cssi/SciSciGPT-SciSciNet huggingface dataset:
Perplexity, confusion and suspicion: a study of selected forms of doctor-patient interactions.

Abstract This paper is concerned with two popular explanations of three common psychological states—perplexity, confusion and suspicion, as they occur within the context of doctor-patient interactions. It is generally held by practitioners that the above are symptomatic of (1) a failure of personality-maturation or disordered personality-functioning, or (2) an unconscious defense mechanism which functions to allay excessive anxiety which threatens to disrupt interpersonal relations. The author will provide a third explanation of their origins, i.e. the above psychological states are a natural consequence of the ambiguities stemming from the doctor-patient interactions themselves. The author will deal with five forms of doctor-patient interactions in which the doctor's handling of the transfer of information played a key role in establishing feelings of perplexity, confusion and suspicion in the mothers of retarded children.
Near-Ir Electrogenerated Chemiluminescence of Tricarbocyanine Dyes in Micellar Systems

Abstract Two tricarbocyanine near-IR dyes containing the same (dimethyl naphthalindole) heterocyclic nuclei, IR144 and IR125, were studied in organic solvents, in water, and in the presence of certain surfactants. The anodic oxidation of IR144 produces electrogenerated chemiluminescence (ECL) in the presence of tri-n-propylamine as a coreactant in sodium dodecyl sulfate surfactant solution or in MeCN/DMSO (2:1 v/v) solution. The one-electron oxidation of IR144 generated the corresponding fairly stable radical cation at +0.48 V vs Ag/AgCl in MeCN/DMSO (2:1). In the micelle system, the potential was shifted to a more positive potential, +1.1 V vs Ag/AgCl, as found by differential pulse voltammetry. The ECL intensity for IR125 was much weaker than that of IR144, and the potential did not change in water or surfactant solution. The absorption spectra indicated extensive dimerization for IR144 in aqueous solution, while IR125 showed little evidence of dimerization. For IR144, the fluorescence intensity in wate...
Clinical outcomes of PD patients having bilateral STN DBS using high-field interventional MR-imaging for lead placement.

Objective Recently, an iMRI-guided technique for implanting DBS electrodes without MER was developed at our center. Here we report the clinical outcomes of PD patients undergoing STN DBS surgery using this surgical approach.
Measuring and Enhancing Prediction Capabilities of Vulnerability Discovery Models for Apache and IIS HTTP Servers

The prediction of the number of vulnerabilities in an HTTP server can allow us to evaluate the security risk associated with its use. Vulnerability discovery models have recently been proposed which can be used to estimate the future number of vulnerabilities expected to be discovered. A detailed analysis of the prediction capabilities of two models termed AML and LVD for the vulnerabilities in the two major HTTP servers is presented. Four complete data sets for Apache and IIS are used, representing an open source and a commercial web server respectively. Both long term predictions involving several years and short term predictions for the following year are considered. Potential methods for enhancing the prediction accuracy are considered. The results show good predictive capabilities of the AML model when constraints are used for estimating the model parameters. The LVD model works well in some special cases when saturation has not yet set in. The results can be used by both developers to plan the test and maintenance effort needed and by users to assess the potential security risks associated with a specific server.
A complete, local and parallel reconfiguration algorithm for cube style modular robots

We present a complete, local, and parallel reconfiguration algorithm for metamorphic robots made up of Telecubes, six degree of freedom cube shaped modules currently being developed at PARC. We show that by using 2 /spl times/ 2 /spl times/ 2 meta-modules we can achieve completeness of reconfiguration space using only local rules. Furthermore, this reconfiguration can be done in place and massively in parallel with many simultaneous module movements. Finally we present a loose quadratic upper bound on the total number of module movements required by the algorithm.
Longitudinal study of birthweight and the incidence of breast cancer in adulthood.

A high birthweight has been associated with an increased risk of breast cancer later in life. The role of adult variables, possible effect modifiers and cancer characteristics has been little studied. We explored these in two large prospective cohort studies of women, the Nurses' Health Study (NHS) and the Nurses' Health Study II (NHS II). We collected information on birthweight from 152,608 female nurses participating in NHS and NHS II. During 10 years and 1.3 million person-years of follow-up, invasive breast cancer was newly diagnosed among 828 premenopausal and 2312 postmenopausal women. Data were analyzed using a Cox proportional hazards model. Premenopausal women with a birthweight of 8.5 lbs: 0.97; 95% CI 0.80-1.16). In these two large prospective cohorts, a low birthweight was associated with a decreased incidence of breast cancer among premenopausal women. This association was independent of other factors operating later in life, except for adult height.
Fast block-iterative domain decomposition algorithm for IR drop analysis in large power grid

