cssi/SciSciGPT-SciSciNet huggingface dataset:
Phase I: Abbreviated Surgery (General Surgery)

There are some important concepts worth considering regarding general surgery for the unstable trauma patient in whom a damage control approach might be considered. Most important is the fact that rarely is the true source of blood loss known prior to exploration. In that regard, the team must be well versed in multiple operative exposures, and individuals must have a keen understanding of their roles within the operative team. This chapter will cover concepts for controlling hemorrhage in the exsanguinating trauma patient. It is intended to supplemnt basic surgical principles with informed deicision making to preserve life and minimize complications associated with life threatening hemorrhage. Detailed definative management of the injuries can be found elsewhere in this text.
Photovoice and Youth Empowerment in Environmental Justice Research: A Pilot Study Examining Woodsmoke Pollution in a Pacific Northwest Community

Woodsmoke pollution is an environmental justice issue for youth living in certain Pacific Northwest cities. Participatory methods such as Citizen Science and Photovoice are effective ways to involve youth in environmental justice research. Little is understood about how youth may be empowered to address woodsmoke issues in their communities. We examined youth empowerment in a citizen science study on woodsmoke, using Photovoice methodology. Ten diverse youth collected and analyzed indoor air samples and photos, then presented their findings to the community and policy makers. Entrance and exit surveys revealed an increased sense of empowerment to take action on woodsmoke pollution. Youth also expressed increased optimism and a resolve to become scientists to combat environmental injustices.
Contraceptive counseling in reproductive-aged women treated for breast cancer at a tertiary care institution: a retrospective analysis

Abstract Objective The objective was to assess the frequency of documented contraceptive and fertility preservation counseling for women treated for breast cancer. Study design We conducted a chart analysis of female breast cancer patients (n=211) ages 18–45 years receiving chemotherapy treatment at Stanford Comprehensive Cancer Center from 2010 to 2014. Primary outcomes of contraceptive counseling and fertility preservation counseling documentation were assessed for frequency. Secondary outcomes included pregnancy testing, contraception use and pregnancy during treatment. Results Among the total sample (n=211), sexual activity was documented in 24% of patients (n=51). Fifty-one percent (n=108) of patients received pregnancy testing prior to initiation of treatment. Past contraception use was documented in 74% of patients (n=156) and current contraception use in 25% (n=53). Twenty-six percent of patients received fertility preservation counseling alone (n=54), 10% received contraceptive counseling alone (n=22), and 12% received both types of counseling (n=25). Patients were three times more likely to receive contraceptive counseling if using contraception at diagnosis [odds ratio (OR) 3.1, confidence interval (CI) 1.1–9.1, p=.04], and older women were significantly less likely to receive counseling (OR 0.2, CI 0.1–1.0, p=.04). Two patients became pregnant and had an abortion during treatment (1%), and neither patient was using contraception nor received contraceptive or fertility preservation counseling. Conclusions Documentation of fertility preservation counseling occurs more frequently than contraceptive counseling, but both occur suboptimally. Lack of documentation does not allow us to conclude that counseling did not occur, but it suggests the need to improve documentation and increase awareness of contraceptive needs and counseling. Implications Women undergoing breast cancer treatment do not consistently receive counseling on contraception or fertility preservation as a part of their care. Efforts are needed to ensure that women treated for breast cancer routinely receive counseling about fertility preservation and contraceptive options.
Computational Cognition and the Age of Supercomputing: Using High-Performance Computing and Usenet to Model Memory, Meaning and the Mind

The Hyperspace Analogue to Language (HAL) model of memory learns what words mean using a simple learning algorithm on 320 million words of Usenet text. The meanings of words are represented in a 140,000 dimensional hyperspace. A variety of metrics are developed in the model have broad explanatory power that captures a range of cognitive phenomena in normal, aging, and disordered individuals. These meaning representations cut across traditional semantic, grammatical, syntactic boundaries making the model useful for a variety of applications such as information retrieval, ambiguity resolution, automatic categorization, and content filtering. The advantage of these models is that they use learning procedures that scale up to real world language problems and make explicit the processes by which systems learn.
Abstract WP249: The “Bucket Test” may Improve Detection of Stroke in Patients With Acute Dizziness

The diagnosis of a stroke in the emergency department (ED) can be difficult when a patient presents primarily with dizziness. Approximately 1/3 of such patients are misdiagnosed with a benign ear c...
Architecture within a circular economy: Process mapping a resource-based design-bid-build project delivery system

