cssi/SciSciGPT-SciSciNet huggingface dataset:
VAGINAL DOUCHING AND INTIMATE PARTNER VIOLENCE Is There an Association

Objective This study tests the hypothesis that vaginal douching among women of reproductive age is associated with exposure to intimate partner violence (IPV). Methods The data source is a cross-sectional population-based sample of 2,002 women ages 18–45 in the Central Pennsylvania Women’s Health Study. The survey included measures of IPV, douching behavior, and relevant sociodemographic and health-related covariates. Findings Six percent of the sample reported experiencing any type of IPV in the past year, and 23% reported douching in the past year. IPV is significantly associated with douching after controlling for sociodemographic and health-related covariates. This finding holds for women with and without current reproductive capacity. Conclusions This is the first study to identify an association between vaginal douching and IPV. Because vaginal douching is a risk factor for sexually transmitted infections, bacterial vaginosis, and adverse pregnancy outcomes, the findings could have important implications for prevention. Further research is needed to identify the reasons why women who have been exposed to IPV are more likely to douche.
Samoświadomość w Stanach Zjednoczonych: historia i definicje

Self-concept has been an important theoretical construct for children and especially for children with mild/moderate disabilities in the history of special education. This chapter will review the role that self-concept has played in the field of special education and how it has impacted children in the history of schooling in the United States. Definitional models of self-concept will be presented and analyzed in light of the impact of the social outcomes on academic/cognitive progress.
Mechanisms and Consequences of Transcription Factor Binding to Nucleosomes

Publisher Summary Biochemical analysis of the proteins involved in transcription by RNA polymerase II has revealed two classes of transcription factors. These include the general initiation factors, which are required in addition to RNA polymerase II for accurate initiation, and regulatory factors, which bind upstream promoter and/or enhancer elements and activate transcription initiation. Biochemical studies of the interactions of regulatory transcription factors with nucleosome cores have illustrated several parameters that restrict the binding of individual transcription factors to nucleosomal DNA. These include a differential intrinsic affinity of different factors for their recognition sites on nucleosomes, the location of the binding sites within the nucleosome core, and inhibition from the core histone amino termini. However, nucleosome-mediated repression of factor binding can be overcome by the facilitated binding of multiple factors, relief of inhibition from the core histone amino termini (that is, by histone acetylation), and through the function of accessory proteins that stimulate factor binding. The binding of regulatory factors to nucleosomes results in the formation of factor/nucleosome ternary complexes that contain bound factors, core histones, and DNA.
A Comparison of the Elastic Properties of Graphene- and Fullerene-Reinforced Polymer Composites: The Role of Filler Morphology and Size

A Comparison of the Elastic Properties of Graphene- and Fullerene-Reinforced Polymer Composites: The Role of Filler Morphology and Size
Tradeoffs between oscillator strength and lifetime in terahertz quantum cascade lasers

Contemporary research into diagonal active region terahertz quantum cascade lasers for high temperature operation has yielded little success. We present evidence that the failure of high diagonality alone as a design strategy is due to a fundamental trade-off between large optical oscillator strength and long upper-level lifetime. We hypothesize that diagonality needs to be paired with increased doping in order to succeed, and present evidence that highly diagonal designs can benefit from much higher doping than normally found in terahertz quantum cascade lasers. In assuming the benefits of high diagonality paired with high doping, we also highlight important challenges that need to be overcome, specifically the increased importance of carrier induced band-bending and impurity scattering.
Hampered by Hardcoreness: How Group Cycling Events Fail to Impact the Everyday Travel Behavior of Novice Cyclists

Group cycling events have become a common practice in the cycling community to encouraging every day cycling. That said, scant literature has evaluated their actual impact on changing participant travel behavior. The purpose of this research is to investigate how group and social dynamics influence cycling behavior. We survey individuals participating in a monthly group cycling event in San Luis Obispo, CA to investigate their motivations for participation and if that participation is reflective of their everyday travel behavior or if is not. We hypothesize that these kinds of events have an impact on encouraging non-regular cyclists to bicycle. We find quite the opposite, those that these events encourage participation of who, on-the-whole, already regular cycling commuters—what we define as ‘hardcore’ cyclists. This offers opportunities to rethink such programs and target them to everyday other users.
Carpal Tunnel Syndrome

: Carpal tunnel syndrome (CTS) is a neuropathy caused by median nerve entrapment and compression within the carpal tunnel at the wrist. It is the most common mononeuropathy seen in clinical practice, causing pain, paresthesia, and weakness in the median nerve distribution.
Metaphors, social practices, and economic life: ASE presidential address

AbstractOur lived experiences of the economy shape the metaphors that we use to describe the economy. Yet, any particular metaphor can only provide a partial perspective. There are two ways our conceptual frameworks have reflected partial perspectives. The first is historical: our conceptual frameworks tend to build upon ideas developed during the factory age. A machine metaphor, grounded in the industrial age, focuses on the transformation of resources into outputs, but it obscures other aspects of economic life. Second, economic concepts and metaphors are affected by our personal standpoints and our social identities. As social economists, we recognize that our economy is embedded in society, a society in which social identities such as class, gender, race, ethnicity, and nationality shape our standpoints. To fully understand the continuities and changes in how social provisioning is organized, we need to be attentive to these social identities and how they are constituted and transformed through social...
A temperature programmed desorption study of non-thermal plasma modified γ-Al2O3

