cssi/SciSciGPT-SciSciNet huggingface dataset:
Preserving the Eggshell Planet: A Global Perspective on Domestic Regulation

In the now famous case of Vosburg v. Putney, the Wisconsin Court enunciated the common law doctrine since known as the "eggshell skull" or "thin skull" rule: you take your victim as you find him. The thin skull rule is a productive starting point for a dialogue on the place of law in any effort to control (or reverse) the cumulative damage to the planet's ecosystem. Any such dialogue requires a global perspective that fuses international and domestic approaches to law. Environmental law must assess not only the level of assault against the earth, but also the risk of the planet's hypervulnerability to further injury. As in Vosburg v. Putney, some of the insult to the planet has been the result of unintended consequences, whose significance we are only now beginning to understand. The planet has become an eggshell victim of industrialization, population growth and the expansion of the consumer society. The purpose of this essay is three-fold: (1) to link the relationship of international trade and domestic environmental regulation to a broader global discourse; (2) to outline this global discourse, which includes both international and domestic elements; and (3) to articulate some additional factors (beyond trade) that are now integral to the relationship between domestic environmental law and the global regulatory discourse.
Mechanisms Underlying the Chronotropic Effect of Angiotensin II on Cultured Neurons From Rat Hypothalamus and Brain Stem

Wang, Desuo, Craig H. Gelband, Colin Sumners, and Philip Posner. Mechanisms underlying the chronotropic effect of angiotensin II on cultured neurons from rat hypothalamus and brain stem. J. Neuroph...
Introduction to GPS geodetic infrastructure for land subsidence monitoring in Houston, Texas, USA

Abstract. Houston, Texas is one of the places that first employed high-accuracy GPS technology for land subsidence monitoring beginning in the late 1980s. Currently, there are over 170 permanent GPS stations located in the Houston metropolitan area. This article summarizes the current GPS geodetic infrastructure in the Houston metropolitan area, which is comprised of three components: a dense GPS network with 170 permanent stations, a stable Houston reference frame (SHRF14), and sophisticated software packages for post positioning processing. Average land subsidence and groundwater-level altitude changes during the past 10 years (2005–2014) also are presented in this paper.
Review of imipenem.

Imipenem, a new carbapenem beta-lactam broad-spectrum antibiotic, is highly active in vitro against most aerobic and anaerobic gram-positive and gram-negative bacteria isolated from infectious diseases of human beings. Except for enterococci and methicillin-resistant staphylococci most gram-positive cocci are inhibited by less than 2 micrograms/ml. Although the MIC-90 of methicillin-resistant staphylococci may be less than 4 micrograms/ml, these bacteria are usually resistant to imipenem by modified testing methods. The enterococcus, S. faecalis, has an MIC-90 of less than 8 micrograms/ml but bactericidal concentration may be much higher. Most Enterobacteriaceae are highly susceptible to imipenem with MIC-90 of 0.5 to 2.0 micrograms/ml. Proteus species are less susceptible with MICs of 4 to 8 micrograms/ml. Isolates of P. aeruginosa have variable susceptibility with MICs ranging from 0.25 to 16 micrograms/ml. Pseudomonas maltophilia and P. cepacia are usually resistant to imipenem. Except for Clostridium species, most strict anaerobes are susceptible to less than 1.0 micrograms/ml of imipenem. When combined with cilastatin (1:1 ratio), the renal elimination of the active form is increased. The serum halflife in normal renal function is about 1 hour and increases to 3.4 hours in anuria. Major adverse effects are similar to those of cephalosporins except for seizures in some patients. Colonization with fungi and drug-resistant bacteria occurs in about 5% of imipenem-treated patients. Clinical studies have demonstrated efficacy in 79% to 96% of patients treated.
Evaluating the Talent Search TRIO program: A Benefit-Cost Analysis and Cost-Effectiveness Analysis

Talent Search was created to improve high school completion and college enrollment for disadvantaged students. Since the program’s inception in 1967, there has not been a valid study on its economic value. In this paper, we perform a full economic evaluation, yielding direct information on the value of Talent Search and highlighting key methodological issues relating to economic evaluations of education programs. We provide rigorous estimates of social costs using the ingredients method. Using prior estimates of impacts from Constantine et al. [(2006). Study Of The Effect of The Talent Search Program On Secondary And Postsecondary Outcomes In Florida, Indiana And Texas: Final Report From Phase II of The National Evaluation. Washington, DC: U.S. Department of Education Office of Planning, Evaluation and Policy Development, Policy and Program Studies Service], we perform a cost-benefit analysis based on new estimates of shadow prices. Finally, to examine site-specific differences in impacts and costs, we undertake cost-effectiveness analysis and derive confidence intervals that illustrate key sensitivity issues. Regarding costs, we find significant resource use beyond federal funding amounts; but we also find that the present value benefits of Talent Search almost certainly exceed the present value of costs by a substantial margin. With regard to cost-effectiveness, we find significant differences across sites and extremely wide confidence intervals. We conclude with an outline of key research issues that need to be addressed to enhance future economic evaluations in educational settings with wide site-specific variation.
Subtle benefits of cooperation to breeding males of the Red-backed Fairywren

