cssi/SciSciGPT-SciSciNet huggingface dataset:
The Changing Social Contexts of Deforestation in the Brazilian Amazon

Objective. This article reviews changes in the social contexts of deforestation in the Brazilian Amazon from the 1970s to the 1990s, moving from the household to the global level. Methods. I draw on satellite imagery, state publications, farm surveys, ethnographic field work, and policy analyses for a comparative analysis that shows how land cover, agriculture, demographics, politics, and markets have changed over time. Results. Alterations in the social contexts of deforestation appear on all levels considered, from household demographic evolution and new land use strategies to a regional demographic transition and the emergence of cattle and timber economies, to a “greening” of Brazilian development policy and changes in national land markets, to multilateral bank loans for new infrastructure and local-international alliances between grassroots and environmental organizations. Conclusions. The social contexts of deforestation are very complex and changing and call for greater attention by social scientists to land cover and land use change.
A new gene involved in DNA double-strand break repair and V(D)J recombination is located on human chromosome 10p

V(D)J recombination, accountable for the diversity of T cell receptor- and immunoglobulin-encoding genes, is initiated by a lymphoid-specific DNA double-strand break. The general DNA repair machinery is responsible for the resolution of this break. Any defect in one of the known components of the DNA repair/V(D)J recombination machinery (Ku70, Ku80, DNA-PKcs, XRCC4 and DNA ligase IV) leads to abortion of the V(D)J rearrangement process, early block in both T and B cell maturation, and ultimately to severe combined immune deficiency (SCID) in several animal models. A human SCID condition is also characterized by an absence of mature T and B lymphocytes, and is associated with an increase in sensitivity to DNA-damaging agents (RS-SCID). None of the above-mentioned genes are defective in these patients, arguing for the likelihood of the existence of yet another unknown component of the V(D)J recombination/DNA repair apparatus. Athabascan-speaking (SCIDA) Navajo and Apache Native Americans have a very high incidence of T – B – SCID. The SCIDA locus is highly linked with markers on chromosome 10p, although the exact molecular defect has not been recognized in these patients. We show here that cells with the SCIDA defect are impaired in the DNA repair phase of V(D)J recombination similarly to RS-SCID, precisely an absence of V(D)J coding joint formation. Moreover, genotyping analysis in several RS-SCID families corroborates a linkage of the RS-SCID locus to the SCIDA region on chromosome 10p. These results demonstrate the presence of a new essential DNA repair/V(D)J recombination gene in this region, the mutation of which causes RS-SCID in humans.
Production and characterisation of a Legionella pneumophila specific monoclonal antibody

To better define the antigenic structure of the outer cell membranes of Legionellae, a panel of 6 monoclonal antibodies was raised against partially purified outer membranes of Legionella pneumophila serogroup 1, Corby strain. This study describes the purification and characterization of one of these monoclonal antibodies reacting with a 135-kDa protein, which was shown to be common to all 14 serogroups of Legionella pneumophila. It shows no cross-reactivity with 20 other Legionella species, or 9 other Gram-negative species tested by SDS-PAGE and Western blotting procedures. The epitope would appear to be predominantly surface exposed and, from preliminary detergent extraction studies, not peptidoglycan-associated.
Enhanced stability of hydrogen peroxide in the presence of subsurface solids

The stabilization of hydrogen peroxide was investigated as a basis for enhancing its downgradient transport and contact with contaminants during catalyzed H(2)O(2) propagations (CHP) in situ chemical oxidation (ISCO). Stabilization of hydrogen peroxide was investigated in slurries containing four characterized subsurface solids using phytate, citrate, and malonate as stabilizing agents after screening ten potential stabilizers. The extent of hydrogen peroxide stabilization and the most effective stabilizer were solid-specific; however, phytate was usually the most effective stabilizer, increasing the hydrogen peroxide half-life to as much as 50 times. The degree of stabilization was nearly as effective at 10 mM concentrations as at 250 mM or 1 M concentrations. The effect of stabilization on relative rates of hydroxyl radical activity varied between the subsurface solids, but citrate and malonate generally had a greater positive effect than phytate. The effect of phytate, citrate, and malonate on the relative rates of superoxide generation was minimal to somewhat negative, depending on the solid. The results of this research demonstrate that the stabilizers phytate, citrate, and malonate can significantly increase the half-life of hydrogen peroxide in the presence of subsurface solids during CHP reactions while maintaining a significant portion of the reactive oxygen species activity. Use of these stabilizers in the field will likely improve the delivery of hydrogen peroxide and downgradient treatment during CHP ISCO.
Antibody-mediated organ-allograft rejection

