cssi/SciSciGPT-SciSciNet huggingface dataset:
Guided crossover: a new operator for genetic algorithm based optimization

Genetic algorithms (GAs) have been extensively used in different domains as a means of doing global optimization in a simple yet reliable manner. They have a much better chance of getting to global optima than gradient-based methods which usually converge to local sub-optima. However, GAs have a tendency of getting only moderately close to the optima in a small number of iterations. To get very close to the optima, the GA needs a very large number of iterations, whereas gradient-based optimizers usually get very close to local optima in a relatively small number of iterations. In this paper we describe a new crossover operator which is designed to endow the GA with gradient-like abilities without actually computing any gradients and without sacrificing global optimality. The operator works by using guidance from all members of the GA population to select a direction for exploration. Empirical results in several engineering design domains demonstrate that the operator can significantly improve the steady state error of the GA optimizer.
Induction of mucosal B-cell memory by intranasal immunization of mice with respiratory syncytial virus.

The capacity of live or inactivated respiratory syncytial virus (RSV) to induce B-cell memory in respiratory-associated lymphoid tissues of mice was examined. Eight weeks after primary inoculation with either live or inactivated RSV, adult BALB/c mice were challenged with 4 × 105 PFU of RSV. Protection from viral shedding and mucosal production of RSV-specific antibodies were examined at various time points after challenge. We found that primary immunization with live, but not inactivated, RSV induced complete and durable protection upon challenge within the upper and lower respiratory tract. Also, primary immunization with live, but not inactivated, RSV enhanced the production of mucosal RSV-specific immunoglobulin A (IgA) upon challenge. Secondary mucosal IgA responses were characterized by (i) the early production of mucosal IgA by B cells that reside in organized nasal-associated lymphoid tissues, cervical lymph nodes, and bronchial lymph nodes, and (ii) the subsequent production of RSV-specific IgA by mucosal effector tissues, such as the tracheal lamina propria and lung. These findings suggest that primary infection of mice with live RSV might induce mucosal IgA-committed memory B cells. A greater understanding of the characteristics of RSA-specific mucosal memory B cells may facilitate the development of an RSV vaccine.
Correlation of Susceptibility of Immature Mice to Fungal Infection (Blastomycosis) and Effector Cell Function

Immature mice are highly susceptible to blastomycosis, which is similar to other mycoses and has parallels in humans. The murine susceptibility is noteworthy in that it persists beyond the development of resistance to other, nonfungal pathogens and the maturation of most immune functions. As the susceptibility to blastomycosis appeared to be related to an early event after infection, primary effector cell function was studied. We found that peritoneal inflammatory cells, enriched for neutrophils, from immature (3-week-old) mice killed nonphagocytizable Blastomyces dermatitidis cells less (25%) than did cells from mature (8-week) mice (70%) (P < 0.01), a defect intrinsic to the neutrophils. This correlated with an impaired immature cell oxidative burst. Killing of phagocytizable Candida albicans was not significantly different, 73 versus 87%. Thioglycolate-elicited cells were more impaired; killing of B. dermatitidis was insignificant, and killing of C. albicans was more impaired in immature (16% killing) than in mature (45%) cells (P < 0.02). Peripheral blood neutrophils from mature animals killed B. dermatitidis (41%) more than did those from immature animals (10%) (P < 0.02); C. albicans was killed efficiently by both. Resting or activated peritoneal macrophages from both types of animals showed no differences in B. dermatitidis killing. These results suggest that the susceptibility of immature mice is related at least in part to the depressed capacity of their neutrophils to kill B. dermatitidis.
Extrusion Processing of Oilseed Meals for Food and Feed Production

There are several different definitions of extrusion depending on the manufacturer as well as the purpose of the extrusion. For the purpose of this chapter, the best definition of extrusion can be explained as “continuous cooking under pressure, moisture and elevated temperature.” During the process of extrusion, several operations take place, such as grinding, hydration, mixing, shearing, thermal treatment, gelatinization, protein denaturation, destruction of micro-organisms and some toxic compounds, shaping, expanding, and partial dehydration. The use of extruders has been expanding rapidly in the food, feed, and oilseed industries over the past few years, although basic extruder technology has been around for a long time. It has been used in one form or another in many industries. New designs of extrusion equipment have increased the range of their application in food, feed, and oilseed processing. Keywords: extrusion; extruder; food production; feed processing; oilseed; expaders; grinding; hydration; shearing; gelatinization; dehydration
A comparison of the AVID and DAVID trials of implantable defibrillators

