cssi/SciSciGPT-SciSciNet huggingface dataset:
PUMPING IONS: RAPID PARALLEL EVOLUTION OF IONIC REGULATION FOLLOWING HABITAT INVASIONS

Marine to freshwater colonizations constitute among the most dramatic evolutionary transitions in the history of life. This study examined evolution of ionic regulation following saline-to-freshwater transitions in an invasive species. In recent years, the copepod Eurytemora affinis has invaded freshwater habitats multiple times independently. We found parallel evolutionary shifts in ion-motive enzyme activity (V-type H + ATPase, Na + /K + -ATPase) across independent invasions and in replicate laboratory selection experiments. Freshwater populations exhibited increased V-type H+ ATPase activity in fresh water (0 PSU) and declines at higher salinity (15 PSU) relative to saline populations. This shift represented marked evolutionary increases in plasticity. In contrast, freshwater populations displayed reduced Na + /K + -ATPase activity across all salinities. Most notably, modifying salinity alone during laboratory selection experiments recapitulated the evolutionary shifts in V-type H + ATPase activity observed in nature. Maternal and embryonic acclimation could not account for the observed shifts in enzyme activity. V-type H + ATPase function has been hypothesized to be critical for freshwater and terrestrial adaptations, but evolution of this enzyme function had not been previously demonstrated in the context of habitat transitions. Moreover, the speed of these evolutionary shifts was remarkable, within a few generations in the laboratory and a few decades in the wild.
Logistic Versus Hazards Regression Analyses in Evaluation Research An Exposition and Application to the North Carolina Court Counselors' Intensive Protective Supervision Project

It is found that, although intensive supervision had the desired impact of reducing the probability of delinquent offenses during the early (first year and a half) phase of the project, this effect deteriorated over the full three and a half years of the experiment. In addition, the hazards regression analysis shows that youths under intensive supervtsion failed (recidivated with status or delinquent offenses) at a more rapid rate than those under regular supervision. Implications are drawn for the management and effectiveness of intensive supervision programs.
The role of postsecondary education in welfare reform. Ohio's JOBS Student Retention Program.

The 1996 federal welfare reform legislation encourages quick employment over education and training for the nation’s welfare recipients. However, some argue that a one-size-fits-all approach ignores the heterogeneity of this population. This article presents findings from a net impact evaluation of Ohio’s JOBS Student Retention Program (JSRP), a program designed to facilitate success for public assistance recipients at 2-year community or technical colleges. The authors evaluate this policy using state administrative data sets. The analyses consist of unadjusted and regression-adjusted comparisons of means for the JSRP group and a constructed comparison group. Outcomes examined include program completion, employment, earnings, and welfare recipiency. Focusing on the most recent 11 of 16 quarters of data available, the average increase in quarterly earnings was 8.45% for program participants and 12.91% for program completers. The results indicate that encouraging postsecondary education for some welfare re...
Optimizing cognitive load for learning from computer-based science simulations

How can cognitive load in visual displays of computer simulations be optimized? Middle-school chemistry students (N = 257) learned with a simulation of the ideal gas law. Visual complexity was manipulated by separating the display of the simulations in 2 screens (low complexity) or presenting all information on 1 screen (high complexity). The mode of visual representation in the simulation was manipulated by presenting important information in symbolic form only (symbolic representations) or by adding iconic information to the display (iconic + symbolic representations), locating the sliders controlling the simulation separated from the simulation or integrating them, and graphing either only the most recent simulation result or showing all results taken. Separated screen displays and the use of optimized visual displays each promoted comprehension and transfer, especially for low prior-knowledge learners. An expertise reversal effect was found for learners' prior general science knowledge. Results indicate that intrinsic and extraneous cognitive load in visual displays can be manipulated and that learners' prior knowledge moderates the effectiveness of these load manipulations.
Reply to Retrospective evaluation of cetuximab-related adverse events from claims databases—methodological concerns

Maier et al. [1] questioned the algorithm we applied to identify infusion reactions (IRs) associated with cetuximab using claims data and the appropriateness of comparing rates of IRs from a claims data analysis with those of clinical trials. Because there is no International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for IRs, we identified IRs based on IR-related diagnoses, procedures and medications indicative of medical interventions that would be associated with treatment of an IR. The algorithm was fully described in the methods section of the paper and where necessary, we cited the limitations of the algorithm. The rate of IRs requiring medical intervention in this study was 8.4%, which is consistent with the 7% reported by Schwartzberg et al. [2], and much lower than the 22% reported by O’Neil et al. [3] using clinical trial data. Furthermore, all-grade IRs are reported in the USA prescribing information for cetuximab as 15%–21%, and the rate of severe reactions are reported as 2%–5%. Given that clinical trials generally study a population that is not completely representative of the general population with colorectal cancer (CRC), it is entirely plausible that the rates we observed are reasonable for the general CRC population. Maier et al. [1] also commented that the rate of IRs during the initial infusion is lower in our study relative to the rate reported in the USA prescribing information for cetuximab. However, the rates reported in our study are consistent with other published literature. More specifically, Needle [4] reported that 33% of patients with severe IRs experienced events after their second dose of cetuximab. Lenz [5] also noted that 10%–30% of IRs to monoclonal antibodies are delayed and occur in later infusions. Differences in patient management between the clinical trial setting and routine clinical practice might contribute to the different findings. In summary, the findings from our study are consistent with other published literature. Using claims data, as we did in our study, provides information about real world clinical practice, and reflects the general population of patients with a given condition.
Time-Stamp-Counter Mechanism and Application on Sensor Networks

