cssi/SciSciGPT-SciSciNet huggingface dataset:
Self-sorting of multicomponent Pt(II) metallacages

Using a social self-sorting phenomenon, two Pt(II)←pyridyl, carboxylate heteroleptic metallacages cage 1 and cage 2 have been constructed in nearly quantitative yields from a single reaction that contained twenty-eight communicative precursors, including five unique species 3–7 in a 2:4:16:2:4 molar ratio. The success of this reaction has been established by multinuclear NMR (31P and 1H), UV/Vis absorption and fluorescence emission spectroscopies. The process depends on various factors such as the energetic preference for Pt←N,O coordination over the Pt←N,N and Pt←O,O coordination motifs, the appropriate selection of stoichiometry and directionality of the precursors, as well as maximum site occupancy while keeping entropic costs as low as possible.
4D Graph-Based Segmentation for Reproducible and Sensitive Choroid Quantification From Longitudinal OCT Scans

Purpose Longitudinal imaging is becoming more commonplace for studies of disease progression, response to treatment, and healthy maturation. Accurate and reproducible quantification methods are desirable to fully mine the wealth of data in such datasets. However, most current retinal OCT segmentation methods are cross-sectional and fail to leverage the inherent context present in longitudinal sequences of images. Methods We propose a novel graph-based method for segmentation of multiple three-dimensional (3D) scans over time (termed 3D + time or 4D). The usefulness of this approach in retinal imaging is illustrated in the segmentation of the choroidal surfaces from longitudinal optical coherence tomography (OCT) scans. A total of 3219 synthetic (3070) and patient (149) OCT images were segmented for validation of our approach. Results The results show that the proposed 4D segmentation method is significantly more reproducible (P < 0.001) than the 3D approach and is significantly more sensitive to temporal changes (P < 0.0001) achieved by the substantial increase of measurement robustness. Conclusions This is the first automated 4D method for jointly quantifying choroidal thickness in longitudinal OCT studies. Our method is robust to image noise and produces more reproducible choroidal thickness measurements than a sequence of independent 3D segmentations, without sacrificing sensitivity to temporal changes.
Diamonds in the sky

WHEN the physicist Marvin Ross announced in 1981 that a giant mine of diamonds might lie buried deep in the interiors of Neptune and Uranus, his paper on the subject – 'Diamonds in the sky' – came as a complete shock to the planetary-science community. But it was a real shock – a shock wave, in fact – that led him to such a bizarre conclusion. At the time, shock-wave studies were the only way that experimentalists could 'see' how matter behaves at the extremes of pressure and temperature that exist in the totally inaccessible interiors of every planet of our solar system – including the Earth.
Cutting costs and standardizing care: Once-per-cycle complete blood count monitoring may be safe for patients undergoing platinum-based chemotherapy.

AIM The aim of this study was to evaluate whether frequency of complete blood count (CBC) testing during chemotherapy for gynecologic cancer impacts hospital admissions or rates of neutropenic fever. METHODS A retrospective cohort study was performed at a single academic institution. Patients undergoing platinum-based chemotherapy for endometrial or ovarian cancer from January 2010 to December 2014 were identified from a clinical database. Patients receiving dose-dense chemotherapy or on a clinical trial were excluded. Electronic chart review collected demographic and clinical characteristics. The primary outcome was the rate of febrile neutropenia or hospital admission. RESULTS A total of 174 patients were identified, 63 (36%) with endometrial and 111 (64%) with ovarian cancer. Fifty-four percent of patients received multiple CBC per cycle compared with 46% who only had one CBC per cycle. The majority of patients were treated with a platinum-based doublet (85%). Dose reductions, addition of granulocyte colony stimulating factor, and rates of grade 3 or 4 anemia and neutropenia were significantly associated with more frequent testing. There was no difference in rates of neutropenic fever (5.3 vs 3.8%, P = 0.45) or hospital admission (22.3 vs 21.3%, P = 0.86) for multiple versus single CBC monitoring. CONCLUSION More frequent laboratory testing detected more cases of grade 3 or 4 hematopoietic toxicities and was associated with more interventions. There were no differences in number of hospitalizations or cases of neutropenic fever by frequency of laboratory testing, suggesting that it may be appropriate to decrease routine laboratory tests for select patients.
Integrating Design Engineering and the Work-Force

Abstract This paper discusses efforts to integrate workers into the process of design (collaborative). It will survey Federal Government programs which support this process. It will describe examples of best practice projects and the initial steps of a multi-site project whose object is to develop collaborative decision making tools.
Arc ubiquitination in synaptic plasticity.

