cssi/SciSciGPT-SciSciNet huggingface dataset:
Bound Rubber and Mechanical Properties of Diene Polymers

Abstract 1. Tensile strength is apparently a function of the particle size of the pigment and how well it is dispersed in a polymer. 2. Modulus and abrasion resistance are apparently functions of the interaction of the pigment and the polymer. This cannot be attributed entirely to bound-rubber formation, since bound rubber may occur without reinforcement, as shown by the results with silica pigment. 3. Results of processing studies show that Philblack O has a stabilizing effect on the polymer during processing and more consistent and better properties are obtained if processing is performed with carbon black present at temperatures below those for gel formation. This effect is more pronounced for less stable polymers such as polybutadiene. 4. Philblack O slows down gel formation. 5. It is possible that silica may have a destabilizing effect on polybutadiene unless it is buffered with agents such as resins, stearic acids, and diethylene glycol.
Quantitative Glycoproteomic Analysis of Optimal Cutting Temperature-Embedded Frozen Tissues Identifying Glycoproteins Associated with Aggressive Prostate Cancer

Prostate cancer is the most common malignancy in men in the United States, and one in seven men with prostate cancer dies of the disease. A major issue of prostate diagnosis is that there is no good method to reliably distinguish aggressive prostate cancer from nonaggressive prostate cancer. This leads to significant unnecessary suffering among prostate cancer patients and massive unnecessary health care expenditures. In this study, we aim to identify glycoproteins associated with aggressive prostate cancer using optimal cutting temperature (OCT)-embedded frozen tissues obtained from patients with known clinical outcome. To eliminate the interference of mass spectrometric analysis by the compounds in OCT and identify extracellular proteins that are likely to serve as biomarkers in body fluids, we employed glycoproteomic analysis using solid-phase extraction of glycopeptides, which allowed the immobilization of glycopeptides to solid support and removal of OCT from sample proteins before releasing the glyc...
Photographic Technique in the Study of Internal Stresses in Laser Rods

Radiation pumping of a laser rod causes internal stress upon absorption of any of the radiation. A photographic technique has been developed to simultaneously record these stresses at two focal points, in order to determine the optical quality of lasers used for scientific and industrial research.
Cerebral aneurysm wall thickness analysis using intraoperative microscopy: effect of size and gender on thin translucent regions

Objective Wall thickness is a poorly documented characteristic of cerebral aneurysms which may provide insight into adaptive aneurysmal growth, aneurysm rupture risk and response to endovascular treatment. The distribution of aneurysm wall thickness, as observed by intraoperative video microscopy, is described. Methods 54 unruptured saccular cerebral aneurysms were selected based on the availability of intraoperative video obtained from patients undergoing microsurgical clipping. Aneurysms were assessed for the distribution of wall thickness based on color translucence and quantitation of pixel values at superthin translucent, intermediate and thick regions of the dome. The data were analyzed with respect to aneurysm morphology, location and associated demographic factors. Results The mean proportions of tissue characteristic among all domes analyzed were found to be 27% superthin, 65% intermediate, and 8% thick. Smaller aneurysms having a maximal dimension D max Conclusion The dome of unruptured aneurysms is a highly heterogeneous region with areas of variable thickness that appear to be intimately related to the process of aneurysm development. This inconstant property affects wall tensile stress, may play a role in aneurysm pathogenesis and focal rupture, and should be incorporated into future analyses of aneurysm rupture risk and mechanics.
How a housing advocacy coalition adds health: A culture of claims-making

Abstract Organizations that pursue health advocacy often tackle other issues too. How do these multi-issue organizations articulate and combine health with other issues? We examine how a Los Angeles coalition focused primarily on housing took up health in its 2008–2011 campaign against a residential development. Participant observation and archival data reveal that cultural context influenced how the coalition made claims about health, in two ways. First, advocates shared two major symbolic categories, which oriented the great bulk of their appeals regarding health. Second, advocates crafted rhetorical appeals that reflected their shared sense of social identity and obligation as spokespersons for a distinctive kind of community. These two kinds of cultural context influenced advocates' claims in public, formal settings as well more internal communication. These distinct, cultural influences on claims-making create challenges for socioeconomically diverse coalitions collaborating on health problems.
Complications Following External Beam Radiation Therapy for Prostate Cancer: An Analysis of Patients Treated with and without Staging Pelvic Lymphadenectomy

