cssi/SciSciGPT-SciSciNet huggingface dataset:
Should Research Ethics Encourage the Production of Cost-Effective Interventions?

This project considers whether and how research ethics can contribute to the provision of cost-effective medical interventions. Clinical research ethics represents an underexplored context for the promotion of cost-effectiveness. In particular, although scholars have recently argued that research on less-expensive, less-effective interventions can be ethical, there has been little or no discussion of whether ethical considerations justify curtailing research on more expensive, more effective interventions. Yet considering cost-effectiveness at the research stage can help ensure that scarce resources such as tissue samples or limited subject populations are employed where they do the most good; can support parallel efforts by providers and insurers to promote cost-effectiveness; and can ensure that research has social value and benefits subjects. I discuss and rebut potential objections to the consideration of cost-effectiveness in research, including the difficulty of predicting effectiveness and cost at the research stage, concerns about limitations in cost-effectiveness analysis, and worries about overly limiting researchers’ freedom. I then consider the advantages and disadvantages of having certain participants in the research enterprise, including IRBs, advisory committees, sponsors, investigators, and subjects, consider cost-effectiveness. The project concludes by qualifiedly endorsing the consideration of cost-effectiveness at the research stage. While incorporating cost-effectiveness considerations into the ethical evaluation of human subjects research will not on its own ensure that the health care system realizes cost-effectiveness goals, doing so nonetheless represents an important part of a broader effort to control rising medical costs.
Early-life antibiotic use and subsequent diagnosis of food allergy and allergic diseases.

Background Antibiotic use in early life has been linked to disruptions in the microbiome. Such changes can disturb immune system development. Differences have been observed in the microbiota of children with and without allergies, but there have been few studies on antibiotic use and allergic disease. Objective We evaluated associations of early-life antibiotic use with subsequent occurrence of food allergy and other allergies in childhood using electronic health record data. Methods We used longitudinal data on 30,060 children up to age 7 years from Geisinger Clinic's electronic health record to conduct a sex and age matched case-control study to evaluate the association between antibiotic use and milk allergy, non-milk food allergies, and other allergies. For each outcome, we estimated conditional logistic regression models adjusting for race/ethnicity, history of Medical Assistance, and mode of birth delivery. Models were repeated separately for penicillins, cephalosporins, and macrolides. Results There were 484 milk allergy cases, 598 non-milk food allergy cases, and 3652 other allergy cases. Children with three or more antibiotic orders had a greater odds of milk allergy (odds ratio; 95% confidence interval) (1.78; 1.28-2.48), non-milk food allergy (1.65; 1.27-2.14), and other allergies (3.07; 2.72-3.46) compared to children with no antibiotic orders. Associations were strongest at younger ages and differed by antibiotic class. Conclusions and Clinical Relevance We observed associations between antibiotic orders and allergic diseases, providing evidence of a potentially modifiable clinical practice associated with pediatric allergic disease. Differences by antibiotic class should be further explored, as this knowledge could inform pediatric treatment decisions. This article is protected by copyright. All rights reserved.
Feasibility and safety study for the use of wound protectors during robotic radical cystectomy and ileal conduit

Robot-assisted laparoscopic radical cystectomy (RALRC) is increasingly being performed for the treatment of muscle-invasive bladder cancer. There is increased tension while performing the ureteroileal anastomosis through a small incision. Patients are at risk to suffer wound and skin complications perioperatively due to possible contamination with bowel contents. The Alexis® retractor helps with retraction of small incisions potentially reducing tension and also reduces wound infection rates as reported in the colorectal literature. This pilot study evaluates the use of the Alexis® wound protector (WP) in RALRC with ileal conduit (IC). The WP was used in 15 consecutive patients at a single institution who all underwent RALRC with IC. All patients had preoperative bowel preparations, antibiotics, and had surgical preparation with chlorhexidine with alcohol in the standard fashion. The Alexis® device was placed following RALRC to protect the skin and fascia during ileal conduit formation. The ileal conduit was then created extracorporeally through the WP in the standard fashion. RALRC with IC was successfully completed in all 15 patients. Patients had no wound complications defined as documentation of cellulitis or hernia on progress or follow-up notes. Using our technique with the WP we had no cases of surgical site infection. Wound barrier protection has been recommended for use in colorectal surgery and we believe that these recommendations translate to RALRC with IC due to the use of bowel to form the urinary diversion. Further studies with the use of WP in this procedure are necessary to validate our findings.
Optimization of nano-hydroxyapatite/poly(lactic-co-glycolic acid) coatings on magnesium substrates using one-step electrophoretic deposition

