cssi/SciSciGPT-SciSciNet huggingface dataset:
On the game server network selection with delay and delay variation constraints

Recent advances in multimedia software and hardware technologies and the availability of high-speed Internet service have been instrumental for growth in the online gaming industry. Multiple servers distributed across the network are commonly used to provide the desired quality-of-service (QoS) for the network game in order to achieve a higher quality-of-experience (QoE) to the players (clients). Each player in this distributed multi-player gaming environment connects to a particular server and it distributes each of the actions to all other players through the servers they are connected to. We imagine the server network to be an overlay network, wherein the latency on a link between two servers is the latency of the Internet path connecting them. We assume that we are given an overlay network of servers with link latencies and a set of players each with a different latency to each of the servers. Now our goal is to develop algorithms that perform the following actions in such a way that delay related QoS constraints are satisfied: (a) choose a subnetwork of the server network (server network selection) and (b) assign each player to a server in the subnetwork (client-assignment). More specifically, the QoS constraints that we address in this paper are a bound on the maximum delay in propagating a player's move to all other players (delay bound) and a bound on the maximum difference in the arrival times of a player's move at all other players (delay-variation bound). We have provided polynomial-time heuristics to determine a minimal cardinality server network and the corresponding client-assignment that satisfy both delay bound and that minimize delay-variation, if such a solution exists. We have considered cases in which the server network follows two communication models: client-server (CS) and peer-to-peer (P2P). Our extensive empirical studies indicate that our heuristic uses significantly less run-time in achieving the tightest delay variation for a given end-to-end delay bound while choosing a minimal number of servers.
Disappearing plants: why they hide and how they return

Prolonged dormancy is a life-history stage in which mature plants fail to resprout for one or more growing seasons and instead remain alive belowground. Prolonged dormancy is relatively common, but the proximate causes and consequences of this intriguing strategy have remained elusive. In this study we tested whether stored resources are associated with remaining belowground, and investigated the resource costs of remaining belowground during the growing season. We measured stored resources at the beginning and end of the growing season in Astragalus scaphoides, an herbaceous perennial in southwest Montana, USA. At the beginning of the growing season, dormant plants had lower concentrations of stored mobile carbon (nonstructural carbohydrates, NSC) than did emergent plants. Surprisingly, during the growing season, dormant plants gained as much NSC as photosynthetically active plants, an increase most likely due to remobilization of structural carbon. Thus, low levels of stored NSC were associated with remaining belowground, and remobilization of structural carbon may allow for dormant plants to emerge in later seasons. The dynamics of NSC in relation to dormancy highlights the ability of plants to change their own resource status somewhat independently of resource assimilation, as well as the importance of considering stored resources in understanding plant responses to the environment.
The Effect of Ambient Temperature and Barometric Pressure on Ambulatory Blood Pressure Variability

Abstract Background The effect of ambient temperature on cardiovascular disease has previously been studied. Less known are the effects of climate on blood pressure (BP) regulation, specifically, the role of temperature on BP variability. Methods: We investigated the effect of temperature and barometric pressure on ambulatory BP variability in 333 men and women with above-optimal BP or stage 1 hypertension participating in the Dietary Approaches to Stop Hypertension (DASH) multicenter feeding trial. Each subject consumed the same diet for 3 weeks. Daytime, nighttime, and 24-h BP were recorded by ambulatory BP monitoring (ABPM). Climatologic data were obtained from local meteorologic centers. Results After adjustment for body mass index (BMI), age, sex, baseline clinic systolic BP, and clinical center, systolic BP variability was inversely associated with 24-h temperature (P = .005) and daytime temperature (P = .006). There was no observed association between BP variability and barometric pressure. There was a significant trend of increasing nighttime systolic BP and diastolic BP with increasing temperature, but these results did not persist after adjustment for confounding variables. Conclusions During periods of cold weather, an increase in BP variability may complicate the diagnosis and management of hypertension and may contribute to the high cardiovascular mortality observed in the winter.
Control of Single-Phase Grid-Connected Converters With LCL Filters Using Recurrent Neural Network and Conventional Control Methods

Single-phase grid-connected inverters are widely used to connect small-scale distributed renewable resources to the grid. However, unlike a three-phase system, control for a single-phase inverter is more challenging, especially when the inverter is used with an LCL filter. This paper proposes a novel recurrent neural network-based vector control method for a single-phase inverter with an LCL filter. The neural network is trained based on adaptive dynamic programming principle, and the objective of the training is to approximate optimal control. The Levenberg–Marquardt plus forward accumulation through time algorithm is developed for training the proposed recurrent neural network controller. The neural network vector control approach is compared with the conventional control methods, including the conventional PI-based vector control method and the PR-based control technique for single-phase inverters. Both the simulations and hardware experiments demonstrate the great advantages of the proposed neural network vector control over the conventional control methods. Compared with conventional control methods, the neural network control allows for low sampling rate and low switching frequency, while maintaining high performance in controlling a single-phase inverter. In addition, no specific damping policy is required to implement the proposed neural network vector control for an LCL -filter based single-phase inverter. The study shows that the neural network vector control is a robust control method, and can provide better control performance even when facing system parameter changes, while under this case, both the conventional PI-based vector control and the PR-based control failed to yield the acceptable results.
Antibody-mimetic ligand selected by mRNA display targets DC-SIGN for dendritic cell-directed antigen delivery.

