cssi/SciSciGPT-SciSciNet huggingface dataset:
Unbound by Chance? Risk, Diversification and Growth

This paper offers a theory of development which links the degree of market incompleteness to capital accumulation and growth. At early stages of development, the presence of indivisible projects limits the degree of risk-spreading (diversification) that the economy can achieve. The desire to avoid highly risky investments slows down capital accumulation and the inability to diversify idiosyncratic risks introduces high uncertainty in the growth process. The typical development pattern will consist of a lengthy period of 'primitive accumulation' with highly variable output, followed by take-off and financial deepening and lastly, steady growth. 'Lucky' countries will spend relatively less time in the primitive accumulation stage and develop faster. Although all agents are price-takers and there are no technological spillovers, the decentralized equilibrium is inefficient because individuals do not take into account their impact on the diversification opportunities of others. We also show that our results generalize to economies with international capital flows.
Renal Artery Angioplasty and Stenting

Renal artery angioplasty and stenting is performed for renal artery occlusive disease. This chapter describes indications, essential steps, variations, and complications of this procedure. It provides a detailed template operative note for the procedure.
Mechanisms of Stereocontrol for Doubly Silylene-Bridged Cs- and C1-Symmetric Zirconocene Catalysts for Propylene Polymerization. Synthesis and Molecular Structure of Li2[(1,2-Me2Si)2{C5H2-4-(1R,2S,5R-menthyl)}{C5H-3,5-(CHMe2)2)}]·3THF and [(1,2-Me2Si)2{η5-C5H2-4-(1R,2S,5R-menthyl)}{η5-C5H-3,5-(CHMe2)2}]ZrCl2

Doubly [SiMe2]-bridged metallocenes (1,2-SiMe2)2{η5-C5H2-4-R}{η5-C5H-3,5-(CHMe2)2}ZrCl2 (R = H (1a), CHMe2 (1b), SiMe3 (1c), CHMe(CMe3) (1d), (+)-menthyl (1e)), when activated by methylaluminoxane (MAO), catalyze propylene polymerization with high activities. The preparations and X-ray structures of the dilithio salt of an enantiopure, doubly silylene-bridged bis(cyclopentadienyl) ligand, Li2[(1,2-Me2Si)2{C5H2-4-(1R,2S,5R-menthyl)}{(C5H-3,5-(CHMe2)2)}]·3THF, as well as the corresponding zirconocene dichloride, [(1,2-Me2Si)2{η5-C5H2-4-(1R,2S,5R-menthyl)}{η5-C5H-3,5-(CHMe2)2}]ZrCl2 (1e), are reported. The Cs-symmetric systems 1a−c are highly regiospecific and syndiospecific (>99.5%) in neat propylene. At lower propylene concentrations, polymers with lower molecular weights and tacticity (mostly m-type stereoerrors) are obtained. The microstructures of polymers produced under differing reaction conditions are consistent with stereocontrol dominated by a site epimerization process, an inversion of configurati...
A Continuous Flow Device for the Purification of Semiconducting Nanoparticles by AC Dielectrophoresis

Single-walled carbon nanotubes (SWCNTs) have attracted significant attention as building blocks for future nanoscale electronics due to their small size and unique electronic properties. However, current SWCNT production techniques generate a mixture of two types of nanotubes with divergent electrical behaviors due to structural variations. Some of the nanotubes act as metallic materials while others display semiconducting properties. This random mixture has prevented the realization of functional carbon nanotube-based nanoelectronics. Here, a method of purifying a continuous flow of semiconducting nanotubes from an initially random mixture of both metallic and semiconducting SWCNTs in suspension is presented. This purification uses A/C dielectrophoresis (DEP), and takes advantage of the large difference of the relative dielectric constants between metallic and semiconducting SWCNTs. Because of a difference in magnitude and opposite directions of a dielectrophoretic force imposed on the random SWCNT solution, metallic SWCNTs deposit onto an electrode while semiconducting SWCNTs remain in suspension [3]. A discussion of these techniques is presented, along with a dielectrophoretic force-utilized microfluidic lab-on-a-chip device that can accomplish purification of semiconducting nanoparticles at high processing rates. The effectiveness of the device is characterized using Raman spectroscopy analysis on separated samples.
Looking down the prospectoscope: obstetrics/gynecology in the year 2000 and beyond.