Abstract This study focuses on optimizing nanocomposite coatings of nanophase hydroxyapatite (nHA) and poly(lactic-co-glycolic acid) (PLGA) on magnesium (Mg) substrates using one-step electrophoretic deposition (EPD). The nHA, PLGA and Mg are all biodegradable in the human body, which makes them favorable for temporary implant applications. Mg and its alloys possess the elastic modulus and strength comparable to cortical bone, and thus reduce the detrimental effects of stress-shielding while providing necessary strength for load-bearing applications. The nHA is an attractive coating material for bone healing due to its osteoconductivity. PLGA promotes coating adhesion, and may neutralize the alkaline degradation products of Mg substrates. The nHA_PLGA composite coatings were deposited on Mg substrates using EPD with acetone as the electrolyte solvent. The parameters for EPD process, such as deposition voltage, time and electrolyte concentration, were studied to determine the optimal condition for creating the nHA_PLGA coating on Mg. The nHA_PLGA coating showed a desirable thickness of 65.85±11.95 µm with a complete homogenous coverage on Mg substrates when the deposition voltage of 75 V was applied for 6 min using an electrolyte containing 1 mg/mL nHA and 0.2 mg/mL PLGA in acetone. The characterization of the coating confirmed the presence of both nHA and PLGA.
Using Resilience and Resistance Concepts to Manage Persistent Threats to Sagebrush Ecosystems and Greater Sage-Grouse

Conservation of imperiled species often demands addressing a complex suite of threats that undermine species viability. Regulatory approaches, such as the US Endangered Species Act (1973), tend to focus on anthropogenic threats through adoption of policies and regulatory mechanisms. However, persistent ecosystem-based threats, such as invasive species and altered disturbance regimes, remain critical issues for most at-risk species considered to be conservation-reliant. We describe an approach for addressing persistent ecosystem threats to at-risk species based on ecological resilience and resistance concepts that is currently being used to conserve greater sage-grouse (Centrocercus urophasianus) and sagebrush ecosystems. The approach links biophysical indicators of ecosystem resilience and resistance with species-specific population and habitat requisites in a risk-based framework to identify priority areas for management and guide allocation of resources to manage persistent ecosystem-based threats. US federal land management and natural resource agencies have adopted this framework as a foundation for prioritizing sage-grouse conservation resources and determining effective restoration and management strategies. Because threats and strategies to address them cross-cut program areas, an integrated approach that includes wildland fire operations, postfire rehabilitation, fuels management, and habitat restoration is being used. We believe this approach is applicable to species conservation in other largely intact ecosystems with persistent, ecosystem-based threats.
Prevalência de sobrepeso e obesidade em adolescentes do ensino médio nas cidades de Miracema e Cordeiro/RJ

A obesidade e caracterizada pelo acumulo excessivo de gordura corporal. Cada vez mais estudos sao realizados para o controle ponderal, uma vez que a obesidade pode acarretar comorbidades associadas. O objetivo desta pesquisa e identificar a prevalencia de sobrepeso e obesidade em estudantes do ensino medio nas cidades de Miracema e Cordeiro-RJ e correlacionar as medidas antropometricas com possiveis quadros hipertensivos. Foram avaliados 261 estudantes de escolas publicas e particulares. Em Miracema, 71 individuos eram do sexo masculino e 79 do sexo feminino com media de idade de 17,25 (± 1,03) e 17, 4 anos (±1,32) respectivamente. Em Cordeiro, 47 eram do sexo masculino e 64 do sexo feminino com media de idade de 17 anos (± 1,08) e 17,04 anos (±1,31) respectivamente. Foi encontrado um percentual de adolescentes do ensino medio com sobrepeso e obesidades de 11,01% e 2,95% respectivamente para as meninas e 8,39% e 2,54% respectivamente para os meninos. Observou-se que o indice de massa corporal (IMC) foi a medida que teve maior correlacao com a hipertensao arterial nos meninos (r = 0,40) e entre as meninas, a circunferencia abdominal (CA) foi a que mais teve correlacao (r = 0,39). Conclui-se, portanto que a maioria dos estudantes do ensino medio esta dentro de uma faixa de peso considerada normal e que o IMC e CA apresentaram maior correlacao com a hipertensao arterial quando comparada a relacao cintura quadril entre os generos. Palavras-chave : obesidade, sobrepeso, hipertensao, adolescente.
Psychiatric Risk in Unstably Housed Sexual Minority Women: Relationship between Sexual and Racial Minority Status and Human Immunodeficiency Virus and Psychiatric Diagnoses.

Abstract Background Stress associated with minority statuses has been linked to mental health disorders. However, research conducted exclusively among impoverished women, a population known to be at risk for poor health owing to overlapping risks, is sparse. We sought to determine if homeless and unstably housed sexual minority (i.e., nonheterosexual) women were at greater psychiatric risk than their heterosexual counterparts. We also sought to determine if racial/ethnic minority and human immunodeficiency virus status contributed to psychiatric risks. Methods Homeless/unstably housed women living in San Francisco between 2008 and 2010 were followed biannually over 3 years. Generalized estimating equation analysis identified significant correlates of any substance use, mood, or anxiety disorder, as well as the total number of psychiatric disorders. Results Among 300 women, 24% reported nonheterosexual identity at the first study visit. Consistent with minority stress theory, lesbian and bisexual identity were associated with higher levels of mental health comorbidity, and bisexual identity was related to greater rates of substance use disorders and mood disorders. Unique to this study, we found that identity assessed 1 or 2 years prior does not predict current substance disorders, but current identity does. In addition, women who were infected with the human immunodeficiency virus also had higher rates of mental health comorbidity and substance use disorders. Contrary to psychosocial stress theory, racial/ethnic minority status was associated with reduced odds of substance use disorder in this population. Recent homelessness was related to greater risk of anxiety disorder. Conclusions Best research and health care practices should include the assessment of sexual orientation and housing status when addressing risks for mental health and substance disorders among low-income women.
Overexpression and Suppression of Artemisia annua 4-Hydroxy-3-Methylbut-2-enyl Diphosphate Reductase 1 Gene (AaHDR1) Differentially Regulate Artemisinin and Terpenoid Biosynthesis.