Dendritic cell (DC)-based vaccines have shown promise as an immunotherapeutic modality for cancer and infectious diseases in many preclinical studies and clinical trials. Provenge (sipuleucel-T), a DC-based vaccine based on ex vivo-generated autologous DCs loaded with antigens, has recently received FDA approval for prostate cancer treatment, further validating the potential of DC-based vaccine modalities. However, direct antigen delivery to DCs in vivo via DC-specific surface receptors would enable a more direct and less laborious approach to immunization. In this study, the recombinant extracellular domains (ECD) of human and mouse DC-SIGN (hDC-SIGN and mDC-SIGN) were generated as DC-specific targets for mRNA display. Accordingly, an antibody-mimetic library was constructed by randomizing two exposed binding loops of an expression-enhanced 10th human fibronectin type III domain (e10Fn3). After three rounds of selection against mDC-SIGN, followed by four rounds of selection against hDC-SIGN, we were able...
Polyol-Silk Bioink Formulations as Two-Part Room-Temperature Curable Materials for 3D Printing

Silk-based bioinks were developed for 2D and 3D printing. By incorporating nontoxic polyols into silk solutions, two-part formulations with self-curing features at room temperature were generated. By varying the formulations the crystallinity of the silk polymer matrix could be controlled to support printing in 2D and 3D formats interfaced with CAD geometry and with good feature resolution. The self-curing phenomenon was tuned and exploited in order to demonstrate the formation of both structural and support materials. Biocompatible aqueous protein inks for printing that avoid the need for chemical or photo initiators and that form aqueous-stable structures with good resolution at ambient temperatures provide useful options for biofunctionalization and a broad range of applications.
Elution Is a Critical Step for Recovering Human Adenovirus 40 from Tap Water and Surface Water by Cross-Flow Ultrafiltration.

ABSTRACT This paper examines the recovery of the enteric adenovirus human adenovirus 40 (HAdV 40) by cross-flow ultrafiltration and interprets recovery values in terms of physicochemical interactions of virions during sample concentration. Prior to ultrafiltration, membranes were either blocked by exposure to calf serum (CS) or coated with a polyelectrolyte multilayer (PEM). HAdV 40 is a hydrophobic virus with a point of zero charge between pH 4.0 and pH 4.3. In accordance with predictions from the extended Derjaguin-Landau-Verwey-Overbeek theory, the preelution recovery of HAdV (rpre) from deionized water was higher with PEM-coated membranes (rprePEM = 74.8% ± 9.7%) than with CS-blocked membranes (rpreCS = 54.1% ± 6.2%). With either membrane type, the total virion recovery after elution (rpost) was high for both deionized water (rpostPEM = 99.5% ± 6.6% and rpostCS = 98.8% ± 7.7%) and tap water (rpostPEM = 89% ± 15% and rpostCS = 93.7% ± 6.9%). The nearly 100% recoveries suggest that the polyanion (sodium polyphosphate) and surfactant (Tween 80) in the eluent disrupt electrostatic and hydrophobic interactions between the virion and the membrane. Addition of EDTA to the eluent greatly improved the elution efficacy (rpostCS = 88.6% ± 4.3% and rpostPEM = 87.0% ± 6.9%) with surface water, even when the organic carbon concentration in the water was high (9.4 ± 0.1 mg/liter). EDTA likely disrupts cation bridging between virions and particles in the feed water matrix or the fouling layer on the membrane surface. For complex water matrices, the eluent composition is the most important factor for achieving high virion recovery. IMPORTANCE Herein we present the results of a comprehensive physicochemical characterization of HAdV 40, an important human pathogen. The data on HAdV 40 surface properties enabled rigorous modeling to gain an understanding of the energetics of virion-virion and virion-filter interactions. Cross-flow filtration for concentration and recovery of HAdV 40 was evaluated, with postelution recoveries from ultrapure water (99%), tap water (∼91%), and high-carbon-content surface water (∼84%) being demonstrated. These results are significant because of the very low adenovirus recoveries that have been reported, to date, for other methods. The recovery data were interpreted in terms of specific interactions, and the eluent composition was designed accordingly to maximize HAdV 40 recovery.
Development of a Microloading Platform for In Vitro Mechanotransduction Studies

Mechanotransduction studies aim to understand the process of cells converting mechanical stimuli into a cellular response. As it can be difficult to study the impact of isolated factors using in vivo studies, in vitro studies are used as they offer more precisely controlled loads for experiments and allow cell culture on a variety of surfaces. Here, we developed a microloading platform for in vitro mechanotransduction studies, stretching the substrate by tenting it with a centrally contacting platen. This platform works through the use of a load cell and microactuator, which was characterized by comparing the reported and measured displacements. In addition, an alignment block was designed for the microloading platform to increase reproducibility between studies, and a cell culture handling system was designed to hold samples before experimentation and reduce preloads, allowing the study of only the controlled loading. A polydimethylsiloxane (PDMS) scaffold was also designed for cell loading, complete with a positional reference grid for observing the response of individual cells to strain. Initial work with this microloading platform includes studying osteocyte-like MLO-Y4 cells and changes in viability in response to mechanical load in vitro. These initial studies have demonstrated the ability to induce cell death in response to microdamage.
Imaging transient events at high angular resolution