We compared 2 studies of implantable cardiac defibrillators (ICDs) to determine the effects of device mode on outcomes. The Antiarrhythmics Versus Implantable Defibrillators (AVID) trial (1993 to 1997) demonstrated improved survival with the ICD compared with antiarrhythmic drug therapy. The Dual-chamber And VVI Implantable Defibrillator (DAVID) trial (2000 to 2002) showed that VVI pacing at 40 beats/min in patients with ICDs reduced the combined end point of death and hospitalization for congestive heart failure compared with DDDR pacing at 70 beats/min. Patients in the AVID trial (631 of 1,016) and the DAVID trial (221 of 506) meeting common inclusion and all exclusion criteria were studied. The major end points were the time to death, and the composite end point of time to death or hospitalization for congestive heart failure. Patients in the AVID and DAVID trials were similar, but more AVID patients had coronary artery disease (p = 0.04), history of myocardial infarction (p = 0.005), and previous ventricular arrhythmias (p = 0.03). DAVID patients underwent more previous revascularization procedures (coronary artery bypass surgery, p = 0.03; percutaneous coronary intervention, p = 0.001), and were more often taking β-blocking drugs at hospital discharge (p
Transborder Labor Liberalization and Social Contracts

The failure of states to liberalize labor as part of the multilateral trade liberalization project stands in stark contradiction to the liberalization of other fundamental economic inputs, thus undermining the vision for a globalized world. The disjuncture and disequilibrium between international trade law and domestic immigration law foster illegal movement across borders and result in the vulnerability of human would-be mobile labor providers to trafficking and other forms of exploitation. As a result, the transnational labor market is characterized by the illegality and temporariness that is assigned by states to mobile and would-be mobile human providers of labor. Yet, the globalized transnational economy demands and stimulates the movement of labor from one domestic economy to another. Domestic social contracts, to the extent that they exist, are subject to the pressures of transnational economic forces that have altered, fundamentally, the existing contracts between, for example, labor and capital. Concepts of distributive justice require democratization of access to the benefits of trade liberalization. To the extent that individual nation-states’ domestic laws demand that labor be rendered immobile and/or that mobile human labor providers be punished for transgressing the laws created to ensure their immobility, labor is denied full access to the benefits of trade liberalization. To create a rights-protective equilibrium in the transnational labor market, I contend that the economic nature of humans — our economic roles in the global economic system — must be more fully recognized. That recognition will require that human labor providers must have the right to easily enter and exit individual domestic labor markets in response to economic stimuli. I propose that the path to the framing, implementation, and enforcement of a global social contract that protects labor is to liberalize labor from some of the nation-state constraints to which the transborder labor market is subject.
Rous sarcoma virus: Contributions of a chicken virus to tumor biology, human cancer therapeutics, and retrovirology

In the early twentieth century, studies of the transmission of a tumor found in the breast of a Plymouth Rock hen formed the foundation for the discovery of Rous sarcoma virus (RSV). At the time, cancer was not believed to have a genetic basis and the idea that a virus could induce tumors was not accepted; however, those ideas would change. As RSV was studied further, it became clear that although it was an RNA virus, it had the property of transforming infected cells by altering their genetic composition. This key observation became the genesis of the “provirus hypothesis,” which led to the discovery of reverse transcription. Finding that RNA was converted to DNA through the activity of the viral reverse transcriptase enzyme was remarkable because the flow of genetic information had previously been thought to occur in only one direction, DNA to RNA. Further investigation of the nature of the integrated provirus and its transforming activity led to a second remarkable breakthrough – the identification of a cellular gene that was highly homologous to the viral transforming gene. The discovery of the src oncogene uncovered cellular pathways that control cell growth and differentiation and play a central role in malignant transformation.
The Chelmsford-Lowell, Massachusetts, earthquake of 23 November 1980: Depth control and fault plane solution

On 23 November 1980, a small (magnitude 2.9) earthquake occurred on the Chelmsford-Lowell, Massachusetts, border, approximately 10 km northeast of the MIT seismic station at Westford, Massachusetts (WFM). Thus we were able to accurately determine the focal depth, which is generally not the case in New England. Our hypocentral solution was latitude 41.63, longitude −71.36, depth 1.5 km, at origin time 00:39:32.0 UTC. The fault plane solution shows either strike-slip or dip-slip faulting with a P axis trending NE-SW, which is in agreement with overcoring measurements in a nearby granite quarry.
Extinction under nine food deprivation levels1

One-hundred-eighty Ss received 60 acquisition trials under 22 h food deprivation and 30 extinction trials with nine different food drive levels for different groups. A regular increase in extinction running speed with drive was observed early in extinction.
Sensitivity to Analogs of Thiamine Pyrimidine Associated with Resistance To Amethopterin or Purine Antagonists.

SummaryA microbiological method for biochemical screening of compounds of potential interest in the chemotherapy of leukemia, using mutants of B. subtilis resistant to amethopterin and E. coli mutants resistant to purine-antagonists, has been described. Greater growth suppression by a test compound in the resistant strain, when contrasted to the parent strain, has been sought (collateral sensitivity). This phenomenon of collateral sensitivity has been observed for several chemical analogs of the pyrimidine moiety of thiamine. Possible significance of these findings for studies in intermediary metabolism and for cancer chemotherapy has been discussed.
Molecule-Based Approaches to High-Performance Second-Order Polymeric Nonlinear Optical Materials. Properties of Ultra-high-Tg Chromophoric Polyimides and Polyureas.

