cssi/SciSciGPT-SciSciNet huggingface dataset:
Can applied external fixators be sterilized for surgery? A prospective cohort study of orthopaedic trauma patients.

Abstract Background Temporary external fixators are often used to stabilize fractures when definitive fracture surgery must be delayed. Sometimes, external fixators are left in place during repeat operations, including definitive internal fixation of tibial pilon and tibial plateau fractures. It is unknown how well current surgical preparation sterilizes these devices, which become part of the surgical field. Our hypothesis was that our institution’s standard surgical preparation creates a low rate of culture-positive environments on external fixators at the time of surgical skin incision. Methods We prospectively consented and enrolled patients to obtain cultures (48 patients, 55 external fixators, 165 sets of culture data). After standard preparation and immediately before incision, cultures were obtained from three sites on each external fixator: 1) most distal pin 1 cm from pin-skin interface, 2) most distal bar at midpoint between pin and clamp connectors, and 3) most distal clamp at bar-clamp interface. Our standard preparation for patients with external fixation in place is to don sterile gloves and wipe down all components of the external fixator with 70% alcohol-soaked sterile 4 × 4 in gauze sponges before skin preparation. The skin and external fixator are then prepped in the usual fashion with ChloraPrep for closed wounds or with povidone iodine scrub and paint for open wounds. Swabs were processed and organisms from cultures identified. Clinicians were blinded to study results until study completion. Results Two of 165 cultures (1.2%; 95% confidence interval [CI]: 0–2.9%) were positive for common pathogens sometimes observed in surgical site infection. Four cultures (2.4%; 95% CI: 0–4.8%) had pathogens that are rarely associated with surgical site infection, and four (2.4%; 95% CI: 0–4.8%) had nonpathogenic organisms. Conclusion Using 70% alcohol on external fixators plus either ChloraPrep for closed wounds or povidone iodine for open wounds seems to result in a low rate of positive cultures. Most species that were isolated are infrequently identified as sources of surgical site infections. This preparation protocol might be effective at producing a relatively clean environment at the time of surgery for patients with external fixators already in place.
Inferences from logistic regression models in the presence of small samples, rare events, nonlinearity, and multicollinearity with observational data

ABSTRACTThe logistic regression model has been widely used in the social and natural sciences and results from studies using this model can have significant policy impacts. Thus, confidence in the reliability of inferences drawn from these models is essential. The robustness of such inferences is dependent on sample size. The purpose of this article is to examine the impact of alternative data sets on the mean estimated bias and efficiency of parameter estimation and inference for the logistic regression model with observational data. A number of simulations are conducted examining the impact of sample size, nonlinear predictors, and multicollinearity on substantive inferences (e.g. odds ratios, marginal effects) when using logistic regression models. Findings suggest that small sample size can negatively affect the quality of parameter estimates and inferences in the presence of rare events, multicollinearity, and nonlinear predictor functions, but marginal effects estimates are relatively more robust to...
Synaptic NMDA Receptor Activation Induces Ubiquitination and Degradation of STEP61

NMDA receptor signaling is critical for the development of synaptic plasticity, learning, and memory, and dysregulation of NMDAR signaling is implicated in a number of neurological disorders including schizophrenia (SZ). Previous work has demonstrated that the STriatal-Enriched protein tyrosine Phosphatase 61 kDa (STEP61) is elevated in human SZ postmortem cortical samples and after administration of psychotomimetics to cultures or mice. Here, we report that activation of synaptic NMDAR by bicuculline or D-serine results in the ubiquitination and proteasomal degradation of STEP61, and increased surface localization of GluN1/GluN2B receptors. Moreover, bicuculline or D-serine treatments rescue the motor and cognitive deficits in MK-801-treated mice and reduce STEP61 in mouse frontal cortex. These results suggest that STEP61 may contribute to the therapeutic effects of D-serine.
MACRA: Big Fix or Big Problem?

This commentary discusses how the design of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will result in unintended consequences and incentives that will increase health care dis...
Reclaiming Instructional Design.

Education and its related disciplines continue to flutter this way and that by every philosophical wind that blows. In an uncertain science and technology, unscientific theories flourish. People are anxious for answers. When answers are slow in coming, uncertain in statement, and difficult to find; then the void is filled with wild speculation and philosophical extremism. This brief statement attempts to make clear our belief that instruction is a science and that instructional design is a technology founded in this science. We attempt to identify some of the assumptions underlying the science-based technology of instructional design, and to clarify its role in the larger context of education and social change.
Physical activity measured with wrist and ankle accelerometers: Age, gender, and BMI effects

