cssi/SciSciGPT-SciSciNet huggingface dataset:
Gaming the system. Dodging the rules, ruling the dodgers.

Although traditional obligations of fidelity require physicians to deliver quality care to their patients, including to utilize costly technologies, physicians are steadily losing their accustomed control over the necessary resources. The "economic agents" who own the medical and monetary resources of care now impose a wide array of rules and restrictions in order to contain their costs of operation. However, physicians can still control resources indirectly through "gaming the system," employing tactics such as "fudging" that exploit resource rules' ambiguity and flexibility to bypass the rules while ostensibly honoring them. Physicians may be especially inclined to game the system where resource rules seriously underserve patients' needs, where economic agents seem to be "gaming the patient," with needless obstacles to care, or where others, such as hospitals or even physicians themselves, may be denied needed reimbursements. Though tempting, gaming is morally and medically hazardous. It can harm patients and society, offend honesty, and violate basic principles of contractual and distributive justice. It is also, in fact, usually unnecessary in securing needed resources for patients. More fundamentally, we must reconsider what physicians owe their patients. They owe what is theirs to give: their competence, care and loyalty. In light of medicine's changing economics, two new duties emerge: economic advising, whereby physicians explicitly discuss the economic as well as medical aspects of each treatment option; and economic advocacy, whereby physicians intercede actively on their patients' behalf with the economic agents who control the resources. ( Arch Intern Med . 1991;151:443-447)
Computational and Experimental Unsteady Pressures for Alternate SLS Booster Nose Shapes

Delayed Detached Eddy Simulation (DDES) predictions of the unsteady transonic flow about a Space Launch System (SLS) configuration were made with the Fully UNstructured Three-Dimensional (FUN3D) flow solver. The computational predictions were validated against results from a 2.5% model tested in the NASA Ames 11-Foot Transonic Unitary Plan Facility. The peak C(sub p,rms) value was under-predicted for the baseline, Mach 0.9 case, but the general trends of high C(sub p,rms) levels behind the forward attach hardware, reducing as one moves away both streamwise and circumferentially, were captured. Frequency of the peak power in power spectral density estimates was consistently under-predicted. Five alternate booster nose shapes were assessed, and several were shown to reduce the surface pressure fluctuations, both as predicted by the computations and verified by the wind tunnel results.
Novel wave effects on anisotropic and ferrite planar slab waveguides in connection with singularity theory

The characteristic interactions of discrete modes supported by planar isotropic and anisotropic dielectric and ferrite slab waveguides are analyzed using singularity and critical point theory, leading to a rigorous and complete explanation of all modal interactions. For an anisotropic planar waveguide having an arbitrarily-orientated optical axis, it is shown that mode coupling is controlled by the presence of an isolated Morse critical point accompanied by a pair of complex-conjugate frequency-plane branch points. The interaction of space-wave leaky modes on a grounded anisotropic slab is studied by investigating the evolution of complex frequency-plane branch point singularities as the orientation of the optical axis varies. Space-wave leaky modes of a biased grounded ferrite slab waveguide are studied in connection with different types of branch-point singularities, resulting in the observation of novel wave effects on ferrite slabs. The general theory is presented, and numerical results are provided for some specific waveguides.
Sum and difference of two squared correlated Nakagami variates in connection with the McKay distribution

General formulas for the probability density function of the sum and the difference of two correlated, not necessarily identically distributed, squared Nakagami variates (or equivalently, gamma variates) are derived. These expressions are shown to be in the form of the McKay "Bessel function" distributions. In addition, formulas for the moments of these distributions, in terms of the Gauss hypergeometric function, are provided. An application of these new results relevant to the calculation of outage probability in the presence of self-interference is discussed.
Hypothalamic oxytocin mediates adaptation mechanism against chronic stress in rats

Accumulation of continuous life stress (chronic stress) often causes gastric symptoms. Although central oxytocin has antistress effects, the role of central oxytocin in stress-induced gastric dysmotility remains unknown. Solid gastric emptying was measured in rats receiving acute restraint stress, 5 consecutive days of repeated restraint stress (chronic homotypic stress), and 7 consecutive days of varying types of stress (chronic heterotypic stress). Oxytocin and oxytocin receptor antagonist were administered intracerebroventricularly (icv). Expression of corticotropin-releasing factor (CRF) mRNA and oxytocin mRNA in the paraventricular nucleus (PVN) of the hypothalamus was evaluated by real-time RT-PCR. The changes of oxytocinergic neurons in the PVN were evaluated by immunohistochemistry. Acute stress delayed gastric emptying, and the delayed gastric emptying was completely restored after 5 consecutive days of chronic homotypic stress. In contrast, delayed gastric emptying persisted following chronic heterotypic stress. The restored gastric emptying following chronic homotypic stress was antagonized by icv injection of an oxytocin antagonist. Icv injection of oxytocin restored delayed gastric emptying induced by chronic heterotypic stress. CRF mRNA expression, which was significantly increased in response to acute stress and chronic heterotypic stress, returned to the basal levels following chronic homotypic stress. In contrast, oxytocin mRNA expression was significantly increased following chronic homotypic stress. The number of oxytocin-immunoreactive cells was increased following chronic homotypic stress at the magnocellular part of the PVN. Icv injection of oxytocin reduced CRF mRNA expression induced by acute stress and chronic heterotypic stress. It is suggested that the adaptation mechanism to chronic stress may involve the upregulation of oxytocin expression in the hypothalamus, which in turn attenuates CRF expression.
Revisiting oocyte–somatic cell interactions: in search of novel intrafollicular predictors and regulators of oocyte developmental competence

