cssi/SciSciGPT-SciSciNet huggingface dataset:
Impact of Displaying Inpatient Pharmaceutical Costs at the Time of Order Entry: Lessons From a Tertiary Care Center.

BACKGROUND A lack of cost-conscious medication use is a major contributor to excessive healthcare expenditures in the inpatient setting. Expensive medicines are often utilized when there are comparable alternatives available at a lower cost. Increasing prescriber awareness of medication cost at the time of ordering may help promote cost-conscious use of medications in the hospital. OBJECTIVE To evaluate the impact of cost messaging on the ordering of 9 expensive medications. DESIGN Retrospective analysis of an institutional cost-transparency initiative. SETTING A 1145-bed, tertiary care, academic medical center. PARTICIPANTS Prescribers who ordered medications through the computerized provider order entry system at the Johns Hopkins Hospital. METHODS Interrupted time series and segmented regression models were used to examine prescriber ordering before and after implementation of cost messaging for 9 highcost medications. RESULTS Following the implementation of cost messaging, no significant changes were observed in the number of orders or ordering trends for intravenous (IV) formulations of eculizumab, calcitonin, levetiracetam, linezolid, mycophenolate, ribavirin, and levothyroxine. An immediate and sustained reduction in medication utilization was seen in 2 drugs that underwent a policy change during our study, IV pantoprazole and oral voriconazole. IV pantoprazole became restricted at our facility due to a national shortage (-985 orders per 10,000 patient days; 𝑃 < 0.001), and oral voriconazole was replaced with an alternative antifungal in oncology order sets (-110 orders per 10,000 patient days; 𝑃 = 0.001). CONCLUSIONS Prescriber cost transparency alone did not significantly influence medication utilization at our institution. Active strategies to reduce ordering resulted in dramatic reductions in ordering.
Partisan bias and expressive voting

Abstract We conduct an experiment to characterize the “expressive” voting behavior of political partisans. We find that participants who are asked to vote on the answer to factual questions tend to offer more partisan responses than those who must answer as decisive individuals. We further test whether voters exploit corrective information that sometimes challenges their partisan views. When information is available, we observe smaller partisan gaps and more correct responses, especially when the information is free. When information is costly to acquire, we find that voters generally choose to remain uninformed, consistent with the Downsian theory of rational ignorance.
Effects of thermal gradients on defect formation during the consolidation of partially impregnated prepregs

We describe the effects of thermal gradients on the consolidation of partially impregnated prepregs. Laminates were cured on a heated tool in isothermal and nonisothermal conditions. Key process pa...
Posttranslational Modifications of RAS Proteins

The three human RAS genes encode four proteins that play central roles in oncogenesis by acting as binary molecular switches that regulate signaling pathways for growth and differentiation. Each is subject to a set of posttranslational modifications (PTMs) that modify their activity or are required for membrane targeting. The enzymes that catalyze the various PTMs are potential targets for anti-RAS drug discovery. The PTMs of RAS proteins are the focus of this review.
Hyperbolic blockade: Photonic density of states and spontaneous emission rate at the interface with a conducting medium

The surface scattering of free electrons strongly modifies the electromagnetic response near the interface. Due to the inherent anisotropy of the surface scattering that necessarily reverses the normal to the interface component of the electron velocity while its tangential component may remain the same, a thin layer near a high-quality interface shows strong dielectric anisotropy. The formation of the resulting hyperbolic dispersion layers near the metal-dielectric interface strongly modifies the local density of states, and leads to orders of magnitude changes in all associated phenomena.
Aromatase Acetylation Patterns and Altered Activity in Response to Sirtuin Inhibition.

Aromatase, a cytochrome P450 member, is a key enzyme involved in estrogen biosynthesis and is dysregulated in the majority of breast cancers. Studies have shown that lysine deacetylase inhibitors (KDI) decrease aromatase expression in cancer cells, yet many unknowns remain regarding the mechanism by which this occurs. While advances have been made to clarify factors involved in the transcriptional regulation of the aromatase gene (CYP19A1). Yet, despite aromatase being a primary target for breast cancer therapy, its post-translational regulation has been virtually unexplored. Acetylation is a post-translational modification (PTM) known to alter the activity and stability of many oncoproteins and given the role of KDIs in regulating aromatase expression, we postulate that aromatase acetylation acts as a novel post-translational regulatory mechanism that impacts aromatase expression and/or activity in breast cancer. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis revealed that aromatase is basally acetylated on several lysine residues (108, 242, 262, 334, 352 and 354) in MCF-7 cells, and treatment with a SIRT-1 inhibitor induced additional acetylation (376, 390, 440 and 448). These acetylated lysine residues are in regions critical for aromatase activity. Site-directed mutagenesis and overexpression studies demonstrated that K108R/Q or K440R/Q mutations significantly altered aromatase activity in breast cancer cells without altering its subcellular localization. Implications: These findings demonstrate a novel post-translational regulation of aromatase and uncover novel anti-cancer effects of deacetylase inhibitors; thus, providing new insight for ongoing development of deacetylase inhibitors as cancer therapeutics.
Tunable Metamaterials Based on the Metal-Insulator Transition in Vanadium Oxide

