cssi/SciSciGPT-SciSciNet huggingface dataset:
Hepatotoxicity of Antiviral Agents

Antiretroviral drugs, targeting the human immune deficiency virus, are the antivirals that more often cause drug-induced liver injury (DILI). DILI secondary to antiretroviral use is mostly asymptomatic and manifested only by elevation of liver enzymes. However, there are specific DILI syndromes associated with antiretroviral therapy: hypersensitivity reactions, lactic acidosis with hepatic steatosis, decompensation of cirrhotic liver, noncirrhotic portal hypertension, and nonalcoholic steatohepatitis. Although the exact pathogenic mechanisms for these forms of DILI may not be fully understood, risk factors have been recognized. Interferon, used for the treatment of hepatitis C and B viruses, can also cause decompensation of a cirrhotic liver. In addition, antivirals targeting Herpesviridae can cause liver enzyme elevations, albeit infrequently, and have occasionally been associated with liver failure.
Disparity in Diagnosis of Pulmonary Embolism in Hospitalized Patients with Pneumonia.

Pulmonary embolism (PE) is a major cause of preventable hospital deaths. Little is known about PE in the setting of pneumonia, as symptoms and signs of PE and pneumonia overlap, confounding diagnosis. With infrequent thromboprophylaxis, PE continues to be a major public health problem. In order to determine the incidence and characteristics of PE in patients with pneumonia, we analyzed statewide discharge data, 1997–2001, collected by the Pennsylvania Health Care Cost Containment Council (PHC4). The analysis included all PE discharges with ICD-9 codes 415.11 and 415.19, excluding pregnant patients and all second or later PE admissions. Infectious disease diagnoses were enumerated by ICD-9 codes, including 030–041, 042, 790.7, 996–998; pneumonia by ICD-9 codes 480–483. 485–487, and 996–998; and diagnostic procedures by revenue code 352 for computerized tomographic (CT), including spiral CT scans. Severity of illness was determined by MediQual Altas Admission Severity Categories. Of 33,036 total PE discharges (all-PE) from Pennsylvania hospital discharges 1997–2001, 5,757 (16.8%) had infection, more than half of which, 3,543 (52.3%), were due to pneumonia (pneumonia-PE). There was a marginal increase in the incidence of pneumonia-PE during this period, 615 (10.3%) in 1997 to 839 (10.5%), p>0.05. Those with pneumonia-PE were typically Caucasian, 77.3%, p
Noise and autism spectrum disorder in children: An exploratory survey.

Abstract Background With more students being educated in schools for Autism Spectrum Disorder (ASD) than ever before, architects and interior designers need to consider the environmental features that may be modified to enhance the academic and social success of autistic students in school. Aim This study explored existing empirical research on the impact of noise on children with ASD and provides recommendations regarding design features that can contribute to noise reduction. Methods and procedures A survey, which addressed the impact of architectural design elements on autism-related behavior, was developed for teachers of children with ASD and distributed to three schools. Outcomes and results Most teachers found noise control to be an important issue for students with autism and many observed children using ear defenders. In terms of managing issues related to noise, most teachers agreed that thick or soundproof walls and carpet in the classroom were the most important issues for children with ASD. Conclusions Suggested future research should address architectural considerations for building an acoustically friendly environment for children with autism, identifying patterns of problematic behaviors in response to acoustical features of the built environment of the classroom setting, and ways to manage maladaptive behaviors in acoustically unfriendly environments.
Probability of Secondary Crash Occurrence on Freeways with the Use of Private-Sector Speed Data:

A percentage of crashes on freeways are suspected to be caused in part by congestion or distraction from earlier incidents. Identification and prevention of these secondary crashes are major goals of transportation agencies, yet the characteristics of secondary crashes—in particular the probability of their occurrence—are poorly understood. Many secondary crashes occur when a vehicle encounters nonrecurring congestion, yet previous efforts to identify incident queues and their secondary crashes have relied either on deterministic queuing theory or on data from uniformly spaced dense loop detectors. This study is the first analysis of secondary crash occurrence to integrate incident timelines and traffic volumes with widely available and legally obtained private-sector speed data. Analysis found that 9.2% of all vehicle crashes were secondary to another incident and that 6.2% of these crashes were tertiary to another primary incident. Secondary crashes occurred on average once every 10 crashes and 54 disab...
Overuse of sentinel lymph node biopsy with breast conserving surgery for clinical DCIS.