4-hydroxy-3-methylbut-2-enyl diphosphate reductase (HDR) catalyzes the last step of the 2-C-methyl-D-erythritol 4- phosphate (MEP) pathway to synthesize isopentenyl pyrophosphate (IPP) and dimethylallyl diphosphate (DMAPP). To date, little is known regarding effects of an increase or a decrease of a HDR expression on terpenoid and other metabolite profiles in plants. In our study, an Artemisia annua HDR cDNA (namely AaHDR1) was cloned from leaves. Expression profiling showed it was highly expressed in leaves, roots, stems, and flowers with different levels. Green florescence protein fusion and confocal microscope analyses showed that AaHDR1 was localized in chloroplasts. The overexpression of AaHDR1 increased contents of artemisinin, arteannuin B and other sesquiterpenes, and multiple monoterpenes. By contrast, the suppression of AaHDR1 by anti-sense of led to opposite results. In addition, an untargeted metabolic profiling showed that the overexpression and suppression altered non-polar metabolite profiles. In conclusion, the overexpression and suppression of AaHDR1 protein level in plastids differentially affect artemisinin and other terpenoid biosynthesis, and alter non-polar metabolite profiles of A. annua. Particularly, its overexpression leading to the increase of artemisinin production is informative to future metabolic engineering of this antimalarial medicine.
Lymph Node Positivity in Appendiceal Adenocarcinoma: Should Size Matter?

Background The management algorithm for appendiceal adenocarcinoma is not well defined. This study sought to determine whether tumor size or depth of invasion better correlates with the presence of lymph node metastases in appendiceal adenocarcinoma, and to compare these rates with colon adenocarcinoma. Study Design A retrospective review of the National Cancer Database was performed to identify patients with appendiceal or colonic adenocarcinoma from 2004 to 2013 who underwent surgical resection. Cases were categorized by tumor size and by T stage. Rates of lymph node metastases were examined as a function of size and T stage. Results A total of 3,402 appendiceal and 314,864 colonic cases were identified. For appendiceal adenocarcinoma, larger tumor size was associated with higher T stage: Pearson correlation of 0.41 (95% CI 0.408 to 0.414; p 1 to 2 cm, >2 to 3 cm, >3 to 4 cm, >4 to 5 cm, and >5 cm, respectively. Lymph node metastases were present in 0%, 11.2%, 12.3%, 35.5%, and 40.0% for in situ, T1, T2, T3, and T4 tumors, respectively. There was no difference in the rates of lymph node metastases between appendiceal and colonic adenocarcinoma for tumor sizes 3 cm and for T2, T3, and T4 tumors (p Conclusions In appendiceal adenocarcinoma, the rate of lymph node metastases is substantial, even for small tumors. Tumor size should play no role in the decision of whether to perform a hemicolectomy. Appendectomy alone does not produce an adequate lymph node sample. Right hemicolectomy should be performed for all appendiceal adenocarcinomas.
Abstract TP122: Identifying Predictors of Seizure Recurrence After Nonconvulsive Seizures Recorded on Continuous Electroencephalogram (cEEG) in Ischemic Stroke

INTRODUCTION: Seizures are well-recognized complications of ischemic strokes (IS). The risk of subsequent development of epilepsy has been shown to be 2-4% in acute IS and much higher in remote IS. However, the risk of epilepsy in IS who have nonconvulsive seizures on cEEG is not well characterized. We present here a five-year retrospective study of IS patients who have nonconvulsive seizures on cEEG identifying risk factors for the development of epilepsy. METHODS: We retrospectively reviewed prospectively collected cEEG and clinical data on consecutive patients monitored from January 1, 2007, to December 31, 2011. We identified those patients with cEEG seizures that were secondary to either acute ( 30 days) ischemic stroke (IS; n=109) and then included in this study only those patients with follow-up encounters. Statistical analyses were performed with JMP 9.0. RESULTS: Sixty-five (41.5% acute IS, 58.5% remote IS) patients met inclusion criteria for this study. All patients were discharged on at least one antiepileptic. Nineteen (29.2%) patients were found to have seizure recurrence (i.e., epilepsy) with 84.2% being remote IS (p=0.0116). Periodic lateralized epileptiform discharges (PLEDs) were seen on cEEG in 21.5% (22.2% acute IS, 21.1% remote IS). 15.8% with PLEDs on initial cEEG developed epilepsy (p=0.74). 33.3% of patients classified as stupor/coma at the time of nonconvulsive seizures were found to have seizure recurrence compared to 24.1% of patients classified as awake/lethargy (p=0.5841). On follow up EEG (mean (SEM) 384.4 (59.1) days), the finding of sharp wave/spike (12.1%) significantly correlated with seizure recurrence (p=0.0175). DISCUSSION: This retrospective study found that patients with remote IS are at a higher risk of developing epilepsy when nonconvulsive seizures are recorded on cEEG in the hospital. Additionally, the finding of sharp waves on follow-up routine EEG further identifies those at risk for recurrence. This study highlights the usefulness of cEEG in patients in patients with acute or remote strokes and provides guidance on utility of follow-up EEG.
Fine-Tuning What We Know About Flexible Work Arrangements: Deconstructing Employees’ Experience

