cssi/SciSciGPT-SciSciNet huggingface dataset:
Mobile Technologies Enhance The E-Learning Opportunity

The objective of this paper is to identify the mobile technologies that enhance the E-Learning opportunity, examine the educational benefits and implementation issues in mobile learning, discuss the guidelines for implementing effective mobile learning, identify the current application and operation of mobile learning, and discuss the future of teaching and learning with mobile technologies.
Ethical Considerations When Including Lysosomal Storage Disorders in Newborn Screening Programs

There is essentially unanimous agreement that newborn screening saves lives. Nevertheless, newborn screening—rated as one of the top 10 successes in public health in the first decade of the twenty-first century by the Centers for Disease Control and Prevention (Koppaka in JAMA 306(5):484–487, 2003)—faces multiple challenges, including questions about how conditions are added to the list of disorders for which screening is done in each state, about the need for parental consent for use of dried blood spots after screening, and the roles of parents in expansion of newborn screening. Such questions figure prominently in controversy surrounding Pennsylvania’s recent passage of House Bill1654, also called Hannah’s Law, which institutes newborn screening and follow-up for 6 lysosomal storage disorders including Krabbe, Fabry, Pompe, Niemann–Pick, types A and B, Gaucher diseases, and mucopolysaccharidosis type I, also called Hurler disease. This review article provides an historical perspective on newborn screening including discussion of how conditions came to be added to the Recommended Uniform Screening Panel, and an overview of current issues and concerns for key stakeholders including parents, healthcare providers, laboratorians, and legislators.
Abstract P4-12-15: Are we appropriately referring and testing breast cancer women for genetic mutations?

Background – Annually it is estimated that Hereditary Breast and Ovarian Syndrome (HBOC) accounts for 5 - 6% of breast cancer in the US. The majority of HBOC are associated with gene mutations in BRCA 1 & 2; other mutations include p53, PTEN, CH1, STK11. These genes are tumor suppressor genes and play a role in the maintainence of genomic integrity. Women with BRCA mutations have a life time risk of developing breast cancer (50 -85%) and ovarian cancer (15-40%). Other cancers have been associated with these mutations as well. The estimated frequency of a mutation in the BRCA gene is 1/800-1/1000. As a primary oncologist it is our responsibility to screen breast cancer patients who may harbour such deleterious mutation and offer appropriate screening, counselling, testing and management. As tests are now available without trained genetic counsellors, the question remains are all appropriate patients being offered genetic testing to assist in treatment and does onsite genetic counselling improve testing rates. Purpose of study – To evaluate the difference in identification of high risk breast cancer patients and the number of women who undergo genetic testing with or without an onsite genetic counsellor. Methods – A retrospective chart review was performed of all newly diagnosed breast cancer patients from March 2012 – February 2014. Year 1 was without a genetic counsellor, March 2012 - February 2013 (Gr.1) and year 2 with an onsite genetic counsellor, March 2013 – February 2014 (Gr.2). Information collected included age, stage of breast cancer, receptor type, reason for referral or genetic testing based on NCCN criteria for HBOC testing and results of tests. Results – 135 new breast cancer patients were identified and 125 were evaluable. In Gr 1, 27/72 (37.5%) met criteria for genetic testing. 15 were offered testing (55.5%). 5/15 (33.3%) completed testing with no patient positive for BRCA mutation; 10 patients were non compliant with recommended testing; 3 patients were tested outside of guidelines with negative results. In Gr 2, 22/53 (41.5%) met criteria for genetic testing. 16 were offered testing (72.3%); 8/16 (50%) completed testing with 4 positive for a BRCA mutation; 8 patients were not tested (6 patients non compliant with recommended testing, 1 due to insurance issuses and 1 refused). See Table 1. The most common reason for genetic testing was patients with primary breast cancer age Conclusion – A greater number of women with newly diagnosed breast cancer were identified and offered genetic testing with an onsite genetic counsellor. The precentage of individuals tested increased with an onsite counsellor. Citation Format: Pankhoori Saraf, Dipen Patel, Alice J Cohen. Are we appropriately referring and testing breast cancer women for genetic mutations? [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P4-12-15.
Spin−1/2 Dirac Equation

What the Schrodinger equation is to nonrelativistic physics, the Dirac equation is to relativistic physics. We begin this chapter by describing three alternative ways of deriving this spin−1/2 wave equation—the more the merrier, in order to develop as much intuition as possible about this fundamental dynamical tool. Next we formulate the Dirac equation in a manifest covariant manner and emphasize the structure of γ-matrix algebra and the positive and negative free-particle solutions. The Dirac equation in the presence of external fields is then generated by minimal replacement, and the resulting electron bound-state energies are obtained for the one-particle Coulomb atom and for a constant external magnetic field. We pay particular attention to the difference between the Dirac atom and the fine-structure level shifts in the Schrodinger atom. Finally, we develop free-particle Dirac equations for spin−1/2 massless neutrinos and spin−3/2 massive particles.
Review Essay: Statistical Portraits of American Business Executives

