cssi/SciSciGPT-SciSciNet huggingface dataset:
Cervical cancer complicating pelvic organ prolapse, and use of a pessary to restore anatomy for optimal radiation: A case report.

Abstract Cervical cancer is the most common gynecologic malignancy worldwide and the third most common gynecologic cancer in the USA. Improved screening methods such as liquid-based cytology accompanied by Human Papilloma Virus (HPV) co-testing have contributed to a declining incidence of cervical cancer. There are approximately 13,000 new cases per year in the United States, accounting for 4200 deaths (Siegel et al., 2011). Pelvic organ prolapse increases with age, obesity and parity. In the absence of bothersome urinary, gastrointestinal or pressure symptoms, patients may choose conservative management options. The index patient was a 72 year old woman with a known history of pelvic organ prolapse who had been managed by her primary physician for 7 years until she developed new-onset vaginal bleeding. One month following worsening prolapse and increased vaginal bleeding she presented to the emergency department and was evaluated. On physical examination the cervix appeared as an 8 cm exophytic fungating mass extruding from the vagina and bled easily from areas of apparent necrosis. Multiple biopsies confirmed an invasive squamous cell carcinoma. The patient underwent the insertion of a Gelhorn pessary and perineorrhaphy to reduce her procidentia, cystocele and enterocele. Chemotherapy with Cisplatin and radiation therapy in the form of brachytherapy and external beam radiation therapy were then administered with curative intent. Cervical cancer complicating a uterine procidentia in an elderly patient is a rare occurrence in the United States and requires a multidisciplinary approach involving a urogynecologist, a gynecologic oncologist and a radiation oncologist. Nonetheless, in carefully selected patients, the outcome can be successful.
[P294] Dose rate dosimetric effects during 6 MV flattening filter free RapidArc-based on stereotactic body radiation therapy on lung

Purpose As the technology advanced we are able, now to develop treatment plans using 6X Flattening Filter Free (FFF) for RapidArc. We noticed that the dose rate has high fluctuations in value during the treatment delivery for 6X FFF. This prompted us to start monitoring the dose delivered using portal dosimetry. We wish to develop protocols for developing arc treatment plans when using dose rates above 600 MU/min. Methods A retrospective study was performed on 25 patients treated using a Varian TrueBeam machine. The SBRT plans were made using RapidArc technique in Varian’s Eclipse. For 25 treatment plans we measured the dose using the Electronic Portal Imaging Dosimetry (EPID) and the diode detectors via Mapcheck. We also recorded the dose rate variance during the treatment delivery and the dose conformality index. We evaluated the biological effective dose (BED), normal tissue complications probability (NTCP) and tumor control probability (TCP). Results For every treatment delivered the dose rate varies between 100 MU/min and the prescribed rate (600–1400 MU/min). The dosimetric measurements are correlating very well with the dose rate variance. There is also a correlation between the dose rate, the width of the treated fields and the arc’s size. The larger the field the higher the dose rate variance. We also noticed difficulties in passing the complex RapidArc QA measuring plans consistency with the range of the dose rate variation. Biological effectiveness is also affected by the dose rate variance in a percentage between 0.75% and 2.73%. Conclusion We found optimum dose rate for RapidArc with a value of 622 MU/min that allow a minimum dose rate variance of 36 MU/min during the treatment delivery and an optimum field size that in combination with the correct dose rate will generate plans that will deliver the calculated dose rate with a minimum variance and will not depend to the arc’s degrees range.
The Future of Lung Transplantation.

The field of lung transplant has made significant advances over the last several decades. Despite these advances, morbidity and mortality remain high when compared with other solid organ transplants. As the field moves forward, the speed by which progress can be made will in part be determined by our ability to overcome several stumbling blocks, including donor shortage, proper selection of candidates, primary graft dysfunction, and chronic lung allograft dysfunction. The advances and developments surrounding these factors will have a significant impact on shaping the field within the coming years. In this review, we look at the current climate (ripe for expanding the donor pool), new technology (ex vivo lung perfusion and bioengineered lungs), cutting-edge innovation (novel biomarkers and new ways to treat infected donors), and evidence-based medicine to discuss current trends and predict future developments for what we hope is a bright future for the field of lung transplantation.
Mitigation of a novel phase-defect-induced laser damage mechanism on NIF final optics

