cssi/SciSciGPT-SciSciNet huggingface dataset:
Medicare Reimbursement for Total Joint Arthroplasty: The Driving Forces

Background: Total joint arthroplasty is a large and growing part of the U.S. Medicare budget, drawing attention to how much providers are paid for their services. The purpose of this study was to examine the variables that affect total joint arthroplasty reimbursement. Along with standard economic variables, we include unique health-care variables. Given the focus on value in the Affordable Care Act, the model examines the relationship of the quality of care to total joint arthroplasty reimbursement. We hoped to find that reimbursement patterns reward quality and reflect standard economic principles. Methods: Multivariable regression was performed to identify variables that correlate with Medicare reimbursement for total joint arthroplasty. Inpatient charge or reimbursement data on Medicare reimbursements were available for 2,750 hospitals with at least 10 discharges for uncomplicated total joint arthroplasty from the Centers for Medicare & Medicaid Services (CMS) for fiscal year 2011. Reimbursement variability was examined by using the Dartmouth Atlas to group institutions into hospital referral regions and hospital service areas. Independent variables were taken from the Dartmouth Atlas, CMS, the WWAMI (Washington, Wyoming, Alaska, Montana, Idaho) Rural Health Research Center, and the United States Census. Results: There were 427,207 total joint arthroplasties identified, with a weighted mean reimbursement of $14,324.84 (range, $9,103 to $38,686). Nationally, the coefficient of variation for reimbursements was 0.19. The regression model accounted for 52.5% of reimbursement variation among providers. The total joint arthroplasty provider volume (p < 0.001) and patient satisfaction (p < 0.001) were negatively correlated with reimbursement. Government ownership of a hospital (p < 0.001) and higher Medicare costs (p < 0.001) correlated positively with reimbursement. Conclusions: Medicare reimbursements for total joint arthroplasty are highly variable. Greater reimbursement was associated with lower patient volume, lower patient satisfaction, a healthier patient population, and government ownership of a hospital. As value-based reimbursement provisions of the Affordable Care Act are implemented, there will be dramatic changes in total joint arthroplasty reimbursements. To meet these changes, providers should expect qualities such as high patient volume, willingness to care for sicker patient populations, patient satisfaction, safe outcomes, and procedural demand to correlate with their reimbursement. Clinical Relevance: Practicing orthopaedic surgeons and hospital administrators should be aware of discrepancies in inpatient reimbursement for total joint arthroplasty from Medicare. Furthermore, these discrepancies are not associated with typical economic factors. These findings warrant further investigation and collaboration between policymakers and providers to develop value-based reimbursement.
Pregnancy status and feedlot performance of beef heifers actively immunized against gonadotropin-releasing hormone.

The contraceptive effect of active immunization against GnRH was evaluated in beef heifers. Crossbred heifers were randomized by breed and weight (initial weight = 227.3 ± 1.2 kg) and assigned to one of three treatment groups. Animals in Group IB (n = 48) were actively immunized against GnRH; heifers in Groups NB (n = 48) and NN (n = 49) did not receive the anti-GnRH vaccine. Sixteen weeks after primary immunization, bulls of proven fertility were introduced into pens containing Groups IB and NB. Bulls were maintained with heifers for 2 mo. Heifers in group NN were not intentionally exposed to fertile males. At the end of the breeding period, heifers received Synovex H implants and entered a commercial feedlot. Heifers were slaughtered after 116 d of feedlot confinement. Anti-GnRH titer was evident in all heifers (48 of 48) immunized against GnRH. Gravid uteri were present at slaughter in 40 of 48 (83.3 %) NB heifers. In contrast, only four (8.3 %) IB and two (4.1 %) NN heifers carried gravid uteri at slaughter. Although ADG did not differ between groups during feedlot confinement, ADG during the breeding period was higher ( P <.05) in IB heifers than in NN control animals. Dressing percentage and longissimus muscle area were decreased ( P < .05) and marbling and quality grade were increased (P <.05) in NB heifers compared with NN control heifers. Carcass traits of IB heifers were intermediate between those of the NB and NN groups. Taken together, these data indicate that active immunization against GnRH reduces the fertility of terminal heifers. These observations suggest that immunoneutralization of GnRH may be an effective management tool that will reduce the incidence of unintended pregnancy in heifers destined for feedlots.
Sex Differences in Neuroanatomy and Neurophysiology: Implications for Brain Function, Behavior, and Neurological Disease

Abstract Sex differences in neurophysiology and behavior are crucial to the understanding of neurological diseases. Alzheimer’s disease, Parkinson’s disease, anxiety, and depression are just a few of the known sexually dimorphic neurological disorders in terms of prevalence, symptom presentation, disease progression, etc. Steroid hormones, particularly estrogen, are thought to play a protective role in some of these diseases. Thus, it is pertinent to understand how steroid hormones affect the central and peripheral nervous systems in order to uncover the underlying mechanisms involved in these diseases. Steroid hormones act on sexually dimorphic brain regions, including several nuclei of the hypothalamus, to influence neuronal signaling (eg, neurotransmitter systems), physiological functions of the body, and sexually dimorphic behaviors like mating and aggression. This chapter discusses the roles of steroid hormones including estrogen, progesterone, and testosterone in neuronal signaling, body functions, behavior, and neurological disease.
FOCUS ON LIBRARIES: Renovating for technology: Partnerships produce quick results: How a little team work went a long way

