cssi/SciSciGPT-SciSciNet huggingface dataset:
Effects of tcpB Mutations on Biogenesis and Function of the Toxin-Coregulated Pilus, the Type IVb Pilus of Vibrio cholerae.

ABSTRACT Vibrio cholerae is the etiological agent of the acute intestinal disorder cholera. The toxin-coregulated pilus (TCP), a type IVb pilus, is an essential virulence factor of V. cholerae. Recent work has shown that TcpB is a large minor pilin encoded within the tcp operon. TcpB contributes to efficient pilus formation and is essential for all TCP functions. Here, we have initiated a detailed targeted mutagenesis approach to further characterize this salient TCP component. We have identified (thus far) 20 residues of TcpB which affect either the steady-state level of TcpB or alter one or more TCP functions. This study provides a solid framework for further understanding of the complex role of TcpB and will be of use upon determination of the crystal structure of TcpB or related minor pilin orthologs of type IVb pilus systems. IMPORTANCE Type IV pili, such as the toxin-coregulated pilus (TCP) in V. cholerae, are bacterial appendages that often act as essential virulence factors. Minor pilins, like TcpB, of these pili systems often play integral roles in pilus assembly and function. In this study, we have generated mutations in tcpB to determine residues of importance for TCP stability and function. Combined with a predicted tertiary structure, characterization of these mutants allows us to better understand critical residues in TcpB and the role they may play in the mechanisms underlying minor pilin functions.
Energy based load-impulse diagrams

Abstract A load-impulse (P-I) diagram is a useful tool in preliminary strength design and damage assessment. Current approaches to derive P-I diagrams are primarily based on numerical dynamic analyses of the structural system. Further, there are no general energy based solutions that define P-I relationships, and very little has been done to address energy flow as a basis for P-I diagrams. Since the behavior of a structural member is governed by the amount and rate of external energy input and its ability to dissipate energy, defining energy flow relationships will characterize the entire domain of structural responses and corresponding damage. This paper presents a comprehensive energy flow approach to enable one to define the entire P-I domain, and illustrates the application of an energy-based P-I diagram. The results are validated using test data and numerical tools, such as DSAS.
An Evaluation of Thread-Safe and Contexts-Domains Features in Cray SHMEM

There is increasing use of multithreading in High Performance Computing (HPC) programs in order to maximize the use of hardware resources of multi-core compute nodes. The latest version of the OpenSHMEM API Specification does not standardize the interaction between threads and OpenSHMEM routines in multithreaded applications. In this paper, we evaluate two proposals that have been put forward to try to address this deficiency: “Thread-Safe” and “Contexts-Domains”. Both of these proposals have been implemented, at least in part, in Cray SHMEM, a vendor-specific OpenSHMEM implementation from Cray Inc. We provide a design overview of the two proposals and give some experimental results showing significant performance benefits of each. To the best of our knowledge, this is the first paper to compare and contrast these two proposals.
Assessment of serum HE4 levels throughout the normal menstrual cycle

Background Human epididymis protein 4 is a serum biomarker to aid in differentiating benign and malignant disease in women with a pelvic mass. Interpretation of human epididymis protein 4 results relies on robust normative data. Objective The purpose of this study was to evaluate whether human epididymis protein 4 levels are variable in women during the normal menstrual cycle. Study Design Healthy women, 18-45 years old, with regular menstrual cycles were recruited from community gynecologic practices in Rhode Island. Women consented to enroll and to participate by the donation of blood and urine samples at 5 specific times over the course of each cycle. Levels of reproductive hormones and human epididymis protein 4 were determined. Data were analyzed with the use of linear regression after log transformation. Results Among 74 enrolled cycles, 53 women had confirmed ovulation during the menstrual cycle and completed all 5 sample collections. Levels of estradiol, progesterone, and luteinizing hormone displayed the expected menstrual cycle patterns. Levels of human epididymis protein 4 in serum were relatively stable across the menstrual cycle, except for a small ovulatory (median, 37.0 pM) increase. Levels of human epididymis protein 4 in urine, after correction for creatinine, displayed the same pattern of secretion observed in serum. Conclusion Serum human epididymis protein 4 levels are relatively stable across the menstrual cycle of reproductive-aged women and can be determined on any day to evaluate risk of ovarian malignancy. A slight increase is expected at ovulation; but even with this higher human epididymis protein 4 level, results are well within the healthy reference range for women (
Fusion of Secure IPsec-Based Virtual Private Network, Mobile Computing and Rich Multimedia Technology

An application of IPsec stack of data exchange protocols in virtual private networks proved to be one of the most reliable and efficient security technologies to provide data protection, confidentiality, integrity, authentication, and access control in computer networks. This chapter presents the outcomes of multi-aspect research project aimed to design and develop IPsec-based mobile virtual private network environments for highly effective, in terms of both security and performance, communications in Web-based rich multimedia systems, including conceptual, design, architectural, and performance modeling of those systems.
Synthesis and biological evaluation of fentanyl acrylic derivatives

