cssi/SciSciGPT-SciSciNet huggingface dataset:
'I Am In No Way This’: Troll Hunters and Pragmatic Digital Self-Reference

If personae are masks used to communicate a certain character in performance, what happens in rapid unmaskings, especially as they occur in digital space? That question is central to the phenomenon of “troll-hunting.” Employing both journalistic and algorithmic tools, troll hunters unmask the offline identity of purveyors of digital hate speech, child pornography, illegal commerce and more. Digital citizens have concerned themselves with the efficacy, privacy, and ethics of such hunting, but have not as frequently explored another area: The narrative distance between a digital persona and a perceived “real” person behind that persona. Such distances can range from some version of the sentiment, "I am in no way this kind of person" to a comfortable coupling between online-offline selves, even during public shaming. Using textual analysis, I critically examine statements of those whose digital troll persona were unmasked, with special attention to the word I and the dissonance in offline-online personae, long discussed by academics, but also becoming an increasingly practical concern.
Distributed fault diagnosis with shared-basis and B-splines-based matched learning

In this paper, we present a so-called matched learning methodology for distributed fault diagnosis of dynamical network systems. The matched learning method is based on neural network approximation with special basis function (hidden neuron) configurations, such that the matching of the learned weights of the target node and its neighbors reflect the health conditions of the nodes (the target node and its neighbors). The advantage of this method is that it does not need to be pre-trained with healthy nodes' data. First, a least-squares-based solution framework for matched learning is introduced, and a shared-basis implementation of matched learning is presented. Then, in order to construct better basis functions for matched learning, based on the least-squares solution framework, we propose a B-splines-based implementation of the matched learning method. Experiments and discussions are given on both the shared-basis and the B-splines-based matched learning methods.
Application of Motivation-Opportunity-Ability Theory in the Consumption of Eco-fashion Products: Were Chinese Consumers Underestimated?

Fueled by increased affluence and modernization process, China is experiencing dramatic changes in its culture, social value, and consumption values. For Chinese people, the satisfaction of functional needs has been taken place by social, emotional, and experiential needs in apparel consumption. This transformation indicates that Chinese consumers’ attitude and products selection are moving toward health, happiness, and self-satisfaction. In general, Chinese have a stronger financial incentive to live sustainably and they have more flexibility to change. Therefore, the purpose of the study is to determine the factors that influence Chinese consumers’ intention to pursue eco-fashion consumption. The Motivation-Opportunity-Ability theory was applied as the theoretical foundation in this study. The data were collected in China through an online survey. Participants (n = 410) were recruited through email survey link and the social media app (WeChat). The SEM analysis results indicated that self-identity, environment consciousness, environmental apparel knowledge, and attitude significantly determine Chinese consumers’ intention to pursue eco-fashion consumption. In addition, the perceived opportunity was found to have a direct effect on the intention toward eco-fashion consumption, as well as mediate the relationship between perceived ability and intention toward eco-fashion consumption.
Conservation of the behavioral and transcriptional response to social experience among Drosophilids

While social experience has been shown to significantly alter behaviors in a wide range of species, comparative studies that uniformly measure the impact of a single experience across multiple species have been lacking, limiting our understanding of how plastic traits evolve. To address this, we quantified variations in social feeding behaviors across 10 species of Drosophilids, tested the effect of altering rearing context on these behaviors (reared in groups or in isolation) and correlated observed behavioral shifts to accompanying transcriptional changes in the heads of these flies. We observed significant variability in the extent of aggressiveness, the utilization of social cues during food search, and social space preferences across species. The sensitivity of these behaviors to rearing experience also varied: socially naive flies were more aggressive than their socialized conspecifics in some species, and more reserved or identical in others. Despite these differences, the mechanism of socialization appeared to be conserved within the melanogaster subgroup as species could cross-socialize each other, and the transcriptional response to social exposure was significantly conserved. The expression levels of chemosensory-perception genes often varied between species and rearing conditions, supporting a growing body of evidence that behavioral evolution is driven by the differential regulation of this class of genes. The clear differences in behavioral responses to socialization observed in Drosophilids make this an ideal system for continued studies on the genetic basis and evolution of socialization and behavioral plasticity.
Animal Domestication in South America

The dog (Canis familiaris) was already domesticated when early humans entered the western hemisphere. Over the ensuing millennia Native Americans domesticated comparatively few indigenous animals, in contrast to the many animals that were genetically and behaviorally modified from their wild ancestors through captive controlled breeding in the Old World. New World animal domesticates included only two large birds (the turkey in North America and muscovy duck, Cairina moschata, from Mexico south into South America), a medium-sized rodent (guinea pig, Cavia porcellus), and two camelids (llama, Lama glama, and alpaca, Vicugna pacos). Diamond (1999) explains this by suggesting that relatively few candidates appropriate for domestication survived the massive extinctions of the terminal Pleistocene, and that geographical peculiarities of the western hemisphere inhibited the subsequent diffusion of domesticates from their areas of origin.
Production of gratings with desired pitch using the Talbot effect

