cssi/SciSciGPT-SciSciNet huggingface dataset:
Teaching emergency airway management using medical simulation: a pilot program.

Objective: Simulation is a tool that has been used successfully in many high performance fields to permit training in rare and hazardous events. Our goal was to develop and evaluate a program to teach airway crisis management to otolaryngology trainees using medical simulation. Methods: A full-day curriculum in the management of airway emergencies was developed. The program consists of three airway emergency scenarios, developed in collaboration between attending otolaryngologists and faculty from the Center for Medical Simulation. Following each scenario, the participants are led in a structured, video-assisted debriefing by a trained debriefer. Didactic material on team leadership and crisis management is built into the debriefings. Pediatric otolaryngology fellows, residents, and medical students have participated in the four courses that have been held to date. Participants evaluated the program on a five-point Likert scale. Results: A total of 17 trainees participated in four pilot training courses. The survey data are as follows: overall program, 5.0 (SD, 0.00); course goals, 4.79 (SD, 0.43); realism, 4.36 (SD, 0.63); value of lecture, 4.71 (SD, 0.47); and quality of debriefings, 4.92 (SD, 0.28). Sample comments include: “This is a valuable tool for students and residents since true emergencies in ORL are often life-threatening and infrequent,” and “This is a great course—really all physicians should experience it.” Overall evaluation was extremely positive and both residents and fellows described the course as filling an important void in their education. Conclusion: Medical simulation can be an extremely effective method for teaching airway crisis management and teamwork skills to otolaryngology trainees at all levels.
Effects of Transvenous Electrode Polarity and Waveform Duration on the Relationship Between Defibrillation Threshold and Upper Limit of Vulnerability

Background The upper limit of vulnerability (ULV) hypothesis for defibrillation predicts that maneuvers that alter the ULV will cause a similar alteration in the defibrillation threshold (DFT). The purpose of this study was to test this prediction by evaluating the effects of electrode polarity and waveform duration on the relationship between the DFT and the ULV. Methods and Results Platinum spring electrodes were placed in the right ventricular (RV) apex and the superior vena cava in 12 pigs. Strength-duration curves were constructed for the DFT and ULV for each electrode polarity with monophasic waveforms (6 pigs) of different durations (2 to 14 ms) and biphasic truncated exponential waveforms (6 pigs) having phase 1 equal to 4 ms and phase 2 of different durations (0 to 10 ms). ULV data were gathered by scanning of the T wave. The ventricular pacing threshold (VPT) and ventricular fibrillation threshold (VFT) were also determined with these same waveforms. For the RV electrode as a cathode for monopha...
Activation of PKCα Downstream from Caspases during Apoptosis Induced by 7-Hydroxystaurosporine or the Topoisomerase Inhibitors, Camptothecin and Etoposide, in Human Myeloid Leukemia HL60 Cells

We previously demonstrated that the anticancer agent and protein kinase C (PKC) inhibitor 7-hydroxystaurosporine (UCN-01) induces apoptosis independently of p53 and protein synthesis in HL60 cells. We now report the associated changes of PKC isoforms. PKCα, βI, βII, δ, and ζ activities were measured after immunoprecipitation of cytosols from UCN-01-treated HL60 cells. UCN-01 had no effect on PKCζ and inhibited kinase activity of PKCβI, βII, and δ. PKCα activity was initially inhibited at 1 h, and subsequently increased as cells underwent apoptosis 3 h after the beginning of UCN-01 treatment. Camptothecin (CPT) and etoposide (VP-16) also markedly enhanced PKCα activity during apoptosis in HL60 cells. However, CPT did not affect PKCβI, βII and ζ, and activated PKCδ. PKCα activation was not due to increased protein levels or proteolytic cleavage but was associated with PKCα autophosphorylation in vitro and increased phosphorylationin vivo. We also found that not only PKC δ but also PKC βI was proteolytically activated in HL60 cells during apoptosis. The PKCα activation and hyperphosphorylation were abrogated byN-benzyloxycarbonyl-Val-Ala-Asp(O-methyl)-fluoromethylketone (z-VAD-fmk) under conditions that abrogated apoptosis. z-VAD-fmk also prevented PKCδ and βI proteolytic activation. Together these findings suggest that caspases regulate PKC activity during apoptosis in HL60 cells. At least two modes of activation were observed: hyperphosphorylation for PKCα and proteolytic activation for PKC δ and βI.
Fission-fusion and lineal effect: aspects of the population structure of the Semai Senoi of Malaysia.

