cssi/SciSciGPT-SciSciNet huggingface dataset:
Fluorocarbon Aerosol Propellants VI: Interspecies Differences in Solubilities in Blood and Plasma and Their Possible Implications in Toxicity Studies

Abstract Solubilities of the three most commonly used fluorocarbon aerosol propellants were determined in the blood and plasma of humans, monkeys, dogs, rats, and mice. Differences as large as ~fourfold in blood and more than 33-fold in plasma were found in different species. The partitioning of fluorocarbons between blood cells and plasma showed even greater differences between species. An indirect method was suggested for the calculation of plasma concentrations from total blood concentrations. A comparative evaluation was reported for the nonprotein bound fractions of fluorocarbons in the blood samples of various species. A correlation was drawn for the pharmacokinetic properties of the fluorocarbons within and between species, and a rationale was provided for the extrapolation of toxicity data from animals to humans.
The Adaptation of Gunda Ulvae to Salinity : I. The Environment

1. The environment of the triclad Gunda ulvae has been studied. This organism lives on the sea shore in the estuaries of very small streams. 2. The components of the external medium are ( a ) stream water, which is rich in Ca and CO 3 , and ( b ) Atlantic sea water. These are mixed in different proportions in different parts of the estuary. 3. An analysis of the stream water is given. 4. The habitat of the organism is described. This extends roughly from high-water neap tides to low-water neap tides. A faunistic survey is given. 5. The conditions which control the limits of the habitat of Gunda are discussed. Between the upper limit of occurrence of Gunda and the place of occurrence of fresh-water forms there is a region devoid of fauna. This region corresponds roughly with the span between high-water neap tides and high-water spring tides. 6. Salinity determinations have been made on samples taken from the actual places where Gunda occurred. It is shown that Gunda has to withstand changes from completely fresh to undiluted sea water. It may normally be exposed to either extreme for several hours. 7. Salinity determinations made continually throughout the range of Gunda show that its environment may vary from one in which it is subjected to the action of sea water for only about I hour at high tide to one in which the sea water is only diluted to about 10 per cent. of its normal strength for a few hours during low tide.
Determination of the optical parameters of the γ phase of cerium sulfide

Abstract The optical parameters of the γ phase of cerium sulfide were measured to determine the magnitude of Frohlich's coupling parameter, α = e 2 ( 1 ϵ ∞ − 1 ϵ 0 ) ( m 2ωℏ 3 ) 1 2 , which determines the strength of the interaction between a conduction electron and the polar lattice. The interaction is sufficiently great as to expect polaron-type corrections to the effective mass and mobility, particularly at the sulfur-rich extreme of the stoichiometric range.
Efficacy and acceptability of a home-based, family-inclusive intervention for veterans with TBI: A randomized controlled trial

AbstractObjective: Traumatic brain injury (TBI) often undermines community re-integration, impairs functioning and produces other symptoms. This study tested an innovative programme for veterans with TBI, the Veterans’ In-home Programme (VIP), delivered in veterans’ homes, involving a family member and targeting the environment (social and physical) to promote community re-integration, mitigate difficulty with the most troubling TBI symptoms and facilitate daily functioning.Setting: Interviews and intervention sessions were conducted in homes or by telephone.Participants: Eighty-one veterans with TBI at a VA polytrauma programme and a key family member.Design: This was a 2-group randomized controlled trial. Control-group participants received usual-care enhanced by two attention-control telephone calls. Follow-up interviews occurred up to 4 months after baseline interview.Main measures: VIP’s efficacy was evaluated using measures of community re-integration, target outcomes reflecting veterans’ self-ident...
PTSD Symptoms in Young Children Exposed to Intimate Partner Violence in Four Ethno-racial Groups

More than 15 million children are eyewitnesses to intimate partner violence (IPV) each year. IPV is associated with higher levels of both externalizing and internalizing problems and places children at a greater risk of developing posttraumatic stress disorder (PTSD) than those who are not exposed. As previous studies have not included a range of ethno-racial groups in their samples of children exposed to IPV, using standardized measures, the present study examines posttraumatic stress symptoms and PTSD diagnoses in four different ethno-racial groups of children, ages 4–6, who witnessed IPV in the last 2 years. Data are derived from interviews with 144 mothers with children participating in a study of the efficacy of an IPV intervention program. Results show high levels of traumatic stress symptoms and PTSD diagnoses (45 %) among the total sample, with significant differences by sex and ethno-racial group. Biracial and Latina females had the highest rates of PTSD relative to other groups. Greater exposure to IPV predicted more extensive PTSD symptoms.
Incorporation of 1-14C-Acetate into C26 fatty acids of the marine spongeMicrociona prolifera