In this paper, we develop a novel method for integrating system thinking into architectural design by mapping its processes in a standard process modeling language. We structured a decision-support framework using process mapping workflows to incorporate sustainable building materials and resource-based design decisions into the architectural practice. We turned to other disciplines’ knowledgebases, such as Business Information Technology (BIT), to develop a workflow for the Design-Bid-Build project delivery method (DBB). Mapping both current and the proposed design processes, including their activities, workflow, and decision nodes, was critical in defining roles, flow of information, and subsequent decisions. In this study, we utilized a qualitative methodology to capture the required knowledge from industry experts in resource-based design and then integrated our findings into a set of process maps to support the materials decisions by the architectural project team. This study establishes a system of information exchange to support the growth of the newly emerging industry of reuse stores and vendors. Through numerous interviews and knowledge capturing sessions with industry experts from the building material reuse industry that acknowledged an absence of a "system of information exchange." It is through this study that an overall system of information exchange will connect the links between the reuse industry and the AEC industry. The primary outcome of this study is a structured process for design with resource reuse. This process will redefine the DBB traditional design process by introducing new procedures, define information exchange and identify key decisions within the proposed processes, define responsibilities and identify key stakeholders. The author conducted an extensive multi-year knowledge capturing process with constructive feedback from the industry experts.
Aberrant expression of p16 INK4a in human cancers - a new biomarker?

The ARF and INK4a genes are located in the same CDKN2a locus, both showing its tumor suppressive activity. ARF has been shown to detect potentially harmful oncogenic signals, making incipient cancer cells undergo senescence or apoptosis. INK4a, on the other hand, responds to signals from aging in a variety of tissues including islets of Langerhans, neuronal cells, and cancer stem cells in general. It also detects oncogenic signals from incipient cancer cells to induce them senescent to prevent neoplastic transformation. Both of these genes are inactivated by gene deletion, promoter methylation, frame shift, and aberrant splicing although mutations changing the amino acid sequences affect only the latter. Recent studies indicated that polycomb gene products EZH2 and BMI1 repressed p16INK4a expression in primary cells, but not in cells deficient for pRB protein function. It was also reported that that p14ARF inhibits the stability of the p16INK4a protein in human cancer cell lines and mouse embryonic fibroblasts through its interaction with regenerating islet-derived protein 3γ. Overexpression of INK4a is associated with better prognosis of cancer when it is associated with human papilloma virus infection. However, it has a worse prognostic value in other tumors since it is an indicator of pRB loss. The p16INK4a tumor suppressive protein can thus be used as a biomarker to detect early stage cancer cells as well as advanced tumor cells with pRB inactivation since it is not expressed in normal cells.
Low-phosphate-selected Auxenochlorella protothecoides redirects phosphate to essential pathways while producing more biomass.

Despite the capacity to accumulate ~70% w/w of lipids, commercially produced unicellular green alga A. protothecoides may become compromised due to the high cost of phosphate fertilizers. To address this limitation A. protothecoides was selected for adaptation to conditions of 100× and 5× lower phosphate and peptone, respectively, compared to ‘wild-type media’. The A. protothecoides showed initial signs of adaptation by 45–50 days, and steady state growth at ~100 days. The low phosphate (P)-adapted strain produced up to ~30% greater biomass, while total lipids (~10% w/w) remained about the same, compared to the wild-type strain. Metabolomic analyses indicated that the low P-adapted produced 3.3-fold more saturated palmitic acid (16:0) and 2.2-fold less linolenic acid (18:3), compared to the wild-type strain, resulting in an ~11% increase in caloric value, from 19.5kJ/g for the wild-type strain to 21.6kJ/g for the low P-adapted strain, due to the amounts and composition of certain saturated fatty acids, compared to the wild type strain. Biochemical changes in A. protothecoides adapted to lower phosphate conditions were assessed by comparative RNA-Seq analysis, which yielded 27,279 transcripts. Among them, 2,667 and 15 genes were significantly down- and up-regulated, at >999-fold and >3-fold (adjusted p-value <0.1), respectively. The expression of genes encoding proteins involved in cellular processes such as division, growth, and membrane biosynthesis, showed a trend toward down-regulation. At the genomic level, synonymous SNPs and Indels were observed primarily in coding regions, with the 40S ribosomal subunit gene harboring substantial SNPs. Overall, the adapted strain out-performed the wild-type strain by prioritizing the use of its limited phosphate supply for essential biological processes. The low P-adapted A. protothecoides is expected to be more economical to grow over the wild-type strain, based on overall greater productivity and caloric content, while importantly, also requiring 100-fold less phosphate.
Studies of intrastromal corneal ring segments for the correction of low to moderate myopic refractive errors.

