cssi/SciSciGPT-SciSciNet huggingface dataset:
Best strategies for patient education about anticoagulation with warfarin: a systematic review

Patient education is an essential component in quality management of the anticoagulated patient. Because it is time consuming for clinicians and overwhelming for patients, education of the anticoagulated patient is often neglected. We surveyed the medical literature in order to identify the best patient education strategies. Study Selection: Two reviewers independently searched the MEDLINE and Google Scholar databases (last search March 2007) using the terms "warfarin" or "anticoagulation", and "patient education". The initial search identified 206 citations, A total of 166 citations were excluded because patients were of pediatric age (4), the article was not related to patient education (48), did not contain original data or inadequate program description (141), was focused solely on patient self-testing (1), was a duplicate citation (3), the article was judged otherwise irrelevant (44), or no abstract was available (25). Data Extraction: Clinical setting, study design, group size, content source, time and personnel involved, educational strategy and domains, measures of knowledge retention. Data Synthesis: A total of 32 articles were ultimately used for data extraction. Thirteen articles adequately described features of the educational strategy. Five programs used a nurse or pharmacist, 4 used a physician, and 2 studies used other personnel/vehicles (lay educators (1), videotapes (1)). The duration of the educational intervention ranged from 1 to 10 sessions. Patient group size most often averaged 3 to 5 patients but ranged from as low as 1 patient to as much as 11 patients. Although 12 articles offered information about education content, the wording and lack of detail in the description made it too difficult to accurately assign categories of education topics and to compare articles with one another. For the 17 articles that reported measures of patient knowledge, 5 of the 17 sites where the surveys were administered were located in anticoagulation clinics/centers. The number of questions ranged from as few as 4 to as many as 28, and questions were most often of multiple choice format. Three were self-administered, and 2 were completed over the telephone. Two reports described instruments along with formal testing of the validity and reliability of the instrument. Published reports of patient education related to warfarin anticoagulation vary greatly in strategy, content, and patient testing. Prioritizing the educational domains, standardizing the educational content, and delivering the content more efficiently will be necessary to improve the quality of anticoagulation with warfarin.
THE IMPACT OF RACISM ON CLINICIAN COGNITION, BEHAVIOR, AND CLINICAL DECISION MAKING

Over the past two decades, thousands of studies have demonstrated that Blacks receive lower quality medical care than Whites, independent of disease status, setting, insurance, and other clinically relevant factors. Despite this, there has been little progress towards eradicating these inequities. Almost a decade ago we proposed a conceptual model identifying mechanisms through which clinicians' behavior, cognition, and decision making might be influenced by implicit racial biases and explicit racial stereotypes, and thereby contribute to racial inequities in care. Empirical evidence has supported many of these hypothesized mechanisms, demonstrating that White medical care clinicians: (1) hold negative implicit racial biases and explicit racial stereotypes, (2) have implicit racial biases that persist independently of and in contrast to their explicit (conscious) racial attitudes, and (3) can be influenced by racial bias in their clinical decision making and behavior during encounters with Black patients. This paper applies evidence from several disciplines to further specify our original model and elaborate on the ways racism can interact with cognitive biases to affect clinicians' behavior and decisions and in turn, patient behavior and decisions. We then highlight avenues for intervention and make specific recommendations to medical care and grant-making organizations.
Characterization and Dynamics of Aggresome Formation by a Cytosolic Gfp-Chimera✪

Formation of a novel structure, the aggresome, has been proposed to represent a general cellular response to the presence of misfolded proteins (Johnston, J.A., C.L. Ward, and R.R. Kopito. 1998. J. Cell Biol. 143:1883–1898; Wigley, W.C., R.P. Fabunmi, M.G. Lee, C.R. Marino, S. Muallem, G.N. DeMartino, and P.J. Thomas. 1999. J. Cell Biol. 145:481–490). To test the generality of this finding and characterize aspects of aggresome composition and its formation, we investigated the effects of overexpressing a cytosolic protein chimera (GFP-250) in cells. Overexpression of GFP-250 caused formation of aggresomes and was paralleled by the redistribution of the intermediate filament protein vimentin as well as by the recruitment of the proteasome, and the Hsp70 and the chaperonin systems of chaperones. Interestingly, GFP-250 within the aggresome appeared not to be ubiquitinated. In vivo time-lapse analysis of aggresome dynamics showed that small aggregates form within the periphery of the cell and travel on microtubules to the MTOC region where they remain as distinct but closely apposed particulate structures. Overexpression of p50/dynamitin, which causes the dissociation of the dynactin complex, significantly inhibited the formation of aggresomes, suggesting that the minus-end–directed motor activities of cytoplasmic dynein are required for aggresome formation. Perinuclear aggresomes interfered with correct Golgi localization and disrupted the normal astral distribution of microtubules. However, ER-to-Golgi protein transport occurred normally in aggresome containing cells. Our results suggest that aggresomes can be formed by soluble, nonubiquitinated proteins as well as by integral transmembrane ubiquitinated ones, supporting the hypothesis that aggresome formation might be a general cellular response to the presence of misfolded proteins.
Medizinische Evaluation von Technologien für die Gesundheitsversorgung

