cssi/SciSciGPT-SciSciNet huggingface dataset:
Utility of Supine Lateral Radiographs for Assessment of Lumbar Segmental Instability in Degenerative Lumbar Spondylolisthesis.

Study design Retrospective chart review OBJECTIVE.: To determine whether supine lateral radiographs increase the amount of segmental instability visualized in single-level lumbar degenerative spondylolisthesis, when compared to traditional lateral flexion-extension radiographs. We hypothesized that supine radiographs increase the amount of segmental instability seen in single-level lumbar spondylolisthesis when compared to flexion-extension. Summary of background data Accurate evaluation of segmental instability is critical to the management of lumbar spondylolisthesis. Standing flexion-extension lateral radiographs are routinely obtained, as it is believed to precipitate the forward-backward motion of the segment; however, recent studies with magnetic resonance imaging and computed tomography have shown that the relaxed supine position can facilitate the reduction of the anterolisthesed segment. Here, we show that inclusion of supine lateral radiographs increases the amount of segmental instability seen in single-level lumbar spondylolisthesis when compared to traditional lateral radiographs. Methods Supine lateral radiographs were added to the routine evaluation (standing neutral/flexion/extension lateral radiographs) of symptomatic degenerative spondylolisthesis at our institution. In this retrospective study, 59 patients were included. The amount of listhesis was measured and compared on each radiograph: standing neutral lateral ("neutral"), standing flexion lateral ("flexion"), standing extension lateral ("extension"), and supine lateral ("supine"). Results A total of 59 patients (51 women, 8 men), with a mean age of 63.0 years (±9.85 yr) were included. The mean mobility seen with flexion-extension was 5.53 ± 4.11. The mean mobility seen with flexion-supine was 7.83% ± 4.67%. This difference was significant in paired t test (P = 0.00133), and independent of age and body mass index. Maximal mobility was seen between flexion and supine radiographs in 37 patients, between neutral and supine radiographs in 11 cases, and between traditional flexion-extension studies in 11 cases. Conclusion Supine radiograph demonstrates more reduction in anterolisthesis than the extension radiograph. Incorporation of a supine lateral radiograph in place of extension radiograph can improve our understanding of segmental mobility when evaluating degenerative spondylolisthesis. Level of evidence 3.
Anisotropic magnetoresistance in Ga 1 − x Mn x As

We have measured the magnetoresistance in a series of ${\mathrm{Ga}}_{1\ensuremath{-}x}{\mathrm{Mn}}_{x}\mathrm{As}$ samples with $0.033l~xl~0.053$ for three mutually orthogonal orientations of the applied magnetic field. The spontaneous resistivity anisotropy (SRA) in these materials is negative (i.e., the sample resistance is higher when its magnetization is perpendicular to the measuring current than when the two are parallel) and has a magnitude on the order of 5% at temperatures near 10 K and below. This stands in contrast to the results for most conventional magnetic materials where the SRA is considerably smaller in magnitude for those few cases in which a negative sign is observed. The magnitude of the SRA drops from its maximum at low temperatures to zero at ${T}_{C}$ in a manner that is consistent with mean-field theory. These results should provide a significant test for emerging theories of transport in this new class of materials.
The quality of numerical software: assessment and enhancement

In this chapter we provide some background on the conference which brought together the researchers whose work is described in this volume. Further information, including access to transparencies and audio recordings of some of the talks, are available at the conference World Wide Web site: http://renoir.csc.ncsu.edu/IFIP/WoCo7/.
Special Production Structures

In this chapter we impose two sets of constraints on the technology, namely a piecewise linear form and a set of scaling law constraints. Many production technologies can be conceptualized as the interaction of a finite number of production sub-technologies called activities. In Section 4.1 we develop the activity analysis structure, starting with a piecewise linear model that satisfies constant returns to scale and strong disposability of inputs and outputs. This structure is then generalized to allow for variable returns to scale and weak but not necessarily strong input and output disposability.
Abstract WP38: High Rates of Conversion of Anesthesia Modality in Agitated Thrombectomy Patients

Background: Patients with large vessel occlusion acute ischemic stroke (AIS) undergoing thrombectomy can be disruptively agitated. We aimed to determine if procedural and neurological outcomes diff...
Seroprevalence of Strongyloides stercoralis and Evaluation of Universal Screening in Kidney Transplant Candidates: A Single-Center Experience in Houston (2012-2017).