The incorporation of 1-14C-acetate into the many fatty acids of the marine spongeMicrociona prolifera was investigated. Probable precursors of 26∶2Δ5,9 and 26∶3Δ5,9,19 showed high levels of radioactivity, supporting the following pathways for the biosynthesis of C26 acids: $$\begin{array}{*{20}c} {16:0 \to \to \to 26:0 \to 26:1\Delta 9 \to 26:2\Delta 5,9} \\ {16:1\Delta 9 \to \to \to 26:1\Delta 19 \to } \\ {26:2\Delta 9,19 \to 26:3\Delta 5,9,19} \\ \end{array}$$
Frequency Distributions and Standards of Anthropometric and Physical Performance Measures for College Women

Abstract Frequency distributions of the records of a random selection of 200 college women in a nonmajor required program on anthropometric and physical performance measures commonly employed in physical education were compared with best-fitting normal curves for the same data. A table of random numbers was used to secure the sample. A percentile table for the various measurements was constructed. It was concluded that various measurements commonly employed by physical educators give a non-normal distribution. Hence, the obtained distribution as found on various measurements in this study does not warrant treating these data as normal.
Predictable Valence Excited States of Anions

The excited states of the 1 1A′ :C≡C–C–R– family and related anions are investigated. Previous work has shown that 1 1A′ C3H– and CCSiH– each possess a rare valence excited state in addition to their dipole-bound excited states. A similar methodology to that employed previously shows that related anions (C3OH–, C3NC–, C4N–, C5H–, and HBCN–) also possess valence excited states. The valence states are the result of breaking the symmetry from C∞v to Cs. The half-filled π or π-type highest occupied molecular orbital (HOMO) is split into a′ and a″ pieces. The valence excitation takes place between these two pieces. If the anion HOMO is not a half-filled π-type orbital because of an increase in symmetry, cyclization, or both, the anion most likely does not exhibit the signs of a valence excited state even if the anion is an isomer of or isoelectronic to an anion that does possess a valence excited state. However, the :C≡C–C–R– set is not the only classification of anions shown to possess valence excited state...
Nonlinear Indicial Response and Internal State-Space Representation and Its Applications on Delta Wing Aerodynamics

A modified nonlinear indicial response method, in conjunction with internal state-space representation (NIRISS) was proposed. It has been found that for a delta wing, its leading-edge vortex has a dominant effect on its aerodynamics and therefore the time-averaged vortex breakdown location is chosen as an internal variable to approximately describe the state of vortex flow over the delta wing. The response of this internal variable to arbitrary motion is estimated by a modified nonlinear indicial response functional. By means of a vortex filament method, this variable offers the additional information required at a given instant for calculating the surface pressure and airloads. Moreover, the method has been further applied to solve trajectories and the instantaneous pressure and air loads for a 65 wing in free-to-roll condition. The good comparisons between measured and predicted results, such as instantaneous pressures, airloads and free-to-roll motion history, show that within the framework of the proposed mathematical model, it is possible to apply this NIRISS method into the nonlinear flight regime.
Examining the Validity of a Juvenile Offending Risk Assessment Instrument Across Gender and Race/Ethnicity

Analysis of predictive validity of the risk/needs assessment used by a criminal justice agency is paramount. The validity of the Positive Achievement Change Tool (PACT) across gender/race/ethnicity in a juvenile sample was examined. Results demonstrate recidivism increases as PACT score increases, with minor exceptions. Findings suggest similar prediction of referral/arrest and adjudication/conviction across subgroups. 95% confidence intervals overlapped for all subgroups on 13 of 19 measures examined. However, which factors predict recidivism across subgroups differ. Criminal history was the most prevalent predictor, while no factor predicted White female offending. “Gender-responsive” item inclusion measuring abusive/traumatic circumstances did not improve prediction.
An Overview on Meshfree Methods: For Computational Solid Mechanics

This review paper presents a methodological study on possible and existing meshfree methods for solving the partial differential equations (PDEs) governing solid mechanics problems, based mainly on the research work in the past two decades at the authors group. We start with a discussion on the general steps in a meshfree method based on nodes, with the displacements as the primary variables. We then examine the major techniques used in each of these steps: (1) techniques for displacement function approximations using nodes, (2) approximation of the gradient of the displacements or strains based on nodes and a background T-cells that can be automatically generated and refined, and (3) formulation techniques for producing algebraic equations. The function approximation techniques include node-based interpolation methods, cell-based interpolation methods, function smoothing techniques, and moving least squares approximation techniques. The gradient approximation includes direct differentiation, gradient smoothing, and special strain construction. Formulation techniques include strong-form, weakform, local weakform, weak-strong-form, and weakened weakform (W2). In theory, a meshfree method can be developed using a combination of function approximation, gradient approximation, and formulation techniques, which can lead to matrix of a large number of possible methods. This review attempts to provide an overall methodological review, rather than a usual review of comparing different methods. We hope to show readers the differences between the forests, and just between the trees.
Long‐term exercise in mice has sex‐dependent benefits on body composition and metabolism during aging

