cssi/SciSciGPT-SciSciNet huggingface dataset:
Patterns of Hospital Performance on the Hospital-Wide 30-Day Readmission Metric: Is the Playing Field Level?

Hospital performance on the 30-day hospital-wide readmission (HWR) metric as calculated by the Centers for Medicare and Medicaid Services (CMS) is currently reported as a quality measure. Focusing on patient-level factors may provide an incomplete picture of readmission risk at the hospital level to explain variations in hospital readmission rates. To evaluate and quantify hospital-level characteristics that track with hospital performance on the current HWR metric. Retrospective cohort study. A total of 4785 US hospitals. We linked publically available data on individual hospitals published by CMS on patient-level adjusted 30-day HWR rates from July 1, 2011, through June 30, 2014, to the 2014 American Hospital Association annual survey. Primary outcome was performance in the worst CMS-calculated HWR quartile. Primary hospital-level exposure variables were defined as: size (total number of beds), safety net status (top quartile of disproportionate share), academic status [member of the Association of American Medical Colleges (AAMC)], National Cancer Institute Comprehensive Cancer Center (NCI-CCC) status, and hospital services offered (e.g., transplant, hospice, emergency department). Multilevel regression was used to evaluate the association between 30-day HWR and the hospital-level factors. Hospital-level characteristics significantly associated with performing in the worst CMS-calculated HWR quartile included: safety net status [adjusted odds ratio (aOR) 1.99, 95% confidence interval (95% CI) 1.61–2.45, p 400 beds, aOR 1.42, 95% CI 1.07–1.90, p = 0.016), AAMC alone status (aOR 1.95, 95% CI 1.35–2.83, p < 0.001), and AAMC plus NCI-CCC status (aOR 5.16, 95% CI 2.58–10.31, p < 0.001). Hospitals with more critical care beds (aOR 1.26, 95% CI 1.02–1.56, p = 0.033), those with transplant services (aOR 2.80, 95% CI 1.48–5.31,p = 0.001), and those with emergency room services (aOR 3.37, 95% CI 1.12–10.15, p = 0.031) demonstrated significantly worse HWR performance. Hospice service (aOR 0.64, 95% CI 0.50–0.82, p < 0.001) and having a higher proportion of total discharges being surgical cases (aOR 0.62, 95% CI 0.50–0.76, p < 0.001) were associated with better performance. The study approach was not intended to be an alternate readmission metric to compete with the existing CMS metric, which would require a re-examination of patient-level data combined with hospital-level data. A number of hospital-level characteristics (such as academic tertiary care center status) were significantly associated with worse performance on the CMS-calculated HWR metric, which may have important health policy implications. Until the reasons for readmission variability can be addressed, reporting the current HWR metric as an indicator of hospital quality should be reevaluated.
Innovating the routine? Signs of evolving organizational performance in surveys of federal managers

Insufficient achievement of performance management in the federal government is widely acknowledged, despite the absence of an accepted way for determining when and how progress has been made. The process of maturation is traced through a model based on Stinchcombe’s innovation framework, enabling progress toward utilization of performance management to be gauged. The premise of this model is that change has to permeate the organization, reaching the level of routines, to be implemented operationally. Assessment of performance management maturity employs a match between the obstacles expected in the distinct stages of adoption and implementation and the hindrances federal agencies have encountered. Quantitative analysis of data provided by pooled Government Accountability Office surveys of federal managers points to activity at the adoption stage, but not at the implementation stage, calling into question the maturity of the performance initiative.
Cash for Cashews: Does It Add Up?

Starting in the 1960s and 1970s, but especially since the 1990s, cashew production has boomed in Guinea Bissau. It has been encouraged by the World Bank, the Guinea Bissau government, European and American development agencies, various NGOs, and experts everywhere, in keeping with development discourse and the neoliberal growth narrative. However, as cashew production has increased, rice production has declined: rather than growing their own rice, people grow cashews to exchange for rice imported from Southeast Asia. Smaller rice harvests and dependence on world cashew prices are leading to food insecurity and social instability. Furthermore, cashews have taken over local ecosystems and once common plants and animals are disappearing. In other words, a self-sufficient, locally controlled, sustainable, environmentally friendly subsistence economy has been turning into an unsustainable, monoculture economy that depends on fluctuating global markets. The shift has brought about changes in social organization, gender relations, and religious activities and is wreaking havoc on the environment. (154)
New Frontiers in American Capital Punishment Litigation

This chapter summarizes two significant developments influencing capital punishment in the United States. First, in Atkins v. Virginia (2002) and Roper v. Simmons (2005), the Supreme Court of the United States held that the death penalty could not be inflicted upon, respectively, mentally retarded persons and persons under the age of eighteen because the characteristics of those groups rendered them insufficiently culpable to justify the punishment. Influential professional groups have proposed extending the principle to mentally ill persons, a proposal that is likely to be adopted case-by-case by the Supreme Court. Second, Cullen v. Pinholster (2011) limited the power of a federal court reviewing a death sentences to examine the state court record independently. But Martinez v. Ryan (2012) for the first time allowed a petitioner seeking federal court review to attack the quality of legal assistance he received in the later stages of state court review. As a result the positive and negative incentives for states to have robust systems of post-conviction review have increased. These two developments should accelerate the existing downward trend in executions.
Some issues in generation from a semantic representation

