cssi/SciSciGPT-SciSciNet huggingface dataset:
Statistical signatures for fast filtering of instruction-substituting metamorphic malware

Introducing program variations via metamorphic transformations is one of the methods used by malware authors in order to help their programs slip past defenses. A method is presented for rapidly deciding whether or not an input program is likely to be a variant of a given metamorphic program. The method is defined for the prominent class of metamorphic engines that work by probabilistically selecting instruction-substituting program transformations. A model of the probabilistic engine is used to predictthe expected distribution of instruction forms for different generations ofvariants. These predicted distributions form a type of "statistical signature" for the output of the metamorphic engines. A classifier is defined based on distance between the observed and the predicted instruction form distributions. A case study using the W32.Evol virus shows the classifier can distinguish between malicious samples from multiple generations. The classification method may be useful for practical malware detection by serving as an inexpensive filter to avoid more in-depth analyses where they are unnecessary
Risk of Lymphoma Associated With Combination Anti–Tumor Necrosis Factor and Immunomodulator Therapy for the Treatment of Crohn's Disease: A Meta-Analysis

Background & Aims Although anti–tumor necrosis factor (TNF) therapy can effectively treat Crohn's disease (CD), there is concern that it might increase the risk of non-Hodgkin's lymphoma (NHL). A meta-analysis was performed to determine the rate of NHL in adult CD patients who have received anti-TNF therapy and to compare this rate with that of a population-based registry and a population of CD patients treated with immunomodulators. Methods MEDLINE, EMBASE, Cochrane Collaboration, and Web of Science were searched. Inclusion criteria included randomized controlled trials, cohort studies, or case series reporting on anti-TNF therapy in adult CD patients. Standardized incidence ratios (SIR) were calculated by comparing the pooled rate of NHL with the expected rate of NHL derived from the Surveillance Epidemiology & End Results (SEER) database and a meta-analysis of CD patients treated with immunomodulators. Results Twenty-six studies involving 8905 patients and 21,178 patient-years of follow-up were included. Among anti-TNF treated subjects, 13 cases of NHL were reported (6.1 per 10,000 patient-years). The majority of these patients had previous immunomodulator exposure. Compared with the expected rate of NHL in the SEER database (1.9 per 10,000 patient-years), anti-TNF treated subjects had a significantly elevated risk (SIR, 3.23; 95% confidence interval, 1.5–6.9). When compared with the NHL rate in CD patients treated with immunomodulators alone (4 per 10,000 patient-years), the SIR was 1.7 (95% confidence interval, 0.5–7.1). Conclusions The use of anti-TNF agents with immunomodulators is associated with an increased risk of NHL in adult CD patients, but the absolute rate of these events remains low and should be weighed against the substantial benefits associated with treatment.
Automatic Layer-Based Generation of System-On-Chip Bus Communication Models

With growing market pressures and rising system complexities, automated system-level communication design with efficient design space exploration capabilities is becoming increasingly important. At the same time, customized network-oriented communication architectures become necessary in enabling a high-performance communication among the system components. To this end, corresponding communication design flows that are supported by efficient design automation techniques need to be developed. In this paper, we present a system-level design environment for the generation of bus-based system-on-chip architectures. Our approach supports a two-stage design flow using automated model refinement toward custom heterogeneous communication networks. Starting from an abstract specification of the desired communication channels, our environment automatically generates tailored network models at various levels of abstraction. At its core, an automatic layer-based refinement approach is utilized. We have applied our approach to a set of industrial-strength examples with a wide range of target architectures. Our experimental results show significant productivity gains over a traditional communication design, allowing early and rapid design space exploration.
Health literacy and its outcomes: Application and extension of elaboration likelihood model

AbstractApproximately 90 million adults in the USA have difficulty understanding and using health information. In 2010, the U.S. Department of Health and Human Services included improved consumer health literacy as one of the top priorities and identified health literacy as an important component of health communication. According to the American Medical Association, poor health literacy is a stronger predictor of a person's health than age, income, employment status, education level and race. It also has been found to be associated with limited knowledge of healthcare issues which may contribute to poor personal healthcare management. Public policy and advocacy organizations have expressed concern as well as studies examining the concept of health literacy with instruments to measure individual level of health literacy. In this study, we review current development of health literacy, its measures and effects on information processing of direct-to-consumer prescription drug advertising. Applying Elaborati...
Multi-layer over-the-cell routing with obstacles

In this paper we present the first multi-layer graph-based router which can handle obstacles on any layer. We show that it improves the performance of a maze router with rip-up and reroute (RR) when obstacles are present. The graph-based router combined with a maze router with RR has yielded the best reported routing results for multi-layer problems with or without obstacles on any layer.
Carbon Monoxide Poisoning of Chicks and Poults in Poorly Ventilated Brooders

