cssi/SciSciGPT-SciSciNet huggingface dataset:
76. IMPLEMENTATION AND EVALUATION OF A COORDINATOR-LED, PEDIATRIC PROGRAM COORDINATOR MONTHLY EDUCATIONAL SERIES

Background With ever expanding requirements from the Accreditation Council of Graduate Medical Education (ACGME), the role of the program coordinator has grown, necessitating updated onboarding materials for new coordinators and continuing education for experienced coordinators. While the need for coordinator education and professional development is well-established, there remains the question of who should provide such education. A needs assessment at a single institution of coordinators representing 177 programs (111 ACGME accredited residencies and fellowships, 66 non-ACGME accredited fellowships) found that although monthly meetings were provided by the Graduate Medical Education Office, gaps still existed in the knowledge and engagement of coordinators across-the-board. 86% of coordinators surveyed indicated that coordinator professional development is very important and needed. Objective To create and assess the impact and feasibility of a coordinator-led educational series for pediatric program coordinators. Methods The Department of Pediatrics at Stanford University School of Medicine instituted a monthly, coordinator-led educational series. Three coordinators organized the series, with a total of nine coordinators collaborating on presentation of topics. Over a period of 18 months, 20 distinct topics were delivered, with some topics being repeated (Figure 1). Participants were asked to rate the entire series as a whole at the end of the 18-month period. Descriptive statistics were used to analyze the results. Results Of 19 pediatric coordinators, 18 completed the final survey (95%). Coordinators reported they were satisfied with the series (94%), likely to recommend to new coordinators (100%), and likely to recommend to experienced coordinators (82%). C-TAGME and opportunities for national participation were identified as topics that would be useful for future sessions. Comments underscored that rolling topics were necessary for new coordinators but would be repetitive for experienced coordinators. The time spent in organization and preparation of the series was estimated at eight hours a month. Conclusion The implementation of a program coordinator-led educational series was found to be feasible and satisfactory, with coordinators likely to recommend the series to others. More work needs to be done to determine the best format, frequency, and topics for a coordinator-led series.
Interwar Modernism and the Liberal World Order: Offices, Institutions, and Aesthetics after 1919

What was the modernist response to the global crisis of liberal world order after 1919? This book tells the story of the origins of liberal world governance in Cambridge modernist circles, the literary response to the Versailles Peace of 1919, and the contestation of that institutional moment across a range of world literary modernities. Challenging standard accounts of reactionary postwar politics, Interwar Modernism and the Liberal World Order articulates a modernism animated by the contradictions of liberal governance between the wars. The book develops a new materialist reading of modernist politics hinged on the official figures that traverse both modernist texts and liberal order. This official liberal world shapes interwar arts and letters from wartime Cambridge to revolutionary Shanghai.
Akupunktur bei Migräne

Die Wirksamkeit der Akupunktur bei Migrane konnte in den GERAC-Studien (2002–2005) nachgewiesen werden. Eine 6‑wochige Akupunkturtherapie zeigte sich ebenso erfolgreich wie eine medikamentose Standardtherapie zur Prophylaxe uber 6 Monate. Seit kurzer Zeit befinden sich monoklonale Antikorper zur Blockierung des CGRP (Calcitonin Gene-related Peptide) bzw. dessen Rezeptoren auf dem Markt. Gemas der STRIVE-Studie, die der Einfuhrung dieser Medikamentengruppe vorausging, berichten 43,3 % der Patienten von einer mindestens 50 %igen Verringerung der Migranetage, die GERAC-Studie kam auf 47 %. Anhand eines Fallberichts soll das praktische Vorgehen bei Migrane diskutiert werden.
Numerical investigation of partial cavitation regimes over a wedge using large eddy simulation

Abstract Partial cavitation over incipient, transitory and periodic regimes is investigated using large eddy simulation (LES) in the (experimental) sharp wedge configuration of Ganesh et al. (2016). The numerical approach is based on a compressible homogeneous mixture model with finite rate mass transfer between the phases. Physical mechanisms of cavity transition observed in the experiments; i.e. re-entrant jet and bubbly shock wave, are both captured in the LES over their respective regimes. Vapor volume fraction data obtained from the LES is quantitatively compared to X-ray densitometry. In the transitory and periodic regimes, void fractions resulting from complex interactions of large regions of vapor in the sheet/cloud show very good comparison with the experiments. In addition, very good agreement with the experiments is obtained for the shedding frequency and the bubbly shock wave propagation speed. In the incipient regime, the qualitative characteristics of the flow (e.g. cavitation inside spanwise vortices in the shear layer) are captured in the simulations. Conditions favoring either the formation of the re-entrant jet or the bubbly shock wave are analyzed by contrasting the LES results between the regimes. In the transitory regime, large pressure recovery from within the cavity to outside, and the resulting high adverse pressure gradient at the cavity closure support the formation of re-entrant jet. In the periodic regime, overall low pressures lead to reduced speed of sound and increased medium compressibility, favoring the propagation of shock waves. In a re-entrant jet cycle, vapor production occurs predominantly in the shear layer, and intermittently within the cavity. In a bubbly shock cycle, vapor production is observed spanning the entire thickness of the cavity. Bubbly shock wave propagation is observed to be initiated by the impingement of the collapse-induced pressure waves from the previously shed cloud. Supersonic Mach numbers are observed in the cavity closure regions, while the regions within the grown cavity are subsonic due to the negligible flow velocities.
Nanoparticles for Immune Cell Reprogramming and Reengineering of Tumor Microenvironment