Abstract The activity-regulated cytoskeleton-associated protein (Arc) is a neuron-expressed activity regulated immediate early gene (IEG) product that is essential for memory consolidation and serves as a direct readout for neural activation during learning. Arc contributes to diverse forms of synaptic plasticity mediated by the trafficking of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors. Notably, Arc protein expression abruptly increases and then rapidly decreases following augmented network activity. A large body of work has focused on Arc transcription and translation. Far fewer studies have explored the relevance of Arc protein stability and turnover. Here, we review recent findings on the mechanisms controlling Arc degradation and discuss its contributions to AMPA receptor trafficking and synaptic plasticity.
Hour-ahead solar PV power forecasting using SVR based approach

The use of solar photovoltaic (PV) in power generation has grown in the last decade. Unlike the traditional power generation methods (i.e. oil and gas), the solar output power is fluctuating and uncertain, mainly due to clouds movement and other weather factors. Therefore, in order to have a stable power grid, the electricity utilities need to forecast the solar output power, so they can prepare ahead adequately. In this work, hour-ahead solar PV power forecasting is performed using Support Vector Regression (SVR), Polynomial Regression and Lasso. The implemented regression models were tested under different feature selection schemes. These features include weather conditions (i.e. sky condition, temperature, etc.), power generated in the last few hours, day and time information. Based on the comparative results obtained, the SVR forecasting model outperforms the other two models in terms of accuracy.
Association of alterations in smell and taste with depression in older adults.

Objective Examine the relationship between depression and changes in smell or taste. Study Design Cross-sectional analysis of 2011-2012 and 2013-2014 National Health and Nutrition Examination Survey (NHANES). Methods We examined 5,275 adults ≥40 years old who completed smell and taste questionnaires as well as a validated depression assessment instrument, the Patient Health Questionnaire (PHQ-9). Analyses incorporated sampling weights to account for the complex sampling design and associations were analyzed using multivariate logistic regression adjusted for related demographics and socioeconomic data. Results The prevalence of altered smell and taste was 23.0% (95% CI: 20.7-25.3%) and 11.9% (95% CI: 10.7-13.1%), respectively. Among those who met criteria for major depressive disorder, the prevalence of altered smell and taste was higher at 39.8% (95% CI: 33.4-46.1%) and 23.7% (95% CI: 18.7-28.7%), respectively. In a multivariate model adjusting for age, gender, education, major comorbidities, smoking history, heavy alcohol use, sinus disease, cold symptoms, and trauma history, adults ≥40 and <65 years old who reported alterations in smell (OR: 1.64, p = 0.004) and adults ≥40 years old who reported alterations in taste (OR: 1.77, p = 0.001) were more likely to meet criteria for major depressive disorder. Conclusion There is a strong association between major depression and alterations in smell and taste among certain age groups in the general U.S. population. Primary care providers should screen for depression when patients report changes in smell or taste. Level of Evidence 4.
Immigration Policy Impasse as an Actor: A Matter of Concern for Educators

This qualitative, ethnographic research inquiry intends to prompt further conversation about how scholar-practitioners in the social sciences approach divisive topics such as immigration policy in teacher education. In the U.S. Southeast, practicing K-12 teachers and the researcher-instructor participated in a federally funded English for Speakers of Other Languages (ESOL) professional development program through a public university. The professional development program’s goal was to advance teachers’ knowledge of working with culturally and linguistically diverse students. Although the school district where the study took place has a high population of immigrant students, statewide policies prohibiting immigrant students from higher education was new information for many teacher-participants. Empirical data includes responses from public school teachers learning about restrictive educational policies that affect immigrant students as well as the researcher-instructor’s auto-ethnographic inquiry as a teacher-activist-scholar. Drawing from actor-network theory (Latour, 2005), this work contributes to conceptual and empirical studies in the nexus of education and policy impacting immigrants in the U.S., with an attempt to better understand ideological gridlock. Keywords: immigration policy, ESOL teachers, teacher professional development, actor-network theory
Dissociation-Based Oblivious Bounds for Weighted Model Counting

We consider the weighted model counting task which includes important tasks in graphical models such as computing the partition function and probability of evidence as special cases. We propose a partition-based bounding algorithm that exploits logical structure and gives rise to a novel set of inequalities from which lower (and upper) bounds can be derived efficiently. The bounds come with correctness guarantees and are oblivious in that they can be computed by minimally manipulating the parameters of the model. We experimentally compare our bounds with the mini-bucket scheme (which is also oblivious) and show that they are often superior to the latter on a wide variety of benchmark networks.
Recombination velocity less than 100 cm/s at polycrystalline Al2O3/CdSeTe interfaces