Tunable metamaterials and THz devices based on vanadium dioxide films are demonstrated. The effects of strain engineering during film growth on the temperature and dynamics of the metal-insulator transition will also be discussed.
Regulation of Phosphate Metabolism by FGF23

Fibroblast growth factor 23 (FGF23) is a recently discovered hormone that is a key regulator of systemic phosphate metabolism. It is expressed in bone and has endocrine effects on renal and parathyroid gland function. FGF23 and its co-factor Klotho interact with vitamin D and parathyroid hormone to form a delicate regulatory network that maintains the optimal balance of mineral ions in the body that is critical for health and survival. This chapter explains the biology and physiology of FGF23, how it interacts with the other calcium and phosphate regulating hormones to maintain mineral ion homeostasis, and how its dysregulation contributes to renal and skeletal disorders.
Malignant Liver Lesions

The liver is a common site for both primary and metastatic malignant lesions. Although the metastatic lesions are the most common, primary malignancies like hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) have become increasingly more common in recent years in the United States [1]. HCC arises from the hepatic parenchymal cells, the hepatocytes, and CC from the cells lining the major bile ducts and gallbladder, the cholangiocytes. In Asian countries like China, Taiwan, and Japan, HCC is one of the three most common causes of death due to malignancy. HCC has a serum marker in the form of α-fetoprotein, and no such marker exists for CC. Gallium-67 citrate, which has been an imaging agent for HCC over the years, still remains popular in places where F-18 fluorodeoxyglucose (F-18 FDG) is not readily available. A filling defect on a radiocolloid liver scan (Fig. 12.1.1) associated with intense Ga-67 uptake (Fig. 12.1.2) and increased serum α-fetoprotein in a patient is more likely to be HCC than any other type of malignancy. F-18 FDG shows avidity for CC, HCC, metastatic lesions, and abscesses. Being a common imaging agent for many different types of liver lesions, F-18 FDG imaging provides no specificity for any one particular type of malignancy.
Multi-stream spectro-temporal features for robust speech recognition.

A multi-stream approach to utilizing the inherently large number of spectro-temporal features for speech recognition is investigated in this study. Instead of reducing the featurespace dimension, this method divides the features into streams so that each represents a patch of information in the spectrotemporal response field. When used in combination with MFCCs for speech recognition under both clean and noisy conditions, multi-stream spectro-temporal features provide roughly a 30% relative improvement in word-error rate over using MFCCs alone. The result suggests that the multi-stream approach may be an effective way to handle and utilize spectro-temporal features for speech applications.
Expertise and Instruction in Software Development

Publisher Summary This chapter surveys the research of the late 1980s and early 1990s on the nature of software development expertise and approaches to teaching software development skills. This literature shows that several complementary developments address the limitations of the early work. The chapter reviews how a cognitive science perspective was employed to develop a theoretical framework for interpreting and refining the empirical studies. Instead of focusing on the efficacy of particular features, research began to characterize the knowledge and skill of programmers and how that knowledge and skill is acquired and developed. Further, the chapter reviews how studies of software expertise have raised the level of analysis from individual lines of code to the design of software systems and to the teamwork involved in such activities. Finally, the chapter examines research and development of programming and design instruction that incorporates these new perspectives on software development expertise.
Stress Fractures of the Foot and Ankle in Athletes

Stress fractures of the foot and ankle are common injuries in athletes. Management differs considerably based on fracture location and predisposing factors. Repetitive loading of the foot and ankle...
Risk of hematological toxicities in patients with advanced breast cancer treated with everolimus: A meta-analysis of phase 3 randomized controlled trials.

e13087Background: Aberrant signaling through the phosphatidylinositol 3-kinase (PI3K)-Akt-mammalian target of rapamycin (mTOR) signaling pathway was shown to involve in endocrine and trastuzumab re...
Increasing Levels of Serum Heat Shock Protein 70 Precede the Development of AIDS-Defining Non-Hodgkin Lymphoma Among Carriers of HLA-B8-DR3.

Background We hypothesized that carriage of presumably high Hsp70-producing gene variants on a specific human major histocompatibility complex haplotype, the 8.1 ancestral haplotype (8.1AH), may predispose HIV-infected individuals to AIDS-non-Hodgkin lymphoma (NHL). Setting We compared serum Hsp70 levels in the years preceding the diagnosis of AIDS-NHL in a matched case-control study (n = 151 pairs) nested in the Multicenter AIDS Cohort Study. Methods We tested the impact of 8.1AH-specific single-nucleotide polymorphism (SNP) and joint SNP-human leukocyte antigen extended haplotypes previously associated with AIDS-NHL in the Multicenter AIDS Cohort Study on the circulating Hsp70 levels in mixed linear models. Results We report elevated serum levels of Hsp70 in the 4 years preceding the diagnosis of AIDS-NHL in cases that carry 8.1AH, but not in noncarrier cases and not in carrier- or non-carrier-matched controls. The strongest predictor of higher serum Hsp70 was the haplotype A-G-A-C formed by SNPs rs537160(A) and rs1270942(G) in the complement factor CFB gene cluster, and rs2072633(A) and rs6467(C) in nearby RDBP and CYP21A2 located 70 Kb apart from the Hsp70 gene cluster. The association with A-G-A-C haplotype (beta = 0.718; standard error = 0.182; P = 0.0002) and with other 8.1AH-specific haplotypes including the high-producing tumor necrosis factor-alpha haplotype rs909253(G)-rs1800629(A) (beta = 0.308; standard error = 0.140; P = 0.032) were observed only with NHL identified as an AIDS-defining condition, but not as a post-AIDS condition, nor in combined AIDS and post-AIDS cases. Conclusion Our combined genetic and functional approach suggests that the altered level of Hsp70 is a correlate of 8.1AH-mediated AIDS-NHL. Further investigation of the Hsp70 gene cluster and nearby loci that are tagged by A-G-A-C could better elucidate the genetic determinants of the malignancy.
Rigorous research on existing child maltreatment prevention programs: introduction to the special section

