cssi/SciSciGPT-SciSciNet huggingface dataset:
Randomized comparison of exercise haemodynamics of Freestyle, Magna Ease and Trifecta bioprostheses after aortic valve replacement for severe aortic stenosis.

Objectives The purpose of this study was to compare haemodynamics at rest and during exercise after clinically indicated aortic valve replacement (AVR) for aortic stenosis among patients randomly assigned to one of three haemodynamically excellent bioprostheses. Methods In a single-centre, prospective trial, 60 patients undergoing clinically indicated AVR were randomly assigned to Freestyle, Magna Ease or Trifecta bioprostheses. Six months after surgery, patients underwent supine bicycle stress echocardiography for the assessment of aortic valve haemodynamics. Results There were 5 protocol deviations from random valve assignments, and 4 patients did not return for follow-up stress echo, yielding a study group of 56 patients {17 Freestyle, 21 Magna Ease, 18 Trifecta; median age 70 [interquartile range (IQR) 63-78 years], 37 (66%) men}. There were no statistically significant differences between groups in valve size, concomitant procedures or exercise variables. Resting haemodynamics revealed significant differences between groups in mean gradient [Freestyle 7 (IQR 5-9) mmHg, Magna Ease 9 (IQR 7-11) mmHg, Trifecta 5 (IQR 4-8) mmHg; P = 0.04], effective orifice area (EOA) [2.5 (IQR 2.2-2.7), 2.1 (IQR 1.7-2.3) and 2.6 (IQR 2.3-2.8), respectively; P = 0.02] and EOA index [1.22 (IQR 1.11-1.32), 1.02 (IQR 0.89-1.14) and 1.31 (IQR 1.00-1.42), respectively; P = 0.03]; in each case, Trifecta had better haemodynamics compared with Magna Ease. With exercise, significant differences between groups were evident in peak velocity at 50 watts and peak exercise; mean gradient at 25 watts, 50 watts and maximal exercise; and EOA at 25 watts and at peak exercise; all with haemodynamic superiority of Trifecta compared with Magna Ease. There were no statistically significant differences between Trifecta and Freestyle haemodynamics at rest or with exercise. Conclusions In a prospective, randomized study comparing haemodynamics after Freestyle, Magna Ease and Trifecta, all three valves exhibited good haemodynamics at rest and with exercise. There were small but significant differences between groups, with favourable haemodynamics associated with Trifecta compared to Magna Ease, and no significant differences between Trifecta and Freestyle. The Trifecta valve appears to offer haemodynamics similar to a stentless valve without the technical complexity of stentless valve implantation. Clinicaltrialsgov identifier NCT01635244.
Heritable Disorders of Hair

Changes in the quality and quantity of hair occur in a large number of hereditary syndromes. Because of their rarity and our lack of knowledge about their pathophysiology, no entirely satisfactory classification of these hair disorders exists. This review arbitrarily groups the heritable disorders of the hair into five classes: primary hair shaft disorders, alopecia without associated defects, ectodermal dysplasias, changes in hair color, and ectopic hair.
Acyanotic Lesions with Increased Pulmonary Blood Flow

Diagnosis and management of the more common defects such as atrial septal defect, ventricular septal defect, endocardial cushion defect, and patent ductus arteriosus are elucidated.
Teaching Macroeconomics with Microsoft Excel

Humberto Barreto gives professors a simple way to teach fundamental concepts for any undergraduate macroeconomics course using Microsoft Excel® with Excel workbooks and add-ins and videos freely available on his university website. The Excel files are designed to be used by students with any textbook, and have been used many times by the author in his own teaching. Each Excel workbook contains links to short screencasts, around five to ten minutes, that show the cursor and typing as the file is manipulated with narration that walks the student through the steps needed to complete a task. The book shows professors a simple way to present macroeconomic models and incorporate data into their courses.
Birth to Three: Early Intervention

The formal system of supports for infants and toddlers with disabilities and their families is early intervention under Part C of IDEA. The major activities undertaken in early intervention are home visits, family-centered practices, coaching, responsive teaching, routine-based interventions, service coordination, and transition to preschool. Challenges remaining to be solved are using models for the effective delivery of services, using technology, providing training and supervision, and offering specialized, inclusive classroom options.
S-Nitrosoglutathione ameliorates acute renal dysfunction in a rat model of lipopolysaccharide-induced sepsis.