Recent studies show that alloantibodies mediate a substantial proportion of graft-rejection episodes, contributing to both early and late graft loss. Rejection that is caused by antibody is mediated by different mechanisms from rejection that is caused by T cells, thereby requiring other approaches to treatment and prevention. Antibody induces rejection acutely through the fixation of complement, resulting in tissue injury and coagulation. In addition, complement activation recruits macrophages and neutrophils, causing additional endothelial injury. Antibody and complement also induce gene expression by endothelial cells, which is thought to remodel arteries and basement membranes, leading to fixed and irreversible anatomical lesions that permanently compromise graft function.
North Atlantic Decadal Variability: Air–Sea Coupling, Oceanic Memory, and Potential Northern Hemisphere Resonance*

In this paper, the causes and mechanisms of North Atlantic decadal variability are explored in a series of coupled ocean–atmosphere simulations. The model captures the major features of the observed North Atlantic decadal variability. The North Atlantic SST anomalies in the model control simulation exhibit a prominent decadal cycle of 12–16 yr, and a coherent propagation from the western subtropical Atlantic to the subpolar region. A series of additional modeling experiments are conducted in which the air–sea coupling is systematically modified in order to evaluate the importance of air–sea coupling for the North Atlantic decadal variability being studied. This shall be referred to as “modeling surgery.” The results suggest the critical role of ocean–atmosphere coupling in sustaining the North Atlantic decadal oscillation at selected time scales. The coupling in the North Atlantic is characterized by a robust North Atlantic Oscillation (NAO)-like atmospheric response to the SST tripole anomaly, which tends to intensify the SST anomaly and, meanwhile, also provide a delayed negative feedback. This delayed negative feedback is predominantly associated with the adjustment of the subtropical gyre in response to the anomalous wind stress curl in the subtropical Atlantic. Atmospheric stochastic forcing can drive SST patterns similar to those in the fully coupled ocean–atmosphere system, but fails to generate any preferred decadal time scales. The simulated North Atlantic decadal variability, therefore, can be viewed as a coupled ocean–atmosphere mode under the influence of stochastic forcing. This modeling study also suggests some potential resonance between the Pacific and the North Atlantic decadal fluctuations mediated by the atmosphere. The modeling surgery indicates that the Pacific climate, although not a necessary precondition, can impact the North Atlantic climate variability substantially.
PAHs Underfoot: Contaminated Dust from Coal-Tar Sealcoated Pavement is Widespread in the United States

We reported in 2005 that runoff from parking lots treated with coal-tar-based sealcoat was a major source of polycyclic aromatic hydrocarbons (PAHs) to streams in Austin, Texas. Here we present new data from nine U.S. cities that show nationwide patterns in concentrations of PAHs associated with sealcoat. Dust was swept from parking lots in six cities in the central and eastern U.S., where coal-tar-based sealcoat dominates use, and three cities in the western U.S., where asphalt-based sealcoat dominates use. For six central and eastern cities, median SigmaPAH concentrations in dust from sealcoated and unsealcoated pavement are 2200 and 27 mg/kg, respectively. For three western cities, median SigmaPAH concentrations in dust from sealcoated and unsealcoated pavement are similar and very low (2.1 and 0.8 mg/kg, respectively). Lakes in the central and eastern cities where pavement was sampled have bottom sediments with higher PAH concentrations than do those in the western cities relative to degree of urbanization. Bottom-sediment PAH assemblages are similar to those of sealcoated pavement dust regionally, implicating coal-tar-based sealcoat as a PAH source to the central and eastern lakes. Concentrations of benzo[a]pyrene in dustfrom coal-tarsealcoated pavement and adjacent soils greatly exceed generic soil screening levels, suggesting that research on human-health risk is warranted.
Photovoltaic Effect at the Schottky Interface with Organic Single Crystal Rubrene

Rubrene single crystals can serve as a model material platform for studying the intrinsic photophysical processes in organic semiconductors and advance our understanding of material functionality in organic photovoltaic applications. The high degrees of structural order and material purity of organic single crystals enable a level of study that is unattainable in materials of current practical importance. Here, the photovoltaic effect at the Schottky interface of rubrene single crystal–aluminum electrode is demonstrated in a lateral ITO–rubrene–Al device geometry. The mechanism of the effect formation is explained based on the reconstructed energy band diagram of the ITO– rubrene–Al heterostructure. In particular, the open circuit voltage ( V OC ) of the devices shows a strong dependency on the interfacial band bending and corresponding built-in potential at the rubrene–Al Schottky interface. Initially, the photovoltage is found to be equal to the built-in potential at the Schottky interface defi ned by the work function difference between the bulk of rubrene and the Al electrode, that is, following the Schottky–Mott model. A good agreement is found between the systematically varied built-in potential and the resulting photovoltage magnitude upon insertion of an ultrathin LiF interlayer between the rubrene and Al electrode.
Low energy Ar ion bombardment damage of Si, GaAs, and InP surfaces