Nanoparticles in cancer therapy have garnered significant attention in the past few decades. Cancer immunotherapy, which is aptly called "the new-generation cancer therapy," is slowly making remarkable strides in the improvement of patient outcome and longevity. Taken together, nanoparticles in immune therapy have the potential to offer advantages of both nanoparticles and immune therapy on a single platform.
Location, year, and tree age impact NIR-based postharvest prediction of dry matter concentration for 58 apple accessions

Abstract Conventional assessments of postharvest traits, like dry matter concentration (DMC) require destructive sampling that can often be limited by fruit availability of apple trees in early years. Alternatively, nondestructive prediction of postharvest traits using NIR spectroscopy has been demonstrated to be rapid and robust in various fruits and vegetables, including apples. With most prediction models built using one to few cultivars, it remains largely unknown if NIR-based prediction can be applied in an apple breeding program with numerous selections that are added, replicated, and evaluated annually. In this study, 2252 fruit from 58 accessions grown at three orchard sites were destructively measured for DMC, and nondestructively measured for NIR spectra. Nondestructive prediction of DMC exhibited high accuracies in most analyses. In characterizing DMC predictive performance of within- versus between-years, both models were highly predictive and comparable, albeit slightly higher for the former. Further analysis of location × year effects revealed that location was a more important factor than year in influencing predictive performance. Finally, in cultivar-specific models, prediction made using fruit from more established trees as a calibration set consistently yielded higher prediction accuracy. Overall, the use of three statistical metrics enhanced our understanding of NIR prediction accuracy, while a control calibration set in all analyses provided a statistical baseline for comparing accuracy outputs. This study provides a framework for understanding the impacts of location, year and tree age on NIR prediction accuracy of DMC in diverse apple breeding accessions. In addition, this study demonstrates the importance of assessing predictive performance using multiple statistical metrics.
Long-Term Surgical Complications After Pancreatoduodenectomy: Incidence, Outcomes, and Risk Factors.

Long-term complications following pancreatoduodenectomy (PD) can significantly impact quality of life and healthcare utilization. Most reports focus on short-term (within 90 days) PD outcomes; however, the incidence and risk factors for long-term complications (> 90 days) remain to be evaluated. We sought to identify the incidence, outcomes, and risk factors for long-term complications post-PD. All PD survivors between 2010 and 2017 were identified from a single-institutional database. Long-term complications (> 90 days post-PD and not resulting from cancer recurrence), including biliary stricture, cholangitis, pancreatitis, peptic ulcer, small bowel obstruction, and incisional hernia, were identified. Logistic regression was used to identify perioperative predictors of long-term complications. Of 906 PDs, 628 long-term survivors met criteria for analysis (mean age of 65.3 years, 47% female). Median follow-up and overall survival were 51.1 months (95% CI 47.6, 55.7) and 68.5 months (95% CI 57.9, 81.4), respectively. A total of 198 (31.5%) experienced at least one long-term complication. Complications included incisional hernia (17.7%), biliary stricture or cholangitis (8.0%), pancreatitis (5.7%), small bowel obstruction (4.3%), and peptic ulcer (3.2%). In total, 108 (17.2%) of the complications required an intervention, nearly half of which were surgical. On multivariable analysis, several predictors of long-term complications were identified: obesity (BMI ≥ 30 kg/m2), postoperative wound infection, prolonged index length of stay, readmission (< 90 days), operative approach (open vs. robotic), and pylorus-preservation. Long-term complications occur in nearly a third of PDs and nearly one-fifth of all PDs require re-intervention. Several modifiable predictors of long-term complications were identified.
Compact W-Band “Swan Neck” Turnstile Junction Orthomode Transducer Implemented by 3-D Printing

A turnstile junction orthomode transducer (OMT) provides polarization separation/combining on a full waveguide bandwidth; however, it bears a complex connecting structure, which accordingly leads to a bulky volume. We present a compact W-band (75–110 GHz) OMT using a “swan neck” twist for the connection between a turnstile junction and an $E$ -plane Y-junction, for minimizing the overall OMT structure. The core volume for the proposed OMT is $9\times $ less than the previously reported stacked-layer OMT. The compact W-band OMT was built by digital light processing (DLP) 3-D printing technology and was postmetallized by silver electroless plating. The return loss of the vertical-polarized port (V-port) and the horizontal-polarized port (H-port) is characterized, as averagely 17 and 15 dB, respectively. The measured average insertion loss from H- and V-ports to the common port is 0.5 and 0.6 dB. The measured isolation between V- and H-ports is averagely 28 dB. Furthermore, the turnstile junction asymmetry along the central axis was revealed in computed tomography (CT) scanned images. The simulation shows a negative effect of the asymmetric structure on the OMT isolation. In addition, the dual-polarized (dual-pol) antenna combining such OMT and a corrugated horn was realized in a compact size. The cross-polarization level of the OMT, characterized in a far-field test of this dual-pol antenna, is averagely −18 dB at the W-band.
Functionalized Dipicolinic Acid Derivatives as TALSPEAK-MME Stripping Agents

