cssi/SciSciGPT-SciSciNet huggingface dataset:
The Silent Epidemic: The Social, Ethical, and Medical Problems Surrounding the Fight against Hepatitis B

Hepatitis B is the "Russian Roulette" of diseases. A person who contracts hepatitis B can die quickly of fulminant hepatitis, or decades later of cirrhosis or cancer of the liver. If the hepatitis does not kill the individual it can drain away all his energy and leave him in a chronic state of malaise a state of never feeling healthy again; or it can leave him feeling perfectly fit, but a "carrier" of the disease for life capable of spreading it to those he cares about most. On the other hand, hepatitis may appear as a clearly defined, acute and self-limiting illness that comes, and then permanently goes, leaving the individual healthy and henceforth immune; indeed it may be so mild as to be unnoticed.1 The exact nature of hepatitis B, its causes, symptoms, effects and transmissions, long remained hidden from medical science. It was easily confused with other liver diseases, and only one route of transrnission was identified. Its pandemic nature was not even suspected. While the mystery ofthe disease was largely solved during the 1960's and 70's by scientific researchers,2 the public's ignorance ofthe disease has remained largely undispelled. The "silent epidemic" still remains basically without a voice outside of scientific and medical circles; this article will in part be concerned with why this disease has received so little public acknowledgement. Hepatitis B is a major disease in its own right, but it is also of significance because of its relationship to the AIDS crisis ofthe 1980's. In many ways the fight against hepatitis B can be seen as a dress rehearsal for the problems raised by AIDS. Many ofthe social, ethical and public health problems posed by the later epidemic first surfaced in the 1960's and 70's with regard to the transrnission and treatment of hepatitis B. The similarities between the two diseases are striking: 1) large numbers of lifetime carriers who can spread the disease but are incurable themselves; 2) the existence ofa test that can identify carriers but also exposes them to the danger of stigmatization, social and economic discrimination and psychological trauma; 3) transrnission (in the United States especially) primarily by sexual contact and blood exchange; 4) homosexuals, intravenous drug users and the non-white poor being prominent among the high risk groups; 5) health care workers who are, or are perceived to be, especially vulnerable to exposure; 6) suspected child carriers who are involved in heated public school controversies because of fears about "casual contact" transrnission and 7) the pandemic nature of the disease, with outbreaks throughout the world. Many of the arguments made and decisions reached concerning how to deal with these problems in relation to hepatitis B helped form precedents for dealing
Serious Illness Conversations With Doctors: Patients Using Information Obtained From Sources Other Than Their Doctors

ABSTRACTThe purpose of this study was to examine how people with serious illnesses communicate information they have acquired about their illness from the Internet and social or mass media to their doctors. Twenty-two in-depth interviews of patients with serious or life-threatening illnesses were conducted and analyzed. Street’s ecological perspective of communication was used to understand the processes that influence when and how patients bring information that they obtained from external sources to their doctors. The reactions patients received from their doctors affected their future communication with them. Results indicate doctors who have a dominant communication style often discourage patients from bringing outside information to them, and in some cases this results in patients changing doctors. On the other hand, doctors who are more attentive make patients feel more comfortable about bringing outside information to them, and this leads to more meaningful and beneficial conversations.
An Analysis of Framework of Economic Efficiency Based on the Division of Labourivision

In this paper the author points out that the division of labour is the basis of economic efficiency and that the technical efficiency of the division decides the potential residual rights, of which the formal ones, however, are determined by the institutional factor. As a result, a framework is given of analysis of economic efficiency based on the division of labour and the allocation of residual rights.
Varieties of Field Theory and the Sociology of the Non‐profit Sector

This paper reviews the use of field theory in the sociological study of the non-profit sector. The review first shows how field theory, as a conceptual framework to explain social action, provides a valuable sociological counterweight to prevailing economic and psychological orientations in the interdisciplinary scholarship on the non-profit sector. However, despite its certain shared assumptions, field theory in sociology encompasses three distinct, albeit interrelated, approaches: the Bourdieusian, New Institutionalist, and Strategic Action Fields perspectives. I comparatively outline the key analytical assumptions and causal claims of each version of field theory, whether and how it recognizes the specificity of the non-profit sector and then delineate its application by sociologists to the non-profit sector. I show how scholars' employment of each articulation of field theory to study non-profit activity has been influenced by pre-existing scholarly assumptions and normative claims about this third space. The article concludes by summarizing the use of these varieties of field theory in the sociology of the non-profit sector and by identifying future directions in this line of research.
Disorders of reproduction.

