cssi/SciSciGPT-SciSciNet huggingface dataset:
Acousto-Optic/CCD Image Processor

Optical image correlators are presented that use acousto-optic and charge-coupled devices as the input and output transducers respectively. Experimental results are presented and the applicability to pattern recognition of a non-linear pseudo-correlation that can also be conveniently computed with these processors, is discussed.
Early Economic Works of Ellis

Beginning with his association with the Mills, Ellis became increasingly interested in the subject of political economy. As a member of J. S. Mill’s study groups, he studied the Wealth of Nations, the works of Ricardo and Malthus, and especially the newer textbooks of James Mill and J. R. McCulloch. These works were the foundation of most of Ellis’s early ideas concerning economics. His most important early writings are the subject of this chapter. This early involvement with economic theory helped prepare Ellis for his later role as popularizer of classical economics, which is examined in Chapter 12.
Recent developments in evaluating pumping behavior of flowable and self-consolidating concretes

In this paper, recent developments in evaluating pumping behavior of flowable and self-consolidating concrete (SCC) are discussed. First, a brief overview of the underlying physics of pumping of concrete is given to introduce the concepts of friction, flow, hydrodynamic and hydrostatic pressure and to present the concept of the lubrication layer. Various methods to assess the lubrication layer properties are then discussed, including tribology and different visualization techniques for the velocity profile. Using tribology on the one hand, or by combining the rheological properties of the concrete and its constituent mortar and knowing the thickness of the lubrication layer on the other hand, it is shown that pressure losses during pumping of concrete can be successfully predicted. An overview is also provided to discuss the influence of flow rate, pipe diameter and critical SCC properties influencing the pressure during pumping.
“But One Ben Jonson Honoured”: Ivor Gurney’s Apprenticeship

In “Prelude,” a later poem from his asylum period, Ivor Gurney places himself in a strange military company of musicians and poets: Great allies me serve—Shakespeare, Beethoven,Shelley’s friend, th...
Surgeon-, pathologist-, and hospital-level variation in suboptimal lymph node examination after colectomy: Compartmentalizing quality improvement strategies

Background The goals of this study were to characterize the variation in suboptimal lymph node examination for patients with colon cancer across individual surgeons, pathologists, and hospitals and to examine if this variation affects 5-year, disease-specific survival. Methods A retrospective cohort study was conducted by merging the New York State Cancer Registry with the Statewide Planning & Research Cooperative System, Medicaid, and Medicare claims to identify resections for stages I–III colon cancer from 2004–2011. Multilevel logistic regression models characterized variation in suboptimal lymph node examination ( Results The overall rate of suboptimal lymph node examination was 32% in 12,332 patients treated by 1,503 surgeons and 814 pathologists at 187 hospitals. Patient-level predictors of suboptimal lymph node examination were older age, male sex, nonscheduled admission, lesser stage, and left colectomy procedure. Hospital-level predictors of suboptimal lymph node examination were a nonacademic status, a rural setting, and a low annual number of resections for colon cancer. The percent of the total clustering variance attributed to surgeons, pathologists, and hospitals was 8%, 23%, and 70%, respectively. Increasing the pathologist and hospital-specific rates of suboptimal lymph node examination were associated with worse 5-year, disease-specific survival. Conclusion There was a large variation in suboptimal lymph node examination between surgeons, pathologists, and hospitals. Collaborative efforts that promote optimal examination of lymph nodes may improve prognosis for colon cancer patients. Given that 93% of the variation was attributable to pathologists and hospitals, endeavors in quality improvement should focus on these 2 settings.
Impact of patient characteristics on compliance to adjuvant chemotherapy in hormone receptor negative breast cancer: A single institution experience.

e19568 Background: Adherence to adjuvant chemotherapy (ACT) has been implicated in poor outcomes in early breast cancer (BC). We investigated factors that may contribute to non-compliance (NC) in h...
Water for Agriculture: the Convergence of Sustainability and Safety

Agricultural water is a precious and limited resource. Increasingly more water types and sources are being explored for use in irrigation within the United States and across the globe. As outlined in this chapter, the Produce Safety Rule (PSR) in the Food Safety and Modernization Act (FSMA) provide irrigation water standards for application of water to fruits and vegetables consumed raw. These rules for production and use of water will continue to develop and be required as the world experiences aspects of a changing climate including flooding as well as drought conditions. Research continues to assess the use of agricultural water types. The increased use of reclaimed water in the United States as well as for selected irrigation water needs for specific crops may provide increased water availability. The use of surface water can be used in irrigation as well, but several studies have shown the presence of some enteric bacterial pathogens (enterohemorrhagic E. coli, Salmonella spp. and Listeria monocytogenes) in these waters that may contaminate fruits and vegetables. There have been outbreaks of foodborne illness in the U.S., South America, Europe, and Australia related to the use of contaminated water in fruit and vegetable irrigation or washing. Unreliable water supplies, more stringent microbial water standards, mitigation technologies and expanded uses of reclaimed waters have all increased interest in agricultural water.
The impact of multimorbidity on grip strength in adults age 50 and older: Data from the health and retirement survey (HRS).

