cssi/SciSciGPT-SciSciNet huggingface dataset:
Review of successful hospital readmission reduction strategies and the role of health information exchange.

Abstract Context The United States has invested substantially in technologies that enable health information exchange (HIE), which in turn can be deployed to reduce avoidable hospital readmission rates in many communities. With avoidable hospital readmissions as the primary focus, this study profiles successful hospital readmission rate reduction initiatives that integrate HIE as a strategy. We hypothesized that the use of HIE is associated with decreased hospital readmissions beyond other observed population health benefits. Results of this systematic review are used to describe and profile successful readmission reduction programs that integrate HIE as a tool. Methods A systematic review of literature provided an understanding of the use of HIE as a strategy to reduce hospital readmission rates. We conducted a review of 4,862 citations written in English about readmission reduction strategies from January 2006 to September 2016 in the MEDLINE-PubMed database. Of these, 106 studies reported 30-day readmission rates as an outcome and only 13 articles reported using HIE. Results Only a very small number (12%) of hospitals incorporated HIE as a primary tool for evidence-based readmission reduction initiatives. Information exchange between providers has been suggested to play a key role in reducing avoidable readmission rates, yet there is not currently evidence supporting current HIE-enabled readmission initiatives. Most successful readmission reduction programs demonstrate collaboration with primary care providers to augment transitions of care to existing care management functions without additional staff while using effective information exchange capabilities. Conclusions This research confirms there is very little integration of HIE into health systems readmissions initiatives. There is a great opportunity to achieve population health targets using the HIE infrastructure. Hospitals should consider partnering with primary care clinics to implement multifaceted transitions of care programs to significantly reduce 30-day readmission rates.
Tree Fruits and Nuts

The US tree fruit and nut crop production is centered in California, which serves as a model for tree fruit and nut agriculture worldwide. Over the past 30 years the California tree fruit and nut industry has shifted away from fresh market fruit crops to fruit and nut crops produced for processing as a result of changes in the food retail industry and domestic and international markets. The authors explore the impacts of external markets on competition among growers, opportunities for small growers, orchard management practices, and the availability of research and development programs. External markets, and environmental impacts associated with climate change, are likely to have a significant impact on tree fruit and nut agriculture in California over the next 100 years.
Tough salami-inspired C f /ZrB 2 UHTCMCs produced by electrophoretic deposition

Abstract One of the biggest challenges of the materials science is the mutual exclusion of strength and toughness. This issue was minimized by mimicking the natural structural materials. To date, few efforts were done regarding materials that should be used in harsh environments. In this work we present novel continuous carbon fiber reinforced ultra-high-temperature ceramic matrix composites (UHTCMCs) for aerospace featuring optimized fiber/matrix interfaces and fibers distribution. The microstructures – produced by electrophoretic deposition of ZrB 2 on unidirectional carbon fibers followed by ZrB 2 infiltration and hot pressing – show a maximum flexural strength and fracture toughness of 330 MPa and 14 MPa m 1/2 , respectively. Fracture surfaces are investigated to understand the mechanisms that affect strength and toughness. The EPD technique allows the achievement of a peculiar salami-inspired architecture alternating strong and weak interfaces.
Graduate Student Parents’ Perceptions of Resources to Support Degree Completion: Implications for Family Therapy Programs

This study explored graduate student parents’ perceptions about the usefulness of campus, community, and potential resources. The results indicated that graduate student parents placed the greatest...
The role of ACE inhibition in heart failure

In the early 1970s, ACE inhibition was viewed as an effective means to block the renin-angiotensin component contributing to the maintenance of vasoconstriction [1]. Earlier work had already demonstrated the activation of the renin angiotensin system (RAS) in decompensated congestive heart failure (CHF) [2, 3] and its implications in terms of increased hemodynamic burden to the failing heart. A pilot study using an angiotensin II (Ang II) receptor blocker, saralasin, in a short clinical experiment, demonstrated that Ang II blockade could successfully reverse the hemodynamic aberrations of decompensated CHF, while improving myocardial economy [4]. The decrease in myocardial oxygen consumption resulting from the fall in systemic vascular resistance was, paradoxically, accompanied by an increase in coronary blood flow, a fact that goes against the principles governing the regulation of coronary blood flow. This surprising observation was subsequently explained by the finding that the vasculature of vital organs (heart, kidney and brain) is particularly sensitive to the vasoconstrictive action of Ang II. Consequently, unlike other pharmacological vasodilators, RAS inhibition results in a preferential vasodilation of the coronary, renal and cerebral vasculature, thus maintaining or improving perfusion of vital organs, even in the face of falling systemic blood pressure [5, 6].
Evolution of 2.4-GHz wireless LANs

This chapter considers the recently successful IEEE 802.11b standard for high-performance wireless Ethernet and a proposed extension that provides for 22 Mbit/s transmission. IEEE 802.11 sets standards for wireless Ethernet or wireless local area networks. The chapter describes the history of the IEEE 802.11 standards and the market opportunities in the wireless Ethernet field. The chapter gives a brief description of the Medium Access Control (MAC) layer and then presents details about the physical layer methods, including coding descriptions and performance evaluations. The chapter also discusses the role and limitations of spread spectrum communications in wireless Ethernet. A comparison in terms of range versus rate with several alternatives is presented.
Mesothelial and Mesothelioma Cell Lines

