cssi/SciSciGPT-SciSciNet huggingface dataset:
Front Matter, Preface, and An Introduction to: Patients with Passports Medical Tourism Law and Ethics

Can your employer require you to travel to India for a hip replacement as a condition of insurance coverage? If injury results, can you sue the doctor, hospital or insurer for medical malpractice in the country where you live? Can a country prohibit its citizens from helping a relative travel to Switzerland for assisted suicide? What about travel for abortion? In my new book, Patients with Passports, just released by Oxford University Press, I tackle these important questions, and provide the first comprehensive legal and ethical analysis of medical tourism. Medical tourism (or "medical travel") is a growing multi-billion dollar industry involving millions of patients who travel abroad each year to get health care. Some seek legitimate services like hip replacements and travel to avoid queues, save money, or because their insurer has given them an incentive to do so. Others seek to circumvent prohibitions on accessing services at home and go abroad to receive abortions, assisted suicide, commercial surrogacy, or experimental stem cell treatments. This material the press has allowed me to upload to SSRN for distribution includes the front matter and the first two chapters of the book.The "Preface" chapter introduces the book and the scope of medical tourism through the stories of six sets of medical tourists (some real persons, others composite) that sketch the very different needs, hopes, and experiences of patients traveling for care. A second chapter, "An Introduction to the Medical Tourism Industry," introduces the industry at a more theoretical and data-centered level. It describes various ways of dividing the industry and brings together all the best existing available data to give a thick descriptive account of the industry and its major players: home country governments, destination country governments, destination country hospitals and their staffs, accreditors, facilitators, insurers, home country partner hospitals, and industry associations. As these chapters and the book itself demonstrates, very different patients are traveling for very different reasons that raise very different legal and ethical issues. Some patients are traveling for cardiac bypass and other legal services to places like India, Thailand, and Mexico. I analyze among other things issues of quality of care, disease transmission, liability, private and public health insurance, and the effects of this trade on foreign health care systems. Other patients are using medical tourism to attain services illegal in the patient's home country, such as organ purchase, abortion, assisted suicide, fertility services, and experimental stem cell treatments. Here, I examine issues such as extraterritorial criminalization, exploitation, immigration, and the protection of children. Through compelling narratives, expert data, and industry explanations, my goal is to connect the reader to the most prevalent legal and ethical issues facing medical tourism today.
Self-Supported Nasopharyngeal Airway Device for Treatment of Hypotonic Upper Airway Obstruction

Abstract Treatment of upper airway obstruction (UAO) in hypotonic patients is challenging due to diffuse multilevel obstruction with lack of muscular airway tone. Currently available treatment options, ranging from palliative care to tracheostomy, either do not effectively treat UAO, or introduce significant morbidity. This study developed a non-surgical self-supported nasopharyngeal airway (ssNPA) device comprising a patency tube to bypass the obstruction and a flexible securement attachment to hold the device in a proper anatomic position without the use of adhesive or strap-based delivery systems. The ssNPA device has been used in two children: an 8 year and 8 months old male and a 17 year and 4 months old female both with quadriplegic cerebral palsy and severe obstructive sleep apnea (OSA). Results show that ssNPA has demonstrated the good tolerability and feasibility of effectively treating OSA in both patients, and Apnea/Hypopnea Index (AHI) was reduced by 92% and 88% for the 8 year and 8 months and 17 year and 4 months old patient, respectively.
Dizziness and Vertigo: The Skillful Examination.

Background The visual, ocular motor and vestibular systems have intimate neural and close anatomical relationship that dictates their assessment in a patient with dizziness and vertigo. Results Recognition of the pearls and pitfalls of a targeted clinical examination HINTS/HINTS "Plus" allows the clinician to probe at the bedside the most crucial hypothesis in a patient with acute isolated vestibular syndrome, "Is this a stroke?" Conclusion By applying a methodical approach to examination of patients with dizziness and vertigo, localization of the offending lesion, management, and even elucidation of the underlying diagnosis is feasible.
Mediator of DNA damage checkpoint 1 (MDC1) is a novel estrogen receptor co-regulator in invasive lobular carcinoma of the breast

ABSTRACT Invasive lobular carcinoma (ILC) is the most common histological subtype of breast cancer, and nearly all ILC tumors express estrogen receptor alpha (ER). However, clinical and laboratory data suggest ILC are strongly estrogen-driven but not equally sensitive to anti-estrogen therapies. We hypothesized that ILC-specific ER transcriptional co-regulators mediate ER functions in ILC and anti-estrogen resistance, and profiled ER-associated proteins by mass spectrometry. Three ER+ ILC cell lines, MDA MB 134VI, SUM44PE, and BCK4, were compared to published data from ER+ invasive ductal carcinoma (IDC) cell lines, and we examined whether siRNA knockdown of identified proteins suppressed ER-driven proliferation in ILC cells. This approach found mediator of DNA damage checkpoint 1 (MDC1), a key tumor suppressor in DNA damage response (DDR), as a putative novel ER co-regulator in ILC. We confirmed ER:MDC1 interaction was specific to ILC cell lines versus IDC cells, and found MDC1 knockdown suppressed ILC cell proliferation and suppressed tamoxifen resistance in MDA MB 134VI. Using RNA-sequencing, we found that in ILC cells, MDC1 knockdown broadly dysregulates the estrogen-driven ER transcriptome, with ER:MDC1 target genes enriched for hormone-response-elements in their promoter regions. Importantly, our data are inconsistent with MDC1 regulating ER via MDC1 DDR and tumor suppressor functions, but instead suggest a novel oncogenic role for MDC1 in mediating ER transcriptional activity as a co-regulator. Supporting this, in breast tumor tissue microarrays MDC1 protein was frequently low or absent in IDC or ER-ILC, but MDC1 loss is rare in ER+ ILC. ER:MDC1 interaction and MDC1 co-regulator functions may underlie cell type-specific ER functions in ILC, and serve as important biomarkers and therapeutic targets to overcome anti-estrogen resistance in ILC.
Targeted Transcriptomics of Frog Virus 3 in Infected Frog Tissues Reveal Non-Coding Regulatory Elements and microRNAs in the Ranaviral Genome and Their Potential Interaction with Host Immune Response.