SUMMARY Human reproduction is an exceedingly complex process susceptible to insult at many stages. The targets of reproductive injury include the male and female worker as well as the conceptus. Because research into the reproductive and developmental effects of occupational exposures is relatively new, there are significant gaps in our knowledge of specific agents, their mechanisms of action, and their adverse effects. At the same time, workers increasingly are turning to their primary health care providers with concerns about potential reproductive hazards. Evaluation of patients includes identifying occupational agents with suspected reproductive or developmental effects, defining exposure parameters, and making estimates of risk based on the best available data. Management includes patient counseling and intervention to decrease hazardous exposures through workplace controls or temporary job transfers and leaves. By taking an occupational history, identifying possible work related problems, and making appropriate referrals, primary care physicians can have an important role in the diagnosis, treatment, and prevention of adverse reproductive outcomes.
Lower bounds to the ground-state expectation value of non-negative operators

A lower bound formula for the ground-state expectation value of a non-negative operator using an approximating trial function is generalized and presented as a matrix-eigenvalue problem which reverts to the original formula in the scalar case. The lower bound is applied to the hydrogen atom and the helium atom to show that significant improvement results from the generalization when the trial function is not of high quality. But as the quality of the trial function increases, data suggest the lower bounds from the generalized method converge to those of the original scalar formula.
Neuropsychological Assessment 1.0

This chapter examines neuropsychological assessment’s developmental history. There is a discussion of the progress of the neuropsychological assessment approaches from simple extensions of either physiological psychology or neurological examinations to contemporary development of the flexible test battery. Ultimately, this involved a review of the technologies used by neuropsychologists during a period referred to as Neuropsychological Assessment 1.0. After a brief summary of neuropsychology’s “prehistory,” there will be discussion of neuropsychological assessment following nineteenth-century medicine and physiology. Here, there will be a development of qualitative approaches and neuropsychological assessments as extensions of the neurological examination. Next, there will be a discussion of the ways in which measures from Neuropsychological Assessment 1.0 developed into the quantitative batteries that continue to be used today. Neuropsychological Assessment 1.0 as conceived herein reflects both standardization and technological shifts as opposed to psychometric rigor alone.
Historians, Authoritarian States and Spectator Sport, 1880–2020

Like all the major social theories of its era, socialism did not anticipate the explosion of sports activity that occurred in the latter half of the nineteenth century. During these years, the burgeoning working classes gained a measure of free time from their labors on the factory floor. They used this increased leisure in a variety of ways, including the playing and watching of sports. When workers took this time to relax, socialists hoped their pursuits would be rational and healthy. A number of groups on the left promoted sporting activities, but these efforts assumed a minor role in the activities of the various electorally successful socialist parties whose intellectual leaders were largely indifferent to the new trends that were entertaining so many workers.
Smart PV modules — Design considerations

This paper explores the design of a smart photovoltaic (PV) module- a PV module in which PV cells in close proximity are electrically grouped to form a pixel and are connected to dc-dc converter blocks which reside embedded in the back pane of the module. An auto-connected flyback converter topology processing less than full power is used to provide high gain and perform maximum power point tracking (MPPT). These dc-dc converters interface with cascaded H-bridge inverter modules operating on feed forward control for dc-link voltage ripple rejection. The proposed configuration is capable of producing 120V/ 240V AC voltage. The PV module now becomes a smart AC module by virtue of embedded intelligence to selectively actuate the individual dc-dc converters and control the output AC voltages directly, thus becoming a true plug and power energy system. Such a concept is ideal for curved surfaces such as building integrated PV (BIPV) system applications where gradients of insolation and temperature cause not only variations from PV module-to-PV module but from group-to-group of cells within the module itself. A detailed analysis along with simulation and experimental results confirm the feasibility of the proposed concept.
Reaching bandwidth saturation using transparent injection parallelization

Although logically available, applications may not exploit enough instantaneous communication concurrency to maximize network utilization on HPC systems. This is exacerbated in hybrid programming models that combine single program multiple data with OpenMP or CUDA. We present the design of a “multi-threaded” runtime able to transparently increase the instantaneous network concurrency and to provide near saturation bandwidth, independent of the application configuration and dynamic behavior. The runtime offloads communication requests from application level tasks to multiple communication servers. The servers use system specific performance models to attain network saturation. Our techniques alleviate the need for spatial and temporal application level message concurrency optimizations. Experimental results show improved message throughput and bandwidth by as much as 150% for 4 KB messages on InfiniBand and by as much as 120% for 4 KB messages on Cray Aries. For more complex operations such as all-to-all c...
MWPCR: Multiscale Weighted Principal Component Regression for High-dimensional Prediction

