cssi/SciSciGPT-SciSciNet huggingface dataset:
Rapid Growth of Mental Health Services at Community Health Centers

Community Health Centers (CHCs) target medically underserved communities and expanded by 70% in the last decade. We know little, however, about mental health services at CHCs. We analyzed data from 2006 to 2015 and determined county-level drivers of these services. Mental health patients at CHCs fall from 2006 to 2007 but then rise consistently from 2007 to 2015. Counties with fewer physicians, greater percent insured and greater percent white population show faster growth in mental health services. Increases in mental health services at CHCs outpace general CHC growth and reflect federal efforts to integrate behavioral health care into primary care.
Development of a Natural Language Processing Tool to Extract Radiation Treatment Sites.

Currently, radiation oncology-specific electronic medical records (EMRs) allow providers to input the radiation treatment site using free text. The purpose of this study is to develop a natural language processing (NLP) tool to extract encoded data from radiation treatment sites in an EMR. Treatment sites were extracted from all patients who completed treatment in our department from April 1, 2011, to April 30, 2013. A system was designed to extract the Unified Medical Language System (UMLS) concept codes using a sample of 11,018 unique site names from 31118 radiation therapy (RT) sites. Among those, 5500 unique site name strings that constitute approximately half of the sample were spared as a test set to evaluate the final system. A dictionary and calculated n-gram statistics using UMLS concepts from related semantic types were combined with manually encoded data. There was an average of 2.2 sites per patient. Prior to extraction, the 20 most common unique treatment sites were used 4215 times (38.3%). The most common treatment site was whole brain RT, which was entered using 27 distinct terms for a total of 1063 times. The customized NLP solution displayed great gains as compared to other systems, with a recall of 0.99 and a precision of 0.99. A customized NLP tool was extracting encoded data from radiation treatment sites in an EMR with great accuracy. This can be integrated into a repository of demographic, genomic, treatment, and outcome data to advance personalized oncologic care.
Development of Advanced Flow Diagnostic Techniques to Characterize Aircraft Icing Phenomena

Aircraft icing phenomena involve in complicated interactions among multiphase flows (i.e., gaseous airflow, super-cooled liquid water droplets/surface water film flows, and ice accreting solid surface) coupled with unsteady heat transfer (i.e., the release of the latent heat of fusion) and dynamic phase changing (i.e., solidification) processes. In the present study, the research progress made in our recent efforts to develop advanced flow diagnostic techniques to characterize the complex multiphase flows pertinent to aircraft icing phenomena is presented. A novel lifetime-based molecular tagging thermometry (MTT) is introduced to achieve simultaneous measurements of droplet size (in terms of volume, height, contact area and the contact angle of the droplet) and temporally-and-spatially-resolved temperature distributions within micro-sized, icing water droplets to quantify the unsteady heat transfer and phase changing process pertinent to the ice formation and accretion processes as water droplets impinge onto frozen cold aircraft wings. A novel structure-light-based digital image projection (DIP) technique is also introduced to achieve quantitative measurements of the droplet/film thickness distributions to quantify the dynamic surface water runback process pertinent to glaze ice accretion process over an airfoil/wing surface. The quantitative measurements are very helpful to elucidate the underlying physics pertinent aircraft icing phenomena as well as to develop more effective and robust anti-/de-icing strategies for aircraft icing mitigation.
Contributing Factors for Pediatric Ambulatory Diagnostic Process Errors: Project RedDE.

Background Pediatric ambulatory diagnostic errors (DEs) occur frequently. We used root cause analyses (RCAs) to identify their failure points and contributing factors. Methods Thirty-one practices were enrolled in a national QI collaborative to reduce 3 DEs occurring at different stages of the diagnostic process: missed adolescent depression, missed elevated blood pressure (BP), and missed actionable laboratory values. Practices were encouraged to perform monthly "mini-RCAs" to identify failure points and prioritize interventions. Information related to process steps involved, specific contributing factors, and recommended interventions were reported monthly. Data were analyzed using descriptive statistics and Pareto charts. Results Twenty-eight (90%) practices submitted 184 mini-RCAs. The median number of mini-RCAs submitted was 6 (interquartile range, 2-9). For missed adolescent depression, the process step most commonly identified was the failure to screen (68%). For missed elevated BP, it was the failure to recognize (36%) and act on (28%) abnormal BP. For missed actionable laboratories, failure to notify families (23%) and document actions on (19%) abnormal results were the process steps most commonly identified. Top contributing factors to missed adolescent depression included patient volume (16%) and inadequate staffing (13%). Top contributing factors to missed elevated BP included patient volume (12%), clinic milieu (9%), and electronic health records (EHRs) (8%). Top contributing factors to missed actionable laboratories included written communication (13%), EHR (9%), and provider knowledge (8%). Recommended interventions were similar across errors. Conclusions EHR-based interventions, standardization of processes, and cross-training may help decrease DEs in the pediatric ambulatory setting. Mini-RCAs are useful tools to identify their contributing factors and interventions.
Gestational weight gain, birthweight and early-childhood obesity: between- and within-family comparisons.