Background Frog Virus 3 (FV3) is a large dsDNA virus belonging to Ranaviruses of family Iridoviridae. Ranaviruses infect cold-blood vertebrates including amphibians, fish and reptiles, and contribute to catastrophic amphibian declines. FV3 has a genome at ~105 kb that contains nearly 100 coding genes and 50 intergenic regions as annotated in its reference genome. Previous studies have mainly focused on coding genes and rarely addressed potential non-coding regulatory role of intergenic regions. Results Using a whole transcriptomic analysis of total RNA samples containing both the viral and cellular transcripts from FV3-infected frog tissues, we detected virus-specific reads mapping in non-coding intergenic regions, in addition to reads from coding genes. Further analyses identified multiple cis-regulatory elements (CREs) in intergenic regions neighboring highly transcribed coding genes. These CREs include not only a virus TATA-Box present in FV3 core promoters as in eukaryotic genes, but also viral mimics of CREs interacting with several transcription factors including CEBPs, CREBs, IRFs, NF-κB, and STATs, which are critical for regulation of cellular immunity and cytokine responses. Our study suggests that intergenic regions immediately upstream of highly expressed FV3 genes have evolved to bind IRFs, NF-κB, and STATs more efficiently. Moreover, we found an enrichment of putative microRNA (miRNA) sequences in more than five intergenic regions of the FV3 genome. Our sequence analysis indicates that a fraction of these viral miRNAs is targeting the 3'-UTR regions of Xenopus genes involved in interferon (IFN)-dependent responses, including particularly those encoding IFN receptor subunits and IFN-regulatory factors (IRFs). Conclusions Using the FV3 model, this study provides a first genome-wide analysis of non-coding regulatory mechanisms adopted by ranaviruses to epigenetically regulate both viral and host gene expressions, which have co-evolved to interact especially with the host IFN response.
Post-arthrogram synovitis: MRI and histopathologic findings

A 57-year-old patient developed severe, persistent pain following MR arthrography with iodinated contrast. MRI 1 week later showed synovitis which was new compared to the prior MRI. Arthroscopy showed severe synovitis. Histopathology showed synovitis characterized by lymphocytes, neutrophils, and necrosis. One out of 4 intraoperative cultures was positive, but ultimately believed to be due to contaminants. CRP normalized within 1 month. Repeat MRI 2 years later showed progressive degenerative findings, but no evidence of ongoing infection, or stigmata of previous infection. We believe this to be an unusually severe case of reactive synovitis. The purpose of the report is to add to knowledge of reactions to intra-articular contrast injection.
Spatially resolved cell atlas of the mouse primary motor cortex by MERFISH.

A mammalian brain is composed of numerous cell types organized in an intricate manner to form functional neural circuits. Single-cell RNA sequencing allows systematic identification of cell types based on their gene expression profiles and has revealed many distinct cell populations in the brain1,2. Single-cell epigenomic profiling3,4 further provides information on gene-regulatory signatures of different cell types. Understanding how different cell types contribute to brain function, however, requires knowledge of their spatial organization and connectivity, which is not preserved in sequencing-based methods that involve cell dissociation. Here we used a single-cell transcriptome-imaging method, multiplexed error-robust fluorescence in situ hybridization (MERFISH)5, to generate a molecularly defined and spatially resolved cell atlas of the mouse primary motor cortex. We profiled approximately 300,000 cells in the mouse primary motor cortex and its adjacent areas, identified 95 neuronal and non-neuronal cell clusters, and revealed a complex spatial map in which not only excitatory but also most inhibitory neuronal clusters adopted laminar organizations. Intratelencephalic neurons formed a largely continuous gradient along the cortical depth axis, in which the gene expression of individual cells correlated with their cortical depths. Furthermore, we integrated MERFISH with retrograde labelling to probe projection targets of neurons of the mouse primary motor cortex and found that their cortical projections formed a complex network in which individual neuronal clusters project to multiple target regions and individual target regions receive inputs from multiple neuronal clusters. As part of the BICCN consortium, the authors used a single-cell transcriptomic imaging method to produce a highly defined atlas of cell types across the mouse primary motor cortex.
Vision Realized in Details: To Walter on His 80th Birthday