Operating the National Ignition Facility (NIF) near its power and energy performance limits has revealed a new damage initiation mechanism in the final UV optics. The typical damage event involves the last three optics in the NIF beamline: the final focusing lens, the grating debris shield, and the target debris shield. It occurs on high power shots from intensifications from small phase defects (pits) on the exit surface of the focusing lens that travel through the grating debris shield before reflecting off the AR-coated target debris shield about 75 cm downstream, then propagate back upstream and damage the input surface of the grating debris shield optic which is 15 cm downstream of the focusing lens. Ray tracing has firmly established the direct relationship between the phase defects on the final focusing lens and the damage on grating debris via the reflection from the target debris shield. In some cases, bulk filamentary damage is also observed in the 1-cm thick fused silica grating debris shield. It is not fully understood at this point how there can be enough energy from the reflected beam to cause damage where the forward-going beam did not. It does not appear that interaction between the forward-going beam and the backward-going reflected beam is necessary for damage to occur. It does appear necessary that the target debris shield be previously exposed to laser shots and/or target debris. Furthermore, there is no evidence of damage imparted to the target debris shield or the final focusing lens. We will describe all the conditions under which we have (and have not) observed these relatively rare events, and the steps we have taken to mitigate their occurrence, including identification and elimination of the source phase defects.
Basic and Advanced Echocardiographic Evaluation of Myocardial Dysfunction in Sepsis and Septic Shock

Sepsis continues to be a leading cause of mortality and morbidity in the intensive care unit. Cardiovascular dysfunction in sepsis is associated with worse short- and long-term outcomes. Sepsis-related myocardial dysfunction is noted in 20%-65% of these patients and manifests as isolated or combined left or right ventricular systolic or diastolic dysfunction. Echocardiography is the most commonly used modality for the diagnosis of sepsis-related myocardial dysfunction. With the increasing use of ultrasonography in the intensive care unit, there is a renewed interest in sepsis-related myocardial dysfunction. This review summarises the current scope of literature focused on sepsis-related myocardial dysfunction and highlights the use of basic and advanced echocardiographic techniques for the diagnosis of sepsis-related myocardial dysfunction and the management of sepsis and septic shock.
The Real Effects of Operational Risk: Evidence from Data Breaches

Operational risk poses unique challenges to corporations around the world. However, little is known about the consequences of risk management vulnerabilities on financing costs and firm outcomes. In this paper, I document substantial and persistent effects on financing costs and debt contracting caused by risk management vulnerabilities following data breaches of public firms. Exploiting data breach events between 2005 and 2015, I find that lenders charge breached firms 15 to 20 percent larger spreads, and tighten covenant intensity, consistent with a shift in control rights over cash flows. The effect is larger for breaches of financial information or malicious cyber-attacks, and for firms with lower attention to risk management. Moreover, financial and operating leverage increases, profitability drops, and firms face a higher probability of default. Ex-ante mispricing by banks does not explain these findings.
The Impact of Transitions of Care Pharmacist Services and Identification of Risk Predictors in Heart Failure Readmission

Background:Heart failure (HF) is a prevalent and costly disease state for adult Americans, with 30-day readmissions rates for patients with HF utilized to limit hospital compensation.Objective:To d...
Pathology and genetics of anaplastic large cell lymphoma

Anaplastic large cell lymphomas are a rare subtype of peripheral/mature T-cell lymphomas which are clinically, pathologically and genetically heterogeneous. Both ALK-positive (ALK+) and ALK-negative (ALK-) ALCL are composed of large lymphoid cells with abundant cytoplasm and pleomorphic features with horseshoe-shaped and reniform nuclei. ALK+ ALCL were considered as a definite entity in the 2008 World Health Organization classification of hematopoietic and lymphoid tissues. ALK-ALCL was included as a provisional entity in the WHO 2008 edition and in the most recent 2017 edition, it is now considered a distinct entity that includes cytogenetic subsets that appear to have prognostic implications (e.g. 6p25 rearrangements at IRF4/DUSP22 locus). ALK+ ALCLs are distinct in epidemiology and pathogenetic origin and should be distinguished from ALK-ALCL, cutaneous ALCL and breast implant associated ALCL which have distinct clinical course and pathogenetic features. Breast implant-associated ALCL is now recognized as a new provisional entity distinct from other ALK-ALCL; notably that it is a noninvasive disease associated with excellent outcome. In this article, we will provide an overview of the salient themes relevant to the pathology and genetic mechanisms in ALCL.
Preparing Residents for Children With Complex Medical Needs

“Patient in room 26 with respiratory distress, saturating 88%. Please assess ASAP.” My stomach drops as the message scrolls across my pager. Although the task of assessing acute hypoxemia as an intern makes me nervous, I recognize most of my anxiety centers on doing so in a child with complex medical needs like this patient, Mary. Mary suffered a perinatal hypoxic event that has led to multiple chronic medical problems, including seizure disorder, intellectual disability, tracheostomy dependence, and gastrostomy tube dependence. She was admitted for altered mental status of unclear cause. With little experience treating hospitalized children with similar medical complexity, her imposing list of comorbidities, medications, and confusing medical equipment have made it challenging for me to care for her as effectively as I would like. As I enter the room to examine Mary, her thin chest heaves effortfully as saliva pools around her tracheostomy site. Her eyes convey a sense of panic that requires no translation, a fear that I share as I recognize my lack of experience troubleshooting respiratory distress in patients with tracheostomies. I call my senior resident who arrives promptly and provides much-needed clarity: deep suction resolves the hypoxemia without requiring transfer to the PICU. Reflecting on this encounter later, I found my primary response was one of shame, something I would experience recurrently intern year when encountering challenging clinical scenarios for … Address correspondence to Benjamin W. Frush, MD, MA, Vanderbilt Internal Medicine and Pediatrics Residency Program, Vanderbilt University Medical Center, 1215 21st Ave S, Medical Center East 7th Floor, Suite 2, Nashville, TN 37232-8300. E-mail: benjamin.w.frush{at}vumc.org
Detection of Saccades and Quick-Phases in Eye Movement Recordings with Nystagmus