Analysis of histories and genealogies from seven relatively un-acculturated, swidden-farming Semai settlements shows that the composition of local groups fluctuates through time. This instability is similar to a pattern which Neel and his colleagues have suggested is typical of primitive society, the fission-fusion model. In addition, the individuals comprising Semai fission groups are kinsmen which implies that the number of independent genomes represented is markedly less than the number of individual migrants (the lineal effect). Fission groups may form new villages or fuse with an established settlement. In either case, the genetic effects of such migration are more pronounced than would be expected on the basis of founder effect or random migration. Despite several conspicuous differences in social organization between the Semai and the South American Indians (e.g., bilateral vs. unilineal descent) whose population structure provided the empirical basis for the fission-fusion, lineal effect model, the basic similarities are striking. The Semai case thus lends support to the proposition that this pattern may be of some generality in technologically primitive populations.
Basic concepts of multiple-discrete valued logic and decision theory

This paper deals with some of the basic concepts of multiple-discrete, as opposed to continuous, valued logic and its relation to decision theory. In particular attention is focused on three-valued logic. In the hardware or human methods of sorting out three things one actually has to resort to three pairings of binary decision making; one would like to really three-sort without first two-sorting or pairing. Moreover, standard statistical techniques can be extended to proper ternary relations (H0, H1, H2) ∈ ℋ × ℋ × ℋ of hypotheses. An example to which the theory can be applied is the several models originating with Pitts–McCulloch (1947) on the study of redundancy of potential command.
Coupled-cluster singles and doubles for extended systems.

Coupled-cluster theory with connected single and double excitation operators (CCSD) and related approximations, such as linearized CCSD, quadratic configuration interaction with single and double excitation operators, coupled-cluster with connected double excitation operator (CCD), linearized CCD, approximate CCD, and second- and third-order many-body perturbation theories, are formulated and implemented for infinitely extended one-dimensional systems (polymers), on the basis of the periodic boundary conditions and distance-based screening of integrals, density matrix elements, and excitation amplitudes. The variation of correlation energies with the truncation radii of short- and long-range lattice sums and with the number of wave vector sampling points in the first Brillouin zone is examined for polyethylene, polyacetylene, and polyyne, and is shown to be a function of the degree of π-electron conjugation or the fundamental band gaps. The t2 and t1 amplitudes in the atomic orbital (AO) basis are obtaine...
Privacy Engineering Emerges as a Hot New Career

Are you concerned about the privacy implications of big data; government surveillance; or the ability of social networks, search engines, and online advertisers to amass detailed profiles of individuals? Do you want to use your technical skills to help reverse the trend toward diminishing privacy? Would you like to help find ways to design privacy into products and services without sacrificing functionality or convenience? Do you want to help people take control over their own personal information? If you answered ?yes? to any of these questions, then a career in privacy engineering may be for you.
A single period model for a multiproduct perishable inventory system with economic substitution

This paper develops a single period model for a specific class of multiproduct perishable inventory systems where demands are interdependent. This class of inventory systems has the property that there is economic substitution between products. It is shown that the optimal policy has the economic substitution property, and that the rate of substitution is age dependent. The model serves as a generalization of a theorem discovered by Ignall and Veinott.
Emotions, Oral Arguments, and Supreme Court Decision Making

Students of linguistics and psychology demonstrate that word choices people make convey information about their emotions and thereby their intentions. Focusing on theory from these related fields we test whether the emotional content of Supreme Court justices’ questions and comments made during oral arguments allow us to predict the decisions they make. Using aggregate data from all arguments between 1979 and 2008 and individual-level data from 2004 through 2008 we find justices’ use of more unpleasant language towards the attorney representing one side of a case reduces the probability that side will prevail on the merits, both in terms of individual justices’ votes and the overall case outcome.
Imaging of vestibular schwannoma and other cerebellopontine angle tumors

In this review of cerebellopontine angle tumors, we focus on the most common neoplasm in this location—vestibular schwannoma. We examine both the usual and unusual imaging manifestations of this tumor, which often presents with sensorineural hearing loss, tinnitus, dizziness, and rarely vertigo. We also review key imaging findings that can have significant implications in presurgical planning. Thereafter, we undertake a brief review of the next most common tumors that occur in this location, including meningioma, facial nerve schwannoma, metastasis, and congenital epidermoid cyst. We emphasize distinctive imaging features of these entities, which can help increase our diagnostic accuracy.
Comparison of cardiovascular event rates in patients without cardiovascular disease in whom atorvastatin or simvastatin was newly initiated.

OBJECTIVE To compare cardiovascular (CV) event rates and risk in patients without previous CV disease in whom atorvastatin or simvastatin was newly initiated in a managed care setting. PATIENTS AND METHODS Patients aged 18 to 64 years in whom atorvastatin or simvastatin was newly initiated between January 1, 2003, and December 31, 2006, and who had no history of CV disease and at least 12 months of preindex and 3 months of postindex continuous eligibility in a managed care health plan, were identified using administrative claims from the HealthCore Integrated Research Database. Descriptive statistics were reported for sample characteristics. Unadjusted CV event rates were compared between treatment groups. A multivariate Cox proportional hazards model was developed to evaluate adjusted CV risk in all patients, as well as in a subset of patients with diabetes mellitus. RESULTS A total of 168,096 patients in the atorvastatin group and 51,333 patients in the simvastatin group were analyzed. Mean ± SD age was 50.2±9.0 years for patients using atorvastatin and 50.6±9.0 years for patients using simvastatin. Mean ± SD follow-up time was 664.2±386.2 days for the atorvastatin group and 511.4±359.8 days for the simvastatin group. Mean ± SD dose and mean ± SD therapy duration for patients taking simvastatin were 29.1±15.1 mg and 188.6±236.3 days, respectively, compared with 16.8±11.1 mg and 241.8±292.0 days, respectively, for patients taking atorvastatin. Unadjusted CV event rates were lower with use of atorvastatin than with simvastatin (hazard ratio, 0.80; 95% confidence interval, 0.75-0.84; P P CONCLUSION In a managed care population with no history of CV disease, risk of CV events was lower among patients taking atorvastatin compared with patients taking simvastatin, after adjusting for known baseline differences.
Financial Risk and Hospital Cost in Stratified, Peripheral Vascular Surgical DRGs Without Complications and Comorbidities