The organizers of this well deserved volume marking your 80th birthday asked me to contribute a picture or anecdote concerning you. Alas, I have neither. However, I did not want this happy occasion to pass without expressing my appreciation for all that you have done for UCSB and for me personally. The organizers have graciously allowed me a brief note with which to do so.
The Role of Product Composition in Determining Detonation Velocity and Detonation Pressure

Four sets of rules for predicting the detonation product compositions of explosives have been investigated: the Kamlet-Jacobs, the KistiakowskyWilson, the modified Kistiakowsky-Wilson and the Springall-Roberts. These can result, for a given compound, in significantly differing detonation products and amounts of heat release. However the resulting detonation velocities D and detonation pressures P obtained for the compound using the Kamlet-Jacobs equations are generally quite similar, with the Kamlet-Jacobs rules leading to the D and P that are, on average, closest to the experimental. The fact that the variations among the D and P values are relatively small can be attributed to a balancing of opposing effects relating to the quantities of gaseous products and the heat releases. Accordingly, obtaining reasonable accuracy for D and P does not necessarily imply corresponding accuracy for the product composition and heat release that were used. The analysis presented explains the observations that D and P can be correlated with loading density alone, even though product compositions are known to change with density.
State Policies, Enterprise Dynamism, and Innovation System in Shanghai, China

Today rapidly growing economies depend more on the creation, acquisition, dis- tribution, and use of knowledge. As such, strategies for enhancing research and innovation capa- bilities have come to occupy a more important position in many developing nations, including China. Already the leading production center, and often seen as China's economic locomotive, Shanghai is striving aggressively to retain its national preeminence and has launched concerted efforts to increase local innovative output. The primary purpose of this paper is to understand how state-led efforts have fared in promoting technology innovation. By situating the city in the national and global context, the paper shows that Shanghai has gained a substantial lead in developing an innovation environment with extensive global linkages and leading research institutions. Recent efforts in building up the research and innovation capacity of the enterprise sector have begun to show progress. Although firms are enthusiastic about its future as an innovation center, Shanghai continues to face challenges of inadequate protection of intellectual property, lack of venture capital investment, and the tightening supply of highly qualified knowledge workers.
Performance Modeling of Sparse Matrix Methods for Distributed Memory Architectures

We present analytical performance models for the numerical factorization phase of the multifrontal method for sparse matrices. Using a concise characterization of parallel architectures, we provide upper-bound estimates for the speedups observed on actual test problems taken from scientific and engineering applications. Representative architectures include an iPSC/2, iPSC/860, various clusters of workstations, and supercomputers connected by HIPPI interfaces. Simulation results suggest that the effective parallelism of these problems is quite sensitive to the communication bandwidth of the underlying architecture and load imbalances in the computational graph due to irregular data patterns.
Mung bean nuclease I. V. A tool for probing low melting regions in deoxyribonucleic acid.

Abstract Partial heat denaturation of preparations of DNA of different origin produced regions that became susceptible to mung bean nuclease I. These regions were distributed throughout the whole molecule of DNA. The susceptible regions were richer in A and T than the over-all composition of the parent DNA, regardless of whether the parent was A + T-rich or C + G-rich DNA. In the digested material C = G, A = T, therefore both strands were attacked simultaneously.
Suppressive Effect of Bacterial Polysaccharides on BAFF System Is Responsible for Their Poor Immunogenicity

Capsular polysaccharides of encapsulated bacteria are weakly immunogenic T cell-independent type 2 (TI-2) Ags. Recent findings suggest that BAFF system molecules have a critical role in the development of Ab responses against TI-2 Ags. In this study, we investigated the effect of bacterial polysaccharides on B cell responses to BAFF and a proliferation-inducing ligand (APRIL). We determined that B cells exposed to meningococcal type C polysaccharide (MCPS) or group B Streptococcus serotype V (GBS-V) were unresponsive to BAFF- and APRIL-induced Ig secretion. Moreover, MCPS and GBS-V strongly downregulated transmembrane activator and calcium-modulator and cyclophilin ligand interactor, the BAFF and APRIL receptor that is responsible for Ab development against TI-2 Ags. Interestingly, (4-hydroxy-3-nitrophenyl)acetyl-Ficoll (NP-Ficoll), a prototype TI-2 Ag, did not manifest a suppressive effect on B cells. Paradoxically, whereas GBS-V and MCPS inhibited IFN-γ-induced BAFF production from dendritic cells, NP-Ficoll strongly increased BAFF secretion. TLR 9 agonist CpG deoxyoligonucleotide (ODN) was able to reverse the MCPS-mediated transmembrane activator and calcium-modulator and cyclophilin ligand interactor suppression but could not rescue the Ig secretion in BAFF- or APRIL-stimulated B cells. In support of these in vitro observations, it was observed that CpG ODN could help augment the Ab response against NP in mice immunized with a CpG ODN-containing NP-Ficoll vaccine but exhibited only marginal adjuvant activity for MCPS vaccine. Collectively, these results suggest a mechanism for the weak immunogenicity of bacterial polysaccharides and explain the previously observed differences between bacterial polysaccharide and NP-Ficoll immunogenicity.
Instructional technology environments for engineering outreach

This paper describes a method for evaluating the instructional technology environment in which to offer engineering outreach courses. It defines the technology environments, the evaluation criteria, and the personal weighting factors used to determine the relevance of the various criteria to a particular instructor and course.
Flavor and Charge Symmetry in the Parton Distributions of the Nucleon

