bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intelligent agents for feature modelling in computer aided design
Authors: Fougères Alain-Jérôme , Ostrosi Egon 
Published: December 2017

Abstract
CAD modelling can be referred to as the process of generating an integrated multiple view model as a representation of multiple views of engineering design. In many situations, a change in the model of one view may conflict with the models of other views. In such situations, the model of some views needs to be adapted in order to make all models consistent. Thus, CAD models should be capable of adapting themselves to new situations. Recently, agent based technologies have been considered in order to increase both knowledge level and intelligence of real and virtual objects. The contribution of this paper consists in introducing the intelligent agents in intelligent CAD modelling. The proposed agents are elementary geometrical and topological objects. They incorporate the functions of observation, decision and action, and possess their own knowledge. Agents have the capacity of communication and inference based on the feature grammars. They are modelled as bio-dynamic objects that enjoy the properties of fusion, division and multiplication. Being aware of the context, the proposed agents interact to form potential regional transitory communities, called regions. Being aware of their belonging in a region, agents interact by generating virtual links (virtual extensions). These virtual links produce: (a) fusion of agents, (b) division of agents and c) multiplication of agents. The emerged agents interact with the other agents in a region to recognize each other and to form specific sub-communities, called intelligent features. From a CAD software development point of view, this paper advocates the idea of a new phase of CAD system development based on the agent-oriented programming (AOP) paradigm.
Highlights This paper proposes the agent paradigm for intelligent CAD modelling. Second section presents the state of art. In the third section, using the linguistic hypothesis of product design, a feature modelling formalism is presented. Fourth section presents a formal model for agent modelling. In the fifth section, agents for feature generation and modelling are formalised and modelled. The sixth section presents the application of the method. Finally, in the last section, the conclusion and future developments are proposed.
RETRACTED: Prediction of heart disease using apache spark analysing decision trees and gradient boosting algorithm
Authors: Chugh Saryu , Arivu Selvan K , Nadesh RK 
Published: December 2017

Abstract
Numerous destructive things influence the working arrangement of human body as hypertension, smoking, obesity, inappropriate medication taking which causes many contrasting diseases as diabetes, thyroid, strokes and coronary diseases. The impermanence and horribleness of the environment situation is also the reason for the coronary disease. The structure of Apache start relies on the evolution which requires gathering of the data. To break down the significance of use programming focused on data structure the Apache stop ought to be utilized and it gives various central focuses as it is fast in light as it uses memory worked in preparing. Apache Spark continues running on dispersed environment and chops down the data in bunches giving a high profitability rate. Utilizing mining procedure as a part of the determination of coronary disease has been exhaustively examined indicating worthy levels of precision. Decision trees, Neural Network, Gradient Boosting Algorithm are the various apache spark proficiencies which help in collecting the information.
Interactive or static reports to guide clinical interpretation of cancer genomics
Authors: Gray Stacy W , Gagan Jeffrey , Cerami Ethan , Cronin Angel M , Uno Hajime , Oliver Nelly , Lowenstein Carol , Lederman Ruth , Revette Anna , Suarez Aaron , Lee Charlotte , Bryan Jordan , Sholl Lynette , Van Allen Eliezer M 
Published: December 2017

AbstractObjectiveMisinterpretation of complex genomic data presents a major challenge in the implementation of precision oncology. We sought to determine whether interactive genomic reports with embedded clinician education and optimized data visualization improved genomic data interpretation.Materials and MethodsWe conducted a randomized, vignette-based survey study to determine whether exposure to interactive reports for a somatic gene panel, as compared to static reports, improves physicians’ genomic comprehension and report-related satisfaction (overall scores calculated across 3 vignettes, range 0–18 and 1–4, respectively, higher score corresponding with improved endpoints).ResultsOne hundred and five physicians at a tertiary cancer center participated (29% participation rate): 67% medical, 20% pediatric, 7% radiation, and 7% surgical oncology; 37% female. Prior to viewing the case-based vignettes, 34% of the physicians reported difficulty making treatment recommendations based on the standard static report. After vignette/report exposure, physicians’ overall comprehension scores did not differ by report type (mean score: interactive 11.6 vs static 10.5, difference = 1.1, 95% CI, −0.3, 2.5, P = .13). However, physicians exposed to the interactive report were more likely to correctly assess sequencing quality (P &lt; .001) and understand when reports needed to be interpreted with caution (eg, low tumor purity; P = .02). Overall satisfaction scores were higher in the interactive group (mean score 2.5 vs 2.1, difference = 0.4, 95% CI, 0.2-0.7, P = .001).Discussion and ConclusionInteractive genomic reports may improve physicians’ ability to accurately assess genomic data and increase report-related satisfaction. Additional research in users’ genomic needs and efforts to integrate interactive reports into electronic health records may facilitate the implementation of precision oncology.
A likely planet-induced gap in the disc around T Cha
Authors: Hendler Nathanial P , Pinilla Paola , Pascucci Ilaria , Pohl Adriana , Mulders Gijs , Henning Thomas , Dong Ruobing , Clarke Cathie , Owen James , Hollenbach David 
Published: December 2017

