What's best when a patient doesn't respond to the maximum dose of an antidepressant?

Consider possible causes of the inadequate response, then weigh treatment options in light of the characteristics of the individual patient and therapy. When managing a patient with nonpsychotic depression and inadequate response to the maximum dose of a single antidepressant, the physician should first identify factors that may contribute to the poor response, such as suboptimal dosage resulting from nonadherence, inadequate duration of therapy, and comorbid medical and psychiatric conditions (strength of recommendation [SOR]: C, expert opinion)

Antibiotic Prophylaxis to Prevent Recurrent UTI in Children

Antibiotic prophylaxis to prevent recurrent UTI may be considered in infants and children with or without vesicoureteral reflux (VUR) after a first UTI. (Strength of Recommendation [SOR]: B, based on inconsistent evidence from systematic reviews and one large randomized controlled trial [RCT]) The potential benefit of preventing recurrent UTI by antibiotic prophylaxis should be weighed against the risk of antimicrobial resistance with future infections. (SOR: B, based on inconsistent evidence from one systematic review and two RCTs) Accurate diagnosis of UTI followed by prompt treatment is recommended. (SOR: C, based on expert opinion

Isoform-specific induction of a retinoid-responsive antigen after biolistic transfection of chimaeric retinoic acid/thyroid hormone receptors into a regenerating limb

Retinoic acid (RA) induces secretory differentiation in the wound epidermis of a regenerating amphibian limb. We investigated the role of individual RA receptor (RAR) types in the newt wound epidermis by introducing chimaeric RA/thyroid hormone (T3) receptors (chi alpha 1 and chi delta 1) that can be activated by T3. A biolistic particle delivery system was employed to transfect cells in the wound epidermis of a regenerating limb and approximately 10% of the cells in targeted surface areas expressed marker genes. Both chi alpha 1 and chi delta 1 were comparable in their ability to stimulate transcription of a synthetic reporter construct through a RA response element after activation with T3 in situ. This activation was also comparable to that obtained by the endogenous complement of RARs in the RA-treated, transfected wound epidermis. The RA-inducible WE3 antigen, a marker for secretory differentiation, which distinguishes the wound epidermis from normal skin (Tassava, R. A., Johnson-Wint, B. and Gross, J. 1986, J. Exp. Zool. 239, 229–240), was used to assess the functional role of chi alpha 1 and chi delta 1. Chimaeric receptors were transfected with an alkaline phosphatase marker gene, activated with T3, and the expression of both the marker and WE3 was analyzed by double-label immunofluorescence. Newt limbs transfected with chi delta 1 showed many double-labelled cells dependent on the presence of T3, whereas contralateral limbs transfected with an alkaline phosphatase marker lacking chimaeric receptor sequences did not

Investigating a Potential Relationship Between Distinct Cancer-Associated Lactobacillus iners and Chemoradiotherapy Resistance in Cervical Cancer Patients

https://openworks.mdanderson.org/sumexp22/1138/thumbnail.jp

Multi-LexSum: Real-World Summaries of Civil Rights Lawsuits at Multiple Granularities

With the advent of large language models, methods for abstractive summarization have made great strides, creating potential for use in applications to aid knowledge workers processing unwieldy document collections. One such setting is the Civil Rights Litigation Clearinghouse (CRLC) (https://clearinghouse.net),which posts information about large-scale civil rights lawsuits, serving lawyers, scholars, and the general public. Today, summarization in the CRLC requires extensive training of lawyers and law students who spend hours per case understanding multiple relevant documents in order to produce high-quality summaries of key events and outcomes. Motivated by this ongoing real-world summarization effort, we introduce Multi-LexSum, a collection of 9,280 expert-authored summaries drawn from ongoing CRLC writing. Multi-LexSum presents a challenging multi-document summarization task given the length of the source documents, often exceeding two hundred pages per case. Furthermore, Multi-LexSum is distinct from other datasets in its multiple target summaries, each at a different granularity (ranging from one-sentence "extreme" summaries to multi-paragraph narrations of over five hundred words). We present extensive analysis demonstrating that despite the high-quality summaries in the training data (adhering to strict content and style guidelines), state-of-the-art summarization models perform poorly on this task. We release Multi-LexSum for further research in summarization methods as well as to facilitate development of applications to assist in the CRLC's mission at https://multilexsum.github.io.Comment: 37 pages, 2 figures, 9 table

Definitions, sources and self-reported consumption of regionally grown fruits and vegetables in two regions of Australia