The synthesis of novel fentanyl acrylate derivatives via bromo-fentanyl using Heck coupling is described. The synthesis is concise and represents an efficient and useful method for functionalizing fentanyl for medicinal chemistry investigations. The agonistic and analgesic activities are evaluated by Mu opioid receptor activation and hot plate assays in mice.
An Empirical Examination of Partnership Frequency and Design within International Nongovernmental Organizations (INGOs)

Despite the increase in public and nonprofit partnerships, there is little understanding of the organizational factors associated with partnership frequency and design. Through negative binomial and multinomial logistic regressions, this study analyzes data from interviews with 149 leaders of international nongovernmental organizations (INGOs), to first examine partnership frequency, and to then examine the formation of different partnerships structures: principal-based partnerships, agent-based partnerships, and shared power-based partnerships. The findings suggest that improving results and increasing funding are the primary goals of partnership adoption, and that the most management intensive forms of partnerships are only adopted when INGOs have sufficient organizational capacity.
Structured dictionary learning for sparse common component and innovation model

Event-related potentials (ERP)s are electrophysiological responses that are commonly used for detecting the brain response to external stimuli. In this paper, we propose to use the sparse common component and innovations model (SCCI) to extract ERPs from multiple EEG signals recorded across closely located electrodes. This model finds the sparse representation of the common component of the signals and their innovation components with respect to pre-determined common and innovation dictionaries, where the common component refer to an event captured by adjacent electrodes such as ERPs. However, different stimuli may produce different responses and predetermining the dictionary may not always be optimal. Therefore, we introduce a structured dictionary learning method to simultaneously learn the two dictionaries from training data. The proposed method is applied to a study of error monitoring where two different types of brain responses are elicited corresponding to the decision made by the subject. The learned dictionaries can discriminate between the response types and extract the ERP corresponding to the two responses.
Federalism and Social Change

A familiar passage in Professors Hart and Wechsler's casebook likens the relationship between federal and state law to that which exists between statutes and the common law. The underlying idea is that federal law rests upon a substructure of state law. "It builds upon legal relationships established by the states, altering or supplanting them only so far as necessary for [its] special purpose."' A similar relationship exists between state and federal judicial systems. State courts are courts of general jurisdiction, assumed to have authority to adjudicate controversies unless Congress has displaced them by conferring exclusive jurisdiction on federal courts. Federal courts, on the other hand, have only a limited jurisdiction carved out of the general jurisdiction of the state courts and conferred for restricted purposes. I mention these well-known relationships to explain why I shall not essay a comprehensive discussion of the Supreme Court's attitudes toward federalism during the past decade. Because of the variety and complexity of the relationships between state and federal law, any attempt to canvass all-or even the important--decisions bearing upon the Court's current attitude toward federalism would necessarily cover a very broad terrain, surely far more than I can traverse within the allotted time.
Medical Narratives in Rhetorical Context: Ethically Researching Anti-Vaccinationists

This article argues that anti-vaccinationists pose an ethical challenge to researchers. On the one hand, research practices in narrative medicine push us to empower illness narratives. On the other...
A TWO-SAMPLE SEQUENTIAL TEST FOR SHIFT WITH ONE SAMPLE SIZE FIXED IN ADVANCE

Publisher Summary This chapter presents a two-sample sequential test for shift with one sample size fixed in advance. Suppose if there is a sample of m observations of a real-valued random variable taken at some point in the past and if one has to take a new sample of size n to test whether the shift in the mean from then until present is positive or negative, then if n is fixed, one has a standard two-sample shift problem. However, if it is possible to take the new sample in a sequential manner, then there may be procedures that afford an average savings in the sample-size needed to attain specified error levels. The size of a new data sample is proportional to the width of the continuation region, inversely proportional to the size of the shift parameter d, and independent of the old data sample size m. For a given old data sample-size m, the elementary normal theory specifies a unique fixed new data sample-size n, which yields a specified α error probability for specified values of the shift parameter d. If a new sample can be taken in a sequential manner, then there can be procedures that afford an average savings in the sample-size needed to attain specified error levels. Enormous savings involving factors of 6 and higher in new data sampling effort—on the average—can be affected by using the recommended sequential procedure. The savings are highest when α is smallest. The fixed sample-size is about double the random sample-size. Failure to sample the new data sequentially can increase the new plus old sample-size by about 50–75%, a moderate increase.
An approach to manipulate frequency selectivity in Basilar metamembrane based broadband frequency sensors