BACKGROUND Disseminated strongyloidiasis in solid organ transplant recipients is a rare but devastating infection. In our center, we implemented a universal screening of all candidates for kidney transplantation. We assessed the seroprevalence and utility of universal screening for strongyloidiasis in our center. METHODS Patients were identified from our transplant referral list (from July 2012 to June 2017). Demographics, pretransplant laboratory, and serological screenings were retrospectively collected. For Strongyloides-seropositive (SSp) patients, data on travel history, symptoms, treatment, and stool ova and parasite examinations were extracted. Logistic regression and multiple imputation for missing data were performed. RESULTS A total of 1689 patients underwent serological screening, of whom 168 (9.9%) were SSp. Univariate analysis revealed that SSp patients had higher rates of eosinophilia, diabetes mellitus, latent tuberculosis and were likely to be either Hispanic or Asian (P < .05). In multivariate analysis, eosinophilia (P = .01), diabetes mellitus (P = .02), and Asian race (P = .03) were associated with being SSp, but 45 (27%) of the SSp patients did not have any of these 3 factors, and 18 SSp patients (11%) had no epidemiological risk factors. All patients received ivermectin, and none developed disseminated strongyloidiasis. Of patients who underwent serological screening on multiple occasions, 6.8% seroconverted while waiting for kidney transplantation. CONCLUSIONS We found a high rate of Strongyloides seropositivity among our kidney transplantation candidates. No epidemiological risk factors effectively predicted SSp status in our population, and universal screening identified a large number of patients without such factors. Serial screening should be considered when a long wait time is expected before transplantation.
Health Equity and Implementation Science in Heart, Lung, Blood, and Sleep-Related Research: Emerging Themes From the 2018 Saunders-Watkins Leadership Workshop.

Disparities in health outcomes for heart, lung, blood, and sleep-related health conditions are pervasive in the United States, with an unequal burden experienced among structurally disadvantaged po...
Capturing intrinsic site-dependent spectral signatures and lifetimes of isolated OH oscillators in extended water networks.

The extremely broad infrared spectrum of water in the OH stretching region is a manifestation of how profoundly a water molecule is distorted when embedded in its extended hydrogen-bonding network. Many effects contribute to this breadth in solution at room temperature, which raises the question as to what the spectrum of a single OH oscillator would be in the absence of thermal fluctuations and coupling to nearby OH groups. We report the intrinsic spectral responses of isolated OH oscillators embedded in two cold (~20 K), hydrogen-bonded water cages adopted by the Cs+·(HDO)(D2O)19 and D3O+·(HDO)(D2O)19 clusters. Most OH oscillators yield single, isolated features that occur with linewidths that increase approximately linearly with their redshifts. Oscillators near 3,400 cm−1, however, occur with a second feature, which indicates that OH stretch excitation of these molecules drives low-frequency, phonon-type motions of the cage. The excited state lifetimes inferred from the broadening are considered in the context of fluctuations in the local electric fields that are available even at low temperature. The broad infrared spectrum of water in the OH stretching region shows how significantly a water molecule is distorted when within a hydrogen-bonding network; it also raises the question of what the spectrum of a single OH oscillator would be. Now, the spectral signatures of isolated OH oscillators embedded in cold water cages have been measured using vibrational spectroscopy.
Web page classification: a survey of perspectives, gaps, and future directions

The explosive growth of the amount of information on Internet has made Web page classification essential for Web information management, retrieval, and integration, Web page indexing, topic-specific Web crawling, topic-specific information extraction models, advertisement removal, filtering out unwanted, futile, or harmful contents, and parental control systems. Owing to the recent staggering growth of performance and memory space in computing machines, along with specialization of machine learning models for text and image classification, many researchers have begun to target the Web page classification problem. Yet, automatic Web page classification remains at its early stages because of its complexity, diversity of Web pages’ contents (images of different sizes, text, hyperlinks, etc.), and its computational cost. This paper not only surveys the proposed methodologies in the literature, but also traces their evolution and portrays different perspectives toward this problem. Our study investigates the following: (a) metadata and contextual information surrounding the terms are mostly ignored in textual content classification, (b) the structure and distribution of text in HTML tags and hyperlinks are understudied in textual content classification, (c) measuring the effectives of features in distinguishing among Web page classes or measuring the contribution of each feature in the classification accuracy is a prominent research gap, (d) image classification methods rely heavily on computationally intensive and problem-specific analyses for feature extraction, (e) semi-supervised learning is understudied, despite its importance in Web page classification because of the massive amount of unlabeled Web pages and the high cost of labeling, (f) deep learning, convolutional and recurrent networks, and reinforcement learning remain underexplored but intriguing for Web page classification, and last but not least (g) developing a detailed testbed along with evaluation metrics and establishing standard benchmarks remain a gap in assessing Web page classifiers.
Restricted Entropy and Spectrum Properties for the Compressively Sensed Domain in Hyperspectral Imaging

The restricted isometry property (RIP) and restricted conformal property (RCP) are two fundamental properties widely used in compressive sensing (CS) for sampling sparse signals. These two properties are sufficient to preserve the magnitude of a signal vector and the angle between two signal vectors in the compressively sensed band domain (CSBD), respectively. This article derives two new CS properties for hyperspectral signal vectors (HSVs), to be called the restricted entropy property (REP) and restricted spectrum property (RSP), which can be shown to preserve the entropy of an HSV and the spectral similarity between two HSVs in CSBD in correspondence to RIP and RCP, respectively. These two properties enable hyperspectral analysis algorithms to be directly applied to CSBD without loss of data integrity, while the dimensionality of CSBD can be considerably reduced. Most importantly, REP and RSP preserve exploitation algorithm performance without the need for decompression so as to avoid specifying a sparse basis.
Addressing General Surgery Residents' Concerns in the Early Phase of the COVID-19 Pandemic.

