cssi/SciSciGPT-SciSciNet huggingface dataset:
Switching tumor necrosis factor inhibitors in the treatment of axial spondyloarthritis.

Abstract Objective To assess the impact of switching tumor necrosis factor (TNF)-alpha inhibitors on patients with axial spondyloarthritis (axSpA). Methods PubMed literature searches were conducted using combinations of search terms including ankylosing spondylitis, spondyloarthropathy, spondyloarthritis, switch/switching, drug survival, and TNF/tumor necrosis factor to identify published articles with data on outcomes related to switching biologic therapies in patients with axSpA. Results Of the 134 studies screened, 21 were identified as reporting data on switching TNF inhibitors in patients carrying a diagnosis of axSpA or ankylosing spondylitis. The most common reasons for switching from the first TNF inhibitor were lack of efficacy (14–68%), loss of efficacy (13–61%), and adverse events/poor tolerability (13–57%). Switching TNF inhibitors was beneficial for a substantial proportion of patients with axSpA who failed to respond to initial or even second TNF inhibitor therapy and adverse effects were not enhanced. Drug survival rates were generally lower for the second (47–72% at 2 years) or third TNF inhibitor (49% at 2 years) than for the first TNF inhibitor (58–75% at 2 years). Predictors of responses in TNF-naive patients included HLA-B27 positivity, absence of enthesitis, age ≤40 years, elevated C-reactive protein level, good functional status, and shorter disease duration. Predictors of drug survival included male sex and peripheral arthritis. Common characteristics of patients who switched TNF inhibitors included female sex, older age, more severe disease, greater symptom burden, higher erythrocyte sedimentation rate, complete ankyloses, and enthesitis. Conclusion When the first or even the second TNF inhibitor fails, switching to an alternate one is not an unreasonable clinical therapeutic decision.
RF interference mitigation techniques to enable radio communications

RF Interference Mitigation is key to enabling reliable and uninterrupted Communications in congested spectrum environments. This paper provides an overview of various types of interference mitigation techniques particularly as encountered by military and government radio systems. The opportunities and challenges associated with developing these technologies will also be discussed.
Theological Implications of the Simulation Argument

Nick Bostrom’s Simulation Argument (SA) has many intriguing theological implications.We work out some of them here. We show how the SA can be used to develop novel versions of the Cosmological and ...
The effect of entrant brand's ownership on national brands' positioning strategies

National brand manufacturers face the threat of new product entry from not only their traditional competitors (other national brand manufacturers) but also from their own customers (the retailer). We compare how national brands can limit the loss due to entry of these two types of entrants by positioning of their brands. Our results show that national brands position farther from one another when the new entrant is a store brand than when the entrant is another national brand. We also find that due to different positioning strategies of these two types of entrant brandsâ€”the entrant store brand positioning â€œinâ€ betweenâ€ incumbent national brands whereas the entrant national brand positioning â€œawayâ€ from incumbent national brandsâ€”incumbent national brands may lose more from the entry of a weaker store brand than from the entry of a stronger national brand. Finally, we find that taking into consideration both pricing and product positioning decisions, consumer and social welfare are generally higher from store brand entry than from national brand entry.
Parallel imaging compressed sensing for accelerated imaging and improved signal-to-noise ratio in MRI-based postimplant dosimetry of prostate brachytherapy.

Abstract Purpose To investigate the feasibility of using parallel imaging compressed sensing (PICS) to reduce scan time and improve signal-to-noise ratio (SNR) in MRI-based postimplant dosimetry of prostate brachytherapy. Methods and Materials Ten patients underwent low-dose-rate prostate brachytherapy with radioactive seeds stranded with positive magnetic resonance-signal seed markers and were scanned on a Siemens 1.5T Aera. MRI comprised a fully balanced steady-state free precession sequence with two 18-channel external pelvic array coils with and without a rigid two-channel endorectal coil. The fully sampled data sets were retrospectively subsampled with increasing acceleration factors and reconstructed with parallel imaging and compressed sensing algorithms. The images were assessed in a blinded reader study by board-certified care providers. Rating scores were compared for statistically significant differences between reconstruction types. Results Images reconstructed from subsampling up to an acceleration factor of 4 with PICS demonstrated consistently sufficient quality for dosimetry with no apparent loss of SNR, anatomy depiction, or seed/marker conspicuity when compared to the fully sampled images. Images obtained with acceleration factors of 5 or 6 revealed reduced spatial resolution and seed marker contrast. Nevertheless, the reader study revealed that images obtained with an acceleration factor of up to 5 and reconstructed with PICS were adequate-to-good for postimplant dosimetry. Conclusions Combined parallel imaging and compressed sensing can substantially reduce scan time in fully balanced steady-state free precession imaging of the prostate while maintaining adequate-to-good image quality for postimplant dosimetry. The saved scan time can be used for multiple signal averages and improved SNR, potentially obviating the need for an endorectal coil in MRI-based postimplant dosimetry.
Evaluating the Transport and Fate of Nutrients in Large Scale River Basins Using an Integrated Modeling System

