cssi/SciSciGPT-SciSciNet huggingface dataset:
Digital Phenotyping and Patient-Generated Health Data for Outcome Measurement in Surgical Care: A Scoping Review

Digital phenotyping-the moment-by-moment quantification of human phenotypes in situ using data related to activity, behavior, and communications, from personal digital devices, such as smart phones and wearables-has been gaining interest. Personalized health information captured within free-living settings using such technologies may better enable the application of patient-generated health data (PGHD) to provide patient-centered care. The primary objective of this scoping review is to characterize the application of digital phenotyping and digitally captured active and passive PGHD for outcome measurement in surgical care. Secondarily, we synthesize the body of evidence to define specific areas for further work. We performed a systematic search of four bibliographic databases using terms related to "digital phenotyping and PGHD," "outcome measurement," and "surgical care" with no date limits. We registered the study (Open Science Framework), followed strict inclusion/exclusion criteria, performed screening, extraction, and synthesis of results in line with the PRISMA Extension for Scoping Reviews. A total of 224 studies were included. Published studies have accelerated in the last 5 years, originating in 29 countries (mostly from the USA, n = 74, 33%), featuring original prospective work (n = 149, 66%). Studies spanned 14 specialties, most commonly orthopedic surgery (n = 129, 58%), and had a postoperative focus (n = 210, 94%). Most of the work involved research-grade wearables (n = 130, 58%), prioritizing the capture of activity (n = 165, 74%) and biometric data (n = 100, 45%), with a view to providing a tracking/monitoring function (n = 115, 51%) for the management of surgical patients. Opportunities exist for further work across surgical specialties involving smartphones, communications data, comparison with patient-reported outcome measures (PROMs), applications focusing on prediction of outcomes, monitoring, risk profiling, shared decision making, and surgical optimization. The rapidly evolving state of the art in digital phenotyping and capture of PGHD offers exciting prospects for outcome measurement in surgical care pending further work and consideration related to clinical care, technology, and implementation.
Previous History of Knee Arthroscopy in Patients Undergoing Total Knee Arthroplasty: An Examination of the Effect of the Literature and American Academy of Orthopaedic Surgeons 2013 Arthroscopy Guidelines on Clinical Practice.

Purpose To compare the rate of previous knee arthroscopy in patients undergoing total knee arthroplasty (TKA) before (2005-2006) and after (2018) publication of landmark studies that examined the effectiveness of knee arthroscopy as well as the American Academy of Orthopaedic Surgeons 2013 knee arthroscopy guidelines. Methods We performed a retrospective chart review of 214 patients who underwent a TKA between 2005 and 2006 (Group 1) and 213 patients who underwent a TKA in 2018 (Group 2). We reviewed medical records to determine whether previous knee arthroscopy was performed. Group comparisons were made using the t test for continuous data and the χ 2 test for categorical data, and means ± standard deviation are presented. Results Patients in Group 2 were older than those in Group 1 (67.0 ± 8.3 vs 64.3 ± 11.5 years, P = .01); however, there were no differences between groups with respect to sex (P = .40), body mass index (P = .36), and laterality of TKA (P = .05). There was no difference in the history of previous knee arthroscopy between Groups 1 and 2 overall (27% vs 32%, P = .27) and within 10 years of TKA (17% vs 15%, P = .44). Conclusions We did not find a difference in the number of previous knee arthroscopies for patients undergoing TKA in 2018 versus 2005-2006. This suggests that the recommendations set forth by landmark clinical trials that examined the effectiveness of knee arthroscopy and the AAOS 2013 knee arthroscopy guidelines did not have a sudden impact within our geographic region, but there is some evidence to suggest a gradual shift in treatment, where knee arthroscopy is withheld near imminent knee arthroplasty. Level of Evidence III, retrospective comparative study.
p53 supplementation as a targeted cancer gene therapy for glioblastoma

Abstract TP53, also referred to as the “elephant gene,” encodes for the proapoptotic protein p53 that guards the genome from mutations and aberrations. It is also one of the most commonly deregulated tumor suppressor genes in cancer. Nearly 84% of glioblastoma (GBM) patients have a dysregulated p53-ARF-MDM2 pathway, which is also evident in 94% of GBM cell lines adopted for in vitro assays. The majority of p53 dysregulation stems from mutations in TP53 and other regulatory proteins that are involved in its biogenesis feedback loop. GBM carries different grades of such mutations and exhibits higher cell invasion, migration, proliferation, evasion from apoptosis, and cancer cell stemness, which ultimately gives raise to resistance to standard therapeutic approaches. Expression of these mutations correlates with worse prognosis, highlighting their potential importance as markers and targets for GBM therapy. Thus, restoration of wild-type p53 function or supplementation of p53 selectively to GBM cells can sensitize the cells to subsequent chemotherapy/radiation therapy by promoting apoptosis, cell cycle arrest, and senescence. In light of the significance of this strategy for the current clinical practices for GBM therapy, in this chapter we will elaborate upon different strategies adopted for restoration or supplementation of wild-type p53 function in GBM, and their clinical potential for efficient therapeutic management. We focus on cancer gene therapy for supplementation of p53 as a strategy to improve chemo- and radiotherapies in GBM.
Virtual Reality after Surgery-A Method to Decrease Pain After Surgery in Pediatric Patients.

