cssi/SciSciGPT-SciSciNet huggingface dataset:
OF THE PSYCHOMETRIC PROPERTIES OF THE MANIFEST NEEDS QUESTIONNAIRE

Recent work has questioned the psychometric properties of the Manifest Needs Questionnaire. The present analysis suggests that this instrument's subscales exhibit unacceptably low levels of internal consistency. Moreover, the factor structure of this instrument does not coincide with that suggested by the existing version of the questionnaire. The rather harsh admonition that “the MNQ does not seem well suited for organizational studies” may have been responsibly placed.
The luminescence characteristics of GaN heteroepitaxial films

The III–V compound semiconductors are widely used throughout the world (as well as in space) for a wide variety of electronic and optoelectronic devices. Recently, a strong commercial interest has developed in the use of the III–V nitrides for high-temperature electronics and visible (i.e., blue and green) light- emitting diodes and injection lasers. The luminescent properties of these materials are of critical importance. This article reports the results of a study on the room-temperature cathodoluminescence and photoluminescence for nominally undoped GaN films grown by low-pressure metalorganic chemical vapor deposition on (0001) oriented sapphire substrates.
Effects of Estrogens on Pressor Responses to Angiotensin and Renin

SummaryAdministration of diethylstilbestrol to normal or nephrectomized rats causes an increase in angiotensinogen concentration in plasma associated with an increase in the pressor response to renin but no change in the pressor response to angiotensin.
76 NEURAL ENDOGENOUS CARBON MONOXIDE LOWERS BLOOD PRESSURE VIA SUPPRESSION OF PERIPHERAL SYMPATHETIC NEURONS

Carbon monoxide (CO) is endogenously produced from the degradation of heme, in a reaction that is catalyzed by heme oxygenase (HO). Systemic blockade of HO acutely decreases neural HO activity, and this increases arterial pressure in a manner that is reversed by CO microinjections into the nucleus tractus solitarii (NTS) of the brain stem; such findings are the original evidence that endogenous CO in the NTS serves as a tonic vasodepressor. Whilst the NTS coordinates the balance and distribution of sympathetic and parasympathetic influences on the cardiovascular system, the actions of the endogenous CO on these autonomic components have not been explored. The purpose of the current study was to identify the sympathetic and parasympathetic influences that contribute to the vasoregulatory actions of the endogenous CO system. Towards this end, male Sprague-Dawley rats were fitted with chronic femoral catheters and permitted four days recovery before conducting awake experiments. The acute blood pressure effects of an HO inhibitor, zinc deuteroporphyrin 2,4-bisglycol (ZnDPBG), were examined in animals pretreated with atropine, prazosine or propranolol to block the muscarinic, α1- or β-adrenergic receptors, respectively. Administration of ZnDPBG (45 μmol/kg, IP) increased arterial pressure from 123 ± 2 to 133 ± 3 mm Hg (p
An approach to abutting adjacent fields.

Abstract Problems arise in designing treatment techniques involving two pair of adjacent opposing fields where machine limitations require the patient to flip from supine to prone positions. Mantle and para-aortic treatments, in particular, can create challenging problems because of changes in patient position, different SSD’s between adjacent fields, internal anatomical changes from supine to prone position, as well as field size and other treatment machine limitations. A simulator technique has been developed which takes cognizance of these limitations in specifying the gap between adjacent fields. It employs collinearity of the 50% decrement lines of adjacent-opposed field edges and the intersection of all four edges at an internal mid-plane match point. The technique maintains dose homogeneity and eliminates hot and cold triangles in the area of abutment. Simulation radiographs facilitate identification of collinearity with respect to a specific vertebra in the plane of abutment. In summary, this approach: Verifies abutment of coplanar fields by use of match film, improves isodose uniformity at mid-plane, evaluates dose distributions when abutment occurs at a point anterior or posterior to midline, prevents the possibility of spinal cord complications that might occur due to three field overlap.
ACTIVE, SOLUBLE PRODUCT OBTAINED BY ENZYMATIC HYDROLYSIS OF PLASMINOGEN.

SummaryInsoluble plasminogen when treated with a certain carboxypeptidase preparation after destruction of CP activity, or with α-chymotrypsin, produced a soluble, active material with all the biochemical activities of the original substance. The identity of the hydrolyzing enzyme has not been established. Evidence is presented that the product obtained is partially hydrolyzed plasminogen (PHP).
Transcatheter Aortic Valve Replacement During Pregnancy.

