cssi/SciSciGPT-SciSciNet huggingface dataset:
Healthcare organizational change: implications for access to care and its measurement.

Abstract OBJECTIVES: To summarize evidence from peer-reviewed literature on access to care for vulnerable HMO enrollee populations; to discuss the potential effect of recent HMO and physician organization changes on access to care and its measurement. STUDY DESIGN: Review and summary of peer-reviewed literature for two HMO populations: those with chronic conditions and diseases, and those subject to discrimination due to income, color, or ethnic background. I also reviewed and summarized literature on three major changes in capitated organizations (HMOs and capitated physician organizations) that could affect access to care for vulnerable populations, and summarized findings from healthcare manager interviews conducted for several recent research projects on health system change. PRINCIPAL FINDINGS: Although mixed, there are enough negative results to raise some concerns about access to care for HMO enrollees with chronic conditions and diseases. Several emerging organizational changes have the potential to change access to care for the vulnerable HMO enrollees. The shift in cost-cutting from fragmented clinical management of specific services at a point in time toward more integrated clinical management of all services for specific types of patients across time may improve access to care, as may increased efforts to attract and retain HMO enrollees. The increased importance of capitated provider organizations within the health system may restrict access in some ways, and expand access in others. CONCLUSIONS: Organizational changes can affect both access to care and its measurement. More research is needed on the effects of these changes on access to care and quality of care. For researchers examining access to care for vulnerable HMO enrollee populations, these changes create challenges to determine the most appropriate measures of access to care, and the most appropriate organizations and organizational characteristics to measure. RELEVANCE TO CLINICAL PRACTICE, MANAGEMENT, AND/OR POLICY: Changes in market competition are leading to organizational changes that affect access to care for vulnerable HMO enrollee populations. Public and/or private policies that improve measurement and reporting can affect market competition and improve access to care.
Untangling ‘An Entangled Bank’: Recent Facts and Theories About Community Food Webs

This paper is an expository and nontechnical review of some recent discoveries about food webs. The discoveries are those I have been privileged to make jointly with two splendid collaborators: Frederic Briand, formerly at the University of Ottawa and now at the International Union for the Conservation of Nature, Gland, Switzerland; and Charles M. Newman, at the University of Arizona, Tucson. These discoveries depend on data collected by scores of field ecologists, so the circle of contributors is much wider.
Associations of Night Smoking and Cravings with Quit Intentions and Attempts

Introduction: Waking at night to smoke can also serve as an indicator of dependence and treatment success. Aims: We sought to examine whether night smoking is associated with features of smoking behaviour in a non-treatment-seeking sample of adult smokers in the general population. Methods: Data for this study come from 1,062 current smokers obtained from an opt-in online panel in July 2010. Night smoking and night craving to smoke were assessed by questionnaire, and dependence was assessed by the Fagerstrom Test for Nicotine Dependence (FTND). Relationships were assessed using linear, logistic, and negative binomial regression. Findings: Overall, 20.6% reported that they woke at night to smoke. FTND scores were substantially higher in those reporting night smoking. Those who reported night cravings were more likely to report quit intentions. Night smokers made 3.6 actual quit attempts (95% CI: 2.8, 4.5) per year, adjusted for other model factors, compared to 2.7 (2.2, 3.2) attempts for night cravers and 2.2 (1.8, 2.7) attempts for smokers who reported neither. Conclusions: Overall, night smokers reported higher nicotine dependence than cravers and those who experienced neither. The current study adds to a growing literature pointing to the importance of overnight smoking as an indicator of nicotine dependence.
Parental Modeling and Deidentification in Romantic Relationships Among Mexican-Origin Youth

This study investigated youth's modeling of and de-identification from parents in romantic relationships, using two phases of data from adolescent siblings, mothers, and fathers in 246 Mexican-origin families. Each parent reported his/her marital satisfaction and conflict, and youth reported on parent-adolescent warmth and conflict at Time 1. Youth's reports of modeling of and de-identification from their mothers and fathers and three romantic relationship outcomes were assessed at Time 2. Findings revealed that higher parental marital satisfaction, lower marital conflict, and higher warmth and lower conflict in parent-adolescent relationships were associated with more modeling and less de-identification from parents. Moreover, higher de-identification was linked to a greater likelihood of youth being involved in a romantic relationship and cohabitation, whereas more modeling was linked to a lower likelihood of cohabitation and older age of first sex. Discussion underscores the importance of assessing parental modeling and de-identification and understanding correlates of these processes.
Design of a parallel continuum manipulator for 6-DOF fingertip haptic display

