cssi/SciSciGPT-SciSciNet huggingface dataset:
Diagnosis and treatment of urinary tract infections across age groups.

Urinary tract infections are the most common outpatient infections, but predicting the probability of urinary tract infections through symptoms and test results can be complex. The most diagnostic symptoms of urinary tract infections include change in frequency, dysuria, urgency, and presence or absence of vaginal discharge, but urinary tract infections may present differently in older women. Dipstick urinalysis is popular for its availability and usefulness, but results must be interpreted in context of the patient's pretest probability based on symptoms and characteristics. In patients with a high probability of urinary tract infection based on symptoms, negative dipstick urinalysis does not rule out urinary tract infection. Nitrites are likely more sensitive and specific than other dipstick components for urinary tract infection, particularly in the elderly. Positive dipstick testing is likely specific for asymptomatic bacteriuria in pregnancy, but urine culture is still the test of choice. Microscopic urinalysis is likely comparable to dipstick urinalysis as a screening test. Bacteriuria is more specific and sensitive than pyuria for detecting urinary tract infection, even in older women and during pregnancy. Pyuria is commonly found in the absence of infection, particularly in older adults with lower urinary tract symptoms such as incontinence. Positive testing may increase the probability of urinary tract infection, but initiation of treatment should take into account risk of urinary tract infection based on symptoms as well. In cases in which the probability of urinary tract infection is moderate or unclear, urine culture should be performed. Urine culture is the gold standard for detection of urinary tract infection. However, asymptomatic bacteriuria is common, particularly in older women, and should not be treated with antibiotics. Conversely, in symptomatic women, even growth as low as 102 colony-forming unit/mL could reflect infection. Resistance is increasing to fluoroquinolones, beta-lactams, and trimethoprim-sulfamethoxazole. Most uropathogens still display good sensitivity to nitrofurantoin. First-line treatments for urinary tract infection include nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole (when resistance levels are <20%). These antibiotics have minimal collateral damage and resistance. In pregnancy, beta-lactams, nitrofurantoin, fosfomycin, and trimethoprim-sulfamethoxazole can be appropriate treatments. Interpreting the probability of urinary tract infection based on symptoms and testing allows for greater accuracy in diagnosis of urinary tract infection, decreasing overtreatment and encouraging antimicrobial stewardship.
eeDTLS: Energy-Efficient Datagram Transport Layer Security for the Internet of Things

In the fast growing world of the Internet of Things (IoT), security has become a major concern. Datagram Transport Layer Security (DTLS) is considered to be one of the most suited protocols for securing the IoT. However, computation and communication overheads make it very expensive to implement DTLS on resource-constrained IoT sensor nodes. In this work, we profile the energy costs of DTLS 1.3, using experimental models for cryptographic computations and radio-frequency (RF) communications. Based on this analysis, we present eeDTLS, a low-energy variant of DTLS, that provides the same security strength as DTLS, but has lower energy requirements. By employing a combination of packet size reduction and optimized handshake computations, eeDTLS can provide up to 45% energy savings in a typical IoT use case. eeDTLS can be implemented in conjunction with any low-energy IoT RF protocol, and the proposed energy models and protocol optimizations can also be used to improve the energy efficiency of custom IoT security architectures.
Problems Related to Coordinated Control and Management of Land and Water Resources — Some Perceptions Derived from the Indian Experience

Developing countries, faced with the twin problems of poverty and rapidly growing populations, must give the highest priority to the optimum mangement of their natural resources of land and water, which constitute their basic life-support systems. The management of these resources must necessarily be attempted in an integrated manner, so closely and inextricably are they inter-linked with each other. However, since the soil is an irreplacable and non-renewable resource and since proper soil and land management automatically results in the conservation of a great deal of water, it would be good strategy to pay special attention to this subject, particularly because it has suffered from serious neglect in the past. The afforestation of denuded water-sheds and waste-lands, the provision of adequate drainage in canal-irrigated areas and the greater use of ground water for irrigation must accordingly form an important part of all river basin development programmes.
A technique for the determination of interfacial properties from debond length measurement

Fiber-matrix interfacial debonding is observed and the debond length is directly measured during flexure tests performed on transparent SiC fiber-reinforced borosilicate glass composites. The relationship among the debond length, applied stress, and interfacial properties is investigated both experimentally and theoretically. A new technique based on debond length measurement is introduced for measuring fiber-matrix interfacial properties such as interfacial shear strength, frictional shear stress, and interfacial debond energy. Analytical models are employed for the new technique to interpret the experimental data. Fiber pushout technique is also employed to measure the interfacial properties independently. It is shown that these two different techniques of debond length measurement and fiber pushout test for measuring the interfacial properties can provide comparable results.
Methodology of Studying the Catecholamine Response to Stress

