cssi/SciSciGPT-SciSciNet huggingface dataset:
Epidemiological analysis of imported malaria in the Baiyun district, Guangzhou city (2005-2011)

Objective To analyze the epidemic characteristics of imported malaria in the Baiyun district , Guangzhou city, and to provide scientific evidences for the prevention and control of malaria in the local area. Methods All the epidemiological data of imported malaria from 2005 to 2011 were analyzed. Results Correlation between the seasonal change and the occurrence of malaria was not found. The ratio of infection between the male and female subjects was 4.33∶1. 70.83% of the patients were aged 20～39. Most of the patients were businessman returning from the malaria epidemic countries and were infected with malignant malaria. Conclusion The situation of imported malaria is grim in Baiyun district. Monitoring of the returning workers should be strengthened.
Pollinator Competition as a Driver of Floral Divergence: An Experimental Test

Optimal foraging models of floral divergence predict that competition between two different types of pollinators will result in partitioning, increased assortative mating, and divergence of two floral phenotypes. We tested these predictions in a tropical plant-pollinator system using sexes of purple-throated carib hummingbirds (Anthracothorax jugularis) as the pollinators, red and yellow inflorescence morphs of Heliconia caribaea as the plants, and fluorescent dyes as pollen analogs in an enclosed outdoor garden. When foraging alone, males exhibited a significant preference for the yellow morph of H. caribaea, whereas females exhibited no preference. In competition, males maintained their preference for the yellow morph and through aggression caused females to over-visit the red morph, resulting in resource partitioning. Competition significantly increased within-morph dye transfer (assortative mating) relative to non-competitive environments. Competition and partitioning of color morphs by sexes of purple-throated caribs also resulted in selection for floral divergence as measured by dye deposition on stigmas. Red and yellow morphs did not differ significantly in dye deposition in the competition trials, but differences in dye deposition and preferences for morphs when sexes of purple-throated caribs foraged alone implied fixation of one or the other color morph in the absence of competition. Competition also resulted in selection for divergence in corolla length, with the red morph experiencing directional selection for longer corollas and the yellow morph experiencing stabilizing selection on corolla length. Our results thus support predictions of foraging models of floral divergence and indicate that pollinator competition is a viable mechanism for divergence in floral traits of plants.
Coherent Backscattering and Anderson Localization of Light

The propagation of classical waves such as light in strongly multiple scattering media has been the subject of renewed interest. One motivation for this interest has been the suggestion that Anderson localization might be observed in such systems [1,2]. Coherent backscattering of waves in a random medium is the precursor to Anderson localization. The enhanced backward scattering in highly disordered materials is responsible for the renormalization of the energy diffusion coefficient as described by the scaling theory of localization [3]. In moderately disordered materials, in which localization is not evident, coherent backscattering has nevertheless been observed. This phenomenon of weak localization has been discussed in the context of electrons in metals by KHMEL’NITSKII [4] and BERGMANN [5]. A number of experiments beginning in 1984 with KUGA and ISHIMARU [6] have demonstrated the coherent backscattering of light [7–10]. The coherent backscattering enhancement was discussed as early as 1969 for scattered radar waves [11]. GOLUBENTSEV [12] calculated the enhancement of the albedo for retroreflectance of scalar waves from a random collection of point-like scattering centers. AKKERMANS, WOLF and MAYNARD [13] obtained a calculated line shape of the backscattered intensity for scalar waves as a function of scattering angle which agreed qualitatively with the experimental data. Although the vector nature of the electromagnetic field does not alter the localization critical point, polarization effects are apparent in angle resolved studies of the backscattered intensity [6–8]. STEPHEN and CWILICH [14] have demonstrated theoretically that for linearly polarized light incident on a scattering medium, the backscattering peak consists of a sharp narrow peak polarized parallel to the incident light as well as a broader depolarized peak.
A Closed Loop High Efficiency Plasma Waste-to-Power Generation Model

This project addresses three major research problems currently treating our globe. These problems are as follows: the pending energy crisis, the environmental degradation due to an ever increasing growth of waste and the environmental degradation due to the continuous generation of greenhouse gas emissions. In light of these problems, efforts are geared towards the development of a `one-stop' solution. A preliminary survey of available technical data indicates that the three problems could be solved through the use of an efficient `plasma combustion' technology. The usage of this plasma technology can simultaneously disintegrate waste while electrical power is generated and greenhouse gas emissions are eliminated. An innovative aspect of this work is the development of a closed-loop renewable power generation system that can potentially be integrated into local communities. A technical and economic analysis of the proposed system is presented in this paper.
Resurfacing the Penis of Complex Hypospadias Repair (“Hypospadias Cripples”)