Since the early twentieth century, scholars have conducted statistical studies of groups of business leaders. These have often been extensive undertakings, calling for the collection of large quantities of information about business executives through the use of surveys, personal interviews, dictionaries, obituaries, and biographies. The scholars who have carried out these studies have come from a range of disciplines, including sociology, history, and economics. The questions they have asked have varied over time. Some have sought to uncover common characteristics among the executives themselves. Others have studied groups of businessmen in order to learn about society (especially the extent of social mobility), or about particular industries and the people who ran them. While the variety of approaches has led some to conclude that these studies present no coherent picture, this article shows an underlying pattern in these efforts and suggests a framework for future study.
Prajna: towards recognizing whatever you want from images without image labeling

With the advances in distributed computation, machine learning and deep neural networks, we enter into an era that it is possible to build a real world image recognition system. There are three essential components to build a real-world image recognition system: 1) creating representative features, 2) designing powerful learning approaches, and 3) identifying massive training data. While extensive researches have been done on the first two aspects, much less attention has been paid on the third. In this paper, we present an end-to-end Web knowledge discovery system, Prajna. Starting from an arbitrary set of entities as inputs, Prajna automatically crawls images from multiple sources, identifies images that have reliably labeled, trains models and build a recognition system that is capable of recognizing any new images of the entity set. Due to the high cost of manual data labeling, leveraging the massive yet noisy data on the Internet is a natural idea, but the practical engineering aspect is highly challenging. Prajna focuses on separating reliable training data from extensive noisy data, which is a key to the capability of extending an image recognition system to support arbitrary entities. In this paper, we will analyze the intrinsic characteristics of Internet image data, and find ways to mine accurate and informative information from those data to build a training set, which is then used to train image recognition models. Prajna is capable of automatically building an image recognition system for those entities as long as we can collect sufficient number of images of the entities on the Web.
Cavity flameholders for ignition and flame stabilization in scramjets - Review and experimental study

This paper describes ongoing research efforts in the scramjet community, in general, as well as specific work at Stanford University on cavity flame-holders, a concept for flame-holding and stabilization in supersonic combustors. During the last few years, cavities have gained the attention of the scramjet community as a promising flameholding device, owing to results obtained in flight test and to feasibility demonstrations in laboratory scale supersonic combustors. However, comprehensive studies are needed to determine the optimal configuration which will yield the most effective flameholding capability with minimum loses. In the first cavity study, reported in this paper, the goals were to demonstrate ultra-high-speed schlieren imaging as applied to study a cavity with length-to-depth-ratio of L/D=3. By combination of simultaneously performed fast response pressure measurements, established cavity oscillations were observed and a sequence of oscillation cycles could be captured during the limited test time (~300us) of the flow facility. The results demonstrate that short duration pulse facilities can be used to study gasdynamics aspects of cavities, though with small dimensions (depth of D=3mm), in hypersonic flows.
Enhanced external counterpulsation (EECP) decreases advanced glycation end products and proinflammatory cytokines in patients with non-insulin-dependent type II diabetes mellitus for up to 6 months following treatment

Enhanced external counterpulsation (EECP) is a noninvasive, non-pharmacologic intervention proven to increase nitric oxide bioavailability in patients with coronary artery disease. The purpose of the present study was to evaluate the potential clinical benefits of EECP on advanced glycation end products (AGEs) and proinflammatory cytokine concentrations in patients with a clinical diagnosis of type II diabetes mellitus (T2DM). Thirty subjects (60.7 ± 1.9 years) with T2DM were randomly assigned (2:1 ratio) to receive either 35 1-h sessions of EECP (n = 20) or time-matched standard care (n = 10). AGEs, receptors for AGEs (RAGEs), soluble vascular cell adhesion molecules-1 (sVCAM-1), and 8-iso-prostaglandin 2α (8-iso-PGF2α) were evaluated before and at 48 h, 2 weeks, 3, and 6 months following EECP treatment or time-matched control. EECP significantly decreased AGEs and RAGEs at all follow-up measurement time points. AGEs and RAGEs were decreased at 48 h (−75 and −16 %), 2 weeks (−87 and −28 %), 3 months (−89 and −29 %), and 6 months (−92 and −20 %) following EECP treatment, respectively. sVCAM-1 and 8-iso-PGF2α were significantly decreased at 48 h (−30 and −49 %) and 2 weeks (−22 and −27 %) following EECP, respectively. sVCAM-1 (−27 %) remained significantly reduced at 3 months following EECP. Nitrite/nitrate (NOx) was significantly increased at 48 h (+48.4 %) and 2 weeks (+51.9 %) following EECP treatment. Our findings provide novel evidence that EECP decreases AGE/RAGE concentrations, inflammation, and oxidative stress in patients with T2DM that persist for up to 6 months following treatment.
It's not the pump, it's how you use the pump!