Abstract Background Multimorbidity, the presence of two or more chronic diseases, is a public health concern. The measurement of grip strength has been proposed as a measure of overall body strength and is reliable and easy to measure. The purpose of this study was to investigate the relationship between the number of chronic diseases and common co-occurring chronic diseases with grip strength. Methods A cross-sectional analysis was conducted of 5877 respondents (2744 = male, 3103 = female) from the 2008 Health and Retirement Study (HRS) who completed grip strength measurements (kg). Results As the number of chronic diseases increased, an incremental decrease in grip strength occurred and became more pronounced with ≥3 chronic diseases present (b = 3.1, 95% CI = 2.3–3.9, p Conclusion Multimorbidity has a statistically significant negative relationship on grip strength. Grip strength should be considered as a physical performance measure to incorporate into the care of patients with multimorbidity.
Modeling valuation and core affect in a cognitive architecture: The impact of valence and arousal on memory and decision-making

Abstract A novel approach to adding primitive evaluative capabilities to a cognitive architecture is proposed. Two sub-symbolic quantities called valuation and arousal are learned for each declarative memory element based on usage statistics and the reward it generates. As a result, each memory element can be characterized as positive or negative and having a certain degree of affective intensity. In turn, these characteristics affect the latency and probability of retrieval for that memory element. Two global accumulators called core-affect-valuation and core-affect-arousal are computed as weighted sums of all retrievable valuations and arousals, respectively. The weights reflect usage history, context relevance, and reward accrual for all retrievable memory elements. These accumulators describe the general disposition or mood of the system. Core affect dynamics are used as reward signals to learn valuation and arousal values for new objects or events. The new architectural mechanism is used to develop two models that demonstrate the impact of affective valence and arousal on memory and decision-making. The models are fit to datasets from the literature and make novel predictions. The value of including valuation and core affect mechanisms in a cognitive architecture is discussed.
Characterization and mechanisms of the supragastric belch in the cat

Rapid strong distension of the thoracic esophagus activates rapid inhalation followed by a belch, which is the sequence of responses that compose the human supragastric belch (SGB). The rapid inhal...
A Performance of Forces: A Combat Veteran, a Poet, and a Psychotherapist in “Narratives Interrupted”

AbstractThis essay in “Notes from Field” illustrates the use of poetry therapy through a narrative lens into the inner world of a combat veteran. Through a poem written by a military veteran, a psychotherapist interrupts the poem with alternative possibilities as a means of narrative reconstruction with the client. Poetry, after all, befuddles the reader, not to mention the poet, with poetic devices: multiple-layered metaphor, altered cadences, vague allusions, and grand illusion. The reader is left with the question of what lies ahead of the therapist facing a poem-narrative and a combat veteran client struggling for meaning and hope post war.“War is ultimately life-destroying, but warriorhood and poetry are life affirming. Poetry can contain war's horror in its grace, chaos in its order, and senselessness in its search for meaning” (Tick, 2015, p. 328).
An untapped resource in the nursing workforce: Licensed practical nurses who transition to become registered nurses.

Abstract Background A more diverse registered nurse (RN) workforce is needed to provide health care in North Carolina (NC) and nationally. Studies describing licensed practical nurse (LPN) career transitions to RNs are lacking. Purpose To characterize the occurrence of LPN-to-RN professional transitions; compare key characteristics of LPNs who do and do not make such a transition; and compare key characteristics of LPNs who do transition in the years prior to and following their transition. Methods A retrospective design was conducted using licensure data on LPNs from 2001 to 2013. Cohorts were constructed based on year of graduation. Findings Of 39,398 LPNs in NC between 2001 and 2013, there were 3,161 LPNs (8.0%) who had a LPN–to–RN career transition between 2001 and 2013. LPNs were more likely to transition to RN if they were male; from Asian, American Indian, or other racial groups; held an associate or baccalaureate degree in their last year as an LPN (or their last year in the study if they did not transition); worked in a hospital inpatient setting; worked in the medical–surgical nursing specialty; and were from a rural area. Discussion Our findings indicate that the odds of an LPN-to-RN transition were greater if LPNs were: male; from all other racial groups except white; of a younger age at their first LPN licensure; working in a hospital setting; working in the specialty of medical-surgical nursing; employed part-time; or working in a rural setting during the last year as an LPN. Conclusion This study fills an important gap in our knowledge of LPN-to-RN transitions. Policy efforts are needed to incentivize: LPNs to make a LPN-to-RN transition; educational entities to create and communicate curricular pathways; and employers to support LPNs in making the transition.
Proapoptotic function of deubiquitinase DUSP31 in Drosophila.