The purpose of this study was to analyze hospital resource consumption in any of the nine non-complicating conditions covered under stratified, peripheral vascular surgical Diagnosis-Related Groups (DRGs) using the new DRG prospective All Payer System in effect in New York. There is significant health policy debate at the level of the United States Congress regarding the improvement of the equity of DRG hospital payment. Although there have been a number of recommendations by federal advisory bodies to further stratify DRGs by complications and comorbidities, no major revision of DRGs along these lines has been implemented. The all payer system uses the DRG format to pay for all patients. We analyzed 788 peripheral vascular surgical patients by payer (Medicare, Medicaid, Blue Cross and commercial insurance) in these stratified, peripheral vascular surgical DRGs with no complications or comorbidities for a three year period. Our study demonstrated that patients within each DRG with more complications and comorbidities generated higher total hospital costs, a longer hospital length of stay, a greater percentage of procedures per patient, financial risk under DRG payment, more outliers, and a higher mortality, compared to patients in these same DRGs with fewer complications and comorbidities. These findings suggest that new, prospective DRG all payer systems may be inequitable to certain groups of patients or types of hospitals in these stratified peripheral vascular surgical DRGs with no complications or comorbidities. This analysis suggests that these peripheral vascular surgical DRGs should be stratified by the numbers and types of complications and comorbidities to more equitably reimburse hospitals under DRGs. Since all payer systems use the federal model, the inequities demonstrated in our study will be applicable to all peripheral vascular patients.
Evaluation of tricuspid annular plane systolic excursion measured with cardiac MRI in children with tetralogy of Fallot

Background Aneurysmal dilation of the right ventricular outflow tract complicates assessment of right ventricular function in patients with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is commonly used to estimate ejection fraction. We hypothesised that tricuspid annular plane systolic excursion measured by cardiac MRI approximates global and segmental right ventricular function, specifically right ventricular sinus ejection fraction, in children with repaired tetralogy of Fallot. Methods Tricuspid annular plane systolic excursion was measured retrospectively on cardiac MRIs in 54 patients with repaired tetralogy of Fallot. Values were compared with right ventricular global, sinus, and infundibular ejection fractions. Tricuspid annular plane systolic excursion was indexed to body surface area, converted into a fractional value, and converted into published paediatric Z-scores. Results Tricuspid annular plane systolic excursion measurements had good agreement between observers. Right ventricular ejection fraction did not correlate with the absolute or indexed tricuspid annular plane systolic excursion and correlated weakly with fractional tricuspid annular plane systolic excursion (r=0.41 and p=0.002). Segmental right ventricular function did not appreciably improve correlation with any of the tricuspid annular plane systolic excursion measures. Paediatric Z-scores were unable to differentiate patients with normal and abnormal right ventricular function. Conclusions Tricuspid annular plane systolic excursion measured by cardiac MRI correlates poorly with global and segmental right ventricular ejection fraction in children with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is an unreliable approximation of right ventricular function in this patient population.
Some intranational evidence on output-inflation trade-offs

In a seminal paper, Robert E. Lucas, Jr. provided the theoretical relationship between aggregate demand and real output based on relative price confusion at the individual market level. Subsequently, an alternative New Keynesian aggregate supply relationship was derived and it was demonstrated that the two theories can be distinguished on the basis of how both the rate of inflation and the volatility of relative prices affect its slope. By emphasizing the first implication of New Keynesian theory, strong evidence was obtained supporting this model using international data. We also concentrate on the second difference between the two theories. We derive the individual market-level equilibrium relationship for the Lucas model, i.e., the disaggregate supply curve. We estimate the crucial parameters of the relationship between aggregate nominal demand shocks and real output using U.S. intranational state and industry data. We find that the Lucas model omits important New Keynesian features of the data.
Lamellipodin promotes actin assembly by clustering Ena/VASP proteins and tethering them to actin filaments