Purpose: After the creation of a neourethra in a “hypospadias cripple,” resurfacing the penis with healthy skin is a significant challenge because local tissue is often scarred and unusable. We reviewed our experience with various strategies to resurface the penis of hypospadias cripples.Materials and Methods: We retrospectively reviewed the records of 215 patients referred after multiple unsuccessful hypospadias repairs from 1981 to 2014. In 130 of 215 patients we performed resurfacing using local penile flaps using various techniques, including Byars flaps, Z-plasty or double Z-plasty, or a dorsal relaxing incision. Of the 215 patients 85 did not have adequate healthy local penile skin to resurface the penis after urethroplasty. Scrotal skin was used to resurface the penis in 54 patients, 6 underwent tissue expansion of the dorsal penile skin during a 12 to 16-week period prior to penile resurfacing, 23 underwent full-thickness skin grafting and another 4 received a split-thickness skin graft.Results: O...
Frequent ingestion of the curry spice curcumin inhibits mastocytosis and suppresses intestinal anaphylaxis in a murine model of food allergy (P6034)

IgE antibodies and mast cells play critical roles in the establishment of allergic responses to food antigens. Curcumin, the active ingredient of the curry spice turmeric, has anti-allergic properties, and thus may have the capacity to modulate mucosal mast cell activation and function during allergic responses. Here we show that frequent ingestion of curcumin inhibits mast cell expansion and suppresses intestinal anaphylaxis in a murine model of ovalbumin (OVA)-induced food allergy. Intragastric exposure to OVA in i.p. sensitized BALB/c mice induced a robust IgE-mediated response accompanied by enhanced OVA-IgE levels, intestinal mastocytosis, elevated serum mMCP-1 and acute diarrhea. In contrast, mice exposed to oral curcumin throughout the experimental regimen appeared to be normal and did not exhibit intense allergic diarrhea or a significant enhancement of OVA-IgE and intestinal mast cell expansion and activation. Furthermore, allergic diarrhea, and mast cell activation and expansion were also suppressed in mice exposed to curcumin during the challenge phase alone, despite the presence of normal levels of OVA-IgE. This suggested that curcumin may have a direct suppressive effect on intestinal mast cell homeostasis and function during food allergy. In summary, our data demonstrate a protective role for curcumin during allergic responses to food antigens, suggesting that frequent ingestion of this spice may modulate the outcome of disease in susceptible individuals.
A box model for representing estuarine physical processes in Earth system models

Abstract Appropriately treating riverine freshwater discharge into the oceans in Earth system models is a challenging problem. Commonly, the river runoff is discharged into the ocean models with zero salinity and arbitrarily distributed either horizontally or vertically over several grid cells. Those approaches entirely neglect estuarine physical processes that modify river inputs before they reach the open ocean. In order to realistically represent riverine freshwater inputs in Earth system models, a physically based Estuary Box Model (EBM) is developed to parameterize the mixing processes in estuaries. The EBM represents the estuary exchange circulation with a two-layer box structure. It takes as input the river volume flux from the land surface model and the subsurface salinity at the estuary mouth from the ocean model. It delivers the estuarine outflow salinity and net volume flux into and out of the estuary to the ocean model. An offline test of the EBM forced with observed conditions for the Columbia River system shows good agreement with observations of outflow salinity and high-resolution simulations of the exchange flow volume flux. To illustrate the practicality of use of the EBM in an Earth system model, the EBM is implemented for all coastal grid cells with river runoff in the Community Earth System Model (CESM). Compared to the standard version of CESM, which treats runoff as an augmentation to precipitation, the EBM increases sea surface salinity and reduces stratification near river mouths. The EBM also leads to significant regional and remote changes in CESM ocean surface salinities.
Re-considering the nature of value in communication design

The concept of value is one of the most complex aspects of the communication professions. Most organization, for example, would admit effective communication adds value to almost any process. After all, effective communication helps members of an organization perform tasks more effectively (enhancing the value their work contributes to the organization). It also helps clients/customers view products as meeting their needs - thus contributing value to the individual's daily life. Yet determining how communication contributes value is a trickier prospect.
Gastric Adenosine Triphosphatases: A Review of their Possible Role in HCL Secretion

In the search for gastric ATPases that might be related to the mechanism of HCl secretion, an interesting and rather unique K+-stimulated ATPase has been discovered. This enzyme is isolated from oxyntic cells and has been associated with the apical plasma membrane and/or tubulovesicular system. Membrane vesicles containing the K+-stimulated ATPase transport H+ into the vesicular lumen under the appropriate conditions of ATP, Mg2+, and KCl. This process can be measured by pH electrode, binding of certain metachromatic dyes to "energized" sites, or accumulation ratios of substances with appropriate pK values. Vesicular interior can be acidified to pH 3.5 or below. At the present time, it is difficult to distinguish between an electrogenic H+ pump and an electroneutral H+/K+ exchange mechanism. A hypothetical scheme for the gastric H+ secretory mechanism is proposed which fits much of the data from studies on the K+-ATPase, vesicular transport, and intact gastric mucosa.
Target-Date Funds: A Regime-Based Approach

