cssi/SciSciGPT-SciSciNet huggingface dataset:
Vocalizations of Northern Elephant Seal Bulls: Development of Adult Call Characteristics during Puberty

Threat vocalizations of adult and juvenile northern elephant seal ( Mirounga angustirostris ) bulls were studied and compared. Adult bulls displayed consistent individual vocal patterns. These vocal signatures may facilitate recognition of individuals within the male dominance hierarchy. The calls of juvenile bulls were more variable than those of adults. Juveniles frequently used more than one syllable type in their threats, and individual syllables were delivered at a variable rate. These characteristics were more common in younger than in older juveniles.
Revisiting noise models in small-animal PET

2601 Objectives Understand the acquisition process of PET in small-animal imaging and sources of potential noise Methods Although considerable work has been done in the denoising of clinical PET data, the literature somewhat lacks similar studies in preclinical small-animal imaging. Under standard illumination, thermo-electronic fluctuations are much stronger than the photon-counting process that motivates the additive white Gaussian noise modeling assumption of the noise in most modalities. However, in low-photon-counting applications such as PET, noise is strongly signal dependent, motivating the Poisson assumption for noise. However, complete independence of the Poisson noise model does not bode well with the image data that posses strong depedence amongst neighboring voxels. Image intensity may therefore be modeled as Poisson distributed and potentially degraded by AWGN (Gaussian-Poisson distributed). Since Gaussian-Poisson noise model has the flexibilty to accommodate both neighborhood dependence as well as counting noise. We present an overview of the existing statistical model and the comparative analysis of different noise models in small-animal PET denoising including Gaussian noise model, Poisson noise model, and Gaussian-Poisson noise model. Results 20 PET scans are collected. A field-of-view of 4.8 cm and 6.7 cm in diameter is scanned with a time coincidence window of 10ns and energy windows of 250-700 keV. Noise statistics of the acquired PET data is empirically estimated. The noise models are evaluated using the performance of individual variance stabilizing tranform (VST) (Fig. 1). It has been demonstrated based on the results that the Gaussian-Poisson noise model fits best the noise present in the acquired data. Further, the clinical comparisons of the models is done in terms of the change in SUV as well as contrast and edge preservation. Conclusions In this work, we rigorously evaluated most commonly used noise models for small-animal PET data, we found that Poisson-Gaussian model fits best the noise characteristics in small animal PET.
Discussion on Coca-cola Beverage Co.Work Safety Supervision and Management Experiences

Taiyuan Coca-cola Beverage Co.,Ltd.has perfect safety management experiences.This paper introduces these experiences in six aspects,safety idea,funds investment,training inspection,supervision system,authentication verification and safety culture and it can be applied widely in practice.
Optimal sequencing during category learning: Testing a dual-learning systems perspective

Abstract Recent studies demonstrate that interleaving the exemplars of different categories, rather than blocking exemplars by category, can enhance inductive learning—the ability to categorize new exemplars—presumably because interleaving affords discriminative contrasts between exemplars from different categories. Consistent with this view, other studies have demonstrated that decreasing between-category similarity and increasing within-category variability can eliminate or even reverse the interleaving benefit. We tested another hypothesis, one based on the dual-learning systems framework—namely, that the optimal schedule for learning categories should depend on an interaction of the cognitive system that mediates learning and the structure of the particular category being learned. Blocking should enhance rule-based category learning, which is mediated by explicit, hypothesis-testing processes, whereas interleaving should enhance information-integration category learning, which is mediated by an implicit, procedural-based learning system. Consistent with this view, we found a crossover interaction between schedule (blocked vs. interleaved) and category structure (rule-based vs. information-integration).
Rights, Race, and Recognition: Race and rights

[Negroes] had … been regarded as beings of an inferior order, and altogether unfit to associate with the white race, either in social or political relations; and so far inferior, that they had no rights which the white man was bound to respect … This opinion was at that time fixed and universal in the civilized portion of the white race. It was regarded as an axiom in morals as well as in politics, which no one thought of disputing … United States Supreme Court, Dred Scott v. Sandford (1857) Though appropriate, the easy assertion by mainstream philosophers that all normal adult human beings are paradigm rightholders rings hollow against the background of American history, in which the opposite proposition has been quietly believed and loudly defended in the courts and legislatures to the detriment of nonwhites, women, and the unpropertied poor. —Anita L. Allen The experience of black people in the United States of America during slavery and subsequently provides a fruitful point of departure for assessing the normative adequacy of the prevailing philosophical conception of the source and value of rights—a conception that posits the existence of a class of rights that individuals are taken to possess prior to and independently of any form of social recognition. Few philosophers have attended to this general connection between the black experience and philosophical conceptions of rights. Philosopher and law professor Anita Allen is a notable exception.
Passive Attention: The Gateway to Consciousness and Autonomic Control

Passive control over autonomic functions or altered states of consciousness is the critical process by which both physical and psychological health are modulated. By investigating such processes we may learn new dimensions of our growth and perhaps change traditional views about the nature of health and sickness.
Python first: a lab-based introduction to computer science tutorial presentation

