cssi/SciSciGPT-SciSciNet huggingface dataset:
Enhancing Fluoride: Clinical Human Studies of Alternatives or Boosters for Caries Management

Dental caries remains a major public health problem, especially for certain high-risk population groups. The goal of this study was to assess the evidence regarding strategies meant to be used as alternatives or booster/supplements to fluoride for caries prevention and management. Articles were selected for inclusion if they had a prospective longitudinal design, with a fluoride control arm, and were conducted in human subjects. Of the included studies, 7/18 studies on calcium-based strategies favored the test product (the majority of studies included exposure of fluoride in all groups). All the arginine studies (8/8) included a combination of arginine and a calcium base, and concluded that this has the potential to significantly boost the performance of fluoride. The remaining included studies focused on the addition of microbial-related strategies to a fluoride-containing vehicle (2 xylitol studies and 1 study using a probiotic milk), and all favored the combination as a booster to fluoride. Thus, the current study did not identify evidence for any strategy to effectively be used as a substitute or alternative to fluoride, but identified some consistent evidence derived from the use of prebiotic strategies (primarily from use of arginine combined with calcium) to support their potential use to boost the mechanism of action of fluoride. Thus, fluoride-based strategies remain the standard for caries prevention and management, with some evidence that boosting the effects of fluoride by the use of prebiotic strategies is a promising possibility.
Corrosive Wear Property of Material of Oil Tubing in Sand-Oil-Water Liquid

Using a rotating disc type corrosive wear tester,a corrosive wear test with different speeds in sand-water liquid and in sand-oil-water liquid were carried out to evaluate the corrosive wear property of material of J55 grade tubing.The results of experiments indicate that the worn loss of the sample in sand-oil-water liquid is higher than that in sand-water liquid.The worn loss of the sample in sand-water liquid is caused by mechanical grinding.The worn loss of the sample in sand-oil-water liquid is caused by corrosion and mechanical grinding.This results in heavy worn loss of the sample in sand-oil-water liquid.
Clinical Study of Acupuncture and Cupping for Treatment of Recurrent Vomiting Children

Objective:To investigate the effectiveness of acupuncture and cupping for treatment of recurrent vomiting.Methods:20 children with recurrent vomiting were treat by acupuncture and cupping.Results:20 children were cured,2children were improved.Totle effective rate is 100%.Conclusion:Acupuncture and cupping is effective treatment for recurrent vomiting and worth further clinical promoting.
Vaxar: A web-based database of laboratory animal responses to vaccinations and its application in the meta-analysis of different animal responses to tuberculosis vaccinations

Animal models are indispensable for vaccine research and development. However, choosing which species to use and designing a vaccine study that is optimized for that species is often challenging. Vaxar (http://www.violinet.org/vaxar/) is a web-based database and analysis system that stores manually curated data regarding vaccine-induced responses in animals. To date, Vaxar encompasses models from 35 animal species including rodents, rabbits, ferrets, primates, and birds. These 35 species have been used to study more than 1300 experimentally tested vaccines for 164 pathogens and diseases significant to humans and domestic animals. The responses to vaccines by animals in more than 1500 experimental studies are recorded in Vaxar; these data can be used for systematic meta-analysis of various animal responses to a particular vaccine. For example, several variables, including animal strain, animal age, and the dose or route of either vaccination or challenge, might affect host response outcomes. Vaxar can also be used to identify variables that affect responses to different vaccines in a specific animal model. All data stored in Vaxar are publically available for web-based queries and analyses. Overall Vaxar provides a unique systematic approach for understanding vaccine-induced host immunity.
Exposing the Spectrum of Whiteness

This chapter continues a practice introduced by critical communication scholars to produce insightful analyses of whiteness. Specifically, this chapter synthesizes a body of rhetorical studies in which rhetors explicitly offered ideal white racial identities and cultural norms to establish and justify white supremacy in Western societies. I call this discourse “white absolutism,” which consists of absolutist religious and scientific appeals, tribalism, and scapegoating. White absolutism centers white masculinity and justifies restoring white patriarchal heterosexual control by negating black, nonwhite, and feminine archetypes that offer motives to conquer, control, and kill nonwhites. White absolutism still exists in coded and postmodern forms, and its scholarly analyses have generated four important areas of communication research: (1) cyberspace hate rhetoric, (2) cultural (re)productions of white superiority, (3) historical studies of whiteness, and (4) new, redemptive, and innocent white identity studies.
Economics of the Oceans: Rights, Rents and Resources

Economics of the Oceans fills a critical gap between broad environmental economics texts and marine resource texts focused on only one resource. Its major strength is the ease with which Paul Hallwood blends background information, case studies and economic theory. He clearly demonstrates that basic microeconomic principles still apply in the ocean, even out on the anarchic waves of the high seas.
Sein und Seinsart der idealen Ordnungsgebilde

