cssi/SciSciGPT-SciSciNet huggingface dataset:
Surgical pearl: use of the vacutainer as a closed, active, surgical drain.

S urgical drains are occasionally used in cutaneous operation. They are most useful in areas where postsurgical defects may have a significant dead space such as the head and neck, and in patients with persistent bleeding to prevent hematoma formation.1,2 Closed suction drains are useful beneath large skin flaps. They improve apposition of tissue surfaces, thereby promoting adherence and healing. They also lower the risk of retrograde infection when compared with open, passive drains by preventing the stasis of blood.3-5 Ideally, drains should perform 4 functions: evacuate fluid; avoid damage to the surrounding tissue; decrease the risk of infection; and be easily removed when no longer needed.3 We demonstrate the unique use of the Vacutainer (Becton Dickinson and Company) as a closed, suction drain that facilitated all of these functions after excision of acne keloidalis nuchae. Excision of acne keloidalis nuchae produces a large, deep defect in a dependent area at the base of the neck; accordingly there is potential for fluid collection. The 10-mL red-topped Vacutainer is capable of producing 75 mm Hg of negative pressure. We used this negative pressure to develop a closed, compact suction drain by attaching the 10-mL redtopped Vacutainer to a 19-gauge winged infusion set (Surflo) placed at the base of the wound after excision of acne keloidalis nuchae. Several fenestrations were made in a circumferential fashion in the tubing approximately 1 cm apart as demonstrated in Fig 1. The metal connecting portions were then cut off, and the tubing placed on the floor of the wound of the posterior neck and sutured to the lateral edges of the incision. The tubing could be lengthened or shortened as needed to accommodate wound size. The wound was closed and the needles of the infusion set were inserted through the rubber stoppers of the Vacutainer tubes located on both sides of the wound (Fig 2). Each 10-mL Vacutainer is able to provide 75 mm Hg of negative pressure forming a compact, closed, active suction drain (Fig 3). These were left in place for 2 days and a total of 13 mL of serosanguinous fluid was drained into the VacuFrom the Department of Dermatology, St Louis University. Funding sources: None. Conflict of interest: None identified. Reprint requests: Anne T. Riordan, MD, Department of Dermatology, St Louis University, 1755 S Grand Ave, St Louis, MO 63104. J Am Acad Dermatol 2003;48:933-4. Copyright © 2003 by the American Academy of Dermatology, Inc. 0190-9622/2003/$30.00 0 doi:10.1067/mjd.2003.70 Fig 1. Demonstration of ports being placed in tubing.
Effects of Penicillin G and Penicillin V on Thiamine Synthesis in the Rat.

SummaryThree salts of penicillin G and one of penicillin V were found to be essentially equal when administered orally in sparing the rat's dietary requirement for thiamine, as determined by rates of growth and thiamine levels in the liver. Growth was not stimulated to a statistically significant degree upon administering these antibiotics intraperitoneally every other day, although thiamine levels in the livers were elevated by such treatment. The effects of penicillin on thiamine levels in ileal and cecal contents were inconclusive.
Technical skills improve after practice on virtual-reality temporal bone simulator†

Objectives/Hypothesis: To assess whether practice on a virtual-reality (VR) temporal bone simulator improves acquisition of technical skills in mastoid surgery. Study Design: Prospective blinded study. Methods: Using a previously validated objective structured assessment of technical skills (OSATS) tool, performance was assessed in 12 residents for two tasks of cortical mastoidectomy: 1) identifying and defining the tegmen and 2) defining the sigmoid sinus and sinodural angle. These surgical tasks were chosen as key steps in mastoid dissection because they were of intermediate complexity. Videos of virtual dissections were captured at baseline and again after practicing each task four to six times. Results: OSATS scores for the tegmen task increased from 2.125 ± 1.25 to 3.1 ± 0.85 (P = .026), whereas for the sigmoid task scores increased from 2 ± 0.45 to 2.75 ± 1.125 (P = .0098). The time to complete the tasks decreased from 8.37 ± 4.78 minutes to 5.39 ± 3.06 minutes (P = .018) for the tegmen task and from 8.99 ± 6.7 minutes to 8.68 ± 5.98 minutes (P = .594) for the sigmoid task. There was a decline in number of injuries from 0.5 ± 1.5 to 0 ± 0.5 (P = .594) for the tegmen task and from 2.5 ± 4 to 0.5 ± 1 (P = .029) for the sigmoid task. Conclusions: Technical skills in mastoidectomy surgery can be acquired during even brief practice on the VR temporal bone simulator. It is anticipated that longer periods of practice presented within the fundamentals of comprehensive curriculum will facilitate procedural learning. Further studies are required to elucidate evidence of transference of these skills to the operating room and to procedures of greater complexity.
Heuristic authentication protocol for TCP/IP network applications under UNIX

