cssi/SciSciGPT-SciSciNet huggingface dataset:
Availability of Definitive Hospital Care for Children

Importance Timely and efficient access to hospital care is essential for the health and well-being of children. As insurance networks, accountable care organizations, and alternative payment methods evolve, these new systems of care must continue to serve the needs of children. Objective To test the hypothesis that the availability of definitive pediatric hospital care is significantly more limited than adult care and is decreasing disproportionately. Design This study used case mix data during fiscal years 2004 through 2014 to measure transfer frequency and identify the site of care completion for all patients seen in acute care hospitals throughout Massachusetts. Patterns of care among children were then compared with patterns of care among adults. Participants were all patients seen in an emergency department or admitted to a hospital from 2004 through 2014, including more than 34 million encounters. Main Outcomes and Measures Hospital Capability Index and Regionalization Index for all acute care hospitals and all conditions within the Clinical Classifications Software of the Healthcare Cost and Utilization Project. Results Over the study period, the Commonwealth of Massachusetts hospital system was composed of 66 acute care hospitals. After excluding newborns and mental health conditions, there were 34 511 312 encounters, with 25 226 014 emergency department visits and 9 285 298 observation or full admissions. From 2004 through 2014, care for adults and children concentrated among hospitals but much more so for pediatric care. The number of children requiring care in more than one hospital increased 36.2% (from 7190 to 9793). The median (interquartile range [IQR]) Hospital Capability Index, reflecting the likelihood of a hospital completing a patient’s care without transfer, decreased 10.8% (from 0.74 [IQR, 0.65-0.81] to 0.66 [IQR, 0.53-0.76]) for adult care and 65.0% (0.20 [IQR, 0.05-0.34] to 0.07 [IQR, 0.01-0.23]) for pediatric care. Almost all of the shift was from nonacademic to academic hospitals. The median Regionalization Index, reflecting the degree to which care for specific conditions is regionalized, was very high for pediatric conditions and further increased from 0.79 (IQR, 0.67-0.91) to 0.87 (IQR, 0.80-0.91). Over the same decade, the mean Regionalization Index for adult conditions was low and increased modestly from 0.25 (IQR, 0.14-0.39) to 0.32 (IQR, 0.19-0.46). Among pediatric conditions, more than 75% were highly regionalized in 2014 compared with fewer than 50% in 2004. Conclusions and Relevance Pediatric hospital care has become increasingly concentrated, and many children with common conditions are now less frequently treated in the community. This finding has significant implications for systemwide capacity management and should be specifically accounted for in public health activities, disaster planning, and determinations of network adequacy.
How does strategic risk taking drive corporate social performance

While the risk-economic performance link has been an important topic of strategy research, what is not well known is the influence of strategic risk on corporate social performance (CSP). How does ...
Perioperative Behavioral Therapy and Pelvic Muscle Strengthening Do Not Enhance Quality of Life After Pelvic Surgery: Secondary Report of a Randomized Controlled Trial.

Background There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse. Objective The purpose of this study was to evaluate the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Design This study is a secondary report of a 2 × 2 factorial randomized controlled trial. Setting This study was a multicenter trial. Participants Participants were adult women with stage 2-4 POP and SUI. Intervention Perioperative BPMT versus usual care and sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS) were provided. Measurements Participants undergoing transvaginal surgery (SSLF or ULS for POP and a midurethral sling for SUI) received usual care or five perioperative BPMT visits. The primary outcome was change in body image and in Pelvic Floor Impact Questionnaire (PFIQ) short-form subscale, 36-item Short-Form Health Survey (SF-36), Pelvic Organ Prolapse-Urinary Incontinence Sexual Questionnaire short form (PISQ-12), Patient Global Impression of Improvement (PGII), and Brink scores. Results The 374 participants were randomized to BPMT (n = 186) and usual care (n = 188). Outcomes were available for 137 (74%) of BPMT participants and 146 (78%) of the usual care participants at 24 months. There were no statistically significant differences between groups in PFIQ, SF-36, PGII, PISQ-12, or body image scale measures. Limitations The clinicians providing BPMT had variable expertise. Findings might not apply to vaginal prolapse procedures without slings or abdominal apical prolapse procedures. Conclusions Perioperative BPMT performed as an adjunct to vaginal surgery for POP and SUI provided no additional improvement in QOL or sexual function compared with usual care.
Targeted Therapy in the Treatment of Orbital and Periorbital Malignancies

