cssi/SciSciGPT-SciSciNet huggingface dataset:
Scope for energy improvement for hospital imaging services in the USA

ObjectiveTo aid radiologists by measuring the carbon footprint of CT scans by quantifying in-hospital and out-of-hospital energy use and to assess public health impacts.MethodThe study followed a standard life cycle assessment protocol to measure energy from a CT scan then expanding to all hospital electrical energy related to CT usage. In addition, all the fuel energy used to generate electricity and to manufacture the CT consumables was measured. The study was conducted at two hospitals.ResultsThe entire life cycle energy for a CT scan was 24–34 kWh of natural resource energy per scan. The actual active patient scan energy that produces the images is only about 1.6% of this total life cycle energy. This large multiplier to get total CT energy is a previously undocumented environmental response to the direct radiology order for a patient CT scan. The CT in-hospital energy related to idle periods, where the machine is on but no patients are being scanned and is 14–30-fold higher than the energy used for t...
An improved deep submicrometer MOSFET RF nonlinear model with new breakdown current model and drain-to-substrate nonlinear coupling

An improved deep submicrometer (0.25 /spl mu/m) MOSFET radio-frequency (RF) large signal model that incorporates a new breakdown current model and drain-to-substrate nonlinear coupling was developed and investigated using various experiments. An accurate breakdown model is required for deep submicrometer MOSFETs due to their relatively low breakdown voltage. For the first time, this RF nonlinear model incorporates the breakdown voltage turnover trend into a continuously differentiable channel current model and a new nonlinear coupling circuit between the drain and the lossy substrate. The robustness of the model is verified with measured pulsed I-V, S-parameters, power characteristics, harmonic distortion, and intermodulation distortion levels at different input and output termination conditions, operating biases, and frequencies.
A machine learning framework for TCP round-trip time estimation

In this paper, we explore a novel approach to end-to-end round-trip time (RTT) estimation using a machine-learning technique known as the experts framework. In our proposal, each of several ‘experts’ guesses a fixed value. The weighted average of these guesses estimates the RTT, with the weights updated after every RTT measurement based on the difference between the estimated and actual RTT. Through extensive simulations, we show that the proposed machine-learning algorithm adapts very quickly to changes in the RTT. Our results show a considerable reduction in the number of retransmitted packets and an increase in goodput, especially in more heavily congested scenarios. We corroborate our results through ‘live’ experiments using an implementation of the proposed algorithm in the Linux kernel. These experiments confirm the higher RTT estimation accuracy of the machine learning approach which yields over 40% improvement when compared against both standard transmission control protocol (TCP) as well as the well known Eifel RTT estimator. To the best of our knowledge, our work is the first attempt to use on-line learning algorithms to predict network performance and, given the promising results reported here, creates the opportunity of applying on-line learning to estimate other important network variables.
Biodegradability of biofilm extracellular polymeric substances

This study discovered that biofilm extracellular polymeric substances (EPS) are biodegradable by their own producers and by other microorganisms when they are starved. The study was performed in a comparative fashion to examine the biodegradability of biofilm EPS by the microorganisms from the original biofilm (its own producers) and from activated sludge (other microorganisms). Four distinctive phases were observed during EPS biodegradation. In the first phase, instantaneous concentration increases of carbohydrate and protein in the test solutions were observed when EPS was added; in the second phase, easily biodegradable EPS from the added EPS was quickly utilized; in the third phase, microorganisms began to produce soluble EPS, using the minimally biodegradable EPS left from the previously added EPS; in the fourth phase, cells consumed the newly produced EPS and microbial activity gradually stopped. This study suggests that EPS can be used as a substrate, and that the EPS carbohydrate can be utilized faster than the EPS protein. The EPS utilization rates (including carbohydrate and protein) in the activated sludge suspension were greater than those in the biofilm suspension. It may take microorganisms longer to get acclimated to a new nutrient environment if they are in a starved state.
A Test of Activation as a General Factor in Strength Performance

Abstract A test was made of the general activation concept as it relates to strength performance. No difference in grip strength was found between an experimental group (N = 35), who performed maximal leg strength exercises between grip trials (in an attempt to raise their level of activation through induced muscular tension), and a control group (N = 35) who read between grip trials. Also, there was no difference in grip strength performance over trials for both groups. Intercorrelations of strength scores between limbs for the experimental group showed more specificity than generality. While these results fail to support a generalized activation effect in the static strength performance context, they do provide additional evidence of neuromuscular specificity in motor ability.
Neuropsychological and Structural Neuroimaging Endophenotypes in Schizophrenia

