cssi/SciSciGPT-SciSciNet huggingface dataset:
Group Psychotherapy and Managed Behavioral Health Care: Current Trends and Future Challenges

ABSTRACTThe rising cost of health care within the private and public sectors has created an increased demand for the management of benefit dollars. This trend has significant implications for group psychotherapists, as group modalities offer cost-effective ways of delivering services to traditional outpatient and inpatient populations. Continued cosl-containment pressures and increasing attention to outcome studies will fitel trends toward briefer, manualized group treatments and intensive group outpatient programs as alternatives to hospitalization. Quality-based demands will challenge payors to (a) address biases against group psychotherapy among providers and patients and (b) integrate recent process-and-outcome research in determining the appropriateness of group versus individual modalities for particular patients and presenting problems.
When Should Government Regulate Lawyer-Client Relationships? The Campaign to Prevent Insurers from Managing Defense Costs

Since 1996, courts and state bar committes have issued an enormous number of opinions regulating insurance carriers' use of staff attorneys, fee audits, litigation management guidelines, and flat fees. On the whole, these opinions have sought to prevent insurers from innovating to reduce defense costs. The purported justification for extensive regulation has been the desire to protect vulnerable policyholders from exploitation. Unfortunately, regulators have no evidence that policyholders are in danger. An exhaustive search of the opinions and other sources provides no factual basis for believing that modern defense cost management techniques have harmed policyholders. The real motive behind the campaign is the desire to empower defense lawyers and to prevent further reductions in fees.
The Automatic Bank Machine User: Demographics, In-Bank Visitation and Inherent Promotional Considerations

Automatic Banking Machines, capable of handling a wide variety of bank transactions are now widely available. This paper examines the demographics of consumers who use ABM’s together with the inherent promotional problems they bring to the bank with the decreasing use of bank premises.
The New Journalism: Pulitzer and Stead

In the 1880s the specter of popular journalism finally became a reality, as the full impact of transatlantic influence began to be felt and absorbed in Britain. As Matthew Arnold was to accurately declaim (though without some of the dire consequences he hinted at), a cheap press was rapidly making its way across the Atlantic seeking a home amidst the relatively unruffled groves of Fleet Street and other centers of newspaper activity in Britain. At the outset of the decade, Britain continued to produce papers that were midway in appearance between the densely concentrated broadsheets of the 1820s and the mass circulation press of 1914. A conventional format of six columns predominated. Crossheads were used only in exceptional circumstances and illustrations appeared relatively infrequently. Both typography and pictures were a means of diversifying what has been described as a “traditionalist, pack-it-in, single-column” text.1 The use of headlines was also limited. Multiple decks had been introduced into American journalism, and were a consistent feature of that nation’s press by the 1880s. Occasionally, ten or more decks preceded a story.
Urban Poverty and Social Reproduction

The theme of urban poverty that is addressed in this book will be illustrated by the existence and visibility of the phenomenon in one of the major cities of the Caribbean, namely, Fort-de-France, Martinique. Urban poverty in Martinique is a by-product of the plantation economy and the continuing dependence of the island on metropolitan France. It is not of recent origins; however, it has become a pronounced and shocking reality in the slums of Fort-de-France and other capitals of the Caribbean islands since the end of the Second World War.
Top-K with Diversity-M Data Retrieval in WSNs

In applications of Wireless Sensor Networks (WSNs) such as monitoring chemical leaks in case of a disaster, a user may be interested in getting top-k with diversity-m (referred as Top (k, m)), that is, top-k data should come from m different sub-regions (clusters) to simultaneously monitor critical areas. In addition, one may also monitor values for persistency, how long the top-k values remain unchanged. In this paper, we have introduced the new problem of continuous top-k query with diversity-m, i.e., we want to find the k highest values from at least m different clusters over a period of time in a WSN. In this context, we introduce an energy efficient scheme Top (k, m) to utilize the Gaussian's probability function to estimate the probability of a sensor node value being in the final top-k set. Based on the probability, the node decides whether to forward data values to the base station or not. Moreover, we make sure that top-k data items are not only collected from m-clusters, but they are also persistency, which is helpful in real-time monitoring applications. We have shown the improved performance of our scheme with respect to recent schemes EXTOK and Grid in terms of communication, energy usage and network life-time.
Introducing py_emra: the Python module for Ensemble Modeling Robustness Analysis

The py_emra module implements the Ensemble Modeling Robustness Analysis (EMRA) algorithm in Python. Previous implementations in MATLAB have been used to gain useful insights into metabolic dynamics and metabolic engineering strategies. The py_emra package performs favorably in comparison to MATLAB. Potential extensions and improvements are discussed.
Release and toxicity comparison between industrial- and sunscreen-derived nano-ZnO particles

