cssi/SciSciGPT-SciSciNet huggingface dataset:
Relationship between observed upper mantle structures and recent tectonic activity across the Southeastern United States

The lithospheric structure of the Southeastern United States is a product of earlier episodes of continental collision and breakup. The region is located in the interior of the North American Plate, away from active plate margins. However, there is ongoing tectonism in the region with multiple zones of seismicity, uplifting arches, and Cenozoic intraplate volcanism. The mechanisms controlling this activity and the state of stress remain enigmatic. Two important factors are plate strength and preexisting, inherited structures. Here we present new tomographic images of the upper mantle beneath the Southeastern United States, revealing large-scale structural variations in the upper mantle. Examples include the relatively thick lithospheric mantle of stable North America that abruptly thins beneath the Paleozoic Appalachian orogeny, and the slow upper mantle of the Proterozoic Reelfoot rift. Our results also indicate fast seismic velocity patterns that can be interpreted as ongoing lithospheric foundering. This provides a viable explanation for seismicity, uplifting, and young intraplate volcanism. We postulate that not only tectonic inheritance but also continuing lithospheric foundering may control the ongoing activity of the region long after it became a passive margin. Based on distinct variations in the geometry and thickness of the lithospheric mantle and foundered lithosphere, we propose that piecemeal delamination has occurred beneath the region throughout the Cenozoic, removing a significant amount of reworked/deformed mantle lithosphere. Ongoing lithospheric foundering beneath the eastern margin of stable North America explains significant variations in thickness of lithospheric mantle across the former Grenville deformation front.
Studio in Transformation: Transformation in Studio

To explore the potential of a holistic pedagogical model that incorporates motion studies into existing curricular structures, the Pedagogy of Motion provides a methodical series of steps regarding the best methods for teaching the principles of transformable architecture. The development of this pedagogy could recast the architectural design process, transmuting the landscape of how we do architecture. As vehicles for examining the opportunities of this approach, two design studios1 in two schools of architecture at Virginia Tech and Texas A&M University were offered, occasioning theoretical overviews and practical methods for designing morphological changes in architecture.
Characterizing rare mis-sense variations of CACNA1I identified in a Swedish schizophrenia cohort

CACNA1I (hCa V 3.3) encodes the α1 pore-forming subunit of human voltage-gated T-type calcium channels. Ca V 3.3 is expressed in a limited subset of neurons including GABAergic neurons of the thalamic reticular nucleus (TRN) where they support oscillatory activity essential for sleep spindle generation. CACNA1I is implicated in schizophrenia risk by emerging genetics including genome-wide association studies (PGC, 2014), and exome sequencing of trio samples (Gulsuner et al., 2013). In order to understand the impact of disease-associated sequence variation on the function of Ca V 3.3, we set out to analyze a complete set of rare mis-sense coding variations in CACNA1I in a Swedish cohort, including 15 variations identified in patients, 20 identified in control subjects, and 23 in both. We established a heterologous expression system of isogenic cell lines, each carrying single-copy inducible cDNA variants of hCa V 3.3, and evaluated their functional impact on channel function by electrophysiology, calcium imaging, and biochemistry. We found at least five coding variations impaired overall channel protein abundance, as well as whole cell current density. In addition, we identified hCa V 3.3 variants with altered voltage-dependence of channel activation and inactivation. Overall, we found that reduced calcium influx through hCa V 3.3 is associated with the group of variants identified in patients, compared to those in both patients and controls. Our findings suggest that patient-specific rare variations of CACNA1I may influence channel-dependent functions, including rebound bursting in TRN neurons, with potential implications for schizophrenia pathophysiology.
Pathogen detection for syndromes of encephalitis and meningitis among child patients in plateau of Qinghai province from 2010 to 2011

Objective To study types and distributions of pathogens of encephalitis and meningitis syndromes among child cases in plateau of Qinghai province. Methods The information on age,gender,nationality,and clinical charasteristics were collected among the children under age of 14 years with syndromes of encephalitis and meningitis. Cerebrospinal fluid(CSF) specimen from the patients were detected for pathogens of Cryptococcus,Staphylococcus aureus,S. pneumoniae,Colibacillus,H. influenzae tape b,N. meningitis,and Bacillus tuberculosis. Real-time(RT)-PCR method were used to detect Japanese encephalitis virus(JEV),enterovirus(EV),mumps virus(MV),and herpes simplex virus type Ⅰ + Ⅱ(HSV Ⅰ + Ⅱ). Results Totally 254 cases were collected and the detection rate of bacterial was 8. 27%. Major pathogens included Staphylococcus aureus and Bacillus tuberculosis,follow ed by Colibacillus,cryptococcus,S. pneumoniae,and N. meningitis. The detection rate of virus was 7. 48%. Totally 15 cases were enterovirus positive, accounting for 78. 95% of positive samples. The mumps virus and herpes simplex virus were also detected from some cases. Conclusion The bacterial were major pathogens for encephalitis and meningitis syndromes in plateau of Qinghai province,and the surveillance and control of enterovirus encephalitis should be strengthened.
Snail/Slug binding interactions with YAP/TAZ control skeletal stem cell self-renewal and differentiation