Prediction and improvement of oocyte competence are two critical issues in assisted reproductive technology to improve infertility therapy. The lack of reliable and objective predictors of oocyte developmental competence for oocyte/embryo selection during in vitro fertilization hampers the effectiveness of this technology. Likewise, the low pregnancy rate resulting from in vitro maturation of human oocytes represents a major obstacle for its clinical application. Oocyte competence is progressively acquired during follicular development, and the oocyte plays a dominant role in regulating granulosa cell functions and maintaining the microenvironment appropriate for the development of its competence. Hence, granulosa cell functions are reflective of oocyte competence, and molecular markers of granulosa cells are potentially reliable predictors of oocyte quality. With the advent of the functional genomics era, the transcriptome of granulosa cells has been extensively characterized. Experimental data supporting granulosa cell markers as predictors of oocyte competence are now emerging in both animal models and humans. Future efforts should focus on integrating granulosa cell genetic markers as parameters for oocyte/embryo selection. Moreover, novel in vitro evidence highlights the effectiveness of exogenous oocyte-secreted factors in promoting oocyte developmental competence in animal models. The challenge in evaluating the effect of oocyte-secreted factors on oocyte quality in a clinical setting is to standardize the various preparations of these recombinant proteins and decipher their complex interactions/cooperativity within the germline-somatic cell regulatory loop.
The Cumulative Causation of International Migration in Latin America

The theory of the cumulative causation of migration posits that as migratory experience grows within a sending community, the likelihood that other community members will initiate a migratory trip increases. This diffusion is expected to vary across time and place according to differences in the mechanisms guiding this behavior. The author compares the effect of the prevalence of migratory experience on the likelihood that adult men would take a first U.S. trip between 1965 and 2001 from the Dominican Republic, Costa Rica, Mexico, Nicaragua, and Puerto Rico. Both the consistencies and inconsistencies among countries suggest that the cumulative causation of migration is an important dynamic in perpetuating migration, although it does not contribute equally to all migration streams. In all countries except Nicaragua, as more members of a community gain U.S. migration experience, other nonmigrant community members are increasingly likely to take a first U.S. trip. In Nicaragua, U.S. migration was mainly driv...
Etching techniques for gold-containing Ag3Sn alloys and amalgams☆

Argon-ion etching and various other chemical etchants were applied to conventional and gold-containing dental alloys and amalgams. The polished and etched specimens were studied by optical and/or electron optical methods and by energy-dispersive x-ray spectroscopy. Chemical etchants, though effective, have the disadvantage of accentuating surface scratches. This, in turn, causes difficulty in the accurate determination of microstructure. Argon-ion etching, on the other hand, was found to clearly reveal microstructural details as well as minute features of the solidification process. Any surface irregularities in this case were not revealed. Although argon-ion etching was successful for the conventional and the gold-containing Ag~Sn annealed alloys, it caused sufficient specimen heating to drive off high-vapor-pressure mercury compounds and hence was unsuitable for amalgams. A double cyanide chemical etchant was found to clearly reveal 3' grains and matrix phases 3't and 3'2 in the conventional amalgam but revealed only 3' grains and (Au-Sn) rings surrounding the y grains in the gold-containing amalgam. After further etching in 30% nitric acid, the gold-containing amalgam revealed 3'] and Au-Sn phases between the boundary regions of the 3, grains.
Human monocytic cells direct the robust release of CXCL10 by bronchial epithelial cells during rhinovirus infection

