cssi/SciSciGPT-SciSciNet huggingface dataset:
Abstract 186: Understanding Readmissions at Minority-Serving Hospitals

Objective: The Affordable Care Act requires that the Centers for Medicare and Medicaid Services (CMS) reduce payments to hospitals with high readmission rates starting in 2013. Minority-serving institutions have higher rates of readmissions, and are therefore likely to be financially penalized as a result of this policy. Our objective was to better understand the characteristics, settings, and strategies that differentiate strong and poor performing minority-serving hospitals. Methods: We conducted case studies at six U.S. hospitals with a patient population over 50% black, choosing sites based on either strong or poor performance on readmissions in 2008-2009. Chief Medical Officers, Chief Executive Officers, Chief Quality Officers, Case Managers, and other key staff at each site each participated in hour-long semi-structured interviews where questions about hospital and patient characteristics, priorities, strategies to reduce readmissions, and general impressions about CMS’s policies were asked. Detailed notes were collected and supplemented by a review of audio tapes. Themes and intensity of comments were coded and prepared as a matrix. Results: Nearly all of the case study respondents felt that the readmission rate was an important quality metric for CMS to assess, and most respondents felt their hospitals could do better to reduce readmissions. However, few respondents knew if they were going to be penalized by CMS. The majority of respondents reported implementing new programs or procedures to try to reduce readmissions regardless of whether they were going to be penalized. Hospitals that had a low proportion of self-pay patients, high occupancy rates, and high margins had more programmatic efforts around reducing readmissions and improving transitions of care. Some strategies employed were the implementation of call centers, focused attention on discharge planning, and availability of local external resources to support program staff. Nevertheless, nearly all respondents felt that they were unable to reduce readmission rates to the level they wished because of patient and community factors, including difficulties with paying for and managing medications, literacy, housing stability, and income. Respondents also identified significant challenges in terms of infrastructure, including inadequate staffing and expertise in this area to implement potentially beneficial programs. Conclusions: Minority-serving hospitals in our case studies faced substantial challenges to reducing readmissions, including their own financial health as well as community and patient-level factors. Better understanding the strategies and approaches that work in resource-poor settings, or accounting for the poverty of the underlying patient population, are two potential strategies for ensuring that CMS’s readmissions policies do not inadvertently worsen disparities.
Evaluating Discipline-Based Education Research for Promotion and Tenure

Discipline-based education research (DBER) is an emergent, interdisciplinary field of scholarship aimed at understanding and improving discipline-specific teaching and learning. The number of DBER faculty members in science, technology, engineering, and mathematics (STEM) departments has grown rapidly in recent years. Because the interdisciplinary nature of DBER involves social science, senior STEM faculty members may find it challenging to evaluate the quality or impact of DBER scholarship. This essay aims to address this issue by providing guidance on evaluating the scholarly accomplishments of DBER faculty members in a way that is useful to departmental colleagues and administrators during the tenure and promotion evaluation process.
On Consistency and Model Validation for Systems with Parameter Uncertainty

Abstract In this note we discuss the issue of consistency and model validation for the identification framework introduced in (Antoulas, 1997) and (Antoulas and Anderson, 1999).
From Innovation to Impact at Scale: Lessons Learned From a Cluster of Research–Community Partnerships

This article presents a description of how an interdisciplinary network of academic researchers, community-based programs, parents, and state agencies have joined together to design, test, and scale a suite of innovative intervention strategies rooted in new knowledge about the biology of adversity. Through a process of cocreation, collective pilot testing, and the support of a measurement and evaluation hub, the Washington Innovation Cluster is using rapid cycle iterative learning to elucidate differential impacts of interventions designed to build child and caregiver capacities and address the developmental consequences of socioeconomic disadvantage. Key characteristics of the Innovation Cluster model are described and an example is presented of a video-coaching intervention that has been implemented, adapted, and evaluated through this distinctive collaborative process.
Rural Finance Schemes Miss the Target: An Empirical Analysis of Gender and Social Inequality Effects

Using survey data from over 1,700 households in rural Bangladesh, this study explores whether access to credit has gender-specific impacts and whether this credit is associated with income distribution effects. To estimate these effects, a panel data model is used to explore the empirical association between access to credit, borrower gender and village income. Contrary to the common claim that microfinance benefits women the most, the results in this study suggest that women benefit from microfinance, but only marginally. The observed positive correlation between access to credit and income inequality may be explained by the fact that wealthier male borrowers benefit more from receiving micro loans. This study has important implications for credit program design. If microloans are targeted towards poor rural women in an effort to empower them and bring them out of poverty, we must design credit programs in ways that achieve these objectives.
Flash Pyrolysis of t-Butyl Hydroperoxide and Di-t-butyl Peroxide: Evidence of Roaming in the Decomposition of Organic Hydroperoxides