Bisher wurde nur das „Wesen“, das Sosein der idealen Ordnungsgebilde untersucht. Ihr Dasein blieb auser Betracht. Unbefangen durch die Frage, ob es denn so etwas wie die gemeinten Gebilde auch tatsachlich gebe, ob sie nicht etwa Einbildungen oder Tauschungen seien, sollte der Bestand der Phanomene aufgenommen und ihre Struktur analysiert werden. Erst von hier aus last sich uber Sein und Seinsart dieser Gebilde entscheiden.
Livestock grazing affects vernal pool specialists more than habitat generalists in montane vernal pools

Questions Do livestock grazing and seasonal precipitation structure species composition in montane vernal pools? Which grazing and precipitation variables best predict cover of vernal pool specialists and species with broader habitat requirements? Is vernal pool species diversity correlated with livestock exclosure, and at what spatial scales? Location Montane vernal pools in northeastern California Methods Vegetation was sampled in twenty vernal pools, including pools where livestock had been excluded for up to twenty years. We compared plant species composition, functional group composition, and species diversity among sites that varied in grazing history and seasonal precipitation using CCA and linear mixed effects models. Results Although vernal pool specialists were dominant in montane vernal pools, over a third of plant cover was comprised of species that occur over a broad range of wetland or upland environments. The species composition of vernal pool plant communities was influenced by both livestock grazing and precipitation patterns, however the relative effects of these environmental variables differed by functional group. Livestock exclosures favored perennial vernal pool specialists over annual vernal pool specialists. By contrast, the cover of habitat generalists was more strongly influenced by seasonal precipitation than livestock grazing. At small spatial scales, species richness and diversity decreased as the number of years a pool had been fenced increased, but this relationship was not significant at a larger spatial scale. Conclusions Both livestock grazing and seasonal precipitation structure the montane vernal pool plant community. We found that livestock grazing promotes the cover of annual vernal pool specialists, but at the expense of perennial vernal pool specialists. Wetter vernal pools, however, support higher cover of wetland generalist species regardless of whether pools are grazed. This article is protected by copyright. All rights reserved.
Dosimetric effects of saline- versus water-filled balloon applicators for IORT using the model S700 electronic brachytherapy source.

Abstract Purpose The Xoft Axxent Electronic Brachytherapy System (Xoft, Inc., San Jose, CA) is a viable option for intraoperative radiation therapy (IORT) treatment of early-stage breast cancer. The low-energy (50-kVp) X-ray source simplifies shielding and increases relative biological effectiveness but increases dose distribution sensitivity to medium composition. Treatment planning systems typically assume homogenous water for brachytherapy dose calculations, including precalculated atlas plans for Xoft IORT. However, Xoft recommends saline for balloon applicator filling. This study investigates dosimetric differences due to increased effective atomic number (Z eff ) for saline (Z eff = 7.56) versus water (Z eff = 7.42). Methods Balloon applicator diameters range from 3 to 6 cm. Monte Carlo N-Particle software is used to calculate dose at the surface ( D s ) of and 1 cm away ( D 1cm ) from the water-/saline-filled balloon applicator using a single dwell at the applicator center as a simple estimation of the dosimetry and multiple dwells simulating the clinical dose distributions for the atlas plans. Results Single-dwell plans show a 4.4–6.1% decrease in D s for the 3- to 6-cm diameter applicators due to the saline. Multidwell plans show similar results: 4.9% and 6.4% D s decrease, for 4-cm and 6-cm diameter applicators, respectively. For the single-dwell plans, D 1cm decreases 3.6–5.2% for the 3- to 6-cm diameter applicators. For the multidwell plans, D 1cm decreases 3.3% and 5.3% for the 4-cm and 6-cm applicators, respectively. Conclusions The dosimetric effect introduced by saline versus water filling for Xoft balloon applicator–based IORT treatments is ∼5%. Users should be aware of this in the context of both treatment planning and patient outcome studies.
Communication-Based Control for DC Microgrids

Centralized communication-based control is one of the main methods that can be implemented to achieve autonomous advanced energy management capabilities in dc microgrids. However, its major limitation is the fact that communication bandwidth and computation resources are limited in practical applications. This can be often improved by avoiding redundant communications and complex computations. In this paper, an autonomous communication-based hybrid state/event driven control scheme is proposed. This control scheme is hierarchical and heuristic, such that on the primary control level, it encompasses state-driven local controllers, and on the secondary control level, an event-driven microgrid centralized controller is used. This heuristic hybrid control system aims at reducing the communication load and complexity, processor computations, and consequently system cost while maintaining reliable autonomous operation during all possible scenarios. A mathematical model for the proposed control scheme using finite state machines has been developed and used to cover all the possible modes/sub-modes of operation, and assure seamless transitions among them during various events. Results of some case studies involving severe operational scenarios were presented and discussed. Results verify the validity and effectiveness of the proposed communication-based control scheme.
Metastable electronic states in uranium tetrafluoride