Awareness of child maltreatment as a major public health problem in the US has increased in recent years. In response, major public initiatives have been launched to fund the delivery of evidence-based programs, such as home visiting, in an effort to promote child and family functioning and health and prevent maltreatment. While promising, the number of families served by these programs remains small relative to need. Further, many families across the US are served by community-designed and supported programs for which rigorous outcome evidence has never been collected. To broaden the evidence-base on child maltreatment prevention programs, and to encourage the use of rigorous research designs in community settings, the Children’s Bureau sponsored four randomized controlled trials of established programs that had a limited or no evidence base. In this introduction to a special section of Prevention Science on the prevention of child maltreatment, an overview is provided on the epidemiology of maltreatment and the funding initiative that sponsored the four trials, and a call is made for further rigorous research by prevention scientists.
Population Pharmacokinetic Model Demonstrates Poor Outcomes with ATG Overexposure in Adults Undergoing Ex Vivo CD34-Selected Allogeneic Hematopoietic Cell

Background We recently showed that empiric weight-based ATG dosing in heavier patients (pts) prior to ex vivo CD34-selected allogeneic hematopoietic cell transplantation (allo-HCT) is associated with high non-relapse mortality (NRM) and poor survival. A more precise method is to assess the relationship between ATG pharmacokinetic (PK) exposure and outcomes. Therefore, we estimated ATG exposure using a population PK model and hypothesized that peri-HCT ATG overexposure would similarly result in unfavorable outcomes secondary to poorer immune reconstitution (IR). Methods We studied 415 consecutive adult pts who underwent first myeloablative ex vivo CD34-selected allo-HCT with ATG (Thymoglobulin) between 2006 and 2017. We estimated pre-/post-HCT and total ATG area under the curve (AUC, in mg*d/L) for all pts using an established PK model (Admiraal et al., Lancet Hematol 2017). We evaluated the association between ATG exposure and outcomes using a nonparametric estimate of median relapse-free survival (RFS) by ATG exposure to define an optimal ATG AUC cut point (highest RFS) that was used to estimate RFS and NRM. We also evaluated how CD4+ T cell IR related to NRM in a subgroup of 232 pts with sufficient data. IR was defined according to prior studies as absolute CD4+ ≥ 50 at ≥ 2 time points before day +100 and 1 subsequent time point within 60 days. Results Among all pts, median age was 55 (range, 19-73), 228 (55%) were male, 204 (49%) had AML, 105 (25%) MDS, 50 (12%) ALL, and 56 (14%) other hematologic diseases. HCT-CI was 0 in 85 (20%), 1-2 in 146 (35%), and ≥ 3 in 184 (45%) of pts. Allografts were HLA matched related in 150 (36%), matched unrelated in 202 (49), and mismatched in 63 (15%). CMV serostatus was positive in 251 (60%). Conditioning regimens were chemotherapy based in 279 (67%) and TBI based in 136 (33%). All but 2 pts, who were inevaluable given early deaths, engrafted. All pts received 1-3 doses of ATG 2.5 mg/kg between days -4 and -1: 361 (87%) received 2 doses, 47 (11%) 3 doses, and 7 (2%) 1 dose. Among all pts, median estimated ATG AUC values were: pre-HCT 19 (range, 9-36), post-HCT 48 (range, 17-101), and total 66 (29-125). Median follow-up among survivors was 3.9 years (range, 0.7-12). A post-HCT ATG AUC of >60 was associated with poorer median predicted RFS (Figure 1). Pts with an estimated post-HCT ATG AUC of >60 and Conclusions Population PK modeling confirms that post-HCT ATG overexposure in certain pts undergoing ex vivo CD34-selected allo-HCT leads to inferior RFS and markedly higher NRM possibly due to poor IR. Identifying the optimal ATG exposure and individualizing ATG dosing may improve early CD4+ IR and ultimately improve survival in these pts.
Upgraded Emission Spectrometer for Scintillation Spectral Analysis of Gold

A high-sensitivity spectrometer for emission spectral analysis based on a modified two-jet DPG-50M plasmatron and high-resolution spectral equipment using a multichannel spectrum recorder is proposed. The spectrometer was tested by measuring gold concentrations by classical and scintillation spectral methods. The possibility of significantly reducing the sensitivity limits of spectral analysis in the determination of small gold contents by the scintillation method is demonstrated.
American black bears and hair snares: a behavioral analysis