This tutorial is intended for computer science educators who seek alternatives to either purely commercial languages, such as Java or C++, or purely educational environments, such as Scheme and Alice, for introductory computing courses. Participants will learn how to make introductory computer courses more attractive to students (1) by teaching an easy to learn yet practical OO language - Python, (2) by making all course resources available in a comprehensive online study pack, and (3) by using an extensive set of detailed and easy to follow self-guided labs. Prior knowledge of the Python language is not required.
Radiocarbon and Climate

Atmospheric radiocarbon fluctuations of ±2.5% and temperature fluctuations of ±0.8C during the Christian era are consistent with a solar activity-solar modulation theory as suggested by Suess. Higher than average sunspot frequency is correlative with higher average annual temperature due to increase in the solar constant, whereas lower atmospheric C14 concentration is consistent with a lower $$ {\bar Q} $$ due to solar modulation of interplanetary magnetic fields.
Survey of Pharmacy Schools' Approaches and Attitudes toward Curricular Integration.

Objective. To identify ways in which curricular integration is addressed in US pharmacy schools, the structure of therapeutics and foundational science courses, and perceptions of the effects current curricular integration methods have on student learning.Methods. An electronic survey was sent to academic leaders representing 131 pharmacy schools in the United States. Frequency data was tabulated and demographic analysis was performed.Results. Respondent data represents 94 schools of pharmacy. Arranging similar content from various disciplines in a course, a skills laboratory and pharmacy practice experiences were the most common methods for achieving curricular integration. More than one half of the schools indicated that foundational sciences were integrated with therapeutics. The most common reported challenge to curricular integration was logistics.Conclusion. Pharmacy education in the United States has evolved in addressing curricular integration in the curricula, which is consistent with changes in ...
Nitrosative Stress-Induced Disruption of Baroreflex Neural Circuits in a Rat Model of Hepatic Encephalopathy: A DTI Study

The onset of hepatic encephalopathy (HE) in liver failure is associated with high mortality; the underlying mechanism is undecided. Here we report that in an acute liver failure model employing intraperitoneal administration of thioacetamide in Sprague-Dawley rats, diffusion weighted imaging revealed a progressive reduction in apparent diffusion coefficient in the brain stem. Diffusion tensor imaging further showed that the connectivity between nucleus tractus solitarii (NTS), the terminal site of baroreceptor afferents in brain stem and rostral ventrolateral medulla (RVLM), the origin of sympathetic innervation of blood vessels, was progressively disrupted until its disappearance, coincidental with the irreversible cessation of baroreflex-mediated sympathetic vasomotor tone signifying clinically the occurrence of brain death. In addition, superoxide, nitric oxide, peroxynitrite and ammonia levels in the NTS or RVLM were elevated, alongside swelling of astroctytes. A scavenger of peroxynitrite, but not an antioxidant, delivered intracisternally reversed all these events. We conclude that nitrosative stress because of augmented peroxynitrite related to accumulation of ammonia and swelling of astrocytes in the NTS or RVLM, leading to cytotoxic edema in the brain stem and severance of the NTS-RVLM connectivity, underpins the defunct baroreflex-mediated sympathetic vasomotor tone that accounts for the high mortality associated with HE.
On the feasibility of an embedded machine learning processor for intrusion detection

Intrusion detection and prevention systems serve a pivotal role in securing computer networks. Using machine learning for an intrusion detection system is important for stopping new attacks that do not have known signatures. Lowering the barrier to entry for microprocessor-based systems has enabled the use of specialized machine learning coprocessors to improve analysis performance. This paper proposes a machine learning approach on a small, low-powered embedded system that uses network-based features to distinguish between normal and abnormal network traffic. A hardware-based approach using a machine learning coprocessor is compared with a software-based approach. Machine learning processors can improve power consumption and processing speed especially when dealing with dig data sets. Results of the analysis show that the machine learning coprocessor obtains 66.67% classification accuracy. Additional results are presented and discussed.
Appositives and their aftermath: Interference depends on at-issue vs. not-at-issue status

Abstract Much research has explored the degree to which not-at-issue content is interpreted independently of at-issue content, or the main assertion of a sentence (AnderBois, Brasoveanu, & Henderson, 2011; Harris & Potts, 2009; Potts, 2005; Schlenker, 2010; Tonhauser, 2011; a.o.). Building on this work, psycholinguistic research has explored the hypothesis that not-at-issue content, such as appositive relative clauses, is treated distinctly from at-issue content in online processing (Dillon, Clifton, & Frazier, 2014; Syrett & Koev, 2015). In the present paper, we explore the way in which appositive relative clauses interact with their host sentences in the course of incremental sentence comprehension. In an offline acceptability judgment, we find that appositive relative clauses contribute significantly less processing difficulty when they intervene between a filler and its gap than do superficially similar restrictive relative clauses. Results from two eye-tracking-while-reading studies suggests that recently processed restrictive relative clauses interfere to a greater degree with processes of integrating the filler at its gap site than do appositive relative clauses. Our findings suggest that the degree of interference observed during sentence processing may depend on the discourse status of potentially interfering constituents. We propose that this arises because the syntactic form of not-at-issue content is rendered relatively unavailable once it has been processed.
Simultaneous versus sequential bilateral cochlear implants in adults: Cost analysis in a US setting.

