cssi/SciSciGPT-SciSciNet huggingface dataset:
Assessing the role of GPs in Nordic health care systems

Purpose This paper examines the changing role of general practitioners (GPs) in Nordic countries of Sweden, Norway and Denmark. It aims to explore the "gate keeping" role of GPs in the face of current changes in the health care delivery systems in these countries. Design/methodology/approach Data were collected from existing literature, interviews with GPs, hospital specialists and representatives of Danish regions and Norwegian Medical Association. Findings The paper contends that in all these changes, the position of the GPs in the medical division of labor has been strengthened, and patients now have increased and broadened access to choice. Research limitations/implications Health care cost and high cancer mortality rates have forced Nordic countries of Sweden, Norway and Denmark to rethink their health care systems. Several attempts have been made to reduce health care cost through market reform and by strenghtening the position of GPs. The evidence suggests that in Norway and Denmark, right incentives are in place to achieve this goal. Sweden is not far behind. The paper has limitations of a small sample size and an exclusive focus on GPs. Practical implications Anecdotal evidence suggests that physicians are becoming extremely unhappy. Understanding the changing status of primary care physicians will yield valuable information for assessing the effectiveness of Nordic health care delivery systems. Social implications This study has wider implications of how GPs see their role as potential gatekeepers in the Nordic health care systems. The role of GPs is changing as a result of recent health care reforms. Originality/value This paper contends that in Norway and Denmark, right incentives are in place to strengthen the position of GPs.
Label-free technologies for target identification and validation

Phenotypic screening is a powerful strategy for identifying active molecules with particular biological effects in cellular or animal disease models. Functionalized chemical probes have been instrumental in revealing new targets and confirming target engagement. However, substantial effort and resources are required to design and synthesize these bioactive probes. In contrast, label-free technologies have the advantage of bypassing the need for chemical probes. Here we highlight the recent developments in label-free methods and discuss the strengths and limitations of each approach.
Development of gastric antral smooth muscle contractility in newborn rabbits

Muscle strips from newborn and adult rabbits were stimulated with acetylcholine (ACh; receptor activation), potassium (membrane depolarization), and calcium (skinned muscle preparation). The study was designed to determine whether postnatal development is associated with agonist-specific increases in force development or with an overall increase in antral smooth muscle contractility. The results can be summarized as follows. 1) Antral smooth muscle from newborn animals developed less active force than tissues from adult animals when stimulated with ACh. 2) Antral smooth muscle from newborn animals developed less active force than tissues from adult animals when stimulated with potassium. 3) Skinned muscle preparations from newborn animals developed less active force than skinned muscle fibers from adult animals when stimulated with calcium. The data suggest that the overall contractility of antral smooth muscle from the newborn is less than that of the adult and that the difference can be attributed, at least in part, to factors past the level of the membrane. The study does not rule out the possibility that differences might also exist with respect to the availability or mobilization of calcium.
Study on vaccination coverage of national immunization programme among children in Xin Hui district in 2014

Objective To know about some status of immune vaccination in Xin Hui District.Methods 482 local children and 418 floating children from 30 villages in Xin Hui District were chosen by PPS methods.Results The immunization card rate and the immunization certificate rate are both 100 %. Among local children,the qualified vaccination rate of BCG,OPV,DPT,MV *,JE,Hep B and the frist injection rate of Hep B were all 95 %,the enhanced vaccination rate of OPV and the qualified vaccination rate of DT,Men AC1,Men AC2 were all 90 %.Compared with the local children,except for the qualified vaccination rate of BCG and the frist injection rate of Hep B,the other vaccine inoculation rate of floating children was significantly lower,the statistic was of significantly differences.Conclusions The basic vaccine inoculation rate of the local children in Xin Hui District was maintained at a high level,but enhanced vaccination rate was low.The coverage vaccination level of the floating children was significantly lower than those of the local children. The most common reasons for unqualified vaccination were missed immunization and delayed immunization,followed by schedule ahead and irregular vaccination interval.
Gas-liquid chromatographic determination of T-2 toxin in plasma

A gas-liquid chromatographic method for the determination of T-2 toxin in plasma is described. The toxin is extracted with benzene, washed with aqueous sodium hydroxide, and chromatographed on a small Florisil column; the heptafluorobutyryl derivative is prepared by reaction with heptafluorobutyrylimidazole. The T-2 HFB derivative is chromatographed on OV-1 at 230 degrees C and measured with an electron capture detector. Iso-T-2, an isomer of T-2 toxin, is added to samples as an internal standard before extraction. Recoveries averaged 98.0 +/- 5.5% at levels ranging from 50 to 1000 ng/mL. The limit of detection is 25 ng/mL.
Identifying Insomnia in Early Pregnancy: Validation of the Insomnia Symptoms Questionnaire (ISQ) in Pregnant Women.