ABSTRACTWe propose a multiscale weighted principal component regression (MWPCR) framework for the use of high-dimensional features with strong spatial features (e.g., smoothness and correlation) to predict an outcome variable, such as disease status. This development is motivated by identifying imaging biomarkers that could potentially aid detection, diagnosis, assessment of prognosis, prediction of response to treatment, and monitoring of disease status, among many others. The MWPCR can be regarded as a novel integration of principal components analysis (PCA), kernel methods, and regression models. In MWPCR, we introduce various weight matrices to prewhitten high-dimensional feature vectors, perform matrix decomposition for both dimension reduction and feature extraction, and build a prediction model by using the extracted features. Examples of such weight matrices include an importance score weight matrix for the selection of individual features at each location and a spatial weight matrix for the incor...
Source to sink evaluation of sediment routing in the Gulf of Alaska and Southeast Alaska: A thermochronometric perspective

In this study, we present a source to sink evaluation of sediment routing at the glaciated convergent margin in Southeast Alaska. We investigate the efficacy of thermochronology to record spatial and temporal exhumation patterns in synorogenic sediment using Neogene strata drilled by Integrated Ocean Drilling Program Expedition 341 in the Gulf of Alaska. We present 1641 and 529 new detrital zircon and apatite fission track ages, respectively, from strata deposited on the continental shelf, slope, and deep-sea fans. These data are compared to results from the proposed source terrains, including the St. Elias Mountains and new data from the Alsek River. We find that the offshore Bagley-Bering sediment contains grains recording cooling ages much older (80–35 Ma) than those reported from the St. Elias syntaxis (3–2 Ma), indicating that extreme rapid exhumation does not extend west of the Seward-Bagley divide. Data from the sediment on the continental shelf, slope, and proximal deep sea all yield similar results, suggesting the same general source region since 1.2 Ma and limited sediment mixing along this glaciated margin. Data from sediment in the distal deep sea show that extreme, rapid, and deep-seated exhumation was ongoing at ~11–8 Ma. Overall, this study demonstrates the strengths and limitations of using detrital fission track thermochronology to understand sediment routing on a glaciated convergent margin and to record changes in exhumation rates over geologic time scales.
Fault Detection and Severity Analysis of Servo Valves Using Recurrence Quantification Analysis

This paper presents the application of recurrence plots (RPs) and recurrence quantification analysis (RQA) in model-based diagnostics of nonlinear systems. A detailed nonlinear mathematical model of a servo electro-hydraulic system has been used to demonstrate the procedure. Two faults have been considered associated with the servo valve including the increased friction between spool and sleeve and the degradation of the permanent magnet of the valve armature. The faults have been simulated in the system by the variation of the corresponding parameters in the model and the effect of these faults on the RPs and RQA parameters has been investigated. A regression-based artificial neural network has been finally developed and trained using the RQA parameters to estimate the original values of the faulty parameters and identify the severity of the faults in the system.
The Becoming of Essence

In the first section of this chapter, Hegel sublates the indifferent relation of the substrate to its states, and thus arrives at a new conception of being-for-itself. In the second section, he uses a specific example to illustrate why this is so. The consideration of this example illustrates that the specific qualities of the substrate are engulfed in an all-round contradiction . Consequently, the distinct qualities or factors of the substrate vanish along with the substrate itself. What remains is a negative unity in which the vanishing moments of being are merely related. The third section reiterates this point, and argues that “relativity” is the determination we find in the sphere of essence . This transition into essence concludes “The Doctrine of Being” in a rather lackluster manner.
HOMP: Automated Distribution of Parallel Loops and Data in Highly Parallel Accelerator-Based Systems

Heterogeneous computing systems, e.g., those with accelerators than the host CPUs, offer the accelerated performance for a variety of workloads. However, most parallel programming models require platform dependent, time-consuming hand-tuning efforts for collectively using all the resources in a system to achieve efficient results. In this work, we explore the use of OpenMP parallel language extensions to empower users with the ability to design applications that automatically and simultaneously leverage CPUs and accelerators to further optimize use of available resources. We believe such automation will be key to ensuring codes adapt to increases in the number and diversity of accelerator resources for future computing systems. The proposed system combines language extensions to OpenMP, load-balancing algorithms and heuristics, and a runtime system for loop distribution across heterogeneous processing elements. We demonstrate the effectiveness of our automated approach to program on systems with multiple CPUs, GPUs, and MICs.
Radiation therapy for rectal cancer

Radiation therapy plays an important role in the management of patients with rectal cancer. Radiation therapy can improve local control and increase sphincter preservation rates. Preoperative chemoradiation and preoperative short course radiotherapy are now considered standards of care for appropriate rectal cancer patients. Specific radiation therapy techniques such as reirradiation and intraoperative radiation therapy may also improve outcomes in selected patients with rectal cancer. This chapter will discuss the various roles of radiation therapy for rectal cancer and review modern approaches for radiation therapy delivery.
Data volume analysis of a 100+ Gb/s LEO-to-ground optical link with ARQ