The authors used a clever and inexpensive method to confirm the conclusions previously described by Wake Forest University investigators, who used vastly more expensive techniques in animals and human models: namely, the source of lipid microemboli during cardiac surgery are largely derived from the return of cardiotomy suction blood and, to a lesser extent, cell saver treated blood (1,2). The authors’ recommendation to limit lipid microembolization is to avoid cardiopulmonary bypass and to use off-pump surgical techniques, at least for routine CABG. The CardioNeuroProtection research team at Wake Forest came to a somewhat different conclusion (3,4). We demonstrated that we could avoid lipid embolization by minimizing bleeding and thereby the need to return any blood products regardless of whether the pump was used or not. Our current research demonstrates that it is not necessary for a lipid or gaseous embolus to occlude a vessel to cause damage (5). The mere passage, or rather extrusion, of a deformable embolus through a vessel can cause a disruption of endothelial function, which in the case of the brain, results in a breakdown of the Blood Brain Barrier with subsequent vasogenic and cytotoxic edema, the release of cytokines, neutrophil adhesions, and the transmigration of leukocytes in to the brain substance (6). Avoiding the return of shed blood in its many forms potentially contributes to a reduction in the systemic inflammatory response. Our recent paper (7) demonstrates equivalent neurologic outcomes between patient groups undergoing CABG with and without the pump by avoiding the use of partial occlusion clamps and minimizing the return of suctioned blood. Further analysis has demonstrated fewer persistent neurologic deficits in the on-pump group than those undergoing off-pump surgery. We speculated that the neuroprotective effect of hypothermia contributed to the improved outcomes in the CPB patients. However, we caution that not all pumps, filters, and cell savers are equally effective at handling gaseous and or lipid microemboli (2,8). The contribution of emboli from the surgical field is a confounding factor when attempting to ascribe “blame” for negative outcomes. The pump is an easy target despite the fact that gaseous and lipid micro-emboli from the surgical field can pass completely through both the patient and circuit. Emboli are not absent during off-pump surgery and they are delivered to a warm brain. It is critical to avoid introducing embolic material and not rely on a filtration system to rectify a preventable problem (9). The clever experimental design used by these investigators will contribute to an accelerated resolution as to how best to avoid lipid microembolization and improve outcomes, with or without the pump.
John Locke and the United States Constitution

John Adams had invoked John Locke in his Thoughts on Government as third after Sidney and Harrington among the modern authors who would convince ‘any candid mind’ to embrace republicanism.1 Eleven years later he repeated his endorsement in defending the United States Constitutions, citing Locke’s ‘very valuable production’ on ‘the principles of government’.2 And his ‘acquaint[ance] with the ancients’.3 Adams praised Locke as defender of ‘the principles of Liberty’. But he also coupled Locke with Milton and Hume as ‘absurd’, when it came to proposing a positive programme,4 and insufficiently committed to ‘popular elections’ in the lower branch of the legislature,5 or the ‘existence and independence of the other two’ branches of government.6 Modern scholars have continued to take so great an interest in Locke, and his putative ‘republicanism’, that it is important to identify his exact relationship with America’s revolutionary generation.7
Neurovegetative und modulatorische Systeme

Dieses Kapitel befasst sich mit drei Teilsystemen des Nervensystems, die ihre Wirkung auf einer breiten raumlichen und zeitlichen Skala entfalten. Eines dieser Systeme ist der neurosekretorische Anteil des Hypothalamus. Ein weiteres System, das der neuronalen Kontrolle durch den Hypothalamus unterliegt, ist das vegetative Nervensystem. Aufgrund seines umfangreichen Verbindungsnetzes innerhalb des Korpers kann das vegetative Nervensystem die Reaktionen vieler innerer Organe, Blutgefase und Drusen kontrollieren. Das dritte System liegt vollstandig im zentralen Nervensystem und setzt sich aus einigen verwandten Zellgruppen zusammen, die ihre Wirkung durch stark divergierende Axonprojektionen mit groser raumlicher Reichweite ausuben. Die zu diesem Teil des Nervensystems gehorenden Zellpopulationen werden als diffuse modulatorische Systeme des Gehirns bezeichnet. Man vermutet, dass diese diffusen Modulationssysteme unter anderem Erregungs- und Gefuhlszustande steuern.
Contusion (bruise) segmentation & diagnosis: A graphical user interphase approach

The medical field has been turning to technology to provide new treatments, techniques, and protocol. Over the past decade the industry has become heavily reliant on technology to vastly improve medical care. With the help of modern image processing techniques diagnosis of many illnesses have been improved as well as preparation for surgical procedures such as tumor removal have become more effective and have led to better outcomes. Although there has been a significant impact in these areas there are still many treatment areas that could benefit with the help of image processing techniques. One such area is contusion (bruise) diagnosis and treatment. This paper presents two graphical user interface technologies that could help medical professionals more effectively diagnosis and treat patient's bruising.
Obesity Is Associated With Increased Morbidity in Moderate to Severe COPD

Background Obesity is prevalent in the United States; however, the impact of obesity on COPD morbidity is unclear. We hypothesized that obesity is associated with worse outcomes in COPD. Methods We examined 3,631 participants from the multicenter prospective cohort study Genetic Epidemiology of COPD (COPDGene) who had spirometry-confirmed COPD, a postbronchodilator FEV 1 2 . We conducted logistic and linear regression analyses to determine the association between COPD outcomes and obesity class, adjusting for relevant confounders. The referent for obesity classes included normal/overweight individuals (BMI range, 18.5-29.9 kg/m 2 ). Results Overall, 35% of participants were obese, with 21% class I (BMI range, 30-34.9 kg/m 2 ), 9% class II (BMI range, 35-39.9 kg/m 2 ), and 5% class III (BMI ≥ 40 kg/m 2 ). The number of comorbidities increased with increasing obesity class ( P Conclusions Obesity is prevalent among individuals with COPD and associated with worse COPD-related outcomes, ranging from QOL and dyspnea to 6MWD and severe AECOPD. These associations were strengthened when obesity was analyzed as a dose-dependent response. Obesity in patients with COPD may contribute to a worse COPD-related course.
The critic as empath: Moving away from totalizing theory