Summary Background Human rhinovirus (HRV) infections are a major cause of exacerbations in chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease, but HRV-induced immune responses of the lower airway are poorly understood. Earlier work examining cytokine release following HRV infection has focused on epithelial cells because they serve as the principal site of viral replication, and internalization and replication of viral RNA appear necessary for epithelial cell mediator release. However, during HRV infection, only a small proportion of epithelial cells become infected. As HRV-induced cytokine levels in vivo are markedly elevated, this observation suggests that other mechanisms independent of direct viral infection may induce epithelial cell cytokine release. Objective Our aim was to test for the importance of interactions between human bronchial epithelial cells (HBECs) and monocytic cells in the control of mediator release during HRV exposure. Methods In vitro models of HRV serotype-16 (HRV16) infection of primary HBECs and human monocytic cells, in mono or co-culture, were used. We assessed HRV16-induced CXCL10 and CCL2 protein release via ELISA. Results Co-culture of human monocytic and bronchial epithelial cells promoted a synergistic augmentation of CXCL10 and CCL2 protein release following HRV16 challenge. Transfer of conditioned media from HRV16-treated monocytic cells to epithelial cultures induced a robust release of CXCL10 by the epithelial cells. This effect was greatly attenuated by type I IFN receptor blocking antibodies, and could be recapitulated by IFN-α addition. Conclusions Our data indicate that epithelial CXCL10 release during HRV infection is augmented by a monocytic cell-dependent mechanism involving type I IFN(s). Our findings support a key role for monocytic cells in the amplification of epithelial cell chemokine production during HRV infection, and help to explain how an inflammatory milieu is created in the lower airways even in the absence of extensive viral replication and epithelial infection. Cite this as: N. L. Korpi-Steiner, S. M. Valkenaar, M. E. Bates, M. D. Evans, J. E. Gern and P. J. Bertics, Clinical & Experimental Allergy, 2010 (40) 1203–1213.
Buried land mine detection using complex natural resonances on GPR data

In this paper, we discuss a modified Prony's algorithm for use in buried land mine detection from ground penetrating radar (GPR) data. The algorithm finds the dominant complex natural resonances (CNRs) for vectors of time-domain GPR data. We consider the identification of objects present in two-dimensional images. The CNR features of an unknown image are processed through distance-based detectors with the CNR features of known objects from an object library. We analyze our algorithm performance versus SNR and also analyze performance for different distance detectors.
Aggregation of topological motifs in the Escherichia coli transcriptional regulatory network

Background Transcriptional regulation of cellular functions is carried out through a complex network of interactions among transcription factors and the promoter regions of genes and operons regulated by them.To better understand the system-level function of such networks simplification of their architecture was previously achieved by identifying the motifs present in the network, which are small, overrepresented, topologically distinct regulatory interaction patterns (subgraphs). However, the interaction of such motifs with each other, and their form of integration into the full network has not been previously examined.
Pragmatics and Open Problems for Inter-schema Constraint Theory

We consider pragmatic issues in applying constraint-based theories (such as that developed for data exchange) to a variety of problems. We identify disconnects between theoreticians and tool developers, and propose principles for creating problem units that are appropriate for tools. Our Downstream Principle then explains why automated schema mapping is a prerequisite to transitioning schemamatching prototypes. Next, we compare concerns, strengths, and weaknesses of database and AI approaches to data exchange. Finally, we discuss how constrained update by business processes is a central difficulty in maintaining n-tier applications, and compare the challenges with data exchange and conventional view update
NUMERICAL METHODS FOR THE SEMICONDUCTOR BOLTZMANN EQUATION BASED ON SPHERICAL HARMONICS EXPANSIONS AND ENTROPY DISCRETIZATIONS

We present a class of numerical methods for the semiconductor Boltzmann Poisson problem in the case of spherical band energies. The methods are based on spherical harmonics expansions in the wave vector and difference discretizations in space–time. The resulting class of approximate solutions dissipate a certain type of entropy.
RNase III Is Required for Actinomycin Production in Streptomyces antibioticus

Using insertional mutagenesis, we have disrupted the RNase III gene, rnc, of the actinomycin-producing streptomycete, Streptomyces antibioticus. Disruption was verified by Southern blotting. The resulting strain grows more vigorously than its parent on actinomycin production medium but produces significantly lower levels of actinomycin. Complementation of the rnc disruption with the wild-type rnc gene from S. antibioticus restored actinomycin production to nearly wild-type levels. Western blotting experiments demonstrated that the disruptant did not produce full-length or truncated forms of RNase III. Thus, as is the case in Streptomyces coelicolor, RNase III is required for antibiotic production in S. antibioticus. No differences in the chemical half-lives of bulk mRNA were observed in a comparison of the S. antibioticus rnc mutant and its parental strain.
Initial Invasion of Cheatgrass (Bromus tectorum) into Burned Piñon-Juniper Woodlands in Western Colorado

We studied initial invasion of cheatgrass (Bromus tectorum) into burned pinon-juniper woodlands to determine: (1) if particular features enhance invasion and (2) if particular grasses promote or retard invasion. We compared cheatgrass cover among roads, burn edges, seeded interiors, unseeded interiors and unburned woodlands and quantified grasses present or absent near cheatgrass. Invasion was favored by burn edges, roads and seeded interiors, but not unseeded interiors. Odds of finding cheatgrass were seven times higher near prairie junegrass (Koeleria macrantha), but six times lower near James' galleta (Hilaria jamesii) and two times lower near intermediate wheatgrass (Agropyron intermedium). Invasion may be favored: (1) in burn edges because of higher seed-bank survival, (2) along roads because of moisture, disturbance and dispersal and (3) in seeded interiors because of seed-mix contamination or seeded species that enhance invasion.
Genome Sequence and Description of the Anaerobic Lignin-Degrading Bacterium Tolumonas Lignolytica Sp. Nov