Networking has brought about the potential of distributed applications to the user. Typically in such applications there are several different interacting processes that run in multiple hosts and communicate across the network for exchanging data and exercising control. Authentication is an intrinsic activity in the context of distributed applications. A server process has to authenticate a client process, possibly running on another network, prior to granting service to that client. A password in clear text might be sent across the network for this purpose, thus endangering the system security. We propose a heuristic protocol, as an alternative approach to the authentication problem. One important characteristic of our protocol is that its success can only be asserted in a probabilistic manner, nevertheless its probability of success, in any given authentication session, can be arbitrarily increased. The major advantage, however, is that no clear text copy of a password need ever be stored or exchanged across the network under the proposed protocol.
Long-term 15N-nitrogen retention in the vegetated sediments of a New England salt marsh

15 N was used in a 7-yr field study and a laboratory investigation of a single growing season to quantify the amount, timing, and mechanisms of annual N retention and loss in the plant-sediment system of a short Spartina alterniflora marsh. There was an initial rapid loss of ∼ 25% of the added 15 NH 4 + through nitrification-denitrification at a rate of 25.2 mg N m -2 d −1 , with the remaining label being incorporated into plant tissues. Label losses decreased throughout the study as 15 N was increasingly sequestered in the dead organic N pool. About 40% of the injected label remained after seven growing seasons. Total annual N losses were 7.3-7.6 g N m 2 yr −1 based on 15 N losses and estimates of the actively cycling N pool. Export accounted for 26-44% and denitrification for 54-77% of the total N loss. Burial of N in dead belowground organic matter was 3.7-4.1 g N m −2 yr −1 , similar to estimates determined from accretion and total sediment N data. Recycling of N through translocation from aboveground to belowground biomass and remineralization of dead belowground biomass was the major pathway in the sediment N cycle, equivalent to 67-79% of the annual plant N demand. Annual N losses were balanced by inputs primarily N 2 fixation. Long-term N retention appears to be controlled primarily by the competition for DIN between the plants and bacterial nitrifiers-denitrifiers and secondarily by the relative incorporation of N into aboveground vs. belowground biomass
Muscarinic Receptors Modulate Dendrodendritic Inhibitory Synapses to Sculpt Glomerular Output

Cholinergic [acetylcholine (ACh)] axons from the basal forebrain innervate olfactory bulb glomeruli, the initial site of synaptic integration in the olfactory system. Both nicotinic acetylcholine receptors (nAChRs) and muscarinic acetylcholine receptors (mAChRs) are expressed in glomeruli. The activation of nAChRs directly excites both mitral/tufted cells (MTCs) and external tufted cells (ETCs), the two major excitatory neurons that transmit glomerular output. The functional roles of mAChRs in glomerular circuits are unknown. We show that the restricted glomerular application of ACh causes rapid, brief nAChR-mediated excitation of both MTCs and ETCs in the mouse olfactory bulb. This excitation is followed by mAChR-mediated inhibition, which is blocked by GABAA receptor antagonists, indicating the engagement of periglomerular cells (PGCs) and/or short axon cells (SACs), the two major glomerular inhibitory neurons. Indeed, selective activation of glomerular mAChRs, with ionotropic GluRs and nAChRs blocked, increased IPSCs in MTCs and ETCs, indicating that mAChRs recruit glomerular inhibitory circuits. Selective activation of glomerular mAChRs in the presence of tetrodotoxin increased IPSCs in all glomerular neurons, indicating action potential-independent enhancement of GABA release from PGC and/or SAC dendrodendritic synapses. mAChR-mediated enhancement of GABA release also presynaptically suppressed the first synapse of the olfactory system via GABAB receptors on sensory terminals. Together, these results indicate that cholinergic modulation of glomerular circuits is biphasic, involving an initial excitation of MTC/ETCs mediated by nAChRs followed by inhibition mediated directly by mAChRs on PGCs/SACs. This may phasically enhance the sensitivity of glomerular outputs to odorants, an action that is consistent with recent in vivo findings.
Evaluating a Seasonal ARIMA Model for Event Detection in New York City

Seasonal autoregressive integrated moving average (ARIMA) models can generate future forecasts, making it a potential method for modeling syndromic data for aberration detection. We built ARIMA models for five routinely monitored syndromes in New York City and tested the models' ability to prospectively detect outbreaks using datasets spiked with simulated outbreaks. Less than 10% of all outbreaks were detected at a fixed alert threshold of 1 signal per 100 days. These models did not perform well in detecting outbreaks and may require frequent monitoring and readjustment of model parameters.
C.A.U.S.E.: Cardiac arrest ultra-sound exam—A better approach to managing patients in primary non-arrhythmogenic cardiac arrest☆