Background Associations of excessive gestational weight gain (GWG) with greater birthweight and childhood obesity may be confounded by shared familial environment or genetics. Sibling comparisons can minimize variation in these confounders because siblings grow up in similar environments and share the same genetic predisposition for weight gain. Methods We identified 96 289 women with live births in 2008-2014 at Kaiser Permanente Northern California. Fifteen percent of women (N = 14 417) had at least two births during the study period for sibling analyses. We assessed associations of GWG according to the Institute of Medicine (IOM) recommendations with birthweight and obesity at age 3 years, using conventional analyses comparing outcomes between mothers and sibling analyses comparing outcomes within mothers, which control for stable within-family unmeasured confounders such as familial environment and genetics. We used generalized estimating-equations and fixed-effects models. Results In conventional analyses, GWG above the IOM recommendations was associated with 88% greater odds of large-for-gestational age birthweight [95% confidence interval (CI): 1.80, 1.97] and 30% greater odds of obesity at 3 years old (95% CI: 1.24, 1.37) compared with GWG within the IOM recommendations. In sibling analyses, GWG above the IOM recommendations was also associated with greater odds of large-for-gestational age [odds ratio (OR): 1.36; 95% CI: 1.20, 1.54], but was not associated with obesity at 3 years old (OR = 0.98; 95% CI: 0.84, 1.15). Conclusions GWG likely has a direct impact on birthweight; however, shared environmental and lifestyle factors within families may play a larger role in determining early-childhood weight status and obesity risk than GWG.
ERG-Mediated Coregulator Complex Formation Maintains Androgen Receptor Signaling in Prostate Cancer.

The TMPRSS2-ERG fusion is the most common genomic rearrangement in human prostate cancer. However, in established adenocarcinoma, it is unknown how the ERG oncogene promotes a cancerous phenotype and maintains downstream androgen receptor (AR) signaling pathways. In this study, we utilized a murine prostate organoid system to explore the effects of ERG on tumorigenesis and determined the mechanism underlying prostate cancer dependence on ERG. Prostate organoids lacking PTEN and overexpressing ERG (Pten-/- R26-ERG) faithfully recapitulated distinct stages of prostate cancer disease progression. In this model, deletion of ERG significantly dampened AR-dependent gene expression. While ERG was able to reprogram the AR cistrome in the process of prostate carcinogenesis, ERG knockout in established prostate cancer organoids did not drastically alter AR binding, H3K27ac enhancer, or open chromatin profiles at these reprogrammed sites. Proteomic analysis of DNA-bound AR complexes demonstrated that ERG deletion causes a loss of recruitment of critical AR coregulators and basal transcriptional machinery, including NCOA3 and RNA polymerase II, but does not alter AR binding itself. Together, these data reveal a novel mechanism of ERG oncogene addiction in prostate cancer, whereby ERG facilitates AR signaling by maintaining coregulator complexes at AR bound sites across the genome. SIGNIFICANCE: These findings exploit murine organoid models to uncover the mechanism of ERG-mediated tumorigenesis and subsequent oncogenic dependencies in prostate cancer.
Trajectory Generation of FBG-Sensorized Needles for Insertions into Multi-Layer Tissue

Several models incorporate needle shape prediction, however prediction in multi-layer tissue for complex needle shape remains an issue. In this work, we present a method for trajectory generation of flexible needles that allows for complex curvatures, extending upon a previous sensor-based model. This model combines curvature measurements from fiber Bragg grating (FBG) sensors and the mechanics of an inextensible elastic rod for shape-sensing. We evaluate the method’s effectiveness in single-and double-layer isotropic tissue prediction. The results illustrate a valid trajectory generation method accounting for complex curvatures in flexible needles.
Abstract 1775: Metformin-mediated natural killer cell cytotoxicity in head and neck squamous cell carcinoma

Head and Neck Squamous Cell Carcinoma (HNSCC) is the 6th most common cancer worldwide. Even with intensive treatment, up to 50% of patients will relapse. Checkpoint inhibitors, including antibodies targeting programmed death 1 (PD-1), have dramatically improved survival outcomes but only elicit a response in 20% of patients. PD-1 is expressed on both T-cells and Natural Killer (NK) cells, and depletion of NK cells has been linked to poor prognosis in several solid tumors. NK cells are essential to the innate immune response, do not require MHC-1 expression for recognition, and can stimulate an anti-cancer response through release of cytotoxic granules and direct killing of cancer cells. Upregulation of several interleukins including IL-6, which induces the JAK/STAT3 pathway and subsequently inhibits cancer cell apoptosis, is correlated with a poor prognosis in HNSCC patients. Importantly, inhibition of phosphorylated STAT3 (pSTAT3) increases NK-specific cancer cytotoxicity, NK cell cytokine release, and anti-tumor cell chemokines. Therefore, we hypothesize that impaired NK cell cytotoxicity results in a poor response to immunotherapy. We have shown that a common anti-diabetes drug with anti-cancer properties, metformin, downregulates NK pSTAT3 with subsequent increase in cytotoxicity of peripheral NK cells in HNSCC patients. Metformin also decreases pSTAT3 pathway related cytokine release from HNSCC cell lines. However, it remains unclear whether metformin-mediated enhanced NK cytotoxicity was through a direct effect on NK cells or indirect through inhibition of pSTAT3 in tumor cells and subsequent decrease in inhibitory cytokine release. In addition, inhibiting pSTAT3 could lead to further activation of innate immunity through activation of NK cell cytotoxicity complementing current PD-1 inhibitor therapy and improved treatment response. Here we report the contribution of metformin-mediated direct and indirect effects on NK cell cytotoxic functions and the combined effect of metformin and pembrolizumab using patient samples from a clinical trial and ex vivo models. Understanding metformin-mediated regulation of pSTAT3 and downstream pathways will provide necessary insight to potentially overcome resistance to PD-1 inhibitors and identifying novel treatment combinations for this disease. Citation Format: McKenzie Crist, Maria Lehn, Trisha Wise-Draper. Metformin-mediated natural killer cell cytotoxicity in head and neck squamous cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1775.
Neoliberal Instrument Choice

