cssi/SciSciGPT-SciSciNet huggingface dataset:
HEALTH IMPACT AND CONTROL OF PARTICLE MATTER

Summary Particulate matter (PM), unlike other air pollutants such as carbon monoxide or ozone, is not a single compound. Particles can be either solids or liquids and can vary greatly in size, shape, and chemical composition. The effects of particulate aerosols on human health include damage to the cardiovascular system, aggravation of existing respiratory diseases, and increases in lung cancer mortality. Evidence of increased mortality from exposure to the types of particulate matter associated with traffic, including diesel exhaust, has been established. Children, the elderly, and those with pre-existing conditions such as asthma are particularly susceptible. Regulatory actions initially focused on larger particles, but increasingly they have targeted the smaller PM10 and PM2.5 fractions. Control strategies for particulate matter must be targeted to a given size fraction and take into account the various origins, both natural and man-made, for each type of particle.
Rats exposed to intermittent ethanol during late adolescence exhibit enhanced habitual behavior following reward devaluation.

Abstract The brain undergoes substantial maturation during adolescence, and repeated exposure to ethanol at this time has been shown to result in long-lasting behavioral and neural consequences. During the broad period of adolescence, different neuronal populations and circuits are refined between early and late adolescence, suggesting the possibility that ethanol exposure at these differing times may lead to differential outcomes. The goal of the current study was to evaluate the impact of adolescent intermittent ethanol (AIE) during early and late adolescence on the formation of goal-directed and habitual behavior in adulthood. Male and female Sprague–Dawley rats were exposed to ethanol via intragastric gavage (4.0 g/kg, 25% v/v) every other day from postnatal day (P) 25–45 or P45–65, considered early and late adolescence, respectively. In adulthood (~P70 early or ~ P90 late), rats were gradually food-restricted and began operant training on a fixed ratio 1 schedule. Rats were then transitioned onto random interval schedules and eventually underwent a sensory-specific satiation procedure as a model of reward devaluation. Few differences as a result of adolescent ethanol exposure were found during instrumental training. Following reward devaluation, rats exposed to water and ethanol during early adolescence exhibited reductions in lever pressing, suggestive of a goal-directed response pattern. In contrast, late AIE males and females demonstrated persistent responding following both devalued and non-devalued trials, findings representative of a habitual behavior pattern. The shifts from goal-directed to habitual behavior noted only following late AIE contribute to the growing literature identifying specific behavioral consequences as a result of ethanol exposure during distinct developmental periods within adolescence. More work is needed to determine whether the greater habit formation following late AIE is also associated with elevated habitual ethanol consumption.
Castleman disease: A single-center case series.

Abstract Background Castleman disease (CD) is a rare lymphocytic disorder. Unicentric CD (UCD) has an excellent long-term prognosis after surgical excision; however, multicentric CD (MCD) has a severe clinical course with poor outcomes. Study design We analyzed the clinical presentation of 28 patients treated at a single institution from 1995 to 2017. Demographics, clinical variables, anatomical site, centricity, histopathology, immunochemistry, and surgical approach were reviewed. We evaluated the 5-year recurrence and survival for patients with UCD and MCD. Results Of the 28 patients, 57 % (n = 16) were female, with a mean age of 41.6 ± 15.6 years. CD was asymptomatic in 57 % (n = 16) of patients, 21 % (n = 6) presented with local symptoms such as pain, and 21 % (n = 6) of patients also had systemic symptoms, including weight loss and fever. CD was unicentric in 64 % (n = 18) and multicentric in 36 % (n = 10). The hyaline vascular variant was noted in 57 % (n = 16) of the tumors, plasmacytoid variant in 36 % (n = 10), and mixed variants in 7% (n = 2) of tumors. Anatomical distributions included: head and neck (20 %), thorax and axilla (24 %), retroperitoneal (13 %), abdominopelvic (30 %) regions, and other (13 %). Complete surgical resection was performed in 95 % of patients with UCD. Surgical biopsy and medical therapy were provided to all patients with MCD. The recurrence rate for UCD and MCD was 6 % (n = 1) and 14 % (n = 1), respectively. The five-year disease-free survival rate for UCD was 95 % (n = 19) and MCD was 33 % (n = 2). We found 100 % survival in patients with UCD and histology demonstrating the HV variant. Conclusion CD is rare and often misdiagnosed due to the absence of specific clinical symptoms. Surgeons should include CD in their differential diagnoses when evaluating patients with lymph node hyperplasia. Surgery can be curative in nearly all patients with UCD. Patients with MCD require a combination of surgical therapy, chemotherapy, and immunotherapy; however, cytoreductive surgery benefits for patients with MCD have not been established.
To Gamify or Not?: On Leaderboard Effects, Student Engagement and Learning Outcomes in a Cybersecurity Intervention