This paper investigates certain problems in the production of text from a languaqe-free representation and proposes a model of generation to treat these problems. We deal with generation of connected text. We show that the generation of a connected text cannot be reduced to a simple combination of phrases expressing sub-parts of the representation, but must be based on patterns of discourse structure reflecting the whole representation.
Effects of Interleukin-3 and Granulocyte-Macrophage Colony-Stimulating Factor on Thrombopoiesis in Congenital Amegakaryocytic Thrombocytopenia

Amegakaryocytic thrombocytopenia (AMT) is a rare and often fatal disorder of infancy and childhood presenting with isolated thrombocytopenia that progresses to marrow failure. The defect in thrombopoiesis is not well understood nor is the etiology of the progressive marrow failure. No standard modality of treatment exists. Here, we evaluated the capacity of marrow cells isolated from five patients with AMT and progressive marrow failure to generate megakaryocyte progenitor cells (CFU-MK). These in vitro studies demonstrated assayable numbers of CFU-MK from all patient bone marrows that responded in vitro to the addition of interleukin-3 (IL-3), granulocyte-macrophage colony-stimulating factor (GM-CSF), or the combination of both. These findings suggest that the defect in AMT might be partially correctable by the administration of these cytokines. A Phase I/II trial of in vivo administration of these same hematopoietins in the identical patients was conducted in which no significant toxicity was observed. IL-3 but not GM-CSF administration resulted in improved platelet counts in two patients and decreased bleeding and transfusion requirement in the remaining three. No clinical benefit was observed when GM-CSF was administered after IL-3 pretreatment. Prolonged IL-3 administration has resulted in platelet increases in an additional two patients. In vitro responsiveness of CFU-MK to either cytokine did not predict the degree of clinical response. Although the optimal dose and schedule of IL-3 either alone or in combination remains to be established, this study suggests that IL-3 may contribute to the treatment of patients with AMT.
Polare aromatische Substitutionen

Bei der Nitrierung von N-Benzylanilin 1 kann die Substitution durch die Wahl des Nitrieragens — Acetylnitrat in Essigsaureanhydrid1 oder HNO3 in Schwefelsaure — entweder in den Anilin- oder den Benzyl-Teil des Molekuls dirigiert werden. Wo tritt die Nitrierung mit welchem Reagens ein und vor allem warum?
Psychoanalytic Resistance and Behavioral Nonresponsiveness

As the editor of this book can attest, we displayed a high degree of resistance to writing this commentary. But Paul Wachtel, able clinician that he is, eschewed an insight-oriented approach and employed an effective cognitive-behavioral style, replete with an awesome arsenal of assertive responses. He did, however, experience several harried months over our procrastination.
Adenosinergic signaling inhibits oxalate transport by human intestinal Caco2-BBE cells through the A2B adenosine receptor.

Most kidney stones (KS) are composed of calcium oxalate, and small increases in urine oxalate affect the stone risk. Intestinal oxalate secretion mediated by anion exchanger SLC26A6 (PAT1) plays a ...
Liver Disease as a Predictor of New-Onset Atrial Fibrillation.

Background Impact of liver disease on development of atrial fibrillation (AF) is unclear. The purpose of the study was to evaluate prevalence of AF in the setting of liver disease and whether incre...
Evaluating Non-Cognitive Skills among Students Switching Into and Out of Charter Schools in North Carolina

Despite several charter schools specifically targeting improving students’ noncognitive skills, the majority of charter school literature focuses on cognitive learning outcomes. Using behavioral me...
Memories light the corners of my mind.

Using light-activated ion channels to stimulate sensory and motivational pathways, Vetere and colleagues constructed fully artificial memories in mice. Mice preferred or avoided an odor they had never smelled before, depending on the pattern of stimulation.
Genetics of neonatal-onset epilepsies

Although the majority of seizures in neonates are related to acute brain injury, a substantial minority are the first symptom of a neonatal-onset epilepsy often linked to a pathogenic genetic variant. Historically, studies on neonatal seizures including treatment response and long-term consequences have lumped all etiologies together. However, etiology has been consistently shown to be the most important determinant of outcome. In the past few years, an increasing number of monogenic disorders have been described and might explain up to a third of neonatal-onset epilepsy syndromes previously included under the umbrella of Ohtahara syndrome and early myoclonic encephalopathy. In this chapter, we define the concept of genetic epilepsy and review the classification. Then, we review the most relevant monogenic neonatal-onset epilepsies, detail their underlying pathophysiologic mechanisms, and present their electroclinical phenotypes. We highlight that, in some cases, such as neonates with KCNQ2 or KCNT1 gene mutations, the early recognition of the electroclinical phenotype can lead to targeted diagnostic testing and precision medicine treatment, enabling the possibility of improved outcome.
Common Reasons for Malpractice Lawsuits Involving Pulmonary Embolism and Deep Vein Thrombosis.