// Sergey A. Sinenko 1, 2 1 Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC 27710, USA 2 Institute of Cytology, Russian Academy of Sciences, Saint Petersburg 194064, Russia Correspondence to: Sergey A. Sinenko, email: s.sinenko@incras.ru Keywords: apoptosis, deubitiquinase, DUSP31, Dark, Drosophila Received: May 27, 2017 Accepted: June 26, 2017 Published: July 31, 2017 ABSTRACT Drosophila have been used to identify new components in apoptosis regulation. The Drosophila protein Dark forms an octameric apoptosome complex that induces the initiator caspase Dronc to trigger the caspase cell death pathway and, therefore, plays an important role in controlling apoptosis. Caspases and Dark are constantly expressed in cells, but their activity is blocked by DIAP1 E3 ligase-mediated ubiquitination and subsequent inactivation or proteasomal degradation. One of the regulatory mechanisms that stabilize proapoptotic factors is the removal of ubiquitin chains by deubiquitinases. In this study performed a modified genetic screen for deubiquitinases (dsRNA lines) to identify those involved in stabilizing proapoptotic components. Loss-of-function alleles of deubiquitinase DUSP31 were identified as suppressors of the Dronc overexpression phenotype. DUSP31 deficiency also suppresses apoptosis induced by the RHG protein, Grim. Genetic analysis revealed for the first time that DUSP31 deficiency sufficiently suppresses the Dark phenotype, indicating its involvement in the control of Dark/Dronc apoptosome function in invertebrate apoptosis.
Molecular Mechanisms of Root Gravitropism

Plant shoots typically grow against the gravity vector to access light, whereas roots grow downward into the soil to take up water and nutrients. These gravitropic responses can be altered by developmental and environmental cues. In this review, we discuss the molecular mechanisms that govern the gravitropism of angiosperm roots, where a physical separation between sites for gravity sensing and curvature response has facilitated discovery. Gravity sensing takes place in the columella cells of the root cap, where sedimentation of starch-filled plastids (amyloplasts) triggers a pathway that results in a relocalization to the lower side of the cell of PIN proteins, which facilitate efflux of the plant hormone auxin efflux. Consequently, auxin accumulates in the lower half of the root, triggering bending of the root tip at the elongation zone. We review our understanding of the molecular mechanisms that control this process in primary roots, and discuss recent insights into the regulation of oblique growth in lateral roots and its impact on root-system architecture and soil exploration.
Durkheim, Emile (1858–1917)

Emile Durkheim (1858–1917) was a French sociologist and philosopher who was born on April 15, 1858 in Epinal, capital town of the department of Vosges, in Lorraine. He came from a long line of rabbinical parentage, but he left his rabbinical interests behind to devote himself to the science of sociology. His many books and articles shaped the discipline, defined its methods, and made it part of the university educational system in France. His notion of social fact had a parallel and equally powerful counterpart in the concept of la langue in the linguistics of the day and in particular in the work of Ferdinand de Saussure, the father of structural linguistics. Even though not quoted directly, his influence was as direct as it was profound on linguistics. Both Durkheim and Saussure are considered founders in their respective disciplines.
Is There an Inter-American International Law? A Case Study of Latin American Juridical History

The independence of the United States in the late 1700s and of most of the Latin American states in the early 1800s represented the first steps in a long and slow process of dismantling the international legal system that the European powers had developed in an attempt to justify and facilitate their global colonial expansion. Through ground-breaking pronouncements, such as Thomas Jefferson’s Declaration of Independence , Juan Pablo Vizcardo y Guzman’s Letter to the Spanish Americans , the Calvo, Tejedor, and Drago doctrines; pioneering multilateral treaties, such as the 1933 Inter-American Convention on the Rights and Duties of States and the 1940 Inter-American Convention on Nature Protection and Wild Life Preservation in the Western Hemisphere ; and many other remarkable resolutions at regional meetings, the countries of the Western Hemisphere put forward a new theory of international law predicated on the noble premises of mutual respect and collective responsibility among states. This new theory of international law is one of the major historical contributions of the American republics. It not only laid the foundation for the massive process of de-colonization of the twentieth century, but it also launched the continuing effort to decentralize the process of globalization.
Experimental Implementation—Solid-State Hybrid Quantum System

In this chapter I will introduce the devices implemented to carry out the presented experiments. The hybrid quantum system consists of a superconducting microwave cavity coupled to macroscopic ensemble of nitrogen-vacancy (NV) defect centers in diamond.
Belief in narcissistic insecurity: Perceptions of lay raters and their personality and psychopathology relations.