Despite the widespread use of noninvasive hair-sampling for American black bear (Ursus americanus) population monitoring, there is no explicit analysis of black bear behavior at hair snare sites. During 2016, we deployed hair snares and camera traps at 40 sites across the northern Lower Peninsula of Michigan, USA, and collected 560 video recordings of black bear activity. Our objectives were to develop an ethogram of bear behaviors at snare sites and quantify their occurrence. We found that bears allocated their time consistently when they were physically inside or outside of the snare, but they divided their time among multiple behaviors when crossing the wire. The inconsistencies in wire crossing revealed unexpected behaviors with important implications for study design. Our findings explicitly describe how black bears interact with hair snares, provide recommendations for addressing the influence of behavior on sampling efficiency, and establish a foundation for further study of animal behavior at hair snares.
Practice Patterns, Work Environments, and Job Outcomes of Rural and Urban Primary Care Nurse Practitioners:

As nurse practitioners (NPs) are increasingly relied on to deliver primary care in rural communities, it is critical to understand the contexts in which they work and whether they are characterized by work environments and infrastructures that facilitate the provision of high-quality patient care. This study compares urban and rural NPs using data from a survey of 1,244 primary care NPs in Arizona, California, New Jersey, Pennsylvania, Texas, and Washington. While rural and urban NPs have a number of similarities in terms of demographic characteristics, practice patterns, and job outcomes, they also have noteworthy differences. Rural NPs report higher levels of independent practice, fewer structural capabilities that facilitate quality care, and poorer relationships with physicians. Health care organizations in rural communities may need to invest in work environments and infrastructures that facilitate high-quality care and autonomous practice for NPs.
Altered DNA methylation in a severe subtype of idiopathic autism: Evidence for sex differences in affected metabolic pathways.

Although differences in DNA methylation have been associated with both syndromic and idiopathic autism, differential methylation has not been examined previously with respect to sex differences. Th...
Mutant myogenin promoter-controlled oncolytic adenovirus selectively kills PAX3-FOXO1-positive rhabdomyosarcoma cells.

The PAX3-FOXO1 fusion gene functions as a transactivator and increases expression of many cancer-related genes. These lead to metastases and other unfavorable outcomes for alveolar rhabdomyosarcoma (ARMS) patients. In order to target ARMS with the PAX3-FOXO1 transactivator, we developed an Oncolytic Adenovirus (OAd) regulated by the myogenin (pMYOG) promoter with a mutation in the Myocyte Enhancer Factor-2 binding site (mMEF2) in this study. The expression of MYOG in the two RMS cell lines (Rh30; PAX3-FOXO1-positive, RD; PAX3-FOXO1-negative) is about 1,000 times higher than normal skeletal muscle cell (SkMC). Ad5/3-pMYOG(S)-mMEF2 (short-length pMYOG-controlled OAd with mMEF2) showed strong replication and cytocidal effect in Rh30, but to a much lesser extent in RD. Ad5/3-pMYOG(S) (pMYOG-controlled OAd with native pMYOG) showed similar effects in RD and Rh30. Neither virus killed SkMC, indicating that Ad5/3-pMYOG(S)-mMEF2 selectively replicates and kills cells with PAX3-FOXO1. Additionally, Ad5/3-pMYOG(S)-mMEF2 showed replication and spread in vitro as well as tumor growth suppression and intratumoral viral spread in vivo, selectively in Rh30 not in RD. Our findings revealed that Ad5/3-pMYOG(S)-mMEF2 shows a promise as a safe and potent therapy to improve treatment in PAX3-FOXO1-positive ARMSs.
Position Paper: Towards a Robust Edge-Native Storage System

Edge environments are generating an increasingly large amount of data due to the proliferation of edge devices. Accommodating this large influx of data at edge servers is a challenging issue. While some data can be processed as it is generated, others must be stored for later access. This paper proposes the features that a new edge-native storage system must possess including support for user mobility and node fluctuation. To motivate this, we first describe several emerging edge applications and their data needs. We then describe the challenges in meeting these needs. We then evaluate an out-of-the-box cloud storage system, Cassandra, to assess it’s suitability as an edge storage system due to many edge-friendly features. We determined that while a cloud-based storage system can be ported to the edge meeting some of the challenges, other challenges require new solutions. Based on the challenges and the results of Cassandra case study, we propose a set of design principles for a new edge-native storage system.
Causes of Renal Allograft Injury in Recipients With Normal Donor-derived Cell-free DNA.