We present a gamified learning experience for cybersecurity education that is designed to provide learners with an understanding of the knowledge and techniques needed to solve everyday problems while simultaneously immersing them in a competitive environment. We provide a framework for measuring skills demonstrated by students within an active learning setting where the primary focus is on practical expertise. We also examine several unique aspects of designing such a gamified framework (e.g. the game itself must be insecure enough to be "hackable'', but secure enough not to be abused), and discuss how the framework was used to expose students to various security concepts. We found that our gamified experience heavily engaged students. We also encountered many pain points during our intervention and discovered a number of important aspects of gamified settings that must be carefully considered. For one, the goals of a semi-structured gamified exercise can sometimes lead to learners discovering solutions that do not meet the desired learning objectives. Furthermore, The exploratory nature of such exercises can also lead learners down a rabbit hole that, without a proper "safety net'', they may not exit. Finally, complex tasks modeled after real world applications can leave little room for error, frustrating students and limiting instructors' ability to accurately assess different levels of skill. Based on our experience designing this intervention, we provide a number of transferable recommendations. The challenges we faced and the lessons we learned can be invaluable to those considering gamification as a cybersecurity education strategy.
At the table but can not break through the glass ceiling:Board leadership positions elude diverse directors

Abstract We explore the labor market effects of gender and race by examining board leadership appointments. Prior studies are often limited by observing only hired candidates, whereas the boardroom provides a controlled setting where both hired and unhired candidates are observable. Although diverse (female and minority) board representation has increased, diverse directors are significantly less likely to serve in leadership positions despite possessing stronger qualifications than nondiverse directors. While specialized skills such as prior leadership or finance experience increase the likelihood of appointment, that likelihood is reduced for diverse directors. Additional tests provide no evidence that diverse directors are less effective.
Recognition- and Reactivity-Based Fluorescent Probes for Studying Transition Metal Signaling in Living Systems

Metals are essential for life, playing critical roles in all aspects of the central dogma of biology (e.g., the transcription and translation of nucleic acids and synthesis of proteins). Redox-inactive alkali, alkaline earth, and transition metals such as sodium, potassium, calcium, and zinc are widely recognized as dynamic signals, whereas redox-active transition metals such as copper and iron are traditionally thought of as sequestered by protein ligands, including as static enzyme cofactors, in part because of their potential to trigger oxidative stress and damage via Fenton chemistry. Metals in biology can be broadly categorized into two pools: static and labile. In the former, proteins and other macromolecules tightly bind metals; in the latter, metals are bound relatively weakly to cellular ligands, including proteins and low molecular weight ligands. Fluorescent probes can be useful tools for studying the roles of transition metals in their labile forms. Probes for imaging transition metal dynamics in living systems must meet several stringent criteria. In addition to exhibiting desirable photophysical properties and biocompatibility, they must be selective and show a fluorescence turn-on response to the metal of interest. To meet this challenge, we have pursued two general strategies for metal detection, termed "recognition" and "reactivity". Our design of transition metal probes makes use of a recognition-based approach for copper and nickel and a reactivity-based approach for cobalt and iron. This Account summarizes progress in our laboratory on both the development and application of fluorescent probes to identify and study the signaling roles of transition metals in biology. In conjunction with complementary methods for direct metal detection and genetic and/or pharmacological manipulations, fluorescent probes for transition metals have helped reveal a number of principles underlying transition metal dynamics. In this Account, we give three recent examples from our laboratory and collaborations in which applications of chemical probes reveal that labile copper contributes to various physiologies. The first example shows that copper is an endogenous regulator of neuronal activity, the second illustrates cellular prioritization of mitochondrial copper homeostasis, and the third identifies the "cuprosome" as a new copper storage compartment in Chlamydomonas reinhardtii green algae. Indeed, recognition- and reactivity-based fluorescent probes have helped to uncover new biological roles for labile transition metals, and the further development of fluorescent probes, including ones with varied Kd values and new reaction triggers and recognition receptors, will continue to reveal exciting and new biological roles for labile transition metals.
Early- and Late-Adolescent Predictors of Psychological Health in Adulthood: Results from the Intergenerational Studies

The longevity of longitudinal samples now allows study of such awaited projects as the prediction of psychological health from adolescence to early, middle, and later adulthood. In this report, we used California Q-sort (CQS) data collected from 106 members of the Intergenerational Studies at ages 14, 18, 30, 40, and 60. A Psychological Health Index (PHI) and measures of six aspects of personality (self-confidence, assertiveness, cognitive commitment, outgoingness, dependability, and warmth) were created from CQS items. Statistical analysis proceeds by univariate and multivariate steps to calculate the separate and combined ability of PHI and personality components in early and late adolescence to predict PHI and personality components at adult ages. Men show more overtime consistency than women in PHI from early adolescence through later adulthood. For both genders, PHI at age 40 draws the best prediction from early-adolescent PHI, still more so for men when late-adolescent effects are partialled out. Of the strong early-adolescent personality components predictive of age 40 PHI for men, dependability shows a unique reversal effect, such that the most psychologically healthy men at age 40 are those who show dependability in early adolescence and undependability in late adolescence. Aspects of social engagement, embodied by outgoingness at age 40, as one element of psychological health, appear most strongly related to this reversal effect of dependability in adolescence.
Apolipoprotein E and progression of chronic kidney disease.