This study advances research on interpersonal perceptions of narcissism by examining the degree to which overt displays of narcissism (e.g. being boastful and arrogant) are viewed by lay raters as resulting from covert insecurity. We wrote a brief set of items to assess this view and collected responses from a large sample of community adults (n = 5 528). We present results both for participants reporting (n = 617; patient subsample) and not reporting (n = 4 911; non-patient subsample) current psychiatric treatment. Results revealed that (1) overt grandiose narcissistic traits generally are viewed as being linked to covert insecurity and vulnerability and (2) items intended to assess this link define a meaningful construct, referred to here as Belief in Narcissistic Insecurity. Patient subsample participants also completed measures of personality and psychopathology. Belief in Narcissistic Insecurity showed modest positive relations with self-rated narcissism and with favourable views of one's personality (i.e. seeing oneself as extraverted and conscientious). These findings contribute to research aimed at explicating how perceptions of narcissism are related to self-views and interpersonal functioning. Copyright © 2017 John Wiley & Sons, Ltd.
A lens model view of the upper echelons perspective: Adding the “why” to the theoretical framework

The upper echelons perspective is the major school of thought underlying research into how top managers affect the performance of a firm through their strategic decision making. While this perspect...
What Controls the Limit of Supercooling and Superheating of Pinned Ice Surfaces

Cold-adapted organisms produce antifreeze proteins and glycoproteins to control the growth, melting and recrystallization of ice. It has been proposed that these molecules pin the crystal surface, creating a curvature that arrests the growth and melting of the crystal. Here we use thermodynamic modeling and molecular simulations to demonstrate that the curvature of the superheated or supercooled surface depends on the temperature and distances between ice-binding molecules, but not the details of their interactions with ice. We perform simulations of ice pinned with the antifreeze protein TmAFP, polyvinyl alcohol with different degrees of polymerization, and model ice-binding molecules to determine the thermal hystereses on melting and freezing, i.e. the maximum curvature that can be attained before, respectively, ice melts or grows irreversibly over the ice-binding molecules. We find that the thermal hysteresis is controlled by the bulkiness of the ice-binding molecules and their footprint at the ice sur...
Raman-encoded Molecular Imaging (REMI) with SERS Nanoparticles to Guide Lumpectomy

We demonstrate that spectral imaging of fresh lumpectomy specimens, topically stained with a multiplexed cocktail of biomarker-targeted SERS nanoparticles, allows for rapid (~15 min) detection of residual tumors at the surgical margin surfaces.
On Jorge Becoming a Boy: A Counselor's Perspective

In this portrait, Travis Wright, writing as a psychology counselor in training, brings the reader into one morning's events in his clinical work with Jorge, a three-year-old boy whose family is experiencing difficult times. Throughout the morning at Jorge's day-care center, Wright encounters scenarios that force him to ask questions about child development, gender identity, masculinity, and family dynamics. Wright observes that boys are often thrust into a gendered world dictated by adult norms before they can make sense of their own life events and losses. The portrait is a poignant narrative of Jorge's experiences in and out of his day-care center, as well as a moving self-reflection on Wright's own gender identity.
Does Effectiveness of Weight Management Programs Depend on the Food Environment

Objective To estimate the causal effects of a population-scale behavioral weight management program and to determine whether the program's effectiveness depends on participants' geographic access to places to purchase healthy and less healthy foods. Data sources Secondary data from U.S. Department of Veterans Affairs clinical and administrative records (2008-2014), retail food environment measures from commercial databases (2008-2014), and the American Community Survey (2009-2014). Study design We estimated the effect of the VA's MOVE! weight management program on body mass index after 6 months using difference-in-difference regressions to compare participants with a propensity score-matched control group. We estimated treatment effects overall and in subgroups with different access to supermarkets, fast-food restaurants, and convenience stores. Principal findings MOVE! reduced BMI by about 0.71 units among men and 0.70 units among women. The program was slightly less effective for men living near fast-food restaurants or convenience stores. We found no evidence that treatment effects varied with the food environment among women. Conclusions The residential food environment modestly alters MOVE! effectiveness among men. A greater understanding of environmental barriers to and facilitators of intentional weight loss is needed. This study highlights important potential intersections between health care and the community.
APOL1 polymorphisms and kidney disease: Loss-of-function or gain-of-function?

The mechanism that explains the association of APOL1 variants with nondiabetic kidney diseases in African Americans remains unclear. Kidney disease risk is inherited as a recessive trait, and many ...
The Influence-Network Model of the Photojournalistic Icon:

Iconic images are those that rise to the forefront of our collective, visual public consciousness to become the defining, enduring image of an event: a naked Vietnamese girl screaming out in pain f...
Experimental Validation of a Closed-Loop Respiratory Control Model using Dynamic Clamp

We have previously introduced a model for closed-loop respiratory control incorporating an explicit conductance-based model of bursting pacemaker cells driven by hypoxia sensitive chemosensory feedback. Numerical solution of the model equations revealed two qualitatively distinct asymptotically stable dynamical behaviors: one analogous to regular breathing (eupnea), and a second analogous to pathologically rapid, shallow breathing (tachypnea). As an experimental test of this model, we created a hybrid in vitrolin silico circuit. We used Real Time eXperimental Interface (RTXI) dynamic clamp to incorporate a living pacemaker cell recorded in vitro into a numerical simulation of the closed-loop control model in real time. Here we show that the hybrid circuit can sustain the same bistable behavior as the purely computational model, and we assess the ability of the hybrid circuit to recover from simulated bouts of transient hypoxia.
Oscillating Piconewton Force Manipulation on Single-Molecule Enzymatic Conformational and Reaction Dynamics

