cssi/SciSciGPT-SciSciNet huggingface dataset:
AB0541 The Prognostic Significance of The Birmingham Vasculitis Activity Score (BVAS) in Patients with Systemic Vasculitis Transferred To The Intensive Care Unit (ICU)

Background Systemic vasculitides represent a heterogeneous group of diseases that share clinical features including respiratory distress, renal dysfunction, and neurologic disorders. These diseases may often cause life-threatening complications requiring admission to an intensive care unit (ICU) [1]. Birmingham Vasculitis Activity Score (BVAS) is the most widely used generic tool to quantify disease activity in systemic vasculitis. Acute Physiology And Chronic Health Evaluation (APACHE II) is a simple and accurate assessment scale of the severity of disease in critically ill patients newly admitted to ICU. Objectives The aim of this study was to identify possible prognostic biomarkers for patients with vasculitis admitted to ICU. Methods A retrospective study was carried out from 2004 to 2014 in patients with systemic vasculitis admitted to the Rheumatology division and transferred to ICU due to clinical worsening, with a length of stay beyond 24 hours. An additional group of patients admitted to ICU, and without history of systemic vasculitis, were used as a matched-control group. A total of 25 patients were included in the analysis. Results ICU mortality was significantly associated with higher BVAS scores performed in the ward (p 8 in the ward and that a BVAS >10 in ICU were significantly related to the mortality in ICU (p Conclusions BVAS appears to be an excellent tool for assessing ICU mortality risk of patients with systemic vasculitides admitted to specialty departments. Our experience has shown that performing the assessment at admission to the ward is more important than determining the evaluation before the clinical aggravation causing the transfer to ICU. References Befort P, et al. BMC Anesthesiol. 2013 Oct 1;13(1):27 Disclosure of Interest None declared
Detecting sudden moving objects in a series of digital images with different exposure times

The method detects moving objects in a set of digital images with various exposures.The method does not rely on camera response function, object detection, reference image.It is a per-image, per-patch, adaptive approach functional in a wide range of scenes.It detects continuous or sudden movements of small or large objects within a scene.It can be further developed for object tracking within different frames of a video. Display Omitted This paper presents an algorithm to detect sudden objects appearing within a set of digital images obtained at different exposures to create a high dynamic range (HDR) image. While some previous work has focused on detecting moving objects within a scene, the majority cannot handle exposure variability. The few techniques developed specifically for HDR images track moving objects that have smaller movements within a scene compared to an abrupt object that appears and disappears quickly. Further, the algorithm advances existing methods because it does not require: 1) robust estimation of a camera response function, 2) supervision of objects in the scene such as explicit object detection and tracking, and 3) selection of a reference image. In this approach, every image in the set is first partitioned into equal size patches. Next, the properties (e.g., histograms of oriented gradients, HOG) of values within the window of the same patch are compared between the images to identify differences. Finally, a statistical classifier is developed to recognize significant differences between patch descriptors and identify patches containing sudden objects. This statistical classifier makes it possible to define confidence levels for categorizing patches into a moving object or not. A sensitivity analysis indicated that the best performance occurs when using four or six digital images. However, the optimal patch size is dependent on the size of the moving object to be detected. Hence, a mechanism is introduced to estimate the range of reasonable patch sizes given an image.
Towards operationalising internal distractibility (Mind Wandering) in adults with ADHD.

Objective To investigate whether specific symptoms of attention deficit hyperactivity disorder (ADHD) can help identify ADHD patients with mind wandering. Methods Subjects were adults ages 18–55 of both sexes (n=41) who completed the Mind-Wandering Questionnaire (MWQ) and the ADHD module of the Schedule for Affective Disorders and Schizophrenia for School-Age Children Epidemiologic Version. We used Spearman’s rank correlation and Pearson’s χ2 analyses to examine associations between the ADHD module and the MWQ and receiver operator characteristic (ROC) analyses to evaluate the diagnostic efficiency of the ADHD module. Results Out of the three ADHD domains, the inattentive ADHD scores had the strongest association with the MWQ (total: r s=0.34, df=39, p=0.03; inattentive: r s=0.38, df=39, p=0.02; Hyperactive: r s=0.17, df=39, p=0.28). Correlation analyses between individual items on the ADHD module and the MWQ showed that two inattention items (‘failure to pay attention to detail’ and ‘trouble following instructions’) were positively associated with total scores on the MWQ (p=0.02). These two inattention items had the strongest association with the MWQ (r s=0.45, df=38, p=0.004). ROC analyses showed that the combined score of the two significant inattention items had the highest efficiency (AUC=0.71) in classifying high-level mind wanderers as defined by scores greater than the median split on the MWQ. The combined score of the two inattention items best identified high-level mind wanderers. Conclusion Results suggest a way to operationalise mind wandering using the symptoms of ADHD.
Scalar extensions of categorical resolutions of singularities

Abstract Let X be a quasi-compact, separated scheme over a field k and we can consider the categorical resolution of singularities of X . In this paper let k ′ / k be a field extension and we study the scalar extension of a categorical resolution of singularities of X and we show how it gives a categorical resolution of the base change scheme X k ′ . Our construction involves the scalar extension of derived categories of DG-modules over a DG algebra. As an application we use the technique of scalar extension developed in this paper to prove the non-existence of full exceptional collections of categorical resolutions for a projective curve of genus ≥1 over a non-algebraically closed field.
Which Results to Return: Subjective Judgments in Selecting Medically Actionable Genes.