Target-date funds automatically shift the asset mix at regular intervals toward safer assets as the fund’s target date, which may be several decades away, draws near. A target-date fund is designed to reduce exposure to loss as the investor moves closer to retirement and has fewer years to offset potential losses. The implicit assumption of a target-date fund is that exposure to loss from risky assets increases as time decreases; hence the shift to safer assets as the investment horizon shrinks. However, another implicit assumption of target-date funds is that the standard deviation of assets is relatively stationary. The typical approach for determining the glide path assumes implicitly that the asset’s annualized standard deviation will not change much during any subperiod within the longer horizon. This second assumption is contrary to experience. Subperiod volatility is highly nonstationary, although it is not entirely unpredictable. Investors would be better served by the strategy this author describes, of not only managing the effect of time on exposure to loss but also accounting for the nonstationarity of risk.
Effect of Loop Length and Sequence on the Stability of DNA Pyrimidine Triplexes with TAT Base Triplets

We report the thermodynamic contributions of loop length and loop sequence to the overall stability of DNA intramolecular pyrimidine triplexes. Two sets of triplexes were designed: in the first set, the C5 loop closing the triplex stem was replaced with 5′-CTnC loops (n = 1–5), whereas in the second set, both the duplex and triplex loops were replaced with a 5′-GCAA or 5′-AACG tetraloop. For the triplexes with a 5′-CTnC loop, the triplex with five bases in the loop has the highest stability relative to the control. A loop length lower than five compromises the strength of the base-pair stacks without decreasing the thermal stability, leading to a decreased enthalpy, whereas an increase in the loop length leads to a decreased enthalpy and a higher entropic penalty. The incorporation of the GCAA loop yielded more stable triplexes, whereas the incorporation of AACG in the triplex loop yielded a less stable triplex due to an unfavorable enthalpy term. Thus, addition of the GCAA tetraloop can cause an increase...
Leukocytospermia is associated with poor semen quality

Semen samples from 179 infertility patients were analyzed for type and number of white blood cells (WBC) by a combination of immunologic techniques. Forty-one (23%) had more than 10(6) WBC/mL semen (leukocytospermia). Semen parameters in patients with less than 10(6) WBC/mL were similar to those of 15 fertile donors. In contrast, the leukocytospermic group had significant reductions in total sperm number, percent sperm motility, sperm velocity, motility index, and total number of motile sperm. Patients with high concentrations of monocytes/macrophages (greater than 5 X 10(5)/mL; n = 27) had significantly reduced ejaculate volume; patients with high numbers of T lymphocytes (greater than 10(5)/mL; n = 19) had a significant reduction in sperm velocity; and patients with high levels of granulocyte elastase in semen (greater than 1,000 ng/mL; n = 26) had significant reductions in ejaculate volume, total sperm number, and total motile sperm number. There was no correlation between the presence of antisperm antibodies and leukocytospermia. Our data suggest that leukocytospermia may occur frequently in male infertility patients and show that elevated levels of WBC in semen are associated with poor semen quality. This provides further rationale for white blood cell testing in semen of male infertility patients, since antibiotic or anti-inflammatory therapy may be helpful in appropriately selected cases.
Welfare of Dry Sows

At any one time, a female breeding herd comprises both dry sows and farrowing/ lactating sows. The term ‘dry sow’ encompasses all gestating sows, sows awaiting service and barren sows within the herd. There is a great diversity of dry sow housing systems currently in use. Over the last few decades, sow housing has generally seen a move from somewhat extensive systems towards intensive systems, although this trend is reversing within Western Europe and a reversal is also beginning to show emergence in the pig industries of other developed countries, such as the U.S.A., Canada and Australia. Until this recent reverse, the major factor behind sow housing design was that of economics of production. Since World War II, there have been steady reductions in the number of individual pig producers, but increases in the size of herds. The trend away form extensive systems with small herd numbers towards larger intensive units was initially fuelled by price incentives in the late 1940s, when the production of cheap, plentiful food to meet post-war demand was often supported by governments. The intensification accelerated in the 1950s as new system-based technology was applied. The cyclical, profit-loss nature of the pig industry also accelerated the decline of the small producer. It made economic sense to increase herd size, increase stocking densities and decrease labor costs by mechanising where possible. The ultimate developments, in terms of gestation housing, were those of stalls and tethers. Keeping the sows in permanent confinement gave the farmer a number of advantages over less intensive systems. For example:
Learning to cope with anxiety: Long-term links from adolescence to adult career satisfaction

This study examined the long-term effect of anxiety on career satisfaction for young adults in the United States. The abilities to positively cope with stress and function competently as an adult were examined as potential moderators of this link, and adolescent developmental precursors of these abilities were also investigated. Analyses revealed a negative association between anxiety at age 21 and career satisfaction at age 27. However, this association was ameliorated for youth with better coping skills and functional competence at age 24. Autonomy and relatedness behaviors with best friends and mothers were examined as potential predictors of these moderators, with positive autonomy and relatedness from friends at age 13 emerging as the sole predictor of these skills. Results suggest that although anxiety may inhibit career satisfaction for many youth, positive coping and adult functional competence skills may allow anxious individuals to achieve career satisfaction. Moreover, these skills may be promoted through peer relationships in early adolescence.
Perceptual sensitivity to spectral properties of earlier sounds during speech categorization.