Space-based optical links can, in principle, support high data rates by using power efficient communication schemes and unconstrained spectrum. In particular, direct links from low-Earth orbit (LEO) to ground have the potential to support very high rates due to the short link distances involved. In this work, we consider an architecture for LEO-to-ground links that operate at peak rates of 100+Gb=s. Such rates are routinely achieved over fiber channels using power-efficient, fiber-coupled transceivers; however, free-space systems that use these devices may need additional error control to ensure reliable communication over an atmospheric channel. We analyze the data volume, or throughput, that can be delivered by a LEO-to-ground system using fiber-coupled transceivers in conjunction with automatic repeat request (ARQ) protocols. We show that many terabytes per day can be delivered error-free from LEO to a single ground terminal for a variety of orbit and ground terminal geometries.
Comparison of adult spinal deformity patients with and without rheumatoid arthritis undergoing primary non-cervical spinal fusion surgery: a nationwide analysis of 52,818 patients.

Abstract Background Context Numerous studies have analyzed the impact of rheumatoid arthritis (RA) on the cervical spine and its related surgical interventions. However, there is a paucity of literature available conducting the same analyses in patients with non-cervical spine involvement. Purpose The objective of this study was to compare patient characteristics, comorbidities, and complications in patients with and without RA undergoing primary non-cervical spinal fusions. Study Design/Setting This is a retrospective national database review. Patient Sample A total of 52,818 patients with adult spinal deformity undergoing non-cervical spinal fusions (1,814 patients with RA and 51,004 patients without RA). Outcome Measures The outcome measures in the study include patient characteristics, as well as complication and mortality rates. Materials and Methods Using the Nationwide Inpatient Sample from 2003 to 2014, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis and procedure codes were used to identify patients aged ≥18 years old with and without RA undergoing primary non-cervical spinal fusions. Univariate analysis was used to determine patient characteristics, comorbidities, and complication values for each group. Bivariate analysis was used to compare the two groups. Significance was set at p Results Patients with RA were older (p Conclusions Patients with RA have an increased number of comorbidities and complication rates compared with patients without RA. Such knowledge can help surgeons and patients with RA have beneficial preoperative discussions regarding outcomes.
The role of electron heating physics in images and variability of the Galactic Centre black hole Sagittarius A

The accretion flow around the Galactic Center black hole Sagittarius A* (Sgr A*) is expected to have an electron temperature that is distinct from the ion temperature, due to weak Coulomb coupling in the low-density plasma. We present four two-temperature general relativistic radiative magnetohydrodynamic (GRRMHD) simulations of Sgr A* performed with the code KORAL. These simulations use different electron heating prescriptions, motivated by different models of the underlying plasma microphysics. We compare the Landau-damped turbulent cascade model used in previous work with a new prescription we introduce based on the results of particle-in-cell simulations of magnetic reconnection. With the turbulent heating model, electrons are preferentially heated in the polar outflow, whereas with the reconnection model electrons are heated by nearly the same fraction everywhere in the accretion flow. The spectra of the two models are similar around the submillimetre synchrotron peak, but the models heated by magnetic reconnection produce variability more consistent with the level observed from Sgr A*. All models produce 230~GHz images with distinct black hole shadows which are consistent with the image size measured by the Event Horizon Telescope, but only the turbulent heating produces an anisotropic `disc-jet' structure where the image is dominated by a polar outflow or jet at frequencies below the synchrotron peak. None of our models can reproduce the observed radio spectral slope, the large near-infrared and X-ray flares, or the near-infrared spectral index, all of which suggest non-thermal electrons are needed to fully explain the emission from Sgr A*.
From precarious work to obsolete labour? Implications of technological disemployment for geographical scholarship

The displacement of jobs via mechanization and automation has long been understood as uncomfortable for labourers but also an intrinsic part of a process of ‘creative destruction’ leading to furthe...
Testicular granulomatous vasculitis mimicking testicular torsion in an anti-neutrophil cytoplasmic antibody-associated vasculitis patient.

Testicular vasculitis is uncommon and can be easily misdiagnosed. Early identification and treatment are essential for patient care. A 63-year-old man, presenting with testicular pain and swelling,...
Transplant Outcomes and Toxicities Are Associated with Changes in Relative Abundance, Diversity and Richness of the Oral and Gastrointestinal Microbiome during Autologous Transplantation for Multiple Myeloma: Results of a Prospective Pilot Study