Bone-marrow-derived skeletal stem/stromal cell (SSC) self-renewal and function are critical to skeletal development, homeostasis and repair. Nevertheless, the mechanisms controlling SSC behaviour, particularly bone formation, remain ill-defined. Using knockout mouse models that target the zinc-finger transcription factors Snail or Slug, or Snail and Slug combined, a regulatory axis has been uncovered wherein Snail and Slug cooperatively control SSC self-renewal, osteoblastogenesis and bone formation. Mechanistically, Snail/Slug regulate SSC function by forming complexes with the transcriptional co-activators YAP and TAZ in tandem with the inhibition of the Hippo-pathway-dependent regulation of YAP/TAZ signalling cascades. In turn, the Snail/Slug-YAP/TAZ axis activates a series of YAP/TAZ/TEAD and Runx2 downstream targets that control SSC homeostasis and osteogenesis. Together, these results demonstrate that SSCs mobilize Snail/Slug-YAP/TAZ complexes to control stem cell function.
The Role of Indocyanine Green Angiography in Breast Reconstruction

Although mastectomy skin flap necrosis is a common complication after breast reconstruction, current methods for assessing the likelihood of necrosis rely almost exclusively on clinician judgment. Indocyanine green (ICG) angiography is a technology, however, that uses near-infrared imaging to visualize perfusion in superficial tissues in real time. In breast reconstruction, studies have shown that ICG angiography independently predicts post-operative outcomes and, when used in conjunction with clinical judgment, decreases rates of mastectomy skin flap necrosis. The goal of this chapter is to introduce the technology of ICG angiography and provide an overview from the recent literature of how the technology can be instrumental in predicting post-operative complications after breast reconstruction.
Reduce risk and enhance wealth transfer in your GRAT

We present a strategy utilizing asset-or-nothing calls to enhance the average wealth transfer of a GRAT from a grantor to grantee—and indeed, to improve the likelihood that that the GRAT transfers any wealth at all. We tested this strategy against other common GRAT strategies using Monte Carlo simulation.
Too hot to trust: Examining the relationship between attractiveness, trustworthiness, and desire to date in online dating

This study expands upon previous research by examining how the enhancement of a dating profile picture might influence perceptions of interpersonal trustworthiness and how this relationship might further influence the perceived attractiveness and desire to date the respective individual. Participants were exposed to one of four online dating profile conditions and were then asked to rate the attractiveness of the person in the profile, as well as their perceived trustworthiness. The results revealed that men in this study perceived a more attractive female profile picture as less trustworthy, while women found a male with a more attractive profile picture to be more trustworthy. An indirect effects model also revealed that perceived trustworthiness mediates the relationship between similarity and attractiveness, though these effects were not moderated by the picture manipulation itself. Finally, this study found that individuals have greater intentions to date individuals whose profile pictures are percei...
Complex Manufacturing and Service Enterprise Systems: Modeling and Computational Framework

This work comes as a contribution to the efforts that are undergoing within engineering systems community to account for the increased complexity of today’s manufacturing or service systems. These systems are becoming more and more complicated due to the increase in the number of elements, interconnections within the system, and necessary integration with other systems. Moreover, through the emphasis on self-organization and considering the multi-stakeholders context and objectives, these systems are crossing the line towards complexity. There is a need for developing a framework to be used in modeling, analysis, and integration of systems that operate in uncertain environments, in which characteristics such as adaptation, self-organization and evolution, or in other words behavior prediction, need to be addressed. The proposed complex enterprise systems framework combines knowledge coming from complex systems science and systems engineering domains, and uses computational intelligence and agent-based systems simulation methodologies. The approach requires computational experience in manipulating large amounts of data and building large-scale simulation models. A significant result to be made possible by this research is that systems may no longer have a fixed, life-cycle long, design based on identified requirements; systems will be engineered to evolve and adapt as needed during the operational phase, while respecting their operational environment constraints.
New Light on Gamma Oscillations

Two papers in this issue of Neuron by Saleem et al. (2017) and Storchi et al. (2017) show that increases in background light intensity trigger proportional increases in narrowband gamma oscillations with a peak at 60 Hz in retina, lateral geniculate, and primary visual cortex of the mouse visual system.
Videoscope Assisted Minimally Invasive Surgery (VMIS): 36-Month Results

