cssi/SciSciGPT-SciSciNet huggingface dataset:
National Administrative Databases in Adult Spinal Deformity Surgery: A Cautionary Tale.

STUDY DESIGN Comparison between national administrative databases and a prospective multicenter physician managed database. OBJECTIVES This study aims to assess the applicability of National Administrative Databases (NADs) in adult spinal deformity (ASD). Our hypothesis is that NADs do not include comparable patients as in a physician-managed database (PMD) for surgical outcomes in adult spinal deformity. SUMMARY OF BACKGROUND DATA NADs such as National Inpatient Sample (NIS) and National Surgical Quality Improvement Program (NSQIP) provide large numbers of publications owing to ease of data access and lack of IRB approval requirement. These databases utilize billing codes, not clinical inclusion criteria, and have not been validated against PMDs in ASD surgery. METHODS The NIS was searched for years 2002 to 2012 and NSQIP for years 2006 to 2013 using validated spinal deformity diagnostic codes. Procedural codes (ICD-9 and CPT) were then applied to each database. A multicenter PMD including years 2008 to 2015 was used for comparison. Databases were assessed for levels fused, osteotomies, decompressed levels, and invasiveness. Database comparisons for surgical details were made in all patients, and also for patients with ≥ 5 level spinal fusions. RESULTS Approximately, 37,368 NIS, 1291 NSQIP, and 737 PMD patients were identified. NADs showed an increased use of deformity billing codes over the study period (NIS doubled, 68x NSQIP, P < 0.001), but ASD remained stable in the PMD.Surgical invasiveness, levels fused and use of 3-column osteotomy (3-CO) were significantly lower for all patients in the NIS (11.4-13.7) and NSQIP databases (6.4-12.7) compared with PMD (27.5-32.3). When limited to patients with ≥5 levels, invasiveness, levels fused, and use of 3-CO remained significantly higher in the PMD compared with NADs (P < 0.001). CONCLUSION National databases NIS and NSQIP do not capture the same patient population as is captured in PMDs in ASD. Physicians should remain cautious in interpreting conclusions drawn from these databases. LEVEL OF EVIDENCE 4.
Theoretical ecology has never been etiological: A reply to Donhauser.

•“Greater” and “lesser” causes cannot be distinguished empirically in ecology.•Theory in ecology lacks empirical support.•Ecological knowledge is historical and particular not general and systematic.
Biosonar Discrimination, Recognition, and Classification

One of the outstanding characteristics of the dolphin sonar system which distinguishes it from any man-made sonar is the ability to make fine distinctions in the features or properties of targets. This ability has amazed and sparked the interest of many involved in the development and use of active sonar systems. The abilities to perform fine target discrimination, recognition, and classification are often considered synonymous; however, there are subtle differences between these functions. Target discrimination means the ability to discern from their echoes that two targets are different. Target recognition means the ability to recognize features of the echoes from specific targets compared with echoes from any other targets; it involves a discrimination capability, an ability to recall from memory the echo features of specific targets, and the ability to compare present sonar echoes with those stored in memory. Target classification means the ability to separate targets into different classes according to some arbitrary criteria such as metal versus nonmetal, organic versus inorganic, edible versus inedible, smooth surface versus rough surface, etc. Most of the experiments discussed in this chapter involve target discrimination; a few involve target recognition.
Hedgehog signalling in liver pathophysiology

Liver disease remains a leading cause of mortality worldwide despite recent successes in the field of viral hepatitis, because increases in alcohol consumption and obesity are fuelling an epidemic of chronic fatty liver disease for which there are currently no effective medical therapies. About 20% of individuals with chronic liver injury ultimately develop end-stage liver disease due to cirrhosis. Hence, treatments to prevent and reverse cirrhosis in individuals with ongoing liver injury are desperately needed. The development of successful treatments requires an improved understanding of the mechanisms controlling liver disease progression. The liver responds to diverse insults with a conserved wound healing response, suggesting that it might be generally beneficial to optimise pathways that are crucial for effective liver repair. The Hedgehog pathway has emerged as a potential target based on compelling preclinical and clinical data, which demonstrate that it critically regulates the liver's response to injury. Herein, we will summarise evidence of the Hedgehog pathway's role in liver disease and discuss how modulating pathway activity might be applied to improve liver disease outcomes.
Influence of Light-Emitting Diodes (LEDs) on Light Sensing and Signaling Networks in Plants

Rapid technological advances and the merging of electronics and crop physiology have led to a new age for controlled environment agriculture (CEA). Food security is being undermined, and this is resulting in the movement of high value and perishable crops indoors. Almost every plant process can be regulated by the physical and electronic properties of light-emitting diodes (LEDs). It is often thought that crop plants can be modified to grow faster by genetically altering the photosynthetic machinery toward the enhancement of energy capture and energy use. However, we propose that instead of modifying the photosynthetic machinery, it would be more effective and faster to focus on enhancing plant attributes using light-induced sensing and signaling networks. The awareness of the characteristics of solar and electric light together with fundamental plant research is critical for understanding how to influence crops by using LEDs to activate or deactivate the rapid and slower sensing and signaling plant networks.
Genetically Engineered Animals, Drugs, and Neoliberalism: The Need for a New Biotechnology Regulatory Policy Framework

