cssi/SciSciGPT-SciSciNet huggingface dataset:
Complexity and Management and Policy: Why Our Interventions Go Astray

The increasing number of administrators in healthcare reflects a mental model of managerialism – a belief in the value of professional managers and of the concepts and methods they use. Among these methods is the use of “performance indicators.” These performance indicators are part of the control systems that administrators use to keep the health care “machine” running. This image of a machine emphasizes the aspects of the organization that are (supposedly) predictable, controllable and reproducible. While it is often hard to see the similarities between health care systems and other systems, such control systems are manifest in the hormonal axes that endocrinologists deal with every day. This chapter shows how a cybernetic model of hormonal axes involved in insulin secretion can serve as an analogy for the development and operation of performance measures for diabetes including some of the unintended consequences. Unintended consequences of actions in complicated or complex systems are a fact of life. Simple systems are predictable. Complicated systems may be computationally tractable and therefore predictable, although expertise is required. Lacking that expertise or the correct computer model, unintended consequences may come as a surprise. Unintended (and often unexpected) consequences are characteristic of action on complex systems; they emerge.
"Implementation Is so Difficult": Survey of National Learning Health System Decision-makers Identifies Need For Implementation Information in Evidence Reviews.

BACKGROUND Evidence use within learning health care systems can improve patient health outcomes. Embedded in the Veterans Health Administration (VHA) since 2007, the Veterans Affairs Evidence Synthesis Program (ESP) provides tailored evidence synthesis services to support VHA's learning health care system goals. As part of the ESP's ongoing quality improvement efforts, we have been surveying our users since 2016. METHODS We reviewed data from a survey of end-users received between September 5, 2016, and June 10, 2019. The survey assessed: (1) nature of decision-making needs; (2) actions resulting from the report's findings; (3) implementation timeframe; and (4) overall perception of report content. RESULTS Feedback was received from 66 of the 138 operational partners requesting ESP products during the fiscal year 2015 through 2018. Requests commonly informed clinical guidance (58%), identified future research needs (58%), and determined VHA-specific implementation strategy (47%). A total of 91% of responders used reports, typically within 3 months after completion (82%). Use was typically for VHA publications and/or presentations to inform VHA policy or guidance (26%), to inform intervention/strategy adoption decisions (23%) and for medical device and therapy procurement decisions (21%). Over half (53%) of respondents indicated that it would be useful for ESP reports to include more guidance on implementing findings. CONCLUSION Our survey of learning health system decision-makers' actual patterns and timing of evidence use provides valuable new information that can further support development of other health system and evidence producer partnerships and identifies key needs for better supporting health systems' uptake of evidence.
Critical Results Reporting in Pediatric Echocardiography

Background: Diagnostic error is defined as a diagnosis that is unintentionally delayed, wrong, or missed as judged from eventual appreciation of the existing data or of more definitive information. Failure to report critical findings in a timely fashion to referring physician is one of the factors contributing to diagnostic error and is preventable. National Patient Safety Goals of the Joint Commission on Accreditation of Healthcare Organizations and American Society of Echocardiography emphasizes that critical results of tests …
Performance Benchmarking of Data Augmentation and Deep Learning for Tornado Prediction

Predicting violent storms and dangerous weather conditions with current models can take a long time due to the immense complexity associated with weather simulation. Machine learning has the potential to classify tornadic weather patterns much more rapidly, thus allowing for more timely alerts to the public. To deal with class imbalance challenges in machine learning, different data augmentation approaches have been proposed. In this work, we examine the wall time difference between live data augmentation methods versus the use of preaugmented data when they are used in a convolutional neural network based training for tornado prediction. We also compare CPU and GPU based training over varying sizes of augmented data sets. Additionally we examine what impact varying the number of GPUs used for training will produce given a convolutional neural network.
Uranium in Ohio, USA Surface Waters: Implications for a Fertilizer Source in Waters Draining Agricultural lands.

Synthetic fertilizer is a potential source of uranium to natural waters, yet evidence is lacking. We analyzed dissolved uranium concentrations in lakes, reservoirs, and rivers in Ohio, USA during the summer of 2017. All water bodies drain areas of extensive agriculture where phosphate-rich fertilizer is applied. Uranium concentrations ranged from 0.3 to 3.9 µg L−1, with the lowest concentrations observed in the most offshore Lake Erie samples. These results, especially when placed in the context of previous work on both surface and groundwater, suggest that dissolved uranium concentrations in this water emanating from agricultural lands are higher than background, and uranium should be categorized similarly to nitrate and phosphate in that it originates in part from fertilizer application.
Harmonic and Rhythmic Oppositions in Jazz: The Special Case of John Coltrane and His Classic Quartet

The body of work produced by John Coltrane's Classic Quartet is notable for its rhetorical language of tension and release among the band members and Coltrane's transcendent playing, seemingly free...
Emotional Experiences in the Workplace: Biological Sex, Supervisor Nonverbal Behaviors, and Subordinate Susceptibility to Emotional Contagion.

