cssi/SciSciGPT-SciSciNet huggingface dataset:
Economic Policy Uncertainty, Learning and Incentives: Theory and Evidence on Mutual Funds

Using the mutual fund industry as a laboratory, we demonstrate theoretically and empirically that economic policy uncertainty affects investment decisions through an information rather than real options channel. Specifically, we find that fund flow-performance sensitivity decreases in uncertainty and does so more strongly for funds with shorter track records. The evidence supports the implication of our model that investor learning about manager ability weakens when uncertainty increases. Further, the effect of uncertainty on learning impacts managerial incentives. Consequently, managers are less likely to engage in active management during periods of greater uncertainty, an effect increasing in career concerns.
Impact of Sugarcane Renewable Fuel on In-Use Gaseous and Particulate Matter Emissions from a Marine Vessel

In-use emissions aboard a Stalwart class vessel, the T/S State of Michigan, were measured from a four-stroke marine diesel generator operating on two fuels: ultra-low-sulfur diesel (ULSD) fuel and ULSD mixed with Amyris renewable diesel (S33; 33% by volume) produced from sugarcane feedstocks with 67% by volume ULSD. Measurements followed the International Organization for Standardization (ISO) 8178 procedures and protocols. Gaseous emissions reported include nitrogen oxides (NOx), carbon monoxide (CO), and carbon dioxide (CO2), while reported particulate matter (PM) emissions include PM2.5 mass, elemental carbon (EC), and organic carbon (OC). Overall, a 4% reduction in NOx emissions, a 10% increase in CO, and a 2% increase in CO2 were observed with S33. For PM, no statistically significant differences were seen with S33. PM2.5 was dominated by OC for both fuels. Overall, there was a 26% reduction in EC and an 8% reduction in OC with S33.
Diabetes Risk and Disease Management in Later Life: A National Longitudinal Study of the Role of Marital Quality

OBJECTIVES We assess the association between marital quality and both the risk of developing diabetes and the management of diabetes after its onset in later life. METHOD We use data from the first two waves of the National Social Life, Health, and Aging Project to estimate regression models with lagged dependent variables. The sample includes 1,228 married respondents, among whom 389 were diabetic. Those with either a reported diagnosis or with HbA1c ≥ 6.5% are identified diabetic. We categorize diabetic respondents into three groups: controlled, undiagnosed, and uncontrolled diabetes. We conduct factor analysis to construct positive and negative marital quality scales. RESULTS For women, an increase in positive marital quality between Waves 1 and 2 is related to a lower risk of being diabetic at Wave 2, net of diabetes status at Wave 1; surprisingly, for men, an increase in negative marital quality between Waves 1 and 2 is related to both a lower risk of being diabetic at Wave 2 and a higher chance of controlling diabetes at Wave 2 after its onset. DISCUSSION Our results challenge the traditional assumption that negative marital quality is always detrimental to health and encourage family scholars to distinguish different sources and types of negative marital quality.
Studies of the Biosynthesis of Renin with a Cell-Free Translation System

1. Poly(A) + mRNA from mouse submaxillary gland encodes a polypeptide of molecular weight 48 000 (48K polypeptide) which is abundant in the male. 2. This polypeptide is selectively absent in the translation products of mRNA from a strain of genetically renin-deficient mice C57 BL/10J. 3. The 48K polypeptide binds and co-elutes in identical fashion with pure authentic renin on pepstatin affinity chromatography. 4. Immunoprecipitation of translation products of male glandular mRNA with renin-specific antibody yielded this 48K band upon analysis by SDS/polyacrylamide gel electrophoresis and fluorography. Pure renin of molecular weight 37 000 blocked the binding of this polypeptide to antirenin antibody. 5. Mouse submaxillary gland synthesizes a renin precursor. The renin mRNA is androgenically regulated.
Appraisal of the modalities used to evaluate an initial abnormal Papanicolaou smear.

Objective To examine the efficacy of the different modalities used to evaluate an initial abnormal Papanicolaou smear. Methods The study population comprised 214 nonpregnant women referred with a Papanicolaou smear diagnosis of cervical intraepithelial neoplasia. Each patient was evaluated by a repeat Papanicolaou smear, colposcopy, and colposcopically directed cervical biopsies. Immediate loop excision was performed to remove the entire transformation zone in all patients. Kappa statistics were calculated to determine agreement among the modalities, and logistic regression was used for determining relative risks (RR). Results There was 53% agreement between the initial and repeat Papanicolaou smears. When low-grade squamous intraepithelial lesion (SIL) was diagnosed by Papanicolaou smear, there was 89% agreement with the colposcopic impression. However, a colposcopic impression of high-grade SIL was found in only one-third of the women diagnosed with high-grade SIL by Papanicolaou smear. A comparison of the histology of the cervical biopsy and the loop specimen revealed 57% agreement. Univariate analysis indicated that each modality was able to predict the RR of high-grade dysplasia in the loop specimen at a statistical significance level of .05. A colposcopic impression of high-grade dysplasia conferred an RR of 7.43 (95% confidence interval [CI] 2.17-25.49) for high-grade dysplasia in the loop specimen. An initial Papanicolaou smear diagnosis of high-grade SIL did not contribute to the multivariate model for calculating the risk of high-grade dysplasia, as the RR was 1.6 (95% CI 0.68-3.81). Conclusion Patients with an initial Papanicolaou smear showing low-grade SIL would benefit from a repeat Papanicolaou smear and colposcopically directed biopsies before proceeding with loop diathermy. In contrast, patients with a colposcopic impression of high-grade dysplasia combined with high-grade SIL on Papanicolaou smear appear to be candidates for immediate loop excision.
Water-gas shift reaction on alumina-supported Pt-CeOx catalysts prepared by supercritical fluid deposition

