cssi/SciSciGPT-SciSciNet huggingface dataset:
Treatment of hepatocellular carcinoma: too many options?

PURPOSEThis study attempts to review the therapeutic interventions being used to treat patients with hepatocellular carcinoma (HCC).DESIGNAn English language literature search, including abstracts and original articles, and a review of the bibliographies of such articles, was conducted.RESULTSSurgery is possible in few patients and curative in only a small percentage. Conventional chemotherapy is ineffective in HCC. Modifications of chemotherapy, including intraarterial infusion, chemoembolization, lipiodol, styrene-maleic acid-neocarzinostatin (SMANCS), and isolated hepatic perfusion, have led to improved tumor responses, but have not materially affected patient outcome. Radioimmunotherapy and conformal radiotherapy have had no more than a marginal impact on patient outcome. Surgical innovations such as cryosurgery and percutaneous alcohol injection have not yet been shown to offer any advantage, and liver transplantation, while curative in some patients, requires an enormous expenditure of resources to ...
Acquiring engineering knowledge from design processes

Knowledge management has recently become the focus of public attention in business and engineering. Because knowledge acquisition is situated in the upstream of knowledge management, capturing knowledge is an important step for enterprises to achieve successful knowledge management. We focus on how engineers solve their design problems under given design contexts and propose a novel model and methods to capture knowledge from engineering design processes. Our goal is to acquire know-how knowledge without disrupting the normal design process. A three-layer design process model is introduced to represent generic design processes, and a grammar and extended dynamic programming (GEDP) method is developed based on the process model. GEDP adopts the grammar approach and EDP to automatically identify meaningful clusters, called operations, from primitive design events. Our approach is evaluated through a case study of designing a double-reduction gear system.
Optimal intra-cell cooperation in the heterogeneous relay networks

Heterogeneous wireless networks have emerged as a new paradigm to meet the fast increasing wireless capacity and coverage demands. Cooperative communication is a promising technique to further improve the cell edge performance for future communication systems by allowing nodes in a communication network to collaborate with each other in information transmission. This paper presents an optimal intra-cell cooperative transmission in a relay based heterogeneous networks to best address both capacity and coverage demands. We first formulate the optimization problem to maximize the time averaged log-scale throughput. The Lagrange dual function is then derived for the proposed optimization problem, from which we use gradient descent method to search the optimal intra-cell cooperative transmission solution. Simulation results show that the optimal cooperative transmission can greatly improve the log-scale throughput in the heterogeneous networks with relays.
Design fault directed test generation for microprocessor validation

Functional validation of modern microprocessors is an important and complex problem. One of the problems in functional validation is the generation of test cases that has higher potential to find faults in the design. We propose a model based test generation framework that generates tests for design fault classes inspired from software validation. There are two main contributions in this paper. Firstly, we propose a microprocessor modeling and test generation framework that generates test suites to satisfy Modified Condition Decision Coverage (MCDC), a structural coverage metric that detects most of the classified design faults as well as the remaining faults not covered by MCDC. Secondly, we show that there exists good correlation between types of design faults proposed by software validation and the errors/bugs reported in case studies on microprocessor validation. We demonstrate the framework by modeling and generating tests for the microarchitecture of VESPA, a 32-bit microprocessor. In the results section, we show that the tests generated using our framework's coverage directed approach detects the fault classes with 100% coverage, when compared to model-random test generation.
A statistical method for efficient segmentation of MR imagery

Magnetic resonance imaging (MRI) has become a widely used research and clinical tool in the study of the human brain. The ability to robustly and accurately quantify repeatable morphological measures from such data is aided by the ability to accurately segment the MRI data set into homogeneous regions such as gray matter, white matter, and cerebro spinal fluid. The large amount of data associated with typical MRI scans makes completely manual segmentation prohibitive on a large scale. In this paper an efficient approach to the segmentation of such MR imagery is presented. The approach uses an estimation-theoretic interpretation of the segmentation problem to develop a computationally efficient, statistically-based recursive technique for its solution. Being statistically based, the method also provides associated measures of uncertainty of the resulting estimates, which are extremely important both for evaluation of the estimates as well as their combination with other sources of information.
Prognosis after syncope: impact of left ventricular function.