This study aims to investigate the relationship among different types of supervisor nonverbal behaviors, subordinate susceptibility to emotional contagion, and subordinate emotional experience. It ...
Species-specific responses of a marsh-forest ecotone plant community responding to climate change

Ecotones are responsive to environmental change and pave a path for succession as they move across the landscape. We investigated the biotic and abiotic filters to species establishment on opposite ends of a tidal marsh-forest ecotone that is moving inland in response to sea level rise. We transplanted four plant species common to the ecotone to the leading or trailing edge of the migrating ecotone, with and without caging to protect them from ungulate herbivores. We found that species exhibited an individualistic response to abiotic and biotic pressures in this ecotone; three species performed better at the leading edge of the ecotone in the coastal forest, whereas one performed better at the trailing edge in the marsh. Specifically, grass species Phragmites australis and Panicum virgatum grew more in the low light and low salinity conditions of the leading edge of the ecotone (forest), whereas the shrub Iva frutescens grew better in the high light, high salinity conditions of the trailing edge of the ecotone (marsh). Furthermore, of the four species, only P. australis was affected by the biotic pressure of herbivory by an introduced ungulate, Cervus nippon, which greatly reduced its biomass and survival at the leading edge (forest). P. australis is an aggressive invasive species and has been observed to dominate in the wake of migrating marsh-forest ecotones. Our findings detail the role of lower salinity stress to promote and herbivory pressure to inhibit the establishment of P. australis during shifts of this ecotone, and also highlight an interaction between two non-native species, P. australis and C. nippon. Understanding migration of the marsh-forest ecotone and the factors controlling P. australis establishment are critical for marsh conservation in the face of sea level rise. More generally, our findings support the conclusion that the abiotic and biotic filters of a migrating ecotone shape the resulting community.
Rocky Mountain bristlecone pine ( Pinus aristata ) is a confirmed host to mountain pine beetle ( Dendroctonus ponderosae )

Mountain pine beetle (MPB) (Dendroctonus ponderosae Hopkins) is a native bark beetle that reproduces in pine (Pinus) species across western North America. High population levels can result in widespread host tree mortality. Over the past 2 decades, MPB has been responsible for pine mortality across millions of forested hectares in the western United States. Although a majority of the pine species found in the western United States are considered hosts to MPB, the host status of Rocky Mountain (RM) bristlecone pine (Pinus aristata) is unclear. We surveyed stands across the range of RM bristlecone pine in Colorado, USA, and quantified MPB-caused mortality within the past 10 years in stands where RM bristlecone and at least one other pine species co-occurred. We also evaluated in the field whether successful MPB brood production occurred in RM bristlecone pine. Our results confirm that RM bristlecone pine is susceptible to MPB attack and suitable for MPB reproduction. In mixed-species stands, pine species availability influenced MPB attack occurrence. The proportion of trees experiencing fatal beetle attack within a particular Pinus species was best predicted by the basal area proportion of that species in the stand prior to the most recent 10 years of mortality. These results indicate that RM bristlecone pine is vulnerable to ongoing climate change–induced contact with MPB.
The Oil and Gas Sector in Russia in 2019

The oil and gas sector is among the basic ones of the Russian economy and is playing an important role in the income generation for the state budget and Russia’s trade balance. Implementation of the OPE, Russia and a number of other countries agreement on the production cut with a simultaneous global crude oil demand growth in 2019 has resulted in the world crude oil prices stabilization in the range of $60–70 per barrel. In 2019, the volumes of crude oil production peaked for the entire post-Soviet period and the extraction of the natural gas hit an all-time high. Under the effect the tax maneuver in force in the oil industry, the crude oil refining volumes have stabilized and significantly increased the refining depth, production of fuel oil and its exports have contracted. March 2020 revealed a crucial discrepancy between the positions taken by Russia and the OPEC member states regarding the deal parameters for the subsequent period. Hence, there were no new agreements, the current deal was not extended and Saudi Arabia notified about the intention to ramp up production. In the wake of coronavirus pandemic and a plunge of the global oil demand the crude oil prices have collapsed.
Collimating electrons with quantum interference in graphene

The relativistic charge carriers in monolayer graphene can be manipulated in manners akin to conventional optics (electron-optics): angle-dependent Klein tunneling collimates an electron beam (analogous to a laser), while a Veselago refraction process focuses it (analogous to an optical lens). Both processes have been previously investigated, but the collimation and focusing efficiency have been reported to be relatively low even in state-of-the-art ballistic pn-junction devices. In this talk, we will present a novel device architecture of a graphene microcavity defined by carefully-engineered local strain and electrostatic fields. We create a controlled electron-optic interference process at zero magnetic field as a consequence of consecutive Veselago refractions in the microcavity, which we utilize to localize uncollimated electrons and further improve collimation efficiency.
Michelangelo's David: Florentine History and Civic Identity

1. The commission and history of the David 2. David, narrative ambiguity, and the competition with antiquity 3. The David and sculpture at the cathedral 4. David and the symbols of the state at the Palazzo della Signoria 5. Naked men in piazza Appendix I: documents for Michelangelo's David and its predecessors Appendix II: report of the commission to advise on the placement of the David.
The design of components for an advanced Rankine cycle test facility.

