cssi/SciSciGPT-SciSciNet huggingface dataset:
Accordion Severity Grading System: Assessment of Relationship Between Costs, Length of Hospital Stay, and Survival in Patients with Complications after Esophagectomy for Cancer

Background The ability to assess and compare the impact of postoperative complications in major cancer surgery is currently limited. The Accordion Severity Grading System provides the opportunity to categorize complications according to treatment responses and resource use. Study Design A retrospective review of patient demographics, perioperative outcomes, and costs was performed using a prospective IRB-approved database of patients undergoing esophagectomy from 2000 to 2008. Results This study included 285 consecutive patients, 83% were male, and mean age was 63.7 years. Histology was predominantly adenocarcinoma (80%). For patients with invasive cancer, overall survival at 5 years was 50%. Mean overall cost and length of stay were $23,419 and 10.4 days, respectively. Neoadjuvant therapy was used in 156 patients (54.7%) and operative mortality rate was 0.7%. Complications were documented in 144 patients (50.5%), with Accordion grades assigned as 1 (29%), 2 (59%), 3 (3%), 4 (6%), 5 (2%), and 6 (0.7%). Accordion grade was significantly related to costs and length of stay in univariate (p Conclusions The Accordion Severity Grading System provides a meaningful approach to classifying complications according to resource use, which also directly correlates with treatment costs and length of stay. Survival is affected by overall occurrence of complications, but was not related to individual Accordion grades in this study. The Accordion Severity Grading System should be a component of prospective data collections and can be used in major cancer surgery to study areas appropriate for quality improvement and cost containment.
Foot TcPO2 Response to Lumbar Sympathectomy in Patients with Focal Ischemic Necrosis

) values of <30 mmHg who received a sympathectomy as the primary treatment of their vascular occlusive disease. Preoperatively, and every 2-3 days in the postoperative period, measurement of TcPO2 of the forefoot was performed. Clinical success was defined as healing of the necrosis or healing of a toe amputation and avoidance of a major below-knee/above-knee amputation for 1 year. Ten patients were available for long-term evaluation. During the first 4-5 days, all patients increased their foot TcPO2 and the mean increase (23 mmHg) was significant (p= 0.04). Clinical improvement was marked by an average increase of 29 mmHg by postoperative day 10. In contrast, patients with clinical failure had only an average increase of 5 mmHg in TcPO2 by the same postoperative interval. Preoperative increase in TcPO2 by at least 20 mmHg in response to dependency predicted a favorable response to sympathectomy. In addition, sustained postoperative increases in tissue oxygen levels by postoperative day 10 also favored wound healing.
Effect of recombination in a high quantum efficiency prototype ionization-chamber-based electronic portal imaging device

The quantum efficiency (QE) of an imaging detector can be increased by utilizing a thick, high-density detection medium to increase the number of quantum interactions. However, image quality is more accurately described by the detection quantum efficiency (DQE). If a significant fraction of the increase in the number of detected quanta from a thick, dense detector were to result in useful imaging signal, this represents a favorable case where enhanced QE leads to increased DQE. However, for ionization-type detectors, one factor that limits DQE is the recombination between ion pairs that acts as a secondary quantum sink due to which enhancement in QE may not result in higher DQE depending on the extent of the signal loss from recombination. Therefore, an analysis of signal loss mechanisms or quantum sinks in an imaging system is essential for validating the overall benefit of high QE detectors. In this paper, a study of ion recombination as a secondary quantum sink is presented for a high QE prototype ion-chamber-based electronic portal imaging device (EPID): the kinestatic charge detector (KCD). The KCD utilizes a high pressure noble gas (krypton or xenon at 100 atm) and an arbitrarily large detector thickness (of the order of centimeters), resulting in a high QE imager. Compared with commercial amorphous silicon flat panel imagers that provide DQE(0) approximately 0.01, the KCD has much higher DQE. Studies indicated that DQE(0) = 0.20 for 6.1 cm thick, 100 atm (rho = 3.4 g/cm3) xenon chamber, and DQE(0)=0.34 for a 9.1 cm thick chamber. A series of experiments was devised and conducted to determine the signal loss due to recombination for a KCD chamber. The measurements indicated a fractional recombination loss of about 14% for a krypton chamber and about 18% for a xenon chamber under standard operating conditions (100 atm chamber pressure and 1275 V/cm electric field intensity). A theoretical treatment of the effect of recombination on imaging signal-to-noise ratio was applied to quantify the loss in DQE. These calculations indicated that recombination had a limited effect (<2%) on DQE under standard operating conditions. This was validated by good agreement between experimentally measured DQE and that obtained using Monte Carlo simulations that did not account for recombination.
Feedback Frequency in Treatment for Childhood Apraxia of Speech.

Purpose To examine the role of feedback frequency in treatment for childhood apraxia of speech (CAS). Reducing the frequency of feedback enhances motor learning, and recently, such feedback frequen...
Allogenic vein as a conduit for coronary artery bypass.