Primary cultures of mesothelial cells have been established from rats, rabbits, mice, and humans (Table 5.1). Mesothelial cell lines provide several advantages for experimental studies: they provide a large number of cells isolated from a single donor, cell lines can be isolated from genetically engineered mice, and primary cell lines limit the number of animals required for experiments. However, cell lines have several disadvantages: variability among donors, variability in culture conditions in different laboratories, potential phenotypic and genetic instability, and a limited life span in vitro (reviewed in ref. 1). Some of these disadvantages can be overcome by quality control procedures. For example, cell lines should not be passaged indefinitely; frozen stocks should be maintained and thawed at regular intervals to prevent phenotypic and genetic instability (reviewed in ref. 2). As in all cell culture models, precautions are required to prevent cross-contamination and contamination with bacteria or viruses. DNA profiles could be useful to identify cell lines; for example Manning et al (3) established initial genetic profiles for their panel of human malignant mesothelioma cell lines. All cultures should be screened for Mycoplasma and other pathogens (2). Technical details regarding primary human mesothelial cell cultures have been summarized by Versnel et al (1) and Gerwin (4). Briefly, primary human mesothelial cells require enriched culture media supplemented with 10% to 20% fetal bovine serum, exogenous growth factors [usually epidermal growth factor (EGF)], insulin, transferrin, and hydrocortisone. Rabbit, mouse, and rat primary mesothelial cells require similar growth conditions, with the important exception that growth of rat pleural mesothelial cells is inhibited by EGF. As reviewed by Walker et al (5), there are additional differences in expression of growth factors and their receptors between human and rat mesothelial cells (6). Differences in growth factor responses have been described in primary human mesothelial cell cultures derived from different donors (7).
Vice and reason

Aristotle's account of vice presents a puzzle: (1) Viciouspeople must be guided by reason, since they act on decision(prohairesis), not on their non-rational desires. (2) And yet theycannot be guided by reason, since they are said to pay attention totheir non-rational part and not to live in accordance with reason. Wecan understand the conception of vice the reconciles these two claims,once we examine Aristotle's account of (a) the pursuit of the fine andof the expedient; (b) the connexion between vice and the pursuit ofpleasure; (c) the particular kind of regret to which the vicious personis subject.
Oral Post-Oral Actions of Low-Calorie Sweeteners: A Tale of Contradictions and Controversies

Objective Many scientists and laypeople alike have concerns about low-calorie sweeteners (LCSs). These concerns stem from both a dissatisfaction with the taste of LCSs and reports that they cause metabolic disruptions (e.g., weight gain, glucose intolerance). Methods This article provides a critical review of the literature on LCSs from the standpoint of their taste, gastrointestinal, and metabolic effects; biological fate in the body; and impact on ingestion and glucose homeostasis. Results and conclusions Mammals can readily discriminate between LCSs and sugars because both types of sweetener activate distinct oral and post-oral sensory pathways. LCSs differ in their ability to access post-oral tissues, but few studies have incorporated this observation into their design. It is difficult to extrapolate results between mice, rats, and humans because of interspecies differences in the taste and post-oral actions of LCSs and the fact that investigators often use different response measures in rodents and humans. There is confounding in the experimental design of some of the most widely cited studies of LCS-induced metabolic disruptions. The uncritical acceptance of these studies has generated considerable controversy. More work is needed to obtain a clearer understanding of the metabolic effects of LCSs.
Evaluation of a Polyurethane Platform for Delivery of Nanohydroxyapatite and Decellularized Bone Particles in a Porous Three-Dimensional Scaffold

The complex dynamic nature of bone tissue presents a unique challenge for developing optimal biomaterials within the field of bone tissue engineering. Materials based on biological and physiologica...
Long-Term Functional Outcomes of Glaucoma Tube Shunt Revision Surgery.