Background Donor-derived cell-free DNA (dd-cfDNA) is a noninvasive biomarker for the early detection of organ transplant rejection and other causes of graft injury. For nonrejection renal injuries, there is little information about the performance characteristics of this biomarker. We highlight some of the possible causes of kidney injury that may arise in patients with normal dd-cfDNA levels. Methods We performed a retrospective analysis of solitary renal transplant cases between January 2017 and November 2019. Those who had an abnormal laboratory or pathological finding within 1 mo of a normal dd-cfDNA test were selected. Subgroups were stratified for those who had normal or abnormal/rising serum creatinine, and differences between the groups were analyzed. Results Of 414 individuals who received a kidney transplant, 24 (7.5%) had a total of 41 normal dd-cfDNA values and 51 abnormal laboratory tests or histologic findings. The most common graft-injuring event was BK virus viremia (24 of 51). Other abnormal findings included urinary traction infections (n = 4), CMV viremia (n = 4), and biopsies demonstrating antibody-mediated rejection (AMR) (n = 2), T cell-mediated rejection (n = 1), focal segmental glomerulosclerosis (n = 2), nondonor-specific antibody chronic AMR (n = 1), and interstitial fibrosis and tubular atrophy (n = 7). Subgroup analysis of those with normal dd-cfDNA and normal/stable versus abnormal/rising creatinine showed that BK virus viremia was the most common abnormal finding in both groups at 53% and 38% respectively. On biopsy, 1 case of acute T cell-mediated rejection (1B and 2B) was seen with normal/stable creatinine, whereas 1 of nonspecific C4d focally positive and 1 of nondonor-specific antibody AMR were seen with abnormal/rising creatinine. Conclusions Low levels of serum dd-cfDNA do not preclude detection of active graft-injuring events and that subclinical injuries may be developing. Context is important in the interpretation of dd-cfDNA, so renal biopsy remains a part of the diagnostic pathway for allograft dysfunction and maintenance of allograft health.
Turbulence: from Complexity to Variety

In this note we advocate the notion of variety as juxtaposed to the notion of complexity. Laminar flows are complex, turbulence is various. When the gradients reach a critical point, laminar flows are subjected to instabilities and transitions, sometime soft, sometime dramatic, and the final result is the variety. Turbulent flows in nature are fascinating, and loosely speaking we could say that a system is complex when differences are suffered, is various when diversities are enjoyed and exploited as opportunities.
Convexity Neglect in Consumer Decision Making

Purchase decisions occasionally involve ratio calculations (e.g., calories per serving). When faced with decisions that involve information presented in such formats, consumers often ignore the convexity inherent in these calculations and rely on the more intuitive arithmetic mean rather than the correct harmonic mean in averaging ratios. In three studies, we show that convexity neglect systematically affects consumers’ judgment and leads to suboptimal choices. In addition, we provide evidence that convexity neglect is a result of individuals’ use of a wrong mental model substituting the arithmetic mean for the harmonic mean, rather than their lack of computational skills or motivation, to conduct the necessary calculations.
Chemistry and Racism: A Special Topics Course for Students Taking General Chemistry at Barnard College in Fall 2020

Science education research has shown that systemic racism, microaggressions, and unwelcoming or unsupportive climates disproportionally impact the ability of some individuals to flourish in chemistry. In order to help students taking general chemistry learn about the impact of systemic racism in chemistry and to provide them with a venue to discuss this issue, a special seminar-style course was created. This relatively low intensity course successfully created a space for intense conversation, reflection, increased understanding of some of the aspects of racism in chemistry, and the impetus for institutional change. A description of the course, along with student opinions, and co-facilitator reflections, are presented.
Cyclical Co-Movements in Industrial Labor and Product Markets: Theory and Evidence

We establish the theoretical connection between industrial labor and product markets within the contractual wage-rigidity new Keynesian explanation of business cycles. We estimate time-series and cross-sectional regressions for 28 private two-digit (S.I.C.) industries and find: 1) greater uncertainty is associated with upward flexibility of the nominal wage and moderates the countercyclical response of the real wage to aggregate demand shocks; 2) an upwardly rigid nominal wage response to energy price shocks reduces the real contractionary effects of these shocks; 3) downwardly inflexible nominal wages are associated with downwardly rigid prices in response to productivity shocks.
Neighborhood safety concerns and daily well-being: A national diary study

Abstract People living in unsafe neighborhoods often report poor health. The reasons for this are multi-faceted, but one possibility is that unsafe neighborhoods create a situation of chronic stress, which may deplete people's resources to cope with the daily stressors of life. How people respond to daily stressors (e.g., with increased self-reported negative affect and physical symptoms) is positively associated with health problems and may thus be one pathway linking perceptions of neighborhood safety to poor health. The current study investigated the relationship between neighborhood safety concerns, daily stressors, affective well-being, and physical health symptoms in a national sample of adults from the Midlife in the United States Study II (n = 1748). In 2004, participants reported neighborhood safety concerns and history of chronic stress exposure. Across eight days, they also reported daily stressors, physical symptoms and negative affect. Greater neighborhood safety concerns were associated with higher negative affect and more physical symptoms, adjusting for other sources of chronic stress. Moreover, lower perceived neighborhood safety was related to greater increases in negative affect and physical symptoms on days during which stressors were reported, even after accounting for established interactions between daily stressors and other sources of chronic stress. Exposure to neighborhoods perceived as unsafe is associated with poorer daily well-being and exacerbated responses to daily stressors, which may serve as an individual-level pathway contributing to poorer health among people living in neighborhoods perceived as unsafe.
Impact of the COVID-19 pandemic on developmental care practices for infants born preterm.