Objectives/Hypothesis From a purely surgical efficiency point of view, simultaneous cochlear implantation (SimCI) is more cost-effective than sequential cochlear implantation (SeqCI) when total direct costs are considered (implant and hospital costs). However, in a setting where only SeqCI is practiced and a proportion of initially unilaterally implanted patients do not progress to a second implant, this may not be the case, especially when audiological costs are factored in. We present a cost analysis of such a scenario as would occur in our institution. Study Design Retrospective review and cost analysis. Methods Between 2005 and 2015, 370 patients fulfilled the audiological criteria for bilateral implantation. Of those, 267 (72.1%) underwent unilateral cochlear implantation only, 101 (27.3%) progressed to SeqCI, and two underwent SimCI. The total hospital, surgical, and implant costs, and initial implant stimulation series audiological costs between August 2015 and August 2016 (29 adult patients) were used in this analysis. Results The total hospital, surgical, and implant costs for this period was $2,731,360.42. Based on previous local trends, if a projected eight (27.3%) of these patients decide to progress to SeqCI, this will cost an additional $750,811.04, resulting in an overall total of $3,482,171.46 for these 29 patients. Had all 29 undergone SimCI, the total projected cost would have been $3,332,991.75, representing a total potential saving of $149,179.67 (4.3%). Conclusions In institutions where only SeqCI is allowed in adults, overall patient management may cost marginally more than if SimCI were practiced. This will be of interest to CI programs and health insurance companies. Level of Evidence 4. Laryngoscope, 127:2615–2618, 2017
Cognitive Compliance for Financial Regulations

Regulations are rules and directives published by authorities to safeguard consumer interest in an industry. Compliance with such regulations is getting increasingly hard due both to the complexity of these documents, which require experts to read, understand, and interpret them manually, and to the sheer volume of regulatory change. Many CFOs rate this as their top challenge. The authors’ Cogpliance platform uses a cognitive approach to achieve regulatory compliance. Here, they describe key compliance-related tasks and demonstrate how Cogpliance helps compliance officers to handle those tasks effectively.
Concise Total Synthesis of (−)-Affinisine Oxindole, (+)-Isoalstonisine, (+)-Alstofoline, (−)-Macrogentine, (+)-Na-Demethylalstonisine, (−)-Alstonoxine A, and (+)-Alstonisine

A highly enantio- and diastereoselective strategy to access any member of the sarpagine/macroline family of oxindole alkaloids via internal asymmetric induction was developed from readily available d-(+)-tryptophan. At the center of this approach was the diastereospecific generation of the spiro[pyrrolidine-3,3′-oxindole] moiety at an early stage via a tert-butyl hypochlorite-promoted oxidative rearrangement of a chiral tetrahydro-β-carboline derivative. This key branching point determined the spatial configuration at the C-7 spiro center to be entirely 7R or 7S. Other key stereospecific processes were the asymmetric Pictet–Spengler reaction and Dieckmann cyclization, which were scalable to the 600 and 150 gram levels, respectively. Execution of this approach resulted in first enantiospecific total synthesis of (+)-isoalstonisine and (−)-macrogentine from the chitosenine series (7R), as well as (+)-alstonisine, (+)-alstofoline, (−)-alstonoxine A and (+)-Na-demethylalstonisine from the alstonisine series (7S).
Food Sovereignty: Reality vs. Assumptions

First paragraph: In We Want Land to Live , author Amy Trauger endeavors to draw attention to food sover­eignty, its practices, and its political implications. Written during a time where the discussion of hunger and poverty in a global context is a top priority, We Want Land to Live presents a convinc­ing argument for understanding how food sover­eignty interacts with not only global political sys­tems but international economic and social systems as well....
Variability in negative emotions among individuals with chronic low back pain: relationships with pain and function

Chronic pain is associated with elevated negative emotions, and resources needed to adaptively regulate these emotions can be depleted during prolonged pain. Studies of links between pain, function, and negative emotions in people with chronic pain, however, have focused almost exclusively on relationships among mean levels of these factors. Indexes that may reflect aspects of emotion regulation have typically not been analyzed. We propose that 1 index of emotion regulation is variability in emotion over time as opposed to average emotion over time. The sample was 105 people with chronic low back pain and 105 of their pain-free spouses. They completed electronic diary measures 5x/d for 14 consecutive days, producing 70 observations per person from which we derived estimates of within-subject variance in negative emotions. Location-scale models were used to simultaneously model predictors of both mean level and variance in patient negative emotions over time. Patients reported significantly more variability in negative emotions compared to their spouses. Patients who reported higher average levels of pain, pain interference, and downtime reported significantly higher levels of variability in negative emotions. Spouse-observed pain and pain behaviors were also associated with greater variability in patients' negative emotions. Test of the inverse associations between negative emotion level and variability in pain and function were significant but weaker in magnitude. These findings support the notion that chronic pain may erode negative emotion regulation resources, to the potential detriment of intra- and inter-personal function.
Effect of wastewater quality parameters on coliform inactivation by tin oxide anodes.