Many consumer products containing ZnO have raised concern for safety in regard to environmental impact and the public health. Widely used sunscreens for protecting against UV and avoiding sunburns represent a great exposure to nano-ZnO, one of the ingredients commonly applied in sunscreens. Applying nanoproducts on beaches may release nanoparticles unintentionally into the ocean. Despite the accumulation of such nanoproducts in the ocean harming or being detrimental to critical marine organisms, few studies have investigated the release and potential toxicity of nanoparticles extracted from products and compared them with those from industrial-type nanoparticles. Results show that the cytotoxicity of both industrial- and sunscreen-derived nano-ZnO to the marine diatom algae, Thalassiosira pseudonana, increased as exposure increases over time, as measured by growth inhibition (%) of the algae at a constant concentration of nano-ZnO (10 mg/L). The extent of toxicity appeared to be higher from industrial-type nano-ZnO compared with sunscreen-extracted nano-ZnO, though the extent becomes similar when concentrations increase to 50 mg/L. On the other hand, at a fixed exposure time of 48 h, the cytotoxicity increases as concentrations increase with the higher toxicity shown from the industrial-type compared with sunscreen-induced nano-ZnO. Results indicate that while industrial-type nano-ZnO shows higher toxicity than sunscreen-derived nano-ZnO, the release and extent of toxicity from nano-ZnO extracted from sunscreen are not trivial and should be monitored for the development of safe manufacturing of nanomaterials-induced products.
The Thomified Eilenberg—Moore spectral sequence

In this paper we will construct a generalization of the Eilenberg-Moore spectral sequence, which in some interesting cases turns out to be a form of the Adams spectral sequence. We recall the construction of both of these in general terms.
Disseminated HSV-2 presenting with relapsing encephalomyelitis.

A previously healthy 39-year-old woman presented with 3 weeks of progressive leg numbness. Examination showed mild bilateral iliopsoas weakness and patchy leg numbness. She was admitted, and spinal MRI revealed T2 enhancing thoracic lesions, nonenhancing cervical cord lesions (figure, A), and subtle pial and cauda equina enhancement (figure, B). Brain MRI revealed multiple periventricular T2 hyperintensities (figure, C). Since the diagnosis of multiple sclerosis (MS) was considered likely, lumbar puncture (LP) was deferred and she received 5 days of IV methylprednisolone. One week later, she developed increasing right-sided hearing loss and vertigo with right cochlear enhancement (figure, D). Two weeks later, a morbilliform and vesicular flank and trunk rash appeared (figure, E and F). She was readmitted and treated with IV acyclovir for presumed disseminated varicella zoster virus (VZV). LP revealed a lymphocytic pleocytosis (90 leukocytes, 100% lymphocytes) and elevated protein (150 mg/dL). Oligoclonal bands were positive, and neuromyelitis optica and human T-cell lymphotropic virus–1 antibodies were negative. A PCR encephalitis panel was positive for herpes simplex virus (HSV)–2 and negative for VZV and HSV-1. Skin biopsy viral culture and PCR were positive for HSV. Three weeks after rash onset, the patient developed worsening leg numbness, received 5 more days of IV methylprednisolone, and soon after developed severe ataxia and weakness. Repeat MRI revealed new pontine lesions atypical for MS, punctate lesions following a vascular distribution, and new enhancing spinal cord lesions (figure, G and H). Repeat LP revealed a decreasing leukocyte count (17 leukocytes) and rising protein (298 mg/dL). CSF HSV-2 PCR was now negative, yet quantitative ELISA revealed positive HSV-2 immunoglobulin G (IgG) (8.83 antibody index [AI]) and negative HSV-1 IgG (0.3 [reference range 0.9 AI]). CSF HSV-1 and HSV-2 immunoglobulin M (IgM) (1.15) and IgG titers were elevated (27.93 [reference range 0.9 AI]). A unifying diagnosis of HSV-2 encephalomyelitis was made. The patient was treated with plasmapheresis, followed by IV immunoglobulin (IVIG), concurrently with 6 weeks of IV acyclovir. A follow-up LP 3 weeks after treatment initiation demonstrated decreasing HSV IgM (0.22 AI) and IgG (7.96 AI) titers, pleocytosis (6 leukocytes), and protein (111 mg/dL), consistent with declining inflammation. Monthly follow-up imaging showed interval resolution of spinal enhancement and no new lesions, commensurate with resolving sensory symptoms and ataxia.
ROMP-based thermosetting polymers from modified castor oil with various cross-linking agents

Polymers derived from bio-renewable resources are finding an increase in global demand. In addition, polymers with distinctive functionalities are required in certain advanced fields, such as aerospace and civil engineering. In an attempt to meet both these needs, the goal of this work aims to develop a range of bio-based thermosetting matrix polymers for potential applications in multifunctional composites. Ring-opening metathesis polymerization (ROMP), which recently has been explored as a powerful method in polymer chemistry, was employed as a unique pathway to polymerize agricultural oil-based reactants. Specifically, a novel norbornyl-functionalized castor oil alcohol (NCA) was investigated to polymerize different cross-linking agents using ROMP. The effects of incorporating dicyclopentadiene (DCPD) and a norbornene-based crosslinker (CL) were systematically evaluated with respect to curing behavior and thermal mechanical properties of the polymers. Isothermal differential scanning calorimetry (DSC) was used to investigate the conversion during cure. Dynamic DSC scans at multiple heating rates revealed conversion-dependent activation energy by Ozawa-Flynn-Wall analysis. The glass transition temperature, storage modulus, and loss modulus for NCA/DCPD and NCA/CL copolymers with different cross-linking agent loading were compared using dynamic mechanical analysis. Cross-link density was examined to explain the very different dynamic mechanical behavior. Mechanical stress-strain curves were developed through tensile test, and thermal stability of the cross-linked polymers was evaluated by
A Machine Learning Approach for One-Stop Learning

