cssi/SciSciGPT-SciSciNet huggingface dataset:
Implementation of a Patient Navigator Program to Reduce 30-day Heart Failure Readmission Rate

With increasing awareness to provide personalized care our institution applied the American College of Cardiology (ACC) Patient Navigator Program to identify hospitalized heart failure (HF) patients and improve transitions and outcomes. Utilizing a Navigator Team (NT) composed of a nurse and clinical pharmacist, we delivered evidenced-based interventions and hypothesized this approach would improve identification of HF inpatients and reduce the 30-day all-cause readmission rate. Patients were followed from admission to discharge and received at least one intervention, tailored to the patient's health literacy and social needs. The 30-day all-cause readmission rate was 17.6% for the Patient Navigator Program and 25.6% for the medical center. Compared to the medical center there was a statistically significant increase in education and follow-up. For patients who received specific NT interventions of education and follow-up the readmission rate was 10.3% and 6.1% respectively. Hospital programs can easily embed a NT into existing initiatives to further reduce the readmission rate.
Modifiable and non-modifiable risk factors for preterm delivery among adolescent and young adult cancer survivors.

A cancer diagnosis in adolescence and young adulthood (AYA, ages 15–39) may affect future pregnancy outcomes. Previous studies have reported an increased risk of preterm delivery (< 37 weeks of gestation) after maternal cancer treatment. In this analysis, we evaluated whether non-cancer characteristics modify the association between an AYA cancer history and preterm birth. North Carolina Central Cancer Registry records (2000–2013) were linked to state birth certificate files (2000–2014) to identify births to AYA cancer survivors (n = 1,980). A comparison cohort of births to women without a cancer diagnosis was selected from birth certificate files (n = 11,860). Log-binomial regression was used to estimate risk ratios (RR) and 95% confidence intervals (CI) for preterm delivery. Effect modification by early prenatal care (1st trimester; yes/no), race/ethnicity (white/black/other), previous live births (0/1+), maternal age (< 25/25–29/30–34/35+), smoking during pregnancy (any/none), and education (high school or less/some college/Bachelor’s degree or higher) was evaluated using likelihood ratio tests (LRT). Overall, preterm births were more common among AYA survivors than the comparison group (RR = 1.24, CI 1.07–1.43). The association was stronger among those who did not receive early prenatal care (RR = 1.73, CI 1.26–2.37) than among those who did (RR = 1.15, CI 0.98–1.35; LRT p = 0.03). Maternal age < 25 was also associated with a greater increase in preterm birth (< 25: RR = 1.80, CI 1.27–2.54; LRT p = 0.07). Associations did not vary strongly by other factors evaluated. An AYA cancer diagnosis may be associated with an increased risk of preterm birth, particularly among women who are younger and receive late or no prenatal care.
Matter-neutrino resonance in a multiangle neutrino bulb model

Simulations of neutrino flavor evolution in compact merger environments have shown that neutrino flavor, and hence nucleosynthesis, can be strongly affected by the presence of matter-neutrino resonances (MNRs), where there is a cancelation between the matter and the neutrino potential. Simulations performed thus far follow flavor evolution along a single neutrino trajectory, but self-consistency requires all trajectories to be treated simultaneously, and it has not been known whether MNR phenomena would still occur in multiangle models. In this paper, we present the first fully multi-angle calculations of MNR. We find that familiar MNR phenomena, where neutrinos transform to a greater extent than anti-neutrinos and a feedback mechanism maintains the cancellation between the matter and neutrino potential, still occurs for a subset of angular bins, although the flavor transformation is not as efficient as in the single-angle case. In addition, we find other types of flavor transformation that are not seen in single-angle simulations. These flavor transformation phenomena appear to be robust and are present for a wide range of model parameters, as long as an MNR is present. Although computational constraints currently limit us to models with spherical symmetry, our results suggest that the presence of an MNR generally leads to large-scale neutrino flavor evolution in multiangle systems.
Asymmetric exchange rate pass-through in U.S. imports of cocoa.

Both the autoregressive distributed lag (ARDL) and the nonlinear ARDL frameworks are applied to model U.S. imports of cocoa beans from Cote d'Ivoire, Ghana, and the Dominican Republic (more than 90% of U.S. cocoa imports originate from these three countries). The results provide evidence of nonlinear and asymmetric pass-through of exchange rates, regional quality difference, and imperfect competition in U.S. cocoa imports. Furthermore, a rise or fall in U.S. income leads to an increase or decrease in U.S. cocoa imports.
Presence of Carotenoid, an Anticarcinogenic Marker, in Nipple Aspirates Postlactation