Genetically engineered (GE) animals that are meant for release in the wild could significantly impact ecosystems given the interwoven or entangled existence of species. Therefore, among other things, it is all too important that regulatory agencies conduct entity appropriate, rigorous risk assessments that can be used for informed decision-making at the local, national and global levels about the release of those animals in the wild. In the United States (US), certain GE animals that are intended for release in the wild may be regulated as new animal drugs by the Food and Drug Administration. This paper argues that the decision to treat them as new animal drugs is attributable to the influence of neoliberalism on the US biotechnology regulatory policy framework. The case is made that there should be public democratic deliberations and decision-making about the values and concerns that should guide the nation’s biotechnology regulatory policy paradigm, including the risk assessment process for GE animals meant for release in the wild.
An approach to fuzzy control of target function in consideration of equipment flexibility and workload in semiconductor photo lithography operations

Cycle-time is an important indicator for semiconductor wafer fabrication. In semiconductor factories, the flow of each wafer contains 300–900 processing steps, in which the most critical layer operation is in the photolithography tools. To achieve the target of cycle time more effectively, accurately modeling dispatching rule for each critical layer becomes more and more important. Existing approaches to rescheduling generally consist of hot lot, process queue time for quality and tool efficiency to maximize tool utilization, which is not enough to operate in a highly dynamic and unpredictable environment. This paper attempts to present a systematic design methodology for fuzzy control of a class of nonlinear systems. An example of a semiconductor wafer fabrication line in Tainan is given. The experimental results demonstrate the effectiveness of the proposed fuzzy control of target function.
Serpin B13 Plays a Role in Beta-Cell Development and Progression to Insulin-Dependent Diabetes

Identifying natural factors of the progression to type 1 diabetes (T1D) provides a unique opportunity to develop novel preventative strategies for this disease. Our laboratory has identified serpin B13 proteinase inhibitor as a potential player, activity of which is involved in modifying the timing of T1D development. In this study we examined whether blocking of serpin B13 with a monoclonal antibody (mAb) in early life causes any changes in pancreatic islet development that may explain beneficial impact of this activity later in life. First, our animal studies showed that blocking of serpin B13 during mid-pregnancy caused robust increase in the number of Ngn3+ progenitor cells at day E16.5 and accelerated conversion of these cells to beta cells. Similar changes were observed in embryonic pancreatic buds in vitro. On the other hand, the serpin B13 protein significantly downregulated the output of Ngn3+ cells in these in vitro cultures. Importantly, at 2 to 3 months after birth, the offspring of serpin B13 mAb-treated mothers demonstrated increased islet cell mass and responded to the diabetes-inducing agent, streptozotocin, with markedly improved glucose tolerance and renal function, compared with control animals. Second, our screening of 280 children, previously enrolled in a DPT-1 clinical trial, for serpin B13 autoantibody (AA) revealed an inverse correlation of this AA with risk level for T1D, as well as a positive association with longer diabetes-free interval. These data demonstrate the significant, long-term impact of serpin B13 activity on islet biology and suggest that blocking this serpin has the potential to partially prevent, or at least slow down, the development of T1D both in the mouse and human. Disclosure Y. Kryvalap: None. M.L. Jiang: None. N. Kryvalap: None. K.A. Mueller: None. J. Czyzyk: None.
Application of content standards for digital geospatial metadata to laboratory data and the site characterization process

This paper examines sources of supporting information for data that is collected in a monitoring program were samples are collected repetitively to detect change in some parameter over time. The development of a monitoring program goes through several steps, including site characterization, site selection, sampling, and analysis. This process involves the evaluation and development of a large amount of information, which generally has not accompanied the reported tabular data. The lack of this information has often limited the application and use of the tabular data. GIS is a valuable tool for analyzing data collected in monitoring programs with other spatial themes. To support the transfer and use of spatial data, the Federal government has adopted content standards for digital geospatial metadata. The intent of these standards is to provide sufficient information for the application and use of a spatial data set. We have developed large sets of that have been underused frequently because the information about this data was either not available or too insufficient to make a decision on the usefulness of the data. In part, this is because of the design of the data systems used to store the reported data values. Additional notes, site descriptions, and comments on a particular parameter were often abbreviated for storage with the tabular data. Retrievals of the data have not identified the associated quality control/ quality assurance documents. Additional information describing the sampling site and sampling procedure were not associated with the sampling data. With the systems and software tools that are currently available, all appropriate information about a sampling program can be available to the user. This information can be associated with the data regardless of the data format. This paper examines the content of information that should be available to document a long-term monitoring program addressing agricultural drainage issues in the San Joaquin Valley of California. This monitoring program is attempting to identify changes in the concentration of selected constituents in drainage water, surface streams, and wildlife on the western side of the San Joaquin Valley.
De novo main-chain modeling with MAINMAST in 2015/2016 EM Model Challenge.