Objective The purpose of this study was to determine the concerns of General Surgery residents as they prepare to be in the frontlines of the response against coronavirus disease 2019 (COVID-19_). Design, Setting, and Participants A qualitative study with voluntary dyadic and focus group interviews with a total of 30 General Surgery residents enrolled at 2 academic medical centers in Boston, Massachusetts was conducted between March 12 to 16, 2020. Results The most commonly reported personal concern related to the COVID-19 outbreak was the health of their family (30 of 30 [100%]), followed by the risk of their transmitting COVID-19 infection to their family members (24 of 30 [80%]); risk of their transmitting COVID-19 infection their patients (19 of 30 [63%]); anticipated overwork for taking care of a high number of patients (15 of 30 [50%]); and risk of their acquiring COVID-19 infection from their patients (8 of 30 [27%]) . The responses were comparable when stratified by sex, resident training level, and residency program. All residents self-expressed their readiness to take care of COVID-19 patients despite the risk of personal or familial harm . To improve their preparedness, they recommend increasing testing capacity, ensuring personal protective equipment availability, and transitioning to a shift schedule in order to minimize exposure risk and prevent burnout. Conclusions General Surgery residents are fully dedicated to taking care of patients with COVID-19 infection despite the risk of personal or familial harm. Surgery departments should protect the physical and psychosocial wellbeing of General Surgery residents in order to increase their ability to provide care in the frontlines of the COVID-19 pandemic.
Optical Generation of Coherent Ultrahigh Frequency Surface Waves

It has been demonstrated [1–4] that coherent bulk acoustic waves can be holographically induced by the interference pattern of two intersecting picosecond laser pulses. The coupling between the optical and elastic fields can either be due to electrostriction or optical absorption which produces thermal stresses. The resulting waveform can then be detected by a third time-delayed laser pulse which diffracts off the density grating of the wave field. The elastic response within the laser spot caused by either coupling mechanism has been shown to consist of 1-D counter-propagating pressure waves. From the frequency and attenuation of the diffracted signal, the wavespeed and attenuation coefficient, respectively, of the medium can be obtained.
Protocol for a mechanistic study of mindfulness based cognitive therapy during pregnancy.

Objective Preventive interventions for postpartum depression (PPD) are critical for women at elevated risk of PPD. Mindfulness based cognitive therapy - perinatal depression (MBCT-PD) is a preventive intervention that has been shown to reduce risk for PPD in women with a prior history of depression. The objective of this clinical trial is to examine two potential mechanisms of action of MBCT-PD, emotion regulation and cognitive control, using behavioral and neuroimaging methods. Method This baseline protocol describes a randomized control trial (RCT) with two arms, MBCT-PD and treatment as usual (TAU). We plan on enrolling 74 females with a prior history of a major depressive episode, with 37 participants randomized to each arm. Participants in the MBCT-PD arm will receive MBCT-PD during pregnancy, and the TAU group will receive standard prenatal care. All participants will complete the Center for Epidemiological Studies Depression Scale - Revised (CESD-R), Emotion Regulation Questionnaire (ERQ), and classic Stroop task at multiple points from pregnancy through six months postpartum. Participants will also complete an fMRI scan at six weeks postpartum. Results All primary outcomes are collected at six weeks postpartum. Primary behavioral outcomes include: depressive symptoms on the CESD-R, cognitive reappraisal on the ERQ, and Stroop task performance. In parallel, the primary neurobiological outcomes include whole-brain activation during fMRI tasks when participants 1) regulate emotional responding and 2) engage cognitive control. Conclusions This results of this innovative RCT will help identify potential behavioral and neurobiological mechanisms of action of preventive interventions for PPD for in-depth examination in larger scale RCTs. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
A Schwarzschild-like model for baryons

We present a toy model of baryons using singular solutions of the SU(2) Yang-Mill-Higgs (YMH) field equations, which bears some similarity to the Schwarzschild solution of general relativity. The SU (2) solutions are used as a background field into which a scalar, SU (2) test particle is placed. This can be compared to placing an electrically charged particle in a Coulomb background field, except the SU (2) YMH solutions are singular on a spherical membrane thus trapping (confining) the test particle inside the sphere in a manner similar to certain bag models of baryons. An interesting consequence of this model is that the composite system is a fermion even though the original Lagrangian contains only bosonic fields.
Development and Assessment of a Systematic Approach for Detecting Disparities in Surgical Access.