Background: Advances in genomics have led to calls for returning information about medically actionable genes (MAGs) to patients, research subjects, biobank participants, and through screening programs, the general adult population. Which MAGs are returned affects the harms and benefits of every genetic testing endeavor. Despite published recommendations of selection criteria for MAGs to return, scant data exist regarding how decision makers actually apply such criteria. Methods: The process and criteria used by researchers when selecting MAGs for a preventive genomic sequencing program targeting the general adult population were examined. The authors observed and audio-recorded the gene selection meetings, and analyzed meeting transcripts, gene scoring sheets, and meeting handouts. Results: To select MAGs, the committee imported, from a preexisting project, “a semiquantitative metric” that scores genes on five criteria. Numerous subjective judgments and conceptual challenges in defining and applying the ...
Effects of Sex and Education on Cognitive Change Over a 27-Year Period in Older Adults: The Rancho Bernardo Study

Objective This study investigated how cognitive function changes with age and whether rates of decline vary by sex or education in a large, homogenous longitudinal cohort characterized by high participation rates, long duration of follow-up, and minimal loss to follow-up. Design/Setting/Participants Between 1988 and 2016, 2,225 community-dwelling participants of the Rancho Bernardo Study, aged 31 to 99 years at their initial cognitive assessment, completed neuropsychological testing approximately every 4 years, over a maximum 27-year follow-up. Measurements Linear mixed effects regression models defined sex-specific cognitive trajectories, adjusting for education and retest effects. Results Significant decline across all cognitive domains began around age 65 years and accelerated after age 80 years. Patterns of decline were generally similar between sexes, although men declined more rapidly than women on the global function test. Higher education was associated with slower decline on the tests of executive and global functions. After excluding 517 participants with evidence of cognitive impairment, accelerating decline with age remained for all tests, and women declined more rapidly than men on the executive function test. Conclusions Accelerating decline with advancing age occurs across multiple cognitive domains in community-dwelling older adults, with few differences in rates of decline between men and women. Higher education may provide some protection against executive and global function decline with age. These findings better characterize normal cognitive aging, a critical prerequisite for identifying individuals at risk for cognitive impairment, and lay the groundwork for future studies of health and behavioral factors that affect age-related decline in this cohort.
The Unraveling of the Matryoshka Doll.

Significant advances have been made in the field of cardiac regenerative medicine. Investigations into the mechanism of action have identified multiple strategies of the delivery of biologics that are both cell and cell free that yield quantitatively equivalent results. Here in, we present a viewpoint of the successive layers within the cell that can be exploited to prevent or treat cardiac dysfunction . In the beginning, it was supposed to be simple, transplant noncommitted bone marrow–derived stem cells to the myocardium, where they would migrate into the infarct zone and differentiate into cardiac myocytes, replacing the lost contractile function of the heart and limiting the risk of heart failure.1 Soon, it became evident that circulating stem cells were being signaled to home to the site of myocardial injury; whether those stem cells were exogenously infused or endogenously released from the bone marrow. These early findings led to a bifurcation of the field where clinicians performed trials trying to prevent or restore cardiac function in patients with ischemic heart disease,2 and bench scientists focused on distinct cell types and mechanisms of action.3 Sixteen years later, stem cell therapy is no closer to standard of care, but we have learned a great deal. Although our successes have been limited,4 our understanding of the physiology and biology has grown immensely: 1. First and foremost, we understand that adult stem cell therapy seems to be safe. Unlike the arrhythmias we observed with skeletal myoblasts, we have not seen adverse electric, mechanical, or oncogenic effects of adult stem cells. 2. The concept of stem cell transplantation at the time of acute myocardial infarction is not as easy as we had first thought as stem cell preparation seems to have significant consequences on whether the therapy will work4 or not.5 3. We have …
High-capacity Li2Mn0.8Fe0.2SiO4/carbon composite nanofiber cathodes for lithium-ion batteries

Abstract Li 2 MnSiO 4 has been considered as a promising cathode material with an extremely high theoretically capacity of 332 mAh g −1 . However, due to its low intrinsic conductivity and poor structural stability, only about half of the theoretical capacity has been realized in practice and the capacity decays rapidly during cycling. To realize the high capacity and improve the cycling performance, Li 2 Mn 0.8 Fe 0.2 SiO 4 /carbon composite nanofibers were prepared by the combination of iron doping and electrospinning. X-ray diffraction, scanning electron microscope, and transmission electronic microscope were applied to characterize the Li 2 Mn 0.8 Fe 0.2 SiO 4 /carbon nanofibers. It was found that Li 2 Mn 0.8 Fe 0.2 SiO 4 nanoparticles were embedded into continuous carbon nanofiber matrices, which formed free-standing porous mats that could be used as binder-free cathodes. The iron doping improved the conductivity and purity of the active material, and the carbon nanofiber matrix facilitated ion transfer and charge diffusion. As a result, Li 2 Mn 0.8 Fe 0.2 SiO 4 /carbon nanofiber cathodes showed promising improvement on reversible capacity and cycling performance.
Research Article: Microbial organic matter reduction in a peatland soil: the importance of water-table level