Physical activity (PA) is associated with various aspects of physical and mental health and varies by age and BMI. We aimed to compare PA measures obtained with wrist and ankle accelerometers and characterize their associations with age and BMI. We assessed PA mean and PA variability (indexed by coefficient of variation (CV)) at daytime and nighttime periods for seven consecutive days (M = 152.90 h) in 47 healthy participants (18-73 years old, 21 females). Diurnally, mean PA for both ankle and wrist and CV of PA for ankle decreased from the first to the second half of daytime (p 0.2). CV of ankle PA at daytime was significantly higher than wrist PA (p < .0001). The opposite pattern was observed at nighttime (p < .0001). Pearson correlation analyses were performed to assess the associations between wrist (or ankle) PA and age and BMI. Mean daytime (but not nighttime) activity for wrist and ankle decreased significantly with age (p < .05). PA variability also decreased with age for wrist and ankle during daytime and for ankle during nighttime (p < .05). BMI was negatively associated with wrist daytime PA variability (p < .05). There were no gender effects on activity measures. These findings indicate that wrist and ankle mean PA measures were not significantly different but were significantly different (p < 0.5) for PA variability in both daytime and nighttime. Age-related decreases of PA-mean and variability were observed during daytime in wrist and ankle, whereas higher wrist daytime variability was inversely associated with BMI. These findings provide new insights into PA features in free-living environment, which are relevant for public health and may have implications for clinical assessment of neurodegenerative disorders impacting PA and their interaction with demographics.
Phonological basis in reading disability: A review and analysis of the evidence

Poor readers are known to do consistently worsethan their normal reading peers on tasks ofphonological processing. They are characterizedby their difficulties in printed wordrecognition, phonological awareness andphonological decoding. An increasing body ofevidence points to deficits in speechperception as a source of subtle but ramifyingeffects in reading impaired children andadults. These deficits may be traced to poorlycoded phonological representations. Thisarticle will attempt to explain poor readers'difficulties in phonological coding by drawingon a gestural account speech development.Implications of this approach for readingintervention will be presented.
Role of Ischemia–Reperfusion Injury in Coronary MVO

Abstract The abrupt restoration of blood flow during the treatment of acute myocardial infarction is associated with coronary microvascular obstruction (MVO) and further myocardial damage, referred to as “ischemia–reperfusion injury.” This chapter reviews and discusses the pathophysiology of MVO during ischemia–reperfusion injury. Proposed mechanisms include oxygen free radicals induced vascular damage, exaggerated capillary vasoconstriction and impaired vasodilatation, external capillary compression by endothelial cell and cardiomyocyte swelling, microembolization from the atherosclerotic plaque, plugging of activated neutrophils interacting with the endothelium and microthrombi formation. Emerging data also suggests that in severe cases of microvascular injury, blood extravasation and local hemorrhage can exacerbate microvascular and myocardial damage. Many of these mechanisms may be synergistic in causing MVO and malperfusion, and it is plausible that depending on the clinical scenarios some mechanisms may predominate over others.
Radar Observations of a Frontal Storm

The development of frontal precipitation as observed by radar is illustrated by data taken on a particular storm. This storm presents a typical sequence of precipitation patterns found to be associ...
Glutamatergic Projections to the Cochlear Nucleus are Redistributed in Tinnitus

Abstract Tinnitus alters auditory–somatosensory plasticity in the cochlear nucleus (CN). Correspondingly, bimodal auditory–somatosensory stimulation treatment attenuates tinnitus, both in animals and humans (Marks et al., 2018). Therefore, we hypothesized that tinnitus is associated with altered somatosensory innervation of the CN. Here, we studied the expression of vesicular glutamate transporters 1 and 2 (VGLUT1 and VGLUT2) in the CN, which reveals glutamatergic projections from the cochlea as well as somatosensory systems to this brainstem auditory center. Guinea pigs were unilaterally exposed to narrowband noise and behaviorally tested for tinnitus using gap-prepulse inhibition of the acoustic startle. Following physiological and behavioral measures, brain sections were immunohistochemically stained for VGLUT1 or VGLUT2. Puncta density was determined for each region of the ipsilateral and contralateral CN. Tinnitus was associated with an ipsilateral upregulation of VGLUT2 puncta density in the granule cell domain (GCD) and anteroventral CN (AVCN). Furthermore, there was a tinnitus-associated interaural asymmetry for VGLUT1 expression in the AVCN and deep layer of the dorsal CN (DCN3), due to contralateral downregulation of VGLUT1 expression. These tinnitus-related glutamatergic imbalances were reversed upon bimodal stimulation treatment. Tinnitus-associated ipsilateral upregulation of VGLUT2-positive projections likely derives from somatosensory projections to the GCD and AVCN. This upregulation may underlie the neurophysiological hallmarks of tinnitus in the CN. Reversing the increased ipsilateral glutamatergic innervation in the CN is likely a key mechanism in treating tinnitus.
A Real-World Password Cracking Demonstration Using Open Source Tools for Instructional Use

