cssi/SciSciGPT-SciSciNet huggingface dataset:
Improving the Numerical Knowledge of Children with Autism Spectrum Disorder: The Benefits of Linear Board Games

A lack of numerical knowledge early on can impede a child's academic development. In past research, playing linear board games improved children's understanding of numerical relations, which the authors theorised could extend to children with autism spectrum disorder. For this pilot study, 10 children played a board game where they moved tokens across coloured tiles displaying the numbers 1–10. During gameplay, students in the experimental group focused on the numbers on the tiles, while the control group focused on the colours. The assessment consisted of a number line estimation task, where students placed numbers ranging from 1 to 9 on a blank number line. Results showed children in the experimental group experienced statistically significant improvement in their understanding of numerical relationships of numbers on the number line estimation task. Findings indicate extended experiences with linear board games can support the numerical development of children with autism spectrum disorder.
Fusing shallow and deep learning for bioacoustic bird species classification

Automated classification of organisms to species based on their vocalizations would contribute tremendously to abilities to monitor biodiversity, with a wide range of applications in the field of ecology. In particular, automated classification of migrating birds' flight calls could yield new biological insights and conservation applications for birds that vocalize during migration. In this paper we explore state-of-the-art classification techniques for large-vocabulary bird species classification from flight calls. In particular, we contrast a “shallow learning” approach based on unsupervised dictionary learning with a deep convolutional neural network combined with data augmentation. We show that the two models perform comparably on a dataset of 5428 flight calls spanning 43 different species, with both significantly outperforming an MFCC baseline. Finally, we show that by combining the models using a simple late-fusion approach we can further improve the results, obtaining a state-of-the-art classification accuracy of 0.96.
Branched-Selective Intermolecular Ketone α-Alkylation with Unactivated Alkenes via an Enamide Directing Strategy.

We describe a strategy for intermolecular branched-selective α-alkylation of ketones using simple alkenes as the alkylating agents. Enamides derived from isoindolin-1-one provide an excellent directing template for catalytic activation of ketone α-positions. High branched selectivity is obtained for both aliphatic and aromatic alkenes using a cationic iridium catalyst. Preliminary mechanistic study favors an Ir–C migratory insertion pathway.
Progeny Density and Nest Availability Affect Parasitism Risk and Reproduction in a Solitary Bee (Osmia lignaria) (Hymenoptera: Megachilidae)

Gregarious nesting behavior occurs in a broad diversity of solitary bees and wasps. Despite the prevalence of aggregative nesting, the underlying drivers and fitness consequences of this behavior remain unclear. I investigated the effect of two key characteristics of nesting aggregations (cavity availability and progeny density) on reproduction and brood parasitism rates in the blue orchard bee (Osmia lignaria Say) (Hymenoptera: Megachilidae), a solitary species that nests gregariously and appears to be attracted to nesting conspecifics. To do so, I experimentally manipulated nest cavity availability in a region of northern Utah with naturally occurring populations of O. lignaria. Nest cavity availability had a negative effect on cuckoo bee (Stelis montana Cresson) (Hymenoptera: Megachilidae) parasitism rates, with lower parasitism rates occurring in nest blocks with more available cavities. For both S. montana and the cleptoparasitic blister beetle Tricrania stansburyi Haldeman (Coleoptera: Meloidae), brood parasitism rate was negatively correlated with log-transformed O. lignaria progeny density. Finally, cavity availability had a positive effect on male O. lignaria body weight, with the heaviest male progeny produced in nest blocks with the most cavities. These results suggest that cavity availability and progeny density can have substantial effects on brood parasitism risk and reproduction in this solitary bee species.
More Caddisfly Species (Insecta: Trichoptera) New to, or Noteworthy Records from, The State of Virginia

Abstract In 2014, 369 species of caddisfly (Trichoptera) had been recorded from the state of Virginia. In the last two plus years two more species have been newly found in the state, bringing the total to 371 species; Hydropsyche carolina Banks and Beraea fontana Wiggins, with the latter being the southernmost record for the species as well as a new family and genus for the state. The presence of Theliopsyche grisea (Hagen) is confirmed with the collection of a male, and further records of noteworthy collections are mentioned.
The Cost of Caring: An Exploration of Compassion Fatigue, Compassion Satisfaction, and Job Satisfaction in Pediatric Nurses.