BackgroundVirtual Reality (VR) is used as an effective tool for distraction and as an adjunct for pain management. This study was conducted to compare VR to standard iPad use after surgery and exam...
Steroidogenic Enzyme and Steroid Receptor Expression in the Equine Accessory Sex Glands.

The expression pattern and distribution of sex steroid receptors and steroidogenic enzymes during development of the equine accessory sex glands has not previously been described. We hypothesized that equine steroidogenic enzyme and sex steroid receptor expression is dependent on reproductive status. Accessory sex glands were harvested from mature stallions, pre-pubertal colts, geldings, and fetuses. Expression of mRNA for estrogen receptor 1 (ESR1), estrogen receptor 2 (ESR2), androgen receptor (AR), 3β-Hydroxysteroid dehydrogenase/Δ5-4 isomerase (3βHSD), P450,17α hydroxylase, 17–20 lyase (CYP17), and aromatase (CYP19) were quantified by RT-PCR, and protein localization of AR, ER-α, ER-β, and 3βHSD were investigated by immunohistochemistry. Expression of AR, ESR2, CYP17, or CYP19 in the ampulla was not different across reproductive statuses (p > 0.1), while expression of ESR1 was higher in the ampulla of geldings and fetuses than those of stallions or colts (p < 0.05). AR, ESR1 and ESR2 expression were decreased in stallion vesicular glands compared to the fetus or gelding, while AR, ESR1, and CYP17 expression were decreased in the bulbourethral glands compared to other glands. ESR1 expression was increased in the prostate compared to the bulbourethral glands, and no differences were seen with CYP19 or 3β-HSD. In conclusion, sex steroid receptors are expressed in all equine male accessory sex glands in all stages of life, while the steroidogenic enzymes were weakly and variably expressed.
Modulation of Autoimmunity by Sex Hormones

It has been known for some time that females are more likely than males to have many autoimmune diseases. Patients with Klinefelter’s disease [in which phenotypic males have an extra X chromosome (XXY) and fail to develop male secondary sexual characteristics] also are more likely to develop autoantibodies or autoimmune disease. These patients often have gynecomastia and an abnormality of hormone mechanism which results in hyperestrogenemia (Stern et al., 1977).
Girls perspectives on family scripts about sex-related topics and relationships: implications for promoting sexual health and reducing sexual risk.

This study explores girls' perspectives of family scripts to develop family-based interventions to reduce HIV/AIDS and STIs. In-depth qualitative interviews with 33 teen girls revealed four common scripts: (a) waiting-to begin dating or to initiate sexual intercourse, (b) danger and protection, (c) abuse, and (d) taking charge. Most low-income families acknowledged pregnancy and HIV/STI risks but some girls experienced conflict with social norms and abusive partners. Most high-income families avoided addressing sexual risks explicitly but encouraged good decisions and expanded life opportunities. These findings suggest that families may tailor scripts to the perceived risk and that interventions should address gender norms among peers, relationship-associated risks, and strategies for developing healthy interpersonal teen relationships.
Calcium imaging and multielectrode recordings of global patterns of activity in the developing nervous system.

Complex but coordinated interactions involving ensembles of neuronal cells result in the accurate processing of information in the adult central nervous system. However, recent studies monitoring the global patterns of activity of neuronal populations have demonstrated that immature neurons also interact to produce coordinated patterns of activity during the early stages of development. In particular, these patterns of coordinated activity occur during the period when neuronal connections are established, thus leading us to believe that such activity patterns might underlie the precision to which many neural pathways are wired up. Multielectrode recording and calcium imaging are two of the techniques that have been intstrumental in revealing the spatial and temporal properties of the coordinated activity of developing neural networks in vitro. While multielectrode arrays measure the action potential activity of the cells, calcium imaging permits changes in intracellular calcium levels to be monitored over time. Both techniques have been used successfully to monitor the activity of cellular networks in culture, but they have also been applied in assessing the patterns of activity in intact or semi-intact pieces of neural tissues, such as the developing retina, neocortex and spinal cord. More recently, it has also been possible to correlate the structure and function of the cellular components of the networks by combining intracellular dye filling with the multineuronal recordings. In this review, brief descriptions and the applications of the two techniques will be presented, and the advantages and limitations of multielectrode array will be compared with that of calcium imaging using recordings of the developing mammalian retina as the primary example. 1998 © Chapman & Hall
Relationships among plumage coloration, blood selenium concentrations, and immune responses of adult and nestling tree swallows

