IMPORTANCE, CAUSES, AND MANAGEMENT RESPONSES TO FARM RISKS: EVIDENCE FROM FLORIDA AND ALABAMA

Despite the contention that risk and uncertainty play an important role in agriculture in North Florida and South Alabama, very little is known about producers' perceptions of risk. This paper describes the procedures used and the results obtained from a statistically random survey of farmers' perceptions of the importance of various sources of risk and alternative risk management practices. Initially, farmers were asked to define risk and then to rank various sources of risk and management responses to risk based on the relative importance of each to their operation. Summary statistics, Chi-squares analyses, and logistic regression techniques were used to analyze the data.Farm Management, Risk and Uncertainty,

Does class size matter? An in-depth assessment of the effect of class size in software defect prediction

In the past 20 years, defect prediction studies have generally acknowledged the effect of class size on software prediction performance. To quantify the relationship between object-oriented (OO) metrics and defects, modelling has to take into account the direct, and potentially indirect, effects of class size on defects. However, some studies have shown that size cannot be simply controlled or ignored, when building prediction models. As such, there remains a question whether, and when, to control for class size. This study provides a new in-depth examination of the impact of class size on the relationship between OO metrics and software defects or defect-proneness. We assess the impact of class size on the number of defects and defect-proneness in software systems by employing a regression-based mediation (with bootstrapping) and moderation analysis to investigate the direct and indirect effect of class size in count and binary defect prediction. Our results show that the size effect is not always significant for all metrics. Of the seven OO metrics we investigated, size consistently has significant mediation impact only on the relationship between Coupling Between Objects (CBO) and defects/defect-proneness, and a potential moderation impact on the relationship between Fan-out and defects/defect-proneness. Based on our results we make three recommendations. One, we encourage researchers and practitioners to examine the impact of class size for the specific data they have in hand and through the use of the proposed statistical mediation/moderation procedures. Two, we encourage empirical studies to investigate the indirect effect of possible additional variables in their models when relevant. Three, the statistical procedures adopted in this study could be used in other empirical software engineering research to investigate the influence of potential mediators/moderators.Comment: Accepted to Empirical Software Engineering (to appear). arXiv admin note: text overlap with arXiv:2104.1234

Large patent ductus arteriosus in an adult complicated by pulmonary endarteritis and embolic lung abscess

Patent ductus arteriosus in the adult is an extremely rare clinical phenomenon. We report the case of a 34-year old man who developed pulmonary endarteritis and subsequent embolic lung abscess secondary to a large patent ductus arteriosus. This brief report also provides an overview of the natural history, potential complications, optimal therapy, and diagnostic dilemmas associated with this persistent congenital cardiac defect in adults

Occurrence and distribution of extended-spectrum β-lactamase in clinical Escherichia coli isolates at Ho Teaching Hospital in Ghana.

Objective: This study determined the occurrence and distribution of Extended Spectrum β-Lactamase (ESBL) genotypes of E. coli isolates in Ho Teaching Hospital, Ghana.Design: A cross-sectional study.Setting: A single centre study was conducted at Ho Teaching Hospital of Ghana.Participants: Patients who visited Ho Teaching Hospital Laboratory with the request for culture and susceptibility testing.Main outcome measure: Escherichia coli were isolated, and Extended-Spectrum β-Lactamase genes were detected.Results: Of the 135 isolates, 56(41.5%,95% CI: 33.1% – 50.3%) were ESBL producers. More males, 14(58.3%), produced ESBL than females, 42(37.8%). The ESBL prevalence was highest among the elderly who were 80 years and above 3(100.0%), with the least prevalence among patients within 50-59 years and 0-9 years age bracket, representing 4(25.0%) and 3(27.3%), respectively. The total prevalence of ESBL was marginally higher among out-patients (41.8% 95% CI: 31.9% - 52.2%) compared to in-patients [40.5% 95% CI: 24.8% - 57.9]. BlaTEM-1 was the predominant ESBL genotype obtained from 83.9% (47/56) of the confirmed ESBL producing isolates, with the least being TOHO-1 4(7.1%). The co-existence of 2 different ESBL genes occurred in 19(33.9%) of the isolates. The single and quadruple carriage were 16(28.6%) and 3(5.4%), respectively. The highest co-existence of the ESBL genotypes was recorded for blaTEM-1 and blaCTXM-1 15(26.8%), followed by blaTEM-1, blaCTXM-1 and blaSHV-73 [12(21.4%)].Conclusion: The high prevalence of ESBL-producing E. coli isolates with multiple resistant gene carriage is a threat to healthcare in the study area

α5 and αv integrins cooperate to regulate vascular smooth muscle and neural crest functions in vivo

The RGD-binding α5 and αv integrins have been shown to be key regulators of vascular smooth muscle cell (vSMC) function in vitro. However, their role on vSMCs during vascular development in vivo remains unclear. To address this issue, we have generated mice that lack α5, αv or both α5 and αv integrins on their vSMCs, using the SM22α-Cre transgenic mouse line. To our surprise, neither α5 nor αv mutants displayed any obvious vascular defects during embryonic development. By contrast, mice lacking both α5 and αv integrins developed interrupted aortic arches, large brachiocephalic/carotid artery aneurysms and cardiac septation defects, but developed extensive and apparently normal vasculature in the skin. Cardiovascular defects were also found, along with cleft palates and ectopically located thymi, in Wnt1-Cre α5/αv mutants, suggesting that α5 and αv cooperate on neural crest-derived cells to control the remodelling of the pharyngeal arches and the septation of the heart and outflow tract. Analysis of cultured α5/αv-deficient vSMCs suggests that this is achieved, at least in part, through proper assembly of RGD-containing extracellular matrix proteins and the correct incorporation and activation of latent TGF-β.National Institutes of Health (U.S.) (Grant PO1-HL66105)National Institute of General Medical Sciences (U.S.) (Cell Migration Consortium Grant GC11451.126452)National Cancer Institute (U.S.) (Koch Institute Support (Core) Grant P30-CA14051)Howard Hughes Medical Institut