Abstract Background Pulmonary embolism and deep vein thrombosis are common clinical entities, and the related malpractice suits affect all medical subspecialties. Claims from malpractice litigation were analyzed to understand the demographics of these lawsuits and the common reasons for pursuing litigation. Methods Cases entered into the Westlaw database from March 5, 1987, to May 31, 2018, were reviewed. Search terms included “pulmonary embolism” and “deep vein thrombosis.” Results A total of 277 cases were identified. The most frequently identified defendant was an internist (including family practitioner; 33%), followed by an emergency physician (18%), an orthopedic surgeon (16%), and an obstetrician/gynecologist (9%). The most common etiology for pulmonary embolism was prior surgery (41%). The most common allegation was “failure to diagnose and treat” in 62%. Other negligence included the failure to administer prophylactic anticoagulation while in the hospital (18%), failure to prescribe anticoagulation on discharge (8%), failure to administer anticoagulation after diagnosis (8%), and premature discontinuation of anticoagulation (2%). The most frequently claimed injury was death in 222 cases (80%). Verdicts were found for the defendant in 57% of cases and for the plaintiff in 27% and settled in 16%. Conclusions The most frequently cited negligent act was the failure to give prophylactic anticoagulation, even after discharge. The trends noted in this study may potentially be addressed and therefore prevented by systems-based practice changes. The most common allegation, “failure to diagnose and treat,” suggests that first-contact doctors such as emergency physicians and primary care practitioners must maintain a high index of suspicion for deep vein thrombosis/pulmonary embolism.
Child Antisocial Behavior Is more Environmental in Origin in Disadvantaged Neighborhoods: Evidence Across Residents’ Perceptions and Geographic Scales in Two Samples

Prior research has suggested that disadvantaged neighborhood contexts alter the etiology of youth antisocial behavior (ASB). Unfortunately, these studies have relied exclusively on governmental data collected in administratively-defined neighborhoods (e.g., Census tracts or block groups, zip codes), a less than optimal approach for studying neighborhood effects. It would thus be important to extend prior findings of GxE using neighborhood sampling techniques, in which disadvantage is assessed via resident informant-reports of the neighborhood. The current study sought to do just this, examining two independent twin samples from the Michigan State University Twin Registry. Neighborhood disadvantage was assessed via maternal and neighbor informant-reports, the latter of which were analyzed multiple ways (i.e., all neighbors within 1 km, nearest neighbor, and all neighbors within the County). Analyses revealed clear and consistent evidence of moderation by neighborhood disadvantage, regardless of informant or the specific operationalization of neighborhood. Shared environmental influences on ASB were observed to be several-fold larger in disadvantaged contexts, while genetic influences were proportionally more influential in advantaged neighborhoods. Such findings indicate that neighborhood disadvantage exerts rather profound effects on the origins of youth ASB. Efforts should now be made to identify the active ingredients of neighborhood disadvantage.
Outcomes research on children with medical complexity: A scoping review of gaps and opportunities

BACKGROUND There has been a recent, rapid increase in the number of studies of children with medical complexity (CMC) and their families. There is a need for attention to gaps and patterns in this emerging field of study. OBJECTIVES The purpose of this scoping review was to identify patterns and gaps in the evidence related to classification systems, data, and outcomes in studies of CMC. DATA SOURCES We searched peer-reviewed journals for reports of quantitative studies focused on CMC outcomes published between 2008 and 2018. On the basis of a structured screening process, we selected 63 reports that met our inclusion criteria. STUDY APPRAISAL AND SYNTHESIS We used the methodological framework for scoping studies described by Arskey and O'Malley to map relevant literature in the field and the ECHO model to categorize studies according to three health outcome domains (economic, clinical, and humanistic). RESULTS The terminology used to describe and classify CMC differed across studies depending on outcome domain. Two thirds of the reports focused on economic outcomes; fewer than a quarter included child or family quality of life as an outcome. A majority of studies used a single source of data, with robust analyses of administrative, payer, and publicly available data. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Research on CMC and their families would benefit from standardization of terms and classification systems, the use of measurement strategies that map humanistic outcomes as trajectories, and more attention to outcomes identified as most meaningful to CMC and their families.
Pretest analysis of shake table response of a two-span steel girder bridge incorporating accelerated bridge construction connections

This paper presents pretest analysis of a shake table test model of a 0.35-scale, two-span, steel plate girder bridge. The objective of pretest analysis was to obtain an insight on the seismic response of the bridge model during the shake table tests. The bridge included seat type abutments, full-depth precast deck panels, and a two-column bent in which columns were pinned to the footing and integral with superstructure. Six accelerated bridge construction connections were incorporated in the bridge model. An analytical model was developed in OpenSees and was subjected to ten input bi-directional earthquake motions including near-fault and far-field records. The overall seismic response of the bridge was satisfactory for all the earthquake records at 100%, 150%, and 200% design level. All connections and capacity-protected components remained elastic, and the average ductility capacity surpassed the ductility demand even at 200% design level. Using experimental fragility curves developed for RC bridge columns, it was predicted that there was a probability of 45% that columns would undergo the imminent failure in the last run and a probability of 30% for their failure.
Cytomegalovirus in Adult Allogeneic Blood and Marrow Transplant Patients Before or Around the Period of Neutrophil Recovery: A Single-Center, Retrospective, Descriptive Study.