In dieser Arbeit werden verschiedene Ansatze und Methoden zur Evaluation medizinischer Technologien prasentiert, mit dem Ziel, arzte, okonomen und andere Wissenschaftler ohne formale Ausbildung in der Evaluationsforschung, der Epidemiologie oder der Biostatistik in dieses Gebiet einzufuhren. Wir werden versuchen, die Begriffe und Methoden mit einem Minimum an Fachausdrucken und ohne viele technische Einzelheiten darzulegen. Anhand ausgewahlter Beispiele spezifischer Technologieevaluationen soll das methodologische Vorgehen illustriert werden.
The Diversity Problem

For people with no religious beliefs, it is not clear what reasons can be given for why they should convert to any particular religion, particularly in the face of many competing claims. This book will employ William Alston’s doxastic-practice epistemology to argue that religious experiences can be grounds for rational religious belief, and that the evidence provided by Theravada Buddhist meditation provides better evidence than Christian religious experiences.
Prevalence of and Risk Factors for Dysphagia in the Community Dwelling Elderly: A Systematic Review.

Objectives This review clarifies current information regarding the prevalence of and risk factors associated with dysphagia (swallowing disorders) in the community dwelling elderly (CDE). A better understanding of prevalence and characteristics of dysphagia in the CDE will help to determine the scope of this problem. Understanding the scope of dysphagia is a critical first step towards early identification, management, and prevention of dysphagia related morbidities in the CDE.
Properties of Rabbit Aorta Amine Oxidase

SummaryAn amine oxidase from rabbit aorta has been purified 20-fold. The enzyme possesses a substrate specificity pattern very similar to that found in rabbit plasma. The enzyme actively catalyzes the oxidation of alkylamines, benzylamine, tyramine, and tryptamine. The pH optimum with respect to benzylamine oxidation is pH 7.9. The enzyme is inhibited by a variety of agents which are known to attack carbonyl functions.
Recent compositions and performance instruments realized in Java Music Specification Language

Java Music Specification Language (JMSL, Didkovsky, Burk) is a Java API for algorithmic music composition and performance. This paper presents an overview of three recent pieces realized in JMSL. The works included here demonstrate a wide range of what JMSL offers the composer and performer, including real-time interactive score generation (Zero Waste for sight reading pianist and computer), physical instrument modeling for compositional purposes (Tube Mouth Bow String for string quartet and live electronics), and the creation of intelligent, real-time performance instruments (Virtual Rhythmicon, based on the Henry Cowell’s Rhythmicon).
The conscience of the specialty.

The American College of Obstetricians and Gynecologists (ACOG) has a two-pronged Quality Assurance program for use by practitioners. The Voluntary Review of Quality Care Program allows hospital departments of obstetrics and gynecology to be reviewed, at their own request, by a team of trained reviewers. The quality Assurance in Obstetrics and Gynecology Manual, published in May 1989, provides clinical indicators and clinical criteria to be used within a department to establish its own quality assurance program
Cryopreservation of alfalfa (Medicago sativa L.) cells by encapsulation-dehydration

Our objective was to establish a cryopreservation protocol for alfalfa (Medicago sativa L.) cells and study the physiological changes occurring in cells during cryopreservation treatment. Cell cultures of Pioneer cvs. 5262 (fall-dormant, winter-hardy) and 5929 (non-dormant, non-hardy) plants initiated regrowth after cryopreservation by encapsulation-dehydration (ED). Pre-treatment of the encapsulated cells for 4 days in B5 medium containing 0.75 M sucrose and dehydration for 4 h in a laminar flow hood were necessary to achieve maximum cell viability after ED and cryopreservation in liquid N2 (EDN). Viability (measured as triphenyl tetrazolium chloride reduction) of the cv. 5262 cells after cryopreservation was two- to three-fold greater than that of the cv. 5929 cells. Cold acclimation of the cells (10 days at 2°C) improved viability after cryopreservation. The addition of 7.6 µM ABA to the B5 medium enhanced viability in ED but did not improve cell cryopreservability. Cold-acclimated cells had higher protein concentrations, but neither ABA nor cold acclimation influenced protein composition of cold-acclimated cells determined using SDS-PAGE. Encapsulated cells pre-treated for 4 days in B5 medium containing 0.75 M sucrose showed an increased concentration of cell protein and an altered protein composition. Suspension cultures were re-initiated from both ED and EDN treatments by transferring beads sequentially to B5 media containing 0.75, 0.5, 0.25 M sucrose and then to fresh B5 medium. The ED cells resumed rapid growth after two subcultures, whereas EDN cells needed four or five subcultures to resume rapid growth.
Somatic JAK2 mutations and their tumor phenotypes.

