportunities, the DSS and its clients benefit by having broad-based expertise brought into homes on a weekly basis. Annual success rates of keeping children out of foster care are cited along with cost effectiveness. The university's role in levels of prevention in a highly coordinated community effort is indicated.
Exploiting affinities between topic modeling and the sociological perspective on culture: Application to newspaper coverage of U.S. government arts funding

Topic modeling provides a valuable method for identifying the linguistic contexts that surround social institutions or policy domains. This article uses Latent Dirichlet Allocation (LDA) to analyze how one such policy domain, government assistance to artists and arts organizations, was framed in almost 8000 articles. These comprised all articles that referred to government support for the arts in the U.S. published in five U.S. newspapers between 1986 and 1997—a period during which such assistance, once noncontroversial, became a focus of contention. We illustrate the strengths of topic modeling as a means of analyzing large text corpora, discuss the proper choice of models and interpretation of model results, describe means of validating topic-model solutions, and demonstrate the use of topic models in combination with other statistical tools to estimate differences between newspapers in the prevalence of different frames. Throughout, we emphasize affinities between the topic-modeling approach and such central concepts in the study of culture as framing, polysemy, heteroglossia, and the relationality of meaning. # 2013 Elsevier B.V. All rights reserved.
On the high order effects in the methods of Krylov-Bogoliubov and Poincare

Determining higher order perturbations for lunar orbiter by Krylov-Bololiubov and Poincare methods
Modeling lesion counts in multiple sclerosis when patients have been selected for baseline activity

The number of new gadolinium-enhancing lesions discovered via magnetic resonance imaging is a well-established outcome for multiple sclerosis studies, especially Phase II Studies. Due to the high cost of magnetic resonance imaging scans, many investigators select participants for the presence of lesions. While this selection procedure is thought to improve the power of inferences, the effect of screening for baseline activity on parameter estimation and interval coverage has not yet been examined. The objective of this study was to investigate the performance of the negative binomial distribution for modeling lesion count data in multiple sclerosis when patients have been selected for activity on a baseline scan. We performed computer simulations to investigate the influence of the screening process on inferences made using a negative binomial model about treatment effects in two independent samples. We also demonstrate how the statistical properties of screening can be incorporated into trial design. We demonstrate that when the negative binomial distribution is used to model lesion counts, while screening for baseline activity improves point estimation, this practice also has the potential to decrease interval coverage and inflate the Type I error rate. For data that is to be modeled using a negative binomial distribution, screening for baseline activity can create a trade-off between cost effectiveness and a higher than desired false positive rate that must be carefully considered in planning Phase II trials.
Simulations of Mars Rover Traverses

Artemis (Adams-based Rover Terramechanics and Mobility Interaction Simulator) is a software tool developed to simulate rigid-wheel planetary rover traverses across natural terrain surfaces. It is based on mechanically realistic rover models and the use of classical terramechanics expressions to model spatially variable wheel-soil and wheel-bedrock properties. Artemis's capabilities and limitations for the Mars Exploration Rovers (Spirit and Opportunity) were explored using single-wheel laboratory-based tests, rover field tests at the Jet Propulsion Laboratory Mars Yard, and tests on bedrock and dune sand surfaces in the Mojave Desert. Artemis was then used to provide physical insight into the high soil sinkage and slippage encountered by Opportunity while crossing an aeolian ripple on the Meridiani plains and high motor currents encountered while driving on a tilted bedrock surface at Cape York on the rim of Endeavour Crater. Artemis will continue to evolve and is intended to be used on a continuing basis as a tool to help evaluate mobility issues over candidate Opportunity and the Mars Science Laboratory Curiosity rover drive paths, in addition to retrieval of terrain properties by the iterative registration of model and actual drive results.
Evidence that glutathione is involved in thermotolerance of preimplantation murine embryos.