Current search engines impose an overhead to motivated students and Internet users who employ the Web as a valuable resource for education. The user, searching for good educational materials for a technical subject, often spends extra time to filter irrelevant pages or ends up with commercial advertisements. It would be ideal if, given a technical subject by user who is educationally motivated, suitable materials with respect to the given subject are automatically identified by an affordable machine processing of the recommendation set returned by a search engine for the subject. In this scenario, the user can save a significant amount of time in filtering out less useful Web pages, and subsequently the user’s learning goal on the subject can be achieved more efficiently without clicking through numerous pages. This type of convenient learning is called one-stop learning (OSL). In this chapter, the contributions made by Lim and Ko (2006) for OSL are redefined and modeled using machine learning algorithms. Four selected supervised learning algorithms: IGI PUBLISHING This paper appears in the publication, Data Mining and Knowledge Discovery Technologies edited by D. Taniar © 2008, IGI Global 701 E. Chocolate Avenue, Suite 200, Hershey PA 17033-1240, USA Tel: 717/533-8845; Fax 717/533-8661; URL-http://www.igi-gl bal.com ITB15231
Utilization and risk of undersea communications

This paper assesses utilization and risks of undersea communications in the context of multiple naval operational environments, with a focus on undersea warfare and anti-submarine warfare (ASW). We considered possible uses of undersea communications capability for both offense and defense., and for supporting undersea warfare in three different contexts: wide area surveillance in deep water, Carrier Strike Group (CSG) protection in deep water, and CSG protection in shallow water.
Identifying Multisensory Dendritic Stimulus Processors

Functional identification is a key methodology for uncovering the logic of neuroinformation processing of brain circuits. For neural circuits modeling sensory systems as dynamical systems, the complexity of the identification algorithm largely depends on the number of stimuli used. Neurons in these circuits consist of dendritic stimulus processors modeling the signal processing in the dendritric tree and biological spike generators modeling the spiking mechanism at the axon hillock. Here, we review the identification of multi-sensory spatio-temporal dendritic stimulus processors that arise in the encoding of auditory scenes, color visual fields, and the mixing of auditory scenes and natural visual fields. We demonstrate the fundamental duality between the identification of the dendritic stimulus processor of a single neuron and the decoding of stimuli encoded by a population of neurons with a bank of dendritic stimulus processors. The duality enables us to reconstruct the originally encoded stimuli from all the generated spikes by using the identified neural circuit. The reconstruction leads to a simple and intuitive evaluation of the identified dendritic stimulus processors in the space of stimuli.
THE IMPACT OF RESIDUAL SYNTAX SCORE IN ACS PATIENTS WITH LV DYSFUNCTION

Background: Several studies have shown the usefulness of residual Syntax score in acute coronary syndrome (ACS) patients. However, it remains uncertain whether it is also evident in ACS patients with left ventricular (LV) dysfunction. Methods: This study was an observational study examining
Inhibition of autophagy: Phase I safety, tolerability, and pharmacokinetics (PK) of hydroxychloroquine (H) in combination with vorinostat (V) in patients with advanced solid tumors.

3073 Background: The histone deacetylase (HDAC) inhibitor V has pleiotropic effects, and induces both apoptosis and autophagy. As autophagy can promote cancer cell survival, we hypothesized that inhibiting autophagy would enhance the anti-cancer activity of V. Our pre-clinical studies showed that inhibition of autophagy using H significantly increased the pro-apoptotic effects of V. The primary objective of this NCI-funded study was to determine the maximum tolerated dose (MTD) of H in combination with V in patients (pts) with advanced solid tumors. Methods: Pts with ECOG PS 0-2 and adequate organ function received PO V 300-400 mg QD and H 400-1000 mg QD in 21d cycles. 3+3 dose escalation. Dose limiting toxicities (DLTs) = non-hem toxicity ≥ grade (Gr) 3 or hem toxicity ≥ Gr 4 in the first 2 cycles. PBMCs were analyzed for autophagic changes at baseline, week 1 + 6. PKs done on cycle 1.Tumor biopsies were performed at baseline and post-cycle 2 on 3 pts at MTD. Results: 31 pts enrolled, 27 evaluable for DL...
Qualification of the Offence: Treaties

In the Colombian-Peruvian Asylum Case, Colombia maintained that the right of unilateral qualification of the offence by the state granting asylum was understood in Article 2 of the Havana Convention.1 This was based first of all on the provision that “asylum… shall be respected to the extent in which allowed as a right or through humanitarian toleration, by the usages, the conventions or the laws of the country in which granted …” Since Colombia, through conventions and usages, had recognized the right of the granting state to qualify the nature of the offence this was the rule which should prevail under the Havana Convention.2 The Court flatly rejected this argument saying that “nothing… can be deduced from this provision so far as qualification is concerned.” 3
Increased firing of lateral habenula neurons mediates ethanol aversion: potential implications for substance use disorders.