Aging is associated with declining exercise and unhealthy changes in body composition. Exercise ameliorates certain adverse age-related physiological changes and protects against many chronic diseases. Despite these benefits, willingness to exercise and physiological responses to exercise vary widely, and long-term exercise and its benefits are difficult and costly to measure in humans. Furthermore, physiological effects of aging in humans are confounded with changes in lifestyle and environment. We used C57BL/6J mice to examine long-term patterns of exercise during aging and its physiological effects in a well-controlled environment. One-year-old male (n = 30) and female (n = 30) mice were divided into equal size cohorts and aged for an additional year. One cohort was given access to voluntary running wheels while another was denied exercise other than home cage movement. Body mass, composition, and metabolic traits were measured before, throughout, and after 1 year of treatment. Long-term exercise significantly prevented gains in body mass and body fat, while preventing loss of lean mass. We observed sex-dependent differences in body mass and composition trajectories during aging. Wheel running (distance, speed, duration) was greater in females than males and declined with age. We conclude that long-term exercise may serve as a preventive measure against age-related weight gain and body composition changes, and that mouse inbred strains can be used to characterize effects of long-term exercise and factors (e.g. sex, age) modulating these effects. These findings will facilitate studies on relationships between exercise and health in aging populations, including genetic predisposition and genotype-by-environment interactions.
High-Temperature Processes for the Production of Metals and Glass

The production of metals has long been associated with high temperatures. Man moved beyond the use of naturally occurring materials, such as wood and stone, in approximately 6000 B.C. It is probable that the discovery that subjecting certain rocks to high temperatures resulted in metals was made accidentally in a cooking fire or, more likely, a potter’s kiln. Since that time the major part of our metal production has been carried out in processes that employ temperatures in the range of 300 to 1600°C. This technology, known as pyrometallurgy, is treated first in this chapter. Alternative or complementary technologies — hydrometallurgy (employing aqueous solutions and comparatively low temperatures, say, less than 200°C) and electrometallurgy (exploiting direct current to bring about electrochemical reactions) — are treated in Chapter 9. At the end of the present chapter we include a brief treatment of the production of glass. Glass production bears a resemblance to pyrometallurgical operations in that high-temperature liquids are handled and ultimately cast into solid form.
The Cardiovascular System after Exercise

Recovery from exercise refers to the time period between the end of a bout of exercise and the subsequent return to a resting or recovered state. It also refers to specific physiological processes ...
Synthesis and characterization of a molecularly imprinted polymer for the isolation of the 16 US-EPA priority polycyclic aromatic hydrocarbons (PAHs) in solution.

A smart sorbent consisting of benzo[k]fluoranthene-imprinted and indeno[1 2 3-cd]pyrene-imprinted polymers mixed at 1:1 (w/w) was successfully screened from several cavity-tuning experiments and used in the isolation of polycyclic aromatic hydrocarbons from spiked solution. The polymer mixture showed high cross selectivity and affinity towards all the 16 US-EPA priority polycyclic aromatic hydrocarbons. The average extraction efficiency from a cyclohexane solution was 65 ± 13.3% (n = 16, SD). Batch adsorption and kinetic studies confirmed that the binding of polycyclic aromatic hydrocarbons onto the polymer particles resulted in formation of a monolayer and that the binding process was the rate limiting step. The imprinted polymer performance studies confirmed that the synthesized polymer had an imprinting efficiency of 103.9 ± 3.91% (n = 3, SD). A comparison of the theoretical number of cavities and the experimental binding capacity showed that the overall extent of occupation of the imprinted cavities in the presence of excess polycyclic aromatic hydrocarbons was 128 ± 6.45% (n = 3, SD). The loss of selectivity was estimated at 2.9% with every elution cycle indicating that the polymer can be re-used several times with limited loss of selectivity and sensitivity. The polymer combination has shown to be an effective adsorbent that can be used to isolate all the 16 US-EPA priority polycyclic aromatic hydrocarbons in solution.
What do PreService Teachers Think About the Recruitment and Retention of Quality Bilingual Teachers in the Classroom

This Study Identified important factors that need to be considered concerning the recruitment and retention of teachers certified in bilingual/ESL from the pre-service teacher perspective.Â The bilingual Pre-Service Teacher Questionnaire (BPTQ) was developed and administered to seventy-three undergraduate students who were enrolled in courses, which would lead to bilingual certification at a large university in Central Texas.Â Students rated the importance of the following areas: (1)resources and materials for the classroom; (2) compensation/salary; (3) professional development provided by the district; (4) and support from administration, parents, and co-workers.Â Additionally, students were asked to respond to the following two questions: (1) Describe when/how ou decidd to become a teacher/bilingual teacher. (Recruitment) (2)What challanges do you anticipate facing in your future bilingual classroom? (Retention) Results indicated that support from administration, parents and co-workers is important for retention of bilingual/Esl teachers.Â The majority of students also knowlodeged that it was an influential/inspirational experience working with bilingual/monolingual students that influenced their decision to become a bilingual teacher (Recruitment)
Prenatal maternal cortisol measures predict learning and short-term memory performance in 3- but not 5-month-old infants

