cssi/SciSciGPT-SciSciNet huggingface dataset:
Bayesian Inference in Mixtures-of-Experts and Hierarchical Mixtures-of-Experts Models with an Application to Speech Recognition

Abstract Machine classification of acoustic waveforms as speech events is often difficult due to context dependencies. Here a vowel recognition task with multiple speakers is studied via the use of a class of modular and hierarchical systems referred to as mixtures-of-experts and hierarchical mixtures-of-experts models. The statistical model underlying the systems is a mixture model in which both the mixture coefficients and the mixture components are generalized linear models. A full Bayesian approach is used as a basis of inference and prediction. Computations are performed using Markov chain Monte Carlo methods. A key benefit of this approach is the ability to obtain a sample from the posterior distribution of any functional of the parameters of the given model. In this way, more information is obtained than can be provided by a point estimate. Also avoided is the need to rely on a normal approximation to the posterior as the basis of inference. This is particularly important in cases where the posteri...
An Overview of the 2004 Workshop on Perceptual Organization in Computer Vision

The 2004 Workshop on POCV emphasized novel, far-reaching ideas in PO rather than extensive experimental validation. This was intended to stimulate more discussion and debate than is typically feasible at a conference such as CVPR. We facilitated this goal by emphasizing novelty and relevance in the reviewing process. Circular reviewing, in which authors reviewed papers, also improved review quality. CVPR authors in PO-related areas were encouraged to submit related, but more advanced (and perhaps unproven) research to POCV. Although this was only marginally successful, it was intended to avoid the common situation where the workshop is primarily a forum for papers rejected from CVPR, while CVPR-accepted papers are not represented at the workshop.
Rheological characterization and analysis of a bismaleimide matrix

Presentation d'un modele rheologique inspire du modele de Williams, Landel et Ferry decrivant le comportement visqueux d'une matrice de resine maleimide modele au cours d'un durcissement et utilisable pour la preimpregnation et le durcissement de composites
Efficiency of pump absorption in double-clad fiber amplifiers. III. Calculation of modes

Using an analogy with quantum mechanics we employ a technique that enables us to calculate the efficiency of an incoherent pump in general-geometry double-clad fibers. This approach yields accurate estimates of the absorption rate of each mode of the pump in the first order of perturbation theory. Such estimates are compared with results of numerical simulations reported recently. The comparison confirms the high efficiency of a spiral-shaped cladding.
Building Toward Major Policy Change: Congressional Action on Civil Rights, 1941–1950

The mid-1960s witnessed a landmark change in the area of civil rights policy in the United States. After a series of tortuous internal battles, with Southern legislators using all available procedural tools to maintain their states' discriminatory Jim Crow legal systems, the United States Congress adopted two statutes—the Civil Rights Act of 1964 and the Voting Rights Act of 1965—which insured civil and political equality for all Americans. The Acts of 1964 and 1965 were the culmination of a decade-long struggle by black Americans to secure the citizenship rights that had been denied to them for more than a half century. Beginning with the Brown v. Board of Education (1954) Supreme Court decision, the civil rights movement built momentum, as formal organizations like the National Association for the Advancement of Colored People (NAACP) grew in strength and informal (grass roots) organizations spread throughout the South and the Nation. As national public opinion shifted increasingly toward providing new civil rights guarantees for blacks, Congress responded with new legislation: the Civil Rights Act of 1957 (the first civil rights law since 1875), the Civil Rights Act of 1960, and a legislative proposal to prohibit the poll tax in 1962 (which would be ratified by three-quarters of the states in 1964 and become the 24th Amendment to the United States Constitution).
Integrins activate trimeric G proteins via the nonreceptor protein GIV/Girdin

Signal transduction via integrins and G protein-coupled receptors is critical to control cell behavior. These two receptor classes have been traditionally believed to trigger distinct and independent signaling cascades in response to extracellular cues. Here, we report a novel mechanism of integrin signaling that requires activation of the trimeric G protein Gαi by the nonreceptor guanine nucleotide exchange factor (GEF) GIV (also known as Girdin), a metastasis-associated protein. We demonstrate that GIV enhances integrin-dependent cell responses upon extracellular matrix stimulation and makes tumor cells more invasive. These responses include remodeling of the actin cytoskeleton and PI3K-dependent signaling, resulting in enhanced haptotaxis and invasion. We show that both GIV and its substrate Gαi3 are recruited to active integrin complexes and that tumor cells engineered to express GEF-deficient GIV fail to transduce integrin signals into proinvasive responses via a Gβγ-PI3K axis. Our discoveries delineate a novel mechanism by which integrin signaling is rewired during metastasis to result in increased tumor invasiveness.
Children's Environmental Health: A Brief History.