Despite rapid advancements in the field of fingertip haptics, rendering tactile cues with six degrees of freedom (6 DOF) remains an elusive challenge. In this paper, we investigate the potential of displaying fingertip haptic sensations with a 6-DOF parallel continuum manipulator (PCM) that mounts to the user's index finger and moves a contact platform around the fingertip. Compared to traditional mechanisms composed of rigid links and discrete joints, PCMs have the potential to be strong, dexterous, and compact, but they are also more complicated to design. We define the design space of 6-DOF parallel continuum manipulators and outline a process for refining such a device for fingertip haptic applications. Following extensive simulation, we obtain 12 designs that meet our specifications, construct a manually actuated prototype of one such design, and evaluate the simulation's ability to accurately predict the prototype's motion. Finally, we demonstrate the range of deliverable fingertip tactile cues, including a normal force into the finger and shear forces tangent to the finger at three extreme points on the boundary of the fingertip.
Pollutant-degrading multifunctional micromotors

This paper reports a novel fabrication technique to create pollutant-degrading, self-propelled, micro soft-robots whose surface is decorated with the high surface-area, photocatalytic ZnO nanowire array. Micromotors/microrobots with photodegradation capabilities have been reported [1], but their form is limited to spherical particles with some functional coatings (e.g. Pt for bubble-generation reactions). Here the proposed micromotor is based on a sub-millimeter, hierarchical, self-folded polymeric structure integrated with functional inorganic nanomaterials that confer desired functionalities such as photodegradation and self-propulsion. To our knowledge, this type of micromotor platform has never been published, and we believe it would provide us with an opportunity to incorporate multiple functionalities.
Overlap Syndromes in Inflammatory Myopathies

Purpose of Review This review discusses the epidemiology, evaluation and treatment of overlap inflammatory myopathy syndromes. Recent findings Evaluation of overlap myopathy in systemic sclerosis (SSc) has shown that the disease is often heterogeneous with variable presentation, histopathology, and response to therapy. These differences have shown to be important in management, specifically with the response to immunosuppression. Inflammation and necrosis are features suggestive of a positive response, whereas fibrosis and neurogenic atrophy are also common and may be less responsive to therapy. Summary Inflammatory myopathy associated with overlap connective tissue disease is often associated with greater morbidity, and there are few studies to guide treatment. Treatment is often tailored to the patient based on severity of muscular and concomitant extramuscular disease. While further research is needed to better understand treatment of overlap syndromes, the absence of consensus criteria remains a limiting factor.
Misapprehensions about the fine-tuning argument

The fine-tuning argument purports to show that particular aspects of fundamental physics provide evidence for the existence of God. This argument is legitimate, yet there are numerous doubts about its legitimacy. There are various misgivings about the fine-tuning argument which are based on misunderstandings. In this paper we will go over several major misapprehensions (from both popular and philosophical sources), and explain why they do not undermine the basic cogency of the fine-tuning argument.
The Role of Physical Educators in Addressing the Needs of Students Who Are Overweight and Obese

The high rates of overweight and obesity continue to be a major health concern in the United States. Teachers and teacher training programs too often overlook students who are overweight and obese ...
Clinical Relevance of Gastrointestinal Microbiota During Pregnancy: A Primer for Nurses:

Emerging evidence about the human microbiome, a collective term for all the microorganisms living in and on the human body, consistently demonstrates the critical influence it has on host physiology and disease risk. The microbiota in the gastrointestinal (GI) tract has the most significant and far-reaching effect on human physiology. The maternal GI microbiota can decrease the risk of adverse pregnancy outcomes by modulating energy extraction, glucose metabolism, vitamin production, and host immunity essential for optimal maternal and neonatal health. Moreover, the maternal GI microbiota is thought to influence colonization of the fetus and neonate that may predispose them to different health trajectories. This article provides a basic understanding about the influence of the structure of the maternal GI microbiota, the fundamental role it plays during pregnancy, and the factors that influence the structure, and subsequently function, of the GI microbiota in the general and pregnant population. While only a small number of studies have examined this topic during pregnancy, the preponderance of the evidence supports the need to clarify baseline structure and function of GI microbiota and its associations with pregnancy outcomes. In addition, the results from the studies conducted in the general population can be extrapolated to pregnancy in many cases. This knowledge is essential for clinicians who need to understand the implications of the microbiota for disease and wellness in order to address the care factors that may adversely influence the GI microbiota during pregnancy.
Thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome.