PURPOSE: Intrastromal corneal ring segments (ICRS) were investigated for safety and reliability in the correction of low to moderate myopic refractive errors. METHODS: Initially, 74 patients with spherical equivalent refractive errors between -1.00 and -4.25 diopters (D) received the ICRS in 1 eye. After 6 months, 51 of these patients received the ICRS in the contralateral eye. The total number of eyes investigated was 125. The outcome measures were uncorrected and best-corrected visual acuity, predictability and stability of the refraction, refractive astigmatism, contrast sensitivity, and endothelial cell morphology. RESULTS: The 89 eyes with 12-month follow-up showed significant improvement with uncorrected visual acuities of 20/16 or better in 37%, 20/20 or better in 62%, and 20/40 or better in 97%. Cycloplegic refraction spherical equivalents showed that 68% of the eyes were within +/- 0.50 D and 90% within +/- 1.00 D of the intended correction. Refractive stability was present by 3 months after the surgery. Only 1 patients had a loss greater than 2 lines or 10 letters of best spectacle-corrected visual acuity, but the patient's acuity was 20/20. Refractive cylinder, contrast sensitivity, and endothelial cell morphology were not adversely affected. The ICRS was removed from the eyes of 6 patients. Three removals were prompted by glare and double images occurring at night; 3 were for nonmedical reasons. All patients returned to within +/- 1.00 D of their preoperative refractive spherical equivalent, and no patients lost more than 1 line of best corrected visual acuity by 3 months after ICRS removal. CONCLUSION: The ICRS safely and reliably corrects myopic refractive errors between -1.00 and -4.50 D.
Senior editor note

The next two papers in this issue are, first, a critique of an earlier MIS Quarterly paper by Graeme Shanks, Elizabeth Tansley, Jasmina Nurendini, Daniel Tobin, and Ron Weber, "Representing Part-Whole Relations in Conceptual Modeling: An Empirical Evaluation" (32:3, pp. 553-573), and, second, a response to that critique. As may or may not be clear from the two papers, this represents a continuation of a debate between the two sets of researchers that has persisted over some years and over several papers. Because an underlying issue of contention between the two sets of authors has been what Bunge said and meant in his book, Treatise on Basic Philosophy: Volume 3: Ontology I: The Furniture of the World (Boston: Reidel, 1977), and how that might inform the practice of modeling, it seemed appropriate to include selections from that book as a Senior Editor Appendix so interested readers can come to their own conclusions. The SE Appendix is available on the MIS Quarterly's website (http://misq.org) in the "Online Supplements" section. An initial selection of quotes was compiled by the senior editor, and both sets of authors have had the opportunity to add other appropriate quotes.
Various Regularity Lemmas in Graphs and Hypergraphs

We are going to formulate and discuss the philosophy of these lemmas and their applications in property testing and at the designing polynomial time approximation schemes for certain graph problems.
Dynamic computed tomographic scans in experimental brain abscess.

Dynamic computed tomograhic scans were performed in an experimental brain abscess model to establish criteria that could be utilized in abscess staging. The vascular phase of the time-density curves did not differentiate cerebritis and capsule stages. The amount of residual enhancement after the first pass of an intra-arterial contrast bolus differed between major abscess stages, the greater residual enhancement being noted in the capsule stage.
Advances in Engineered Human Liver Platforms for Drug Metabolism Studies

Metabolism in the liver often determines the overall clearance rates of many pharmaceuticals. Furthermore, induction or inhibition of the liver drug metabolism enzymes by perpetrator drugs can influence the metabolism of victim drugs (drug-drug interactions). Therefore, determining liver-drug interactions is critical during preclinical drug development. Unfortunately, studies in animals are often of limited value because of significant differences in the metabolic pathways of the liver across different species. To mitigate such limitations, the pharmaceutical industry uses a continuum of human liver models, ranging from microsomes to transfected cell lines and cultures of primary human hepatocytes (PHHs). Of these models, PHHs provide a balance of high-throughput testing capabilities together with a physiologically relevant cell type that exhibits all the characteristic enzymes, cofactors, and transporters. However, PHH monocultures display a rapid decline in metabolic capacity. Consequently, bioengineers have developed several tools, such as cellular microarrays, micropatterned cocultures, self-assembled and bioprinted spheroids, and perfusion devices, to enhance and stabilize PHH functions for ≥2 weeks. Many of these platforms have been validated for drug studies, whereas some have been adapted to include liver nonparenchymal cells that can influence hepatic drug metabolism in health and disease. Here, we focus on the design features of such platforms and their representative drug metabolism validation datasets, while discussing emerging trends. Overall, the use of engineered human liver platforms in the pharmaceutical industry has been steadily rising over the last 10 years, and we anticipate that these platforms will become an integral part of drug development with continued commercialization and validation for routine screening use.
The Question of Profits

Where do profits come from? Are they morally justified? Sraffians provide a clear answer to the first question but have declined to give a direct answer to the second question. This article argues ...
Risk of Venous Thromboembolism for Patients with Pancreatic Ductal Adenocarcinoma Undergoing Preoperative Chemotherapy Followed by Surgical Resection.

