cssi/SciSciGPT-SciSciNet huggingface dataset:
Alternating Antipyretics for Fever Reduction in Children: An Unfounded Practice Passed Down to Parents from Pediatricians

A convenience sample of parents/caregivers completed a 10-question survey on their patterns of antipyretic therapy administration to determine if antipyretics were alternated, how often, who advised them to do this, and how they learned to dose the antipyretic. Of the 256 caregivers (93%) who completed the survey, 67% responded that they alternated acetaminophen and/or ibuprofen. The frequency varied: every 2 hours (9%), every 3 hours (16%), every 4 hours (43%), every 6 hours (23%) and other (8%). Of these, 81% stated that their health care provider/pediatrician advised them to alternate acetaminophen and/or ibuprofen; 8% stated that nobody advised them. Only 61% received written instructions on how to dose antipyretics from their health care provider. Most caregivers of young children reported alternating acetaminophen and ibuprofen for fever reduction in their children. There was a wide variability of the dosing interval. Most learned this practice from their pediatrician/health care provider.
Cultural and health implications of fish advisories in a Native American community.

Introduction: Fish advisories are issued in an effort to protect human health from exposure to contaminants, but Native American communities may suffer unintended health, social, and cultural consequences as a result of warnings against eating local fish. This paper focuses on the Mohawk community of Akwesasne, which lies downstream from a Superfund site, and explores how fish advisories have impacted fish consumption and health. Methods: 65 Akwesasne community members were interviewed between March 2008 and April 2009. Interviews were semi-structured, lasted from 30–90 minutes and consisted of open-ended questions about the impacts of environmental contamination on the community. Detailed field notes were also maintained during extensive visits between 2007–2011. Interviews were transcribed, and these transcripts as well as the field notes were analyzed in NVivo 8.0. This research received approval from the Akwesasne Task Force on the Environment Research Advisory Committee, as well as the Brown University Institutional Review Board. Results: Three-quarters of the 50 Akwesasne Mohawks interviewed have ceased or significantly curtailed their local fish consumption due to the issuance of fish advisories or witnessing or hearing about deformities on fish. Many of these respondents have turned to outside sources of fish, from other communities or from grocery stores. This change in fish consumption concerns many residents because cultural and social connections developed around fishing are being lost and because fish has been replaced with high-fat high-carb processed foods, which has led to other health complications. One-quarter of the 50 interviewees still eat local fish, but these are generally middle-aged or older residents; fish consumption no longer occurs in the multi-generational social context it once did. Conclusions: Human health in Native American communities such as Akwesasne is intimately tied to the health of the environment. Fish advisories should not be used as an institutional control to protect humans from exposure to contaminants; if Akwesasne are to achieve optimal health, the contaminated environment has to be remediated to a level that supports clean, edible fish.
“Conquerors of The Künlün”? The Schlagintweit Mission to High Asia, 1854–57:

Recit biographique sur la famille Schlagintweit et en particulier la mission religieuse, politique et scientifique entreprise de 1854 a 1857 en Inde et en Asie.
Embryological and Genetic Manipulation of Chick Development

The ability to combine embryological manipulations with gene function analysis in an amniote embryo makes the chick a valuable system for the vertebrate developmental biologist. This chapter describes methods for those unfamiliar with the chick system wishing to initiate experiments in their lab. After outlining methods to prepare chick embryos, protocols are provided for introducing beads or cells expressing secreted factors, and for culturing tissue explants as a means of assessing development in vitro. Approaches to achieve gain of function and loss of function (morpholino oligonucleotides) in chick are outlined, and methods for introducing these reagents by electroporation are detailed.
Electoral Fraud or Fraudulent Rhetoric: An Analysis of Jurisprudential and Political Arguments Over Voter Photo Identification Laws

This paper argues that there are consistent rhetorical frameworks employed by politicians and judges who take opposite stances on the question of whether procedural laws relating to voting should be made or be permitted to be made more stringent, versus those who want the procedural requirements left alone or made simpler. Advocates of more stringent laws emphasize the rhetoric of individual choice and capacity, while their opponents often focus on the issue of interest group balancing and differential impact of procedural voting laws on particular groups within society. These frameworks are used to illuminate the debate over controversial voter photo identification laws in both the political sphere and the legal sphere. In the latter case, the central focus is on the Supreme Court’s recent opinion in Crawford v. Marion County which upheld Indiana’s photo identification law, and whether the identified rhetorical dichotomy suggests possible room for future as-applied challenges to such laws. In addition to presenting and elaborating on the rhetorical dichotomy and its impact on the voter identification debate, this paper draws connections between that dichotomy and other voting laws, as well as the census sampling debate and Voting Rights Act litigation. It also questions whether the participants in these debates have argued in good faith.
Substance Use and Addictions