The catecholamines (epinephrine, norepinephrine and dopamine), as measured in urine or plasma, increase dramatically in response to a variety of stressors including emotional stimuli, cognitive challenges, and physical activity. Measuring the catecholamine response to stress is often desirable because it provides the most direct assessment of sympathetic nervous system activity. This chapter discusses the methodology for measuring catecholamine responses to stress. Because catecholamines are so responsive to a variety of stimuli, a number of factors which must be carefully controlled in studies of catecholamine responses are discussed. The techniques for collecting both urine and plasma samples are presented along with a discussion of the appropriate timing of samples. Finally, procedures for preparing and storing urine and plasma samples and for assaying catecholamine levels are presented.
The Bidomain Model of Cardiac Tissue: From Microscale to Macroscale

Cardiac muscle is made up of coupled myocytes, embedded in an interstitial space comprised of blood vessels, connective tissue, fibroblasts fluid, and other cell types and adjoining some extracellular fluid. The bidomain model was originally developed to describe the current flow in both these three spaces using continuous partial differential equations. The classical form assumes averaged potentials and currents and considers the intracellular and interstitial spaces to be separated by a cell membrane, defined at every point in space. Over the last 40 years, the model has been used to study stimulation through the extracellular or interstitial currents, the effect of the adjoining fluid on wavefront propagation and the basis for the extracellular potentials often recorded clinically. In this chapter, we derive the bidomain model from idealized lattice of cells coupled through gap junctions and show how the tissue conductivities and associated anisotropy relate to the underlying cellular structure. We also discuss some of the challenges to bidomain prediction that may necessitate changes to the underlying formulation to capture certain diseased states.
Expand the Pool of Living Donors for Kidney Transplantation.

In this issue of the Clinical Journal of the American Society of Nephrology , de Weerd et al. ([1][1]) report findings from their meta-analysis examining outcomes after blood group–incompatible (ABO-incompatible) living donor kidney transplantation. Their analysis included single-center cohort
Vehicle Detection and Classification in Aerial Imagery

We present a novel method for vehicle detection and classification in aerial imagery. First, change detection analyzes a pair of mutually aligned images captured at the same location but at different time instants to generate vehicle proposals. Next, a trained Convolutional Neural Network (CNN) classifier is applied to (1) determine if a proposal truly contains a vehicle, and (2) classify any vehicle present into major categories. Experimental results using infrared (IR) data demonstrate the efficacy of our method: vehicle detection rate is over 99%; light-duty vehicles (e.g. sedan) are classified with 89% accuracy, medium-duty vehicles (e.g., van and pickup) with 79% and heavy-duty vehicles (e.g., trucks and buses) with 73% accuracies. The classification performance difference among different vehicle types is attributed to the size of training samples available in each category. Our system can process data at video rate making it feasible for real-time traffic monitoring.
Carrying capacity of a spatially-structured population: Disentangling the effects of dispersal, growth parameters, habitat heterogeneity and habitat clustering.

Abstract Carrying capacity, K, is a fundamental quantity in theoretical and applied ecology. When populations are distributed over space, carrying capacity becomes a complicated function of local, global and nearby environments, dispersal rate, and the relationship between population growth parameters, e.g., r and K. Expressions for the total carrying capacity, Ktotal, in an n-patch model that explicitly disentangle all of these factors are currently lacking. Therefore, here we derive Ktotal for a linear spatial array of n habitat patches with logistic growth and strong or weak random dispersal of individuals between adjacent patches. With strong dispersal, Ktotal depends on the mean r and K over all patches (〈r〉 and 〈K〉), the among-patch variance in K, and the linear regression coefficient of r on K, βr,K. Strong dispersal increases Ktotal only if βr, K > 〈r〉/〈K〉, which requires a positive convex or negative concave association between r and K, and decreases Ktotal if βr, K
Management of surgical overcorrections following surgery for Duane syndrome with esotropia in primary position

Summary Surgery for esotropic Duane syndrome may result in overcorrections. Managing these overcorrections can be challenging. We describe the most common over-correction scenarios and recommendations for their surgical management.
Assessing Parental Attributions through an Implicit Measure: Development and Evaluation of the Noncompliance IAT.

Assessing parental attributions can be challenging given the reticence of some caregivers to report information that may be considered controversial or pejorative. To address this issue, recent efforts have focused on expanding existing parenting assessment batteries to include implicit measures. One of the most common methods for implicit assessment, the Implicit Association Test (IAT), had not yet been adapted to assess parental attributions. Two studies evaluated the psychometric properties (including convergent, concurrent, incremental, and predictive validity) of the novel Noncompliance IAT (N-IAT). Study 1 included a low-risk sample of mothers (N = 60) of preschoolers. Study 2 included a diverse and higher risk sample of mothers and fathers who were assessed at three time points: immediately before the birth of their first child (N = 202 women; N = 144 male partners) and then 6 and 18 months after the birth. Findings from both studies supported the utility of the N-IAT as a measure of implicit parental attributions. The N-IAT demonstrated evidence of convergent and concurrent validity (e.g., significant correlations with explicit attribution measures and with measures of parenting) in both studies. The longitudinal design of Study 2 allowed for the evaluation of incremental and predictive validity; N-IAT scores before childbirth predicted later N-IAT scores, with indications that the N-IAT could demonstrate incremental validity related to child abuse risk. Study 2 also demonstrated moderate test stability for mothers and fathers. These results suggest that the N-IAT may be a helpful adjunct to assessments of parental attribution.
A Review of Spontaneous Intracranial Hypotension