Purpose To characterize long-term outcomes of tube shunt revision surgeries and identify factors associated with their failure. Design Retrospective chart review. Participants One eye from each of 179 patients who underwent tube shunt revision surgery at the Wilmer Eye Institute between 2004 and 2015 with a minimum follow-up of 6 weeks. Methods Eligible eyes were identified from billing records and data related to their care were extracted from electronic medical records. Eyes were analyzed in aggregate and by indication for revision, including hypotony, high intraocular pressure (IOP), tube reposition, and tube exposure. Main Outcome Measures Surgical failure, defined as a need for further tube shunt revision or other glaucoma surgery, unsatisfactory IOP at last follow-up, or both. Secondary outcomes included postoperative infection and functional visual impairment. Results With a median follow-up of 4.2 years, 126 failures occurred among 179 eyes. By Kaplan-Meier analysis, the cumulative rates of surgical failure at 1, 2, and 5 years after revision were 49%, 59%, and 74%, respectively. Most revision failures (105/126) were the result of the need for additional surgery, whereas 11 eyes showed IOP above target levels and 10 eyes showed dysfunctionally low IOP at the last follow-up. Factors associated with failure in a stepwise regression model were revision for hypotony (hazard ratio [HR], 6.79; P = 0.002), different surgeons performing the original and revision surgeries (HR, 2.80; P = 0.002), longer duration of symptoms before revision (P = 0.01), revision of a right eye (HR, 1.92; P = 0.03), and presumed preoperative infection (HR, 2.47; P = 0.04). In univariate analysis, success varied significantly by prior surgeon (P = 0.01), but not by revision surgeon. There was a 16% cumulative incidence of postoperative infection, with the highest risk in those with presumed preoperative infections (P = 0.01) and in persons of non-African, non-European derivation (P = 0.03). Conclusions The estimated rate of failure of tube shunt revision is 75% by 5 years, most often because of a need for further surgery. The major potentially modifiable feature associated with success is tube shunt revision being performed by the original surgeon.
Disinfection Surveillance in Basic Level Medical Instifutions of Gongjing District,Zigong City

Objective To understand the disinfection condition of medical institutions in basic level so as to control the iatrogenic infection.Method Disinfection surveillance was conducted in individual clinics and village health-centers in Gong jing District.Result The disinfection qualified rate was 44.00%,in which the qualified rate of individual clinics was 56.82%,of village health-centers 40.83%.Conclusion The disinfection qualified rate is low in basic level medical instifutions of Gongjing District.Necessary management rules and regulations of disinfection showld be established and perfected and disifection surreillace be streng thened.
Numerical Methods for Event-Detection State Vector Simulation of Switched-Mode Power Supplies

This article presents a new method for the state vector simulation of switched-mode power supplies using decomposed matrices. With this method, switching instances are updated reliably from previously computed values, providing a highly efficient means for event-detection state vector simulation. The method is demonstrated on a 23rd-order state-space piecewise linear model of a boost converter with and without control feedback, resulting in up to $1000\times $ speedup of the simulation, relative to the same circuit simulated in LTspice or Piecewise Linear Electrical Circuit Simulation for Simulink (PLECS).
Making Young Voters: Converting Civic Attitudes into Civic Action

In 2016, 90% of young Americans reported an interest in politics. 80% intended to vote. Yet only 43% of people between the ages of 18 and 29 ended up actually casting a ballot. Making Young Voters investigates what lies at the core of this gap. The authors' in-depth, interdisciplinary approach reveals that political apathy is not the reason for low levels of youth turnout. Rather, young people too often fail to follow through on their political interests and intentions. Those with 'noncognitive' skills related to self-regulation are more likely to overcome internal and external barriers to participation. This book combines theory from psychology, economics, child development, and more to explore possible solutions rooted in civic education and electoral reform. This potentially paradigm-shifting contribution to the literature of American politics serves to influence not only our understanding of voter turnout, but also the fundamental connections between the education system, electoral institutions, and individual civic behavior in a democracy. How young people vote affects not only each individual future, but that of the United States, and of us all.
Ion Content of Polyelectrolyte Complex Coacervates and the Donnan Equilibrium

Oppositely charged polyelectrolytes in solution spontaneously associate into hydrated complexes or coacervates, PECs. The morphology, stability, and properties of PECs depend strongly on their ion ...
Individualized prediction of late-onset dysphagia in head and neck cancer survivors.

BACKGROUND Limited data exist regarding which head and head and neck cancer (HNC) survivors will suffer from long-term dysphagia. METHODS From a population-based cohort of 1901 Utah residents with HNC and ≥3 years follow-up, we determined hazard ratio for dysphagia, aspiration pneumonia, or gastrostomy associated with various risk factors. We tested prediction models with combinations of factors and then assessed discrimination of our final model. RESULTS Cancer site in the hypopharynx, advanced tumor classification, chemoradiation, preexisting dysphagia, stroke, dementia, esophagitis, esophageal spasm, esophageal stricture, gastroesophageal reflux, thrush, or chronic obstructive pulmonary disease were associated with increased risk of long-term dysphagia. Our final prediction tool gives personalized risk calculation for diagnosis of dysphagia, aspiration pneumonia, or gastrostomy tube placement at 5, 10, and 15 years after HNC based on 18 factors. CONCLUSION We developed a clinically useful risk prediction tool to identify HNC survivors most at risk for dysphagia.
Safety and Tolerability of Cannabidiol in Parkinson Disease: An Open Label, Dose-Escalation Study.

