cssi/SciSciGPT-SciSciNet huggingface dataset:
Agriculture of the Middle Participation in State Branding Campaigns: The Case of Kentucky

In the past decade, statewide agricultural branding campaigns have blossomed. Examining the case of the Kentucky Proud™ (KyP) program, this paper investigates the potential benefit of a state-level marketing strategy for the declining class of midsize farms, referred to as Agriculture of the Middle (AOTM). First, we discuss why AOTM farms are important to maintaining a viable agriculture structure. Second, we introduce the context of state branding and explain how KyP developed as part of the transition from highly tobacco-dependent agriculture. Using recent agricultural census data and a survey of KyP members, we compare the key characteristics between three sets of pairs: (a) U.S. AOTM farmers and Kentucky AOTM farmers, (b) Kentucky AOTM farmers and KyP-member AOTM farmers, and (c) KyP AOTM farmers and other KyP-member farmers. The findings indicate that Kentucky's AOTM farmers are unique compared to U.S. AOTM farmers, and that the KyP program benefits particularly those AOTM farmers transitioning from tobacco-dependent agriculture. We also found that the logo of the state branding campaign helps member farmers differentiate their products, and that the program helps most members gain knowledge and skills for marketing their products. Overall, findings suggest that state branding campaigns designed to incentivize agricultural marketing of local foods have the potential to help farmers of the middle. Further research needs to be done in order to track the long-term impact of different agricultural branding campaigns.
Distinct Role for Fyn-Kinase in αIIbß3-Mediated Signaling.

Recent studies have shown that Src-family kinases (SFKs) play an important role in mediating integrin signaling. αIIbβ3 has been shown to interact with multiple SFK members. We analyzed the role of Fyn in αIIbβ3-signaling and hemostasis. Fyn associated with αIIbβ3 in resting as well as thrombin aggregated platelets. In contrast, the interaction between αIIbβ3 and another SFK member, cSrc, was seen predominantly in resting but not in thrombin aggregated platelets. Based on this difference, we explored if the Fyn − / − mice exhibit any abnormalities in hemostasis and platelet function. Fyn − / − mice had significantly prolonged second bleeding times compared to wild-type (WT) controls (3.61 min for Fyn − / − compared to 1.04 min for WT mice, n=11). Platelets from Fyn−/− mice also exhibited delayed spreading on fibrinogen coated surfaces. Fyn, but not cSrc, localized to focal adhesions in CHO cells adherent to fibrinogen via αIIbβ3, and association of Fyn and cSrc depends on different segments of the cytoplasmic tail of the β3 subunit in this model cell system In the CHO cell system, Fyn mediated αIIbβ3-dependent cell spreading in the absence of Rho-GTPase recruitment. Using mutant forms of Fyn, we found that its kinase activity is required for its localization to focal adhesions and to mediate αIIbβ3-dependent cell spreading. These results show previously unidentified roles for Fyn in αIIbβ3-signaling and hemostasis.
Particlelike solutions to classical noncommutative gauge theory

We construct perturbative static solutions to the classical field equations of noncommutative $U(1)$ gauge theory for the three cases: (a) space-time noncommutativity, (b) space-space noncommutativity, and (c) both (a) and (b). The solutions tend to the Coulomb solution at spatial infinity and are valid for intermediate values of the radial coordinate $r$. They yield a self-charge inside a sphere of radius $r$ centered about the origin which increases with decreasing $r$ for case (a), and decreases with decreasing $r$ for case (b). For case (a) this may mean that the exact solution screens an infinite charge at the origin, while for case (b) it is plausible that the charge density is well behaved at the origin, as happens in Born-Infeld electrodynamics. For both cases (a) and (b) the self-energy in the intermediate region grows faster as $r$ tends to the origin than that of the Coulomb solution. It then appears that the divergence of the classical self-energy is more severe in the noncommutative theory than it is in the corresponding commutative theory. We compute the lowest order effects of these solutions on the hydrogen atom spectrum and use them to put experimental bounds on the space-time and space-space noncommutative scales. For the former we get a significant improvement over previous bounds. We find that cases (a) and (b) have different experimental signatures.
Zettawatt-exawatt lasers and their applications in ultrastrong-field physics

Since its birth, the laser has been extraordinarily effective in the study and applications of laser-matter interaction at the atomic and molecular level and in the nonlinear optics of the bound electron. In its early life, the laser was associated with the physics of electron volts and of the chemical bond. Over the past fifteen years, however, we have seen a surge in our ability to produce high intensities, 5 to 6 orders of magnitude higher than was possible before. At these intensities, particles, electrons, and protons acquire kinetic energy in the megaelectron-volt range through interaction with intense laser fields. This opens a new age for the laser, the age of nonlinear relativistic optics coupling even with nuclear physics. We suggest a path to reach an extremely high-intensity level ${10}^{26--28}\mathrm{W}/{\mathrm{cm}}^{2}$ in the coming decade, much beyond the current and near future intensity regime ${10}^{23}\mathrm{W}/{\mathrm{cm}}^{2}$, taking advantage of the megajoule laser facilities. Such a laser at extreme high intensity could accelerate particles to frontiers of high energy, teraelectron volt, and petaelectron volt, and would become a tool of fundamental physics encompassing particle physics, gravitational physics, nonlinear field theory, ultrahigh-pressure physics, astrophysics, and cosmology. We focus our attention on high-energy applications, in particular, and the possibility of merged reinforcement of high-energy physics and ultraintense laser.
Career retention in the dental hygiene workforce in Texas