Computerized treatments offer increasingly available, standardized, and empirically supported treatments for mental health disorders. In the particular case of substance-use disorders, computerized treatments can provide anonymity and may lower the threshold for treatment seeking as internet-based, in-home treatments become more accessible. In this chapter, we begin by reviewing relevant domains of computerized substance-use treatments, including brief and extended interventions and varying treatment modalities such as cognitive behavioral therapy, motivational enhancement therapy, contingency management, and the community reinforcement approach. Finally, from the framework of the pioneering computer scientist, Alan Turing, we propose and adapt the Turing test as an evaluative criterion of computerized treatments. Using this adapted evaluative test, termed the Addiction Technology Treatment Test, we assess computerized treatments compared with current standards of care for substance-use disorders to identify strengths and areas for improvement within the field of computerized treatments.
Effect of Four Soybean Cropping Systems on the Abundance of Foliage-Inhabiting Insect Predators

Foliage-inhabiting predators were collected in sweep nets in four soybean cropping systems(full season, conventionally plowed; full season, drill planted; no till, double cropped soybeans after barley; and no till, double cropped soybeans after wheat) in Westmoreland County, Virginia, during 1981 and 1982. In both years, Orius insidiosus (Say) was the most abundant insect predator, followed by Nabis roseipennis Reuter. Geocoris spp. were fourth most abundant in 1981 and third in 1982. Coccinellids were third most abundant in 1981 and fourth in 1982. Total predator counts on the foliage were highest in August and early September, at the time of soybean podfill. While O. insidiosus, N. roseipennis , and Geocoris spp. were more abundant in drill-planted fields, coccinellids were most numerous in double-cropped barley-bean and drill-planted fields. Analyses of variance on each sampling date revealed that the total predators were most numerous in barley-bean and drill-planted fields until late August to early September, when predators were more abundant in all three narrow row systems than in conventionally planted fields. At least three factors—planting date, row spacing, and presence of previous crop stubble—may contribute to the enhancement of the natural enemy complex in narrow-row and no-till cropping systems.
One-sided sequential stopping boundaries for clinical trials: a decision-theoretic approach.

SUMMARY We address one-sided stopping rules for clinical trials, or more generally, drug development programs, from a decision-theoretic point of view. If efflcacy results are sufflciently negative then the trial will be stopped. But regardless of how positive the efflcacy results are, the trial will continue in order to demonstrate safety. We show how sequential decisions should be made by a pharmaceutical company attempting to maximize its expected profits. When should a drug development program be stopped for evidence that suggests that the drug has insufficient efficacy? When should a drug program be stopped for adverse experiences? These questions are of paramount concern to pharmaceutical companies. They can be addressed using the rather formal cost-benefit analysis provided by statistical decision theory. We focus on the first question here. While we do not address the second question explicitly, adverse events should be taken into account in assessing the loss structure of the problem we do consider. We show how to decide when to stop the development of an experimental drug as a function of accumulating information on the drug's performance. But to relate our approach to the more classical methods of interim analysis (Armitage, McPherson, and Rowe, 1969; Pocock, 1977; Lan and DeMets, 1983), we address the apparently smaller question of when efficacy results from a clinical trial are sufficiently negative that the trial should be stopped. The trial will not be stopped for positive results. This is consistent with the need for safety information regarding an experimental drug; the trial will continue as planned to obtain this information even if interim efficacy results are very favorable. There is no issue related to adjusting P-values for early stopping, for example, because the trial results would not then be used to convince anyone of the drug's efficacy: by stopping the trial the company effectively gives up on the possibility of obtaining marketing approval for the drug. We will take a Bayesian decision-theoretic approach (Raiffa and Schlaifer, 1961; DeGroot, 1970) in which consequences of the various decisions are considered explicitly in terms of the company's assessment of the various consequences. There are many types of consequences that are related to the objectives of the clinical trial. Some of these can be easily assessed and compared with each other, and some cannot. We consider only those consequences that are financial or can be easily converted to a financial scale.
Civic Stratification and the Exclusion of Undocumented Immigrants from Cross-border Health Care:

This paper proposes a theoretical framework and an empirical example of the relationship between the civic stratification of immigrants in the United States, and their access to healthcare. We use the 2007 Pew Hispanic Center/Robert Wood Johnson Foundation Hispanic Healthcare Survey, a nationally representative survey of U.S. Latinos (N = 2,783 foreign-born respondents) and find that immigrants who are not citizens or legal permanent residents are significantly more likely to be excluded from care in both the United States and across borders. Legal-status differences in cross-border care utilization persisted after controlling for health status, insurance coverage, and other potential demographic and socioeconomic predictors of care. Exclusion from care on both sides of the border was associated with reduced rates of receiving timely preventive services. Civic stratification, and political determinants broadly speaking, should be considered alongside social determinants of population health and health care.
Value of neutrophil CD64 in strengthening the rational use of antimicrobial agents

