cssi/SciSciGPT-SciSciNet huggingface dataset:
A generalized health economic and outcomes research model for the evaluation of companion diagnostics and targeted therapies

Aims: To present a generalized model to evaluate health and economic outcomes of targeted drug therapies and associated companion diagnostic tests with two applications. Method: An analytical model and derivatives applied to a nonlinear equation representing the costs and benefits of targeted therapy and associated companion diagnostics is developed. Economic analysis is then applied to a breast and colorectal cancer application with a multiparameter sensitivity analysis. Results: The generalized model readily facilitates trade-off analysis between, for example, alternative diagnostic test strategy cost and performance, and accounts for alternative therapy costs and benefits. Example applications demonstrate test performance and therapy costs and benefits are generally more critical parameters relative to diagnostic test cost. Conclusion: While obtaining accurate data on therapy cost and benefits, test performance remains a key challenge in these analyses, the model presents key trade-offs and priorities ...
Variable Pathogenicity Determines Individual Lifespan in Caenorhabditis elegans

A common property of aging in all animals is that chronologically and genetically identical individuals age at different rates. To unveil mechanisms that influence aging variability, we identified markers of remaining lifespan for Caenorhabditis elegans. In transgenic lines, we expressed fluorescent reporter constructs from promoters of C. elegans genes whose expression change with age. The expression levels of aging markers in individual worms from a young synchronous population correlated with their remaining lifespan. We identified eight aging markers, with the superoxide dismutase gene sod-3 expression being the best single predictor of remaining lifespan. Correlation with remaining lifespan became stronger if expression from two aging markers was monitored simultaneously, accounting for up to 49% of the variation in individual lifespan. Visualizing the physiological age of chronologically-identical individuals allowed us to show that a major source of lifespan variability is different pathogenicity from individual to individual and that the mechanism involves variable activation of the insulin-signaling pathway.
Dynamic scheduling of multiclass open queueing networks in a slowly changing environment

The popularity and importance of Web have increased dramatically in the past few years as well as the complexity of Web server systems. Workload characterization studies reveal that there exist strong time-of-day effects in the Web traffic. Many Web sites have sustained and higher hit rates during certain time periods of a day than other time periods. During the peak hours, the Web servers may even be overloaded. Simple stochastic processes with a fixed rate fails to capture this time varying characteristic of the Web systems. Therefore, we herein consider that the Web system is operating in a changing environment. Whenever the environment changes state, the arrival rates of user requests change as well as the service rates and the routing decisions.
The Leydig cell in larval amphibian epidermis. Fine structure and function.

The large, presumably mucus and/or fluid secreting cells of Leydig have been studied in the epidermis of the newt, Taricha torosa, by light and electron microscopy. Mitotic activity in visibly differentiated Leydig cells results in their increasing numbers so that by mid-larval stages they comprise the major cellular component of tailfin skin. Subsequently, the number of these cells diminishes as the epidermis thickens; their final disappearance coincides with metamorphosis and epidermal cornification. During the course of larval life, clear vesicles within Leydig cell cytoplasm accumulate granular material and, in time, assume the morphology of typical mucous aggregates. Concomitantly, the cytoplasm progressively becomes clear in appearance and nearly devoid of organelles. The surface of larval skin is normally provided with a thin mucous coat by continual production on the part of apical epidermal cells. When this surface is exposed to air, observation over a period of time reveals that the outer mucous coat hardens rapidly. There is no indication that additional fluid or mucus is provided to the drying surface from Leydig cells. Rather, light and electron micrographs of epidermis after various degrees of desiccation suggest that Leydig cells do respond to drying, but do so by adding fluid and perhaps mucous material to subsurface, extracellular compartments of the epidermis. The concept that Leydig cells provide an internal fluid reserve is discussed in relation to epidermal development and prevailing physiological and structural evidence bearing on intercellular compartments.
Steady-state cellular growth during directional solidification.

We study cellular structures moving at constant velocity, in a symmetric model of directional solidification. This is done by employing Newton's method to solve a discretized version of the integro-differential equation for the solid-liquid boundary. Our results indicate that there is a continuous band of allowed wavelengths and that there is a generic fold in the solution diagram. This fold provides a maximum allowed wavelength for any given velocity. Also, we argue that the mechanism of microscopic solvability serves to fix the tip shape at fixed wavelength. The implications of our results for wavelength and shape selection are briefly discussed.
Effects of implementing (APA) ethical principles in collecting classroom data

Abstract The study examined the effects of providing six levels of research information to 270 classroom subjects on the data obtained from three different cognitive tasks. The effects of the three tasks on the subjects' academic self-concepts were also investigated. No significant differences were found among the six levels of information for each of the three tasks. On the logical task a significant linear relationship was found supporting previous research which indicates that the more information that is given to research subjects, the more negative the results. There were no significant differences on self-concept scores across the three tasks used. Overall, the implementation of ethical principles had little effect on data collected in classroom settings, indicating support for implementation. This data did indicate, however, that providing more information than required under the ethical principles can result in data bias on a specific task.
Distributed algorithms for minimum cost multicast with network coding