The DFT+U approach, where U is the Hubbard-like on-site Coulomb interaction, has successfully been used to improve the description of transition metal oxides and other highly correlated systems, including actinides. The secret of the DFT+U approach is the breaking of d or f shell orbital degeneracy and adding an additional energetic penalty to non-integer occupation of orbitals. A prototypical test case, UO2, benefits from the +U approach whereby the bare LDA method predicts UO2 to be a ferromagnetic metal, whereas LDA+U correctly predicts UO2 to be insulating. However, the concavity of the energetic penalty in the DFT+U approach can lead to a number of convergent "metastable" electronic configurations residing above the ground state. Uranium tetrafluoride (UF4) represents a more complex analogy to UO2 in that the crystal field has lower symmetry and the unit cell contains two symmetrically distinct U atoms. We explore the metastable states in UF4 using several different methods of selecting initial orbital occupations. Two methods, a "pre-relaxation" method wherein an initial set of orbital eigenvectors is selected via the self-consistency procedure and a crystal rotation method wherein the x, y, z axes are brought into alignment with the crystal field, are explored. We show that in the case of UF4, which has non-collinearity between its crystal axes and the U atoms' crystal field potentials, the orbital occupation matrices are much more complex and should be analyzed using a novel approach. In addition to demonstrating a complex landscape of metastable electronic states, UF4 also shows significant hybridization in U-F bonding, which involves non-trivial contributions from s, p, d, and f orbitals.
Comparative effectiveness of school-based caries prevention: a prospective cohort study

Dental caries is the world’s most prevalent childhood disease. School-based caries prevention can reduce the risk of childhood caries by increasing access to care. However, the optimal mix of treatment services, intensity, and frequency of care is unknown. Data were derived from two prospective cohorts of US children participating in two caries prevention programs with different treatment intensities. One program provided primary and secondary prevention (glass ionomer sealants and interim therapeutic restorations) and one primary prevention only (glass ionomer sealants), both given twice yearly in six-month intervals. Primary study outcomes included untreated decay and the total observed caries experience. Analysis used generalized additive models to estimate nonlinear effects and trends over time. Results were compared to those estimated using generalized estimating equations and mixed-effects multilevel Poisson regression. Primary and secondary prevention combined did not significantly reduce total caries experience compared to primary prevention alone, but did reduce the risk of untreated decay on permanent dentition. Additionally, the rate of new caries experience was slower in the primary and secondary prevention group. Nonlinear trends for dental caries across both programs were statistically significant from zero (p < .001). Caries prevention consisting of primary and secondary prevention agents may be more effective than primary prevention alone in reducing the risk of tooth decay over time. Results suggest that the impact of caries prevention may not be constant over the medium- and long-term, suggesting reduced effectiveness with continued treatments.
Thyristor di/dt and current pulse capability

If the initial rate of the anode current rise, di/dt, exceeds a certain value, the thyristor may be either destroyed or permanently damaged due to the excessive junction temperature. The limiting di/dt value depends on the size of the initially turned-on area and on the velocity of the plasma spreading along the n emitter. It is, therefore, advantageous to increase the initially fired area. To achieve this, several methods—such as interdigitation, field-initiated turn on, amplifying gate, and emitter gate—are used.
The Southern Oklahoma Aulacogen: A Cambrian analog for Mid-Proterozoic AMCG (Anorthosite-Mangerite-Charnockite-Granite) complexes?

Comparison of the Cambrian Southern Oklahoma Aulacogen and the distinctive anorthosite-mangerite-charnockite-granite (AMCG) complexes of the Mid-Proterozoic reveal striking similarities in the temporal and spatial association of igneous rock types in these provinces that suggests a commonality in their petrogenesis. Igneous rocks that comprise the Cambrian Southern Oklahoma Aulacogen include: 1) voluminous anorthositic gabbros, 2) Fe-rich, Ti-rich, and P-rich, biotite-bearing gabbros, 3) A-type leucocratic alkali-feldspar rhyolite and granites (some with rapakivi textures, see Price et al., 1996a), and 4) a suite of “late” diabase dikes. Nearly all of these igneous units have counterparts that occur within AMCG complexes. A noticeable exception in the Southern Oklahoma Aulacogen is the absence of coarse grained massif-type anorthosites, with their characteristic high-Al orthopyroxene megacrysts. This important distinction is interpreted to reflect differences in the conditions of crystallization and emplacement of magmas giving rise to these two provinces. AMCG complexes develop at significantly deeper levels in the crust where assimilation of aluminous continental crust may operate more efficiently due to higher ambient temperatures. In contrast, the epizonal to volcanic conditions of crystallization, and lack of evidence for significant contributions of ancient crust in either mafic or felsic igneous rocks, suggest that parent magmas to the igneous rocks of the Southern Oklahoma Aulacogen were rapidly transported to the emplacement level, where they cooled quickly, thus inhibiting opportunities for large scale crustal assimilation. We further speculate that, if exposed, the large mid-crustal mafic root beneath the Southern Oklahoma Aulacogen, inferred from geophysical and petrologic arguments, would have the appearance of a typical Mid-Proterozoic AMCG complex. Conversely, penecontemporaneous tectono-magmatic provinces, such as the Southern Oklahoma Aulacogen, may have overlain Mid-Proterozoic AMCG complexes and have been subsequently removed by erosion.
Concentrically Loaded Circular RC Columns Partially Confined with FRP

