cssi/SciSciGPT-SciSciNet huggingface dataset:
Increased leukotriene C4 and vasogenic edema surrounding brain tumors in humans

Leukotrienes are pharmacologically active compounds that promote vascular permeability. In this study we sought to determine whether tissue leukotriene-like immunoreactivity was increased in intracranial tumors associated with peritumoral edema. In 20 patients undergoing craniotomy tissue specimens were immediately frozen after removal and tissue leukotriene C4 levels were determined by radioimmunoassay. An index of peritumoral edema was estimated from preoperative contrast-enhanced computed tomographic scans. There was a significant correlation between brain edema and tissue leukotriene levels (p less than 0.003). Metastatic tumors (n = 8) had the highest leukotriene C4 level at 13.8 +/- 8.5 pg/mg tissue (mean +/- SE) and the highest index of edema 5.7 +/- 1.8. The mean leukotriene C4 level in the gliomas (n = 5) was 6.2 +/- 2.3 pg/mg tissue and the edema index was 2.1 +/- 0.6. There was no edema and no neoplasm in the temporal lobes removed for seizure (n = 2), and their level of leukotriene C4 was 0.4 +/- 0.1 pg/mg tissue. The formation of leukotriene C4 is stimulated by intracranial tumors. Leukotrienes increase blood-brain barrier permeability and may be important in the formation of vasogenic edema surrounding tumors.
Reduction of the Dynamic Load Capacity in a Squeeze Film Damper Operating With a Bubbly Lubricant

Squeeze film dampers (SFDs) are effective means to reduce vibrations and to suppress instabilities in rotor-bearing systems. However, at operating conditions while traversing critical speeds with large orbital whirl motions, ingestion and entrapment of air into the thin lands of SFDs generates a bubbly mixture (air in lubricant) which is known to reduce the dynamic film pressures and the overall damping capability. This pervasive phenomenon lacks proper physical understanding and sound analytical modeling. An experimental investigation to quantify the forced performance of a SFD operating with a controlled bubbly mixture is detailed. Tests are conducted in a constrained circular orbit SFD to measure the dynamic squeeze film pressures and journal motion at two whirl frequencies (8.33 and 16.67 Hz) as the air content in the mixture increases from 0% to 100%. The analysis of period-averaged film pressures reveals a zone of uniform low pressure of magnitude equal to the discharge pressure, independently of the mixture composition. The uniform pressure zone extends as the mixture void fraction increases. Radial and tangential film forces are estimated from the dynamic pressures at two axial locations of measurement. The tangential (damping) force decreases proportionally with the mixture volume fraction, while a radial hydrostatic force remains nearly invariant. The experimental results quantify effects previously known by qualitative description only, thus providing a benchmark towards the development of sound theoretical models.Copyright © 1998 by ASME
Direct leach approaches to Platinum Group Metal (PGM) ores and concentrates: A review

Abstract Platinum Group Metals (PGMs), often with associated gold, have very few occurrences where they are present in an ore deposit at economically extractable levels. They are classified as both precious and critical metals due to their scarcity and their wide industrial use. With deteriorating socio-political environments in most primary PGM producing countries, PGM deposits that are smaller but in less risky jurisdictions have to be evaluated. However, the lower PGM grades, increased mineralogical complexity of the ores, capital intensity and strict environmental regulations in other international jurisdictions, limit the implementation of conventional metallurgical processing options, particularly smelter-based operations. The conventional smelter-based process options are justifiable for high grade, low chromite, large resource and long life-of-mine operations. In the present paper, we review some of the most recent literature on the predominantly hydrometallurgical approaches to PGM extraction. A number of metallurgical processes that generate either a PGM rich leachate or a residue containing metal values, and the various methods in use for their recoveries from pregnant rich solutions are reviewed. Sixteen process flowsheet variants combining conventional and proprietary unit process technologies are provided, and their process chemistries and key technical operating parameters are compared. Where appropriate, the key thermodynamic and kinetic factors are given and compared.
Evidence On The Effect Of Financial Distress On Type II Audit Errors

A Type II audit error is defined as the failure of an auditor to issue a going concern audit opinion for a client that subsequently declares bankruptcy. Prior research studies have examined audit effectiveness (as measured by Type II audit errors) following the Sarbanes-Oxley Act of 2002, and have generally found an increase in the auditor’s likelihood of issuing going-concern audit opinions. This increase in the auditor’s likelihood of issuing a going concern opinion postSarbanes-Oxley has been interpreted as an increase in the level of auditor conservatism. [For example, see Geiger et al. (2005) and Fargher and Jiang (2008)]. However, prior studies have often limited their analysis of going-concern audit effectiveness to firms that were already in financial distress, and have also failed to specifically address the extent to which varying levels of financial distress affects the auditor’s propensity to issue a going-concern opinion. This raises the main research questions addressed in this study: Does the relationship between financial distress and the probability of receiving a going-concern differ for distressed versus non-distressed firms, and more importantly, to what extent do varying levels of financial distress affect this relationship? We find that the relationship between financial distress and the probability of receiving a going-concern opinion is not linear, as is assumed in prior studies. Rather, we find that the positive relationship between financial distress and going-concern opinions applies only for certain levels of financial distress. These results have implications both in the interpretation of previous auditing research that has incorporated variables for financial distress, as well as implications for the design and interpretation of future research.
Hardware implementation of low-overhead data aided timing and Carrier Frequency Offset correction for OFDM signals