In this issue of Blood , [Grisouard et al][1] use transgenic mice to describe the phenotype associated with the human polycythemia vera (PV)-associated JAK2 exon 12 mutation ( JAK2-N542-E543del ) and demonstrate Stat1-independent erythroid-only proliferation.[1][2] ![Figure][3] Domain
Long-Term Demyelinating Disease Activity Following Initial Diagnosis of Acute Disseminated Encephalomyelitis: Clinical Relapses, Flares, or No Evidence of Disease Activity? (P6.115)

Objective: To characterize the frequency and spectrum of relapsing demyelinating disease after an initial acute disseminated encephalomyelitis (ADEM) diagnosis and to radiologically characterize no evidence of disease activity (NEDA) at last known follow-up in clinically monophasic patients. Background: Longitudinal assessment of brain MRIs in ADEM patients has not yet been analyzed for NEDA to our knowledge. Detailed clinical and radiological depiction of relapsing disease may guide future treatment strategies, clarify prognosis, and provide earlier points of intervention in patients. Methods: Patients of any age diagnosed with ADEM (01-2000 to 12-2014, ICD-9 codes 323.61 and 323.81) at the Massachusetts General Hospital were included. Patients who experienced clinical evidence of relapses (defined as new symptoms >3 months after initial presentation) were clinically characterized. There were two pre-defined endpoints: a) subsequent clinical events during observed follow-up, and b) brain MRI activity based on an independent neuroradiologist’s review of last versus first brain imaging, blinded to clinical events. Results: Of 72 patients (32 pediatric, 31 male, median follow-up 25 months (IQR 13-74), 2 deaths), 17 patients experienced a demyelinating relapse. Another 8 patients were diagnosed with non-demyelinating disease and were excluded from further analysis. Eight patients experienced monophasic (n=4) or recurrent (n=4) optic neuritis. Two patients each experienced two relapses including encephalopathy after initial encephalopathic presentation. Gadolinium enhancement persisted on follow-up MRI in 6 clinically monophasic patients (16[percnt]), but none showed other evidence of disease activity. All patients who experienced relapsing demyelinating disease had evidence of disease activity (n=9) or interval demyelination (n=6) on last available MRI. Conclusions: Several distinctive patterns can be identified including relapsing disease and both radiologically and clinically monophasic disease. NEDA was identified in all ADEM patients who remained monophasic clinically. However, the lack of routine long-term MRI follow-up may prohibit the identification of clinically silent lesions in some cases. Disclosure: Dr. Koelman has nothing to disclose. Dr. Klein has received personal compensation in an editorial capacity for AccessMedicine Neurology. Dr. Mateen has nothing to disclose.
Dose Dense, High Intensity Induction Therapy Followed by Early High Dose Chemotherapy (HDT) and Autologous Hematopoietic Stem Cell Transplantation(AHSCT) for Mantle Cell Lymphoma (MCL).

Abstract Introduction: Though response may occur with standard therapy, early relapse is common with advanced stage MCL, suggesting the importance of drug resistance in this disease process.It appears that repeated cycles of aggressive chemotherapy to a point of maximum response, followed by HDT and AHSCT, provides improved disease free intervals, though the impact on overall survival (OS) remains uncertain. A concern with this approach is that the eventual high relapse rate seen in most trials may be due to the emergence of drug resistance prior to HDT. In an attempt to circumvent the problem of drug resistance due to multiple cycles of chemotherapy, we designed a dose dense approach using only one cycle of an aggressive induction regimen. Patients demonstrating at least PR and a BM uninvolved by morphology and flow cytometry studies proceeded with chemotherapy-primed PBPC collection, before receiving HDT and AHSCT. Patients and Methods: HIDAC 3 gm/m2 over 1 hour q12 hours for 12 doses in combination with mitoxantrone 12mg/m2 daily for 3 days were given as induction therapy. Responders were mobilised with either VP-16 2 gm/m2 or cyclophosphamide 4 gm/m2 followed by G-CSF 10 mcg/kg daily until stem cell collection. The preparative regimen consisted of BCNU 15mg/kg over 2 hours D-6, VP-16 60mg/kg over 4 hours D-4 and cyclophosphasmide 100mg/kg over 2 hours D-2. Results: Twenty one stage IV patients and 2 stage III patients were enrolled, including 7 with relapsed/refratory disease. Median age was 56 yo(40–74). Nine (39%) patients achieved CR and 11 (48%) patients achieved PR with all showing >80% reduction in tumor size. Three patients died after induction: 1 from sepsis; 2 from disease progression. Seventeen (74%) of the 20 patients with CR or > 50% PR proceeded to PBPC mobilisation whereas 3 were deemed too ill to undergo HDT (2 of these were in CR from induction). A total of 14 (10 previously untreated and 4 had failed prior therapy) eventually had adequate stem cell collected and underwent planned HDT and were fully evaluable for outcome. There was no TRM to HDT and while only 6 patients entered HDT in CR, all 14 patients attained a CR at recovery from transplant. With a median follow-up from study entry for these 14 autotransplant patients of 36 months (17–68), 8 patients are still alive and in CR. The estimated 4 year OS and event free survival (EFS) for these 14 patients were both 64% and the median survival was 57 months.(see figure) Conclusions: The study shows that a dose dense, high intensity approach for advanced MCL provides a very high CR and PR rate. Those who were able to complete this protocol have a high chance of achieving favorable disease free survival. Download : Download high-res image (119KB) Download : Download full-size image Figure.
Trends in Operating Room Assistance for Major Urologic Surgical Procedures: An Increasing Role for Advanced Practice Providers.