Abstract Argon bombardment damage to (100) surfaces of Si, GaAs, and InP for sputter ion-gun potentials of 1, 2, and 3 kilovolts was studied using Rutherford backscattering. Initial damage rates and saturation damage levels were determined. Bombardment damage sensitivity increased for the sequence Si, GaAs, and InP. Saturation damage levels for Si and GaAs correspond reasonably to LSS projected range plus standard deviation estimates; damage to InP exceeded this level significantly. For an ion-gun potential of 3 keV, the initial sputter yield of P from an InP surface exceeded the sputter yield of In by four atoms per incident Ar projectile.
Circadian rhythms lit up in Chlamydomonas

Recent work on the circadian clock of the unicellular green alga Chlamydomonas reinhardtii strengthens its standing as a convenient model system for circadian study. It was shown to be amenable to molecular engineering using a luciferase-based real-time reporter for circadian rhythms. Together with the completed draft genomic sequence, the new system opens the door for genome-scale forward and reverse genetic analysis.
TYROSINASE AND PLANT RESPIRATION

The evidence presented in this paper supports the conclusion that at least 85 per cent of the oxygen uptake of the respiring tissue of potato tuber enters the chemistry of the cell by way of a tyrosinase-catalyzed oxidation. The qualitative aspects of this conclusion are in agreement with the claim made by Boswell and Whiting. However, the evidence offered by them in support of this conclusion is shown to be inadequate.
Prescription Drugs And The Changing Patterns Of Treatment For Mental Disorders, 1996–2001

This paper uses detailed data on prescription drug and other services from the Medical Expenditure Panel Survey (MEPS) to examine recent trends in mental health and substance abuse (MH/SA) treatment between 1996 and 2001. While use of ambulatory services remained constant, prescription drug use increased rapidly, with the result that 5.5 million more Americans received treatment in 2001. Prescription drug spending increased at a real rate of almost 20 percent a year. About one-third of this increase came from more MH/SA medication users and two-thirds from higher costs per user.
Competitive Cofactor Recruitment by Orphan Receptor Hepatocyte Nuclear Factor 4α1: Modulation by the F Domain

For most ligand-dependent nuclear receptors, the status of endogenous ligand modulates the relative affinities for corepressor and coactivator complexes. It is less clear what parameters modulate the switch between corepressor and coactivator for the orphan receptors. Our previous work demonstrated that hepatocyte nuclear factor 4alpha1 (HNF4alpha1, NR2A1) interacts with the p160 coactivator GRIP1 and the cointegrators CBP and p300 in the absence of exogenously added ligand and that removal of the F domain enhances these interactions. Here, we utilized transient-transfection analysis to demonstrate repression of HNF4alpha1 activity by the corepressor silencing mediator of retinoid and thyroid receptors (SMRT) in several cell lines and on several HNF4alpha-responsive promoter elements. Glutathione S-transferase pulldown assays confirmed a direct interaction between HNF4alpha1 and receptor interaction domain 2 of SMRT. Loss of the F domain resulted in marked reduction of the ability of SMRT to interact with HNF4alpha1 in vitro and repress HNF4alpha1 activity in vivo, although the isolated F domain itself failed to interact with SMRT. Surprisingly, loss of both the A/B and F domains restored full repression by SMRT, suggesting involvement of both domains in the SMRT interaction. Finally, we show that when coexpressed along with HNF4alpha1 and GRIP1, CBP, or p300, SMRT can titer out HNF4alpha1-mediated transactivation in a dose-dependent manner and that this competition derives from mutually exclusive binding. Collectively, these results suggest that HNF4alpha can functionally interact with both a coactivator and a corepressor without altering the status of any putative ligand and that the presence of the F domain may play a role in discriminating between the different coregulators.
A Validation Study of the School Attitude Assessment Survey

This article describes the development of the School Attitude Assessment Survey (SAAS), an instrument that measures self-concept, self-motivation and self-regulation, attitude toward school, and pe...
CHARACTERISTICS OF TEACHER LEADERS FOR INFORMATION AND COMMUNICATION TECHNOLOGY

This chapter presents a typology of four dimensions of teacher leadership-a disposition to continually learn from and improve practice, collaboration with peers through critical examination and evolution of each others collaboration around technology; interpersonal networking in technology-active communities; and contributions through organizations to share knowledge about how technology is best used in teaching. The chapter concludes by pointing to several ways that technology leadership might be fostered.
Workshop The Challenge And The Reward Of Being An Entrepreneur In Medical Physics And Biomedical Engineering

Most medical physicists and biomedical engineers think of research in terms of the following paradigm: Conducting research leads to the discovery of new information. When this new information is placed in the context of what is already known through scientific publications and presentations of others, it constitutes new knowledge. This new knowledge becomes the subject of one or more scientific publications. These publications enhance the prospects of the physicist or engineer for new and continued research funding. The funding supports additional research that leads to discovery of more information, leading to additional new knowledge and publications. Through this process, the cycle repeats itself over and over - at least if the investigator is able to sustain his or her funding.
Dichotomy of Tenure and Biomedical Engineering Research with a Purpose in an Academic Setting.