Abstract In this paper, the effect of non-thermal RF plasma modification on the point of zero charge (PZC) of γ-Al2O3 has been explored. Samples of alumina were first modified with air, CO2, N2 or Ar plasma and then measurements of the PZC were taken. In order to determine the mechanism behind PZC shift, the surface area and crystal phase were measured for each sample using nitrogen physisorption (BET) and X-ray diffraction (XRD). Additionally, the presence of plasma gas on the surface of alumina was determined qualitatively using a modified temperature programmed desorption (TPD) technique. Air and CO2 modification of alumina powder decreased the PZC from 7.48 to 4.86 and 6.57 respectively. However, N2 and Ar modification did not result in any PZC shift. BET and XRD measurements showed no significant surface area or phase changes occurred due to non-thermal plasma modification. TPD profiles for air and CO2 modified samples showed new peaks corresponding to the adsorption of plasma ions on the alumina surface. These results demonstrate that PZC changes in a support after plasma treatment is caused by the adsorption of plasma species.
Sertoli-Leydig Cell Tumor with Concurrent Rhabdomyosarcoma: Three Case Reports and a Review of the Literature.

Sertoli-Leydig Cell Tumors (SLCTs) make up <1% of all ovarian tumors and are benign or malignant, androgen-secreting tumors. Rhabdomyosarcoma (RMS) is a heterogeneous group of malignant tumors that resemble developing skeletal muscle. There have been case reports of patients with concurrent SLCT and RMS with limited treatment options. We aim to demonstrate treatment strategies used in our patients, which seemed to have prolonged survival when compared to prior case reports of patients not cured by surgical resection. Herein we describe 22 cases of SLCT with RMS elements as discussed in prior case reports and three cases from the authors’ institution. Of the 19 cases from prior case reports, five were lost to follow-up and two had NED after surgical intervention. Eleven patients had recurrence and were deceased within one year. Of those patients not surgically cured, only three patients were documented as living beyond two years, all of whom received chemotherapy. The three patients presented from our institution had clinical evidence of response to chemotherapy that is traditionally used for RMS. In conclusion, chemotherapy with doxorubicin and ifosfamide has activity in patients with SLCT and RMS as does salvage chemotherapy with vincristine, irinotecan, and temozolomide.
Erethizon dorsatum dorsatum (North American porcupine)

These findings are based on 9 animals trapped in Vermont and New Hampshire, USA. All had similar karyotypes from blood, kidney and skin cultures. The karyotypes displayed here are from fibroblast cultures. The chromosomes are difficult to pair accurately. Some pairs of small autosomes and the two X chromosomes often differ in size. The short arm of the Y and the central portion of the X are late replicating. The long arm of the Y is latest to replicate. The length of the X is approximately 12%, and the Y, 6%, of the haploid set.
Putative Independent Evolutionary Reversals from Genotypic to Temperature-Dependent Sex Determination are Associated with Accelerated Evolution of Sex-Determining Genes in Turtles

The evolutionary lability of sex-determining mechanisms across the tree of life is well recognized, yet the extent of molecular changes that accompany these repeated transitions remain obscure. Most turtles retain the ancestral temperature-dependent sex determination (TSD) from which multiple transitions to genotypic sex determination (GSD) occurred independently, and two contrasting hypotheses posit the existence or absence of reversals back to TSD. Here we examined the molecular evolution of the coding regions of a set of gene regulators involved in gonadal development in turtles and several other vertebrates. We found slower molecular evolution in turtles and crocodilians compared to other vertebrates, but an acceleration in Trionychia turtles and at some phylogenetic branches demarcating major taxonomic diversification events. Of all gene classes examined, hormone signaling genes, and Srd5a1 in particular, evolve faster in many lineages and especially in turtles. Our data show that sex-linked genes do not follow a ubiquitous nor uniform pattern of molecular evolution. We then evaluated turtle nucleotide and protein evolution under two evolutionary hypotheses with or without GSD-to-TSD reversals, and found that when GSD-to-TSD reversals are considered, all transitional branches irrespective of direction, exhibit accelerated molecular evolution of nucleotide sequences, while GSD-to-TSD transitional branches also show acceleration in protein evolution. Significant changes in predicted secondary structure that may affect protein function were identified in three genes that exhibited hastened evolution in turtles compared to other vertebrates or in transitional versus non-transitional branches within turtles, rendering them candidates for a key role during SDM evolution in turtles.
Comparison of Observed Harms and Expected Mortality Benefit for Persons in the Veterans Health Affairs Lung Cancer Screening Demonstration Project.

