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IMPORTANCE: Deficiencies in advance care planning and symptom management are associated with avoidable acute care use among patients with cancer. Community health worker (CHW)–led approaches may be an approach to reduce acute care use but remain untested in community settings. OBJECTIVE: To determine whether a CHW-led advance care planning and symptom screening intervention can reduce acute care use more than usual care in a community setting. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was conducted among patients with newly diagnosed advanced-stage or recurrent solid and hematologic cancers from August 8, 2017, through November 30, 2021. Data analysis was performed November 30, 2021, through January 1, 2022, by intention to treat. INTERVENTIONS: Participants were randomized 1:1 to usual care (control group) or usual care with the 6-month CHW-led intervention (intervention group). MAIN OUTCOMES AND MEASURES: The primary outcome was acute care use. Secondary outcomes included advance care planning documentation, supportive care use, patient-reported outcomes, survival, and end-of-life care use. RESULTS: Among 128 participants, median (range) age was 67 (19-89) years; 61 (47.7%) were female; and 2 (1.6%) were American Indian or Alaska Native, 11 (8.6%) were Asian, 5 (3.9%) were Black, 23 (18.0%) were Hispanic or Latino, 2 (1.6%) were of mixed race, 2 (1.6%) were Native Hawaiian or other Pacific Islander, 86 (67.2%) were White, and 20 (15.6%) did not report race. Intervention participants had 62% lower risk of acute care use than the control (hazard ratio, 0.38; 95% CI, 0.19-0.76) within 6 months. At 12 months, intervention participants had 17% lower odds of acute care use (odds ratio [OR], 0.83; 95% CI, 0.69-0.98), 8 times the odds of advance care planning documentation (OR, 7.18; 95% CI, 2.85-18.13), 4 times the odds of palliative care (OR, 4.46; 95% CI, 1.88-10.55), nearly double the odds of hospice (OR, 1.83; 95% CI, 1.16-2.88), and nearly double the odds of improved mental and emotional health from enrollment to 6 and 12 months postenrollment (OR, 1.82; 95% CI, 1.03-3.28; and OR, 2.20; 95% CI, 1.04-4.65, respectively) than the control. There were no differences in the death (control, 26 [40.6%] vs intervention, 32 [50.0%]). Fewer intervention participants had acute care use (0 vs 6 [23.1%]) in the month before death than the control. CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, integration of a CHW-led intervention into cancer care reduced acute care use and is one approach to improve cancer care delivery for patients with advanced stages of disease in community settings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03154190

In recent years, a new generation of “digital credit” products have transformed the consumer lending landscape in many low- and middle-income countries. Offering short- term, high-interest loans via mobile phones or other digital platforms, these products have become wildly popular. This article reviews the small but emerging evidence on the welfare impacts of digital credit. These studies document very high rates of takeup – well in excess of traditional microcredit – despite the fact that customers often do not understand the terms of their loans. Overall, there is little evidence that access to credit has consistent positive impacts on borrower welfare, though two impact evaluations document positive effects on resilience and subjective well-being, respectively. No study finds statistically significant negative impacts of digital credit.

Additional file 1: Table S1. Primers for JIP1 and Itch constructs.

Additional file 3. Western blots.

Additional file 2: Fig. S1. Specificity of anti- phospho-JIP1 antibody. Fig. S2. Notch2-IC or Notch3-IC level was unaffected by JIP1 deficiency. Fig. S3. Numb, Itch and phospho-JNK level were unchanged by JIP1 deficiency. Fig. S4. Phopho-Itch at Thr222 enhances interaction with Notch1-IC.

Additional file 1: Figure S1. Characterization of differentiated SH-SY5Y cells. Figure S2. Cytotoxicity of compounds evaluated in the HTS. Figure S3. Effects of luteolin in respiratory capacity and ΔΨm. Figure S4. Effects of luteolin in mitochondrial biogenesis and cristae organization. Figure S5. Effects of luteolin on calcium levels and characterization of isolated mitochondrial fractions.