Abstract ONE of the hazards incident to raising poultry is artificial brooding. This process must include not only proper temperatures, adequate floor space, regulated humidity, and a balanced diet, but also correct ventilation to insure livability in chicks and poults from disease-free stock. This article is the outgrowth of experience gained over a period of years in examination of young chicks and poults received from farm flocks for diagnoses. Records on about 6,000 chicks show pullorum disease in 52.4 percent, while the specific cause of death was undetermined in 47.6 percent. Many of these specimens were sterile on culture or developed small numbers of organisms belonging to the colon group or other miscellaneous types of bacteria commonly found in dead chicks. Since these birds were under three weeks of age, faulty nutrition or parasitism seldom was an important factor in causing death. Observations on nearly 3,000 poults gave negative bacteriological results . . .
A unified hardware/software MPSoC system construction and run-time framework

With the continual enhancement of heterogeneous resources in FPGA devices, utilizing these resources becomes a challenging burden for developers. Especially with the inclusion of sophisticated multiple processor system-on-chips, the necessary skill set to effectively leverage these resources spans both hardware and software expertise. The maturation of high level synthesis tools and programming languages aim to alleviate these complexities, yet there still exist systematic gaps that must be bridged to provide a more cohesive hardware/software development environment. High level MPSoC design initiatives such as Redsharc have reduced the costs of entry, simplifying application implementation. We propose a unified hardware/software framework for system construction, leveraging Redsharc's APIs, efficient on-chip interconnects, and run-time controllers. We present system level abstractions that enable compilation and implementation tools for hardware and software to be merged into a single configurable system development environment. Finally, we demonstrate our proposed framework with Redsharc, using AES encryption/decryption spanning software implementations on ARM and MicroBlaze processors and hardware kernels.
Focus Group Evaluation of Customized Family Health History Education Materials in a North Carolina Community

Abstract Background: The Does It Run In The Family? booklets provide educational materials about family health history (FHH) and basic genetics to readers of all levels and are customizable for local communities. Purpose: The booklets were customized and provided to focus groups to evaluate their usefulness in conveying health information at a low reading level. Methods: Three focus groups with 19 participants reviewed the booklets. A semi-structured focus group guide was used. Transcripts were analyzed manually and coded for themes. Results: Five themes emerged across all three focus groups: appearance, organization, content, length, and reading comprehension of the booklets. Many participants noted that the booklets were attractive, well organized, contained useful information and were understandable. Participants indicated that the customized materials were interesting. Concerns were expressed about the booklets' length and lack of detailed information. Discussion: The focus groups revealed that litera...
Normal and Abnormal Grain Growths in BaTiO3 Fibers

The grain growth mechanisms along the BaTiO3 fibers were studied between 1150°C and 1250°C. The normal grain growth always reached a stagnant stage after certain heat-treatment duration caused by the surface pinning effect. However, the abnormal grain growth (AGG) was not pinned by such surface effect, and can grow continuously. The confined normal grain (or matrix grain) size provides the driving force for AGG. The fiber diameter has an important influence on the grain growth behaviors. Submicrometer fibers have relative small stagnant grain sizes, resulting in large driving force for AGG. Abnormal grain growth occurred below 1200°C in the submicrometer diameter fibers, but was not observed at the same temperature in the fibers with diameter of above 1 μm. Due to the large AGG driving force, large number densities of abnormal grains were observed in submicrometer fibers, resulting in “bamboo-like” microstructure. Fibers with diameters of 1–2 μm were able to be converted into single crystal fibers up to several tens of micrometers due to the relative small AGG driving forces.
The world of Alexander Johnston: the creolization of ambition, 1762-1787.

Eighteenth-century Jamaica, the ‘devil of a country’ to which Dr Alexander Johnston referred, seems an unlikely candidate, at the historian's first glance, for consternation. Today's visitor would find that the ‘Garden Parish’, St Ann's, truly exudes everything warm and wonderful associated with tropical stereotypes. Yet two hundred years ago Dr Alexander Johnston, ‘Practitioner of Physick and Chiurgery’ rarely observed this very paradise, the foothills of coastal St Ann's, in a positive light. To this particular Scot, the bright reds and greens clearly took second place to the shabby problems of daily life in the Caribbean.
Comment on Sichel

© 1997 by the President and Fellows of Harvard College and the Massachusetts Institute of Technology
The Design, Development, and Evaluation of Measures to Survey Worldview in Organizations

This article describes the development and initial validation of an instrument of individual worldview which incorporates the three constructs which primarily differentiate worldview - level of explanation, causation, and observation. Results support the use of the worldview instrument as a research tool for measuring individuals' most deeply held beliefs and assumptions.
Use of Ultrananocrystalline Diamond as a Phase-contrast Aperture Material