Spontaneous intracranial hypotension (SIH) is an underdiagnosed phenomenon predominantly presenting with low cerebrospinal fluid (CSF) pressure and postural headache in setting of CSF leak. The goal of this paper is to provide updates on the pathology, diagnosis, and management of SIH. The utility of multiple imaging modalities and the use of epidural blood patches and fibrin glue polymers are explored. In regard to diagnosis, new non-invasive modalities in detection of SIH including transorbital ultrasound and serum biomarkers are found. In addition, increased efficacy of large volume and repeated placement of multiple epidural blood patches (EBP) are seen. In addition, the management of refractory SIH using fibrin glue polymers has proved efficacious in recent case series. While the diagnosis may be challenging for clinicians, future research in SIH is leading to more rapid detection methods. Future studies may target optimal use of EBP in comparison to fibrin glue polymers, in addition to new developments in increased understanding of SIH physiology and phenotype.
Crystal and molecular structures of derivatives formed by reaction between toluenesulfonhydrazide and D-glucose, D-galactose, and L-arabinose

Derivatives formed by reaction of toluenesulfonhydrazide with D-glucose, D-galactose, and L-arabinose are shown by X-ray crystal structure analysis to be N-glycosides rather than open-chain hydrazones in the solid state. All three sugar derivatives assume the 4C1 pyranosyl form, and in all three cases the orientation of the N-glycosidic linkage is equatorial. The gauche conformation of the glucoside and galactoside at the N(2)–N(1)–C(1)–C(2) linkage allows formation of an intramolecular hydrogen bond between the O(2) hydroxyl group and a sulfonyl oxygen atom, but no corresponding intramolecular interaction is found in the arabinoside due to its trans conformation at this linkage. In both the galactoside and arabinoside an S–O bond is eclipsed with the phenyl ring, but in the glucoside the phenyl ring assumes a staggered orientation with respect to the S–O bonds. Intermolecular hydrogen bonding interactions bind the molecules together to form alternating layers of hydrophilic groups (the pyranosyl rings) and hydrophobic groups (the aryl rings) in the crystal.
Fast and Communication-efficient Distributed Pca

This paper focuses on principal components analysis (PCA), which involves estimating the principal subspace of a data covariance matrix, in the age of big data. Massively large datasets often require storage across multiple machines, which precludes the use of cen-tralized PCA solutions. While a number of distributed solutions to the PCA problem have been proposed recently, convergence guarantees and/or communications overhead of these solutions remain a concern. With an eye towards communications efficiency, this paper introduces two variants of a distributed PCA algorithm termed distributed Sanger’s algorithm (DSA). Principal subspace estimation using both variants of DSA is communication efficient because of its one time-scale nature. In addition, theoretical guarantees are provided for the asymptotic convergence of basic DSA to the principal subspace, while its "accelerated" variant is numerically shown to have faster convergence than the state-of-the-art.
Update on foodborne viruses: molecular-based detection methods

Abstract: Insights are provided into rapid molecular methods for potential application to detect foodborne viruses, the globally recognized causes of nonbacterial gastroenteritis, in foods and the environment. The use of molecular amplification techniques such as the reverse-transcriptase polymerase chain reaction (RT-PCR) is described.
Acidity changes immunology: a new VISTA pathway.

Hypoxia and acidity in the tumor microenvironment promote resistance to immunotherapy. Hypoxia upregulates multiple immunoinhibitory pathways, including VISTA, and acidity enables VISTA to interact with PSGL-1 to inhibit immune activation selectively in the acidic tumor microenvironment.
Microtubule dynamics in healthy and injured neurons

Most neurons must last a lifetime and their microtubule cytoskeleton is an important contributor to their longevity. Neurons have some of the most stable microtubules of all cells, but the tip of every microtubule remains dynamic and, although requiring constant GTP consumption, microtubules are always being rebuilt. While some ongoing level of rebuilding always occurs, overall microtubule stability can be modulated in response to injury and stress as well as the normal developmental process of pruning. Specific microtubule severing proteins act in different contexts to increase microtubule dynamicity and promote degeneration and pruning. After axon injury, complex changes in dynamics occur and these are important for both neuroprotection induced by injury and subsequent outgrowth of a new axon. Understanding how microtubule dynamics is modulated in different scenarios, as well as the impact of the changes in stability, is an important avenue to explore for development of strategies to promote neuroprotection and regeneration.
Maternal Diet Alters Trained Immunity in the Pathogenesis of Pediatric NAFLD