In this paper a trained timing synchronization method using a matched filter and Carrier Frequency Offset synchronization method based on a modified correlation scheme is implemented in hardware for Orthogonal Frequency Division Multiplexing. MATLAB System Generator is used to target a Virtex-6 FPGA on the ML605 Xilinx evaluation board, with an optimized number of board resources utilized. A complex pseudo-noise sequence is used as a preamble for timing. The employed training sequence for frequency synchronization consists of only one pilot symbol, distinguishing this system from most approaches which rely upon multiple pilot symbols. By reducing the number of symbols required for the training period, it is possible to increase throughput. In addition, to ensure that the system has flexibility and is not protocol specific, the system allows for a variable number of FFT sizes and pilot symbol design parameters to be used. Performance of the system is shown to improve over an Additive White Gaussian Noise channel by implementing the design in comparison to not compensating for the distortion.
Molluscum Contagiosum Virus Transcriptome in Abortively Infected Cultured Cells and a Human Skin Lesion

UNLABELLED Molluscum contagiosum virus (MOCV), the only circulating human-specific poxvirus, has a worldwide distribution and causes benign skin lesions that may persist for months in young children and severe infections in immunosuppressed adults. Studies of MOCV are restricted by the lack of an efficient animal model or a cell culture replication system. We used next-generation sequencing to analyze and compare polyadenylated RNAs from abortive MOCV infections of several cell lines and a human skin lesion. Viral RNAs were detected for 14 days after MOCV infection of cultured cells; however, there was little change in the RNA species during this time and a similar pattern occurred in the presence of an inhibitor of protein synthesis, indicating a block preventing postreplicative gene expression. Moreover, a considerable number of MOCV RNAs mapped to homologs of orthopoxvirus early genes, but few did so to homologs of intermediate or late genes. The RNAs made during in vitro infections represent a subset of RNAs detected in human skin lesions which mapped to homologs of numerous postreplicative as well as early orthopoxvirus genes. Transfection experiments using fluorescent protein and luciferase reporters demonstrated that vaccinia virus recognized MOCV intermediate and late promoters, indicating similar gene regulation. The specific recognition of the intermediate promoter in MOCV-infected cells provided evidence for the synthesis of intermediate transcription factors, which are products of early genes, but not for late transcription factors. Transcriptome sequencing (RNA-seq) and reporter gene assays may be useful for testing engineered cell lines and conditions that ultimately could provide an in vitro replication system. IMPORTANCE The inability to propagate molluscum contagiosum virus, which causes benign skin lesions in young children and more extensive infections in immunosuppressed adults, has constrained our understanding of the biology of this human-specific virus. In the present study, we characterized the RNAs synthesized in abortively infected cultured cells and a human skin lesion by next-generation sequencing. These studies provided an initial transcription map of the MOCV genome, suggested temporal regulation of gene expression, and indicated that the in vitro replication block occurs prior to intermediate and late gene expression. RNA-seq and reporter assays, as described here, may help to further evaluate MOCV gene expression and define conditions that could enable MOCV replication in vitro.
Turndown Control Structures for Distillation Columns

Future chemical plants may be required to have much higher flexibility and agility than existing process facilities in order to be able to handle new hybrid combinations of power and chemical units...
Challenge and response in the São Francisco River Basin

The Sao Francisco River has been, and continues to be, the only major river in arid Northeast Brazil and, as such, continues to be a major focus for development policy in this poorest part of the country. In a context of persistent water scarcity and recurring drought, the imperative is to develop a water development and management framework capable of simultaneously creating a platform for growth, dealing with distributive conflicts and ensuring rational usage. Addressing this challenge has been complicated by the multi-layered institutions of Brazilian federalism. This paper traces the development of the institutional framework for water management in the Sao Francisco Basin, highlighting the role of both local innovation and the pressures of federal centralization. The single most important policy debate currently affecting the basin is an ambitious inter-basin transfer project that aims to provide secure water supply to major cities and irrigation projects in neighboring basins. The paper provides an in-depth analysis of the project, with a special focus on understanding the policy process underpinning the project. This analysis anchors the discussion in the difficult dilemmas currently faced by policymakers and gives some insights into the actual functioning of a complex and sometimes ambiguous institutional set-up.
Multiple Design: An Extension of Routine Design for Generating Multiple Design Alternatives

Many engineering design situations require the generation of multiple designs to meet a common set of specifications. This research introduces an effective approach for generating multiple designs. The method developed utilizes and builds on the generic task approach to knowledge-based systems, as well as the specific design technique, known as Routine Design.
A Prospective Study of Hypodermoclysis Performed by Caregivers in the Home Setting.