This book chapter reviews the influence on economic thought about instrument choice and its influence upon United States climate change policy. It shows that the theory of instrument choice made a positive contribution to the United States policy arsenal by emphasizing the cost effectiveness advantages of emissions trading. But because of an ideological climate uncritically supportive of free markets prevailed during the period of U.S. failure to address climate change, the United States favored overly broad trading programs, both in terms of geography and scope. This posture had a large influence on the Kyoto Protocol, leading the world to adopt a structure that creates significant risks of losing emission reductions and less incentive for innovation than a more narrowly designed program would offer. The chapter highlights the tension between sound regulatory policy and maximization of cost savings, which broad design favors. This chapter forms part of a forthcoming book, edited by the author, evaluating economic thought's influence on United States climate change policy.
Evidence that the interferon-induced Daudi cell human lupus inclusions are de novo synthesized complexes of ribonucleoprotein and membrane

Quantitative electron microscope autoradiography has been used to define the macromolecular composition of the interferon-induced human lupus-type inclusions (LI) in the human B lymphoblastoid cell line, Daudi. LI were first apparent in Daudi cell cultures 12 h after the addition of 100 units/ml of the purified recombinant human leukocyte interferon, IFLrA. Radiolabels were added at this time and allowed to incorporate over the following 12 h during which an estimated greater than 99% of the LI material present at 24 h was formed. The LI-incorporated radiolabels were present only during this discrete 12-h period after the interferon activation of LI cell pathways in order to detect LIs de novo synthesized macromolecular components. The estimate relative specific activities of the LI-incorporated radiolabels were: choline at 4.042, mannose at 2.631, uridine at 0.664, glucosamine at 0.578, and amino acids at 0.477. With thymidine the estimated LI specific activity was 0.000. LI isolated from whole cells retained the tubular elements and the interwoven membrane network. These results provide direct evidence that the interferon-induced Daudi cell LI are de novo synthesized complexes of ribonucleoprotein and membrane.
In sync over distance: flexible coordination through communication in geographically distributed software development work

In this dissertation, I examine how the members of a distributed software development team (LC) operating entirely virtually for four and half years developed useful social practices to collaborate across time and space. Based on various communication data from LC, I analyze the communicative structuring of distributed work in members' daily practices. I show that "temporal flexibility," often mentioned as key advantage of virtual organizing, is socially accomplished through "boundary management," as members negotiate different temporal boundaries and learn and adapt to others' temporal patterns. Second, I identify dynamic coordination practices in LC that interweave multiple modes of communication and coordination in evolving work contexts, and demonstrate how these coordination practices facilitate temporal flexibility in LC. Finally, I analyze how members used the asynchronous communication medium of email to coordinate their tasks, using the notion of genre and genre system. My analysis suggests that communicating, coordinating, and temporal structuring are not distinctive activities, but are closely bound up with each other in a local practice; time, communication, and coordination are dynamically reconfigured over time, reflecting evolving work, social relations, and local contexts. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.) Key Words: distribute teams, virtual teams, virtual organizing, technology-mediated communication, temporal flexibility, coordinating, communicating, temporal structuring, social practices, communicative structuring, genre and genre system, reconfiguration of time, communication, and coordination.
The use of exfoliative cytology for the early diagnosis of oral cancers: is there a role for it in education and private practice?

Abstract Background. Early detection of oral cancers is not easy, because oral precancerous lesions and early oral cancers can mimic many benign conditions in the mouth, leading to delays in diagnosis and treatment. There is a need to emphasize the early diagnosis of oral cancers in order to reduce the unacceptably high morbidity and mortality. Methods. A survey regarding oral exfoliative cytology was completed by 132 dentists in Virginia who were randomly chosen from a mailing list. Results. Less than half of the dentists (41.7%) had been taught how to obtain a cytologic smear, and only 26.0% knew the clinical indications for doing so. Only 9.2% of the dentists had ever obtained a cytologic smear in private practice. Of the 13 dentists in the survey who had done so, 12 had been trained in the technique. Interest in learning the cytologic technique and getting the needed supplies was indicated by 79.2% of the dentists. Conclusions. Diagnostic aids in the evaluation of oral mucosal lesions can serve an imp...
Training interdisciplinary “wicked problem” solvers: applying lessons from HERO in community-based research experiences for undergraduates