Watershed management is essential in minimizing riverine and receiving water pollution. No watershed model is currently available that adequately model the large river basin system over long periods of time in a satisfied level of detail. Watershed models must be linked to riverine or other detailed receiving water models in order to adequately represent the intricacies of the physical system under study. Watershed models are used to provide “boundary conditions,” both hydrologic/hydraulic and nonpoint source loading fluxes, to the receiving water models. The objectives of this study were to develop an integrated watershed and riverine modeling system using Soil and Water Assessment Tool (SWAT) model and Hydrologic Engineering Center-River Analysis System (HEC-RAS) model to evaluate the transport and fate of nutrients and water quality impacts in large scale river basins. The SWAT model was constructed for the Upper Mississippi River Basin (UMRB) in an attempt to account for key elements associated with crop production and land use changes. The model was calibrated and validated by using 18 years of observed United States Geological Survey (USGS) streamflow discharge and water quality data. The SWAT model was used to predict flow and nutrient exports from each tributary within the watershed. The results were used as HEC-RAS model’s inputs through an interface. The HEC-RAS model was able to simulate the transport and fate of nutrients and dynamic changes in riverine nutrient concentrations. The integrated SWAT and HEC-RAS modeling system provides a systematic approach to modeling nonpoint nutrient sources, transport, and fate in a large scale river basin. The modeling system can be used to predict downstream water quality impacts with land use changes and assess the effectiveness of different watershed management practices whether directed toward nutrient source supply or abatement.
Model-Based Approach for Combustion Monitoring Using Real-Time Chemical Reactor Network

Flame stability and pollution control are significant problems in the design and operation of any combustion system. Real-time monitoring and analysis of these phenomena require sophisticated equipment and are often incompatible with practical applications. This work explores the feasibility of model-based combustion monitoring and real-time evaluation of proximity to lean blowout (LBO). The approach uses temperature measurements, coupled with Chemical Reactor Network (CRN) model to interpret the data in real-time. The objective is to provide a computationally fast means of interpreting measurements regarding proximity to LBO. The CRN-predicted free radical concentrations and their trends and ratios are studied in each combustion zone. Flame stability and a blowout of an atmospheric pressure laboratory combustor are investigated experimentally and via a phenomenological real-time Chemical Reactor Network (CRN). The reactor is operated on low heating value fuel stream, i.e., methane diluted with nitrogen with N2/CH4 volume ratios of 2.25 and 3.0. The data show a stable flame-zone carbon monoxide (CO) level over the entire range of the fuel-air equivalence ratio (Φ), and a significant increase in hydrocarbon emissions approaching blowout. The CRN trends agree with the data: the calculated concentrations of hydroxide (OH), O-atom, and H-atom monotonically decrease with the reduction of Φ. The flame OH blowout threshold is 0.025% by volume for both fuel mixtures. The real-time CRN allows for augmentation of combustion temperature measurements with modeled free radical concentrations and monitoring of unmeasurable combustion characteristics such as pollution formation rates, combustion efficiency, and proximity to blowout. This model-based approach for process monitoring can be useful in applications where the combustion measurements are limited to temperature and optical methods, or continuous gas sampling is not practical.
381 STANDARDIZED PATIENT RATINGS PREDICT ACTUAL PATIENT SATISFACTION.

Purpose Standardized patients (SPs) are routinely used during medical education for the assessment of clinical skills, particularly history-taking and physical examination skills. However, no studies have assessed whether SP ratings of interpersonal skills and satisfaction are predictive of actual patient satisfaction. Methods During the 1999-2002 academic years, all internal medicine residents at the University of Kentucky underwent a single SP Clinical Evaluation Exercise (CEX), during which residents were expected to do a complete history and physical on an SP portraying a common medical condition. After each resident encounter, the SP completed a series of checklists, including rating resident nonverbal behaviors and their overall satisfaction with the “visit.” Nonverbal behavior was rated on a 10-item, 7-point Likert-type instrument (eg, The residents tone of voice was 1 = unexpressive, monotone to 7 = very expressive, emotional). SP satisfaction was assessed on a 5-item, 7-point Likert-type scale. Resident nonverbal behavior and SP satisfaction were represented by the mean score across the 10 items and 5 items, respectively. Over the same time period, patients in the internal medicine resident continuity clinics completed a 7-item patient satisfaction questionnaire on the residents. The patient satisfaction questionnaire consisted of seven commonly used patient satisfaction statements rated on a 10-point Likert-type scale. For the purposes of analysis, patient satisfaction was represented as the mean score across all seven items on this questionnaire. The data were analyzed using simple correlation and multiple regression approaches to assess the association between SP ratings and actual patient satisfaction. Results A total of 86 residents had ratings from both SPs and clinic patients. Actual clinic patient satisfaction was correlated to both SP ratings of satisfaction (r = .31, p = .003) and resident nonverbal skills (r = .29, p = .006). In the multiple regression analysis, controlling for resident gender and experience, actual patient satisfaction was independently predicted by SP ratings of resident nonverbal behavior (p = .03) but not by the completeness of the resident9s history-taking and physical examination. Conclusions During a single-station SP CEX, resident nonverbal behaviors and SP ratings of satisfaction are both associated with actual patient satisfaction. Further, nonverbal communication seems more important than thoroughness of the visit in predicting patient satisfaction. Educators should consider using SPs to provide trainees feedback about their interpersonal skills, particularly nonverbal behaviors.
Differentiating Typical From Atypical Speech Production in 5-Year-Old Children With Cerebral Palsy: A Comparative Analysis.