Recent calculations of charge symmetry violation (CSV) in the valence quark distributions of the nucleon have revealed that the dominant symmetry breaking contribution comes from the mass associated with the spectator quark system. Assuming that the change in the spectator mass can be treated perturbatively, we derive a model independent expression for the shift in the parton distributions of the nucleon. This result is used to derive a relation between the charge and flavor asymmetric contributions to the valence quark distributions in the proton, and to calculate CSV contribution to the nucleon sea. The CSV contribution to the Gottfried sum rule is also estimated, and found to be small.
The 3He Abundance in the Planetary Nebula NGC 3242

Using the NRAO 140 Foot Telescope, we have confirmed our earlier detection of 3He in the planetary nebula NGC 3242 made with the 100 m radio telescope of the Max-Planck-Institut fur Radioastronomie. Both spectrometers show that the observed 3He+ hyperfine line has a double-peaked structure. This line shape naturally arises if NGC 3242 is modeled as a dense core surrounded by a very low density expanding shell. The observed 3He+ emission suggests an abundance by number of 3He/H = (2–5) × 10-4, which is more than an order of magnitude higher than typically found in Galactic H II regions.
Variational Principles in Structural Mechanics

This chapter introduces the calculus of variations and associated mathematical operators on functionals, which are used to formulate boundary value problems in structural mechanics. Weak forms of equilibrium are derived in terms of the principle of virtual work and the theorem of minimum potential energy. These are used to establish the governing field equations (Euler–Lagrange differential equations) and associated geometric, natural, or mixed boundary conditions. Weak forms of kinematic compatibility are derived in terms of the principle of complementary virtual Work and the theorem of minimum complementary potential energy. Examples are provided for each. Keywords: calculus of variations; functionals; variational principles; structural mechanics; principle of virtual work; minimum potential energy theorems; Hamilton's principle; Euler-Lagrange equations
An architecture for performance management of multimedia networks

A principal requirement for multimedia networks is the ability to allocate resources to network services with different quality-of-service demands. The objectives of achieving efficient resource utilization, providing quality-of-service guarantees, and adapting to changes in traffic statistics make performance management for multimedia networks a challenging endeavor. In this paper, we address the following questions: what is the respective role of the real—time control system, the performance management system, and the network operator, and how do they interact in order to achieve performance management objectives? We introduce an architecture for performance management, which is based on the idea of controlling network performance by tuning the resource control tasks in the traffic control system. The architecture is built around the L-E model, a generic system-level abstraction of a resource control task. We use a cockpit metaphor to explain how a network operator interacts with the management system while pursuing management objectives.
The Enzymatic Carboxylation of Phosphoenolpyruvate III. INVESTIGATION OF THE KINETICS AND MECHANISM OF THE MITOCHONDRIAL PHOSPHOENOLPYRUVATE CARBOXYKINASE-CATALYZED REACTION

Abstract Comparative kinetic studies at pH 6.8, 7.3, and 8.0 reveal that the phosphoenolpyruvate carboxykinase-catalyzed inosine triphosphate-dependent oxalacetate-H14CO3- exchange is much more rapid than either the over-all decarboxylation or carboxylation reactions. At pH 6.8, the relative carboxylation, decarboxylation, and oxalacetate-H14CO3- exchange rates are 1.0, 8.3, and 30, respectively. While the pH optima for all three reactions are essentially the same (pH 6.6), the shapes of pH optimum curves for the carboxylation and oxalacetate-H14CO3- exchange reaction differ markedly from that for the decarboxylation reaction. Under conditions which permit rapid P-enolpyruvate carboxykinase-catalyzed oxalacetate-H14CO3- exchange; neither GTP-GDP-8-14C-, ITP-32 P-enolpyruvate-, nor oxalacetate-P-enolpyruvate-1-14C-exchange occurs at a significant rate. The inability of carboxykinase to catalyze these exchange reactions renders unlikely (a) the formation of phosphorylenzyme from GTP (or ITP) and enzyme as a step in the oxalacetate-H14CO3- exchange reaction or (b) the dissociation of either enzyme-P-enolpyruvate or enzyme-IDP (or GDP) as a rate-limiting step in the over-all decarboxylation reaction. The results support a two-step reaction sequence in which an ITP-dependent cleavage of the β-carboxyl carbon—carbon bond of oxalacetate yields HCO3- (or CO2) and an intermediate containing the elements of ITP and a 3 carbon moiety derived from carbon atoms 1, 2, and 3 of oxalacetate. Two mechanisms compatible with these results and other known characteristics of the reaction are proposed. Kinetic constants (Km and V values) for all substrates and cofactors of the carboxykinase-catalyzed carboxylation, decarboxylation, and oxalacetate-H14CO3- exchange reaction were determined. The Km values (0.025 m and 0.027 m, respectively) for bicarbonate in the carboxylation (pH 7.5) and oxalacetate-H14CO3- exchange (pH 7.3) reactions were in close agreement. Bicarbonate is a competitive inhibitor (with respect to oxalacetate) of the decarboxylation reaction. Competition between oxalacetate and HCO3- is also evident in the oxalacetate-H14CO3- exchange reaction suggesting a common HCO3- and β-carboxyl site on the enzyme. The Km values (1.6 to 5.8 x 10-4 m, pH 7.3) for ITP and GTP in the decarboxylation and oxalacetate-H14CO3- exchange reaction determined under similar conditions agreed closely. The oxalacetate-H14CO3- exchange reaction is strongly inhibited by P-enolpyruvate, whereas, the decarboxylation rate is unaffected at similar P-enolpyruvate concentrations. Both the oxalacetate-H14CO3- exchange and decarboxylation reactions are inhibited by GMP and GDP.
Condition number complexity of an elementary algorithm for computing a reliable solution of a conic linear system

