cssi/SciSciGPT-SciSciNet huggingface dataset:
Effect of congenital heart defects on language development in toddlers with Down syndrome.

Background Down syndrome (DS, OMIM #190685) is the most commonly identified genetic form of intellectual disability with congenital heart defect (CHD) occurring in 50% of cases. With advances in surgical techniques and an increasing lifespan, this has necessitated a greater understanding of the neurodevelopmental consequences of CHDs. Herein, we explore the impact of CHD on language development in children with DS. Methods Twenty-nine children with DS were observed systematically in parent–child interactions using the Communication Play Protocol to evaluate their language use; they also completed the Mullen Scales of Early Learning and MacArthur Communication Development Inventory. Mean ages were 31.2 months for children with DS and CHD (DS + CHD, n = 12) and 32.1 months for children with DS and a structurally normal heart (DS − CHD, n = 17). Results Compared with the DS − CHD controls, the DS + CHD group revealed lower scores in multiple areas, including fine motor skills and expressive and receptive vocabulary. Whereas most differences were not statistically significant, the Communication Development Inventory word count and symbol-infused joint engagement differed significantly (P < 0.01) and marginally (P = 0.09) between groups. Conclusions Finding that CHDs may account for part of the variation in language delay allows us to consider the specific mechanisms underlying the impact of CHDs on language acquisition in children with DS. Conclusions from this first study on early language outcomes of children with DS + CHD may be useful for clinicians in providing developmental surveillance and early intervention programmes with specific emphasis on language therapy as part of long-term follow-up for children with DS + CHD.
Effect of high-dose cranberry juice on the pharmacodynamics of warfarin in patients

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT Case reports suggest an association between cranberry juice and potentiation of warfarin. Studies using 240 ml of cranberry juice daily demonstrated no interaction. It is unknown if higher amounts of cranberry juice will interact with warfarin. WHAT THIS STUDY ADDS Cranberry juice at 240 ml twice daily does not alter the pharmacodynamics of warfarin. AIM To determine if high-dose cranberry juice (240 ml twice daily) alters the pharmacodynamic action of warfarin. METHODS Ten male patients taking stable doses of warfarin were given cranberry juice at 240 ml twice daily for 7 days. Prothrombin times were drawn at baseline and days 2, 6 and 8 after administration of the juice. Prothrombin times were averaged for each day and mean times were compared from each study day to baseline using repeated measures anova. RESULTS There was no statistical difference between mean prothrombin time at baseline and any day tested during juice administration. CONCLUSIONS Cranberry juice (240 ml twice daily for 1 week) did not alter the pharmacodynamics of warfarin in patients.
Anaerobic Degradation of Cyanuric Acid, Cysteine, and Atrazine by a Facultative Anaerobic Bacterium

A facultative anaerobic bacterium that rapidly degrades cyanuric acid (CA) was isolated from the sediment of a stream that received industrial wastewater effluent. CA decomposition was measured throughout the growth cycle by using a high-performance liquid chromatography assay, and the concomitant production of ammonia was also measured. The bacterium used CA or cysteine as a major, if not the sole, carbon and energy source under anaerobic, but not aerobic, conditions in a defined medium. The cell yield was greatly enhanced by the simultaneous presence of cysteine and CA in the medium. Cysteine was preferentially used rather than CA early in the growth cycle, but all of the CA was used without an apparent lag after the cysteine was metabolized. Atrazine was also degraded by this bacterium under anaerobic conditions in a defined medium.
Bipolar switched reluctance machines

This work presents the results of an investigation on components of the electromagnetic force in the air gap of an 8/6 switched reluctance machine (SRM). Using Maxwell stress method variations of radial and tangential force components with respect to saliency of the machine and saturation effects have been studied. Access to distribution of the force components acting on the rotor and stator enables us to provide a more accurate picture of the torque generation and vibration in this family of electric machines. Furthermore, distribution of magnetic forces under multiphase excitation has been studied in details. Our findings show that bipolar excitation of SRM phases, resulting in a short flux path magnetic circuit, favors its efficiency and power quality while generating slightly higher torque with less pulsation. This is a significant improvement especially for automotive current intensive applications where the difference in price of power electronics components can be justified. An experimental, 2 kW, 42 volts, 8/6 SRM drive which has been designed and manufactured in our energy system laboratory was targeted for this study. In addition to our extensive finite element (FE) analysis, experimental work is being carried out on our motor to validate some of the findings of this investigation.
Effect of material strength models on numerical prediction of instability growth solids