Abstract Peatlands are among the most important ecosystems in the global carbon cycle. These wetlands store roughly one-third of the terrestrial soil organic matter (SOM) and are important sources of the potent greenhouse gas methane (CH4) to the atmosphere. Understanding carbon cycling, and in particular CH4 dynamics, within peatland soils has important implications for understanding biosphere-climate feedbacks. There is mounting evidence that under anaerobic conditions microbes can reduce organic terminal electron acceptors in place of oxygen in peatland soils. This microbial respiration of SOM can dominate anaerobic decomposition and competitively suppress CH4 production, but the controls of this process are not well understood. We explored SOM reduction in a peatland soil using laboratory microcosms that allowed for water-table level manipulations. Measurements of electron shuttling demonstrate that SOM was progressively reduced following flooding and was quickly re-oxidized following water-table draw...
Conhecimento & Diversidade em novos aportes

Este numero da Revista Conhecimento & Diversidade /RCD marca o inicio de sua versao online . Nessa nova etapa de sua trajetoria mantem-se o interesse em estudos das areas de Ensino, Interdisciplinar, Educacao, Direito, Psicologia, Historia. Estudos de outras areas tambem interessam a RCD, ressaltando-se a importância de que se faca alguma mencao as areas citadas.
The Native Hawaiian Insect Microbiome Initiative: A Critical Perspective for Hawaiian Insect Evolution

Insects associate with a diversity of microbes that can shape host ecology and diversity by providing essential biological and adaptive services. For most insect groups, the evolutionary implications of host–microbe interactions remain poorly understood. Geographically discrete areas with high biodiversity offer powerful, simplified model systems to better understand insect–microbe interactions. Hawaii boasts a diverse endemic insect fauna (~6000 species) characterized by spectacular adaptive radiations. Despite this, little is known about the role of bacteria in shaping this diversity. To address this knowledge gap, we inaugurate the Native Hawaiian Insect Microbiome Initiative (NHIMI). The NHIMI is an effort intended to develop a framework for informing evolutionary and biological studies in Hawaii. To initiate this effort, we have sequenced the bacterial microbiomes of thirteen species representing iconic, endemic Hawaiian insect groups. Our results show that native Hawaiian insects associate with a diversity of bacteria that exhibit a wide phylogenetic breadth. Several groups show predictable associations with obligate microbes that permit diet specialization. Others exhibit unique ecological transitions that are correlated with shifts in their microbiomes (e.g., transition to carrion feeding from plant-feeding in Nysius wekiuicola). Finally, some groups, such as the Hawaiian Drosophila, have relatively diverse microbiomes with a conserved core of bacterial taxa across multiple species and islands.
Chemometric Methods for Biomedical Raman Spectroscopy and Imaging

The vibrational spectrum is a quantitative measure of a sample’s molecular composition. Hence, classical chemometric methods, especially regression-based, have focused on exact mapping between identity and sample composition. While this approach works well for molecular identifications and scientific investigations, problems of biomedical interest often involve complex mixtures of stochastically varying compositions and complex spatial distributions of molecules contributing to the recorded signals. Hence, the challenge often is not to predict the identity of materials but to determine chemical markers that help rapidly detect species (e.g. impurities, conformations, strains of bacteria) in large areas or indicate changes in function in complex tissue (e.g. cancer or tissue engineering). Hence, the rate of data analysis has to be rapid, has to be robust with respect to stochastic variance and the provided information is usually related to biomedical context and not to molecular compositions. The emergence of imaging techniques and clinical applications are spurring growth in this area. In this chapter, we discuss chemometric methods that are useful in this milieu. We first review methods for data pre-processing with a focus on the key challenges facing a spectroscopist. Next, we survey some of the well known, widely used pattern classification techniques under the framework of supervised and unsupervised classification. We discuss the applicability, advantages and drawbacks of each of these techniques and help the reader not only gain useful insights into the techniques themselves but also acquire an understating of the underlying ideas and principles. We conclude by providing examples of the coupled use of chemometric and statistical tools to develop robust classification protocols for prostate and breast tissue pathology. We specifically focus on the critical factors and pitfalls at each step in converting spectral data sets into hi-fidelity images useful for decision making.
The Effect of Forward-Facing Steps on Stationary Crossflow Instability Growth and Breakdown