In a number of taxa, males and females both display ornaments that may be associated with individual quality and could be reliable signals to potential mates or rivals. We examined the iridescent blue/green back and white breast of adult tree swallows (Tachycineta bicolor) to determine whether plumage reflectance is related to adult or offspring immune responses. We simultaneously addressed the influence of blood selenium levels and the interaction between blood selenium and plumage coloration on adult and nestling immunity. Selenium is a well-known antioxidant necessary for mounting a robust immune response but its importance in wild birds remains poorly understood. In females, the brightness of white breast coloration was positively associated with bactericidal capacity, but there was no association with blood selenium. In contrast, male bactericidal capacity was associated with an interactive effect between dorsal plumage coloration and blood selenium concentration. Males with bluer hues and greater blue chroma showed increased bactericidal capacity as blood selenium concentrations increased, while bactericidal capacity declined in greener males at higher blood selenium concentrations. In nestlings, bactericidal capacity was positively associated with nestling blood selenium concentrations and white brightness of both social parents. These results suggest that white plumage reflectance is indicative of quality in tree swallows and that greater attention should be paid to the reflectance of large white plumage patches. Additionally, the role of micronutrients, such as selenium, in mediating relationships between physiology and signals of quality, should be explored further.
Connecting the Dots from Curriculum to Practicum

Abstract This innovative case study in one urban school of social work connects the dots from the curriculum to the practicum setting, assessing the agency field instructors' view of the adequacy of student preparation for advanced practice. Results support the need for systematic assessment of the fit between curriculum and the actual practice arena, to empower field education directors to better promote a fit between, and integration of, class and field. For example, in this case study, the findings suggest that integration of competencies such as problem solving and ethnic-sensitive interviewing, overshadowed by content on psychotherapy in this advanced practice curriculum, should be fostered.
Quantum-mechanical study of ro-vibrational transitions in H2 induced by He atoms

We describe quantum-mechanical scattering calculations of ro-vibrational transitions in H2 induced by collisions with He. We use a close-coupled description of the dynamics which includes full ro-vibrational coupling and a reliable potential energy surface. Rate coefficients for rotational and vibrational transitions in ortho- and para-H2 are presented in the temperature range 10≤T≤5000 K.
Contemporary Rituals and the Confucian Tradition: a Critical Discussion

After defining what I mean by “rituals,” I list some benefits claimed for rituals by Confucians, but then go on to develop utilitarian, existentialist, liberal, radical, and Confucian critiques of rituals. (The Confucian critiques are particularly poignant. Rituals can hinder, rather than forward the goals of the Confucian tradition.) The drawbacks of rituals are not merely historical accidents; they grow out of essential features of rituals and are ineliminable. Yet there is hope. Because the drawbacks appear when rituals decay, they can be ameliorated by fostering the creation of new rituals as alternatives to the old ones.
Utility of minimum F-wave latencies compared with F-estimates and absolute reference values in S1 radiculopathies: Are they still needed?

Introduction: The utility of F-waves in assessing radiculopathies is debated. The aim of this study is to determine the frequency of abnormal minimum tibial F-wave latencies compared to an F-estimate and an absolute reference value in patients with electromyography (EMG) confirmed S1 radiculopathies. Methods: A retrospective review of F-waves in patients with an EMG-confirmed isolated S1 radiculopathy was performed. The minimum and mean latencies of 8 tibial F-waves were compared with the calculated F-estimate and to an absolute reference value, and the frequencies of abnormal responses were determined. Results: Of the 50 patients with an S1 radiculopathy, 4% had prolongation of the minimum reproducible F-wave latency, and 8% had prolongation of the mean latency relative to the calculated F-estimate. Conclusions: The minimum and mean F-wave latencies are infrequently abnormal when compared with an estimated F-wave latency in S1 radiculopathies and are insensitive in the assessment of S1 nerve root injury. Muscle Nerve 49: 809–813, 2014
The Unicornuate Uterus and Its Variants Clinical Presentation, Imaging Findings, and Associated Complications

This article will describe the different variants of the unicornuate uterus, their clinical presentation and imaging findings, as well their associated complications. We will also review the associated renal anomalies. Patients' symptoms and their imaging findings will vary depending on the unicornuate subtype. Radiologic evaluation includes a combination of hysterosalpingography, sonography, and magnetic resonance imaging. Complications include obstetric ones related to the small uterine size and endometriosis and ectopic pregnancies when a cavitary rudimentary uterine horn is present. Radiologists should be familiar with all variants of the unicornuate uterus as well as their clinical presentation and associated imaging findings.
Dystrophin Dp71 Is Critical for the Clustered Localization of Potassium Channels in Retinal Glial Cells

