cssi/SciSciGPT-SciSciNet huggingface dataset:
Work-up for infectious diarrhea after allogeneic hematopoietic stem cell transplantation: single specimen testing results in cost savings without compromising diagnostic yield.

Abstract: Background. Diarrhea is a common complication of allogeneic bone marrow transplantation. Microbiologic stool studies are frequently ordered to rule out infectious etiology. The utility of examining multiple stool specimens per diarrheal episode has not been examined. Methods. We performed a retrospective review of 169 adult and pediatric patients who underwent hematopoietic stem cell transplantation at Memorial Sloan-Kettering Cancer Center from January 1, 2000 though December 31, 2001, who had at least 1 microbiologic stool study. We report on the incidence of enteric pathogens in our population and diagnostic yield of stool studies. A diarrheal episode was defined as a 14-day period from the date of the first stool study. Cost savings analysis was based on projected savings from implementation of proposed guidelines to the study population. Results. A total of 1649 stool tests were performed (mean 10.6 tests per patient). An infectious cause of diarrhea was found in 45 (28.8%) patients. Diagnostic yield was 6.2% for Clostridum difficile toxin assay, 12.9% for viral cultures, and 1.3% for rotavirus enzyme immunoassay. Bacterial cultures for enteric pathogens, examination for parasites, and rotavirus antigen assay combined had 0.5% positive yield. Conclusions. Testing of multiple specimens per diarrheal episode did not increase diagnostic yield. The estimated cost savings by implementing single testing for each type of stool study per diarrheal episode was $49,764 annually (in 2001 US dollars). Judicious use of stool tests to evaluate diarrhea results in significant cost savings without compromising diagnostic yield.
A microfabricated wall shear-stress sensor with capacitative sensing

A silicon-based micromachined, floating-element sensor for low-magnitude wall shear-stress measurement has been developed. Sensors over a range of element sizes and sensitivities have been fabricated by thin-wafer bonding and deep-reactive ion-etching techniques. Detailed design, fabrication, and testing issues are described in this paper. Detection of the floating-element motion is accomplished using either direct or differential capacitance measurement. The design objective is to measure the shear-stress distribution at levels of O(0.10 Pa) with a spatial resolution of approximately O(100 /spl mu/m). It is assumed that the flow direction is known, permitting one to align the sensor appropriately so that a single component shear measurement is a good estimate of the prevalent shear. Using a differential capacitance detection scheme these goals have been achieved. We tested the sensor at shear levels ranging from 0 to 0.20 Pa and found that the lowest detectable shear-stress level that the sensor can measure is 0.04 Pa with an 8% uncertainty on a 200 /spl mu/m/spl times/500 /spl mu/m floating element plate.
PAR’s Social Equity Footprint

During the 75th anniversary of Public Administration Review (PAR), this article examines the social equity scholarship published in PAR from 1940 to 2013. Less than 5 percent of all articles published in PAR since its inception focus on social equity. The articles published in PAR are primarily concentrated within the areas of personnel and public policy. Very few articles were published in the areas of budgeting or ethics. While social equity scholarship published in PAR has made a valuable contribution to understanding the career inequities of women and minorities in the public sector, scholars and professionals need to more thoroughly examine the black box of agency practice and structural inequities to examine why they persist. The challenge for future social equity research in public administration is to examine broader dimensions of equity and to understand how social inequities in administration can be mitigated.
Secure message transmission in mobile ad hoc networks

The vision of nomadic computing with its ubiquitous access has stimulated much interest in the mobile ad hoc networking (MANET) technology. However, its proliferation strongly depends on the availability of security provisions, among other factors. In the open, collaborative MANET environment, practically any node can maliciously or selfishly disrupt and deny communication of other nodes. In this paper, we propose the secure message transmission (SMT) protocol to safeguard the data transmission against arbitrary malicious behavior of network nodes. SMT is a lightweight, yet very effective, protocol that can operate solely in an end-to-end manner. It exploits the redundancy of multi-path routing and adapts its operation to remain efficient and effective even in highly adverse environments. SMT is capable of delivering up to 83% more data messages than a protocol that does not secure the data transmission. Moreover, SMT achieves up to 65% lower end-to-end delays and up to 80% lower delay variability, compared with an alternative single-path protocol––a secure data forwarding protocol, which we term secure single path (SSP) protocol. Thus, SMT is better suited to support quality of service for real-time communications in the ad hoc networking environment. The security of data transmission is achieved without restrictive assumptions on the network nodes trust and network membership, without the use of intrusion detection schemes, and at the expense of moderate multi-path transmission overhead only. � 2003 Elsevier B.V. All rights reserved.
Fluorine: A new element in protein design

Fluorocarbons are quintessentially man-made molecules, fluorine being all but absent from biology. Perfluorinated molecules exhibit novel physicochemical properties that include extreme chemical inertness, thermal stability, and an unusual propensity for phase segregation. The question we and others have sought to answer is to what extent can these properties be engineered into proteins? Here, we review recent studies in which proteins have been designed that incorporate highly fluorinated analogs of hydrophobic amino acids with the aim of creating proteins with novel chemical and biological properties. Fluorination seems to be a general and effective strategy to enhance the stability of proteins, both soluble and membrane bound, against chemical and thermal denaturation, although retaining structure and biological activity. Most studies have focused on small proteins that can be produced by peptide synthesis as synthesis of large proteins containing specifically fluorinated residues remains challenging. However, the development of various biosynthetic methods for introducing noncanonical amino acids into proteins promises to expand the utility of fluorinated amino acids in protein design.
Thermodynamic Characterization of RNA Triloops