In this paper mathematical relations which determine grating pitch have been derived for the case of a spherical wave according to the theory of the selfhimaging of the Talbot effect. These relation allow us to choose the proper parameter to give the desired pitch. Gratings of the desired pitch can be successfully obtained without aberration using a single experimental sethup.
RNA Interference-Based Therapies Against Brain Tumors: Potential Clinical Strategies

Harnessing the transcriptional pathway as a “master-switch” for re-profiling of aberrant signaling and metabolic cascades of tumors provides a novel mode of clinical intervention, particularly against neoplasms that are refractive to standard therapies. Brain tumors are prime candidates for new modes of therapy, as conventional therapies including surgical intervention, radiotherapy, and chemotherapy fare poorly against them. Two potent molecular techniques are available for interfering with a tumor's transcriptional machinery, i.e., small interfering RNA (siRNA), designed and administered exogenously, and microRNA (miRNA), an endogenous, self-regulated cellular repertoire of molecules that impart a tertiary level of gene regulation above and over the influence of classical signal transduction pathways. Both RNAi moieties are currently being examined in preclinical settings for their potential utility against malignant gliomas in future clinical applications. In this chapter, we will examine the glioma-specific cellular strategies that are presented for targeting via both siRNA and miRNA. Current progress in brain tumor-directed targeting of therapeutic amounts of RNAi, including those developed for traversing the blood–brain barrier will also be discussed. The challenges that need to be overcome in utilizing miRNA in a future clinical strategy against glioma, and imaging techniques under development for visualizing RNAi delivery will also be addressed.
A retrospective evaluation of unplanned hospital admission rates for women with ovarian cancer.

e18129Background: Unplanned admission following chemotherapy is a measure of quality cancer care. Large retrospective datasets have shown admission rates 10-35% in women with ovarian cancer receivi...
Mechanical response of an epithelial island subject to uniaxial stretch on a hybrid silicone substrate.

The mechanical response of large multi-cellular collectives to external stretch has remained largely unexplored, despite its relevance to normal function and to external challenges faced by some tissues. Here, we introduced a simple hybrid silicone substrate to enable external stretch while providing a physiologically relevant physical micro-environment for cells. We micropatterned epithelial islands on the substrate using a stencil to allow for a circular island shape without restraining island edges. We then used traction force microscopy to determine the strain energy and the inter-cellular sheet tension within the island as a function of time after stretch. While the strain energy stored in the substrate for unstretched cell islands stayed constant over time, a uniaxial 10% stretch resulted in an abrupt increase, followed by sustained increase in the strain energy of the islands over tens of minutes, indicating slower dynamics than for single cells reported previously. The sheet tension at the island mid-line perpendicular to the stretch direction also more than doubled compared to unstretched islands. Interestingly, the sheet tension at the island mid-line parallel to the stretch direction also reached similar levels over tens of minutes indicating the tendency of the island to homogenize its internal stress. We found that the sheet tension within large epithelial islands depends on the midline direction relative to that of the stretch initially, but not at longer times. We suggest that the hybrid silicone substrate provides an accessible substrate for studying the mechanobiology of large epithelial cell islands.
Testing a novel audit and feedback method for hand hygiene compliance: a multicenter quality improvement study.

Objective Although most hospitals report very high levels of hand hygiene compliance (HHC), the accuracy of these overtly observed rates is questionable due to the Hawthorne effect and other sources of bias. In the study, we aimed (1) to compare HHC rates estimated using the standard audit method of overt observation by a known observer and a new audit method that employed a rapid (l15 minutes) "secret shopper" method and (2) to pilot test a novel feedback tool. Design Quality improvement project using a quasi-experimental stepped-wedge design. Setting This study was conducted in 5 acute-care hospitals (17 wards, 5 intensive care units) in the Midwestern United States. Methods Sites recruited a hand hygiene observer from outside the acute-care units to rapidly and covertly observe entry and exit HHC during the study period, October 2016-September 2017. After 3 months of observations, sites received a monthly feedback tool that communicated HHC information from the new audit method. Results The absolute difference in HHC estimates between the standard and new audit methods was ~30%. No significant differences in HHC were detected between the baseline and feedback phases (OR, 0.92; 95% CI, 0.84-1.01), but the standard audit method had significantly higher estimates than the new audit method (OR, 9.83; 95% CI, 8.82-10.95). Conclusions HHC estimates obtained using the new audit method were substantially lower than estimates obtained using the standard audit method, suggesting that the rapid, secret-shopper method is less subject to bias. Providing feedback using HHC from the new audit method did not seem to impact HHC behaviors.
Proceedings of the 24th International Stroke Genetics Consortium Workshop: Washington, DC, USA

The 24th workshop of the International Stroke Genetics Consortium (ISGC) was held at the beautiful National Museum of the American Indian on November 8–9, 2018 in Washington, DC, and was hosted by Paul Nyquist, MD, MPH and John Cole, MD, MS, and co-hosted by Jemma Hopewell, PhD and Matthew Traylor, PhD. The ISGC is an international collaboration of physicians and scientists who have agreed to pool resources and expertise in an effort to unravel the genetic basis of stroke and its comorbidities. It was formed in 2007 by a small group of scientists and has since grown to over 200 members representing over 50 countries in North and South America, Europe, Australia, Africa, and Asia. ISGC workshops are held semi-annually and provide a forum for ISGC scientists and researchers to report on progress of ongoing scientific projects and discuss new ideas that help advance the ISGC's research mission. The ISGC nurtures its junior members by offering several travel awards to young investigators. Many abstracts in these Proceedings reflect the contributions of active junior investigators. Herein, we present the Proceedings and official published abstracts of the 24th ISGC workshop.
The 2019 Veblen-Commons Award Recipient: Janet Knoedler