Due to the extremely large sizes of power grids, IR drop analysis has become a computationally challenging problem both in terms of runtime and memory usage. In order to design scalable algorithms to handle ever increasing power-grid sizes, the most promising approach is to use a “divide-and-conquer” strategy such as domain decomposition. Such an approach not only decomposes a large problem into manageable sub-problems, it also naturally allow a parallel processing solution for further speedup in computation time. As a result, a power-grid analysis algorithm based upon the traditional domain decomposition method has been reported in [9]. Unfortunately, the method in [9] has strong limitation on the size of the interfaces between the sub-problems and therefore severely limits its capability in solving very large problems. In this paper, we present a block-iterative domain-decomposition algorithm which effectively combines the advantages of direct solvers and iterative methods. With a carefully chosen domain decomposition strategy, our approach does not suffer from the difficulties of [9]. While the algorithm in [9] fails to analyze a power grid of 4 millions nodes, our algorithm solves a power grid of 42 millions nodes accurately in 1.5 hours.
Comparison of three microquantity techniques for measuring total lipids in fish

To measure lipids in juvenile and adult fishes, we refined three microquantity approaches (microgravimetric, microcolorimetric sulfophosphovanillan (SPV), and Iatroscan thin layer chromatography – ...
Electrical model of the injection laser

The simplest electrical model of the injection laser assumes that the active layer, the layer in which spontaneous and stimulated radiative recombination take place, is a homogeneous layer. The only parameters of such an electrical model are the thickness of the active layer, and the electron and hole concentrations and quasi-Fermi levels. If such a model is combined with an optical model with no k -selection rule, one obtains reasonable agreement with experimental threshold current densities, particularly if energy band tails are taken into account. The theory, however, predicts a superlinear relation between gain constant and current density near room temperature, while the observed relation is linear. An alternative electrical model by Pikus assumes that the quasi-Fermi levels of electrons and holes are constant in the active layer. This model, when combined with an optical model having a k -selection rule, gives a strong superlinear dependence of gain on current and is therefore also in disagreement with experiment. A realistic electrical model of the injection laser requires a knowledge of the impurity concentration at each point and solution of the equations governing the motion of electrons and holes. We are carrying out such calculations, using a method of solution developed by J. W. Cooley and G. Hachtel. Preliminary results show that at room temperature the spontaneous emission rate and the stimulated emission rate may have substantially different spatial dependences. The calculations will give information about the effect of different impurity profiles on injection laser performance and on the effect of different current densities on the electron and hole distributions. A detailed account of this work Will be submitted for publication later.
Cystic Neoplasia of the Pancreas: Pathology and Biology

In contrast with solid tumors, most of which are invasive ductal adenocarcinoma with dismal prognosis, cystic lesions of the pancreas are often either benign or low-grade indolent neoplasia. Those that are mucinous, namely, intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs), constitute the most important category, not only because they are the most common, but more importantly because they have well-established malignant potential, representing an adenomacarcinoma sequence. While many are innocuous adenomas — in particular, those that are small and less complex, and in the case of IPMN, those that are branch-duct type are more commonly benign, some harbor or progress into in situ or invasive carcinomas. For this reason, pancreatic cysts with mucinous differentiation ought to be evaluated carefully, preferably by experts familiar with subtle evidences of malignancy in these tumors. In the past few years, the definition of IPMNs and MCNs has become more refined. The presence of ovarian-type stroma has now almost become a requirement for the diagnosis of MCN, and when defined as such, MCN is seen almost exclusively in women of perimenopausal age group as thick-walled multilocular cystic mass in the tail of the pancreas in contrast with IPMN which afflicts an elder population, both genders in almost equal numbers, and occur predominantly in the head of the organ. While mucinous lesions have well-established pre-malignant properties, most of the entities that fall into the nonmucinous true cyst category such as serous tumors, lymphoepithelial cysts, congenital cysts, and squamoid cyst of ducts have virtually no malignant potential. In contrast, the rare cystic tumors that occur as a result of degenerative/necrotic changes in otherwise solid neoplasia such as the rare cystic ductal adenocarcinomas, cystic endocrine neoplasia, and most importantly, solid-pseudopapillary tumor (SPT) in which cystic change is so common that it used to be incorporated into its name (“solid-cystic,” “papillary-cystic”) are malignant neoplasia, albeit variable degrees of aggressiveness. SPT holds a distinctive place among pancreatic neoplasia because of its highly peculiar characteristics, undetermined cell lineage, occurrence almost exclusively in young females, association with β-catenin pathway, and also by being a very low-grade curable malignancy. In conclusion, cystic lesions in the pancreas constitute a biologically and pathologically diverse category most (but not all) of which are either benign or treatable diseases; however, a substantial subset, especially mucinous ones, has malignant potential that requires careful analysis.
Biological Control of the Weed Hemp Sesbania (Sesbania exaltata) in Rice (Oryza sativa) by the Fungus Myrothecium verrucaria