Tolumonas lignolytica BRL6-1(T) sp. nov. is the type strain of T. lignolytica sp. nov., a proposed novel species of the Tolumonas genus. This strain was isolated from tropical rainforest soils based on its ability to utilize lignin as a sole carbon source. Cells of Tolumonas lignolytica BRL6-1(T) are mesophilic, non-spore forming, Gram-negative rods that are oxidase and catalase negative. The genome for this isolate was sequenced and returned in seven unique contigs totaling 3.6Mbp, enabling the characterization of several putative pathways for lignin breakdown. Particularly, we found an extracellular peroxidase involved in lignin depolymerization, as well as several enzymes involved in β-aryl ether bond cleavage, which is the most abundant linkage between lignin monomers. We also found genes for enzymes involved in ferulic acid metabolism, which is a common product of lignin breakdown. By characterizing pathways and enzymes employed in the bacterial breakdown of lignin in anaerobic environments, this work should assist in the efficient engineering of biofuel production from lignocellulosic material.
Would you like to talk? The impact of media and interpersonal communication on knowledge about candidates and likelihood of voting

WOULD YOU LIKE TO TALK?: THE IMPACT OF MEDIA AND INTERPERSONAL COMMUNICATION ON KNOWLEDGE ABOUT CANDIDATES AND LIKELIHOOD OF VOTING Donna M. Elkins July 22, 2009 Scholars have long considered the role media play in shaping levels of political knowledge and voting behavior. The specific context of this study is the 2000 and 2004 presidential elections. It examines the influence of newspaper reading, television viewing, Internet use and interpersonal communication on levels of candidate issue and background knowledge and likelihood to vote. The results testify to the influence of media in citizens' level of knowledge about presidential candidates. The results also provide a confirmation of the limited impact of Internet campaigning in the 2000 presidential election (Weaver & Drew, 2001) and show increased impact in the 2004 election. In addition, the results confirm the significance of interpersonal discussion to heightening levels of political knowledge (Feldman & Price, 2008; Huckfeldt & Sprague, 1995). Interpersonal communication about the campaign was also a significant factor predicting whether a citizen would vote in both of these presidential election years.
A survey of blood pressure parameters after aneurysmal subarachnoid hemorrhage.

Purpose/aim: Blood pressure (BP) regulation is recommended following aneurysmal subarachnoid hemorrhage (aSAH) to prevent re-bleeding and to treat delayed cerebral ischemia. However, optimal BP thresholds are not well established. There is also variation with regard to the BP component (e.g. systolic vs. mean) that is targeted or manipulated. Materials and methods: An 18-question survey was distributed to physicians and advanced practitioner members of the Neurocritical Care Society. Respondents were asked which BP parameter they manipulated and what their thresholds were in different clinical scenarios. They were also asked whether they were influenced by the presence of incidental aneurysms. Answers were analyzed for differences in training background and treatment setting. Results: There were 128 responses. The majority were neurointensivists (47 neurology and 37 non-neurology) and treated patients in dedicated neurointensive care units (n = 98). Systolic BP (SBP) was preferred over mean arterial press...
Age-associated impact on presentation and outcome for penetrating thoracic trauma in the adult and pediatric patient populations.

Background Studies reporting on penetrating thoracic trauma in the pediatric population have been limited by small numbers and implied differences with the adult population. Our objectives were to report on a large cohort of pediatric patients presenting with penetrating thoracic trauma and to determine age-related impacts on management and outcome through comparison with an adult cohort. Methods A Level I trauma center registry was queried between 2006 and 2012. All patients presenting with penetrating thoracic trauma were identified. Patient demographics, injury mechanism, injury severity, admission physiology, and outcome were recorded. Patients were compared, and outcomes were analyzed based on age at presentation, with patients 17 years or younger defining our pediatric cohort. Results A total of 1,423 patients with penetrating thoracic trauma were admitted during the study period. Two hundred twenty patients (15.5%) were pediatric, with 205 being adolescents (13-17 years) and 15 being children (≤ 12 years). In terms of management for the pediatric population, tube thoracostomy alone was needed in 32.7% (72 of 220), whereas operative thoracic exploration was performed in 20.0% (44 of 220). Overall mortality was 13.6% (30 of 220). There was no significant difference between the pediatric and adult population with regard to injury mechanism or severity, need for therapeutic intervention, operative approach, use of emergency department thoracotomy, or outcome. Stepwise logistic regression failed to identify age as a predictor for the need for either therapeutic intervention or mortality between the two age groups as a whole. However, subgroup analysis revealed that being 12 years or younger (odds ratio, 3.84; 95% confidence interval, 1.29-11.4) was an independent predictor of mortality. Conclusion Management of traumatic penetrating thoracic injuries in terms of the need for therapeutic intervention and operative approach was similar between the adult and pediatric populations. Mortality from penetrating thoracic trauma can be predicted based on injury severity, the use of emergency department thoracotomy, and admission physiology for adolescents and adults. Children may be at increased risk for poor outcome independent of injury severity. Level of evidence Epidemiologic study, level III.
PHARMACOLOGICAL INDUCTION OF FIBRINOLYTIC ACTIVITY IN THE DOG.