Virtually any molecule can serve as a target for therapy. The ideal target, however, is present only on abnormal cells, allowing normal cells to be spared from the treatment effect. Rituximab was the first monoclonal antibody approved by the United States Food and Drug Administration for the treatment of cancer. It is a chimeric human/murine monoclonal anti-CD20 immunoglobulin G1 (IgG1) antibody. CD20 is a cell surface protein expressed on most B cells but not on uncommitted hematopoietic precursor cells. Rituximab is approved for the treatment of B-cell lymphoma. Rituximab has also been used successfully in the treatment of other lymphoprolif-erative disorders in the orbit, including lymphoid hyperplasia Ibritumomab is a murine IgG1 anti-CD20 antibody. It can be coupled with tiuxetan, a chelator, and ibritumomab tiuxetan can bind yttrium-90 to form yttrium-90-labeled ibritumomab tiuxetan (hereafter referred to as ibritumomab; Zevalin) [32]. In a trial comparing rituximab to rituximab plus ibritumomab for refractory or relapsed follicular or low-grade non-Hodgkin lymphoma, response rates were 56% for rituximab alone and 80% for the combination. In a prospective trial, 12 patients underwent combined treatment with rituximab and ibritumomab as front-line treatment for stage I-E ocular adn-exal lymphoma. Ten patients had a complete response, and two had a partial response. There was one local recurrence during the follow-up period; there were no distant relapses[14]. Imatinib mesylate (imatinib; Gleevec) is a selective tyrosine kinase inhibitor used in the treatment of chronic myeloid leukemia (CML) and gastrointestinal stromal tumors. Edema is the most commonly seen adverse effect associated with imatinib mesylate, and the periorbital region is the most common site for edema. In a phase I trial of imatinib for the treatment of gastrointestinal stromal tumor, edema of the periorbital region or eyelids was seen in 55.1% of the 174 patients treated. Rarely, the edema can be so severe that surgical treatment is required. Cetuximab is a monoclonal antibody directed against epidermal growth factor receptor (EGFR), a member of the ErbB family of tyrosine kinase receptors. Cetuximab is used in the treatment of colon cancer and head and neck squamous cell carcinoma (SCC). Although SCC in the head and neck can involve the orbit, we found no published reports of cetuximab used in the treatment of periorbital SCC at the time of preparation of this chapter. However, there have been reports of EGFR expression in conjunctival SCC as well as in both ocular and extraocular sebaceous gland carcinomas, suggesting a potential role for EGFR inhibitors in treatment of conjunctival SCC, and sebaceous gland carcinoma of the eyelid. A common ocular side effect of cetuximab and other EGFR inhibitors is trichomegaly
MR imaging of the craniovertebral junction.

SUMMARY There has been a renewed interest in the CVJ with the rapid growth of MR imaging. Many congenital and acquired lesions affect this region and compress the underlying CMJ and cranial nerves. Basilar invagination, basilar impression, and cranial settling are readily assessed with MR imaging in the sagittal plane, and evaluation of this region on all cranial and cervical spine studies should become routine.
Rydberg-atom collisions with SF6 and CCl4 at very high n.

Rate constants for Rydberg-atom destruction through electron transfer in collisions between K(np) Rydberg atoms and ${\mathrm{SF}}_{6}$ and ${\mathrm{CCl}}_{4}$ have been measured for values of principal quantum number n up to n\ensuremath{\sim}400 using an apparatus specifically developed for very-high-n collision studies. Analysis of the data using the free-electron model provides cross sections for electron attachment to ${\mathrm{SF}}_{6}$ and ${\mathrm{CCl}}_{4}$ at electron energies down to \ensuremath{\sim}10 \ensuremath{\mu}eV, which are far below those accessible using any alternate technique. The measured cross sections are inversely proportional to electron velocity and are consistent with the Wigner threshold law for s-wave attachment.
Understanding Public Opinion of Nanotechnology

A common refrain among scientists, policymakers, academics, and even consumer advocacy groups is that the public is simply too uninformed about, disinterested in, or otherwise afraid of groundbreaking emerging sciences like nanotechnology. Scapegoats for these problems abound, with blame placed alternately on a fickle media culture that emphasizes sensation over substance, the decline of science sections in newspapers, the use of nanotechnology as a narrative device in science fiction stories, or else simply the decline and stagnation of scientific literacy in the USA. But to what extent do these explanations hold up to empirical scrutiny? To what extent do they help us gain a better understanding of opinion formation about nanotechnology as opposed to distracting us from other important questions of public opinion? This chapter tackles these questions by evaluating empirical data on public opinion of nanotechnology from the past decade.
Murine Leukemia Viruses with Recombinant env Genes: A Discussion of Their Role in Leukemogenesis

In 1951 Ludwik Gross reported experiments which demonstrated the viral etiology of certain murine leukemias. His work identified the presence of an infectious agent in cell-free extracts of AKR thymomas which could transmit leukemia to C3Hf/Bi mice (Gross 1951). Subsequent electron microscopic analysis demonstrated the presence of virus particles with the characteristic type c morphology of murine leukemia virus in both preparations of AKR thymomas and of leukemias induced in C3Hf/Bi mice by Gross’ protocol (Dmochowski and Grey 1957; Bernhard 1960). In the ensuing 30 years it has become obvious that the murine leukemia viruses (MuLV) are a polymorphic family of infectious agents, heterogeneous in their ability to induce disease in mice and even in their ability to infect and replicate in mouse cells (for review see Stephenson 1980). Host range classes of MuLV have been defined that are ecotropic, i.e., infectious for mouse cells, and xenotropic, i.e., infectious for cells of heterologous species but not for mouse cells. In addition, it has become clear that MuLV are maintained in the murine population predominantly via vertical transmission of endogenous viral loci carried by the mouse genome, rather than by horizontal transmission of infectious virus. These viral loci consist of complete and partial viral genomes, the expression of which can result in production of infectious virus or in synthesis of viral gene products in the absence of virus replication. A great deal of effort has been directed toward characterization of the repertoire of MuLV that exists in the mouse, and toward identification of the factors which influence the complex virus-host interaction which governs their expression in vivo (for review see Lilly and Pincus 1973; Old and Stockert 1977; Jolicoeur 1979). One outcome of these investigations has been the identification by Hartley and co-workers (1977) of the particular class of leukemogenic MuLV which Gross assayed in his early experiments.
Performance of a whole-body human dust inhalation challenge exposure chamber.