○ Objective.-To evaluate the usefulness and feasibility of measuring plasma von Willebrand factor (vWF)-cleaving metalloprotease activity (ADAMTS 13) in the differential diagnosis of thrombotic thrombocytopenic purpura (TTP), the hemolytic uremic syndrome, and other thrombotic microangiopathies. Data Sources.-Articles published in the medical literature. Data Extraction and Synthesis.-In TTP, a multimeric form of vWF that is larger than that ordinarily found in the plasma may cause systemic platelet aggregation under the high-shear conditions of the microcirculation. ADAMTS 13 is a divalent cation-activated, vWF-cleaving metalloprotease that converts unusually large vWF multimers derived from endothelial cells into smaller vWF forms in normal plasma. ADAMTS 13 is severely reduced or absent in most patients with TTP. The vWF-cleaving metalloprotease is present in fresh-frozen plasma, cryoprecipitate-depleted plasma (cryosupernatant), and in plasma that has been treated with solvent and detergent. The enzyme is defective in children with chronic relapsing TTP. Infusion of any of the plasma products that contain the vWF-cleaving metalloprotease stops or prevents (for about 3 weeks) TTP episodes in these patients. An immunoglobulin (Ig) G autoantibody to the vWF-cleaving metalloprotease is found transiently in many adult patients with acquired acute idiopathic, recurrent, and ticlopidine/clopidogrel-associated TTP. Patients with acquired TTP require plasma exchange, that is, both infusion of a plasma product containing vWF-cleaving metalloprotease and removal of autoantibody and/or unusually large vWF multimers by plasmapheresis. The pathophysiology of platelet aggregation in bone marrow transplantation/chemotherapy-associated thrombotic microangiopathy, as well as in hemolytic uremic syndrome, is not established. In neither condition is there a severe decrease in plasma vWF-cleaving metalloprotease activity, as there is in TTP. Conclusions.-The presently available lengthy and complicated procedure for estimation of plasma vWF-cleaving metalloprotease activity is not yet practical for rapid diagnostic use. This test has supplanted the equally lengthy and difficult, less specific analysis of plasma vWF multimeric pattern. If the clinical distinction between TTP and hemolytic uremic syndrome is uncertain, it is appropriate to acquire (before therapy) a citrate-plasma sample for the ultimate determination of vWF-cleaving metalloprotease activity.
HLA associations in clozapine-induced agranulocytosis

We previously reported preliminary results of association of clozapine-induced agranulocytosis (CA) with HLA-B38, DR4, DQ3 in five Ashkenazi Jewish patients and with HLA-DR2, DQ1 in four non-Jewish patients. In the present study, 31 additional patients with CA, 10 Ashkenazi Jewish, and 21 of non-Jewish ancestry, were studied. HLA alleles and haplotypes were compared among 52 patients (33 Ashkenazi Jewish, 19 non-Jewish) matched for ethnic background and clinical status. Our results show two associations and define the HLA allele markers for the Ashkenazi Jewish and non-Jewish haplotypes associated with CA. The most important markers for susceptibility for CA in Ashkenazi Jewish patients were DRB1*0402, DQB1*0302, and DQA1*0301, and in non-Jewish patients, HLA-DR*02, DQB1*0502, and DQA1*0102. HLA-DRB1*011 and DQB1*0301 were underrepresented in Ashkenazi Jewish patients when compared with controls. We hypothesize that genes of the major histocompatability complex, other than class I and class II, are responsible for CA; among them are the variants of the heat-shock proteins 70 or the tumor necrosis factor loci.
Recruitment and retention strategies for hospital laboratory personnel in urban and rural settings.

Laboratory directors and administrators play vital roles in the recruitment and retention processes of their employees. A total of 71 laboratory directors from hospitals across 51 counties in Tennessee responded to questionnaires regarding recruitment and retention strategies. Respondents reported strategies for recruitment and retention, which were agreed to be effective by management. Overall, these major strategies were consistent regardless of geographic location and limited differences were noted with regard to urban-rural locations. The findings that varied significantly between urban and rural locations included: 1) rural employees needed additional supervision; 2) rural hospitals relied on local residents more so than urban hospitals; 3) rural laboratory administrators noted more limited access to resources; and the 4) lower effectiveness of recruitment agencies and family relocation programs for rural hospitals. This is significant given the disparities often associated with rural areas, and the potential to develop more successful recruitment and retention strategies for those areas Active managers in clinical laboratory science programs in the hospital setting should note effective strategies for both, recruitment and retention of personnel, and note the potential impact of geography on such processes. ABBREVIATIONS: NAACLS-National Accrediting Agency for Clinical Laboratory Science, MLS-medical laboratory scientist, MLT-medical laboratory technician,
Automatic Detection of Ambiguous Terminology for Software Requirements

Identifying ambiguous requirements is an important aspect of software development, as it prevents design and implementation errors that are costly to correct. Unfortunately, few efforts have been made to automatically solve the problem. In this paper, we study the problem of lexical ambiguity detection and propose methods that can automatically identify potentially ambiguous concepts in software requirement specifications. Specifically, we focus on two types of lexical ambiguities, i.e., Overloaded and Synonymous ambiguity. Experiment results over four real-world software requirement collections show that the proposed methods are effective in detecting ambiguous terminology.
Scalable and flexible management of medical image big data