A conic linear system is a system of the form¶¶(FPd)Ax=b¶x∈CX,¶¶where A:X?Y is a linear operator between n- and m-dimensional linear spaces X and Y, b∈Y, and CX⊂X is a closed convex cone. The data for the system is d=(A,b). This system is “well-posed” to the extent that (small) changes in the data d=(A,b) do not alter the status of the system (the system remains feasible or not). Renegar defined the “distance to ill-posedness,”ρ(d), to be the smallest change in the data Δd=(ΔA,Δb) needed to create a data instance d+Δd that is “ill-posed,” i.e., that lies in the intersection of the closures of the sets of feasible and infeasible instances d′=(A′,b′) of (FP(·)). Renegar also defined the condition number ?(d) of the data instance d as the scale-invariant reciprocal of ρ(d) : ?(d)=\(\).¶In this paper we develop an elementary algorithm that computes a solution of (FPd) when it is feasible, or demonstrates that (FPd) has no solution by computing a solution of the alternative system. The algorithm is based on a generalization of von Neumann’s algorithm for solving linear inequalities. The number of iterations of the algorithm is essentially bounded by¶¶O(\(\) ?(d)2ln(?(d)))¶¶where the constant \(\) depends only on the properties of the cone CX and is independent of data d. Each iteration of the algorithm performs a small number of matrix-vector and vector-vector multiplications (that take full advantage of the sparsity of the original data) plus a small number of other operations involving the cone CX. The algorithm is “elementary” in the sense that it performs only a few relatively simple computations at each iteration.¶The solution \(\) of the system (FPd) generated by the algorithm has the property of being “reliable” in the sense that the distance from \(\) to the boundary of the cone CX, dist(\(\),∂CX), and the size of the solution, ∥\(\)∥, satisfy the following inequalities:¶¶∥\(\)∥≤c1?(d),dist(\(\),∂CX)≥c2\(\), and \(\)≤c3?(d),¶¶where c1, c2, c3 are constants that depend only on properties of the cone CX and are independent of the data d (with analogous results for the alternative system when the system (FPd) is infeasible).
Housing Segregation and Black Employment: Another Look at the Ghetto Dispersal Strategy

There is some irony in how the debate about whether black inner-city ghettos should be dispersed or developed has been translated into public policy on revitalization of central city areas. Recall how, a decade ago, vehement defenders of ghetto dispersal were stating that black employment opportunities had been restricted because of housing segregation and suburbanization of jobs. Along with low automobile ownership among ghetto residents and declining low-skill job opportunities in the central business district, housing segregation and suburbanization of jobs were factors ranking high on the list of explanations of why gilding of ghettos should not be encouraged. The alternative offered was ghetto dispersal.
Soap operas and the history of fan discussion

For decades, fans of U.S. soap operas have formed social networks surrounding their shows, and they did so even before the concept entered the vernacular. Soap fans, who started on a geographically local scale and built their communities through grassroots efforts, have found a variety of venues to connect with one another over the past several decades. This study looks at the pre-Internet development of these social networks to show how that trajectory relates to the current online community of soap opera fans. Although several scholars have studied soap opera fandom, few have taken an historical approach at understanding the trajectory of soap fandom, a view especially necessary in an era where online social networks are at the center of audience studies and where cornerstone U.S. soap operas are struggling to retain relevance and audience. To fill this gap, I argue that understanding fan networks today requires looking back to previous methods of fan networking. Soaps' longevity (the youngest U.S. soap is more than 20 years old) and frequency (all U.S. daytime soaps are daily) make them crucial texts in demonstrating how the roots of fan social networks in a pre-Internet era helped shape that fandom's transition onto the Internet, and they also illustrate the continued evolution of these networks as fans move online.
Alcohol, drug intoxication, or both at the time of burn injury as a predictor of complications and mortality in hospitalized patients with burns

The objective of this study was to characterize the association between drug and alcohol intoxication at the time of injury and subsequent complications and mortality in hospitalized patients with burns. A computerized burn database was used to analyze data on 3047 consecutive adult (21 to 75 years) hospitalized patients with burns admitted between January 1982 and August 1994. Data for intoxicated (by history, blood alcohol content, or positive drug screen) and nonintoxicated patients were compared. The same analysis was also conducted on 429 consecutive adolescent patients with burns (ages 14 to 20 years) admitted during the same time period. The incidence of intoxication at the time of burn was 6.9%. No significant differences in age, sex, race, or burn size were noted. Intoxicated patients had a higher incidence of associated injuries. Skin graft loss, cellulitis, donor site conversion, hypotension, and pneumonia were more common in the intoxicated group. They also had more intensive care unit admissions, ventilator days, operations, transfusions, and total hospital days. Intoxicated patients had a lower mortality (7.1%) than patients in the control group (10.9%). Intoxication at the time of burn injury is an important predictor of complications in adult patients with burns.
Combined gas chromatography and mass spectrometry of aromatic β-carbolines