Abstract Protein tertiary structure modeling is a critical step for the interpretation of three dimensional (3D) election microscopy density. Our group participated the 2015/2016 EM Model Challenge using the MAINMAST software for a de novo main chain modeling. The software generates local dense points using the mean shifting algorithm, and connects them into Cα models by calculating the minimum spanning tree and the longest path. Subsequently, full atom structure models are generated, which are subject to structural refinement. Here, we summarize the qualities of our submitted models and examine successful and unsuccessful models, including 3D models we did not submit to the Challenge. Our protocol using the MAINMAST software was sometimes able to build correct conformations with 3.4–5.1 A RMSD. Unsuccessful models had failure of chain traces, however, their Cα positions and some local structures were quite correctly built. For evaluate the quality of the models, the MAINMAST software provides a confidence score for each Cα position from the consensus of top 100 scoring models.
A Time-Dependent Principal Components-Based Dimension Reduction Approach to Analyzing the Influence of Product Interventions on User Engagement with Mobile Applications

We propose a new framework of identifying mobile applications interventions (e.g., updates, new features, or new versions) with positive (or negative) users' attitudes, by analyzing temporal changes in a defined set of usage metrics, yielding a general metric, a Mobile Application User Engagement (MAUE). The new metric is a linear combination of user engagement time-series metrics, accounting for the largest amount of the variance in usage data via principal component analysis (PCA). Our proposed approach has been applied to 1533651 behavioral data records of The Weather Company (TWC) IOS users, to analyze the influence of an app update that occurred during the time interval of data collection. Our results indicate that the time-dependent fluctuations of the MAUE trends for the epochs before and after the app update are characterized with a power-law decrease, where a faster decrease is observed for the time period after app update and indicates a higher MAUE score for this time period.
Dispersion-enhanced tunability of the laser-frequency response to the cavity-length change

We report on the controllable response of the lasing frequency to the cavity round-trip path change. This is achieved by modifying the dispersion of the intracavity medium in the four-wave mixing regime in Rb. We can either increase the response by at least a factor of 2.7 or drastically reduce it. The former regime is useful for sensitive measurements tracking the cavity round-trip length and the latter regime is useful for precision metrology.
Antiretroviral drugs and tobacco smoke dysregulate human platelets: A novel investigation into the etiology of HIV co-morbid cardiovascular disease.

While antiretroviral drugs (ARVs) successfully suppress Human Immunodeficiency Virus (HIV), HIV-infected persons still have a shorter lifespan and are at higher risk of developing cardiovascular disease (CVD) compared to uninfected persons. CVD is the number one cause of death globally, and is now appreciated as an inflammatory disease. HIV-infected persons experience chronic inflammation, thought to be caused by low levels of HIV proteins, daily use of ARVs, and increased rates of smoking. The impact of ARVs on CVD risk remains unclear, with some studies linking ARVs to CVD. Additionally, when controlled for smoking status HIV-infected persons were still at greater risk for CVD. Platelets are important in the development of CVD, but the effects of ARVs on platelets are unstudied. Additionally, cigarette smoke is known to activate platelets, inducing inflammation. Our novel study investigates the effects of ARVs and cigarette smoke, alone and in combination, on human platelet function. Our striking in vitro findings demonstrate that the ARVs Ritonavir and Darunavir, as well as cigarette smoke, dysregulate platelet function. Treatment with the protease inhibitor Ritonavir resulted in a dose-dependent increase in platelet production of proinflammatory mediator prostaglandin E 2 (PGE 2 ) (p 2 (p
Substance Use Among Older People Living With HIV: Challenges for Health Care Providers

Older people living with HIV (OPLWH) have higher rates of substance use (tobacco, alcohol, and other drugs) than their HIV-negative peers. Addressing health care needs of OPLWH who use substances is more challenging than for those who do not: they are highly impacted by comorbid conditions, substance use can interact with other medications (including antiretroviral therapy-ART) and reduce their effectiveness, and substance use has been associated with reduced adherence to ART and increased risky behaviors (including sexual risks). People who use substances also suffer disparities along the HIV continuum of care, resulting in lower viral suppression rates and poorer health outcomes. They are especially impacted by stigma and stress, which have implications for HIV treatment and care. Recommendations for health care providers working with OPLWH who use substances include: (1) the need to screen and refer for multiple associated conditions, and (2) training/continuing education to enhance care management and maximize health outcomes.
Operational Value-Based Energy Storage Management for Photovoltaic (PV) Integrated Active Power Distribution Systems

