cssi/SciSciGPT-SciSciNet huggingface dataset:
ERG and other discriminators between advanced hydroxychloroquine retinopathy and retinitis pigmentosa

To study whether the ERG and other clinical findings help to distinguish between advanced hydroxychloroquine (HCQ) retinopathy and pericentral or diffuse retinitis pigmentosa (RP) with similar fundus appearance. We conducted a retrospective analysis of patients with advanced HCQ retinopathy (n = 11), pericentral RP (n = 8) and diffuse RP (n = 8). Pericentral RP was defined as having limited fundus damage and relatively normal flicker ERG time-to-peak. Diffuse RP had typical loss of the rod ERG and flicker timing delay. All patients showed reduced amplitude of the ISCEV responses in the full-field electroretinogram (ERG). Aspects of history, visual field results, fundus appearance, fundus autofluorescence and ocular coherence tomography were also compared. Relative to pericentral RP, patients with HCQ toxicity showed delayed flicker ERG time-to-peak and lower ERG amplitudes, particularly combined rod–cone responses. Relative to diffuse RP, most HCQ toxicity patients had some preserved rod ERG response, and there was no obvious predilection for rod over cone damage. In addition, patients with HCQ toxicity usually lacked markers of long-standing degeneration such as bone spicule figures or severe loss of peripheral field. History of familial disease and long-standing night blindness were specific to RP. While the early signs of HCQ damage are typically regional in the posterior pole, advanced disease is characteristically diffuse (unlike pericentral RP). This is appropriate for a systemic toxin, as is the finding that rods and cones were both affected in the ERG to a similar degree (unlike genetic rod–cone dystrophies). For patients with severe HCQ exposure and some of our discriminatory findings, and no family history or prior night blindness, HCQ toxicity is a sufficient diagnosis without invoking a second rare disease (Occam’s razor).
Meta-analysis and Harmonization of Life Cycle Assessment Studies for Algae Biofuels

Algae biodiesel (BioD) and renewable diesel (RD) have been recognized as potential solutions to mitigating fossil-fuel consumption and the associated environmental issues. Life cycle assessment (LCA) has been used by many researchers to evaluate the potential environmental impacts of these algae-derived fuels, yielding a wide range of results and, in some cases, even differing on indicating whether these fuels are preferred to petroleum-derived fuels or not. This meta-analysis reviews the methodological preferences and results for energy consumption, greenhouse gas emissions, and water consumption for 54 LCA studies that considered algae BioD and RD. The significant variation in reported results can be primarily attributed to the difference in scope, assumptions, and data sources. To minimize the variation in life cycle inventory calculations, a harmonized inventory data set including both nominal and uncertainty data is calculated for each stage of the algae-derived fuel life cycle.
Impact of Enforcement on Healthcare Billing Fraud: Evidence from the USA

Each state’s Medicaid Fraud Control Unit (MFCU) prosecutes billing fraud cases against individual healthcare providers who fraudulently bill Medicaid for services provided. Once an individual is convicted of billing fraud, the Office of Inspector General for the Department of Health and Human Services may exclude the individual from billing any federal government healthcare program, including Medicaid. Excluded individuals are added to a public list of exclusions, which restricts their ability to practice professionally. Prompted by criminology research into the impact of policing resources, we test whether these government enforcement initiatives against fraud serve as a deterrent to would-be fraudulent billers. We document that key enforcement proxies, the staffing level and budget of an MFCU, are positively associated with the yearly number of exclusions added at the state level. Our results are consistent with the exclusion list not being a deterrent but provide support for MFCUs’ fraud detection efforts. This paper provides industry-specific fraud insights for auditors and other individuals involved in public policy, specifically Medicaid, and introduces a novel dataset to the accounting fraud research literature.
Automated influenza case detection for public health surveillance and clinical diagnosis using dynamic influenza prevalence method.

Objectives To assess the performance of a Bayesian case detector (BCD) for influenza surveillance and clinical diagnosis. Methods BCD uses a Bayesian network classifier to compute the posterior probability of a patient having influenza based on 31 findings from narrative clinical notes. To assess the potential for disease surveillance, we calculated area under the receiver operating characteristic curve (AUC) to indicate BCD's ability to differentiate between influenza and non-influenza encounters in emergency department settings. To assess the potential for clinical diagnosis, we measured AUC for diagnosing influenza cases among encounters having influenza-like illnesses. We also evaluated the performance of BCD using dynamically estimated influenza prevalence, and measured sensitivity, specificity and positive predictive value. Results For influenza surveillance, BCD differentiated between influenza and non-influenza encounters well with an AUC of 0.90 and 0.97 with dynamic influenza prevalence (P < 0.0001). For clinical diagnosis, the addition of dynamic influenza prevalence to BCD significantly improved AUC from 0.63 to 0.85 to distinguish influenza from other causes of influenza-like illness. Conclusions and policy implications BCD can serve as an influenza surveillance and a differential diagnosis tool via our dynamic prevalence approach. It enhances the communication between public health and clinical practice.
The Foundations of General Equilibrium