Abstract Objectives To assess the impact of the COVID-19 pandemic on rates of hospital visitation and rates and durations of developmental care practices for infants born preterm. Methods We analyzed electronic medical record data from 129 infants born at less than 32 weeks gestational age (GA) cared for in the Lucile Packard Children's Hospital neonatal intensive care unit (NICU) in a COVID-19-affected period (March 8, 2020 to Nov 30, 2020, n = 67) and the analogous period in 2019 (n = 62). Rates of family visitation and of family- and clinical staff-delivered developmental care were compared across cohorts, adjusting for covariates. Results Families of infants visited the hospital at nearly half of the rate during 2020 as during 2019 (p = 0.001). Infants experienced developmental care less frequently in 2020 vs. 2019 (3.0 vs. 4.3 activities per day; p = 0.001), resulting in fewer minutes per day (77.5 vs. 130.0; p = 0.001). In 2020, developmental care activities were 5 min shorter, on average, than in 2019, p = 0.001. Similar reductions occurred in both family- and staff-delivered developmental care. Follow-up analyses indicated that effects persisted and even worsened as the pandemic continued through fall 2020, despite relaxation of hospital visitation policies. Conclusions The COVID-19 pandemic has negatively impacted family visitation and preterm infant developmental care practices in the NICU, both experiences associated with positive health benefits. Hospitals should create programs to improve family visitation and engagement, while also increasing staff-delivered developmental care. Careful attention should be paid to long-term follow up of preterm infants and families.
Dynamics of a Closed Chain Manipulator

In many manipulator configurations, where the end effector of the manipulator is in contact with a fixed object, a complete mathematical model for the manipulator dynamics should include the effects of the resulting contact force between the end effector and the fixed object. Equations for such a closed chain manipulator are developed, where the end effector constraint is defined by a smooth manifold. These equations are shown to be complete in the sense that the direct dynamics problem and the inverse dynamics problem are well-posed. This formulation suggests a new approach to planning and tracking control for manipulators in a constrained environment.
Making Inclusive Education Work in Nigeria: Evaluation of Special Educators' Attitudes

The researcher investigated the attitudes toward inclusive education held by 141 special educators in Nigeria. Participants were administered a modified version of the Attitudes Towards Inclusion in Africa Scale (ATIAS). The scale was divided into four factors, namely, Behavior Issues, Student Needs, Resource Issues, and Professional Competency. The mean score for each of the ATIAS factors was compared by categories of eight descriptive variables. Female respondents indicated more confidence in their professional competency to teach special needs children than male respondents. Younger respondents and those with prior training in inclusion were more likely than their counterparts to believe that adequate resources were available to assist teachers to implement inclusion. Advanced formal education was associated with a greater tolerance for negative behaviors (that are sometimes connected with special needs students) and with a more positive attitude toward special supports for students with sensory disabilities. Special educators employed in Northern states were more likely than their Southern counterparts to believe that students with behavioral issues should attend their neighborhood schools. Participants expressed in open-ended comments their concerns that schools lack trained special education personnel, specialized materials, and architecturally-friendly buildings. Recommendations were made for the successful practice of inclusion in Nigeria. Keywords: inclusive education; Nigeria; special educators; attitudes; behavioral issues; student needs; resource issues; professional competency
The U.S. Navy Healthy Back Program: Effect on Back Knowledge among Recruits

This study assessed the immediate effects of the U.S. Navy's Healthy Back Program in changing knowledge about back injury prevention. The prevalence of back problems among incoming recruits and correlates of back pain also were examined. Intervention recruits (n = 1,772) received the Healthy Back Program presentation, then completed a questionnaire. Control subjects (n = 1,658) completed an identical questionnaire but received no presentation. Intervention recruits scored significantly higher on back knowledge (67%) than controls (50%). About 41% of all recruits had experienced a back problem, 27% reported at least one back problem within the past year, and 11% reported back pain during recruit training. Lifting, sports participation, and bending were the leading causes of previous back problems. Better self-reported health and fitness were associated with fewer low back problems.
Narratives, Health, and Healing: Communication Theory, Research, and Practice

Contents: A.W. Frank, Foreword. Preface. Part I: Overview of Narrative and Health Communication Theorizing. P.M. Japp, L.M. Harter, C.S. Beck, Introduction. L.M. Harter, P.M. Japp, C.S. Beck, Vital Problematics of Narrative Theorizing About Health and Healing. A.S. Babrow, K.N. Kline, W.K. Rawlins, Narrating Problems and Problematizing Narratives: Linking Problematic Integration and Narrative Theory in Telling Stories About Our Health. Part II: Personal Narratives and Public Dialogues. P.M. Japp, Introduction. C.S. Beck, Becoming the Story: Narratives as Collaborative, Social Enactments of Individual, Relational, and Public Identities. L.M. Harter, E.L. Kirby, A. Edwards, A. McClanahan, Time, Technology, and Meritocracy: The Disciplining of Women's Bodies in Narrative Constructions of Age-Related Infertility. P.M. Japp, D.K. Japp, Desperately Seeking Legitimacy: Narratives of a Bio-Medically Invisible Disease. T. Workman, Death as the Representative Anecdote in the Construction of Collegiate "Binge Drinking" Problem. T. Carabas, L.M. Harter, State-Induced Illness and Forbidden Stories: The Role of Storytelling in Healing Individual and Social Traumas in Romania. A. Singhal, K. Chitnis, A. Sengupta, Cross-Border Mass-Mediated Health Narratives: Narrative Transparency, "Safe Sex," and Indian Viewers. Part III: Narrating and Organizing Health Care Events and Resources. L.M. Harter, Introduction. W.K. Rawlins, Our Family's Physician. J. Morgan-Witte, Narrative Knowledge Development Among Caregivers: Stories From the Nurse's Station. Sunwolf, L.R. Frey, L. Keranen, Rx Story Prescriptions: Healing Effects of Storytelling and Storylistening in the Practice of Medicine. S.L. Ragan, T. Mindt, E. Wittenberg-Lyles, Narrative Medicine and Education in Palliative Care. P.M. Buzzanell, L.L. Ellingson, Contesting Narratives of Workplace Maternity. M.Z. Miller, P.G. Martin, K.C. Beatty, Wholeness in a Breaking World: Narratives as Sustenance for Peace. Part IV: Narrative Sense-Making About Self and Other. C.S. Beck, Introduction. B.F. Sharf, How I Fired My Surgeon and Embraced an Alternate Narrative. W.A. Beach, J. Mandelbaum, "My Mom Had a Stroke": Understanding How Patients Raise and Providers Respond to Psychosocial Concerns. M.P. Keeley, J.K. Kellas, Constructing Life and Death Through Final Conversation Narratives. C. Bosticco, T.L. Thompson, An Examination of the Role of Narratives and Storytelling in Bereavement. D. O'Hair, D. Scannell, S. Thompson, Agency Through Narrative: Patients Managing Cancer Care in a Challenging Environment. C.S. Beck, L.M. Harter, P.M. Japp, Afterword: Continuing the Conversation: Reflections on Our Emergent Scholarly Narratives.
Generation of maximally entangled charge-qubit arrays via a cavity mode