Pancreatic ductal adenocarcinoma (PDA) is associated with a hypercoagulable state, resulting in a high risk of venous thromboembolism (VTE). Risk of VTE is well established for patients receiving chemotherapy for advanced disease and during the perioperative period for patients undergoing surgical resection. However, data are lacking for patients undergoing neoadjuvant treatment followed by resection, who may have a unique risk of VTE because of exposure to both chemotherapy and surgery. The study included patients with PDA who underwent neoadjuvant therapy followed by surgery from 2007 to June 2017. Development of VTE was evaluated from the start of treatment through the 90-day postoperative period. Risk factors including demographic, treatment, and laboratory variables were evaluated. The study investigated 426 patients receiving neoadjuvant therapy before surgical resection. Of these patients, 20% had a VTE within 90 days postoperatively (n = 87), and 70% of the VTE occurred during the postoperative period. The VTE included pulmonary embolism (30%), deep vein thrombosis (33%), and thrombosis of the portal vein (PV)/superior mesenteric vein (SMV) (40%). A pretreatment hemoglobin level lower than 10 g/dL and a platelet count higher than 443 were independently associated with VTE during neoadjuvant treatment. The independent predictors of postoperative VTE were a body mass index higher than 35 kg/m2, a preoperative platelet-to-lymphocyte ratio higher than 260, resection with distal pancreatectomy with celiac axis resection/total pancreatectomy, PV/SMV resection, and longer operative times. Development of VTE was associated with worse overall and disease-free survival and an independent predictor of survival and decreased likelihood of receiving adjuvant chemotherapy. Venous thromboembolism during neoadjuvant therapy and the subsequent perioperative period is common and has a significant impact on outcome. Further study into novel thromboprophylaxis measures or protocols during neoadjuvant treatment and the perioperative period is warranted.
Methylsulfonylmethane (MSM) Treatment Enhances C2C12 Wound Closure and Protects Cells from Oxidative Stress

MSM is known to provide anti-inflammatory and anti-oxidant effects in both animals and humans. Because both exercise and chronic disease have the potential to induce inflammation and oxidative stre...
Crawling and classification strategies for generating a multi-language corpus of sign language video

Although there is considerable sign language content available online, it can be hard to locate content in a specific sign language on a particular topic. The Sign Language Digital Library (SLaDL) aims to improve access through the generation of a multi-language corpus of sign language video. SLaDL uses a combination of crawling to collect potential sign language content and applying multimodal sign language detection and identification classifiers to winnow the collected videos to those believed to be in a particular sign language. Here we compare the quantity and variety of sign language videos located via breadth-first, depth-first, and focused crawling strategies. Then we examine the accuracy of different approaches to combining textual metadata and video features for the 3-way classification task of identifying videos in American Sign Language (ASL), British Sign Language (BSL), and without-sign language. Finally, due to the high computational cost of generating the video features used for classification, we explore the tradeoffs when using a cascading classifier and when generating features based on motion in sampled frames on classifier accuracy.
Climate change impacts on agriculture using improved multi-region input-output framework

The agricultural sector plays a central role in the climate change adaptation and mitigation strategies. As one of the key global emitters of greenhouse gasses (GHGs), much effort has to be put in order to reduce its carbon footprint (Smith el al., 2014). At the same time, according to many studies, it is arguably the most vulnerable sector to face the impacts of global warming with both land and water availability, as well as yields productivity, being under pressure (Porter et al., 2014; Fischer et al., 2005). One of the approaches that attempts to consistently account for the global interactions between climate-related adaptation and mitigation strategies in the agricultural sector is the multi-region input-output (MRIO) framework (von Lampe et al., 2014). In particular, several modelling tools reported within the Agricultural Model Intercomparison and Improvement Project (AgMIP, 2014) are based on the input-output framework. In this study, we use a computable general equilibrium (CGE) model ENVISAGE (van der Mensbrugghe, 2017), which is based on the latest Global Trade Analysis Project (GTAP) Data Base (Aguiar et al., 2016), to provide an assessment of climate change impacts on agricultural sectors under the set of economic, climate change and adaptation scenarios within the AgMIP protocols. To this end, we dramatically improve the agricultural representation of the GTAP Data Base. This database can be considered an MRIO, which when reconciles its data inputs focuses on international datasets more than in the various Input-Output (IO) tables at its core.
Structures of ISCth4 transpososomes reveal the role of asymmetry in copy-out/paste-in DNA transposition.

Copy-out/paste-in transposition is a major bacterial DNA mobility pathway. It contributes significantly to the emergence of antibiotic resistance, often by upregulating expression of downstream genes upon integration. Unlike other transposition pathways, it requires both asymmetric and symmetric strand transfer steps. Here, we report the first structural study of a copy-out/paste-in transposase and demonstrate its ability to catalyze all pathway steps in vitro. X-ray structures of ISCth4 transposase, a member of the IS256 family of insertion sequences, bound to DNA substrates corresponding to three sequential steps in the reaction reveal an unusual asymmetric dimeric transpososome. During transposition, an array of N-terminal domains binds a single transposon end while the catalytic domain moves to accommodate the varying substrates. These conformational changes control the path of DNA flanking the transposon end and the generation of DNA-binding sites. Our results explain the asymmetric outcome of the initial strand transfer and show how DNA binding is modulated by the asymmetric transposase to allow the capture of a second transposon end and to integrate a circular intermediate.
Total Cross Sections of π +/- and K +/- on Protons and Deuterons between 50 and 200 GeV/c