This chapter introduces the primitive notions of a general equilibrium theory. Throughout this book I specifically focus on the problem of the social organization of pure barter or exchange processes. Therefore, I explicitly exclude production from the theory.1 The theory is designed using the so-called axiomatic approach as developed in full extent for economic theory in Debreu (1959). The axiomatic approach is a general methodology underlying any mathematical modelling. It amounts to the reduction of a scientific object to a number of irreducible primitive notions and a number of axioms describing the relationship between those primitive notions. Thus, it describes how to model the object under consideration and explain certain phenomena as observed, in relation to the object. Consequently, the axiomatic method allows the modelling of a scientific object to be performed at several levels. Certain primitive concepts may be irreducible in the first instance of reduction, but may be subject to a second reduction.
Conceptions of Genocide and the Ethics of Memorialization

Conceptions of genocide can be broadly divided into individualistic and collectivistic. According to the former, genocide is essentially a crime against (many) individuals; according to the latter, it is a crime against a group, which is not reducible to an aggregate of the individuals who belong to it. This chapter argues for the latter on the grounds that it is necessary to capture the distinctive moral evil of genocide. It also argues for a non-consequentialist way of accounting for the ethical value of memorializing genocide. This is called an expressivist approach and three attitudes that memorials may express are highlighted and explored: respect, self-respect, and fidelity to the dead. Different accounts are then presented to explain how these attitudes can belong not only to individuals but also to groups and how, therefore, an expressivist ethic of remembrance for groups is possible. The chapter concludes with a discussion of the principle of warranted self-testifying, according to which those who suffer harm are in an ethically privileged position to testify to it. This principle is applied to group memorialization of genocidal harm, conceived as a group practice.
Errors versus speed on the trail making test: Relevance to driving performance.

Abstract Background/Objectives Many studies have demonstrated that speed to complete items on the Trail Making Tests (TMT A and TMT B) is useful in the prediction of driving safety. However, there is no consensus regarding optimal “cut scores” to discriminate between safe and unsafe drivers. In this study, we examine TMT speed and errors in drivers referred for a road test. Design Retrospective analysis. Setting Patients referred for a DriveWise® evaluation at Beth Israel Deaconess Medical Center in Boston, Massachusetts. Participants Drivers age 65 or older were included (total n = 373). Forty-five percent of the sample had been diagnosed with Cognitive Impairment (CI) whereas the remaining participants were in the No Cognitive Impairment (NCI) group. Measurements TMT Parts A & B, Folstein Mini Mental Status Examination, Washington University Road Test. Results CI drivers with TMT A speed exceeding 46 s were more likely to fail the road test whereas TMT B speed was not a sensitive metric in this group. In the No Cognitive Impairment (NCI) group, TMT B speed exceeding 131 s predicted driving impairment whereas TMT A speed was not sensitive. Error scores were not useful in the determination of driving fitness for either group. Conclusions This study provides useful criteria for health providers working with older people in the determination of driving fitness. Results suggest that TMT speed, but not error rate, is associated with road test performance. Based on our work, we advocate that pre-existing dementia should be taken into consideration when using TMT performance as a screen for driving.
Diplomatic Material: Affect, Assemblage, and Foreign Policy: Durham and London: Duke University Press, 2017. 174 pages. Paperback ($22.62). ISBN: 978-0-822-36911-0.

Jason Dittmer's Diplomatic Material follows a pattern of scholarship in political geography generally referred to as critical geopolitics. With such geographers as Gerard Toal and Klaus Dodds, amon...
Understanding the Context of Unbalanced Domestic Contributions: The Influence of Perceiver's Attitudes, Target's Gender, and Presentational Format

A person perception study explored undergraduates' assessments of fairness and entitlement when a woman, a man, and a gender-indeterminate person overcontributed domestic work. Ninety women and 90 men evaluated 1 of 4 vignettes in which 1 member of a dual-employed, married couple reported doing 2/3 of the weekly household chores. More subtle indices revealed that men were viewed as more entitled to undercontribute than women. In stereotypic contexts where women overcontributed, undercontributing men were more acceptable to raters holding sexist attitudes. Student raters were more likely to detect unfairness with a tabular presentation than with a more ambiguous verbal description. These findings suggest that perceptions of fairness depend on presentational format, the attitudes of perceivers, and how the gender of an undercontributor (stereotypically and realistically a man) fits within its context (the stereotypically feminine domestic sphere).
Predictive Modeling of Carbon Nanotube Devices

Silicon based devices have been the forerunner in mainstream computing for the last 40 years. Their success relies on simultaneously achieving sustainable scaling of physical dimensions and device performance [1]. However, such a scaling trend has been significantly slowing down in recent years due to fundamental physics, materials, and manufacturing limits. Examples of major bottlenecks for continual scaling include short channel effects, high leakage currents, large process variations and reliability issues [2–4]. These pitfalls are rendering design and fabrication of integrated circuits increasingly difficult with scaled silicon devices. As we approach these fundamental limits in planar CMOS process, it becomes imperative to search for alternative materials, structures, and devices to replace silicon transistor as the building block of future nanoelectronics.
Restoration of coupling factor activity to Escherichia coli ATPase missing the delta subunit