Relatively few thermodynamic parameters are available for RNA triloops. Therefore, 24 stem-loop sequences containing naturally occurring triloops were optically melted, and the thermodynamic parameters ΔH°, ΔS°, ΔG°(37), and T(M) for each stem-loop were determined. These new experimental values, on average, are 0.5 kcal/mol different from the values predicted for these triloops using the model proposed by Mathews et al. [Mathews, D. H., Disney, M. D., Childs, J. L., Schroeder, S. J., Zuker, M., and Turner, D. H. (2004) Proc. Natl. Acad. Sci. U.S.A. 101, 7287-7292]. The data for the 24 triloops reported here were then combined with the data for five triloops that were published previously. A new model was derived to predict the free energy contribution of previously unmeasured triloops. The average absolute difference between the measured values and the values predicted using this proposed model is 0.3 kcal/mol. These new experimental data and updated predictive model allow for more accurate calculations of the free energy of RNA stem-loops containing triloops and, furthermore, should allow for improved prediction of secondary structure from sequence.
An Investigation of the SOAR Study Method

Students are rarely taught how to study. When strategy instruction occurs, weak strategies are often advocated or strategies are presented in a hodgepodge, leaving students without a systematic stu...
REVERSION AT THE HIS1 LOCUS OF YEAST

The his1 gene (chromosome V) of Saccharomyces cerevisiae specifies phosphoribosyl transferase (E.C.2.4.2.17), the first enzyme of histidine biosynthesis. This hexameric enzyme has both catalytic and regulatory functions.—The spontaneous reversion rates of seven his1 mutations were studied. The reversion rates of the alleles at the proximal end of the locus (relative to the centromere) were about 50-fold higher than distal alleles.—Spontaneous reversion to prototrophy was studied in diploids homoallelic for each of the seven his1 mutations. Based on tetrad analysis, the prototrophy revertants could be assigned to three classes: (1) revertant tetrads that carried a prototrophic allele indistinguishable from wild type; (2) revertant tetrads that carried a prototrophic allele characterized by histidine excretion and feedback resistance; and (3) revertant tetrads that did not contain a prototrophic spore, but rather a newly derived allele that complemented the original allele intragenically. Four of the seven his1 mutations produced the excretor revertant class, and two mutations produced the complementer revertant class. The significance of these findings to our understanding of gene organization and the catalytic and regulatory functions of gene products are discussed.
Simulation-assisted inductive learning

Learning by induction can require a large number of training examples. We show the power of using a simulator to generate training data and test data in learning rules for an expert system. The induction program is RL, a simplified version of Meta-DENDRAL. The expert system is ABLE, a rule-based system that identifies and locates errors in particle beam lines used in high energy physics. A simulator of beam lines allowed forming and testing rules on sufficient numbers of cases that ABLE's performance is demonstrably accurate and precise.
Molecular Dynamics Investigations into the High Permeability of Siloxane Polymers

The polysiloxanes are known to have unusually high permeabilities, and have therefore been much investigated with regard to their possible use as gasseparation membranes. In particular, their permeabilities are much higher than those of n-alkanes such as polyethylene (PE), a polymer which has already been extensively investigated using molecular dynamics simulations. In order to gain insight into the molecular origin of this high permeability, such simulations have been carried out on hypothetical model systems in which the structure of the polyethylene chain [−CH2−CH2−]x is converted step-wise into that of the most important polysiloxane, poly(dimethylsiloxane) (PDMS) [−Si(CH3)2−O−]x. The structural modifications thus investigated include (i) increase in the C-C bond length, (ii) change of the system's density from the density of PE to the density of PDMS, (iii) change of bond angles of PE to the alternate bond angles of PDMS, (iv) replacement of the torsional potential of PE by the torsional potential of PDMS, (v) change of masses of CH2 units along the chain to alternate masses of Si(CH3)2 and 0 units, (vi) change of Lennard-Jones parameters of CH2 groups for the appropriate parameters of Si and 0 units. At each of the six steps the self-diffusion coefficients of polymer segments and penetrant molecules (CO2) were calculated, allowing for the assessment of the influence of the structure of the polymer on the diffusion of the penetrant.
Comparative analysis of isocentric 3-dimensional C-arm fluoroscopy and biplanar fluoroscopy for anterior screw fixation in odontoid fractures.