This study examines how a high false-positive rate in lung cancer screening influences the harm-to-benefit ratio for higher- vs lower-risk patients.
A novel work holding method for hard turning using the shoe-centerless concept

Abstract The widespread use of hard turning processes in industry has been facilitated by efficient work holding methods. In this paper, a novel application of the shoe-centerless work holding method is proposed for hard turning. Since changes in cutting forces during hard turning affect force balance, rotational instability can occur with shoe-centerless work holding. This paper describes the effect of changes in cutting forces due to tool wear on work rotational stability during shoe-centerless hard turning. It also presents guidelines to determine the optimum shoe setup angles for various hard turning process conditions to ensure work rotational stability and geometrical rounding stability.
Diagnostic accuracy of whole slide imaging for cutaneous, soft tissue, and melanoma sentinel lymph node biopsies with and without immunohistochemistry.

BACKGROUND Diagnostic accuracy with whole slide imaging (WSI) for complex inpatient and outpatient dermatopathology cases with immunohistochemistry (IHC) is unknown. METHODS WSI (Leica Aperio AT2 Digital Pathology scanner, N = 151 cases) was performed for Emory inpatient and outpatient skin (N = 105), soft tissue (N = 30), and melanoma sentinel lymph node biopsies (N = 16) collected between 2000 and 2016. Resultant images were uploaded to an online cloud storage system for review by 2 board-certified dermatopathologists (reviewers 1 and 2) with greater than 5 years of dermatopathology experience and 1 dermatopathology fellow (reviewer 3). RESULTS Reviewers 1 (diagnostic accuracy = 97%) and 2 (diagnostic accuracy = 95%) demonstrated high diagnostic accuracy with WSI. Diagnostic accuracy was greater than 90% for inpatient biopsies, melanocytic lesions, melanoma sentinel lymph node biopsies, and cases with immunohistochemistry, but was slightly lower for soft tissue cases (reviewer 1 = 89%; reviewer 2 = 89%). The dermatopathology fellow (reviewer 3) demonstrated lower diagnostic accuracy (84%). CONCLUSIONS Diagnostic accuracy with WSI for skin, soft tissue, and melanoma sentinel lymph node biopsies with and without immunohistochemistry was greater than 95% for 2 reviewers with greater than 5 years of dermatopathology experience. Professional experience signing out dermatopathology cases may impact diagnostic accuracy with WSI.
Asynchronous Online Debriefing with Health Care Workers: Lessons Learned

Abstract Background This article describes how monitored asynchronous online debriefing was performed with health care workers who were part of a larger study that examined the effect of virtual reality simulation (VRS) on evacuation of neonates by workers. Method Asynchronous online debriefing was performed with VRS participants (N = 34). An analysis of discussion board postings was completed. Also, two focus groups provided supplementary data associated with this debriefing experience. Results Participation rates from VRS one to VRS four debriefing ranged from 72% to 53%. Responses were focused more on the VRS format than on participant learning. Conclusions Monitored online asynchronous debriefing can be beneficial to participants. Clear instructions, facilitator monitoring, and participant commitment are needed for success.
Forced Convection Film Boiling

The mechanism of heat transfer beyond the dryout point in forced convection boiling is described. Selected empirical correlation equations are presented for predicting wall temperature or heat flux. Also phenomenological models leading to predictions of Tw and q are presented.
Controlling Leasing Conflicts between Retail Owner/Managers and Tenants

Retail owner/managers are aware that tenants have an incentive to maximize their own wealth by undermaintenance or overuse of leased property so as to increase their short-term income at the expense of the property’s long-term value. This chapter analyzes many of the currently available methods for controlling unwanted retail tenant behavior. First, a rigorous understanding of retail leasing that examines the effects of tenant undermaintenance and overuse is developed. Then this framework is used to evaluate the efficiency of various lease arrangements and provisions used to restrict unwanted tenant behavior. Using numerical examples, this chapter demonstrates that variable lease payments that peg lease rates to the level of asset abuse (such as security deposits and penalty clauses) work better at controlling unwanted tenant actions than fixed-lease payments (such as maintenance contracts and higher lease payments).
Exchange Rates and the International Control Conundrum

The design of an effective management control system for domestic companies is burdened with the problem of information asymmetry and goal incongruence between parent and subsidiaries. In an international setting, the problems are further compounded by exchange rate fluctuations between the foreign subsidiary’s local currency and the parent company’s reference currency.1 To be reliable, management control systems for multinational corporations (MNCs) must somehow incorporate a multiplicity of complicating factors such as exchange rates, differential rates of inflation, and byzantine national price and exchange controls.
Stochastic solution approximation for high-complexity problems

Publisher Summary This chapter presents a stochastic solution approximation for high-complexity problems. Stochastic analysis finds a numerical solution for an investigated physical problem that satisfies the physics of the problem and optimally fits with a reasonable accuracy the stochastic analysis output, assuming that some of the problem parameters are random quantities. The chapter describes two types of stochastic solution approximation techniques that are based on the stochastic field (functional) expansion—a generalized Wiener-Fourier series expansion and a generalized local-average-series expansion. To handle quite complex pattern non-Gaussian stochastic fields (functional), it is often advantageous to represent them using a generalized Wiener–Fourier-type series representation. Stochastic local-average expansion is based on a two-level hierarchical representation of stochastic response. In contrast to the Wiener–Fourier series representation, the local-average expansion employs local basis functions rather than global basis functions. This technique has a great potential for solving high-dimensional and high-complexity stochastic problems.
Management of the Difficult Abdominal Closure