Objective To characterize changes in surgical assistance patterns over time for commonly performed urologic operations. Materials and Methods This study used the Medicare Physician/Supplier Procedure Summary Master File to identify cases performed by urologists from 2003 to 2014. Current Procedural Terminology modifiers were used to identify operations assisted by second surgeons and advanced practice providers (APPs). Rates were reported annually for 6 common urologic operations, and average annual rates of change were determined using least squares regression and tested using t tests (α = .05). Results Of the urologic operations analyzed, 5.0% of cases (n = 33,895) were assisted by APPs compared with 27.0% (n = 182,842) assisted by a second surgeon. The proportion of cases assisted by an APP rose significantly for all procedures; conversely, the proportion of cases assisted by a second surgeon declined significantly for all procedures, except for open partial nephrectomy. The largest changes were seen in robotic prostatectomies for which second surgeon assistance fell from 26% in 2004 to 15% in 2014, whereas APP assistance rose from Conclusion Urologists are increasingly using APPs as assistants in surgery, particularly in robotic and laparoscopic operations. This trend will likely continue as the shortage of urologists worsens in the coming years.
Management of Necrotizing Soft Tissue Infection

Necrotizing soft tissue infection is a relatively rare, but highly morbid condition requiring immediate surgical evaluation and initiation of multimodal treatment. The key to effective treatment for NSTI is early recognition of the problem, facilitated by history and physical examination, as well as laboratory data. Imaging is rarely helpful and often only serves to delay definitive surgical evaluation and debridement. Severe systemic disease can manifest as septic shock and multisystem organ failure, and surgical source control is the mainstay of successful treatment, when combined with broad spectrum antibiotic administration and hemodynamic support to minimize progression of organ failure. It may be necessary to perform radical debridement, even amputation, to arrest progression of the disease, and interval reoperations should continue until no further debridement of necrotic tissue is needed. Adjunctive therapies may be helpful, but should be considered secondary and should not delay definitive surgical debridement or transfer to a facility if surgical intervention is not available.
Galef’s Transfer-of-Information Effect Occurs in a Free-Foraging Situation

Galef and his colleagues have repeatedly shown that one rat may transfer information regarding the type of food it has consumed to other conspecifics. Such experiments typically have been conducted in wire-mesh cages or a wooden maze. The present experiments sought to extend this paradigm to the open-field foraging situation having six food patches to choose from. Following interaction with a demonstrator that had consumed either a cocoa or a cinnamon diet, single observers (Experiment 1) were tested in the foraging situation. Food-consumption scores indicated that observers consumed significantly more of their specific demonstrator’s diet than a second diet that was available also. Experiment 2 involved the simultaneous testing of two observers in the foraging laboratory. In Experiment 3 two observers were once again tested, but each had been provided a different food-type message prior to foraging. Positive results, mirroring those of Experiment 1, were obtained in both Experiments 2 and 3. The results of these three experiments underscore the robustness of this phenomenon and its generalizability to other testing conditions.
Gamma Putty shielding effect in megavoltage photon beam

Purpose: Traditionally, lead and Cerrobend have been employed for field shaping in radiation therapy. Lately, another shielding material called Gamma Putty has emerged. The objective of this report is to examine its dosimetric and shielding characteristics in megavoltage photon beam. Methods: All measurements were carried out in a dual energy linac. Data were collected using a calibrated ionization chamber. Percent transmission, linear attenuation, and field size dependence were evaluated for open square fields (4 × 4 cm 2 to 10 × 10 cm 2 ) defined by collimator jaws and for different Gamma Putty thicknesses (t = 0, 0.3, 0.5, 1.0, 1.5, 2.0, and 2.5 cm) at 6 and 18 MV photon beams. The measurements were performed both in air using appropriate acrylic buildup cap and in solid water. Results: The Gamma Putty tray factor (GPTF) increased steadily with field size for both 6 and 18 MV. It was characterized by a half value thickness (HVT) of 2.513 ± 0.101 and 2.855 ± 0.024 cm for 6 and 18 MV, respectively. The reduction in surface dose was about 6%, 14.5%, 22%, 36.37%, and 54% for 6 MV and 2.75 %, 9.36 %, 16.25 %, 28.95 %, and 44.47 % for 18 MV for Gamma Putty thicknesses of 0.3, 0.5, 1.0, 1.5, 2.0, and 2.5 cm. Conclusion: The result of Gamma Putty shielding on the photon beam output increases with thickness, beam energy, and field size. Therefore, clinical use of Gamma Putty tray factors should be tailored for all thicknesses, beam energies, and field sizes.
Active Implementation Frameworks: Their Importance to Implementing and Sustaining Effective Mental Health Programs in Rural Schools

Implementing and sustaining school mental health programs can be a challenging and multifaceted process. Over the past several decades, considerable research, policy, and funding have been focused on the use of evidence-based programs and practices. Far less focus has been given to the implementation of these practices. The combination of effective programs and effective implementation methods is required to assure consistent use of programs and reliable benefits to students with mental health needs. This chapter outlines how implementation science and the use of evidence-based Active Implementation Frameworks (Fixsen et al. Implementation research: A synthesis of the literature. University of South Florida, Tampa, FL, 2005) can guide the process of implementation from selection of a program through full and effective use of that program. The information in this chapter is intended to help educators and mental health professionals become familiar with these Active Implementation Frameworks and their importance to implementing and sustaining effective mental health programs in rural educational settings.
A minimal physiologically based pharmacokinetic model that predicts anti-PEG IgG-mediated clearance of PEGylated drugs in human and mouse