STUDY DESIGN Retrospective clinical study. OBJECTIVE To compare long-term radiographic and clinical outcomes of patients undergoing anterior odontoid screw placement using traditional biplanar fluoroscopy or isocentric 3-dimensional C-arm (iso-C) fluoroscopy-assisted techniques. SUMMARY OF BACKGROUND DATA Anterior screw fixation of odontoid fractures preserves motion at the C1-C2 joint, but accurate screw positioning is essential for successful outcomes. Biplanar fluoroscopy image guidance is most often used; however, iso-C imaging improves the ease and accuracy of screw placement with less radiation exposure. METHODS Fifty-one patients underwent anterior odontoid screw fixation for type II (48 patients) and rostral type III fractures (3 patients). Procedures were guided by biplanar fluoroscopy in 25 (49%) patients, and with iso-C assistance in 26 (51%). Length of surgery, complications, and clinical outcomes based on the Smiley-Webster score were evaluated. Computed tomography confirmed adequate screw placement. Follow-up ranged from 3 to 9 months. RESULTS At 3-month follow-up, screw position and fusion across the fracture were evident in 87% of the cases treated with biplanar fluoroscopy and in 100% treated by iso-C. The average outcome score in the iso-C group was superior to that of the biplanar group (1.08 vs. 1.33, respectively), although not statistically significant. At last follow-up, the rate of successful fusion was 88% in the biplanar group and 95% in the iso-C group. Length of surgery was significantly lower in the iso-C group compared with the biplanar group (P=0.05). The significantly longer preparation time in the iso-C group (P=0.04) accounted for no overall difference in total operating room occupancy time between the 2 groups. CONCLUSIONS Iso-C significantly decreased surgical time. At last follow-up iso-C assistance was associated with improved rates of radiographic fusion with comparable outcome and complication profiles. This series represents the largest cohort of patients treated with intraoperative real-time navigation assistance for odontoid fractures.
Analysis on the epidemiological characteristics of other infectious diarrhea in Ninghe county from 2008 to 2012

Objective The study was designed to analyze the incidence of other infectious diarrhea in Ninghe county from 2008 to2012, in order to master the epidemiological characteristics of other infectious diarrhea in Ninghe county. Methods The cases of otherinfectiousdiarrhea reported by nationaldiseases information managementsystem were analyzed by descriptive epidemiological methodology. Results From 2008 to 2012, 5149 cases of other infectious diarrhea were reported in Ninghe county. The peak season for incidence of the disease was from May to September, and 3119 cases were reported during the peak season, accounting for60.57% of all cases. A total of 1073 cases were reported to be associated with children less than one year old, taking up of 20.84%ofthetotalreported cases. Thetop threeoccupationaltypesofpatientsweredispersed children, peasantsand students, with a totalof4365 cases reported(84.77%). The highest incidence of other infectious diarrhea was reported in the town of Lutai, with a total of2191 cases reported(42.55%). Conclusion Other infectious diarrhea played an important role in mandatory reporting contagious diseasesin Ninghe. It is necessary to strengthen the surveillance and control work.
Surgical Approach to Borderline Resectable Tumors of the Left Pancreas

Resections of the pancreas typically involve removal of either the pancreatic head or varying portions of the pancreatic body and tail depending on the actual location of the tumor. The line of transection during a typical pancreaticoduodenectomy is constant in most cases and is that region of parenchyma directly overlying the SMV/portal vein, often called the pancreatic neck. Occasionally, that line of transection will move to the patient’s left should the tumor extend out of the pancreatic head. However, from a surgical anatomy standpoint the pancreatic head is defined as all of the pancreatic tissue lying to the right of the SMV/portal vein. Similarly, the left pancreas is defined as all of the pancreatic tissue lying to the left of the SMV/portal vein. It contains both the body and tail of the pancreas as is commonly depicted in anatomy texts. Traditionally, the line of parenchymal transection for tumors of the left pancreas is not always constant and can move leftward from the SMV/portal vein with more distal locations of disease (i.e., those located in the tail.) Thus, a distal pancreatectomy is a more nebulously defined concept in comparison to the typical Whipple procedure when referring to the actual location of parenchymal transection. In this chapter we will be discussing what we believe is the optimal approach to the oncologic resection of the left side of the pancreas. We advocate for a modular approach employing a constant transection line in typical resections of malignant tumors of the left pancreas. That line is at the SMV/portal vein. Thus, the entire left pancreas is removed regardless of the tumor’s location within the body or tail. Occasionally, the pancreas will require division at the union of the head and neck in order achieve a negative margin.
Racial Bias in Medicine.

The author presents her thoughts on why racial bias exists in medicine, stating that minorities such as African-Americans and Latinos routinely receive worse care. She suggests this can be addressed by a great emphasis on recruiting and retaining medical students who reflect the diverse populations in the U.S. In addition, she argues that white medical trainees should not avoid discussing race in order to bring more attention to racial bias.
Requirement for engrailed and invected genes reveals novel regulatory interactions between engrailed/invected, patched, gooseberry and wingless during Drosophila neurogenesis

During neurogenesis, the transmembrane protein Patched (Ptc) promotes a wingless (wg)-mediated specification of a neuronal precursor cell, NB4-2, by repressing gooseberry (gsb). In this study, novel interactions of these genes with engrailed (en) and invected (inv) during neurogenesis have been uncovered. While in row 4 cells Ptc represses gsb and wg, in row 5 cells en/inv relieve Ptc repression of gsb by a non-autonomous mechanism that does not involve hedgehog (hh). This differential regulation of gsb leads to the specification of NB5-3 and NB4-2 identities to two distinct neuroblasts. The uncoupling of the ptc-gsb regulatory circuit also enables gsb to promote Wg expression in row 5 cells. Our results suggest that the en/inv-->ptc-->gsb-->wg pathway uncovered here and the hh-->wg are distinct pathways that function to maintain wild-type level of Wg. Our results also indicate that Hh is not the only ligand for Ptc and similarly Ptc is not the only receptor for Hh.
"Cool" Topic: Feeding During Moderate Hypothermia After Intracranial Hemorrhage.