Creation au sein d'une bibliotheque universitaire d'une salle comprenant 58 postes de travail sur ordinateur (ordinateur Pentium 220 MHz) destines aux etudiants
Oxygen Electroreduction on M-N4 Macrocyclic Complexes

Inspired by biological catalysts, such as myoglobin and hemoglobin, many M-N4 macrocycles have been investigated as promising catalysts for the oxygen reduction reactions (ORRs) in alkaline and acid media for several decades. Such macrocyclic complexes include transition-metal porphyrins (MPs) or phthalocyanines (MPcs)-like molecules, and nitrogen-chelated transition metal clusters in a carbon matrix (pyrolyzed M-N4/C). Although extensive research has been carried out to acquire understanding on how the ORRs progress on these M-N4 macrocyclic complexes, there are still several key fundamental aspects to be clarified. It is still debatable about the nature of the active sites of M-N4 complex catalysts for the ORRs and the ORR reaction mechanisms on the M-N4/C catalysts. In this chapter, we reviewed the studies of ORRs on M-N4 macrocyclic complexes up to date from both experimental and computational perspectives. First, we surveyed the experimental results about the various factors affecting the catalytic performance of the M-N4 macrocyclic complexes for ORR. Then, we specifically discussed how heat treatment and carbon nanostructured substrates would significantly enhance the catalytic performance of the M-N4 macrocyclic catalysts. As the focus of this paper, we summarized the advancements on application of quantum mechanical calculations to gain insights into the ORRs on the M-N4 macrocyclic catalysts at an electronic and atomistic scale.
Development and Optimization of AAV hFIX Particles by Transient Transfection in an iCELLis® Fixed-Bed Bioreactor

Adeno-associated virus (AAV) vectors are increasingly popular in gene therapy because they are unassociated with human disease, replication dependent, and less immunogenic than other viral vectors and can infect a variety of cell types. These vectors have been used in over 130 clinical trials, and one AAV product has been approved for treatment of lipoprotein lipase deficiency in Europe. To meet the demand for the increasing quantities of AAV required for clinical trials and treatment, a scalable high-capacity technology is required. Bioreactors meet these requirements but limited options are available for adherent HEK 293T/17 cells. Here we optimize the transient transfection of HEK293T/17 cells for the production of AAV human factor IX in a disposable fixed-bed bioreactor, the iCELLis® Nano (PALL Corporation). A fixed bed in the center of the iCELLis bioreactor is surrounded by culture medium that is pumped through the bed from the bottom of the bioreactor so that a thin film of the medium overflows the...
Risk of Digital Vascular Events in Scleroderma Patients Who Have Both Anticentromere and Anti-Interferon-Inducible Protein 16 Antibodies.

Objective To evaluate whether scleroderma patients who are double-positive for anti-interferon-inducible protein 16 (anti-IFI-16) antibodies and anticentromere (anti-CENP) antibodies are at increased risk for significant digital vascular events relative to patients positive for anti-CENP antibodies alone. Methods Sera from 165 scleroderma patients who tested positive for anti-CENP antibodies upon clinical evaluation were reassayed for both anti-CENP and anti-IFI-16 antibodies using enzyme-linked immunosorbent assay testing. Patients who were positive for anti-CENP antibodies alone were then compared to patients who were double-positive for both anti-IFI-16 and anti-CENP antibodies. The association between a history of significant digital vascular events (digital pits, ischemic digital ulcers, and/or gangrene) and double-positive antibody status was examined using chi-square tests. After completion of univariate analysis, multivariable analyses were done to adjust for clinically relevant covariates. Results Of the 165 anti-CENP antibody positive patients, 21 (12.7%) also had anti-IFI-16 antibodies. Patients who were double-positive for anti-CENP and anti-IFI-16 antibodies were more likely to have had digital pits, ischemic digital ulcers, and/or gangrene (P = 0.03). After adjustment for clinically relevant covariates (age, cutaneous subtype, disease duration, and smoking), double-positive patients remained at significantly higher odds of having severe Raynaud's phenomenon (odds ratio 3.5 [95% confidence interval 1.1-11.1]; P = 0.03). Conclusion Scleroderma patients who are double-positive for antibodies recognizing CENP and IFI-16 are significantly more likely to have significant digital vascular events during the course of their disease. This study provides further evidence that anti-CENP and anti-IFI-16 antibodies are disease biomarkers that may be used for risk stratification of vascular events in scleroderma.
Evaluating warehouse strategies for two-product class distribution planning