The design of a facility for testing components of an advanced Rankine cycle power system is summarized. The facility is a three-loop system in which lithium, potassium and NaK-78 are the working fluids of the primary, secondary and heat-rejection loops, respectively. Design bases and performance predictions for the major loop components, including the lithium heater and the potassium boiler, condenser and preheater, are outlined.
The Case for Weaker Patents

This Article provocatively asserts that lawmakers should weaken patents significantly — by between 25% and 50%. The primary impetus for this conclusion is the underappreciated effects of new and emerging technologies, including three-dimensional printing, synthetic biology, and cloud computing. These and other technologies are rapidly decreasing the costs of each stage of the innovation cycle: from basic research, through inventing and prototyping, to marketing and distribution. The primary economic theories supporting patent law hold that inventors and innovators need patents to recoup the costs associated with research, inventing, and commercializing. Because new technologies have begun — and will continue — to dramatically decrease these costs, the case for weakening patents is ripe for analysis.
"Miss Eurafrica": Men, Women's Sexuality, and Métis Identity in Late Colonial French Africa, 1945-1960

The 1960 issue of the magazine VEumfricain (The Eurafrican) featured a cover photo of a woman announced as "Miss L'Eurafrique" (figure l).1' Edited from Dakar under the auspices of the Union internationale des metis (International Union of MixedRace Persons), the magazine was written in French and printed in Paris. The membership of the union consisted of metis primarily from French-ruled sub-Saharan Africa. The primary mandate of the union was to advocate for financial, moral, and educational assistance to metis children. Published once or twice a year between 1945 and 1960, UEumfricain was the public face of the organization. The publication was a medium through which contributors sought to cultivate a sense of common identity among metis persons across geographical boundaries, facilitate communication among members, report on various metis social and cultural events, and promote the organization's lobbying efforts. Contributors to VEumfricain included metis across French-speaking Africa as well as some black and white benefactors. It is not clear from extant records whether an actual pageant was held, what the criteria for judging were, who witnessed the pageant, how many contestants competed, and from where in French Africa these contestants hailed. The photo is a headshot of a cafe au lait-toned woman identified as Miss Marie Celine, a "young metisse (mixed-race woman) of Niger." A rather modest photo in comparison to those of post-World War II pageants in the United States, Miss L'Eurafrique looks at the camera in an unprovocative and grave manner. Her long hair is plaited into a single, neat
Steroid hormone receptors and in vitro transcription

Steroid hormone receptors are ligand-inducible transcription factors that exhibit potent effect on gene expression in living cells. Precise dissection of their mode of action at the molecular level can best be carried out in functional cell-free systems. This article will describe the benefits of such systems and review their development up to the recent establishment of steroid receptor-dependent in vitro transcription. Subsequent advances in our knowledge of receptor function arising from the exploitation of this powerful experimental tool will be described. Particular emphasis will be placed upon two key problems: the role of steroid hormone in receptor action and the mechanisms by which steroid receptors activate gene transcription.
Posture and Activity Recognition and Energy Expenditure Estimation in a Wearable Platform

The use of wearable sensors coupled with the processing power of mobile phones may be an attractive way to provide real-time feedback about physical activity and energy expenditure (EE). Here, we describe the use of a shoe-based wearable sensor system (SmartShoe) with a mobile phone for real-time recognition of various postures/physical activities and the resulting EE. To deal with processing power and memory limitations of the phone, we compare the use of support vector machines (SVM), multinomial logistic discrimination (MLD), and multilayer perceptrons (MLP) for posture and activity classification followed by activity-branched EE estimation. The algorithms were validated using data from 15 subjects who performed up to 15 different activities of daily living during a 4-h stay in a room calorimeter. MLD and MLP demonstrated activity classification accuracy virtually identical to SVM ( ∼ 95%) while reducing the running time and the memory requirements by a factor of >103. Comparison of per-minute EE estimation using activity-branched models resulted in accurate EE prediction (RMSE = 0.78 kcal/min for SVM and MLD activity classification, 0.77 kcal/min for MLP versus RMSE of 0.75 kcal/min for manual annotation). These results suggest that low-power computational algorithms can be successfully used for real-time physical activity monitoring and EE estimation on a wearable platform.
Inductive 27.12 MHz diathermy in arterial peripheral vascular disease