This work describes the results of an assessment of two derivatives of dipicolinic acid (DPA) as the actinide-selective stripping reagents in the combined HEH[EHP]/Cyanex-923 system, TALSPEAK-MME (...
Longitudinal profiling of the macaque vaginal microbiome reveals similarities to diverse human vaginal communities: implications for use as a pre-clinical model for bacterial vaginosis

The vaginal microbiota plays an important role in women9s reproductive and urogenital health. Disturbances in this microbial community can lead to several adverse outcomes including pelvic inflammatory disease, bacterial vaginosis (BV) as well as increased susceptibility to sexually transmitted infections, miscarriage, and pre-term births. It is now well accepted that while the microbiome of healthy women in the developed world is dominated by Lactobacillus species, vaginal communities in asymptomatic women, especially those in the developing world, can be comprised of a diverse set of micro-organisms. The presence of a diverse vaginal microbiome has been associated with increased susceptibility to HIV infection but their implications for women9s health remain poorly understood. Rhesus macaques are an excellent translational animal model due to significant physiological and genetic homology with humans. In this study, we performed a longitudinal analysis of clinical and microbiome data from 16 reproductive age female rhesus macaques. Many animals showed hallmarks of BV, including Nugent scores above 7 and high vaginal pH. At both the taxonomic and functional level, the rhesus macaque vaginal microbiome was most similar to that of women who harbor a diverse vaginal community associated with asymptomatic/symptomatic bacterial vaginosis. Specifically, rhesus macaque vaginal microbiomes harbored a diverse set of anaerobic gram-negative bacteria, including; Snethia, Prevotella, Porphyromonas, and Mobilluncus. Interestingly, some animals were transiently colonized by Lactobacillus and some with Gardnerella. Our in-depth and comprehensive analysis highlights the importance of the model to test interventions for manipulating the vaginal microbiome.
Primary urachal carcinoma: A systematic review.

e16502Background: Primary urachal carcinoma (PUC) is a rare cancer of unknown definite cause, and various treatment approaches given its very low incidence and the scarcity of prospective studies. ...
Analysis of dependent data aggregated into intervals

Abstract Many series of data record individual observations as intervals, such as stock market values with daily high-low values, or minimum and maximum monthly temperatures, recorded over time. With the advent of massively large data sets from contemporary computers, it is frequently the case that observations are aggregated into (meaningful) classes of observations, so that resulting data are perforce intervals (or histograms, or other forms of so-called symbolic data). What is known is that taking the average stock market price, or average temperature results in a loss of information. Therefore, this article looks at autocovariance/autocorrelation functions for interval-valued autoregressive series models. Maximum likelihood estimators are derived by exploiting the ideas of composite likelihood and the pairwise likelihood of Lindsay (1988) and Davis and Yau (2011). Different internal distributions of the intervals themselves are also studied. Asymptotic properties of these estimators are obtained. A simulation study shows that the new estimators perform considerably better than those obtained from the set-valued estimators of Wang et al. (2016).
Moving beyond 99.9% Coulombic efficiency for lithium anodes in liquid electrolytes

As Li-ion battery costs decrease, energy density and thus driving range remains a roadblock for mass-market vehicle electrification. While Li-metal anodes help achieve Department of Energy targets of 500 Wh kg−1 (750 Wh l−1), Li Coulombic efficiencies fall below the 99.95+% required for 1,000+ cycles. Here we examine historical electrolyte developments underlying increased Coulombic efficiency and discuss emerging frameworks that support rational strategies to move beyond 99.9%. While multiple electrolytes reach 98–99% Coulombic efficiency over subsets of cycles, achieving >99.9% Coulombic efficiency consistently throughout cycling is an as yet unmet challenge. We analyse important interplays between electrolyte, solid electrolyte interphase composition, plating–stripping kinetics and Li morphology, many of which are only recently being quantified experimentally at the Li interface, and which collectively determine Coulombic efficiency. We also discuss forward-looking strategies that, if mastered, represent new opportunities to refine understanding and support new record values of Coulombic efficiency in the coming years. Irreversibility is one of the biggest obstacles in realizing practical Li-metal batteries. This Review surveys the trends in Coulombic efficiency (CE)—a reversibility indicator—reported for Li-metal batteries over the last five decades, abstracts key CE descriptors and analyses promising strategies to improve CE.
Long-term Phosphorus Fertilization for Corn-Soybean Rotations

Introduction A study was conducted from 1976 to 2002 to evaluate the effect of annual phosphorus (P) fertilization on soil P and yields of corn and soybeans. Both crops were grown each year in a rotation by alternating them between two halves of the area. Cornstalks were chisel-plowed in the fall and disked in the spring. Soybean residue was disked in spring. The Webster soil predominated, and there were small areas of Canisteo. Soil pH varied from 6.0 to 8.2. Less than 15% of the area had a pH of 7.3 or higher (calcareous).
Comments On Forum Non Conveniens Issues in International Cases