Background: Therapeutic moderate hypothermia (MH; Tcore 33°C–34°C) is being studied for treatment of spontaneous intracerebral hemorrhage (ICH). Nutrition assessment begins with accurate basal metabolic rate (BMR) determination. Although early enteral nutrition (EN) is associated with improved outcomes, it is often deferred until rewarming. We sought to determine the accuracy of predictive BMR equations and the safety and tolerance of EN during MH after ICH. Materials and Methods: Patients were randomized to 72 hours of MH or normothermia (NT; Tcore 36°C–37°C). Harris-Benedict (BMR-HB) and Penn-State equation (BMR-PS) calculations were compared with indirect calorimetry (IC) at day (D) 0 and D1–3. Patients with MH received trophic semi-elemental gastric EN. Occurrences of feeding intolerance, gastrointestinal (GI)–related adverse events, and ventilator-associated pneumonia (VAP) were analyzed with a double-sided matched pairs t test. Results: Thirteen patients with ICH participated (6 MH, 7 NT). Mean time...
Christianity and agnosticism

In this paper I wish to make one or two critical observations concerning Alvin Plantinga's important and challenging Warranted Christian Belief} Fortunately it will not be necessary to my limited purposes to explain any of Plantinga's contentions in any great detail and with one or two exceptions I will omit discussion of Plantinga's extended arguments in favor of these contentions. The reason for my simplifications is that, for the sake of argument, I propose to take for granted that most though not all of the contentions on which I will focus are defensible or true. I begin, then, by outlining the main claims on which I intend to focus.
The rhetoric of conservative resistance

The rhetoric of the conservative resistance movement exhibits a number of characteristics which are uncommon in persuasive discourse and in movement rhetoric. This study identifies these characteristics and illustrates them through an examination of the psychological origins and ideological statements of a particular conservative resistance movement—the West Virginia textbook protest.
Hybrid Imaging System for Simultaneous Spiral MR and X-ray (MRX) Scans

The needs and the feasibility of simultaneous computed tomography (CT) and magnetic resonance imaging (MRI) were recently reported. In this paper, a spiral magnetic resonance X-ray CT (MRX) imaging system is proposed for head and extremities imaging, which serves as a simple, cost-effective solution on the path to a full-scale CT-MRI fusion. While MRI and X-ray radiography were integrated before, we propose novel designs to acquire simultaneous CT and MR views for synchronized radiographic imaging or joint tomographic reconstruction. Our preliminary permanent magnet configurations achieve a magnetic field strength between 0.1 and 0.2 T while keeping weight low enough for portability. We have also shown that a field strength up to 0.35 T is achievable with permanent magnets that maintain a compact profile, though increased weight would hinder ease of transportation. Simulation results of a joint tomographic reconstruction scheme show the advantage of simultaneously acquired images. The proposed MRX system performs double helical scans in CT and MRI mechanisms, and has multiple niche applications, such as medical imaging on disaster sites, in battle fields, and for under-developed regions.
Amnesia and criminal responsibility.

Under common law, criminal responsibility usually distinguishes between intentional act and accident, and most serious criminal offenses consist of both a voluntary act and a guilty mind.1 This treatment presumes that no defendant should be held criminally responsible without a finding of fault. Despite this long-standing conceptual commitment to fairness, criminal law continues to punish defendants who cannot remember the crime that they allegedly committed. Some evidence shows a high frequency of crime-related amnesia, and the medical community finds the phenomenon legitimate. This note will first explore standards used to evaluate criminal responsibility in general, crime-related amnesia from the medical perspective, and how courts currently address amnesiac criminal defendants. This note will further argue that current legal treatment is problematic, because amnesia is both procedurally and substantively relevant to criminal responsibility.
Finite buckling of fiber-reinforced columns

Finite, plane buckling deformations of slabs or columns composed of initially straight, parallel fibers embedded in a weaker matrix are discussed. The fibers are treated as continuously distributed and inextensible, and the composite is treated as incompressible. It is found that the critical buckling load, per unit of length normal to the plane of deformation, isGH, the infinitesimal shear modulusG times the widthH of the column. Stability of buckled states is considered. Limits on the applicability of the present theory to real composites are discussed.
Reducing the Desire to Drink Pharmacology and Neurobiology

The past decade has witnessed major advances in understanding of neural functioning and neurobiological bases of alcohol consumption. Concurrent with this, a range of exciting investigations have been conducted on pharmacologic agents that may curb drinking behavior. Research is reviewed on several promising medications influencing neurotransmitter and endocrine systems with particular attention to the serotonergic and opioid systems. Following this overview, recommendations are offered regarding research methodology to support future pharmacotherapy trials.
Characterizing User Influence Within Twitter