Background: Cannabis is increasingly used in Parkinson disease (PD), despite little information regarding benefits and risks. Objectives: To investigate the safety and tolerability of a range of do...
The Necessity of Using Changes in Absorption Time to Implicate Intestinal Transporter Involvement in Oral Drug-Drug Interactions

In drug discovery and development, it is of high interest to characterize the potential for intestinal drug-drug interactions to alter bioavailability of a victim drug. For drugs that are substrates of both intestinal transporters and enzymes, estimating the relative contribution of each process has proved challenging, especially since the susceptibility of drug to uptake or efflux transporters in vitro does not always translate to clinically significant in vivo involvement. Here we introduce a powerful methodology to implicate intestinal transporters in drug-drug interactions based on the theory that clinically relevant intestinal transporter interactions will result in altered rate of absorption of victim drugs. We present exemplary clinical drug-drug interaction studies that utilize well-characterized clinical substrates and perpetrators to demonstrate how mean absorption time (MAT) and time to maximum concentration (tmax) are expected to change (or remain unchanged) when either intestinal transporters or metabolic enzymes were/are altered. Apixaban was also selected to demonstrate the utility of the methodology, as the purported involvement of both intestinal enzymes and transporters has been suggested in its FDA package insert. Acute inhibition of gut efflux transporters resulted in decreased MAT and tmaxvalues, induction increased these values, while inhibition of intestinal metabolic enzymes did not result in altered MAT or tmax. Involvement of intestinal efflux transporters in apixaban disposition is unlikely. Utilization of this simple but powerful methodology to implicate intestinal transporter involvement will have significant impact on how drug-drug interactions are interpreted.
The Trauma Assessment

This chapter will teach you how to conduct a trauma assessment in accordance with EMT and EMR National Registry of Emergency Medical Technicians (NREMT) guidelines.
ROSflight: A Lean Open-Source Research Autopilot

ROSflight is a lean, open-source autopilot system developed with the primary goal of supporting the needs of researchers working with micro aerial vehicle systems. The project consists of firmware designed to run on low-cost, readily available flight controller boards, as well as ROS packages for interfacing between the flight controller and application code and for simulation. The core objectives of the project are as follows: maintain a small, easy-to-understand code base; provide high-bandwidth, low-latency communication between the flight controller and application code; provide a straightforward interface to research application code; allow for robust safety pilot integration; and enable true software-in-the-loop simulation capability.
Patients undergoing overlapping posterior single-level lumbar fusion are not at greater risk for adverse 90-day outcomes.

Abstract Objective This study evaluated overlapping surgery on long-term outcomes following elective, single-level lumbar fusion on exact matched patients undergoing surgery with or without overlap. Patients and Methods 3799 consecutive adult patients undergoing single-level, posterior-only lumbar fusion over a six-year period at a multi-hospital university health system were retrospectively followed. Reported outcomes included reoperation, emergency department (ED) visit, readmission, overall morbidity and mortality in the 90 days following surgery. Coarsened Exact Matching was used to match patients with and without overlap on key demographic factors. Patients were subsequently matched by both demographic data and by the attending surgeon performing the operation. Univariate analysis was carried out on the whole population, the demographic matched cohort, and demographic and surgeon matched cohort, with significance set at a p-value Results Patients with overlap had a longer duration of surgery and were less likely to have an ED visit within 90 days of surgery (p Conclusions Patients undergoing overlapping, single-level lumbar fusion were not at greater risk of long-term morbidity or mortality, despite having a significantly longer duration of surgery.
A Novel Therapeutic Target, BACH1, Regulates Cancer Metabolism

BTB domain and CNC homology 1 (BACH1) is a transcription factor that is highly expressed in tumors including breast and lung, relative to their non-tumor tissues. BACH1 is known to regulate multiple physiological processes including heme homeostasis, oxidative stress response, senescence, cell cycle, and mitosis. In a tumor, BACH1 promotes invasion and metastasis of cancer cells, and the expression of BACH1 presents a poor outcome for cancer patients including breast and lung cancer patients. Recent studies identified novel functional roles of BACH1 in the regulation of metabolic pathways in cancer cells. BACH1 inhibits mitochondrial metabolism through transcriptional suppression of mitochondrial membrane genes. In addition, BACH1 suppresses activity of pyruvate dehydrogenase (PDH), a key enzyme that converts pyruvate to acetyl-CoA for the citric acid (TCA) cycle through transcriptional activation of pyruvate dehydrogenase kinase (PDK). Moreover, BACH1 increases glucose uptake and lactate secretion through the expression of metabolic enzymes involved such as hexokinase 2 (HK2) and glyceraldehyde 3-phosphate dehydrogenase (GAPDH) for aerobic glycolysis. Pharmacological or genetic inhibition of BACH1 could reprogram by increasing mitochondrial metabolism, subsequently rendering metabolic vulnerability of cancer cells against mitochondrial respiratory inhibition. Furthermore, inhibition of BACH1 decreased antioxidant-induced glycolysis rates as well as reduced migration and invasion of cancer cells, suggesting BACH1 as a potentially useful cancer therapeutic target.
Retinal degeneration in mice and humans with neuronal ceroid lipofuscinosis type 8