In greenhouse and field experiments, a mycelial formulation of the fungus Myrothecium verrucaria (IMI 361690) containing 0.20% Silwet L-77 surfactant exhibited high bioherbicidal efficacy against the problematic weed hemp sesbania. Infection and mortality levels of 100% of hemp sesbania seedlings occurred within 48 h after fungal application in the greenhouse. In rice field tests conducted over a three year period, M. verrucaria at an inoculum concentration of 50 g L−1 (dry mycelium equivalent) controlled 95% of ≤20 cm tall hemp sesbania plants. M. verrucaria also controlled larger plants (≥60 cm tall) using this high inoculum concentration. This level of weed control, as well as rice yields from plots where weeds were effectively controlled, were similar to those which occurred with the herbicide acifluorfen. These results suggest that a mycelial formulation of M. verrucaria has potential as a bioherbicide for controlling hemp sesbania in rice.
Adolescent alcohol use, suicidal ideation, and suicide attempts.

Abstract Purpose To examine the association between self-reported alcohol use and suicide attempts among adolescents who did and did not report suicidal ideation during the past year. Methods Screening data from 31,953 students attending schools in the United States that implemented the Signs of Suicide (SOS) program in 2001–2002 were used in this analysis. Two types of alcohol use were investigated: heavy episodic drinking, and drinking while down. Self-reported suicide attempts were regressed on suicidal ideation and both measures of alcohol use, controlling for participants' levels of depressive symptoms, and demographic characteristics. Results Logistic regression analyses indicated that both drinking while down and heavy episodic drinking were significantly associated with self-reported suicide attempts. Analyses examining the conditional association of alcohol use and suicidal ideation with self-reported suicide attempts revealed that drinking while down was associated with significantly greater risk of suicide attempt among those not reporting suicidal ideation in the past year. Heavy episodic drinking was associated with increased risk of suicide attempt equally among those who did and did not report suicidal ideation. Conclusions This study identified the use of alcohol while sad or depressed as a marker for suicidal behavior in adolescents who did not report ideating prior to an attempt, and hence, may not be detected by current strategies for assessing suicide risk. Findings from this study should provide further impetus for alcohol screening among clinicians beyond that motivated by concerns about alcohol and substance use.
PDDG/PM3 and PDDG/MNDO: improved semiempirical methods.

Two new semiempirical methods employing a Pairwise Distance Directed Gaussian modification have been developed: PDDG/PM3 and PDDG/MNDO; they are easily implemented in existing software, and yield heats of formation for compounds containing C, H, N, and O atoms with significantly improved accuracy over the standard NDDO schemes, PM5, PM3, AM1, and MNDO. The PDDG/PM3 results for heats of formation also show substantial improvement over density functional theory with large basis sets. The PDDG modifications consist of a single function, which is added to the existing pairwise core repulsion functions within PM3 and MNDO, a reparameterized semiem- pirical parameter set, and modified computation of the energy of formation of a gaseous atom. The PDDG addition introduces functional group information via pairwise atomic interactions using only atom-based parameters. For 622 diverse molecules containing C, H, N, and O atoms, mean absolute errors in calculated heats of formation are reduced from 4.4 to 3.2 kcal/mol and from 8.4 to 5.2 kcal/mol using the PDDG modified versions of PM3 and MNDO over the standard versions, respectively. Several specific problems are overcome, including the relative stability of hydrocarbon isomers, and energetics of small rings and molecules containing multiple heteroatoms. The internal consistency of PDDG energies is also significantly improved, enabling more reliable analysis of isomerization energies and trends across series of molecules; PDDG isomerization energies show significant improvement over B3LYP/6-31G* results. Comparison of heats of formation, ionization potentials, dipole moments, isomer, and conformer energetics, intermo- lecular interaction energies, activation energies, and molecular geometries from the PDDG techniques is made to experimental data and values from other semiempirical and ab initio methods.
Making Childhood Asthma Management Education Happen in the Community: Translating Health Behavioral Research into Local Programs

The public health benefits of research can be realized only if proven new techniques are translated into readily usable processes and materials and widely adopted by professionals and patients alike. To accomplish this, a systematic technology transfer process is needed.One recent outcome of health behavior research has been identification of the skills needed by children and parents to effectively manage childhood asthma. Methods for teaching these skills were tested on hundreds of families in a variety of health care settings. They were then packaged in program manuals that guide health professionals through the teaching process and provide all necessary materials for conducting sessions. The resulting four programs teach attack prevention and control skills. They also emphasize coping skills and help families come to terms with the behavioral factors that impinge on asthma management and affect compliance with medical advice.A technology transfer project for getting initial community adoption of these ...
Adenotonsillar enlargement in pediatric organ transplant recipients: a cross-sectional analysis.