This paper explores whether influence can be quantified from public Twitter data. Compared to other social media applications, Twitter is content-centered, rather than relationship-centered. There is no indication of mutual relationships for the user within the application, making it difficult to gauge influence. By analyzing the data that already had mutual relationships, we identify the characteristics that created the boundaries of a community, and influence within it. We looked at Twitter user data, as well as Tweet data to find ways to characterize user influence among them. We measure type of users based on factors such as: those that they follow and how active they are. The Expert members are mutually agreed upon, as evidenced by their large followings, and the large number of followers who have added them to a list. They are most likely to post replies and original tweets, and are unlikely to re-tweet. Active members keep the conversation going, as evidenced by their strong followings. They are more likely than the other types to re-tweet. Passive members, the largest group, participate by liking (Favorite) tweets that they consume, encouraging experts and active members to continue their actions, and sustaining the boundaries of the group.
Consensus Statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the Quality of DXA Scans and Reports

ABSTRACT Objective: High-quality dual-energy X-ray absorptiometry (DXA) scans are necessary for accurate diagnosis of osteoporosis and monitoring of therapy; however, DXA scan reports may contain errors that cause confusion about diagnosis and treatment. This American Association of Clinical Endocrinologists/American College of Endocrinology consensus statement was generated to draw attention to many common technical problems affecting DXA report conclusions and provide guidance on how to address them to ensure that patients receive appropriate osteoporosis care. Methods: The DXA Writing Committee developed a consensus based on discussion and evaluation of available literature related to osteoporosis and osteodensitometry. Results: Technical errors may include errors in scan acquisition and/or analysis, leading to incorrect diagnosis and reporting of change over time. Although the International Society for Clinical Densitometry advocates training for technologists and medical interpreters to help eliminat...
On Quantiles Estimation Based on Different Stratified Sampling with Optimal Allocation

This work considers the problem of estimating a quantile function based on different stratified sampling mechanism. First, we develop an estimate for population quantiles based on stratified simple...
How Small Jurisdictions Compete in International Financial Services

The growing prominence of small jurisdictions in cross-border corporate and financial services over recent decades has raised a host of complex and highly contentious issues that remain exceedingly difficult to resolve. How small jurisdictions relate to larger markets in various fields of cross-border finance; what challenges small jurisdictions face as they work to develop capacity in their respective fields of specialisation; and what opportunities might arise that small jurisdictions would be uniquely well positioned to pursue, are all matters that involve numerous professions, disciplines, and regulatory fields. These questions are also intimately bound up with hotly contested political and diplomatic debates regarding the propriety and legitimacy of various modes of cross-border regulatory competition—and as in other such fraught contexts, much turns on how the debate is framed, and the perspective from which one views the issues at hand.
Where are We in Weak Intermolecular Interactions

This article, written as a recollection of a summarizing lecture of this NATO Workshop, affords the opportunity to portray with broad and probably inaccurate strokes a field of research which has been and continues to be fundamental to many areas of chemistry.
Cook Islands Asset Protection Trust Law

I. HISTORY OF THE LAW 321 II. AMENDMENTS TO THE LAW 323 III. DUE DILIGENCE 325 IV. RESPONSE TO THE AMENDMENTS 325 V. COOK ISLANDS CASES 328 A. Pacific Heritage Bank v. Radke 329 B. 515 S. Orange Grove Owners Association v. Orange Grove Partners 329 C. Case No.2 (1996) CKHC 2: CA Plaint No.36 of 1996 Court of Appeal 331 D. In re XYZ Irrevocable Trust 331 E. United States of America v. A Ltd 333 F. A v. B 334 A. A v. E & Ors. 334 B. E and Another v. A 336 VI. CONCLUSION 336
VALUE AND PERFORMANCE OF ACCOUNTABLE CARE ORGANIZATIONS: A COST-MINIMIZATION ANALYSIS

OBJECTIVES Determine the relationship between quality of an accountable care organization (ACO) and its long-term reduction in healthcare costs. METHODS We conducted a cost minimization analysis. Using Centers for Medicare and Medicaid cost and quality data, we calculated weighted composite quality scores for each ACO and organization-level cost savings. We used Markov modeling to compute the probability that an ACO transitioned between different quality levels in successive years. Considering a health-systems perspective with costs discounted at 3 percent, we conducted 10,000 Monte Carlo simulations to project long-term cost savings by quality level over a 10-year period. We compared the change in per-member expenditures of Pioneer (early-adopters) ACOs versus Medicare Shared Savings Program (MSSP) ACOs to assess the impact of coordination of care, the main mechanism for cost savings. RESULTS Overall, Pioneer ACOs saved USD 641.24 per beneficiary and MSSP ACOs saved USD 535.59 per beneficiary. By quality level: (a) high quality organizations saved the most money (Pioneer: USD 459; MSSP: USD 816); (b) medium quality saved some money (Pioneer: USD 222; MSSP: USD 105); and (c) low quality suffered financial losses (Pioneer: USD -40; MSSP: USD -386). CONCLUSIONS Within the existing fee-for-service healthcare model, ACOs are a mechanism for decreasing costs by improving quality of care. Higher quality organizations incorporate greater levels of coordination of care, which is associated with greater cost savings. Pioneer ACOs have the highest level of integration of services; hence, they save the most money.
Uses of Resonance Scattered Neutrons