Abstract Context Decreased oral intake is very common at the end of life. Dehydration can aggravate symptoms, such as fatigue, myoclonus, and confusion. Intravenous hydration at home can be logistically difficult and expensive. Hypodermoclysis is easy to provide and inexpensive; however, it is rarely used to provide hydration at the end of life in the home setting. Objectives The purpose of this study was to determine if caregivers were capable of administering hypodermoclysis in the home hospice setting. Methods All caregivers underwent a 45-minute training session on hypodermoclysis administration and assessment of infusion site delivered by a specially trained nurse. Caregivers received daily calls and on-site evaluation on Day 8. Results A total of 21 patient/caregivers dyads were admitted to this preliminary study: 10 (48%) female patients and 16 (76%) female caregivers. All patients had advanced cancer, receiving hospice care at home. All caregivers who received training were able to start the infusion. The infusion was facilitated by gravity or weight. Side effects were minimal with one (5%) because of the care of the needle and leakage. Conclusion This preliminary study suggests that subcutaneous hydration could be administered by caregivers at home with minimal burden, equipment, and technical support.
Interrater agreement in the interpretation of neonatal electroencephalography in hypoxic-ischemic encephalopathy.

Author(s): Wusthoff, Courtney J; Sullivan, Joseph; Glass, Hannah C; Shellhaas, Renee A; Abend, Nicholas S; Chang, Taeun; Tsuchida, Tammy N | Abstract: ObjectiveResearch using neonatal electroencephalography (EEG) has been limited by a lack of a standardized classification system and interpretation terminology. In 2013, the American Clinical Neurophysiology Society (ACNS) published a guideline for standardized terminology and categorization in the description of continuous EEG in neonates. We sought to assess interrater agreement for this neonatal EEG categorization system as applied by a group of pediatric neurophysiologists.MethodsA total of 60 neonatal EEG studies were collected from three institutions. All EEG segments were from term neonates with hypoxic-ischemic encephalopathy. Three pediatric neurophysiologists independently reviewed each record using the ACNS standardized scoring system. Unweighted kappa values were calculated for interrater agreement of categorical data across multiple observers.ResultsInterrater agreement was very good for identification of seizures (κ = 0.93, p l 0.001), with perfect agreement in 95% of records (57 of 60). Interrater agreement was moderate for classifying records as normal or having any abnormality (κ = 0.49, p l 0.001), with perfect agreement in 78% of records (47 of 60). Interrater agreement was good in classifying EEG backgrounds on a 5-category scale (normal, excessively discontinuous, burst suppression, status epilepticus, or electrocerebral inactivity) (κ = 0.70, p l 0.001), with perfect agreement in 72% of records (43 of 60). Other specific background features had lower agreement, including voltage (κ = 0.41, p l 0.001), variability (κ = 0.35, p l 0.001), symmetry (κ = 0.18, p = 0.01), presence of abnormal sharp waves (κ l 0.20, p l 0.05), and presence of brief rhythmic discharges (κ l 0.20, p l 0.05).SignificanceWe found good or very good interrater agreement applying the ACNS system for identification of seizures and classification of EEG background. Other specific EEG features showed limited interrater agreement. Of importance to both clinicians and researchers, our findings support using the ACNS system in identifying seizures and classifying backgrounds of neonatal EEG recordings, but also suggest limited reproducibility for certain other EEG features.
Temporal Relations of Unplanned Readmissions Following Total Knee Arthroplasty: A Study of Large State Inpatient Databases.

Abstract Background Centers for Medicare & Medicaid Services stipulate a 90-day global period for hospitals for unplanned readmissions after primary total knee arthroplasty (TKA). However, not all readmissions are directly attributable to index surgery, and reasons for readmissions vary during this time period. This study identifies causes and temporal relations of readmissions using large state inpatient databases. Methods State inpatient databases of New York and California were queried for all primary TKAs performed from 2005 to 2011 and frequencies of all causes of unplanned readmission were identified from 0 to 90 days after index surgery using the International Classification of Diseases, Ninth Revision , codes. Temporal differences in proportions of readmission diagnoses were tested using the Pearson chi-square test. Results The query identified 419,805 cases of primary TKA from 2005 to 2011. There were 26,924 readmissions during the 90-day recovery period, with 15,547 (57.7%) at 0-30 days, 6593 (24.5%) at 31-60 days, and 4784 (17.8%) at 61-90 days. Primary diagnoses at readmission that were identified to be directly attributable to surgery comprised 38.3% readmissions at 0-30 days, 24.0% at 31-60 days, and 16.3% at 60-90 days. Proportion of readmissions directly attributable to surgery decreased over the 90-day period after index surgery. Conclusion From this analysis of 2 large state inpatient databases, primary diagnoses at readmission vary with time, and majority of these may not be directly attributable to index surgery or postoperative state up to 90 days. These findings suggest that the current 90-day global period policy for this procedure should be reformed to better reflect the profile of unplanned readmissions after TKA.
Nutrition in adolescent girls in South Asia

Victor Aguayo and Kajali Paintal review the nutritional status of adolescent girls in South Asia and suggest ways to accelerate improvement of their nutrition
Current Applications of Robotics in Spine Surgery: A Systematic Review of the Literature