Abstract Background Children's environmental health (CEH), the branch of pediatrics that studies the influence of the environment on children's health, has grown substantially in the past 3 decades and become an increasingly visible and important component of pediatric medicine. Goals To trace the historical origins of CEH; to identify factors responsible for its recent growth. Findings CEH has historical roots in toxicology, epidemiology, and occupational medicine. It arose in the second half of the 20th century through a melding of insights from pediatric toxicology, nutritional epidemiology, and social science research. Convergent research in these 3 fields has documented children's unique sensitivities to chemical, nutritional, and psychosocial hazards during windows of vulnerability in early development and has shown that early-life exposures can produce disease and disability in childhood and across the life span. Key events in the development of CEH were: 1) formation by the American Academy of Pediatrics in 1957 of a committee on environmental health that has nurtured the growth of the field for 5 decades and evolved into the Council on Environmental Health; 2) observations made in the 1980s that nutritional deficiency in utero increased risk for adult-onset obesity, diabetes, and cardiovascular disease—work that led to the hypothesis of the developmental origins of health and disease; 3) social science research showing that early exposure to psychosocial stress and trauma increases risk for chronic illness; and 4) publication in 1993 by the National Academy of Sciences of a report, Pesticides in the Diets of Infants and Children , which elevated awareness among national policy makers of children's vulnerability to toxic hazards, moved US environmental policy toward protection of children's health, and catalyzed research investment in CEH in the United States and globally. Conclusions CEH has made substantial progress but faces emerging challenges, including new chemicals and pesticides; increasing movement of polluting industries to poor countries where environmental and public health protections are few; and global climate change. In the future, CEH will require continued investment in research and education and will need to adopt an increasingly global perspective.
Decoding hepatocellular carcinoma: the promise of microRNAs

MicroRNAs (miRNAs) may play an important role in the development and progression of hepatocellular carcinoma (HCC). Understanding the mechanism of specific miRNAs may provide opportunity for development of biomarkers and novel therapeutics in hepatocellular carcinoma which are desperately needed.
The Role of the Team Physician and Athletic Trainer, Including Non-operative Management

In order for a patient to receive a timely diagnosis of sports hernia or athletic pubalgia, athletic trainers and physicians must be mindful of the signs and symptoms of this frustrating entity. Once the physician confirms the diagnosis, athletic trainers provide the first line of treatment by attempting non-operative management of the condition. The design of the rehabilitation program should be preceded by a thorough evaluation, which includes a detailed history, postural and flexibility assessment, and dynamic movement screen. For the best possible outcome, the conservative treatment plan should combine both passive and active therapies. Passive therapies include rest, physical therapy modalities, and manual therapy. Physicians may also prescribe oral anti-inflammatories or varying types of local injections to assist in decreasing pain and inflammation. Active therapies should focus on restoring range of motion, improving motor control, increasing core stability, and correcting muscular imbalances or deficits. A rehabilitation progression is provided based on the current evidence in the literature as well as the authors’ clinical experience. While a number of factors play into the decision, surgical management of sports hernia should not be considered until a patient fails to improve despite attempting a multi-faceted rehabilitation program.
Exploiting the facile release of trifluoroacetate for the α-methylenation of the sterically hindered carbonyl groups on (+)-sclareolide and (-)-eburnamonine.

An efficient method for the α-methylenation of carbonyl groups is reported, and this transformation is accomplished by a facile elimination of trifluoroacetate during the formation of the olefin. This method represents an improvement beyond existing protocol in cases of steric hindrance, and we have demonstrated the utility of the process across a series of ketones, lactams, and lactones. Additionally, we have applied this method to produce semisynthetic derivatives of the natural products (+)-sclareolide and (−)-eburnamonine, in which the carbonyl group is proximal to bulky functional groups. Mechanistic insight is also provided from a time course of 19F NMR. Biological evaluation of the natural-product-derived enones led to the identification of a derivative of (−)-eburnamonine with significant cytotoxicity (LC50 = 14.12 μM) in drug-resistant MDA-MB-231 breast cancer cells.
Genetics of Febrile Seizures

The genetics of febrile seizures (FS) are reviewed by members of the Department of Pediatrics, Fukuoka University; Department of Neuropsychiatry, Hirosaki University, Japan; and National Institutes of Health, Research Triangle Park, NC, USA.
Thyroid Hormones and Timing of Pubertal Onset in a Longitudinal Cohort of Females, Northern California, 2006-11.

BACKGROUND Pubertal timing is regulated by a complex interplay of hormones. Few studies have evaluated the role of thyroid hormones in pubertal onset. We investigated the associations between blood concentrations of free and total thyroxine (FT4, TT4), free triiodothyronine, and thyroid stimulating hormone and pubertal onset among females. METHODS Participants included 323 Kaiser Permanente Northern California members followed at annual intervals during 2004-11, who provided a blood sample during the first 3 years of the study. Thyroid hormone concentrations were measured in serum in the first blood specimen available for each participant. Pubertal onset was defined as Tanner stage ≥2 for breast (thelarche) and pubic hair (pubarche) development. Associations between thyroid hormones and pubertal onset were assessed by multivariable logistic regression and Cox proportional hazards modelling. RESULTS At blood draw, participants were age 6.5-10.1 (median 7.7) years, 10% had reached thelarche, and 12% had reached pubarche. Participants were followed 0-5 years after blood draw (median 4). At most recent clinical visit, participants were age 6.7-14.7 (median 12.3) years, 92% had reached thelarche, and 89% had reached pubarche. No associations were identified between having reached thelarche or pubarche at time of blood draw and thyroid hormones. Examined longitudinally, higher concentrations of pre-pubertal FT4 and TT4 were associated with earlier pubarche (adjusted hazard ratio (HR) 1.41, 95% confidence interval (CI) 1.06, 1.86; per ng/dL and aHR 1.07, 95% CI 1.02, 1.12; per μg/dL respectively). CONCLUSIONS Higher pre-pubertal concentrations of FT4 and TT4 are associated with earlier pubarche.
Analysis on the relationship between PM2.5 concentration in ambient air and hospital outpatients with respiratory diseases in Chengdu