Summary form only given, as follows. Considerable research has been devoted to the subject of the instability phenomena that appear on material interfaces. While instability phenomena in perfect fluids and gases are reasonably well understood, the problem of characterizing these phenomena in real materials possessing strength, viscosity, compressibility or phase transitions remains an open question. In 1999, researchers at the All Russian Scientific Institute of Experimental Physics (VNIIEF) conducted a series of tests on aluminum plates that had been given a small sinusoidal perturbation on one side. The plates in these tests are subjected simultaneously to a high pressure (/spl sim/15 GPa) and a high strain rate (/spl sim/10/sup 3/ - 10/sup 6/), a region for which testing mechanisms have only recently been developed. Results for a variety of wavelengths and amplitudes for the initial perturbations and of initial temperatures of the plate are presented in the report "Influence of Thermal Reduction of Strength on Instability Growth in Solids". The goal of my research is to use the data presented in this report in validating various material strength models, notably the Johnson-Cook, Steinberg-Guinan, Preston-Tonks-Wallace and mechanical threshold stress models. The first question of the simulations is whether the different models predict different behavior for a given initial wavelength, amplitude of perturbation and temperature. If so, the next step is to see if there is a consistent pattern to the predictions in terms of wavelength or amplitude of the perturbation or in terms of initial temperatures. CHAD (Computational Hydrodynamics for Advanced Design), a 3-dimensional, parallel, unstructured-grid, finite-volume, Lagrangian method, was used to do the numerical simulations. It is apparent that the various strength models predict different behaviors in the growth of the perturbation of the surface. The PTW and MTS models come closest to capturing the trends in the data. The Steinberg-Guinan model tends to underestimate the growth in amplitude of the perturbation. The Johnson-Cook results tend to overestimate this growth. Numerical simulations such as this one can be used to help determine the kinds of experiments that might provide useful data for researchers attempting to develop more realistic material strength models, especially in strain and strain rate regimes where little or no data currently exists. In particular, upcoming efforts will include simulations of Atlas pulsed-power experiments.
On-Chip Busses

The on-chip bus is the backbone of any SoC, and it is a means to efficiently connect various components including processors, memory, and peripherals. The challenges for an on-chip bus are not minor: it has to accommodate a wide range of communication needs with a single, unified architecture. In this chapter we review the key characteristics of the on-chip bus, using several existing on-chip bus standards as examples: ARM/AMBA, IBM/Coreconnect, and Wishbone. We also look at some of the long-term challenges for on-chip interconnect, and how this will affect the design of hardware–software interfaces.
Platelike cutaneous osteoma

Platelike osteoma cutis is a rare lesion that is most often congenital. An 85-year-old man developed a plate, or sheet, of subcutaneous bone in an area previously affected by morphea. The sheet of bone was visualized with a variety of imaging technics, including xerography, computed tomography, and radionuclide bone scans.
Dual-band spectral-domain optical coherence tomography for in vivo imaging the spectral contrasts of the retinal nerve fiber layer

The ultimate goal of the study is to provide an imaging tool to detect the earliest signs of glaucoma before clinically visible damage occurs to the retinal nerve fiber layer (RNFL). Studies have shown that the optical reflectance of the damaged RNFL at short wavelength (<560nm) is reduced much more than that at long wavelength, which provides spectral contrast for imaging the earliest damage to the RNFL. To image the spectral contrast we built a dual-band spectral-domain optical coherence tomography (SD-OCT) centered at 808nm (NIR) and 415nm (VIS). The light at the two bands was provided by the fundamental and frequency-doubled outputs of a broadband Ti:Sapphire laser. The depth resolution of the NIR and VIS OCT systems are 4.7µm and 12.2µm in the air, respectively. The system was applied to imaging the rat retina in vivo. Significantly different appearances between the OCT cross sectional images at the two bands were observed. The ratio of the light reflected from the RNFL over that reflected from the entire retina at the two bands were quantitatively compared. The experimental results showed that the dual-band OCT system is feasible for imaging the spectral contrasts of the RNFL.
A quasi-newton method for minimum trace factor analysis

In the past several algorithms have been given to solve the minimum trace factor analysis (MTFA) and the constrained minimum trace factor analysis (CMTFA) problems. Some of these algorithms, depending on the initial value, may converge to points that are not the solution to the above problems, some converge linearly, and some are quadratically convergent but are somewhat difficult to implement. In this paper we propose modified Han–Powell algorithms to solve the MTFA and CMTFA problems. The modifications deal with the problem of multiple eigenvalues. The proposed algorithms are globally convergent and their speed is locally superlinear. We also give a modified Han–Powell algorithm to solve the weighted minimum trace factor analysis (WMTFA) problem. This method is also locally superlinear and is simpler to implement as compared to methods proposed earlier. Four examples are given to show the performance of the proposed algorithms. More generally, our experience with these algorithms shows that, starting at...
Coliphage λnutL−: A unique class of mutants defective in the site of gene N product utilization for antitermination of leftward transcription

Abstract A special procedure was developed to isolate a new class of plaque-forming (Spi − ) mutants of phage λ that are unable to express the leftward N -dependent red and gam gene functions by reason of cis -dominant defects located between the p L promoter and the N gene. The p L promoter is intact in these mutants, as the rate of transcription in the p L - N - t L1 region is high. Also, their gene N does not appear to be altered, as shown by genetic complementation. The mutations map near the center of the transcribed interval (about 124 base-pairs long) defined by the left ends of the λdv1 plasmid and the imm434 substitution. Thus, they map near the promoter, but interfere with antitermination at terminators located farther downstream. We conclude that the mutations define a new kind of recognition site (which we designate nut , for N utilization ) that controls an early step in the N-mediated antitermination mode of transcription.
Universal outlier detection for particle image velocimetry (PIV) and particle tracking velocimetry (PTV) data