Circulating antibodies that specifically bind polyethylene glycol (PEG), a polymer routinely used in protein and nanoparticle therapeutics, have been associated with reduced efficacy and increased adverse reactions to some PEGylated therapeutics. In addition to acute induction of anti-PEG antibodies (APA) by PEGylated drugs, typically low but detectable levels of APA are also found in up to 70% of the general population. Despite the broad implications of APA, the dynamics of APA-mediated clearance of PEGylated drugs, and why many patients continue to respond to PEGylated drugs despite the presence of pre-existing APA, remains not well understood. Here, we developed a minimal physiologically based pharmacokinetic (mPBPK) model that incorporates various properties of APA and PEGylated drugs. Our mPBPK model reproduced clinical PK data of APA-mediated accelerated blood clearance of pegloticase, as well as APA-dependent elimination of PEGyated liposomes in mice. Our model predicts that the prolonged circulation of PEGylated drugs will be compromised only at APA concentrations greater than ~500 ng/mL, providing a quantitative explanation to why the effects of APA on PEGylated treatments appear to be limited in most patients. This mPBPK model is readily adaptable to other PEGylated drugs and particles to predict the precise levels of APA that could render them ineffective, providing a powerful tool to support the development and interpretation of preclinical and clinical studies of various PEGylated therapeutics.
A Strategic Model for Multinational Corporation Social Responsibility in the Third World

Frequent criticism of multinational corporation social responsibility is contrasted with the “Friedman Doctrine,” which maintains that the social responsibility of business is to increase profits. ...
A goal-based approach to the identification of essential transformation variables in support of the implementation of the 2030 agenda for sustainable development

The United Nations' 2030 Agenda for Sustainable Development sets seventeen Sustainable Development Goals (SDGs) to be achieved by 2030. Earth observation are needed that can support the development...
Superacidic Mesoporous Catalysts Containing Embedded Heteropolyacids

Superacidic mesoporous silica materials containing embedded heteropolyacids (HPAs) were synthesized by sol–gel method in acidic media. In these materials, HPAs were immobilized into the silica structure covalently. The most acidic materials were obtained at the use of Pluronic P123 as a non-ionic pore-forming agent. Ionic surfactants also formed mesoporous structures, however, their interaction with HPA reduced acidity of the products. Obtained materials were tested as heterogeneous catalysts in liquid-phase alkylation of 1,3,5-trimethylbenzene by 1-decene. The most effective catalyst demonstrated higher conversion of starting substances to long-chain isomeric alkylbenzenes as compared to the activity of zeolite HY, a well-known alkylation catalyst. No leaching of HPA from silica gel was observed after the alkylation.
New Media Usage and Privacy Policies in Baltic States' Newspaper Websites

This report summarizes how the new media has penetrated the top twelve online newspaper websites in the Baltic States (Estonia, Latvia, and Lithuania). New media involves new communication techniques such as social networks, mobile applications software (mobile apps), weblog (blogs), and Internet forums (forums) or message boards (boards). Results show that the top twelve Estonian newspaper websites have the most new media features with links to social networking sites such as Facebook and Twitter, Really Simple Syndication feeds (RSS feeds), blogs, and search engines. Privacy policies related to new media tend to be inconsistent across newspapers.
Practice, Preferences, and Practical Tips From Primary Care Physicians to Improve the Care of Cancer Survivors.

PURPOSE:There is a need to improve the coordination of care and communication between primary care physicians (PCPs) and oncology after completion of initial cancer treatment. We sought to evaluate...
Clinical Reasoning: A 55-year-old obese woman with headache and rhinorrhea.

A 55-year-old obese woman with a history of migraine and tension-type headaches presented with headache for 5 days with acute worsening for 1 day. The headache was throbbing, holocephalic, and maximal at the left temple, and worsened with both standing and lying down and with exertion. The headache was initially mild for 4 days before acutely worsening in severity and waking her from sleep with associated nausea and photophobia. Unlike her typical headaches, it did not improve with over-the-counter analgesics and was more prolonged. There were no associated visual complaints, hearing changes or phonophobia, jaw claudication, weakness, numbness, or paresthesias.
Francis Abiola Irele: his exemplarity, our critical ancestor

There were features of Francis Abiola Irele’s early life that shaped his intellectual pathway and that we must wait for the occasion to explore fully. For now, let us note a few details: he was bor...
The effect of anesthesia choice on post-operative outcomes in women undergoing exploratory laparotomy for gynecologic malignancy.

e20571 Background: The goal of this study is to examine how regional anesthesia choice in women undergoing laparotomy for gynecologic malignancy affects their pain and hospital stay. Methods: This ...
Calcific tendonitis of the flexor pollicis longus tendon at the thumb interphalangeal joint in childhood.

