cssi/SciSciGPT-SciSciNet huggingface dataset:
Referral management: Which patients are deemed not appropriate for neurologic consultation, and what happens to them?

Abstract Objective In many if not most institutions in the US, demand for neurology services exceeds the supply, resulting in poor access. This study examines whether the use of a limited resource – time for outpatient neurology consultation – can be optimized by screening referrals for appropriateness and whether it is safe to do so. Patients and methods An established triage activity at an academic outpatient clinic – experienced nurses flagging possibly inappropriate outpatient referrals and a group of neurologists triaging them – was examined by obtaining referral characteristics and detailed one year follow up for patients that were referred but not scheduled, over a period of 6 months. A narrative of issues related to this activity is provided as well. Results 180 “Declined” referrals were identified. Most frequent reason for declined referral were pain, headache and dizziness. The most frequently recommended disposition was follow up with the referring primary care physician (32%), pain or spine clinic (11%) or reevaluation by a previously involved outside neurologist (12%). Review of follow up care – as far as available - indicated that in the majority of cases (52%), no further neurologic evaluation was pursued. Triage was considered reasonably safe (i.e. very little if any pathology was missed or work up delayed). In 15%, referring providers tried to circumvent the triage system by various means; we also felt that the option to reach the triaging neurologist was rather underused and that at least a fraction of referring physicians disapproved of triage efforts. Conclusions Triaging referrals by chart review appears to be safe, but its effectiveness is limited by the time investment, limited acceptance by some referring providers and other factors.
Laryngeal squamous cell carcinoma: Early-stage disease

A computerized PubMed search of MEDLINE from 1966 to 2005 was performed. The diagnosis terms “larynx,” “glottic,” or “true vocal cord” were exploded and combined. The terms “cancer,” “carcinoma,” or “squamous cell carcinoma” were exploded and combined. The above two searches were then limited to “early stage,” “T1,” “T2,” “stage I,” or stage II to yield articles focused on early-stage I–II glottic cancer. These articles were then subjected to the PubMed Clinical Queries using Research Methodology Filters [1] optimized for sensitive/broad search for articles in the category of “therapy,” yielding 311 articles. These articles were then cross-referenced with the headings “radiation,” “radiotherapy,” “laser excision,” “endoscopic surgery,” “endolaryngeal resection,” “transoral surgery,” “CO2 cordectomy,” “laser cordectomy,” or “microsurgery,” yielding a total of 250 publications, whose titles and abstracts were reviewed to identify those that met the following inclusion criteria: 1) patient population with primary newly diagnosed, biopsyproven T1 or T2 larynx carcinoma, 2) intervention with radiation or endoscopic resection (with or without laser), 3) outcome measured in terms of survival, local recurrence, and/or larynx preservation.
Effect of temperature on performanceof LaNi4.76Sn0.24 metal hydride electrode

The effect of temperature on the performance of a LaNi4.76Sn0.24 metal hydride electrode was investigated in the temperature range of 0 to 50°C. The electrode showed a maximum discharge capacity at 25°C. The total resistance increases with a decrease of temperature from 50°C to 0°C. The apparent activation enthalpies at different states of charge were determined by evaluating the polarization resistance at different temperatures. It was found that the apparent activation enthalpy is an indicator of the relative reaction rate of the charge-transfer reaction and hydrogen absorption.
The Therapeutic Potential of Liver Repopulation for Metabolic or Endocrine Disorders

Liver repopulation with transplanted cells should be of significant interest for multiple genetic and acquired disorders. The regenerative potential of liver cells offers many opportunities for genetic manipulations and cell transplantation research. The general consideration is that use of mature hepatocytes or stem/progenitor cells for this purpose will provide effective ways to ameliorate specific diseases. Recent progress in various aspects of liver-directed cell therapy has been highly promising. For instance, it has become clear that transplanted cells can engraft efficiently and proliferate under suitable conditions to repopulate significant portions of the liver. Moreover, specific disorders can be corrected by hepatocyte transplantation. Also, genetic manipulation of cells before transplantation offers further opportunities for treating diseases. However, a variety of relevant issues still need to be resolved, including the types of cells that will be most efficacious for clinical applications, effective ways to cryopreserve cells for use at short notice, and abrogation of allograft rejection by nontoxic means. Contemplating liver-directed cell therapy for major endocrine disorders such as type 1 diabetes mellitus requires identification of suitable cells that could be modified to induce regulated hormone or enzyme expression. Recent studies suggest that stem/progenitor cell populations isolated from the fetal human liver will be effective for this purpose. Of course, advances in stem cell biology raise hopes for generating alternative sources of cells in view of the limited supply of adult human organs, which should further facilitate applications of liver cell therapy.
Symmetry Reductions in Model-Checking