Purpose The purpose of this study was to determine the factors that influence the retention and attrition of dental hygienists within the workforce in Texas. Respondents' perception of the role of employee benefits and practice of dental hygiene on career retention were explored. Demographic descriptors, including educational level, marital status, age, employment setting, and practice statuses, were also examined. Methods A questionnaire modified from the American Dental Hygienists' Association Extension Study: Retention of Dental Hygienists in the Workforce Final Report, April 1992, was mailed to a systematic sample of licensed Texas dental hygienists in March 1999. Descriptive statistics were computed for dental hygienists currently in practice in Texas and those not in practice at the time of the survey. Differences in demographics, benefits, and attitudes between dental hygienists currently in practice in Texas and dental hygienists not in practice at the time of the survey were tested using independent t-tests for interval data and chi-squared tests for categorical data. All statistical analyses were conducted using the Statistical Package for Social Scientists (SPSS v. 9, Chicago, Illinois). Results A response rate of 68.1% was obtained. Results revealed the primary reasons for remaining in the practice of dental hygiene were salary, family responsibility, professional collaboration, and variety of work. The primary reasons for leaving dental hygiene practice were family responsibility, boredom, salary, and lack of benefits. Secondary and tertiary reasons stated for staying in clinical practice revealed additional factors including benefits, participation in decision-making, and a safe environment. Dental hygienists in clinical practice were more likely to be employed by a dentist in a single practice and see more patients per day, have a certificate or associate's degree, be unmarried, have fewer children, and be younger than dental hygienists not in practice. Conclusion The findings suggest that dental hygienists in Texas who remain in the workforce are positively influenced primarily by salary. Dental hygienists in Texas who had left the workforce were primarily influenced to leave practice because of family responsibility. Boredom and lack of benefits were also important factors in deciding to leave clinical practice. Employers of dental hygienists need to be aware of these factors in the hiring process. In addition, dental hygiene educators should prepare students in interviewing techniques for better communication regarding retention factors.
Mystery Case: CNS posttransplant lymphoproliferative disorder.

A 74-year-old right-handed Hispanic woman with history of renal transplant 19 years prior presented at an away institution with episodic confusion and gait ataxia progressing over 2 weeks. She was alert and oriented on initial presentation but with fluctuation in mental status and without obvious cranial nerve, motor, or sensory deficits. The patient received transplant immunosuppression therapy with mycophenolate mofetil (Cellcept; Roche, Basel, Switzerland) and had a history of hypertension and chronic kidney disease. CT of the head showed a hypodense lesion in the right temporal lobe. MRI of the brain demonstrated multifocal, infiltrative T2-hyperintense white matter lesions involving the right temporo-parietal region, right frontal lobe, left parietal lobe, and left thalamus (figure, A–C). Gadolinium was not administered due to renal dysfunction. Lumbar puncture (LP) showed 63 leukocytes with lymphocytic pleocytosis (88%), elevated protein (80 mg/dL), and normal glucose (71 mg/dL). CSF Gram stain and culture were negative. She was treated with corticosteroids and acyclovir for presumed autoimmune/demyelinating vs infectious etiologies. She developed multiple witnessed periods of behavioral arrest with eye blinking and confusion concerning for seizures. She was transferred to our institution.
Spaces of Random Variables

This chapter is chiefly concerned with two metric spaces consisting of collections of random variables on a probability space (Ω, (ℱ, P): L1(Ω, ℱ, P), consisting of all random variables X: Ω → ℝ such that E(|X|) < ∞, and L2 (Ω, ℱ, P), consisting of those X for which E(X 2) < ∞. The space L2(Ω, ℱ, P) has additional structure which makes it a ‘Hilbert space’. General Hilbert spaces are introduced in the first section, and L2(Ω, ℱ, P) is treated in second section. Basic results from these two sections will play an important role in the definition of conditional probability distributions in Chapter 21. The metric space L1(Ω, ℱ, P) is discussed briefly in the third section, and the final section of the chapter treats an application of Hilbert space methods to an estimation problem.
Higher Aminopeptidase Activity Determined by Electroosmotic Push–Pull Perfusion Contributes to Selective Vulnerability of the Hippocampal CA1 Region to Oxygen Glucose Deprivation