Proton and antiproton total cross sections on protons and deuterons have been measured at 50, 100, 150, and 200 GeV/c. The proton cross sections rise with increasing momentum. Antiproton cross sections fall with increasing momentum, but the rate of fall decreases between 50 and 150 GeV/c, and from 150 to 200 GeV/c there is little change in cross section.
Long-term trends in local and transported PM2.5 pollution in New York City

Abstract Previous source apportionment analyses of New York City (NYC) PM2.5 have found that transported pollution can account for up to half of total fine particulate matter (PM2.5) mass. In recent years, several local and federal emissions regulations on both the transportation and energy sector have been introduced, such as the Clean Heavy-Duty Bus and Truck Rule, and policies related to the NYC Clean Heat Program. Since the implementation of these regulations, there have been limited studies on regional transport of particulate air pollution into NYC. This paper aims to quantify long-term changes in local and regional contributions to PM2.5 in NYC. The composition of PM2.5 in NYC over the period 2002–2018 was evaluated using data from the US Environmental Protection Agency (EPA) Chemical Speciation Network (CSN) and the New York City Community Air Survey (NYCCAS). Background site data obtained from EPA CSN was used to assess regional transport. Two estimates of transported PM2.5 were calculated, one assuming that transported PM2.5 consists solely of ammonium sulfate and ammonium nitrate as a lower bound and the other taking into account organic matter (OM) as an upper bound. Using this method, regional transport was estimated to account for 25–46% of total PM2.5 measured in NYC in 2018, down from 46 to 57% in 2002. Secondary PM2.5 output from the Community MultiScale Air Quality (CMAQ) model for the years 2008, 2011, and 2017 was used as an additional upper-bound estimate of regional transport (56%, 35%, and 30%, respectively). In addition to CMAQ model estimates of sulfate, nitrate, and primary emitted PM2.5, land-use regression (LUR) models for sulfur, vanadium, copper, nickel, and PM2.5 measurements at 60 locations across NYC during the winter and summer seasons of 2008–2015 were assessed for changes in local emissions. The results indicate decreased emissions from residual oil burning, traffic, and ships. As a consequence of regional and local changes, PM2.5 in NYC had fallen to approximately 55% of its 2002 levels by 2018. The observed temporal and spatial trends of PM2.5 and its components point to the effect of regulations as well as economic influences on fuel usage, such as the decline of coal in favor of natural gas, in reducing air pollution over the last two decades. While other major PM2.5 constituents have declined, OM is becoming an increasingly dominant component with potential implications for PM2.5 toxicity. Further improvements in NYC air quality could be achieved by targeting sources of ambient OM, such as commercial cooking, traffic, and biomass burning for residential heating.
The Potential of Harnessing IL-2-Mediated Immunosuppression to Prevent Pathogenic B Cell Responses

Immunosuppressive drugs can partially control Antibody (Ab)-dependent pathology. However, these therapeutic regimens must be maintained for the patient's lifetime, which is often associated with severe side effects. As research advances, our understanding of the cellular and molecular mechanisms underlying the development and maintenance of auto-reactive B cell responses has significantly advanced. As a result, novel immunotherapies aimed to restore immune tolerance and prevent disease progression in autoimmune patients are underway. In this regard, encouraging results from clinical and preclinical studies demonstrate that subcutaneous administration of low-doses of recombinant Interleukin-2 (r-IL2) has potent immunosuppressive effects in patients with autoimmune pathologies. Although the exact mechanism by which IL-2 induces immunosuppression remains unclear, the clinical benefits of the current IL-2-based immunotherapies are attributed to its effect on bolstering T regulatory (Treg) cells, which are known to suppress overactive immune responses. In addition to Tregs, however, rIL-2 also directly prevent the T follicular helper cells (Tfh), T helper 17 cells (Th17), and Double Negative (DN) T cell responses, which play critical roles in the development of autoimmune disorders and have the ability to help pathogenic B cells. Here we discuss the broader effects of rIL-2 immunotherapy and the potential of combining rIL-2 with other cytokine-based therapies to more efficiently target Tfh cells, Th17, and DN T cells and subsequently inhibit auto-antibody (ab) production in autoimmune patients.
Factors for Selecting a Consumer Directed Health Care Plan