Cynthia M. Boyd, MD, MPH cyboyd@jhmi.edu Division of Geriatric Medicine and Gerontology Department of Medicine Johns Hopkins University School of Medicine Baltimore, Md Jonathan D. Darer, MD, MPH Midatlantic Permanente Medical Group Baltimore, Md Chad Boult, MD, MPH, MBA Roger C. Lipitz Center for Integrated Health Care Johns Hopkins Bloomberg School of Public Health Linda P. Fried, MD, MPH Lisa Boult, MD, MPH, MA Division of Geriatric Medicine and Gerontology Department of Medicine Johns Hopkins University School of Medicine Albert W. Wu, MD, MPH Johns Hopkins Bloomberg School of Public Health
Nursing Student Library Usage Patterns in Online Courses: Findings and Recommendations

This study looked at patterns of online library usage of a sample of undergraduate nursing students (n = 82) from a medium-sized southeastern university. Specifically, information-seeking behaviors of nursing students related to electronic or remotely accessible resources (i.e., electronic databases) compared to physical library resources (i.e., reference books) were examined. Additionally, this study further investigated students' preferred methods for seeking additional assistance and information about library research, as well as overall satisfaction and usage patterns relating to library tools and assistance by librarians or other school personnel. Results indicate that these undergraduates preferred electronic resources (with particular emphasis on electronic databases) to traditional, in-person research. Other relevant findings and suggestions relating to electronic access and training with library tools are provided.
Eight years of ubiquitous technology access and digital curricula: business and marketing high school teachers' perspective

This research was conducted during the 2009-2010 school term as a case study of a large school division's technology initiative after eight years to chronicle its effect on high school business and marketing teachers‘ use and integration of technology. The 18 teachers were business and marketing teachers from eight high schools, two technical centers and one alternative school who participated in the one-to-one laptop initiative from its inception and who were asked to participate in the study. A web-based survey on technology use and adoption was administered to 18 high school business and marketing teachers. The researcher conducted a total of four unannounced observations of each teacher's instruction, specifically for technology use, by using the Instructional Technology Resource Teachers' Technology Integration form. Additionally, the teachers were asked to participate in one of two focus group interviews to determine their level of technology use along with their perceptions regarding the technology initiative and its effect on their instruction and teaching strategies. This case study has relevance to school districts with technology initiatives or districts considering adopting one. The high school business and marketing teachers' vantage point provided unique information about the effect a one-to-one laptop initiative has made on business and marketing teachers' technology use over the last eight years. The effect that a comprehensive, one-to-one initiative had on business and marketing high school teachers' technology use was twofold. First, instruction was affected. Teachers and students were found to manage data electronically, the amount of and methods for teachers' communication changed, and exemplars surfaced. Second, challenges emerged. Teachers' classroom management responsibilities included laptop monitoring, access issues as a consequence of network filtering policies, and a need for additional technology-based professional development for teachers and time to practice new skills. While some positive effects were visible, eight years into the one-to-one laptop initiative problems were evident, and administrative support as well as teacher acceptance seemed to play an important role in teachers' willingness to regularly and enthusiastically modify their pedagogy to include technology in teaching strategies and student lessons.
TLR4 has a TP53-dependent dual role in regulating breast cancer cell growth

Breast cancer is a leading cause of cancer-related death, and it is important to understand pathways that drive the disease to devise effective therapeutic strategies. Our results show that Toll-like receptor 4 (TLR4) drives breast cancer cell growth differentially based on the presence of TP53, a tumor suppressor. TP53 is mutationally inactivated in most types of cancer and is mutated in 30–50% of diagnosed breast tumors. We demonstrate that TLR4 activation inhibits growth of TP53 wild-type cells, but promotes growth of TP53 mutant breast cancer cells by regulating proliferation. This differential effect is mediated by changes in tumor cell cytokine secretion. Whereas TLR4 activation in TP53 mutant breast cancer cells increases secretion of progrowth cytokines, TLR4 activation in TP53 wild-type breast cancer cells increases type I IFN (IFN-γ) secretion, which is both necessary and sufficient for mediating TLR4-induced growth inhibition. This study identifies a novel dichotomous role for TLR4 as a growth regulator and a modulator of tumor microenvironment in breast tumors. These results have translational relevance, demonstrating that TP53 mutant breast tumor growth can be suppressed by pharmacologic TLR4 inhibition, whereas TLR4 inhibitors may in fact promote growth of TP53 wild-type tumors. Furthermore, using data generated by The Cancer Genome Atlas consortium, we demonstrate that the effect of TP53 mutational status on TLR4 activity may extend to ovarian, colon, and lung cancers, among others, suggesting that the viability of TLR4 as a therapeutic target depends on TP53 status in many different tumor types.
Why school health service