Due to lacking of specific clinical manifestations of early bacterial infection,the use of many antibacterial drugs without indications led to the emergence of drug-resistant strains. Bacterial culture is the gold standard for diagnosis of bacterial infection,but the detection is time-consuming and has many interference factors,so it cannot be used for early diagnosis. WBC( white blood cell),ESR( erythrocyte sedimentation rate) and CRP( C-reactive protein) are nonspecific index. Several studies have found that neutrophil CD64 is a reliable index for diagnosis of bacterial infection. This review summarized some literature about neutrophil CD64 in the diagnosis of bacterial infections in recent years. The result showed that CD64 has some clinical value to distinguish between types of bacterial infection and can be used as a new index of use and withdrawal of antimicrobial drug,in order to strengthen the rational use of antimicrobial drugs.
Effects of calcium and magnesium ions upon fat absorption by sacs of everted hamster intestine.

ABSTRACT Sacs of everted hamster jejunum were incubated with fatty acid and monoglyceride in bile salt solutions either with or without added salts of calcium and magnesium. At very low concentrations of Ca2 + and Mg2 +, the intestine produced very few chylomicrons. However, at physiological concentrations of the ions, the gut-preparation released numerous chylomicron-like particles into the serosal fluid.
Control of cell motility during tissue invasion

Invasion of the surrounding tissue by tumor cells is a complex process and involves tissue destruction and active tumor cell movement. Regulation of cell motility is complex. There are cell type-specific differences (for example, differences between fibroblasts and epithelial cells) and differences between transformed cells and their normal counterparts. Under normal circumstances, fibroblasts exist in the tissue as single cells. Reflecting this, fibroblasts migrate as single cells. Epithelial cells exist as sheets of cells or threedimensional masses. Epithelial cell migration involves groups of cells moving together as well as movement by individual cells. For both fibroblasts and epithelial cells, in vitro motility requires a substratum to which the cells can adhere. Components of the extracellular matrix including fibronectin and laminin provide a suitable substrate. Differences between normal and transformed cells in elaboration of fibronectin/laminin and differences in interaction with these motilityinducing matrix molecules contribute to differences in motility. When fibroblasts interact with fibronectin (or other motility-supporting matrix molecules), binding to cell surface adhesion receptors initiates a cascade of signaling events that results in organization of the cell for movement. In epithelial cells, interaction with the matrix is also critical to cell movement. However, significant movement does not occur unless there is also interaction with soluble motility-stimulating factors (i.e. growth factors, chemokines and complement components). While the process of tumor cell motility has been extensively studied in simple two-dimensional or three-dimensional assay systems, recent studies using intact tissue in organ culture have validated many of the observations resulting from in vitro studies in simple two-dimensional or three-dimensional assay systems.
Reduction in anticoagulation-related adverse drug events using a trigger-based methodology.

Article-at-a-Glance Background An initiative was undertaken by Novant Health System to address warfarin-related adverse drug events (ADEs) using lab-based patient-specific International Normalized Ratio (INR) triggers and pharmacy-based patient-specific Vitamin K triggers. The goal was to reduce ADEs related to the use of warfarin in both the inpatient and outpatient settings. Process improvements and medication management protocols were developed for patients managed with warfarin anticoagulation. Methods During each month's seven-day sampling period, the hospital information system generated the lab and pharmacy triggers, and the clinical pharmacists used these patient-specific triggers to identify the patient charts for review. All triggered charts were reviewed. Preliminary harm classification based on the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index was assigned by the clinical pharmacists and recorded for each patient. Results The system achieved reductions in ADEs related to warfarin administration on an inpatient management (45%) and outpatient management (52%) basis. Discussion Although based on inpatient facility-generated triggers, the initiative also served as a reasonable outpatient model, with improvements seen in the outpatient physician intervention groups.
Chapter 1 – An Overview of Physisorption

There are two principal methods to measure the adsorption isotherm: the volumetric method and the gravimetric method. The volumetric method is the most common measurement because it is simple and relatively inexpensive. The first step in analysis of the isotherm is to determine the classification to which the isotherm belongs. A further recommendation is to determine the classification of the isotherm according to the standard curve representation or the chi plot representation. The chapter presents chi plots that correspond to different types of isotherms. The chapter provides the characteristics and conventional interpretation of different types of hysteresis loops. The chapter discusses the calculation of surface area by determining the amount of material in one monolayer of adsorbate, which can be determined by using the cross-sectional area of the adsorbate molecule. The statistical treatment of isotherms and the determination of porosity by physical adsorption are also discussed. The first step in determining porosity by using physical adsorption is to determine whether the porosity consists of micropores or mesopores. The chapter discusses standard curves, which is the most reasonable method for analyzing micropores.
Myopathy as the initial presentation of Addison's disease