Primary closure of the abdominal wound following laparotomy in patients with hemorrhagic shock, massive transfusions, swollen abdominal viscera, and loss of compliance of the abdominal wall cannot be achieved without excessive tension. Persistence at primary closure in such patients leads to respiratory compromise, oliguria, enterocutaneous fistula, impaired abdominal wall nutrient blood flow, necrotizing fasciitis, evisceration, and sometimes death of the patient. A method of closure using an abdominal wall pack consisting of fluff gauze and rayon cloth is described. This method allows for fascia approximation and secondary wound healing without hernia in about 7 to 10 days as the patient enters the diuretic phase of resuscitation.
Histopathology of the Mucosa of Eustachian Tube Orifice at the Middle Ear in Chronic Otitis Media With Effusion: Possible Insight Into Tuboplasty Failure.

Introduction:Balloon dilation of the cartilaginous segment of the Eustachian tube has emerged as a means to directly augment tubal dilatory function, and this has been applied as a potential treatm...
Populism and Institutional Design: Methods of Selecting Candidates for Chief Executive

Donald Trump would most likely not be President but for the institutional change made in the 1970s, and analyzed here, in the nature of the presidential nomination process. In the 1970s, the United States shifted almost overnight from the methods that had been used for nearly 200 years to select party nominees, in which official representatives of the political parties played the major role in deciding the parties’ candidates for President, to a purely populist mode (primaries and caucuses) for selecting presidential nominees. This article explores the contrast between nomination processes that entail a central role for “peer review” – in which party leaders have a central voice in the selection of their parties’ nominees – and purely populist selection methods, such as currently used in the United States, in which ordinary voters completely control the selection of nominees and party figures have no special role. The first half of the article is historical and focuses on the United States. The second half is comparative and explores how other major democracies structure the process of choosing party leaders and candidates for chief executive. In the historical sections, we seek to show both how radical the change was that was made in the 1970s and yet how accidental, contingent, and inadvertent this transformation was. The “framers” of these changes did not actually intend to create the system with which we ended up, in which the primaries and caucuses completely determine the parties’ nominees. The comparative sections show that the U.S. system is an extreme outlier among major democracies: in no other democracy is the selection completely controlled by the mass of ordinary voters. Most other democracies use systems of pure peer review to select candidates for chief executive; or use systems that mix elements of peer review with popular participation; and in other ways continue to give official representatives of the parties much greater say than in the United States over the selection of the parties’ nominees for Chief Executive. The institutional design through which democracies choose nominees who compete to become a nation’s Chief Executive is among the most consequential features in the design of democratic elections. Yet there is surprisingly little scholarship that explores this issue in detail. This article also contributes to the general analysis of the rise of populist politics in many democracies today by showing how the institutional design for how party nominees are chosen can enable or constrain how easily and quickly populist political forces are able to capture control of government.
Reinforcement Learning: Improve Feedback Mechanism with Indicator based Reward, VirtualTA towards Growth Mindset

Automatic grading systems such as Web-CAT are widely used when students learn programming, especially in CS1/CS2 courses in colleges and universities. Current feedback mechanism in these systems benefits students with performance-based information. They have negative effects to often frustrate students especially novice programmers to belief of fixed mindset - their programming abilities are native and limited. Students with fixed mindset can seriously influence female and minority enrollment and retention rate in CS major. It is important to move students to growth mindset instead - belief their programming skills can be improved by practice and hard work. Recently effort were made to improve feedback mechanism in automatic grading systems. One effort was the design and implementation of a group of indicators to reflect students' progress and effort, based on their programming submissions. Another effort was the design of virutalTA Maria to deliver positive comments to encourage and reinforce students. We demonstrate the design of boosters (rewards) component and positive encourage and reinforcement comments feedback by virtualTA, based on indicators information. We simulated boosters (rewards) and comments component with a historical programming dataset to validate boosters (rewards) strategy. Simulated results found only 32 percent students did not get any Booster (rewards). 68 percent students won four types of booster range from Tier 1 to Tier 4. This result is what we are as expected. We also designed positive encouraging and reinforcement comments feedback from VirtualTA in adaptive style, based on indicator information. We plan to apply these two designed components to classroom for evaluation.
Catalyst Removal from Hydrogenated Oils Using Membrane Technology

Nickel catalyst currently is recovered from hydrogenated oil-catalyst mixtures by high capacity filter presses, but the process is highly labor-intensive. The use of membranes potentially could reduce labor expenses and the amount of oil lost during catalyst recovery, and can extend the useful life of catalysts. In the current study, catalyst ranging from 1 to 100 microns in particle size, did not pass through the membrane. All the nickel catalyst was recovered in the retentate fraction, resulting in a clear permeate stream. Experiments were performed over various pressure and temperature ranges, with flow rates ranging from 3.5 to 119 Imh.
Radio frequency heating of metallic and semiconducting single-walled carbon nanotubes