The effect of six water quality constituents on wastewater effluent disinfection by tin oxide anodes (TOAs) was investigated in single cell laboratory reactors. Several concentrations of suspended solids, chemical oxygen demand (COD), alkalinity, ammonia-nitrogen, nitrite-nitrogen, and nitrate-nitrogen were added to media containing 106 total coliform bacteria mL-1. Current was applied through the TOAs, and coliform bacteria viability was analyzed over time. Over 99.9% inactivation of coliform bacteria was found over 15 min in TOA reactors. Concentrations of the six water quality constituents typical of concentrations found in wastewaters had no effect on TOA disinfection efficacy. The results of this research demonstrate that TOAs, which could potentially be powered by solar panels, have potential as a sustainable disinfection process compared to chlorine, ozone, and ultraviolet light.
Measuring and testing the agreement of matrices

The problem of comparing the agreement of two n × n matrices has a variety of applications in experimental psychology. A well-known index of agreement is based on the sum of the element-wise products of the matrices. Although less familiar to many researchers, measures of agreement based on within-row and/or within-column gradients can also be useful. We provide a suite of MATLAB programs for computing agreement indices and performing matrix permutation tests of those indices. Programs for computing exact p-values are available for small matrices, whereas resampling programs for approximate p-values are provided for larger matrices.
Social Activists: Lessons for Community Psychology

In a graduate class in community psychology, each student studied the lives and achievements of social activists. This article integrates the work and accomplishments of 5 social activists into a conceptual and methodological framework for social change within community psychology. These activists worked on issues including national liberation, women's suffrage, the rights of migrant workers, and community development. The methods used by these activists are particularly relevant to the field of community psychology. The article discusses the implications of the work and accomplishments of these social change agents.
Benign incidental CT findings and corresponding metabolic changes in FDG PET/CT: A pictorial essay

1014 Learning Objectives 1. To emphasize the importance of systematically review the CT portion of the PET/CT scan. 2. To understand the FDG metabolic changes corresponding to benign CT detected abnormalities. 3. To avoid false positive interpretation of such abnormalities. 4. To implement an innovative way to display radiographic images using a digital media frame. PET/CT provides invaluable metabolic and anatomical information about known or suspected malignancy which will lead to treatment planning and patient outcome. Our PET/CT protocol includes a low dose non contrast CT. However, a full diagnostic contrast CT is used in some institutions which provide more detailed images and help in the assessment of the anatomical structures. The review of the CT can lead to the detection of incidental anatomical alterations, which can present with or without metabolic abnormalities and should be properly characterized by the reading physician to avoid a false positive interpretation. We are presenting a large series of benign incidental CT findings with metabolic changes and MRI and diagnostic CT correlation involving the head and neck (e.g. Brain infarct, carotid aneurysm ± thrombus pituitary adenoma, thyroid cyst), thorax (e.g. hiatal hernia, breast lipoma, esophagitis, thoracic aneurysm, granuloma), abdomen (e.g. AAA ± thrombus, pancreatic/liver/renal cysts , exofitic renal tumors, gastritis, pancreatitis), pelvis (e.g. uterine fibroids, ovarian cysts, menstrual changes in the uterus), and musculoskeletal (e.g. bone island, bone infarction, active osteoarthropathy, septic joint effusion, postsurgical changes). These radiographic images will be presented in an innovative high quality dynamic digital media frame which will be included in the body of the poster and will provide us with the advantage of presenting a higher quality and higher number of images, rotating MIPs, correlated coronal and saggital MRI and diagnostic CT images
Efficacy of PD-1 and PD-L1 inhibitors in older adults: A meta-analysis.

e21544Background: Immune checkpoint inhibitors (ICIs) have a promising activity in variety of malignancies however little is known regarding their efficacy and toxicity profile in older adults (≥65...
Flu's cues: Exploiting host post-translational modifications to direct the influenza virus replication cycle.

Precise coordination of cellular processes requires prompt specification of protein function in response to various stimuli. This specification includes regulating protein abundance, localization, catalysis, and binding. Post-translational modifications (PTMs) provide cells the plasticity for dynamic and reversible control of protein function. Viral infections provide an exciting lens through which to study PTMs, since PTMs contribute to both cellular responses to infection and viral hijacking of the host. PTMs enhance the already multifunctional nature of viral proteins and offer another level of functional diversity within limited genetic space. Influenza virus protein functions are fine-tuned by diverse types of PTMs, including phosphorylation, ubiquitination, SUMOylation, neddylation, ISGylation, glycosylation, ADP-ribosylation, palmitoylation, and acetylation. All of the major viral proteins are subject to at least one type of PTM. Additionally, as influenza viruses encode no known protein-modifying enzymes, all of these PTMs are mediated by host machinery. Here, we use influenza virus and its proteins as exemplars for how PTMs impact virus replication (Fig 1). Open in a separate window Fig 1 Post-translation control of key steps during the influenza virus replication cycle. Simplified diagram of key steps during the influenza virus life cycle highlighting events that are regulated by PTMs to viral or host proteins. The specific modifications, target proteins, and references are listed for each step. Two processes are highlighted in depth; these examples were chosen because the PTMs and causative host enzymes are known and the modifications have discrete effects on replication. In addition, a large number of PTMs have been identified on viral proteins, but no discrete function has yet been assigned [14]. Ac, acetylation; ADPr, ADP-ribosylation; cRNA, plus-sense genomic RNA; dsRNA, double-stranded RNA; Glycos., N-linked glycosylation; ISG15, ISGylation; Nedd8, neddylation; NP, nucleoprotein; NS1, nonstructural protein 1; PO4, phosphorylation; PTM, post-translational modification; RNP, ribonucleoprotein complex; SA, sialic acid; SUMO, SUMOylation; Ub, ubiquitin and ubiquitination; vRNA, minus-sense genomic RNA.
Tall Cell Variant of Papillary Thyroid Carcinoma: Impact of Change in WHO Definition and Molecular Analysis