I am pleased and honored to introduce the 2019 winner of the Veblen Commons Award, Janet Knoedler. As I thought about what I was going to say, I realized that in many ways Jan and I have shared a c...
Reviews of Science for Science Librarians: Low-FODMAP Diets for Irritable Bowel Syndrome and Related Disorders

While there are a number of prescription medical treatment options for the tens of millions of Irritable Bowel Syndrome sufferers in the US, their effectiveness in symptom control varies significan...
Characterization and Quantification of Major Flavonol Glycosides in Ramps ( Allium tricoccum)

The ramp (Allium tricoccum) is a traditional plant in the eastern Appalachian Mountains. Ramps have been used in traditional medicine for their health-promoting roles in lowering blood pressure and cholesterol. Information on the chemical composition of the potentially bioactive components in ramps is limited. Therefore, the aim of this work was to characterize and quantify major flavonols in ramps. Flavonoids were extracted in 50% methanol and 3% acetic acid. Characterization was conducted using UHPLC-PDA-MS and MS/MS, and quantification was performed using UHPLC-PDA detection. The major flavonol glycosides were kaempferol sophoroside glucuronide, quercetin sophoroside glucuronide, kaempferol rutinoside glucuronide, quercetin hexoside glucuronide, quercetin sophoroside, and kaempferol sophoroside. All conjugates were detected in leaves. Quercetin and kaempferol sophoroside glucuronide conjugates were detected in the stem, but no flavonol glycosides were detected in the bulb. The total amounts of the identified quercetin and kaempferol conjugates in whole ramps were 0.5972 ± 0.235 and 0.3792 ± 0.130 mg/g dry weight, respectively. Flavonol conjugates were concentrated in the leaves. To our knowledge, this work is the first to identify and quantify the major flavonol glycosides in ramps. Our findings suggest that specifically the leaves may harbor the potentially bioactive flavonols components of the plant.
Prevalence and predictors of HIV screening in invasive cervical cancer: a 10 year cohort study

Background Invasive cervical carcinoma is associated with a human immunodeficiency virus (HIV) prevalence of >0.1%, and screening is recommended and cost-effective for cancer populations exceeding this threshold. HIV status is also prognostic for cancer-specific survival, but compliance with HIV screening is poor in the USA and abroad. Objectives This study aims to describe HIV screening practices in a US comprehensive cancer center. To guide quality improvement, we identify characteristics which may predict compliance with screening. Study design Women treated for invasive cervical cancer from January 2007 to December 2017 were identified by local cancer registry and billing data. We assessed age, race, ethnicity, insurance status, histology, stage, pregnancy, drug use, and HIV testing status. Univariate logistical regression was performed to assess predictors of completed HIV screening. Results Of 492 eligible women, the cumulative screening rate was 7.6%. Race, ethnicity, histology, and funding source were not predictive of screening. Every 5 year increase in age was associated with a lower chance of screening (OR 0.86, p=0.015), as was earlier stage at diagnosis (OR 0.43, p=0.017). Pregnancy during, or antecedent to, invasive cervical cancer diagnosis was significantly more predictive of screening compliance (OR 10.57, p=0.0007). Only 8/492 (1.6%) women in the cohort were active or former drug users, but within this group HIV screening was performed more frequently (OR 22.7, p Conclusion Despite US and international recommendations for HIV screening in AIDS-defining cancers, compliance remains low. In our centers, factors including earlier age, advanced stage, active pregnancy at diagnosis, and any drug use history were predictive of greater compliance with screening. These data will inform a tailored intervention to improve compliance with HIV screening in our population.
Work Evaluation of the Visually Impaired: A Perspective:

Work evaluation is defined as work and work-related observations made in order to formulate definitive statements about an individual's work potential. The Clawson Work Sample Test for visually imp...
Sex and racial disparity in utilization and outcomes of t-PA and thrombectomy in acute ischemic stroke.