Abstract It should be emphasized that the American College of Obstetricians and Gynecologists is advocating that those Obstetrician/Gynecologists who wish to be included under this new designation primary care physician "provide only ambulatory primary care," states the Executive Director, Dr. Ralph W. Hale. Thus, we enter a new era and must understand the lexicons, including HMO, independent provider organization, PPO, managed care organization, exclusive provider organization, IPA, hospital-physician organization, health plan provider data and information set, physician-hospital organization and utilization management--all these have become words with increased meaning for all clinicians. It is a rare physician lounge without physicians preoccupied by discussions regarding managed care, "Have you heard the latest reimbursement schedule?" or "It's less than Medicaid," and the discussions continue indefinitely. There has been a continued effort to have physicians be cost-efficient in their approach to all aspects of obstetrical and gynecological care. Capitation has proven to be the virtually exclusive method of reimbursement. Continued care with respect to clinical outcome, resource utilization, patient satisfaction, and quality care restructuring of practice/personnel/patient approach is based on the quarterly patient surveys, which have been evaluated and carefully reviewed. Patient satisfaction with a sincere effort to provide quality of care remains the underlying theme with respect to obstetrical and gynecological patient care. These are basic tenets. What is the future of obstetrics/gynecology with respect to managed health care? It does make sense to have a planned and well-coordinated approach to delivery of obstetrical as well as gynecological care with the goal of "quality" delivered at a "lower cost" having an overall positive impact on OB/GYN health care delivery. Currently, there are a number of states which have specific legislation enabling a patient to proceed to secure gynecological without going through a "gatekeeper." As we approach the year 2000 and beyond, clearly the prediction is that this will be an ever-increasing goal and objective of state medical societies to provide easy access for women's health care. Thus, we have awakened into a new era that is hallmarked by efficient, quality medical care provided by a physician who initially trained to be a subspecialist and now is an ambulatory primary care physician.
Assessing the deamination rate of a covalent aminomutase adduct by burst phase analysis.

Burst-phase kinetic analysis was used to evaluate the deamination rate of the aminated–methylidene imidazolone (NH2–MIO) adduct of a Taxus phenylalanine aminomutase. The kinetic parameters were interrogated by a non-natural substrate (S)-styryl-α-alanine that yielded a chromophoric styrylacrylate product upon deamination by the aminomutase. Transient inactivation of the enzyme by the NH2–MIO adduct intermediate resulted in an initial burst of product, with reactivation by deamination of the adduct. This study validated the rate constants of a kinetic model demonstrating that the NH2–MIO adduct and cinnamate intermediate are sufficiently retained to catalyze the natural α- to β-phenylalanine isomerization.
Application of Test Technology in 500 kV Yushan Smart Substation

As the development of new technologies such as pure optical transformer,IEEE1588 clock synchronization technology,IEC61850-9-2 network construction etc.in recentyears,these new technologies have been preliminarily explored to be applied in some digital substations.It is a prominent problem to systematically evaluate the performance of digital substation.This paper introduces the project's scheme and practical experience of digital interval test in east Suzhou(Yushan substation),proposes the content and measure of the digital substation test,and concludes some problems in the test.
Tracking Test,Analysis and Judgment of Discharge Fault in SF_6 Circuit Breaker

The SF6 circuit breaker having self-restoring insulation discharge fault was tracked and monitored.It is verified by the monitoring data and the strip inspection of the circuit breaker that the fault met the criterion of φ(SO2)/φ(H2S) 7;the limitation on φ(SO2)and φ(H2S)is not so strict;even 100 uL/L is not instantly dangerous to the safe operation of equipment and maintenance can be scheduled;as for overheating of bare conductor unrelated to non-self-restoring insulation,the criterion for self-restoring insulation discharge fault can be used.
LAPAROSCOPIC ULTRASOUND : A VALUABLE ADJUNCT TO LAPAROSCOPIC SURGERY

Laparoscopic ultrasound represents a recent merger in the laparoscopic technology and intraoperative ultrasound and shows a diagnostic accuracy higher than preoperative studies. Laparoscopic ultrasound can be used during laparoscopic cholecystectomy to screen the bile duct. It is particularly useful for diagnosing and staging malignancies, including hepatobiliary, pancreatic and gastroesophageal cancers. By demonstrating the interior of organs and deep structures, it can compensate for the limitation of laparoscopic examination. Laparoscopic ultrasound will become a valuable adjunct to laparoscopic surgery.
Post-prandial compositional changes of fluid- and particle-associated ruminal microorganisms.

Two ruminally cannulated cows were fed a diet containing 65% alfalfa haylage and 35% concentrate every 12 h. During two collection periods, whole ruminal contents were sampled before feeding, when feed not eaten was removed (1 h after initiation of feeding) and 1, 2, 3, 4, 6, 8, 10 and 12 h after removal. At each sampling, fluid-associated microorganisms were obtained by straining whole ruminal contents through eight layers of cheesecloth. A portion of the particle-associated population was obtained by chilling squeezed particles before seven successive extractions with saline solution. Microbial ash concentrations ranged from 9.9 to 16.6% of dry matter, with differences due to population (P less than .01) and to time after feeding for both fluid- (P less than .05) and particle-associated (P less than .01) microorganisms. Within 1 h after initiation of feeding, N decreased (P less than .05) from a pre-feeding concentration of 9.5% of organic matter to 7.7% for fluid-associated microorganisms, and from 9.2 to 6.7% for particle-associated microorganisms. Both populations did not return to pre-feeding concentrations until 6 h after feed removal. Nucleic acid concentrations decreased (P less than .05) in both populations after feeding, and did not return to pre-feeding concentrations until 6 h for fluid-associated and 4 h for particle-associated microorganisms. Nucleic acid-to-N ratios were higher (P less than .01) in the fluid- than particle-associated organisms.(ABSTRACT TRUNCATED AT 250 WORDS)
Successful Treatment of Pyoderma Gangrenosum with Cryoglobulinemia and Hepatitis C.