Basilar metamembrane (BM2) based frequency sensors have received growing interest in the engineering community for its ability to control the sensing/analyzing broadband frequency spectrum while mimicking the geometry and functionality of a basilar membrane (BM) in mammalian cochlea. Membrane stiffness plays the principal role in spatial selection of acoustic frequencies in BM2. Likewise natural BM, conventional BM2 possess homogeneous stiffness over the membrane length. However, broadband frequency selection ability of the BM2's are considerably less due to geometric simplicity adopted in BM2's (uniform thickness) compared to BM (tapered thickness). This work presents the possibility to manipulate (increase/decrease) the broadband frequency selection ability of the sensor, using functionally graded membrane stiffness. Three popular functions (logarithmic, exponential and linear) are presented as potential expression to grade membrane stiffness. A detailed insight is provided, how sensing parameters of a specific frequency band (e.g. sensing location of band start and end frequency, membrane segment width necessary to sense whole frequency band) can be influenced by coefficients of the functions.
Effectiveness of Health Promotion, Management, and Maintenance Interventions Within the Scope of Occupational Therapy for Community-Dwelling Older Adults: A Systematic Review

Objective This systematic review examined the effectiveness of health promotion, management, and maintenance interventions within the scope of occupational therapy to improve occupational performance and quality of life (QOL) and decrease health care utilization for community-dwelling older adults. Method Thirty-eight articles representing 36 studies were included in the review. Articles were published 2008-2015 and described studies of participants with a mean age of 65 or older who were living in the community. Results Strong evidence supports the use of group, individual, or a combination of group and individual interventions to improve occupational performance. Group interventions were also effective at improving QOL. The evidence was insufficient that any of these interventions decreased health care utilization. Conclusion Addressing health promotion, management, and maintenance is within the scope of occupational therapy practice and has been shown to improve occupational performance and QOL for older adults. Implications for practice and future research are discussed.
Hierarchical Temporal Memory Based on Spin-Neurons and Resistive Memory for Energy-Efficient Brain-Inspired Computing

Hierarchical temporal memory (HTM) tries to mimic the computing in cerebral neocortex. It identifies spatial and temporal patterns in the input for making inferences. This may require a large number of computationally expensive tasks, such as dot product evaluations. Nanodevices that can provide direct mapping for such primitives are of great interest. In this paper, we propose that the computing blocks for HTM can be mapped using low-voltage, magnetometallic spin-neurons combined with an emerging resistive crossbar network, which involves a comprehensive design at algorithm, architecture, circuit, and device levels. Simulation results show the possibility of more than $200\times$ lower energy as compared with a 45-nm CMOS ASIC design.
SUPERNOVAE AND NUCLEAR STRUCTURE: Electron Capture and the Nuclear Incompressibility

: We consider the effects of electron capture and the high density equation of state on supernovae. Electron captures on nuclei with 60 < A < 100 proceed primarily through thermal deexcitation GT transitions. Quenching of the matrix elements due to ground state correlations and isobaric mixing and the energetics of the process are considered. For densities greater than ρS it is helpful for supernovae to have a soft equation of state Present knowledge of the nuclear matter parameters is considered and implications for supernovae are drawn.
Poster: Local Algorithms for Sensor Selection

In sensor networks, the sensor selection task is to activate only a subset, possibly a small subset, of the sensors while gaining as much utility as possible from the sensors. Most solutions are centralized algorithms with full knowledge of the network. We explore local algorithms for sensor selection. In these algorithms, each sensor independently decides if it should be included in the selection based on knowledge of its neighborhood alone. We design algorithms for increasing levels of knowledge in terms of the neighborhood size and demonstrate on randomly generated graphs representing sensor networks the improvement possible with more knowledge.
Supporting Whole-Person Health: Socially Just Application of Religion and Spirituality in an Outpatient Care Facility for Individuals with Chronic Illnesses

Successful medical family therapy (MedFT) interventions require the skillful utilization and application of the BioPsychoSocial-Spiritual (BPSS) model. In contrast to brief short-term MedFT, long-term standard 1-h therapeutic care in outpatient facilities provides opportunities to assess, explore, and collaborate with a variety of care providers to expand upon positive religious and spiritual experiences supporting individuals with chronic illnesses and their families. This chapter will briefly introduce long-term MedFT services, specifically in a collaborative outpatient medical setting that fostered integrative services including primary care, mental health, and behavioral health. Using two case examples of a couple and a family, I will discuss the impact of chronic illnesses on patients and families and demonstrate the integration of positive religious and spiritual beliefs in the treatment plan and overall therapeutic process.
T cells transduce T-cell receptor signal strength by generating different phosphatidylinositols