Network coding techniques are used to find the minimum-cost transmission scheme for multicast sessions with or without elastic rate demand. It is shown that in wireline networks, solving for the optimal coding subgraphs in network coding is equivalent to finding the optimal routing scheme in a multicommodity flow problem. A set of node-based distributed gradient projection algorithms are designed to jointly implement congestion control/routing at the source node and "virtual" routing at intermediate nodes. The analytical framework and distributed algorithms are further extended to interference-limited wireless networks where link capacities are functions of the signal-to-interference-plus-noise ratio (SINR). To achieve minimum-cost multicast in this setting, the transmission powers of links must be jointly optimized with coding subgraphs and multicast input rates. Node-based power allocation and power control algorithms are developed for the power optimization. The power algorithms, when iterated in conjunction with the congestion control and routing algorithms, converge to the jointly optimal multicast configuration. The scaling matrices required in the gradient projection algorithms are explicitly derived and are shown to guarantee fast convergence to the optimum from any initial condition.
Melorheostosis in a patient with familial osteopoikilosis

We report on a 40-year-old woman with melorheostosis who also had radiographic findings of generalized osteopoikilosis. Three of her sibs have osteopoikilosis, but none of them have melorheostosis. Several cases of “mixed sclerosing bone dysplasia” have been described previously, and all have been sporadic. Isolated melorheostosis without osteopoikilosis is also generally a sporadic condition, but osteopoikilosis has been described as an autosomal-dominant trait. The finding of mixed sclerosing bone dysplasia in a family with osteopoikilosis suggests that the melorheostotic component of this disorder may be due to a second mutation at the same locus that causes isolated familial osteopoikilosis. Am. J. Med. Genet. 72:43–46, 1997. © 1997 Wiley-Liss, Inc.
Pathogenicity and Immunogenicity of Mynah Pox Virus in Chickens and Bobwhite Quail

An avian pox virus was isolated from cutaneous proliferative lesions removed from greater hill mynahs (Gracula religiosa) imported from Malaysia. Cutaneous inoculation of specific pathogen-free chickens and bobwhite quail with the mynah pox virus resulted in severe proliferative cutaneous lesions similar to those seen in the naturally infected mynah birds. Microscopically, the reaction in the chickens and quail at sites of virus inoculation was characterized by marked epithelial hyperplasia with ballooning degeneration and formation of cytoplasmic inclusion bodies. Inoculation of conjunctival and oral mucosae of chickens by applying pox virus with a cotton swab did not result in gross or microscopic lesions. In cross-protection studies, chickens and bobwhite quail immunized with either quail, fowl, pigeon, turkey, or psittacine pox vaccines were not protected from challenge with mynah pox virus. Following vaccination of quail and chickens with mynah pox virus vaccine, there was no resistance to challenge by quail, fowl, pigeon, turkey, or psittacine pox viruses. Significant protection against development of lesions following inoculation with mynah pox virus was attained only when the homologous virus was used as a vaccine.
Anion-directed assembly of a non-interpenetrated square-grid metal–organic framework with nanoscale porosity

A non-interpenetrated square grid metal–organic framework (MOF) comprised of octahedral Zn(II) ions and linear N,N′-di(4-pyridyl)-1,4,5,8-naphthalenediimide (DPNDI) ligands was formed in the presence of noncoordinating perchlorate counterions that occupied the cavities of the porous network by forming CH⋯anion hydrogen bonds with DPNDI ligands, whereas a linear coordination polymer was obtained when Zn(II)-coordinated nitrate ions were present as counterions.
Scaling and correlation in financial time series

We discuss the results of three recent phenomenological studies focussed on understanding the distinctive statistical properties of nancial time series { (i) The probability distribution of stock price uctuations: Stock price uctuations occur in all magnitudes, in analogy to earthquakes { from tiny uctuations to very drastic events, such as the crash of 19 October 1987, sometimes referred to as \Black Monday". The distribution of price uctuations decays with a power-law tail well outside the Levy stable regime and describes uctuations that dier by as much as 8 orders of magnitude. In addition, this distribution preserves its functional form for uctuations on time scales that dier by 3 orders of magnitude, from 1 min up to approximately 10 days. (ii) Correlations in nancial time series: While price uctuations themselves have rapidly decaying correlations, the magnitude of uctuations measured by either the absolute value or the square of the price uctuations has correlations that decay as a power-law, persisting for several months. (iii) Volatility and trading activity: We quantify the relation between trading activity { measured by the number of transactions Nt { and the price change Gt for a given stock, over a time interval [t; t+t]. We nd that Nt displays long-range power-law correlations in time, which leads to the interpretation that the long-range correlations previously found for jGtj are connected to those of Nt. c 2000 Elsevier Science B.V. All rights reserved.
RHUS (TOXICODENDRON) DERMATITIS