This paper presents an operational cost-based approach for battery energy storage management. In this approach, the operation value is derived to optimally manage one battery application—photovoltaic (PV) capacity firming or PV smoothing. The proposed approach is an optimization framework that augments a PV smoothing algorithm where the battery is used to smooth the output of intermittent PV farm. The objective of the optimization framework is to provide maximum operational benefits for the battery. To this end, first, a formal method is developed that finds the operational benefits which is then demonstrated using a field verified electro-magnetic transient (EMTP) model of a real-world feeder. Second, the positive effect in the operation of the feeder is quantified in terms of monetary value. It is demonstrated that the knowledge of monetary value can provide better operational benefits of energy storage applications such as PV smoothing.
TCDD-mediated suppression of naïve human B cell IgM secretion involves aryl hydrocarbon receptor-mediated reduction in STAT3 serine 727 phosphorylation and is restored by interferon-γ

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) is a persistent environmental contaminant formed as a byproduct in organic synthesis and burning of organic materials. TCDD has potent immunotoxic effects in B lymphocytes resulting in decreased cellular activation and suppressed IgM secretion following activation with CD40 ligand. Previous work from our lab demonstrated that TCDD treatment of naive human B cells resulted in significant increases in the levels of the tyrosine phosphatase SHP-1, which corresponded with suppression of IgM secretion. STAT3 is a critical B cell transcription factor for B cell activation and secretion of immunoglobulins (Ig). STAT3 dimerizes and translocates to the nucleus following phosphorylation as a result of cytokine receptor signaling. We hypothesized that TCDD-mediated increases in SHP-1 could result in decreased STAT3 tyrosine phosphorylation. Interestingly, only modest changes in the levels of STAT3 tyrosine phosphorylation were observed. By contrast, TCDD significantly reduced levels of STAT3 serine phosphorylation as early as 12h post B cell activation. These results corresponded with decreased inhibitory phosphorylation of the serine specific phosphatase PP2a, which is regulated by SHP-1. Further, studies revealed that interferon gamma (IFNγ), which signals through the type II interferon receptor, can non-canonically induce STAT3 activation via Src kinase activity. Indeed, treatment of human B cells with IFNγ resulted in increased STAT3 serine phosphorylation and reversed TCDD-mediated suppression of the IgM response. Together, these data putatively identify a key event in the mechanism by which TCDD induces suppression of Ig secretion and demonstrate the potential of IFNγ as a means to reverse this effect in primary human B lymphocytes.
Upper airway surgery to rescue the "untitratable" patient with OSA and obesity

This is a case report of an 41-year-old male with obesity (body mass index 90 kg/m2), severe obstructive sleep apnea (OSA), and an apnea-hypopnea index of 90 events/h despite high bilevel positive ...
Creatinine filtration kinetics in critically Ill neonates.

BACKGROUND Creatinine values are unreliable within the first weeks of life; however, creatinine is used most commonly to assess kidney function. Controversy remains surrounding the time required for neonates to clear maternal creatinine. METHODS Eligible infants had multiple creatinine lab values and were admitted to the neonatal intensive care unit (NICU). A mathematical model was fit to the lab data to estimate the filtration onset delay, creatinine filtration half-life, and steady-state creatinine concentration for each subject. Infants were grouped by gestational age (GA) [(1) 22-27, (2) >27-32, (3) >32-37, and (4) >37-42 weeks]. RESULTS A total of 4808 neonates with a mean GA of 34.4 ± 5 weeks and birth weight of 2.34 ± 1.1 kg were enrolled. Median (95% confidence interval) filtration onset delay for Group 1 was 4.3 (3.71, 4.89) days and was significantly different than all other groups (p < 0.001). Creatinine filtration half-life of Groups 1, 2, and 3 were significantly different from each other (p < 0.001). There was no difference in steady-state creatinine concentration among the groups. CONCLUSIONS We quantified the observed kidney behavior in a large NICU population as a function of day of life and GA using creatinine lab results. These results can be used to interpret individual creatinine labs for infants to detect those most at risk for acute kidney injury. IMPACT One of the largest cohorts of premature infants to describe the evolution of kidney development and function over their entire hospitalization. New concept introduced of the kidney filtration onset delay, the time needed for the kidney to begin clearance of creatinine, and that it can be used as an early indicator of kidney function. The smallest premature infants from 22 to 27 weeks gestation took the longest time to begin and complete maternal creatinine clearance. Clinicians can easily compare the creatinine level of their patient to the normative curves to improve understanding of kidney function at the bedside.
SNPP and NOAA-20 VIIRS on-orbit geolocation trending and improvements