Background Few reports exist on pre-engraftment cytomegalovirus (CMV) DNAemia in allogeneic blood or marrow transplant (allo BMT) recipients. We describe this clinical entity, its management, and the potential effect of 3 different quantitative CMV deoxyribonucleic acid (DNA) tests used during the 6-year study period. Methods We performed a retrospective, single-center study of allo BMT recipients from 2010 to 2015 who developed CMV DNAemia before neutrophil recovery (absolute neutrophil count [ANC] Results Among 1151 adult allo BMT patients, 73 developed CMV DNAemia before engraftment or while neutropenic after initial engraftment. Most patients were eventually treated (valganciclovir or ganciclovir, N = 68; foscarnet, N = 1); 4 were not treated. First CMV detection occurred at median day +12 (range, 0-48), but treatment was not started until median day +33 (range, 4-105) at median ANC of 760 cells/mm3. Six patients had peak viral loads >5000 IU/mL; none had tissue-invasive disease. One developed ganciclovir resistance. No significant differences were observed upon stratification by quantitative CMV DNA test. Conclusions Cytomegalovirus DNA was detected in 6.3% of pre- and peri-engraftment allo-HSCT patients. Ganciclovir derivatives were commonly used for treatment despite risk of neutropenia. Treatment was typically deferred until CMV DNA and ANC rose. With rare exceptions, this treatment strategy did not appear to have adverse clinical consequences with respect to acute CMV. Different CMV DNA quantification tests used performed similarly from a clinical perspective despite different analytical performance characteristics.
Compute-in-Memory with Emerging Nonvolatile-Memories: Challenges and Prospects

This invited paper surveys the recent progresses of compute-in-memory (CIM) prototype chip designs with emerging nonvolatile memories (eNVMs) such as resistive random access memory (RRAM) technology. 8kb to 4Mb CIM mixed-signal macros (with analog computation within the memory array) have been demonstrated by academia and industry, showing promising energy efficiency and throughput for machine learning inference acceleration. However, grand challenges exist for large-scale system design including the following: 1) substantial analog-to-digital (ADC) overhead; 2) scalability to advanced logic node limited by high write voltage of eNVMs; 3) process variations (e.g. ADC offset) that degrade the inference accuracy. Mitigation strategies and possible future research directions are discussed.
Course Outline for Teaching Undergraduates about Toxicology and the Safe Handling of Chemicals

This paper describes the course outline for a three credit hour nonlaboratory course in Environmental Health Chemistry which was taught from 1981 until 2008 at the State University of New York Coll...
An evolutionary view of a biomedically important gene family

A recommendation of: Juan C. Opazo, Federico G. Hoffmann, Kattina Zavala, Scott V. Edwards Evolution of the DAN gene family in vertebrates https://doi.org/10.1101/794404
Keynes and Samuelson Combined Provided the Complete Foundation for a Science of Macroeconomics: Complexity Modeling Is Welcome, But Not Necessary, for a Scientific Foundation for Macroeconomics

Keynes and Samuelson provided the theoretical, technical and mathematical modeling necessary in order to provide a complete scientific foundation for macroeconomic theory. Keynes’s Aggregate Supply Curve (ASC),presented initially on pp. 55-56 in footnote 2 of the General Theory and in great detail in chapter 20, provided the foundations for incorporating multiple equilibria and degrees of uncertainty, based on his analysis of interval valued probability and weight of the evidence from the A Treatise on Probability, into macroeconomic analysis. Keynes’s 1938-39 work on Harrod’s draft copy of dynamic, intertemporal, economic growth, based on multiplier-accelerator interactions, which generated positive feedback impacts, combined with Samuelson’s work on the interaction of the multiplier and accelerator in 1939 and in his dissertation, showed that microeconomic optimization techniques, based on negative feedback, can’t incorporate interactive feedback impacts. They are inapplicable at a macro level dealing with multiple equilibria. Only the stability properties of the multiple equilibria can be examined. It is impossible to determine whether the many, possible, different equilibriums are optimal in the sense of being full employment equilibriums or unemployment equilibriums. Unfortunately, the current dominant approach to macroeconomics, with its claims of constant, inter-temporal, dynamic utility and profit maximization over all times with known subjective probability distributions, is, as Savage stated, “utterly ridiculous”, as well as being “preposterous”. The Lucas-Real Business cycle model approach to macroeconomics with a single representative agent needs to be replaced as soon as possible by the combined work of J M Keynes and Paul Samuelson that was done in the late 1930’s.
A practical method for determining automated EEG interpretation software performance on continuous Video-EEG monitoring data