Distribution networks often manage products with varying life cycles, where demand for some products is relatively stable throughout the year (basic) and the demand for others is short-lived (fashion). Beyond the coordination of inventory and transportation decisions, decisions at the warehouse must be considered as its resources are frequently shared by both product classes simultaneously. For this two-product class distribution planning problem, we focus on characterising three real-world distribution strategies observed in industry and evaluating them based on total distribution cost and warehouse measures (e.g. workforce plan and workload variation) against a benchmark ILS-based heuristic. Experimental results suggest that there are in fact strategies in industry that under specific system configurations may provide competitive solutions compared to the benchmark heuristic on large problem instances (e.g. 200 stores, 1000 products, and 28 days). Several managerial insights are derived to compare such ...
Cost‐Effectiveness of Ready for Recess to Promote Physical Activity in Children

BACKGROUND Many school-based recess interventions have been shown to be effective in increasing physical activity but their relative efficiency compared to other school-based programs are unknown. This study examined the cost-effectiveness of Ready for Recess, a program designed to increase students' physical activity in 2 elementary schools. METHODS Standard cost-effectiveness analysis method was used from a program's perspective for this study. Program effectiveness was measured as total metabolic equivalent (MET) hours gained. Program costs included equipment, training, and personnel costs during the 1-year intervention. The cost-effectiveness was measured as the ratio of program costs to total MET-hours gained. RESULTS Ready for Recess cost $27,643.97 for the 2 schools in the first year of implementation. Physical activity increased by 1.8 MET-hours per day per student. Approximately 32 cents were spent on Ready for Recess to produce an additional MET-hour per student per school day in the 2008-2009 school year. CONCLUSIONS Ready for Recess was cost-effective in its first year of implementation using 35 cents as a benchmark and it was cost-effective relative to other school-based physical activity interventions. The program may be more cost-effective if implemented for a longer time and on a larger scale.
Abstract 2749: Liquid biopsy testing allows highly-sensitive detection of plasma cfDNA mutations in 87 breast cancer-related genes

Liquid biopsies have the potential to revolutionize the way physicians select personalized anti-cancer therapies, monitor patient responses to treatment, and characterize acquired resistance to cancer drugs. New tests that use a simple peripheral blood draw offer snapshots of a patient‘s total tumor DNA mutation profile and are attractive because of their minimally-invasive modality and because they integrate information from both primary and metastatic disease. Currently, most plasma cell-free DNA (cfDNA) mutation detection tests used in clinical research detect known hotspot mutations in a limited number of genes. Technologies that interrogate multi-gene panels in cfDNA are advancing, but commercially-available options suitable for clinical use are limited, come at a high cost, and are not customizable. We designed and developed a customized, next generation sequencing-based, liquid biopsy assay capable of detecting somatic mutations in 87 breast cancer genes involved in cell cycle and estrogen receptor signaling. Targeted regions (147 Kb) were enriched using hybrid capture resulting in an average capture specificity and uniformity of 65.93% and 96.38%, respectively. When tested on cfDNA from healthy donors (n=14), we demonstrated a level of specificity >99.99%. Analytical sensitivity of 0.1% was established on HapMap and reference mutant cell line DNA. Using a pool of HapMap genomic DNA (n=10), 96% (48/50) of SNPs with expected allele frequency of 0.1% were detected. In reference mutant cell line DNA with 1% or 0.1% mutant allele frequencies, we were able to reliably detect all mutations present at 1% and mutations at 0.1% in 50% of the cases. Assay validation on plasma cfDNA with matching tumor from ER+, HER2- breast cancer patients will be presented. In conclusion, we developed a highly sensitive and specific liquid biopsy assay to interrogate 87 breast cancer-related genes. The high level of specificity and sensitivity makes the test ideal not only for detecting known cancer gene hotspot mutations but also for detection of novel gene mutations that may arise during treatment as a result of acquired drug resistance. Citation Format: Maruja E. Lira, Tao Xie, Shibing Deng, Jennifer Kinong, Jingjin Gao, Zhou Zhu, Nathan Lee, Paul Rejto, Jadwiga Bienkowska, James Hardwick, Kai Wang, Stephen Huang. Liquid biopsy testing allows highly-sensitive detection of plasma cfDNA mutations in 87 breast cancer-related genes [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2749. doi:10.1158/1538-7445.AM2017-2749
Lipid mediators in the regulation of endothelial barriers.

Lipid mediators play a critical role in the development and resolution of vascular endothelial barrier dysfunction caused by various pathologic interventions. The accumulation of excess lipids directly impairs endothelial cell (EC) barrier function that is known to contribute to the development of atherosclerosis and metabolic disorders such as obesity and diabetes as well as chronic inflammation in the vascular endothelium. Certain products of phospholipid oxidation (OxPL) such as fragmented phospholipids generated during oxidative and nitrosative stress show pro-inflammatory potential and cause endothelial barrier dysfunction. In turn, other OxPL products enhance basal EC barrier and exhibit potent barrier-protective effects in pathologic settings of acute vascular leak caused by pro-inflammatory mediators, barrier disruptive agonists and pathologic mechanical stimulation. These beneficial effects were further confirmed in rodent models of lung injury and inflammation. The bioactive oxidized lip...
A 24-Year-Old Woman With Precipitous Respiratory Failure After Lung Transplantation.