Symmetries occur in different forms in concurrent programs. Such symmetries are induced by processes that behave similarly, and also by data items which are treated similarly by the processes. The talk will present three different methods, based on symmetry reductions, in containing the state explosion problem in model checking. The first method considers the symmetries in the program as well the formula. In this method we first construct a quotient structure, corresponding to the reachable part of the global state graph, and then check the satisfaction of the formula in the quotient structure using the traditional model checking algorithms. This method is primarily useful in checking safety properties. The second method considers only the symmetries in the program and is based on the construction of Annotated Quotient Structure (AQS). The AQS is like the quotient structure excepting that the edges carry additional information. This additional information is used for checking correctness under fairness. This method allows checking of both safety and liveness properties.The third method employs Guarded Quotient Structures (GQS). This method can be employed for employing symmetry reductions in systems that are almost symmetric. In this method, we expand the asymmetric system by adding new edges. We construct the AQS of the expanded reachability graph, and add guards to the edges of the AQS to obtain the GQS. In order to check for correctness, we unwind the GQS. The guards on the edges are used to only consider the edges in the original graph. The method employs formula decomposition and sub-formula tracking to further speed up the model-checking process.The talk will also present a Symmetry based Model Checker, called SMC. It is an on-the-fly model checker that employs symmetry reductions and checks for correctness under a variety of fairness conditions. SMC permits the user to invoke two different types of symmetry reductions-- process symmetry and state symmetry. It also allows the user to specify the type of fairness that needs to be invoked-- weak fairness, strong fairness. It also allows the user to specify different types of on-the-fly options that need to be invoked.
Mutual Mistake or Excuse: Which Approach to Pursue When Seeking Judicial Relief From Contractual Obligations on the Basis of Supervening Knowledge?

When a person seeks to be relieved from their contractual obligations on the basis of supervening knowledge of a fact existing at the time of contracting that has rendered their performance impracticable or even impossible, and/or has frustrated their purpose in entering into the contract, they would appear to have choice between asserting a mutual mistake enforce-ability defense, or instead asserting one or more of the impossibility, impracticability, or frustration of purpose excuse defenses. Do they in fact have this choice, or does each of these approaches for obtaining relief have its own distinct scope of application, with little if any overlap? If there are circumstances where a person does have this choice, which approach is likely to be more promising as the primary means of seeking relief? There is unfortunately a relative absence of clarifying case law on this question, and this brief article considers the guidance provided by Sections 152 and 266 of the Restatement (Second) of Contracts and the associated Official Comments. The article concludes that where there is a choice available between the two approaches the question as to which one to most aggressively pursue, rather than only plead secondarily in the alternative, turns upon the definition of “materiality” that will be applied by the court with regard to the mutual mistake defense. The mutual mistake defense approach is likely to be the more promising tact in all instances, although perhaps only marginally so if the court applies the most stringent materiality criterion suggested by the Official Comment to Restatement (Second) Section 152.
Firearm legislation and statewide suicide rates: The moderating role of household firearm ownership levels

Firearm legislation is associated with statewide suicide rates; however, prior research has often relied upon older data and categorical legislative grades while also failing to consider the nuanced role of firearm ownership. Therefore, the robust literature base on legislation and suicide has not directly examined regarding the extent to which the value of legislation hinges upon the rate of firearm ownership in a given state. The current study examined 2015 US statewide firearm legislation strength scores from Giffords Law Center to Prevent Gun Violence and 2016 statewide suicide rates from the Centers for Disease Control and Prevention. Firearm legislation strength was inversely associated with statewide overall and firearm suicide rates, but not with non-firearm suicide rates. Firearm ownership rates moderated the association between firearm legislation strength and statewide overall suicide rates. Specifically, firearm legislation strength was inversely associated with statewide overall suicide rates at mean and high levels of firearm ownership. Findings support the potential utility of firearm legislation as part of a national effort to decrease US suicide deaths, particularly in areas with higher firearm ownership rates.
Platelet mechanosensing axis revealed

An intermediate affinity state of integrin αIIBβ3 has been identified to be a key player in platelet mechanosignalling.
Infantile refractory seizures due to de novo KCNT 1 mutation

We describe a term female infant who presented with multiple seizures early in infancy. The clinical and electrical seizures were refractory to traditional antiepileptic medications. After extensive workup, seizure panel testing revealed KCNT1 gene mutation, which is associated with nocturnal frontal lobe epilepsy and epilepsy of infancy with migrating focal seizures. The infant's condition improved with the combination of traditional as well non-traditional antiepileptic therapy.
Charisma, Social Aspects of

This article is a revision of the previous edition article by S. Abbruzzese, volume 3, pp 1653–1659, © 2001, Elsevier Ltd.
Computational Model for Biological Neural Network for Localisation of Sound in the Vertical Plane

Abstract We build a computational rate model for a biological neural network found in mammals that is thought to be important in the localisation of the sound in the vertical plane. We find the response of neurons in the brain stem that participate in the localisation neural circuit to pure tones, broad band noise and notched noise and compare them to experimentally obtained response of these neurons. Our model is able to reproduce the sensitivity of these neurons in the brain stem to spectral properties of sounds that are important in localisation. This is the first rate based population model that elucidates all the response properties of the neurons in the vertical localisation pathway to our knowledge.
Chronic Lymphocytic Leukemia of the Aortic Valve: A Case Report.

