cssi/SciSciGPT-SciSciNet huggingface dataset:
Malpractice litigation in the endovascular era

Abstract Objective The standard of care in the treatment of vascular disease continues to evolve as endovascular therapies develop. Currently, it is unclear how medical malpractice litigation has adapted to the "endovascular era." This retrospective case review is the most comprehensive analysis to date of malpractice actions involving endovascular procedures performed by vascular surgeons (VSs), interventional radiologists (IRs), interventional cardiologists (ICs), and cardiothoracic surgeons (CTSs). Methods The legal databases LexisNexis and Westlaw were searched for all published legal cases in the United States involving endovascular procedures. The search was limited to state and federal cases up to and including the year 2016. Keywords included "malpractice," "vascular," "endovascular," "catheter," "catheterization," "stent," "angiogram," "angiography," and "surgery." Cases involving tax revenue, insurance disputes, Social Security Disability, and hospital employment contract disputes were excluded. Data were analyzed using χ 2 test. Results There were 2115 initial search results identified, and 369 cases were included in final analysis. The rate of endovascular procedure-related lawsuits (per 1000 active physicians in the specialty) was highest for ICs (105.56), whereas rates for VSs and IRs were comparable (18.47 and 16.85, respectively); 93% of the IC cases were related to coronary interventions. Overall, 55% (148/271 classifiable cases) of actions were related to elective procedures. For VSs specifically, 46% (25/54) of cases arose from diagnostic angiography and inferior vena cava filter placement, two relatively minor procedure types. Overall, 83% (176/211 finalized cases) of verdicts favored defendants, with no significant differences across the specialties; 43% (157/368) of total cases involved death of the patient. Among the four specialties, there was a significant ( P = .0004) difference in the primary allegation (informed consent, preprocedure negligence, intraprocedure complications, or postprocedure complications) underlying the litigation. For CTSs and VSs, there was a predominance of informed consent and preprocedure negligence allegations (70% [7/10] and 52% [28/54], respectively). Intraprocedure negligence was the most common allegation for IRs (59% [23/39]), whereas allegations were more evenly distributed among ICs. Conclusions Key issues were identified regarding malpractice litigation involving the specialties that commonly perform endovascular procedures. Despite the increasing number of ICs doing peripheral interventions, a large majority of IC cases were related to coronary treatments. A surprisingly large percentage of VS cases were related to seemingly minor cases. There were significant interspecialty differences in the primary underlying allegations. As the scope of endovascular procedures broadens and deepens, it is important for clinicians to be aware of legal considerations relevant to their practice.
The Stress Response in Candida albicans

Prokaryotic and eukaryotic cells respond to various forms of physiological stress by the increased production of an array of proteins called stress proteins [2,3,18,30,31,40]. These proteins may be induced by the stress or may be constitutive proteins whose production is markedly increased as a response to such stress. In nearly every system where stress has been studied, stress-response proteins have been found [3,18,30,31,40]. In some organisms, production of the stress proteins is associated with an increased tolerance to the stressful event [8,36,37].
A comparison of clinicians' racial biases in the United States and France.

Abstract Rationale Clinician bias contributes to racial disparities in healthcare, but its effects may be indirect and culturally specific. Objective The present work aims to investigate clinicians' perceptions of Black versus White patients' personal responsibility for their health, whether this variable predicts racial bias against Black patients, and whether this effect differs between the U.S. and France. Method American (N = 83) and French (N = 81) clinicians were randomly assigned to report their impressions of an identical Black or White male patient based on a physician's notes. We measured clinicians' views of the patient's anticipated improvement and adherence to treatment and their perceptions concerning how personally responsible the patient was for his health. Results Whereas French clinicians did not exhibit significant racial bias on the measures of interest, American clinicians rated a hypothetical White patient, compared to an identical Black patient, as significantly more likely to improve, adhere to treatment, and be personally responsible for his health. Moreover, in the U.S., personal responsibility mediated the racial difference in expected improvement, such that as the White patient was seen as more personally responsible for his health, he was also viewed as more likely to improve. Conclusion The present work indicates that American clinicians displayed less optimistic expectations for the medical treatment and health of a Black male patient, relative to a White male patient, and that this racial bias was related to their view of the Black patient as being less personally responsible for his health relative to the White patient. French clinicians did not show this pattern of racial bias, suggesting the importance of considering cultural influences for understanding racial biases in healthcare and health.
The Pursuit of Innovation

The symposium brings together leading scholars who will share their perspectives of the following topics. First, who is driving innovation in our economy? The role of startup and incumbent firms. S...
Molecular Genetics of Myelin Basic Protein in Mouse and Humans