Abstract A cardiac cause of syncope has been associated with increased sudden death risk, whereas unexplained syncope has a benign prognosis. However, in patients who have depressed left ventricular function, the accuracy of diagnostic tests and the efficacy of therapy, such as antiarrhythmic drugs, are reduced. Previous studies of patients with syncope have not evaluated the contribution of left ventricular performance in risk stratification for sudden death. The purpose of our study of a large population of patients with syncope was to determine the impact of left ventricular dysfunction on sudden death risk if syncope is caused by a cardiac cause or remains unexplained after electrophysiologic testing. We retrospectively evaluated the relationship of left ventricular ejection fraction to sudden death prognosis in 88 consecutive patients referred for electrophysiologic testing to determine a cause of syncope. The mean age was 57 ± 18 years, left ventricular ejection fraction was 0.41 ± 0.20, and 66 patients (75%) had structural heart disease. In 49 patients (56%) a cardiac cause of syncope was diagnosed, and in 39 patients (44%) the cause of syncope remained unexplained after evaluation. Cardiac syncope was attributed to ventricular tachycardia in 27 patients, bradyarrhythmia in 11 patients, and supraventricular tachyarrhythmia in 11 patients. By logistic regression only structural heart disease was independently associated with cardiac cause of syncope ( p = 0.003). After a mean follow-up of 790 ± 688 days, nine patients had died suddenly, eight (89%) of whom had left ventricular ejection fraction less than 0.30. In 51 patients who had left ventricular ejection fraction greater than 0.30, 3-year actuarial sudden death risk was similarly low for patients who had cardiac compared with unexplained causes of syncope (0 vs 8%, p = NS). In 47 patients who had ejection fraction less than 0.30, sudden death risk was substantial for both patients who had cardiac syncope (58%) and for those who had unexplained syncope (50%, p = NS). In the Cox multivariate analysis reduced left ventricular ejection fraction ( p
Depletion of neutrophils in a protective model of pulmonary cryptococcosis results in increased IL-17A production by gamma/delta T cells

Protective responses in mice immunized with an interferon-gamma producing strain of Cryptococcus neoformans, H99γ, are associated with IL-17A production by neutrophils. Neutrophil depletion in H99γ-immunized mice did not affect pulmonary fungal burden, indicating that neutrophils are not required for clearance. However, we observed an increase in IL-17A in the lungs of neutrophil-depleted H99γ infected mice, which corresponded to an increase in IL-17A+ γδ+ T cells. Moreover, we observed increased IL-17A+/ CD3+ cells and IL-17A+/γδ+ cells, but decreased IL-17A+/Ly6G+ neutrophils in the lungs of IL-17 receptor (R)A deficient mice compared to wild-type mice. Increased production of IL-17A in neutropenic mice coincided with increased IL-6 and CXCL1, but not Th17 inducing cytokines TGF-β, IL-21 and IL-23. Concurrent depletion of neutrophils and γδ+ T cells reduced IL-17A levels. Our results suggest that γδ+ T cells mediate significant IL-17A production in neutropenic mice during the protective response to C. neoformans infection.
Morphology and Acoustic Character of the Antarctic Wilkes Land Turbidite Systems: Ice-Sheet-Sourced Versus River-Sourced Fans

The Wilkes Land continental slope contains an intricate network of submarine canyons that on the continental rise develop into a series of channel and overbank deposits of turbidite systems. We can define upper-fan, middle-fan, and lower-fan provinces. The Wilkes Land upper fans are characterized by large channels with relief up to 900 m, distances between levee crests up to 18 km, and channel-floor widths up to 6 km. Middle-fan channels also have high relief (∼300 m), and locally, interchannel areas exhibit mounded contourite-style deposits with high relief (up to 490 m). Within middle-fan sediment mounds there are acoustic facies of channel-overbank deposits from turbidity currents, and of sediment waves from contour-current sedimentation. The lower rise is characterized by small, shallow channels (50-75 m relief) and by interchannel areas of low relief, both characteristic of a lower-fan environment. The Wilkes Land turbidite systems show the following significant morphological differences compared to most river-sourced fans: (1) multiple large tributary channels across the upper and middle fan, (2) channel relief several times greater (900 m) than typical relief (100-200 m) for channels on fans less than 300 km in diameter, and (3) steep middle-fan and lower-fan gradients. We interpret the differences in channel network patterns, channel size, and middle-fan and lower-fan gradients between the Wilkes Land fans and other fans to result from the continental ice sheet feeding glacial ice streams that reached the outer continental shelf at times of glacial maxima. The Wilkes Land canyon-channel network patterns are comparable with the high-latitude Laurentian Fan and Labrador Sea channels. The Laurentian Fan also has large upper-fan channels with larger relief (800 m) than typical relief (200-300 m) expected for fans that are 600 km in diameter. Both the Labrador Sea and Laurentian Fan are fed by continental ice sheets at the shelf edge.
Evidence that the Axis Comprised of TSP1-TGFβ-CTGF Plays a Major Role In the Pathophysiology of Diabetic Retinopathy:Regulatory Role Of IL-4 and IL-13