Abstract Background/purpose : Racial/ethnic and sex disparity may occur in stroke throughout the continuum of care. Endovascular therapy (EVT) became standard of care in 2015 for eligible patients with acute ischemic stroke (AIS). We evaluated for racial and sex differences in t-PA and EVT utilization and outcomes in 2016 in the National Inpatient Sample. Methods : Treatment rates for t-PA, EVT, and t-PA+EVT and outcomes including home discharge, in-hospital mortality and prolonged length of stay (pLOS) were evaluated by sex and race. Multivariate survey-logistic regression was performed to evaluate outcomes. Results The study had 468,630 patients – 49.3% men, 50.7% women; 69.3% whites, and 30.7% non-whites. There was no difference in treatment utilization by sex, women vs men for t-PA (7.65% vs 7.76%; aOR:1.02; 95% CI:0.97–1.07), EVT (1.74% vs 1.67%; aOR:1.09; 95% CI:0.99–1.20) and t-PA+EVT (0.57% vs 0.57%; aOR:1.01; 95% CI:0.85–1.21); and by race, non-white vs white for t-PA (7.62% vs 7.74%; aOR:0.98; 95% CI:0.93–1.05), EVT (1.62% vs 1.74%; aOR:0.91; 95% CI:0.78–1.07), and t-PA+EVT(0.59% vs 0.56%; aOR:1.05; 95% CI:0.84–1.30). Compared to men, women treated with t-PA had less home discharge (37.2% vs 46.3%; aOR:0.81; 95% CI:0.72–0.90), more in-hospital mortality (5.7% vs 3.9%; aOR:1.37; 95% CI:1.06–1.77) and less pLOS (8.3% vs 9.6%; aOR:0.82; 95% CI:0.69–0.98); women treated with EVT had less home discharge (15.8% vs 23.7%; aOR:0.69; 95% CI:0.52-0.91). Compared to whites, non-whites treated with t-PA had lower odds of home discharge (42.1% vs 41.6%; aOR:0.79; 95% CI:0.69–0.90), less in-hospital mortality (3.7% vs 5.3%; aOR:0.65; 95% CI:0.49–0.87), and higher pLOS (11.4% vs 7.9%; aOR:1.3; 95% CI:1.07–1.56); non-whites treated with EVT had less home discharge (18%vs 20.2%; aOR:0.70; 95% CI:0.51–0.97) and higher pLOS (35.1% vs 24%; aOR:1.52; 95% CI:1.16–1.99). Conclusion : Sex and racial disparity exists for outcomes of t-PA and EVT despite no difference in utilization rates.
The Syrian Insurgency and Its Aftermath

The failure of the Syrian revolution was the violent culmination of the popular revolutions that thrust themselves in 2010 upon the Arab world, known popularly as the ‘Arab Spring’. Bashar Assad’s uncompromising reaction was the culmination of a reactionary trend aimed at defeating the upsurge of the popular Arab desire for a democratic polity. An examination of the contrary forces that halted the Arab spring is crucial to understanding the endless nature of the conflict in Syria. The extreme and violent reaction by Syrian government forces, while driving the popular will underground, opened the field for organized radical Islamic groups. The chapter looks at the reasons that motivated the Assad government in persisting with its violent reaction and whether another road was possible. In the context of the US occupation of Iraq, Syrian reaction created a rationale, no less a precedent, on the part of regional and world powers to enter the civil war. The motivation for their entry, unmindful of international law prescriptions, is elaborated.
Regulation of Lipoprotein Homeostasis by Self-Assembling Peptides

High levels of serum low-density lipoprotein (LDL) cholesterol contribute to atherosclerosis, a key risk factor of cardiovascular diseases. PCSK9 is a circulatory enzyme that downregulates expressi...
Recycling of Nitrate and Organic Matter by Plants in the Vadose Zone of a Saturated Riparian Buffer

In agricultural land-use regions, excess nitrate in the soil contributes to eutrophication and pollution of both surface and subsurface waters. This study examines the role of plant uptake within the vadose zone of a saturated riparian buffer (SRB) to reduce nitrate from the soil pore water. Two hypotheses were explored: (1) during the growing season, nitrate removal will be greater in the presence of plants than where plants are absent (barren), and (2) following the growing season, nitrate concentration in the soils underlying a barren plot will be less than in the soils underlying a plot with plants. Within the SRB, three experimental blocks each composed of two plots were established. One plot allowed the growth of plants, primarily switchgrass (Panicum virgatum L.); the other plot was barren. Statistical comparison among the treatments, pre-growing season, plot with plants, and barren plot, and among the different depths, 30 cm, 60 cm, and 90 cm, identified significantly different soil NO3−-N concentrations. Plots with plants experienced a reduction in nitrate from the soil and vadose waters. Nitrate concentrations in the soils underlying the barren plot were higher than in the soils with plants, a result of no plant uptake and of the decomposition of the residual plants’ material returning nitrogen to the vadose. Sustained nitrate concentrations imply plants withdraw nitrate from the vadose zone, generating organic matter that is recycled year-to-year, suggesting that the plants serve as a short-term nitrate sink.
LigaSure™ haemorrhoidectomy and the risk of postoperative bleeding.

Aim LigaSure™ is an electro-surgical device that has increasingly been utilized in haemorrhoid surgery. However, recent literature has highlighted a possible increased risk of delayed postoperative bleeding following LigaSure haemorrhoidectomy (LH). We aim to evaluate the rates of postoperative bleeding following LigaSure compared to Ferguson (closed) haemorrhoidectomy (FH). Methods A retrospective cohort study was undertaken at our single academic safety-net county hospital from August 2016 through July 2019 evaluating patients who received FH or LH. Patient demographics, surgical data, postoperative emergency department visit for pain or bleeding within 30 days and resulting transfusion requirement, and rates of readmission and interventions within 30 days were collected. Results Sixty-one FH and 66 LH patients were identified. The groups had no difference in demographics. The LH group and FH group had similar rates of postoperative emergency department visits (29% vs. 23%, P = 0.454), as well as visits for bleeding (20% vs. 11%, P = 0.204). The average operating time was also significantly shorter with LH (14.5 min vs. 24.9 min, P ≤ 0.001). On multivariate analysis, male sex (OR 7.28, 95% CI 1.88-28.25) and haemorrhoid grade ≤2 (OR 4.64, 95% CI 1.31-16.49) were significantly associated with postoperative bleeding on multivariate analysis. Use of LH was not independently associated with postoperative bleeding risk (OR 1.89, 95% CI 0.70-5.11). Conclusions LH and FH have similar risks for postoperative bleeding and other complications. Male sex and haemorrhoid Grades 1 or 2 may be associated with increased postoperative bleeding risk. Excisional haemorrhoidectomy should be undertaken with caution for male patients with lower internal haemorrhoid grades.
Health care costs for adolescents and young adults with cancer: a Wisconsin community-based hospital study between 2005 and 2020.