OBJECTIVE Surgical robotics has demonstrated utility across the spectrum of surgery. Robotics in spine surgery, however, remains in its infancy. Here, the authors systematically review the evidence behind robotic applications in spinal instrumentation. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Relevant studies (through October 2016) that reported the use of robotics in spinal instrumentation were identified from a search of the PubMed database. Data regarding the accuracy of screw placement, surgeon learning curve, radiation exposure, and reasons for robotic failure were extracted. RESULTS Twenty-five studies describing 2 unique robots met inclusion criteria. Of these, 22 studies evaluated accuracy of spinal instrumentation. Although grading of pedicle screw accuracy was variable, the most commonly used method was the Gertzbein and Robbins system of classification. In the studies using the Gertzbein and Robbins system, accuracy (Grades A and B) ranged from 85% to 100%. Ten studies evaluated radiation exposure during the procedure. In studies that detailed fluoroscopy usage, overall fluoroscopy times ranged from 1.3 to 34 seconds per screw. Nine studies examined the learning curve for the surgeon, and 12 studies described causes of robotic failure, which included registration failure, soft-tissue hindrance, and lateral skiving of the drill guide. CONCLUSIONS Robotics in spine surgery is an emerging technology that holds promise for future applications. Surgical accuracy in instrumentation implanted using robotics appears to be high. However, the impact of robotics on radiation exposure is not clear and seems to be dependent on technique and robot type.
Patient-reported quality-of-life outcomes after de-escalated chemoradiation for human papillomavirus-positive oropharyngeal carcinoma: Findings from a phase 2 trial.

Background The current study represents a subset analysis of quality-of-life (QOL) outcomes among patients treated on a phase 2 trial of de-escalated chemoradiation for human papillomavirus (HPV)-associated oropharyngeal cancer. Methods Eligibility included newly diagnosed, (American Joint Committee on Cancer, 7th edition) stage III or IV oropharyngeal squamous cell carcinoma, p16 positivity, age ≥ 18 years, and a Zubrod performance status of 0 to 1. Treatment was induction paclitaxel at a dose of 175 mg/m2 and carboplatin at an area under the curve of 6 for 2 cycles followed by response-adapted, dose-reduced radiation of 54 Gy or 60 Gy with weekly concurrent paclitaxel at a dose of 30 mg/m2 . The University of Washington Quality of Life (UW-QOL) and the Functional Assessment of Cancer Therapy-Head and Neck questionnaires were used to assess patient-reported QOL as a secondary endpoint. Results A total of 45 patients were registered, 40 of whom completed QOL surveys and were evaluable. Nadirs for overall UW-QOL and Functional Assessment of Cancer Therapy-Head and Neck scores were reached at 4 weeks after treatment but returned to baseline at 3 months. Nearly all functional indices returned to baseline levels by 6 to 9 months. The mean overall UW-QOL score was 71.6 at baseline compared with 70.8, 73.0, 83.3, and 81.1, respectively, at 3 months, 6 months, 1 year, and 2 years after therapy. The percentage of patients rating their overall QOL as "very good" or "outstanding" at 6 months, 1 year, and 2 years using the UW-QOL was 50%, 77%, and 84%, respectively. Conclusions This de-escalation regimen achieved QOL outcomes that were favorable compared with historical controls. These results serve as powerful evidence that ongoing de-escalation efforts lead to tangible gains in function and QOL. Cancer 2018;124:521-9. © 2017 American Cancer Society.
Anatomic Customization of Root-Analog Dental Implants With Cone-Beam CT and CAD/CAM Fabrication: A Cadaver-Based Pilot Evaluation

Existing root-analog dental implant systems have no standardized protocols regarding retentive design, surface manipulation, or prosthetic attachment design relative to the site's unique anatomy. Historically, existing systems made those design choices arbitrarily. For this report, strategies were developed that deliberately reference the adjacent anatomy, implant and restorable path of draw, and bone density for implant and retentive design. For proof of concept, dentate arches from human cadavers were scanned using cone-beam computed tomography and then digitally modeled. Teeth of interest were virtually extracted and manipulated via computer-aided design to generate root-analog implants from zirconium. We created a stepwise protocol for analyzing and developing the implant sites, implant design and retention, and prosthetic emergence and connection all from the pre-op cone-beam data. Root-analog implants were placed at the time of extraction and examined radiographically and mechanically concerning ide...
CATHETER ABLATION VESUS RATE CONTROL IN ATRIAL FIBRILLATION AND HEART FAILURE WITH REDUCED EJECTION FRACTION

Atrial Fibrillation (AF) and Heart Failure with Reduced Ejection Fraction (HFrEF) impact each other's prognosis negatively. The effect of catheter ablation (CA) of AF in patients with HFrEF when compared to conventional treatment remains controversial. A meta-analysis of randomized controlled
Technology effectiveness in the mathematics classroom: a systematic review of meta-analytic research