Resolving the spatial structure of transient events provides insights into their physical nature and origin. Recent observations using long baseline optical/infrared interferometry have revealed the size, shape, and angular expansion of bright novae within a few days after their outbursts. This has implications for understanding the timescale for the development of asymmetric features in novae ejecta. Additionally, combining spectroscopic measurements of the expansion velocity with the angular expansion rate provides a way to measure a geometric distance to the nova. In this paper, I provide a review of interferometric observations of novae, with a focus on recent results on the expansion and spatial structure of nova V339 Del in 2013. I also discuss other promising applications of interferometry to transient sources, such as measuring the image size and centroid displacements to measure planetary masses in gravitational microlensing events. Given the timescales of transient events, it is critical for interferometric arrays to respond rapidly to targets of opportunity in order to optimize the instrumental sensitivity and baselines required to resolve the source while its brightness and size change over time.
Graphs. Geometric Structure

The properties of a finite graph (only type considered) may be divided into two distinct groups: geometric, really topological properties, and algebraic properties. In the present chapter, we present the geometry of a graph and in the next its algebra.
Perceived Instructor Argumentativeness and Verbal Aggressiveness in the College Classroom: Effects on Student Perceptions of Climate, Apprehension, and State Motivation.

Because argumentativeness and verbal aggressiveness are associated with positive and negative relational outcomes, respectively (Infante & Rancer, 1996), we were interested in whether perceived instructor argumentativeness and verbal aggressiveness are related to college student perceptions of classroom climate, classroom apprehension, and state motivation. Participants were 236 undergraduate students enrolled in a variety of communication courses at a mid‐Atlantic university. Results indicate that (a) perceived instructor argumentativeness was not related to perceived classroom climate whereas perceived instructor verbal aggressiveness was negatively related to perceived classroom climate, (b) neither perceived instructor argumentativeness nor verbal aggressiveness was related to perceived student classroom apprehension, and (c) perceived instructor argumentativeness was positively related to perceived student state motivation whereas perceived instructor verbal aggressiveness was negatively related to p...
Waveguide detection of radiation from a random sheet of nanowires

Contactless high-frequency information about nanowires is obtained by placing patterned sheets of oriented wires on a dielectric insert that partially fills a rectangular waveguide. Exact expressions for the fields within the guide are derived by treating the nanowire sheet within the partially-filled guide as an impedance boundary condition at the air-dielectric interface. Because the partially filled guide mixes TM and TE modes of an empty rectangular guide in a specific way, the S-parameters of a segment of such a guide are sensitive to the presence of the coated air-dielectric interface, whose surface impedance can be de-embedded from the measurements. Effects of disorder in wire orientation and location on the surface can be included in the surface impedance description and the de-embedding procedure.
Phagolysosomal pH of human neutrophils

Human neutrophils sequester yeast cells or zymosan particles in two classes of phagocytic vacuoles: sealed and unsealed. The pH of sealed vacuoles was measured by a newly devised fluorometric procedure that used fluoresceinated zymosan particles, derived from Saccharomyces cerevisiae, as a pH probe. Five minutes after initiation of phagocytosis, sealed vacuoles were alkaline, exhibiting a pH of 7.80 +/- 0.19 (mean +/- SEM). Their acidity subsequently increased, so that the pH fell to 7.38 +/- 0.25 after 15 min. 6.35 +/- 0.35 after 30 min, and 5.68 +/- 0.26 after 60 min. The implications of these findings for neutrophil microbicidal mechanisms are discussed.
The Drug Court Pharmacist: Expanding Pharmacy Practice and Addressing Substance Abuse

Problem solving courts, including Drug Court, were established to address substance abuse while providing an alternative to prison sentences and traditional corrections supervision. Drug Courts have been shown to reduce crime in participants and graduates, save the criminal justice and health care systems money, reduce victimization, and restore families. Pharmacists in Tippecanoe County, Indiana, and Carlton County, Minnesota, have established innovative practices as members of Drug Court teams; these practices include the provision of a variety of pharmaceutical and health-related services that other Drug Court team members are not able to provide. The role of the pharmacist on the Drug Court team deserves exploration in light of the increasing needs of problem-solving courts across the United States and the current substance abuse epidemic that unfortunately includes prescription drugs. Conflict of Interest "We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties." Type: Idea Paper
Summary and Future Directions