Objective The aim of this study was to analyze the relationship between PM2.5 concentration(particulate matter ≤ 2.5microm in aerodynamic diameter) and the visits of hospital outpatients with respiratory diseases in Chengdu. Methods The daily visiting frequencies of hospital outpatients with respiratory diseases from three general hospitals in Chengdu and the weather data as well as the air pollution information were collected from January 1st, 2013 to December 31 st, 2013. A generalized additive model with Poisson distribution was used to estimate the relationship between 10 μg/m3 increases in PM2.5 exposures and the visits of hospital outpatients with respiratory diseases for different lag periods. Results During the study period, the average annual concentration of PM2.5 in Chengdu was 96.9 μg/m3. The visit number of hospital outpatients with respiratory diseases was significant correlated with multiple air pollutants(SO2、NO2、CO、PM2.5、PM10) by Spearman rank correlation analysis(P0.05). Generalized additive model was applied and adjusted for weather conditions, day of the week and holiday effects. A 10 μg/m3 increment of PM2.5 on lag-day one corresponded to a 0.58%(95%CI: 0.32%~0.84%) increase in total visit number of hospital outpatients with respiratory diseases. Conclusion This study provided evidence suggesting that the current air pollution levels had an adverse effect on the health of respiratory system. The results may help guide future monitoring and emission-control polices to prevent and reduce health impact of PM2.5.
Applications of signal multiplexing in fiber optic-based acoustic and seismic sensors

Fiber optic systems are deployed in a variety of settings as strain sensors to locate small disturbances along the length of the optical fiber cable, which is often tens of kilometers long. This technology has the advantages of low cost and design simplicity, as the sensor is its own source of telemetry and may be easily repaired or replaced. One of the limitations of current technology is noise from optical backscatter events in the fiber resulting in a degraded signal in individual spatial zones leading to signal fading. Detection within these zones along the length of the fiber is then obscured. Signal multiplexing may be used to increase sensitivity and signal-to-noise ratio and reduce signal fading. In such an architecture, multiple channels are multiplexed together and transmitted along the fiber. In this article, we report on results from two different systems that were tested using such techniques. Results are then compared with a single channel system.
Abnormal Neck Veins

A woman in her 50s was admitted after several months of progressive dyspnea on exertion and severe lower extremity edema. She had undergone aortic valve replacement for aortic stenosis, 2-vessel coronary artery bypass, and permanent pacemaker placement 1 year before presentation. She had a history of mantle chest radiotherapy for Hodgkin lymphoma at age 17 years, which was curative. After successful intravenous diuresis, neck examination at approximately 60° (Figure 1A andVideo) revealed a regular carotid pulsationanddiscernible internal jugular venouspulse.After examination of the neck at rest, the patient took a small breath and held it for a few seconds.Hemodynamicdata at left and rightheart catheterizationare shown in Figure 1B. Video at jamacardiology.com WHAT IS YOURDIAGNOSIS? A. Tamponade B. Myocardial restriction C. Right ventricular failure D. Wide-open tricuspid regurgitation 120 160
Abstract 3786: Novel regulation of cyclin D1 stability and the DNA damage response