Study Objectives:Although a substantial number of pregnant women report symptoms of insomnia, few studies have used a validated instrument to determine the prevalence in early gestation. Identifica...
Husserl on Reason, Reflection, and Attention

This paper spells out Husserl’s account of the exercise of rationality and shows how it is tied to the capacity for critical reflection. I first discuss Husserl’s views on what rationally constrains our intentionality (section 1). Then I localize the exercise of rationality in the positing that characterizes attentive forms of intentionality and argue that, on Husserl’s account, when we are attentive to something we are also pre-reflectively aware of what speaks for and against our taking something to be a certain way (section 2). After discussing the conditions under which this pre-reflective awareness gives way to reflective deliberation (section 3), I contrast this account to a compelling Kantian-inspired account of the activity of reason that has recently been developed by Matthew Boyle (section 4). In particular, I argue that Husserl delimits the scope of the exercise of rationality differently than Boyle, and I show how this implies different accounts of the self.
Creating and Sustaining an Experiential Learning Component on Aging in a BSW Course

Regardless of their particular field of practice, social workers increasingly serve the growing population of older adults in the United States. This article describes the process of integrating an...
Is There a Paradox between Ethics and Happiness? Moral Formation for Lawyers

Explores happiness as a more long-term sense of fulfillment from making decisions consistent with one's moral code. Provides background on the growth of moral psychology and the recognition that approaches can stimulate growth in persons into adulthood. Explores numerous gray area legal ethical scenarios and provides decision-making frameworks the authors have offered as ways to begin dealing with challenges.
Politeness Strategies in Confrontations of Prejudice

ABSTRACTThis project draws on the self-regulation of prejudiced responses model and politeness theory to investigate the role of politeness strategies in interpersonal confrontations of prejudice. One hundred and three participants were exposed to experimental confrontations of prejudiced remarks made about Native Americans. The results generally indicate that direct confrontations, which included an explanation of why the response was perceived as prejudiced, were most effective in reducing prejudiced responses and reducing levels of reported prejudice. Furthermore, participants generally accepted confrontations of their prejudiced responses and did not negatively evaluate their confronters. Finally, the more positive politeness participants perceived in the confrontations, the more positively they evaluated their confronter. Implications for theory and the confrontation of prejudice in everyday life are discussed.
Dementia and depression symptomatology as assessed through screening tests of older patients in an outpatient clinic.

OBJECTIVE This study examined the prevalence of dementia and depression symptoms as assessed through screening instruments in older patients visiting a family practice clinic, compared screening results with indications of either a dementia or depression-related diagnosis as reported on patients' medical records and billing statements, and examined the relationship between screening instrument results and patients' demographics. METHODS A total of 214 patients were interviewed and completed a written survey relating to dementia (Mini-Mental State Exam), depression (Beck Depression Inventory), medical conditions, and demographics. Patients were 60 years of age and older visiting a family practice clinic serving an outpatient population in northwest Illinois and southern Wisconsin. The clinic is an undergraduate teaching site of the University of Illinois College of Medicine at Rockford. Patients were interviewed at the time of their visits for routine medical care as they appeared on study recruitment days. RESULTS The response rate was greater than 90%. About 20% of the patients scored in the range of possible cognitive impairment and over 22% scored in the range of possible mild to moderate depression. Overall, about 38% of the patients showed symptoms of either dementia or depression, or both. Based on chart review, there was significant under-reporting of dementia or cognitive difficulties and low correlation between screening results and chart and billing information related to depression. CONCLUSIONS The results reaffirm a significant rate of mental health problems in older patients in outpatient settings. This situation warrants examination of the reasons for under-reporting of mental health problems and the potential relationship between mental health problems and the general health status of elderly patients.
TLR7/TLR9- and B Cell Receptor-Signaling Crosstalk: Promotion of Potentially Dangerous B Cells.

B cells are capable of receptor-mediated responses to foreign antigens. Recognition of microbial-derived nucleic acid (NA) by Toll-like receptors (TLRs) 7 and 9 in B cells has been substantiated. Endogenous NA released from damaged or dying cells can also be immunogenic in certain contexts, and can incite aberrant activation of B cells. When TLR-driven B Cell Receptor (BCR)-activated B cells are not properly constrained, pathologic autoantibodies are produced. It is also clear that endosomal TLR7/TLR9 can operate in conjunction with BCR. In addition to BCR signaling, a balance between TLR7 and TLR9 is pivotal in the development of B cell autoreactivity. While TLR9 is important in normal memory B cell responses through BCR, TLR9 activation has been implicated in autoantibody production. Paradoxically, TLR9 also plays known protective roles against autoimmunity by directly and indirectly inhibiting TLR7-mediated autoantibody production. Herein we summarize literature supporting mechanisms underpinning the promotion of pathological BCR-activated B cells by TLR7 and TLR9. We focus on the literature regarding known points of TLR7/TLR9 and BCR crosstalk. Data also suggest that the degree of TLR responsiveness relies on alterations of certain intrinsic B-cell signaling molecules and is also context specific. Because allogeneic hematopoietic stem cell transplantation (HCT) is a high NA and BAFF environment, we conclude that B cell studies of synergistic TLR-BCR signaling in human diseases like chronic graft versus host disease (cGVHD) are warranted. Further understanding of the distinct molecular pathways mediating TLR-BCR synergy will lead to the development of therapeutic strategies in autoimmune disease states.
Teaching ethos from the dumpster: Dive and food waste rhetoric

Courses: Rhetorical Criticism, Composition, Environmental CommunicationObjectives: This unit activity, for which students view a documentary to identify and evaluate persuasive ethos and then create their own rhetorical messages for reducing food waste, serves as a platform for teaching both the critique and practice of rhetoric, as well as familiarizing students with the complexities of the global food system and food waste.
Emulating a target trial of antiretroviral therapy regimens started before conception and risk of adverse birth outcomes.