Abstract
We present high-resolution (0.11 × 0.06 arcsec2) 3 mm ALMA observations of the highly inclined transition disc around the star T Cha. Our continuum image reveals multiple dust structures: an inner disc, a spatially resolved dust gap, and an outer ring. When fitting sky-brightness models to the real component of the 3 mm visibilities, we infer that the inner emission is compact (≤1 au in radius), the gap width is between 18 and 28 au, and the emission from the outer ring peaks at ∼36 au. We compare our ALMA image with previously published 1.6 μm VLT/SPHERE imagery. This comparison reveals that the location of the outer ring is wavelength dependent. More specifically, the peak emission of the 3 mm ring is at a larger radial distance than that of the 1.6 μm ring, suggesting that millimeter-sized grains in the outer disc are located farther away from the central star than micron-sized grains. We discuss different scenarios to explain our findings, including dead zones, star-driven photoevaporation, and planet-disc interactions. We find that the most likely origin of the dust gap is from an embedded planet, and estimate – for a single planet scenario – that T Cha's gap is carved by a 1.2MJup planet.
Jet-driven and jet-less fireballs from compact binary mergers
Authors: Salafia O S , Ghisellini G , Ghirlanda G 
Published: December 2017

Abstract
During a compact binary merger involving at least one neutron star (NS), a small fraction of the gravitational energy could be liberated in such a way to accelerate a small fraction (∼10−6) of the NS mass in an isotropic or quasi-isotropic way. In presence of certain conditions, a pair-loaded fireball can form, which undergoes accelerated expansion reaching relativistic velocities. As in the standard fireball scenario, internal energy is partly transformed into kinetic energy. At the photospheric radius, the internal radiation can escape, giving rise to a pulse that lasts for a time equal to the delay time since the merger. The subsequent interaction with the interstellar medium can then convert part of the remaining kinetic energy back into radiation in a weak isotropic afterglow at all wavelengths. This scenario does not require the presence of a jet: the associated isotropic prompt and afterglow emission should be visible for all NS–NS and BH–NS mergers within 90 Mpc, independent of their inclination. The prompt emission is similar to that expected from an off-axis jet, either structured or much slower than usually assumed (Γ ∼ 10), or from the jet cocoon. The predicted afterglow emission properties can discriminate among these scenarios.
The effect of pair cascades on the high-energy spectral cut-off in gamma-ray bursts
Authors: Gill Ramandeep , Granot Jonathan 
Published: December 2017

Abstract
The highly luminous and variable prompt emission in gamma-ray bursts (GRBs) arises in an ultra-relativistic outflow. The exact underlying radiative mechanism shaping its non-thermal spectrum is still uncertain, making it hard to determine the outflow's bulk Lorentz factor Γ. GRBs with spectral cut-off due to pair production (γγ → e+e−) at energies Ec ≳ 10 MeV are extremely useful for inferring Γ. We find that when the emission region has a high enough compactness, then as it becomes optically thick to scattering, Compton downscattering by non-relativistic e±-pairs can shift the spectral cut-off energy well below the self-annihilation threshold, Esa = Γmec2/(1 + z). We treat this effect numerically and show that Γ obtained assuming Ec = Esa can underpredict its true value by as much as an order of magnitude.
Chikungunya Outbreak in Kedougou, Southeastern Senegal in 2009–2010
Authors: Sow Abdourahmane , Faye Oumar , Diallo Mawlouth , Diallo Diawo , Chen Rubing , Faye Ousmane , Diagne Cheikh T , Guerbois Mathilde , Weidmann Manfred , Ndiaye Youssoupha , Senghor Cheikh Sadibou , Faye Abdourahmane , Diop Ousmane M , Sadio Bakary , Ndiaye Oumar , Watts Douglas , Hanley Kathryn A , Dia Anta T , Malvy Denis , Weaver Scott C , Sall Amadou Alpha 
Published: December 2017