A 16-year-old patient presented with three presyncopal episodes, muscle weakness, elevated creatine kinase and myopathic changes on electromyography, was diagnosed with Addison's disease through laboratory testing. Corticosteroid replacement produced marked improvement in muscle strength and normalized creatine kinase levels. In children, low corticosteroid state should be considered in the differential diagnosis of a myopathy, particularly in the setting of other signs and symptoms of adrenal insufficiency. To our knowledge, this is the first case report of a myopathy as the initial presentation of Addison's disease in this age group.
Concurrent Trajectories of Female Drinking and Smoking Behaviors Throughout Transitions to Pregnancy and Early Parenthood

The purpose of this longitudinal study was to investigate whether there are distinct etiological processes explaining dual usage of alcohol and conventional cigarettes by mothers from preconception through the early parenting years. Data on 8800 biological mothers were drawn from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), representative of US births in 2001. A general growth mixture model (GGMM) was used to empirically identify developmental trajectories of maternal smoking and drinking over the 5–6-year study period. Six classes defined by alcohol consumption and cigarette smoking were identified. These included a nonsmoking, low probability of drinking class (41%), and two drinking classes displaying no smoking with either moderate (26%) or escalating high (8%) probability drinking. Additionally, two predominantly smoking classes were identified, one displaying temporary reduction in smoking during pregnancy and low probability of drinking (11%) and one following a trajectory of persistent heavy smoking with a declining probability of drinking (9%). The sixth class was described by temporary reduction in smoking during pregnancy with high probability of drinking (6%). Covariates differentially predicted class membership, e.g., having a high school degree but not further education predicted concurrent drinking and smoking, and breastfeeding for more than 6 months is protective against concurrent use. Prior to conception, during prenatal care, and in post-natal clinical visits, whether for personal or pediatric care, screening women of reproductive age via characteristics that predict heterogeneity in smoking and drinking trajectories may help guide prevention and treatment options.
Pediatric liver transplantation for fulminant hepatic failure secondary to intentional iron overdose

Acute iron poisoning may lead to life-threatening hepatotoxicity. We present the cases of two pediatric patients with hepatotoxicity following intentional iron ingestion that progressed rapidly to fulminant hepatic failure despite treatment with deferoxamine. Liver transplantation was lifesaving in both patients. These cases emphasize the need for a high index of suspicion for iron ingestion, close monitoring for liver toxicity, and timely consideration for liver transplantation.
Lupus-like cutaneous reaction following pembrolizumab: An immune-related adverse event associated with anti-PD-1 therapy

PD-1 (programmed cell death-1) inhibitors, used to treat metastatic melanoma and other malignancies, are associated with development of immune-related adverse events in the skin. Such reactions include morbilliform eruptions, vitiligo, alopecia areata and bullous pemphigoid. In this report, we describe a patient who developed a lupus-like cutaneous reaction in the setting of pembrolizumab therapy for metastatic melanoma, adding to the spectrum of reactions which may be observed in association with PD-1 inhibitor therapy.
A Framework for Computing Artistic Style Using Artistically Relevant Features

We present two artistically-relevant algorithms to aid in the quantification of artistic style, the Discrete Tonal Measure (DTM) and Discrete Variational Measure (DVM). These quantitative features can provide clues to the artistic elements that enable art scholars to categorize works as belonging to different artistic styles. We also introduce two new datasets for analysis of artistic style: one based on the school of art to which artists belong and one based on the medium used by a specific artist. We show results of initial experiments for classifying paintings on each of these datasets with DTM and DVM using a scientific workflows framework that will allow reuse and extension of many visual stylometry methods, as well as allowing easy reproducibility of analytical results, by publishing datasets and workflows packaged as linked data.
Hybrid EGU-based group event participation prediction in event-based social networks

Abstract The increased popularity of event-based social networks (EBSNs) connects online social communities with offline event activities, and makes it interesting and necessary to understand users’ event participation behaviors on this new type of online social platform, especially when groups are explicitly defined as event organizers and have declared memberships from individual users. Accurate event participation prediction can help guide more effective event participation, event organization, and community development. In this work, using data collected from the popular Meetup.com EBSN spanning three major cities with diverse cultures, we first conduct detailed analysis on group- and user-specified event behaviors. Based on this analysis, we propose a group-based event participation prediction framework that uses personalized random walk with restart on a hybrid EGU (event-group category-user) network to capture intrinsic social relationships, and fuses that with newly designed content and contextual features to predict event participation by group members. Detailed evaluations using the Meetup datasets demonstrate that our prediction frameworks achieves high prediction performance with the proposed features.
The History of Science And The Future of Science Education