I am one of the many biomedical engineering researchers whose work is built on strong interactions with physicians and basic scientists who find value in the way we approach healthcare problems from alternate perspectives. For example, I collaborated with multiple lung critical care physicians in the past 5 years, one of whom was a pediatric critical care physician at a children’s hospital in Memphis, TN, USA. We met regularly in lung physiology research meetings organized by our mentor to discuss problems relating to pediatric lung health, and we carried out research activities to understand the role of mechanobiology of potassium channels in the context of mechanical ventilation (1, 2). In addition to these types of research collaborations, biomedical engineers in academia contribute to the healthcare of pediatric patients also via design initiatives. Just yesterday, I listened to a set of senior design projects that displayed prototypes of at-home mechanical ventilator systems for young children aimed to increase their mobility. These projects were based on collaborations established between the therapists, clinicians, and professors at multiple institutions (Le Bonheur Children’s Hospital, University of Memphis, University of Tennessee Health Science Center). As such, most would agree with me in saying that these collaborations are important and necessary to develop and optimize healthcare solutions.
Short-Run Advertising Effects on Children: A Field Study:

Most evidence concerning the impact of television commercials on children has been derived from anecdotal reports [1] or from studies in which the dependent measures have been cognitive or attitudinal rather than behavioral [e.g., 6]. The exceptions are two recent experimental studies which have demonstrated that commercials can have a significant effect on children's behavioral choices in a laboratory setting [3, 5]. The present study examines the effectiveness of children's commercials in a field setting. Changes in children's toy and game choices were measured during the Christmas toy and game advertising campaign of November-December 1972. In the immediate pre-Christmas months, toy and game commercials constituted more than 50% of the advertising on children's television programs [2]. Whereas the usually predominant food and beverage advertising is spread throughout the year, half of the total volume of children's toy and game advertising is presented in November and December. This advertising concentration permits a naturalistic setting for a beforeand-after study of children's toy and game choices.
The beginning and release depth of mudstone overpressure in different evolution stages and its implication

The beginning and release depth of mudstone overpressure in different evolution stages have been studied quantitatively by using the mechanism of mudstone break and heal.The result indicates that except the first evolution stage where the release depth of overpressure is about 2.57 times of its beginning depth,other evolution stages have the release depths about 2 times of the beginning depths.This study can help predict the times of overpressure release as well as current evolution stage and ancient overpressure value,and study the terms of hydrocarbon expulsion from overpressure source rock and the times of hydrocarbon accumulation and diffusion.Taking K1qn mudstone in Well Gu11 in Gulong Sag of Songliao Basin as an example,the pattern of overpressure release depth in different evolution stages has been studied,and its implication of hydrocarbon expulsion and preservation is discussed.
Uplift and erosion of genomic islands with standing genetic variation

Details of the processes that generate biological diversity have long been of interest to evolutionary biologists. A common theme in nature is diversification via divergent selection with gene flow. Empirical studies on this topic find variable genetic differentiation throughout the genome, that genetic differentiation is non-randomly distributed, and that loci of adaptive significance are often found clustered together within “genomic islands of divergence”. Theoretical models based on new mutations show how these genomic islands can arise and grow as a result of a complex interaction of various evolutionary and genic processes. In the current study, I ask if such genomic islands can alternatively arise from divergent selection from standing genetic variation and I tested this using a simple two locus model of selection. There are numerous ways in which standing genetic variation can be partitioned (e.g., between alleles, between loci, and between populations) and I tested which of these scenarios can give rise to an island pattern compared to no genomic differentiation or complete genomic differentiation. I found that divergent selection, even without reciprocal gene exchange between populations, following a bout of admixture can relatively quickly produce an island pattern. Moreover, I found two pathways in which islands can form from divergence from standing variation: 1) through the build up of islands and 2) through the breakdown of larger, genome-wide differentiation. Lastly, similar to new mutation theory, I found that the frequency of recombination is an important determinant of island formation from standing genetic variation such that mating behavior of a species (e.g., facultative or obligate sexual) can impact the likelihood of island formation.
Therapeutic Nanoreactors: Toward a Better Blood Substitute

Nanoscience, once a field for discovery alone, has evolved into a design engineering enterprise. This is evident in the proliferation of multicomponent nanomaterials created to take advantage of unique material and interfacial features present in materials with nanoscale dimensions. Nanoreactors are a subset of such materials, designed as hosts for chemical and physical reactions generating physical conditions at the nanoscale that allow difficult processes to take place with minimal energy expenditure. This chapter outlines the use of this exciting technology in the development of therapeutic nanoparticles in the field of blood substitutes.
Mist Cooling Technology for Thermoelectric Power Plants