A generalization of the universal outlier detection method of Westerweel and Scarano (2005 Universal outlier detection for PIV data Exp. Fluids 39 1096–100) has been made, allowing the use of the above algorithm on both gridded (PIV) and non-gridded (PTV) data. The changes include a different definition of neighbors based on Delaunay tessellation, a weighting of neighbor velocities based on the distance from the point in question and an adaptive tolerance to account for the different distances to neighbors. The new algorithm is tested on flows varying from impinging jets to turbulent boundary layers and wakes to wingtip vortices, both PIV and PTV. The residuals for these flows also show universality in their probability density functions, similarly suggesting the use of a single threshold value to identify outliers. Also the new algorithm is found to work with data up to about a 15% spurious vector content.
Site-directed mutagenesis of active site glutamate-217 in mouse adenosine deaminase.

Mouse adenosine deaminase (ADA) contains an active site glutamate residue at position-217 that is highly conserved in other adenosine and AMP deaminases. Previous research has suggested that proton donation to N-1 of the adenosine ring occurs prior to catalysis and supports the mechanism as proceeding via formation of a tetrahedral intermediate at C-6 of adenosine. The proposed catalytic mechanism of ADA based on the recent elucidations of the crystal structure of this enzyme with transition- and ground-state analogs hypothesized that Glu217 was involved in this proton donation step [Wilson, D. K., Rudolph, F. B., & Quiocho, F. A. (1991) Science 252, 1278−1284; Wilson, D. K., & Quiocho, F. A. (1993) Biochemistry 32, 1689−1693]. Site-directed mutagenesis of the equivalent glutamate in human ADA resulted in a dramatic loss of enzyme activity [Bhaumik, D., Medin, J., Gathy, K., & Coleman, M. (1993) J. Biol. Chem. 268, 5464−5470]. To further study the importance of this residue, site-directed mutagenesis was ...
Successful strategies for renal transplantation in primary oxalosis

Successful strategies for renal transplantation in primary oxalosis. Eleven patients, aged 6 months to 47 years, with renal failure due to primary oxalosis, received renal allografts and were followed for 1 to 9 years. A specialized strategy for medical management included intensive pre-transplant hemodialysis and post-transplant long-term diuresis, administration of neutral phosphate, Mg ++ , and pyridoxine. Seven of ten living-related (LRD) transplants have good renal function, six with no biopsy evidence of renal oxalate deposition at up to 7 years after transplant. Two LRD graft losses from recurrent oxalosis, accompanied by massive secondary oxalate deposits, occurred in patients following endstage renal failure for over 3 years. A third LRD graft loss occurred following long-term (6 month) peritoneal dialysis in an infant. One cadaver transplant recipient has survived with recurrent oxalosis and poor graft function for 9 years. It is possible to perform successful renal transplantation in small children and adults with primary oxalosis and to completely prevent the deposition of oxalate in the renal allograft. Renal transplantation, with a strict medical protocol, would appear to be the initial treatment of choice for renal failure due to primary oxalosis. Strategies reussies de transplantation renale au cours de l'oxalose primitive. Onze malades, âges de 6 mois a 47 ans, atteints d'insuffisance renale par oxalose primitive, ont recu des allogreffes renales, et ont ete suivis de 1 a 9 ans. Une strategie specialisee de soin medical comprennait une hemodialyse pre-transplantation intensive et une diurese post-transplantation a long terme, l'administration de phosphates neutres, de Mg ++ , et de pyridoxine. Sept des dix transplants de donneurs vivants (LRD) avaient une bonne fonction renale, dont six sans evidence biopsique de depot renal d'oxalate jusqu'a 7 ans apres la transplantation. Les deux pertes de greffons LRD par oxalose recidivente, accompagnees par des depots massifs secondaires d'oxalates, sont survenues chez des malades apres une insuffisance renale terminale pendant plus de 3 ans. Un troisieme perte de greffon LRD est survenue apres a long terme (6 mois) dialyse peritoneal dans un petit enfant. Un receveur de transplant de cadavre a survecu avec une oxalose recidivante et une fonction du greffon mediocre pendant 9 ans. Il est possible de faire une transplantation renale reussie chez de petits enfants et chez des adultes atteints d'oxalose primitive, et de prevenir completement le depot d'oxalate dans l'allogreffon renal. La transplantation renale, avec un protocole medical strict, pourrait apparaitre comme le traitement initial de choix de l'insuffisance renale par oxalose primitive.
Validity of the functional independence measure for persons with traumatic brain injury