T-cell receptor (TCR) signaling strength is a dominant factor regulating T-cell differentiation, thymic development, and cytokine signaling. The molecular mechanisms by which TCR signal strength is transduced to downstream signaling networks remains ill-defined. Using computational modeling, biochemical assays, and imaging flow cytometry, we found here that TCR signal strength differentially generates phosphatidylinositol species. Weak TCR signals generated elevated phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2) and reduced phosphatidylinositol (3,4,5)-trisphosphate (PIP3) levels, whereas strong TCR signals reduced PI(4,5)P2 and elevated PIP3 levels. A proteomics screen revealed that focal adhesion kinase bound PI(4,5)P2, biochemical assays disclosed that focal adhesion kinase is preferentially activated by weak TCR signals and is required for optimal Treg induction, and further biochemical experiments revealed how TCR signaling strength regulates AKT activation. Low PIP3 levels generated by weak TCR signals were sufficient to activate phosphoinositide-dependent kinase-1 to phosphorylate AKT on Thr-308 but insufficient to activate mTOR complex 2 (mTORC2), whereas elevated PIP3 levels generated by a strong TCR signal were required to activate mTORC2 to phosphorylate Ser-473 on AKT. Our results provide support for a model that links TCR signaling to mTORC2 activation via phosphoinositide 3-kinase signaling. Together, the findings in this work establish that T cells measure TCR signal strength by generating different levels of phosphatidylinositol species that engage alternate signaling networks to control cell fate decisions.
AQB-565 Shows Promise in Preclinical Testing in the Model of Epileptic Spasms During Infancy: Head-to-Head Comparison with ACTH

Abstract Epileptic spasms during infancy (infantile spasms) represent a serious treatment and social problem despite their rare occurrence. Current treatments include hormonal therapy (adrenocorticotropin-ACTH or corticosteroids) or vigabatrin (per se or in the combination). These treatments are partially effective and with potentially significant adverse effects. Thus, the search for new effective drugs is warranted. We tested efficacy of a novel fusion peptide AQB-565 developed by Aequus Biopharma in a model of infantile spasms consisting of prenatal exposure to betamethasone and repeated postnatal trigger of spasms with N-methyl- d -aspartic acid (NMDA). AQB-565 molecule includes the first 24 amino acids of ACTH, a ten amino acid linker and a modified melanocyte-stimulating hormone molecule. In contrast to ACTH with almost uniform activity over all peripheral and central melanocortin receptor isoforms, AQB is preferentially active on central melanocortin receptors MC3 and MC4. Here, we used equivalent doses of rat ACTH (full molecule) and AQB-565 and compared their efficacy in a prospective randomized test against of repeated bouts of spasms on postnatal days (P)12, P13 and P15 in the rat model. All doses of ACTH (range 0.02–1.0 mg/kg s.c.) and all doses but one of AQB-565 in the same range suppressed spasms in P15 rats (treatment stopped on P14). There was no dose-dependent effect and both compounds had all-or-none effect that is similar to clinical outcome of hormonal treatment of infantile spasms in children. Thus, AQB-565 may represent a novel treatment of infantile spasms similarly effective as ACTH but with potentially limited side effects.
Planning in games using approximately learned macros

Publisher Summary This chapter discusses a planning technique called knowledge-enabled planning (KEP). To begin with, there are several requirements a knowledge-based planner must fulfill to be useful in game domains. It should be able to cope with imperfect knowledge as, in many complex domains, the learner can only afford to learn approximately correct knowledge. While the planner is allowed to make some errors because of its imperfect knowledge, its errors must reduce with improved knowledge. To justify the cost involved in the arduous task of learning, planning with knowledge should be faster than knowledge-free planning such as alpha-beta search. The chapter highlights KEP by using a planner that is a part of an implemented system called lazy explanation-based learner (LEBL). LEBL is found to satisfy several properties desirable in a knowledge based planner. Also, the role of knowledge in systems like KEP is mainly to reduce the errors rather than reduce the number of nodes searched, which is already quite small. The implementation of LEBL in KEP allows for a compromise between learning time and planning time.
Two Proxies for Shareholder Influence: A Case of Payout Policy

Using the Banzhaf index as a proxy for voting power, this paper investigates the relative importance of the size of equity ownership and voting power of large shareholders in influencing corporate policy regarding cash dividends and share repurchase. Our empirical findings indicates that consideration of voting power in models may results in conclusions different from those that consider the size of equity ownership. Conclusions may also differ for large insider and outsider shareholders, if firms are either paying dividends or repurchasing shares, or doing both.
Triggers, clinical manifestations, and management of pediatric erythema multiforme: A systematic review.