The limits of the current diagnostic systems have led to a variety of efforts to identify alternate expressions of mental disorders that are broader than the DSM or ICD diagnostic criteria needed to diagnose them (e.g., Research Diagnostic Criteria, or RDoC). These newer approaches reflect a growing consensus that characterizing multiple, dimensional phenotypes can advance the search for identifying etiological or modulatory factors of psychiatric disorders. Moreover, the failure of Mendelian genetics to make progress in psychiatric disorders has led some to propose an alternative genetic focus on the traits associated with illnesses rather than on the diagnosis per se. These alternate phenotypes or endophenotypes (e.g., neuroanatomical, psychophysiological or neuropsychological abnormalities) of disorders may be more specific and amenable to objective measurement than clinical symptoms, and presumably reflect variation among smaller numbers of genes than more complex, clinical symptoms that are hypothesized to be more distal from their genetic origins. This has led to a dramatic growth of using endophenotypes in genetic studies, and consideration of their potential usefulness in the development of targets for early interventions. In this chapter, we review neuropsychological and structural neuroimaging endophenotypes for schizophrenia and for schizophrenia spectrum disorders, with an emphasis on key conceptual criteria for assessing endophenotypes, including their relationships to schizophrenia, to non-psychotic relatives, and to heritability. Future directions for establishing the validity of endophenotype research are also discussed. Keywords: endophenotypes; neuropsychological markers; neuroimaging markers; structural magnetic resonance imaging (sMRI); memory; executive function; attention; schizophrenia
Revenue submodularity

We introduce revenue submodularity, the property that market expansion has diminishing returns on an auction's expected revenue. We prove that revenue submodularity is generally possible only in matroid markets, that Bayesian-optimal auctions are always revenue-submodular in such markets, and that the VCG mechanism is revenue-submodular in matroid markets with i.i.d bidders and "sufficient competition". We also give two applications of revenue submodularity: good approximation algorithms for novel market expansion problems, and approximate revenue guarantees for the VCG mechanism with i.i.d bidders.
Effects of Obeticholic Acid on Lipoprotein Metabolism in Healthy Volunteers

The bile acid analogue obeticholic acid (OCA) is a selective farnesoid X receptor (FXR) agonist in development for treatment of several chronic liver diseases. FXR activation regulates lipoprotein homeostasis. The effects of OCA on cholesterol and lipoprotein metabolism in healthy individuals were assessed. Two phase I studies were conducted to evaluate the effects of repeated oral doses of 5, 10 or 25 mg OCA on lipid variables after 14 or 20 days of consecutive administration in 68 healthy adults. Changes in HDL and LDL cholesterol levels were examined, in addition to nuclear magnetic resonance analysis of particle sizes and sub-fraction concentrations. OCA elicited changes in circulating cholesterol and particle size of LDL and HDL. OCA decreased HDL cholesterol and increased LDL cholesterol, independently of dose. HDL particle concentrations declined as a result of a reduction in medium and small HDL. Total LDL particle concentrations increased because of an increase in large LDL particles. Changes in lipoprotein metabolism attributable to OCA in healthy individuals were found to be consistent with previously reported changes in patients receiving OCA with non-alcoholic fatty liver disease or non-alcoholic steatohepatitis.
Non-cavitated dental radiolucent lesions: A challenge for the dental healthcare provider

Pre-eruptive intracoronal radiolucencies (PIR) and post-eruptive hidden caries (PHC) are non-cavitated intracoronal dental lesions that are usually detected only through radiographic observation. As a result, these lesions present numerous challenges for the dental healthcare provider that markedly differs from that of other non-cavitated dental lesions (early/incipient/demineralized white spots). Best practice principles should be employed, for example, timely recognition and radiographic surveillance/observation, logical treatment management, along with judicious communication amongst all parties involved (parent/guardian, pediatric dentist and orthodontist). This article attempts to review and discuss the literature of these conditions and present a case report of a patient with PIR.
Mathematical Methods for Modeling Chemical Reaction Networks

Cancer's cellular behavior is driven by alterations in the processes that cells use to sense and respond to diverse stimuli. Underlying these processes are a series of chemical processes (enzyme-substrate, protein-protein, etc.). Here we introduce a set of mathematical techniques for describing and characterizing these processes.
A Comparison of Classical and H-Type Bovine Spongiform Encephalopathy Associated with E211K Prion Protein Polymorphism in Wild-Type and EK211 Cattle Following Intracranial Inoculation.

In 2006, a case of H-type bovine spongiform encephalopathy (BSE-H) was diagnosed in a cow that was associated with a heritable polymorphism in the bovine prion protein gene (PRNP) resulting in a lysine for glutamine amino acid substitution at codon 211 (called E211K) of the prion protein. Although the prevalence of this polymorphism is low, cattle carrying the K211 allele may be predisposed to rapid onset of BSE-H when exposed or to the potential development of a genetic BSE. This study was conducted to better understand the relationship between the K211 polymorphism and its effect on BSE phenotype. BSE-H from the US 2006 case was inoculated intracranially (IC) in one PRNP wild type (EE211) calf and one EK211 calf. In addition, one wild type calf and one EK211 calf were inoculated IC with brain homogenate from a US 2003 classical BSE case. All cattle developed clinical disease. The survival times of the E211K BSE-H inoculated EK211 calf (10 months) was shorter than the wild type calf (18 months). This genotype effect was not observed in classical BSE inoculated cattle (both 26 months). Significant changes in retinal function were observed in H-type BSE challenged cattle only. Cattle challenged with the same inoculum showed similar severity and neuroanatomical distribution of vacuolation and disease-associated prion protein deposition in the brain, though differences in neuropathology were observed between E211K BSE-H and classical BSE inoculated animals. Western blot results for brain tissue from challenged animals were consistent with the inoculum strains. This study demonstrates that the phenotype of E211K BSE-H remains stable when transmitted to cattle without the K211 polymorphism, and exhibits a number of features that differ from classical BSE in both wild type and heterozygous EK211 animals.
The Return on Investment for Higher Education in the United States