We describe an assembly of N Cooper-pair boxes (CPB) contained in a single mode cavity. In the dispersive regime, the correlation between the cavity field and each Cooper-pair box results in an effective interaction between CPBs that can be used to dynamically generate maximally entangled states. With only collective manipulations, we show how to create maximally entangled quantum states and how to use these states to reach the Heisenberg limit in the determination of a spectroscopy frequency. This scheme can be applied to other types of superconducting qubits.
De novo 9q gain in an infant with tetralogy of Fallot with absent pulmonary valve: Patient report and review of congenital heart disease in 9q duplication syndrome

Genomic disruptions, altered epigenetic mechanisms, and environmental factors contribute to the heterogeneity of congenital heart defects (CHD). In recent years, chromosomal microarray analysis (CMA) has led to the identification of numerous copy number variations (CNV) in patients with CHD. Genes disrupted by and within these CNVs thus represent excellent candidate genes for CHD. Microduplications of 9q (9q+) have been described in patients with CHD, however, the critical gene locus remains undetermined. Here we discuss an infant with tetralogy of Fallot with absent pulmonary valve, fetal hydrops, and a 3.76 Mb de novo contiguous gain of 9q34.2-q34.3 detected by CMA, and confirmed by karyotype and FISH studies. This duplicated interval disrupted RXRA (retinoid X receptor alpha; OMIM #180245) at intron 1. We also review CHD findings among previously reported patients with 9q (9q+) duplication syndrome. This is the first report implicating RXRA in CHD with 9q duplication, providing additional data in understanding the genetic etiology of tetralogy of Fallot, CHD, and disorders linked to 9q microduplication syndrome. This report also highlights the significance of CMA in the clinical diagnosis and genetic counseling of patients and families with complex CHD.
Cost Burden of Chronic Pain Patients in a Large Integrated Delivery System in the United States

Objectives To estimate all-cause healthcare resource utilization and costs among chronic pain patients within an integrated healthcare delivery system in the United States. Methods Electronic medical records and health claims data from the Henry Ford Health System were used to determine healthcare resource utilization and costs for patients with 24 chronic pain conditions. Patients were identified by ≥ 2 ICD-9-CM codes ≥ 30 days apart from January to December, 2010; the first ICD-9 code was the index event. Continuous coverage for 12 months pre- and postindex was required. All-cause direct medical costs were determined from billing data. Results A total of 12,165 patients were identified for the analysis. After pharmacy, the most used resource was outpatient visits, with a mean of 18.8 (SD 13.2) visits per patient for the postindex period; specialty visits accounted for 59.0% of outpatient visits. Imaging was utilized with a mean of 5.2 (SD 5.5) discrete tests per patient, and opioids were the most commonly prescribed medication (38.7%). Annual direct total costs for all conditions were $386 million ($31,692 per patient; a 40% increase from the pre-index). Pharmacy costs comprised 14.3% of total costs, and outpatient visits were the primary cost driver. Conclusions Chronic pain conditions impose a substantial burden on the healthcare system, with musculoskeletal conditions associated with the highest overall costs. Costs appeared to be primarily related to use of outpatient services. This type of research supports integrated delivery systems as a source for assessing opportunities to improve patient outcomes and lower the costs for chronic pain patients.
Magnetization and 13C NMR spin-lattice relaxation of nanodiamond powder