Introduction Diabetic retinopathy is the most severe of several ocular complications of diabetes. Diabetes afflicts approximately 6% of the US population, thus retinopathy remains an important problem (PMID: 14702427). Our laboratory has provided evidence of the significant role of a pro-inflammatory axis during chronic inflammation (PMID: 19485899). The axis is comprised of TSP1-TGFβ-CTGF. We now provide evidence of an additional player within the axis, namely IL-4. A series of biochemical measurements were used to assess the role of the above mentioned axis in the progression of disease, from non-proliferative diabetic retinopathy (NPDR) to proliferative diabetic retinopathy (PDR). Methods Institutionally approved IRB and informed consent allowed this prospective study to recruit a total of 40 individuals from a vulnerable population disproportionately afflicted by this disease and representative of the population that we served in North Philadelphia with type-2 diabetes. Western-blotting technique was utilized to document the presence of fragments from CTGF in plasma, which have been shown in vitreous fluid to be angiogenic (PMID: 14988298). Multiplexed protein profiling on microarrays by rolling-circle amplification was employed to determine IL-4, IL-13, and MIP-1β levels. Commercially available ELISA was the method to determine the plasma concentration of TSP1, TGFβ and CTGF. Results and Discussion TSP1 (p<0.002), TGFβ (p<0.001), CTGF (p<0.05), IL4 (p<0.0002), MIP-1β (p<0.05) but not IL-13 were found significantly elevated in NPDR patients when compared to PDR patients or control group. Fragments of CTGF were more abundant in patients with PDR when compared to NPDR or the control group. Interestingly, the systemic plasma circulation of CTGF during the NPDR phase (elevated) may explain the subsequent vitreous accumulation of CTGF fragments described in the literature during the PDR phase apparently with angiogenic and fibrotic properties. Furthermore, IL-4 regulates CTGF (PMID:11967989) by interfering with TGFβ-induced transcriptional activation of the CTGF gene (blocking 50% of the SMAD pathway). Thus, the elevated levels during the NPDR phase may be a protective response to prevent CTGF synthesis and secretion. The steady-state levels of IL-13 (normal control group) where significantly higher when compared to the NPDR or PDR group with a trend for higher levels of IL-13 in the NPDR group. IL-13 is anti-angiogenic and thus its progressive decrease as a function of length of disease is of interest. Mean H1ac levels were not significantly different in the NPDR patients (8.0 ± 3.5) when compared with PDR patients (8.3 ± 2.2). In summary, our data suggests that the pro-inflammatory axis described above, now including IL-4 and IL-13, overall, plays a major role in the pathophysiology of diabetic retinopathy. The mechanistic pathway is currently under investigation in our laboratory. Disclosures: No relevant conflicts of interest to declare.
Seeing Like a Nation: Nationalist Political Persuasion and Positioning in Shanghai and Bombay in the 1920s and 1930s

Nationalist movements are exercises in political persuasion. The content and direction of nationalist movements reflects the contingencies of the environment in which movement participants and their audiences find themselves. Nationalist identity and narratives, as many have noted, emerge through discursive practice, embedded and encoded in the habits, symbols, and “ways of talking” (Billig 1995) about a nation. Nationalist movements, like other social movements, can be understood in terms of how leaders frame issues and create symbols that connect with the everyday lives of their audiences.
The First Forty Years

OR 40 years, the JOURNAL OF MARKETING has played an integral role in the development of marketing as a discipline, a practice, a science. This article examines these four decades in terms of both the development of the JOURNAL itself and the developments in marketing as they have been reflected in its pages. In conclusion, some personal observations on the business-academic controversy and the importance of governmentmarketing relations are offered as clues to-and recommendations for-the future.
Mechanistic investigations of cooperative catalysis in the enantioselective fluorination of epoxides

This report describes mechanistic studies of the (salen)Co- and amine-cocatalyzed enantioselective ring opening of epoxides by fluoride. The kinetics of the reaction, as determined by in situ 19F NMR analysis, are characterized by apparent first-order dependence on (salen)Co. Substituent effects, nonlinear effects, and reactivity with a linked (salen)Co catalyst provide evidence for a rate-limiting, bimetallic ring-opening step. To account for these divergent data, we propose a mechanism wherein the active nucleophilic fluorine species is a cobalt fluoride that forms a resting-state dimer. Axial ligation of the amine cocatalyst to (salen)Co facilitates dimer dissociation and is the origin of the observed cooperativity. On the basis of these studies, we show that significant improvements in the rates, turnover numbers, and substrate scope of the fluoride ring-opening reactions can be realized through the use of a linked salen framework. Application of this catalyst system to a rapid (5 min) fluorination to...
Strategic Elements of Atsdr's Great Lakes Human Health Effects Research Program

The goal of the Agency for Toxic Substances and Disease Registry's (ATSDR) Great Lakes Human Health Effects Research Program is to identify at-risk populations and to prevent potential human health effects associated with exposure to chemical contaminants in the Great Lakes basin. While this research effort is mandated by the Great Lakes Critical Programs Act of 1990, it also represents a significant opportunity to define a broader model or strategy for other regional or systems-level studies of potential health effects in at-risk populations.This article describes the strategy developed by ATSDR for this purpose in the Great Lakes Basin, as well as the program's specific research objectives and current status. It also outlines the projected implications of this research effort for greater comprehension of the potential health effects of exposure to contaminants in the Great Lakes Basin.
Fibrinogen Baltimore I: polymerization defect associated with a gamma 292Gly----Val (GGC----GTC) mutation.

Fibrinogen Baltimore I is one of the very first congenital abnormal fibrinogens reported over several decades ago; however, the molecular defect of this dysfibrinogen has eluded identification. In fact, several reports misidentified the functional defect of Baltimore I, which has impaired fibrin monomer polymerization. Reversed-phase high- performance liquid chromatography analysis of lysyl endopeptidase digest of the purified Baltimore I gamma-chain showed an abnormal peptide not found in the co-existing normal gamma-chain of this heterozygote. Amino acid sequencing of this peptide indicated that gamma-chain Gly292 is replaced by valine. This observation was confirmed, and the genetic defect was determined by direct nucleotide sequencing of a polymerase chain reaction product containing codon gamma 292, which is mutated: GGC\---|-GTC. The molecular defect of Fibrinogen Baltimore I lies in a region of the gamma-chain required for fibrin polymerization, suggesting that the integrity of gamma Gly292 is critical for fibrin assembly.
Detection of carriers for factor IX (PTC) deficiency.