Abstract Purpose The purpose of this study was to describe levels of compassion satisfaction, compassion fatigue, and job satisfaction among pediatric nurses in the United States and determine if there was a relationship among these constructs. Design and Methods All members Society of Pediatric Nurses were sent an electronic invitation to participate, and those who consented received three measures; a demographic questionnaire, the Job Satisfaction Survey (JSS) and the Professional Quality of Life (ProQOL) measure. Results Three hundred eighteen (10.6%) of members of the Society of Pediatric Nurses participated in the study: Over three quarters (245, 76%) of the sample had another career before nursing. The sample's mean job satisfaction level was 149.8 (SD = 29.74), which was significantly higher than published reported means for nurses. Bivariate analyses revealed a significant relationship between gender and the compassion satisfaction, in that women were more likely to evidence compassion satisfaction than men (t = 1.967, p = .05, df = 298). No other significant relationships were found. Conclusions The majority of nurses had high levels of compassion satisfaction and job satisfaction; further, female gender was associated with higher levels of compassion satisfaction. Practice Implications This current study had a very high response from second-career nurses (n = 245, 76.8%) and overall, the sample had higher levels of compassion satisfaction. It is possible that second career nurses are better equipped in some way that helps them mediate negative responses of caring as a pediatric nurse and future research should explore this. Due to the significant financial costs to institutions of having nurses who have low levels of job satisfaction and high levels on compassion fatigue, it is imperative for hospital administrators to develop infrastructures to support employees.
Spontaneous perforating hematoma of the rectum. Report of a case.

Intramural hematomas of the intestine most often occur in the setting of blunt abdominal trauma. However, spontaneous hematomas can occur secondary to either hematologic disorders or use of anticoagulant therapy. There has been no clearly documented report of a spontaneous rectal hematoma. We describe the novel treatment of a patient with a spontaneous intramural hematoma of the rectum which presented as an abdominal catastrophe.
Genome Sequence of the Amphotericin B-Resistant Candida duobushaemulonii Strain B09383.

ABSTRACT Candida duobushaemulonii is a drug-resistant yeast that can cause invasive candidiasis. Here, we report the first genome sequence of C. duobushaemulonii, isolate B09383, generated using PacBio sequencing technology. The estimated genome size was 12.5 Mb with a GC content of 46.84%.
Parallel decentralized detection with dependent randomization

We consider a binary parallel decentralized detection system. It employs n local detectors (LDs) to observe a binary phenomenon in order to accept one of two hypotheses about the phenomenon (hypothesis H 0 or hypothesis H 1 ). Each LD uses a local decision rule to compress its local observations into a binary local decision. The Data Fusion Center (DFC) uses a fusion rule to combine all binary local decisions into a global binary decision. The combination of the global fusion rule and all local decision rules in the system is referred to as a decision strategy. In many scenarios, the system uses a single (deterministic) decision strategy — the DFC used a single deterministic fusion rule and each LD uses a single deterministic decision rule. A randomized strategy involves a randomized or pseudo — randomized choice between several deterministic decision strategies. In some instances, such randomized strategy is needed to ensure that the Receiver Operator Characteristic (ROC) curve of the architecture is convex. We are interested in scenarios that require that the randomized strategy be coordinated between the DFC and the LDs, maintaining synchronization between the selection scheme of local decision rules and global fusion rules. Circumstances that require such coordinated randomized selection are labeled “dependent randomization.” We present systems that use dependent randomization, and also discuss their response when synchronization is occasionally lost.
Opioid analgesic drugs in the elderly

Much is known about opioid metabolism, which is critical in administering these agents to the elderly. Fear of addiction and tolerance are the major barriers to their use among patients as well as health-care professionals. Addressing these issues early in the initiation opioid therapy will help to alleviate these concerns. Once therapy with an opioid is initiated, the role of renal function is critical. Because many metabolites of the opioids are renally cleared and have activity either in analgesia or as undesired side effects, it is critical to be aware of the creatinine clearance (not just serum creatinine) in the elderly. The initiating doses of the opioids can be equal to that of younger patients, but the clinician should anticipate using a longer frequency of dosing interval or smaller doses during the course of therapy. Methadone, propoxyphene, and meperidine are not recommended for use in elderly people, because of the toxicity of their metabolites. Of all the unwanted effects of the opioids, the most difficult to deal with is that of constipation. Here, an aggressive approach using bowel stimulating laxatives is critical in order to prevent this problem. It is anticipated that a variety of newly formulated opioids will shortly be available for clinical use. Finally, as a better understanding of the neurophysiology of pain is gained, the clinician can anticipate having more analgesic opioids that target their receptors without agonist or antagonist effect on other opioid receptors. This will allow the clinician to better relieve pain with a minimum of unwanted side effects.
Examining Bacterial Population Diversity within the Octopus Spring Microbial Mat Community

The importance of preserving biodiversity has gained considerable attention as the possibility of destroying our remaining natural ecosystems has been realized (Schulze and Mooney, 1993). Consequently questions about how the loss of vast, species-rich habitats such as rain forests might influence global scale processes are receiving serious consideration. A more pragmatic view holds that a reduction in species diversity might result in the loss of valuable commodities, such as natural compounds with medicinal properties. Certainly bacteria influence processes on a global scale and produce many of humanity’s most beneficial and commercially valuable products, yet sequence-based population surveys have proven that only a small minority of bacteria have been studied. Some recent findings underscore this point. In 1993, it was discovered that macroscopic symbionts of surgeonfish are actually bacterial cells (Ahern, 1993; Angert et al., 1993), designated Epulopiscium fishelsoni. This bacterium is the largest prokaryote known, and its existence has forced a reevaluation of the limit of prokaryotic cell size. In the same year, new bacteria that perform a novel type of photosynthesis, phototropic iron oxidation, were discovered (Widdel et al., 1993; Ehrenreich and Widdel, 1994), presenting a possible new explanation for the origin of banded iron formations. In 1994, an entirely new branch of Archaea was discovered. Termed the Korarchaeota, these bacteria represent the most deeply divergent archaeal group known (Barns et al., 1994,1996). With such striking diversity now revealed, it seems certain that new insights into nutrient cycling and bacterial metabolites remain to be discovered.
English Language Learners: Experiences of Teachers of Students with Visual Impairments who Work with this Population:

IntroductionThis article presents a study that gathered data from 66 teachers of students with visual impairments about their preparation to work with children who are visually impaired and are lea...
The Limits of the Limits of the Law: How Useable Are DMCA Anticircumvention Exceptions?

The U.S. Digital Millennium Copyright Act (DMCA) criminalizes decryption of “copy protected” digital content, even if the decryption itself serves lawful purposes that do not infringe on copyright. However, temporary exemptions to this prohibition are granted triennially if communities of practice can demonstrate that the encryption ban adversely affects noninfringing uses. This study explores to what degree members of communities with existing exemptions for audiovisual work (1) are aware of the DMCA ban on encryption and (2) are aware of the relevant exemptions, and (3) whether they believe they can use the exemptions with confidence. We find that existing knowledge of DMCA exemptions is low, but that creators may employ the exemption reliably if given the exemption language. This empirical evidence demonstrates creative and productivity costs of narrow exemptions, as well as the importance of education. Results are relevant to discussions about international treaty intellectual property discussions, about the function of exemptions in intellectual property law, and about the consequences of criminalizing decryption.
Survivor clinic attendance among pediatric- and adolescent-aged survivors of childhood cancer.

Childhood cancer survivors need regular, risk-adapted, long-term survivor care. This retrospective study describes the proportion of survivors seen for an initial survivor clinic visit within a large pediatric oncology program. Patients diagnosed with non-central nervous system childhood malignancies from 2007 to 2012 were followed from the time of survivor clinic eligibility (2 years following completion of therapy) through their initial survivor clinic visit or end of study. Demographic, cancer-related, and logistical factors related to clinic attendance were examined using Kaplan-Meier curves and Cox proportional regressions. Eligible survivors were 53.0% male, 51.5% non-Hispanic white, and 30.9% survivors of leukemia. Among the 866 eligible survivors for this study, 610 (70.4%) completed their initial visit. After controlling for sex and time eligible, survivors who received surgery only (aHR 0.04 (0.02, 0.08)) or radiation only (0.24 (0.15, 0.39)) and who had Medicaid (0.77 (0.64, 0.92)) were significantly less likely to have an initial visit as were those of black or other/mixed race and those who lived > 25 mi from the clinic (p < 0.01). Survivors aged 6–11 years or 12–17 years at eligibility were significantly more likely to complete an initial visit as compared to those aged 2–5 years (1.55 (1.24, 1.93) and 1.44 (1.14, 1.83), respectively). Nearly a third of survivors were not seen in a pediatric survivor clinic despite the importance of survivor care. These results identify populations at risk for not pursuing long-term survivorship care. Failure to transition to pediatric survivor care may lead to lifelong non-engagement and incorrect perceptions about future health.
High-pressure and high-temperature gas cell for absorption spectroscopy studies at wavelengths up to 8 µm

Abstract An optically accessible gas cell has been designed, manufactured, and tested for the purpose of enabling spectroscopic measurements in the mid-wave infrared at both high pressures and high temperatures. The water-cooled inconel cell has been tested to sustain pressures over 200 atm or operating temperatures above 1200 K. Interchangeable sapphire or calcium-fluoride rods, transmissive up to 8 µm in wavelength, are used to span the thermal gradients at the edge of the heating zone, providing for a low-temperature seal on one end and access to a thermally uniform test section on the other. In this paper, we detail the cell design and validation testing, while highlighting cell capabilities with laser absorption measurements of gas spectra in the 2–8 µm domain at high-pressure ( > 100 atm) and high-temperature ( > 1200 K) conditions. The maximum cell pressure and temperature reached simultaneously was 102 atm and 1030 K. Non-ideal spectroscopic phenomena (e.g. line mixing) are revealed at the extreme conditions investigated.
Effect of secretin on acid and pepsin secretion in cat and dog.

