cssi/SciSciGPT-SciSciNet huggingface dataset:
Healthcare system effects of pay-for-performance for smoking status documentation.

Objectives To evaluate the impact on smoking status documentation of a payer-sponsored pay-for-performance (P4P) incentive that targeted a minority of an integrated healthcare delivery system's patients. Study design Three commercial insurers simultaneously adopted P4P incentives to document smoking status of their members with 3 chronic diseases. The healthcare system responded by adding a smoking status reminder to all patients' electronic health records (EHRs). We measured change in smoking status documentation before (2008-2009) and after (2010-2011) P4P implementation by patient P4P eligibility. Methods The P4P-eligible patients were compared primarily with a subset of non-P4P-eligible patients who resembled P4P-eligible patients and also with all non-P4P-eligible patients. Multivariate models adjusted for patient and provider characteristics and accounted for provider-level clustering and preimplementation trends. Results Documentation increased from 48% of 207,471 patients before P4P to 71% of 227,574 patients after P4P. Improvement from 56% to 83% occurred among P4P-eligible patients (adjusted odds ratio [AOR], 3.6; 95% confidence interval [CI], 2.9-4.5) and from 56% to 80% among the comparable subset of non-P4P-eligible patients (AOR, 3.0; 95% CI, 2.3-3.9). The difference in improvement between groups was significant (AOR, 1.3; 95% CI, 1.1-1.4; P = .009). Conclusions A P4P incentive targeting a minority of a healthcare system's patients stimulated adoption of a system wide EHR reminder and improved smoking status documentation overall. Combining a P4P incentive with an EHR reminder might help healthcare systems improve treatment delivery for smokers and meet "meaningful use" standards for EHRs.
Deletion of the gene Pip4k2c, a novel phosphatidylinositol kinase, results in hyperactivation of the immune system

Type 2 phosphatidylinositol-5-phosphate 4-kinase (PI5P4K) converts phosphatidylinositol-5-phosphate to phosphatidylinositol-4,5-bisphosphate. Mammals have three enzymes PI5P4Kα, PI5P4Kβ, and PI5P4Kγ, and these enzymes have been implicated in metabolic control, growth control, and a variety of stress responses. Here, we show that mice with germline deletion of type 2 phosphatidylinositol-5-phosphate 4-kinase gamma (Pip4k2c), the gene encoding PI5P4Kγ, appear normal in regard to growth and viability but have increased inflammation and T-cell activation as they age. Immune cell infiltrates increased in Pip4k2c(-/-) mouse tissues. Also, there was an increase in proinflammatory cytokines, including IFNγ, interleukin 12, and interleukin 2 in plasma of Pip4k2c(-/-) mice. Pip4k2c(-/-) mice had an increase in T-helper-cell populations and a decrease in regulatory T-cell populations with increased proliferation of T cells. Interestingly, mammalian target of rapamycin complex 1 (mTORC1) signaling was hyperactivated in several tissues from Pip4k2c(-/-) mice and treating Pip4k2c(-/-) mice with rapamycin reduced the inflammatory phenotype, resulting in a decrease in mTORC1 signaling in tissues and a decrease in proinflammatory cytokines in plasma. These results indicate that PI5P4Kγ plays a role in the regulation of the immune system via mTORC1 signaling.
Assessment of varicose veins with the retrograde leg-milking test.

The success of treating varicose veins depends on the completeness with which the sites of valvular incompetency are interrupted. The pattern of valvular insufficiency and varicose veins varies greatly from patient to patient and must be assessed thoroughly before operation. To identify and localize valvular incompetency, the author recommends use of the retrograde leg-milking test, which he describes as a simple procedure that may be applied to all patients.
Energy Security: A Problem of Complex Systems and Complex Situations

This paper addresses the following aspects: Identifies the domain of energy security, describes the energy security in relation to a concept of Homeland Security, identifies issues of energy security in relation to complex systems, such as the risk of nuclear installations and the availability of resources at national level, such as oil, and identifies the vulnerability of the national economy to a lack of energy security.
Five Asset Price Bubbles in 30 Years — A New World Record

In December 1979 the Nikkei 225 stock price index in Japan was 8500; 10 years later the index peaked at nearly 40,000. Real estate prices in Japan in 1989 were nine times higher than in 1979. The market value of Japanese real estate was twice the market value of US real estate (even though Japan’s GDP was less than half of US GDP); one quip in Tokyo was that the land around the Imperial Palace in Tokyo was more valuable than all the real estate in California.
ABSOLUTE STANDARDS FOR CLIMATE MEASUREMENTS