The eﬀect of a forward-facing step on stationary crossﬂow transition was studied using standard stereo particle image velocimetry (PIV) and time-resolved PIV. Step heights ranging from 53 to 71% of the boundary-layer thickness were studied in detail. The steps above a critical step height of approximately 60% of the boundary-layer thickness had a signiﬁcant impact on the stationary crossﬂow growth downstream of the step. For the critical cases, the stationary crossﬂow amplitude grew suddenly downstream of the step, decayed for a short region, then grew again. The adverse pressure gradient upstream of the step resulted in a region of crossﬂow reversal. A secondary set of vortices, rotating in the opposite direction to the primary vortices, developed underneath the uplifted primary vortices. The wall-normal velocity disturbance (V' ) created by these secondary vortices impacted the step, and is believed to feed into the strong vortex that developed downstream of the step. A large but very short negative crossﬂow region formed for a short region downstream of the step due to a sharp inboard curvature of the streamlines near the wall. For the larger step height cases, a crossﬂow-reversal region formed just downstream of the strong negative crossﬂow region. This crossﬂow reversal region is believed to play an important role in the growth of the stationary crossﬂow vortices downstream of the step, and may be a good indication of the critical forward-facing step height.
Granulomatous/sarcoid-like lesions associated with checkpoint inhibitors: a marker of therapy response in a subset of melanoma patients

Immune checkpoint therapy has dramatically changed the landscape of cancer therapy, providing an efficacious and durable therapeutic option for patients with advanced-stage disease. However, dermatologic toxicities are a well-recognized side effect in patients receiving this therapy. A spectrum of immune related adverse events (irAEs) involving the skin can occur and include immunobullous disorders, lichenoid dermatitis, and vitiligo. Granulomatous/sarcoid-like lesions are now being recognized with the current class of checkpoint inhibitors (CPIs) that involve the dermis, the subcutaneous tissue (panniculitis), and lymph nodes. We report 3 patients who developed granulomatous/sarcoid-like lesions while being treated with immune checkpoint therapy for advanced-stage melanoma, and we provide a comprehensive review of the literature in which similar cases are described. To date, 26 patients (including the 3 from this report) have been described with a median age of 57 years who developed granulomatous/sarcoid-like lesions associated with CPIs (median onset 6 months), of which 77% of patients had melanoma as primary tumor. To manage this adverse side effect, therapy was withheld in 38% of patients and 44% of the patients were treated with systemic steroids and 8% patients with localized therapy (one patient with intralesional triamcinolone). 96% of patients demonstrated either resolution or improvement of granulomatous/sarcoid-like lesions associated with CPIs irrespective of medical intervention. Therapeutic response, stable disease, or remission of primary malignancy was observed in 71% of reported patients who developed granulomatous/sarcoid-like lesions associated with CPIs over a median follow-up of 11.5 months since initiation of treatment. The development of granulomatous/sarcoid-like lesions associated with CPIs is a recognized manifestation with the current class of immune checkpoint therapy that may clinically and radiographically mimic disease recurrence. Awareness of this type of toxicity is important for appropriate management and possible measurement of therapeutic response in a subset of patients who manifest this type of immune-mediated reaction.
The effect of variance in district magnitude on party system inflation

Abstract We argue that variance in district magnitude affects party system inflation by shaping the process of within- and cross-district coordination. First, at the stage of within-district coordination, electoral systems with large magnitude variance generate different party systems across districts, with larger districts having more fragmented party systems with a greater number of parties. Second, at the stage of cross-district coordination, district party systems dissimilar to each other make it more difficult for elites from different districts to engage in the projection of district parties onto national-level parties. This in turn leads to the inflation of the number of parties at the national level. Through numerical simulations and an observational study, we demonstrate that variance in district magnitude is positively associated with party system inflation.
Influence of Aggregate Source and Warm-Mix Technologies on the Mechanical Properties of Asphalt Mixtures

This study evaluated the impact of three aggregate sources (limestone, quartzite, and natural gravel) and three different WMA processes (Advera, Evotherm, and plant foaming) on the properties of asphalt mixtures. The aggregate source and warm-mix process were found to have an impact on the mixing and compaction temperatures of the WMA. The performance of the WMA mixtures was evaluated in terms of moisture damage, rutting, thermal cracking, and fatigue cracking resistance. Based on the results of the analysis of variance (ANOVA) of the data, the aggregate source, WMA technology type, and the interaction between the two were shown to have moderate to significant effects on the performance of the asphalt mixtures for certain tests, whereas having no effect for other tests. Statistical differences were found when comparing indirect tensile strength and tensile strength ratio values, flow number, asphalt pavement analyzer rut depth, and fatigue cracking test results for the various mixtures. None of the WMA mixtures performed, as well as the HMA, except in the beam fatigue test. This was mainly related to the difference between the HMA and WMA short-term aging procedures. However, WMA mixtures exhibited similar or higher moisture damage, rutting, and fatigue cracking resistance than the HMA mixtures produced at the WMA temperatures or with 2-h short-term conditioning, instead of the recommended 4 h by Superpave. Dynamic modulus results showed that, on average, WMA mixtures had significantly lower dynamic modulus values than the HMA mixtures, but similar values to HMA mixtures produced at the WMA temperature and short-term conditioning. The thermal stress restrained specimen test (TSRST) showed that the reduction of production temperatures and short-term aging lowered the fracture temperature, whereas it did not impact the fracture stress. The impact of WMA technology on thermal cracking and fatigue characteristics depended on the type of aggregate.
Comparison of Dermatologist Density Between Urban and Rural Counties in the United States