Digital imaging plays a critical role for image guided diagnosis and clinical trials, and the amount of image data is fast growing. There are two major requirements for image data management: scalability for massive scales and support of comprehensive queries. Traditional Picture Archiving and Communication Systems (PACS for short) are based on relational data management systems and suffer from limited scalability and query support. Therefore, new systems that support fast, scalable and comprehensive queries on image data are highly demanded. In this paper, we introduce two alternative approaches: DCMRL/XMLStore (RL/XML for short)-a parallel, hybrid relational and XML data management approach, and DCMDocStore (DOC for short)-a NoSQL document store approach. DCMRL/XMLStore manages DICOM images as binary large objects and metadata as relational tables and XML documents based on IBM DB2, which is parallelized through data partitioning. DCMDocStore manages DICOM metadata as JSON objects, and DICOM images as encoded attachments in MongoDB running on multiple nodes. We have delivered two open source systems DCMRL/XMLStore and DCMDocStore. Both systems support scalable data management and comprehensive queries. We also evaluated them with nearly one million DICOM images from National Biomedical Imaging Archive. The results show that, DCMDocStore demonstrates high data loading speed, high scalability and fault tolerance. DCMRL/XMLStore provides efficient queries, but comes with slower data loading. Traditional PACS systems have inherent limitations on flexible queries and scalability for massive amount of images.
Convergence of sums of dependent Bernoulli random variables: an application from portfolio theory

AbstractGeneralizations of the Central Limit Theorem to N dependent random variables often assume that the dependence falls off as N→∞. In this paper we present an example from mathematical finance...
Bi-Directional Four Quadrant DC/AC Droop-Controlled Inverter Model that Accounts for DC Side Dynamics

The current revisions of IEEE 1547 standard, California rule 21 and Hawaii rule 14H, if ratified, would allow 4 quadrant operation of distributed energy resources DERs. That means that a DER could produce and/or consume real and reactive powers (P and Q) to support the grid. Many DERs utilize dc/ac droop-controlled inverters and thus these inverters need to be bi-directional to produce or consume P and Q. Hence, dc side circuitry could be included to allow a bi-directional inverter to absorb P and/or Q. In this paper, a new model of a bi-directional dc/ac droop-controller voltage source inverter is proposed that includes the dc side dynamics. The inverters model consists of proportional-integral voltage and current controllers, droop controllers and a pulse width modulation (PWM) circuit. Simulation results show the four quadrant operational capability of the proposed inverter model. The model could serve as a basis for future IEEE 1547 compliant inverters.
Mathematical Analysis of the Role of Heterogeneous Distribution of Excitable and Non-excitable Cells on Early Afterdepolarizations

Early afterdepolarizations (EADs) are abnormal oscillations during the plateau phase of the cardiac action potential and have been linked to cardiac arrhythmias. At the cellular level, EADs can be caused by reactivation of the L-type calcium (Ca2+) channels, spontaneous Ca2+ releases from the sarcoplasmic reticulum, or both. In tissue, these EADs can trigger action potentials in neighboring cells, which may propagate as a nonlinear wave. In this scenario, EADs are attributed to cellular/subcellular/channel properties. In this study, we show a novel mechanism of EADs due to heterogeneous distribution of excitable and non-excitable cells in tissue, using a physiologically detailed computational model and mathematical analysis. In tissue, excitability of cells depends on the cell type and physiological and pathological conditions. Non-excitable cells create a non-excitable gap in tissue, which has been thought to be a cause of slow waves and reflected waves. Here, we show that the non-excitable gap also can be responsible for EAD generation. However, EADs occur only when the non-excitable gap size is optimal. If the gap size is too small, no EADs occur. If the gap size is too large, the action potential wave cannot propagate through the gap region. We also demonstrate that EADs caused by the non-excitable gap can initiate reentry in tissue, which has been linked to ventricular tachycardia and fibrillation. Thus, the non-excitable gap can lead to both focal and reentrant arrhythmias. EADs shown in this study are spatial phenomena and require tissue heterogeneity. Our study sheds light on the role of tissue heterogeneity on focal and reentrant arrhythmias.
The efficacy of pregabalin for the treatment of neuropathic pain in Japanese subjects with moderate or severe baseline pain.

Purpose Although analyses of pooled clinical trial data have reported how international populations respond to pregabalin by baseline neuropathic pain (NeP) severity, no studies have evaluated this specifically in patients from Japan. Thus, this post hoc pooled analysis evaluated the efficacy of pregabalin in Japanese subjects for treating moderate or severe baseline NeP. Patients and methods Data were pooled from three placebo-controlled trials enrolling Japanese subjects with postherpetic neuralgia (PHN), diabetic peripheral neuropathy (DPN), and spinal cord injury (SCI). The efficacy of pregabalin was evaluated by baseline pain severity (moderate or severe NeP). The trials on PHN and DPN included a 1-week titration of pregabalin from 150 mg/day to 300 or 600 mg/day; the SCI trial included a 4-week dose optimization phase (150 mg/day, titrated up to 600 mg/day). Treatment durations were 13-16 weeks (excluding 1-week taper periods), and pregabalin was administered in two divided doses per day. Results Mean baseline pain scores and demographic characteristics were comparable between treatment cohorts. Pregabalin treatment significantly reduced pain scores from baseline to endpoint compared with placebo in subjects with both moderate (P<0.001) and severe (P<0.05) baseline pain. Significant improvements in mean sleep scores from baseline to endpoint were associated with pregabalin compared with placebo in subjects with both moderate and severe baseline pain (both P<0.0001). A greater proportion of subjects in both pain cohorts achieved a ≥30% reduction in pain from baseline with pregabalin vs placebo (P<0.05). Higher proportions of pregabalin-treated vs placebo-treated subjects shifted to a less severe pain category at endpoint. Consistent with the known safety profile of pregabalin, common adverse events included dizziness, somnolence, weight gain, and peripheral edema. Conclusion Pregabalin demonstrated efficacy for pain relief and sleep improvement with a consistent safety profile in Japanese subjects with either moderate or severe baseline pain severity. ClinicalTrialsgov identifiers NCT0039490130, NCT0055347522, NCT0040774524.
How to Select and Evaluate New Products on the Market