1125 Background: The National Comprehensive Cancer Network (NCCN) guidelines recommend against sentinel lymph node biopsy (SLNB) for ductal carcinoma in-situ (DCIS) treated with breast conservation surgery (BCS). SLNB is appropriate with mastectomy because it precludes subsequent SLNB if invasive cancer is identified. However, SLNB is commonly performed with BCS for DCIS. We hypothesize SLNB use in the setting of BCS for DCIS varies and may be over used in some cancer centers. Methods: We examined 6,070 cases with initial biopsy showing DCIS presenting to 13 institutions participating in the NCCN Breast Outcomes Database from 1998-2009. Receipt of SLNB was defined as SLNB performed at any point in primary treatment for those with a final diagnosis of DCIS or at the first surgical procedure for those upstaged to invasive cancer. Characteristics of patients who did and did not have SLNB were compared using Chi-square tests. Logistic models adjusting for clinical and pathologic variables were performed to as...
Does Prior Cartilage Restoration Impact Outcomes Following Knee Arthroplasty

This study compared patients who failed a cartilage restoration procedure and underwent ipsilateral knee arthroplasty with matched control subjects undergoing knee arthroplasty without prior cartilage restoration. Although patients with a failed cartilage procedure derived benefit from knee arthroplasty, their magnitude of improvement and final outcomes scores were lower than the matched control subjects. In this cohort, the cartilage patients also experienced little to no benefit from cartilage restoration, suggesting that unmeasured shared patient characteristics may play a role. This information can be used to counsel this difficult patient population on expected outcomes following arthroplasty procedures. Further research identifying characteristics of responders to treatment remains critical to refine clinical decision-making for this difficult patient group.
3D printing and milling a real-time PCR device for infectious disease diagnostics.

Diagnosing infectious diseases using quantitative polymerase chain reaction (qPCR) offers a conclusive result in determining the infection, the strain or type of pathogen, and the level of infection. However, due to the high-cost instrumentation involved and the complexity in maintenance, it is rarely used in the field to make a quick turnaround diagnosis. In order to provide a higher level of accessibility than current qPCR devices, a set of 3D manufacturing methods is explored as a possible option to fabricate a low-cost and portable qPCR device. The key advantage of this approach is the ability to upload the digital format of the design files on the internet for wide distribution so that people at any location can simply download and feed into their 3D printers for quick manufacturing. The material and design are carefully selected to minimize the number of custom parts that depend on advanced manufacturing processes which lower accessibility. The presented 3D manufactured qPCR device is tested with 20-μL samples that contain various concentrations of lentivirus, the same type as HIV. A reverse-transcription step is a part of the device’s operation, which takes place prior to the qPCR step to reverse transcribe the target RNA from the lentivirus into complementary DNA (cDNA). This is immediately followed by qPCR which quantifies the target sequence molecules in the sample during the PCR amplification process. The entire process of thermal control and time-coordinated fluorescence reading is automated by closed-loop feedback and a microcontroller. The resulting device is portable and battery-operated, with a size of 12 × 7 × 6 cm3 and mass of only 214 g. By uploading and sharing the design files online, the presented low-cost qPCR device may provide easier access to a robust diagnosis protocol for various infectious diseases, such as HIV and malaria.
Improving Consensus Scoring of Crowdsourced Data Using the Rasch Model: Development and Refinement of a Diagnostic Instrument

Background: Diabetic retinopathy (DR) is a leading cause of vision loss in working age individuals worldwide. While screening is effective and cost effective, it remains underutilized, and novel methods are needed to increase detection of DR. This clinical validation study compared diagnostic gradings of retinal fundus photographs provided by volunteers on the Amazon Mechanical Turk (AMT) crowdsourcing marketplace with expert-provided gold-standard grading and explored whether determination of the consensus of crowdsourced classifications could be improved beyond a simple majority vote (MV) using regression methods. Objective: The aim of our study was to determine whether regression methods could be used to improve the consensus grading of data collected by crowdsourcing. Methods: A total of 1200 retinal images of individuals with diabetes mellitus from the Messidor public dataset were posted to AMT. Eligible crowdsourcing workers had at least 500 previously approved tasks with an approval rating of 99% across their prior submitted work. A total of 10 workers were recruited to classify each image as normal or abnormal. If half or more workers judged the image to be abnormal, the MV consensus grade was recorded as abnormal. Rasch analysis was then used to calculate worker ability scores in a random 50% training set, which were then used as weights in a regression model in the remaining 50% test set to determine if a more accurate consensus could be devised. Outcomes of interest were the percent correctly classified images, sensitivity, specificity, and area under the receiver operating characteristic (AUROC) for the consensus grade as compared with the expert grading provided with the dataset. Results: Using MV grading, the consensus was correct in 75.5% of images (906/1200), with 75.5% sensitivity, 75.5% specificity, and an AUROC of 0.75 (95% CI 0.73-0.78). A logistic regression model using Rasch-weighted individual scores generated an AUROC of 0.91 (95% CI 0.88-0.93) compared with 0.89 (95% CI 0.86-92) for a model using unweighted scores (chi-square P value<.001). Setting a diagnostic cut-point to optimize sensitivity at 90%, 77.5% (465/600) were graded correctly, with 90.3% sensitivity, 68.5% specificity, and an AUROC of 0.79 (95% CI 0.76-0.83). Conclusions: Crowdsourced interpretations of retinal images provide rapid and accurate results as compared with a gold-standard grading. Creating a logistic regression model using Rasch analysis to weight crowdsourced classifications by worker ability improves accuracy of aggregated grades as compared with simple majority vote. [J Med Internet Res 2017;19(6):e222]
Characterization of intact sialylated glycopeptides and phosphorylated glycopeptides from IMAC enriched samples by EThcD fragmentation: Toward combining phosphoproteomics and glycoproteomics