Abstract. In a world of changing climate, political uncertainty, and ever-changing budgets, the benefit of measurements traceable to SI standards increases by the day. To truly resolve climate change trends on a decadal time scale, on-orbit measurements need to be referenced to something that is both absolute and unchanging. One such mission is the Climate Absolute Radiance and Refractivity Observatory (CLARREO) that will measure a variety of climate variables with an unprecedented accuracy to definitively quantify climate change. In the CLARREO mission, we will utilize phase change cells in which a material is melted to calibrate the temperature of a blackbody that can then be observed by a spectrometer. A material’s melting point is an unchanging physical constant that, through a series of transfers, can ultimately calibrate a spectrometer on an absolute scale. CLARREO consists of two primary instruments: an infrared (IR) spectrometer and a reflected solar (RS) spectrometer. The mission will contain orbiting radiometers with sufficient accuracy to calibrate other space-based instrumentation and thus transferring the absolute traceability. The status of various mission options will be presented.
The Perioperative Use of Echocardiography for Fluid Management

This chapter will discuss some common “static” echocardiographic measurements that can guide fluid management including echocardiographic quantification of ventricle dimensions, areas, and volumes. The chapter will mainly focus on “dynamic” echocardiographic measurements of fluid responsiveness that can guide the perioperative physician in the fluid management of patients in the operating room, the postanesthesia care unit (PACU), and in the critical care unit. These include echocardiographic quantification of inferior vena cava and superior vena cava diameters and collapsibility index to guide fluid therapy. In addition, Doppler ultrasound guided approaches to quantification of stroke volume changes both in mechanically ventilated patients (using respiratory-induced changes) and in spontaneously breathing patients (using the passive leg raising test) will be described.
El Niño increases the risk of lower Mississippi River flooding.

Mississippi River floods rank among the costliest climate-related disasters in the world. Improving flood predictability, preparedness, and response at seasonal to decadal time-scales requires an understanding of the climatic controls that govern flood occurrence. Linking flood occurrence to persistent modes of climate variability like the El Nino-Southern Oscillation (ENSO) has proven challenging, due in part to the limited number of high-magnitude floods available for study in the instrumental record. To augment the relatively short instrumental record, we use output from the Community Earth System Model (CESM) Last Millennium Ensemble (LME) to investigate the dynamical controls on discharge extremes of the lower Mississippi River. We show that through its regional influence on surface water storage, the warm phase of ENSO preconditions the lower Mississippi River to be vulnerable to flooding. In the 6–12 months preceding a flood, El Nino generates a positive precipitation anomaly over the lower Mississippi basin that gradually builds up soil moisture and reduces the basin’s infiltration capacity, thereby elevating the risk of a major flood during subsequent rainstorms. Our study demonstrates how natural climate variability mediates the formation of extreme floods on one of the world’s principal commercial waterways, adding significant predictive ability to near- and long-term forecasts of flood risk.
Dynamic energy management with scenario-based robust MPC

We present a simple, practical method for managing the energy produced and consumed by a network of devices. Our method is based on (convex) model predictive control. We handle uncertainty using a robust model predictive control formulation that considers a finite number of possible scenarios. A key attribute of our formulation is the encapsulation of device details, an idea naturally implemented with object-oriented programming. We introduce an open-source Python library implementing our method and demonstrate its use in planning and control at various scales in the electrical grid: managing a smart home, shared charging of electric vehicles, and integrating a wind farm into the transmission network.
Smart library: identifying books on library shelves using supervised deep learning for scene text reading

Physical library collections are valuable and long standing resources for knowledge and learning. However, managing and finding books or other volumes on a large collection of bookshelves often leads to tedious manual work, especially for large collections where books or others might be missing or misplaced. Recently, deep neural-based models have been successful in detecting and recognizing text in images taken from natural scenes. Based on this, we investigate deep learning for facilitating book management. This task introduces further challenges including image distortion and varied lighting conditions. We present a library inventory building and retrieval system based on scene text reading. We specifically design our text recognition model using rich supervision to accelerate training and achieve state-of-the- art performance on several benchmark datasets. Our proposed system has the potential to greatly reduce the amount of manual labor required for managing book inventories.
NUCare: Advancing research on technological integration for self-management in the aging population.

Abstract Background The Center for Technology in Support of Self-Management and Health (NUCare) is an exploratory research center funded by the National Institute of Nursing Research's P20 mechanism positioned to conduct rigorous research on the integration of technology in the self-management of the older adult population. Purpose The purpose of this paper is to describe the development and application of an evaluation plan and preliminary evaluation results from the first year of implementation. Methods This evaluation plan is derived from and is consistent with Dorsey et al.'s (2014) logic model. Dorsey's model provided guidelines for evaluating sustainability, leveraging of resources, and interdisciplinary collaboration within the center. Discussion Preliminary results and strategies for addressing findings from the first year of evaluation are discussed. A secondary aim of this paper is to showcase the relevance of this center to the advancement and maintenance of health in the aging population.
Abstract 15816: Normal Distribution of Wall Shear Stress in the Coronary Arteries

Introduction: The ability to detect hemodynamically significant coronary artery disease non-invasively has been a goal that has the potential to improve patient care significantly. New non-invasive...
Fairness in Decision-Making — The Causal Explanation Formula

