cssi/SciSciGPT-SciSciNet huggingface dataset:
Factors associated with red blood cell, platelet, and plasma transfusions among inpatient hospitalizations: a nationally representative study in the United States

BACKGROUND Demographic and hospital-level factors associated with red blood cell (RBC), plasma, and platelet transfusions in hospitalized patients across the U.S. are not well characterized. METHODS We conducted a retrospective analysis of the National Inpatient Sample (2014). The unit of analysis was a hospitalization; sampling weights were applied to generate nationally-representative estimates. The primary outcome was having ≥ 1 RBC transfusion procedure; plasma and platelet transfusions were similarly assessed as secondary outcomes. For each component, factors associated with transfusion were measured using adjusted prevalence ratios (adjPR) and 95% confidence intervals (95% CI) estimated by multivariable Poisson regression. RESULTS The prevalence of RBC, plasma, and platelet transfusion was 5.8%, 0.9%, and 0.7%, respectively. RBC transfusions were associated with older age (≥ 65 vs. < 18 years; adjPR = 1.80; 95% CI = 1.66-1.96), female sex (adjPR = 1.13; 95% CI = 1.12-1.14), minority race/ethnic status, and hospitalizations in rural hospitals compared to urban teaching hospitals. Prevalence of RBC transfusion was lower among hospitalizations in the Midwest compared to the Northeast (adjPR = 0.73; 95% CI = 0.67-0.80). All components were more likely to be transfused in patients with a primary hematologic diagnosis, patients with a higher number of total diagnoses, patients who experienced a higher number of other procedures, and patients who eventually died in the hospital. In contrast to RBC transfusions, prevalence of platelet transfusion was greater in urban teaching hospitals (vs. rural; adjPR = 1.71; 95% CI = 1.49-1.98) and lower in blacks (vs. whites; adjPR = 0.80; 95% CI = 0.76-0.85). CONCLUSIONS Nationally, there is heterogeneity in factors associated with transfusion between each blood component, including by hospital type and location. This variability presents patient blood management programs with potential opportunities to reduce transfusions.
Electrophoretic Mobility Shift Assay and Dimethyl Sulfate Footprinting for Characterization of G-Quadruplexes and G-Quadruplex-Protein Complexes

DNA G-quadruplexes are globular nucleic acid secondary structures which occur throughout the human genome under physiological conditions. There is accumulating evidence supporting G-quadruplex involvement in a number of important aspects of genome functions, including transcription, replication, and genomic stability, and that protein and enzyme recognition of G-quadruplexes may represent a key event to regulate physiological or pathological pathways. Two important techniques to study G-quadruplexes and their protein interactions are the electrophoretic mobility shift assay (EMSA) and dimethyl sulfate (DMS) footprinting assay. EMSA, one of the most sensitive and robust methods for studying the DNA-protein interactions, can be used to determine the binding parameters and relative affinities of a protein for the G-quadruplex. DMS footprinting is a powerful assay for the initial characterization of G-quadruplexes, which can be used to deduce the guanine bases involved in the formation of G-tetrads under physiological salt conditions. DMS footprinting can also reveal important information in G-quadruplex-protein complexes on protein contacts and regional changes in DNA G-quadruplex upon protein binding. In this paper, we will provide a detailed protocol for the EMSA and DMS footprinting assays for characterization of G-quadruplexes and G-quadruplex-protein complexes. Expected outcomes and references to extensions of the method will be further discussed.
The role of knowledge in water resource management: an assessment of the Oregon general public

Oregon has a long-held reputation of water abundance, however water shortages and droughts throughout the state reveal this is not an accurate perception. Projected climate change impacts and popul...
What Physical Facilities Are Needed: The Question of Medical Clearance in Emergency Psychiatric Settings

The topic of medical clearance has been debated for years; traditionally, the focus has been on how to most appropriately screen psychiatric patients presenting to the medical emergency department (ED) for transfer to inpatient psychiatric units. A clear dichotomy existed between medical and psychiatric issues; however, the advent of integrated care has given this issue a more complex new shape. The need for expeditious identification of acute medical illness using history, physical exam, and basic laboratory testing, needs to be balanced with the need to monitor chronic conditions that can affect psychiatric care.
Effects of Depression on Heart Failure Self-Care.