(1993). The critic as empath: Moving away from totalizing theory. Western Journal of Communication: Vol. 57, Ideology and Communication, pp. 178-190.
A low-voltage power MOSFET with a fast-recovery body diode for synchronous rectification

A power MOSFET suitable for synchronous rectification in 1-10 MHz switching power supplies is presented. Three device structures are compared to find the lowest on-state resistance, off-state capacitance product. The lightly doped drain region typical of most power MOSFETs is removed to give a body diode with a 1 ns reverse recovery time. Both of these types are needed for efficient operation at high frequencies. Process details and experimental results are also discussed. >
Increased Proliferation of the Pancreatic Duct Gland Compartment in Type 1 Diabetes

Context: Pancreatic duct glands (PDGs) have been proposed as a source of regeneration in response to exocrine pancreas injury, and thus may serve as an organ stem cell niche. There is evidence to suggest ongoing beta-cell formation in longstanding type 1 diabetes (T1D), but the source is unknown. Objective: To investigate the pancreatic duct gland (PDG) compartment of the pancreas in humans with T1D for evidence of an active regenerative signature (presence of progenitor cells and increased proliferation) and, in particular, as a potential source of beta-cells. Design, Setting and Participants: Pancreas from 46 brain dead organ donors (22 with T1D, 24 nondiabetic controls) were investigated for activation (increased proliferation) and markers of pancreatic exocrine and endocrine progenitors. Results: PDG cell replication was increased in T1D (6.3 ± 1.6 vs. 0.6 ± 0.1%, p < 0.001, T1D vs. ND), most prominently in association with pancreatic inflammation. There were increased progenitor-like cells in PDGs of...
Aspergillus aortitis: a case with near-complete occlusion of the brachial artery and large ascending aortic mycotic pseudoaneurysm in an immunocompetent patient

Invasive cardiac aspergillosis is an extremely rare life threatening disease in immunocompetent hosts that has been described in the literature in a few cases Most cases have presented in the setting of an underlying pulmonary aspergillosis in the setting of an immunocompromised status This is to report an exceptionally rare aspergillusaortitis in an immunocompetent patient presenting with near complete occlusion of the brachial artery and a large ascending aortic mycotic pseudoaneurysm To our knowledge this is the first reported case of aspergillus aortitis in an immunocompetent host presenting initially as intraarterial thrombosis without intracardiac thrombosis or valvular vegetation The patient did not have any pre existing pulmonary or mediastinal disease but had a history of coronary artery bypass grafting years prior to the infection nbsp
Wowing the Public: The Space Shuttle as a Cultural Icon

From first flight to the present the Space shuttle has been an important symbol of United States technological capability, universally recognized as such by both the American people and the larger international community. NASA’s Space shuttle remained until retirement one of the most highly visible symbols of American excellence worldwide. This chapter will consider the evolving place of the Space shuttle as a cultural icon from its first conceptualization until the present.
Patient and operating room staff radiation dose during fenestrated/branched endovascular aneurysm repair using premanufactured devices.

Abstract Introduction Fenestrated endovascular aneurysm repair (FEVAR) is the highest radiation dose procedure performed by vascular surgeons. We sought to characterize the radiation dose to patients and staff during FEVAR procedures with different premanufactured devices. Methods A single-center prospective study of FEVARs was performed over 24 months. Three FEVAR devices were included: off-the-shelf (OTS; t-Branch, p-Branch), Zenith Fenestrated (ZFen), and investigational custom-made devices (CMDs). Radiation doses to the surgeon, trainee, anesthesiologist, and scrub/circulating nurses were measured using a personal dosimetry system (DoseAware, Philips Healthcare, Amsterdam, The Netherlands). Procedure type, patient body mass index (BMI), reference air kerma (RAK), and kerma area product (KAP) were recorded. RAK and KAP were corrected for BMI based on an exponential fit of fluoroscopy dose rate and the dose per radiographic frame. Operator dose was corrected for BMI by the ratio of corrected to actual KAP. A one-sided Wilcox rank-sum test was used to compare personnel radiation doses, RAKs, and KAPs between procedure types. Statistical significance was set at P ≤ .05. Results There were 80 FEVARs performed by a single surgeon on a Philips Allura XperFD20 fluoroscopy system equipped with Clarity technology. Average BMI was 27 kg/m2. Sixty CMDs (36 four-, 21 three-, and 3 two-vessel fenestrations), 11 ZFens (8 three- and 3 two-vessel fenestrations), and 9 OTS devices (4 p-Branch, 5 t-Branch) were included. ZFens had significantly lower patient (1800 mGy vs 2950 mGy; P = .004), operator (120 μSv vs 370 μSv; P = .004), assistant (60 μSv vs 210 μSv; P = .003), circulator (10 μSv vs 30 μSv; P = .049), and scrub nurse dose (10 μSv vs 40 μSv; P = .02) compared with CMDs. OTS devices had significantly lower operator (220 μSv vs 370 μSv; P = .04), assistant (110 μSv vs 210 μSv; P = .02), and circulator doses (4 μSv vs 30 μSv; P = .001) compared with CMDs. Four-vessel fenestrated devices had significantly higher patient dose (3020 mGy) compared with three-vessel FEVARs (2670 mGy; P = .03) and two-vessel FEVARs (1600 mGy; P = .0007), and significantly higher operator dose (440 μSv) compared with three-vessel FEVARs (170 μSv; P = .0005). Patient dose was lowest with ZFens. Operating room personnel dose was lower with ZFens and OTS devices compared with CMDs. Four-vessel fenestrations required significantly more radiation compared with those involving three-vessel fenestrations; however, the dose increase was only 12% and should not preclude operators from extending coverage, if anatomically required. Conclusions Overall, patient and personnel radiation doses during FEVAR with all devices were within acceptable limits and lower in our series than previously reported.
Surgical Management Navicular and Cuboid Fractures