Cardiac arrest is a condition frequently encountered by physicians in the hospital setting including the Emergency Department, Intensive Care Unit and medical/surgical wards. This paper reviews the current literature involving the use of ultrasound in resuscitation and proposes an algorithmic approach for the use of ultrasound during cardiac arrest. At present there is the need for a means of differentiating between various causes of cardiac arrest, which are not a direct result of a primary ventricular arrhythmia. Identifying the cause of pulseless electrical activity or asystole is important as the underlying cause is what guides management in such cases. This approach, incorporating ultrasound to manage cardiac arrest aids in the diagnosis of the most common and easily reversible causes of cardiac arrest not caused by primary ventricular arrhythmia, namely; severe hypovolemia, tension pneumothorax, cardiac tamponade, and massive pulmonary embolus. These four conditions are addressed in this paper using four accepted emergency ultrasound applications to be performed during resuscitation of a cardiac arrest patient with the aim of determining the underlying cause of a cardiac arrest. Identifying the underlying cause of cardiac arrest represents the one of the greatest challenges of managing patients with asystole or PEA and accurate determination has the potential to improve management by guiding therapeutic decisions. We include several clinical images demonstrating examples of cardiac tamponade, massive pulmonary embolus, and severe hypovolemia secondary to abdominal aortic aneurysm. In conclusion, this protocol has the potential to reduce the time required to determine the etiology of a cardiac arrest and thus decrease the time between arrest and appropriate therapy.
Electrochemical Detection in Thin-Layer Chromatography (TLC): A Review and Application of Direct On-Plate Square-Wave Anodic Stripping Voltammetry for TLC

The use of square-wave anodic stripping voltammetry (SWASV) as a direct on-plate detection method for thin-layer chromatography (TLC) is described. A commercially available carbon screen-printed microelectrode array, complete with a reference and auxiliary electrode, was used to detect Cd2+, Cu2+ and Pb2+ during the chromatographic separation. Detection limits are typically less than 10 ng for each analyte. A comprehensive review of all on-plate electrochemical detection methods for TLC is also provided.
Clinical Correlations of Chromosome Change in Human Solid Tumors: The Tip of the Iceberg?

It is now clearly recognized that a large variety of human cancers (including many solid tumors) display recurring chromosome abnormalities. However, what is the biologic significance of these findings? How do these chromosomal changes relate to changes in expression of important growth regulatory genes, e.g., cellular oncogenes? What clinical significance, if any, do specific cytogenetic abnormalities have, particularly for solid tumors, in which they are often found against a background of other genetic alterations? These and other related questions have received a significant amount of attention over the past 5 years. In general, it appears that recurring sites of chromosome change may indeed represent the byproduct of molecular events, which themselves may participate in the generation or progression of human cancers. Our recognition and ultimately our molecular understanding of chromosome abnormalities will unquestionably provide further insights into neoplasms generally and solid tumors particularly. The diversity of structural chromosome alterations across the spectrum of human cancers is enormous and increasing rapidly. Information on cancer-associated chromosome alterations is currently accumulating at a rate in excess of 2,000 new cases per year, with well over 15,000 cases of chromosome abnormalities in cancers now reported in the literature (7,2). Recent attempts of a special committee (2) to summarize this immense amount of technical information has resulted in the identification of 149 nonrandom chromosome changes involving 43 types of neoplastic disorders, including now many benign proliferations (2). These changes include a plethora of genomic alterations including deletions, translocations, isochromosomes, insertions, inversions, etc. Taken together, every human chromosome except the Y can now be included in some form of neoplasia-associated alteration. With the explosion in our knowledge base of human chro
Fine-grained self-healing hardware for large-scale autonomic systems

The hardware redundancy costs required for self-healing systems increase with system complexity, creating concerns about the cost-feasibility of large-scale autonomic systems. Redundancy costs can be minimized without reducing reliability by providing finest-grained fault recovery, but modern redundancy techniques are not effective for sub-component-level recovery. This paper introduces a design technique for low-cost, fine-grained self-healing hardware. Small amounts of reconfigurable logic are integrated within primarily fixed-logic circuits to provide heterogeneous redundancy for efficient fine-grained, self-contained fault detection, diagnosis, and recovery. When combined with traditional coarse-grained recovery techniques for larger failures, this technique enables large-scale self-healing systems with reduced redundancy costs.
The economic efficiency and equity of abortion.

On the face of it, the protracted public controversy over abortion in the United States and elsewhere might seem to rest on intractable normative questions inaccessible to economic analysis. But an influential early essay in the now sizable philosophical literature on the subject suggests otherwise. Judith Jarvis Thomson (1971) disarmingly inclined toward the view that “the fetus has already become a human person well before birth”,. presumably with all the rights pertaining thereto. She denied, however, that such rights necessarily include use of the mother's womb until birth. To illustrate her point, she compared the mother's situation to that, for example, of an unwilling Good Samaritan with a uniquely suited blood type, who is forced to share a kidney for 9 months with a famous, ailing violinist who needed its use for that duration to recover. Even if the life of a human being was at stake, the assertion of rights for the violinist or the fetus, she argued, would be too degrading for either the Good Samaritan's or the mother's status as a person, where large unwanted sacrifices would be required. Reduced to its economic essentials, the argument is that the mother has property rights to her own body, including the right to expel a “trespasser”. who would die as a consequence. Thus, the antiabortion position is neatly undercut by granting its major premise (the humanity of the fetus) while denying its conclusion.
Culture and Chronic Mental Illness

The relationship of culture to chronic mental illness is reviewed in a cross-national and cross-ethnic perspective. The author critically examines the argument, based on differential prognosis for serious mental illness in developing and industrial countries, that chronicity is a cultural artifact. Key questions include whether cultural beliefs and practices that minimize social stigma, self-devaluation, and patients' assumption of the sick role are linked to better prognosis. World view, religion, alternative healing resources, values of interdependence, extended kinship structure, family support, and professionals' willingness to work collaboratively with families are viewed as cultural strengths that may help to mediate the course of mental illness. Issues that are relevant to treatment of long-term psychiatric disability in ethnic patients in the United States include interetbnic differences in the distribution of cases and service utilization patterns, diagnostic and medication issues, and developmen...
Binding of a murine proteinase inhibitor to the acrosome region of the human sperm head.