Abstract Background Evaluation of the performance of a whole-body human dust exposure chamber is presented in this report. Methods The volume of the chamber is 2.13 m3 and it is operated at a flow rate of 1.0 m3/min. Makeup and exhaust air were filtered. A Wright Dust Feeder was used to generate fly ash, the testing agent. An elutriator was used to maintain particles in the respirable range. A Rupprecht and Patashnick PM-10 TEOM, a direct reading instrument, was used to monitor particle concentration. Particle size distributions were determined by a QCM cascade impactor. The evenness of dust concentrations in the chamber was determined gravimetrically. Results Dust concentrations measured at different points within the chamber were associated with variability less than 10%. Dust concentrations measured by the TEOM, in μg/m3, at 0.2, 0.4, 0.8 and 1.6 RPMs of the Wright Dust Feeder, were 110 ± 2.8, 173 ± 8.5, 398 ± 20 and 550 ± 17, respectively. Particle size distributions (MMD and GSD) were 1.27 μm and 2.35, 1.39 and 2.22, 1.46 and 2.08, 1.15 and 2.2, respectively. Total dust concentrations measured gravimetrically in μg/m3, were 135 ± 21, 200 ± 35, 333 ± 18 and 891 ± 27, respectively. Conclusion The whole-body human exposure chamber offers several advantages and has better performance than most of the inhalation challenge systems previously described.
101) Using Quantitative Sensory Testing to Assess the Pain System in Sexual Assault Survivors

Trauma exposure, especially sexual assault (SA), is highly correlated with pain conditions, in that many chronic pain samples report trauma histories. However, our understanding of the mechanisms behind this relationship is limited. Previous findings from our lab suggest that SA disrupts descending pain modulation. However, to date, no study has used quantitative sensory testing (QST) to comprehensively assess the pain system in SA survivors. 41 healthy, pain-free SA survivors were matched to a group of 41 healthy, pain-free trauma exposed persons without SA (TE). These groups were compared to a group of healthy, pain-free persons with no trauma history (no-TE; N=62). QST included warm, cool, heat, cold, ischemia, and electric thresholds, and heat, cold, ischemia, and electric tolerances. The nociceptive flexion reflex (NFR) threshold was used to assess spinal nociception. Results suggested SA survivors had higher cool thresholds than the TE and no-TE groups. Moreover, SA survivors had lower cold thresholds, cold tolerances, and heat tolerances than no-TE. Surprisingly, SA survivors had higher ischemia tolerances than no-TE and TE groups. The TE group had lower heat and cold tolerances than the no-TE group. None of the other group differences were significant for any pain outcome. These findings suggest that SA is associated with greater sensitivity in A-delta fibers (cool thresholds) and hyperalgesia in response to thermal stimuli (heat, cold). However, hypoalgesia was noted in response to deep tissue pain (ischemia). By contrast, TE is primarily associated with reduced tolerance to heat and cold. These group differences are not likely due to spinal sensitization due to the lack of group differences in NFR. Future studies are needed to replicate these findings and determine whether QST responses can predict negative sequela of SA and non-SA trauma exposure.
On the Hölder and Cauchy–Schwarz Inequalities

A generalization of the Holder inequality is considered. Its relations with a previously obtained improvement of the Cauchy–Schwarz inequality are discussed.
Mung Bean Protein Supplement Improves Muscular Strength in Healthy, Underactive Vegetarian Adults.

Although vegetarian diets are considered generally protective against chronic disease, nutrient deficiencies, including protein, are possible due to low bioavailability from plant-based sources. The consequences of inadequate dietary protein include reduced lean body mass (LBM) and muscle weakness. This study examined relationships between protein intake, strength, and LBM in 37 underactive vegetarians and recorded the impact of protein supplementation (18 g/day mung bean protein) on these indices utilizing an eight-week, randomized, controlled, feeding trial. Both handgrip and knee flexor and extensor strength were measured at baseline and week eight. At baseline, LBM was significantly related to grams of protein consumed daily. LBM was also correlated to grip strength (r = 0.569, p < 0.001) and lower body strength (r = 0.763 to 0.784; p < 0.001). Twenty-five vegetarians completed the feeding trial, including 11 in the protein supplementation group (PRO) and 14 in the control group (CON). At the end of the trial, LBM and strength did not differ significantly between groups. However, the average percent change for grip, flexor, and extensor strength did differ between PRO and CON participants (+2.9 ± 7.2% and −2.6 ± 7.3% respectively, p = 0.05). Thus, there were strong associations between dietary protein, LBM, and strength in vegetarians and an indication that supplementary vegetarian protein increased strength in the absence of exercise and independent of LBM.
A Comprehensive Investigation of Universal Verification Methodology (UVM) Standard for Design Verification