The purpose of this systematic review was to examine trends in prior meta-analytic research to provide recommendations for future mathematics education research and instructional praxis. The current study aims to contextualize the effects of technology-enhanced instruction in the mathematics classroom. The researchers conducted a comprehensive literature search of articles written between 1980 and 2015. The final pool of studies comprised 18 meta-analyses inclusive of studies conducted between 1986 and 2014, representing 1193 independent effect sizes. The results suggest that the effects of technology on mathematics achievement range from small to large. Results suggest that researchers and educators should consider grade level, duration, and the instructional role of technology as key components when incorporating technology in the mathematics classroom. Results also suggest that race, socioeconomic status (SES), and gender did not moderate the effects of technology integration, although they were examined less frequently across studies. Implications are provided for practice, and research related to these results. Because of the chosen research approach, the research results provide relevant and practical implications to support classroom teaching with technology. This study contributes to the literature on technology-enhanced mathematics instruction by providing synthesis of 30 years of meta-analytic research.
Risk Factors for Intraarticular Heterotopic Bone Formation in the Temporomandibular Joint in Juvenile Idiopathic Arthritis

Objective Intraarticular corticosteroid (IAC) injections are often used to treat temporomandibular joint (TMJ) arthritis associated with juvenile idiopathic arthritis (JIA). One potential complication of IA therapy is heterotopic bone formation (HBF). The purpose of our study was to evaluate risk factors for HBF development in children with JIA who received IA therapy for TMJ arthritis. Methods This was a retrospective study of children with JIA who had received ≥ 1 IAC injection into the TMJ. Survival regression analysis was performed to identify risk factors for the development of HBF. Results There were 238 children included, of whom 33 (14%) developed HBF. No cases of HBF were diagnosed prior to the initial injection. Univariate analysis revealed that the risk factors for development of HBF were the total number of injections received into the TMJ and age at diagnosis of JIA, while the length of time from diagnosis of JIA to the first injection was inversely associated with the risk of HBF formation. The total number of injections was no longer significant following adjusted survival models. Children with HBF had increased physical examination evidence of acute or chronic changes, namely decreased maximal incisal opening and increased likelihood of jaw deviation. Conclusion HBF within the TMJ is relatively common in patients with JIA receiving IAC injections for TMJ arthritis. Future prospective studies are required to delineate the risks posed by the injections themselves as opposed to the underlying disease activity, as well as to evaluate alternative forms of local therapy to the TMJ.
Abstract 11603: Structural Insights Into C-terminus and N-terminus of a Designer cGMP Activating ANP-Based Antihypertensive Peptide: ZD100

Introduction: As importantly underscored by the SPRINT Trial, innovative blood pressure (BP) lowering and multiorgan protective drugs are needed for treating hypertension (HTN). We engineered a Mayo Clinic designer atrial natriuretic peptide (ANP)-based drug, ZD100, which possesses a unique 12 amino acid (AA) carboxy-terminus (CT) extension while maintaining the N-terminus (NT) of ANP. ZD100 is more potent than ANP in reducing BP, inducing natriuresis and inhibiting aldosterone via pGC-A and its second messenger cGMP. To date, the in vivo actions of ZD100 in a model of essential HTN are undefined. Further, in attempt to enhance and/or minimize pGC-A activation, the importance of specific AAs in the CT and NT of ZD100 is unknown and is critical to define. Hypothesis: We hypothesize that ZD100 is a potent anti-HTN drug activating pGC-A/cGMP system and that specific AA variations in the CT and/or NT of ZD100 will modify the ability of activating pGC-A. Methods: Spontaneously hypertensive rats (SHRs) received intravenous (IV) ZD100 or vehicle and BP, plasma and urinary cGMP and the natriuretic effects were determined. We then engineered 15 strategic ZD100 variants (Vs) consisting of mutated peptides in the CT or NT or both. We stimulated HEK293 cells overexpressing pGC-A with ZD100 and the 15 Vs (10-8 M) and measured intracellular cGMP generation. Results: In SHRs, acute IV ZD100 reduced BP, increased plasma and urinary cGMP generation and induced natriuresis demonstrating efficacy in HTN. In vitro, we found two more potent pGC-A activators (+100% cGMP activation) only among the CT-only mutated ZD100 Vs. Importantly, key mutations of either the CT or NT resulted in 6 loss-of-function Vs identifying importance of peptide-receptor dependency. Conclusions: We demonstrate for the first time in a genetic model of HTN that ZD100 reduces BP, activates systemic and renal pGC-A/cGMP and induces natriuresis. Enhanced or reduced pGC-A activation with targeted AA mutations in the CT and NT of ZD100 provides key structure function insights into ZD100 which may lead to next generation ZD100 therapeutic peptides. These findings support ZD100 as a novel peptide therapeutic strategy for HTN and will help guide the selection of best-in-class ZD100 analogues.
Toward developing an applied framework to help foster success in generational transition of family businesses

Family business is a critical component of most economies worldwide as a majority of businesses are either owned or managed by family members. The transfer of ownership across generations that will...
Kinesiology Gets Moving! The NAKHE Leadership Development Workshop Goes Outside

In 2010, The National Association of Kinesiology in Higher Education (NAKHE) began a summer program to develop leadership in kinesiology professionals. The Leadership Development Workshop (LDW) was...
Cardiopulmonary exercise test indices of respiratory buffering before and after aerobic exercise training in women with pulmonary hypertension: Differentiation by magnitudes of change in six-minute walk test performance.