As the United States economy continues its recovery from the financial crisis, investments of all types are treated with higher levels of optimism. A college education is no exception; however, it does bring up the question of what the rate of return the investment of a college education provides an individual This paper attempts to build off of Mincer’s (1975), Cohn’s and Hughes’s (1994), Psacharopoulos’s (1994) and Athanassiadis’s (2011) research by first modeling the overall return on investment for higher education for full-time workers through a Mincer earnings function, and then determining the return on investment on earnings for workers across various time periods through “the short-cut method.”
Effects of Centrally Administered Opioid Agonists on Macrophage Nitric Oxide Production and Splenic Lymphocyte Proliferation

In recent years nitric oxide has received a great deal of attention. Although nitric oxide has been well known to environmental scientists for some time, the impact of nitric oxide in the biological sciences is recent and overwhelming. In fact, Science named nitric oxide the molecule of the year in 1992, and over 4,000 papers have been published since that time. Nitric oxide has been shown to play a role in a wide variety of biological activities, being produced and utilized in practically every major organ system in the body. Despite the short half life and simplistic chemical structure of nitric oxide, it has become clear that this molecule plays an important role in immune processes.
The Cancer Stem Cell Hypothesis

The “cancer stem cell” hypothesis is receiving increasing interest and has become the object of considerable debate among cancer biologists and clinicians. This ongoing debate is focusing attention on the very definition of stemness and its significance in the context of a malignancy. From a therapeutic standpoint, the cancer stem cell hypothesis emphasizes the cellular heterogeneity in cancers, and the need to specifically target small cell populations that resemble tissue stem cells and are phenotypically different from the majority of cancer cells. Regardless of their origin, these cells divide slowly, have the ability to undergo asymmetric cell division and are highly resistant to conventional chemotherapeutics. These characteristics make them prime suspects as potential causes of disease recurrence and metastasis, which are the main causes of morbidity and mortality in oncology. This chapter provides an introduction to the cancer stem cell hypothesis, briefly summarizes the evidence supporting this theory and the aspects that remain controversial. Finally, we present a brief discussion of the possible therapeutic significance of cancer stem cells and the current efforts to target developmental pathways on which these cells depend.
Kairomone strains of Euclytia flava (Townsend), a parasitoid of stink bugs

Tachinid flies commonly use the pheromones and allomones of stink bugs (Pentatomidae) as host-finding kairomones. Pheromone-baited traps for predaceous (Podisus spp.) and phytophagous (Euschistus spp.) pentatomids were used to obtain tachinid parasitoids in order to study the semiochemical relationships between these parasitic flies and their stink bug hosts. Gas chromatography–electroantennogram detector (GC-EAD) experiments and field tests were conducted to determine if pheromone strains of the tachinids, Euclytia flava and Hemyda aurata, occur in nature and to determine if the EAD-active compound, (E)-2-octenal (a common allomone compound of Heteroptera), affects attraction of tachinid parasitoids to synthetic Podisus pheromones. Addition of (E)-2-octenal to Podisus spp. synthetic pheromones in field traps tended to suppress attraction of the bugs, whereas (E)-2-octenal decreased, did not affect, or increased pheromonal attraction of tachinid parasitoids depending on the host species pheromone being tested and the habitat type in which the traps were deployed. Evidence from GC-EAD experiments of E. flava associated with different stink bug hosts suggested that kairomone-strains of this tachinid parasitoid coexist naturally. The significance of cryptic kairomone strains of parasitoids for classical biological control is disc ussed, and the mechanisms whereby parasitoids evolve kairomonally mediated host-shifts is considered.
Single-case Experimental Designs in Clinical Settings

Single-case experimental design has a distinct tradition in the behavioral sciences. It emphasizes intensive repeated observations of a particular subject in order to demonstrate precise control over targeted behavior. There are many variations of these types of designs. Typically, the data from single-case designs are analyzed by visual inspection of graphs, but such interpretation, though simple, is prone to error. There is increasing attention to statistical approaches to data analysis and to aggregation of results from independent studies to enhance the generalizability of the findings of single-case experimental designs.
Entomofauna de la Reserva Científica Ébano Verde, Cordillera Central, República Dominicana

A preliminary list of the insect species reported for the Reserva Cientifica Ebano Verde (RCEV), Cordillera Central, Dominican Republic, is compiled from the published entomological literature and the study of recent collections. The list includes a total of 350 species of insects classified in 254 genera, 70 families and 12 orders. Four species of Syrphidae (Diptera) and one species of Vespidae (Hymenoptera) are new records for the Dominican Republic and Hispaniola. Obviously these data represent only a small portion of the total entomofauna that inhabits the area. They should be useful to propitiate other entomological studies in the reserve and advance the knowledge of insects in the Dominican Cordillera Central and other protected areas of the island.
Feasible Nash Implementation of Social Choice Rules When the Designer Does Not Know Endowments