In the continuing campaign to enhance science instruction one battle we are winning relates to the inclusion of elements of the nature of science (NOS) in official recommendations designed to guide the development of the science curriculum. Increasingly, standards documents in the U.S. states (which effectively control what is taught within their borders), the U.S. national science education standards (NRC, 1996) (which does not have the force of law but is regularly consulted in planning science instruction by the individual states) and many other nations now include explicit requirements to include the nature of science in plans for science learning. We seem to have responded positively to the 1970 call from Carey and Stauss who stated that, “if the teacher’s understanding and philosophy of science are not congruent with the current interpretations of the nature of science, ... then the instructional outcomes will not be representative of science” (p. 363). There is little doubt that NOS should have a central place in the science curriculum and it is time that teachers blend both NOS and more traditional content to ensure that students come to understand what science is and how it functions.
The effect of diet changes and food loss reduction in reducing the water footprint of an average American

We analyzed the consumptive water reduction of diet shifting along with food waste reductions in the case of the United States. We find that a dietary shift to healthy diet will not always lead to reduced water footprint. Dietary shifts to vegan and vegetarian diets provide larger reduction in the consumptive water footprint. Reducing food loss and waste produced the largest potential water footprint reduction in our analysis of the US food system. Our findings suggest that a combination of measures that include dietary shift, reducing caloric intake, and reducing food waste result in a significant decline in water footprint.
Validation of the Omni: A Novel, Multimodality, and Longitudinal Surgical Skills Assessment.

Objective The breadth of technical skills included in general surgery training continues to expand. The current competency-based training model requires assessment tools to measure acquisition, learning, and mastery of technical skill longitudinally in a reliable and valid manner. This study describes a novel skills assessment tool, the Omni, which evaluates performance in a broad range of skills over time. Design The 5 Omni tasks, consisting of open bowel anastomosis, knot tying, laparoscopic clover pattern cut, robotic needle drive, and endoscopic bubble pop, were developed by general surgery faculty. Component performance metrics assessed speed, accuracy, and quality, which were scaled into an overall score ranging from 0 to 10 for each task. For each task, ANOVAs with Scheffe's post hoc comparisons and Pearson's chi-squared tests compared performance between 6 resident cohorts (clinical years (CY1-5) and research fellows (RF)). Paired samples t-tests evaluated changes in performance across academic years. Cronbach's alpha coefficient determined the internal consistency of the Omni as an overall assessment. Setting The Omni was developed by the Department of Surgery at Duke University. Annual assessment and this research study took place in the Surgical Education and Activities Lab. Participants All active general surgery residents in 2 consecutive academic years spanning 2015 to 2017. Results A total of 62 general surgery residents completed the Omni and 39 (67.2%) of those residents completed the assessment in 2 consecutive years. Based on data from all residents' first assessment, statistically significant differences (p Conclusions The Omni is a novel composite assessment tool for surgical technical skill that utilizes objective measures and scoring algorithms to evaluate performance. In this pilot study, 3 tasks demonstrated discriminative ability of performance by CY, and all 5 tasks demonstrated construct validity by showing longitudinal improvement in performance. Additionally, the Omni has adequate internal consistency for a formative assessment. These results suggest the Omni holds promise for the evaluation of resident technical skill and early identification of outliers requiring intervention.
Currency Betas and Interest Rate Spreads

We document that the relationship between currencies and risk premia has changed dramatically since the financial crisis: the covariance of equity returns and exchange rates sharply increased after the crisis. Since 2008, 21 per cent of the variation in monthly currency appreciations can be explained by the interaction of the currency’s conditional equity beta with the contemporaneous return on the US stock market, compared to less than 1 per cent beforehand. We provide evidence that, prior to the crisis, interest rate spreads responded to risk premia changes in a way that decreased the sensitivity of exchange rates to risk premia.
Point-of-Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta-Analysis.

Background Ocular complaints are common presentations to the emergency department (ED). Among these, retinal detachment can cause significant vision loss if not rapidly diagnosed and referred for appropriate treatment. Point-of-care ultrasound has been suggested to identify the diagnosis rapidly when the ocular examination is limited or the ophthalmology service is not readily available. However, prior studies were limited by small sample sizes, resulting in wide ranges of potential accuracy. The primary outcome for this review was to determine the test characteristics of point-of-care ocular ultrasound for the diagnosis of retinal detachment. Methods PubMed, CINAHL, Scopus, LILACS, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all prospective and randomized controlled trials assessing the accuracy of point-of-care ultrasound for identifying retinal detachment. Data were dual extracted into a predefined worksheet and quality analysis was performed using the QUADAS-2 tool. Data were summarized and a meta-analysis was performed with planned subgroup analyses by location and provider specialty. This review was registered with PROSPERO CRD42018097288. There was no funding for this review. Results Eleven studies (n = 844 patients) were identified. Overall, ultrasound was 94.2% (95% confidence interval [CI] = 78.4% to 98.6%) sensitive and 96.3% (95% CI = 89.2% to 98.8%) specific for the diagnosis of retinal detachment with a positive likelihood ratio of 25.2 (95% CI = 8.1 to 78.0) and a negative likelihood ratio of 0.06 (95% CI = 0.01 to 0.25). Subgroup analysis found that ultrasound was more accurate among ED patients, but was not significantly different when performed by ED or non-ED providers. Conclusions Point-of-care ocular ultrasound is sensitive and specific for the diagnosis of retinal detachment. Future studies should determine the ideal training protocol and the influence of color Doppler and contrast-enhanced ultrasound on diagnostic accuracy.
The 3-modular character table of the automorphism group of the sporadic simple O’nan group