ABSTRACT Cooperative breeding is a phenomenon whereby breeding and nonbreeding individuals collectively provision young. Nonbreeding group members (“helpers”) may gain indirect and/or direct fitness benefits by breeding in a group, but there has been conflicting evidence regarding the benefits to breeders. In fact, the presence of helpers may sometimes be detrimental to aspects of breeder fitness. For example, in some species of the chiefly Australian genus Malurus, breeding males with helpers have lower within-pair paternity than do males without helpers. Additionally, indirect benefits to breeding males are often limited by low relatedness to their helpers due to high extrapair paternity rates, and helpers often appear to have minimal impact on breeder reproductive success. However, the presence of helpers may allow breeding males to shift their behaviors from guarding and provisioning young to alternative behaviors that affect other components of fitness, such as extraterritory forays (which might incr...
Effects of Microwave Treatment of Live Oak Acorns on Germination and on Curculio sp. (Coleoptera: Curculionidae) Larvae

Microwave irradiation of live oak acorns was evaluated in the laboratory as an alternative to hydrothermal treatments for controlling larvae of weevils, Curculio sp., in commercial production of live oaks. Seed and larvae contained therein exposed to microwaves for 0–180s suffered similarly increasing levels of mortality; quenching the seed briefly in cool water reduced injury both to the pest and its host. The approach, as tested, does not appear promising as a means of weevil control.
Proline dehydrogenase 2 (PRODH2) is a hydroxyproline dehydrogenase (HYPDH) and molecular target for treating primary hyperoxaluria

The primary hyperoxalurias (PH), types 1-3, are disorders of glyoxylate metabolism that result in increased oxalate production and calcium oxalate stone formation. The breakdown of trans-4-hydroxy-L-proline (Hyp) from endogenous and dietary sources of collagen makes a significant contribution to the cellular glyoxylate pool. Proline dehydrogenase 2 (PRODH2), historically known as hydroxyproline oxidase, is the first step in the hydroxyproline catabolic pathway and represents a drug target to reduce the glyoxylate and oxalate burden of PH patients. This study is the first report of the expression, purification, and biochemical characterization of human PRODH2. Evaluation of a panel of N-terminal and C-terminal truncation variants indicated that residues 157-515 contain the catalytic core with one FAD molecule. The 12-fold higher k(cat)/K(m) value of 0.93 M⁻¹·s⁻¹ for Hyp over Pro demonstrates the preference for Hyp as substrate. Moreover, an anaerobic titration determined a K(d) value of 125 μM for Hyp, a value ~1600-fold lower than the K(m) value. A survey of ubiquinone analogues revealed that menadione, duroquinone, and CoQ₁ reacted more efficiently than oxygen as the terminal electron acceptor during catalysis. Taken together, these data and the slow reactivity with sodium sulfite support that PRODH2 functions as a dehydrogenase and most likely utilizes CoQ₁₀ as the terminal electron acceptor in vivo. Thus, we propose that the name of PRODH2 be changed to hydroxyproline dehydrogenase (HYPDH). Three Hyp analogues were also identified to inhibit the activity of HYPDH, representing the first steps toward the development of a novel approach to treat all forms of PH.
Yrast states in Fe 52 , Mn 52 and the decay of Fe m 52

The properties of yrast states of $^{52}\mathrm{Fe}$ and $^{52}\mathrm{Mn}$ were studied using the $^{40}\mathrm{Ca}$ + $^{14}\mathrm{N}$ reaction. In-beam $\ensuremath{\gamma}$-ray singles, $\ensuremath{\gamma}\ensuremath{-}\ensuremath{\gamma}$ coincidence, and $n\ensuremath{-}\ensuremath{\gamma}$ coincidence data establish the positions of the lowest ${2}^{+}$ and ${4}^{+}$ states of $^{52}\mathrm{Fe}$ as 849.1\ifmmode\pm\else\textpm\fi{}0.3 and 2384.6\ifmmode\pm\else\textpm\fi{}0.7 keV, respectively. No $\ensuremath{\gamma}$ rays associated with other $^{52}\mathrm{Fe}$ states could be found. This is because an $^{52}\mathrm{Fe}$ isomer at 6.83 MeV ${\ensuremath{\beta}}^{+}$ decays to $^{52}\mathrm{Mn}$, diverting strength from the $^{52}\mathrm{Fe}$ $\ensuremath{\gamma}$ cascade. Delayed $\ensuremath{\gamma}$-ray singles and $\ensuremath{\gamma}\ensuremath{-}\ensuremath{\gamma}$ coincidence data give information on the high-spin yrast states of $^{52}\mathrm{Mn}$ populated in the ${\ensuremath{\beta}}^{+}$ decay of the isomer. The results are consistent with several recently published works, and unambiguously establish that the $^{52}\mathrm{Mn}$ ${8}^{+}$ state is at 2286.0\ifmmode\pm\else\textpm\fi{}0.4 keV. The delayed spectra show no indication of direct $\ensuremath{\gamma}$ decay of the $^{52}\mathrm{Fe}$ isomer. An upper limit on the $\ensuremath{\gamma}$ decay branch is 4 \ifmmode\times\else\texttimes\fi{} ${10}^{\ensuremath{-}3}$. On the basis of the ${(1{f}_{\frac{7}{2}})}^{n}$ model with "bare" nucleon charges, direct $E4$ $\ensuremath{\gamma}$ emission should be the dominant decay mode. It is argued that the absence of $E4$ decay, taken together with known $B(E4)$ data on $^{44}\mathrm{Sc}$, $^{52}\mathrm{Mn}$ and $^{53}\mathrm{Fe}$, shows $E4$ effective charges in the ($1{f}_{\frac{7}{2}}$) shell are different for nuclei located near the beginning or end of the shell. Further, the effective charges near the end of the shell seem to be quite different from those found in $E2$ transitions, i.e., ${e}_{p}\ensuremath{\sim}0.5$, ${e}_{n}\ensuremath{\sim}\ensuremath{-}0.5$. First order perturbation calculations in the ${(1f,2p)}^{n}$ model offer qualitative, but not quantitative, insight as to the $E4$ effective charge behavior.RADIOACTIVITY $^{52}\mathrm{Fe}^{m}$; measured ${T}_{\frac{1}{2}}$. $\ensuremath{\beta}\ensuremath{\gamma}$ coin., $\ensuremath{\beta}$-delayed $\ensuremath{\gamma}$ and $\ensuremath{\gamma}\ensuremath{\gamma}$ coin; deduced $log\mathrm{ft}$, $E4$ limit. $^{52}\mathrm{Mn}$ deduced levels.NUCLEAR REACTIONS $^{40}\mathrm{Ca}$($^{14}\mathrm{N}$, $\mathrm{np}$)$^{52}\mathrm{Fe}$, $E=29 \mathrm{to} 38$ MeV; measured prompt $\ensuremath{\gamma}$ and $n\ensuremath{\gamma}$ coinc., deduced $^{52}\mathrm{Fe}$ levels.
DIFFERENTIAL AVOIDANCE OF CORAL SNAKE BANDED PATTERNS BY FREE-RANGING AVIAN PREDATORS IN COSTA RICA.