ABSTRACT Background Depression has been identified as a barrier to effective heart failure self-care, but recent studies suggest that the relationship between depression and self-care is more complex than was previously believed. This study was designed to clarify the relationship between depression and self-care in hospitalized patients with HF. Methods and Results During hospitalization with a confirmed clinical diagnosis of HF, 400 patients completed a structured interview to diagnose Diagnostic and Statistical Manual, 5th edition (DSM-5) depressive disorders, the Patient Health Questionnaire (PHQ-9) depression questionnaire, the Self-Care of Heart Failure Index (SCHFI), and several psychosocial questionnaires. Multivariable models were fitted to each SCHFI scale; separate models were run with DSM-5 disorders and PHQ-9 depression scores. Higher PHQ-9 depression scores were independently associated with lower (worse) scores on the SCHFI Maintenance (P Conclusions Patients with a combination of psychosocial problems, including symptoms of depression, stress, anxiety, and inadequate social support, may be more likely than other patients to display difficulties with HF self-care that can increase their risk for hospitalization. Research is needed on “broad-spectrum” psychosocial interventions for patients with HF self-care deficits.
Nature Writing as a Frontier of Twentieth-Century Poetics: The Case of Francis Ponge and René Char

Although it has never constituted itself as a genre within the French sphere, within the cannon of twentieth-century "Literature" are many texts that share the characteristics traditionally associa...
Outcomes and CT scan three-dimensional volumetric analysis of emergent paraesophageal hernia repairs: predicting patients who will require emergent repair.

Elective repair versus watchful waiting remains controversial in paraesophageal hernia (PEH) patients. Generation of predictive factors to determine patients at greatest risk for emergent repair may prove helpful. The aim of this study was to evaluate patients undergoing elective versus emergent PEH repair and supplement this comparison with 3D volumetric analysis of hiatal defect area (HDA) and intrathoracic hernia sac volume (HSV) to determine risk factors for increased likelihood of emergent repair. A retrospective review of a prospectively enrolled, single-center hernia database was performed on all patients undergoing elective and emergent PEH repairs. Patients with adequate preoperative computed tomography (CT) imaging were analyzed using volumetric analysis software. Of the 376 PEH patients, 32 (8.5%) were emergent. Emergent patients had lower rates of preoperative heartburn (68.8%vs85.1%, p = 0.016) and regurgitation (21.9%vs40.2%, p = 0.04), with similar rates of other symptoms. Emergent patients more frequently had type IV PEHs (43.8%vs13.5%, p 0.05). With a formal PEH repair, there was no difference in rate or timing of recurrence. Emergent patients are more likely to suffer complications, require ICU care, have a higher mortality, and an increased likelihood of reoperation. A graduated increase in HSV increasingly predicts the need for an emergent operation. Those patients presenting electively with a large PEH may benefit from early elective surgery.
Fibrous dysplasia patients with and without craniofacial involvement report reduced quality of life inclusive of stigma, depression, and anxiety.

ObjectivesFibrous dysplasia is a rare bone disorder that causes deformity, fractures, and pain that typically manifests in childhood and persists as a chronic illness. This study evaluates adult pa...
Living in a Vehicle

Nothing offends constitutional sensibilities quite like a local ordinance that sets police against poor people as a way of cleaning-up litter. Yet Section 85.02 [PDF]of the Los Angeles Municipal Code, which was enacted in 1983 and prohibits the use of a vehicle for living quarters, was lifted out of obscurity in 2010, years after having been enacted but not enforced, for the express purpose of responding to "the illegal dumping of trash and human waste on city streets that was endangering public health." Note that the dumping was already illegal. The litter ordinance or even the disorderly conduct ordinance, if necessary, could have been invoked against that behavior. But the city dredged up this old anti-homeless law because neighbors claimed that it was homeless folks who were dumping the trash and waste. And after enough homeless people were ticketed and jailed under the ordinance, they brought a lawsuit against the city. This article is about the Ninth Circuit’s artful handling of the appeal in that case.
Teaching Statistics without Sadistics

Abstract Social work students generally dread statistics courses, and social work educators appear to share this apprehension. This article describes five steps in a developmental research project designed to take the sadistics out of statistics. First, statistics anxiety is examined and identified as an educational problem. Second, instructional objectives and procedures to achieve them are identified. Third, methods and tools for evaluating the course are explored. Fourth and fifth, strategies for and obstacles to making widespread use of this approach are considered.
‘A Closet or a Secret Field’: Horace, Protestant Devotion and British Retirement Poetry

Contrary to studies that link British poems celebrating rural retirement with the Latin poetry of Horace, this essay argues that such poems equally reflect the influence of Protestant devotional writing and ritual. Retirement poetry not only appears in religious guidebooks and collections of devotional verse but also shares much of the rhetoric characterising devotional writing of the period. The essay also stresses the importance of taking into account audience, context and function when categorising eighteenth-century poetry as secular or religious. An appendix lists over 300 retirement poems published in the British Isles between 1690 and 1830.
How do I provide leukapheresis products? Blood center experience and evidence for process improvement