In rare instances, calcific tendonitis may manifest in the pediatric population as inflammatory calcium hydroxyapatite deposition. To our knowledge, there have been no previous case reports involvi...
The Energy Crisis and Unconventional Resources

After World War II, substantial petroleum resources were found in South America, the Niger Delta, the North Sea, northern Africa, and western Australia, with the biggest oil strikes of all located in the Middle East, including the super-giant Al-Ghawar oil field in Saudi Arabia. International oil exploration was initially carried out by large U.S., British, and French companies in partnerships with governments, but as local populations became educated in petroleum technology and oilfield engineering operations, governments discovered that they could produce petroleum and natural gas on their own. The oil companies shifted focus to collect crude oil on tankers, ship it off to refineries, and then distribute the resulting products in domestic and international sales. Oil producers had a market, and oil consumers had access to low cost and plentiful oil supplies. This system worked well until politics intervened.
Deep Reinforcement Learning-Assisted Energy Harvesting Wireless Networks

Heterogeneous ultra-dense networking (HUDN) with energy harvesting technology is a promising approach to deal with the ever-growing traffic that can severely impact the power consumption of small-cell networks. Unfortunately, the amount of harvested energy, which depends on the transmission environment, is highly random and difficult to predict. Since there may be multiple sources of energy in the HUDN, e.g., macro base stations or TV towers, the challenging issue is when and where to harvest energy. Optimally controlling the HUDN can profoundly influence the performance of both data transmission and energy harvesting. However, the working pattern of individual small cell base stations needs to be determined in every time slot. To find an optimal solution in a highly random environment we propose reinforcement learning methods, such as deep deterministic policy gradient (DDPG) and wolpertinger DDPG (W-DDPG). Since the action space is large and discrete for the controlling tasks, a W-DDPG algorithm has been found to be the best approach. The simulation results verify that, compared with the original DDPG algorithm and deep Q-learning, the proposed W-DDPG method can achieve a superior performance in terms of both energy efficiency and throughput.
Evolution of the ionosonde

Almost 60 years development of ionosondes and their data processing capabilities are described with emphasis on the authors contributions from the early beginnings of ionospheric studies to the latest digital equipment to be used for the exploration of the magnetosphere.
CFTR Modulators for the Treatment of Cystic Fibrosis

Publisher Summary This chapter focuses on cystic fibrosis transmembrane conductance regulator (CFTR) modulators for the treatment of cystic fibrosis (CF). It summarizes the recent progress made in the discovery of CFTR potentiators and correctors for the treatment of CF, with focus on compounds that have been most extensively characterized or for which chemical optimization has been reported.CF is caused by mutations in the gene encoding the CF transmembrane conductance regulator (CFTR), an epithelial chloride-and bicarbonate-selective ion channel activated by cyclic AMP-dependent protein kinase A (PKA). Current therapies to treat CF lung disease, including mucolytics, antibiotics, and anti-inflammatory agents, target the downstream disease consequences that are secondary to the loss of CFTR function. Increasing CFTR function may provide clinical benefits to CF patients with systemic therapies that appear to be well tolerated. However, more studies are required to study the effects of long-term use of CFTR modulators in a greater diversity of CF patients in terms of their genetic background, age, and disease stage; CFTR drug discovery is still at an early stage.
A simple framework to estimate distributed soil temperature from discrete air temperature measurements in data‐scarce regions

Soil temperature is a key control on belowground chemical and biological processes. Typically, models of soil temperature are developed and validated for large geographic regions. However, modeling frameworks intended for higher spatial resolutions (much finer than 1 km2) are lacking across areas of complex topography. Here we propose a simple modeling framework for predicting distributed soil temperature at high temporal (i.e., 1 h steps) and spatial (i.e., 5 × 5 m) resolutions in mountainous terrain, based on a few discrete air temperature measurements. In this context, two steps were necessary to estimate the soil temperature. First, we applied the potential temperature equation to generate the air temperature distribution from a 5 m digital elevation model and Inverse Distance Weighting interpolation. Second, we applied a hybrid model to estimate the distribution of soil temperature based on the generated air temperature surfaces. Our results show that this approach simulated the spatial distribution of soil temperature well, with a root-mean-square error ranging from ~2.1 to 2.9°C. Furthermore, our approach predicted the daily and monthly variability of soil temperature well. The proposed framework can be applied to estimate the spatial variability of soil temperature in mountainous regions where direct observations are scarce.
Primary myelofibrosis associated glomerulopathy: significant improvement after therapy with ruxolitinib

Primary myelofibrosis (PMF) is a type of myeloproliferative neoplasm (MPN) characterized by the predominant proliferation of megakaryocytes and granulocytes in the bone marrow, leading to the deposition of fibrous tissue, and by a propensity toward extramedullary hematopoiesis. Renal involvement in PMF is rare, but kidney tissue samples from these patients reveal MPN-related glomerulopathy, a recently discovered condition, in the late stages of the disease. We present the first case described in the medical literature of a patient with early renal glomerular involvement in PMF/MPN. A 60-year-old man with stage 4 chronic kidney disease and a recent diagnosis of PMF (within 4 weeks of presentation at our renal division) presented with generalized body swelling, acute kidney injury, and massive nephrotic-range proteinuria. Kidney biopsy was performed to determine the etiology of the patient’s renal dysfunction and revealed early renal glomerular involvement that was histologically characteristic of MPN-related glomerulopathy. Early diagnosis and prompt medical management returned the patient’s kidney functionality to the levels seen on initial presentation at our hospital. Large studies with long follow-up durations are necessary to identify and categorize the risk factors for the development of MPN-related glomerulopathy, to standardize therapeutic regimens, and to determine whether aggressive management of the myelofibrosis slows the progression of kidney disease.
The Effects of Coaching Subjects in the Recognition of Facial Expressions