Abstract A method is described for the analysis of substituted aromatic β-carbolines employing gas chromatography combined with mass spectrometry (GC-MS). The spectra of the β-carbolines obtained by GC-MS are presented. Mass spectrometric patterns have been studied for their utility in the structural identification of biologically synthesized β-carbolines.
A Business Process Management Approach to Perioperative Supplies/Instrument Inventory and Workflow

This study examines business process management practices applied to monitor, measure, and improve a hospital's perioperative supply workflow and corresponding inventory management. This paper identifies how dynamic technological activities of analysis, evaluation, and synthesis applied to internal and external organizational data can highlight complex relationships within integrated hospital processes to target opportunities for improvement and ultimately yield improved process capabilities. The identification of existing limitations, potential capabilities, and the subsequent contextual understanding are contributing factors that yield measured improvement within a hospital's perioperative process. Based on a 10-year longitudinal study of a large 909 registered-bed teaching hospital, this case study investigates the impact of integrated information systems to identify, qualify, and quantify business analytics used to improve perioperative efficiency and effectiveness across patient quality of care, operational efficiency, and financial cost effectiveness. The theoretical and practical implications and/or limitations of this study's results are also discussed with respect to practitioners and researchers alike.
Making Muscle or Mitochondria by Selective Splicing of PGC-1α

Endurance training induces the transcriptional coactivator PGC-1α in skeletal muscle, promoting mitochondrial biogenesis and skeletal muscle remodeling. In a recent issue of Cell, Ruas et al. (2012) show that resistance training regulates the splicing of a novel isoform of PGC-1α (PGC-1α4), which is sufficient to stimulate skeletal muscle hypertrophy.
IFN-τ Suppresses Both the Autoreactive Humoral and Cellular Immune Responses and Induces Stable Remission in Mice with Chronic Experimental Allergic Encephalomyelitis

Abstract We have previously shown that interferon-τ (IFN-τ) pretreatment inhibits the development of both acute and chronic mouse experimental allergic encephalomyelitis (EAE), an animal model for the human demyelinating disease multiple sclerosis (MS). IFN-τ is a type I IFN that has pregnancy recognition hormone activity in ruminants. Here, we show that IFN-τ induced remission in SJL/J mice that had ongoing chronic active EAE disease and protected mice against secondary relapses. IFN-τ treatment reversed lymphocyte infiltration and microglial activation in the central nervous system. Mice that were treated with IFN-τ had lower levels of anti-MBP antibodies than untreated mice in both chronic and acute forms of EAE. MBP induced proliferation in B cells from EAE mice, but treatment with IFN-τ either in vivo or in vitro blocked activation. Furthermore, IFN-τ inhibited MBP activation of T cells from EAE mice. Thus, IFN-τ inhibits the humoral arm as well as the cellular arm of the autoimmune disease EAE. The data presented here show that IFN-τ inhibits both B cell and T cell responses in EAE as well as active, chronic EAE, and this may help explain the effectiveness of type I IFNs in treatment of MS.
Student self-evaluation, teacher evaluation, and learner performance

A total of 341 Latvian students and eight teachers participated in this study of student self-evaluation and teacher evaluation. Students completed a 12-lesson teacher-directed instructional program on conducting and writing a report of their own experimental research. Sixteen classes were randomly assigned to one of four treatment conditions: (1) no in-program evaluation, (2) self-evaluation and revision at the research design and draft final report stages, (3) teacher evaluation and student revision at both stages, (4) self-plus-teacher evaluation and student revision at both stages. Students in the teacher-evaluation and self-plus-teacher evaluation conditions received significantly higher ratings from an independent rater on their final research reports. However, students under the self-evaluation conditions had greater confidence in their ability to conduct future experiments.
Low-Frequency Electromagnetic Response Function for Strong-Coupling Superconductors

A simple method for calculating the low-frequency electromagnetic response function from tunneling derived ${\ensuremath{\alpha}}^{2}(\ensuremath{\omega})F(\ensuremath{\omega})$ has been developed and applied to Pb, ${\mathrm{Pb}}_{0.90}$${\mathrm{Bi}}_{0.10}$, amorphous Bi, amorphous ${\mathrm{Pb}}_{0.45}$${\mathrm{Bi}}_{0.55}$, and amorphous ${\mathrm{Sn}}_{0.90}$${\mathrm{Cu}}_{0.10}$. The results have been compared with previous calculations and experiments. A correction to the calculation of the $T=0$ values given by Kerchner and Ginsberg is given. Although the calculations agree with experiment for crystalline Pb, the calculated temperature dependence is much stronger near ${T}_{c}$ than that inferred from kinetic inductance measurements for amorphous Bi.
Adaptive bleaching: A general phenomenon