It has been known for over a century that the hippocampus, the center for learning and memory in the brain, is selectively vulnerable to ischemic damage, with the CA1 being more vulnerable than the CA3. It is also known that leucine enkephalin, or YGGFL, is neuroprotective. We hypothesized that the extracellular hydrolysis of YGGFL may be greater in the CA1 than the CA3, which would lead to the observed difference in susceptibility to ischemia. In rat organotypic hippocampal slice cultures, we estimated the Michaelis constant and the maximum velocity for membrane-bound aminopeptidase activity in the CA1 and CA3 regions. Using electroosmotic push–pull perfusion and offline capillary liquid chromatography, we inferred enzyme activity based on the production rate of GGFL, a natural and inactive product of the enzymatic hydrolysis of YGGFL. We found nearly 3-fold higher aminopeptidase activity in the CA1 than the CA3. The aminopeptidase inhibitor bestatin significantly reduced hydrolysis of YGGFL in both regi...
Participation and Local Political Culture: Analysis of Recent Nationwide Trends in Volunteering

Volunteer behavior and participation can be a proxy for social capital accumulation. Using the Census’ Current Population Survey, we test two basic questions: 1. Has social capital accumulation in the form of participating in volunteer organizations increased or decreased over time? What factors influence participation? 2. How does local political culture influence participation and volunteer behavior? We find strong evidence of an Elazar-style breakdown of US political culture in the form of volunteer work. We hypothesize that building social capital through volunteering is more strongly favored and prestigious in moralistic cultures. We find that the moralistic, agricultural Midwest resembles the traditionalistic South in traditional volunteer activities such as Religion because these regions draw their morality from traditional sources such as the Bible. However, in moralistic regions such as New England, the Pacific Northwest, and to a lesser extent the Mountainous Midwest, volunteering New Political Culture issue-specific volunteering is more common than the country as a whole. These regions maintain the strong Puritan tradition of helping others and prestige in volunteering generally, but have moved on from valuing traditional morality like religion to new issues like the environment. We still find that individualistic cultures tend not to volunteer as much, but that Alaska may be actually moralistic in nature and California more individualistic, as opposed to Elazar’s original classifications. We find some evidence that Putnam’s diagnosis of declining civic participation may be partially correct. For every type of organization except environmental, we find that volunteering as increased over the last decade. This is true of most volunteer activities as well. However, the exception of “working with people in your neighborhood to solve a problem” is non-trivial. Participation has increased, all else equal, since the question was originally asked in 2006. “Working with people in your neighborhood” was the question best designed to parse out volunteer activities not done through any organization. An increasing in working with people in your neighborhood while formal organizational activity has decreased suggests that Putnam is correct in that formal organizational membership is declining, but Clark is also correct in that informal organization is stagnant or increasing. The social landscape is simply changing, not weakening.
The Impact of Zero Tolerance Policy on Children with Disabilities

The Zero Tolerance policy was intended to eliminate learners who are a danger to a learning institution (Henson, 2012). The development of this policy was to assist schools with better policing approaches of students conducts by employing tough disciplinary action and subsequently provide a safer learning environment. While the Zero Tolerance policy sought to reinforce security measures in schools, the students with emotional or learning disabilities and behavioral disorders were predisposed to expulsions and suspensions (Henson, 2012). The situation is facilitated by the all-encompassing nature of this policy as it fails to accommodate the fact that some of the behaviors demonstrated by students with disabilities are beyond their control. While some of these behaviors are considered to fall under the zero-tolerance policy guidelines, it subjects this group of learners several disciplinary actions that were not initially included in addressing their special needs.
Corepressors and nuclear hormone receptor function.

Nuclear hormone receptor mediated transcription has become a paradigm for the study of how gene activation and gene repression are regulated (for review see Mangelsdorf et al. 1995; Tenbaum and Baniahmad 1997). The focus of this review is to highlight recent work from several groups that addresses the mechanisms by which nuclear hormone receptors can function as transcription repressors. Many studies over the past several years have established that nuclear receptors activate gene expression in response to ligand binding and repress gene expression in its absence (for reviews see Shibata et al. 1997; Torchia et al. 1998; Xu et al. 1999). In the presence of ligand, a series of molecular interactions occur resulting in the recruitment of a multiprotein complex that includes the coactivators CBP/p300, pCAF, and p160 proteins (SRC-1, GRIP1/TIF2, ACTR/RAC3/pCIP) (see reviews by Minucci and Pelicci 1999; Xu et al. 1999; Torchia et al. 1998). As these proteins all have intrinsic histone acetyltransferase (HAT) activity (Ogryzko et al. 1996; Spencer et al. 1997; Bannister and Kouzarides 1996), a hallmark of igand-induced transcriptional activation by nuclear hormone receptors is the ability of this complex to alter the local chromatin structure through histone acetylation. Indeed, recent studies demonstrate that estrogen receptor (ER) and retinoic acid receptor (RAR) target gene promoters undergo histone hyperacetylation in response to ligand and that the HAT activity of CBP/p300 protein is required (Chen et al. 1999).
Kv7 (KCNQ) Potassium Channels and L-type Calcium Channels in the Regulation of Airway Diameter