Pediatric nonalcoholic fatty liver disease (NAFLD) affects 1 in 10 children in the US, increases risk of cirrhosis and transplantation in early adulthood, and shortens lifespan, even after transplantation. Exposure to maternal obesity and/or a diet high in fat, sugar and cholesterol is strongly associated with development of NAFLD in offspring. However, mechanisms by which "priming" of the immune system in early life increases susceptibility to NAFLD are poorly understood. Recent studies have focused on the role "non-reparative" macrophages play in accelerating inflammatory signals promoting fibrogenesis. In this Commentary, we review evidence that the pioneering gut bacteria colonizing the infant intestinal tract remodel the naive immune system in the offspring. Epigenetic changes in hematopoietic stem and progenitor cells, induced by exposure to an obesogenic diet in utero, may skew lineage commitment of myeloid cells during gestation. Further, microbial dysbiosis in neonatal life contributes to training innate immune cell responsiveness in the gut, bone marrow, and liver, leading to developmental programming of pediatric NAFLD. Comprehensive understanding of how different gut bacteria and their byproducts shape development of the early innate immune system and microbiome will uncover early interventions to prevent NAFLD pathophysiology.
Role of the Internal Limiting Membrane in Structural Engraftment and Topographic Spacing of Transplanted Human Stem Cell-Derived Retinal Ganglion Cells.

Summary Retinal ganglion cell (RGC) replacement holds potential for restoring vision lost to optic neuropathy. Transplanted RGCs must undergo neuroretinal integration to receive afferent visual signals for processing and efferent transmission. To date, retinal integration following RGC transplantation has been limited. We sought to overcome key barriers to transplanted human stem cell-derived RGC integration. Following co-culture ex vivo on organotypic mouse retinal explants, human RGCs cluster and extend bundled neurites that remain superficial to the neuroretina, hindering afferent synaptogenesis. To enhance integration, we increased the cellular permeability of the internal limiting membrane (ILM). Extracellular matrix digestion using proteolytic enzymes achieved ILM disruption while minimizing retinal toxicity and preserving glial reactivity. ILM disruption is associated with dispersion rather than clustering of co-cultured RGC bodies and neurites, and increased parenchymal neurite ingrowth. The ILM represents a significant obstacle to transplanted RGC connectivity and its circumvention may be necessary for functional RGC replacement.
Death of Dillon’s Rule: Local Autonomy to Control Land Use

Abstract: Dillon’s Rule is a judicial doctrine holding that courts are to construe narrowly legal authority delegated to local governments and that they are to resolve any fair doubt against the existence of contested local powers. The Rule has reigned with surprising strength for over 150 years, shedding doubt on the legal authority of municipalities to confront critical challenges such as furthering sustainable development, regulating oil and gas production, and mitigating climate change. This article analyzes two 1868 Iowa Supreme Court cases authored by Judge John Dillon and describes the confusion that the two holdings have caused for courts, scholars, and municipal attorneys. It focuses on the extent to which the narrow construction Rule has served as a clutch on the exercise of local land use authority despite the fact that it has been has been overruled by constitutional provisions, state legislation, and judicial decisions in at least 40 states. It then argues that state legislatures have delegated a suite of local powers to municipal governments to protect the public health, safety, morals, and welfare giving rise to a presumption of validity in the face of new state legislation that some argue preempt municipal powers. As the consequences of climate change become more evident and municipalities confront the disturbing effects of polluting industries, they need to act boldly and broadly, freed from the lingering presence of the Rule.
Lenvatinib-Induced Destructive Thyroiditis in a Patient With Hepatocellular Carcinoma

Lenvatinib is an antineoplastic oral agent that acts as a multi-kinase inhibitor against vascular endothelial growth factor (VEGF). This drug is commonly known for its use against radioiodine-refractory differentiated thyroid cancer, but it is also approved for unresectable hepatocellular carcinoma (HCC). Side effects such as fatigue, hypertension, palmar-plantar erythrodysesthesia, diarrhea, decreased appetite, and hypothyroidism are frequently reported adverse effects. However, the incidence of hyperthyroidism is a less known phenomenon. This case describes a patient with HCC on lenvatinib therapy who develops destructive thyroiditis. A 69-year-old man with hepatitis c cirrhosis complicated by progressive hepatocellular carcinoma (Child-Pugh class A6) presented with generalized weakness, unintentional weight loss, heat intolerance, palpitations, and tremors. He had been started on chemotherapy with lenvatinib 12 mg/day four weeks prior to presentation. Endocrinology was consulted due to abnormal thyroid function tests (TFTs). He had no previous history of thyroid function abnormalities or family history of thyroid disease. Laboratory tests revealed a hyperthyroid state [total thyroxine (T4), 14.3 µg/dL (normal range 4.5-11.7); free thyroxine (FT4), 1.9 ng/dL (normal range 0.9-1.7); thyroid-stimulating hormone (TSH), 0.07 µIU/mL (normal range 0.27-4.20), and negativity for antibodies [anti-thyroid peroxidase antibody (TPO Ab), 0.8 IU/mL (normal range 0.0-9.0); thyroglobulin antibody (Tg Ab), < 0.9 IU/mL (normal range 0.0-4.0); thyroid stimulating immunoglobulin (TSI), 90% (normal range < 122)]. Ultrasonography revealed a mildly prominent thyroid gland, a homogenous echo texture, and no suspicious thyroid nodules. In addition, a 99m-technetium (99mTc) scintigraphy demonstrated reduced radioactive uptake that was consistent with thyroiditis. Therefore, this patient was diagnosed with lenvatinib-induced destructive thyroiditis. Palpitations improved with a beta-blocker and the patient was resumed on a lower dose of lenvatinib, 8 mg/day, one week later. About six weeks after the initial dose of lenvatinib, his TFT results normalized. Lenvatinib disrupts cell proliferation which can affect many organs, including the thyroid gland. Although several theories have been proposed, the exact underlying mechanism by which this occurs remains unknown. It is important to note that in addition to hypothyroidism, lenvatinib may also cause hyperthyroidism in the form of a transient destructive thyroiditis. This emphasizes the need to routinely check TFTs prior to the initiation of lenvatinib and throughout the course of therapy.
A muscle-related contractile tissue specified by myocardin-related transcription factor activity in Porifera