Abstract Success with peripheral arterial reconstruction using autogenous saphenous vein led to the use of allogenic saphenous vein in instances where saphenous vein was unavailable. With the advent of coronary artery bypass grafting, use of this conduit was applied to coronary reconstruction when conventional autogenous conduit was inadequate. However, follow-up angiography revealed graft patency rates of 15% at 6 to 12 months [1], 50% at 1 to 77 months [2], and 47% at 1 to 68 months [3], which were not improved by ABO matching.
Molecular analysis of a binding site for quinidine in a human cardiac delayed rectifier K+ channel. Role of S6 in antiarrhythmic drug binding.

Abstract The antiarrhythmic agent quinidine blocks the human cardiac hKv1.5 channel expressed in mammalian cells at therapeutically relevant concentrations (EC50, 6.2 μmol/L). Mechanistic analysis has suggested that quinidine acts as a cationic open-channel blocker at a site in the internal mouth of the ionic pore and that binding is stabilized by hydrophobic interactions. We tested these hypotheses using site-directed mutagenesis of residues proposed to line the internal mouth of the channel or of nearby residues. Amino acid substitutions in the midsection of S6 (T505I, T505V, T505S, and V512A) reduced the dissociation rate for quinidine, increased the affinity (0.7, 1.5, 3.4, and 1.4 μmol/L, respectively), and preserved both the voltage-dependent open channel–block mechanism and the electrical binding distance (0.19 to 0.22). In contrast, smaller or nonsignificant effects were observed for: deletion of the intracellular C-terminal domain, charge neutralizations in the region immediately C-terminal to S6...
Application of an exponential isotherm equation for describing gas adsorption on microporous activated carbons

Abstract A new equation for gas adsorption on microporous solids is proposed on the basis of the exponential adsorption isotherm, which is generated by the virial expansion of the spreading pressure. Expressions associated with this equation are derived also for the adsorption potential distribution, the differential molar enthalpy, and the differential molar entropy of adsorption. It is shown that this equation gives a good description of benzene adsorption on activated carbons with different degrees of microporosity and structural heterogeneity.
Study of nuclear dissipation via muon-induced fission. A relativistic lattice calculation

Abstract Excited muonic atoms in the actinide region may induce prompt nuclear fission via inverse internal conversion. We solve the time-dependent Dirac equation for a state describing a muon in the Coulomb field of the fissioning nucleus on a three-dimensional lattice and demonstrate that the muon attachment probability to the light fission fragment decreases with the energy dissipated during fission.
Effects of short IV infusions of DT‐009, a novel adenosine (A1−) receptor agonist, on renal function in healthy subjects

Purpose To study the renal effects of DT-009, a selective A1-receptor agonist currently in phase II clinical testing for ventricular rate control in atrial fibrillation. Methods Ten healthy young volunteers (age: 21–35) received a 30-minute infusion of 1μg/kg, 5μg/kg of DT-009 or saline on three different occasions. The subjects were hydrated by saline infusion (200 ml/min) for one hour prior to and five hours after the start of study drug infusion. Serial plasma and urine samples were taken over 24 hours to measure creatinine, Na and K by validated methods. The following renal function markers were assessed over time: urinary flow rate (UF), creatinine clearance (CLCrea), Na and K clearance (CLNa and CLK). Results Initially, DT-009 transiently reduced diuresis, natriuresis and kaliuresis due to a significant, dose-dependent inhibition of CLCrea, CLNa and to a lesser extent CLK. The inhibitory effects on CLCrea were shorter (1–2 hours) than the effects on CLNa (3–4 hours). Dose-dependent secondary effects (rebounds) in UF and natriuresis were apparent after 5–10 hours. Conclusions DT-009 transiently reduces glomerular filtration, presumably by renal vasoconstriction, as well as tubular reabsorption via activation of renal A1-receptors. Counter-regulatory mechanisms seem to blunt these primary effects. Clinical Pharmacology & Therapeutics (2005) 77, P58–P58; doi: 10.1016/j.clpt.2004.12.112
Vibration isolation using extreme geometric nonlinearity

A highly deformed, slender beam (or strip), attached to a vertically oscillating base, is used in a vibration isolation application to reduce the motion of a supported mass. The isolator is a thin strip that is bent so that the two ends are clamped together, forming a loop. The clamped ends are attached to an excitation source and the supported system is attached at the loop midpoint directly above the base. The strip is modeled as an elastica, and the resulting nonlinear boundary value problem is solved numerically using a shooting method. First the equilibrium shapes of the loop with varying static loads and lengths are studied. The analysis reveals a large degree of stiffness tunability; the stiffness is dependent on the geometric configuration, which itself is determined by the supported mass, loop length, and loop self-weight. Free vibration frequencies and mode shapes are also found. Finally, the case of forced vibration is studied, and the displacement transmissibility over a large range of forcing frequencies is determined for varying parameter values. Experiments using polycarbonate strips are conducted to verify equilibrium and dynamic behavior.
MMICs and Remote Sensing Science Instruments - A Technology Success Story

Developments in GaAs and InP transistor technology has had a large impact on science. With low noise and high frequency performance, these devices have revolutionized radio astronomy and Earth science, and changed the way that space science missions are designed and implemented. MMIC integration has shortened mission development times and enabling missions to be efficiently implemented in a cost-constrained environment. MMICs have also enabled a new generation of receiver arrays, creating a paradigm shift in experimental design. Some of this history will be discussed, citing specific examples of technology insertion and the impact on science.
Buprenorphine in the Treatment of Opiate Dependence: Its Pharmacology and Social Context of Use in the U.S.