Abstract Alumina-supported platinum catalysts, both with and without ceria, were prepared by supercritical fluid deposition and evaluated for activity for water-gas shift reaction. The organometallic precursor, platinum(II) acetylacetonate, was deposited from solution in supercritical carbon dioxide. Analysis of the catalysts by high resolution scanning transmission electron microscopy indicated that platinum was present in the form of highly dispersed metal nanoparticles. Pretreatment of the alumina-supported ceria in hydrogen prior to the deposition of the platinum precursor resulted in more platinum nucleated on ceria than non-pretreated alumina-supported ceria but varied in both particle size and structure. The ceria-containing catalyst that was not pretreated exhibited a more uniform particle size, and the Pt particles were encapsulated in crystalline ceria. Reaction rate measurements showed that the catalyst was more active for water-gas shift, with reaction rates per mass of platinum that exceeded most literature values for water-gas shift reaction on Pt-CeO x catalysts. The high activity was attributed to the significant fraction of platinum/ceria interfacial contact. These results show the promise of supercritical fluid deposition as a scalable means of synthesizing highly active supported metal catalysts that offer efficient utilization of precious metals.
Predicting isocitrate dehydrogenase genotype in malignant glioma with multimodality imaging markers.

2009Background: Malignant gliomas with mutations in the isocitrate dehydrogenase (IDH) gene family confer longer overall survival relative to their IDH wild-type counterparts. Accurately determinin...
Effects of Rainfall on Vehicle Crashes in Six U.S. States

AbstractRainfall is one of many types of weather hazard that can lead to motor vehicle crashes. To better understand the link between rainfall and crash rates, daily gridded precipitation data and automobile crash data are gathered for six U.S. states (Arkansas, Georgia, Illinois, Maryland, Minnesota, Ohio) for the period 1996–2010. A matched pair analysis is used to pair rainfall days with dry days to determine the relative risk of crash, injury, and fatality. Overall, there is a statistically significant increase in crash and injury rates during rainfall days of 10% and 8%, respectively, leading to an additional 28 000 crashes and 12 000 injuries in the 1 May–30 September period each year relative to what would be expected if those days were dry. The risk of crashes and injuries increases for increasing daily rainfall totals, with an overall increase in crashes and injuries of 51% and 38% during days with more than 50 mm (2 in.) of rainfall. While urban counties and rural counties with and without inter...
Evaluation of nonpeptidic ligand conjugates for the treatment of hypoxic and carbonic anhydrase IX-Expressing cancers

As tumors grow, vasculature is often deficient or malformed, resulting in many localized areas of hypoxia. Cells located in these hypoxic regions exhibit an altered gene expression pattern that can significantly alter resistance to conventional anticancer treatments such as ionizing radiation and chemotherapeutic drugs. A priori knowledge of the level of hypoxia within a tumor may better guide clinical care. In an effort to create a hypoxia specific imaging agent, a ligand for the tissue hypoxia marker, carbonic anhydrase IX (CA IX), was synthesized and used as a targeting ligand to deliver an attached 99mTc-chelating agent. Binding of the resulting conjugates to hypoxic cancer cells was first characterized in vitro. Whole animal imaging and biodistribution studies then were performed to determine tumor specificity in vivo. Several conjugates were found to bind selectively to CA IX expressing tumors in a receptor-dependent manner. We suggest that such conjugates could prove useful in identifying hypoxic c...
Kidney Disease Population Health Management in the Era of Accountable Care: A Conceptual Framework for Optimizing Care Across the CKD Spectrum

Since its passage in 2010, the Affordable Care Act has led to the creation of numerous accountable care organizations that face the challenge of transforming the traditional care delivery model to provide more patient-centered, high-quality, and low-cost care. Complex patients, including those with chronic kidney disease (CKD), present the most challenges and opportunities. CKD is a condition with significant morbidity, mortality, and cost and thought to be partly secondary to known gaps in care delivery. Successful population management for CKD requires consideration of the needs of patients at all phases of the disease. In this article, we offer a comprehensive framework for a population-based approach to CKD and examples of programs we are implementing in each area. These initiatives include the development and implementation of an electronic nephrology consult (e-consult) platform, CKD quality metrics, CKD registry, CKD collaborative care agreement, multidisciplinary care clinic for advanced CKD, end-stage renal disease care coordinator program, shared decision-making tools for renal replacement, CKD education videos, and a tablet-based CKD patient-reported outcome measures tool.
The Constitution of Valley Glaciers