Objective Sepsis induces an inflammatory response that results in acute renal failure (ARF). The current study is to evaluate the role of S-Nitrosoglutathione (GSNO) in renoprotection from lipopolysaccharide (LPS)-induced sepsis. Methods Rats were divided to three groups. First group received LPS (5 mg/kg body weight), second group was treated with LPS + GSNO (50 μg/kg body weight), and third group was administered with vehicle (saline). They were sacrificed on day 1 and 3 post-LPS injection. Serum levels of nitric oxide (NO), creatinine and blood urea nitrogen (BUN) were analysed. Tissue morphology, T lymphocyte infiltrations, and the expression of inflammatory (TNF-α, iNOS) and anti-inflammatory (IL-10) mediators as well as glutathione (GSH) levels were determined. Key finding Lipopolysaccharide significantly decreased body weight and increased cellular T lymphocyte infiltration, caspase-3 and iNOS and decreased PPAR-γ in renal tissue. NO, creatinine and BUN were significantly elevated after LPS challenge, and they significantly decreased after GSNO treatment. TNF-α level was found significantly increased in LPS-treated serum and kidney. GSNO treatment of LPS-challenged rats decreased caspase-3, iNOS, TNF-α, T lymphocyte infiltration and remarkably increased levels of IL-10, PPAR-γ and GSH. Conclusion GSNO can be used as a renoprotective agent for the treatment of sepsis-induced acute kidney injury.
Tissue Type-Specific Bioenergetic Abnormalities in Adults with Major Depression

Brain bioenergetic abnormalities have been observed frequently in adults with major depressive disorder (MDD); however, results have been inconsistent regarding whether decreased or increased metabolism was observed. Phosphorus-31 magnetic resonance spectroscopy (31P MRS) allows for the quantification of bioenergetic molecules, containing high-energy phosphates, over the whole brain as well as measuring the differences between gray matter and white matter. We recruited 50 subjects with a current diagnosis of MDD, not currently treated with psychotropic medication, between ages of 18 and 65 (mean±SD age: 43.4±13.6; 46% female) and 30 healthy volunteers, matched for age and gender (39.0±12.5 years of age; 36.6% female). All subjects received a T1 MP-FLASH scan for tissue segmentation followed by 31P MRS, chemical shift imaging scan with 84 voxels of data collected over the entire brain utilizing a dual-tuned, proton-phosphorus coil to minimize subject movement. Phosphocreatine and inorganic phosphate (Pi) varied in opposite directions across gray matter and white matter when MDD subjects were compared with controls. This finding suggests alterations in high-energy phosphate metabolism and regulation of oxidative phosphorylation in MDD patients. In addition, within the MDD group, gray matter Pi, a regulator of oxidative phosphorylation, correlated positively with severity of depression. These data support a model that includes changes in brain bioenergetic function in subjects with major depression.
IDC reengineering Phase 2 & 3 US industry standard cost estimate summary

Sandia National Laboratories has prepared a ROM cost estimate for budgetary planning for the IDC Reengineering Phase 2 & 3 effort, using a commercial software cost estimation tool calibrated to US industry performance parameters. This is not a cost estimate for Sandia to perform the project. This report provides the ROM cost estimate and describes the methodology, assumptions, and cost model details used to create the ROM cost estimate. ROM Cost Estimate Disclaimer Contained herein is a Rough Order of Magnitude (ROM) cost estimate that has been provided to enable initial planning for this proposed project. This ROM cost estimate is submitted to facilitate informal discussions in relation to this project and is NOT intended to commit Sandia National Laboratories (Sandia) or its resources. Furthermore, as a Federally Funded Research and Development Center (FFRDC), Sandia must be compliant with the Anti-Deficiency Act and operate on a full-cost recovery basis. Therefore, while Sandia, in conjunction with the Sponsor, will use best judgment to execute work and to address the highest risks and most important issues in order to effectively manage within cost constraints, this ROM estimate and any subsequent approved cost estimates are on a 'full-cost recovery' basis. Thus, work can more » neither commence nor continue unless adequate funding has been accepted and certified by DOE. « less
Oncogenic Nras Grants Apoptosis Resistance to Hematopoietic Stem Cells

Abstract Genetic lesions hijack the regulatory programs of hematopoietic stem cells and progenitors (HSC/P) to transform them into leukemic stem cells (LSC). These initiating mutations confer a competitive advantage to promote clonal expansion of pre-leukemic stem cells (pre-LSC). Pre-LSCs are believed to serve as a reservoir for leukemia relapses and a cure for leukemia likely depends on the eliminating of pre-LSCs. Better understanding of how mutations dysregulate HSCs to transform them into pre-LSCs will identify new therapeutic targets to eliminate pre-LSCs. Activating RAS mutations are highly prevalent in hematopoietic malignancies. We have previously shown that a single allele of oncogenic NrasG12D promotes clonal expansion in hematopoietic stem cells (HSCs) through increased proliferation and self-renewal, but the role apoptosis plays in the clonal dominance of NrasG12D HSCs remains unclear. Here we report that oncogenic NRasG12D protects HSCs from cellular stress. Upon cytokine starvation and γ-irradiation, HSCs fromMx1-cre; LSL-NrasG12D/+ mice display reduced apoptosis as measured by Annexin V staining and Caspase 3/7 activation. This NRasG12D-mediated HSC survival is not dependent on autophagy since Bafilomycin A, an inhibitor previously shown to inhibit autophagy in HSCs, did not rescue the phenotype. Moreover, NrasG12D HSCs exhibits decreased levels of cellular reactive oxygen species (ROS), and restoration of ROS levels with buthionine sulfoximine significantly blocked the survival of NrasG12D HSCs. We next sought to identify the signaling activated by NRasG12D to promote HSC survival. Although our previous studies show that STAT5 is required for NRasG12D-mediated HSC proliferation, STAT5 is dispensable for NRasG12D-mediated HSC survival. We then determined whether inhibition of the canonical Ras effector pathways blocks NRasG12D-mediated HSC survival. To our surprise, inhibition of PI3K/AKT, MEK/ERK, or mTOR signaling did not abrogate the pro-survival effect of NRasG12D in HSCs. However, inhibition of protein kinase C (PKC) with two structurally independent inhibitors rescued the pro-survival phenotype of NrasG12D/+ HSCs. PKC inhibition also led to increased ROS levels in NrasG12D mutant HSCs, suggesting that NRasG12D reduces ROS and protects HSCs from stress through activation of PKC signaling. Taken together, we discover that in addition to increasing HSC proliferation, oncogenic NRasG12D promotes HSC survival under stress conditions. Furthermore, we reveal a pathway NRasG12D relies on to evade apoptosis and manage reactive oxygen species in HSCs independent of the STAT5 signaling that governs cell proliferation. Targeting PKC signaling, alone or in combination with STAT5 signaling, may have therapeutic benefit in eliminating pre-LSCs. Disclosures No relevant conflicts of interest to declare.
The Sequential Co-Construction of the Joint Problem Space

