cssi/SciSciGPT-SciSciNet huggingface dataset:
A Thematic Analysis of Online Discussion Boards for Brachial Plexus Injury.

Purpose Patients with brachial plexus injury (BPI) and their family members contribute to Internet discussion groups dedicated to BPI. We hypothesized that a thematic analysis of posts from BPI Internet discussion groups would reveal common themes related to the BPI patient experience, providing topics for patient education and counseling. Methods Internet discussion boards were identified using the search term "brachial plexus injury support group" in Google, Bing, and Yahoo! search engines. Two discussion boards had substantially more posts than other Web sites and were chosen for analyses. Posts from January 1, 2015, through January 1, 2016, were examined. Using an iterative and established process, 2 investigators (M.T.M. and C.J.D) independently analyzed each post using thematic analysis in 3 steps (open coding, axial coding, and selective coding) to determine common themes. In this process, each post was reviewed 3 times. Results A total of 328 posts from the 2 leading discussion boards were analyzed. Investigators reached a consensus on themes for all posts. One central theme focused on emotional aspects of BPI. Four other central themes regarding information support were identified: BPI disease, BPI treatment, recovery after BPI treatment, and process of seeking care for BPI. Conclusions Examination of posts on Internet support groups for BPI revealed recurring concerns, questions, and opinions of patients and their family members. The most common themes related to disease information, treatment, recovery, and the emotional element of BPI. Clinical relevance These findings provide a helpful starting point in refining topics for patient education and support that are targeted on patients' interests and concerns.
Internet Standards and Developing Countries: Problems and Opportunities

The World Summit on the Information Society (WSIS) Declaration of Principles identified technical standardization as a foundation of the global information society. Specifically, Paragraph 44 of the WSIS Declaration of Principles cited so-called open standards as a precursor to affordable ICT diffusion in the developing world:“The development and use of open, interoperable, non-discriminatory and demand-driven standards that take into account needs of users and consumers is a basic element for the development and greater diffusion of ICTs and more affordable access to them, particularly in developing countries.”However, the institutional processes and underlying intellectual property arrangements of ICT standards do not always create an opening to reflect the political and economic interests of developing countries. For example, developing country interests often have no voice in standards-setting institutional processes dominated by private western corporations. Intellectual property restrictions can create impediments to later entrant entrepreneurs in developing countries seeking to compete or innovate in products based on entrenched ICT standards. Furthermore, developing countries often lack the installed base of ICT infrastructure inherent in the West and are more significantly impacted by intellectual property restrictions and heightened product costs associated with the standards necessary to build infrastructure. Additionally, as traditional global trade barriers diminish, standards are increasingly emerging as non-pecuniary technical barriers to trade impeding technical interoperability and economic openness between regions.This paper examines ways in which the degree of openness in ICT standards has pronounced implications to developing countries and suggests opportunities for promoting greater openness and interoperability. This paper asks how institutional processes, intellectual property arrangements, and standards adoption policies can provide a greater opening for developing country interests to enter the political and economic decisions made in standards ascent and for encouraging more of a level playing field for economic competition and entrepreneurial innovation. Specifically, this paper recommends that the multitude of institutions that establish Internet-related standards should establish, and would benefit from establishing, policies promoting greater participatory openness in the standards-setting process, greater procedural transparency, and fewer intellectual property restrictions. Finally, this paper describes how developing countries themselves can intervene by establishing government procurement policies that favor open Internet standards.
Multifunctional epitaxial systems on silicon substrates

Multifunctional heterostructures can exhibit a wide range of functional properties, including colossal magneto-resistance, magnetocaloric, and multiferroic behavior, and can display interesting physical phenomena including spin and charge ordering and strong spin-orbit coupling. However, putting this functionality to work remains a challenge. To date, most of the work reported in the literature has dealt with heterostructures deposited onto closely lattice matched insulating substrates such as DyScO3, SrTiO3 (STO), or STO buffered Si(100) using concepts of lattice matching epitaxy (LME). However, strain in heterostructures grown by LME is typically not fully relaxed and the layers contain detrimental defects such as threading dislocations that can significantly degrade the physical properties of the films and adversely affect the device characteristics. In addition, most of the substrates are incompatible with existing CMOS-based technology, where Si (100) substrates dominate. This review discusses recent advances in the integration of multifunctional oxide and non-oxide materials onto silicon substrates. An alternative thin film growth approach, called “domain matching epitaxy,” is presented which identifies approaches for minimizing lattice strain and unwanted defects in large misfit systems (7%–25% and higher). This approach broadly allows for the integration of multifunctional materials onto silicon substrates, such that sensing, computation, and response functions can be combined to produce next generation “smart” devices. In general, pulsed laser deposition has been used to epitaxially grow these materials, although the concepts developed here can be extended to other deposition techniques, as well. It will be shown that TiN and yttria-stabilized zirconia template layers provide promising platforms for the integration of new functionality into silicon-based computer chips. This review paper reports on a number of thin-film heterostructure systems that span a variety of ferroelectric, multiferroic, magnetic, photocatalytic, and smart materials. Their properties have been extensively investigated and their functionality found to be comparable to films grown on single-crystal oxide substrates previously reported by researchers in this field. In addition, this review explores the utility of using laser processing to introduce stable defects in a controlled way and induce magnetism and engineer the optical and electrical properties of nonmagnetic oxides such as BaTiO3, VO2, NiO, and TiO2 as an alternative for incorporating additional magnetic and conducting layers into the structure. These significant materials advancements herald a flurry of exciting new advances in CMOS-compatible multifunctional devices.
Clinical productivity of primary care nurse practitioners in ambulatory settings