THERE has been a marked change in our concept of the term "school health service." Early activities in this field were almost wholly devoted to the control of communicable disease. Today, thanks to immunization, the antibiotic drugs and health education, most of the old enemies of child health have been conquered. As a result, the years that a child spends in school have been made the healthiest period of life, when appraised by the crude measure of mortality. Why then school health service? Let me first define what I mean by this term. It comprises health supervision of the school child by educators, public health nurses and school physicians for case-finding and health guidance. At no other time of life is the child or family so readily available for preventive medical service and health education. Public health cannot afford to neglect this ready access to so large a segment of the population—actually more than 20 million persons. Entrance to kindergarten and first grade is perhaps the most valuable of these opportunities. For all too many children, this is the first health examination since the first year of life. Habit disorders or physical defects which have developed in the preschool years can be brought to light and treatment advised. A convincing demonstration of the value of a good medical examination at this time of life occurred recently when I was instructing a group of fourth year medical students. As part of their pediatric training, they visited a school to do some examinations under supervision.
Purification and characterization of a β‐glucosidase from Trichoderma reesei

A beta-glucosidase has been purified from culture filtrates of the fungus Trichoderma reesei QM9414 grown on microcrystalline cellulose. The beta-glucosidase was purified using two successive DEAE-Sephadex anion-exchange chromatography steps, followed by SP-Sephadex cation-exchange chromatography and concanavalin-A--agarose chromatography. Evidence for homogeneity is provided by polyacrylamide disc gel electrophoretic patterns, which show a single protein band. Sedimentation equilibrium analysis yielded a molecular mass of 74.6 +/- 2.4 kDa. Sodium dodecyl sulfate/polyacrylamide gel electrophoresis yielded a single protein band with a molecular mass of 81.6 kDa. Thus, the enzyme appears to be a single, monomeric polypeptide. The beta-glucosidase is isoelectric at pH 8.5. The enzyme is rich in basic amino acids and contains few half-cystine and methionine residues. The purified beta-glucosidase contains less than 1% by weight of neutral carbohydrate. The beta-glucosidase catalyzes the hydrolysis of cellobiose, p-nitrophenyl beta-D-glucopyranoside and 4-methylumbelliferyl beta-D-glucopyranoside; the values of V/Km for each substrate were determined to be 2.3 X 10(4), 6.9 X 10(5) and 2.9 X 10(6) M-1 S-1 respectively. The enzyme is optimally active from pH 4.5 to 5.0 and is labile at higher hydrogen ion concentrations. The beta-glucosidase has an unusually high affinity for D-glucose (Ki = 700 microM). Comparison of inhibition constants for cello-oligosaccharides suggests that the substrate-binding region of the beta-glucosidase comprises multiple subsites.
APhA Academies reflect on the Pharmacists’ Patient Care Process of the Joint Commission of Pharmacy Practitioners

Applying the patient care process in practice The Pharmacists’ Patient Care Process is not net new; it is generally the care pharmacists have historically been providing patients in all practice settings. What is new is the development of a contemporary consensus-based document supported by national pharmacy organizations that articulates how all pharmacists in all care settings should be providing care. The document also recognizes key elements within each step of care. Regardless of the setting (e.g., hospital, community, clinic, long-term care, or managed care), when a patient receives care from a pharmacist, the process performed by the pharmacist is the same. APhA–APPM Overview of pharmacists’ patient care process Pharmacy practice is evolving into patient-centered care with the pharmacist serving as an accountable and integral member of the health care team. To refl ect this change, in November 2013, the Joint Commission of Pharmacy P r a c t i t i o n e r s (JCPP) adopted a vision for pharmacy practice that states, “Patients achieve optimal health and medication outcomes with pharmacists as essential and accountable providers, within patient-centered team-based health care.” The JCPP identifi ed three key drivers to reach the vision: (1) development, adoption, and implementation of a consistent, uniform, and widely applied patient care process; (2) quality measures to quantify the value of services provided; and (3) robust health information technology to support patient care and payment for pharmacists’ services.1 The fi rst key driver, the Pharmacists’ Patient Care Process, was developed through a review of several recognized resources on pharmaceutical care and medication therapy management using a collaborative, consensus-based process. The fi nal document was adopted for implementation by JCPP in May 2014 and supported by 13 national pharmacy organizations.2 The process includes the following fi ve steps: collect, assess, plan, implement, and follow up: monitor and evaluate (Figure 1). As the role of pharmacists transforms in the health care system, implementation of a uniform patient care process establishes and promotes consistent expectations about pharmacist-provided patient care to patients, health care providers, payers, and regulatory bodies. In addition, a consistent process of care is needed to deliver services that permit objective measurement of patient care outcomes and quality measures that are comparable from one pharmacist to another and from one setting to another across the health care system. Regardless of
The Firm Size, Farm Size, and Transaction Costs: The Case of Hazelnut Farms in Turkey