Thermal decomposition of t-butyl hydroperoxide and di-t-butyl peroxide was investigated using flash pyrolysis (in a short reaction time of <100 μs) and vacuum-ultraviolet (λ = 118.2 nm) single-photon ionization time-of-flight mass spectrometry (VUV-SPI-TOFMS) at temperatures up to 1120 K and quantum computational methods. Acetone and methyl radical were detected as the predominant products in the initial decomposition of di-t-butyl peroxide via O–O bond fission. In the initial dissociation of t-butyl hydroperoxide, acetone, methyl radical, isobutylene, and isobutylene oxide products were identified. The novel detection of the unimolecular formation of isobutylene oxide, as supported by the computational study, was found to proceed via a roaming hydroxyl radical facilitated by a hydrogen-bonded intermediate. This new pathway could provide a new class of reactions to consider in the modeling of the low temperature oxidation of alkanes.
Regulation of Choline Phosphorylation in Rat Striatum

In cholinergic nerve terminals, choline is an important precursor molecule for the synthesis of both acetylcholine (ACh) and phosphorylcholine (PCh) through reactions catalyzed by choline acetyltransferase (CAT) and choline kinase (CK), respectively. While studies have indicated that CAT exists in both soluble and membrane associated forms which may subserve different primary functions in the nerve terminal (Smith and Carroll, 1980; Benishin and Carroll, 1983), little similar information has been available for CK. This enzyme catalyzes the first and possibly rate-limiting step (infante, 1977) in the cytidine pathway (Kennedy and Weiss, 1956) which is the major pathway for the incorporation of choline into phosphatidylcholine in brain (Ansell and Spanner, 1968). Since choline serves as a substrate for both CAT and CK, it might be expected that the nerve terminal has regulatory mechanisms to channel choline through the pathway that requires the precursor most at any given instant. Indeed, an association between the acetylation and phosphorylation pathways has been suggested (Ansell and Spanner, 1970; Collier, 1970). Therefore, to further our understanding of the utilization of choline by the cholinergic neuron, we studied the properties of CK and the modulation of choline phosphorylation by endogenous agents.
Climate-driven disturbances in the San Juan River sub-basin of the Colorado River

Abstract. Accelerated climate change and associated forest disturbances in the southwestern USA are anticipated to have substantial impacts on regional water resources. Few studies have quantified the impact of both climate change and land cover disturbances on water balances on the basin scale, and none on the regional scale. In this work, we evaluate the impacts of forest disturbances and climate change on a headwater basin to the Colorado River, the San Juan River watershed, using a robustly calibrated (Nash–Sutcliffe efficiency 0.76) hydrologic model run with updated formulations that improve estimates of evapotranspiration for semi-arid regions. Our results show that future disturbances will have a substantial impact on streamflow with implications for water resource management. Our findings are in contradiction with conventional thinking that forest disturbances reduce evapotranspiration and increase streamflow. In this study, annual average regional streamflow under the coupled climate–disturbance scenarios is at least 6–11 % lower than those scenarios accounting for climate change alone; for forested zones of the San Juan River basin, streamflow is 15–21 % lower. The monthly signals of altered streamflow point to an emergent streamflow pattern related to changes in forests of the disturbed systems. Exacerbated reductions of mean and low flows under disturbance scenarios indicate a high risk of low water availability for forested headwater systems of the Colorado River basin. These findings also indicate that explicit representation of land cover disturbances is required in modeling efforts that consider the impact of climate change on water resources.
The Application of Detrital Actors in Industrial Systems

Abstract Biological systems have evolved to retain and recycle materials via decomposer networks. However, engineered systems are often deficient in the employment of decomposers despite their potential to improve efficiency and sustainability. These systems favor unmitigated growth and exploit natural resources, exporting pollutants to the environment as waste. Reducing this disparity between industrial and natural systems presents the opportunity for greater material and energetic efficiency. This study demonstrates the application of decomposer networks in industrial settings through constructed wetlands and pyrolysis driven biomass upcycling integrated into a steel industry's water network. The results from this study show a 26.64%, 57.87%, and 28.29% reduction of fresh water, effluent, and costs respectively. However, common sustainable design principles at design conception leave these system-level improvements unrealized. As such, this study points to the need for a predictive tool in sustainable engineering design, incorporating time-dependent flow metrics to more effectively leverage the decomposer role.
Cytogenetic Mapping in Plants

The first cytological maps in plants were based on natural features such as centromeres, the nucleolus organizing regions, and euchromatin-heterochromatin boundaries. Subsequently, researchers identified and used stains such as quinacrine and Giemsa to stain types of chromatin, such as AT-rich regions, differentially. Cytology was instrumental in mapping various chromosomal rearrangements. Electron microscopy has also proven to be a powerful tool, permitting three-­dimensional reconstruction of chromosomes from whole-nucleus preparations as well as providing a direct link between linkage and physical distance by localization of recombination nodules on synaptonemal-complex spreads. The application of in situ hybridization (ISH) greatly advanced plant cytogenetic mapping. The development of nonradioactive probe-labeling techniques, such as biotinylation and more recently fluorescence, has made ISH an accessible method for the localization of specific nucleic-acid sequences along the physical chromosomes of plants. A variety of DNA probes have been used in plant cytogenetic mapping, including genetic marker sequences, large DNA fragments, and repetitive sequences. Several tissues and techniques have been used to prepare target chromosomes for mapping, each affording different advantages and disadvantages with regard to resolution and availability. Recently, additional techniques have been developed that elongate chromosomes for even higher resolution. Cytogenetic mapping has proven useful for observing genome organization, and much research is currently focused on integration of plant cytological and linkage maps.
Pressure dependence of elastic constants of ( V 1 − x Cr x ) 2 O 3 at 296 K