BACKGROUND Pyoderma gangrenosum is a rare, ulcerative cutaneous condition that was first described by Brocq in 1916. This diagnosis is quite challenging as the histopathological findings are nonspecific. Pyoderma gangrenosum is usually associated with inflammatory bowel disease, leukemia, and hepatitis C. We describe a rare clinical case of a patient with hepatitis C (HCV), mixed cryoglubinemia, and pyoderma gangrenosum, which was successfully treated with prednisone in combination with the new antiviral medication ledipasvir/sofosbuvir. CASE REPORT A 68-year-old male with a history of untreated HCV presented to the clinic with a left lower extremity ulcer that had progressively worsened over 4 days after the patient sustained a minor trauma to the left lower extremity. Examination revealed a 2×3 cm purulent ulcer with an erythematous rim on medial aspect of his left lower leg. HCV viral load and genotype analysis revealed genotype 1A with polymerase chain reaction (PCR) showing viral counts of 9,506,048 and cryoglobulinemia. With a worsening and enlarging erythematous ulcer and failure of IV antibiotic therapy, the patient underwent skin biopsy, which showed acanthotic epidermis with superficial and deep perivascular lymphoplasmacytic dermatitis admixed with mild neutrophilic infiltrate. The patient was subsequently started on ledipasvir/sofosbuvir and prednisone with a high suspicion of pyoderma gangrenosum. At one-month follow-up at the hepatology clinic, the patient demonstrated a near resolution of the lower extremity ulcer with undetectable viral load. CONCLUSIONS Pyoderma gangrenosum is an inflammatory process of unknown etiology, and establishing the correct diagnosis can be a difficult task. For this reason it is prudent for clinicians to consider Pyoderma gangrenosum in their differential diagnosis, especially in the setting of a nonhealing surgical wound or skin infection.
Conclusion: Our Veterans, Ourselves

The object of this book was neither to bring war to an end, nor to show us how to cure the suffering of veterans, but rather to show that our current attempts to end war and our attempts to cure veteran suffering have in common a particular understanding of what it means to be human, an understanding that helps to perpetuate both war and the suffering of veterans. This view of humanity, this view that is never stated, but is instead the presupposed and necessary ground of these attempts, can be seen when we try to understand not only the apparent contradiction of how war can be waged as aggression to end aggression, but of how our ethico-legal institutions can say that war is sometimes right and sometimes wrong, and of how our medico-psychiatric institu tions can say that the suffering of war is sometimes normal and some times abnormal. These contradictions are only contradictions, however, so long as we narrow-mindedly think that all aggression is the same, for common sense tells us that defensive aggression is not the same as offensive aggression, and that the physical consequences of aggression need not be the same as the mental consequences of aggression. Just as we can know whether our aggression is just or unjust because of the norms of war, we can likewise know whether our response to aggression is normal or abnormal because of the norms of peace, and in both cases others can use these norms to make such judgments for us.
Treating Psychopaths Fairly

Hubner and White (2016) question the ethical justification of employing risky neurosurgical interventions to treat imprisoned psychopaths. They argue that (1) such interventions would confer no med...
Comparative Effects of Phosphodiesterase Inhibitors on Detached Rod Outer Segment Function

In vertebrate retinal rods light reduces a standing inward current that flows into the outer segment in darkness. Current is carried primarily by sodium ( 70%) and calcium ( 15%) ions which pass through channels in the outer segment surface membrane that are opened by cGMP (Yau and Baylor, 1989). A photoproduct (Rh *) formed by isomerization of rhodopsin catalyzes GTP-GDP exchange to activate a G protein (transducin, T) which stimulates cGMP-specific phosphodiesterase (PDE) causing cGMP hydrolysis, channel closure and a decrease in dark current. The recovery of current following light exposure involves inactivation of the light stimulated PDE and an increase in cGMP synthesis by activation of guanylate cyclase (Hodgkin and Nunn, 1988; Detwiler et al., 1989). The sequential activation and inactivation of PDE in the onset and recovery of rod light responses has been probed using IBMX, a membrane permeant phosphodiesterase inhibitor (Beavo et al., 1970; Capovilla et al., 1983; Hodgkin and Nunn, 1988). While such studies have provided useful information about the orchestration of transduction IBMX is not an ideal inhibitor. It is not very potent (K i = 1 × 10−5M) which makes it practically impossible to use to fully inhibit light-stimulated PDE. It is also non-specific in that it inhibits many kinds of cyclic nucleotide phosphodiesterases which could potentially complicate the interpretation of results. Assays on isolated enzymes have shown two compounds (dipyridamole and MB Gillespie and Beavo, 1989) and are 20 to 100 times more potent than IBMX (K t = 3.8 × 10−7M and 1 × 10−7M respectively). This short paper compares the effects of IBMX, dipyridamole (FitzGerald, 1987) and M&B:22,948 (Broughton et al., 1974) on dark current and light responses recorded from detached rod outer segments during whole-cell voltage clamp. Our results show that there are significant differences in the action of the three inhibitors, which suggests that they may affect more than PDE. In the course of these experiments we also discovered that in nucleoside triphosphate depleted outer segments steps of bright light cause an increase rather than a decrease in dark current. Since these cells contain little or no GTP and dark current is maintained by an exogenous source of cGMP, the production of inward or inverted light responses suggests that steps of strong light can inhibit PDE possibly through a G protein independent pathway.
The Effectiveness of Aerobic Exercise Instruction for Totally Blind Women