Oscillation force has been demonstrated in theoretical studies as a critical role in unraveling the comprehensive enzymatic dynamics and addressing its regulation on enzyme activity. Utilizing the imposed external mechanical oscillation force by our newly developed magnetic tweezers coupled with a single-molecule photon-stamping imaging spectroscopic microscope, we experimentally studied a millisecond-scale oscillation force manipulation on single horseradish peroxidase enzymatic conformational and reaction dynamics. We have studied the enzymatic reaction dynamics and found that the enzyme activity changes under the real-time oscillatory force manipulation. Moreover, the oscillation force shows the capability of manipulating the enzyme active-site conformational state as well as the nascent-formed product’s interaction with the active site of the enzyme, which impacts on the product release pathways. Specifically, we have identified that there are two product releasing pathways, the solvation-mediated dif...
Solid-Phase Detoxification of Chemical Warfare Agents using Zirconium-Based Metal Organic Frameworks and the Moisture Effects: Analyze via Digestion.

Zirconium-based metal organic frameworks (Zr-MOFs) are highly chemically and thermally stable and have been of particular interest as reactive sorbents for chemical warfare agent (CWA) removal due ...
Characterization of the mouse rod transducin α subunit gene

Abstract A genomic clone spanning the mouse rod transducin alpha subunit (Tr alpha) gene has been isolated by screening a mouse genomic library with a bovine Tr alpha cDNA clone. The coding region of the mouse Tr alpha gene reveals an 88.7% nucleotide identify and 99.7% amino acid identity with bovine Tr alpha. The mouse Tr alpha gene is composed of 8 exons and 7 introns within its coding region. These introns are in the same locations as introns in human Gi alpha genes, that encode G proteins closely related to transducin. Primer extension, RNA sequencing, and S1 nuclease protection analyses indicate that the mouse Tr alpha gene transcription start site is 84 bases upstream of the initiation codon. Northern blot analysis shows that the mouse Tr alpha is expressed in the retina, but not in brain, kidney, liver, or heart.
Molecular Mechanisms Driving Switch Behavior in Xylem Cell Differentiation

Plant xylem cells conduct water and mineral nutrients. Although most plant cells are totipotent, xylem cells are unusual and undergo terminal differentiation. Many genes regulating this process are well characterized, including the Vascular-related NAC Domain 7 (VND7), MYB46, and MYB83 transcription factors, which are proposed to act in interconnected feedforward loops (FFLs). Less is known regarding the molecular mechanisms underlying the terminal transition to xylem cell differentiation. Here, we generate whole-root and single-cell data, which demonstrate that VND7 initiates sharp switching of root cells to xylem cell identity. Based on these data, we identified 4 candidate VND7 downstream target genes capable of generating this switch. Although MYB46 responds to VND7 induction, it is not among these targets. This system provides an important model to study the emergent properties that may give rise to totipotency relative to terminal differentiation and reveals xylem cell subtypes.
Transcriptional Regulation of INSR, the Insulin Receptor Gene

The insulin receptor gene encodes an evolutionarily conserved signaling protein with a wide spectrum of functions in metazoan development. The insulin signaling pathway plays key roles in processes such as metabolic regulation, growth control, and neuronal function. Misregulation of the pathway features in diabetes, cancer, and neurodegenerative diseases, making it an important target for clinical interventions. While much attention has been focused on differential pathway activation through ligand availability, sensitization of overall signaling may also be mediated by differential expression of the insulin receptor itself. Although first characterized as a “housekeeping” gene with stable expression, comparative studies have shown that expression levels of the human INSR mRNA differ by tissue and in response to environmental signals. Our recent analysis of the transcriptional controls affecting expression of the Drosophila insulin receptor gene indicates that a remarkable amount of DNA is dedicated to encoding sophisticated feedback and feed forward signals. The human INSR gene is likely to contain a similar level of transcriptional complexity; here, we summarize over three decades of molecular biology and genetic research that points to a still incompletely understood regulatory control system. Further elucidation of transcriptional controls of INSR will provide the basis for understanding human genetic variation that underlies population-level physiological differences and disease.
Ketamine's dose related multiple mechanisms of actions: Dissociative anesthetic to rapid antidepressant.