Boron-doped “ultrananocrystalline diamond” (UNCD), available as a 2 μm-thick layer on a “diamond on insulator” wafer (Advanced Diamond Technologies, Romeoville, IL), is investigated as a potential material for making devices that can be placed in the back focal plane of the objective lens of a TEM, the goal being to produce high contrast for in-focus images of weak phase objects. The resistance of diamond to knock-on damage when irradiated, even at 300 keV, is an attractive feature. In addition, diamond (indeed, carbon in general) is not expected to form a native oxide that is thicker than a monolayer. The ultrananocrystalline form of diamond is favored over a microcrystalline form because unwanted, “patchy” variations in surface potential (due to differences in the work-function for different crystal facets) are expected to decay more rapidly, i.e. on a length scale comparable to the domain size. We believe, however, that care must be taken to compensate for the contact potential (Galvani potential) between the UNCD device layer and the supporting (boron-doped) silicon wafer (handle).
More A than I: Why Artificial Intelligence Isn't, but You Are

Artificial Intelligence has the potential to change the world. The application of A.I. to robotics, control systems, text recognition, voice recognition, and autonomous vehicles will prove both revolutionary and useful. However, humans and machines process information in fundamentally different ways, and if those differences are not appreciated and exploited, a great deal of time and money will be wasted by expecting the wrong outcomes and capabilities of our machines. This paper reviews the most critical differences between human and machine information processing from the point of view of information theory, and also introduces the concept of "information lensing" that provides a novel framework for understanding patterns of information processing that are currently unique to humans. The addition of information lensing to efforts to mimic human thought processes through a combination of neural networks, distributional semantics, and natural language computation may provide a closer convergence between human and machine information processing.
Cerebral Aneurysm Clipping Surgery Simulation Using Patient-Specific 3D Printing and Silicone Casting

Background Neurosurgery simulator development is growing as practitioners recognize the need for improved instructional and rehearsal platforms to improve procedural skills and patient care. In addition, changes in practice patterns have decreased the volume of specific cases, such as aneurysm clippings, which reduces the opportunity for operating room experience. Objective The authors developed a hands-on, dimensionally accurate model for aneurysm clipping using patient-derived anatomic data and three-dimensional (3D) printing. Design of the model focused on reproducibility as well as adaptability to new patient geometry. Methods A modular, reproducible, and patient-derived medical simulacrum was developed for medical learners to practice aneurysmal clipping procedures. Various forms of 3D printing were used to develop a geometrically accurate cranium and vascular tree featuring 9 patient-derived aneurysms. 3D printing in conjunction with elastomeric casting was leveraged to achieve a patient-derived brain model with tactile properties not yet available from commercial 3D printing technology. An educational pilot study was performed to gauge simulation efficacy. Results Through the novel manufacturing process, a patient-derived simulacrum was developed for neurovascular surgical simulation. A follow-up qualitative study suggests potential to enhance current educational programs; assessments support the efficacy of the simulacrum. Conclusions The proposed aneurysm clipping simulator has the potential to improve learning experiences in surgical environment. 3D printing and elastomeric casting can produce patient-derived models for a dynamic learning environment that add value to surgical training and preparation.
Implementation and Enforcement of Best Management Practices for Florida Ornamental Aquaculture with an Emphasis on Nonnative Species

AbstractTropical ornamental aquaculture is dominated by the production of nonnative species and is an important industry in Florida. However, the escape of nonnative species can pose challenges to the industry and also natural resource managers. Escapement of nonnative species and their potential impacts has led to suggestions that ornamental aquaculture is unregulated and lacks transparency. Comprehensive regulation of Florida aquaculture began in 1999 with the creation of the Division of Aquaculture (Florida Department of Agriculture and Consumer Services; FDACS) along with aquaculture best management practices (BMPs). Although FDACS regulates commercial aquaculture through application of BMPs, which includes provisions for escapement of nonnative species, the implementation of aquaculture BMPs has been largely unverified. Our objective was to examine how aquaculture BMPs have been implemented to prevent the escape of nonnative species, how facilities are inspected, and the rates and causes of noncompli...
Development of a Measure to Assess Parent Perceptions of Barriers to Child Weight Management

Abstract Background: Families face many barriers related to creating or maintaining a healthy lifestyle, which likely contributes to the prevalence of childhood obesity in the United States; however, no measure currently exists to examine these barriers. This study developed a quantitative measure of parents' perceptions of barriers to family healthy lifestyle. Methods: Parents of children between the ages of 7–17 were recruited using Amazon Mturk (n = 812). Exploratory and confirmatory factor analyses and preliminary convergent validity analyses were conducted. Results: Four factors emerged in the final measure: Parent Disengagement, Cost and Built Environment, Lack of Family Support, and Family Time Constraints, with the final 19-item measure having good initial psychometric properties, including reliability and validity. Conclusions: Future research is needed to examine whether this measure may be used in clinical practice to identify barriers to a healthy family lifestyle, to tailor interventions for ...
Deterministic OpenMP for race-free parallelism