OBJECTIVE: Our goal was to statistically correlate adenotonsillar hypertrophy (ATH) in the pediatric posttransplant population with potential risk factors and to monitor the progression of ATH over time.STUDY DESIGN AND SETTING: Participants were evaluated for ATH through a standardized 65-point questionnaire and an 8-point physical examination. They were also evaluated for current age, age at time of transplantation, type of organ transplant, gender, tacrolimus use, history of transplant rejection, Epstein-Barr virus (EBV) serology, and cytomegalovirus (CMV) serology. We evaluated 243 pediatric solid organ transplant recipients, with 116 patients undergoing repeat evaluation.RESULTS: A statistically significant negative correlation was noted between age at time of transplantation and both questionnaire scores (P = 0.0075) and examination scores (P = 0.013). A significant negative correlation was also seen between age at time of evaluation and questionnaire score (P = 0.028) but not examination score (P =...
Effects of high count rate and gain shift on isotope-identification algorithms

Abstract Spectroscopic gamma-ray detectors are used for many research, industrial, and homeland-security applications. Thallium-doped sodium iodide (NaI(Tl)) scintillation crystals coupled to photomultiplier tubes provide medium resolution spectral data about the surrounding environment. NaI(Tl)-based detectors, paired with spectral identification algorithms, are often effective for identifying gamma-ray sources by isotope. However, intrinsic limitations for NaI(Tl) systems exist, including gain shifts and spectral marring (e.g., loss of resolution and count-rate saturation) at high count rates. These effects are hardware-dependent and have strong effects on the radioisotopic identification capability of NaI(Tl)-based systems. In this work, the effects of high count rate on the response of isotope-identification algorithms are explored. It is shown that a small gain shift of a few tens of keV is sufficient to disturb identification. The onset of this and other spectral effects is estimated for NaI(Tl) crystals, and a mechanism for mitigating these effects by estimating and correcting for them is implemented and evaluated.
Benthic Indicators of the Initial Effect of Opening a Channel

Packery Channel was a natural channel that linked Corpus Christi Bay, Texas with the Gulf of Mexico that has been closed since 1912. A construction project began in 2004 to reopen Packery Channel b...
Results on Gas Detection and Concentration Estimation Via Mid-IR-Based Gas Detection System Analysis Model

In recent decades, laser-based spectroscopy has been used in a wide range of research and application fields due to developments in laser technology and infrared spectroscopy. A particular application of interest is mid-infrared (IR) laser-based gas detection systems for health and environment assessment. In this paper, we use our statistical analysis model for a generic mid-IR pulsed-laser gas detection system to predict trace gas detection and concentration estimation performance, and their sensitivity to system parameters. Based on the Pacific Northwest National Laboratory data and the Beer-Lambert law, we use the three main spectral peaks of a trace gas, as the basis for gas detection, and use the relationship between gas transmittance β, molar absorptivity e, concentration c, and the sample-mean measurement, xN, from the photo-detector, as the basis for concentration estimation using a standard confidence interval method. We also demonstrate the analysis model's adaptability and system performance sensitivity to system parameter values.
Analysing Local Sparseness in the Macaque Brain Network

Understanding the network structure of long distance pathways in the brain is a necessary step towards developing an insight into the brain’s function, organization and evolution. Dense global subnetworks of these pathways have often been studied, primarily due to their functional implications. Instead we study sparse local subnetworks of the pathways to establish the role of a brain area in enabling shortest path communication between its non-adjacent topological neighbours. We propose a novel metric to measure the topological communication load on a vertex due to its immediate neighbourhood, and show that in terms of distribution of this local communication load, a network of Macaque long distance pathways is substantially different from other real world networks and random graph models. Macaque network contains the entire range of local subnetworks, from star-like networks to clique-like networks, while other networks tend to contain a relatively small range of subnetworks. Further, sparse local subnetworks in the Macaque network are not only found across topographical super-areas, e.g., lobes, but also within a super-area, arguing that there is conservation of even relatively short-distance pathways. To establish the communication role of a vertex we borrow the concept of brokerage from social science, and present the different types of brokerage roles that brain areas play, highlighting that not only the thalamus, but also cingulate gyrus and insula often act as “relays” for areas in the neocortex. These and other analysis of communication load and roles of the sparse subnetworks of the Macaque brain provide new insights into the organisation of its pathways.
Differentiating Occult Propionibacterium acnes Infection From Aseptic “Biologic” Interference Screw Hydrolysis After Anterior Cruciate Ligament Reconstruction: Introducing a Novel Culture Protocol for Detecting Low-Virulence Organisms