The Muller cell is the principal glial cell of the vertebrate retina. The primary conductance in Muller cells is the inwardly rectifying potassium channel Kir4.1 (BIR10 and KAB-2), which is highly concentrated at the endfeet at the vitreal border and to processes enveloping blood vessels. Such asymmetric and clustered distribution of Kir4.1 channels in Muller cells is thought to be critical for the buffering of extracellular potassium concentration in retina. Herein we investigated whether the distribution and functional properties of Kir4.1 channels are dependent on expression of the Dp71, a dystrophin isoform expressed in Muller cells. Kir4.1 distribution was determined in mouse retinal sections and whole mounts using anti-Kir4.1 antibodies and confocal microscopy. In Muller cells from wild-type mice, Kir4.1 is highly clustered in their endfeet and perivascular processes. In contrast, in Muller cells from the mdx(3Cv) mouse, which lacks the expression of Dp71, the Kir4.1 immunoreactivity is evenly distributed throughout the cell membrane. Surface expression of Kir4.1 is not affected in mdx(3Cv) Muller cells as current density of barium-sensitive inward currents in mdx(3Cv) Muller cells are not different from wild type. Focal extracellular potassium increases in isolated Muller cells shows that Kir channels in the mdx(3Cv) cells, as opposed to wild type, are less prominently concentrated in their endfeet. In summary, our data indicate that Dp71 is critical for the clustering but not membrane expression of Kir4.1 in mouse Muller cells. These results point to a new role for dystrophin in glial cells.
Aggregin: a platelet ADP receptor that mediates activation.

ADP is known to induce platelet shape change, aggregation, and exposure of fibrinogen binding sites as well as inhibit stimulated adenylate cyclase. The platelet is unique in that its purinergic receptor prefers ADP over ATP, which functions as a competitive antagonist. The affinity reagent, 5'-p-fluorosulfonylbenzoyl adenosine (FSBA), has been used to covalently label a single membrane protein, aggregin, on the external platelet surface with mol wt of 100 kDa. Concomitant with incorporation of FSBA, ADP-induced shape change, aggregation, and fibrinogen binding is inhibited. FSBA is also a weak agonist at short times and high concentration, which suggests that prior noncovalent binding to aggregin takes place before covalent modification. Aggregin differs from platelet glycoprotein IIIa in its physical and immunochemical properties. Aggregin is distinct from the receptor coupled to adenylate cyclase. Using FSBA as a probe, platelet aggregation by thromboxane A2 analogs and collagen was shown to be depende...
Programming Protocol Optimization for Analog Weight Tuning in Resistive Memories

Analog weight tuning in resistive memories is attractive for multilevel operation and neuro-inspired computing. To tune the device conductance to the desired states as fast as possible without sacrificing the accuracy, we propose an optimization programming protocol by adjusting the pulse amplitude incremental steps, the pulsewidth incremental steps, and the start voltages. Our experimental results on HfOx-based resistive memories indicate that avoiding over-reset by appropriate programming parameters is critical for fast convergence of the conductance tuning. The over-reset behavior is caused by the stochastic nature of filament formation and rupture, as simulated by a 1-D filament model.
Topological mass term for gravity induced by matter

Abstract The contribution of massive fermions and topologically massive gauge fields to a Chern-Simons term for the graviton is computed to one-loop order in three dimensions. Invariance under large coordinate transformations places restrictions on the number of these massive matter fields. The parity anomaly for massless fermions is determined, and a possible parity anomaly for massless gauge fields is suggested.
Lack of cystic fibrosis transmembrane regulator -type chloride current in pediatric human atrial myocytes

Abstract Mature cardiomyocytes have been shown to possess a cyclic AMP-mediated chloride channel (I Cl ) which is the product of the cystic fibrosis transmembrane regulator (CFTR) gene. Species variability has been demonstrated for other ion channels. This study was designed to evaluate human I Cl regulation using the whole-cell patch-clamp bioassay. Atrial tissue obtained from children undergoing congenital heart surgery was enzymatically dispersed into isolated myocytes. The patients ranged in age from 1 day to 11 years (mean 2 years). Isoproterenol was used to activate the CAMP second-messenger system in a potassium-free environment. Membrane calcium and sodium channels were pharmacologically blocked. Of 20 human atrial myocytes obtained from 13 pediatric patients, 80% had a small basal chloride current. The current could be inhibited by the anion transport blocker, 9-anthracene carboxylic acid. In 4 of 20 otherwise viable myocytes, no I Cl could be elicited, either at baseline or with β-adrenergic stimulation. Of the 16 myocytes with a basal I Cl , the current was unaffected by cAMP stimulation in 15 (94%) cells. There were no significant differences in age, gender or clinical status of patients whose cells conducted Cl − current compared with patients whose myocytes had no measurable I Cl . Ten mature guinea pig ventricular myocytes were evaluated using the same whole-cell patch-clamp technique. Seven of 10 cells showed a reversible increase in I Cl with isoproterenol exposure. Despite presence of the CFTR gene in human cardiomyocytes, functional expression of the cAMP-activated I Cl , does not appear evident in isolated pediatric atrial myocytes. Whether the pathophysiology of congenital heart disease may influence chloride current modulation via alterations in adrenergic tone, intracellular Ca + regulation, and cellular osmotic conditions remains to be established.
Free radical reactions for heterocycle synthesis. Part 4: A double ipso substitution reaction for azacoumarins

Abstract A highly efficient route to azacoumarins with an unusual mechanism of double ipso substitutions is described.
Pyrolytic production of Se (3P) from carbon diselenide. II. Rate of CSe2 decay

