cssi/SciSciGPT-SciSciNet huggingface dataset:
Total Health Care Expenditure in Patients With a Herniated Lumbar Disk That Ultimately Require Surgery: A 3- and 6-month Cost Comparison of Maximum Nonoperative Treatment.

STUDY DESIGN A retrospective cohort study. OBJECTIVE To compare the cost of maximum nonoperative therapy (MNT) in patients diagnosed with a herniated lumbar disk undergoing primary (1-3 mo) versus prolonged (4-6 mo) conservative management before microdiscectomy. SUMMARY OF BACKGROUND DATA Patients diagnosed with a herniated lumbar disk often attempt a 3-month trial of conservative management before microdiscectomy. A paucity of data exists characterizing the cost of a subsequent round of nonoperative therapies in patients who fail their initial trial, rather than undergo surgery. METHODS Clinical records from patients diagnosed with a herniated lumbar disk undergoing index microdiscectomy surgery from 2007 to 2017 were gathered from a large insurance database. Records were searchable by International Classification of Diseases diagnosis/procedure codes, Current Procedural Terminology codes, and generic drug codes. Two cohorts were established: patients undergoing primary (1-3 mo) versus prolonged (4-6 mo) courses of conservative management. Nonoperative therapy utilization was documented from initial herniation diagnosis to microdiscectomy surgery. "Utilization" encompassed cost billed to patients, prescriptions written, and quantity of units dispensed. RESULTS The 3-month MNT cohort included 4587 patients and the 6-month MNT cohort contained 1506 patients. A greater percentage of 6-month cohort patients utilized opioids (P=0.0052), muscle relaxants (P=0.0061), and lumbar steroid injections (P<0.0001). When considering the average amount spent on conservative management, 6-month patients ($1824/patient) spent 1.55 times more than 3-month patients ($1178/patient). The 6-month:3-month average spending ratio was <2.0 for all of the nonoperative therapies except nonsteroidal anti-inflammatory drugs (2.66) and epidural steroid injections (2.25). When normalized by the number of opioid users, the number of opioid medications dispensed was proportionally less in 3-month patients compared with 6-month patients, with a 6-month:3-month ratio of 1.52. CONCLUSIONS The costs associated with a subsequent course of nonoperative therapies for symptomatic lumbar disk herniation seem to be slightly less than that of the primary trial. Assuming a minimal clinical benefit after the initial trial of nonsurgical therapies, the incremental cost-effectiveness ratio of a subsequent trial versus surgery may be unfavorable. Future studies identifying patients likely to benefit from surgery earlier in the treatment course is required. LEVEL OF EVIDENCE Level III.
Achieving Successful Titration of Sacubitril/Valsartan in the Veterans Population

Introduction Real-world evidence suggests a significant proportion of eligible patients do not receive target doses of medications in heart failure (HF) with reduced ejection fraction (HFrEF). In some patients medications are either discontinued or doses decreased due to tolerability. Sacubritil/Valsartan (S/V) has the highest reported dose reduction due to disease severity and intolerance. There is little known about the titration and tolerability of S/V in the Veterans population. Objective: We evaluated the proportion of Veterans who achieved the evidence-based target dose of S/V and identified factors that limit optimal dose titration. Methods We performed a retrospective cohort study of HFrEF patients receiving S/V that were followed by cardiology or multidisciplinary HF clinic from 2016 until present. Medications, vitals, clinical and laboratory data were collected pre-initiation of S/V and at subsequent encounters. We defined the target dose of S/V as 97/103 mg twice daily. The Fisher's exact test was used to compare proportion achieving target S/V dosing between pharmacist and non-pharmacist managed patients; paired t-tests were used to compare SBP and eGFR between baseline and first titration. Results To date, 46 patients have met inclusion criteria. The mean age was 69 (s.d.±7) years, 50% had ischemic etiology, median ejection fraction (EF) was 30%, IQR= 20-30%, 63% had symptoms of NYHA class II-III, and 80% patients were on target doses of ACEI/ARBs prior to switching to S/V. There was no significant difference in SBP and eGFR pre and post initiation of S/V. Twelve patients are still undergoing titration. Eight patients (17%) discontinued S/V due to hypotension, hyperkalemia or intolerance at subsequent titrations. Among the 34 patients that either completed, reached maximum tolerated doses, or discontinued titration, 17 (50%) reached target S/V dose. The average time to complete titration to target was 10 weeks (±9). A higher proportion of patients reached target doses of S/V if managed by pharmacist compared to non-pharmacist (62.5 vs 20%, p=0.06). Sixteen patients at either target or max tolerated doses had a repeat echocardiogram, of these 7 had an improved EF. Conclusions We observed a modest percentage of patients reached target doses of S/V. Due to the small number of patients we were unable to detect a difference between pharmacist managed vs non-pharmacist reaching target doses, however the observed difference was clinically meaningful. The slower titration rate in our population, compared to the trial recommendations, may have helped to safely achieve target doses. Data collection is ongoing and additional findings will help us to further optimize S/V among Veteran patients.
Quantification of Tau Protein Lysine Methylation in Aging and Alzheimer's Disease