This study analyzes the effects of transaction costs on the size of hazelnut farms in Turkey. The study finds that higher land slope and higher variance of rain, as transaction-cost-increasing natural effects, lead to smaller hazelnut land holdings. High slope and weather variation can increase the costs of monitoring the laborers, make moving inputs or output up and down harder, limit the use of machinery, and reduce contractual performance of labor contracts. For farm production functions, land is a complex input with measurable interactions with nature. Contrary to common production theory approaches that take natural properties of land as given, the study develops a production function that incorporates natural properties, such as, slope and rain variance. The study utilizes two separate data sets for the estimations. The first data set explores the characteristics of hazelnut farmers, while the second one analyzes the regional characteristics of hazelnut farms.
The dolomite problem: Stable and radiogenic isotope clues

At what time(s) in the history of a sediment did dolomite form? What kinds of solutions were involved? Were conditions (e.g. temperature, ocean composition) at the earth's surface different than they are today? Isotopic analyses are just one tool which can be used to constrain answers to these important questions. But isotopic data alone are almost never unequivocal, and a single isotopic system rarely useful. Isotopic data must be obtained within a sedimentologic and petrographic framework, and used in conjunction with elemental analyses and quantitative models. Only in this way can these powerful tools be wisely used.
Leadership, Self-Governance and Nationhood in the Hebrew Bible

This article extends prior work on the political theory of the Hebrew Bible. Previous papers presented the Garden of Eden story as a prolegomenon outlining concepts of legitimate authority; the stories of the Dark Age and the Flood as justifying the role of government and law in human society; the accounts of the Patriarchs as an exploration of patriarchal organization; and the early chapters of the book of Exodus as comparing and contrasting nomadism, dependency, slavery and nationhood as models of political organization. The present paper examines the biblical author’s ideas about self-governances as a step towards the achievement of nationhood. Key elements of self-governance are a population to be organized, a need for organization, a leader capable of performing the organizing task, and political action to establish the group’s autonomy. The author provides a remarkably sophisticated treatment of charismatic leadership and the tension between the leader’s personal and political identities.
Primary follicular large cell lymphoma of the testis in a child

Abstract Primary follicular lymphoma of the testis in childhood is extremely rare. To our knowledge, only 5 cases have been reported to date. We report a case in a 6-year-old boy who presented with painless right scrotal enlargement. Right radical orchiectomy revealed a follicular large cell lymphoma with diffuse areas confined to the testis and epididymis, clinical stage IE. Immunohistochemical stains demonstrated that the neoplastic cells were of B-cell lineage, positive for CD10, CD20, CD79a, and BCL-6. Staining for CD21 accentuated networks of dendritic reticulum cells within the nodules. The cells were negative for BCL-2, p53, and T-cell antigens. There was no evidence of the t(14;18) detected by polymerase chain reaction. The data suggest that follicular lymphoma of the testis in children has a different pathogenesis than follicular lymphoma in adults.
Food and water deprivation effects on reproduction in female Blattella germanica

The effects of food and water deprivation on survival and reproduction of adult female German cockroaches were examined. Females, maintained under constant conditions, were deprived of food or water following adult maturation, mating, during the oothecal incubation period, and after first oothecal hatch. It was found that both food and water deprivations caused increased mortality, delays in the reproductive cycle and decreased oothecal hatch. The relative importance of food vs. water deprivation on reproduction is discussed along with possible reproductive strategies for this species. RESUME Action du jeune et de la suppression d'eau sur la reproduction de femelles de Blattella germanica L. Les femelles, maintenues en conditions constantes, ont ete privees d'aliments et d'eau apres la maturite imaginale, l'accouplement, pendant la periode d'incubation et apres l'eclosion de la premiere ootheque. On a observe une mortalite accrue, un retard dans le cycle de reproduction et une diminution des eclosions de l'ootheque. L'importance relative de l'alimentation par rapport au jeune hydrique sur la reproduction est discutee en relation avec les strategies reproductives possibles de cette espece.
Collective Identities of Class and Gender: Working‐Class Women in the Pittston Coal Strike

This article investigates the intersections and tensions between two collective identities, those of class and gender, for working-class women involved in supporting the 1989-1990 strike against Pittston Coal Group in southwestern Virginia. In the case of this year-long (and ultimately successful) strike, women were organized by United Mine Workers of America (UMWA) staff in strike support activities, but they also sought to organize themselves as women. The tensions between their identity as members of the working class and their identity as women are revealed by examining their forms of activism, their relationship with the UMWA, the divisions between groups of activist women, and the articulation of women 's involvement in the strike. The experiences of these women are briefly compared with women's activism in the 1984-1985 British Coal strike. The article concludes by arguing that collective identity is best understood as it emerges in response to specific contexts.
Using the zebrafish lateral line to uncover novel mechanisms of action and prevention in drug-induced hair cell death