Laboratory and field data bearing on the adaptive bleaching hypothesis (ABH) are largely consistent with it; no data of which we are aware refute it. We generalize the ABH in light of these data and observations. The population of zooxanthellae within an organism is dynamic, the diversity of zooxanthellae is both surprising and difficult to ascertain, and field experiments demonstrate both turn-over in zooxanthella types and habitat-holobiont correlations. Dynamic change in symbiont communities, and the idea of an equilibrium or optimal community that matches the environment at a particular place and time, are concepts that underlie or emerge from much of the recent literature. The mechanism we proposed to explain responses to acute bleaching appears to operate continuously, thereby enabling the host-symbiont holobiont to track even subtle environmental changes and respond promptly to them. These findings enhance the potential importance of the ABH in the outcomes of acute bleaching, which can (1) accelerate this process of holobiont change, and (2) change the set of possible trajectories for how symbiont communities might recover.
Chronic care costs in managed care

This DataWatch presents estimates of the health care costs for all adults who were continuously enrolled in a large staff-model health maintenance organization (HMO) during 1992. More than one-third of these adults were diagnosed with at least one chronic condition in 1992, and costs for this population are at least twice those of the population without chronic conditions. A diagnosis of a chronic condition results in an expected increase in costs of 80 percent-300 percent, depending on age, sex, and chronic condition profile. Previous studies of the costs of chronic illness have focused on the fee-for-service sector. As managed care continues to grow, it is important that economic analyses focus on this market segment.
Causal temporal order in HCI

This paper proposes applying principles of human causal reasoning to graphical interface design to make interfaces more intuitive. In particular, we present a design guideline for making graphical interfaces consistent with causal temporal order and demonstrate its effectiveness in an experiment where participants solve a puzzle with a novel interface. We also present preliminary results of its application to a text formatting task and propose several other causal principles that are directly applicable to interface design.
Repeated Episodes of Transient Radiating Back and Leg Pain Following Spinal Anesthesia With 1.5% Mepivacaine and 2% Lidocaine

Background and Objectives Transient radiating back and leg pain defined as pain or dysesthesias in the buttocks, thighs, or calves within 24 to 48 hours after recovery from spinal anesthesia has been described with the use of 2% and 5% lidocaine. These symptoms have also been associated with other local anesthetics such as bupivacaine and tetracaine, although with a much lower incidence. A recent case report and prospective study have described transient radiating back and leg pain occurring following spinal anesthesia with 4% mepivacaine. Methods We describe a case of transient radiating back and leg pain following spinal anesthesia with 1.5% mepivacaine in a patient with unrecognized spinal stenosis who had had repeated episodes of transient radiating back and leg pain associated with lidocaine spinals. Results Spinal anesthesia with 1.5% mepivacaine was associated with transient radiating back and leg pain, which was similar in quality and duration to prior episodes following spinal anesthesia with lidocaine. Conclusions Transient radiating back and leg pain may occur with lower concentrations (1.5%) of mepivacaine, as it does with lidocaine. The relationship between transient radiating back and leg pain and spinal stenosis is also discussed.
Manifest anxiety: a cluster analytic study.

Abstract Subjects in graduate classes voluntarily completed the Manifest Anxiety Scale. A cluster analysis assessed the internal structure of the scale. Three clusters presented as the most parsimonious and meaningful solution given the data: Cluster I, a generalized anxiety cluster including 60% of the items; Cluster II, physiological concomitants of anxiety; and Cluster III, a worry-tension component. The solution is discussed in relation to prior work on both the scale and anxiety, in general.
Reliability and Validity of the Trauma Symptom Checklist for Young Children – Spanish Version

The reliability and validity of the Trauma Symptom Checklist for Young Children—Spanish Version (TSCYC-SP) were assessed with a sample of 121 children from Spanish-speaking families referred to a community mental health center in a Southwest city of the United States (U.S.). The Child Behavior Checklist-Spanish and the TSCYC-SP were completed by parents who referred their children for outpatient services. Females scored higher than males on the TSCYC-SP scales of Depression and Post-traumatic Stress Arousal. Families living in the U.S. between zero and 11 years obtained higher scores on the TSCYC-SP scales of Anxiety, Depression, and Post-traumatic Stress. Cronbach alphas ranged from 0.67 to 0.93. Convergent validity for the TSCYC-SP scales was supported. The study indicates that the TSCYC-SP is a reliable and valid measure. Additional studies with larger samples are recommended.
A mitotically unstable human dicentric Y chromosome in a male pseudohermaphrodite

A patient with a mitotically unstable dic(Y)(p11) chromosome is reported. Physical examination revealed a small penis with severe hypospadia, undescended testes, rudimetary vagina, uterus, left fallopian tube, and no stigmata of Turner syndrome. Longitudinal chromosome studies over a four-year period, including blood, skin, foreskin, and testicular tissue, revealed 45,X/46,X,dic(Y)(p11)/46,X,del(dic Y) mosaicism. The proportions of these cells varied in the different tissues, and only 45,X and 46,X,del(dic Y) were major cell lines in testicular tissue. Additional minor cell lines were present mainly in peripheral blood: 47,X,dicY,dicY; 47,X,dicY,del(dicY); and 47,X,del(dicY),del(DICY). Premature disjunction of one of the centromeres in a high percentage of the dicentric Y chromosomes in metaphase was observed by Q- and C-banding. Lymphocytes at anaphase and telophase showed lagging Y chromosomes, fragments, and nondisjunction. These observations indicate a high degree of mitotic instability and thus raise the question of the effect of premature centromeric disjunction on mitotic instability of dicentric chromosomes.
The selective functionalization of saturated hydrocarbons. Part 28. The activation of benzylic methylene groups under GoAggIV and GoAggV conditions