New devices and products often promise to protect health-care workers and patients from transmission of viral infections. These need to be evaluated carefully for efficacy, applicability, and cost in an objective, structured manner.
Criminal justice and the liberal good of ‘order’

Recent liberal political theory – and political philosophy generally – has had little to say about the criminal justice system, focusing instead on concerns of pluralism and social welfare. But I a...
Marker lesion study of oral FGFR inhibitor BGJ398 in patients with FGFR3-altered intermediate-risk nonmuscle-invasive bladder cancer.

510Background: FGFR3 alterations are prevalent in non-muscle-invasive bladder cancer (NMIBC). We conducted a marker lesion study of the oral FGFR inhibitor BGJ398 in patients with intermediate-risk...
Relationship Between Dietary Magnesium Intake and Incident Heart Failure Among Older Women: The WHI.

Background Women represent a large proportion of the growing heart failure (HF) epidemic, yet data are lacking regarding optimal dietary and lifestyle prevention strategies for them. Specifically, ...
Hepatocellular Carcinoma Brain Metastases: A Single-Institution Experience

Background Brain metastases (BMs) from hepatocellular carcinoma (HCC) are rare, with a paucity of reported cases. In the present retrospective cohort report, we assessed the proportion of BMs arising from HCC and characterized the related details, including patient demographics, clinical characteristics, treatment modalities, and survival outcomes. Methods We retrospectively identified and reviewed the medical records of 14 patients with BMs from HCC seen at our institution from 2008 to 2018. Results Among all patients with BMs, the proportion originating from primary liver cancer was 0.39%. In every case (n = 14), the liver cancer was HCC. The median age at the BM diagnosis was 64 years (range, 37–82 years). The median alpha-fetoprotein level at the diagnosis of BM was 540 ng/mL (range, 3–10,000 ng/mL). The median interval from the HCC diagnosis to the development of BMs was 31.1 months (range, 3.17–107 months). Of the 14 patients, 8 (57%) had had metastases to the brain parenchyma and 6 had had skull or dural metastases. For patients with brain parenchymal metastases, the median number of metastases was 1 (range, 1–5). Of the 14 patients, 13 have died, with a median overall survival after the BM diagnosis of 2.83 months (range, 0.430–24.0 months). At the latest follow-up examination, the survival for the 14th patient was 142 months after the BM diagnosis. Resection of BMs with radiosurgery was associated with increased survival compared with radiosurgery alone (10.9 months vs. 2.8 months; P = 0.04). Conclusions HCC BMs are rare and constitute a small fraction of the total incidence of BMs. The prognostic data we have provided can aid medical providers in caring for patients with HCC BMs.
The new gay for pay: the sexual politics of American television production

Everyone knows that LGBT representations on television have played a critical role in changing hearts and minds on issues such as marriage equality; it is a truth universally acknowledged.As pervas...
Ultra-slow Oscillations in fMRI and Resting-State Connectivity: Neuronal and Vascular Contributions and Technical Confounds

Ultra-slow, ∼0.1-Hz variations in the oxygenation level of brain blood are widely used as an fMRI-based surrogate of "resting-state" neuronal activity. The temporal correlations among these fluctuations across the brain are interpreted as "functional connections" for maps and neurological diagnostics. Ultra-slow variations in oxygenation follow a cascade. First, they closely track changes in arteriole diameter. Second, interpretable functional connections arise when the ultra-slow changes in amplitude of γ-band neuronal oscillations, which are shared across even far-flung but synaptically connected brain regions, entrain the ∼0.1-Hz vasomotor oscillation in diameter of local arterioles. Significant confounds to estimates of functional connectivity arise from residual vasomotor activity as well as arteriole dynamics driven by self-generated movements and subcortical common modulatory inputs. Last, methodological limitations of fMRI can lead to spurious functional connections. The neuronal generator of ultra-slow variations in γ-band amplitude, including that associated with self-generated movements, remains an open issue.
Teaching Data Science to Social Sciences and Humanities Students

This tutorial provides guidance on how to teach data science to non-technical students, especially for social science and humanities students. In this tutorial, I will share resources, strategies, and models for teaching data science to non-technical students. After the presentation and discussion, participants will conduct hands-on activities, including developing their own data science programs. Participates are recommended to bring information on faculty, student, and current courses from their institutions in preparation for the activities.
Improvised city: architecture and governance in Shanghai, 1843–1937: Cole Roskam Seattle, University of Washington Press, 2019 ISBN 978 0 29574 478 0 £54.00/$65.00, Hardback pp. 304, illus.