Case-controlled studies have identified a protective effect of lactation against breast cancer; however, little is known about the nature of this protective mechanism. The purpose of this study was to examine postweaned, nipple aspirate fluid (NAF) from women, ages 18 to 45, for carotenoid, a known antioxidant and anticarcinogenic marker, and compare carotenoid availability in NAF with that reported in colostrum. Women who had lactated at least 6 months and weaned for at least 6 months were recruited into the study. A prestudy and poststudy serum prolactin level was obtained. NAF was obtained through a nipple aspirator method. Total carotenoid ranged from 0.4 to 4.0 µg/mL, with a mean level of 1.9 ± 1.2 (SD). Women who had weaned earlier ( 12mo) (P = 0.04). These levels were similar to those known to occur in colostrum. This research elucidates possible mechanisms of the protective effect of lactation on the microenvironment of the breast.
Painting with DEGAS: (digitally extrapolated graphics via algorithmic strokes)

Most photograph-to-oil-painting algorithms are based off of the techniques described by [Litwinowicz 1997] and improved upon by [Hertzmann 2001]. They are essentially fully-automated processes which place strokes at random, choosing stroke orientations to follow local gradient normals. These strokes are built up over several layers, each layer in a decreasing order of stroke size - painting broad strokes and then filling in details. Outside of the initial chosen parameters and some masking considerations, the user has little agency in how the algorithm chooses stroke placement, nor has the ability to make direct changes or touch-ups until every stroke is laid down on the canvas - essentially it behaves like an "image filter" applied as one would adjust contrast or add texture.
Sequential Imaging in Patient With Suspected Menière's Disease Identifies Endolymphatic Sac Tumor.

Objective:The standard evaluation of patients with suspected Meniere's disease (MD) includes initial imaging to rule out tumors of the temporal bone. Few guidelines, however, advocate sequential imaging. We propose that sequential imaging may reveal other etiologies of auditory and vestibular sympto
The epidemiology of bacterial culture–positive and septic transfusion reactions at a large tertiary academic center: 2009 to 2016

Background Bacterial contamination and associated septic transfusion reactions (STRs) remain the leading infectious risk to the blood supply. We sought to characterize the risk and clinical presentation of blood culture-positive transfusion reactions (BCPTRs) and STRs at our institution. Study design and methods A retrospective analysis was conducted of all suspected transfusion reactions reported to the transfusion service at a 1000-bed tertiary academic medical center from January 2009 to September 2016. Routine investigation included review of the clinical presentation, Gram stain, and bacterial culture of residual blood from the transfused product or associated blood bag. BCPTRs were defined by the presence of a positive bacterial culture in the blood product and/or recipient. STRs met definitive Centers for Disease Control and Prevention hemovigilance criteria for transfusion-transmitted infection, with definite imputability and concordant bacterial culture of the blood product and recipient. Results A total of 688,514 blood products were transfused during the study period, 3170 transfusion reactions were reported, and 18 (0.57%) were BCPTRs of which seven (0.22%) were STRs. Fifteen of 18 (83.3%) BCPTRs and six of seven (85.7%) were associated with transfusion of apheresis platelets. Major symptoms and signs of BCPTRs included chills (67%), fever (61%), and nausea and vomiting (50%). Four of seven (57.1%) STRs were classified as severe or life-threatening. Conclusion BCPTRs are rare yet potentially serious. The signs and symptoms of BCPTRs, and associated STRs, are not specific, posing risk of misclassification. Challenges surrounding reporting and case ascertainment underscore the need for laboratory measures to address residual risk of contamination.
When Developers Disagree: Divergent Advice as a Potential Catalyst for Protégé Growth

Developmental relationships offer rich opportunities for personal growth, which enables people to operate effectively in complex work environments. Although it is now widely recognized that protege...
Crude Optimism: Romanticizing Alberta’s Oil Frontier at the Calgary Stampede

Designed to preserve and promote western heritage and culture, the Calgary Exhibition and Stampede has become entwined with, and politically and economically expedient for, Alberta’s oil and gas in...
Cocoon Heat Tolerance of Pheretimoid Earthworms Amynthas tokioensis and Amynthas agrestis

In the United States earthworms of two Asian species (Amynthas tokioensis and A. agrestis) are leading a northward invasion into temperate forests and horticultural landscapes. Some studies have shown temperature sensitivity in earthworms, but none has explicitly tested the range of heat tolerance for A. tokioensis and A. agrestis cocoons. This study tested the hypothesis A. tokioensis and A. agrestis cocoons would become nonviable when exposed to 55 C in a laboratory setting. Clitellate earthworms of A. tokioensis and A. agrestis were established in replicate incubation cultures to quantify cocoon production rate and to obtain cocoons of known source. Cocoons were then exposed to heat treatments (3 or 15 d at 20, 30, 40, 45, 50, 55, or 60 C) to determine viability after heat exposure. Twelve A. tokioensis and A. agrestis earthworms produced as many as 74 and 82 cocoons in 20 d, respectively (overall mean = 0.14 ± 0.10 cocoons earthworm–1 d–1). All heat treatments ≥40 C resulted in zero viability (P < 0.001), but the 30 C treatment was no different than the control at 20 C (P = 1.000). These findings were consistent regardless of species, treatment length, or period of incubation during which the cocoons were collected. The threshold of tolerance was between 27.1 C (maximum of the 30 C treatment) and 38.1 C (minimum of the 40 C treatment) for A. tokioensis and A. agrestis cocoons. These data may guide management decisions concerning the spread of A. tokioensis and A. agrestis to new locations.
A tissue-specific, injectable acellular gel for the treatment of chronic vocal fold scarring