Management of “wicked problems”, messy real-world problems that defy resolution, requires thinkers who can transcend disciplinary boundaries, work collaboratively, and handle complexity and obstacles. This paper explores how educators can train undergraduates in these skills through applied community-based research, using the example of an interdisciplinary research program at Clark University in Worcester, Massachusetts, USA. Participating students strengthened their abilities to handle setbacks in the research process, improved communication and teamwork skills, and gained familiarity with interdisciplinary investigation. Programmatic elements that could transfer well to other settings include studying local human–environment problems, working in multigenerational, small groups, and using multiple methodologies.
Silent no more! The lived experiences of women with lichen sclerosis.

Purpose: Lichen Sclerosis (LS) is an often unrecognized and misdiagnosed chronic inflammatory skin condition of the anogenital area that affects quality of life, bringing severe discomfort and distress to affected men, women, and children. The purpose of this qualitative study is to explore the lived experiences of women with LS. Data sources: Content analysis was conducted of data obtained from three public online forums/blogs used by women with LS. A total of 527 postings/entries were analyzed for patterns and themes by four researchers. Conclusions: Five core themes emerged as a result of this study, revealing feelings of frustration and despair stemming from healthcare providers’ lack of knowledge in relation to Lichen Sclerosis, often leading to misdiagnosis, prolonged suffering, and an altered quality of life. Implications for practice: Knowledgeable healthcare providers and additional research into the cause, treatment, and cure of Lichen Sclerosis are needed. Advance-practice nurses stand to play an important role in the areas of education, research, policy making, and clinical practice to advocate for and empower women with LS. Lichen sclerosis (LS) is a chronic inflammatory skin condition of the anogenital area that affects quality of life, bringing discomfort, desolation, distress, and anxiety, to affected men, women, and children (Edwards & Goldson, 2003; Jones, Scurry, Neill, & MacLean, 2008; Powell & Wojnarowska, 1999; Val & Almeida, 2005). Known as balanitis xerotica obliterans in men, it can develop on the uncircumcised foreskin and head of the penis (Scheinfelf, Keough, & Lehman, 2010). LS occurs in women of all ages at a range between 6 and 10 times more frequently than in men (Yesudian, Sugunendran, Bates, & O’Mahony, 2005). In women, LS typically affects the anogenital area, although it also appears extragenitally in 15%‐20% of those affected (Edwards & Goldson, 2003; Neill, Lewis, Tatnall, & Cox, 2010; Pulgleise & Morey, 2007; Yesudian, Sugunendran, Bates, & O’Mahony, 2005). LS has been diagnosed in children as young as 6 months with an average diagnostic age of 5 years, often following accusations of child abuse because of the presentation of vulva soreness and anal fissures (Poindexter & Morrell, 2007; Wood & Bevan, 1999). There is a dearth of literature on LS despite the severe physical and psychological consequences the disease presents. The purpose of this qualitative study is to explore the lived experience of women with LS—a topic that remains scarce in the literature. The goal of this study is to fill this identified gap in the literature and to equip advanced practice nurses and other healthcare professionals with the knowledge they need to provide women with LS with timely, patient-centered, and competent evidence-based care. Review of the literature
Econometric modeling of technical change

Abstract The purpose of this paper is to present a new approach to econometric modeling of substitution and technical change. Substitution is determined by observable variables, such as prices of output and inputs and shares of inputs in the value of output. Our principal innovation is to represent the rate and biases of technical change by unobservable or latent variables. This representation is considerably more flexible than the constant time trends employed in the previous literature. An added advantage of the new representation is that the latent variables can be projected into the future, so that the rate and bias of technical change can be incorporated into econometric projections.
Theory of photon-drag phenomena in polar and piezoelectric crystals☆

Abstract The photon-drag effect in polar and piezoelectric crystals is considered. Equations are derived for both the electric field and the current generated by this effect.
Click It or Ticket: Boosting Seat Belt Use in Hawaii

In compliance with its mandatory seat belt law, Hawaii is a high-use state. Seat belt use from 1998 to 2001 has averaged 81%, compared with 70% nationally. Efforts to increase belt use beyond 90% have not been successful, at least until the most recent effort, which entailed a combined enforcement and public information campaign. Described are patterns of belt use over time and the effects of the "Click It or Ticket" campaign that was launched this year. In January 2002, before the program was started, there was an overall belt use rate of 83.5%. After increased enforcement and publicity, Hawaii experienced an immediate increase in belt use by 6.9%. Belt use increased dramatically in each of the state's four counties: in Honolulu, a 7.5% increase; Maui, 10.1% increase; and Kauai, 5% increase. The county of Hawaii, however, increased its rate by only 2.7%. Additional surveys in the months following the campaign indicated that in the days and weeks immediately after the Click It or Ticket campaign, there was a significant drop-off in belt use; but 144 days after, belt use in Honolulu County has stabilized at above 90%. This is surprising because the actual observed current rate is higher than the rate projected on the basis of observations conducted during the weeks immediately after the campaign was initiated. While more surveys and analysis are planned, the campaign was successful in Hawaii. Comments are provided about increasing belt use in a high-use state and implications are described for other traffic safety programs and initiatives.
Synthesis of the C(2)-C(13) fragment (the A-B spiroketal unit) of spongistatin 1 (altohyrtin A): use of a common intermediate for the synthesis of both spongistatin spiroketals.