SummaryIntravenous injections of carbachol, epinephrine, and atropine in dogs are followed by a marked transitory increase in fibrinolytic activity of venous blood. This could be repeated on the same dog at hourly and daily intervals without abating the effect.
Relationship among depression scores, beta-endorphin, and angina pectoris during exercise in patients with coronary artery disease.

Objectives:To determine the relationship between depression scores and (1) anginal indices during exercise including time to onset of angina, duration of angina, and severity of angina and (2) β-endorphin at rest and in response to exercise.Design:Prospective clinical trial.Setting:Tertiary-care uni
Long-term outcomes after Gamma Knife radiosurgery for patients with a nonfunctioning pituitary adenoma.

BACKGROUND Nonfunctioning pituitary adenomas recur after microsurgery. Gamma Knife radiosurgery (GKRS) has been used to treat recurrent adenomas. OBJECTIVE To evaluate the long-term rates of tumor control and development of hypopituitarism in patients with nonfunctioning pituitary adenomas after GKRS. METHODS Forty-eight patients with a nonfunctioning pituitary adenoma treated between 1991 and 2004 at the University of Virginia were studied. All patients had more than 4 years of clinical and imaging follow-up. RESULTS All patients underwent follow-up imaging and endocrine evaluations, with a duration ranging from 50 to 215 months (median, 80.5 months) and 57 to 201 months (median, 95 months), respectively. New hormone deficiency after GKRS occurred in 19 of 48 patients (39%). Corticotropin/cortisol deficiency developed in 8% of patients, thyroid hormone deficiency in 20.8%, gonadotropin deficiency in 4.2%, growth hormone/insulin-like growth factor 1 in 16.7%, and diabetes insipidus in 2%. Panhypopituitarism including diabetes insipidus developed in 1 patient. Overall, control of tumor volume was 83%. Tumor volume decreased in 36 patients (75%), increased in 8 patients (17%), and was unchanged in 4 patients (8%). Tumor volumes greater than 5 mL at the time of GKRS were associated with a significantly greater rate of growth (P = .003) compared with an adenoma with a volume of 5 mL or less. CONCLUSION GKRS resulted in a high and durable rate of tumor control in patients with a nonfunctioning pituitary adenoma. A higher preoperative tumor volume was associated with an increased rate of tumor growth.
Laser-induced fluorescence spectroscopy of human colonic mucosa: Detection of adenomatous transformation

To evaluate the potential of laser-induced fluorescence spectroscopy for the detection of premalignant lesions of the gastrointestinal tract, the hypothesis that adenomatous transformation of colonic mucosa results in an alteration of laser-induced fluorescence that enables its differentiation from normal or hyperplastic tissue was tested. A fiberoptic catheter coupled to a helium-cadmium laser (325 nm) and an optical multichannel analyzer were used to obtain fluorescence spectra (350–600 nm) from 35 normal colonic specimens and 35 resected adenomatous polyps. A score based on six wavelengths was derived by stepwise multivariate linear regression analysis of the spectra. The mean score (±SEM) was + 0.86 ± 0.06 for normal mucosa and −0.86 ± 0.06 for adenomatous polyps (P < 0.001). Spectra from an additional 34 normal specimens, 16 adenomatous polyps, and 16 hyperplastic polyps were prospectively classified with accuracies of 100%, 100%, and 94%, respectively. The mean score for hyperplastic polyps was significantly different from adenomatous (P < 0.001) but not from normal tissue. Thus, quantitative analysis of fluorescence spectra enables the detection of adenomatous transformation in colonic mucosa.
Rapid MB CK subform assay and the early diagnosis of myocardial infarction.