Gel-based injectable biomaterials have significant potential for treating vocal fold defects such as scarring. An ideal injectable for vocal fold lamina propria restoration should mimic the microenvironment of the lamina propria to induce scarless wound healing and functional tissue regeneration. Most current synthetic or natural injectable biomaterials do not possess the same level of complex, tissue-specific constituents as the natural vocal fold lamina propria. In this study we present a newly-developed injectable gel fabricated from decellularized bovine vocal fold lamina propria. Blyscan assay and mass spectrometry indicated that the vocal fold-specific gel contained a large amount of sulfated glycosaminoglycans and over 250 proteins. Gene Ontology overrepresentation analysis revealed that the proteins in the gel dominantly promote antifibrotic biological process. In vivo study using a rabbit vocal fold injury model showed that the injectable gel significantly reduced collagen density and decreased tissue contraction of the lamina propria in vocal folds with chronic scarring. Furthermore, this acellular gel only elicited minimal humoral immune response after injection. Our findings suggested that the tissue-specific, injectable extracellular matrix gel could be a promising biomaterial for treating vocal fold scarring, even after the formation of mature scar. STATEMENT OF SIGNIFICANCE: Vocal fold lamina propria scarring remains among the foremost therapeutic challenges in the management of patients with voice disorders. Surgical excision of scar may cause secondary scarring and yield inconsistent results. The present study reports an extracellular matrix-derived biomaterial that demonstrated antifibrotic effect on chronic scarring in vocal fold lamina propria. Its injectability minimizes the invasiveness of the delivery procedure and the degree of mucosal violation. In this work we also describe a new methodology which can more accurately identify proteins from the complex mixture of an acellular extracellular matrix gel by excluding interfering peptides produced during the enzymatic digestion in gel fabrication.
Control of Intracranial Pressure in Severe Head Injury

The presence of sustained increased intracranial pressure (ICP) greater than 25 mm Hg has been associated with a high mortality in head trauma patients in our experience (6, 13, 14). Early treatment of any suspected etiologic contributing factors of raised ICP is carried out in the hope of decreasing the incidence of persistent pathologic increased intracranial pressure and of increasing survival (2, 3, 4, 5, 10, 11, 12). To study this hypothesis, we devised strict protocols for treatment of our patients and then reviewed our recent experience. Next we compared our new data with our previous studies.
Lying and knowing

This paper defends the simple view that in asserting that p, one lies iff one knows that p is false. Along the way it draws some morals about deception, knowledge, Gettier cases, belief, assertion, and the relationship between first- and higher-order norms.
Awareness of family health history in a predominantly young adult population

Family health history (FHH) is a key predictor of health risk and is universally important in preventive care. However, patients may not be aware of the importance of FHH, and thus, may fail to accurately or completely share FHH with health providers, thereby limiting its utility. In this study, we conducted an online survey of 294 young adults and employees based at a US university setting regarding their knowledge, sharing behaviors, and perceived importance of FHH, and use of electronic clinical tools to document and update FHH. We also evaluated two educational interventions (written and video) to promote knowledge about FHH and its importance to health. We found that 93% of respondents were highly aware of their FHH, though only 39% reported collecting it and 4% using an online FHH tool. Seventy-three percent of respondents, particularly women, had shared FHH with their doctor when prompted, and fewer had shared it with family members. Participants in the video group were significantly more likely to understand the benefits of FHH than those in the written group (p = 0.02). In summary, educational resources, either video or written, will be helpful to promote FHH collection, sharing, and use of online FHH tools.
Hydrothermal growth of BaSnO3 single crystals for wide bandgap applications

Abstract A method for the synthesis of single crystals of BaSnO3 is reported. The growth employs a hydrothermal process using simple Ba(OH)2 and SnO2 powders in water at 650 °C and 140 MPa, with 5 M CsOH mineralizer in welded inert metal liners. Solubility studies indicate that the crystals have positive solubility coefficients that increase with temperature and mineralizer concentration in the growth regimes investigated. The tetravalent tin ions are somewhat aggressive toward the inert metal liners, especially silver and gold, requiring platinum liners for longer term growth runs. The (1 1 0) and (1 0 0) faces are commonly observed on the as-grown crystals. The crystals are thermally and chemically stable and can be readily polished as substrates for subsequent epitaxial growth. Crystals that are n-doped (La:BaSnO3) can be grown by the addition of the desired amount of La2O3 to the initial feedstock. The band gap for this hydrothermally-grown BaSnO3 was measured using the Tauc plot method to be 2.94 eV, with approximately 0.3 eV shift to higher energy upon n-doping.
Chemical Front Propagation: Initiation and Relative Stability