We reviewed the treatment morbidity associated with definitive high energy external beam radiotherapy in 289 consecutive patients with clinically localized prostate cancer (stages A2 to C) treated from 1984 to 1988 inclusively. All patients were treated with 18 mv. photon beams via a 4-field box technique. Radiation doses ranged from 5,858 to 6,900 cGy., with a mean dose of 6,456 cGy. and a median dose of 6,400 cGy. A total of 65 patients underwent extraperitoneal pelvic staging lymphadenectomy before radiotherapy. Complications noted in 42 patients were mild (generally trivial) in 23 and moderate in 19 (6.6%). There were no severe complications. The actuarial incidence of moderate complications was 9% at 5 years. Only 6 patients experienced symptoms for longer than 6 months. The risk of complications was not increased in patients who had undergone prior lymph node dissection, and only 2 of 65 had mild lymphedema, which resolved in both cases. We conclude that high energy external beam radiation for prostate cancer can be delivered with a low risk of serious complications, even in patients who have undergone extraperitoneal staging pelvic lymphadenectomy, provided the patients are treated to limited fields with high energy photons and at doses limited to 6,800 cGy. or less.
Epidemiology of Clostridium difficile infection in hospitalized oncology patients

The epidemiology of Clostridium difficile infection (CDI) among oncology inpatients is poorly understood. In multivariate analysis we identified age, history of CDI, and prior receipt of cephalosporins, β-lactam/β-lactamase inhibitors, metronidazole, and blood transfusion as risk factors associated with CDI. Reducing broad-spectrum antibiotic use, particularly among older patients and those with a CDI history and recent blood transfusions, may decrease CDI risk in this population.
Selection of alternatives in esthetic blepharoplasty.

Upper and lower lid blepharoplasty are discussed with a focus on the alternatives that must be selected. Preoperative evaluation and counseling and postoperative care are also considered.
Adverse Effects of the Treatment for Hyperlipidemia

A variety of treatments to lower elevated plasma lipid levels in patients with hyperlipidemia are available. Adverse side effects ranging from mere annoyances to uncommon serious consequences may be associated with dietary modification, recreational physical exercise, and drug intervention. As in other clinical circumstances, risk-to-benefit ratios must be taken into consideration in the management of hyperlipidemia.
Dynamic interpretations of civic duty: implications for governance

This essay explores the norms of civic duty, based on the legal, ethical, and practical interpretations of democratic citizenship. The authors find that interpretations of civic duty are dynamic and touch on a fundamental political question: What is the proper balance between elected officials and the professional civil service in a liberal democracy? They conclude that the norms of civic duty are political interpretations concerning an institutional struggle over governance as much as they are matters of law, ethics, and best practice. Successive interpretations of civic provide an opportunity for the renewal of citizenship while channeling political conflict into liberal democracy’s established institutions
Amino Acids Bound to DNA

The purest preparations of DNA from many laboratories and many tissues have always been reported to contain small amounts of amino acids (Bendich and Rosenkrantz, 1963). Recently a number of investigators have attempted to verify this observation. Using a variety of techniques and several different sources, they, too, were unable to prepare samples completely free of amino acids (Bendich and Rosenkrantz, 1963; Champagne et al.,1964; Sarfert and Venner, 1965; Olenick and Hahan, 1964; Berns and Thomas, 1965). Some, despite the consistency of this observation, feel that the amino acids are simply impurities difficult to remove and refer to their DNA preparations as having “less than” a certain arbitrary amount of amino acids. Nevertheless, the most striking aspect of these observations is the fact that no matter which solvents or precipitants are used, even when completely new procedures are introduced such as biphasic liquid-liquid extraction in which no opportunities for coprecipitation of impurities is given, a limiting value is reached; the same amount of amino acids are found (Rudin and Albertsson, 1967; Favre and Pettijohn, 1967). Not only do all DNAs have amino acids associated with them but the amounts and kinds bound to the DNA from a given source are reproducible. These amino acids are tissue and species specific and vary with the age and sex of the source (Salser and Balis, 1967, 1972).
Clonal Diversity and Mutated Genes in Myelodysplastic Syndromes

Myelodysplastic syndromes (MDS) are driven by somatic genetic mutations that drive clonal explansion of neoplastic cells. The identification of these lesions has enabled large-scale studies to assess the association of genetic lesions with clinical and biological phenotype. Single mutations in driver genes in isolation, without concurrent mutations in additional driver genes, commonly do not cause overt disease, but rather cause an expanded population of blood cells without cytopenias, a condition that we have termed clonal hematopoiesis of indeterminate potential (CHIP). CHIP is common in the general population and is associated with age, risk of hematologic malignancy, and overall mortality. In contrast, patients with MDS generally have mutations in multiple genes as well as the disease-defining morphologic dysplastia and peripheral blood cytopenias. The particular mutations that drive MDS in an individual patient are powerfully associated with clinical phenotype, including cytopenias, specific morphologic abnormalities, blast percentage, overall survival, and response to therapy. Clonal architecture adds an additional layer of complexity as disease progression or response to therapy may be associated with shifts in the dominant genetic clone in the bone marrow. As the availability of genetic testing for panels of genes becomes widespread as a clinical assay, current endeavors are to move validated research findings into routine clinical use and to employ deep genetic analyses to evaluate response to investigational therapies in clinical trials. Disclosures Ebert: Genoptix: Consultancy, Patents & Royalties; H3 Biomedicine: Consultancy; Celgene: Consultancy.
New views of the distant stellar halo