Background The past few decades have seen a resurgence of interest in leukapheresis products to improve the survival of infected patients with neutropenia. These products have a short shelf life and require donor stimulation with dexamethasone before collection. Additionally, a system with good communications and logistical support is essential. A recent survey of blood centers in North America revealed that the majority of centers collecting leukapheresis products use steroid-stimulated donors. The survey results suggested that an analysis of the process and potential process improvement would be of interest to the transfusion medicine community. Study Design and Methods Data from 2008 to 2011 regarding donor selection, donor dexamethasone stimulation, leukapheresis collection, and correlations between potentially pertinent variables for process improvement were analyzed. Results from an analysis of cost are also included. Results We evaluate 432 leukapheresis donations and demonstrate correlations between 1) pre- and poststimulation white blood cell (WBC) count (p < 0.0001), 2) interval (donor stimulation to collection) and poststimulation WBC count (p < 0.0001), and 3) poststimulation WBC count and leukapheresis product granulocyte yield (p < 0.0001). Conclusions Significant improvement in granulocyte quality and yield can be accomplished in dexamethasone-stimulated donors, by selecting eligible donors with relatively high normal prestimulation WBC counts and/or previously good responses to dexamethasone, increasing the duration between dexamethasone stimulation and granulocyte collection, and maintaining optimal hematocrit (5%-10%) in granulocyte collections. Because the majority of surveyed blood centers collecting stimulated granulocytes use steroids alone, modifications presented here may prove useful. Further assessment of correlation between granulocyte yield and clinical outcome will await results of additional studies.
Direct molecular testing to assess the incidence of meningococcal and other bacterial causes of meningitis among persons reported with unspecified bacterial meningitis

Confirmed and probable cases of invasive Neisseria meningitidis (Nm) infection are reportable in New York City. We conducted a study to identify Nm among culture-negative reports of bacterial and viral meningitis. During the study period, 262 reports of suspected meningitis were eligible. Cerebrospinal fluid (CSF) specimens from 138 patients were obtained for testing. No Nm cases were detected. Results from real-time polymerase chain reaction and 16S on CSF specimens were concordant with hospital microbiology findings in 80%; however, other pathogenic organisms were detected in 14 culture-negative specimens. New York City's surveillance system appears to be effective at capturing cases of Nm meningitis. Nucleic acid testing is useful for detecting the presence of bacterial DNA when antibiotic therapy precedes lumbar puncture or bacterial cultures are negative. It remains unanswered whether culture-negative cases of Nm bacteremia are being missed by reportable disease surveillance.
Domain communication in the dynamical structure of human immunodeficiency virus 1 protease.

Abstract A dynamical model for the structure of the human immunodeficiency virus 1 (HIV-1) protease dimer in aqueous solution has been developed on the basis of molecular dynamics simulation. The model provides an accurate account of the crystal geometry and also a prediction of the structural reorganization expected to occur in the protein in aqueous solution compared to the crystalline environment. Analysis of the results by means of dynamical cross-correlation coefficients for atomic displacements indicates that domain-domain communication is present in the protein in the form of a molecular "cantilever" and is likely to be involved in enzyme function at the molecular level. The dynamical structure also suggests information that may ultimately be useful in understanding and further development of specific inhibitors of HIV-1 protease.
The games psychologists play (and the data they provide).

Computer games and the technologies marketed to support them provide unique resources for psychological research. In contrast to the sterility, simplicity, and artificiality that characterizes many cognitive tests, game-like tasks can be complex, ecologically valid, and even fun. In the present paper, the history of psychological research with video games is reviewed, and several thematic benefits of this paradigm are identified. These benefits, as well as the possible pitfalls of research with computer game technology and game-like tasks, are illustrated with data from comparative and cognitive investigations.
Disseminated intravascular coagulation caused by abdominal aortic aneurysm

Disseminated intravascular coagulation (DIC) has been described as an occasional complication of abdominal aortic aneurysm. This is usually a perioperative coagulopathy, which may progress into a hemorrhagic diathesis. Rarely, DIC is present preoperatively as a result of the aneurysm itself. In the presence of additional pathophysiologic factors, a "compensated state" of secondary fibrinolysis may deteriorate into a clinically manifest coagulopathy. Heparin can be a useful adjunct in preoperative management of DIC, but definitive treatment requires surgical repair of the aneurysm. Long-term follow-up is essential to ensure that DIC is due to the aneurysm and that other disease processes are not overlooked. We report a case of DIC caused by an abdominal aortic aneurysm, with resolution after surgical treatment.
Junction conditions for odd-parity perturbations on most general spherically symmetric space-times

Perturbations of a general background space-time with a hypersurface of discontinuity, such as the history of a collapsing star, are considered. The junction conditions that these perturbations obey are expressed in terms of the perturbed first and second fundamental forms (intrinsic metric and extrinsic curvature) of the (perturbed) set of hypersurfaces one of which is the discontinuous one. These junction conditions are applied to the odd-parity metric and hydrodynamical asymmetries of a slightly aspherical but otherwise general and realistic spherically collapsing star. The junction conditions are stated in terms of those metric and matter perturbational objects that are the most natural, economic, and versatile: gauge-invariant geometrical objects. For odd-parity perturbations these are scalars and vectors on the totally geodesic submanifold spanned by the time and radial coordinates. The end result is simple: The junction conditions amount to the continuity of the gradient of a master gauge-invariant scalar wave function from which all other perturbational quantities can be derived.
Cloning of estrogen receptor alpha and aromatase cDNAs and gene expression in turtles (Chrysemys picta and Pseudemys scripta) exposed to different environments