Abstract A wide range of individual differences in the ability to identify facial expressions of emotion has been reported. As evidence that these inequalities are due in large part to differences of practice in reacting to expressive criteria, rather than to innate factors, F. H. Allport has offered the data from an experimental observation of the effects of training subjects of varying ability for fifteen minutes in the analysis of facial expressions. The gain in score made by his subjects on the facial expression test after the training period was roughly inversely proportional to their original standing; i.e., the less proficient persons gained the most and the more proficient gained the least. Repeating this procedure with larger groups of subjects, both with the same and longer study periods, the writer largely confirmed Allport's data. However, a control experiment, affording no opportunity for study, yielded similar data, except that on the average no gain in score resulted. The inverse relationsh...
Strategy and Planning

Strategic planning emerged as a management tool in the 1960s and can be considered an umbrella for a range of activities, including mission statements, goal setting, and action plans. Currently, strategic planning has a high rate of adoption and strong user satisfaction among firms worldwide. Firms who do not plan strategically may find themselves at a competitive disadvantage relative to competitors and are consequently at risk for lessened performance. Firms must address a range of questions when developing their planning infrastructures, including the balance of top-down versus bottom-up initiatives, the sequencing of decision processes, and the specific elements to include. Keywords: firm performance; mission; goals
Block cross processing: an innovative approach to constraint management

Block cross processing (BXP) is an innovative system developed to provide manufacturing operations with a means for managing constrained areas of a process line using intra-site or inter-site material movement. This system is a proactive process that improves flexibility and increases capacity. The BXP system can be applied to any factories running a common process; it segments the fab process into several "blocks" that are identified as "technically safe" with respect to queue times, integrated yield issues, equipment and/or recipe matching, and capacity concerns. Blocks are a group of operation steps that range in size from 1 to about 10 operation steps depending on the technology and capacity issues within the block. Lots exercising BXP are processed through an entire block on a single manufacturing floor. BXP significantly reduced the amount of transferring between the two New Mexico 6" fab floors. In addition BXP data was used as a diagnostic tool for improving yield by identifying and closing unmatched "gaps" between different factories at a block level. This paper depicts the process used to develop and qualify BXP. It records key learning within the process and notes suggestions for possible improvements.
Investigating positive DUV resist profile on TiN

It is well known that chemically amplified positive tone DUV resists are sensitive to substrate contamination, manifesting themselves as a 'foot' on TiN substrates. Studies have proposed that there is an interaction between nitrogen used in the formation of the TiN and the chemically amplified resist. This reaction occurs when the acid generated in the resist is neutralized by nitrogen and hence a foot is formed. However, the 'foot' abnormality of DUV resist over TiN substrates has not been fully understood or eliminated. In this paper, we study the performance of 0.25 mm features using Shipley's UVIIHS resist on a TiN/metal layer. When UVIIHS was initially evaluated the primary problem was the presence of a 'foot' at the bottom of the resist line. Subsequent studies were conducted on the effects of TiN thickness and composition. The results show the TiN thickness has little effect on the 'foot' while the TiN composition has a profound effect. As the N content in the TiN film increases the size of the food decreases. The foot decreases significantly when a very low nitrogen concentration is used and eliminated completely when using a barrier layer of 100 Ang Ti. Our results also demonstrate that surface pre-treatment of TiN using oxygen plasma can result in good 0.25 mm resist profiles with no noticeable foot present. The results we obtained indicate that chemical and physical properties of the TiN surface play a critical role in DUV resist performance. Therefore multiple spectroscopies have been employed to characterize TiN films including Rutherford backscattering, x-ray photoelectron, and time of flight secondary ion mass. These analysis provide many insights into the mechanism of the resist 'foot' phenomenon.
5.5GHz system z microprocessor and multi-chip module

The new System z microprocessor chip (“CP chip”) features a high-frequency processor core running at 5.5GHz in a 32nm high-κ CMOS technology [1], using 15 levels of metal. This chip is a successor to the 45nm product [2], with significant improvements made to the core and nest (i.e. the logic external to the cores) in order to increase the performance and throughput of the design. Also, special considerations were necessary to ensure robust circuit operation in the high-κ technology used for implementation. As seen in the die photo, the chip contains 6 processor cores (compared to 4 cores in the 45nm version), and a large shared 48MB DRAM L3 cache. Each core includes a pair of data and instruction L2 SRAM caches of 1MB each. In addition, the chip contains a memory control unit (MCU), an I/O bus controller (GX), and two sets of interfaces to the L4 cache chips (also in 32nm technology). The CP chip occupies 598 mm2, contains about 2.75B transistors, and has 1071 signal IOs.
Auxin Transport and Geoelectric Potential in Corn Coleoptile Sections.