Passwords are the among the most standard ways to protect and authenticate the security of a network or any other confidential information. Password cracking helps in the penetration testing so that we can find out the strength of a password. In this paper, we are going to discuss different types of password cracking tools with an emphasis on THC Hydra. We are also going to discuss different types of attacks that can be launched by password cracking tools. The paper specifically demonstrates the attack of THC Hydra on an FTP server and an SSH server that can be used in the teaching of a foundational cybersecurity course. We conclude the paper with a discussion on several actions that can be taken for end-user protection.
Abstract C35: Examining the role of social support and spirituality on the health status of Hispanic cancer survivors

Purpose: Although overall survival rates continue to improve for many cancers, disparities persist for ethnic minorities who have a disproportionately high risk of experiencing poor mental health and quality of life. However, limited research has examined the role of social support and spirituality on the health status of Hispanic cancer survivors. This study examined differences between Hispanics and non-Hispanics on health status, emotional support, and spirituality. It also examined the role of social support and spirituality on health status of cancer survivors directly and mediated through emotional distress and mental health. Methods: We analyzed data (N=9,170) from the American Cancer Society9s Study of Cancer Survivors-II (SCS-II), a national cross-sectional study of adult cancer survivors diagnosed at 2, 5, or 10 years prior to sampling. Preliminary analysis compared sociodemographic and medical characteristics between Hispanic and non-Hispanic cancer survivors to identify significant covariates of health status. We used structural equation modeling (SEM) to assess if the latent variables of mental health and emotional distress mediate the impact of social support and spirituality (also modeled as latent variables) on the health status of Hispanic cancer survivors. The final model included sociodemographic characteristics such as age and marital status, health insurance coverage, and cancer-related covariates such as time since diagnosis. Measurement models for social support, spirituality, emotional distress, and mental health were built based on literature and modified through adding meaningful error-covariances. SEM models were estimated in Mplus 7.4. Model fit was assessed using chi-square, RMSEA, TLI, and CFI. Results: Overall, 7.6% of survivors were Hispanics (n=693) and 92.4% were non-Hispanics (n=8,477). Compared to their non-Hispanic counterparts, Hispanics were significantly younger (M= 63.4 ±12.6 vs 67.7 ±11.8, p=0.002) and had lower levels of educational attainment (X2=347.7, p Conclusion: Hispanic cancer survivors were more likely to report poor health (general health, mental health, and emotional distress). Although data were cross-sectional, findings from this study suggest that the association between spirituality and health is mediated by mental health among Hispanic cancer survivors. Future studies are needed to determine if interventions to enhance spiritual well-being as a coping mechanism will have a direct impact on health of Hispanic cancer survivors. Citation Format: Carol Ochoa, Regine Haardorfer, Cam Escoffery, Kevin Stein, Kassandra I. Alcaraz. Examining the role of social support and spirituality on the health status of Hispanic cancer survivors [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C35.
Predictive Modeling of Obesity Prevalence for the U.S. Population

Modeling obesity prevalence is an important part of the evaluation of mortality risk. A large volume of literature exists in the area of modeling mortality rates, but very few models have been deve...
Reverted austenite with distinct characteristics in a new cobalt-free low lattice misfit precipitate-bearing 19Ni3Mo1.5Ti maraging steel

Abstract We elucidate here the morphological evolution of reverted austenite in a newly designed cobalt-free maraging steel and its significance in predicting the mechanical behavior. Three distinct types of reverted austenite, granular reverted austenite at grain boundaries (γG1), lamellar reverted austenite in the matrix (γL) and globular reverted austenite (γG2) were observed, depending on the aging temperature and time. At low temperatures (560 °C and 640 °C), only γG1 and γL were observed. While at relatively high temperature (700 °C), γG1 and γL decreased with the increase of holding time and were completely transformed to γG2 at equilibrium condition. The observation of three different morphologies of reverted austenite are envisaged to be a consequence of competition between the nucleation rate and growth rate of reverted austenite at different aging temperatures. The weak texture of maraging steel with high Schmid factor at high aging temperature implied that γL and γG2 are the reasons for superior toughness and ductility. The present study of nature of austenite is also of significant interest in next generation of advanced high strength steels because of its remarkable effect on ductility.
Adult exposure to insecticides causes persistent behavioral and neurochemical alterations in zebrafish.