Two Visible Infrared Imaging Radiometer Suite (VIIRS) sensors have been in operations for more than 8.5 and 2.5 years since they were launched in October 2011 on SNPP satellite and in November 2017 on NOAA-20 satellite, respectively. These are two satellites in the Join Polar Satellite System (JPSS) constellation, of which Suomi National Polar-orbiting Partnership (SNPP) is a risk reduction satellite and NOAA-20 is the first of four JPSS satellites (JPSS-1 became NOAA- 20 after launch). Accurate geolocation is a critical element in data calibration for accurate retrieval of global biogeophysical parameters. In this paper, we describe the latest trends in the continuously improved geolocation accuracy in VIIRS Collection-1 (C1) and C2 re-processing. We implemented a VIIRS instrument geometric model update (VIGMU) for both sensors that correct for geolocation error oscilations in the scan direction. We borrowed code from Moderate Resolution Imaging Spectroradiometer (MODIS) geolocation software to correct for time-dependent pointing variations, that are particularly acute in NOAA-20 VIIRS, and some pointing anomalies in SNPP VIIRS. We developed a Kalman Filter using gyro data to correct for attitude errors due to the degradation of the star trackers performance from the SNPP satellite. We also present an improved ground control point matching (CPM) tool, in which the ground control point (GCP) chips library is refreshed using recently launched Landsat-8 images.
Corrigendum to “Marginal Effects in Interaction Models: Determining and Controlling the False Positive Rate”:

After publication of Esarey and Sumner, we recognized substantively significant errors in the paper. We correct those errors here. We discovered these errors as part of work on another, unrelated p...
Healthcare-associated infections among patients hospitalized for cancers of the lip, oral cavity and pharynx.

Author(s): Sankaran, Satheeshkumar P; Villa, Alessandro; Sonis, Stephen | Abstract: IntroductionThe negative consequences of healthcare-associated infections (HAI) on the burden of illness (BOI) of cancer patients are well-established. However, there is a paucity of research on HAI among cancers of the lip, oral cavity and pharynx (CLOCP), and whether HAI-related BOI differed for other common solid tumors-malignant neoplasm of the colon (MNC) and malignant neoplasm of the lung (MNL).MethodsWe utilized the United States' National Inpatient Sample database 2017 to study longitudinal inpatient hospital stay of CLOCP, MNC and MNL. Patient demographics and hospital characteristics of patients were assessed, and the impact of HAI-related BOI compared based on differences in length of hospital stays (LOS), total charges during hospitalization and mortality were compared.FindingsIn 2017, of the 54,934 patients with CLOCP, 1.2% had HAI, compared to MNC (n=64,470) with 2% HAI and MNL (n=154,685) with 1.2% HAI. In adjusted multivariable regression analysis, we determined CLOCP patients with HAI had LOS of 5.6 days longer (95% CIs, 3.0-8.2 days, Pnl 0.001), and hospitalization charges of $40,341 higher (95%CIs 15,715-64,967, Pnl 0.01) than the non-HAI CLOCP patients. Mortality was not significantly different among HAI and non-HAI CLOCP patients (odds ratio: 0.80; 95%CIs 0.35-1.87, Pn= 0.6). In unadjusted analysis, LOS and total charges were higher for CLOCP-HAI patients vs. MNC-HAI or MNL-HAI patients.ConclusionHAI in patients with CLOCP patients were associated with an increased BOI, and this is considerably higher than observed in patients with MNC or MNL patients who had HAI.
Complicating Cops and Criminals: Racial Politics in the Classic Network Crime Drama

In the US system of broadcasting, television writers work within a set of constraints that include a desire to appeal to large audiences, satisfy the needs of advertisers, and navigate a storytelling act structure necessitated by commercial interruptions. Television storytelling has traditionally used clearly defined genres to ensure that programming will appeal to viewers, and so the codes and conventions associated with each story type provide additional limits for writers in the medium. These factors remain relevant in the present day, but they were the most pronounced during the classic network era that began in the late 1950s and continued into the 1980s. This chapter explores the development of a script for the crime drama Ironside, written by Sy Salkowitz, a prolific television writer from this era whose archived papers illuminate how a story idea moved from an initial inspiration to a completed episode. Like other writers of the time, Salkowitz strove to engage and surprise the viewer, even as he relied on formulas of network television.
Use of prescription sialagogues for management of xerostomia in chronic graft-vs-host disease