Theories of collaborative learning have identified the central role of the joint problem space in coordinating work and establishing intersubjective understanding. The concept of problem space had its inception within the information-processing perspective as a characterization of individual problem-solving activity. It was then reformulated and extended within the learning sciences. Based on a detailed analysis of sustained online collaborative problem-solving activity by a small group of students over multiple sessions, we propose that the theory of the joint problem space should now be further expanded. In addition to the dimensions of social relations and domain content, which are increasingly recognized in the learning sciences, we argue for the salience of the temporal dimension. Our analysis shows that the joint problem space is co-constructed at the group unit of analysis through the temporal and sequential orientation to inter-subjective meaning making.
An Introduction to Ethics: Framing and Key Themes in Business Ethics

This technical note provides an introduction into some of the key concepts of ethics relevant to thinking about business.
Second-line treatment in patients with pancreatic ductal adenocarcinoma: A meta-analysis.

BACKGROUND There are limited therapeutic options for treatment-refractory pancreatic ductal adenocarcinoma (PDAC), with a paucity of data to support the best option after progression on gemcitabine-based regimens. The authors performed a meta-analysis to determine the effectiveness of adding oxaliplatin (OX) or various irinotecan formulations to a fluoropyrimidine (FP) after first-line treatment progression in patients with PDAC. METHODS Different databases, including PubMed, EMBASE, and Cochrane, were searched to identify randomized controlled trials comparing FP monotherapy versus FP combination therapy that included either oxaliplatin (FPOX) or various irinotecan formulations (FPIRI) in patients with PDAC who progressed after first-line treatment. Secondary analyses were planned to assess the effectiveness of FPOX and FPIRI compared with FP. Outcomes of interest included overall survival (OS) and progression-free survival (PFS). RESULTS Five studies with 895 patients were identified. Patients randomized to receive FPIRI/FPOX had a significantly improved PFS and a trend toward improved OS compared with those who received FP monotherapy. When comparing FPIRI with FP, there was an improvement in both PFS (hazard ratio, 0.64; 95% confidence interval, 0.47-0.87; P = .005) and OS (hazard ratio, 0.70; 95% confidence interval, 0.55-0.89; P = .004) in patients who received the combination. Conversely, FPOX produced only a modest improvement in PFS with no improvement in OS. CONCLUSIONS Combination chemotherapy with OX or various IRI formulations appears to improve PFS compared with single-agent FP. FPIRI, but not FPOX, appears to confer an OS advantage. The combination of FP with irinotecan formulations appears to be the appropriate next line of treatment upon progression after gemcitabine-based chemotherapy regimens. Cancer 2017. © 2017 American Cancer Society.
Histoire de l’endoscopie pédiatrique Débuts et perspectives d’avenir

Plus de vingt ans se sont ecoules depuis les premieres endoscopies digestives en pediatrie. Les ameliorations techniques des instruments ont grandement influence l’endoscopie pediatrique. Une etude critique des modeles existants ainsi que des principes de perfectionnements futurs sont exposes. Le rendement diagnostique et therapeutique de l’endoscopie est etudie en fonction d’elements de base concernant l’examen endoscopique. La formation du gastroenterologue pediatre est abordee. Enfin, des alternatives a l’endoscopie (moins invasives) ainsi que les perspectives des futurs developpements de cette technique sont analyses.
Simultaneous Multicolor Single-Molecule Tracking with Single-Laser Excitation via Spectral Imaging