Abstract Farmers are often chronically exposed to insecticides, which may present health risks including increased risk of neurobehavioral impairment during adulthood and across aging. Experimental animal studies complement epidemiological studies to help determine the cause-and-effect relationship between chronic adult insecticide exposure and behavioral dysfunction. With the zebrafish model, we examined short and long-term neurobehavioral effects of exposure to either an organochlorine insecticide, dichlorodiphenyltrichloroethane (DDT) or an organophosphate insecticide chlorpyrifos (CPF). Adult fish were exposed continuously for either two or 5 weeks (10–30 nM DDT, 0.3–3 μM CPF), with short- and long-term effects assessed at 1-week post-exposure and at 14 months of age respectively. The behavioral test battery included tests of locomotor activity, tap startle, social behavior, anxiety, predator avoidance and learning. Long-term effects on neurochemical indices of cholinergic function were also assessed. Two weeks of DDT exposure had only slight effects on locomotor activity, while a longer five-week exposure led to hypoactivity and increased anxiety-like diving responses and predator avoidance at 1-week post-exposure. When tested at 14 months of age, these fish showed hypoactivity and increased startle responses. Cholinergic function was not found to be significantly altered by DDT. The two-week CPF exposure led to reductions in anxiety-like diving and increases in shoaling responses at the 1-week time point, but these effects did not persist through 14 months of age. Nevertheless, there were persistent decrements in cholinergic presynaptic activity. A five-week CPF exposure led to long-term effects including locomotor hyperactivity and impaired predator avoidance at 14 months of age, although no effects were apparent at the 1-week time point. These studies documented neurobehavioral effects of adult exposure to chronic doses of either organochlorine or organophosphate pesticides that can be characterized in zebrafish. Zebrafish provide a low-cost model that has a variety of advantages for mechanistic studies and may be used to expand our understanding of neurobehavioral toxicity in adulthood, including the potential for such toxicity to influence behavior and development during aging.
Analysis of quasi-dynamic ordinary differential equations and the quasi-dynamic replicator

Abstract We study the mathematical properties of the quasi-dynamic ordinary differential equations defined empirically in Chen et al. (2019). In particular, we show how the allometric scaling mentioned in that work emerges naturally from the generalized Lotka–Volterra model under the quasi-dynamic ordinary differential equations paradigm. We then define and study the proportional quasi-dynamic ordinary differential equations and discuss the relationship of this equation system to both the classical and discrete time replicator dynamics. We prove asymptotic properties of these systems for large and small populations and show that there exist populations for which the proportion of the population varies cyclically as a function of total logarithmic population size.
Analysis of malignant thyroid nodules that do not meet ACR TI-RADS criteria for fine-needle aspiration

OBJECTIVE. Compared with other guidelines, the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) has decreased the number of nodules for which fine-needle aspiration is recommended. The purpose of this study was to evaluate the characteristics of malignant nodules that would not be biopsied when the ACR TI-RADS recommendations are followed. MATERIALS AND METHODS. We retrospectively reviewed a total of 3422 thyroid nodules for which a definitive cytologic diagnosis, a definitive histologic diagnosis, or both diagnoses as well as diagnostic ultrasound (US) examinations were available. All nodules were categorized using the ACR TI-RADS, and they were divided into three groups according to the recommendation received: fine-needle aspiration (group 1), follow-up US examination (group 2), or no further evaluation (group 3). RESULTS. Of the 3422 nodules, 352 were malignant. Of these, 240 nodules were assigned to group 1, whereas 72 were assigned to group 2 and 40 were included in group 3. Sixteen of the 40 malignant nodules in group 3 were 1 cm or larger, and, on the basis of analysis of the sonographic features described in the ACR TI-RADS, these nodules were classified as having one of five ACR TI-RADS risk levels (TR1-TR5), with one nodule classified as a TR1 nodule, eight as TR2 nodules, and seven as TR3 nodules. If the current recommendation of no follow-up for TR2 nodules was changed to follow-up for nodules 2.5 cm or larger, seven additional malignant nodules and 316 additional benign nodules would receive a recommendation for follow-up. If the current size threshold (1.5 cm) used to recommend US follow-up for TR3 nodules was decreased to 1.0 cm, seven additional malignant nodules and 118 additional benign nodules would receive a recommendation for follow-up. CONCLUSION. With use of the ACR TI-RADS, most malignant nodules that would not be biopsied would undergo US follow-up, would be smaller than 1 cm, or would both undergo US follow-up and be smaller than 1 cm. Adjusting size thresholds to decrease the number of missed malignant nodules that are 1 cm or larger would result in a substantial increase in the number of benign nodules undergoing follow-up.
Using Online Communication Skills Training to Increase Organ Donation Authorization

Introduction:Family denial of organ donation from deceased donor-eligible patients is a major contributor to the deficit of transplantable organs in the United States.Research Question:Does an evid...
Off-Peak Near-Infrared-II (NIR-II) Bioimaging of an Immunoconjugate Having Peak Fluorescence Emission in the NIR-I Spectral Region for Improving Tumor Margin Delineation

The primary treatment for malignant tumors remains to be resection. The strongest predictor of recurrence and postoperative prognosis is whether diseased tissue/cells remain(s) at the surgical marg...
A Novel Use of Artificial Intelligence to Examine Diversity and Hospital Performance.