Objectives The objective of this study was to analyze use patterns of prescription sialagogues for management of xerostomia in patients with chronic graft-vs-host disease (cGVHD) after allogeneic hematopoietic cell transplant (allo-HSCT). Methods A retrospective chart review was conducted of patients who were diagnosed with cGVHD and prescribed sialogogue therapy from 2005 to 2019. Data collected included patient demographic characteristics, date of transplant, date of oral cGVHD diagnosis, concurrent immunosuppressive medication, sialogogue regimen including start and end dates, worst xerostomia score reported, and patient-reported percentage improvement. Results This study included 67 patients with a median age of 64 years (range, 25-78 years) diagnosed with oral cGVHD at a median of 8.2 months after allo-HSCT. Most patients were prescribed pilocarpine (81%) at 5 mg (88.5%) or, less frequently, 7.5 mg (3.8%), 10 mg (5.8%), or 15 mg (1.9%). Cevimeline was prescribed less frequently (19%), always at 30 mg. The median worst xerostomia score was 6.5 (range, 1-10). Pilocarpine dose was increased in 2 patients (4%) with no subsequent change in worse xerostomia score or percentage improvement. Overall median duration of therapy was 7.4 months (range, 1-152). For patients receiving pilocarpine, the median duration on therapy was 7 months (range, 1-152), and for patients on cevimeline, the median duration was 10 months (range, 1-111 months). The overall median patient-reported percentage improvement was 20% (range, 0-100%). Most common side effects were diarrhea (1.6%) and nausea (2.9%); excessive sweating was infrequent (1.4%). Conclusions The median duration of sialogogue therapy was 7.4 months, and most patients were prescribed pilocarpine at 5 mg. The median overall reported improvement was 20%, and side effects were infrequent and did not lead to therapy discontinuation. Patients receiving higher dosages of pilocarpine had a higher worst xerostomia score and a lower percentage improvement in symptoms. The prolonged duration of therapy suggests perceived benefits; however, prospective studies are needed.
Informed Decision-making for Health Insurance Enrollment: Survey Study.

Background: Health insurance enrollment is a difficult financial decision with large health impacts. Challenges such as low health insurance literacy and lack of knowledge about choosing a plan further complicate this decision-making process. Therefore, to support consumers in their choice of a health insurance plan, it is essential to understand how individuals go about making this decision. Objective: This study aims to understand the sources of information used by individuals to support their employer-provided health insurance enrollment decisions. It seeks to describe how individual descriptive factors lead to choosing a particular type of information source. Methods: An introduction was presented on health insurance plan selection and the sources of information used to support these decisions from the 1980s to the present. Subsequently, an electronic survey of 151 full-time faculty and staff members was conducted. The survey consisted of four sections: demographics, sources of information, health insurance literacy, and technology acceptance. Descriptive statistics were used to show the demographic characteristics of the 126 eligible respondents and to study the response behaviors in the remaining survey sections. Proportion data analysis was performed using the Cochran-Armitage trend test to understand the strength of the association between our variables and the types of sources used by the respondents. Results: In terms of demographics, most of the respondents were women (103/126, 81.7%), represented a small household (1-2 persons; 87/126, 69%), and used their insurance 3-12 times a year (52/126, 41.3%). They assessed themselves as having moderate to high health insurance literacy and high acceptance of technology. The most selected and top-ranked sources were Official employer or state websites and Official Human Resources Virtual Benefits Counselor Alex. From our data analysis, we found that the use of official primary sources was constant across age groups and health insurance use groups. Meanwhile, the use of friends or family as a primary source slightly decreased as age and use increased. Conclusions: In this exploratory study, we identified the main sources of health insurance information among full-time employees from a large state university and found that most of the respondents needed 2-3 sources to gather all the information that they desired. We also studied and identified the relationships between individual factors (such as age, gender, and literacy) and 2 dependent variables on the types of primary sources of information. We encountered several limitations, which will be addressed in future studies. Trial Registration:
Growth in written academic word use in response to morphology-focused supplemental instruction

The aims of the current project were to: (1) describe average change in the use of academic words across the school year in writing and (2) examine potential predictors of growth in academic word use in response to morphology-focused supplemental instruction. Investigators utilized written expository responses of 824 students in 5th grade before and after a 20 week supplemental language instruction that focused on morphological knowledge in academic words. Students received supplemental Word Knowledge Instruction (n = 515) or business-as-usual (n = 307). The sample included students who were English Learners (ELs), previous ELs with fluent English proficiency (FEP), never ELs, and students with language-based learning disabilities (LLD). Small but significant increases in academic word use in written responses were evidenced from fall to spring. Results from a two-level hierarchical linear model with students nested within teachers indicated that a supplemental instructional approach predicted change in academic word use from fall to spring for students with differential effects by EL status. The morphology-focused supplemental instruction was related to larger gains in academic word use in writing than business-as-usual for students with LLD and FEP students. ELs with limited English proficiency showed similar outcomes in both conditions.
Complications Associated With Nasopharyngeal COVID-19 Testing: An Analysis of the MAUDE Database and Literature Review.