Myelin is a multi-lamellar membrane structure which ensheathes the axon and acts to increase nerve conduction velocity without a significant increase in axonal diameter. Myelin occurs mainly in vertebrates (1), although some invertebrates have been found to have a myelin like structure as well. The myelin sheath is synthesized by oligodendrocytes in the central nervous system (2) (CNS) and Schwann cells in the peripheral nervous system (3) (PNS). The myelin sheath synthesized by these two cell types is morphologically similar and consists of a series of concentrically wrapped membrane bilayers which are extensions of the oligodendrocyte or Schwann cell plasma membrane (4). During myelination, these membrane extensions are repeatedly wrapped about the axon and are then compacted at both apposed cytoplasmic and extracellular membrane surfaces to form the intraperiod and major dense lines seen by electron microscopy in mature myelin (5) [see Figure 1]. Maturation of the myelinating cell and deposition of the myelin sheath is, thus, accompanied by a number of drastic morphological and physiological changes which also include the synthesis of a set of new proteins found only in myelin (6). Although Schwann cells and oligodendrocytes synthesize morphologically similar membrane structures, they have different embryological origins and distinct biological properties (2, 3). This chapter concerns mainly oligodendrocyte gene expression, thus the following discussion will focus on the oligodendrocyte and CNS myelination.
Structural Motif Descriptors as a Way To Elucidate the Agonistic or Antagonistic Activity of Growth Hormone–Releasing Hormone Peptide Analogues

The synthesis of analogues of hypothalamic neuropeptide growth hormone–releasing hormone (GHRH) is an efficient strategy for designing new therapeutic agents. Several promising synthetic agonist and antagonist analogues of GHRH have been developed based on amino acid mutations of the GHRH (1–29) sequence. Because structural information on the activity of the GHRH agonists or antagonists is limited, there is a need for more effective analytical workflows capable of correlating the peptide sequence with biological activity. In the present work, three GHRH agonists—MR-356, MR-406, and MR-409—and three GHRH antagonists—MIA-602, MIA-606, and MIA-690—were investigated to assess the role of substitutions in the amino acid sequence on structural motifs and receptor binding affinities. The use of high resolution trapped ion mobility spectrometry coupled to mass spectrometry allowed the observation of a large number of peptide-specific mobility bands (or structural motif descriptors) as a function of the amino acid...
Image Reconstruction and the Solution of Inverse Problems in Medical Imaging

An overview of reconstruction methods applicable to medical tomography is given. Analytic methods based on the continuous form of the inverse Radon transform and matrix inversion and pseudoinversion methods based on a discrete formalism are presented. Statistical principles such as maximum likelihood and Bayesian estimation are also discussed.
Limits on Client Autonomy in Legal Ethics

This Article examines legal ethics provisions that limit client autonomy and identifies the spectrum of reasons for which code drafters have circumscribed client autonomy. It concludes that, by failing to tailor limiting provisions to their justifications, the professional code drafters drafters have promulgated a series of flawed rules. Part I of this Article describes a variety of justifications for imposing limitations, ranging from the lawyer's superior decisionmaking expertise to independent societal interests that outweigh the client's interest in autonomy. Part II relates the existing rules that limit client autonomy to their justifications, demonstrating that at least some of the rules have been drafted poorly. Part III analyzes the ramifications of these drafting deficiencies. The purpose of this Article is not to second-guess the aims of the legal ethics codes. The Article accepts, as a given, the validity of the drafters' initial decisions to limit client freedoms and, often, to take a paternalistic posture. Its focus, instead, is on demonstrating the importance of rigor in code drafting, especially when the codes shift moral or tactical responsibility for decisions from clients to lawyers.
State Farm 'with Teeth': Heightened Judicial Review in the Absence of Executive Oversight

While courts and commentators have considered the information-forcing role of executive oversight and judicial review of agency action, the dynamic relationship between the two has yet to be considered. This Article presents a novel justification for heightened judicial scrutiny in the absence of meaningful executive oversight, premised on a reasoned decision-making basis. Judicial review of certain types of agency determinations should be more stringent because those determinations have not been vetted by executive oversight and are thus less likely to be premised on reasons backed by empirical support. Agency cost-benefit analyses and agency conflict preemption determinations — two realms rarely if ever considered together — are compared in terms of their reliance on underlying factual predicates and contrasted in terms of the existing framework for executive oversight and judicial review of agency determinations. A heightened judicial review standard — what I term “State Farm with teeth” — should guide courts’ evaluations of the cost-benefit analyses performed by independent agencies not subject to executive oversight. This Article is the first to draw the distinction between independent and executive agencies in the State Farm hard-look context. It is also the first to explore the recent Business Roundtable decision by the D.C. Circuit through this analytical lens. The stringent “State Farm with teeth” standard should likewise be applied to judicial review of agency determinations of conflict preemption made in the absence of executive oversight. As this Article discusses, recent developments involving the Office of the Comptroller of the Currency’s preemption assertions regarding state banking laws provide a compelling illustration of why this should be so. This Article also points to a potential new information-forcing role for Congress. Using the Dodd-Frank Act as an illustration, this Article shows how Congress can set parameters for judicial review of administrative agencies’ fact-based conflict preemption determinations.
Patient-Ventilator Dyssynchrony