In this paper, the time-stamp-counter mechanism is applied to sensor networks. This mechanism improves the security, scalability, and flexibility of sensor network. It supports larger sensor networks. A designer can choose to trade off between many different kinds of resources. By applying this mechanism to SNEP as an example, it shows that our protocol can automatically synchronize counters, which makes the counter exchange protocol of SNEP an option not a must. Pair-wise counter is not a must. Instead, a dynamic counter allocation can be used, which reduces the number of counters. The mechanism also reduces the counter length. All of this resource reducing is important for resource limited networks, such as sensor networks and home networks.
Generation of banded iron formations by internal dynamics and leaching of oceanic crust

Banded iron formations are plentiful in the rocks representing early Earth, but the mechanisms by which they formed remain controversial. Geochemical modelling indicates that the hydrothermal leaching of low-aluminium ocean crust and subsequent chemical reactions in iron- and silica-rich hydrothermal fluids could have triggered the alternating deposition of iron and silica-dominated sediments. The chemical signatures and mineralogy of banded iron formations have the potential to provide information about the ocean environment on early Earth1,2,3,4,5,6,7. Their formation requires iron- and silicon-rich fluids, but the mechanisms by which the alternating layers of Si- and Fe-rich rock formed remain controversial8,9,10,11. Here we use thermodynamic calculations to show that Fe- and Si-rich fluids can be generated by hydrothermal leaching of low-Al oceanic crustal rocks such as komatiites. We find that positive feedbacks occur among the chemical reactions when hydrothermal fluids mix with ambient sea water. These feedbacks lead to alternating precipitation of Fe and Si minerals, owing to the formation of complexes between Fe(II) and silicic acid. We suggest that the small-scale (<1 cm) banding was produced by internal dynamics of the geochemical system, rather than any external forcing. As the Archaean eon progressed, the oceanic crust produced was rich in Al12. When Al-rich crust undergoes hydrothermal alteration, Fe is locked in Al–Fe silicate minerals. This results in iron-depleted hydrothermal fluids, and thus prevents the deposition of Fe-rich minerals. We therefore conclude that the widespread cessation of banded iron formation deposition 1.7 billion years ago reflects the changing composition of the oceanic crust.
Automated Verification Tool for DHTML

Automated verification for client-side programs of DHTML applications has become necessary. This is because DHTML applications are increasingly complicated in order to enhance the functionality and usability of dynamic Web content. We are therefore motivated to create a tool for automatically verifying a JavaScript program of a DHTML application against a specification describing the page flows. The verification is based on a type inference technique focusing on DOM updates.
Electron Cryotomography of the E. coli Pyruvate and 2-Oxoglutarate Dehydrogenase Complexes

The E. coli pyruvate and 2-oxoglutarate dehydrogenases are two closely related, large complexes that exemplify a growing number of multiprotein “machines” whose domains have been studied extensively and modeled in atomic detail, but whose quaternary structures have remained unclear for lack of an effective imaging technology. Here, electron cryotomography was used to show that the E1 and E3 subunits of these complexes are flexibly tethered ~11 nm away from the E2 core. This result demonstrates unambiguously that electron cryotomography can reveal the relative positions of features as small as 80 kDa in individual complexes, elucidating quaternary structure and conformational flexibility.
Immune Effects of Chemotherapy, Radiation, and Targeted Therapy and Opportunities for Combination With Immunotherapy

There have been significant advances in cancer treatment over the past several years through the use of chemotherapy, radiation therapy, molecularly targeted therapy, and immunotherapy. Despite these advances, treatments such as monotherapy or monomodality have significant limitations. There is increasing interest in using these strategies in combination; however, it is not completely clear how best to incorporate molecularly targeted and immune-targeted therapies into combination regimens. This is particularly pertinent when considering combinations with immunotherapy, as other types of therapy may have significant impact on host immunity, the tumor microenvironment, or both. Thus, the influence of chemotherapy, radiation therapy, and molecularly targeted therapy on the host anti-tumor immune response and the host anti-host response (ie, autoimmune toxicity) must be taken into consideration when designing immunotherapy-based combination regimens. We present data related to many of these combination approaches in the context of investigations in patients with melanoma and discuss their potential relationship to management of patients with other tumor types. Importantly, we also highlight challenges of these approaches and emphasize the need for continued translational research.
Women's oral health: the evolving science.