Historically, arthroscopic anterior cruciate ligament (ACL) reconstruction has a low rate of infection, with a reported prevalence of 0.14% to 5.7%.12,14,21 While uncommon, these infections generally occur early and are characterized by either cellulitis at the graft insertion site and/or septic arthritis.5 Subacute infections are less well characterized. Although bioabsorbable interference screws have the potential advantages of osseointegration, limited postoperative imaging artifact, and decreased hardware removal rates, the potential for acting as the nidus for a sterile abscess, which can both mimic and/or set the stage for infection, exists.2 Typically, distinguishing a sterile abscess from infection is clinically apparent. However, we describe 2 patients with subacute postsurgical medial tibial pain in which this distinction was not evident. Application of a novel culture protocol taken from the prosthetic joint infection literature6 identified infection by a low-virulence organism and directed therapeutic treatment.
Walking the Talk of Food Systems at a Small Land-Grant University: Overcoming Process Barriers to a Transdisciplinary Approach

In this paper we present the evolution of a transdisciplinary food systems (FS) initiative at a small land-grant university. The first indication of the relevance of food systems study at this university came from faculty and students, which then progressed to the establishment of structural changes and financial support by the administration. This commentary demonstrates that successfully incorporating transdisciplinary academic support, research, and educational programs is not an easy endeavor and requires multilevel buy-in from all strata within the organization. This approach also takes substantial time and resource commitment from faculty, staff, students, administration, and the community. If approached in a holistic, transdisciplinary manner, FS initiatives will link what universities do best with improvement in the FS continuum from food production to public health. As with most new initiatives, there are both barriers and triggers to success, and work is ongoing. Using the lens of the University of Vermont (UVM), this paper poses questions and provides best practice advice to others who seek collaboration across disciplines that goes beyond inter- or multidisciplinarity collaboration.
Polyurethane Copolymers Containing Covalently Attached RGD-Peptide: Synthesis and Cell Adhesion Studies

Synthesis of novel polyurethane copolymers containing covalently attached, well-oriented Arg-Gly-Asp (RGD) peptides was explored. A poly(tetramethylene oxide) based polyurethane was synthesized, and a bimolecular nucleophilic substitution reaction was then employed to incorporate ethyl carboxylate groups onto the polymer backbone. Cell-adhesive peptides Gly-Arg-Gly-Asp-Ser-Tyr (GRGDSY) and Gly-Arg-Gly-Asp-Val-Tyr (GRGDVY) were covalently bound to the polyurethane backbone via the formation of amide bonds. Nuclear magnetic resonance (NMR) and Fourier transform infrared (FTIR) spectroscopies were used to monitor the reactions. The amount of grafted peptide was determined by amino acid analysis. Electron spectroscopy for Chemical Analysis (ESCA) suggested the presence of the grafted peptide at the polymer-air interface in vacuo. Dynamic contact angle analysis showed that, in water, the peptide-grafted polyurethane surfaces were more polar than the underivatized polyurethane. The attachment and spreading of human umbilical vein endothelial cells (HUVECs) on the underivatized and peptide-grafted polyurethanes was investigated. The GRGDSY-and GRGDVY-grafted substrates supported cell adhesion and spreading even without serum in culture medium. The GRGDVY-grafted substrate supported a larger number of adherent cells and a higher extent of cell spreading than the GRGDSY-grafted substrate. These RGD-containing peptide grafted polyurethane copolymers may be useful in providing an easily prepared cell-adhesive substrate for various biomaterial applications.
Endoplasmic reticulum--associated structures in lymphocytes from patients with chronic lymphocytic leukemia

Fresh peripheral blood lymphocytes of 61 patients with chronic lymphocytic leukemia (CLL), 28 patients with other lymphoproliferative neoplasms, and 64 noncancerous human subjects were examined by electron microscopy. Lymphocytes from 13 (21%) CLL patients contained three endoplasmic reticulum (ER)-associated structures. Six of these patients had some drug treatment either for CLL or for some other malignancy and 7 had no cancer chemotherapy prior to the first blood sample collection. These structures were either fibrillar, crystalline, or granulofilamentous. Except for the crystalline structure which occurred in 80%-90% of lymphocytes of one CLL patient, the other ER-associated structures were infrequently observed. Lymphocytes from the noncancerous subjects and from the patients with other lymphoproliferative neoplasms did not contain these structures. The occurrence of these structures in untreated patients and their persistence in the lymphocytes of 7 patients who had provided two or more samples during a period of 9 yr suggested a physiologic defect in the lymphocytes of these patients and supported the hypothesis of a clonal origin of leukemic lymphocytes. The presence of the ER-associated structures in the lymphocytes of a small percentage of CLL patients was not considered pathognomonic of the disease. The structures were related to neither the chemotherapy administered to the patients nor to their lymphocyte count during the course of the disease.
Effects of ATP on pre- and postglomerular juxtamedullary microvasculature.