Case Presentation A 24-year-old woman with ΔF508/Y1092X cystic fibrosis (CF) complicated by severe obstructive lung disease (FEV1 of 30% predicted) was admitted for IV antibiotics for planned sinus surgery resulting from severe chronic sinusitis causing frequent exacerbations and declining lung function. She had persistent airway infection with multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and growth of a fungus presumed to be an airway colonizer, identified as Stephanoascus ciferrii 1 year before presentation. Two days after surgery, she developed acute respiratory failure requiring mechanical ventilation. On day 4 of mechanical ventilation, venovenous-extracorporeal membrane oxygenation (VV-ECMO) was initiated for refractory respiratory failure. The following day, she was listed for bilateral lung transplant and was transplanted 4 days later. Following transplantation, she was decannulated from ECMO; however, over the next 12 hours, oxygenation deteriorated requiring reinstitution of VV-ECMO for presumed severe primary graft dysfunction. Despite treatment with broad spectrum antimicrobial coverage with piperacillin/tazobactam, ciprofloxacin, linezolid, micafungin, voriconazole, and ganciclovir, she failed to improve and developed complex bilateral pleural effusions.
Single-Phase Concentrated Solid-Solution Alloys: Bridging Intrinsic Transport Properties and Irradiation Resistance

Single-phase concentrated solid-solution alloys (SP-CSAs), including high entropy alloys, are compositionally complex but structurally simple, and provide a playground of tailoring material properties through modifying their compositional complexity. The recent progress in understanding the compositional effects on the energy and mass transport properties in a series of face-centered-cubic SP-CSAs is the focus of this review. Relatively low electronic and thermal conductivities, as well as small separations between the interstitial and vacancy migration barriers have been generally observed, but largely depend on the alloying constituents. We further discuss the impact of such intrinsic transport properties on their irradiation response; the linkage to the delayed damage accumulation, slow defect aggregation, and suppressed radiation induced swelling and segregation has been presented. We emphasize that the number of alloying elements may not be a critical factor on both transport properties and the defect behaviors under ion irradiations. The recent findings have stimulated novel concepts in the design of new radiation-tolerant materials, but further studies are demanded to enable predictive models that can quantitatively bridge the transport properties to the radiation damage.
The Effect of Obesity in Shoulder Arthroplasty Outcomes and Complications.

The effect of obesity in shoulder arthroplasty has been recently reported in the literature with different and conflicting results. This review analyzes the role of obesity on outcomes and complications in shoulder arthroplasty. Morbid obesity (body mass index >40 kg/m2), more than standard obesity, is associated with a longer operative time, higher complication rate, reoperation rate and superficial infection. Obesity does not have a detrimental effect on functional outcomes. The magnitude of functional improvement in obese patients, however, can be inferior to that in nonobese patients. Obesity and morbid obesity do not increase hospital charges.
Feature Recognition During Design Evolution

This paper presents an approach to recognize features using intermediate part geometry data. Part geometry is defined by manifold dual model representation, namely, the boundary representation (Brep) and constructive solid geometry (CSG) tree. In the dual modeling system, the boundary of each primitive is split into two parts by a intersection edges. One of the split boundaries of a solid is joined with one of the two of the other solid to make a new solid. One of the two joined as the new solid is identified as feature by topological and geometrical properties. In this approach, features can be recognized by just matching a isolated set of faces (split boundary) with templates instead of searching. Moreover, the necessary volume (volume feature) can be generated based on the recognized feature (surface feature) using the split boundaries.
What Cats Can Teach Us About Excellent Customer Service

Supporting IT on a college campus can be overwhelming. It's easy to end up feeling as if you are 'herding cats'-making a futile attempt to impose control over the inherently uncontrollable and unwieldy. We propose that by thinking of our support experiences individually it can be easier to make them successful. In other words, the best way to wrangle cats may be one at a time. In this session, we'll review established customer service best practices and then discuss how best to apply these practices when providing technical support to the cats from T.S. Eliot's Old Possum's Book of Practical Cats.
Lightweight Instrumentation and Analysis Using OpenSHMEM Performance Counters

Partitioned Global Address Space (PGAS) programming models, such as OpenSHMEM, are popular methods of parallel programming; however, performance monitoring and analysis tools for these models have remained elusive. In this work, we propose a performance counter extension to the OpenSHMEM interfaces to expose internal communication state as lightweight performance data to tools. We implement our interface in the open source Sandia OpenSHMEM library and demonstrate its mapping to libfabric primitives. Next, we design a simple collector tool to record the behavior of OpenSHMEM processes at execution time. We analyze the Integer Sort (ISx) benchmark and use the resulting data to investigate several common performance issues—including communication schedule, poor overlap, and load imbalance—and visualize the impact of optimizations to correct these issues. Through this study, our tool uncovered a performance bug in this popular benchmark. Finally, by using our tool to guide the application of several pipelining optimizations, we were able to improve the ISx key exchange performance by more than 30%.
A novel gene of tomato preferentially expressed in fruit encodes a protein with a Ca2+-dependent lipid-binding domain.