Tau is a microtubule-associated protein that normally interacts in monomeric form with the neuronal cytoskeleton. In Alzheimer’s disease, however, it aggregates to form the structural component of neurofibrillary lesions. The transformation is controlled in part by age- and disease-associated post-translational modifications. Recently we reported that tau isolated from cognitively normal human brain was methylated on lysine residues, and that high-stoichiometry methylation depressed tau aggregation propensity in vitro. However, whether methylation stoichiometry reached levels needed to influence aggregation propensity in human brain was unknown. Here we address this problem using liquid chromatography–tandem mass spectrometry approaches and human-derived tau samples. Results revealed that lysine methylation was present in soluble tau isolated from cognitively normal elderly cases at multiple sites that only partially overlapped with the distributions reported for cognitively normal middle aged and AD cohorts, and that the quality of methylation shifted from predominantly dimethyl-lysine to monomethyl-lysine with aging and disease. However, bulk mol methylation/mol tau stoichiometries never exceeded 1 mol methyl group/mol tau protein. We conclude that lysine methylation is a physiological post-translational modification of tau protein that changes qualitatively with aging and disease, and that pharmacological elevation of tau methylation may provide a means for protecting against pathological tau aggregation.
The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Responsive Parenting Intervention for Firstborns Impacts Feeding of Secondborns

Background The Intervention Nurses Start Infant Growing on Healthy Trajectories (INSIGHT) study's responsive parenting (RP) intervention, initiated in early infancy, prevented the use of nonresponsive, controlling feeding practices and promoted use of structure-based feeding among first-time parents compared with controls. Objectives We sought to examine the spillover effect of the RP intervention on maternal feeding practices with their secondborn (SB) infants enrolled in an observational-only study, SIBSIGHT, and to test the moderating effect of spacing of births. Methods SB infants of mothers participating in the INSIGHT study were enrolled into the observation-only ancillary study, SIBSIGHT. SBs were healthy singleton infants ≥36 weeks of gestation. Infant feeding practices (i.e., food to soothe, structure vs. control-based practices) were assessed using validated questionnaires: Babies Need Soothing Questionnaire, Infant Feeding Styles Questionnaire, and the Structure and Control in Parent Feeding Questionnaire. Results SBs (n = 117 [RP: 57, control: 60]; 43% male) were delivered 2.5 ± 0.8 y after firstborns (FBs). At age 1 y, the Structure and Control in Parent Feeding Questionnaire revealed that the mothers in the RP group used more consistent feeding routines (4.19 [0.43] compared with 3.77 [0.62], P = 0.0006, Cohen's D: 0.69) compared with control group mothers. From the Infant Feeding Styles Questionnaire, RP group mothers also used less nonresponsive, controlling feeding practices such as pressuring their SB infant to finish (1.81 [0.52] compared with 2.24 [0.68], P = 0.001, Cohen's D: 0.68) compared with controls. In contrast to our hypotheses, no differences were detected in bottle-feeding practices such as putting to bed with a bottle/sippy cup or adding cereal to the bottle, despite observing study group differences in FBs. Spacing of births did not moderate intervention effects. Conclusions RP guidance given to mothers of FBs may prevent the use of some nonresponsive, controlling feeding practices while establishing consistent feeding routines in subsequent siblings.
Cooperation & Conflict in the Patriarchal Labyrinth

This essay offers a new way of visualizing structures of collective power based on gender, emphasizing the role of social institutions in shaping women's ability to bargain over the distribution of...
A Formal Investigation of Q-Theory in Comparison to Autosegmental Representations

We use model theory to rigorously evaluate Q-Theory as proposed in Shih and Inkelas 2019 as an alternative to Autosegmental Phonology. We find that Q-Theory is remarkably similar to Autosegmental Phonology, contra some of Shih and Inkelas’s claims. In particular, Q-Theory does not eschew the association relation, in Q-Theory the tone-bearing unit is the vowel, and Q-Theory and Autosegmental Phonology are equivalent in terms of the constraints they can express. However, this formal analysis clarifies the truly novel contribution of Q-Theory, which is the empirical claim that all segments are tripartite
Assessing the Impact of Information and Communication Technologies on Electoral Integrity

The question of whether or not the introduction of information and communication technologies (ICTs) into critical aspects of election administration would improve electoral integrity has been wide...
Moving Beyond Templates: A Bricolage Approach to Conducting Trustworthy Qualitative Research:

Although the rising popularity of methodological templates has yielded an increasing interest in qualitative research, we discuss how the misuse of methodological templates can diminish the quality...
Highly Sensitive Pharmaceutical and Clinical Analysis Using Selective Solid-Phase Extraction Coupled to Microflow Liquid Chromatography and Isotope-Dilution Mass Spectrometry