For patients receiving mechanical ventilation who are not using their respiratory muscles, all of the work of breathing is done by the ventilator. This scenario often occurs in the setting of deep sedation, paralysis, or significant neurologic dysfunction. However, many patients receiving mechanical ventilation are active participants in the respiratory process and use their respiratory muscles. The ventilator’s role for these patients is to reduce the work of breathing. In order for this collaboration between the patient and the ventilator to occur successfully, a significant amount of synchrony is necessary for breath initiation (trigger), inspiratory flow determination (target), and breath termination (cycle). Dyssynchrony between the patient and the ventilator can result in significant patient discomfort and increased work of breathing. The types of dyssynchrony are characterized as those that occur during the trigger phase, the target phase, and the cycle phase.
Orbital Fat Injection: Technique and 5-Year Follow-Up

Orbital volume loss, early or late, is common after placement of an orbital implant or dermis fat graft, and there is currently no satisfactory long-lasting solution. Hyaluronic fillers are relatively easy to administer but are prone to migration and are temporary. Cannula-based orbital fat grafting has not gained the status of standard of care because of perceived low likelihood of success in the near term. This paper describes a technique for fat volume augmentation, its rationale, long-term follow-up, and a description of a complication unique to fat grafting in the orbit. Ten consecutive subjects with acquired anophthalmic enophthalmos were enrolled in two IRB (institutional review board)-approved protocols (10.27 and 12.01) undergoing a single session of autologous fat grafting to the orbit using a closed blunt cannula technique. Preoperative photography and non-contrast MRIs (magnetic resonance imaging) were obtained prior, immediately after, and at 1 year after injection. Yearly postoperative photography was performed on subjects with successful results. Three of five subjects in IRB 10.27 clearly showed a clinically apparent increase in orbital volume at 1 year. One subject who failed to show improvement also sustained inadvertent injection into three extraocular muscles; she subsequently volunteered to enter IRB 12.01. Three of five subjects in IRB 12.01 did benefit, showing volume increase at 1 year, including the subject who had experienced intramuscular injection in 10.27. One subject in IRB 12.01 was lost to follow-up. Of the total of ten subjects enrolled, three showed no improvement and one was lost to follow-up; six subjects showed volume improvement at 1 year with two retaining the correction at 5 years and four showing variable diminution over 2–5 years. With the exception of the subject who sustained injection into extraocular muscles, none experienced complications. A modified technique is recommended for orbital fat injection distinct from methods used elsewhere in the body. Theoretical limits of volumetric enhancement temper expectations in orbital fat grafting and should inform surgical planning. Cannula-based orbital fat grafting can be done safely and result in a gain of orbital fat volume at 1 year and in some cases up to 5 years. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
'Too Gay for Facebook': Presenting LGBTQ+ Identity Throughout the Personal Social Media Ecosystem

Most US social media users engage regularly with multiple platforms. For LGBTQ+ people, this means making self-presentation decisions not just on one platform, but many. These choices are made in the face of sometimes-overlapping platform environments, which can have consequentially different norms, audiences, and affordances. Moreover, many LGBTQ+ users face high stakes in online self-presentation, due to the risk of stigmatization of their LGBTQ+ identity, increasing the importance of self-presentation decisions that enable them to achieve their goals and avoid stigmatization. This combination of environmental complexity and high stakes is not adequately accounted for in existing work on self-presentation, but doing so is important to support and understand the experiences of LGBTQ+ and other potentially stigmatized users. We adopt an ecological approach to an interview and cognitive mapping study of 20 LGBTQ+ social media users. We find that participants employ the platforms, audiences, affordances, and norms within what we call their "personal social media ecosystems" to avoid stigmatization while still allowing for expression of their LGBTQ+ identity and the flexibility to adjust their presentation over time.
Tumor Copy Number Data Deconvolution Integrating Bulk and Single-cell Sequencing Data

Resolving tumor heterogeneity is a crucial step in understanding cancer development and evolution but it is hampered by limits of all available data sources. Bulk sequencing has become the most common technology to assess the tumor heterogeneity but it has the limitation of mixing many genetically distinct cells in each sample which must then be computationally deconvolved. This genomic deconvolution generally has low resolution and high error rates in reconstructing clonal population structure. Recent technological developments in single-cell sequencing (SCS) provide the potential for providing high resolution, whole-genome reconstructions of clonal structure. However, the limitations of SCS – such as high noise, difficulty in scaling to large populations, various challenging technical artifacts, and the large data sets it produces – have so far made it impractical for applying to study cohorts of sufficient size to identify statistically robust features of tumor evolution. To address these problems, we have developed strategies to combine limited amounts of bulk and single-cell data to gain some advantages of single-cell resolution with much lower cost. We specifically focus on the problem of deconvolving copy number data from bulk samples assisted by information from small numbers of SCS sequences. We developed a mixed membership model for clonal deconvolution via Non-Negative Matrix Factorization (NMF) balancing deconvolution quality of the bulk data with similarity to single-cell samples and an associated efficient coordinate descent algorithm. We improve on that algorithm by integrating deconvolution with clonal phylogeny inference, using an integer linear programming (ILP) model to add a minimum evolution phylogenetic cost to the problem objective so as to bias deconvolution to favor inferred clones that are plausibly related to observed SCS data. We demonstrate the effectiveness of these methods on semi-simulated data of known ground truth, showing significantly enhanced deconvolution accuracy relative bulk data alone.
Robustly assigning unstable items