Abstract Background Nurse practitioners are increasingly being integrated into primary care delivery to help meet the growing demand for primary care. It is therefore important to understand nurse practitioners' productivity in primary care practice. Purpose We examined nurse practitioners' clinical productivity in regard to number of patients seen per week, whether they had a patient panel, and patient panel size. We further investigated practice characteristics associated with their clinical productivity. Methods We conducted cross-sectional analysis of the 2012 National Sample Survey of Nurse Practitioners. The sample included full-time primary care nurse practitioners in ambulatory settings. Multivariable survey regression analyses were performed to examine the relationship between practice characteristics and nurse practitioners' clinical productivity. Results Primary care nurse practitioners in ambulatory settings saw an average of 80 patients per week (95% confidence interval [CI]: 79–82), and 64% of them had their own patient panel. The average patient panel size was 567 (95% CI: 522–612). Nurse practitioners who had their own patient panel spent a similar percent of time on patient care and documentation as those who did not. However, those with a patient panel were more likely to provide a range of clinical services to most patients. Nurse practitioners' clinical productivity was associated with several modifiable practice characteristics such as practice autonomy and billing and payment policies. Discussions The estimated number of patients seen in a typical week by nurse practitioners is comparable to that by primary care physicians reported in the literature. However, they had a significantly smaller patient panel. Nurse practitioners' clinical productivity can be further improved.
Biologics in Transplantation (Anti-thymocyte Globulin, Belatacept, Alemtuzumab): How Should We Use Them?

The use of immunosuppressive agents for induction and maintenance therapies continues to vary widely among countries and transplant centers. This review will consolidate the published body of evidence addressing the effectiveness and safety of the use of three biological agents: anti-thymocyte globulin, alemtuzumab, and belatacept in adult kidney transplant recipients. Clinical evidence clearly supports the use of Thymoglobulin in high immunological risk patients, while its benefit in low immunological risk patients remains controversial. Alemtuzumab has the advantage of easy administration with comparable efficacy to Thymoglobulin but concerns regarding increased risk for late rejection. Belatacept is the newest biological agent. It is associated with higher glomerular filtration rates compared to cyclosporine. Belatacept has not been compared to tacrolimus or studied in high immunological risk patients in sufficiently large numbers. Tailoring immunosuppressive therapy to patient’s characteristics and immunological risk is the key for successful transplantation.
Quadrilingual education in Singapore: pedagogical innovation in language education, edited by Rita Elaine Silver and Wendy D. Bokhorst-Heng,

How does language pedagogy respond to current policies and to social changes in language use? What does language education at the primary level in Singapore currently look like, and how similar or ...
Paying for Leadership (in More Ways Than One)

This paper explores the common distinction made between the concepts of “leading” and “managing,” including the tendency to celebrate the former and downplay the value of the latter while ignoring ...
The reduced lighting environment impacts gait characteristics during walking

Abstract Objectives This study aimed to investigate how different light intensities affect human gait patterns during walking. Humans rely on visual information from the surroundings to mediate foot placement and maintain balance during walking. The reduction of light, which diminishes visual input, is recognized as a contributing factor in the incidence of falling; however, such impact on gait characteristics has not been identified yet at different constrained levels of light intensities. Methods Twelve healthy adults were instructed to walk at their self-selected pace on a treadmill either in high or low lighting conditions. The light intensity during treadmill walking was reduced using a pair of goggles attached to different layers of window films. Three-dimensional spatiotemporal gait data were collected using a motion capture system. Results The significantly decreased stride length, stride time, double support time, and the significantly increased gait variability of stride length and stance time, were presented in the reduced lighting condition. Conclusions Overall, this study indicates that the lighting intensity impacts gait adjustments during walking. Underground workers navigating in a dim and constrained environment could alter their walking patterns that relate to falling accidents. Relevance to industry Slips, trips and falls are common accidents occurred in underground workers which correlate to the insufficient lighting condition. This study investigated the impact of different lighting conditions on gait adjustment which contributes to the safety of workers situating in a reduced lighting environment.
Instructional Design Competencies for Online High School Teachers Modifying their own Courses