Ten patients with moderate to severe arterial peripheral vascular disease (PVD) were monitored during treatment with inductive pulsed electromagnetic diathermy therapy. The therapy consisted of 20 daily treatments lasting one-half hour each per day and spread over one month. The application of the electromagnetic energy to the mid-anterior thigh and plantar surface of the foot of the treated leg was accomplished by the use of two inductive application heads and resulted in tissue heating. Patient measurements included surface temperature, transcutaneous partial pressure of oxygen (tcpO/sub 2/), segmental Doppler blood pressure, and superficial blood flow measured with a laser Doppler flowmeter, in addition to the patients subjective assessments of their overall condition. Temperature measurements indicated a repeatable heating pattern for each patient. The maximum temperature was not reached within 20 minutes of heating at the maximum output, while at 10% of maximum output for 10 minutes after maximum output a temperature plateau was reached. TcpO/sub 2/ indicates that the non-treated limb was also affected by the treatment. Sixty percent (60%) of the subjects indicated their belief that the therapy had some discernible therapeutic effect on their condition. The remaining 40% of the subjects experienced no perceptible change during or after the treatment. Based upon the small sample of patients the studies suggest that there is a maximum heating rate applicable to long duration heating using this modality of diathermy. The principle effect on PVD for the subjects studied appears to have been the stimulation of vasodilation. >
Members of the src and ras oncogene families supplant the epidermal growth factor requirement of BALB/MK-2 keratinocytes and induce distinct alterations in their terminal differentiation program.

Abstract BALB-/MK-2 mouse epidermal keratinocytes required epidermal growth factor for proliferation and terminally differentiated in response to high Ca2+ concentration. Infection with retroviruses containing transforming genes of the src and ras oncogene families led to rapid loss of epidermal growth factor dependence, in some cases, accompanied by alterations in cellular morphology. The virus-altered cells continued to proliferate in the presence of high levels of extracellular calcium but exhibited alterations in normal keratinocyte terminal differentiation that appear to be specific to the particular oncogene. These alterations bore similarities to abnormalities in differentiation observed in naturally occurring squamous epithelial malignancies.
The Specie Circular and Sales of Public Lands: A Comment

The chronology of events in 1836 surrounding Jackson's Specie Circular and the Act to Regulate the Deposits of Public Money, under which the Federal fiscal surplus was distributed to the states, has never been much in dispute. The orthodox analysis of these events likewise has been almost universally accepted. The Specie Circular has been seen as a device that provoked an increase in the demand for hand-to-hand specie in the West where the public lands were being sold, at the same time that specie was needed in the East to effect the distribution of the surplus. The monetary system could not have its specie in two places at once, the argument has been, and the attempt to do so led to the disastrous breakdown of the banking system and to the ensuing business recession of 1837.
Cost effectiveness of nonoperative management versus laparoscopic appendectomy for acute uncomplicated appendicitis

Background Appendectomy remains the gold standard in the treatment of acute, uncomplicated appendicitis in the United States. Nonetheless, there is growing evidence that nonoperative management is safe and efficacious. Methods We constructed a decision tree to compare nonoperative management of appendicitis with laparoscopic appendectomy in otherwise healthy adults. Model variables were abstracted from a literature review, data from the Healthcare Cost and Utilization Project data, the Medicare Physician Fee schedule, and the American College of Surgeons Surgical Risk Calculator. Uncertainty surrounding parameters of the model was assessed via 1-way and probabilistic sensitivity analyses. Results Operative management cost $12,213 per patient. Nonoperative management without interval appendectomy (IA) was the dominant strategy, costing $1,865 less and producing 0.03 more quality-adjusted life-years (QALYs). Nonoperative management with IA cost $4,271 more than operative management, but yielded only 0.01 additional QALY. One-way sensitivity analysis suggested operative management would become the preferred strategy if the recurrence rate was >40.5% or the total cost of appendectomy was decreased to Conclusion Nonoperative management without IA is the least costly, most effective treatment for acute, uncomplicated appendicitis and warrants further evaluation in a disease thought to be definitively surgical.
Theoretical studies of hydrogen-bonded complexes of H3SiO(H)AlH3 with OH2, NH3, and CH4

Abstract The hydrogen-bonded complexes ZH … OH2, ZH … NH3, and ZH … CH4 (where ZH = H3SiO(H)AlH3) have been studied at different levels of ab initio molecular orbital theory with the highest level being G2(MP2) theory. These complexes are models for adsorption of CH4, NH3, and H2O at acid sites in zeolites. We have also considered complexes where the hydroxyl hydrogen has been transferred, i.e. Z− … HOH2+, Z− … HNH3+, and Z− … HCH4+. Both rigid and relaxed geometries have been considered. The results provide benchmark calculations for future studies of molecular interactions at acid sites in zeolites using larger aluminosilicate clusters. The HF/3-21G level of theory systematically overestimates the binding of the complexes by 5–10 kcal mol−1. When going beyond the HF/6-31G(d) level of theory, electron correlation stabilizes the complexes while extended basis sets, which include polarization and diffuse functions, cause destabilization. Complexation energies obtained at the G2(MP2) level are reproduced to better than 1 kcal mol−1 by the MP2/6-311+G(3df,2p) level of theory, indicating that the dominant correlation correction is obtained by secondorder Moller-Plesset perturbation theory.
Political, economic, and administrative resources available for the control of vaccine-preventable diseases.