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo and dizziness. Patients with those symptoms can be diagnosed by the presence of a specific pattern of nystagmus during the Dix-Hallpike maneuver. However, almost half of dizzy patients visiting Emergency Department (ED) are misdiagnosed, leading to significant morbidity and high medical costs. This can be attributed to the lack of specialized expertise of front-line physicians and to the lack of validated automatic commercial devices and software for nystagmus detection and quantification. Here we aim to enhance saccade detection thereby improving automatic nystagmus quantification. The proposed method is evaluated on a nystagmus dataset recorded from patients in the ED as they undergo the Dix-Hallpike maneuver. Additionally, the proposed method is also tested on a publicly available saccade dataset and compared with state-of-the-art eye movement detection methods.
County-Level Variation in Utilization of Surgical Resection for Early-Stage Hepatopancreatic Cancer Among Medicare Beneficiaries in the USA

Geographic variations in access to care exist in the USA. We sought to characterize county-level disparities relative to access to surgery among patients with early-stage hepatopancreatic (HP) cancer. Data were extracted from the Surveillance, Epidemiology, and End Results (SEER)-Medicare Linked database from 2004 to 2015 to identify patients undergoing surgery for early-stage HP cancer . County-level information was acquired from the Area Health Resources Files (AHRF). Multivariable logistic regression analysis was performed to assess factors associated with utilization of HP surgery on the county level. Among 13,639 patients who met inclusion criteria, 66.9% (n = 9125) were diagnosed with pancreatic cancer and 33.1% (n = 4514) of patients had liver cancer. Among patients diagnosed with early-stage liver and pancreas malignancy, two-thirds (n = 8878, 65%) underwent surgery. Marked county-level variation in the utilization of surgery was noted among patients with early-stage HP cancer ranging from 57.1% to more than 83.3% depending on which county a patient resided. After controlling for patient and tumor-related characteristics, counties with the highest quartile of patients living below the poverty level had 35% lower odds of receiving surgery for early stage HP cancer compared patients who lived in a county with the lowest proportion of patients below the poverty line (OR 0.65, 95% CI 0.55–0.77). In addition, patients residing in counties with the highest surgeon-to-population ratio (OR 2.01, 95% CI 1.52–2.65), as well as the highest hospital bed-to-population ratio (OR 1.29, 95% CI 1.07–1.54), were more likely to undergo surgical treatment for an early-stage HP malignancy. Area-level variations among patients undergoing surgery for early-stage HP cancer were mainly due to differences in structural measures and county-level factors. Policies targeting high-poverty counties and improvement in structural measures may reduce variations in utilization of surgery among patients diagnosed with early-stage HP cancer.
Borrelia miyamotoi strain LB-2001 retains plasmids and infectious phenotype throughout continuous culture passages as evaluated by multiplex PCR.

Abstract Borrelia miyamotoi is a tick-borne spirochete of the relapsing fever borrelia group and an emerging pathogen of public health significance. The genomes of relapsing fever borreliae and Lyme disease borreliae consist of multiple linear and circular plasmids in addition to the chromosome. Previous work with B. burgdorferi sensu lato found diminished infectivity upon continuous in vitro culture passage that was attributable to plasmid loss. The effect of long-term culture passage on B. miyamotoi is not known. We generated a series of plasmid-specific primer sets and developed a multiplex PCR assay to detect the 14 known plasmids of B. miyamotoi North American strains LB-2001 and CT13−2396. We assessed the plasmid content of B. miyamotoi LB-2001 over 64 culture passages spanning 15 months and determined that strain LB-2001 retained all plasmids upon prolonged in vitro cultivation and remained infectious in mice. We also found that strain LB-2001 lacks plasmid lp20−1 which is present in strain CT13−2396. These results suggest that B. miyamotoi remains genetically stable when cultured and passaged in vitro.
Contribution of viral infection to risk for cancer in systemic lupus erythematosus and multiple sclerosis