Speech perception is heavily influenced by surrounding sounds. When spectral properties differ between earlier (context) and later (target) sounds, this can produce spectral contrast effects (SCEs) that bias perception of later sounds. For example, when context sounds have more energy in low-F1 frequency regions, listeners report more high-F1 responses to a target vowel, and vice versa. SCEs have been reported using various approaches for a wide range of stimuli, but most often, large spectral peaks were added to the context to bias speech categorization. This obscures the lower limit of perceptual sensitivity to spectral properties of earlier sounds, i.e., when SCEs begin to bias speech categorization. Listeners categorized vowels (/ɪ/-/ɛ/, Experiment 1) or consonants (/d/-/g/, Experiment 2) following a context sentence with little spectral amplification (+1 to +4 dB) in frequency regions known to produce SCEs. In both experiments, +3 and +4 dB amplification in key frequency regions of the context produced SCEs, but lesser amplification was insufficient to bias performance. This establishes a lower limit of perceptual sensitivity where spectral differences across sounds can bias subsequent speech categorization. These results are consistent with proposed adaptation-based mechanisms that potentially underlie SCEs in auditory perception. Recent sounds can change what speech sounds we hear later. This can occur when the average frequency composition of earlier sounds differs from that of later sounds, biasing how they are perceived. These “spectral contrast effects” are widely observed when sounds’ frequency compositions differ substantially. We reveal the lower limit of these effects, as +3 dB amplification of key frequency regions in earlier sounds was enough to bias categorization of the following vowel or consonant sound. Speech categorization being biased by very small spectral differences across sounds suggests that spectral contrast effects occur frequently in everyday speech perception.
Hydroxychloroquine: Another Battle Lost in the Campaign to Find Effective Therapies for Hand Osteoarthritis.

The findings from the HERO (Hydroxychloroquine Effectiveness in Reducing symptoms of hand Osteoarthritis) trial are reported in this issue. The editorialists discuss the observation of no benefit o...
DC distributed systems stabilization and performance improvement using small-signal voltage injection

In this paper, we introduce a method to eliminate the impact of constant power loads (CPLs) on dc distributed systems. A CPL, in small-signal sense, resembles a negative resistance that is connected to its source. The negative resistance interacts with the source output impedance, leading to instability or degrading the dynamic performance at the dc-bus. The proposed method injects the bus-voltage oscillations into the control loop of the source-converter using a high-pass filter. The filter suppresses the dc quantity of the bus-voltage, while passing the high-frequency oscillations. Thus, the operating point of the source-converter is not modified, while the dynamic performance is improved. A prototype dc distributed system was analytically analyzed, simulated, and experimentally tested in order to validate the effectiveness of the proposed controller.
221. Transhepatische Endlosdrainage nach Goetze-Dick bei Stenosen der intra- und extrahepatischen Gallenwege

Bericht uber 49 Falle von intra- und extrahepatischen Stenosen der Gallenwege (1970–1977), bei denen durch eine transhepatische Endlosdrainage nach Goetze-Dick der Galleabflus wieder hergestellt wurde. Hauptindikation ist ein Verschlusikterus durch inoperable Tumoren der Gallenblase (21 Falle), der Gallengange (12 Falle) und des Pankreas (8 Falle). In 5 Fallen wurde eine benigne intrahepatisch gelegene Stenose mit Verschlusikterus durch die Endlosdrainage nach Dick beseitigt. Auf Indikationsstellung, Fruh- und Spatkomplikationen sowie auf die postoperative Nachsorge wird naher eingegangen.
Intrinsic Fiber-Optic Sensors for Spatially Resolved Combinatorial Screening

Computational methods for the calculation of the structure and properties of molecules have achieved a high degree of accuracy. However, structure-based drug design, while being a powerful approach, often does not afford the reliability needed for targeted synthesis of molecules that show a desired drug action. An alternative approach is the synthesis of large numbers of compounds and the systematic evaluation of these compounds for a desired effect. This approach led to the development of the field of combinatorial chemistry. For the combinatorial approach to be effective, three basic questions must be addressed.
Control of telomere elongation and telomeric silencing in Drosophila melanogaster.