Potassium channels in airway smooth muscle cells (ASMCs) help to maintain negative membrane voltages and thereby oppose the opening of voltage-sensitive calcium channels (VSCCs). There is considerable evidence that an influx of calcium ions (Ca2+) through L-type VSCCs contributes to induce contraction of ASMCs and bronchoconstriction of small airways, both physiologically and in diseases such as asthma in which exaggerated bronchoconstrictor responses are evident. Suppression of potassium channel activity is one mechanism to promote Ca2+ influx via VSCCs, though little is known regarding the involvement of potassium channels in bronchoconstrictor signal transduction. Pharmacological enhancement of potassium channel activity is expected to reduce Ca2+ influx via VSCCs and relax airways, though no K+ channel activators have yet been successfully developed as therapies for asthma. This chapter summarizes recent evidence that Kv7 (KCNQ family) voltage-activated K+ channels are expressed in ASMCs and that they serve as signal transduction intermediates in the actions of bronchoconstrictor agonists. The extent to which these channels contribute to regulation of airway diameter, the contributions of L-type VSCCs, and the potential to develop novel bronchodilator therapies based on these biochemical pathways are also discussed.
DEFORMATION OF SAND AT FAILURE

The failure conditions in an Ottawa sand are studied by means of a new soil test box and stress control device. Failure envelopes for the soil in a medium dense and medium loose state are obtained and plotted on an octahedral plane. The relation between the failure stress and the void ratio of the soil is also obtained for the soil under triaxial compression and triaxial extension stress states.
Adjustment to Medical Illness

A medical condition, especially a chronic or life-threatening illness, can have a profound impact on children and their families. It is estimated that in the past 20 years chronic illness in children has more than doubled, so helping children to understand and process their feelings about their illness is imperative (Eccleston et al. 2012). Recent studies recognize parents’ critical role in positively or negatively influencing their child’s adjustment to a chronic illness (Eccleston et al. 2012; Campbell et al. 2017). Additional factors influencing this adjustment include the age or developmental stage of the child, parental or family stressors, and family dynamics. One way to help children and their families adapt to an illness is to promote active coping skills. The concept of coping can be described as the ability to manage or overcome life’s challenges with limited, or without, distress. This is often difficult to do with children and adolescents, especially during a medical illness. Children can experience fear, worry, and pain and may not always know how best to manage these feelings. The published literature recognizes that helping children and their families with effective coping strategies is beneficial and can optimize recovery and improve treatment outcomes (Eccleston et al. 2012; Coakley and Wihak 2017; Mechtel and Stoeckle 2017; Schonfeld and Demaria 2015).
Vererbung der anderen Art

Schadliche Chemikalien, Stress und andere Einflusse konnen auf Dauer festlegen, welche Gene aktiv sind, und zwar ohne dass sich die Buchstabenabfolge der DNA verandert. Nicht nur das: Offenbar bleiben einige dieser »epigenetischen« Veranderungen sogar in nachfolgenden Generationen erhalten und verursachen auch bei ihnen Krankheiten.
Valuing Independent Thought Within Cultural Groups in the Workplace

There are many cultural groups in the workplace. Many members of these groups are treated as if they are monolithic in their thoughts and actions. Although organizations are different, their leaders are sometimes monolithic in their perceptions of cultural groups. Not all cultural group members have the same views on structure, policies, and beliefs. Culture differences and the constant evolution of each society dictates that some accommodation and adjustment for differences be made. The alternative is embarrassment and failure of businesses that have had to suffer unnecessary loss of reputation and money because they do not acknowledge cultural differences. With rapid changes of America’s demography, the social and ethnic composition of the workforce is changing. However, the contribution of some groups is not always optimally utilized. HR practitioners and scholars are beginning to review their understanding of formal diversity policy and their actual inclusive HR practices. Organizational leaders who are willing to think differently about diversity within cultures and integrate them into workforce inter-personnel diversity initiatives may produce results that cost the organization only the amount of time it takes to align people to their strengths and potential. They will avoid having hidden figures within their organizations as those who are performing at their best will be openly recognized for their performance.
Weather Radar Network Benefit Model for Tornadoes

AbstractA monetized tornado benefit model is developed for arbitrary weather radar network configurations. Geospatial regression analyses indicate that improvement of two key radar parameters—fract...
Influence of PEGylation on the Strength of Protein Surface Salt Bridges

Conjugation of polyethylene glycol (PEGylation) is a well-known strategy for extending the serum half-life of protein drugs and for increasing their resistance to proteolysis and aggregation. We previously showed that PEGylation can increase protein conformational stability; the extent of PEG-based stabilization depends on the PEGylation site, the structure of the PEG-protein linker, and the ability of PEG to release water molecules from the surrounding protein surface to the bulk solvent. The strength of a noncovalent interaction within a protein depends strongly on its microenvironment, with salt-bridge and hydrogen-bond strength increasing in nonpolar versus aqueous environments. Accordingly, we wondered whether partial desolvation by PEG of the surrounding protein surface might result in measurable increases in the strength of a salt bridge near a PEGylation site. Here we explore this possibility using triple-mutant box analysis to assess the impact of PEGylation on the strength of nearby salt bridges at specific locations within three peptide model systems. The results indicate that PEG can increase the nearby salt-bridge strength, though this effect is not universal, and its precise structural prerequisites are not a simple function of secondary structural context, of the orientation and distance between the PEGylation site and salt bridge, or of salt-bridge residue identity. We obtained high-resolution X-ray diffraction data for a PEGylated peptide in which PEG enhances the strength of a nearby salt bridge. Comparing the electron density map of this PEGylated peptide versus that of its non-PEGylated counterpart provides evidence of localized protein surface desolvation as a mechanism for PEG-based salt-bridge stabilization.
Sonographic Indices in Patients with Severe Acute Tubular Necrosis during Early Post-Kidney Transplantation Period.