Secretin in doses which produced a maximal inhibition of gastric secretion in the dog and maximal stimulation of pancreatic secretion in the cat had no effect on gastrin-stimulated gastric secretion in the cat. Irrigation of the duodenum with acid produced a much smaller inhibition of gastrin-stimulated gastric secretion in the cat than in the dog, thus suggesting that endogenous secretin is not so important for the control of acid secretion in the cat as in the dog. We conclude that the disparity between the action of secretin on gastric secretion in the cat and dog represents a true species difference. Identical doses (on a body weight basis) of secretin, however, produced strong stimulation of pepsin secretion in both the cat and dog. Stimulation was produced by continuous intravenous infusions of secretin in doses submaximal for pancreatic secretion. In addition the effect of natural secretin was reproduced exactly by the synthetic hormone, indicating that the stimulation of pepsin secretion is a property of the secretin molecule. Endogenous secretin, released by either exogenous acid in the duodenum or by closing the gastric fistula, reproduced the effect of the exogenous secretin or pepsin secretion. We conclude, therefore, that the stimulation of pepsin secretion is a physiological action of secretin.
Case series of 331 cases of sugammadex compared to neostigmine in patients under 2 years of age.

BACKGROUND Sugammadex is a novel neuromuscular blockade reversal agent approved by the Food and Drug Administration in 2015, but little literature exists for patients less than 2 years of age. AIMS The aims of this study were to: describe a cohort of patients 2 years old and younger who received sugammadex; describe any adverse effects of sugammadex in this age group; compare time from end of surgery to out of operating room for sugammadex versus neostigmine; compare time between last dose of neuromuscular blocking drug and reversal; and use train-of-four data to assess reversal. METHODS Chart review of the medical record and the anesthesia information system captured all patients in this age cohort who received sugammadex or neostigmine over a two-year period. Adverse medication events were pulled from a mandatory quality improvement field in the electronic anesthesia record. T-tests were used for analyses. RESULTS No adverse effects were reported with 331 doses of sugammadex. The average time in minutes between end of surgery and out of operating room was similar for neostigmine (19.6) versus sugammadex (19.4) (mean difference 0.2, 95% CI -1.5-1.8, P = 0.85). The average time in minutes between last dose of neuromuscular blocking drug and reversal agent was longer for neostigmine (103) than for sugammadex (84) (mean difference 19, 95% CI 13-26, P < 0.001). CONCLUSIONS Sugammadex administration in this young population did not result in any adverse effects. It appears to be equally effective as neostigmine in patients under 2 years of age.
A new species of Astropecten (Echinodermata: Asteroidea: Paxillosida: Astropectinidae) and a comparison of the Astropecten species from the Gulf of Mexico and the East Florida Shelf.

A new species of Astropecten is described, supported by morphological and molecular evidence, from the Gulf of Mexico and the East Florida Shelf with most specimens from 30–60 m in depth. The new species, A. mcedwardi n. sp ., is small, with a maximum major radius < 30 mm. Specimens of A. mcedwardi n. sp . have been found in five museums as an undescribed species or misidentified under several names. The spination of the oral surface most closely resembles that of Astropecten antillensis Lutken, 1859 from the Caribbean, but the body form is similar to that of Astropecten duplicatus Gray, 1840, which is found in the same geographic range. Examination of specimens from different collections indicates that the new species may overlap in distribution with A. antillensis along the East Florida Shelf. Sequencing and phylogenetic analysis of two mitochondrial genes reveal that A. mcedwardi is closely related to A. antillensis but that its phylogenetic lineage is distinct from that of A. antillensis .
A Robotic Prototype System for Child Monitoring

Abstract Child monitoring systems can use different technologies, such as camera systems, wireless technology using RFID sensors, and GPS based systems. These systems are capable of remotely reporting the status of the children but not able to take actions based on the interpretation of the scenarios. A robotic child monitoring system has the advantage that it can take actions to warn and possibly protect the child from danger. In this paper we present the design and experimental testing of a robotic child monitoring prototype system. The whole system consists of a Khepera robot, a host computer, the distraction/alarm circuitry and a testing table. The experimental testing results show that this prototype system fulfills the requirement of finding and following the baby prop and also taking certain actions when the baby prop approaches a danger area. Keywords: Autonomous Robots, Household Robots, Child Monitoring. 1. INTRODUCTION Different technologies have been used to implement child monitoring systems to release parents from continuous observation of their children. These techniques include camera systems, wireless technology using RFID sensors, and GPS systems. Cooper
The Role of Pelvic Lymphadenectomy at the Time of Radical Cystectomy for Bladder Cancer

Pelvic lymphadenectomy at the time of radical cystectomy is a standard therapeutic adjunct which has been shown to improve both staging and survival for patients with muscle-invasive bladder cancer. However, there exists great controversy in determining the optimal extent of lymphadenectomy as well as in defining appropriate quality metrics for assessing the completeness of lymph node dissection. In this chapter, the anatomy of pelvic lymphadenectomy templates is defined, the available evidence in support of extended lymphadenectomy is summarized and appraised, and the role of lymphadenectomy in patients with clinical node-positive disease is visited. We also critically evaluate the utilization of lymph node counts as a surrogate for lymphadenectomy completeness and address possible alternatives. Due to the intrinsic limitations of observational studies, it is not yet certain what the optimal extent of lymphadenectomy is and ongoing clinical trials to address these questions are therefore reviewed.
Traffic Sign Detection and Recognition for Autonomous Driving in Virtual Simulation Environment.