Recent deterministic parallel programming models show promise for their ability to replay computations and reproduce bugs, but they currently require the programmer to adopt restrictive or unfamiliar parallel constructs. Deterministic OpenMP (DOMP) is a new deterministic parallel environment built on the familiar OpenMP framework. By leveraging OpenMP's block-structured synchronization annotations, which are largely compatible with the constraints of a deterministic model, DOMP eases the parallelization of legacy serial code and preserves substantial compatibility with OpenMP software. A few OpenMP constructs, however, such as atomic and critical, are semantically nondeterministic and unsupported in DOMP. In three well-known parallel benchmark suites, we find that most (81%) uses of these nondeterministic constructs express programming idioms that are compatible with determinism but not directly expressible in OpenMP. DOMP therefore adds new OpenMP constructs to express such idioms deterministically, supporting pipelines and generalized reductions.
How Can Engineering Students Learn to Care? How Can Engineering Faculty Teach to Care?

This chapter focuses on a missing dimension to the traditional engineering experience: care, defined here as an active compassion, empathy, and concern for the wellbeing of other living (and sometimes non-living) things. The chapter begins with an introduction to the ethics of care, a normative ethical theory that emphasizes responsibility, relationship and context over rules and consequences. It then gives an overview of the engineering profession that shows the extent to which care is manifest in engineering practice. Throughout the chapter, a five element framework for care ethics adopted from the literature is used as a guide to demonstrate how engineers can become more effective at caring, particularly through work performed in philanthropic areas such as engineering for community service, disaster recovery, and international development—endeavors referred to collectively as humanitarian engineering (H.E.). However, in spite of the obvious opportunities for care in H.E., the practice of ethical caring is wrought with pitfalls, which are discussed, followed by way to overcome them through a proposed mindset that enables engineers to become more willing and better able to contribute constructively to issues of social and ecological justice.
Conceptualizing American Attitudes toward Immigrants’ Dual Loyalty:

The social issue of immigrants’ dual loyalty figures prominently in the 2016 U.S. presidential primaries, yet little is known about Americans’ views on the subject. Drawing on data from a nationall...
NSAID induced perforated peptic ulcer in a pediatric sickle cell patient

Abstract Peptic ulcer disease is a relatively rare entity in the pediatric population. Given the trend toward multimodal pain control for pain crises in Sickle Cell Disease patients, they are at an increased risk of developing complications secondary to peptic ulcer disease. We discuss a case of a Sickle Cell Disease patient on multimodal therapy that presented with a perforated peptic ulcer requiring emergent surgery. While multimodal therapy helps ease the dependency on narcotic pain medication, it does present other potential problems like potential bleeding or perforation. For those that can be categorized in this select group of patients, routine surveillance with esophagogastroduodenoscopy should be considered for those at highest risk to prevent devastating complications.
Water Infrastructure and New Music as Agents of Environmental Awareness

Visually conspicuous sites of water infrastructure have historically served to publicly acknowledge water’s essential role in urban civilization and the feats necessary to maintain its supply. By b...
On Using Simulations to Inform Decision Making During Instrument Development

Although content validity—how well each item of an instrument represents the construct being measured—is foundational in the development of an instrument, statistical validity is also important to the decisions that are made based on the instrument. The primary purpose of this study is to demonstrate how simulation studies can be used to assist the decision making of researchers who are developing or updating instruments. A hypothetical research study is presented in which the researcher needs to make choices that will guide his or her development of a universal behavior screener. In the study, he or she wishes to make choices regarding the number of items to include, the pilot sample size, average difficulty of the items, and the amount of information provided by the instrument at different cut scores. Simulation is then used to create data sets with varying levels of each of these aspects, and decisions are subsequently made regarding the levels that should be applied in the actual study. Rationale for ...
Are we near the predictability limit of tropical Indo-Pacific sea surface temperatures?

The predictability of seasonal anomalies worldwide rests largely on the predictability of tropical sea surface temperature (SST) anomalies. Tropical forecast skill is also a key metric of climate models. We find, however, that despite extensive model development, the tropical SST forecast skill of the operational North American Multi-Model Ensemble (NMME) of eight coupled atmosphere-ocean models remains close both regionally and temporally to that of a vastly simpler linear inverse model (LIM) derived from observed covariances of SST, sea surface height, and wind fields. The LIM clearly captures the essence of the predictable SST dynamics. The NMME and LIM skills also closely track and are only slightly lower than the potential skill estimated using the LIM's forecast signal-to-noise ratios. This suggests that the scope for further skill improvement is small in most regions, except in the western equatorial Pacific where the NMME skill is currently much lower than the LIM skill.
What Editors and Reviewers Look for: Tips for Successful Research Publication

Scientific reporting is challenging, but getting it right is important. A well reported trial informs thought and guide care, while a confusing or misleading one can cause harm. This chapter offers one approach to this complex and sometimes-frustrating process. Key elements include: Getting started (asking clear research questions), demonstrating the robustness of the project (methods), structuring a manuscript to make it easy to follow, communicating research results plainly and effectively, and maintaining perspective with one’s main messages. Finally, we summarize several pitfalls of scientific reporting, including conflicts of interest, the common kinds of bias in clinical research, ethical issues associated with authorship (plagiarism, duplicate submission, and redundant publication), and the difference between statistical significance and clinical importance.
Exploring paraprofessional and classroom factors affecting teacher supervision.