Reducing recombination in polycrystalline solar cells by orders of magnitude is currently one of the greatest challenges for increasing thin-film solar cell efficiency to theoretical limits. The question of how to do this has been a challenge for the thin-film community for decades. This work indicates that effective interface passivation is critical. Here, polycrystalline Al2O3/CdSeTe/Al2O3/glass heterostructures are grown, and a combination of spectroscopic, microscopic, and time-resolved electro-optical measurements demonstrates that the interface recombination velocity at alumina/thin-film interfaces can be less than 100 cm/s. This is three orders of magnitude less than typical CdTe interfaces without passivation, commensurate with single-crystal epitaxial CdMgSeTe/CdSeTe/CdMgSeTe double heterostructures, and enables minority-carrier lifetimes in polycrystalline CdSeTe well above 100 ns. Microscopic interfacial electric-field measurements identify the field effect as a potential mechanism for polycrystalline Al2O3/CdSeTe interface passivation. The results provide guidance for modeling and interface passivation in devices and indicate future paths to realize highly efficient thin-film solar cells.Reducing recombination in polycrystalline solar cells by orders of magnitude is currently one of the greatest challenges for increasing thin-film solar cell efficiency to theoretical limits. The question of how to do this has been a challenge for the thin-film community for decades. This work indicates that effective interface passivation is critical. Here, polycrystalline Al2O3/CdSeTe/Al2O3/glass heterostructures are grown, and a combination of spectroscopic, microscopic, and time-resolved electro-optical measurements demonstrates that the interface recombination velocity at alumina/thin-film interfaces can be less than 100 cm/s. This is three orders of magnitude less than typical CdTe interfaces without passivation, commensurate with single-crystal epitaxial CdMgSeTe/CdSeTe/CdMgSeTe double heterostructures, and enables minority-carrier lifetimes in polycrystalline CdSeTe well above 100 ns. Microscopic interfacial electric-field measurements identify the field effect as a potential mechanism for polycrys...
Some Nonlinear Systems of Differential Equations Equivalent to Linear Systems

Publisher Summary It has been shown that the solution of the nonlinear differential equation y″ + p(x) y + cy−3 = 0 is written in the form y = √u2 − v2, where u and v are appropriately the selected solutions of the linear equation u″ + pu = 0. This chapter discusses a problem for systems of two and three equations. The results for the case n = 2, that is, two-dimensional linear systems, are closely parallel to the results of Herbst and Thomas for linear homogeneous second order equations. The chapter describes the linear systems in three unknowns.
Convergence in Distribution of Self-Normalized Sup-Norms of Kernel Density Estimators

Let fn denote a kernel density estimator of a density f on the real line, for a bounded, compactly supported probability kernel. Under relatively weak smoothness conditions on f and K it is proved, for every 0 < β < 1/2, that the sequence $${{\hat{A}}_{n}}\left( {\frac{{\sqrt {{n{{h}_{n}}}} }}{{\parallel K{{\parallel }_{2}}\parallel {{f}_{n}}\parallel _{\infty }^{{1/2 - \beta }}}}\mathop{{\sup }}\limits_{{t \in {{{\hat{D}}}_{{{{a}_{n}}}}}}} \frac{{|{{f}_{n}}(t) - f(t)|}}{{f_{n}^{\beta }(t)}} - {{{\hat{A}}}_{n}}} \right)$$ converges in distribution to the double exponential law. Here \({{\hat{A}}_{n}}\) is constructed from the sample, a n → ∞ as a power of n and \({{\hat{D}}_{{{{a}_{n}}}}} = \{ t:{{f}_{n}}(t) \geqslant a_{n}^{{ - 1}}\}\). Thus, this result provides distribution free asymptotic confidence bands for densities on the real line.
Passive Steering of Miniature Walking Robot Using the Non-Uniformity of Robot Structure

This paper discusses the steering of a miniature, vibratory walking robot taking advantage of the robot's structural non-uniformity. Non-uniformity from fabrication and assembly can be detrimental to performance of miniature robots, but its potential for modifying robot locomotion is discussed in this work. A 3-centimeter-wide piezoelectric robot is described for the study of steering opportunities. This includes turning behavior that occurs away from resonance due to leg asymmetries and shuffling behavior caused by lateral motion of the actuators. Finite Element Analysis and beam theory are used to explain the resonances of the designed structure. The parameter variances are studied and experimentally validated, to illustrate the variability of locomotion effects emerging across the robot legs. Further explanation of the robot dynamics helps to determine possible mechanisms for steering, with rotational turning motion around resonance explainable with a previous dynamic model, and some candidate explanations for shuffling examined. The motion of the robot is recorded within the frequency range of 1.2 to 4.6 kHz, within which both turning and shuffling are observed in addition to longitudinal motion.
The Effects of Strontium Addition on the Microstructures and Mechanical Properties of Al-7Si Alloy Reinforced with In Situ Al 3 Ti Particulates

Al3Ti particulates (5 vol%) were produced in situ via aluminum-K2TiF6 reactions in an Al-7Si alloy. The effects of strontium (Sr) addition (200 ppm) on the microstructure and mechanical properties were studied. In addition to the modification on the morphology of eutectic Si, Sr addition resulted in the reduction of Al3Ti particulate sizes. As a result, the yield strength, tensile strength and ductility of composites with Sr addition are simultaneous improved compared to composites without Sr addition for both as-cast and T6 states. The enhanced mechanical properties are attributed to the small-sized Al3Ti particulates and a refined microstructure.
THE PROGNOSTIC ROLE OF VENTRICULAR-ARTERIAL COUPLING IN TRANSCATHETER AORTIC VALVE REPLACEMENT: THE IMPACT OF PULMONARY ARTERIAL PROPORTIONAL PULSE PRESSURE

In severe aortic stenosis, chronic LV pressure overload can be transmitted to the pulmonary vascular bed, resulting in increased RV afterload and RV failure. We assessed the role of the pulmonary arterial proportional pulse pressure (PAPPP), a novel hemodynamic index of right ventricular-arterial
Surfactant-induced spreading of nanoparticles is inhibited on mucus mimetic surfaces that model native lung conditions