Abstract Objective: Replicate and extend studies of the construct validity of the Functional Independence Measure (FIM) for persons with traumatic brain injury (TBI). Design: A cross-sectional study of admissions to acute rehabilitation evaluated 6 months to 5 years after discharge. Setting: An inpatient brain injury rehabilitation unit in a large, academic medical center. Subjects: Ninety-five patients with primary diagnosis of TBI stratified by time postdischarge. Main Outcome Measures: Prediction of (1) average daily minutes of assistance and (2) supervision required in comparison to the Sickness Impact Profile (SIP) and SF-36. Results: The FIM was highly predictive of minutes of assistance (83% accuracy), supervision (82% accuracy), and the need for either type of assistance (78% accuracy). Prediction was only minimally improved by measures of neurobehavioral impairment. The accuracy of the FIM was superior to the SIP and SF-36. Conclusions: Results provided substantial support for the validity of the FIM as a measure of functional independence for persons with TBI. The importance of supervision as a type of assistance required after TBI was evident, with the FIM highly predictive of this need, as well.
Listening to youth: Adolescents’ reasons for substance use as a unique predictor of treatment response and outcome.

National efforts have focused on improving adolescent substance use disorder (SUD) treatment outcomes, yet improvements remain modest. Because adolescents are noteworthy for heterogeneity in their clinical profiles, treatment might be enhanced by the identification of clinical subgroups for which interventions could be more effectively tailored. Some of these subgroups, such as those based on abstinence motivation, substance involvement, and psychiatric status are promising candidates. This study examined the unique predictive utility of adolescents’ primary reason for alcohol and other drug use. Adolescent outpatients (N=109; 27% female, aged 14–19) were assessed at treatment intake on their reason for substance use, as well as demographic, substance use, and clinical variables, and re-assessed at 3, 6, and 12 months. Reason for use fell into two broad domains: using to enhance a positive state (positive reinforcement [PR]; 47% of youth) and using to cope with a negative state (negative reinforcement [NR] 53% of youth). Compared to PR patients, NR patients were significantly more substance-involved, reported more psychological distress, and had a more extensive treatment history. Importantly, NR patients showed a significant treatment response whereas PR patients showed no improvement. PR/NR status also uniquely predicted treatment response and outcome independent of a variety of other predictors including abstinence motivation, self-efficacy, coping, and prior treatment. Adolescents’ primary reason for substance use may provide unique clinical information that could inform treatment planning and patient-treatment matching.
A Comparison of Weekly Monitoring Methods of the Palmer Drought Index

Abstract A method for weekly monitoring of the Palmer Drought Index (PDI) by using four parallel month-long calculation chains in rotation (“ROLLING” method) was tested for the Kansas Northwest Climate Division and the South Carolina Southern Climate Division and compared to two other methods, a modified version of the Climate Prediction Center’s weekly Palmer Drought Index monitoring method with a modified set of coefficients (“WEEKLY” method) and the National Climatic Data Center’s (NCDC’s) projected monthly Palmer Drought Index method using long-term historical daily normal temperature and precipitation (“NORMALS” method). The results for the Kansas Northwest Climate Division and the South Carolina Southern Climate Division generally agreed. The weekly method produced drought severity values that differ most from standard monthly PDI values despite using a modified set of coefficients. The method recently adopted by NCDC successfully estimated Palmer Modified Drought Index (PMDI) values late in the mon...
Apheresis enhances the selective removal of antinuclear antibodies in systemic lupus erythematosus.

Apheresis suppresses clinical manifestations of lupus and reduces levels of antinuclear antibodies implicated in the pathogenesis of systemic lupus erythematosus (SLE). It is not known, however, if reduced levels of antinuclear antibodies are due to nonspecific removal, or specific mechanisms associated with decreased production, or enhanced clearance from the circulation. In order to distinguish between specific and nonspecific effects of apheresis on antinuclear antibodies in SLE, we compared plasma levels of IgG antibodies to DNA and IgG antibodies to microbial antigens in 13 SLE patients before and after apheresis. Although apheresis lowered plasma levels of IgG (21% mean reduction), there was a disproportionate reduction in IgG antibodies to DNA (42% mean reduction, p<0.13). In marked contrast, reduction in antibodies to microbial antigens did not exceed those of plasma IgG. A rapid rebound of serum anti-DNA antibodies following apheresis in certain SLE patients suggests that the selective reduction in anti-DNA antibodies is due to enhanced clearance from the circulation rather than decreased production. These results indicate that apheresis enhances selective removal of antinuclear antibodies in some patients with SLE.
A magnetically staged fluidized bed for countercurrent gas—solids contacting

Abstract This paper evaluates the performance of grate-type magnetic distributor—downcomers (MDDs) when used to control the hold-up of magnetic particles in multistage fluidized beds where countercurrent contacting of gas and particles is desired. Two modes of operation were investigated: continuously varying the current through the grid, and applying intermittent current for a fraction of a timing period. Either mode was found to be acceptable. However, the continuous-current mode appears more promising for control of mixtures of magnetic and nonmagnetic particles. Proportional controllers for each stage and a simple decoupling strategy were used to control the amount of particles on each stage. Set-point change control experiments for individual stage hold-ups are presented.
Cholelithiasis in mice: effects of different chemicals upon formation and prevention of gallstones.