The harnessing of broad social mobilization with immunization appears to be the only feasible way of controlling the vaccine-preventable diseases and of achieving universal immunization by 1990. Burkina Faso Colombia Nigeria Syria and Turkey have marshalled national forces to assist the health sector with the result that sizeable gains in immunization have been made in the past 3 years. In these countries effective use has been made of the personal involvement of top political leaders beginning with presidents and prime ministers. The media has been used to deliver a single message: get your child vaccinated. This message has been reinforced through coalitions involving religious leaders primary teachers village heads policeman soldiers and truck drivers. Support has been gathered from nongovernmental organizations and individuals ranging from Rotary International to actors comedians and sports figures. These political economic and administrative resources constitute a low-cost elastic permanently renewable resource base that can aid health ministers not only in beginning immunization coverage but also in maintaining it. (authors)
The reversal of amiodarone-induced perioperative reduction in cardiac systolic reserve in dogs

There is controversy about the myocardial depressant effects of amiodarone in patients with decreased cardiac function undergoing surgery. Some surgeons believe that these effects complicate the discontinuation of cardiopulmonary bypass. Accordingly, the hemodynamic effects of amiodarone were evaluated in two groups of anesthetized mongrel dogs that had undergone a median sternotomy. A control group of 10 dogs and an amiodarone-treated group (15 mg/kg per day for 3 weeks) of 10 dogs were studied, and serum (0.26 to 1.09 micrograms/ml) and tissue (cardiac 2.97 to 11.60 micrograms/ml) levels of amiodarone were measured by liquid chromatography. Hemodynamic measurements were made at baseline and after administration of routine therapeutic intravenous doses of dobutamine (10 micrograms/kg per min), isoproterenol (0.06 micrograms/kg per min) and epinephrine (2 micrograms/min). The amiodarone-treated dogs had a smaller increase in cardiac output compared with baseline than did control dogs. For each drug when the amiodarone-treated group was compared with the control group, increases in cardiac output (liters/min) were: dobutamine, 1.32 +/- 0.24 versus 1.73 +/- 0.31; isoproterenol, 0.84 +/- 0.26 versus 1.43 +/- 0.28; epinephrine, 0.25 +/- 0.15 versus 0.44 +/- 0.53. Amiodarone-treated dogs were also given higher doses of drugs, dobutamine (50 micrograms/kg per min), isoproterenol (1.2 micrograms/kg per min) and epinephrine (20 micrograms/min). Increases in cardiac output were 1.24 +/- 0.24, 1.62 +/- 0.25 and 2.82 +/- 0.64, respectively. All cardiac outputs were significantly increased from the baseline values (p less than 0.05) except those measured in the amiodarone group receiving the lower dose of epinephrine. Thus, amiodarone-treated dogs have a relative reduction of perioperative cardiac systolic reserve.(ABSTRACT TRUNCATED AT 250 WORDS)
Postcardiotomy LVAD support and transesophageal echocardiography in a child

A case of postcardiotomy cardiogenic shock after repair of a congenital ventricular septal defect in a 5-year-old boy is reported. Mechanical circulatory support, instituted with a centrifugal left ventricular assist device, adequately supported the patient for 50 hours until recovery of native left ventricular function occurred. Transesophageal echocardiography proved to be useful in assessment of left ventricular function, allowing for timely institution and withdrawal of mechanical circulatory support.
NMR pattern recognition of peracetylated mono- and oligosaccharide structures. Classification of residues using principal-component analysis, K-nearest neighbor analysis, and SIMCA class modeling

Abstract Attempts have been made to correlate the NMR chemical shifts of carbonyl carbons, anomeric protons, acetyl methyl protons, and pyranose ring protons to residue structures contained in peracetylated mono- and oligosaccharides. The chemical shifts have been treated in a comprehensive manner as components of a 13-dimensional vector characterizing each residue. Residues could then be classified according to their structure and glycosidic linkages made to neighboring residues using pattern recognition methods including principal-component analysis, K -nearest neighbor classification, and SIMCA class modeling. Of these methods, the SIMCA soft modeling algorithm was most successful in classifying a group of test residues according to their structure, irrespective of glycosidic linkages made to adjoining residues. Of the chemical-shift variables used in the final SIMCA analysis, those belonging to the C2 carbonyl carbon, the H2 acetyl methyl protons, and the H 1, H3, and H4 pyranose ring protons were found to be the most important in modeling residue classes or discriminating between classes. In general, all of the pattern recognition methods support the use of an integrated approach in the treatment of NMR parameters as applied to structural analysis.
Data Acquisition Aspects of Super-PETT

Incorporation of differential time-of-flight (TOF) information in positron emission tomography offers significant performance improvement at the cost of increasing the quantity of data to be processed. A tomographic unit utilizing TOF data, called Super-PETT, is currently nearing the final stage of construction. Design and implementation aspects of the data acquisition system are described with an emphasis on instrument operation in an on-line preprocessing mode.
Modified simulated annealing for multiple-objective engineering design optimization