Empirical studies of mimicry have rarely been conducted under natural conditions. Field investigations of some lepidopteran systems have provided a bridge between experiments examining artificial situations and the mimicry process in nature, but these systems do not include all types of mimicry. The presence of dangerous or deadly models is thought to alter the usual rules for mimicry complexes. In particular, a deadly model is expected to protect a wide variety of mimics. Avoidance of different types of mimics should vary according to how closely they resemble the model. Coral snake mimicry complexes in the neotropics may provide natural systems in which these ideas can be examined, but there is no direct evidence that the patterns of venomous coral snakes or potential mimics are avoided in the wild. Plasticine replicas of snakes were used to assess the frequency of avian predation attempts as a function of color pattern. Avian predators left identifiable marks on the replicas, the position of which indicated that replicas were perceived as potentially dangerous prey items by birds. The number of attacks on unmarked brown replicas was greater than that on tricolor coral snake banded replicas. This result was true whether replicas were placed on natural or plain white backgrounds, suggesting that coral snake banded patterns function aposematically. In a separate experiment, replicas representing all six patterns of proposed coral mimics at the study site were attacked less often than unmarked brown replicas. Within these six banded patterns, some were attacked significantly more often than others. This study provides direct field evidence that coral snake banded patterns are avoided by free-ranging avian predators and supports theoretical predictions about mimicry systems involving deadly models.
The Scope of Mitigation in the Death Penalty

### Court Rules on Limits of Mitigation In Moore v. Parker , 425 F.3d 250 (6th Cir. 2005), the U.S. Court of Appeals for the Sixth Circuit reviewed the denial by the U.S. District Court for the Western District of Kentucky at Louisville of Keith Moore's petition for a writ of habeas corpus based on
Maternal death associated with premature rupture of the membranes

Abstract Between August, 1957, and December, 1964, 1,054 maternal deaths were reviewed by the Maternal Mortality Committee of the State of California. From this material, 54 maternal deaths associated with premature rupture of the membranes were gathered. This paper is a detailed study of these deaths, 38 of which occurred from sepsis, 7 from amniotic fluid embolism, 4 from hemorrhage, 4 from ruptured uteri, and one from cardiac arrest. Sepsis was the major factor. Too frequently, antibiotic therapy was begun too late and in too small a dose to be effective. Seven patients were killed by overtreatment. The risk to the mother has been demonstrated to be roughly one death for each 5,451 cases of premature rupture of the membranes.
Study on Technology Features of Germany KHS Labeler

KHS labeling machine adopts the servo motor control technology to improve the accuracy and speed of chromatic light labeling,eye detection label MARK point accurately control the length of label,MCU programmable control and parameter setting function,promotion has the advantages of simple operation,convenient production and conversion program,play its efficient,stable operation of the important technical means.
Trace determination of mercury in rice using microwave digestion coupling with atomic fluorescence spectrometry

Objective:To establish a rapid,precise and sensitive method for the trace determination of mercury in rice by microwave digestion coupling with atomic fluorescence spectrometer approach.Methods:After a pretreatment with nitric acid/hydrogen peroxide microwave digestion system,we used atomic fluorescence spectrometer methodology to determine trace mercury in rice.Results:Under the optimized digestion and detection conditions: nitric acid/water/hydrogen peroxide ratio,4:4:2;KBH4 concentraton,0.3%(w/w);lamp current,20 mA;flow rate of carrying gas,300 ml/min;carrying flow,5% HCl,wide linear relationship was achieved in the range of 0.1~50.0 μg/L with relative coefficient of 0.9999 and the detection limit was estimated to be 0.0114 μg/L.We got satisfied recovery rates of spiked samples of 98.9% to 105.9% with RSD of four replicate experiments less than 6.6%.Conclusion:The present method is precise,rapid and sensitive enough for determination of trace mercury in rice.The detection results indicate that rice in Ningbo market is mostly safe.
Characterization and Modelling of Hygrothermal Effects in Thermoplastic Nanocomposites