We separated the two minor subunits (δ and e) of the E. coli ATPase from the major subunits (α, β, and γ). The minor subunit fraction was obtained by treating purified ATPase with pyridine following the procedure that Nelson et al. (J. Biol. Chem. 348, 2049 [1973]) used to separate the subunits of chloroplast ATPase. The minor subunit fraction restored the capacity of ATPase lacking the delta subunit to recombine with ATPase-depleted membrane vesicles and to reconstitute energy coupling to the transhydrogenase and oxidative phosphorylation in the vesicles. These results clearly implicate the delta subunit in the attachment of the ATPase to the membrane.
Epidemiology of Child Motor Vehicle Crash Injuries and Fatalities

Although children represent only 10–15 % of the overall traffic fatality burden in the United States, motor vehicle crashes (MVCs) remain the leading cause of death and disability for children and young adults; and, close to half of all unintentional injury deaths to children and adolescents (Centers for Disease Control and Prevention National Center for Injury Prevention and Control, Web-based Injury Statistics Query and Reporting System [CDC NCIPC WISQARS] 2010). Moreover, their exposure to motor vehicle risk is significant because they travel by motor vehicles nearly as much as adults. Prevention of the fatalities, injuries and disability associated with MVC must be a priority for ensuring our children’s overall health.
Abstract 4149: Inhibition of ribonucleotide reductase (RNR) in Ewing sarcoma cells results in suppression of protein synthesis

Ewing sarcoma is a highly aggressive bone and soft tissue cancer that is caused by the EWS-FLI1 fusion protein. EWS-FLI1 is required for tumor growth and survival. However, directly targeting EWS-FLI1 with drugs has been challenging and an alternative therapeutic approach is to identify unique vulnerabilities incurred by the oncoprotein. In previous work, we identified that Ewing sarcoma cells are uniquely vulnerable to drugs that inhibit ribonucleotide reductase (RNR), which is the rate limiting enzyme in the synthesis of deoxyribonucleotides. Furthermore, we also showed that blocking the function of checkpoint kinase 1 (CHK1), a major regulator of the response to impaired DNA replication, using either a small molecule inhibitor or siRNA-mediated knockdown causes synergistic toxicity with gemcitabine, an irreversible inhibitor of the RRM1 subunit of RNR, in Ewing sarcoma cells. In the current work, we identifiy that inhibition of RNR in Ewing sarcoma cells in vitro and in vivo results in the suppression of protein synthesis. Moreover, we have found that the treatment of Ewing sarcoma cell lines with gemcitabine results in an increase in the active (unphosphorylated) form of 4E-BP1, which is a well-described inhibitor of protein translation. However, in contrast to the Ewing sarcoma cells, treatment of other cell types with gemcitabine did not alter 4E-BP1 phosphorylation or protein synthesis. Currently, ongoing work is focused on the in vivo testing of gemcitabine, alone and in combination with CHK1, ataxia telangiectasia and rad3-related protein (ATR), and protein synthesis inhibitors, as a novel therapeutic approach for the treatment of Ewing sarcoma. Citation Format: Stacia Koppenhafer, Kelli Goss, David Gordon. Inhibition of ribonucleotide reductase (RNR) in Ewing sarcoma cells results in suppression of protein synthesis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4149.
A Communication-Avoiding 3D LU Factorization Algorithm for Sparse Matrices

We propose a new algorithm to improve the strong scalability of right-looking sparse LU factorization on distributed memory systems. Our 3D sparse LU algorithm uses a three-dimensional MPI process grid, aggressively exploits elimination tree parallelism and trades off increased memory for reduced per-process communication. We also analyze the asymptotic improvements for planar graphs (e.g., from 2D grid or mesh domains) and certain non-planar graphs (specifically for 3D grids and meshes). For planar graphs with n vertices, our algorithm reduces communication volume asymptotically in n by a factor of O{log n} and latency by a factor of O{log n}. For non-planar cases, our algorithm can reduce the per-process communication volume by 3× and latency by O{n^1/3} times. In all cases, the memory needed to achieve these gains is a constant factor. We implemented our algorithm by extending the 2D data structure used in superLU. Our new 3D code achieves speedups up to 27× for planar graphs and up to 3.3× for non-planar graphs over the baseline 2D superLU when run on 24,000 cores of a Cray XC30.
Deconstruction of the Surgical Approach to the Jugular Foramen Region: Anatomical Study.