Transcatheter aortic valve replacement (TAVR) is an approved and widely accepted standard treatment for severe symptomatic aortic stenosis (AS) in high-risk surgical candidates.1 Severe symptomatic AS during pregnancy presents a difficult clinical challenge.2 A 22-year-old female patient presented to our service at 15 weeks’ gestation with congenital symptomatic AS. After a thoughtful heart team evaluation, TAVR was recommended to the patient and performed at 22 weeks’ gestation. The authors further explore and discuss the preprocedure planning and treatment decisions of this case. The heart team focused on the timing and special considerations needed to ensure the health and safety of the patient and fetus. With careful preprocedural planning, TAVR can be a low-risk treatment option during pregnancy and provide a reliable bridge to a healthy, term delivery. A 22-year-old pregnant female patient presented with severe symptomatic AS at 15 weeks’ gestation. The patient was 165 cm tall, weighed 74 kg with a body mass index of 27 kg/m2 and body surface area of 1.84 m2 at the time of presentation. The patient’s clinical history includes congenital bicuspid aortic valve disease, which required balloon aortic valvuloplasty (BAV) at the age of 9 years. Throughout young adulthood, she had been asymptomatic with high levels of activity. Her chief complaints on presentation were increased dizziness, dyspnea on exertion, and chest discomfort. Echocardiography demonstrated a normal ejection fraction, an aortic peak flow velocity of 4.04 m/s, an aortic valve mean gradient of 38.22 mm Hg, an aortic valve area of 1.0 cm2, and mild-to-moderate aortic insufficiency (AI). The ascending aorta was mildly enlarged (3.9 cm). There was mild narrowing of periductal isthmus with no Doppler gradient (Figure 1; Table 1). Stress echocardiography testing showed moderate AI and below-average exercise capacity. The patient completed 8 to 9 metabolic equivalents …
Abstract IA23: Molecular and clinical impact of APOBEC3B mutagenesis in breast cancer

Recent studies have revealed a role for the DNA cytosine deaminase APOBEC3B in breast cancer mutagenesis. First, APOBEC3B mRNA is up-regulated in the majority of primary breast tumors and breast cancer cell lines. Second, endogenous APOBEC3B protein is predominantly nuclear and the only detectable source of DNA C-to-U editing activity in breast cancer cell line extracts. Third, APOBEC3B knockdown causes a corresponding decrease in genomic uracil concentrations, mutation frequencies, and C-to-T mutation levels in breast cancer cell lines. Fourth, the biochemical signature of APOBEC3B is evident in breast cancer mutation spectra. Fifth, breast carcinomas that express high levels of APOBEC3B have twice as many mutations as those expressing low levels. Finally, high levels of APOBEC3B associate with poorer prognostic outcomes including shorter survival durations. All of these data are consistent with a model in which APOBEC3B-catalyzed DNA cytosine deamination provides a chronic source of DNA damage and mutagenesis in breast carcinomas that helps to explain how some tumors evolve rapidly and manifest gross heterogeneity. Citation Format: Reuben S. Harris. Molecular and clinical impact of APOBEC3B mutagenesis in breast cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Breast Cancer Research: Genetics, Biology, and Clinical Applications; Oct 3-6, 2013; San Diego, CA. Philadelphia (PA): AACR; Mol Cancer Res 2013;11(10 Suppl):Abstract nr IA23.
Best Practices for Communicating Radiation Exposure Risk to Nuclear Medicine Patients

2730 Objectives Identify accurate radiation exposure levels and cancer risks associated with diagnostic nuclear medicine procedures; Recognize the ethical importance of the principle of informed consent; Identify accessible tools for educating patients about ionizing radiation; Apply shared-decision making principles to a variety of patient circumstances; Discuss current best practices in communicating radiation risk to patients; Support the appropriate use of nuclear medicine procedures. Methods Research regarding patient risk communication was reviewed and technologists resources were explored to determine best practices of communicating radiation risk to nuclear medicine patients. Results Health care providers have an inadequate knowledge of patient radiation exposure levels, which are often underestimated. Research reveals numerous risk communication techniques with disagreement on which is most effective. Much depends on patient comprehension. Many online resources are easily available to technologists and patients to help accurately understand the radiation risk imposed during nuclear medicine procedures. Conclusions More research is needed in this area to determine the most effective practice of risk communication. Nevertheless, the technologist may apply existing risk communication suggestions to a variety of patients.
Abstract 18580: Living in a Food Desert Fails to Predict Heart Failure Readmissions

Introduction: Limited access to healthy food has been linked to an unfavorable cardiovascular risk profile. This study sought to determine whether living in a food desert or an area with low access to fresh food impacts 30-day readmissions and total hospitalizations for heart failure patients. Hypothesis: Living in a food desert is associated with heart failure readmissions. Methods: We identified patients admitted to a university hospital between 01/01/2013 and 12/31/2013 with a primary diagnosis of heart failure. We entered patients’ zip codes into the USDA Food Access Research Atlas to identify patients who live in areas with low access to fresh food or food deserts. Low-access areas are defined as regions where ≥ 33% of the population live > 1 mile (in urban areas) or > 10 miles (in rural areas) from a supermarket. Food deserts have the additional stipulation of areas where median income is ≤ 80% of statewide median. We used regression analysis to compare 30-day readmissions and total hospitalizations for patients living in low-access or food deserts vs. living in adequate-access areas. Additional variables including poverty level, health insurance status, and education level were also examined for each zip code. Results: There was 2063 hospitalizations from 1598 unique patients in this sample (54% male, 41.1% African American, mean age 65±17 years, mean EF 41±19%). 789 (49.4%) patients lived in low-access areas and 318 (19.9%) lived in food deserts. 211 (13.2%) patients had at least one 30-day readmission. Living in a low-access area or a food desert was not associated with a 30-day readmission or the total number of heart failure-related hospitalizations (p > 0.05). Living in zip codes with levels of poverty, high school dropout rate, and uninsured status above the national average did not correlate with 30-day readmissions or total heart failure-related hospitalizations for our sample (p > 0.05). Conclusion: Living in a food desert or low-access area is not predictive of 30-day heart failure readmissions or total heart failure-related hospitalizations in this population. Further investigation examining additional outcome measures with a larger cohort and broader geography is necessary to substantiate these findings.
Collective Spin States Coupled to a Single Mode Cavity—Strong Coupling