Background Ceroid lipofuscinosis type 8 belongs to a heterogenous group of vision and life-threatening neurodegenerative diseases, neuronal ceroid lipofuscinosis (NCL). Effective therapy is limited to a single drug for treatment of ceroid lipofuscinosis type 2, necessitating animal disease models to facilitate further therapeutic development. Murine models are advantageous for therapeutic development due to easy genetic manipulation and rapid breeding, however appropriate genetic models need to be identified and characterized before being used for therapy testing. To date, murine models of ocular disease associated with ceroid lipofuscinosis type 8 have only been characterized in motor neuron degeneration mice. Methods Cln8-/- mice were produced by CRISPR/Cas9 genome editing through the International Mouse Phenotyping Consortium. Ophthalmic examination, optical coherence tomography, electroretinography, and ocular histology was performed on Cln8-/- mice and controls at 16 weeks of age. Quantification of all retinal layers, retinal pigmented epithelium, and the choriocapillaris was performed using images acquired with ocular coherence tomography and planimetry of histologic sections. Necropsy was performed to investigate concurrent systemic abnormalities. Clinical correlation with human patients with CLN8-associated retinopathy is provided. Results Retinal degeneration characterized by retinal pigment epithelium mottling, scattered drusen, and retinal vascular attenuation was noted in all Cln8-/- mice. Loss of inner and outer photoreceptor segment demarcation was noted on optical coherence tomography, with significant thinning of the whole retina (P=1e-9), outer nuclear layer (P=1e-9), and combined photoreceptor segments (P=1e-9). A global reduction in scotopic and photopic electroretinographic waveforms was noted in all Cln8-/- mice. Slight thickening of the inner plexiform layer (P=0.02) and inner nuclear layer (P=0.004), with significant thinning of the whole retina (P=0.03), outer nuclear layer (P=0.01), and outer photoreceptor segments (P=0.001) was appreciated on histologic sections. Scattered lipid vacuoles were noted in splenic red pulp of all Cln8-/- mice, though no gross systemic abnormalities were detected on necropsy. Retinal findings are consistent with those seen in patients with ceroid lipofuscinosis type 8. Conclusions This study provides detailed clinical characterization of retinopathy in adult Cln8-/- mice. Findings suggest that Cln8-/- mice may provide a useful murine model for development of novel therapeutics needed for treating ocular disease in patients with ceroid lipofuscinosis type 8.
Predictors of on-task Behaviors: Evaluating Student-level Characteristics.

Objective In this study, we examined students' fitness, body mass index (BMI), and demographics as predictors of observed time on-task (TOT) behaviors as an indicator of behavioral inattention. Methods We collected demographics, fitness estimates, and BMI from 2020 fourth-graders (Mean age = 8.6 (SD = 0.5); 47% girls; 49% white) from 28 schools. We measured TOT through momentary time sampling observations. Three-level linear models were conducted to determine whether characteristics predicted differences in TOT. We tested interactions between characteristics and TOT. Results Older students exhibited greater percent of TOT (estimate = 2.34, SE = 1.02, df = 919, t = 2.30, p .15). Conclusions Girls and older students spent more TOT. These findings are of interest to educators and psychologists working on the development of research-based guidelines aimed to support elementary students' engagement in the classroom.
Nicotine Increases Macrophage Survival through α7nAChR/NF-κB Pathway in Mycobacterium avium paratuberculosis Infection.

Recently, we reported that nicotine plays a role in the failure of the macrophage in the clearance of Mycobacterium avium subspecies paratuberculosis (MAP) during infection in Crohn’s disease smokers. We also demonstrated that nicotine enhances macrophages cellular survival during MAP infection. Blocking α7 nicotinic acetylcholine receptor (α7nAChR) with the pharmacological antagonist—mecamylamine—subverted the anti-inflammatory effect of nicotine in macrophages. Yet, it is still unknown how α7nAChR is involved in the modulation of the macrophage response during MAP infection. Here, we studied the mechanistic role of nicotine-α7nAChR interaction in modulating NF-ĸB survival pathway, autophagy, and effect on cathelicidin production in MAP-infected macrophages using THP-1 cell lines. Our results showed that nicotine upregulated α7nAChR expression by 5-folds during MAP infection compared to controls. Bcl-2 expression was also significantly increased after nicotine exposure. Moreover, Nicotine inhibited autophagosome formation whereas infection with MAP in absence of nicotine has significantly increased LC-3b in macrophages. Nicotine also further upregulated NF-ĸB subunits expression including Rel-B and p100, and increased nuclear translocation of p52 protein. We also discovered that cathelicidin production was significantly suppressed in MAP-infected macrophages, treatment with nicotine showed no effect. Overall, the study provides new insight toward understanding the cellular role of nicotine through α7nAChR/NF-ĸB p100/p52 signaling pathway in inducing anti-apoptosis and macrophage survival during MAP infection in Crohn’s disease smokers.
Analyzing the Role of Digital Communication Channels in Debt Collection