Background Erythema multiforme (EM) is an acute inflammatory mucocutaneous condition. EM is rarely described in children and infants. Objective To investigate the triggers, clinical manifestations, and treatment of pediatric EM. Methods Systematic literature review of pediatric EM. Results After full-text article review, we included 113 articles, representing 580 patients. The mean age was 5.6 years, ranging 0.1-17 years. Infectious agents were the main triggers: herpes simplex virus (HSV) in 104 patients (17.9%) and Mycoplasma pneumoniae in 91 patients (15.7%). In total, 140 cases (24.1%) were drug-related and 89 cases (15.3%) had other triggers, such as vaccines (19 patients, 3.2%). In total, 229 patients had EM major (39.5%). Treatment was supportive care only (180 patients, 31.1%), systemic corticosteroids (115 patients, 19.8%), antivirals (85 patients, 14.6%), and antibiotics (66 patients, 11.3%), mostly macrolides (45 patients, 7.7%). Long-term sequelae were rare (1.3%). Pediatric EM was reported in 19 infants (3.2%). The main trigger was vaccination (9 patients). Infantile EM was EM major in 2 cases and EM minor in 17. Infants were less prone to develop EM major than older children (P Limitations Potential confusion between Steven Johnson syndrome and EM major in addition to publication bias. Conclusion Pediatric EM is a rare disease, mainly triggered by infections. This condition can affect all mucosal surfaces, most commonly the oral mucosae. The diagnosis is clinical, and management relies on supportive care. Vaccines are a particular trigger in infants. Recurrent cases are most commonly linked to HSV. Dermatologists and pediatricians should be aware of this potentially recurrent and severe condition.
Global Violence Against Women

Gender-based violence exists in virtually every culture around the globe, although local manifestations are highly dependent on structural inequalities; cultural definitions of gender; and the levels of violence in the larger society. Responses to gender-based violence in the West began as criminal justice interventions but expanded in the 1990s to include a global perspective of women's human rights, as well as greater attention to the collection of internationally comparable data sets. The current discourse (2014) incorporates dialogue on the intersectionality of oppressions, rethinking the concept of agency and focusing attention on indigenous women's perspectives.
An in silico map of the SARS-CoV-2 RNA Structurome

SARS-CoV-2 is a positive-sense single-stranded RNA virus that has exploded throughout the global human population. This pandemic coronavirus strain has taken scientists and public health researchers by surprise and knowledge of its basic biology (e.g. structure/function relationships in its genomic, messenger and template RNAs) and modes for therapeutic intervention lag behind that of other human pathogens. In this report we used a recently-developed bioinformatics approach, ScanFold, to deduce the RNA structural landscape of the SARS-CoV-2 transcriptome. We recapitulate known elements of RNA structure and provide a model for the folding of an essential frameshift signal. Our results find that the SARS-CoV-2 is greatly enriched in unusually stable and likely evolutionarily ordered RNA structure, which provides a huge reservoir of potential drug targets for RNA-binding small molecules. Our results also predict regions that are accessible for intermolecular interactions, which can aid in the design of antisense therapeutics. All results are made available via a public database (the RNAStructuromeDB) where they may hopefully drive drug discovery efforts to inhibit SARS-CoV-2 pathogenesis.
Thoracic Radiation Oncology Clinical Trial Accrual and Reasons for Nonenrollment: Results of a Large, Prospective, Multiyear Analysis

Purpose Clinical trials are considered the gold standard in evidence-based medicine, yet few patients with cancer ultimately enroll. Here we examine patients screened for thoracic radiation oncology clinical trials to better understand enrollment trends. Methods and Materials A prospective database tracking screening and enrollment for patients referred for thoracic radiation oncology consultation at our institution from 2016 to 2019 was evaluated. Proportional enrollment rates, patient and disease characteristics, self-reported socioeconomic factors, and reasons for ineligibility or nonenrollment across 17 radiation therapy trials were compared. Results Enrollment data on 2372 patients were available for analysis. Of these patients, 40.0% (949) were deemed “not eligible” (NE) for any trial or were unwilling to be further screened. Reasons for ineligibility included stage (44%), histology (13%), radiation therapy not indicated (12%), patient decision (7%), and enrollment in a competing medical or surgical oncology trial (5%). The remaining 60.0% (1423) were “potentially eligible” (PE) for one or more trials. Most had non-small cell lung cancer (71%) or esophageal cancer (16%), and there were significantly fewer stage IV PE (29%) versus NE (49%) patients (P Conclusions Only 12% of patients screened for radiation therapy trials ultimately enrolled, and more than two-thirds had no trial available or were found ineligible. In addition, 19% of potential eligible patients did not enroll because the patient or physician declined. Future trials may benefit from pragmatic designs with more inclusive enrollment criteria and multidisciplinary engagement of referring providers.
Designing Professional Development to Support Teachers’ Productive Beliefs, Knowledge, and Practices for Teaching Mathematics to English Language Learners

This chapter describes a professional development (PD) program for teachers of mathematics who teach English language learners (ELLs). Participants received instruction in second language acquisition as well as cultural and linguistic factors that may influence ELLs’ learning, practices to support ELLs’ learning of mathematics, growth mindset in the mathematics classroom, and mathematical knowledge for teaching rational numbers. The program included two summer institutes in subsequent summers, coaching visits, workshops during the school year, and a mathematics summer camp for ELLs. The authors suggest PD designers keep six principles in mind when supporting teachers of mathematics’ development of productive beliefs, knowledge, and practices needed to effectively teach ELLs.
Dynamics of Deep Recirculation Cells Offshore of the Deep Western Boundary Current in the Subtropical North Atlantic (15°─30°N)