Prior research has generally found a positive relationship between flexible work arrangements (FWA) and employee attitudes. However, we know relatively little about organizational boundary conditio...
Socioeconomic factors associated with full childhood vaccination in Bangladesh, 2014.

Abstract Objectives Childhood vaccination in Bangladesh has improved, but there is room for improvement. This study estimated full immunization coverage in Bangladeshi children and characterized risk factors for incomplete immunization. Methods Using the 2014 Bangladesh Demographic and Health Survey (DHS), full vaccination of children aged 12 to 24 months was examined; this was defined as the receipt of one dose of bacillus Calmette–Guerin (BCG), three doses of pentavalent vaccine, three doses of oral polio vaccine (OPV), and one dose of measles-containing vaccine (MCV). Associations between full vaccination and selected risk factors were assessed by logistic regression. Results Overall, 83% of children were fully vaccinated. BCG had the highest completion (97%), followed by OPV (92%), pentavalent vaccine (91%), and MCV (85%). Full vaccination coverage ranged from 64.4% in Sylhet to 90.0% in Rangpur and was lowest among non-locals of all regions (78.4%). Children who were in the lowest wealth quintile, who had mothers without antenatal care visits, or who had mothers without autonomy in healthcare decision-making were less likely to be fully vaccinated. Conclusions Overall, full vaccination of children is high, but varies by vaccine type. Disparities still exist by wealth and by region. Maternal access to care and autonomy in healthcare decision-making are associated with higher vaccination coverage.
Resolving pseudosymmetry in γ-TiAl using cross-correlation electron backscatter diffraction with dynamically simulated reference patterns

Pseudosymmetry is a phenomenon that occurs when grains with different lattice parameters produce nearly identical diffraction patterns such that conventional electron backscatter diffraction (EBSD) techniques are unable to unambiguously differentiate the lattice orientations. This commonly occurs in materials with near-unity tetragonality, such as γ-TiAl. The current study uses cross-correlation EBSD to resolve pseudosymmetry in γ-TiAl. Three dynamically simulated reference patterns are generated for each point in the scan, one for each of the three potential pseudosymmetric orientations, which are subsequently correlated with the original pattern using six different methods in order to identify the correct orientation. The methods are first applied to a scan of dynamically simulated patterns, which is used to evaluate the sensitivity of the method to pattern resolution, pattern noise and pattern center error. It was determined that all six methods were 100% successful up to about 13 µm of pattern center error and pattern resolutions of about 80 × 80 pixels, and hence the methods were applied to an experimental sample of lamellar γ-TiAl. A hybrid combination of two of the methods was shown to successfully select the correct pseudosymmetry for about 96% of the points in the scan, improving upon the 70% accuracy of the Hough-based methods for the current study and 90% accuracy for previous studies resolving pseudosymmetry in lamellar γ-TiAl.
A New Method of Odds Ratio and Hazard Analysis of Head and Neck Cancer

The main topic of this paper is to focus on a new method for calculating odds ratios and hazard ratios through probabilities and effect modification. This probability is derived through an odds ratio proof for the common conditional odds ratio of Cochran Mantel Hansel showing theta equals one. Subsequently, the probability formula is obtained and the hazard ratio expression derived. However, the new relation of this proof is to show that logits equals itself through probability. From this derivation, an expression of risk is obtained which is an odds ratio. Parameters are obtained through a novel method of Survreg and its proportional hazard assumption. The odds ratio obtained is given as per strata as well as hazard ratio method demonstrated which is curvilinear to probability in comparison for the interaction model to represent percent change. The odds ratios from PROC GLIMMIX for interaction model has odds ratio of 1.76 vs 1.73 and 1.83 vs 1.76 for white and black males of a logit expression another expression of a logit. A parametric analysis shows correlation to the odds ratios for strata and probability Pr(z) that can work from a new derivation for an odds ratio with for the exposure shown to have power with the RANTBL function of about 83 % with effect modification included at 100% power. The comparison of effect modification P values to hazard ratio is then made for differences across strata.
The Empirical Clinical Practice Debate

Empirically based models of social work practice are derived from research and prescribe ongoing evaluation of practice. Some researchers have argued against this approach to practice. The authors ...
Key Business, Trade and Regulatory Issues