This contribution describes the synthesis and properties of three classes of model NLO chromophore-functionalized high-Tg polymers which test current ideas about architecture-Tg- χ(2) performance relationships. Condensation of bismaleimides with diallylamino-functionalized donor-acceptor chromophores yields polable matrices with Tg values as high as 325°C and χ(2) responses as high as 0.7 × 10-7 esu (27 pm/V; λohigh as 0.7 × 10-7 esu (27 pm/V; λo = 1064 nm; 1.17 eV). Likewise, = 1064 nm; 1.17 eV). Likewise, condensation of o,o’-diallylbisphenol A with bismaleimides followed by chromophore functionalization yields an analogous series of polyimides with Tg values as high as 260°C and χ(2) response as high as 1.0 × 10-7 esu (42 pm/V at λo = 1064 nm). Polymerization of a bis(4-aminophenyl)lophine chromophore with bismaleimides or diisocyanates yields polymers with Tg values as high as 350°C and χ(2) = 0.62 × 10-7 esu (25 pm/V at λo = 1064 nm). All members of the above series exhibit minor to negligible decay in χ(2) response on aging in air at 100°C for 1000 h. The lophine-based material exhibits only ∼10% χ(2) decay on aging for 100 h at 200 °C under N2.
Development of Standard Device for Resistive Current Tester for Zinc Oxide Surge Arrester

The topic research,standard device for resistive current tester for zinc oxide surge arrester,can be used for calibration for resistive current tester for zinc oxide surge arrester.The equip’s functions involve: total current,resistive component of current,capacitance component of current,active power,reference voltage,phase angle and harmonic component of current.The topic introduces the working principle and the core technology of the standard device,among which the most innovative points are the"smoothing signal generation"and"traceability design".
Analysis of hepatitis B virus infection models in population in Guangdong Province

Objectives:To investigate incidences of hepatitis B virus infection models for Guangdong people and analyze the relation of the models to people′s age,sex and source.Methods:Through multistagerandom sampling methods,we selected 3925 people from six districts.All the objects were investigated by the questionnaire and examined the serological market by blood sampling.Results:There were 11 infection models for Guangdong people and 6 of them are frequent models.The positive rates of model"2","all five markets negative","25","145","135" and "5"are 40.36%,22.73%,22.29%,6.65%,4.23% and 3.52% respectively.With age increasing,the positive rates of model"145","5" and "25" increase and the positive rate of model "2" decrease.Children aged 5~14 have the highest positive rates of"all five markets negative".To men,The positive rate of model "2" is higher than women but the rate of model "25" is lower than women significantly.To citizen people,the positive rates of model "145","135" and "5" are lower than those of countryside people but the rates of model "2" and "all five markets negative" are higher than those of countryside people significantly.Conclusion:Comparing with other districts,The rates of recovery period models especially single-HBsAb-positive model are high and the rates of infective period models such as "145" and "135" are low in Guangdong Province.It indicates that our immunization strategy is effective and the protective level of people is high in Guangdong Province.
Portable infrared pupillometry in critical care

Infrared pupillometry was introduced in 1962 but portable instruments that use this technology have only recently become available in the hospital setting. Questions surrounding the accuracy of these instruments have been addressed by documenting the inter-observer agreement on pupillary measurements and also by comparisons with standard pen-light examinations. The following commentary summarizes the development of these devices and provides a wider perspective on how the pupil and its reflexes might be used in providing care for patients with critical illness.
Pharmacological activation of FOXO3 suppresses triple-negative breast cancer in vitro and in vivo

// See-Hyoung Park 1, 2, * , Young Min Chung 1, * , Jessica Ma 1 , Qin Yang 3 , Jonathan S. Berek 1 , Mickey C-T. Hu 1 1 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA 94305, USA 2 Current address: Department of Biological and Chemical Engineering, Hongik University, Sejong, 339-701, Korea 3 Cancer Biology Division, Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO 63108, USA * These authors contributed equally to this work Correspondence to: Mickey C-T. Hu, email: mhu1@stanford.edu Keywords: FOXO3, breast cancer, bepridil, trifluoperazine, dopamine receptor Received: January 18, 2016 Accepted: May 12, 2016 Published: June 07, 2016 ABSTRACT Triple-negative breast cancer (TNBC) is the most lethal form of breast cancer. Lacking effective therapeutic options hinders treatment of TNBC. Here, we show that bepridil (BPD) and trifluoperazine (TFP), which are FDA-approved drugs for treatment of schizophrenia and angina respectively, inhibit Akt-pS473 phosphorylation and promote FOXO3 nuclear localization and activation in TNBC cells. BPD and TFP inhibit survival and proliferation in TNBC cells and suppress the growth of TNBC tumors, whereas silencing FOXO3 reduces the BPD- and TFP-mediated suppression of survival in TNBC cells. While BPD and TFP decrease the expression of oncogenic c-Myc, KLF5, and dopamine receptor DRD2 in TNBC cells, silencing FOXO3 diminishes BPD- and TFP-mediated repression of the expression of these proteins in TNBC cells. Since c-Myc, KLF5, and DRD2 have been suggested to increase cancer stem cell-like populations in various tumors, reducing these proteins in response to BPD and TFP suggests a novel FOXO3-dependent mechanism underlying BPD- and TFP-induced apoptosis in TNBC cells.
Short and long term benefits of enjoyment and learning within a serious game