A convergent synthesis of 14 corresponding to the A−B spiroketal core of spongistatin 1 has been accomplished via an iodo-spiroketalization reaction of glycal 9, which was synthesized in three steps from a late-stage intermediate used in our synthesis of the C−D spiroketal fragment of spongistatin 1. Elaboration of 14 to the A−B spiroketal 15 was accomplished in three steps.
TARP Phosphorylation Regulates Synaptic AMPA Receptors through Lipid Bilayers

Neurons use neurotransmitters to communicate across synapses, constructing neural circuits in the brain. AMPA-type glutamate receptors are the predominant excitatory neurotransmitter receptors mediating fast synaptic transmission. AMPA receptors localize at synapses by forming protein complexes with transmembrane AMPA receptor regulatory proteins (TARPs) and PSD-95-like membrane-associated guanylate kinases. Among the three classes of ionotropic glutamate receptors (AMPA, NMDA, and kainate type), AMPA receptor activity is most regulatable by neuronal activity to adjust synaptic strength. Here, we mutated the prototypical TARP, stargazin, and found that TARP phosphorylation regulates synaptic AMPA receptor activity in vivo. We also found that stargazin interacts with negatively charged lipid bilayers in a phosphorylation-dependent manner and that the lipid interaction inhibited stargazin binding to PSD-95. Cationic lipids dissociated stargazin from lipid bilayers and enhanced synaptic AMPA receptor activity in a stargazin phosphorylation-dependent manner. Thus, TARP phosphorylation plays a critical role in regulating AMPA receptor-mediated synaptic transmission via a lipid bilayer interaction.
Vehicle steering maneuvers with direct trajectory optimization

Steering control systems have been used to develop vehicle automated lane change maneuvers or evasive maneuvers for collision avoidance. Most of these systems have used predetermined desired trajectories to perform the required maneuvers. In this study, an optimal trajectory is found while ensuring minimization of lateral acceleration throughout the maneuver. Collocation technique was used to numerically solve the nonlinear programming problem. The results show a near optimal trajectory can be achieved. The generated trajectory is compared to that of a fifth-order polynomial. The resultant trajectory was substantially better than the polynomial one, with both a lower peak and the overall lateral accelerations.
Which Surfaces of Revolution Core Like a Sphere

A spherical ring is the object that remains when a cylindrical drill bit bores through a solid sphere along an axis, removing from the sphere a capsule consisting of a cylinder with a spherical cap on each end, as shown in Figure 1. Remarkably, the volume of such a spherical ring depends only on its height, defined as the height of its cylindrical inner boundary, and not on the radius of the sphere from which it was cut.
Textile graphics applied to textile printing

Textile Graphics is a computer-aided technique for developing a textile design and textile patterning mechanism information from an artist's drawing. The computer is operated by a textile designer-technician who understands the particular textile machinery for which he is adapting the original drawing. The designer-technician inputs the original drawing by a combination of graphical input devices; tracing on an on-line digitizing tablet, drawing free-hand with light-pen on the screen of the IBM 2250 and manipulating the design with function keys.
The microwave spectrum and 35Cl nuclear quadrupole coupling in chlorotrifluoroethylene

Abstract The microwave spectrum of F 2 CCF 35 Cl was observed in the 8–26 GHz frequency range. The rotational constants are (MHz): A = 4506.05 ± 0.02; B = 2268.66 ± 0.02; and C = 1508.09 ± 0.01. The 35 Cl quadrupole coupling constants along the appropriate inertial axes are (MHz): χ aa = −50.10 ± 0.10; χ bb = +11.36 ± 0.10; and χ cc = +38.74 ± 0.20. The 35 Cl quadrupole coupling constants in H 2 CCF 35 Cl were remeasured and a structure was proposed for this molecule. The coupling constants are (MHz): χ aa = −73.04 ± 0.10; χ bb = +38.60 ± 0.10; and χ cc = +34.44 ± 0.20. The coupling constants in both molecules were transformed into the principal field gradient axis systems and compared with quadrupole coupling constants in similar molecules.
A magnetic field system using implanted sensors to track limb movements in the monkey.