I begin with certain basic premises of international law. Customary international law does not or at the very least does not ordinarily dictate the decisions of a state regarding which civil cases it courts will and will not hear. The most obvious manifestation of this premise is that rules regarding access to and the authority of courts differ. Disputes between states regarding the exercise of jurisdiction in civil cases typically involve assertions that a state (or its court) has exceeded its jurisdiction, not that it has breached an international duty by failing to hear a case. I am aware of no rule of customary international law to the effect that plaintiffs choice of forum must be honored or extinguishes the jurisdiction of other courts. The right to determine access to its courts is a right unquestionably enjoyed by a Latin American state. It is also a right unquestionably enjoyed by the United States. Neither can force a civil case into the courts of the other against its will. And while
Federal Criminal Workload, Guilty Pleas, and Acquittals: Statistical Background

The appendices assembled in this document compile statistics relating to workload and case processing in the federal criminal justice system over the years. These compilations provide the background necessary to understand the significance of trends over the years in acquittal and guilty plea rates, as discussed in a companion article, Trial Distortion and the End of Innocence in Federal Criminal Justice, published in volume 154 of the University of Pennsylvania Law Review, also available at papers.ssrn.com/abstract=702901. In addition, these appendices offer more detail on issues of data collection and interpretation, and allow more extended discussion of issues tangential to the central discussion in the companion article.
Interactive Training for Synthetic Characters

Compelling synthetic characters must behave in ways that reflect their past experience and thus allow for individual personalization. We therefore need a method that allows characters to learn. But simply adding traditional machine learning algorithms without considering the characters’ own motivations and desires will break the illusion of life. Intentional characters require interactive learning. In this paper, we present the results of Sydney K9.0, a project based on the Synthetic Characters creature kernel framework. Inspired by pet training, we have implemented a character that can be trained using the “clicker training” technique. Clicker training utilizes the natural desires of an animal and employs operant conditioning procedures for shaping their behavior. The necessary plasticity of system interconnections shaped by associations and rewards that is required by clicker training was integrated into the creature kernel framework. The implemented system also includes a module named DogEar that is designed for collecting real-world acoustic data, such as human voice commands, integrated into the creature kernel’s perception system. This provides a seamless interface between the simulated and real worlds. Detailed implementation and interaction results are presented.
First-principles study of piezoelectricity in tetragonal PbTiO 3 and PbZr 1/2 Ti 1/2 O 3

The local orbital extension of the linearized augmented plane wave (LAPW+LO) method within the general gradient approximation was used to determine structural and ferroelectric properties of tetragonal ${\mathrm{PbTiO}}_{3}$ (PT), and two chemically ordered ${\mathrm{PbZr}}_{1/2}{\mathrm{Ti}}_{1/2}{\mathrm{O}}_{3}$ (PZT 50/50) phases, with B-site cations ordered along [001], and [111] directions. Stable ferroelectric ground states were found in all structures. Bulk spontaneous polarization, dynamical charges ${(Z}^{*}),$ and piezoelectric stress tensor elements were determined from ground-state Berry's phase calculations. Ordering along the polar [001] direction was found to enhance the ${e}_{33}$ piezoelectric stress modulus in PZT 50/50. While theoretical piezoelectric stress moduli of PT, ${e}_{15}=3.15 \mathrm{C}/{\mathrm{m}}^{2},$ ${e}_{31}=\ensuremath{-}0.93 \mathrm{C}/{\mathrm{m}}^{2},$ and ${e}_{33}=3.23 \mathrm{C}/{\mathrm{m}}^{2},$ agree well with single-crystal experimental data, computed proper moduli of bulk crystalline PZT, ${e}_{33}(P4\mathrm{mm})=4.81 \mathrm{C}/{\mathrm{m}}^{2}$ and ${e}_{33}(I4\mathrm{mm})=3.60 \mathrm{C}/{\mathrm{m}}^{2},$ differ significantly from low-temperature experimental moduli of polycrystalline samples.
Levetiracetam for the treatment of pediatric status epilepticus: A case series

The purpose of this study was to investigate if levetiracetam (LEV) is an effective agent in the treatment of status epilepticus (SE) in children, evaluate the dosing of LEV being used, and to record the incidence of adverse effects. A retrospective chart review was done for patients who had received LEV for the treatment of SE and grand mal seizure at a 180-bed academic pediatric teaching hospital. Patients met inclusion criteria if they had received LEV for the treatment of SE, and if the dose, administration time, and administration route were documented in their charts. The primary outcome was the rate of seizure cessation attributed to treatment with LEV. Additional data collected included overall rate of seizure cessation regardless of agent used, rate of seizure cessation based on age, type of seizure(s) experienced, history of intractable seizures, and where in the sequence of therapy LEV was used. A total of 20 of 51 patients met inclusion criteria and treatment with LEV resulted in seizure cessation in 15 patients (75%). The average dose received by patients was 37.5 mg/kg (range: 16–98.8 mg/kg) as an intravenous bolus. The adverse effects experienced were similar to what is described in the literature. LEV may be a successful first line or adjunct treatment for pediatric patients in SE regardless of the patients’ age, type of seizure, or history of intractable epilepsy. It also appears to be a safe treatment option. Optimal dosing still needs to be defined.
Un)frozen in time