Little is known about relations between maternal prenatal stress and specific cognitive processes—learning and memory—in infants. A modified crib-mobile task was employed in a longitudinal design to test relations between maternal prenatal cortisol, prenatal subjective stress and anxiety, psychosocial variables, and learning and memory in 3- and 5-month-old infants. Results revealed that maternal prenatal cortisol was affected by particular psychosocial variables (e.g., maternal age, whether or not the infant's grandmother provided childcare, financial status), but was unrelated to measures of maternal depression, anxiety, and stress. Although maternal prenatal cortisol was not predictive of learning or memory performance in 5-month-old infants, higher levels of basal maternal cortisol and reduced prenatal cortisol response was predictive of some learning and short-term memory measures in 3-month-old infants. These results suggest an influence of maternal neuroendocrine functioning on fetal neurological development, and the importance of separate examination of subjective and biological measures of stress.
Pressure, hydrolytic degradation and plasticization drive high temperature blistering failure in moisture saturated polyimides

Abstract Polyimides and polyimide matrix composites are used in electronics, automotive, aerospace and other applications, particularly in situations where high temperature resistance and low weight are required. Under conditions in which polyimides have absorbed water, either by exposure to high humidity or by direct immersion, if the material is rapidly heated it may fail by high pressure water vapor induced blistering and/or delamination. Such hygrothermal failures can be a limiting factor to the use of polyimides and their composites in extreme environments. Despite prior experimental studies, the mechanisms of such failures remain a question due to the lack of complete material model for polyimide. In this work, a novel time, temperature and moisture dependent constitutive model is developed and presented for the first time. This model is built on previous experimental and modeling studies of high temperature viscoelastic and viscoplastic deformation in the polyimide HFPE-II-52 and on studies of the effects of moisture degradation on the mechanical properties. The model is implemented in a finite element simulation providing a means for the study of blistering under different heating rates and moisture levels. The results show for the first time that high temperature blistering failures are driven not only by steam pressure and thermal softening but by the synergy of pressure loading and material softening due to hydrolytic degradation and plasticization.
Pretransplant Psychosocial Risk Factors May Not Predict Late Nonadherence and Graft Rejection in Adult Liver Transplant Recipients.

OBJECTIVE A psychosocial evaluation before liver transplant aims to identify risk factors for nonadherence and poor outcomes posttransplant. Despite broad support for such evaluations, evidence justifying its components is thus far limited. We investigated whether variables assessed during the psychosocial evaluation before liver transplant predict immunosuppressant nonadherence and graft rejection. MATERIALS AND METHODS Our study included 248 adult liver recipients at least 1 year after transplant with at least 3 measured tacrolimus levels. Predictor variables from the pretransplant evaluation were defined a priori and included sociodemographic factors (age, race, time since transplant), psychiatric history, substance abuse history, education level, and social support. Nonadherence was determined using the medication level variability index, which is an objective measure of adherence reflective of high medication level fluctuation from nonadherence. Outcomes (medication level variability index and biopsy-confirmed rejection) were obtained 1-year posttransplant to the present. RESULTS We found that 50% of patients were nonadherent to tacrolimus (medication level variability index > 2.5). The 41 patients with rejection (t = 2.71, P < .01) and black patients (F = 3.10, P = .02) had significantly higher index scores. Time since transplant was correlated with medical level variability index (r = 0.15, P = .02). However, in logistic regression, none of the predefined psychosocial variables predicted nonadherence (P = .40) or rejection (P = .19). CONCLUSIONS Our results confirmed a significant association between medication level variability index and rejection, validating it as an objective measure of clinically significant nonadherence. In a large sample with high rates of nonadherence, none of the pretransplant psychosocial variables commonly used in standard liver transplant evaluations predicted nonadherence or rejection. These findings call into question current selection criteria. Future prospective studies are needed to investigate more com-prehensive psychosocial variables and their ability to determine posttransplant outcomes.
Appropriation Concerns, Bargaining Power and Small Firms' Ability to Negotiate Alliance Contracts

Smaller firms are not as powerless in alliance negotiations as they have traditionally been portrayed. However, their power is likely impacted by their resources and alliance context. Thus, this st...
Influence of airborne particulates on respiratory tract deposition of inhaled toluene and naphthalene in the rat.

Objective: Most studies report that inhaled volatile and semivolatile organic compounds (VOCs/SVOCs) tend to deposit in the upper respiratory tract, while ultrafine (or near ultrafine) particulate ...
Semiparametric Regression Analysis of Multiple Right- and Interval-Censored Events.