OBJECTIVE To compare the effect of preconception initiation of zidovudine, lamivudine, nevirapine (ZDV/3TC/NVP) versus tenofovir, emtricitabine, efavirenz (TDF/FTC/EFV) on adverse birth outcomes. DESIGN Emulation of a hypothetical (target) trial using a birth surveillance study in Botswana during an era of CD4-based antiretroviral therapy (ART) initiation. METHODS In women who initiated ART less than 3 years from HIV diagnosis, conceived 0.5-5 years after ART initiation, and delivered at least 24-week gestation, we estimated risk ratios for stillbirth, preterm delivery (<37 weeks), very preterm delivery (<32 weeks), small-for-gestational-age (SGA) (<10 percentile), very SGA (<3 percentile), and any adverse or severe birth outcome for first-line ZDV/3TC/NVP versus TDF/FTC/EFV. We conducted a historical comparison in women who initiated TDF/FTC/EFV in 2012-2015 and ZDV/3TC/NVP in 2004-2011, and a contemporaneous comparison in an era of overlapping use from 2009 to 2013. RESULTS In the historical comparison, 1108 women initiated TDF/FTC/EFV and 637 initiated ZDV/3TC/NVP. In the contemporaneous comparison, 1052 initiated TDF/FTC/EFV and 298 initiated ZDV/3TC/NVP. TDF/FTC/EFV initiators were younger and more likely to be nulliparous than ZDV/3TC/NVP initiators in both comparisons. In the historical comparison, the adjusted risk ratios (95% confidence interval) comparing ZDV/3TC/NVP with TDF/FTC/EFV were 2.95 (1.76, 4.96) for stillbirth, 1.40 (1.17, 1.67) for preterm delivery, 2.58 (1.70, 3.91) for very preterm delivery, 1.96 (1.64, 2.34) for SGA, 2.32 (1.73, 3.09) for very SGA, 1.54 (1.38, 1.72) for any adverse birth outcome, and 2.20 (1.76, 2.75) for any severe birth outcome, and were similar in the contemporaneous comparison. CONCLUSION Preconception initiation of ZDV/3TC/NVP compared with TDF/FTC/EFV may increase the risk of adverse birth outcomes.
A qualitative investigation of healthcare workers’ strategies in response to readmissions

Readmission of a patient to a hospital is typically associated with significant clinical changes in the patient’s condition, but it is unknown how healthcare workers modify their provision of care when considering these changes. The purpose of the present study was to determine how healthcare workers shift their care strategies when treating readmitted patients. A typical case sampling study of healthcare workers was conducted using the grounded theory approach. The study setting comprised several patient care units at an academic center and tertiary-care hospital. We purposively sampled 34 healthcare workers (19 women, 15 men) to participate in individual interviews, either face-to-face or by telephone. We asked the participants semi structured questions regarding their thoughts on readmissions and how they altered their process and behavior for readmitted patients. Interviews were audio-recorded and transcribed. We used a qualitative data analyses based on an inductive approach to generate themes about how healthcare workers shift their strategies for readmitted patients. Healthcare workers’ shifts in strategy for readmissions were reflected in three major themes: clinical assessment, use and management of information, and communication patterns. Participants reported that they became more conservative in their assessment of the clinical condition of a readmitted patient. The participants also indicated that readmitted patients would be treated in a similar way to normal admission based on care requirements; however, somewhat paradoxically, they also expressed that having access to prior patient information changed the way they treated a readmitted patient. Although healthcare workers may exhibit a tendency to become more conservative with readmissions, readily available patient information from the previous admission played a large part in guiding their thinking. A more conservative approach with a readmitted patient, on its own, does not necessarily lead to improved documentation or better patient care.
Creating a Program for Junior Faculty Professional Development: A Tool Kit.