Deregulation of the cell division cycle is critical for cancer development. Transition from G1 to S phase of the cell cycle is promoted by D-type cyclins (D1, D2 and D3). Cyclin D1 is a critical regulator of cell cycle progression due to its ability to activate cyclin dependent kinases (CDK) 4 and 6, which phosphorylate and inactivate the retinoblastoma protein (pRb) and activates the transcription factor E2F1 to promote the expression of genes essential for G1/S progression. Importantly, mutations in the tumor suppressor gene RB1 or inactivation of the RB tumor suppressor pathway occurs in almost all human malignancies and one such mechanism involves cyclin D1 overexpression. Even in cancer cells with amplified or elevated cyclin D1 mRNA, the Cyclin D1 protein rapidly declines as cells progress through the G1 phase of the cell cycle to reach undetectable levels in S-phase, and this is thought to be dependent on the Skp1-Cul1-F-box protein (SCF) E3 ubiquitin ligase complex. The identity of the E3 ubiquitin ligase that is specifically involved in downregulating cyclin D1 during S-phase of the cell cycle or the functional significance of cyclin D1 downregulation however, remains unknown, as recent genetic studies in mice demonstrated that the steady state levels or stability of cyclin D1 protein, are not altered following the inactivation of the known regulators of cyclin D1 stability. Using a genetic si-RNA-based screen, we have identified a novel E3 ubiquitin ligase; SCF-FBXW5, which specifically interacts with and downregulates cyclin D1 protein, both in unperturbed proliferating cancer cells and following DNA damage. Importantly, inactivation of this E3 ubiquitin ligase inhibits the proliferation of cancer cells primarily through cyclin D1-dependent inhibition of S-phase progression and sensitizes cancer cells to DNA damage induced by UV or ionizing radiation. These findings identify a novel axis of regulating cyclin D1 stability in cancer cells with implications for targeting this axis to inhibit cyclin D1-driven cancers. Citation Format: Fadila Guessous, Jinho Heo, Naga Vaddadi, Tarek Abbas. Novel regulation of cyclin D1 stability and the DNA damage response. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3786. doi:10.1158/1538-7445.AM2015-3786
Team-Based Care: A Concept Analysis.

AIM The purpose of this concept analysis is to clarify and analyze the concept of team-based care in clinical practice. BACKGROUND Team-based care has garnered attention as a way to enhance healthcare delivery and patient care related to quality and safety. However, there is no consensus on the concept of team-based care; as a result, the lack of common definition impedes further studies on team-based care. METHODS This analysis was conducted using Walker and Avant's strategy. Literature searches were conducted using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO, with a timeline from January 1985 to December 2015. RESULTS The analysis demonstrates that the concept of team-based care has three core attributes: (a) interprofessional collaboration, (b) patient-centered approach, and (c) integrated care process. This is accomplished through understanding other team members' roles and responsibilities, a climate of mutual respect, and organizational support. Consequences of team-based care are identified with three aspects: (a) patient, (b) healthcare professional, and (c) healthcare organization. CONCLUSION This concept analysis helps better understand the characteristics of team-based care in the clinical practice as well as promote the development of a theoretical definition of team-based care.
Situation-Aware Community Computing Model for Developing Dynamic Ubiquitous Computing Systems

For many complex and dynamic ubiquitous services, context-aware cooperation can be a solution. However, the way is not yet clear to make individual objects cooperate with each other as situations change. In addition, in the present environment in which many smart agents are already deployed, we are able to quickly develop ubiquitous services by utilizing existing agents. In the case of urgent but unavailable services, such fast development is required but there is no existing work to provide a path. To meet such requirements, in this paper, we thus introduce community computing as a new paradigm in which ubiquitous services are provided through context-aware cooperation among existing agents. To design such systems intuitively, we propose an abstraction model, called the situation-aware community computing model which includes the community situation model and the situation-aware cooperation model. In addition, for fast and convenient system development, we propose a development process based on the MDA (Model-Driven Architecture) approach (OMG, 03). Following the development steps of MDA, we propose three models each having different abstraction levels and the model transformation process from the high-level model, CCM, to the source code. To make such transformation semi-automatic, we develop a toolkit, called CDTK. By using CDTK, we are able to implement a community computing system conveniently and systematically. To verify the proposed work, we implemented two small systems based on motivated scenarios; CHILDCARE and COEX-Mall. Through the simulated results of those systems, we examined the possibility of community computing as a new development paradigm.
Emerging Metabolic Therapies in Pulmonary Arterial Hypertension

Pulmonary hypertension (PH) is an enigmatic vascular disorder characterized by pulmonary vascular remodeling and increased pulmonary vascular resistance, ultimately resulting in pressure overload, dysfunction, and failure of the right ventricle. Current medications for PH do not reverse or prevent disease progression, and current diagnostic strategies are suboptimal for detecting early-stage disease. Thus, there is a substantial need to develop new diagnostics and therapies that target the molecular origins of PH. Emerging investigations have defined metabolic aberrations as fundamental and early components of disease manifestation in both pulmonary vasculature and the right ventricle. As such, the elucidation of metabolic dysregulation in pulmonary hypertension allows for greater therapeutic insight into preventing, halting, or even reversing disease progression. This review will aim to discuss (1) the reprogramming and dysregulation of metabolic pathways in pulmonary hypertension; (2) the emerging therapeutic interventions targeting these metabolic pathways; and (3) further innovation needed to overcome barriers in the treatment of this devastating disease.
A Noise-Power-Area Optimized Biosensing Front End for Wireless Body Sensor Nodes and Medical Implantable Devices