This article reviews the current fund of knowledge on poison ivy, poison oak, and poison sumac dermatitis. It is intended as a global summary to provide the primary care provider with the required information and sources for more esoteric academic pursuits. Toxicodendron characteristics, morphology, and biology are reviewed. The overall medical impact is delineated as well as the clinical manifestations, pathophysiology, prevention, and treatment. Historical perspectives are mentioned throughout, as are future trends in research.
Pharmacological Evidence for the Importance of Catecholamines in Cardiac Rhythmicity

Dogs with complete heart block were used to explore the dependence of the intrinsic rhythmicity of the heart on catecholamine activity. By the use of reserpine, hexamethonium, and surgical sympathectomy, it was demonstrated that, while reduction in catecholamine activity slows both the atrial and the ventricular rates, the ventricular pace maker was always affected to a greater degree. The effect of a combination of reserpine and hexamethonium on the ventricle was greater than when either agent was administered alone, suggesting that the greater the sympathetic blockade, the greater the depression in pacemaker rhythmicity. Since the course of its action on the heart paralleled that of catecholamine depletion, it seems probable that the effect of reserpine on rhythmicity was due to its catecholamine depleting action. It was thought unlikely that prolonged hypotension contributed to the reserpine action on the heart. It is indicated that disturbances in electrolyte balance and blood pH did not play a role in the effects observed.
Anterior levatorplasty for the treatment of chronic anal fissures in females with a rectocele: a randomized, controlled trial.

It is postulated that an anterior anal fissure can result from mucosal trauma occurring during distention of a rectocele and that repair of the rectocele by anterior levatorplasty can lead to healing of these anal fissures. This study was designed to compare anterior levatorplasty with internal sphincterotomy for the management of anterior anal fissures in females with a rectocele. From June 2000 until May 2002, 54 consecutive females with an anterior anal fissure and a rectocele were randomized to be managed by internal sphincterotomy or anterior levatorplasty. Preoperatively, manometry was performed, continence was measured using the Cleveland Clinic scoring system, pain scores were obtained using a visual analog scale, and the symptoms of bleeding and straining to defecate were assessed. Postoperatively, pain scores were obtained at Days 2, 7, and 21. Manometry, continence scores, and resolution of symptoms were measured between 8 and 12 weeks. Patient satisfaction and fissure healing also were assessed between 8 and 12 weeks. The average length of follow-up was 20 (range, 6–30) months. Postoperatively, lateral sphincterotomy caused a decrease in the resting pressures and anterior levatorplasty resulted in an increased length of the anal canal. Anterior levatorplasty also caused increased postoperative pain scores. There were no differences in fissure healing and patient satisfaction. These data suggest that anterior levatorplasty is an option for the management of patients with a rectocele, which may avoid the risk of incontinence with lateral internal sphincterotomy and better address the etiology of anterior anal fissures.
Vertebrate metacommunity structure along an extensive elevational gradient in the tropics: a comparison of bats, rodents and birds

Aim We evaluated the structure of metacommunities for each of three vertebrate orders (Chiroptera, Rodentia and Passeriformes) along an extensive elevational gradient. Using elevation as a proxy for variation in abiotic characteristics and the known elevational distributions of habitat types, we assessed the extent to which variation in those factors may structure each metacommunity based on taxonspecific characteristics. Location Manu Biosphere Reserve in the Peruvian Andes. Methods Metacommunity structure is an emergent property of a set of species distributions across geographic or environmental gradients. We analysed elements of metacommunity structure (coherence, range turnover and range boundary clumping) to determine the best-fit structure for each metacommunity along an elevational gradient comprising 13 250-m elevational intervals and 58 species of rodent, 92 species of bat or 586 species of passerine. Results For each taxon, the environmental gradient along which the metacommunity was structured was highly correlated with elevation. Clementsian structure (i.e.groups of species replacing other such groups along the gradient) characterized rodents, with a group of species that was characteristic of rain forests and a group of species that was characteristic of higher elevation habitats (i.e. above 1500 m). Distributions of bats were strongly nested, with more montane communities comprising subsets of species at lower elevations. The structure of the passerine metacommunity was complex and most consistent with a quasi-Clementsian structure. Main conclusions Each metacommunity exhibited a different structure along the same elevational gradient, and each structure can be accounted for by taxonspecific responses to local environmental factors that vary predictably with elevation. The structures of rodent and bird metacommunities suggest species sorting associated with habitat specializations, whereas structure of the bat metacommunityisprobablymouldedbyacombinationof species-specifictolerancestoincreasingly cold, low-productivity environs of higher elevations and the diversity and abundance of food resources associated with particular habitat types.
System dynamics modeling of an inspection-based process