Abstract Protein phosphorylation and glycoprotein sialylation play a major role in regulating numerous cellular and molecular processes. Several previous studies demonstrated that it is possible to combine in-depth analysis of the phosphoproteome and sialome with common phosphopeptide enrichment methods that simultaneously enrich for sialylated glycopeptides. However, earlier workflows included enzymatic release of glycans and separation of phosphopeptides and formerly glycosylated peptides before independent LC–MS/MS analyses. Here, we demonstrate that electron-transfer/higher-energy collision dissociation (EThcD) enables identification of intact sialylated N-glycopeptides from IMAC enriched samples without additional sample preparation. Furthermore, this method allows for identification of intact glycopeptide sequences modified by phosphorylated glycans such as mannose-6-phosphate (M6P). This suggests that EThcD fragmentation of IMAC enriched samples provides a relatively straightforward means of implementing sialome and M6P-proteome analysis into existing phosphoproteomic workflows.
Metabolic Acidosis and Subclinical Metabolic Acidosis in CKD

Metabolic acidosis is not uncommon in CKD and is linked with bone demineralization, muscle catabolism, and higher risks of CKD progression and mortality. Clinical practice guidelines recommend maintaining serum total CO2 at ≥22 mEq/L to help prevent these complications. Although a definitive trial testing whether correcting metabolic acidosis improves clinical outcomes has not been conducted, results from small, single-center studies support this notion. Furthermore, biologic plausibility supports the notion that a subset of patients with CKD have acid-mediated organ injury despite having a normal serum total CO2 and might benefit from oral alkali before overt acidosis develops. Identifying these individuals with subclinical metabolic acidosis is challenging, but recent results suggest that urinary acid excretion measurements may be helpful. The dose of alkali to provide in this setting is unknown as well. The review discusses these topics and the prevalence and risk factors of metabolic acidosis, mechanisms of acid-mediated organ injury, results from interventional studies, and potential harms of alkali therapy in CKD.
Laparoscopic adrenalectomy for malignancy

Background Controversy exists as to whether laparoscopic adrenalectomy should be performed for malignant or potentially malignant tumours affecting the adrenals. Methods This was a retrospective analysis of all patients undergoing laparoscopic adrenalectomy at this institution from 1993 to 1999. Patients were classified by their preoperative diagnosis and analysed with respect to their final pathological diagnosis, operation and postoperative course. Results Some 121 patients underwent 133 laparoscopic adrenalectomies. Preoperative classification was type I (benign disease; 67 patients), type II (possibly malignant disease; 46 patients) and type III (malignant disease; eight patients). After operation, 11 patients had malignancy on pathological diagnosis including all eight patients with known preoperative malignancy (one adrenocortical carcinoma (3 × 3 cm) presenting as a virilizing tumour, two neuroblastomas, one lymphoma, one bilateral staged adrenalectomy for metastatic colon cancer, two metastatic lung cancers and one metastatic renal cell carcinoma). One patient with adrenocortical cancer (8 × 6 cm) had incorrect preoperative classification by cytology (type I; oncocytoma). Two of 14 patients with Cushing's adrenal tumour (type II) had adrenocortical cancer (12 × 9 cm and 3 × 3 cm). Mean length of stay was 1·8 days in patients with malignancy. No procedure was converted to open adrenalectomy and no significant complications were encountered. Only the four patients with adrenocortical carcinoma had a recurrence (two required open re-resection 3 months and 2 years after initial operation, one had laparoscopic re-resection 2 years after operation for local recurrence and one presented with recurrence 1 year after operation). Conclusion Forty-five per cent of patients undergoing laparoscopic adrenalectomy may be classified as having potentially malignant disease (type II or III). Most malignant tumours of the adrenals can be treated laparoscopically, but adrenocortical carcinomas are at high risk of recurrence after laparoscopic adrenalectomy. © 2000 British Journal of Surgery Society Ltd
Equivalent isentropic expansion efficiency of real fluid subject to concurrent pressure drop and heat transfer

Concurrent pressure drop and cooling of a super-critical or sub-cooled liquid stream can have the same effect as adiabatic expansion even though there is no work extraction. A practical implementation is as straight forward as counter-flow heat exchange with a colder fluid. The concurrent pressure drop need not be continuous with respect to the heat exchange, but may occur in a step-wise manner, in between heat exchange. Two aspects of this effect of pressure drop with heat transfer are examined; a thermodynamic and a practical process equivalent isentropic expansion efficiency. This real fluid phenomenon is useful to understand in applications where work extraction is either not practical or has not been developed. A super-critical helium supply, often around 3 bar and 4.5 K, being ultimately used as a superfluid (usually around 1.8 to 2.1 K) to cool a Niobium superconducting radio frequency cavity or a superconducting magnet is one such particular application. This paper examines the thermodynamic nature of this phenomenon.
Patient preference for time-saving telehealth postoperative visits after routine surgery in an urban setting.