This study identifies competencies specific and beneficial to online high school teachers that are modifying their own courses. Existing instructional design standards, available to guide online teachers, are not only too numerous, they are also inconsistent. Moreover, a lack of clarity exists about which specific standards benefit this emerging professional group in the process of developing and revising their courses. The Delphi design enabled participants in related fields and separated by physical distance to make and refine judgments without stress and with anonymity, to achieve consensus on specific competencies. Based on this consensus, online high school educators now have a clearly defined set of instructional design competencies that will support modifying learning objects within their classes.
Bioinspired Tuned Mass Damper for Mitigation of Wind-Induced Building Excitation

AbstractThis paper presents a novel bioinspired actuator that mimics the sacrificial bond and hidden length mechanism, a highly efficient energy dissipation mechanism found in bio-organisms such as...
Analysis of a distributed estimation and control scheme for formation flying spacecraft

Abstract The stability characteristics of a distributed consensus-based Kalman filter estimation and control scheme are studied through analytic and numerical means. This estimation scheme seeks to minimally reduce the necessary bandwidth for communication while maintaining overall stability. A weaker form of the separation principle is proven to hold whereby control could be designed independently but not estimation. However, actuation limitations still provide the possibility for a semi-independent design of estimators. Numerical simulations confirm that the stability depends very heavily on consensus on estimation and ultimately the amount of information available to the system as it evolves.
Wnt/β-catenin signaling regulates IL-15-mediated terminal maturation and interferon-gamma production of invariant NKT cells.

The Wnt/β-catenin signaling pathway is important for various cellular functions including survival and proliferation. The indispensable role of this pathway in conventional T cell development is well established but little is known about its role in innate T cell development. In this study, we investigated the role of the Wnt/β-catenin signaling in the development of invariant natural killer T (NKT) cells using mice that express a constitutively active form of b-catenin (CAT-Tg) or deficient in β-catenin (CAT-KO). Thymic NKT cells were increased in CAT-Tg and decreased in CAT-KO mice compared to their wild type littermates. Thymic NKT cells progress from Stage 0 to Stage 3 as they mature. In the absence of Wnt signaling (CAT-KO), we observed accumulation of Stage 0 NKT cells. In contrast, in CAT-Tg mice, the final maturation was compromised - more Stage 2 but less Stage 3 NKT cells. Thus, stage-specific regulation of Wnt signaling may be critical for the thymic NKT development. Indeed, endogenous β-catenin expression was high in early stages but low in late stages, suggesting that its reduction mounts the stage-2 to -3 NKT transition. The CAT-Tg mice also had lower number of IFN-gamma expressing NKT cells, which, in these cells, correlated with reduced expression of transcription factor Tbet and CD122 (IL-2R & IL-15R subunit), requisites for final maturation and IFN-gamma expression of NKT cells. Further, although PLZF, a master transcription factor for NKT cell development is expressed at high levels in CAT-Tg NKT cells, Wnt signaling-mediated NKT cell maturation was found to be independent of PLZF. Together, our data shows that regulation of Wnt/β-catenin signaling is necessary for terminal maturation and IFN-gamma production of NKT cells.
Relationship Between State-Level Google Online Search Volume and Cancer Incidence in the United States: Retrospective Study

Background: In the United States, cancer is common, with high morbidity and mortality; cancer incidence varies between states. Online searches reflect public awareness, which could be driven by the underlying regional cancer epidemiology. Objective: The objective of our study was to characterize the relationship between cancer incidence and online Google search volumes in the United States for 6 common cancers. A secondary objective was to evaluate the association of search activity with cancer-related public events and celebrity news coverage. Methods: We performed a population-based, retrospective study of state-level cancer incidence from 2004 through 2013 reported by the Centers for Disease Control and Prevention for breast, prostate, colon, lung, and uterine cancers and leukemia compared to Google Trends (GT) relative search volume (RSV), a metric designed by Google to allow interest in search topics to be compared between regions. Participants included persons in the United States who searched for cancer terms on Google. The primary measures were the correlation between annual state-level cancer incidence and RSV as determined by Spearman correlation and linear regression with RSV and year as independent variables and cancer incidence as the dependent variable. Temporal associations between search activity and events raising public awareness such as cancer awareness months and cancer-related celebrity news were described. Results: At the state level, RSV was significantly correlated to incidence for breast (r=.18, P=.001), prostate (r=–.27, P<.001), lung (r=.33, P<.001), and uterine cancers (r=.39, P<.001) and leukemia (r=.13, P=.003) but not colon cancer (r=–.02, P=.66). After adjusting for time, state-level RSV was positively correlated to cancer incidence for all cancers: breast (P<.001, 95% CI 0.06 to 0.19), prostate (P=.38, 95% CI –0.08 to 0.22), lung (P<.001, 95% CI 0.33 to 0.46), colon (P<.001, 95% CI 0.11 to 0.17), and uterine cancers (P<.001, 95% CI 0.07 to 0.12) and leukemia (P<.001, 95% CI 0.01 to 0.03). Temporal associations in GT were noted with breast cancer awareness month but not with other cancer awareness months and celebrity events. Conclusions: Cancer incidence is correlated with online search volume at the state level. Search patterns were temporally associated with cancer awareness months and celebrity announcements. Online searches reflect public awareness. Advancing understanding of online search patterns could augment traditional epidemiologic surveillance, provide opportunities for targeted patient engagement, and allow public information campaigns to be evaluated in ways previously unable to be measured.
Sex differences in cerebrovascular pathologies on FLAIR in cognitively unimpaired elderly