We conducted a prospective study to determine the longitudinal microbial profile in patients undergoing HCT for multiple myeloma (MM), and whether changes in microbial composition correlate with HCT outcomes and/or toxicities. Samples were collected from 15 patients at baseline (T-2), during marrow aplasia (T+7) and after engraftment (T+30). Ion-Torrent PGM workflow was used. Amplicons generated from 16s rRNA and the ITS genes were sequenced for bacterial and fungal identification, respectively. Relative abundance, diversity and richness were determined at the phylum and genus levels at each time point, in oral and fecal microbiome. Diversity and richness of the oral mycobiome decreased at T+7 from baseline with further decrease noted at T+30. Fecal mycobiome diversity (T-2 vs T+7, p=0.05) and richness decreased from baseline to T+7, and richness trended towards significance (p=0.06) with further decrease at T+30. In fecal samples, lower bacterial diversity at T+7 associated with more severe diarrhea (p= 0.03). Anaerobic targeting antibiotic exposure on or before T+7 affected the bacterial genus diversity (p=0.015) and richness at T+7 (p=0.014). The bacterial genus richness at baseline (p=0.03) and the diversity/richness at T+7 (p=0.01) were associated with fever development on or after T+7. Exposure to anaerobic depleting antibiotics correlated with oral mycobiome genus richness at T+30 (p=0.04). At the bacterial phylum level, the oral community composition changed at T+30 compared to baseline (Bray-curtis p=0.046) and T+7 (Bray-curtis p=0.025). When examining the changes in the mycobiome composition, test for dissimilarity showed a significant difference in the fecal fungal genus between baseline and T+30 (BrayPA p=0.025). In fecal samples, a higher abundance of Bacteriodetes present at T+7 was associated with the severity of diarrhea experienced (p=0.03). Blautia and Ruminococcus, both belonging to the Firmicutes phylum and Clostridium Class, when detected at T+7 were associated with a higher severity of vomiting (p=0.05). In oral samples, the presence of the genus Glomerella at T+7 was negatively associated with rates of neutrophil engraftment (p=0.03). Our results show that oral and fecal microbiota undergo dynamic changes in diversity, composition and relative abundance during the course of transplantation. Bacterial and fungal microbiota present specifically at count nadir could be important players. The relative abundance of particularly the anaerobic bacterial phyla, Bacteroidetes and Firciumtes during marrow aplasia, correlated with post transplant toxicities. We identified a correlation between exposure to anaerobic organism depleting antimicrobials and changes in genus diversity and richness. Baseline microbial diversity/richness and changes coinciding with marrow aplasia correlate with the incidence and severity of post transplant toxicities.
Sources of metals in atmospheric particulate matter in Tehran, Iran: Tree bark biomonitoring

Abstract Chemical and Pb isotopic compositions of pine tree bark and atmospheric PM samples from urban areas in Tehran, Iran, are reported. We used tree bark biomonitoring to determine the spatial distribution of metals and to identify the principal sources of Pb and other toxic metals in the atmosphere of Tehran. Concentrations of major and trace elements in all urban samples are higher than their respective values in the background sample. We calculated the enrichment factors (EF) of analyzed metals to assess the pollution levels. The range of EF values in our samples indicate that Pb, Zn, Mo, and Cd are moderately to severely enriched compared to background with EF values ranging from 2 to >10, while V, Cr, Co, Ni, Fe, Mn, Ti, Sr, and Nd display minimal enrichments (EFs less than 3 for most samples). In general, higher levels of metal contamination are observed in the southern and southeastern areas of Tehran. The Pb isotopic compositions show a wide range (206Pb/204Pb from 17.490 to 18.437 ± 0.015 and 208Pb/204Pb from 37.289 to 38.455 ± 0.063), and display a well-defined two component mixing array in Pb isotope plots, consistent with mixing between the natural background dust and an unradiogenic source inferred to be traffic-related emissions. However, in 208Pb/207Pb versus Pb (N), 208Pb/207Pb versus 1/Pb (N), and 206Pb/204Pb versus 1/Pb plots our data do not fall along binary mixing lines, but rather fall within multi-component mixing envelopes. Most of these variations are explained by three endmember mixing between Arabian dust, cement factory and/or oil refinery, and traffic-related emissions.
Multiarm star polymers based on thiol–ene photoclick cyclodextrin cores

Highly efficient synthesis of multifunctional initiators based on cyclodextrin (CD) cores was achieved by a thiol–ene photoclick strategy. Different from existing approaches, the method reported here uses a thiol containing an ATRP initiating moiety to enable rapid and complete multivalent functionalization of the primary and secondary faces of α-, β-, and γ-CDs. The photoclick CD cores were attained in high yield through simple purification. They were successfully employed in a “core-first” approach to prepare well-defined multiarm star polymers via ATRP.
Genetic variation and admixture of red-eared sliders (Trachemys scripta elegans) in the USA.