We compute the 3-modular character table of the group \(\mathrm{O'N}.2\). Much of the table is deduced character theoretically from the known 3-modular character table of the sporadic simple O’Nan group \(\text {O}'\text {N}\). We finish the remaining questions module theoretically with an application of condensation.
Kant on Laws

This book focuses on the unity, diversity, and centrality of the notion of law as it is employed in Kant's theoretical and practical philosophy. Eric Watkins argues that, by thinking through a number of issues in various historical, scientific, and philosophical contexts over several decades, Kant is able to develop a univocal concept of law that can nonetheless be applied to a wide range of particular cases, despite the diverse demands that these contexts give rise to. In addition, Watkins shows how Kant comes to view both the generic conception of law which he develops and its different particular instances as crucial components of his systematic philosophy as a whole. This volume's new and unified account of a major current running through Kant's work will be important for scholars interested in numerous aspects of his philosophy, from the theoretical and abstract to the practical and empirical.
Well Begun is Half Done: Using Online Orientation to Foster Online Students' Academic Self-Efficacy

Past research suggests that the use of an online learning orientation is an effective proactive strategy to ease online students' transition into online learning. Based on a sample of 3888 online students from an urban public university, we used ordinal logistic regression to understand the influence of students' satisfaction with an online learning orientation (OLO), their prior level of online learning experience, and their demographics on their academic self-efficacy (ASE). Consistent with prior research, our findings confirmed the influence of students’ satisfaction with OLO, their prior online learning experience, and their gender on their ASE. In contrast, students’ age and enrollment status proved not to be significant. Overall, our findings provide strong evidence about how the use of an OLO as proactive support strategy can boost online students' academic self-efficacy.
A Single-chain Templated Polymer-based Target Receptor as a New Platform for Label-free Selective Electrochemical Sensing

We report a novel single-chain polymer-based chemical receptor that can be used for the label-free electrochemical detection of an analyte with high selectivity. The polymer was developed using poly-N-isopropylacrylamide (pNIPAM) as a backbone structure in addition to other functional monomers that are used to imprint the template molecule 4-nitrophenol. The polymer also contains a redox reporting monomers (ferrocene) which create a change in the electrochemical signal upon molecular recognition. We hypothesize that the analyte binding to the receptor causes the polymer conformation change from the extended to the collapsed phase. After anchoring the polymer-based receptors onto the surfaces of the gold electrode, when exposed to the analyte, the changes in the electrochemical signals were observed which confirmed the selective target binding as well as the polymer conformation change as a result.
Melanoma cell-derived exosomes in plasma of melanoma patients suppress functions of immune effector cells

Melanoma patients’ plasma contains exosomes produced by malignant and normal cells. Plasma exosomes were isolated and separated by immunocapture into two fractions: melanoma cell-derived exosomes (MTEX) and normal cell-derived exosomes (non-MTEX). Immunosuppressive effects of MTEX on primary human immune cells were evaluated. Exosomes were isolated from plasma of 12 melanoma patients and six healthy donors (HDs). Expression levels of 19 immunoregulatory proteins in MTEX, non-MTEX and HDs exosomes were evaluated by on-bead flow cytometry. Functional/phenotypic changes induced in CD8+ T or natural killer (NK) cells by MTEX or non-MTEX were compared. Plasma protein levels were higher in patients than HDs (P < 0.0009). In patients, MTEX accounted for 23–66% of total exosomes. MTEX were enriched in immunosuppressive proteins (P = 0.03). MTEX, but not HDs exosomes, inhibited CD69 expression (P ≤ 0.0008), induced apoptosis (P ≤ 0.0009) and suppressed proliferation (P ≤ 0.002) in CD8+ T cells and downregulated NKG2D expression in NK cells (P = 0.001). Non-MTEX were enriched in immunostimulatory proteins (P = 0.002) and were only weakly immunosuppressive. Elevated MTEX/total exosome ratios and, surprisingly, non-MTEX ability to induce apoptosis of CD8+ T cells emerged as positive correlates of disease stage. MTEX emerge as the major mechanism of tumor-induced immune suppression and as an underestimated barrier to successful melanoma immunotherapy.
Improving the Memory Window/Resistance Variability Trade-Off for 65nm CMOS Integrated HfO 2 Based Nanoscale RRAM Devices