Transit times of 30-MHz ultrasonic waves in (${\mathrm{V}}_{1\mathrm{\ensuremath{-}}\mathrm{x}}$${\mathrm{Cr}}_{\mathrm{x}}$${)}_{2}$${\mathrm{O}}_{3}$ single crystals, with nominal (actual) x values of 0.015 (0.013) and 0.030 (0.028), were measured at 296 K using hydrostatic pressures up to 4 kbar for x=0.03 and 1.2 kbar for x=0.015. The results were used to deduce 1-bar values and pressure derivatives of the elastic constants. Two of the elastic constants, ${C}_{11}$ and ${C}_{12}$, have unusual negative pressure dependences resulting in both the ${\ensuremath{\lambda}}_{4}$ elastic eigenvalue and the bulk modulus B decreasing strongly with increasing pressure. The behavior of ${\ensuremath{\lambda}}_{4}$ indicates that pressure tends to make the lattice unstable toward a deformation which increases the c/a ratio without changing the crystal symmetry. This is consistent with the structural change at the pressure-induced, paramagnetic insulator-to-metal transition. For (${\mathrm{V}}_{0.97}$${\mathrm{Cr}}_{0.03}$${)}_{2}$O $_{3}$, we deduce a negative elastic \ensuremath{\gamma} which disagrees with its positive thermal \ensuremath{\gamma} whereas these \ensuremath{\gamma}'s agree with each other in ${\mathrm{V}}_{2}$${\mathrm{O}}_{3}$. These results are due to the elastic \ensuremath{\gamma} having strong negative contributions from some acoustic modes in certain directions in (${\mathrm{V}}_{0.97}$${\mathrm{Cr}}_{0.03}$${)}_{2}$O $_{3}$ but not in ${\mathrm{V}}_{2}$${\mathrm{O}}_{3}$.
The Elephant in the Classroom: A Proposed Framework for Applying Viewpoint Neutrality to Student Speech in the Secondary School Setting

In Morse v. Frederick,1 the Supreme Court’s latest (and, some might say, futile) foray into student speech rights, Justice Stevens chastised the majority for creating a jurisprudential test that “invites stark viewpoint discrimination”2 in violation of a “cardinal First Amendment principle[].”3 However, just as quickly as Stevens condemned the Court’s abandonment of viewpoint neutrality, he conceded that, in light of the special characteristics of the school environment, “it might well be appropriate to tolerate some targeted viewpoint discrimination in this unique setting.”4 Stevens’ dissent, which held tightly to the notion that viewpoint discrimination is a most “egregious”5 constitutional violation, but seemed inclined to loosen its grip in the school setting, epitomizes the uncertainty characterizing the Court’s application of viewpoint neutrality to student speech.
Translational Regulation in the Heat-Shock Response of Drosophila Cells

The heat-shock response has been the subject of intense investigation for several years. The speed of the induction, the magnitude of the response, and the reproducibility of the effect combine to make it an ideal system for investigating mechanisms of gene expression in a wide variety of organisms. In this chapter, I will review current knowledge of translational regulation in the response, focusing on the fruit fly Drosophila melanogaster for two reasons: First, the response of Drosophila cells is the strongest known example of differential gene expression regulated at the translational level. Second, more is known about heat-shock protein synthesis in this organism than in any other.
Disability Rights: Do We Really Mean It?

This chapter will argue that the disability rights (DR) movement has a much lower level of acceptance than other civil rights movements, especially within the academy. This is true even though the other movements are regarded (at least by disability rights advocates) as similar in nature. By “within the academy” I mean within the discourses, formal and informal, of professional academicians: professors and other intellectuals and their students. I will try to demonstrate by example that positions held by the DR movement are summarily rejected by many within the academy, even though similar positions are unquestioningly endorsed when stated by advocates of women’s rights and “racial” or ethnic civil rights. My claim is not that women’s rights and racial civil rights are genuinely supported within the academy. Racism and sexism still exist, and have serious negative effects. However, racism and sexism are almost never openly endorsed in today’s academic discourse. The mismatch between discourse and practice is regrettable. However (I suggest) if practice matched discourse, minorities and women would have very nearly equal rights with majorities and men within the academy. Disabled people would still not have equal rights with nondisabled people. Basic DR principles are rejected not only in practice but also in discourse.
Combinatorial Prg4 and Il-1ra Gene Therapy Protects Against Hyperalgesia and Cartilage Degeneration in Post-Traumatic Osteoarthritis