Abstract Single-molecule tracking (SMT) offers rich information on the dynamics of underlying biological processes, but multicolor SMT has been challenging due to spectral cross talk and a need for multiple laser excitations. Here, we describe a single-molecule spectral imaging approach for live-cell tracking of multiple fluorescent species at once using a single-laser excitation. Fluorescence signals from all the molecules in the field of view are collected using a single objective and split between positional and spectral channels. Images of the same molecule in the two channels are then combined to determine both the location and the identity of the molecule. The single-objective configuration of our approach allows for flexible sample geometry and the use of a live-cell incubation chamber required for live-cell SMT. Despite a lower photon yield, we achieve excellent spatial (20–40 nm) and spectral (10–15 nm) resolutions comparable to those obtained with dual-objective, spectrally resolved Stochastic Optical Reconstruction Microscopy. Furthermore, motions of the fluorescent molecules did not cause loss of spectral resolution owing to the dual-channel spectral calibration. We demonstrate SMT in three (and potentially more) colors using spectrally proximal fluorophores and single-laser excitation, and show that trajectories of each species can be reliably extracted with minimal cross talk.
Introduction to Part Four

Drilling is one of the most fundamental and widely used of machining operations. A single-engine fighter aircraft or a missile could need as many as a quarter of a million holes drilled. Yet drilling, for lack of understanding of the operation, is an art rather than a science. Consequently, drilling costs could be unnecessarily high without being noticed.
Counseling Patients with Chronic Lung Disease: Interdisciplinary Strategies for Reducing Distress

Patients with chronic lung disease (CLD) experience a progressively debilitating loss of lung function over time. The symptom of breathlessness is commonly cited as the most distressing aspect of living with CLD, whether due to emphysema, asthma, interstitial lung disease, or cystic fibrosis. Current therapies, both allopathic and alternative, target relief of symptoms, but do not reverse loss of lung function. As a result, anxiety and depression are prevalent among patients with CLD. Counseling patients on how to live with their disease and maximize functionality is a critical but often overlooked aspect of patient care. This chapter focuses on the approach to counseling patients with CLD, addressing five pillars of optimum functioning.
Hard-Core Predicates for a Diffie-Hellman Problem over Finite Fields

A long-standing open problem in cryptography is proving the existence of (deterministic) hard-core predicates for the Diffie-Hellman problem defined over finite fields. In this paper, we make progress on this problem by defining a very natural variation of the Diffie-Hellman problem over \(\mathbb{F}_{p^2}\) and proving the unpredictability of every single bit of one of the coordinates of the secret DH value.
MOLECULAR PROPERTIES OF PLATELET MAO IN PSYCHIATRIC PATIENTS AND CONTROLS

ABSTRACT Abnormal activities of platelet monoamine oxidase (MAO) have been reported in a number of neuropsychiatric disorders. All reports, however, are not consistent. Many factors may contribute to the variance in the measurement of MAO activity. These include the number of enzyme molecules, enzyme structure, platelet isolation procedure, enzyme activity assay procedure, drugs, hormones, activators and inhibitors. It may be necessary to evaluate other parameters of MAO in addition to enzyme activity. The finding of a lowered Vmax and Km for tyramine in chronic schizophrenic patients is reviewed. Procedures are described for quantitating the number of active MAO molecules with 3 H-pargyline and resolving labeled molecules on the basis of net charge by gel electrophoresis. MAO from platelets isolated by the washout technique from controls and psychiatric patients are compared. Enzyme activity and the number of active enzyme molecules are significantly correlated (r = 0.94). Patients and controls were similiar. These procedures can help to determine whether alterations in platelet MAO activity are due to differences in the number of enzyme molecules or factors that modulate the activity of the enzyme molecule.
Cell Loss with Aging

There have been several techniques developed to determine the number of cells in the central nervous system. Probably the simplest and the most common technique has been the ocular micrometric method. This was originally used by Hammerberg in 1895 and while other techniques may be mentioned, it is at the present time the most consistent and dependable. It involves examination of tissue with the aid of a micrometer disc inserted into the ocular of a compound microscope. Cells which fall within the squares of the disc may then be counted and total counts made as well as graphs showing relative populations within any portion of the section. This is most useful in determining cell numbers within a brain stem nuclear structure since it is possible in serial section counting to obtain an impression of the cell population at any specific point. By examination in several planes, one may obtain a 3-dimensional impression of the nucleus, and to compare specific sites within the nucleus in a number of brain specimens when the nucleus is of similar size. Direct optical examination of tissue by the investigator also makes possible a differentiation of neurons from glial cells and discriminates fairly easily when there is an overlapping of cells.
Calcium and Cyclic AMP Effects on Rabbit Epididymal Spermatozoa

The divalent cation Ca+2 plays a central role in many physiological processes through its control of many properties and functions of cell membranes (1, 2). Morita and Chang (3) have reported that Ca+2 was required to maintain the motility of hamster spermatozoa incubated at 37°C, but that the motility of guinea pig, rat and rabbit spermatozoa was maintained in the absence of this ion. Effects of Ca+2 on rabbit spermatozoa might be expected, since rabbit oviduct fluid contains about 2 mM Ca+2, as originally shown by Holmdahl and Mastroianni (4). Increased respiration by rabbit spermatozoa in rabbit oviduct fluid has been demonstrated (5, 6), but this has been attributed to HCO3 in the fluid. The effect of Ca+2 in this regard has never been assessed. We have shown in this laboratory (7, 8) a direct effect of Ca+2 on the mitochondria in hypotonically treated rabbit sperm cells in which mitochondria are intact and accessible to added reagents: respiration is increased as Ca+2 is taken up in an energy-linked process which competes rather poorly for the high energy intermediates of oxidative phosphorylation. The physiological significance of this mitochondrial Ca+2 uptake is as obscure for the sperm cell as it is for other mammalian cells in which the uptake is far more efficient (9–11).
Hypothesis Testing of the Q -matrix