Abstract The dynamics of the deep recirculation offshore of the deep western boundary current (DWBC) between 15° and 30°N within the upper North Atlantic Deep Water layer (1000 ≤ z ≤ 3000 m) is investigated with two different eddy-resolving numerical simulations. Despite some differences in the recirculation cells, our assessment of the modeled deep isopycnal circulation patterns (36.77 ≤ σ 2 ≤ 37.06 kg m −3 ) shows that both simulations predict the DWBC flowing southward along the continental slope, while the so-called Abaco Gyre and two additional cyclonic cells recirculate waters northward in the interior. These cells are a few degrees wide, located along the DWBC path, and characterized by potential vorticity (PV) changes occurring along their mean streamlines. The analysis of the mean PV budget reveals that these changes result from the action of eddy forcing that tends to erode the PV horizontal gradients. The lack of a major upper-ocean boundary current within the study region, and the fact that the strongest eddy forcing is constrained within a few hundreds of kilometers of the western boundary, suggest that the DWBC is the primary source of eddy forcing. Finally, the eddies responsible for forcing the recirculation have dominant time scales between 100 and 300 days, which correspond to the primary observed variability scales of the DWBC transport at 26.5°N.
Navigation with Cellular Signals of Opportunity

This chapter focuses on explaining how user equipment‐based navigation could be achieved. It discusses how cellular signals could be used for positioning, navigation, and timing (PNT) by presenting relevant signal models, receiver architectures, PNT sources of error and corresponding models, navigation frameworks, and experimental results. The chapter begins by providing an overview of the evolution of cellular systems. It then discusses modeling the clock error dynamics to facilitate estimating the unknown base transceiver stations' (BTSs) clock error states. This is followed by a description of frameworks for navigation in cellular environments. Further, the chapter discusses how to navigate with cellular code‐division multiple access and long‐term evolution signals, respectively. It discusses a timing error that arises in cellular networks: clock bias discrepancy between different sectors of a BTS cell. The chapter highlights the achieved navigation solution improvement upon fusing cellular signals with global navigation satellite system signals.
Impact of comorbidities and treatment burden on general well-being among women's cancer survivors.

Gains in cancer detection and treatment have meant that more patients are now living with both cancer and other chronic health conditions, which may become burdensome. We used the Patient Experience with Treatment and Self-Management (PETS) framework to study challenges in self-management and its impact on health among survivors of women’s cancers who are caring for other chronic health conditions. Applicability of the PETS domains among survivors of women’s cancers with comorbidities was assessed in focus groups to create the study survey. Women surviving primary breast, cervical, ovarian, or endometrial/uterine cancer treated between 6 months and 3 years prior at two large healthcare systems in Virginia were mailed study invitation letters to complete a telephone-based survey. The survey included questions on cancer treatment history, comorbid conditions prior to cancer, treatment and self-management experiences, health literacy, financial security, and items on self-management activities, self-management difficulties and self-management impact (i.e., role/social activity limitations and physical/mental exhaustion). Additionally, general health was assessed with items from the Patient-Reported Outcomes Measurement Information System (PROMIS). Hierarchical regression models and path analysis were used to examine correlates of self-management impact on general physical health (GPH) and mental health (GMH). Of 1448 patients contacted by mail, 274 (26%) returned an interest form providing their consent to be contacted. Of these, 183 completed the survey. Reasons for non-completion included ineligibility (42), unable to be reached (33) and refusal (6). The majority were survivors of breast (58%) or endometrial/uterine cancer (28%), and 45% resided in non-urban locations. After adjusting for age, race, and cancer type, survivors with higher self-management difficulty reported higher self-management impact, which was associated with lower perceived general health. Reports of higher self-management impact was associated with being single or unmarried, white race, fulltime employed, higher financial insecurity, lower health literacy and more comorbidities. In path analysis, self-management impact was a significant mediator in the association of comorbidity and financial insecurity on GPH and GMH. Among survivors of women’s cancer, pre-diagnosis comorbidity, health literacy, and financial security are associated with psychosocial impact of self-management and general physical and mental health in the 6 month to 3-year period after cancer treatment has ended. The impact of self-management on psychosocial functioning is an important factor among cancer survivors caring for multiple chronic health conditions. This study provides evidence on the importance of assessing cancer survivors’ self-management difficulties such as in future interventions to promote health and wellness.
Are Economics and Financial Literacy Education Substitutes? A Difference-in-Difference Approach to Measuring the Returns to Financial Literacy Education.