Introduction The jugular foramen occupies a complex and deep location between the skull base and the distal-lateral-cervical region. We propose a morphometric anatomical model to deconstruct its surgical anatomy and offer various quantifiable target-guided exposures and angles-of-attack. Methods Six cadaveric heads (12 sides) were dissected using a combined postauricular infralabyrinthine and distal transcervical approach with additional anterior transstyloid and posterior far lateral exposures. We identified anatomical landmarks and combined new and previously described contiguous triangles to expose the region; we defined the jugular and deep condylar triangles. Angles-of-attack to the jugular foramen were measured after removing the digastric muscle, styloid process, rectus capitis lateralis, and occipital condyle. Results Removing the digastric muscle and styloid process allowed 86.4° laterally and 85.5° anteriorly, respectively. Resecting the rectus capitis lateralis and jugular process provided the largest angle-of-attack (108.4° posteriorly). The occipital condyle can be drilled in the deep condylar triangle only adding 30.4° medially. A purely lateral approach provided a total of 280.3°. Cutting the jugular ring and mobilizing the vein can further expand the medial exposure. Conclusion The microsurgical anatomy of the jugular foramen can be deconstructed using a morphometric model, permitting a surgical approach customized to the pathology of interest.
Bone marrow transplantation rescues monocyte recruitment defect and improves cystic fibrosis in mice

One Sentence Summary In this study, we demonstrate that correcting the monocyte adhesion defect in CFTRΔF508 mice (CF mice) by bone marrow transplantation significantly improved survival and reduced inflammation. Abstract Cystic fibrosis (CF) is an inherited life-threatening disease accompanied by repeated lung infections and multi-organ inflammation that affects tens of thousands of people worldwide. The causative gene, cystic fibrosis transmembrane conductance regulator (CFTR), is mutated in CF patients. Monocytes from CF patients show a deficiency in integrin activation and adhesion. Since monocytes play critical roles in controlling infections, defective monocyte function may contribute to CF progression. In this study, we demonstrate that monocytes from CFTRΔF508 mice (CF mice) show defective adhesion under flow. Transplanting CF mice with wild-type bone marrow after sublethal irradiation replaced most (60-80%) CF monocytes with wild-type monocytes, significantly improved survival, and reduced inflammation. Wild-type/CF mixed bone marrow chimeras directly demonstrated defective CF monocyte recruitment to the bronchoalveolar lavage and the intestinal lamina propria in vivo. Our findings show that providing wild-type monocytes by bone marrow transfer rescues gastrointestinal (GI) mortality in CF mice, suggesting that wild-type bone marrow stem cells might mitigate CF inflammation.
The Funding of Academic Research in the U.S.

This chapter presents the broad context of government funding of academic research in the U.S. It illustrates substantial disparities in federal funding for academic research across states. The chapter also briefly discusses why this has become a public policy issue and how federal government has responded.
Loss of flow responsive Tie1 results in Impaired Aortic valve remodeling.

The mechanisms regulating endothelial cell response to hemodynamic forces required for heart valve development, especially valve remodeling, remain elusive. Tie1, an endothelial specific receptor tyrosine kinase, is up-regulated by oscillating shear stress and is required for lymphatic valve development. In this study, we demonstrate that valvular endothelial Tie1 is differentially expressed in a dynamic pattern predicted by disturbed flow during valve remodeling. Following valvular endocardial specific deletion of Tie1 in mice, we observed enlarged aortic valve leaflets, decreased valve stiffness and valvular insufficiency. Valve abnormalities were only detected in late gestation and early postnatal mutant animals and worsened with age. The mutant mice developed perturbed extracellular matrix (ECM) deposition and remodeling characterized by increased glycosaminoglycan and decreased collagen content, as well as increased valve interstitial cell expression of Sox9, a transcription factor essential for normal ECM maturation during heart valve development. This study provides the first evidence that Tie1 is involved in modulation of late valve remodeling and suggests that an important Tie1-Sox9 signaling axis exists through which disturbed flows are converted by endocardial cells to paracrine Sox9 signals to modulate normal matrix remodeling of the aortic valve.
Risk Factors for Pseudarthrosis After Surgical Site Infection of the Spine

ABSTRACT Background: Pseudarthrosis following spinal fusion is a complication that frequently requires revision surgery. Reported rates of pseudarthrosis after surgical site infection (SSI) range from 30% to 85%, but few studies have identified infection as an independent risk factor for its development. The purpose of this study was to determine the incidence of clinically symptomatic pseudarthrosis in patient who developed SSI following lumbar fusion and to identify factors associated with its development. Methods: This was a retrospective review of a prospectively collected database. Patients who underwent spinal surgery and developed SSI between January 2005 and March 2015 with a minimum 2-year follow-up were included. Patient-specific and procedural characteristics were recorded. Presence of pseudarthrosis was determined clinically by the treating surgeon and was confirmed radiographically. All those in the Pseudarthrosis group required a revision procedure after the eradication of infection. Univariate and multivariate analyses were conducted as appropriate. Results: A total of 416 patients were included. Of these, 21 (5.0%) developed symptomatic pseudarthrosis following SSI. In this cohort, multivariate regression showed that age, Charlson Comorbidity Index, male sex, and surgical approach were not significant predictors of pseudarthrosis formation. However, number of levels fused was found to be the leading predictor for pseudarthrosis development (odds ratio [OR], 1.356/level, P Conclusions: The number of spinal levels fused and body mass index are independent predictors of pseudarthrosis in patients who develop SSI after spinal fusion. Level of Evidence: Level 4 Clinical Relevance: This is the first known study to specifically identify risk factors for the development of symptomatic pseudarthrosis.
More Unnecessary Imaginary Worlds - Part 3: Cystic Fibrosis and the Institute for Clinical and Economic Review's Draft Evidence Report.