Experiments were conducted to determine whether or not glutathione (GSH) is involved in thermotolerance responses of murine morulae. In the first experiment, morulae were exposed to either homeothermic temperature (37'C), mild heat shock (40°C for 1 h), severe heat shock (43 0 C for 2 h), or a mild heat shock followed by severe heat shock (to induce thermotolerance). Exposure to mild heat shock did not affect viability and development, but severe heat shock reduced viability (i.e., live/dead staining) and the proportion of morulae that developed to blastocysts. This effect of 43 0 C was reduced if embryos were first exposed to a mild heat shock of 40 0 C. In the presence of DL-buthionine-[S,R]-sulfoximine (BSO), an inhibitor of GSH synthesis, the ability of 40°C to confer thermotolerance was reduced. BSO decreased embryonic GSH content but did not decrease overall protein synthesis. In another experiment, administration of S-adenosyl-L-methionine, an inducer of GSH synthesis, decreased the deleterious effects of heat shock of 43 0 C for 2 h on viability and percentage of embryos that became blastocysts. Addition of 5 1 M GSH or GSH ester reduced the effect of 42'C for 2 h on viability but not on continued development. The results suggest a role for GSH-dependent mechanisms in the processes by which murine embryos limit deleterious effects of heat shock.
Automata Theory as an Abstract Boundary Condition for the Study of Information Processing in the Nervous System

This conference convenes 25 years after Warren McCulloch and Walter Pitts (1943) initiated the automaton-theoretic approach to information processing in the nervous system with their paper “A Logical Calculus of the Ideas Immanent in Nervous Activity,” and a few weeks before Warren McCulloch celebrates his 70th birthday. I should thus like to dedicate this paper to Warren McCulloch, in honor of his continuing stimulation to many who would understand “What’s in the Brain that Ink may Character?” [McCulloch, 1965].
Enhanced timing-based transition delay testing for small delay defects

This paper proposes a technique for testing small delay defects that incorporates the use of standard transition delay ATPG along with timing information gathered from standard static timing analysis (STA), in order to obtain a high defect coverage of the small delay defects that lie along the critical paths of a given design. This technique takes advantage of the fact that transition delay APTG can easily create patterns for node-based delay defects, and it then uses the timing information gathered from STA to ensure that the patterns that test given paths are grouped with like patterns and are tested at near maximum frequency. We present the experimental results, which demonstrate the effectiveness of this technique to detect small delay defects using transition delay ATPG.
Farming Practices and Adherence to an Alternative‐Conventional Agricultural Paradigm1

Can a farmer's paradigmatic attitudes predict the actual production system used? Data on actual production practices were collected from a statewide random sample of agricultural producers in Nebraska and used to evaluate the research question. Findings suggest that a relationship does exist between production practices and world view, with specific attitudes related to agricultural production practices. These attitudes are especially salient when it comes to the importance of community in maintaining quality of life among agricultural producers.
Asymmetric Mating Isolation between Two Caridean Shrimp: Lysmata wurdemanni and Lysmata boggessi

ABSTRACT In many animals, sex pheromones are involved in behavioral reproductive isolation, which is thought to be more important than other isolation barriers in causing rapid speciation. Lysmata species living in the western Atlantic waters have been recently redefined taxonomically, with some of the species having overlapping distribution. It has been found that prezygotic mating isolation is not complete between two Lysmata species—Lysmata wurdemanni and Lysmata boggessi—and there is asymmetry in mate recognition between the two species. Male-role L. wurdemanni can mate with female-role L. boggessi, but not vice versa. This study shows that the asymmetric mating isolation is caused by the difference in sex pheromone detection (both distance and contact sex pheromones). Male L. wurdemanni can detect and respond to distance sex pheromones secreted by female L. boggessi, even at low concentrations, but male L. boggessi did not respond to distance sex pheromones of L. wurdemanni at any concentration, whic...
The aspartate aminotransferase-to-platelet ratio and the evaluation of non-alcoholic fatty liver disease