Alcohol use disorder (AUD) is characterized by craving, loss of control over intake and continued use despite negative consequences. This article is protected by copyright. All rights reserved
Revisiting the One-shot method for modeling limit cycle oscillations: Extension to two-degree-of-freedom systems

Abstract In this paper, the harmonic-balance-based One-shot method is extended to model limit-cycle-oscillations (LCO) for pitch/plunge airfoils. The difference of this approach from more traditional partitioned aeroelastic analyses is presented. A careful investigation is carried out to determine the spurious energy generated by the coupling of segregated computational fluid dynamic and computational structural dynamic solvers. A remedy to eliminate this issue, which is inherent in time-accurate aeroelastic as well as aeroelastic harmonic balance (A-HB) techniques, is proposed for the One-shot method. It is shown that, unlike other approaches, the One-shot method eliminates the need to use dynamic meshing where the fluid mesh needs to be gradually deformed from one physical time to the next along with sub-iterations of the flow solver. In addition, methods for efficiently determining the LCO frequency are discussed. The One-shot method is applied to a two-degree-of-freedom Isogai aeroelastic model for the NACA 64A010 airfoil in the transonic flow regime. The results are compared to the so-called HB/LCO and A-HB methods as well as a classical time-accurate approach. Finally, the advantages of the One-shot method over these techniques is demonstrated.
Description of Two New Surface Behaviors in the Antlion Vella americana Drury (Neuroptera: Myrmeleontidae)

Two surface behaviors were described in the larva of the antlion V. americana. Vella americana were observed flicking in a similar manner to pit builders, but in a way that does not lead to pit construction. A new spyhop behavior also was observed in which a larva exposes its head and thorax above the sand and remains very still for some time. It is hypothesized that these behaviors assist larval V. americana in hunting and orientation. The flicking motion may attract the attention of certain prey species, and the spyhop exposes the larva's stalked stemmata and multi-segmented antennae to increase sensitivity to prey or disturbance.
Elevated Markers of Inflammation Are Associated With Longitudinal Changes in Brain Function in Older Adults.

Background Chronic inflammation has been linked to memory and other cognitive impairments, as well as Alzheimer's disease. Here, we investigate the association between inflammatory markers and changes in brain activity measured by regional cerebral blood flow (rCBF) to assess the relationship between inflammation and brain function in older individuals. Methods Annual 15O water resting-state positron emission tomography (PET) scans collected over a 5-year period were assessed in 138 cognitively normal older participants (77 males; mean age at baseline = 71.3; mean scans per participant = 3.5) in the Baltimore Longitudinal Study of Aging. Voxel-wise linear mixed models were used to investigate associations between rCBF and C-reactive protein (CRP) and interleukin-6 (IL-6) at the time of scanning. We examined relationships between baseline CRP and IL-6 levels and baseline rCBF, and relationships between baseline and mean inflammatory levels over time and longitudinal rCBF changes. Results Higher baseline CRP and IL-6 were each associated with lower baseline rCBF primarily in frontal and occipital regions, with only the lingual gyrus surviving atrophy correction. Higher baseline and mean CRP were also associated with greater rCBF declines over time in anterior cingulate and hippocampal regions, whereas higher baseline and mean IL-6 levels were associated with greater rCBF declines in orbitofrontal and hippocampal regions. Conclusions Higher levels of inflammation are associated with longitudinal changes in brain function in regions important for cognition. These results, along with previous studies, suggest that chronic inflammation in older adults may contribute to age-associated declines in cognitive function.
Recent Developments in the Use of Clinical Trials to Support Individualizing Therapies: A Regulatory Perspective

This chapter covers a broad range of issues centered around the topic of optimizing therapies for individuals and the role of the clinical trial in reaching that goal. We describe how the clinical trial has been increasingly relied upon to provide the evidence for the patient level or patient marker level differential benefit or risk of therapies and how the study design choices can change depending upon the various study objectives. We consider the definition and role of prognostic and predictive classifiers or markers in the different clinical trial designs used for selecting and evaluating enriched study populations, and the difference between the retrospective and prospective approaches to evaluating differential treatment effects among marker subgroups. Some examples are given to illustrate the issues. Two of the most challenging aspects of identifying and validating a predictive marker are the simultaneous need to quantify the performance characteristics (sensitivity and specificity) of the classifier and the choice of whether the study design should include all comers or selection of the marker positive only subgroup. The motivation for these clinical trial approaches to individualizing therapy is to maximize the benefits and minimize the safety risks of therapies for patients.
Enabling users to self-manage networks: collaborative anomaly detection in wireless personal area networks

Personal area networks such as home or small office LANs are usually more vulnerable to cyber-attacks than those with dedicated support staff and the ability to invest consistently in security defenses. In this paper I propose leveraging physical characteristics of these personal area networks in order to enable non-technical individuals to secure their networks or at least be aware that their devices have been compromised. This proposal leverages records of location for mobile devices, proximity authentication, and individual homophily. In this work, I summarize previous studies on securing personal networks, proximity authentication, and software attestation. I then present a preliminary design for the detection of and recovery from infection for personal area networks. Limitations and future work are also discussed.
Forage legumes as living mulches for trees in agroforestry practices: preliminary results