Buprenorphine's physiological effects are produced when it attaches to specific opiate receptors that are designated mu, kappa, or delta. Buprenorphine, a partial agonist at the mu receptor and an antagonist at the kappa receptor, produces typical morphine-like effects at low doses. At higher doses, it produces opiate effects that are less than those of full opiate agonists. Knowledge of the physiological effects of opiate receptors and the way they interact with opiate agonists, partial opiate agonists, and opiate antagonists is fundamental to understanding the safety and efficacy of buprenorphine in treatment of pain and opiate addiction. Knowledge of the historical and social context of opiate agonist treatment of opiate dependence is fundamental to understanding how nonpharmacological factors may limit the clinical adoption and utility of a safe and effective medication in treatment of opiate dependence. This article reviews the pharmacology of sublingual buprenorphine and the historical context of opiate agonist therapy; delineates classes of opiate receptors and their interaction with opiate agonists, partial agonists, and antagonists; and describes the commercially available pharmaceutical formulations of buprenorphine. It focuses on sublingual buprenorphine tablets, Subutex and Suboxone, the FDA-approved formulations of buprenorphine for treatment of opiate dependence. Sublingual buprenorphine, and the combination of sublingual buprenorphine/naloxone, have unique pharmacological properties that make them a logical first-line intervention in the treatment of opioid dependence.
Integral estimates for null Lagrangians

Sobolev spaces of differential forms are studied, Lp-projections onto exact forms are introduced as a tool to obtain integral estimates for null Lagrangians. New results on compensated compactness are given and mean-coercive variational integrals are found. Existence of minima of certain mean-coercive functionals is established.
Risk and Protective Factors for Drug Use among Latino and White Adolescents

Several different theories have been suggested to account for drug use among Latinos, however, no one theory adequately explains this behavior. The authors developed a model of drug use that incorporated many potential risk and protective factors and tested both direct and buffering influences on drug involvement. From data on Latino, Latina, and White teenagers, 14 factors related to drug use were selected and assigned empirically to either a multipk protective (PFI) or risk factor (RFI) index. Bivariate and multiple regression analyses were used to examine the relationships of the RFI, PFI, and their interaction on frequency and/or quantity of cigarette, alcohol, cannabis, cocaine, and hard drug use. Both indexes and their interaction contributed significantly tofrequency and quantity of drug use among all groups.
3C-SiC nanobeam optomechanical crystals

We report the first demonstration of high-quality (Qi ~2.8-3.2x10^3) 3C silicon carbide photonic crystal nanobeams. With the strong optomechanical coupling (gOM/2p~100 GHz/nm), we observed clear optical transduction of the thermal mechanical motion of the couple-nanobeam.
Effect of amphotericin B lipid complex (ABLC) in very low birth weight infants

The aim of this retrospective, case–control study was to determine the effect of the amphotericin B lipid complex (ABLC) on serum creatinine (SCr), blood urea nitrogen (BUN), sodium (Na), and potassium (K) in very low birth weight (VLBW) infants. Medical records of all VLBW infants who were admitted to our Neonatal Intensive Care Unit between May 1998 and May 2006 and had received ABLC for at least 2 weeks were reviewed for patient demographics, use of medications (ABLC, diuretics, xanthines, indomethacin, vancomycin, gentamicin, pressors, and inotropes), fluid intake, urinary output, and serum electrolytes. Thirty-five patients who received ABLC were identified and matched by gestational age (GA) to 35 patients who served as controls. Infants who received ABLC had an average GA of 25.7 ± 2.1 weeks and a birth weight of 764 ± 196 g. Between day 1 and 14 of ABLC treatment, the BUN decreased from 17.5 ± 11.5 to 10.5 ± 6.8 mg/dl (p = 0.01), the SCr varied between 0.78 ± 0.32 and 0.69 ± 0.32 mg/dl, Na varied between 136.6 ± 5.8 and 137.8 ± 3.6 mEq/l, and K varied between 4.8 ± 0.9 and 4.9 ± 0.6 mEq/l, respectively. Based on these results, we conclude that treatment with ABLC for 2 weeks did not increase BUN or SCr, nor decrease Na or K in VLBW infants.
Fischer and Ravizza on moral responsibility

The author argued elsewhere that a necessary condition that John Fischer and Mark Ravizza offer for moral responsibility is too strong and that the sufficient conditions they offer are too weak. This article is a critical examination of their reply. Topics discussed include blameworthiness, irresistible desires, moral responsibility, reactive attitudes, and reasons responsiveness.
Behavioral kinetics: Dynamics of the unconditioned response to footshock