FACTORS FOR SELECTING A CONSUMER DIRECTED HEALTH CARE PLAN By David William Jordan, Ph.D., MBA A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Health Related Sciences at Virginia Commonwealth University. Virginia Commonwealth University, 2013 Major Director: John James Cotter, Ph.D., Associate Professor, Department of Gerontology Health Reimbursement Arrangements (HRAs) and Health Savings Account (HSA) eligible High Deductible Health Plans (HDHPs) emerged as a new health care insurance models referred to as Consumer Directed Health Plans (CDHPs) in the early 2000s. The purpose of this study is to examine the association between enrollees’ prior financial experiences as they relate to health care access and use with plan choice when a Managed Care Preferred Provider Organization (PPO), HRA, and HSA eligible HDHP are offered concurrently in an ESI program. It is important to examine new health insurance structures, such as CDHPs, to better understand their impact on enrollees’ choice of health plan. Factors that determine enrollees’ plan choice can influence the distribution of socio-economic, health risk, and behavioral characteristics across plans. These factors in turn can affect the financial costs, risk pools, and long-term solvency of such plans. The theoretical framework used in this study is adapted from Andersen’s behavioral model and suggests economic enabling resources, self-perceived need for health care, predisposing characteristics, and plan cost character ristics are significant factors in Managed Care verses CDHP choice. First, descriptive statistics are used to describe the enrollee population relative to available plans. Then, multivariate analyses are used to examine hypotheses developed to examine employee earnings, prior Flexible Spending Account (FSA) participation, prior total cost sharing and Relative Risk Scores (RRS). Findings suggest first that CDHPs benefit from favorable selection, however the type of CDHP is a critical factor in the dynamics of plan choice. It is important not to categorize different forms of HRAs and HSA eligible HDHPs generically as CDHPs, but treat them as unique based upon their cost and administrative characteristics. Second, enrollees appear to select a plan that minimizes their future financial exposure based on past ESI experiences. Finally, CDHP choice and enrollee earnings may not have a simple linear relationship as suggested by prior research. Plan choice may depend largely on the dynamics between factors of economic resources, perceived need, and plan cost characteristics.
A steady state decoupled Kalman filter technique for multiuser detection

In this paper, we describe a Kalman filter based technique for multiuser detection of asynchronous CDMA systems. Similar to previously proposed techniques, we use a decoupled form of the Kalman filter, which processes each user independently. We then make the further simplifying assumption that the channel statistics are constant over a single symbol allowing us to reduce the Kalman gain to a constant dependent on the current signal to interference plus noise ratio. We study the performance of the constant gain filter and show that by appropriate choice of the gain you can optimize for either minimum bit error rate or maximum interference reduction.
The use of “exercise tests” in connection with venous pressure measurements for the detection of venous obstruction in the upper and lower extremities

Abstract 1. 1. The fact that it is impossible, in some cases, to detect the presence of localized venous obstruction by measuring the basal venous pressure is discussed. 2. 2. A description is given of simple methods which enable one to measure “general” or “local” venous pressure in the antecubital vein, and “local” venous pressure in the popliteal vein, during exercise. 3. 3. The effects of these “exercise tests” upon the venous pressures of normal persons, patients with heart failure, and patients with localized venous obstruction are presented. 4. 4. The value of the “exercise tests” in the endeavor to demonstrate the presence of localized venous obstruction in the upper and lower extremities is illustrated by means of case reports.
Rough Sets - What Are They About?

We discuss philosophical and metamathematical origins of rough sets and their fundamental properties. We argue that rough sets are necessary in the light of the Platonian concept of ideal mathematical objects. We show how rough sets have been present in concept formation, diagnosis, classification and other reasoning tasks. We present examples indicating that the intuitive idea of a rough set has been used (under various names) by physicians, engineers and philosophers as a basic tool to classify and utilize concepts in their respective domains of activity. We discuss the differences between rough sets and other approaches to incomplete and imprecise information such as fuzzy logic and logics that formalize the process of “jumping to conclusions”.
Korean Myths and Folk Legends

Reviewed Medium: book Authors: Pae-gang Hwang Translators: Young-Hie Han, Se-Chung Kim, Seung-Pyong Chwae Year: 2006 Pages: xxxi + 253 Publisher: Jain Publishing Company ISBN: 0-89581-855-8 (hard cover). Prices: $60.00 USD(hard cover).
Abrogation of Wild-type p53-mediated Transactivation is Insufficient for Mutant p53-induced Immortalization of Normal Human Mammary Epithelial Cells