Background: Clinical outcomes from videoscope assisted minimally invasive surgery (VMIS) at 36 to 58 months are reported.Methods: Fourteen patients having sites with residual probing depth (PD) of at least 5 mm and 2 mm loss of clinical attachment level (CAL) after initial non-surgical therapy were treated with VMIS.Results: At 36 months or greater post-surgery there was a statistically significant improvement (P <0.001) in mean PD and CAL (PD: 3.80 ± 1.18 mm, CAL: 4.16 ± 1.18 mm) in all surgical sites compared with baseline. There was a mean improvement in soft tissue height (0.36 ± 0.64 mm, P = 0.03). In most cases, patients reported no postoperative discomfort.Conclusions: Improvements from VMIS appear to be favorable when compared with previously reported results of periodontal regenerative surgery. All improvements were stable over time. The lack of post-surgical recession after VMIS has not been reported with traditional regenerative surgery.
3-D Radar Imaging Based on a Synthetic Array of 30-GHz Impulse Radiators With On-Chip Antennas in 130-nm SiGe BiCMOS

We report a 30-GHz impulse radiator chip for high-resolution 3-D radar imaging. In this paper, an asymmetrical topology in the cross-coupled pulsed VCO is introduced to minimize timing jitter of radiated impulses to 178 fs, which enables highly efficient spatial combining. The coherent combining over the air has been performed with two widely spaced impulse radiators. The shortest full-width-at-half-maximum pulsewidth of 60 ps is recorded. 3-D images of various metallic objects and dielectric objects are produced using a custom-designed synthetic array imaging system. A depth resolution of 9 mm and a lateral resolution of 8 mm at a range of 10 cm have been achieved. The impulse radiator was implemented in a 130-nm SiGe BiCMOS process technology with an area of 2.85 mm2 and an average power consumption of 106 mW.
Fostering resiliency in kids : protective factors in the family, school, and community

The field of prevention, both research and practice, came a long way in the1980s: from short-term, even one-shot, individual-focused interventions in the school classroom to a growing awareness and beginning implementation of long-term, comprehensive, environmental-focused interventions expanding beyond the school to include the community. Furthermore, in the mid-1980s we finally started to hear preventionists talking about prevention strategies and programs based on research identifying the underlying risk factors for problems such as alcohol and other drug abuse, teen pregnancy, delinquency and gangs, and dropping out (Hawkins, Lishner, and Catalano, 1985). While certainly a giant step in the right direction, the identification of risks does not necessarily provide us with a clear sense of just what strategies we need to implement to reduce the risks. More recently, we are hearing preventionists talk about “protective factors,” about building “resiliency” in youth, about basing our strategies on what research hast old us about the environmental factors that facilitate the development of youth who do not get involved in life-compromising problems (Benard, March 1987). What clearly becomes the challenge for the l990s is the implementation of prevention strategies that strengthen protective factors in our families, schools, an communities. As Gibbs and Bennett (1990) conceptualize the process, we must”turn the situation around by translating negative risk factors into positive action strategies” which are, in essence, protective factors. After a brief overview of the protective factor research phenomenon, this paper will discuss the major protective factors that research has identified as contributing to the development of resiliency in youth and the implications of this for building effective prevention programs.
Bone Remodeling, Dynamics of

Bone remodeling is a physiological process in which bone is resorbed and replaced with new bone. It occurs in millions of discrete locations within the bone, with an overall effect of continuous bone renewal.
Novel technique to identify large river host fish for freshwater mussel propagation and conservation

Abstract Skipjack Herring (Alosa chrysochloris) has long been proposed as the sole host for Reginaia ebenus (Ebonyshell) and Elliptio crassidens (Elephantear), but these relationships were unconfirmed because of difficulties with maintaining this fish species in captivity. We confirmed the suitability of Skipjack Herring as host for both mussel species, and we also showed that Alabama Shad (Alosa alabamae) is an additional suitable host for E. crassidens; both fish species produced large numbers of juvenile mussels. No other fish species tested (n = 12) were suitable hosts for either mussel species. Our results, combined with results from other studies, suggest these mussel species are specialists on genus Alosa. Traditional methods for host identification were problematic for herrings because of their sensitivity to handling and the large volumes of water required to maintain them in captivity. In addition to traditional methods, we confirmed the suitability of these fishes as hosts using a novel technique in which fish gills infected with glochidia were excised from sacrificed fishes and held in recirculating holding tanks with flow until metamorphosis was complete. Completion of metamorphosis on excised gills required glochidia spend at least 11–17 d encapsulated on live fishes before gill excision. This technique may be useful for other large or sensitive fishes that do not lend themselves well to traditional methods for host identification. Confirmation of Alosa spp. as primary hosts for R. ebenus and E. crassidens supports the idea that dams and other river modifications that disrupt migrations of these fishes are key factors in the range restrictions of these mussel species.
Comparison of two tools to assess dyad feeding interaction in infants with gastroesophageal reflux disease.