A cDNA clone, called CLB1, was isolated from a cDNA library from tomato (Lycopersicon esculentum) and characterized. The CLB1 cDNA contains an open reading frame of 1518 bp, and encodes a putative protein of 506 amino acids with a predicted molecular mass of 54 633 Da. The deduced CLB1 amino acid sequence contains a domain that exhibits from 26% to 37% identity with the Ca2+-dependent lipid-binding domains of cytosolic phospholipase A2, protein kinase C, Rabphilin-3A, and Synaptotagmin I of animals. Southern blot analysis indicates that the CLB1 gene belongs to a small gene family in the tomato genome. The CLB1 mRNA is preferentially expressed in fruit tissues.
Youth as historical actors in the production of possible futures

In this paper, we expand the concept of historical actors to elaborate on how transformative agency has been addressed in our work with youth from nondominant communities, particularly as they leve...
Direct observation of atomic exchange during surface self-diffusion

Abstract The first direct observation of atomic exchange during the surface self-diffusion of single adatoms is reported. Iridium adatoms from a source enriched to ≥ 93% 191Ir was deposited onto an atomically clean and smooth Ir(100) plane as observed in a field ion microscope. Following thermally activated surface self-diffusion the adatom was field desorbed and mass analyzed. Detection of the 193Ir isotope in one-half of the cases demonstrates conclusively that atomic exchange can occur during surface self-diffusion.
Fanon and Marx Revisited

On this 200th anniversary of Marx’s birth, what can we learn from Fanon’s turn to Marx over 60 years ago? This paper reviews Fanon’s active engagements with Marx throughout his work from Black Skin...
Attract and kill: spinosad containing spheres to control onion maggot (Delia antiqua).

Background Onion maggot (Delia antiqua) is a pest of onions worldwide. Current means of managing this pest rely heavily on prophylatic insecticide treatments at planting. These options may not be viable in organic production systems or situations where insecticide-resistant populations occur. Here we explore the efficacy of an attract and kill strategy for control of D. antiqua evaluating the ability of attractive, spinosad containing spheres to kill adult D. antiqua and reduce crop losses. Results Spinosad containing spheres were able to consistently kill D. antiqua adults over the course of the field season (mortality range: between 49% and 59% on average). Pairing spinosad spheres with Delia Lure increased efficacy by 72% compared with the spheres alone. Performance of this attract and kill strategy also can reduce damage by D. antiqua larvae in the field, but it did not achieve a level of control comparable to the level provided by a conventional insecticide treatment. Conclusion Implementation of this attract and kill strategy could be a valuable tool in situations where conventional pesticides are either not available or desired, where additional control techniques are needed, or to provide a season-long option for control of D. antiqua populations. © 2020 Society of Chemical Industry.
Availability and Readability of Online Patient Information on Osteosarcoma: Assessment of Pediatric Hospital and National Cancer Institute-Designated Cancer Center (NCIDCC) Osteosarcoma Web Pages.

Online patient information (OPI) plays an important role in pediatric orthopaedic patient/caregiver education and decision-making. We assessed the availability and readability of OPI about osteosarcoma found at pediatric hospital and U.S. National Cancer Institute-designated cancer center (NCIDCC) websites. Methods The websites of all NCIDCCs and the top 50 pediatric hospitals identified using U.S. News & World Report were included. The names of NCIDCCs and pediatric hospitals along with the terms "osteosarcoma," "bone sarcoma," and "sarcoma" were entered into Google.com, and were classified according to the availability of osteosarcoma-specific web pages. Unpaid monthly visits were assessed using the Ahrefs.com Organic Traffic Score (OTS) metric. Readability was assessed using 5 validated metrics and the composite grade level (CGL), the rounded mean of the 5 metrics. Results Of the 71 NCIDCCs and 50 pediatric hospitals, 48 (67.6%) and 18 (36.0%), respectively, did not have at least 1 web page dedicated to osteosarcoma-specific OPI. The mean OTS for all 116 NCIDCC and pediatric hospital osteosarcoma-specific web pages assessed was 177 estimated visits per month, which was less than the mean OTS for the top 10 Google.com "osteosarcoma" search results (3,287.9; p < 0.001). The 52 NCIDCC web pages with osteosarcoma OPI (representing 23 centers) had an average CGL of 12.9, representing a readability level of at least a high school degree. The mean CGL for the 64 pediatric hospital web pages with osteosarcoma OPI (representing 32 hospitals) was 12.8, also representing readability of at least a high school degree. Only 8 (12.5%) of the 64 web pages were written at a seventh or eighth-grade level. Conclusions Taken together, the majority of NCIDCCs and pediatric hospitals did not have a dedicated page of OPI for osteosarcoma. Of those that did, NCIDCC and pediatric hospital sites were visited much less frequently than sites visited through the most common Google.com searches. None of the osteosarcoma web pages offering OPI from NCIDCCs and pediatric hospitals met the American Medical Association readability recommendation (sixth-grade reading level). Therefore, greater effort must be made to create and direct patients and parents toward high-quality OPI of the appropriate level. Clinical Relevance The clinical relevance of this study lies in its evaluation of OPI and its ability to impact the patient experience of clinical care.
Saudi Female International College Students' Self-Identities through the Use of Social Media in the United States.