To properly triage and treat patients with chest pain, it is necessary to provide an early objective diagnosis of infarction within 4 to 6 hours of onset of symptoms. This need is fueled by the necessity to administer thrombolytic therapy within 6 to 8 hours of onset of infarction, together with the need to be more cost effective in screening patients with chest pain that require admission to the hospital. Results of a large trial performed in 11,000 patients with chest pain showed MB CK Subforms reliably excludes or confirms myocardial infarction in the first 6 hours of onset of symptoms. A more recent multi-centered double blind trial confirmed the sensitivity and specifity of MB CK Subforms for early diagnosis. Furthermore, MB CK Subforms correctly diagnosed all the individuals with MI in the first hour of presentation into the emergency room.
Pedometers Without Batteries: An Energy Harvesting Shoe

The demand for thin, light wearables with long battery lifetimes motivate novel energy optimization techniques for a wide range of devices with applications ranging from telemedicine in clinical devices to activity recognition in consumer applications. In this paper, we present a simple activity monitoring system based on a piezoelectric energy-harvesting platform. The device requires no battery, no recharging, and no complex algorithms, instead leveraging the relationship between energy harvesting efficiency and user activity to create an effective wearable device with an indefinite lifetime. Experimental results confirm that the system can be used for coarse-grained activity monitoring with no external power source.
Comparing Stroke and Bleeding with Rivaroxaban and Dabigatran in Atrial Fibrillation: Analysis of the US Medicare Part D Data

No studies have directly compared the effectiveness and safety of dabigatran and rivaroxaban using US Medicare data. Our objective was to compare effectiveness and safety between rivaroxaban 20 mg/dabigatran 150 mg and rivaroxaban 15 mg/dabigatran 75 mg among patients with atrial fibrillation (AF). Using 2010–2013 US Medicare Part D data, we selected patients with AF initiating dabigatran 150/75 mg or rivaroxaban 20/15 mg between 4 November 2011 (when rivaroxaban was approved) and 31 December 2013. Our sample included 7322 patients receiving dabigatran 150 mg, 5799 patients receiving rivaroxaban 20 mg, 1818 receiving dabigatran 75 mg, and 2568 receiving rivaroxaban 15 mg. We followed them until stroke, other thromboembolic events, bleeding, discontinuation or switch of an anticoagulant, death, or 31 December 2013. We constructed Cox proportional hazard models with propensity score weighting to compare clinical outcomes between groups. There was no difference in the risk of stroke between dabigatran 150 mg and rivaroxaban 20 mg (hazard ratio [HR] 1.05; 95 % confidence interval [CI] 0.97–1.13) or between dabigatran 75 mg and rivaroxaban 15 mg (HR 1.05; 95 % CI 0.94–1.18). Compared with dabigatran 150 mg, rivaroxaban 20 mg was associated with a higher risk of other thromboembolic events (HR 1.28; 95 % CI 1.14–1.44), major bleeding (HR 1.32; 95 % CI 1.17–1.50), and death (HR 1.36; 95 % CI 1.19–1.56). The risk of thromboembolic events other than stroke (HR 1.37; 95 % CI 1.15–1.62), major bleeding (HR 1.51; 95 % CI 1.25–1.82), and death (HR 1.21; 95 % CI 1.04–1.41) was also higher for rivaroxaban 15 mg than for dabigatran 75 mg. There was no difference in stroke prevention between rivaroxaban and dabigatran; however, rivaroxaban was associated with a higher risk of thromboembolic events other than stroke, death, and bleeding.
Small Dense Low-Density Lipoprotein-Cholesterol Concentrations Predict Risk for Coronary Heart Disease The Atherosclerosis Risk in Communities (ARIC) Study

Objective—To investigate the relationship between plasma levels of small dense low-density lipoprotein-cholesterol (sdLDL-C) and risk for incident coronary heart disease (CHD) in a prospective study among Atherosclerosis Risk in Communities (ARIC) study participants. Approach and Results—Plasma sdLDL-C was measured in 11 419 men and women of the biracial ARIC study using a newly developed homogeneous assay. A proportional hazards model was used to examine the relationship among sdLDL-C, vascular risk factors, and risk for CHD events (n=1158) for a period of ≈11 years. Plasma sdLDL-C levels were strongly correlated with an atherogenic lipid profile and were higher in patients with diabetes mellitus than non–diabetes mellitus (49.6 versus 42.3 mg/dL; P<0.0001). In a model that included established risk factors, sdLDL-C was associated with incident CHD with a hazard ratio of 1.51 (95% confidence interval, 1.21–1.88) for the highest versus the lowest quartile, respectively. Even in individuals considered to b...
Denoising of images with multiplicative noise corruption

Multiplicative noise is signal dependent and is difficult to be removed without impairing image details. It causes difficulties for many real world imaging applications. Previously, a hypothesis test based wavelet denoising algorithm had been proposed with promising results. In this paper, the algorithm has been further studied by fitting it into the framework of contourlet transform, an emerging two-dimensional technique for image processing and analysis. The developed contourlet denoising algorithm has been evaluated with standard test images, yielding successful results. It has also been demonstrated that the proposed algorithm outperformed the original wavelet based approach.
The Aortic Ring Assay and Its Use for the Study of Tumor Angiogenesis