We study the Robust Assignment Problem where the goal is to assign items of various types to containers without exceeding container capacity. We seek an assignment that uses the fewest number of containers and is robust, that is, if any item of type \(t_i\) becomes corrupt causing the containers with type \(t_i\) to become unstable, every other item type \(t_j \ne t_i\) is still assigned to a stable container. We begin by presenting an optimal polynomial-time algorithm that finds a robust assignment using the minimum number of containers for the case when the containers have infinite capacity. Then we consider the case where all containers have some fixed capacity and give an optimal polynomial-time algorithm for the special case where each type of item has the same size. When the sizes of the item types are nonuniform, we provide a polynomial-time 2-approximation for the problem. We also prove that the approximation ratio of our algorithm is no lower than 1.813. We conclude with an experimental evaluation of our algorithm.
Language and technology: Partners in helping students with disabilities develop numeracy: Paper delivered at the Successful Learning Conference, University of Sydney, July 1, 2002.

Improving the mathematics skills of students with disabilities has long challenged both teachers and researchers. Not surprisingly, the research in this area has focused primarily on identifying and teaching students strategies for unlocking the meaning of text‐based problems because most instructional materials and assessments define problem solving this way. However, text‐based problems rarely generate the academic, attitudinal, and emotional responses in low‐achieving students that problems in everyday life do. This paper describes how Enhanced Anchored Instruction (EAI) uses video‐based math problems to promote the development of math skills in low‐achieving adolescents.
The effects of integrated writing on linguistic complexity in L2 writing and task-complexity

Abstract Drawing on research on task-based L2 teaching and writing, this study examines the effects of integrated writing – as a function of task-complexity – on the quality of written texts produced by intermediate learners of German at a U.S. university. Participants completed six writing tasks over ten weeks: three were based on authentic resources (two multimodal and one print-only texts), while three required learners to describe their own experiences based on textbook prompts (non-content supported tasks). In line with current TBLT research, learners' texts were analyzed for syntactic complexity, grammatical accuracy, fluency, lexical accuracy, choice and richness. The results suggest that content provision likely reduced learners’ cognitive processing burden, resulting in improvements on all linguistic features. These findings offer theoretical, methodological and pedagogical insights for investigating integrative writing within TBLT research, especially regarding the use of authentic source texts and the potential benefit of multimodal source texts for promoting L2 writing quality.
Enantioselective synthesis of the (5S, 6R, 9R) and (5S, 6R, 9S) analogs of lactacystin β-lactone

Abstract The synthesis of two diastereomers of lactacystin β-lactone (2), the β-lactones 3 and 4, is described.
High-Resolution Photoelectron Spectroscopy

Abstract This article presents recent progresses in photoelectron spectroscopy (PES) of transient metal complexes and clusters at sub-meV energy resolution. Short-lived metal species are prepared through in situ laser-assisted synthesis and cooled by supersonic expansions. Three variants of high-resolution PES are described along with representative applications in coordination and organometallic chemistry. They are pulsed-filed-ionization zero electron kinetic energy (ZEKE), mass-analyzed threshold ionization (MATI), and low-energy photoelectron velocity-map imaging (PEVMI) spectroscopies.
Spontaneous Conception during In Vitro Fertilization prior to Embryo Transfer without the Opportunity for Preimplantation Genetic Testing

In addition to the potential for multiple pregnancy, spontaneous conception during in vitro fertilization (IVF) can lead to undesired genetic outcomes. We present a case of a patient undergoing IVF with the intention of subsequent frozen embryo transfer after preimplantation genetic testing (PGT). Unprotected intercourse 6 days prior to egg retrieval resulted in a spontaneous pregnancy before the opportunity for embryo transfer. This case report highlights that spontaneous conception during IVF compromises the ability to transfer embryos that are euploid, unaffected by single gene disorders, or intended for gender balancing within a family when desired.
Contribution of Epithelial Cell Dysfunction to the Pathogenesis of Chronic Rhinosinusitis with Nasal Polyps.