Regional food systems are complex networks, with numerous retail sources that underpin a local economy. However, evidence is limited regarding how consumers define, identify, and source regionally grown fresh fruits and vegetables (RGFFV). A cross-sectional study was conducted in Tasmania (TAS) and South Western Australia (SWA) to compare how RGFFV are defined, identified and sourced by consumers, including self-reported consumption of selected RGFFV. Survey data were analyzed using the Chi-square test and t-tests. Results (TAS n = 120, SWA n = 123) identified that consumers had mixed perceptions of how RGFFV are defined, including produce sold at farmers markets, or grown within their region (TAS/SWA). RGFFV were commonly identified using product labelling (55% TAS, 69% SWA; p \u3e 0.05). Respondents reported frequently shopping for RGFFV at major supermarkets, with more TAS respondents shopping weekly in comparison to SWA respondents (67% vs. 38%; p \u3c 0.001). Supermarkets offered convenience and consumers enjoyed the experience of farmers’ markets, especially in TAS (42%) in comparison to SWA (21%; p = 0.012). The major RGFFV consumed were root vegetables and apples/pears, but consumers were frequently unsure about the produce’s provenance. Our findings indicate multiple opportunities to improve consumption of fresh, regional produce in TAS and SWA, which may positively impact regional economic growth and community health. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Australian consumer perceptions of regionally grown fruits and vegetables: Importance, enablers, and barriers

Fresh fruits and vegetables are a cornerstone of a balanced diet; their consumption has health, environmental, ethical, and economic implications. This pilot study aimed to: (i) measure fruit and vegetable consumption; (ii) understand consumer perceptions of the perceived importance of regionally grown fresh fruit and vegetables (RGFFV); and (iii) identify the barriers and enablers of access and consumption of RGFFV. The study took place in Tasmania (TAS) and South Western Australia (SWA). A 54-item survey included questions relating to purchasing and consumption patterns; barriers and enablers related to access and consumption of RGFFV; and sociodemographic information. Survey data were analyzed using Chi-square test and binary logistic regression. A total of n = 120 TAS and n = 123 SWA adult respondents participated. SWA respondents had higher intakes of fruit (p \u3c 0.001) and vegetables (p \u3c 0.001). Almost all respondents (97%) rated purchasing of RGFFV as important. Top enablers included produce freshness (97%), and to financially support local farmers (94%) and the local community (91%). Barriers included limited seasonal availability of the produce (26%), the belief that RGFFV were expensive (12%) and food budgetary constraints (10%). Recommendations include broader marketing and labelling of seasonal RGFFV; increasing ‘buy local’ campaigns; consumer information about how RGFFV benefits producers and communities; and pricing produce according to quality

An Internal Carbon Price for the City of Ann Arbor

Carbon pricing is frequently cited as an effective and economically viable policy solution. However, few examples of carbon pricing programs, like a carbon tax or fee, currently exist at the local scale. Where entities might lack jurisdiction to implement a carbon tax or are otherwise constrained by budget, politics, or other resources, internal carbon pricing offers a solution. An internal carbon price allows an organization to put a price on carbon for its own energy consumption or production to reduce harmful emissions and demonstrate a commitment to sustainability goals. For this report, a carbon price refers to any program that applies a price to carbon emissions. Carbon fee is used interchangeably with carbon tax, both of which are used to refer to carbon pricing programs that levy a specific charge on a unit of emissions (e.g. one metric ton). The City of Ann Arbor’s Office of Sustainability and Innovations (“the Client”) recruited our team of four University of Michigan (“the University”) master’s students from the School for Environment and Sustainability (SEAS) to explore the impacts of and design an internal carbon fee program. The program would place a price solely on Ann Arbor’s municipal carbon emissions and is proposed to start in the upcoming 2021 fiscal year. This is a major step in achieving the city’s carbon neutrality goals, consistent with its landmark A2Zero plan. Over approximately 14 months, our team researched how to create an operable internal carbon fee program for the City of Ann Arbor. Using skills in economic modeling and data analysis, we modeled the energy, cost, and emissions impacts of a $5/metric ton fee on the City of Ann Arbor’s buildings and fleet emissions. We also put together a detailed program design and supporting materials to help kickstart the process in its first year. Researching this project required in-depth understanding of the economics of carbon pricing, the City of Ann Arbor’s internal operating structure, budgeting mechanism, and utility billing process. We began the process with a review of professional and academic evidence, and municipal data provided by the Client. We coupled the literature review with interviews with professional and academic experts in public policy, urban planning, and environmental economics. Following this initial research phase and through meetings with members of Ann Arbor’s city government, we created an economic model and a detailed process for the program. The economic model determines the fee owed by each department based on energy, natural gas, gasoline, and diesel consumption. The model also projects program revenue and expected emissions reductions as a result of the program through 2030. The program is designed to fit into existing city financial and operating structures to collect carbon fee revenue and allocate the funds back to departments to support energy efficiency investments. Under the$5/metric ton carbon fee scenario, we estimated that energy and fuel costs would increase by between 1.5 to 4.4 percent in 2020. The internal carbon fee would yield a 0.1 percent emissions reduction and generate $173,200 in revenue by the end of the first program year. With an annual incremental$5/metric ton increase in fee, the program would impose a $55/metric ton cost on emissions that results in a 7.4 percent emissions reduction and bring$1.2 million in gross revenue in 2030. We recommend for the Client to use the economic model to calculate each department’s carbon fee (i.e. program revenues). Finance and Administrative Services (“Finance”) would collect program revenues into an internal service fund called the Carbon Fund. The Client would oversee the Carbon Fund and determine the prioritization and use of funds. As a result of our work, we provide the following short-term recommendations to the Client: ● Pilot an internal carbon fee with a $5/metric ton starting price, beginning in FY2021. ● Work with the Finance department to create an internal service fund to collect fees from departments operating under the City’s General Fund. ● Calculate and apply each department’s internal carbon fee based on energy consumption and fleet fuel usage. ● Communicate internal carbon fee structure and fee impacts to each affected department using informational materials such as frequently asked questions (FAQ) documents or an energy report. ● Allocate program revenue to prioritize building energy audits, followed by the most relevant and important energy efficiency upgrades as determined by the audits and city needs at the time of investment. ● Following effective program implementation, explore potential expansion of the program to departments outside of the City’s General Fund. Our experience has also provided us with general takeaways and best practices for internal carbon pricing program design and implementation: ● Perform extensive background research into similar carbon pricing schemes before designing a final program. ● Accurately track and inventory all emissions within the project scope to support accurate price calculations and forecasting. ● Create a user-friendly model that allows employees to easily track the impacts of a fee on the system. ● Garner support from key stakeholders, establish clear rules for participation in the program, and integrate its functions into existing operating structures.Master of ScienceSchool for Environment and SustainabilityUniversity of Michiganhttps://deepblue.lib.umich.edu/bitstream/2027.42/155014/1/354 internal carbon price for city of ann arbor.pd