Permafrost regions occupy nearly a quarter of Earth9s terrestrial surface. The extent of subarctic permafrost has been reduced significantly during the past century, leading to widespread subsidence and damage to roads and buildings. In his Perspective, Nelson reports from a recent meeting on permafrost and its roles in environmental change. He concludes that one of the greatest challenges in the field is to separate climate-induced impacts from local anthropogenic influences. This challenge can only be met with more detailed and extensive data records.
Testing and Parameterization of Elastomers for Modeling of Linear Vibration Systems

Representation of elastomers for use in modeling of linear systems requires great care in the acquisition of test data. Current industry-standard test techniques are not adequate for quantitative description of elastomerssubjected to small amplitude sinusoidal excitation. Equally important to accurate dynamic testing of elastomers is parameterization of the test data for use in modeling of systems. The paper discusses testing and parameterization techniques used to describe elastomers for use in a linear, low-frequency vibration model of an automobile. Accuracy requirements of test instrumentation, selection of suitable linear elastomer models, and interpolating functions (used for equivalent linearization and ambient condition corrections) are discussed in some detail.
THE DEVELOPMENT OF HIGH PURITY TANTALUM AND ALLOYS FOR LIQUID PLUTONIUM CONTAINMENT IN LAMPRE I

By combining arc casting and electron beam melting, spectroscopically pure tantalum and alloys, suitable for containment of molten Pu-Fe alloys, were produced. The 0.1% W alloy was used for the first LAMPRE loading. The effects of a large number of additives on the corrosion resistance of tantalum were tested. Additions of up to 10% tungsten gave increasing endurance. Specimens of tantalum irradiated with neutrons until 3% converted to tungsten were stitl satisfactory in mechanical properties for reactor use. Either tungsten or the traces of yttrium remaining after arc melting can raise the one-hour recryatatlization temperature of tantalum by 400 deg C. Effects of internal strain, critical strain and precipitation hardening in tantalum alloys were studied. High-temperature annealed tantalum had superior corrosion resistance, while impact extruded and ironed material was better than deep-drawn metal. Mechanical tests on tantalum with added interstitial elements showed that their presence to the extent expected in LAMPRE would be unlikely to weaken the tantalum. Evidence was found that oxygen promotes plutonium attack on tantalum. Small amounts of hydrogen, nitrogen and carbon had no effect on corrosion. (auth)
Molecular classification of thyroid nodules by cytology.

Objectives: Fine needle aspiration (FNA) biopsy of thyroid nodules provides cytologic specimens whose interpretation can direct patients toward either thyroidectomy or observation. Approximately 20% of FNA specimens yield an indeterminate result. Recent studies have characterized differences in gene expression between benign and malignant conditions, most often using whole tissue. Our goal was to determine the feasibility of quantitative polymerase chain reaction (qPCR)-based gene expression analysis in cytologic samples. For five genes shown to be over-expressed in thyroid carcinomas (fibronectin, galectin-3, Met/HGFR, MUC1, and GA733-precursor), we compared expression among pathologic states. Study Design: Prospective laboratory analysis of 20 thyroidectomy specimens. Methods: Routine microscopy was performed. Cytologic samples were obtained from the dominant nodules, and RNA was extracted. Preliminary analysis using fluorometry and reverse-transcriptase (RT)-PCR was performed. Expression levels of the test genes in nodules and from control samples were measured by real-time qPCR. Fold changes in gene expression were compared. Results: Only one specimen did not yield sufficient intact RNA for gene expression analysis. RT-PCR revealed satisfactory RNA recovery in all other specimens. qPCR showed significant over-expression of fibronectin in the papillary carcinomas compared with the goiters (P = .0013), follicular adenomas (P = .0014), and follicular carcinomas (P = .0001). Differences in both fibronectin and MUC1 expression between the follicular carcinomas and the follicular adenomas were also significant (P = .025 and .045, respectively). Conclusions: Cytologic specimens were a satisfactory source of tissue for qPCR-based gene expression analysis. Both fibronectin and MUC1 were differentially expressed in follicular adenomas and follicular carcinomas, and fibronectin expression differed in papillary carcinomas compared with the other lesions. These results may form the basis of a clinical predictor for lesions with indeterminate or suspicious cytology.
Role of Prostate Specific Antigen and Immediate Confirmatory Biopsy in Predicting Progression During Active Surveillance for Low Risk Prostate Cancer