This article reports on a study of the effectiveness of a multifaceted method of teaching aerobic exercises to three congenitally blind women. The results indicate that visually impaired persons ca...
Single intervention for a reduction in portable chest radiography (pCXR) in cardiovascular and surgical/trauma ICUs and associated outcomes

Abstract Purpose Studies suggest that “on-demand” radiography is equivalent to daily routine with regard to adverse events. In these studies, provider behavior is controlled. Pragmatic implementation has not been studied. Materials and methods This was a quasi-experimental, pre-post intervention study. Medical directors of two intervention ICUs requested pCXRs be ordered on an on-demand basis at one time point, without controlling or monitoring behavior or providing follow-up. Results A total of 11,994 patient days over 18 months were included. Combined characteristics: Age: 56.7, 66% male, 96% survival, APACHE II 14 (IQR: 11–19), mechanical ventilation (MV) (occurrences)/patient admission: mean 0.7 (SD: 0.6; range: 0–5), duration (hours) of MV: 21.7 (IQR: 9.8–81.4) and ICU LOS (days): 2.8 (IQR: 1.8–5.6). Average pCXR rate/patient/day before was 0.93 (95% CI: 0.89–0.96), and 0.73 (95% CI: 0.69–0.77) after. Controlling for severity, daily pCXR rate decreased by 21.7% (p Conclusions In critically ill adults, pCXR reduction can be achieved in cardiothoracic and trauma/surgical patients with a pragmatic intervention, without adversely affecting patient care, outside a controlled study.
Clinical Factors and Outcomes of Dialysis-Dependent End-Stage Renal Disease Patients with Emergency Department Septic Shock.

Abstract Background Infection is the second leading cause of death in end-stage renal disease (ESRD) patients. Prior investigations of acute septic shock in this specific population are limited. Objective We aimed to evaluate the clinical presentation and factors associated with outcome among ESRD patients with acute septic shock. Methods We reviewed patients prospectively enrolled in an emergency department (ED) septic shock treatment pathway registry between January 2014 and May 2016. Clinical and treatment variables for ESRD patients were compared with non-ESRD patients. A second analysis focused on ESRD septic shock survivors and nonsurvivors. Results Among 4126 registry enrollees, 3564 (86.4%) met inclusion for the study. End-stage renal disease was present in 3.8% (n = 137) of ED septic shock patients. Hospital mortality was 20.4% and 17.1% for the ESRD and non-ESRD septic shock patient groups ( p = 0.31). Septic shock patients with ESRD had a higher burden of chronic illness, but similar admission clinical profiles to non-ESRD patients. End-stage renal disease status was independently associated with lower fluid resuscitation dose, even when controlling for severity of illness. Age and admission lactate were independently associated with mortality in ESRD septic shock patients. Conclusion ESRD patients comprise a small but important portion of patients with ED septic shock. Although presentation clinical profiles are similar to patients without ESRD, ESRD status is independently associated with lower fluid dose and compliance with the 30-mL/kg fluid goal. Hyperlactatemia is a marker of mortality in ESRD septic shock.
Path toward Precision Oncology: Review of Targeted Therapy Studies and Tools to Aid in Defining "Actionability" of a Molecular Lesion and Patient Management Support.

Precision medicine trials and targeted therapies have shifted to the forefront of oncology. Although targeted therapies have shown initial promise, implementation across the broad landscape of oncology has many challenges. These limitations include an incomplete understanding of the functional significance of variant alleles as well as the need for clinical research and practice models that are more patient-centered and account for the complexity of individual patient tumors. Furthermore, successful implementation of targeted therapies will also be predicated on efforts to standardize the framework for patient management support. Here, we review current implementations of targeted therapies in precision oncology and discuss how "actionability" is defined for molecular targets in cancer therapeutics. We also comment on the growing need for bioinformatics tools and data platforms to complement advances in precision oncology. Finally, we discuss current frameworks for integrating precision oncology into patient management and propose an integrated model that combines features of molecular tumor boards and decision support systems. Mol Cancer Ther; 16(12); 2645-55. ©2017 AACRSee related article by Pilie et al., p. 2641.
Intradermal tranexamic acid injections to prevent post-inflammatory hyperpigmentation after solar lentigo removal with a Q-switched 532-nm Nd:YAG laser

ABSTRACTIntroduction: Post-inflammatory hyperpigmentation (PIH) after solar lentigo removal using a Q-switched (QS) 532-nm Nd:YAG laser is a cause for concern. This study aimed to evaluate the effi...
The Development of Blowpipe Analysis

