cssi/SciSciGPT-SciSciNet huggingface dataset:
Exercise has a Disproportionate Role in the Pathogenesis of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy in Patients Without Desmosomal Mutations

Background Exercise is associated with age‐related penetrance and arrhythmic risk in carriers of arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C)‐associated desmosomal mutations; however, its role in patients without desmosomal mutations (gene‐elusive) is uncertain. This study investigates whether exercise is (1) associated with onset of gene‐elusive ARVD/C and (2) has a differential impact in desmosomal and gene‐elusive patients. Methods and Results Eighty‐two ARVD/C patients (39 desmosomal, all probands) were interviewed about regular physical activity from age 10. Participation in endurance athletics, duration (hours/year), and intensity (MET‐Hours/year) of exercise prior to clinical presentation were compared between patients with desmosomal and gene‐elusive ARVD/C. All gene‐elusive patients were endurance athletes. Gene‐elusive patients were more likely to be endurance athletes ( P <0.001) and had done significantly more intense (MET‐Hrs/year) exercise prior to presentation ( P <0.001), particularly among cases presenting < age 25 ( P =0.027). Family history was less prevalent among gene‐elusive patients (9% versus 40% desmosomal, P <0.001), suggesting a greater environmental influence. Gene‐elusive patients without family history did considerably more intense exercise than other ARVD/C patients ( P =0.004). Gene‐elusive patients who had done the most intense (top quartile MET‐Hrs/year) exercise prior to presentation had a younger age of presentation ( P =0.025), greater likelihood of meeting ARVD/C structural Task Force Criteria (100% versus 43%, P =0.02), and shorter survival free from a ventricular arrhythmia in follow‐up ( P =0.002). Conclusions Gene‐elusive, non‐familial ARVD/C is associated with very high intensity exercise suggesting exercise has a disproportionate role in the pathogenesis of these cases. As exercise negatively modifies cardiac structure and promotes arrhythmias, exercise restriction is warranted.
Rate-distortion analysis and streaming of SP and SI frames

The new SP and SI picture types, introduced in the latest video coding standard H.264, allow drift-free bitstream switching and can also be used for error-resilience and random access. In this paper, we propose a model for the rate-distortion performance of SP and SI pictures and compare it to experimental results, obtained with our implementation of an SP/SI encoder, made publicly available and recently adopted by the Joint Video Team. The model predicts how the relative sizes of SP and SI slices can be traded off. We analyze, both theoretically and experimentally, how this can be used to minimize the transmitted bit rate when SP frames are used for video streaming with packet losses and derive optimal settings for our encoder. We investigate the benefits of SI and SP frames for error resilience as compared with periodic I frame insertion. Empirical rate-distortion curves predict rate-distortion gains may be obtained. Experiments carried out over a simulated throughput-limited network confirm this to be the case when the end-to-end delay is limited. We analyze the influence of loss rate and delay on the congestion-rate-distortion performance of streaming with SI and SP frames. Our results identify scenarios for which SI and SP frames provide an attractive alternative to streaming with I frames.
Hybrid Integration of a Bowtie Slot Antenna and a Quantum Dot Mode-Locked Laser

This letter discusses the integration of a mode-locked quantum dot (QD) laser and an antenna. A brief theory of operation for the reconfigurable mode-locked QD laser is first presented, and the design of the antenna as well as the matching network used to connect the photonic source to the antenna are explained and discussed. The ultimate goal is to achieve a compact RF/photonic chip that can radiate from 10 to 100 GHz. Here, we present the initial proof of concept and the challenges associated with integrating the antenna with the QD mode-locked laser.
Consequences of the increasing rationality of music: A reassessment of Weberian rationalization

Max Weber's theory of the rationalization of music is used to demonstrate that there is a nexus between the tonal structure of music, which is formally “rational” in the Weberian sense, and the fundamental irrational properties on which it rests. It is posited that Weber, although failing to differentiate between types of irrationality, was primarily concerned with only two forms: harmonic‐structural and interpretational. Ironically, there is another more sociological type of irrationality that Weber failed to address. This type may be termed “interactional” irrationality. The importance of recognizing this element within the musical organization is critical, as the balance between rationality and irrationality becomes increasingly delicate. Case studies of professional, classically trained symphonic musicians and conductors illustrate the irrational consequences of growing rationality within the social organization of symphonic music.
Emerging Endoscopic Therapies for Nonvariceal Upper Gastrointestinal Bleeding

Several new devices and innovative adaptations of existing modalities have emerged as primary, adjunctive, or rescue therapy in endoscopic hemostasis of gastrointestinal hemorrhage. These techniques include over-the-scope clip devices, hemostatic sprays, cryotherapy, radiofrequency ablation, endoscopic suturing, and endoscopic ultrasound-guided angiotherapy. This review highlights the technical aspects and clinical applications of these devices in the context of nonvariceal upper gastrointestinal bleeding.
Hybrid solar cells using GaAs nanopillars