In this paper, we present a noise, power, and area efficient biosensing front-end application specified integrated circuit (ASIC) for the next-generation wireless body sensor nodes and implantable devices. We identify the key design parameter tradeoffs in the biomedical recording systems and carry out a thorough analysis and optimization to maximize them. Based on our analysis and optimization of the front end, we propose a design methodology for the recording channel that is applicable to various biomedical applications. The ASIC is implemented in a 0.18- $\mu \text{m}$ CMOS process to validate our optimization methodology. The ASIC is reconfigurable to accommodate various biopotentials with the high-pass and low-pass cutoff frequencies being 0.5–300 Hz and 150 Hz–10 kHz, respectively. The low-pass cutoff is provided by an ultralow power $G_{m}$ - ${C}$ low-pass filter, which also acts as an antialiasing filter for the switching-optimized 10-b successive approximation register (SAR) analog-to-digital converter (ADC). The analog front end (AFE) gain is also programmable from 38 to 72 dB. A comprehensive power management unit provides the power supply, multiple reference voltages, and bias currents to the entire chip. The AFE and ADC dissipate only $5.74~\mu \text{W}$ and 306 nW from the on-chip regulators, respectively. The measured input-referred noise is $2.98~\mu \text{V}_{{\text {rms}}}$ , resulting in the noise efficiency factor and power efficiency factor equals 2.6 and 9.46, respectively. The active area of the AFE is 0.0228 mm2. We verify the chip functionality in a number of in vivo and ex vivo biological experiments.
Assessing Screening Guidelines for Cardiovascular Disease Risk Factors using Routinely Collected Data

This study investigates if laboratory data can be used to assess whether physician-retesting patterns are in line with established guidelines, and if these guidelines identify deteriorating patients in a timely manner. A total of 7594 patients with high cholesterol were studied, along with 2764 patients with diabetes. More than 90% of borderline high cholesterol patients are retested within the 3 year recommended period, however less than 75% of pre-diabetic patients have repeated tests within the suggested 1-year time frame. Patients with borderline high cholesterol typically progress to full high cholesterol in 2-3 years, and pre-diabetic patients progress to full diabetes in 1-2 years. Data from routinely ordered laboratory tests can be used to monitor adherence to clinical guidelines. These data may also be useful in the design of adaptive testing strategies that reduce unnecessary testing, while ensuring that patient deterioration is identified in a timely manner. Established guidelines for testing of total serum cholesterol for hypercholesterolemia are appropriate and are well-adhered to, whereas guidelines for glycated hemoglobin A1c testing for type 2 diabetes mellitus could be improved to bring them in line with current practice and avoid unnecessary testing.
Osteoarthritis action alliance consensus opinion - best practice features of anterior cruciate ligament and lower limb injury prevention programs.

Osteoarthritis action alliance consensus opinion - best practice features of anterior cruciate ligament and lower limb injury prevention programs
An Analysis of the Firearms and Related Specimens from Like-A-Fishhook Village and Fort Berthold I

(1955). An Analysis of the Firearms and Related Specimens from Like-A-Fishhook Village and Fort Berthold I. Plains Anthropologist: Vol. 2, No. 4, pp. 3-12.
Effectiveness of Skin-to-Skin Care for Procedure-Related Pain in Newborns.

Skin-to-skin care, also known as kangaroo care, effectively reduces physiologic and behavioral measures of pain in neonates during painful procedures and has no identified adverse effects. Infants who received skin-to-skin care during painful procedures had a heart rate of 10.8 beats per minute less, cried for 34 fewer seconds, and had reduced pain scores immediately following the procedure compared with infants who did not receive skin-to-skin care.
Abstract P5-07-13: MicroRNA-mediated restoration of tamoxifen sensitivity in triple negative breast cancer through modulation of estrogen receptor alpha/beta ratio using Myrothamnus flabellifolius

Triple negative breast cancer (TNBC) represents approximately 20% of all breast cancer cases worldwide. Prognosis for this subtype of cancer is especially dire due to the absence of Estrogen (ER), Progesterone and Human Epidermal Growth Factor receptors, usually targeted by neoadjuvant therapies like Tamoxifen. Myrothamnus flabellifolius (MF), a well-studied South African medicinal herb, has shown significant potency against TNBC with minimal effect on normal cells. In this study, we use miRNA profiling, Ingenuity Pathway Analysis (Qiagen), MTT, immunoblots and immunofluorescence to characterize the targeted cytotoxic mechanism of MF in TNBC. We found deregulation in the expression of several oncogenic and anti-cancer miRNAs in TNBC post MF treatment. Using Ingenuity Pathway Analysis to analyze the miRNA expression profiles of the treated cells, we determined Estrogen Signaling as a pathway significantly affected by MF in TNBC. Immunoblots confirmed increase of the ERa/ERs ratio in TNBC, a well-studied marker for Tamoxifen-therapy sensitivity in TNBC. MTT cell viability assay and Annexin V staining confirmed increased sensitivity to Tamoxifen post treatment with low doses of MF, with up to 70% cell death at half the IC50 of Tamoxifen in TNBC. This study establishes a potential non-toxic therapeutic to supplement Estrogen-receptor targeting therapies in TNBC by increasing the ERa/ERs ratio. The data also evaluates the ERa/ERs ratio as a potential target for combination therapies in TNBC. Citation Format: Fultang N, Klase Z, Mercier I, Peethambaran B. MicroRNA-mediated restoration of tamoxifen sensitivity in triple negative breast cancer through modulation of estrogen receptor alpha/beta ratio using Myrothamnus flabellifolius [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-07-13.
Adaptive appointment scheduling for patient-centered medical homes