Objective To examine sex differences in cerebrovascular pathologies (CVPs) as seen on fluid-attenuated inversion recovery (FLAIR) MRI and in cardiovascular and metabolic risk factors in a population-based cognitively unimpaired cohort and to examine whether sex is independently associated with FLAIR findings after accounting for differences in important midlife risk factors. Methods We identified 1,301 cognitively normal participants (663 men and 638 women) enrolled in the Mayo Clinic Study of Aging (age ≥70 years) who had FLAIR MRI and ascertained total burden of white matter (WM) hyperintensities (WMH), subcortical infarctions, and cortical infarctions. We compared CVPs and midlife and late-life vascular risk factors between men and women. We fit regression models with each CVP as an outcome, treating age, sex, and midlife risk factors as predictors. Results Women had significantly greater WMH volume relative to their WM volume compared to men (2.8% vs 2.4% of WM, p p Conclusions There were important sex differences in CVP findings on FLAIR in cognitively unimpaired elderly. Understanding these sex differences could aid in the development of sex-specific preventive strategies.
Recurrence Identities of b-ary Partitions

Solving the b-ary partition problem, counting the number \(p_b(n)\) of partitions of n into powers of b, is a pursuit which dates back to Euler. The function \(p_b(n)\) satisfies a recurrence, and this note examines a family of identities which can be deduced by iterating the recurrence in a suitable way. These identities can then be used to calculate \(p_b(n)\) for large values of n. Further, these identities correspond to generating function identities involving a sequence of polynomials which have suggestive connections to Eulerian polynomials.
Blackmun's List

In Flood v. Kuhn, 407 U.S. 258 (1972), a majority of the Supreme Court voted to reaffirm its holding from a half-century earlier that the business of baseball did not affect interstate commerce and thus was exempt from the antitrust laws. In Part I of his remarkable majority opinion, Justice Harry Blackmun regales the wonders of baseball and then lists, without citation, "the many names, celebrated for one reason or another, that have sparked the diamond and its environs and that have provided tinder for recaptured thrills, for reminiscence and comparisons, and for conversation and anticipation in-season and off-season." He lists 88 names of ballplayers, owners, managers, one umpire and one sports writer. In this paper, I reveal for the first time the source of Blackmun's list. In addition, using Justice Blackmun's papers from the Library of Congress and other sources, I explore the Justice's personal views about the game and relate his comments over the years to what he characterized in correspondence as his most favorite opinion. Although Justice Blackmun took time to extol baseball's eternal verities, he could not have considered how baseball's reserve system impacted on the lives of the men he celebrated in his list. Using interviews conducted in the 1960s by Lawrence Ritter that are now at the Baseball Hall of Fame in Cooperstown (where I currently serve on my sabbatical as Scholar-in-Residence), the paper reconstructs the careers and experiences of the men on Blackmun's list from their earliest professional games until their retirements.
Specific Responsivity: An Assessment of the Effect of Verbal and Math Cognitive Abilities on the Completion of Prison Programs

The risk, need and responsivity (RNR) model has emerged as an influential factor in the paradigm shift experienced by the American correctional system. Apparent by the existing literature, scholars...
Social Facilitation, Psychology of

Social facilitation refers to the effect of the presence of others on the individual. This rudimentary form of social influence has been studied experimentally since 1898. A large body of evidence has accumulated to indicate that individuals perform simple tasks more quickly in the presence of others, but that the presence of others impairs performance of complex tasks. Effects of the presence of others on animal behavior and human physiology have also been reported. Illustrative studies are reviewed, as are explanations for the social facilitation and impairment of human task performance.
MDM2 and MDMX Regulators of p53 Activity