The tarsal navicular is a critical component of the foot's medial longitudinal arch. Injuries to the navicular have significant long-term functional consequences. In addition to stress fractures, acute injuries to the navicular include acute avulsion, tuberosity, and body fractures. Nonoperative treatment is the mainstay for avulsion injuries and nondisplaced body fractures. Open reduction and internal fixation is performed to achieve anatomic reduction in the other situations. Common complications following operative intervention include pain, stiffness, post-traumatic arthritis, avascular necrosis, nonunion, and hindfoot deformity. This article provides an overview for recognition and treatment of common presentations of these injuries as described in the literature.
Fast online collision avoidance for mobile service robots through potential fields on 3D environment data processed on GPUs

This paper demonstrates the fitness of massively parallel exact Euclidean distance transform (EDT) computation for fast 3D online motion planning with potential field and wavefront planners. We combine point-cloud sensor data to gather detailed 3D voxel maps of complex environments. Unlike other approaches, we do not use 3D polygon meshes or reduce the environment to 2D or 2.5D models to improve planning times. The evaluation shows that fast sub-second local and global planning times on the basis of GPU EDT are possible.
New nomenclature and DNA testing guidelines for myotonic dystrophy type 1 (DM1)

Myotonic dystrophy (DM; OMIM 160900, also known as dystrophia myotonica, myotonia atrophica and Steinert disease) is an autosomal dominant myotonic myopathy associated with abnormalities of other organs, including eyes, heart, endocrine system, central and peripheral nervous systems, gastrointestinal organs, bone, and skin.1 The mutation underlying DM is an expansion of an unstable cytosine-thymine-guanine (CTG) trinucleotide repeat in the 3' untranslated region of the myotonic dystrophy protein kinase (DMPK) gene in chromosome 19q13.3.2-4 In 1994, Thornton et al.5 described an autosomal dominant disorder similar to DM without CTG repeat expansion at the DM locus. Ricker et al.6 named this disease "proximal myotonic myopathy" (PROMM; OMIM 600109) because of predominantly proximal muscle weakness without atrophy as opposed to the distal muscle involvement seen in DM. Subsequently, Meola et al.7 described a variant of PROMM with unusual myotonic and myopathic features, which they named "proximal myotonic myopathy syndrome," and Udd et al.8 described a PROMM-like family with dystrophic features, which they named "proximal myotonic dystrophy" (PDM). Researchers at the University of Minnesota9,10 found another multisystemic myotonic disorder that closely resembles DM with distal muscle weakness but no CTG repeat expansion. Because of the close phenotypic resemblance to DM, they called this disease "myotonic dystrophy type 2" (DM2; OMIM 602668). In 1998, Ranum et al.9 assigned the DM2 locus to chromosome 3q in a large kindred. Shortly after that, Ricker et al.11 found that the majority of German PROMM families show linkage to the DM2 locus. PDM was also mapped to this region (Krahe and Udd, personal communication, 1999). Whether PROMM, PDM, and DM2 represent different phenotypic expressions of a disease caused by the same mutation or if they are allelic disorders remains to be determined. It is also possible that these disorders are caused by mutations in different genes that are closely linked in the chromosome 3q region.12 Furthermore, the disease loci in some typical PROMM families11 and other families with multisystemic myotonic disorders have been excluded from both DM and DM2 loci. Because of the genetic and phenotypic heterogeneity in this group of disorders, it became necessary to establish a new nomenclature foreseeing the future discovery of new disease loci and phenotypic variability.
Excimer Laser–Assisted Removal of Embedded Inferior Vena Cava Filters A Single-Center Prospective Study