Importance Although optimal access is accepted as the key to quality care, an accepted methodology to ascertain potential disparities in surgical access has not been defined. Objective To develop a systematic approach to detect surgical access disparities. Design, Setting, and Participants This cross-sectional study used publicly available data from the Health Cost and Utilization Project State Inpatient Database from 2016. Using the surgical rate observed in the 5 highest-ranked counties (HRCs), the expected surgical rate in the 5 lowest-ranked counties (LRCs) in North Carolina were calculated. Patients 18 years and older who underwent an inpatient general surgery procedure and patients who underwent emergency inpatient cholecystectomy, herniorrhaphy, or bariatric surgery in 2016 were included. Data were collected from January to December 2016, and data were analyzed from March to July 2020. Exposures Health outcome county rank as defined by the Robert Wood Johnson Foundation. Main Outcomes and Measures The primary outcome was the proportional surgical ratio (PSR), which was the disparity in surgical access defined as the observed number of surgical procedures in the 5 LRCs relative to the expected number of procedures using the 5 HRCs as the standardized reference population. Results In 2016, approximately 1.9 million adults lived in the 5 HRCs, while approximately 246 854 lived in the 5 LRCs. A total of 28 924 inpatient general surgical procedures were performed, with 4521 being performed in those living in the 5 LRCs and 24 403 in those living in the 5 HRCs. The rate of general surgery in the 5 HRCs was 13.09 procedures per 1000 population. Using the 5 HRCs as the reference, the PSR for the 5 LRCs was 1.40 (95% CI, 1.35-1.44). For emergent/urgent cholecystectomy, the PSR for the 5 LRCs was 2.26 (95% CI, 2.02-2.51), and the PSR for emergent/urgent herniorrhaphy was 1.83 (95% CI, 1.33-2.45). Age-adjusted rate of obesity (body mass index [calculated as weight in kilograms divided by height in meters squared] greater than 30), on average, was 36.6% (SD, 3.4) in the 5 LRCs vs 25.4% (SD, 4.6) in the 5 HRCs (P = .002). The rate of bariatric surgery in the 5 HRCs was 33.07 per 10 000 population with obesity. For the 5 LRCs, the PSR was 0.60 (95% CI, 0.51-0.69). Conclusions and Relevance The PSR is a systematic approach to define potential disparities in surgical access and should be useful for identifying, investigating, and monitoring interventions intended to mitigate disparities in surgical access that effects the health of vulnerable populations.
Hospital-acquired Clostridioides difficile infection among patients at an urban safety-net hospital in Philadelphia: Demographics, neighborhood deprivation, and the transferability of national statistics.

Objective: To investigate associations between healthcare-associated Clostridioides difficile infection and patient demographics at an urban safety-net hospital and compare findings with national surveillance statistics. Methods: Study participants were selected using a case-control design using medical records collected between August 2014 and May 2018 at Hahnemann University Hospital in Philadelphia. Controls were frequency matched to cases by age and length of stay. Final sample included 170 cases and 324 controls. Neighborhood-level factors were measured using American Community Survey data. Multilevel models were used to examine infection by census tract, deprivation index, race/ethnicity, insurance type, referral location, antibiotic use, and proton-pump inhibitor use. Results: Patients on Medicare compared to private insurance had 2.04 times (95% CI, 1.31–3.20) the odds of infection after adjusting for all covariables. Prior antibiotic use (2.70; 95% CI, 1.64–4.46) was also associated with infection, but race or ethnicity and referral location were not. A smaller proportion of hospital cases occurred among white patients (25% vs 44%) and patients over the age of 65 (39% vs 56%) than expected based on national surveillance statistics. Conclusions: Medicare and antibiotics were associated with Clostridioides difficile infection, but evidence did not indicate association with race or ethnicity. This finding diverges from national data in that infection is higher among white people compared to nonwhite people. Furthermore, a greater proportion of hospital cases were aged <65 years than expected based on national data. National surveillance statistics on CDI may not be transportable to safety-net hospitals, which often disproportionately serve low-income, nonwhite patients.
Marketing Health Psychology

Professional services are not products, and marketing professional services is not simply product marketing. A product is tangible, something you can see and touch. A service, by contrast, is intangible. Clinical psychologists in health care organizations provide professional services to patients, health care providers (i.e., physicians, nurses, and other health care professionals), and other systems within the health care organization.
Personality and insomnia symptoms in older adults: the Baltimore Longitudinal Study of Aging.

Study objective To examine associations of personality dimensions and facets with insomnia symptoms in a community sample of older adults. Methods We studied 1,049 participants aged 60-97 years in the Baltimore Longitudinal Study of Aging. Personality was assessed by the Revised NEO Personality Inventory (NEO-PI-R), and insomnia symptom severity was measured by the Women's Health Initiative Insomnia Rating Scale (WHIIRS). Results Adjusting for demographic characteristics, higher neuroticism, lower conscientiousness, and lower extraversion were associated with greater insomnia symptom severity. These associations remained significant for neuroticism and conscientiousness when further adjusting for depressive symptoms and comorbidities. Higher scores on neuroticism facets Anxiety, Angry Hostility, and Depression, and lower scores on conscientiousness facets Competence, Order, and Achievement-Striving and on agreeableness facet Altruism were associated with greater insomnia symptom severity in fully adjusted models. Results were similar among cognitively normal older adults (N=966), except higher scores on extraversion facets Warmth and Assertiveness associated with lower insomnia symptom severity, and agreeableness facet Altruism was unassociated. Conclusion Among older adults, insomnia symptoms appear partially related to personality, with persons higher in neuroticism experiencing greater insomnia symptom severity, and those higher in conscientiousness experiencing lower insomnia symptom severity. Exploring facets of the Big Five dimensions may provide additional insight regarding the etiology and resolution of sleep disturbance, and some of these associations may differ based on cognitive status. Future studies should investigate the hypothesis that sleep impairment mediates part of the association between specific personality traits and health-related outcomes.
Intrasellar hemorrhagic chordoma masquerading as pituitary apoplexy: case report and review of the literature