Successful establishment and growth of tree seedlings in an agroforestry practice is dependent on the control of competing herbaceous vegetation. Conventional weed control methods (i.e., chemical, mechanical, and physical suppression) are effective but can be costly in terms of time, damage to non-target vegetation, or increased soil erosion. Alternatively, some living mulches can exclude undesirable vegetation, protect the soil, compete minimally with associated trees, and supplement soil nitrogen. In this study, small and large white clover (Trifolium repens L.), red clover (T. pratense L.), kura clover (T. ambiguum Bieb.), strawberry clover (T. fragiferum L.), birdsfoot trefoil (Lotus corniculatus L.), hairy vetch and ’AU Early‘ hairy vetch (Vicia villosa Roth) were selected for evaluation as living mulches. These species were established in 9 m ×9 m replicated plots along with two controls [tall fescue (Festuca arundinacea Schreb.) and bare soil kept vegetation free using glyphosate]. The controls represent ’high competition‘ and ’no competition‘, respectively. Eastern black walnut (Juglans nigra L.), honeylocust (Gleditsia triacanthos L.), and hybrid pitch × loblolly pine (Pinus rigida L. × P. taeda L.) seedlings were planted in association with each living mulch. Tree seedling heights and diameters were measured during the first two years and forage performance evaluated. All seedlings grew better in the absence of competition. Tall fescue greatly reduced the growth of hardwood seedlings. Red clover and ladino clover showed the greatest promise as living mulches for use with the hardwood and pine seedlings, respectively.
Problems in Hamiltonian PDE’S

The purpose of this expose is to describe a line of research and problems, which I believe, will not be by any means completed in the near future. As such, we certainly hope to encourage further investigations. The list of topics in this field is fairly extensive and only a few will be commented on here. Their choice was mainly dictated by personal research involvement. It should also be mentioned that the different groups of researchers may have very different styles and aims. As a science, claims and results range from pure experimentation to rigorous mathematical proofs. Although my primary interest is this last aspect, I have no doubt that numerics or heuristic argumentation may be equally interesting and important. The history of the Korteweg-de-Vries equation for instance is a striking example of how a problem may evolve through these different interacting stages to eventually create a beautiful theory. As a mathematician, I feel however that it is essential one remains fully aware of what is rigorous mathematical argumentation and what is not. Failure to do so would result in general confusion about the nature of the statements and a great loss of challenging mathematics.
Column Web Strength in Beam-to-Column Connection

The present AISC Specification formula is shown to be conservative for grades of steel to 100 ksi yield stress. It does not permit consideration of any load carrying capacity in the region of sections with column web depth-to-thickness ratios greater than 189 divided by the square root of σ y . The objective of this paper is to develop a method of determining ultimate loads for this condition. A simulation test was conducted that involved the placing of a short length of column horizontally between loading platens of a testing machine. The machine was then compressed at the top and bottom faces of the column. A bar was tack-welded to the column flange to simulate a beam flange framing into it at that point. The deflection in the direction of the applied load and the lateral deflection were monitored. The lateral deflection indicated the stability of the column web. Test results and theoretical predictions are presented.
Lambert-Eaton myasthenic syndrome associated with alemtuzumab administration.

Abstract Background Alemtuzumab administration is known to cause secondary autoimmune disease but has not been associated with the development of neurologic autoimmune conditions. Lambert–Eaton myasthenic syndrome (LEMS) is caused by autoantibodies directed against calcium channels on the neuromuscular junction. Case report We report a case of a patient with relapsing-remitting multiple sclerosis (RRMS) treated with alemtuzumab who develop generalized weakness initially attributed to progression of MS but eventually determined to be due to LEMS. Conclusion Alemtuzumab treatment can result in the development of neurologic autoimmune conditions that could mimic MS progression.
High-Level Approaches for Leveraging Deep-Memory Hierarchies on Modern Supercomputers

There is a growing demand for supercomputers that can support memory-intensive applications to solve large-scale problems from various domains. Novel supercomputers with fast and complex memory subsystems are being provisioned to meet this demand. While complex and deep-memory hierarchies offer increased memory-bandwidth they can also introduce additional latency. Optimizing the memory usage of the applications is required to improve performance. However, this can be an effort-intensive and a time-consuming activity if done entirely manually. Hence, high-level approaches for supporting the memory-management and memory-optimization on modern supercomputers are needed. Such scalable approaches can contribute towards supporting the users at the open-science data centers - mostly domain scientists and students - in their code modernization efforts. In this paper, we present a memory management and optimization workflow based on high-level tools. While the workflow can be generalized for supercomputers with different architectures, we demonstrate its usage on the Stampede2 system at the Texas Advanced Computing Center that contains both Intel Knights Landing and Intel Xeon processors, and each Knights Landing node offers both DDR4 and MCDRAM.
Total Knee Arthroplasty Outcomes in Patients with Medicare, Medicare Advantage, and Commercial Insurance

As more commercial insurance companies adopt a bundled reimbursement model, similar to the Comprehensive Care for Joint Replacement (CJR) algorithm for Medicare beneficiaries, accurate risk adjustment of patient-reported outcomes (PROs) is critical to ensure success. With this movement toward bundled reimbursement, it is unknown if a formula adjusting for similar risks in the Medicare population could be applied to PROs in commercially insured and Medicare Advantage populations undergoing total knee arthroplasty (TKA). This study was performed to compare PROs after TKA in these insurance groups after adjusting for proposed risks. Demographics and clinical data were abstracted from medical records of 302 patients who underwent TKA performed by a single surgeon at a university-based orthopaedic practice during 2013 to 2017. Differences in PROs between commercially insured, Medicare Advantage, and Medicare patients during the 6 months following surgery were evaluated while controlling for demographics, clinical data, and baseline PRO scores. Medicare and Medicare Advantage patients were older (p
Influencing the timing of parenteral nutrition initiation in the pediatric intensive care unit.