Osteoarthritis (OA) is a degenerative disease of synovial joints characterized by progressive loss of articular cartilage, subchondral bone remodeling, and intra-articular inflammation with synovitis that results in chronic pain and motor impairment. Despite the economic and health impacts, current medical therapies are targeted at symptomatic relief of OA and fail to alter its progression. Given the complexity of OA pathogenesis, we hypothesized that a combinatorial gene therapy approach, designed to inhibit inflammation with interleukin-1 receptor antagonist (IL-1Ra) while promoting chondroprotection using lubricin (PRG4), would improve preservation of the joint compared to monotherapy alone. Employing two surgical techniques to model mild, moderate and severe posttraumatic OA, we found that combined delivery of helper-dependent adenoviruses (HDVs), expressing IL-1Ra and PRG4, preserved articular cartilage better than either monotherapy in both models as demonstrated by preservation of articular cartilage volume and surface area. This improved protection was associated with increased expression of proanabolic and cartilage matrix genes together with decreased expression of catabolic genes and inflammatory mediators. In addition to improvements in joint tissues, this combinatorial gene therapy prolonged protection against thermal hyperalgesia compared to either monotherapy. Taken together, our results show that a combinatorial strategy is superior to monotherapeutic approaches for treatment of posttraumatic OA.
Motherhood reimagined: Experiences of women with SMI surrounding parenting.

Objective Much of the extant literature on women with serious mental illness (SMI) has focused on the risks associated with motherhood, including violence, custody loss, poverty, and homelessness. The present study was conducted to characterize women's broader experiences surrounding the parenting role. Method Twenty women with SMI, both those with and without children, were interviewed. Qualitative data were analyzed using grounded theory approach. Results Five themes pertaining to the topic of motherhood emerged from the data: motherhood declined, motherhood derailed, motherhood disabled, motherhood reimagined, and mattering through motherhood. Conclusions and implications for practice Women with SMI face a number of challenges in their relationship to the role of mother. Clinicians can support women with SMI in their decision-making process with regard to having children or not, emphasizing self-determination and evaluation of the resources that might be needed to manifest this goal. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
No espelho da linguagem, a elisão das diferenças: uma proposta de espelhamento entre os contos “A benfazeja” e “Sinhá secada”, de João Guimarães Rosa

O presente trabalho propoe-se a analisar as personagens Mula-Marmela, do conto “A benfazeja”, e Sinha, do conto “Sinha Secada”, que integram respectivamente as obras Primeiras estorias e Tutameia : Terceiras estorias , do escritor mineiro Joao Guimaraes Rosa, segundo uma proposta de alteridade: sugere-se um enfraquecimento dos limites constituintes das diferencas identitarias para uma melhor apreensao do individuo enquanto ser. Para tanto, propoe-se uma aproximacao entre as diferentes personagens, para alem das diferencas do enredo, que passa pela narrativa “Os irmaos Dagobe” e estende-se aos contos dos quais fazem parte as personagens, segundo uma ampliacao do espelhamento sugerido por Consuelo Albergaria em sua obra Bruxo da linguagem no grande sertao . Consideradas as afinidades identitarias destacadas entre as personagens, a despeito de todas as diferencas contextuais, destaca-se a simbologia da cruz como simbolo maximo da exclusao. A analise se conclui com uma reflexao apoiada no pensamento de Octavio Paz, que discorre sobre os estreitos limites que separam o eu e o outro na constituicao do ser, e, tambem, no pensamento de Henri Bergson, que questiona a separacao sujeito/objeto para introduzir a ideia de uma continuidade universal e sugerir uma essencia humana imperscrutavel para alem dos tracos identitarios, inclusive de genero, como proposta de uma melhor apreensao do outro.
Multi-Functional Neural Probes for Pharmacological and Optogenetic Manipulation and Detection of Neurotransmitter Release

The ability to monitor neurotransmitter release in freely behaving animals is key to understanding neuronal processes underlying complex behaviors. Commonly used methods either offer rapid measurements of a single analyte (e.g., fast-scan cyclic voltammetry) or provide multiple analyte measurement with insufficient temporal resolution (microdialysis). However, behaviors are controlled by neuronal networks employing multiple neurotransmitters and neuromodulators. Efforts to understand how neurons within these networks interact to control behavior will be greatly facilitated by a means with which to both modulate and measure multiple neuroactive molecules simultaneously and in near-real time. To this end, we are developing MEA enzymatic biosensors with built-in microfluidics and optical guides for pharmacological and optogenetic control of transmitter release in brain tissue.
Profanity and the president: News use of Trump’s shithole comment:

When President Trump used “shithole” to describe several countries in discussion of immigration, news organizations faced violating journalistic norms against profanity to use his precise language....
Working alliance does not mediate the relation between outcome expectancy and symptom improvement following cognitive behavioural therapy for social anxiety disorder