We investigated the ability of surfactant-induced spreading to promote nanoparticle distribution on model mucus hydrogels. The hydrogels were formulated with viscoelastic properties and surface tensions that match those of native lung mucus. Nanoparticle-containing droplets with or without surfactant were deposited on the mucus surface and spreading patterns were monitored by time-course fluorescence imaging. Overall, surfactant-induced spreading of nanoparticles required an appropriate balance between Marangoni forces and viscoelastic subphase resistance. Spreading was enhanced on bare gels by increasing the concentration of surfactant in the droplets or reducing the viscoelastic properties of the subphase. However, with a pre-existing film of pulmonary surfactant on the mucus surface, spreading was dramatically inhibited as the surface tension gradient between the droplets and the surrounding subphase decreased. A complete lack of spreading was observed at surface tensions that matched those in the tracheobronchial region of the lungs, even with full-concentration Infasurf. These studies demonstrate that the magnitude of spreading on lung mucus-like surfaces is limited by native mucosal properties.
Increasing Accuracy of Iterative Refinement in Limited Floating-Point Arithmetic on Half-Precision Accelerators

The emergence of deep learning as a leading computational workload for machine learning tasks on large-scale cloud infrastructure installations has led to plethora of accelerator hardware releases. However, the reduced precision and range of the floating-point numbers on these new platforms makes it a non-trivial task to leverage these unprecedented advances in computational power for numerical linear algebra operations that come with a guarantee of robust error bounds. In order to address these concerns, we present a number of strategies that can be used to increase the accuracy of limited-precision iterative refinement. By limited precision, we mean 16-bit floating-point formats implemented in modern hardware accelerators and are not necessarily compliant with the IEEE half-precision specification. We include the explanation of a broader context and connections to established IEEE floating-point standards and existing high-performance computing (HPC) benchmarks. We also present a new formulation of LU factorization that we call signed square root LU which produces more numerically balanced L and U factors which directly address the problems of limited range of the low-precision storage formats. The experimental results indicate that it is possible to recover substantial amounts of the accuracy in the system solution that would otherwise be lost. Previously, this could only be achieved by using iterative refinement based on single-precision floating-point arithmetic. The discussion will also explore the numerical stability issues that are important for robust linear solvers on these new hardware platforms.
Stochastic Home Energy Management Systems with Varying Controllable Resources

This paper studies the performance of a model predictive control (MPC) algorithm in a home energy management system (HEMS) as the set of controllable resources varies and under both a constant and a time-of-use (TOU) electricity price structure. The set of controllable resources includes residentially-owned photovoltaic (PV) panels, a home battery system (HBS), an electric vehicle (EV), and a home heating, ventilation, and air conditioning (HVAC) system. The HEMS optimally schedules the set of controllable resources given user preferences such as indoor thermal comfort and electricity cost sensitivity. The home energy management system is built on a chance constrained, MPC-based algorithm, where the chance constraint ensures the indoor thermal comfort is satisfied with a high probability given uncertainty in the outdoor temperature and solar irradiance forecasts. Simulation results for varying sets of controllable resources under two different electricity price structures demonstrate the variation in the HEMS control with respect to HBS operation, electricity cost, and grid power usage.
"A Dream to Go Abroad": Undocumented Student Participation in Education Abroad.

This phenomenological study examined the lived experiences of eight undocumented students who successfully studied abroad between 2012 and 2016. In-depth interviews of students at a public research...
Inferior pedicle breast reduction and long nipple-to-inframammary fold distance: How long is safe?

Abstract Background Free nipple grafting indications in breast reduction surgery are outdated. Safety of inferior pedicle technique for large resections and long pedicles has not been clearly defined. We evaluated patients who underwent inferior pedicle reduction mammoplasty to define the safety constraints of the inferior pedicle. Methods A retrospective review of patients who underwent inferior pedicle reduction mammoplasty due to symptomatic macromastia at Mayo Clinic over a six-year period was conducted. Patients with prior breast surgeries were excluded. Demographics, breast measurements, and surgical outcomes were collected. Univariate and multivariate analyses were performed to assess for predictors of necrosis. Results Overall, 288 patients (576 breasts) underwent inferior pedicle breast reduction from 2014 to 2019. The mean sternal notch-to-nipple (SN N) distance was 31.5 cm (standard deviation[SD]:4.2; range[r]:16–48), and the mean nipple-to-inframammary fold (N-IMF) distance was 14.8 cm (SD:4.0; r:7.5–27). The mean resection weight was 699.6 g (SD:310.4; r:125–2,385). The median follow-up was 3.9 months (interquartile range[IQR]:2.8–9.0). The overall skin or nipple areolar complex necrosis rate was 2.1%; the overall complication rate was 14.8%. On multivariate analysis, overall necrosis was not found to be associated with the N-IMF distance (adjusted odds ratio[aOR]:1.05, 95%-CI 0.88–1.16). Resection weight was statistically associated with an increased risk of overall necrosis (aOR:1.003, 95%-CI 1.001–1.005), adjusting for N-IMF and SN N distances. Conclusion Inferior pedicle breast reduction offers low risk of necrosis and can be safely performed in patients regardless of the N-IMF distance. No association was found between N-IMF distance and overall necrosis in our cohort, including lengths >15 cm. However, large resections could increase the risk of necrosis.
Google Trends Data of Radiologists Who Accept Medicare: A Potential Tool for Predicting State Demand.