The recent surge of interests in cognitive assessment has led to the development of cognitive diagnosis models. Central to many such models is a specification of the Q-matrix, which relates items to latent attributes that have natural interpretations. In practice, the Q-matrix is usually constructed subjectively by the test designers. This could lead to misspecification, which could result in lack of fit of the underlying statistical model. To test possible misspecification of the Q-matrix, traditional goodness of fit tests, such as the Chi-square test and the likelihood ratio test, may not be applied straightforwardly due to the large number of possible response patterns. To address this problem, this paper proposes a new statistical method to test the goodness fit of the Q-matrix, by constructing test statistics that measure the consistency between a provisional Q-matrix and the observed data for a general family of cognitive diagnosis models. Limiting distributions of the test statistics are derived under the null hypothesis that can be used for obtaining the test p-values. Simulation studies as well as a real data example are presented to demonstrate the usefulness of the proposed method.
Vasopressin antagonism for decompensated right-sided heart failure.

Abstract Background Targeted treatment for decompensated right heart failure (RHF) with or without left heart failure is lacking. Vasopressin antagonists (vaptans) may offer an option by increasing urine output and fluid mobilization when used in acute decompensated RHF without impacting blood pressure or renal function, both common complications of loop diuretics. Methods and results We searched electronic medical records from 2 institutions over 4 years for patients with RHF treated with vaptans. Urine output, creatinine, BUN and sodium, 1 day pre- versus 1 day post-vaptan initiation were compared. Baseline (admission) pre-vaptan values for patients with RHF who met inclusion criteria (n = 112) were RAP, median (interquartile range) = 19 (13–24) mmHg; cardiac index, mean ± standard deviation = 1.8 ± 0.4 L/min/m2; BNP, 1078 (523–1690) pg/ml; creatinine clearance of 51 (39–69) ml/min, BUN, 37 (26–54) mg/dl, and serum [Na+] 132 (126–135) mEq/L. Most patients (n = 103/112) received intravenous inotrope (prior to vaptan, n = 91). Overall length of stay was 27 (16–43) days. Vaptan treatment (90% tolvaptan, 10% conivaptan) was associated with increased 24 h urine output, 1517 (906–2394) vs 2337 (1425–3744) mL, p = 0.005, and [Na+], 127 (124–130) vs 130 (126–135) mEq/L, p = 0.001, without significant change in Cr or BUN. Furosemide IV dose equivalent decreased or remained unchanged in 75% of patients at 24 h and 64% at 72 h compared to the 24 h prior to vaptan use. Conclusion Vaptans were associated with a significant increase in urine output and serum sodium with an apparent reduction or stabilization of furosemide equivalent dosing in the early treatment period in patients with decompensated RHF. Vaptans may offer a management option for patients failing conventional diuretic-based treatment.
Proctectomy for rectal cancer – What is the data for open, laparoscopy and robotics?

Abstract Since the first reported radical resection by Miles in 1908, innovation in the field of rectal cancer surgery has continued at a steady pace. Improved preoperative staging, chemoradiation therapy for local advanced disease and pelvic MRI have drastically changed the course of disease for rectal cancer patients. Despite these important advances, surgical resection remains the cornerstone of treatment for rectal cancer. Surgical approaches to rectal cancer have also evolved to improve oncologic outcomes and reduced associated morbidity. Greater attention to pathologic assessment, total mesorectal excision, minimal invasive approaches, and minimizing the impact of sexual, bladder and bowel dysfunction have become the focus of modern-day rectal cancer surgeons. This chapter focuses on proctectomy for rectal cancer, current approaches and the high-level data to support their use.
Influence ofHost Polarity on Correlating Salt Concentration,Molecular Weight, and Molar Conductivity in Polymer Electrolytes

We use coarse-grained molecular dynamics simulations to study the effect of salt concentration and host polymer molecular weight on ion transport in polymer electrolytes. We find that increasing sa...
Social-cognitive mechanisms in the cycle of violence: Cognitive and affective theory of mind, and externalizing psychopathology in children and adolescents