Abstract Ketamine induces safe and effective anesthesia and displays unusual cataleptic properties that gave rise to the term dissociative anesthesia. Since 1970, clinicians only utilized the drug as an anesthetic or analgesic for decades, but ketamine was found to have rapid acting antidepressant effects in 1990s. Accumulated evidence exhibits NMDAR antagonism may not be the only mechanism of ketamine. The contributions of AMPA receptor, mTor signal pathway, monoaminergic system, sigma-1 receptor, cholinergic, opioid and cannabinoid systems, as well as voltage-gated calcium channels and hyperpolarization cyclic nucleotide gated channels are discussed for the antidepressant effects. Also the effects of ketamine’s enantiomers and metabolites are reviewed. Furthermore ketamine’s anesthetic and analgesic mechanisms are briefly revisited. Overall, pharmacology of ketamine, its enantiomers and metabolites is very unique. Insight into multiple mechanisms of action will provide further development and desirable clinical effects of ketamine.
Monolayer Graphene Grown on Nanoscale Pt Films Deposited on TiO2 Substrates for Micro- and Nanoelectromechanical Systems

This study presents chemical vapor deposition (CVD) growth of high-quality monolayer graphene on 100 nm-thick Pt thin films deposited on TiO2-coated silicon wafers. Conventional graphene growth on ...
Multidrug-Resistant Organism Carriage in Wisconsin Children

Background: Children attending daycare are at increased risk of carrying multidrug-resistant organisms (MDROs) compared to children not attending daycare. Carriage of MDROs greatly increases the risk of infection, not only in the child but also for others living in the household. Understanding the epidemiology of MDRO carriage in children is essential to devising effective containment strategies. Here, we present the findings from a cross-sectional study assessing MDRO carriage in daycare-attending and nonattending children in Wisconsin. Methods: We applied the following enrollment criteria: Children aged between 6 months and 1 organism (11.4%). From stool samples, 6 children (13.6%, 2 in daycare) were C. difficile carriers, 3 were VRE carriers (6.8%, 1 in daycare), 8 carried an ESBL GNR (18.2%, 4 in daycare), and 3 carried MRSA (6.8%, 1 in daycare). One child was positive for H. influenzae (2.3%, not in daycare) and 2 were positive for S. pneumoniae (4.6%, 1 in daycare) from nares swabs. One child was positive for MRSA (2.3%, not in daycare) from a skin swab. We detected no significant differences between children with and without daycare exposure for any organism. Conclusions: Children in this population had higher than expected rates of ESBL GNRs and MRSA for a community population. Daycare exposure was not correlated with increased carriage in this small pilot study, though larger longitudinal studies are needed. Funding: None Disclosures: None
The Remaking of the Supreme Court: Implications for Climate Change Litigation and Regulation

With Justice Amy Coney Barrett on the Supreme Court—following the confirmation of Justices Gorsuch and Kavanaugh—a 6-3 conservative judicial majority appears cemented for decades to come. While politicians, scholars, and the media have largely focused on what a Barrett nomination means for the Affordable Care Act and Roe v. Wade, the transformed Supreme Court significantly impacts a wide swath of environmental and climate change cases for years to come. It is increasingly clear that we have a generation—and no longer—to reduce our Greenhouse Gas (GHG) emissions and tackle the climate crisis. The President, Congress, and administrative agencies will need to take climate action. But what are the legal challenges to such action with the conservative shakeup? And how likely are they to succeed? Justice Barrett’s record on the Seventh Circuit is not long, but her academic writing and rulings on judicial standing, the nondelegation doctrine, and agency deference may make it more difficult both for pro-environmental plaintiffs to establish standing and for President-elect Biden to pursue aggressive climate action independent of Congress via agency action and rulemaking. Barrett’s nomination follows President Trump’s successful appointment of Justices Gorsuch and Kavanaugh, both of whom have signaled a willingness to chip away at longstanding administrative law doctrines that have afforded agencies discretion in regulating GHG emissions. A transformed, 6-3 Court that replaces Justice Ginsburg with Justice Barrett has significant implications for the ability of Congress and the President to tackle climate change and other pressing environmental challenges—and for the ability of plaintiffs to address those challenges in court.
Patient preferences for medication adherence financial incentive structures: A discrete choice experiment.

Abstract Background Medication adherence for chronic conditions continues to be a challenge for patients. Patient incentives for medication adherence may help. Financial incentives delivered at the point of care may act as cues for medication-taking behavior. Objectives The purpose of this study was to investigate patient preferences for specific structures of financial medication adherence incentives that could feasibly be delivered at the point of care. Methods A discrete choice experiment (DCE) was performed using a national online survey. Study participants were adults who self-reported taking at least one prescription medication for one or more chronic conditions. Following an orthogonal design generated in SAS, the DCE included 32 paired-choice tasks. Data were analyzed using mixed logit models and stratified on participants’ income level. Results In the full cohort (n = 933), form of financial reward (such as gift-card or cash) was 1.02 times as important to participants as the probability of incentive receipt, 1.58 times as important as monetary value, and 1.93 times as important as timing of receipt. Participants were willing to give up $31.04 of an incentive's monetary value (95% CI = $27.11-$34.98) to receive the incentive 5 months sooner (1-month vs. 6-month time-lag); $60.79 (95% CI = $53.19-$68.39) for probability of receipt to increase from a 1 out of 100 chance to a 1 out of 20 chance; and $10.52 (95% CI = $6.46-$14.58) to receive an incentive in the form of a Visa® gift-card instead of grocery store voucher. These patterns of trade-offs between attributes were generally consistent among participants with lower and higher income. Conclusions Regardless of socioeconomic status, patient preferences for financial medication adherence incentives delivered at the point of care may be most heavily influenced by incentive form and probability of receipt. This has implications for designing medication adherence programs in terms of incentive sustainability, patient engagement, plan star ratings, and patient outcomes.
Making the Call: College Students' Legal Consciousness and Hypothetical Activation of Police for Sexual Assaults.