Background: Kidney transplantation is the most effective and optimal treatment for end-stage renal disease. Objective: To investigate the association between serially measured ultrasound indices during the early post-operative period to determine severe acute tubular necrosis (ATN) in kidney allografts. Methods: In a prospective study, we assessed sonographic renal indices including interlobar arteries peak systolic velocity (PSV), end-diastolic velocity (EDV), resistance index (RI), pulsatility index (PI), power doppler grading (PDG), acceleration time (AT), and renal volume on the 3 rd and 9 th days after kidney transplantation in 46 adult recipients who had no other significant complications except ATN. Biopsies were performed in patients with prolonged delayed graft function (DGF) to exclude other pathologies, especially acute rejection. Results: 12 (20%) recipients experienced biopsy-proven severe ATN. The differences in the ultrasound indices and their measured discrepancies on the 1 st and 2 nd examinations between the groups were not statistically significant except for the 1st examined RI (p=0.029) and PI (p=0.04). No patient had PDG of >2. The first RI, with a cut-off value of 0.66, had a sensitivity of 91.7% and a specificity of 50% for predicting severe ATN (area under the ROC curve = 0.71). To compensate for the low specificity of this index, we suggest using the first PDG scale of equal to 2 with a specificity of 85.3%. Overall sensitivity, specificity, and positive and negative predictive values in established severe ATN throughout early post-operative days for a 3 rd day RI >0.66 and PDG = 2, were 38%, 92.5%, 64.1%, and 80.9%, respectively. Conclusions: The RI and the PDG measured on the 3rd day after renal transplantation are useful indices for the diagnosis of established severe ATN in kidney allografts. Furthermore, donor characteristics, post-harvesting organ preservation status, main renal vascular anastomosis, and early post-operative recipient’s clinical situations may also influence the incidence of severe ATN. Although the 1 st ultrasound examination on the 3 rd day in early post-transplantation provides important diagnostic and prognostic information, repeated assessment about one week later provides no more valuable information.
Structural Commutation Relations for Stochastic Labelled Graph Grammar Rule Operators.

We show how to calculate the operator algebra and the operator Lie algebra of a stochastic labelled-graph grammar. More specifically, we carry out a generic calculation of the product (and therefore the commutator) of time-evolution operators for any two labelled-graph grammar rewrite rules, where the operator corresponding to each rule is defined in terms of elementary two-state creation/annihilation operators. The resulting graph grammar algebra has the following properties: (1) The product and commutator of two such operators is a sum of such operators with integer coefficients. Thus, the algebra and the Lie algebra occurs entirely at the structural (or graph-combinatorial) level of graph grammar rules, lifted from the level of elementary creation/annihilation operators (an improvement over [1], Propositions 1 and 2). (2) The product of the off-diagonal (state-changing) parts of two such graph rule operators is a sum of off-diagonal graph rule operators with non-negative integer coefficients. (3) These results apply whether the semantics of a graph grammar rule leaves behind hanging edges (Theorem 1), or removes hanging edges (Theorem 2). (4) The algebra is constructive in terms of elementary two-state creation/annihilation operators (Corollaries 3 and 8). These results are useful because dynamical transformations of labelled graphs comprise a general modeling framework, and algebraic commutators of time-evolution operators have many analytic uses including designing simulation algorithms and estimating their errors.
Neonatal respiratory extracorporeal membrane oxygenation and primary diagnosis: trends between two decades.

OBJECTIVE Examine changing neonatal respiratory extracorporeal membrane oxygenation (ECMO) practice trends and outcomes. STUDY DESIGN Retrospective cohort study comparing neonatal respiratory ECMO in the 1990 and 2010 decades (1994-1995 and 2014-2015). Patients ≤ 30 days of life, reported to the Extracorporeal Life Support Organization registry, were included. RESULTS Four thousand one hundred and twenty-five patients met inclusion criteria. ECMO cases decreased by 33%. The primary ECMO diagnosis changed significantly over time (p < 0.0001). Survival to discharge decreased (76 vs 67%, p < 0.0001) and ECMO duration increased (131 vs 158 h, p < 0.001). Lung recovery was the most common reason to discontinue ECMO although family request for withdrawal and a diagnosis considered "incompatible with life" was increasingly common in the 2010s. CONCLUSION Although the use of ECMO for neonatal respiratory diagnoses has decreased over time, its use has increased for patients with more complex diagnoses and ECMO duration is longer. ECMO continues to be an important supportive therapy, improved understanding of which patients would benefit most is needed.
Attorney Referral, Negligence, and Vicarious Liability