Proteinase inhibitors are present in the various glands, tissues, and secretions of the male reproductive tract. Some of these inhibitors bind to the acrosomal region of the sperm, and their release during in vitro or in utero incubation suggests that they may play a role in capacitation. In the mouse, the binding site for a trypsin-acrosin inhibitor, the acceptor, has been implicated in capacitation, zona binding, and the acrosome reaction. This presentation demonstrates that a component, molecular weight ˜T20,000, on the human sperm head may recognize the murine inhibitor. Furthermore, the acrosome reaction can be induced in capacitated human sperm by immunoaggregation of bound murine inhibitor. The data indicate that the proteinase inhibitor binding site on the human sperm head may, as with a similar site on murine sperm, play a role in the early events of fertilization. © 1993 Wiley-Liss, Inc.
Optimal Age and Block Replacement for a General Maintenance Model

We continue the study of our general cost structure for a maintained system. Here we focus on the optimization questions for an age or block policy. The notion of a marginal cost function is rigorously formulated and its utility investigated. Various applications are considered, including a new model in which minimal repairs are performed as long as the total accumulated repair costs do not exceed a fixed amount.
Dimensional analysis of the electroencephalogram during general anesthesia

An investigation of the electroencephalogram (EEG) under anesthetic sleep conditions was conducted to evaluate dimensionality as an EEG-derived parameter that might reflect complex brain dynamics in a clinically useful way. Dimensional analysis of EEG has resulted in reported apparent dimensions ranging from 2 to 9. The homogeneity of the present results suggests that the wide range of reported EEG dimensional values may be attributable to discrepancies in methodology (data collection or dimensional algorithms). It is concluded that dimensional analysis provides an alternative to spectral analysis that may reflect additional information content. >
Biomarkers of secondhand smoke exposure in automobiles

Objectives The objectives of this study were: (1) to characterise the exposure of non-smokers exposed to secondhand smoke (SHS) in a vehicle using biomarkers, (2) to describe the time course of the biomarkers over 24 h, and (3) to examine the relationship between tobacco biomarkers and airborne concentrations of SHS markers. Methods Eight non-smokers were individually exposed to SHS in cars with fully open front windows and closed back windows over an hour from a smoker who smoked three cigarettes at 20 min intervals. The non-smokers sat in the back seat on the passenger side, while the smoker sat in the driver9s seat. Plasma cotinine and urine cotinine, 3-hydroxycotinine (3HC) and 4-(methylnitrosoamino)-(3-pyridyl)-1-butanol (NNAL) were compared in samples taken at baseline (BL) and several time-points after exposure. Nicotine, particulate matter (PM 2.5 ) and carbon monoxide (CO) were measured inside and outside the vehicle and ventilation rates in the cars were measured. Results Average plasma cotinine and the molar sum of urine cotinine and 3HC (COT+3HC) increased four-fold, urine cotinine increased six-fold and urine NNAL increased ∼27 times compared to BL biomarker levels. Plasma cotinine, urine COT+3HC and NNAL peaked at 4–8 h post-exposure while urine cotinine peaked within 4 h. Plasma cotinine was significantly correlated to PM 2.5 (Spearman correlation r s =0.94) and CO (r s =0.76) but not to air nicotine. The correlations between urine biomarkers, cotinine, COT+3HC and NNAL, and air nicotine, PM 2.5 and CO were moderate but non-significant (r s range = 0.31–0.60). Conclusions Brief SHS exposure in cars resulted in substantial increases in levels of tobacco biomarkers in non-smokers. For optimal characterisation of SHS exposure, tobacco biomarkers should be measured within 4–8 h post-exposure. Additional studies are needed to better describe the relationship between tobacco biomarkers and environmental markers of SHS.
Do Envious CEOs Cause Merger Waves

We develop a model in which CEOs envy each other based on their compensation. When CEO compensation is increasing in the firm's market value and size, we show that envy can cause merger waves even when the shock that precipitated the first merger in the wave is purely idiosyncratic. The analysis produces numerous predictions, some of which are as follows. First, the earlier acquisitions in a merger wave display higher synergies than the later acquisitions in the wave, so bidder returns will be higher for the earlier acquisitions. Second, earlier acquisitions in a merger wave involve smaller targets than later acquisitions. Third, the gain in compensation for the top management team of the acquiring firm should be higher for earlier acquisitions than for later acquisitions. Fourth, more envious CEOs are more likely to engage in acquisitions and pay higher premia. Fifth, an envy-generated merger wave is more likely in a bull stock market than in a bear market even when there is no mispricing that creates opportunities to time the market, so the quality of bull-market acquisitions is lower than that of bear-market acquisitions. Finally, controlling for the dispersion in firm values, the bull-market-versus-bear-market effect largely disappears. We test the first three predictions and find strong empirical support.
The Role of GM1 and Other Gangliosides in Neuronal Differentiation Overview and New Findingsa