MDM2 possesses three activities that, together, effectively inhibit the p53 tumor suppressor. First, it binds to p53 and sterically blocks p53 interaction with TATA box protein accessory factors thereby shutting down its transcriptional transactivation function. Second, MDM2 shuttles p53 from its site of action within the nucleus into the cytoplasm. Third, MDM2 is an E3 ligase that transfers ubiquitin onto lysine residues of p53. Ubiquitinated p53 is rapidly degraded by the 26S proteosome. Because the MDM2 oncoprotein mediates three progressive stages of inhibition, it is the principal regulator of p53 activity. TheMDM2gene is located on chromosome 12q14.3-q15 and is amplified in several types of neoplasms, most of which are of mesenchymal tissue origin. MDM2 binding to p53 can be inhibited by phosphorylation of either MDM2 or p53. The kinases responsible for this phosphorylation are activated by cell stressors in general (hypoxia, nitric oxide, hydrogen peroxide) and DNA damaging agents in particular (ionizing radiation, UV-light). MDM2 can be inhibited by RAS or MYC oncoproteins. RAS and MYC activate the tumor suppressor protein p19Arf which sequesters MDM2 into the nucleolus and, in doing so, allows p53 levels to rise. The MDM2gene is activated by p53, which means that, in effect, p53 inhibits itself through MDM2. The cell requires a fine balance of MDM2 and p53 to maintain cell growth and a rapid response to stressors. MDMX is a paralog of MDM2 that has retained the ability to inhibit p53 binding to TATA box protein accessory factors. MDMX does not possess other p53 inhibitory activities. There has been recent progress in the development of small molecules that block MDM2 from binding to p53. Although these molecules are in the early stages of development, it is hoped that they will contribute to the war on cancer. This chapter summarizes the key studies that have increased our understanding of the interplay between p53, MDM2, and MDMX.
Narcissism and Involvement in Risk-Taking Behaviors

Multiple studies investigated the effects of narcissism on risk-taking behaviors utilizing both self-report and behavioral measures. Most research focused on grandiose narcissism. Recently, research has also assessed vulnerable narcissism and relationships between the homogenous traits of narcissism and risk-taking behavior. Grandiose narcissism was linked with increased involvement in risky sexual behaviors, sexual aggression, aggressive driving, compulsive exercise, alcohol use and abuse, illicit drug use and abuse, compulsive buying behaviors, and gambling. Vulnerable narcissism was associated with aggressive driving and compulsive buying behaviors. The homogenous traits of narcissism, including grandiosity, exploitativeness, and entitlement, were associated with sexual aggression, involvement in high-risk sports, gambling, and unethical behaviors. With regard to performance on behavioral measures designed to assess risk-taking behaviors, the relationship between narcissism and risk-taking is more mixed. The mechanisms underlying why narcissists take risks are also examined. Avenues for future study are presented.
Burnout Among Physicians, Advanced Practice Clinicians and Staff in Smaller Primary Care Practices

Burnout among primary care physicians, advanced practice clinicians (nurse practitioners and physician assistants [APCs]), and staff is common and associated with negative consequences for patient care, but the association of burnout with characteristics of primary care practices is unknown. To examine the association between physician-, APC- and staff-reported burnout and specific structural, organizational, and contextual characteristics of smaller primary care practices. Cross-sectional analysis of survey data collected from 9/22/2015–6/19/2017. Sample of smaller primary care practices in the USA participating in a national initiative focused on improving the delivery of cardiovascular preventive services. 10,284 physicians, APCs and staff from 1380 primary care practices. Burnout was assessed with a validated single-item measure. Burnout was reported by 20.4% of respondents overall. In a multivariable analysis, burnout was slightly more common among physicians and APCs (physician vs. non-clinical staff, adjusted odds ratio [aOR] = 1.26; 95% confidence interval [CI], 1.05–1.49, APC vs. non-clinical staff, aOR = 1.34, 95% CI, 1.10–1.62). Other multivariable correlates of burnout included non-solo practice (2–5 physician/APCs vs. solo practice, aOR = 1.71; 95% CI, 1.35–2.16), health system affiliation (vs. physician/APC-owned practice, aOR = 1.42; 95%CI, 1.16–1.73), and Federally Qualified Health Center status (vs. physician/APC-owned practice, aOR = 1.36; 95%CI, 1.03–1.78). Neither the proportion of patients on Medicare or Medicaid, nor practice-level patient volume (patient visits per physician/APC per day) were significantly associated with burnout. In analyses stratified by professional category, practice size was not associated with burnout for APCs, and participation in an accountable care organization was associated with burnout for clinical and non-clinical staff. Burnout is prevalent among physicians, APCs, and staff in smaller primary care practices. Members of solo practices less commonly report burnout, while members of health system-owned practices and Federally Qualified Health Centers more commonly report burnout, suggesting that practice level autonomy may be a critical determinant of burnout.
Management of Crush Injuries and Crush Syndrome

Crush injury – Occurs as a result of pressure applied to any part of the body, usually extremities, for a prolonged period of time. It may be associated or not with limb fractures. Complications of a crush injury are crush syndrome and compartment syndrome.
Electrospinning 3D Nanofiber Structure of Polycaprolactone Incorporated with Silver Nanoparticles