The satellite industry is among the most complex of any business in the world. Success depends on developing and implementing new technologies in space and on the ground as well. It also requires implementing the most modern of operating systems that utilize the maximum amount of automation. Perhaps of equal importance are strategic, trade, business and regulatory issues. To operate a successful global satellite business requires the ability to have access to a range of assigned frequencies for satellite communications operating on satellites with internationally registered orbital locations within the international regulatory processes of the International Telecommunication Union (ITU). There is also the need to formally establish “landing rights” in every country where service is provided.
Randomized, Placebo-Controlled Study of Lamifiban with Thrombolytic Therapy for the Treatment of Acute Myocardial Infarction: Rationale and Design for the Platelet Aggregation Receptor Antagonist Dose Investigation and Reperfusion Gain in Myocardial Infarction (PARADIGM) Study.

The benefits of thrombolytic therapy in the treatment of acute myocardial infarction are incontrovertible. Large-scale studies combining angiographic and clinical endpoints have demonstrated a perfusion-mortality relationship, with the highest survival rate among patients with early restoration of TIMI grade 3 coronary arterial flow. Despite advances in thrombolytic strategies, a substantial number of patients fail to rapidly achieve and maintain adequate coronary perfusion with thrombolysis. Conjunctive therapy with aspirin has proven useful in thrombolytic regimens, likely countering the heightened platelet activity central to acute coronary syndromes. The antiplatelet effect of aspirin is relatively weak compared with that of glycoprotein IIb/IIIa platelet receptor antagonists, which block the final common pathway of platelet aggregation. Lamifiban is a nonpeptide glycoprotein IIb/IIIa receptor antagonist. In early experimental studies, Lamifiban in combination with thrombolytic therapy has been shown to effectively restore coronary arterial patency, and phase I and phase II data have shown its use to be safe. To determine the optimal dose with regard to safety and efficacy of Lamifiban to be used with thrombolytic therapy in a large-scale trial, a phase II study is underway. The Platelet Aggregation Receptor Antagonist Dose Investigation and Reperfusion Gain in Myocardial Infarction (PARADIGM) study is a randomized, placebo-controlled study of Lamifiban in 400 patients receiving thrombolysis as treatment for acute myocardial infarction. By studying 90-minute angiography, platelet aggregation, continuous electrocardiography, and clinical outcome in PARADIGM, important insights will be obtained to determine the optimal dose of Lamifiban for phase III study. We provide the background and rationale for the study of Lamifiban in PARADIGM and other ongoing studies in acute coronary syndromes.
Laws in Logic and Combinatorics

This is a survey of logical results concerning random structures. A class of relational structures on which a (finitely additive) probability measure has been defined has a 0–1 law for a particular logic if every sentence of that logic has probability either 0 or 1. The measure may be an asymptotic probability on finite structures or generated on a class of infinite structures by assigning fixed probabilities to independently occurring properties. Conditions under which all sentences of a logic have a probability, and under which 0–1 laws occur, are examined. Also, the complexity of computing probabilities of sentences is considered.
Historical Dynamics in the Contact Era

The 500-year anniversary of the dramatic encounter of Old and New World peoples initiated by the Columbian voyages lends a somewhat artificial perspective to the phenomenon of “culture contact.” Although this volume and, to an extent, our individual research interests are conditioned by the quincentenary of a remarkable event, we are primarily interested in the contact period as the beginning of an extended process of mutual discovery and cultural change that continues to the present day.
Design of DSP-based monitoring system for control transformer operating parameters

The fault of control transformer will directly lead to the damage of power supply in the control system of electromagnetic starter, inverter, soft starter and other equipment, and seriously affect the normal operation of such equipment. Herein, based on the analysis of structure and basic working principle of control transformer, the monitoring system for operating parameters of control transformer is designed by using a digital signal processor (DSP). And the voltage monitoring circuit, current monitoring circuit, 3.3 V and 5 V power supply circuit were detailed designed.
Writing the Past in the Present

My grandmother was born in 1918. This is what my family has always known. Her government ID cards list her name, Suey Fun Low, followed by her date of birth, October 28, 1918, and each year we counted out the candles for her birthday cake accordingly. When she turned eighty years old several years ago, she had two birthday parties-one with all her friends and relatives in Vancouver, and another larger one with all our relatives in Zhongshan County in southern China, just north of Macau. So it was a bit of a surprise when I discovered that she was actually born a year later in 1919.
Computational analyses to identify and study cis-regulatory regions in eukaryotes

16 Background 17 Results and discussion 21 Conclusions 29 Methods 30 Acknowledgements 37 References 37 Figures 42 Tables 47 Additional files 51 CHAPTER 3: TSRCHITECT: A TOOL TO IDENTIFY PROMOTERS FROM LARGE-SCALE TRANSCRIPTION START SITE DATA 64 Abstract 64 Background 65 Implementation 68 Results and discussion 78 Conclusions 80 References 81 Figures 8464 Background 65 Implementation 68 Results and discussion 78 Conclusions 80 References 81 Figures 84
Uncommon malignant renal tumors and atypical presentation of common ones: a guide for radiologists