Wrapping reinforced concrete (RC) columns with fiber reinforced polymer (FRP) composites is effective in increasing their capacity. The current state of the art concentrates primarily on fully wrapped columns and few studies dealt with partially wrapped ones. The objective herein is to evaluate the effectiveness of partial wraps (or strips) and to develop a confined concrete compressive stress–strain (fc − ec) model that accounts for partial wrapping. Three-dimensional finite element (FE) models are generated to evaluate the influence of different parameters on the behavior of concentrically loaded RC circular columns that are partially and fully wrapped with FRP. The results indicated an increase in ductility as the number of FRP strips is increased, and revealed that longitudinal steel had little influence on the confined fc − ec relationship. The proposed fc − ec model, derived from the parametric study, accounts for the effect of partial and full confinement, the unconfined concrete strength $$ f^{\prime}_{c} $$ , and yielding of transverse steel. Comparison of the results generated using the proposed model with FE and experimental results are in good agreement.
A Markov decision process approach to vacant taxi routing with e-hailing

Abstract The optimal routing of a vacant taxi is formulated as a Markov Decision Process (MDP) problem to account for long-term profit over the full working period. The state is defined by the node at which a vacant taxi is located, and action is the link to take out of the node. State transition probabilities depend on passenger matching probabilities and passenger destination probabilities. The probability that a vacant taxi is matched with a passenger during the traversal of a link is calculated based on temporal Poisson arrivals of passengers and spatial Poisson distributions of competing vacant taxis. Passenger destination probabilities are calculated directly using observed fractions of passengers going to destinations from a given origin. The MDP problem is solved by value iteration resulting in an optimal routing policy, and the computational efficiency is improved by utilizing parallelized matrix operations. The proposed model and an efficient implementation of the value iteration algorithm are tested in a case study with parameters derived from GPS trajectories of over 12,000 taxis in Shanghai, China for a study period of 5:30 - 11:30 am on a typical weekday. The optimal routing policy is compared with three heuristics based on simulated trajectories. Results show that the optimal routing policy improves average unit profit by 23.0% and 8.4% over the random walk and local hotspot heuristic respectively; and improves occupancy rate by 23.8% and 8.3% respectively. The improvement is larger during higher demand periods.
The nonlinear complementarity problem with applications, part 2

The main existence and uniqueness theorem of Part 1 is applied to three specific problems, namely, (a) the symmetric, dual, nonlinear programs of Dantzig, Eisenberg, and Cottle, (b) the saddle point problem of a differentiable scalar function over an unbounded product set, and (c) the equilibrium point problem of ann-person game.
Mammalian Target of Rapamycin: A Metabolic Rheostat for Regulating Adipose Tissue Function and Cardiovascular Health

The complex relationship between diet and metabolism is an important contributor to cellular metabolism and health. Over the past few decades, a central role for mammalian target of rapamycin (mTOR) in the regulation of multiple cellular processes, including the response to food intake, maintaining homeostasis, and the pathogenesis of disease, has been shown. Herein, we first review our current understanding of the biochemical functions of mTOR and its response to fluctuations in hormone levels, like insulin. Second, we highlight the role of mTOR in lipogenesis, adipogenesis, β-oxidation of lipids, and ketosis of carbohydrates, lipids, and proteins. Special attention is paid to recent advances in mTOR signaling in white versus brown adipose tissues. Finally, we review how mTOR regulates cardiovascular health and disease. Together, these insights define a clearer picture of the connection between mTOR signaling, metabolic health, and disease.
Abstract P284: The Chemotherapeutic Agent Docetaxel Disrupts Mitochondrial Energetics in 3D Human Bioengineered Myobundles

Taxanes (i.e. docetaxel, (TAX)) comprise the first line-treatment for breast cancer (BC), mostly in combination with anthracyclines like doxorubicin (DOX). The efficacy of these drugs as antineopla...
Characterization of a stress tolerance-defective mutant of Lactobacillus rhamnosus LRB.