Simulated annealing is adopted as a tool for engineering design optimization. The annealing algorithm was originally designed for single-objective, discrete variable problems. In this study, the annealing algorithm has been significantly modified to handle multiple-objective, continuous variable problems. Cam design is used as a test-bed for the modified annealing algorithm. The result is compared with those from other cam design methods. Computational experience with the modified annealing algorithm is presented and discussed.
Concerning some unusual trimethylsilyl proton chemical shifts

Proton and 13C NMR data are presented for six different compounds containing the fragment C6H5CCH2SiMe3. In a number of instances it was observed that, in the 1H NMR spectrum, the SiMe3 groups had a chemical shift significantly upfield from internal tetramethylsilane (δ = −0·14 to −0·36). These unexpected upfield chemical shifts of the SiMe3 groups are suggested to result from the predominance, on a time averaged basis, of conformations which place the methyl groups attached to silicon in the face of an aromatic ring. The preference for such conformations is, in turn, the result of rotational preferences exhibited by the ‘flat’ aromatic ring. These results suggest that conformational analysis of systems containing a phenyl ring should take more explicit account of the fact that the preferred orientation of this phenyl ring can have a profound influence on the conformation adopted by the remainder of the molecule. In addition, the preferred conformation of the phenyl ring can have a significant effect upon the observed 1H NMR chemical shifts, while the 13C chemical shifts are relatively insensitive to conformational factors and can be explained by well-known substituent effects previously delineated for all-carbon systems.
RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR (rt-PA) APPEARS TO RESTORE MAJOR ORGAN PERFUSION IN MENINGOCOCCAL PURPURA FULMINANS. 243

Fulminant meningococcemia is characterized by acute onset of fever and petechiae with rapid progression to generalized purpura, septic shock, and multisystem organ failure (MSOF). Microvascular thrombosis due to disseminated intravascular coagulation (DIC) has a major role in the pathogenesis of MSOF. Endotoxin enhances the release of plasminogen activator inhibitor - 1 (PAI-1) which impairs fibrinolysis. Elevation of PAI-1 correlates with development of shock, renal failure, and death. Rt-PA interferes specifically with PAI-1, induces a clot-selective fibrinolysis and has no direct effect on hemodynamics. Therefore rt-PA may safely lead to the dissolution of microvascular thromboses and restore organ perfusion in patients with sepsis and DIC.
Behavior Engineering Proposals: 4. Is ‘Backwards Reading’ an Effective Proofreading Strategy?

Summary.-A series of experiments is reported that examined the effectiveness of a proofreading technique occasionally used by students-reading backwards. Although many educators advocate this strategy, no controlled research has been conducted to evaluate its effectiveness. Exp. 1 showed that backwards reading was actually inferior to reading forwards in detecting contextual errors, with no benefit for detecting misspellings. However, subjecrs were given standard instructions to proofread quickly, which may have negated any possible benefits of proofreading backwards. Exp. 2, which was designed to eliminate some potential problems with the first experiment, showed that backwards reading can be a beneficial strategy when subjects are specifically instructed to slow down as they read backwards. Exp. 3 further indicated that reading speed is a crucial variable when comparing forwards vs backwards proofreading. The main conclusion from the experiments is that backwards proofreading is an effective strategy for detecting misspellings, provided that it is used to slow students down and help them to focus on each individual word.
A Survey of OB/GYN Physicians' Training & Current Practice Patterns in Breast Care

To the Editor: Although it is clear that Ob/Gyns need education in care of the breast, specific training during residency in this area is highly varied. The core competencies described by the residency review committee (RRC) requirements mandate some fundamental core skills in breast management, but there are many gaps in expected experiences (1). This is surprising, not only because delayed or missed breast cancer diagnosis is a significant problem in US but because office-based breast procedures are typically quite straight-forward, particularly for a surgical specialty like Ob/Gyn. We conducted a survey of the practice patterns related to breast disease and the extent of residency training in breast care in a nationally representative sample of Ob/Gyns. A total of 400 ACOG fellows and junior fellows, who were members of the collaborative ambulatory research network (CARN) were invited to participate. CARN is a representative group of practicing US Ob/ Gyns (ACOG members) who volunteer to participate in periodic surveys. Demographic and current practice setting information were collected as well as the answers to 35 questions about breast care practices and their residency training in breast care. Data were analyzed using SPSS version 16.0. Chisquared and t-tests were used to compare responses as appropriate. IRB approval for this survey was obtained through American University on July 14, 2009.
Left ventricular inflow obstruction and atrial septal deffect: Diagnosis by real time two-dimensional echocardiography☆

Abstract This report describes the usefulness of real time two-dimensional echocardiography in the diagnosis of left ventricular inflow obstruction associated with atrial septal defect. Echocardiographically, left ventricular inflow obstruction was at the level of the mitral valve in case one, mitral and subvalvular in cases 2 and 3 supravalvular in case 4 (left atrial membrane). In all patients the defect was of the secundum variety and was seen as a constant discontinuity in the atrial septal image. The diagnosis was confirmed in all patients by cardiac catheterization, surgery or autopsy.
Phase-only information-based heterocorrelation

In our previous paper "Theoretical analysis and simulation of heterocorrelation filter" we attempted to find the best conditions that makes the relative intensity of the autocorrelation to be equal to the heterocorrelation. Our theoretical modeling and computer simulation based on the theory developed in the previous papers showed that in order to make the autocorrelation equal to the heterocorrelation, it is essential to have phase-only based heterocorrelation.
Injuries, changes in fitness, and medical demands in deployed National Guard soldiers.