This study developed a traffic sign detection and recognition algorithm based on the RetinaNet. Two main aspects were revised to improve the detection of traffic signs: image cropping to address the issue of large image and small traffic signs; and using more anchors with various scales to detect traffic signs with different sizes and shapes. The proposed algorithm was trained and tested in a series of autonomous driving front-view images in a virtual simulation environment. Results show that the algorithm performed extremely well under good illumination and weather conditions. Its drawbacks are that it sometimes failed to detect object under bad weather conditions like snow and failed to distinguish speed limits signs with different limit values.
Novel Titanium Cages for Minimally Invasive Lateral Lumbar Interbody Fusion: First Assessment of Subsidence

Introduction Implant subsidence is a potential complication of spinal interbody fusion and may negatively affect patients subjected to procedures relying on indirect decompression such as minimally invasive transpsoas lateral lumbar interbody fusion (LLIF). The porous architecture of a recently developed titanium intervertebral cage maximizes bone-to-implant contact and minimizes stress shielding in laboratory experiments; however, its subsidence rate in patients has not yet been evaluated. The goal of this current study was to evaluate implant subsidence in patients subjected to LLIF. Methods Our institutional review board-approved single-center experience included 29 patients who underwent 30 minimally invasive LLIF from July 2017 to September 2018 utilizing the novel 3D-printed porous titanium implants. Radiographs, obtained during routine postoperative follow-up visits, were reviewed for signs of implant subsidence, defined as any appreciable compromise of the vertebral endplates. Results Radiographic subsidence occurred in 2 cases (6.7%), involving 2 out of 59 porous titanium interbody cages (3.4%). Both cases of subsidence occurred in four-level stand-alone constructs. The patients remained asymptomatic and did not require surgical revision. Ten surgeries were stand-alone constructs, and 20 surgeries included supplemental posterior fixation. Conclusions In our patient cohort, subsidence of the porous titanium intervertebral cage occurred in 6.7% of all cases and in 3.4% of all lumbar levels. This subsidence rate is lower compared to previously reported subsidence rates in patients subjected to LLIF using polyetheretherketone implants.
National trends in the diagnosis and repair of SLAP lesions in the United States.

Background:Since superior labrum anterior-to-posterior (SLAP) tear was introduced as an International Classification of Diseases-Ninth Revision, Clinical Modification diagnosis in 1994, awareness, ...
Simultaneous Left Ventricular Volume and Strain Changes During Chemotherapy Associate With 2‐Year Postchemotherapy Measures of Left Ventricular Ejection Fraction

Background Although changes in left ventricular end‐systolic volume (LVESV), left ventricular end‐diastolic volume, and global circumferential strain occur during cancer treatment, the relationship...
Predicting Postsecondary Pathways: The Effect of Social Background and Academic Factors on Routes through School:

Access to institutions of higher education has increased in recent decades; however, increased access has not led to parallel increases in degree completion among all types of students. In this art...
Characterization of the response to abiotic stresses of high ascorbate Arabidopsis lines using phenomic approaches

L-Ascorbic acid (AsA, vitamin C) is a key antioxidant and enzyme cofactor in plants. Ascorbate controls cell division, affects cell expansion, and plays an important role in modulating plant senescence. It protects plants against reactive oxygen species that are produced in response to abiotic and biotic stresses. Manual phenotyping indicated that Arabidopsis lines over-expressing enzymes in the myo-inositol pathway have elevated AsA, accumulate more biomass of both aerial and root tissues and are tolerant to abiotic stresses including salt, cold, heat, and environmental pollutants. However, manual phenotyping is time consuming, low throughput, subjective, and limited to the resolution of the human eye. In contrast, high throughput phenotyping technologies are accurate, non-destructive, and more sensitive, allowing the detection of subtle phenotypes. Therefore, we used a phenomics platform to phenotype our high AsA Arabidopsis lines with visible, fluorescence, and near infrared cameras. Based on this approach, high AsA lines grew faster, accumulated more biomass, and displayed healthier chlorophyll fluorescence and water content profiles than controls. By studying abiotic stress in a high throughout fashion using optimized protocols, we have also shown that these high AsA lines are tolerant to salt and water limitation stresses. In addition, we developed open source algorithms to analyze images and by comparing results obtained with a widely used commercial software against our algorithms, here we show that our method achieved good accuracy for all phenotypic parameters of interest including projected leaf area, rosette diameter (caliper length), compactness, and color classification.
Racial discrimination, racial identity affiliation, and heavy alcohol use among multiracial individuals