Introduction Junior academic faculty must balance increasing clinical responsibilities whilst maintaining academic portfolios aimed at promotion. Our goal was to design, implement, and evaluate a c...
Pixon-Based Multiresolution Image Reconstruction and Quantification of Image Information Content

This paper describes the theory of pixon-based image reconstruction. After a brief introduction of the basic concepts of the pixon, the paper concentrates primarily on our current implementation of the techniques along with the approximations and shortcuts that seem to provide practical software algorithms. We then present an example of application of the method to astrophysical data, i.e. imaging of the Einstein ring in the gravitational lens of FSC 10214+4724.
Subharmonic generation by shear waves in a 1D resonator formed with a relaxing material

The low shear moduli of soft elastic media such as rubber and tissue facilitate the excitation of shear waves that exhibit significant finite-amplitude effects. Measurements performed by Andreev et al. [Acoust. Phys. 57, 779 (2011)] of the amplitude-dependent response of a 1D shear-wave resonator formed with a rubber-like material revealed reasonable agreement with numerical simulations based on a monorelaxing material model. At the previous ASA meeting the present authors developed an augmented Duffing equation as a model for plane shear waves in a resonator formed with a monorelaxing material that is shaken at one end and free at the other [J. Acoust. Soc. Am. 142, 2723 (2017)]. The focus of the previous work was on the response at drive frequencies near the lowest resonance. Here the augmented Duffing model is used to investigate subharmonic generation associated with a drive frequency of approximately three times that of the lowest mode. Conditions on the amplitude and frequency of excitation for whic...
Risk assessment methodology for karst aquifers : (1) Estimating karst conduit-flow parameters

Quantitative ground-water tracing of conduit-dominated karst aquifers allows for reliable and practical interpretation of karst ground-water flow. Insights into the hydraulic geometry of the karst aquifer may be acquired that otherwise could not be obtained by such conventional methods as potentiometric-surface mapping and aquifer testing. Contamination of karst aquifers requires that a comprehensive tracer budget be performed so that karst conduit hydraulic-flow and geometric parameters be obtained. Acquisition of these parameters is necessary for estimating contaminant fate-and-transport. A FORTRAN computer program for estimating total tracer recovery from tracer-breakthrough curves is proposed as a standard method. Estimated hydraulic-flow parameters include mean residence time, mean flow velocity, longitudinal dispersivity, Peclet number, Reynolds number, and Froude number. Estimated geometric parameters include karst conduit sinuous distance, conduit volume, cross-sectional area, diameter, and hydraulic depth. These parameters may be used to (1) develop structural models of the aquifer, (2) improve aquifer resource management, (3) improve ground-water monitoring systems design, (4) improve aquifer remediation, and (5) assess contaminant fate-and-transport. A companion paper demonstrates the use of these hydraulic-flow and geometric parameters in a surface-water model for estimating contaminant fate-and-transport in a karst conduit. Two ground-water tracing studies demonstrate the utility of this program for reliable estimation of necessary karst conduit hydraulic-flow and geometric parameters.
Inherited Optic Neuropathies

Most metabolic optic neuropathies involve derangements that affect mitochondria and oxidative phosphorylation. These may be inherited or acquired, the latter being further divided into toxic and nutritional deficiency states. This article discusses inherited disorders of metabolism that affect the optic nerve in isolation. Such inherited optic neuropathies are Leber's hereditary optic neuropathy (LHON), dominant optic atrophy (DOA), and congenital recessive optic atrophy (ROA). Mitochondria are always impaired, sometimes from mutations of their own DNA (mtDNA), other times by mutations of nuclear DNA involved in the transcription of mitochondrial proteins or substrates for mitochondrial biochemistry. The clinical presentation remains stereotypic and usually involves bilateral symmetric visual loss with dyschromatopsia, and central or cecocentral visual field defects.
Relation of F-actin Organization to Microtubules in Drug Treated Haemanthus Mitosis

We report observations on the effects of cytochalasin D, pressure injection of anti-actin antibody, and of a microtubule-disrupting drug (amiprophos methyl), on the distribution of F-actin bundles in endosperm of the higher plant, Haemanthus. The course of mitosis and cell plate formation in vivo was recorded with video time-lapse. Cells recorded in vivo were fixed and processed with non-fading immunogold and/or immunogold silver-enhanced stain to follow the distribution of actin bundles or microtubules. Double stain (actin and microtubules in the same cell) was applied extensively. Three-dimensional spatial relation of actin to microtubules was analyzed with serial optical sectioning in video microscopy.
In Vitro Methods to Predict Skin Irritation

Whole-animal tests represent true physiological and metabolic relationships of macromolecules, cells, tissues, and organs that can evaluate the reversibility of toxic effects. However, these tests are costly, timeconsuming, insensitive, and difficult to standardize and are sometimes poorly predictive of human in vivo response.
The Notion of Basic Needs

We describe Maslow’s hierarchy of basic needs and the importance of basic needs satisfaction and how lack of provision leads to stress. When basic needs are not provided, it creates a situation of stress, leading to poorer health outcomes. We discuss the outline of the book where we discuss two new comprehensive measures of basic needs. In Chapter 2, we describe the creation and validation of a comprehensive measure of basic needs. In Chapter 3, we examine the evolutionary inheritances of basic needs as they pertain to the evolved nest, discuss and test a retrospective measure of basic needs in childhood and contrast it with the evolved developmental niche (EDN) history measure. In Chapter 4, we examine the relation of basic needs to moral functioning. In Chapter 5, we examine other models of basic needs and draw some conclusions.
Convolutional Nonlinear Differential Recurrent Neural Networks for Crowd Scene Understanding

With the growth of crowd phenomena in the real world, crowd scene understanding is becoming an important task in anomaly detection and public security. Visual ambiguities and occlusions, high densi...
Integrated Brief Intervention for PTSD and Substance Use in an Antepartum Unit.