ABSTRACTPurpose: To characterize noncombat injury/illness, determine changes in physical fitness, and evaluate the influence of these changes on medical resource utilization by National Guard (NG) Soldiers. Methods: Fifty-four Soldiers from the Arizona NG completed pre- and postdeployment fitness testing. Additionally, individual deployment medical records were inventoried. Results: The majority of noncombat-related medical visits (41%) were musculoskeletal in nature, followed by miscellaneous (33%) and respiratory (13%). Soldiers experienced significant decreases in percent fat mass (−11.1%, p < 0.001) and VO2 peak (−10.8%, p < 0.001). There were significant increases in push-ups (16.4%, p < 0.001), sit-ups (11.0%, p = 0.001), bench-press (10.2%, p < 0.001), and back squat (14.2%, p < 0.001) measures. VO2 peak was inversely correlated to medical resource utilization (r = −0.45 to −0.28, p ≤ 0.05). The tertile of Soldiers experiencing the sharpest declines in VO2 peak had significantly more medical visits...
Organic Crystal Engineering with 1,4-Piperazine-2,5-diones. 7. Crystal Packing of Piperazinediones Derived from 2-Amino-7-nitro-4-methoxyindan-2-carboxylic Acid

1,4-Piperazine-2,5-diones derived from 2-amino-7-nitro-4-methoxyindan-2-carboxylic acid were prepared in meso, racemic, and enantiomerically pure forms, crystallized from DMSO or DMF, and the supramolecular organization in the crystals determined by X-ray crystallography. These molecules were designed to bear two strongly dipolar p-nitroanisole groups, aligned in the enantiomeric stereoisomers and opposed in the meso stereoisomer. Consistent with piperazinediones of similar size and shape bearing nonpolar or weakly dipolar arene groups, these compounds engage in R22(8) hydrogen bonding, most often forming one-dimensional tapes. However, the preference for arene perpendicular edge-to-center interactions seen in the former is replaced by a preference for parallel edge-to-center arene interactions. While the dipoles of parallel edge-to-center associated arenes are often opposed, this is not a requirement in the solid state.
After “The Darkness at Noon”: A Biographical Study of Marxism as Critical Theory

Rethinking Marxism after the Cold War includes the task of reconstructing its genesis, beginning with the role of left Hegelianism in Marx′s development of historical materialism. Reviews the debates within the Hegelian school at the time of Marx′s “conversion” to it, in order to situate his dissertation project (1838‐41) on the difference between the Democritean and Epicurean philosophy of nature. A standard view has Marx writing from the perspectives of his mentor, Bruno Bauer, with whom he later broke in “On the Jewish Question” (1843). Argues that this view is incorrect. Instead, Marx constructs an analogy, according to which Democritus is to the Old Hegelians as Epicurus is to the Young Hegelians. The Epicurean “atom” then becomes a cryptogram of Bauerian Selbstbewusstsein. Although Epicurus has his sympathy, Marx is ultimately critical of him. Epicurean freedom is abstract and theoretical, but the liberation Marx aims towards is concrete and effective.
Percolation of electrical and elastic properties of granular materials at the transition from a suspension to a loose packing

Abstract The behavior of elastic and electrical properties of granular materials at various consolidation stages was studied in two experiments: (1) Conductive spheres were immersed in a fluid with same density. We find that both elastic and electrical properties exhibit a critical behavior at the transition from a suspension to a loose packing. (2) We infer the distribution of bonds vs. pressure from conductivity measurements where conductive beads are mixed with smaller non-conductive beads. We find that the dependence of static elastic moduli on the number of bonds follows an effective medium theory type relation while dynamic moduli are rather insensitive to the number of bonds.
Role of Asp544 in subunit I for Na(+) pumping by Vitreoscilla cytochrome bo.