Though a very modest instrument by modern standards, the blowpipe was, nonetheless, a laboratory staple of the analytical chemist and the mineralogist for more than a century. By the middle of the 19th century it had played a small but significant role in the discovery and characterization of close to a dozen chemical elements (Table 1) and had actually been used by Reich and Richter in 1863 to isolate the first specimen of the element indium (1).
Historical Background of Vascular Imaging

Imaging of the cardiovascular system has been transformed over the past 35 years by advances and innovations in technology of non-invasive imaging modalities. These enhancements have currently provided diagnostic quality imaging of arteries about 1 mm in diameter in some areas of the body. Advances in electronic components and computer technology have had pivotal roles in accelerating imaging processing and storage capacity. Widespread digital formats have allowed an electronic environment of immediate image transmission throughout our hospitals, communities and, indeed, the world. Such information transfer allows imaging data and reports to become part of the entire electronic medical record.
On approximate projection models

Approximate projection (AP) schemes are widely used in computational studies of diradicals and transition metal systems to remove spin contamination in unrestricted density functional theory and Ha...
Feasibility of Episode-Based Bundled Payment for a Pediatric Surgical Condition: Posterior Spinal Fusion.

Introduction Episode-based bundled payment (EBBP) is an alternative model of health-care payment that aims to align providers' and hospitals' incentives toward delivery of more coordinated, higher quality, and lower cost care. EBBP programs have been studied for numerous adult conditions over the past decade, yet there have been no studies exploring the use of EBBP in pediatric conditions. Methods This article explores the feasibility of EBBP for a relatively common, costly, pediatric surgical procedure: spinal fusion for adolescent idiopathic scoliosis. We begin with a review of successful EBBP programs in the United States. We then apply American College of Surgeons criteria for bundled payment episode selection to identify benefits and challenges of using EBBP for this condition. Results We identify several features of pediatric spinal fusion that make it an attractive EBBP target: high variability in costs with multiple distinct targets for cost reduction, high variability in quality across hospitals, and proven methods for improvement via application of standardized, evidence based pathways. We find that challenges to EBBP may arise due to the relatively low incidence of the procedure, which limits overall savings to the health-care community. Conclusions Our results suggest that spinal fusion for adolescent idiopathic scoliosis is an attractive pediatric target for EBBP, with potential benefits to patients, providers, health systems, and payers if limitations in procedure volume and administrative expense are overcome. The framework presented may also be useful for analyzing feasibility of EBBP for other pediatric conditions.
Decisión 2016: Comparative Analysis of Journalistic Role Performance on Spanish- and English-language TV Networks

This study is one of the first to compare journalistic role performances of English– and Spanish–language TV networks during the 2016 U.S. primaries. Previous research finds that the corporate stru...
Assessing hospital system resilience to disaster events involving physical damage and Demand Surge

Abstract This paper investigates the effectiveness of formalized collaboration strategies through which patients can be transferred and resources, including staff, equipment and supplies, can be shared across hospitals in response to a disaster incident involving mass casualties and area-wide damage. Inflicted damage can affect hospital infrastructure and its supporting lifelines, thus impacting capacity and capability or, ultimately, services that are provided. Using a discrete event simulation framework and underlying open queuing network conceptualization involving patient flows through 9 critical units of each hospital, impacts on critical resources, physical spaces and demand are modeled and the hospital system's resilience to these hazard events is evaluated. Findings from numerical experiments on a case study involving multiple hospitals spaced over a large metropolitan region replicating a system similar to the Johns Hopkins Hospital System show the potential of strategies involving not only transfers and resource sharing, but also joint capacity enhancement alternatives to improve post-disaster emergency health care service delivery through joint action.
Evaluating the Prevent-Teach-Reinforce (PTR) Model in General Education Settings.

Students in general education classrooms are increasingly being identified as being in need of individualized behavior supports. Thus, this study assessed the Prevent-Teach-Reinforce (PTR) model to...
In-Flight Emergencies: Medical Mile High Club

This chapter provides a review of medical emergencies on commercial airliners. In addition to discussing the legal ramifications of rendering aid and the logistics of available medical equipment, we discuss the major physiological effects of flying which may lead to encountered pathology.
Analytical Framework of Beamwidth Selection for RT-ICM Millimeter-Wave Clusters

Beamforming for mmWave communications is well-studied in the PHY based on the channel parameters to develop optimum receiver processing techniques. However, even before signal processing, antenna structure and radiation parameters affect the beamforming performance primarily. For example, in contrast to common belief, narrow beamwidth (bmW) may result in degraded beamforming performance. In order to address the impairments such as beam misalignments, outage loss, tracking inability, blockage, etc., an optimum value of the bmW must be determined. In this paper, assuming a communication system that creates a beam per cluster, we theoretically investigate the bmW and received power relation in the cluster level mmWave channels. We adopt ULA structure and formulate its antenna gain with respect to the bmW. Two beam models are considered for the main lobe of the array pattern, rectangular and triangular. We derive bmW-dependent extracted power expressions for two intra-cluster channel models, 802.11ad and our previous work, RT-ICM. Combining antenna and channel gains, in case of a beam misalignment, we find that the optimum bmW that maximizes the received power is larger than the alignment error when the error itself is larger than the standard deviation of the cluster power-angle spectrum. Once the alignment error is smaller than the standard deviation, we confirm that the optimum bmW converges zero. Performing asymptotic analysis of the received power, we give the formulation and insights that the practical nonzero bmW values can be achieved although sacrificing subtle from the maximum received power. Our analysis shows that to reach 95% of the maximum power for an indoor mmWave cluster, a practical bmW of 7-10 degrees is enough, which can be created with 18-20 antenna elements. In the simulation section, we show that the expressions given by the analysis match to the simulated results.
Comparative effectiveness of second-line (2L) single-agent atezolizumab (A), nivolumab (N), and pembrolizumab (P) in patients (Pts) with locally advanced or metastatic urothelial cancer (aUC) who progressed on platinum-based systemic chemotherapy (plat-chemo): Results from a real-world dataset.