BackgroundIn the past, the airway epithelium was thought to be primarily an inert physical barrier. We now know that the upper airway epithelium plays a critical role in both innate and adaptive im...
Theme-based Book Review: Critical Views of Public Administration in Practice and Research

Within public administration circles, a certain normative sense of service and consideration of the public interest is often assumed. A simplistic view of doing the public good has increasingly com...
USDA's Rural Utilities Service and Rural Broadband: A Multistakeholder Approach to American Broadband Policy

Drawing on the increasing body of literature on policy stakeholders and the ever-growing acknowledgement that communication policy is crafted by more than just parliamentarians and formal communication regulators this paper examines the role that another set of regulators plays in communication policy: agriculture regulators. Based on a study of the United States Department of Agriculture’s Rural Utilities Service (RUS), this paper explores alternative agents of communication policy. More specifically, through document analysis and in-depth elite interviews we examine the way in which RUS has shaped rural broadband policy over the last three decades. We label RUS a “reluctant regulator” when it comes to rural broadband to signal its perceived legitimacy in the space but lack of consistent initiative in setting policy. The implications for this research are broad as it brings another actor into the policy making process, provides a comprehensive description of rural broadband policy, and pushes communication policy scholars to consider the role that non-traditional communication regulators play in the communication policy making process.
Rings arising from finite tight hypergroups

Abstract The notion of a hypergroup (in the sense of [8] ) provides a far reaching and meaningful generalization of the concept of a group. Specific classes of hypergroups have given rise to challenging questions and interesting connections to geometric and group theoretic topics; cf. [4] , [9] , [10] , and [14] . The present article is a continuation of a study of residually thin hypergroups which was initiated in [4] . One of the main results of [4] says that finite tight hypergroups, that is hypergroups all elements h of which satisfy h h ⁎ h = { h } , are residually thin; cf. [4, Theorem 7.7] . (Tight hypergroups occur in the study of metathin association schemes; cf. [3] , [5] , [6] , [7] , [12] , [13] .) In the present article, we take advantage of this result in order to construct, for each finite tight hypergroup satisfying a mild extra condition, an associative ring. The rings which we find generalize the construction of scheme rings for a certain class of association schemes, including those which correspond to finite groups (group rings).
A multi-omic characterization of temperature stress in a halotolerant Scenedesmus strain for algal biotechnology.

Microalgae efficiently convert sunlight into lipids and carbohydrates, offering bio-based alternatives for energy and chemical production. Improving algal productivity and robustness against abiotic stress requires a systems level characterization enabled by functional genomics. Here, we characterize a halotolerant microalga Scenedesmus sp. NREL 46B-D3 demonstrating peak growth near 25 °C that reaches 30 g/m2/day and the highest biomass accumulation capacity post cell division reported to date for a halotolerant strain. Functional genomics analysis revealed that genes involved in lipid production, ion channels and antiporters are expanded and expressed. Exposure to temperature stress shifts fatty acid metabolism and increases amino acids synthesis. Co-expression analysis shows that many fatty acid biosynthesis genes are overexpressed with specific transcription factors under cold stress. These and other genes involved in the metabolic and regulatory response to temperature stress can be further explored for strain improvement. Sara Calhoun, Tisza Ann Szeremy Bell, Lukas Dahlin and colleagues characterize the growth and biomass accumulation of a halotolerant microalga Scenedesmus sp. NREL 46B-D3. They sequenced the genome and profiled the transcriptomic and metabolomic response of this strain under high and low-temperature stress, and shed light on the genes involved in the metabolic and regulatory response to temperature stress.
Common biomarkers of physiologic stress and associations with delirium in patients with intracerebral hemorrhage.

Abstract Purpose To examine associations between physiologic stress and delirium in the setting of a direct neurologic injury. Materials and methods We obtained initial neutrophil-to-lymphocyte ratio (NLR), glucose, and troponin in consecutive non-comatose patients with non-traumatic intracerebral hemorrhage (ICH) over 1 year, then used multivariable regression models to determine associations between each biomarker and incident delirium. Delirium diagnoses were established using DSM-5-based methods, with exploratory analyses further categorizing delirium as first occurring 24 h after presentation (“later-onset”). Results Of 284 patients, delirium occurred in 55% (early-onset: 39% [n = 111]; later-onset: 16% [n = 46]). Patients with delirium had higher NLR (mean 9.0 ± 10.4 vs. 6.4 ± 5.5; p = 0.01), glucose (mean 146.5 ± 59.6 vs. 129.9 ± 41.4 mg/dL; p = 0.008), and a higher frequency of elevated troponin (>0.05 ng/mL; 21% vs. 10%, p = 0.02). In adjusted models, elevated NLR (highest quartile: OR 3.4 [95% CI 1.5–7.8]), glucose (>180 mg/dL: OR 3.1 [95% CI 1.1–8.2]), and troponin (OR 3.0 [95% CI 1.2–7.2]) were each associated with delirium, but only initial NLR was specifically associated with later-onset delirium and with delirium in non-mechanically ventilated patients. Conclusions Stress-related biomarkers corresponding to multiple organ systems are associated with ICH-related delirium. Early NLR elevation may also predict delayed-onset delirium, potentially implicating systemic inflammation as a contributory delirium mechanism.
Skill Acquisition During Transdiagnostic Treatment With the Unified Protocol.