The p53 protein has become a subject of intense interest since the discovery that about 50% of human cancers carry p53 mutations. Mutations in the p53 gene are the most frequent genetic lesions in breast cancer, suggesting a critical role for p53 protein in normal mammary epithelial cell (MEC) growth control. We previously demonstrated that abrogation of the p53 function by a cancer-derived p53 mutant, del239, was sufficient to induce immortalization of normal MECs. To further extend these findings and to examine the mechanism of mutant p53-induced immortalization of MECs, we tested the immortalizing ability of four selected p53 mutants (R175H, R248W, R249S, and R273H), which involve residues that cluster close to N239 in the three-dimensional structure and which are critical for the DNA-binding function of p53. Interestingly, two of these mutants (R175H and R249S) reproducibly immortalized 76N normal MECs, whereas the other two mutants (R248W and R273H) induced an extension of life span but not immortalization. These results further substantiate that selective ablation of p53 function with dominant-negative mutants is sufficient for immortalization of MECs. To determine whether abrogation of the transactivation function of endogenous p53 was important for the differential immortalizing ability of p53 mutants, we measured the effects of mutant p53 on the endogenous wild-type p53-mediated transactivation of a chloramphenicol acetyltransferase reporter linked to a consensus p53 binding DNA sequence in transiently transfected 76N MECs. All of the mutants, regardless of their immortalizing phenotype, abrogated the endogenous wild-type p53-mediated transactivation to a similar extent. Thus, abrogation of transactivation function is not sufficient for mutant p53-induced immortalization of normal MECs. The p53-immortalized MECs showed substantial telomerase activity; however, induction of telomerase activity occurred at late passages and was undetectable in mutant p53-expressing cells prior to immortalization. We suggest that mechanisms other than abrogation of transactivation and induction of telomerase activity determine the differential MEC-immortalizing behavior of various p53 mutants.
Methotrexate in Rheumatoid Arthritis

When a patient taking methotrexate should have a liver biopsy to assess for liver damage is a difficult and critical question for rheumatologists. It is not cost effective nor medically necessary to perform biopsies on all patients after a specific dose of methotrexate has been reached, nor after they have been treated for a definite length of time. Clinicians should take into account a patient’s possible pre-existing factors (hepatitis, diabetes, obesity, past and present alcohol consumption), concomitant medications, intercurrent illnesses and serial laboratory evaluations when assessing the need for a biopsy in an individual patient being treated with methotrexate.
Shareholder Decision Rights in Acquisitions: Evidence from Tender Offers

Using a 2013 Delaware law that reduces the approval threshold from 90% to 50% to conduct a short-form merger after a tender offer, we investigate whether variation in the required level of shareholder support affects acquisition outcomes. We find that lower authorization requirements increase the use of tender offers relative to mergers for Delaware targets. Further, Delaware targets collectively receive greater acquisition premiums and returns after the passage of the new law relative to target firms incorporated other states. We do not find evidence that managers use the lower threshold to extract private benefits. Our results suggest that supermajority shareholder approval is unnecessary for tender offers and can increase the risk of holdup by activist investors.
Ampicillin disk diffusion susceptibility testing of Haemophilus influenzae.

A total of 114 strains of Haemophilus influenza were characterized with respect to beta-lactamase production and ampicillin MIC. Of this total, 41 strains produced a TEM-type beta-lactamase, and ampicillin MICs for these strains were greater than or equal to 2.0 microgram/ml. It was found that 54 strains lacked TEM-type beta-lactamase activity, and ampicillin MICs for them were less than or equal to 0.5 microgram/ml. The remaining 19 strains were beta-lactamase negative, but ampicillin MICs were greater than or equal to 2.0 micrograms/ml. Disk diffusion susceptibility tests were performed with two media, i.e., Mueller-Hinton agar containing 1.0% hemoglobin and 1.0% IsoVitaleX supplement (CHOC-MHA) and enriched chocolate agar (CHOC), by using disks containing 10 and 2 micrograms of ampicillin. If strains of H. influenzae for which ampicillin MICs were greater than or equal to 2.0 micrograms/ml were considered resistant, while strains for which MICs were less than or equal to 0.5 microgram/ml were considered susceptible, the following zone diameter interpretive criteria were identified as indicating ampicillin susceptibility: CHOC-MHA (10-micrograms disks), greater than or equal to 20 mm; CHOC-MHA (2-micrograms disks), greater than or equal to 17 mm; CHOC (10-micrograms disks), greater than or equal to 25 mm; and CHOC (2-micrograms disks), greater than or equal to 20 mm. In all cases, zones of inhibition less than those listed above would be interpreted as indicating resistance. Each of these four combinations was found to be essentially equivalent in identifying susceptible and resistant strains of H. influenzae, irrespective of beta-lactamase production.
Postpartum toxic shock syndrome.

To summarize the findings, we have observed a patient with infertility, amenorrhea-galactorrhea, marked hyperprolactinemia responding to bromocriptine. and signs of hypopituitarism, who developed a pituitar) apoplexv-like syndrome and was found to have an intrasellar and intrasphenoidal arachnoidocele. It is speculated that this case represents a transitional form between basal encephalocele’ and so-called “empty” sella. At least some cases of empty sella can be congenital and the associated hormonal abnormalities may be due to a coexistent pituitary dy:sembrvogenesis. As suggested previously by others, It IS recommended that we abandon the term “empty” sella and use “arachnoidocele” instead. According to the anatom\. the arachnoidocele can be intrasellar (previously empt> sella). transsphenoidal or nasopharyngeal (previousl! basal encephalocele), or intrasphenoidal (our case). The origin of the observed pituitary apoplexy-like syndrome is not clear. It is possible that incarceration of a herniated arachnoidocele and locally increased cerebrospinal fluid pressure may have been involved.
Parietal Area 5 and the Initiation of Self-Timed Movements versus Simple Reactions