Health sciences research often involves both right- and interval-censored events because the occurrence of a symptomatic disease can only be observed up to the end of follow-up, while the occurrenc...
Congenital anomalies of the odontoid process

Anomalous development of the odontoid is uncommon, and its clinical significance lies in its potential for producing serious neurologic sequelae due to atlantoaxial instability. Although there are several recognized variations (aplasia, hypoplasia, and os odontoideum), clinically they share the same signs and symptoms, and the treatment is identical. Symptoms are usually due to instability of the atlantoaxial joint, with compression of the spinal cord and anteriorly against the axis or posteriorly from the ring of the atlas. Patients may present with no symptoms, with persistent neck complaints, with transient or permanent neurologic deficits, or with sudden death. Symptoms from cranial nerve irritation seldom occur, but occasionally symptoms of cerebral and brain stem ischemia are noted as a result of compression of the vertebral arteries in the area of the atlas. If the condition is suspected, the diagnosis usually can be confirmed on lateral flexion-extension roentgenograms. Special techniques are often required, particularly lateral laminagrams, and flexion-extension stress roentgenograms are necessary to determine the presence and degree of atlantoaxial instability. The role of prophylactic surgical stabilization is not yet established. If instability greater than 5 mm. is demonstrated or the patient has clinical findings of neurologic compromise, surgical fusion should be performed.
Opioid and non-opioid drug responding under states of chronic pain: A timeline spanning 1980 to present day

It has been long recognized that chronic pain is a significant public health concern. After many decades of research and development investment for alternatives, the most effective pharmacological tools for managing diverse chronic pains remain the opioid analgesics. Several serious side effects including, the risks of addiction or diversion of opioid-containing dosage forms to nonpatient populations render the use of opioid medication for treatment of pain complicated. At the same time, it been asserted repeatedly that patients with established chronic pain demonstrate reduced propensity to acquire addiction to opioids than the general population. For over 30 years, neuropharmacological studies in rodent models of opioid self-administration have suggested that responding for opioids is, in fact, significantly altered under conditions of established chronic pain, and often reduced. However, with the introduction of the sustained release opioid preparations, the expansion of opioid prescribing, and appropriately heightened concerns regarding opioid-related addiction and mortality by respiratory depression, this long-standing assertion that patients with chronic pain are less susceptible to addiction has been recently challenged. In response to this challenge the opportunity arises, perhaps, to consider that chronic pain is a generic term that refers to a broad spectrum of painful conditions; these pain conditions may have common neurobiological mechanisms, but also key distinctions. Understanding the neurobiology underlying distinct chronic pain conditions as they relate to opioid addiction may help to better predict the therapeutic window and side effect risks associated with chronic opioid therapy. Progress has been made in this area, but it is currently recognized that more specific information is greatly needed. As a primer to planning such future studies, the present chapter is intended to summarize the prior three and a half decades of neuropharmacological studies that have systematically evaluated opioid (and non-opioid) analgesic responding in animal models of opioid addiction.
A CAROTID SINUS BARORECEPTOR AND WALL MODEL SUITABLE FOR BAROPACING

ABSTRACT A baroreceptor model is developed from a two-layered, cylindrical wall model for arteries and a neuromime. This model is intended to be used in baropacing. It is capable of reproducing the relationship between arterial pressure and sinus nerve activity for a single baroreceptive cell. The best results are achieved when the linking between the wall model and the neuromime is taken to be the stress difference between the two layers.
Caspase Activation: Revisiting the Induced Proximity Model

Caspases execute cell death. The mechanism of effector caspase activation primarily involves reorganization of active site loops following the activation cleavage. The Induced Proximity hypothesis, originally proposed to explain the activation of initiator caspases, has recently been reinterpreted to be proximity-driven dimerization of initiator caspases, and consequently their activation. The evidence supporting these models is critically evaluated and other possible mechanisms for initiator caspase activation are discussed.
Liquid crystals for signal processing applications in the microwave and millimeter wave frequency ranges

Liquid crystal technology has a long well-established history of applications in visible light, primarily in the display industry. In contrast, applications at lower frequencies (microwave through ...
A Predictor-Based Framework for Delay Compensation in Networked Closed-Loop Systems

One of the main challenges in networked closed-loop systems is that communication delays can significantly deteriorate system performance and even cause instability. A predictor-based framework was proposed previously to improve the networked closed-loop system performance by compensating constant network delays. The key feature of this prediction scheme is that it does not require a dynamic model of the remote subsystem and has only one design parameter to tune for each predictor to mitigate the communication delays. In this paper, the predictor-based framework is developed further. Specifically, previously the predictor was developed and its stability was analyzed for constant delays only. In this paper, the predictor structure is extended to the varying delay case and its stability is established for the first time for varying delays in a sufficient but not very conservative range by leveraging a Markov chain based approach from the literature. To that end, the key assumption of the approach that varying delays can be modeled using a two-time-scale Markov chain is tested using actual network delay data. Next, to test the performance of the framework on a networked closed-loop system, it is applied to a simulated networked motor-shaft-geartrain system with different constant and varying delay models, as well as a real network. Predictors are shown to be effective in significantly reducing the negative effects caused by delays and greatly improve the fidelity of the networked integration. Finally, stability of the closed-loop system with predictor-based framework is studied with constant delays using a “mixed” small gain and passivity theorem from the literature and it is demonstrated that the predictors can even help stabilize a closed-loop linear time-invariant system when the nonpredictor-based networked system is unstable due to constant delays.
The Role of Commercial Health Insurance Characteristics in Bariatric Surgery Utilization.