AI plays an increasingly prominent role in society since decisions that were once made by humans are now delegated to automated systems. These systems are currently in charge of deciding bank loans, criminals' incarceration, and the hiring of new employees, and it's not difficult to envision that they will in the future underpin most of the decisions in society. Despite the high complexity entailed by this task, there is still not much understanding of basic properties of such systems. For instance, we currently cannot detect (neither explain nor correct) whether an AI system can be deemed fair (i.e., is abiding by the decision-constraints agreed by society) or it is reinforcing biases and perpetuating a preceding prejudicial practice. Issues of discrimination have been discussed extensively in political and legal circles, but there exists still not much understanding of the formal conditions that a system must meet to be deemed fair. In this paper, we use the language of structural causality (Pearl, 2000) to fill in this gap. We start by introducing three new fine-grained measures of transmission of change from stimulus to effect, which we called counterfactual direct (Ctf-DE), indirect (Ctf-IE), and spurious (Ctf-SE) effects. We then derive what we call the causal explanation formula, which allows the AI designer to quantitatively evaluate fairness and explain the total observed disparity of decisions through different discriminatory mechanisms. We apply these measures to various discrimination analysis tasks and run extensive simulations, including detection, evaluation, and optimization of decision-making under fairness constraints. We conclude studying the trade-off between different types of fairness criteria (outcome and procedural), and provide a quantitative approach to policy implementation and the design of fair AI systems.
Galactosemia: Biochemistry, Genetics, Pathophysiology, and Developmental Aspects

The manifold problems emerging from studies of the disease galactosemia have stimulated investigations in many fields of medicine. The term “galactosemia” means simply “galactose in the blood.” In animals, galactosemia can be achieved by overloading the organism with this sugar by feeding a diet rich in galactose. In man, one has encountered two types of congenital disease, both called “galactosemia.” One type of hereditary galactosemia is caused by a defect in galactokinase, which catalyzes the first step in galactose metabolism. The other, more common, type is caused by a defect in galactose-1-phosphate uridylyl transferase, which catalyzes the second step of this pathway. Accumulation of free galactose, as well as its reduction product, occurs with either type of galactosemia in patients who consume normal amounts of milk. However, the more prevalent type, in which the second step in galactose metabolism is blocked also gives rise to accumulation of galactose-1-phosphate. With this type, the pathophysiology is particularly complex in that it includes mental retardation, a symptom not found in galactokinase deficiency. The pathophysiology of galactosemia has been studied extensively in young animals that are maintained on diets including abnormally high amounts of galactose. However, aside from cataract of the lens, the pathogenesis of the disease remains largely unexplained.
Cephalosporins in Surgery

Prophylactic antibiotics in surgery are intended to prevent morbidity and mortality, as well as to reduce the duration and cost of hospitalisation. The indications for prophylaxis, and its effectiveness, should be evaluated with these criteria in mind. The basis for antibiotic prophylaxis in surgery is either provision of an effective concentration of antibiotic in the tissue site at the time of potential contamination, or (primarily in the case of colorectal surgery) to reduce the inoculum of potentially contaminating bacteria. Cephalosporins are the antibiotics most widely used for prophylaxis in surgery, and have clearly been shown to reduce postoperative morbidity in vaginal hysterectomy, resection of head and neck cancers, vascular grafting, total joint replacement, repair of hip fractures, and high risk gastroduodenal surgery. They are probably also useful in cardiac surgery, abdominal hysterectomy, caesarean section, and colorectal surgery. For orthopaedic, cardiac, gynaecological, and gastroduodenal procedures it is important to select an antibiotic with proven clinical activity against Gram-positive organisms. For head and neck surgery, the spectrum of activity should also include oral anaerobes and Enterobacteriaceae. For biliary surgery an antibiotic effective against both Gram-positive and Gram-negative organisms may offer at least theoretical advantages, while for appendicectomy a cephamycin represents the most appropriate choice. In colorectal procedures, activity against B. fragilis is the major consideration in selecting an antibiotic for systemic prophylaxis. When intra-abdominal sepsis occurs following surgery, a potentially wide range of bacteria may be implicated, but in practice such infections are due to a small number of species, with B. fragilis most commonly implicated. The most useful cephalosporins in this setting are those active against both aerobic Gram-negative bacteria and anaerobes, especially B. fragilis. In practice, an aminoglycoside is often administered concomitantly. Importantly, prompt surgical treatment is the cornerstone of management of abdominal sepsis, and empirical antibiotic therapy should be adjusted as needed when culture and sensitivity tests become available.
Sensitivity to Conflict between Visual Touch and Tactile Touch

The two point discrimination test is a well known means of assessing tactile sensory acuity. In this paper, we describe a similar test wherein one point of stimulation is tactile and the other one is visual. We propose this test to measure how vision and taction combine to form a unified touch percept, in the presence of sensory conflict. We perform the test at the leg above the knee, using virtual reality to render the visual “touch” while the real touch occurs by means of a monofilament. The results are compared with those obtained from a traditional two point discrimination test performed at the same location. This information can be used to understand how to allocate tactors in a haptic feedback array as well as to better inform the design of future virtual reality accessories.
Genomic and epigenomic bases of transgressive segregation – New breeding paradigm for novel plant phenotypes