A dynamic simulation model of an inspection-based software lifecycle process has been developed to support quantitative process evaluation. The model serves to examine the effects of inspection practices on cost, scheduling and quality throughout the lifecycle. It uses system dynamics to model the interrelated flows of tasks, errors and personnel throughout different development phases and is calibrated to industrial data. If extends previous software project dynamics research by examining an inspection-based process with an original model, integrating it with a knowledge-based method for risk assessment and cost estimation, and using an alternative modeling platform. While specific enough to investigate inspection practices, it is sufficiently general to incorporate changes for other phenomena. It demonstrates the effects of performing inspections or not, the effectiveness of varied inspection policies, and the effects of other managerial policies such as manpower allocation. The results of testing indicate a valid model that can be used for process evaluation and project planning, and can serve as a framework for incorporating other dynamic process factors.
Random-projection-based dimensionality reduction and decision fusion for hyperspectral target detection

Random projection for dimensionality reduction of hyperspectral imagery with a goal of target detection is investigated. Random projection is attractive in this task because it is data independent and computationally more efficient than other widely-used dimensionality-reduction methods, such as principal component analysis or the maximum-noise-fraction transform. Experimental results reveal that dimensionality reduction based on random projections yields improved target detection after decision fusion across multiple instances of the projections. Parallel implementation using a graphics processing unit is also investigated.
A parametric study of the lateral stability of a rail bogie on a roller rig

AbstractThe development of experimental facilities for rail vehicle testing is being complemented by analytical studies. The purpose of this effort has been to gain insight into the dynamics of rai...
Algorithms for detection and measurement of spontaneous events

The development of the personal computer and its mass storage capabilities has enabled long-term digitization of voltage records at high sampling rates. This paper presents a program that employs algorithms to analyze a sampled record for spontaneously occurring events. A detection algorithm employs amplitude and temporal parameters to identify the onsets of these events. Other algorithms then characterize size and shape features of these events. Examples of the results of these algorithms are given for intracellularly recorded excitatory postsynaptic potentials (EPSPs). These algorithms permit rapid and accurate quantitation of tens of thousands of events that may occur over many minutes. It is suggested that this set of algorithms may be applied to biological events other than synaptic potentials.
Elongation factor EF-1 alpha gene dosage alters translational fidelity in Saccharomyces cerevisiae.

Abstract Changes in the dosage of genes encoding elongation factor EF-1 alpha were shown to cause parallel changes in the misreading of nonsense codons. Higher amounts of EF-1 alpha were correlated with increased nonsense suppression, suggesting that the level of EF-1 alpha is critically involved in translational fidelity.
Effects of oxygenation and hypercapnia on diaphragmatic function and central drive during respiratory failure

The effects of oxygenation and hypercapnia on diaphragmatic function and central drives were assessed during the development of respiratory failure in anesthetized unbound spontaneously breathing rabbits. Oxygenation significantly altered endurance times, whereas hypercapnia had no effect. Isolated high-frequency contractile fatigue of the diaphragm was found in hyperoxic animals; all other animals had no evidence of contractile fatigue. Oxygenation and hypercapnia did not significantly alter the response of breathing frequency or duty cycle to loading. In all animals, there was a falloff in the intensity of central drive before apnea, with intensity of central drive remaining submaximal throughout loading. Oxygenation significantly altered the time and/or load at which drive intensity fell off, although critical blood gas levels were not associated with the falloff in intensity. We conclude that oxygenation influences the development of respiratory failure during inspiratory loading but does not directly explain the alterations is central drive. On the other hand, hypercapnia has no direct effect on respiratory muscle function or central drives during loading to respiratory failure. When the effects of hypoxemia are obviated by hyperoxia, high-frequency contractile fatigue may occur.
Suprasellar choristoma associated with congenital hydrocephalus, anophthalmia, cleft lip and palate, and clinodactly: a proposed variant of a unique new syndrome

A male infant was born with a bilateral cleft lip and/or palate, absent nasal structures, left anophthalmos, right coloboma, and bilateral fifth digit clinodactly. Brain magnetic resonance imaging revealed severe asymmetric hydrocephalus, absent corpus callosum, a suprasellar mass with a high riding third ventricle, and no pituitary gland. He had a normal male karyotype and normal prenatal laboratory testing. He had no significant family history and no renal, vertebral, gastrointestinal, or cardiac malformations. This combination of central nervous system findings, ocular and craniofacial abnormalities, a normal karyotype, and limited skeletal abnormalities to our knowledge has only been previously described once in the literature in association with a disruption in Pax and Sonic Hedgehog protein pathways, and we conclude this patient represents a variant of this described syndrome.
The Politics and Economics of the Romantic Poetess