Muscle-based movement is a hallmark of animal biology, but the evolutionary origins of myocytes - the cells that comprise muscle tissues - are unknown. Sponges (Porifera) provide an opportunity to reconstruct the earliest periods of myocyte evolution. Although sponges are believed to lack muscle, they are capable of coordinated whole-body contractions that purge debris from internal water canals. This behavior has been observed for decades, but their contractile tissues remain uncharacterized; it is an open question whether they have affinity to muscle or non-muscle contractile tissues in other animals. Here, we characterize the endothelial-like lining of water canals (the endopinacoderm) as a primary contractile tissue in the sponge Ephydatia muelleri. We find tissue-wide organization of contractile actin-bundles that contain striated-muscle myosin II and transgelin, and that contractions are regulated by the release of internal Ca2+ stores upstream of the myosin-light-chain-kinase (MLCK) pathway. Further, we show that the endopinacoderm is developmentally specified by myocardin-related transcription factor (MRTF) as part of an environmentally-inducible transcriptional complex that otherwise is known to function in muscle development, plasticity, and regeneration in other animals. We conclude that both muscle tissues and the endopinacoderm evolved from a common, multifunctional contractile tissue in the animal stem-lineage. Furthermore, as an actin-regulated force-sensor, MRTF-activity offers a mechanism for how water canals dynamically remodel in response to flow and can re-form normally from stem-cells in the absence of the intrinsic positional cues characteristic of embryogenesis in other animals.
Treatment and Survival Disparities of Colon Cancer in the Texas-Mexico Border Population: Cancer Disparities in Border Population

ABSTRACT Background Previous studies have reported healthcare disparities in the Texas-Mexico border population. Our aim was to evaluate treatment utilization and oncologic outcomes of colon cancer patients in this vulnerable population. Methods Patients with localized and regional colon cancer (CC) were identified in the Texas Cancer Registry (1995-2016). Clinicopathological data, hospital factors, receipt of optimal treatment, and overall survival (OS) were compared between Texas-Mexico Border (TMB) and the Non-Texas-Mexico Border (NTMB) cohorts. Multivariable analysis was performed to identify risk factors associated with decreased survival. Results We identified 43,557 patients with localized/regional CC (9% TMB and 91% NTMB). TMB patients were more likely to be Hispanic (73% versus 13%), less likely to have private insurance (13% versus 21%), were more often treated at safety net hospitals (82% versus 22%) and less likely at ACS-CoC accredited hospitals (32% versus 57%). TMB patients were more likely to receive suboptimal treatment (21% versus 16%) and had a lower median OS for localized (8.58 versus 9.58 y) and regional colon cancer (5.75 versus 6.18 y, all P Conclusions While TMB CC patients had worse OS, TMB status itself was not found to be a risk factor for decreased survival. This survival disparity is likely associated with higher rate of suboptimal treatment, Medicare/Uninsured status, and decreased access to ACS-CoC accredited hospitals.
Patient-Reported Care Coordination is Associated with Better Performance on Clinical Care Measures

Prior studies using aggregated data suggest that better care coordination is associated with higher performance on measures of clinical care process; it is unclear whether this relationship reflects care coordination activities of health plans or physician practices. Estimate within-plan relationships between beneficiary-reported care coordination measures and HEDIS measures of clinical process for the same individuals. Mixed-effect regression models in cross-sectional data. 2013 Medicare Advantage CAHPS respondents (n=152,069) with care coordination items linked to independently collected HEDIS data on clinical processes. Care coordination measures assessed follow-up, whether doctors had medical records during visits, whether doctors discussed medicines being taken, how informed doctors seemed about specialist care, and help received with managing care among different providers. HEDIS measures included mammography, colorectal cancer screening, cardiovascular LDL-C screening, controlling blood pressure, 5 diabetes care measures (LDL-C screening, retinal eye exam, nephropathy, blood sugar/HbA1c <9%, LCL-C<100 mg/dL), glaucoma screening in older adults, BMI assessment, osteoporosis management for women with a fracture, and rheumatoid arthritis therapy. For 9 of the 13 HEDIS measures, within health plans, beneficiaries who reported better care coordination also received better clinical care (p<0.05) and none of the associations went in the opposite direction; HEDIS differences between those with excellent and poor coordination exceeded 5 percentage points for 7 measures. Nine measures had positive associations (breast cancer screening, colorectal cancer screening, cardiovascular care LDL-C screening, 4 of 5 diabetes care measures, osteoporosis management, and rheumatoid arthritis therapy). Within health plans, beneficiaries who report better care coordination also received higher-quality clinical care, particularly for care processes that entail organizing patient care activities and sharing information among different healthcare providers. These results extend prior research showing that health plans with better beneficiary-reported care coordination achieved higher HEDIS performance scores.
Internal corporate restructuring