Currently, only a small number of Milky Way (MW) stars are known to exist beyond 100 kpc from the Galactic Centre. Though the distribution of these stars in the outer halo is believed to be sparse, they can provide evidence of more recent accretion events than in the inner halo and help map out the MW's dark matter halo to its virial radius. We have re-examined the outermost regions of 11 existing stellar halo models with two synthetic surveys: one mimicking present-day searches for distant M giants and another mimicking RR Lyra (RRL) projections for the Large Synoptic Survey Telescope (LSST). Our models suggest that colour and proper motion cuts currently used to select M giant candidates for follow-up successfully remove nearly all self-contamination from foreground halo dwarf stars and are useful for focusing observations on distant M giants, of which there are thousands to tens of thousands beyond 100 kpc in our models. We likewise expect that LSST will identify comparable numbers of RRLe at these distances. We demonstrate that several observable properties of both tracers, such as proximity of neighbouring stars, proper motions and distances (for RRLe), could help us separate different accreted dwarf galaxies from one another in the distant MW halo. We also discuss prospects for using ratios of M giants to RRLe as a proxy for accretion time, which in the future could provide new constraints on the recent accretion history of our Galaxy.
This is my house – respect it

My first day working in the prison was an eye opening experience. I had never previously worked in an environment that was enclosed by high barbed wire fences, surrounded by watchtowers, and patrolled by armed officers. As I entered the medical clinic, I stepped in an unknown fluid, uttered an expletive, and said, “This place sucks.” In the hallway, sitting on a chair, …
The past is a foreign country revisited

David Lowenthal continues to astound. With wisdom and wit he revisits that foreign country known as the past. Displaying once again an impressive knowledge of Western literature and highly refined ...
Immunity to metastatic mammary carcinoma in STAT6-deficient mice involves reduction of immature myeloid cells and production of nitric oxide by M1 macrophages.

2348 Following surgical removal of primary 4T1 mammary carcinoma, >60% of BALB/c Stat6-deficient mice reject spontaneous metastatic disease and survive indefinitely. In contrast, 100% of post-surgery Stat6-competent BALB/c mice die from metastatic disease. Because the immune response in Stat6-deficient mice is so potent, we are examining the mechanisms underlying enhanced immunity. Several cell populations could be involved: 1) Type 1 CD4+ T cell responses are hypothesized to enhance CD8-mediated anti-tumor immunity. Because Stat6 is a transcription factor required for IL-4 and IL-13-mediated signaling and Stat6 −/− mice lack this factor, their CD4 responses are polarized towards a Type 1 response. 2) Type 1 macrophages have tumoricidal activity because of their production of nitric oxide (NO). Preferential generation of Type 1 macrophages is thought to facilitate anti-tumor immunity. 3) Excess immature myeloid cells (IMC) which are frequently induced by large tumor burdens cause immune suppression and block anti-tumor immunity. We have determined if any of these cells are involved in the potent anti-tumor immunity of Stat6-deficient mice. Both BALB/c and Stat6 −/− mice with primary tumors in situ have levels of IMC in excess of 30% of splenocytes. However, following surgical removal of primary tumor, IMC levels in Stat6-deficient mice revert to −/− mice were added to cultures of splenocytes from D011.10 transgenic mice (specific for ovalbumin peptide 323-339/I-A d ) pulsed with ova peptide, and proliferation was measured. Suppression resulted from arginase production since treatment of IMC with an arginase inhibitor reversed suppression. To determine if macrophages of BALB/c and Stat6 −/− mice differ in NO production, IL4 and IL13 pretreated macrophages were stimulated with IFNγ and LPS. Although BALB/c macrophages had significantly reduced NO production, NO levels of Stat6 −/− macrophages were unaffected, suggesting that Stat6 −/− macrophages are of the M1 type and are cytotoxic. Taken together these observations suggest that in Stat6 −/− mice enhanced immunosurveillance is a combined effect of rapid recovery from arginase-mediated IMC-induced T cell suppression and the presence of NO producing M1 type macrophages. Therefore, reduction of IMC and production of M1 macrophages are pre-requisites for protective immunosurveillance and immunotherapy.
Regulation of Pain and Itch by TRP Channels

Nociception is an important physiological process that detects harmful signals and results in pain perception. In this review, we discuss important experimental evidence involving some TRP ion channels as molecular sensors of chemical, thermal, and mechanical noxious stimuli to evoke the pain and itch sensations. Among them are the TRPA1 channel, members of the vanilloid subfamily (TRPV1, TRPV3, and TRPV4), and finally members of the melastatin group (TRPM2, TRPM3, and TRPM8). Given that pain and itch are pro-survival, evolutionarily-honed protective mechanisms, care has to be exercised when developing inhibitory/modulatory compounds targeting specific pain/itch-TRPs so that physiological protective mechanisms are not disabled to a degree that stimulus-mediated injury can occur. Such events have impeded the development of safe and effective TRPV1-modulating compounds and have diverted substantial resources. A beneficial outcome can be readily accomplished via simple dosing strategies, and also by incorporating medicinal chemistry design features during compound design and synthesis. Beyond clinical use, where compounds that target more than one channel might have a place and possibly have advantageous features, highly specific and high-potency compounds will be helpful in mechanistic discovery at the structure-function level.
Lateral and vertical distribution of downstream migrating juvenile sea lamprey