The morphologic criteria for tall cell variant (TCV) of papillary thyroid carcinoma (PTC) were modified in the 2017 WHO Classification of Tumors of Endocrine Organs, with a decrease in the requirements for both the height of cells and in the percentage of tumor demonstrating a tall cell morphology. The aim of this study was to determine if the change in criteria would result in a significant increase in the percentage of tumors that meet criteria for TCV. In addition, we evaluated the correlation between morphology, molecular alterations, and clinical behavior of TCV. We studied three cohorts to evaluate the above stated questions. The first cohort was comprised of 97 PTC consecutively resected over a 12-month period that were originally diagnosed as classic PTC, PTC with tall cell features, or TCV. Tumor slides of each case were reviewed to determine the percentage of the tall cell component ( 50%) and the height of the cells in this component. This cohort was evaluated to determine if the change in WHO criteria would result in a significant increase in the percentage of tumors that meet criteria for TCV. Our second cohort consisted of nine consecutively resected PTC with a tall cell component > 30% (with tall cells defined as at least 2–3× as tall as wide) that had molecular characterization through a targeted, next-generation sequencing (NGS) assay. The molecular characteristics were correlated with the percentage of the tall cell component. Finally, a third cohort comprised of seven clinically aggressive TCV (defined as those with T4 disease, disease recurrence, or subsequent tumor dedifferentiation) was evaluated to determine histologic and molecular characteristics. In cohort 1, the number of cases classified as TCV increased significantly with the change in definition of TCV: 8 (8%) cases met the previous criteria for TCV (cells 3× as tall as wide in > 50% of the tumor), whereas 24 (25%) cases met the new 2017 WHO criteria (cells 2–3× as tall as wide in > 30% of the tumor) (p = 0.0020). Molecular analysis of cohort 2 revealed that all 9 cases harbored a BRAF V600E mutation. Pathogenic secondary mutations were absent in cases with 50% tall cells (2 cases with TERT promoter mutations, including 1 that also had an AKT2 mutation). Histologic and molecular analysis of the clinically aggressive cohort (cohort 3), revealed that all cases had > 50% tall cells and 3 (43%) had secondary oncogenic mutations (all TERT promoter mutations). We found that the modified morphologic criteria put forth in the 2017 WHO tripled the number of cases that would be classified as TCV. Moreover, clinically aggressive tumors and those harboring secondary oncogenic mutations all had a tall cell component > 50%. Additional large multi-institutional studies incorporating clinical outcome and molecular data would be valuable to determine the best histologic definition of TCV.
A feasibility study using a touchscreen tool in the AYA population.

9575 Background: Adolescent and young adults (AYA) 15 to 39 years present unique health care needs; however, barriers to communication of treatment-related and psychosocial difficulties exist. We h...
The UN Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs)

Almost like the United Nations Sustainable Development Goals (SDGs), it was envisaged that the United Nations Millennium Development Goals (MDGs) would lead to commitment by governments and actors to increase their efforts towards improving public health. When one reviews the MDGs, it is notable that some of the goals were directly related to health while the others were lateral but had a great influence on health. As such, it is important that the MDGs should not be viewed in isolation because they were interlinked in some way, and therefore successful implementation would have required concerted effort from a multi-sectoral perspective. It is worth highlighting that due to a number of factors, there were variations across countries/regions in their success in meeting the targets of the MDGs. While it was good that the MDGs created impetus for commitment towards improving public health, blanket targets for the MDGs as well as vertical programmes aimed at achieving the MDGs were not helpful because they ignored the unique underlying challenges of each setting and issues of sustainability and ownership. The MDGs were not an end in themselves, as the work continues in the new developmental era of the Sustainable Development Goals (SDGs).
THE PREPARATION AND DETERMINATION OF STRUCTURE OF BENZYLPENICILLOYL COMPOUNDS USED IN SKIN-TESTING FOR PENICILLIN ALLERGY

The preparation of α-D-benzylpenicilloyl-n-propylamine and octa-e-(α-D-benzylpenicilloyl)-octa-α-L-lysine are described. Their structures were established by chemical and spectroscopic evidence. Proton and carbon-13 nuclear magnetic resonance spectra of these two penicillin derivatives and some related compounds are provided. These compounds are useful in skin testing for penicillin allergy.
Functional Luminal Imaging Probe Panometry Identifies Achalasia-Type Esophagogastric Junction Outflow Obstruction.