Abstract Background Focusing on high-value delivery of health care, we describe our implementation of telephone postoperative visits as alternatives to in-person follow-up after routine, low-risk surgery in an urban setting. Our pilot program assessed telephone postoperative visit feasibility as well as patient satisfaction and clinical outcomes. Methods We offered telephone postoperative visits to all clinically eligible, in-state patients scheduled for appropriate low-risk operations. An advanced practitioner conducted the telephone postoperative visit within 2 weeks of the operation and discharged patients from routine follow-up if recovery was satisfactory. We reviewed the medical records to identify encounters and adverse events in the 30-day postoperative period. Results Telephone postoperative visits were opted for by 92/94 (98%) clinically eligible, in-state patients. Most patients cited convenience (55%), travel (34%), and time (22%) as their main motivations. The average patient opting in was 55 ± 16 years old (range 23–88, 8% > 65) and lived 22 ± 26 miles from our clinic (range 0.9–124). Of 50 patients completing telephone postoperative visits, 48 (96%, 2 were not asked) were satisfied with the telephone postoperative visit as their sole postoperative visit, 44 (88%) of whom required no additional follow-up. On average, telephone postoperative visits lasted 8.6 ± 3.9 minutes, compared with the 82.8 ± 33.4 minutes for preintervention, postoperative visit time. Adding travel times, we estimate each patient saved an average of 139–199 minutes or 94–96% of the time they would have spent coming to clinic. No instances of major morbidity or mortality were identified on chart review. Conclusion Many patients find telephone postoperative visits more convenient than in-clinic visits. Moreover, estimates of time saved are compelling. Amid changing regulations and reimbursement, our findings support the growing use of telehealth for postoperative care of routine, low risk operations.
Motion-compensated image reconstruction vs postreconstruction correction in respiratory-binned SPECT with standard and reduced-dose acquisitions

PURPOSE Cardiac perfusion images in single-photon emission computed tomography (SPECT) can suffer from respiratory motion blur. We investigated a reconstruction approach for correcting respiratory motion in respiratory-binned acquisitions and assessed the benefit of this approach in both standard dose and reduced dose. METHODS We modeled the acquired data from different respiratory bins by a joint probability distribution which was parameterized with respect to a common reference bin. The acquired data from all the respiratory bins were then utilized simultaneously for determining the source distribution in the reference bin using maximum a posteriori (MAP) estimation. We evaluated this approach with simulated imaging data and ten sets of clinical acquisitions, and compared it with a postreconstruction motion correction approach developed previously. We quantified the accuracy of the reconstruction results both at standard dose and with imaging dose reduced by 50% and 75%, respectively. RESULTS The proposed motion-compensated reconstruction (MCR) approach led to improved reconstruction of the myocardium in terms of both noise level and LV wall resolution. Compared to traditional acquisition (without motion correction), the proposed approach reduced the mean squared error of the image intensity in the myocardium by 27.59%, 20.59%, and 12.05% at full, half-, and quarter dose, respectively; the LV resolution, quantified by the full width at half-maximum (FWHM), was improved by 17.34%, 14.35%, and 12.95% at full, half-, and quarter dose, respectively; in addition, the proposed approach also improved the perfusion defect detectability at both full dose and reduced dose. Furthermore, with motion correction, the reconstruction results obtained at half-dose were comparable to that obtained at full dose without correction. Similar improvements were also demonstrated in the clinical acquisitions at different dose levels. CONCLUSIONS Respiratory motion correction in perfusion SPECT can improve the reconstruction of the myocardium at both standard and reduced dose. At half-dose, the results obtained with motion correction are comparable to that of traditional reconstruction obtained at full dose. MCR can be more accurate than postreconstruction correction.
Molecular Interactions Between Silver Nanoparticles and Model Cell Membranes

Silver (Ag) nanoparticles (NPs) are well known for their antibacterial properties. However, concerns have been raised on their possible toxicity to humans. This work is aimed to understand molecular interactions between Ag NPs and model mammalian cell membranes. Sum frequency generation (SFG) vibrational spectroscopy was used to study such interactions, supplemented by attenuated total reflectance–Fourier transform infrared spectroscopy (ATR–FTIR). Based on the SFG and ATR–FTIR results, it was found that Ag NPs could induce flip-flop of substrate supported lipid bilayers serving as model mammalian cell membranes. The Ag NPs could accumulate onto the model cell membrane and may aggregate. The Ag NP–model cell membrane interactions depend on the Ag NP solution concentration. At low Ag NP solution concentration, lipid flip-flop was observed. At higher Ag NP concentrations, Ag NPs caused lipid flip-flop faster and might aggregate. Therefore, the lipid flip-flop rates and Ag NP accumulation/aggregation rates are directly related to the Ag NP concentration of the subphase in contact with the lipid bilayer.
Exploring the boundaries of post-retrieval extinction in healthy and anxious individuals.