5032Background: Five PD-1/L1 inhibitors (PDi) are approved for 2L therapy (Rx) for aUC after progression on plat-chemo, but none compared with each other in randomized trials. Here, we assessed com...
Isaiah J. (Josh) Fidler, DVM, PhD, FAACR: In Memoriam (1936–2020)—A Visionary Research Career Dedicated to Understanding the Complexities of Cancer Metastasis

![][1] In a time of pandemic distractions and anxieties, it is easy to succumb to the tyranny of the immediate. Then an event happens to jolt the senses and trigger a flood of memories and broader reflection on those rare individuals who truly make a difference in advancing science
State and federal abortion restrictions increase risk of COVID-19 exposure by mandating unnecessary clinic visits.

Abstract Objective To quantify the number of medically unnecessary clinical visits and in-clinic contacts monthly caused by US abortion regulations. Study Design We estimated the number of clinical visits and clinical contacts (any worker a patient may come into physical contact with during their visit) under the current policy landscape, compared to the number of visits and contacts if the following regulations were repealed: (1) State mandatory in-person counseling visit laws that necessitate two visits for abortion, (2) State mandatory-ultrasound laws, (3) State mandates requiring the prescribing clinician be present during mifepristone administration, (4) Federal Food and Drug Administration Risk Evaluation and Mitigation Strategy for mifepristone. If these laws were repealed, “no-test” telemedicine abortion would be possible for some patients. We modeled the number of visits averted if a minimum of 15 percent or a maximum of 70 percent of medication abortion patients had a “no-test” telemedicine abortion. Results We estimate that 12,742 in-person clinic visits (50,978 clinical contacts) would be averted each month if counseling visit laws alone were repealed, and 31,132 visits (142,910 clinical contacts) would be averted if all four policies were repealed and 70 percent of medication abortion patients received no-test telemedicine abortions. Over 2 million clinical contacts could be averted over the projected 18-month COVID-19 pandemic. Conclusion Medically unnecessary abortion regulations result in a large number of excess clinical visits and contacts. Policy Implications Repeal of medically unnecessary state and federal abortion restrictions in the United States would allow for evidence-based telemedicine abortion care, thereby lowering risk of SARS-CoV-2 transmission.
Development of a Simple Clinical Tool for Predicting Early Dropout in Cardiac Rehabilitation: A SINGLE-CENTER RISK MODEL

BACKGROUND Nonadherence to cardiac rehabilitation (CR) is common despite the benefits of completing a full program. Adherence might be improved if patients at risk of early dropout were identified and received an intervention. METHODS Using records from patients who completed ≥1 CR session in 2016 (derivation cohort), we employed multivariable logistic regression to identify independent patient-level characteristics associated with attending <12 sessions of CR in a predictive model. We then evaluated model discrimination and validity among patients who enrolled in 2017 (validation cohort). RESULTS Of the 657 patients in our derivation cohort, 318 (48%) completed <12 sessions. Independent risk factors for not attending ≥12 sessions were age <55 yr (OR = 0.23, P < .001), age 55 to 64 yr (OR = 0.35, P < .001), age ≥75 yr (OR = 0.64, P = .06), smoker within 30 d of CR enrollment (OR = 0.40, P = .001), low risk for exercise adverse events (OR = 0.54, P = .03), and nonsurgical referral diagnosis (OR = 0.66, P = .02). Our model predicted nonadherence risk from 23-90%, had acceptable discrimination and calibration (C-statistics = 0.70, Harrell's E50 and E90 2.0 and 3.6, respectively) but had fair validity among 542 patients in the validation cohort (C-statistic = 0.62, Harrell's E50 and E90 2.1 and 11.3, respectively). CONCLUSION We developed and evaluated a single-center simple risk model to predict nonadherence to CR. Although the model has limitations, this tool may help clinicians identify patients at risk of early dropout and guide intervention efforts to improve adherence so that the full benefits of CR can be realized for all patients.
Is a College Promise Program an Effective Use of Resources? Understanding the Implications of Program Design and Resource Investments for Equity and Efficiency:

Also known as “free tuition,” college promise programs are emerging across the United States as a potential mechanism for improving college access and affordability, Whether these initiatives are a...
The Association of Seasonality With Resource Use in a Large National Cohort of Infants With Bronchiolitis.