This study explored 14 Saudi female international college students’ self-identities through social media use while they were studying in the United States. Data was collected by semistructured interviews. In addition, participants were asked to draw pictures that represented how they experience social media use in Saudi Arabia and in the United States as part of the interviews. The findings revealed that many participants indicated they experienced some changes to their identities after coming to the United States. Many of the participants expressed they were more open and more independent after coming to the United States. They felt they could express their identities on social media to a greater degree and enjoyed using it to connect with others. Although most of the participants became more comfortable with interaction and expression on social media in the United States, many of them still retained some measures to ensure their privacy.
TruSight Oncology 500: Enabling Comprehensive Genomic Profiling and Biomarker Reporting with Targeted Sequencing

Abstract Background As knowledge of mechanisms that drive the development of cancer grows, there has been corresponding growth in therapies specific to a mechanism. While these therapies show improvements in patient outcomes, they can be expensive and are effective only for a subset of patients. These treatments drive interest in research focused on the assignment of cancer therapies based on aberrations in individual genes or biomarkers that assess the broader mutational landscape, including microsatellite instability (MSI) and tumor mutational burden (TMB). Methods Here we describe the TruSight™ Oncology 500 (TSO500; Research Use Only) bioinformatics workflow. This tumor-only approach leverages the next-generation sequencing-based assay TSO500 to enable high fidelity determination of DNA variants across 523 cancer-relevant genes, as well as MSI status and TMB in formalin-fixed paraffin-embedded (FFPE) samples. Results The TSO500 bioinformatic workflow integrates unique molecular identifier (UMI)-based error correction and a dual approach variant filtering strategy that combines statistical modeling of error rates and database annotations to achieve detection of variants with allele frequency approaching 5% with 99.9998% per base specificity and 99% sensitivity in FFPE samples representing a variety of tumor types. TMB determined using the tumor-only workflow of TSO500 correlated well with tumor-normal (N =170, adjusted R2=0.9945) and whole-exome sequencing (N=108, adjusted R2=0.933). Similarly, MSI status determined by TSO500 showed agreement (N=106, 98% agreement) with a MSI-PCR assay. Conclusion TSO500 is an accurate tumor-only workflow that enables researchers to systematically characterize tumors and identify the next generation of clinical biomarkers.
Integrated Building Design Technology

The thermal state of photon is controlled by inducing Bose-Einstein (B-E) discrete photon mechanism and Higgs boson (H → γγ−) electro-quantum charge application to cool and heat the building naturally. To cool the building naturally, helium (He)-aided curtain wall is utilized to capture the solar energy to cool the photons by employing Bose-Einstein (B-E) photonic bandgap to form a cooling-state photon. This cooling-state photon is named as the Hossain cooling photon (HcP−). When needed this HcP− can be reformed into a heating-state photon here signified as Hossain thermal photon (HtP−) which is created by Higgs boson (H → γγ−) electromagnetic quantum empowered by a single-diode semiconductor. It is because the Higgs boson (H → γγ−) quantum is proposed to be instigated into the curtain wall through the extreme low-range weak force which regulates the HcP− quantum to get agitated in order to convert it into an HtP−. The creation of HcP− and the reformation of HtP− have been clarified with the use of a set of computational mathematics, which revealed the feasibility of reformed photons (HcP− and HtP−) that are positively doable in the exterior curtain wall to cool and heat the building naturally.
Toward Functional Safety of Systolic Array-Based Deep Learning Hardware Accelerators

High accuracy and ever-increasing computing power have made deep neural networks (DNNs) the algorithm of choice for various machine learning, computer vision, and image processing applications across the computing spectrum. To this end, Google developed the tensor processing unit (TPU) to accelerate the computationally intensive matrix multiplication operation of a DNN on its systolic array architecture. Faults manifested in the datapath of such a systolic array due to latent manufacturing defects or single-event effects may lead to functional safety (FuSa) violation. Although DNNs are known to resist minor perturbations with their inherent fault-tolerant characteristics, we show that the classification accuracy of the model plummets from 97.4% to 7.75% with a minimal fault rate of 0.0003% in the accelerator, implying catastrophic circumstances when deployed across mission-critical systems. Hence, to ensure FuSa of such accelerators, this article provides an extensive FuSa assessment of the accelerator exposed to faults in the datapath, by varying the network parameters, position, and characteristics of the induced error across multiple exhaustive data sets. Furthermore, we propose two novel strategies to obtain a diminutive set of functional test patterns to detect FuSa violation in a DNN accelerator. Our experimental results demonstrate that the obtained test sets can achieve an average of 92.63% (in some cases, up to 100%) fault coverage with cardinality as low as 0.1% of the entire test data set.
Tensiones y debates para desmercantilizar la educación en Chile