The evidence base for women’s oral health is emerging from legislative action, clinical research, and survey documentation. The Women’s Health in the Dental School Curriculum study (1999) followed a similar study (1996) of medical school curricula. Both of these major efforts resulted from statutory mandates in the National Institutes of Health Revitalization Act of 1993 (updated October 2000). A major study of the Institute of Medicine (IOM) National Academy of Sciences in 2001 concluded that “the study of sex differences is evolving into a mature science.” This IOM study documented the scientific basis for gender-related policy and research and challenged the dental research enterprise to conduct collaborative, cross-disciplinary research on gender-related issues in oral health, disease, and disparities. This report chronicles some of the factors that have and continue to influence concepts of women’s oral health in dental education, research, and practice. Gender issues related to women’s health are no longer restricted to reproductive issues but are being considered across the life span and include psychosocial factors that impact women’s health and treatment outcomes.
Return to Learn: a review of cognitive rest versus rehabilitation after sports concussion

BACKGROUND: Cognitive rest is the recommendation for all patients with acute sports concussion. OBJECTIVE/METHODS: A comprehensive literature search was conducted for the research question "What is the optimal cognitive load for patients with a sports concussion?" RESULTS: Seven studies met the inclusion criteria. The optimal cognitive load for patients after sports concussion is yet to be determined. CONCLUSIONS: Additional controlled trials of cognitive rehabilitation are needed to establish best clinical practice. The authors suggest memory training, cognitive behavioral therapy, and environmental interventions as areas of future research for sports concussion injuries. Language: en
Clinical coaching: The means to achieving a legacy of leadership and professional development in nursing practice

The theory of clinical coaching has growing significance within the profession of nursing. Due to increasing turnover rates and decreasing retention rates of novice nurses has amplified the need for clinical coaching by expert nurses. By equipping the expert nurse with the knowledge, skills, and behaviors which promotes the legacy of leadership and professional development in nursing practice, effective clinical coaching will foster supportive, professional relationships, and lead to excellent patient care standards.
Formulating Lake Models which Preserve Spectral Statistics

The ability of numerical lake models to predict verifiable results is very poor. Difficulties with the popular point by point verification method are intractable when confronted with these turbulent flows which have only reproduceable statistics. A lake transport model is formulated which permits the calculation of not only mean field quantities but the known spectral details of turbulent flow. Higher order spatial averaging of the nonlinear terms by a low pass filter results in a sequence of third order differential terms. Additionally, the correlated terms resulting from the filtration are closed with the Smagorinsky subgrid scale viscosity representation. Finite difference representations were used with second order accurate schemes on the third order corrective differential terms and fourth order on all others. Mean flow field computations were verified by intercomparison with existing rigid lid circulation models. Differences between computations were negligible with only small increases in time and storage.
Compari son of Load Path Definitions in 2 -D Continuum Structures

The structural mechanics community has developed several methods to identify and visualize load paths in structures. There is no single accepted approach or method to characterize, quantify , visualize and tailor load paths. This paper compares various methods proposed to characterize and visualize load paths. The comparison is performed for a two dim ensional (2 -D) rectangular plate under plane stress conditions arising from different loading and boundary conditions. The effectiveness and computational effort of each method are compared . The comparisons shows the methods provide different results and i nsights into the load transfer mechanisms. No single method appears to emerge as a clear choice for characterizing load pat hs. However, some methods provide more qualitative and quantitative information on the trajectory and efficiency of load transfer alo ng load paths. I. Introduction Structural design engineers need to be able to visualize how a load is transferred from its application point to the support or reaction points . Knowing how load “flows” in a structure is important at the design stage to make s ure that the structure will perform its intended function properly. It is also important for optimum material utilization and for ass essing the overall integrity of a structure. In case the structure is damage d, it is crucial to anticipate how the load flo w will change in order to ensure that the structure can continue to perform it s basic functions. Thus , it is important to identify alternate load paths in case the primary load path is damaged. In addition to identifying alternate load paths, engineers may want to be able to specifically tailor alternate load paths so that the structure can perform its basic functions under various unforeseen damage conditions. Although it is clear why knowledge of load pathways is important , no unified approach has been de veloped to quantify, characterize, and visualize av ailable load paths in a structure . This work presents and compares different methods that have been developed for characte rizing load paths . . The methods are used to visualize load paths in a rectangular plate structure under various boundaries and loading conditions. The effectiveness of each method is investigated by analyzing the information obtained from each visualization. II. Load Path Definitions Over the years , the structural community has developed se veral methodologies that can be used to define load paths in a structure. Each method was derived differently and therefore result s in varied visualization s and interpretation s of structural load paths. The different methods investigated in this work are explained in the following sections. A. Using vectors aligned with directions of principal stresses
Patterns of Bile Acids and Microflora in the Human Small Intestine: II. Microflora