CHOLECYSTITIS AND GALLSTONE formation in the mouse can be induced by a lithogenic diet containing 1% cholesterol and 0.5% cholic acid by weight [20]. Gallstones formed more rapidly and frequently in conventional than germ-free mice fed the lithogenic diet, although the development of cholecystitis was similar in onset and degree in both cases [12]. This finding and the inability to culture bacteria from the gallbladder wall or bile of conventional mice fed the lithogenic diet makes it unlikely that bacteria have any major role in gallstone formation in the mouse [13].
Markov Random Processes are not Recoverable After Quantization and Mostly not Recoverable From Samples

Markov random processes and general random processes are considered. It is shown that continuous-time, continuous-valued, wide-sense stationary, Markov random processes that have absolutely continuous second order distributions are not bandlimited. It is also shown that when these processes are strictly stationary and continuous almost surely, they cannot be recovered without error from their quantized versions. Further, it is shown that continuous-time, discrete-valued Markov random processes, which are uniformly bounded and satisfy an additional condition, can be recovered with zero average distortion from an appropriate set of samples for a general distortion measure. A similar result is shown for general continuous-time random processes with rth power distortion measure. Additionally, it is shown that under a milder condition on the Markov processes and a different condition on the sampling times (e.g., uniform sampling), such processes cannot be recovered with zero average distortion. Finally, the notion of information-singularity is extended to continuous-time random processes, and it is shown that both continuous- and discrete-time Markov processes are not information-singular.
A vapor-phase hydroxide dislocation etch for GaAs

Abstract Vapor from molten KOH can be effectively used to reveal dislocations in single-crystal GaAs. This slower etch is more reproducible and controllable than simple molten KOH. Moreover it can be used in a semi-destructive fashion, with one side of the sample protected from the vapor.
The use of Alloderm in the closure of a giant omphalocele

Giant omphaloceles are associated with a considerable loss of abdominal domain. Early primary repair of the fascia is either not possible or poorly tolerated by the infant. Current surgical options result in a ventral hernia requiring future surgery or involve the chronic use of prosthetic patches with or without tissue expanders. This case presentation describes an alternative surgical approach that results in early fascial closure using an interposition graft of Alloderm.
Effect of environmental carcinogens and other chemicals on murine alpha/beta interferon production

Abstract Mouse embryo fibroblast cultures were pretreated with a variety of chemicals found in the environment. After chemical treatment, polyriboinosinic-polyribocytidylic acid was added to the cultures to induce alpha/beta interferon. Pretreatment of the cell cultures with the chemical carcinogens chloroform and β-propiolactone severely inhibited the production of alpha/beta interferon, while pretreatment of the cell cultures with their poorly or noncarcinogenic analogs 1,1,1-trichloroethane and γ-butyrolactone had no effect on interferon induction. Pretreatment of the cell cultures with the possible carcinogen diethylstilbestrol had no effect on alpha/beta interferon induction. Pretreatment of the cells with the poor or noncarcinogens pyrene and ascorbic acid did not effect interferon induction; in fact, treatment with ascorbic acid may have enhanced interferon production. These results augment previous findings that most potent carcinogens can inhibit the induction of alpha/beta interferon.
Implications of reaction-diffusion theory for the disinfection of microbial biofilms by reactive antimicrobial agents

Abstract A theoretical framework was developed for analyzing the efficacy of antimicrobial agents when applied to microbial biofilms with which they react. Reaction-diffusion theory was adapted to investigate the potential for transport limitation of the overall rate of biofilm disinfection and the rate of antimicrobial penetration into the biofilm. Disinfection efficacy was investigated with simulations that assumed catalytic reaction of the antimicrobial agent with live and dead cells in a uniformly thick slab with simultaneous transformation of live to dead cells by an independent rate process (disinfection). The intrinsic rate of disinfection was assumed to follow first-order dependence on antimicrobial concentration. Zero- and first-order reaction kinetics of antimicrobial agent with biomass were analyzed. Microbial growth and external mass transfer resistance were neglected. Results show that antimicrobial efficacy, defined as the ratio of the observed rate of biofilm disinfection to the rate that would prevail in the absence of mass transport limitation, decreases sharply as the Thiele modulus exceeds one. The reduction in efficacy worsens when the antimicrobial dose is more concentrated or longer. A second case examined the penetration of an antimicrobial agent into a biofilm with which it reacts stoichiometrically, as would be expected with an oxidizing biocide such as chlorine or ozone. The antimicrobial agent eventually penetrates the biofilm by depleting the reactive biomass constituent, but the time scale for penetration can exceed the time scale for transient diffusion in the absence of reaction by orders of magnitute. These results provide a theoretical basis for explaining experimentally observed resistance of biofilms to chemical disinfectants.
P5.023 Novel Emergency Department Registration Kiosk For HIV Screening Increases Engagement of High Risk Patients and is Cost-Effective