For a holistic approach in developing the stress-resilient crops of the 21st century, modern genomic biology will need to re-envision the underappreciated phenomena in classical genetics, and incorporate them into the new plant breeding paradigm. Advances in evolutionary genomics support a theory that genetic recombination under genome shock during hybridization of widely divergent parents is an important driver of adaptive speciation, by virtue of the novelties of rare hybrids and recombinants. The enormous potential of genetic network rewiring to generate developmental or physiological novelties with adaptive advantage to special ecological niches has been appreciated. Developmental and physiological reconfiguration through network rewiring involves intricate molecular synergies controlled both at the genetic and epigenetic levels, as typified by the phenomenon of transgressive segregation, observed in both natural and breeding populations. This paper presents modern views on the possible molecular underpinnings of transgressive phenotypes as they are created in plant breeding, expanded from classical explanations through the Omnigenic Theory for quantitative traits and modern paradigms of epigenetics. Perspectives on how genomic biology can fully exploit this phenomenon to create novel phenotypes beyond what could be achieved through the more reductionist approach of functional genomics are presented in context of genomic modeling.
Targeting EGFR-TK with radiolabeled cyclam-tyrosine

2394 Purpose. The epidermal growth factor receptor (EGFR) is expressed in a variety of human solid tumors. When EGFR is triggered, EGFR tyrosine kinase (TK) is activatedand leading to initiate the receptor-mediated signal transduction, cell proliferation, survival, angiogenesis, and metastasis. This study was to develop radiolabeled cyclam-tyrosine to assess EGFR-TK activity. Method. Cyclam-tyrosine was synthesized by conjugating O-3-tosylpropyltyrosine with cyclam N,N,N-tri (trifluoroacetate), followed by hydrolysis. In vitro cell culture were conducted using epidermoid carcinoma (A431), lung papillary adenocarcinoma (H441) and lung adenocarcinoma (H3255) cells. The cells (50,000 cells/well) were incubated with ZD1839 (gefitinib, 1-20 uM) for 1 hrs and Western blot was performed. Cellular uptake of 99mTc-cyclam-tyrosine (2 uCi/well) was conducted at 1.5 hrs after the cells (50,000 cells/well) were incubated with ZD1839 (gefitinib, 1-20 uM) for 6 hrs. The cellular upatek findings were correlated Western Blot assays Cyclam-tyrosine was also labeled with 68Ga (PET isotope). PET and planar imaging studies with 68Ga/ 99mTc-cyclam-tyrosine were conducted in tumor-bearing rodents. Results. Western blot analysis showed that high EGFR-TK expression (A431, H3255) could be inhibited with ZD1839 whereas poor EGFR-TK (H441) could not be inhibited. In vitro cellular uptake assays indicated that EGFR-TK activity correlated well with 99mTc-EC-DG. PET and planar scintigraphy in animal models demonstrated the tumor could be clearly visualized by 68Ga-cyclam-tyrosine and 99mTc-cyclam-tyrosine. Conclusion.. Radiolabeled cyclam-tyrosine could assess EGFR-TK activity in tumor cells. Such compounds may be useful in selecting patients who may respond to EGFR-TK therapy.
Open pediatric ureterocelectomy with associated calculus excision and ureteroneocystostomy.

Introduction Pediatric ureteroceles have a cited incidence at autopsy between 1 in 4000 and 1 in 500. In some cases, a calculus may be associated with the ureterocele. This case presentation and surgical video highlights successful management of an intravesical ureterocele and calculus using an open approach. Patient and Method A 12 year old male presented to our clinic with irritative LUTS, incomplete emptying, and intermittent incontinence. A urinalysis was positive for blood and follow-up renal ultrasound revealed a 3cm ureterocele with a 1.5cm diameter calculus. Using an open, transabdominal approach, the ureterocele was incised and the calculus was removed. The ureterocele sac was excised at its junction with the bladder, and the distal ureter was released. In a Cohen cross-trigonal approach, a ureteroneocystostomy was then completed. Results Our patient tolerated surgery well, and was discharged on post-operative day one. Bladder ultrasound at three months revealed resolution of the ureterocele. Conclusion With a post-operative course comparable to robotic surgery, open ureterocelectomy is an important approach that may be utilized in management of complex ureteroceles.
Application of the Effect of Latitude on the Starting of Hand, Foot, and Mouth Disease Epidemic on Early Warning in Dalian, Liaoning Province, China.