Importance As the US population continues to increase and age, there is an unmet need for dermatologic care; therefore, it is important to identify and understand the characteristics and patterns of the dermatologist workforce. Objective To analyze the longitudinal dermatologist density and urban-rural disparities using a standardized classification scheme. Design, Setting, and Participants This study analyzed county-level data for 1995 to 2013 from the Area Health Resources File to evaluate the longitudinal trends and demographic and environmental factors associated with the geographic distribution of dermatologists. Main Outcomes and Measures Active US dermatologist and physician density. Results In this study of nationwide data on dermatologists, dermatologist density increased by 21% from 3.02 per 100 000 people to 3.65 per 100 000 people from 1995 to 2013; the gap between the density of dermatologists in urban and other areas increased from 2.63 to 3.06 in nonmetropolitan areas and from 3.41 to 4.03 in rural areas. The ratio of dermatologists older than 55 years to younger than 55 years increased 75% in nonmetropolitan and rural areas (from 0.32 to 0.56) and 170% in metropolitan areas (from 0.34 to 0.93). Dermatologists tended to be located in well-resourced, urban communities. Conclusions and Relevance Our findings suggest that substantial disparities in the geographic distribution of dermatologists exist and have been increasing with time. Correcting the workforce disparity is important for patient care.
A field study of related video recommendations: newest, most similar, or most relevant?

Many video sites recommend videos related to the one a user is watching. These recommendations have been shown to influence what users end up exploring and are an important part of a recommender system. Plenty of methods have been proposed to recommend related videos, but there has been relatively little work that compares competing strategies. We describe a field study of related video recommendations, where we deploy algorithms to recommend related movie trailers. Our results show that recency- and similarity-based algorithms yield the highest click-through rates, and that the recency-based algorithm leads to the most trailer-level engagement. Our findings suggest the potential to design non-personalized yet effective related item recommendation strategies.
Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period

Functional neuroimaging studies in mild traumatic brain injury (mTBI) have been largely limited to patients with persistent post-concussive symptoms, utilizing images obtained months to years after the actual head trauma. We sought to distinguish acute and delayed effects of mild traumatic brain injury on working memory functional brain activation patterns < 72 hours after mild traumatic brain injury (mTBI) and again one-week later. We hypothesized that clinical and fMRI measures of working memory would be abnormal in symptomatic mTBI patients assessed < 72 hours after injury, with most patients showing clinical recovery (i.e., improvement in these measures) within 1 week after the initial assessment. We also hypothesized that increased memory workload at 1 week following injury would expose different cortical activation patterns in mTBI patients with persistent post-concussive symptoms, compared to those with full clinical recovery. We performed a prospective, cohort study of working memory in emergency department patients with isolated head injury and clinical diagnosis of concussion, compared to control subjects (both uninjured volunteers and emergency department patients with extremity injuries and no head trauma). The primary outcome of cognitive recovery was defined as resolution of reported cognitive impairment and quantified by scoring the subject’s reported cognitive post-concussive symptoms at 1 week. Secondary outcomes included additional post-concussive symptoms and neurocognitive testing results. We enrolled 46 subjects: 27 with mild TBI and 19 controls. The time of initial neuroimaging was 48 (+22 S.D.) hours after injury (time 1). At follow up (8.7, + 1.2 S.D., days after injury, time 2), 18 of mTBI subjects (64%) reported moderate to complete cognitive recovery, 8 of whom fully recovered between initial and follow-up imaging. fMRI changes from time 1 to time 2 showed an increase in posterior cingulate activation in the mTBI subjects compared to controls. Increases in activation were greater in those mTBI subjects without cognitive recovery. As workload increased in mTBI subjects, activation increased in cortical regions in the right hemisphere. In summary, we found neuroimaging evidence for working memory deficits during the first week following mild traumatic brain injury. Subjects with persistent cognitive symptoms after mTBI had increased requirement for posterior cingulate activation to complete memory tasks at 1 week following a brain injury. These results provide insight into functional activation patterns during initial recovery from mTBI and expose the regional activation networks that may be involved in working memory deficits.
Physically Sufficient Neural Mechanisms of Consciousness

Neural correlates of consciousness (for brevity NCC) are foundational to the scientific study of consciousness. Chalmers (2000) has provided the most informative and influential definition of NCC, according to which neural correlates are minimally sufficient for consciousness. However, the sense of sufficiency needs further clarification since there are several relevant senses with different entailments. In section one of this article, we give an overview of the desiderata for a good definition of NCC and Chalmers's definition. The second section analyses the merit of understanding the sufficiency of neural correlates for corresponding consciousness according to three relevant types of sufficiency: logical, metaphysical, and physical. In section three, a theoretical approach to consciousness studies is suggested in light of the sense in which NCC are sufficient for consciousness. Section four addresses a concern some might have about this approach. By the end, it will become apparent that our conception of NCC has important implications for research methodology, neuroethics, and the vitality of the search for NCC.
Axicabtagene Ciloleucel, an Anti‐CD19 Chimeric Antigen Receptor T‐Cell Therapy for Relapsed or Refractory Large B‐Cell Lymphoma: Practical Implications for the Community Oncologist