Reproductive changes have been observed in painted turtles (Chrysemys picta) from a site with known contamination located on Cape Cod, MA, USA. We hypothesize that these changes are caused by exposure to endocrine-disrupting compounds and that genes playing a significant role in reproduction are affected. cDNA sequences were determined for estrogen receptor alpha and aromatase in the painted turtle. These genes were measured in our study animals using quantitative PCR. Adult turtles were trapped from our study site (Moody Pond, MP) or a reference site (Washburn Pond) and exposed to laboratory environments containing soil from either site. The red-eared slider (Pseudemys scripta), a pond turtle closely related to the painted turtle, was used to assess neonatal exposure to soil and water from the sites. Our results show an increase in hepatic estrogen receptor, which suggests exposure to estrogenic contaminants. Female turtles from MP appear to have a long-term effect on hepatic ER. Other findings were apparent age-dependent differences in expression of aromatase and ER in the brains of neonate and year-old juvenile turtles. Phylogenetic analyses of the cDNA sequences further support the hypothesis that turtles are in a sister clade to birds and crocodilians.
Effect of body doping on double-gate MOSFET characteristics

This paper presents a systematic study of the body doping effect on symmetric double-gate (DG) MOSFETs. Two-dimensional simulation tools are used to investigate the doping effect on long-channel and short-channel devices. Both n-type and p-type doping are studied. For long-channel devices, the threshold voltage shift due to body doping is proportional to the total dopant when the device is fully depleted. Thus, it is straightforward to include the doping effect in compact models. When the device is partially depleted, in addition to the threshold voltage shift, the subthreshold slope can be degraded. For short-channel devices, improvement of the short-channel effects is observed when the body doping concentration is close to the level that makes the device partially depleted.
Microfluidic-packaged CMOS chemiresistor detector for micro-scale gas chromatograph

The implementation of a microfluidic ‘detector cell’ is presented, which integrates a nanofabricated chemiresistor (CR) array with monolithic CMOS baseline cancellation circuitry and a microfluidic chamber for use in a micro-scale gas chromatograph (μGC). A robust packaging method was developed to facilitate a microfluidic interface between the detector cell and external μGC components while also reducing dead volume and the sorbence of sample vapours. The efficacy of the integrated detector cell was elucidated by consistent chip responses taken from a 4×2 CR array fabricated on the silicon dioxide surface of a custom-designed CMOS readout chip.
Use of luting agents with an implant system: Part I

The purposes of this study were to determine the amount of die space necessary to reduce seating discrepancies of castings cemented onto implant abutments and to determine the effect that this space created for the luting-agent has on crown retention. Noble metal castings were made with 0.000 inch, 0.001 inch, 0.002 inch, and 0.003 inch spacing for premanufactured titanium implant abutments. The castings were cemented onto the abutments with three permanent luting agents. Seating discrepancies of each casting/abutment combination were measured, and the castings were pulled from the abutments by use of tensile force. The results of this study indicate that the use of die spacing decreased seating discrepancies and increased retentive values under the test conditions.
Sequencing jobs in an engineer-to-order engineering environment

Engineer–to-order (ETO) firms produce complex – one of a kind – products and desire shorter lead time as a key component to cost competitiveness. In ETO firms, the engineering process is the largest controllable consumer of lead time. Given that lead time is a function of completion rate and scheduling policy, one critical process is to accurately sequence jobs in front of the engineering function. However, unlike other manufacturing models, such as make–to-stock or make-to-order models, the design for an ETO product is not realized until after the engineering process has been completed. Hence, the only information available does not include data normally required by most sequencing algorithms. Therefore, the problem becomes the determination of an accurate schedule within a complex transactional process for jobs which have not even been designed yet. This paper investigates this topic in the context of the engineering process within the ETO model. Based on research conducted in conjunction with multiple ...
Two-Stage Ordering of Spins in Dipolar Spin Ice on the Kagome Lattice

Spin ice, a peculiar thermal state of a frustrated ferromagnet on the pyrochlore lattice, has a finite entropy density and excitations carrying magnetic charge. By combining analytical arguments and Monte Carlo simulations, we show that spin ice on the two-dimensional kagome lattice orders in two stages. The intermediate phase has ordered magnetic charges and is separated from the paramagnetic phase by an Ising transition. The transition to the low-temperature phase is of the three-state Potts or Kosterlitz-Thouless type, depending on the presence of defects in the charge order.
Performance evaluations based on financial information: how do managers use situational information?