Chordomas are centrally located, expansile soft tissue neoplasms that arise from the remnants of the embryological notochord. Hemorrhagic presentation is exceedingly rare and can resemble pituitary...
Sulfide Production in Waste Stabilization Ponds

This investigation deals with the production and release of hydrogen sulfide from waste stabilization ponds, and required design modifications, resulting from increased sulfate or hydrogen sulfide content. A 6-ft deep facultative pond was operated under seven different operating conditions. The experiments were designed to study the relationships between sulfide concentration in the pond and four operating characteristics, namely; detention time, concentration of sulfate ion in the influent, BOD surface load, and sulfate surface load. When detention time and BOD surface loadings were constant, a linear relationship was found to apply between sulfide concentration in the pond and sulfate concentration in the influent. Sulfide concentrations in the pond of about 7 mg per 1 were accompanied by an almost complete disappearance of algae, but the BOD removal rates on a short-term basis were not noticeably affected.
Role of Aquaporin 0 in lens biomechanics.

Maintenance of proper biomechanics of the eye lens is important for its structural integrity and for the process of accommodation to focus near and far objects. Several studies have shown that specialized cytoskeletal systems such as the beaded filament (BF) and spectrin-actin networks contribute to mammalian lens biomechanics; mutations or deletion in these proteins alters lens biomechanics. Aquaporin 0 (AQP0), which constitutes ∼45% of the total membrane proteins of lens fiber cells, has been shown to function as a water channel and a structural cell-to-cell adhesion (CTCA) protein. Our recent ex vivo study on AQP0 knockout (AQP0 KO) mouse lenses showed the CTCA function of AQP0 could be crucial for establishing the refractive index gradient. However, biomechanical studies on the role of AQP0 are lacking. The present investigation used wild type (WT), AQP5 KO (AQP5(-/-)), AQP0 KO (heterozygous KO: AQP0(+/-); homozygous KO: AQP0(-/-); all in C57BL/6J) and WT-FVB/N mouse lenses to learn more about the role of fiber cell AQPs in lens biomechanics. Electron microscopic images exhibited decreases in lens fiber cell compaction and increases in extracellular space due to deletion of even one allele of AQP0. Biomechanical assay revealed that loss of one or both alleles of AQP0 caused a significant reduction in the compressive load-bearing capacity of the lenses compared to WT lenses. Conversely, loss of AQP5 did not alter the lens load-bearing ability. Compressive load-bearing at the suture area of AQP0(+/-) lenses showed easy separation while WT lens suture remained intact. These data from KO mouse lenses in conjunction with previous studies on lens-specific BF proteins (CP49 and filensin) suggest that AQP0 and BF proteins could act co-operatively in establishing normal lens biomechanics. We hypothesize that AQP0, with its prolific expression at the fiber cell membrane, could provide anchorage for cytoskeletal structures like BFs and together they help to confer fiber cell shape, architecture and integrity. To our knowledge, this is the first report identifying the involvement of an aquaporin in lens biomechanics. Since accommodation is required in human lenses for proper focusing, alteration in the adhesion and/or water channel functions of AQP0 could contribute to presbyopia.
Space reactor shielding fabrication

The fabrication of space reactor neutron shielding by a melting and casting process utilizing lithium hydride is described. The first neutron shield fabricated is a large pancake shape 86 inches in diameter, containing about 1700 pounds of lithium hydride. This shield, fabricated by the unique melting and casting process, is the largest lithium hydride shield ever built.
SU‐D‐207‐02: Automated Respiratory Motion Tracking with Machine Vision