The microbial flora of the small bowel and feces were examined in 12 normal control subjects, 8 patients with ileal resection (4 with and 4 without recurrent regional enteritis), and 3 patients with small bowel stasis. Intestinal contents were collected and cultured under rigorous anaerobic conditions to assure growth of oxygen-intolerant bacteria. The samples of intestinal fluids were collected from five areas, 50 cm apart. Most normal subjects yielded from their proximal and mid-small bowels small numbers of gram-positive aerobic bacteria. In addition, some of these controls yielded from the same regions populations of coliforms and anaerobic bacteria (bacteroides) at levels up to 104 per ml. Four patients with ileal resection had significant overgrowth of a fecal-type flora in the small bowel regardless of whether or not small bowel disease was present. Impressive overgrowth of a fecal-type flora was present in the small intestine of all 3 stasis patients. Anaerobic tapered rods (fusiform-shaped bacteria) were present in the feces of resection patients less often than in normal subjects. There were no other differences in fecal flora among the three groups.
Considerations for model curation in model-centric systems engineering

Contemporary systems are often highly complex sociotechnical systems that require models to help system engineers with sense-making and decision-making. The systems community has developed and instantiated many modeling approaches, practices, formal languages and toolsets, which are all areas of progress. If models and their instantiations could be managed as assets, documented, archived, protected, retrieved and re-used as such, modeling and analysis tasks would likely gain in quality and timeliness. This paper asks the question "What would a curator need to know about models or their instantiations to provide a model curation function"? Considerations of the activities and body of knowledge associated with curation of models are presented. The potential usefulness of a curated system modeling approach is illustrated in an example.
Circuit optimization algorithms for real-time spectrum sharing between radar and communications

The ability of radar and communication applications to share the radio spectrum will require the use of innovative agile circuit techniques for radar and communications. Reconfigurable circuits can provide real-time adjustment of operating frequency and spectral output, while maintaining system performance and maximizing power efficiency. This paper discusses recent developments in circuit optimization techniques for power efficiency and spectral performance. Optimization of a single parameter (load reflection coefficient) for multiple criteria is first addressed, followed by multiple-parameter, multiple-criteria optimizations. The use of the recently innovated Smith Tube to optimize additional parameters, such as input power and bias voltage, simultaneously with the load impedance is discussed. Optimization examples and a forward look to fast, emerging multidimensional circuit optimization techniques are provided.
Leadership and behavior in humanitarian and development transnational non-governmental organizations

Does leadership matter in the governance of civil society organizations? In particular, do the CEOs of humanitarian and development NGOs exhibit different leadership styles and perceive their work environments in different ways as the literature suggests. To explore this question we interviewed 96 CEOs—32 from humanitarian NGOs and 64 from development NGOs. In the process we found support for the descriptions of the leadership of these two types of organizations extant in the research and practitioner literatures. Those in charge of humanitarian NGOs were more likely to challenge the constraints in their environments, to be interested in influencing what was happening, to want to affect outcomes, and to be focused on addressing the needs of those in the communities facing the crisis, disaster, or emergency. They viewed themselves as having short time in which to respond and chose to communicate and act informally as well as to only collaborate with other organizations if pushed. Providing direct aid and service were high priorities as was advocacy to secure the funding necessary for completing their task. In contrast, CEOs leading development NGOs focused more on respecting and working within the constraints of their positions, being adaptable and flexible in working on having an impact—in effect, being interested in building coalitions and achieving consensus as well as indulging in compromise with the intent of solving the endemic problems that they were there to address. They had a longer time perspective than their humanitarian counterparts and were willing to work within fairly hierarchical structures as well as with a variety of types of collaborators to reach their goals.
Consideration of Envelope Airtightness in Modelling Commercial Building Energy Consumption

AbstractAs strategies for improving building envelope and HVAC equipment efficiencies are increasingly required to reduce building energy use, a greater percentage of energy loss will occur through building envelope leakage. Although the energy impacts of unintended infiltration on a building’s energy use can be significant, current energy simulation software and design methods are generally not able to accurately account for envelope infiltration and the impacts of improved airtightness. The airflow analyses capabilities of several energy simulation software tools are summarized, including whether the program calculates airflow rates for the user or accepts them as inputs. The bases of these airflow rate estimation approaches are evaluated for their physical soundness and accuracy. A new strategy to more accurately incorporate airflow calculations into energy software is also proposed, which is based on relationships between building infiltration rates calculated using detailed multizone airflow models a...
CATO: The Clone Alignment Tool