The hygrothermal and mechanical characterization of continuous fiber-reinforced nanocomposites in compression molded E-Glass fiber-reinforced in polyamide-6 or nylon-6 matrix with and without different weight addition of nanoclay have been performed. E-Glass/Nylon-6 nanocomposite was characterized by means of X-Ray Diffraction to determine the nanoclay dispersion morphology. Significant improvement were achieved in compressive strength, shear strength and barrier properties with relatively low nanoclay loadings. The baseline and nanoclay modified E-Glass/Nylon-6 specimens were immersed in de-ionized water at 50 °C and aged hygrothermally. Mechanical tests on unaged E-Glass/Nylon-6 nanocomposite confirmed strength enhancement with nanoclay addition, with a significant improvement in compressive strength (50% at 4 wt.% nanoclay loading) and shear strength (∼36% at 4 wt.% nanoclay loading). Mechanical tests on hygrothermally aged E-Glass/Nylon-6 modified with 4 wt.% nanoclay loading showed that hydrothermal degradation is drastically reduced with a significant reduction ( ~ 30%) in moisture uptake compared to baseline E-Glass/Nylon-6 composites. An analytical model is developed to capture the diffusion mechanism and attribute the change in diffusivity and moisture uptake with weight addition of nanoclay to tortuosity and reduction in free volume created by the presence of nanoclay. The loss in change in free volume computed using Atomic Force Microscopy images is compared with analytical model.
Exposing cancer's deep evolutionary roots

Paul Davies argues that cancer is an ancient genetic program present within us all, with roots in the dawn of multicellularity over a billion years ago.
A Prospective Study of the Reliability and Validity of the Live Donor Assessment Tool

Background The psychosocial evaluation is an important part of the live organ donor evaluation process, yet this is not standardized across institutions. Objective This study was designed to prospectively test the reliability and validity of a semistructured psychosocial evaluation tool that was recently developed and reported in the literature (the Live Donor Assessment Tool [LDAT]). Methods A total of 248 live donor candidates who presented for evaluation were invited to participate in a study that involved the LDAT being scored as part of the standard psychosocial evaluation process; 222 provided informed consent. Evaluations were conducted by staff experienced with psychosocial evaluation of living donors and trained in the use of the LDAT. Furthermore, 123 donor candidates were evaluated twice, as per routine standard of care, and had 2 LDATs administered. Reliability of the LDAT was assessed by calculating the internal consistency of the LDAT items and inter-rater reliability. Validity was assessed by comparing LDAT scores across the risk-group categories (the traditional outcome designation of the psychosocial evaluation) and in 86 eventual donors, associations between LDAT scores, and indicators of psychosocial outcomes post-donation. Results The LDAT was found to have good internal consistency, strong inter-rater reliability, and showed signs of validity: LDAT scores differentiated the traditional risk-group categories, and a significant association between LDAT score and treatment adherence post-donation was revealed. Conclusions The LDAT demonstrated good reliability and validity, but future research on the LDAT and the ability to implement the LDAT across institutions is warranted.
Synthesis of Oligodeoxynucleotides Containing a C8-2′-Deoxyguanosine Adduct Formed by the Carcinogen 3-Nitrobenzanthrone

This unit describes the detailed procedure in five parts for the synthesis of the C8-2'-deoxyguanosine-3-aminobenzanthrone adduct located in a desired site in an oligonucleotide. The synthesis of the protected 2'-deoxyguanosine, O6 -benzyl-N2 -DMTr-3'-5'-bisTBDMS-C8-Br-2'-deoxyguanosine, is described in the first part. The synthesis of the reduced carcinogen 3-aminobenzanthrone is detailed in part two. The third part outlines the key step of the adduct formation between the reduced carcinogen and the protected nucleoside by a palladium-catalyzed cross coupling reaction. The final two parts describe phosphoramidite synthesis from the nucleoside-carcinogen adduct followed by its site-specific incorporation into DNA by solid-phase oligonucleotide synthesis. The adducted oligonucleotides are purified by reversed-phase HPLC and characterized by mass spectrometry. © 2017 by John Wiley & Sons, Inc.
Catastrophic antiphospholipid syndrome in a patient with systemic sclerosis and hereditary angioedema: case report and literature review

AbstractCatastrophic antiphospholipid syndrome (CAPS) is a rare form of the antiphospholipid syndrome (APS) in which microvascular thrombotic events cause rapidly progressive multiorgan dysfunction. We describe a case of CAPS presenting in a patient with suspected systemic sclerosis (SSc) and hereditary angioedema (HAE), and conduct a literature review to examine the reported cases of CAPS in individuals with SSc. Two reported cases of APS occurring with HAE were also found. In CAPS, there may be multiple thrombi in the microvasculature of any organ, most commonly in the intra-abdominal viscera. Patients rapidly develop multiorgan dysfunction or failure. Diagnosis is partly based upon the presence of positive antiphospholipid antibodies. The recommended therapy is systemic anticoagulation, high-dose corticosteroids, and plasma exchange with or without the addition of intravenous immunoglobulin. Given the high mortality rate of CAPS, urgent diagnosis and treatment are necessary to attempt to halt the progr...
Intervalley scattering by donor ions in germanium