1. A new assay for factor IX (PTC) is described. 2. With the use of this assay, 11 of 14 obligatory carriers of factor IX deficiency were found to have subnormal factor IX activity. 3. One of these carriers has a mild hemorrhagic history.
RECENT DEVELOPMENTS IN STDS. I, BACTERIAL DISEASES

Bacterial pathogens account for a significant portion of the current STD epidemic in the United States. Gonorrhea, syphilis, and chancroid are especially rife in the nation's poverty pockets. Chlamydial infection, the most common bacterial STD, is prevalent at all socioeconomic levels. A recurrent theme in these diseases is coexisting infection, sometimes involving HIV.
Decision Making in Environments with Non‐Independent Dimensions

This paper tests whether the dimensions involved in preferential choice tasks are evaluated independently from one another. Common decision heuristics satisfy dimensional independence, and multi-strategy models that assume that decision makers use a repertoire of these heuristics predict that they are unable to represent and respond to dimensional dependencies in the decision environment. In contrast, some single-strategy models are able to violate dimensional independence, and subsequently adapt to environments that feature interacting dimensions. Across five experiments, this paper documents systematic violations of the assumption of dimensional independence. This suggests that decision makers are able to modify their behavior to respond to dimensional dependencies in their environment, and in turn those models that are unable to do this do not provide a full account of human strategy selection and behavior change. This paper ends with a discussion of ways in which some existing models can be modified to incorporate violations of dimensional independence. Copyright © 2016 John Wiley & Sons, Ltd.
Information Technology Applications in Quality Assurance and Quality Improvement, Part II

Many information technologies have been or could be applied to efforts to measure and improve health care quality. This article reviews the recent literature in medical informatics, quality assurance, and quality improvement to identify these and current, emerging, and potential technologies.
Estradiol does not affect spasms in the betamethasone‐NMDA rat model of infantile spasms

SummaryObjective This study attempted to validate the effects of neonatal estradiol in ameliorating the spasms in the prenatally betamethasone-primed N-methyl-d-aspartate (NMDA) model of infantile spasms in rats as shown previously in a mouse Arx gene knock-in expansion model of infantile spasms. Methods Neonatal rats prenatally exposed to betamethasone (on day 15 of pregnancy) were treated with subcutaneous 40 ng/g estradiol benzoate (EB) between postnatal days (P)3–P10 or P0–P5. A synthetic estrogen analogue, diethylstilbestrol, was used between P0 and P5 (2 μg per rat, s.c.). On P12, P13, and P15, the rats were subjected to NMDA-triggered spasms, and latency to onset and number of spasms were evaluated. Rats with EB on P3–P10 were tested after spasms in the open field, novel object recognition, and elevated plus maze to determine effects of treatment on behavior. Additional rats with P3–P10 or P0–P5 EB were investigated for γ-aminobutyric acid (GABA)ergic neurons (glutamate decarboxylase [GAD]67 expression) in the neocortex. As a positive control, a group of rats received either subcutaneous adrenocorticotropic hormone (ACTH) (2 × 0.3 mg/kg on P12 and 3 × 0.3 mg/kg on P13 and P14) or vehicle after the first episode of spasms on P12. Results Neither EB treatment nor diethylstilbestrol consistently affected expression of spasms in this model, although we found a significant increase in GAD67-immunopositive cells in the neocortex after P3–P10 and P0–P5 EB treatment, consistent with a study in mice. Behavioral tests showed increase in lateralization in male rats treated with P3–P10 EB, a behavioral trait usually associated with female sex. Diethylstilbestrol treatment in male rats resulted in arrested pubertal descent of testes. ACTH had robust effects in suppressing spasms. Significance Treatment of infantile spasms (IS) using neonatal EB may be justified in those cases of IS that present with detectable deficits in GABAergic neurons. In other types of IS, the efficacy of neonatal EB and its analogues is not supported.
Measurements of Cross-Correlations in a Two-Mode Dye Laser

The tendency of a homogeneously broadened two-mode laser, such as a dye ring laser, to switch spontaneously, and at random times between the two modes is now well established[1–6]. Although in the early years the phenomenon was attributed to spurious external disturbances, and can indeed be induced by such disturbances, it was later recognized that spontaneous quantum fluctuations in the laser must be expected to produce the same effect, even in the absence of any external disturbances. Since that time the switching phenomenon has been studied in a more quantitative manner[4–6]. We wish to report the first measurements of the cross-correlation between the two light intensities for a range of working points of the laser.
Episodic and Intermittent Ataxias