Based on evidence that extracellular ATP can influence vascular smooth muscle function in other organ systems, experiments were conducted to characterize the responsiveness of rat juxtamedullary mi...
The Rhetoric of Slavery

The problematization of American slavery through abolitionist discourse was as much an affective process as a cognitive one. Drawing upon nineteenth-century cultural traditions of Sentimentalism, Republicanism, and Evangelical Protestantism, abolitionist protest rhetoric framed slavery respectively as a form of cruelty, a corruption of power, and a national sin. Lamb-Books demonstrates that what made the three main abolitionist problem frames most effective was pathos and not their logos per se. Specifically, much emotional intensity stems from the status implicatures sown into the package and the resultant production of audience moral emotions. For microsociology, the affective umph or kick of status-oriented protest rhetoric is crucial for understanding what makes social movements move via the processes of charisma, identification, problematization, commitment, and persistence.
What Justifies a Future with Humans in It

Antinatalist commentators recommend that humanity bring itself to a close, on the theory that pain and suffering override the value of any possible life. Other commentators do not require the voluntary extinction of human beings, but they defend that outcome if people were to choose against having children. Against such views, Richard Kraut has defended a general moral obligation to people the future with human beings until the workings of the universe render such efforts impossible. Kraut advances this view on the grounds that we are obliged to exercise beneficence toward others and on the grounds that the goods available in human lives are morally compelling. This account ultimately succeeds in making no more than a prima facie defense of human perpetuation because considerations of beneficence could override – in some cases probably should – override any duty to perpetuate human beings. While the goods of human life may be distinctive, they cannot serve as reason-giving in regard to their own perpetuation. Ironically, the exercise of beneficence may authorize the extinction of human beings, if it becomes possible to enhance the goods available to human descendants in a way that moves them away from human nature as now given. The defense of a morally obligatory and strictly human future remains elusive, even as it becomes morally desirable to work against Fateful Catastrophes, those human-caused events that threaten to extinguish existing lives already good and enriching for their bearers.
Single-center experience in single-stage conversions of gastric banding to sleeve gastrectomy: is it as safe as 2-stage conversions?

Abstract Background Laparoscopic sleeve gastrectomy (LSG) can be performed after obesity persistence following laparoscopic adjustable gastric banding (LAGB) with a positive safety profile. However, some argue that the conversion should be performed in 2 stages rather than 1 because of perioperative complications. The aim of this study is to determine the safety profile of single-stage LAGB to LSG conversion. Setting Academic hospital, United States. Material and methods From October 2009 to July 2016, a total of 76 patients underwent conversions to a LSG because of obesity persistence after LAGB. Of these cases, 65 were done as single-stage procedures and 11 were done in 2 stages. Perioperative complications were compared between the 1-stage and 2-stage conversion groups. Results Mean operative time was 122.5±26.1 minutes (range, 75-186) in the single-stage group and 103.6±29.7 minutes (range, 66–145) in the 2-stage group ( P >0.08). Mean length of hospital stay was 1.5±.6 days (range, 1–3) in the single-stage group and 1.6±.7 days (range, 1–3) in the 2-stage group (sleeve gastrectomy portion) ( P > .58). Two patients (3.1%) in the single-stage group required readmission within 60 days after the conversion because of dehydration (n = 1) and abdominal wall cellulitis (n = 1). Both patients were treated conservatively, and no patient in the 2-stage group required readmission within 60 days from LSG. No patient required reoperation within 60 days, and no patient developed a staple line leakage during the period of follow-up. Conclusion Single-stage laparoscopic conversion of LAGB to LSG is feasible and, in appropriately selected patients, does not seem to increase the risk of complications compared with 2-stage procedures.
Linear rash leaves your patient itching

A 9-year-old boy has developed an itchy vesicular rash on his left leg that has spread to his other leg and to both arms and hands. What is the diagnosis?
P021 Differential clinical and neurophysiological outcomes after premotor rTMS in Parkinson’s disease

Question Weekly sessions of low frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over supplementary motor area (SMA) have shown motor improvement as add-on therapy for Parkinson’s disease (PD). We conducted an active-controlled study to explore potential additive effects of rTMS over both SMA and dorsal premotor area (PMd) compared to SMA alone and potential neurophysiological (NPh) correlates. Methods PD patients with Hoehn & Yahr scores 2–3 participated in a parallel double-blind randomized study of four weekly sessions of LF rTMS. Intervention arms were rTMS over SMA (SMA-alone) and rTMS over both PMd and SMA (PMd + SMA). Clinical outcomes were Unified Parkinson’s Disease Rating Scale-III (UPDRS-III) score; axial, tremor, rigidity, and bradykinesia sub-scores. NPh outcomes were motor evoked potentials, cortical silent period (SP), short interval intra-cortical inhibition and intra-cortical facilitation. Outcomes were analyzed at baseline and 4-weeks post-treatment completion. Results Baseline demographics in Table 1 Figure options Download full-size image Download high-quality image (294 K) Download as PowerPoint slide ; 14 patients completed all study visits. UPDRS-III improved in both arms, SMA-alone (19.8%, p < 0.05) and PMd + SMA (21.0%, p < 0.05). SMA-alone significantly decreased bradykinesia sub-scores (BrS) (z = -2.21, p < 0.05) while PMd + SMA decreased both BrS (z = -2.0, p < 0.05) and axial sub-scores (AxS) (z = -2.4, p < 0.05). NPh outcomes revealed significant increase of SP in PMd + SMA vs. SMA-alone (U = 7.0, p < 0.05). Also, the change in SP showed mod-high correlation with the change in AxS when participants were pooled together (r = -0.60, p < 0.05; Fig. 1 Figure options Download full-size image Download high-quality image (276 K) Download as PowerPoint slide ). Other NPh outcomes were not significant. Conclusions We confirmed weekly LF premotor rTMS can improve motor scores and BrS. AxS improvement seen in the PMd + SMA arm may indicate therapeutic selectivity. As such, the correlation between SP and AxS suggests prolonging SP correlates with improved posture, balance and gait (axial symptoms). As PD patients have shortened SP, this correlation could reflect adequate restorative intra-cortical modulation.
Surgery for Chest Wall Disease in the Elderly