A novel mist-based cooling concept is analyzed with the objective of reducing water consumption in thermoelectric power plants. Additionally, this concept offers the potential to increase electricity generation capacity. The concept involves the integration of two independent mist-based technologies. In the first technology, the cooling tower is replaced with a two stage heat exchanger consisting of air-cooled and water mist-cooled sections. The mist-cooled heat exchanger chills the cooling water to near wet bulb temperature ambient, which enables lowered condenser pressures and temperatures. Enhanced evaporation control through mist cooling allows the mist to reach temperatures closer to wet bulb temperature conditions than cooling towers. In the second technology, the shell-and-tube steam condenser is replaced with a direct contact condenser, wherein Rankine cycle steam condenses on water mist streams. The large area offered by mist droplets increases heat transfer rates significantly, resulting in compact, low maintenance condensers.Analyses show that mist cooling technology can reduce water consumption by up to 65 %, compared to present-day cooling towers of the same power output. Furthermore, by reducing the condenser pressure, electricity generation can be increased by 4 % while still consuming less water than cooling towers. First-order techno-economic analyses reveal that mist cooling technology can benefit 17 out of 18 coal-fired power plants in Texas. It is expected that this technology will significantly benefit other U.S. power plants located in water-stressed areas.Copyright © 2016 by ASME
Environmental effects of a hard clam (Mercenaria mercenaria) aquaculture site in the Indian River Lagoon, Florida

Abstract The impact of the growout of cultured hard clams was evaluated at a commercial mariculture site in the Indian River Lagoon, Florida. Selected biological, chemical and physical factors were compared between a hard clam growout facility and two nearby reference locations. Measurements of water column nutrients, chlorophyll and dissolved oxygen concentrations gave no indication of differences which could be associated with the presence of the clam farm. Alteration of sediments towards a decreased mean sediment grain size associated with an increase in silt/clay sized particles, as well as an increase in organic content, were observed within 1 m of clam growout bags. Sediment changes did not result in significant changes in benthic dwelling organisms. Differences in mobile macrofauna were minimal, and most differences appear to be associated with variation in seagrass coverage.
The Role of Teachers' Social-Emotional Competence in Their Beliefs About Peer Victimization

One hundred fifty preservice teachers and 25 in-service teachers were surveyed to examine whether mental representations of relationships, confidence about managing bullying, empathy toward victims...
ETIOLOGIES, TRENDS AND PREDICTORS OF EARLY READMISSION AFTER VENTRICULAR TACHYCARDIA ABLATION: AN ANALYSIS OF 4,614 PATIENTS

Catheter ablation of Ventricular tachycardia(VT) has high efficacy but associated with several complications. Exploring etiologies, trends and predictors related to early readmission after VT ablation is critical to reduce cost burden. Study cohort was derived from National readmission dataset 2013
Don't be stupid

We are studying control knowledge for a general problem solver, named BLOCKHEAD. Currently the problem solver is based on negative heuristics, which has led to surprising efficiency in suitable domains. The lesson seems to be that it is easier to avoid being stupid than to try to be smart. Stupid plans are defined and a plan improvement method proposed. Analyses of stupid plans and failed plans suggest effective negative heuristics.
Aeration Systems for Large Navigable Rivers

River aeration systems, using only slight modifications of commercially available components, appear to offer a very economical means of achieving dissolved oxygen standards on major rivers. Whether surface aerators or bottom air diffusers are applicable to a given site depends primarily upon requirements of navigation. Spacing of aerator sites would require an analysis of dispersion characteristics and biochemical-oxygen-demand regimen. On critical areas of the Delaware estuary costs of obtaining the last milligram per liter of dissolved oxygen by river aeration are estimated to be less than one-third of the cost of obtaining the same objective through waste treatment only. There is a possibility that even lesser costs could be realized through use of pure oxygen dispersers, but these possibilities do not appear to have been fully explored.
What's the Risk? Older Women Report Fewer Symptoms for Suspected Acute Coronary Syndrome than Younger Women

The purpose of the study was to determine whether older (≥65 years) and younger (<65 years) women presenting to the emergency department (ED) with symptoms suggestive of acute coronary syndrome (ACS) varied on risk factors, comorbid conditions, functional status, and symptoms that have implications for emergent cardiac care. Women admitted to five EDs were enrolled. The ACS Symptom Checklist was used to measure symptoms. Comorbid conditions and functional status were measured with the Charlson Comorbidity Index and Duke Activity Status Index. Logistic regression models were used to evaluate symptom differences in older and younger women adjusting for ACS diagnosis, functional status, body mass index (BMI), and comorbid conditions. Analyses were stratified by age, and interaction of symptom by age was tested. Four hundred women were enrolled. Mean age was 61.3 years (range 21-98). Older women (n = 163) were more likely to have hypertension, hypercholesterolemia, never smoked, lower BMI, more comorbid conditions, and lower functional status. Younger women (n = 237) were more likely to be members of minority groups, be college-educated, and have a non-ACS discharge diagnosis. Younger women had higher odds of experiencing chest discomfort, chest pain, chest pressure, shortness of breath, nausea, sweating, and palpitations. Lack of chest symptoms and shortness of breath (key symptoms triggering a decision to seek emergency care) may cause older women to delay seeking treatment, placing them at risk for poorer outcomes. Younger African American women may require more comprehensive risk reduction strategies and symptom management.
Dissemination of healthy kids out of school principles for obesity prevention: A RE-AIM analysis.