Chronic lymphocytic leukemia (CLL) is characterized by the chronic accumulation of mature B-cell lymphocytes in the bone marrow. CLL accounts for approximately one-quarter of new leukemia cases each year and is the most common leukemia in Western countries. Most notably, this leukemia involves the lymph nodes, spleen, and liver, whereas non-lymphoid tissue is seldom associated with CLL infiltration. A large percentage of patients are asymptomatic at presentation; however, for those who are symptomatic, lymphadenopathy is the most common presenting complaint. This is the case of a 75-year-old Caucasian male with CLL on ibrutinib who presented with chest pressure and worsening shortness of breath. The patient underwent cardiac catheterization, which revealed demonstrable aortic stenosis. His aortic valve was subsequently replaced, and tissue was sent for histochemical analysis. Stains were positive for CD20, BCL2, CD5, and CD23, compatible with the CLL of the valve. To be able to investigate those with a known leukemic disease in patients with valvular disease would be beneficial to clinicians as CLL can present in atypical locations.
Silent Sitting and Meditation: Building Teachers’ Acceptance, Implementation, and Self-awareness in a Malaysian School

This chapter explores challenges teachers faced while implementing silent sitting in a primary school in Malaysia. The objectives of the study were focused on exploring three areas: teachers’ acceptance and implementation of silent sitting in classrooms; the challenges they faced while exploring the implementation of silent sitting and Light Meditation as a new practice; and their perceptions of any changes in their self-awareness as an outcome of the practice.
Search Atlas: Visualizing Divergent Search Results Across Geopolitical Borders

The internet is full of invisible borders—geographic, linguistic, cultural, political—that circumscribe the information each user sees. Search engines shape such “information borders” by tailoring results according to geolocation, language, and other user profiling. We present Search Atlas, a tool paired with visualizations that enable users to see and cross these borders. For instance, how do search results for the same query differ for Brazilian, Turkish, and Indian users? Given a query, the tool displays multiple lists of Google search results, highlighting distinctive words for each set of parameters. Then, we provide visu- alizations that juxtapose and cluster Google results across countries, revealing new information borders and regions that can vary widely depending on the query. By exposing the partial perspective of a search engine, Search Atlas invites users to experience the internet from divergent positions and to reflect on how their online lives are conditioned by technologi- cal infrastructures and geopolitical regimes.
Hybrid SMART spheroids to enhance stem cell therapy for CNS injuries.

Although stem cell therapy holds enormous potential for treating debilitating injuries and diseases in the central nervous system, low survival and inefficient differentiation have restricted its c...
Attack Patterns: A New Forensic and Design Tool

A pattern is an encapsulated solution to a problem in a given context that can be used to guide system design and evaluation. Analysis, design and architectural patterns are established formalisms for designing high quality software. Security patterns guide the secure design of systems by providing generic solutions that prevent a variety of attacks. This paper presents an attack pattern, a new type of pattern that is specified from the point of view of an attacker. The pattern describes how an attack is performed, enumerates the security patterns that can be applied to defeat the attack, and describes how to trace the attack once it has occurred. An example involving DoS attacks on VoIP networks is used to demonstrate the value of the formalism to security designers and forensic investigators.
Thermal conductivity of the Kondo Superconductor Zn--Mn

The thermal conductivity in bulk samples of pure Zn and the Kondo alloy Zn-Mn have been measured in the temperature range 0.360 to about 1.0 K for concentrations 2.7, 6.0, 8.4, 10.0, and 11.7 ppm Mn. Our results for the depression of the superconducting to normal state transition temperature (Tc) with Mn concentration and for the temperature dependence of the thermal conductivity of pure Zn agree with the results obtained by other workers. The ratio of the thermal conductances in the superconducting and normal states has been quantitatively compared with the Bardeen-Rickayzen-Tewordt and Ambegaokar-Griffin theories. We found agreement between the Ambegaokar-Griffin theory and experiment at all temperatures for Mn concentrations lower than 10.0 ppm and discrepancy between theory and experiment in the 10.0 ppm and 11.7-ppm samples. In the latter specimens the measured conductance ratio was greater than the theoretical predictions. For these two samplesTc occurs at about the temperature where ordering (impurity-impurity interactions) is observed in the normal state. We have analyzed our measurements using those solutions of the Kondo problem in superconductors dealing mainly with the existence of bound states in the energy gap, as well as available theories on the effects of impurity-impurity interactions. We have concluded that our results can be qualitatively understood using the ideas of Fowler and Maki and of Zittartz and Muller-Hartmann which give a bound state in the energy gap. It appears that the growth of the impurity band and spin ordering (impurity-impurity interactions) are intrinsically related.
International Economic Sanctions: Improving the Haphazard U.S. Legal Regime

1. Introduction Scope of the book 2. Overview of the history and effectiveness of sanctions 3. Non-emergency laws: an overview and bilateral government programs 4. Exports from the United States 5. Imports to the United States 6. Private financial transactions 7. International financial institutions 8. Miscellaneous laws for non-emergencies 9. Present laws for a declared national emergency 10. Possible powers of the President beyond the statutes 11. Looking to the allies 12. Planning for the future.
Tubulin isotypes and the multigene tubulin families.