Enabled/Vasodilator (Ena/VASP) proteins promote actin filament assembly at multiple locations, including: leading edge membranes, focal adhesions, and the surface of intracellular pathogens. One important Ena/VASP regulator is the mig-10/Lamellipodin/RIAM family of adaptors that promote lamellipod formation in fibroblasts and drive neurite outgrowth and axon guidance in neurons. To better understand how MRL proteins promote actin network formation we studied the interactions between Lamellipodin (Lpd), actin, and VASP, both in vivo and in vitro. We find that Lpd binds directly to actin filaments and that this interaction regulates its subcellular localization and enhances its effect on VASP polymerase activity. We propose that Lpd delivers Ena/VASP proteins to growing barbed ends and increases their polymerase activity by tethering them to filaments. This interaction represents one more pathway by which growing actin filaments produce positive feedback to control localization and activity of proteins that regulate their assembly.
Compared with radical nephrectomy, nephron-sparing surgery offers a long-term survival advantage in patients between the ages of 20 and 44 years with renal cell carcinomas (≤4 cm): an analysis of the SEER database.

Abstract Purpose Compared with radical nephrectomy (RN), partial nephrectomy (PN) decreases the risk of developing chronic kidney disease. Although numerous studies have demonstrated the survival advantage of PN in older patients, they have been criticized by selection bias toward the procedure owing to comorbidities. We hypothesized that long-standing effects of renal preservation would manifest in a survival advantage of a younger patient population, where selection bias owing to comorbidities is minimized. Materials and methods The Surveillance, Epidemiology, and End Results 18-registries database was queried for patients aged 20 to 44 years surgically treated between 1993 and 2003 for renal cell carcinoma (RCC)≤4 cm with known grade and histology. Patients with prior RCC, multiple tumors, and metastatic or locally advanced disease were excluded. The final cohorts consisted of 222 and 494 subjects treated with PN and RN, respectively. The chi-square and log-rank analyses compared patient and tumor characteristics and patient survival, respectively. Results There were no differences between the groups in demographics or tumor characteristics. Additionally, there was no difference in cancer-specific survival at 5 or 10 years ( P = 0.34 and P = 0.1, respectively). Although there was no difference in 5-year overall survival ( P = 0.07), PN offered an advantage in 10-year overall survival ( P = 0.025). Conclusions Present Surveillance, Epidemiology, and End Results analyses demonstrate that compared with RN, PN improved overall survival in patients with small, localized RCC. As expected, the survival advantage is observed late and supports the importance of long-term renal functional preservation. Although our study is limited by lack of comorbidities, the results suggest that detrimental effects of RN may have implications on overall survival in younger patients with RCC.
Blunt trauma induced splenic blushes are not created equal

Background: Currently, evidence of contrast extravasation on computed tomography (CT) scan is regarded as an indication for intervention in splenic injuries. In our experience, patients transferred from other institutions for angioembolization have often resolved the blush upon repeat imaging at our hospital. We hypothesized that not all splenic blushes require intervention. Methods: During a 10-year period, we reviewed all patients transferred with blunt splenic injuries and contrast extravasation on initial postinjury CT scan. Results: During the study period, 241 patients were referred for splenic injuries, of whom 16 had a contrast blush on initial CT imaging (88% men, mean age 35 ± 5, mean ISS 26 ± 3). Eight (50%) patients were managed without angioembolization or operation. Comparing patients with and without intervention, there was a significant difference in admission heart rate (106 ± 9 vs 83 ± 6) and decline in hematocrit following transfer (5.3 ± 2.0 vs 1.0 ± 0.3), but not in injury grade (3.9 ± 0.2 vs 3.5 ± 0.3), systolic blood pressure (125 ± 10 vs 115 ± 6), or age (38.5 ± 8.2 vs 30.9 ± 4.7). Of the 8 observed patients, 3 underwent repeat imaging immediately upon arrival with resolution of the blush. In the intervention group, 4 patients had ongoing extravasation on repeat imaging, 2 patients underwent empiric embolization, and 2 patients underwent splenectomy for physiologic indications. Conclusions: For blunt splenic trauma, evidence of contrast extravasation on initial CT imaging is not an absolute indication for intervention. A period of observation with repeat imaging could avoid costly, invasive interventions and their associated sequelae.
3D underwater imaging using vector acoustic sensors

Marine surveys that use vector acoustic sensors may allow for 3D imaging of underwater environments with a much smaller amount of data than current 3D hydrophone surveys. Newly developed sensors make vector-acoustic-based surveys practical. This concept is demonstrated with data from a three-axis accelerometer and a collocated hydrophone in an acoustic water tank using a short-pulse source and passive scattering targets. One algorithm rectifies the vector data with scalar pressure data and another maps the vector data into a 3D volume, showing several slices of the volume images. The imaging algorithm maps the scattered energy using the direction and traveltime independently for each source-receiver pair rather than using the phase coherence methods common in exploration seismology. Imaging a more complex and realistic marine environment requires vector wavefield decomposition techniques and other theoretical developments but may allow for 3D vector-acoustic seismic surveys using logistics similar to 2D surveys that use conventional hydrophones.
Vaccinia Virus E2L Null Mutants Exhibit a Major Reduction in Extracellular Virion Formation and Virus Spread