The capacity of ultrasensitive quantification is highly desirable in many clinical and pharmaceutical applications, such as the PK study of low-dose administration and quantification of low-abundance markers in circulating systems. Nonetheless, this task is highly challenging even for a LC-MS/MS approach, due to the extremely low levels of analytes and the highly complex matrices. Here we describe a robust method for the ultrasensitive quantification of therapeutic agents or clinical markers in highly complex biological systems. This is achieved by the combination of a selective solid-phase extraction (SPE) with a highly sensitive capillary LC (μLC)-MS/MS analysis. Comparing to a conventional LC-MS/MS, a μLC-MS/MS provides much higher sensitivity due to the lower peak dilution. SPE washing and elution conditions were optimized so that target drugs are selectively extracted from the biological matrix. By eliminating most undesirable matrix components, this selective SPE procedure enabled a high sample loading volume on the μLC column without compromising chromatographic performance and operational robustness, and helped to achieve ultralow detection limits. Sufficient μLC separation was employed in order to further improve analytical sensitivity and to decrease matrix effects. To show the application of this strategy, three paradigms, respectively, the quantifications of (1) corticosteroids after an intravitreous injection, (2) an anticancer agent after a low-dose treatment, and (3) several vitamin D (VitD) metabolites in plasma, are introduced in this chapter. Typically, low pg/mL LOQ were achieved, and the linearity, accuracy, and precision of these developed methods were excellent.
Long-term noise interferometry analysis in the northeast Pacific Ocean

Noise interferometry is the method of passively estimating acoustic propagation using ambient sound. It has been used for long-term ocean monitoring applications such as tomography, thermometry, and measuring flow velocity. Using noise interferometry, the time domain Greene’s function (TDGF) between two locations can be estimated. In this talk, we use 6 years (2015–2020) of acoustic data recorded by two hydrophones in the northeast Pacific Ocean to analyze the long-term TDGF. The hydrophones are deployed at the Cabled Array which is maintained by the Ocean Observatories Initiative (OOI). They are separated by 3.2 km, located on the ocean floor at a depth of 1500 m, and have a sampling rate of 200 Hz. We calculate the signal-to-noise ratio (SNR) of the TDGF estimate for different propagation paths and study how it varies for different average times, local shipping densities, and oceanographic variables such as sound speed. [Work supported by ONR.]
SARA: scaling a reconfigurable dataflow accelerator

The need for speed in modern data-intensive work-loads and the rise of "dark silicon" in the semiconductor industry are pushing for larger, faster, and more energy and area-efficient architectures, such as Reconfigurable Dataflow Accelerators (RDAs). Nevertheless, challenges remain in developing mechanisms to effectively utilize the compute power of these large-scale RDAs. To address these challenges, we present SARA, a compiler that employs a novel mapping strategy to efficiently utilize large-scale RDAs. Starting from a single-threaded imperative abstraction, SARA spatially maps a program onto RDA's distributed resources, exploiting dataflow parallelism within and across hyperblocks to saturate the compute throughput of an RDA. SARA introduces (a) compiler-managed memory consistency (CMMC), a control paradigm that hierarchically pipelines a nested and data-dependent control-flow graph onto a dataflow architecture, and (b) a compilation flow that decomposes the program graph across distributed heterogeneous resources to hide low-level RDA constraints from programmers. Our evaluation shows that SARA achieves close to perfect performance scaling on a recently proposed RDA—Plasticine. Over a mix of deep-learning, graph-processing, and streaming applications, SARA achieves a 1.9× geo-mean speedup over a Tesla V100 GPU using only 12% of the silicon area.
Angellic Content

I provide a truthmaker semantics for Angell’s system of analytic implication and establish completeness.
Percent mother's own milk feedings for preterm neonates predicts discharge feeding outcomes.

No studies have determined if there is a threshold whereby use of mother’s own milk (MOM) during hospitalization predicts exclusive MOM feeding at discharge. Among 113 very low birthweight neonates, the ratio of MOM to enteral feeds was measured in the first 14 days, 28 days, and overall hospital stay. The primary outcome was exclusive MOM feeding at discharge. For every 1% increase in MOM consumption in the first 14 and 28 days, the odds of being discharge home on an exclusive MOM diet increased nearly 7-fold (OR 7.01, 95% CI: 2.09–23.50) and 17-fold (OR 17.46, 95% CI 4.67–63.31), respectively. A threshold of >50%, >83%, and >85% MOM consumption compared to overall enteral feeds in the first 14 days, 28 days, and throughout hospitalization, respectively, is recommended. Promotion of MOM consumption in the first 2–4 weeks is of paramount importance, with negligible impact of increasing MOM consumption after 28 days.
Perhaps More Consideration of Pavlovian-Operant Interaction May Improve the Clinical Efficacy of Behaviorally Based Drug Treatment Programs.