In this era of information over-abundance and sophisticated technologies, we need to hone our thinking skills more than ever. An entire generation of young people, as young as 2 years of age, is growing up immersed in digital media. We know that these experiences influence the way they see the world, think through ideas, and form their opinions. In order to help this generation learn to use technology appropriately, it is important for educators and parents to understand how the mind works during the normal thinking process (reviewed in Chaps. 3 and 4) and the impediments to thinking (Chap. 7). We also need to understand how young people use technology (Chap. 2), how these uses may interact with thinking and learning (Chaps. 5 and 6), and the ways in which technology can be used to enhance those processes (Chap. 8).
Detection and notification of preterm labor in high-risk pregnancies

Women who have a high-risk of preterm labor would benefit from a device that continuously-monitors their cervical dilation. The proposed methodology for such a device consists of an internal device that measures the woman's cervical dilation and wirelessly transmits these measurements to an external device as well as her physician. When critical dilation is detected, the woman will be prompted to visit her physician for further examination.
Clostridium difficile infections in Finland, 2008–2015: trends, diagnostics and ribotypes

We evaluated Clostridium difficile (CD) diagnostics in Finnish clinical microbiology laboratories during 2006–2011, with an update in 2015, in relation to CD surveillance data of the National Infectious Disease Register (NIDR) and ribotyping data from the national reference laboratory during the years 2008–2015. In 2011, diagnostic activity varied regionally more than three-fold and the positivity rate ranged between 7 and 21%. Nucleic acid amplification testing (NAAT) was implemented in the regions with high activity and NAAT users tested 30% more patients and found 15% more cases per population than those not using it. Culture was performed in 79% of laboratories, primary toxin testing by enzyme immunoassay (EIA) in 83% and by NAAT in 17%. In 2014, 12/19 laboratories used NAAT as the primary detection method and four as the secondary method, and ten cultured. Increasing usage of NAAT was not systematically related to various trends detected regionally in annual CD rates. Polymerase chain reaction (PCR) ribotyping of 1771 CD isolates (4.1% of CD cases) identified 146 distinct profiles, of which 37% were binary toxin positive. The most common ribotype was 027, but its proportion decreased, while 078 slightly increased. Transition from culture to NAAT in CD infection (CDI) diagnostics did not cause a significant increase in the observed CDI incidence. Major differences between diagnostic activity, methods and strategies in different regions have persisted over the years, which should be considered when comparing the regional epidemiology of CDI.
Ideal Time and Utopian Space in the Chan Pivot Experience

Chan Buddhist philosophy as expressed in the Blue Cliff Record and related gongan case commentarial literature is primarily based on the notion of the instantaneous pivot moment, in which a master creates a profound turnaround experience reflecting his own liberation so as to reveal the deficient tendencies of his dialogue partner in a way that leads both parties to enhance their spiritual awareness. What are the implications of the pivot experience for understanding the overall Chan view of time and space? From the standpoint of temporality, Chan emphasizes the unity of momentary experience and continuity unbound yet not oblivious to sequential limitations. In terms of spatiality, the Chan pivot is a universal experience but is realized in particular manifestations of natural phenomena as perceived by an awakened observer.
Herniation despite Decompressive Hemicraniectomy in Large Hemispherical Ischemic Strokes

Background Despite decompressive hemicraniectomy (DHC), progressive herniation resulting in death has been reported following middle cerebral artery (MCA) strokes. We aimed to determine the surgical parameters measured on brain computed tomography (CT) scan that are associated with progressive herniation despite DHC in large MCA strokes. Methods Retrospective chart review of medical records of patients with malignant hemispheric infarction who underwent DHC for cerebral edema was performed. Infarct volume was calculated on CT scans obtained within 24 hours of ictus. Radiological parameters of craniectomy bone flap size, brain volume protruding out of the skull, adequate centering of the craniectomy over the stroke bed, and the infarct volume outside the craniectomy bed (volume not centered [VNC]) were measured on the postoperative brain CT. Results Of 41 patients who underwent DHC, 7 had progressive herniation leading to death. Radiographic parameters significantly associated with progressive herniation included insufficient centering of craniectomy bed on the stroke bed (P = .03), VNC (P = .011), additional anterior cerebral artery infarction (P = .047), and smaller craniectomy length (P = .05). Multivariate logistic regression analysis for progressive herniation using craniectomy length and VNC as independent variables demonstrated that a higher VNC was significantly associated with progressive herniation despite surgery (P = .029). Conclusions In large MCA strokes, identification of large infarct volume outside the craniectomy bed was associated with progressive herniation despite surgery. These results will need to be verified in larger prospective studies.
Four thoughts on Charles Mills – Black rights/white wrongs: the critique of racial liberalism

In what follows I provide a review of Charles Mills’ text, Black Rights/White Wrongs: The Critique of Racial Liberalism. In four points I critique and build upon Mills’ contributions on (1) the mul...
Coprophagia in an 8-Year-Old Hospitalized Patient: A Case Report and Review of the Literature