The aim of the present paper is to analyze the problem of assuring the feasibility of a mechanism (game form), implementing in Nash equilibrium a given social choice rule abbreviated as (SCR) when the mechanism is constrained as to the way in which it is permitted to depend on endowments. A social choice rule is a correspondence specifying outcomes considered to be desirable in a given economy (environment). A mechanism is defined by (a) an outcome function and (b) a strategy domain prescribed for each player. Our outcome functions are not permitted to depend at all on the initial endowments. As to strategy domains, the ith agent’s strategy domain Si is only permitted to depend on that agent’s endowment, but not on the endowments, other agents. (For earlier results concerning endoment manipulation, see Postlewaite (1979) and Sertel (1990).)
Moderate Alcohol Consumption Inhibits Sodium-Dependent Glutamine Co-Transport in Rat Intestinal Epithelial Cells in Vitro and Ex Vivo

Malnutrition is present in chronic alcoholics. However, how moderate alcohol consumption affects the absorption of nutrients like glutamine has not been investigated. Glutamine, an amino acid, is vital to gastrointestinal health. Glutamine is absorbed via sodium-dependent glutamine co-transport (B0AT1; SLC6A19) along the brush border membrane of absorptive villus cells. Rat intestinal epithelial cells (IEC-18) and sixteen-week-old Sprague Dawley rats were administered the equivalent of a 0.04% blood alcohol content of ethanol (8.64 mM; 2 g/kg) to investigate the effect of moderate alcohol on sodium-glutamine co-transport. Sodium-dependent 3H-glutamine uptakes were performed to measure B0AT1 activity. Inorganic phosphate was measured as a function of Na-K-ATPase activity. Protein expression was analyzed by immunohistochemical and Western blot analysis. Ethanol significantly inhibited sodium-dependent glutamine absorption and Na-K-ATPase activity in enterocytes in vitro and ex vivo. Kinetic studies suggested that the mechanism of inhibition was due to decreased maximal rate of uptake (Vmax) of the B0AT1 co-transporter, corresponding to decreased B0AT1 protein expression and secondary to an inhibited sodium-gradient at the cellular level in vitro and ex vivo. In all, moderate ethanol significantly inhibited glutamine absorption at the level of decreased B0AT1 expression at the brush border membrane and a reduced sodium gradient, which may contribute to malnutrition present in chronic alcoholics.
Reducing undocumented supplies in hybrid ORs through multidisciplinary process improvement

Abstract Introduction Massachusetts General Hospital (MGH) is a large academic medical center, where many proceduralists are using Hybrid Operating Rooms (OR) to perform cases, and these specialties often utilize supply inventory in the rooms and nearby spaces, but also transport supplies from other procedural areas outside of the OR. For these Hybrid ORs, we saw an increase in supply discrepancies for items used during procedures but that were not documented, and wanted to determine the root cause to minimize these events. Methods A multidisciplinary team was assembled from across Perioperative Services, Cardiology, and Radiology to address this issue. Through a series of process improvement efforts, including relocation of Radiofrequency Identification cabinets, creation of new control processes, and education of key staff, we were able to address this problem. Results Through the work of a multidisciplinary team, we achieved a nearly 90% decrease in the incidence of these missing supplies. This project served as one of the first initiatives of the MGH Procedural Services Committee—a group that is now working on a variety of initiatives across the procedural areas to improve patient care, increase efficiency, and reduce costs. Conclusion As the procedural areas across hospitals continue to become more similar with respect to equipment, resources, staffing competencies, and supplies, there will need to be increased efforts to collaborate to solve shared problems. As many hospitals across the country continue to see margin pressures and declining reimbursement, it will be vitally important to standardize, share best practices, and create additional economies of scale where possible for these procedural areas.
Innovative Solar Sail Earth-Trailing Trajectories Enabling Sustainable Heliophysics Missions

The presented trajectory design study demonstrates that near-future solar sails can reach and maintain innovative science orbits about non-traditional Earth-trailing equilibrium points. The proposed configurations can enable long duration stereoscopic solar imaging while potentially alleviating telemetry requirements constraining current solar sail studies. Initial guesses for controlled periodic orbits about equilibrium points that trail the Sun-Earth line by 1.5∘-15∘ are constructed from a linearized solar sail circular restricted three body problem equations of motion. Orbits are then converged in the full nonlinear model using a high order direct collocation method. Transfers to Earth-trailing orbits are then constructed under the assumption that the solar sail is a secondary payload on a larger spacecraft en-route to the Sun-Earth L1 Lagrange point. Naturally occurring gravitational manifolds flowing towards the Lagrange point, as well as navigation data from previous Lagrange point missions, are used to generate a set of baseline trajectories for the primary spacecraft. End-to-end trajectory design and optimization is then carried out to construct time optimal solar sail transfers to each target science orbit from initial conditions constrained to lie on the carrier spacecraft’s Lagrange point trajectory. Additionally, trade studies are performed to assess how sail performance and Earth-trailing orbit selection affect transfer time of flight and instrument pointing accuracy. Results indicate that, based on current technological developments, near future solar sails are capable of station keeping about periodic Earth-trailing orbits while maintaining near-constant solar observation. Moreover, time of flights on the order of 1 year are observed for most combinations of sail performance and feasible initial conditions.
Modeling Active Galactic Nucleus Feedback in Cool-core Clusters: The Balance between Heating and Cooling