Abstract Over a dozen studies have examined the efficacy of post-retrieval extinction (PRE) in healthy adults in the fear conditioning laboratory, with a recent meta-analysis reporting an overall small-moderate effect on attenuating the return of fear compared to standard extinction. The current study was designed to extend PRE effects to a mixed sample of healthy and anxious individuals, explore potential moderators, and examine the benefit of PRE for a memory conditioned over multiple days. Healthy (n = 49) and anxious (n = 43) adults received either one day of acquisition followed by PRE, one day of acquisition followed by extinction, or three days of acquisition followed by PRE. Comparing participants who received one day of acquisition followed by PRE or extinction, no significant effect of PRE was observed on differential skin conductance response reinstatement or reactivity to the conditioned stimulus alone. Anxiety symptoms did not moderate outcomes. There was no difference in return of fear for anxious participants who received three days of acquisition followed by PRE versus one day of acquisition followed by PRE. These results further highlight the variability of findings in the PRE literature and need for further examination of individual difference factors that may moderate PRE effects.
Towards fusion of feature extraction and acoustic model training: a top down process for robust speech recognition.

This paper presents a strategy to learn physiologicallymotivated components in a feature computation module discriminatively, directly from data, in a manner that is inspired by the presence of efferent processes in the human auditory system. In our model a set of logistic functions which represent the rate-level nonlinearities found in most mammal hearing system are put in as part of the feature extraction process. The parameters of these rate-level functions are estimated to maximize the a posteriori probability of the correct class in the training data. The estimated feature computation is observed to be robust against environmental noise. Experiments conducted with the CMU Sphinx-III on the DARPA Resource Management task show that the discriminatively estimated rate-nonlinearity results in better performance in the presence of background noise than traditional procedures which separate the feature extraction and model training into two distinct parts without feed back from the latter to the former.
Statistical Learning Mechanisms in Infancy

Infants’ ability to learn about their world is nothing short of astounding. In this chapter, recent research on infants’ ability to learn statistical structure (probability distributions, sequential structure, and associations between different forms of information) and, when possible, the neural processes supporting such learning are reviewed. The review is focused on language development but connections are also made to learning in other domains, such as visual perception and event processing. These studies reveal that infants are not limited to the stimulus–response learning of classical learning theory, but rather learn myriad statistical structures, resulting in sensitivity to fine-grained detail and high-level generalizations.
The Interplay between Feature-Saliency and Feedback Information in Visual Category Learning Tasks.

What is the role of feedback information in different visual category learning (VCL) scenarios? To address this question we tested participants’ performance in VCL tasks in which stimuli varied in three feature dimensions, one of which was relevant for the task and the other two were irrelevant. The relevant feature could be identified based on trial-by-trial feedback. In one condition the task relevant and irrelevant features were highly-salient. In the second condition all features had low-visual-saliency. Feedback information was also manipulated: In the high-information condition the task relevant feature could be identified by the information provided in each trial whereas in the mid-information condition the feedback was ambiguous and information from several learning trials was required in order to confidently identify the relevant feature. Surprisingly, our data shows that mid- and high-information feedback are similarly effective in high-saliency VCL tasks. In contrast, in low-saliency VCL tasks, mid-information feedback impairs learning. We suggest that VCL can be done effectively either when feedback is ambiguous or in low-saliency conditions, but not in scenarios when both challenges occur concurrently.
Optical Frequency Measurements at 1×10−18 Uncertainty with Ytterbium Optical Lattice Clocks

We describe ytterbium optical lattice clocks under development at NIST. This includes the characterization of optical frequency stability and uncertainty, as well as measurements between two independent clocks, at the 10−18level. We also report on optical frequency ratio measurements with other optical clocks at NIST.
Airborne mammary carcinogens and breast cancer risk in the Sister Study.

Abstract Introduction Potentially carcinogenic hazardous air pollutants (air toxics) have been inconsistently associated with breast cancer. Whether metabolic factors modify these associations is unknown. We studied 29 non-metallic air toxics classified as mammary gland carcinogens in animal studies in relation to breast cancer risk. Methods Participants included 49,718 women from the Sister Study. Census tract air toxic concentration estimates from the 2005 National Air Toxics Assessment were linked to enrollment residential addresses. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for individual air toxics were estimated using Cox regression. Body mass index (BMI) was considered a potential modifier. Relevant mixtures were identified using classification trees. Results Over follow-up (average = 8.4 years), 2975 women were newly diagnosed with breast cancer (invasive or ductal carcinoma in situ). Several air toxics, including methylene chloride, polycyclic organic matter, propylene dichloride, and styrene, were associated with increased risk. Of these, methylene chloride was most consistently associated with risk across multiple analyses. It was associated with overall (HR quintile 4vs1 = 1.21 (95%CI = 1.07–1.38)) and estrogen receptor positive (ER+) invasive breast cancer (HR quintile 4vs1 = 1.28 (95%CI = 1.08–1.52)) in individual pollutant models, although no dose-response was observed. Associations were stronger among overweight/obese (vs. non-overweight/obese) women ( p Conclusions Some non-metallic air toxics, particularly methylene chloride, were associated with the hazard for overall and ER+ breast cancer. Overweight/obese women may be particularly susceptible to air toxics.
Finite Point Configurations in the Plane, Rigidity and Erdős Problems

For a finite point set E ⊂ ℝd and a connected graph G on k + 1 vertices, we define a G-framework to be a collection of k + 1 points in E such that the distance between a pair of points is specified if the corresponding vertices of G are connected by an edge. We consider two frameworks the same if the specified edge-distances are the same. We find tight bounds on such distinct-distance drawings for rigid graphs in the plane, deploying the celebrated result of Guth and Katz. We introduce a congruence relation on a wider set of graphs, which behaves nicely in both the real-discrete and continuous settings. We provide a sharp bound on the number of such congruence classes. We then make a conjecture that the tight bound on rigid graphs should apply to all graphs. This appears to be a hard problem even in the case of the nonrigid 2-chain. However, we provide evidence to support the conjecture by demonstrating that if the Erd˝os pinned-distance conjecture holds in dimension d, then the result for all graphs in dimension d follows.
Improved Overall Survival With Comprehensive Local Consolidative Therapy in Synchronous Oligometastatic Non-Small-Cell Lung Cancer.