States are increasingly mandating financial literacy education as a high school graduation requirement. However, most states already include economics education as part of their curriculum, and it is unclear whether financial literacy education and economics education differ. We examine the returns to financial literacy education and compare the gains in financial knowledge to those acquired in economics courses. Using observational data (n=127) and difference-in-difference methodology we test for differences in returns across courses at the college level. We find that both financial literacy courses and economics courses increase financial knowledge. We also find no evidence that financial literacy courses increase understanding of financial literacy concepts at a higher rate than economics courses. We disaggregate financial knowledge into six areas of financial understanding as defined by the Test of Financial Literacy. We find the returns to financial literacy education are higher than economics courses in five categories, however these findings are driven mostly by observable differences between the financial literacy and economics students. We also find the returns to financial literacy education are higher for female students, even when controlling for observables. Female students experience a gain of 0.8 standard deviations in the Test of Financial Literacy, when enrolled in financial literacy courses relative to economics courses, providing evidence that financial literacy education is better at narrowing the gender financial literacy gap. Our results are important to policymakers introducing financial literacy education mandates and to school administrators determining implementation.
Nonesterified Fatty Acids and Kidney Function Decline in Older Adults: Findings From the Cardiovascular Health Study.

Rationale & Objective Circulating nonesterified fatty acids (NEFAs) make up a small portion of circulating lipids but are a metabolically important energy source. Excessive circulating NEFAs may contribute to lipotoxicity in many tissues, including the kidneys. We investigated the relationship between total circulating NEFA concentration and kidney outcomes in older, community-dwelling adults. Study Design Prospective cohort study. Setting & Participants 4,698 participants ≥65 years of age in the Cardiovascular Health Study who underwent total fasting serum NEFA concentration measurements in 1992-1993. Exposure Fasting serum NEFA concentration at one time point. Outcome Three primary outcomes: estimated glomerular filtration rate (eGFR) decline of ≥30%, the composite of eGFR decline ≥ 30% or kidney failure with replacement therapy, and change in eGFR. These outcomes were assessed over 4- and 13-year periods. Analytical Approach Logistic regression for the dichotomous outcomes and mixed effects models for the continuous outcome, with sequential adjustment for baseline covariates. Inverse probability of attrition weighting was implemented to account for informative attrition during the follow-up periods. Results Serum NEFA concentrations were not independently associated with kidney outcomes. In unadjusted and partially adjusted analyses, the highest quartile of serum NEFA concentration (compared with lowest) was associated with a higher risk of ≥30% eGFR decline at 4 years and faster rate of decline of eGFR. No associations were evident after adjustment for comorbidities, lipid levels, insulin sensitivity, medications, and vital signs: the odds ratio for the eGFR decline outcome was 1.33 (95% CI, 0.83-2.13), and the difference in eGFR slope in the highest versus lowest quartile of serum NEFA concentration was −0.15 (95% CI, −0.36 to 0.06) mL/min/1.73 m2 per year. Limitations Single NEFA measurements, no measurements of post-glucose load NEFA concentrations or individual NEFA species, no measurement of baseline urine albumin. Conclusions A single fasting serum NEFA concentration was not independently associated with long-term adverse kidney outcomes in a cohort of older community-living adults.
Hobbling: The Effects of Proactive Policing and Mass Imprisonment on Children's Education

Researchers have written a good deal in the last two decades about the relationship between public education and criminal justice as a pipeline by which public school practices correlate with or ca...
Addressing the Community Trauma of Inequity Holistically: The Head and The Heart Behind Structural Interventions

Childhood trauma — or toxic stress — presents potential lifelong consequences on health and well-being and on family and neighborhood stability. The consequences of childhood trauma are grave, but recent research highlights the value of early intervention in addressing childhood trauma. As a result, calls for trauma-informed practices and programs have grown. Moving beyond individualized approaches, research increasingly looks to address a community’s ability to prevent or mitigate trauma. But more broadly, what if the community itself is a victim of trauma? How do communities dealing with the chronic stresses of intergenerational poverty, discrimination, and violence heal? Are there interventions that might help? This Article explores this systemic “community trauma,” using cities as examples to illustrate the complex issues involved and the potential trauma-informed, comprehensive interventions available. Specifically, this Article focuses on structural reforms that address the root causes of trauma. I will discuss the effect of trauma on the following systems: health, education, housing, criminal justice, wealth, and employment. These systems are strong candidates for intervention. I then propose next steps to address community trauma across systems. But while this Article discusses discrete policy issues, it ultimately argues that community trauma requires broad solutions. These solutions are grounded in social policies. I call this side the “head” of treating community trauma. Beyond this, however, achieving holistic justice via unified action requires community unity, a recognition of the value and dignity in the whole that is greater than self. I call this side the “heart” of treating community trauma. This Article calls for a re-envisioned way of effective structural policy reform, one driven by greater appreciation of the need for civic engagement and community building versus sole reliance on appeals to an idealized, “rational” policy solution. Drawing on literature from across fields (e.g., public health, political philosophy, behavioral economics), this Article seeks to build the case for a transdisciplinary, iterative, and fundamentally interpersonal approach to address complex, intersectoral, inequity-driving, and inequity-maintaining problems for healthier community development. Thus, in addition to the substantive goals, this Article also explores capacity-building approaches to community development to rethink how to remedy systemic inequity, the “trauma” that haunts many of our communities. In sum it takes the “head” and the “heart”—the whole community.
Race and neonatal respiratory morbidity in the late preterm period.