Abstract Health-promoting behaviors for childhood obesity prevention are needed across multiple environments where children spend time, including out-of-school time (OST). Therefore Healthy Kids Out of School (HKOS) developed intervention strategies to promote three evidence-based principles (Drink Right, Move More, Snack Smart) for obesity prevention in OST. The strategies were developed with stakeholder input, disseminated, and evaluated (2012–2015) in two volunteer-led OST organizations, Boy Scouts of America (BSA) and 4-H, across three US states using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Mixed methods were used involving surveys, key informant interviews, and organizational-level data collection. Sixty out of 81 (74.1%) BSA districts and 4-H counties reaching 84,590 children (72% of children participating in BSA and 4-H in three states) adopted the strategies. 530 surveys completed by local OST leaders at baseline and 294 at follow-up showed the percentage of programs offering healthy beverages and opportunities for physical activity increased from baseline to follow-up (beverages 26% baseline, 35% follow-up, odds ratio (OR) 1.53; physical activity 31% baseline, 45% follow-up, OR 1.79; all p Intervention strategies developed with stakeholder input and disseminated with training can effectively facilitate healthy environments for children, and have potential for national scale.
Intermolecular Forces Model for Lipid Microbubble Shells.

Lipid-coated microbubbles are currently used clinically as ultrasound contrast agents for echocardiography and radiology and are being developed for many new diagnostic and therapeutic applications...
Multiphysics Modeling in Electromagnetics: Technical Challenges and Potential Solutions

As computational methods for solving Maxwell's equations mature, we can now start to tackle much more challenging multiphysics problems that have numerous applications in science and technology fields. In this article, we use four examples to illustrate the nature and modeling of multiphysics problems. The first example is related to electromagnetic (EM) hyperthermia for cancer treatment, which requires solving EM and bioheat transfer equations for the planning and optimization of the treatment process. The second example concerns the heat problem in integrated circuits (ICs) due to EM dissipated power, its effects, and a potential cooling solution, which requires an electrical-thermal-fluid-mechanical cosimulation. The third example considers modeling of monolithic microwave ICs (MMICs), which consist of both distributive and lumped circuit components. The fourth example simulates the air and dielectric breakdown in high-power microwave devices by coupling EM modeling with various plasma models. With these examples, we detail some of the technical challenges typically encountered in multiphysics modeling and their potential solutions.
The impact of expanded Medicaid eligibility on access to naloxone.

Background and aims Federal, state and local US governments have sought interventions to reduce deaths due to opioid overdoses by increasing the availability of naloxone. The Affordable Care Act (ACA) expanded Medicaid coverage to low-income, childless adults, potentially giving this group financial access to naloxone. The aims of this paper are: (1) to describe the changes in the amount of Medicaid-covered naloxone used between 2009 and 2016 and (2) to quantify the differential change in the amount of dispensed naloxone between states that expanded their Medicaid programs and states that did not. Design A quasi-experimental approach based on states' ongoing choice to expand their Medicaid program to all adults with incomes between 100 and 138% of the federal poverty line (FPL), starting in 2014. As of 2018, 37 states had expanded and 14 states had not. Estimation of the policy impact relies on a difference-in-difference method. Setting US state Medicaid programs. Participants and measurements Data are from the Medicaid Drug Rebate Program and include all dispensed prescriptions of naloxone through the Medicaid program. State/quarters with fewer than 10 prescriptions are suppressed; n = 1632. Findings Prior to Medicaid expansion, the number of Medicaid-covered naloxone prescriptions was very similar in expansion and non-expansion states. On average, states that expanded Medicaid had 78.2 (95% confidence interval = 16.0-140.3, P = 0.02) more prescriptions per year for naloxone compared with states that did not expand Medicaid coverage, a nearly 10 increase over the pre-expansion years. Medicaid expansion contributed to this growth in Medicaid-covered naloxone more than other state-level naloxone policies. Conclusions Medicaid accounts for approximately a quarter of naloxone sales. Medicaid expansion generated 8.3% of the growth in naloxone units from 2009 to 2016, holding other factors constant.
Percutaneous Endoscopic Gastrostomy (PEG) Rescue

Percutaneous endoscopic gastrostomy (PEG) tubes are a common method of enteral feeding access. Early dislodgment can present challenges for safe management and replacement. Here we highlight the challenges of this clinical problem and considerations when entertaining endoscopic management. The patient characteristics that determine appropriateness for PEG rescue are discussed. Technical components of PEG rescue as well as concepts pertaining to natural orifice transluminal endoscopic surgery (NOTES) are explained.
Wearable Egocentric Camera as a Monitoring Tool of Free-Living Cigarette Smoking: A Feasibility Study