Consult-liaison psychiatrists often encounter difficult clinical scenarios. We present a pediatric case of presumptive coprophagia. After a negative medical work-up, the pediatrics team asked psychiatry to assist them in managing this relatively rare disorder in the hospital setting. Little is known about the etiology and treatment of coprophagia in the pediatric population. Using the case as a catalyst, we discuss what is known about this disorder as well as treatment strategies in the hospital setting.
Karp, Matthew. (2016). This Vast Southern Empire: Slaveholders at the Helm of American Foreign Policy. Cambridge, MA: Harvard University Press, 368 pp., $29.95, £23.95, €27.00, ISBN-9780674737259

In 1858, whilst being nominated to run for a United States Senate seat in Illinois, Abraham Lincoln declared, “A house divided against itself cannot stand. I believe this government cannot endure, ...
The Role of the Leydig Cell in Spermatogenic Function

Two anatomically distinct compartments, respectively, the interstitium where Leydig cells reside and the seminiferous tubules contribute the major functions of the testis, testosterone secretion and sperm production. This structural partitioning is achieved by peritubular myoid cells, which surround the seminiferous tubules. Despite the anatomic separation of the two compartments, they are functionally coupled by endocrine and paracrine inter-communication. For example, the testosterone secreted by Leydig cells under the stimulus of luteinizing hormone (LH), diffuses into seminiferous tubules and drives spermatogenesis together with another gonadotropic hormone, follicle-stimulating hormone (FSH). This dependency of the seminiferous epithelium on testosterone illustrates the significance of the Leydig cell in spermatogenesis.
Structure-based Search for Peptide Ligands that Cross-react with Melanocortin Receptors

Purpose. To define sequence motifs that can be used to identify peptide ligands of the melanocortin receptor (MCR).
Gamete, Embryo, Larval Development

This chapter presents descriptions of the origin, structure, and differentiation of gametes, larval development, and larval metamorphosis. Recent reviews of sponge reproduction have appeared or will shortly, and reference can be made to them for other points of view (Fell, 1974a, 1983, in press; Reiswig, in press; Sara, in press; Simpson, in press; Tuzet, 1973a; Brien, 1973; Sara and Vacelet, 1973).
Long-Wave Interfacial Instabilities in Viscous Liquid Films

One well-known instability that can occur in a viscous liquid film produces a wavelike deformation of the free surface over a wavelength that is much larger than the thickness of the film. We shall examine this motion and explain the dynamics of the instability mechanism by carefully interpreting the mathematical approximations used to solve the stability problem.
Development of Expert Networks: A Hybrid System of Expert Systems and Neural Networks

This chapter introduces the basic principles of a hybrid system, called an expert network, composed of an expert system and a neural network. It describes the application of an expert network to bioseparation process design and development, taking as an example the prediction of separation performance and the synthesis of process flowsheets for separating a multicomponent protein mixture into pure component products by liquid-liquid extraction using a system of two aqueous polymer solutions.
Emergent Transcatheter Aortic Valve Replacement for the Treatment of Severe Aortic Stenosis Patients Presenting With Cardiogenic Shock or Cardiac Arrest; A Case Series

Background: Patients with severe aortic stenosis (AS) often present acutely with decompensated heart failure, cardiogenic shock or cardiac arrest requiring immediate intervention. Transcatheter aor...
Exponential and lp-Stability in Volterra Equations

This chapter is devoted primarily to the exponential and lp-stability of Volterra difference equations. Lyapunov functionals are the main tools in the analysis. It is pointed out that in the case of exponential stability, Lyapunov functionals are hard to extend to vector Volterra difference equations or to Volterra difference equations with infinite delay . In addition, we use nonstandard discretization scheme due to Mickens [122] and apply them to continuous Volterra integro-differential equations. We will show that under the discretization scheme the stability of the zero solution of the continuous dynamical system is preserved. Also, under the same discretization, using a combination of Lyapunov functionals, Laplace transforms, and z-transforms, we show that the boundedness of solutions of the continuous dynamical system is preserved.
Salt Marsh Restoration and the Shellfishing Industry: Co-evaluation of Success Components

This study uses an ecosystem services framework to document the current relationship between salt marsh restoration and the shellfishing industry in five towns on Cape Cod, Massachusetts, USA. Salt...
Multivariate machine learning models for prediction of pathologic response to neoadjuvant therapy in breast cancer using MRI features: a study using an independent validation set.

To determine whether a multivariate machine learning-based model using computer-extracted features of pre-treatment dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can predict pathologic complete response (pCR) to neoadjuvant therapy (NAT) in breast cancer patients. Institutional review board approval was obtained for this retrospective study of 288 breast cancer patients at our institution who received NAT and had a pre-treatment breast MRI. A comprehensive set of 529 radiomic features was extracted from each patient’s pre-treatment MRI. The patients were divided into equal groups to form a training set and an independent test set. Two multivariate machine learning models (logistic regression and a support vector machine) based on imaging features were trained to predict pCR in (a) all patients with NAT, (b) patients with neoadjuvant chemotherapy (NACT), and (c) triple-negative or human epidermal growth factor receptor 2-positive (TN/HER2+) patients who had NAT. The multivariate models were tested using the independent test set, and the area under the receiver operating characteristics (ROC) curve (AUC) was calculated. Out of the 288 patients, 64 achieved pCR. The AUC values for predicting pCR in TN/HER+ patients who received NAT were significant (0.707, 95% CI 0.582–0.833, p < 0.002). The multivariate models based on pre-treatment MRI features were able to predict pCR in TN/HER2+ patients.
Impact of payer status on survival in parotid malignancy