Lactobacillus rhamnosus is a lactic acid bacterium that survives diverse ecological niches, including the human oral cavity and gastrointestinal tract. L. rhamnosus is an acidogenic bacterium that produces copious amounts of lactic acid. The organism is also considered as aciduric, since it can survive prolonged exposure to an acidic environment. For a probiotic bacterium such as L. rhamnosus, it is necessary to understand how this organism survives acid stress. In this study we used L. rhamnosus LRB to isolate one spontaneous mutant that was sensitive to acid stress. The mutant, which we named RBM1, also displayed sensitivity to a wide range of stresses including osmotic, thermal, and others. Using whole genome sequencing, we mapped the putative mutations in the mutant strain. It appears that three single nucleotide substitutions occurred in the mutant as compared to the wild-type LRB strain. Among those, the most relevant mutation occurred in the ftsH gene that created a single amino acid change in the protein. We performed a comparative proteomic study to understand the molecular basis for stress sensitivity and found that ~15% of the proteome is altered in the mutant strain. Our study suggests that generation of spontaneous mutants during L. rhamnosus colonization could drastically affect bacterial physiology and survival under stress conditions.
Interaction-dependent anisotropy of fractional quantum Hall states

In the absence of rotational symmetry, a fractional quantum Hall (FQH) system can exploit a geometric degree of freedom to minimize its ground-state energy. The mass anisotropy of bare particles interacting isotropically is partially inherited by the many-body FQH state, to an extent that depends on the type of interaction, filling fraction, and ground-state phase. Using numerical infinite density matrix renormalization group simulations, we investigate the transference of elliptical (${C}_{2}$-symmetric) anisotropy from the band mass of the bare particles to the FQH states, for various power-law interactions. We map out the response of FQH states to small anisotropy as a function of power-law exponent, filling, and statistics (bosonic or fermionic) of the constituents. Interestingly, we find a nonanalyticity in the linear response of the FQH state at a special filling-dependent value of the power-law exponent, above which the interactions effectively become zero-range (pointlike). We also investigate the effect of ${C}_{4}$-symmetric band distortions, where we observe a strikingly different dependence on filling.
Inferring Networks From Random Walk-Based Node Similarities

Digital presence in the world of online social media entails significant privacy risks. In this work we consider a privacy threat to a social network in which an attacker has access to a subset of random walk-based node similarities, such as effective resistances (i.e., commute times) or personalized PageRank scores. Using these similarities, the attacker seeks to infer as much information as possible about the network, including unknown pairwise node similarities and edges. For the effective resistance metric, we show that with just a small subset of measurements, one can learn a large fraction of edges in a social network. We also show that it is possible to learn a graph which accurately matches the underlying network on all other effective resistances. This second observation is interesting from a data mining perspective, since it can be expensive to compute all effective resistances or other random walk-based similarities. As an alternative, our graphs learned from just a subset of effective resistances can be used as surrogates in a range of applications that use effective resistances to probe graph structure, including for graph clustering, node centrality evaluation, and anomaly detection. We obtain our results by formalizing the graph learning objective mathematically, using two optimization problems. One formulation is convex and can be solved provably in polynomial time. The other is not, but we solve it efficiently with projected gradient and coordinate descent. We demonstrate the effectiveness of these methods on a number of social networks obtained from Facebook. We also discuss how our methods can be generalized to other random walk-based similarities, such as personalized PageRank scores. Our code is available at https://github.com/cnmusco/graph-similarity-learning.
Resisting resistance: gearing up for war

Where do we stand in our fight against antimicrobial resistance (AMR)? Many antimicrobials may lose their clinical efficacy, particularly due to the rise of multidrug-resistant (MDR) and extended drug-resistant (XDR) pathogens, including bacteria, fungi, and parasites. We need weapons against them all. Society must come together against these pathogens, just like we did against HIV, cancer, and heart disease. This opinion piece is, first and foremost, a call to arms for all partners involved in the war against AMR. Even more so, it is an attempt to highlight the positives in a seemingly long line of failures, and to identify the current set of challenges we must work on. So, how do we win the war against AMR? We must learn from the past, so we can act in the present, to save the future.
Wife, Inc.: the business of marriage in the twenty-first century

Author Suzanne Leonard pens Wife, Inc. as a close look into the shifting paradigm at the intersection of pop culture and feminism through the lens of evolving “wifedom.” Her analysis ranges from th...
Inaugural Readmission Penalties for Total Hip and Total Knee Arthroplasty Procedures Under the Hospital Readmissions Reduction Program.