Abstract The conserved Glu540 in subunit I of Escherichia coli cytochrome bo (a H+ pump) is replaced by Asp544 in the Vitreoscilla enzyme (a Na+ pump). Site-directed mutagenesis of the Vitreoscilla cytochrome bo operon changed this Asp to Glu, and both wild type and mutant cyo’s were transformed into E. coli strain GV100, which lacks cytochrome bo. Compared to the wild type transformant the Asp544Glu transformant had decreased ability to pump Na+ as well as decreased stimulation in respiratory activity in the presence of Na+. Preliminary experiments indicated that this mutant also had increased ability to pump protons, suggesting that this single change may provide cation pumping specificity in this group of enzymes.
National Coin Week: Third Week in April

Each year, National Coin Week, the third week in April, brings together coin enthusiasts in honor of one of the world's oldest and most popular pastimes. Numismatics, the study and collecting of coins, draws a large following with a variety of interests. Some have specific interests, such as primitive monies, error coins, counterfeits, or commemoratives. Others study coins for the insight they offer into art, royalty, military history, or politics and economics. Regardless of the reason, coin collectors have an important role. As precious metals disappear from coins, and coin usage decreases, the history represented by coins may become the province of the collector.
An epigenetic activation role of Piwi and a Piwi-associated piRNA in Drosophila melanogaster

Heterochromatin, representing the silenced state of transcription, consists largely of transposon-enriched and highly repetitive sequences. Implicated in heterochromatin formation and transcriptional silencing in Drosophila are Piwi (P-element induced wimpy testis) and repeat-associated small interfering RNAs (rasiRNAs). Despite this, the role of Piwi in rasiRNA expression and heterochromatic silencing remains unknown. Here we report the identification and characterization of 12,903 Piwi-interacting RNAs (piRNAs) in Drosophila, showing that rasiRNAs represent a subset of piRNAs. We also show that Piwi promotes euchromatic histone modifications and piRNA transcription in subtelomeric heterochromatin (also known as telomere-associated sequence, or TAS), on the right arm of chromosome 3 (3R-TAS). Piwi binds to 3R-TAS and a piRNA uniquely mapped to 3R-TAS (3R-TAS1 piRNA). In piwi mutants, 3R-TAS loses euchromatic histone modifications yet accumulates heterochromatic histone modifications and Heterochromatin Protein 1a (HP1a). Furthermore, the expression of both the 3R-TAS1 piRNA and a white reporter gene in 3R-TAS becomes suppressed. A P element inserted 128 base pairs downstream of the 3R-TAS1 piRNA coding sequence restores the euchromatic histone modifications of 3R-TAS and the expression of 3R-TAS1 piRNA in piwi mutants, as well as partly rescuing their defects in germline stem-cell maintenance. These observations suggest that Piwi promotes the euchromatic character of 3R-TAS heterochromatin and its transcriptional activity, opposite to the known roles of Piwi and the RNA-mediated interference pathway in epigenetic silencing. This activating function is probably achieved through interaction with at least 3R-TAS1 piRNA and is essential for germline stem-cell maintenance.
Clarifications of Certain Ambiguities and Failings of Poisson’s Ratios in Linear Viscoelasticity

Detailed new analytical investigations are presented describing the behavior of Class I, II and III viscoelastic Poisson’s ratios (PR). Their previously demonstrated dependence on stress-time histories, which lead to the inability to consider them as universal viscoelastic material properties and the incapacity to produce a general elastic–viscoelastic correspondence principle (EVCP) based, is expanded. A new Class VI PR is analytically derived from the viscoelastic constitutive relations in the Fourier transform (FT) space to achieve the proper FT form of the elastic/viscoelastic correspondence principle, i.e., the elastic-viscoelastic analogy. However, even though this PR Class is a pure universal material property function, it still fails to provide a convenient and useful path to a correspondence principle due to its inopportune constitutive form in real time space vis-a-vis a thermodynamic model with equivalent attributes. Consequently, no general EVCP involving PRs can be formulated. The derived Class VI PRs are equivalent to the defined Class III PRs with 1-D loadings (stresses).
Stress-induced changes in mood and cortisol release predict mood effects of amphetamine

Abstract Background Stress is thought to contribute to both initiation and relapse to drug abuse. However, the mechanisms by which stress influences drug use are unclear. Interestingly, responses to acute administration of stimulant drugs resemble certain neuronal and hormonal responses to acute stress, and there is accumulating evidence that individual variation in the positive reinforcing or euphorigenic effects of a drug is related to individual differences in responsivity to acute stress. Methods In this study we evaluated relationships between physiological and subjective responses to a stressful task and to an oral dose of d-amphetamine in healthy adult volunteers (N = 34). Individuals participated in four experimental sessions; two behavioral sessions involving a stressful task (i.e., public speech) or a non-stressful control task, and two drug sessions involving oral administration of d-amphetamine (20 mg) or a placebo. The dependent measures included salivary cortisol, heart rate, mean arterial pressure, and subjective ratings of mood. Results As expected, both stress and d-amphetamine increased cortisol, heart rate and blood pressure. Stress increased negative mood, whereas d-amphetamine induced prototypic stimulant effects and increased ratings of drug liking. Analyses revealed that increased negative mood states after stress were correlated with positive mood after amphetamine. In addition, increased cortisol after stress was correlated with positive mood responses to amphetamine. Finally, there were modest positive correlations between cortisol and heart rate increases after stress and mean arterial pressure after amphetamine. Conclusions These results support and extend previous observations that responses to acute stress are correlated with certain subjective, hormonal and cardiovascular effects of a stimulant drug.