Drug abuse remains costly. Drug-related cues can evoke cue-reactivity and craving, contributing to relapse. The Pavlovian extinction-based cue-exposure therapy (CET) has not been very successful in treating drug abuse. A functional operant analysis of complex rituals involved in CET is outlined and reinterpreted as an operant heterogeneous chain maintained by observing responses, conditioned reinforcers, and discriminative stimuli. It is further noted that operant functions are not predicated on Pavlovian processes but can be influenced by them in contributing to relapse; several empirical studies from the animal and human literature highlight this view. Cue-reactivity evoked by Pavlovian processes is conceptualized as an operant establishing/motivating operation. CET may be more effective in incorporating an operant-based approach that takes into account the complexity of Pavlovian-operant interaction. Extinction of the operant chain coupled with the shaping of alternative behaviors is proposed as an integrated therapy. It is proposed that operant-based drug abuse treatments (contingency management, voucher programs, and the therapeutic work environment) might consider incorporating cue-reactivity, as establishing/motivating operations, to increase long-term success—a hybrid approach based on Pavlovian-operant interaction
Initial acculturation and HIV risk among new Hispanic immigrants.

PURPOSE: Research on the initial stage of acculturation of new immigrants is crucial for identifying AIDS prevention policies and priorities for this vulnerable population. METHODS: This study employed an exploratory approach and qualitative data collection methods to identify and describe social and behavioral factors influencing risk for HIV infection among recent Hispanic immigrants (<3 years in the United States). Immigrants from Guatemala, El Salvador, Honduras, the Dominican Republic and Mexico were interviewed in urban, suburban and semirural settings in the New York Metropolitan Area. Data were collected through ethnographic fieldwork, in-depth interviews (N=51), focus groups (N=11; total number of participants=86) and individual interviews with health and social service providers (N=26). RESULTS: Initial stages of acculturation for immigrants reflect both retention and change in attitudes and behaviors involving their mental health, gender role norms, social and sexual behavior, and alcohol and other drug use. Current living environments may introduce conditions affecting HIV risk and prevention, while sustained connections to countries of origin may support retention of attitudes and behaviors with positive and negative risk implications. CONCLUSIONS: Specific epidemiological, environmental, economic, social and psychosocial factors are identified that provide the context for risk and prevention. The challenges and opportunities faced by these new communities must be distinguished from those of more acculturated immigrant populations if culturally appropriate interventions are to be developed.
Impact of Planning and Control Sophistication in Small Business

Significant research has been conducted using numerical measures to establish criteria and determine the relationship between planning sophistication and business success. This research takes a different approach by using a one-on-one interview with closed ended questions to evaluate management perceptions of planning sophistication and its relationship to perceptions of company performance. Our study addresses sophistication in terms of: planning knowledge, time period the plan covers, external/internal considerations, and internal metrics used to measure success. It addresses measurement and control in terms of: goals and objectives, and monitoring frequency. Management's perceptions of how increased knowledge of the strategic planning discipline might impact future company performance are also evaluated. Findings indicate that managers ' perceptions of greater sophistication in their planning efforts are slightly positively related to perceptions of better company performance. Overwhelming evidence is submitted indicating increased knowledge will moderately to significantly impact future company performance.
Two contrasting explanations of involvement violations: expectancy violations theory versus discrepancy arousal theory

Among the theories that address the impact of variations in immediacy behaviors during ongoing interactions are expectancy violations (EV) and discrepancy arousal (DA) theories. This study of the effects of violations of expectations on arousal, reciprocity, and compensation in the medical practitioner-patient relationship contrasts EV predictions with DA predictions. EV theory predicts that given a communicator with high reward valence, high and very high involvement (including touch and close proximity) should be met with reciprocation (increased involvement), and low and very low involvement should be met with compensation (increased involvement). DA theory predicts compensating very high involvement with decreased involvement, reciprocating high involvement with increased involvement, compensating low involvement with increased involvement, and reciprocating very low involvement, with decreased involvement. Results supported neither theory as all involvement changes were met with reciprocity. Additionally, although all violations/discrepancies were followed by changes in arousal, size of arousal change was not monotonically related to size of involvement change, as predicted by DA theory. Finally, although positive versus negative emotional experiences were not related to physiological indicators of arousal change, size of involvement change was directly related to the experience of positive and negative emotions. Thus, it appears that involvement change size directly predicts emotional experience and is not mediated by arousal change.
Adaptor proteins in lymphocyte antigen-receptor signaling

Adapter molecules contain discrete modular domains that direct specific intermolecular interactions to orchestrate assembly of signaling complexes. A number of adapter proteins play critical roles in both positive and negative regulation of antigen-receptor signaling, influencing lymphocyte development and function.
A Survey Methodology for Measuring Safety-Related Trends in the National Airspace System

Making informed judgments about the effects of technological, human, or environmental changes on civil aviation requires reliable information. The National Aviation Operational Monitoring Service (NAOMS), a research project under NASA’s Aviation Safety Program, developed and tested a survey methodology designed to provide statistically reliable information on changes over time in safety-related events in the national airspace. Such information would aid decision makers in determining what areas required attention. To evaluate the NAOMS concept, data from nearly 20,000 randomly selected air-carrier pilots were collected over 3 years. Results demonstrate that the NAOMS approach can reliably identify changes over time in the rates of safety-related events.
1219 PYRUVATE DEHYDROGENASE COMPLEX DEFICIENCY EXPRESSED IN LYMPHOCYTES