Importance The Hospital Readmissions Reduction Program (HRRP) is a Centers for Medicare and Medicaid Services policy that levies hospital reimbursement penalties based on excess readmissions of patients with 4 medical conditions and 3 surgical procedures. A greater understanding of factors associated with the 3 surgical reimbursement penalties is needed for clinicians in surgical practice. Objective To investigate the first year of HRRP readmission penalties applied to 2 surgical procedures—elective total hip arthroplasty (THA) and total knee arthroplasty (TKA)—in the context of hospital and patient characteristics. Design, Setting, and Participants Fiscal year 2015 HRRP penalization data from Hospital Compare were linked with the American Hospital Association Annual Survey and with the Healthcare Cost and Utilization Project State Inpatient Database for hospitals in the state of Florida. By using a case-control framework, those hospitals were separated based on HRRP penalty severity, as measured with the HRRP THA and TKA excess readmission ratio, and compared according to orthopedic volume as well as hospital-level and patient-level characteristics. The first year of HRRP readmission penalties applied to surgery in Florida Medicare subsection (d) hospitals was examined, identifying 60 663 Medicare patients who underwent elective THA or TKA in 143 Florida hospitals. The data analysis was conducted from February 2016 to January 2017. Exposures Annual hospital THA and TKA volume, other hospital-level characteristics, and patient factors used in HRRP risk adjustment. Main Outcomes and Measures The HRRP penalties with HRRP excess readmission ratios were measured, and their association with annual THA and TKA volume, a common measure of surgical quality, was evaluated. The HRRP penalties for surgical care according to hospital and readmitted patient characteristics were then examined. Results Among 143 Florida hospitals, 2991 of 60 663 Medicare patients (4.9%) who underwent THA or TKA were readmitted within 30 days. Annual hospital arthroplasty volume seemed to follow an inverse association with both unadjusted readmission rates (r = −0.16,P = .06) and HRRP risk-adjusted readmission penalties (r = −0.12,P = .14), but these associations were not statistically significant. Other hospital characteristics and readmitted patient characteristics were similar across HRRP orthopedic penalty severity. Conclusions and Relevance This study’s findings suggest that higher-volume hospitals had less severe, but not significantly different, rates of readmission and HRRP penalties, without systematic differences across readmitted patients.
Cardiotoxicity associated with immune checkpoint inibitors: A systemic review and meta-analysis.

e15131Background: Immune checkpoint inhibitors (ICI) are associated with multiple immune related adverse events (irAE). Cardiotoxicities are rare but fatal complications. Since PD-1 and PD-L1 are e...
Polymer Genome: A Polymer Informatics Platform to Accelerate Polymer Discovery

The Materials Genome Initiative has brought about a paradigm shift in the design and discovery of novel materials. In a growing number of applications, the materials innovation cycle has been greatly accelerated as a result of insights provided by data-driven materials informatics platforms. High-throughput computational methodologies, data descriptors, and machine learning are playing an increasingly invaluable role in research development portfolios across both academia and industry. Polymers, especially, have long suffered from a lack of data on electronic, mechanical, and dielectric properties across large chemical spaces, causing a stagnation in the set of suitable candidates for various applications. The nascent field of polymer informatics seeks to provide tools and pathways for accelerated polymer property prediction (and materials design) via surrogate machine learning models built on reliable past data. With this goal in mind, we have carefully accumulated a dataset of organic polymers whose properties were obtained either computationally (bandgap, dielectric constant, refractive index, and atomization energy) or experimentally (glass transition temperature, solubility parameter, and density). A fingerprinting scheme that captures atomistic to morphological structural features was developed to numerically represent the polymers. Machine learning models were then trained by mapping the polymer fingerprints (or features) to their respective properties. Once developed, these models can rapidly predict properties of new polymers (within the same chemical class as the parent dataset) and can also provide uncertainties underlying the predictions. Since different properties depend on different length-scale features, the prediction models were built on an optimized set of features for each individual property. Furthermore, these models are incorporated in a user friendly online platform named Polymer Genome (www.polymergenome.org). Systematic and progressive expansion of both chemical and property spaces are planned to extend the applicability of Polymer Genome to a wide range of technological domains.
Upper Airway Anatomy and Physiology

Extending from the lips and nostrils to the subglottis of the larynx, the upper airway is divided into four segments—the nasal passage, oral cavity, pharynx, and larynx. Though separate, these segments are continuous with one another and share many physiologic functions. They work in concert to optimize respiration, protect the airway, produce voice, and act as a passage for ingested food and drink. The upper airway is also the site of olfaction, taste, middle ear ventilation, and digestion, among other myriad functions. Understanding the complex interplay between these segments requires an appreciation for not just the anatomy but also the physiology of each. This knowledge makes airway endoscopy an invaluable clinical tool for both diagnosis and management of a multitude of pathologies. With that in mind, this chapter will focus on each of the four segments of the upper airway with an emphasis on features that are especially important for those practicing endoscopy. In addition to providing an overview of the basic anatomy of the upper airway, this chapter will review current concepts governing our understanding of the physiology of the upper airway.
Abstract SP066: Omitting radiotherapy in select situations

Advances in breast imaging, surgery, pathology, and systemic therapy have rendered certain patients with breast cancer at sufficiently low risk of local recurrence that they may reasonably consider the omission of radiation therapy to reduce toxicity and burden. For decades, clinical trials have been conducted to try to identify the population of patients in whom the risk of recurrence in the absence of radiotherapy is sufficiently small that omission of radiotherapy might reasonably be considered after breast conserving surgery. Although trials to date, including ER+ patients selected based upon clinicopathologic characteristics alone, have largely proven unsuccessful, guidelines do currently identify older women with early-stage, node-negative, hormone receptor-positive disease to be candidates for radiotherapy omission after lumpectomy. This talk will review historical trials evaluating the role of radiotherapy after breast conserving surgery as well as exciting ongoing trials leveraging our growing appreciation of tumor biology to identify a population of patients who may reasonably consider omitting radiotherapy after breast conserving surgery. Citation Format: R Jagsi. Omitting radiotherapy in select situations [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr SP066.
Book Review—At Our Best: Building Youth–Adult Partnerships in Out-of-School Time Settings