Estados Unidos, Inglaterra y Chile, son considerados los primeros paises en aplicar politicas neoliberales durante los anos ’70. La educacion, en el caso de Chile, actualmente es considerada un paradigma de la mercantilizacion y la privatizacion. En este marco, producto de la presion de los movimientos sociales protagonizamos por los estudiantes desde el ano 2009 se han comenzado a desarrollar reformas para su desmercantilizacion. El presente articulo aborda en analisis los cuerpos legales que han se han incorporado como una forma de regular los procesos de neoliberalizacion del sistema educativo en Chile: Ley General de Educacion (2009), Ley de Aseguramiento de la Calidad (2011), Ley de Inclusion (2015) y Ley de Educacion Publica (2017). A partir del analisis de fuentes primarias documentales, leyes, decretos y otros, se analizan las tensiones y resistencias. Se evidencia que, junto con las medidas tomadas para dar una nueva orientacion al sistema educativo, se ha incorporado y mantenido la regulacion de mercado. Esta situacion demuestra las tensiones vigentes en la legislacion, a pesar de proponer reformas para desmercantilizar la educacion, el mercado educativo es persistente en el caso chileno. Palabras claves: Privatizacion. Neoliberalismo. Chile. Desmercantilizar la educacion.
SARS-CoV-2 Cardiac Involvement in Young Competitive Athletes.

Background: Cardiac involvement among hospitalized patients with severe coronavirus disease 2019 (COVID-19) is common and associated with adverse outcomes. This study aimed to determine the prevale...
The Impact of Particle Size on Cycle Life and Stress Evolution in Silicon-Based Composite Electrodes

In practical silicon electrodes the coupled mechanical and chemical degradation of the solid electrolyte interphase (SEI) is a critical issue. During electrochemical cycling, the extremely large mechanical strains that are applied to the SEI on Si are a primary factor that limits cycle life. However, the effect of particle size on these strains has not been investigated in prior work. To address this, we have integrated measurements on silicon nanoparticle composite electrodes with an in situ method for applying controlled mechanical strains to SEI during electrochemical cycling and a finite element model (FEM). Comparisons of electrodes with different particle sizes show lower capacity loss with smaller particles. This finding is explained with the FEM. Variations in the SEI formation were also investigated, using different cycling conditions and electrolyte additives.
Evaluating the Routine Use of Head Computed Tomography Angiography in Blunt Cerebrovascular Trauma.

ABSTRACT Background The aim of this study was to evaluate a protocol change that mandated routine incorporation of head computed tomography angiography (CTA) for the work-up of suspected blunt cerebrovascular injury (BCVI) at an academic Level I trauma center. Methods The BCVI screening guidelines at our institution changed in 2018 to include the addition of a head CTA for all patients receiving a neck CTA as part of our BCVI screening guidelines. We performed a retrospective chart review of patients between 2018 and 2019 who were 18 years or older and met screening criteria for BCVI based on our institutional guidelines. The head CTAs of this cohort were assessed for findings that could potentially alter the course of the patients’ treatment. Results A total of 319 patients fit this criterion and had a head CTA as part of their trauma workup. Findings that could potentially alter a patient's clinical course were identified in 6.6% (n = 21) of the head CTA's. These included decreased arterial perfusion (n = 9), active bleeds (n = 6), vessel occlusions (n = 1), aneurysms (n = 1), and vasospasms (n = 2). Of these 21 patients, 8 had clinically significant findings that affected their course of management (2.5% of total sample). They also had a higher mortality rate and ISS compared to the rest of the cohort. Conclusions In patients with clinically suspected BCVI, the addition of head CTA to the existing BCVI screening guideline identified clinically significant vascular abnormalities that affected management in 2.5% of cases.
A Human Factors Evaluation of Backhoe Control Designs and Related Safety Issues

A field study was conducted in which the control arrangements of four major backhoe models were investigated. The existing designs are compared to design recommendations presented in the literature to assess their compatibility. The issue of standardization of operator controls on an industry-wide basis is addressed on the premise that safety would be improved and training times reduced if a standard arrangement were implemented. Critical incident interviews were collected in an effort to verify the hypothesis that safety problems are associated with inadequate control design and lack of standards. Recommendations for mechanical and procedural changes that may enhance production as well as safety are included. Language: en
Unicast performance analysis of extended ODMRP in a wired-to-wireless ad-hoc network testbed

The on-demand multicast routing protocol (ODMRP) is an effective and efficient routing protocol designed for mobile wireless ad-hoc networks. One of the major strengths of ODMRP is its capability to operate both as a unicast and a multicast routing protocol. This versatility of ODMRP can increase network efficiency as the network can handle both unicast and multicast traffic with one protocol. We have extended ODMRP to provide the Internet connectivity to the ad-hoc network. We describe the unicast functionality and mobility-handling feature of extended ODMRP and analyze the protocol performance in a real wired-to-wireless ad-hoc network testbed at an indoor environment. We generate various topological scenarios in our heterogeneous testbed by applying mobility to the wireless network hosts and study their impacts on our protocol performance. A static routing scheme has been used at the router level to allow wired nodes to access the ad-hoc nodes. The possible impact of using various mobility-handling schemes at the router level for ad-hoc node access has been discussed. We believe that the performance study in a testbed network can help us analyze the protocol in a realistic way and point us to the future research direction.
REFORMING (AND SAVING) THE IRS BY RESPECTING THE PUBLIC'S RIGHT TO KNOW