Pyrolytic decay of carbon diselenide was monitored by ultraviolet absorption spectroscopy in reflected shock waves in the temperature range of 1600–2600°K. The temperature dependence of the absorption coefficient of CSe2 at 2308 A was determined and was used to provide kinetic information along with a deconvolution procedure which accounted for and removed systematic distortions of the fast time-resolved absorbance profile. For temperatures of 1600–2600°K and argon densities of 1.5–7.0 × 10−5 mol/cm3 dilute (1.0–9.0 × 10−9 mol/cm3) CSe2 pyrolyzed with measured first-order decay rates in the range of log10k1 (sec−1) = 3.0−5.7; at midrange (2100°K and 4.3 × 10−5 mol/cm3 in Ar) k1 ≈ 3 × 104 sec−1. The decay probably occurs via a unimolecular low-pressure process, first order in both CSe2 and Ar, for which k2 ± 109 cm3/mol·sec at 2100°K. The deconvoluted data yield Arrhenius activation energies of 53.2 kcal/mol under second-order treatment, but the activation energy is less reliable than the general magnitude of the rate constant. A comparison of CSe2 with other molecules which are isoelectronic in their valence shells (CO2, CS2, OCS, and N2O) is made.
Performance evaluation for cluttered infrared image based on Fringe- adjusted Joint Transform Correlator

Several metrics for quantifying the performance of fringe-adjusted joint transform correlator (JTC) technique are investigated in this paper. The criteria used for measuring the performance of fringe-adjusted JTC include peak sharpness, signal-to-clutter measure, distortion invariance, signal-to-noise ratio and a new metric called peak-to-background correlation energy is proposed in this paper. These metrics are used to estimate the reliability of signal detection in the input scene with respect to clutter, noise and other associated distortions. Detailed analysis and simulation results for quantifying the performance of fringe-adjusted JTC are presented.
Wine and health: state of proofs and research needs.

Regular moderate wine consumption is often associated with reduced morbidity and mortality from to a variety of chronic diseases in which inflammation is a root cause. Wine comes in a wide variety of styles that contain quite different ethanol and polyphenol contents. Controversy remains as to whether the alcohol or polyphenols contribute more to the health benefits of regular moderate wine consumption. The variety of wines available to consumers can be expected to affect health differently in accordance with a particular wine’s total polyphenolic content and spectrum of individual polyphenols. The overall effect of wine consumption on health depends upon the total amounts consumed, the style and possibly the pattern of consumption. The apparent effect of wine consumption may be modified by the non-wine diet composition of the consumer in that alcohol may appear as the primary component in consumers with high fruit, vegetable and whole grain intakes while phytochemical benefit may become significant in diets where wine is the primary dietary source of phytochemical. In this review, wine polyphenol mechanisms of action will be reviewed in connection with the mechanism the development of atherosclerotic cardiovascular disease (ASCVD). Selected clinical studies published in 2004–2008 were reviewed. Experimental requirements for valid clinical studies, translation of in vitro to in vivo application and areas where additional evidence needs to be developed were identified.
A FISH 'n chips appetizer

Genome-wide studies reveal somatically acquired regions of uniparental isodisomy (UPD) in 25% of pediatric acute lymphoblastic leukemia (ALL). These regions probably contain tumor-suppressor genes involved in pathogenesis.
Precision Laser Annealing of Silicon devices for Enhanced Electro-Optic Performance.

We present results from laser annealing experiments in Si using a passively Q-switched Nd:YAG microlaser. Exposure with laser at fluence values above the damage threshold of commercially available photodiodes results in electrical damage (as measured by an increase in photodiode dark current). We show that increasing the laser fluence to values in excess of the damage threshold can result in annealing of a damage site and a reduction in detector dark current by as much as 100x in some cases. A still further increase in fluence results in irreparable damage. Thus we demonstrate the presence of a laser annealing window over which performance of damaged detectors can be at least partially reconstituted. Moreover dark current reduction is observed over the entire operating range of the diode indicating that device performance has been improved for all values of reverse bias voltage. Additionally, we will present results of laser annealing in Si waveguides. By exposing a small (<10 um) length of a Si waveguide to an annealing laser pulse, the longitudinal phase of light acquired in propagating through the waveguide can be modified with high precision, <15 milliradian per laser pulse. Phase tuning by 180 degrees is exhibited with multiple exposures to one arm of a Mach-Zehnder interferometer at fluence values below the morphological damage threshold of an etched Si waveguide. No reduction in optical transmission at 1550 nm was found after 220 annealing laser shots.
Associations between circadian activity rhythms and functional brain abnormalities among euthymic bipolar patients: a preliminary study.