Publisher Summary This chapter describes several episodic ataxia syndromes and highlights the recent genetic discoveries that provide insight into the molecular mechanisms of these dramatic clinical disorders. Episodic ataxia type 1 (EA-1) is characterized by brief episodes of ataxia and interictal myokymia while episodic ataxia type 2 (EA-2) is manifested by longer episodes of ataxia with interictal nystagmus. Magnetic resonance imaging (MRI) often shows atrophy of the cerebellum, particularly the midline, with EA-2. The degree of atrophy with EA-2 is most prominent in patients with longstanding symptoms and signs. Non-specific paroxysmal slowing on electroencephalography (EEC) is reported with both EA-1 and EA-2. Continuous muscle rippling (myokymia) can be detected in patients with EA-1 and EA-2, particularly after provocation by limb ischemia. Repetitive duplets, triplets, or multiplets on EMG underlie the continuous muscle activity. At the present time, genetic testing for EA-1 and EA-2 is not available in clinical laboratories. Automated techniques are available to rapidly screen these genes for the known point mutations. Since emotional stress is often a trigger for attacks in patients with episodic ataxia syndromes, stress management techniques such as biofeedback and meditation can be helpful in controlling symptoms in some patients. Alcohol and caffeine should be avoided and regular modest exercise should be encouraged. Vigorous exercise often triggers attacks of the episodic ataxia. Fluid and food intake should be regularly distributed throughout the day and binges should be avoided.
Heavy Alcohol Drinking Associated Akathisia and Management with Quetiapine XR in Alcohol Dependent Patients

Heavy drinking contributes to involuntary body movements such as akathisia. Quetiapine has been shown to alleviate symptoms of akathisia; however, its efficacy in the alcohol dependent population is not well established. Thus, we aimed to identify efficacy of Quetiapine in treating akathisia in very heavy drinking alcohol dependent patients. 108 male and female heavy alcohol consuming study participants received 13 weeks of Quetiapine XR. Drinking history (Timeline Followback, TLFB), depression (Montgomery-Asberg Depression Rating Scale, MADRS), and movement (Barnes Akathisia Scale, BARS) measures were collected at baseline (0 W), week 6 (6 W), and week 12 (12 W). The role of drinking, symptoms of depression, and efficacy of Quetiapine for treating akathisia were assessed. In patients with no symptoms of depression (low MADRS), Quetiapine treatment decreased symptoms of akathisia. Patients with clinically significant depression (high MADRS) reported a significant increase in akathisia measures at 6 W which eventually decreased at 12 W to below baseline levels. The increase in akathisia at 6 W corresponded with a significant increase in the patients’ total drinks and heavy drinking pattern. Treatment with Quetiapine progressively lowered the occurrence of akathisia in alcohol dependent patients who do not show symptoms of depression. Quetiapine treatment lowered akathisia over time in heavy drinkers who had clinically significant symptoms of depression.
A seventh‐order numerical method for solving boundary value nonlinear ordinary differential equations

A numerical method for solving two-point boundary value problems associated with systems of first-order nonlinear ordinary differential equations is described. It needs three function evaluations for each sub-interval and is of order O(h7), where h is the space chop. Results of computational experiments comparing this method with other known methods are given.
Antifungal Prophylaxis (AFP) for Patients (Pts) with Acute Myelogenous Leukemia (AML) and High-Risk Myelodysplastic Syndrome (HR-MDS) Undergoing Intensive Chemotherapy: An Experience with 730 Pts.

Abstract 3102 Poster Board III-39 Despite the advances in the development of antifungal agents, invasive fungal infections (IFI) remain a significant threat to patients with hematologic malignancies. The importance of early intervention for patients at high-risk for IFI has been widely discussed in several publications; however, the question of whether an early intervention such as prophylaxis is better than empiric or pre-emptive treatment still remains unanswered. Antifungal prophylaxis continues to be routinely used at MDACC for AML and HR-MDS patients. An ideal AFP regimen should be effective, safe, and uncomplicated for the patients. In the search of this ideal regimen, we have explored several options, including different type of drugs and various delivery schedules. Hereby, we report our experience since September 1997 to August 2009 with 730 AML and HR-MDS patients who received AFP for intensive chemotherapy. Proven IFI were defined as per the EORTC criteria. The following regimens were studied: Amphotericin B Lipid Complex (ABLC): 2.5 mg/kg IV three times/week; Liposomal Amphotericin B (AMBI 3TIW): 3 mg/kg IV three times/week; Fluconazole 400 mg (tab) /d + Itraconazole:200 mg (caps) /d (F + I); IV Itraconazole (IV ITRA):200 mg BID X 2 d, then 200 mg IV/d; Caspofungin (CASPO):50 mg IV /d; Voriconazole (IV VORI):400 mg IV BID x 2 d, then 300 mg IV BID; Liposomal Amphotericin B (AMBI 9/W): 9 mg/kg IV once per week; and Voriconazole (PO VORI ): 400 mg BID PO x 1 day, followed by 200 mg PO BID. Patients received ABLC, IV ITRA, F+I, AMBI 3TIW and CASPO since day 1 of IC until IC response was assessed. Pt on IV VORI, AMBI 3TIW and PO VORI started AFP within 24 hours after the last dose of IC until IC response was assessed. There were no significant differences among the pts in the 8 regimens with regards to age, gender, diagnosis, cytogenetics, performance status, presence of no fungal infection at start IC and stayed in protected environment. Table 1 shows our results. Although none of the pts receiving Voriconazole (IV or PO) developed proven IFI, all comparisons of efficacy among the AFP regimens were not significant (p= 0.291). None of the patients on AMBI 3TIW and either VORI had mold infections. There was a significant difference in the number of side effects among the 8 groups (p = 0.03). CASPO and PO VORI were the less toxic regimens. In addition, PO VORI was significantly less toxic than IV VORI (p=0.031). We conclude that PO VORI is safe, efficacious and easy to administer to the patients for the prevention of IFI in pts with AML and HR-MDS undergoing IC. CASPO is a safe alternative. Disclosures No relevant conflicts of interest to declare.
Basic Postoperative Management of the Bariatric Patient