Purpose: We evaluated predictors of progression after starting active surveillance, especially the role of prostate specific antigen and immediate confirmatory prostate biopsy.Materials and Methods: A total of 238 men with prostate cancer met active surveillance eligibility criteria and were analyzed for progression with time. Cox proportional hazards regression was used to evaluate predictors of progression. Progression was evaluated using 2 definitions, including no longer meeting 1) full and 2) modified criteria, excluding prostate specific antigen greater than 10 ng/ml as a criterion.Results: Using full criteria 61 patients progressed during followup. The 2 and 5-year progression-free probability was 80% and 60%, respectively. With prostate specific antigen included in progression criteria prostate specific antigen at confirmatory biopsy (HR 1.29, 95% CI 1.14–1.46, p <0.0005) and positive confirmatory biopsy (HR 1.75, 95% CI 1.01–3.04, p = 0.047) were independent predictors of progression. Of the 61 c...
A Clinicopathologic Study of the Eyes in Familial Adenomatous Polyposis by Extracolonic Manifestations (Gardner's Syndrome)

The eyes of a 51-year-old woman with familial adenomatous polyposis and extracolonic manifestations (Gardner's syndrome) were obtained postmortem and studied by light microscopy and by transmission and scanning electron microscopy. We found a generalized abnormality in melanogenesis of the retinal pigment epithelium and at least three types of pigmented lesions. The histologic findings in one type of lesion were consistent with congenital hypertrophy of the retinal pigment epithelium or benign pigmented nevus of the retinal pigment epithelium. The other two types of lesion were most consistent with hamartomatous malformations of the retinal pigment epithelium featuring cellular hypertrophy, hyperplasia, and rarely retinal invasion and formation of a minute mushroom-shaped tumor. These histopathologic findings indicate a generalized effect of the familial adenomatous polyposis gene on the retinal pigment epithelium. This oncogene, which is responsible for tumor formation in the gastrointestinal tract, soft tissues, bone, and other locations in patients with familial adenomatous polyposis, also leads to a generalized defect in melanogenesis and focal lesions of the retinal pigment epithelium.
Relative proteolytic action of milk-clotting enzyme preparations on bovine α-, β- and κ-casein

Concentrations of seven milk-clotting enzyme preparations were standardized to equal clot times. Portions of bovine α s -, β- and κ-casein were treated with enzymes. Proteolytic activity of the coagulants on each casein fraction was determined using the TNBS (2,4,6-trinitrobenzenesulfonic acid) procedure. Recombinant chymosin showed the lowest degree of proteolysis on α s - and β-caseins. Excessive proteolysis of calf rennet appeared to be due to the pepsin fraction. M. miehei and M. pusillus var Lindt proteases showed similar degradation of caseins, but M. pusillus var Lindt was more proteolytic when β-casein was the substrate. C. parasitica protease showed the highest degree of proteolysis on α s - and β-caseins but was the least proteolytic on κ-casein.
TU‐EE‐A2‐04: A Hybrid Dose Evaluation Method for Rapid Monte Carlo‐Based IMRT Optimization

Purpose: To develop and test a hybrid method for optimizing IMRT plans using Monte Carlo(MC) dose calculation algorithms which retains the accuracy of MC while reducing the MC dose computational requirements. Method and Materials: A hybrid dose calculation strategy in which initial optimization is performed with a fast pencil beam (PB) algorithm using deliverable‐based IMRToptimization. Following convergence, doses are re‐computed with the VMC++ MC algorithm to determine correction factors for further PB‐based optimization. The correction/re‐optimization procedure is repeated until convergence. The hybrid method was benchmarked with respect to MC‐deliverable—based optimization for 5‐prostate IMRT plans. Figures of merit included number of MC dose computations required, final plan quality score, and optimization dose‐volume indices. Results: The hybrid method required a maximum of 3 MC dose calculations to converge to a result which provided equivalent dose coverage to the complete MC‐based optimization plan. The complete MC‐based optimization required between 6 and 9 MC dose computations to converge, depending on the specific patient. After 2 MC dose computations, the hybrid plan quality score was equal to or less than the MC‐based score for 4 of the 5 plans, the remaining plan required 3 iterations to achieve a score equal to that for the MC‐based optimization. Monitor units for the hybrid and complete MC‐optimization were within 5%. Conclusion:Hybrid PB‐MC‐IMRT dose calculation method is practical and results in plans equivalent to those achieved when MC‐dose calculation is used for all optimization iterations. The hybrid method reduced the number of MC calculations by a factor of ∼3, reducing overall optimization time by a factor of 2.8, and allowing for VMC++ MC‐based optimization to be completed in <30 min on a 20×2.4 Ghz CPU cluster. (Supported in part by NIH‐R01CA98524).
Assembling and installing line-replaceable units for the National Ignition Facility

Within the 192 National Ignition Facility (NIF) beamlines, there are more than 7000 large (40×40 cm) optical components, including laser glass, mirrors, lenses, and polarizers. These optics are held in large optomechanical assemblies called line-replaceable units (LRUs). Each LRU has strict specifications with respect to cleanliness, alignment, and wavefront so that once activated, each NIF beamline will meet its performance requirements. NIF LRUs are assembled, tested, and refurbished in on-site cleanroom facilities. The assembled LRUs weigh up to 1800 kg, and are about the size of a phone booth. They are transported in portable clean "canisters" and inserted into the NIF beampath using robotic transporters. This plug-and-play design allows LRUs to be easily removed from the beampath for maintenance or upgrades. Commissioning of the first NIF quad, an activity known as NIF Early Light (NEL), has validated LRU designs and architecture, as well as demonstrated that LRUs can be assembled and installed as designed. Furthermore, it has served to develop key processes and tools forming the foundation for NIF's long-term LRU production and maintenance strategy. As we look forward to building out the rest of NIF, the challenge lies in scaling up the production rate while maintaining quality, implementing process improvements, and fully leveraging the learning and experience gained from NEL. This work provides an overview of the facilities, equipment, and processes used to assemble and install LRUs in NIF.
GTP-binding protein Gq mediates muscarinic-receptor-induced inhibition of the inwardly rectifying potassium channel IRK1 (Kir 2.1).