OBJECTIVES: Examine the degree of seasonal variation in nonrecommended resource use for bronchiolitis management subsequent to publication of the American Academy of Pediatrics (AAP) 2014 guidelines. METHODS: We performed a multicenter retrospective cohort study using the Pediatric Health Information System database, examining patients aged 1 to 24 months, diagnosed with bronchiolitis between November 2015 and November 2018. Exclusions included presence of a complex chronic condition, admission to the PICU, hospital stay >10 days, or readmission. Primary outcomes were use rates of viral testing, complete blood count, blood culture, chest radiography, antibiotics, albuterol, and systemic steroids. Each hospital’s monthly bronchiolitis census was aggregated into hospital bronchiolitis census quartiles. Mixed-effect logistic regression was performed, comparing the primary outcomes between bronchiolitis census quartiles, adjusting for patient age, race, insurance, hospitalization status, bacterial coinfection, time since publication of latest AAP bronchiolitis guidelines, and clustering by site. RESULTS: In total, 196 902 bronchiolitis patient encounters across 50 US hospitals were analyzed. All hospitals followed a similar census pattern, with peaks during winter months and nadirs during summer months. Chest radiography, albuterol, and systemic steroid use were found to significantly increase in lower bronchiolitis census quartiles, whereas rates of viral testing significantly decreased. No significant variation was found for complete blood count testing, blood culture testing, or antibiotic use. Overall adherence with AAP guidelines increased over time. CONCLUSIONS: Resource use for patients with bronchiolitis varied significantly across hospital bronchiolitis census quartiles despite adjusting for potential known confounders. There remains a need for greater standardization of bronchiolitis management.
Predictors of Veterans Health Administration utilization and pain persistence among soldiers treated for postdeployment chronic pain in the Military Health System.

Chronic pain presents a significant burden for both federal health care systems designed to serve combat Veterans in the United States (i.e., the Military Health System [MHS] and Veterans Health Administration [VHA]), yet there have been few studies of Veterans with chronic pain that have integrated data from both systems of care. This study examined 1) health care utilization in VHA as an enrollee (i.e., linkage to VHA) after military separation among soldiers with postdeployment chronic pain identified in the MHS, and predictors of linkage, and 2) persistence of chronic pain among those utilizing the VHA. Observational, longitudinal study of soldiers returning from a deployment in support of the Afghanistan/Iraq conflicts in fiscal years 2008–2014. The analytic sample included 138,206 active duty soldiers for whom linkage to VHA was determined through FY2019. A Cox proportional hazards model was estimated to examine the effects of demographic characteristics, military history, and MHS clinical characteristics on time to linkage to VHA after separation from the military. Among the subpopulation of soldiers who linked to VHA, we described whether they met criteria for chronic pain in the VHA and pain management treatments received during the first year in VHA. The majority (79%) of soldiers within the chronic pain cohort linked to VHA after military separation. Significant predictors of VHA linkage included: VHA utilization as a non-enrollee prior to military separation, separating for disability, mental health comorbidities, and being non-Hispanic Black or Hispanic. Soldiers that separated because of misconduct were less likely to link than other soldiers. Soldiers who received nonpharmacological treatments, opioids/tramadol, or mental health treatment in the MHS linked earlier to VHA than soldiers who did not receive these treatments. Among those who enrolled in VHA, during the first year after linking to the VHA, 49.7% of soldiers met criteria for persistent chronic pain in VHA. The vast majority of soldiers identified with chronic pain in the MHS utilized care within VHA after military separation. Careful coordination of pain management approaches across the MHS and VHA is required to optimize care for soldiers with chronic pain.
A Subscription Model for Prescription Drugs

Several states in the U.S. have piloted a type of subscription model for prescription drugs, under which a state pays a fixed amount to a pharmaceutical manufacturer for a targeted population (e.g., inmates) over a contract horizon. We analyze the implications of executing the subscription model by characterizing a healthcare provider’s drug-administering decisions, which entails delivering both services and products. In a public-health setting in which service delivery is commonly contracted out using a capitation system, the subscription model additionally contracts out product delivery, meaning drug-administering decisions are subject to a global budget cap. Thus, pressures to minimize costs can lead to the rationing of care despite the promise of unlimited drug supply. We characterize the provider’s cost-minimizing decisions and show increasing the capped amount does not change the propensity for rationing. To induce the provider away from a singular focus on cost minimization, we analyze a case in which the provider faces two objectives — maximizing cures and minimizing mortality — subject to a budget constraint. We develop a novel approach that determines the efficient frontier of this bi-objective problem in a polynomial time; our approach entails converting the bi-objective problem into a tri-objective problem, which is then decomposed into multiple subproblems. The efficient frontier captures trade-offs resulting from the provider’s actions. In addition, and importantly, we show the efficient frontier can be attained through a variety of performance-based incentive schemes.
Stomatocystis goerresi, a new species of gregarine parasite (Apicomplexa, Monocystidae) from the invasive Japanese earthworm Amynthas tokioensis (Megascolecidae), with a description of the parasite's life cycle.