Ice streams composing a compound valley glacier may be juxtaposed, inset or superimposed, and Demorest’s concepts of ice flowage provide a plausible explanation for these relations. If valley floors are accordant, juxtaposition results because the waxing force of gravity and obstructed gravity flow in the tributary glacier overcomes the waning force of obstructed extrusion flow from the trunk glacier enabling the tributary to force its way into a juxtaposed position with the trunk glacier in the main valley. If discordance in valley floors is less than the thickness of the trunk glacier, an insert position develops by the same mechanism. If the discordance is greater than the thickness of the trunk glacier, superimposition results. Locally, superimposed or inset relations may be established by exceptionally rapid advances, even with accordant valley floors, but any superimposed ice stream shortly becomes inset by sinking into the underlying ice, at least in temperate glaciers.
Principles of Memory-Centric Programming for High Performance Computing

The memory wall challenge -- the growing disparity between CPU speed and memory speed -- has been one of the most critical and long-standing challenges in computing. For high performance computing, programming to achieve efficient execution of parallel applications often requires more tuning and optimization efforts to improve data and memory access than for managing parallelism. The situation is further complicated by the recent expansion of the memory hierarchy, which is becoming deeper and more diversified with the adoption of new memory technologies and architectures such as 3D-stacked memory, non-volatile random-access memory (NVRAM), and hybrid software and hardware caches.The authors believe it is important to elevate the notion of memory-centric programming, with relevance to the compute-centric or data-centric programming paradigms, to utilize the unprecedented and ever-elevating modern memory systems. Memory-centric programming refers to the notion and techniques of exposing hardware memory system and its hierarchy, which could include DRAM and NUMA regions, shared and private caches, scratch pad, 3-D stacked memory, non-volatile memory, and remote memory, to the programmer via portable programming abstractions and APIs. These interfaces seek to improve the dialogue between programmers and system software, and to enable compiler optimizations, runtime adaptation, and hardware reconguration with regard to data movement, beyond what can be achieved using existing parallel programming APIs. In this paper, we provide an overview of memory-centric programming concepts and principles for high performance computing.
Thermally induced coloration of KBr at high pressures

Laser-heated diamond-anvil cell (LHDAC) experiments reveal electronic changes in KBr at pressures between $\ensuremath{\sim}13--81\phantom{\rule{0.28em}{0ex}}\mathrm{GPa}$ when heated to high temperatures that cause runaway heating to temperatures in excess of $\ensuremath{\sim}5000\phantom{\rule{0.28em}{0ex}}\mathrm{K}$. The drastic changes in absorption behavior of KBr are interpreted as rapid formation of high-pressure F-center defects. The defects are localized to the heated region and thus do not change the long-range crystalline order of KBr. The results have significant consequences for temperature measurements in LHDAC experiments and extend the persistence of F centers in alkali halides to at least 81 GPa.
Impact of Corn Earworm (Lepidoptera: Noctuidae) on Field Corn (Poales: Poaceae) Yield and Grain Quality

Corn earworm, Helicoverpa zea (Boddie), commonly infests field corn, Zea mays (L.). The combination of corn plant biology, corn earworm behavior in corn ecosystems, and field corn value renders corn earworm management with foliar insecticides noneconomical. Corn technologies containing Bacillus thuringiensis (Bt) Berliner (Bacillales: Bacillaceae) were introduced that exhibit substantial efficacy against corn earworm and may reduce mycotoxin contamination in grain. The first generation Bt traits in field corn demonstrated limited activity on corn earworm feeding on grain. The pyramided corn technologies have greater cumulative protein concentrations and higher expression throughout the plant, so these corn traits should provide effective management of this pest. Additionally, reduced kernel injury may affect physical grain quality. Experiments were conducted during 2011-2012 to investigate corn earworm impact on field corn yield and grain quality. Treatments included field corn hybrids expressing the Herculex, YieldGard, and Genuity VT Triple Pro technologies. Supplemental insecticide treatments were applied every 1-2 d from silk emergence until silk senescence to create a range of injured kernels for each technology. No significant relationship between the number of corn earworm damaged kernels and yield was observed for any technology/hybrid. In these studies, corn earworm larvae did not cause enough damage to impact yield. Additionally, no consistent relationship between corn earworm damage and aflatoxin contamination was observed. Based on these data, the economic value of pyramided Bt corn traits to corn producers, in the southern United States, appears to be from management of other lepidopteran insect pests including European and southwestern corn borer.
Nucleon-Nucleus Scattering to the Continuum

Various aspects of inclusive nucleon-nucleus scattering are discussed which are important in understanding features of cross sections and spin observables in the continuum region. These include: 1) contributions from two-step processes, 2) damping of the response from 2p-2h excitations, 3) the “optimal” choice of frame in which to evaluate the nucleon-nucleon amplitudes, and 4) the effect of optical and spin-orbit distortions, which are included in a model based in the distorted wave impulse approximation.
A tri-level programming model for attack-resilient control of power grids