The pronounced increases in gangliosides belonging to the gangliotetraose family during the neurite outgrowth phase of neuronal differentiation have suggested a functional requirement for these substances related to process extension, arborization, and possibly synaptogenesis. Support for this hypothesis has come from a variety of experimental paradigms utilizing neuroblastoma cell lines, primary neuronal cultures, and observations on the developing nervous system. We have recently observed that differentiation of both primary neurons and neuroblastoma cells by Ca(2+)-elevating stimulants is characterized by upregulation of GM1 in the nuclear membrane. Immunostaining revealed these Ca(2+)-induced neurites to have axonal characteristics. Recent work has indicated that nuclear GM1 facilitates efflux of nuclear Ca2+, thereby contributing to the reduced level of nuclear Ca2+ that characterizes the differentiated neuron. Thus, while GM1 is generally recognized as a pluripotent molecule with several modulatory roles in the plasma membrane of developing and mature neurons, regulation of Ca2+ flux across the nuclear membrane is proposed as another critical function of this ganglioside in neuronal development, with special relevance to axonogenesis.
Why Quasi-Monte Carlo is Better Than Monte Carlo or Latin Hypercube Sampling for Statistical Circuit Analysis

At the nanoscale, no circuit parameters are truly deterministic; most quantities of practical interest present themselves as probability distributions. Thus, Monte Carlo techniques comprise the strategy of choice for statistical circuit analysis. There are many challenges in applying these techniques efficiently: circuit size, nonlinearity, simulation time, and required accuracy often conspire to make Monte Carlo analysis expensive and slow. Are we-the integrated circuit community-alone in facing such problems? As it turns out, the answer is “no.” Problems in computational finance share many of these characteristics: high dimensionality, profound nonlinearity, stringent accuracy requirements, and expensive sample evaluation. We perform a detailed experimental study of how one celebrated technique from that domain-quasi-Monte Carlo (QMC) simulation-can be adapted effectively for fast statistical circuit analysis. In contrast to traditional pseudorandom Monte Carlo sampling, QMC uses a (shorter) sequence of deterministically chosen sample points. We perform rigorous comparisons with both Monte Carlo and Latin hypercube sampling across a set of digital and analog circuits, in 90 and 45 nm technologies, varying in size from 30 to 400 devices. We consistently see superior performance from QMC, giving 2× to 8× speedup over conventional Monte Carlo for roughly 1% accuracy levels. We present rigorous theoretical arguments that support and explain this superior performance of QMC. The arguments also reveal insights regarding the (low) latent dimensionality of these circuit problems; for example, we observe that over half of the variance in our test circuits is from unidimensional behavior. This analysis provides quantitative support for recent enthusiasm in dimensionality reduction of circuit problems.
Determinants of Elderly Interstate Migration in the United States, 1985-1990

This article applies a three-level nested logit model to the microdata of the 1990 U.S. census to explain the 1985 to 1990 return and onward interstate migration patterns of the elderly aged 65+ by personal factors and state attributes. The elderly were split into three groups defined by age: 65 to 69 70 to 74 and 75+. Analysis reveals that both return and onward migrants were sensitive to amenity factors racial similarity and the distance decay effect although return migrants were less affected by the distance decay effect than onward migrants. The motivations for a return or onward migration were also observed to vary with respect to age groups with amenity effects more important for the young elderly. Several personal characteristics also were found to systematically influence the migration choice process including level of education and marital status. (EXCERPT)
Adenoid cystic carcinoma of the breast in the United States (1977 to 2006): a population-based cohort study

Adenoid cystic carcinoma of the breast (breast-ACC) is a rare and special type of basal-like tumor for which scant population-based descriptive data exist. We sought to provide new population-based information on breast-ACC incidence, relative survival, and associated cancer risk in the United States. Using data from the Surveillance, Epidemiology and End Results Program, we calculated age-adjusted incidence rates (IRs), IR ratios (IRRs), and relative survival for breast-ACC, and standardized incidence ratios (SIRs) for other cancers. Overall 338 women (IR = 0.92/1 million person-years) were diagnosed with breast-ACC during 1977 to 2006. Blacks had 39% lower IRs than Whites (IRR = 0.61, 95% confidence interval = 0.37 to 0.96), and IRs remained constant over the 30-year period. Ninety-five percent of cases presented with localized stage (n = 320; IR = 0.87), and the highest IRs were observed for estrogen receptor (ER)-negative/progesterone receptor (PR)-negative tumors (IR = 0.56). Like other typically ER-negative tumors, age-specific IRs increased until midlife and then plateaued. Five-year, 10-year, and 15-year relative survival was 98.1%, 94.9%, and 91.4%, respectively. The risk of female breast cancer was not increased following (SIR = 0.89, 95% confidence interval = 0.43 to 1.64) or preceding (SIR = 0.71, 95% confidence interval = 0.28 to 1.46) breast-ACC. Similarly, no association was observed for breast-ACC and risk of all other cancers combined, solid tumors, or lymphohematopoietic malignancies. Breast-ACC among women is characterized by ER-negative/PR-negative expression, rare regional lymph node involvement, a favorable prognosis with excellent survival, and absence of associated cancers. These findings reinforce the importance of tailored treatments for breast-ACC and lend credence to the apparent heterogeneity of basal-like breast cancers.
Adaptive power amplifier linearization by digital pre-distortion with narrowband feedback using genetic algorithms