Abstract Incorporating patient-centered medical home (PCMH) principles, we develop an adaptive appointment scheduling model for a primary care setting. We propose a simulation optimization approach to sequentially schedule appointments to provide desirable schedules from the perspective of both patients and the medical practices. The objective minimizes the weighted expected cost of patient direct and indirect waiting time, physician idle time, and physician overtime. Our efficient data-driven algorithm considers patient preferences and future appointment requests, while employing overbooking to mitigate patient related uncertainties, such as no-shows and lateness. Benchmarking against myopic and optimal algorithms, computational results show that the adaptive scheduling approach provides significant value. The adaptive method provides considerable cost savings even under conditions of high patient uncertainty. In addition, the method produces high quality solutions in little time, thus providing a viable tool for practice.
Microvascular studies on the origins of perfusion-limited hypoxia

Abstract Two forms of hypoxia are thought to exist in tumours: (1) hypoxia caused by limitations of its diffusion (chronic hypoxia); and (2) hypoxia caused by changes in perfusion (acute hypoxia). Indirect information suggests the existence of perfusion-limited hypoxia, but there is no direct proof that fluctuations in blood flow can lead to hypoxia, nor is there any information regarding potential causes of fluctuant flow. In this study, we have begun to explore these questions using R3230AC tumours transplanted into rat dorsal-flap window chambers. Two types of fluctuant flow have been observed. The first type, usually confined to single vessels, is typified by instability of flow magnitude and direction, and total vascular stasis occurs, but only for a few seconds at a time (4% incidence). The second type of fluctuation occurs in groups of vessels and is cyclic, with cycle times ranging from 20-60 min. Total vascular stasis does not necessarily occur, but the fluctuations in red cell flux are accompanied by changes in vascular oxygen content, as measured by microelectrodes. Another source of chronic hypoxia has also been identified in these experiments. Nine per cent (9%) of vessels examined had plasma flow, but very low or absent red cell flux over periods of many minutes.
Evidence-Based Treatments for Children with Chronic Illnesses

A discussion of the use of evidence-based treatments (EBTs) in children with chronic illnesses presents a problematic but well-known dilemma. Many of the treatments for psychological distress in these children have historically been modified from better-known and validated treatments in children without chronic illness. In other words, what works in children who are not ill has been taken and modified to work with children who are ill. Any discussion of EBTs in children with chronic illness must take into consideration the work that has been done in the non-ill population. We will discuss the general themes, assessments, and interventions that have been discussed in the literature. One of the main overarching themes in pediatric psychology (in which psychological applications are made with children with chronic illnesses) is that psychological difficulties are similar, regardless of setting. When dealing with food refusal, the mental health worker will use similar interventions in children who are healthy and those who have a specific gastrointestinal disorder, such as Crohn‘s disease. Modifications may have to be made, given the unique medical history and care these ill children receive; but overall, the interventions will appear similar. In taking EBTs that have been demonstrated in healthy populations, researchers have had to adapt and modify these interventions. Thus, the literature has only recently begun to report EBTs in children who have chronic illnesses. In order to address the use of EBTs in this population, we will discuss the use of psychological interventions in several broad illness categories, with a view toward the application of these interventions across a range of illnesses.
Looking to the Future of Elderly Sexuality

The field of elderly sexuality has already begun to establish its importance as a clinical domain, but much room remains for progress, education, and advocacy.
Dial Multifactorial for Murder: The Intersection of Genes and Culture

Culture, more than genes, determines rates of murder and other violence. As illustrated by a tragic individual story, genetically influenced psychiatric diseases such as schizophrenia can lead to murder. Also, genes and endocrine factors are predictive. However, explanations of behavior based on these innate factors represent a too-incomplete version of the complex puzzle of behavior, and our incompleteness of understanding is exemplified for severe, rare behaviors such as murder.
Steric Effects of pH Switchable, Substituted (2-pyridinium)urea Organocatalysts: a Solution and Solid Phase Study.

The study of hydrogen bonding organocatalysis is rapidly expanding. Much research has been directed at making catalysts more active and selective, with less attention on fundamental design strategi...
Preliminary analysis of single-nucleotide polymorphisms in IL-10, IL-4, and IL-4Rα genes and profile of circulating cytokines in patients with gastric Cancer