The significance of modern power grids is acknowledged every time there is a major threat. This paper proposes the novel approaches to aid power system planner to improve power grid resilience by making appropriate hardening strategies against man-made attack or natural hazards. The vulnerability indices are introduced, which return the most vulnerable component in the system based on a tri-level defender-attacker-operator (DAO) interdiction problem which solves iteratively. The output of DAO is the set of hardening strategies that optimally allocated along the network to mitigate the impact of the worst-case damages. By repeating DAO problem based on the proposed algorithm, the various crafted attack is imposed on the system, and the defender’s behavior demonstrates how an element is vulnerable to threats. The WSCC 9-bus, IEEE 24-bus, and IEEE 118-bus systems are employed to evaluate the model performance. The counter-intuitive results are proven by the proposed robust hardening strategy, which shows how the hardening strategy should be allocated to improve power network resilience against threats.
Religion-State Identification and Religious Freedom in Ethiopia

Two major conclusions come out of the study of Ethiopia’s experience with religion-state relations. First, the interaction between religion-state relations and the freedom of religion has followed patterns suggested by the Ryskamp-Durham model. The most serious violations of the freedom of religion took place under the establishment of Orthodox Christianity during the imperial regime and can be seen in the current imposition of the Ahbash movement. The anti-clerical orientations of the Marxist regime also represented another low point. Accommodationist and cooperationist policies under the laicite informed 1994 Constitution, on the other hand, seem to have provided the optimal condition for the exercise of the freedom. Within the system established by the 1994 Constitution one can see how insensitive separationist policies such as the Ministry of Education’s directive can make the exercise of religion onerous in educational institutions, while accommodationist and especially cooperationist policies can also lead to discrimination when taken to the edges of preference and endorsement.
What’s the Problem Represented to Be? Problem Definition Critique as a Tool for Evaluative Thinking:

Problem definition in program planning and evaluation is rarely problematized. In this article, I discuss why the lack of problem problematization is itself problematic—in other words, why treating...
Resolving and Understanding Differences Between Agent-Based Accounts of Scientific Representation

Agent-based accounts of scientific representation all agree that the representational relationship is constituted by the actions of scientists. Despite this agreement, there are several differences in how agent-based accounts describe scientific representation. In this essay, I argue that these differences do not undercut the compatibility between the accounts. I make my argument by examining the nature of human agency and demonstrating that scientific, representational actions are multiply describable. I then argue that the differences between the accounts are valuable because they help to bring different parts of the representational practices of science into greater focus.
Assessment of the FDA Risk Evaluation and Mitigation Strategy for Transmucosal Immediate-Release Fentanyl Products

Importance Transmucosal immediate-release fentanyls (TIRFs), indicated solely for breakthrough cancer pain in opioid-tolerant patients, are subject to a US Food and Drug Administration (FDA) Risk Evaluation and Mitigation Strategy (REMS) to prevent them from being prescribed inappropriately. Objectives To evaluate knowledge assessments of pharmacists, prescribers, and patients regarding appropriate TIRF use; to describe sponsor assessments, based on claims data, of whether the REMS program was meeting its goals; and to characterize how the FDA responded to REMS assessments. Design, Setting, and Participants Qualitative analysis of 4877 pages of FDA documents obtained through a Freedom of Information Act request, including 6 annual REMS assessment reports (2012-2017), FDA evaluations of these reports, and FDA-sponsor correspondence about safety issues. Exposure A REMS program to reduce the risk of adverse outcomes, including misuse, abuse, addiction, and overdose, arising from use of TIRFs. Main Outcomes and Measures (1) Knowledge assessments of pharmacists, prescribers, and patients; (2) survey and claims-based prescribing assessments; (3) FDA and TIRF sponsor communications; (4) modifications to the REMS program; and (5) disenrollment of noncompliant prescribers. Results Twelve months after initiation of the program, 24 of 302 pharmacists (7.9%), 35 of 302 prescribers (11.6%), and 5 of 192 patients (2.6%) incorrectly reported that TIRFs can be prescribed to opioid-nontolerant patients, with similar levels of misunderstanding maintained in the subsequent reports. At 60 months, product-specific analyses of claims data indicated that between 34.6% and 55.4% of patients prescribed TIRFs were opioid-nontolerant. In the 48-month survey, 106 of 310 prescribers (34.2%) reported prescribing TIRFs for opioid-tolerant patients with chronic, noncancer pain; at 60 months, 54 of 302 prescribers (18.4%) and 148 of 310 patients (47.7%) erroneously reported that TIRFs were FDA-approved for such use. Over the 60-month period examined, there were few substantive changes made to the REMS to address evidence of high rates of off-label TIRF use, and, although the REMS program had a noncompliance plan, there was no report of prescribers being disenrolled for inappropriate prescribing. Conclusions and Relevance In this review of FDA documents pertaining to the TIRF REMS, surveys of pharmacists, prescribers, and patients reflected generally high levels of knowledge regarding proper TIRF prescribing, yet some survey items as well as claims-based analyses indicated substantial rates of inappropriate TIRF use. Despite these findings, the FDA did not require substantive changes to the program.
A GraphBLAS Approach for Subgraph Counting