Abstract Objective In the setting of current national healthcare reform, it becomes especially relevant to understand the current state of healthcare disparities with regards to insurance status. To determine the impact of payer status on survival in parotid malignancy, we utilized the National Cancer Database (NCDB). Study design Retrospective database review. Setting National Cancer Database (2004–2012). Subjects and methods The NCDB was queried for cases of primary malignancy of the parotid gland between 2004 and 2012. The impact of payer status on overall survival was evaluated, as well as the relationship of insurance status with patient and tumor variables. Results 15,815 cases met inclusion criteria. A majority had private insurance (47.8%), followed by Medicare (40.9%), Medicaid (5.0%), uninsured (3.2%) and other government sources (1.3%). Medicare patients had the lowest 5 and 10-year survival rates (50.7% (95% CI [49.3–52.1]) and 27.8% (95% CI [25.0–30.9]), respectively). On multivariable analysis, uninsured, Medicare, and Medicaid patients had worse overall survival than the privately insured (HR 1.42, 95% CI [1.17–1.74]; HR 1.29, 95% CI [1.17–1.42]; HR 1.36, 95% CI [1.13–1.62], respectively). Uninsured and Medicaid patients were more likely than the privately insured to present with advanced stage disease, nodal metastasis and longer times to treatment following diagnosis. Conclusion In parotid malignancy, uninsured, Medicaid, and Medicare patients have worse survival outcomes compared to those with private insurance. Uninsured and Medicaid patients also present with more advanced stage disease and have increased wait times before definitive treatment is initiated.
Cost-effectiveness of Shared Telemedicine Appointments in Young Adults With T1D: CoYoT1 Trial

OBJECTIVE Young adults with type 1 diabetes (T1D) often struggle to achieve glycemic control and maintain routine clinic visits. We aimed to evaluate the societal cost-effectiveness of the Colorado young adults with T1D (CoYoT1) Clinic, an innovative care model of shared medical appointments through home telehealth. RESEARCH DESIGN AND METHODS Patients self-selected into the CoYoT1 (N = 42) or usual care (N = 39) groups. RESULTS Within the trial, we found no significant differences in 9-month quality-adjusted life; however, the control group had a larger decline from baseline in utility than the CoYoT1 group, indicating a quality of life (QoL) benefit of the intervention (difference in difference mean ± SD: 0.04 ± 0.09; P = 0.03). There was no significant difference in total costs. The CoYoT1 group had more study-related visits but fewer nonstudy office visits and hospitalizations. CONCLUSIONS The CoYoT1 care model may help young adults with T1D maintain a higher QoL with no increase in costs.
The prevalence of birth defects among non-Hispanic Asian/Pacific Islanders and American Indians/Alaska Natives in Texas, 1999-2015.

Background There is considerable variability in the prevalence of birth defects among racial/ethnic groups. This study estimated birth defect prevalence among the less studied non-Hispanic (NH) Asian/Pacific Islander (PI) and American Indian/Alaska Native (AI/AN) populations in Texas relative to NH Whites. Methods Data were obtained from the Texas Birth Defect Registry from 1999 to 2015 for deliveries to Texas-resident women who were NH White, NH Asian/PI, or AI/AN. This covers a live birth population of 2.6 million. Prevalence ratios and 95% confidence intervals (95% CIs) were calculated for NH Asian/PIs and AI/ANs (relative to NH Whites) for 44 birth defects using Poisson regression adjusting for maternal age. Results After adjustment there were 33 statistically significant prevalence ratios (aPRs). Among NH Asian/PIs, 23 defects had a lower aPR (0.38-0.86) and three defects had a higher aPR (1.19-2.50). AI/ANs had one defect with a significantly lower aPR (0.64) and six with a higher aPR (1.36-4.63). Conclusions Non-Hispanic Asian/PIs generally have a lower prevalence ratio for many birth defects while AI/ANs have a higher prevalence ratio compared to NH Whites. These findings update the limited literature on this topic and warrant additional research to identify the true associations across a range of birth defects among these understudied racial/ethnic groups.
Accurate mass and retention time library of serum lipids for type 1 diabetes research

Dysregulated lipid species are linked to various disease pathologies and implicated as potential biomarkers for type 1 diabetes (T1D). However, it is challenging to comprehensively profile the blood specimen lipidome with full structural details of every lipid molecule. The commonly used reversed-phase liquid chromatography-tandem mass spectrometry (RPLC-MS/MS)-based lipidomics approach is powerful for the separation of individual lipid species, but lipids belonging to different classes may still co-elute and result in ion suppression and misidentification of lipids. Using offline mixed-mode and RPLC-based two-dimensional separations coupled with MS/MS, a comprehensive lipidomic profiling was performed on human sera pooled from healthy and T1D subjects. The elution order of lipid molecular species on RPLC showed good correlations to the total number of carbons in fatty acyl chains and total number of double bonds. This observation together with fatty acyl methyl ester analysis was used to enhance the confidence of identified lipid species. The final T1D serum lipid library database contains 753 lipid molecular species with accurate mass and RPLC retention time uniquely annotated for each of the species. This comprehensive human serum lipid library can serve as a database for high-throughput RPLC-MS-based lipidomic analysis of blood samples related to T1D and other childhood diseases.
Energy Regulation Mechanism and Therapeutic Potential of Asprosin.