It may not be common to co-write a book review, but we, an architectural researcher-designer and a historian of China, decided to do it for Cole Roskam’s Improvised City. The reason is simple: the ...
Risk Perceptions of Low Nicotine Cigarettes and Alternative Nicotine Products across Priority Smoking Populations

Background: As the U.S. Food and Drug Administration considers a low nicotine product standard for cigarettes, it is important to examine how people who smoke, especially individuals from priority populations disproportionately affected by smoking, perceive low nicotine content (LNC) cigarettes and their relative risk perceptions of alternative nicotine delivery system (ANDS) products, including e-cigarettes and snus, and medicinal nicotine. Methods: Data are from Wave 4 (2016–2017) of the adult Population Assessment of Tobacco Use and Health (PATH) Study. We examined respondents’ absolute risk perceptions about nicotine, LNC cigarettes, ANDS products and medicinal nicotine; their relative risk perceptions of LNC cigarettes and ANDS products compared to conventional cigarettes; and their relative risk perceptions of medicinal nicotine compared to ANDS products. Results: The majority of respondents across priority smoking populations indicated snus, e-cigarettes, and LNC cigarettes were ‘about the same’ level of harmfulness or addictiveness as conventional cigarettes. The majority of respondents indicated e-cigarettes to be ‘about the same’ harmfulness as medicinal nicotine. Conclusions: Our study indicates that adults who smoke cigarettes generally have misperceptions about the harms of nicotine and the relative risks of ANDS products and such misperceptions exist regardless of their racial/ethnic identity, sexual orientation, and gender identity.
Osip Mandelstam’s Poetic Practice and Theory and Pavel Florensky’s Philosophical Contexts

This essay examines Osip Mandelstam’s poetological theory and poetic practice in their relation to important philosophical contexts of his time—primarily Russian idealist philosophy of the Silver Age (Solovyev, Lossky, Frank) and its aftermath (Florensky). I trace the ways Mandelstam’s poetics and philosophy of language and verbal art evolve from a youthful engagement with Symbolism through the famed heyday of Acmeism to post-revolutionary writings of the nineteen-twenties and nineteen-thirties. At each stage, Mandelstam’s poetry and theory are read in dialogue with relevant philosophical problems and texts. These include: Vladimir Solovyev’s “The Meaning of Art” and “Beauty in Nature,” Nikolai Lossky’s The World as an Organic Whole, Semyon Frank’s The Unknowable, and Pavel Florensky’s The Pillar and the Ground of the Truth. An avid intellectual, Mandelstam idiosyncratically intertwines and imaginatively reworks philosophical ingredients in his writings. The relationship between poetic practice, theory, and philosophical arguments thus emerges as a dynamic interplay.
Recompose Event Sequences vs. Predict Next Events: A Novel Anomaly Detection Approach for Discrete Event Logs

One of the most challenging problems in the field of intrusion detection is anomaly detection for discrete event logs. While most earlier work focused on applying unsupervised learning upon engineered features, most recent work has started to resolve this challenge by applying deep learning methodology to abstraction of discrete event entries. Inspired by natural language processing, LSTM-based anomaly detection models were proposed. They try to predict upcoming events, and raise an anomaly alert when a prediction fails to meet a certain criterion. However, such a predict-next-event methodology has a fundamental limitation: event predictions may not be able to fully exploit the distinctive characteristics of sequences. This limitation leads to high false positives (FPs). It is also critical to examine the structure of sequences and the bi-directional causality among individual events. To this end, we propose a new methodology: Recomposing event sequences as anomaly detection. We propose DabLog, a LSTM-based Deep Autoencoder-Based anomaly detection method for discrete event Logs. The fundamental difference is that, rather than predicting upcoming events, our approach determines whether a sequence is normal or abnormal by analyzing (encoding) and reconstructing (decoding) the given sequence. Our evaluation results show that our new methodology can significantly reduce the numbers of FPs, hence achieving a higher F1 score.
High Throughput Multiple Device Chain Diagnosis Methodology for Clock and Control Line Defects

Accuracy and throughput are the most important considerations for any scan-based diagnosis methods. When chain test fails on an Integrated Circuit (IC), massive failures must be logged to perform software-based chain diagnosis. Moreover, failing chain tests indicate presence of defects not just on the scan path but also on global signals such as clocks and control signals. For a successful volume diagnosis of chain failures, a methodology that can work with minimal failure logging and yet accurately identifies the defect locations with high throughput is desirable. In this paper, we propose a production proven scan chain diagnosis methodology based on multiple device diagnosis (MDD) that makes uses of a Design for Diagnosis (DFD) technique and accurately identifies clock and control signal defects in addition to defects in scan-paths. Accuracy results of the proposed methodology is proven through Physical Failure Analysis (PFA) on silicon, and the run time of the proposed algorithm achieved up to 19X speed-up over the incumbent approach.
Capsule networks with non-iterative cluster routing