Pyruvate dehydrogenase complex (PDC) deficiency is usually detected by assaying activity in fibroblasts. Dephosphorylation and phosphorylation of PDC by preincubation with dichloroacetate (DCR) or fluoride (F) increases the difference in activity between normal and abnormal cells. For a rapid alternative assay, we evaluated use of lymphocytes obtained in whole blood and separated by the Ficoll-Pague method. PDC activity in lymphocytes is similar to fibroblasts, linear in relation to time and protein, increased by pre-incubation with DCA, and decreased by pre-incubation with F. Activity remains sufficient for assay in whole blood after 48 hr. DCA stimulated PDC activity (nmol/min/mg protein; mean, range) was compared in lymphocytes from 30 control adults, fibroblasts from 18 control children, and in both from 17 children with lactic acidosis: Other lactic acidosis (n=11) 2.21(1.0-3.8) 2.48(1.0-4.0) The other 3 patients had reduced PDC in only lymphocytes (1) or fibroblasts (2). PDC deficiency is therefore expressed in lymphocytes as well as in fibroblasts, providing a useful alternative and supplementary assay for diagnosis. Lymphocytes can also be used to detect pyruvate carboxylase deficiency.
Theoretical and experimental studies on analog fiber optic links utilizing the FM gain in transmissions

We report a new type of high-performance RF-lightwave transmitter, which can provide >10 dB RF insertion gain at <0 dBm optical power with high spur-free dynamic range and low noise in analog fiber links.
VARIATION IN OVIPOSITION PREFERENCE OF HELIOTHIS VIRESCENS IN RELATION TO MACROEVOLUTIONARY PATTERNS OF HELIOTHINE HOST RANGE.

When cotton, geranium, petunia, tobacco, tomato, and velvetleaf were presented simultaneously to strains of the Heliothine moth, Heliothis virescens (F.), from Arizona (AZ), Mississippi (MS), and North Carolina (NC), oviposition choices were similar, while a strain from the Virgin Islands (VI) was significantly different from both the AZ and MS strains. In the MS-VI six-host test, the VI strain laid a higher proportion of its eggs on tomato and a lower proportion of its eggs on petunia than did the MS strain. Since petunia and tomato are in the same plant family (Solanaceae), differences between the strains in host preference do not appear to involve traits common to all members of a plant family. In the AZ-VI six-host test, the AZ strain laid a higher percentage of its eggs on tobacco and lower percentages on geranium and velvetleaf (Malvaceae) than did the VI strain. The percentages of eggs laid on cotton (Malvaceae) by the two strains were not significantly different. When moths were placed in cages with only tobacco and geranium, the AZ strain again laid a higher percentage of its eggs on tobacco than did the VI strain. However, when host choice was restricted to tobacco and cotton or velvetleaf and cotton, no significant difference between strains was found. Reciprocal hybrids of the AZ and VI strains were intermediate to the parental stocks in their preference for tobacco over geranium, indicating that a genetic mechanism was responsible for oviposition preference. The relevance of these findings to seemingly rapid fluxes in host range among members of the Heliothinae is discussed.
Influence of angiotensinase inhibitors on the enzymatic activity of renin

Abstract Asp 1 -Ileu 5 -angiotensin I, added to pooled normal human plasma at pH 5.5 or at 7.4, was shown to be fully protected from enzymatic degradation and conversion to angiotensin II by addition to plasma of a combination of angiotensinase inhibitors including ethylenediaminetetraacetic acid, diisopropylfluorphosphate, dimercaptopropanol, and 8-hydroxyquinoline hemisulfate. Addition of Dowex resin to the incubation media (pH 5.5) did not increase the protection of angiotensin I afforded by this combination of inhibitors. For these studies, both bioassay and radioimmunoassay were employed, which allowed for evaluation of N-terminal and C-terminal alteration of the peptide. In the presence of Dowex resin (pH 5.5), plasma renin activity was shown to be depressed. By the use of an angiotensinase-free isolated system of human angiotensinogen and homologous renin, this decrease in activity was found to be due to binding of renin, and not of the renin substrate, to the resin. At pH 5.5, although 3.4 m m 8-hydroxyquinoline was shown to exert maximal inhibition of angiotensin degradation, yielding an increase in measured plasma renin activity, at higher concentrations of 8-hydroxyquinoline an overall inhibition of angiotensin generation was observed. At pH 7.4, on the other hand, 8-hydroxyquinoline inhibited renin activity at all concentrations studied. The inhibition of renin activity at pH 7.4 was minimized by reduction of the 8-hydroxyquinoline concentration to 1.7 m m . This latter concentration was of equal effectiveness in preventing angiotensin degradation. Although protection of angiotensin I was complete at pH 5.5 and 7.4, it was found that plasma renin activity was increased at pH 7.4. It was concluded that maximization of angiotensin I generation in plasma, by endogenous renin, was dependent not only on the pH of incubation, but also upon the type and concentration of angiotensinase inhibitors employed which affect the renin reaction itself.
Evolutionary conservation of KLF transcription factors and functional conservation of human γ-globin gene regulation in chicken