Maintenance of adequate caloric intake, progression of key milestones, and knowing what complications to consider for each specific procedure are critical in the postoperative management of bariatric patients. It is essential that all practitioners involved in the care of bariatric patients understand the various procedures and are familiar with postoperative issues. All patients need to be monitored closely in the postoperative period to minimize side effects while continuing to offer good weight loss results. The purpose of this chapter will be to highlight key issues in postoperative management of the various procedures and touch briefly on what complications should be considered during this period.
Hotspot Thermal Management via Thin-Film Evaporation—Part II: Modeling

We developed a unified semianalytical thermal–fluidic model for hotspot (HS) thermal management via thin-film evaporation from well-defined silicon micropillar wicks. The capillary pressure generated at a receding liquid meniscus is matched with the flow resistance of the micropillar wick to estimate the dryout heat flux. In addition to modeling the fluidic transport within the porous wick structure, the thermal transport was modeled by solving the 3-D heat diffusion equation. The model prediction for the capillary-limited dryout heat flux agrees within ±20% accuracy with our experiments for the range of heat fluxes reported in this paper. Our comprehensive thermal–fluidic model shows that ultrahigh heat fluxes in excess of 10 kW/cm2 can be dissipated from a $640 \times 620~\mu \text{m}^{2}$ HS area via thin-film evaporation from microstructured surfaces by carefully selecting the thickness and thermal conductivity of the substrate. Furthermore, our results show that there is a global optimum pillar diameter-to-spacing ratio for a given micropillar wick thickness and spreading radius that maximizes the capillary-limited dryout heat flux. The physical insights gained from this paper can be used to improve and optimize the design of wicking structures for extreme heat flux thermal management.
Modeling Gas Flow Dynamics in Metal–Organic Frameworks

Modeling fluid flow dynamics in metal organic frameworks (MOFs) is a required step toward understanding mechanisms of their activity as novel catalysts, sensors, and filtration materials. We adapted a lattice Boltzmann model, previously used for studying flow dynamics in meso- and microporous media, to the nanoscale dimensions of the MOF pores. Using this model, rapid screening of permeability of a large number of MOF structures, in different crystallographic directions, is possible. The method was illustrated here on the example of an anisotropic MOF, for which we calculated permeability values in different flow directions. This method can be generalized to a large class of MOFs and used to design MOFs with the desired gas flow permeabilities.
A database for assessment of effect of lossy compression on digital mammograms

With widespread use of screening digital mammography, efficient storage of the vast amounts of data has become a challenge. While lossless image compression causes no risk to the interpretation of the data, it does not allow for high compression rates. Lossy compression and the associated higher compression ratios are therefore more desirable. The U.S. Food and Drug Administration (FDA) currently interprets the Mammography Quality Standards Act as prohibiting lossy compression of digital mammograms for primary image interpretation, image retention, or transfer to the patient or her designated recipient. Previous work has used reader studies to determine proper usage criteria for evaluating lossy image compression in mammography, and utilized different measures and metrics to characterize medical image quality. The drawback of such studies is that they rely on a threshold on compression ratio as the fundamental criterion for preserving the quality of images. However, compression ratio is not a useful indicator of image quality. On the other hand, many objective image quality metrics (IQMs) have shown excellent performance for natural image content for consumer electronic applications. In this paper, we create a new synthetic mammogram database with several unique features. We compare and characterize the impact of image compression on several clinically relevant image attributes such as perceived contrast and mass appearance for different kinds of masses. We plan to use this database to develop a new objective IQM for measuring the quality of compressed mammographic images to help determine the allowed maximum compression for different kinds of breasts and masses in terms of visual and diagnostic quality.
The Interaction Between LACI and Heparin

Lipoprotein-associated coagulation inhibitor (LACI) is a multivalent protease inhibitor that directly inhibits factor Xa and, in a factor Xa dependent fashion, inhibits the factor VIIa/Tissue Factor (TF) catalytic complex (1). Its structure is unique: An acidic amino-terminal domain is followed by three tandem Kunitz-type protease inhibitor domains and a basic carboxyl-terminal region (Fig. 1) (2). The Kunitz-2 domain in LACI is needed for inhibition of factor Xa, while the Kunitz-1 domain is required for the inhibition of the factor VIIa in a factor Xa-LACI-factor VIIa/TF quaternary inhibitory complex (3). The function of the Kunitz-3 domain in LACI is not known. In human blood, LACI circulates predominantly in association with the plasma lipoproteins but it is also carried in platelets which release LACI following stimulation by thrombin (4, 5). A third pool of LACI is thought to be bound to glucosaminoglycans at the surface of the endothelium and is released into plasma following the infusion of heparin in vivo (6, 7).
Multiple Interactions between Media, Growth Factors and the Environment of Carrot Cultures: Effects on Growth and Morphogenesis