Background: Lack of benefit and potential harm of early parenteral nutrition (PN) initiation in critically ill children was highlighted in the 2016 published results of a large multicenter, randomized controlled trial. Objectives: The purpose of this project was to implement a process to delay PN initiation for up to five days after admission to our pediatric intensive care unit (PICU). Methods: Patients greater than thirty days of age, admitted to the PICU beginning July 1, 2016 were included in the analysis of the healthcare improvement initiative to decrease early PN initiation. A meeting was held with PICU fellows, attending physicians, dietitians, and pharmacists to reach a consensus to delay initiation of parenteral nutrition until PICU day five. The dietitian, with pharmacist support, reiterated recommendations on rounds and in formal notes. Results: A total of 2333 patients were identified in the pre-intervention group and a total of 2491 patients in the post-intervention group. The percentage of patients receiving PN prior to day five within the PICU was 5.5% in the pre-intervention group versus 3.1% in the delayed PN group (p<0.001). PICU patients receiving PN less than or equal to three days decreased from 2.6% pre-intervention to 1.5% post-intervention (p=0.01). For the subset of patients who were initiated on PN after admission to the PICU, median PICU length of stay was 7 days versus 6 days in the pre-intervention versus post-intervention group (p=0.26). Conclusions: Decrease in PN utilization was seen in the pre and post-intervention groups as assessed by percentage of patients initiated on PN prior to day five of PICU admission. Consensus among practitioners with consistent recommendations from the frontline dietitian and pharmacist, with nutrition support team collaboration, contributed to the evidence based quality initiative results. Delaying PN did not adversely affect length of stay pre versus post-intervention.
Interprofessional Care: Why Teamwork Matters

Interprofessional care is an important part of geriatric medicine. The most common teams are interdisciplinary and multidisciplinary. Successful interdisciplinary teamwork promotes strong team communication, resulting in higher quality of patient care.
Screening for Mental Health and Substance Use Disorders in Obstetric Settings

The objective of this review is to describe the extent to which (1) obstetric settings are currently screening for mental health and substance use disorders and social determinants of health (SDoH), and (2) screening is followed by systematic approaches for ensuring an adequate response to positive screens. Additionally, clinical and policy implications of current screening practices and recommendations are discussed. Screening for perinatal depression in obstetric settings has increased. Despite their prevalence and negative impact, screening for other mental health and substance use disorders and SDoH is much less common and professional society recommendations are either nonexistent, less consistent, or less prescriptive. To truly address maternal mental health, we need to move beyond focusing solely on depression and address other mental health and substance use disorders and the contextual social determinants in which they occur.
Second Generation Pre-Raphaelitism: The Poetry of The Oxford and Cambridge Magazine

With its distinctive focus on creative writing, The Oxford and Cambridge Magazine (1856) marked an important if relatively underappreciated stage in the development of literary Pre-Raphaelitism. The OCM's inclusion of poetry motivated its two most distinguished writers, Dante Gabriel Rossetti and William Morris, to refine their earlier efforts into the crafted, evocative style which would characterize their later volumes of poetry. Rossetti brought three of his best-known works into near-final form, and his OCM versions of “The Blessed Damozel,” “The Staff and Scrip,” and "The Burden of Nineveh" reflected as well as influenced the Magazine's distinctive combination of romantic medievalism, heightened language, and resistance to conventional norms in art and politics. Morris acquired greater skill in the use of strong rhythms, visual imagery, and dramatic settings employed in the 1858 Defence of Guenevere. William Fulford influenced his fellow contributors through his critical zeal for Tennyson and commitment to women's rights; his poem “To the English Army Before Sebastopol” celebrates an ethical militance latent in the imagery of his fellow OCM poets. The OCM's sole female contributor Georgiana Burne-Jones left no further poetic legacy, but in later life continued its ideals through her political efforts and her eloquent account of the Magazine's origins. The existence of the OCM thus not only encouraged several lifelong collaborations but helped shape the further development of Pre-Raphaelite poetry in accord with its secular, avant-garde, and anti-establishmentarian aesthetic ideals.
Anti-GPR56 monoclonal antibody potentiates GPR56-mediated Src-Fak signaling to modulate cell adhesion