Chromosome length in Drosophilais maintained by the targeted transposition of two families of non-LTR retrotransposons, HeT-Aand TART. Although the rate of transposition to telomeres is sufficient to counterbalance loss from the chromosome ends due to incomplete DNA replication, transposition as a mechanism for elongating chromosome ends raises the possibility of damaged or deleted telomeres, because of its stochastic nature. Recent evidence suggests that HeT-Atransposition is controlled at the levels of transcription and reverse transcription. HeT-Atranscription is found primarily in mitotically active cells, and transcription of a w +reporter gene inserted into the 2L telomere increases when the homologous telomere is partially or completely deleted. The terminal HeT-Aarray may be important as a positive regulator of this activity in cis, and the subterminal satellite appears to be an important negative regulator in cis. A third chromosome modifier has been identified that increases the level of reverse transcriptase activity on a HeT-A RNA template and greatly increases the transposition of HeT-A. Thus, the host appears to play a role in transposition of these elements. Taken together, these results suggest that control of HeT-Atransposition is more complex than previously thought.
Universality of a mesenchymal transition signature in invasive solid cancers

In this brief communication, additional computational validation is provided consistent with the unifying hypothesis that a shared biological mechanism of mesenchymal transition, reflected by a precise gene expression signature, may be present in all types of solid cancers when they reach a particular stage of invasiveness.
The Concept of Convenience in Marketing: A Definition and Suggested Approach in the Study of Household Time-Savings

The concept of convenience forms an integral part of the study of the changing household.This paper suggests that clear definition is needed from the perspective of the consumer, rather than that of the researcher or the product manufacturer. Product use in a time-saving situation is often inferred based on the simple purchase of a convenience-related good, rather than actual report by the consumer.A systems perspective is adopted to relate the notion of convenience to input-output tradeoffs within the household productive process.Suggestions are given for extending these notions for future research.
Cows, Milk, and Milking

In this chapter I take up as an allegorical focus a Hindu spirit story, regarding a disciple’s relationship with a master around cows and milk and milking. I apply elements of this experience to the work of teaching and psychotherapy and supervision, using the landscape of a supervised therapist and her effort to wed experience with conceptualization.
Low-Grade Appendiceal Mucinous Neoplasm Diagnosed during Exploratory Laparoscopy for a Presumed Pelvic Mass.

Abstract Study Objective To demonstrate a surgical video of laparoscopic management of an appendiceal mass preoperatively misdiagnosed as a pelvic mass. This study was deemed to be exempt from the Yale New Haven Hospital Institutional Review Board. Design A step-by-step explanation of the diagnosis and laparoscopic management of an appendiceal mass using an instructive video (Canadian Task Force classification III). Setting A teaching hospital in New Haven, Connecticut. Patient A 53-year-old multiparous perimenopausal woman. Intervention Laparoscopic management of an appendiceal mass. Measurements and Main Results A 53-year-old multiparous perimenopausal patient underwent workup for pelvic pain. Pelvic imaging revealed a 72 × 35 × 28 mm cystic structure abutting the uterine fundus with thin partial septum but no mural nodules or concomitant pelvic lymphadenopathy. Exploratory laparoscopy showed unremarkable pelvic anatomy. After the entire small bowel was run, the cystic structure abutting the uterine fundus was deemed to be an appendiceal mass. The observed convergence of the 3 taeniae coli at the junction of the cecum with the cystic mass confirmed the diagnosis. For laparoscopic resection the umbilical fold port site was extended to 12 mm to introduce the Endo GIA stapler (Medtronic, Minneapolis, MN). The appendiceal mass was stabilized in view with a laparoscopic grasper, and the stapler was articulated to fit the base of the appendix without narrowing the lumen of the cecum. The specimens were removed through the umbilical port site in a laparoscopic bag without spillage. Pathology returned low-grade appendiceal mucinous neoplasm with no evidence of invasion. The patient was managed appropriately with laparoscopic appendectomy and discharged home on the day of surgery. Conclusion Appendiceal masses should be considered in the differential diagnosis of a presumed pelvic mass. For low-grade appendiceal mucinous neoplasms that are diagnosed intraoperatively, laparoscopic resection without spillage or rupture is a feasible and appropriate approach for treatment 1 , 2 , 3 .
The Influence of Child Sexual Abuse on Preschool-Aged Children.

Child Sexual Abuse (CSA) is a social plight that affects the lives of roughly 400,000 children annually within the United States. However, while a significant body of research exists conceptualizin...
Modifiable pathways from pain to functional status: Confirmatory baseline results from a randomised trial of African American patients with cancer pain.