Abstract Sea lamprey is considered an invasive and nuisance species in the Laurentian Great Lakes, Lake Champlain, and the Finger Lakes of New York and is a major focus of control efforts. Currently, management practices focus on limiting the area of infestation using barriers to block migratory adults, and lampricides to kill ammocoetes in infested tributaries. No control efforts currently target the downstream-migrating post-metamorphic life stage which could provide another management opportunity. In order to apply control methods to this life stage, a better understanding of their downstream movement patterns is needed. To quantify spatial distribution of downstream migrants, we deployed fyke and drift nets laterally and vertically across the stream channel in two tributaries of Lake Champlain. Sea lamprey was not randomly distributed across the stream width and lateral distribution showed a significant association with discharge. Results indicated that juvenile sea lamprey is most likely to be present in the thalweg and at midwater depths of the stream channel. Further, a majority of the catch occurred during high flow events, suggesting an increase in downstream movement activity when water levels are higher than base flow. Discharge and flow are strong predictors of the distribution of out-migrating sea lamprey, thus managers will need to either target capture efforts in high discharge areas of streams or develop means to guide sea lamprey away from these areas.
Precipitation Behavior of 1.3%Si Non-oriented Silicon Steels During Strip Casting Process

In this work, the precipitation behaviors of 1.3%Si non-oriented silicon steel during the sub-rapid solidification process under different melt superheat were investigated using scanning electron microscope and transmission electron microscope, based on strip casting process. The results showed that the precipitates of as-cast strips were dominated by coarse AlN, and MnS particles were seldom observed. The mean size of AlN particles rapidly increased from 75 to 1060 nm, and the volume fraction increased from 0.028 to 0.069%, when the melt superheat increased from 20 to 70 °C. Besides, the precipitation quantity in the center layer of as-cast strip was obviously more than the surface layer. According to the different solubility ability in the liquid and ferrite matrix, Al or N elements tend to segregate during the sub-rapid solidification process, which is attributed to the nucleation and coarsening of AlN. On the condition of low melt superheat, the solidified layers suffered from hot deformation from the solidification end point to the nip point, which provided additional nucleation sites for precipitates and can be attributed to fine particles size. In addition, different heat conductivity and hot deformation degree in various thickness layer resulted in inhomogeneous distribution of particles through the thickness of as-cast strips.
Guidelines for Controlled Clinical Trials of Biofeedback

The authors of the foregoing chapters have assembled a tremendous amount of data pertaining to the clinical efficacy of biofeedback. Their evaluations of the evidence lead to the conclusion that significant progress is being made in the quality as well as the quantity of biofeedback research. In spite of these very positive and encouraging findings, however, the research in the area is not flawless, and it is important to ask how even stronger evidence could be generated in the future. In other words, what features should be incorporated into the next generation of clinical biofeedback studies? The authors of each chapter were instructed to address this question from the perspective of their own area of expertise. One conclusion, common to all areas, was that more studies are needed that could be described as controlled clinical trials. The purpose of this chapter is to provide a guide to some of the issues that should be considered in conducting controlled clinical trials used to evaluate biofeedback as a treatment modality. The emphasis on the word guide is important because research is largely a creative endeavor, and it is impossible to provide a formula applicable to all situations.
The distinct influence of power distance perception and power distance values on customer satisfaction in response to loyalty programs

Abstract In today's fiercely competitive environment, firms are increasingly relying on loyalty programs to influence customers' repeat purchase behavior. However, little is known about how customers' cultural values shape their satisfaction in response to loyalty programs. Such knowledge is important because it allows marketers to identify cultural segments that may be more or less likely to respond favorably to loyalty programs, and hence increase the effectiveness of such programs. In the current research, we propose that power distance perception — defined as the extent to which people observe power disparities in society — positively influences satisfaction of customers who hold loyalty status, but negatively influences satisfaction of customers who do not hold loyalty status with a firm. In contrast, power distance values — defined as the extent to which people endorse power disparities in society — negatively influences satisfaction of customers who hold loyalty status, but positively influences satisfaction of customers who do not hold loyalty status with a firm. A quasi-field study and several lab experiments support these propositions, shed light on the underlying mechanisms, and rule out alternative explanations. Our findings also uncover several distinct tools that marketers could use to influence non-loyalty status and loyalty status customers' satisfaction with businesses.
Erratum: Persistence of Neonatal Brachial Plexus Palsy among Nulliparous Versus Parous Women.