Light conversion and carrier transport in hybrid solar cells fabricated by spin coating poly(3-hexylthiophene) (P3HT) on ordered n-GaAs nanopillars are studied via electrical and optical characterization. The performance of hybrid nanopillar/P3HT solar cells is compared to control cells having either only P3HT or only GaAs nanopilllars. The hybrid devices show better performance, with a V oc , J sc and FF of 0.2 V, 8.7 mA/cm2 and 32% respectively. Efficient exciton dissociation at the P3HT/GaAs interface was confirmed by PL quenching measurements.
Hormones and the Bone Marrow: Panhypopituitarism and Pancytopenia in a Man with a Pituitary Adenoma

In rare cases, pancytopenia results from hormonal deficiencies that arise in the setting of panhypopituitarism. Here we describe the unusual case of a 60-year-old man who presented with progressive fatigue and polyuria, and whose laboratory workup revealed a deficiency of the five hormones associated with the action of the anterior pituitary (thyroid hormone, testosterone, cortisol, prolactin, and insulin-like growth factor-1). Imaging of the pituitary demonstrated a cystic mass consistent with a pituitary adenoma replacing much of the normal pituitary tissue. His symptoms and hematologic abnormalities rapidly resolved with prednisone and levothyroxine supplementation. While the majority of reported cases of panhypopituitarism with bone marrow suppression are the result of peripartum sepsis or hemorrhage leading to pituitary gland necrosis (Sheehan’s syndrome), it is also important to consider the diagnosis of hypopituitarism in patients with hypothyroidism, low cortisol levels, and pancytopenia. The causal relationship between pancytopenia and panhypopituitarism is not well understood, though it does reinforce the important influence of these endocrine hormones on the health of the bone marrow.
Predicting survival in patients with metastatic kidney cancer by gene-expression profiling in the primary tumor

To identify potential molecular determinants of tumor biology and possible clinical outcomes, global gene-expression patterns were analyzed in the primary tumors of patients with metastatic renal cell cancer by using cDNA microarrays. We used grossly dissected tumor masses that included tumor, blood vessels, connective tissue, and infiltrating immune cells to obtain a gene-expression “profile” from each primary tumor. Two patterns of gene expression were found within this uniformly staged patient population, which correlated with a significant difference in overall survival between the two patient groups. Subsets of genes most significantly associated with survival were defined, and vascular cell adhesion molecule-1 (VCAM-1) was the gene most predictive for survival. Therefore, despite the complex biological nature of metastatic cancer, basic clinical behavior as defined by survival may be determined by the gene-expression patterns expressed within the compilation of primary gross tumor cells. We conclude that survival in patients with metastatic renal cell cancer can be correlated with the expression of various genes based solely on the expression profile in the primary kidney tumor.
Breast-feeding in the management of the newborn with phenylketonuria: A practical approach to dietary therapy

Abstract Guidelines introduced in 1979 for breast-feeding infants with phenylketonuria included a formula containing low amounts of phenylalanine (PHE) as part of the dietary prescription. Although the guidelines were revised in 1988, new PHE-free products were not included. In addition, the guidelines recommend infant weight checks before and after feeding to ensure correct dietary intake of breast milk. In this study, we present data based on treatment of 13 infants for the first 6 months of life using a PHE-free product and human milk (n=9) or commercial formula (n=4). The study began with nine breast-fed infants; five were weaned before 6 months of age and were discontinued from the study. Published estimates of volume and energy of daily human milk consumption were used to prescribe and assess intake of breast milk. No differences were noted between the groups in blood levels of PHE at initiation of dietary therapy, age at initiation of dietary therapy, or length of time to achieve metabolic control. Furthermore, blood levels of PHE and growth parameters for each month up to 6 months of age were similar for both groups. These data support the efficacy of PHE-free formula and estimation of breast milk volumes in managing the diet of infants with phenylketonuria.
Error Probability Bounds for Bit-Interleaved Space–Time Trellis Coding Over Block-Fading Channels

In this correspondence, we investigate the error probability bounds of a bit-interleaved space-time trellis coding (BISTTC) scheme, which concatenates bit-interleaved coded modulation (BICM) with a space-time trellis code (STTC). We focus on general block-fading channels, wherein each data packet or frame spans a number of independent fading blocks. BICM applied to such channel environments can effectively exploit both time and frequency selectivity, while a STTC maximizes the spacial diversity order. The exact pairwise error probability (PEP) and weight enumeration function (WEF) of BISTTC are used to evaluate the error bound. Due to the concatenation of an outer error correction code (ECC) and a STTC, the overall WEF of BISTTC is obtained by combining the WEF of the outer code with that of the STTC through an uniform interleaver. The main challenge here is to compute the WEF of a STTC for block-fading channels with reasonable complexity. We rely on constructing a composite state transition matrix based on a number of single-step virtual trellises, each corresponding to an independent fading block within a frame. We discuss how this approach reduces storage and computational requirements in the bound analysis, compared to the existing method of obtaining the state transition matrix through accumulation of single-step transition matrices. The derived bound is applicable to both spatially uncorrelated and correlated channels as well as to both flat and frequency-selective block-fading channels. The bound is shown to provide a reasonably close estimate of the simulated performance based on the turbo equalizer-like iterative processing of soft information between the STTC decoder and the ECC decoder.
Build an operating system from scratch: a project for an introductory operating systems course