Abstract Firms that alter their divisional configurations on average increase shareholder wealth. Gains appear to come from information about investment opportunities and increases in efficiency. Performance before the restructurings suggests poorly organized firms are motivated by market pressures to change their organizations. Change also occurs in healthy firms as part of the growth process. Restructuring often occurs where there is no evidence of takeover threats. While stock prices increase around the restructurings, there is a contemporaneous decline in earnings due to increased expenses. These findings appear inconsistent with the contention that the market pressures managers into focusing on short-run earnings.
Heuristic algorithms for the fiber optic network expansion problem

We consider a network expansion problem for fiber optic networks. Given the network topology, edge costs, and node profit per period, the network is built over T periods due to limited budget available per period. The problem is to find edges to be added at each period so that their edge cost does not exceed the budget limit and the resulting network is connected, with the objective of maximizing profit over T periods. We first consider some special graphs: lines, cycles, and trees. Then we show that NEP is strongly NP?complete for general graphs, and present three heuristic algorithms and their performance analyses. Computational results show evidence that the simple greedy algorithm performs very effectively for finding a near optimal solution.
Real-time interharmonics detection and measurement based on FFT algorithm

The modern power systems are supplying an increasing number of non-linear loads like: double conversion systems, arc furnaces, arc discharging, high power Cycloconverter (CCV) etc. These loads are harmonics and interharmonics sources. Therefore, it is important to measure interharmonics accurately. The Fast Fourier Transform (FFT) is used for signal processing because of its computational efficiency. Most power quality meters and digital relays adopt FFT-Based algorithm to characterize harmonics of the measured signals. The International Electrotechnical Commission (IEC) standards on power quality have defined the terminology, limits and measurements guidelines for interharmonics. This paper shows effects on windowing in the interharmonics detection based on IEC technique. Simulations and experimental results based on the Real-time platforms are discussed.
Impact of statin use on survival in patients undergoing resection for early-stage pancreatic cancer.

OBJECTIVES It has been suggested that statins exert potential anti-tumor effects. The relationship between statin use and outcomes in pancreatic cancer is controversial. We hypothesized that statin use at baseline would impact survival among patients with early-stage pancreatic cancer and that the effect might vary by individual statin agent.
Active probes for on-wafer millimeter-wave network analysis

Emerging mm-wave and high-speed fiber-optic applications will demand signal and network instrumentation with bandwidths beyond 1O0 GHz. We have developed nonlinear transmission line (NLTL) pulse generators and NLTL-based sampling circuits with bandwidths exceeding 500 GHz. For on-wafer parameter and waveform measurements, we have constructed active probes incorporating an NLTL-based network analyser IC and rugged, low-loss quartz coplanar-waveguide probe tips. Measurements are made with a pulsed (NLTL) stimulus signal with frequency information obtained by Fourier transformation. On-wafer measurements have been demonstrated to 200 GHz. >
Membrane topology of the pBR322 tetracycline resistance protein. TetA-PhoA gene fusions and implications for the mechanism of TetA membrane insertion.

The tetracycline resistance gene of pBR322 encodes a 41-kDa inner membrane protein (TetA) that acts as a tetracycline/H+ antiporter. Based on hydrophobicity profiles, we identified 12 potential transmembrane segments in TetA. We used oligonucleotide deletion mutagenesis to fuse alkaline phosphatase (PhoA) to the C-terminal edge of each of the predicted periplasmic and cytoplasmic segments of TetA. In general, the PhoA activities of the TetA-PhoA fusions support a TetA topology model consisting of 12 transmembrane segments with the N and C termini in the cytoplasm. However, several TetA-PhoA fusions have unexpected properties. One PhoA fusion to a predicted cytoplasmic segment (C6) has high activity. However, previous protease accessibility studies on the related Tn10 TetA protein indicated that C6 is cytoplasmically localized as predicted (Eckert, B., and Beck, C. F. (1989) J. Biol. Chem. 264, 11663-11670). PhoA fusions to three predicted periplasmic segments (P1, P2, and P5) have low to intermediate activity. In each case, the preceding transmembrane segment (TM1, TM3, and TM9) contains an aspartate (Asp17, Asp86, and Asp287). We show that these aspartates act like signal sequence mutations for PhoA export: (i) Asp—-Ala mutations increase the PhoA activity of fusions to P1, P2, and P5. (ii) The signal sequence mutation suppressor prlA402 increases the PhoA activity of these same fusions. We also show that the aspartates in TM1, TM3, and TM9 are critical for wild-type TetA function; they are conserved in related TetA proteins and Asp—-Ala mutations reduce or eliminate tetracycline resistance. The properties of the anomalous TetA-PhoA fusions suggest that TetA sequences C-terminal to some cytoplasmic and periplasmic segments are required for the proper localization of those segments, i.e. long range interactions may be more important in determining the membrane topology of TetA than suggested in some general models.
A Survey of Consumers’ Perceptions Toward Medical Tourism (2012 Study)