Abstract A contribution to the intervalley scattering rate in n -germanium is the direct transition induced by the donor-ion potential, U . The scattering rate for this process is calculated to lowest order in U , using the relation between the intervalley matrix elements of U and the singlet-triplet splitting of the donor ground state. The predicted scattering rate for Arsenic agrees with the experimental results of Weinreich, Sanders and White for the intervalley scattering due to donor ions, above 40°K.
Lysozyme-catalyzed formation of a conjugated polyacetylene

Hen egg white lysozyme catalyzes the polymerization of 2-ethynylpyridine in water as the singular protein catalyst. Inhibition and NMR spectroscopy studies support the hypothesis that polymerization takes place in the active site cleft of the protein. This discovery marks the first time a metal-free hydrolase has been observed activating the formation for a conjugated polymer.
Reducing Emergency Room Visits and In-Hospitalizations by Implementing Best Practice for Transitional Care Using Innovative Technology and Big Data.

Background Efforts to improve care transitions require coordination across the healthcare continuum and interventions that enhance communication between acute and community settings. Aims To improve post-discharge utilization value using technology to identify high-risk individuals who might benefit from rapid nurse outreach to assess social and behavioral determinants of health with the goal of reducing inpatient and emergency department visits. Methods The project employed a before and after comparison of the intervention site with similar primary care practice sites using population-level Medicaid claims data. The intervention targeted discharged persons with preexisting chronic disease and delivered a care transition alert to a nurse care coordinator for immediate telephonic outreach. The nurse assessed social determinants of health and incorporated problems into the EHR to share across settings. The project evaluated health outcomes and the value of nursing care on existing electronic claims data to compare utilization in the years before and during the intervention using negative binomial regression to account for rare events such as inpatient visits. Results Avoiding readmissions and emergency visits, and increasing timely outpatient visits improved the individual's experience of care and the work life of healthcare providers, while reducing per capita costs (Quadruple Aim). In the intervention practice, the nurse care coordinator demonstrated the value of nursing care by reducing inpatient (25%) and emergency (35%) visits, and increasing outpatient visits (27%). The estimated value of avoided encounters over the secular Medicaid trend was $664 per adult with chronic disease, generating $71,289 in revenue from additional outpatient visits. Linking evidence to action Using health information exchange to deliver appropriate and timely evidence-based clinical decision support in the form of care transition alerts and assessment of social determinants of health, in conjunction with data science methods, demonstrates the value of nursing care and resulted in achieving the Quadruple Aim.
Normalizing Struggle: Dimensions of Faculty Support for Doctoral Students and Implications for Persistence and Well-Being

Faculty mentoring is a durable structure of doctoral education that facilitates intellectual growth, professional socialization, and progressive independence. We must more deeply understand, howeve...
Immunologic Response to Human Sarcomas: Relation of Antitumor Antibody to the Clinical Course

Publisher Summary This chapter discusses the immunologic response to human sarcomas. Sequential antisarcoma antibody titers to the SA-1 antigen were determined on at least four serial serum samples from each of 41 patients. The patients had sarcomas of various histologic types and the extent of their disease varied from a localized primary to diffuse metastases. Six patients who had definitive surgery for their primary tumor and continued free of disease were all found to have at least a fourfold rise in antitumor antibody removal of the tumor. Additionally, these antibody titers remain elevated to the present time and these patients continue to be free of disease. In contrast, six patients with antisarcoma antibody titers of percentage or less on preoperative analysis had no increment in antibody titer surgery. Five of these patients developed recurrence within 6 months. The sera from an additional 18 patients were also analyzed preoperatively.
The doctor will be with you ... shortly

The Emergency Medical Treatment and Active Labor Act (EMTALA) requires that Medicare-participating hospitals screen and stabilize all individuals appearing in their emergency departments, regardless of expected compensation. To counter the incentive to prioritize revenue-generating patients, the law also prohibits facilities from delaying care to under-insured individuals. I estimate whether timeliness of emergency care is, in fact, unaffected by payer source as mandated. Using the National Hospital Ambulatory Medical Care Survey, I first examine the direct effect of under-insurance and find that under-insurance is associated with an approximately 6–10 % increase in emergency department wait time. Because of concerns that the effects of under-insurance may be mediated by triage assignment, I subsequently estimate the relationship between under-insurance and triage assignment, using the office hours of general practitioners as an exogenous source of variation in payer source. Instrumental variable results suggest that under-insured patients are inexplicably assigned higher triage scores which are known to lengthen waits. Contrary to the stipulations of EMTALA, discrepancies in timeliness of care do exist. Yet, this noncompliance is not readily apparent; roughly 80 % of the increase in under-insured individuals’ wait times are masked by adjustments to triage scores.
Tetraspanins as Facilitators of Viral and Cellular Information Transfer