Abstract Background The US population is becoming more racially and ethnically diverse. Research suggests that cultural diversity within organizations can increase team potency and performance, yet this theory has not been explored in the field of surgery. Furthermore, when surveyed, patients express a desire for their care provider to mirror their own race and ethnicity. In the present study, we hypothesize that there is a positive correlation between a high ranking by the US News and World Report for gastroenterology and gastrointestinal (GI) surgery and greater racial, ethnic, and gender diversity among the physicians and surgeons. Methods We used the 2019 US News and World Report rankings for best hospitals by specialty to categorize gastroenterology and GI surgery departments into 2 groups: 1-50 and 51-100. Hospital websites of these top 100 were viewed to determine if racial diversity and inclusion were highlighted in the hospitals' core values or mission statements. To determine the rates of diversity within departments, Betaface ( Betaface.com ) facial analysis software was used to analyze photos taken from the hospitals’ websites. This software was able to determine the race, ethnicity, and gender of the care providers. We examined the racial and ethnic makeup of the populations served by these hospitals to see if the gastroenterologists and surgeons adequately represented the state population. We then ran the independent samples t-test to determine if there was a difference in rankings of more diverse departments. Results Hospitals with gastroenterology and GI surgery departments in the top 50 were more likely to mention diversity on their websites compared with hospitals that ranked from 51-100 (76% versus 56%; P = 0.035). The top 50 hospitals had a statistically significant higher percentage of underrepresented minority GI physicians and surgeons (7.01% versus 4.04%; P Conclusions We used artificial intelligence software to determine the degree of racial and ethnic diversity in gastroenterology and GI surgery departments across the county. Higher ranking hospitals had a greater degree of diversity of their faculty and were more likely to emphasize diversity in their mission statements. Hospitals stress the importance of having a culturally diverse staff, yet their care providers may not adequately reflect the populations they serve. Further work is needed to prospectively track diversity rates over time and correlate these changes with measurable outcomes.
Driven-dissipative Ising Model: An exact field-theoretical analysis

Driven-dissipative many-body systems are difficult to analyze analytically due to their nonequilibrium dynamics, dissipation, and many-body interactions. In this paper, we consider a driven-dissipative infinite-range Ising model with local spontaneous emission, which naturally emerges from the open Dicke model in the large-detuning limit. Utilizing an adaptation of the Suzuki-Trotter quantum-to-classical mapping, we develop an exact field-theoretical analysis and a diagrammatic representation of the spin model that can be understood from a simple scattering picture. With this representation, we are able to analyze critical behavior, finite-size scaling, and the effective temperature near the respective phase transition. Our formalism further allows a detailed study of the ordered phase where we find a ``heating'' region within which the effective temperature becomes negative, thereby exhibiting a truly nonequilibrium behavior. At the phase transition, we find two distinct critical behaviors with overdamped and underdamped critical dynamics at generic and weakly dissipative critical points, respectively. We further show that the underdamped critical behavior is robust against short-range perturbations and is not an artifact of the mean-field nature of the model. To treat such perturbations, we extend our diagrammatic representation to include the coupling to spin waves due to the short-range interactions. The field-theoretical approach and the diagrammatics developed in this work should prove useful in applications to generic short-range driven-dissipative spin systems.
Project DRIVE: Decreasing Redundant and Irrelevant Vitals Every Day

Background Assessing vitals at regular intervals can be disruptive to a patient’s rest and unnecessary if the patient is clinically stable. These interruptions may lead to impaired sleep, parental fatigue and anxiety, and delayed discharge. Moreover, alarm fatigue has been described with over-monitoring of patients, as has the overuse of staff resources that might be better utilized in other patient care activities. At our tertiary freestanding children’s hospital, we found that clinically stable patients received 5.9 interruptions/24 hours related to obtaining heart rate, respiratory rate, blood pressure, and temperature measurements every 4 …
Permanent Supportive Housing With Housing First: Findings From a Community Guide Systematic Economic Review.

Introduction The annual economic burden of chronic homelessness in the U.S. is estimated to be as high as $3.4 billion. The Permanent Supportive Housing with Housing First (Housing First) program, implemented to address the problem, has been shown to be effective. This paper examines the economic cost and benefit of Housing First Programs. Methods The search of peer-reviewed and gray literature from inception of databases through November 2019 yielded 20 evaluation studies of Housing First Programs, 17 from the U.S. and 3 from Canada. All analyses were conducted from March 2019 through July 2020. Monetary values are reported in 2019 U.S. dollars. Results Evidence from studies conducted in the U.S. was separated from those conducted in Canada. The median intervention cost per person per year for U.S. studies was $16,479, and for all studies, including those from Canada, it was $16,336. The median total benefit for the U.S. studies was $18,247 per person per year, and it was $17,751 for all studies, including those from Canada. The benefit-to-cost ratio for U.S. studies was 1.80:1, and for all studies, including those from Canada, it was 1.06:1. Discussion The evidence from this review shows that economic benefits exceed the cost of Housing First Programs in the U.S. There were too few studies to determine cost–benefit in the Canadian context.
What do we measure when we measure perceptions of everyday discrimination