In this work, we have addressed cycle to cycle switching variability by modifying a key step in CMOS integrated RRAM devices fabrication, namely the atomic layer deposition (ALD) process used to deposit the HfO 2 switching layer. Two different HfO 2 ALD processes were utilized, one with an organic-based precursor, the other with a chlorine-based precursor. The trade-off between memory window (MW) and variability in the high resistance state (HRS) for RRAM cells was investigated with respect to compliance currents and reset voltages for multiple devices using both ALD precursors. The RRAM devices fabricated with the Cl-based precursor showed significant improvement in their MW/HRS resistance variability trade-off, compared to devices fabricated with the organic-based precursor over a range of compliance currents (150 μΑ to 450 μΑ) and reset voltages (−1.3V to −1.7V). Additionally, the MW shows stronger correlation with resistance variability as a function of reset voltage, mostly due to the significant change in average HRS values. To gain a statistically significant comparison, all 64 1 Transistor 1 RRAM (1T1R) cells in an 8×8 RRAM array were tested on a center die on wafers processed using both ALD precursors. Based on those 64 tested 1T1R cells, we demonstrated more than 80% switching yield for the Cl precursor HfO 2 based RRAM devices, as compared to 38% for the organic precursor devices. Additionally, 1T1R RRAM arrays fabricated using the Cl-based precursor showed more than 2× improvement in MW versus those fabricated using the organic-based precursor.
Single-Institution Phase 1/2 Prospective Clinical Trial of Single-Fraction, High-Gradient Adjuvant Partial-Breast Irradiation for Hormone Sensitive Stage 0-I Breast Cancer

Purpose We sought to evaluate the feasibility and tolerability of a novel accelerated partial breast irradiation regimen delivered in a single fraction postoperatively. Methods and Materials We enrolled 50 patients with low-risk, hormone-sensitive breast cancer from 2015 to 2018 on a prospective phase 1/2 trial to receive single-fraction, high-gradient partial-breast irradiation (SFHGPBI) 2 to 8 weeks after lumpectomy for node-negative, invasive, or in situ breast cancer. The high gradient was achieved by prescribing 20 Gy to the surgical bed and 5 Gy to the breast tissue within 1 cm of the surgical bed simultaneously in 1 fraction using external beam. Results The median age was 65 (range, 52-84). Ten patients (20%) had small-volume ductal carcinoma in situ while the remainder had stage I disease. At a median follow-up of 25 months, we evaluated toxicity, patient- and physician-reported cosmesis, patient-reported quality of life (QOL), and initial tumor control. There was no Common Terminology Criteria for Adverse Events v4.0 grade 3+ toxicity. Only 34% of patients experienced grade 1 erythema. Good-to-excellent pretreatment cosmesis was present in 100% and 98% per physicians and patients, respectively, and did not change post-SFHGPBI. Quantitative cosmesis by percentage of breast retraction assessment significantly improved over time during the post-SFHGPBI period per mixed repeated measures modeling (P = .0026). QOL per European Organization for Research and Treatment of Cancer QOL Questionnaires C30 and BR-23 did not decline other than temporarily in the systemic therapy effects and hair loss domains, both of which returned to pretreatment values. There was 1 noninvasive in-breast recurrence in a separate untreated quadrant 18 months post-SFHGPBI and 1 isolated axillary recurrence 30 months post-SFHGPBI, both salvaged successfully. There were no distant recurrences or cancer-related deaths observed. Conclusions Accelerated partial-breast irradiation delivered in a single fraction postoperatively using external beam techniques is a novel, feasible, well-tolerated regimen. SFHGPBI does not adversely affect cosmesis or QOL as reported by both physicians and patients. Initial tumor control rates are excellent, with longer follow-up required to confirm efficacy.
Patrons of the Department

Jessie Bancroft Cox, sister of Jane Bancroft Cook, gave money to construct the Cox Building – home of the current Department. The gift was in memory of her late husband, William C. Cox.
Barriers to breast cancer screening among Navajo Nation women.