We study the long-term evolution of an idealized cool-core galaxy cluster under the influence of momentum-driven active galactic nucleus (AGN) feedback using three-dimensional high-resolution (60 pc) adaptive mesh refinement simulations. The feedback is modeled with a pair of precessing jets whose power is calculated based on the accretion rate of the cold gas surrounding the supermassive black hole (SMBH). The intracluster medium first cools into clumps along the propagation direction of the jets. As the jet power increases, gas condensation occurs isotropically, forming spatially extended structures that resemble the observed Hα filaments in Perseus and many other cool-core clusters. Jet heating elevates the gas entropy, halting clump formation. The cold gas that is not accreted onto the SMBH settles into a rotating disk of ~1011 M ☉. The hot gas cools directly onto the disk while the SMBH accretes from its innermost region, powering the AGN that maintains a thermally balanced state for a few Gyr. The mass cooling rate averaged over 7 Gyr is ~30 M ☉ yr–1, an order of magnitude lower than the classic cooling flow value. Medium resolution simulations produce similar results, while in low resolution runs, the cluster experiences cycles of gas condensation and AGN outbursts. Owing to its self-regulating mechanism, AGN feedback can successfully balance cooling with a wide range of model parameters. Our model also produces cold structures in early stages that are in good agreement with the observations. However, the long-lived massive cold disk is unrealistic, suggesting that additional physical processes are still needed.
Tungsten skarn mineral resource assessment of the Great Basin region of western Nevada and eastern California

Abstract A new quantitative mineral resource assessment for tungsten, a critical mineral commodity with highly concentrated production and a moderate risk of global supply disruption, was conducted for the Great Basin region of western Nevada and eastern California. This assessment was part of a larger effort focusing on three regions in the United States and represents the first study of domestic tungsten resources and mineral potential in over twenty years. By integrating geology, bedrock and stream sediment geochemistry, geophysics, and remote sensing data with recently developed software tools and analyses, estimates of undiscovered tungsten skarn deposits in permissive tracts are combined with grade and tonnage distributions of known deposits to generate probabilistic estimates of undiscovered resources. Identified resources in the Great Basin region total 168 thousand metric tons (kt) of tungsten trioxide (WO3), including 116 kt of past production and 52 kt remaining in place. Consistent with the historic significance of the Great Basin region as a past producer containing a large portion of U.S. identified resources, undiscovered resources are likely to occur adjacent to known deposits and prospects and at unexplored depths. Undiscovered deposits are estimated to contain median resources of 940 kt of WO3 with a 90% probability of at least 420 kt and a 10% probability of at least 1.7 million metric tons (Mt), of which 240 kt to 1.1 Mt may be economic to extract. Based on a 20-year average price, median recoverable undiscovered resources are estimated at 570 kt WO3 equivalent with a net present value of $3 billion U.S. dollars. The methods, data, results, and economic significance of the assessment contribute to a scientific understanding of a critical mineral resource with direct implications for policy and land management decisions.
English Spelling Performance in Writing Samples Among Spanish-Speaking ELLs.

The depth of the English orthography makes reading and spelling in English a difficult task; particularly for English language learners (ELLs) whose first language (L1) has a shallow orthography. M...
Improving transitions of care for patients initiated on buprenorphine for opioid use disorder from the emergency departments in King County, Washington.

Study objective: Opioid use disorder (OUD) is on the rise nationwide with increasing emergency department (ED) visits and deaths secondary to overdose. Although previous research has shown that patients who are started on buprenorphine in the ED have increased engagement in addiction treatment, access to on-demand medications for OUD is still limited, in part because of the need for linkages to outpatient care. The objective of this study is to describe emergency and outpatient providers' perception of local barriers to transitions of care for ED-initiated buprenorphine patients. Methods: Purposive sampling was used to recruit key stakeholders, identified as physicians, addiction specialists, and hospital administrators, from 10 EDs and 11 outpatient clinics in King County, Washington. Twenty-one interviews were recorded and transcribed and then coded using an integrated deductive and inductive content analysis approach by 2 team members to verify accuracy of the analysis. Interview guides and coding were informed by the Consolidated Framework for Implementation Research (CFIR), which provides a structure of domains and constructs associated with effective implementation of evidence-based practice. Results: From the 21 interviews with emergency and outpatient providers, this study identified 4 barriers to transitions of care for ED-initiated buprenorphine patients: scope of practice, prescribing capacity, referral incoordination, and loss to follow-up. Conclusion: Next steps for implementation of this intervention in a community setting include establishing a standard of care for treatment and referral for ED patients with OUD, increasing buprenorphine prescribing capacity, creating a central repository for streamlined referrals and follow-up, and supporting low-barrier scheduling and navigation services.
Atypical case of syphilitic hepatitis.