Dear Editor, We thank Agilli et al. and Kayadibi et al. for their interest in our manuscript [1]. Taken together, their letters raise points of clarification regarding the utility and general applicability of the ‘aspartate aminotransferase-to-platelet ratio index’ (APRI) test in the evaluation of liver fibrosis. Our first comment is that their concern over confounders of the APRI unrelated to liver disease is valid. Indeed, confounders would diminish the ability of APRI to predict advanced liver fibrosis, leading to false negatives. Given that our results were significant, this insight strengthens our findings. Also, in defense of APRI, most other non-invasive predictors of liver fibrosis are vulnerable to confounding by extraneous conditions, which could instead lead to false positives. The ‘hepascore’ and ‘fibrotest’, for example, utilizes bilirubin (confounded by Gilbert's) and Gamma-Glutamyl Transferase (GGT) (confounded by cholestasis) [2]. Second, Kayadibi et al. posit that non-invasive tests could replace liver biopsy, but the clinical outcomes and cost-effectiveness of this strategy in this population have not been evaluated. For the time being, clinicians should seriously consider biopsy in patients with non-alcoholic fatty liver disease. This is especially true for those with intermediate or contradictory results from non-invasive tests. Furthermore, guidelines recommend liver biopsy to diagnosis non-alcoholic steatohepatitis [3]. Like the authors, we also agree that non-invasive tests to determine the presence of steatohepatitis and fibrosis are advancing. Third, both groups raise issues regarding test cut-offs. Specifically, they argue that the upper limits of normal AST differ between both laboratories and genders and that APRI’s cut-off value could be 1.5. In general, arbitrary cut-offs reduce the clinical and statistical power of laboratory tests. Additionally, we agree that the prevalence of significant liver disease beneath the so-called ‘upper limits of normal’ (ULN) should not be ignored [4, 5]. APRI is just one helpful piece of information that assists in clinical decision-making. In principle, one could optimize the characteristics of the APRI test by adjusting its parameters. In response to the specific criticisms, we show below how, the lower the cut-off, the higher the sensitivity and the lower the specificity of APRI (Table 1). However, there are many powerful tests for the non-invasive prediction of fibrosis [6, 7]. APRI's comparative advantage is its ease of use. The power of APRI could be improved, but at the cost of complexity. One could render it into a continuous variable with a beta coefficient or adjust the precise cut-off to some fraction other than our figure of 1.0, or by using different AST cut-offs. Yet, no matter how far optimized, it is unlikely to compete for accuracy with more sophisticated tests [6]. The virtue of APRI is—and always has been—its simplicity [8]. Table 1. The effect of AST upper limit of normal cut-off on the performance of the AST-to-platelet ratio
A brief therapist-delivered intervention reduces self-reported aggression and alcohol consequences in adolescents who present for emergency care.

Commentary on: MA Walton, ST Chermack, JT Shope, et al.. Effects of a brief intervention for reducing violence and alcohol misuse among adolescents: a randomized controlled trial. JAMA2010;304:527–35.
International Trade and Accounting Policy Choice: Theory and Canadian Evidence

The accounting policy choice literature has identified many factors which have been shown to be useful in explaining cross-sectional variation in the accounting methods used by public companies. One relationship which has been relatively unexplored in this literature is the potential effect of international trade on accounting choice. This study proposes that international trading activities may create incentives for firms to choose income increasing accounting policies. This proposition was tested by examining the depreciation choices of a sample of Canadian firms. Results suggest that importers were more likely to choose income increasing accounting methods than non-importers, while exporting was not found to be related to this accounting choice. These diverging results may be caused by the declining value of the Canadian dollar (relative to the US dollar), which tends to benefit exporters, but is of detriment to importers.
A distributed decision approach to speaker verification

A speaker-verification system based on an HMM connected word recognizer and a distributed detection decision algorithm is presented. We discuss a text-independent system in which the local decisions are based on individual spectral parameters, and a text-dependent system in which the local decisions are based on the spectral parameters for a single word. The text-independent system assumes the parameter vectors to be normally distributed, while the text-dependent system uses a nonparametric test based solely on the imposter distribution. In both cases, the distributed approach provides robustness against discrepancies between the statistical characteristics of the speech parameters in the training and the test phases. Both distributed-decision speaker verification systems have been evaluated on a database of speech collected during the trial of a real verification system and have been shown to be superior to systems based on conventional decision algorithms. >
Are prediction models for Lynch syndrome valid for probands with endometrial cancer