On 20 February 2020, the Institute for Clinical and Economic Review (ICER) released its draft evidence report to establish the value of innovative therapies in the treatment of cystic fibrosis. Following its usual practice, ICER contracted with an outside group to construct a value assessment framework, in this case a microsimulation model, to generate value claims. The primary outcomes for value claims were incremental cost-per-QALY simulations for four target cystic fibrosis populations. The value assessment, in common with the same model applied earlier by ICER in cystic fibrosis, recommended substantial price discounts based on arbitrary threshold cost-per-QALY values. Unfortunately, the entire exercise, as detailed in previous commentaries in INNOVATIONS in Pharmacy is essentially a waste of time. Not only is the reference case model presented by ICER only one of a multiverse of other models, all driven by a selective application of model structure and assumptions, but the fact that the utilities that are applied to hypothetical time spent in different disease stages to modeled QALYs and lifetime cost-per-QALY claims fail to meet fundamental measurement axioms: they are ordinal manifest scores. Applied to target cystic fibrosis target patient groups, the modeled claims are meaningless. From the manufacturer’s perspective, in this case Vertex Pharmaceuticals who have developed all the cystic fibrosis therapies ‘modeled’ by the ICER contractor, their response to ICER claims should be to reject them out of hand; the constructs are imaginary and the outcome claims nonsense. Article Type: Commentary
Lateral Internal Sphincterotomy for Fissure-in-ano

This chapter describes the technical aspects of lateral internal sphincterotomy for fissure-in-ano including patient positioning, instrumentation, type of incision, and steps of the procedure. The authors also offer pearls and pitfalls.
Assistant coach hiring trends: an updated investigation of homologous reproduction in intercollegiate women’s sport

This study sought to update and expand upon previous applications of homologous reproduction in sport through an investigation of assistant coach hiring trends for six National Collegiate Athletic ...
TFP, News, and

We propose a novel identification scheme for a non-technology business cycle shock, that we label "sentiment." This is a shock orthogonal to identified surprise and news TFP shocks that maximizes the short-run forecast error variance of an expectational variable, alternatively a GDP forecast or a consumer confidence index. We then estimate the international transmission of three identified shocks – surprise TFP, news of future TFP, and "sentiment" – from the US to Canada. The US sentiment shock produces a business cycle in the US, with output, hours, and consumption rising following a positive shock, and accounts for the bulk of short-run business cycle fluctuations in the US. The sentiment shock also has a significant impact on Canadian macro aggregates. In the short run, it is more important than either the surprise or the news TFP shocks in generating business cycle comovement between the US and Canada, accounting for up to 50% of the forecast error variance of Canadian GDP and about one-third of Canadian hours, imports, and exports. The news shock is responsible for some comovement at 5-10 years, and surprise TFP innovations do not generate synchronization.
Editorial Commentary: Emergency Department Evaluation After Hip Arthroscopy Occurs More than Expected: Here's Where Patient Education and a Multimodal Approach to Pain Management Can Be Helpful.

Abstract Hip arthroscopy is known to be a relatively safe procedure with a limited and unique set complications and low hospital readmission rates. Many patients, however, may seek emergency department evaluation after surgery for postoperative pain or complaints unrelated to the most commonly cited complications, such as traction neuropraxia. It is important to recognize and understand the reasons why patients seek medical care after surgery because many of these encounters may be preventable with optimization of perioperative multimodal pain control regimens and proper patient education regarding their expected postoperative course. Patients with barriers to health care access, such as Medicare and Medicaid patients, may be at higher risk for emergency department evaluation of their problems after surgery and clinicians should consider providing additional counseling to these patients regarding when and how to seek medical evaluation after surgery.
Improving All-Cause Inpatient Mortality After Percutaneous Endoscopic Gastrostomy

Percutaneous gastrostomy (PEG) is a common inpatient procedure. Prior data from National Inpatient Sample (NIS) in 2006 reported a mortality rate of 10.8% and recommended more careful selection of PEG candidates. This study assessed for improvement in the last 10 years in mortality rate and complications for hospitalized patients. A retrospective cohort analysis of all adult inpatients in the NIS from 2006 to 2016 undergoing PEG placement compared demographics and indication for PEG placement per ICD coding. Survey-based means and proportions were compared to 2006, and rates of change in mortality and complication rates were trended from 2006 through 2016 and compared with linear regression. Multivariable survey-adjusted logistic regression was used to determine predictors of mortality and complications in the 2016 sample. A total of 155,550 patients underwent PEG placement in 2016, compared with 174,228 in 2006. Mortality decreased from 10.8 to 6.6% without decreased comorbidities (p < 0.001). This trend was gradual and persistent over 10 years in contrast to a stable overall inpatient mortality rate (p = 0.113). Stroke remained the most common indication (29.7%). The majority of patients (64.6%) had Medicare. Indications for placement were stable. Complication rates were stable from 2006 (4.4%) to 2016 (5.1%) (p = 0.201). Inpatient PEG placement remains common. Despite similar patient characteristics, mortality has decreased by approximately 40% over the last 10 years without a decrease in complications likely reflecting improved patient selection.
Advanced Surgical and Percutaneous Approaches to Pulmonary Vascular Disease.