Organizations regularly use budgets as benchmarks for performance, and budgets represent a key control feature for almost every organization (Brown and Solomon (1993)). Research has demonstrated that outcome effects are pervasive in performance evaluation processes, and that performance evaluators do not interpret situational information consistently. An experiment is conducted to examine the effects of situational information on managers’ performance and ability attributions under conditions of favorable and unfavorable financial outcomes. The findings indicate that when financial outcomes are unfavorable, outcome effects dominate the performance evaluation process, and situational information has little effect on performance evaluations. The results of cognitive load manipulations indicate that situational information is not ignored, but rather discounted when financial outcomes are favorable.
Management of Late Preterm and Early-Term Pregnancies Complicated by Mild Gestational Hypertension/Pre-Eclampsia

Gestational hypertension/pre-eclampsia is the most frequent obstetrical complication, complicating 26%-29% of all gestations in nulliparous women. In general, the diagnosis of mild gestational hypertension/pre-eclampsia is made at 38 weeks or more in approximately 80% of cases. For many years, the optimal timing of delivery for patients with mild gestational hypertension/pre-eclampsia at 37-0/7 to 39-6/7 weeks was unclear. Recently, investigators of the HYPITAT (Pregnancy-induced hypertension and pre-eclampsia after 36 weeks: induction of labor versus expectant monitoring: A comparison of maternal and neonatal outcome, maternal quality of life and costs) randomized trial evaluated maternal and neonatal complications in patients at 36-40 weeks' gestation who were randomized to either induction of labor or expectant monitoring. The results of this trial revealed that induction of labor at or after 37-0 weeks was associated with lower rate of maternal complications without increased rates of either cesarean delivery or neonatal complications. In contrast, the optimum management for those with mild hypertension/pre-eclampsia with stable maternal and fetal conditions at 34-0/7 to 36-6/7 weeks remains uncertain. Therefore, there is urgent need for research to evaluate the reasons for late preterm birth in such women as well as for a randomized trial to evaluate the optimal timing for delivery in such patients.
Characterization of a resolved oxygen-evolving photosystem II preparation from spinach thylakoids

Abstract An oxygen-evolving Photosystem (PS) II preparation was isolated after Triton X-100 treatment of spinach thylakoids in the presence of Mg2+. The structural and functional components of this preparation have been identified by SDS-polyacrylamide gel electrophoresis and sensitive spectrophotometric analysis. The main findings were: (1) The concentration of the primary acceptor Q of PS II was 1 per 230 chlorophyll molecules. (2) There are 6 to 7 plastoquinone molecules associated with a ‘quinone-pool’ reducible by Q. (3) The only cytochrome present in significant amounts (cytochrome b-559) occurred at a concentration of 1 per 125 chlorophyll molecules. (4) The only kind of photochemical reaction center complex present was identified by fluorescence induction kinetic analysis as PS IIα. (5) An Em = − 10 mV has been measured at pH 7.8 for the primary electron acceptor Qα of PS IIα. (6) With conventional SDS-polyacrylamide gel electrophoresis, the preparation was resolved into 13 prominent polypeptide bands with relative molecular masses of 63, 55, 51, 48, 37, 33, 28, 27, 25, 22, 15, 13 and 10 kDa. The 28 kDa band was identified as the PS II light-harvesting chlorophyll a b- protein . In the presence of 2 M urea, however, SDS-polyacrylamide gel electrophoresis showed seven prominent polypeptides with molecular masses of 47, 39, 31, 29, 27, 26 and 13 kDa as well as several minor components. CP I under identical conditions had a molecular mass of 60–63 kDa.
Implicit Theories of Ability of Grade 6 Science Students: Relation to Epistemological Beliefs and Academic Motivation and Achievement in Science.

We investigated: (a) the associations of implicit theories and epistemological beliefs and their effects on the academic motivation and achievement of students in Grade 6 science and (b) the mean differences of implicit theories, epistemological beliefs, and academic motivation and achievement as a function of gender and race/ethnicity (N = 508). Path analysis revealed that an incremental view of ability had direct and indirect effects on adaptive motivational factors, whereas fixed entity views had direct and indirect effects on maladaptive factors. Epistemological beliefs mediated the influence of implicit theories of ability on achievement goal orientations, self-efficacy, and science achievement. Results are discussed in relation to Dweck and Leggett’s (1988) social-cognitive theory with a focus on middle school science.
Recent advances in displacement measuring interferometry

The present state of high-resolution displacement measuring interferometry is reviewed. Factors which determine the accuracy, linearity and repeatability of nanometre-scale measurements are emphasized. Many aspects of interferometry are discussed, including general metrology and alignment errors, as well as path length errors. Optical mixing and the nonlinear relation between phase and displacement are considered, as well as the influence of diffraction on accuracy. Environmental stability is a major factor in the repeatability and accuracy of measurement. It is difficult to obtain a measurement accuracy of 10-7 when working in air. Several approaches to improving this situation are described, including multiwavelength interferometry. Recent measurements of the short- and long-term frequency stability of lasers are summarized. Optical feedback is a subtle, but important source of frequency destabilization, and methods of detection and isolation are reviewed. Calibration of phase measuring electronics used for subfringe interpolation is included. Progress in 'in situ' identification of error sources and methods of validating accuracy are emphasized.
Using a Hierarchical Model to Estimate Risk‐Adjusted Mortality for Hospitals Not Included in the Reference Sample