Gretchen Brion-Meilsels, Jessica Tseming Fei, and Deepa Sriya Vasduevan’s At Our Best: Building Youth–Adult Partnerships in Out-of-School Time Settings brings together the work of over 50 youth and adults to build a youth–adult partnership praxis centered around ideas of trust, problem-solving methodologies, democratic participation, and collective action. The book, focusing on youth–adult partnerships for the purpose of social change, explores a set of field-expanding questions such as, “What do youth–adult partnerships look like in practice?” and “What are the relational and organizational practices that enable youth–adult partnerships to exist?” In addition to youth workers and youth development organizations, other groups of adults would benefit from reading the chapters’ rich exploration of dilemmas and strategies, such as funders, K-12 educators, and evaluators. Ultimately, this book honors young people and youth workers as important actors in social change and elevates the importance of their joint efforts. The deep relationship between youth work and a strong democracy clearly emerges, challenging us all to be “at our best.”
Bipolar Fractional Radiofrequency Treatment of Suprapatellar Skin Assessment Using Noninvasive Devices and Microbiopsy.

BACKGROUND Noninvasive treatments for skin tightening are gaining popularity. However, no studies have assessed bipolar fractional radiofrequency treatment on suprapatellar skin. OBJECTIVES The purpose of this study was to evaluate the efficacy of bipolar fractional radiofrequency treatment on suprapatellar skin. METHODS Twenty patients received 1 bilateral suprapatellar bipolar fractional radiofrequency treatment. They returned 7 days, 3 weeks, 3 months, and 6 months posttreatment. Noninvasive measurements were obtained at each visit, including high-resolution ultrasonography, optical coherence tomography, transepidermal water loss and skin elasticity. Microbiopsies were collected in the treatment area for histologic and gene expression analyses. Three clinicians completed photographic evaluations comparing texture and laxity at baseline vs 6 months posttreatment. RESULTS Fifteen subjects completed all 6 visits. Both transepidermal water loss and dermal-epidermal junction roughness were increased at 3 weeks and 3 months posttreatment. Both attenuation coefficient and stiffness were increased significantly at 3 and 6 months posttreatment. Blood flow 0.5 mm below the surface and expression of epidermal hyaluronic acid and inflammatory genes IL-1b and IL-6 were significantly higher at 7 days posttreatment compared with pretreatment and 3 months posttreatment. There were no statistically significant changes in collagen- or elastin-related genes and proteins at 7 days or 3 months posttreatment. An improvement in texture and laxity was observed at 6 months posttreatment in 17.7% and 24.4% of photographs, respectively. CONCLUSIONS Radiofrequency treatment by microneedling of suprapatellar skin shows limited effects in decreasing skin laxity and improving skin appearance. At a molecular level, the treatment resulted in lower elastin and hyaluronic acid levels and increased dermal-epidermal junction roughness based on histology and optical coherence tomography imaging. LEVEL OF EVIDENCE: 4
What Makes Homeowners Consider Protective Actions to Reduce Disaster Risk? An Application of the Precaution Adoption Process Model and Life Course Theory

We hypothesize that for disaster risk mitigation, many households, despite being aware of their risk and possible mitigation actions, never seriously consider doing anything about them. In mitigation-focused decisions, since there is no equivalent to warning messages, the decision process is likely to evolve over an extended time. We explore what activates hurricane mitigation protective action decisions through three research questions: (1) to what extent are homeowners unengaged in protective action decision making? (2) What homeowner characteristics are associated with lack of engagement? And (3) to what extent do different life events trigger engagement in the decision-making process? We use the Precaution Adoption Process Model to conceptualize engagement as distinct from decision making; the broader protective action decision-making literature to explore drivers of engagement; and Life Course Theory to examine potential transitions from unengaged to engaged. We use survey data of homeowners in North Carolina to examine these questions empirically. Findings suggest that one-third of respondents had never engaged in protective action decisions, that life experiences differ in their occurrence frequency and effect on households’ mitigation decisions, and that some events, such as renovating, reroofing, or purchasing a home may offer critical moments that could be leveraged to encourage greater engagement in mitigation decision making.
Benign Uterine Neoplasm as a Cause of Prepubertal Bleeding.