Background Working memory and underlying functional brain deficits have been observed in euthymic bipolar disorder (BD) patients, though there is heterogeneity in the degree of deficits. Sleep/circadian rhythm abnormalities are thought to be a core component of BD and may explain some of the heterogeneity in functional abnormalities. This preliminary study examined associations between sleep/circadian rhythm abnormalities and functional magnetic resonance imaging (fMRI) brain response on a working memory task among BD patients.
H1 boundedness of oscillatory singular integrals with degenerate phase functions

In this paper we study the uniform boundedness of oscillatory singular integral operators with degenerate phase functions on the Hardy space H1. The H1 boundedness was previously known when the phase function is nondegenerate. Here we obtain a sufficient condition for H1 boundedness which allows the phase function vanishing to infinite order.
Self-Organized Communities of Practice in Physical Education

The National Board for Professional Teaching Standards (NBPTS) was created in 1987 with the purpose of establishing standards for instruction for K–12 teachers within the U.S. The NBPTS was tasked with identifying and certifying teachers who met their standards. In the current article, we theorize on the potential avenues by which the NBPTS is currently establishing a Community of Practice (CoP) through its certification process. We examine pertinent literature and the certification process to support our theorization. In order to achieve this aim, Complexity Theory and Communities of Practice Theory serve as a lens for the explanation of CoPs among National Board Certification Candidates.
Continuous oxygen saturation monitoring following rectal methohexitone induction in paediatric patients.

Rectal methohexitone has been used to induce anaesthesia in paediatric patients for a number of years. This study was conducted in order to confirm the safety of this method of induction for uncomplicated routine paediatric patients. Children between the ages of six months and six years were considered candidates for induction with methohexitone (10%, 25–30 mg · kg−1). Patients were monitored with a continuous oxygen saturation recording. Forty-nine patients participated in this study and anaesthesia was induced successfully in 44. The mean age of the patients was 2.7 ±1.6 yr. The mean weight was 13.8 ±4.3 kg and the mean dose of methohexitone for successful induction was 27.0 ±3.0 mg kg−1. Continuous oximeter recordings were available in 31 of the 42 patients who allowed oximeter placement prior to administration of methohexitone. No major desaturation events were noted in any patient. Two brief episodes of desaturation occurred. One with a nadir of 90% which lasted for 45 sec and another with a nadir of 86% which lasted for 26 sec. Both children had their heads flexed over their parents’ shoulders at the time of the event resulting in partial airway obstruction. Both of these episodes were the result of upper airway obstruction which was clinically diagnosed by the anesthetist and readily corrected by repositioning the head. This study confirms the efficacy and safety of rectal methohexitone for induction of general anaesthesia in children. Mechanical obstruction of the airway following induction seems to be the most likely cause for oxygen desaturation. Monitoring of pulse oximetry does not appear necessary provided the child is carefully observed for adequacy of air exchange.
George shultz on managing the white house

Embedded in Turmoil and Triumph, George Shultz's [1993] 1100-plus pages account of his service as secretary of state, is his assessment of Ronald Reagan as president and his guide to managing the executive branch. As to the former, Shultz makes the best case he can for Reagan without resorting to either significant distortions or misleading omissions. Shultz portrays President Reagan as a forceful leader with vision and sound judgment and argues he left "the country far better than he found it" [1993, p. 1133], but does not cover over Reagan's managerial incompetence. Although Shultz does not set out specific organizational and staffing rules for an effectively managed White House, Turmoil and Triumph can be mined to yield clear, credible guidelines. In this brief piece it is not possible to capture fully the complex interaction that shaped Shultz's guidelines, but I can derive and discuss his management rules, give a flavor of the dynamics of the Reagan foreign policy process, and spell out why Shultz's insights on managing the White House are so important. Secretary Shultz, who offers by far the most interesting and useful insider look at Reagan as manager and leader to date, is such a valuable critic because he himself had been an outstanding top-level manager in the private and public sectors over a long period of time. Few cabinet secretaries have come to their position with comparable organizational knowledge and prior managerial success. Before becoming secretary of state, Shultz had been a business school dean and head of a major corporation, as well as Office of Management and Budget director and secretary of both Labor and Treasury in the Nixon-Ford years, thus serving both at the top of the White House as well as a cabinet secretary. Beyond his managerial experience, wisdom, and competence, Shultz's high integrity shows clearly in his treatment of the appropriate relationship between a president and his principal policy advisers, be they White House staff or cabinet secretaries.
Use of Larger Species such as Dog and Pig as Model Systems to Study Cardiac Disease.

The advent of genetically engineered mouse models has greatly expanded the scientific tools available to study cellular and molecular mechanisms of cardiac disease. But in many applications, large animal models are needed to study human disease, in particular when regional function in the heart plays a key role in the disease. Measurements such as regional cardiac mechanics, electrophysiology and hemodynamics are typically better suited for study in large animal models, and can be complementary to molecular scale investigations typically done in the mouse.
The fine structure of charmonium and electric confinement

Abstract It is argued that the charmonium 3 P state spectrum does not require the confining potential to be a Lorentz scalar. A nonrelativistic spin-potential is parameterized in a way that is compatible with electric confinement and the known 3 P state masses. The 3 D 1 mass is then computed to be 3762 MeV, which compares quite favorably with the experimental value of 3770 ± 3 MeV.
A mid-infrared attenuated total internal reflection cure sensor for control of resin transfer moulding of a pre-ceramic polymer