In the theoretical part of this thesis I described in great detail the electromagnetic field of single mode cavities and the interaction with the magnetic moment of single or ensembles of electron spins.
Fronto-Temporal Connectivity Predicts ECT Outcome in Major Depression.

Background: Electroconvulsive therapy (ECT) is arguably the most effective available treatment for severe depression. Recent studies have used MRI data to predict clinical outcome to ECT and other antidepressant therapies. One challenge facing such studies is selecting from among the many available metrics, which characterize complementary and sometimes non-overlapping aspects of brain function and connectomics. Here, we assessed the ability of aggregated, functional MRI metrics of basal brain activity and connectivity to predict antidepressant response to ECT using machine learning. Methods: A radial support vector machine was trained using arterial spin labeling (ASL) and blood-oxygen-level dependent (BOLD) fMRI metrics from n=46 (26 female, mean age 42) depressed patients prior to ECT (majority right-unilateral stimulation). Image preprocessing was applied using standard procedures, and metrics included cerebral blood flow (CBF) in ASL, and regional homogeneity (ReHo), fractional amplitude of low-frequency modulations (fALFF), and graph theory metrics (strength, local efficiency and clustering) in BOLD data. A 5-repeated 5-fold cross-validation procedure with nested feature selection validated model performance. Linear regressions were applied post hoc to aid interpretation of discriminative features. Results: The range of balanced accuracy in models performing statistically above chance was 58-68%. Here, prediction of nonresponders was slightly higher than for responders (maximum performance 74% and 64%, respectively). Several features were consistently selected across cross-validation folds, mostly within frontal and temporal regions. Among these were connectivity strength amongst: a fronto-parietal network (including left dorsolateral prefrontal cortex), motor and temporal networks (near ECT electrodes), and/or subgenual anterior cingulate cortex. Conclusions: Our data indicate that pattern classification of multimodal fMRI metrics can successfully predict ECT outcome, particularly for individuals who will not respond to treatment. Notably, connectivity with networks highly relevant to ECT and depression were consistently selected as important predictive features. These included the left dorsolateral prefrontal and the subgenual anterior cingulate cortex, which are both targets of other neurostimulation therapies for depression, as well as connectivity between motor and right temporal cortices near electrode sites. Future studies that probe additional functional and structural MRI metrics and other patient characteristics may further improve the predictive power of these and similar models.
THE MAP ROOM

OCTOBER 2003 AMERICAN METEOROLOGICAL SOCIETY | ake-effect and ocean-effect clouds and precipitation are well-documented mesoscale phenomena that can significantly impact the weather in coastal regions. The Chesapeake Bay is a large marine estuary that extends from Maryland to southeastern Virginia (Fig. 1), where the mouth opens to the Atlantic Ocean north of Hampton Roads (Newport News to Virginia Beach). Chesapeake Bay is approximately 240 km long and ranges from 15 km wide in Maryland to over 30 km wide near the mouth in southern Virginia. The complex coastline encompasses many smaller bays and expands the lateral coverage of water to over 65 km in the Virginia portion. Cloud and precipitation plumes can develop in the Chesapeake Bay, similar to the mesoscale phenomena observed in the Great Lakes and Atlantic coastal areas. These plumes can impact aviation and marine interests, enhance synoptic rainfall or snowfall, and sometimes produce waterspouts. The effects are very localized, yet can have significant impact on a population of over 1 million people, including a large segment of our nation’s military. Due to the narrow range of thermodynamic and kinematic conditions that support their development, bay plumes occur most frequently from the fall through spring. Plume formation is normally associated with postfrontal strong low-level cold temperature advection. Bay water temperatures are also climatologically warmer than air temperatures during this period. Air–sea temperature differences can support development of bay plumes that affect the Hampton THE MAP ROOM
Association of intensive care unit delirium with sleep disturbance and functional disability after critical illness: an observational cohort study