Introduction Adolescents and young adults (AYA) with cancer are at risk of high cumulative healthcare system costs potentially associated with poor health and financial outcomes. Although this has been studied at academic centers, little data on AYA costs at community-based practices exist. The goals of this study were to understand direct health care costs for AYA patients, identify factors for high costs, and assess how total health care costs may relate to survival. Methods AYA patients (15-39 years) treated at a community hospital in Wisconsin (USA) between 2005 and 2020 were identified. Patient demographics, cancer characteristics, therapies, support services, and all direct health care charges (including up to 1 year prior to diagnosis to capture any diagnostic workup) were collected. Logistic and Cox proportional hazard regression models identified factors associated with high costs and survival, respectively. Results The 388 AYA patients had a median follow-up of 9 years (97% survival). Most were 30-39 years (62%), female (61%), white (95%), diagnosed early-stage (85%), and underwent surgery (83%). Complete health care costs were available for 233 patients (60%). Median total costs per patient were $123 K (range, $73-$215 K). On adjusted analysis, higher direct health care costs (> $125 K) were associated with greater odds of hospital admissions (odds ratio [OR] = 1.7, 95% CI = 1.35-2.27), chemotherapy (OR = 4.1, 95% CI = 1.44-12.70), and breast cancer diagnosis (OR = 3.8, 95% CI = 1.07-14.70). Living farther from the hospital (OR = 0.1, 95% CI = 0.02-0.50), later year of diagnosis (OR = 0.7, 95% CI = 0.55-0.77), and uninsured/unknown insurance status (OR = 0.1, 95% CI = 0.01-0.57) were associated with decreased odds of having higher health care costs. On adjusted analysis, death was associated with greater odds of higher direct health care costs per $125 K (hazards ratio [HR] = 7.9, 95% CI = 2.22-27.80) and radiation (HR = 31.8, 95% CI = 3.15-321) but lower odds of hormone therapy (HR = 0.1, 95% CI = 0.01-0.72) and later year of diagnosis (HR = 0.3, 95% CI = 0.12-0.60). Conclusion High direct health care costs among AYA patients are associated with hospital admissions, chemotherapy, breast cancer diagnosis, hospital proximity, and earlier year of diagnosis. Death was associated with high direct health care costs, earlier years of diagnosis, and radiation therapy. Total health care costs in community-based hospitals should be considered in the context of AYA patients with cancer.
Association Between Radiation Oncologist Density and Medicare Spending.

PURPOSE/OBJECTIVE(S) The accessibility of radiation oncology services impacts the likelihood of radiation therapy receipt during cancer care. The density of radiation oncologists (ROs) varies nationally, impacting the geographic access to radiation therapy. We aimed to assess the relationship between RO density and Medicare spending to better evaluate this impact of this relationship. MATERIALS/METHODS We used the Physician and Other Supplier Public Use File from the Centers for Medicare & Medicaid Services to ascertain the total Medicare reimbursements to each provider marked as a "Radiation Oncologist" for the year 2017. We then placed each radiation oncologist within a Hospital Referral Region (HRR), designed by the Dartmouth Atlas to represent regional healthcare markets for tertiary medical care, using a publicly available zip code-to-HRR crosswalk from the Dartmouth Atlas. We summed the total Medicare reimbursements to ROs in each HRR and compared this to the total Medicare reimbursements (part A+B) in each HRR for the year 2017, as reported by the Dartmouth Atlas group. After winsorization of the top and bottom 2% of HRRs by RO density, linear regression was used to evaluate the relationship between RO density and percentage of Medicare expenditure on RO. Modeling without a constant was used as in an HRR without an RO, there can be no RO services billed. RESULTS We identified 4,533 ROs in the United States that received a total of $1.38 billion in Medicare reimbursements in 2017. This represented 0.5% of total Medicare reimbursements in 2017. There were 17.0 ROs per 100,000 Medicare enrollees in the US in 2017. On an HRR level, there was an average of 15.4 ROs per 100,000 Medicare enrollees (range 0 - 139.4, standard deviation 10.6). On linear regression, there was a positive relationship between the percentage of Medicare spending on RO and the number of ROs per 100,000 Medicare enrollees: for every additional RO per 100,000 Medicare enrollees, an additional 0.027% (95% CI = 0.025% - 0.030%; P < 0.001) of Medicare expenditures in a given HRR were spent on RO. CONCLUSION Using density of RO by HRR as a proxy for access to care, this analysis suggests that with increasing access to care, an increasing proportion of Medicare dollars are spent on RO services at the HRR level.
Drought adaptation of two species of Cotoneaster