Abstract

Background
In Senegal, Chikungunya virus (CHIKV), which is an emerging mosquito-borne alphavirus, circulates in a sylvatic and urban/domestic cycle and has caused sporadic human cases and epidemics since 1960s. However, the real impact of the CHIKV sylvatic cycle in humans and mechanisms underlying its emergence still remains unknown.

Methodology
One thousand four hundred nine suspect cases of CHIKV infection, recruited from 5 health facilities located in Kedougou region, south-eastern Senegal, between May 2009 to March 2010, together with 866 serum samples collected from schoolchildren from 4 elementary schools in May and November 2009 from Kedougou were screened for anti-CHIKV immunoglobulin (Ig)M antibodies and, when appropriate, for viral nucleic acid by real-time polymerase chain reaction (rPCR) and virus isolation. In addition, mosquitoes collected in the same area from May 2009 to January 2010 were tested for CHIKV by rPCR and by virus isolation, and 116 monkeys sera collected from March 2010 to May 2010 were tested for anti-CHIKV IgM and neutralizing antibodies.

Results
The main clinical manifestations of the CHIKV suspect cases were headache, myalgia, and arthralgia. Evidence for CHIKV infection was observed in 1.4% (20 of 1409) of patients among suspect cases. No significant difference was observed among age or sex groups. In addition, 25 (2.9%) students had evidence of CHIKV infection in November 2009. Chikungunya virus was detected in 42 pools of mosquitoes, mainly from Aedes furcifer, and 83% of monkeys sampled were seropositive.

Conclusions
Our findings further documented that CHIKV is maintained in a sylvatic transmission cycle among monkeys and Aedes mosquitoes in Kedougou, and humans become infected by exposure to the virus in the forest.
Risk Factors for Viridans Group Streptococcal Bacteremia in Neutropenic and Non-neutropenic Patients: A Single Center Case-Case-Control Study
Authors: Dulanto Chiang Augusto , Sinaii Ninet , Palmore Tara N 
Published: December 2017

Abstract

Background
Viridans group streptococcal (VGS) bacteremia is common among neutropenic patients. Although VGS bacteremia occurs in non-neutropenic patients, risk factors are not well established. We conducted a case-case-control study to identify risk factors for VGS among neutropenic and non-neutropenic patients.

Methods
Patients with VGS bacteremia between January 2009 and December 2014 in our 200-bed clinical research hospital were identified using microbiology records. Neutropenic and non-neutropenic patients at the time of positive culture were matched 1:1 to controls on the basis of neutrophil count (ANC), ward, and length of stay. We extracted demographic, laboratory, medication, and other clinical data from chart reviews. Data were analyzed using McNemar’s test, Wilcoxon signed-rank test, and conditional logistic regression modeling.

Results
Among 101 patients, 63 were neutropenic and 38 non-neutropenic at the time of VGS bacteremia. In multivariable analysis of neutropenic patients, only lower ANC predicted VGS bacteremia (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.05–0.59; P = 0.006). Recent use of vancomycin was protective (OR, 0.23; 95% CI, 0.07–0.73; P = 0.013). No clinical factors were associated with VGS in the non-neutropenic cases.