Objective Our objective was to compare persistence of neonatal brachial plexus palsy (NBPP) at 1 and 2 years in children of nulliparous versus parous women. Study Design We conducted a retrospective cohort study of children diagnosed with NBPP followed at the University of Michigan, Interdisciplinary Brachial Plexus Program (UM-BPP). Self-reported demographics, delivery history, including birth weight (BW) Results Of 337 children with NBPP, 43% (146) were of nulliparas and 57% (191) of multiparas. At 1 year, children with persistent NBPP were similar in both groups (87% vs. 88%, aOR 1.357, 95% CI: 0.297–6.208). Persistent NBPP was not significantly different among nulliparous and multiparous women at 2 years (97% vs. 92% respectively, aOR 0.079, 95% CI: 0.006–1.050). Conclusion In one of the largest cohorts of NBPP, maternal parity did not influence the likelihood of NBPP persistence at 1 and 2 years.
What Is the Right to Exclude and Why Does It Matter

The “right to exclude” is commonly said to be a central element of the formal structure of property, and some relatively sweeping claims have been made about its role and effect. This chapter, written for Property Theory: Legal and Political Perspectives (M.H. Otsuka & J.E. Penner eds., Cambridge University Press 2018), seeks to provide a clearer understanding of the right to exclude and its relationship to property. First, it sets out a precise account of what the term means. A right to exclude is any right to forbid a use or set of uses of a particular resource by one or more people; more formally, it is any negative claim-right concerning the use of a discrete “thing.” The chapter comments on these features, both in terms of their implications for how property systems operate and in terms of ways in which those features are misunderstood. Second, the chapter sketches and briefly evaluates certain normative assertions about the right to exclude. It concludes, inter alia, that stronger versions of these arguments, both supportive and critical, conflate rights to exclude with rights of broad scope. Finally, the chapter critically examines various arguments for the primacy of the right to exclude. In its essence, property is an authority structure, in which control or dominion over a particular subject is the animating idea, and rights to exclude have been unhelpfully cleaved from this parent concept, leading to significant confusion about what property is and how property works.
Simulation-based optimization to improve hospital patient assignment to physicians and clinical units

A fundamental activity in hospital operations is patient assignment, which we define as the process of assigning hospital patients to specific physician services and clinical units based on their diagnosis. When the preferred assignment is not possible, typically due to capacity limits, hospitals often allow for overflow, which is the assignment of patients to other services and/or units. Overflow accelerates assignment, but can also reduce care quality and increase length of stay. This paper develops a discrete-event simulation model to evaluate different assignment strategies. Using a simulation-based optimization approach, we evaluate and heuristically optimize these strategies accounting for expected hospital and physician profit, care quality and patient waiting time. We apply the model using data from the University of Chicago Medical Center. We find that the strategies that use heuristically optimized designation of overflow services and units increase expected profit relative to the capacity-based strategy in which overflow patients are assigned to a service and unit with the most available capacity. We also find further improvement in the strategy that uses heuristically optimized overflow services and units as well as a holding unit that holds patients until a bed in their primary or secondary unit becomes available. Additionally, we demonstrate the effects of these strategies on other performance measures such as patient concentration, waiting time, and outcomes.
Association Between Patient Experience With Patient-Reported Outcome Measurements and Overall Satisfaction With Care in Neurology.

Abstract Background There has been increasing focus on both patient-reported outcome measurement (PROM) collection and patient satisfaction ratings; nevertheless, little is known about their relationship. Objectives To determine the association between patient experience with PROM collection and visit satisfaction and to identify characteristics of better ratings for each. Methods This cross-sectional observational study included all patients seen in 15 neurological clinics who completed PROMs as well as 6 questions on the patient experience with PROMs at least once from October 1, 2015 to December 31, 2016. Visit satisfaction was evaluated using a composite measure of physician communication, overall physician rating, and the likelihood of recommending that physician as indicated on the Clinician and Group Consumer Assessment of Healthcare Providers and Systems survey. Predictors of PROM experience and satisfaction were identified using proportional odds and logistic regression models, respectively. Results There were 6454 patients (average age 58 ± 15 years, 59% women) who completed PROMs and responded to the Clinician and Group Consumer Assessment of Healthcare Providers and Systems survey. There were significant positive associations between each PROM experience question and visit satisfaction (r = 0.11-0.19; P Conclusions Although there was a significant association between better PROM experience and higher visit satisfaction, relationships with clinical characteristics differed, providing insights into how PROMs may be associated with patients' visit satisfaction. Further research is necessary to confirm whether PROMs can be used to improve visit satisfaction, particularly in patients who historically have reported lower quality of care.
Performance optimization of reactive molecular dynamics simulations with dynamic charge distribution models on distributed memory platforms