The purpose of this paper is to present an instrument and behavioral assay for monitoring the unconditioned response to footshock in the rat. The instrument provides measures of the total force exerted by a subject in response to a footshock, the duration of the subject's response, and the subject's latency to respond to the stimulus. The assay is developed to minimize the error variance inherent in behavioral measurements. In the second part of this paper, the relationships between the response and the physical parameters of the stimulus are investigated. The total force exerted by a subject, and the duration of the subjects response are linearly related to the multiplicative interaction of stimulus current and stimulus duration. The subject's latency to respond is curvilinearly related to stimulus current alone. The form of this relationship is hyperbolic. These results are discussed in the context of the measurement of behavioral and psychophysical processes in psychobiological research.
Thinning of aluminum powder particles for transmission electron microscopy

Abstract This article outlines a relatively simple and quick method for producing thin-foil samples of aluminum powder particles for transmission electron microscopy (TEM) examination. Details of solution preparation, experimental procedure, and results achieved are discussed. The procedure involves deposition of a nickel substrate around the individual aluminum powder particles to facilitate thinning to a thickness compatible with TEM examination. Photomicrographs of successful depositions and examples of microstructures of elevated temperature and high-strength aluminum powder metallurgy alloys are included.
A roadmap for comprehensive online privacy policy management

A framework supporting the privacy policy life cycle helps guide the kind of research to consider before sound privacy answers may be realized.
Immunoelectroadsorption: The fundamentals of the immunoelectroadsorption method

Abstract The fundamentals involved in the newly developed immunoelectroadsorption method to detect immunological reactions are described. An immunoelectroadsorption assay consists in adsorbing on a metalized slide first a layer of antigen and then a layer of antibodies. Both adsorptions are carried out with the help of a small electric current with the appropriate polarity. The thickness of the layer adsorbed from the antiserum is a function of the concentration of antibodies. The conditions under which the assay is to be conducted are described and the results obtained with the antigens serum bovine albumin, ovalbumin, and growth hormones are reported. These results show that the method is extremely sensitive, concentrations of growth hormone as small as 10 −9 g/ml can be estimated even in the presence of a large excess of foreign protein.
Basolateral Amygdala Lesions Facilitate Reward Choices after Negative Feedback in Rats

The orbitofrontal cortex (OFC) and basolateral amygdala (BLA) constitute part of a neural circuit important for adaptive, goal-directed learning. One task measuring flexibility of response to changes in reward is discrimination reversal learning. Damage to OFC produces well documented impairments on various forms of reversal learning in rodents, monkeys, and humans. Recent reports show that BLA, though highly interconnected with OFC, may be differentially involved in reversal learning. In the present experiment, we compared the effects of bilateral, ibotenic acid lesions of OFC or BLA (or SHAM) on visual discrimination and reversal learning. Specifically, we used pairwise visual discrimination methods, as is commonly administered in non-human primate studies, and analyzed how animals use positive and negative trial-by-trial feedback, domains not previously explored in a rat study. As expected, OFC lesions displayed significantly slower reversal learning than SHAM and BLA rats across sessions. Rats with BLA lesions, conversely, showed facilitated reversal learning relative to SHAM and OFC groups. Furthermore, a trial-by-trial analysis of the errors committed showed the BLA group benefited more from incorrectly performed trials (or negative feedback) on future choices than either SHAM or OFC rats. This provides evidence that BLA and OFC are involved in updating responses to changes in reward contingency and that the roles are distinct. Our results are discussed in relation to a competitive framework model for OFC and BLA in reward processing.
Economic Contests with Incomplete Information and Optimal Contest Design

This paper analyzes contests where contestants have private information about their abilities, and these abilities may be correlated. It differs from previous work chiefly in that it allows for such imperfect correlation, and that it restricts attention to a discrete output space. The latter aspect enables a complete characterization of possible equilibria. The analysis draws special attention to the possibility that equilibrium may involve lower ability contestants choosing higher effort and winning the contest. It is demonstrated that it may be optimal for the contest designer to induce such equilibria, and some conditions for this are derived. Different possible objectives of the contest designer are also discussed.
A laboratory investigation of lower hybrid wave interactions with a field-aligned density depletion

Spatially localized bursts of intense lower hybrid wave radiation are often encountered in ionospheric observations. These electric field enhancements have been correlated with depletions in plasma density. This laboratory investigation was undertaken to provide the kind of insight into the nature of the interaction which is difficult to obtain from ionospheric observations alone. The experiments were performed in the LArge Plasma Device (LaPD) at UCLA. The dependence of the interaction on wave frequency, depletion shape and size and density gradient is investigated in three spatial dimensions and in time. This letter concentrates on the dependence of the phenomenon on the density gradient. The main result is that the lower hybrid waves are observed to have the largest electric field in the regions of steepest density gradient.
Cemental Annulation as an Age Criterion in Forensic Dentistry

Intact teeth were obtained from three cadavers of known age 56, 67, and 76 years, respectively. Cross-sections 100-150 micrometers thick were taken from the roots using a diamond saw. Individual sections were stained, mounted on glass slides, and photographed on a light microscope. The usual number of years for the eruption of any particular tooth were added to the annulation count to determine the estimated age for that cadaver.
A 50GHz 130µW inductorless prescaler in 45nm SOI CMOS using ETSPC logic

We present a compact dual-modulus prescaler working at 50GHz without using inductors. A novel divider-by-2/3 in a reduced logic with minimum number of transistors is presented. For the first time, a single-phase clock digital-logic-based prescaler operating at frequencies in the mm-wave band is demonstrated. A power consumption of 130.2µW at 50GHz, gives the best power-efficiency reported. The prescaler is designed in a 45nm SOI CMOS technology with 1V supply.
Can the repeated prisoner's dilemma game be used as a tool to enhance moral reasoning?