Abstract Rationale. The Everyday Discrimination Scale forms the backbone of hundreds of studies documenting the health effects of perceived discrimination. Researchers regularly use the scale to examine specific types of discrimination (e.g., racial, ethnic, gender- and age-based) as well as discrimination more generally among the “general population.” To date, no study has analyzed the frameworks respondents use to interpret and answer the questions that comprise the scale. As such, what exactly researchers are measuring when they ask about “everyday discrimination” – and how this may vary within and across social groups – remains unknown. Objective This study analyzes data from cognitive interviews to assess patterns of interpretation and response to the EDS to assess whether the meaning of the resulting data may vary across diverse social groups. Methods Researchers conducted structured cognitive interviews with a diverse sample of thirty-eight adults in the Southeastern United States (US). Interview transcripts were qualitatively analyzed using MAXQDA, in a process of reiterative coding. Results Results show that respondents interpret the survey questions in markedly different ways, with some interpreting the scale as asking about negative interactions; others viewing it through a lens of social inequalities; and still others through a lens specifically of racism. Racial/ethnic and gender statuses may structure question interpretation. Conclusions Pronounced and patterned variation in respondents’ interpretation raises questions about its validity. Findings underscore the importance of schemas for assessing the meaning of data generated by the EDS and for measuring the health effects of perceived discrimination and mistreatment.
Does location determine medical practice patterns

Variations in medical practice are far more complex than the simple narrative popularly attributed to the Dartmouth Atlas.
A Septennium of English Civil Procedure, 1932-1939

In this article the author examines the English system of civil procedure; specifically, the author discusses the developments that took place within the system between the years of 1932 ad 1939. Through a discussion of the New Procedure and its abolition, the joinder of claims, delivery of pleadings, summons for directions, summary judgment practice, the jury trial, evidence, the writes of mandamus, prohibition, certiorari, and quo warranto, appellate jurisdiction, and the enforcement of judgments and other executory titles, the author examines various aspects of English civil procedure. In concluding his article, the author discusses the disappearance of the New Procedure, the scope of the summary judgment, the provision for a court expert, the notice to admit documents, and the changes that occurred as a result of the Evidence Act of 1938 in relation to American procedural reform.
Composite Role-Based Monitoring (CRBM) for Countering Insider Threats

Through their misuse of authorized privileges, insiders have caused great damage and loss to corporate internal information assets, especially within the Intelligence Community (IC). Intelligence management has faced increasing complexities of delegation and granular protection as more corporate entities have worked together in a dynamic collaborative environment. We have been confronted by the issue of how to share and simultaneously guard information assets from one another. Although many existing security approaches help to counter insiders’ unlawful behavior, it is still found at a preliminary level. Efficiently limiting internal resources to privileged insiders remains a challenge today. In this paper we introduce the CRBM (Composite Role-Based Monitoring) approach by extending the current role-based access control (RBAC) model to overcome its limitations in countering insider threats. CRBM not only inherits the RBAC’s advantages, such as scalable administration, least privilege, and separation of duties, but also provides scalable and reusable mechanisms to monitor insiders’ behavior in organizations, applications, and operating systems based on insiders’ current tasks.
The incidence of fat necrosis in balloon-based breast brachytherapy

Purpose To investigate the incidence of and potential risk factors for fat necrosis in high dose-rate (HDR) balloon-based breast brachytherapy (BBB).
Choosing Which Rule To Break First: An In-House Attorney Whistleblower’s Choices After Discovering a Possible Federal Securities Law Violation

The early twenty-first century has seen several instances of large-scale federal securities law violations—such as Enron, WorldCom, and the Bernie Madoff scandal—that have garnered widespread attention and heavily impacted the global economy. In each of these cases, whistleblowers tried to expose the underlying fraud. These and other scandals led to the enactment of new laws to protect whistleblowers who seek to expose these kinds of violations. In-house attorneys are in a special position to discover, understand, and expose their organization’s federal securities violations. However, should in-house attorneys discover misconduct, and when deciding whether or not to take action, they must take into account several different and potentially conflicting governing regimes. As whistleblowers, they can be subject to various state and federal laws, each of which will require them to respond differently in order to be protected from retaliation. These laws have also been interpreted in different ways by different courts. As attorneys, they are subject to state rules of professional conduct, and perhaps other rules governing professional conduct under federal law. As in-house attorneys, they may face additional restrictions, since their employer is also their client. These different regimes can permit or even require attorneys to take conflicting actions in any given situation, making it potentially difficult for an attorney to act without breaking at least one rule or law. This Note argues that in-house attorney whistleblowers should be expected to act in the same way across different governing regimes. Inhouse attorneys should be required to report federal securities violations internally first and be permitted to report externally thereafter if the violation is not resolved.
Quantifying truncation errors in effective field theory