Publisher Summary This chapter describes tubulin gene structure, evolution, and expression. Microtubules are long filamentous structures that are found ubiquitously in eukaryotic cells and are intimately associated with many cellular functions. The major structural component of microtubules is tubulin, a dimer of α- and β-chains each of about 55,000 daltons. In spite of the remarkable diversity of microtubule functions, many independent lines of evidence point to a close evolutionary conservation among tubulin proteins. Indeed, hybrid microtubules may be formed in vitro by the copolymerization of α- and β-tubulins from different species. The evolutionary conservation of tubulin genes is dramatically shown at the nucleic acid level by the ability of cDNA probes constructed from chicken α- and β-tubulin mRNAs to cross-hybridize with genomic DNAs from a wide variety of eukaryotes under stringent conditions. Given that all cells express tubulin genes and that the proteins they encode are highly evolutionarily conserved, the extent of structural diversity among tubulin gene families from various species is rather remarkable.
A Note on Mahfouz's Effort to Strike a Balance Between East and West

Long before the Nobel prize for literature was awarded to Naguib Mahfouz in 1988, a large number of his fifty or so novels and short stories (published from 1938 to the present) had created a stir in Arabic literary and religious circles upon publication, ranging from high praise to death threats for allegedly blasphemous writings. The most recurring criticism of Mahfouz, however, concerns what some scholars have labeled as "a total Westernization of thought. . . seen in the far-from-Eastern elements which he has forced upon the Arabic novel." Others have gone as far as to criticize "the excessive reliance of Mahfouz and his generation on Western fictional models." The validity of such accusations can be determined by a literary, social, and cultural study of Mahfouz's use of language, setting, atmosphere, and characters in his novels. The result will show that though the laureate, by his own admission, employs Western forms and techniques in his writings, his works have not only successfully managed to retain a distinctly Egyptian flavor, but have also made numerous contributions to the growth of Arabic literature as a whole.
Transfusion of older red blood cells is associated with decreased graft survival after orthotopic liver transplantation

Investigations have demonstrated conflicting results regarding the influence of the red blood cell (RBC) storage duration on outcomes. We evaluated whether graft failure or mortality after orthotopic liver transplantation (OLT) increased when recipients were transfused with older RBCs. This study included 637 patients who underwent OLT between January 2001 and June 2011. Baseline and perioperative data were obtained from our blood bank, the Unified Transplant Center database, and the United Network for Organ Sharing database. Recipients whose transfused RBCs were all stored for ≤15 days were grouped in a younger group, and recipients who were transfused with RBCs stored for >15 days were placed in an older group. The relationship between graft survival/mortality and the age of intraoperatively transfused RBCs was studied by Kaplan-Meier estimation with a log-rank test and multivariate Cox proportional hazards regression. Three hundred thirty-four patients and 303 patients were grouped in the younger and the older RBC groups, respectively, on the basis of the ages of intraoperatively transfused RBCs. Kaplan-Meier estimates of graft survival/mortality as a function of the posttransplant time were significantly different: the older group experienced the outcome sooner than the younger group [P = 0.02 (log-rank test)]. After covariate adjustments, the risk of graft failure/mortality was significantly different at any given time after transplantation between patients receiving intraoperative transfusions of older RBC units and patients receiving intraoperative transfusions of younger RBC units (hazard ratio = 1.65, 95% confidence interval = 1.18-2.31). In conclusion, patients who received intraoperative transfusions of RBCs with longer storage times had an increased risk of adverse outcomes. Liver Transpl 19:1181–1188, 2013. © 2013 AASLD.
Acme-Based Software Architecture Interchange

An important issue for the specification and design of software architectures is how to combine the analysis capabilities of multiple architectural definition languages (ADLs) and their supporting toolsets. In this paper, we describe our experience of integrating three ADLs: Wright, Rapide, and Aesop. We discovered that it is possible to achieve interoperability in ADL tools for a non-trivial subset of the systems describable by these languages, even though the languages have different views about architectural structure and semantics. To carry out the integration we used the Acme architectural interchange language and its supporting tools.
CMOS ICs power-supply related decoupling properties

On-die decoupling plays important role in CMOS integrated circuits power delivery. A consistent extraction and modeling methodology of on-die inherent and intentional decoupling elements is presented. Measurements show accurate correlation to simulation of die capacitance.
Alert dissemination protocol using service discovery in Wi-Fi direct