Subgraph counting aims to count the occurrences of a subgraph template T in a given network G. The basic problem of computing structural properties such as counting triangles and other subgraphs has found applications in diverse domains. Recent biological, social, cybersecurity and sensor network applications have motivated solving such problems on massive networks with billions of vertices. The larger subgraph problem is known to be memory bounded and computationally challenging to scale; the complexity grows both as a function of T and G. In this paper, we study the non-induced tree subgraph counting problem, propose a novel layered softwarehardware co-design approach, and implement a shared-memory multi-threaded algorithm: 1) reducing the complexity of the parallel color-coding algorithm by identifying and pruning redundant graph traversal; 2) achieving a fully-vectorized implementation upon linear algebra kernels inspired by GraphBLAS, which significantly improves cache usage and maximizes memory bandwidth utilization. Experiments show that our implementation improves the overall performance over the state-of-the-art work by orders of magnitude and up to 660x for subgraph templates with size over 12 on a dual-socket Intel(R) Xeon(R) Platinum 8160 server. We believe our approach using GraphBLAS with optimized sparse linear algebra can be applied to other massive subgraph counting problems and emerging high-memory bandwidth hardware architectures.
Synthetic Bistability and Differentiation in Yeast

Engineered systems that control cellular differentiation and pattern formation are essential for applications like tissue engineering, biomaterial fabrication, and synthetic ecosystems. Synthetic circuits that can take on multiple states have been made to engineer multicellular systems. However, how to use these states to drive interesting cellular behavior remains challenging. Here, we present a cellular differentiation program involving a novel synthetic bistable switch coupled to an antibiotic resistance gene that affects growth in yeast (S. cerevisiae). The switch is composed of a positive feedback loop involving a novel transcription factor and can be switched ON and OFF via two different transient inducer inputs. By further coupling the bistable switch with an antibiotic resistance gene, we obtained a growth differentiation circuit, where yeast cells can be switched to stable HIGH or LOW growth rate states via transient inducer inputs. This work demonstrates a rationally designed and experimentally ...
Hypoxia-Induced PIM Kinase and Laminin-Activated Integrin α6 Mediate Resistance to PI3K Inhibitors in Bone-Metastatic CRPC

ABSTRACT Bone-metastatic castration-resistant prostate cancer (CRPC) is lethal due to inherent resistance to androgen deprivation therapy, chemotherapy, and targeted therapies. Despite the fact that a majority of CRPC patients (approximately 70%) harbor a constitutively active PI3K survival pathway, targeting the PI3K/mTOR pathway has failed to increase overall survival in clinical trials. Here, we identified two separate and independent survival pathways induced by the bone tumor microenvironment that are hyperactivated in CRPC and confer resistance to PI3K inhibitors. The first pathway involves integrin α6β1-mediated adhesion to laminin and the second involves hypoxia-induced expression of PIM kinases. In vitro and in vivo models demonstrate that these pathways transduce parallel but independent signals that promote survival by reducing oxidative stress and preventing cell death. We further demonstrate that both pathways drive resistance to PI3K inhibitors in PTEN-negative tumors. These results provide preclinical evidence that combined inhibition of integrin α6β1 and PIM kinase in CRPC is required to overcome tumor microenvironment-mediated resistance to PI3K inhibitors in PTEN-negative tumors within the hypoxic and laminin-rich bone microenvironment.
Evaluating the effect of nano-particle additives in Kevlar® 29 impact resistant composites

Abstract Kevlar® 29 impact resistant composites are commonly employed for a wide range of applications including ballistic resistant armor. Advancement in the composite’s energy absorption and the reduction of weight are critical for increasing their effectiveness in application. Carbon nano-tubes and nano-sized core shell rubber particles are added for thermoset resin systems to enhance toughness and energy absorption. V 50 ballistic testing was conducted on three classes of Kevlar composites and their energy absorption characteristics were evaluated with a ballistic impact testing and post shot Raman spectroscopy. This study showcases the influence of nano-particle additives on the energy absorption of the composite via the Kevlar® 29 fibers corresponding residual Raman spectral shifts. Investigating both the 1611 cm−1 and the 1649 cm−1 reference Raman bands, a discussion of as to how the additives are enhancing energy absorption and overall composite performance is presented as well. This work indicates that different mechanisms employed by the two different nano-additives enhance V50 ballistic performance by 7.3% and 8% respectively over baseline panels with a 1% weight addition of nano and micro-sized particles by matrix toughening, cavitation, and strengthening the fiber–matrix interface.
National trends in endovascular therapy for acute ischemic stroke: utilization and outcomes