The Kruppel-like factors (KLFs) are a family of Cys2His2 zinc-finger DNA binding proteins with homology to Drosophila Kruppel. KLFs can bind to CACCC elements, which are important in controlling developmental programs. The CACCC promoter element is critical for the developmental regulation of the human gamma-globin gene. In the present study, chicken homologues of the human KLF2, 3, 4, 5, 9, 11, 12, 13, and 15 genes were identified. Phylogenetic analysis confirms that these genes are more closely related to their human homologues than they are to other chicken KLFs. This work also represents the first systematic study of the expression patterns of KLFs during erythroid development. In addition, transient transfections of human globin constructs into 5-day (primitive) chicken red blood cells show that human gamma-globin expression is regulated via its CACCC promoter element. This indicates that a CACCC-binding factor(s) important for gamma-globin expression functions in 5-day chicken red cells.
Dysmyelination, demyelination and reactive astrogliosis in the optic nerve of the taiep rat

Taiep is an autosomal recessive mutant rat that shows a highly hypomyelinated central nervous system (CNS). Oligodendrocytes accumulate microtubules (MTs) in association with endoplasmic reticulum (ER) membranes forming MT-ER complexes. The microtubular defect in oligodendrocytes, the abnormal formation of CNS myelin and the astrocytic reaction were characterized by immunocytochemical and ultrastructural methods during the first year of life. Optic nerves of both control and taiep rats were processed by the immunoperoxidase method using antibodies against tubulin, myelin basic protein (MBP) and glial fibrillary acidic protein (GFAP). Taiep oligodendrocytes are strongly immunoreactive against tubulin, indicative of a significant accumulation of microtubules. Early differentiated oligodendrocytes observed with electron microscopy show that MT-ER complexes are mainly present in the cell body. This defect increases during the first year of life; oligodendrocytes show large MT-ER complexes projected within oligodendrocyte processes. Using anti-MBP, there was a progressive reduction of immunolabeling in the myelin sheaths as taiep rats grew older. Ultrastructural analysis revealed severely dysmyelinated axons with a frequently collapsed periaxonal collar. However, through age the myelin sheath became gradually infiltrated by MTs, suggesting their contribution to premature loss of myelin in the taiep rat. Axons of one-year-old taiep rats were severely demyelinated. Modifications in astrocytes revealed by the GFAP antibody showed a strong hypertrophy with increased immunostaining in their processes. As demyelination of axons progressed, taiep rats developed a strong astrogliosis. The present findings suggest that in taiep rats the early abnormal myelination of axons affects the adequate maintenance of myelin, leading to a progressive loss of myelin components and severe astrogliosis, features that should be considered in the pathogenesis of dysmyelinating diseases.
Community Development Among Distance Learners: Temporal and Technological Dimensions

This paper explores social support and community development among members of a computer-supported distance learning program. The research focuses on what characterizes this community, and how students define and maintain community while largely restricted to communication through media that have been viewed as unsuitable for the maintenance of close social bonds. Interviews conducted over a year with 17 students reveal the importance of community and its role in supporting them in their “different kind of world” and important temporal and technological dimensions associated with community development. Each cohort begins in physical proximity with an intensive, on-campus “boot camp” that acts as a lasting bonding experience. When students return home, they reinvent this physical proximity as virtual proximity, appropriating technology and the opportunities afforded them by class and program structures to socialize and work with people they met on-campus. They enjoy the temporal proximity of “live” lectures and appropriate Internet Relay Chat's “whispering” facility to socialize; they make near-synchronous use of email, and use the timing of assignment submission to initiate email exchanges. Those who fail to make such connections feel isolated and more stressed than those who are more active in the community. Recommendations include promoting initial bonding, monitoring and supporting continued interaction and participation, and providing multiple means of communication to support the need to engage in work and social interaction, both publicly and privately. Overall, our interviews show that belonging to a community brings benefits to the individuals and to the program, and supports efforts by educators who strive to provide such a community for their distance learners.
Corrigenda to “estimation of stature from long limb bones of American Whites and Negroes,” American Journal Physical Anthropology (1952)

The amount of disparity between the lengths of the radii and ulnae of 177 Negro female skeletons of the Terry Collection was questioned. An error was found and corrections have been made in the relevant statistics and tables.
Role of Viagra after radical prostatectomy.