The majority of hearing loss and balance disorders are caused by the permanent loss of mechanosensory hair cells of the inner ear. Identification of genes and compounds that modulate susceptibility to hair cell death is frequently confounded by the difficulties of assaying for such complex phenomena in mammalian models. The zebrafish has emerged as a powerful animal model for genetic and chemical screening in many contexts. Several characteristics of the zebrafish, such as its small size and external location of mechanosensory hair cells within the lateral line sensory organ, uniquely position it as an ideal model organism for the study of hair cell toxicity. We have used this model to screen for genes and compounds that affect hair cell survival during ototoxin exposure and have identified agents that would not be expected to play a role in this process based on a priori knowledge of their function. The identification of such agents yields better understanding of hair cell death and holds promise to stem hearing loss and balance disorders in the human population.
Risk of thiazide-induced metabolic adverse events in older adults.

Objectives To evaluate the risk and predictorsof thiazide-induced adverse events (AEs) in multimorbidolder adults in real-world clinical settings.
Managing Conscientious Objection in Health Care Institutions

It is argued that the primary aim of institutional management is to protect the moral integrity of health professionals without significantly compromising other important values and interests. Institutional policies are recommended as a means to promote fair, consistent, and transparent management of conscience-based refusals. It is further recommended that those policies include the following four requirements: (1) Conscience-based refusals will be accommodated only if a requested accommodation will not impede a patient’s/surrogate’s timely access to information, counseling, and referral. (2) Conscience-based refusals will be accommodated only if a requested accommodation will not impede a patient’s timely access to health care services offered within the institution. (3) Conscience-based refusals will be accommodated only if the accommodation will not impose excessive burdens on colleagues, supervisors, department heads, other administrators, or the institution. (4) Whenever feasible, health professionals should provide advance notification to department heads or supervisors. Formal review may not be required in all cases, but when it is appropriate, several recommendations are offered about standards and the review process. A key recommendation is that when reviewing an objector’s reasons, contrary to what some have proposed, it is not appropriate to adopt an adversarial approach modelled on military review boards’ assessments of requests for conscientious objector status. According to the approach recommended, the primary function of reviews of objectors’ reasons is to engage them in a process of reflecting on the nature and depth of their objections, with the objective of facilitating moral clarity on the part of objectors rather than enabling department heads, supervisors, or ethics committees to determine whether conscientious objections are sufficiently genuine.
Mixing and Entrainment in the Red Sea Outflow Plume. Part I: Plume Structure

When the salty and heavy water of the Red Sea exits from the Strait of Bab el Mandeb, it continues downslope into the Gulf of Aden mainly along two channels. The 130-km-long “Northern Channel” (NC) is topographically confined and is typically only 5 km wide. In it, the Red Sea plume shows unanticipated patterns of vertical structure, turbulent mixing, and entrainment. Above the seafloor a 25–120-m-thick weakly stratified layer shows little dilution along the channel. Hence this bottom layer undergoes only weak entrainment. In contrast, a 35–285-m-thick interfacial layer shows stronger entrainment and is shown in a companion paper to undergo vigorous turbulent mixing. It is thus the interface that exhibits the bulk of entrainment of the Red Sea plume in the NC. The interfacial layer also carries most of the overall plume transport, increasingly so with downstream distance. The “Southern Channel” (SC) is wider than the NC and is accessed from the latter by a sill about 33 m above the floor of the NC. Entrainment into the bottom layer of the SC is diagnosed to be strong near the entry into the SC such that the near-bottom density and salinity are smaller in the SC than in the NC at the same distance from Bab el Mandeb. In comparison with winter conditions, the authors encountered weaker outflow with shallower equilibration depths during the summer cruise. Bulk Froude numbers computed for the whole plume varied within the range 0.2–1. Local maxima occurred in relatively steep channel sections and coincided with locations of significant entrainment.
A novel (non sinusoidal) signal delay and attenuation measurement of long RF cables with variable insertion loss

This paper describes the use of a novel, non-sinusoidal pulse named “Speedy Delivery” or “SD” to measure combined delay and attenuation. These delay measurements are obtained with precision not found using the conventional methods of Time Domain Reflection (TDR) or vector network analyser analyses. The measurements accurately estimate the insertion loss through 200 feet of coax and two small magnetically coupled loops at varying separation distances in air, water, and seawater. The measurement method is Time Domain Transmission (TDT) using the SD pulse as the test signal for improved resolution.[1]-[5] The SD signal results are compared with the loss of a sinusoid chosen for having an “equivalent” frequency, ie. equal to the bandwidth of the Ultra Wide Band (UWB) SD pulse.[6] The leading edge of the SD pulse does not change shape or exhibit dispersion, which makes accurate measurements of delay or attenuation possible, even on long cables with insertion losses exceeding 60 dB.
Solvent-casting of Photo-refractive Chalcogenide Glasses and their Application in Quantum Cascade Laser Tuning