Objective Early diagnosis of speech disorders in children with cerebral palsy (CP) is of critical importance. A key problem is differentiating those with borderline or mild speech motor deficits fr...
GraphBLAST: A High-Performance Linear Algebra-based Graph Framework on the GPU

Author(s): Yang, Carl; Buluc, Aydin; Owens, John D | Abstract: High-performance implementations of graph algorithms are challenging to implement on new parallel hardware such as GPUs because of three challenges: (1) the difficulty of coming up with graph building blocks, (2) load imbalance on parallel hardware, and (3) graph problems having low arithmetic intensity. To address some of these challenges, GraphBLAS is an innovative, on-going effort by the graph analytics community to propose building blocks based on sparse linear algebra, which will allow graph algorithms to be expressed in a performant, succinct, composable and portable manner. In this paper, we examine the performance challenges of a linear-algebra-based approach to building graph frameworks and describe new design principles for overcoming these bottlenecks. Among the new design principles is exploiting input sparsity, which allows users to write graph algorithms without specifying push and pull direction. Exploiting output sparsity allows users to tell the backend which values of the output in a single vectorized computation they do not want computed. Load-balancing is an important feature for balancing work amongst parallel workers. We describe the important load-balancing features for handling graphs with different characteristics. The design principles described in this paper have been implemented in "GraphBLAST", the first high-performance linear algebra-based graph framework on NVIDIA GPUs that is open-source. The results show that on a single GPU, GraphBLAST has on average at least an order of magnitude speedup over previous GraphBLAS implementations SuiteSparse and GBTL, comparable performance to the fastest GPU hardwired primitives and shared-memory graph frameworks Ligra and Gunrock, and better performance than any other GPU graph framework, while offering a simpler and more concise programming model.
An On-Board Spectral-CT/CBCT/SPECT Imaging Configuration for Small-Animal Radiation Therapy Platform: A Monte Carlo Study

This study investigated the feasibility of a highly specific multiplexed image-guided small animal radiation therapy (SART) platform based on triple imaging from on-board single-photon emission computed tomography (SPECT), spectral-CT, and cone-beam CT (CBCT) guidance in radiotherapy treatment. As a proof-of-concept, the SART system was built with the capability of triple on-board image guidance by utilizing an x-ray tube and a single cadmium zinc telluride (CZT) semiconductor photon-counting imager via a Monte Carlo simulation study. The x-ray tube can be set at a low tube current for imaging mode and a high tube current for radiation therapy mode, respectively. In the imaging mode, both x-ray and gamma-ray projection data were collected by the imager to reconstruct CBCT, SPECT and spectral CT images of small animals being treated. The modulation transfer function (MTF) of the pixelated CZT imager measured was 8.6 lp/mm. The overall performances of the CBCT and SPECT imaging of the system were evaluated with sufficient spatial resolution and imaging quality to be fitted into the SART platform. The material differentiation and decomposition capacities of spectral CT within the system were verified using K-edge imaging, image-based optimal energy weighted imaging, and image-based linear material decomposition methods. The triple imaging capability of the system was demonstrated using a PMMA phantom containing gadolinium, iodine and radioisotope 99mTc inserts. All the probes were clearly identified in the registered image. The results demonstrated that a novel SART platform with high-quality on-board CBCT, spectral-CT, SPECT image guidance is technically feasible by using a single semiconductor imager, thus affording comprehensive image guidance from anatomical, functional, and molecular levels for radiation treatment beam delivery.
Repair and Recycling of Composites

The subject of recovery and recycling of composites has assumed great importance since large-scale applications, especially in the aerospace and wind industries. Different repair techniques such as cosmetic repair, bolted repair, and bonded repair are described. This is followed by a description of different recycling techniques used for PMCs: mechanical recycling, thermal techniques, solvolysis, and microwave assisted recycling. Recycling of aluminum matrix composites and recycling of tungsten carbide particulate composites are described.
Genome-scale metabolic rewiring to achieve predictable titers rates and yield of a non-native product at scale