PURPOSE The aim of this study was to compare the Mother-Infant/Toddler Feeding Scale (MITFS) and the Nursing Child Assessment Feeding Scale (NCAFS). Specific questions were as follows: (1) Are there differences between the results of the MITFS and the NCAFS tools in terms of rating infant feeding interactions? And (2) does one tool provide a more detailed, nuanced overview of the quality of feeding interactions than the other? DESIGN AND METHODS This comparative descriptive study is a secondary analysis of a study evaluating a massage intervention for infants with symptoms of gastroesophageal reflux disease (GERD). A feeding observation for each dyad was scored using both the NCAFS and MITFS. Infants were 6-18 weeks of age. RESULTS There were moderate correlations (r = 0.3-0.8) between 11 of 20 possible NCAFS and MITFS mother-related subscales, and between 3 of 10 possible NCAFS and the MITFS infant-related subscales. A total of 19 dyads (83%) had one or more NCAFS subscale scores that were at least 1 standard deviation (SD) below normative scores, and 21 dyads (91%) had one or more MITFS subscale T-scores that deviated 1 SD from the normative T-scores. Agreement between the two instruments on scores deviating from the norm was 78%. PRACTICE IMPLICATIONS Both instruments discussed in this paper are standardized ways of assessing an infant feeding. Use of a standardized feeding tool is an objective way to evaluate feedings and can potentially identify specific areas of concern to guide an individualized intervention for a mother-infant dyad. Thus, nurses and other health professionals working with mothers and babies, whether in the hospital, pediatrician offices, or clinics would benefit from learning how to use a standardized feeding tool. Use of a feeding tool also provides the opportunity for nurses to understand the basis of important qualities of a feeding interaction, and a way for nurses who regularly feed infants to self-evaluate their feeding methods. This may minimize less than optimal interactions and allow for optimal support for infants during feedings by mothers and nurses.
Introducing sustainability in engineering design education: A case study using analysis of impacts during the design for sustainability (AID-DS)

This work presents an academic initiative to introduce sustainability in engineering design education based on a case study approach that uses indicators to measure the sustainability performance of a product. The proposed approach uses strategic actions to redesign the product and to measure the sustainability performance under the new conditions. The performances of different alternatives resulting from the strategic interventions are compared to determine the most sustainable solution considering the effect of the strategic actions on the three pillars of sustainability.
Marketing Energy Efficiency in High-Profile Markets

The U.S. EPA recently finalized an agreement with the consumer electronics industry on a voluntary industry-government partnership to promote energy efficient TV, VCR, and TV/VCR combination products using the ENERGY STAR” label. The industry and the U.S. EPA will officially launch the program at the Consumer Electronics Show” in January, 1998. The European Union (EU) and the Group on Energy Efficient Appliances (GEA) have been developing and implementing similar government-industry partnerships that promote consumer electronics energy efficiency.
Aortic extra cellular matrix (ECM) remodeling

Abstract: The extracellular matrix (ECM), a vital network of supportive fibrous proteins, confers biomechanical strength and organization to body tissues. It is not simply a passive scaffold on which cells attach and move, but a dynamic regulator of tissue growth and development. Within the vasculature, the ECM is critical to withstanding the range of blood pressures and shear forces acting on vessel walls. ECM components undergo a highly regulated process of remodeling that balances matrix protein deposition and degradation by proteases. Dysregulation of these homeostatic systems results in vascular ECM remodeling disorders, including aneurysm of the thoracic aorta. This is currently treated surgically but there may soon be a targeted medicinal treatment alternative. This chapter reviews histology of the thoracic aorta, pathophysiological changes resulting in aneurysm development and regulation of ECM proteases involved, and discusses current challenges to clinical therapy.
The tuberculosis structural genomics consortium: a structural genomics approach to drug discovery.

Abstract Structural genomics is changing the way we study and understand biological systems, providing insight into the biology and life cycle of an organism at the molecular level through determination of protein structures. Structural genomics can be a particularly useful tool in the study of infectious diseases, especially to facilitate the development of new chemotherapeutics by providing a structural foundation for drug discovery. The Tuberculosis Structural Genomics Consortium (TBSGC) is applying a structural genomics approach to solving the structures of biologically and medically important proteins in the pathogenic bacterium Mycobacterium tuberculosis, adding to the scientific knowledge base essential for developing novel and effective antitubercular drugs. Tuberculosis (TB) has been declared a global health emergency by the World Health Organization (WHO). With the rise in the number of multidrug resistant (MDR) and extensively drug resistant (XDR) TB strains, the need for more effective TB treatments has become urgent. In contrast to other structural genomics projects, the TBSGC specifically prioritizes proteins based on their potential as drug targets. We describe the consortium’s high-throughput (HT) structure determination pipeline that enables an efficient distribution of resources while also incorporating knowledge from several scientific fields. The success of this pipeline is illustrated in the number of successful structure solutions as demonstrated in the case studies presented in this chapter.
Web-Based Control of Mobile Manipulation Platforms via Sensor Fusion

The World Wide Web (WWW) eliminates traditional communication problems such as long distance and time constraints. Furthermore, the WWW provides us with an unprecedented comprehensive environment for distributing information over a large network so that people living in distant locates can share their ideas and work together. In this article, we focus on web-based tele-operated mobile platformcontrol. In teleoperation tasks, remote users can control a remote mobile manipulation platform to extend human sensory and control ranges. The tele-operation tasks are potentially useful in dangerous and unpredictable environments such as at a construction site, space, underwater, service environments, and in nuclear power stations.
Biotechnological Approaches to Altering Seed Composition