Abstract While aerobic exercise training (AET) has generally been shown to improve 6-min walk test (6MWT) distance (6MWD) in patients with pulmonary hypertension (PH), a substantial number of patients appear to adapt differently, with minimal or even negative changes in 6MWT distance being reported. Purpose To compare post-aerobic exercise training adaptations in cardiorespiratory functional capacity across three groups of patients with PH: those with high (HI), low (LI) and negative (NEG) post-training increases in 6MWD. Methods Participants were 25 females (age 54 ± 11 years; BMI 31 ± 7 kg/m2) who completed a vigorous, 10-week, thrice weekly, supervised treadmill walking exercise program. Cardiopulmonary exercise tests (CPET) and 6MWT were completed before and after training. Ten of the 25 participants were classified as HI (range = 47–143 m), 11 were classified as LI (range = 4–37 m) and 4 were classified as NEG (range = −17 to −53 m). Results Peak CPET duration, WR and time to anaerobic threshold (AT) were significantly higher (p Conclusion These findings suggest that sustained ventilatory inefficiency and restricted respiratory buffering may mediate exercise intolerance and impede the ability to adapt to exercise training in some patients with PH.
Stoichiometric oxygen content in Na x Co O 2

The crystal structure and oxygen stoichiometry in two-layer ${\mathrm{Na}}_{0.74}\mathrm{Co}{\mathrm{O}}_{2}$ and ${\mathrm{Na}}_{0.38}\mathrm{Co}{\mathrm{O}}_{2}$ at room temperature are analyzed by powder neutron diffraction. Two sets of diffraction data for each sample, taken at different incident neutron wavelengths, $\ensuremath{\lambda}=1.1968\phantom{\rule{0.3em}{0ex}}\mathrm{\AA{}}$ and $\ensuremath{\lambda}=1.5403\phantom{\rule{0.3em}{0ex}}\mathrm{\AA{}}$, are analyzed simultaneously by the Rietveld method, allowing for the independent refinement of all structural parameters. The fractional oxygen site occupancies are found to be 1.01(1) for ${\mathrm{Na}}_{0.74}\mathrm{Co}{\mathrm{O}}_{2}$ and 0.99(2) for ${\mathrm{Na}}_{0.38}\mathrm{Co}{\mathrm{O}}_{2}$, respectively. These results indicate that the oxygen content of these phases is stoichiometric to a precision of 1 to 2%, and therefore the formal cobalt oxidation state is determined solely by the sodium content. The analysis also reveals that both types of sodium ions in the structure are in off-center distorted trigonal prismatic geometry.
Wideband Rapidly Tunable Delay-Controlled Optoelectronic Oscillator

With the recent advancements in photonic integrated circuits, integrated RF photonics has increasingly been considered as a viable avenue to meet the demands of many emerging applications in telecommunication, sensing and signal processing. In this paper, an integrated, rapidly tunable, wideband optical delay line is used to implement an optoelectronic oscillator that can be continuously tuned from 594 MHz to 634 MHz. The oscillator exhibits a relatively flat modulation response at high frequencies (larger than 400 MHz), accommodating wideband fast frequency chirp generation with applications in radar and imaging. The on-chip variable delay line is characterized by continuously delaying an ultra-wide band 0.5–5 GHz monocycle pulse between 0–100 ps. The photonic integrated chip consists of silicon nanowaveguides, phase modulators, multimode interference coupler, a Mach-Zehnder interferometer, and a photodiode. The chip is fabricated on IME 180 nm Silicon Photonics platform and has an area of 0.55 mm2.
Exploring the Boundaries of Low-Resource BERT Distillation

In recent years, large pre-trained models have demonstrated state-of-the-art performance in many of NLP tasks. However, the deployment of these models on devices with limited resources is challenging due to the models’ large computational consumption and memory requirements. Moreover, the need for a considerable amount of labeled training data also hinders real-world deployment scenarios. Model distillation has shown promising results for reducing model size, computational load and data efficiency. In this paper we test the boundaries of BERT model distillation in terms of model compression, inference efficiency and data scarcity. We show that classification tasks that require the capturing of general lexical semantics can be successfully distilled by very simple and efficient models and require relatively small amount of labeled training data. We also show that the distillation of large pre-trained models is more effective in real-life scenarios where limited amounts of labeled training are available.
Monitoring and Application of Low-voltage Distribution Network Leakage Protector Based on Internet of Things

In view of the problems existing in the operation management of low-voltage distribution network leakage protectors, the “cloud-pipe-side-end” idea is adopted, based on the intelligent deployment of modular TTU, a low-voltage distribution network based on the Internet of Things is proposed System architecture, designed the configuration and monitoring scheme of the leakage protector based on the Internet of Things, to achieve remote centralized monitoring of the total leakage protection, intermediate leakage protection and user leakage protection status of the station area; according to the leakage protection monitoring status and the monitoring of the branch and user perception unit of the station area Information, realize the intelligent perception of low-voltage distribution network and the research and judgment of low-voltage faults, and give the actual application situation of under-report monitoring based on the Internet of Things in Hubei area, thereby shortening the time of fault detection and improve the level of operation, maintenance and management.
Type 1 diabetic Akita mice have low bone mass and impaired fracture healing.