Achieving high titer rates and yields (TRY) remains a bottleneck in the production of heterologous products through microbial systems, requiring elaborate engineering and many iterations. Reliable scaling of engineered strains is also rarely addressed in the first designs of the engineered strains. Both high TRY and scale are challenging metrics to achieve due to the inherent trade-off between cellular use of carbon towards growth vs. target metabolite production. We hypothesized that being able to strongly couple product formation with growth may lead to improvements across both metrics. In this study, we use elementary mode analysis to predict metabolic reactions that could be targeted to couple the production of indigoidine, a sustainable pigment, with the growth of the chosen host, Pseudomonas putida KT2440. We then filtered the set of 16 predicted reactions using -omics data. We implemented a total of 14 gene knockdowns using a CRISPRi method optimized for P. putida and show that the resulting engineered P. putida strain could achieve high TRY. The engineered pairing of product formation with carbon use also shifted production from stationary to exponential phase and the high TRY phenotype was maintained across scale. In one design cycle, we constructed an engineered P. putida strain that demonstrates close to 50% maximum theoretical yield (0.33 g indigoidine/g glucose consumed), reaching 25.6 g/L indigoidine and a rate of 0.22g/l/h in exponential phase. These desirable phenotypes were maintained from batch to fed-batch cultivation mode, and from 100ml shake flasks to 250 mL ambr® and 2 L bioreactors.
Cover Combinatorial Filters and their Minimization Problem (Extended Version)

Recent research has examined algorithms to minimize robots' resource footprints. The class of combinatorial filters (discrete variants of widely-used probabilistic estimators) has been studied and methods for reducing their space requirements introduced. This paper extends existing combinatorial filters by introducing a natural generalization that we dub cover combinatorial filters. In addressing the new -- but still NP-complete -- problem of minimization of cover filters, this paper shows that multiple concepts previously believed to be true about combinatorial filters (and actually conjectured, claimed, or assumed to be) are in fact false. For instance, minimization does not induce an equivalence relation. We give an exact algorithm for the cover filter minimization problem. Unlike prior work (based on graph coloring) we consider a type of clique-cover problem, involving a new conditional constraint, from which we can find more general relations. In addition to solving the more general problem, the algorithm also corrects flaws present in all prior filter reduction methods. In employing SAT, the algorithm provides a promising basis for future practical development.
Experimental Investigation of Topology-Optimized Deep Reinforced Concrete Beams with Reduced Concrete Volume

This paper presents an experimental investigation of digitally manufactured, reinforced concrete beams designed with topology optimization. The backbone of the current work is a hybrid mesh topology optimization algorithm that automatically generates strut-and-tie layouts. The resulting designs have tensile truss elements describing the reinforcing phase and compressive continuum force flow elements that illustrates how the concrete is carrying load. The aim of this work is to investigate the effect of removing a percentage of the non-load carrying concrete phase. A beam is designed with a standard, by-hand approach and the same steel amount is used in to generate a topology-optimized design. This work considers three beam designs; (i) the standard, (ii) a topology-optimized beam with a prismatic section (i.e. 100% concrete), and (iii) the topology-optimized steel layout in a beam with a reduced concrete volume (herein 75%). An alternative reinforcement method is used in which steel plates are cut by waterjet. To improve the bond quality between concrete and reinforcement, corrugations and anchors are added to the steel layouts. However, as opposed to previous experimental tests conducted by the authors, a poor bond quality is achieved, leading to premature failures of all test specimens. Due to the lack of proper bonding, comparison can only be made in the early elastic range. Here, a significant trend is that the by-hand and the topology-optimized specimens with 75% concrete exhibit near identical behaviors.
Separating Newborns from Mothers and Maternal Consent for Newborn Care and the Association with Health Care Satisfaction, Use and Breastfeeding: Findings from a longitudinal survey in Kenya