Surgery for chest wall disease in the elderly can be a challenge. A comprehensive preoperative evaluation to determine the risks and benefits prior to proceeding with chest wall resection and reconstruction is warranted. A team approach of thoracic surgeons, plastic surgeons, critical care specialists, and oncologist is necessary to maximize the successful outcome with minimal morbidity and mortality in elderly patients who undergo surgery for chest wall diseases.
Editorial: Special Issue on Hardware/Software Partitioning

graph models. The fourth approach uses coarse-grain task descriptions (as synchronous data-flow graphs) in a targeted simulation environment. For a specific architecture, partitioning of an algorithmic description results in a partition of operations or tasks into hardware and software portions. An exact solution to such a partitioning problem even in the simplest cases requires solution to known intractable problems. This provides motivation for heuristic solutions. The first paper by Kalavade and Lee presents a heuristic approach that uses a combination of global and local measures to guide the partitioning algorithm. These separate measures are used to direct the algorithmic search to good solution while at the same time ensuring the satisfaction of the partitioning goals without excessive backtracking in the design space. These measures effectively compensate for the modeling limitations in system design by providing additional (expert) information to guide the search for a good solution. As mentioned earlier, the partitioning and synthesis subtasks such as scheduling and resource allocation and binding are closely inter-related: that is, a good solution to any one of the subtasks uses solutions for the other subtasks. This dilemma, in the specific case of partitioning and scheduling, is addressed directly in the second paper by Niemann and Marwedel. The authors describe an integer programming (IP) formulation for the partitioning problem that uses an approximate schedule of operations. Solution to this partitioning IP formulation is followed by a solution to the IP formulation of the scheduling problem that updates the schedule. A similar relationship of partitioning and allocation can be seen in the third paper by Madsen and co-authors. The fourth paper by Vahid and Le considers a host of methods to speed up the hardware/software partitioning algorithm using group migration techniques without sacrificing the quality of results. The four papers included in this issue were selected from a total nine submissions after an exhaustive review process in which each of the submissions underwent at least two rounds of reviews. My sincere thanks to the authors for their prompt response and patience with inevitable delays in the review process. My sincere gratitude to all the reviewers for their constructive comments. Finally, I would like to thank Karen Cullen of the journal editorial staff and Mike Casey of the journal production staff for their help in putting this issue
Microlite orientation in obsidian flow measured by synchrotron X-ray diffraction

Clinopyroxene and plagioclase (andesine) microlites in an obsidian flow from Glass Mountain (NE California, USA) display strong alignment. Synchrotron X-ray diffraction, coupled with Rietveld analysis, was used to quantify crystallographic-preferred orientation (CPO). Clinopyroxene, with a rod-shaped morphology, shows a strong alignment of [001] in the flow direction and (010) aligned parallel to the inferred flow plane. Andesine, with a platy morphology, displays an alignment of (010) platelets in the flow plane. Some pole densities exceed 90 multiples of random distribution. Applying a model of rigid ellipsoidal inclusions in a viscous matrix, the local pure shear strains are between 2 and 3.
Mathematical Tool for Systems Reliability Analysis

Abstract The subject of this paper is the mathematical tools and methods for systems reliability analysis. Although there are possibly as many approaches and models to system reliability analysis as there are analysts, the methods presented hereby, if applied informally, do provide general methods for reliability evaluation, prediction and optimization of physical systems (that can be mechanical, electronic, electrical).
Collinear scaling and sequential estimation in sparse optimization algorithms