With the advent of neutron spallation sources giving high in­tensities in the several eV range it is worthwhile to consider the potential uses of neutron resonance scattering for condensed matter investigations since there are several dozens of resonances in this energy range among the heavy nuclei. In the table we list some of these strong scattering resonances (taken from BNL 325). There are two noteworthy features of resonant neutron scattering: the scattering amplitudes near resonance are 1–2 orders of magnitude larger than non-resonant (potential) amplitudes, and the phase of the amplitude increases from 0 to π, as one increases the energy of the incident neutron from well below the resonance to well above it.
A fluorescent nucleoside from glutamic acid tRNA of Escherichia coli K 12

Abstract Glutamic acid tRNA from E. coli K 12 contains three minor nucleosides in the anticodon loop, namely, 2-methyladenosine, 5-methylaminomethyl-2-thioridine and a modified pyrimidine nucleoside, which is highly fluorescent. This tRNA has a chain length of 76 nucleotides and does not contain 7-methylguanosine or dihydrouridine as do the other nine sequenced E. coli tRNAs of chain length 76–77 nucleotides.
Hyperglycemia in the Surgical Intensive Care Unit

Hyperglycemia is the most common metabolic disturbance seen in the postoperative, intensive care patient. It can occur in patients with previously diagnosed diabetes mellitus, with undiagnosed diabetes,1 and in patients without diabetes under the acute stress of trauma, surgery, or myocardial infarction.2 Critical illness induces insulin resistance at the cellular level, which coupled with relative insulin inadequacy and unabated hepatic glucose release, leads to persistent elevation in blood glucose. A number of factors released during acute illness and stress act as mediators for this response, including cytokines, growth hormone, glucagon, catecholamines, and cortisol.3 Impairment of insulin action leads to lipolysis and protein catabolism that produce substrates for additional glucose production by the liver. Glycogenolysis is promoted by release or administration of catecholamines. Insulin-mediated glucose uptake by heart and skeletal muscle is impaired and further worsens glucose homeostasis. To some extent, the resultant increase in blood glucose can be adaptive to provide increased substrate to organs that do not require insulin for glucose uptake such as brain and blood cells. Not surprisingly, when pushed to the extreme by critical illness these accommodations can lead to untoward consequences requiring interventions in order to reverse this metabolic derangement.
Skeletal Myoblast Transplantation for Cardiac Repair

Coronary heart disease remains the single largest killer of American men and women. The American Heart Association statistics show that approx 1.1 million Americans suffer a myocardial infarction (MI) annually. Of those who survive, 22% of men and 46% of women are disabled with heart failure (1). Although cardiomyocytes of infarcted or failing human hearts have been shown to undergo mitoses (2,3), this regenerative capacity is by far too limited to compensate for the loss of cardiac cells resulting from a large infarct. In areas of ischemia, cell death ensues and scar forms in the place of myocardium. The remaining myocardial cells respond to mitotic signals by hypertrophy rather than hyperplasia. Necrotized myocardial cells are replaced by fibroblasts. If no viable myocardium is present, scar formation ensues with ventricular wall thinning and dilation of the ventricular cavity. This leads to symptoms of heart failure in a significant number of patients. For conventional coronary revascularization to be beneficial, viable myocardium must be present. The prognosis for these patients is poor, with a 1-yr mortality rate of 20% and a 5-yr mortality rate of close to 50% (1).
Optimizing the Wisdom of the Crowd: Inference, Learning, and Teaching

The increasing need for labeled data has brought the booming growth of crowdsourcing in a wide range of high-impact real-world applications, such as collaborative knowledge (e.g., data annotations, language translations), collective creativity (e.g., analogy mining, crowdfunding), and reverse Turing test (e.g., CAPTCHA-like systems), etc. In the context of supervised learning, crowdsourcing refers to the annotation procedure where the data items are outsourced and processed by a group of mostly unskilled online workers. Thus, the researchers or the organizations are able to collect large amount of information via the feedback of the crowd in a short time with a low cost. Despite the wide adoption of crowdsourcing, several of its fundamental problems remain unsolved especially at the information and cognitive levels with respect to incentive design, information aggregation, and heterogeneous learning. This tutorial aims to: (1) provide a comprehensive review of recent advances in exploring the power of crowdsourcing from the perspective of optimizing the wisdom of the crowd; and (2) identify the open challenges and provide insights to the future trends in the context of human-in-the-loop learning. We believe this is an emerging and potentially high-impact topic in computational data science, which will attract both researchers and practitioners from academia and industry.
Emerging Use of CRISPR Technology — Chasing the Elusive HIV Cure

A new form of gene therapy termed genetic editing or gene targeting has become possible owing to advances in genetic engineering technology.1 The intent of genetic editing is to alter the DNA code ...
Unveiling kinematic structure in the starburst heart of NGC 253