Intelligent Tutoring Systems (ITSs) have been used for decades to teach students domain content or strategies. ITSs often struggle to maintain students' interest and sustain a productive practice environment over time. ITS designers have begun integrating game components as an attempt to engage learners and maintain motivation during prolonged interactions. Two studies were conducted to investigate enjoyment and performance at short-term (90 minutes) and long-term (3 weeks) timescales. The short-term study (n=34) found that students in a non-game practice condition performed significantly better and wrote more than the game-based practice. However, the long-term study (n=9) found that when students were in the game-based environment they produced longer contributions than when in the non-game version. Both studies revealed trends that the game-based system was slightly more enjoyable, though the differences were not significant. The different trends across studies indicate that games may contribute to an initial decrease in performance, but that students are able to close this gap over time.
Socio-demographic vs domain predictors of perceived stress: Racial differences among American women

Using data from a national probability sample of black and white females, this study focuses on racial differences and similarities in factors affecting levels of global perceived stress. Selected socio-demographic characteristics as well as satisfactions with the major domains of life — such as self, standard of living, health, family life, and leisure — are examined as predictors of global perceived stress. Generally, domain satisfactions are found to be stronger predictors of perceived stress than are socio-demographic characteristics. Moreover, no racial differences between black and white females are found when socio-demographic factors are controlled. However, a significant racial difference is encountered for one domain: satisfaction with leisure appears to be a stronger predictor of perceived stress for black females than it is for white females.
Effects of New Funding Models for Patient-Centered Medical Homes on Primary Care Practice Finances and Services: Results of a Microsimulation Model.

PURPOSE We assess the financial implications for primary care practices of participating in patient-centered medical home (PCMH) funding initiatives. METHODS We estimated practices’ changes in net revenue under 3 PCMH funding initiatives: increased fee-for-service (FFS) payments, traditional FFS with additional per-member-per-month (PMPM) payments, or traditional FFS with PMPM and pay-for-performance (P4P) payments. Net revenue estimates were based on a validated microsimulation model utilizing national practice surveys. Simulated practices reflecting the national range of practice size, location, and patient population were examined under several potential changes in clinical services: investments in patient tracking, communications, and quality improvement; increased support staff; altered visit templates to accommodate longer visits, telephone visits or electronic visits; and extended service delivery hours. RESULTS Under the status quo of traditional FFS payments, clinics operate near their maximum estimated possible net revenue levels, suggesting they respond strongly to existing financial incentives. Practices gained substantial additional net annual revenue per full-time physician under PMPM or PMPM plus P4P payments ($113,300 per year, 95% CI, $28,500 to $198,200) but not under increased FFS payments (−$53,500, 95% CI, −$69,700 to −$37,200), after accounting for costs of meeting PCMH funding requirements. Expanding services beyond minimum required levels decreased net revenue, because traditional FFS revenues decreased. CONCLUSIONS PCMH funding through PMPM payments could substantially improve practice finances but will not offer sufficient financial incentives to expand services beyond minimum requirements for PCMH funding.
Dreams and Sexuality: A Psychoanalytical Reading of Klimt's Beethoven Frieze

This essay presents a philosophical and psychoanalytical interpretation of the work of the Viennese Secession artist, Gustav Klimt. The manner of depiction in Klimt’s paintings underwent a radical shift around the turn of the twentieth century, and the author attempts to unveil the internal and external motivations that may have prompted and contributed to this transformation. Drawing from Friedrich Nietzsche’s The Birth of Tragedy as well as Sigmund Freud’s The Interpretation of Dreams, the article links Klimt’s early work with what may be referred to as the Apollonian or consciousness, and his later work with the Dionysian or the subconscious. It is then argued that the Beethoven Frieze of 1902 could be understood as a “self-portrait” of the artist and used to examine the shift in stylistic representation in Klimt’s oeuvre.
Corpus-Derived Key Profiles Are Not Transpositionally Equivalent

A fundamental assumption of distributional key-finding methods is that the frequency distributions of pitch classes in all keys are transpositionally equivalent. We tested this assumption with three experiments. First, using data from the openings of 995 major-key pieces and 596 minor-key pieces in the Yale-Classical Archives Corpus, we found that scale-degree distributions differ significantly from one key to another, and further analysis revealed that pieces keys with signatures having relatively more accidentals exhibit significantly more chromaticism than keys with fewer accidentals. Second, we examined whether these data might be accounted for by different keys’ varying modulation tendencies, and found this to be the case: keys with more accidentals modulate more frequently to more distant keys. Finally, we attempted to exclude modulatory passages from our data using a key profile analysis to identify key and mode within our dataset; however, the results of Experiment 1 still held. In sum, even when using a method that assumes transpositional equivalence, we found a difference between key profiles of different keys.
Real-time in vivo mitochondrial redox assessment confirms enhanced mitochondrial reactive oxygen species in diabetic nephropathy