Here we report the effect of metallic (m-) and semiconducting (s-) properties of single-walled carbon nanotubes (SWCNTs) on the response of SWCNT films to radio frequency (RF) heating. We separated high-purity m- and s-SWCNTs from an initial SWCNTs mixture and prepared thin films using vacuum filtration method. The areal density of the films is 9.6 μg cm−2, and the DC conductivities are in the range of 7800–49 000 S m−1. We show rapid and non-contact Joule heating of films using a fringing-field RF applicator, and we observe maximum heating rates in the frequency range of 60–70 MHz. We determine that the more conductive m-SWCNT films reflect RF fields and heat at a maximum rate of 1.51 °C s−1 compared to maximum heating rate of 25.6 °C s−1 for s-SWCNT films. However, m-SWCNTs heat up faster than s-SWCNTs when dispersed in a dielectric medium. Our results confirm the non-monotonic relationship between RF heating rate and conductivity for CNT-based materials such that conductivity is required for heating but high values are correlated with reflections. Our findings also suggest that RF heating could be a possible metric for evaluating film purity because impurities in the films affect the conductivity and thus RF heating rate. We anticipate that RF heating may occur in SWCNT-based electronics and affect their performance.
Die Metallurgie des Zinks

Gegenwartig last sich die Metallurgie des Zinks kurz folgendermasen zusammenfassen. Das wichtigste Erz ist die Zinkblende, Zinksulfid, ZnS, welches bei den gewohnlichen technischen Ofentemperaturen unschmelzbar und nicht fluchtig ist, welches sich aber leicht zu ZnO abrosten last. Das Rosten der Zinkblende wird (in Amerika) meistens in ofen mit mechanischen Ruhrvorrichtungen vorgenommen, welchen das Erz im zerkleinerten Zustand zugefuhrt wird, weil die Blende fest und dicht ist und nur langsam abrostet. Das gerostete Erz, hauptsachlich aus ZnO bestehend, wird mit uberschussigem Kohlenstoff als Reduktionsmittel vermischt und in geschlossenen Retorten aus feuerfestem Ton mit angeschlossenen Kondensationseinrichtungen erhitzt. Bei 1033° treten Zinkdampfe auf und bei der Arbeitstemperatur von etwa 1200 bis 1300° ist die Entwicklung lebhaft. Zinkdampf und Kohlenoxyd durchstreichen die Kondensationseinrichtungen; hier wird das Zink niedergeschlagen, ein Teil in der Form eines feinen Staubes (wie Reif), das meiste aber in flussigem Zustand. Das Kadmium der Blende und etwas Blei, wenn solches vorhanden ist, destillieren mit dem Zink und bilden die wesentlichsten Verunreinigungen des Produktes. Bisweilen enthalt das Kondensationsprodukt auch Arsen. Eisen destilliert nicht. Das Zink kann aber nachtraglich aus den Loffeln und Formen, welche zum Transport und beim Giesen des flussigen Metalles verwendet werden, etwas Eisen aufnehmen.
Pre-clinical toxicology for a potent anti-cancer agent, a human ribonuclease variant

677 The objective of this study was to determine the pre-clinical toxicology profile of QBI-139, a member of the Evade™ Ribonuclease family, which are a novel class of therapeutic agents being developed for the treatment of cancer. These proteins are variants of the naturally occurring human pancreatic ribonuclease, engineered to evade the native ribonuclease inhibitor. QBI-139 was selected for pre-clinical studies based on tumor growth inhibition in the range of 80-90% in several mouse xenograft models. The efficacy of QBI-139 has been compared to standard chemotherapy agents, including 5-fluorouracil (pancreatic) and cisplatin (lung), as well as newer therapies such as erlotinib (lung), and representative data will be provided. The lead candidate QBI-139 was expressed in inclusion bodies in E. coli and purified by traditional column chromatography. The enzymatic activity was determined using a UV-based assay with cytidine 2’, 3’-cyclic monophosphate as the substrate. QBI-139 was tested for its ability to inhibit the growth of human tumors implanted in the flanks of nude mice (xenograft model). To evaluate the safety of QBI-139, toxicology studies were conducted. Acute dose studies were performed in both mice and rats to determine the maximum tolerated dose (MTD). Clinical observation, body weight, and clinical chemistry were used to identify organ-specific toxicities and determine the reversibility of the toxicities. The animals were dosed by bolus i.v. injection. The MTD for single dose administration in mice and rats was determined. A repeat dose (30 day) study in mice demonstrated the efficacious dose (75-100 mg/kg) is within the safe dose (>200 mg/kg). The pre-clinical toxicology data for QBI-139 supports the development as therapeutic agents. QBI-139 was well tolerated in the dose ranges anticipated to be efficacious.
Outcomes of Isolated Neutropenia Referred to Pediatric Hematology Oncology Clinic