Abstract An attenuated total internal reflection (ATR) mid-infra red (m.i.r.) sensor has been constructed and interfaced with a resin transfer moulding (RTM) system to monitor the progression of chemical reactions during processing. Software, resident on the microcomputer used to control the Fourier transform infrared (FT-i.r.) spectrometer, automatically collects the spectra and converts the m.i.r. spectra to a single number indicative of the ‘degree of cure’. This index is then sent to the process control computer. Programmable cure is achieved by using the ‘degree of cure’ signal from the FT-i.r. in a model-based feedback cure controller cascaded to the base-level temperature controller. Thus, the cure cycle is expressed as a cure history, not as a temperature history as is typical in composites processing. Cure control was simulated to test the effectiveness of the control algorithm.
Nanoscale phase separation and local icosahedral order in amorphous alloys of immiscible elements

We demonstrate that local icosahedral ordering, as well as spinodal compositional modulations with nanometer scale wavelengths, are characteristic of amorphous structures formed in an immiscible system with large positive heat of mixing. This unique nature of the atomic-level structures allows the amorphous alloy to lower its enthalpy such that the heat of crystallization is of a magnitude comparable to that typically seen for amorphous phases in easy glass-forming systems. The development of such chemical decomposition and topological order in the short to medium range has been monitored in the Ag-Ni model system using molecular dynamics (MD) simulations. The MD findings of the structural features and enthalpies, as well as their correlation, are consistent with the experimental characterization results of vapor-deposited Ag-Ni amorphous phases.
Performance analysis for complex FastICA algorithms in MIMO OFDM systems

MIMO OFDM systems are applied in IEEE 802.11n wireless communication standard for improvement of transmission ability. In MIMO OFDM systems, to recover mixed source signals in receivers is one of significant objectives. Blind signal separation (BSS) techniques are such suitable methods to separate linearly mixed independent source signals given only observations in receivers of MIMO OFDM systems. Complex FastICA algorithms are important algorithms of BSS techniques and have attracted extensive attention in wireless communication. In this paper, a testing environment based on MIMO OFDM systems is designed to evaluate and compare the performance of a family of complex FastICA algorithms. The performance measures include bit error rate (BER) and the convergence speed. From an engineering point of view, the results obtained from the designed testing environment are very essential, since the research includes most important members of complex FastICA algorithms and such a comprehensive performance analysis need to be done in MIMO OFDM systems.
Clinical and renal biopsy observations in oliguric glomerulonephritis.

Abstract The development of oliguric glomerulonephritis has been seen in five relatively young men (mean age: 29.8 years). Four had bacteriological and/or serological evidence of recent streptococcal infection; the fifth had received early antibiotic therapy for a sore throat. The primacy of these attacks of glomerulonephritis is suggested on the basis of the patients' previous military screening, clinical features, latent period post-infection and initial evaluations of renal size. Three patients who expired were maintained for periods of 4, 7 and 28 weeks (of oliguria or anuria) by dialysis techniques. One totally anuric patient has been on a chronic dialysis program for one year and the second oliguric survivor has been referred for renal homotransplantation. Biopsy and autopsy studies revealed the rapidity with which crescent formation may occur and glomerular obsolescence produce the histopathological picture of chronic glomerulonephritis. Capsular epithelial proliferation appeared to be the most significant morphological and destructive factor, although an early exudative response was prominent in two patients. Two had the autopsy features of Goodpasture's syndrome without evidence of vasculitis. One of these had minimal respiratory symptoms and the second responded rapidly to corticosteroids during three exacerbations of pulmonary involvement, but ultimately succumbed to this aspect of his illness. Such rapid progression of Ellis Type-1 nephritis into a histological picture of chronic glomerulonephritis supports both their pathogenetic relationship and the need for a critical re-assessment of the significance of histopathological classification for the clinician. While the widespread obliterative capsular lesion seems to exclude functional return, chronic dialysis and renal homotransplantation have become realistic alternatives to the previous situation of therapeutic ineffectuality.
It's all in how you view it: pessimism, social relations, and life satisfaction in older adults with osteoarthritis.

Objectives: Current treatments for osteoarthritis (OA) continue to leave those burdened by the condition with pain and disability which affects physical and psychological well-being. The present study examines other psychosocial factors, such as dispositional personality and social relationships, in order to investigate their influence on the well-being of 160 older adults with OA (80% women). Method: Older adults were recruited for self-reported knee or hip OA. Participants completed self-report measures of optimism and pessimism, social support, social strain, and life satisfaction using the computer program MediaLab. Measures were taken twice 9–12 months apart. Results: Results showed that, both cross-sectionally and longitudinally, pessimism was related to lower social support and higher social strain. In addition, pessimism was mediated by social support in its relationship to life satisfaction. Discussion: Our models support the combined roles of pessimism and social support influencing life satisfa...
Strategies for teaching dancers of all abilities.