Capsule networks use routing algorithms to flow information between consecutive layers. In the existing routing procedures, capsules produce predictions (termed votes) for capsules of the next layer. In a nutshell, the next-layer capsule's input is a weighted sum over all the votes it receives. In this paper, we propose non-iterative cluster routing for capsule networks. In the proposed cluster routing, capsules produce vote clusters instead of individual votes for next-layer capsules, and each vote cluster sends its centroid to a next-layer capsule. Generally speaking, the next-layer capsule's input is a weighted sum over the centroid of each vote cluster it receives. The centroid that comes from a cluster with a smaller variance is assigned a larger weight in the weighted sum process. Compared with the state-of-the-art capsule networks, the proposed capsule networks achieve the best accuracy on the Fashion-MNIST and SVHN datasets with fewer parameters, and achieve the best accuracy on the smallNORB and CIFAR-10 datasets with a moderate number of parameters. The proposed capsule networks also produce capsules with disentangled representation and generalize well to images captured at novel viewpoints. The proposed capsule networks also preserve 2D spatial information of an input image in the capsule channels: if the capsule channels are rotated, the object reconstructed from these channels will be rotated by the same transformation.
Risk factors for the development of low anterior resection syndrome

Abstract Disorders of defecatory function are common after treatment for rectal cancer, especially following restorative proctectomy and radiotherapy, administered either in the neoadjuvant or postoperative adjuvant setting. The low anterior resection score (LARS) score is the most widely used questionnaire for assessing bowel function after restorative proctectomy. However, the LARS score, despite providing an effective means to pool data for meta-analyses and prediction modelling, has limitations because of the lack of a precise definition of LARS. An international consensus definition was only recently established, and further work is required to convert this into a scoring system that can hopefully more accurately quantify and discriminate changes that occur over time and with treatment. Only then will we be able to identify true and actionable risk factors for LARS.
Postnatal Sepsis and Bronchopulmonary Dysplasia in Premature Infants: Mechanistic Insights into "New BPD".

Bronchopulmonary dysplasia (BPD) is a debilitating disease in premature infants resulting from lung injury that disrupts alveolar and pulmonary vascular development. Despite the use of lung-protective ventilation and targeted oxygen therapy, BPD rates have not significantly changed over the last decade. Recent evidence suggests that sepsis and conditions initiating the systemic inflammatory response syndrome in preterm infants are key risk factors for BPD. However, the mechanisms by which sepsis-associated systemic inflammation and microbial dissemination program aberrant lung development are not fully understood. Progress has been made within the last 5 years with the inception of animal models allowing mechanistic investigations into neonatal acute lung injury and alveolar remodeling due to endotoxemia and NEC. These recent studies begin to unravel the pathophysiology of early endothelial immune activation via pattern recognition receptors such as Toll Like Receptor 4 and disruption of critical lung developmental processes such as angiogenesis, extracellular matrix deposition, and ultimately alveologenesis. Here we review scientific evidence from preclinical models of neonatal sepsis-induced lung injury to new data emerging from clinical literature.
A Mecca for Militants: An Examination of the Development of International Terrorism in Peshawar, Pakistan, 1970-2010

This paper is an examination of the beginnings of global terrorism in Peshawar, Pakistan—a modern region of violence and militancy. This city has been a major proponent in one of the most problematic global issues of this era, international terrorism. Examining the environment in which this type of militancy began and what incurred is vital to understanding how to assuage the issue as it stands today and how to further the development of peaceful conditions in the future. The development of this center of violence is examined through analysis of the city’s modern history. By delving into the social, political and economic issues that plagued the city from 1970 to the turn of the century, one may see what factors created this disparate area of corruption. Analysis of this time frame indicates that irresponsibility on behalf of international super powers such as the U.S., India, Russia, and Saudi Arabia is a central cause behind Peshawar’s militant issues. Although local factors played a vital role in the extrapolation of militancy, this dissertation will focus on the global factors because by understanding these it is possible to avoid the further development of international violence. This is an argument that militancy does not develop solely because of inherent cultural tendencies but also because of the intrusion of international dilemmas and dogma, and should be addressed accordingly.
Determining articulator configuration in voiced stop consonants by matching time-domain patterns in pitch periods