GPR56 is a member of the adhesion G-protein-coupled receptor family shown to play important roles in cell adhesion, brain development, immune function, and tumorigenesis. GPR56 is highly upregulated in colorectal cancer and correlates with poor prognosis. Several studies have shown GPR56 couples to the Gα12/13 class of heterotrimeric G-proteins to promote RhoA activation. However, due to its structural complexity and lack of a high-affinity receptor-specific ligand, the complete GPR56 signaling mechanism remains largely unknown. To delineate the activation mechanism and intracellular signaling functions of GPR56, we generated a monoclonal antibody (mAb) that binds with high affinity and specificity to the extracellular domain (ECD). Using deletion mutants, we mapped the mAb binding site to the GAIN domain, which mediates membrane-proximal autoproteolytic cleavage of the ECD. We showed that GPR56 overexpression in 293T cells leads to increased phosphorylation of Src, Fak, and paxillin adhesion proteins and activation of the Gα12/13-RhoA-mediated serum response factor (SRF) pathway. Treatment with the mAb potentiated Src-Fak phosphorylation, RhoA-SRF signaling, and cell adhesion. Consistently, GPR56 knockdown in colorectal cancer cells decreased Src-Fak pathway phosphorylation and cell adhesion. Interestingly, GPR56-mediated activation of Src-Fak phosphorylation occurred independent of RhoA, yet mAb-induced potentiation of RhoA-SRF signaling was Src-dependent. Furthermore, we show that the C-terminal portion of the Serine-Threonine-Proline-rich (STP) region, adjacent to the GAIN domain, was required for Src-Fak activation. However, autoproteolytic cleavage of the ECD was dispensable. These data support a new ECD-dependent mechanism by which GPR56 functions to regulate adhesion through activation of Src-Fak signaling.
Allogeneic adipose-derived stem cells mitigate acute radiation syndrome by the rescue of damaged bone marrow cells from apoptosis.

Acute radiation syndrome (ARS) is the radiation toxicity that can affect the hematopoietic, gastrointestinal, and nervous systems upon accidental radiation exposure within a short time. Currently, there are no effective and safe approaches to treat mass population exposure to ARS. Our study aimed to evaluate the therapeutic potential of allogeneic adipose-derived stem cells (ASCs) for total body irradiation (TBI)-induced ARS and understand the underlying mitigation mechanism. We employed 9.25 Gy TBI dose to C57BL/6 mice and studied the effect of allogeneic ASCs on mice survival and regeneration of the hematopoietic system. Our results indicate that intraperitoneal-injected ASCs migrated to the bone marrow, rescued hematopoiesis, and improved the survival of irradiated mice. Our transwell coculture results confirmed the migration of ASCs to irradiated bone marrow and rescue hematopoietic activity. Furthermore, contact coculture of ASCs improved the survival and hematopoiesis of irradiated bone marrow in vitro. Irradiation results in DNA damage, upregulation of inflammatory signals, and apoptosis in bone marrow cells, while coculture with ASCs reduces apoptosis via activation of DNA repair and the antioxidation system. Upon exposure to irradiated bone marrow cells, ASCs secrete prosurvival and hematopoietic factors, such as GM-CSF, MIP1α, MIP1β, LIX, KC, 1P-10, Rantes, IL-17, MCSF, TNFα, Eotaxin, and IP-10, which reduces oxidative stress and rescues damaged bone marrow cells from apoptosis. Our findings suggest that allogeneic ASCs therapy is effective in mitigating TBI-induced ARS in mice and may be beneficial for clinical adaptation to treat TBI-induced toxicities. Further studies will help to advocate the scale-up and adaptation of allogeneic ASCs as the radiation countermeasure.
Visual agnosia

The visual agnosias are an intriguing class of clinical phenomena that have important implications for current theories of high-level vision. Visual agnosia is defined as impaired object recognition that cannot be attributed to visual loss, language impairment, or a general mental decline. At least in some instances, agnostic patients generate an adequate internal representation of the stimulus but fail to recognize it. In this review, we begin by describing the classic works related to the visual agnosias, followed by a description of the major clinical variants and their occurrence in degenerative disorders. In keeping with the theme of this issue, we then discuss recent contributions to this domain. Finally, we present evidence from functional imaging studies to support the clinical distinction between the various types of visual agnosias.
Sorting Through the Evidence: A Step Toward Prioritization of Evidence-Based Community Supervision Practices:

Studies of implementation of evidence-based supervision policies and procedures often report minimal to moderate adherence to evidence-based models. The few studies that exist examine the degree to...
Use of Imagery in Grief Therapy

Loss and its companion, grief, are life’s inseparable pair. To grow and move forward, we must let go of the past and accept the resulting pain of loss. This process begins at our birth and does not end until our death. Denying loss may temporarily ease the pain, but not its effect. Such pain continues its impact on life until it is faced and integrated into one’s total personality.
The BME3 (Blue Micropylar End 3) GATA zinc finger transcription factor is a positive regulator of Arabidopsis seed germination