We review some topics in the study of chemical waves which may occur in nonlinear reactive systems far from equilibrium. First, we consider the mechanism of the initiation of chemical waves, which are concentration gradients that travel through space in excitable and oscillatory systems. In an oscillatory system, concentrations of some chemical species vary in time periodically as long as the system is maintained far from equilibrium. In an excitable system, there exists a stationary state in which the concentrations of chemical species are constant in time. Upon perturbation of that stationary state, where some concentrations are perturbed in a given direction with threshold changes in magnitude, a substantial excursion of concentrations through the phase space of all concentrations follows prior to the system’s return to the stationary state. There has been some discussion in the literature whether initiation of chemical waves in excitable and oscillatory systems occurs by thermal fluctuations or by heterogeneous means, such as dust particles in the solution of the reactive system. We address this issue and show by numerical solutions of deterministic reaction-diffusion equations, by comparison with experiments, and by simple stochastic calculations that initiation due to thermal fluctuations is most unlikely in the Belousov—Zhabotinsky (BZ) reaction, and hence the probable mechanism of initiation of waves in these media is one involving heterogeneities.
Rate of Peritoneal Carcinomatosis in Resected Stage II and III Colon Cancer.

Incidence of peritoneal carcinomatosis (PC) after curative resection of stage II and III colon cancer varies widely. Although certain features are considered high risk for PC, the impact of these features on PC incidence is unclear. A retrospective analysis was performed on patients ≥ 18 years old with resected stage II and III colonic adenocarcinoma treated at two academic institutions from 2007 to 2018. Clinicopathologic features, treatment and outcomes data were recorded. Patients with reported high-risk features (pT3N0-2 with mucinous/signet ring components, pT4, pN1c, perforation) were identified. The remaining stage II and III patients were used for comparison. Of 219 eligible patients, 93/219 (42.5%) were stage II and 126/219 (57.5%) were stage III. Median follow-up time was 25 (1–146) months. Adjuvant systemic treatment was administered to 133/219 (60.7%) patients. Overall incidence of PC was 14/219 (6.4%) and the median time to PC was 18 (1–37) months. The high-risk and comparison groups contained 113 and 106 patients, respectively. Incidence of PC was significantly different between groups (high-risk 9.7% vs comparison 2.8%, p = 0.04). Median time to PC was not significantly different between the groups [high-risk 17 (1–37) months vs comparison 20 (7–36) months, p = 0.88]. Overall PC incidence in patients with resected stage II and III colon cancer was 6.4%. Although the high-risk group developed PC at a significantly higher rate, the rate of PC in this group was still below 10%. The results of this study represent real-world rates of PC and should be taken into account when designing future studies.
Lyric analysis in adult mental health settings: An exploratory interpretivist study of music therapists’ clinical decision-making processes

Abstract Music therapists frequently use lyric analysis interventions in adult mental health settings. As clinical decision making (CDM) represents an important process in providing effective and quality care, it is crucial to gain an understanding of music therapists’ experiences and expertise to establish best practices. Therefore, the purpose of this exploratory interpretivist study was to investigate the CDM processes of music therapists using lyric analysis interventions in adult mental health settings. We conducted semi-structured interviews with four board-certified music therapists who had six to 12 years of experience in various adult mental health settings. We used an inductive approach to thematic analysis to analyze data and incorporated member checking and trustworthiness to verify and improve clarity of results. Three themes emerged as primary factors that influence the CDM processes of music therapists in mental health settings: A) Internal processes related to therapists’ experience, abilities, and approaches; B) Service user considerations and preferences; and C) Facility-based factors. The emerging themes and subthemes provide insight into the complexity of CDM in adult mental health settings and various factors music therapists consider when using lyric analysis interventions. Implications for clinical practice, limitations, and suggestions for future research are provided.
Ballistic supercavitating nanoparticles driven by single Gaussian beam optical pushing and pulling forces

Directed high-speed motion of nanoscale objects in fluids can have a wide range of applications like molecular machinery, nano robotics, and material assembly. Here, we report ballistic plasmonic Au nanoparticle (NP) swimmers with unprecedented speeds (~336,000 μm s-1) realized by not only optical pushing but also pulling forces from a single Gaussian laser beam. Both the optical pulling and high speeds are made possible by a unique NP-laser interaction. The Au NP excited by the laser at the surface plasmon resonance peak can generate a nanoscale bubble, which can encapsulate the NP (i.e., supercavitation) to create a virtually frictionless environment for it to move, like the Leidenfrost effect. Certain NP-in-bubble configurations can lead to the optical pulling of NP against the photon stream. The demonstrated ultra-fast, light-driven NP movement may benefit a wide range of nano- and bio-applications and provide new insights to the field of optical pulling force.
Angiotensin-II modulates GABAergic neurotransmission in the mouse substantia nigra.