In medical intensive care unit (MICU) patients, the predictors of post-discharge sleep disturbance and functional disability are poorly understood. ICU delirium is a risk factor with a plausible link to sleep disturbance and disability. This study evaluated the prevalence of self-reported post-ICU sleep disturbance and increased functional disability, and their association with MICU delirium and other ICU factors. This was an observational cohort study of MICU patients enrolled in a biorepository and assessed upon MICU admission by demographics, comorbidities, and baseline characteristics. Delirium was assessed daily using the Confusion Assessment Method for the ICU. Telephone follow-up interview instruments occurred after hospital discharge and included the Pittsburgh Sleep Quality Index (PSQI), and basic and instrumental activities of daily living (BADLs, IADLs) for disability. We define sleep disturbance as a PSQI score > 5 and increased disability as an increase in composite BADL/IADL score at follow-up relative to baseline. Multivariable regression modeled the associations of delirium and other MICU factors on follow-up PSQI scores and change in disability scores. PSQI and BADL/IADL instruments were completed by 112 and 122 participants, respectively, at mean 147 days after hospital discharge. Of those surveyed, 63% had sleep disturbance by PSQI criteria, and 37% had increased disability by BADL/IADL scores compared to their pre-MICU baseline. Total days of MICU delirium (p = 0.013), younger age (p = 0.013), and preexisting depression (p = 0.025) were significantly associated with higher PSQI scores at follow-up. Lower baseline disability (p < 0.001), older age (p = 0.048), and less time to follow-up (p = 0.024) were significantly associated with worsening post-ICU disability, while the occurrence of MICU delirium showed a trend toward association (p = 0.077). After adjusting for important covariates, total days of MICU delirium were significantly associated with increased post-discharge sleep disturbance. Delirium incidence showed a trend toward association with increased functional disability in the year following discharge.
Defining and Certifying Diversity: Affirmative Action

This article is a chapter of my forthcoming book Diversity in America: Keeping Government at a Safe Distance (Harvard U. P., early 2003). The book also contains chapters on a conceptualization/taxonomy of diversity ("The Diversity of Diversity"), an intellectual history of diversity-as-ideal (just published as "The Perceived Values of Diversity, Then and Now," 22 Cardozo L. Rev. 1915 (2001)), and chapters analyzing the law and policy governing immigration-related diversity, diversity in residential communities, and religious diversity. There are also introductory and concluding chapters. This article consists of ten sections: (1) an introduction; (2) the definitions, designs, and domains of affirmative action; (3) the importance of context in assessments of affirmative action; (4) the size of affirmative action preferences in different domains, especially higher education; (5) rationales and counter-rationales for ethno-racial preferences (restitution, merit, anti-caste, leadership cadre, market failure, institutional pragmatism, and diversity); (6) the politics of affirmative action (political history, public attitudes, and political survival); (7) the consequences of affirmative action (rate of black progress, distribution of benefits in and outside the favored group, and incidence and distribution of costs); (8) the re-segregation nightmare; (9) alternatives (better targeting within favored groups, disadvantage-based preferences, lottery, addressing root causes, time-limited programs, and voluntary programs); and (10) a conclusion. Prescriptively, I argue that whether or not the diversity rationale for legally-mandated ethno-racial preferences in higher education (and probably elsewhere) can pass constitutional muster (apart from the narrow opening under the Court's Paradise test), public law preferences are unjust and unwise, and are steadily becoming more so. Private preferences, however, are acceptable if the entities using them publicly disclose the nature and magnitude of those preferences and do not discriminate against blacks and other minorities entitled to the highest level of protection under the Constitution.
Reactivity of Isopropanol On H-Zsm-5 By in Situ, Flow Nmr MOnitoring

Abstract The first use of flow NMR for the study of heterogeneous reactions is reported. A NMR flow cell packed with H-ZSM-5 acts as a fixed bed reactor. Continuous flow of 13 C enriched isopropanol vapor diluted 1n N 2 or Xe is contacted with the catalyst at temperatures from 100–180°C. Reaction products are collected and analyzed. 13 C and 129 Xe NMR monitoring of the reaction zone is accomplished with a JEOL FX200 spectrometer. Acid catalyzed dehydration of isopropanol is observed at temperatures above 100°C.
Policy Challenges for the 1990s and Beyond

This volume has sketched out some of the complexities of analyzing, formulating, and coordinating the science and technology policies of interdependent industrial and industrializing economies. Building on my earlier arguments, this chapter briefly considers two future policy challenges: (1) developing technology policies to improve national innovative performance and (2) reducing the international frictions produced by the interaction of the domestic technology policies of independent states. The response of United States and other nations’ policymakers to these challenges will influence the future of the global trading system as well as the living standards of the citizens of the global economy of the twenty-first century.
Trends in and Predictors of Carbapenem Consumption across North American Hospitals: Results from a Multicenter Survey by the MAD-ID Research Network.