Conclusions
Only lower ANC nadir increased the risk for VGS bacteremia in the neutropenic group, and vancomycin was protective. Other previously described factors (chemotherapy, radiation, oral conditions) related to neutropenia were not independently associated with VGS bacteremia. No tested clinical factors predicted infection in the non-neutropenic group. Our results suggest that VGS bacteremia should be anticipated when making antimicrobial choices in profoundly neutropenic patients, and merit further exploration in non-neutropenic patients.
Misplacement of Stent Into Epidural Venous Plexus With Resultant Cauda Equina Syndrome and Open Surgical Treatment: A Case Report
Authors: Whiting Benjamin B , Mulholland Celene B , Daniels Lorin , Kakarla U Kumar , Theodore Nicholas , Snyder Laura A 
Published: December 2017

Abstract

BACKGROUND AND IMPORTANCE
Endovascular therapy has proven to be a safe, minimally invasive treatment for multiple etiologies, but proper precautions must be taken to avoid complications. When complications occur, they should be promptly identified and corrected when possible. This case report describes endovascular stents misplaced into the epidural spinous venous plexus rather than the iliofemoral arteries, causing cauda equina syndrome, as well as the spinal procedure performed to treat the resulting spinal canal compression.

CLINICAL PRESENTATION
A 67-yr-old man had undergone what he thought was iliofemoral arterial stenting at an outside hospital for peripheral vascular disease. He presented 8 d later to our hospital with cauda equina syndrome comprising back pain, right L5 radiculopathy, perianal numbness, urinary retention, and constipation. Scans demonstrated stents deployed into the venous system, traversing the spinal canal and the right L5-S1 neural foramen, resulting in severe spinal canal stenosis, right L5-S1 foraminal stenosis, and moderate left S1-S2 foraminal stenosis. The patient underwent an L5-S1 laminectomy with full right L5-S1 facetectomy and left S1-S2 medial facetectomy, with associated L5-S1 posterolateral fusion with fixation to remove the stent and decompress the neural elements.

CONCLUSION
Although stent misplacement is an uncommon complication of endovascular therapy, this case demonstrates the importance of ensuring access to the proper vessel before stent placement. Once this complication was recognized, safe removal of the stents was possible and the patient demonstrated meaningful postoperative improvement in symptoms and strength.
Intravenous Acetaminophen Reduces Length of Stay Via Mediation of Postoperative Opioid Consumption After Posterior Spinal Fusion in a Pediatric Cohort
Authors: Olbrecht Vanessa A. , Ding Lili , Spruance Kristie , Hossain Monir , Sadhasivam Senthilkumar , Chidambaran Vidya 
Published: December 2017

Objectives:
Since approval of intravenous acetaminophen (IV APAP), its use has become quite common without strong positive evidence. Our goal was to determine the effect of IV APAP on length of hospital stay (LOS) via mediation of opioid-related side effects in pediatric patients.

Materials and Methods:
After Institutional Review Board approval, 114 adolescents undergoing posterior spinal fusion were prospectively recruited and managed postoperatively with patient-controlled analgesia and adjuvant therapy. Patients were divided into 2 groups based on the use of IV APAP: control (n=70) and treatment (n=44). Association of IV APAP use with opioid outcomes was analyzed using inverse probability of treatment weighting (IPTW)-adjusted propensity scores to balance the 2 groups for all significant covariates except postoperative opioid consumption. Mediation analysis was carried out for LOS with IV APAP as the independent variable and morphine consumption as the mediator.

Results:
Oral intake was delayed by ∼1 day (P<0.001) and LOS was 0.6 days longer in the control group (P=0.044). After IPTW, time to oral intake remained significantly longer in the control group (P=0.014). The mediation model with IPTW revealed a significant negative association between IV APAP and morphine consumption (P<0.001), which significantly increased LOS (P<0.003). IV APAP had a significant opioid-sparing effect associated with shorter LOS.

Discussion:
IV APAP hastens oral intake and is associated with decreased LOS in an adolescent surgery population likely through decreased opioid consumption. Through addition of IV APAP in this population, LOS may be decreased, an important implication in the setting of escalating health care costs.
Four Types of Pulse Oximeters Accurately Detect Hypoxia during Low Perfusion and Motion
Authors: Louie Aaron , Feiner John R. , Bickler Philip E. , Rhodes Laura , Bernstein Michael , Lucero Jennifer 
Published: December 2017

Abstract

Background
Pulse oximeter performance is degraded by motion artifacts and low perfusion. Manufacturers developed algorithms to improve instrument performance during these challenges. There have been no independent comparisons of these devices.