Research has identified the necessity of sexual assault victims to label their experience as criminal to initiate reporting. However, barriers exist in labeling uninvited sexual contact as criminal...
Acute Thromboembolism from Trauma in a Patient with Abdominal Aortic Aneurysm.

Author(s): Sebt, Solomon; Kim, Chris; Hoonpongsimanont, Wirachin; Leroux, Eric | Abstract: Case Presentation: A 64-year-old man with a history of a 5.5-centimeter (cm) abdominal aortic aneurysm (AAA) presented to the emergency department (ED) complaining of severe back pain after climbing over a fence and falling a distance of eight feet. Prior to arrival, the prehospital paramedics reported that the patient did not have palpable pulses in either lower extremity. The initial physical examination in the ED was significant for absent dorsalis pedis pulses bilaterally as well as absent posterior tibialis pulses bilaterally and cold, insensate lower extremities. Point-of-care ultrasound identified an approximate 7-cm infrarenal AAA with a mural thrombus present. After receiving several computed tomography (CT) studies including CT head without contrast and CT angiography of the chest, abdomen and pelvis, the patient was diagnosed with acute thrombosis of AAA and associated thromboembolic occlusion of both his right and left distal iliac vessels causing bilateral acute limb ischemia. He immediately received unfractionated heparin and was admitted to the hospital for embolectomy and intra-arterial tissue plasminogen activator.Discussion: Acute thrombosis of AAA and subsequent thromboembolic events are a rare but significant complication that can occur in patients with a history of AAA. Thromboembolic events may occur spontaneously or in the setting of blunt abdominal trauma. Common presenting signs and symptoms include distal limb ischemia and absent femoral pulses. Timely management and recognition of this rare complication is vital as this condition can ultimately result in limb loss or death if not treated in a timely manner. Heparinization after confirmation of non-ruptured AAA as well as vascular surgery, and therapeutic and vascular interventional radiology consultations are key steps that should be taken to decrease patient morbidity and mortality.
Role of Toll‑like receptors in natural killer cell function in acute lymphoblastic leukemia (Review)

Natural killer (NK) cells are specialized lymphocytes primarily involved in the response to infection and tumors. NK cells are characterized by the presence of specific surface molecules, as well as a wide repertoire of receptors that impart microenvironment-dependent effector functions. Among these receptors, Toll-like receptors (TLRs) can be activated to condition the NK response to either a cytotoxic or immunoregulatory phenotype. However, cellular function is frequently impaired during disorders such as cancer. In the last decade, it has become increasingly evident that the stimulation of NK cells is a requirement for their increased cytotoxic activity. TLR activation has been suggested as an alternative route for reestablishing the antitumor activity of NK cells. The present review summarizes the characteristics of NK cells, their receptors, the expression and function of NK cell TLRs, and their functional status in cancer, primarily acute lymphoblastic leukemia.
Bounded Continuous Outcomes

This chapter presents a TMLE of the additive treatment effect on a bounded continuous outcome. A TMLE is based on a choice of loss function and a corresponding parametric submodel through an initial estimator, chosen so that the loss-functionspecific score of this parametric submodel at zero fluctuation equals or spans the efficient influence curve of the target parameter. Two such TMLEs are considered: one based on the squared error loss function with a linear regression model, and one based on a quasi-log-likelihood loss function with a logistic regression submodel. The problem with the first TMLE is highlighted: the linear regression model is not a submodel and thus does not respect global constraints implied by the statistical model. It is theoretically and practically demonstrated that the TMLE with the logistic regression submodel is more robust than a TMLE based on least squares linear regression. Some parts of this chapter assume familiarity with the core concepts, as presented in Chap. 5. The less theoretically trained reader should aim to navigate through these parts and focus on the practical implementation and importance of the presented TMLE procedure. This chapter is adapted from Gruber and van der Laan (2010b).
Influence of infusate viscosity on intestinal absorption in the rat: An explanation of previous discrepant results

Previous studies of the influence of increased luminal viscosity on intestinal absorption have yielded conflicting results ranging from no effect to a marked diminution. We measured the absorption of three probes (carbon monoxide, [14C]warfarin, 5.5 mM glucose) from a saline infusate or from saline containing 0.6% guar, which yielded a 20-fold increase in viscosity. Two animal models were used: (a) conscious nonlaparotomized rats with chronically implanted cannulas and (b) anesthetized laparotomized rats. In the anesthetized laparotomized rats, absorption was independent of perfusate viscosity. In the conscious nonlaparotomized rats, the absorption of each of the three probes was significantly greater than in the anesthetized laparotomized rats and increased viscosity caused a 60%-70% decrease in the clearance of the three probes. In anesthetized laparotomized rats, we have shown that fluid moves with laminar flow, and increased infusate viscosity cannot further reduce luminal stirring (or absorption). In conscious, nonlaparotomized rats, laminar flow is disrupted by normal gut motility causing better luminal stirring. Such stirring is inhibited by a viscous infusate resulting in decreased absorption. We conclude that the conflicting results seen in previous studies can be attributed to the model used. In conscious animals where luminal stirring was good, a viscous infusate caused decreased absorption.
The impact of mineral nutrients in food crops on global human health