This paper describes a semester project where students design an operating system from the ground-up, capable of booting from a floppy disk on an actual machine. Unlike previous projects of this kind, this project was designed for students with only one semester of programming experience and no prior exposure to data structures, assembly language, or computer organization. Students nevertheless wrote a full system consisting of system calls, program execution, a file system, a command-line shell, and support for multiprocessing. The project was assigned to a class and successfully completed by nearly every student.
Predicting streamflow response to fire-induced landcover change: Implications of parameter uncertainty in the MIKE SHE model

Abstract Fire is a primary agent of landcover transformation in California semi-arid shrubland watersheds, however few studies have examined the impacts of fire and post-fire succession on streamflow dynamics in these basins. While it may seem intuitive that larger fires will have a greater impact on streamflow response than smaller fires in these watersheds, the nature of these relationships has not been determined. The effects of fire size on seasonal and annual streamflow responses were investigated for a medium-sized basin in central California using a modified version of the MIKE SHE model which had been previously calibrated and tested for this watershed using the Generalized Likelihood Uncertainty Estimation methodology. Model simulations were made for two contrasting periods, wet and dry, in order to assess whether fire size effects varied with weather regime. Results indicated that seasonal and annual streamflow response increased nearly linearly with fire size in a given year under both regimes. Annual flow response was generally higher in wetter years for both weather regimes, however a clear trend was confounded by the effect of stand age. These results expand our understanding of the effects of fire size on hydrologic response in chaparral watersheds, but it is important to note that the majority of model predictions were largely indistinguishable from the predictive uncertainty associated with the calibrated model—a key finding that highlights the importance of analyzing hydrologic predictions for altered landcover conditions in the context of model uncertainty. Future work is needed to examine how alternative decisions (e.g., different likelihood measures) may influence GLUE-based MIKE SHE streamflow predictions following different size fires, and how the effect of fire size on streamflow varies with other factors such as fire location.
Stability analysis of refrigeration systems for electronics cooling

In modeling studies of vapor compression cycles, the momentum balance equation is usually ignored in the dynamic heat exchanger models. However, in micro-scale heat exchangers, significant pressure drop has been observed. In this paper, we investigate the effects of the momentum balance through a systematic study of the open loop stability of a heat exchanger. We consider 1-D compressible fluid flow in a general circular channel with heat transfer exists. The mass, momentum, and energy conservation equations are all included in the analysis. For the complete cycle, we model the compressor and valve as static elements, since they have much faster dynamics. Based on the finite difference approximation of the dynamic model, we obtained a necessary and sufficient condition for the open loop stability of the vapor compression cycle about a given operating point. A simple simulation example shows that the stabilizing condition agrees with the numerical simulation results. The results of this study form the foundation to investigate the open loop stability and closed loop control design for vapor compression cycles used in electronics cooling systems.
Controlled release of flavour in food products

Publisher Summary This chapter provides an overview of the processes used to encapsulate flavorings and discusses controlled release in this context. Owing to the wide range in techniques used for this purpose, only major processes have been discussed in the chapter. In many food applications, it is desirable to use some method of encapsulation for the protection of food flavorings from losses. Encapsulation is also used in some applications to afford a controlled release property to the flavoring. Controlled release is a means of further offering protection to a flavoring in that the flavor is “locked” up in an encapsulation matrix until some point later in the processing, storage, home preparation, or even consumption stage, when it is released for sensing. This delay in release can minimize flavor volatilization, oxidation, or chemical reaction, thereby improving the performance of the flavoring.
On the Properties of the Primary Loss and the Excess Loss in NCCI's Experience Rating Plan

The split credibility has been used in practice for several decades, though the foundational theory of split credibility was only investigated recently. This paper intends to study the properties of the primary loss and the excess loss in NCCI's split experience plan. We first revisit the the claim that the excess loss is more volatile than the total loss. We show that this is true in the collective risk model with an arbitrary frequency distribution; this generalizes the previous result in the literature where the frequency distribution is assumed to be Poisson. We also show that the primary loss is less volatile than the total loss. Next, we point out that the usual setup of credibility theory entails an exchangeable model, then we propose a generalized collective risk model, and show that the previously established ordering of the CV's of the primary loss, the excess loss and the total loss also holds in such a model. Finally, we investigate the covariance and correlation coefficient between the primary loss and the excess loss. The paper concludes with two conjectures.
Hepatitis C virus: how to provide the best treatment with what I have

The therapeutic landscape for the treatment of chronic hepatitis C virus infection has been rapidly evolving, and by 2016 there will be six approved, all-oral regimens for use in patients in the USA and most of Western Europe. However, as many as patient populations will have limited access to new direct acting antiviral regimens, patients and physicians are often faced with the challenge of selecting the best regimen available, as opposed to the optimal treatment. In this paper, the challenges and opportunities in developing a high cure regimen for different patient populations will be discussed and highlighted through case-based scenarios.
Epidermal growth factor receptor downregulation by small heterodimeric binding proteins