We sought to define trends in and predictors of carbapenem consumption across community, teaching, and university-affiliated hospitals in the United States and Canada. We conducted a retrospective multicenter survey of carbapenem and broad-spectrum noncarbapenem beta-lactam consumption between January 2011 and December 2013. Consumption was tabulated as defined daily doses (DDD) or as days of therapy (DOT) per 1,000 patient days (PD). Multivariate mixed-effects models were explored, and final model goodness of fit was assessed by regressions of observed versus predicted values and residual distributions. A total of 20 acute-care hospitals responded. The centers treated adult patients (n = 19/20) and pediatric/neonatal patients (n = 17/20). The majority of the centers were nonprofit (n = 17/20) and not affiliated with medical/teaching institutions (n = 11/20). The median (interquartile range [IQR]) carbapenem consumption rates were 38.8 (17.4 to 95.7) DDD/1,000 PD and 29.7 (19.2 to 40.1) DOT/1,000 PD overall. Carbapenem consumption was well described by a multivariate linear mixed-effects model (fixed effects, R2 = 0.792; fixed plus random effects, R2 = 0.974). Carbapenem consumption increased by 1.91-fold/quarter from 48.6 DDD/1,000 PD (P = 0.004) and by 0.056-fold/quarter from 45.7 DOT/1,000 PD (P = 0.93) over the study period. Noncarbapenem consumption was independently related to increasing carbapenem consumption (beta = 0.31 for increasing noncarbapenem beta-lactam consumption; P < 0.001). Regular antibiogram publication and promotion of conversion from intravenous (i.v.) to oral (p.o.) administration independently affected carbapenem consumption rates. In the final model, 58.5% of the observed variance in consumption was attributable to between-hospital differences. Rates of carbapenem consumption across 20 North American hospitals differed greatly, and the observed differences were correlated with hospital-specific demographics. Additional studies focusing on the drivers of hospital-specific carbapenem consumption are needed to determine whether these rates are justifiable.
The Social Construction of Multiple Personality Disorder

In the first part of this paper, the senior author (SJL) provides a first-person account of his observations as a supervising psychologist at a state mental hospital that specialized in the treatment of multiple personality disorder (MPD). These observations encompass a fertile and influential period in the history of the evolving conceptualization and treatment of serious dissociative disorders. In the second part of the paper, Judith Pintar and the senior author maintain that MPD can be understood in terms of the way narratives of multiplicity are embedded in social interactions and emerge within the discourse of a psychotherapeutic relationship. The paper retains the conversational tone adopted in presenting an earlier version of the manuscript as a spoken commentary on Sherrill Mulhern’s talk on the topic of sociocultural factors in the treatment of multiple pesonality disorders.
Thoughts on Engineering Creativity [Point of View]

This short article deals with engineering creativity. In a recent public radio program, creativity was defined as “the ability to generate innovation which works.” For engineering creativity, I would make it more specific: it is the ability to change the direction of technological progress drastically and beneficially, or the ability to induce an inflection point in the development of some engineering field. I shall describe here a few examples of creative ideas that I encountered in my area (analog signal processing and data converters) during my long career in the field. I shall start with some sobering thoughts about the limited range of engineering (indeed, of human) creativity.
Intertemporal variation in the information content of aggregate earnings and its effect on the aggregate earnings-return relation

We develop and test explanations for sources of intertemporal variation in the information content of aggregate earnings and how that variation explains variation in the relation between aggregate earnings growth and market returns over time. We find that the correlation between aggregate earnings growth and leading market-wide real output shocks (measured by the growth in the Federal Reserve Board’s index of industrial production) becomes more pronounced in the 1990s and 2000s, which explains why the aggregate earnings-return relation is significantly positive in this period. Further analysis shows that an increasingly positive relation between aggregate earnings growth and real output shocks is attributable to the changing nature of the economic activity in the United States, namely, a shift in the composition of firms toward financial services and away from manufacturing. Changes in accounting measurement rules over time to include more fair value estimates also play a role in explaining why the aggregate earnings–return relation has become significantly positive in recent decades.
CHAPTER V – Shape Operators

Publisher Summary This chapter discusses shape operators. The chapter reviews the analogous measurement problem for surfaces. The shape of a surface M in E3 is described infinitesimally by a certain linear operator S defined on each of the tangent planes of M. As with curves, to say that two surfaces in E3 have the same shape means simply that they are congruent. Just as with curves, the chapter justifies the infinitesimal measurements by proving that two surfaces with “the same” shape operators are congruent. Thus, the algebraic invariants (determinant, trace,…) of its shape operators have geometric meaning for the surface M. From the viewpoint of linear algebra, a symmetric linear operator on a two-dimensional vector space is a very simple object. The Gaussian curvature is reviewed. The determinant and trace of a linear operator may be defined as the common value of the determinant and trace of all its matrices.
Evaluation of the performance for a dynamic insulation system suitable for switchable building envelope