BACKGROUND Alcohol use is disproportionately higher among multiracial than monoracial adults; yet, associated risk and protective factors are underexplored. The present study compared levels of experienced racial discrimination, racial identity affiliation, and heavy alcohol use among multiracial and monoracial adults and tested whether racial identity affiliation, experienced racial discrimination, and their interaction were significantly associated with heavy alcohol use among multiracial individuals. METHODS We conducted secondary analyses of data from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Participants are a nationally representative sample of all U.S. adults (N = 29,026; 56.4% female) and were interviewed for the study from 2012 to 2013. The sample includes 598multiracial individuals. RESULTS Linear regression analyses showed that multiracial individuals experienced significantly greater racial discrimination than White (b = -1.26, 95% CI [-1.47, -1.05], p < 0.001) or Asian individuals (b = -0.30, 95% CI [-0.53, -0.06], p = 0.013) but less than Black individuals (b = 0.29, 95% CI [0.08, 0.50], p = 0.007). Furthermore, multiracial individuals reported less affiliation with their racial identity than Black (b = 4.92, 95% CI [4.23, 5.62], p < 0.001) or Asian individuals (b = 3.86, 95% CI [3.09, 4.63], p < 0.001) but did not differ significantly from White individuals. Logistic regression analysis showed that multiracial individuals were significantly more likely to report heavy drinking than Asian individuals (OR = 0.53, 95% CI [0.36, 0.78], p = 0.001) but did not differ significantly from White or Black individuals. Finally, experienced racial discrimination was significantly related to heavy alcohol use in multiracial adults (b = 0.11, 95% CI [0.01, 0.20], p = 0.031), though neither racial identity affiliation nor the interaction of racial identity affiliation with experienced racial discrimination were significantly related to heavy alcohol use. CONCLUSIONS Our results suggest that multiracial individuals, as compared to other minoritized individuals who are monoracial, report high levels of experienced racial discrimination and heavy alcohol use and low levels of racial identity affiliation. Further understanding of the effects of racial identity affiliation and experienced racial discrimination on the risk for heavy alcohol use could help in the development of interventions aimed at reducing alcohol use disparities among multiracial individuals.
Improving emergency department blood product use through nursing education.

BACKGROUND Rapid access to blood products can be lifesaving for hemorrhaging patients, but placing blood components in easily accessible locations in the emergency department (ED) can lead to wasteful patterns of use. Education can lead to improvements in transfusion behavior, but such changes for the better are often short lived. METHODS To facilitate the early initiation of balanced resuscitation, an emergency blood refrigerator was placed in our ED in February 2015. Physician education to give blood components in a 1:1 plasma:red blood cell (RBC) unit ratio with the plasma given first was given repeatedly with short-term success. Finally, nurses were trained and empowered to strongly suggest that blood components be given in balanced ratios and that plasma be given first. Plasma:RBC unit ratios were compared in successive years with the chi-square test for trend. RESULTS A total of 1165 RBC units and 623 plasma units were issued from the ED emergency blood refrigerator over 5 years. Intensive physician education is documented at start, in late 2016 to early 2017, and again in early and late 2018. Ratios of components (U plasma/U RBCs) were 2015, 17%; 2016, 26%; 2017, 61%; 2018, 49%; and 2019, 91% (p < 10-18 chi-square for trend). Higher ratios of plasma use were associated with $40,000+ annual savings. CONCLUSIONS Giving the ED senior nurses formal education about the need for and a policy to give guidance on massive transfusion protocol (MTP) blood component administration sequence has achieved compliance with our MTP's intention. Increasing plasma use reduces group O RBC use and total blood costs.
The Changing Health Insurance Coverage Landscape in the United States.

Changes in the health insurance coverage landscape in the United States during the past decade have important implications for receipt and affordability of cancer care. In this paper, we summarize ...
Time Between an Emergency Department Visit and Initiation of Physical Therapist Intervention: Health Care Utilization and Costs

Objective The aim of this study was to examine the association between the length of time between an emergency department (ED) visit and the subsequent initiation of physical therapist intervention for low back pain (LBP) on 1-year LBP-related health care utilization (ie, surgery, advanced imaging, injections, long-term opioid use, ED visits) and costs. Methods This retrospective cohort study focused on individuals who consulted the ED for an initial visit for LBP. Claims from a single statewide, all-payers database were used. LBP-related health care use and costs for the 12 months after the ED visit were extracted. Poisson and general linear models weighted with inverse probability treatment weights were used to compare the outcomes of patients who attended physical therapy early or delayed after the ED visit. Results Compared with the delayed physical therapy group (n = 94), the early physical therapy group (n = 171) had a lower risk of receiving lumbar surgery (relative risk [RR] = 0.47, 95% CI = 0.26-0.86) and advanced imaging (RR = 0.72, 95% CI = 0.55-0.95), and they were less likely to have long-term opioid use (RR = 0.45, 95% CI = 0.28-0.76). The early physical therapy group incurred lower costs (mean = $3,806, 95% CI = $1,998-$4,184) than those in the delayed physical therapy group (mean = $8,689, 95% CI = $4,653-$12,727). Conclusion Early physical therapy following an ED visit was associated with a reduced risk of using some types of health care and reduced health care costs in the 12 months following the ED visit. Impact statement The ED is an entry point into the health care system for patients with LBP. Until now, the impact of the length of time between an ED visit and physical therapy for LBP has not been well understood. This study shows that swift initiation of physical therapy following an ED visit for LBP is associated with lower LBP-related health utilization for some important outcomes and lower LBP-related health care costs.
The Right to Self-Defense Against the State