The Treadway Commission examined the causes offraudulent financial reporting and maderecommendations to curb its occurrence. In itsrecommendations to educators, the TreadwayCommission (1987) stated that ``(b)usinessschools should encourage business andaccounting faculty to develop their ownpersonal competence as well as classroommaterials for conveying information, skills,and ethical values that can help prevent,detect, and deter fraudulent financialreporting'' (p. 83). The purpose of this studywas to determine whether the repeatedprisoner's dilemma game could be used as a toolto increase individuals' moral reasoning. Itwas hoped that this exercise would encouragetrust (Rapoport and Chammah, 1965) andreciprocal altruism (Dawes, 1988) as theylearned to cooperate with one another in orderto maximize their payoffs.
COMPARATIVE STUDIES ON RESPIRATION : XI. THE EFFECT OF HYDROGEN ION CONCENTRATION ON THE RESPIRATION OF PENICILLIUM CHRYSOGENUM.

1. Variations in pH value between 4 and 8 produce practically no effect on the normal rate of respiration (the rate at neutrality is called normal). 2. Increasing the pH value to 8.80 causes respiration to fall to 60 per cent of the normal, after which it remains stationary for the duration of the experiment. 3. Decreasing the pH value to 2.65 causes a gradual rise and a gradual return to normal; at pH 1.10 to 1.95 the preliminary rise amounts to 20 per cent and is followed by a fall to below the normal. 4. The decrease in respiration brought about by solutions of a pH value of 1.95 or less are irreversible, while a similar decrease which occurs at pH 8.80 is reversible, the rate coming back to practically normal after the material is replaced in a neutral solution. 5. Determinations by means of Winkler's method showed an increase in the consumption of oxygen in acid solutions and a decrease in alkaline solutions.
Hair cell distribution and orientation in goldfish otolith organs.

Structurally diverse sensory regions occur in the otolith organs of the goldfish inner ear. Scanning electron microscopy reveals regional distinctions based on thre criteria. (1) Hair cells have difference sizes of apical bundles, based on thickness. In all three maculae, two central regions have hair cells with bundles significantly thicker than those in surrounding regions. (2) Hair cell population density varies, with regional aggregations present. The central regions with thick bundles have two to three times the density of surrounding regions with thin bundles, and contain 40-80% of the total hair cell number in each macula. (3) Hair cell orientation maps show that each macula has two oppositely oriented cell populations that can be separated completely, not by a zone of interspersion, but apparently by a single unbroken line The lagena is like the utricle in having hair cells with the kinocilium on the side of the cell toward the opposition line, but in the saccule the kinocilia face away from the line, and the small macula neglecta consists of two completely separate, oppositely oriented patches. The opposition line does not divide each macula simply down its midline; instead, the line divides the regions with thick bundles into narly equal opposing aras, except for a remarkably abrupt large loop in the line in the anterior part of the saccule The regional structural diversity in these organs may relate to localized functional diversity of responses to tilt, vibration and sound.
Toward a Historiography of the Popular

The greatest challenge that theatre scholars face today—as we watch the seemingly inexorable march of U.S. imperialism and capitalist globalization— is to remember, to historicize rigorously and resourcefully, to render events (in Brecht's words) “remarkable,” to “expose the world's mechanism on a grand scale and to copy it in such a way that it would be more easily serviced.” When we practice a mimeticism that keeps “impermanence always before our eyes, . . . our own period can be seen to be impermanent too.” We must remember in order to be able to demystify the pieties disseminated by our politicians, pundits, and journalists who so blithely disregard the brutalities and deceptions that structure the histories they glibly rewrite that one would think they sprinkled water from the River Lethe on their Cheerios every morning. For remembering, as Pierre Bourdieu points out, represents a reconstruction not only of the past but also of the dynamics of disavowal and forgetting. To historicize means to “reconstruct the history of the historical labour of dehistoricization [italics in original quote].” This reconstructive labor seems all the more urgent during a period when theatre scholars (who have long been considered more or less irrelevant within the humanities) must face the increasing corporatization of the universities for which we work, the continuing intellectual paralysis of the Left, the relentless commercialization and retrenchment of American theatre (for better or worse), and the rise of a discipline, performance studies, that is challenging, reinvigorating, and partially displacing theatre studies.
Management of the Depression-Pain Syndrome