While the typical imaging features of the more common RCC subtypes have previously been described, they can at times have unusual, but distinguishing features. Rarer renal tumors span a broad range of imaging features, but they may also have characteristic presentations. We review the key imaging features of atypical presentations of malignant renal tumors and uncommon malignant renal tumors. Renal tumors have many different presentation patterns, but knowledge of the distinguishing MR and CT features can help identify both atypical presentation of common malignancies and uncommon renal tumors.
Earth comes after postmodernism

If the claim is true that postmodernity is dead—I’m skeptical of grand narratives—its specter still haunts the question of what comes after. What haunts at least is the ambiguity of the preposition...
Impact of Immunotherapy after Resection of Pancreatic Cancer.

Background Adjuvant immunotherapy has improved outcomes in patients with advanced melanoma; however, the potential benefit for patients with pancreatic ductal adenocarcinoma (PDAC) remains unknown. The aim of this study was to determine the impact of adjuvant chemotherapy and immunotherapy (CTx-IT) compared with CTx alone on patient survival after resection of PDAC. Study Design Patients who underwent resection of PDAC from 2004 to 2015 were identified from the National Cancer Database. Univariate and multivariate Cox proportional hazards models were used to determine predictors of overall survival (OS) based on the type of adjuvant therapy received. Patients who received adjuvant immunotherapy were compared with those who received adjuvant CTx alone by propensity score matching. Results Of 21,313 patients who received curative-intent resection for PDAC followed by adjuvant systemic therapy, 269 (1.3%) patients were treated with adjuvant CTx-IT. Propensity score matching resulted in a cohort of 477 patients: (229 CTx only and 248 CTx-IT). The 5-year OS was higher in the CTx-IT group compared with CTx alone (29.2% vs 18.3%; p = 0.0045). On multivariate analysis, the addition of adjuvant immunotherapy was associated was improved overall survival (hazard ratio 0.74; p = 0.007). Conclusions The addition of adjuvant immunotherapy to chemotherapy is associated with improved survival compared with chemotherapy alone after curative-intent resection of pancreatic adenocarcinoma. Future research is warranted to match specific immunotherapy agents with susceptible patient populations to improve outcomes for this aggressive disease.
Usability of an immersive augmented reality based telerehabilitation system with haptics (Artesh) for synchronous remote musculoskeletal examination

This study describes the features and utility of a novel augmented reality based telemedicine system with haptics that allows the sense of touch and direct physical examination during a synchronous immersive telemedicine consultation and physical examination. The system employs novel engineering features: (a) a new force enhancement algorithm to improve force rendering and overcoming the “just-noticeable-difference” limitation; (b) an improved force compensation method to reduce the delay in force rendering; (c) use of the “haptic interface point” to reduce disparity between the visual and haptic data; and (d) implementation of efficient algorithms to process, compress, decompress, transmit and render 3-D tele-immersion data. A qualitative pilot study (n=20) evaluated the usability of the system. Users rated the system on a 26-question survey using a seven-point Likert scale, with percent agreement calculated from the total users who agreed with a given statement. Survey questions fell into three main categories: (1) ease and simplicity of use, (2) quality of experience, and (3) comparison to in-person evaluation. Average percent agreements between the telemedicine and in-person evaluation were highest for ease and simplicity of use (86%) and quality of experience (85%), followed by comparison to in-person evaluation (58%). Eighty-nine percent (89%) of respondents expressed satisfaction with the overall quality of experience. Results suggest that the system was effective at conveying audio-visual and touch data in real-time across 20.3 miles, and warrants further development.
Treating Taboo or Forbidden Thoughts: Integrating Mindfulness, Acceptance, and Emotion Regulation Into an Exposure-Based Intervention

Individuals with obsessive compulsive disorder (OCD) who struggle with taboo or unacceptable obsessions (i.e., aggressive, sexual, or religious intrusions) tend to rely upon mental rituals to regulate their distress and possess difficulties labeling and regulating their affective state. Moreover, these individuals respond poorly to exposure with response prevention when the treatment is grounded in emotional processing theory. To improve patients' therapeutic outcomes, clinicians can consider integrating mindfulness- and acceptance-based skills into an exposure-based treatment to: facilitate the identification and acceptance of covert ritualistic urges, improve the accuracy of emotion labeling, and increase the efficiency of emotion regulation efforts. Additionally, in line with inhibitory learning theory, clinicians can design exposures to violate expectancies to promote the maintenance of long-term gains. Through a case vignette, the current article will demonstrate how to integrate these strategies into a standard exposure with response prevention intervention to meet the needs of a patient with taboo thoughts.
Social Integration, Social Networks, and Health

This article is a revision of the previous edition article by L.F. Berkman, volume 21, pp. 14327–14332, © 2001, Elsevier Ltd.
Pancreatitis associated with human immunodeficiency virus infection: a matched case-control study.