This chapter reviews some of the biotechnological approaches being used to alter seed composition and some of the challenges faced in this area. Directed modification of starch content and composition requires a better understanding of the roles of particular enzymes in starch biosynthesis. Progress in expressing novel carbohydrates in plant seeds is reviewed. The section on lipid modification discusses examples involving both edible and industrial oils. Most seed protein work has focussed on amino acid composition, and several approaches to that goal are presented, along with briefer discussions concerning protein functionality and the use of seeds as production systems. In the final section some practical considerations are presented around the conversion of transgenic plant lines produced in the laboratory to useful commercial lines.
Impact of Shear History on Powder Flow Characterization Using a Ring Shear Tester

In this study, we have investigated the impact of repeated shear displacement on powder flow properties. We show that when multiple yield loci are obtained using the same bulk solid specimen by stepping through different stress levels (i.e., stress walk [SW]), the shear deformation of the powder in a rotational shear cell, that is, Schulze Ring Shear Tester, is maximized, reducing the powder shear strength. This approach is material and time sparing; however, it imprecisely predicts better powder flowability. The magnitude of the change in the unconfined yield strength, σc, due to this prolonged shear displacement appears to be material-dependent, being less impactful for free-flowing powders. Using the SW and the individual yield loci-generated flow properties, we have demonstrated that in hopper design, the shear displacement effect impacts the computed critical arching diameter more than the critical mass flow angle. This knowledge of powder flow properties highlights limitations associated with the SW. An exponential function was found to describe the relationship between the change in σc at the highest major principal stress and the density weighted flowability, ffρ, with an R2 of 0.98. Such a model could be a valuable tool for correcting shear strength results obtained from SW, saving time, and material.
HbA1c Measured in the First Trimester of Pregnancy and the Association with Gestational Diabetes.

We aimed to examine the prospective association between first trimester HbA1c and gestational diabetes (GDM) and explore the utility of HbA1c for prediction of GDM. We used data from a case-control study within the prospective NICHD Fetal Growth Studies-Singleton Cohort (2009–2013), which enrolled 2,802 women at 12 U.S. clinical centers. HbA1c was measured in GDM cases (n = 107) and matched controls (n = 214) targeted at 8–13, 16–22, 24–29, and 34–37 gestational weeks. We excluded women with HbA1c ≥ 6.5% (48 mmol/mol) at enrollment (n = 3) or who had a hemoglobin variant (n = 6). At 8–13 gestational weeks, women who later developed GDM had significantly higher HbA1c (5.3[standard deviation 0.3]%; 34[4]mmol/mol) than women without GDM (5.1[0.3]%; 32[3] mmol/mol) (P ≤ 0.001); this difference remained significant throughout pregnancy. Each 0.1% (1 mmol/mol) HbA1c increase at 8–13 weeks was associated with an adjusted 22% increased GDM risk (95% confidence interval 1.09–1.36). First trimester HbA1c significantly improved GDM prediction over conventional risk factors (AUC 0.59 vs 0.65; P = 0.04). In conclusion, women who develop GDM may have impaired glucose homeostasis early in or prior to pregnancy, as indicated by their elevated first trimester HbA1c. First trimester HbA1c may aid in early identification of at risk women.
Outcomes in non-Hodgkin lymphoma by Latino country-of-origin (COO).

e18727Background: Despite significant geographic, genetic, and environmental heterogeneity among Latinos living in the U.S., differences in epidemiology and outcomes among Latino subgroups diagnose...
Generalization of a Result of Fabian on the Asymptotic Normality of Stochastic Approximation

Stochastic approximation (SA) is a general framework for analyzing the convergence of a large collection of stochastic root-finding algorithms. The Kiefer–Wolfowitz and stochastic gradient algorithms are two well-known (and widely used) examples of SA. Because of their applicability to a wide range of problems, many results have been obtained regarding the convergence properties of SA procedures. One important reference in the literature, Fabian (1968), derives general conditions for the asymptotic normality of the SA iterates. Since then, many results regarding asymptotic normality of SA procedures have relied heavily on Fabian’s theorem. Unfortunately, some of the assumptions of Fabian’s result are not applicable to some modern implementations of SA in control and learning. In this paper we explain the nature of this incompatibility and show how Fabian’s theorem can be generalized to address the issue.
Post-processing to Modify the α Phase Micro-Texture and β Phase Grain Morphology in Ti-6Al-4V Fabricated by Powder Bed Electron Beam Melting

Additively manufactured Ti-6Al-4V has columnar β grains along the build direction with a 〈001〉 fiber texture. Because of Burgers Orientation Relationship, the resulting α phase becomes textured albeit less strongly than the β phase. Microtexture zones have been identified in the α phase in laser-based systems. There have been limited studies on α phase texture and its impact on mechanical behavior of Ti-6Al-4V fabricated via electron beam melting (EBM) powder bed additive manufacturing along with the use of super-transus heat treatments to modify the resulting α phase texture. We present the role of texture on influencing the tensile behavior of EBM Ti-6Al-4V. We observed that super-transus heat treatment of the alloy also results in columnar to equiaxed transition of β grains with a subsequent change in α phase texture. Potential mechanisms for the formation of equiaxed β are discussed.
Talent and Performance