Purpose To evaluate the efficacy of a brief education session affecting patient perspectives on follow up care of substance use and trauma treatment in pregnant women admitted to a medical hospital. Description Participants (N = 31) were recruited from the antepartum unit at Magee-Women’s Hospital at the University of Pittsburgh who had current substance use and history of trauma. A voluntary individual educational session was offered that discussed the diagnosis and treatment of substance use and trauma, fundamental coping skills, and local resources. Utility of the session, knowledge of PTSD, and barriers of care were evaluated through a pre- and post- session questionnaire. Assessment All participants found the session improved their knowledge of PTSD, substance use, safe coping skills, and increased their likelihood of pursuing further follow up treatment. Conclusion Brief educational interventions that are integrated in the medical hospital are found to be useful by patients and reported to influence their decision to seek further treatment. Further studies are needed to analyze the long-term outcomes of brief interventions.
Deep Sequencing of Somatosensory Neurons Reveals Molecular Determinants of Intrinsic Physiological Properties

Summary Dorsal root ganglion (DRG) sensory neuron subtypes defined by their in vivo properties display distinct intrinsic electrical properties. We used bulk RNA sequencing of genetically labeled neurons and electrophysiological analyses to define ion channel contributions to the intrinsic electrical properties of DRG neuron subtypes. The transcriptome profiles of eight DRG neuron subtypes revealed differentially expressed and functionally relevant genes, including voltage-gated ion channels. Guided by these data, electrophysiological analyses using pharmacological and genetic manipulations as well as computational modeling of DRG neuron subtypes were undertaken to assess the functions of select voltage-gated potassium channels (Kv1, Kv2, Kv3, and Kv4) in shaping action potential (AP) waveforms and firing patterns. Our findings show that the transcriptome profiles have predictive value for defining ion channel contributions to sensory neuron subtype-specific intrinsic physiological properties. The distinct ensembles of voltage-gated ion channels predicted to underlie the unique intrinsic physiological properties of eight DRG neuron subtypes are presented.
Assessment of Practice Management Entrustable Professional Activities by Pharmacists in North Dakota.

Objective. To quantify the use of core entrustable practice activities (EPAs) in contemporary pharmacy practice in North Dakota. Methods. Given the large number of core EPAs, this study focused on those supporting tasks categorized within the practice manager domain. The survey instrument was sent to all registered pharmacists living and practicing in North Dakota (n=990). This manuscript reports on the practice manager domain and the activities and examples of supportive tasks in this domain. Results. Four hundred fifty-seven (46.1%) of the pharmacists responded; however, only 102 survey instruments were fully completed and usable. Respondents rated the “fulfill a medication order” activity the highest EPA overall (mean=9.1, SD=2.7). The “oversee the pharmacy operations for an assigned work shift” activity (mean=7.8, SD=3.9) was also rated highly. Responses to “oversee the pharmacy operations for an assigned work shift” were significantly different between independent practice settings and all other practice settings. The manager was more likely than other pharmacy positions to report performing seven of the nine tasks within this EPA. Significant differences in five of nine tasks were found across pharmacies located in rural or more urban communities, including “assist in the evaluation of pharmacy technicians” and “identify pharmacy service problems and/or medication safety issues.” Conclusion. This study provides empirical evidence suggesting that EPAs can be a useful means to assess outcomes in pharmacy education.
Multilevel Stochastic Gradient Methods for Nested Composition Optimization

Stochastic gradient methods are scalable for solving large-scale optimization problems that involve empirical expectations of loss functions. Existing results mainly apply to optimization problems ...
Optimum Linear Codes With Support-Constrained Generator Matrices Over Small Fields

We consider the problem of designing optimal linear codes (in terms of having the largest minimum distance) subject to a support constraint on the generator matrix. We show that the largest minimum distance can be achieved by a subcode of a Reed–Solomon code of small field size and with the same minimum distance. In particular, if the code has length $n$ , and maximum minimum distance $d$ (over all generator matrices with the given support), then an optimal code exists for any field size $q\geq 2n-d$ . As a by-product of this result, we settle the GM–MDS conjecture in the affirmative.
Oleothorax: Review of Literature; Report of a Case Study and a Potential Treatment for Multi-Resistant Tuberculosis (MRTB)

An 83 year-old-female died of dementia with history of no previous disease. On dissection, paraffin was found in the right pleural cavity, indicated that the person received therapy for cavitary tuberculosis in the 1940s or1950s but no gross evidence of pulmonary or pleural tubercular disease was identified in the patient. Literature review on oleothorax indicated several reported complications of oleothorax. This case notes the lack of any apparent complications caused by oleothorax. In this paper, we present a case and outlines the importance of oleothorax in the medical history of tuberculosis, and as a potential treatment for multi-resistant tuberculosis (MRTB).
Developing efficient and effective behavioral treatment for insomnia in cancer survivors: Results of a stepped care trial