Gastric Cancer is highly prevalent and deadly worldwide. In Colombia, it is the most lethal form of cancer. Some single-nucleotide polymorphisms in IL-10, IL-4, and IL-4Rα genes have been associated with an anti-inflammatory environment and a Th2 profile in detriment of the antitumor Th1 response. This research sought to detect single-nucleotide polymorphisms in promoter sequences, like − 1082 (G/A), − 592 (C/A), and − 819 (C/T), as well as − 590 (C/T) of the IL-10 and IL-4 genes, respectively; in addition to the IL-4Rα mutation variants, Ile50Val and Q576R, together with circulating levels of IL-4, TNF-α, IL-10, and IFN-γ in patients with gastric carcinoma in Cucuta, Colombia. In a cross-sectional study, 17 patients and 30 healthy individuals were genotyped for the six polymorphisms mentioned through PCR-RFLP of DNA obtained from peripheral blood cells and serum samples were analyzed by sandwich ELISA to quantify cytokines. Statistical difference between groups was determined along with the association between the presence of polymorphisms and the risk of gastric cancer, as well as the mortality in patients, using Mann-Whitney U test and logistic regression analysis, respectively. An association between the − 1082 (G/A) and the risk of gastric cancer was found (OR = 7.58, range 0.77–74.06, P = 0.08). Furthermore, patients had a significant increase in IL-4 serum levels (P 0.05). We infer that two possible biomarkers (one immunological and one genetic) could be considered in association with gastric cancer in our population, which should be confirmed by subsequent studies involving a greater number of individuals.
Court-Connected General Civil ADR Programs: Aiming for Institutionalization, Efficient Resolution, and the Experience of Justice

State and federal courts in the U.S. have institutionalized various ADR procedures to resolve general civil (non-family) matters, such as personal injury disputes, contract claims, lawsuits arising out of alleged discrimination or violation of civil rights, etc. This chapter reports the results of interviews with the directors of leading court programs regarding their structural choices in offering mediation and non-binding arbitration. In addition, the chapter considers the implications of available empirical research regarding factors that appear to maximize: the use of court-connected civil ADR programs, the achievement of settlements in such programs, and their provision of fair and just processes. Specifically, the chapter provides guidance regarding: reasons for institutionalizing ADR; who should be involved in the design and implementation of a court’s ADR program; the types of ADR that are suitable for general civil cases; how to promote good program management; how to initiate a program; whether participation should be mandatory or voluntary; statutes, rules and forms that may be drafted; education of judges, court staff, attorneys and others; selecting cases for ADR; different referral systems; the timing of referrals to ADR; who should serve as neutrals; appropriate qualifications and training for neutrals; support and evaluation of neutrals; the roles to be played by parties and their attorneys; ethical rules for parties, judges, and neutrals; planning for the assessment of ADR programs’ effectiveness; procedures for hearing and resolving complaints; and funding a court-connected ADR program.
Life on the thermodynamic edge: Respiratory growth of an acetotrophic methanogen.

Although two-thirds of the nearly 1 billion metric tons of methane produced annually in Earth’s biosphere derives from acetate, the in situ process has escaped rigorous understanding. The unresolved question concerns the mechanism by which the exceptionally marginal amount of available energy supports acetotrophic growth of methanogenic archaea in the environment. Here, we show that Methanosarcina acetivorans conserves energy by Fe(III)-dependent respiratory metabolism of acetate, augmenting production of the greenhouse gas methane. An extensively revised, ecologically relevant, biochemical pathway for acetotrophic growth is presented, in which the conservation of respiratory energy is maximized by electron bifurcation, a previously unknown mechanism of biological energy coupling. The results transform the ecological and biochemical understanding of methanogenesis and the role of iron in the mineralization of organic matter in anaerobic environments.
Explaining What a Neural Network has Learned: Toward Transparent Classification

Deep Neural Networks (DNNs) have limited ability to explain their acquired knowledge or decision rationale. As a result, end-users perceive DNNs as black-boxes and are hesitant to fully adopt them in safety-critical applications. Therefore, developing explainable DNNs has become a prime interest in neural network research. This paper presents a methodology for linguistically explaining the knowledge a DNN classifier has acquired in training. The main objective is to help users understand what the DNN has learned about each class. The presented methodology is fuzzy logic based and involves end-users of the system in the explanation process, enabling users to customize the explanations to match their requirements. This paper presents the explanation methodology, metrics of explanation quality, validation steps, and a discussion of advantages and limitations. The explanation methodology was implemented on a benchmark classification problem. Experimental results demonstrated the method’s capability to explain the DNN-knowledge and validated the explanations.
Temporal Frame Sub-Sampling for Video Object Tracking

Temporal frame sub-sampling (TFS) for reducing video object tracking (VOT) computing time is investigated. With a sampling ratio N, the TFS VOT algorithm will process a shorter video by sampling 1 out of N frames of the given video. The object trajectory of the remaining frames will be interpolated linearly based on those of sampled frames. Thus, TFS can result in a significant reduction of processing time at a cost of losing tracking accuracy. More importantly, it can be applied to accelerate any VOT algorithms. However, it is observed that when the object trajectory is smooth, the tracking accuracy of a TFS VOT algorithm may be improved compared to non-TFS results. In this work, we provide an empirical analysis of this unexpected outcome of the TFS scheme. We also suggest rules of thumb to leverage this property to use TFS to enhance efficiency and accuracy of VOT.
Tug-of-War with Noise: Case p ∈ [2, ∞)