Universal Verification Methodology (UVM) is getting attention of researchers and functional verification community due to its advance flexibility, reusability and reliability features for design verification of multifaceted embedded systems. This is the reason that different tool vendors like Mentor Graphics support UVM-based simulation for design verification. Similarly, researchers frequently explore / utilize UVM to enhance the verification capabilities for embedded systems. In this context, there is a strong need to summarize the latest advancements, tools and techniques for UVM standard. Therefore, this article performs a Systematic Literature Review (SLR) to identify 27 studies (i.e. 2017-2019) pertaining to UVM standard. Subsequently, 21 UVM-based frameworks and 9 tools are identified. Moreover, key benefits of UVM standard are investigated. Finally, a comparative analysis of UVM with OVM (Open Verification Methodology) is performed. It is concluded that UVM provides advanced phasing mechanism, reporting, callbacks, objections, sequence libraries and control over simulation as compared to OVM. Researchers and practitioners of domain can highly benefit from findings of this article.
Validation of an Objective Assessment Tool for Tonsillectomy in Otolaryngology Resident Training

OBJECTIVE Create and validate an objective structured assessment of technical skills (OSATS) for otolaryngology residents learning how to perform a tonsillectomy. STUDY DESIGN Multicenter prospective longitudinal validation study. METHODS A multi-institutional study at six tertiary academic otolaryngology residency programs from July 2009 to May 2012. Using the modified Delphi technique, a panel of pediatric otolaryngologists created a tonsillectomy task-based checklist (TBC) for a tonsil OSATS using a 5-point Likert-type scale. Residents were assessed by pediatric otolaryngology staff at the time of surgery with the TBC and a global rating scale. Procedure time, patient age, number of previously performed tonsillectomies, and surgical technique were also collected. RESULTS One hundred sixty-seven tonsil OSATS were completed for 38 residents, and competency was recorded for 99 (59.2%). Residents scored as competent had performed significantly more previous tonsillectomies than those deemed noncompetent, 44.4 ± 35.6 and 13.5 ± 11.6, respectively (P < .001). The mean overall score on the tonsil TBC was 4.0 ± 0.8 and 2.6 ± 1.0 for competent and noncompetent, respectively (P < .001). Higher number of tonsillectomies performed and mean tonsil TBC score significantly increased the likelihood of competency (P < .001). Each additional tonsillectomy performed increased the likelihood of achieving competency by 6.3% (P = .006, 95% confidence interval (CI): 1.330-1.110), and each 1.0 point increase in mean tonsil TBC score increased the likelihood of competency by a factor of 2.71 (P = .006, 95% CI:1.330-5.513). There is a 95% likelihood of competency at 48 tonsillectomies or a tonsil TBC score of 4.91. CONCLUSION The tonsil OSATS is a valid and feasible instrument to assess resident competency with tonsillectomy and provides timely objective feedback. LEVEL OF EVIDENCE 4. Laryngoscope, 131:E359-E366, 2021.
Characterization and verification of lead thickness of commercially available lead foil tape for the measurements of lead equivalency of radio-protective shields

PURPOSE Radiation protective apparatus is normally specified in "millimeter" of lead equivalence. Typically, it is less than 0.5 mmPb with the exception of lead eyeglasses, which may be 0.75 mmPb equivalent. Upon discovery of commercially available lead foil tape, manufactured by 3M™ "Lead Foil Tape 421" (LFT) which is designed for industrial utility applications. We set out to determine if this LFT can, indeed, be employed as the reference lead in the evaluation of lead equivalency of various protective apparatus. METHOD The LFT is cut to appropriate size (50 mm × 50 mm) and stacked for varying the total lead thickness for the transmission measurements. The transmission curves are obtained following the geometry spelled out in ASTM Designation F3094-14 standards. The radiation beam qualities corresponding to modern cardiovascular angiography equipment in the range of 60~120 kVp, in increments of 10 kVp, and in combination with the spectral shaping filters of 0, 0.1, 0.2, 0.3, 0.6 and 0.9 mmCu were employed for characterization of the lead foil tape. The transmission data of lead pieces with known thicknesses (1/64", 1/32" and 3/64") are superimposed on the lead foil tape transmission curves to validate that the 3M™ LFT is indeed usable as 0.1 mm lead. RESULTS The transmission ratio (data points) of lead pieces with known thicknesses at various radiation beam qualities mentioned above, fall right onto the transmission curves of 3M™ LFT with better than 2% accuracy. Therefore, it is indeed behaving like 0.1 mm thick lead sheet, based on the superimposed transmission curves. The 3M™ "Lead Foil Tape 421" is employed as the reference lead for evaluation of radiation protective apparatus at this institution. Verification of lead protective apparatus with unknown lead equivalence can now be determined with a high accuracy and certainty.
A Dynamic Model of Policy and Health Effects on Living Arrangement Transitions of Elderly Persons