Purpose: Current systems for obtaining respiratory information at time of treatment typically require the use of additional equipment and add to patient setup time. In this study, we develop a fully automated method to track respiratory motion by tracking the motion of the diaphragm surface, making use of only current imaging technology and without the need for additional mechanical, pneumatic, or optical devices. Methods: A statistical algorithm, RANdom SAmple Consensus (RANSAC), was used for direct tracking of the diaphragm surface through kV CBCT projection images. A third order polynomial was used to model the shape of the diaphragm. Model constraints based on the diaphragm shape as well as a small motion assumption (between adjacent projections) were incorporated to constrain the model. The changing position of the diaphragm along the Superior-Inferior direction as the patient respires then gives the respiratory trace. Results: On the patients studied, the respiratory trace can be obtained with between 5,000 and 1,000,000 iterations of the RANSAC algorithm, per projection. Visual comparison with the projection images in a cine like mode shows the computed respiratory trace matches well with the true respiratory cycle. With a low number of iterations (<10,000 per projection), the diaphragm location computation time is similar to projection image acquisition and therefore the trace can be computed in real time. Conclusion: The RANSAC algorithm is a viable method for obtaining a respiratory trace with the patient on the treatment couch. Implementing the RANSAC algorithm on a GPU should allow for a significantly larger number of iterations while maintaining the ability to acquire the respiratory trace in real time. This method of obtaining a respiratory trace should reduce costs for technology such as 4DCBCT as well as reduce patient setup times and improve patient comfort.
Associations Between Sleep Disorders, Sleep Duration, Quality of Sleep, and Hypertension: Results From the National Health and Nutrition Examination Survey, 2005 to 2008

J Clin Hypertens (Greenwich). 2011;13:739–743. ©2011 Wiley Periodicals, Inc. Sleep is a contributing factor to optimal health and vitality. However, to date, no national study has evaluated the simultaneous relationship between sleep disorders, quality, and duration with hypertension. Using data from National Health and Nutrition Examination Survey (NHANES) (2005 to 2008), hypertension was defined by current use of antihypertensive medication or systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg. Self-reported sleep disorders and duration were categorized from a single household interview question, and sleep quality was determined from several questions on sleeping habits. The prevalence of hypertension was 30.2% and 7.5%, and 33.0% and 52.1% reported having sleep disorders, short sleep, and poor sleep, respectively. After adjustment for demographic characteristics and comorbidities, having sleep disorders only was not significantly associated with hypertension (odds ratio [OR], 1.65; 95% confidence interval [CI], 0.73−3.77). However, this association was modified by sleep duration: significant associations were observed among adults with concurrent sleep disorders and short sleep (OR, 2.30; 95% CI, 1.49−3.56) and with sleep disorders, short sleep, and poor sleep (OR, 1.84; 95% CI, 1.13−2.98). These findings indicate an association between a combination of sleep problems and hypertension, but prospective studies are needed to understand the complex interplay between them.
Nucleotide sequence of the Escherichia coli rfe gene involved in the synthesis of enterobacterial common antigen. Molecular cloning of the rfe-rff gene cluster.

The genetic determinants of enterobacterial common antigen (ECA) include the rfe and rff genes located between ilv and cya near min 85 on the Escherichia coli chromosome. The rfe-rff gene cluster of E. coli K-12 was cloned in the cosmid pHC79. The cosmid clone complemented mutants defective in the synthesis of ECA due to lesions in the rfe, rffE, rffD, rffA, rffC, rffT, and rffM genes. Restriction endonuclease mapping combined with complementation studies of the original cosmid clone and six subclones revealed the order of genes in this region to be rfe-rffD/rffE-rffA/rffC-rffT-rffM . The rfe gene was localized to a 2.54-kilobase ClaI fragment of DNA, and the complete nucleotide sequence of this fragment was determined. The nucleotide sequencing data revealed two open reading frames, ORF-1 and ORF-2, located on the same strand of DNA. The putative initiation codon of ORF-1 was found to be 570 nucleotides downstream from the termination codon of rho. ORF-1 and ORF-2 specify putative proteins of 257 and 348 amino acids with calculated Mr values of 29,010 and 39,771, respectively. ORF-1 was identified as the rfe gene since ORF-1 alone was able to complement defects in the synthesis of ECA and 08-side chain synthesis in rfe mutants of E. coli. Data are also presented which suggest the possibility that the rfe gene is the structural gene for the tunicamycin sensitive UDP-GlcNAc:undecaprenylphosphate GlcNAc-1-phosphate transferase that catalyzes the synthesis of GlcNAc-pyrophosphorylundecaprenol (lipid I), the first lipid-linked intermediate involved in ECA synthesis.
Online sampling of high centrality individuals in social networks

In this work, we investigate the use of online or “crawling” algorithms to sample large social networks in order to determine the most influential or important individuals within the network (by varying definitions of network centrality). We describe a novel sampling technique based on concepts from expander graphs. We empirically evaluate this method in addition to other online sampling strategies on several real-world social networks. We find that, by sampling nodes to maximize the expansion of the sample, we are able to approximate the set of most influential individuals across multiple measures of centrality.
Dissecting Distributed Coordination

This paper derives necessary and sufficient communication for distributed applications that perform certain actions uniformly in asynchronous systems. We show there is an essential structure of information flow in any solution to Uniform Coordination, suggesting message-minimal solutions. We show it is necessary for processes to conspire against each other to make progress, and we show this conspiracy requires processes to stop communicating with each other. This, we show, renders Uniform Coordination insensitive to channel delivery guarantees. We introduce the notion of exempting processes from coordinating. We show that ‘primary partition’ behavior (Isis) arises from the desire to make exempt an process indistinguishable from a crashed process. Defining weaker exemptions for distributed coordination problems gives rise to many problems solvable in asynchronous systems as well as in systems that partition.
Assessing Genetic Variants of Uncertain Significance: The Example of Breast Cancer