Abstract Objectives: To determine whether the response to sildenafil citrate (Viagra) in patients with erectile dysfunction after radical prostatectomy was influenced by the presence or absence of neurovascular bundles, the interval from surgery to the initiation of drug therapy, and the dose of the drug. Methods: Baseline and follow-up data from 91 patients presenting with erectile dysfunction after radical prostatectomy were obtained. The patients were stratified according to the type of nerve-sparing (NS) procedure: bilateral NS, unilateral NS, and non-NS. They were interviewed using the Cleveland Clinic Post Prostatectomy (CCPP) questionnaire and the International Index of Erectile Function (IIEF) questionnaire. Results: The presence or absence of the neurovascular bundles influenced the ability to achieve vaginal intercourse. In the patients who had undergone bilateral NS, 71.7% (38 of 53) responded; in those with unilateral NS, 50% (6 of 12) responded; and in those with non-NS, 15.4% (4 of 26) responded. The IIEF questionnaire confirmed the quality of the positive responses, with significant improvements in response to question 3 (frequency of penetration), question 4 (frequency of maintenance of erection), and question 7 (satisfaction with intercourse). The magnitude of improvement in responses was higher in the bilateral NS group than in the unilateral NS and non-NS groups (P Conclusions: Successful treatment of erectile dysfunction with sildenafil citrate after radical prostatectomy depends on the presence of the neurovascular bundles. Our data suggest that the response to sildenafil is not related to the interval between the surgery and initiation of drug therapy but is related to the dose.
Modeling of an immobilized-cell three-phase fluidized-bed bioreactor

A mathematical model of a three-phase, tapered, fluidized-bed bioreactor has been developed. This model includes the effects of the tapered bed, a variable dispersion coefficient, and the concentration profile inside the biocatalyst bead on the reaction rate within the bed. Parameters in this model were obtained by adjusting them, within a realistic range, such that the square of the difference between the values predicted by the model and those obtained experimentally was minimized. The model was found to predict experimentally obtained concentration profiles quite accurately. It also demonstrates the need to include the effects of variable dispersion in three-phase systems where the gas phase is being generated inside the reactor, as the dispersion coefficient varied by more than an order of magnitude across the bed.
The use of the ureteric stent.

The use and placement of ureteric stents either endoscopically or as part of an open procedure are outlined. The ureteric stent can replace the pyelostomy or nephrostomy tube and significantly reduce the postoperative morbidity. Summary We feel that ureteric stents do permit primary healing following procedures such as pyelotomy, ureterotomy, and nephrotomy. Stents are well tolerated by the patient, help to improve the comfort of the convalescent period, and decrease the incidence of wound infection, stricture, and fistula. Problems with ureteric stents are rare and are easily managed. The extra effort required to insert a ureteric stent is insignificant compared with its advantages, and we recommend its adoption. We believe that for too long surgeons have tolerated postoperative urine leakage as inevitable, but it need not be. With adequate internal drainage associated with meticulous surgical repair, urine leakage and proximal urinary diversion should be phenomena of the past.
1989 Ogura Memorial Lecture: Mediastinal Dissection

Because the mediastinal dissection operation is now safe, it should be applied more liberally in head and neck oncology situations such as subglottic extension of laryngeal cancer, advanced thyroid cancers, cervical esophageal and tracheal cancers, and all head and neck tumors with low-nodal disease
Fluorometric determination of zirconium with quercetin: Separation of interferences by extraction with TTA

Abstract The fluorometric determination of microgram quantities of zirconium in the presence of milligram quantities of interfering elements (particularly iron, vanadium and titanium) is described. The method involves extraction of zirconium with 2-thenoyltrifluoroacetone and development of fluorescence with quercetin. A study of experimental variables is included. The precision of the method is ± 4%.
Dynamic vehicle dispatching at the intermodal transfer station

Transfer time is one of the most important service quality indicators for evaluating intermodal transit systems. In the advent of advanced public transportation systems, vehicle arrival times and transfer demand can be obtained in real time. Thus, the decision of dispatching vehicles at transfer stations can be optimized to reduce the transfer cost. A time-varying total-cost function, including connection delay and missed-connection costs incurred by transfer passengers and vehicle holding cost, is formulated as a function of holding times for vehicles that are ready to be dispatched at transfer stations. A procedure is developed to dynamically optimize the dispatching time for each ready vehicle by minimizing the time-varying objective function. A transit network consisting of four routes connecting at a transfer terminal is designed in this study to demonstrate the application of the dispatching model. The proposed method can be used to advance transit vehicle dispatching strategies and reduce the transfer time.
World-wide increase in tropospheric methane, 1978–1983

Tropospheric concentrations of methane in remote locations have averaged a yearly world-wide increase of 0.018±0.002 parts per million by volume (ppmv) during the period from January 1978 to December 1983. The concentrations in the north temperate zone are always greater than those in the south temperate zone by 7±1% because the major methane sources are all predominantly located in the northern hemisphere. The average world-wide tropospheric concentration of methane in dry air was 1.625 ppmv at the end of 1983, measured against an NBS standard certified as 0.97 ppmv (but with an accuracy of only ±1%). The world-wide concentration increases are described by a linear equation with a standard deviation of 0.003 ppmv for ten different collection periods during 1978–1983. The precision of measurement of the methane concentration in the atmospheric samples and in the standard was measured to be ±0.4% for each. Repetitive measurements of an air sample collected in November 1977 have shown the same concentration for six years with a standard deviation for these data of ±0.003 ppmv.
On zap time minimization in IPTV networks