To determine the frequency of pancreatitis and to define risk factors for pancreatitis in patients with AIDS, we compared patients with pancreatitis to patients without pancreatitis in an urban infectious disease practice. Pancreatitis was defined as at least one clinical sign or symptom (nausea, vomiting, abdominal pain, or tenderness) accompanied by elevation of serum amylase or lipase. Twenty-four (22%) of 105 patients with AIDS, 2 (4%) of 46 patients with AIDS-related complex, 1 (3%) of 39 asymptomatic patients infected with HIV-1, and none of 9 uninfected patients at risk for HIV-1 developed pancreatitis as defined above. Fourteen patients experienced multiple episodes and three were symptomatic for more than 2 months. Pancreatitis was more likely to have occurred in patients with AIDS (P < .001), biliary tract disease (P = .013), and hypertriglyceridemia (P = .032). After matching for these factors and duration of current HIV disease, cryptosporidiosis, intravenous pentamidine, and isoniazid were each associated independently with pancreatitis (P < .05). Before didanosine (ddl) became available, 22% of the patients with AIDS in this practice had pancreatitis. Cryptosporidiosis, isoniazid, and intravenous pentamidine should be considered among the potential etiologies.
An Ensemble of Face Recognition Algorithms for Unsupervised Expansion of Training Data

Facial recognition is a classical problem in computer vision. The accuracy of face recognition algorithms is crucial in practice, as systems are increasingly secured with biometric locks. However, the performance of these algorithms is heavily dependent upon the size of the training data. This paper proposes an unsupervised ensemble method for expanding the set of training faces when only a single labeled face per subject is known. We show that the ensemble's confidence measure is sufficient to expand the training set to the point where more sophisticated algorithms can take over in classification.
Repeated regime shifts in a desert rodent community

Many communities are experiencing temporal changes in the abundances and/or identities of the species that comprise them. Understanding whether communities are changing gradually or via rapid regime shifts is important because different mechanisms are implicated in different patterns of change. We used a machine learning approach to examine the long-term dynamics of a desert rodent community undergoing compositional change. Our approach detected three regime shifts, where changes in the relative abundances of dominant and rare species occurred, and a period of increased variance in the structure of the community. These events coincided with extreme climate events (two high rain events and two droughts) that caused major declines in rodent abundances, suggesting a possible link between climate and regime shifts at this site. Continued study of the dynamics of community change will provide important information on the processes structuring communities and provide guidance for forecasting how community changes in the future.
Tracing the US Military’s Presence in Africa

ABSTRACTIn recent years there has been growing recognition of the militarisation of US foreign policy in Africa, especially following the establishment of a dedicated, regional combatant command (Africa Command, or AFRICOM) in 2007. At the same time knowledge of the extent and aims of US military activities in Africa remains murky, especially when compared to other regions such as the Middle East and Europe. This article begins by conceptualising AFRICOM as a geopolitical assemblage, an approach we believe useful for analysing its composition and emergence. Next we discuss the challenges involved in tracing the US military’s evolving presence in Africa and the methods utilised in our analysis. Following this we present three case studies: the first compares the composition and geographies of manned and unmanned aerial surveillance assemblages, the second details logistics infrastructures and the military’s use of contractors to develop logistical capabilities across the continent, the third examines growi...
A Multiple Feature Category Data Mining and Machine Learning Approach to Characterize and Detect Health Misinformation on Social Media

In this article, we characterize health misinformation infiltration as a dynamic dissemination process on social media in addition to content-based features. Using Zika discussion on Twitter in 2016 as the study system, we identified 264 most influential tweets with misinformation and matched 455 tweets with real information. We developed an algorithm to infer information dissemination network through retweeting for each tweet, and extracted nine network metrics. We then approximated information dissemination as nonhomogeneous Poisson process (NHPP) signal. We then extracted 40 signal features to characterize each NHPP. For content-based features, we applied both linguistic inquiry and word count and document-to-vector to further extract 63 and 50 features for each tweet, respectively. Finally, we also considered four user features. Based on these extracted feature categories, we trained support vector machine and random forest (RF) classifiers. Using all feature categories combined as input, an RF classifier achieved > 83% accuracy and > 90% AUC to detect misinformation.
Development of a Real-Time Reverse Transcription-PCR Assay To Detect and Quantify Group A Rotavirus Equine-Like G3 Strains.

Since 2013, group A rotavirus strains characterized as novel DS-1-like intergenogroup reassortant "equine-like G3" strains have emerged and spread across 5 continents among human populations in at least 14 countries. Here, we report a novel one-step TaqMan quantitative real-time reverse transcription-PCR assay developed to genotype and quantify the viral load for samples containing rotavirus equine-like G3 strains. Using a universal G forward primer and a newly designed reverse primer and TaqMan probe, we developed and validated an assay with a linear dynamic range of 227 to 2.3 × 109 copies per reaction and a limit of detection of 227 copies. The percent positive agreement, percent negative agreement, and precision of our assay were 100.00%, 99.63%, and 100.00%, respectively. This assay can simultaneously detect and quantify the viral load for samples containing DS-1-like intergenogroup reassortant equine-like G3 strains with high sensitivity and specificity, faster turnaround time, and decreased cost. It will be valuable for high-throughput screening of stool samples collected to monitor equine-like G3 strain prevalence and circulation among human populations throughout the world.
Robotic bronchoscopy and future directions of interventional pulmonology.