SummaryThe transpiration of Cotoneaster salicifolius and C. lacteus previously subjected to mild, moderate or severe water stress was persistently reduced compared to the unstressed controls. For C. salicifolius this was due to partial stomatal closure as well as to a decrease in leaf area following water stress. For C. lacteus it was mostly due to a lengthy reduction in leaf conductance. In previously unstressed C. salicifolius and C. lacteus water stress had an after-effect on stomatal opening, whereby leaf conductance did not increase readily as plant water status recovered after irrigation. However, the leaf conductances of C. lacteus plants that underwent several stress cycles increased readily after irrigation, independently of leaf water potentials which were slower to recover.
Chapter 2 Effects of Homogeneous Strain on the Electronic and Vibrational Levels in Semiconductors

Publisher Summary This chapter describes the effects of homogeneous strain on the electronic and vibrational levels in semiconductors. It reviews the effects of homogeneous strains on the electronic states of the highest valence and lowest conduction bands of diamond- and zincblende-type materials, focusing on the band extrema at the center of the Brillouin zone (BZ). Electronic deformation potentials for a number of relevant bands are summarized in the chapter. The effects of an external stress on the quantum levels of quantum wells and the properties of strained-layer superlattices with built-in strain are discussed in the chapter. The influence of a homogeneous strain on the optic phonons at the BZ center of certain materials is described and also for this situation, vibrational deformation potentials are listed in the chapter. The introduction of a homogeneous strain in a solid produces changes in the lattice parameter and, in some cases, in the symmetry of the material. These in turn produce significant changes in the electronic band structure and vibrational modes. All configurations of homogeneous strain can be divided into the following two contributions: the isotropic or hydrostatic components, which give rise to a volume change without disturbing the crystal symmetry, and the anisotropic component, which in general reduces the symmetry present in the strain-free lattice.
Protective IL-10-producing Th1 cells also make IL-21, which is regulated by the T-bet/Bcl6 ratio, in a mouse model of chronic malaria (MPF7P.709)

Chronic exposure to the malaria parasite is required for full clinical protection, possibly due to improved survival versus maintenance of effector function of CD4 memory T cells (Tmem). IFN-γ is required for protection; therefore, we investigated the development of Th1 memory in chronic Plasmodium chabaudi malaria infection using ifng -reporter mice. We observed that the expression of Th1 markers (T-bet, CXCR3) peaked well before T cell contraction, suggesting poor long-term commitment to IFN- γ production. In addition, markers of T follicular helper cells (Tfh), such as CXCR5 and Bcl6, were on most Th1 cells, and some co-produced IL-21 and IL-10. While Th1 effector cells differentiate into CXCR3 + Tmem in malaria, they are Tbet lo and do not maintain ifng expression, unless they are dividing, though they do express Bcl6 and IL-21. Interestingly, Bcl6-deficient Th1 cells produce more IL-21, while infection of IL-10-deficient mice increased T cell expression of both T-bet and Bcl6, generating more mixed phenotype cells. P. chabaudi infected IL-10 -/- mice die of T cell-mediated pathological inflammation, suggesting that the dominant Th1/Tfh phenotype is pathogenic if not regulated. Expression of Bcl6 and IL-21 in Th1 cells has been described as an early and transient event before full commitment; however, these results suggest that this intermediate stage can be maintained in chronic infection, potentially to prevent both exhaustion and pathology, via IL-10.
A Policy Framework for Confronting Obesity

The effects of obesity have become practically ubiquitous in the US. This book aims to provide an alternative framework through which to explore the important and controversial obesity debate that has spilled over from the medical community. This book is not about obesity as a medical condition, nor does it offer a wide-ranging discussion on the health effects of obesity or the role of the ‘right’ diet.
Diffuse Large B-Cell Lymphoma, Not Otherwise Specified

Diffuse large B-cell lymphoma (DLBCL), not otherwise specified, is a neoplasm composed of large B-cells growing in a diffuse pattern. DLBCL is the most frequent type of non-Hodgkin lymphoma worldwide, and it encompasses a heterogeneous group of diseases that can be subdivided according to clinical, morphologic, phenotypic, or molecular criteria. Some cases of DLBCL arise in distinct clinicopathologic settings and may be better classified as unique entities, such as primary mediastinal (thymic) large B-cell lymphoma or as subtypes, such as DLBCL arising in patients with immunodeficiency or EBV + DLBCL of the elderly. In this Atlas, we focus on only those cases of DLBCL that present as nodal disease.
Modeling PLA variation of privacy-enhancing personalized systems

Privacy-enhancing personalized (PEP) systems address individual users' privacy preferences as well as privacy laws and regulations. Building such systems entails modeling two different domains: (a) privacy constraints as mandated by law, voluntary self-regulation, or users' individual privacy preferences, and modeled by legal professionals, and (b) software architectures as dictated by available software components and modeled by software architects. Both can evolve independently, e.g., as new laws go into effect or new components become available. In prior work, we proposed modeling PEP systems using a product line architecture (PLA). However, with an extensional PLA, these domain models became strongly entangled making it difficult to modify one without inadvertently affecting the other. This paper evaluates an approach towards modeling both domains within an intensional PLA. We find evidence that this results in a clearer separation between the two domain models, making each easier to evolve and maintain.
A Very High-Performance Algorithm for NAS EP Benchmark