The inwardly rectifying potassium channel IRK1, a member of the Kir 2.0 family, is inhibited by m1 muscarinic receptor stimulation. In this study the mechanism of action underlying the muscarinic response was investigated by identification of the subtype of heterotrimeric G-protein involved in transduction of the signal. tsA201 cells were simultaneously transfected with cDNAs encoding IRK1, m1 and the Gα subunit of either Gq, G12 or G13. The whole-cell patch–clamp technique was used to study the effects of G-protein transfection. Antibodies generated against the C-terminal regions of Gαq/11 and Gα12 were used to confirm G-protein expression by Western blot. When challenged with carbachol, IRK1 currents recorded from cells co-transfected with Gαq were potently inhibited compared with controls. Conversely, co-transfection with Gα12 or Gα13 subunits had no effect on muscarinic-receptor-induced inhibition of IRK1. Concentration response curves revealed that carbachol was 16 times more potent at inhibiting IRK1 currents in cells co-transfected with Gαq as compared with Gα12 co-transfected cells. Immunoblotting illustrated low levels of endogenous Gαq/11 and Gα12 in untransfected tsA cells. Transfection with Gαq or Gα12 cDNAs greatly increased the levels of G-protein expression in both cell populations. G-protein expression did not interfere with m1 muscarinic receptor expression levels. These findings suggest that the m1 muscarinic-receptor-induced inhibition of IRK1 is mediated by the heterotrimeric G-protein, Gαq, in tsA cells.
High-performance confocal system for microscopic or endoscopic applications

We designed a high-performance confocal system that can be easily adapted to an existing light microscope or coupled with an endoscope for remote imaging. The system employs spatially and temporally patterned illumination produced by one of several mechanisms, including a micromirror array video projection device driven by a computer video source or a microlens array scanned by a piezo actuator in the microscope illumination path. A series of subsampled "component" video images are acquired from a solid-state video camera. Confocal images are digitally reconstructed using "virtual pinhole" synthetic aperture techniques applied to the collection of component images. Unlike conventional confocal techniques that raster scan a single detector and illumination point, our system samples multiple locations in parallel, with particular advantages for monitoring fast dynamic processes. We compared methods of patterned illumination and confocal image reconstruction by characterizing the point spread function, contrast, and intensity of imaged objects. Sample 3D reconstructions include a diatom and a Golgi-stained nerve cell collected in transmission.
1274 Relationship Between Compliance with the |[ldquo]|Cham Jam|[rdquo]| Intervention and Physical Activity Levels in Bronx Elementary School Students

Background and aims: A “CHAM JAM” intervention aims to increase physical activity (PA) in schools without daily physical education (PE). Compliance with delivering an intervention as planned is a fidelity measure important in interpreting intervention's effect. Aim: To assess the relationship between compliance with “CHAM JAM” and PA levels. Methods: A cluster-randomized wait-listed controlled study at 4 schools. Students in 2 schools received “CHAM JAM”, an audio CD with 10-minute, education-focused aerobic activities. Teachers were instructed to use intervention 3 or more times/day. Compliance with “CHAM JAM” was measured by unannounced random direct observations. PA was measured on 5 consecutive days at baseline, 3- and 6-months post-intervention using a pedometer. Hierarchical linear models were used to evaluate differences in PA levels in relation to degree of compliance. Results: 913 students participated (456 intervention; 457 control). After adjusting for baseline PA, grade level, recess and PE class participation, greater compliance with intervention was associated with increased PA levels 3- and 6-months postintervention, p 2.5 times/day had greater PA levels as compared to controls at 3-months (3152 (SD 1288) steps vs. 2556 (SD 1150) steps, p=.0029) and 6-months (3822 (SD 1231) vs. 3448(SD 1488), p=.09) post-intervention. Overall, compliance with “CHAM JAM” was higher 3-months (mean 1.81, range 0-4 times/day) than 6-months post-intervention (mean 1.56, range 0-6 times/day). Conclusions: A dose-response relationship exists between compliance with “CHAM JAM” and PA levels. These results may have implications for further program evaluation and dissemination.
Assignment of the absolute configuration of [n]-ladderanes by TD-DFT optical rotation calculations