Carrot explants appropriately nourished and stimulated proliferate and yield cells which produce plantlets in great abundance; the cells so cultivated are, in fact, totipotent. In this respect, and as they give rise to embryoids, the cultured cells behave like zygotes. Significantly, certain stimuli that induce the growth of initially quiescent carrot cells are drawn from the environment of immature embryos, i.e., the liquid endosperm of coconut (cocos), an extract of immature grains of corn (Zea) or the fluid from the vesiculate embryo sac of fruits of horsechestnut (Aesculus). It is from such sources that evidence of balanced and partial growth promoting systems and of interactions between their component parts has been drawn. The superiority of the naturally balanced fluids over their defined, but still incomplete, experimental replacements has been stressed (Steward and Degani, 1969). In fact, in a variety of ways, the effectiveness of the environment of the ovule, which may bring one cell that can grow to maturity as an embryo plantlet, has to be recognized. This effectiveness is attributable to a combination of circumstances, of which the interactions here described are but a part. Since carrot cells may give rise to small proembryonic cell clusters that undergo embryogenesis, evidence accumulated that the course of their development could be modulated by controllable properties of the environment (Steward et al., 1970).
Professionalism in pediatric anesthesiology: Affirmation of a definition based on results of a nationally administered survey of pediatric anesthesiologists.

Background Previously published work established the need for a specialty-specific definition of professionalism in pediatric anesthesiology. That work established a composite definition consisting of 11 domains and their component "defining themes" for professionalism in pediatric anesthesiology. As a next step toward assessing generalizability of our single-center findings, we sought to gain input from a national sample of pediatric anesthesiologists. Aims The aim of this study was to establish the construct validity of our previously published multidimensional definition of professionalism in pediatric anesthesiology using a nationally representative sample of pediatric anesthesiologists. Methods A survey was distributed via snowball sampling to the leaders of every pediatric anesthesiology fellowship program and pediatric anesthesia department or clinical division in the United States. Survey items were designed to validate individual component themes in the working definition. For affirmed items, the respondent was asked to rate the importance of the item. Respondents were also invited to suggest novel themes to be included in the definition. Results A total of 216 pediatric anesthesiologists representing a variety of experience levels and practice settings responded to the survey. All 40 themes were strongly supported by the respondents, with the least supported theme receiving 71.6% approval. 92.8% of respondents indicated that the 11 domains previously identified formed a comprehensive list of domains for professionalism in pediatric anesthesiology. Four additional novel themes were suggested by respondents, including wellness/self-care/burnout prevention, political advocacy, justice within a practice organization, and respect for leadership/experienced partners. These are topics for future study. The survey responses also indicated a near-universal agreement that didactic lectures would be ineffective for teaching professionalism. Conclusion This national survey of pediatric anesthesiologists serves to confirm the construct validity of our prior working definition of professionalism in pediatric anesthesiology, and has uncovered several opportunities for further study. This definition can be used for both curriculum and policy development within the specialty.
Catheter ablation of polymorphic ventricular tachycardia/fibrillation in patients with and without structural heart disease

Background Catheter ablation for polymorphic ventricular tachycardia and ventricular fibrillation (PMVT/VF) may target triggering premature ventricular contractions (PVCs). Targeting ventricular scar has also been suggested, but data are limited. Objective The purpose of this study was to characterize the electrophysiological findings and ablation outcomes for patients with PMVT/VF and structural heart disease (SHD) compared to those with idiopathic VF. Methods Data from 32 consecutive patients (13 idiopathic VF, 19 SHD) with recurrent PMVT/VF who underwent catheter ablation were reviewed. Results A low-voltage area of myocardial scar was present in 15 of 19 patients with SHD. Sustained monomorphic ventricular tachycardia (SMVT) associated with scar was inducible and targeted in 8, 3 of whom had previous SMVT episodes separate from PMVT/VF episodes and 5 had no history of SMVT. Triggering PVCs were identified in 11 patients and arose from an area of endocardial scar in 6. Only scar ablation was performed in 8 patients who did not have triggering PVCs. All idiopathic VF patients underwent PVC ablation only. During a median of 540 days, 74% of SHD patients and 77% of idiopathic VF patients were free of recurrence, including 75% of those with only PVC ablation, 86% of those with scar plus PVC ablation, and 63% of those with only scar ablation. Conclusion Patients with recurrent PMVT/VF and SHD often have a low-voltage scar associated with PVCs or inducible SMVT, which may also be the substrate for PMVT/VF. When present, substrate ablation targeting scar is a reasonable option for treatment of PMVT/VF even if PVCs are absent.
The Effects of Dietary Supplements that Overactivate the Nrf2/ARE System.