Hand, foot, and mouth disease (HFMD) is a common infectious gastrointestinal disease in children under the age of 5. Many studies have documented that meteorological variables, especially temperatu...
The Effects of p-Azidophenylalanine Incorporation on Protein Structure and Stability

Functionalization is often needed to harness the power of proteins for beneficial use but can cause losses to stability and/or activity. State of the art methods to limit these deleterious effects accomplish this by substituting an amino acid in the wild-type molecule into an unnatural amino acid (uAA), such as p-azidophenylalanine (pAz), but selecting the residue for substitution a priori remains an elusive goal of protein engineering. The results of this work indicate that all-atom molecular dynamics simulation can be used to determine whether substituting pAz for a natural amino acid will be detrimental to experimentally-determined protein stability. These results offer significant hope that local deviations from wild-type structure caused by pAz incorporation observed in simulations can be a predictive metric used to reduce the number of costly experiments that must be done to find active proteins upon substitution withpAz and subsequent functionalization.
Expansion of Surgical Graduate Medical Education Training Programs: A Return on Investment Analysis.

Abstract Background The productivity of surgical departments is limited by the staffing of attending surgeons as well as surgical residents. Despite ongoing surgeon shortages, many health care organizations have been reluctant to expand training programs because of concerns about cost. We sought to determine the return on investment for the expansion of surgical training programs within our health system. Methods This study was completed as a retrospective review comparing two independent surgical departments at separate hospitals within a single integrated health system, including complete fiscal information from 2012 to 2019. Hospital A is a 594-bed hospital with large growth in its graduate surgical training programs over the study's period, whereas Hospital B is a 320-bed hospital where there was no expansion in surgical education initiatives. Case volumes, the number of full-time employees (FTE), and revenue data were obtained from our health systems business office. The number of surgical trainees, including general surgery residents and vascular surgery fellows, was provided by our office of Graduate Medical Education. The average yearly net revenue per surgeon was calculated for each training program and hospital location. Results Our results indicate a positive association between the number of surgical trainees and departmental net revenue, as well as the annual revenue generated per physician FTE. Each additional ancillary provider per physician FTE resulted in a positive impact of $112,552-$264,003 (R2 of 0.69 to 0.051). Conclusions Regardless of hospital location or surgical specialty, our results demonstrate a positive association between the average net revenue generated per surgeon and the number of surgical trainees supporting the department. These findings are novel and provide evidence of a positive return on investment when surgical training programs are expanded.
Treadmill Running of Mouse as a Model for Studying Influence of Maternal Exercise on Offspring

Epidemiological studies robustly show the beneficial effects of maternal exercise in reducing maternal birth complications and improving neonatal outcomes, though underlying mechanisms remain poorly understood. To facilitate mechanistic exploration, a protocol for maternal exercise of mice is established, with the regimen following the exercise guidelines for pregnant women. Compared to volunteer wheel running, treadmill running allows precise control of exercise intensity and duration, dramatically reducing variations among individual mouse within treatments and facilitating translation into maternal exercise in humans. Based on the maximal oxygen consumption rate (VO2max) before pregnancy, the treadmill exercise protocol is separated into three stages: early stage (E1.5 to E7.5 at 40% VO2max), mid stage (E8.5 to E14.5 at 65% VO2max), and late stage of pregnancy (E15.5 to birth at 50% VO2max), which demonstrated persistent beneficial effects on maternal health and fetal development. This protocol can be useful for standardizing maternal treadmill exercise using mice as an experimental model.
Health Care Reform: Walking the Fine Line between Epic and Tragic

The recent changes to the core structure of modern American health care are nothing short of epic, rivaled in historic scale only by the introduction of Medicare in 1965. Although each decade over the past 50 years has in some way used government programs and incentives in an attempt to urge health care to undergo recalibration as a means to establish industry stability, by the end of the first decade of the 21st Century it had become evident that health care in the United States was fast becoming unsustainable as it existed. Three years after the Federal Government passed the Affordable Care Act in an attempt to right the sinking ship, we the people are still waiting for the tide to turn. Having survived last summer’s monumental challenge before the United States Supreme Court and a presidential election in November, the Affordable Care Act has not only emerged as the law of the land, it has cemented its place as health care’s blueprint throughout America for decades to come.
The Surgical Legacy of Randolph Lee Clark Jr, MD: First Surgeon-in-Chief and Director of University of Texas MD Anderson Cancer Center I. Training and Surgical Practice Before Recruitment to University of Texas MD Anderson Hospital

Dr R. Lee Clark Jr was the first Surgeon-in-Chief and permanent Director of the University of Texas MD Anderson Cancer Hospital, leading the institution from 1946 to 1978. He is known for his visionary leadership as President, but much less about his prodigious activity as a general surgeon and for his academic contributions as a clinical researcher and surgical educator. His general surgery training at the Mayo Clinic from 1935 to 1939 was extensive, having been involved in over 2000 operations. Dr Clark then began a prodigious surgery practice for 2 years in Jackson, MS. He described his clinical practice: “I have done more than 600 major operations a year, of all types—from the brain to the colon”. He was commissioned into the Army Air Force in 1942, as Chief of Surgical Services, with 30 surgeons at a 1000-bed hospital in North Carolina. In 1944, he transferred to Wright Patterson Field in Dayton, OH, as Chief of the Experimental Surgical Unit. He published numerous articles about surgical problems in aviation medicine and edited the journal Air Surgeon’s Bulletin. His final assignment in 1945 was Chairman of the Department of Surgery at Randolph Field in San Antonio, TX. On 12 July 1946, after a rather turbulent and vacillating recruitment process, Dr Clark received a unanimous vote by the University of Texas Board of Regents to become the first permanent Director and Surgeon-in-Chief, and so, Randolph Lee Clark Jr began the most productive and impactful phase of his career.
Use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers associated with lower risk of COVID-19 in household contacts.