Abstract Purpose To identify and analyze the demand for radiologists who accept Medicare per state from 2004 to 2009, as reflected by volume of Google searches, and to place such demand in context with other available data by state. Methods The number of radiologists who accept Medicare by state was divided by each state's population to achieve the radiologist density per 10,000 residents. Relative search volume (RSV) for the term “radiologist” was collected from Google Trends from 2004 to 2009. The Radiologist Demand Index (RDI) for each state was then calculated by dividing each state's RSV by the radiologist density for that state. To standardize values, each state's RDI was divided by the largest RDI to generate the Relative Radiologist Demand Index (RRDI). Utilization of medical imaging per 1000 Medicare beneficiaries in each state, overall health of a population in each state, and percentage of the population enrolled in Medicare in each state were used to compare trends with the RRDI. Results West Virginia had the greatest curiosity about radiologists who accept Medicare (as represented by proportion of Google searches) (RSV=100), followed by Mississippi (RSV=95), and Arkansas (RSV=87). Oregon demonstrated the lowest level of curiosity about radiologists who accept Medicare, by having the lowest proportion of google searches (RSV=43), followed by Vermont (RSV=49), California (RSV=50), and Colorado (RSV=50). The highest radiologist densities per population were found in Montana, D.C., and Wyoming (3.25, 1.56, 1.11, respectively). The lowest radiologist densities were found in Oklahoma, Texas, and Utah (0.4, 0.4, 0.41, 0.41, respectively). The RRDI was greatest in Louisiana (100), Arkansas (94.8), and Texas (86.3), and smallest in Montana (10.6), D.C. (17.7) and Wyoming (28.4). Positive trends between utilization of medical imaging per 1000 Medicare beneficiaries and state overall health and the RRDI were recognized. No trend between each state's RRDI and percentage of population enrolled in Medicare was noted. Conclusion Imaging studies performed, an indirect measure of demand, showed trends with RRDI. Higher RRDI and imaging per 1000 Medicare beneficiaries trended with lower health scores for a state's general population. RRDI may be a useful tool reflecting each state's demand for radiologist who accepts Medicare.
Bee (Apoidea) community response to perennial grass treatments managed for livestock production and conservation

Abstract Most grasslands world-wide have been converted into various row crops for agriculture and pasture for livestock foraging. This conversion has likely disrupted arthropod communities, including pollinating bee communities. Pollinating native bees have been in decline in recent decades and much of this decline has been attributed to intensive agricultural practices. Native warm-season grasses have been promoted as alternatives to non-native grasses [e.g., bermudagrass (Cynodon dactylon)] in beef production systems. Reestablishing native grasses may provide an opportunity for land-sharing where agricultural production can enable conservation practices that potentially enhance bee biodiversity. Therefore, agricultural practices such as growing native perennial grasses for livestock forage that may minimize pollinating bee community disruption should be considered. We used colored pan traps to collect bees in four treatments of perennial grass plantings associated with operational livestock pastures during 2011−2012. The four treatments were: (1) mix of Bermuda and tall fescue (Schedonorus arundinaceus) grass grazed with cattle; (2) monocultures of Indiangrass (Sorghastrum nutans) grazed with cattle; (3) native grass polyculture [(Indiangrass, little bluestem (Schizachyrium scoparium), and big bluestem (Andropogon gerardii)] grazed with cattle; and (4) native grass polyculture without cattle. We generally documented greater abundances and richness of bees in native grass treatments compared to exotic grass treatments; however, treatment-level differences were bee genera- or species-dependent. Lack of grazing in the native grass mixture treatment did result in higher bee abundance and taxa richness compared to the native grass mixture treatment with cattle. Our results support the conception that perennial native grasses have the potential to attract numerous, beneficial bee species and may provide some pollen rewards and suitable nesting substrate for bees. Therefore, using native perennial grasses as livestock forage may be a more ecologically friendly surrogate to non-native forage used for livestock production to promote pollination services and native bee diversity in agricultural lands.
Congenital heart disease and neurodevelopmental evaluation: National guidelines vs. single center utilization