Abstract The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders is an emotion-focused, cognitive-behavioral intervention developed to address the full range of anxiety, depressive, and related disorders. The UP consists of core therapeutic skills that, though unique in focus, are each designed to promote an approach-oriented stance toward emotional experiences. The goal of the present investigation was to characterize changes in these skills for patients that received a course of treatment with the UP, as well as to examine associations between skills and symptoms changes. Patients with principal anxiety disorders, assigned to receive treatment with the UP (N = 88) as part of a randomized controlled trial, were included in this study. They completed validated self-report measures of UP skills (Understanding Emotions, Mindful Emotion Awareness, Cognitive Flexibility, Countering Emotional Behaviors, and Interoceptive Awareness and Tolerance), as well as clinician-rated measures of psychological symptoms. Skill measures improved significantly over the course of 12 to 16 UP treatment sessions and changes in these skills measures were associated with improvements in anxiety symptoms. Determining whether improvement on all the skills learned during a course of treatment with UP is associated with symptom remission is critical to establishing the most streamlined and efficient interventions that may ultimately be best suited to widespread dissemination.
Automatic gate-level synthesis of speed-independent circuits

A CAD tool for the synthesis of asynchronous control circuits using basic gates such as AND gates and OR gates is presented. The synthesized circuits are speed-independent-that is, they work correctly regardless of individual gate delays. Synthesis results for a variety of specifications taken from industry and previously published examples are presented. The speed-independent circuits are compared with those non-speed-independent circuits synthesized using previously described algorithms, in which delay elements are added to remove circuit hazards. These synthesis results show that the new circuits are on average approximately 25% faster with an area penalty of only 15%. This work demonstrates that direct synthesis of gate-level speed-independent circuits is not only feasible, but also produces robust and relatively efficient circuits compared to those synthesized with timing constraints. >
Market Expectations of a Warming Climate

Abstract We compare prices of financial derivatives whose payouts are based on future weather outcomes to CMIP5 climate model predictions as well as observed weather station data across eight cities in the US from 2001 through 2020. Derivative prices respond both to short-term weather forecasts for the next two weeks and longer-term warming trends. We show that the long-term trends in derivative prices are comparable to station-level data and climate model output. The one exception is February in the northeastern US, where financial markets price in a polar vortex-induced cooling effect, a recent scientific finding that was not present in the older CMIP5 climate output. When looking at the spatial and temporal heterogeneity in trends, futures prices are more aligned with climate model output than observed weather station trends, suggesting that market participants closely align their expectations with scientific projections rather than recent observations.
Evaluation of Patient-Reported Outcome Measures of Positive Psychosocial Constructs in Children and Adolescent/Young Adults with Cancer: A Systematic Review of Measurement Properties.

Introduction: Children, adolescents, and young adults with cancer are a vulnerable population in whom improvements in psycho-oncology care would be valuable. We previously published a scoping review exploring what is known about positive psychological constructs in this population. A key finding was that evidence-based patient-reported outcome measures (PROMs) were needed to standardize psycho-oncology research. Methods: We undertook a systematic review of measurement properties focused on PROMs in the pediatric and adolescent/young adults (AYAs) with cancer populations. We searched for PROMs that measured at least 1 of 15 previously identified, key positive constructs. This systematic review followed COSMIN guidelines, considered the gold standard manual for systematic reviews of measurement properties. Results: We identified 20 (22 if proxy reports are counted separately) unique PROMs that met inclusion criteria. Of those, only five were recommended for use given the current evidence. The remainder may be used if no alternative exists. Only eight PROMs had any evidence of content validity, considered the most important psychometric property by COSMIN. Many studies were at risk of bias owing to incomplete or suboptimal methods. Discussion: Five PROMs are considered reliable for the pediatric and AYA with cancer populations. A number of PROMs require additional research to ensure their items and instructions are comprehensive, relevant, and comprehensible to children and AYAs. Given the overall lack of research, this review may be considered a starting point for the future refinement of a core set of PROMs to measure positive psychological constructs.
A 24-Year-Old Woman Presenting With Altered Mental Status and Multiorgan Failure.

Case Presentation A 24-year-old previously healthy woman was brought to the hospital for acute altered mental status. One week prior to presentation, she had developed a sore throat, nausea, and vomiting. At that time, SARS-CoV-2 polymerase chain reaction and rapid streptococcal pharyngitis test results were both negative. On the day prior to presentation, the patient had developed an erythematous painful rash on her left arm. The following day she was noted to be agitated, combative, and having trouble communicating, prompting ED evaluation. In the ED, the patient was tachycardic to 108 beats/min and tachypneic to 30 breaths/min but normotensive and afebrile. Her initial workup was notable for leukocytosis with bandemia, acute liver injury with coagulopathy, and acute renal failure. She was intubated, transferred to our hospital, and admitted to the MICU. The patient’s medical history was notable for obesity and oral contraceptive use. She had no family history of autoimmune, rheumatologic, or hematologic disorders. She was a student and worked part time in retail. She had no recent travel or outdoor exposure. The patient’s family was unaware of any tobacco or drug use but did report that she drank socially.
Large Bolted and Riveted Shingle Splices