The timing of action has been studied extensively in reaction-time tasks in which an abrupt sensory stimulus triggers a movement. In these experiments, neurophysiologists have attempted to explain variability in movement time with variability in neuronal activity. However, in natural settings, movements are not usually triggered by abrupt sensory cues. What underlies the timing of action under such circumstances, when movements are uncoupled or only weakly coupled to abrupt events in the external world? We trained monkeys to perform the same arm movement either in direct reaction to a salient visual event, or as a self-timed action, less coupled to any obvious external trigger. Neurons in cortical area 5 exhibited phasic discharge modulations that were generally comparable for both modes of action, with some neurons increasing and others decreasing their firing rates with movement. For self-timed movements, however, there was an additional, slow ramp-up or ramp-down of activity in the few hundred milliseconds before the phasic discharge. These ramping modulations occurred well before any detectable changes in arm-muscle activity and their time course bore a striking resemblance to activity in the putamen preceding self-timed movements, observed previously. Together, the results suggest a possible mechanism for the internal timing of action within the motor system. In this model, reverberant activity in corticobasal-ganglia circuits reaches a threshold level resulting in much larger perimovement discharges within the same network, consequently driving the initiation of action.
African Politics and the Strategic Use of Ethnic Identity

Institutions and Ethnic Politics in Africa. By Daniel N. Posner Cambridge: Cambridge University Press, 2005. 358 pp., $70.00 cloth (ISBN: 0-521-83398-1), $27.99 paper (ISBN: 0-521-54179-4). In past studies of African politics, a great deal of attention has focused on the role of ethnic conflicts as a root cause of political violence. Daniel Posner, in Institutions and Ethnic Politics in Africa , takes a different approach by examining variations in ethnic identities and nonviolent policy choices. Specifically, he asks several important questions about when and why individuals in postindependent Zambia identify themselves as either members of a particular tribe or a broader national language group when they make voting decisions. Posner builds upon past research that has demonstrated that ethnic identity is best viewed as a fluid concept that changes in response to shifts in the relevant social and political context (Mitchell 1956; Epstein 1958; Barth 1969). He also draws on a rich body of past field research in Africa, along with his own field studies and analyses of aggregate data from Zambia. What makes Posner's case study of a single African nation-state of potential interest to a wider audience than African scholars is the fact that he attempts to use …
Viscoelastic fluid flow past a submerged spheroidal body

Abstract A numerical study has been carried out of the problem of homogeneous, axisymmetric flow of second and third order fluids past a spheroidal body. The numerical solution was shown to agree well with existing analytical solutions for several limiting cases (such as flow past a sphere), and was used to investigate the effects of (a) body shape, (b) free stream conditions, and (c) fluid elasticity on the local velocity and stress fields. The results indicate that while a submerged spheroid gives rise to strong and highly localized stress fields, flow past a sphere creates a stress field of moderate strength extending over larger distances. It was also found that the different free stream velocity fields studied, which included uniform flow, simple extensional flow, and converging flow, resulted in different stress fields the strongest of which was produced by the extensional flow. Finally, it was found that the elasticity of the fluid has a profound effect on the local stresses. The computed flow kinematics were used to calculate the expected molecular orientation through the flow birefringence of the macromolecules. In addition, the free energy change due to flow was computed and the relationship between the free energy and stress fields and their possible bearing on flow-induced phase separation of polymers was considered.
The focal index as a singular metric for beamforming effectiveness

Hearing-impaired individuals frequently cite intelligibility problems in multi-talker environments. Microphone arrays performing time-delay beamforming address conditions of poor signal-to-noise ratio by spatially filtering incoming sound. Existing beam pattern metrics including peak side lobe level, integrated side lobe level, beamwidth, and planar directivity index fail to quantitatively capture all elements essential for improving speech intelligibility in multi-talker situations. The focal index (FI) was developed to address these deficiencies. Simulations were performed to exemplify the robust nature of the FI and to demonstrate the utility of this metric for driving array parameter selection. Beam patterns were generated and the metrics were calculated and evaluated against the strict unidirectional requirements for the array. Array performance was assessed by human subjects in a speech recognition task that incorporated competing speech from multiple locations. Simulations of array output were pres...
Custeio baseado em atividades aplicado à prestação de serviços médicos de radiologia

This study uses the Activity-based Costing Method in order to quantify the unit cost of radiology exams realized at the Conventional Medical Radiology Sector of a Health Institution.We verified the cost of 111 types of examinations, 27 of which were carried out through contrast agents, while 84 were conventional exams, observing the radiology film consumption attributes of each type. Results show that the ABC provides an adequate level of detail in relation to the activities selected for realizing conventional and contrast radiology exams, since these objects were grouped according to radiology film consumption attributes.