The NAS (Numerical Aerodynamic Simulation) Parallel Benchmarks have been developed at NASA Ames Research Center to study the performance of parallel supercomputers. Major algorithmic improvements to the Embarrassingly Parallel (EP) Benchmark are described. Using IBM RS/6000 workstations and IBM SP-1 scalable parallel machines as examples, we also describe tuning techniques to obtain very high performance on this benchmark. Compared to the generic EP code, various algorithmic and tuning techniques have resulted in a performance improvement by nearly a factor of 18. The techniques described are generally applicable to many numerical algorithms on most RISC machines.
Selection of an attenuated Coxsackievirus B3 variant, using a monoclonal antibody reactive to myocyte antigen.

Abstract Previously, we described a heart-reactive monoclonal antibody (MAb), 10A1, derived from a coxsackievirus B3 (CVB3)-infected mouse. This MAb selectively inhibits infection of HeLa cells and myocytes with the myocarditic virus variant (CVB3W). A plaque-purified variant (H3) of CVB3W was isolated from the heart of an infected animal, and a second virus (H3-10A1) was obtained by growing H3 in HeLa cells in the presence of MAb 10A1. As with the parental CVB3W virus, H3 infection of HeLa cells can be inhibited by MAb 10A1, but the antibody-selected H3-10A1 variant is resistant to MAb inhibition (presumably an escape mutant). BALB/c mice infected with 10(6) PFU of CVB3W, H3, or H3-10A1 resulted in approximately 90% animal mortality with CVB3W or H3 and less than 10% mortality with H3-10A1, suggesting that the escape mutant is less pathogenic. Additionally, hearts from animals infected with H3-10A1 demonstrated only half the amount of myocarditis observed in either CVB3W- or H3-infected mice. Cardiac virus titers were also reduced approximately 200-fold in H3-10A1-infected animals compared with those in mice given the pathogenic variants. In vitro studies indicate that H3-10A1 is less effective in inhibiting cellular RNA and protein synthesis and show reduced virus replication compared with that of pathogenic viruses in cultured myocytes.
Intravesical bacille Calmette-Guérin (BCG) in immunologically compromised patients with bladder cancer

What's known on the subject? and What does the study add? Intravesical bacille Calmette-Guerin (BCG) is generally considered to be contraindicated in immunologically compromised patients with bladder cancer because it may be ineffective and potentially toxic. Therefore, there is little experience with BCG in individuals with impaired immune systems. The present study provides evidence that intravesical BCG is safe and effective in the short term against non-muscle-invasive bladder cancer affecting patients who were receiving immunosuppressive medications. This included anti-rejection drugs to support a solid organ transplant, high-dose steroids for autoimmune inflammatory diseases, and the first description of BCG use in patients who were receiving concomitant systemic chemotherapy for unrelated malignant neoplasms. Objective To investigate the outcomes of bacille Calmette-Guerin (BCG) therapy in patients with bladder cancer who were immunologically compromised. Patients and Methods In all, 45 immunosuppressed patients with high-grade non-muscle-invasive bladder cancer received BCG therapy. Twelve had functioning organ transplants, 23 were undergoing systemic chemotherapy for unrelated cancers, and 10 were taking steroids for autoimmune or related diseases. Patients received a 6-week induction course of BCG therapy. Relapsing patients were eligible for retreatment. All patients were followed for median (range) of 40 (12–72) months. End points were response to BCG and 5-year recurrence-free, progression-free and overall survival rates. Results In all, nine of the 12 transplant patients responded completely to one or two cycles of BCG compared with 99% (32/33) of other immunosuppressed patients. Half the patients with unrelated cancers and autoimmune diseases recurred vs all but one of the transplant patients (P = 0.008). Of the 12 transplant patients, six of 12 progressed vs five of 33 (15%) of the other patient groups (P = 0.02). Five patients died (11%), two of bladder cancer (both in transplant patients), and three of unrelated causes. BCG was well tolerated. None of the patients developed bacterial or BCG sepsis. Although this is largest series evaluating BCG in transplant and other immune-suppressed patients, it represents few patients and results must be interpreted with caution. Conclusions We conclude that intravesical BCG is safe and effective in immunologically compromised patients with bladder cancer. Transplant patients fare worse and should be considered for early cystectomy if they fail BCG therapy.
Congential Nevus Mimicking Melanoma in Infancy