We deposited photo-modifiable chalcogenide films through a low-temperature, solvent-casting technique. Their thermal and optical properties were characterized and these glasses were applied to quantum cascade lasers to realize all-optical room temperature tuning.
The evolution of parental care in fishes, with reference to Darwin's rule of male sexual selection

A simple two part hypothesis is proposed to describe the sources of selection influencing the evolution of parental care in fishes. It is derived in part from the observation that most fishes exhibiting complex patterns of parental behavior are freshwater forms. The first aspect of the hypothesis assumes that differential zygote mortality occurs in spatially and temporally varying environments. The second assumes that rates of gametogenesis are faster in males than in females. These aspects interact to generate a series of predictions: 1. When the zygote requires an external resource such as an optimal site for development, and that resource is scarce relative to the breeding population and is reusable, the male should monopolize it (male reproductive territoriality). 2. When bearing is derived from male guarding, the male will be the bearer. 3. When bearing evolves from a condition other than male guarding, the female will be favored as the bearer and the male will be favored as the gamete donor. 4. In all of the above cases except male bearing, the males reproductive success is limited primarily by the number of females he can attract rather than his own rate of gamete production and hence the male will tend to be the sexually selected sex. These and other predictions are tested against the existing literature on reproduction in fishes, and competing hypotheses are critically reviewed.
Role of Diffractive Coupling and Self-Focusing or Defocusing in the Dynamical Switching of a Bistable Optical Cavity

Optical bistability transients have been computed including one transverse Cartesian coordinate. With a Gaussian transverse input profile but weak diffractive coupling, the switchup intensity is radially dependent, and the output requires hundreds of round trips to reach steady state. Strong diffractive coupling results in whole-beam switchup and much faster convergence to steady state.
Transplantation in the highly sensitized pediatric patient

Sensitization against HLA antigens is a growing problem in the field of pediatric cardiac transplantation. Although surgical outcomes for congenital heart disease have improved over the decades, these successes have added to the growing list of sensitized patients who eventually may require transplantation.Cardiac transplantation survival has improved, but morbidity and mortality secondary to HLA antibodies hinder outcome. Aside from acute hemodynamic compromise, there is compelling evidence linking sensitization and AMR with the development of CAV, a major limiting factor affecting long-term graft survival. Clinical advances have improved our understanding of the roles of antibody type, CFAs and non-CFAs, and DSAs and non-DSAs. Therapeutic strategies target both the T- and B-cell lines. Combinations that include plasmapheresis, IVIG, cyclophosphamide, and rituximab have been used in clinical studies with variable success.Two newer agents show promise, targeting both ends of the antibody-mediated spectrum: Bortezomib depletes plasma cell populations, and eculizumab blocks the terminal effects of antibody action, thus preventing myocardial cell dysfunction and death. Despite numerous diagnostic and therapeutic advances, many questions remain about the best approaches.The role of HLA antibodies remains the central target of investigation.
Automated docking in crystallography: Analysis of the substrates of aconitase

Automated docking of substrates to proteins of known structure aids the process of crystallographic analysis in two ways. First, automated docking can be used to generate a small number of starting models for substrates using only protein coordinates from an early stage of refinement. Second, automated docking provides a method for exploring aspects of catalysis that are inaccessible to crystallography by postulating binding modes of catalytic intermediates. This paper describes the use of automated docking to explore the binding of substrates to aconitase. The technique starts with a substrate molecule in an arbitrary configuration and position and finds favorable docked configurations in a (static) protein active site based on a molecular mechanics type force field. Using protein coordinates from an early stage of refinement of an aconitase-isocitrate complex, we successfully predicted the binding configuration of isocitrate. Four configurations were found, the energetically most favorable of which fit the observed electron density well and was used as a starting model for further refinement. Two configurations were found in citrate docking experiments, the second of which approximates the mode of substrate binding in an aconitase-nitrocitrate complex. We were also able to propose two binding modes of the catalytic intermediate cis-aconitate. These correspond closely to the isocitrate and the citrate binding modes. The relation of these new results to the proposed reaction mechanism is discussed.
When the Land Tells a Story: Using Geographic Information Systems (GIS) for Landscape Monitoring and Humanitarian Relief: Innovations Case Discussion: Pingree Easement