No single engineered protein has been shown previously to robustly downregulate epidermal growth factor receptor (EGFR), a validated cancer target. A panel of fibronectin-based domains was engineered to bind with picomolar to nanomolar affinity to multiple epitopes of EGFR. Monovalent and homo- and hetero-bivalent dimers of these domains were tested for EGFR downregulation. Selected orientations of non-competitive heterodimers decrease EGFR levels by up to 80% in multiple cell types, without activating receptor signaling. These heterodimers inhibit autophosphorylation, proliferation and migration, and are synergistic with the monoclonal antibody cetuximab in these activities. These small (25 kDa) heterodimers represent a novel modality for modulating surface receptor levels.
Student Accountability in Team-based Learning Classes

Team-based learning (TBL) is a form of small-group learning that assumes stable teams promote accountability. Teamwork promotes communication among members; application exercises promote active learning. Students must prepare for each class; failure to do so harms their team’s performance. Therefore, TBL promotes accountability. As part of the course grade, students assess the performance of their teammates. The evaluation forces students to rank their teammates and to provide rationale for the highest and lowest rankings. These evaluations provide rich data on small-group dynamics. In this paper, we analyze 211 student teammate assessments. We find evidence that teams consistently give the lowest evaluations to their least involved members, suggesting that the team component increases accountability, which can promote learning. From these findings we draw implications about small-group dynamics in general and the pedagogy of TBL in particular.
PKU and State Legislation—Good and Bad

It is time to be at least equally concerned with the quality of state legislation for children as with its quantity. Although 29 states passed legislation related to phenylketonuria (PKU) by November 1965, there are serious drawbacks to the structure of some of the laws. For example, most of the 29 states require that newborn infants be tested for the presence of metabolic abnormalities which may be expected to result in subsequent mental deficiency (PKU Test).
Information as IP Subject Matter

This paper is a draft chapter from a forthcoming book on copyright law in the digital environment. This chapter (Draft Chapter 1 in the book) addresses the basic question of information as subject matter of IP regulation, especially in the context of copyright law. It develops a conception of information that seeks to descriptively and prescriptively inform the debate over property-like rights in "information" at a rather abstract level. The paper further suggests that this conception is applicable to numerous questions of regulation, policy and judicial interpretation.
Morphology and Cytology of Diplocarpon Maculatum on Crataegus. I. The Entomosporium Stage

(1966). Morphology and Cytology of Diplocarpon Maculatum on Crataegus. I. The Entomosporium Stage. Mycologia: Vol. 58, No. 6, pp. 949-960.
The Effect of Mass Resolution During Ion Implantation on Defect Formation and Electrical Properties in Gallium Arsenide.

Control of threshold voltage during gallium arsenide (GaAs) Metal Semiconductor Field Effect Transistor (MESFET) processing is critical. Channel formation typically is done using ion implantation of 29Si+ from a SiF4 source. The use of Si+ presents a variety of potential cross-contamination problems. 28Si+ and 30Si+ beams can become contaminated with 28N2+, 28CO+, and 30NO+. While 29Si+ is relatively pure, the abundance of 29Si+ in the mass spectrum is 4.67%, thus reducing the potential beam current. This study investigates the effects of varying the mass resolving power of an Eaton 6200AV implanter on the electrical parameters and defect formation. The mass resolving power was adjusted by changing the mean path size through the slit of the aperture opening and magnetic separator current. Electrical device characterization measured a small shift in saturated source-drain current (Idss) and break down voltage, while threshold voltage shifts of approximately 80 mV were observed, with the various mass resolution powers. Transmission Electron Microscopy (TEM) showed that there is minimal change in the extended defect density with changes in isotope and aperture opening. Secondary Ion Mass Spectrometry (SIMS) measured the amount of cross contamination and these results correlated well with the observed changes in device electrical properties.
The Microchemistry of Grain Boundaries in Ni3Al

Grain boundary regions in B-doped as well as B-free Ni3AI were studied by field-ion microscopy and atom probe microanalysis. In the ductile, recrystallized, Ni-rich alloys the segregation of boron was often accompanied by an enrichment of nickel. Such an enrichment was not observed at boundaries in B-free alloys. Boron was also observed to segregate to the boundaries in a 25.2A1 - IB alloy which was reported to contain boron clusters. Such clusters were not observed, instead a high concentration of boron pairs were found.
Pathogenesis of Alcoholic Liver Disease