Abstract Background Local consolidative therapy (LCT) to optimize disease control is an evolving management paradigm in non–small-cell lung cancer (NSCLC) patients who present with a limited metastatic disease burden. We hypothesized that LCT to all sites of disease would be associated with improved overall survival (OS) among patients with synchronous oligometastatic NSCLC. Patients and Methods Patients presenting to a single institution (2000-2017) with stage IV NSCLC and ≤ 3 synchronous metastases were identified. Intrathoracic nodal disease was counted as one site. Landmark and propensity-adjusted Cox regression analyses were performed to identify factors associated with OS. Results Of 194 patients, 143 (74%) had 2 or 3 sites of metastasis. LCT was delivered to all sites of disease in 121 patients (62%), to some but not all sites in 52 (27%), and were not used in 21 (11%). Comprehensive LCT was independently associated with improved OS (hazard ratio [HR] = 0.67; 95% confidence interval [CI], 0.46-0.97; P = .034), with the greatest therapeutic effect among patients without thoracic nodal disease, bone metastases, or > 1 metastatic site. Among patients who underwent comprehensive LCT, tumor histology (squamous: HR = 2.32; 95% CI, 1.28-4.22; P = .006), intrathoracic disease burden (T3-4: HR = 1.67; 95% CI, 0.97-2.86; P = .065; N3: HR = 1.90; 95% CI, 0.90-4.03; P = .093), and bone metastases (HR = 1.74; 95% CI, 1.02-3.00; P = .044) were associated with poor OS. Conclusion Comprehensive LCT was associated with improved OS in this large cohort of patients with synchronous oligometastatic NSCLC. These results support ongoing prospective efforts to characterize the therapeutic benefits associated with this management strategy.
Is Alcohol Consumption Associated With Protection Against Peri-Implantitis? A Retrospective Cohort Analysis.

Purpose Recent studies have pointed to the effects of social factors on the health of dental implants. We investigated whether varying levels of alcohol consumption will influence the health of dental implants and associated peri-implant inflammation. Patients and Methods A retrospective cohort study was performed to evaluate implants placed from 2006 to 2012 at the Philadelphia Veteran's Affairs Medical Center. Alcohol consumption was gathered from the health maintenance records within 3 months of implant placement and served as the predictor variable. Analysis was performed at follow-up visits for the presence of the outcome variable, peri-implantitis, which was assessed at an implant level. A multivariable generalized estimating equation logistic regression model was constructed, and a Wald test was used to analyze the statistical significance of each parameter. The results were interpreted as an odds ratio estimate, including the 95% confidence interval. Descriptive statistics were used to compute and analyze the data, with P Results Demographically, our cohort consisted mainly of male patients (92%), with an average age of 60 years at implant placement. The mean interval to peri-implantitis was 30 ± 25 months. Peri-implantitis occurred most frequently within 2 years of implant placement. The incidence of peri-implantitis was greatest among heavy alcohol consumers (42%) and lowest among mild and moderate consumers (12 and 6%, respectively). Compared with no consumption, mild alcohol consumption was associated with a 47% decrease in peri-implantitis (P Conclusions The results from our retrospective cohort analysis revealed that mild to moderate alcohol consumption is associated with a lower rate of peri-implantitis. However, heavy consumption was associated with an increase in the incidence of peri-implantitis among patients with dental implants.
Cabozantinib use in metastatic renal cell carcinoma patients in clinical practice: Evaluation of dosing patterns, tolerability, and outcomes compared to clinical trials.

IntroductionDespite first-line approval in metastatic renal cell carcinoma (mRCC), the tyrosine kinase inhibitor cabozantinib is associated with frequent treatment-limiting side effects. Dose reduc...
Studies on the conflict-crash relationship

Abstract Past studies on the relationship between traffic conflicts and crashes are overviewed. Two large-scale studies suggested that a single coefficient connecting conflicts and crashes may be sufficient if traffic maneuvers, type of interaction, and types of involved road users do not change from observation to observation and other conditions are similar. Recent research has demonstrated that the crash-conflict ratio may remain stable under certain conditions. Identifying a traffic conflict by relying only on detecting an evasion maneuver leads to overstating the number of conflicts. Major difficulties arise from comparing conflicts observed in short periods with crashes reported in much longer periods. A new approach based on extreme value theory and exceedance statistics does not require crash data to estimate the crash-conflict relationship.
Evolving Larger Convolutional Layer Kernel Sizes for a Settlement Detection Deep-Learner on Summit