Abstract Background Paraprofessionals serve a primary role in supporting students with disabilities in the classroom, which necessitates teachers’ supervision as a means to improve their practice. Yet, little is known regarding what factors affect teacher supervision. Aims We sought to identify how paraprofessional competence and classroom type affected the levels of teacher direction. Methods and procedures We administered an adapted version of the Paraprofessional Needs, Knowledge & Tasks Survey and the Survey for Teachers Supervising Paraprofessionals to teachers supervising paraprofessionals in elementary schools. Structural Equation Modeling was used to examine the link between paraprofessional competence and classroom factors affecting the level of teacher supervision. Outcomes and results Our results indicated that when teachers perceived paraprofessionals as being more skilled, they provided more supervision, and when more supervision was provided the less they thought paraprofessionals should be doing their assigned tasks. Additionally, paraprofessionals working in classrooms with more students with mild disabilities received less supervision than paraprofessionals working in classrooms with more students with moderate-to-severe disabilities. Those paraprofessionals in classrooms serving mostly children with mild disabilities were also perceived as having lower levels of skill competence than those serving in classrooms with students with more moderate-to-severe disabilities. Conclusion and implications By understanding the factors that affect teacher supervision, policy and professional development opportunities can be refined/developed to better support both supervising teachers and paraprofessionals and, in turn, improve the outcomes of children with disabilities.
Does Comfort with Technology Affect Use of Wealth Management Platforms? Usability Testing with fNIRS and Eye-Tracking

Most wealth management firms offer online platforms where investors with varied levels of comfort with technology manage their portfolios. Past research shows that comfort with technology is crucial for users’ acceptance of new technologies. We investigated how users’ comfort level with technology influences their use of a new wealth management online platform. We used a multi-modal approach that incorporates survey, behavioral, eye-tracking and neural measures to assess investors’ comfort with technology on web-platform usability to provide a rigorous test of the effects of comfort with technology on usability experiences for a wealth management firm. Our findings suggest that traditional survey measures do not show any differences in users’ evaluations. However, behavioral and neurophysiological measures reveal insights that traditional survey measures fail to reveal.
Coronary artery calcium and incident cerebrovascular events in an asymptomatic cohort. The MESA Study.

Abstract Objectives This study assessed the predictive value of coronary artery calcium (CAC) score for cerebrovascular events (CVE) in an asymptomatic multiethnic cohort. Background The CAC score, a measure of atherosclerotic burden, has been shown to improve prediction of coronary heart disease events. However, the predictive value of CAC for CVE is unclear. Methods CAC was measured at baseline examination of participants (N = 6,779) of MESA (Multi-Ethnic Study of Atherosclerosis) and then followed for an average of 9.5 ± 2.4 years for the diagnosis of incident CVE, defined as all strokes or transient ischemic attacks. Results During the follow-up, 234 (3.5%) adjudicated CVE occurred. In Kaplan-Meier analysis, the presence of CAC was associated with a lower CVE event-free survival versus the absence of CAC (log-rank chi-square: 59.8, p Conclusions CAC is an independent predictor of CVE and improves the discrimination afforded by current stroke risk factors or the Framingham stroke risk score for incident CVE in an initially asymptomatic multiethnic adult cohort.
Clinical and Research Applications of Markers of Thrombosis

We provide a brief overview of vascular thrombosis as applied to the arterial circulatory system. This background serves as a template for understanding potential biomarkers of thrombosis. Additionally, the integrated relationship between genotype and phenotypic expression of disease, measurable as circulating (soluble) proteins and cell-based products, including fibrinogen, thrombin, thrombomodulin, tissue factor, tissue factor pathway inhibitor, platelet surface markers, and others, is highlighted. Finally, the role of endothelial cell and endothelial cell-surface markers as biomarkers of thrombosis is discussed. As applicable, the clinical and potential research applications of specific biomarkers of thrombosis are provided.
Laparoscopic cholecystectomy in the inner-city hospital