Abstract This paper describes the design and construction of a magnetic field system with implanted sensors, capable of tracking limb orientation during unconstrained movements of awake, behaving monkeys. Tiny sensors (approximately 5 mm diameter) made from two orthogonal coils of wire are implanted in the monkey's upper arm, forearm, and hand. Three mutually orthogonal magnetic fields are detected by each sensor, providing sufficient information to determine the orientation of each limb segment. The use of implanted sensors and magnetic fields overcomes the two main difficulties associated with the use of existing tracking systems with monkeys. (1) It is impossible for the monkey to interfere with the sensors. (2) The sensors are never obscured because the body is permeable to magnetic fields. The tracking system provides highly accurate yaw, pitch, and roll orientation information for each limb segment within a cubical workspace approximately 50 cm on a side. Noise is less than 0.3 degrees, and long-term drift is on the order of 0.2 degrees/h. The system is insensitive even to large pieces of steel within the field, provided the sensors remain at least 10–15 cm from the metal.
Non-ICU Hospital Care of Diabetes Mellitus in the Elderly Population

The concept of lower is better when considering the goal for glycemic control in patients with diabetes mellitus has recently been challenged due to recent studies, such as ACCORD, ADVANCE, and VADT, which have observed increased morbidity and mortality from intensive control, especially in older adults, and in those with long duration of diabetes disease and chronic complications. Although evidence in younger patients suggest that blood glucose levels should not be above 180 mg/dl (10.0 mmol/l), there are many unanswered questions and controversies regarding the benefits and risks, methods to achieve and maintain these levels while avoiding hypoglycemia (<70 mg% (3.9 mmol/l)) in the older population. Since the population is aging with a greater life expectancy, it is crucial that these questions be answered. Although several studies of inpatient non-ICU diabetes management have been published, few include older patients. This review will examine available recommendations and explore those controversies regarding non-ICU hospital management in this vulnerable patient population. Additional conditions that impact upon achieving glycemic control will also be discussed. Finally, the older individual has many special needs which may be more important to consider than in young or middle-aged individuals, when transitioning care from in-hospital to home in a patient-centered approach, as recommended by the American Diabetes Association (ADA) and European Society for the Study of Diabetes (EASD).
NEUROBEHAVIORAL ASSESSMENT OF WELL & ILL PREMATURES OF |[le]|32 WEEKS GESTATION

The Brazelton Neonatal Behavioral Assessment Scale, adapted for very premature infants, was used to assess the neurobehavioral status of 46 infants of ≤ 32 weeks gestation at age ≤3 days. There were 14 cases of uncomplicated prematurity (PBLC). The remaining 32 sustained complications such as respiratory distress syndrome, intracranial hemorrhage, hyperbilirubinemia, or sepsis; of these 13 died. The exam comprised standard reflex items, asessments of tone, color, posture, and Brazelton's behavioral items, eg, orientation and adaptation to repeated stimuli. PBLCs differed from the ill survivor group by displaying greater ability to adapt to repeated stimuli. PBLCs showed better orientation to, and following of, rattle, face, and voice. Their level of spontaneous and elicited activity was higher than that of ill survivors. PBLCs demonstrated more sustained alertness and were more easily brought to an alert state. Nonsurvivors attained lowest scores on items assessing orientation to light, rattle, and face. Nonsurvivors also exhibited lowest scores on the activity and alertness scales, were more difficult to bring to an alert state, were relatively hypoirritable, and tended to achieve a lower peak of arousal than the surviving prematures. Gross muscle tone did not distinguish reliably between the PBLCs and the nonsurvivor group. These results help define normal neurobehavioral function in very premature infants and thus identify abnormal findings with implications for clinical management.
Satellite measurements of nitric oxide in the polar region

Ultraviolet measurements of the (1, 0) gamma band of nitric oxide in fluorescence by a satellite at high latitudes show nitric oxide concentrations which are highly variable in both time and space. The average nitric oxide concentration is 3 to 4 times higher at high latitudes than at midlatitudes. If auroral activity is responsible for the larger nitric oxide densities and if the reaction N(2D) + O2 is the source of NO, then auroral processes must be more efficient in the production of N(2D) atoms than dayglow processes.
The growth and decay of resonant plasma oscillations excited by a small pulsed dipole

Stationary phase method of integration for growth and decay of resonant plasma oscillations excited by small pulsed dipole, noting Landau damping
Quantitative Laser-Induced Fluorescence Measurements of Reactive Species: Spectroscopy and Collision Dynamics of SiCl

Laser-induced fluorescence (LIF) is an ideal technique to determine the gas phase concentration of the chemically reactive radical species in processing plasmas. Quantitative species concentration measurements require spectroscopic and collision dynamics data. Experiments to obtain such data for the B2 and Σ+ B′2 Δ states of SiCl are described. Using LIF, the transition strengths, radiative lifetimes, and collisional removal rates are determined. Collisional transfer between the two excited electronic states, B′→B, shows a very unusual quantum state specificity for the final vibrational levels which is quite different for each of the rare gas collision partners (He, Ne, Ar). Such energy transfer makes the B′2 Δ state unsuitable for quantitative LIF diagnostics; however, the B2Σ+ state appears to be an ideal excited state for LIF diagnostic measurements in silicon etching plasmas.
Clinical implications of endoscopic ultrasound: the American Endosonography Club Study