Background & Aims The etiologies of esophagogastric junction outflow obstruction (EGJOO) vary, as do their therapeutic implications. We aimed to identify patients with EGJOO most likely to benefit from achalasia-type treatment, based on findings from functional luminal imaging probe (FLIP) panometry. Methods We performed a retrospective study of 34 patients who received a diagnosis of EGJOO from January 2015 through July 2017. Our analysis included patients who had been evaluated with timed barium esophagram, FLIP, or upper endoscopy. Results Among the 34 patients with idiopathic EGJOO, 7 (21%) had a normal esophagogastric junction distensibility index (EGJ-DI), based on FLIP panometry, and all had repetitive antegrade contractions. None of the patients had radiographic evidence of EGJOO (RAD-EGJOO), defined as liquid barium retention and/or barium tablet impaction. On the other hand, all 18 patients with RAD-EGJOO had an EGJ-DI less than 2 mm2/mm Hg. Nine of the 18 patients with RAD-EGJOO and EGJ-DI less than 2 mm2/mm Hg underwent achalasia-type treatment, and 77.8% of these (7 of 9) had improvements in Eckardt score. Of the 6 patients with a normal EGJ-DI (>3 mm2/mm Hg) who were treated conservatively and followed up, 100% had improvements in subsequent Eckardt scores. Conclusions We found that FLIP is useful in identifying patients with EGJOO who are most likely to benefit from achalasia-type therapy. Patients with a low EGJ-DI responded well to achalasia-type treatment, whereas patients with normal results from FLIP panometry had good outcomes from conservative management. FLIP panometry might help select management strategies for this difficult population of patients.
Diffusion Magnetic Resonance Imaging Phenotypes Predict Overall Survival Benefit From Bevacizumab or Surgery in Recurrent Glioblastoma With Large Tumor Burden

BACKGROUND Diffusion magnetic resonance (MR) characteristics are a predictive imaging biomarker for survival benefit in recurrent glioblastoma treated with anti-vascular endothelial growth factor (VEGF) therapy; however, its use in large volume recurrence has not been evaluated. OBJECTIVE To determine if diffusion MR characteristics can predict survival outcomes in patients with large volume recurrent glioblastoma treated with bevacizumab or repeat resection. METHODS A total of 32 patients with large volume (>20 cc or > 3.4 cm diameter) recurrent glioblastoma treated with bevacizumab and 35 patients treated with repeat surgery were included. Pretreatment tumor volume and apparent diffusion coefficient (ADC) histogram analysis were used to phenotype patients as having high (>1.24 μm2/ms) or low (<1.24 μm2/ms) ADCL, the mean value of the lower peak in a double Gaussian model of the ADC histogram within the contrast enhancing tumor. RESULTS In bevacizumab and surgical cohorts, volume was correlated with overall survival (Bevacizumab: P = .009, HR = 1.02; Surgical: P = .006, HR = 0.96). ADCL was an independent predictor of survival in the bevacizumab cohort (P = .049, HR = 0.44), but not the surgical cohort (P = .273, HR = 0.67). There was a survival advantage of surgery over bevacizumab in patients with low ADCL (P = .036, HR = 0.43) but not in patients with high ADCL (P = .284, HR = 0.69). CONCLUSION Pretreatment diffusion MR imaging is an independent predictive biomarker for overall survival in recurrent glioblastoma with a large tumor burden. Large tumors with low ADCL have a survival benefit when treated with surgical resection, whereas large tumors with high ADCL may be best managed with bevacizumab.
Simulation and measurement of image charge detection with printed-circuit-board detector and differential amplifier.

We present a novel and thorough simulation technique to understand image charge generated from charged particles on a printed-circuit-board detector. We also describe a custom differential amplifier to exploit the near-differential input to improve the signal-to-noise-ratio of the measured image charge. The simulation technique analyzes how different parameters such as the position, velocity, and charge magnitude of a particle affect the image charge and the amplifier output. It also enables the designer to directly import signals into circuit simulation software to analyze the full signal conversion process from the image charge to the amplifier output. A novel measurement setup using a Venturi vacuum system injects single charged particles (with diameters in the 100 s of microns range) through a PCB detector containing patterned electrodes to verify our simulation technique and amplifier performance. The measured differential amplifier presented here exhibits a gain of 7.96 µV/e− and a single-pass noise floor of 1030 e−, which is about 13× lower than that of the referenced commercial amplifier. The amplifier also has the capability to reach a single-pass noise floor lower than 140 e−, which has been shown in Cadence simulation.
A Simulation Study on Minimizing Threshold Voltage Variability by Optimizing Oxygen Vacancy Concentration Under Metal Gate Granularity