Recent changes in federal US regulations allowed debt collection agencies to expand their channels of communication from physical letters and phone calls only, to adopt digital communication channels including emails and SMS text messages. With changing demographics, debt collection companies stand to gain substantially if they can improve when and how they communicate with their account holders, both in driving more payments and in saving money through the reduced cost of the digital channels. This study explores the data provided by a leading debt collection agency on their debt holders. One of the key issues is that there is a limited understanding of the extent to which the new channels are affecting customer behaviors and payments in terms of frequency and timing. To answer these questions, we apply statistical models analyzing the impact of the various communication channels on the probability that a debtor pays and how much of their outstanding debt that they pay. Initial analysis is based on A/B testing of the various customer segments and whether their payment activity increased. We then draw insights on the channel and the timing of communication on the amount of revenue earned by the agency using an adstock-like model. Modeling communication is key to understand and better manage debt collection, increasing the likelihood of payment while indicating potential for saving costs and improve customer satisfaction.
Effect of Fragmented Care for Pediatric Rhabdomyosarcoma Patients

Background/Purpose: Pediatric rhabdomyosarcoma (RMS) patients undergo multi-modal, complex treatments and may be subject to fragmented care among different institutions and providers. For adult cancer patients, fragmented care has been associated with poor clinical outcomes. We hypothesized that fragmented care for pediatric RMS patients would confer inferior outcomes compared to consolidated care at one institution. Methods: We queried the …
Arrhythmogenic right ventricular cardiomyopathy in the pediatric population.

PURPOSE OF REVIEW Review the current state of the art of arrhythmogenic right ventricular cardiomyopathy (ARVC) diagnosis and risk stratification in the pediatric population. RECENT FINDINGS ARVC is an inherited cardiomyopathy characterized by progressive myocyte loss and fibrofatty replacement of predominantly the right ventricle and high risk of ventricular arrhythmias and sudden cardiac death (SCD). ARVC is one of the leading causes of arrhythmic cardiac arrest in young people. Early diagnosis and accurate risk assessment are challenging, especially in children who often exhibit little to no phenotype, even if genotype positive. Multimodal imaging provides more detailed assessment of the right ventricle and has been shown in pediatric patients to identify earlier preclinical disease expression. Identification of patients with ARVC allows the clinician to intervene early with appropriate exercise restrictions, even if genotype positive only without phenotypic expression. Emphasis should be placed on stratifying the patient's risk of ventricular arrhythmias and SCD. SUMMARY ARVC is a challenging diagnosis to make in adolescents who often do not exhibit clinical symptoms. Newer multimodal imaging techniques and improvements in genetic testing and biomarkers should help improve early diagnosis. Exercise restriction for children with ARVC has been shown to reduce disease advancement and decreases the risk of a life-threatening event.
Modeling Ultimate Reality: God, Consciousness, and Emergence

Three fundamental ideas from common experience have been developed metaphorically and philosophically in religious cultures to symbolize and facilitate human engagement of ultimate reality. These are: (1) the idea of the person, elaborated in assorted ways in theisms, (2) the idea of consciousness, elaborated variously in South Asian religions, and (3) the idea of spontaneous emergence of determinate changes from non-being, typical of East Asian thought. After sketching these developments, the paper presents a brief analysis of ultimate reality as an ontological creative act that cannot be modeled in any sense of one-to-one isomorphism. Then a theory of symbolic engagement is presented that shows how this ultimate reality can, under the right circumstances, be symbolized truly with the metaphors on personhood, consciousness, and spontaneous emergence.
Transitional Justice Globalized

Interest in transitional justice has surged in legal scholarship, in the human rights field generally and most notably in the domain of politics. ‘Transitional justice’ is an expression I coined in 1991 at the time of the Soviet collapse and on the heels of the late 1980’s Latin American transitions to democracy. In proposing this terminology, my aim was to account for the self-conscious construction of a distinctive conception of justice associated with periods of radical political change following past oppressive rule. Today we see that an entire field of inquiry, analysis and practice has ensued that reflects scholarly interest; the launching of this journal, the publication of books in a wide variety of related areas such as rule of law and postconflict studies, international centers and research institutes dedicated to work in this area, interest groups, conferences, domains,web sites, etc. One cannot help but be struck by the humanist breadth of the field, ranging from concerns in law and jurisprudence, to ethics and economics, psychology, criminology and theology.
Legal Protection of Software: A Survey

Publisher Summary This chapter surveys one of the most active areas in the rapidly evolving field of computer-related law: the legal protection of software. The chapter focuses on three important means of protecting intellectual property as it applies to software: copyright, patent, and trade secrecy. The chapter mentions the 1976 copyright act, which states that copyright protection subsists in original works of authorship, fixed in any tangible medium of expression, now known or later developed, from which they can be perceived, reproduced, or otherwise communicated, either directly, or with the aid of a machine or device. A patent is a grant of the right to exclude others from making, using, or selling one's invention, and includes the right to license others to make, use, or sell it. A trade secret is any formula, pattern, device, or compilation of information which is used in one's business, and which gives one a competitive advantage over those who do not know it. The chapter outlines the basic legal concepts and rules and provides some of the historical background needed to understand the current state of the law. The chapter summarizes the current state of the law and speculates on what the future might or should hold. The chapter discusses some of the unanswered questions as yet, concerning software protection.
Transient Stability and Frequency Response of the Us Western Interconnection Under Conditions of High Wind and Solar Generation