As a consequence of requests from clients or prospective clients, lawyers are often placed in a position of giving referrals, especially in situations of cross-specialty referrals (such as an estate planning attorney whose longtime client has become a party in a personal injury lawsuit) or cross-jurisdictional referrals (such as an attorney in Michigan who is contacted by a prospective client who must respond to a lawsuit that was filed in Ohio). But if the lawyer who receives the referral commits malpractice in handling the case, can the lawyer who made the referral be held liable for the client's loss? This paper argues that plaintiffs can draw analogies to doctrines of undue influence and breach of fiduciary duty, while defendants can invoke an analogy to the business judgment rule.
Incorporating leading-edge technologies in an artificial intelligence course

Artificial intelligence technologies have advanced significantly over the past several years, with new achievements making news virtually daily in the field of intelligent systems. Furthermore, a number of these technologies have been open-sourced or are otherwise available for educational and research use free or at very low cost. This paper presents an innovative artificial intelligence course approach using some of the latest AI technologies, from computer vision using Google's TensorFlow to natural language sentiment and intent parsing using NLTK and Mycroft Adapt, as well as IBM's Watson API, all at no cost to the institution or the students. Five programming projects in Python, plus a term project, are described in sufficient detail for other faculty to adapt and use these leading-edge AI technologies in their own courses.
Optimizing Primary User Privacy in Spectrum Sharing Systems

Spectrum regulators are pursuing centralized, dynamic sharing systems that will enable spectrum access for new wireless technologies. These sharing systems will leverage cognitive radio concepts to automatically identify suitable spectrum for users. Collected user information may be considered sensitive, and some incumbents are hesitant about spectrum sharing, citing privacy concerns. Privacy preserving strategies are needed to promote widespread spectrum sharing. However, privacy preserving techniques typically come at the expense of spectrum efficiency, resulting in reduced utility for the users. In this work we study this privacy-performance tradeoff. We develop a generalized spectrum sharing system architecture and formulate the multi-utility, user privacy optimization problem, where privacy is measured by exposure to potential adversary inference attacks. We derive the optimal solution for this spectrum sharing privacy problem and then formulate an efficient heuristic strategy that exploits the problem structure. Via numerical analysis, we demonstrate substantial improvement over the prevailing obfuscation strategies applied in the literature, with up to a 50% increase in privacy and negligible impact on spectrum efficiency for a real-world use case. To our knowledge, this is the first work to formally derive the optimal solution to the user privacy problem in a generalized spectrum sharing framework.
Risk of Total Wrist Arthrodesis or Reoperation Following 4-Corner Arthrodesis or Proximal Row Carpectomy for Stage-II SLAC/SNAC Arthritis: A Propensity Score Analysis of 502 Wrists.

Background For stage-II scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) patterns of wrist arthritis, the optimal method of surgical treatment remains unclear. Previous literature has demonstrated similar clinical outcomes between proximal row carpectomy (PRC) and 4-corner arthrodesis (FCA), making the risk of reoperation a focus of particular interest. In the present study, the primary null hypothesis was that there would be no difference in the rate of conversion to total wrist arthrodesis between PRC and FCA. Additionally, we hypothesized that the rate of secondary surgical procedures would be similar between the 2 procedures. Methods The national Veterans Health Administration Corporate Data Warehouse was utilized to identify 2,449 patients who underwent either PRC or FCA between 1992 and 2016. With use of operative reports to identify the arthritis pattern, only cases of stage-II SLAC/SNAC were included. All complications and subsequent surgical procedures were confirmed by manual chart review. Propensity score analyses with matching weights were utilized to balance the PRC and FCA cohorts. The rates of conversion to wrist arthrodesis and secondary surgical procedures were calculated. Results Of the 1,168 patients with stage-II SLAC/SNAC arthritis, 933 wrists underwent PRC and 257 wrists underwent FCA. Ten-year survival free of total wrist arthrodesis in the matching PRC (251 procedures) and FCA (251 procedures) cohorts was 94.3% (95% confidence interval [CI], 92.3% to 96.3%) and 94.1% (95% CI, 90.8% to 97.4%), respectively. Survival free of a secondary surgical procedure other than wrist arthrodesis was 99.7% (95% CI, 99.3% to 100.0%) for PRC and 83.5% (95% CI, 78.2% to 88.8%) for FCA. Conclusions PRC and FCA demonstrated similarly low rates of conversion to total wrist arthrodesis. In contrast, the rate of secondary surgical procedures following FCA was significantly higher compared with PRC. Given the historically similar clinical outcomes between PRC and FCA, the results of the present study show that PRC may be a preferable treatment for stage-II SLAC/SNAC wrist arthritis. Level of evidence Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
A cognitively demanding working-memory intervention enhances extinction

Improving extinction learning has the potential to optimize psychotherapy for persistent anxiety-related disorders. Recent findings show that extinction learning can be improved with a cognitively demanding eye-movement intervention. It is, however, unclear whether [1] any cognitively-demanding task can enhance extinction, or whether it is limited to eye movements, and [2] the effectiveness of such an intervention can be enhanced by increasing cognitive load. Participants (n = 102, n = 75 included in the final sample) completed a Pavlovian threat conditioning paradigm across two days. One group underwent standard extinction (Control), a second group underwent extinction paired with a 1-back working memory task (Low-Load), and a third group underwent extinction paired with a 2-back working memory task (High-Load). We found that the conditioned response during extinction was reduced for both the Low-Load and the High-Load groups compared to the Control group. This reduction persisted during recovery the following day when no working memory task was executed. Finally, we found that within the High-Load group, participants with lower accuracy scores on the 2-back task (i.e., for who the task was more difficult) had a stronger reduction in the conditioned response. We did not observe this relationship within the Low-Load group. Our findings suggest that cognitive load induced by a working memory intervention embedded during extinction reduces persistent threat responses.
Abjection and mourning in the struggle over fetal remains