We quantify the effect of market disruptions due to COVID-19 on the lives of householdsin rural areas of Liberia and Malawi, utilizing panel data from phone surveys that were implemented as part of a randomized cash transfer experiment. The surveys began collection several months before the pandemic and have continued throughout it. The household survey included a consistent set of internationally accepted and validated questions on food security (the householddietary diversity score, the household hunger scale, and the food consumption score). In both countries, market activity was severely disrupted and we observe large declines in income among market vendors, but we find no evidence of declines in food security for households in the short run. Even though we observe no adverse effects of the lockdowns on food securityamong the control group, cash transfers improved dietary quality and quantity over the low levels observed at baseline.

Recently, image-to-image translation has obtained significant attention. Among many, those approaches based on an exemplar image that contains the target style information has been actively studied, due to its capability to handle multimodality as well as its applicability in practical use. However, two intrinsic problems exist in the existing methods: what and where to transfer. First, those methods extract style from an entire exemplar which includes noisy information, which impedes a translation model from properly extracting the intended style of the exemplar. That is, we need to carefully determine what to transfer from the exemplar. Second, the extracted style is applied to the entire input image, which causes unnecessary distortion in irrelevant image regions. In response, we need to decide where to transfer the extracted style. In this paper, we propose a novel approach that extracts out a local mask from the exemplar that determines what style to transfer, and another local mask from the input image that determines where to transfer the extracted style. The main novelty of this paper lies in (1) the highway adaptive instance normalization technique and (2) an end-to-end translation framework which achieves an outstanding performance in reflecting a style of an exemplar. We demonstrate the quantitative and qualitative evaluation results to confirm the advantages of our proposed approach.

Adult T-cell leukemia/lymphoma (ATLL) is a rare and highly aggressive type of peripheral T-cell lymphoma associated with human T-lymphotropic virus, type I (HTLV-I) infection. ATLL has a long latency and only a small percentage of HTLV-I infected individuals develop ATLL, suggesting the requirement of additional genetic events for neoplastic transformation of HTLV-I infected lymphocytes. The disease is endemic in several regions of the world, in particular, southwestern Japan and the Caribbean basin. The clinical features of Caribbean ATLL have been reported to differ from Japanese cases, includ- ing a younger age at diagnosis, higher frequency of the lymphomatous subtype, and a more aggressive clinical course [1–7]. A number of publications have described the cytogenetic profile of Japanese ATLL [8–11]; however, cytogenetic data on Caribbean ATLL are limited [5,6]. In this study, we assessed the cytogenetic alterations in a large series of Caribbean ATLL cases to investigate whether the differences in the types and frequencies of karyotype abnormalities account for the reported differ- ences in clinical presentation and outcome between Japanese and Caribbean patients.

The government's unclassified terror watchlist, the Terrorist Screening Database (TSDB), has grown dramatically, stressing government screening and counterterrorism resources. The TSDB has been criticized for lacking independent oversight and transparency in its operations, which has led some to allege it is discriminatory toward minority communities. How should the TSDB be improved to improve transparency, efficiency, and accuracy, and to decrease secrecy and perceived bias? This thesis is a policy analysis that examines the TSDB administrative processes to determine the extent to which the structure and function serve or compromise national security. It also considers the difficulties the system of redress poses for those classified as a "Known or Suspected Terrorist" by their inclusion on the watchlist. This thesis recommends that the evidentiary standard needed to list a person on the watchlist should not be changed, but the government should extend the procedures recently adopted for No Fly subjects to all citizens and lawfully admitted permanent residents who request redress of their watchlist status. Judicial oversight and fixed review periods should be added to the redress process to facilitate independent review of the government's watchlisting determinations and ensure that all information contained in the TSDB is regularly reviewed. http://archive.org/details/thewatchlistimpr1094561240 Civilian, Department of Homeland Security Approved for public release; distribution is unlimited.