Author(s): Cohen, Daniel P; Turner, Jean L; Consiglio, S Michelle | Abstract: ABSTRACT We observed the Brackett α emission line (4.05 μm) within the nuclear starburst of NGC 253 to measure the kinematics of ionized gas, and distinguish motions driven by star formation feedback from gravitational motions induced by the central mass structure. Using NIRSPEC on Keck II, we obtained 30 spectra through a $0^{\prime \prime }_{.}5$ slit stepped across the central ∼5 arcsec × 25 arcsec (85 × 425 pc) region to produce a spectral cube. The Br α emission resolves into four nuclear sources: S1 at the infrared core (IRC), N1 at the radio core, and the fainter sources N2 and N3 in the northeast. The line profile is characterized by a primary component with Δvprimary ∼90–130 $\rm km\, s^{-1}$ (full width at half-maximum) on top of a broad blue 2wing with Δvbroad ∼300–350 $\rm km\, s^{-1}$, and an additional redshifted narrow component in the west. The velocity field generated from our cube reveals several distinct patterns. A mean NE–SW velocity gradient of +10 $\rm km\, s^{-1}$ arcsec−1 along the major axis traces the solid-body rotation curve of the nuclear disc. At the radio core, isovelocity contours become S-shaped, indicating the presence of secondary nuclear bar of total extent ∼5 arcsec (90 pc). The symmetry of the bar places the galactic centre, and potential supermassive black hole, near the radio peak rather than the IRC. A third kinematic substructure is formed by blueshifted gas near the IRC. This feature likely traces a ∼100–250 $\rm km\, s^{-1}$ starburst-driven outflow, potentially linking the IRC to the galactic wind observed on kpc scales.
Epitaxial GaP grown on Silicon by MEE and MBE Techniques as a Pathway for Dilute Nitride-Si Tandem Solar Cells

Dilute nitride materials grown on Si offer a pathway for inexpensive, lattice matched multijunction solar cells. A comparison in device performance between two-terminal and three-terminal tandem solar cells with a dilute nitride top cell and a Si bottom cell was done by detailed-balance modelling. The hetero-integration of dilute nitrides on Si is an important part of realizing such a solar cell structure. Towards this end, a first key step is to optimize the growth of GaP on Si. In this work, the surface of GaP grown epitaxially on Si wafers of various orientations was studied using atomic force microscopy (AFM). Pits were observed on the GaP surface and showed an increase in feature size with higher growth temperatures.
Multiscale Characterization of Complex Binding Interactions of Cellulolytic Enzymes Highlights Limitations of Classical Approaches

Abstract Cellulolytic microorganisms, like Trichoderma reesei or Clostridium thermocellum, frequently have non-catalytic carbohydrate-binding modules (CBMs) associated with secreted or cell surface bound multidomain carbohydrate-active enzymes (CAZymes) like cellulases. Mostly type-A family CBMs are known to promote cellulose deconstruction by increasing the substrate-bound concentration of cognate cellulase catalytic domains. However, due to the interfacial nature of cellulose hydrolysis and the structural heterogeneity of cellulose, it has been challenging to fully understand the role of CBMs on cellulase activity using classical protein-ligand binding assays. Here, we report a single-molecule CAZyme assay for an industrially relevant processive cellulase Cel7A (from T. reesei) to reveal how subtle CBM1 binding differences can drastically impact cellulase motility/velocity and commitment to initial processive motion for deconstruction of two well-studied crystalline cellulose allomorphs (namely cellulose I and III). We take a multifaceted approach to characterize the complex binding interactions of all major type-A family representative CBMs including CBM1, using an optical-tweezers based single-molecule CBM-cellulose bond ‘rupture’ assay to complement several classical bulk ensemble protein-ligand binding characterization methods. While our work provides a basis for the ‘cautious’ use of Langmuir-type adsorption models to characterize classical protein-ligand binding assay data, we highlight the critical limitations of using such overly simplistic models to gain a truly molecular-level understanding of interfacial protein binding interactions at heterogeneous solid-liquid interfaces. Finally, molecular dynamics simulations provided a theoretical basis for the complex binding behavior seen for CBM1 towards two distinct cellulose allomorphs reconciling experimental findings from multiscale analytical methods. Significance Statement Multimodal biomolecular binding interactions involving carbohydrate polymers (e.g., cellulose, starch, chitin, glycosaminoglycans) are fundamental molecular processes relevant to the recognition, biosynthesis, and degradation of all major terrestrial and aquatic biomass. Protein-carbohydrate binding interactions are also critical to industrial biotechnology operations such as enzymatically-catalyzed bioconversion of starch and lignocellulose into biochemicals like ethanol. However, despite the ubiquitous importance of such interfacial processes, we have a poor molecular-level understanding of protein-polysaccharide binding interactions. Here, we provide a comprehensive experimental and theoretical analysis of bulk ensemble versus single-molecule binding interactions of enzyme motors and associated non-catalytic binding domains with cellulosic polysaccharides to highlight the critical limitations of applying classical biochemical assay techniques alone to understanding protein adsorption or biological activity at solid-liquid interfaces.
Voter Sex, Party, and Gender-Salient Issues: Attitudes about Sexual Harassment and Brett Kavanaugh in the 2018 Elections

Since the election of President Trump and the dawning of the #MeToo movement, gender-salient issues have had a primary place in recent American politics. This was particularly evident in 2018 in th...
Olmsted’s pencil sharpener