A small body of research shows that the working alliance mediates the relation between outcome expectancy and treatment response, but this model has not been applied to the treatment of social anxiety disorder. The present study tests the hypothesis that the working alliance mediates the relation between outcome expectancy and symptom improvement within a randomized controlled trial testing the efficacy of virtual reality exposure therapy for social anxiety disorder. A sample of 54 individuals diagnosed with social anxiety disorder completed eight sessions of virtual reality exposure therapy or exposure group therapy. Participants completed standardized self-report measures of outcome expectancy at the first session, of the working alliance at each session, and three measures of social anxiety symptoms at pre- and post-treatment. The working alliance did not mediate the relation between outcome expectancy and symptom improvement across time points, dependent measures, and treatment type. Bayes factors were calculated for the relation between the working alliance and symptom reduction, while controlling for outcome expectancy and therapist effects. Results were inconclusive. These null findings are intriguing and urge further study of the mechanisms through which common factors relate to treatment response. Utilization of Bayesian analyses may help to clarify the nature of these relations.Key learning aims(1) Readers will consider the role of common factors in treatment for social anxiety disorder.(2) Readers will learn about how different common factors may interact with each other.(3) Readers will be encouraged to consider how the therapeutic relationship may manifest in a unique manner in treatment for social anxiety.
MXene–Organic Hybrid Materials

Organic–inorganic hybrid materials are important class of materials which find applications in electrochemical energy conversion and storage, electronics, optics, biomedical applications, and many other areas of our daily life. Material properties of hybrid nanomaterials can be improved by changing either organic or inorganic component in a given hybrid matrix resulting in nearly unlimited combinations of innovative materials. MXenes are 2D inorganic sheets which are known for their metallic conductivity, high mechanical strength, hydrophilicity, and structural diversity. These properties are much needed in an inorganic component of a hybrid material. While the potential of MXenes in their pristine form is well documented, their applications in manufacturing organic–inorganic hybrid nanomaterials are relatively less explored. In this chapter, we have reported recent advances in MXene–organic hybrid materials. We summarized various MXene–organic hybrid synthesis approaches such as oxidant-free polymerization, self-assembly, diazonium chemistry, and others. With the help of computational methods, we have explained the host–guest interaction mechanisms, charge transfer mechanisms, and propagation of monomers into polymers. The role of polarity in organic molecules/polymers is discussed which may guide the design of new MXene–organic hybrid materials with well-defined properties for a variety of applications. We have also summarized the properties and various applications of MXene–organic hybrids. This chapter concludes with the remaining challenges and outlook to our readers.
Cranial Nerve Stimulation for Olfaction (Cranial Nerve 1)

Like sensory maps in other systems, the sense of smell has an organizational structure based on converging projections of olfactory receptor neurons containing unique odorant receptors onto the olfactory bulb in synaptic aggregations termed glomeruli. This organizational structure provides the potential for electrical stimulation and restoration of smell. Prior animal and human studies support the feasibility of an olfactory stimulation device, encouraging ongoing work in development of olfactory implants.
Pediatric cervical spine injuries on CT: difference in accuracy of interpretations by pediatric versus non-pediatric radiologists

To retrospectively compare the accuracy of interpretation of initial cervical computerized tomography (CCT) by a non-pediatric radiologist (NPR) versus a pediatric radiologist (PR). IRB approval and consent waiver were granted to review all injured children from 2010 to 2014 in the trauma registry with CT and magnetic resonance imaging (MRI) of the cervical spine. Patients with negative CCT who subsequently had positive MRI from a single institution comprised the study group. Patients with negative CCT and MRI, matched by age, gender, and severity scores, comprised the control group. The CCTs from both groups were initially interpreted at the time of service by a NPR. Subsequently, a single PR with 20 years of experience blinded to clinical/imaging data reinterpreted these CCT examinations. CT interpretations were then compared with MRI results and evaluated for statistical significance using SSPS software. The data analysis utilized summary statistics, two-tailed binomial test, and univariate χ2 test. Significance for all comparisons was assessed at P < 0.05. The study group was comprised of the 21 patients with negative CCT and positive MRI. Of the cohort included, 76% (16) were male and 24% (5) were female. The age range was 1 month–17 years, with a mean age of 9.7 years. CCT interpretation by NPR had a specificity of 91.7% (sensitivity 71.2%, positive predictive value 81.3%, and negative predictive value 86.3%) compared with results of MRI. Six of the 21 negative CCTs were interpreted by the PR as positive, mainly craniocervical junction injuries, and confirmed by MRI (28.6%, P < .001 compared with the NPR); no control CCT was interpreted by the PR as positive (sensitivity 100%, positive predictive value 100%, and negative predictive value 58.3%). In our retrospective study, a pediatric radiologist has improved recognition of pediatric cervical spine injuries on CT compared with non-pediatric radiologist.
Effective Photometric Alignment for Surround View Monitoring System