Alcoholic liver disease (ALD) is a spectrum of injury to the liver that includes steatosis, inflammation, fibrosis, and cirrhosis. Hepatic steatosis is the first manifestation of excessive drinking and, while reversible, signifies the presence of ongoing metabolic stress on the liver which underlies the more serious stages of ALD. Lipid accumulation results from widespread disturbances in the handling of fat by the body (adipose dysfunction), increased de novo synthesis, and impaired fatty acid oxidation and export as VLDL. These metabolic disturbances are driven by oxidative and ER stress, generation of ceramide, abnormal homocysteine metabolism, activation of the innate immune response, and dysfunctional transcriptional control of lipid-metabolizing pathways. The alcoholic fatty liver probably is always mildly inflamed and sensitive to necrosis, apoptosis, and necroptosis when additional stresses are imposed. The most important of these is the exposure to abnormal levels of lipopolysaccharide reaching the liver from an abnormally permeably gut. Inflammation involves particularly innate immune mechanisms, in particular the release of TNFα by the Kupffer cells, and is a prime driver of fibrosis mediated by hepatic stellate cells (HSC). Unconventional contributors to ALD include the complement system, coagulation pathway, and osteopontin. Improved therapies will need to take into consideration the numerous metabolic and signaling pathways deranged in heavy drinkers.
α9α10 Acetylcholine receptors: structure and functions

The α9 and α10 nicotinic acetylcholine receptor (nAChR) subunits assemble as pentameric complexes with a central ligand-gated cation-selective pore. However, these subunits do not assemble with other nAChR subunits. The general topology of each subunit is similar to that of other Cys-loop ligand-gated ion channels. Although the sequence and genomic organization of the α9 and α10 subunits determined their classification as nicotinic subunits, α9α10 nAChRs exhibit peculiar pharmacological properties that are not common to other nicotinic or muscarinic receptors. α9α10 nAChRs are expressed in diverse tissues, including auditory sensory hair cells, afferent neurons in the vestibular sensory organs, neurons of the dorsal root ganglion, skin, and bronchial epithelia. Furthermore, it has become apparent that nAChRs containing α9 and α10 subunits play essential roles in various physiological processes. For example, α9 is required for the normal development of the efferent synapses in the inner ear, and after the onset of hearing α9α10 nAChRs serve as the unique source of extracellular calcium for Ca 2+ -activated potassium channels in mature auditory hair cells. The development of drugs that selectively target α9/α10 receptors promises to be of therapeutic benefit since these receptors have distinct physiologic functions. They hold promise as pharmacological targets to treat complex auditory and vestibular pathologies, neuropathic pain, and pathologies of the skin and bronchia.
Role of Organic Acids During Processing to Improve Quality of Channel Catfish Fillets

A microbial preparation derived from aquacultured channel catfish fillets (Ictalurus punctatus) was acidified with 0, 1, 2 and 4% (vol/vol) weak organic and held in an ice bath at 0 degree C to simulate the chilling process. Additionally, catfish fillets were sprayed under varying pressures at 15 degrees C with organic acids to evaluate the efficacy of concentrations of organic acids and spray pressures to ameliorate the microbiological quality. To determine plate counts, the dilution fluid was neutralized to pH 7.2 with 1.0 M NaOH. The aerobic plates counts of microorganisms in the chilling water were monitored over a 20-min interval. Aerobic plate counts were found on the channel catfish fillets before and after spray washing with organic acids. Plates were incubated at 35 degrees C for 48 h. The addition of organic acids tot he microbial preparation used in simulating the chilling process significantly (P 0.05) different in influencing the aerobic counts of the catfish fillets.
Earlier operation for left-sided Pseudomonas endocarditis in drug addicts.

Three consecutive patients with Pseudomonas endocarditis were treated by early operation with no deaths. The indications for operation were severe failure, systemic embolization, and infection refractory to antibiotics. The organism is aggressive, characterized by early invasion of the myocardium. Wide debridement of the anulus is necessary to remove any vegetations or intramyocardial abscessed wall. Because multiple valve infection is common, it is important to evaluate all four cardiac valves at the time of operation. Removing a second rim of the mitral anulus for separate culture at the time of mitral valve replacement may demonstrate the degree to which the valve resection has removed all infection. Early operation is necessary for reinfection of the prosthetic valve; however, metastatic abscess should also be considered in the face of continued signs of infection postoperatively. Patients should receive a 6 week postoperative course of antibiotics which have been shown by in vitro testing to be serum bactericidal in at least a 1:8 dilution. The operative findings of invasion of the myocardium by the organism and the surgical success in this small series have resulted in our recommending earlier operation in patients with these indications.
Acquired Childhood Dysarthria Classification

Published reports of acquired childhood dysarthria since 1980 were reviewed at University Hospital, Rotterdam; and the Department of Medical Psychology, Ziekenhuis Walcheren, Vlissingen, The Netherlands, and cases were classified on the basis of neuroradiological location of lesion and associated motor disorders.
Readmission Following Laparoscopic Sleeve Gastrectomy.