Digital television systems have a clear disadvantage relative to analog systems in users' quality of experience, most notably in the time required to change channels, or zap time. The goal of this research is to improve the performance of a multicasting IPTV network, both in user experience and in resource consumption. We formulate the problem of assigning IPTV clients to servers as an integer programming model, in variants which minimize channel-change times, overall network capacity consumption, or both. This problem is shown to be computationally hard, and the performance of the models is tested on problems of different sizes. Polynomial-time heuristics are presented which address a relaxed version of the problem, and the performance of these heuristics is measured.
Prohormone Atrial Natriuretic Peptides 1-98 and 31-67 Increase with Exercise in Congestive Heart Failure Patients

ABSTRACT Recently two peptides consisting of amino acids (a.a.) 1–30 and 31–67 of the N-terminus of the 126 a.a. prohormone of atrial natriuretic factor (pro ANF), as well as atrial natriuretic factor (ANF, a.a. 99–126; C-terminus) were found to have vasodilatory and natriuretic properties. These peptides, as well as ANF, circulate in man as part of the N-terminus of the prohormone. To determine the effect of graded exercise on the circulating concentration of the N-terminus and C-terminus of the ANF prohormone in persons with abnormal salt and water metabolism, 12 individuals with stable congestive heart failure (CHF) were evaluated before and after bicycle exercise testing and the results were subdivided based on the maximal exercise they could achieve. In all of the CHF patients, the circulating concentration of the whole N-terminus (ie, a.a. 1–98), the midportion of the N-terminus (pro ANF 31–67), which circulates as a distinct 3900 molecular weight (m.w.) peptide after being proteolytically cleaved from the N-terminus, and the C-terminus (ANF) increased with exercise. The patients who were able to achieve 100 and 125 watts of workload had a greater maximal oxygen consumption and, in general, a greater percent increase in the circulating concentration of both the N-terminus and the C-terminus of the ANF prohormone than those who had less exercise capacity. Evaluation of the echocardio-graphic, radionucleotide, and the exercise parameters revealed that the circulating concentrations of these atrial peptides correlated best with left atrial dimension, but that left ventricular systolic and diastolic dimensions also correlated positively with their concentrations. Left and right ventricular ejection fractions, as well as the maximal oxygen consumption, correlated negatively with the circulating concentrations of the N-and C-terminal portions of the ANF prohormone.
Problems With Imaging Sensor Systems Used For Terminal Homing

A smart sensor is defined as one that measures the appropriate quantities with the required accuracy and extracts the maximum amount of information from those measurements. In that context, an imaging sensor system, consisting of an imaging sensor, a reference image, and an image matcher, is discussed. The interaction of the elements of the system are explored, highlighting technology shortfalls and the problems of realizing the design in hardware are touched on. The basic deficiency in developing an optimum sensor is the lack of an analytical model for the images and the matching process.© (1979) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Interlaboratory Measurement Comparison Among Fiber Manufacturers to Determine the Effective Cutoff Wavelength and Mode-Field Diameter of Single-Mode Fiber

An interlaboratory measurement comparison to determine an effective cutoff wavelength and mode field diameter of a single-mode fiber was conducted by the National Bureau of Standards in cooperation with the Electronic Industries Association (EIA). Participants include NBS, several U.S. manufacturers, and some foreign laboratories. The purpose of the comparisons is to gather Information on interlaboratory agreement when the same measurement techniques are used and to determine systematic offsets between different techniques. The various procedures tested are currently pending before the EIA and represent current practice for manufacturers.1
Consequences of occupational asthma.

Seventy-nine patients attending hospital for follow-up of occupational asthma were interviewed, on average 6 years after asthma developed. Although 90% thought their symptoms had improved, 10% had required a hospital admission (apart from for investigation), 72% still took medication and most reported symptoms in the last 3 months. One-third were currently unemployed and 40–73% reported limitation in everyday activities, such as housework or shopping. Symptoms on waking were used as an index of troublesome asthma. Those 31 in whom this occurred at least once a week reported limitation in everyday activities significantly more commonly than others. This relation was more marked in men than women. Limitation in everyday activities was, however, more frequently reported by women than men, who were also more likely than men to be unemployed, suggesting that factors other than impairment of function also contribute to handicap in occupational asthma.
Extraesophageal Manifestations of Gastroesophageal Reflux Disease

This article discusses the current state of knowledge regarding the relationship between gastroesophageal reflux disease (GERD) and pulmonary and ear/nose/throat manifestations of reflux and outlines the recent developments in the diagnostic and treatment strategies for this difficult group of patients. Upper gastrointestinal endoscopy and pH monitoring are poorly sensitive for diagnosing reflux in this group of patients. Instead it is recommended that in those without warning symptoms, an empiric trial of proton-pump inhibitors be the initial approach to diagnosing and treating the potential underlying cause of these extraesophageal symptoms.