In certain situations, there may be an urgent need to disseminate alerts without the support of communication infrastructure. For example, when a disaster like an earthquake strikes, it may cause the loss of cellular coverage, Wi-Fi hotspots, etc. In this and similar application scenarios, last mile connectivity will be needed for prompt delivery of alerts. Nearly everyone nowadays carry a smart device that is equipped with at least three communication options that do not need any infrastructure, namely, Bluetooth, Wi-Fi Ad-hoc, and Wi-Fi Direct. Despite their ability to work without infrastructure, all these options need a connection setup phase before starting data dissemination. The setup phase incurs unneeded overhead and delay, which diminish their utility in delivering time-critical data. In this paper, we propose a protocol that uses the service discovery mechanism in Wi-Fi Direct to addresses these shortcomings. The protocol embeds the alert data to be disseminated in a Wi-Fi Direct service discovery frame and stores it locally. Other devices interested in receiving alerts send service discovery requests to get updates. The protocol also takes care of forwarding the received alerts to other devices as well. The evaluations showed that the proposed protocol is capable of transmitting timely alerts.
The Social Norms of Discrete Consumer Exchange: Classification and Quantification [*]

Social norms have been recognized as an important influence in long-term relational exchange between firms. It is argued that social norms are equally important in short-term discrete exchange that takes place between firms and consumers. The norms of consumer exchange are, however, of a different kind. To clarify the difference, a classification system is presented. Based on the classification, the social norms of discrete consumer exchange are defined and a method of quantifying these norms is proposed.
Twenty years of cryptography in the open literature

The paper concentrates on the real world problems created in the last two decades (1973-99) by cryptographers who publish in the open literature, and also mentions what gave rise to these problems-the solutions we gave to various theoretical problems, often of our own posing. For the last twenty years (1980-99), the annual IEEE Symposia on Security and Privacy have provided us with a stimulating and encouraging environment within which to expand cryptography's structure and visibility, while exposing us to criticism from workers in other security-related areas. Cryptography has been an important component of S&P, but seldom a major one. Much work presented is from conferences other than S&P. But S&P's influence has been ubiquitous and formative for the worldwide community of open literature cryptographers. To set the problems stage, the author presents six propositions for consideration, not necessarily for acceptance.
Studies on the mechanism of fatty acid synthesis. 18. Preparation and general properties of the enoyl acyl carrier protein reductases from Escherichia coli.

Abstract Preparations of enoyl acyl carrier protein (ACP) reductase have been purified 250-fold over crude extracts of Escherichia coli. Such preparations catalyze the reduction of α,β-unsaturated acyl-ACP to saturated derivatives. They utilize both TPNH and DPNH as electron donors for the reduction of the substrate. Available evidence indicates that the TPNH-dependent and the DPNH-dependent reductase activities are due to two distinct enzymes, a TPNH enoyl-ACP reductase and a DPNH enoyl-ACP reductase. The TPNH enoyl reductase is unstable at higher pH values (g7.50) and is enzymatically inactive above pH 8.0. It exhibits an absolute specificity for the acyl-ACP substrates and is more active on crotonyl-ACP than on longer chain α,β-unsaturated acyl-ACP. It has a functional thiol group and can be readily inhibited by p-hydroxymercuribenzoate, iodoacetate, and N-ethylmaleimide. In contrast, the DPNH enoyl-ACP reductase is relatively stable at higher pH values and is enzymatically active over a wide range of pH values. It utilizes both acyl-ACP and acyl coenzyme A substrates and exhibits higher activity with decenoyl-ACP than with crotonyl-ACP. It has a functional thiol group and can be readily inhibited by p-hydroxymercuribenzoate and iodoacetate, but not by N-ethylmaleimide which causes 2- to 3-fold stimulation of enzymatic activity. The reductase reaction is essentially irreversible, and the stoichiometry of the reaction is consistent with the formulation that 1 mole of reduced pyridine nucleotide is consumed for every mole of α,β-unsaturated acyl-ACP reduced. Evidence is presented that the fatty acid-synthesizing system of E. coli requires both TPNH and DPNH for maximum activity. The requirement for DPNH is at the reductase step, and both nucleotides have a synergistic effect in total fatty acid synthesis.
A study of strobilation in Aurelia aurita under controlled conditions

The maintenance of Aurelia aurita polyps in this laboratory has made possible the study of strobilation under well controlled laboratory conditions for the first time. The development of pulsing, statocysts and gastric filaments during normal strobilation occurring in artificial sea water at constant temperature was observed. Comparisons made of intact strobilae and segments cut from strobilae revealed that isolated segments of strobilae differentiated at a rate comparable to segments of intact strobilae. Furthermore, segments and pieces of segments which appeared morphologically to be polyp tissue and which exhibit no differentiation of structure were already “programmed” to become medusa tissue. Since isolated completed segments developed into ephyrae without further contributions of cells or substances from the parent it was postulated that segments of intact strobilae are, likewise, independent in their development once segments are completed. Studies of atypical strobilation resulting from simple environmental change emphasized that mechanisms that regulate segmentation are different from and probably independent of those that regulate metamorphosis of the segments into ephyrae. A discussion of the major processes involved in strobilation is presented and a close analogy to the metamorphosis of higher animals is drawn. The value of this primitive form of metamorphosis for studies of mechanisms involved in growth and differentiation is demonstrated.
Radiation Hydrodynamic Models of Eclipsing Low-Mass X-Ray Binaries