Background Use of angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) has been hypothesized to affect COVID-19 risk. Objective To examine the association between use of ACEI/ARB and household transmission of COVID-19. Methods We conducted a modified cohort study of household contacts of patients who tested positive for COVID-19 between March 4 and May 17, 2020 in a large Northeast US health system. Household members were identified by geocoding and full address matching with exclusion of addresses with >10 matched residents or known congregate living functions. Medication use, clinical conditions and sociodemographic characteristics were obtained from electronic medical record (EMR) data on cohort entry. Cohort members were followed for at least one month after exposure to determine who tested positive for SARS-CoV-2. Mixed effects logistic regression and propensity score analyses were used to assess adjusted associations between medication use and testing positive. Results 1,499 of the 9,101 household contacts were taking an ACEI or an ARB. Probability of COVID-19 diagnosis during the study period was slightly higher among ACEI/ARB users in unadjusted analyses. However, ACEI/ARB users were older and more likely to have clinical comorbidities so that use of ACEI/ARB was associated with a decreased risk of being diagnosed with COVID-19 in mixed effect models (OR 0.60, 95% CI 0.44–0.81) or propensity score analyses (predicted probability 18.6% in ACEI/ARB users vs. 24.5% in non-users, p = 0.03). These associations were similar within age and comorbidity subgroups, including patients with documented hypertension, diabetes or cardiovascular disease, as well as when including other medications in the models. Conclusions In this observational study of household transmission, use of ACEIs or ARBs was associated with a decreased risk of being diagnosed with COVID-19. While causality cannot be inferred from these observational data, our results support current recommendations to continue ACEI/ARB in individuals at risk of COVID-19 exposure.
Integrative mechanisms and the maintenance of cardiovascular and body fluid homeostasis: the central processing of sensory input derived from the circumventricular organs of the lamina terminalis.

Publisher Summary This paper discusses the neural substrates and mechanisms involved in the integration and processing of the humorally derived information from two of these sensory circumventricular organs (CVOs), the subfornical organ (SFO) and the organum vasculosum laminae terminalis (OVLT). The CVOs associated with the lamina terminalis, the SFO, and the OVLT in all probability contain sensory elements critical for the maintenance of cardiovascular and body fluid homeostasis. Both anatomical and functional evidence indicates that the SFO and OVLT are reciprocally tied to components of the anteroventral third ventricle (AV3V), particularly the median preoptic nucleus (MnPO). It is reasonable to believe that substantial processing of central input, derived through the two-lamina terminalis-associated CVOs, occurs within the AV3V. The research reviewed in this chapter indicates that the SFO/AV3V is related to mechanisms that maintain consistency in extracellular fluid volume. Specifically, present evidence suggests that ANG II and norepinephrine interact in structures within the AV3V, particularly the ventral MnPO, to facilitate volume expansion.
SU-E-T-703: Site Specific Image-Guided Radiotherapy (IGRT) Tolerances for Patient Safety

Purpose: To present our single institution experience of a very large pool of data, for all treatment sites, with image-guided radiotherapy, comparing patient’s external tattoo marks, kV or MV orthogonals to align to bony anatomy, and CBCT for soft tissue registration of the tumor volumes. To present measurement based tolerances for daily imaging registration shifts that could be used as guidelines. Methods: From March 2013 to March 2014, 17197 patient treatment fields were analyzed for the treatment of brain, chest-wall, esophagus, head and neck, lung, pelvis, prostate, spine, extremities, and breast. TrueBeam trajectory log files for all imaging types as well as all treatment types were accessed, and couch parameters compared. Three types of shifts are evaluated: i) kV, or MV orthogonal imaging shifts from patient’s tattoo marks to bony anatomy surrounding the tumor, ii) CBCT imaging shifts from patients bony alignment to soft tissue alignment of tumor, iii) CBCT imaging shifts from patients tattoo marks to soft tissue alignment of tumor. Shifts in the anterior-posterior (AP), superior-inferior (SI), and left-right (LR) dimensions were recorded. Site specific mean and standard deviation of absolute differences were also compared. Results: Site specific observed imaging tolerances are: brain (1.82 cm), chest-wall (1.26 cm), esophagus (1.60 cm), head and neck (1.2 cm), lung (1.97 cm), pelvis (3.65 cm), prostate (2.64 cm), spine (1.38 cm), extremities (3.96 cm). Conclusion: These site specific imaging tolerances could be used as guidelines for raising a red flag when exceeded.
Entire solutions of $(u_{z_{1}})^{m}+(u_{z_{2}})^{n}=e^{g}$