The vaccinia virus E2L (VACWR058) gene is conserved in all sequenced chordopoxviruses and is predicted to encode an 86-kDa protein with no recognizable functional motifs or nonpoxvirus homologs. Although the region immediately upstream of the open reading frame lacked optimal consensus promoter motifs, expression of the E2 protein occurred after viral DNA replication. Transfection studies, however, indicated that the promoter was weak compared to well-characterized intermediate and late promoters. The E2 protein was present in mature virions purified from infected cells but was more abundant in extracellular enveloped forms. Despite the conservation of the E2L gene in chordopoxviruses, deletion mutants could be isolated from both the WR and IHD-J strains of vaccinia virus. These null mutants produced very small plaques in all cell lines tested, reduced amounts of mature infectious virions, and very low numbers of extracellular virions. Nevertheless, viral protein synthesis appeared qualitatively and quantitatively normal. The defect in extracellular virus formation was corroborated by electron microscopy, which also showed some aberration in the wrapping of virions by cisternal membranes. Extracellular virions that did form, however, were able to induce actin tail formation.
Searcher adaptation: A response to topic difficulty

Some search topics pose little challenge to a search system (“easy”), and some are more difficult (“hard”). We investigated the relationship between one measure of searcher behavior (queries entered per minute), and one measure of system response (the average length of the lists returned) for topics at two levels of difficulty. Specifically, each of 36 participants searched for information about 12 topics: 2 that were “easy” and 10 that were “hard”. We find that when working on easy topics, searchers entered queries less frequently over the course of the search. We also find that lists of retrieved items, as returned by the system, were longer on average for easy topics. We propose that these findings may be useful in designing interactive search systems capable of “awareness” of search difficulty.
Sample Complexity of Testing the Manifold Hypothesis

The hypothesis that high dimensional data tends to lie in the vicinity of a low dimensional manifold is the basis of a collection of methodologies termed Manifold Learning. In this paper, we study statistical aspects of the question of fitting a manifold with a nearly optimal least squared error. Given upper bounds on the dimension, volume, and curvature, we show that Empirical Risk Minimization can produce a nearly optimal manifold using a number of random samples that is independent of the ambient dimension of the space in which data lie. We obtain an upper bound on the required number of samples that depends polynomially on the curvature, exponentially on the intrinsic dimension, and linearly on the intrinsic volume. For constant error, we prove a matching minimax lower bound on the sample complexity that shows that this dependence on intrinsic dimension, volume and curvature is unavoidable. Whether the known lower bound of O(k/e2 + log 1/δ/e2) for the sample complexity of Empirical Risk minimization on k-means applied to data in a unit ball of arbitrary dimension is tight, has been an open question since 1997 [3]. Here e is the desired bound on the error and δ is a bound on the probability of failure. We improve the best currently known upper bound [14] of O(k2/e2 + log 1/δ/e2) to O(k/e2 (min (k, + log4 k/e/e2)) + log 1/δ/e2). Based on these results, we devise a simple algorithm for k-means and another that uses a family of convex programs to fit a piecewise linear curve of a specified length to high dimensional data, where the sample complexity is independent of the ambient dimension.
Second-Order Axial Deflections of Imperfect 3-D Beam-Column

Beam-columns, in general, undergo axial elongation not only from the applied axial forces but also from the transverse deflections. A practical method that takes into account the effects of these transverse deflections on the total axial deformation of a beam-column δ\d\it is by multiplying the first-order axial stiffness \IAE\N/\iL by the geometrically nonlinear factor \is\d1 [i.e., δ\d\it=\iP/(\is\d1\IAE\N/\iL)]. A general solution for \is\d1 is derived for the combined effects of end moments, a uniformly distributed load, a series of concentrated loads, sidesway, and out-of-straightness. This solution requires numerical integration and is limited to 3D elastic prismatic beam-columns with doubly symmetrical cross sections or singly symmetrical 2D beam-columns under small strains. The proposed solution can be applied to the second-order and stability analyses of frames and to the evaluation of the axial load induced by transverse loads in beams built into rigid supports. These effects are particularly important in long-span structures. An example is presented to show the validity of the proposed formulation.
On the furthest-distance-first principle for data scattering with set-up

Message size, packetization, the set-up time, queueing delays, and the order of dispatching packets interact with one another in complicated ways. The paper studies how such interaction affects the performance of the data scattering operation. First, we show that the maximum buffer size needed is at most that of the largest packet. A counter-example demonstrates that the well-known furthest-distance-first (FDF) principle no longer guarantees optimal performance on trees when both the set-up time and packetization are allowed; however, it still works for linear arrays. The packetization problem with set-up time is shown to be reduced to a convex programming problem, which can be solved in polynomial time. Furthermore, we prove that a special class of data scattering problems is also reducible to the same optimization problem. In the absence of set-up time, the FDF principle can produce optimal schedules for trees. Finally, we show that, for any network, the FDF principle can be applied to any breadth-first spanning tree to obtain the optimal schedule in the absence of the set-up time. >
Impact of Oropharyngeal Dysphagia on Long-Term Outcomes of Lung Transplantation