This chapter introduces the Tug-of-War with random noise and establishes its relation to the p-Laplace equation in case p ≥ 2. The following topics are covered: the p-Laplacian and the p-harmonic functions, the mean value expansions and averaging principles, construction of Tug-of-War, dynamic programming principle, relation to Brownian motion when p = 2.
Malignant Hematopoietic Disorders of the Lung

Hematopoietic tumors of the lung are uncommon. They comprise cases of non-Hodgkin lymphomas, classic Hodgkin lymphoma, plasmacytoma, and acute myeloid leukemia/myeloid sarcoma (Pina-Oviedo et al. Adv Anat Pathol 22:355–375, 2015). Primary lung involvement by these neoplasms is far less common than involvement by systemic disease. Histologically they are identical to their nodal or other extranodal counterparts. Therefore, the definition of a hematopoietic lung neoplasm as primary or secondary relies on clinical presentation and prior history of a hematolymphoid neoplasm. By imaging, lung hematopoietic tumors have a variable presentation depending on the subtype, and they are indistinguishable from localized pneumonia, sarcoidosis, tuberculosis, or a non-hematopoietic tumor (carcinoma, metastasis), and the diagnosis requires histopathologic confirmation (Zhang et al. Am J Med Sci 357:316–322, 2019; Sirajuddin et al. Radiographics 36:53–70, 2016). Tissue is usually obtained by interventional radiology in the form of a fine needle aspiration or a core biopsy or by video-assisted thoracoscopy and less common as an open lung biopsy. The differential diagnosis of hematolymphoid neoplasms of the lung varies depending on the entity and is discussed for each subtype of tumor.
School Nurses on the Front Lines of Healthcare: Children With Medical Devices-Shunt System Malfunctions and Infections

An important subgroup of children with special healthcare needs are those children with medical complexities who require long-term intensive healthcare interventions and treatments. As medical technology continues to advance and children with complex medical needs survive the neonatal period and progress into school-age, it is essential for school nurses to be able to recognize and acutely manage complications and malfunctions of devices in children requiring assistance from medical devices. An example of a common medical device includes shunts systems (e.g., a ventriculoperitoneal shunt) to drain excess cerebrospinal fluid. These devices put children at serious medical or surgical risk when they malfunction or become infected, so it is important for healthcare providers, especially school nurses who are the first responders in schools, to recognize malfunctions and initiate appropriate care management. This article describes the initial assessment and management of common medical emergencies in students who have those devices.
LTCC PoP Technology-Based Novel Approach for mm-Wave 5G System for Next Generation Communication System

This paper presents a comprehensive 5G system design methodology targeting 1Gbit/s next-generation, cellular communication based on Low-Temperature Co-fired Ceramics (LTCC), Package on Package (PoP) solution for mm wave module at 28-GHz in 5G communication System. The tile type package contributes to a dramatic reduction in size of the 5G communication system in single package along with the obvious merit of ceramic housing, which is better consistency of Coefficient of Thermal Expansion (CTE), compared to the traditional combination of ceramic board and metal housing. In addition, the paper presents the schematic diagram of heterogenous integration into an LTCC package including MMIC and RFIC (TX/RX) and 5G modem package mounted on LTCC base package and proposes a novel vertical interconnection based on Ball Grid Array (BGA) to connect vias in the lid and those in the stage of the main LTCC pan. This transition provides excellent signal integrity at high-speed data rates up to 28 Gbits/s.The paper also investigates the timing budget of TX/RX (at 28GHz) mm-wave signals in PoP technology for integrating a MMIC, PMIC, RFIC and 5G modem IC on another package. It starts by examining the package electrical modeling methodology used in GHz I/O device modeling in a more robust and accurate way to support high-volume manufacturing and high signal quality. This is followed by frequency and time domain analysis of package models to determine the optimized design parameters to achieve good signal performance.
A Carbon Nanotube Inkjet-Printed Hybrid Circuit for Non-Conventional Computing

Inkjet-printed technology offers a cost-efficient, low-energy, minimal footprint, and adaptable form of alternative computing. Inkjet-printed sensors and circuits use minimal waste, are often biodegradable and can be revised and/or reprinted in an additive manner. This report introduces a transistor-inspired inkjet-printed element with simulated CMOS hybridization as an early form of a more dynamical and non-linear computing element. Although the presented device has low functionality, the research efforts result in a step toward hybridized electronics that may be used for non-Von Neumann computing. The inkjet printed element was made by layering silver and carbon nanotube nanoparticles on paper and polyethylene terephthalate substrates in a way that mimicks the structure of a transistor. A mathematical modeling of the carbon nanotube element was made in MATLAB, then used in PSpice for analog behavioral modeling. The output was validated and used to design a hybridized linear dynamical circuit. Experimental data and simulation results show these early designs have usefulness in circuits and systems fabrication.
Activity and Water Footprint of Unconventional Energy Production under Hydroclimate Variation in Colorado

Unconventional oil and gas (UOG) production requires intensive freshwater consumption, but whether hydroclimate variation, which alters regional water availability, affects its activity and water f...