Deep-learner hyper-parameters, such as kernel sizes, batch sizes, and learning rates, can significantly influence the quality of trained models. The state of the art for finding optimal hyper-parameters generally uses a brute force, grid search approach, random search, or Bayesian-based optimization among other techniques. We applied an evolutionary algorithm to optimize kernel sizes for a convolutional neural network used to detect settlements in satellite imagery. Usually convolutional layer kernel sizes are small – typically one, three, or five – but we found that the system converged at, or near, kernel sizes of nine for the last convolutional layer, and that this occurred for multiple runs using two different datasets. Moreover, the larger kernel sizes had fewer false positives than the 3x3 kernel sizes found as optimal via a brute force uniform grid search. This suggests that this large kernel size may be leveraging patterns found in larger areal features in the source imagery, and that this may be generalized as possible guidance for similar remote sensing deep-learning tasks.
Development and validation of a novel scoring tool for predicting facility discharge after elective posterior lumbar fusion.

BACKGROUND CONTEXT Discharge to acute/intermediate care facilities is a common occurrence after posterior lumbar fusion and can be associated with increased costs and complications after these procedures. This is particularly relevant with the growing popularity of bundled payment plans, creating a need to identify patients at greatest risk. PURPOSE To develop and validate a risk-stratification tool to identify patients at greatest risk for facility discharge after open posterior lumbar fusion. STUDY DESIGN/SETTING Retrospective cohort study PATIENT SAMPLE Patients were queried using separate databases from the institution of study and the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) for all patients undergoing open lumbar fusion between 2011 and 2018. OUTCOME MEASURES Discharge to intermediate care and/or rehabilitation facilities. METHODS After identification of the eligible cohort, demographic (age, sex, body mass index [BMI], smoking status, diabetes, and american Society of Anesthesiologists [ASA] Class ≥ 3) and perioperative variables (number of levels fused, history of prior lumbar surgery, and presence of spondylolisthesis [isthmic or degenerative]) were assessed and recorded for each patient. The NSQIP cohort was subsequently subjected to an 80:20 training and testing split, whereby collected perioperative demographic and operative variables were used in a multivariate logistic regression to identify potential risk factors for postoperative facility discharge, retaining those with a p-value RESULTS A total of 11,486 patients (10,453 NSQIP, 1,033 local cohort) were deemed eligible for study, of which 16.1% were discharged to facilities (16.7% NSQIP, 9.6% local cohort). Utilizing training data, age (p CONCLUSIONS Using preoperative variables as predictors, this scoring system demonstrated high efficiency in risk-stratifying patients with an approximate four to fivefold difference in rates of facility discharge after posterior lumbar fusion. This tool may help inform medical decision-making and guide reimbursement under bundled-care repayment plans. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
Synthetic high-density lipoproteins loaded with an antiplatelet drug for efficient inhibition of thrombosis in mice

Antiplatelet agents offer a desirable approach to thrombosis prevention through the reduction of platelet reactivity. However, major bleeding events greatly attenuate the clinical outcomes of most antithrombotic agents. Therefore, the development of safer and more effective strategies to prevent vascular occlusion and avoid bleeding is urgently needed. A reconstituted nanoparticle, synthetic high-density lipoprotein (sHDL), which mimics the native HDL, has been established as clinically safe and is easily manufactured on a large scale. In this study, we propose that the delivery of the antiplatelet drug ML355, a selective inhibitor of 12(S)-lipoxygenase (12-LOX), by sHDL will efficiently inhibit thrombosis by targeting ML355 to the intended site of action, improving the pharmaceutical profile and harnessing the innate antithrombotic efficacy of the sHDL carrier. Our data show that ML355-sHDL exhibits more potent inhibition of thrombus formation in both small arterioles and larger arteries in mice without impairing the normal hemostasis in vivo.
Production and migration of turbulent kinetic energy in bluff body shear layers

Abstract An experimental campaign on a bluff body of rectangular cross section, having a side-length ratio of 5:1 was carried out using both particle image velocimetry and hot wire anemometry at a Reynolds number of 3.04 × 10 4 . Results show that under a slight angle of attack, the development of unsteadiness in the form of turbulent kinetic energy is significantly amplified on the pressure side of the body. A series of linear corrections fail to fully collapse the behavior of the curved shear onto the growth rates of the canonical planar mixing layer solution as expected. In pursuit of providing a physical mechanism to a non-linear contribution to shear layer transition, inspection of relevant components of the Karman-Howarth-Monin-Hill equation suggest a re-orientation of energy in scale-space, resulting in a combined forward and reverse energy transfer. It is shown that this reorganization process and energy transfer depend on the orientation of energetic structures within the shear layer.
Flash Continuous Glucose Monitoring: A Practical Guide and Call to Action for Pharmacists.