GABAergic projections neurons of the substantia nigra reticulata (SNr), through an extensive network of dendritic arbors and axon collaterals, provide robust inhibitory input to neighboring dopaminergic neurons in the substantia nigra compacta (SNc). Angiotensin-II (Ang-II) receptor signaling increases SNc dopaminergic neuronal sensitivity to insult, thus rendering these cells susceptible to dysfunction and destruction. However, the mechanisms by which Ang-II regulates SNc dopaminergic neuronal activity are unclear. Given the complex relationship between SN dopaminergic and GABAergic neurons, we hypothesized that Ang-II could regulate SNc dopaminergic neuronal activity directly and indirectly by modulating SNr GABAergic neurotransmission. Herein, using transgenic mice, slice electrophysiology, and optogenetics, we provide evidence of an AT1 receptor-mediated signaling mechanism in SNr GABAergic neurons where Ang-II suppresses electrically-evoked neuronal output by facilitating postsynaptic GABAA receptors and prolonging the action potential duration. Unexpectedly, Ang-II had no discernable effects on the electrical properties of SNc dopaminergic neurons. Also, and indicating a nonlinear relationship between electrical activity and neuronal output, following phasic photoactivation of SNr GABAergic neurons, Ang-II paradoxically enhanced the feedforward inhibitory input to SNc dopaminergic neurons. In sum, our observations describe an increasingly complex and heterogeneous response of the SN to Ang-II by revealing cell-specific responses and nonlinear effects on intranigral GABAergic neurotransmission. Our data further implicate the renin-angiotensin-system as a functionally relevant neuromodulator in the basal ganglia, thus underscoring a need for additional inquiry. SIGNIFICANCE STATEMENTAngiotensin II (Ang-II) promotes dopamine release in the striatum and, in the substantia nigra compacta (SNc), exacerbates dopaminergic cell loss in animal models of Parkinsons disease. Despite a potential association with Parkinsons disease, the effects of Ang-II on neuronal activity in the basal ganglia is unknown. Here we describe a novel AT1 receptor-dependent signaling mechanism in GABAergic projection neurons of the SN reticulata (SNr), a major inhibitory regulator of SNc dopaminergic neurons. Specifically, Ang-II suppresses SNr GABAergic neuronal activity, subsequently altering GABAergic modulation of SNc dopaminergic neurons in a nonlinear fashion. Altogether, our data provide the first indication of Ang-II-dependent modulation of GABAergic neurotransmission in the SN, which could impact output from the basal ganglia in health and disease.
Through Glass VIAS using an Industry Compatible Glass Handling Solution

Thin glass (≤ 200 μm) has ideal properties for electronic packaging and RF applications. In electronic packaging, a smooth, dimensionally stable surface allows high resolution line/space patterning, while through glass via (TGV) technology permits integration in many relevant packaging structures. These capabilities combine with a low loss tangent at microwave frequencies and robustness to temperature and humidity to yield high performance for RF applications. In this paper we discuss a thin glass handling solution coupled with recent innovations that give glass an entry point into these applications at large scale using existing fabrication infrastructure. Our new polymer-free bonding process allows glass to be temporarily bonded to a handle such as silicon or other glass substrates. The Viaffirm™ bonding material is non-outgassing and capable of handling temperatures in excess of 400°C while remaining temporary. When silicon is used as the handle, the opacity and form factor of the silicon substrate means that the resulting bonded stack is compatible with existing silicon processing equipment. We discuss the properties of our bonding system including temperature performance, tunability of the bond energy for different applications, and approaches to debonding. We also describe the formation and metallization of TGVs utilizing our proprietary process. When using a silicon wafer as the handle substrate, vias in the glass terminate on the silicon and are thus comparable to blind vias in silicon. We discuss the ability to make tapered TGVs while tuning their size and via profile, as well as results in metallization to produce fully filled, void free vias using a range of seed and plating approaches.
Heterogeneous Causal Effect of Polysubstance Usage on Drug Overdose.

In this paper, we propose a system to estimate heterogeneous concurrent drug usage effects on overdose estimation, that consists of efficient co-variate selection, sub-group selection, generation of and heterogeneous causal effect estimation. Although, there has been several association studies have been proposed in the state-of-art methods, heterogeneous causal effects have never been studied in concurrent drug usage and drug overdose problem. We apply our framework to answer a critical question, "can concurrent usage of benzodiazepines and opioids has heterogeneous causal effects on opioid overdose epidemic?" Using Truven MarketScan claim data collected from 2001 to 2013 have shown significant promise of our proposed framework's efficacy. Our efficient causal inference model estimated that the causal effect is higher (19%) than the regression studies (15%) to estimate the risks associated with the concurrent usage of opioid and benzodiazepines on opioid overdose.
Impact of lay navigation on utilization and Medicare spending for cancer survivors in the "Deep South".