The addition of large amounts of wind and solar generation to bulk power systems that are traditionally subject to operating constraints set by transient stability and frequency response limitations is the subject of considerable concern in the industry. The US Western Interconnection (WI) is expected to experience substantial additional growth in both wind and solar generation. These plants will, to some extent, displace large central station thermal generation, both coal and gas-fired, which have traditionally helped maintain stability. This paper reports the results of a study that investigated the transient stability and frequency response of the WI with high penetrations of wind and solar generation. The main goals of this work were to (1) create a realistic, baseline model of the WI, (2) test selected transient stability and frequency events, (3) investigate the impact of large amounts of wind and solar generation, and (4) examine means to improve performance.
Leucine-Induced Amino Acid Antagonism in Rats: Muscle Valine Metabolism and Growth Impairment

The deleterious effects of branched-chain amino acid (BCAA) antagonism caused by excess dietary leucine include growth depression and subnormal valine and isoleucine pools. To investigate mechanisms causing these changes, rats were gavage-fed low-protein (9%) diets with or without BCAA supplements, and the metabolism of another BCAA (valine) was measured in incubated rat epitrochlearis muscles. A 10% leucine supplement (HL-10) inhibited growth; growth remained subnormal even when 2.6% isoleucine and 2.4% valine (HLIV-10) were added to the diet. Valine decarboxylation in muscle increased 170-270% in rats fed the HL-10 or HLIV-10 diets, but was still markedly lower than we previously found in muscle of rats fed a 14% protein diet. Valine incorporation into muscle protein as an estimate of protein synthesis was unaffected by any of the BCAA supplements. When a lower (4%) concentration of leucine (without or with 0.16% isoleucine and 0.16% valine) was studied, growth was also suppressed but only if rats had not been preconditioned to 9% protein. Although increased BCAA decarboxylation in muscle caused by excess dietary leucine contributes to low valine and isoleucine pools, abnormal growth appears to be independent of low valine and isoleucine levels and is not reflected in suppression of valine incorporation into muscle protein.
New carbon nanotube-epoxy composite for dampening microwave cavity resonance

We studied the dampening effect of multiwalled carbon nanotubes (MWNTs)-epoxy composite to microwave cavity resonance. Six groups of MWNT-epoxy composite samples with different MWNT outside-diameters (OD) were fabricated and tested. The weight percentages of MWNTs in each sample group were in the range of 1–10%. In general, the MWNTs with smaller outside-diameters had higher microwave dampening efficiency at 9.968 GHz than the larger ones. The SEM analysis and microwave measurements showed that the microwave dampening efficiency of the CNTs was also affected by the morphologies of MWNTs in individual bundles. A higher density of MWNTs in CNT bundles results in relatively lower efficiency in dampening the microwave fields at the central frequency of 9.968GHz.
Topographical distribution of bronchial eosinophilia: significance for biopsy diagnosis.

Field-by-field (0.324 × 0.09 μM) counts of eosinophils were applied to the lamina propria of cartilaginous bronchi from 47 Los Angeles and 22 Miami residents 11 to 30 years of age who died suddenly from violence. A highly variable topographical distribution was found that appeared to be due mainly to variations in confluent eosinophil-positive fields and “hot spots” (≥3 eosinophils per field). Since biopsy is the gold standard for the diagnosis of bronchial eosinophilia, there is a need to resolve the problem of non-uniformity. New measurements applicable to biopsy diagnosis are presented having potential usefulness for providing insight into the severity and topographical distribution of eosinophilia within bronchi that are the sites of biopsy. The additional finding of a 30.4% incidence of moderate to marked eosinophilia (>1.5 eosinophils/mm reticular basement membrane) suggests a high level of asthma or asthmatic-like disease in the young subjects of this study.
Congratulations to Akusticheskii Zhurnal on the occasion of its 50th anniversary. Vibrations of spherical inclusions in elastic solids

Variational principles are derived for the analysis of dynamical phenomena associated with spherical inclusions embedded in homogeneous isotropic elastic solids. The starting point is Hamilton’s principle, with the material properties assumed to vary only with the radial distance r from the origin. Attention is restricted to disturbances that are symmetric about the polar (z) axis, such that the nonzero displacement components in spherical coordinates, u r and u θ, are independent of the polar coordinate φ. The symmetry allows for a decoupling of the polar components, the nth of which is described by U r, n (r, t)P n (cosθ) and U θ, n (r, t)dP n /dθ. A variational principle is subsequently derived for the field quantities U r, n and U θ, n . Concepts analogous to those of the theory of matched asymptotic expansions are used to embellish the principle in order to allow for the damping associated with the outward radiation of elastic waves. Examples illustrating the use of the variational principle for formulating plausible lumped-parameter models are given for the cases of n = 0 and n = 1.
Enzyme Kinetics and Interaction Studies for Human JNK1β1 and Substrates Activating Transcription Factor 2 (ATF2) and c-Jun N-terminal kinase (c-Jun)