Abstract This paper evaluates a prototype of dynamic insulation systems (DIS) suitable for switchable building envelope to minimize heating and cooling thermal loads while maintaining indoor thermal comfort. The thermal performance of the novel DIS prototype has been evaluated through both experimental and numerical analyses when applied to an opaque wall section. The DIS prototype is able to vary continuously the R-value of the building envelope using rotating insulation layers controlled through an actuator to a specific angle depending on the desired thermal resistance level. The experimental testing showed that the prototype DIS provides a significant reduction of over 50% of the wall R-value when the insulation layers no longer overlap due to the increased convection inside the wall cavity. The CFD analysis predictions, matching the experimental results, demonstrate that the DIS prototype offers a simple design option that can be easily controlled and modulated to adjust the R-value of the building envelop based on the angle of the insulation layers. The CFD analysis also showed that the DIS performance depends on several design features including the depth of the wall cavity as well as the width and the thickness of the insulation layers.
Chapter 7 – Ignition

Chemical chain and thermal ignition phenomena are described. The thermal theories of Semenov and Frank-Kamenetskii are developed for analysis of the criteria for spontaneous ignition. Forced ignition by sparks and the concept of minimum ignition energy are presented as well as ignition by adiabatic compression and shock waves. Other specialized ignition processes, such as hypergolicity, pyrophoricity, and catalytically assisted ignition, are introduced.
Intrathrombus Fibrin Attenuates Spatial Sorting of Phosphatidylserine Exposing Platelets during Clotting Under Flow.

Background As thrombosis proceeds, certain platelets in a clot expose phosphatidylserine (PS) on their outer membrane. These PS+ platelets subsequently sort to the perimeter of the mass via platelet contraction. It remains unclear how thrombin and fibrin may alter PS+ platelet sorting within a clot. Objective We investigated the role of fibrin in PS+ platelet sorting. Methods We used an 8-channel microfluidic assay of clotting over collagen (±tissue factor) at 100 s−1 initial wall shear rate. Temporal PS+ platelet sorting was measured using a Pearson's correlation coefficient between the annexin V distribution in a clot at 9 versus 15 minutes. Spatial PS+ platelet sorting was measured using an autocorrelation metric of the final annexin V distribution. Results By 6 minutes, PS+ platelets were distributed throughout the platelet deposits and became highly spatially sorted by 15 minutes when thrombin and fibrin were blocked with Phe-Pro-Arg-chloromethylketone (PPACK). Fibrin polymerization (no PPACK) attenuated temporal and spatial PS sorting and clot contraction. With Gly-Pro-Arg-Pro (GPRP) added to block fibrin polymerization, PS sorting was prominent as was clot contraction. Exogenously added tissue plasminogen activator drove fibrinolysis that in turn promoted clot contraction and PS sorting, albeit to a lesser degree than the PPACK or GPRP conditions. Clots lacking fibrin displayed 3.6 times greater contraction than clots with fibrin. Conclusion PS sorting correlated with clot contraction, as previously reported. However, fibrin inversely correlated with both percent contraction and PS sorting. Fibrin attenuated clot contraction and PS sorting relative to clots without fibrin.
Graves' Thyrotoxicosis Following SARS-CoV-2 Infection.

Abstract Objective Graves' disease is an autoimmune thyroid disease that is thought to develop following environmental exposure in patients with genetic predisposition. Our objective is to present the first report of Graves' disease onset immediately following recovery from mild coronavirus disease 2019 (COVID-19), a close temporal occurrence that should be studied further. Methods We describe the clinical course and laboratory features, including thyroid function studies, antibody testing, and polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2. Results A 21-year-old woman with prediabetes, obesity, asthma, and gastroesophageal reflux disease presented to the emergency department reporting 3 days of tachycardia, palpitations, anxiety, and shortness of breath. Laboratory investigation revealed a thyroid-stimulating hormone level of 0.01 (0.30-5.00) mcIU/mL with a free thyroxine level of 3.8 (0.6-1.6) ng/dL, prompting endocrinology consultation. On physical examination, she had mild diffuse thyromegaly without tenderness and a history, which included hypothyroidism in her mother. Antibody testing results demonstrated thyroid-stimulating immunoglobulin and thyrotropin receptor antibody levels of 2.6 ( Conclusion This case documents the occurrence of Graves' thyrotoxicosis following mild symptomatic COVID-19. Whether the preceding infection is coincidental or contributed to GD development requires definitive studies. This presentation may align with the theory of a viral link in the development of autoimmune thyroid disease in those with genetic predisposition.
Large Granular Lymphocytosis With Cytopenias After Allogeneic Blood or Marrow Transplantation: Clinical Characteristics and Response to Immunosuppressive Therapy.