A five-month old girl presented with a 5 cm brown patch on her right lower leg. The lesion had a 6 mm area of hyperpigmentation that was removed by shave biopsy for pathologic diagnosis. The clinical diagnosis at the time was that of congenital nevus but the multicolored appearance of the lesion raised the index of suspicion for melanoma. Histology revealed junctional activity with melanocytes distributed in the dermis including migration around appendages and among collagen bundles as seen in congenital nevi. However, there were some unusual features that warranted careful analysis. The lesion was asymmetric, with numerous single melanocytes in confluence at the dermo-epidermal interface. Single cells and nests were noted in the epidermis. Our case illustrates a congenital nevus with atypical patterns easily confused with those of melanoma. Our lesion exhibited pagetoid melanocytes, which is considered virtually diagnostic of melanoma. However, these melanocytes were monomorphous as opposed to the pleomorphic appearance found in melanoma. Additionally, there was evidence of cellular maturation in the dermis as well as a lack of variance in nest size, which favors the diagnosis of congenital nevus1.
ON SOME APPLICATIONS OF BAYESIAN METHODS IN CANCER CLINICAL TRIALS

The NCCTG randomized controlled clinical trial for the treatment of advanced colorectal carcinoma is a wonderful case study of the dynamic interplay between scientific learning and statistical inference. Ethical concerns for minimizing the number of patients assigned to an inferior treatment and interest in identifying subsets of patients for whom a treatment is most likely efficacious pose challenging problems for the practice of statistics. In the first part of this paper, I comment on the applications of Bayesian methods to these problems in the NCCTG trial as presented by Freedman and Spieglehalter and Dixon and Simon, respectively. In the second part of this paper, I discuss and illustrate a Bayesian approach to model sensitivity analysis with a particular focus on model specification and criticism. The Bayesian approach provides a formal methodology to assess the sensitivity of inferences to the inputs into an analysis so that it is possible to investigate the consequences of the specification of the model. I apply these methods to the specification and criticism of a class of survival models for the analysis of survival times in the NCCTG trial.
Fruit and vegetable exposure in children is linked to the selection of a wider variety of healthy foods at school

Schools often offer healthy fruits and vegetables (FV) and healthy entrees. However, children may resist these efforts due to a lack of familiarity with the offerings. While numerous exposures with a food increase its liking, it may be that an exposure to a variety of FV at home leads to greater willingness to select other foods - even those that are unrelated to those eaten at home. As an initial test of this possibility, this study was designed to examine how self-reports of exposure and consumption of various FV were associated with the selection of FV and lunch entrees at school. Participants (n = 59) were a convenience sample of elementary children. A median split was used to place students into high- and low-exposure groups for self-reports of both exposure and consumption at home. The primary dependent variables were self-reports of selecting FV at school; the children's absolute and relative ratings of eight 'healthier' lunch entrees; and self-reports of selecting these entrees. These entrees were recently added to the school menu and, therefore, tended to be less familiar to children. Food ratings were collected through taste exposures conducted at school. Results indicate that children who reported more frequent exposure to FV at home consumed a wider variety of FV at school and were more likely to report selecting 'healthier' entrees at school lunch. These data suggest that exposure to, and the consumption of, a variety of FV may make children more willing to select a wider range of FV and other healthy entrees.
Work-related traumatic injuries onboard freezer-trawlers and freezer-longliners operating in Alaskan waters during 2001-2012

BACKGROUND: Workers onboard freezer-trawl (FT) and freezer-longline (FL) vessels in Alaska may be at high risk for fatal and non-fatal injuries. METHODS: Traumatic occupational injuries onboard vessels in the FT and FL fleets were identified through two government data sources. RESULTS: The annual risk of fatal injuries was 125 per 100,000 FTEs in the FT fleet, and 63 per 100,000 FTEs in the FL fleet. The annual risk of non-fatal injuries was 43 per 1,000 FTEs in the FT fleet and 35 per 1,000 FTEs in the FL fleet. The majority of injuries in the FT fleet occurred in the factories and freezer holds, whereas the most common injuries in the FL fleet occurred on deck while working the fishing gear. CONCLUSIONS: The findings confirmed that workers in those fleets were at high risk for work-related injuries. Injury prevention should focus on removing hazards in the work processes injuring the most workers. Language: en
Investigation and validation of technological learning versus market performance

Abstract This paper details a journey of discovery for conceptualizing, identifying, documenting and validating instances of higher-order learning, its nature, as well as its content, process, context and impact. The authors are engaged in a multi-industry, longitudinal, empirical study to investigate the relationship between technological learning activities and firm market performance. This relationship is postulated to vary under specific firm, market and industry conditions, so that the effects of learning can enhance or limit market performance, emerge over different periods of time, and require varying levels of investment. For this paper, we conduct a pilot study using a preliminary sample of 19 firms from four industries over a period of twelve years as a pilot study for a broader analysis of approximately 100 firms in these industries covering 25 years. The empirical analysis in this pilot study shows little evidence of a relationship between technological learning and market performance; however, the lack of evidence is due to the crude nature of the measures used and the limitations of available data. A more comprehensive research design is proposed which will provide a better test of the relationship.
The Optimal Gas Tax for California

This paper calculates the optimal gasoline tax for the state of California. According to our analysis, the optimal gasoline tax in California is $1.37/gal, which is over three times the current California tax when excluding sales taxes. The Pigovian tax is the largest part of this tax, comprising $0.85/gal. Of this, the congestion externality is taxed the most heavily, at $0.27, followed by oil security, accident externalities, local air pollution, and finally global climate change. The other major component, a Ramsey tax, comprises a full $0.52 of this tax, reflecting the efficiency in raising revenues from a tax on gasoline consumption due to the inelastic demand of this consumption good.