This dissertation presents a study of linearization techniques that have been applied to power amplifiers in the cellular communication industry. The objective of this work is to understand the limitations of power amplifiers, specifically the limitations introduced by the use of spectrally efficient modulation schemes. The digitization of communication systems has favored the use of new techniques and technologies capable of increasing the efficiency of costly power amplifiers. The work explores traditional and digital linearization systems; an algorithm based on the principles of natural recombination is proposed to directly address the limitations of previous embodiments. Previous techniques, although effective, have significant implementation costs that increase exponentially with the increasing signal bandwidths. The proposed software-hardware architecture significantly reduces implementation costs and the overall complexity of the design without sacrificing performance. To fulfill the requirements of this study, multiple systems are implemented through simulation and closed-loop hardware. Both simulation and hardware embodiments meet the expected performance metrics, providing validation of the proposed algorithm. The application of the algorithm to memory power amplifier linearization is a new approach to adaptive digital pre-distortion using narrowband feedback. The work will show performance improvements on an amplifier with memory effects suggesting that this technique can be employed as a lower-cost solution to meet requirements when compared to typical system implementations.
Layout Techniques for Minimizing OnChip Interconnect Self Inductance

Because magnetic effects have a much longer spatial range than electrostatic effects, an interconnect line with large inductance will be sensitive to distant variations in interconnect topology. This long range sensitivity makes it difficult to balance delays in nets like clock trees, so for such nets inductance must be minimized. In this paper we use two- and three-dimensional electromagnetic field solvers to compare dedicated ground planes to a less area-consuming approach, interdigitating the signal line with ground lines. The surprising conclusion is that with very little area penalty, interdigitated ground lines are more effective at minimizing self-inductance than ground planes.
Comparison of Plane Strain and Triaxial Tests on Sand

Conventional laboratory practice consistently uses triaxial test procedures for soil strength investigations although many field cases in soil mechanics approximate plane strain conditions. Data from a wide variety of sources indicate that, for drained tests on sand, plane strain gives the greatest strength. Very little is known about the comparative strength and deformation properties in undrained tests. This study describes a series of drained and undrained tests on saturated sand under a wide range of density and confining pressure conditions using both triaxial and plane strain loading. It was found that, for undrained conditions, at low pressures triaxial tests gave the greatest strengths, but at high pressures the greatest strengths were determined from plane strain loading. Several arguments were offered to explain this and other observations in the behavior of plane strain versus triaxial tests on saturated sands.
Certain affections of the liver that arise spontaneously in so-called normal stock albino mice.

ConclusionCertain pathological states which arise spontaneously in the livers of so-called normal stock mice, especially with increasing age, have been described. Of particular interest are the hepatic lesions of (a) infiltration and necrosis, and (b) of intranuclear inclusion bodies-both occurring in Rockefeller Institute and Swiss strains of albino mice. The relation of the two types of changes is still to be studied as well as their etiology.
Research on the Shell Flight-time Fit of Anti-aircraft Gun

This paper researchs into the problem on fitting the shell flight-time of anti-aircraft gun by interpolation and quadratic approximation.By analysing the interpolation formula principle and the error rule,we put forward "remainder inspection" in available area,and explains to the application range of the formula.By analysing the compute result of the quadratic approximation formula,we educe the conclusion that 3 is the best rank code for the quadratic approximation formula.This conclusion is also applicable for the shell flight-time fit of other antiaircraft artillery.
Epidemiology Survey on Outbreaks of Human Rotavirus Diarrhea in 2 Urban Pediatric Wards

Objective To investigate outbreaks of infant diarrhea in 2 major hospitals' pediatric wards in Shenzhen, China. Methods Polyacrylamide gel electrophoresis (PAGE) method as well as field epidemiology ways were adopted. Results Both 2 outbreaks were confirmed to be hospital-acquired HRV infection. Epidemiology investigation hinted that daily contact spread was the main prevalent approach in both 2 diarrhea epidemics. Seasonal environmental limitations, bad health habit of companions as well as ill antisepsis measures were major influential factors. Conclusions Virus tests should be adopted as a routine in identifying infant diarrhea outbreaks. Prevention should be focused on antisepsis measures and diarrhea related health education.
Characterization Of An Acquired IgG Autoantibody To Bβ and γ Chains Of Fibrinogen Resulting In Delayed Fibrin Polymerization and Severe Bleeding