Patients with autoimmune disorders (AD) have altered cancer risks compared to the general population. Systemic lupus erythematosus and multiple sclerosis lead to a heightened risk for hematological malignancies and decreased risk for breast, ovarian, and prostate malignancies. Often patients with autoimmune disease have dysregulated antiviral immune responses, including against oncogenic viruses. To uncover the relationship between viral incidence and cancer risk in the context of autoimmune disease, we extracted electronic health records (EHR) from Vanderbilt University. ICD-9/10 codes and laboratory values were collected for hematological, lung, anal-vaginal, thyroid, hepatobiliary, bladder, prostate, and breast cancers; and viruses including Epstein Barr virus (EBV), Human papilloma virus (HPV), and Hepatitis A/B/C (Hep). Only viral infections that led to a physician visit or laboratory test were entered into the EMR; therefore, only clinically relevant cases were noted and considered positive in this study. The relationship between virus infection and cancer in an SLE cohort (SLE-cases n = 2,313, and SLE-controls n = 5,702) and an MS cohort (MS-case n = 7,277, MS-control n = 7,277) was examined by multilinear logistic regression. Viral infection was strongly associated with increased risk for cancer overall. SLE and MS patients were more susceptible to all viral infections. MS patients trended toward increased risk for cancers overall, while decreased risk for hormone-based cancers in SLE patients non-significantly reduced their risk for overall cancer. Both SLE and MS patients had increased clinically relevant EBV infection, which was associated with risk for hematological cancers. Preventing viral infections by vaccination may be especially helpful in controlling risk for cancer in SLE and MS patients.
A framework for constructing linear free energy relationships to design molecular transition metal catalysts

A computational framework for ligand-driven design of transition metal complexes is presented in this work. We propose a general procedure for the construction of active site-specific linear free energy relationships (LFERs), which are inspired from Hammett and Taft correlations in organic chemistry and grounded in the activation strain model (ASM). Ligand effects are isolated and quantified in terms of their contribution to interaction and strain energy components of ASM. Scalar descriptors that are easily obtainable are then employed to construct the complete LFER. We successfully demonstrate proof-of-concept by constructing and applying an LFER to CH activation with enzyme-inspired [Cu2O2]2+ complexes. The key benefit of using ASM is a built-in compensation or error cancellation between LFER prediction of interaction and strain terms, resulting in accurate barrier predictions for 37 of the 47 catalysts examined in this study. The LFER is also transferable with respect to level of theory and flexible towards the choice of reference system. The absence of interaction-strain compensation or poor model performance for the remaining systems is a consequence of the approximate nature of the chosen interaction energy descriptor and LFER construction of the strain term, which focuses largely on trends in substrate and not catalyst strain.
Effect of Lung Blocks Parameters on Lung and Cardiac Doses in Total Body Irradiation Using 3D Dosimetry.

Purpose/Objective(s) Despite being an integral part of stem cell transplant, the technical aspects of classical total body irradiation (TBI) remain relatively crude. In particular, the implementations of lung and cardiac shielding vary widely between institutions. We hypothesize that the block margins away from anatomical landmarks could substantially alter lung and cardiac dose parameters, and thus affecting the likelihood of TBI-related toxicities such as radiation pneumonitis and late cardiotoxicities. This work seeks to utilize a newly commissioned 3D TBI beam model to determine potential dosimetric effects caused by variations in the choice of shielding parameters to better understand the potential for such detrimental effects. Materials/Methods We commissioned a TBI beam model in a treatment planning system. CT scans of 3 anonymized patients without gross disease are contoured following typical clinical practice. Patients are planned in the classic standing AP/PA at extended distance technique for a total dose of 1200 cGy in 6 fractions to midline at umbilicus level, with 3/6 fractions delivered with lung blocks. Lung blocks are modeled using automated script in the treatment planning system, with varying superior (from clavicles), inferior (from diaphragms), and lateral margins from 0 to 2 cm, as well as cases for which the cardiac silhouette was blocked or unblocked for the study. Dose to lungs and heart were calculated and compared for the following metrics: mean dose, volume receiving 10 Gy (V10 Gy) and 12 Gy (V12 Gy), and point dose behind the blocks. Results The results showed that the point dose behind the blocks is approximately 75% of prescription dose for all patients, with insignificant changes with varying block margins. The dose off the block center increases rapidly that much of the tissue under the blocks receives 80% to 90% of prescription dose. Similar results are observed for mean lung dose. In contrast, the lung V10 Gy increases by nearly two-fold, from approximately 30% to 60% over the 0 to 2 cm block margin range. The mean heart dose increased by approximately 7.5% when the cardiac silhouette is unblocked, while the cardiac V12 Gy increased by approximately 25%. The mean dose to left anterior descending artery (LAD) increases significantly in the unblocked case, with as much as 43% difference. Conclusion This work has shown that margins of lung blocks could affect the dose to lungs and heart substantially, despite the indifference that the commonly used point dose parameter, point dose behind the blocks, indicates. A 3D TBI model could provide more dosimetry data to help future studies to correlate TBI-associated toxicity to the heart and lungs.
Addressing Childhood Obesity: Opportunities for Prevention