Abstract Type 1 diabetes (T1DM) impairs bone formation and fracture healing in humans. Akita mice carry a mutation in one allele of the insulin-2 (Ins2) gene, which leads to pancreatic beta cell dysfunction and hyperglycemia by 5–6 weeks age. We hypothesized that T1DM in Akita mice is associated with decreased bone mass, weaker bones, and impaired fracture healing. Ins2 ± (Akita) and wildtype (WT) males were subjected to femur fracture at 18-weeks age and healing assessed 3–21 days post-fracture. Non-fractured left femurs were assessed for morphology (microCT) and strength (bending or torsion) at 19–21 weeks age. Fractured right femurs were assessed for callus mechanics (torsion), morphology and composition (microCT and histology) and gene expression (qPCR). Both Akita and WT mice gained weight from 3 to 18 weeks age, but Akita mice weighed less starting at 5 weeks (−5.2%, p
Initial experience using a handheld fully articulating software-driven laparoscopic needle driver in TAPP inguinal hernia repair

The laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair is a widely performed minimally invasive operation, but can present considerable ergonomic challenges for the surgeon. Our objective was to determine if a novel handheld software-driven laparoscopic articulating needle driver can mitigate these difficulties. The video recordings of a consecutive series of TAPP cases by a single surgeon using the articulating device were compared with a series of cases using straight-stick laparoscopy. Two critical steps of the procedure were analyzed for time: mesh fixation and peritoneal suture closure. These steps were then compared before and after 10 initial consecutive cases to analyze whether the surgeon demonstrated improvement. A cost analysis was also performed between the two techniques. For mesh fixation, the surgeon averaged 227 s using tacker devices, compared with 462.4 s using the novel laparoscopic device (p = 0.06). For the peritoneal closure component of the operation, the surgeon improved the time per suture pass during closure from 60.61 s during the first 10 cases to 38.84 s after the first 10 cases (p = 0.0004), which was comparable to the time per stitch for standard laparoscopy (34.8 s vs 34.84 s, p = 0.997). Left-sided inguinal hernia repairs using the articulating device demonstrated a significantly longer time per stitch during peritoneal closure compared to the right side after first 10 cases (left: 40.62 s; right: 27.91, p = 0.005). Our direct cost analysis demonstrated that suture closure of the peritoneum using the articulating device was more cost-effective than tack fixation. After only a 10 case initial experience, a laparoscopic hand-held articulating needle driver is comparable to standard laparoscopy to complete suture mesh fixation and peritoneal closure for TAPP inguinal hernia repair. Further, the feasibility of suture mesh fixation minimizes the need for costly tacker devices. This instrument appears to be a promising tool in this largely minimally invasive era of hernia repair.
Geographic differences in contraception provision and utilization among federally funded family planning clinics in South Carolina and Alabama.

PURPOSE Access to the full range of contraceptive options is essential to providing patient-centered reproductive health care. Women living in rural areas often experience more barriers to contraceptive care than women living in urban areas. Therefore, federally funded family planning clinics are important for ensuring women have access to contraceptive care, especially in rural areas. This study examines contraceptive provision, factors supporting contraceptive provision, and contraceptive utilization among federally funded family planning clinics in 2 Southern states. METHODS All health department and Federally Qualified Health Center clinics in Alabama and South Carolina that offer contraceptive services were surveyed in 2017-2018. Based on these surveys, we examined differences between rural and urban clinics in the following areas: clinic characteristics, services offered, staffing, staff training, policies, patient characteristics, contraceptive provision, and contraceptive utilization. Differences were assessed using Chi-square tests of independence for categorical variables and independent t-tests for continuous variables. FINDINGS Urban clinics had more staff on average than rural clinics, but rural clinics reported greater ease in recruiting and retaining family planning providers. Patient characteristics did not significantly vary between rural and urban clinics. While no significant differences were observed in the provision of long-acting reversible contraceptives (LARCs) overall, a greater proportion of patients in urban clinics utilized LARCs. CONCLUSIONS While provision of most contraceptives is similar between rural and urban federally funded family planning clinics, important differences in other factors continue to result in women who receive care in rural clinics being less likely to choose LARC methods.
Impact of Engineering Features on Double Shell Implosions on the NIF

Double shell targets1 on the National Ignition Facility (NIF) provide for an alternative path to a high yield experiment compared to the single shells. The concept of the design is that through kinetic energy transfer between an outer ablator and inner pusher, conditions needed for robust burn can be achieved with a lower convergence ratio and internal temperature compared to a single shell. Due to the multilayer construction of the target, features that can perturb any of the multiple layers of the capsule and degrade target performance are a concern. Understanding the mechanics of these degradations and ways to prevent them is extremely important for a successful design.
DoAR: An Augmented Reality Based Door Security Prototype Application.