Background Lung transplantation, definitive therapy for end-stage lung disease, is limited long-term by allograft dysfunction including bronchiolitis obliterans syndrome (BOS). Few modifiable risk factors for pulmonary transplant-related mortality are recognized. However, oropharyngeal dysphagia frequently occurs after thoracic surgical procedures, including lung transplantation, and increases morbidity. We evaluated the impact of oropharyngeal dysphagia on survival and BOS after lung transplantation. Methods A total of 263 consecutive lung transplant patients were reviewed. Each underwent clinical swallowing evaluation early after surgery; 149 patients underwent additional fiberoptic or videofluoroscopic swallowing evaluation (SE). Results of SE were correlated with BOS, defined by accepted criteria, and mortality using Kaplan-Meier survival curves. Cox proportional hazard modeling assessed preoperative and postoperative variables associated with development of BOS and mortality. Results Mean follow-up was 920 ± 560 days. The SE identified tracheal aspiration and (or) laryngeal penetration in 70.5%. Preoperative tobacco abuse, gastroesophageal reflux, and cardiopulmonary bypass independently predicted oropharyngeal dysphagia. Peak FEV 1 (forced expiratory volume in the first second of expiration) alone independently predicted BOS (hazard ratio 0.98; confidence interval 0.975 to 0.992, p p = 0.038) and peak FEV 1 ( p p = 0.03). Conclusions Oropharyngeal dysphagia, often overlooked on clinical examination, is common after lung transplantation. Normal deglutition may improve survival after lung transplantation, but oropharyngeal dysphagia does not independently affect BOS. Institution of protocols aimed at identifying previously unrecognized dysphagia may improve results of pulmonary transplantation.
The Drifting Edge Illusion: a stationary edge abutting an oriented drifting grating appears to move because of the 'other aperture problem'.

We describe the Drifting Edge Illusion (DEI), in which a stationary edge appears to move when it abuts a drifting grating. Although a single edge is sufficient to perceive DEI, a particularly compelling version of DEI occurs when a drifting grating is viewed through an oriented and stationary aperture. The magnitude of the illusion depends crucially on the orientations of the grating and aperture. Using psychophysics, we describe the relationship between the magnitude of DEI and the relative angle between the grating and aperture. Results are discussed in the context of the roles of occlusion, component-motion, and contour relationships in the interpretation of motion information. In particular, we suggest that the visual system is posed with solving an ambiguity other than the traditionally acknowledged aperture problem of determining the direction of motion of the drifting grating. In this ‘second aperture problem’ or ‘edge problem’, a motion signal may belong to either the occluded or occluding contour. That is, the motion along the contour can arise either because the grating is drifting or because the edge is drifting over a stationary grating. DEI appears to result from a misattribution of motion information generated by the drifting grating to the stationary contours of the aperture, as if the edges are interpreted to travel over the grating, although they are in fact stationary.
The Impact of Networks on CEO Turnover, Appointment, and Compensation

I study the influence of networks and connectedness on CEO labor market outcomes, including new CEO appointments, CEO termination, and CEO compensation. I distinguish between the pairwise specific CEO-board connectedness and the strength and structure of the CEO’s overall connectedness. I find that both types of connectedness add to traditional turnover and compensation variables in distinct and economically significant ways. Specific connectedness increases CEO entrenchment. Greater overall CEO connectedness on the employment network results in greater likelihood of CEO departure, greater turnover-performance sensitivity, and more rapid re-employment of a departed CEO. The existence of specific links between the CEO candidate and the board of directors enhances the chances of appointment in the event a company chooses to appoint an outsider as the CEO. Finally, CEOs with better overall connectedness enjoy higher total compensation. The evidence suggests that the general connectedness of a CEO in the employment network has significant and distinct economic effects beyond those of the connections between the CEO and the board in the current firm.
Epilepsy in Patients With Duplications of Chromosome 14 Harboring FOXG1

Abstract Background Dup(14q12) harboring FOXG1 has been recently reported in individuals with developmental delay of variable severity, delayed/absent speech, and epilepsy/infantile spasms. FOXG1 was described as a dosage-sensitive gene encoding G1, a forkhead protein that is a brain-specific transcription factor with a role in brain development. Patients We extensively reviewed all published cases with dup(14) harboring FOXG1 and highlighted those epileptological features that are more commonly found among such cases. We also describe one new patient, detailing his peculiar clinical and neurophysiological findings. Results To date, 15 patients with dup(14) including FOXG1 have been reported; within those patients, nine also presented with epilepsy. At onset, the more frequent seizure type in the report and also in our patient is the epileptic spasm. Focal seizures might also be present. Outcomes in patients with epilepsy associated with dup(14) should be considered separately regarding seizures and cognitive and motor development. In the majority of patients (seven of 10, including ours), seizures tend to disappear and motor skills improve; however, instead stagnation of cognitive development is evident in all of them, associated with severe speech difficulties. Conclusions There are some common features that should be considered: seizures with onset during the first year of life, particularly clusters of spasms and focal seizures with hypsarrhythmic electroencephalograph pattern; different degrees of cognitive impairment possibly associated with behavior disturbances and severe speech disabilities; and dysmorphic features in the absence of significant microcephaly.
The performance of dually polarized M-QAM and L-QPRS systems with crosstalk and differential phase shift