For Anna Letitia Barbauld, Felicia Hemans, and Letitia Elizabeth Landon the term “poetess,” as it is colloquially understood today, does them disservice, for it not only undercut the accomplishments of these women, but it does little to credit the skill, cunning, and, for Landon and Hemans especially, the business sense of these women. Anna Letitia Barbauld, Felicia Hemans, and Letitia Elizabeth Landon – these were women of letters. While some women did write because it might be a nice way to spend a rainy afternoon, some did so because they had to, and they did so with great success. Landon and Hemans functioned as writers, reviewers, and editors, and were creating and publishing at a time of a significant shift in writing – the moment when imaginative and creative writing claimed a place within society and the economy as a commercial activity. While many female writers of the Romantic period were widely read and highly respected, such a shift opened all imaginative and creative writing to great scrutiny, particularly works written or edited by women. For women, like Landon and Hemans, who came to depend upon the writing economy for their livelihood, they were forced to balance creative expression with considerations of the social and cultural conditions of their time as well as the opinions of their critics. For others, like Barbauld, economic independence granted them the luxury of expression.Although women had laid claim to a place in the new writing economy, that place remained severely restricted. Landon and Hemans had to navigate these various restrictions, which limited their expression of subject, style, and person, to make a living. To this end, Hemans and Landon developed specifically gendered strategies for establishing credentials to gain, and then maintain, their legitimacy as poets; whereas Barbauld – though she too desired an audience – had the economic freedom to write whatever and however she wished. However, all three women of letters employed similar strategies of embracing a writerly persona, expressing great beauty in their work, and rooting their poems in history and philosophy not only to establish a readership, but also to criticize the dominant paradigm.
Assessment of Problem Behavior

Challenging behaviors are common in individuals with a number of different developmental disabilities. These challenging behaviors can upset an individual’s social, occupational, or academic daily functioning. When mental health professionals examine these individuals’ challenging behaviors, it is important to gather information about the topography, frequency, duration, intensity, and potential functions of the behavior. Functional behavior assessment includes three main types of assessment: standardized assessment, descriptive assessment, and functional analysis. Standardized assessment, also known as informant-based assessment, involves the administration of measures in which parents, teachers, direct care staff, or other caregivers provide information about the individual’s behavior. There are numerous standardized assessments available for gathering descriptive qualities of the individual’s behavior as well as information for pretreatment functional assessment, which will be discussed in the chapter. In descriptive assessment, clinicians assess circumstances in which the behavior occurs by observing the individual in their natural setting and recording events that precede and follow behavior. Descriptive assessment methods, such as event recording (e.g., contingency event recording, continuous event recording) and time sampling, will be discussed. Since functional analysis is a complex procedure requiring specialized training, an entirely separate chapter is dedicated to this topic (see Chap. 9).
Through the Lens of Life: Teaching Principles of Economics with Humans of New York

Stories create a direct and powerful connection with students and course material, increasing their level of attention, bringing abstract economic concepts to life, and refining their critical thinking skills. Humans of New York is an immensely popular blog and unique photojournalism project that chronicles the stories of ordinary New Yorkers. The blog provides an opportunity for economics educators to connect students with meaningful illustrations and personal accounts of economics in the real world. This teaching tool can reduce the abstract nature of economic theory and give students a concrete example to attach to economics terms and concepts, often in a way that reflects their own environment, culture or experiences. We highlight several stories and show how they can be incorporated into lectures.
Introduction: Mitochondrial Medicine

Fifty years has passed since the first description of a case with illness caused by mitochondrial dysfunction was published. Mitochondrial diseases occur primarily as a result of mutations occurring in genes that encode the approximate 1100–1500 genes responsible for mitochondrial structure, maintenance, and function. The mitochondria is the source of the vast majority of energy production within the cell, extracting energy from the molecular bonds within proteins, carbohydrates, and fat by way of a series of biochemical couples resulting in proton translocation across an impermeable membrane, and then capturing that energy as the protons flow back through the membrane resulting in the condensation of inorganic phosphate onto adenosine diphosphate to form adenosine triphosphate. In this process, oxygen serves as a sink for chemical reduction to water. Although mitochondrial disease is believed to be due to lack of adequate energy production, the additional functions of the mitochondria suggest that, in part, altered free radical production may also play a role in illness. The clinical aspects of mitochondrial dysfunction are varied, and diagnosing mitochondrial disease involves identifying the clinical phenotype and ordering confirmatory biochemical and/or genetic tests. This introduction will review the history of mitochondrial disease and serve to introduce the basic structure and function of the mitochondria.
BMT for severe aplastic anemia using cyclosporine.