Patients often visit their primary care provider hoping to find relief from physical pain. When a physiological origin cannot be identified, one hypothesis suggests depression is responsible for the pain. Depression screening is recommended for those experiencing unexplained pain because the diagnosis may be depression-pain syndrome. A treatment plan using both pharmacologic agents and psychotherapy is suggested; however, these may not fully resolve all symptoms. Providers should be knowledgeable about complementary/alternative therapies. A balanced combination of conventional and complementary/alternative medical services can enhance treatment and provide practical tools to improve the quality of life for a patient with depression-pain syndrome.
On the Demands of Truthfulness in Writing Personal Loss Narratives

Abstract There's no doubt that [your] descriptions evoke detailed images, but I think it's the honesty of that voice that makes the reader listen in the first place. and I also think that it's an honesty of content and not just of tone, (personal letter from Mika Uematsu, July 5, 1995) He wrote me a wonderful letter… The crux of what he said was that I should never be afraid of appearing angry, small-minded, obtuse, mean, immoral, amoral or calculating. “Take no care for your dignity,” he said, and I have followed his advice scrupulously ever since. (From Mary Karr, author of The Liar's Club, writing about a letter from Tobias Wolff, author of This Boy's Life, quoted in Basbanes, 1995)
EXPERIMENTAL MANIPULATIONS OF TOP-DOWN AND BOTTOM-UP FACTORS IN A TRI-TROPHIC SYSTEM

There is much interest in assessing the relative importance of “top-down” (from the trophic level above) vs. “bottom-up” (from the trophic level below) effects in ecological communities. This study compares the strength of top-down effects of parasites and bottom-up effects of plants on herbivores. We established populations of sea-oxeye daisy, Borrichia frutescens, and gall-making flies, Asphondylia borrichiae, on 12 separate off-shore islands in Pinellas County, Florida (USA). High levels of parasitism were obtained by adding high densities of parasitized galls, and high levels of host-plant nitrogen were obtained by adding fertilizer. We established three replicates of each of the following treatments: low parasitism, low nitrogen; low parasitism, high nitrogen; high parasitism, low nitrogen; and high parasitism, high nitrogen. There was a significant interaction of parasitism and plant nitrogen: parasitism was important only on high-nitrogen plants where galls were abundant. Thus, our results contribute new insights into top-down vs. bottom-up effects: bottom-up forces set the stage on which top-down forces may act.
Temperature-dependent high-angle electron scattering from a phase-separated amorphous GeTe thin film

Abstract This paper describes the results of experiments and simulations on the thermal diffuse scattering of 200 keV electrons from an amorphous Ge 48 Te 52 thin film using high-angle annular-dark-field (HAADF) imaging in a scanning transmission electron microscope (STEM). This imaging techniques shows that the film is phase separated on a ∼ 10–20 nm length scale into Te-rich and Ge-rich amorphous domains. The average high-angle-scattered intensity increases as the temperature increases from 106 to 300 K. The contrast between the two domains decreases over this same range indicating that, in addition to the atomic-number ( Z ) effects on contrast for a given temperature, the temperature-dependent vibrational properties and, hence, phonon-scattering behavior are different for the two different elements in this specimen. Simulations of the HAADF intensity based on an Einstein model using a Debye expression for the mean-square vibrational amplitude give qualitative agreement where temperature-dependent contrast variations are due to differences in atomic number, Debye temperature, and atomic-scattering factor.
IT WORKERS SHORTAGE: Implications for Education Policy

This article examines the information technology (IT) worker shortage by comparing the rate of salary increase for IT workers from 1995 to 1998 to the rate of inflation for those same years. Findings show that the median salary for IT workers has increased at twice the rate of inflation. Universities and businesses form partnerships to develop innovative products. Continuous innovation has meant that both industry and universities require workers, students and faculty to continuously change their skill sets. At every point as technology changes there is a shortage of the newest combination of required skill sets. A recommendation is made to change education strategy so IT workers have easier access to continuous education via the Internet, funded by their employers.
Stapes surgery in a residency training program.

Objectives: Determine parameters for successful stapedectomy and whether this procedure can be performed safely by residents in a teaching hospital. Study Design: Retrospective analysis of techniques and results for 71 stapedectomy procedures. Materials and Methods: Charts were reviewed for technique, audiological test results, complications, operative time, and anesthetic used. Results: Overall, closure of the air-bone gap at 10 dB was achieved in 87% of patients. Use of general anesthesia and a laser-assisted, small-fenestra technique allowed residents to complete more operations. No severe sensorineural hearing loss was noted. Conclusions: Residents can safely and successfully perform stapes surgery using a laser-assisted, small-fenestra technique.
Neighborhood risk factors for obesity.