The overweight and obesity epidemic among children and adolescents in the United States continues to worsen, with notable racial, ethnic, and socioeconomic disparities. Risk factors for pediatric obesity include genetics; environmental and neighborhood factors; increased intake of sugar-sweetened beverages (SSBs), fast-food, and processed snacks; decreased physical activity; shorter sleep duration; and increased personal, prenatal, or family stress. Pediatricians can help prevent obesity by measuring body mass index at least yearly and providing age- and development-appropriate anticipatory guidance to families. Public policies and environmental interventions aim to make it easier for children to make healthy nutrition and physical activity choices. Interventions focused on family habits and parenting strategies have also been successful at preventing or treating childhood obesity.
Firm Internationalization: A Comparison of Current Models

There are many taxonomical models of firm internationalization currently in use. Because the models were developed by various authors for various research purposes, it is quite possible to describe one firm using a number of labels. This paper presents and explains a number of models. The stage of the models are compared to assist researchers in the selection of the appropriate model to meet specific research objectives and to assist in the understanding of other researchers’ works.
Sample Size Planning

Sample size planning is the systematic approach to selecting the number of participants to include in a research study so that some specified goal or set of goals can be satisfied with the minimum sample size. Sample size planning addresses the question, “What size sample should be used in this study?” However, an answer to an appropriate sample size question must be based on the particular goal(s) articulated by the researcher. Because of the variety of research questions that can be asked and the multiple inferences made in many studies, planning an appropriate sample size is not often straightforward. The appropriate sample size depends at least on the research questions of interest, the statistical model used, the assumptions specified in the sample size planning procedure, and the goal(s) of the study. Keywords: experimental methods; power; research design; sample size; statistical power
C) Means to enhance penetration

Abstract Recent advances in biotechnology and the increasingly availability of proteins and of peptides with potential therapeutic applications have generated a renewed necessity for the controlled delivery of this class of macromolecules. Due to their large size and hydrophilic nature, these proteins and peptides are incapable of permeating cellular membranes without the assistance of specific cell-membrane transporters or carriers. Although cellular uptake of proteins is dependent upon endocytosis, passage through endothelial and epithelial barriers, i.e., transcytosis, will govern delivery from the site of administration to the site of action. The transport of proteins can be achieved by either modification of the native protein or attachment to receptor-specific or membrane-adsorptive carrier molecules. The design of an effective macromolecular drug carrier system requires an understanding of these intricate cellular transport and processing mechanisms. In some cases these processes can be manipulated in a pharmacological manner in order to improve significantly their transport. The exploitation of endocytotic and transcytotic processes is likely to become useful for the delivery of therapeutic proteins as well as other desirable macromolecules.
Comparison of selected physiological and personality variables in regular and nonregular adult male exercisers.

Abstract The purpose of this study was to compare regular and nonregular adult exercisers on selected physiological and personality measures over a four-year period. Forty-eight participants in the 1971 Purdue Adult Fitness Program were retested four years later. As a result three groups of 16 subjects each were established, based on responses to an Exercise and Leisure Questionnaire. Relevant physiological data were collected and physical fitness scores were obtained for each subject using the criterion of Ismail and others. Personality traits were assessed using the same form of the Cattell 16 Personality Factor Questionnaire as both pre- and posttests. The data were analyzed at both test periods using the ANOVA technique. The effect of different activity levels was assessed by several fitness parameters such as percent lean body weight, resting and submaximal heart rates, submaximal RQ, [Vdot]O2 max, and physical fitness score. The two regularly active groups increased significantly in physical fitness...
An enhancement to speed estimation using single loop detectors

Speed estimation plays an important role in many components in intelligent transportation systems (ITS). In practice, traffic data from single loop detectors are one of the dominant data sources. Speed estimation from single loop detectors is mainly based on occupancy data, a conversion factor from occupancy to density (which is potentially related to the vehicle length), and the assumed relationship between flow, speed, and density. This paper investigates the discrepancy between the speed estimated with single loops and the speed estimated with double loops. It was found that the discrepancy between the two is mainly caused by the high variance in vehicle pace, which, especially under congested traffic, is often accompanied with the high skewness. Accuracy can be improved by computing occupancy in a different way, using the median vehicle passage time over the detector as opposed to the mean vehicle passage time often used in the conventional method. The performance of the enhanced speed estimation method is very promising. The use of the median vehicle passage time reduces the skewness of pace data.
Graph-theoretical methods in computer vision

The management of large databases of hierarchical (e.g., multi-scale or multilevel) image features is a common problem in object recognition. Such structures are often represented as trees or directed acyclic graphs (DAGs), where nodes represent image feature abstractions and arcs represent spatial relations, mappings across resolution levels, component parts, etc. Object recognition consists of two processes: indexing and verification. In the indexing process, a collection of one or more extracted image features belonging to an object is used to select, from a large database of object models, a small set of candidates likely to contain the object. Given this relatively small set of candidates, a verification, or matching procedure is used to select the most promising candidate. Such matching problems can be formulated as largest isomorphic subgraph or largest isomorphic subtree problems, for which a wealth of literature exists in the graph algorithms community. However, the nature of the vision instantiation of this problem often precludes the direct application of these methods. Due to occlusion and noise, no significant isomorphisms may exists between two graphs or trees. In this paper, we review our application of spectral encoding of a graph for indexing to large database of image features represented as DAGs. We will also review a more general class of matching methods, called bipartite matching, to two problems in object recognition.
Information in prices about future earnings