(2011). Strategies for Teaching Dancers of All Abilities. Journal of Physical Education, Recreation & Dance: Vol. 82, No. 2, pp. 24-31.
The effect of calcium on the bilayer stability of lipids from bovine rod outer segment disk membranes

The phase behavior of bovine rod outer segment disk lipids has been investigated using freeze-fracture and 31P nuclear magnetic resonance (NMR) techniques. 31P-NMR spectra of isolated disk membranes were taken as a function of temperature between 25°C and 45°C. The 31P-NMR spectrum characteristic of phospholipid bilayers was observed at all temperatures both in the absence of Ca2+ and in the presence of 10 mM and 50 mM Ca2+. A similar study was performed on lipids isolated from the disk membranes. In the absence of Ca2+ only lamellar phase behavior was observed. In the presence of less than 10 mM Ca2+, however, there was a change in morphology to non-lamellar structures. Removal of the Ca2+ caused the system to reassume the lamellar form.
Becoming a daughter.

It was just another Wednesday morning. I was sitting in my tiny basement office with a stack of patient charts to my right, a folder opened to the pedigree on my left as I chipped away at summary letters on my outdated computer. My colleague was seeing patients at one of our outreach clinics, the phones were relatively quiet, and I anticipated a quiet and productive day. Suddenly, I realized I hadn’t received my daily e-mail from my mother and had the urge to call her. She picked up the phone on the first ring and I asked how she was and where she’d been that morning. She said, “My annual mammogram was this morning, remember?” “Oh yes, was it good?” A short silence, and then I revised, “Well, not good, of course, I’m sure its never fun, but did it go okay?” Another short silence and then my heart skipped a beat. “Well honey, not really. The radiologist found something.” A short shocked silence, and then the bargaining began. “Found something? Like a small calcification? Perhaps a small DCIS?,” I negotiated with my physician mother, trying to keep any hint of panic from my voice. A measured pause, “Actually honey, she feels that there is an invasive component. They performed a biopsy and we will have the path tomorrow.” I don’t remember what I said next, but I hoped it sounded calm and reassuring. I told her I loved her and hung up the phone.
Hand preference for visually guided reaching in human infants and adults

As the collection of new research reports in this volume shows, the question of handedness in non-human primates has become a subject of intense interest among psychologists and primatologists. The historical evidence also shows that this interest is of long standing (see Harris, Ch. 1, this volume). Still, the question remains controversial. There is a measure of agreement that individual animals show reliable hand preference but no consensus that this is a species characteristic.
Behavioral management of conversion disorder in children

Abstract Objective: To describe the behavioral management of conversion disorder in children and to preliminarily assess its effectiveness. Design: Retrospective case series. Setting: Inpatient pediatric rehabilitation unit. Patients: The first eight patients with conversion disorder treated on our pediatric rehabilitation unit, between 9 and 18 years of age. Six were girls. Three cases are described in detail. Interventions: All patients were treated as inpatients, using a behavioral approach. Inadvertent reinforcement of illness behavior was identified, and a reward system was established for good attainment. Some patients had a "level" system instituted, with increasing privileges for goal achievement. All patients and their families had psychological assessment and instruction in pain and stress management strategies. Main Outcome Measures: Restoration of normal gait and function, independence in activities of daily living (ADL), and symptom recurrence after discharge. Results: All patients attained normal gait and ADL function before discharge. Conclusions: (1) Behavioral management of conversion disorder in children appears to be as effective as in adults, although at times a behavioral reward or "level" system may be necessary for adequate reinforcement. (2) Instruction of the patient and family in appropriate stress and pain management appears key to maintaining treatment effect over time.
Risk factors for central serous chorioretinopathy: A case-control study

Abstract Purpose To identify systemic factors associated with the development of central serous chorioretinopathy (CSCR). Design Retrospective, case–control study. Participants and controls: 312 cases and 312 controls. Results By use of a multivariate analysis, the previously described risk factors, systemic steroid use (odds ratio [OR], 37.1; 95% confidence interval [CI], 6.2–221.8), and pregnancy (OR, 7.1; 95% CI, 1.0–50.7), were strongly associated with CSCR. Additional risk factors identified by this study include antibiotic use (OR, 6.2; 95% CI, 1.0–37.9), alcohol use (OR, 4.9; 95% CI, 1.5–16.3), untreated hypertension (OR, 3.3; 95% CI, 1.3–8.5), and allergic respiratory disease (OR, 2.5; 95% CI, 1.2–5.1). Conclusions A wide variety of systemic factors are associated with CSCR. Prospective studies are warranted to evaluate the nature and significance of these associations further.
Early Autism Identification: In Reply

All the issues raised by Dr Pivalizza are pertinent to developmental surveillance and screening for autism. We agree that access to health care is pivotal to any public health effort. The American Academy of Pediatrics (AAP) is committed to every child's access to a medical home, including children with autism and other developmental disorders.1 The medical home should be linked to an array of specialty services with which children who screen positive for autism can be evaluated to confirm the diagnosis. The child should also be referred to a local early intervention program, coincident with such evaluation.2,3 In the United States, early …