Abstract Under GoAggIV and GoAggV conditions, cyclohexadienes were oxidized to give aromatic products instead of ketones and alcohols. At the same time, anthracene was oxidized to give anthraquinone. Under GoAggIV and GoAggV conditions, xanthene, fluorene and diphenylmethane were oxidized to give the corresponding xanthone, fluorenone and benzophenone following two possible pathways: a) alkane to alkyl t-butylperoxide to ketone, and b) alkane to ketone, in which alkyl hydroperoxide, derived from oxygen, may be the reaction intermediate. Xanthyl azide was formed when sodium azide was added to the reaction mixture of xanthene under GoAggIV and GoAggV conditions. The reaction of triphenylmethane under GoAggV conditions gave triphenylmethyl t-butyl peroxide as the major product and hydroperoxide as the minor product. When TEMPO was added, triphenylmethyl hydroperoxide was the only product.
The removal and metabolism of chylomicron triglycerides by the isolated perfused rat heart: The role of a heparin-released lipase

Summary 1. Experiments were performed to demonstrate the ability of the myocardium to remove circulating dietary chylomicron triglyceride and to utilize the triglyceride fatty acid as an oxidizable substrate. Hearts from normal fed rats were perfused for various time intervals with a buffer-serum medium containing 14 C-labeled chylomicra. The perfusions were carried out in the presence or absence of heparin to determine the effect of a heparin-released lipase (clearing facto-lipase) on the removal of chylomicron triglyceride. 2. Stimulation of the release of a lipase by exogenous heparin was not required for the removal and utilization of 14 C-labeled chylomicron triglyceride fatty acids by the heart. However, a faster rate of removal of triglyceride ester and radioactivity coupled with a transient rise in the radioactivity of the perfusate free fatty acid suggested that in the heparin-perfused hearts the flux of triglycerides out of the vascular compartment was facilitated by hydrolysis either prior to, or during, the process of removal. 3. The changes observed in triglycerides, free fatty acids and phospholipids in the tissue during perfusion with 14 C-labeled chylomicra were essentially the same in the heparin-perfused and control groups. However, the specific activity of the tissue free fatty acids was higher in the heparin-perfused hearts than that in the controls; this finding suggested that a greater percentage of this fraction was derived from chylomicron triglyceride fatty acids extracted by the heart in the form of free fatty acids. 4. 14 CO 2 production from both control and heparin-perfused hearts lagged during the first 10 min of perfusion. After 15 min of perfusion, the 14 CO 2 production increased in both groups, but at an accelerated rate in the heparin-perfused hearts. 5. It is apparent that dietary triglyceride can serve as an energy source for myocardial metabolism in the rat.
Reversible Binding of ACTH to a Glass Surface

The behavior of both natural ACTH and a synthetic adrenocorticotropic tricosapeptide has been studied in phosphate buffer at pH 7.4. At those concentrations which are normally used for bio-assay and which are also similar to the range of concentrations found in plasma, a very rapid apparent “inactivation” occurs. This was shown to be caused primarily by adsorption of the hormone to the surface of the glass rather than by oxidation. Furthermore, this adsorption onto the glass was found to be reversible, and the hormonal activity could be recovered by elution from the glass surface by a more acidic solution.
Improvement of Pituitary Function after Surgical Decompression for Pituitary Tumor Apoplexy

Hypopituitarism is a major manifestation of pituitary adenoma apoplexy. We postulated that the acute deterioration in pituitary function may be caused by compression of portal vessels and the pituitary stalk, secondary to a sudden increase in intrasellar contents. If this were the case, one would predict improvement in pituitary function to occur after surgical decompression. We studied pituitary function in eight patients presenting with the clinical syndrome of pituitary adenoma apoplexy before and on multiple occasions after urgent surgical decompression. Partial or complete hypopituitarism was seen in all subjects at the time of presentation. Serum cortisol levels were inappropriately low (5.9 +/- 1.4 micrograms/dL; 162.8 +/- 38 nmol/L) for the degree of stress in seven patients and appropriately elevated in only one subject (55.3 micrograms/dL; 1525.7 nmol/L). High normal increments in cortisol levels were noted in three subjects given test doses of cosyntropin. Patients were given glucocorticoids before, during, and for 2 days after surgery. Serum cortisol concentrations measured on or after the third day when glucocorticoids had already been stopped were normal in seven subjects and consistently low in one. These seven subjects were discharged on no replacement and were subsequently documented by dynamic testing to have normal pituitary-adrenal function. Gonadal function improved in two of four men and in one of two women who had hypogonadism on presentation. Improvement in thyroid function was documented in two of three subjects with preoperative hypothyroidism. Gradual improvement and almost complete resolution of the neuroophthalmological abnormalities occurred days to weeks after decompression. These observations demonstrate that urgent surgical decompression after pituitary tumor apoplexy was associated with improvement not only in neurological defects but also in pituitary function. The rapid improvement in pituitary function indicates not only that the hypopituitarism was reversible, but also that it might be caused by compression of the portal circulation and pituitary stalk by the sudden increase in intrasellar contents.