Currently, three prediction models are used to predict a patient’s risk of having Lynch syndrome (LS). These models have been validated in probands with colorectal cancer (CRC), but not in probands presenting with endometrial cancer (EMC). Thus, the aim was to determine the performance of these prediction models in women with LS presenting with EMC. Probands with EMC and LS were identified. Personal and family history was entered into three prediction models, PREMM(1,2), MMRpro, and MMRpredict. Probabilities of mutations in the mismatch repair genes were recorded. Accurate prediction was defined as a model predicting at least a 5% chance of a proband carrying a mutation. From 562 patients prospectively enrolled in a clinical trial of patients with EMC, 13 (2.2%) were shown to have LS. Nine patients had a mutation in MSH6, three in MSH2, and one in MLH1. MMRpro predicted that 3 of 9 patients with an MSH6, 3 of 3 with an MSH2, and 1 of 1 patient with an MLH1 mutation could have LS. For MMRpredict, EMC coded as “proximal CRC” predicted 5 of 5, and as “distal CRC” three of five. PREMM(1,2) predicted that 4 of 4 with an MLH1 or MSH2 could have LS. Prediction of LS in probands presenting with EMC using current models for probands with CRC works reasonably well. Further studies are needed to develop models that include questions specific to patients with EMC with a greater age range, as well as placing increased emphasis on prediction of LS in probands with MSH6 mutations.
Regulating Gamete Donation in the U.S.: Ethical, Legal and Social Implications

This article explores the practice of gamete donation in the U.S. having in mind the larger question of what do we as a society owe children born as a result (donor-conceived children). Do recipient-parents have a duty to tell their donor-conceived child about his/her genetic origins? Should the identity of the donor be disclosed or remain anonymous? Does the child have a right to know her conception story and to receive information, including identifying information, about the donor? Furthermore, if a donor-conceived child has a right to know, who has the duty to tell her/him about it? The Article underscores the ethical, legal and social dilemmas that arise, comparing and contrasting with international developments in this arena. It highlights the market-based and more specific medical justifications for regulating this field, explores the emerging so-called right of the child to know his/her genetic origins (“the right to know”), and considers the challenges such a right evokes to existing legal culture and principles of medical ethics in the U.S. as well as other broader societal implications of such a right.
Doctor-patient communication in surgery: attitudes and expectations of general surgery patients about the involvement and education of surgical residents.

Abstract BACKGROUND: Education is a major function of academic medical centers. At these teaching institutions residents provide a substantial amount of care on medical and surgical services. The attitudes of patients about the training of surgical residents and the impact of residents on patients' perceptions of care in a surgical setting are unknown. STUDY DESIGN: Patients admitted to the gastrointestinal surgery service completed a 30-item survey designed for this study. Patients included in the study underwent operations and had a postoperative inpatient hospital stay. We analyzed patients' answers to determine frequency and correlations among answers. RESULTS: Two hundred patients participated in the study during a 7-month period between July 1999 and January 2000. A majority of patients were comfortable having residents involved in their care (86%) and felt it was important to help educate future surgeons (91%). Most did not feel inconvenienced by being at a teaching hospital (71%) and felt they received extra attention there (74%). Patients were more willing to participate in resident education if they expected to have several physicians involved in their care, felt that they received extra attention, or if the teaching atmosphere did not inconvenience them. Despite the stated willingness of patients to help with surgical resident education, 32% answered that they would not want residents doing any of their operation. CONCLUSIONS: Surgical resident education is well received and considered important by patients. Patient orientation to the resident education process is vital to patients' perceptions of care and may render patients more willing to participate in educational activities.
I Quit . . . Again

Ethical dilemmas are not always of our making. Carol, a licensed CPA, finds herself in the middle of a scheme concocted by two employees of her firm to defraud the U.S. government. Carol must negotiate both a legal and ethical tightrope. Her choice to do the ethically correct thing could lead to her dismissal or other retaliation by her boss. The case could be used in the following undergraduate or graduate courses: accounting, business law, business ethics, human resources.
Density-Aware Clustering Based on Aggregated Heat Kernel and Its Transformation