This paper is intended to accomplish two tasks. It gives a tutorial introduction to quasi-Newton methods and to collinear scaling methods for unconstrained optimization. It also addresses the problem of developing unconstrained optimization techniques which take advantage of a known sparsity pattern in the Hessian matrix of the objective function. Methods which generalize quasi-Newton methods to the sparse case are discussed and an example is given which indicates that positive definite update formulas may, not generalize well. This is because the quasi-Newton equation may be inconsistent with sparsity and positive definiteness. It is shown that the method of collinear scaling together with sparse Cholesky, factor updates may overcome these difficulties. The connection between sequential estimation and this updating process is briefly discussed.
Sales and Stock Valuation: The Case of High-Tech Industry

This study examines the role of sales revenue in the valuation of high-tech stocks. We compare the associations of high-tech stock prices and earning, sales revenues, and cash flows, over the period 1990 through 1999. We find evidence that sales outperform earnings and cash flows in valuating high-tech stocks in general, and high-tech firms reporting losses in particular.
Clinical Features and Pathogenesis of Chronic Bullous Disease of Childhood

Chronic bullous disease of childhood (CBDC) also known as linear IgA disease (LAD), although rare, is the most common acquired immunobullous disease of childhood. It shares the same immunohistochemical features as LAD in adults characterized by the deposition of IgA along the basement membrane zone which causes a subepidermal blister. The distinct clinical presentation of CBDC distinguishes it from other entities and will be reviewed in this chapter. The etiology of CBDC is most often idiopathic. Drug-induced linear IgA especially from vancomycin is more common in adults than children and may respond to stopping the medication culprit. Standard of care is treatment with dapsone, but other treatments have been used with varying success. Although mucous membrane involvement and scarring may occur in a subset of patients, the majority of children with this condition have a good prognosis, with remission expected within months to a few years.
Management of Glial Tumors: Viewpoint—Surgery and Intra-cavitary Radiopharmaceutical Therapy

Glial tumors are primary tumors of the central nervous system and can be divided into low and high-grade tumors. Even though there are no randomized control studies on extent of resection, there is a growing body of evidence supporting maximal, safe resection when surgery is pursued for patients with these tumors. The management of low-grade gliomas (World Health Organization grade II tumors) consists of maximal surgical resection without causing deficits for tumors that are growing or causing mass effect. Incidentally discovered, small low-grade gliomas can be considered for routine surveillance with frequent imaging. High-grade gliomas (World Health Organization grade III and IV tumors) should undergo maximal surgical resection while avoiding iatrogenic deficits. Despite maximal surgical resection, the majority of patients with both low and high-grade tumors will inevitably have recurrence and eventually die from progressive disease. The majority of this recurrence occurs in close proximity to the tumor margins. One type of adjuvant therapy that has been developed to increase radiation to the tumor margins while minimizing toxicity to surrounding normal brain parenchyma is intra-cavitary radiopharmaceutical therapy, also known as brachytherapy. This therapy involves placement of radioisotopes in the tumor bed either peri- or postoperatively and shows promise in that patients with both low and grade gliomas can undergo local radiation therapy, and therefore are not subjected to the neurocognitive problems associated with external brain radiation and the systemic toxicity of chemotherapy. However, clinical trials have yet to show a significant survival benefit for patients undergoing brachytherapy.
Hospital resource utilization and presence of advance directives at the end of life for adults with congenital heart disease.

OBJECTIVE Overall health care resource utilization by adults with congenital heart disease has increased dramatically in the past two decades, yet little is known about utilization patterns at the end of life. The objective of this study is to better understand the patterns and influences on end-of-life care intensity for adults with congenital heart disease. METHODS We identified a sample of adults with congenital heart disease (n = 65), cancer (n = 10 784), or heart failure (n = 3809) who died between January 2010 and December 2015, cared for in one multi-hospital health care system. We used multivariate analysis to evaluate markers of resource utilization, location of death, and documentation of advance care planning among patients with congenital heart disease versus those with cancer and those with heart failure. RESULTS Approximately 40% of adults with congenital heart disease experienced inpatient and intensive care unit (ICU) hospitalizations in the last 30 days of life; 64% died in the hospital. Compared to patients with cancer, patients with adult congenital heart disease (ACHD) were more likely to have inpatient (adjusted risk ratio 1.57; 95% CI 1.12-2.18) and ICU admissions in the last 30 days of life (adjusted risk ratio 2.56; 95% CI 1.83-3.61), more likely to die in the hospital (adjusted risk ratio 1.75; 95% CI 1.43-2.13), and more likely to have documentation of advance care planning (adjusted risk ratio 1.46; 95% CI 1.09-1.96). Compared to patients with heart failure (HF), patients with ACHD were less likely to have an ICU admission in the last 30 days of life (adjusted risk ratio 0.73; 95% CI 0.54-0.99). CONCLUSIONS Adults with congenital heart disease have significant hospital resource utilization near the end of life compared to patients with cancer, notable for more hospitalizations and a higher likelihood of death in the hospital. This population represents an important opportunity for the application of palliative and supportive care.