Cells that are infected by a virus can infect other cells by passing on the viral genome. Such transfer of viral genetic information can occur by fusion of infected and uninfected cells, or through extracellular particles that are shed from infected cells and which carry the viral genome together with viral structural proteins and/or enzymes to uninfected target cells. The transfer of viral information, either by cell-cell fusion or via viral particles, requires the coordination of numerous membrane-based functions, several of which are regulated by tetraspanins.
Health Care Delivery Services

This article defines health services and delivery systems of health care services, focusing specifically on formal systems of care, and the formal arrangements constructed to deliver health care services to defined populations. Special emphasis is given to an examination of: (a) the principle actors or components within health care delivery systems; (b) the variety of system types often present in highly developed health systems; (c) major characteristics of contemporary health care delivery systems; and (d) strategies for assessing health delivery system performance. A number of recent trends in the health sector and among health care organizations are discussed, particularly since they highlight the difficulties in assessing delivery system performance in the twenty-first century using standard measures of performance, most of which were developed during simpler times.
Examining potential gaps in supportive medication use for US and foreign-born Hispanic women with breast cancer

Compared to non-Hispanic Whites, Hispanic women are more likely to report pain, depression, and other mental health concerns. However, little is known about Hispanic women’s use of supportive medications, and whether use differs depending on nativity (US- vs. foreign-born). This study’s objectives were to examine patterns of supportive medication use and investigate potential differences by ethnicity/nativity among women with breast cancer. We used the Surveillance, Epidemiology, and End Results data linked with Medicare claims to identify women diagnosed with incident breast cancer between July 1, 2007, and December 31, 2011. Supportive medication use (opioid pain and non-opioid psychotropic medications) in the 90 days after diagnosis was the primary outcome. We categorized ethnicity/nativity as US-Born non-Hispanic, US-born Hispanic, foreign-born non-Hispanic, and foreign-born Hispanic. Modified Poisson models examined associations between ethnicity/nativity and medication use, adjusting for tumor, treatment, and demographic characteristics. We included 23,091 women, of whom 88% were US-born non-Hispanics, 4% US-born Hispanics, 6% foreign-born non-Hispanics, and 2% foreign-born Hispanics. Supportive medication use varied by ethnicity/nativity. Compared to US-born non-Hispanics, foreign-born Hispanics and non-Hispanics were 5% (95% CI 0.92–0.98) and 10% (95% CI 0.85–0.96) less likely to receive supportive medications, respectively. US-born Hispanics were 5% (95% CI 1.02–1.09) more likely to receive supportive medications. Observed differences persisted when analyses were limited to stage I–III breast cancer cases. This work highlights potential disparities in the pharmacologic treatment of psychosocial needs of foreign-born breast cancer patients. Future studies should explore if differences observed here are reflective of health disparities or differential patient preferences.
Self-organization controls expression more than abundance of molecular components of transcription and translation in confined cell-free gene expression

Cell-free gene expression using purified components or cell extracts has become an important platform for synthetic biology that is finding a growing number of practical applications. Unfortunately, at cell-relevant reactor volumes, cell-free expression suffers from excessive variability (noise) such that protein concentrations may vary by more than an order of magnitude across a population of identically constructed reaction chambers. Consensus opinion holds that variability in expression is due to the stochastic distribution of expression resources (DNA, RNAP, ribosomes, etc.) across the population of reaction chambers. In contrast, here we find that chamber-to-chamber variation in the expression efficiency generates the large variability in protein production. Through analysis and modeling, we show that chambers self-organize into expression centers that control expression efficiency. Chambers that organize into many centers, each having relatively few expression resources, exhibit high expression efficiency. Conversely, chambers that organize into just a few centers where each center has an abundance of resources, exhibit low expression efficiency. A particularly surprising finding is that diluting expression resources reduces the chamber-to-chamber variation in protein production. Chambers with dilute pools of expression resources exhibit higher expression efficiency and lower expression noise than those with more concentrated expression resources. In addition to demonstrating the means to tune expression noise, these results demonstrate that in cell-free systems, self-organization may exert even more influence over expression than the abundance of the molecular components of transcription and translation. These observations in cell-free platform may elucidate how self-organized, membrane-less structures emerge and function in cells.
Demyelinating Disease and Pregnancy

Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO) are chronic inflammatory disorders of the central nervous system that often affect women during their childbearing years. Therefore, many patients and providers navigate pregnancy-related management decisions. The current review provides updated information on the clinical effects of pregnancy on MS and NMO course, as well as the available data on safety of immunomodulatory MS treatments for pregnant and lactating women. We also address broader management issues of women with MS and NMO during conception, gestation and the postpartum period.
Characteristic Mode Analysis of the Effect of the UAV Frame Material on Coupling and Interference

Most studies that investigate electromagnetic coupling and interference to wires and Printed Circuit Boards (PCBs) simulate these structures in free-space or in a simplistic environment. In this work, we study how the frames of Unmanned Aerial Vehicles (UAVs), which can be fabricated from a wide range of conducting and dielectric materials, can affect coupling and interference to the mounted wires and PCBs. Characteristic Mode Analysis (CMA) is evoked to calculate fundamental modes of perfectly conducting and dielectric UAV frames and to identify the locations on the UAV’s frame where the modes will exhibit maximum or minimum effective currents. Using the CMA analysis, we develop a framework that can be used to optimize the placement of sensitive wires and PCBs on the frame mitigating interference from undesired electromagnetic sources.
Cultural Identity Matters: Engaging African American Girls in Middle School