BACKGROUND AND OBJECTIVES Prior studies have established a 1.7-4.33% readmission rate for laparoscopic sleeve gastrectomy (LSG), a rate that falls within the reported range for other bariatric procedures. The current report describes the incidence of 30-day readmission after primary LSG procedures performed at a single bariatric center of excellence (COE) and examines factors that may be associated with readmission. METHODS Data on 343 consecutive LSG operations performed from February 2010 to May 2014 by a single surgeon (PG) were analyzed. Patients readmitted within 30 d were compared to the remaining patients by using Student's t test for continuous variables and the χ2 test for categorical variables. RESULTS All LSGs were completed laparoscopically with no conversions to open procedures. There were no reoperations, leaks, perioperative hemorrhages, or mortalities. Twelve patients (3.5%) were readmitted; 1 was readmitted twice. There were no identified risk factors for readmission, including patient demographics, comorbidities, and perioperative factors. Notably, 7 (7%) readmissions occurred in the initial 100 patients and 5 (2%) in the remaining 243 patients (P = .04). Clinical pathways were modified after the initial 100 patients; routine contrast esophagograms were no longer performed, and a 1-day routine postoperative stay was adopted. Operative time also decreased from 94.2 ± 23.8 to 78.2 ± 20.0 min (P < .001). CONCLUSIONS Readmission rates after LSG remain in a range similar to those described for other laparoscopic bariatric procedures. Larger prospective studies are needed to identify patterns of complications and readmissions in patients undergoing LSG that may differ from other bariatric procedures.
Impaired left atrial function predicts inappropriate shocks in primary prevention implantable cardioverter-defibrillator candidates

Introduction Inappropriate implantable cardioverter-defibrillator (ICD) shocks, commonly caused by atrial fibrillation (AF), are associated with an increased mortality. Because impaired left atrial (LA) function predicts development of AF, we hypothesized that impaired LA function predicts inappropriate shocks beyond a history of AF. Methods and results We prospectively analyzed the association between LA function and incident inappropriate shocks in primary prevention ICD candidates. In the Prospective Observational Study of ICD (PROSE-ICD), we assessed LA function using tissue-tracking cardiac magnetic resonance (CMR) prior to ICD implantation. A total of 162 patients (113 males, age 56 ± 15 years) were included. During the mean follow-up of 4.0 ± 2.9 years, 26 patients (16%) experienced inappropriate shocks due to AF (n = 19; 73%), supraventricular tachycardia (n = 5; 19%), and abnormal sensing (n = 2; 8%). In univariable analyses, inappropriate shocks were associated with AF history prior to ICD implantation, age below 70 years, QRS duration less than 120 milliseconds, larger LA minimum volume, lower LA stroke volume, lower LA emptying fraction, impaired LA maximum and preatrial contraction strains (Smax and SpreA), and impaired LA strain rate during left ventricular systole and atrial contraction (SRs and SRa). In multivariable analysis, impaired Smax (hazard ratio [HR]: 0.96, P = 0.044), SpreA (HR: 0.94, P = 0.030), and SRa (HR: 0.25, P < 0.001) were independently associated with inappropriate shocks. The receiver-operating characteristics curve showed that SRa improved the predictive value beyond the patient demographics including AF history (P = 0.033). Conclusion Impaired LA function assessed by tissue-tracking CMR is an independent predictor of inappropriate shocks in primary prevention ICD candidates beyond AF history.
Deaflympians' Satisfaction With Athletic Training Services at the 2013 Deaflympic Summer Games.

Context: Athletic trainers have the opportunity to treat unique populations. Determining athletes' satisfaction with the athletic training services supplied can offer insights into how to improve the health care provided to athletes. Objective: To explore Deaflympians' satisfaction with athletic training services at the 2013 Deaflympic Summer Games. Design: Cross-sectional survey. Setting: The 2013 Deaflympic Summer Games in Sofia, Bulgaria. Patients or Other Participants: Of the 115 Deaflympians contacted, 55 completed the questionnaire, for a 48% response rate (women = 33, men = 22). Main Outcome Measure(s): The Medical Interview Satisfaction Survey–Athletic Training was used. The questionnaire gathered demographic data and included 25 Likert-scale items that assessed 6 components of athletic training. Descriptive statistics were calculated as normalized scores to adjust for the different numbers of questions for each item. On a 5-point scale, the scores ranged from 3.82 (management) to 4.24 (envi...
Supporting Regular Early Childhood Teachers in Integrating Young Children with Disabilities: A Power Continuum.

There is a growing body of philosophical, legal, and empirical support for integrated preschool programs. Yet, many young children with moderate to severe disabilities are not successfully integrat...
Investment, Inflation, and Employment: A Macroeconomic Framework