A 31-year-old immunocompetent, heterosexual man with no relevant medical history presented with 1 week of jaundice, abdominal pain, cough and headache. Examination revealed scleral icterus, right upper quadrant tenderness and hepatomegaly. Initial investigations revealed hyperbilirubinaemia and elevated transaminases. Serum studies were positive for antinuclear antibodies, antimitochondrial antibodies, and herpes simplex virus IgM. Despite being started on intravenous acyclovir, his bilirubin and transaminase levels continued to rise. He was subsequently tested for syphilis given his maculopapular rash on the soles of his feet and it returned positive. He improved clinically with the initiation of penicillin. In this case, we will discuss the presentation, diagnosis and treatment of syphilitic hepatitis.
Help when you need it: Perspectives of adults with T1D on the support and training they would have wanted when starting CGM.

Abstract Aims The purpose of this study was to explore preferences that adults with type 1 diabetes (T1D) have for training and support to initiate and sustain optimal use of continuous glucose monitoring (CGM) technology. Methods Twenty-two adults with T1D (M age 30.95 ± 8.32; 59.1% female; 90.9% Non-Hispanic; 86.4% White; diabetes duration 13.5 ± 8.42 years; 72.7% insulin pump users) who had initiated CGM use in the past year participated in focus groups exploring two overarching questions: (1) What helped you learn to use your CGM? and (2) What additional support would you have wanted? Focus groups used a semi-structured interview guide and were recorded, transcribed and analyzed. Results Overarching themes identified were: (1) “I got it going by myself”: CGM training left to the individual; (2) Internet as diabetes educator, troubleshooter, and peer support system; and (3) domains of support they wanted, including content and format of this support. Conclusion This study identifies current gaps in training and potential avenues for enhancing device education and CGM onboarding support for adults with T1D. Providing CGM users with relevant, timely resources and attending to the emotional side of using CGM could alleviate the burden of starting a new device and promote sustained device use.
An Analysis of Means-End Hierarchies in Cross-Cultural Context: What Motivates Asian and Western Business Travelers to Stay at Luxury Hotels?

Abstract This article aims to show the potentialities of means-end chains for cross-cultural hospitality research. By means of laddering interviews, this work attempted to uncover major attribute-consequence-value chains for luxury hotels that may exist among Asian and Western business travelers. The results, although exploratory, suggest that the personally relevant meanings that customers hold for luxury hotels might depend on the individual's ethnic background. Managerial implications of the findings for global luxury hotels are discussed.
Crowdsourcing and Individual Creativity Over Time: The Detrimental Effects of Past Success

Several organizations have developed online crowdsourcing platforms that tap into the “wisdom” (creative ideas for new products and services) of a large “crowd” of non-experts (consumers). The crowdsourcing model seems very attractive because consumers are intrinsically motivated to freely contribute their creative ideas, but little is known about the effectiveness of these approaches. Two years of panel data from Dell’s IdeaStorm system are used to empirically explore the relationship between individual creativity, productivity, and past success. Estimation results from random effects and conditional fixed effects logit models reveal that individual creativity is positively related to current effort, but negatively related to past success. Thus, productive individuals are likely to have creative ideas, but are unlikely to repeat their early creative success once their ideas are recognized as being creative. These findings highlight some of the difficulties in maintaining an adequate supply of creative ideas from existing crowdsourcing applications, and emphasize the need for a greater understanding of the reward and feedback mechanisms in these systems.
IN-SPIRE InfoVis 2004 Contest Entry

This is the first part (summary) of a three-part contest entry submitted to IEEE InfoVis 2004. The contest topic is visualizing InfoVis symposium papers from 1995 to 2002 and their references. The paper introduces the visualization tool IN-SPIRE, the visualization process and results, and presents lessons learned.
Circuit sizing and supply-voltage selection for low-power digital circuit design

This paper analyzes energy minimization of digital circuits operating at supply voltages above threshold and in the sub-threshold region. Circuit sizing and supply-voltage selection are simultaneously analyzed to determine where the minimum energy solution occurs. In this work we address the effects of architectural modifications on the design choices in different regions of operation. Two new architectural parameters are introduced that can be used for fast design comparison in the low power region of operation.
Interval and Fuzzy Analysis: A Unified Approach

Publisher Summary A unified approach to real-valued interval and fuzzy analysis emphasizing common themes is presented in this chapter. Interval analysis and fuzzy analysis are viewed as a bridge between deterministic problem solving and problems with generalized uncertainty. The chapter discusses the basic knowledge of interval analysis and fuzzy set theory. Interval analysis and fuzzy set theory, as active fields of research and application, are relatively new mathematical disciplines receiving the impetus that defined them as separate fields. The connection between interval analysis and possibility theory arose out of fuzzy set theory. The theory of interval analysis models, among other things, the uncertainty arising from numerical computation, which can be considered a source of ambiguity. Fuzzy set theory and possibility theory model, among other things, the uncertainty of vagueness and ambiguity arising from the transitional nature of entities and a lack of information. The chapter also discusses the distinction between fuzzy set theory and possibility theory.
Structure and Composition of Costa Rican Montane Oak Forests

The current chapter provides some insight into the structure, composition and diversity of Costa Rica’s montane oak forest. It is meant to set the stage on this particularly rich and voluminous forest, in order to better understand its spatial and temporal patterns and processes, and above all, its functioning as an ecosystem. In subsequent chapters (Chaps. 15, 17, 23, 24, 26 and 30), these themes will be dealt with by the author, co-authors and colleagues who have studied the magnificent Talamancan montane oak forest environment over the last two decades.
Characterization of Europium and Americium Dipicolinate Complexes