Abstract Background Children with congenital heart defects have a higher risk of acquiring developmental disabilities. Routine developmental evaluations throughout childhood increase the chances of identifying these deficits, prompting referral to Early Intervention services. Objectives We hypothesized that referral rates to Early Intervention and/or neurodevelopmental evaluation were low despite national guidelines. We also sought to investigate the relationship between type of congenital heart disease and results of neurodevelopmental evaluation. Methods A retrospective chart review was performed for congenital heart disease patients requiring cardiac surgery within their first year of life. Variables assessed included type of congenital heart disease, prenatal diagnosis, number of surgeries in the first year of life, and neurodevelopmental referral, evaluation, and quantitative assessment. Results 151 patients met inclusion criteria from 1/1/13 through 12/31/18. 64 (42%) were referred to neurodevelopmental services, of which 60 patients accessed services. Single ventricle patients had an increased rate of neurodevelopmental referral (88% vs 31, p Conclusions Only 42% of congenital heart disease patients were referred to neurodevelopmental services, despite known risks. Most congenital heart disease patients had low to average neurodevelopment scores. Excluding single ventricle patients, there was no difference between congenital heart disease type and neurodevelopmental outcomes. Single ventricle patients scored particularly low in cognition and gross motor. Ultimately, 67% of patients who underwent initial evaluation received additional Early Intervention services, demonstrating the significant importance of initial neurodevelopmental evaluation.
Livewired Neural Networks: Making Neurons That Fire Together Wire Together.

Until recently, artificial neural networks were typically designed with a fixed network structure. Here, I argue that network structure is highly relevant to function, and therefore neural networks should be livewired (Eagleman 2020): dynamically rewired to reflect relationships between higher order representations of the external environment identified by coincident activations in individual neurons. I discuss how this approach may enable such networks to build compositional world models that operate on symbols and that achieve few-shot learning, capabilities thought by many to be critical to human-level cognition. Here, I also 1) discuss how such livewired neural networks maximize the information the environment provides to a model, 2) explore evidence indicating that livewiring is implemented in the brain, guided by glial cells, 3) discuss how livewiring may give rise to the associative emergent behaviors of brains, and 4) suggest paths for future research using livewired networks to understand and create human-like reasoning.
Wandering Gastrostomy

Percutaneous endoscopic gastrostomy (PEG) is a relatively safe and effective method of providing nutrition to patients with neurologic deficits or proximal gastrointestinal pathology. Complications that follow this common procedure include dislodgement, dysfunction, infection, gastric/colonic perforation, bleeding, peritonitis, or death. The emergency physician should be aware of the complications and symptoms/signs associated for appropriate management of these patients. We present a case of a young lady who developed a cerebral infarction following amniotic fluid embolism during her cesarean section and had undergone a PEG tube placement. She developed displacement of this PEG tube and underwent another PEG tube placement. She later presented to us with PEG tube migration into the transverse colon and required surgical removal of the same PEG tube.
Etta and Dan: Seeking the Prelude to a Transformative Journey

This article focuses on the complex and inspiring relationship depicted by Gerald Lopez in Rebellious Lawyering between Dan, a young lawyer, and his mentor, Etta, a community organizer (lay lawyer). Dan’s journal entries show us one model of rebellious lawyering (and living), a quiet rebellion, in which he identifies and includes his feelings, recognizes and challenges assumptions and biases, redefines productivity and success, and embraces vulnerability and uncomfortable risks. This article poses the question of what role legal pedagogy might play in creating, sustaining or preserving Dan’s rebellious core and leading him, and other students, to mentors like Etta. It uses Dan’s experience to formulate both an internal path to rebellion, in which legal educators teach rebelliously by modeling Dan’s vulnerabilities, as well as his strengths, and an external path involving teachers ceding their position at the front of the classroom to organizers and other lay lawyers. The article concludes by proposing greater inclusion of, and support for, organizing and activism in law schools and considers the incorporation of integrative medicine into the traditional, western medical curriculum as one potential model for challenging entrenched notions of authority and values about what is worth teaching and who is a teacher.
The CD8 T Cell in Multiple Sclerosis: Suppressor Cell Or Mediator of Neuropathology?

Multiple sclerosis (MS) is the most common human demyelinating disease of the central nervous system. It is universally accepted that the immune system plays a major role in the pathogenesis of MS. For decades, CD4 T cells have been considered the predominant mediator of neuropathology in MS. This perception was largely due to the similarity between MS and CD4 T-cell-driven experimental allergic encephalomyelitis, the most commonly studied murine model of MS. Over the last decade, several new observations in MS research imply an emerging role for CD8 T cells in neuropathogenesis. In certain experimental autoimmune encephalomyelitis (EAE) models, CD8 T cells are considered suppressors of pathology, whereas in other EAE models, neuropathology can be exacerbated by adoptive transfer of CD8 T cells. Studies using the Theiler's murine encephalomyelitis virus (TMEV) model have demonstrated preservation of motor function and axonal integrity in animals deficient in CD8 T cells or their effector molecules. CD8 T cells have also been demonstrated to be important regulators of blood-brain barrier permeability. There is also an emerging role for CD8 T cells in human MS. Human genetic studies reveal an important role for HLA class I molecules in MS susceptibility. In addition, neuropathologic studies demonstrate that CD8 T cells are the most numerous inflammatory infiltrate in MS lesions at all stages of lesion development. CD8 T cells are also capable of damaging neurons and axons in vitro. In this chapter, we discuss the neuropathologic, genetic, and experimental evidence for a critical role of CD8 T cells in the pathogenesis of MS and its most frequently studied animal models. We also highlight important new avenues for future research.
The “I” of the Camera: Hollywood Reconsidered: Reflections on the Classical American Cinema