Though lay navigation programs have proven beneficial for individuals during cancer treatment, little is known about the effects of lay navigation on health care utilization and Medicare spending among older adults during cancer survivorship. This retrospective cohort study used administrative claims data to evaluate a lay navigation program implemented from 2012 to 2015 at 12 academic and community cancer centers in the Southeast. Medicare beneficiaries age ≥65 years navigated during survivorship were compared to propensity score–matched, non-navigated cancer survivors. Quarterly trends in Medicare spending were estimated using repeated measures mixed models. Rate ratios (RRs) and 95% confidence intervals (CIs) were estimated using repeated measures generalized linear models for quarterly emergency room (ER) visits and hospitalizations. Medicare spending for navigated (n = 3255) versus non-navigated older cancer survivors (n = 3255) was initially higher but declined faster by $513 per patient per quarter (95% CI −$616, −$410). Per patient per quarter risk of ER visits decreased by 11% (RR 0.89, 95% CI 0.86, 0.92) and hospitalizations decreased by 16% (RR 0.84, 95% CI 0.81, 0.88) over time comparing navigated versus non-navigated patients. Similar results were seen for patients enrolled in navigation post-treatment (N = 1893). In older cancer survivors receiving care in the Deep South, patients receiving lay navigation compared to those non-navigated had significant reductions in Medicare spending, hospitalizations, and ER visits. Though much emphasis has been placed on lay navigation during initial cancer treatment, navigation is needed throughout survivorship due to the high costs and health care utilization that persist post-treatment.
Potential Spreading Dynamics of COVID-19 with Temporary Immunity: A Mathematical Modelling Study

Background: The immune response to COVID-19 is currently unknown. Contemporary studies have found that the antibody titre levels in infected patients decrease over time. The recent discoveries of isolated but fully documented reinfection cases from around the world raise the question of what profile the epidemic trajectories may take if immunity were really to be temporary in a significant fraction of the population. Methods: We employ mathematical modelling to answer the above question. We construct a novel delay differential equation model tailored to accommodate different kinds of immune response. We consider two immune responses here : (a) where a recovered case becomes completely susceptible after a given time interval following infection and (b) where a first-time recovered case becomes susceptible to a lower virulence infection after a given interval following recovery, and becomes permanently immunized by a second infection. Findings: Possible solutions to the above model exhibit a large number of waves of disease with the first immune response and two to three waves with the second. These multiple wave solutions are manifest only for some intermediate values of the reproduction number R, which is governed by public health intervention measures. For sufficiently low as well as sufficiently high R, we find conventional single-wave solutions despite the short-lived immunity. Interpretation: Our results cast insight into the potential spreading dynamics of the disease and will also be useful for analysing the spread after a vaccine is invented, and mass vaccination programs initiated. Funding: None to report. Declaration of Interests: The authors have no conflict of interests.
UNIT 7.5 Molecular Modeling of Nucleic Acid Structure

This unit is the first in a series of four units covering the analysis of nucleic acid structure by molecular modeling. The unit provides an overview of the computer simulation of nucleic acids. Topics include the static structure model, computational graphics and energy models, the generation of an initial model, and characterization of the overall three-dimensional structure. Curr. Protoc. Nucleic Acid Chem. 54:7.5.1-7.5.13. © 2013 by John Wiley & Sons, Inc. Keywords: nucleic acid chemistry; nucleic acid structure and folding; structural analysis of biomolecules; experimental determination of structure; folding and conformational change
Exploring the Experience of Benefit Finding in Parents of Children with Cancer: A Grounded Theory Study

EXPLORING THE EXPERIENCE OF BENEFIT FINDING IN PARENTS OF CHILDREN WITH CANCER: A GROUNDED THEORY STUDY By Carol E. Zogran, Ph.D., R.N. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2008 Director: Rita H. Pickler, Ph.D., R.N., Professor and Chair, Department of Family and Community Health Nursing The diagnosis of cancer in a child is one of the most significant stressors a parent can experience, and research in the area of stress-related effects of illness on parents has emerged in many areas. The majority of studies have focused on the potential or actual negative impact on parents during and after treatment of their child’s illness. However, studies that initially set out to explore the difficulties associated with coping with childhood cancer found that parents often reported positive aspects about the experience. There is now increasing interest and support for the study of “positive-health” factors that contribute to protective variables influencing the health and well being of parents, such as benefit finding. The present study aimed to illuminate the process of benefit finding in x parents of children with cancer and to develop a theoretical model of this process based on the findings. This grounded theory study resulted in a conceptual model that organized and depicted the constructs and structures related to the process of benefit finding. Through constant comparative analysis, the Basic Psychosocial Problem was identified as being overwhelmed with fear. The parents identified intervening conditions that helped move them from feeling overwhelmed to feeling that they could manage the fear. Many parents identified a specific event, an “epiphenomenon” that created a turning point for them. This event, along with the intervening conditions, moved the parent from being overwhelmed to managing/transforming the fear, which was the Basic Psychosocial Process. The strategies that the parents identified as helping to manage the fear are being in the present, being strong, having faith/maintaining hope, and making meaning out of the event, of which benefit finding was the major component. This entire process occurred within the context of being a parent, as this awareness colored the entire experience. Benefit finding emerged as both a strategy and an outcome within this process and encompassed a growth in character, strengthening of relationships, and a gain in perspective. The theoretical model and substantive theory that emerged during the course of this study provide a way to understand this process in parents of children with cancer. CHAPTER
Structural Weight Comparison of a Joined Wing and a Conventional Wing