Mutations in the BRCA1 or 2 genes can lead to an inherited increased risk of breast, ovarian and other cancers. Molecularly, these mutations manifest primarily as frameshift or nonsense mutations, leading to prematurely truncated proteins that would otherwise function as tumour suppressors. Up to 10–20% of all BRCA mutations are reported as variants of uncertain significance (VUS); these manifest as missense mutations (with resultant amino acid substitution), intronic variants with resultant effect on splicing capacity or in-frame deletions and insertions, which may or may not change the reading frame of a gene. These variant sequences can confound rather than guide the risk assessment process in the genetic counselling of patients and family members, whether afflicted or not with an actual cancer. Several molecular methods are now able to discriminate those as yet unclassified variants between high and low risk for cancer development; databases have been generated accordingly and may allow some further prediction of the probability of deleterious behaviour. This article aims to clarify the clinical relevance of BRCA VUS, to assimilate resources and make suggestions for estimating their clinical impact, and to highlight the need for further studies in this area. Key Concepts: There are limited guidelines for the specific management and surveillance of patients and their family members who harbour genetic variants of uncertain significance. Integrated models to discriminate high-risk from low-risk variants have been generated. Application of these models is considered. Further clinical trials for risk management are advocated. Up to 20% of BRCA 1 and 2 mutations can be missense mutations which amount to variants of uncertain significance, the deleterious nature of which are unclear in clinical practice. Keywords: BRCA; genetic variants; genetic counselling; VUS; BRCA 1; BRCA 2
Operations analysis for a large lunar telescope

Consideration is given to a study of the operations and assembly of a 16-m large lunar telescope (LLT), which deals with the operations and assembly of the telescope from LEO to the lunar surface for assembly. The study of LLT operations and assembly is broken down into three divisions to allow easier operations analysis: earth to orbit operations, LEO operations (transfer to lunar surface operations), and lunar surface operations. The following guidelines were set down to ensure a reasonable starting point for a large, lunar, untended installation: the existence of a lunar base, a space transportation system from LEO to the lunar surface, continuous manning of the lunar base during the assembly period, and availability/capability to perform lunar assembly with the lunar base crew. The launch/vehicle packaging options, lunar site selection and assembly options, and assembly crew assumptions are discussed.
In situ studies of the interface of natural and man-made systems in a metropolitan harbor

1. The Los Angeles-Long Beach, California, Harbor underwent its first major development early in the twentieth century. It is now the third largest port in the United States, a focal point for seven million southern California residents. 2. Pressures for pollution abatement and for development of a deeper water port make an integrated research program necessary. 3. Allan Hancock Foundation personnel have undertaken a comprehensive study with support from the federal Sea Grant Program, private industry and local harbor departments. 4. Plankton-productivity, marine and public health microbiology, midwater settling rack fauna, benthic fauna, water quality parameters, circulation patterns, and sediment content have been sampled. 5. Sequence of red tide and other phytoplankton blooms have been postulated and predicted. 6. Plankton-settling volumes have been good indicators of short-term stress or pollution. 7. Settling racks suspended monthly have shown a much greater diversity of species and higher categories present in the water column than are present in polluted bottom muds. 8. Some 60 species of 30 polychaete families were taken in bottom samples throughout the harbor. 9. Settling rack sampling measures relatively short-term stress and benthic sampling is a good indicator of longer-term stress.
The lambda spanin components Rz and Rz1 undergo tertiary and quaternary rearrangements upon complex formation

Phage holins and endolysins have long been known to play key roles in lysis of the host cell, disrupting the cytoplasmic membrane and peptidoglycan (PG) layer, respectively. For phages of Gram-negative hosts, a third class of proteins, the spanins, are involved in disrupting the outer membrane (OM). Rz and Rz1, the components of the lambda spanin, are, respectively, a class II inner membrane protein and an OM lipoprotein, are thought to span the entire periplasm by virtue of C-terminal interactions of their soluble domains. Here, the periplasmic domains of Rz and Rz1 have been purified and shown to form dimeric and monomeric species, respectively, in solution. Circular dichroism analysis indicates that Rz has significant alpha-helical character, but much less than predicted, whereas Rz1, which is 25% proline, is unstructured. Mixture of the two proteins leads to complex formation and an increase in secondary structure, especially alpha-helical content. Moreover, transmission electron-microscopy reveals that Rz–Rz1 complexes form large rod-shaped structures which, although heterogeneous, exhibit periodicities that may reflect coiled-coil bundling as well as a long dimension that matches the width of the periplasm. A model is proposed suggesting that the formation of such bundles depends on the removal of the PG and underlies the Rz–Rz1 dependent disruption of the OM.
Driving And Community Mobility: Occupational Therapy Strategies Across The Lifespan

As baby boomers enter their senior years, injured soldiers return from operations, and youth with special needs approach adulthood, the demand for occupational therapy (OT) practitioners to address...
Sex and ethnic differences in the associations between lipoprotein(a) and peripheral arterial disease in the Multi-Ethnic Study of Atherosclerosis