Summary In many plant species, seed dormancy is broken by cold stratification, a pre-chilling treatment of fully imbibed seeds. Although the ecological importance of seed response to cold temperature is well appreciated, the mechanisms underlying the physiological changes during cold stratification is unknown. Here we show that the GATA zinc finger protein expressed in Arabidopsis seeds during cold stratification plays a critical role in germination. Characterization of an enhancer-trap population identified multiple lines that exhibited β-glucuronidase (GUS) expression in the micropylar end of the seed (named Blue Micropylar End, BME lines). One of these lines, BME3, had a T-DNA insertion site in the 5′ upstream region of a GATA-type zinc finger transcription factor gene (termed BME3-ZF). The BME3-ZF mRNA accumulated in seeds during cold stratification. Characterization of the BME3-ZF promoter indicated that this gene was activated specifically in the embryonic axis, which was still enclosed by the endosperm. The zinc finger gene knockout plants produced seeds exhibiting deeper dormancy, which showed reduced response to cold stratification. The ungerminated knockout seeds exhibited testa rupture, but failed to penetrate the endosperm layer. Application of gibberellic acid (GA3) rescued impaired germination of knockout seeds without cold stratification, indicating that the normal GA signal transduction pathway is present in the knockout mutants. Expression of GA20-oxidase and GA3-oxidase genes was greatly reduced in the knockout seeds, suggesting the potential involvement of the zinc finger protein in GA biosynthesis. These results suggest that the GATA zinc finger protein is a positive regulator of seed germination.
LIQUID DESICCANT SOLAR HEAT PUMP FOR DEVELOPING NATIONS

ABSTRACT The U.S.C. liquid sorbent solar air conditioner has been redesigned to include a heating cycle, while at the same time to be more economical to construct and to operate. The triethylene glycol desiccant has been replaced with a calcium chloride solution. Concentration of the desiccant by direct solar radiation absorbed by the colored liquid allows collector operation at low temperature and high efficiency. The easily constructed open-channel trickle collector system is not used for transfer of sensible heat, but rather it is used for mass transfer of water absorbate from the absorbent solution to the natural ambient air stream. The hardware necessary to build this system is readily available worldwide. In the cooling mode, the process air is cooled and dehumidified by contact with concentrated sorbent solution flowing across cooling coils. Sensible heat as well as the heat of sorption is absorbed by shallow well-water in rural regions, while in urban areas, municipal water is used for cooling and then returned to the water mains where the heat is dissipated into the earth. Final cooling to a temperature lower than the well-water is achieved by humidification of the cool, dry ai rstream. In the heating mode, the process air is warmed and humidified by contact with the dilute sorbent solution as the air flows through the solar collectors. Final heating to a temperature higher than the storage temperature is achieved by the heat of sorption furnished by the dehumidfication of the warm, wet airstream.
THE APPLICATION OF FUZZY LOGIC TO THE CONSTRUCTION OF THE RANKING FUNCTION OF INFORMATION RETRIEVAL SYSTEMS

We propose a fuzzy logic (FL) approach to defining the ranking function. FL provides a convenient way of converting knowledge expressed in a natural language into fuzzy logic rules. The resulting ranking function could be easily viewed, extended, and verified: • if (tf is high) and (idf is high) → (relevance is high); • if (overlap is high) → (relevance is high). By using above FL rules, we are able to achieve performance approximately equal to the state of the art search engine Apache Lucene (∆P10 +0.92%; ∆MAP -0.1%). The fuzzy logic approach allows combining the logic-based model with the vector model. The resulting model possesses simplicity and formalism of the logic based model, and the flexibility and performance of the vector model.
Applying propensity scores estimated in a full cohort to adjust for confounding in subgroup analyses

A correctly-specified propensity score (PS) estimated in a cohort (“cohort PS”) should in expectation remain valid in a subgroup population. We sought to determine whether using a cohort PS can be validly applied to subgroup analyses and thus add efficiency to studies with many subgroups or restricted data. In each of 3 cohort studies we estimated a cohort PS, defined 5 subgroups, and then estimated subgroup-specific PSs. We compared difference in treatment effect estimates for subgroup analyses adjusted by cohort PSs versus subgroup-specific PSs. Then, 10M times, we simulated a population with known characteristics of confounding, subgroup size, treatment interactions, and treatment effect, and again assessed difference in point estimates. We observed that point estimates in most subgroups were substantially similar with the two methods of adjustment. In simulations, the effect estimates differed by a median of 3.4% (interquartile [IQ] range 1.3% to 10.0%). The IQ range exceeded 10% only in cases where the subgroup had <1000 patients or few outcome events. Our empirical and simulation results indicated that using a cohort PS in subgroup analyses was a feasible approach, particularly in larger subgroups.
Michael and Malott's dialog on linguistic productivity.

Abstract This is an informal dialog between Jack Michael and Dick Malott inspired by Malott's commentary (In press) on Relational Frame Theory: A Post-Skinnerian Account of Human Language and Cognition (Hayes, Barnes-Holmes, Roche; 2001). Topics range from psychologist Skinner to linguist Hockett and from the Skinner box to verbal behavior (AKA language).
Design and construction of a wideband efficient electro-optic modulator

construction, together with the results, are given.1. INTRODUCTIONWideband chirping, or rapid frequency shifting, is needed for laser radar for the same reasons as it is needed forsome types of microwave radar. A frequency modulator for the mid stages of a laser radar transmitter should have ahigh power output as the last stages of amplification are necessarily gain-bandwidth limited. Modulation efficienciesabove 50% andGHz bandwidth require a long traveling wave interaction between the modulating drive and the laser