A structural weight comparison was made between a new concept wing design, called a "Joined Wing," and a reference conventional wing-plus-horizontal tail (Boeing 727). The joined-wing analysis includes two cases that differ only in minimum gage skin thickness. The comparison was accomplished by constructing finite-element computer models of each wing configuration, analyzing each for optimum skin thickness, then determining the structural weight of each wing. The optimizations were based on a fully stressed design concept using a Von Mises criterion for maximum allowable stress. The joined wing was found to be lighter by 12-22%.
Isotropy in the two-point angular correlation function of the CMB

We study the directional dependence of the angular two-point correlation function in maps of the cosmic microwave background (CMB). We propose two new statistics, one which measures the correlation of each point in the sky with a ring of points separated angle theta away, and a second that measures the missing angular correlation above 60 degrees as a function of direction. Using these statistics, we find that most of the low power in cut-sky maps measured by the WMAP experiment comes from unusually low contributions from the directions of the lobes of the quadrupole and the octupole. These findings may aid a future explanation of why the CMB exhibits low power at large angular scales.
Fast NMDA Receptor–Mediated Synaptic Currents in Neurons From Mice Lacking the ε2 (NR2B) Subunit

TheN-methyl-d-aspartate (NMDA) receptor has been implicated in the formation of synaptic connections. To investigate the role of the e2 (NR2B) NMDA receptor subunit, which is prominently expressed ...
Surface-based inversions above central Greenland

[1] Surface-based temperature inversions (SBIs) are studied at Summit Station in central Greenland during the period spanning July 2010 to May 2012. The frequency and intensity of SBI are examined using microwave radiometer (MWR) temperature retrievals, radiosonde profiles, and near-surface meteorological data. Using the MWRs' high temporal resolution, the diurnal, monthly, and annual cycles are investigated. Monthly mean values in SBI occurrence and intensity show that surface-based inversions are prevalent in the winter with decreasing values in the summer months. A case study on 20 February 2011 suggests that factors other than solar elevation angle influence the intensity of surface-based inversions. An increase in liquid water path corresponds to a decrease in SBI intensity, suggesting that liquid-bearing clouds, especially within the lowest 1 km, are associated with weaker surface-based inversions.
Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta‐analysis

Background Free tissue transfer is commonly used in the reconstruction of post-ablative defects of the mandible. Due to lack of statistical power, comparing the survival of various free flaps, even in large studies, is challenging. The purpose of this study was to perform a meta-analysis comparing the survival of the most commonly used free flaps for mandibular reconstruction. Methods We searched PubMed, EMBASE, and SCOPUS for relevant studies. A meta-analysis using the Peto one-step odds ratio (OR) with 95% confidence intervals (CI) was used to compare the pooled survival of the most commonly used free flaps for mandibular reconstruction. Results Of the 25,303 studies reviewed, 17 were selected for data extraction. A total of 1,221 subjects received 1,262 free flaps. Sixty-five free flaps failed. The pooled survival of all free flaps used for mandibular reconstruction was 94.8%. The deep circumflex iliac artery (DCIA) flap was associated with a seven-fold increase in failure when compared to the radial forearm free flap (Peto OR 7.40; 95% CI 1.38, 39.75, P = 0.02). There was no difference in survival when comparing other commonly used free flaps. Conclusions The results of this study suggest that free flap reconstruction of the mandible is highly successful. With the exception of the increased survival of the radial forearm when compared to the DCIA, there is no difference in recipient site survival when comparing various free flaps for mandibular reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery 35:576–587, 2015.
Clinical risk factors for death after release from prison in Washington State: a nested case-control study.