Objective The aim of this study was to understand relationships among insurance plan type, out-of-pocket cost sharing, and the utilization of bariatric surgery among commercially insured patients. Background Only 1% of eligible persons undergo bariatric operations, and this underutilization is often attributed to lack of insurance coverage. But even among the insured, underinsurance is now recognized as a major barrier to accessing medical care. The relationships among commercial insurance design, out-of-pocket cost sharing, and elective surgery utilization, particularly in bariatrics, are not well understood. Methods Retrospective review of 73,002 commercially insured members of the IBM MarketScan commercial claims database who underwent bariatric surgery from 2014 to 2017. The exposure variables were insurance plan type and out-of-pocket cost sharing. The outcome was utilization of bariatric surgery. We also examined seasonal trends in bariatric surgery utilization stratified by average levels of cost sharing. Results Utilization of bariatric surgery was higher in plans with lower cost sharing, such as PPOs (20 operations/100,000 enrollees) than in HDHPs (high-deductible health plans, 12.1 operations/100,000 enrollees). Overall, every $1000 increase in cost sharing was associated with 5 fewer bariatric operations per 100,000 insured lives; this association was strongest in plans with high cost sharing (high-deductible and consumer-directed health plans). Members of all plan types had higher surgical utilization in quarter 4 relative to quarter 1 of each year; these seasonal variations were also most pronounced in plans with high cost sharing. Conclusions Insurance plan types with higher cost sharing have lower utilization of bariatric surgery. Underinsurance may represent a newly identified barrier to surgical care that should be addressed by advocates and policymakers.
Comparison of Rural vs Urban Direct-to-Physician Commercial Promotion of Medications for Treating Opioid Use Disorder.

Importance In the United States, access to medications prescribed for opioid use disorder (OUD) is lower in rural counties than in urban counties. Considering the positive associations between direct-to-physician promotion of opiates and OUD medications and their prescribing rates, a study examining the association between pharmaceutical promotion of these medications and county-level rurality has merit. Objective To assess whether rural counties received less pharmaceutical promotion of OUD medications compared with urban counties. Design, Setting, and Participants This cross-sectional county-level study used all reported direct-to-physician pharmaceutical payments from manufacturers of medications prescribed for OUD from January 1, 2014, through December 31, 2017, as well as demographic and economic data at the county level from 3140 US counties. Logistic regression was used with year and state-level fixed effects to compare rural county and urban county odds of receiving any promotion of OUD medications. A negative binomial model was used with year and state-level fixed effects to compare the mean pharmaceutical payments per physician and per population in rural vs urban counties. Main Outcomes and Measures A binary indicator for whether physicians in a county received any promotion related to OUD medications in a year. The second outcome was the value of promotion (eg, meals), with dollar amount of payments for each county by year. Counties were separated into metropolitan, micropolitan, and rural categories using the National Center for Health Statistics Urban-Rural Classification Scheme. Results Of 3140 US counties with 18 318 physicians to whom promotion of OUD medications was directed, 1166 (37.1%) were metropolitan (16 740 physicians [91.4%]), 641 (20.4%) were micropolitan (1049 physicians [5.7%]), and 1333 (42.5%) were rural (529 physicians [2.9%]). Compared with physicians in metropolitan counties, physicians in rural counties had reduced odds of receiving any promotion (adjusted odds ratio, 0.57; 95% CI, 0.44-0.74) and received lower payments (adjusted incidence rate ratio, 0.24; 95% CI, 0.17-0.34). Conclusions and Relevance The study findings suggest that promotion for OUD medications is less likely to occur in rural counties and that this difference in promotion of OUD medications may be associated with differential commercial costs and benefits of promotion in rural settings.
Selective Estrogen Receptor Modulators (SERMs) in Clinical Practice

The objective of this literature review is to familiarize the reader with the clinical data on selective estrogen receptor modulators (SERMs) and antiestrogens currently in use in the US, excluding data on breast effects. Four compounds in the SERM and antiestrogen families are presently in clinical use in the US: clomiphene (CC), tamoxifen (TAM), toremifene (TOR), and raloxifene (RLX). The clinical databse on these compounds is among the largest available. Each compound demonstrates a specific profile for its target tissue effects, and this may differ between premenopausal and postmenopausal women. CC is the most widely used agent for ovulation induction. TAM is indicated in the management of breast cancer and for prevention in women at high risk. TAM may have additional effects on the cardiovascular and skeleal systems. TOR also is used for its effects on breast tissue and may have positive cardiovascular effects. RLX is approved in the management of osteoporosis with data supporting favorable effects o...
Abstract 60: Semaphorin 7a promotes cell survival and resistance to endocrine therapy in ER+ breast cancer