The documentary history of Olmsted, Jr’s search for a patent (number 1,070,284) unfolds in Job File 2919 of the Olmsted Associates records, housed at the Library of Congress and accessible digitall...
Securing Approval of Your Research Proposal

Any experienced traveler will tell you that a crucial final step before departing on any journey is to secure any necessary pre-travel approvals. In the case of a trip where you are traveling with others that would include reaching agreement on all of the essential details of the trip including the hotels where you plan to stay, who is making the various travel arrangements and procuring confirmations, and how the costs of the trip are going to be shared.
Evaluation and optimization of a long-term fish monitoring program in the Hudson River

Abstract Long-term monitoring programs are essential for understanding the dynamics of fish populations in freshwater ecosystems, which are threatened by anthropogenic change. Assessment of monitoring programs helps ensure that they continue to meet stated goals, but published assessments are rare. Here we use a power analysis to assess the three surveys that form the core of the Hudson River Biological Monitoring Program, one of the longest-running fish monitoring programs in the United States. All three surveys had substantial power to detect changes in young-of-year abundance for anadromous species of primary management interest and for a variety of other species with diverse life histories and habitat preferences. In particular, the Beach Seine Survey and Fall Juvenile Survey could reliably detect declines in abundance of 15–30% or more over ten years, while the Long River Ichthyoplankton Survey could reliably detect declines of 40–55% or more over ten years. Simulated reduction of sampling intensity to 75–25% of the historical level of effort in these surveys still yielded good power to detect change for many species, particularly for the Beach Seine and Fall Juvenile surveys. Power to detect change varied in freshwater and brackish portions of the river and across different habitat zones, as well as by survey and species. Our results provide guidance for the re-design of fish monitoring programs in the Hudson River following the recent cessation of the historical funding for those programs, and could serve as a useful model for assessing similar programs in large river and estuarine ecosystems around the world.
Market microstructure and asset pricing

Abstract This research investigates the influence of market microstructure on liquidity premiums. Premiums of a competitive, multiple-dealership market (NASDAQ) are contrasted with those of a monopolistic, specialist system (NYSE). Differences in liquidity premiums are estimated from monthly stock returns. For small firms, the average returns of NYSE securities exceed the average returns of NASDAQ securities. This return differential persists after controlling for size, risk, and liquidity-related variables. Neither the NYSE nor NASDAQ dominates the other in providing liquidity. The NASDAQ appears to have a liquidity advantage over the NYSE for small firms but not for large companies.
Twinning and Branch Campuses

Branch campuses, twinning arrangements, and other manifestations of cross-border higher education are booming. Universities in Europe, Australasia, and North America see a huge market by offering their degrees in other countries. At the same time, Singapore and several of the states in the Arabian Gulf have identified themselves as educational centers and are attracting international higher education providers.
Data exfiltration from sensor networks subject to delay, connectivity and frequency re-use constraints

There has been extensive research on clustering techniques, routing protocols, sleep-mode protocols and adaptive power control algorithms for unattended ground-based sensor (UGS) networks. That previous work has mainly focused on energy-efficient operation and improved system lifetimes. This paper instead examines the problem of exfiltrating data from a large, self-forming UGS network via multiple, parallel SATCOM channels subject to the following operational and design constraints. The delay constraints for the bulk-data upload preclude the use of one central exfiltration point, so that a clusterhead based approach is required. However, the available RF spectrum requires the assignment of non-overlapping frequency/time-slot/code assignments to each pair of adjacent clusters. Results are presented based on both graph-theoretic and analytical approaches
Coarctation of the aorta, with rupture of the wall below the point of constriction

Abstract 1. 1. A case of coarctation of the aorta, with rupture of the wall below the point of constriction, into the esophagus, is presented. 2. 2. The five previously published cases of coarctation with rupture of the wall below the constriction are reviewed. 3. 3. We believe that back pressure plays an important role in the mechanism of rupture of the wall below the site of coarctation.
Biosynthesis of acyl dihydroxyacetone phosphate in guinea pig liver mitochondria.

Abstract Dihydroxyacetone phosphate was converted to a lipid by guinea pig liver mitochondria in the presence of fatty acids, coenzyme A (CoA), ATP, and Mg++. The isolated product was identified as acyl dihydroxyacetone phosphate by its chemical and chromatographic properties. The structure of the product was confirmed by comparing the infrared spectra of synthetic and biosynthetic palmitoyl dihydroxyacetone phosphate. The requirement for fatty acid, CoA, and ATP could be replaced by acyl-CoA. When the rate of esterification was examined with different fatty acids, the highest rate was obtained with palmitic acid. At concentrations above 0.1 mm, unsaturated acids such as oleic and linoleic were incorporated at a much lower rate than were palmitic and stearic. Similar results were obtained when the rates of esterification with palmitoyl-, stearoyl-, and oleoyl-CoA were compared. Palmitoyl dihydroxyacetone phosphate was synthesized by mitochondria of brain, kidney, and heart, as well as liver. Biosynthesis of acyl dihydroxyacetone phosphate was also catalyzed by the liver microsomal fraction, but the selective incorporation of saturated fatty acids was not seen.