Publisher Summary An important contribution to macroeconomic analysis with price rigidities over the relevant period has been made by Malinvaud. This work is motivated by the frequent observation in advanced industrial economies that quantities adjust faster than prices; by the need to avoid simplistic, partial equilibrium links in the analysis of unemployment; and by the need to explain stagflation. This chapter discusses an alternative formulation of rigidities. In the short run, the quantities of goods transacted are given by past decisions, whereas labor incomes follow from current decisions by firms about how much output is profitable to bring to market in the next period. Prices are such that the current output market clears—with the important simplification that all output is sold—so that there is no undesired inventory accumulation. This formulation of short-run rigidities is probably better suited to the study of temporary equilibrium in less advanced economies experiencing substantial price increases. The main link between stocks and flows is the identity at current prices equating household saving with changes in household wealth. Equilibrium conditions in the markets for goods, labor, and credit are derived. Overall equilibrium values are obtained for the nominal rate of interest, the price level, the real wage, and employment, given the rate of inflation expected by firms. The current price level, relative to the one last period, gives the current rate of inflation. For the last period, firms may or may not have guessed the current rate correctly.
Conditions for the effective chilling of fish using a nano-sized ice slurry

Parameters for chilling fish using nano-sized ice crystals (NI) made from 3.6% salt water were investigated. Flake ice mixed with salt water (CS) was utilized for comparative purposes. The effect of ice : fish ratio (2:1, 1.5:1, 1:1) on chilling rates and on time, at, or below threshold temperatures (lowest achievable, 0 °C, and 4 °C) were investigated. Meltwater handling techniques were also investigated: initially drained (INIT), continuously drained (CONT), or non-drained (NODR). Ice : fish ratio did not significantly affect fish chilling time (p > .05). Increasing ice : fish ratio doubled time at or below 0 °C (11 → 24 → 41 hr) and increased it 1.5-fold for 4 °C (23 → 34 → 48 hr). Both NI INIT and CONT performed similarly as fish cooled to 0 °C. However, lowest internal fish temperature (–.81 °C) was achieved and fish were chilled for longer times at or below 0 °C and 4 °C with NI INIT. Practical applications Chilling and storage of fish in slurries of ice and seawater are common postharvest handling practices for fishing vessels. Chilling with a slurry ice is advantageous to solid ice because it more effectively interacts with the product surface to absorb heat. Limitations of slurry ice include the tendency of the ice to float to the container surface and form hard ice crusts. The resultant ice crusts have to be physically broken (usually with a shovel) by employees and this action often damages product. The nano-sized ice crystals in the slurry investigated does not create damaging ice crusts. It is also gel-like in texture and therefore less abrasive. Finally, it is created directly from salt water thereby negating the need for fishermen to buy their ice. The smaller ice crystal size, however, may result in more rapid melting and less effective chilling than more traditional slurry ice. The project demonstrated, that despite the small size of the ice crystals, this type of slurry ice is just as effective in chilling fish and keeping fish below temperature thresholds as currently commercially available ice slurries.
The Inadequacy of Judicial Enforcement of Constitutional Rights Provisions to Rectify Economic Inequality, and the Inevitability of the Attempt

This essay, to appear in a chapter in Judicial Review: Process, Power and Problems, edited by Shruti Bedi and Lokendra Malik, a festschrift for Upendra Baxi, argues that the pursuit of judicially enforced social welfare and equality rights in the modern world is bound to fail but must be pursued. The contemporary picture of judicial enforcement of social welfare rights in one in which there is a consensus that such enforcement is possible, general agreement that enforcement should be dialogic rather than coercive, and a sense that enforcement is rather less effective than is desirable. As to the last, the essay argues that the predicate for generating resources to finance the provision of social welfare rights – investment from abroad – generates economic and legal limitations that inhibit the government from accumulating those resources. The essay develops a parallel argument about judicial enforcement of substantive equality rights, referring specifically to problems associated with the horizontal effect/state action doctrine. The conclusion here is that courts have the capacity to move outcomes in the direction of substantive equality, and might not face overwhelming constraints from the domestic political system, but their ability to achieve true substantive equality is limited by economics, both domestic and international. Yet, where constitutions are committed to substantive equality and social and economic rights, the lesson of the twentieth century is that judges will – and should – attempt to enforce those commitments. Enforcing the constitution – the entire constitution – is what democratic-minded citizens have come to expect of their courts. What is needed is a realistic understanding of what courts can accomplish – less than one might hope (the noble dream), but more than nothing (the nightmare). The attempt more than the achievement is what matters. The task then might be to develop a judicial rhetoric associated with the enforcement of these rights that effectively communicates why what the courts are doing is worth doing, why what they are doing is not enough, and why it is as much as the courts can do.
Framing anew ocean genealogy: The case of Venetian cartography in the early modern period

For about 100 years, an emerging world of islands and coastal rims appeared indistinctly on European cartographic representations of the “Atlantic” and “Southeast Asian” worlds, as if they somehow ...
Prospective assessment for pathogenic germline alterations (PGA) in pancreas cancer (PAC).