Bayesian procedures designed to quantify truncation errors in perturbative calculations of quantum chromodynamics observables are adapted to expansions in effective field theory (EFT). In the Bayesian approach, such truncation errors are derived from degree-of-belief (DOB) intervals for EFT predictions. Computation of these intervals requires specification of prior probability distributions (``priors'') for the expansion coefficients. By encoding expectations about the naturalness of these coefficients, this framework provides a statistical interpretation of the standard EFT procedure where truncation errors are estimated using the order-by-order convergence of the expansion. It also permits exploration of the ways in which such error bars are, and are not, sensitive to assumptions about EFT-coefficient naturalness. We first demonstrate the calculation of Bayesian probability distributions for the EFT truncation error in some representative examples and then focus on the application of chiral EFT to neutron-proton scattering. Epelbaum, Krebs, and Mei\ss{}ner recently articulated explicit rules for estimating truncation errors in such EFT calculations of few-nucleon-system properties. We find that their basic procedure emerges generically from one class of naturalness priors considered and that all such priors result in consistent quantitative predictions for 68% DOB intervals. We then explore several methods by which the convergence properties of the EFT for a set of observables may be used to check the statistical consistency of the EFT expansion parameter.
Public Wrongs, Private Rights: Private Attorneys General for Civil Rights

The critical question explored by this Article is whether valid regulations that implement Title VI can be enforced by private parties. Regulations are binding laws, and they are often intended to provide additional protection of civil rights. Of course, regulations are only valid if they are consistent with the purposes underlying the enabling statute controlling the promulgation of such regulations. If a regulation is ultra vires the statute, it is nugatory. Congressional intent is, therefore, of great importance in this context. The test of whether a private right of action exists to enforce regulations has various permutations that are explored in this Article. Nevertheless, the essential syllogism for determining whether a private right of action exists is that if regulations are consistent with congressional intent, and if congressional intent dictates that private parties can sue to vindicate civil rights that flow from the enabling statute, it follows that private parties may also sue for vindication of civil rights that emanate from the regulations.
A Natural Experiment Identifying Disease Regulation Effects on Recreational Fishing

This paper analyzes changes in angler behavior in response to state natural resource agency regulations designed to limit the spread of Viral Hemorrhagic Septicemia virus (VHSv) in the Great Lakes and connecting waterways. These regulations restrict the use of baitfish and vary in stringency over parts of the state and have varied over time. We use a linked participation model to identify the combined effect of the disease and associated regulations on angler site choice and trip frequency. Survey data was collected on Michigan anglers over a period of several years, including the years before and after the agency regulations were introduced. Results indicate that anglers significantly alter their behavior at the site choice and participation levels in response to a new disease and its regulations. We find that anglers were less likely to visit a site considered to be VHSv positive and subject to bait use restrictions and more likely to choose a site free of disease regulations. To our knowledge, this is the first such study to apply a multi-dimensional database to modeling wildlife disease regulations. We expect that natural resource policy makers will find these results useful in developing and maintaining the regulations necessary for the sustainable use of recreational fisheries.
Safety and Mission Assurance: A NASA Perspective

Manned spaceflight is an incredibly complex and inherently risky human endeavor. As the result of the lessons learned through years of triumph and tragedy, the National Aeronautics and Space Administration (NASA) has embraced a comprehensive and integrated approach to the challenge of ensuring safety and mission success. This presentation will provide an overview of some of the techniques employed in this effort, with a focus on the processing operations performed at the Kennedy Space Center (KSC).
Response to Candace Vogler, "In Support of Moral Absolutes"

Response to a paper on moral absolutes by Candace Vogler at a conference honoring the work of John Finnis.
Architecting Dependable and Secure Systems Using Virtualization

We outline ways of leveraging virtualization for enhancing system dependability and security, and describe the practical realization of some of these enhancements using the Xen open-source virtual machine monitor (VMM). Using combinatorial modeling, we perform reliability analysis of multiple design choices when a single physical server is used to host multiple virtual servers. The analysis shows that unless certain conditions (e.g., regarding the number of virtual servers) are met, virtualization could decrease the reliability of a single physical server. The analysis also shows that improving the reliability of the VMM is crucial to improving the reliability of a virtualized physical node. Motivated by this observation, we show how the enhancements we have implemented can be combined to produce a more reliable Xen VMM architecture, called R-Xen. The Xen VMM consists of a hypervisor core and a privileged virtual machine (VM) called Dom0. Dom0, being much bulkier than the hypervisor core, is the weak link for Xen reliability. Consequently, R-Xen focuses on improving the reliability of Dom0 through replication in which Dom0 replicas mutually monitor each other for intrusion and faults. R-Xen converts more severe Dom0 replica faults into fail-stop behavior, and rejuvenates a failed replica. The approach is transparent and does not require any modifications to regular Xen VMs (user domains).
Economic Transition and Social Security Policies in Lithuania