Stomatocystis goerresi sp. n., a gregarine (phylum Apicomplexa, Monocystidae) parasite of an important invasive earthworm in North America, Amynthas tokioensis (Beddard), is described. This is the second species placed into the genus, and details of its morphology and life cycle support Stomatocystis Bandyopadhyay, Mitra et Gocmen, 2006 as a valid taxon. The new species is described using standard nomenclature, measurements, shape descriptors, and photographs of living cells. The parasite was found only in A. tokioensis, and absent in sympatric earthworm species, suggesting it arrived when the earthworms were introduced from their origin from Japan. The species is distinctive from the type species in the genus, S. indica Bandyopadhyay, Mitra et Gocmen, 2006, in being substantially larger in all stages, found in only the host's seminal vesicles, and found in a different host species from East Asia. The distinctive trophozoites/gamonts develop a large funnel structure ringed with a collar of pronounced ridges, and the funnel appears even in the smallest cells. This funnel varies greatly in relative size (to the cell body) and shape, sometimes forming a large fan. The life cycle of S. goerresi is described including distinctive syzygy in which the funnels fuse and then produce a large cell with local centres of isogamete production (thus sex without gender). Gametes are large ( ~5 μm) spheres with complex tips. Oocyst production is large, > 1,000 per mature gametocyst. The genus Stomatocystis is placed into the Monocystidae, but the life cycle of the new species differs from those of other monocystid taxa, which may mean the Monocystidae are not monophyletic or life cycles are variable within the family. Prevalence of S. goerresi at the type locality was high (~ 90%). The parasites destroy the earthworm's organ of sperm self-storage thus eliminating the male function in the hermaphroditic host which may influence the ability of the earthworm to invade and be successful at new sites.
How Many Es? What Must Public Administrators Consider in Providing for the Public Good?

Scholars and practitioners of public administration often discuss the core values of the field. Referred to as the pillars of public administration, economy, efficiency, effectiveness and equity ha...
Production of research and clinical‐grade recombinant adeno‐associated virus vectors

Publisher Summary Recombinant adeno-associated virus (rAAV) vectors are constructed by replacing the rep and cap genes with the transgene of interest while retaining the flanking ITR sequences. Construction of rAAV vectors is possible because the AAV inverted terminal repeats (ITRs) supply all of the cis acting sequences for vector production and transduction. Recombinant AAV vector constructs are flanked by AAV ITRs and other cis-sequences control transgene expression including constitutive or regulated promoters, enhancers, and intron sequences. In general, there are two different approaches for packaging rAAV vectors: ‘‘isotype’’ and ‘‘pseudotyped’’ vectors. The major improvements in production and purification of rAAV vectors include enhanced output of the number of DNase resistant particles (drp) per cell and the emergence of scaleable systems. Large-scale purification by column chromatography is made possible by two changes in the preparations of crude lysates. Having reliable, specific, and sensitive assays is crucial during development of production and purification methods, and to show lot consistency. Once made and purified, the rAAV vector stocks are characterized using a variety of techniques to ensure they are safe, pure, potent, and stable.
New Observational Clues on Binary Formation in the Galaxy

New observations of binaries are beginning to provide new clues on the formation and evolution of binary and multiple systems in a variety of stellar populations in the Galaxy. New orbital determinations are shedding light on the frequency and orbital characteristics of binaries in the disk and the halo of our Galaxy, both in clusters and the field. These results support the view that the formation of binaries involving solar-mass stars is relatively independent of the stellar environment. Evolutionary effects can have a major influence for close binaries with periods up to at least ten days, with a strong dependence on the age of the population. Progress towards determining the frequency of low-mass companions and planetary systems is promising but still very limited.
The Language of Gene Interaction

> The study of variation and heredity, in our ignorance of the causation of those phenomena, must be built of statistical data, as Mendel knew long ago; but, as he also perceived, the ground must be prepared by specific experiment. The phenomena of heredity and variation are specific questions. That
A Review of “Empire of Humanity: A History of Humanitarianism”

The challenging argument of Michael Barnett's Empire of Humanity: A History of Humanitarianism is embedded in its title. Modern humanitarians bear the ethical burdens of their predecessors, who, tr...
Aging as an emergent factor that contributes to phenotypic variation in Cryptococcus neoformans

Cryptococcus neoformans, similar to other eukaryotes, undergoes replicative aging. Replicative life spans have been determined for clinical C. neoformans strains, and although they are a reproducible trait, life spans vary considerably among strains. C. neoformans has been proposed as an ideal model organism to investigate the contribution of replicative aging in a fungal pathogen population to emerging phenotypic variation during chronic cryptococcal infections. C. neoformans cells of advanced generational age manifest a distinct phenotype; specifically, a larger cell size, a thicker cell wall, drug resistance, as well as resistance to hydrogen peroxide-mediated killing. Consequently, old cells are selected in the host environment during chronic infection and aging could be an unanticipated mechanism of pathogen adaptation that contributes to persistent disease. Aging as a natural process of phenotypic variation should be further studied as it likely is also relevant for other eukaryotic pathogen populations that undergo asymmetric replicative aging.