Abstract The most ubiquitous, abundant, and invasive turtle on Earth, Trachemys scripta elegans (TSE, “red-eared slider”), is one of four taxa in a clade that is native to the USA and adjacent Mexico (three subspecies of Trachemys scripta plus Trachemys gaigeae). The present range-wide study of this clade is based on 173 known-locality mtDNA sequences combined with ddRAD libraries for 43 samples emphasizing the western part of the range of TSE, its contact with that of T. gaigeae, and anthropogenic hybrids between TSE and T. s. scripta. The data presented here are the first to sample the TSE × T. s. scripta intergrade zone or TSE × T. s. scripta crosses from introduced turtles. In the western part of its range (New Mexico and Texas), most samples of TSE from the Pecos River have mtDNA haplotypes matching T. gaigeae. Structure analysis of SNPs from the ddRAD show evidence of genetic admixture between T. gaigeae and TSE in all included samples from the Rio Grande and Pecos River. These populations also exhibit T. gaigeae-like head stripes, i.e., a postorbital marking that does not reach the eye. The genetic and morphological data are thereby reconciled, as both suggest that these TSE are intergrades. We recommend that these populations continue to be considered TSE, despite the admixture with T. gaigeae. In the Eastern United States, some samples of the morphologically intermediate subspecies T. s. troostii are not genetically distinct from TSE and some samples share morphological characters and genetic affinities with T. s. scripta. Based on these observations we conclude that the taxon T. s. troostii represents intergrades between TSE and T. s. scripta and should not be considered a valid taxon. Near the already established part of the intergrade zone between TSE and T. s. scripta, TSE mtDNA haplotypes have naturally introgressed into typical-looking samples of T. s. scripta in Georgia. Hybrids between introduced TSE and T. s. scripta are also confirmed deeper within the natural range of T. s. scripta in South Carolina and Virginia. Given the examples of feral hybrids deep within its range shown here and elsewhere, the threat of genetic pollution of T. s. scripta by feral TSE is established.
Research to Resource: Evidence-Based Strategies for Improving Wind Intonation:

Intonation is one of the most challenging performance elements for developing wind instrumentalists. There is a need to provide in-service band directors with evidence-based instructional strategie...
Racial Differences in Contraception Encounters and Dispensing Among Female Medicaid Beneficiaries with Systemic Lupus Erythematosus

OBJECTIVE African American and Hispanic women with systemic lupus erythematosus (SLE) have the highest rates of potentially avoidable pregnancy complications, yet racial disparities in family planning among reproductive-age women with SLE have not been well-studied. Our objective was to examine whether there are racial differences in contraception encounters and dispensing among US Medicaid-insured women with SLE. METHODS Using Medicaid claims data from 2000-2010, we identified women ages 18-50 years with SLE. We examined contraception encounters and uptake over 24 months. We used multivariable logistic regression to estimate the odds ratio and 95% confidence interval by race/ethnicity of contraception encounters, any contraception dispensing, and highly effective contraception (HEC) use, adjusted for age, region, year, SLE severity, and contraindication to estrogen. We also compared contraception encounters and dispensing among women with SLE to the general population and women with diabetes mellitus. RESULTS We identified 24,693 reproductive-age women with SLE; 43% were African American, 35% White, 15% Hispanic, 4% Asian, 2% other race, and 1% American Indian/Alaska Native. Nine percent had a contraceptive visit, 10% received any contraception, and 2% received HEC. Compared to White women, African American and Asian women had lower odds of contraception dispensing, and African American women had lower odds of HEC use. Women with SLE were more likely to receive HEC than the general population and women with diabetes mellitus. CONCLUSION In this study of reproductive-age women with SLE, African American and Asian women had lower odds of contraception dispensing and African American women had lower odds of HEC use. Further study is needed to understand the factors driving these racial disparities among this population.
Medical, nursing, and physician assistant student knowledge and attitudes toward climate change, pollution, and resource conservation in health care

Climate change and pollution generated by the health care sector impose significant public health burdens. This study aimed to assess medical, nursing and physician assistant student knowledge and attitudes regarding climate change, pollution from the health care sector, and responsibility for resource conservation within professional practice. In February–March, 2018, medical, nursing, and physician assistant students at Yale University (1011 potential respondents) were sent a 17-question online Qualtrics survey. Data analysis included descriptive statistics, as well as Fisher’s exact test and logistic regression to assess associations between variables of interest and the personal characteristics of gender, age, geographic place of origin, school, and year in school (among medical students). The response rate was 28% (280 respondents). 90% felt that physicians, nurses, and physician assistants have a responsibility to conserve resources and prevent pollution within their professional practice. 63% agreed or strongly agreed that the relationship between pollution, climate change, and health should be covered in the classroom and should be reinforced in the clinical setting. 57% preferred or strongly preferred reusable devices. 91% felt lack of time and production pressure, and 85% believed that lack of education on disease burden stemming from health care pollution, were barriers to taking responsibility for resource conservation and pollution prevention. Women and physician assistant students exhibited a greater commitment than men and medical students, respectively, to address pollution, climate change, and resource conservation in patient care and professional practice. We found that health professional students are engaged with the concept of environmental stewardship in clinical practice and would like to see pollution, climate change, and health covered in their curriculum. In order for this education to be most impactful, more research and industry transparency regarding the environmental footprint of health care materials and specific clinician resource consumption patterns will be required.
Assessment of hospitalization rates for immune-related adverse events with immune checkpoint inhibitors.