Objective Higher lipoprotein(a) [Lp(a)] has been linked with peripheral arterial disease (PAD). Also, elevated Lp(a) serum levels have been observed in women and African Americans (AAs). It remains uncertain if sex and ethnicity modify the association between Lp(a) and PAD. Methods Lp(a) mass concentration was measured with a latex-enhanced turbidimetric immunoassay, from blood collected at baseline clinic visits after a 12-hour fast, in a multiethnic cohort. Also at baseline, the ankle-brachial index was measured. PAD was defined as an ankle-brachial index Results In 4618 participants, the mean age was 62 ± 10 years; Lp(a) mean was 30 ± 32 mg/dL and median (interquartile range) was 18 (8-40 mg/dL); 48% were male; 36% were European American, 29% were AA, 23% were Hispanic American (HA), and 12% were Chinese American; and 11% had PAD. Across all ethnic groups, serum Lp(a) was higher among women compared with men and highest among AAs compared with other ethnicities. After adjustments for traditional cardiovascular disease risk factors (age, sex, ethnicity, hypertension, diabetes, smoking, total cholesterol, and high-density lipoprotein cholesterol) as well as interleukin-6, fibrinogen, D-dimer, and homocysteine levels, one log unit increase in Lp(a) was associated with greater odds for PAD (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.01-1.25). In fully adjusted models, significant gender ∗ ln [Lp(a)] and ethnicity ∗ ln [Lp(a)] interactions were observed ( P = .08 for both). The association between higher Lp(a) and PAD was strongest in HA men (OR, 1.73; 95% CI, 1.07-2.80) and HA women (OR, 1.49; 95% CI, 1.07-2.08). Nonsignificant associations were observed for European American, AA, and Chinese American men and women. Conclusions We observed a significant and independent association between elevated Lp(a) and PAD only among HA women and men, despite higher serum Lp(a) levels among AAs. Future studies are needed to determine the role that lowering of Lp(a) may have on the burden of PAD in HAs.
Projections of the nuclei of the periaqueductal gray matter in the cat.

To obtain more evidence in support of the theory of tri-nuclear division of the periaqueductal gray matter (PAG) in the cat, the projection systems of each of the nuclei were investigated. Direct current lesions were stereotaxically placed in the three nuclei of the PAG and the resulting fibers of degeneration were stained by reduced silver impregnation techniques. Degenerating axons from the lesion in the nucleus medialis were traced ventrally to the tegmentum in a radiating pattern and rostrally to the fields of Forel and the ventral tegmental area. Descending fibers were traced to their termination in the dorsal tegemental nucleus. Lesions in the nucleus dorsalis resulted in no radiating or descending fibers of degeneration, but a bundle of degenerating fibers running within the PAG could be followed to the level of the mesencephalic-diencephalic junction. Here the axons terminated in the pretectal area and the lateral habenular nucleus. The pattern of degeneration was completely ipsilateral for the two nuclear lesions described above and predominately ipsilateral for the third nucleus, the lateralis. From it, all the ascending fibers were ipsilateral, but the heavy radiating fibers to the tectum and tegmentum did extend somewhat to the contralateral side. The large bundle of axons of degeneration ran rostrally within the PAG to diencephalic levels and divided into numerous fasciculi and terminated in the periventricular gray, the posterior hypothalamus and numerous thalamic nuclei. The evidence that each nucleus projects differently supports the theory of tri-nuclear division of the PAG.
Properties of a glucoamylase from Aspergillus phoenicis

Abstract The extracellular glucoamylase of [α- D -(1→4)-glucan glucohydrolase, E. C. 3.2.1.3] of Aspergillus phoenicis Staley 155, as purified by chromatography on ion-exchange columns of DEAE-cellulose consists of two forms. One of these was isolated in high purity, as indicated by sedimentation velocity and disc electrophoresis. The enzyme has a molecular weight of 63,600 by sedimentation approach-to-equilibrium studies. Optimal conditions for action on starch by the purified enzyme are 60° and pH 4.6. The glucoamylase loses 45% of its activity after 192 h at 25°. The enzyme is a glycoprotein containing 17% of total carbohydrate. The carbohydrate component was not dissociated by treatment with urea or during gel filtration in urea. D -Mannose is the preponderant sugar component and lesser proportions of D -glucose and D -galactose are present; sialic acid and hexosamines appear to be absent.
Developing economic measures of hospital productivity

Abstract This study presents a methodology for measuring hospital output and estimating hospital productivity. A productivity index is developed for a sample of hospitals in New York City for which information was far more detailed than in systematic national sources, and sources of differences among hospitals in productivity are investigated. Internal consistencies in the productivity relationships are examined, and the findings are compared with cost relationships derived from the same data base. The analysis suggests that much better measures for a number of service areas and improved methods for dealing with variations in quality of care will be needed before reasonably accurate hospital-wide measures of output and productivity can be attained.