Children who are victims of interpersonal violence have a markedly elevated risk of engaging in aggressive behavior and perpetrating violence in adolescence and adulthood. Although alterations in social information processing have long been understood as a core mechanism underlying the link between violence exposure and externalizing behavior, scant research has examined more basic social cognition abilities that might underlie this association. To that end, this study examined the associations of interpersonal violence exposure with cognitive and affective theory of mind (ToM), core social-cognitive processes that underlie many aspects of social information processing. In addition, we evaluated whether difficulties with ToM were associated with externalizing psychopathology. Data were collected in a community-based sample of 246 children and adolescents aged 8-16 who had a high concentration of exposure to interpersonal violence. Violence exposure was associated with lower accuracy during cognitive and affective ToM, and the associations persisted after adjusting for co-occurring forms of adversity characterized by deprivation, including poverty and emotional neglect. Poor ToM performance, in turn, was associated with externalizing behaviors. These findings shed light on novel pathways that increase risk for aggression in children who have experienced violence.
Hierarchical fault classification for resource constrained systems

Abstract Prognostics and health management (PHM) is the study of using health information to support decision making to improve maintenance and operations. There are many existing methods for PHM but most solely focus on predictive accuracy and ignore resource constraints. In a real-world application of a PHM system, resources consumed by the predictive algorithm at the core of the PHM system could be a limiting factor. In this study, we propose using a hierarchical classification scheme to break the conventional classification problem into many sub-problems arranged in a hierarchy. By splitting the diagnostic task into many sub-problems, the hierarchical classifier can be constructed to maximize accuracy while minimizing resource consumption. Reinforcement learning is proposed to select the classifiers for each sub-problem. The proposed methodology is applied to condition monitoring of a hydraulic actuator where power is a limiting resource. Numerical experiments demonstrate that the proposed hierarchical classification method can reduce resource consumption compared to a traditional flat classification approach.
Obstetrics and Gynecology Attendings' Comfort Level in Allowing Residents to Operate.

Study Objective To assess attendings’ comfort level in allowing residents to operate. Design Cross-sectional study. Setting Gynecology conferences from November 2018 to April 2019 and hospitals where authors had access to. Patients or Participants 91 attendings. Interventions Paper survey. Measurements and Main Results Attendings' self- comfort level in performing various gynecologic procedures and their comfort in allowing different level of residents’ participation was surveyed using a Likert-scale ranging from -3 (not at all comfortable) to 3 (extremely comfortable). Means and standard deviation (SD) were calculated and Kruskal-Wallis test was applied when appropriate. Survey response rate was 91%. Mean participant age was 47, and 60% were female. Mean years in practice was 14, respondents averaged 13.1 non-obstetrical surgeries per month, and 77.8% practiced in a teaching institution. 58.2% were generalists and the rest were subspecialty trained (27.5% FMIGS, 8.8% Gynecology Oncology, 3.3% UroGynecology, and 2.2% MFM). Attendings were least comfortable performing vaginal hysterectomies (mean=1.8, SD=1.7), followed by laparoscopic hysterectomy (mean=2.3, SD=1.2), and most comfortable with D&C hysteroscopy (mean=2.9, SD=0.2) and laparoscopic treatment of ectopic pregnancy (mean=2.9, SD=0.2). Both, attending's self-comfort level and attending's comfort level in allowing PGY4s to perform abdominal hysterectomy were higher than that of vaginal hysterectomy (p None of the participants reported that resident's gender would influence their decision to allow residents to operate. 71.4% reported that having a prior complication or law suit does not affect their decision. Participants stated that familiarity with resident's skill (96.5%), resident's surgical experience (94.1%), resident's request to do more (79.8%), resident's ownership of patient (76.2%) and time constraints (71.8%) would influence their decision. Conclusion Attendings were least comfortable to perform vaginal hysterectomy or allow residents participation, despite it being the recommended approach, when feasible.
Nonlinear control by backstepping applied to the web winding system

The key system in the reversible cold rolling mill is the web winding system (WWS). The WWS is a complex process characterized by multiple variables with varying parameters in time, a strong coupling and a non-linearity, various operating conditions. For many products, such as thin film tapes, highly precise control of web tension and web velocity to prevent bending or breaking of the web is of paramount importance throughout the manufacturing process. Because of the radius variation and broad range of roller inertia, the dynamic system changes strongly during the winding process. In this work, we present the design of a new version of the nonlinear backstepping control law for the WWS, in order to guarantee that the final product does not undergo deformations or breaks. It is an adaptive control approach of backstepping with introduction of integral actions. Using Lyapunov stability theory, we verify that trajectory dynamics are asymptotically stable. Simulation studies with the MATLAB/SIMULINK environment are presented to exemplify the effectiveness and performances of the proposed controllers.
WOULD YOU CUT IT OUT

A 75 year old male presented for consultation after he was incidentally found to have a 3.3 × 1.7 cm intrapericardial mass on a CT Coronary Calcium scan. He was asymptomatic and a physical exam was unremarkable. He described no chest trauma or personal history of malignancy. No family history of
Generation of Wideband Antenna Performance by [Z] and [Y] Matrix Interpolation in the Method of Moments