Lithuania is facing serious difficulties in its political, economic, and social life during the transition to a market economy. The main goal of the government now is to become reintegrated into the European and world communities after more than 50 years of Soviet occupation. Before World War II, Independent Lithuania had political, economic, and cultural relations with all European countries, the United States, and Canada. The Soviet system broke down these relations, even with Lithuania's closest neighbor, Poland. The Soviet-run economy was created in such a centralized way that even inside the former Soviet Union the trade balance between Lithuania and Russia was much larger than between Lithuania and its other closest neighbor, Latvia. Lithuania now manages its own social security system since regaining independence in 1990. The main goal of social security now is to protect the population in this period of growing economic instability and to maintain the current standard of living.
Emergent Measure-Dependent Probabilities from Modified Quantum Dynamics Without State-Vector Reduction

Counting outcomes is the obvious algorithm for generating probabilities in quantum mechanics without state-vector reduction (i.e., many-worlds). This procedure has usually been rejected because for purely linear dynamics it gives results in disagreement with experiment. Here it is shown that if non-linear decoherence effects (previously proposed by other authors) are combined with an exponential time dependence of the scale for the non-linear effects, the correct measure-dependent probabilities can emerge via outcome counting, without the addition of any stochastic fields or metaphysical hypotheses.
Subnational Fiscal Policy in Large Developing Countries: Some Lessons from the 2008-09 Crisis for Brazil, China and India

In response to the Great Recession of 2008, many national governments implemented fiscal stimuli packages in 2009 and 2010 to prevent further declines in aggregate demand and to jump start their economic recovery. Where subnational governments responded with fiscal contraction, as in the United States, the impact was muted; where states/provinces also expanded expenditures, as in China and India, the impact was magnified. Increases in recurrent expenditure, which were made in Brazil and India, acted as short-term stimulants; additional public investment, as in China, appears to have had a more lasting impact on growth. Large developing countries typically exhibit high interregional inequality in levels of development and global integration, resulting in differential magnitude and timing of the crisis impact. For example, coastal states in India were affected more severely and quickly than landlocked states; revenue moved in opposite directions in the two types of state in 2009. Where fiscal stress varies widely across subnational entities, central transfers alone cannot prevent pro-cyclicality of subnational fiscal response to a recession. There is need for flexibility in subnational borrowing within a sustainable fiscal framework. Many Indian states were able to maintain or accelerate their spending thanks to the additional borrowing permitted in 2009 and 2010. In comparison, limited borrowing capacity and lack of flexibility in federal grants restricted the contribution of Brazilian states to fiscal stimulus. Legal prohibition of subnational borrowing induced China's provinces to finance additional investments through extra-budgetary borrowing by nongovernment entities, with significant fiscal risks on account of contingent liabilities.
Mistaking Computers for Technology: Technology Literacy and the Digital Divide

No other information and communication technology has swept the globe with greater speed than the Internet, having the potential to promote vast social, economic, and political transformations. As new technologies become available the pattern of adoption and diffusion creates disparities in access and ownership. At the most basic this gap is termed the digital divide and its most common antidote has been the computer. To close this divide, sizeable capital has been spent on deploying computer integration into public schools around the globe. This article uses the case of Brazil to analyze the role of computers in schools as tools to close the digital divide and promote pedagogical change. Massive computer integration will not be the cure for to the digital gap. As new technological tools continue to develop, new gaps will arise. An approach focusing on technology literacy is the only sustainable way to avoid present and future technological divides.
Neutrinos in a Vacuum Dominated Cosmology

We explore the dynamics of neutrinos in a vacuum dominated cosmology. First we show that such a geometry will induce a phase change in the eigenstates of a massive neutrino and we calculate the phase change. We also calculate the delay in the neutrino flight times in this geometry. Applying our results to the presently observed background vacuum energy density, we find that for neutrino sources further than 1.5 Gpc away both effects become non-trivial, being of the order of the standard relativistic corrections. Such sources are within the observable Hubble Deep Field. The results which are theoretically interesting are also potentially useful, in the future, as detection techniques improve. For example such effects on neutrinos from distant sources like supernovae could be used, in an independent method alternative to standard candles, to constrain the dark energy density and the deceleration parameter. The discussion is extended to investigate Caianiello's inertial or maximal acceleration (MA) effects of such a vacuum dominated spacetime on neutrino oscillations. Assuming that the MA phenomenon exists, we find that its form as generated by the presently observed vacuum energy density would still have little or no measurable effect on neutrino phase evolution, for neutrinos in the energy range of a few eV.