Objective Following widespread acceptance of endovascular therapy (ET) for large vessel occlusion stroke in 2015, we assessed nationwide utilization of revascularization for acute ischemic stroke (AIS). Methods We utilized the 2013–2016 Healthcare Cost and Utilization Project Nationwide Readmissions Database. We identified AIS admissions, treatment with intravenous thrombolysis (IVT), ET, and vascular risk factors using International Classification of Disease Clinical Modification codes. Main predictor of outcome was the time period of index admission (‘pre-endovascular era (pre-EA)’ January 2013–January 2015 and ‘endovascular era (EA)’ February 2015– December 2016). We calculated the proportion of AIS admissions in which, first, VT and second, ET was performed. Among patients treated with ET, we examined the association between era and discharge disposition, in-hospital mortality during index admission, and 30-day readmission. Results There were 925 363 index AIS admissions before the EA and 857 347 during. A higher proportion of AIS patients received IVT (8.4% vs 7.8%) and ET (2.6% vs 1.3%) in the EA. Although length of stay (LOS) was shorter in the EA (5.70 vs 6.80 days), total charges were greater ($56 691 vs $53 878), and admissions were more often to a metropolitan hospital (65.2% vs 57.2%). Among those treated with ET, a smaller proportion received IVT (29.7% vs 44.9%), LOS was substantively shorter (9.75 vs 12.76 days), and patients had a lower odds of discharge home. Conclusions The utilization of ET has doubled in the EA but ET remains underutilized. ET is predominantly provided at metropolitan teaching hospitals and associated with higher charges despite shorter LOS and unchanged in-hospital mortality.
To the Editor: Anticoagulation for atrial fibrillation.

TO THE EDITOR : As a geriatric medicine fellow, I eagerly read Hagerty and Rich’s review “Fall risk and anticoagulation for atrial fibrillation in the elderly: A delicate balance”[1][1] and Suh’s editorial, “Whether to anticoagulate: Toward a more reasoned approach”[2][2] in the January
Governance for Urban Services: Towards Political and Social Inclusion in Cities

Cities provide opportunities for economies of scale, products, income, services and social experimentation. However, urbanization has led to an increasing incidence of urban poverty and inequity, deteriorating quality of the urban environment and deficiencies in access to basic urban services, including water supply and sanitation, urban shelter, waste management, energy, transport and health. This chapter provides a framework to examine the role of urban local governance in promoting access to services, participation in local decision making and accountability and transparency. It presents challenges and opportunities of urbanization (Sect. 1), the paradigm shift in our thinking about development from economic growth focus to poverty alleviation and human development and about governance from traditional public administration to democratic governance in developing countries (Sect. 2), and forms, driving forces and impacts of decentralizing governance (Sect. 3). After defining access, participation, accountability and transparency, the chapter identifies four sets of intermediate-term outcomes of local governance for urban services (Sect. 4) and key features of “good” urban governance and policy challenges identified in the New Urban Agenda endorsed by HABITAT III (Sect. 5). Finally, it describes key themes and findings of each of the book chapters that follow (Sect. 6).
Proline Behavior in Model Prebiotic Peptides Formed by Wet–Dry Cycling

The amino acid proline plays critical roles in polypeptide structure and function. However, the influence of proline residues on proto-peptide evolution is unknown. In order to begin exploring this...
Contrast Sensitivity Loss in Patients With Posttreatment Lyme Disease.

Purpose Posttreatment Lyme disease (PTLD) is marked by neurologic symptoms, cognitive impairment, and significant symptom burden, including fatigue and ocular complaints. The purpose of this study was to determine whether contrast sensitivity (CS) is altered in patients with PTLD compared with healthy controls and, second, whether CS is associated with cognitive and/or neurologic deficits. Methods CS was measured using a Pelli-Robson chart with forced-choice procedures, and the total number of letters read was recorded for each eye. CS impairment was defined for age <60 years as logCS of 1.80 (36 letters or fewer) and for those age ≥60 years as logCS of 1.65 (33 letters or fewer). Participants self-administered a questionnaire to assess presence of ocular symptoms and underwent a neurologic exam and battery of neurocognitive tests. Results CS impairment was associated with an increased odds of being in the PTLD group that was 2.6 times as high as those without CS impairment (odds ratio, 2.6; 95% confidence interval, 1.3-5.2). Neither cases nor controls had significant distance acuity impairment. CS impairment was not associated with any of the ocular complaints in cases but was borderline associated with neurologic abnormalities and cognitive impairment. Conclusions CS impairment in patients with PTLD is linked to signs of cognitive and neurologic impairment and may be a marker of illness severity. Translational Relevance Further investigation into the value of testing CS impairment in PTLD cases is warranted, especially if it is an indicator of cognitive or neurologic manifestations.
How Might Manufacturers of E-Cigarettes Get New Product and MRTP Orders from FDA More Quickly and Easily?

According to manufacturers and some members of the public health and tobacco control communities, exclusively using e-cigarettes is much less harmful and risky to users and exposed nonusers than tobacco smoking. But federal law prohibits manufacturers and importers from labeling or marketing their e-cigarettes as delivering fewer toxins or being less harmful than cigarettes or other smoked tobacco products unless they first obtain permissive orders from FDA. Being allowed to make such reduced-exposure or reduced-risk claims would help a manufacturer attract smokers to use its e-cigarettes instead, giving them a powerful new competitive advantage. But no e-cigarette company has yet applied to FDA to obtain the new product and modified risk tobacco product (MRTP) orders they need to be allowed to market their e-cigarettes as less toxic or less harmful to use. Apparently, the process for obtaining the necessary permissive orders from FDA is too complicated, costly, and uncertain even to be worth trying. This paper suggests a way that e-cigarette companies might secure new product and MRTP orders more quickly and easily — or at least establish a test case that could prompt the courts to ensure that the order process provides a reasonable way for e-cigarettes to enter or stay on the U.S. market and be advertised with reduced-risk claims, consistently with FDA’s statutory duty to protect the public health.
Abstract 164: Endothelial Gab1 Limits Vascular Remodeling and Atherosclerosis Through Inhibition of Endothelial Inflammation

Objective: We have previously shown that docking protein Grb2-associated binder 1 (Gab1) is a mechano-effector protein in response to fluid shear stress and regulates postnatal angiogenesis. The ai...
Learning fast while avoiding spurious excitement and overcoming cue competition requires setting unachievable goals: reasons for using the logistic activation function in learning to predict categorical outcomes

Language learning often involves predicting categorical outcomes based on a set of cues. Error in predicting a categorical outcome is the difference between zero or one and the outcome’s current le...
A systematic review of binge eating, loss of control eating, and weight loss in children and adolescents.