ABSTRACT Large granular lymphocytosis (LGL)—or LGL leukemia—is a T- or NK-cell lymphoproliferative disorder that often results in cytopenias and autoimmune phenomena. Several studies have described LGL in a subset of patients after allogeneic blood or marrow transplantation (alloBMT), almost exclusively in the setting of asymptomatic lymphocytosis. Some have suggested an association with improved transplant-related outcomes. In contrast, clinically significant LGL after alloBMT is only described in small case reports. This study sought to assess the characteristics, significance, and response to treatment of LGL associated with unexplained anemia, thrombocytopenia, or neutropenia after alloBMT. We performed a retrospective analysis of 150 patients who were evaluated for LGL by peripheral blood flow cytometry (LGL flow) for unexplained cytopenias following initial engraftment after alloBMT from January 1 2012 to July 1, 2019. We identified patients with abnormally increased populations of LGL cells (LGL+) as assessed by Johns Hopkins Hematopathology. We collected demographic, transplantation, and LGL treatment information from electronic medical records. We compared LGL+ patients to patients with unexplained cytopenias with negative flow cytometry for LGL (LGL−) in this cohort. We also assessed change in blood counts after 4 weeks of immunosuppressive therapy in LGL+ patients. Cytopenias occurred at a median of 5.7 months (range 1-81) after alloBMT. The majority of the transplants were nonmyeloablative from haploidentical donors, and all patients received post-transplantation cyclophosphamide for graft-versus-host disease prophylaxis, consistent with the overall alloBMT characteristics at our center. We identified 70 patients with LGL and cytopenias, representing 47% of those evaluated by flow cytometry. There were no significant demographic or transplant-related differences between LGL+ patients and LGL− patients. The median age was 59, and 63% were male. LGL+ patients were more likely to have had cytomegalovirus (CMV) viremia (73% versus 28%, P
Telemedicine experience of NYC Internal Medicine residents during COVID-19 pandemic.

Background The COVID-19 pandemic challenged the resilience of public health, including diagnostic testing, antiviral development and transmission prevention. In addition, it also affected the medical education of many residents and learners throughout the country. Historically, physicians undergoing their residency training were not involved in telemedicine. However, in response to the challenges faced due to COVID-19, the Accreditation Council for Graduate Medical Education (ACGME) released a provision in May 2020 to allow residents to participate in telemedicine. Method Lincoln Medical Center, located in the South Bronx of New York City, currently has 115 Internal Medicine residents, and telemedicine clinic visits have been conducted by residents since June 2020. An anonymous 25-question survey was sent to all Internal Medicine residents between August 8, 2020 to August 14, 2020. Result Of 115 residents, 95 (82.6% of the residents) replied to this questionnaire. Residents revealed feeling less confident in managing chronic diseases through telemedicine visits. The survey also shows that 83.1% of respondents prefer in-person visits during their training, 65.3% feel that the telemedicine experience will affect their future career choice, and 67.4% would prefer less than 50% of visits to be telemedicine in their future careers. Outcome The purpose of the new ACGME rules allowing telemedicine was to prevent the undertraining of residents and maintain health care for the patient during the COVID-19 pandemic. This affects residency training and the experiences of residents, which in turn can influence their future career plans.
Utility of CT in the workup of adults with sore throat in the emergency department

Abstract Objective The goal of this study was to determine if computed tomography (CT) added any clinical information that was incorporated into the decision regarding treatment for patients who presented to the Emergency Department (ED) with sore throat. Methods A retrospective chart review of adult patients who presented to the ED with a chief complaint of sore throat who subsequently underwent CT during that ED visit between 1/1/18 and 12/31/18 at our tertiary academic health center was performed. The association between palatal bulge on Otolaryngology physical exam with successful drainage procedure was examined. The mean Hounsfield units (HU) and maximum dimension of measurable fluid collection on CT were compared between patients who underwent a successful drainage procedure and those who did not undergo a drainage procedure or attempted drainage was unsuccessful. Results Ninety-four patients met inclusion criteria, with 53% (50/94) men. Of the 22 patients with a palatal bulge on physical examination by Otolaryngology, 86% (19/22) underwent a successful drainage procedure (p Conclusion Palatal bulge is a reliable finding in identifying patients with a drainable peritonsillar abscess, and CT scans could largely be avoided in patients without physical exam findings suggestive of more extensive deep neck space abscesses. If a CT scan is obtained, HU should be measured and incorporated into the shared decision-making process with the patient.
A Review of Formaldehyde Sensitivity and Toxicity

This book is an excellent compendium of studies related to the potential toxic effects of formaldehyde. Although the majority of chapters deal with allergenicity and other effects on the skin and respiratory tract, there is a broad base of information on formaldehyde chemistry, on quantitation of exposure, and on other acute and chronic cffccts in humans and animals. The author has surveyed the literature in these areas, but also has added valuable interpretation of the results. In most cases, anecdotal data are differentiated from results of controlled scientific studies. However, the overwhelming number of uncontrolled studies may bias the casual reader towards their results.
Speech, Spouses, and Standing: Is There Standing to Sue When Sanctions Threatened Against One's Spouse Chill Protected Expression?