This paper studies the factors that influence an American's decision to seek medical treatment outside the United States, known as "medical tourism." Street-intercept sampling was conducted in eight urban and rural locations in North Carolina in three stages between June 2010 and March 2012. Respondents provided 597 samples, which included socio-economic data and data about their attitudes toward medical tourism. By means of principal components analysis, the attitude data were reduced to three factors – risk, social-related, and vacation. The paper tests several hypotheses about Americans' motivation to use medical tourism by regressing these three factors to thirteen health-related, travel-related, and socio-economic variables. Among the paper's major findings are: (1) The Medicare recipients are more sensitive to risk factors than holders of other insurance types but they are less sensitive to social-related factors than their counterparts; (2) the middle income groups are more motivated by risk factors than the lower income or the higher income groups but they are less motivated by social-related factors than the two extreme income earners; (3) in contrast, the Blacks are less sensitive than other ethnic groups to risk factors but are more sensitive than others to social-related factors; (4) the older consumers are more likely than the younger ones to be motivated by social-related factors to travel for treatment, and surprisingly, the young adults are more motivated by risk factors than other older age groups; (5) the single respondents are less motivated by social-related factors to travel than other marital status; (6) the less educated consumers are less motivated by risk or social-related factors than the well-educated. Medical tourism has the potential to ease the strain on the healthcare systems of developed countries and to restrain healthcare inflation. How well it does this will depend on how policy makers address these factors.
Societal Membership, Score Status, and Game Behavior: A Phenomenological Analysis

Appartenance sociale, bilan relatif des gains acquis et comportement de jeu. Analyse phenomenologique. — Etude des preferences, des raisons et du comportement reel de choix de sujets belges et americains dans une tâche qui laisse la possibilite de se comporter cooperativement ou competitivement. La tâche utilisee est un jeu a somme non-nulle dont la matrice est structured de telle sorte que l'on puisse differencier deux objectifs parmi trois possibles : maximiser son propre gain (ou le gain conjoint des deux partenaires) ou bien maximiser la difference entre son propre gain et celui de l'autre. Les Auteurs ont compare 15 dyades de sujets belges et 15 dyades de sujets americains, jouant en 100 essais. Les resultats montrent que le choix reel des sujets est tres semblable d'une culture a l'autre et que, dans chaque culture, il varie selon que les gains deja acquis par un sujet sont superieurs, inferieurs ou egaux a ceux du partenaire, au moment du choix. Enfin, on note que, bien qu'aucune difference marquee n'apparaisse dans le comportement reel, il y a des differences sensibles d'une culture a l'autre dans les raisons invoquees par les sujets pour justifier leurs preferences : ces differences sont encore plus apparentes si on tient egalement compte de l'etat relatif des gains deja acquis par un sujet par rapport a son partenaire. En general, les sujets belges ont tendance a justifier leur preference pour la competition par des raisons de competition; les sujets americains, surtout quand ils ont l'avantage, par des raisons relatives a leur gain personnel. Cette derniere reaction est “irrationnelle” dans la presente tâche puisque la preference pour une attitude cooperative permet de maximiser son propre gain.
Old Ideas and New Investments: Divergent Pathways to a Knowledge Economy in Denmark and Finland

This article identifies and explains two very different pathways to a knowledge economy, based on investment in training in Denmark and research in Finland. The fact that these ostensibly similar countries have pursued such divergent strategies cannot be explained using the established literature on employer organization, labor power resources, and small states. This article develops and resolves this puzzle by focusing on the interaction among organized actors. It argues that nineteenth-century economic and geopolitical challenges generated two distinctive and enduring collective responses based on industry–labor cooperation in Denmark and state–industry cooperation in Finland. Those coalitions continue to shape the twenty-first-century experimentation, supporting investment in continuing education in Denmark and technological innovation in Finland. In explaining these differences, this article not only identifies an enduring and constructive role for strategic cooperation but also explains how it varies among ostensibly similar coordinated economies.
Extracellular microfibrils in vertebrate development and disease processes.