There is increasing interest in methods to evaluate hospital performance, especially patient mortality, with respect to some group standard. Hospital “profiles” for cardiac surgery have been published in several regions, leading to careful study of the associated statistical issues (Gatsonis et al. 1995; Normand, Glickman, and Gatsonis 1997; Hannan et al. 2005;). Extending this approach, the Agency for Healthcare Research and Quality (AHRQ) has published Inpatient Quality Indicators (IQI), described at http://qualityindicators.ahrq.gov, that allow hospitals to compare their performance in several areas to the outcomes expected from the reference databases of the AHRQ Healthcare Cost and Utilization Project (HCUP). The American College of Surgeons (ACS) has also been a leader in this effort, by supporting the development of a National Trauma Data Bank (NTDB) to combine registry data from multiple trauma centers and compare their outcomes. Many hospital performance evaluations today rely on multilevel (ML) or hierarchical logistic regression modeling. While these methods can have theoretical advantages in modeling institutional mortality and are increasingly accessible due to software advances, they can present challenges as well. For example, the AHRQ or ACS NTDB data may be used to compute performance measures for a set of hospitals, but other hospitals not included in the original analysis may also be interested in comparing their outcomes to these standards. The purpose of this paper is to derive a method by which such a comparison can be made. The method we propose could be useful in several contexts. Analysts can use this method to compute performance measures for hospitals that were not included in an original analysis. Hospitals that were included in the original analyses can also use this method to verify “report cards” provided by an agency conducting the analysis. Hospitals or other observers can use this method to derive updated scores based on the original model but incorporate newer data that become available. Finally, experiments can be conducted to see how the scores might change if certain aspects of the data were to change.
Synthetic lethality of combined glutaminase and Hsp90 inhibition in mTORC1-driven tumor cells

The mammalian target of rapamycin complex 1 (mTORC1) integrates multiple signals from growth factors, nutrients, and cellular energy status to control a wide range of metabolic processes, including mRNA biogenesis; protein, nucleotide, and lipid synthesis; and autophagy. Deregulation of the mTORC1 pathway is found in cancer as well as genetic disorders such as tuberous sclerosis complex (TSC) and sporadic lymphangioleiomyomatosis. Recent studies have shown that the mTORC1 inhibitor rapamycin and its analogs generally suppress proliferation rather than induce apoptosis. Therefore, it is critical to use alternative strategies to induce death of cells with activated mTORC1. In this study, a small-molecule screen has revealed that the combination of glutaminase (GLS) and heat shock protein 90 (Hsp90) inhibitors selectively triggers death of TSC2-deficient cells. At a mechanistic level, high mTORC1-driven translation rates in TSC1/2-deficient cells, unlike wild-type cells, sensitizes these cells to endoplasmic reticulum (ER) stress. Thus, Hsp90 inhibition drives accumulation of unfolded protein and ER stress. When combining proteotoxic stress with oxidative stress by depletion of the intracellular antioxidant glutathione by GLS inhibition, acute cell death is observed in cells with activated mTORC1 signaling. This study suggests that this combination strategy may have the potential to be developed into a therapeutic use for the treatment of mTORC1-driven tumors.
Preparing for what never came: Chemical and biological warfare in World War II

(1986). Preparing for what never came: Chemical and biological warfare in World War II. Defense Analysis: Vol. 2, No. 2, pp. 107-121.
Moving Out: Residential Independence Among Young Adults With Disabilities and the Role of Families

This article examines the transition to adulthood from a life course perspective, highlighting the experiences of youth with disabilities and the role that families make in that transition. Here, we focus on youth leaving home as a key marker of transition to adulthood and address historical and contemporary trends in leaving home and current influences on youths' residential opportunities. The literature reviewed here helps us to understand how larger social structures and contexts shape the nature of the residential opportunities available to all youth, especially youth with disabilities. Some implications regarding the role of families as social supports for youth with disabilities are addressed.
Protein Surface Recognition by Synthetic Receptors: A Route to Novel Submicromolar Inhibitors for α-Chymotrypsin

A family of synthetic receptors for protein surface recognition has been prepared. The receptors are based on a design in which four peptide loops are arrayed around a central calilx[4]arene core. By varying the sequence of the loop regions a range of differently functionalized receptor surfaces approximately 450 A2 in area can be prepared. From this family we have identified potent inhibitors of chymotrypsin that function by binding to the surface of the protein. The most potent of these (1) shows slow binding kinetics in an analogous manner to several of the natural protein proteinase inhibitors. Detailed kinetic analysis showed 1 to be a competitive inhibitor with Ki and Ki* values of 0.81 and 0.11 μM, respectively.
Circulating anti-tumor and autoantibodies in breast carcinoma: relationship to stage and prognosis.