c-Jun N-terminal kinase (JNK) is a stress signal transducer linked to cell death, and survival. JNK1 has been implicated in obesity, glucose intolerance, and insulin resistance. In this study we report the kinetic mechanism for JNK1β1 with transcription factors ATF2 and c-Jun along with interaction kinetics for these substrates. JNK1β1 followed a random sequential mechanism forming a ternary complex between JNK-substrate-ATP. K(m) for ATF2 and c-Jun was 1.1 and 2.8 μM, respectively. Inhibition studies using adenosine 5'-(β,γ-methylenetriphosphate) and a peptide derived from JNK interacting protein 1 (JIP1) supported the proposed kinetic mechanism. Biolayer interferometry studies showed that unphosphorylated JNK1β1 bound to ATF2 with similar affinity as it did to c-Jun (K(D) = 2.60 ± 0.34 versus 1.00 ± 0.35 μM, respectively). The presence of ATP increased the affinity of unphosphorylated JNK1β1 for ATF2 and c-Jun, to 0.80 ± 0.04 versus 0.65 ± 0.07 μM, respectively. Phosphorylation of JNK1β1 decreased the affinity of the kinase for ATF2 to 11.0 ± 1.1 μM and for c-Jun to 17.0 ± 7.5 μM in the absence of ATP. The presence of ATP caused a shift in the K(D) of the active kinase for ATF2 to 1.70 ± 0.25 μM and for c-Jun of 3.50 ± 0.95 μM. These results are the first kinetic and biochemical characterization of JNK1β1 and uncover some of the differences in the enzymatic activity of JNK1β1 compared with other variants and suggest that ATP binding or JNK phosphorylation could induce changes in the interactions with substrates, activators, and regulatory proteins.
Communication dynamics in endogenous social networks

We develop a model of information exchange through communication and investigate its implications for information aggregation in large societies. An underlying state (of the world) determines which action has higher payoff. Agents decide which agents to form a communication link with incurring the associated cost and receive a private signal correlated with the underlying state. They then exchange information over the induced communication network until taking an (irreversible) action. We define asymptotic learning as the fraction of agents taking the correct action converging to one in probability as a society grows large. Under truthful communication, we show that asymptotic learning occurs if (and under some additional conditions, also only if) in the induced communication network most agents are a short distance away from "information hubs", which receive and distribute a large amount of information. Asymptotic learning therefore requires information to be aggregated in the hands of a few agents. We then provide a systematic investigation of what types of cost structures and associated social cliques (consisting of groups of individuals linked to each other at zero cost, such as friendship networks) ensure the emergence of communication networks that lead to asymptotic learning. Finally, we show how these results can be applied to several commonly studied random graph models, such as preferential attachment and Erdos-Renyi graphs.
Multiscale modeling and simulation of single-crystal MgO through an atomistic field theory

The present work is concerned with the application of an atomistic-continuum field theory (AFT) in modeling and simulation of crystalline materials. Atomistic formulation of the field theory and its finite element implementation are introduced. Single-crystal MgO under mechanical loading is modeled and simulated. With a coarse mesh, the field theory is shown to be able to simulate dynamic and nonlinear behavior of multi-atom crystalline materials without the need of additional numerical treatments. Reducing the finite element mesh to the atomic scale, i.e., the finite element size is equal to the size of the primitive unit cell, atomic-scale critical phenomena, including dislocations nucleation and motion, have been successfully reproduced.
Distinguishing bottom and turbidity current coarse layers on the continental rise

ABSTRACT The heavy mineralogy and texture of six sand layers from five cores taken on the lower continental rise off North Carolina were examined. Based upon megascopic criteria, two sand layer types were evident: relatively thick (> 10 cms), visibly graded sand layers and thinner, non-graded layers of fine sand or coarse silt. The former are assumed to be of turbidity current origin and the latter of bottom current origin. Turbidity coarse layers exhibit much greater vertical variability of both grain size and heavy mineralogy than bottom current sand layers. Plots of the percentages of stable versus unstable heavy minerals within sand fractions appear to be a particularly accurate means of determining coarse layer genesis. The results of this study indicate that megascopic criteria, which can be used in shipboard or laboratory core description, can be an adequate means of distinguishing the two types of layers. This should greatly facilitate study of the controversial problem of continental rise origin.
First-order effects of the Earth's oblateness upon coasting bodies

The Kustaanheimo-Stiefel transformation and perturbation techniques are employed in deriving approximate closed-form expressions for the trajectories of bodies coasting about an oblate Earth. The solutions are used to obtain Lambert type solutions which include oblateness effects.
Information exchange and use in small group decision making

This study examines information exchange and decision-making processes in small groups that interacted verbally orwitha group support system (GSS). Six-memberGSSand non-GSS groups worked to solve a...
Degradation of Cellulose During Mechanical Processing Part II: Action of Beaters on Cotton

Previous work [9] on the degradation of cotton during mechanical processing has been extended to include a study of the action of the pickers under various operating conditions. The results indicate that blade and carding beater types cause different amounts of degradation, that the amount of degradation caused by a very close setting can be differentiated from that due to wider spacings, and that the speed of rotation of the beater has a degradation effect which is detectable only after several passes—i.e., several consecutive picker operations. The effect of consecutive picker operations under similar conditions of the other variables is readily discernible.