BACKGROUND: Nasopharyngeal swab testing, which has greatly increased in utilization due to the COVID-19 pandemic, is generally safe and well-tolerated, although it may be rarely associated with adverse events. METHODS: Publicly reported adverse events associated with nasopharyngeal COVID-19 testing within the Manufacturer and User Facility Device Experience (MAUDE) database and the published literature were queried. RESULTS: A total of 129 adverse events were reported, including 66 from the MAUDE database and 63 from literature review. The most common complications were swab fracture resulting in retained foreign body (47%), followed by epistaxis (17%), and headache (11%). Seven (12%) of the reported retained foreign body cases required removal under general anesthesia, while 1 (5%) of the epistaxis cases required surgical intervention. The most serious adverse event was meningitis following cerebrospinal fluid leak. CONCLUSIONS: Patients and healthcare providers should be aware of the potential risks associated with testing, with attention to ensuring proper technique, and be prepared to recognize and manage adverse events.
Effect of the Lifestyle, Exercise, and Nutrition (LEAN) Study on Long-Term Weight Loss Maintenance in Women with Breast Cancer

Lifestyle interventions among breast cancer survivors with obesity have demonstrated successful short-term weight loss, but data on long-term weight maintenance are limited. We evaluated long-term weight loss maintenance in 100 breast cancer survivors with overweight/obesity in the efficacious six-month Lifestyle, Exercise, and Nutrition (LEAN) Study (intervention = 67; usual care = 33). Measured baseline and six-month weights were available for 92 women. Long-term weight data were obtained from electronic health records. We assessed weight trajectories between study completion (2012-2013) and July 2019 using growth curve analyses. Over up to eight years (mean = 5.9, SD = 1.9) of post-intervention follow-up, both the intervention (n = 60) and usual care (n = 32) groups declined in body weight. Controlling for body weight at study completion, the yearly weight loss rate in the intervention and usual care groups was -0.20 kg (-0.2%/year) (95% CI: 0.06, 0.33, p = 0.004) and -0.32 kg (-0.4%/year) (95% CI: 0.12, 0.53, p = 0.002), respectively; mean weight change did not differ between groups (p = 0.31). It was encouraging that both groups maintained their original intervention period weight loss (6% intervention, 2% usual care) and had modest weight loss during long-term follow-up. Breast cancer survivors in the LEAN Study, regardless of randomization, avoided long-term weight gain following study completion.
Usage-Based Insurance—Impact on Insurers and Potential Implications for InsurTech

Insurers are increasingly embracing the InsurTech ecosystem. The most important InsurTech-related trend in automobile insurance is usage-based insurance (UBI), which enables insurers to access and ...
Computer System Security Threat Evaluation Based Upon Artificial Immunity Model and Fuzzy Logic

Despite extensive efforts during recent years within the technical community to improve computer security, serious security problems continue to receive increasing coverage in both the popular and technical media. A large part of the problem stems from poor systems engineering of software and networks. In biological systems, natural internal immune system responses identify and protect the organism. A key mechanism in this immunity process is the ability to distinguish between self (i.e. normal organisms or behaviors) and non-self (i.e. abnormal or anomalous behavior). To deal with the ambiguities and imprecision in the process of anomaly detection for computer system security, we introduce a hierarchical fuzzy inference system to capture normal behavior deviations. Fuzzy logic has been widely used in control systems, decision-making, information retrieval, and many other applications. In this paper, we explore its capability in the area of computer security threat evaluation modeling and anomaly detection. Initial studies indicate promising results for this approach
La ira en la primera tradición cidiana

The expressions of the wrath in the Cantar de Mio Cid include a group of traditions of different nature, which constitute a point of departure for the proper interpretation of the text. On the one hand, the ira regia ('regal wrath') is related to the emotional medieval theory on wrath, and, on the other hand, the analysis of the political dimension of wrath in the Cantar and in the preceding Cidian tradition, contributes with new aspects on cultural practices and legal systems in the Middle Ages.
Incorporating Oracle on-line space management with long-term archival technology

The storage requirements of today's organizations are exploding. As computers continue to escalate in processing power, applications grow in complexity and data files grow in size and in number. As a result, organizations are forced to procure more and more megabytes of storage space. This paper focuses on how to expand the storage capacity of a Very Large Database (VLDB) cost-effectively within a Oracle7 data warehouse system by integrating long term archival storage sub-systems with traditional magnetic media. The Oracle architecture described in this paper was based on an actual proof of concept for a customer looking to store archived data on optical disks yet still have access to this data without user intervention. The customer had a requirement to maintain 10 years worth of data on-line. Data less than a year old still had the potential to be updated thus will reside on conventional magnetic disks. Data older than a year will be considered archived and will be placed on optical disks. The ability to archive data to optical disk and still have access to that data provides the system a means to retain large amounts of data that is readily accessible yet significantly reduces the cost of total system storage. Therefore, the cost benefits of archival storage devices can be incorporated into the Oracle storage medium and I/O subsystem without loosing any of the functionality of transaction processing, yet at the same time providing an organization access to all their data.
Characterization of endogenous cytokine concentrations after high-dose chemotherapy with autologous bone marrow support