Axicabtagene ciloleucel is the first U.S. Food and Drug Administration-approved autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for the treatment of patients with relapsed or refractory large B-cell lymphoma after ≥2 prior systemic therapies. Although axicabtagene ciloleucel is administered only at authorized treatment centers, community oncologists play a critical role in the CAR T-cell treatment journey, recognizing potentially eligible patients for referral and then, after treatment, closely collaborating with treatment centers to monitor and manage patients long term. ZUMA-1, the pivotal, multicenter, phase I/II study of 108 patients treated with axicabtagene ciloleucel, resulted in an objective response rate of 83%, including 58% complete responses. With a 27.1-month median follow-up, 39% of patients had ongoing responses. CAR T-cell therapy is associated with the potentially life-threatening adverse events (AEs) of cytokine release syndrome and neurologic events, which generally occur early after treatment. In ZUMA-1, cytokine release syndrome and neurologic events were generally reversible and grade ≥3 cytokine release syndrome and neurologic events occurred in 11% and 32% of patients, respectively. Frequent prolonged AEs included hypogammaglobulinemia, B-cell aplasia, and cytopenias requiring supportive care until recovery of hematopoietic function. Rate of treatment-related mortality was low, at <2%. With appropriate management of common AEs, axicabtagene ciloleucel offers the potential for long-term durable responses in patients who otherwise lack curative treatment options. IMPLICATIONS FOR PRACTICE: Community oncologists should be familiar with key aspects of chimeric antigen receptor (CAR) T-cell indications and eligibility to help recognize and refer potential patients for this paradigm-changing treatment option at the appropriate time during the disease course. To ensure optimal long-term outcomes for patients who have been treated with CAR T-cell therapy, oncologists must also be familiar with common prolonged AEs and their monitoring and management.
D.I.Y. FunGuide: Grow your own Oyster Mushrooms at Home

Oyster mushrooms are commonly found on hardwoods throughout the north temperate zone; they are edible and have many nutritious qualities. This 5-page document describes how you can grow your own oyster mushrooms at home. Written by Chih-Ming Hsu, Khalid Hameed, Van T. Cotter, and Hui-Ling Liao and published by the UF/IFAS Department of Soil and Water Sciences, January 2018. http://edis.ifas.ufl.edu/ss662
A Tchebycheff-based multi-objective combined with a PSO–SQP dynamic real-time optimization framework for cycling energy systems

Abstract The aim in this work is to develop an optimization framework to address cycling of baseload energy systems due to the penetration of renewables into the grid. The developed strategy corresponds to a multi-objective and dynamic real-time optimization (MOO-DRTO) framework applied to a postcombustion MEA-based CO2 capture process from a baseload coal-fired power plant under cycling conditions. A Tchebycheff-based method is used for the multi-objective optimization (MOO) component. Also, a hybrid approach consisting of Particle Swarm Optimization (PSO) and Sequential Quadratic Programming (SQP) is implemented for the first time in process systems engineering to solve the dynamic real-time optimization (DRTO) component. The objectives considered in the MOO-DRTO framework are economic and environmental. The proposed MOO-DRTO strategy is successfully implemented and 24-h optimal output trajectories for the carbon capture system under cycling are generated. Also, the optimal compromise is chosen from the Pareto front according to a set of selected weights for the objectives with minimal interaction between the framework and decision maker. The results indicated that the developed framework has potential to be extended to plant-wide optimization applications under cycling.
Preparation and Application of Nanosensor in Safeguarding Heparin Supply Chain

Heparin has been in clinical use as an anticoagulant for the last eight decades and used worldwide in more than 100 million medical procedures every year. This lifesaving drug is predominantly obta...
Cefazolin Inoculum Effect and Methicillin-Susceptible Staphylococcus aureus Osteoarticular Infections in Children.

Select methicillin-susceptible Staphylococcus aureus (MSSA) strains may produce β-lactamases with affinity for first-generation cephalosporins (1GCs). In the setting of a high inoculum, these β-lactamases may promote the cleavage of 1GCs, a phenomenon known as the cefazolin inoculum effect (CzIE). We evaluated the prevalence and impact of CzIE on clinical outcomes among MSSA acute hematogenous osteomyelitis (AHO) cases. MSSA AHO isolates obtained from two children's hospitals between January 2011 and December 2018 were procured through ongoing surveillance studies. Isolates were tested for CzIE via a broth macrodilution assay using an inoculum of 107 CFU/ml; CzIE was defined as a cefazolin MIC of ≥16 μg/ml. Isolates were characterized by accessory gene regulator group (agr). The progression from acute to chronic osteomyelitis was considered an important outcome. A total of 250 cases with viable isolates were included. Notably, 14.4% of isolates exhibited CzIE with no observed temporal trend; and 4% and 76% of patients received a 1GC as an empirical and definitive therapy, respectively. CzIE isolates were more often resistant to clindamycin, belonged to agrIII, and associated with the development of chronic osteomyelitis. In multivariable analyses, agrIII, multiple surgical debridements, delayed source control, and CzIE were independently associated with progression to chronic osteomyelitis. A higher rate of chronic osteomyelitis was observed with CzIE isolates regardless of definitive antibiotic choice. CzIE is exhibited by 14.4% of MSSA AHO isolates in children. CzIE is independently associated with progression to chronic osteomyelitis in cases of AHO irrespective of final antibiotic choice. These data suggest that negative outcomes reported with CzIE may more accurately reflect strain-dependent virulence factors rather than true antibiotic failure.
Single-center series of boys with recurrent strokes and rotational vertebral arteriopathy