Serum antibodies to breast tumor antigen(s) and circulating autoantibodies were tested in 175 patients with various stages of carcinoma of the breast, followed for a mean period of 51 months. Antibodies to surface membrane and to cytoplasmic antigens of autologous and allogeneic tumor cells were measured. Peripheral lymphocyte count and skin reaction to six recall antigens were also tested. Patients with metastatic disease had significantly lower prevalence of antibodies to autologous tumor cells and lower total lymphocyte count than patients with early breast cancer. Patients with locally advanced disease (⩾4 positive axillary nodes) had the highest frequency of anti-tumor antibodies, the second highest lymphocyte count, but with the lowest prevalance of autoantibodies. Presence or absence of anti-tumor or autoantibody did not correlate with results of skin tests or other standard blood tests. Among patients with locally advanced or metastatic breast cancer, those who had a positive skin test or whose lymphocyte count was 1500 to 2500 per cu mm had significantly better 5-year absolute survival rates (p = 0.04, p = 0.002, respectively). This study suggests that in patients with locally advanced or metastatic breast cancers, skin test reactivity and optimal peripheral lymphocyte count may be useful prognostic indicators. In contrast, neither the presence of anti-tumor antibodies to membrane or cytoplasmic antigens, nor the presence of autoantibodies, correlates with prognosis in patients with early or late breast cancers.
Estrogenic activity and reproductive effects of the UV-filter oxybenzone (2-hydroxy-4-methoxyphenyl-methanone) in fish

Previous studies in extracts of sediments surrounding municipal outfalls off the coast of California, USA and effluents of New York City, NY, USA indicated the UV-filtering agent, oxybenzone (CAS# 131-57-7; benzophenone-3) as a potential estrogen. The effects of oxybenzone on estrogenic activity and reproduction were evaluated using a 14-day juvenile rainbow trout assay for plasma vitellogenin and a subsequent 21-day Japanese medaka reproduction assay. Significant induction of vitellogenin was observed in the rainbow trout at the 1000 microg/L nominal concentration (749 microg/L median measured value) of oxybenzone which was approximately 75 times greater than the concentrations observed in previous wastewater effluent. Vitellogenin induction was also observed in the 1000 microg/L nominal concentration (620 microg/L median measured) of oxybenzone in male Japanese medaka (Oryzias latipes) after 21 days of exposure. The number of eggs produced per female per day exposed to the same concentration (620 microg/L) were significantly lower after 7 days, but returned to control values after 21 days. Fertilized eggs were then monitored for 20 days to assess hatching success. The overall percentage of fertilized eggs collected during the 21-day exposure that hatched was significantly lower in the 620 microg/L oxybenzone concentration. There was also a temporal effect at this concentration as egg viability (percentage of fertilized eggs that hatched) was diminished 13-15 days after eggs were collected. All three oxybenzone concentrations (16, 132, and 620 microg/L) and the 50 ng/L estradiol positive control showed reduced hatching of eggs at day 15, and the 132 and 620 microg/L oxybenzone concentrations diminished the percentage of eggs that hatched on days 13-15. These data indicate that the UV-filter oxybenzone alters endocrine or reproduction endpoints in two fish species, but at concentrations significantly higher than those measured in the environment.
Neuroanatomical and functional alterations resulting from early postnatal cerebellar insults in rodents

This review examines neuroanatomical and functional alterations in rodents resulting from postnatal insults during cerebellar development. Treatments such as irradiation and methylazoxymethanol (MAM) administration produced near birth ( postnatal day 8 for irradiation treatment and > postnatal day 4 for MAM treatment). The functional alterations also differ: insults produced near birth result in hypoactivity, ataxia, tremor and accompanying learning deficits, whereas those produced later result in hyperactivity and few learning deficits. This hyperactivity may have relevance to human disorders. Brief discussions of cerebellar and functional alterations (e.g., hyperactivity) resulting from neonatal infection with the Borna disease virus and induction of hypo- and hyperthyroidism during the preweaning period are also presented.
On Dual Functionals of polynomials in B-Form

Abstract We consider the space of multivariate polynomials in B-form and give an explicit representation of its dual space. Using this space, the B-form of a monomial can be easily obtained. We also derive a simple algorithm to convert a polynomial from its Taylor expansion to its B-form. Each basis element of the dual space is bounded, and we give explicit upper bounds. These upper bounds can be used to improve some known estimates by giving explicit constants.
Thermal and mechanical evaluation of cyanate ester composites with low-temperature processability

Abstract A low viscosity bisphenol E cyanate ester monomer was used as a reactive diluent in a bisphenol A/novolac cyanate ester to achieve a low viscosity prepolymer with a viscosity suitable for processing at room temperature. Dynamic mechanical analysis was conducted on carbon fiber composite specimens manufactured from two cyanate ester blends with varying catalyst compositions. It was shown that post-curing was needed to produce a polymer matrix with a single glass transition relaxation, but increases in post-cure temperature above 204 °C resulted in slight reductions in T g and modulus. Also, increasing catalyst composition was shown to have a negative effect on T g .
The development of a computer-assisted curriculum in reproductive endocrinology and infertility for residents.