The Second Amendment is accepted as protecting a right, but it is commonly accepted that the right is not unrestricted. I will explore the most commonly suggested restrictions proposed by gun control advocates and show why these restrictions to the Second Amendment are unjustifiably high, especially when compared with restrictions we accept for other Constitutional rights. I argue that these restrictions violate a central function of the Second Amendment—to enable the people to protect themselves against a tyrannical government. The three restrictions I will be discussing are: (1) licensing requirements for gun ownership, (2) gun tracing with a national database of gun owners, and (3) concealed carry restrictions.
How the elderly fare after brain tumor surgery compared to younger patients within a 30-day follow-up: A National surgical Quality Improvement Program analysis of 30,183 cases.

Abstract The growing elderly population in Western societies has led to an increasing number of primary brain tumors occurring in patients beyond the age of 65. The purpose of this study was to assess and compare the safety, efficacy, and outcomes of oncological craniotomy procedures between patients above and below 65 years. We performed a retrospective analysis of the ACS-NSQIP database to identify patients undergoing supratentorial and infratentorial tumor excisions by neurosurgeons between 2008 and 2016. We stratified them based on a cutoff age of 65 years and analyzed for minor and major complications, reoperation, the total length of hospital stay, and mortality within a standardized 30-day follow-up. Among the 30,183 analyzed patients, 9,652 (32%) were elderly (age ≥ 65). The bivariate analysis demonstrated significantly increased risk of complications, including major and minor complications and mortality in patients with metabolic syndrome, preoperative steroid use, and ASA classification ≥3. (p-value ≤ 0.001***). After controlling for confounding variables in our logistic regression models, older age, metabolic syndrome, extended operative time beyond 5 h, dependent functional health status, ASA class ≥3, steroid use pre-operatively, and black/African American race were found to be significant predictors of major and minor complication. Our study provides a comprehensive analysis of perioperative risk factors and predictors of adverse outcomes following craniotomy for supratentorial and infratentorial tumors in elderly patients. We identified increased age as an independent risk factor for minor and major adverse events as well as extended hospitalization.
The Diameter and Automorphism Group of Gelfand–Tsetlin Polytopes

Gelfand–Tsetlin polytopes arise in representation theory and algebraic combinatorics. One can construct the Gelfand–Tsetlin polytope $$\mathrm{GT}_\lambda $$ for any partition $$\lambda = (\lambda _1,\ldots ,\lambda _n)$$ of weakly increasing positive integers. The integral points in a Gelfand–Tsetlin polytope are in bijection with semi-standard Young tableau of shape $$\lambda $$ and parametrize a basis of the $$\mathrm{GL}_n$$ -module with highest weight $$\lambda $$ . The combinatorial geometry of Gelfand–Tsetlin polytopes has been of recent interest. Researchers have created new combinatorial models for the integral points and studied the enumeration of the vertices of these polytopes. In this paper, we determine the exact formulas for the diameter of the 1-skeleton, $$\mathrm{diam}(\mathrm{GT}_\lambda )$$ , and the combinatorial automorphism group, $$\mathrm{Aut}(\mathrm{GT}_\lambda )$$ , of any Gelfand–Tsetlin polytope. We exhibit two vertices that are separated by at least $$\mathrm{diam}(\mathrm{GT}_\lambda )$$ edges and provide an algorithm to construct a path of length at most $$\mathrm{diam}(\mathrm{GT}_\lambda )$$ between any two vertices. To identify the automorphism group, we study $$\mathrm{GT}_\lambda $$ using combinatorial objects called $$ladder diagrams $$ and examine faces of co-dimension 2.
Exploring Interactive Survivorship Care Plans to Support Breast Cancer Survivors: Protocol for a Randomized Controlled Trial.