BACKGROUND Insomnia is common among cancer survivors. Although behavioral treatments for insomnia are effective, access is limited. Stepped care delivery models may provide insomnia treatment that is more efficient and accessible to cancer survivors. METHODS Fifty-one survivors (mean age, 55 years) with elevated Insomnia Severity Index (ISI) scores (≥12) first participated in Sleep Training Education Program (STEP)-1: a single, sleep education session. Those reporting elevated ISI scores 1 month later were offered STEP-2: a 3-session, group cognitive behavioral treatment for insomnia that has been demonstrated to be efficacious. Participants were considered treatment responders if their ISI score improved by ≥6 points and were considered as having remitted if their posttreatment ISI score was <12. Mood was assessed with the Profile of Mood States-Short Form (POMS-SF). RESULTS Following STEP-1, ISI scores improved (17.1 to 11.2; P < .001), with 45% responding and 41% remitted. Insomnia remission after STEP-1 was associated with lower insomnia severity and shorter duration of sleep problems at baseline. Of the 30 (59%) survivors with unremitted insomnia after STEP-1, 14 (47%) participated in STEP-2. Following STEP-2, ISI scores improved (16.9 to 8.8; P < .001), with 79% responding and 71% remitted. STEP-2 participation was associated with interest in sleep treatment at baseline, but not demographic/health-related variables. Mood improved significantly following both STEP-1 and STEP-2 (P < .001). CONCLUSION A stepped care approach to treating insomnia among cancer survivors has the potential to improve treatment accessibility. A sizable proportion of survivors can benefit from 2 different low-intensity approaches that could be delivered by nonsleep specialists. For individuals who require more intensive care, assessing treatment interest can identify those who are likely to engage.
Academic skills in children with autism spectrum disorders with monolingual or bilingual experience

Background and aimsThe academic development of children with autism spectrum disorders is important to investigate as it can provide opportunities for higher education, independent living, and succ...
Risk and protective factors for opioid misuse in American Indian adolescents

Abstract Background American Indian (AI) youth have disproportionately high rates of both heroin and other opioid misuse and recently have seen a large increase in negative outcomes due to opioid misuse. To address the dearth of research on within-group risk factors for heroin and other opioid misuse in AI adolescents, the goal of the present study is to explore the influence of peer, family, and school factors on opioid use among AI youth. Methods Participants (n = 3498, 49.5 % female, Mage = 14.8) were drawn from a large school-based sample of AI youth living on or near reservations, across six geographic regions, between 2009 and 2013. Participants completed a self-report questionnaire regarding substance use and related factors. Multilevel logistic regression was utilized to examine the role of peer, family, and school-related factors on past-month and lifetime heroin and other opioid misuse. Results Greater peer substance use (OR = 1.14, p Conclusions Findings highlight the need for interventions and offer potential factors to consider in developing interventions for heroin and/or other opioid misuse among AI adolescents.
How skin color, class status, and gender intersect in the labor market: Evidence from a field experiment

Abstract This article examines skin color discrimination in two Brazilian labor markets using a field experimental approach. Fictitious resumes including photographs of job candidates were randomly assigned one skin color category via photo manipulation and submitted to entry-level job openings. In addition to assessing the extent of skin color discrimination, this article adopts an intersectional framework to examine how the effect of skin color in employment is moderated by class status and varies by gender. I found mixed results about the role of skin color in predicting the employment outcomes at the initial stages of the hiring process. Results from logistic regression and Linear Probability Models show that skin color is a weak predictor of hiring outcomes (e.g. receiving a callback from employers) among male applicants and for female applicants with brown skin. However, I find strong evidence that having dark skin is causally associated with hiring outcomes among female applicants. I also found that having a higher-class status erases skin color differences, thus identifying a potential mechanism that mitigates the effects of skin color in hiring.
Informed Trading Support for the Amateur Investoron the New York Stock Exchange

While a large number of data-powered investment solutions exist, the majority are targeted at enterprise-scale wealth generation. Wherein high capital, real-time market access, instant execution, and high-performance infrastructure are all common prerequisites for implementation and success of most wealth management and trading strategies. Amateurs, however, are often relegated to more manual approaches, frequently including technical analysis (trendlines), study of chart patterns and educated guesses/risks. In this work, we aim to harness the high-volume and high-velocity attributes of Big Data source offered by the New York Stock Exchange by providing a novel system for investment decisions that can support the amateur investor. Rather than performing high-frequency trading approaches, we use easily accessible public data and machine learning to automate chart pattern analysis in a way that suggests weekly trading as a more practical approach in the context of nonprofessional investors. We show that the system outperforms uniform investment over the course of a year, demonstrating potential Big Data-powered wealth generation for individuals outside the financial sector.
Topographic Anatomical Relationships of the Breast, Chest Wall, Axilla, and Related Sites of Metastases