High-throughput cloning efforts produce large numbers of sequences that need to be aligned, edited, compared with reference sequences, and organized as files and selected clones. Different pieces of software are typically required to perform each of these tasks. We have designed a single piece of software, CATO, the Clone Alignment Tool, that allows a user to align, evaluate, edit, and select clone sequences based on comparisons to reference sequences. The input and output are designed to be compatible with standard data formats, and thus suitable for integration into a clone processing pipeline. CATO provides both sequence alignment and visualizations to facilitate the analysis of cloning experiments. The alignment algorithm matches each of the relevant candidate sequences against each reference sequence. The visualization portion displays three levels of matching: 1) a top-level summary of the top candidate sequences aligned to each reference sequence, 2) a focused alignment view with the nucleotides of matched sequences displayed against one reference sequence, and 3) a pair-wise alignment of a single reference and candidate sequence pair. Users can select the minimum matching criteria for valid clones, edit or swap reference sequences, and export the results to a summary file as part of the high-throughput cloning workflow.
A REVIEW OF THE USE OF CALCIUM LIQUID VERSUS CALCIUM TABLETS FOR MAINTAINING CORRECTED CALCIUM LEVELS

Aim Since the discontinuation of a commercially available liquid calcium medicine, there have been various local strategies to obtain adequate calcium levels, particularly in suspected 22Q11.2 deletion syndrome children post cardiothoracic surgery. Pharmacy obtained on special order a Calcium Liquid food supplement (0.5 mmol calcium/ml) for use in those children whom effervescent tablets did not appear to improve corrected calcium. Anecdotally it was thought that calcium liquid was better tolerated and absorbed, resulting in quicker recovery time of corrected calcium than use of the effervescent tablets. This review of patients was intended to determine if the use of the liquid was associated with a significant improvement in calcium levels compared to the use of tablets. Method A dispense report was undertaken to identify those patients supplied with the calcium liquid product from May 2014 to May 2015. Using the electronic prescribing system, the patients electronic health record was accessed, and the following information recorded; calcium, albumin, intake calcium in fluids, TPN, oral and Intravenous. The data was collected for seven days previous to the first administration of calcium liquid and seven days after where available. Corrected calcium was calculated using an accepted method (calcium=serum calcium+0.02* (normal albumin – patient albumin)). Results Nine children supplied with calcium liquid between May 2014 and May 2015. Four patients who did not have histories on the electronic prescribing system were excluded for ease of analysis. The electronic medication record of the five remaining patients was used to compare calcium intake from all sources including fluids and feed. As expected calcium levels (and corrected calcium level where relevant) did improve when calcium liquid was added in. However four of the patients received calcium from multiple sources. Of these three received more calcium (mmol/kg/day) in fluids and feeds than from the administered pharmacy product. One single patient did not receive calcium from any other sources (fluids/TPN/feed). However there did not appear to be a significant change in calcium levels when calcium liquid was introduced as opposed to calcium tablets. Conclusion Although based on a small number of patients, from this experience it would not seem that the calcium liquid obtained by pharmacy results in higher calcium serum levels. Further analysis may be required to distinguish the effects from calcium intake in feed/fluid and calcium intake from medicines.
An approximate method for solving fractional optimal control problems by hybrid functions

In this paper, a new numerical method for solving fractional optimal control problems by using hybrid functions is presented. The Riemann–Liouville fractional integral operator for hybrid functions...
Promoting cancer screening among churchgoing Latinas: Fe en Acción/faith in action.

Cancer screening rates among Latinas are generally low, reducing the likelihood of early cancer detection in this population. This article examines the effects of a community intervention (Fe en Accion/Faith in Action) led by community health workers (promotoras) on promoting breast, cervical and colorectal cancer screening among churchgoing Latinas. Sixteen churches were randomly assigned to a cancer screening or a physical activity intervention. We examined cancer knowledge, barriers to screening and self-reported mammography, clinical breast exam, Pap test, fecal occult blood test and sigmoidoscopy or colonoscopy at baseline and 12 months follow-up. Participants were 436 adult Latinas, with 16 promotoras conducting a cancer screening intervention at 8 out of 16 churches. The cancer screening intervention had a significant positive impact on self-reported mammography (OR = 4.64, 95% CI: 2.00-10.75) and breast exams in the last year (OR= 2.82, 95% CI: 1.41-5.57) and corresponding reductions in perceived (87.6%) barriers to breast cancer screening (P < .008). Cervical and colorectal cancer screening did not improve with the intervention. These findings suggest Fe en Accion church-based promotoras had a significant impact on promoting breast cancer screening among Latinas. Colon cancer screening promotion, however, remains a challenge.
OPM Data Breach Case Study: Mitigating Personnel Cybersecurity Risk