Between 1984 and 1991 24 patients with severe aplastic anemia (SAA) were transplanted with HLA identical sibling donor BM. The overall long-term survival was 79 +/- 8%. The average age was 21 years (range 4-53 years) and the median pre-transplant disease duration was 35 days (range 12-2998 days). Over one-half (15 of 24) of the patients had received > 10 units of blood product transfusions prior to BMT. The pre-transplant conditioning regimen consisted of 200 mg/kg cyclophosphamide (CY). Cyclosporine (CYA) was administered from 2 days prior to BMT and continued for 6-12 months. Two of the 24 patients failed to achieve primary engraftment (FTE). One of these patients had autologous recovery of BM function and is alive and well. Five of the 22 patients who engrafted failed to sustain engraftment (FTSE). Of these, three are alive and well following a second BMT or marrow boost. Only 1 of the 22 patients who engrafted had clinically significant (i.e. Stage II-IV) acute GVHD. No patient developed chronic GVHD. Our results indicate that BMT following a regimen consisting of CY with the continuous use of CYA in the post-transplant period is well tolerated and associated with excellent long-term survival. The high incidence of secondary graft instability (i.e. FTSE), however, suggests that future studies should focus on post-transplantation immunomodulation.
The unique aspects of presentation and diagnosis of hemophagocytic lymphohistiocytosis in adults

Hemophagocytic lymphohistiocytosis (HLH) was initially described as an inflammatory condition affecting young children but is increasingly diagnosed in adults. Presenting features such as fever, cytopenias, phagocytosis, elevated ferritin, and increased levels of soluble IL-2 receptor are common in both age groups, but the prevalence of several clinical and biochemical criteria differ between pediatric and adult patients. Specifically, an elevated ferritin level does not have the same specificity for HLH in adults, and many other inflammatory conditions need to be considered in the differential. In contrast to the high incidence of infectious triggers seen in pediatric HLH, HLH in adults is often precipitated by a hematologic malignancy. Malignancy-associated HLH has unique manifestations and a uniformly very poor prognosis. Given these differences, diagnostic scoring systems unique to adult HLH have been proposed, and additional prognostic clinical and immunologic parameters are being explored. Although a genetic predisposition is increasingly found to underlie cases of adult-onset HLH, the mutations are less likely to be bi-allelic and differ slightly from those seen in pediatric cases of familial HLH. The facilitating genetic and environmental factors governing presentation of HLH in adults remain elusive. Understanding the clinical aspects and pathophysiology specific to adults with HLH is necessary to tailor therapies derived in pediatric disease to this under-recognized population.
Recent Advances in Difference Sets

According to Schuetzenberger [5] we also know, that if v is even then k-X is a square. The incidence matrix of a (bib) with parameters (4N1, 2N -1, N-1) can be used to construct Hadamard matrices of order 4N. To do this one replaces the zeros of the incidence matrix by -1 and borders the resulting matrix by a row and a column of l's. Other Hadamard matrices may be obtained directly (without bordering) from (bib) designs with parameters 4N2, 2N2 N, N2 N. Hadamard matrices have been used in the construction of binary codes [4], and there is no reason why other (bib) designs should not prove advantageous especially in asymmetric channels. It seems also reasonable to expect that codes constructed from groups and especially from Abelian groups will be relatively easy to implement. Apart from its intrinsic interest as a problem in combinatorial analysis, therefore, the construction of difference sets and the question of their existence for certain parameter combinations is of interest in the theory of error correcting codes. We shall restrict ourselves here principally to Abelian groups because not much is known about difference sets in non-Abelian groups. The difference sets with k =v and with k = v-I are called trivial and will not be considered here. It is easy to see that the complement of every difference set is a difference set so that we may always assume k <v/2. The research here goes in two directions: The construction of new sets, and the proof of the impossibility of solutions for certain parameter combinations. While progress in construction of difference sets was comparatively slow, an impressive number of theorems ruling out many infinite classes of parameter combinations have been obtained in recent years. These impossibility proofs sometimes refer to all Abelian groups and sometimes to specific groups only. Cyclic and elementary Abelian groups have received special attention. A complete result has been obtained for groups of order 2m. It has been shown [3] that the only possible solutions for v, k, X are v=22m, k =22m-1_2m-1, X=22m-2_2m-1. Difference sets for these parameter combinations can be constructed easily in groups which are the direct products of fourgroups and of cyclic groups of order 4. According to R. Turyn [7] one can take
Localization of and Immune Response to the Lipid-Modified Azurin of the Pathogenic Neisseria

The development of vaccines to prevent Neisseria infections has been impeded by antigenic diversity of most Neisseria surface components. The lipid-modified azurin (Laz), one of two distinct surface proteins recognized by the H.8 monoclonal antibody, is present in all pathogenic Neisseria. The mature protein has two domains; one contains an H.8 epitope and the other has extensive homology to azurins, a class of bacterial copper-binding proteins. The cellular location of Laz and the serum immune response to Lax were examined in patients with disseminated Neisseria infections. The data demonstrated that Laz is probably contained in the Neisseria outer membrane, although unlike most outer membrane proteins it is Sarkosyl soluble. By probing recombinant bacteriophages encoding the H.8 and azurin domains of Laz, results showed that whereas the H.8 epitope is immunogenic in patients with disseminated Neisseria infections, the azurin domain of Laz plays little role in eliciting an antibody response in these patients.
Combining research and dental hygiene.