Abstract Objectives Disrespectful and poor treatment of newborns such as unnecessary separation from parents or failure to obtain parental consent for medical procedures occurs at health facilities across contexts, but little research has investigated the prevalence, risk factors, or associated outcomes. This study aimed to examine these practices and associations with health care satisfaction, use, and breastfeeding. Design Prospective cohort study Setting Health facilities in Nairobi and Kiambu counties in Kenya Participants Data were collected from women who delivered in health facilities between September 2019 and January 2020. The sample included 1,014 women surveyed at baseline and at least one follow-up at 2-4 or 10 weeks postpartum. Primary and secondary outcome measures 1) Outcomes related to satisfaction with care and care utilization, 2) Continuation of post-discharge newborn care practices such as breastfeeding. Results 17.6% of women reported being separated from their newborns at the facility after delivery, of whom 71.9% were separated over 10 minutes. 44.9% felt separation was unnecessary and 8.4% reported not knowing the reason for separation. 59.9% reported consent was not obtained for procedures on their newborn. Women separated from their newborn (>10 minutes) were 44% less likely to be exclusively breastfeeding at 2-4 weeks (aOR=0.56, 95%CI: 0.40, 0.76). Obtaining consent for newborn procedures corresponded with 2.7 times greater likelihood of satisfaction with care (aOR=2.71, 95%CI: 1.67, 4.41), 27% greater likelihood of postpartum visit attendance for self or newborn (aOR=1.27, 95%CI: 1.05, 4.41), and 33% greater likelihood of exclusive breastfeeding at 10 weeks (aOR=1.33, 95%CI: 1.10, 1.62). Conclusions Newborns, mothers, and families have a right to high quality, respectful care, including the ability to stay together, be informed and have proper consent for care. The implications of these practices on health outcomes a month or more after discharge illustrate the importance of a positive experience of postnatal care. Article Summary Strengths and Limitations of the Study This is one of the first studies to include survey questions surrounding details of separation of newborns from mothers and maternal consent for care, including risk factors and reasons for separation. This study used longitudinal data collected over 10 weeks following delivery to assess associations with outcomes, including postpartum visit attendance and breastfeeding. Differences in participants who responded to the 2-4week and 10 week follow-up interviews may have introduced bias due to differences in composition, thus comparisons of associations with outcomes between these two points should be interpreted conservatively. Findings may have limited generalizability to other contexts, as the study sample included women who gave birth at facilities in Nairobi and Kiambu counties.
Abstract PS6-59: Impact of Cholecystectomy in Breast Cancer Recurrence

Background: Several published studies demonstrate that bile acid metabolites may influence the growth of breast cancer cells in vitro. Our group has shown reduced plasma concentrations of cholic acid and chenodeoxycholic acid (primary bile acids) and deoxycholic acid and lithocholic acid (secondary bile acids) in breast cancer patients that later on develop tumor recurrence. Cholecystectomy reduces the circulating bile acid pool. In patients with prior cholecystectomy, changes in bile acid metabolites may contribute to breast cancer tumorigenesis and recurrence. This study investigates our institutional rate of cholecystectomy in women diagnosed with breast cancer and its impact on breast cancer recurrence. Methods: A retrospective review of patients with an invasive breast cancer diagnosis between 2014-2015 was conducted. Demographics, preoperative variables, surgical history and clinical outcome data was collected. 5-year disease-free survival (DFS) was compared using a Log-rank (Mantel-Cox) test. Results: The study included 264 patients with mean age of 60.9. Most were Caucasian (83.5%). The majority were diagnosed at Stage II or lower (80.3%) and had hormone receptor positive, HER2 negative breast cancer (72.9%). Approximately 22.7% of patients had prior cholecystectomy surgery. The only statistically significant heterogeneity in demographic data between patients with and without cholecystectomy was body mass index (BMI). Patients with cholecystectomy had a mean BMI of 33.3, versus 29.1 in patients with intact gallbladders. The 5-year DFS in breast cancer patients with cholecystectomy was 91.6%, versus 97.1% in patients with intact gallbladders (p=0.06). Conclusion: Women with breast cancer who had a history of cholecystectomy had increased rates of breast cancer recurrence over a 5-year period compared to women with breast cancer with intact gallbladders. Although this result was not statistically significant, a trend was seen. Future study of a larger patient sample size sample may lead to a statistical significant difference. The statistically significant difference in BMI between the two patient groups is likely a confounding factor, given increased BMI is a known risk factor for developing cholecystitis and breast cancer. This data supports existing in vitro studies that bile acids may influence the growth of breast cancer cells. There may be utility in closer follow-up of women with breast cancer and a history of cholecystectomy given the increased rate of breast cancer recurrence in this population. Citation Format: Isheeta Madeka, Rohin Gawdi, Katherine L Cook, Akiko Chiba. Impact of Cholecystectomy in Breast Cancer Recurrence [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-59.
SAFT-γ-Mie Cross-Interaction Parameters from Density Functional Theory-Predicted Multipoles of Molecular Fragments for Carbon Dioxide, Benzene, Alkanes, and Water

Determining unlike-pair interaction parameters, whether for group contribution equation of state or molecular simulations, is a challenge for the prediction of thermodynamic properties. As the number of components and their respective complexity increase, it becomes impractical to fit all the unlike interactions. Lorentz-Berthelot combining rules work well for systems, where the main interactions are dispersion forces, but they do not account for electrostatics. In this work, we derive predictive combining rules within the SAFT-γ-Mie framework. In the resulting model, the unlike-pair interactions account for the effect of ionization energies, partial charges, dipole moments, and quadrupole moments. We then estimate these properties for molecular fragments using density functional theory calculations and demonstrate their use to obtain realistic cross-interaction energies without the need for experimental data. An open-source python package, Multipole Approach to Predictively Scale Cross-Interactions, is included to facilitate use of the methods presented in this work. A good qualitative agreement was obtained for all phase equilibria calculations of binary mixtures containing carbon dioxide with propane, hexane, benzene, and water, as well as mixtures of hexane and benzene. Finally, we discuss future improvements to our methodology, including the use of physical insights when fitting self-interaction parameters.
Burnout, Depression, Anxiety, and Stress Among Family Physicians in Kansas Responding to the COVID-19 Pandemic.