As the U.S. increasingly explores creative policies to address the needs of its growing elderly population, a better understanding of the effects of these policies and programs on the individuals they are intended to benefit is needed. The effectiveness of state long-term care policies in enhancing access to needed services and reducing unmet needs is of particular importance but not well understood or documented. Little is known, for example, about the impact of such policies on intended outcomes, such as intensity and composition of care received or stability and independence of living arrangements. Research that ties policy decisions to differences in measurable outcomes is a key element in evaluating the effectiveness of state LTC policy strategies (Kemper, 2003). In this paper, we use a simultaneous random-effects specification to model elderly persons' living arrangement transitions, with a special focus on the effects of functional decline and state LTC policies. We use longitudinal data on a cohort of disabled elderly persons with measures at five different points in time to characterize functional decline and living arrangement transitions e.g., moves from independent living in the community to coresidence with family members or others, to nursing home entry over a 10-year span (1993-2002). Our approach, which takes into account state and duration dependence in living arrangement choices as well as multiple types of transitions will enable us to estimate policy effects (controlling for fucntional decline and other factors) on both the stability and transition out of each living arrangement something that, to our knowledge has not been done before. The results allow us to estimate the impact of policy, socio-demographic characteristics, health and other factors on living arrangements accounting for competing risks of transitions into other states, including death and censoring. Based these findings we conduct policy simulations to find the relative merit of alternative program design options in enhancing stability and reducing transitions into more dependent settings. Given the increasing numbers of elderly persons and the unresolved questions concerning the effectiveness of existing initiatives, the results of this study will have important implications for both policy and program development.
CODIT: Code Editing with Tree-Based Neural Models

The way developers edit day-to-day code tends to be repetitive, often using existing code elements. Many researchers have tried to automate repetitive code changes by learning from specific change templates which are applied to limited scope. The advancement of deep neural networks and the availability of vast open-source evolutionary data opens up the possibility of automatically learning those templates from the wild. However, deep neural network based modeling for code changes and code in general introduces some specific problems that needs specific attention from research community. For instance, compared to natural language, source code vocabulary can be significantly larger. Further, good changes in code do not break its syntactic structure. Thus, deploying state-of-the-art neural network models without adapting the methods to the source code domain yields sub-optimal results. To this end, we propose a novel tree-based neural network system to model source code changes and learn code change patterns from the wild. Specifically, we propose a tree-based neural machine translation model to learn the probability distribution of changes in code. We realize our model with a change suggestion engine, CODIT, and train the model with more than 30k real-world changes and evaluate it on 6k patches. Our evaluation shows the effectiveness of CODIT in learning and suggesting patches. CODIT can also learn specific bug fix pattern from bug fixing patches and can fix 27 bugs out of 75 one line bugs in Defects4J.
Pediatric allergic contact dermatitis. Part 2: Patch testing series, procedure, and unique scenarios

Patch testing is the criterion standard for diagnosing allergic contact dermatitis. Causative allergens differ between children and adults, necessitating the development of pediatric-specific patch test series. The Pediatric Baseline Series was developed in 2018 through expert consensus and includes relevant pediatric allergens that dermatologists can use in practice. Obstacles in patch testing, such as the need for multiple office visits, length of patch application, and avoidance of sweat and water on the testing area, are particularly challenging for the pediatric population, and several strategies are proposed. Aside from formal patch testing, alternatives like the repeat open application test and empiric allergen avoidance can be helpful in children. The key to management of allergic contact dermatitis is allergen avoidance, with emphasis on the need to properly identify causative allergens. Continued data collection through registries allows for a better understanding of the diagnosis and management of pediatric allergic contact dermatitis.
Novel Approach of Spatial Modulation: Polarization-Aware OFDM Subcarrier Allocation

6th Generation (6G) wireless communication seriously considers energy efficient systems aligned with the green energy technology. The novel spatial modulation (SM) scheme utilizing the polarization domain is proposed to improve SM demodulation error rate. The cross-polarization discrimination (XPD) can be estimated via incorporating multi-polarized antenna elements at the receiver (Rx). The XPD enhances the performance in classification of antenna indices at the Rx. Further, the practical orthogonal frequency division multiplexing (OFDM) system is considered for SM; subcarrier allocation algorithm utilizing the XPD is proposed with remarkable improvement of the system performance in terms of SM error rate.
Care received by patients from nurse practitioners and physicians in U.S. primary care settings.