A 88 year-old woman was referred to our center for 3 weeks of gastrointestinal bleeding and a spontaneous right rectus femoris hematoma. The prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT) and reptilase time (RT) were markedly prolonged ([Table 1][1]). Assays for coagulation factors V, VIII, IX and X were normal. A fibrinogen concentration of < 50 mg/dl was measured by Clauss method while fibrinogen concentration measured by radial immunodiffusion was 180 mg/dl. Following infusions of cryoprecipitate there was accelerated clearance of fibrinogen as measured by the Clauss method. An inhibitor of fibrinogen function was suspected. View this table: Table 1 When the patient’s plasma was tested towards immobilized fibrinogen in ELISA plates, a concentration dependent specific binding of IgG was seen while under similar conditions control IgG had no significant binding ([Figure 1][2]). The IgG antibody was polyclonal comprising of both kappa and lambda subtypes. ![Figure][3] The IgG fraction was purified on a Protein A column and the isolated IgG fraction prolonged the thrombin time of normal plasma in a concentration dependent manner. The effect of the isolated IgG fraction on fibrin polymerization was measured by monitoring the absorbance at λ390 in a spectrophotometer. The IgG inhibited fibrin polymerization in a concentration dependent manner. Control IgGs had no significant effect on polymerization under these conditions ([Figure 2][4]). ![Figure][3] The immunologic specificity of antibody was tested in immunoblots of fibrinogen subjected to SDS-PAGE. The patients IgG reacted with fibrinogen in unreduced buffers. Under reducing conditions, the IgG reacted with Bβ and γ chains of fibrinogen while the control IgG did not ([Figure 3][5]). ![Figure][3] The patient was treated with rituximab and steroids. After four, weekly doses of rituximab, fibrinogen levels by Clauss method normalized (450 mg/dl). There was no detectable antibody to fibrinogen and no further bleeding was noted. Conclusion This is a description of a rare case of a polyclonal autoantibody to Bβ and γ chains of fibrinogen that inhibited fibrin polymerization leading to a severe bleeding diathesis. Disclosures: No relevant conflicts of interest to declare. [1]: #T1 [2]: #F1 [3]: pending:yes [4]: #F2 [5]: #F3
Management Lessons from Clinical Trials of Kidney Disease in Systemic Lupus Erythematosus

Clinically significant lupus nephritis occurs in about 40% of the overall systemic lupus erythematosus population. Despite aggressive therapy with anti-inflammatory and immunosuppressive drugs, chronic kidney damage and kidney failure are common in lupus nephritis patients. Also, standard-of-care treatment regimens are associated with significant toxicity and patient morbidity. To address this problem, a number of prospective, controlled, randomized clinical trials of potential new therapies have been undertaken recently in lupus nephritis. Unfortunately, none of these trials succeeded in demonstrating better renal outcomes or less toxicity than the standard-of-care approaches. Despite these failures, all of the trials provide important insights into the clinical behavior of lupus nephritis, which can be translated into more effective management strategies. This chapter examines lessons from lupus nephritis clinical trials and uses these lessons to build a new framework for future trials of new therapeutics.
Treat-and-Extend Regimen for Macular Edema Secondary to Central Retinal Vein Occlusion: 12-Month Results

Purpose To determine treatment outcomes after 12 months of bevacizumab and ranibizumab therapy using a treat-and-extend regimen in patients with macular edema resulting from central retinal vein occlusion (CRVO). Design Retrospective, interventional, consecutive case series. Methods Sixty eyes of 58 patients diagnosed with CRVO and associated macular edema between May 2010 and June 2014 were included. Eyes were treated with bevacizumab and/or ranibizumab for a minimum of 1 year, using a treat-and-extend regimen. Main Outcome Measures Outcome measures were change from baseline visual acuity (VA), proportion of eyes gaining/losing ≥3 VA lines, change from baseline central retinal thickness (CRT), mean number of injections administered, and the longest treatment-free interval attained between injections. Results At baseline, mean logMAR VA was 1.18±0.71 (Snellen equivalent: 20/302), which improved to 0.85±0.71 (Snellen equivalent: 20/142) after 12 months of therapy (P = 0.018). During this period, 44.9% of eyes had gained ≥15 letters, while 10.2% had lost ≥15 letters. The mean CRT improved from 564.7±219.3 μm at baseline to 302.8±115.8 μm at 12-month follow-up (P Conclusions The treat-and-extend regimen is effective in achieving visual and anatomic improvements in patients with macular edema secondary to CRVO through the first year of therapy. Change in CRT during the first 3 months of treatment may help predict which patients will respond more favorably to an extension phase at or beyond 8 weeks.
Labia Minora Reduction

Labia minora reduction is a technique for reducing the width of the labia minora and is indicated in the case of labia minora hypertrophy, congenital or acquired, or in the case of emotional or psychological distress or physical limitation caused by the presence of protruding labia minora. While many techniques have been developed for reducing the labia minora, central wedge resection is most commonly used and described here. Possible postoperative complications include over-resection, wound dehiscence, scarring, asymmetry, dyspareunia, hematoma, and infection.
An Embedded Device for Real-Time Noninvasive Intracranial Pressure Estimation.