Despite advances in diabetes technology, the proportion of patients with type 2 diabetes achieving recommended glycemic goals remains suboptimal. There is a growing interest in flash continuous glu...
Surface passivation of bare aluminum nanoparticles using perfluoroalkyl carboxylic acids

Surface passivation of unpassivated Al nanoparticles has been realized using self-assembled monolayers (SAMs). Nanoscale Al particles were prepared in solution by catalytic decomposition of H 3 Al.NMe 3 or H 3 Al.N(Me)Pyr by Ti(O i Pr) 4 and coated in situ using a perfluoroalkyl carboxylic acid SAM. Because the Al particles are prepared using wet chemistry techniques and coated in solution, they are free of oxygen passivation. This SAM coating passivates the aluminum and appears to prevent the oxidation of the particles in air and renders the composite material, to some extent, soluble in polar organic solvents such as diethyl ether. Characterization data including scanning electron microscopy, transmission electron microscopy, thermogravimetric analysis, and attenuated total reflectance-Fourier transform infrared spectroscopy of prepared materials are presented.
Neural Multi-Task Learning for Adverse Drug Reaction Extraction

A reliable and searchable knowledge database of adverse drug reactions (ADRs) is highly important and valuable for improving patient safety at the point of care. In this paper, we proposed a neural multi-task learning system, NeuroADR, to extract ADRs as well as relevant modifiers from free-text drug labels. Specifically, the NeuroADR system exploited a hierarchical multi-task learning (HMTL) framework to perform named entity recognition (NER) and relation extraction (RE) jointly, where interactions among the learned deep encoder representations from different subtasks are explored. Different from the conventional HMTL approach, NeuroADR adopted a novel task decomposition strategy to generate auxiliary subtasks for more inter-task interactions and integrated a new label encoding schema for better handling discontinuous entities. Experimental results demonstrate the effectiveness of the proposed system.
Metformin Actions on the Liver: Protection Mechanisms Emerging in Hepatocytes and Immune Cells against NASH-Related HCC

Nonalcoholic fatty liver disease (NAFLD) is strongly linked to the global epidemic of obesity and type 2 diabetes mellitus (T2DM). Notably, NAFLD can progress from the mildest form of simple steatosis to nonalcoholic steatohepatitis (NASH) that increases the risk for hepatocellular carcinoma (HCC), which is a malignancy with a dismal prognosis and rising incidence in the United States and other developed counties, possibly due to the epidemic of NAFLD. Metformin, the first-line drug for T2DM, has been suggested to reduce risks for several types of cancers including HCC and protect against NASH-related HCC, as revealed by epidemical studies on humans and preclinical studies on animal models. This review focuses on the pathogenesis of NASH-related HCC and the mechanisms by which metformin inhibits the initiation and progression of NASH-related HCC. Since the functional role of immune cells in liver homeostasis and pathogenesis is increasingly appreciated in developing anti-cancer therapies on liver malignancies, we discuss both the traditional targets of metformin in hepatocytes and the recently defined effects of metformin on immune cells.
Coordinated regulation of CB1 cannabinoid receptors and anandamide metabolism stabilize network activity during homeostatic scaling down

Neurons express overlapping homeostatic mechanisms to regulate synaptic function and network properties in response to perturbations of neuronal activity. Endocannabinoids (eCBs) are bioactive lipids synthesized in the post-synaptic compartments that regulate synaptic transmission, plasticity, and neuronal excitability throughout much of the brain, by activating pre-synaptic cannabinoid receptor CB1. The eCB system is well situated to regulate neuronal network properties and coordinate pre- and post-synaptic activity. However, the role of the eCB system in homeostatic adaptations to neuronal hyperactivity is unknown. We show that in mature cultured rat cortical neurons, chronic bicuculline treatment, known to induce homeostatic scaling-down, induces a coordinated adaptation to enhance tonic eCB signaling. Hyperexcitation triggers down regulation of fatty acid amide hydrolase (FAAH), the lipase that degrades the eCB anandamide. Subsequently, we measured an accumulation of anandamide and related metabolites, and an upregulation of total and cell surface CB1. We show that bicuculline induced downregulation of surface AMPA-type glutamate receptors and upregulation of CB1 occur through independent mechanisms. Finally, using live-cell microscopy of neurons expressing an extracellular fluorescent glutamate reporter (iGluSnFR), we confirm that cortical neurons in vitro exhibit highly synchronized network activity, reminiscent of cortical up-states in vivo. Up-state like activity in mature cortical cultures requires CB1 signaling under both control conditions and following chronic bicuculline treatment. We propose that during the adaptation to chronic neuronal hyperexcitation, tonic eCB signaling is enhanced through coordinated changes in anandamide metabolism and cell-surface CB1 expression to maintain synchronous network activity. Significance statementNeurons are remarkably resilient to perturbations in network activities thanks to the expression of overlapping homeostatic adaptations. In response to network hyperactivity or silencing, neurons can respond through changes in excitatory and inhibitory post-synaptic neurotransmitter receptors, probability of pre-synaptic neurotransmitter release, or changes in membrane excitability. The endocannabinoid system is a prominent signaling pathway at many synapses that is known to be involved in multiple forms of short and long-term synaptic plasticity. Here we find that components of the endocannabinoid system are upregulated in response to chronic hyperexcitation of cultured cortical neurons, and that endocannabinoid signaling is required to maintain synchronized network activity. This work supports a novel tonic homeostatic function for the endocannabinoid system in neurons.