Background: Breast cancer is the most common form of cancer among American women, accounting for 23% of all cancer survivors nationally. Yet, the availability of adequate resources and tools for supporting breast cancer survivors has not kept up with the rapid advancement in treatment options, resulting in unmet supportive care needs, particularly among low-income and minority populations. This study explores an alternative means of delivering breast cancer survivorship care plans (SCPs), with the aim of improving survivor morbidity, patient knowledge, and self-management of treatment-related symptoms, as well as addressing inconsistencies in follow-up care visits. Objective: The overall goal of this study is to improve the uptake of SCP recommendations via an educational intervention for breast cancer survivors, to improve treatment-related morbidity, patient knowledge, self-management, and adherence to follow-up visits. The specific aims of the study are to (1) evaluate the feasibility of the online SCP, and (2) assess the impact of the online SCP on survivorship outcomes. Methods: We will enroll 50 breast cancer survivors who have completed initial breast cancer treatment into a 2-armed, randomized, waitlist-controlled pilot trial, and collect data at baseline and 6 months. For the first aim, we will use mixed methods, including surveys and personal interviews among the intervention group, to determine the feasibility of providing an online, interactive SCP (called ACESO) based on the survivors’ online user experience and their short-term adoption. For the secondary aim, we will compare the 2 groups to assess the primary outcomes of survivor knowledge, self-efficacy for self-management, perceived peer support, and adherence to SCP-recommended posttreatment follow-up visits to oncology and primary care; and the secondary outcomes of treatment-related morbidity (body weight, fatigue, depression, anxiety, sexual function, distress, and sleep quality). We assess these outcomes by using measurements from validated instruments with robust psychometric properties. Results: We have developed and refined the online breast cancer survivorship plan, ACESO, with consultation from breast cancer oncologists, nurses, and survivors. Approval for the study protocol has been obtained from the Institutional Review Board. An advisory board has also been established to provide oversight and recommendations on the conduct of the study. The study will be completed over a period of 2 years. Conclusions: The results of this pilot study will inform the feasibility and design of a larger-scale pragmatic trial to evaluate the impact of an online breast cancer SCP on treatment-related morbidity and self-efficacy for self-management.
Induction of Peanut Allergy Through Inhalation of Peanut in Mice.

Peanut (PN) allergy is a common life-threatening disease; however, our knowledge on the immunological mechanisms remains limited. Here, we describe the first mouse model of inhalation-driven peanut allergy. We administered PN flour intranasally to naive wild-type mice twice a week for 4 weeks, followed by intraperitoneal challenge with PN extract. Exposure of mice to PN flour sensitized them without addition of adjuvants, and mice developed PN-specific IgE, IgG1, and IgG2a. After challenge, mice displayed lower body temperature and other clinical signs of anaphylaxis. This inhalation model is an ideal system to allow for future examination of immunological mechanisms critical for the development of PN allergy.
Study on effects of DSE-Based instrumentation channel error correction on protective relays

Abstract This paper presents the effects of dynamic state estimation (DSE)-based instrumentation channel error correction on protective relays. It discusses the possible mis-operations of relays caused by current transformer (CT) saturation for three typical protection schemes: distance protection, current differential protection and setting-less protection. For each protection scheme, it compares the relay responses with the estimated measurement samples and with the legacy measurement samples, respectively. Extensive cases have demonstrated that when large errors introduced by CT saturation, the legacy measurement samples can lead to slower operations for distance relay in case of internal faults, and unnecessary trip decisions during external faults for current differential relay and setting-less relay. In contrast, with the estimated measurement samples, the relays can correctly identify internal faults and avoid mis-operation in case of external faults.
Allocations Made in Accordance with Partners' Interests in the Partnership

Tax law allocates partnership tax items in accordance with the partners' interests in the partnership if the allocations do not have substantial economic effect. Tax law also uses the partners' interests in the partnership to test whether certain allocations satisfy the test for substantiality. These rules that rely upon partners' interests in a partnership are at the heart of partnership taxation. Nonetheless, tax law does a poor job of defining partners' interests in a partnership. This article illustrates the problems that arise because of that inadequate definition. It also recommends a few changes that could help remedy the existing shortcomings.
Evaluating implementation of the Transparency and Openness Promotion (TOP) guidelines: the TRUST process for rating journal policies, procedures, and practices.

The Transparency and Openness Promotion (TOP) Guidelines describe modular standards that journals can adopt to promote open science. The TOP Factor is a metric to describe the extent to which journals have adopted the TOP Guidelines in their policies. Systematic methods and rating instruments are needed to calculate the TOP Factor. Moreover, implementation of these open science policies depends on journal procedures and practices, for which TOP provides no standards or rating instruments. We describe a process for assessing journal policies, procedures, and practices according to the TOP Guidelines. We developed this process as part of the Transparency of Research Underpinning Social Intervention Tiers (TRUST) Initiative to advance open science in the social intervention research ecosystem. We also provide new instruments for rating journal instructions to authors (policies), manuscript submission systems (procedures), and published articles (practices) according to standards in the TOP Guidelines. In addition, we describe how to determine the TOP Factor score for a journal, calculate reliability of journal ratings, and assess coherence among a journal’s policies, procedures, and practices. As a demonstration of this process, we describe a protocol for studying approximately 345 influential journals that have published research used to inform evidence-based policy. The TRUST Process includes systematic methods and rating instruments for assessing and facilitating implementation of the TOP Guidelines by journals across disciplines. Our study of journals publishing influential social intervention research will provide a comprehensive account of whether these journals have policies, procedures, and practices that are consistent with standards for open science and thereby facilitate the publication of trustworthy findings to inform evidence-based policy. Through this demonstration, we expect to identify ways to refine the TOP Guidelines and the TOP Factor. Refinements could include: improving templates for adoption in journal instructions to authors, manuscript submission systems, and published articles; revising explanatory guidance intended to enhance the use, understanding, and dissemination of the TOP Guidelines; and clarifying the distinctions among different levels of implementation. Research materials are available on the Open Science Framework: https://osf.io/txyr3/ .