Despite progress in modern medical therapy, pulmonary hypertension remains an unremitting disease. Once severe or refractory to medical therapy, advanced percutaneous and surgical interventions can palliate right ventricular overload, bridge to transplantation, and overall extend a patient's course. These approaches include atrial septostomy, Potts shunt, and extracorporeal life support. Bilateral lung transplantation is the ultimate treatment for eligible patients, although the need for suitable lungs continues to outpace availability. Measures such as ex vivo lung perfusion are ongoing to expand donor lung availability, increase rates of transplant, and decrease waitlist mortality.
Development of a Micro Tensile Kolsky Bar

A design for a miniature tensile Kolsky bar is proposed. The design is intended to test metallic samples with typical gage lengths of 500 μm and cross-sectional areas on the order of 10,000 μm2. The bars will be steel and 1.5 mm in diameter, although smaller diameter output bars will be used to suit sample needs. The projectile, at least in the initial design, will be accelerated by a spring to avoid the complexities involved in fabricating a small gas gun. Optical instrumentation will be used instead of strain-gages; normal displacement interferometers will be used to measure the displacement of the free end of each bar. This will provide the necessary data to analyze the specimen behavior. The ultimate objective is to use this bar to study the influence of microstructural defects on failure of ductile metals.
The morbidity of open tumor biopsy for intraabdominal neoplasms in pediatric patients.

Tumor biopsy is often essential for diagnosis and management of intraabdominal neoplasms found in children. Open surgical biopsy is the traditional approach used to obtain an adequate tissue sample to guide further therapy, but image-guided percutaneous core-needle biopsy is being used more often due to concerns about the morbidity of open biopsy. We used a national database to evaluate the morbidity associated with open intraabdominal tumor biopsy. We identified all patients undergoing laparotomy with tumor biopsy in the National Surgical Quality Improvement Project-Pediatric (NSQIP-P) database from 2012 to 2018 and measured the frequency of complications in the 30 days postoperatively. We tested associations between patient characteristics and outcomes to identify risk factors for complications. We identified 454 patients undergoing laparotomy for biopsy of an intraabdominal neoplasm. Median postoperative hospital stay was 7 days (IQR 4–12) and operative time was 117 min (IQR 84–172). The overall complication rate was 12.1%, with post-operative infection (6%) and bleeding (4.2%) being the most common complications. Several patient characteristics were associated with bleeding, but the only significant association on multivariable analysis was underlying hematologic disorder. Open abdominal surgery for pediatric intraabdominal tumor biopsy is accompanied by significant morbidity. Postoperative infection was the most common complication, which can delay initiation of further therapy, especially chemotherapy. These findings support the need to prospectively compare percutaneous image-guided core-needle biopsy to open biopsy as a way to minimize risk and optimize outcomes for this vulnerable population.
Optimal Routing in Stochastic Networks with Reliability Guarantees

Optimal routing in highly congested street networks where the travel times are often stochastic is a challenging problem with significant practical interest. While most approaches to this problem use minimizing the expected travel time as the sole objective, such a solution is not always desired, especially when the variance of travel time is high. In this work, we pose the problem of finding a routing policy that minimizes the expected travel time under the hard constraint of retaining a specified probability of on-time arrival. Our approach to this problem models the stochastic travel time on each segment in the road network as a discrete random variable, thus translating the model of interest into a Markov decision process. Such a setting enables us to interpret the problem as a linear program. Our work also includes a case study on the street of Manhattan, New York where we constructed the model of travel times using real-world data, and employed our approach to generate optimal routing policies.
Spiritus Vini [Ethyl Alcohol]

§ 207. Spiritus [Vini] is miscible with water, a general property of three kinds of materials, namely alkalis, acids and inflammables.
Rediscovering Historical Memory: German Foreign Military Intervention Decision Making Through the Second Lebanon War

This research tests theories for explaining recent German decisions to deploy or not deploy forces abroad. Underpinning this research is the rejection of a common scholarly reaction to German intervention policy, which is to disregard it as irrational or simply inexplicable, thereby degrading our overall understanding of interventions. Four approaches for unraveling this puzzle are tested, three common to the foreign policy literature but a fourth is borrowed from social psychology. Each of these approaches predicts to subsequent behaviors by first establishing decision maker “problem representations” emphasizing the process of option generation rather than option selection. Verbatim parliamentary statements of German representatives are coded for periods between 1990 and 2006. The study hypothesizes that the observation of problem representations provides a hitherto lacking theoretical structure to decisions. Data from 1,436 speeches provide mixed evidence. First, it indicates that German decision making vis-a-vis foreign military interventions is systematic and theoretically structured. Among the patterns is the importance of institutionalist problem representations. Also, results indicate a strength of realist problem representations and a weakness of historical-cultural problem representations with the main exception of the Lebanon occasion. The study concludes with observations on the generalizability of these findings to other decision-making contexts.
Interstudy variability in cardiac magnetic resonance imaging measurements of ventricular volume, mass, and ejection fraction in repaired tetralogy of Fallot: a prospective observational study.