In this thesis I will be concerned with linking the observed speech signal to the configuration of articulators. Due to the potentially rapid motion of the articulators, the speech signal can be highly non-stationary. The typical linear analysis techniques that assume quasi-stationarity may not have sufficient time-frequency resolution to determine the place of articulation. I argue that the traditional low and high-level primitives of speech processing, frequency and phonemes, are inadequate and should be replaced by a representation with three layers: (1) short pitch period resonances and other spatio-temporal patterns; (2) articulator configuration trajectories; (3) syllables. The patterns indicate articulator configuration trajectories (how the tongue, jaws, etc. are moving), which are interpreted as syllables and words. My patterns are an alternative to frequency. I use short time-domain features of the sound waveform, which can be extracted from each vowel pitch period pattern, to identify the positions of the articulators with high reliability. These features are important because by capitalizing on detailed measurements within a single pitch period, the rapid articulator movements can be tracked. No linear signal processing approach can achieve the combination of sensitivity to short term changes and measurement accuracy resulting from these nonlinear techniques. The measurements I use are neurophysiologically plausible: the auditory system could be using similar methods. I have demonstrated this approach by constructing a robust technique for categorizing the English voiced stops as the consonants B, D, or G based on the vocalic portions of their releases. The classification recognizes 93.5%, 81.8% and 86.1% of the b, d and g to ae transitions with false positive rates 2.9%, 8.7% and 2.6% respectively. (Copies available exclusively from MIT Libraries, Rm. 14-0551, Cambridge, MA 02139-4307. Ph. 617-253-5668; Fax 617-253-1690.)
State of the Art in Subgrid-Scale Modeling

The need for turbulence models is well known. Only in the last few years has it become possible to compute any turbulent flow without models. We can now simulate homogeneous turbulent flows at moderate Reynolds numbers and are beginning to simulate simple inhomogeneous low-Reynolds-number flows. Although the range of flows accessible to direct or exact simulation will increase as further improvements are made in computer hardware, there is no possibility of this approach becoming an engineering tool in the foreseeable future. Even if large enough computers were available, it is unlikely that an engineer would want to generate the enormous amount of data exact simulation would produce in order to get a few pieces of significant information. What is desired, obviously, is a method which produces the information needed for design purposes (pressure distribution, skin friction, etc.) and as little else as possible.
The Continent Ileal Pouch: Absorptive and Motor Features

In 8 patients, 6 to 40 months after proctocolectomy and construction of a continent ileal pouch, selected absorptive and motor functions of the pouch were assessed. Test solutions of 100 or 200 ml, containing a nonabsorbable marker, were placed in the pouch and sampled serially for 1 hr; an oro-intestinal tube was used to prevent contamination of the pouch by endogenous secretions. Sodium, chloride, and water were absorbed in a fashion similar to that reported previously for normal ileum. Similarly, the resting mucosal potential difference and its response to glucose were like those of normal ileum. The pouch also absorbed vitamin B12 that was instilled together with intrinsic factor. The distribution of primary and secondary bile acids in duodenal content suggested that decreased dehydroxylation of bile acids, also seen after conventional ileostomies, occurs in pouch patients. The pattern of motility in pouches was consistent with that reported previously for normal ileum. Thus, the functions of the mucosa and smooth muscle of the continent ileal pouch are quite similar to those of normal ileum.
Tutorial: holey fibers: fundamentals and applications

The wavelength-scale features in holey fibres lead to novel properties including endlessly single-mode guidance and anomalous dispersion well below 1.3 microns. Fundamentals and recent progress will be reviewed, ranging from fabrication and modelling to devices and applications.
The United States and Nicaragua: Understanding the Breakdown in Relations

Although the United States and Nicaragua maintained cooperative relations for a period after the Sandinista revolution of 1979, ties between the two states deteriorated. What explains the shift from cordial to hostile relations? The two dominant explanations have been that the aggressive policies of the new Reagan administration forced the Sandinista regime into a defensive position of hostility or that a downward spiral occurred based on the security dilemma. This paper rejects both and offers an alternative: The Sandinistas for ideological and domestic political reasons chose antagonistic relations when they opted to arm and support the rebels in El Salvador in violation of an earlier agreement between the two states. Drawing on research that shows the aggressive tendencies of revolutionary states, the article contrasts this theory with the spiral model. Moreover, analysis of the archives of the early Reagan administration shows that it wanted to find an accommodation with Managua. Although the revoluti...
Are the novel anticoagulants better than warfarin for patients with atrial fibrillation

Atrial fibrillation (AF) is associated with significant morbidity and mortality related to stroke due to thromboembolism. Several novel oral anticoagulants (NOACs) have been developed that dosedependently inhibit thrombin or activated factor X (factor Xa). These new agents offer potential advantages over vitamin K antagonists, however, several limitations exist. We will review the four large randomized trials comparing the efficacy and safety of new oral anticoagulants with warfarin for stroke prevention in patients with AF as well as assess “real world” data and discuss the limitations of the new agents.
Novel cytotoxic acylated oligorhamnosides from Mezzettia leptopoda.

Activity-guided fractionation of a stem extract of Mezzettia leptopoda using human oral epidermoid carcinoma (KB) cells led to the isolation of seven highly acylated oligorhamnosides. Four of these...