Current spectral clustering algorithms suffer from the sensitivity to existing noise and parameter scaling and may not be aware of different density distributions across clusters. If these problems are left untreated, the consequent clustering results cannot accurately represent true data patterns, in particular, for complex real-world datasets with heterogeneous densities. This article aims to solve these problems by proposing a diffusion-based Aggregated Heat Kernel (AHK) to improve the clustering stability, and a Local Density Affinity Transformation (LDAT) to correct the bias originating from different cluster densities. AHK statistically models the heat diffusion traces along the entire time scale, so it ensures robustness during the clustering process, while LDAT probabilistically reveals the local density of each instance and suppresses the local density bias in the affinity matrix. Our proposed framework integrates these two techniques systematically. As a result, it not only provides an advanced noise-resisting and density-aware spectral mapping to the original dataset but also demonstrates the stability during the processing of tuning the scaling parameter (which usually controls the range of neighborhood). Furthermore, our framework works well with the majority of similarity kernels, which ensures its applicability to many types of data and problem domains. The systematic experiments on different applications show that our proposed algorithm outperforms state-of-the-art clustering algorithms for the data with heterogeneous density distributions and achieves robust clustering performance with respect to tuning the scaling parameter and handling various levels and types of noise.
Transmission line relay mis-operation detection based on time-synchronized field data

In this paper, a real-time tool to detect transmission line relay mis-operation is implemented. The tool uses time-synchronized measurements obtained from both ends of the line during disturbances. The proposed fault analysis tool comes into the picture only after the protective device has operated and tripped the line. The proposed methodology is able not only to detect, classify, and locate transmission line faults, but also to accurately confirm whether the line was tripped due to a mis-operation of protective relays. The analysis report includes either detailed description of the fault type and location or detection of relay mis-operation. As such, it can be a source of very useful information to support the system restoration. The focus of the paper is on the implementation requirements that allow practical application of the methodology, which is illustrated using the field data obtained the real power system. Testing and validation is done using the field data recorded by digital fault recorders and protective relays. The test data included several hundreds of event records corresponding to both relay mis-operations and actual faults. The discussion of results addresses various challenges encountered during the implementation and validation of the presented methodology.
Preparation of Dental Resins Resistant to Enzymatic and Hydrolytic Degradation in Oral Environments

The short average service life of traditional dental composite restorative materials and increasing occurrence of secondary caries adjacent to composite restorations and sealants are necessitating the development of new, longer lasting compositions. Novel monomers and their polymers, reinforcing fillers, and adhesive components are needed. The goal of this research is to develop resin systems for use in restorations, sealants, and other dental services that are superior in properties and endurance to currently used bisphenol A glycidyl dimethacrylate/triethylene glycol dimethacrylate (Bis-GMA/TEGDMA) and urethane-dimethacrylate products. Ether-based monomers and their polymers that were not susceptible to enzymatic or hydrolytic degradation were prepared and characterized. They showed no degradation under hydrolytic and enzymatic challenges, whereas the hydrolysis of ester links weakened contemporary resins within 16 days under these challenges. The success of the ether-based materials is promising in making durable systems that are subjected to long-term biochemical and hydrolytic challenges in oral environments.
Mechanisms of Chromate, Selenate, and Sulfate Adsorption on Al-Substituted Ferrihydrite: Implications for Ferrihydrite Surface Structure and Reactivity