The OPM data breach reminds us that the government’s stored information is always at risk and under attack by malign actors. Knowledge of such persistent threats must not be ignored. Likewise, knowledge of relevant threats must be spread through government to the entire cybersecurity workforce through effective and efficient training. Further, mandatory and timely reporting of cybersecurity incidents and data breaches is required so that employees have the best opportunity to protect themselves and the government. In the event that such timely notification does not occur, there needs to be a standard to which officials can be held accountable. These methods may be easier and more cost-effective ways to mitigate cybersecurity risk across the government (compared to various attempts by OPM) and protect the nation’s security. Such prophylactic methods can be thought of as rectifying “sloppy cyber hygiene,” identified in the wake of the OPM Data Breach.
Encoder logic for reducing serial I/O power in sensors and sensor hubs

Communicating data from sensors such as gyroscopes and accelerometers, to processors, typically occurs over printed circuit board traces. This communication can cost up to 40 µW at data rates of 1 Mb/s.
NEW INSIGHTS FROM COST ACCOUNTING INTO BRITISH ENTREPRENEURIAL PERFORMANCE CIRCA 1914

This article takes issue with economic historians who have tried to rehabilitate the reputation of the late Victorian and Edwardian entrepreneur. It argues that the revisionist attempt to ground their case on cost, profit, and productivity calculations flounders because of an insufficient analysis of the factors involved in arriving at cost, profit, and productivity. The economic historian, preoccupied with recent European economic development could, therefore, improve his analysis by incorporating the science of management accounting into his methodology. A companion piece to this article will be published in the fall issue of the journal.
Missed Testing Opportunities for HIV Screening and Early Diagnosis in an Urban Tertiary Care Center

Newark, New Jersey, is disproportionally affected by HIV with one of the highest prevalence rates in the United States. Rutgers New Jersey Medical School is a major healthcare provider to Newark’s underserved population and has implemented a HIV testing program that can diagnose and link newly diagnosed individuals to care. We conducted a retrospective chart review of all new patients seen in the Infectious Disease Practice from January 1, 2013, to December 31, 2014, to determine the proportion of patients with a missed testing opportunity (MTO) (patients with a new HIV diagnosis with an encounter at the institution in the 1 year prior to their first appointment). 117 newly diagnosed patients were identified. 36 (31%) had at least one MTO. A total of 34 (29%) of newly diagnosed patients had AIDS at presentation and 17% had CD4 counts of 50 cells/μL ( value 0.5). The two most common locations of a missed testing opportunity were the hospital ED (45%) and subspecialty clinics (37%). This study demonstrates that, even in a high prevalence institution with HIV counseling, testing, and referral service, HIV screening is lacking at multiple points of care and patients are missing opportunities for earlier diagnosis and treatment.
Globalization and Human Resources Management in the Public Sector

Despite the current advocacy of a limited role for the state and the drive for privatization, governments continue to play a primary role in the delivery of services. However, following the recession of 2008, which was accompanied by auto, banking and housing industry failures in the United States, there is now increased demand for government control. Despite President Trump’s call for a reduction in the role of the government , his ambitious plans for border security and immigration control, and economic regulations will require the recruitment of more public personnel. Most of the countries in the world face complex problems which defy easy solutions. As a result, there is an increased emphasis on the role played by human resources management (HRM) in the public sector. This chapter discusses the problems of recruitment resulting from the loss of prestige, and the loss of tenure in public employment. Khan analyzes the current challenges of performance, procedural justice, diversity, democracy and the protection of whistle blowers.
Effects of an upbeat and positive attitude in customer service interactions

Effects of an Upbeat and Positive Attitude In Customer Service Interactions by Brent Pritchett Clark Kincaid, Committee Chair Assistant Professor of Hotel Management In an extension of research demonstrating the effects of an upbeat and positive attitude in customer service interactions, the experiment and case studies examined in this paper identified evidence in support of displaying a positive behavior during customer service interactions. In the experiment, casino table game dealers were identified that exuded a consistent upbeat and positive attitude. These dealers were compared to other dealers who were inconsistent in their behavior. The experiment revealed that dealers, who engaged customers with a positive attitude, earned more in tipped income. In a series of case studies, service surveys were taken from customers that experienced a normal wait for service at counter service areas and in receiving beverage service. Those customers who experienced a normal wait, but received service from an upbeat and positive employee, rated the interaction better than or equal to service received in a timely manner. It is clear when customer service employees perform their duties with an upbeat and positive attitude, have the ability to affect certain aspects of customer service interactions.
Doug Rauch: Solving the American Food Paradox