Designing antennas for modern radar and communications applications often requires the evaluation of the antenna’s ultra-wide band (UWB) operation capabilities. Identifying the appropriate electromagnetic modeling tools for UWB antennas can be challenging, since such antennas come in a wide-variety of configurations that range from thin-wire types to complex structures such as spirals, bow-ties, etc. The triangular surface patch method of moments (MoM) formulation1,2 is one popular modeling approach. The surface mesh allows flexibility in modeling detailed antenna features. Since the elements of the MoM impedance matrix, or [Z], must be recomputed for each new frequency, the computation of antenna performance over an wide frequency range can take a long time.
Universal Terahertz Integrated Systems: Bridging the ‘THz’ and ‘Application’ Gap in the Next Decade

The spectrum beyond 100 GHz has undergone transformative changes in the past decade, both in the form of technological progress and simultaneously in application development. With the evolution of 5G in the sister millimeter-wave band, the field of integrated THz technology has progressed significantly towards enabling efficient and compact Terahertz systems operable at room temperature and deployable at large scales. This has been facilitated by key developments in a multitude of integrated technology substrates in electronics, photonics and also hybrid systems. While f max of III-V based devices have crossed 1.5 THz, silicon-based THz systems have shown remarkable advancements in complex systems including chip-scale phased arrays, active and passive imagers, and wireless communication systems. While this technological progress has led to steady closing of the ‘THz gap’ in the past ten years, there needs to be concerted effort in closing the ‘THz’ and ‘application’ gap in the next ten years to allow large scale deployment of THz technology. In this paper, we summarize the advancements in integrated THz systems in the past decade, discuss future challenges and directions to progress towards that goal.
Fatigue Behavior of FRCM-Strengthened RC Beams

Abstract Fabric-reinforced cementitious matrix (FRCM) composites are thin laminates of mortar that embody synthetic and mineral-based continuous fabrics. FRCM materials are proven to be an effectiv...
Counterpoint: lack of evidence for echocardiography screening in athletes.

Prevention of sudden cardiac death (SCD) in athletes continues to be a major focus for sports medicine health professionals. While the incidence is low, the consequences can be devastating. Over the years, our understanding of SCD aetiologies and the ability to identify those at higher risk for SCD continues to improve. The preparticipation examination (PPE) is critical to this mission. While the necessity of a PPE is not questioned, the key elements of the PPE continue to fuel an ever-evolving debate. The history and physical (H&P) are a cornerstone of the PPE at all levels. There is debate whether to incorporate the 12-lead ECG as part of this screening process. This is based on the idea that the H&P alone may not be enough to fully ascertain diseases associated with SCD. It is supported by many studies, including one of 3620 high school athletes in which the American Heart Association 14-element PPE H&P was found to have decreased sensitivity, specificity and positive predictive value for conditions associated with SCD compared with an ECG (18.8% vs 87.5%, 68% vs 97.5% and 0.3% vs 13.6%, respectively).1 There is concern, however, regarding variability in ECG interpretation and available follow-up resources, so this may not be the best choice for all communities. Thus, American guidelines endorse inclusion of the ECG at the discretion of individual medical entities based on regional athlete risk and resources.2 Importantly, some cardiovascular disease phenotypes do not manifest until later in life and therefore may have a normal initial PPE. Additionally, some conditions, …
A proteomics approach for the identification of cullin-9 (CUL9) related signaling pathways in induced pluripotent stem cell models

CUL9 is a non-canonical and poorly characterized member of the largest family of E3 ubiquitin ligases known as the Cullin RING ligases (CRLs). Most CRLs play a critical role in developmental processes, however, the role of CUL9 in neuronal development remains elusive. We determined that deletion or depletion of CUL9 protein causes aberrant formation of neural rosettes, an in vitro model of early neuralization. In this study, we applied mass spectrometric approaches in human pluripotent stem cells (hPSCs) and neural progenitor cells (hNPCs) to identify CUL9 related signaling pathways that may contribute to this phenotype. Through LC-MS/MS analysis of immunoprecipitated endogenous CUL9, we identified several subunits of the APC/C, a major cell cycle regulator, as potential CUL9 interacting proteins. Knockdown of the APC/C adapter protein FZR1 resulted in a significant increase in CUL9 protein levels, however, CUL9 does not appear to affect protein abundance of APC/C subunits and adapters or alter cell cycle progression. Quantitative proteomic analysis of CUL9 KO hPSCs and hNPCs identified protein networks related to metabolic, ubiquitin degradation, and transcriptional regulation pathways that are disrupted by CUL9 deletion in both hPSCs. No significant changes in oxygen consumption rates or ATP production were detected in either cell type. The results of our study build on current evidence that CUL9 may have unique functions in different cell types and that compensatory mechanisms may contribute to the difficulty of identifying CUL9 substrates.
The Cupola: an additional layer of protection for providers working in the oropharyngeal region.