ABSTRACTSchool engagement has emerged as a significant predictor of positive academic and vocational outcomes. This study investigated the effects of a culturally responsive group intervention deve...
Image-guided video-assisted thoracoscopic resection (iVATS): Translation to clinical practice-real-world experience

Objective We developed a novel approach for localization and resection of lung nodules, using image-guided video-assisted thoracoscopic surgery (iVATS). We report our experience of translating iVATS into clinical care. Methods Methodology and workflow for iVATS developed as part of the Phase I/II trial were used to train surgeons, radiologists, anesthesiologists, and radiology technologists. Radiation dose, time from induction to incision, placement of T-bar to incision and incision to closure, hospital stay, and complication rates were recorded. Results Fifty patients underwent iVATS for resection of 54 nodules in a clinical hybrid operating room (OR) by six surgeons. Fifty-two (97%) nodules were successfully resected. Forty-two (84%) patients underwent wedge resection, four (7%) lobectomies, and two (4%) segmentectomy all with lymph node dissection. Median time from induction to incision was 89 minutes (range: 13-256 minutes); T-bar placement was 14 minutes (10-29 minutes); and incision to closure, 107 minutes (41-302 minutes). Average and total procedure radiation dose were: median = 6 mSieverts (range: 2.9-35 mSieverts). No deaths were reported and median length of stay was 3 days (range: 1-12 days). Conclusions Translation of iVATS into clinical practice has been initiated using a safe step-wise process, combining intraoperative C-arm computed tomography scanning and thoracoscopic surgery in a hybrid OR.
Center and Donor Factors Associated with Discrepant Responses to Donor Lung Offers

Purpose Practice standardization may decrease donor lung shortages, however, the cause of organ acceptance pattern variation is not known. Our objective was to compare donor call practices in diverse settings. Methods This was a prospective, multi-center study of 10 centers from 6 distinct regions. Characteristics of consecutive, first-recipient eligible, donor offers (aged ≥13) received by participating centers with definitive decisions from May 1, 2016 to October 31, 2016 were abstracted along with reasons for organ offer turn downs (as applicable) and final organ disposition. A discrepant decision was defined as a donor lung offer declined by one center that was then accepted for transplant by an alternate center. Results We evaluated 2,000 consecutive offers; the majority (89.9%) were brain dead donors (BDD). Mean transplant volume was 33 transplants/year (range 11-98). Most centers had ex vivo lung perfusion and all had extra-corporeal membrane oxygenation bridging programs. Surgeons made final acceptance determinations at all centers. Declined organs had a mean donor age of 39 years, with a mean PaO2 to FiO2 (P/f) ratio of 352. The most common primary reason for offer decline was abnormal imaging followed by a low or decreasing P/f ratio. There were 412 (20.7%) discrepant offer decisions (8.1 to 41.2% of offers depending on center). Discrepant decisions significantly differed from non-discrepant decisions by transplant center mean annual volume, donor age, absolute and decreasing P/f ratio, and donor type (BDD versus circulatory death) (p Conclusion One in five donor offers that were initially declined by one transplant center were accepted for transplantation by another, highlighting significant variability in donor practices. Key donor and center factors were associated with discrepant decisions.
The treatments of Crohn′s disease complications

Crohn's disease (CD) complications include intestinal complications, parenteral complications, and systemic manifestations, of which intestinal complications are the most common. These complications result in serious damage to the quality of life, the risk of life-threatening may also appear. How to deal with these complications has become a major challenge for clinicians. CD requires a multidisciplinary treatment team, treatment complications versa. This review summarized the treatments of CD common complications. Key words: Crohn disease/CO/TH; Review
On the theory of H2 rotational excitation

A number of mechanisms for exciting higher-J states in the ground vibrational level are considered. Attention is given to collisions with H atoms and electrons. Other mechanisms involve a cascading down from upper vibrational levels, following absorption and reemission of photons in the Lyman and Werner bands, or a cascading down from upper vibrational levels, following formation of hydrogen molecules in excited vibrational and rotational levels. Theoretical population densities of rotational levels are shown in a graph.
Unexplained systemic inflammatory response following ileostomy closure after ileal pouch-anal anastomosis: a deeper dive into a rare entity

The purpose of this study is to shed light on a rare complication following ileostomy closure after 3-stage IPAA for further study and discussion. Our department IPAA database was queried for all patients who underwent 3-stage IPAA creation from 2011 through 2018. Data was reviewed and analyzed using the SPSS application. Chi-square test and Fisher’s exact test were used for categorical variables. t test or ANOVA was used for continuous variables. Significance was set at p < 0.05. Three hundred seventy-eight charts were queried. Sixty-eight complications (18.0%) were identified after ileostomy closure. Thirty-seven were small bowel obstruction or partial small bowel obstruction (SBO or pSBO, 9.79%), 5 cases of leak from ileoileostomy anastomosis (7.4%), and 4 cases of leak from pouch (5.9%). There was no significant difference in time between restorative proctocolectomy with IPAA and loop ileostomy closure with cases where a complication occurred and where one did not (p = 0.28). Eight patients developed a SIRS response in the first 5 days after surgery without an identified intraabdominal source after extensive work-up. Of these patients, 87.5% also had negative re-explorations (both open and laparoscopic). None required re-diversion, and all recovered well. While SBO remains the most common complication following ileostomy closure, a surprisingly large number of presents present with a SIRS response with no identifiable source. All of these patients recovered with supportive care, and none required further intervention or diversion. This is a poorly understood phenomenon which is unique to ileostomy closure after IPAA, and further study is required.
Estimating the Extent of Exfoliation of Dielectric and Magnetodielectric Coatings with Surface Microwaves