We present the results of self-consistent two-dimensional radiation hydrodynamic models of winds and coronae above accretion disks in low-mass X-ray binaries. The numerical method combines adaptive mesh refinement for the hydrodynamics with combined ray tracking/flux-limited diffusion for the radiation. The results of the models are compared with EXOSAT observations of X1822-371 and 2S 0921-630, two eclipsing systems that are ideal for direct tests of coronal structure. Excellent fits to the eclipses by the companion star are found for models with intrinsic system luminosities ≈ 0.1LEdd. Estimates are made of the equivalent width of the Fe Kα emission, and values in the range 50-200 eV are found, comparable to estimates from recent observations.
A theoretical decision model to help inform advance directive discussions for patients with COPD

Background Advance directives (AD) may promote preference-concordant care yet are absent in many patients with Chronic Obstructive Pulmonary Disease (COPD). In order to begin to inform AD discussions between clinicians and COPD patients, we constructed a decision tree to estimate the impact of alternative AD decisions on both quality and quantity of life (quality adjusted life years, QALYs).
ON PERIODIC PRODUCTS OF GROUPS

Adian introduced periodic n-products of groups which are given by imposing of defining relations of the form An=1 on the free product of groups Gα, α∈I, without involutions. The defining relations An=1 are constructed by a complicated induction which is quite similar to the inductive construction of free Burnside groups due to Novikov and Adian. This periodic n-product of groups Gα, α∈I, has the remarkable property that for every either xn=1 or x is conjugate to an element of Gα for some α. The main result of the article is that this property of periodic n-product can be taken as its definition. This gives a new non-inductive characterization of periodic n-products. An analogous characterization of periodic -products due to Ol’shanskii is also given.
Application of vector scan electron-beam lithography to 45-nm node extreme-ultraviolet lithography reticles

Extreme UVL (EUVL) is expected to meet the manufacturing lithography requirements of the 45 nm node and below. The manufacturer of 45 nm EUVL reticles will require advancement in both traditional mask production capabilities as well as requirements uniquely related to EUVL reticles. Photonics is actively pursuing EUVL reticle capability along two paths. First, the NGL Mask Center of Competency (MCoC) has been developing mask technology to support proximity x-ray, electron projection lithography (EPL) and EUVL for several years. The MCoC has applied high resolution lithography and pattern transfer processes developed for 125 nm and below 1X processes to 4X EUVL masks. In addition, the McoC is collaboration with suppliers on the development of low defect mask blanks and inspection techniques as well as developing low temperature chemically amplified resist processes and low stress materials deposition and processing specifically for EUVL mask fabrication. Key process technology including high resolution vector scan EB lithography and chemically amplified resist processes and has been transferred from the MCoC to manufacturing sites. Secondly, as a natural extension of the optical reticle product line, EUVL reticles will benefit from current and continued mask manufacturing development. Vector scan e-beam lithography with chemically amplified resists will be used at both the Photonics MCoC and manufacturing facilities to improve resolution and productivity for sub 100 nm reticle production.
Restoration of growth by human growth hormone (Roos) in hypopituitary dwarfs immunized by other human growth hormone preparations: clinical and immunological studies.

ABSTRACT Antibodies to human growth hormone (hGH) have been detected in 12 of 37 hypopituitary dwarfs treated in our clinic with hGH supplied by the National Pituitary Agency (NPA-hGH). Two who had loss of subcutaneous fat at their injection sites experienced an impaired growth response to continued hGH administration. When hGH prepared by a modification of the Roos method (AB Kabi) was substituted for NPA-hGH, both patients experienced dramatic resumption of their growth. The hGH binding capacity fell when NPA-hGH therapy was discontinued and did not rise when Roos hGH therapy was begun. A greater percentage binding of hGH and a higher hGH binding capacity distinguished the antibodies of the two patients with growth attenuation from those of patients who continued to grow. In the patients with growth attenuating antibodies, the rate of removal of 131I-hGH from plasma was delayed, suggesting that binding to antibody reduced the availability of the hormone to tissues. These studies show that patients sensi...
Benchmarking customer service on the internet: best practices from family businesses

Purpose – The importance of using the internet to achieve competitive advantage has been well‐documented. An ever‐expanding array of technologies exist that enable firms to accomplish customer service online. Yet for many firms, determining which applications to employ can be perplexing. This study purports to examine the practices of service sector market leaders and measure performance results of adopting selected customer service applications. The aim was to identify inspirational targets and internet applications benchmarks among family owned businesses since for them, the importance of reputation may well hinge on providing outstanding customer service to the local community.Design/methodology/approach – A six‐page self‐administered survey questionnaire was used to collect data from 374 family firms in West Michigan.Findings – Findings suggest that while over 75 percent of firms use e‐mail to communicate with current customers and for customer service purposes, what distinguishes best practices is e‐...
304 Å photoelectron spectra of CO, N2, O2 and CO2