Abstract Purpose Nurse practitioners (NPs) and physicians serve in both usual source of care (USC) and supplement roles to each other in the provision of primary care to patients. Yet little is known about the care that patients receive from providers in these roles. This study examined the care individuals received when NPs and physicians served in USC and supplemental roles. Methods Pooled data from the Household Component of the Medical Expenditure Panel Survey 2002-2013. Cross-sectional, secondary data analysis using propensity score matching and multinomial logistic regression. Data were collected from a national subsample of households. Findings Regardless of provider role, patients reported receiving more therapeutic or preventive care from NPs but more diagnostic care and biomedical treatments from physicians. Patients reported having similar diagnoses when seen by NPs and physicians serving in USC roles, but different diagnoses when NPs and physicians served in supplemental roles. Discussion NPs and physicians providing different care when serving in the same role. Findings can inform policy-makers as they develop policies for serving patients and utilizing the relevant expertise of NPs and physicians.
Are you entertained?: Black popular culture in the twenty-first century: edited by Simone C. Drake and Dwan K. Henderson, Durham, Duke University Press, 2020, 336pp, $27.95 (paperback), ISBN 978-1-4780-0678-7

In his classic essay, “What is this ‘Black’ in Black Popular Culture,” Stuart Hall opens with a question: “What sort of moment is this in which to pose the question of black popular culture?”. Hall...
Association between the Functional Gait Assessment and spatiotemporal gait parameters in individuals with obesity compared to normal weight controls: A proof-of-concept study.

OBJECTIVES Obesity is a significant global health concern that involves motor impairment, including deficits in gait and balance. A simple tool would be useful to capture gait and balance impairment in obesity. We assessed whether the Functional Gait Assessment (FGA) captures impairment in individuals with obese BMI (≥30 kg/m2) and whether impairment was related to spatiotemporal gait parameters. METHODS Fourteen individuals with obese BMI and twenty individuals of normal weight underwent the FGA. Spatiotemporal gait parameters were collected while participants walked on a pressure sensitive walkway under five conditions: pre-baseline (flat ground walking), crossing small, medium, and high obstacles, and final-baseline (flat ground walking). RESULTS Individuals with obesity had lower scores on the FGA (p≤0.001) and showed less efficient spatiotemporal gait parameters than healthy controls, particularly when crossing over obstacles (all ps≤0.05). For participants with obesity, lower FGA scores were associated with decreased gait velocity, but only during obstacle crossing (p≤0.05). CONCLUSIONS The FGA may be a useful tool to capture gait impairment in populations with obesity. Obstacles may help reveal meaningful gait impairments. To our knowledge, this is the first study to examine the FGA in individuals with obesity, and represents a proof-of-concept that motivates further validation studies.
Gateway Moments to Literate Identities

Drawing from theories of identity, language, and race, we conceptualize gateway moments to literate identities in high school English language arts classrooms enrolling language-minoritized youth. ...
Taking control to do more: how local governments and communities can enact ambitious climate mitigation policies

While local governments have emerged as policy leaders on climate change, evidence indicates that many of the policies enacted do not significantly reduce greenhouse gas emissions. This study focus...
Addressing Individualized Risk Response to Climate Resilience Assessment by Fostering Adaptive Capacity

Asheville, North Carolina, launched a Climate Resilience Assessment in conjunction with a new Comprehensive Plan in 2017. While initiated separately, the efforts eventually melded together as the Climate Resilience Assessment folded into the Comprehensive Plan as an appendix. In 2019, Asheville developed the first action step in terms of an outreach plan targeted at individual homeowners and neighborhoods. The approach began in a way that places the burden of the risk response on individuals instead of society. The response neglects the causal mechanisms in terms of structural and cultural issues that have led to risks and to certain groups and locations becoming more vulnerable than others. Why is it that some houses are dilapidated and vulnerable to flooding or that some people rely on public transportation or food assistance? In not accounting for cultural and structural factors, climate response efforts fail to address resilience and instead simply constitute an approach to adaptation. True resilience would address the causes of vulnerability and build adaptive capacity that has individual and societal/community dimensions and focuses on building financial, knowledge, and most importantly social capital. However, building and summing individual capital does not equate to building community social capital or community adaptive capacity, especially since individuals do not drive or cause climate threats, thus illustrating a scale mismatch. Therefore, there is a need to incorporate best practices in risk and resilience theory and practice.
Free to Learn: Why Unleashing the Instinct to Play Will Make Our Children Happier, More Self-Reliant, and Better Students for Life

Our children spend their days being passively instructed, and made to sit still and take tests--often against their will. We call this imprisonment schooling, yet wonder why kids become bored and misbehave. Even outside of school children today seldom play and explore without adult supervision, and are afforded few opportunities to control their own lives. The result: anxious, unfocused children who see schooling--and life--as a series of hoops to struggle through. In Free to Learn, developmental psychologist Peter Gray argues that our children, if free to pursue their own interests through play, will not only learn all they need to know, but will do so with energy and passion. Children come into this world burning to learn, equipped with the curiosity, playfulness, and sociability to direct their own education. Yet we have squelched such instincts in a school model originally developed to indoctrinate, not to promote intellectual growth. To foster children who will thrive in today's constantly changing world, we must entrust them to steer their own learning and development. Drawing on evidence from anthropology, psychology, and history, Gray demonstrates that free play is the primary means by which children learn to control their lives, solve problems, get along with peers, and become emotionally resilient. This capacity to learn through play evolved long ago, in hunter-gatherer bands where children acquired the skills of the culture through their own initiatives. And these instincts still operate remarkably well today, as studies at alternative, democratically administered schools show. When children are in charge of their own education, they learn better--and at lower cost than the traditional model of coercive schooling. A brave, counterintuitive proposal for freeing our children from the shackles of the curiosity-killing institution we call school, Free to Learn suggests that it's time to stop asking what's wrong with our children, and start asking what's wrong with the system. It shows how we can act--both as parents and as members of society--to improve children's lives and promote their happiness and learning.
Relating the biological stability of soil organic matter to energy availability in deep tropical soil profiles