Abstract Despite evidence to suggest that as many as 30% of hospitalized patients with altered mental status may be having subclinical seizures for which treatment may improve patient outcomes, the adoption of continuous video electroencephalography (EEG) monitoring (cvEEG) into non-academic centers has remained slow. With the continued progress in EEG networking technology and telemedicine, the traditional barriers to the use of cvEEG in community hospitals may soon be removed. This will lead to significant increases in the volume of cvEEG data that needs to be reviewed. The application of computer analytics to automate the process of cvEEG review has been ongoing for many years. One solution has been the use of graphic trends to allow more rapid review and assessment of the content of the cvEEG data over long periods of time. However, high false positive rates, the lack of specificity, and the requirement for frequent review of the raw cvEEG data to confirm the results has limited the use of this modality as a bedside monitoring tool. Thus, the development of truly automated cvEEG readers will be needed. Here we address the challenges of assessing the performance of such automated readers using the traditional core measures of performance: sensitivity, specificity, false positive/negative rates and diagnostic accuracy, and introduce an alternative approach to measuring and assessing performance that focuses on agreement. Our work demonstrates that traditional approaches to objectively assess agreement and performance of automated readers are difficult to apply and may not provide accurate estimates of the real-world performance of computer analytic interpretations of cvEEG data. We introduce our “Pure Gold” approach to the assessment of automated cvEEG reading tools. This novel approach uses compiled EEG segments representing a single target pattern to measure true error rates for the automated reader, visual graphical representation of automated reader outputs for comparison to human reviews of the same data, and agreement comparisons with correction for human variation. We suggest our approach represents a better method for performance assessment than traditional metrics of sensitivity and specificity.
The distribution and epidemic characteristics of cerebrovascular disease in followed-up hypertension patients.

To explore distribution and epidemic characteristics of CVD in followed-up HP patients. Using the Hypertension Follow-up Management System database in Jiading district in Shanghai. We designed a retrospective cohort study that included all followed-up hypertension patients between 2002 and 2020. The endpoint was the occurrence of CVD confirmed by the hospital; otherwise, the patients were tracked until September 30, 2020. Record information of every patient has been collected in the registration card and each followed-up record. Among 223,097 observational followed-up HP patients, the total number of person years of observation was 4,244,421.25 person-year, 11,143 patients had developed CVD from hypertension before the deadline, the total incidence density was 0.00263 per person-year (male 0.00292; female 0.00238) and the complication ratio of CVD in HP patients was 4.99% (male 5.25%; female 4.76%) during follow-up period. The proportion of ischemic cerebrovascular, hemorrhagic cerebrovascular and unclassified stroke was respectively 71.18%, 5.95% and 22.87% in hypertensive CVD. Complication ratio of CVD increased with age, the group under 30 was 0, and the group over 70 was the highest (6.90%). The complication ratio of grad I, grad II and grad III blood pressure were respectively 4.79%, 4.96% and 6.13%. The complication ratio was 4.92% in only high systolic blood pressure patients; 17.23% in only high diastolic blood pressure patients; 4.59% in high systolic and diastolic blood pressure patients. The peak of complication ratio of CVD was 9–10 years after the registered and followed-up. The proportion of CVD cases in HP patients from April to June was the largest in the four seasons; the proportion of patients from October to December was the minimum. HP patient was prone to falling cerebrovascular disease; the main type of disease was cerebral infarction. Complication ratio in male incidence was higher than that in female. The complication ratio of CVD increased with age, blood pressure and duration of HP patients. It had seasonal characteristics, which was relatively high from April to June within year.
Rippled-Field Magnetron with a Transparent Cathode

The rippled field magnetron is a source of millimeter-wave radiation theoretically described and experimentally verified by Bekefi [1]. It uses an array of azimuthally periodic permanent magnets to modulate electrons and allow them to become synchronous with a fast TM or TE electromagnetic mode in a smooth interaction space. The azimuthally periodic permanent magnets create an azimuthally periodic magnetic field (wiggler). Due to the radial component of the wiggler B r , electrons undergoing an azimuthal $\text{ve}=\mathrm{E}_{\mathrm{r}}\text{xH}$ , drift will experience an extra force $\mathrm{v}\theta\text{xB}_{\mathrm{r}},$ causing them to oscillate in the axial direction and bunching them in the azimuthal direction.
The Determinants of TeachersA Occupational Choice

Among college graduates, teachers have both low average AFQT and high average risk aversion, perhaps because the compression of earnings within teaching attracts relatively risk-averse individuals. Using a dynamic optimization model with unobserved heterogeneity, we show that were it possible to make teacher compensation mimic the return to skills and riskiness of the non-teaching sector, overall compensation in teaching would increase. Moreover, this would make many current teachers substantially worse off, making reform challenging. Importantly, our conclusions are sensitive to the degree of heterogeneity for which we allow. Since even a model with no unobserved heterogeneity fits well within sample, one could easily conclude that allowing for two or three types fits the data adequately. Formal methods reject this conclusion. The BIC favors seven types. Ranking models using cross-validation, nine types is better although the improvements of going from six to seven, from seven to eight and from eight to nine types are noticeably smaller than those from adding an additional type to a lower base.
Comprehensive Flood Damage Prevention