Abstract Photoelectron spectra have been recorded with 304 A He II radiation, dispersed with a grazing incidence monochromator, from the gases CO, N 2 , O 2 and CO 2 . For these molecules, transitions to electronic states with ionization potentials in the range 30 to 40.8 eV are shown to be dissociative. Preliminary branching ratios for transitions to all the electronic states appearing in each spectrum at 304 A are given.
Construction of low-resolution x-ray crystallographic electron density maps of the ribosome.

Advances in X-ray crystallography now allow biological macromolecules of almost any size to be imaged at atomic resolution. Here, I outline the strategy that allowed for the solution of the 70S ribosome structure to 7.8-A resolution. The most important factors involve the effective use of synchrotron radiation and the application of existing crystallographic software to very large structures.
A Rapid HPLC Assay for the Determination of Dextro‐propoxyphene Related Substances in Combination with Aspirin, Acetaminophen, and Caffeine in Tablet and Capsule Formulations

Abstract A 23 min gradient HPLC assay has been developed to simultaneously measure related substances of dextro‐propoxyphene salts (napsalate, hydrochloride) and other actives that are routinely found in combination in capsules or tablets: aspirin, acetaminophen, and caffeine. This method has shown the ability to resolve all known active ingredients, impurities, and degradation products from the propoxyphene and other active drug parent peaks. All the propoxyphene related substances are quantified against a 1‐point propoxyphene external standard prepared at 2% of the typical sample concentration. Propoxyphene related substance measurements occur at 210 nm. For acetaminophen combinations, wavelength switching is used starting at 280 nm to measure acetaminophen related substances, then switching to 210 nm for propoxyphene related substance measurements. Two sample solvents can be used for propoxyphene related substance quantitation, the second of which is used to provide enhanced room temperature stability‐...
Surgical resection of pulmonary metastases from colorectal adenocarcinoma

From 1962 to 1982, 27 patients with pulmonary metastases as the only site of recurrent colorectal carcinoma underwent pulmonary resection at Roswell Park Memorial Institute. Only five of these patients had symptomatic pulmonary lesions. No postoperative mortality occurred. The median survival after pulmonary resection was 27 months. Five patients are alive presently without recurrent colorectal cancer and two patients are alive with recurrent pulmonary metastases. Patients with solitary lesions had a better survival than patients with multiple lesions. The major sites of recurrence following thoracotomy were the lungs and liver.
Impaired learning in mice with abnormal short-lived plasticity

Abstract Background Many studies suggest that long term potentiation (LTP) has a role in learning and memory. In contrast, little is known about the function of short-lived plasticity (SLP). Modeling results suggested that SLP could be responsible for temporary memory storage, as in working memory, or that it may be involved in processing information regarding the timing of events. These models predict that abnormalities in SLP should lead to learning deficits. We tested this prediction in four lines of mutant mice with abnormal SLP, but apparently normal LTP – mice heterozygous for a α -calcium calmodulin kinase II mutation ( α CaMKII +/− ) have lower paired-pulse facilitation (PPF) and increased post-tetanic potentiation (PTP); mice lacking synapsin II (SyII −/− ), and mice defective in both synapsin I and synapsin II (SyI/II −/− ), show normal PPF but lower PTP; in contrast, mice just lacking synapsin I (SyI −/− ) have increased PPF, but normal PTP. Results Our behavioral results demonstrate that α CaMKII +/− , SyII −/− and SyI/II −/− mutant mice, which have decreased PPF or PTP, have profound impairments in learning tasks. In contrast, behavioral analysis did not reveal learning deficits in SyI −/− mice, which have increased PPF. Conclusions Our results are consistent with models that propose a role for SLP in learning, as mice with decreased PPF or PTP, in the absence of known LTP deficits, also show profound learning impairments. Importantly, analysis of the SyI −/− mutants demonstrated that an increase in PPF does not disrupt learning.
The Reliability of the McCarthy Screening Test from the Criterion-Referenced Testing Perspective.