America's experience of film is virtually unique in that in almost every other country, the impact of film cannot be separated from the process or at least the specter of Americanization. In America, film in no sense represents something external; it is simply American. But what is American about American film? For a decade or so after the first film exhibitions in 1895, film shows presented a grab bag of travelogues, news films, filmed vaudeville acts, trick films, and gag films. The audience for film in America was disproportionately urban and was made up of recent immigrants, largely from Eastern Europe. (The extent to which that was true is a subject of some contention among film historians.) In a sense, film has been involved, even in America, in a process of Americanization – “naturalizing” recent arrivals, teaching them how Americans live (and also breaking down regional differences, a process that television has taken over with a vengeance). However, following the sudden growth of nickelodeons in 1908, exhibitions were skewed to be more “upscale.” The theatrical narrative – especially adaptations of “legitimate” novels and stage plays – became the dominant form of film in America, as it has remained to this day. Griffith's early films made for the Biograph Company were clearly intended for an audience of Americans who, like Griffith himself, could take for granted the fact, if not the meaning, of their Americanness.
Distributed synaptic modification in neural networks induced by patterned stimulation

Activity-dependent changes in synaptic efficacy or connectivity are critical for the development, signal processing and learning and memory functions of the nervous system. Repetitive correlated spiking of pre- and postsynaptic neurons can induce a persistent increase or decrease in synaptic strength, depending on the timing of the pre- and postsynaptic excitation. Previous studies on such synaptic modifications have focused on synapses made by the stimulated neuron. Here we examine, in networks of cultured hippocampal neurons, whether and how localized stimulation can modify synapses that are remote from the stimulated neuron. We found that repetitive paired-pulse stimulation of a single neuron for brief periods induces persistent strengthening or weakening of specific polysynaptic pathways in a manner that depends on the interpulse interval. These changes can be accounted for by correlated pre- and postsynaptic excitation at distant synaptic sites, resulting from different transmission delays along separate pathways. Thus, through such a 'delay-line' mechanism, temporal information coded in the timing of individual spikes can be converted into and stored as spatially distributed patterns of persistent synaptic modifications in a neural network.
Association of risk factors with unfavorable outcomes after resection of adult benign intradural spine tumors and the effect of hospital volume on outcomes: an analysis of 18, 297 patients across 774 US hospitals using the National Inpatient Sample (2002-2011).

OBJECT Because of the limited data available regarding the associations between risk factors and the effect of hospital case volume on outcomes after resection of intradural spine tumors, the authors attempted to identify these associations by using a large population-based database. METHODS Using the National Inpatient Sample database, the authors performed a retrospective cohort study that involved patients who underwent surgery for an intradural spinal tumor between 2002 and 2011. Using national estimates, they identified associations of patient demographics, medical comorbidities, and hospital characteristics with inpatient postoperative outcomes. In addition, the effect of hospital volume on unfavorable outcomes was investigated. Hospitals that performed fewer than 14 resections in adult patients with an intradural spine tumor between 2002 and 2011 were labeled as low-volume centers, whereas those that performed 14 or more operations in that period were classified as high-volume centers (HVCs). These...
Exponential Tightness and Projective Systems in Large Deviation Theory

Let {E α ,p α β } be a projective system of Hausdorff topological spaces; here α,β∈A, a directed set, and p α β :E β →E α is a continuous surjective map for α<β (for details, see Section 3). Let E be a Hausdorff topological space endowed with a σ-algebra,e (possibly smaller than the Borel σ-algebra), and for each α∈A, let p α :E→E α be a continuous measurable surjective map such that p α =p α β 0p β for a α<β Let {µn}be a sequence of probability measures on e,and assume that for each a α∈ A,the sequence {µn o p α -1 } satisfies the large deviation principle (see Section 2). In this paper we show that under suitable additional assumptions, the large deviation principle for {µn} follows.
Enzymatic Conversion of Vitamin B12s to a Cobamide Coenzyme, α-(5,6-Dimethylbenzimidazolyl)deoxyadenosylcobamide (Adenosyl-B12)

Abstract 1. Clostridium tetanomorphum contains an enzyme, "adenosylating enzyme," that converts B12s (a reduced form of vitamin B12 in which the cobalt atom is in the +1 oxidation state) to the cobamide coenzyme, adenosyl-B12 (B12s + adenosine triphosphate → adenosyl-B12 + tripolyphosphate). 2. The enzyme has been purified approximately 300-fold, with an over-all recovery of about 40% by treatment of sonically disrupted cells with protamine, followed by selective heat denaturation and chromatography on diethylaminoethyl cellulose. The purified enzyme is free from B12a reductase and glutamate mutase. 3. The pH optimum for the enzyme is 8.0. Michaelis constants for B12s and ATP are 1.0 and 1.6 x 10-5 m, respectively. B12s cannot be replaced by B12r or B12a (forms of B12 in which the oxidation state of cobalt is +2 and +3, respectively). ATP can be replaced by cytidine triphosphate and, to a lesser degree, by the triphosphates of uridine, guanosine, and inosine. Mn++ is required as divalent cation; Co++ and Mg++ are less effective. 4. With the purified enzyme the forward reaction can be demonstrated spectrophotometrically by means of the increase in absorbance at 525 mµ as B12s is converted to adenosyl-B12. No evidence could be obtained for reversal of the reaction.
Thresholded rewards: acting optimally in timed, zero-sum games