Abstract Stock return over a period reflects the market's revision in expectation of future earnings. Accounting earnings over the same period, however, have limited ability to reflect such revised expectations. Therefore, returns anticipate earnings changes and the earnings response coefficient from a regression of returns on contemporaneous earnings changes is biased toward zero. We reduce this bias by including leading-period returns in price-earnings regressions. The resulting estimated earnings response coefficient magnitudes suggest that the capital market, on average, views earnings changes to be largely permanent. This is consistent with the random walk time series property of annual earnings.
Modeling interconnect behavior with a calibrated FEM model

As dimensions continue to shrink and device densities increase, power and heat dissipation become an ever-increasing challenge. In this work, we investigate heat flow ramifications for a variety of very simple patterns. We start by describing the use of a finite element method (FEM) tool. This includes a brief description of the modeling procedure. The model results, for a given set of boundary conditions, are then compared to the physical measurements for that structure. Excellent agreement is demonstrated, thus calibrating the model. We then extend this model to structures for which we have no physical measurements. As importantly, we extend this model to structures and patterns that may be desirable for the next generation.
Studies on the electron transport system. III. The properties of two modified forms of ETP.

Some enzymic properties and the composition of two modified forms (I and II) of the electron transport particle (ETP) have been examined. Such preparations contain per mg of protein 0.42·10−3 μmole of flavin, 2.5·10−3 μmoles of heme, 6.2·10−3 μmoles of non-heme iron and 2.4·10−3 μmoles of copper—the molecular or atomic ratios being in round numbers 1:6:15:6. The antimycin titer of the preparations was 0.5·10−3 μmole/mg. The oxido-reduction of the prosthetic hemes in presence of DPNH and oxygen has been demonstrated. Heme reduction was partially inhibited by antimycin. The absorption spectrum of the enzyme indicates the presence of at least two groups of hemes—one group with bands at 563, 554, 535 and 525 mμ—the other with a band at 603 mμ.
Association between CpG Island Methylation and Microsatellite Instability in Colorectal Cancer

De novo methylation of promoter region CpG islands has been increasingly associated with transcriptional inactivation of important genes in neoplasia. To study the potential mechanisms underlying aberrant methylation in cancer, we have determined the methylation patterns of selected genes in colorectal cancers with and without microsatellite instability (MI), which results from defects in one of several base mismatch repair genes. A total of 47 colorectal cancers were analyzed, of which 15 were MI+ (32%). We now report that both the frequency and the extent of de novo methylation are strikingly increased in MI+ cancers. Hypermethylation of the p16 gene was found in 60% of MI+ cancers, compared to only 22% in MI- cancers (P = 0.02). Similarly, hypermethylation of the thrombospondin-1 (TSP-1) gene, an angiogenesis inhibitor, was increased in MI+ cancers (27% versus 0%; P = 0.008). Extensive methylation of insulin-like growth factor II (IGF2) and hypermethylated in cancer-1 (HIC-1) genes was observed in 60 and 80% of MI+ cancers, respectively, as contrasted with 6 and 38% of MI- cancers (P = 0.0002 and 0.01, respectively). Furthermore, 60% of the MI+ cancers displayed the hypermethylation events at two or more loci in a concordant manner compared to only 9% of the MI- cancers (P < 0.001). These results demonstrate a strong link between promoter hypermethylation and genetic instability due to deficient DNA repair.
Simultaneous ex vivo Functional Testing of Two Retinas by in vivo Electroretinogram System

An In vivo electroretinogram (ERG) signal is composed of several overlapping components originating from different retinal cell types, as well as noise from extra-retinal sources. Ex vivo ERG provides an efficient method to dissect the function of retinal cells directly from an intact isolated retina of animals or donor eyes. In addition, ex vivo ERG can be used to test the efficacy and safety of potential therapeutic agents on retina tissue from animals or humans. We show here how commercially available in vivo ERG systems can be used to conduct ex vivo ERG recordings from isolated mouse retinas. We combine the light stimulation, electronic and heating units of a standard in vivo system with custom-designed specimen holder, gravity-controlled perfusion system and electromagnetic noise shielding to record low-noise ex vivo ERG signals simultaneously from two retinas with the acquisition software included in commercial in vivo systems. Further, we demonstrate how to use this method in combination with pharmacological treatments that remove specific ERG components in order to dissect the function of certain retinal cell types.
Normative Values for Sudomotor Axon Reflex Testing using QSWEAT™ (P1.282)