Estrogen receptor positive (ER+) breast cancers comprise the largest percentage, ~70%, of all breast cancers diagnosed in the Unites States. Despite the development of effective anti-estrogen based therapies, such as tamoxifen, aromatase inhibitors, and fulvestrant, 1 in 5 women with an ER+ tumor will experience recurrence within 10 years of diagnosis. Thus, the largest number of breast cancer-related deaths each year are attributed to ER+ breast cancers. Additionally, metastatic ER+ breast tumors uniformly develop resistance to anti-estrogen-based therapies, including combination targeted therapies with CDK4/6 and mTOR inhibitors, which represent some of the best therapeutic advances of the last five years and reflect our increasing understanding of cross-targeting to overcome acquired resistance. Our studies have shown that Semaphorin 7a expressing tumors are resistant to ER targeting therapies, including tamoxifen and fulvestrant. Furthermore, Semaphorin 7a expressing tumors do not respond to CDK4/6 inhibition. We have utilized luciferase reporter assays to show that Semaphorin 7a is initially regulated by ER; we then utilized overexpression studies to show that sustained upregulation of Semaphorin 7a results in downregulation of ER in xenograft models. This downregulation of ER is accompanied by upregulation of cell survival signaling mediated by pro-survival kinase Akt. In TCGA and METABRIC datasets, Semaphorin 7a expression is associated with significant decreases in overall survival. Furthermore, using KmPlot analysis, we have shown that Semaphorin 7a expression in patients treated with endocrine therapy predicts for poor survival rates. Thus, we sought to determine whether Semaphorin 7a expressing tumors would be susceptible to PI3K/Akt targeted therapies. We observe that Semaphorin 7a expressing tumors are sensitive to PI3K/Akt inhibition, as well as to inhibition of the ER target gene Bcl2. Thus, we suggest that patients with high Semaphorin 7a expression be considered as candidates for the addition of Venetoclax, an FDA approved Bcl2 targeted therapy, to their current therapeutic regimen. As Venetoclax is in Phase II trials in combination with fulvestrant for advanced CDK4/6 inhibitor refractory breast cancer, we believe our results could be rapidly translated to the clinical setting and will improve outcomes for the thousands of ER+ breast cancer patient that develop resistance to endocrine therapy. Citation Format: Traci Renae Lyons. Semaphorin 7a promotes cell survival and resistance to endocrine therapy in ER+ breast cancer [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 60.
Comparison of Reluctance and Surface Permanent Magnet Coaxial Magnetic Gears

The noncontact operation of magnetic gears offers significant potential advantages over mechanical gears. Reluctance magnetic gears (RMGs) have been proposed as an alternative to surface permanent magnet gears (SPMGs) at high speeds. This paper explains the operating principles of RMGs and provides a thorough parametric comparison between RMGs and SPMGs using 2-D and 3-D finite element analysis (FEA). SPMGs are found to outperform RMGs in torque density, as expected. However, contrary to the results of nonoptimized comparisons in previous papers, optimal SPMGs also can achieve better magnet utilizations and efficiencies than optimal RMGs. Additionally, the RMGs with the highest torque densities suffer from significantly more torque ripple than the SPMGs with the highest torque densities. Also, the simulations demonstrate that the optimal SPMGs and optimal RMGs with the same stack lengths tend to suffer comparable reductions in torque from end effects.
Consensus Embeddings for Networks with Multiple Versions

Machine learning applications on large-scale network-structured data commonly encode network information in the form of node embeddings. Network embedding algorithms map the nodes into a low-dimensional space such that the nodes that are “similar” with respect to network topology are also close to each other in the embedding space. Many real-world networks that are used in machine learning have multiple versions that come from different sources, are stored in different databases, or belong to different parties. Due to efficiency or privacy concerns, it may be desirable to compute consensus embeddings for the integrated network directly from the node embeddings of individual versions, without explicitly constructing the integrated network. Here, we systematically assess the potential of consensus embeddings in the context of processing link prediction queries on user-chosen combinations of different versions of a network. For the computation of consensus embeddings, we use linear (singular value decomposition) and non-linear (variational auto-encoder) dimensionality reduction methods. Our results on a large selection of protein-protein interaction (PPI) networks (eight versions with 255 potential combinations) show that consensus embeddings enable real-time processing of link prediction queries on user-defined combinations of networks, without requiring explicit construction of the integrated network. We observe that linear dimensionality reduction delivers better accuracy and higher efficiency than non-linear dimensionality reduction. We also observe that the performance of consensus embeddings is amplified with increasing number of networks in the database, demonstrating the scalability of consensus embeddings to growing numbers of network versions.
Evidence for magnetic clusters in stoichiometric quantum critical CeRu 2 Si 2