Measures intended to reduce flood damages have taken many forms. For most communities, the adopted plan consists of some degree of flood control. Limited use has been made of other means such as flood plain regulations and flood proofing. Past efforts have generally considered only one or two of the many possible measures. Similarly, little use has been made of local talent in developing plans. The comprehensive plan adopted by the cities of Bristol, Tenn., and Bristol, Va., was determined by a committee of local citizens with guidance and technical assistance provided by federal and state agencies. Certain elements of the customary benefit-cost analysis are included as local contributions. The program is now in the action phase.
Speeding Up Non-Parametric Bootstrap Computations for Statistics Based on Sample Moments in Small/Moderate Sample Size Applications

In this paper we propose a vectorized implementation of the non-parametric bootstrap for statistics based on sample moments. Basically, we adopt the multinomial sampling formulation of the non-parametric bootstrap, and compute bootstrap replications of sample moment statistics by simply weighting the observed data according to multinomial counts instead of evaluating the statistic on a resampled version of the observed data. Using this formulation we can generate a matrix of bootstrap weights and compute the entire vector of bootstrap replications with a few matrix multiplications. Vectorization is particularly important for matrix-oriented programming languages such as R, where matrix/vector calculations tend to be faster than scalar operations implemented in a loop. We illustrate the application of the vectorized implementation in real and simulated data sets, when bootstrapping Pearson’s sample correlation coefficient, and compared its performance against two state-of-the-art R implementations of the non-parametric bootstrap, as well as a straightforward one based on a for loop. Our investigations spanned varying sample sizes and number of bootstrap replications. The vectorized bootstrap compared favorably against the state-of-the-art implementations in all cases tested, and was remarkably/considerably faster for small/moderate sample sizes. The same results were observed in the comparison with the straightforward implementation, except for large sample sizes, where the vectorized bootstrap was slightly slower than the straightforward implementation due to increased time expenditures in the generation of weight matrices via multinomial sampling.
Cardiovascular function in patients with progressive systemic sclerosis (scleroderma)

Sixteen patients with progressive systemic sclerosis (PSS), including 3 with the "CREST" (calcinosis, Raynaud's, esophageal dysfunction, sclerodactyly, and/or telangiectasias) variant, were evaluated with resting M-mode echocardiography and noninvasive measurements of cardiac output at rest and during submaximal exercise to determine the nature and extent of any cardiovascular impairment. No patient had arterial hypertension, significant renal impairment, clinical evidence of large vessel coronary artery disease, or severe pulmonary dysfunction. The duration of disease was 1 to 12 years (9 to 30 for patients with the CREST variant). Echocardiographic abnormalities included increased right ventricular dimension (3 patients), reduced left ventricular ejection fraction (3 patients), and pericardial effusion (3 patients). Cardiac index (CI) and stroke volume index (SVI) at rest were similar for patients and controls. Patients and controls were exercised to similar heart rates (130 +/- 3 vs 124 +/- 4; p, NS). Total peripheral resistance (TPR) was higher for patients (1123 +/- 81 vs 810 +/- 44 dyn X s X cm-5) and their mean SVI failed to increase significantly compared with sitting rest values (30 +/- 2 vs 35 +/- 3 ml/m2). The control subjects had the expected increase in SVI (36 +/- 2 vs 51 +/- 5; p less than 0.01). Ten patients with an abnormal hemodynamic response to exercise had a normal echocardiographic circumferential fiber shortening (VCF) or ejection fraction (EF) at rest. The data indicate that PSS patients have a greater degree of cardiovascular dysfunction than would be predicted from clinical data and laboratory evaluation of cardiovascular and pulmonary function at rest. Multiple mechanisms, including right and left ventricular dysfunction and abnormal vasoconstrictor activity, are likely to contribute to the reduction in exercise capacity seen in patients with PSS.
Dual representation of Polyakov loop in 3d SU(2) lattice Yang-Mills theory

We consider the expectation value of a Polyakov loop in 3d SU(2) lattice Yang--Mills theory and transform it to the dual representation in terms of sums over spins. The spin dependence of the amplitudes is computed explicitly by a graphical method. We also determine the asymptotic (large spin) limit of the amplitude factors.
INTERACTION OF PURIFIED ACTIN-BINDING PROTEIN WITH THE PLATELET MEMBRANE GLYCOPROTEIN IB-IX COMPLEX