Reactive molecular dynamics (MD) simulations are important for high-fidelity simulations of large systems with chemical reactions. Iterative linear solvers used to dynamically determine atom polarizations in reactive MD models and redundancies related to bond order calculations constitute significant bottlenecks in terms of time-to-solution and the overall scalability of reactive force fields. The objective of this work is to address these bottlenecks. To accomplish this goal, several optimizations are explored including acceleration of the charge model solver through an effective preconditioning technique and a numerical method with reduced communication overheads, as well as initialization and data structure changes for bond order calculations. Detailed scalability analysis of these optimizations and their overall impact is presented. A single-allreduce pipelined non-blocking conjugate gradient (PIPECG) solver coupled with a sparse approximate inverse (SAI) based preconditioner has been observed to yield significant speedups over the baseline standard CG solver with Jacobi preconditioner. These results are significant as they can facilitate scalable simulations of large reactive systems, and presented techniques can be used in other polarizable MD models.
Global Dialysis Perspective: United States

Kidney failure, leading to ESKD, is invariably an irreversible condition that, for survival, typically requires RRT—either in the form of dialysis or a kidney transplant. ESKD is associated with high mortality and morbidity, lower quality of life, and high resource utilization and cost, thereby posing a substantial burden primarily on patients, but also on families and society at large. The focus of this mini-review is to summarize the state of dialysis management and changes in financing of dialysis in the United States over the last decade. In addition we briefly highlight the recently announced federal executive order, “Advancing American Kidney Health,” that promises to raise awareness and improve kidney disease management in the United States. Based on a survey of 79 countries (1), the United States has the second highest incidence of treated ESKD, which is attributed to age, race, genetic predisposition, and a high prevalence of risk factors such as obesity, diabetes, and hypertension (2). Primordial risk factors—such as inequities related to race, income, education, food security, recreational and routine physical activity, access to healthy food options, healthcare, and environmental factors—likely play a major role to in the predisposition to disease and its complications; kidney disease is no exception (3). There were 746,557 prevalent patients with ESKD in the United States at the end of 2017, 124,500 of which were new cases of ESKD, translating to a crude incidence rate of 370.2 per million per year (Figure 1). The adjusted ESKD incidence rate has stabilized, however, and has begun to decline slightly in recent years. About 30% of patients with prevalent ESKD and 3% of patients with incident ESKD had a functioning kidney transplant (4). For quite some time now, diabetes and hypertension have remained the leading assigned primary causes of ESKD in the United States (Table 1) (4 …
A qualitative study on mixed experiences of discrimination and healthcare access among HIV-positive immigrants in Spain

Immigrants are disproportionally impacted by HIV infection in Europe and in Spain. Immigrants are also identified as a vulnerable population during economic crises. Various socioeconomic barriers hinder HIV-positive immigrants from accessing healthcare services in the host country. As a result of the 2008 financial crisis, Spain has implemented multiple austerity measures, one of which was the enactments of Royal Decree Law (RDL) 16/2012 and Royal Decree (RD) 1192/2012 which abolished universal healthcare coverage. In this context, this study examined: 1) Participants’ mixed experiences in accessing health care after the enactment of 2012 RDL and RD, and 2) Distress felt by the participants and their experiences as HIV-positive immigrants living in Spain. Participants were recruited through a nongovernmental organization (NGO) during routine visits at the center. A total of 12 participants were interviewed to reach data saturation. Participants were HIV-positive immigrants living in Spain for 1 or more years, allowing for substantial experience with navigating the healthcare system. Thematic analysis was performed to identify common themes in participants’ experiences living as HIV-positive individuals in Spain and in accessing healthcare. Four primary themes were identified. The primary systemic barrier to accessing health care encountered by participants was the inability to fulfill the requirement of having proof of registration in an Autonomous Community for the required time period, thus not being able to apply for a public health insurance card and utilize free care services. Participants identified a positive impact of third party (NGO, social worker, friend/family member) guidance on their experience of applying for a public health insurance card. Participants expressed experiencing emotional or physical (eg, side effects of medication) distress in adapting to life as HIV-positive individuals. Participants also identified experiencing discrimination while living as HIV-positive immigrants in Spain. HIV-positive immigrants are underserved in Spain. They encounter systemic barriers while accessing healthcare services, and experience fear and/or discrimination. The study underscores the role of NGOs in helping HIV-positive immigrants navigate the healthcare system. More research is needed on comprehensive approaches to address healthcare needs of HIV-positive immigrants in Spain.
Risks and benefits of reinduction ipilimumab/nivolumab in melanoma patients previously treated with ipilimumab/nivolumab