Introduction Wearable sensors may be used for the assessment of behavioral manifestations of cigarette smoking under natural conditions. This paper introduces a new camera-based sensor system to monitor smoking behavior. The goals of this study were (1) identification of the best position of sensor placement on the body and (2) feasibility evaluation of the sensor as a free-living smoking-monitoring tool. Methods A sensor system was developed with a 5MP camera that captured images every second for continuously up to 26 hours. Five on-body locations were tested for the selection of sensor placement. A feasibility study was then performed on 10 smokers to monitor full-day smoking under free-living conditions. Captured images were manually annotated to obtain behavioral metrics of smoking including smoking frequency, smoking environment, and puffs per cigarette. The smoking environment and puff counts captured by the camera were compared with self-reported smoking. Results A camera located on the eyeglass temple produced the maximum number of images of smoking and the minimal number of blurry or overexposed images (53.9%, 4.19%, and 0.93% of total captured, respectively). During free-living conditions, 286,245 images were captured with a mean (±standard deviation) duration of sensor wear of 647(±74) minutes/participant. Image annotation identified consumption of 5(±2.3) cigarettes/participant, 3.1(±1.1) cigarettes/participant indoors, 1.9(±0.9) cigarettes/participant outdoors, and 9.02(±2.5) puffs/cigarette. Statistical tests found significant differences between manual annotations and self-reported smoking environment or puff counts. Conclusions A wearable camera-based sensor may facilitate objective monitoring of cigarette smoking, categorization of smoking environments, and identification of behavioral metrics of smoking in free-living conditions. Implications The proposed camera-based sensor system can be employed to examine cigarette smoking under free-living conditions. Smokers may accept this unobtrusive sensor for extended wear, as the sensor would not restrict the natural pattern of smoking or daily activities, nor would it require any active participation from a person except wearing it. Critical metrics of smoking behavior, such as the smoking environment and puff counts obtained from this sensor, may generate important information for smoking interventions.
Patterns of Treatment among Patients with Recently-Diagnosed Myelodysplastic Syndromes in a National Registry, 2006–2008

Abstract Background: Patterns of treatment among patients with recently-diagnosed myelodysplastic syndrome (MDS) are of particular interest with the recent introduction of disease-modifying treatments (DMT), and have not been characterized on a population basis. Methods: The “Patient Registries at Slone: MDS” is a national disease-based observational registry conducted by Boston University. All patients with MDS diagnosed within 4 months of enrollment are eligible for inclusion. Patients obtain information about the registry from their treating physicians or the internet and self-enroll. Information on treatment, clinical events, and quality of life is obtained by questionnaire and medical record review at baseline and at six-month intervals. We report on 290 patients residing in 44 states who were enrolled from June 2006 through June 2008 and completed a baseline questionnaire within six months of diagnosis. Results: A total of 71 of the 290 patients (24%) had received DMT since diagnosis, including azacitidine (9%), decitabine (7%), lenalidomide (6%), or multiple agents (2%). In contrast, 167 (58%) reported receiving supportive therapy such as erythropoesis-stimulating agents (ESAs; 43%), myeloid growth factors (12%), iron chelators (1%), or antibiotics (16%)(categories not mutually exclusive). Patients from New England had the lowest prevalence of DMT (6%). Overall, lack of prescription drug coverage was associated with a lower rate of DMT (11% vs. 25% in covered patients). Patients who received DMT were also more likely to receive supportive therapy: 55% were treated with ESAs compared to 39% of patients without DMT (p=0.03); the corresponding proportions for myeloid growth factors were 32% vs. 5% (p Conclusions: Our results suggest that in the modern treatment era, the majority of newly-diagnosed MDS patients in the United States receive supportive therapy soon after their initial diagnosis, while relatively few receive DMT. In our cohort, those who did receive DMT were much more likely to receive supportive treatment as well, perhaps to ameliorate the hematologic side effects of treatment. It is noteworthy that nearly one-third of patients treated with a DNA hypomethylating agent were classified as intermediate-1. A sizable proportion who received lenalidomide either did not have 5q- or were classified as intermediate-2, which are outside the drug's approved indications.
The effect of Instagram and photograph editing on seeking dermatologic care.