NDOGENOUSLY PRODUCED cytokines appear to E influence multiple physiologic processes affecting regulation of the hematopoietic system. These proteins may also directly or indirectly contribute to treatment-associated toxicities, such as hypotension and liver or renal dysfunction after high-dose chemotherapy. Administration of cytokines such as recombinant human tumor necrosis factor-a (rHuTNF-a) produces some symptoms similar (although less in degree) to those found in patients developing major organ toxicity following bone marrow transplantation (BMT). ‘3’ High concentrations of endogenous serum TNF have been reported to precede major transplant-related complication^.^.^ Elevated serum interleukin-6 (IL-6) and macrophage colonystimulating factor (M-CSF) have also been found in patients developing major organ toxi~ity.~.~ Previous studies in BMT patients have reported an association between endogenous serum erythropoietin (EPO) and Cytostatic drugs may also stimulate EPO production for undetermined reason~.~,~~ Patients may experience significant exposure to endogenous cytokines such as granulocyte colony-stimulating factor (G-CSF) during the myeloablative phase following high-dose chemotherapy. The exact etiology of these elevations (accelerated production or reduced clearance) is unclear; however, some data suggest serum G-CSF concentrations may correlate to myeloid engraftment.”
A transition criterion for the multigrid expectation maximization reconstruction algorithm for positron emission tomography

The multigrid expectation maximization algorithm (MGEM), an extension of the maximum likelihood (ML) algorithm, has been applied to the problem of reconstruction in positron emission tomography (PET). The MGEM algorithm implemented the expectation maximization (EM) algorithm at different image resolutions. The coarse grids were used to extract the low-frequency components and the finer grids to extract the high-frequency components. The convergence-rate of the MGEM algorithm was used to determine when to switch grid levels. A grid-level transition criterion which used the co-occurrence matrix statistics of the reconstructed image is presented. These statistics were computed on an image reconstructed from simulated PET data and provided a reliable transition criterion. >
THE FINANCIALIZATION OF URBAN POLICY IN THE AGE OF OBAMA

It is customary to ascribe responsibility to a sitting president for the policy enactments rolled out during that president’s term in office. To do so, however, neglects the effect on policy of his...
Differentiating patterns of prescription stimulant medical and nonmedical use among youth 10–18 years of age

OBJECTIVE: To assess the past 30-day prevalence of prescription stimulant use, report different forms of nonmedical use, and investigate different characteristics associated with Medical Users Only, Nonmedical Users Only, and youth who reported both medical and nonmedical use (MU+NMU youth). METHODS: The National Monitoring of Adolescent Prescription Stimulants Study recruited 11,048 youth aged 10-18 years from entertainment venues in 10 US cities. RESULTS: In this study, 6.8% youth used prescription stimulants in the past 30 days, with 3.0% reporting Medical Use Only (MU Only), 1.1% reporting Both Medical and Nonmedical Use (MU+NMU), and 2.5% reporting Nonmedical Use Only (NMU Only). Use of other's stimulants was the most frequently reported form of nonmedical use (88.4%), followed by using more than prescribed (38.9%), and using outside of the prescribed route (32.2%). Medical Users Only and MU+NMU youth did not differ from Non-Users in cigarette, alcohol, and illicit drug use. MU+NMU youth tended to have more conduct problem behaviors compared to Medical Users Only (p=0.0011) and Nonmedical Users Only (p=0.0132). Compared to MU+NMU youth, Nonmedical Users Only were more likely to have close friends who tried Adderall (p=0.0123), endorse binge drinking (p=0.0118) and illicit drug use (pCONCLUSIONS: Future research should investigate the sources of the nonmedically used prescription stimulants and how they were diverted. Intervention programs need to acknowledge the differences between MU+NMU youth and Nonmedical Users Only, and employ different strategies to prevent nonmedical use in these subgroups. Language: en
Enjoyment and Success: Reciprocal Factors in Behavior Change

This study assessed the role of behavior enjoyableness in development of long-term behavior. First, as expected from the literature on attitude and behavior change (Ajzen, 1991; Ryan & Deci, 2000), initial enjoyableness of a behavior predicted how successful participants were in performing the behavior in the short term (i.e., the time until they first violated their behavioral intentions). Of primary interest, repeated successful performance was, in turn, associated with an increase in reported enjoyableness of the behavior in the longer term. The study demonstrates the importance of a reciprocal relationship of behavior enjoyableness and performance for behavior change, such that even initially non-enjoyable behaviors can become more enjoyable with repeated performance. These findings are particularly relevant for long-term, goal-related behaviors.
Investment decisions and transferable discharge permits: An empirical study of water quality management under policy uncertainty

The problem of investiment decisions for sources participating in transferable discharge permit (TDP) markets has not received much attention. One way TDPs offer potential savings is with their ability to influence development in a region. Static models have assessed the potential savings of TDPs but do not explicitly consider investment decisions; thus they do not capture this long run role nor that of policy uncertainty and tend to understate both the cost saving potential and the difficulty in achieving it. This paper addresses both problems by emphasizing the temporal dimension of TDPs. A two-period investment model investigates the magnitude of these potential savings and the effects of two types of policy uncertainty upon expected gains from permit trading.