Purpose To assess the interstudy variability of cardiac magnetic resonance imaging (CMR) parameters of ventricular size and function in repaired tetralogy of Fallot (TOF). Materials and Methods Patients with TOF (n = 30, median age 23.5 years, 43% male) were enrolled prospectively. Each patient underwent two consecutive CMR examinations on the same day. Each examination was analyzed for ventricular size and function by two observers and multiple comparisons were made with assessment of agreement using Bland–Altman analysis and intraclass correlation coefficients (ICC). Results Agreement for most measures of ventricular size and function was high when a single observer analyzed both studies. Agreement was worse when different observers analyzed sequential studies. This effect was most prominent on measurements of right ventricular (RV) mass and there was slight improvement when mass was measured during systole. Aside from ventricular mass, agreement was similar for RV and left ventricular (LV) parameters. Conclusion CMR measures of ventricular size and function have acceptable repeatability across serial examinations in patients with repaired TOF. Measurements of RV mass are subject to higher variability. For most parameters, agreement limits are wider when measurements are performed by multiple operators. These results will aid in the interpretation of study-to-study variations in the follow-up of individual patients and in designing future clinical trials. J. Magn. Reson. Imaging 2013;38:829–835. © 2013 Wiley Periodicals, Inc.
Improving in-season nitrogen recommendations for maize using an active sensor

An active crop canopy reflectance sensor could be used to increase N-use efficiency in maize (Zea mays L.), if temporal and spatial variability in soil N availability and plant demand are adequately accounted for with an in-season N application. Our objective was to evaluate the success of using an active canopy sensor for developing maize N recommendations. This study was conducted in 21 farmers’ fields from 2007 to 2009, representing the maize production regions of east central and southeastern Pennsylvania, USA. Four blocks at each site included seven sidedress N rates (0–280 kg N ha −1 ) and one at-planting N rate of 280 kg N ha−1. Canopy reflectance in the 590 nm and 880 nm wavelengths, soil samples, chlorophyll meter (SPAD) measurements and above-ground biomass were collected at the 6th–7th-leaf growth stage (V6–V7). Relative amber normalized difference vegetative index (ANDVIrelative) and relative SPAD (SPADrelative) were determined based on the relative measurements from the zero sidedress treatment to the 280 kg N ha−1 at-planting treatment. Observations from the current study were compared to relationships between economic optimum N rate (EONR) and ANDVIrelative, presidedress NO3 test (PSNT), or SPADrelative that were developed from a previous study. These comparisons were based on an absolute mean difference (AMD) between observed EONR and the previously determined predicted relationships. The AMD for the relationship between EONR and ANDVIrelative in the current study was 46 kg N ha −1 . Neither the PSNT (AMD = 66 kg N ha−1) nor the SPADrelative (AMD =7 2 kg Nh a−1) provided as good an indicator of EONR. When using all the observations from the two studies for the relationships between EONR and the various measurements, ANDVIrelative (R2 = 0.65) provided a better estimate of EONR than PSNT (R 2
Magma mixing as a source for Pinatubo sulphur

On 15 June 1991, a huge plinian eruption at Mount Pinatubo discharged 3.7–5.3 km3of pyroclastic material1, along with a minimum of 17 megatonnes of SO2 gas2,3. This represents the largest stratospheric SO2 cloud ever measured, and the SO2 generated in this eruption is believed to have had a significant effect on global climate2,4 and the ozone layer4 for several years after the event. The source for this massive amount of SO2 aerosols remains controversial. Here I present thermodynamic arguments which suggest that the source of the SO2, along with the trigger for the eruption itself, can be attributed to redox reactions accompanying the injection of a reduced sulphide-saturated basaltic magma into an oxidized sulphate-saturated dacitic melt. The proposed mixing event would drive most sulphur out of both dacitic and basaltic liquids and would drive both anhydrite and iron-rich sulphide liquid outside their stability field, thus purging sulphur from all major non-volatile sulphur-bearing phases in the mixed volume. Similar eruptions are possible any time that an oxidized sulphate-saturated magma interacts with a reduced sulphide-saturated magma, and this mechanism may therefore be relevant to recent volcanic activity at Popocatepetl Volcano in Mexico.
Beyond Principal Components: Deep Boltzmann Machines for face modeling