Background In melanoma patients who progress after prior ipilimumab/nivolumab (ipi/nivo) combination immunotherapy, there is no information regarding the risks and benefits of reinduction ipi/nivo. Methods This was a retrospective review of 26 melanoma patients treated at Memorial Sloan Kettering Cancer Center (MSKCC) since 2012 who received reinduction ipi/nivo at least 6 months following completion of an initial course of ipi/nivo. We collected data on demographics, genetics, immune-related adverse events (irAEs), best overall responses (BORs), time to treatment failure (TTF) and overall survival (OS). Results The BOR rate (complete response+partial response) was 74% (95% CI 52% to 90%) after the first course of ipi/nivo but only 23% (95% CI 8% to 45%)) after reinduction. Response to reinduction did not correlate with response to the initial course. Among the 16 patients who had an objective response to the first course, only four (25%) responded to reinduction. Of five patients who did not respond to the first course, one responded to reinduction. For all patients, median TTF was 5.3 months after reinduction; TTF was shorter for reinduction than for the first course in 85% of patients. Median OS from reinduction was 8.4 months; estimated 2-year OS was 18%. Although reinduction was associated with fewer irAEs than the initial course of ipi/nivo (58% of patients vs 85% of patients in the initial course), eight (31%) patients experienced at least one new irAE after the second course. Conclusions BOR rate and TTF were markedly less favorable after reinduction with ipi/nivo than after the initial course of ipi/nivo. Reinduction ipi/nivo was associated with frequent irAEs although less frequent than for the initial course.
Master Class: Arbitration Clauses II

Commentary and analysis of the general trend to enforce arbitration provisions in derogation of the plaintiffs’ ability to pursue classwide relief. Consequently, defendants have discovered that arbitration clauses may provide an effective means to avoid class action litigation. The article discusses issues relating to whether claims may be pursued on a classwide basis in arbitration. When a court orders enforcement of an arbitration clause, may a plaintiff instead obtain a classwide arbitration of its claims? May a defendant invoke classwide arbitration, as well? The article surveys emerging case law from the Seventh Circuit repudiating classwide arbitration, and the SEC rule excluding class actions from arbitration. The Federal Arbitration Act (FAA) is itself silent on the question of classwide arbitration. Plaintiffs have advanced the argument that Fed. R. Civ. P. 81(a)(3) allows federal courts to apply Rule 23 (governing class actions) to order that an arbitration proceed as a class action. In contrast to developments in federal courts, state courts in California and Pennsylvania have authorized classwide arbitration of claims.
Cytochrome aa3 gene regulation in members of the family Rhizobiaceae : comparison of copper and oxygen effects in Bradyrhizobium japonicum and Rhizobium tropici

Abstract Dithionite-reduced minus ferricyanide-oxidized difference spectra on membranes from Rhizobium tropici (formerly Rhizobium leguminosarum bv. phaseoli) incubated at progressively lower O2 concentrations showed only a slight concomitant decrease in A603, the alpha-peak of cytochrome aa3. In contrast to previous results on Bradyrhizobium japonicum, R. tropici showed no significant O2-mediated reduction in the level of either coxA transcription or cytochrome aa3 activity (as measured by ascorbate-N,N,N',N'-tetramethyl-p-phenylenediamine [TMPD] oxidase) even in the cells incubated at 12.5 microM O2. Bean nodule R. tropici bacteroids contained 65% of the fully aerobic free-living levels of the coxA transcript. Primer extension analyses established the transcription initiation site of the R. tropici coxA genes. Sequence analyses of the regions upstream of the transcription initiation site revealed no homology with previously reported Rhizobiaceae family promoters, including the coxA promoter of B. japonicum. The R. tropici deduced CoxA sequence itself is highly homologous to the B. japonicum and Paracoccus denitrificans CoxA sequences. In both B. japonicum and R. tropici, coxA transcript levels were the same for cells grown with copper (0.02 microM) in the medium or in medium completely devoid of copper. However, a posttranscriptional effect of copper deprivation was observed for both bacteria; difference absorption spectra on membranes from cells grown without copper showed that B. japonicum lacked spectroscopically detectable cytochrome aa3, whereas R. tropici retained approximately 50% of normal cytochrome aa3 levels.
Privatization and Human Resources Management: Some Equity Challenges - The Case of the City of Tampa

Many state and local governments must reduce operating costs. To do so, some are reducing their workforces by privatizing services. In the City of Tampa, the mayor recommended the possible layoff of janitorial and security employees. City council members were concerned that the lowest wage employees comprised mostly of racial minorities would be hardest hit. This case study discusses the challenges when the value of lower cost services collide with social equity and social representation.
Improved understanding of geologic CO2 storage processes requires risk‐driven field experiments

Improved understanding of geologic CO 2 storage processes requires risk-driven field experiments Curtis M. Oldenburg Lawrence Berkeley National Laboratory One Cyclotron Road Berkeley, CA 94720 CMOldenburg@lbl.gov, (510) 486-7419
Generation of a foveomacular transcriptome