The endogenous hormone secretions, lactation, immunoglobulins of parturition, and maintenance of the development and function of the breast are intrinsically dependent upon the pituitary-adrenocortical axis. This physiological support is critical to the development and maintenance of ducts and the lobules of the organ with prepubertal development and puberty. Both epithelial and glandular elements of the breast are embedded in the loose connective tissue of each lobule. Within each lobule, the epithelial cells are robustly populated with ductal elements supported by a matrix of dense connective tissue that surrounds each lobular unit. With pituitary stimulation and endogenous ovarian and adrenal hormonal secretion, proliferative enlargement of the active (pregnant) human mammary gland, alveolar elements of the organ become conspicuously enlarged in the early proliferative cycle and breast milk emanates within lobules of the breast; distinct alveoli are identifiable. Dense connective tissue septa separate individual lobules in the lactation state. These influential hormones of ovarian, pituitary, and adrenal origin provide feedback regulation of secretion and milk formation that determine size, configuration, and weight of the gland in the pregnant and developmental phases of breast development, maintenance, and disease.
Therapeutic effects of stronger neo-minophagen C on liver function damage caused by diarrhea and its influence on immune function of patients

Objective To explore the therapeutic effect of stronger neo-minophagen C (SNMC) on liver function damage caused by diarrhea in children and its influence on immune function of children. Methods Ninety-six children with diarrhea-induced liver dysfunction admitted to Shanxi Children’s Hospital from June 2016 to June 2018 were divided into observation group (SNMC+ montmorillonite powder+ routine treatment, n=48) and control group (gantaile+ montmorillonite powder+ routine treatment, n=48) by random number table method. The therapeutic effects of the two groups were observed. Results After treatment, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) in the two groups were lower than those before treatment (P all<0.05), and the above indexes in the observation group were lower than those in the control group (P all<0.05). The effective rate of treatment in the observation group was higher than that in the control group (P<0.05). The levels of serum immunoglobulin A (IgA), immunoglobulin M (IgM) and immunoglobulin G (IgG) increased after treatment in both groups (P<0.05), and the levels of serum IgA and IgM in the observation group were higher than those in the control group (P<0.05). After treatment, the levels of CD4+, CD8+ and CD4+ /CD8+ in both groups were higher than those before treatment (P all<0.05), and the levels of CD4+ in the observation group were higher than those in the control group (P<0.05). Conclusions SNMC is a recrudescent glycyrrhizic acid preparation with less adverse drug reactions. It can effectively protect the liver function of children with diarrhea-induced liver damage and improve their immune function. The therapeutic effect is remarkable. Key words: Stronger neo-minophagen C; Diarrhea; Liver function damage; Therapeutic effect; Immune function
Ag+ Ion Binding to Human Metallothionein-2A is Cooperative and Domain Specific

Metallothioneins (MTs) constitute a family of cysteine-rich proteins that play key biological roles for a wide range of metal ions, but unlike many other metalloproteins, the structures of apo- and partially metalated MTs are not well understood. Here, we combine nano-electrospray ionization-mass spectrometry (ESI-MS) and nano-ESI-ion mobility (IM)-MS with collision-induced unfolding (CIU), chemical labeling using N-ethylmaleimide (NEM), and both bottom-up and top-down proteomics in an effort to better understand the metal binding sites of the partially metalated forms of human MT-2A, viz., Ag4-MT. The results for Ag4-MT are then compared to similar results obtained for Cd4-MT. The results show that Ag4-MT is a cooperative product, and data from top-down and bottom-up proteomics mass spectrometry analysis combined with NEM labeling revealed that all four Ag+ ions of Ag4-MT are bound to the β-domain. The binding sites are identified as Cys13, Cys15, Cys19, Cys21, Cys24, and Cys26. While both Ag+ and Cd2+ react with MT to yield cooperative products, i.e., Ag4-MT and Cd4-MT, these products are very different; Ag+ ions of Ag4-MT are located in the β-domain, whereas Cd2+ ions of Cd4-MT are located in the α-domain. Ag6-MT has been reported to be fully metalated in the β-domain, but our data suggest the two additional Ag+ ions are more weakly bound than are the other four. Higher order Agi-MT complexes (i = 7-17) are formed in solutions that contain excess Ag+ ions, and these are assumed to be bound to the α-domain or shared between the two domains. Interestingly, the excess Ag+ ions are displaced upon addition of NEM to this solution to yield predominantly Ag4NEM14-MT. Results from CIU suggest that Agi-MT complexes are structurally more ordered and that the energy required to unfold these complexes increases as the number of coordinated Ag+ increases.
EFFECT OF HARVESTING TIME ON MILLING YIELD AND GRAIN BREAKAGE FOR EGYPTIAN PADDY RICE

The effect of harvesting time on rice sensory and physio-chemical properties not well understood. Timing of harvesting rice with meteorological conditions can allow growers to gain more for high head rice yield. Three of Egyptian varieties Sakha 106, Giza 179 and Hybrid1 were grown during 2015 to estimate the total milling yield and grain breakage at five different harvest times {22, 25, 28, 31 and 34 days after 50% of flowering (DAF)}.It was concluded that the highest total milling yield and lowest grain breakage was obtained at the 28, 25 and 31 day after 50% of the flowering for Sakha 106, Giza 179 and Hybrid1 respectively. So harvest management preserves rice quality that contribute directly to profit, and then rice growers must harvest rice as carefully as they grow it. Although this study showed that harvesting time is very important, there are many factors have effect on milling quality. Among of these that were investigated is the harvesting time.
Strident harmony from the perspective of an inductive learner