Should the remains of aborted fetuses be treated as human corpses or medical waste? How can feminists defend abortion rights without erasing the experiences of women who mourn fetal death or lending support to pro-life constructions of fetal personhood? To answer these questions, I trace the role of abjection and mourning in debates over fetal remains disposal regulations. Critiquing pro-life views of fetal personhood while challenging feminists to develop richer and more compelling accounts of fetal remains, I argue that embracing the ambiguity and diversity of pregnant bodies can strengthen rather than undermine reproductive autonomy. I conceptualize reproductive autonomy relationally, contending that it entails the pregnant subject’s authority to construct as well as to interpret her lived body, including the fetus. Additionally, because the embodied self is inextricable from social context, reproductive autonomy also requires community support. To support these claims, I develop an account of pregnant bodies as ontologically multiple and advocate embracing abjection rather than suppressing it. Finally, I object to fetal remains regulations because they inscribe fetal grievability into the law.
Oropharyngeal hemorrhage in patients with COVID-19: A multi-institutional case series.

Abstract Background Patients with COVID-19 who are intubated and require mechanical ventilation have been observed to have oropharyngeal bleeding necessitating otolaryngology intervention. Methods We report five cases of oropharyngeal hemorrhage in COVID-19 patients on mechanical ventilation requiring evaluation by otolaryngologists at George Washington University Hospital (GWUH) and Boston Medical Center (BMC) from March to April 2020. Institutional Review Board at both institutions exempted this study from informed consent because there were no identifiable patient characteristics, photographs, or imaging studies included. Results All five patients were managed conservatively; four required packing with Kerlix gauze by an otolaryngologist. Two patients had the additional requirement of extracorporeal membrane oxygenation (ECMO) and associated anticoagulation. Three patients improved with oropharyngeal packing; two had persistent bleeding. Three patients expired. Endotracheal tubes were repositioned less frequently due to the COVID-19 pandemic. Conclusions Intubated patients with COVID-19 may have an increased risk of oropharyngeal hemorrhage. This may be due to anticoagulation, prolonged intubation, or decreased frequency of endotracheal tube repositioning. Otolaryngologists should wear appropriate PPE when managing this hemorrhagic complication.
Empowering the Latino Community Related to Palliative Care and Chronic Disease Management through Promotores de Salud (Community Health Workers).

Background: Latinos are the largest minority group in the United States and when compared with non-Latino whites suffer from higher rates of certain chronic diseases. Latino community health worker...
Formal Verification of ECCs for Memories Using ACL2

Due to the ever-increasing toll of soft errors in memories, Error Correction Codes (ECCs) like Hamming and Reed-Solomon Codes have been used to protect data in memories, in applications ranging from space to terresterial work stations. In past seven decades, most of the research has focused on providing better ECC strategies for data integrity in memories, but the same pace research efforts have not been made to develop better verification methodologies for the newer ECCs. As the memory sizes keep increasing, exhaustive simulation-based testing of ECCs is no longer practical. Hence, formal verification, particularly theorem proving, provides an efficient, yet scarcely explored, alternative for ECC verification. We propose a framework, with extensible libraries, for the formal verification of ECCs using the ACL2 theorem prover. The framework is easy to use and particularly targets the needs of formally verified ECCs in memories. We also demonstrate the usefulness of the proposed framework by verifying two of the most commonly used ECCs, i.e., Hamming and Convolutional codes. To illustrate that the ECCs verified using our formal framework are practically reliable, we utilized a formal record-based memory model to formally verify that the inherent properties of the ECCs like hamming distance, codeword decoding, and error detection/correction remain consistent even when the ECC is implemented on the memory.
Dicer promotes genome stability via the bromodomain transcriptional co-activator Brd4.

Abstract RNA interference is essential for transcriptional silencing and genome stability, but conservation of this role in mammals has been difficult to demonstrate. Dicer1-/- mouse embryonic stem cells have microRNA-independent proliferation defects, and we conducted a CRISPR-Cas9 screen to restore viability. We identified suppressor mutations in transcriptional activators, H3K9 methyltransferases, and chromosome segregation factors, strongly resembling Dicer suppressors in fission yeast. Suppressors rescued chromosomal defects, and reversed strand-specific transcription of major satellite repeats in Dicer1-/-. The strongest suppressors were in Brd4, and in the transcriptional elongator/histone acetyltransferase Elp3. Using viable mutants and pharmaceutical inhibitors, we demonstrate that deletion of specific residues in Brd4 rescue genome instability defects of Dicer1-/- in both mammalian cells and fission yeast, implicating Dicer in coordinating transcription and replication of satellite repeats. Summary Replication and segregation defects in Dicer1-/- stem cells depend on centromeric transcription by Brd4, and are deeply conserved in fission yeast.
Crack Growth Under Conditions of Creep and Damage