This study presents a one-station 3D fabrication technique of nanofibrous scaffold for tissue engineering. A divergence static electric field was introduced in an electrospinning system to induce a self-assembly of aligned polycaprolactone (PCL) nanofibers into a tunable 3D architecture with thickness ranging from 2 to 12 mm. Silver nanoparticles were incorporated into the PCL solution to alter the electrical conductivity. Human fibroblast cells were cultured on the pure PCL nanofiber scaffolds in vitro for 7 days. It was found that the occurrence of nanofiber bridging phenomenon depended on the solution viscosity. The minimum viscosity to form a 3D nanofiber structure was higher than that to form a 2D nanofiber mat. The homogeneity of nanofiber distribution within the 3D space was positively correlated with the electrical conductivity and the weight of the nanofibers. In the cell culture test, fibroblasts proliferated on the scaffold and organized as an aligned matrix which mimicked the microstructure of native musculoskeletal tissues.
Housing, liquidity risk, and monetary policy

Abstract There is increasing recognition that the effects of monetary policy are not symmetric across different sectors in the economy. For example, in recent empirical work, Givens and Reed (2018) focus exclusively on the capital goods sector and find that the impact of monetary policy on residential investment is more than twice as high as the behavior of fixed investment at the aggregate level. Why are the effects of monetary policy on residential investment so impactful compared to the overall capital sector? Further, what role do financial intermediaries play in promoting housing which is a significant component of personal wealth in the United States? To address the importance of housing for wealth accumulation, we study a model in which housing is traded across generations of individuals. Following Diamond and Dybvig (1983), individuals face stochastic liquidity preference shocks which impede housing accumulation. Intermediaries arise to help insure individuals against such idiosyncratic risk. However, inflation also limits the extent of risk-sharing. In this manner, the model follows recent contributions which emphasize that shocks to discount rates contribute to wealth inequality. Moreover, in contrast to one-sector monetary growth models, we demonstrate that it is important to disaggregate fixed investment between the residential and non-residential sectors to determine the effects of money growth. In particular, monetary policy will have asymmetric effects across the components of the overall capital stock.
How do Lebanese patients perceive the ideal doctor based on the CanMEDS competency framework

During their training, Lebanese medical students develop a high medical expertise but are not focusing on other competencies such as communication, collaboration, erudition, professionalism, leadership and health promotion. There is also insufficient data about patients’ preference for these skills. This study describes the different weights patients attribute to these physician’s competencies. This is a cross-sectional study based on a questionnaire distributed to 133 Lebanese patients. It included 15 questions assessing how patients prioritize the physician’s competencies, with open-ended questions asking them to define “the good doctor”. Krippendorff’s alpha coefficient was used to analyze the reliability of the competencies’ classification. One hundred twenty five patients completed the questionnaire in this cross-sectional study. Their mean age was 48 ± 16.76 years. When classifying competencies, 73.6% opted for medical expertise as first choice and 48% put communication as second. Based on the Krippendorff’s coefficient, we identified a moderate agreement for the seven choices (alpha = 0.44). In open-ended questions, patients defined the good doctor in 325 answers: 64.3% mentioned medical expertise, 34.1% high ethics and 26.2% communication. This patient-centered study concurs well with the worldwide practice that puts medical expertise at the center of medical education. However Lebanese patients don’t perceive equally other competencies and favor professionalism and communication that should be integrated in priority in students’ curricula.
Remittances and household spending strategies: evidence from the Life in Kyrgyzstan Study, 2011–2013

Globalised labour migration and remittances can help alleviate household poverty and provide supplemental income in many countries. Kyrgyzstan, like other Central Asian countries, has experienced d...
Race and socioeconomic differences associated with endovascular peripheral vascular interventions for newly diagnosed claudication.

Abstract Background Despite guidelines cautioning against the use of endovascular peripheral vascular interventions (PVI) for claudication, more than 1.3 million PVI procedures are performed annually in the United States. We aimed to describe national rates of PVI for claudication, and identify patient and county-level risk factors associated with a high rate of PVI. Methods We used the Medicare claims database to identify all Medicare beneficiaries with a new diagnosis of claudication between January 2015 and June 2017. A hierarchical logistic regression model accounting for patient age, sex, comorbidities; county region and setting; and a patient race-county median income interaction was used to assess the associations of race and income with a high PVI rate. Results We identified 1,201,234 patients with a new diagnosis of claudication for analysis. Of these, 15,227 (1.27%) underwent a PVI. Based on hierarchical logistic regression accounting for patient and county-level factors, black patients residing in low-income counties had a significantly higher odds of undergoing PVI than their white counterparts (odds ratio [OR], 1.30; 95% confidence interval [CI], 1.20-1.40), whereas the odds of PVI for black versus white patients was similar in high-income counties (OR, 1.06; 95% CI, 0.99-1.14). PVI rates were higher for low versus high-income counties in both the black (OR, 1.46; 95% CI, 1.31-1.64) and white (OR, 1.19; 95% CI, 1.12-1.27) groups. There were no significant associations of Hispanic, Asian, North American native, or other races with PVI in either low- or high-income counties after risk adjustment (all P ≥ .09). Conclusions In the Medicare population, the mean rate of PVI of 12.7 per 1000 claudication patients varies significantly based on race and income. Our data suggest there are racial and socioeconomic differences in the treatment of claudication across the United States.
Chemical roadblocking of DNA transcription for nascent RNA display