Surround view monitoring (SVM) system provides a composite bird-eye view of the vehicle to assist in safe parking. Since each camera independently performs auto exposure (AE) and auto white balance (AWB), the composite bird-eye view has noticeable boundaries between adjacent views. To achieve a seamlessly stitched bird-eye view, we propose an effective photometric alignment for surround view monitoring system using a simple additive gain model. Experimental results show that the proposed method provides a seamlessly stitched bird-eye view. And the processing time of the proposed method achieves 3ms on the NVIDIA Tegra CX embedded platform.
RNA-Binding Protein HuR Promotes Th17 Cell Differentiation and Can Be Targeted to Reduce Autoimmune Neuroinflammation

Dysregulated Th17 cell differentiation is associated with autoimmune diseases such as multiple sclerosis, which has no curative treatment. Understanding the molecular mechanisms of regulating Th17 cell differentiation will help find a novel therapeutic target for treating Th17 cell-mediated diseases. In this study, we investigated the cell-intrinsic processes by which RNA-binding protein HuR orchestrates Th17 cell fate decisions by posttranscriptionally regulating transcription factors Irf4 and Runx1 and receptor Il12rb1 expression, in turn promoting Th17 cell and Th1-like Th17 cell differentiation in C57BL/6J mice. Knockout of HuR altered the transcriptome of Th17 cells characterized by reducing the levels of RORγt, IRF4, RUNX1, and T-bet, thereby reducing the number of pathogenic IL-17+IFN-γ+CD4+ T cells in the spleen during experimental autoimmune encephalomyelitis. In keeping with the fact that HuR increased the abundance of adhesion molecule VLA-4 on Th17 cells, knockout of HuR impaired splenic Th17 cell migration to the CNS and abolished the disease. Accordingly, targeting HuR by its inhibitor DHTS inhibited splenic Th17 cell differentiation and reduced experimental autoimmune encephalomyelitis severity. In sum, we uncovered the molecular mechanism of HuR regulating Th17 cell functions, underscoring the therapeutic value of HuR for treatment of autoimmune neuroinflammation.
Latch-Up Detection During ESD Soft Failure Characterization Using an On-Die Power Sensor

ESD-induced latch up is detected with an on-die energy counter circuit. Raw values are accessed through a Linux operating system kernel call, then the power consumption is calculated. Persistent power consumption increase indicates the latch-up occurrence, thus avoiding the need of external equipment for its detection. The failure mode is not visually noticeable and requires full power cycling to fully recover.
Patient Expectations of Adult Spinal Deformity Correction Surgery.

Background There is a growing interest in examining preoperative expectations as a potential predictor of postoperative outcome. However, it has never been studied in the setting of adult spinal deformity (ASD). This study aims to characterize patient expectations before ASD surgery and examine the relationship between preoperative expectation and postoperative patient-reported outcomes (PROs). Methods Analysis of prospectively collected clinical and PRO data was performed on patients who underwent ASD surgery. Inclusion criteria were age >18 years, a diagnosis of ASD, >3 vertebral level instrumentation, and completed pre- and postoperative surveys. The preoperative expectation survey included expectations of surgical outcome, pain reduction, complications, and the duration of postoperative recovery. Relationships between patient expectations and PROs were assessed. Results Twenty-seven patients who underwent operative management of ASD met the inclusion criteria. In their preoperative survey, 66% of patients expected highly successful surgery, whereas 22% had a moderate expectation of complications. Patients anticipated an average 71% reduction in back pain (range 42%–100%) and 68% reduction in leg pain (range 0%–100%). Patients who met their expectations of leg pain reduction had significantly greater satisfaction scores than those who did not. There were moderate-to-strong positive correlations between preoperative expectation and observed improvement in back pain, leg pain, and mental health. Conclusions While substantial variability in patient expectation exists for the surgical management of ASD, patients anticipated a positive outcome with a significant reduction in pain. Greater postoperative satisfaction was associated with patients who met the expected improvement in leg pain. Preoperative expectation was positively correlated with change in pain and mental health scores.
Shorter drug testing intervals are associated with improved drug misuse rates.

Objective: The Centers for Disease Control and Prevention (CDC) recommend that clinicians prescribing opioids for chronic pain should consider at least annual urine drug testing (UDT). We evaluated whether shorter intervals for repeat UDT are associated with decreased rates of drug misuse. Design: Retrospective analysis of deidentified serial UDT and matched prescribing data. Setting: We analyzed Quest Diagnostics 2016-2017 UDT results from new patients being monitored for prescription drug adherence, in nonsubstance use disorder (SUD) treatment environments. Main Outcome Measures: Drug misuse was defined as the absence of a prescribed substance or the presence of a nonprescribed substance. Patients with ≥ 3 sets of the UDT results were included. Results: UDT results from 49,601 patients (148,803 specimens) were tested. Declines in misuse between the first and second UDT were highest for those tested at the shortest intervals: approximately weekly, 19 percent; monthly, 15 percent; bimonthly, 12 percent; quarterly, 9 percent; semiannually, 3 percent; misuse rates increased by 1 percent for patients tested annually. Declines in misuse were more pronounced for opioids than other drug groups. Substantial declines in positivity were noted for heroin (32 percent) and nonprescribed fentanyl (10 percent). Declines in misuse between the second and third UDT followed a similar pattern. Conclusions: UDT intervals of ≤ quarterly were associated with marked declines, but testing annually or semiannually was not associated with consistent decreases. Our findings suggest that clinical strategies that include serial testing conducted quarterly or sooner may be instrumental in decreasing drug misuse. Testing more frequently than “at least once annually” should be considered by clinicians monitoring potential drug misuse.
Mycobacterium marinum: nodular hand lesions after a fishing expedition