Background High operating costs challenge sustainability of successful U.S. Emergency Department(ED) HIV screening programmes. Free-standing registration kiosks could potentially reduce the marginal costs of ED HIV screening. We investigated a cost-effectiveness ratio(CER) as cost per new HIV diagnosis for a kiosk-based approach for offering screening, versus a counsellor-based approach. Methods A rapid oral-fluid HIV screening programme, instituted in a U.S. ED since 2005, had a rate of new HIV diagnosis 0.16% in 2012. A two-phase quasi experimental design, including a counsellor-based approach to offer testing at the bedside (Phase I, August and September 2011) and a kiosk-based approach to offer testing at ED registration (Phase II, December 2011 and January 2012), was performed. CER per new HIV diagnosis was defined as total cost of the screening programme divided by number of newly diagnosed cases. Costs included screening programme personnel (study coordinator, testing staff, and kiosk helpers), diagnostic assays (rapid and confirmatory tests), and kiosks (2 kiosks, software, and IT consulting fees). Sensitivity analyses were performed. Results Slightly higher rates of newly diagnosed HIV positivity were observed with kiosk approach [I: 0%(0/538); II: 0.47%(2/430; 95% CI: 0.08%, 1.53%)]. Compared to phase I, those tested via kiosk were more likely to be younger and report high-risk sexual behaviours and/or injection drug use(IDU) [phase I vs. II: age: 39 years, 35 years; high-risk sexual behaviours: 30%, 51%; IDU: 1%, 7% (all p Conclusions Our pilot data demonstrated that use of kiosks for offering HIV screening engaged more high-risk patients, identified more unrecognised infections, and was potentially more cost-effective than a counsellor-based bedside approach.
Rayleigh and predissociative fluorescence imaging of total and quantum state-specific densities from a combustion bomb using tunable excimer laser light

ABSTRACTRayleigh Scattering (RS) and Planar Laser Induced Predissociative Fluorescence (PLIPF) are used to obtain2-D images of total and of state specific [i.e., of defmite rotational levels of OH (V' = 0) and 02 (v' = 2, 3, 6, or 7)]densities of the burned and unburned zones inside a combustion bomb. A tunable excimer laser, operated in eitherthe 193nm- or 248nm-range, is used. Our bomb is about the size of an automobile engine cylinder. As each volumeelement of the fuel mixture burns, it forms high-T products with large specific volumes. Because the thermodynamics are well known, the bomb may serve as a reference device for diagnostics for high temperature species via pulsed-laser methods. The total densities and the mole fractious of the various constituents can be accurately calculated. Workhas been done with various compositions of hydrogen-air and propane-air fuel mixtures.1. INTRODUCTIONRecent technological developments, like improved tunable UV-lasers, short-gated ultrasensitive photometriccameras, and fast digital image processing, have led to the practical application of several light scattering mechanismsto the production of images of complex gaseous media. Tunable excimer lasers are particularly well suited to lightimaging methods.1 Their light is in the UV which is desirable for the work described here because a) induced
Impact of Virtual Cross Match on Waiting Times for Heart Transplantation

Background Heart transplantation for sensitized patients has been a significant challenge. In this study, outcome of heart transplantation in sensitized patients with virtual cross match was compared with prospective cross match. Methods Prior to July 2007, prospective cross match was used and afterward, virtual cross match with Luminex (One Lambda, Inc, Canoga Park, CA) based antibody analysis was used for potential heart transplant recipients. Prospectively collected data for the 3 years before and after July 2007, in sensitized (panel reactive antibody greater than 10%) and nonsensitized heart transplant recipients were reviewed. Results One hundred sixty-eight patients met inclusion criteria for analysis (78 patients for prospective cross match and 90 patients for virtual cross match). Multiple parameters were compared for the prospective cross match and virtual cross match eras. Three-year survivals in nonsensitized patients were 84.6% and 77.2% and in sensitized patients were 76.9% and 77.4% (p = 0.49) for prospective cross match and virtual cross match eras, respectively. Freedom from 3A (2R) cellular rejection in nonsensitized patients was 96.9% and 95.3%, and in sensitized patients was 90.9% and 100% (p = 0.83). Freedom from antibody-mediated rejection in nonsensitized patients was 95.3% and 96.8%, and in sensitized patients was 90.9% and 90.5% (p = 0.65). Mean waiting time was 129 ± 246 days (mean ± SD) for the period before virtual cross match and 59 ± 78 days with virtual cross match (p = 0.018). Donor geographic area was similar for prospective and virtual cross match. Conclusions In sensitized heart transplant candidates, virtual cross match may shorten waiting time to heart transplantation without increasing subsequent occurrence of cellular rejection, antibody mediated rejection, and mortality after heart transplantation.
Investigation of oxygen reduction reaction kinetics at (111)-(100) nanofaceted platinum surfaces in Acidic Media

The oxygen reduction reaction (ORR) was studied on CO-treated and untreated (111)−(100) nanofaceted platinum surfaces [Komanicky et al. J. Phys. Chem. 2005, 109, 23543] in sulfuric and perchloric acids using the rotating disk electrode technique. Activities of nanofaceted surfaces are found to be considerably higher than a simple average of the activities of (111) and (100) surfaces. We find that the high activity in sulfuric acid is consistent with the higher activity of (111) facets. It is due the weaker sulfate adsorption on finite-size (111) surfaces than on (111) single crystal surfaces where the ORR activity is suppressed by strong sulfate adsorption. However, the high activity found in the weakly absorbing perchloric acid cannot be explained by the finite-size effect, since the activities are reportedly insensitive to terrace sizes [Macia, M. D.; et al. J. Electroanal. Chem., 2004, 564, 141]. We propose a cooperative activity, unique to nanoscale objects, which results from oxy species crossing ove...
The First Five-Year Plan and the Geography of Soviet Defence Industry