, When a public employee's spouse forgoes expression protected by the First Amendment for fear of direct, employment-related sanctions against the public employee, the spouse has suffered a chilling injury. Courts are split on whether such injuries constitute injuries in fact sufficient for standing, however. This Note explores chilling injuries as a basis for standing and suggests that the tests courts employ to determine whether chilling injuries are injuries in fact are inconsistently applied and inadequately protect First Amendment rights. This Note argues that courts should focus on the choice at the heart of any chilling injury: the choice between forgoing protected expression or suffering consequences. One should have standing to sue when government action forces one to make an intolerably difficult choice of whether to engage in protected
Adam Smith, Aristotle, and the Virtues of Commerce

Etude de la conception des vertus du commerce developpee par A. Smith dans «The wealth of nations» (1976) a partir de la definition aristocratique des vertus chez Aristote. Defendant les vertus de justice, prudence, maitrise de soi et bienfaisance universelle, fondees sur l'idee de sympathie, dans le cadre de la societe commerciale et de l'economie de la libre-entreprise, Smith partage avec Aristote la dimension sociale des vertus individuelles, l'idee de magnanimite vertueuse et les vertus particulieres ordonnees a la generosite et a la liberalite, mais il elabore une theorie pratique depourvue de tout telos et definit la morale comme critere du bien-etre economique
Visceral myopathy of the gastrointestinal and genitourinary tracts in infants

Abstract We describe 4 infants who had chronic intestinal pseudoobstruction caused by visceral myopathy. Three of the 4 were girls. Two were symptomatic at birth and 2 were symptomatic by 3 wk of age. All had abdominal distention and emaciation, 3 of the 4 had severe obstipation and fecal impactions, and 3 had signs of urologic obstruction. All had gaseous distention of the small bowel and colon, and barium studies showed dilated small bowel and colon, with slow transport through the small intestine. Two of 3 had enlarged stomachs and slowed gastric emptying, and 3 had dilated bladders and ureters. The 1 infant studied by esophageal manometry had absence of esophageal contractions. Despite total parenteral nutrition in 3, all died within 10–18 mo. The pathologic features of visceral myopathy were identified in variable sample sites from the esophagus, stomach, small intestine, colon, bladder, and ureter of the 4 infants. Of 170 family members related to 3 of the infants, there was no consanguinity and no one appeared to be clinically affected. Thus, an infantile form of visceral myopathy exists which, pathologically, is identical to the familial and sporadic forms of visceral myopathy previously identified in adolescents and adults.
Should U.S. Fiscal Policy Address Slow Growth or the Debt? A Nondilemma

The United States faces two economic challenges: slow growth and an ever-increasing ratio of debt to GDP. Many policymakers believe they face a dilemma because the policy solutions to the two problems are opposite. To address the slow recovery, standard — Keynesian — economics suggests further fiscal stimulus in the form of lower taxes or higher spending. But that recommendation runs head-first into the economy’s second crucial challenge, the long-run fiscal imbalance. Yet policymakers are wrong to see this as a dilemma. The Keynesian model does not evaluate government expenditure using the standard microeconomic concepts of economic efficiency (cost-benefit analysis); rather, it assumes that all expenditure is beneficial. Some government purchases, however, are not a productive use of resources, and transfer payments distort economic incentives and thus can reduce economic output. In contrast, broad-based tax cuts, especially those that lower marginal tax rates, enhance economic growth. The implication is that tax cuts are the most appealing kind of fiscal stimulus because they are beneficial on both Keynesian and efficiency grounds. Higher transfers and government purchases — increased expenditures — are questionable because any Keynesian benefits must be balanced against potentially large efficiency costs. Thus the United States should cut unproductive expenditures while keeping tax rates low. A high deductible for Medicare would save money and improve the efficiency of the health care market. With rising life expectancies, Social Security is more generous than necessary to accomplish any reasonable goal of the program. Much military spending goes to programs not related to the defense of the United States. Business subsidies, drug prohibition, and pork-barrel spending should be cut. The United States therefore has a simple path to a brighter economic future: slash expenditures and keep tax rates low. Reducing expenditures will improve the debt outlook and make the economy more productive, implying higher levels of output and further debt reductions for any given tax rates. Keeping tax rates low will improve the incentives for labor effort, savings, and entrepreneurship, which promotes a more productive economy.
Legume-based cropping systems have reduced carbon and nitrogen losses

In agricultural systems, optimization of carbon and nitrogen cycling through soil organic matter can improve soil fertility and yields while reducing negative environmental impact. A basic tenet that has guided the management of soil organic matter for decades has been that equilibrium levels of carbon and nitrogen are controlled by their net input and that qualitative differences in these inputs are relatively unimportant1,2,3. This contrasts with natural ecosystems in which there are significant effects of species composition and litter quality on carbon and nitrogen cycling4,5. Here we report the net balances of carbon and nitrogen from a 15-year study in which three distinct maize/soybean agroecosystems are compared. Quantitative differences in net primary productivity and nitrogen balance across agroecosystems do not account for the observed changes in soil carbon and nitrogen. We suggest that the use of low carbon-to-nitrogen organic residues to maintain soil fertility, combined with greater temporal diversity in cropping sequences, significantly increases the retention of soil carbon and nitrogen, which has important implications for regional and global carbon and nitrogen budgets, sustained production, and environmental quality.