The interaction of platelet membrane glycoprotein (GP) Ib-IX complex with the cytoplasmic membrane skeleton is potentially of major importance in regulating platelet function. Indirect evidence suggested that this interaction is mediated by actin-binding protein, but it is not known whether GP Ib-IX and actin-binding protein associate directly. To examine more closely the nature of this association, purified GP Ib-IX complex was specifically bound and oriented on the surface of impermeable polymer beads via a monoclonal antibody, AK 2, directed against the extracytoplasmic domain of GP Ib alpha (glycocalicin). Binding was specific since 1) it was abolished by excess unlabeled actin-binding protein; 2) there was no detectable specific binding of radiolabeled actin-binding protein to beads coated with glycocalicin, the major extracytoplasmic proteolytic fragment of GP Ib alpha; and 3) unlike actin-binding protein, there was no specific binding of bovine serum albumin or human platelet vinculin to the GP Ib-IX complex-coated beads. Binding of actin-binding protein to the GP Ib-IX complex-coated beads, but not to the glycocalicin-coated beads, was saturable and reversible (apparent Kd = 1 x 10(-7) M). These experiments provide direct evidence that actin-binding protein can bind to the cytoplasmic domain of a membrane glycoprotein. Because actin-binding protein is found submembranously in cells other than the platelet, it is possible that this protein may link actin filaments to the plasma membrane in those cells.
Use of cone beam computed tomography in the determination of mental foramen location in relation to mandibular 1st and 2 nd premolars

USE OF CONE BEAM COMPUTED TOMOGRAPHY IN THE DETERMINATION OF MENTAL FORAMEN LOCATION IN RELATION TO MANDIBULAR 1 AND 2 PREMOLARS By Sanjay P. Bhagchandani DMD, BS A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2010 Program Director: Karan J. Replogle DDS, MS, Chair and Postgraduate Program Director, Endodontics The purpose of this study was to use existing Cone Beam Computer Tomography images to determine the vertical and horizontal location of the mental foramen in relation to the mandibular first and second premolars, as well as the distance in millimeters from the apex of each. The distance from the inferior border of the foramen to the inferior border of the mandible was also recorded. The average distance from the apices of the mandibular first and second premolars to the mental foramen was 7.43mm (SD= 1.97) and 5.30mm (SD=1.65) respectively. The foramen was located 11.44mm (SD=1.49) from the inferior border of the mandible. The foramen was in line with the apex of the mandibular second premolar 41% of the time. The mental foramen was further away from the inferior border of the mandible in males and older patients. Mental foramina seemed to be positioned more apically and distally in older patients.
Overview of conventional imaging-based intervention in clinical practice

This article presents an overview of image-guided interventions using conventionally available imaging modalities. It discusses technical and clinical aspects of the interventions, and also focuses on site-specific biopsies such as liver, spleen, renal, and soft tissue biopsies in the abdomen. It briefly discusses the emerging role of PET imaging and other technologies that will improve the diagnostic yield of image-guided biopsies.
Story Composition Skills of Middle-Grade Students with Learning Disabilities:

This study examined the story composition abilities of learning disabled (LD) and normally achieving young adolescents as indicated by measures of writing category, cohesion, and fluency. Findings suggest that although adolescents with learning disabilities have a rudimentary knowledge of story form, this knowledge is less well developed than that of their nondisabled peers. Students with learning disabilities also had greater coherence problems in their writing and were less fluent writers. Several important age trends were noted when results of this investigation were compared with outcomes from a similar investigation involving younger students.
Acts of Contrition, Forgiveness by God, and Death Anxiety Among Older Mexican Americans

The purpose of this study is to see if performing acts of contrition in order to be forgiven by God is associated with lower levels of death anxiety among older Mexican Americans. A conceptual model containing the following relationships was developed to evaluate this and other hypotheses: (a) It is hypothesized that older Mexican Americans who attend church more often will have a stronger sense of God-mediated control (i.e., the belief that God works together with people to attain desired goals and eliminate unwanted stressors), (b) individuals with a stronger sense of God-mediated control will be more likely to perform acts of contrition in order to earn God's forgiveness, (c) performing acts of contrition will enhance feelings of self-worth, and (d) a stronger sense of self-esteem will be associated with lower levels of death anxiety. Data from a nationwide sample of older Mexican Americans provide support for each of these relationships.
Nobelium chemistry: Aqueous complexing with carboxylate ions☆

Abstract The tendency of divalent nobelium to form complexes with citrate, oxalate, and acetate ions in an aqueous medium of 0·5 M NH4NO3 has been examined by solvent extraction techniques and compared with the complex forming ability of calcium and strontium under the same conditions. In general, for each anion, the complexing tendency of nobelium is between that of calcium and strontium, being more nearly like that of strontium. The data allow the estimation of concentration quotients for the formation of NoHCit and NoOx. The extraction data for nobelium with acetate in the aqueous phase suggest a difference in nobelium chemistry from that of calcium and strontium.
“We Don’t Take the Pledge”: Environmentality and environmental skepticism at the epicenter of US wind energy development