Developing new functional TCs

Transparent Conductors (TCs) are increasingly critical to the performance and reliability of a number of technologies. Traditionally based primarily on oxides of Ga, In, Zn and Sn the class is rapidly expanding into new materials including both other oxides and more recently composites of metallic or carbon nanowires. Many of these materials offer unique functionality as well as processing and reliability advantages over some of the historic materials. These compounds are all classically non-stoiciometric and often metastable consisting of oxide, non-oxide and composite materials which are being collectively looked at for an increasingly broad set of applications including photovoltaics, solid state lighting, power electronics and a broad class of flexible and wearable electronics. In this talk, we will focus on two main areas; the development of predictive models to be able to identify dopants and the processing regimes where they can be activated as well as the use of nanowire oxide composites to develop a new generation of tunable high performance TC. The complex set of demands for a desired TC include not only classical performance, but also processibility, cost and reliability necessitating a search for new materials. The ability to use materials genomics to identify new dopable TC materials that are experimentally realizable is rapidly increasing. We will discuss recent work on predicting the dopability of Ga2O3 films, which potentially have broad applicability as buffer layers, TCOs, and in power electronics if the doping level can be well controlled. We will discuss the theoretical predictions for the process windows to activate both Sn and Si as dopants and compare this to experimental results and the literature. We will also present resent results on the theoretical prediction and realization of a new p-type TC based on CuZnS, which has demonstrated conductivities of up to 100 S/cm. The latter while not classically an oxide is certainly non-stoichiometric and properties are enhanced in many cases by the use of complex oxide, sulfide and selenide materials. Together these will illustrate the evolving tools both theory and experiment to develop and realize dopants in wide band gap materials. In cases where single materials may not be sufficient, nanowire (metal or carbon based) composites with oxides is increasingly attractive. For example, Ag, and potentially Cu, nanowires embedded in a metal oxide matrix can potentially produce TCs that can be processed at low temperature, have conductivity and transparency comparable to the best TCOs, control interface stability and electronic properties and are suitable to flexible electronics. We will present work on ZnO, InZnO and ZnSnO composites with Ag nanowires where the performance can be as good as high quality InSnO with films Rs\u3c 10 Ohms/sq. We will discuss the dependence on the interrelationship between the nanowire properties and the oxide properties. We will also discus the concept of employing sandwich oxides to separately optimize the top and bottom interfacial properties. This work was supported, in part, by the Center for the Next Generation of Materials by Design, an Energy Frontier Research Center funded by the U.S. Department of Energy, Office of Science, Basic Energy Sciences. This research also supported in part by the Solar Energy Research Institute for India and the U.S. (SERIIUS) funded jointly by the U.S. Department of Energy subcontract DE AC36-08G028308 (Office of Science, Office of Basic Energy Sciences, and Energy Efficiency and Renewable Energy, Solar Energy Technology Program, with support from the Office of International Affairs) and the Government of India subcontract IUSSTF/JCERDC-SERIIUS/2012 dated 22nd Nov. 2012