Asymimetry of indoleacetic acid distribution has been associated with the development of plant bioelectric potentials. In the absence of auxin, no detectable potential develops, but when auxin is supplied auxin asymmetries caused by differences in transport give rise to bioelectric potentials (4, 6). Recently (2) it was demonstrated that under anoxia, where no potential develops, corn coleoptiles still showed geotropic curvature response. This raised 3 related questions: A) Are geoelectric potentials a mandatory consequence of auxin transport-induced asymmetries? B) If gravity-ilnduced asymmetries
The incorporation of acetate-2-14C and mevalonate-2-14C into cholesterol during vitamin B12 deficiency.

SummaryCholesterol biosynthesis was studied in male rats from mothers fed a vitamin B12 deficient diet during pregnancy and lactation. Deficient males had significantly lower plasma cholesterol levels, the ester fraction being diminished. Adrenal cholesterol was appreciably higher, relative to levels observed in the B12 fed rats, while cholesterol content of testes and brain was not significantly different between the two groups. Vitamin B12 deficiency enhanced the rate of acetate incorporation into liver cholesterol while mevalonate incorporation remained unchanged after 30 min and 2 hr but was markedly lower in the deficient group after 4 hr. Mevalonate incorporation into adrenal and testicular cholesterol was also reduced at 4 hr but incorporation into brain cholesterol was unchanged.
A Jefferson Letter

McCormick privides context to and a transcription of a Thomas Jefferson letter (Jan. 1. 1819) concerning the establishment of the University of Virginia held in the Rutgers Library.
Flux pinning in interdiffusing thin films

Abstract Large changes in the flux pinning force and critical fields have been observed during room-temperature interdiffusion of a polycrystalline Pb—18%Bi film with a coating of either Pb or Tl. The flux pinning evolution is highly dependent on the reduced field h ≡ H/H c2. In Tl-coated films the transverse flux pinning force F p⊥ (i.e. measured with the applied magnetic field H normal to the film surface) increases rapidly with ageing, then slowly declines. In Pb-coated films F p⊥ rises and falls, although in a different manner; for h ≫ 0·5, in fact, there is a brief initial period during which F p⊥ declines. These phenomena are attributed to the growth of localized variations in composition around each grain boundary during interdiffusion; such variations modify the intrinsic local perturbation in the electron mean free path (and the Ginzburg-Landau parameter κ) which is produced by the grain boundary itself (Zerweck 1981), and thus alter F p⊥. Calculations based on an electron-scattering-flux-pinning...
Approximation Algorithms for k -hurdle Problems

The polynomial-time solvable k-hurdle problem is a natural generalization of the classical s-t minimum cut problem where we must select a minimum-cost subset S of the edges of a graph such that |p∩S|≥k for every s-t path p. In this paper, we describe a set of approximation algorithms for “k-hurdle” variants of the NP-hard multiway cut and multicut problems. For the k-hurdle multiway cut problem with r terminals, we give two results, the first being a pseudo-approximation algorithm that outputs a (k−1)-hurdle solution whose cost is at most that of an optimal solution for k hurdles. Secondly, we provide a $2(1-\frac{1}{r})$-approximation algorithm based on rounding the solution of a linear program, for which we give a simple randomized half-integrality proof that works for both edge and vertex k-hurdle multiway cuts that generalizes the half-integrality results of Garg et al. for the vertex multiway cut problem. We also describe an approximation-preserving reduction from vertex cover as evidence that it may be difficult to achieve a better approximation ratio than $2(1-\frac{1}{r})$. For the k-hurdle multicut problem in an n-vertex graph, we provide an algorithm that, for any constant e>0, outputs a ⌈(1−e)k⌉-hurdle solution of cost at most O(log n) times that of an optimal k-hurdle solution, and we obtain a 2-approximation algorithm for trees.
Modeling and Control of Acute Infection of Toxoplasma Gondii

Toxoplasma gondii is a protozoan capable of replicating sexually in cats and asexually in other warm-blooded animals. When the parasites first enter a host, the replication process begins very quickly as the free parasites invade healthy host cells, until a host-mediated immune response suppresses replication of the rapidly replicating parasites. To study the effects of this process, a data-driven model is developed where the number of parasites and the IFN-γ level are selected as state variables. The reproduction number, R0 is calculated to determine the criteria for sustaining infection within the host. Stability analyses are carried out for the endemic equilibriums. Parameter fitting is performed using maximum likelihood to match existing data to the model. Finally, an optimal control problem is formulated to investigate the optimal immune strategy when minimizing the negative host reaction to increased IFN-γ levels. The results shed light into the role the immune response plays in suppressing acute infection of Toxoplasma gondii.© 2012 ASME
Disorder delineated semiconductor waveguides

The routing ability of waveguide structures patterned by impurity induced layer disordering of AlGaAs superlattice and graded barrier heterostructures is discussed. Also considered are issues associated with the integration of multiple optical devices into the waveguides.© (1990) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.