Doug Rauch, the former president of grocery store chain Trader Joe's, had long been troubled by the amount of food, especially fresh and healthy produce, which was wasted in the food system. Simultaneously, he was frustrated by the paradox he saw in the U.S. food system: rising food insecurity, broadly defined as a lack of access to enough food to fully meet basic needs at all times, concurrent with an obesity epidemic, suggesting that low-income communities lacked access not just to food in general, but to healthy foods in particular. Rauch believed he could build a non-profit grocery store model that took advantage of grocery stores' built-in waste and channeled that wasted food to be resold at a significant discount. Rauch faced significant challenges in the implementation and execution of his plan, notably legal hurdles related to selling products past their expiration date, marketing challenges, and convincing grocers to partner with him to combat waste. He had to carefully select a partner from a number of interested parties. Finally, he would need to change shopping, eating, and cooking behaviors of a community. In doing so, he hoped to leave a lasting positive health impact and a scalable model for change across the United States.Learning Objective: Look at new solutions to food policy and obesity issues in the U.S. Examine creative business models and partnerships. Look at private sector's role in solving large societal problems such as obesity and lack of access to healthy foods. Examine business models, logistics, and planning for unique food retail operation. Examine current food retail model and inherent inefficiencies. Identify synergies and alignment in partnerships that will allow for good relationships and also red flags in partnerships that will likely make success hard to achieve. Discuss the benefits and restrictions of a mission-driven operation, especially in the retail context.
Evoked Potentials in Patients with Neurological Disorders

Averaged evoked potentials have been investigated in the research laboratory for many years but it is only in the last few years that the clinical applications of these methods have received emphasis. In the preceding three chapters of this volume clinically oriented research is presented. These investigations and other related material are discussed in the first part of this chapter. The second part consists of a brief review of the applications of evoked potential methods in the clinical evaluation of patients with neurological disorders.
Implications of the replaced right hepatic artery originating from the gastroduodenal artery in the setting of a pancreatic head mass.

Abstract Purpose The anatomic variability of the hepatic artery has important implications in the treatment of periampullary cancers. The purpose is of this report is to describe the importance of the replaced right hepatic artery originating from the gastroduodenal artery, which is typically removed during a pancreatic head resection, and to demonstrate how this variant can markedly alter treatment planning and intraoperative decision making. Materials and methods In this report, two cases of a replaced right hepatic artery originating from the gastroduodenal artery are described in the setting of a borderline-resectable pancreatic adenocarcinoma identified on preoperative CT imaging. Results The importance of identifying this variant preoperatively is highlighted. In addition, the implications involved in preserving the replaced right hepatic artery are emphasized, requiring preservation of a portion of the gastroduodenal artery within the pancreatic parenchyma during pancreaticoduodenectomy. Conclusion The location of this variant in the setting of a pancreatic head malignancy mandates its attention by a multidisciplinary team of radiologists, radiation oncologists, medical oncologists, and surgeons, prior to pancreaticoduodenectomy.
Selling Anthropocene space: situated adventures in sustainable tourism

The Anthropocene is a proposed technical term for a new geological timeframe, but it is also a conceptual tool with the potential to redefine the stakes of contemporary environmental politics. One ...
Mortality and Neurodevelopmental Outcomes in the Heart Rate Characteristics Monitoring Randomized Controlled Trial.

Objective To test whether the composite outcome of death or neurodevelopmental impairment (NDI) at 18-22 months corrected age for infants ≤1000 g at birth is decreased by continuous monitoring of heart rate characteristics during neonatal intensive care. Study design We studied a subset of participants enrolled in a multicenter randomized trial of heart rate characteristics monitoring. Survivors were evaluated at 18-22 months corrected age with a standardized neurologic examination and the Bayley Scales of Infant Development-III (BSID-III). NDI was defined as Gross Motor Function Classification System of >2 (moderate or severe cerebral palsy), BSID-III language or cognitive scores of Results The composite outcome, death or NDI, was obtained for 628 of 884 study infants (72%). The prevalence of this outcome was 44.4% (136/305) among controls (infants randomized to heart rate characteristics monitored but not displayed) and 39.4% (127/321) among infants randomized to heart rate characteristics monitoring displayed (relative risk, 0.89; 95% CI, 0.74-1.07; P = .22). Mortality was reduced from 32.0% (99/309) among controls to 24.2% (79/327) among monitoring displayed infants (relative risk, 0.75; 95% CI, 0.59 to 0.97; P = .028). The composite outcomes of death or severe CP and death or mildly low Bayley cognitive score occurred less frequently in the displayed group (P Conclusions We found no difference in the composite outcome of death or NDI for extremely preterm infants whose heart rate characteristics were and were not displayed during neonatal intensive care. Two outcomes that included mortality or a specific NDI were less frequent in the displayed group.
Assessing the Ability of Comorbidity Indexes to Capture Comorbid Disease in the Inpatient Rehabilitation Spinal Cord Injury Population.