Abstract Background: Despite increased clinical use of endoscopic ultrasound (EUS), there are little data regarding complications of EUS or its impact on patient management. Methods: A prospective multicenter study was completed to evaluate clinical outcomes of EUS. Before each EUS examination the endosonographer recorded further theoretical patient management plans as if EUS was unavailable. After the EUS, endosonographers recorded actual management plans based on EUS results. The actual management plan after EUS was compared to the theoretical management before EUS. Complications were assessed in short-term follow-up. Results: Four hundred twenty-eight subjects were enrolled. Of subjects able to be evaluated, EUS changed the treatment plan in 74%. Management changes of major importance occurred in 120 patients (31% of subjects able to be evaluated) and included decisions regarding surgery (62 patients), decisions regarding nonsurgical invasive management (36 patients), and decisions regarding further follow-up (22 patients). When there was a change in management, the change was to less costly, risky, or invasive management in 55%, to more costly/risky/invasive in 37%, and to equally costly/risky/invasive in 8%. Short-term follow-up was completed in 81% of subjects, with six complications identified (1.7%). Three complications were mild, two were moderate, one severe, and none fatal. Conclusions: (1) Changes in management plan may occur in the majority of patients based on EUS results. (2) The management changes are often of major importance with regard to health care costs and safety, and are more often in the direction of less costly, risky, and invasive management. (3) EUS is safe in experienced hands. (Gastrointest Endosc 1996;44:371-7.)
Synthesis, characterization and photocatalytic properties of novel zinc germanate nano-materials

Abstract We report the first instance of a hydrothermal synthesis of zinc germanate (Zn2GeO4) nano-materials having a variety of morphologies and photochemical properties in surfactant, template and catalyst-free conditions. A systematic variation of synthesis conditions and detailed characterization using X-ray diffraction, ultraviolet–visible diffuse reflectance spectroscopy, Raman spectroscopy, electron microscopy, X-ray photoelectron spectroscopy and small angle X-ray scattering led to a better understanding of the growth of these particles from solution. At 140 °C, the zinc germanate particle morphology changes with pH from flower-shaped at pH 6.0, to poly-disperse nano-rods at pH 10 when the Zn to Ge ratio in the synthesis solution is 2. When the Zn to Ge ratio is reduced to 1.25, mono-disperse nano-rods could be prepared at pH 7.5. Nanorod formation is also independent of the addition of cetyltrimethylammonium bromide (CTAB), in contrast to previous reports. Photocatalytic tests show that Zn2GeO4 nano-rods (by weight) and flower shaped (by surface area) are the most active for methylene blue dye degradation among the synthesized zinc germanate materials.
Focal cortical dysplasia IIb presenting as slowly progressive aphasia mimicking a brain tumor

Focal cortical dysplasia type IIb (FCDIIb) is a malformation of cortical development characterized by the presence of balloon cells and dysmorphic neurons and often associated with focal epilepsy1, but not with progressive neurological deficits. We report a patient with slowly progressive aphasia as the predominant symptom of FCDIIb with no evidence of electrographic seizures on scalp EEG. Eight years after initial presentation, subacute worsening of her language prompted repeat MRI which revealed changes suggestive of a neoplasm. Biopsy instead revealed FCDIIb. This case exemplifies a challenging differential diagnosis and an unusual presentation of FCDIIb.
Insulin status and vascular responses to weight loss in obesity.

Objectives The aim of this study was to determine whether the effects of weight loss on arterial function are differentially modified by insulin status. Background Clinical studies suggest that plasma insulin levels may predict the extent of cardiovascular benefit achieved with weight loss in obese individuals, but mechanisms are currently unknown. Methods We prospectively followed 208 overweight or obese patients (body mass index [BMI] ≥25 kg/m2) receiving medical/dietary (48%) or bariatric surgical (52%) weight-loss treatment during a median period of 11.7 months (interquartile range: 4.6 to 13 months). We measured plasma metabolic parameters and vascular endothelial function using ultrasound at baseline and following weight-loss intervention and stratified analyses by median plasma insulin levels. Results Patients age 45 ± 1 years, with BMI 45 ± 9 kg/m2, experienced 14 ± 14% weight loss during the study period. In individuals with higher baseline plasma insulin levels (above median >12 μIU/ml; n = 99), ≥10% weight loss (compared with Conclusions Insulin status is an important determinant of the positive effect of weight reduction on vascular function with hyperinsulinemic patients deriving the greatest benefit. Integrated improvement in both microvascular and macrovascular function was associated with ≥10% weight loss. Reversal of insulin resistance and endothelial dysfunction may represent key therapeutic targets for cardiovascular risk reduction in obesity.
Intergenerational Transmission of Intimate Partner Violence: A Behavioral Genetic Perspective

Because intimate violence tends to run in families, social learning theory posits that children learn to be violent through watching their parents and through being reinforced for their own aggressive behaviors. This account of intimate partner violence considers only environmental influences on familial resemblance, but familial resemblance may also be due to genetic factors. A genetically sensitive design is required to examine the extent to which genetic and environmental factors contribute to individual differences in intimate violence. This article reviews evidence for the intergenerational transmission of intimate violence and discusses why a genetically sensitive design is needed. It reviews behavioral genetic research that shows that aggression is genetically influenced and discusses how this research is pertinent to the study of intimate violence from a behavioral genetic perspective. It is urged that behavioral genetic studies of intimate violence be undertaken so that we may have a better understanding of this behavior.
T Cell-Independent and Toll-like Receptor-Dependent Antigen-Driven Activation of Autoreactive B Cells