OBJECTIVE This study tested a model of cancer-related pain and functional status in African American patients, including beliefs about the ability to control pain as a key determinant of distress and functional status. METHODS Baseline data from a randomised clinical trial consisting of clinical and patient-reported outcomes were used. Participants were 228 African American patients experiencing moderate to severe pain within the past 2 weeks. The model comprised four latent constructs: pain, perceived control over pain, pain-related distress and functional status. Confirmatory factor analysis was used to validate the factor structure of the measurement model. Structural equation modelling was used to estimate direct and mediated effects. RESULTS The measurement model fit well (RMSEA = 0.06, SRMR = 0.05) with all loadings significant (p < 0.05). The structural model also fit well (RMSEA = 0.04, SRMR = 0.05). The complex mediated pathway from pain to functional status through perceived control over pain and pain-related distress was strong and significant (specific indirect effect = -0.456, p = 0.004). Mediation by perceived control accounted for a 47% reduction of the effects of pain on functional status. CONCLUSION If these results hold up longitudinally, interventions to increase perceived control over pain have the potential to improve functional status by decreasing pain-related distress.
Data Efficient Learning of Robust Control Policies

This paper investigates data-efficient methods for learning robust control policies. Reinforcement learning has emerged as an effective approach to learn control policies by interacting directly with the plant, but it requires a significant number of example trajectories to converge to the optimal policy. Combining model-free reinforcement learning with model-based control methods achieves better data-efficiency via simultaneous system identification and controller synthesis. We study a novel approach that exploits the existence of approximate physics models to accelerate the learning of control policies. The proposed approach consists of iterating through three key steps: evaluating a selected policy on the real-world plant and recording trajectories, building a Gaussian process model to predict the reality-gap of a parametric physics model in the neighborhood of the selected policy, and synthesizing a new policy using reinforcement learning on the refined physics model that most likely approximates the real plant. The approach converges to an optimal policy as well as an approximate physics model. The real world experiments are limited to evaluating only promising candidate policies, and the use of Gaussian processes minimizes the number of required real world trajectories. We demonstrate the effectiveness of our techniques on a set of simulation case-studies using OpenAI gym environments.
Serial Assessment of Pulmonary Artery Pulsatility Index Provides Incremental Risk Assessment for Early Right Ventricular Failure after Left Ventricular Assist Device Implantation

Purpose PAPi (pulmonary artery pulsatility index) is a predictor of early right ventricular failure (RVF) post left ventricular assist device (LVAD) implantation and has been studied using hemodynamics from single, isolated time points. Since multiple clinical factors and therapies are known to impact RV function in pre-LVAD patients, we hypothesized that serial PAPi measurements would provide incremental risk stratification for early post-LVAD RVF. Methods A total of 394 consecutive patients undergoing primary durable LVAD implantation at our center from 2004 to 2017 were retrospectively enrolled. Serial invasive hemodynamics obtained during inpatient swan guided therapy (77%) or consecutive outpatient right heart catheterizations were recorded. The lowest, highest (“Best”), change (“Delta”) and most proximal PAPi to LVAD implant were calculated. RVF was defined as need for RVAD or prolonged inotrope use > 14 days post-operatively. Multivariate logistic regression determining independent associates of early RVF was performed. Results RVF occurred in 82 of the 394 patients (21%). Those who developed early RVF had significantly lower mean Delta PAPi (2.0 vs 5.3, p Conclusion The best PAPi achieved during medical optimization prior to LVAD implantation provides independent and incremental risk stratification for early RVF, likely identifying RV reserve.
Clinical Differences Between The Calcium Channel Blocking Agents

The clinical differences between the different drugs which have been classified as calcium channel blocking agents are not as yet completely defined. The vast majority of literature which has appeared to date evaluates a single one of these drugs in comparison to placebo or less frequently in comparison to beta blockers. There are only a handful of studies which evaluate two or more of these new drugs in the same patient population. Assuming appropriate dose equivalency (which is not necessarily readily agreed upon), this latter type of study involves the least presumptions about clinical differences between these agents and thus potentially allows direct comparison of their relative efficacy and toxicity. However, the number of such studies is quite limited, the number of patients studied are small and dose equivalence between different agents is not as yet firmly established. Thus, most of the available information for comparing the different calcium channel blocking agents comes from independent studies of one or another of these agents. Such indirect comparisons can reasonably be inferred from studies of single agents when the clinical response appears to be a duplication and/or extension of pharmacologic effects observed in animals and when qualitatively different side effects are noted in the consensus of independent investigations. Table 1 lists the cardiovascular diseases and syndromes for which calcium channel blocking agents have been advocated. In this brief review I will indicate the clinical highlights of few emerging calcium channel blocking agents, emphasing the clinical differences that have been noted when these agents have been used to treat cardiovascular disease and syndromes of major clinical importance.
Do Straight Teachers Experience This? Performance as a Medium to Explore LGBTQ World Language Teacher Identity.

School and work climate studies of LGBTQ-identified students and educators often reflect challenging environments for those with non-normative sexual and gender identities. Thus, this study sought ...
Segmental and Brain Stem Mechanisms

There are different mechanisms that modify or modulate a pain signal along its pathway. Pain modulation occurs peripherally or centrally at the level of the spinal cord or supraspinal structures. Sensitization of the receptors can lead to hyperalgesia. Peripheral hyperalgesia can be primary or secondary. Sensitization can also occur centrally due to segmental and spinal cord mechanisms leading to facilitation of transmission of the pain signal. Central hypersensitization is commonly referred to as the “Wind-up” phenomenon. Changes in neurochemistry of the dorsal horn due to repetitive stimulation as well as recruitment of non-neuronal cells, such as astrocytes and microglial cells, are believed to play an important role in central sensitization. Inhibition occurs at both spinal and supraspinal levels due to different mechanisms. Gate control theory, concomitant release of inhibitory neurotransmitters, and descending inhibitory pathways are different mechanisms that lead to inhibition.
Munson's Sign: An Obvious Finding to Explain Acute Vision Loss.