(1965). Talent and Performance. The Journal of Higher Education: Vol. 36, No. 6, pp. 356-357.
Determination of Postacute Hospitalization Level of Care

In the United States, we are blessed with many options for postacute care: inpatient rehabilitation facilities, long-term acute care hospitals, skilled nursing facilities, home health agencies, and outpatient rehabilitation. However, choosing the appropriate level of care can be a daunting task. It requires interdisciplinary input and involvement of all stakeholders. The decision should be informed by outcomes data specific to the patient's diagnosis, impairments, and psychosocial supports.
Noninvasive thermal evaluation for shunt failure in the emergency room.

Author(s): Xu, Jordan; Poole, Cassie; Sahyouni, Ronald; Chen, Jefferson | Abstract: Background:Ventriculoperitoneal shunts (VPSs) have been the mainstay of treating hydrocephalus since the 1950s. However, shunts have a reported complication rate reaching nearly 50%. Devices have been developed that utilize noninvasive thermal transcutaneous diffusion technology. These shunt evaluation devices measure temperature gradients to detect shunt cerebrospinal fluid flow. We assessed the utility using a thermal diffusion technique to work up shunt failure in the emergency room (ER). Methods:This was a retrospective case series at a single medical center ER. We included consecutive patients with possible VPS malfunction who were evaluated with a thermal sensor. The time period of data collection included September 2015-April 2018. Results:Eight patients were reviewed, including four males and four females. The average age of reviewed patients was 35.1 (+/- ; 16.5). In our case series, three patients had adequate shunt flow as assessed by the shunt evaluation device, and the decision was made to discharge the patient and follow-up in clinic. In two patients, the flow was diminished, but due to other reassuring signs, the patients were still discharged with follow-up. Two patients were noted to have poor flow and were admitted for shunt revision. Conclusion:It is important to determine whether a malfunction is present and whether an intervention is necessary for patients who present to the emergency department with possible symptoms of shunt failure. A thermal sensor is a fast and noninvasive tool in the evaluation of shunt flow and helps determine whether it is safe to send a patient home or intervene appropriately.
Vertical Banded Gastroplasty Revision to Gastric Bypass Leads to Effective Weight Loss and Comorbidity and Dysphagia Symptom Resolution

Up to 50% of patients with vertical banded gastroplasty (VBG) experience failure or complications in the mid- and long-term and present for revisional bariatric surgery. This study aimed to review our experience for patient outcomes after VBG revisions and compare their benefits to those of primary laparoscopic Roux-en-Y gastric bypass (LRYGB) operations. Data from patients who underwent VBG revision between 2009 and 2015 at a center of excellence were reviewed. Patient demographics, symptoms, comorbidities, weight loss, reinterventions, reoperations, and hospital stay were analyzed and compared with those of primary LRYGB patients (control group). Fifty-two patients (88.5% female, 55 ± 9.6 years old) underwent revisional surgery during the study period (86.5% LRYGB, 11.5% VBG reversal, and 2% sleeve gastrectomy). Patients presented 17.3 ± 7.2 years after their VBG for weight regain (55.8%), dysphagia (19.2%), or both (25%). Patients who underwent conversion to LRYGB for weight regain and for mix-symptoms had similar weight loss to the control group (38.2 ± 11.8 vs 35.6 ± 7.7, p = 0.108), along with similar comorbidity resolution. However, even though the early (< 30 days) complication rate was similar between the two groups, the conversion group had higher 4-year reoperation rate (29% vs 9.5%, p < 0.001) and length of stay (5.4 ± 5.3 vs 2.6 ± 3.1, p < 0.001). Additionally, dysphagia resolved in all the patients of our cohort. VBG conversion to LRYGB leads to significant weight loss, resolution of dysphagia, and comorbidities similarly to the primary LRYGB operations. However, higher mid-term complication rates should be expected.
Design of geocell reinforced roads through fragility modeling

Abstract Several studies have confirmed the geocell reinforcement system as potential road material. However, there is a wide gap between the number of research studies evaluating the geocell in the laboratory and those dealing with road design methods using the geocell. Due to this gap, the geocell system has not reached its full potential in highways. The present study proposes fragility modeling to design low volume roads by considering the geocell reinforced layer's modulus. A predictive model was developed to estimate the geocell layer's modulus using laboratory and finite element analysis results. The results indicate that geocell reinforcement reduces the stresses on the underlying road layers. The developed fragility approach is then used to examine three road designs for Texas's low volume road involving different geocell reinforced layers. The obtained fragility curves indicate the reliability of each of the three road designs against the traffic load and can thereby assist decision-makers in selecting the optimum design. By designing geocell reinforced roads via fragility modeling, highway officials will be able to integrate any uncertainties in the design inputs and check designs against road performance criteria such as rutting and fatigue cracking, and against decision criteria such as cost, emissions, etc.
Isolated Cerebral Mucormycosis: A Case Report (P5.022)