While increased mitochondrial reactive oxygen species have been commonly implicated in a variety of disease states, their in vivo role in the pathogenesis of diabetic nephropathy remains controversial. Using a two-photon imaging approach with a genetically encoded redox biosensor, we monitored mitochondrial redox state in the kidneys of experimental models of diabetes in real-time in vivo . Diabetic ( db/db ) mice that express a redox-sensitive Green Fluorescent Protein biosensor (roGFP) specifically in the mitochondrial matrix ( db/db mt-roGFP) were generated, allowing dynamic monitoring of redox changes in the kidneys. These db/db mt-roGFP mice exhibited a marked increase in mitochondrial reactive oxygen species in the kidneys. Yeast NADH-dehydrogenase, a mammalian Complex I homolog, was ectopically expressed in cultured podocytes, and this forced expression in roGFP-expressing podocytes prevented high glucose–induced increases in mitochondrial reactive oxygen species. Thus, in vivo monitoring of mitochondrial roGFP in diabetic mice confirms increased production of mitochondrial reactive oxygen species in the kidneys.
Surface phase diagrams of titanium in Oxygen, Nitrogen and Hydrogen environments: A first principles analysis

Abstract Density functional theory and ab initio thermodynamics studies are performed to investigate the interaction of oxygen, nitrogen and hydrogen molecules with hexagonal close packed Ti (0001) surfaces. The system is modeled as a slab where the concentration of the adsorbed atoms is systematically increased and the most favorable configuration is determined based on total energy comparisons. Varying tendencies are observed for the ground state structures of oxygen, nitrogen and hydrogen adsorption. Oxygen and hydrogen atoms are found to be adsorbed on the surface with increasing concentration and tend to migrate to interior layer only after surface saturation. However, nitrogen prefers to migrate into the interior layers. For all elements, the favorable position in the interior layers is the octahedral interstitial site. Taking into account the partial pressure of oxygen, nitrogen and hydrogen and the effect of temperature, we develop surface phase diagrams that display stable surface configurations. Our studies provide an atomic insight into the structure of the surface scale, passivation effects, and surface tension of Ti for advanced powder manufacturing processes and applications in catalysis.
Peership and Play: Techniques for Facilitating an Optimal Pediatric Visit

Jennifer was angry. It had all started when they told her about the diabetes. Her body had behaved strangely for a couple of months before she actually got sick and they took her to Dr. Stein. She always had to go to the bathroom, for example. But now she felt worse, even though she knew what was wrong with her. She had to learn how to use a needle to inject herself with insulin and how to take her blood sugar count each morning. They wouldn’t let her go home from the hospital until she had learned these things. She didn’t like it at all. And now, after she had gotten sick at her friend’s birthday party, they had rushed her to the doctor’s office again.
Two examples on the property of the noise in the systems of equations of fluid mechanics

Abstract In this manuscript, we discuss two examples of the results on the systems of partial differential equations in fluid mechanics obtained via stochastic analysis, for which deterministic case has no counterpart. Firstly, it is well-known that for a deterministic system of equations in fluid mechanics, a lack of diffusion creates a significant obstacle in proving its global well-posedness for a sufficiently small initial data. Nevertheless, it may be proven that for the Hall-magnetohydrodynamics system forced by L e vy noise, such a result may be obtained even with zero viscous diffusion. Secondly, we may extend the classical Kelvin’s conservation of circulation flow, as well as the Cauchy’s vorticity transport formula, on the Euler equations to show that the solution to the damped Euler equations enjoys the exact same identities except with an exponential decay in time. Such identities are known to completely fail once we add diffusion and consider the damped Navier–Stokes equations. Nevertheless, discovering a stochastic Lagrangian formulation, we are able to show that such identities indeed do continue to hold informally on average, i.e. via a mathematical expectation, over the random ensemble at earlier time. The stochastic Lagrangian formulation and these identities have also been obtained for the solution to the Boussinesq system. These results are rigorously proven in Mohan and Yamazaki (0000) and Yamazaki (0000). In this manuscript we will not pursue complete proofs, which were in particular mostly inspired by Kim (2011) and Iyer (2006), but rather elaborate on motivations, difficulty and remaining open problems for future works.
Tutorial: High-speed low-power neuromorphic systems based on magnetic Josephson junctions