We present the results of a study that confirms the high efficiency of using surface microwaves in assessing the extent of exfoliation of dielectric and magnetodielectric coatings from a metal base. The complex coefficient of attenuation of the field of a surface electromagnetic wave along the normal to the coating surface is used as a parameter for estimating the extent of exfoliation. In contrast to the existing approaches, the developed electrodynamic measurement model takes into account the real and imaginary parts of the complex dielectric permittivity and magnetic permeability of the coating with allowance for their frequency dispersion; this improves the accuracy and reliability of estimating the extent of exfoliation. An algorithm is developed for estimating the extent of coating exfoliation based on the search for the maximum joint probability density of the coefficient of attenuation of the field of a surface electromagnetic wave measured at a set of frequencies. We introduce and substantiate a statistical limit of the resolution of two values of exfoliation; this makes it possible to evaluate the possibility of discriminating between two close values of exfoliation depending on the bandwidth of attenuation coefficient measurements, their number, and the signal-to-noise ratio. The structure of a measuring complex that implements the proposed approaches to exfoliation assessment is provided. Numerical and field experiments have shown the fundamental possibility of estimating the value of recorded values of exfoliation of dielectric and magnetodielectric coatings from a metal substrate with a thickness of 20 μm or less in the frequency band of 9–13.5 GHz.
Can Preemption Protect Public Participation

This article argues that federal law would preempt state legislation to prevent law school clinics from helping clients participate in implementation of environmental laws. The article first discusses the role of public participation in the regulatory process. Next, it reviews the history of a 2010 legislative effort to de-lawyer the clients of the Tulane Environmental Law Clinic and shows that an effort to enact de-lawyering legislation is a disreputable tactic. Next, the article demonstrates that laws that would de-lawyer an environmental law clinic's clients would conflict with Congress’ mandate in environmental laws for enhanced public participation and would lack a reasonable relationship to a legitimate state purpose. The article then shows that attorney fees may be available to plaintiffs in preemption challenges to de-lawyering bills under 42 U.S.C. § 1983. The article concludes that, in the context of environmental law, state de-lawyering laws are not only unwise, they are illegal under the Supremacy Clause.
Unaccompanied Children at the US-Mexico Border

Unaccompanied children and youth arriving at the United States-Mexico border for entry have increased in number as they flee poverty and violence. In recent years they have not been allowed the support to become productive citizens, but have been cast as invaders who take taxpayer jobs and resources. While some youth arrive unaccompanied, others are separated from their families, caregivers and support networks. Young immigrants are often detained in prison-like settings in remote locations or put into hotels or foster care far from anyone they know. Reports of maltreatment are extensive and examples cruelty, torture and human rights violations, as outlined in the United Nations Convention on the Rights of the Child. Use of a clinical sociological approach could prevent rights violations in the first instance and mitigate the impact of trauma when violations occur.
THE FUTURE VISION AND STRATEGIC GOALS SCHEMATIC OF THE STATE OF KUWAIT UNTIL 2035

Kuwait's vision is to transform the State of Kuwait into a financial and commercial center that attracts investment, in which the private sector plays an important role in leading the economic activity, promoting the spirit of competition, raising the efficiency of the production apparatus, achieving balanced development, increasing the contribution of non-oil sectors to the added value of the domestic product, increasing employment opportunities, reducing unemployment and improving opportunities. The social level of the population, through increasing the gross domestic product, raising the standard of living, supporting human development, and leading the private sector for development, by developing the Kuwaiti economy and transforming it into a knowledge economy based on technology, good performance, and the diversification of the Kuwaiti economy. Conclusively, of the previous results that the State of Kuwait is recommended to encourage the private sector in economic development and work on the policy of diversification of innovation
Marketplace Lending: Matching Small Businesses with Specialized Fintech Lenders

Fintech promises improvements in access to credit for small businesses through more efficient search and better pricing. Using novel data from a marketplace platform of 115,000 loan offers from 46 online lenders I show that the primary contribution of fintech is not in precisely measuring and pricing risk, but rather in facilitating search between small firms and preferred-habitat lenders. Loan rate offers are largely unexplained by firm characteristics and differ substantially even for the same applicant. The dispersion in offers is largely explained by the fact that lenders have preferred habitats -- lending to borrowers of certain risk types and charging relatively uniform rates to all applicants. Interest rates sort borrowers such that the highest interest rate lenders match with firms that have been rejected by lenders with lower rates. This sorting leads to equilibrium loan rates that appear to be closely tied to the characteristics of the firm. The findings highlight the importance of marketplace platforms that reduce search frictions for firms seeking credit among lenders with distinct lending practices.