Mycobacterium marinum is a slow-growing, acid-fast bacillus in the category of non-tuberculous mycobacteria which most commonly cause skin and soft tissue infections in patients, particularly those with aquatic exposure. Classically, M. marinum skin and soft tissue infections clinically manifest with formation of nodular or sporotrichoid extremity lesions, or deeper space infections such as tenosynovitis and osteomyelitis. Disseminated disease may occur in immunocompromised hosts. M. marinum is a slow-growing organism that is challenging to culture, as it typically requires 5-14 days (yet may take up to several weeks) with low temperatures of approximately 30°C to yield growth. In terms of treatment, further data are needed to elucidate the optimal regimen and duration for M. marinum infections. Combination therapy with clarithromycin and ethambutol is recommended for treatment of skin and soft tissue infections, with addition of rifampicin for deeper space infections. Surgery may be needed in addition to medical management.
Natural Language Processing to Identify Advance Care Planning Documentation in a Multisite Pragmatic Clinical Trial

Abstract Context Large multisite clinical trials studying decision-making when facing serious illness require an efficient method for abstraction of advance care planning (ACP) documentation from clinical text documents. However, the current gold standard method of manual chart review is time-consuming and unreliable. Objectives To evaluate the ability to use natural language processing (NLP) to identify ACP documention in clinical notes from patients participating in a multisite trial. Methods Patients with advanced cancer followed in three disease-focused oncology clinics at Duke Health, Mayo Clinic, and Northwell Health were identified using administrative data. All outpatient and inpatient notes from patients meeting inclusion criteria were extracted from electronic health records (EHRs) between March 2018 and March 2019. NLP text identification software with semi-automated chart review was applied to identify documentation of four ACP domains: (1) conversations about goals of care, (2) limitation of life-sustaining treatment, (3) involvement of palliative care, and (4) discussion of hospice. The performance of NLP was compared to gold standard manual chart review. Results 435 unique patients with 79,797 notes were included in the study. In our validation data set, NLP achieved F1 scores ranging from 0.84 to 0.97 across domains compared to gold standard manual chart review. NLP identified ACP documentation in a fraction of the time required by manual chart review of EHRs (1-5 minutes per patient for NLP, vs. 30-120 minutes for manual abstraction). Conclusion NLP is more efficient and as accurate as manual chart review for identifying ACP documentation in studies with large patient cohorts.
Advanced thermal denitration conversion processes for aqueous-based reprocessing and recycling of spent nuclear fuels

This chapter focuses on advanced thermal denitration methods for conversion of nitrate solutions of uranium and plutonium to oxide particles with good ceramic properties for fabrication of recycle fuel. Specifically, the Japanese microwave heating process and the U.S. modified direct denitration process are described and compared, with emphasis on co-conversion of mixed uranium-plutonium nitrate solutions to produce mixed oxide. Process chemistry, processing equipment, oxide product characteristics, and co-conversion process comparisons are described.
Census data for transportation planning, analysis, and implementation

Transportation has long relied on the decennial census to provide critical information including detailed worker characteristics and journey-to-work flows needed to plan, analyze, manage, and implement transportation systems and programs. The Census Bureau has implemented an on-going annual survey program, The American Community Survey (ACS), to produce the detailed transportation information traditionally gathered once a decade through the census long form. In May 2005, a conference entitled Census Data for Transportation Planning: Preparing for the Future was held in Irvine California. The main objectives of that conference were to: 1) demonstrate applications of 2000 Census data in transportation; 2) review the ACS and assess its usefulness for transportation; 3) recommend improvements to census products and methods; and 4) recommend actions that federal, state, and regional agencies and the Census Bureau can take to improve the use of census transportation products. This paper, summarizing and building on the conference, discusses census information from the perspective of the transportation community. It looks at uses of census data, presents key issues related to the efficacy of the ACS for transportation, presents possible solutions to issues with current data programs, and concludes with suggestions that should enhance the value of census data for transportation.
The structure and stability of the functional independence measure

The Functional Independence Measure (FIM) records the severity of disability of rehabilitation patients. The necessarily curvilinear relationship between the finite range of recorded FIM raw scores and the conceptually infinite range of additive disability measures is resolved through Rasch analysis. The analysis of admission and discharge FIM ratings of 14,799 patients shows that the 18 FIM items define two statistically and clinically different indicators. Thirteen items define disability in motor functions. Five items define disability in cognitive functions. Additive measures for each indicator have the same characteristics at admission and discharge, so that these measures can be used to assess change in patient status.
SOCIAL ORGANIZATION OF ANTS AND HUMANS