Dipicolinic acid (pyridine-2,6-dicarboxylic acid, DPA) is a well-known complexant that forms moderately strong complexes with a variety of metal ions, including trivalent lanthanides. A search of open literature reports and thermodynamic databases produced no information on equilibrium constants for dipicolinate complexes of trivalent actinides. Such information represents an essential starting point for assessing the potential for application of dipicolinate to the task of trivalent lanthanide/actinide separations, specifically as a potential substitute for diethylenetriamine-N,N,N′,N″,N″-pentaacetic acid (DTPA) in the TALSPEAK process. The Am(III)/Eu(III)-dipicolinate system is the subject of the following report. Protonation constants of dipicolinic acid are pK1 = 2.15 (±0.02) and pK2 = 4.62 (±0.02) in µ = 1.0 M NaClO4 media, T = 25.0 (±0.1)°C. Stability constants of Eu3+ and Am3+ with DPA have been determined using solvent extraction distribution methods coupled with radiometric detection. The resolve...
Utilizing Kinematic Redundancy in Robotic Systems: Practical Implementations and Fundamental Limitations

The motion of kinematically redundant systems is typically represented by a linear relationship between end effector velocities or acceleration and joint velocities or accelerations. This allows one to formulate the inverse kinematic transformation in a conceptually appealing mathematical form. Unfortunately, such a formulation is usually a poor basis for the implementation of a numerical algorithm and also tends to abstract some of the limitations of a fundamentally nonlinear relationship. This work discusses some of the issues in implementing an efficient and numerically stable algorithm for utilizing redundancy. In addition, some of the limitations in the use of redundancy will be addressed including algorithmic singularities and repeatability.
Evidence-based medicine: is the evidence out there for primary care clinicians?

Background: Finding evidence to answer clinical questions is essential to the practice of evidence-based medicine (EBM). However, practising EBM in primary care is thought to be problematic because of concerns about whether evidence exists to answer specific questions. Objectives: To determine the highest level of evidence per question; to ascertain the number of questions unanswered because of a lack of evidence; to establish the frequency with which guidelines answered questions; and to determine the domain of websites used to answer questions. Methods: Clinical questions were identified from two primary care answering services: ATTRACT and National Library for Health (NLH) Primary Care Answering Service. The types of evidence used to answer the question were noted, including whether this was from systematic reviews or meta-analyses (level one evidence) or from randomised controlled trials (level two). The data were collected from March to June 2008. Results: Level 1 or level 2 evidence answered 11% of questions. Sixteen per cent were unanswered because of a lack of evidence. Over 40% of questions were answered using guidelines. Forty-three per cent of questions were answered with one type of evidence and 24% with two. Conclusion: Guidelines are useful resources for primary care clinicians, answering two-fifths of questions.
Food sovereignty in international context : discourse, politics and practice of place

1. Putting Food Sovereignty in Place Amy Trauger Part 1: Discourse 2. Where are the Local Communities? Food Sovereignty Discourses on International Agrobiodiversity Conservation Strategies Claudio Brenni 3. Farmers, Foodies and First Nations: Getting to Food Sovereignty in Canada? Annette Aurelie Desmarais and Hannah Wittman 4. Food Sovereignty in the Global North: The Application of a Social Justice Framework for a Common Language and Approach Alanna Higgins 5. Framing Food Provisioning Research in the UK: Whither Food Sovereignty? Carol Morris, Susanne Seymour and Adam Spencer Part 2: Politics 6. Food Security, Food Sovereignty, and the Nation-state: Historicizing Norwegian Farmland Policy Heidi Vinge 7. Repositioning Food Sovereignty: Between Ecuadorian Nationalist and Cosmopolitan Politics Alberto Arce, Stephen Sherwood and Myriam Paredes 8. Seed Sovereignty as Civil Disobedience in Northern India? Amy Trauger 9. Talking Around TT: Food Sovereignty as Unifying Discourse in the Southern Alberta Food System Trina Filan Part 3: Practice 10. Framing Multiple Food Sovereignties: Comparing the Nyeleni Declaration and the Local Food and Self-Governance Ordinance in Maine Hilda E. Kurtz 11. Gender, Food Sovereignty and Agrarian Reforms Susie Jacobs 12. Food Sovereignty in the Fields: Seed Exchange and Participatory Plant Breeding of Wheat Landraces in Italy Elisa Da Via 13. When Global goes Sweet, Locals turn Sour: Wine Sovereignty in Switzerland Melaine Laessle
HLA–B27 Alters the Response to Tumor Necrosis Factor α and Promotes Osteoclastogenesis in Bone Marrow Monocytes From HLA–B27–Transgenic Rats