Ferrihydrite is a nanocrystalline Fe (hydr)oxide and important sink for environmental contaminants. Although Fe (hydr)oxides are rarely pure in natural systems, little is known about the effects of structural impurities such as Al on the surface properties and reactivity of ferrihydrite. In this study, we characterized the adsorption mechanisms of chromate, selenate, and sulfate on Al-substituted ferrihydrite (0, 6, 12, 18, and 24 mol % Al) using in situ attenuated total reflection Fourier transform infrared spectroscopy. Spectral data sets recorded as a function of pH were processed using a multivariate curve resolution technique to identify which types of surface species form and to generate their concentration profiles as a function of pH and Al content. Results show a significant increase in relative fraction of outer-sphere complexes for all three oxyanions with increasing Al substitution. In addition, the effect of Al substitution is found to be mechanism-specific in the case of chromate, with bidentate complexes disproportionately suppressed over monodentate complexes at higher Al contents. Overall, our findings have important implications for the fate of chromate, selenate, and sulfate in subsurface environments and offer new insight into the surface reactivity of Al-ferrihydrite.
Reinforcement Learning for Active Length Control of Shape Memory Alloys

The ability to actively control the shape of aerospace structures has initiated research regarding the use of Shape Memory Alloy actuators. These actuators can be used for morphing or shape change by controlling their temperature, which is effectively done by applying a voltage difference across their length. The ability to characterize this temperature-strain relationship using Reinforcement Learning has been previously accomplished, but in order to control Shape Memory Alloy wires it is more beneficial to learn the voltage-position relationship. "umerical simulation using Reinforcement Learning has been used for determining the temperature-strain relationship for characterizing the major and minor hysteresis loops, and determining a limited control policy relating applied temperature to desired strain. Since Reinforcement Learning creates a non-parametric control policy, and there is not currently a general parametric model for this control policy, determining the voltage-position relationship for a Shape Memory Alloy is done separately. This paper extends earlier numerical simulation results and experimental results in temperature-strain space by applying a similar Reinforcement Learning algorithm to voltage-position space using an experimental hardware apparatus. Results presented in the paper show the ability to converge on a near-optimal control policy for Shape Memory Alloy length control by means of an improved Reinforcement Learning algorithm. These results demonstrate the power of Reinforcement Learning as a method of constructing a policy capable of controlling Shape Memory Alloy wire length.
Lenalidomide - the new melphalan?

In this issue of Leukemia and Lymphoma, Zagouri et al., describes the efficacy and tolerability of lenalidomide and dexamethasone in relapsed/refractory multiple myeloma (MM) patients.[1] The inves...
Role of electronic excitations in ground-state-forbidden inelastic collisions between ultracold atoms and ions.

The role of electronic excitation in inelastic collisions between ultracold Ca atoms and ${\mathrm{Ba}}^{+}$ ions, confined in a hybrid trap, is studied for the first time. Unlike previous investigations, this system is energetically precluded from undergoing inelastic collisions in its ground state, allowing a relatively simple experimental determination and interpretation of the influence of electronic excitation. It is found that while the electronic state of the ion can critically influence the inelastic collision rate, the polarizability mismatch of the neutral atom electronic states suppresses short-range collisions, and thus inelastic processes, involving electronically excited neutral atoms. As a result of these features, it is experimentally demonstrated that it is possible to mitigate inelastic collision loss mechanisms in these systems, marking an important step toward long-lived hybrid atom-ion devices.
SU-D-204-07: Retrospective Correlation of Dose Accuracy with Regions of Local Failure for Early Stage Lung Cancer Patients Treated with Stereotactic Body Radiotherapy