Genetic studies of patients with neonatal progeroid syndrome led to the discovery of the novel fasting-induced, glucogenic, and orexigenic hormone named asprosin, the C-terminal cleavage product of profibrillin. Upon secretion, asprosin travels to the liver, where it exerts a glucogenic effect through OR4M1, an olfactory G-protein–coupled receptor. It also crosses the blood-brain barrier to stimulate appetite-modulating neurons in the arcuate nucleus of the hypothalamus, exerting an orexigenic effect via an as yet unidentified receptor. Specifically, it stimulates appetite by activating orexigenic AgRP neurons and inhibiting anorexigenic POMC neurons. Studies have also focused on the therapeutic potential of inhibiting asprosin for treatment of obesity and type 2 diabetes, both of which are characterized by high levels of circulating asprosin. It has been shown that anti-asprosin monoclonal antibodies reduce blood glucose, appetite, and body weight, validating asprosin as a therapeutic target. Current work aims to uncover key features of the asprosin biology such as the identification of its neuronal receptor, identification of the secretion mechanism from adipose tissue, and development of anti-asprosin monoclonal antibodies as diabetes and obesity therapies.
Global phenotypic profiling identifies a conserved actinobacterial cofactor for a bifunctional PBP-type cell wall synthase

Members of the Corynebacterineae suborder of Actinobacteria have a unique cell surface architecture and, unlike most well-studied bacteria, grow by tip-extension. To investigate the distinct morphogenic mechanisms shared by these organisms, we performed a genome-wide phenotypic profiling analysis using Corynebacterium glutamicum as a model. A high-density transposon mutagenized library was challenged with a panel of antibiotics and other stresses. The fitness of mutants in each gene under each condition was then assessed by transposon-sequencing. Clustering of the resulting phenotypic fingerprints revealed a role for several genes of previously unknown function in surface biogenesis. Further analysis identified CofA (Cgp_0016) as an interaction partner of the peptidoglycan synthase PBP1a that promotes its stable accumulation at sites of polar growth. The related Mycobacterium tuberculosis proteins were also found to interact, highlighting the utility of our dataset for uncovering conserved principles of morphogenesis for this clinically relevant bacterial suborder.
Art Making as Research

Music is an art that must be viewed in deep connection to other art forms, such as dance, poetry, or theater. This chapter investigates how art-making methodologies from different disciplines can contribute to each other and suggests that these approaches can be used as modes of academic inquiry.
Problem Solving and Teaching How to Solve Problems in Technology-Rich Contexts

Problem solving is perhaps the key characteristic that makes us human. Given the kinds of problems that we face in a competitive economy and society, the new generation of learners is ever more req...
Constitutive production of interleukin-6 and tumor necrosis factor-alpha from spontaneously proliferating T cells in patients with human T-cell lymphotropic virus type-I/II.

The human T-cell lymphotropic viruses (HTLV) type I and type II are capable of inducing a variety of cellular genes, including many of the cytokines that regulate cell proliferation. To determine if the spontaneous proliferation of peripheral blood mononuclear cells from patients infected with HTLV-I and HTLV-II was related to coordinate expression of cytokines, we analyzed the levels of interleukin-1 beta (IL-1 beta), IL-2, IL-3, IL-4, IL-6, tumor necrosis factor-alpha (TNF- alpha) and interferon-tau (IFN-tau) in culture supernatants derived from spontaneously proliferating cells. Significantly elevated levels of IL-6 and TNF-alpha were present in culture supernatants from HTLV- I/II-infected individuals when compared with normal controls (P less than .01). Kinetic experiments showed that both IL-6 and TNF-alpha were elevated by day 5. None of the other cytokines (IL-1 beta, IL-2, IL-3, IL-4, and IFN-tau) were detectable in any of the culture. These data suggest that release of IL-6 and TNF-alpha may regulate lymphocyte proliferation in HTLV-I/II-infected individuals.
24. IMPROVING RESIDENT EDUCATION IN THE PEDIATRIC INTENSIVE CARE UNIT THROUGH THE IMPLEMENTATION OF A STANDARDIZED CURRICULUM