Fibrillins are large cysteine-rich glycoproteins that are evolutionarily conserved from scyphozoans to mammals. Fibrillin assemblies (microfibrils) serve two key physiological functions: the function of a structural support that imparts tissue integrity and the function of a regulator of signaling events that instruct cellular performance (1, 2). The importance of microfibrils in organ formation and tissue homeostasis was originally underscored by the finding that mutations of human fibrillin-1 and fibrillin-2 are responsible for the pleiotropic manifestations of MFS2 (OMIM 154700) and congenital contractural arachnodactyly (OMIM 121050), respectively (3). Fibrillins display a common modular structure that consists predominantly of cbEGF domains interspersed with TB/8-Cys modules (Fig. 1) (1, 2, 4). TB/8-Cys modules are unique to fibrillins and LTBPs. Fibrillins polymerize into microfibrils in which individual molecules are organized in a head-to-tail arrangement and interact laterally; furthermore, microfibrils associate or interact with additional proteins, such as elastin in elastic fibers (Fig. 2) (1, 2, 4, 5). Fibrillins also control the bioavailability of endogenous (local) TGFβ and BMP ligands by targeting the respective complexes to the ECM (Fig. 1) (1–3). FIGURE 1. Schematic representation of prototypical fibrillin and LTBPs (not in scale). Sites of interactions between fibrillin and TGFβ and BMP complexes are shown. For a detailed description of the structural features of fibrillins and LTBPs, see Hubmacher ... FIGURE 2. Diagram highlighting the main steps in microfibril biogenesis. They include the polymerization of fibrillins in a head-to-tail organization (step a) that is visualized by electron microscopy as multiple strings with regularly spaced beads (step b). ... This article focuses on the instructive function of fibrillin-rich microfibrils in organ development and tissue homeostasis. A number of excellent reviews are available that describe in greater detail the structural and biosynthetic aspects of fibrillin assemblies (2, 4, 5).
Antisense inhibition of P-glycoprotein expression using peptide-oligonucleotide conjugates.

Abstract Antisense oligonucleotides are potentially a powerful tool for the therapeutic manipulation of genes associated with cancer. However, pharmacological applications of oligonucleotides have been hindered by the inability to effectively deliver these compounds to their sites of action within cells. In this study, we have prepared peptide–oligonucleotide conjugates with the intent of improving intracellular delivery. The phosphorothioate oligonucleotide component of the conjugates was complementary to a site flanking the AUG of the message for P-glycoprotein, a membrane ATPase associated with multidrug resistance in tumor cells. Two types of peptide–antisense oligonucleotide conjugates, but not mismatched control conjugates, provided substantial inhibition of cell surface expression of P-glycoprotein. Surprisingly, the peptide–oligonucleotide conjugates were more potent in the presence of serum than when used under serum-free conditions; this is in striking contrast to most other approaches for intracellular delivery of nucleic acids. Effective inhibition of P-glycoprotein expression was attained with submicromolar concentrations of antisense conjugates under serum-replete conditions. The combination of relatively modest molecular size and good efficacy in the presence of serum proteins suggests that peptide–antisense oligonucleotide conjugates may have significant promise for in vivo therapeutic applications.
Facts and Myths in Protecting the Cloud

Facts and Myths in Protecting the Cloud Cloud computing is the new buzzword in the information technology field. How do organizations secure data that’s stored in the cloud? How safe is your information? Though cloud computing really is not a new technology, it has become more popular and an integral part of our technological life. What exactly is Cloud Computing? Some experts argue that cloud computing is anything used outside of a firewall, others define cloud computing as virtual servers available over the Internet. No matter the definition you choose, cloud computing is a way for organizations to increase capacity relatively quickly without the huge investments of infrastructure, software licensing and personnel training.
Macrophage phenotype as a predictor of constructive remodeling following the implantation of biologically derived surgical mesh materials [Acta Biomaterialia 8 (2012) 978–987]

The authors wish to add the following Disclosure:Dr. Badylak served on the advisory board to Cook Biotech, Inc. from 1995–1997 and also served on the advisory board to A Cell, Inc. until2005. Dr. Badylak receives no ﬁnancial gains for any of the products sold by either company. Dr. Badylak currently conducts sponsoredresearch for C.R. Bard, Inc.
Exploring interactions between saprotrophic microbes and ectomycorrhizal fungi using a protein–tannin complex as an N source by red pine (Pinus resinosa)

Summary • Recent studies suggest that some plants may circumvent N mineralization carried out by saprotrophs because their ectomycorrhizal fungi have the capacity to hydrolyse protein. When complexed by tannins, however, proteins may be unavailable to some ectomycorrhizal fungi. • Here we tested the hypothesis that when protein–tannin complex is the N source, Pisolithus tinctorius will promote N uptake into red pine (Pinus resinosa) only in the presence of saprotrophs. • The model protein–tannin complex was stable at field pH. P. tinctorius could not obtain N from it, but saprotrophs could. Pre-treatment of the complex by saprotrophs did make its N available to ectomycorrhizal fungi. However, when the protein–tannin complex was the major N source, P. tinctorius increased shoot P but not N content, even in the presence of saprotrophs. • Interactions between saprotrophs and ectomycorrhizal fungi may be different for N and P because of immobilization of N by ectomycorrhizal fungi, or by the more rapid diffusion of ammonium than phosphate, rendering the absorptive surface area of ectomycorrhizal fungi superfluous for uptake of N but not for P.