In languages with strident harmony, stridents within a particular domain are required to have the same minor place of articulation. Harmony is often required only of stridents within a root or stem morpheme, and doesn't trigger alternations. Harmony is also often quite local, applying exclusively or more strongly between stridents in the same or adjacent syllables. Finally, harmony may be morpheme specific, triggering alternations in some affixes but not others. All of these specifics of a given harmony pattern give rise to exceptions to harmony at the level of the word, and may require a morphologically parsed learning corpus in order to be acquired. This paper explores the learnability of strident harmony in text corpora from three languages: Nkore-Kiga (Bantu), Papantla Totonac (Totonacan) and Navajo (Athapaskan). The analyses show that word level exceptions largely obscure the harmony pattern as an overall phonotactic in a language. The three languages also serve as a test of the Projection Induction Learner (Gouskova and Gallagher 2020), which is found to be successful when the generalizations in the data are strong but may fail in the face of patterned exceptions.
Spontaneous Facet Joint Osteoarthritis in NFAT1-Mutant Mice

Objectives: Although rodent models of traumatically or chemically induced intervertebral facet joint osteoarthritis (FJOA) were previously described, the characteristics of spontaneous FJOA animal models have not been documented. This study aimed to identify the characteristics of a murine model of spontaneous FJOA and its underlying mechanisms. Methods: The lumbar facet joints of mutant mice carrying a disrupted NFAT1 (nuclear factor of activated T cells 1) allele and of wild-type control mice were examined by histochemistry, quantitative gene expression analysis, immunohistochemistry, and histomorphometry using a novel FJOA scoring system at 2, 6, 12, and 18 months of age. The reproducibility of the FJOA scoring system was analyzed by inter-observer and intra-observer variability tests. Tissue-specific histomorphometric and gene expression changes were statistically analyzed. Results: NFAT1-mutant facet joints displayed dysfunction of articular chondrocytes and synovial cells with aberrant gene and protein expression in cartilage and synovium as early as 2 months, followed by osteoarthritic structural changes such as articular surface fissuring and chondro-osteophyte formation at 6 months. Deeper cartilage lesions, synovitis, separation of cartilage from thickened subchondral bone, and tissue-specific molecular and cellular alterations in NFAT1-mutant facet joints became evident at 12 and 18 months. Osteoarthritic structural changes were not detected in wild-type facet joints at any ages, though age-related cartilage degeneration was observed at 18 months. Conclusions: Using NFAT1-mutant mice, this study has identified for the first time an animal model of spontaneous FJOA with age-dependent osteoarthritic characteristics, developed the first FJOA scoring system, and elucidated the molecular mechanisms of NFAT1 mutation-mediated FJOA.
Developing a Conversational Recommendation Systemfor Navigating Limited Options

We have developed a conversational recommendation system designed to help users navigate through a set of limited options to find the best choice. Unlike many internet scale systems that use a singular set of search terms and return a ranked list of options from amongst thousands, our system uses multi-turn user dialog to deeply understand the user’s preferences. The system responds in context to the user’s specific and immediate feedback to make sequential recommendations. We envision our system would be highly useful in situations with intrinsic constraints, such as finding the right restaurant within walking distance or the right retail item within a limited inventory. Our research prototype instantiates the former use case, leveraging real data from Google Places, Yelp, and Zomato. We evaluated our system against a similar system that did not incorporate user feedback in a 16 person remote study, generating 64 scenario-based search journeys. When our recommendation system was successfully triggered, we saw both an increase in efficiency and a higher confidence rating with respect to final user choice. We also found that users preferred our system (75%) compared with the baseline.
Disparities in the use of checkpoint inhibitors and CAR T-cell therapy: A systematic review.

e18541Background: With increasing numbers of newly approved cancer immunotherapy regimens, research is needed to understand whether these costly treatments are equally used by all patients who coul...
Translanguaging as Culturally Sustaining Pedagogy: Transforming Traditional Practices in an ESOL Classroom for Older Adults from Refugee Backgrounds

This chapter examines the equity aspects of implementing translanguaging as a form of culturally sustaining pedagogy to nurture linguistic, literate, and cultural pluralism in an ESOL classroom for Nepali-speaking Bhutanese older adults resettled in the United States as refugees. Taking a teacher-action research approach, the authors collaborated to design and deliver lessons informed by translanguaging pedagogy. The study’s findings show that implementing translanguaging pedagogy enabled the reimagination of students’ and teachers’ traditional power roles toward becoming co-teachers and co-learners and challenged the linguistic hierarchy that posits English speakers and their language practices as more powerful and prestigious than any others. Findings also showed that this pedagogy disrupted the assimilationist and monolingual practices often found in traditional ESOL programs while embracing and fostering the linguistic and cultural practices older students brought into the classroom. Implications for ESOL practitioners are discussed.