Laparoscopic cholecystectomy (LCCY) has become the treatment of choice for patients undergoing elective CCY. Inner-city hospitals treat a large number of patients with advanced or acute disease, and the ability to perform LCCY in this patient population is unclear. The records of the first 107 patients undergoing LCCY were reviewed. There were 96 women and 11 men with a mean age of 42 years (range 14-86 years). Twenty-seven (42%) of the patients were admitted through the emergency room and were operated upon urgently, whereas 35 (58%) underwent elective LCCY. More than two-thirds of the patients were either uninsured or covered by Medicaid. In the urgent group, 38% had gallstone pancreatitis, 41% had abnormal LFTs, and 26% had a WBC > 13,000. A total of 70% of these patients were discharged within 48 hours after LCCY. The conversion rate was 9% and was similar between urgent and elective LCCY. In summary, acute biliary tract pathology accounted for one-half of the patients undergoing LCCY in our hospital. In conclusion, LCCY can be performed in this group of patients with low morbidity, especially if the need for liberal conversion to open CCY is recognized.
Neuropathic pain: Review of mechanisms and pharmacologic management

Neuropathic pain is a challenge for clinicians because it is resistant to commonly prescribed analgesics, such as opioids and nonsteroidal antiinflammatory drugs. Fortunately, adjuvant analgesics, drugs not typically thought of as pain relievers, may be effective. It is helpful to classify adjuvant analgesics used to treat neuropathic pain into two broad categories: (1) membrane stabilizing agents, which inhibit ectopic discharges on damaged neural membranes, and (2) drugs that enhance dorsal horn inhibition, which may augment biogenic amine or GABAergic mechanisms in the dorsal horn of the spinal cord. Current evidence regarding efficacy generally does not support the use of one drug over another, and selection of a particular drug may depend on experience or expected side effects. The overall efficacy of tricyclic antidepressants for neuropathic pain is modest, and they may produce intolerable side effects. Based on current studies, gabapentin is a reasonable alternative to antidepressants, as initial monotherapy or add-on treatment, particularly for painful diabetic peripheral neuropathy and postherpetic neuralgia. From a practical standpoint, to optimize analgesia more than one drug may be necessary. Although polypharmacy is the result, this approach may improve therapy and minimize side effects. From a safety standpoint, medications generally should be started at low doses and titrated to effect. Although labor-intensive, this strategy can improve compliance and optimize patient care.
Want Your Opinions Reversed? Hire a Yale Clerk (and Don't Require the Bar)

This paper examines whether clerks to federal district court judges influence judicial opinions by reviewing whether there is a relationship between characteristics of clerks hypothesized to be important and the likelihood of a subsequent Shepard's "warning" signal (roughly equivalent to a reversal). The clerk characteristics addressed are whether clerks are expected to take the bar and the law schools they attended. A finding that there is such a relationship provides evidence consistent with the hypothesis that clerks matter. Using a sample of 36,107 opinions written by 220 federal district court judges, this paper finds: There is a negative relationship between the likelihood of a reversal and the fraction of a judge's clerks from U.S. News & World Report top 6 law schools where the clerks are expected to take the bar. Where clerks are not expected to take the bar, the higher fraction of the judge's clerks from Yale Law School is associated with a higher likelihood of a reversal. In this regard, Yale Law School seems in a class of its own among the top 18 law schools. Where judges do not expect clerks to take the bar, one can reject the hypothesis of equality of the parameter estimates for the fraction of clerks from Yale Law School and either the fraction of clerks from Harvard Law School or Stanford Law School, with p-values of 0.01 or smaller. These results are consistent with the hypothesis that clerks matter, and that Yale Law School is true to a description by its former Dean as "the most theoretically and academically oriented law school in America." This paper reports results of conditional (fixed effects) logistic regressions, which estimate the likelihood of reversal conditional on the number of reversals each judge has in the sample. The results thus account for the possibility that judges inherently more likely to be reversed hire clerks with particular attributes.
Effects of early amino acid administration during total parenteral nutrition on protein metabolism in pre-term infants

1. We investigated the effects of starting amino acid administration on post-natal day 2 on protein turnover and nitrogen balance in appropriate-for-gestational-age, very-low-birth-weight infants. Eighteen infants were divided into two groups. Group A received from day 2 onwards an amino acid solution, whereas group B started on this solution after day 4. Both groups were exclusively parenterally fed, 200 kJ day-1 kg-1 on post-natal days 3 and 4. Group A (birth weight 1.5 +/- 0.3 kg) received 4.6 g of glucose, 1.9 g of fat and 2.3 g of amino acids day-1 kg-1 body weight. Group B (birth weight 1.4 +/- 0.2 kg) received 7.0 g of glucose and 1.9 g of fat day-1 kg-1 body weight. 2. At post-natal day 3, a primed constant infusion of 3 mg of [15N]glycine day-1 kg-1 was given. Protein flux, protein synthesis and protein breakdown were calculated from the 15N enrichment in urinary ammonia. In five out of nine infants in group B no plateau of 15N enrichment in urinary urea could be detected, whereas in group A two out of nine infants did not reach a plateau. For this reason we did not use the end product urea for our calculations. 3. The administration of the amino acids resulted in a higher protein flux (6.9 +/- 1.5 g day-1 kg-1 versus 5.2 +/- 0.9 g day-1 kg-1) and a higher protein synthesis rate (6.0 +/- 1.4 g day-1 kg-1 versus 4.6 +/- 0.8 g day-1 kg-1) in group A.(ABSTRACT TRUNCATED AT 250 WORDS)
Robust Optimal Energy Pricing and Dispatch for a Multi-Microgrid Industrial Park Operating Based on Just-In-Time Strategy