Keratoconus is a progressive disorder affecting the cornea, which causes the cornea to become weakened and conical in appearance. The resultant decrease in structural integrity of the cornea predisposes affected individuals to acute corneal hydrops, a break in Descemet’s membrane, the deepest layer of the cornea, resulting in pain and acute vision loss. We present here a case of this little-known cause of acute vision loss, and an example of Munson’s sign, which is a v-shaped protrusion of the lower eyelid on downward gaze that is characteristic of advanced keratoconus. We hope to highlight Munson’s sign as a simple identifier of keratoconus in an otherwise undiagnosed individual suspected of having acute corneal hydrops.
Two Cases of Rare Pancreatic Malignancies.

Abstract Background: Pancreatic adenocarcinoma remains one of the most lethal malignancies with little treatment advancements. Other less common pancreatic cancer histologies have different outcome...
Preparation and adsorption performance evaluation of activated carbon fibers derived from rayon

Activated carbon fiber (ACF) is a material that has attracted significant attention because ACFs derived from several fiber sources have been adapted as filter materials. Here, we described successful ACF preparation via single- and two-step thermal treatments of rayon. Methylene blue adsorption abilities of the resulting ACFs were evaluated. Results indicated that ACFs derived from rayon which is prepared by the two-step thermal treatment demonstrate adsorption ability. Moreover, the average gray-scale intensities (GIs) of the carbonized samples were obtained from images captured with a common digital camera, and the results exhibited meaningful correlations for both yield and absorption ability with GI. Correlation between GI and absorption ability suggests the potential for a simple, nondestructive method of evaluating the absorption ability of ACFs. Results obtained for rayon is easily transferred to other fiber products or industrial waste materials generated during the manufacture of textiles that offers potential energy savings.
Correlation measures and distillable entanglement in AdS / CFT

Recent developments have exposed close connections between quantum information and holography. In this paper, we explore the geometrical interpretations of the recently introduced $Q$-correlation and $R$-correlation, ${E}_{Q}$ and ${E}_{R}$. We find that ${E}_{Q}$ admits a natural geometric interpretation via the surface-state correspondence: it is a minimal mutual information between a surface region $A$ and a cross section of $A$'s entanglement wedge with $B$. We note a strict trade-off between this minimal mutual information and the symmetric side-channel-assisted distillable entanglement from the environment $E$ to $A$, ${I}^{ss}(E⟩A)$. We also show that the $R$-correlation, ${E}_{R}$, coincides holographically with the entanglement wedge cross section. This further elucidates the intricate relationship between entanglement, correlations, and geometry in holographic field theories.
Joint effects of parental smoking cessation and an antismoking parenting program on children’s susceptibility to smoking: A three-year prospective study

Cognitive susceptibility to smoking is indicated by positive social expectancies about smoking, being curious about smoking, wanting to try smoking, and intending to try smoking. Among children, cognitive susceptibility is a risk factor for initiating smoking; reducing susceptibility is, therefore, a viable primary prevention strategy. Our study tested prospectively the combined effect of two variables—parental modeling of smoking cessation and parental exposure to an antismoking parenting program—on cognitive susceptibility to smoking among children who had never puffed on a cigarette. The study sample comprised 859 daily smokers who called a state Quitline seeking assistance to quit smoking and these adults’ 8- to 10-year-old children. The factors in the 2 × 2 design were parental modeling of cessation (successful cessation vs. continued smoking) and parental exposure to an antismoking parenting program (program vs. control). We hypothesized that children whose parents both quit smoking and received the antismoking parenting program would report lower susceptibility to smoking than children exposed to one or neither of these factors. Multivariable analysis of variance, conducted using child-reported susceptibility to smoking collected 12, 24, and 36 months post-baseline, confirmed this hypothesis. Post hoc tests for simple main effects showed that, at each time point, parent smoking cessation had a significant protective effect on children’s susceptibility to smoking, but only among children whose parents received the parenting program. These tests also showed that the parenting program had a significant protective effect on children’s susceptibility to smoking, but only among children whose parents had successfully quit smoking. Our study results suggest that Quitlines and other programs that assist adults in quitting smoking could extend the reach and benefits of such assistance by providing parents with resources that promote antismoking parenting practices.
Transition Metal-Free Alkyne Hydrogenation Catalysis with BaGa2, a Hydrogen Absorbing Layered Zintl Phase