The paper is concerned with description of entire solutions of the partial differential equations where m ≥ 2, n ≥ 2 are integers and g is a polynomial or an entire function in C 2. Descriptions are given and complemented by various examples.
High-Order Tensor Decomposition for Large-Scale Data Analysis

Higher-order tensor decomposition is a basis for many important data mining tasks and the efficient large-scale tensor decomposition algorithms will have positive impact on clustering, trend detection, and anomaly detection. In the paper, we develop a scalable and distributed version of the Tucker tensor decomposition, MR-T, using the Hadoop MapReduce framework. We avoid large matrix-matrix multiplication and exploit the sparsity of large data sets to minimize intermediate data and flops by sequentially computing the intermediate matrices and generating the intermediate tensor vector-wise.
Trauma Practice in the Wake of September 11, 2001

Abstract The attacks of September 11th, 2001 were unprecedented in several respects. They were the first attacks on U.S. soil by a foreign power in several generations, were witnessed live on television throughout the U.S. and the world, and shattered widely held assumptions about security in the U.S. and, by implication, elsewhere. Some questions and challenges evoked by the events of September 11th of particular relevance to trauma practitioners are discussed. The contents of Trauma Practice in the Wake of September 11, 2001, are summarized and framed as representing a preliminary attempt to respond to some of these questions. Finally, some of the opportunities created by the September 11th attacks-increasing public awareness of trauma and its impact, fostering compassion for victims of various types of trauma, and strengthening international collaboration among traumatologists and advocates of world peace-are considered.
E-democracy at the American grassroots: Not now … not likely?

Using data from two national surveys conducted in 2006 and 2011, we empirically examine whether, and the extent to which, grassroots or local governments in the United States have adopted electronic democracy e-democracy. We contrast this empirical reality against the claims made by e-democracy advocates. The survey results show that few American local governments have adopted e-democracy, particularly meaningful elements through which citizens can actively participate in governmental activities, programs and decision-making. Even fewer local governments plan to do so in the near future. These empirical results are highly inconsistent with the claims of e-democracy advocates. Based on the survey results, we conclude that two important reasons account for the lack of e-democracy at the American grassroots: lack of funding to support e-democracy applications and lack of perceived demand for e-democracy. A third important factor may well be the fact that early predictions were, for various reasons, incorrect. Based on these findings, we would expect that e-democracy at the American grassroots will not be substantially different in the foreseeable future than it is now.
Stigma in Financial Markets Evidence from liquidity auctions and discount window borrowing during the crisis

We provide empirical evidence for the existence, magnitude, and economic impact of stigma associated with discount window liquidity provision by the Federal Reserve. We find that during the height of the financial crisis banks were willing to pay a premium of at least 37 basis points (150 basis points after Lehman’s bankruptcy) on average to borrow from the Term Auction Facility (TAF) rather than from the discount window. The incidence of stigma varied with bank characteristics and market conditions. Finally, we find that discount window stigma is economically relevant since it increased banks’ borrowing costs during the crisis. Our results have important implications for the provision of liquidity by central banks.
“Learning by instruction” in connectionist systems

ABSTRACT Essentially all work in connectionist learning up to now has been induction from examples (e.g. Hinton, 1987), but instruction is also important in conventional artificial intelligence (e.g. Rychener, 1986) as it is in nature. This paper describes an implemented connectionist learning system that transforms an instruction expressed in a description language into an input for a connectionist knowledge representation system, which in turn changes the network in order to integrate new knowledge. Integration is always important when a single new fact causes changes in several parts of the knowledge-base; it is an adjustment which cannot easily be done with learning-by-example techniques. The new, integrated knowledge can be used in conjunction with prior knowledge. The learning method used is recruitment learning (Diederich, 1988, 1989), a technique which converts network units from a pool of free units into units which carry meaningful information.
Avoiding Algorithmic Obfuscation in a Message-Driven Parallel MD Code

Parallel molecular dynamics programs employing shared memory or replicated data architectures encounter problems scaling to large numbers of processors. Spatial decomposition schemes offer better performance in theory, but often suffer from complexity of implementation and difficulty in load balancing. In the program NAMD 2, we have addressed these issues with a hybrid decomposition scheme in which atoms are distributed among processors in regularly sized patches while the work involved in computing interactions between patches is decomposed into independently assignable compute objects. When needed, patches are represented on remote processors by proxies. The execution of compute objects takes place in a prioritized message-driven manner, allowing maximum overlap of work and communication without significant programmer effort. In order to avoid obfuscation of the simulation algorithm by the parallel framework, the algorithm associated with a patch is encapsulated by a single function executing in a separate thread. Output and calculations requiring globally reduced quantities are similarly isolated in a single thread executing on the master node. This combination of features allows us to make efficient use of large parallel machines and clusters of multiprocessor workstations while presenting minimal barriers to method development and implementation.
Computing maximum association graph in microscopic nucleus images

In this paper, we study the problem of finding organization patterns of chromosomes inside the cell nucleus from microscopic nucleus images. Emerging evidence from cell biology research suggests that global chromosome organization has a vital role in fundamental cell processes related to gene expression and regulation. To understand how chromosome territories are neighboring (or associated) to each other, in this paper we present a novel technique for computing a common association pattern, represented as a Maximum Association Graph (MAG), from the nucleus images of a population of cells. Our approach is based on an interesting integer linear programming formulation of the problem and utilizes inherent observations of the problem to yield optimal solutions. A two-stage technique is also introduced for producing near optimal approximations for large data sets.
Induction of the SOS response in Escherichia coli inhibits Tn5 and IS50 transposition.