Background—Although chronically implanted inferior vena cava filters may result in filter-related morbidity, there is currently no routine option for removing such filters when they become firmly embedded along the vena cava endothelium. Methods and Results—During a 3-year period, 100 consecutive patients were prospectively enrolled in a single-center study. There were 42 men and 58 women (mean age, 46 years; limits, 18–76 years). Retrieval indications included filter-related acute inferior vena cava thrombosis, chronic inferior vena cava occlusion, and pain from retroperitoneal or bowel penetration. Filter retrieval was also performed to prevent risks from prolonged implantation and to potentially eliminate the need for lifelong anticoagulation. After standard methods failed, photothermal tissue ablation was attempted with a laser sheath powered by a 308-nm xenon chloride excimer laser. Applied forces were recorded with a digital tension meter before and during laser activation. Laser-assisted retrieval ...
Upscaling soil-atmosphere CO2 and CH4 fluxes across a topographically complex forested landscape

Abstract Upscaling soil-atmosphere greenhouse gas (GHG) fluxes across complex landscapes is a major challenge for environmental scientists and land managers. This study employs a quantile-based digital soil mapping approach for estimating the spatially continuous distributions (2 m spatial resolution) and uncertainties of seasonal mean mid-day soil CO2 and CH4 fluxes. This framework was parameterized using manual chamber measurements collected over two years within a temperate forested headwater watershed. Model accuracy was highest for early (r2 = 0.61) and late summer (r2 = 0.64) for CO2 and CH4 fluxes. Model uncertainty was generally lower for predicted CO2 fluxes than CH4 fluxes. Within the study area, predicted seasonal mean CO2 fluxes ranged from 0.17 to 0.58 μmol m−2 s−1 in winter, and 1.4 to 5.1 μmol m−2 s−1 in early summer. Predicted CH4 fluxes across the study area ranged from −0.52 to 0.02 nmol m−2 s−1 in winter, and −2.1 to 0.61 nmol m−2 s−1 in early and late summer. The models estimated a per hectare net GHG potential ranging from 0.44 to 4.7 kg CO2 eq. hr−1 in winter and early summer, with an estimated 0.4 to 1.5% of emissions offset by CH4 uptake. Flux predictions fell within ranges reported in other temperate forest systems. Soil CO2 fluxes were more sensitive to seasonal temperature changes than CH4 fluxes, with significant temperature relationships for soil CO2 emissions and CH4 uptake in pixels with high slope angles. In contrast, soil CH4 fluxes from flat low-lying areas near the stream network within the watershed were significantly correlated to seasonal precipitation. This study identified key challenges for modeling high spatial resolution soil CO2 and CH4 fluxes, and suggests a larger spatial heterogeneity and complexity of underlying processes that govern CH4 fluxes.
Neurocomputational Modeling of Human Physical Scene Understanding

National Science Foundation (U.S.). Science and Technology Centers (STCs): Integrative Partnerships Program (Award CCF-1231216)
Time-Resolved Electrical Scanning Probe Microscopy of Layered Perovskites Reveals Spatial Variations in Photoinduced Ionic and Electronic Carrier Motion

We study light-induced dynamics in thin films comprising Ruddlesden-Popper phases of the layered 2D perovskite (C4H9NH3)2PbI4. We probe ionic and electronic carrier dynamics using two complementary scanning probe methods, time-resolved G-mode Kelvin probe force microscopy and fast free time-resolved electrostatic force microscopy, as a function of position, time, and illumination. We show that the average surface photovoltage sign is dominated by the band bending at the buried perovskite-substrate interface. However, the film exhibits substantial variations in the spatial and temporal response of the photovoltage. Under illumination, the photovoltage equilibrates over hundreds of microseconds, a time scale associated with ionic motion and trapped electronic carriers. Surprisingly, we observe that the surface photovoltage of the 2D grain centers evolves more rapidly in time than at the grain boundaries. We propose that the slower evolution at grain boundaries is due to a combination of ion migration occurring between PbI4 planes, as well as electronic carriers traversing grain boundary traps, thereby changing the time-dependent band unbending at grain boundaries. These results provide a model for the photoinduced dynamics in 2D perovskites and are a useful basis for interpreting photovoltage dynamics on hybrid 2D/3D structures.
A carnivores’ oasis? An isolated fisher (Pekania pennanti) population provides insight on persistence of a metapopulation

Landscape level species assessments are rarely available to inform conservation planning. Recent advances in multi-taxa survey techniques, however, have made them more obtainable by improving efficiency of collecting species occurrence data and genetic samples. Here, we used a multi-taxa survey technique to provide a landscape level portrait of fisher (Pekania pennanti) population status in a portion of the northern Rockies where the species’ history has been heavily influenced by humans. From 2010 to 2014 we deployed 497 winter forest carnivore bait stations across a 23,000 km2 study area centered on northern Idaho, United States. The stations collected remote camera images and hair samples for DNA analysis. We used 12 microsatellite loci to identify 58 individual fisher in the study area. We identified two fisher populations for which we estimated effective population size (Ne) and genetic neighborhood size (NS). We calculated local genetic diversity measures [observed (Ho) and expected (He) heterozygosity, allelic richness (Ar), fixation index (FST), and number of migrants per generation (Nm)] and mapped continuous gradients of genetic diversity [Ar and inbreeding coefficient (FIS)] across the study area. We identified a fisher population in the West Cabinet Mountains [Ne of 26 (15.3–55.5), NS of 50–60] which is effectively isolated from the small population we detected in the Saint Joe/Coeur d’Alene Mountains [Ne of 6.5 (2.7–15), NS of 10–25]. We determined fisher have been effectively extirpated from the Selkirk and Purcell mountains and the lack of genetic connectivity between the two small remaining populations casts doubt on long term viability. Our study suggests northern Rockies fisher populations are vulnerable to landscape barriers and successful recovery will depend on future management and augmentation. We recommend these factors be considered when determining how, and if, species recovery should proceed.
Impact of Gold Nanoparticles on Testosterone Metabolism in Human Liver Microsomes