Background Trainees at our institution have traditionally found the Pediatric Intensive Care Unit (PICU) to be a challenging rotation, with patient acuity and workload that often makes regular didactic teaching difficult. Aim Statement Our goal was to improve the educational experience in the PICU for our residents by increasing the frequency of structured lectures from a baseline of less than half the days to at least half the days of the week over one year. These measures were assessed with anonymous resident surveys. Interventions In collaboration with PICU faculty and fellows, we developed and implemented a brief daily teaching curriculum based on content specifications for pediatric boards. The curriculum is comprised of a series of prompts and associated teaching points. Prompts include visual aids, schematics, and board-style questions. Through process mapping and workflow redesign, we created a 15-minute block in the weekday schedule to allow for dedicated teaching sessions prior to morning rounds. Measures Pre-intervention survey responses were collected from June through July 2019, surveying all residents who had rotated through the PICU in the prior 2 years (n= 32). The survey assessed resident satisfaction with overall educational experience, didactic teaching experience, and the frequency of teaching sessions. Following implementation of the teaching curriculum in August 2019, the same survey was administered to residents after each PICU rotation block. There have been 5 rotation blocks since implementation of the new curriculum (n= 12). Results At baseline, 15% of residents surveyed reported didactic teaching half or more days per week, as compared with 93% of residents after implementation of the new curriculum (Figure 1). The mean resident satisfaction with overall educational experience increased from 3.4 to 4.2 on a 5-point Likert scale, with 5 being extremely satisfied and 1 being extremely dissatisfied. Conclusions and Next Steps We developed and implemented a standardized curriculum that has led to an increase in the frequency of didactic teaching sessions and improvements in resident satisfaction with the overall educational experiences in the PICU. Going forward, it will be important to gather additional feedback from trainees and PICU staff to improve the lecture materials and identify barriers to lectures taking place. It will be helpful to gather more objective data on the frequency of lectures and to look at resident exam scores pre- and post-intervention.
FSI Study of Structures Containing Fluid

Some structures contain fluids internally. One of the examples is a fluid tank. When such structure is subjected to dynamic loading, FSI occurs for the system. Hydrodynamic ram is one of the phenomena as a projectile penetrates into a structure such as a fuel tank. This chapter investigated the dynamic responses of composite structures containing different amounts of water while the structures were impacted by mechanical loading [1].
Predictors of Inappropriate Helicopter Transport

BackgroundHelicopter transport (HT) is an efficient, but costly, means for injured patients to receive life-saving, definitive trauma care. Identifying the characteristics of inappropriate HT prese...
Physical structure of the protoplanetary nebula CRL618. I. Optical long-slit spectroscopy and imaging

In this paper (paper I) we present optical long-slit spectroscopy and imaging of the protoplanetary nebula CRL618. The optical lobes of CRL618 consist of shock-excited gas, which emits many recombination and forbidden lines, and dust, which scatters light from the innermost regions. From the analysis of the scattered Halpha emission, we derive a nebular inclination of i=24+-6 deg. The spectrum of the innermost part of the east lobe (visible as a bright, compact nebulosity close to the star in the Halpha HST image) is remarkably different from that of the shocked lobes but similar to that of the inner HII region, suggesting that this region represents the outermost parts of the latter. We find a non-linear radial variation of the gas velocity along the lobes. The largest projected LSR velocities (~80 km/s) are measured at the tips of the lobes, where the direct images show the presence of compact bow-shaped structures. The velocity of the shocks in CRL618 is in the range ~75-200 km/s, as derived from diagnostic line ratios and line profiles. We report a brightening (weakening) of [OIII]5007AA ([OI]6300AA) over the last ~10 years that may indicate a recent increase in the speed of the exciting shocks. From the analysis of the spatial variation of the nebular extinction, we find a large density contrast between the material inside the lobes and beyond them: the optical lobes seem to be `cavities' excavated in the AGB envelope by interaction with a more tenuous post-AGB wind. The electron density, with a mean value n_e~5E3-1E4 cm-3, shows significant fluctuations but no systematic decrease along the lobes, in agreement with most line emission arising in a thin shell of shocked material (the lobe walls) rather than in the post-AGB wind filling the interior of the lobes. (...)
Regulation in a Multisectored Financial Services Industry: An Exploratory Essay

This Essay reviews differences in regulatory structure across sectors of the financial services industry in the United States and then explores the difficulties these differences pose to our current system of regulation and also to proposals for financial modernization. The Essay begins with a description of a range of financial transactions from simple contracts to pooled investment vehicles to complex financial intermediaries. After reviewing the policy justifications underlying regulation across the financial services industry, the Essay summarizes the distinctive regulatory structures that characterize U.S. oversight of each major sector of the industry: private contract, securities regulation, futures contracts, investment companies, depository institutions, insurance companies, and employee benefit plans. The Essay then reviews the legal definitions that are used to classify which regulatory structure applies to which financial transactions. Distinctions are drawn between formal and functional definitions of financial products, and the Essay claims that functional definitions, which suffer from both overinclusion and indeterminacy, are typically bounded by four types of limitations: de minimus exceptions, sophisticated investor exclusions, institutional carve-outs, and extraterritorial exemptions. The Essay continues to review a series of recent legal disputes in which private parties and government regulators have disagreed over the application of this system of classifying financial products. The Essay then draws some preliminary conclusions as to why disputes over legal classifications of financial products are so common and concludes by exploring the implications of the foregoing analysis for recent proposals to modernize the U.S. system of financial regulation.