Objective This study was undertaken to determine the features of an effective computer-based residency curriculum in reproductive endocrinology and infertility. Study design A review of the literature to determine those features that have been used by training programs in medicine. Reproductive endocrinology and infertility division directors, current obstetrics and gynecology residents, and obstetrics and gynecology practitioners in the community were surveyed to evaluate critical subjects for study. Results Programs most successful in using computers in training health care providers use a case-based approach that prioritizes important subjects. Areas of greatest importance to the 3 groups surveyed include infertility, dysfunctional uterine bleeding, and management of the climacteric, and several other areas were also deemed critical. Conclusion Benefits of computer-based learning include consistency, the ability to develop problem solving skills for life-long learning, and a self-paced approach, but its validity as a teaching tool will require rigorous appraisal.
Dynamics of hepatic connective tissue matrix constituents during murine Schistosoma mansoni infection.

Hepatic fibrosis is the major clinical sequela of infection with the helminth Schistosoma mansoni. However, little is known regarding its dynamics and regulation in schistosomiasis. The present study presents the dynamics of deposition and resorption of two major extracellular matrix components of fibrosis, glycosaminoglycans and collagens, during the course of experimental S. mansoni infection. Early in infection (6 weeks), glycosaminoglycan biosynthesis was markedly elevated, as was collagen biosynthesis. This led to significant accumulations of these two molecules at a glycosaminoglycan/collagen ratio similar to that observed in livers of un-infected mice (uronic acid/hydroxyproline ratio of 1.10 at 6 weeks compared to normal value of 1.25). During maximal hepatic fibrosis (12 to 18 weeks), both collagen and glycosaminoglycan biosynthesis continued to increase but the extracellular matrix shifted to a lower glycosaminoglycan/collagen ratio of 0.42, suggesting enhanced glycosaminoglycan breakdown. In addition, during this acute stage of infection, Type I collagen was the predominant isotype synthesized, whereas total collagenolytic activity degrading Type I collagen was maximal. During chronic infection, a decrease in the content of both hepatic glycosaminoglycans and collagens were noted, with a glycosaminoglycan/collagen ratio of 0.63. Decreased glycosaminoglycan content paralleled diminished biosynthetic rates. On the other hand, an over 50% reduction in collagen content (from 18 to 24 weeks) appeared not to result from diminished biosynthesis but from a switch in the predominant collagen isotype synthesized (from Type I to Type III), matched by an enhanced constitutive collagenolytic activity directed toward this type of collagen. These differences in the extracellular matrix separate schistosomal-induced hepatic fibrosis from most other types of fibrotic liver disease and may explain differences in the clinical manifestations observed during different stages of infection.
Error-prone polyploid mitosis during normal Drosophila development

Endopolyploidy arises during normal development in many species when cells undergo endocycles—variant cell cycles in which DNA replicates but daughter cells do not form. Normally, polyploid cells do not divide mitotically after initiating endocycles; hence, little is known about their mitotic competence. However, polyploid cells are found in many tumors, and the enhanced chromosomal instability of polyploid cells in culture suggests that such cells contribute to tumor aneuploidy. Here, we describe a novel polyploid Drosophila cell type that undergoes normal mitotic cycles as part of a remodeling process that forms the adult rectal papillae. Similar polyploid mitotic divisions, but not depolyploidizing divisions, were observed during adult ileum development in the mosquito Culex pipiens. Extended anaphases, chromosome bridges, and lagging chromosomes were frequent during these polyploid divisions, despite normal expression of cell cycle regulators. Our results show that the switch to endocycles during development is not irreversible, but argue that the polyploid mitotic cycle is inherently error-prone, and that polyploid mitoses may help destabilize the cancer genome.
Misconceptions at the Intersection of Measurement Theory and Practice.

Finding ourselves in a bull market for educational testing, is it time to carefully re-examine assumptions, issues, and practices? What misconceptions about testing exist that influence what we do?
Fruiting efficiency in cotton: boll size and boll set percentage.

Cotton plants, Gossypium hirsutum L., initiate more fruiting buds than are matured. This research quantified the boll set percentage and boll size by fruiting site in a population of cotton plants. The fruiting sites of harvestable bolls were recorded for 2 yr in eight cultivars : Stoneville 213 (ST 213), Stoneville 506 (ST506), Stoneville 825 (ST 825), Tamcot CAMD-E (CAMD-E), Deltapine 50 (DPL 50), McNair 235 (MC 235), DES 119, and Deltapine 20 (DPL 20) (...)
Direct optical subharmonically injection-locked mesfet oscillators

Reported here are the results of direct optical subharmonically injection-locked oscillators at 5.455 and 15.011 GHz. Multiplication of subharmonics was achieved mainly by overmodulation of a laser diode. Significant locking ranges were attained, and subharmonic factors of up to 1/15 were used. © 1993 John Wiley & sons, Inc.