The bulk magnetization at temperatures of $1.8--400\phantom{\rule{0.3em}{0ex}}\mathrm{K}$ and in magnetic fields up to $70\phantom{\rule{0.3em}{0ex}}\mathrm{kOe}$, the ambient temperature $^{13}\mathrm{C}$ NMR spin-lattice relaxation, ${T}_{1,C}$, and the elemental composition of three nanodiamond powder samples have been studied. The total magnetization of nanodiamond can be explained in terms of contributions from (1) the diamagnetic effect of carbon, (2) the paramagnetic effect of unpaired electrons present in nanodiamond grains, and (3) ferromagneticlike and (4) superparamagnetic contributions from Fe-containing particles detected in spatially resolved energy-dispersive spectroscopy. Contributions (1) and (2) are intrinsic to nanodiamond, while contributions (3) and (4) arise from impurities naturally present in detonation nanodiamond samples. $^{13}\mathrm{C}$ NMR ${T}_{1,C}$ relaxation would be unaffected by the presence of the ferromagnetic particles with the bulk magnetization of $\ensuremath{\sim}0.01\phantom{\rule{0.3em}{0ex}}\mathrm{emu}∕\mathrm{g}$ at $300\phantom{\rule{0.3em}{0ex}}\mathrm{K}$. Thus, a reduction of ${T}_{1,C}$ by 3 orders of magnitude compared to natural and synthetic microdiamonds confirms the presence of unpaired electrons in the nanodiamond grains. The spin concentration in nanodiamond powder corresponds to $\ensuremath{\sim}30$ unpaired electrons per $\ensuremath{\sim}4.6\phantom{\rule{0.3em}{0ex}}\mathrm{nm}$ diameter nanodiamond grain.
Semi-active vibration control of structures via variable damping elements

Abstract A semi-active control strategy is developed to suppress vibration of flexible structures by on-line varying the characteristics of variable dampers. This novel algorithm is designed on the basis of sliding mode control theory. The approach is insensitive to the spillover problem encountered in the fully-active control case. The control law is synthesised and illustrated on a beam structure example. Computer simulations are performed to examine the theoretical predictions. The results of this fundamental study are essential for advancing the technology of designing and controlling complex structural and mechanical systems.
Is Experience the Best Teacher?: The Potential of Coupling Classroom and Community-Based Field Experiences

Dewey argued that personal experiences in schools are critical to the education of teachers; however, he also argued that all experiences are not necessarily educative. This study examines the potential of a novel approach to providing prospective teachers with experiences with children. This article describes the benefits of teacher education students’ participation in concurrent field placements, one in the conventional classroom setting and the second in a community-based after-school program. Prospective teachers’ reflections on these experiences indicated that contrasting settings for learning and teaching were instrumental in their understanding the multiple sources of influence that create both opportunities and constraints to teaching and learning at each site.
Measurements of local skin friction downstream of grit-type boundary-layer-transition trips at M equals 2.17 and zero heat transfer

Supersonic skin friction measurements in grit type boundary layer transition trips with zero heat transfer
Molecular analysis of base damage clustering associated with a site-specific radiation-induced DNA double-strand break.

Abstract Datta, K., Jaruga, P., Dizdaroglu, M., Neumann, R. D. and Winters, T. A. Molecular Analysis of Base Damage Clustering Associated with a Site-Specific Radiation-Induced DNA Double-Strand Break. Radiat. Res. 166, 767–781 (2006). Base damage flanking a radiation-induced DNA double-strand break (DSB) may contribute to DSB complexity and affect break repair. However, to date, an isolated radiation-induced DSB has not been assessed for such structures at the molecular level. In this study, an authentic site-specific radiation-induced DSB was produced in plasmid DNA by triplex forming oligonucleotide-targeted 125I decay. A restriction fragment terminated by the DSB was isolated and probed for base damage with the E. coli DNA repair enzymes endonuclease III and formamidopyrimidine-DNA glycosylase. Our results demonstrate base damage clustering within 8 bases of the 125I-targeted base in the DNA duplex. An increased yield of base damage (purine > pyrimidine) was observed for DSBs formed by irradiation in ...
Mechanics Modeling of the Compressive Stiffness and Strength of Open-Celled Aluminum Foams

This article presents the results of analytical modeling of the strength and stiffness of open-celled aluminum foams under compressive loading. The analytical models are based on a four-strut structure unit that was extracted from the real open-celled aluminum foam structure. Deformation and strength were first studied in the idealized structure unit bounds. The effects of asymmetric factors were also considered. The models predicted ranges in foam strength and stiffness as functions of relative densities, length ratio, and strut orientation. The predictions from the models were in good agreement with the experimentally measured strengths stiffnesses for open-celled aluminum foams.
Radiation Effects in Silica at Low Temperatures

Optical absorption bands induced in fused silica and crystalline $\ensuremath{\alpha}$ quartz of low impurity content at 77\ifmmode^\circ\else\textdegree\fi{}K by fast electrons or x-rays bleach slowly at room temperature. The presence of O${\mathrm{H}}^{\ensuremath{-}}$ ions in fused silica inhibits the formation of such radiation-induced absorption. Comparison of the number of centers produced at 215 m\ensuremath{\mu} ($C$ band) in Corning 7943 fused silica (O${\mathrm{H}}^{\ensuremath{-}}$ free) for equal absorbed dose when irradiated with electrons and x-rays indicates that displacements are not involved in the initial formation of the color centers. A defect model requiring simple ionization seems adequate to explain most of the observed phenomena in this pure fused silica. No simple model can be proposed which adequately describes the data in the case of the Corning 7940 fused silica (O${\mathrm{H}}^{\ensuremath{-}}$ bearing).