Methods
We evaluated the performance of four pulse oximeters (Masimo Radical-7, USA; Nihon Kohden OxyPal Neo, Japan; Nellcor N-600, USA; and Philips Intellivue MP5, USA) in 10 healthy adult volunteers. Three motions were evaluated: tapping, pseudorandom, and volunteer-generated rubbing, adjusted to produce photoplethsmogram disturbance similar to arterial pulsation amplitude. During motion, inspired gases were adjusted to achieve stable target plateaus of arterial oxygen saturation (SaO
2) at 75%, 88%, and 100%. Pulse oximeter readings were compared with simultaneous arterial blood samples to calculate bias (oxygen saturation measured by pulse oximetry [SpO
2] − SaO
2), mean, SD, 95% limits of agreement, and root mean square error. Receiver operating characteristic curves were determined to detect mild (SaO
2 < 90%) and severe (SaO
2 < 80%) hypoxemia.

Results
Pulse oximeter readings corresponding to 190 blood samples were analyzed. All oximeters detected hypoxia but motion and low perfusion degraded performance. Three of four oximeters (Masimo, Nellcor, and Philips) had root mean square error greater than 3% for SaO
2 70 to 100% during any motion, compared to a root mean square error of 1.8% for the stationary control. A low perfusion index increased error.

Conclusions
All oximeters detected hypoxemia during motion and low-perfusion conditions, but motion impaired performance at all ranges, with less accuracy at lower SaO
2. Lower perfusion degraded performance in all but the Nihon Kohden instrument. We conclude that different types of pulse oximeters can be similarly effective in preserving sensitivity to clinically relevant hypoxia.
The Superiorly Based Partial Rectus Abdominis and External Oblique Flap: A New Technique for Breast Asymmetry Reconstruction
Authors: Nowicki Jake L. , Lam Quoc Tai Khoa , Dean Nicola R. 
Published: December 2017

Summary:
Breast asymmetry has a wide spectrum of presentations with several employable strategies for surgical correction. Historically, the external oblique muscle has proven to be a versatile flap option for the reconstruction of both local and distant defects. It has also been described for use in breast reconstruction for coverage of the lower pole of implant prostheses. The external oblique muscle flap can be harvested in several ways to capture overlying fat and skin. In this study, we describe the use of a superiorly based partial rectus and external oblique flap for surgical correction of lower pole breast hypoplasia. This flap provides vascularized autologous volume to the lower pole of the breast with minimal donor morbidity. Other advantages of this flap are that it can increase the nipple to inframammary fold distance and lower the inframammary fold. This technique represents an evolution of an under-utilized flap and is the first study describing the use of the external oblique flap in the management of breast asymmetry.
The Addition of Dexmedetomidine as an Adjunctive Therapy to Benzodiazepine Use in Alcohol Withdrawal Syndrome
Authors: Ferenchak Tarenne A. 
Published: December 2017

Abstract
Alcohol withdrawal syndrome (AWS) is commonly encountered in the intensive care unit population. Currently, the mainstay treatment for AWS is the use of benzodiazepines. However, some patients are refractory to benzodiazepine treatment due to heavy alcohol abuse. In addition, escalating doses of benzodiazepines can lead to respiratory depression, requiring intubation and mechanical ventilation. Intubation and mechanical ventilation increase both intensive care unit and hospital length of stay. The addition of pharmacological agents to reduce the amount of benzodiazepine use in AWS has recently been studied. Most recently, the addition of dexmedetomidine, a selective α2 adrenoceptor agonist, has been explored. Dexmedetomidine provides sedation without depressing the respiratory system, making it an ideal pharmacological agent to use. The addition of dexmedetomidine in adjunct to benzodiazepine use has been proven to reduce the amount of benzodiazepine administered, decrease the number of patients requiring intubation and mechanical ventilation, and decrease length of intensive care unit stay and overall length of hospital stay. However, the use of dexmedetomidine has also produced harmful side effects such as hypotension and bradycardia. The use of dexmedetomidine in conjunction with benzodiazepines in the setting of AWS is promising; however, more research needs to be conducted in regard to the safety and efficacy of its use.