This chapter describes protocols developed in our laboratory to prepare and analyze angiogenic cultures of rat aorta. Rings of rat aorta cultured in collagen gels produce neovessel outgrowths which reproduce ex vivo key steps of the angiogenic process including endothelial migration, proliferation, proteolytic digestion of the extracellular matrix, capillary tube formation, pericyte recruitment, and vascular regression. The angiogenic response of aortic explants can be stimulated with growth factors or inhibited with anti-angiogenic molecules. Aortic ring cultures can also be used to study tumor angiogenesis. Protocols outlined in this chapter describe how this assay can be modified to investigate the angiogenic activity of cancer cells.
Malaria parasite CelTOS targets the inner leaflet of cell membranes for pore-dependent disruption

Half of the world’s population are at risk of contracting malaria: a disease caused by parasites that are spread by mosquito bites. Yet antimalarial drugs are becoming less and less effective because many of the parasites have grown to be resistant to them. Furthermore, and although some vaccines are already being trialed, there is not an effective vaccine that has been approved to control the disease. As such, many researchers hope that understanding more about the critical stages in the life cycle of the parasites will unveil new targets for antimalarial drugs and vaccines. To complete their life cycle, malaria parasites must move through various cells in the human and mosquito. Parasites that lack a protein called CelTOS can enter these cells, but remain stuck inside. It was not known why this was the case, in part because the sequence of building blocks called amino acids that make up CelTOS is unlike that of other proteins which do have a known activity or function. Jimah et al. sought to understand how CelTOS allows malaria parasites to pass through cells by solving its three-dimensional structure. This is because a protein’s function often depends more on the protein’s structure than the specific sequence of its amino acids; such that two proteins that have a similar shape are very likely to work in similar ways. Jimah et al. solved the structure of CelTOS using a technique called X-ray crystallography and found that it resembles proteins known to bind and disrupt cell membranes. Further experiments showed that CelTOS from malaria parasites specifically binds to a fatty molecule that is predominantly found in the inner face of cell surface membranes. It was also confirmed that CelTOS forms pores that disrupt cell membranes. Together, these findings suggest that CelTOS breaches the cell membranes from the inside of infected human and mosquito cells to enable the parasites to exit. While a vaccine based on the CelTOS protein is already being tested in clinical trials, the findings of Jimah et al. should enable this vaccine to be refined if it is not effective, or redesigned based on knowledge of its structure, function and mechanism. This new knowledge could also provide clues as to which kinds of molecules might neutralize the CelTOS protein’s activity and therefore might lead to new antimalarial drugs.
Asset Data Handover for a Large Educational Institution: Case-Study Approach

AbstractOwners of multiple facilities who maintain large capital portfolios are challenged with efficient maintenance to streamline operational processes and costs. Clearly defined and structured i...
Perspectives on Noticing in the Preparation of Elementary Mathematics Teachers

The development of practice is at the heart of educational programs for pre-service teachers and professional development opportunities for educational professionals. A key focus of this work is to ‘make sense’ of the classroom including students’ thinking, discussions, and work so that this sense making provides useful contexts and information for the teacher to interpret as a basis for instructional decisions. This idea of ‘making sense’ is replete with different perspectives on exactly what it means to make sense. Noticing is a process that provides an approach to this sense making. In this chapter, van Es and Sherin’s (J Technol Teacher Educ 10:571–596, 2002) definition explicated through three critical components of noticing will be used to better understand how noticing supports pre-service mathematics teachers make sense of the complexity of classroom events. These three components are (a) identifying what is important or noteworthy about a classroom situation; (b) making connections between the specifics of classroom interactions and the broader principles of teaching and learning they represent; and (c) using what one knows about the context to reason about classroom interactions (p. 573).
Thermodynamics of Amyloid-β Fibril Elongation: Atomistic Details of the Transition State

Amyloid-β (Aβ) fibrils and plaques are one of the hallmarks of Alzheimer’s disease. While the kinetics of fibrillar growth of Aβ have been extensively studied, several vital questions remain. In particular, the atomistic origins of the Arrhenius barrier observed in experiments have not been elucidated. Employing the familiar thermodynamic integration method, we have directly simulated the dissociation of an Aβ(15–40) (D23N mutant) peptide from the surface of a filament along its most probable path (MPP) using all-atom molecular dynamics. This allows for a direct calculation of the free energy profile along the MPP, revealing a multipeak energetic barrier between the free peptide state and the aggregated state. By definition of the MPP, this simulated unbinding process represents the reverse of the physical elongation pathway, allowing us to draw biophysically relevant conclusions from the simulation data. Analyzing the detailed atomistic interactions along the MPP, we identify the atomistic origins of the...
Outlier Detection Using Robust Optimization with Uncertainty Sets Constructed from Risk Measures

We consider a robust optimization formulation for the problem of outlier detection, with an uncertainty set determined by the risk preference of the decision maker. This connection between risk measures and uncertainty sets is established in 3. Inspired by this methodology for uncertainty set construction under a distortion risk measure, we propose a regularized optimization problem with a finite number of constraints to estimate a robust regression plane that is less sensitive to outliers. An alternating minimization scheme is applied to solve for the optimal solution. We show that in three different scenarios differentiated by the location of outliers, our Risk Measure-based Robust Optimization (RMRO) approach outperforms the traditionally used robust regression 12 in terms of the estimation accuracy and detection rates.
Verification of Memory Management Units