Energy dispatch in multi-user networks with limited energy resources can lead to competitive markets where individuals would place bids with the goal of maximizing their own profits. Game theoretic techniques are elegant mathematical candidates to solve such problems. However, they cannot guarantee the existence of equilibrium points. Even if such points are somehow reached, Pareto optimality of the solution cannot be ensured. In this paper, an alternative approach based on multi-objective optimization is proposed in order to maximize the “collective benefits” of a group of players. Instead of allowing individuals to compete for resources directly, a neutral third party finds a solution that is Pareto optimal and meets all constraints associated with individual users. A multi-microgrid industrial park is considered here, where the park is assumed to be equipped with a central controller that purchases energy from the grid and dispatches it among individual microgrids. When this energy is limited due to capacity constraints, each microgrid would try to receive a larger portion so as to increase its profit level. Naturally, these individual objectives are contradictory. As such, the problem is formulated as multi-objective optimization and solved using a modified approach based on goal programming to ensure the Pareto optimality of the overall solution. This way, the limited energy resource is shared in a way that maximizes the collective profit of the group, instead of individuals. The problem formulation is, then, extended by developing its robust counterpart so that model and parameter uncertainties can also be taken into account.
Combining electronic mail with online retrieval in a library context

Le courrier electronique s'est developpe dans 2 directions: dans les bureaux pour l'industrie et l'administration, et dans les bibliotheques avec la creation des catalogues en ligne. Les reseaux et les passerelles inter-reseaux etendant les possibilites d'acces a ces 2 domaines, et en general le lien entre les differentes fonctions augmente l'utilite de chacune d'elles. L'utilisation du courrier electronique par une bibliotheque est etudiee a titre d'exemple, notamment en liaison avec un catalogue en ligne. (INTD)
Stable Unassisted Solar Water Splitting on Semiconductor Photocathodes Protected by Multifunctional GaN Nanostructures

Producing hydrogen by unassisted solar water splitting is one essential step to make direct solar fuel conversion a viable energy source. To date, however, there has been no demonstration of stable...
Design of Large Effective Apertures for Millimeter Wave Systems Using a Sparse Array of Subarrays

We investigate synthesis of a large effective aperture using a sparse array of subarrays. We employ a multi-objective optimization framework for placement of subarrays within a prescribed area dictated by form factor constraints, trading off the smaller beam width obtained by spacing out the subarrays against the grating and side lobes created by sparse placement. We assess the performance of our designs for the fundamental problem of bearing estimation for one or more sources, comparing performance against estimation-theoretic bounds. Our tiled architecture is motivated by recent progress in low-cost hardware realizations of moderately sized antenna arrays (which play the role of subarrays) in the millimeter wave band, and our numerical examples are based on 16-element ( $4 \times 4$ ) subarrays in the 60 GHz unlicensed band.
Receptors for peanut agglutinin (Arachus hypogea) in childhood acute lymphoblastic leukemia: Possible clinical significance

The presence of lymphocyte receptors for peanut agglutinin in significant numbers (greater than 15%) was identified on leukemic cells from T-cell acute lymphoblastic leukemia (T-ALL) (3/4), B-cell ALL (B- ALL) (2/4), null cell ALL (8/17), and on normal fetal thymic lymphocytes but not on normal human peripheral blood lymphocytes. Peanut agglutinin (PNA) binding was blocked specifically on leukemia lymphoblasts and thymic lymphocytes by the addition of galactose to the medium. When all immunologic subgroups of ALL are combined, preliminary data suggest that of the 13 ALL patients having greater than 15% PNA- positive lymphoblasts, 8 had relapsed, whereas none of the 12 ALL patients with less than 15% PNA-positive cells have recurrent disease at this time. It is likely that analysis of PNA receptors on ALL lymphoblasts may be a useful adjunct to the existing clinical and immunologic prognostic indicators.
Knowledge and beliefs regarding temporomandibular disorders among orthodontists