Inexpensive, transition metal-free intermetallic compounds have received almost no attention as heterogeneous catalysts. Here, we show that BaGa2, a Zintl–Klemm compound composed of honeycomb sheet...
Factors Affecting Trust Among Natural Resources Stakeholders, Partners, and Strategic Alliance Members: A Meta-Analytic Investigation

Trust, defined as a willingness of one entity (e.g., stakeholders) to be vulnerable to the discretionary actions of another (e.g., a wildlife management agencies), is a key attribute of effective environmental management. A lack of clarity about which factors matter most in developing and sustaining trust creates an impediment to good governance. Our objective was to derive a set of antecedents of trust from research reported in peer-reviewed literature in natural resource and environmental science, management and policy domains. We conducted a meta-analysis of the relationships between trust and seven antecedents: reputation, communication, shared norms and values, cooperation/support, negative past behaviors, satisfaction with/quality of services, and fairness. We also examined whether relationships between antecedents and trust differ depending on whether the target of trust is a specific person or the organization as an entity, as well as whether the relationship with the referent of trust is horizontal (i.e., between natural resource agencies partnering together) or vertical (i.e., between stakeholders and agencies). Results provide estimates of relationships between each antecedent and trust, as well as the relative importance of the antecedents in predicting trust. We conclude by evaluating the state of the literature on trust and providing recommendations for future research.
Hearing loss and cognitive decline among older adults with atrial fibrillation: the SAGE-AF study.

Objective To examine the association between hearing loss and cognitive function cross-sectionally and prospectively among older adults with atrial fibrillation (AF). Methods Patients with AF ≥ 65-year-old (n = 1244) in the SAGE (Systematic Assessment of Geriatric Elements)-AF study were recruited from five internal medicine or cardiology clinics in Massachusetts and Georgia. Hearing was assessed by a structured questionnaire at baseline. Cognitive function was assessed by Montreal Cognitive Assessment (MoCA) at baseline and one year. Cognitive impairment was defined as score ≤ 23 on the MoCA. The associations between hearing loss and cognitive function were examined by multivariable adjusted logistic regression. Results Participants with hearing loss (n = 451, 36%) were older, more likely to be male, and have depressive symptoms than patients without hearing loss. At baseline, 528 (42%) participants were cognitively impaired. Individuals with hearing loss were significantly more likely to have cognitive impairment at baseline [adjusted odds ratio (OR) = 1.37, 95% confidence interval (CI): 1.05-1.81]. Among the 662 participants who did not have cognitive impairment at baseline and attended the one-year follow-up visit, 106 (16%) developed incident cognitive impairment. Individuals with, versus those without, hearing loss were significantly more likely to develop incident cognitive impairment at one year (adjusted OR = 1.68, 95% CI: 1.07-2.64). Conclusions Hearing loss is a prevalent but under-recognized factor associated with cognitive impairment in patients with AF. Assessment for hearing loss may be indicated among these patients to identify individuals at high-risk for adverse outcomes.
Dysmenorrhea and Endometriosis in Transgender Adolescents.

Abstract Study Objective To study the presentation of dysmenorrhea and endometriosis in transmasculine adolescents and review their treatment outcomes. Design A retrospective review. Setting Boston Children's Hospital. Participants Transmasculine persons younger than 26 years old who were diagnosed with dysmenorrhea and treated between January 1, 2000 and March 1, 2020. Interventions Not applicable. Main Outcome Measures An electronic medical record review of the clinical characteristics, transition-related care, and treatment outcomes. Results Dysmenorrhea was diagnosed in 35 transmasculine persons. Mean age was 14.9 years ± 1.9 years. Twenty-nine (82.9%) were diagnosed after social transition. Twenty-three of 35 (65.7%) were first treated with combined oral contraceptives, but 14/23 (61%) discontinued or transitioned to alternative therapy. Twelve patients with dysmenorrhea alone initiated testosterone treatment, and 4/12 (33.3%) experienced persistent symptoms. Seven of 35 patients with dysmenorrhea (20.0%) were laparoscopically evaluated for endometriosis, and it was confirmed in all seven. Six had stage I disease, and one had stage II. Three of the 7 (42.9%) were diagnosed after social transition, with one diagnosed 20 months after initiating testosterone treatment. Their endometriosis was treated with combined oral contraceptives, danazol, or progestins; four experienced suboptimal response during treatment with these therapies alone. Two of those with suboptimal response subsequently resolved their dysmenorrhea when using testosterone. Five patients with endometriosis initiated testosterone treatment, and of the 5 (40%) experienced persistent symptomatology with combined testosterone and progestin therapies. Conclusion To our knowledge, this is the first study to characterize endometriosis in transmasculine persons. Evaluation for endometriosis was underutilized in transmasculine persons with dysmenorrhea, despite those who underwent laparoscopic evaluation and had disease confirmation. Although testosterone treatment can resolve symptoms in some, others might require additional suppression. Endometriosis should be considered in transmasculine persons with symptoms even when they are using testosterone.