Background Photograph editing has become popular for individuals using social media like Instagram. However, it is unknown if the use of social media and photograph editing applications by young adults has an association with seeking dermatologic care. Aims To assess the frequency of photograph editing among a cohort of young adults using Instagram and the association with seeking dermatologic care. Methods A population-based survey was administered to undergraduate students from April 2019 to May 2019 through an online platform. Results Of the 257 responses, 228 (88.7%) reported that they edited a photograph prior to posting on Instagram. Of those who reported editing a photograph, 145 (63.6%) edited a skin lesion, 104 (45.6%) whitened teeth, and 70 (30.7%) altered the size of their body. Of those who edited skin lesions, 128 (88.3%) edited acne/acne scars. Those who felt the editing made them more aware of their skin lesions were significantly more likely to feel they needed to see a dermatologist (P = .02, 95% CI). Conclusion Photograph editing is common among young adults using Instagram, especially in individuals with acne/acne scars. The effect of this behavior may be a motivating factor for individuals seeking dermatologic care.
A quality improvement project to decrease utilization of multilumen peripherally inserted central catheters

We performed a quality improvement project to decrease utilization of multilumen peripherally inserted central catheters (PICCs) in favor of single-lumen PICCs and midline catheters. Through optimization of electronic orders, education and decision support, we decreased utilization of multilumen PICCs, changed provider ordering patterns, and showed a downward trend in CLABSIs.
Risk Factors and Predictors of Rebound Hyperbilirubinemia in a Term and Late-Preterm Infant with Hemolysis

Objective This study aimed to assess the incidence and predictors of rebound in term and late-preterm infants with hemolytic hyperbilirubinemia postphototherapy. Study Design A 4-year retrospective data analysis of neonates with hemolytic indirect hyperbilirubinemia admitted to the neonatal intensive care unit (NICU) of Medina Maternity and Children's Hospital was conducted. Bilirubin rebound was defined as the return of total serum bilirubin (TSB) to phototherapy threshold within 72 hours of postphototherapy. Results Of 386 identified neonates; 44 (11%) experienced rebound. Neonates in the rebound group demonstrated significantly higher levels of peak TSB, TSB at discontinuation of phototherapy, and lower value of relative TSB (difference between TSB at phototherapy termination and the American Academy of Pediatrics [AAP] threshold for phototherapy at concurrent age) compared with nonrebound group (p-value: Conclusion Relative TSB at phototherapy termination is the best predictor for postphototherapy rebound hyperbilirubinemia in neonates with hemolytic etiology. Key Points
CS as a Novel Biomarker for Diagnosis of Cardiac Allograft Rejection

Purpose Cardiac bridging integrator 1 (cBIN1) is a cardiomyocyte protein which regulates excitation-contraction coupling and is downregulated with adverse myocardial remodeling. The natural log of the inverse of cBIN1 plasma concentration known as CS, has been shown to be a diagnostic and prognostic marker for ambulatory heart failure patients. In this pilot study, we examined the performance of CS as a diagnostic marker of cardiac allograft rejection. Methods Out of 708 heart transplant (HT) recipients consented for the study from 2014 to 2018, 12 patients experienced advanced rejection (AMR/ACR grade ≥2) with CS level drawn at the time. Convalescent sera were drawn at least 6 months post therapy. A control group of 11 patients was matched by age, sex and time since HT. CS was measured in plasma samples by Sarcotein, Inc. Pair-wise comparison of CS among the 2 groups was performed using the Wilcoxon signed rank test. Major adverse outcomes (MACE), defined as ventricular tachycardia, cardiac allograft vasculopathy, recurrent rejection, cardiac hospitalization, and death were determined by chart review at most recent clinic visit. Results Rejection occurred at 211 (IQR 127-303) days post-HT. Patients with rejection had significantly lower CS levels compared to controls (1.92[IQR 1.57-2.33] vs 2.36[IQR 1.86-3.71] p=0.03). Following anti-rejection therapy, CS values were determined at 189 (IQR 126.8-303) days after the episode and did not differ significantly from the time of rejection. Notably, post rejection patients experienced a high rate of MACE (7/12) at 4 years of follow-up. Those who experienced MACE had a numerically higher median increase in CS values on follow-up compared to those who did not (1.04 vs 0.50). Conclusion In this pilot study, CS shows promise as a marker of cardiac allograft rejection. CS was significantly decreased by 20% in the setting of rejection compared to matched control samples. Larger studies are needed to validate our findings and determine the prognostic value of CS level changes post-therapy.
The Adult Respiratory Distress Syndrome

Acute respiratory insufficiency, although previously recognized in certain types of extra-thoracic trauma prior to and during World War II, has recently been shown to accompany a wide variety of conditions not primarily involving the chest. In addition to direct damage by penetrating injuries of the chest, burns involving the airway, contustion of the lung, and lung transplantation or reimplantation, pulmonary function may be compromised by fat embolism, high concentrations of oxygen, long term positive ressure respiratory support, intracranial injury, extra-thoracic trauma, and shock of several etiologies. The clinical picture and the histology of the lung changes in each of these conditions is quite similar reflecting the probability that the lung is limited in the response it can produce to damage. Although in a given patient, several of these factors may contribute to the clinical condition, they will be discussed separately.
'I'm being forced to make decisions I have never had to make before': Oncologists and the conundrums created by COVID-19

12001Background: The COVID-19 pandemic has created conundrums for physicians. This study examines the experiences of oncologists who engage in complex decision-making regarding the use of chemother...