Introduction: Patients with absolute neutrophil count (ANC) Methods: We performed a five-year IRB-approved, retrospective chart review of patients referred to a Pediatric Hematology-Oncology clinic for isolated neutropenia. Patients were excluded if they also had anemia or thrombocytopenia at the time of the referral. Degree of neutropenia was categorized: 1) at the time of referral, 2) at the lowest value, and 3) at the current ANC as Mild: 1.001-1.500 x109/L, Moderate: 0.501-1.000 x109/L, Severe: 0.201-0.5 x109/L, or Very Severe ≤0.2 x109/L. Descriptive statistics and odds ratios were performed. Results: Among 154 patients referred with isolated neutropenia over five years, 45 (29%) had mild neutropenia, 65 (42%) had moderate neutropenia, 29 (19%) had severe neutropenia, and 15 (10%) had very severe neutropenia. Only 29 (19%) patients progressed to a lower ANC category than their referral ANC category. At a median follow-up of 12 months, 101 (66%) patients had resolved neutropenia, 40 (26%) patients had mild, ten (6%) patients had moderate, three patients had severe, and one patient had very severe neutropenia. Most patients (54%) were not identified with a specific diagnosis. The most common diagnoses included viral suppression (16%), autoimmune neutropenia (14%) and drug induced neutropenia (8%). The most common medications reported as responsible for neutropenia were either anti-epileptic medications or immunosuppressant medications. No patients were diagnosed with a malignancy. Black patients had a 3.5 times higher odds of having persistent, mild, undiagnosed neutropenia which, for some patients, may be benign ethnic neutropenia. Seven (4.5%) patients received G-CSF therapy. Five patients were either managed by a Rheumatologist or an Immunologist. Finally, there were 16 hospitalizations that occurred in 10 patients for a prevalence of one admission for every 21 patient years. The most common admission diagnosis was febrile neutropenia without subsequent bacteremia (n=13). Conclusion: Most pediatric patients referred for isolated neutropenia do not progress, develop leukemia, or require sub-specialty interventions. Hospitalization of patients referred for isolated neutropenia is rare as is bacteremia. This study provides important outcome data that can improve our counseling of pediatric patients identified with isolated neutropenia. Download : Download high-res image (97KB) Download : Download full-size image Disclosures Howard: Novartis: Consultancy. Lebensburger: Novartis: Consultancy; Pfizer: Research Funding.
How What You Measure Matters: Risk-Adjusted Length of Stay and Observation Status.

* Abbreviations: OBS — : observation status RA-LOS — : risk-adjusted geometric mean length of stay The underlying vision for pediatric quality measurement is improved care and health outcomes for children. Quality measures help realize this vision, through capturing system successes and failures in supporting child health. There are a large number of quality measures, some of which are focused on processes, some on outcomes, and some on use.1 To accurately assess successes and failures in care delivery, measure design matters. This is because measures can deeply incentivize behavior because of their use in reputational (eg, public reporting) and financial incentive (value-based purchasing) programs. In this issue of Pediatrics , Gay et al2 focus on risk-adjusted geometric mean length of stay (RA-LOS), a commonly used metric for understanding hospital use. Hospitals and payers often use this to assess efficiency and throughput, with the most familiar manifestation being the focus on “discharge before noon.” But increased RA-LOS can also signal issues with patient safety and increased hospital-acquired conditions.3,4 Hence, getting this measure design right is important because the measure informs hospitals not only about their relative efficiency and throughput compared with other hospitals nationally but also about potentially important failures in patient safety. Ga2y et al2 focus on a specific … Address correspondence to Naomi S. Bardach, MD, MAS, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, 3333 California St, Suite 265, San Francisco, CA 94118. E-mail: naomi.bardach{at}ucsf.edu
Here waits the bride? The effect of Ethiopia's child marriage law

Abstract Child marriage is still common in the developing world: in 2012, one in three women was married by age 18, with more than 10% married before age 15. Beginning in 2000, Ethiopia's semi-autonomous regions raised the legal minimum age of marriage from 15 to 18. This study leverages the natural experiment arising from the staggered roll out of the policy in a difference-in-differences and event study framework. The results suggest that the reform delayed women's marriage, and in particular delayed marriages of girls under 16 by about 17 percent (6.8 percentage points) in areas where early marriage was more common prior to the reform. However, the effect of the reform, though larger, is insignificant among women belonging to ethnic groups with the strongest norms toward early marriage. Women's fertility was delayed and may be lower over their lifetimes.
OB STARS AND STELLAR BOW SHOCKS IN CYGNUS-X: A NOVEL LABORATORY ESTIMATING STELLAR MASS LOSS RATES