Machine comprehension question answering, which finds an answer to the question given a passage, involves high-level reasoning processes of understanding and tracking the relevant contents across various semantic units such as words, phrases, and sentences in a document. This paper proposes the novel question-aware sentence gating networks that directly incorporate the sentence-level information into word-level encoding processes. To this end, our model first learns question-aware sentence representations and then dynamically combines them with word-level representations, resulting in semantically meaningful word representations for QA tasks. Experimental results demonstrate that our approach consistently improves the accuracy over existing baseline approaches on various QA datasets and bears the wide applicability to other neural network-based QA models.

Copy number mutations implicate excess production of α-synuclein as a possibly causative factor in Parkinson's disease (PD). Using an unbiased screen targeting endogenous gene expression, we discovered that the β2-adrenoreceptor (β2AR) is a regulator of the α-synuclein gene (SNCA). β2AR ligands modulate SNCA transcription through histone 3 lysine 27 acetylation of its promoter and enhancers. Over 11 years of follow-up in 4 million Norwegians, the β2AR agonist salbutamol, a brain-penetrant asthma medication, was associated with reduced risk of developing PD (rate ratio, 0.66; 95% confidence interval, 0.58 to 0.76). Conversely, a β2AR antagonist correlated with increased risk. β2AR activation protected model mice and patient-derived cells. Thus, β2AR is linked to transcription of α-synuclein and risk of PD in a ligand-specific fashion and constitutes a potential target for therapies.

Gandhāran art is well known for the Hellenistic legacy in its art and architecture, and its emergence and flourishing under the Kushan rulers has been the subject of numerous studies. Less attention has been paid to its gradual demise in the area covered by modern Pakistan and neighbouring regions, and to the transitional period from Kushan rule to the Gupta period. However, it is at this time that some of its art fully reflects early Mahāyāna ideas, that Kharosthi script is replaced by Brahmi, and that figural art proliferates and stucco appears to become the most prominent sculptural material. For this period, different academic disciplines base their theories on diverging sets of assumptions and rarely speak to each other. This conference aims to facilitate a dialogue across these disciplines and to bring the academic discourse on this period up to date.

This study sought to demonstrate the potential applications of the solar chimney for the naturally ventilating a building. Computational fluid dynamics (CFD) was used to model various room configurations to assess ventilation strategies. A parametric study of the solar chimney system was executed, and three-dimensional simulations were compared and validated with experiments. A new definition for the hydraulic diameter that incorporated the chimney geometry was developed to predict the flow regime in the solar chimney system. To mitigate the cost and effort to use experiments to analyze building energy, a mathematical approach was considered. A relationship between small- and full-scale models was investigated using non-dimensional analysis. Multiple parameters were involved in the mathematical model to predict the air velocity, where the predictions were in good agreement with experimental data as well as the numerical simulations from the present study. The second part of the study considered building design optimization to improve ventilation using air changes per hour (ACH) as a metric, and air circulation patterns within the building. An upper vent was introduced near the ceiling of the chimney system, which induced better air circulation by removing the warm air in the building. The study pursued to model a realistic scenario for the solar chimney system, where it investigated the effect of the vent sizes, insulation, and a reasonable solar chimney size. It was shown that it is critical to insulate the backside of the absorber and that the ratio of the conditioned area to chimney volume should be at least 10. Lastly, the application of the solar chimney system for basement ventilation was discussed. Appropriate vent locations in the basement were determined, where the best ventilation was achieved when the duct inlet was located near the ceiling and the exhaust vent was located near the floor of the chimney. Sufficient ventilation was also achieved even for scenarios of a congested building when modeling the presence of multiple people. Ph. D.