Introduction This project was undertaken to accomplish 2 objectives: (1) to identify whether there is a discrepancy between orthodontists and experts in temporomandibular disorders (TMD) related to diagnosis and treatment of TMD patients, and (2) to influence the manner in which TMD curricula are taught in orthodontic residency programs, better preparing future orthodontic specialists to diagnose and treat (and refer) patients with TMD. Methods A survey invitation was e-mailed to 8870 members of the American Association of Orthodontists. Items were answered on a 6-point scale (0 = I don't know; 1 = strongly disagree; 2 = disagree; 3 = neutral; 4 = agree; 5 = strongly agree). A group consensus was attributed when more than 50% of the orthodontists supported a response. Previously published responses of TMD experts were used as a reference to evaluate the orthodontists' responses. Comparisons between the responses from the 2 groups were assessed using a z-test. Results Among the participants who responded to the questionnaire, 148 were residents, 1132 were private practitioners, and 61 were full-time faculty. Sixty-two percent of the participants did not think they received enough training in TMD during their orthodontic residency. Although 62% of participants indicated that they feel comfortable diagnosing TMD patients, 50.2% do not feel comfortable treating TMD patients. There was no significant difference between the 2 groups' responses under one-third of the questions. Conclusions It is clear that orthodontic residencies in the U.S. need to improve methods of teaching TMD concepts. Although most orthodontists feel comfortable diagnosing TMD patients, less than half feel comfortable treating those patients, and the difference in responses with the TMD expert group was significant in 71% of the questions.
Epidural hematoma due to Gardner-Wells Tongs placement during pediatric spinal deformity surgery.

To our knowledge, this is the first documented report of an operative cranial epidural hematoma secondary to skull fracture due to placement of Gardner-Wells Tongs (GWT) in the setting of a spinal deformity reconstruction. The objective is to illustrate the possibility of cranial pathology secondary to GWT placement and the need to properly correlate intraoperative neuromonitoring findings. Case report. A 14-year-old male with Marfan’s Syndrome presented for three-column osteotomy spinal reconstruction for a large and stiff thoracic kyphoscoliosis. Gardner-Wells Tongs (GWT) was placed prior to prone positioning to provide neck stability without issue. During the lumbar posterior column osteotomies the patient began to lose upper and lower extremity motor data. This indicated a cranial pathology. A temporary rod was placed on the concavity and an emergent flip without closure was performed. Upon flip, the patient was fixed and dilated with only right corneal reflex. The patient was rushed to the CT scanner where a large right-sided epidural hematoma was noted with a temporal bone fracture at the pin site, with the patient’s right temporal bone noted to be only 1.3 mm in thickness. The patient underwent emergent epidural hematoma evacuation by the Neurosurgical team. The patient was discharged to rehabilitation 1 week after his cranial epidural hematoma surgery with a complete recovery including with full strength examination of all extremities. He subsequently underwent a definitive posterior spinal fusion with posterior column osteotomies 8 weeks later. Cranial pin fixation has the rare possibility to produce cranial pathology and has a specific complication protocol. Proper utilization and interpretation of neuromonitoring is essential to aid in intraoperative decision-making.
Peripheral Markers of Neurovascular Unit Integrity and Amyloid-β in the Brains of Menopausal Women.

Background The identification of blood-borne biomarkers for the diagnosis and prognosis of Alzheimer's disease and related dementias is more feasible at the population level than obtaining cerebrospinal fluid or neuroimaging markers. Objective This study determined the association of blood microvesicles, derived from cells of the neurovascular unit, with brain amyloid-β deposition in menopausal women. Methods A subset of women from the Kronos Early Estrogen Prevention Study underwent brain amyloid-β positron emission tomography three years following cessation of study treatment with placebo (PL, n = 29), transdermal 17β-estradiol (tE2; n = 21), or oral conjugated equine estrogen (oCEE; n = 17). Isolated peripheral venous blood microvesicles were analyzed by digital flow cytometry using fluorophore conjugated antibodies directed toward total tau, amyloid-β 1-42 (Aβ1-42), neuron specific class III β-tubulin (Tuj1), microglia ionized calcium -binding adaptor molecule 1(Iba1), glial fibrillary acid protein (GFAP), and low density lipoprotein receptor-related protein1 (LRP1). Principal components analysis reduced the dimensionality of these selected six markers to two principal components (PCs). Proportional odds ordinal logistic regression analysis was used with amyloid-β deposition regressed on these PCs. Results Only the number of microvesicles positive for Aβ1-42 differed statistically among prior treatment groups (median [IQR]: 6.06 [2.11, 12.55] in PL; 2.49 [0.73, 3.59] in tE2; and 4.96 [0.83, 10.31] in oCEE; p = 0.032). The joint association between the 2 PCs and brain amyloid-β deposition was significant (p = 0.045). Conclusion Six selected markers expressing peripheral blood microvesicles derived from cells of the neurovascular unit, when summarized into two principal components, were associated with brain amyloid-β deposition.
Regulatory T Cells in Multiple Sclerosis.

Regulatory T Cells in Multiple Sclerosis Regulatory T cells suppress inflammation and are defective in autoimmune diseases. A recent study provides new insight into how these cells become dysregula...