Site-specific arrest of RNA polymerases (RNAPs) is fundamental to several technologies that assess RNA structure and function. Current in vitro transcription "roadblocking" approaches inhibit transcription elongation by blocking RNAP with a protein bound to the DNA template. One limitation of protein-mediated transcription roadblocking is that it requires inclusion of a protein factor extrinsic to the minimal in vitro transcription reaction. In this work, we developed a chemical approach for halting transcription by Escherichia coli RNAP. We first established a sequence-independent method for site-specific incorporation of chemical lesions into dsDNA templates by sequential PCR and translesion synthesis. We then show that interrupting the transcribed DNA strand with an internal desthiobiotin-triethylene glycol modification or 1,N6-etheno-2'-deoxyadenosine base efficiently and stably halts Escherichia coli RNAP transcription. By encoding an intrinsic stall site within the template DNA, our chemical transcription roadblocking approach enables display of nascent RNA molecules from RNAP in a minimal in vitro transcription reaction.
Squared Primes Modulo 24

We show visually that the square of a prime greater than or equal to 5 is congruent to 1 modulo 24.
Opt-Out, Routine Emergency Department Syphilis Screening as a Novel Intervention in At-Risk Populations.

Background With syphilis rates rising rapidly in the United States, novel means of reaching high-risk populations for screening and treatment are needed. Building on successful models for emergency department (ED) HIV screening, a routine opt-out syphilis screening program was implemented in a large, urban, tertiary care hospital ED in May 2019. This study aims to assess the prevalence of syphilis in this population and to evaluate the routine, opt-out syphilis screening model. Methods A retrospective chart review was performed of all patients screened for syphilis in the ED from June through December 2019. Demographic information, HIV status, chief complaint, and follow up visits were examined. Results During the study period, 9198 people ages 18 to 64 were screened for syphilis. Of these, 97 (1.1%) had presumed active syphilis infection (PAI), 354 (3.8%) were presumed not to have active syphilis, and 8747 (95.1%) were negative for infection. PAI were more likely to be male (67%, aOR 3.5, 95% CI (2.3, 5.3), p Conclusions Syphilis rates in this community are very high, and many infections were found in populations traditionally considered lower risk by demographic or presenting complaint, indicating that universal screening is needed. Routine ED syphilis screening in high-prevalence communities will be critical to addressing the syphilis epidemic.
Complicated, Complete, Indirect, Irreducible Right Inguinoscrotal Hernia:

Inguinal hernias are the most common of all hernias. A complicated hernia is irreducible, and the contents are obstructed or strangulated. Sonography is considered the imaging modality of choice fo...
Studies on the electron transfer system. XXV. The isolation and properties of a lipoflavoprotein with diaphorase activity from beef heart mitochondria.

A broad spectral absorbance band in the near infrared region of cytochrome oxidase* (cf. Fig. 1) was first reported by Griffiths and Wharton (2). They observed that this band near 830 rnp disappeared on complete reduction of the enzyme by substrate and reappeared on reoxidation. The rate of these changes was roughly equivalent to the rate of the changes observed in the a-peak at 605 rnp. In addition, they found that in the presence of cyanide the chromophore could be reduced but could not be reosidized. Recent,ly, Gibson and Greenwood2 observed, through the use of rapid reaction techniques, that the kinetics of the changes in the absorbance of cytochrome oxidase in the near infrared region and in the or-band were essentially identical, These data support the hypothesis that the chromophore absorbing near 830 rnp is an integral component of cytochrome oxidase, but they do not identify the chromophore. The accumulat’ing evidence that many copper-containing prot,eins exhibit absorption bands in the near infrared region (3-6), together with the demonstration that purified preparations of cytochrome oxidase contain copper (2, 7-12), directed our attention toward the possibliity that this metal may be a constituent of the chromophore in question. In this communication, experiments are described that establish a precise correlation among the intensity of the near infrared band, the copper content, and specific activity. This correlation persists as the values of these entities are decreased or obliterated by a variety of treatments and are partially restored by others.
Public–Private Partnerships and Contract Choice in India’s Water and Wastewater Sectors:

Public provision of water and wastewater services in urban India has been a noteworthy failure, often providing service that ranges from non-existent to unreliable. Over the past decade, a number of reforms were undertaken that focused on infrastructure construction and urban governance, including broader use of public–private partnerships (PPPs). We examine a new data set of 163 water and wastewater PPP contracts initiated during 1999-2012 to study the determinants of a city’s decision to invite varying amounts of private participation though a PPP agreement. Cities with larger populations, better PPP regulatory environments, regional party rule, and lower sanitation scores are associated with higher levels of private participation through PPPs. Indian municipalities have often failed to engage the public before and during contract discussions, sometimes resulting in lukewarm public support for PPPs. Our findings highlight the role of cities’ socioeconomic indicators in determining the type of PPP contra...
Early Growth and Cognitive Development in Children Born Preterm: Relevance of Maternal Body Mass Index.