OBJECTIVE: To establish normative values for QSWEAT™ in a large volunteer cohort. BACKGROUND: The indirect sudomotor response to iontophoresis of acetylcholine provides valuable information about the integrity of postganglionic sudomotor fibers. This methodology has been used for many years as Quantitative Sudomotor Axon Reflex Test (QSART) using proprietary equipment. A commercially available device (QSWEAT™) is now widely used in autonomic laboratories. Studies have shown that QSART- and QSWEAT™-derived sweat volumes - although strongly correlated - differ in magnitude. Previously reported normative values for QSART are therefore not suitable for QSWEAT™. DESIGN/METHODS: Over 400 healthy volunteers were recruited at the University of Hawaii and Mayo Clinic Rochester. All subjects underwent routine autonomic function testing using standardized environmental and skin temperature control. Acetylcholine (10[percnt] solution/gel) was iontophoresed into skin at four standardized sites. The evoked sweat response was measured using QSWEAT™ equipment. RESULTS: The sweat response distribution revealed increasing sweat volumes with age until a stable plateau was reached by age 20 with again decreasing sweat volumes beyond age 70. We therefore combined the data of subjects between ages 20 and 69 years for percentile calculations of adult normative values. Data of the young (≤19) and elderly (蠅70) were analyzed separately. 376 volunteers fell in the age range 20-69 years (men=148, women=228). Sweat volumes were significantly lower in women, but there was no significant difference by study site. The 5th percentiles of normal in the adult age range were (female/male): Forearm: 0.08/0.25; Proximal Leg: 0.19/0.48; Distal Leg: 0.14/0.62; Foot: 0.07/0.15mcl. CONCLUSIONS: We present normative values and suggested cut-offs of normal for sudomotor testing using QSWEAT™. Sweat volumes plateaued between ages 20-69, and were as expected markedly lower in women. Inspite of climate and racial differences, sweat volumes were not different between study sites. Supported by NIH (P01NS44233, U54NS065736, K23NS075141, UL1RR24150), Mayo Funds. Disclosure: Dr. Sletten has nothing to disclose. Dr. Grandinetti has nothing to disclose. Dr. Weigand has nothing to disclose. Dr. Gehrking has nothing to disclose. Dr. Gehrking has nothing to disclose. Dr. Low has received personal compensation for activities with Chelsea Therapeutics, Pfizer Inc., and WR Medical Electronics Company as a consultant. Dr. Singer has received license fee payments from Jacobus Pharmaceutical.
How McGruff and the Crying Indian Changed America: A History of Iconic Ad Council Campaigns

In How McGruff and the Crying Indian Changed America: A History of Iconic Ad Council Campaigns, Wendy Melillo offers the backstory to six Ad Council public service announcement campaigns (and a sev...
Marijuana and body weight

Acute marijuana use is classically associated with snacking behavior (colloquially referred to as "the munchies"). In support of these acute appetite-enhancing effects, several authorities report that marijuana may increase body mass index in patients suffering from human immunodeficiency virus and cancer. However, for these medical conditions, while appetite may be stimulated, some studies indicate that weight gain is not always clinically meaningful. In addition, in a study of cancer patients in which weight gain did occur, it was less than the comparator drug (megestrol). However, data generally suggest that acute marijuana use stimulates appetite, and that marijuana use may stimulate appetite in low-weight individuals. As for large epidemiological studies in the general population, findings consistently indicate that users of marijuana tend to have lower body mass indices than nonusers. While paradoxical and somewhat perplexing, these findings may be explained by various study confounds, such as potential differences between acute versus chronic marijuana use; the tendency for marijuana use to be associated with other types of drug use; and/or the possible competition between food and drugs for the same reward sites in the brain. Likewise, perhaps the effects of marijuana are a function of initial weight status-i.e., maybe marijuana is a metabolic regulatory substance that increases body weight in low-weight individuals but not in normal-weight or overweight individuals. Only further research will clarify the complex relationships between marijuana and body weight.
Quantum-well Inp-Inl−xGaxPl−zAsz heterostructure lasers grown by liquid phase epitaxy (LPE)