Objective: The goal of this study was to explore neighborhood environmental factors associated with obesity in a sample of adults living in a major U.S. metropolitan area. Research Methods and Procedures: This was a multi-level study combining data from the U.S. Behavioral Risk Factor Surveillance System with data from the U.S. Census. A total of 15,358 subjects living in 327 zip code tabulation areas were surveyed between 1998 and 2002. The outcome was obesity (BMI >30), and independent variables assessed included individual level variables (age, education, income, smoking status, sex, black race, and Hispanic ethnicity), and zip code level variables (percentage black, percentage Hispanic, percentage with more than a high school education, retail density, establishment density, employment density, population density, the presence of a supermarket, intersection density, median household income, and density of fast food outlets). Results: After controlling for individual level factors, median household income [ relative risk (RR) = 0.992; 95% confidence interval (CI) = 0.990, 0.994] , population density (RR = 0.98; 95% CI = 0.972, 0.990), employment density (RR = 1.004; 95% CI = 1.001, 1.009), establishment density (RR = 0.981 95% CI = 0.964, 0.999), and the presence of a supermarket (RR = 0.893; 95% CI = 0.815, 0.978) were associated with obesity risk. Fast food establishment density was poorly associated with obesity risk. Discussion: Where one lives may affect obesity status. Given the influence of the presence of a supermarket on obesity risk, efforts to address food access might be a priority for reducing obesity.
Real-world objects are more memorable than photographs of objects

Research studies in psychology typically use two-dimensional (2D) images of objects as proxies for real-world three-dimensional (3D) stimuli. There are, however, a number of important differences between real objects and images that could influence cognition and behavior. Although human memory has been studied extensively, only a handful of studies have used real objects in the context of memory and virtually none have directly compared memory for real objects vs. their 2D counterparts. Here we examined whether or not episodic memory is influenced by the format in which objects are displayed. We conducted two experiments asking participants to freely recall, and to recognize, a set of 44 common household objects. Critically, the exemplars were displayed to observers in one of three viewing conditions: real-world objects, colored photographs, or black and white line drawings. Stimuli were closely matched across conditions for size, orientation, and illumination. Surprisingly, recall and recognition performance was significantly better for real objects compared to colored photographs or line drawings (for which memory performance was equivalent). We replicated this pattern in a second experiment comparing memory for real objects vs. color photos, when the stimuli were matched for viewing angle across conditions. Again, recall and recognition performance was significantly better for the real objects than matched color photos of the same items. Taken together, our data suggest that real objects are more memorable than pictorial stimuli. Our results highlight the importance of studying real-world object cognition and raise the potential for applied use in developing effective strategies for education, marketing, and further research on object-related cognition.
Systemic Hemodynamic and Cardiac Function Changes in Patients Undergoing Orthotopic Liver Transplantation

The objective of this study was to determine the changes in systemic hemodynamics (systemic vascular resistance [SVR], cardiac output [CO], systemic blood pressure [SBP]) and cardiac function (pulmonary artery pressure [PAP] and pulmonary wedge pressure [PWP]) during the 96 hours following orthotopic liver transplantation (OLT) and correlate these with changes in hepatic and renal function and patient outcome. The study took place in a 12-bed medical respiratory intensive care unit in a large teaching hospital. Twenty-one patients had OLT performed over a 21.5-month period (January 1988 to October 15, 1989) for end stage liver disease (ESLD) from a variety of causes. A flow-directed right heart catheter and an indwelling arterial cannula were inserted for hemodynamic monitoring over a 96-hour postoperative period. Liver and renal function studies, total serum calcium, serum albumin, and fluid balance were determined daily. The SVR increased significantly to 12.8±0.6 U at 48 hours compared with immediate (
Victorian caricature and classicism: Picturing the London water crisis

This study assesses Victorian artistic response to the crisis of the poor quality of Victorian London's water supply—a situation exacerbated by comparison of London to the ancient capitals, most notably Rome, and water's classical associations with beauty, purity, and bounty. Two major and distinct responses emerge: Victorian caricature and Victorian classicism. Artists from both camps summoned the classical tradition to allude to the irony of classical ideal versus contemporary reality. In low Victorian art the truth lay in the caricature of the classical image. In high Victorian art the truth lay in the reality that the classical image could only serve to index. To be sure, the classical tradition furnished ample material through which the artist might allow a myth, for example, to allude subtly to a social problem, and through idealization, to suggest a powerful contrast between myth and reality. Thus the artist could “strike” with the requisite decorum and without appearing resistant to the artistic and socio-political establishment.
Randomized, prospective comparison of open and closed peritoneal lavage for abdominal trauma.

Study objective: The study was designed to determine if open peritoneal lavage is superior to closed peritoneal lavage. Design and participants: Patients who were admitted to a trauma center and needed peritoneal lavage were assigned to alternate trauma teams. Team 1 performed only open lavages one month and then switched to closed lavages; team 2 did only closed lavages and then switched to open lavages. Measurements: The incidences of positive lavages and lavage complication were noted, Also measured were the length of time for catheter insertion, length of time of fluid retrieval, volume of effluent, technical difficulty of lavage, training level of the operator, effluent RBC count, and material cost. Results: Two hundred twenty patients were randomized, No differences were noted in complication rate, volume of effluent, or length of time for fluid retrieval. Significant differences were noted for catheter insertion time (3,6 minutes for closed lavage and 6.9 minutes for open), ease of catheter insertion (closed technique is favored), and material cost ($96.26 for open lavage and $69.70 for closed lavage). Conclusion: Closed peritoneal lavage is superior to open peritoneal lavage in abdominal trauma; it is faster, easier to use, cheaper, and as safe as open lavage.
Monolayer-protected nanoparticle film assemblies as platforms for controlling interfacial and adsorption properties in protein monolayer electrochemistry.