The dissipative criterion is introduced for slow crack growth under creep and damage. The crack length and damage are determined by a system of two ordinary nonlinear differential equations of the first order. An integrable combinations is obtained. An example is considered of a crack growing in the strip under tension.
What are the Risk Factors for Cerebrovascular Accidents After Elective Orthopaedic Surgery

Perioperative cerebrovascular accidents (CVAs) are one of the leading causes of patient morbidity, mortality, and medical costs. However, little is known regarding the rates of these events and risk factors for CVA after elective orthopaedic surgery. Our goals were to (1) establish the national, baseline proportion of patients experiencing a 30-day CVA and the timing of CVA; and (2) determine independent risk factors for 30-day CVA rates after common elective orthopaedic procedures. Patients undergoing elective TKA, THA, posterior or posterolateral lumbar fusion, anterior cervical discectomy and fusion, and total shoulder arthroplasty, from 2006 to 2012, were identified from the American College of Surgeons National Surgical Quality Improvement Program® database. A total of 42,150 patients met inclusion criteria. Thirty-day CVA rates were recorded for each procedure, and patients were assessed for characteristics associated with CVA through univariate analysis. Multivariate regression models were created to identify independent risk factors for CVA. A total of 55 (0.13%) patients experienced a CVA within 30 days of the procedure, occurring a median of 2 days after surgery (range, 1–30 days) with 0.08% of patients experiencing a CVA after TKA, 0.15% after THA, 0.00% after single-level anterior cervical discectomy and fusion, 0.38% after multilevel anterior cervical discectomy and fusions, 0.20% after single-level posterior or posterolateral lumbar fusion, 0.70% after multilevel posterior or posterolateral lumbar fusion, and 0.22% after total shoulder arthroplasty. Independent risk factors for CVA included age of 75 years or older (odds ratio [OR], 2.50; 95% CI, 1.44–4.35; p = 0.001), insulin-dependent diabetes mellitus (OR, 3.08; CI, 1.47–6.45; p = 0.003), hypertension (OR, 2.71; CI, 1.19–6.13; p = 0.017), history of transient ischemic attack (OR, 2.83; CI, 1.24–6.45; p = 0.013), dyspnea (OR, 2.51; CI, 1.30–4.86; p = 0.006), chronic obstructive pulmonary disease (OR, 2.33; CI, 1.06–5.13; p = 0.036), and operative time of 180 minutes or greater (OR, 3.25; CI 1.60–6.60; p = 0.001). Numerous nonmodifiable patient comorbidities and increased operative time were associated with CVA after elective orthopaedic procedures. However, the American College of Surgeons National Surgical Quality Improvement Program® database does not code for cardiac arrhythmia or atrial fibrillation, which other studies have suggested may be important predictor variables; those may be important risk factors, although we were unable to evaluate them in our study. Surgeons should counsel patients with these risk factors and limit their operative time to reduce the risk of these adverse events, and future studies should examine other patient characteristics such as arrhythmia and noncoronary heart disease and assess the role of pharmacologic prophylaxis in patients with these risk factors. Level III, prognostic study.
Corrosion behavior of technetium waste forms exposed to various aqueous environments

Technetium is a long-lived beta emitter produced in high yields from uranium as a waste product in spent nuclear fuel and has a high degree of environmental mobility as pertechnetate. It has been proposed that Tc be immobilized into various metallic waste forms to prevent Tc mobility while producing a material that can withstand corrosion exposed to various aqueous medias to prevent the leachability of Tc to the environment over long periods of time. This study investigates the corrosion behavior of Tc and Tc alloyed with 316 stainless steel and Zr exposed to a variety of aqueous media. To date, there is little investigative work related to Tc corrosion behavior and less related to potential Tc containing waste forms. Results indicate that immobilizing Tc into stainless steel-zirconium alloys can be a promising technique to store Tc for long periods of time while reducing the need to separately store used nuclear fuel cladding. Initial results indicate that metallic Tc and its alloys actively corrode in all media. We present preliminary corrosion rates of 100% Tc, 10% Tc - 90% SS{sub 85%}Zr{sub 15%}, and 2% Tc - 98% SS{sub 85%}Zr{sub 15%} in varying concentrations of nitric acid and pH 10 NaOH using more » the resistance polarization method while observing the trend that higher concentrations of Tc alloyed to the sample tested lowers the corrosion rate of the proposed waste package. « less
A new reliability measure for computer networks

A new reliability measure for computer communication networks, mean 2-terminal throughput per unit capacity, is proposed as an alternative to conventional reliability measures. It gives an idea of the amount of traffic that can be reliably transferred from the source to the destination in a network with unreliable components, per unit installed capacity. The measure is then extended to an index of overall network reliability. A computationally efficient scheme to evaluate the proposed measure is presented and numerical examples are provided to illustrate the effectiveness of this measure over conventional measures. Finally, another method of evaluating the measure, as a function of the routing scheme, is presented. >