Josephson junctions and single flux quantum (SFQ) circuits form a natural neuromorphic technology with SFQ pulses and superconducting transmission lines simulating action potentials and axons. Josephson junctions consist of superconducting electrodes with nanoscale barriers that modulate the coupling of the complex superconducting order parameter across the junction. When the order parameter undergoes a 2π phase jump, the junction emits a voltage pulse with an integrated amplitude of a flux quantum ϕ0 = h/(2e) = 2.068 × 10−15 V s. The coupling across a junction can be controlled and modulated by incorporating the nanoscale magnetic structure in the barrier. The magnetic state of embedded nanoclusters can be changed by applying small current or field pulses, enabling both unsupervised and supervised learning. The advantage of this magnetic/superconducting technology is that it combines natural spiking behavior and plasticity in a single nanoscale device and is orders of magnitude faster and lower energy than other technologies. Maximum operating frequencies are above 100 GHz, while spiking and training energies are ∼10−20 J and 10−18 J, respectively. This technology can operate close to the thermal limit, which at 4 K is considerably lower energy than in a human brain. The transition from deterministic to stochastic behavior can be studied with small temperature modifications. Here, we present a tutorial on the spiking behavior of Josephson junctions; the use of the nanoscale magnetic structure to modulate the coupling across the junction; the design and operation of magnetic Josephson junctions, device models, and simulation of magnetic Josephson junction neuromorphic circuits; and potential neuromorphic architectures based on hybrid superconducting/magnetic technology.
Granule transformation in a twin screw granulator: Effects of conveying, kneading, and distributive mixing elements

Abstract This work presents experimental data from granule transformation studies in a Twin Screw Granulator (TSG). Three types of screw elements were considered: conveying elements (CEs), kneading elements (KEs) with 60o forward (F) and 60o reverse (R)configurations, and distributive mixing elements (DMEs) with F and R configurations. The TSG was divided into three sections: an upstream CE section, a mixing section that contained either CEs, KEs (F/R), or DMEs (F/R), and a downstream CE section. The screw pullout method was used to collect granules from the upstream and downstream CE sections. For the powder feed number used in the experiments, the granule properties in the upstream CE section were nearly identical in all of the experiments regardless of the element type used in the mixing section. For the experiments with CEs in the mixing section, the granule properties in the downstream CE section were similar to those in the upstream section, indicating that CEs do not significantly modify the granule properties. The average granule size increased, porosity decreased, and liquid binder concentration uniformity increased downstream of the mixing section in comparison to the upstream granule properties when either KE or DME elements were used. The granules downstream of the 60oR KE section had larger average size, smaller porosity, and higher liquid binder concentration uniformity compared to the granules collected downstream of the 60 °F KE section. The granules downstream of the DME section had a uniform liquid binder concentration distribution and showed little difference in size and porosity whether forward or reverse configurations were used. This work extends previously published granule transformation studies by examining a larger range of operating parameters and element types. In addition, a new model for predicting the granule size distribution in conveying elements is presented.
Survey of quality of life, phenotypic expression, and response to treatment in Krabbe leukodystrophy

Objectives To develop a quality of life (QOL) survey for Krabbe disease (KD), and to thereby improve understanding of its phenotypic expression and response to treatment. Methods The survey, the Leukodystrophy Quality of Life Assessment (LQLA) and the Vineland Adaptive Behavior Scales were co-administered to 33 patients or their caretakers. These included the phenotypes of early infantile KD (EIKD; 0-6 months old at onset), late infantile cases (LIKD; 7-12 months old at onset), and cases that emerged after 12 months old, late onset (LOKD). The sample included cases with and without stem cell transplantation (SCT). Reliability and concurrent validity were assessed for overall and subscale scores. Analysis of variance tested differences in QOL between phenotypes and transplant groups (none, pre-, post-symptom). Results Good concurrent validity with the Vineland was shown for total, communication, daily activity, social, and motor scales and good reliability was observed. LOKD cases had better communication skills than either EIKD or LIKD and better overall QOL than EIKD. Analyses of individual items showed that communication items, mostly, contributed significantly to phenotype differences. Presymptomatic SCT significantly improved QOL compared to postsymptomatic SCT or no treatment. Presymptomatically treated patients had near-normal total scores. Conclusions The LQLA is valid and reliable. Despite small sample size, phenotypic demarcation was determined to be due mainly to differences in communication skills. There was a relative enhancement of QOL in LOKD patients, and in those who had presymptomatic SCT. These results apply to the current controversy about recommendations for newborn screening for this condition.
Middle Meningeal Artery Embolization for the Treatment of an Expanding Epidural Hematoma.