Abstract Tropical subsoils contain large reservoirs of carbon (C), most of which is stored in soil organic matter (SOM). Subsoil OM is thought to be particularly stable against microbial decomposition due to various mechanisms and its position in the soil profile, potentially representing a long-term C sink. However, few experiments have explicitly investigated SOM stability and microbial activity across several orders of magnitude of soil C concentrations as a function of soil depth. The objective of this study was to evaluate the biological stability of SOM in the upper 1.4 m of tropical forest soil profiles. We did so by measuring CO 2 evolution during a 90-day laboratory incubation experiment on a sample set that was previously characterized for C and nutrient concentrations and microbial biomass. We concurrently measured the energy content of SOM using differential scanning calorimetry (DSC) as an index of the energy available for microbial metabolism, with the hypothesis that the biological stability of SOM would be inversely related to the energy contained within it. Cumulative CO 2 evolution, mean respiration rates, and the energy density of SOM (energy released during combustion normalized to soil C) all declined with soil depth (P
What would jiminy cricket do? lessons from the first social wearable

Work towards the development of a "wearable conscience" that helps individuals make healthy decisions in their everyday lives is described. To be effective, such a system must be portable, sense key elements of the user's environment, have knowledge of counseling and health behavior change techniques, be able to effectively communicate with the user, and have social competencies for maintaining an ongoing working relationship. The design of a prototype system is presented, along with results from a series of design and usability studies. Current and future directions for the research are also discussed.
The gas composition of jupiter derived from 5-μm airborne spectroscopic observations

It is pointed out that Jupiter's 5-micron spectrum is a very diagnostic observational tool to probe the troposphere of this giant planet. A report is presented of abundance analyses of NH3, PH3, CH4, CH3D, CO, and GeH4 in the 1- to 6-bar pressure range in Jupiter's troposphere. All the considered molecules have been previously detected in ground-based, airborne, and spacecraft observations of Jupiter. The contribution made by the present study is related to a self-consistent simultaneous determination of the abundances of all of these molecules at the same physical level in Jupiter's atmosphere using one high spectral resolution dataset and a radiative transfer model. It is found that most abundances deviate significantly from expectations based upon an atmospheric model assuming solar composition and chemical equilibrium. The D/H ratio in Jupiter is comparable to that measured in the interstellar medium.
DISCONNECTION OF OPEN CORONAL MAGNETIC STRUCTURES

We have examined the Solar Maximum Mission coronagraph/polarimeter observations for evidence of magnetic disconnection of previously open magnetic structures and a number of likely examples have been found. Probable coronal disconnections typically appear as pinching off of helmet streamers followed by the release and outward acceleration of a large U or V-shaped structure. The observed sequence of events is consistent with reconnection across the heliospheric current sheet between previously open magnetic field regions, and the creation of a detached magnetic structure which is open to interplanetary space at both ends. Sunward of the reconnection point, coronal disconnection events would return previously open magnetic flux to the Sun as closed field arches. Here we (1) describe one clear disconnection event (1 June 1989); (2) examine the results of a limited survey of disconnection events; and (3) discuss the potential importance of coronal disconnections for maintaining flux in interplanetary space.
The Relationship Between Nurses’ Perception of Work Environment and Patient Satisfaction in Adult Critical Care

Background: Patient satisfaction in critical care is rarely measured yet has a major impact on hospital reimbursement. The critical care setting is characterized by high patient acuity and a fast-paced work environment. Nurses’ perception of work environment in relation to various patient outcomes including patient satisfaction has not been explored exclusively in critical care. Objectives: (a) Examine patient's perception of nursing care associated with their hospitalization in the intensive care unit. (b) Describe nurses’ perception of work environment within a defined sample of adult critical care units, using the Practice Environment Scale of the Nursing Work Index (PES-NWI). (c) Explore the relationships between nurses’ perception of work environment and patient satisfaction in adult critical care. Methods: This study used existing data to address the study aims. Unit-level comparisons were examined using analysis of variance. The final aim was examined using multilevel modeling for longitudinal data. Results: Patients were very satisfied with their hospitalization (4.48 out of 5.0). Significant differences were noted among all unit level comparisons (p < .001). Nurses also reported moderate satisfaction with work environment as measured by the PES-NWI, with perception of the role of their nurse manager receiving the highest scores. Perception of nurse manager leadership and ability was significantly related to patient satisfaction (p= .018). Favorable perception of the nurse manager was associated with a .424 point increase in patient satisfaction. Conclusions: This study offers preliminary support for the relationship between nurses’ perception of work environment and patient satisfaction in critical care. It also highlights the pivotal role of the nurse manager in both nurse and patient satisfaction. Clinical Relevance: This study examines two important aspects that are both relevant and important to clinical nursing. The first aspect is the healthy work environment. Multiple studies have linked the nursing work environment to patient outcomes and this is an area that deserves further attention. The second aspect, patient satisfaction, is now associated with hospital reimbursement. The relationship between the nursing work environment and patient satisfaction highlights an important link to improving patient care.
Morphological and genetic variability in Plantago cordata (Plantaginaceae), a threatened aquatic plant