Background Inflammation is one of the most misunderstood aspects of human health. People have been encouraged to eat foods that have a high antioxidant capacity, and in vitro tests for total antioxidant capacity emerged. They were based on measuring the destruction of oxidized test compounds in direct reactions with the antioxidants in foods. Many dietary supplements arrived in the market. They contained purified antioxidants, such as resveratrol and EGCG that were and still are widely assumed by many to be quite healthy at any dose. Methods The literature on inflammation and the Nrf2/ARE antioxidant system was searched systematically. Articles from prestigious, peer-reviewed journals were obtained and read. The information obtained from them was used to write this review article. Results Over 150 articles and books were read. The information obtained from them showed that very few dietary antioxidants exert their effects by reacting directly with Reactive Oxygen and Nitrogen Species (RONS). Instead, most of the effective antioxidants activate the endogenous Nrf2/ARE antioxidant system. This helps prevent smoldering inflammation and the diseases that it can cause. However, when overactivated or activated constitutively, the Nrf2/ARE antioxidant system can cause some of these diseases, including many types of multidrug resistant cancer, autoimmune, neurodegenerative and cardiovascular diseases. Conclusion Even though green tea, as well as many fruits, vegetables and spices are quite healthy, dietary supplements that deliver much higher doses of antioxidants may not be. People who are diagnosed with cancer and plan to start chemotherapy and/or radiotherapy should probably avoid such supplements. This is because multidrug resistant tumors can hijack and overactivate the Nrf2/ARE antioxidant system.
Muscle Mass Assessed by the D3-Creatine Dilution Method and Incident Self-reported Disability and Mortality in a Prospective Observational Study of Community-Dwelling Older Men.

Background Whether low muscle mass is a risk factor for disability and mortality is unclear. Associations between approximations of muscle mass (including lean mass from dual-energy x-ray absorptiometry [DXA]), and these outcomes are inconsistent. Methods Muscle mass measured by deuterated creatine (D3Cr) dilution and appendicular lean mass (ALM, by DXA) were assessed at the Year 14 Visit (2014-2016) of the prospective Osteoporotic Fractures in Men study (N = 1,425, age 77-101 years). Disability in activities of daily living (ADLs), instrumental ADLs, and mobility tasks was self-reported at the Year 14 visit and 2.2 years later; deaths were centrally adjudicated over 3.3 years. Relative risks and 95% confidence intervals (CI) were estimated per standard deviation decrement with negative binomial, logistic regression, or proportional hazards models. Results In age- and clinical center-adjusted models, the relative risks per decrement in D3Cr muscle mass/wgt was 1.9 (95% CI: 1.2, 3.1) for incident self-reported ADL disability; 1.5 (95% CI: 1.3, 1.9) for instrumental ADL disability; and 1.8 (95% CI: 1.5, 2.2) for mobility disability. In age-, clinical center-, and weight-adjusted models, the relative risks per decrement in D3Cr muscle mass was 1.8 (95% CI: 1.5, 2.2) for all-cause mortality. In contrast, lower DXA ALM was not associated with any outcome. Associations of D3Cr muscle mass with these outcomes were slightly attenuated after adjustment for confounding factors and the potentially mediating effects of strength and physical performance. Conclusions Low muscle mass as measured by D3Cr dilution is a novel risk factor for clinically meaningful outcomes in older men.
Teaching NeuroImages: Intracranial DICER1-associated spindle cell sarcoma in a child.

An 8-year-old boy presented with a 2-week history of worsening right-sided headache and left-sided jerking movements. Symptoms were associated with vomiting, photophobia, phonophobia, and diplopia but no loss of consciousness. cEEG demonstrated increased voltage on the right but no evidence of seizures. Brain MRI demonstrated a large right frontoparietal mass (figure 1). The pathologic findings were compatible with DICER1 -associated pleomorphic spindle cell sarcoma (figure 2). Recently described, DICER1 mutation predisposes individuals to development of a subgroup of tumors termed “spindle cell sarcoma with rhabdomyosarcoma-like features, DICER1 mutant” although it may present as “primary intracranial sarcoma, DICER1 -mutant.”1,2
Information Technology on the Beat: The Impacts of Body-Worn Camera and Facial Recognition Technology on Public Safety

Body-worn cameras (BWCs) have transformed the criminal justice system by facilitating information gathering and thereby enhancing public safety. Despite the promise of this technology, there is also much skepticism about its efficacy. This study examines the effect of BWC implementation on the likelihood of a suspect being arrested and on the overall crime rate. In addition, we delve into whether and how the BWC, an information gathering tool, interacts with facial recognition technology, a data analysis tool. To identify the impacts of BWC implementation, we exploit a quasi-experimental setting, in combination with a matching technique, by using a federal grant program for BWC implementation as a natural shock. Using granular crime incident–level data during the period 2010–2016, we find that the adoption of BWCs is positively associated with the probability of apprehension under its jurisdiction, especially on-view (warrantless) arrests based on a probable cause. Furthermore, machine learning–powered facial recognition technology appears to augment the effectiveness of BWC in apprehension. Using police agency–level data, the implementation of BWCs is found to be negatively associated with overall crime rates. This study sheds new light on the societal value of IT and machine learning in the public sector, beyond its business value, providing meaningful implications for policymakers and researchers.