THE RESULTS OF TWO FULL-SIZE SIMULATED BRIDGE JOINTS OF A CHORD MEMBER AND SPLICE ON THE BATON ROUGE INTERSTATE BRIDGE, A THREE-SPAN CANTILEVER TRUSS BRIDGE OVER THE MISSISSIPPI RIVER ARE REPORTED. ALSO GIVEN ARE THE RESULTS OF FIVE SMALL CONTROL TESTS. COMPARATIVE INFORMATION WAS OBTAINED ON THE BEHAVIOR OF RIVETED AND BOLTED JOINTS. THIS INCLUDED THE MAGNITUDE AND DISTRIBUTION OF SLIP, THE TRANSFER OF FORCE IN THE SHINGLED PLATES AND THEIR RELATIONSHIP TO DESIGN. IT WAS FOUND THAT THE SLIP BEHAVIOR OF THE LARGE JOINTS WAS IN REASONABLE AGREEMENT WITH THE SMALL CONTROL JOINTS. ALSO, THE OVERALL DEFORMATION OF THE LARGE RIVETED JOINT ALWAYS EXCEEDED THE COMPARABLE DEFORMATION IN THE BOLTED JOINT AT ALL LOAD LEVELS. THE FORCE TRANSFER WITHIN THE JOINT DIFFERED SIGNIFICANTLY FROM THE FORCE TRANSFER COMMONLY ASSUMED FOR DESIGN. /AUTHOR/
Place, Stress, and Health

Place is a multidimensional concept which can be defined geographically as well as by its social characteristics. Its geographical definition references its unique spatial attributes as distinct from the other surrounding spaces. However, places are varied by the environments by which they are surrounded which can differ politically, socially, culturally, and economically. Over time, the importance of place as an influence on physical and mental health has been recognized by social scientists. However, research in this area in the social sciences was sporadic until the late 1980s with much of the research literature limited to examining determinants of health at the individual level rather than examining structural influences on health that are place-based. Since then researchers have found that place of residence of an individual can impact both the physical and mental health of that individual. The context of place references both the physical context of where a person lives as well as its social and cultural characteristics. So, rather than considering only individual level characteristics as determinants of health, researchers in fields such as sociology began to focus more on social determinants such as place of residence. Keywords: health; neighborhoods; stress
Proofs Without Words: Exercises in Visual Thinking

1. Geometry and algebra 2. Trigonometry, calculus and analytic geometry 3. Inequalities 4. Integer sums 5. Sequences and series.
Progress in adaptive control of flexible spacecraft using lattice filters

This paper reviews the use of the least square lattice filter in adaptive control systems. Lattice filters have been used primarily in speech and signal processing, but they have utility in adaptive control because of their order-recursive nature. They are especially useful in dealing with structural dynamics systems wherein the order of a controller required to damp a vibration is variable depending on the number of modes significantly excited. Applications are presented for adaptive control of a flexible beam. Also, difficulties in the practical implementation of the lattice filter in adaptive control are discussed.
Dissipative Mechanics Using Complex-Valued Hamiltonians

We show that a large class of dissipative systems can be brought to a canonical form by introducing complex co-ordinates in phase space and a complex-valued hamiltonian. A naive canonical quantization of these systems lead to non-hermitean hamiltonian operators. The excited states are unstable and decay to the ground state . We also compute the tunneling amplitude across a potential barrier.
Why Unitary Boards are Not Best Practice: A Case for Compound Boards

The paper identifies the manifold conflicts of interest inherent in firms governed by a unitary board and how they exacerbate information overload and bounded rationality while paradoxically not providing sufficient information, independent of management, to direct, monitor, control, and change management. Compound boards introduce a division of power to mediate conflicts, allow access to superior feedback information from stakeholders, and enhance the cybernetic integrity of how a firm is governed. Transaction byte analysis is used to explain bounded rationality and identify how compound boards decompose decision making labour. Compound boards are identified as a necessary condition for reducing the cost of finance and developing (i) holonic architecture, (ii) social tensegrity, (iii) self-regulation and self-governance, (v) sustainable employee and/or other stakeholder participation in governance, and (vi) superior performance. This makes unitary boards inconsistent with convergence and knowledge intensive or network firms seeking to bond human capital with employee ownership.
Surface Analysis of OFE-Copper X-Band Accelerating Structures and Possible Correlation to RF Breakdown Events

X-band accelerator structures meeting the Next Linear Collider (NLC) design requirements have been found to suffer vacuum surface damage caused by radio frequency (RF) breakdown, when processed to high electric-field gradients. Improved understanding of these breakdown events is desirable for the development of structure designs, fabrication procedures, and processing techniques that minimize structure damage. RF reflected wave analysis and acoustic sensor pickup have provided breakdowns localization in RF structures. Particle contaminations found following clean autopsy of four RF-processed travelling wave structures, have been catalogued and analyzed. Their influence on RF breakdown, as well as that of several other material-based properties, will be discussed.
Out of Crisis: Rethinking Our Financial Markets