The probability of symbol error (P/sub E/) performance is studied for cross-polarized M-QAM (M-ary quadrature amplitude modulation) and L-QPRS (L-ary quadrature partial response signal) systems operating in the depolarization crosstalk and differential phase shift environment. Explicit general formulas are provided and results presented for dual-channel 4-QAM (QPSK-quadrature phase-shift keying) and 9-QPRS. It is demonstrated that the P/sub E/ varies with a period of 90 degrees with differential phase shift and that L-QPRS systems are less sensitive to differential phase shift than the corresponding M-QAM systems; the sensitivity is measured by the ratio of maximum to minimum P/sub E/. >
More goodness-of-fit tests for the power-law process

The power-law process is often used as a model for reliability growth of complex systems or for reliability of repairable systems. There are many results on estimation and hypothesis testing concerning parameters of the power-law process. Goodness-of-fit tests for the power-law process were presented in Park & Kim (1992) using Kolmogorov-Smirnov, Cramer-von Mises, and Anderson-Darling statistics. This paper considers the same problem using three statistics, Kuiper, Watson and weighted Watson. Tables of critical values for the three statistics are presented and the results of a power study are given under the alternative hypothesis that failure data come from a nonhomogeneous Poisson process with log-linear intensity function. The power study shows that the tests have acceptable power for various parameter values and the Cramer-von Mises Statistics, in Park and Kim (1992), has the highest power among the six statistics. An example from the Cox air conditioning repair data is presented. >
Diagnosis and Natural History of HIV-Associated Nephropathy

HIV-associated nephropathy (HIVAN) is a largely distinctive phenotype induced by HIV-1 infection and is the most recognized and detrimental kidney disease in HIV-infected patients. Host and viral characteristics have been implicated in the pathogenesis of HIVAN that may explain its exclusive predilection to patients of African descent. In untreated patients, the disorder is clinically manifested by an acute decline in kidney function, most often in conjunction with high-grade proteinuria and uncontrolled HIV-1 infection. Histologically, proliferating glomerular epithelial cells are the prominent feature of the disease. Data have evolved over the past decade suggesting that highly active antiretroviral therapy (HAART) can change the natural history of HIVAN, not only by preventing its development but also by halting its progression once developed. Consequently, with the widespread use of HAART, the prevalence of HIVAN is declining in Western countries. In contrast, the epidemiology of the disease is not well defined in the poorest areas in the world, which bear a disproportionate share of the HIV-1 epidemic's burden. Corticosteroids and inhibition of the renin-angiotensin axis are recommended as adjunctive agents in treating patients with established HIVAN and are potentially helpful in delaying the need for renal replacement therapy. However, the long-term value and potential risks of using corticosteroids in this population are unclear.
Cognitive Outcomes After Sertaline Treatment in Patients With Depression of Alzheimer Disease

Objectives Although many depressed patients with Alzheimer disease (AD) are treated with antidepressants, the effect of such treatment on cognitive performance in these patients is not known. The authors report cognitive outcomes in patients with depression of AD (dAD) after a 24-week trial of sertraline or placebo. Design Placebo-controlled, randomized, double-blind trial. Setting Outpatient memory clinics at five academic medical centers in the United States. Participants A total of 131 patients with dAD (60 men) and Mini-Mental State Examination scores of 10–26. Intervention Sertraline (n = 67), target dose of 100 mg daily or matching placebo (n = 64). Caregivers received standardized psychosocial intervention throughout the trial. Measurements Mini-Mental State Examination, cognitive subscale of the Alzheimer's Disease Assessment Scale, letter fluency, backward digit span, Symbol Digit Modalities Test, and Finger Tapping Test, administered at baseline, and 8, 16, and 24 weeks following baseline. Results A series of linear models indicated no effect of treatment or of depression remission on cognitive test performance at 24 weeks. Regardless of treatment condition, very little change in cognitive test performance was noted in general. Conclusions Treatment with sertraline in patients with dAD is not associated with greater improvement in cognition at week 24 than treatment with placebo.
Adaptive aberration correction of GRIN lenses for confocal endomicroscopy

Graded-index (GRIN) lenses serve as a key component for miniature endoscopes because of their small diameters and ease of assembly. However, the nonaplanatic nature of GRIN lenses causes inherent spatial aberrations that lower image resolution and sharpness. Here we present the diagnosis of the aberrations in GRIN probes and the use of adaptive optics to compensate for the wavefront errors in the endoscope. Two different operation schemes based on preset and in situ measurements are demonstrated, both resulting in a substantial reduction of the wavefront error from 0.42 to <0.1 μm.
Readmissions and the law of unintended consequences