Introduction: COVID-19 has spread rapidly, with vast global implications. This study assessed how family physicians in Kansas were responding to COVID-19 and the effects of the pandemic on their well-being. Methods: The authors conducted a cross-sectional survey of 113 family physicians in Kansas between May 22, 2020 and June 25, 2020. The study participants completed an anonymous, 36-item survey assessing their concerns about being exposed to COVID-19 and levels of personal depression, anxiety, stress, and burnout in addition to demographic information. Results: There was a 45.6% response rate, with 50.4% (n = 57) of the respondents reporting manifestations of burnout. The physicians who personally treated any presumptive or confirmed COVID-19 patient, compared with those who did not, were more likely to report at least 1 manifestation of burnout, experience emotional exhaustion, and feel a higher level of personal stress. Conclusion: Our findings demonstrate that the COVID-19 pandemic may be taking an emotional toll on family physicians in Kansas. This study provides a baseline from which to continue further monitoring of outcomes. Data can help drive initiatives at local, state, and national levels to help diminish the negative impact of the COVID-19 pandemic on physicians.
Cognitive Action Theory: An Overview

Incorporating a conscious 1st person observer in scientific theories has been hampered by the lack of physically viable mind/body models. I will present a Cognitive Action Theory (Baer 2020) model of an integrated mind/body system and identify the process of creating conscious experience as the basic building block of reality. This building block is a cyclic process in time, connecting the first person experience with its 3d person physical models so that conscious phenomena are possible. To allow the construction of such a basic building block we propose a fundamental shift to consider what we do to be conscious as an a-priory activity that must be happening for us to be able to ask the question, “How can conscious beings exist in our physical world?” This shift means first asking, “How does the memory of a physical world exist in a conscious being”? The answer to this question leads to Conscious Action Theory (CAT) and the physical formulation of a conscious being as a self contained action cycle with the mental and physical phases. This activity contains both qualia and its explanation to produce what physicist Archibald Wheeler [1,2] described as a self measuring explanatory cycle. At this level of abstraction such a cycle of activity can accommodate any belief system defining physical reality as an explanation for personal experience and therefore provide a framework which accommodates both scientific and spiritual traditions. Visualizing such an abstract activity as the motion of masses and charges allows us to couple what we do to the formalism of classic and quantum physics. Such a theory integrates the subjective and objective aspect of our experience in a single physical framework, reducing to the linear quantum formalism when the motions involved are small enough to be reversible [3,4].
Understanding the Impact of Regulatory Changes on the Implementation of Therapeutic Day Treatment: A Case Study Approach

UNDERSTANDING THE IMPACT OF REGULATORY CHANGES ON THE IMPLEMENTATION OF THERAPEUTIC DAY TREATMENT: A CASE STUDY APPROACH By Angie M. Mann-Williams, Ph.D., LCSW A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2014 Chair: Mary C. Secret, Ph.D. Associate Professor School of Social Work Therapeutic Day Treatment (TDT) is a community-based mental health treatment program regulated and funded by the Department of Medical Assistance Services (DMAS) in the Commonwealth of Virginia. This case study sought to understand how DMAS regulatory changes impacted the implementation of the TDT program in the Commonwealth between fiscal years 2004 and 2011. In an effort to respond to this question, sources of qualitative and quantitative data were collected including: TDT feefor-service data, regulations in the Community Mental Health and Rehabilitative Services manual guiding the implementation of the TDT program, and structured interviews with eight key stakeholders who interface with the TDT program. The fee-for-services analysis found that there was a 269% increase in fee-for-service expenditures between fiscal years 2007 and 2011. The analysis of the regulations found DMAS added language to provide greater clarity to the existing regulators. Some of these changes include the implementation of the PA process with KePRO as well as the VICAP process. Additionally, staff requirements changed and paraprofessionals were no longer able to provide TDT programming. Caseload limits were also set for TDT programming. Four themes emerged through the analysis of the structured interviews. These themes include: 1) fraudulent practices and misuse of TDT services, 2) regulatory oversight, 3) cost containment, and 4) evaluation. Implications focused on the areas of policy, practice, and research by suggesting further research studies focusing on TDT and policy, offering the foundation of a more comprehensive theory focusing on policy implementation, and lastly the researcher provided a logic model for the TDT program in an effort to propel evaluation research forward. Change isn’t easy and it doesn’t happen overnight, but the people writing mental health laws need to know what is broken before we can even begin to start down a path to fixing it. --Virginia State Senator Creigh Deeds
How the physical proximity of climate mitigation projects influences the relationship between affect and public support