The current controversy involving possible political targeting by the IRS in administering the exempt organization (EO) tax laws is simply the latest in a long succession of similar allegations spanning at least five decades. This article proposes to address the problem through increased transparency of the IRS’s administrative actions involving EOs. Greater transparency responds directly to the public’s frustration in not being able to monitor the agency and gain confidence that the laws are being applied in an even-handed manner.Proposals to increase the transparency of government commonly confront some claimed governmental interest in secrecy, such as a national security or law enforcement concern. Transparency of the government’s tax decisions, however, encounters the further problem that it violates the privacy rights of taxpayers. This latter clash arises because the government’s tax administration decisions generally turn on the information it has extracted under compulsion from taxpayers. Thus, meaningful transparency of one (the government’s tax decisions) almost necessarily requires meaningful transparency of the other (taxpayer tax return information). Fortunately, Congress has long recognized good policy reasons to make public a substantial amount of EO tax return information. Thus, slight liberalizations of the existing disclosure rules for such information may allow sufficient transparency to satisfy the public’s right to know in the precise area of the law that has generated the most controversy. Opening up more EO tax return information and IRS EO decision-making to public scrutiny would tend to deter IRS misbehavior, reduce suspicions of such misconduct, and promote fuller communication both to establish any impropriety and avert false charges against the agency.
Banking, Business Cycles, and the Basle Accord: Some Empirical Evidence

This paper presents a theoretical and empirical analysis of the portfolio adjustments and financing adjustments of U.S. banks over the business cycle. The model describes a representative bank whose portfolio is financed with deposits and equity claims. At the core of the model is a moral hazard problem between relatively more risk averse depositors and relatively less risk averse equity investors. The solution to this moral hazard problem takes the form of shared management of the bank between depositors (or the deposit insuring agency) and equity investors. Towards this end portfolio decisions are made to conform to the risk aversion of equity investors, while financing decisions are made so as to offset any changes in portfolio risk caused by portfolio adjustments. Portfolio adjustments in turn are initiated by exogenous changes in the risk aversion of equity investors that are revealed to bank managers in equity share prices. The resulting portfolio adjustments and changes in portfolio risk then triggers financing adjustments that insulate depositors from any changes in portfolio risk. The model predicts that the loan component of a bank's portfolio is positively related to changes in bank stock prices, while the equity leverage ratio varies directly with the bank's loan to asset ratio. The regression evidence in this paper does not reject these two predictions. Finally the financing adjustments uncovered here were found to predate U.S. capital adequacy legislation for banks. This suggests that private arrangements may have achieved much the same qualitative results in the past as the Basle Accord now attempts to achieve with regulatory legislation.
The immunophenotypic stability of plasma cell myeloma by flow cytometry

Summary Introduction: Flow cytometry (FC) has become increasingly utilized in the diagnosis and monitoring of plasma cell myeloma (PCM), though few studies have evaluated the longitudinal stability of antigen expression. Methods: We studied 45 PCM patients by four-color FC for shifts in CD19, CD20, CD38, CD45, CD56, and cytoplasmic light chain expression, between diagnostic/first encounter and positive follow-up analyses. An immunophenotypic (IP) change was defined as gain, loss, or ½ log shift of antigen expression. Results: An IP change was observed in 14/45 (31%) patients, with single IP changes in 9/14, two changes in 2/14, and three changes in 3/14. 3/14 reverted from an aberrant to a normal plasma cell IP, while remaining light chain-restricted. Changes in expression of CD45 occurred in 9/45 (20%), CD19 in 5/45 (11.1%), CD20 in 2/45 (4.4%), and CD56 in 5/45 (11.1%). Conclusion: Approximately 1/3 of PCM cases show IP changes over time, with CD45 the least stable antigen. Recognition of this relative instability is important to avoid narrow targeting of follow-up FC analyses, especially for minimal residual disease monitoring.
Quantum Impurity Models as Reference Systems for Strongly Correlated Materials: The Road from the Kondo Impurity Model to First Principles Electronic Structure Calculations with Dynamical Mean-Field Theory

Dynamical mean field theory (DMFT) relates extended systems (bulk solids, surfaces and interfaces) to quantum impurity models (QIM) satisfying a self-consistency condition. This mapping provides an economic description of correlated electron materials. It is currently used in practical computations of physical properties of real materials. It has also great conceptual value, providing a simple picture of correlated electron phenomena on the lattice, using concepts derived from quantum impurity models such as the Kondo effect. DMFT can also be formulated as a first principles electronic structure method and is applicable to correlated materials.
Developing pedagogical practices for English-language learners: a design-based approach

This study draws on the application of sociocultural theory to second-language learning and teaching to examine the impact of a design-based research approach on teacher development and literacy instruction to English-language learners (ELLs). Design-based research methodology was employed to derive theoretical suppositions relating to the process of learning as well as the means by which this process is supported. Our research questions were: (a) How will this professional development model result in shifts in teacher thinking about language and literacy learning for ELLs; (b) what innovations in teachers' repertoires of practice will be developed; and (c) in what ways will these shifts in teachers' thinking and innovations in their repertoire of practice bring about new forms of language and literacy learning? Our findings point to the need to place development in the forefront of teacher professional development models. Also foregrounded is the importance of promoting teachers' critical reflection on c...