Morphological and genetic variation were studied in Plantago cordata Lam., an imperiled aquatic plant. The existence of distinct seasonal morphs was confirmed by numerical morphological analyses of specimens from 53 populations. Plants from two North Carolina populations possessed leaves that were significantly shorter, narrower, and fewer-veined than populations in other portions of the species range. Genetic variation within and among ten populations in seven states/ provinces (Illinois, Missouri, New York, North Carolina, Ohio, Ontario, and Wisconsin) was examined electrophoretically. The species is an apparent allopolyploid with fixed heterozygosity observed at 67% of the loci surveyed. Electrophoretic variation was mostly partitioned among populations. The genetic identity among populations was high except for North Carolina populations which differed at 27% of the loci surveyed.
Impacts of Cotyledon Removal on Survival of Blackbrush (Coleogyne ramosissima: Rosaceae) Seedlings

Despite the ecological importance of the regeneration stage of plant life histories (Grime 2001), some of the factors affecting seedling survival, including the interaction between seedlings and their herbivores, are not well-understood (Hanley and May 2006). Herbivory is a major cause of seedling mortality for many woody plant species (Hanley 1998; Moles and Westoby 2004; Fenner and Thompson 2005). The ability of seedlings to cope with herbivory is likely affected by seed size, the presence or absence of cotyledons, and the time elapsed since germination (Bonfil 1998). Because seedlings of woody plant species are small, they can suffer high mortality due to herbivory (Kitajima and Augspurger 1989; Howe 1990; Osunkoya et al. 1992; Asquith et al. 1997; Kitajima 2003). Carbohydrate reserves are important for seedling recovery after tissue loss, especially in shaded understories where photosynthesis is limited (McPherson and Williams 1998; Canham et al. 1999). Cotyledons can support energy and nutrient demands of a young seedling either as photosynthetic or reserve organs (Kitajima 2003). Cotyledons have nutritional value, and it is common to find young seedlings in the field with cotyledons that have been partially or completely removed by insects and browsing vertebrates (Smythe 1978). Such removal of cotyledons before development of the first true leaf is usually fatal (Kitajima 2003). However, even after development of the first leaf, cotyledon loss may greatly reduce seedling survival (Kitajima 2003). Using greenhouse experiments, I investigated how the timing of cotyledon damage and variation in its magnitude influencing survival of young blackbrush (Coleogyne ramosissima Torr.) seedlings through simulated cotyledon herbivory. Specifically, I examined whether differences in the ability of 4-month-old Coleogyne seedlings to survive detachment of cotyledons were related to the timing and extent of cotyledon removal in an environmentally controlled greenhouse.
Long-Term Treatment and Prevention of Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a disabling condition almost universally associated with psychiatric comorbidity, reduced quality of life, and a chronic, often lifelong, course. Although acute treatment with selective serotonin reuptake inhibitors (SSRIs) has been shown to be effective, successful strategies for preventing PTSD have not been established. In addition, studies of the long-term treatment of chronic PTSD are just beginning to emerge. This review considers available evidence for the secondary prevention of PTSD in the acute aftermath of trauma and the long-term treatment of established PTSD. Unanswered questions pertaining to duration of treatment, candidates for long-term treatment, and potentially harmful treatments will also be considered.
Test for the Comparison of Two Exponential Distributions

Let X (1), …, X (k) be the first k ordered observations of a sample of size m from the distribution with p.d.f. f(x; β1, θ) = (1/θ) exp [-(x – β1)/θ] for x ≥ β1 ≥ 0, θ > 0 and zero elsewhere (2 ≤ k ≤ m); let Y (i), …, Y (l) be the first l ordered observations of a sample of size n from the distribution with p.d.f. g(y; β2, θ) = (1/θ) exp [—(y – β2)/θ] for y ≥ β2 ≥ 0, θ > 0 and zero elsewhere (2 ≤ l ≤ n). It is assumed that θ is unknown. A test based on (X (1), …, X (k), Y (1), …, Y (l)) is proposed for the null hypothesis β1 = β2 against the alternative β1 ≠ β2. The distribution of the test statistic under the null hypothesis is derived. The significance points for various values of k, I, m, n are tabulated for (α = .05 and .Ol.
The Market Structure of Commercial Banking in the United States

I. Introduction, 62. — II. Some salient features of a banking market, 63. — III. Prices, profits, costs, 69. — IV. Banking market structure in small market towns and large cities, 73. — V. Impact of horizontal combination on banking structures, 79. — VI. Concluding observations, 83.