On the lupus-prone MRL-lpr/lpr (MRL-lpr) background, AM14 rheumatoid factor (RF) B cells are activated, differentiate into plasmablasts, and undergo somatic hypermutation outside of follicles. Using multiple strategies to impair T cells, we found that such AM14 B cell activation did not require T cells but could be modulated by them. In vitro, the signaling adaptor MyD88 is required for IgG anti-chromatin to stimulate AM14 B cell proliferation when T cells are absent. However, the roles of Toll-like receptors (TLRs) in AM14 B cell activation in vivo have not been investigated. We found that activation, expansion, and differentiation of AM14 B cells depended on MyD88; however, mice lacking either TLR7 or TLR9 displayed partial defects, indicating complex roles for these receptors. T cell-independent activation of certain autoreactive B cells, which gain stimuli via endogenous TLR ligands instead of T cells, may be the initial step in the generation of canonical autoantibodies.
Lipid Trafficking sans Vesicles: Where, Why, How?

Eukaryotic cells possess a remarkable diversity of lipids, which distribute among cellular membranes by well-characterized vesicle trafficking pathways. However, transport of lipids by alternate, or "nonvesicular," routes is also critical for lipid synthesis, metabolism, and proper membrane partitioning. In the past few years, considerable progress has been made in characterizing the mechanisms of nonvesicular lipid transport and how it may go awry in particular diseases, but many fundamental questions remain for this rising field.
Third Order Optical Properties of Quasi-Two Dimensional Conjugated Discs: Silicon Naphthalocyanine,

Since the basic phthalocyanine structure intrinsically possesses high thermal and oxidative stabilities, phthalocyanines incorporated into sol-gel glasses provide an attractive approach for realizing highly stable nonlinear optical media. Experimental results recently obtained for the nonresonant and resonant third order optical properties of metallophthalocyanines are reviewed in this paper.
An investigation of the silicon&#8212;Sapphire interface using the MIS capacitance method

Measurements of the MIS capacitance as a function of voltage were carried out on aluminum-sapphire-silicon structures. The results were used to determine the doping of the silicon and the interface-state density and flat-band charge density at the silicon-sapphire interface. The density of states function D s (cm-2eV-1) is found to be qualitatively similar to that reported for the Si-SiO 2 interface but is larger in magnitude by a factor of 5-10.
Design of novel bioconjugates for targeted drug delivery

This paper summarizes recent work on the design and development of targeted polymeric bioconjugates based on N-(2-hydroxypropyl)methacrylamide (HPMA) copolymers. Polymerizable antibody Fab’ fragment (MA-Fab’) has been developed and used in the preparation of targeted HPMA copolymer–mesochlorin e6 conjugates for the treatment of human ovarian carcinomas. The reactivity of the MA-Fab’ in copolymerization with HPMA depended on the length of the spacer between the monomer double bond and the antibody Fab’ fragment. The biological activity of the antibody Fab’ fragment was maintained after incorporation into the HPMA copolymer. Novel aromatic azo spacers were designed and incorporated into HPMA copolymer–drug (cyclosporin A, 9-aminocamptothecin) conjugates for the colon-specific drug delivery and for the treatment of colon diseases. The colon-specific drug release from the conjugates was controlled by the structures of both drug and spacers. Lectins, wheat germ agglutinin (WGA) and peanut agglutinin (PNA), were conjugated to the colon-specific polymer drug conjugates to enhance specific adhesion onto colon tissues.
Transmembrane domain of surface-exposed outer membrane lipoprotein RcsF is threaded through the lumen of β-barrel proteins

RcsF (regulator of capsule synthesis) is an outer membrane (OM) lipoprotein that functions to sense defects such as changes in LPS. However, LPS is found in the outer leaflet, and RcsF was thought to be tethered to the inner leaflet by its lipidated N terminus, raising the question of how it monitors LPS. We show that RcsF has a transmembrane topology with the lipidated N terminus on the cell surface and the C-terminal signaling domain in the periplasm. Strikingly, the short, unstructured, charged transmembrane domain is threaded through the lumen of β-barrel OM proteins where it is protected from the hydrophobic membrane interior. We present evidence that these unusual complexes, which contain one protein inside another, are formed by the Bam complex that assembles all β-barrel proteins in the OM. The ability of the Bam complex to expose lipoproteins at the cell surface underscores the mechanistic versatility of the β-barrel assembly machine.
Heterodox environments: pre-undergraduate ESS experiences beyond the AP ®

This essay adds to the call to maintain diversity within environmental sciences and studies (ESS) curricula. Using two different examples of how ESS curricula get designed for high school students, this essay points to the diverse learning environments out of which college students emerge in the USA as well as the need to maintain epistemological diversity in ESS in the secondary school level. The essay reviews the AP ® Environmental Science curricula as a proxy for how many high school students experience ESS and contrasts this example with a 9th-grade-level curriculum from an independent school to show an alternate way to maintain epistemological diversity with curriculum design and implementation. In drawing attention to the heterodox environments in which ESS curricula can and does live, this essay stresses the role of epistemological diversity in ESS towards the pedagogical and civic goals of ESS itself.