Objective To describe a pediatric stroke syndrome with chronic focal vertebral arteriopathy adjacent to cervical abnormalities. Methods At a single pediatric stroke center, we identified consecutive children with stroke and vertebral arteriopathy of the V3 segment with adjacent cervical bony or soft tissue abnormalities. We abstracted clinical presentation, treatment and follow-up data from medical charts. Results From 2005 to 2019, 10 children (all boys, ages 6–16 years) presented with posterior circulation strokes and vertebral arteriopathy with adjacent cervical pathology. Two children had bony abnormalities: one had a congenital arcuate foramen and one had os odontoideum with cervical instability. In children without bony pathology, vertebral artery narrowing during contralateral head rotation was visualized by digital subtraction angiography. Eight boys had recurrent ischemic events despite anti-thrombotic treatment (including 5 with multiple recurrences) and were treated surgically to prevent additional stroke. Procedures included vertebral artery decompression (n = 6), endovascular stent and spinal fusion (n = 1), or vertebral artery endovascular occlusion (n = 1). In boys treated with decompression, cervical soft tissue abnormalities (ruptured atlantoaxial bursa, ruptured joint capsule or connective tissue scarring) were directly visualized during open surgery. No other etiology for stroke or dissection was found in any of the cases. Two boys without recurrent stroke were treated with activity restriction and anti-thrombotics. At a median follow-up of 51 months (range 17–84), there have been no additional recurrences. Conclusions Children with V3 segmental vertebral arteriopathy frequently have stroke recurrence despite anti-thrombotics. Cervical bone imaging and angiography with neck rotation can identify underlying pathology.
The 'Ulama in Contemporary Pakistan: Contesting and Cultivating an Islamic Republic

In this book, Mashal Saif explores how contemporary 'ulama, the guardians of religious knowledge and law, engage with the world's first and most populated Islamic nation-state: Pakistan. In mapping these engagements, she weds rich ethnography with rigorous textual analysis and offers insight into some of the most significant and politically charged issues in recent Pakistani history. These include debates over the rights of women; the country's notorious blasphemy laws; the legitimacy of religiously mandated insurrection against the state; sectarian violence; and the place of Shi'as within the Sunni majority nation. These diverse case studies are knit together by the project's most significant contribution: a theoretical framework that understands the 'ulama's complex engagements with their state as a process of both contestation and cultivation of the Islamic Republic by citizen-subjects. This framework provides a new way of assessing state-'ulama relations not only in contemporary Pakistan but also across the Muslim world.
Deciding on drawing: the topic matters when using drawing as a science learning strategy

Given the strong relationships found between high-level learning strategies such as drawing and summarising, and student comprehension and performance, we have seen an increase in drawing-to-learn ...
Peeling Apple: Antitrust Standing and Intermediary Defendants

When market intermediaries unlawfully acquire market power, vertically related market participants may sue under the antitrust laws to recover damages. Their ability to recover depends upon an intricate set of doctrines that define private standing, including the indirect-purchaser rules set down by the Supreme Court most notably in Illinois Brick. In Apple Inc. v. Pepper, the Court decided the application of the indirect-purchaser rules to a particular kind of intermediary, a platform in a two-sided market. The Article explores private antitrust standing doctrines as they apply to market intermediaries, using Apple to frame the exposition. The Court there held that iPhone owners are not barred by Illinois Brick from recovering damages from Apple for monopolizing the distribution of iPhone apps. The Article argues that the Court may have reached the right result, but not for the right reason. The dissent and Apple reached the wrong result, or at least did not offer the right reason. Apple imposed an ad valorem charge for using its platform in a two-sided transaction market, and in these circumstances, whether iPhone users had a right to sue for damages depends on whether the marginal costs of distribution were positive, a condition that was not addressed.
Cardiac Motion and its Impact on Target Coverage During SBRT for Refractory Ventricular Tachycardia.