The McCarthy Screening Test, used to identify children with learning difficulties, yields a pass-fail decision for each subtest. The reliability of these decisions is studied using several criterion-referenced testing methods (N = 1,323). The several results are evaluated. It is suggested that dependability indices be adopted for clinical instruments such as the MST.
Structures of nitrogen-rich sulfides: SN5 and SN6

Structures of nitrogen-rich sulfides SN 5 and SN 6 (neutral molecules and ions) with low spin are optimized and characterized by harmonic vibrational frequency analysis using ab initio and density functional theory methods. Their stability is studied by evaluating dissociation barriers and by comparison of their total energies with those of S 8 + N 2 (x = 5, 6). The important role d orbitals play in nitrogen-rich sulfides is discussed. We have identified two charged SN 5 structures and three charged SN 6 structures that can be good candidates for high-energy density materials.
“He sounded like a vile, disgusting pervert …” An Analysis of Persuasive Attacks on Rush Limbaugh During the Sandra Fluke Controversy

This article examines the persuasive attacks made against Rush Limbaugh after his insults of Georgetown Law student Sandra Fluke. The persuasive attacks against Limbaugh attempted to increase perceptions of his responsibility for the acts, but the majority worked to increase the perceived offensiveness of his acts. The most successful attacks extended Limbaugh's attacks to the audience, pointed out Limbaugh's own inconsistencies, applied pejorative labels to Limbaugh's words, and linked Limbaugh to the positions and ideologies of the Republican Party. The analysis found that the attacks were successful in the short-run, but less so in the long-term.
Vacuum ultraviolet resonance Raman studies of the valence excited electronic states of benzene and benzene‐d6: The E1u state and a putative A2u state

A resonance Raman study of benzene has been performed with the use of excitation wavelengths ranging from 184 to 160 nm. Excitation resonant with the 1 1E1u (ππ*) state results in Raman spectra dominated by progressions in the totally symmetric ring breathing vibration (ν1) both alone and in combination with the overtone of the e1g CH bending vibration (ν10) and the overtone of the b2g ring deformation vibration (ν4). Much weaker progressions are observed involving ν1 and fundamental and overtone transitions of the Jahn–Teller active e2g vibrations. The observation of intensity in e2g fundamental vibrations indicates that the E1u electronic state is, at least slightly, Jahn–Teller active. More significant however, is the observation of considerable intensity in many of the out‐of‐plane vibrations indicating that benzene is distorted from planarity in the 1 1E1u electronic state. In addition, the observation of the ν10 fundamental transition and the 2ν10, 2ν4, and 2ν8 overtone transitions in the Raman spec...
Disturbing behaviors in demented elders: A concept synthesis

This article describes the use of concept synthesis, as defined by Walker and Avant, to extract meaningful syndromes of disturbing behaviors as they are manifested in demented elders. The process resulted in the identification of five distinct behavioral clusterings: Aggressive Psychomotor Behavior, Nonaggressive Psychomotor Behavior, Verbally Aggressive Behavior, Passive Behavior and Functionally Impaired Behavior. These synthesized concepts are an initial attempt at clarifying nursing perspective on disturbing behaviors in dementia.
Acute effects of iontophoresis on human skin in vivo: cutaneous blood flow and transepidermal water loss measurements

The objective of this study was to quantify the acute effects of iontophoretic current passage on human skin in vivo. Specifically, local skin blood flow (SBF) and transepidermal water loss (TEWL) have been measured at the sites of electrode application before and subsequent to iontophoresis at current levels which are generally considered to be ‘reasonable’. Infrared spectra were also recorded at the same skin sites using the attenuated total reflectance technique (ATR-IR). The current levels administered were up to 0.5 mA/cm2 for a maximum of 25 min. It was found that current application for only 5 min was sufficient to cause a significant increase in SBF. Longer periods of current flow induced greater changes in SBF, the elevated level of which persisted for longer times after the termination of iontophoresis. Typically, SBF increased more beneath the anode than beneath the cathode, although visually the degree of irritation was sometimes difficult to distinguish. All subjects were able to feel the application of current, the majority registering greater discomfort at the anode. Apart from the occlusive effect of the electrode chamber solutions, iontophoresis elicited no significant change in TEWL relative to the no-current controls. Similarly, ATR-IR detected no major changes in the spectroscopic profile of the outer stratum corneum. Only relatively minor alterations in protein conformational distribution were observed. In summary, the acute effects of iontophoresis on human skin in vivo are quite moderate. The most significant effect is the rather consistent induction of an erythematous response, the persistence of which depends upon the quantity of charge and the absolute level of current delivered.
Cathodoluminescence as a method of microstructure characterization of biphasic ceramics composed of hydroxyapatite and β-tricalcium phosphate

This paper describes the investigation into the use of cathodoluminescence for distinguishing HA and β-TCP phases within the biphasic calcium phosphate ceramic microstructure. Polished samples were scanned using SEM-CL at an accelerating voltage in the range of 10-15 keV with a beam current of 5-10 nA. The grayscale images produced reveal distinctive patterns for each composition. EDS and EPMA suggest chemical differences among the contrasting regions. Image analysis of voxel values indicate that areas of bright contrast correspond to β-TCP grains with phase amounts confirmed by XRD.
Thermodynamics of Irreversible Processes across a Boundary: Elementary Principles

The commonly used thermodynamic variables are generalized so as to take account of irreversible processes across a thin boundary separating a system from its surroundings. This permits one to relate heat transfer and work performance in irreversible processes to those carried out reversibly. The commonly used functions of state have been generalized to include the contribution of irreversible changes to the entropy of the system. These contributions are specified in terms of experimental observables.