Objective To determine whether HLA–B27 expression alters the response of bone marrow monocytes from HLA–B27/human β2-microglobulin–transgenic (B27-Tg) rats to tumor necrosis factor α (TNFα) and, if so, whether this affects the cells involved in bone homeostasis. Methods Bone marrow monocytes were treated with RANKL or with TNFα to promote osteoclast formation. Osteoclasts were quantified by counting. Gene expression was measured using quantitative polymerase chain reaction analysis, and protein was detected by enzyme-linked immunosorbent assay, immunoblotting, or immunofluorescence. Effects of endogenously produced cytokines on osteoclast formation were determined with neutralizing antibodies. Results TNFα treatment enhanced osteoclast formation 2.5-fold in HLA–B27–expressing cells as compared to wild-type or to HLA–B7/human β2-microglobulin–expressing monocytes. TNFα induced ∼4-fold up-regulation of HLA–B27, which was associated with the accumulation of misfolded heavy chains, binding of the endoplasmic reticulum (ER) chaperone BiP, and activation of an ER stress response, which was not seen with HLA–B7. No differences were seen with RANKL-induced osteoclastogenesis. Enhanced interleukin-1α (IL-1α) production from ER-stressed bone marrow monocytes from B27-Tg rats was found to be necessary and sufficient for enhanced osteoclast formation. However, bone marrow monocytes from B27-Tg rats also produced more interferon-β (IFNβ), which attenuated the effect of IL-1α on osteoclast formation. Conclusion HLA–B27–induced ER stress alters the response of bone marrow monocytes from B27-Tg rats to TNFα, which is associated with enhanced production of IL-1α and IFNβ, cytokines that exhibit opposing effects on osteoclast formation. The altered response of cells expressing HLA–B27 to proinflammatory cytokines suggests that this class I major histocompatibility complex allele may contribute to the pathogenesis of spondyloarthritis and its unique phenotype through downstream effects involving alterations in bone homeostasis.
WHAMM Directs the Arp2/3 Complex to the ER for Autophagosome Biogenesis through an Actin Comet Tail Mechanism

Nucleation-promoting factors (NPFs) control the spatio-temporal activity of Arp2/3 complex in cells]. Thus, WASP and the WAVE complex direct the formation of branched actin networks at the leading edge during cell motility and endo/exocytosis, whereas the WASH complex is involved in endosomal transport. Less understood are WHAMM and JMY, two NPFs with similar domain architecture. JMY is found in the nucleus and the cytosol and is involved in transcriptional regulation, cell motility, and trans-Golgi transport. WHAMM was reported to bind microtubules and to be involved in ER to cis-Golgi transport. Here, we show that WHAMM directs the activity of Arp2/3 complex for autophagosome biogenesis through an actin-comet tail motility mechanism. Macroautophagy--the process by which cytosolic material is engulfed into autophagosomes for degradation and/or recycling--was recently shown to involve actin, but the mechanism is unknown. We found that WHAMM forms puncta that colocalize and comigrate with the autophagy markers LC3, DFCP1, and p62 through a WHAMM-dependent actin-comet tail mechanism. Under starvation, WHAMM and actin are observed at the interface between neighboring autophagosomes, whose number and size increase with WHAMM expression. Interfering with actin polymerization, inhibiting Arp2/3 complex, knocking down WHAMM, or blocking its interaction with Arp2/3 complex through mutagenesis all inhibit comet tail formation and reduce the size and number of autophagosomes. Finally, JMY shows similar localization to WHAMM and could be involved in similar processes. These results reveal a link between Arp2/3-complex-dependent actin assembly and autophagy.
Kierkegaard's Phenomenology of Spirit

Kierkegaard's preoccupation with a separation between the ‘inner’ and the ‘outer’ runs through his work and is widely thought to belong to his rejection of Hegel's idealist monism. Focusing on The Concept of Irony and Either/Or, I argue that although Kierkegaard believes in various metaphysical distinctions between inside and outside (the inwardness of faith and the outwardness of ethics and language; the inwardness of emotion and the outwardness of behavior), he nonetheless understands the task of the philosopher as that of making outside and inside converge in a representation. Drawing on Hegel's philosophy of art, I show that Kierkegaard's project in both of these books is the aesthetic project of revealing the inner essence of something in its outward appearance. Kierkegaard's portrait of Socrates in The Concept of Irony is a phenomenology of the spirit of irony. My interpretation adds a new dimension to our understanding of Kierkegaard's aesthetics and his relation to Hegel; it presents him as a follower of Plato, whom he is usually thought to have dismissed; and it uncovers a deep connection between Kierkegaard's first two books, which are never read in conjunction.
The Structure of a New Terpenoid Acid, 6 (S)-Isopropyl-3ξ-methyl-3ξ-hydroxy-9-oxo-4 E-decenoic Acid, Isolated from Turkish Tobacco

The structure of a new hydroxy terpenoid acid, 6(S)-isopropyl-3ξ-methyl-3ξ-hydroxy-9-oxo-4E-decenoic acid (1a), isolated from a solvent-extract of Turkish tobacco, was elucidated by the spectroscopic properties and chemical evidence. This compound was suggested to be derived from thunberganoid diterpenoids and be a precursor of two dienoic acids, 6(S)-sopropyl-3-methyl-9-oxo-2E,4E-decadienoic acid (3a) and 6(S)-isopropyl-3-methyl-9-oxo-2Z,4E-decadienoic acid (4a) in Turkish tobacco.