Objective Maternal pre-pregnancy body mass index (BMI) represents a surrogate marker of fetal exposures to the maternal metabolism during pregnancy. Yet, it remains poorly understood whether this marker indicates risk of altered trajectories in postnatal growth and development in children born preterm. This study aimed to determine whether maternal pre-pregnancy BMI is associated with altered growth and development in children born preterm. Study design A retrospective cohort study evaluated pre-pregnancy BMI as the exposure for childhood outcomes using linear regression and mixed effects models. The 38 children included in this follow-up evaluation originally participated in a prospective, observational cohort study to determine longitudinal levels of lipid species in preterm human milk expressed by women who delivered prior to 32 weeks. Childhood outcomes in this study were anthropometric measures during hospitalization (n = 38), after discharge through 36 months (n = 34) and Bayley-III developmental scores through 18 months corrected age (n = 26). Results In 38 children born prior to 32 weeks, higher maternal pre-pregnancy BMI was independently associated with higher preterm infant growth velocity during hospitalization, but not associated with in-hospital change in length or head circumference and/or postdischarge growth. In univariate linear regression models, higher maternal BMI was associated with lower cognitive scores at 18 months corrected age. This significant association remained in an adjusted model accounting for relevant influences on early childhood development. Conclusion Increasing maternal pre-pregnancy BMI may reflect risk of altered growth and cognitive development in children born preterm. Key points · Maternal BMI was associated with early preterm infant weight gain.. · Maternal BMI was not associated with postdischarge growth.. · Increased maternal BMI may be associated with lower cognitive function scores in offspring..
Detection of Central Retinal Artery Occlusion by Point-of-Care Ultrasound in the Emergency Department: A Case Series.

Central retinal artery occlusion (CRAO) is a rare, but serious, diagnosis that can lead to blindness, most often due to thromboembolic disease. In the emergency department (ED), CRAO can present as acute, painless loss of vision. Physicians need quick ways to rule in this diagnosis due to the time-sensitive nature of the event. We describe two patients in this cases series who present to the same ED with unilateral painless vision loss and histories that include notable risk factors such as thromboembolic and atherosclerotic disease. Upon arrival, point-of-care ultrasound (POCUS) done at the bedside allowed for quick determination of CRAO. ​​​​​​​The importance of this case series is to emphasize the efficacy of POCUS in evaluating patients with painless vision loss in the ED setting.
Toward a Unified Componential Theory of Human Intelligence: I. Fluid Ability

A progress report on the development of a unified theory of human intelligence is presented. The report deals with that portion of the theory that concerns fluid ability, which is viewed as roughly synonymous with reasoning. The unified theory applied to reasoning comprises a number of hierarchically nested subtheories, each of which accounts for successively more specific aspects of human reasoning behavior. The basic unit of the theory is the component: It is claimed that a relatively small set of components can account for behavior in a wide range of reasoning tasks, and that individual components are general across the vertical range of the hierarchy. The components and the sub-theories in which they play a part are briefly described, and where available, data testing the subtheories are summarized. These data provide at least tentative support for the proposed theoretical structure.
Dynamic Spectrum Management: Optimization and Game Theoretic Formulations

Achieving efficient spectrum usage is a major challenge in the management of a complex communication system. With multiple users having conflicting objectives who share a common spectrum, some of whom may be hostile, careful resource allocation is essential for the effective utilization of the available frequency. Conventionally, spectrum sharing is achieved via orthogonal transmission schemes whereby the available frequency band is divided into multiple tones (or bands) which are pre-assigned to all the users on a non-overlapping basis. However, such "static orthogonal spectrum sharing" approach can lead to low bandwidth utilization. In fact, various recent spectrum occupancy studies have demonstrated that a typical geographical region has wide swathes of frequencies (up to 2/3 of the allocated radio spectrum) that are not used at any given time. While the utilization of spectrum varies with time, a significant amount of spectrum is available for opportunistic wireless applications among secondary users. Spectrum-sensing cognitive radio technology allows devices to dynamically and automatically seek out and use the optimum frequencies and bandwidth. To take advantage of the unused spectrum capacity, the users dynamically adapt to the spectral environment and change transmission or reception parameters on the fly. This allows for more efficient wireless communication without causing harmful interference with legacy systems or other devices using the same frequency bands. In these systems all users are allowed to use all the tones simultaneously. In comparison with the static spectrum sharing policies, this setup offers significantly greater freedom in utilizing the spectrum. A major challenge in the development of opportunistic spectrum sharing technology is to devise efficient algorithms for the distributed management of frequency slots and transmit power. This tutorial will describe various optimization and game theoretic formulations of the dynamic spectrum management and present some recent results on its complexity, duality and approximation.