Gold nanoparticle (AuNP)-protein corona complexes can alter cytochrome P450 (CYP)-mediated testosterone (TST) metabolism by altering their physicochemical properties. We investigated the impact of NP size, surface chemistry, and protein corona in TST metabolism in pooled human liver microsomes (pHLM) employing 40 and 80 nm AuNP functionalized with branched polyethylenimine (BPEI), lipoic acid (LA), and polyethylene glycol (PEG) as well as human plasma protein corona (PC). Individual variation in AuNP-mediated TST metabolism was also characterized among single donor HLM that contained different levels of CYP activities. Inhibitory effects of 40 nm AuNP and to a lesser degree of 80 nm AuNP occurred for the production of a total of five hydroxylated metabolites of TST in pHLM but PC alleviated them. Meanwhile, naked AuNP increased androstenedione production. Interindividual variation in TST metabolism occurred within single donor HLM. In most cases, 40 and 80 nm naked and PC AuNP essentially suppressed TST metabolism at non-inhibitory concentration but PC PEG-AuNP increased androstenedione. These studies contribute to a better understanding of the role of AuNP as TST disruptor by altering TST metabolism and could be utilized to screen other NP as potential endocrine disruptor.
Therapist Experience, Personal Therapy, and Distressing States of Mind: Regulation and Resonance as Dialectics of Therapeutic Empathy

The current study is based on the notion of an empathic dialectic, marked by states of emotional resonance and regulation, which has been described by contemporary theories of therapeutic empathy and empirically supported by research on non-therapists. We operationalized emotional resonance as personal distress empathy, and we sought to examine how activities promoting self-regulation impact the association between personal distress empathy, and other facets of poor self-regulation. This was accomplished through an online study, which administered several self-report instruments to a sample of 158 non-therapists and 139 therapists of various levels of experience, collecting participants’ demographic information, attachment status, level of shame-proneness, the fear of invalidity, and personal distress empathy. We examined the impact of several moderators on the paths from attachment anxiety, shame-proneness, and the fear of invalidity to personal distress empathy; and, thus, on the indirect effect between attachment anxiety and personal distress empathy. For our first hypothesis, we expected therapist status to significantly moderate the paths in this proposed meditation. For our second hypothesis, we anticipated personal therapy sessions would significantly moderate this meditation. For our third hypothesis, we expected that both personal therapy and therapist experience level would moderate this mediation. Most notably, our results indicated that the fear of invalidity explained the association between attachment anxiety and personal distress empathy, and this mediation was stronger among non-therapists when compared to therapists. Yet, personal therapy did not similarly impact the relationships among these variables. Implications for future research are discussed.
Stress, craving and mood as predictors of early dropout from opioid agonist therapy.

Abstract Background Treatment with opioid agonists is effective for opioid use disorder, but early discontinuation of treatment is a major obstacle to success. Intensive longitudinal methods — which take many repeated measurements over time, usually in the field— have provided unique insight into the effects of stress, mood and craving on drug use while people are being treated; these methods might also be useful for studying the processes that lead people to drop out of treatment. Methods Ecological momentary assessment (EMA) was conducted for up to 17 weeks by obtaining multiple electronic diary entries per day from 238 participants being treated with methadone or buprenorphine-naloxone. Survival analysis was used to study two outcomes: dropping out of treatment and noncompliance with EMA self-report requirements. Self-reports of stress, craving, and mood were used as time-varying predictors. Demographic and psychosocial variables measured with the Addiction Severity Index at the start of treatment were used as time-invariant predictors. Results Dropping out of treatment was more likely in participants with more reported hassles (a measure of stress), higher levels of cocaine craving, lower levels of positive mood, a recent history of emotional abuse, a recent history of being bothered frequently by psychological problems, and with buprenorphine rather than methadone as their medication. In contrast, study noncompliance was not significantly associated with any of the variables analyzed. Conclusions Assessment of stress, craving and mood during treatment might identify people who are at greater risk of dropping out, and therapeutic interventions targeting these processes might increase retention.
Structure of the P element transpososome reveals new twists on the DD(E/D) theme

The first structure of this unusual recombinase in complex with substrate DNAs reveals surprisingly unpaired and refolded transposon end DNAs that are positioned in part by direct interactions with a GTP cofactor.
PA-CRM: A continuous reassessment method for pediatric phase I oncology trials with concurrent adult trials.