Systems that have been prepared to undergo a second-order phase transition at zero Kelvin, the so-called quantum critical systems, appear to fall into two categories: (chemically) heavily doped systems where the unusual properties can be related to a disorder-induced distribution of Kondo shielding temperatures, and (almost) stoichiometric systems where the departures from Fermi-liquid theory have been attributed to intrinsic instabilities. Here we show that this distinction is not as clear-cut and that magnetic clusters associated with a distribution of Kondo shielding temperatures are also present in ${\mathrm{CeRu}}_{2}{\mathrm{Si}}_{2}$, a system close to a quantum critical point. By revisiting the published data on this system and comparing them to the results for heavily doped quantum critical $\mathrm{Ce}{({\mathrm{Ru}}_{0.755}{\mathrm{Fe}}_{0.245})}_{2}{\mathrm{Ge}}_{2}$, we show that clusters exist in both systems at low temperatures and that the moments of the Ce ions within these clusters have all lined up with their neighbors. This implies that the dominant physics that drives heavily doped systems, namely, the spontaneous formation of magnetic clusters, should also play a leading role in the response of homogenous systems. This represents a notable departure from how the physics that governs quantum critical points is treated in the literature.
Utilizing simulation to prepare nursing students to coordinate care through transitions

Effective care coordination and transitions are critical factors for patients to improve health outcomes. Providing prelicensure nursing students with the opportunity to demonstrate practical application of these concepts will assist in preparing them for entry into practice. This article discusses how an associate degree nursing program instituted a simulation that focused on coordination of care for a patient transitioning through multiple settings. This realistic experience allowed students to engage in clinical reasoning and judgements through the role of the observer and the nurse. Changes since COVID-19 pandemic are discussed.
Amplicon remodeling and genomic mutations drive population dynamics after segmental amplification.

New enzymes often evolve by duplication and divergence of genes encoding enzymes with promiscuous activities that have become important in the face of environmental opportunities or challenges. Amplifications that increase the copy number of the gene under selection commonly amplify many surrounding genes. Extra copies of these co-amplified genes must be removed, either during or after evolution of a new enzyme. Here we report that amplicon remodeling can begin even before mutations occur in the gene under selection. Amplicon remodeling and mutations elsewhere in the genome that indirectly increase fitness result in complex population dynamics, leading to emergence of clones that have improved fitness by different mechanisms. In this work, one of the two most successful clones had undergone two episodes of amplicon remodeling, leaving only four co-amplified genes surrounding the gene under selection. Amplicon remodeling in the other clone resulted in removal of 111 genes from the genome, an acceptable solution under these selection conditions, but one that would certainly impair fitness under other environmental conditions.
The Institutional Grammar: A Method for Coding Institutions and its Potential for Advancing Third Sector Research

Institutions—defined as strategies, norms and rules (Ostrom Understanding institutional diversity, Princeton University Press, Princeton, 2005)—are omnipresent in third sector contexts. In this paper, we present the Institutional Grammar (IG) as a theoretically informed approach to support institutional analysis in third sector research. More specifically, the IG coding syntax allows the researcher to systematically wade through rich text and (transcribed) spoken language to identify and dissect institutional statements into finer syntactical segments of interest to the researcher. It is a versatile method that can generate data for small- or large-N research projects and can be integrated with mixed-method research designs. After first introducing and describing the IG, we present a case study to illustrate how a IG-based syntactic analysis can be leveraged to inform third sector research. In the case, we ask: Do the rules embedded in regulatory text addressing the involuntary dissolution of charity organizations differ between bifurcated and unitary jurisdictions in the United States? Using IG’s ABDICO 2.0 syntax, we identify eleven “Activation Condition” (AC) categories that trigger action and assess variation among the 46 jurisdictions. We ultimately conclude that the rules do not differ between bifurcated and unitary jurisdictions, but that finding is not the primary concern. The case demonstrates IG as an important methodological advance that yields granular, structured analyses of rules, norms and strategies in third sector settings that may be difficult to identify with other methods. We then emphasize four areas of third sector research that could benefit from the addition of IG-based methods: analysis of (1) rule compliance, (2) inter-organizational collaboration, (3) comparative study of institutional design, and (4) the study of institutional change. We close the paper with some reflections on where IG-based analysis is headed.
The Promise of Biomarkers in Diagnosing Major Depression in Primary Care: the Present and Future

Major depressive disorder (MDD) is the most prevalent psychiatric disorder, but it can be underdiagnosed or misdiagnosed. Most people with depression are seen in primary care settings, where there are limited resources to diagnose and treat the patient. There is a lack of clinically validated objective laboratory-based diagnostic tests to diagnose MDD; however, it is clear that these tests could greatly improve the correct and timely diagnosis. This review aims to give a cross-sectional view of current efforts of DNA methylomic, transcriptomic, and proteomic approaches to identify biomarkers. We outline our view of the biomarker developmental steps from discovery to clinical application. We then propose that better cooperation will lead us closer to the common goal of identifying biological biomarkers for major depression. “The important thing is not to stop questioning. Curiosity has its own reason for existing.” Albert Einstein.