The “interpretation through synthesis”, i.e. Active Appearance Models (AAMs) method, has received considerable attention over the past decades. It aims at “explaining” face images by synthesizing them via a parameterized model of appearance. It is quite challenging due to appearance variations of human face images, e.g. facial poses, occlusions, lighting, low resolution, etc. Since these variations are mostly non-linear, it is impossible to represent them in a linear model, such as Principal Component Analysis (PCA). This paper presents a novel Deep Appearance Models (DAMs) approach, an efficient replacement for AAMs, to accurately capture both shape and texture of face images under large variations. In this approach, three crucial components represented in hierarchical layers are modeled using the Deep Boltzmann Machines (DBM) to robustly capture the variations of facial shapes and appearances. DAMs are therefore superior to AAMs in inferring a representation for new face images under various challenging conditions. In addition, DAMs have ability to generate a compact set of parameters in higher level representation that can be used for classification, e.g. face recognition and facial age estimation. The proposed approach is evaluated in facial image reconstruction, facial super-resolution on two databases, i.e. LFPW and Helen. It is also evaluated on FG-NET database for the problem of age estimation.
Detecting Nitrous Oxide Reductase (nosZ) Genes in Soil Metagenomes: Method Development and Implications for the Nitrogen Cycle

ABSTRACT Microbial activities in soils, such as (incomplete) denitrification, represent major sources of nitrous oxide (N2O), a potent greenhouse gas. The key enzyme for mitigating N2O emissions is NosZ, which catalyzes N2O reduction to N2. We recently described “atypical” functional NosZ proteins encoded by both denitrifiers and nondenitrifiers, which were missed in previous environmental surveys (R. A. Sanford et al., Proc. Natl. Acad. Sci. U. S. A. 109:19709–19714, 2012, doi:10.1073/pnas.1211238109). Here, we analyzed the abundance and diversity of both nosZ types in whole-genome shotgun metagenomes from sandy and silty loam agricultural soils that typify the U.S. Midwest corn belt. First, different search algorithms and parameters for detecting nosZ metagenomic reads were evaluated based on in silico-generated (mock) metagenomes. Using the derived cutoffs, 71 distinct alleles (95% amino acid identity level) encoding typical or atypical NosZ proteins were detected in both soil types. Remarkably, more than 70% of the total nosZ reads in both soils were classified as atypical, emphasizing that prior surveys underestimated nosZ abundance. Approximately 15% of the total nosZ reads were taxonomically related to Anaeromyxobacter, which was the most abundant genus encoding atypical NosZ-type proteins in both soil types. Further analyses revealed that atypical nosZ genes outnumbered typical nosZ genes in most publicly available soil metagenomes, underscoring their potential role in mediating N2O consumption in soils. Therefore, this study provides a bioinformatics strategy to reliably detect target genes in complex short-read metagenomes and suggests that the analysis of both typical and atypical nosZ sequences is required to understand and predict N2O flux in soils. IMPORTANCE Nitrous oxide (N2O) is a potent greenhouse gas with ozone layer destruction potential. Microbial activities control both the production and the consumption of N2O, i.e., its conversion to innocuous dinitrogen gas (N2). Until recently, consumption of N2O was attributed to bacteria encoding “typical” nitrous oxide reductase (NosZ). However, recent phylogenetic and physiological studies have shown that previously uncharacterized, functional, “atypical” NosZ proteins are encoded in genomes of diverse bacterial groups. The present study revealed that atypical nosZ genes outnumbered their typical counterparts, highlighting their potential role in N2O consumption in soils and possibly other environments. These findings advance our understanding of the diversity of microbes and functional genes involved in the nitrogen cycle and provide the means (e.g., gene sequences) to study N2O fluxes to the atmosphere and associated climate change.
Visually optimized image reconstruction

Exploiting human visual limitations in image reconstruction significantly reduces computational complexity. Based on a multiresolution pyramid image representation, direct and indirect exploitation of these limitations are attainable. In this study, direct exploitation of the variable acuity feature of the human visual system is achieved through tracking the viewer's fovea. Multiresolution images are reconstructed such that high resolution is assigned to a rectangular region, centered at the fovea, with spatial resolution dropping gradually with eccentricity. Indirect exploitation makes use of the human visual sensitivity to abrupt intensity changes (edges) in the image. Accordingly, high resolution need only be preserved within 2X2 pixel neighborhood around the detected edges while low resolution is assigned elsewhere. The amount of savings in the number of pixels rendered could be as high as 98% for the direct exploitation and may exceed 50% (depending on image edge density) for the indirect application.© (1990) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Expectations and Preferences for Sequences of Health and Money

Three experiments demonstrated that preferences for sequences of money differed from preferences for sequences of health. Undergraduates gave preference ratings for graphs that illustrated how monetary income or health quality might change over time, with total amount of money or health held constant. In Experiment 1, subjects expected to experience health that decreased over a lifetime; they also preferred such a sequence. In contrast, they expected to experience increasing monetary income over their lifetimes and preferred such monetary sequences. Experiment 2 showed that these different preferences for sequences of health and money did not hold true for short, 1-year sequences, where subjects had similar expectations about health and money. Experiment 3 replicated Experiment 2 and showed that expectations mediate the effect on preference of decision domain (health or money) and sequence length. These results point to the importance of expectations in forming preferences for sequences.