Soviet and Western scholars alike have generally hailed the successes of Soviet industrialisation in building up new industrial centres in the geographically secure heart of the Soviet Union during...
Garnet inclusions in diamond and the state of the upper mantle

Temperature and pressure estimates for Earth's upper mantle generally are based on indirect information derived from phase equilibria studies and the measurement of temperature and pressure dependent physical and chemical properties for relevant mantle materials. This paper describes an alternative approach, based on solid-inclusion piezothermometry, which utilizes the thermoelastic properties of direct mantle derived mineral samples. In particular, this study provides the theoretical development, based on the Murnaghan equation of state for solids, for a simple method of calculating isomeke lines for host and inclusion minerals of cubic symmetry which may be extrapolated accurately to upper mantle pressure and temperature conditions. The method is demonstrated for the particular case of garnet inclusions in diamond, for which adequate laboratory thermoelastic data are available. A specific application is made in the evaluation of the depth of formation of the D1 garnet-diamond inclusion system described by Harris et al. (1970). The pressure and temperature conditions of inclusion formation lie along the calculated isomeke line within the range constrained by recent graphite-diamond phase equilibria data. However, because the isomeke line for the garnet-diamond system and the graphite-diamond phase transition are very similar in slope, a further constraint is required. Assuming, therefore, that temperature in the upper mantle is bounded by the “Oceanic” and “Shield” geotherms of Clark and Ringwood (1964), the present results indicate that the D1 garnet-diamond system formed within the depth range 138 to 155 km (about 45 to 53 kbar pressure). This result, which relates to the genesis of kimberlite xenoliths, is generally consistent with the results of other studies which utilize phase equilibria data.
The Tolerance Approach to Sensitivity Analysis in Linear Programming

In constrast to "ordinary" sensitivity analysis in linear programming, the tolerance approach considers simultaneous and independent changes in the objective function coefficients and in the right-hand side terms. This approach yields a maximum tolerance percentage such that, as long as selected coefficients or terms are accurate to within that percentage of their estimated values, the same basis is optimal. In particular, if the objective function coefficients are accurate to within the maximum tolerance percentage of their specified values, then the same solution is optimal.
Avoidance of false PCR results with the integron–retron junction in multiple antibiotic resistant Salmonella enterica serotype Typhimurium

Salmonella infections continue to cause gastrointestinal and systemic disease throughout the world. Another concern with this pathogen is the ability to acquire integrons that confer resistance to multiple antibiotics. For multiresistant Salmonella enterica serotype Typhimurium, the most common multiresistant Salmonella serotype, an integron structure can be found between thdF and a retron. Our objective was to investigate the utility of a 450 bp thdF-retron amplicon as an indicator of an insertless thdF-retron junction thus indicating an integron-free strain. Surprisingly, we found that the 450 bp thdF-retron amplicon was present, and thus incorrectly suggesting an integron-free status, in some multiresistant S. enterica serotype Typhimurium isolates. However, this phenomenon was not observed if the isolate was enriched in the presence of two antibiotics. This demonstrates that, within some individual clinical isolates of multiresistant S. enterica serotype Typhimurium, there exists a small subpopulation of integron-free bacteria. Consequently, it appears that the thdF-retron amplicon is an inaccurate predictor of integron status in S. enterica serotype Typhimurium unless multiresistance is used as a selection tool during enrichment.
Self-adaptive asymmetric on-line boosting for detecting anatomical structures

In this paper, we propose a self-adaptive, asymmetric on-line boosting (SAAOB) method for detecting anatomical structures in CT pulmonary angiography (CTPA). SAAOB is novel in that it exploits a new asymmetric loss criterion with self-adaptability according to the ratio of exposed positive and negative samples and in that it has an advanced rule to update sample's importance weight taking account of both classification result and sample's label. Our presented method is evaluated by detecting three distinct thoracic structures, the carina, the pulmonary trunk and the aortic arch, in both balanced and imbalanced conditions.
Superficial dosimetry imaging based on Čerenkov emission for external beam radiotherapy with megavoltage x-ray beam.