OBJECTIVE This review synthesizes literature on changes in binge eating (BE) and loss of control eating (LOC) following weight loss and the association between BE/LOC and weight loss in children and adolescents. METHODS A systematic literature search was conducted in PubMed, Scopus, and PsycInfo. Eligible studies included all peer-reviewed journal articles of primary research that assessed BE/LOC and weight change following a weight-loss intervention in individuals under 18 years of age. RESULTS The 29 articles included studies on behavioral therapy, pharmacotherapy, and surgical interventions. Of the 14 studies that assessed the relationship between weight loss and BE/LOC at baseline, 4 showed that higher baseline BE/LOC was associated with less weight loss, whereas 10 showed no significant association. BE/LOC behaviors significantly decreased following weight-loss interventions in 20 of 21 studies. A greater decrease in BE/LOC was associated with improved weight loss in 4 of 9 studies that assessed this change. CONCLUSIONS Weight-loss interventions are associated with improved BE/LOC in youth with obesity. The persistence of BE/LOC symptoms may be associated with less weight loss. These results can aid in guiding future treatment for youth with BE/LOC seeking weight-loss treatment.
Morning report for all: a qualitative study of disseminating case conferences via podcasting.

Despite its long-established importance, diagnostic reasoning (DR) education has suffered uneven implementation in medical education. The Clinical Problem Solvers (CPSolvers) podcast has emerged as a novel strategy to help teach DR through case conferences with expert diagnosticians and trainees. CPSolvers has 25,000 listeners in 147 countries. The aim of this study was to evaluate the podcast by eliciting the developers’ goals of the podcast, then determining to what extent they aligned with the listeners’ actual usage habits, features they valued, and perceptions of the podcast. We conducted semi-structured interviews with 3 developers and 8 listeners from April–May 2020, followed by qualitative thematic analysis. Three major developer goals with sub-goals resulted: Listeners’ usage habits, valued features, and perceptions overall strongly aligned with all these aspects, except for (1c) clinical knowledge, and (1d) diagnostic reasoning terminology. Listeners identified (1a) schemas, and (2c) promotion of psychological safety as the most valuable features of the podcast. CPSolvers has been perceived as a highly effective and novel way to disseminate DR education in the form of case conferences, serving as an alternative to traditional in-person case conferences suspended during COVID-19. CPSolvers combines many known benefits of in-person case conferences with a compassionate and entertaining teaching style, plus advantages of the podcasting medium — democratizing morning report for listeners around the world.
Symptom severity and clinical characteristics of patients with bloating.

BACKGROUND Abdominal bloating is common in functional gastrointestinal disorders (FGID). To better characterize this patient population, we evaluated clinical and psychological characteristics of bloating and analyzed their differences by bloating severity. METHODS Patients with FGIDs evaluated at a single academic outpatient referral gastroenterology clinic were surveyed. Bloating severity was classified as minimal, moderate or severe. Symptom-specific questionnaires were used to evaluate bowel habits, abdominal bloating, depression, anxiety, somatization and sleep disturbance. Associations between bloating severity, clinical characteristics and FGID subtypes were analyzed in univariate and multivariate modeling. KEY RESULTS Of 612 FGID patients included (78% female, mean age of 44 ± 16.5 years), bloating was reported as minimal in 231(37.8%), moderate in 217(35.4%), or severe in 164(26.8%). Patients with severe bloating were more likely to be female, younger, and have co-existing functional dyspepsia than those with minimal bloating (p < 0.05). Bloating severity and severity of abdominal distension were significantly correlated (p < 0.05). On multivariable regression, patients who met criteria for functional constipation and functional dyspepsia had 80% and 125% higher odds, respectively, of severe bloating compared to minimal to moderate bloating. Younger age, abdominal pain and constipation severity, and somatization scores were also independently associated with severity of bloating. CONCLUSIONS & INFERENCES Severe bloating is associated with younger age, and with more severe abdominal pain, constipation, and somatization. Patients who met criteria for functional constipation and functional dyspepsia are more likely to experience severe bloating.
Investigating Laminin-α3β3γ2's Potential Role in Epithelial-to-Mesenchymal Transition in Pulmonary Epithelia

The extracellular matrix (ECM) provides physical scaffolding for cells but also is essential for many biochemical and biomechanical cues in tissue differentiation and homeostasis. Under normal phys...
Studies on the histamine content of blood, with special reference to leukemia, leukemoid reactions and leukocytoses.