Purpose of review To describe the emerging field of robotic bronchoscopy within advanced diagnostic bronchoscopy. We review the literature available for these two novel platforms to highlight their differences and discuss the impact on future directions. Recent findings There are two distinct technologies both known as robotic bronchoscopy. The Monarch robotic-assisted bronchoscopy is based on electromagnetic guidance whereas the Ion robotic-assisted bronchoscopy is founded on shape sensing technology. Although there is ongoing work to explore the capabilities of these systems, studies have shown that both are safe modalities. Furthermore, both hold promise to improve diagnostic yield and may eventually pave the way for therapeutic bronchoscopic ablation in the future. Summary Although both platforms fall under the umbrella term of robotic-assisted bronchoscopy, the Monarch and Ion systems are quite unique in their technology. Thus far, both have demonstrated safety, and early data shows promising results for improved diagnostic yield compared to previously advanced bronchoscopy modalities, especially when combined with advanced confirmatory imaging. Future directions may include bronchoscopic ablation of peripheral lesions given the stability and reach of these platforms.
Oscillations and Multiple Equilibria in Microvascular Blood Flow

We investigate the existence of oscillatory dynamics and multiple steady-state flow rates in a network with a simple topology and in vivo microvascular blood flow constitutive laws. Unlike many previous analytic studies, we employ the most biologically relevant models of the physical properties of whole blood. Through a combination of analytic and numeric techniques, we predict in a series of two-parameter bifurcation diagrams a range of dynamical behaviors, including multiple equilibria flow configurations, simple oscillations in volumetric flow rate, and multiple coexistent limit cycles at physically realizable parameters. We show that complexity in network topology is not necessary for complex behaviors to arise and that nonlinear rheology, in particular the plasma skimming effect, is sufficient to support oscillatory dynamics similar to those observed in vivo.
A Pragmatist's Guide to Long-Run Equity Returns, Market Valuation, and the CAPE

When practitioners evaluate the equity market, two important questions recur. What long-run returns should investors expect? And, are there fundamental yardsticks that reliably indicate when the market is overvalued? Researchers have not reached a consensus on either of these questions. Equity prices have been high relative to their historical average, which has led many analysts to predict future equity returns will be below their historical average. Forecasts for real returns vary widely, however, from as low as 2%, to approximately 6%, which is close to the 6.5% average since 1871. Disagreements about returns reflect disagreement about how earnings will be affected by slower GDP growth, lower dividends, share buybacks, and the profitability of retained earnings. The current paper introduces Federal Reserve Flow of Funds and S&P500 book value data into this debate, and these data are generally supportive of the optimistic forecasts for equity returns. Estimates of long-run returns have implications for valuation metrics such as Shiller’s CAPE (cyclically adjusted price-earnings ratio).
Overcoming Redemption: Neoliberalism, Atonement, and the Logic of Debt

This paper discusses and critiques the structure of debt at work in Anselm's satisfaction theory of atonement and the way in which it resonates with other economic and non-economic mechanisms that neoliberalism uses to create indebted subjects. The first part of this paper uses the work of Maurizio Lazzarato to understand how neoliberalism works to create indebted subjects. The second part of the paper discusses how debt structures Anselm's satisfaction theory of atonement how the latter resonates with the general sense of indebtedness operative in neoliberalism. The third part of this paper discusses how recent appropriations of the satisfaction theory as an alternative to neoliberalism fail, based on the reading provided in the second part. The conclusion explores alternative theological proposals for thinking beyond the logic of debt.
The Depression of 2008

The U.S. economy as well as much of the global economy will very likely fall into a depression in 2008. This booklet will explain why there will be a recession and depression by the end of the decade of 2000-2010, and why the most probable year is 2008. You will learn how you can minimize your losses or even gain from this depression, and how government policies need to change to prevent future depressions.
What parents of rheumatic fever patients don't understand about the disease and its prophylactic management.

Interviews with 60 parents of children attending a rheumatic fever clinic showed confusion and many unrealistic beliefs about the disease and its long-term effects, about recurrences, and about the rationale for the prophylactic program. The parents9 all-pervading anxiety about heart disease and death led them to impose or continue restrictions contrary to medical advice, even on children with normal hearts. The mothers9 lack of understanding correlated with their level of education and a number of social and environmental factors. One group of families with a clearly defined pattern of social characteristics-almost entirely Negro, on public assistance, with a low educational level, a very low income, and a high degree of family disorganization-stood out because of its lack of understanding about the disease and about its prophylactic treatment. The responses of Negro mothers on public assistance as well as those with higher educational and income levels were similar in several respects and differed from those of Caucasian mothers. On the basis of what the mothers reported, communication about the disease was remarkably poor between physician and parent, parent and child, and physician and patient.