4102Background: Cancer predisposition syndromes are identified in a subset of PAC. Identifying PGA has implications for therapy as well as for cancer predisposition in blood relatives. Germline tes...
Toward a method for the rapid collection of public concerns and benefits of emerging energy technologies

The speed and scale with which new technologies emerge sometimes force decision makers to act without the benefit of thorough risk analyses and environmental and social impact analyses. Insights fr...
Cardiorespiratory Fitness and Coronary Artery Calcification in a Primary Prevention Population

Abstract Objective To elucidate whether cardiorespiratory fitness (CRF) is protective or contributory to coronary artery disease plaque burden. Patients and Methods Study participants were working middle-aged men from the Mayo Clinic Executive Health Program who underwent coronary artery calcium (CAC) assessment and exercise treadmill testing for risk stratification. Data from January 1, 1995, through December 31, 2008, were considered. The CAC assessment score was used for lifelong plaque burden analysis; functional aerobic capacity (FAC) from treadmill testing was analyzed as 4 ranked categories of CRF. Known risk factors for cardiovascular disease, including family history, were also considered. Results In 2946 male patients in this retrospective, cross-sectional, observational study, known cardiovascular risk factor profiles and risk calculations tended to uniformly improve with increasing CRF, defined by the FAC level. Only the above-average group, or the third of 4 levels, was found consistently lower than other levels of FAC for CAC scores. The above-average group also had statistical significance after controlling for age, body mass index, and family history of coronary artery disease in a U-shaped distribution rather than the expected linear dose-response relationship. Plaque burden was significantly increased in patients with the highest FAC level (P=.005) compared with the above-average group despite the observed maximal risk factor optimization in all known conventional cardiovascular risk factors. Conclusion For men, maximal CRF is associated with increased atherosclerosis, established with CAC scores. By comparison, average-to-moderate CRF appears to be cardioprotective regardless of either age or the influence of other contributing, recognized cardiac risk factors.
Time Trends and Risk Factors for 30-Day Adverse Events in Black Patients Undergoing Primary Total Knee Arthroplasty.

Abstract Background Increased adverse events (AEs) have been reported among black patients undergoing joint arthroplasty, but little is known about their persistence and risk factors. The purpose of this study is (1) to examine recent annual trends in 30-day outcomes after total knee arthroplasty (TKA) and (2) to develop a preoperative risk stratification model in this racial minority. Methods The American College of Surgeons National Surgical Quality Improvement Program was queried for all black/African American patients who underwent primary TKA between 2011 and 2017. Time trends in demographic variables, comorbid conditions, perioperative characteristics, length of stay (LOS), and 30-day readmissions, reoperations, medical complications, surgical complications, and mortality were assessed. Multivariate logistic regression analyses were performed to identify independent risk factors for development of 30-day AEs. Results In total, 19,496 black patients were analyzed. Between 2011 and 2017, there have been improved comorbidity profiles (P 2, dependent functional status, congestive heart failure, chronic obstructive pulmonary disease, metastatic cancer, dyspnea, chronic kidney disease, bilateral TKA, and operative time >100 minutes. Conclusion There have been significant improvements in the annual trends of LOS and 30-day outcomes among black patients undergoing primary TKA in recent years. A predictive model for 30-day AEs was developed to help guide risk stratification and optimization of modifiable factors, namely anemia, tobacco smoking, bilateral surgery, and operative time.
Cost comparison of arthroscopic rotator cuff repair with arthroscopic vs. open biceps tenodesis.

Purpose To use a nationwide database to determine differences in cost between patients who underwent arthroscopic rotator cuff tear with open vs. arthroscopic biceps tenodesis (BT). Methods The 2014 State Ambulatory Surgical and Services Databases from 6 US states was utilized. All cases with CPT codes 29827 (arthroscopic rotator cuff repair [RCR]) and either 23430 (tenodesis of long tendon of biceps) or 29828 (arthroscopic BT) were selected. Cases that included both 23430 and 29828 were excluded, as were those missing demographic data. Generalized linear models were used to model costs based on the surgical and patient variables that were significant in the initial bivariate analysis (P Results A total of 3635 RCR and BT cases were identified. There were 2847 (78.3%) with arthroscopic BT and 788 (21.7%) with open BT. Patients undergoing arthroscopic BT were 3.1 years older than patients undergoing open BT (P Conclusions In a large series of patients undergoing arthroscopic RCR with open vs. arthroscopic BT, open BT was associated with $5542 lower costs than arthroscopic. Given that both techniques have been shown to be similarly effective in long-term follow-up, surgeons should be aware of opportunities for cost saving, particularly with the advent of bundled surgical reimbursements.
Tunneling Spectroscopy of Quantum Spin Liquids.

We examine the spectroscopic signatures of tunneling through a Kitaev quantum spin liquid (QSL) barrier in a number of experimentally relevant geometries. We combine contributions from elastic and inelastic tunneling processes and find that spin-flip scattering at the itinerant spinon modes gives rise to a gapped contribution to the tunneling conductance spectrum. We address the spectral modifications that arise in a magnetic field, which is applied to drive the candidate material $\ensuremath{\alpha}\text{\ensuremath{-}}{\mathrm{RuCl}}_{3}$ into a QSL phase, and we propose a lateral 1D tunnel junction as a viable setup in this regime. The characteristic spin gap is an unambiguous signature of the fractionalized QSL excitations, distinguishing it from magnons or phonons. We discuss the generalization of our results to a wide variety of QSLs with gapped and gapless spin correlators.