This study investigates how the physical proximity of university-sponsored climate mitigation projects may moderate the relationship between affect and project support and impact public support for the respective projects. Using a mail survey (N = 667) of residents near a major university in New York State, we find that positive and negative affective responses to proposed climate mitigation projects have a stronger association with project support when the project will be implemented in close, as opposed to distant, physical proximity. In contrast, we do not find that the physical distance of project implementation moderates the relationship between affective responses to climate change in general and project support. In addition, we find no evidence of a NIMBY effect in public support/opposition to the particular projects, but do find that public support varies depending on the type of project that is being proposed.
Topics In Ring Theory

In this chapter we shall make a study of rings satisfying certain ascending chain conditions. In the non-commutative case-and this is really the only case with which we shall be concerned- the decisive and incisive results are three theorems due to Goldie. The main part of the chapter will be taken up with a presentation of these.
Exploration Of ‘Click’ Chemistry For Microelectronic Applications

The ‘Click’ chemistry was explored for low temperature snap cure and for possible use as an adhesion promoter in electronic applications. Several azide and alkyne resins were synthesized and their curing potential was evaluated with a special emphasis on exploring Cu(I) catalyst effect. The preliminary curing study in the absence of catalysts showed a strong dependence of cure temperatures on the electronic nature of alkynes. The cure temperatures showed a tendency to increase with decreasing electronegativity of the substituent on alkynes. The capability of Cu(I) catalysts to accelerate the ‘Click’ chemistry was demonstrated for the first time in bulk phase. Using several Cu(I) catalysts, the cure temperatures could be lowered by as much as 40–100°C compared to the control, depending on the nature of catalyst and the catalyst loading. We discovered a novel synergistic effect between Cu(I) and silver filler in lowering the cure temperatures. Using this combination, lower cure temperatures could be obtained than using either alone. Among several resins screened, one resin system has shown promise for 80°C snap-cure in which the aforementioned synergistic effect is operative. Solution phase ‘Click’ chemistry was employed for the synthesis of a hybrid triazole-epoxy resin system. This system was found to cure without added amine curative. The triazole group here serves as a linker as well as an internal adhesion promoter. To address the incompatibility and volatility issues, which arose during evaluation, a controlled oligomerization method has been developed using controlled heating of azides and alkynes in solution phase.
Detection of preinvasive cancer cells

Early-warning changes in precancerous epithelial cells can now be spotted in situ. More than 85% of all cancers originate in the epithelium that lines the internal surfaces of organs throughout the body. Although these are readily treatable provided they are diagnosed in one of the preinvasive stages1, early lesions are often almost impossible to detect. Here we present a new optical-probe technique based on light-scattering spectroscopy that is able to detect precancerous and early cancerous changes in cell-rich epithelia.
Oil and Anthropology

In addition to its established interest in the relationships among states, corporations, and communities near extraction sites, recent anthropological and allied interdisciplinary interest in oil extends to encompass pipeline infrastructures, financial and commodity markets, reserve estimates and calculations, international legal battles, and the creation of geological, environmental, and petrochemical knowledge. This review suggests that, across these issues and around the world, two analytic issues have emerged as topics of special interest: temporality and materiality. The former includes the ways in which the oil complex shapes senses of cyclical boom and bust, of acceleration and deceleration, and of past, present, and future. The latter includes the ways in which humans encounter, transform, and represent various qualities and properties of oil as a substance.
Exotic crust formation on Mercury: Consequences of a shallow, FeO-poor mantle

The range in density and compressibility of Mercurian melt compositions was determined to better understand the products of a possible Mercurian magma ocean and subsequent volcanism. Our experiments indicate that the only mineral to remain buoyant with respect to melts of the Mercurian mantle is graphite; consequently, it is the only candidate mineral to have composed a primary floatation crust during a global magma ocean. This exotic result is further supported by Mercury's volatile-rich nature and inexplicably darkened surface. Additionally, our experiments illustrate that partial melts of the Mercurian mantle that compose the secondary crust were buoyant over the entire mantle depth and could have come from as deep as the core-mantle boundary. Furthermore, Mercury could have erupted higher percentages of its partial melts compared to other terrestrial planets because magmas would not have stalled during ascent due to gravitational forces. These findings stem from the FeO-poor composition and shallow depth of Mercury's mantle, which has resulted in both low-melt density and a very limited range in melt density responsible for Mercury's primary and secondary crusts. The enigmatically darkened, yet low-FeO surface, which is observed today, can be explained by secondary volcanism and impact processes that have since mixed the primary and secondary crustal materials.
“I’ve got an idea”: A social semiotic perspective on agency in the second language classroom

Abstract This paper addresses the role of multimodal fluency in establishing agency in the second language classroom. The focus of the paper is on the semiotic resourcefulness of an English Language Learner in an English as a Second Language classroom in the United States. Framed from a social semiotic perspective, fine grained multimodal analysis of teacher–student interaction during second language online writing reveals how one student demonstrates fluency with the multiple semiotic demands of the language classroom—using his fluency to commit transgressional acts that preserve agency. Implications for the role of intersubjectivity in identifying learner competencies are discussed.
Assessing oxygen requirement after discharge in chronic lung disease: a survey of current practice.