OBJECTIVE: We report a rare case of isolated cerebral mucormycosis without any extracerebral manifestations. BACKGROUND: Mucormycosis is an aggressive fungal infection caused by genera of the family Mucoraceae and is usually found in immunocompromised patients. Most cases are orbito-rhino-cerebral, where the infection ascends upwards through nasal passages to reach brain parenchyma. METHODS: Case report RESULTS: A 50 year old African-American male with history of diabetes and polysubstance abuse presented with sudden onset of right sided weakness, slurred speech, fever, and confusion. MRI Brain W/O contrast showed DWI/ADC changes consistent with acute ischemic stroke involving left basal ganglia and internal capsule. They were mostly hemorrhagic on gradient echo sequence. He was treated empirically with broad-spectrum antibiotics including vancomycin, ceftriaxone and metronidazole. Infectious work up was negative and included: Blood cultures, HIV, syphilis, toxoplasma, and aspergillus. Cerebrospinal fluid (CSF) analysis: WBC 513/mm3 (59 % neutrophils), RBC 188/mm3, protein 153 mg/dl and low CSF glucose of 54 mg/dl (serum glucose 176 mg/dl). Further, CSF was negative for bacterial culture, cryptococcal antigen, fungal culture, viral culture, HSV PCR, VZV PCR and aspergillus. Magnetic resonance spectroscopy showed high lactate peak with diminished N-Acteyl Aspartate peak suggestive of ischemic infarction of basal ganglia. Thus, brain biopsy was pursued, which was negative for any infectious etiology. Unfortunately, he developed another similar lesion of the right basal ganglia and internal capsule after 48 hours. He continued to deteriorate clinically and eventually expired. Autopsy showed numerous microabscesses permeated with fungal hyphae involving the basal ganglia bilaterally and thrombosed blood vessels. The hyphae were broad, branched at right angles, and non-septate, consistent with Mucor species. CONCLUSION: Isolated cerebral mucormycosis is a rare and fatal condition. It is should be considered in immunocompromised patients with persistent fever not responding to antibiotics, rapidly evolving focal neurologic deficits. High index of clinical suspicion and aggressive medical management with anti-fungal therapy may result in better outcomes. Disclosure: Dr. Dhakar has nothing to disclose. Dr. Rayes has nothing to disclose. Dr. Williams has nothing to disclose. Dr. Tselis has recieved research support from Teva Neuroscience and Biogenic Idec. Dr. Norris has nothing to disclose.
Total Individual Account Retirement Plan Assets, by Demographics, 2007, With Market Adjustments to March 2010

Workers’ participation in a retirement plan, either through an employment-based arrangement or individually, is a crucial factor in accumulating sufficient resources to pay for expenses in retirement. This paper examines the distribution of total assets held in individual account retirement plans (401(k)-type plans, IRAs, and Keogh plans) across various demographic characteristics of American families, based on the latest data from the Federal Reserve’s Survey of Consumer Finances. The distribution of the retirement plan assets is then compared against the distribution of all assets owned. The analysis also shows the changes in the distribution of these assets from 1992 to 2007, as well as market return-adjusted values for March 2010. Total individual account retirement assets amounted to $8.979 trillion in 2007. Employment-based plan assets ($4.823 trillion) exceeded individual retirement account/Keogh account assets ($4.157 trillion) by $0.666 trillion. Approximately 70 percent of the employment-based retirement plan assets were held by families headed by individuals ages 45-64. The largest concentration of IRA and Keogh assets is held by families with heads in the next oldest age group (ages 55-74), who own just over 60 percent of these assets. Retirement plan assets are less concentrated than overall financial assets in many categories. For example, families with white, non-Hispanic heads owned 85.1 percent of active employment-based individual account retirement plan assets, compared with 91.9 percent of all financial assets. Families in the top 10 percent of net worth held 50.0 percent of these active employment-based retirement assets, compared with 72.3 percent of all financial assets. The PDF for the above title, published in the May 2010 issue of EBRI Notes, also contains the fulltext of another May 2010 EBRI Notes article abstracted on SSRN: “Retirement Annuity and Employment-Based Pension Income, Among Individuals Age 50 and Over: 2008.”
Multiplayer Game Cheating Prevention with Pipelined Lockstep Protocol

Multiplayer games are becoming more and more popular. One of the reasons is that they let geographically distant players play together. We first look at a synchronization protocol and a protocol for prevention of common cheating techniques in real-time multiplayer games. We then propose an optimization to the current cheat-proofing techniques which takes advantage of synchronization delay inherent in current implementation of multiplayer games. Previous work has studied synchronization techniques [1] and cheat-proofing techniques [2] in isolation, without exploring their interaction. Our optimization has the same guarantee as current cheat-proofing techniques and can increase interaction rate between players in real-time multiplayer games.
Identification of Rydberg States in the Atomic Lanthanides and actinides