IntroductionImmune checkpoint inhibitors (ICIs) have become the standard of care in many cancer types. As the number of patients receiving ICIs for various cancers continues to expand, patients and...
Feasibility and Acceptability of mHealth Interventions for Managing Hyperphosphatemia in Patients Undergoing Hemodialysis.

Objective The objective of the study was to evaluate the feasibility and acceptability of mobile health (mHealth) phosphorus management programs in hemodialysis (HD) patients. Methods Patients receiving thrice-weekly HD who had 3-month average serum phosphorus of >5.5 mg/dL were randomized to one of the three self-directed phosphorus management programs delivered using tablet PCs: (1) educational videos and handouts (Education), (2) education intervention plus mobile self-monitoring with email feedback (Monitoring), or (3) education and monitoring interventions plus social cognitive theory–based behavioral videos (Combined). Feasibility and acceptability were assessed based on enrollment and retention and training needs (feasibility) and adherence to self-monitoring and reported satisfaction (acceptability). Results Of 312 patients, 56 expressed interest, and 40 were enrolled. The majority of participants (80%) completed the 6-month study; none withdrew for intervention-related reasons. The Monitoring and Combined groups received 44 ± 15 minutes of technology training, which was considered adequate by most (75%). Self-monitoring rates were initially high, with 78% and 71% of the participants recording at least one meal and phosphate binder in week 1, respectively, but decreased over time to 15% and 9% in the final week. Most participants reported that self-monitoring helped them stay motivated (64%), track nutrients (80%), and understand how to change diet (76%), and nearly two-thirds of participants (64%) stated that they would like to continue using the tablet PC to manage their health. However, few participants (16%) indicated that self-monitoring was worth the effort. The Monitoring and Combined groups did not differ from the Education group in study outcomes. Conclusion Although the mHealth programs were generally well received, self-monitoring rates decreased substantially over time and were unaffected by social cognitive theory-based videos. Self-directed mHealth programs may be a useful adjunct to standard care but should be compared to more resource intensive programs (e.g., involving more "live" contact with a dietitian) to determine overall cost-effectiveness and role in HD care.
Personal value, self-efficacy, and social acceptability of a social behavior as correlates of behavioral action in social anxiety.

Abstract Introduction Current therapies for social anxiety disorder emphasize taking behavioral action; active engagement of a behavior despite any present fear or anxiety that is associated with the behavior, through use of exposures. However, less is known about the mechanisms of behavioral action. The present study aimed to examine personal value, self-efficacy, and the perceived social acceptability of a social behavior as correlates of behavioral action in a high social anxiety sample. Method The present study utilized vignettes and self-report measures to examine self-efficacy, personal value, and the social acceptability of a social behavior as correlates of behavioral action in a high social anxiety sample (N = 92). Results The findings indicated that self-efficacy, but not personal value or social acceptability, was significantly associated with social anxiety. Additionally, with all variables included in the multiple regression model, social anxiety was significantly associated with behavioral action, while personal value and self-efficacy were associated with behavioral action over and above social anxiety. Discussion The results highlight the potential for self-efficacy and personal value as target mechanisms for increasing engagement with exposures and behavioral experiments in treatments for social anxiety.
For Better or Worse? The Economic Implications of Paid Sick Leave Mandates

Public calls for a national paid sick leave policy continue to grow in the United States. In the absence of a federal policy, many localities and states enacted their own paid sick leave mandates. We document an average increase of 1.9% in employment following the implementation of a paid sick leave policy. As predicted, workers with ex ante lower access to paid sick leave drive the employment effect, a result which holds with county-quarter fixed effects. Several non-mutually exclusive mechanisms can explain our findings. Following the implementation of a mandatory paid sick leave policy, we find a decline in labor turnover which has implications for labor productivity and, hence, labor demand. We also find results consistent with an increase in the labor supply. Finally, paid sick leave mandates are associated with an increase in household income, creating positive spillover effects on local markets and greater demand for local goods and services.
Constructability Reviews Utilization Practices for Traditional and Alternative Project Delivery Methods Across State Transportation Agencies

State Transportation Agencies (STAs) recognized that to enhance the quality of construction documents, a review process must be incorporated into project planning, design, and procurement to evalua...
The impact of industry on oncology research and practice

Public scrutiny has increased over potential conflicts of interest among oncology researchers and providers. Given the increased prevalence and complexity of industry relationships, oncologists are...
Reciprocal regulation of polarized cytokine production by effector B and T cells.