BACKGROUND AND AIMS: While mortality rates after prison release are high, little is known about clinical risk factors for death. We sought to identify risk and protective factors for all-cause and accidental poisoning (overdose) death. DESIGN: Nested case control study of people released from prison. SETTING: Washington State Department of Corrections, Washington, USA. PARTICIPANTS: Cases (699 all-cause deaths, of which 88 were among women, and 206 additional overdose deaths, of which 76 were among women) between 1999 and 2009 matched 1:1 to controls on sex, age and year of release using risk set sampling. MEASUREMENTS: Prison medical charts were abstracted for clinical information. Independent associations between clinical characteristics and all-cause and overdose mortality were assessed using conditional logistic regression. FINDINGS: Key independent risk factors for all-cause mortality included homelessness (Odds Ratio [OR] 1.53, 95% Confidence Interval [CI] 1.06, 2.23), injection drug use (OR 1.54, 95% CI 1.15, 2.05), tobacco use (OR 1.50, 95% CI 1.06, 2.12), cirrhosis (OR 4.42, 95% CI 1.63, 11.98), and psychiatric medications before release (OR 2.37, 95% CI 1.71, 3.29). Independent risk factors for overdose mortality included substance dependence (OR 2.33, 95% CI 1.32, 4.11), injection drug use (OR 2.43, 95% CI 1.53, 3.86), panic disorder (OR 3.87, 95% CI 1.62, 9.21), psychiatric prescriptions before release (OR 2.44, 95% CI 1.55, 3.85), and problems with opiates/sedatives (OR 2.81, 95% CI 1.40, 5.63). Substance use disorder treatment during the index incarceration was protective for all-cause (OR 0.67, 95% CI 0.49, 0.91) and overdose (OR 0.57, 95% CI 0.35, 0.90) mortality. CONCLUSIONS: Injection drug use and substance use disorders are risk factors for death after release from prison. In-prison substance use treatment services may reduce the risk. This article is protected by copyright. All rights reserved. Language: en
Reactive atomization of silicon to form in situ oxide sintering aids

The present investigation demonstrated the feasibility of using reactive atomization to produce Si powder within situ oxide sintering aids. With further process optimization, this powder may be an alternative starting material to the conventional, mechanically blended, Si-plus-oxide powder used to produce commercial sintered reaction bonded silicon nitride (SRBSN). In the reactive atomization approach, yttrium and aluminum additives were introduced into silicon metal during induction melting. Reactive atomization was accomplished using a N2-5 pct O2 mixture as the atomization gas. During atomization, oxygen in the atomization gas reacted with Y and Al in the Si melt to produce Y2O3 and Al2O3, which act asin situ sintering aids. The reactive atomized powder demonstrated a Gaussian distribution with a mean diameter of 36 μm. The powder fines (<38 μm) were used to produce cold isostatically pressed compacts that were subsequently reaction bonded and sintered. The results demonstrate that β-Si3N4 formed during reaction bonding and sintering. The density of the SRBSN was 77 pct of theoretical. Transmission electron microscopy (TEM) studies indicated the presence of a glassy phase on the grain boundaries, which is typical in SRBSN and indicative of the presence of thein situ sintering aids. A kinetic model was used to study the influence of processing parameters, such as droplet temperature and oxygen partial pressure, on the kinetics of oxide formation during reactive atomization. The results suggest that the volume fraction of oxides increases with increasing droplet temperature and oxygen partial pressure in the atomization gas mixture.
Integrating AI and optimization for decision support: a survey

Abstract Optimization models have been the workhorses of computer based decision support. Their emphasis is on model structure, quantification and solution efficiency. However, there also are important meta-modeling, analysis and interpretation activities associated with practical decision making. AI methods, because of their aim of emulating human reasoning and thinking activities, have the potential of providing computer based support for these other decision making activities. There has been a growing literature on the integration of AI and optimization techniques for decision support. Much of this body of work describes techniques that are application or problem specific. Others describe more general methods addressing different specific aspects of decision making. In this paper we use a conceptual framework to survey and analyze these efforts. Our survey shows that efforts to integrate AI and Optimization have been focused mainly on model formulation and selection. Other activities such as post solution analysis or solver selection, have received considerably less attention for automated support. The dramatic difference in paradigms between AI and Optimization result in vastly different data structures and control primitives in their respective software implementations. We conjecture that this disparity will continue to thwart the development of general tools for seamless AI/Optimization integration.
A Mechanical Model of Porcine Vascular Tissues-Part II: Stress–Strain and Mechanical Properties of Juvenile Porcine Blood Vessels

Our laboratory is studying the influence of the volume fractions and the organization of various macromolecules and cells in vascular tissue on the physical properties of vessel wall. The current investigation reports various mechanical properties of aorta, vena cava, carotid artery and iliac artery of the swine including: low-strain and high-strain moduli, transition from low-strain to high-strain behavior, the ultimate tensile stress, and the ultimate strain. Tissues were tested using a uniaxial incremental stress–strain technique, which allowed us to capture viscous, elastic, and total data simultaneously. Vessels were strained throughout their entire strain range until failure was achieved. Low-strain modulus showed sporadic differences between blood vessels and some dependence on strain-rate. The high-strain modulus was consistently greater in vena cava (2.2 MPa for viscous stress–strain—9.6 MPa for total stress–strain) than other vessels. The ultimate tensile strength of vena cava (0.46 MPa for viscous and 2.5 MPa for total) was again greater than in other vessels and there was some strain-rate dependence. The ultimate strain of carotid artery (180%) was greater in the transverse direction than in other vessels. Viscosity measurements indicated that blood vessels are thixotropic (viscosity decreased 2 orders of magnitude for 2 orders of magnitude increase in strain-rate). Our data suggests that differences in mechanical properties of blood vessels occur depending on where in the vascular tree the tissue is located. These differences may be required by the physiological and mechanical demands on individual vessels.