An Introduction to the Argument PART ONE: ON OUR SITUATION Chapter 1 The Suddenly Obvious and the Already Decided Chapter 2 Melodramatic Narratives Chapter 3 Blue Water: the Allure of Modern Finance Chapter 4 Tragedy and Law PART TWO: ON RETHINKING Chapter 5 Policy Thought, Regulation, Innovation Chapter 6 Constructing Healthy Markets Chapter 7 Metaphors for Thinking Socially About Capitalism PART THREE: ON POLICY Chapter 8 Restoring Confidence (Cleaning Up After a Crash) Chapter 9 Confronting Systemic Risk Chapter 10 The Old Questions, the Old Answers Conclusion: Fears and Other Possibilities
Photoinduced Polymer Chain Scission of Alkoxyphenacyl Based Polycarbonates

We report the design and development of a new class of alkoxyphenacyl based photodegradable polycarbonates. These polymers incorporate the photoactive moiety in the backbone and, when irradiated at...
Supramalleolar fatigue fractures of the tibia

Objective. The objective of this paper is to describe fatigue fractures in the supramalleolar area of the tibia. The spectrum of imaging findings in 14 cases is presented, with emphasis on plain film radiographic findings. Design and patients. Fourteen patients with fatigue fractures in the supramalleolar area of the distal tibia were seen in a 6-year period. The 13 men and 1 woman had an age range from 14 to 64 years (mean 30 years). These patients had no underlying conditions that would predispose them to fractures. Sequential plain film radiographs and other special imaging studies (technetium-99m scans and computed tomography) were retrospectively reviewed. Results and conclusions. Initial plain film radiographs showed a horizontal linear band of increased density in only 2 cases, a subtle cortical bulge in 5 cases, a focal ”graying” of the cortex in 2 cases, a single layer periosteal reaction in 1 case, and no abnormality in the final 4 cases. Technetium-99m scans were done in 11 cases and showed focal areas of increased uptake in all 11. These areas of increased uptake were vertically orientated in 10. One patient had computed tomography showing cortical thickening around a linear lu-cency. The spectrum of imaging findings is similar to that seen in fatigue fractures in more common locations. Supramalleolar fatigue fractures should be suspected in patients who have pain in the distal tibia even when initial plain film radiographs are normal. When initial radiographs are normal, technetium-99m scans can confirm the diagnosis.
Soundscapes offer unique opportunities for studies of fish communities.

Resource partitioning is a fundamental ecological concept in which cooccurring species reduce competition by using or specializing on different resources (1). It is widely accepted as a mechanism permitting similar species to cooccur, leading to increased levels of species diversity (2). Typically, resources are thought of as food, habitat, or behavioral features such as timing of foraging and pattern of prey capture. However, the concept applies equally well to any niche parameter that affects species success. This includes the “space” to effectively communicate with conspecifics (3). In PNAS, Ruppe et al. (4) document apparent resource partitioning in the acoustic communication behavior of a community of nocturnal marine fishes found in a cave environment on the rocky coastline of South Africa. They recorded and analyzed 2,793 instances of 17 distinctive sounds that differed in peak frequency and pulsing characteristics. They assumed those distinctive sounds represent separate species and found that sounds from sonic species recorded during the day were less acoustically distinct from one another than those recorded at night. The authors interpret this pattern as indicative of resource partitioning among nocturnal species that are largely limited to acoustic communication modalities. In contrast, the acoustic signals of diurnal species in the same community, for which visual displays undoubtedly play a larger role, are not so constrained and overlap considerably in frequency at the resolution used in their analysis (∼700 Hz).
Structure and chance: melding logic and probability for software debugging

Software errors abound in the world of computing. Sophisticated computer programs rank high on the list of the most complex systems ever created by humankind. The complexity of a program or a set of interacting programs makes it extremely difficult to perform offline verification of run-time behavior. Thus, the creation and maintenance of program code is often linked to a process of incremental refinement and ongoing detection and correction of errors. To be sure, the detection and repair of program errors is an inescapable part of the process of software development. However, run-time software errors may be discovered in fielded applications days, months, or even years after the software was last modified—especially in applications composed of a plethora of separate programs created and updated by different people at different times. In such complex applications, software errors are revealed through the run-time interaction of hundreds of distinct processes competing for limited memory and CPU resources. Software developers and support engineers responsible for correcting software problems face difficult challenges in tracking down the source of run-time errors in complex applications. The information made available to engineers about the nature of a failure often leaves open a wide range of possibilities that must be sifted through carefully in searching for an underlying error.
The nature of faith

This paper examines the psychological conditions that bring the experience of faith into being, and the psychological components the word “faith” refers to and except for which faith would not be experienced. The problem of maintaining faith without recourse to supernaturalism is discussed in terms of man's social relations and value satisfactions.