BACKGROUND Prematurity is one of the leading causes of perinatal morbidity and mortality. Some studies suggest that respiratory disease may differ by race in early preterm infants. However, the role of race in late preterm neonatal morbidity is not yet established. OBJECTIVE The objective of our study was to determine whether neonatal respiratory morbidity differs by race in neonates born late preterm. STUDY DESIGN This was a secondary analysis of a randomized trial of women at high risk for late preterm delivery (Antenatal Late Preterm Steroids). Our study was limited to women with nonanomalous, singleton gestations, delivering between 34+0 to 36+6 weeks. Women were categorized into 4 groups by race: Black, White, Asian, or other/mixed. The primary outcome was a neonatal composite of treatment in the first 72 hours (continuous positive airway pressure or high-flow nasal cannula >2 hours, oxygen >4 hours, extracorporeal membrane oxygenation or mechanical ventilation) or stillbirth or neonatal death before 72 hours. The secondary outcomes included severe respiratory morbidity (the primary outcome extending continuous positive airway pressure or high-flow nasal cannula to >12 continuous hours and oxygen to at least 24 continuous hours), respiratory distress syndrome, transient tachypnea of the newborn, apnea, neonatal intensive care unit admission, bronchopulmonary dysplasia, and surfactant administration. The primary and secondary outcomes were assessed in the active (steroid) and placebo groups separately. We fit a logistic regression model to adjust for confounders related to respiratory morbidity. RESULTS Of a total of 2331 included women, 26.9% (n=627) were Black/African American, 57.1% (n=1333) White, 3.56% (n=83) Asian, and 12.36% (n=288) were other/mixed. In the placebo group, the rate of the primary outcome was significantly higher in Whites (18.6%) and Asians (22.8%) compared with the African American/Black group (12.3%) (P=.03). Adjusting for confounders, the primary outcome was not significant between the groups. The primary predictor for respiratory morbidity was a prior pregnancy with neonatal respiratory morbidity. Findings were similar in the steroid group, but severe respiratory morbidity was less common in Black infants compared with White infants (adjusted odds ratio, 0.45; 95% confidence interval, 0.24–0.83). However, a prior pregnancy with neonatal respiratory complications was no longer associated with respiratory morbidity after receipt of betamethasone. CONCLUSION Late preterm respiratory morbidity was similar between racial groups. Although a history of pregnancy with previous neonatal respiratory disease is the strongest risk factor for recurrence, this risk factor is mitigated by the receipt of steroids.
Long-term follow-up of adult hematopoietic stem cell transplant recipients diagnosed with COVID-19

e19028Background: Long-term complications of COVID-19 in hematopoietic stem cell transplant (HCT) recipients are unknown. Recent studies have described short term outcomes of COVID-19 infection pos...
The End of the Road for Gas Powered Automobiles

In seemingly shocking news, Norway, France, the United Kingdom, India, and China have announced intentions to give up and do away with gas-powered cars. Although the proposals vary in method, timing, and formal adoption, all seek elimination of the combustion engine to reduce unhealthy air pollution, stave off catastrophic climate change, or both. This article summarizes the proposals.
The Practice of Austere (Resource-Limited) Dermatology

Access to dermatology care in rural settings requires sustainable, affordable, and ethical interventions. Previous efforts to increase access to dermatology care in austere settings have provided a framework for future successful interventions. Effective training of local health care professionals provides the foundation for treating the disease burden in the region of interest. The general approach to building sustainable dermatology services involves a step-wise approach: consultation with local health authorities, planning and delineation of targeted interventions, careful implementation, and establishment of patient follow-up. Innovative telehealth solutions may provide an opportunity to augment the abilities of local providers with expert consultation that may not be available in some locations. Special techniques in procedural dermatology, including biopsy and cryosurgery, may expand opportunities for diagnosis and intervention in resource-limited environments; however, facilities for dermatopathology tissue processing may be difficult to access. In addition, successful management of basic dermatologic conditions requires access to appropriate medications. This chapter reviews general concepts, integration, and techniques focused on sustainable expansion of dermatology services along with discussion of ethical issues surrounding access to care in austere settings.