The literature concerning blood histamine has been reviewed, including the evidence that the incorporation of histamine within the myeloid leukocytes may be one of the metabolic functions of myelopoiesis. Data are presented on the histamine content of blood in normal subjects and in subjects with acute leukemia, chronic myelocytic leukemia, erythremia, and with leukocytoses or leukemoid reactions of other etiologies. The changing relationships of total blood histamine to unit myeloid cell histamine in subjects receiving irradiation therapy for chronic myelocytic leukemia are also presented. The data indicate that total blood histamine in chronic myelocytic leukemia is usually very high in comparison to normal, that the values in erythremia show a definite but less marked tendency in the same direction, while the values in leukocytoses of other etiology are, with few exceptions, normal or low. The blood histamine per million myeloid cells is, on the average, about twice normal in subjects with chronic myelocytic leukemia, within the normal range or a little low in erythremia, and very low on the average in the group of leukocytoses studied. The suggestion is tentatively made that an aberration in this metabolic process (histamine incorporation within myeloid leukocytes) may be an inherent component of chronic myelocytic leukemia, whereas in physiologic leukocytoses and leukemoid reactions this is not the case. ACKNOWLEDGMENTS The authors wish to express their grateful appreciation to Mr. John Fuschetti for valuable technical assistance in performing the histamine determinations. The cooperation and aid of Dr. Gurth E. Carpenter, Dr. Henry H. Henstell, Dr. Myron Prinzmetal and of many members of the staff of Wadsworth General Hospital, Veterans Administration, Los Angeles were invaluable in obtaining blood specimens from suitable clinical material, and to them the authors wish to express their sincere thanks.
Normal-state properties of ABa2Cu3O7-y compounds (A=Y and Gd): Electron-electron correlations

Resistivity, thermoelectric power, Hall effect, and magnetic susceptibility measurements are reported in the normal state of the high-${T}_{c}$ compounds $\mathrm{Y}{\mathrm{Ba}}_{2}{\mathrm{Cu}}_{3}{\mathrm{O}}_{7\ensuremath{-}y}$ and $\mathrm{Gd}{\mathrm{Ba}}_{2}{\mathrm{Cu}}_{3}{\mathrm{O}}_{7\ensuremath{-}y}$. The results are different from those expected for an uncorrelated metallic band. We suggest that Coulomb interactions are important and that the interaction energy is comparable to or larger than the uncorrelated bandwidth, leading to moderately heavy-fermion-like behavior in the normal state. The Sommerfeld coefficient $\ensuremath{\gamma}$ calculated from the susceptibility indicates that the electron-phonon coupling constant at ${T}_{c}$ is not unusually large.
The Role of Subjective Probability and Utility in Decision-Making

Although many philosophers and statisticians believe that only an objectivistic theory of probability can have serious application in the sciences, there is a growing number of physicists and statisticians, if not philosophers, who advocate a subjective theory of probability. The increasing advocacy of subjective probability is surely due to the increasing awareness that the foundations of statistics are most properly constructed on the basis of a general theory of decision-making. In a given decision situation subjective elements seem to enter in three ways: (i) in the determination of a utility function (or its negative, a loss function) on the set of possible consequences, the actual consequence being determined by the true state of nature and the decision taken; (ii) in the determination of an a priori probability distribution on the states of nature; (iii) in the determination of other probability distributions in the decision situation.
Adding Colors to the Chameleon: Why the Supreme Court Should Have Adopted a New Compelling Governmental Interest Test for Race-Preference Student Assignment Plans

When the Supreme Court ordered the City of Birmingham to desegregate its schools in 1954, it failed to consider the long range implications of its mandate. School districts across the country responded to the Court's order by adopting race-preference school assignment plans, created to designate the particular public elementary or secondary school a student should attend. Now that these plans have successfully achieved their goals of desegregating classrooms, the question has become whether the continuation of the very programs that helped achieve those goals remain legal? In other words, as Justice Ginsburg recently said in arguments before the Supreme Court, could it now be that "what's constitutionally required one day gets constitutionally prohibited the next day?" Under the Court's current strict scrutiny test, the Court can only uphold race-preference programs if they meet one of two stated compelling governmental interests; remedying present effects of past discrimination or achieving "viewpoint diversity" in a classroom of higher education. This article argues that if the school desegregation plans fail to satisfy either of the Court's two stated compelling interest tests the Court should consider evaluating the programs under a new third compelling interest. Given the Court's commitment to enforcing social justice, the article proposes that the Court should find a compelling governmental interest in upholding a race-preference plan in instances where abolishing the plan would threaten a return to the de facto segregation the plan originally sought to cure. Part I of this article will define the historical evolution of the strict scrutiny test and the Court's willingness to allow the context of a particular race-preference issue to drive the definition of a compelling governmental interest. Part II of this article will consider appellate court responses to the applicability of the Court's two articulated compelling governmental interests particularly in cases considering challenges to race-preference student assignment plans. Finally, Part III will argue that the Court must create a new compelling governmental interest for evaluation of race-preference student assignment plans, since invalidation of these school board plans would cause a return to the social conditions that originally necessitated their creation.