Abstract Objective To examine whether commonly used comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, the Centers for Medicare and Medicaid Services [CMS] comorbidity tiers) capture comorbidities in the acute traumatic and nontraumatic SCI inpatient rehabilitation population. Design Retrospective cross-sectional study. Participants Data were obtained from the Uniform Data System for Medical Rehabilitation from October 1, 2015 to December 31, 2017 for adults with spinal cord injury (SCI) (Medicare-established Impairment Group Codes 04.110-04.230, 14.1, 14.3). This study included SCI discharges (N=66,235) from 833 inpatient rehabilitation facilities. Main Outcome Measures International Classification of Diseases–10th Revision–Clinical Modifications (ICD-10-CM) codes were used to assess 3 comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, CMS comorbidity tiers). The comorbidity codes that occurred with >1% frequency were reported. The percentages of discharges for which no comorbidities were captured by each comorbidity index were calculated. Results Of the total study population, 39,285 (59.3%) were men and 11,476 (17.3%) were tetraplegic. The mean number of comorbidities was 14.7. There were 13,939 distinct ICD-10-CM comorbidity codes. There were 237 comorbidities that occurred with >1% frequency. The Deyo-Charlson comorbidity index, Elixhauser comorbidity index, and the CMS tiers did not capture comorbidities of 58.4% (95% confidence interval, 58.08%-58.84%), 29.4% (29.07%-29.76%), and 66.1% (65.73%-66.46%) of the discharges in our study, respectively, and 28.8% (28.42%-29.11%) of the discharges did not have any comorbidities captured by any of the comorbidity indexes. Conclusion Commonly used comorbidity indexes do not reflect the extent of comorbid disease in the SCI rehabilitation population. This work suggests that alternative measures may be needed to capture the complexity of this population.
CD209L/L-SIGN and CD209/DC-SIGN act as receptors for SARS-CoV-2 and are differentially expressed in lung and kidney epithelial and endothelial cells

Abstract The spike protein (S) of SARS-CoV-2 mediates entry into human cells by interacting with human angiotensin-converting enzyme 2 (ACE2) through its receptor-binding domain (RBD). Here, we report identification of CD209L/L-SIGN and a related protein, CD209/DSIGN as alternative receptors capable of mediating SARS-CoV-2 entry into human cells. Immunofluorescence staining of human tissues revealed a prominent expression of CD209L in the lung and kidney epithelial and endothelial cells of small and medium-sized vessels, whereas CD209 was detected only in a limited number of cell types. Biochemical assays revealed that ectopically expressed CD209L and CD209 bind to S-RBD and mediate SARS-CoV-2 S-pseudotyped virus entry. Furthermore, we demonstrate that human endothelial cells endogenously express CD209L and are permissive to SARS-CoV-2 infection. Soluble CD209L-Fc neutralized virus entry. Our observations show that CD209L and CD209 serve as alternative receptors for SARS-CoV-2 in disease-relevant cell types, including the vascular system. This may have implications for antiviral drug development.
Understanding the Effects of Iron Precursor Ligation and Oxidation State Leads to Improved Synthetic Control for Spinel Iron Oxide Nanocrystals

Iron oxide nanocrystals have the potential for use in a wide variety of applications if we can finely control and tune the diverse structural attributes that lead to specific, desired properties. At the high temperatures utilized for thermal decomposition based syntheses, commonly used Fe(III) alkylcarboxylate precursors are inadvertently reduced and produce wustite (FeO), which is paramagnetic, as opposed to the desired ferrimagnetic spinel phases of magnetite (Fe3O4) and maghemite (γ-Fe2O3). To circumvent this issue, we carried out syntheses at lower temperatures (∼230 °C) using an esterification-mediated approach. Under these conditions, formation of the FeO phase can be avoided. However, we found that the precursor oxidation state and ligation had a surprisingly strong influence on the morphologies of the resulting nanocrystals. To investigate the cause of these morphological effects, we carried out analogous nanocrystal syntheses with a series of precursors. The use of Fe(III) oleate precursors yielded highly crystalline, largely twin-free nanocrystals; however, small amounts of acetylacetonate ligation yielded nanocrystals with morphologies characteristic of twin defects. During synthesis at 230 °C, the Fe(III) oleate precursor is partially reduced, providing sufficient quantities of Fe(II) that are needed to grow the Fe3O4 nanocrystals (wherein one-third of the iron atoms are in the Fe(II) state) without twinning. Our investigations suggest that the acetylacetonate ligands prevent reduction of Fe(III) to Fe(II), leading to twinned structures during synthesis. Harnessing this insight, we identified conditions to predictably and continuously grow octahedral, spinel nanocrystals as well as conditions to synthesize highly twinned nanocrystals. These findings also help explain observations in the thermal decomposition synthesis literature which suggest that iron oxide nanocrystals produced from Fe(acac)3 are less prone to FeO contamination in comparison to those produced from Fe(III) alkylcarboxylates.