Are you interested in how periodontal disease affects the body? Do you have a theory on how a product or medicine affects the oral cavity? Do you wonder how dental-related materials and therapies work and if they are effective? Then research may be a way for you to combine your dental hygiene knowledge, satisfy your quest for more in-depth knowledge of a subject, and answer your question. This is how it happened for me while I was a student at the University of North Carolina at Chapel Hill.
Immunosuppressive therapy in renal transplantation.

Immunosuppressive therapy has a major influence on renal transplant survival. The administration of these drugs drastically alters the patient’s immune response. Nurses must understand the actions and toxic side effects of these drugs. They must act promptly and appropriately to protect the patient and the graft against the adverse effects of immunosuppressant therapy.
Child Physical Activity Associations With Cardiovascular Risk Factors Differ by Race.

Purpose: The objective of this study was to characterize the relationship between objectively-measured physical activity (PA) and cardiovascular risk factors in 7-year-old children and test the hypothesis that it differs by race. Methods: Cross-sectional study of 308 7-year-old children drawn from a major US metropolitan community. PA (moderate-to-vigorous, MVPA; light, LPA; and inactivity, IA) was measured by accelerometry (RT3). Cardiovascular risk factors included BMI, blood pressure, and serum lipids, glucose and insulin concentrations. General linear modeling was used to evaluate the independent associations between PA measures and cardiovascular risk factors and interactions by race. Results: In black children, greater time spent in PA was independently associated with lower levels of triglycerides (MVPA and LPA, both p < .01), glucose (MVPA, p < .05), and insulin (MVPA, p < .01); these associations were not evident in white children. Across races, greater inactivity was independently associated wit...
Modifications to the butterfly graft used to treat nasal obstruction and assessment of visibility

ImportanceGraft visibility in the supratip region has been the main criticism of the butterfly graft. Because of the graft location, slightly unfavorable supratip fullness can occur, resulting in p...
C. S. Lewis on Politics and the Natural Law

Conventional wisdom holds that C. S. Lewis was uninterested in politics and public affairs. The conventional wisdom is wrong. As Justin Buckley Dyer and Micah J. Watson show in this groundbreaking work, Lewis was deeply interested in the fundamental truths and falsehoods about human nature and how these conceptions manifest themselves in the contested and turbulent public square. Ranging from the depths of Lewis' philosophical treatments of epistemology and moral pedagogy to practical considerations of morals legislation and responsible citizenship, this book explores the contours of Lewis' multi-faceted Christian engagement with political philosophy generally and the natural-law tradition in particular. Drawing from the full range of Lewis' corpus and situating his thought in relationship to both ancient and modern seminal thinkers, C. S. Lewis on Politics and the Natural Law offers an unprecedented look at politics and political thought from the perspective of one of the twentieth century's most influential writers.
Distance from a Comprehensive Cancer Center: A proxy for poor cervical cancer outcomes?

Abstract Objective To evaluate the potential relationship between outcomes in cervical cancer patients based on distance from our Comprehensive Cancer Center (CCC). Methods A retrospective cohort study of cervical cancer patients was performed. Abstracted data included: demographics, clinicopathologic variables, treatment, and survival. Analyses both by quartiles and distance Results 390 patients living a median distance of 58.1miles (range 1.2–571miles) from our CCC were identified. Patients were generally white ( n =249), non-smokers ( n =226), with Stage IB disease ( n =222), squamous histology ( n =295) and underwent primary surgical therapy ( n =229). Patients were divided into both quartiles as well as two strata: p =0.040). Cox proportional hazard modeling noted that advanced stage was predictive of inferior PFS and OS, while other clinical covariates including age, BMI, race, smoking status and histology had a variable impact on outcomes and distance >100miles was associated with a higher risk of death (hazard ratio [HR]=1.68, 95% confidence interval [CI] 1.11–2.54). Conclusion Overall survival for patients living >100miles from our CCC was worse when compared to patients in closer proximity. Outreach efforts and utilization of navigators may help decrease the impact of geographic and racial disparities on outcomes.
Dosimetric comparison of helical tomotherapy using different techniques, simultaneous integrated boost and sequential boost for craniospinal irradiation: a single institution experience