Data management is a critical part of analyzing large data sets, and a sensible management system is needed to fully exploit their value. Methods sophisticated enough to cope with many data points and types are necessary to fully interrogate the results of modern gene profiling and/or expressed sequence tag (EST)–based studies. To best exploit all relevant data available from multiple data sources, it is necessary to design an organizational structure best suited for continuously adding data. In this manuscript, we present a platform developed to provide access to relevant foveomacular gene expression data, but which could be adapted to define the expression profile for any other tissue- or cellspecific phenomenon. Using the Perl scripting language and MySQL query language, we have developed a standardized system to extract relevant data from various public sources and compile the data in a form immediately useful to the end user. Perl is well suited to our needs for several reasons: It is a well-established scripting language with a strong history in computational biology, and is particularly adept at text parsing, the function required to extract portions of data from online records. We chose MySQL as our relational database query language for several reasons, including availability, community support, and wide acceptance by the computational biology community. Relational databases are especially suited to this project, as they allow simple expansion of data types and sources. Our interests focus on understanding the biology of the human fovea. The human fovea is a 1.5 mm diameter region at the center of the macula of the retina responsible for acute, detailed color vision [1]. The fovea and the macula (foveomacula, a 5 mm diameter region at the center of the retina) have morphology and function distinct from the peripheral retina, and are affected by a unique set of heritable and age-related disorders [2]. The major obstacle to studying the fovea is its relatively small size and the difficulty in obtaining human foveomacular tissue. Moreover, with the exception of analogous avian structures [3], primates are the only vertebrates that possess a foveal structure, meaning that no suitable non-primate mammal exists to model the human fovea. Although several genes that when mutated lead to macular degenerative states have been cloned and their functions determined [4], a significant number of disease states remain uncharacterized genetically, particularly those with a non-Mendelian inheritance pattern or sporadic develop
Esophageal Disorders in Childhood

Esophageal biopsies are frequently performed during the diagnostic evaluation of children presenting with a variety of nonspecific symptoms such as vomiting, abdominal pain, failure to thrive, and dysphagia. In contrast to adult gastroenterologists, pediatric gastroenterologists perform mucosal biopsies much more frequently during the course of endoscopic examination due to the poor correlation that exists between endoscopic and histologic findings in children (Biller et al. 1983).
Postprandial changes in the content and composition of nonprotein nitrogen in human milk

The effect of a meal on human milk (HM) total nitrogen (TN) and nonprotein nitrogen (NPN) content and composition was examined. Two studies were performed in which milk and blood samples were collected 2-3 h after subjects consumed either a test breakfast or lunch. To monitor the rate of transfer of plasma urea into milk, two women were given [15N]2-urea with the meal. Milk TN concentrations were not significantly different from premeal values. However, concentrations of milk NPN, urea nitrogen, and alanine were increased by greater than or equal to 20% over premeal values. [15N]2-Urea appeared in plasma and milk within 15 min and reached maximum enrichments of 10% and 5.5% in plasma and milk, respectively. Several HM NPN components increase in concentration postprandially; however, these concentrations were not always correlated with changes in plasma concentrations, suggesting that milk NPN may also reflect metabolic activities within the mammary gland.
Kumho Tire Co., Ltd. v. Carmichael.

The U.S. Supreme Court considered an appeal by the defendant, Kumho Tire, in a products liability action. The appeal resulted from a ruling by the Court of Appeals in the Eleventh Circuit that overturned the district court's exclusion of expert testimony. The plaintiff's expert had sought to testify regarding the reasons for a tire failure and blowout. The subsequent accident resulted in personal injury and the death of a passenger in the plaintiff's vehicle. The Supreme Court held that expert testimony, whether based on professional studies or on personal experience, is subject to the same standard of scrutiny for relevancy and reliability. This decision resolved a conflict that had arisen among the circuit courts of appeal with respect to this issue. The article first outlines the Court's decision, then considers the implication the decision has for the admissibility of expert opinion testimony in future cases.
Medication use and misuse: physician-patient discrepancies.

INTRODUCTION DURING recent years a substantial literature has developed on the subjects of physician prescribing patterns [IA], medication use by various population groups [5-71, and patient compliance with taking prescribed medications [S-15]. Physician-patient communication has been reviewed under the assumption that compliant behavior can only occur as the result of appropriate communication [I 1, 12, 151. Methodological studies have been done to compare the accuracy of various methods for measuring patient compliance [13, 14, 16-201. The present paper introduces a quantitative method for analyzing data on medication use and misuse among patients with either adult onset diabetes mellitus or congestive heart failure. This study was undertaken within the context of a more comprehensive research effort. Representatives from two organizations, the American Academy of Family Physicians and the Department of Epidemiology at the University of North Carolina, undertook the development of a research design, which was both original in concept and feasible to implement, as a method of assessment of primary medical care [21]. Two of the areas for assessment are physician-patient communication and patient compliance. Communication represents the extent to which the physician is successful in transmitting information and instructions to the patient, while compliance measures the extent to which the patient’s behavior is modified by these instructions. Medicationtaking behavior is an important indicator of both communication and compliance. Study of medication use has the potential for introducing another concept into the evaluation scheme; that is, the recognition that communication is a two-way phenomenon. Not only should the patient take drugs as recommended by the