Introduction Epidural hematomas (EHs) usually originate from traumatic injury to the middle meningeal artery (MMA). Although large EHs may need to be emergently evacuated, the management of smaller EHs is less clear, especially in the absence of significant mass effect or neurologic deficits. Endovascular treatment via MMA embolization for epidural hematomas has only been recently reported. Herein, we present a case whereby MMA embolization was performed to prevent further growth of an expanding, right-sided EH after a larger left EH was surgically evacuated. Case Description A 31-year-old male patient was brought to the emergency department after he was found down by the police at his house. He was initially conversant but quickly became obtunded within a few minutes. An initial scan showed bilateral (left larger than right) acute EHs, and the patient was taken to the operating room for a left craniotomy. Immediate postoperative imaging demonstrated an expanding right-sided EH. The patient was emergently taken to the endovascular suite and obvious contrast extravasation was noticed from the parietal branch of the MMA. The MMA was embolized via a transradial approach. Follow-up imaging revealed stable hematoma size without the need for additional surgery. The patient was discharged without any neurologic deficits. Conclusions Herein, we report the successful endovascular treatment of an expanding EH following a contralateral craniotomy. Active bleeding of the MMA was observed via angiography and may predict further EH expansion. Endovascular exploration and possible treatment can be justified in patients with EH that do not have a clear surgical indication.
Loss to follow-up 1 year after lower extremity peripheral vascular intervention is associated with worse survival:

Loss to follow-up (LTF) has been associated with worse outcomes after procedures. We sought to identify differences in lower extremity peripheral vascular intervention (PVI) patients with and without LTF, and to determine if LTF impacted survival. Patients in the PVI registry of the Vascular Quality Initiative (VQI) were included (n = 39,342), where t-test and chi-squared analysis were used to compare those with and without LTF. Multivariable logistic regression was used to identify factors associated with LTF while Cox regression analysis was applied to compare survival among those with and without LTF. The overall 1-year follow-up rate was 91.6%. LTF patients were more often male, Hispanic, of black race, and had a higher rate of diabetes, coronary artery disease, congestive heart failure, and dialysis. LTF patients had a higher prevalence of critical limb ischemia, underwent popliteal or distal intervention, and were intervened upon urgently. There was also a higher rate of postoperative complications, and a lower rate of technical success for LTF patients. After controlling for center effects, the independent variables associated with LTF included male sex, age, diabetes, dialysis dependence, ASA class 3 or greater, as well as complications requiring admission. Preoperative aspirin, preadmission home living status, prior carotid intervention, and discharge aspirin were protective against LTF. Adjusted survival analysis showed decreased survival in LTF, with those returning face-to-face surviving longer than those with phone follow-up. Efforts should be focused on understanding these differences to improve follow-up rates and help improve overall survival.
Physics and Principles of Ultrasound

A clinical ultrasound image is the end result of a complex interaction between hardware design elements and software processing. The goal of this chapter is to ensure that clinicians using this technology are aware of the key concepts and principles of ultrasound physics, without having to possess advanced understanding of the underlying engineering. This chapter addresses the basics of wave properties, ultrasound wave generation and reception, and the behavior of sound in tissue. Common ultrasound artifacts are explained from the physics perspective, and the special case of Doppler is discussed.
A multifaceted exercise intervention did not alter cognitive function and cerebral perfusion in individuals with Parkinson's disease

Summary Objectives To investigate cerebral perfusion as a potential mechanism of exercise-related cognitive improvements and to further associate cognition and cerebral perfusion in Parkinson's disease. Equipment and methods Cerebral perfusion was measured continuously at rest and during a cognitive task using near-infrared spectroscopy before and after a multifaceted exercise program in thirteen individuals with Parkinson's disease. Results Cognitive function was not significantly impaired in our group of Parkinson's disease participants at baseline. Cerebral perfusion (69.91% ± 2.43) was significantly greater during cognitive testing than while resting (68.12% ± 2.42) (P ≤ 0.001). Our results are inconclusive with respect to the effect of exercise on cognitive dysfunction in PD.
CD10 and P63 Expression in a Sarcomatoid Undifferentiated Melanoma: A Cautionary (and Molecularly Annotated) Tale

Undifferentiated melanoma should be considered in the differential diagnosis of sarcomatoid cutaneous malignancies to ensure that patients receive the correct treatment. Dermatopathologists should recognize the pitfalls of relying too heavily on immunohistochemistry to establish this diagnosis and consider ancillary tests, including single-nucleotide polymorphism (SNP) copy number arrays and targeted next-generation sequencing (NGS), when a definitive diagnosis cannot be rendered on a primary or metastatic tumor. This technology can also help to exclude a collision of melanoma and sarcoma when both differentiated and undifferentiated components are juxtaposed. We describe an exceedingly rare, illustrative example of undifferentiated sarcomatoid melanoma presenting as a pedunculated nodule. The clinical context and presence of a small differentiated component helped to establish the diagnosis; however, the transition from differentiated to undifferentiated melanoma was accompanied by an abrupt loss of S100, Sox10, MITF, MelanA, and HMB45 with gain of CD10 and p63 staining. SNP copy number array and NGS revealed shared chromosomal copy number changes and overlapping mutations with additional aberrances detected exclusively in the sarcomatoid component, thereby excluding a collision tumor and confirming our putative impression of melanoma with progression to an undifferentiated sarcomatoid phenotype.
Abstract 473: Will Obesity Bankrupt the United States? Obese Patients Who Underwent Cardiopulmonary Resuscitation Have Increased Thirty-Day Readmission and Total Hospital Cost