Although B cells produce cytokines it is not known whether B cells can differentiate into effector subsets that secrete polarized arrays of cytokines. We have identified two populations of "effector" B cells (Be1 and Be2) that produce distinct patterns of cytokines depending on the cytokine environment in which the cells were stimulated during their primary encounter with antigen and T cells. These effector B cell subsets subsequently regulate the differentiation of naive CD4+ T cells to TH1 and TH2 cells through production of polarizing cytokines such as interleukin 4 and interferon gamma. In addition, Be1 and Be2 cells could be identified in animals that were infected with pathogens that preferentially induce a Type 1 and Type 2 immune response. Together these results suggest that, in addition to their well defined role in antibody production, B cells may regulate immune responses to infectious pathogens through their production of cytokines.
Computational Modeling and Experimental Characterization of Martensitic Transformations in Nicoal for Self‐Sensing Materials

Fundamental changes to aero-vehicle management require the utilization of automated health monitoring of vehicle structural components. A novel method is the use of self-sensing materials, which contain embedded sensory particles (SP). SPs are micron-sized pieces of shape-memory alloy that undergo transformation when the local strain reaches a prescribed threshold. The transformation is a result of a spontaneous rearrangement of the atoms in the crystal lattice under intensified stress near damaged locations, generating acoustic waves of a specific spectrum that can be detected by a suitably placed sensor. The sensitivity of the method depends on the strength of the emitted signal and its propagation through the material. To study the transition behavior of the sensory particle inside a metal matrix under load, a simulation approach based on a coupled atomistic-continuum model is used. The simulation results indicate a strong dependence of the particle’s pseudoelastic response on its crystallographic orientation with respect to the loading direction and suggest possible ways of optimizing particle sensitivity. The technology of embedded sensory particles will serve as the key element in an autonomous structural health monitoring system that will constantly monitor for damage initiation in service, which will enable quick detection of unforeseen damage initiation and progression in real-time and during on-ground inspections.
Image Loci are Ridges in Geometric Spaces

In this paper, we show that most interesting features in an image, such as boundaries and skeletons, are height ridges in an extended Euclidean space, the extension parameters being directions and aperture. We define the notion of a height ridge and show how height ridges have been used by other authors. We also provide a catalog of useful variations of the basic definition. We then show the generic behavior of the maximal convexity form of ridge and its generic transitions in one parameter families. Finally, we discuss connectors, an extension to such ridges.
Boundary value problems in transport with oblique and mixed derivative boundary conditions: More on steady state solutions

Abstract Boundary value problems involving oblique or mixed second derivative boundary conditions[1,3] arise in the description of heat (or mass) transfer in stationary media which are peripherally cooled (or leached) by a fluid in which the temperature (or concentration) is varying significantly in the direction of flow. By decomposing the energy equation into a pair of first order systems Ramkrishna and Amundson have shown[1] how the originally non-selfadjoint boundary value problems can be reduced to selfadjoint problems. The foregoing decomposition allows for an elegant analytical solution of the boundary value problems which is also numerically efficient. This paper relaxes certain redundant constraints imposed earlier on the method of solutions[1] and demonstrates the power of the method by actual numerical calculations for a constant heat source function.
Trends in cell phone voice processing

Some of the significant trends in cell phone voice processing are discussed. It has been observed that the increase in processing power has enabled DSP audio engineers to use more advanced voice processing to provide features and solve several unresolved problems. Continued efforts have been made to develop smaller, thinner, and lighter cell phones after the introduction of the first wireless phone. This trend to shrink the cell phone has a significant impact on the acoustic design and has driven the need for better voice processing features and performance. Microphones move away from the mouth of a speaker as devices continue to shrink in size, reducing signal-to-noise ratio (SNR) at the microphone. Another trend has emerged to provide multiple microphones in an effort to address the need for improved background noise reduction.
Dead Reckoning in Tunnel Propagation of the Formosan Subterranean Termite (Isoptera:Rhinotermitidae)

ABSTRACT Subterranean termites excavate extensive tunnel complexes in search of resources. The high energetic cost of digging through soil places stringent requirements on the efficiency of tunnel patterns for both search and transport at the time of their initial construction. An efficient spread of tunnels could result from simple diffusion away from a shared origin, but the ability to actively orient the burgeoning tunnels allows for the construction of efficient patterns when faced with the possibility of detours or directional drift. In this study, termite excavators were made to dig through one or two 90° forced turns of varying length that displaced them laterally and changed their heading. When allowed to tunnel freely again, they invariably corrected for the displacement by moving along a vector away from a point of tunnel origination, termed the global away vector (GAV), that was the opposite of a homing vector. Through the elimination of reliable allothetic cues, idiothetic dead reckoning was s...