ABSTRACT Background Vaginal bleeding in the prepubertal child has several etiologies, including structural anomalies, endocrinologic dysfunction, infection, trauma, foreign body, and hematologic disorders. Case An 8-year-old premenarcheal girl presented with vaginal bleeding. On ultrasound, she was found to have an intramural hyperechogenic mass in the left uterine fundus. This was biopsied and showed smooth muscle. She was subsequently started on a GnRH agonist to suppress bleeding and has since been followed with serial ultrasounds. We have 6 years of follow-up imaging showing a presumed adenomyoma versus fibroid that has been stable in size. Summary and Conclusion We present a novel case of adenomyosis presenting as prepubertal bleeding. Pelvic imaging is prudent to exclude structural etiologies as the cause of prepubertal vaginal bleeding.
Poor bone matrix quality: What can be done about it?

Bone’s ability to withstand load resisting fracture and adapting to it highly depends on the quality of its matrix and its regulators. This review focuses on the contribution of bone quality to fracture resistance and possible therapeutic targets for skeletal fragility in aging and disease. The highly organized, hierarchical composite structure of bone extracellular matrix together with its (re)modeling mechanisms and microdamage dynamics determines its stiffness, strength, and toughness. Aging and disease affect the biological processes regulating bone quality, thus resulting in defective extracellular matrix and bone fragility. Targeted therapies are being developed to restore bone’s mechanical integrity. However, their current limitations include low tissue selectivity and adverse side effects. Biological and mechanical insights into the mechanisms controlling bone quality, together with advances in drug delivery and studies in animal models, will accelerate the development and translation to clinical application of effective targeted-therapeutics for bone fragility.
Technology-Enabled Co-Regulation as a New Regulatory Approach to Blockchain Implementation

Blockchain technology has great potential to reshape the financial industry. However, the existing policy and regulatory regimes fail to provide a supportive environment for blockchain technology to fulfill its potential. In this article, I propose technology-enabled co-regulation as a new approach to blockchain implementation, especially in the financial markets. This approach has two distinctive elements: a collaborative environment and a technology-enabled mechanism. A collaborative environment consists of regulatory and industry sandboxes in which regulators and industry representatives can experiment with novel ideas. A technology-enabled mechanism is empowered by regulatory technologies (RegTech) and supervisory technologies (SupTech) that support compliance with regulatory and reporting requirements and facilitate supervisory obligations. This technology-enabled co-regulation can help to achieve policy and regulatory goals: a fair and efficient market, financial stability, consumer and investor protection, law enforcement efficiency, and, most importantly, technology innovation. Technology-enabled co-regulation is preferable to traditional command-and-control regulation and self-regulation. Its collaborative and technological elements are also more advanced than a simple co-regulation is. To reach this conclusion, I conducted an impact assessment of proposed regulatory options. The impact assessment consists of five analytic steps, asking the following questions: What problems have emerged from existing policies and regulations? What are the objectives of the proposed regulations? What are the regulatory options? What are the possible impacts? How do the options compare?
CRIMINAL PROCEDURE Bonds and Recognizances: Amend Forfeiture Provisions

The Act amends the Code sections relating to time frames for the holding of execution hearings for forfeiture of the bail bonds, should the principal not appear. Changes are also made in the circumstances under which forfeiture will not be entered.
Systemic Clostridium toxicity resulting from a knee laceration in a child

This report describes the clinical course and treatment of a C. perfringens infection in a child following an injury to the knee that resulted in sepsis and multi-organ system failure. Diagnosis of the causative agent and systemic nature of the infection was delayed because of the non-traditional presentation, in which the patient appeared to have a localized necrotizing fasciitis and did not display symptoms consistent with severe systemic involvement. He was treated with vancomycin, wound debride- ment and fasciotomy. After identification of C. perfringens, vancomycin therapy was discontinued in favor of penicillin and clindamycin. With intensive supportive care, the patient recovered fully and resumed regular activities within two months. These infections are rare in children, but they can be life threatening. It is important to include systemic Clostridium infection in a differential so it can be recognized early and appropriate treatment begun as soon as possible.
Gene Therapy: Ethical Issues

To discern the ethical issues involved in current gene therapy research, to explore the problems inherent in possible future gene therapies, and to encourage debate within the scientific community about ethical questions relevant to both, we surveyed American Society of Human Genetics scientists who engage in human genetics research. This study of the opinions of U.S. scientific experts about the ethical issues discussed in the literature on gene therapy contributes systematic data on the attitudes of those working in the field as well as elaborative comments. Our survey finds that respondents are highly supportive of the potential use of somatic cell gene therapy to cure serious diseases in adults and children as well as prospective offspring. A clear majority, however, believe that using such genetic techniques for enhancement purposes is unacceptable. Delineating the line between disease/disorder and improvement/enhancement poses a problem not easily resolved and one conducive to the growth of slippery-slope apprehensions. The majority of respondents also advocate germ-line therapy, in theory at least, and under similar restrictions, but they recognize the roadblock that the existence of unanticipated negative consequences currently presents. Another complex matter involves trying to determine appropriate reasons for choosing target diseases for research, for which the dichotomy between rare single-gene and common multifactorial diseases reveals an ongoing dilemma.