In response to DNA damage or the inhibition of normal DNA replication in Escherichia coli, a set of some 20 unlinked operons is induced through the RecA-mediated cleavage of the LexA repressor. We examined the effect of this SOS response on the transposition of Tn5 and determined that the frequency of transposition is reduced 5- to 10-fold in cells that constitutively express SOS functions, e.g., lexA(Def) strains. Furthermore, this inhibition is independent of recA function, is fully reversed by a wild-type copy of lexA, and is not caused by an alteration in the levels of the Tn5 transposase or inhibitor proteins. We isolated insertion mutations in a lexA(Def) background that reverse this transposition defect; all of these mapped to a new locus near 23 min on the E. coli chromosome.
On the Analysis and Interpretation of Vigilance: Some Remarks on Two Recent Articles by Craig

In a recent article, Craig (1977) has considered the question, first attacked by Broadbent and Gregory (1963), as to the applicability of signal detection theory (SDT) to the vigilance situation, a...
How to Make a Superior Cell

Engineering cells and microbes to make a commercially valuable product has been successfully accomplished by introducing foreign genes into target cells ( Zaslavskaia et al.). According to the Perspective by Stephanopoulos and Kelleher, successful gene modification may require intervention at multiple steps in a metabolic pathway to optimize the desired cellular properties. As the authors explain, this necessitates successive rounds of genetic modification and physiological evaluation, a strategy that forms the basis of metabolic engineering.
To Fukushima with love: lessons on long-term antinuclear citizen participation from Three Mile Island.

We revisit long-term politically active citizens at the Three Mile Island nuclear plant in the wake of ongoing environmental and nuclear crises in Japan to better understand how long-term citizen participation focused on environmental disasters might be fostered and sustained. In our qualitative study of 31 long-term antinuclear activists, we examine the confluence of psychological and sociopolitical dimensions of active citizenship for over 3 decades. Psychological dimensions include moral obligations and civic-mindedness, emotions, such as anger, stress, and deepened convictions, and the importance of social solidarity and silent supporters. Sociopolitical dimensions include the lack of social power, the importance of formal groups, and strong leadership. Additionally, we compare first-time active citizens with those with prior political experience and argue that at least 2 types of active citizens may exist: those who are intrinsically inspired and those who are motivated by a direct threat. Implications for promoting increased active citizenship around environmental and technological crises are discussed.
High-performance liquid chromatographic separation and electrochemical or spectrophotometric determination of R(—)N-n-propylnorapomorphine and R(—)10,11-methylenedioxy-N-n-propylnoraporphine in primate plasma

Abstract The dopamine receptor agonist R (—)N- n -propylnorapomorphine (NPA) and its proposed prodrug R (—)10,11-methylenedioxy-N- n -propylnoraporphine (MDO-NPA) were isolated simultaneously from monkey plasma using a solid-phase extraction procedure. R (—)Apomorphine (APO) and R (—)10,11-methylenedioxyaporphine (MDO-APO) were added as internal standards, and separation and quantification were by high-performance liquid chromatography with electrochemical or ultraviolet detection of the free catechol and MDO compounds, respectively. The detection limits for NPA and MDO-NPA in plasma were 0.5 and 10 ng/ml and the coefficient of variation (S.D./mean) within assays and between days of assays for both drugs was 5.6% or less. Quantification of plasma levels of NPA and MDO-NPA was possible at ranges of 2–1000 and 40–5000 ng/ml, respectively, including concentrations found after intravenous administration of these agents.
Accounting for the Business of Suffering: A Study of the Antebellum Richmond, Virginia, Slave Trade

When the Congress barred the importation of slaves into the United States in 1808, it left the internal slave trade intact. The trade took on a new importance as the slave states of the Old South saw their agricultural economies shift to a point that holding large numbers of slaves became too expensive. During this time, the large agricultural concerns shifted to the New South, where cotton and sugar plantations needed the cheap labour provided by the institution of slavery. As this transition intensified, Richmond, Virginia, became a central slave market that facilitated the interstate slave trade as Old South planters chose the course of selling slaves as a valuable commodity rather than the course of manumission. The records of two businesses—Dickinson & Hill and Hector Davis & Company—which plied the slave trade in the Richmond market, have survived into the twenty-first century. These records revealed a primitive, yet sophisticated, process to account for the consignment, purchase, and sales of human merchandise in this haunting story of the ‘business of suffering’.