Pediatric phase I trials are usually carried out after the adult trial testing the same agent has started, but not completed yet. As the pediatric trial progresses, in light of the accrued interim data from the concurrent adult trial, the pediatric protocol often is amended to modify the original pediatric dose escalation design. In practice, this is done frequently in an ad hoc way, interrupting patient accrual and slowing down the trial. We developed a pediatric-continuous reassessment method (PA-CRM) to streamline this process, providing a more efficient and rigorous method to find the maximum tolerated dose for pediatric phase I oncology trials. We use a discounted joint likelihood of the adult and pediatric data, with a discount parameter controlling information borrowing between pediatric and adult trials. According to the interim adult and pediatric data, the discount parameter is adaptively updated using the Bayesian model averaging method. Numerical study shows that the PA-CRM improves the efficiency and accuracy of the pediatric trial and is robust to various model assumptions.
Transient uterine hypercontractility causes fetal cerebral oxidative stress and enduring mitochondrial and behavioral abnormalities in adolescent male rat offspring

The impact of transient ischemic-hypoxemic insults on the developing fetal brain is poorly understood despite evidence suggesting an association with neurodevelopmental disorders such as schizophrenia and autism. To address this, we designed an aberrant uterine hypercontractility paradigm with oxytocin to better assess the consequences of acute, but transient, placental ischemia-hypoxemia in term pregnant rats. Using MRI imaging, we confirmed that oxytocin-induced aberrant uterine hypercontractility significantly compromised uteroplacental perfusion. This was supported by the observation of oxidative stress and increased lactate concentration in the fetal brain. Genes related to oxidative stress pathways were significantly upregulated in male, but not female, offspring 1 h after oxytocin-induced placental ischemia-hypoxemia. Persistent upregulation of select mitochondrial electron transport chain complex proteins in the anterior cingulate cortex of adolescent male offspring suggested that this sex-specific effect was enduring. Functionally, offspring exposed to oxytocin-induced uterine hypercontractility showed male-specific abnormalities in social behavior with associated region-specific changes in gene expression and functional cortical connectivity. Our findings, therefore, indicate that even transient but severe placental ischemia-hypoxemia could be detrimental to the developing brain and point to a possible mitochondrial link between intrauterine asphyxia and neurodevelopmental disorders.
Brain-Selective Estrogen Therapy Prevents Androgen Deprivation-Associated Hot Flushes in a Rat Model

Hot flushes are best-known for affecting menopausal women, but men who undergo life-saving castration due to androgen-sensitive prostate cancer also suffer from these vasomotor symptoms. Estrogen deficiency in these patients is a direct consequence of androgen deprivation, because estrogens (notably 17β-estradiol, E2) are produced from testosterone. Although estrogens alleviate hot flushes in these patients, they also cause adverse systemic side effects. Because only estrogens can provide mitigation of hot flushes on the basis of current clinical practices, there is an unmet need for an effective and safe pharmacotherapeutic intervention that would also greatly enhance patient adherence. To this end, we evaluated treatment of orchidectomized (ORDX) rats with 10β, 17β-dihydroxyestra-1,4-dien-3-one (DHED), a brain-selective bioprecursor prodrug of E2. A pilot pharmacokinetic study using oral administration of DHED to these animals revealed the formation of E2 in the brain without the appearance of the hormone in the circulation. Therefore, DHED treatment alleviated androgen deprivation-associated hot flushes without peripheral impact in the ORDX rat model. Concomitantly, we showed that DHED-derived E2 induced progesterone receptor gene expression in the hypothalamus without stimulating galanin expression in the anterior pituitary, further indicating the lack of systemic estrogen exposure upon oral treatment with DHED.
A Convenient Prognostic Tool and Staging System for Progressive Supranuclear Palsy.

Background Progressive supranuclear palsy (PSP) causes major disability, shortens life, and as yet has no disease-modifying and little symptomatic treatment. A convenient prognostic tool is needed to assist patients, families, and clinicians in planning care. Objectives We calculated times to acquisition of certain disease milestones and death. Methods We followed a cohort of 417 patients with PSP-Richardson syndrome from 1995 to 2016, applying the Progressive Supranuclear Palsy Rating Scale (PSPRS) at each visit. We generated median times to acquisition of 13 milestones using the input variables of sex, onset age, rate of disease progression from motor symptom onset to initial visit, and PSPRS score at the baseline. Of the outcome milestones, 5 were stages of a new, provisional PSP staging system. The other 8 milestones comprised death and disabling levels of cognitive loss, gaze palsy, dysarthria, dysphagia, and gait/balance impairment. Results We derived median times to milestones, with 25th and 75th percentiles and 95% confidence intervals of the median for baseline PSPRS scores from 25 to 65 (scale range, 0-100). Sex and initial progression velocity significantly influenced the death milestone, but not most of the others. Median time to death ranged from 4.8 years for a man with PSPRS score of 25 and a slow progression velocity from onset to initial visit of 0.51 PSPRS points/month to 1.8 years for a woman with PSPRS 65 and rapid initial velocity of 2.25 points/month. Conclusions We have created a convenient, inexpensive, noninvasive reference for counseling patients with PSP-Richardson syndrome on approximate time to encountering 13 life-altering disease milestones.
Quark Matter: Status and Challenges

Abstract The study of QCD matter under extreme temperature and/or density is a vibrant and challenging field. Much has been learned in the past year and a half - much more than can be summarized in a single talk. Consequently, I will focus here on a subset of the new results, hopefully identifying some of the key questions to be addressed in this exciting conference.