Purpose: Cerenkov radiation emission occurs in all tissue, when charged particles (either primary or secondary) travel at velocity above the threshold for the Cerenkov effect (about 220 KeV in tissue for electrons). This study presents the first examination of optical Cerenkov emission as a surrogate for the absorbed superficial dose for MV x-ray beams. Methods: In this study, Monte Carlo simulations of flat and curved surfaces were studied to analyze the energy spectra of charged particles produced in different regions near the surfaces when irradiated by MV x-ray beams. Cerenkov emission intensity and radiation dose were directly simulated in voxelized flat and cylindrical phantoms. The sampling region of superficial dosimetry based on Cerenkov radiation was simulated in layered skin models. Angular distributions of optical emission from the surfaces were investigated. Tissue mimicking phantoms with flat and curved surfaces were imaged with a time domain gating system. The beam field sizes (50 × 50–200 × 200 mm2), incident angles (0°–70°) and imaging regions were all varied. Results: The entrance or exit region of the tissue has nearly homogeneous energy spectra across the beam, such that their Cerenkov emission is proportional to dose. Directly simulated local intensity of Cerenkov and radiation dose in voxelized flat and cylindrical phantoms further validate that this signal is proportional to radiation dose with absolute average discrepancy within 2%, and the largest within 5% typically at the beam edges. The effective sampling depth could be tuned from near 0 up to 6 mm by spectral filtering. The angular profiles near the theoretical Lambertian emission distribution for a perfect diffusive medium, suggesting that angular correction of Cerenkov images may not be required even for curved surface. The acquisition speed and signal to noise ratio of the time domain gating system were investigated for different acquisition procedures, and the results show there is good potential for real-time superficial dose monitoring. Dose imaging under normal ambient room lighting was validated, using gated detection and a breast phantom. Conclusions: This study indicates that Cerenkov emission imaging might provide a valuable way to superficial dosimetry imaging in real time for external beam radiotherapy with megavoltage x-ray beams.
Surrogate decision makers' responses to physicians' predictions of medical futility.

Background Although physicians sometimes use the futility rationale to limit the use of life-sustaining treatments, little is known about how surrogate decision makers view this rationale. We sought to determine the attitudes of surrogates of patients who are critically ill toward whether physicians can predict futility and whether these attitudes predict surrogates' willingness to discontinue life support when faced with predictions of futility. Methods This multicenter, mixed qualitative and quantitative study took place at three hospitals in California from 2006 to 2007. We conducted semistructured interviews with surrogate decision makers for 50 patients who were critically ill and incapacitated that addressed their beliefs about medical futility and inductively developed an organizing framework to describe these beliefs. We used a hypothetical scenario with a modified time-trade-off design to examine the relationship between a patient's prognosis and a surrogate's willingness to withdraw life support. We used a mixed-effects regression model to examine the association between surrogates' attitudes about futility and their willingness to limit life support in the face of a very poor prognosis. Validation methods included the use and integration of multiple data sources, multidisciplinary analysis, and member checking. Results Sixty-four percent of surrogates (n = 32; 95% confidence interval [CI], 49 to 77%) expressed doubt about the accuracy of physicians' futility predictions, 32% of surrogates (n = 16; 95% CI, 20 to 47%) elected to continue life support with a Conclusions Doubt about physicians' ability to predict medical futility is common among surrogate decision makers. The nature of the doubt may have implications for responding to conflicts about futility in clinical practice.
Management of acute type B aortic dissection; ADSORB trial

Objectives Type B dissection accounts for 25% to 40% of all aortic dissections. The current brief review presents an update on this disease, focusing on new data and insights that have come to light in the past 2 years since the topic was last reviewed at the 2012 AATS Aortic Symposium. Methods A literature search using PubMed (www.ncbi.nih.gov/pubmed) was performed with the search terms "acute type B aortic dissection" and "ADSORB trial," and all English-language articles published in print or available online between 2011 and March 2014 were carefully reviewed. Articles were selected for inclusion on the basis of perceived novel important insights into the pathophysiology and management of acute type B dissection. Data from the ADSORB (Acute Dissection: Stent graft OR Best medical therapy) trial were graciously provided by the ADSORB investigators prior to trial publication. Results Important new findings regarding acute type B aortic dissection include data on differences between blacks and whites with acute aortic dissection, proposed changes to the current classification system, anatomic predictors of late outcomes, long-term results with thoracic endovascular aortic repair, as well as additional insights into the uncommon but potentially deadly complication of retrograde type A dissection after endovascular repair. Further, early results from the ADSORB trial suggest a benefit for thoracic endovascular repair plus best medical therapy over medical therapy alone for aortic remodeling outcomes 1 year post dissection. Conclusions A great deal of important information on acute type B aortic dissection has become available in the past 2 years since the 2012 AATS Aortic Symposium, some of which is summarized in this brief review. Further, it is clear that much additional investigation is needed so we in the aortic disease management community may continue to gain "new insights into an old disease."
Religious Cults, the Individual and the Family

Relatively little attention has been paid in the professional literature to the cult phenomenon: what it is, how it attracts converts, what differentiates the vulnerable youth from the non-vulnerable; the effects of cult membership on the convert's family, and, particularly, in what ways the family can be aided during and after involvement with the cult. The authors have drawn on clinical observations, interviews, and extant literature from a variety of disciplines in constructing a portrait of the vulnerable youth; the techniques used by cults to attract, recruit, and convert members; the dynamics of the recruits family; and the most effective modes of therapy for intervening. The intent of the article is to stimulate: 1) professional awareness of and knowledge about the cults, and 2) further research into related family dynamics and therapeutic techniques.