Purpose/Objective(s) Refractory ventricular tachycardia (VT) is a common cause of death and morbidity in the heart failure population. Stereotactic body radiation therapy (SBRT) is a new and promising approach to treating VT, but there are practical concerns about SBRT delivery to the heart, which undergoes motion from both cardiac and respiratory cycles. In this study, we investigate motion magnitudes from both cycles and their impact on treatment margins and target coverage for VT SBRT. Materials/Methods Twenty-one patients were treated with SBRT for VT at our institution between April 2018 and December 2020 under an IRB-approved registry protocol. All patients had respiratory-correlated 4DCT for treatment planning and 7 patients had diagnostic cardiac-gated CT scans taken less than two weeks prior to treatment. Target structures were delineated on free-breathing CT and transferred to respiratory average (RAVG) CT via rigid registration. Dose was initially calculated on the RAVG per current institutional standard of care. For this retrospective study, deformable image registration (DIR) was applied between RAVG and the cardiac average CT (CAVG), systolic, and diastolic CTs from the cardiac dataset. Target contours were transferred to the registration target image. Motion magnitudes and distributions from the deformation vector fields were analyzed. Internal target volumes (ITVs) were created on the respiratory average images for quantitative analysis of target motion and coverage changes. From these 7 patients, 11 distinct target volumes were treated, with 8 being epicardial and 3 endocardial. Motion and dosimetry for all 11 targets were analyzed separately. Results The average (SD) target shift magnitudes (in mm) from the RAVG to CAVG CTs were 2.0 ± 1.0, 2.0 ± 1.3, and 4.0 ± 2.0 in the left-right (LR), anterior/posterior (AP), and superior/inferior (SI) directions. Endocardial targets had greater motion magnitude than epicardial targets, with mean shifts of 2.2 ± 1.0, 2.3 ± 1.9, and 4.2 ± 2.4 in the LR, AP, and SI directions versus 1.4 ± 0.9, 1.3 ± 0.8, and 3.6 ± 0.5. Cardiac cycle motion showed more variability for epicardial targets with shifts of 1.4 ± 2.5, 2.4 ± 3.0, and 2.5 ± 3.7 in the LR, AP and SI directions, versus 2.0 ± 0.6, 2.1 ± 0.8, and 1.6 ± 0.7 for endocardial targets. Creation of motion encompassing ITVs led to an average target size increase of 100% (25 cm3). V95 for initial target volumes was 99.9 ± 0.4% while the average V95 for ITVs was 84.1 ± 15.6%. Similarly, D95 for the target dropped from 108.2 ± 5.7% to 75.3 ± 28.4%. Conclusion In this cohort of patients undergoing SBRT for VT, cardiac shifts were location-dependent and were largest in the SI direction. These shifts typically exceeded the 1-5 mm margins used for SBRT treatment planning and ITV generation to encompass all target motion led to a doubling in target size. Our data suggest that cardiac-gated delivery may be helpful to minimize treatment volumes and spare cardiac tissue.
The Remarkable Nature of Cylindrically Anisotropic Elastic Materials Exemplified by an Anti-Plane Deformation

A material is cylindrically anisotropic when its elastic moduli referred to a cylindrical coordinate system are constants. Examples of cylindrically anisotropic materials are tree trunks, carbon fibers [1], certain steel bars, and manufactured composites [2]. Lekhnitskii [3] was the first one to observe that the stress at the axis of a circular rod of cylindrically monoclinic material can be infinite when the rod is subject to a uniform radial pressure (see also [4]). Ting [5] has shown that the stress at the axis of the circular rod can also be infinite under a torsion or a uniform extension. In this paper we first modify the Lekhnitskii formalism for a cylindrical coordinate system. We then consider a wedge of cylindrically monoclinic elastic material under anti-plane deformations. The stress singularity at the wedge apex depends on one material parameter γ. For a given wedge angle α, one can choose a γ so that the stress at the wedge apex is infinite. The wedge angle 2α can be any angle. It need not be larger than π, as is the case when the material is homogeneously isotropic or anisotropic. In the special case of a crack (2α=2π) there can be more than one stress singularity, some of them are stronger than the square root singularity. On the other hand, if γ < $$ - \frac{1}{2}$$ there is no stress singularity at the wedge apex for any wedge angle, including the special case of a crack. The classical paradox of Levy [6] and Carothers [7] for an isotropic elastic wedge also appears for a cylindrically anisotropic elastic wedge. There can be more than one critical wedge angle and, again, the critical wedge angle can be any angle.
Effects of enhanced caregiver training program on cancer caregiver’s self-efficacy, preparedness, and psychological well-being

Purpose We examined the effects of an enhanced informal caregiver training (Enhanced-CT) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients.
Meaning is in the Mind of the Reader: A Rejoinder to Burk, Cotter, and Lemley

As beauty is in the eye of the beholder, meaning is in the mind of the reader. In three responses to my article, "Purging Patent Law of 'Private Law' Remedies," 92 Texas L. Rev. 517 (2014), Dan Burk, Tom Cotter, and Mark Lemley offer three distinct readings and, hence, attribute three distinct meanings. In this rejoinder to Burk, Cotter, and Lemley, I endeavor to convey to the reader my intended meaning by pointing out what I believe are mischaracterizations of my original article in Burk’s and Lemley’s responses. Additionally, I rebut various criticisms in all of the responses and stake out areas of consensus.