This paper describes the formal verification of two memory management units using the HOL theorem prover. The verification effort demonstrates the use of hierarchical decomposition and abstract theories. Both devices authorize memory requests and translate virtual addresses to real addresses. The first unit was designed and verified to the gate level. The second memory management unit is implemented with an abstract representation and provides some operating system support. Memory requests are validated based on a memory resident segment table. These units are being used as a basis for the verification of a composed chip set to form a trusted computing base.
Clinical and preclinical evidence of sex-related differences in anthracycline-induced cardiotoxicity

Anthracyclines are very effective chemotherapeutic agents that are widely used to treat pediatric and adult cancer patients. Unfortunately, the clinical utility of anthracyclines is limited by cardiotoxicity. There are several established risk factors for anthracycline-induced cardiotoxicity (AIC), including total cumulative dose, very young and very old age, concomitant use of other cardiotoxic agents, and concurrent mediastinal radiation. However, the role of sex as a risk factor for AIC is not well defined. In pediatric cancer patients, most studies support the notion that female sex is a significant risk factor for AIC. Conversely, there is anecdotal evidence that female sex protects against AIC in adult cancer patients. The lack of consistency in study designs and the different definitions of cardiotoxicity preclude reaching consensus regarding the role of sex as a risk factor for AIC in both pediatric and adult cancer patients. Therefore, more clinical research using reliable techniques such as cardiac magnetic resonance imaging is needed to determine if there truly are sex differences in AIC. In adult preclinical rodent studies, however, there is unequivocal evidence that female sex confers significant protection against AIC, with a possible protective effect of female sex hormones and/or a detrimental role of the male sex hormones. Although findings of these rodent studies may not perfectly mirror the clinical scenario in adult anthracycline-treated cancer patients, understanding the mechanisms of this significant sexual dimorphism may reveal important cardioprotective mechanisms that can be therapeutically targeted.
Killer Pov: First-Person Camera and Sympathetic Identification in Modern Horror

Killer POV—a subjective camera without a reverse shot—is at the center of many of the most influential critical writings on modern horror. However, these discussions often start from the assumption that the camera’s point of view produces identification. This essay attempts to disengage our understanding of horror spectatorship from such models and to provide an alternative reading of killer POV that engages with the genre’s structures of looking/being looked at while remaining sensitive to what precisely is being communicated to viewers by these shots. Killer POV signals to the viewer the presence of a threat without displaying the monster/killer/bearer of the look onscreen. In addition to keeping the threat un-embodied (or only vaguely embodied) and unplaced, killer POV alerts the viewer to the films’ withholding of crucial diegetic information, both of which are essential to understanding the unique mode of spectatorship provoked by modern horror films.
Scanning is Just the Beginning: Exploiting Text and Language Technologies to Enhance the Value of Historical Manuscripts

In this paper we present a digital process for the explicitation of the textual, linguistic and semantic content of historical manuscripts. The proposed workflow is composed of a sequence of incremental steps, each of which is described both on a methodological and practical perspective. The steps are: 1) visualization and structuring of metadata, 2) transcription, 3) structural encoding, 4) annotation, 5) lexical and conceptual structuring.
Stevens Johnson Syndrome – “Steven Who? And Why I Should Care About His Johnson?”

Diagnosing rashes in the emergency department can be challenging. If the rash is extensive and targetoid, include Stevens-Johnson Syndrome (SJS) on your differential and be sure to obtain a thorough history to identify possible offending agents. Additionally, prioritize supportive care and obtaining a dermatology/burn consult to coordinate appropriate care.
The Dynamic Electoral Connection: Symbolic Representation and the Effects of Elections on Public Perception of Elected Officials

Scholars have long recognized that elections, by themselves, are not enough to ensure the vitality of democratic governance (e.g., Dahl 1971). Sham elections in authoritarian states throughout the world (e.g., Cuba, Iraq) illustrate that Madison’s claim that frequent elections are essential, also requires meaningful choice to ensure that the government has "....an immediate dependence on, and an intimate sympathy with, the people.” (Federalist 52). For citizens’ voices to matter, they must be given a choice between candidates and they must have the capacity to evaluate them. In this paper, we investigate how elections affect the nature of non-policy representation. We focus on the behavior both of legislators and citizens to examine how, and to what extent, impending elections affect legislators’ non-policy behavior and citizens responses to such changes. To do so we employ text analysis to explain how citizens’ evaluations of their elected officials correspond with pursuit the re-election goal. We ultimately find mixed results on this idea, indicating a need for further study into the topic of election and citizens’ perceptions.