We use mid-infrared images from the Spitzer Space Telescope Cygnus X Legacy Survey to search for stellar bow shocks (BSs), a signature of early-type 'runaway' stars with high space velocities. We identify ten arc-shaped nebulae containing centrally located stars as candidate BSs. New spectroscopic observations of five stars show that all are late-O to early-B dwarfs, while one is a previously classified B0.2 giant. These stars have moderate radial velocities, differing by DELTAV< 10 km s{sup -1} from members of the Cygnus OB2 Association. The spectral energy distributions (SEDs) of the other four stars are consistent with late-O to early-B dwarfs at the nominal {approx}1.6 kpc distance of Cyg OB2. Our morphologically selected sample of BS candidates encompasses diverse physical phenomena. Three of the stars appear to be pre-main-sequence objects on the basis of rising SEDs in the mid-IR, and their nebulae may be photon-dominated regions illuminated by the central star but shaped by external sources such as winds from Cyg OB2. Four objects have ambiguous classification. These may be partial dust shells or bubbles. We conclude that three of the objects are probable BSs, based on their morphological similarity to analytic prescriptions. Their nebular morphologies reveal no systematic patternmore » of orientations that might indicate either a population of stars ejected from or large-scale hydrodynamic outflows from Cyg OB2. The fraction of runaways among OB stars near Cyg OB2 identified either by radial velocity or BS techniques is {approx}0.5%, much smaller than the {approx}8% estimated among field OB stars. We discuss possible reasons for this difference. We also obtained a heliocentric radial velocity for the previously known BS star, BD+43{sup 0}3654, of -66.2 +- 9.4 km s{sup -1}, solidifying its runaway status and implying a space velocity of 77 +- 10 km s{sup -1}. We use the principles of momentum-driven BSs in conjunction with the observed sizes, BS luminosities and SEDs, and dust/polycyclic aromatic hydrocarbon emission models to arrive at a novel method for estimating stellar mass loss rates. Derived mass loss rates range between 10{sup -7} and few x10{sup -6} M{sub sun} yr{sup -1} for the three O5V-{approx}B2V stars identified as generating BSs. These values are at the upper range of, but broadly consistent with, estimates from other methods. We calculate a relatively large mass loss rate of 160 x 10{sup -6} M{sub sun} yr{sup -1} for O4If star BD+43{sup 0}3654 using the same method.« less
Anisotropic thermal conductivity of layered indium selenide

Layered indium selenide (InSe) has emerged as a promising two-dimensional semiconductor due to its high electron mobility and direct optical bandgap in the few-layer limit. As InSe is integrated into high-performance electronic and optoelectronic systems, thermal management will become critical, thus motivating detailed characterization of intrinsic thermal properties. Here, we report the room-temperature thermal conductivity of exfoliated crystals of InSe along the through-plane and in-plane directions using conventional and beam offset time-domain thermoreflectance (TDTR), respectively. InSe crystals with varying thicknesses were prepared by mechanical exfoliation onto Si(100) wafers followed by immediate encapsulation with a 3-nm-thick AlOx passivation layer to prevent ambient degradation prior to coating with metal films for TDTR measurements. The measured thermal conductivity in the in-plane direction, Λin ≈ 8.5 ± 2 W/m K, is an order of magnitude higher than that in the through-plane direction, Λthrough ≈ 0.76±0.15 W/m K, which implies a high thermal anisotropy ≈11 ± 3. These relatively high anisotropy and low thermal conductivity compared to other layered semiconductors imply that InSe will require unique thermal management considerations when implemented in electronic, optoelectronic, and thermoelectric applications.
Active Sampling for Linear Regression Beyond the $\ell_2$ Norm.

We study active sampling algorithms for linear regression, which aim to query only a small number of entries of a target vector $b\in\mathbb{R}^n$ and output a near minimizer to $\min_{x\in\mathbb{R}^d}\|Ax-b\|$, where $A\in\mathbb{R}^{n \times d}$ is a design matrix and $\|\cdot\|$ is some loss function. For $\ell_p$ norm regression for any $0<p<\infty$, we give an algorithm based on Lewis weight sampling that outputs a $(1+\epsilon)$ approximate solution using just $\tilde{O}(d^{\max(1,{p/2})}/\mathrm{poly}(\epsilon))$ queries to $b$. We show that this dependence on $d$ is optimal, up to logarithmic factors. Our result resolves a recent open question of Chen and Derezi\'{n}ski, who gave near optimal bounds for the $\ell_1$ norm, and suboptimal bounds for $\ell_p$ regression with $p\in(1,2)$. We also provide the first total sensitivity upper bound of $O(d^{\max\{1,p/2\}}\log^2 n)$ for loss functions with at most degree $p$ polynomial growth. This improves a recent result of Tukan, Maalouf, and Feldman. By combining this with our techniques for the $\ell_p$ regression result, we obtain an active regression algorithm making $\tilde O(d^{1+\max\{1,p/2\}}/\mathrm{poly}(\epsilon))$ queries, answering another open question of Chen and Derezi\'{n}ski. For the important special case of the Huber loss, we further improve our bound to an active sample complexity of $\tilde O(d^{(1+\sqrt2)/2}/\epsilon^c)$ and a non-active sample complexity of $\tilde O(d^{4-2\sqrt 2}/\epsilon^c)$, improving a previous $d^4$ bound for Huber regression due to Clarkson and Woodruff. Our sensitivity bounds have further implications, improving a variety of previous results using sensitivity sampling, including Orlicz norm subspace embeddings and robust subspace approximation. Finally, our active sampling results give the first sublinear time algorithms for Kronecker product regression under every $\ell_p$ norm.
Role of formats in the life cycle of data

This paper's perspective is based on the author's experience generating, analyzing, archiving, and distributing data obtained from satellites, and on the experience gained in data modeling and the development of standards for data understanding under the Consultative Committee for Space Data Systems (CCSDS). Data formats are used to represent all information in digital form, and thus play a major role in all interchanges and access to this information. The need to more efficiently manage and process rapidly growing quantities of data, and to preserve the information contained therein, continue to drive a great interest in data formats. The purpose of this paper is to examine the role of formats as they support the use of data within a space agency. The life-cycle identified is only one of many variations that would be recognized by those familiar with the 'space business', however it is expected that most of the issues raised will be pertinent to other 'space business' life cycles and to other 'non-space' disciplines as well.
Personality Characteristics of Psychosomatic Patients