The advent of massive technological paradigm shift to subsequent interest in augmented reality (AR) paved the way for designers to design, develop and deploy new use cases of AR in the service industry. In this paper, we investigate the use of augmented reality as an option for providing entry into secured buildings by comparing it against the traditional radio frequency identification devices cards. 51 participants from various backgrounds were recruited to enter a secured building using an AR-based app and an RFID card. The results stipulate that AR-based app had a greater acceptance among participants in terms of security and ease of use. 40 participants thought AR-based app is more secure than RFID cards and 34 participants felt the application was easier to use compared to RFID cards. 32 participants indicated that they would prefer to use the AR-based on daily basis. The result only came short in favor of RFID-based systems in terms of faster access with a margin of 3 persons where RFID systems outperformed AR-Based systems. The results indicate that the system is a suitable option but further research is needed to deploy the research in real-world settings.
Medical education in the United States: do residents feel prepared?

Background Medical schools face a growing challenge in providing a comprehensive educational experience. Students must graduate with not only the medical knowledge but also the requisite skills to care for patients and serve as physicians-in-training.
Global Climate Change Control: Is There a Better Strategy than Reducing Greenhouse Gas Emissions

Many environmentalists and some developed nations appear to have concluded that there is one Many environmentalists and some developed nations appear to have concluded that there is one climate change problem, global warming, and that there is only one solution to it, reducing greenhouse gas emissions, usually through the Kyoto Protocol. This paper argues instead that there are actually four major inter-related problems and concludes that several different approaches, including engineered climate selection, would be required to solve all of them. Although some measures can address certain climate change problems, none can address all of them. The paper first reviews the four major climate change problems, analyses whether the most prominent of the greenhouse gas control approaches (the Kyoto Protocol) is likely to be either effective or efficient in solving them, and then analyses both management and technological alternatives to this approach. The paper concludes that the most efficient and effective approach would be to actively pursue both engineered climate selection approaches involving radiative forcing using stratospheric particles optimized for this purpose as well as a new effort to reduce ocean acidification, with immediate priority given to the former in order to solve all the non-ocean acidification problems quickly while the more difficult, much slower, and much more costly effort to reduce ocean acidification is analyzed and carried out. This two-fold approach could be used to rapidly reduce the risks from adverse feedback/tipping point problems from global warming and from global cooling from major volcanic eruptions, and to rapidly stabilize average global temperatures at any desired level. This should also allow a little time for a new effort to better understand ocean acidification and design and carry out a careful program to reduce it directly, or possibly to decrease the carbon dioxide levels themselves to the extent that this is the most effective and lowest cost approach. If the latter, this should result in the lowest possible costs of carbon dioxide control by stretching out the period in which they would be made given the sensitivity of the costs of carbon dioxide emissions reductions to the rapidity with which they occur.
Effect of Number of Measurement Locations in the Implementation of Iterative Wavenumber Fitting for Viscoelastically Damped Structures

The work presented here is an experimentally-based parametric study of a layered viscoelastically-damped system containing intermediate structural fasteners. The effect of fastener preload, fastener location and the number of fasteners on the loss factor are examined. The loss factor is found to change by as much as 22% with change in some of these parameters. Two different approaches are used to measure loss factor. The first method uses the internal algorithm from a signal analyzer. The second method is an iterative algorithm that estimates the complex wavenumber, which is then used to find the damping loss factor. An advantage of the latter technique is the ability to measure loss factor over a range of frequencies. This research also investigates the effect of the number of measurement positions on the accuracy of loss factor. It is shown that the accuracy has a strong dependence on the number of measurement locations, particularly at low frequencies.
Improved Anticoagulation with a Weight-Adjusted Heparin Nomogram in Patients with Acute Coronary Syndromes: A Randomized Trial.

The optimal heparin dosing schedule to achieve rapid and therapeutic anticoagulation has not been established. The objective of this study is to determine whether an intravenous heparin dosing nomogram based on body weight achieves adequate anticoagulation more rapidly than a standard-care nomogram. Sixty-four patients requiring intravenous heparin treatment for acute coronary syndromes, but who did not receive thrombolytic therapy, were randomized to a standard-care nomogram in which heparin was given as a 5000 unit IV bolus followed by 1000 U/hr, or a weight adjusted nomogram in which heparin was given as an 80 U/ kg IV bolus and 18 U/kg/hr. Activated partial thromboplastin time (APTT) values were checked at 6,12,18, 24, and 48 hours and adjusted either by 100–200 U/hr (standard-care nomogram) or by 2–4 U/kg/hr (weight-based nomogram). Activated partial thromboplastin times were measured using a widely generalizable laboratory method. The primary goal was to achieve and maintain the APTT between 60 and 90 seconds. The median APTT values were higher in the weight adjusted group compared with the standard-care group at 6, 12, 18, 24, and 48 hours: 150 versus 83 (p=0.001), 100 versus 79 (p=0.09), 66 versus 61 (p=0.005), 63 versus 56 (p = 0.09), and 64 versus 56 (p=0.11). At 18 hours only 11% of patients in the weight-adjusted group had an APTT <61 compared with 26% in the standard-care nomogram (p=0.007). No major bleeding complications were noted in either group. A weight-adjusted heparin nomogram offers improved anticoagulation in the first 24 hours after heparin initiation compared with a standard-care nomogram in patients with acute coronary artery syndromes.