Natural ventilation is an effective method to save energy required to condition buildings and to improve indoor air quality. Computational fluid dynamics (CFD) was used to model single-sided buoyancy-driven natural ventilation in a single room with a heater and door. The velocity and temperature profiles at the doorway agreed fairly well with published literature that includes Mahajan's experimental [2] and Schaelin et al's numerical studies [1]. The 2D and 3D models predicted the neutral level with a difference of 5.6 % and 0.08 % compared to the experimental results, respectively. Using solutions at the doorway, heat transfer rates were calculated. More realistic situations were studied considering conduction, various ambient conditions, wind speeds, and additional heat sources and furniture in the room. The heat loss through the wall was modeled and the airflow and temperature within the room showed no significant changes despite modeling conduction through the walls. Various ambient temperatures and wind speeds were tested, and the neutral level height and total heat transfer rate through the doorway increased with decreasing ambient temperatures. However, the neutral level did not significantly change as wind speeds varied. Total heat transfer rate at the doorway became positive, that is heat transferred into the room, with wind speed. Lastly, the effect of additional heat sources (mini-refrigerator, monitor and computer) and furniture (bookshelf, desk, chair and box) on airflow and heat transfer in the room was analyzed by comparing with a simple case of a room with a heater. Large velocities and high temperatures were predicted in the vicinity of the heat sources. However, the spatially averaged velocity and temperature did not change significantly despite additional heat sources. The room with furniture was modeled at lower ambient temperature, where the spatially averaged velocities were larger and temperatures were lower than the simple case. The room heated up and reached its thermal comfort level, but the velocities exceeded the maximum acceptable level set by ASHRAE guidelines [8]. Wind was considered simultaneously with the lower temperature, and the room was cooled faster with wind. However, the room was never able to achieve the comfortable level both in velocity and temperature. Master of Science

For decades, the Democrats have been viewed as the party of the poor, with the Republicans representing the rich. Recent presidential elections, however, have shown a reverse pattern, with Democrats performing well in the richer blue states in the northeast and coasts, and Republicans dominating in the red states in the middle of the country and the south. Through multilevel modeling of individual-level survey data and county- and state-level demographic and electoral data, we reconcile these patterns. Furthermore, we find that income matters more in red America than in blue America. In poor states, rich people are much more likely than poor people to vote for the Republican presidential candidate, but in rich states (such as Connecticut), income has a very low correlation with vote preference.

Scholars disagree over the extent to which presidential campaigns activate predispositions in voters or create vote preferences that could not be predicted. When campaign related information flows activate predispositions, election results are largely predetermined given balanced resources. They can be accurately forecast well before a campaign has run its course. Alternatively, campaigns may change vote outcomes beyond forcing predispositions to some equilibrium level. We find most evidence for the former: opinion poll data are consistent with Presidential campaigns activating predispositions, with fundamental variables increasing in importance as a presidential election draws near.

In this paper we describe an exploratory experiment in which we examined the effect of three agent social behaviors (Cooperativity, Reliability, Benevolence) on four measures of organizational performance: cognitive effort, physical effort, communication effort, and idle time.

Neurodegenerative diseases are a spectrum of chronic, debilitating disorders characterised by the progressive degeneration and death of neurons. Mitochondrial dysfunction has been implicated in most neurodegenerative diseases, but in many instances it is unclear whether such dysfunction is a cause or an effect of the underlying pathology, and whether it represents a viable therapeutic target. It is therefore imperative to utilise and optimise cellular models and experimental techniques appropriate to determine the contribution of mitochondrial dysfunction to neurodegenerative disease phenotypes. In this consensus article, we collate details on and discuss pitfalls of existing experimental approaches to assess mitochondrial function in in vitro cellular models of neurodegenerative diseases, including specific protocols for the measurement of oxygen consumption rate in primary neuron cultures, and single-neuron, time-lapse fluorescence imaging of the mitochondrial membrane potential and mitochondrial NAD(P)H. As part of the Cellular Bioenergetics of Neurodegenerative Diseases (CeBioND) consortium ( www.cebiond.org ), we are performing cross-disease analyses to identify common and distinct molecular mechanisms involved in mitochondrial bioenergetic dysfunction in cellular models of Alzheimer's, Parkinson's, and Huntington's diseases. Here we provide detailed guidelines and protocols as standardised across the five collaborating laboratories of the CeBioND consortium, with additional contributions from other experts in the field.