In timed, zero-sum games, the goal is to maximize the probability of winning, which is not necessarily the same as maximizing our expected reward. We consider cumulative intermediate reward to be the difference between our score and our opponent's score; the "true" reward of a win, loss, or tie is determined at the end of a game by applying a threshold function to the cumulative intermediate reward. We introduce thresholded-rewards problems to capture this dependency of the final reward outcome on the cumulative intermediate reward. Thresholded-rewards problems reflect different real-world stochastic planning domains, especially zero-sum games, in which time and score need to be considered. We investigate the application of thresholded rewards to finite-horizon Markov Decision Processes (MDPs). In general, the optimal policy for a thresholded-rewards MDP will be non-stationary, depending on the number of time steps remaining and the cumulative intermediate reward. We introduce an efficient value iteration algorithm that solves thresholded-rewards MDPs exactly, but with running time quadratic on the number of states in the MDP and the length of the time horizon. We investigate a number of heuristic-based techniques that efficiently find approximate solutions for MDPs with large state spaces or long time horizons.
Exploring the Mental Life and Home Life of Children: The Role of a Television History.

Background: Media entertainment is a pervasive presence in the lives of our children. It presents a series of stories that a child can select as important or intriguing to him or her. Method: A good history of television and media viewing uses this omnipresent influence in a child’s life to attempt to gain insight into the child’s hopes and fears as well as information concerning the structure of the home. Conclusion: It is a useful exercise that could be done with each new child patient, and could provide a quick means to assess the child’s thoughts as well as assessing the child’s home environment.
Effect of a Prophylactic Brace on Wrist and Ulnocarpal Joint Biomechanics in a Cadaveric Model

BackgroundWrist pain from repetitive dorsiflexion and compression during pommel horse exercises is common among male gymnasts.PurposeTo determine the biomechanical effects of a prophylactic wrist brace on the wrist and ulnocarpal joints during mechanical loading in a cadaveric model.HypothesisThe lateral wedge of the palmar pad of the brace will compensate for positive ulnar variance, distributing contact forces more evenly across the radioulnar carpal joint.Study DesignControlled laboratory study.MethodsSix male and six female fixed cadaveric forearm-wrist specimens were subjected to a 32.13-kg compressive load applied through the long axis of the pronated forearm with a dorsiflexed wrist in contact with a support surface. Wrist joint dorsiflexion angle and ulnocarpal joint intraarticular peak pressure were assessed under three brace conditions: Ezy ProBrace with and without palmar pad and a nonbraced control.ResultsWrist joint dorsiflexion angle was significantly reduced by the Ezy ProBrace with and wit...
Chronic pain after hip and knee replacement

Chronic pain after hip and knee replacement is a prevalent and overlooked issue to be addressed in the health care industry. Patients seek out joint replacements to relieve their chronic pain and restore their functional activities because of arthritis and injury. The intensity and duration of postsurgical pain vary, but with uncomplicated wound healing, the pain typically shows progressive attenuation. Chronic pain after surgery occurs after the normal time for tissue to heal and can be detrimental for the patient. It is possible that certain nerve damage or irritation during surgery plays a role in development of persistent pain after joint replacement. The nature and properties of persistent postsurgical pain are poorly characterized. Risk factors for persistent postsurgical pain after these surgeries are vast and inclusive of preoperative, intraoperative, and postoperative factors in relation to pain catastrophizing, surgical approach, nerve injury, and acute pain management. Pain catastrophizing is conceptualized as a negative cognitive–affective response to anticipated or actual pain and has been associated with many important pain-related outcomes. The majority of the times the views of medical and surgical interventions differ from the surgeons and the patients, especially in respect to the assessment of function and pain. Patient-reported outcome tools and assessment of satisfaction are included to ensure the patient's perception of the end results is included in the evaluation of total knee replacement.
Likelihood ratio tests for a mixture of two von Mises distributions.

SUMMARY. It is proposed that the orientation of elongate objects, such as bones, may be used to identify the flow direction of ancient river deposits. If true, elongate objects could be of great value when ancient bedforms such as ripples and dunes are not visible. Two sandstone quarries were investigated wherein the paleoflow direction was determined from both bedforms and elongate dinosaur bones. A mixture of two von Mises distributions captures the observation that elongate bones transported under unidirectional flow conditions will align both parallel and perpendicular to the flow direction. Likelihood ratio tests for a mixture of two von Mises distributions are given. The power of these tests is investigated by simulation since the direction of dinosaur bones agrees with the primary bedforms if the hypothesis test comparing the dominant mean direction of the bones to the paleoflow direction fails to reject. The likelihood ratio test on the dominant mean direction has reasonable power. If the two mean directions in the mixture distribution are ir apart, a more powerful likelihood ratio test can be used. The likelihood ratio test on the hypothesis that the two mean directions are exactly ir apart is useful in determining if the assumptions of the more powerful test are satisfied.