From the Section of Thoracic Surgery, School of Medicine, Yale University, New Haven, Conn. Disclosures: Author has nothing to disclose with regard to commercial support. Received for publication Sept 3, 2015; accepted for publication Sept 5, 2015. Address for reprints: Anthony W. Kim, MD, Section of Thoracic Surgery, School of Medicine, Yale University, 330 Cedar St, BB 205, New Haven, CT 06520 (E-mail: Anthony.kim@yale.edu). J Thorac Cardiovasc Surg 2015;150:1030-1 0022-5223/$36.00 Copyright 2015 by The American Association for Thoracic Surgery http://dx.doi.org/10.1016/j.jtcvs.2015.09.047
Rethink the Laws Relating to Fathers (Change: With the Decline in Married Mothers and Traditional Families, the Legal Image of Dads Needs Re-Examination)

This "marital presumption" permitted courts to assume a set of biological facts in the name of preserving the sanctity and stability of what was assumed to be the cornerstone of a healthy society - the traditional family of husband, wife and children. In the last decades of the 20th century, science developed paternity testing with results approaching certainty. Despite the availability of DNA testing, the marital presumption is still used in many courtrooms to answer the question of who is the legal father. What one scholar has called "the law's struggle to preserve the fiction of an older moral order" has become increasingly inadequate in defining today's father.For the record, not all fathers in these cases are innocent victims. They may have consented to paternity to solidify a relationship with the child's mother or to facilitate receipt of welfare benefits. Whatever the motive for agreeing to paternity without DNA tests, that decision often prevents further investigation or legal determination of paternity until too late for the child to establish a relationship with the biological father.While the statutes of limitations approach - which defines fatherhood by the number of years a paternity order has been in place - is generally better for children, it ignores the child's definition of father. In some situations, letting the man "off the hook" will make sense for the child. Perhaps the child has no emotional bond with - or even knowledge of - the man whose name is on the paternity order. Maybe it's not too late to find the biological father and develop or legally recognize a relationship with that man or a stepfather or another man who has assumed the role of father in a child's life.
Spaces of Authoritarian Deliberation: Online Public Deliberation in China

Modern authoritarianism relies on a combination of patriotism and legitimacy based on performance rather than ideology. As such, a modern authoritarian government has to allow for some forms of political discussion and participation from which popular consent to authoritarian rule is derived. With 335 million Internet users, 182 million bloggers, and 155 million netizens able to access the Internet through their mobile phones (CNNIC, 2009b), China presents an interesting case to examine public deliberation online. Adapting the concept of authoritarian deliberation (He, 2006a) from an offline environment to an online one, this article proposes four types of online spaces of authoritarian deliberation extending from the core to the peripheries of authoritarian rule: central propaganda spaces, government regulated commercial spaces, emergent civic spaces, and international deliberative spaces. The paper discusses their characteristics and implications for political participation in China and argues that democracy need not be a precursor to public deliberation. Instead, public deliberation may flourish as a viable alternative to the radical electoral democracy in authoritarian countries like China.
Reflective Inquiry in the Round

Efforts to support teachers as reflective practitioners have been a feature of educational initiatives for decades, despite the frequent challenges these efforts encounter in school settings. Individual teachers have moved beyond school walls and the school day to create out-of-school opportunities for structured, analytic dialogue about critical issues in their practice. Since 1995, a voluntary group of educational practitioners have been gathering on the first Saturday of every month at the Harvard Graduate School of Education. These gatherings, called “Rounds” and building on that medical model, provide an uncommon setting for participants to engage in reflective inquiry. This essay, written by the founder and facilitator of Rounds, presents a brief history of this practice and how it has evolved, explores the mechanisms utilized for collaborative investigations, outlines the protocols for the processes of looking at student work and discussing complex and timely educational issues.
Lost in Translation: Why Due Process Demands Deference to the Refugee's Narrative

This Article argues that adjudicators of political asylum applications must presume that the applicant speaks the truth, rather than proceeding from the cultural, psychological and institutional assumptions of incredibility. Decisions at every administrative level reveal that too many adjudicators, without any grasp of narrative or empathy, essentially ignore the plain language of the applicant's testimony and her cultural and psychological uniqueness, in direct violation of our international obligations and the Emma Lazarus-like rhetoric of our asylum law. Due process demands that these adjudications be subject to an articulated and factual presumption of credibility, rebuttable only by clear and convincing evidence of material misrepresentation.
Food Assistance Landscape March 2006

One in five Americans participates in at least one of USDA's food and nutrition assistance programs during the year. In fiscal 2005, an estimated 55 percent of USDA's budget supported the programs that provide children and low-income people with access to food, a healthful diet, and nutrition education. The Economic Research Service (ERS) is responsible for conducting studies and evaluations of USDA's food assistance programs. This report uses preliminary data from USDA's Food and Nutrition Service (FNS) to examine trends in the food assistance programs through fiscal 2005 (October 1, 2004, to September 30, 2005). It also discusses a recent ERS study that examined patterns of entry into and exit from the Food Stamp Program.