To reduce the spread of the infection, especially during aerosol generating procedures, we invented “The Cupola”, a shield that creates a mechanical barrier around the patient’s head and body. With this pilot study we aimed to assess the effectiveness of an additional layer of protection (The Cupola) developed for providers working in the oropharyngeal region. The mean number of 0.3 μm particles with no Cupola was 3777 (SD: ± 556), with The Cupola was 2068 (SD: ± 1468) and with the Cupola and Drape was 2031 (SD: ± 1108) (p < 0.015). The mean number of 0.5 μm airborne particles with no Cupola was 65 (SD: ± 7), with The Cupola was 29 (SD: ± 28) and with the Cupola and Drape was 28 (SD: ± 23) (p < 0.05). Results showed a significant reduction of aerosols generated during simulated dental procedures when the Cupola was used. The Cupola offers an extra layer of protection in addition to the recommended personal protective equipment.
Bayesian Balance-Regression in Microbiome Studies Using Stochastic Search

In microbiome studies, 16S rRNA sequencing is commonly used to quantify the taxonomic abundance of a microbial community. The resulting data are counts of amplicons. However, the total count is not informative because of the sampling, sample preparation, and sequencing processes. These counts are used to obtain estimates of the relative abundance of the taxa, which is compositional with a unit sum constraint. Analysis of compositional data requires special statistical treatment to account for the intrinsic dependence of the components due to this constraint. Balance, defined as the normalized log-ratio of the geometric mean of the values for the two groups of components, provides an interesting way of studying microbial community structure, where the two groups represent the beneficial and detrimental taxa, respectively. Such a balance can be used to quantify dysbiosis of the microbial community that is associated with a clinical outcome. However, identification of the outcome-associated balance is challenging. In this paper, we introduce a Bayesian balance-regression and a Markov Chain Monte Carlo (MCMC) stochastic search algorithm to identify the compositional balance that is associated with the outcome. Specifically, we propose a random walk strategy in MCMC that explores the very large space of all possible balance defined from high-dimensional compositional vector. Simulation studies suggest that the algorithm can identify the bacterial taxa that define the outcome-associated balance with a high probability. The effect of the balance on the outcome can be easily inferred from their predictive posterior distribution. We apply the proposed methods to two human microbiome studies and identify the balance of gut microbiome composition associated with body mass index and risk of inflammatory bowel disease, respectively.
Generative adversarial networks in medical imaging

Abstract Generative adversarial networks (GANs) are a recently introduced class of state-of-the-art generative models. GANs are characterized by a unique training process that, although unstable, enables them to accurately learn highly complex distributions. While much of the recent attention that GANs have received in the machine learning and computer vision communities is due to their ability to synthesize highly realistic images, this is but one of many potential uses for these models. In this chapter, we survey several recent applications of GANs in medical imaging, highlighting significant developments, and illustrating avenues for future work in this nascent area of research.
Evaluation of Wild Flora Surrounding Blueberry Fields as Viable Hosts of Drosophila suzukii (Matsumura, 1931) (Diptera: Drosophilidae) in Georgia

Drosophila suzukii, an economically important pest of small and thin-skinned fruits, has caused annual crop losses up to 20% in the state of Georgia's multimillion-dollar blueberry industry. The known host range of D. suzukii is large, yet the breadth of uncultivated and wild plants that can serve as alternative hosts in the southeastern United States is still not fully understood. Establishing comprehensive lists of non-crop D. suzukii hosts in woodlands near blueberry production will assist in the creation of more sustainable integrated pest management (IPM) strategies. Objectives of this study were to determine viability of wild fruiting plant species to this pest based on survivorship to adulthood and assess D. suzukii short-range preference between cultivated blueberries and wild fruit. Laboratory choice and no-choice assays were performed to determine if D. suzukii could complete its development on wild fruits sampled from the field. Results from our no-choice assays indicated that multiple species of wild fruits surveyed in Georgia were viable D. suzukii hosts including blackberry species, deerberry, hillside blueberry, common pokeweed, beautyberry, elderberry, evergreen blueberry, and large gallberry. Yet, none of these hosts were preferred by adult female D. suzukii as ovipositional substrates when compared to cultivated blueberries. However, these uncultivated species have the potential to sustain D. suzukii populations pre- and post-harvest season. This information can help farmers do more targeted management of these viable alternative hosts from wooded areas surrounding blueberry fields in order to minimize D. suzukii populations.
Material Culture of Kinishba

The architecture and burials of the prehistoric pueblo of Kinishba have been presented in a previous issue of American Antiquity. The present article is a preliminary report of the lesser objects of material culture as represented by the pottery, stone and bone implements, ornaments, a few charred fragments of basketry and textiles, food, and ceremonial objects. The majority of these specimens are made from imperishable material. Clothing, sandals, baskets, various types of textiles, wooden implements, and other perishable materials have but a very short existence in open sites such as Kinishba. Hence the following description of the artifacts presents only a limited picture of the arts and crafts of these prehistoric people.
Average Run Lengths of Exponentially Weighted Moving Average Control Charts

A computer program is presented that calculates the average run length of exponentially weighted moving average charts for controlling the mean of a normal process...
InP/InGaAsP MQW thin film edge emitting lasers for embedded waveguide chip to chip optical interconnections

This paper reports the first demonstration of a thin film (microns thick) heterogeneously integrated edge emitting laser bonded to a Si host substrate. Preliminary processing for embedding these thin film lasers into BCB polymer waveguides has also been discussed toward the implementation of embedded edge emitting sources in planar lightwave circuits.