Nutrient sufficiency is the basis of good health, productive lives and longevity for everyone. Nutrient availability to people is primarily determined by the output of foods produced from agricultural systems. If agricultural systems fail to provide enough food diversity and quantity to satisfy all the nutrients essential to human life, people will suffer, societies will deteriorate and national development efforts will stagnate. Importantly, plant foods provide most of the nutrients that feed the developing world. Unfortunately, as a result of population pressures, many global food systems are not currently providing enough micronutrients to assure adequate micronutrient intakes for all people. This has resulted in an increasing prevalence of micronutrient deficiencies (e.g., iron deficiency, vitamin A deficiency, and iodine deficiency disorders) that now afflicts over three billion people globally mostly among resource-poor women, infants and children in developing countries. The consequences of micronutrient malnutrition are profound and alarming for human existence. Agricultural approaches to finding sustainable solutions to this problem are urgently needed. This review presents some ways in which plant nutritionists can contribute to preventing micronutrient malnutrition in sustainable ways.
Differential recognition of OR1 and OR3 by bacteriophage 434 repressor and Cro.

The developmental decisions of bacteriophage 434 depend on the ability of 434 repressor and Cro to bind OR1 and OR3 with different relative affinities; repressor binds OR1 tighter than OR3, whereas Cro slightly prefers OR3 over OR1. Studies with operator mutants show that repressor's lower relative affinity for OR3 results from a deviation in the sequence of OR3 from consensus; an A-->G change at position 4 in one half-site (OR1: A-C-A-A-A-C-T-T-T-C-T-T-G-T; OR3: A-C-A-G-T-T-T-T-T-C-T-T-G-T). Similar experiments show that Cro binds operators containing either A.T or G.C bases pairs at position 4 equally well, but cannot bind operators containing C.G or T.A base pairs at this position. A Gln33-->Ala mutation in 434 repressor diminishes, but does not eliminate, its ability to distinguish between purines at position 4. This shows that a glutamine at amino acid 33 is not the sole determinant of repressor's position 4 specificity. Changing Gln33-->Leu, the amino acid at the homologous position in Cro, does not confer "Cro-like" position 4 base specificity on repressor. Similarly, a Cro protein bearing Gln at this position does not exhibit repressor's position 4 base preferences. The residual specificities of these mutant proteins indicates that in each protein, more than 1 amino acid is responsible for recognizing bases at position 4. These were identified by analyzing the binding specificities of multiply mutated repressors, in vitro. The types of substitutions made were guided by sequence homologies between 434 repressor and Cro. At least three mutations are needed to eliminate repressor's position 4 base specificity; Gln33-->Ala, Glu32-->Gln, and Thr27-->Lys, although no set of amino acid substitutions in repressor was able to confer Cro-like position 4 specificity to repressor. These results indicate that at least the amino acids at these positions are involved in recognition of the position 4 base. Other evidence suggests that Cro and repressor use identical amino acids present at homologous positions in the DNA recognition helix in different ways.
When tight blood pressure control is not for everyone: a new model for performance measurement in hypertension.

Article-at-a-Glance Background Many patients with hypertension have legitimate reasons to forego standard blood pressure targets yet are nonetheless included in performance measurement systems. An approach to performance measurement incorporating clinical reasoning was developed to determine which patients to include in a performance measure. Design A 10-member multispecialty advisory panel refined a taxonomy of situations in which the balance of benefits and harms of anti-hypertensive treatment does not clearly favor tight blood pressure control ( Findings The panel identified several broad categories of reasons for exempting a patient from performance measurement for blood pressure control. These included (1) patients who have suffered adverse effects from multiple classes of antihypertensive medications; (2) patients already taking four or more antihypertensive medications; (3) patients with terminal disease, moderate to severe dementia, or other conditions that overwhelmingly dominate the patient's clinical status; and (4) other patient factors, including comfort care orientation and poor medication adherence despite attempts to remedy adherence difficulties. Several general principles also emerged. Performance measurement should focus on patients for whom the benefits of treatment clearly outweigh the harms and should incorporate a longitudinal approach. In addition, the criteria for exempting a patient from performance measurement should be more strict in patients at higher risk of adverse health outcomes from hypertension and more lenient for patients at lower risk. Conclusions Incorporating "real world" clinical principles and judgment into performance measurement systems may improve targeting of care and, by accounting for patient case mix, allow for better comparison of performance between institutions.