Exploring Mobile Social Networking Sites Continuance Intention from the Perspective of Network Externalities and Mobile Value

Key shifts in the nature and characteristics of technology have led to evolutions in social media usage. For the first time in history, the internet is being accessed from more mobile devices than desktop computers. This revolution is especially felt among social networking sites, many of whom have presciently developed and released mobile applications of their platforms. Drawing from the Perceived Value Theory, Network Externalities and the Expectation Confirmation Theory of IS Continuance, we tested a model that sought to explain the effect of Network Externalities on Perceived Value and in turn Continuance Intention. Data was collected from 452 students from a university in Ghana and analyzed using the Partial Least Square approach to Structural Equation Modeling. Results from the current study showed that Referent Network Size and Perceived Complementarity had significant effects on both Utilitarian and Hedonic Value as well as Satisfaction. Hedonic Value, Utilitarian Value and Satisfaction in turn were found to be significant predictors of Continuance Intention. In all, the model accounted for 58.0% of the variance in continuance intention. The implications and limitations of the current study are discussed, and directions for future research proposed

Operational and Financial Performance of Georgia\u27s Critical Access Hospitals

Background: Georgia’s Critical Access Hospitals (CAHs) face increasingly complex threats to financial sustainability, as demonstrated by the disproportionally high number of closures in comparison to other states in the nation. Methods: Financial performance measures (including profitability, revenue, liquidity, debt, utilization, and productivity), site visits, key personnel interviews, and a revenue cycle management assessment were used to assess the strategic landscape of CAHs in Georgia, analyze financial and operational performance, and provide recommendations. Results: For CAHs in Georgia, financial and operating performance indicators, interviews, and assessments depict a challenging operating environment, but opportunities for improvement exist through implementation of a Lean Six Sigma program and improved benchmarking processes. Conclusions: Georgia’s CAHs operate in a challenging environment, but operational improvement strategies (such as a Lean Six Sigma program) and benchmarking directed towards business processes, including revenue cycle management, provide opportunities for sustainability in the future. Key words: Critical Access Hospital, financial performance, Process Improvement, LEAN Six Sigma, rural hospita

Georgia\u27s Critical Access Hospitals: Financial Performance and Process Improvement

Background: Georgia’s Critical Access Hospitals (CAH) are in crisis. Within the last 2 years, four CAHs have closed their doors due to failed financial and operational performance. Evidence points to the risk that several more are on the brink of closure. CAH closures have far-reaching impact on residents. Negative impacts include the extra distance that patients must travel to seek care, the displacement of health professionals and the unravelling of the entire fabric of the communities these hospitals serve. We hope to help participants understand the financial and operational challenges of CAHs, and to identify realistic strategies to enhance the resilience of these hospitals. Methods: The Georgia Southern team worked with a cohort of CAHs across the state of Georgia to identify financial and operational best practices. Year 1 of this project focused on data collection, analysis and benchmarking. Year 2 is currently focused on performance improvement through Lean Six Sigma. Results: CAHs face financial constraints due to factors such as low volume, declining market share, unfavorable payer mix, challenges relating to collections, and difficulties in recruiting providers. CAHs in Georgia performed more poorly on the financial indicators assessed, in comparison to respective national medians. Many CAHs in our cohort are better organized to deal with crises – utilizing strong executive and bureaucratic structures – than to pursue ongoing improvement through employee empowerment and a process focus. Conclusions: Improvements in the operational and financial management practices of Georgia’s CAHs may significantly improve performance. Evidence-based strategies for operational and financial improvement are vital to sustainability. Opportunities exist for collaboration between public health systems and rural hospitals, including CAHs in assuring healthcare access for rural populations

Strain fields in twisted bilayer graphene

Van der Waals heteroepitaxy allows deterministic control over lattice mismatch or azimuthal orientation between atomic layers to produce long wavelength superlattices. The resulting electronic phases depend critically on the superlattice periodicity as well as localized structural deformations that introduce disorder and strain. Here, we introduce Bragg interferometry, based on four-dimensional scanning transmission electron microscopy, to capture atomic displacement fields in twisted bilayer graphene with twist angles < 2{\deg}. Nanoscale spatial fluctuations in twist angle and uniaxial heterostrain are statistically evaluated, revealing the prevalence of short-range disorder in this class of materials. By quantitatively mapping strain tensor fields we uncover two distinct regimes of structural relaxation -- in contrast to previous models depicting a single continuous process -- and we disentangle the electronic contributions of the rotation modes that comprise this relaxation. Further, we find that applied heterostrain accumulates anisotropically in saddle point regions to generate distinctive striped shear strain phases. Our results thus establish the reconstruction mechanics underpinning the twist angle dependent electronic behaviour of twisted bilayer graphene, and provide a new framework for directly visualizing structural relaxation, disorder, and strain in any moir\'e material.Comment: 29 pages, 6 figures plus supporting information (42 pages, 28 figures