Objective: The monitoring of intracranial pressure (ICP) is indicated for diagnosing and guiding therapy in many neurological conditions. Current monitoring methods, however, are highly invasive, limiting their use to the most critically ill patients only. Our goal is to develop and test an embedded device that performs all necessary mathematical operations in real-time for noninvasive ICP (nICP) estimation based on a previously developed model-based approach that uses cerebral blood flow velocity (CBFV) and arterial blood pressure (ABP) waveforms.
Specifying An Expanded Framework for Classifying and DescribingDecision Support Systems

This article defines an expanded conceptual framework for classifying and describing Decision Support Systems (DSS) that consists of one primary dimension and three secondary dimensions. The primary dimension is the dominant technology component or driver of decision support. The three secondary dimensions are the targeted users, the specific purpose of the system and the primary deployment or enabling technology. Five generic DSS types are identified and defined based upon the dominant technology component, including Communications-driven, Data-driven, Document-driven, Knowledge-driven, and Model-driven Decision Support Systems. Specific targeted users like individuals, groups, or customers can use any of the five generic types of DSS. Also, a DSS can be created for a decision- specific or a more general purpose. Finally, in the framework, the DSS deployment and enabling technology may be a mainframe computer, a client/server LAN, a spreadsheet or a webbased technology architecture.
A New Coral From the Bucatunna Clay (Middle Oligocene) of Alabama

A new ahermatypic coral, Paracyathus macneili is described, illustrated, and compared. The species occurs in the Bucatunna Clay Member of the Byram Formation, and is considered a guide fossil of that member. A condensed stratigraphic account of the Byram Formation is also presented.
Indian Perspectives on Treating Substance Use Disorders

ABSTRACTAlthough research on substance use disorders (SUDs) largely focuses on the developed world, treatment programs from the developing world seldom get international attention. Focusing on India, this study was designed (1) to describe India’s treatment programs, and (2) to report Indian perspectives on critical factors related to treating SUDs. An online survey instrument was created, based on mixed-methods approach with concurrent strategies, to collect data. Participants were India’s clinicians (N = 112). Indian treatment approach suggests that SUDs must be treated by a multidisciplinary treatment team with a comprehensive plan that must include systemically focused clinical interventions in patients’/clients’ relevant relational systems. Findings may have relevance to clinicians, researchers, and policy makers globally.
Bubble removal with the use of a vacuum pressure generated by a converging-diverging nozzle

Bubbles are an intrinsic problem in microfluidic devices and they can appear during the initial filling of the device or during operation. This report presents a generalizable technique to extract bubbles from microfluidic networks using an adjacent microfluidic negative pressure network over the entire microfluidic channel network design. We implement this technique by superimposing a network of parallel microchannels with a vacuum microfluidic channel and characterize the bubble extraction rates as a function of negative pressure applied. In addition, we generate negative pressure via a converging-diverging (CD) nozzle, which only requires inlet gas pressure to operate. Air bubbles generated during the initial liquid filling of the microfluidic network are removed within seconds and their volume extraction rate is calculated. This miniaturized vacuum source can achieve a vacuum pressure of 7.23 psi which corresponds to a bubble extraction rate of 9.84 pL/s, in the microfluidic channels we characterized. Finally, as proof of concept it is shown that the bubble removal system enables bubble removal on difficult to fill microfluidic channels such as circular or triangular shaped channels. This method can be easily integrated into many microfluidic experimental protocols.
Self-Directed Learning: Pedagogical Influences on Graduate Student Perspectives

Self-directed learning SDL, while essential to graduate student success and continued professional development beyond the degree, is rarely addressed intentionally in the college curriculum. In this mixed-method study with 91 participants from two counseling-related degree programs, researchers examined the impact of integrating a unit focused on SDL. Students in both online and face-to-face courses reported their learning and experiences with the topic. Findings suggest that intentionally exposing students to SDL allows them to understand the concept and grow in awareness of its importance. Similar gains were reported regardless of course delivery format. Student perspectives discussed include student appreciation of the process of collaboration for professional growth, student understanding of the centrality of SDL for ongoing development, and student motivation to utilize SDL with those they work with in order to and expand personal agency.
Additive manufactured micro-sensor from silver nanoparticles for measuring shear stress and pressure

Additive manufacturing is considered as a revolution in manufacturing. One of this type of manufacturing, three-dimensional (3D) inkjet printing is capable of quickly printing conductive tracks on flexible materials, and have attracted considerable attentions in recent years. To take advantage of this technology, flexible micro-sensors for measuring shear stress and pressure are fabricated from silver nanoparticles with digital models by 3D inkjet printing rapidly. The influence of printing layers and sintering temperature on the chemical and physical properties of micro-sensors are investigated. Surface morphology and electrical resistivity are also examined ex-situ. Test results show the thickness and electrical resistivity of AM micro-sensors deceased significantly as the increase of sintering temperature, which achieve 1.41 µm and 7.64×10−8 Ω·m at the sintering temperature of 250 °C, shear stress and pressure. The novel AM micro-sensors provide a new route to the economic and rapid development of shear stress and pressure sensing.