An accurate determination of an atomic ionization potential usually requires an observation of a Rydberg progression or the determination of a photoionization threshold. In the lanthanides and the actinides direct measurements of limit values using conventional techniques are prohibitively difficult. For example, a uv absorption spectrum is usually hard to interpret due to the existence of many high (low) lying states of low (high) lying valence configurations. Transitions to these high lying valence states are stronger and more numerous than transitions to Rydberg states. As a rule, Rydberg series are hopelessly obscured in the absorption spectrum. Similarly, uv photoionization spectra are complicated by transitions from many low lying metastable levels that have significant populations at the temperatures at which the atomic species have reasonable vapor pressures. Usually, photoionization occurs at wavelengths significantly longer than that necessary to ionize ground state atoms. It is nearly an impossible task to separate the photoionization spectrum originating on the atomic ground state from that on the metastable states. While long Rydberg series in 3 lanthanide elements have been identified using conventional methods [1,2], more sensitive and flexible methods are required to systematically study these heavy multielectron atoms.
Service-oriented Architecture in Medical Software: Promises and Perils

In the current issue of JAMIA , Kawamoto and Lobach1 propose a software framework intended to facilitate widespread, effective, clinical decision support. The proposed framework embraces a service-oriented-architecture (SOA) approach. Service-oriented-architecture is a philosophy of design described as “the software equivalent of Lego bricks,”2 where a toolset of mix-and-match units (“services”), each performing a well-defined task, can reside on different machines (including geographically separated ones), ready to be used when needed. The most widespread implementations of SOA involve the use of Web services, where a given computational resource/service can be invoked by a remote machine via messages composed in XML and sent over HTTP, so that they can operate across firewalls. Think of a Web service, in its simplest form, as a subroutine that can be called over the Internet. Thanks to success stories such as Amazon.com,3 and at software giants such as SAP,4,5 the status of SOA in the business information technology (IT) domain has risen meteorically. The Kawamoto and Lobach paper1 reiterates the following potential benefits of SOA: Some IT articles, however, present a “caveat emptor” skepticism about SOA.6,7 One must carefully inspect the claimed benefits of SOA closely, examine its potential drawbacks, and take a balanced approach to any proposed new SOA application while taking into consideration past lessons from business IT. In software design, simplification through problem decomposition into semi-independent units (subroutines, classes) is an important, incontrovertible principle. In SOA, where the units (services) lead a relatively autonomous existence (e.g., units are free to reside on physically separate hardware), …
Application of iChip to Grow "Uncultivable" Microorganisms and its Impact on Antibiotic Discovery.

Antibiotics have revolutionized modern medicine, allowing significant progress in healthcare and improvement in life expectancy. Development of antibiotic resistance by pathogenic bacteria is a natural phenomenon; however, the rate of antibiotic resistance emergence is increasing at an alarming rate, due to indiscriminate use of antibiotics in healthcare, agriculture and even everyday products. Traditionally, antibiotic discovery has been conducted by screening extracts of microorganisms for antimicrobial activity. However, this conventional source has been over-used to such an extent that it poses the risk of “running out” of new antibiotics. Aiming to increase access to a greater diversity of microorganisms, a new cultivation method with an in situ approach called iChip has been designed. The iChip has already isolated many novel organisms, as well as Teixobactin, a novel antibiotic with significant potency against gram-positive bacteria. This article is open to POST-PUBLICATION REVIEW . Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.
Anti-inflammatory effects of propofol during cardiopulmonary bypass: a pilot study.

Introduction: Propofol has been suggested as a useful adjunct to cardiopulmonary bypass (CPB) because of its potential protective effect on the heart mediated by a decrease in ischemia-reperfusion injury and inflammation at clinically relevant concentrations. In view of these potentially protective properties, which modulate many of the deleterious mechanism of inflammation attributable to reperfusion injury and CPB, we sought to determine whether starting a low dose of propofol infusion at the beginning of CPB would decrease inflammation as measured by pro-inflammatory markers. Materials and Methods: We enrolled 24 patients undergoing elective coronary artery bypass graft (CABG). The study group received propofol at rate of 120 mcg/kg/min immediately after starting CPB and was maintained throughout the surgery and for the following 6 hours in the intensive care unit (ICU). The control group received propofol dose of 30-50 mcg/kg/min which was started at the time of chest closure with wires and continued for the next 6 hours in the ICU. Interleukins (IL) -6, -8 and -10 and tumor necrosis factor alpha (TNFalpha) were assayed. Result: The most significant difference was in the level of IL-6 which had a P value of less than 0.06. Starting a low dose propofol early during the CPB was not associated with significant hemodynamic instability in comparison with the control group. Conclusion: Our study shows that propofol may be suitable as an anti-inflammatory adjunct for patients undergoing CABG.