In this work, we discuss the mitigation of threshold voltage ( ${V}_{{TH}}$ ) variability in nanoscale FinFET by exploiting the interaction of oxygen vacancies (OV) against metal gate granularity (MGG). Deposition of a metal gate on high- $\kappa $ dielectric HfO2 is known to generate OV in the dielectric which induces variability in surface potential. A higher workfunction of metal grain increases the probability of OV formation. Interestingly, while a higher workfunction metal grain decreases the surface potential of the channel underneath, the positive charge of OV increases the potential. Therefore, the concentration of OV can be controlled to negate the surface potential variability induced by MGG. We discuss the law of mass action-based concentration models of OV under MGG to analyze this. We also present TCAD simulations supporting the above hypothesis. In our simulations, for 10-nm channel FinFET, MGG-induced $\sigma $ ( ${V}_{{TH}}$ ) can be reduced to ~20 mV from ~35 mV for four-sided planar grains with 8 nm average edge length under the optimal OV concentration.
A comparison of dopaminergic and cholinergic populations reveals unique contributions of VTA dopamine neurons to short-term memory

Abstract We systematically compared the contribution of two dopaminergic and two cholinergic ascending populations to a spatial short-term memory task in rats. In ventral tegmental area dopamine (VTA-DA) and nucleus basalis cholinergic (NB-ChAT) populations, trial-by-trial fluctuations in activity during the delay period related to performance with an inverted-U, despite the fact that both populations had low activity during that time. Transient manipulations revealed that only VTA-DA neurons, and not the other three populations we examined, contributed causally and selectively to short-term memory. This contribution was most significant during the delay period, when both increases or decreases in VTA-DA activity impaired short-term memory. Our results reveal a surprising dissociation between when VTA-DA neurons are most active and when they have the biggest causal contribution to short-term memory, while also providing new types of support for classic ideas about an inverted-U relationship between neuromodulation and cognition.
The Status of Nutritional Management Guidelines for Head and Neck Cancer Patients.

Introduction Head and neck cancer (HNC) is the seventh leading cause of cancer worldwide. Approximately 35%-60% patients with HNC are malnourished from the disease onset, malnutrition being associated with worsened health outcomes among these patients. This study aimed to review and synthesize existing guidelines regarding nutritional interventions in HNC patients and assess providers' knowledge, opinions, and practice of guidelines for the nutritional management of HNC patients. Methods This is a multimethod study that includes a systematic review of guidelines for nutritional intervention in HNC patients and a providers' survey regarding their knowledge and opinions regarding nutrition therapy guidelines for HNC patients. Results Our review yielded seven guidelines. Of the seven guidelines reviewed, all were specific to cancer patients, however, only three were specific for HNC patients. Three of the guidelines recommended using a nutritional screening tool, however, only two mentioned a specific screening tool. Out of 193 surveys included in our analysis, the highest percentage of respondents were physicians (52.4%), followed by registered nurses (33.5%). The majority of respondent (77.5%) worked in a hospital-based practice, while 18.8% worked in clinic-based practice. A large proportion (46.6%) of respondents were not aware of nutritional guidelines for HNC patients; with 23.6% not aware of any, and 23.0% aware of their existence but not aware of their content. The majority (81.5%) of respondents said that a more detailed guideline should be available for HNC patient with regards to nutrition. Conclusion Nutritional deficiencies in HNC patients continue to cause significant complications in treatment and recovery. Existing practice guidelines are limited and lack specific recommendations. A universal standard of care with regard to addressing nutrition in HNC patients is needed to improve healthcare outcomes among NHC patients.
Arginine to ornithine ratio as a diagnostic marker in patients with positive newborn screening for hyperargininemia.

Abstract Arginase deficiency is a rare inborn error of metabolism that interrupts the final step of the urea cycle. Untreated individuals often present with episodic hyperammonemia, developmental delay, cognitive impairment, and spasticity in early childhood. The newborn screening (NBS) algorithms for arginase deficiency vary between individual states in the US but often include hyperargininemia and elevated arginine to ornithine (Arg/Orn) ratio. Here, we report 14 arginase deficiency cases, including two patients with positive NBS for hyperargininemia in whom the diagnosis of arginase deficiency was delayed owing to normal or near normal plasma arginine levels on follow-up testing. To improve the detection capability for arginase deficiency, we evaluated plasma Arg/Orn ratio as a secondary diagnostic marker in positive NBS cases for hyperargininemia. We found that plasma Arg/Orn ratio combined with plasma arginine was a better marker than plasma arginine alone to differentiate patients with arginase deficiency from unaffected newborns. In fact, elevated plasma arginine in combination with an Arg/Orn ratio of ≥1.4 identified all 14 arginase deficiency cases. In addition, we examined the impact of age on plasma arginine and ornithine levels. Plasma arginine increased 0.94 μmol/L/day while ornithine was essentially unchanged in the first 31 days of life, which resulted in a similar increasing trend for the Arg/Orn ratio (0.01/day). This study demonstrated that plasma Arg/Orn ratio as a secondary diagnostic marker improved the detection capability for arginase deficiency in newborns with hyperargininemia, which will allow timely detection of arginase deficiency and hence initiation of treatment before developing symptoms.
Vertically aligned two-dimensional materials-based thick electrodes for scalable energy storage systems