In this study, we report theoretical specific rotation values for a series of cis-/trans-alkylated-[5]-ladderanes and cis-/trans-methylated-[n]-ladderanes. Using time-dependent density functional response theory optical rotation calculations, we can assign (+) and (-) optical rotation signs to trans-(S)-alkyl-[5]-ladderane and trans-(R)-alkyl-[5]-ladderane configurations, respectively. In order to qualitatively validate our absolute configuration predictions, we computed optical rotation values at three different levels of theory--B3LYP, RI-BP86, and Hartree-Fock--using the aug-cc-pVDZ basis set. We observe a novel rung-parity-controlled oscillatory optical rotatory phenomenon in our computations, which, to the best of our knowledge, has never been reported or observed before. Furthermore, this preliminary analysis of optical rotation properties in this class of compounds should facilitate the correct absolute stereochemical assignment of natural and synthetic ladderanes, such as the trans-isomer of pentacyclic C(20)-fatty acid methyl ester (pentacycloanammoxic methyl ester), without the need for derivatization, in particular for cases where NMR or X-ray crystal structures are not readily available.
Diastolic Heart Failure: Definitions and Terminology

Patients with chronic heart failure can be divided into 2 broad categories: systolic heart failure and diastolic heart failure. There are significant differences in demographics, prognosis, left ventricular structure, as well as systolic and diastolic function between these 2 groups of patients. The purpose of this presentation is to define the terminology used to describe these 2 broad categories of heart failure and to characterize the functional measurements that constitute their pathophysiological mechanisms.
Social science in medicine: The question of ‘relevance’

Social science differs from the other basic medical sciences in that its perspective for understanding illness is not centered on processes within the individual. For this reason the relevance of social science knowledge to clinical practice is not obvious to many medical educators and students. Initial efforts at the University of North Carolina to develop a social science curriculum that is obviously relevant are described. Strategies include the use of small-group seminars taught by social-scientist/clinician teams and an organizing framework which links social science knowledge to clinical practice. Response to the curriculum from faculty and students has been encouraging.
Harm reduction psychotherapy comes out of the closet

Harm reduction psychotherapy gives a name to a practice many therapists have quietly been conducting for years. Some of us have been doing psychotherapy with clients who present with both psychological and addictive behavior problems, despite the ideological barriers that have promulgated total separation of these two sets of problems in terms of treatment philosophies, interventions, and providers. This article chronicles the author's evolution from viewing addictions as distinct from psychological problems to understanding and treating them as a subset of human behaviors causing suffering that can and should be integrated into a more comprehensive psychotherapeutic framework. © 1998 John Wiley & Sons, Inc.
Steps toward the ripening of relationship science.

Recent decades have seen remarkable growth in research and theorizing about relationships. E. Berscheid (1999) invigorated this growth by proclaiming “The Greening of Relationship Science,” the emergence of a multidisciplinary science of interpersonal relationships with enormous potential to advance knowledge about human behavior and to provide an empirically informed framework for improving the human condition. Here I discuss several steps necessary to move the field from a green science toward a more mature, ripened one, including the need to be action oriented but in a theory-building way, to become more cumulative and collective, and to develop an integrated network of theories, constructs, and their observable manifestations. Perceived partner responsiveness is one possible central organizing theme for the diverse phenomena relationship scientists study.
Surface‐Enhanced Raman Detection of Nerve Agent Simulant (DMMP and DIMP) Vapor on Electrochemically Prepared Silver Oxide Substrates

Surface-enhanced Raman scattering (SERS) spectra of the chemical nerve agent simulants dimethyl methylphosphonate (DMMP) and diisopropyl methylphosphonate (DIMP) were obtained in the vapor phase. The spectra obtained demonstrate the possibility of detecting these nerve agent species in the vapor phase using electrochemically roughened silver oxide substrates prepared from silver foil.
America in the Twenties and Thirties: The Olympian Age of Franklin Delano Roosevelt

In this, the third volume of an interdisciplinary history of the United States since the Civil War, Sean Dennis Cashman provides a comprehensive review of politics and economics from the tawdry affluence of the 1920s throught the searing tragedy of the Great Depression to the achievements of the New Deal in providing millions with relief, job opportunities, and hope before America was poised for its ascent to globalism on the eve of World War II. The book concludes with an account of the sliding path to war as Europe and Asia became prey to the ambitions of Hitler and military opportunists in Japan. The book also surveys the creative achievements of America's lost generation of artists, writers, and intellectuals; continuing innovations in transportation and communications wrought by automobiles and airplanes, radio and motion pictures; the experiences of black Americans, labor, and America's different classes and ethnic groups; and the tragicomedy of national prohibition. The cast of characters includes FDR, the New Dealers, Eleanor Roosevelt, George W. Norris, William E. Borah, Huey Long, Henry Ford, Clarence Darrow, Ernest Hemingway, Scott Fitzgerald, W.E.B. DuBois, A. Philip Randolph, Orson Welles, Wendell Willkie, and the stars of radio and the silver screen. The first book in this series, America in the Gilded Age, is now accounted a classic for historiographical synthesis and stylisic polish. America in the Age of the Titans, covering the Progressive Era and World War I, and America in the Twenties and Thirties reveal the author's unerring grasp of various primary and secondary sources and his emphasis upon structures, individuals, and anecdotes about them. The book is lavishly illustrated with various prints, photographs, and reproductions from the Library of Congress, the Museum of Modern Art, and the Whitney Museum of American Art.