In the broad context of the science of ethology ants occupy an unusual place. Most· studies focus on vertebrates, especially primates, due to their physiological similari ty to man. This study focuses on ants because of their socialsimilarity to man. Ants have the adaptability to live in almost any environment and tend to dominate any environment in which they live. Man is the only other animal species of which this may be said. In addition, the ant is truly a social insect. Of all insects, the ant is the most manlike in behavior and the most adaptive. Some other insects form inflexible societies, but ants show great variation in behavior and social organization, even within the same species. And most interesting is the fact that the patterns of social and biological evolution of ants are parallel. As the physiology of ants evolved there was a parallel evolution in social organization. Since many of the 4000 species of ants represent evolutionary atavisms, this pattern of parallel evolution may be seen, not just reconstructed. Therefore, study of ant evolution may provide clues to the study of human evolution...-both physiological and social.
Vocal Production by a Language-Competent Pan paniscus

Human spoken language and nonhuman primate vocalization systems have traditionally been regarded as qualitatively different from one another with respect to their semanticity and the way in which individuals acquire and utilize these signals. However, recent studies of the vocal behaviors of both captive and free-ranging monkeys and apes suggest that this dichotomy may not be unequivocal. We examined the vocalizations produced by a linguistically-competent adult male bonobo (Pan paniscus) named Kanzi. We analyzed his vocalizations during communicative interactions with humans in order to determine whether they vary systematically according to the semantic context in which they are produced. We determined semantic contexts based upon a vocalization's co-occurrence with predefined behavioral correlates. Spectrographic and statistical analyses revealed that acoustic structure is similar among the vocalizations that occurred within a specific semantic context and structural differences are evident between the vocalizations produced in different contexts. The results provide evidence that, during communicative interactions with humans, Kanzi modulates his vocal output on both the temporal and spectral levels.
The utility of transvaginal ultrasound in the ED evaluation of complications of first trimester pregnancy

Abstract Background For patients with early intrauterine pregnancy (IUP), the sonographic signs of the gestation may be below the resolution of transabdominal ultrasound (TAU); however, it may be identified by transvaginal ultrasound (TVU). We sought to determine how often TVU performed in the emergency department (ED) reveals a viable IUP after a nondiagnostic ED TAU and the impact of ED TVU on patient length of stay (LOS). Methods This was a retrospective cohort study of women presenting to our ED with complications of early pregnancy from January 1, 2007 to February 28, 2009 in a single urban adult ED. Abstractors recorded clinical and imaging data in a database. Patient imaging modality and results were recorded and compared with respect to ultrasound (US) findings and LOS. Results Of 2429 subjects identified, 795 required TVU as part of their care. Emergency department TVU was performed in 528 patients, and 267 went to radiology (RAD). Emergency department TVU identified a viable IUP in 261 patients (49.6%). Patients having initial ED US had shorter LOS than patients with initial RAD US (median 4.0 vs 6.0 hours; P P P = .43). There was no difference in LOS for those who had a viable IUP confirmed on ED TAU vs ED (median 3.1 vs 3.2 hours, respectively; P Conclusion When an ED TVU was performed, a viable IUP was detected 49.6% of the time. Emergency department LOS was significantly shorter for women who received ED TVU after indeterminate ED TAU compared with those sent to RAD for TVU, with more marked time savings among those with live IUP diagnosed on ED TVU. For patients who do not receive a definitive diagnosis of IUP on ED TVU, this approach does not result in increased LOS.
The Bearing of Discovery on Justification

The point of the traditional distinction between the contexts of discovery and justification is to insist on the normative character of epistemology. The point is not to dismiss from epistemology merely the genesis of ideas; into the context of discovery go also descriptions of evaluative practices and decisions. However ideas are created, scrutinized, and judged, it is only the approbation to which they are entitled, accorded or not, that allegedly matters to epistemology. The criticism, familiar since N.R. Hanson's Patterns of Discovery,1 that philosophy ought not to ignore the genesis of ideas is ironically conservative. If what is not normative epistemology is to be ignored, then the distinction would have us ignore even the reception and appraisal of scientific ideas.
A Simple World Model for an Autonomous Vehicle

A critical component of the guiding intelligence of an autonomous vehicle is the system's computational model of its physical environment. This world model must be able to represent the important attributes of the vehicle's environment, the vehicle's placement in that environment, and the system status (or health) of the vehicle. For a submersible autonomous vehicle, important environment attributes include the bottom topography, the surf ace topography (if under an ice layer), and objects of note (including itself) . System status is somewhat more vehicle specific, but includes those aspects of the vehicle which are critical to sustained operation: sensors, effectors, energy budget, and various "vital signs". This paper presents a prototypical world model which ad dresses these issues. The model was implemented using an object oriented programming language. This approach was found to be quite advantageous in that the decomposition of the physical environment into smaller units resulted in a set of easily coded entities. in this model, each environment attribute is represented by a computational object which records data and behaviors concerning that attribute. For example, bottom and surface topographies are represented by a collection of programming objects which are arranged in a quadtree data structure and maintained by functions which are bound to those objects.