Together with the blooming of portable smart devices and electric vehicles in the last decade, electrochemical energy storage (EES) devices capable of high-energy and high-power storage are urgently needed. Two-dimensional (2D) materials, benefiting from the short solid-state diffusion distance, are well recognized to possess excellent electrochemical performance. However, liquid diffusion, the rate-determining process in thick electrodes, is notably slow in 2D materials-based electrodes stemming from their stacking during electrode processing, which considerably limits their applications for high energy storage. To fully exploit intrinsic advantages of 2D materials for scalable energy storage devices, this review summarizes several important strategies, ranging from assembly to template methods, to fabricate vertically aligned 2D materials-based electrodes. We further discuss the advantages and challenges of these methods in terms of key features of thick electrodes and illustrate the design principles for high-energy/power devices.
Effects of dietary tallow containing trace amounts of ractopamine on beef cattle performance and tissue residue levels and the effect of withdrawal time on ractopamine residues in the gastrointestinal-tract digesta

ABSTRACT Objective The objectives of these experiments were to evaluate (1) if inclusion of inedible tallow containing ractopamine (RAC) in the cattle diet influences feedlot performance, carcass characteristics, and results in detectable RAC in tissues and (2) the effect of withdrawal time on RAC residues in the gastrointestinal-tract digesta of cattle. Materials and Methods In Exp. 1, beef steers (n = 28) were assigned to dietary treatments formulated with feed tallow ranging from 100% inedible tallow to 100% technical tallow. After 91 d, steers were transported to a commercial abattoir and slaughtered, and tissues were collected for RAC analysis. In Exp. 2, steers fitted with ruminal and duodenal cannulas were assigned to the control group (no RAC) or a group in which RAC was supplemented at 400 mg of RAC∙animal−1∙d−1 for 28 d. On d 29, RAC supplementation was withdrawn. Daily ruminal, duodenal, and fecal samples were obtained for RAC analysis beginning 3 d before RAC withdrawal and continuing to d 13 after withdrawal. Results and Discussion No treatment effects of dietary inedible tallow inclusion was observed for final BW (P Implications and Applications The results indicate that RAC residue in feed tallow does not affect animal performance or carcass characteristics. Detectable RAC in sampled tissues and gastrointestinal digesta suggests a need for further investigation of RAC residues to maintain compliance for exported beef products.
Human inducible pluripotent stem cells: Realization of initial promise in drug discovery.

Over the course of the last decade, the biopharmaceutical industry has slowly adopted human inducible pluripotent stem cell (hiPSC) technology to enable the development of humanized model systems to test new therapeutic molecules and drug modalities. The adoption of hiPSC-based models by the industry has increased appreciably in the past 3–5 years. This increase has paralleled the explosion in availability of high-quality human genetic data to mine for new drug targets and the emergence of human-specific therapeutic modalities.
Humility will get you further than ego or pride in your career as a surgeon

Surgeons exhibit disproportionately higher levels of arrogance, narcissism, and social apathy relative to other healthcare providers. Pride, when cut loose, handicaps the individual from relating and empathizing with others and blinds him/her from their flaws and shortcomings, and deceptively leading to their inevitable downfall. An untamed ego dwells on pride and has the potential for serious damage to the person who harbors it and others. An untamed ego reinforces a fixed mindset, which is grounded on talent, within the individual rather than a growth mindset, which is grounded on practice.
Asymmetric Subsidies and the Bail Crisis

When individuals are arrested or indicted for a crime, governments have legitimate interests in assuring that those individuals show up for future legal proceedings and also do not cause more social harm in the meanwhile. To serve those legitimate interests, governments may restrain the personal liberty of those presumptively innocent individuals—traditionally accomplished either by incarceration or by release subject to certain sureties and conditions. The choice, in short, is between jail and bail. Currently, governments skew that choice by subsidizing the costs of jail but not bail. The result—wholly predictable given the size and asymmetric nature of the subsidy—is that the United States maintains an inefficiently large jail population that both costs taxpayers too much and excessively limits the liberty of too many. Prior commentators and reformers have correctly identified the overuse of pretrial detention in jails as a major public policy crisis and have urged substantial reforms to current bail processes up to and including the abolition of state constitutional rights to bail (as one state has recently done). We believe that the hostility toward bail overlooks the root cause of the problem, which is the asymmetric subsidization of jail over bail. We propose a balanced subsidization system that can preserve the beneficial aspects of a traditional bail surety system while (i) reducing unnecessary and inefficient restraints on individual liberty, (ii) addressing the distributional inequities of current practices, and (iii) saving taxpayers billions of dollars per year.
Distal instrumented level selection in adult deformity surgery

Abstract Adult spinal deformity surgery has many aspects that need to be considered prior to and during surgery for the best long-term outcome. Determining where to place the lower instrumented level in the fusion construct can be a difficult decision. There are multiple factors that need to be taken into account including the individual patient's anatomy, the mechanical concept of a fusion mass, surgical techniques, and junctional levels particularly the L5-S1 level when determining where to end a fusion. Understanding these concepts will decrease the risk of complications at this level post-operatively.