In order to survey current management of oxygen in children with chronic lung disease (CLD) of prematurity in the United Kingdom and Ireland, 260 questionnaires asking about criteria that were considered important when removing supplemental oxygen from a child with CLD were sent to consultant paediatricians identified as being likely to be involved in the follow-up of children with CLD. A total of 120 questionnaires were returned from 114 centres. The factors that were considered important when removal of the patient's supplemental oxygen was being considered were: the oxygen saturation level in 100% responders; the respiratory rate in 62%; the heart rate in 37%; the length of time that the child had been in oxygen in 25%; changes on the chest radiograph in 22%; capillary blood gases in 18%, and arterial blood gases in 7%. The specific oxygen saturation level above which it was felt that the patient could stop oxygen therapy ranged from 85% to 98% (mean 93%). The situations which would prevent discontinuation of oxygen were: desaturation while feeding/ sleeping or exercising in 95% responders; failure to gain weight in 78%; presence of pulmonary hypertension in 62%, the parents' opinion or perception of their child's needs for supplemental oxygen in 58%; recent withdrawal of steroid therapy in 52%; a recent infection of the respiratory tract in 42%; history of cyanotic spells in 28%; and the advent of winter in 23%. Conclusion: there is an enormous variety of practice with regard to the management of supplemental oxygen for children with chronic lung disease suggesting an urgent need for research and evidence-based guidelines.
Evaluating correlated outcomes and sources of new information

Abstract This paper considers the difficulties associated with evaluating the expected value of additional information when the outcomes of various decision alternatives may be correlated. Such correlation is explained in terms of dependence of outcomes on common exogenous factors and it is argued that decisions regarding what, if any, additional information to collect should take such dependencies into account. A model-based ‘fixed-parameter’ approach to evaluating EVPI in such a context is developed and compared to the traditional ‘fixed-correlation’ approach. The results suggest that different assumptions about the issue of correlation can produce different, sometimes contradictory, conclusions about the expected value of additional information and bence, should be explicitly stated as part of any pre-posterior analysis. A hybrid model encompassing both approaches and rooted in the theory of psychology of inference is then proposed and illustrated.
YouTube? For Health Education?

Abstract Objectives: Secondary school teachers and college health education majors will examine the possibilities and procedures of using YouTube videos as teaching tools in health education. A recent search, using the 10 content areas of health, yielded 285,564 videos. The article includes rationale for using YouTube videos, guidelines for video selection, and examples of how YouTube videos can be used in 9-12 health courses. Target Audience: Health educators of grades 9-12 and health education majors.
θ-Role Assignment in Derived Nominals

Chomsky and Stowell attribute an asymmetry in noun and verb complement systems to how these categories assign Case. Here, Case assignment is dependent on structural configurations that θ-role theory determines; it is the latter which explains asymmetries in the noun and verb complement systems. Several predicate attribute and Vk (clausal) complement types are examined, and all confirm the θ-role theory in which V can assign θ-roles directly to sisters of any phrasal type, while N and A can assign θ-roles only "indirectly," to Ymax appearing in PP structures. This predicts the new patterns examined here, as well as the asymmetry in how objects of verbs and derived nominals are syntactically realized.
Laboratory investigation of MIC threat due to hydrotest using untreated seawater and subsequent exposure to pipeline fluids with and without SRB spiking

Abstract Microbiologically Influenced Corrosion (MIC) is a major threat to integrities of pipelines and storage tanks. Even though MIC during hydrotest itself may be limited due to lack of nutrients and a relatively short duration, biofilms left behind may flourish after a pipeline or storage tank is commissioned, resulting in failures due to MIC pinhole leaks over the long run. This work investigated MIC threats in simulated hydrotest with X65 coupons using untreated natural seawater and enriched artificial seawater spiked or not spiked with a laboratory strain of Sulfate Reducing Bacteria (SRB) for up to 90 days. The MIC threat after hydrotested pipes were subsequently exposed to pipeline fluids was also investigated by using simulated pipeline fluids containing a mixture of LVT-200 oil, natural seawater and CO 2 or a mixture of LVT-200 oil, simulated formation water (65,000 ppm (w/w) NaCl, 22 mM SO 4 2 - ) and CO 2 . Tests were performed at 22 °C and 37 °C in anaerobic vials. The effectiveness of a 30 min slug of Tetrakis Hydroxymethyl Phosphonium Sulfate (THPS) treatment of the coupons right after hydrotest was also evaluated. MIC pitting was observed in simulated hydrotest using enriched artificial seawater spiked with SRB. MIC pitting was also observed on coupons exposed to simulated pipeline fluids after hydrotesting with SRB spiking using either natural seawater or enriched artificial seawater.