Assembled films of nonaqueous nanoparticles, known as monolayer-protected clusters (MPCs), are investigated as adsorption platforms in protein monolayer electrochemistry (PME), a strategy for studying the electron transfer (ET) of redox proteins. Modified electrodes featuring MPC films assembled with various linking methods, including both electrostatic and covalent mechanisms, are employed to immobilize cytochrome c (cyt c) for electrochemical analysis. The background signal (non-Faradaic current) of these systems is directly related to the structure and composition of the MPC films, including nanoparticle core size, protecting ligand properties, as well as the linking mechanism utilized during assembly. Dithiol-linked films of Au225(C6)75 are identified as optimal films for PME by sufficiently discriminating against detrimental background current and exhibiting interfacial properties that are readily engineered for cyt c adsorption and electroactivity (Faradaic current). Surface concentrations and denat...
Molecular Epidemiology of Bacterial Infections: Examples of Methodology and of Investigations of Outbreaks

Plasmid profile analysis, plasmid and chromosomal bacterial restriction endonuclease DNA analysis, and DNA hybridization are increasingly used in clinical microbiology and epidemiology. These techniques have been applied, singly and in combination, to investigations of outbreaks, including those of diarrheal diseases caused by pandemic Vibrio cholerae, enterotoxigenic and enterohemorrhagic Escherichia coli, Salmonella muenchen, and Salmonella typhimurium. The techniques have been critical in the unraveling of outbreaks of disease caused by nosocomial and community-acquired pathogens. Although there are limitations to these methods, their applications have important ramifications for basic science and public health.
Overexpression of the gag-pol precursor from human immunodeficiency virus type 1 proviral genomes results in efficient proteolytic processing in the absence of virion production.

Abstract The expression of the gag-pol polyprotein of human immunodeficiency virus type 1 (HIV-1) occurs via ribosomal frameshifting between the gag and pol genes. Because low levels of the gag-pol precursor are naturally produced in HIV-1-infected cells, a limited amount of information is available on the biology of this molecule. To further study this polyprotein, two mutant HIV-1 proviral genomes were created to position the gag and pol genes in the same translational reading frame. The mutations inserted a single thymidine nucleotide at the site of ribosomal frameshifting (nucleotide 1635), which results in the addition of a phenylalanine residue (frameshift 1 [FS1]), or a single adenine nucleotide, which results in the addition of a leucine residue (frameshift 2 [FS2]). Transfection of the mutant proviral genomes into COS-1 cells resulted in the expression of the p160gag-pol polyprotein precursor as well as the proteolytically processed gag and pol gene products. Metabolic labeling of the transfected cells with [3H]myristic acid revealed that the p160gag-pol and p17gag proteins expressed from the mutant genomes were myristylated. While the supernatants from COS-1 cells transfected with wild-type or mutant proviral genomes contained similar amounts of p24 antigen, the levels of reverse transcriptase were, on the average, 10 times greater in the supernatants from cells transfected with the FS1 and FS2 proviral genomes. The cells transfected with the wild-type proviral genome released infectious viral particles, while the mutant proviral genomes released p24 and reverse transcriptase in the absence of detectable particle formation. The mutant proviral genomes were completely noninfectious as determined by coculture of the transfected COS-1 cells with SupT1 cells. These results demonstrate that the gag-pol polyprotein of HIV-1 contains the appropriate signals for proteolytic processing and association with intracytoplasmic membranes in the absence of virion formation.
The impact of surgical duration on plastic surgery outcomes

Historically, prolonged operative time has been associated with increased risk for morbidity and mortality. However, there is a paucity of clear data regarding the effect of longer operative times on outcomes in the field of plastic surgery. We endeavored to investigate the impact of operative time on postoperative morbidity and mortality in plastic surgery. Utilizing a multi-institutional surgical outcomes database spanning from 2006 to 2010, we identified 15,289 plastic surgery procedures. Operative time was tracked in 30-min increments. Multivariate logistic regression was utilized to investigate the relationship between operative time and primary outcomes of interest (medical complications, surgical complications, overall complications, and mortality). Subgroup analysis explored the relationship between operative time and outcomes in a homogenous high-risk cohort. When progressing from the shortest surgical duration cohort to the longest, we see an incremental increase in overall complications (6.22 to 24.86 %), surgical complications (2.73 to 13.08 %), and medical complications (3.68 to 15.89 %). Furthermore, for every 30-min increase in operative time, there was a corresponding increased risk for 30-day overall complications (odds ratio (OR) 1.13, 95 % confidence interval (CI) 1.08–1.18), medical complications (OR 1.14, 95 % CI 1.06–1.23), and surgical complications (OR 1.14, 95 % CI 1.09–1.20). There was no significant association with 30-day mortality. Findings were substantiated through subgroup analysis. Drawing from data on over 15,000 plastic surgery procedures, we determined that increased operative time was associated with a higher risk of medical, surgical, and overall complications. As outcome measures take a more prominent role in the care of plastic surgery patients, these findings will advance patient education and practice management. Level of Evidence: Level III, pronostic/risk study