Writing a chapter about the personality characteristics of psychosomatic-prone patients poses several difficulties. The main problem arises from the ubiquitous nature of psychosomatic phenomena. To fall ill when stressed is as human as falling in love.
“There and Back Again”: Latin American Social Movements and Reasserting the Powers of Structural Theories

Two anthologies published in the 1990s declared a theoretical and empirical watershed by advocating for and applying New Social Movement (NSM) theorizing to studies of Latin American social-movement activism, at the same time declaring older movements and theories passe. We criticize both the novelty and the fruitful applicability of NSM-style theory to Latin America’s social-movement universe of recent decades, and re-advocate the virtues and analytical powers of perspectives rooted in political economy and political sociology. The claims made by advocates of NSM theorizing, that certain social movements—those rooted in economic interests or in material and political deprivations—have been eclipsed in number and importance by culture-and-identity-focused movements are shown to be without merit. We buttress that assertion with reference to a wide array of recent movements among workers, consumers, debtors, racial and ethnic groups, women, and students, among others. We also look closely at two very large, yet rather different movements, the Landless Rural Workers’ Movement (MST) in Brazil and Bolivia’s Movimiento al Socialismo (MAS).
DOES MANDATORY DIVORCE EDUCATION FOR PARENTS WORK

In a court-mandated, child-focused class for divorcing parents, parental mastery of skills taught were evaluated both immediately after the class and 6 months later. Parents perceived the classes to be realistic and useful. Skills were effectively learned and were maintained over the evaluation period. Parents reported that they were successful in dramatically lowering exposure of their children to parental conflict. Relative to a comparison group of parents divorcing the year before the classes were initiated, parents completing the class were better able to work through how they would handle difficult child-related situations with their ex-spouses and were willing to let their children spend more time with the other parent. Few gender differences were observed—mothers perceived the class as more realistic; fathers showed greater improvement on some skills. Similarly, interest level in further training was not predictive of class benefits, suggesting that enthusiasm for parenting training is probably not essential.
Opioid and adenosine peripheral antinociception are subject to tolerance and withdrawal

The selective mu-opioid agonist, D-Ala2,N-Me-Phe4,Gly5-ol-enkephalin (DAMGO), or the selective A1-adenosine agonist N6-cyclopentyladenosine (CPA), when coinjected intradermally with prostaglandin E2 (PGE2), dose-dependently inhibited PGE2-induced mechanical hyperalgesia in the rat hindpaw, as determined by the Randall-Selitto paw-withdrawal test. Repeated (hourly x 3) intradermal injections of DAMGO or CPA produced tolerance to the antinociceptive effect of a fourth injection 1 hr later. Furthermore, repeated (hourly x 3) intradermal injections of DAMGO produced cross-tolerance to the antinociceptive effect of CPA, and repeated (hourly x 3) intradermal injection of CPA produced cross-tolerance to the antinociceptive effect of DAMGO. The demonstration of the bidirectional cross-tolerance between the peripheral antinociceptive effects of DAMGO and CPA supports the hypothesis that both these agents produced antinociception by acting on the same cell, presumably the primary afferent nociceptor, and that the development of tolerance involves changes downstream to activation of mu-opioid and A1-adenosine receptors. The opioid antagonist naloxone, which had no effect on paw-withdrawal threshold in normal paws, produced withdrawal threshold in normal paws, produced withdrawal hyperalgesia in DAMGO-tolerant paws. Furthermore, naloxone elicited a cross-withdrawal hyperalgesia response in CPA-tolerant paws. Similarly, the A1-adenosine antagonist 1,3-dipropyl-8-(2-amino-4- chlorophenyl)-xanthine (PACPX), which had no effect on paw-withdrawal threshold in normal paws, elicited a withdrawal hyperalgesia response in CPA-tolerant paws and cross-withdrawal hyperalgesia responses in DAMGO-tolerant paws. These cross-dependence and cross-withdrawal responses suggest that the development of dependence to mu-opioid and A1-adenosine agonists involves changes in the same second messenger system downstream to both mu-opioid and A1-adenosine receptor activation.
Avoidant symptoms cloaking the diagnosis of PTSD in patients with severe accidental injury

In a pilot study of seriously injured accident victims, 15 patients selected in initial intake interviews were followed at 9- to 10-week intervals for 9 months after admission to a community shock-trauma center. Psychiatric diagnoses were based on a structured psychiatric interview. A total of six patients met criteria for PTSD. In two cases, PTSD was not diagnosed until 3 to 6 months after injury, primarily because of severe avoidant symptomatology. In another case, intrusive and arousal symptoms were not immediately explainable as a manifestation of PTSD, because it was mistakenly believed that the patient had been unconscious during the accident. Diagnosis in two of these would probably have been missed without frequent follow-up interviews. Findings suggest that avoidant symptoms of PTSD can interfere with diagnosis. This has important consequences for outcome studies. It is suggested that frequent follow-up after a traumatic event may reduce the level of false negatives in population studies.