Purpose Craniospinal irradiation (CSI) has become an important and challenging radiation technique for radiation oncologists. Helical tomotherapy (HT) seems to have dosimetric advantage for CSI compared with other radiation modalities. The purpose of this study was to compare dosimetric data between two different HT plans; simultaneous integrated boost (SIB) and sequential boost (Sq). Method Twelve previously treated CSI contoured datasets by SIB technique were replanned. Dosimetric comparative parameters of targets were conformity index (CI) and homogeneity index (HI). For organ at risk (OARs), the mean dose of parallel organs, D2% of serial organs and whole body integral dose (ID) were also investigated. Result SIB plan significantly provided more conformed dose to CSI and tumour boost while resulting in a similar CI in spinal boost region compared with Sq plan. The HI showed no differences between two plans. Radiation exposure to serial organs and ID were also significantly lower in SIB plan. Conclusion CSI treatment using HT, SIB technique was feasible and had more target coverage while minimising the radiation dose to healthy tissues.
Replication of tobacco mosaic virus: II. The in vitro synthesis of high molecular weight virus-specific RNAs☆☆☆

Abstract The products synthesized in vitro by a crude replicase enzyme extract prepared from TMV-infected tobacco plants have been analyzed by polyacrylamide-agarose gel electrophoresis. The activity of this enzyme is insensitive to deoxyribonuclease and actinomycin D. About 65% of the phenol-extracted product is insensitive to pancreatic ribonuclease but is completely digestible by KOH. A portion of the synthesized RNA coelectrophoreses with double-stranded TMV replicative form of molecular weight of 4 × 10 6 daltons. A ribonuclease-sensitive, higher molecular product was detected on occasion; it was considered to be the TMV replicative intermediate of about 5 × 10 6 daltons. No single-stranded RNA corresponding in size to TMV-RNA was observed.
Consequences of Low-Quality Audits for Engagement Partners: The Importance of Audit Firm Quality Control Systems

We investigate the consequences of low-quality audits for engagement partners in the US and the role audit firm quality control systems play in this process. We employ a sample period during which the identity of the engagement partner on specific audits is not publicly known to isolate the effect of quality control systems on partner management. We find that restatements result in partner changes for both restating and non-restating clients. Because the identity of the partner on an audit is not publicly known, non-restating clients may not be fully aware of the restatements associated with their engagement partners. We find that audit firms with ineffective partner quality control systems take advantage of this opaque information environment and do not replace low quality partners, especially if the partners can bring in large audit fees. Even if these audit firms replace the partner, they do not supply a new partner with higher quality. Our results highlight the importance of an effective quality control system in disciplining partners. When audit firm quality control systems fail, enhanced transparency through disclosing the identity of the engagement partner may be necessary in disciplining the auditing labor market.
Applications of Communication Theory: II — Interpretations of Keats’ ”Ode on a Grecian Urn”

It is proposed that the arts and humanities have an objective substructure, along with the profound subjectivity that characterizes them. This follows if one looks upon these fields as applications of communication theory, mainly as communication-pleasure in which self-attitudes are everywhere at issue. Using Keats’ Ode on a Grecian Urn as an example, the paper outlines the objectivity that is substructure to the arts and humanities, paralleling the subjectivity that is substructure of science.
Pregnancy and immune stimulation: re-imagining the fetus as parasite to understand age-related immune system changes in US women.

Objectives Pregnancy can increase production of Immunoglobulin E (IgE), an immune response more often directed towards parasite infections. An absence of parasitism makes the US population ideal to test the hypothesis that the maternal immune system recognizes a fetus as a parasite. We predict that total IgE levels are positively associated with a history of pregnancy across all ages of adult women, mirroring patterns of IgE in parasitized populations. Methods Reproductive-aged women (n = 2201) from the National Health and Nutrition Examination Survey 2005-2006 were analyzed in a cross-sectional design using complex survey regression and multiple imputation to evaluate associations between total IgE levels, pregnancy history, and interactions between age and pregnancy. Results Women with a history of pregnancy have significantly higher IgE levels and a significantly shallower slope of IgE levels across ages (P = .031). Conclusions This research supports the hypothesis that maternal immune systems respond to prior pregnancies as they do to macro-parasitic exposures, and may modify the expected linear declines of IgE levels in women that accompanies aging. These finding have implications for understanding the evolution of internal gestation in mammals.
Hospital value-based purchasing performance: Do organizational and market characteristics matter?

EXECUTIVE SUMMARY The hospital value-based purchasing (HVBP) program of the Centers for Medicare & Medicaid Services challenges hospitals to deliver high-quality care or face a reduction in Medicare payments. How do different organizational structures and market characteristics enable or inhibit successful transition to this new model of value-based care? To address that question, this study employs an institutional theory lens to test whether certain organizational structures and market characteristics mediate hospitals' ability to perform across HVBP domains.Data from the 2014 American Hospital Association Annual Survey Database, Area Health Resource File, the Medicare Hospital Compare Database, and the association between external environment and hospital performance are assessed through multiple regression analysis. Results indicate that hospitals that belong to a system are more likely than independent hospitals to score highly on the domains associated with the HVBP incentive arrangement. However, varying and sometimes counterintuitive market influences bring different dimensions to the HVBP program. A hospital's ability to score well in this new value arrangement may be heavily based on the organization's ability to learn from others, implement change, and apply the appropriate amount of control in various markets.