their entire jurisdiction using three key technologies: geographic information systems (GIS), remote sensing (RS), and global positioning systems (GPS). The novelty in the case lies neither in the technology nor the application, but rather in the management setting where the innovation took place. As Jim Levitt wrote, the size of the easement, the “largest conservation easement project ever realized in the course of American history,” carried with it the significant challenge of tracking landscape changes due to “human population pressures and attendant disruptive environmental impacts” while wisely investing monetary resources in these technologies and human resources. As is true with national parks, designating lands for protection and developing a set of permissible uses is only the start; managers must then find the resources to monitor and enforce those uses. With a finite, albeit robust, budget and personnel who could not always be present, the New England Forestry Foundation (NEFF) distributed a call for proposals to experts in the field of landscape monitoring. Each group that replied to NEFF employed some aspect of GIS/RS in its plan to monitor and track changes to the landscape of the Pingree forest. Given the Randall B. Kemp and Sanjeev Khagram
Uremic leontiasis ossea: "bighead" disease in humans? Radiologic, clinical, and pathologic features.

PURPOSE: To describe the clinical, radiologic, and pathologic findings in patients with uremic leontiasis ossea (ULO). MATERIALS AND METHODS: Five patients with renal osteodystrophy developed marked hyperostosis of the facial and cranial bones. Radiologic studies included plain radiography of the skull (n = 5), computed tomography with three-dimensional reconstruction (n = 4), magnetic resonance imaging (n = 3), and fluorine-18 sodium fluoride positron emission tomography (PET) (n = 1). Specimens from bone biopsies (three patients) were examined. RESULTS: Skull and facial alterations were remarkably similar. Numerous nodules of varying attenuation and signal intensity in the widened diploic space suggested brown tumors in different stages of evolution. Biochemical data and PET findings enabled confirmation of markedly increased bone turnover. Bone specimens demonstrated severe osteitis fibrosa. After parathyroidectomy, facial changes in all patients stabilized or improved mildly. CONCLUSION: A similar ent...
Droplet–turbulence interactions in low-Mach-number homogeneous shear two-phase flows

Several important issues pertaining to dispersion and polydispersity of droplets in turbulent flows are investigated via direct numerical simulation (DNS). The carrier phase is considered in the Eulerian context, the dispersed phase is tracked in the Lagrangian frame and the interactions between the phases are taken into account in a realistic two-way (coupled) formulation. The resulting scheme is applied for extensive DNS of low-Mach-number, homogeneous shear turbulent flows laden with droplets. Several cases with one- and two-way couplings are considered for both non-evaporating and evaporating droplets. The effects of the mass loading ratio, the droplet time constant, and thermodynamic parameters, such as the droplet specific heat, the droplet latent heat of evaporation, and the boiling temperature, on the turbulence and the droplets are investigated. The effects of the initial droplet temperature and the initial vapour mass fraction in the carrier phase are also studied. The gravity effects are not considered as the numerical methodology is only applicable in the absence of gravity. The evolution of the turbulence kinetic energy and the mean internal energy of both phases is studied by analysing various terms in their transport equations. The results for the non-evaporating droplets show that the presence of the droplets decreases the turbulence kinetic energy of the carrier phase while increasing the level of anisotropy of the flow. The droplet streamwise velocity variance is larger than that of the fluid, and the ratio of the two increases with the increase of the droplet time constant. Evaporation increases both the turbulence kinetic energy and the mean internal energy of the carrier phase by mass transfer. In general, evaporation is controlled by the vapour mass fraction gradient around the droplet when the initial temperature difference between the phases is negligible. In cases with small initial droplet temperature, on the other hand, the convective heat transfer is more important in the evaporation process. At long times, the evaporation rate approaches asymptotic values depending on the values of various parameters. It is shown that the evaporation rate is larger for droplets residing in high-strain-rate regions of the flow, mainly due to larger droplet Reynolds numbers in these regions. For both the evaporating and the non-evaporating droplets, the root mean square (r.m.s.) of the temperature fluctuations of both phases becomes independent of the initial droplet temperature at long times. Some issues relevant to modelling of turbulent flows laden with droplets are also discussed.
DistAl: An inter-pattern distance-based constructive learning algorithm

Multi-layer networks of threshold logic units TLU offer an attractive framework for the design of pattern classification systems. A new constructive neural network learning algorithm DistAl based on inter-pattern distance is introduced. DistAl constructs a single hidden layer of hyperspherical threshold neurons. Each neuron is designed to determine a cluster of training patterns belonging to the same class. The weights and thresholds of the hidden neurons are determined directly by comparing the inter-pattern distances of the training patterns. This offers a significant advantage over other constructive learning algorithms that use an iterative and often time consuming weight modification strategy to train individual neurons. The individual clusters represented by the hidden neurons are combined by a single output layer of threshold neurons. The speed of DistAl makes it a good candidate for datamining and knowledge acquisition from large datasets. The paper presents results of experiments using several artificial and real-world datasets. The results demonstrate that DistAl compares favorably with other learning algorithms for pattern classification.