By means of computer-controlled liquid-phase epitaxy (LPE), undoped single-and multiple-quantum-well InP-Inl-xGaxPl-zAsz (x∼0.13, z∼0.29) heterostructures of uniform well (Lz∼150 A) and coupling barrier size (200–300A ) have been grown and examined in photolumi-nescence. Undoped samples are used to eliminate problems with impurities and to make possible study of the fundamental properties of quaternary quantum-well heterostructures. For a single quaternary quantum-well heterostructure of small enough well size (Lz∼150A), which still collects holes but not electrons (electron scattering length >LZ), hot-electron (p2/2mn∼ΔEc) recombination from Ec(InP) to bound holes in the valence-band well (i.e., to Ev(InGaPAs)), leads to stimulated emission in a band ∼ 80 meV below Eg(InP) and thus to an estimate of Δ Ev∼ 80 meV (ΔEc∼2×ΔEv) for the InP-InGaPAs valence-band discontinuity. On rectangular samples of multiple quantum-well LPE InP-In1-xGaxP1-zAsz heterostructures laser operation has been identified on LO phonon sidebands located below the lowest confined-particle transitions. A 5-barrier, 6-well quaternary quantum-well heterostructure exhibits phonon-assisted laser operation shifted in energy below confined-particle transitions by an InGaAs-like phonon (¯hωL0∼31 meV) and for an 11-barrier, 12-well heterostructure shifted by an InP-like phonon (¯hωL0∼43 meV). The 11+12 quaternary quantum-well heterostructure is shown to be capable of operating as a room temperature continuous (CW, 300K) laser (¯hω<Eg ) .
Contingency awareness and interpersonal attraction

The role of contingency awareness in research concerned with attitude similarity and interpersonal attraction was investigated by using both a traditional attitude questionnaire and a correlated attitude questionnaire procedure for manipulating attitude similarity. The results showed that the correlated questionnaire procedure led to fewer subjects who were judged to be contingency aware. Both of the procedures led to replications of the often reported finding that interpersonal attraction is directly related to the proportion of attittude similarity between two people. This effect was obtained both for subjects who were judged to be contingency aware and for subjects who were not so judged.
ETHICAL DILEMMAS FACED BY CRITICAL CARE NURSES IN CLINICAL PRACTICE: Walking the Line

The experience of the critical care nurse includes frequent ethical dilemmas, both in patient care and in professional relationships. The moral development of the critical care nurse is presented in terms of learning theory, perceptive transformation, and ethical theory as it applies to the predominantly female profession of nursing. Four case studies and verbatim accounts of the experiences of critical care nurses illustrate moral development.
Sedimentary Fabrics of Debris Flow-Dominated, Stream-Modified Alluvial Fan, Saline Valley, California: ABSTRACT

Although depositional sequences in alluvial-fan deposits may reflect tectonic activity, they are difficult to distinguish from those produced by changes of climate or by local aggradation. This presentation deals with an alluvial fan depositional style that occurs in arid conditions in which rare, large-scale debris flows are modified by more frequent, but small-scale, stream floods. Recognition of this type of deposition in an alluvial-fan succession could indicate change of climate and aggradational sequences may be seen by changes in its fabric. A small alluvial fan in Saline valley, California, was described from apex to toe to determine the types of fabrics produced and their relative distributions. Debris flows produce levees and lobes which appear as 1 to 3 m high mounds of poorly sorted, matrix-supported conglomerates. These mounds become lower, less regularly distributed downfan and disappear before the fan toe. The tops and outer edges of levees and lobes have the largest boulders, which are tightly packed in a near-vertical, imbricatelike pattern. Fan-toe debris-flow fabric is 1 to 10-cm thick pebbly mud sheets with irregular lines of isolated cobbles. The small streams are deeply incised between levees at the fan apex, shallow and anastomosing around levees and lobes at mid-fan, and braided at the fan toe. Deep chann ls are floored by step patterns produced by partly or completely exhumed debris-flow boulders with fine gravel or sand deposited on the upstream side. Shallow channels have two major fabrics: (1) 5 to 20-cm high hummocks of poorly sorted, muddy gravel surrounded by fine gravel and sand with better sorting, and (2) muddy, moderately well-sorted gravel in which the long axes are horizontal and oriented parallel with flow. The braided channels at the fan toe are dominated by horizontally discontinuous lamination and abundant mud intraclasts. Windblown sand commonly accumulates in channels, preserving mud curls and mud drapes from the last flood. All fabrics observed in the small fan in Saline valley were also seen in larger fans there and in several other Mojave basins. These fabrics were also found in some Triassic alluvial-fan deposits in New Jersey. End_of_Article - Last_Page 633------------
Formation of functional polyethersulfone electrospun membrane for water purification by mixed solvent and oxidation processes

Most water-based filtration applications of electrospun nanofibrous membranes require the substrate to possess suitable strength, wettability and permeability, where the size, inter-fiber adhesion and hydrophilicity of electrospun nanofiber must be carefully controlled in order to meet these criteria. In this study, we demonstrate the fabrication of high quality polyethersulfone (PES) nanofibrous membranes that are particularly useful for water purification. Two treatments were illustrated that can significantly improve the mechanical property and hydrophilicity of the PES membrane without compromising its porosity and water permeance. The first treatment involves the use of mixed solvents (DMF/NMP), containing a high vapor pressure component (NMP), where the mechanical properties (e.g. modulus and strength) of the membrane are improved by solvent-induced fusion of inter-fiber junction points. The second method involves the short time oxidation treatment with a strong oxidant (ammonium persulfate), where the hydrophilicity of the membrane is greatly increased.