5377 Background. In the past two decades, the Arab American population has increased over 40% with over a million Arab Americans currently in the US. Michigan has the highest concentration of Arab Americans among states. Individuals of Arab descent comprised 1.2% of the total population in 2000. Yet, it is believed that census underestimates the population of Arab Americans and that the estimated population size is at least three times that calculated by census. Cancer is a major cause of morbidity and mortality within this population yet the distribution of cancer among Arab Americans is poorly defined. To examine the utilization of screening for breast, cervical, and colorectal cancers, data from the Special Cancer Behavioral Risk Factor Survey (SCBRFS) were analyzed. Methods. The SCBRFS uses telephone surveillance with a disproportionate stratified, random-digit dial sampling design. The target population for the SCBRFS consisted of Michigan men and women aged 50 years and older. The SCBRFS over-sampled for African Americans, American Indians, Hispanics, and Arab Americans. A total of 3,649 interviews were completed. The Arab American component of the SCBRFS included 398 interviews. This study was reviewed and approved by Institutional Review Boards. Data were weighted to adjust for number of phone lines in households, unequal sampling rate between listed and non-listed numbers within strata, and the disproportionate sampling. Calculations of prevalence estimates and confidence intervals were performed using SUDAAN, a statistical computing program designed for analyzing multistage sample surveys data Results. In 2002, 65.2% (95% CI: 88.6%-41.8%) of eligible Arab American women age reported that they had appropriate breast cancer screening, 76.9% (95% CI: 93.7%-60.1%) reported that they had a Pap test within the past 3 years, and 34.0% (95% CI: 51.7%-16.3%) of Arab American men and women reported that they had a lower gastrointestinal (GI) endoscope within the past 10 years. In comparison, 64.1% (95% CI: 69.2%-59.0%) of eligible women within the General Population reported that they had breast cancer screening, 86.5% (95% CI: 89.5%-83.5%) had received a Pap test within the past 3 years, and 45.5% (95% CI: 49.5%-41.5%) of men and women age 50 years and older within the General Population had a lower GI endoscope within the past 10 years. Conclusion. There is disparity in age appropriate cancer screening for cancers such as cervical and colorectal cancers in this underserved hard-to- reach community. Culturally competent tailored interventions and outreach efforts are needed to increase utilization of life saving early detection and ultimately reduce cancer morbidity in Arab-American populations.
Are Older Nontraditional Workers Able to Find Health and Retirement Coverage

In contrast to traditional employment, where employers provide health and retirement benefits, workers in nontraditional jobs have to seek out other options for health insurance coverage and retirement saving. How successful are they at finding alternatives? This study uses the Health and Retirement Study to examine older workers ages 50-64, who are both the largest cohort of workers in nontraditional jobs, and probably the group most in need of consistent health coverage and the ability to save for their imminent retirement. The study finds that about one-third of older workers in nontraditional jobs are uninsured, with the majority finding coverage through a spouse’s employer or a past employer of their own. The Affordable Care Act has also helped these workers find coverage, most often through Medicaid; the study finds that workers in nontraditional employment in states that expanded Medicaid saw greater increases in coverage (especially public coverage) than similar workers in non-expansion states. While policy reform has helped increase health insurance coverage, workers in nontraditional jobs are largely left without convenient, tax-deferred retirement saving options, in part because their spouses in traditional employment do not tend to save more to compensate. These results suggest that policies such as auto-IRA plans may be especially useful to workers in nontraditional employment.
The Development of a Crosswalk for Functional Measures in Postacute Medicare Claims.

Objective Although Medicare assessment files will include Standardized Patient Assessment Data Elements from 2016 forward, lack of uniformity of functional data prior to 2016 impedes longitudinal research. The purpose of this study was to create crosswalks for postacute care assessment measures and the basic mobility and daily activities scales of the Activity Measure for Post-Acute Care (AM-PAC) and to test their accuracy and validity in development and validation datasets. Methods This cross-sectional study is a secondary analysis of AM-PAC, the Inpatient Rehabilitation Facility Patient Assessment Instrument, the Minimum Data Set, and the Outcome and Assessment Information Set data from 300 adults receiving rehabilitation recruited from 6 health care networks in 1 metropolitan area. Rasch analysis was used to co-calibrate items from the 3 measures onto the AM-PAC metric and to create look-up tables to create estimated AM-PAC (eAM-PAC) scores. Mean scores and correlation and agreement between actual and estimated scores were examined in the development dataset. Scores were estimated in a cohort of Medicare beneficiaries with hip, humerus and radius fractures. Correlations between eAM-PAC and Functional Independence Measure motor scores were examined. Differences in mean eAM-PAC scores were evaluated across groups of known differences (age, fracture type, dementia). Results Strong correlations were found between actual and eAM-PAC scores in the development dataset. Moderate to strong correlations were found between the eAM-PAC basic mobility and Functional Independence Measure motor scores in the validation dataset. Differences in basic mobility scores across known groups were statistically significant and appeared to be clinically important. Differences between mean daily activities scores were statistically significant but appeared not to be clinically important. Conclusion Although further testing is warranted, the basic mobility crosswalk appears to provide valid scores for aggregate analysis of Medicare postacute care data. Impact This study reports on a method to take data from different Medicare administrative data sources and estimate scores on 1 scale. This approach was applied separately for data related to basic mobility and to daily activities. This may allow researchers to overcome challenges with using Medicare administrative data from different sources.