Purpose: To correlate dose distributions computed using six algorithms for recurrent early stage non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT), with outcome (local failure). Methods: Of 270 NSCLC patients treated with 12Gyx4, 20 were found to have local recurrence prior to the 2-year time point. These patients were originally planned with 1-D pencil beam (1-D PB) algorithm. 4D imaging was performed to manage tumor motion. Regions of local failures were determined from follow-up PET-CT scans. Follow-up CT images were rigidly fused to the planning CT (pCT), and recurrent tumor volumes (Vrecur) were mapped to the pCT. Dose was recomputed, retrospectively, using five algorithms: 3-D PB, collapsed cone convolution (CCC), anisotropic analytical algorithm (AAA), AcurosXB, and Monte Carlo (MC). Tumor control probability (TCP) was computed using the Marsden model (1,2). Patterns of failure were classified as central, in-field, marginal, and distant for Vrecur ≥95% of prescribed dose, 95–80%, 80–20%, and ≤20%, respectively (3). Results: Average PTV D95 (dose covering 95% of the PTV) for 3-D PB, CCC, AAA, AcurosXB, and MC relative to 1-D PB were 95.3±2.1%, 84.1±7.5%, 84.9±5.7%, 86.3±6.0%, and 85.1±7.0%, respectively. TCP values for 1-D PB, 3-D PB, CCC, AAA, AcurosXB, and MC were 98.5±1.2%, 95.7±3.0, 79.6±16.1%, 79.7±16.5%, 81.1±17.5%, and 78.1±20%, respectively. Patterns of local failures were similar for 1-D and 3D PB plans, which predicted that the majority of failures occur in centraldistal regions, with only ∼15% occurring distantly. However, with convolution/superposition and MC type algorithms, the majority of failures (65%) were predicted to be distant, consistent with the literature. Conclusion: Based on MC and convolution/superposition type algorithms, average PTV D95 and TCP were ∼15% lower than the planned 1-D PB dose calculation. Patterns of failure results suggest that MC and convolution/superposition type algorithms predict different outcomes for patterns of failure relative to PB algorithms. Work supported in part by Varian Medical Systems, Palo Alto, CA
Short-Time Overloading Capability and Distributed Generation Applications of Solid Oxide Fuel Cells

This paper presents some application studies of the dynamic solid oxide fuel cell (SOFC) model developed by the authors and reported in C. Wang and M. H. Nehrir, ldquoA physically-based dynamic model for solid oxide fuel cells,rdquo IEEE Trans. Energy Convers. First, the model is used to investigate the short-time overloading capability of the SOFC. Then, the application of the model in distributed generation (DG) system studies is explored. Controller design methodologies are also presented for grid-connected SOFC DG power conditioning units to control power flow from the SOFC DG to the utility grid. Simulation results show that the SOFC DG system is able to manage real and reactive power flows to the utility grid to which it is connected. They also show that a properly designed SOFC DG can remain stable under temporary electrical faults.
Kant's Sublime: A Form of Pure Aesthetic Reflective Judgment

Qu'est-ce que le sublime chez Kant ? Une forme de jugement reflexif esthetique pur ? L'A. repond a ces questions en fondant sa reflexion sur la Critique de la faculte de juger. L'A. donne une definition de chacun de ces termes et montre comment Kant articule jugement esthetique, analytique du beau et sublime dans sa pensee philosophique. Il souleve le probleme de l'apparente assimilation entre sentiment du sublime et sentiment moral dans le kantisme. L'A. conclut en montrant dans quel mesure Kant assimile sublime et jugement reflexif esthetique
Openness of patients' reporting with use of electronic records: psychiatric clinicians' views.

Objectives Improvements in electronic health record (EHR) system development will require an understanding of psychiatric clinicians' views on EHR system acceptability, including effects on psychotherapy communications, data-recording behaviors, data accessibility versus security and privacy, data quality and clarity, communications with medical colleagues, and stigma. Design Multidisciplinary development of a survey instrument targeting psychiatric clinicians who recently switched to EHR system use, focus group testing, data analysis, and data reliability testing. Measurements Survey of 120 university-based, outpatient mental health clinicians, with 56 (47%) responding, conducted 18 months after transition from a paper to an EHR system. Results Factor analysis gave nine item groupings that overlapped strongly with five a priori domains. Respondents both praised and criticized the EHR system. A strong majority (81%) felt that open therapeutic communications were preserved. Regarding data quality, content, and privacy, clinicians (63%) were less willing to record highly confidential information and disagreed (83%) with including their own psychiatric records among routinely accessed EHR systems. Limitations single time point; single academic medical center clinic setting; modest sample size; lack of prior instrument validation; survey conducted in 2005. Conclusions In an academic medical center clinic, the presence of electronic records was not seen as a dramatic impediment to therapeutic communications. Concerns regarding privacy and data security were significant, and may contribute to reluctances to adopt electronic records in other settings. Further study of clinicians' views and use patterns may be helpful in guiding development and deployment of electronic records systems.