Abstract This study analyzes pro-wind, “anti-environmental” discourses prevalent among key stakeholders in Nolan County, Texas, the epicenter of US wind power. We draw upon interviews conducted within a Q-method study to examine environmental views held by key actors in wind-farm development. We frame our analysis within the theoretical field that engages the formation of environmental subjects, defined as the process through which individuals and communities align their environmental practices with state ends. We argue that this is a process that can be incomplete or in tension with other subject positions, which together may lead to unexpected environmental views. We introduce “environmental skepticism,” defined as a rejection of ecological science steeped in deep anthropocentrism and possessive individualism, as a dominant counter-narrative informing certain environmental subjectivities. The remainder of the paper describes Texas wind stakeholders’ views or subject positions on energy and the environment and reveals how environmental skepticism is not overturned even as renewable energy supports the local economy. We analyze wind stakeholders’ environmental subjectivity in terms of emergent subject positions as “reflexive environmental skepticism,” a view that accepts the economic products, processes, and policy innovations advocated by ecological modernization without accepting the core claim that innovations are required to adapt to environmental change.
Virtual machine monitor-based lightweight intrusion detection

As virtualization technology gains in popularity, so do attempts to compromise the security and integrity of virtualized computing resources. Anti-virus software and firewall programs are typically deployed in the guest virtual machine to detect malicious software. These security measures are effective in detecting known malware, but do little to protect against new variants of intrusions. Intrusion detection systems (IDSs) can be used to detect malicious behavior. Most intrusion detection systems for virtual execution environments track behavior at the application or operating system level, using virtualization as a means to isolate themselves from a compromised virtual machine.In this paper, we present a novel approach to intrusion detection of virtual server environments which utilizes only information available from the perspective of the virtual machine monitor (VMM). Such an IDS can harness the ability of the VMM to isolate and manage several virtual machines (VMs), making it possible to provide monitoring of intrusions at a common level across VMs. It also offers unique advantages over recent advances in intrusion detection for virtual machine environments. By working purely at the VMM-level, the IDS does not depend on structures or abstractions visible to the OS (e.g., file systems), which are susceptible to attacks and can be modified by malware to contain corrupted information (e.g., the Windows registry). In addition, being situated within the VMM provides ease of deployment as the IDS is not tied to a specific OS and can be deployed transparently below different operating systems.Due to the semantic gap between the information available to the VMM and the actual application behavior, we employ the power of data mining techniques to extract useful nuggets of knowledge from the raw, low-level architectural data. We show in this paper that by working entirely at the VMM-level, we are able to capture enough information to characterize normal executions and identify the presence of abnormal malicious behavior. Our experiments on over 300 real-world malware and exploits illustrate that there is sufficient information embedded within the VMM-level data to allow accurate detection of malicious attacks, with an acceptable false alarm rate.
Excessive Th1 responses due to the absence of TGF-β signaling cause autoimmune diabetes and dysregulated Treg cell homeostasis

TGF-β signaling in T cells is critical for peripheral T-cell tolerance by regulating effector CD4+ T helper (Th) cell differentiation. However, it is still controversial to what extent TGF-β signaling in Foxp3+ regulatory T (Treg) cells contributes to immune homeostasis. Here we showed that abrogation of TGF-β signaling in thymic T cells led to rapid type 1 diabetes (T1D) development in NOD mice transgenic for the BDC2.5 T-cell receptor. Disease development in these mice was associated with increased peripheral Th1 cells, whereas Th17 cells and Foxp3+ Treg cells were reduced. Blocking of IFN-γ signaling alone completely suppressed diabetes development in these mice, indicating a critical role of Th1 cells in this model. Furthermore, deletion of TGF-β signaling in peripheral effector CD4+ T cells, but not Treg cells, also resulted in rapid T1D development, suggesting that conventional CD4+ T cells are the main targets of TGF-β to suppress T1D. TGF-β signaling was dispensable for Treg cell function, development, and maintenance, but excessive IFN-γ production due to the absence of TGF-β signaling in naive CD4+ T cells indirectly caused dysregulated Treg cell homeostasis. We further showed that T cell–derived TGF-β1 was critical for suppression of Th1 cell differentiation and T1D development. These results indicate that autocrine/paracrine TGF-β signaling in diabetogenic CD4+ T cells, but not Treg cells, is essential for controlling T1D development.
Local tests for consistency of support hyperplane data

Support functions and samples of convex bodies in R n are studied with regard to conditions for their validity or consistency. Necessary and sufficient conditions for a function to be a support function are reviewed in a general setting. An apparently little known classical such result for the planar case due to Rademacher and based on a determinantal inequality is presented and a generalization to arbitrary dimensions is developed. These conditions are global in the sense that they involve values of the support function at widely separated points. The corresponding discrete problem of determining the validity of a set of samples of a support function is treated. Conditions similar to the continuous inequality results are given for the consistency of a set of discrete support observations. These conditions are in terms of a series of local inequality tests involving only neighboring support samples. Our results serve to generalize existing planar conditions to arbitrary dimensions by providing a generalization of the notion of nearest neighbor for plane vectors which utilizes a simple positive cone condition on the respective support sample normals.