Purpose: To determine the relationship between obesity and thirty-days readmission, mortality, morbidity, and health care resource utilization in patients who underwent cardiopulmonary resuscitatio...
Metrics for assessing physician activity using electronic health record log data

Electronic health record (EHR) log data have shown promise in measuring physician time spent on clinical activities, contributing to deeper understanding and further optimization of the clinical environment. In this article, we propose 7 core measures of EHR use that reflect multiple dimensions of practice efficiency: total EHR time, work outside of work, time on documentation, time on prescriptions, inbox time, teamwork for orders, and an aspirational measure for the amount of undivided attention patients receive from their physicians during an encounter, undivided attention. We also illustrate sample use cases for these measures for multiple stakeholders. Finally, standardization of EHR log data measure specifications, as outlined here, will foster cross-study synthesis and comparative research.
Description of Turner Syndrome

Turner syndrome describes females who have partial or complete absence of the second sex chromosome and can present with a variety of phenotypic and genotypic features. This chapter serves to summarize many of these features as well as provide an overview of clinical management guidelines. Incidence and karyotype findings are discussed prior to an overview of phenotype, commenting on skeletal manifestations, ovarian failure, cardiovascular and heart disease, lymphatic obstruction, renal abnormalities, autoimmune diseases, psychological and cognitive implications, and malignancy risk. Many of the topics introduced in this chapter will be described in further detail in subsequent chapters.
Histopathologic assessment of cultured human thymus.

The maintenance and propagation of complex mixtures of cells in vitro in the form of native organs or engineered organoids has contributed to understanding mechanisms of cell and organ development and function which can be translated into therapeutic benefits. For example, allogeneic cultured postnatal human thymus tissue has been shown to support production of naive recipient T cells when transplanted into patients with complete DiGeorge anomaly and other genetic defects that result in congenital lack of a thymus. Patients receiving such transplants typically exhibit reversal of their immunodeficiency and normalization of their peripheral blood T cell receptor V-beta repertoire, with long-term survival. This study was designed to assess the histopathologic changes that occur in postnatal human thymus slices when cultured according to protocols used for transplanted tissues. Results showed that as thymic organ cultures progressed from days 0 through 21, slices developed increasing amounts of necrosis, increasing condensation of thymic epithelium, and decreasing numbers of residual T cells. The architecture of the thymic epithelial network remained generally well-preserved throughout the 21 days of culture, with focal expression of cytokeratin 14, a putative biomarker of thymic epithelial cells with long-term organ-repopulating potential. All organ slices derived from the same donor thymus closely resembled one another, with minor differences in size, shape, and relative content of cortex versus medulla. Similarly, slices derived from different donors showed similar histopathologic characteristics when examined at the same culture time point. Taken together, these results demonstrate that diagnostic criteria based on structural features of the tissue identifiable via hematoxylin and eosin staining and cytokeratin immunohistochemistry can be used to evaluate the quality of slices transplanted into patients with congenital athymia.
Reducing Antibiotic Prescription Errors in the Emergency Department: A Quality Improvement Initiative.

Introduction Discharge prescription errors from the pediatric emergency department (ED) are common. Despite the implementation of clinical pathways for common infections recommending specific antibiotic therapy and aids built into the electronic health record, errors in antibiotic prescriptions for patients discharged home from the ED persist. Methods We developed and implemented ED antibiotic discharge order panels for urinary tract infection (UTI) and skin and soft tissue infections (SSTI) that modeled antibiotic therapy from our institutional clinical pathways. We aimed to reduce antibiotic prescription errors by 50% within 6 months of implementation. Results With the implementation of the ED discharge order panels, the overall error rate for prescriptions for UTI and SSTI improved from a baseline rate of 29.3% to 12.6% (P < 0.001). Individually, the baseline number of prescriptions with errors for UTI and SSTI improved from 26.1% and 32.8%, respectively, to 13.8% and 12.5% within 6 months. Sustained improvement continued for 17 months after the implementation of the order panels. Conclusions Development and implementation of ED antibiotic discharge order panels decrease antibiotic prescription errors for UTI and SSTI by improving compliance with institutional clinical pathways. Additional order panels should be developed and implemented for other conditions to help reduce discharge prescription errors.
Novel Quasi-Emulsion Solvent Diffusion-Based Spherical Cocrystallization Strategy for Simultaneously Improving the Manufacturability and Dissolution of Indomethacin

Successful development of tablet formulations of many active pharmaceutical ingredients (APIs) is challenged by their poor manufacturability (e.g., flowability, tabletability) and dissolution chara...
Ligand Incorporation into Protein Microcrystals for MicroED by On-Grid Soaking

Summary A high throughout method for soaking ligands into protein microcrystals on TEM grids is presented. Every crystal on the grid is soaked simultaneously using only standard cryoelectron microscopy vitrification equipment. The method is demonstrated using proteinase K microcrystals soaked with the 5-amino-2,4,6-triodoisophthalic acid (I3C) magic triangle. A soaked microcrystal is milled to a thickness of approximately 200 nm using a focused ion beam, and MicroED data are collected. A high-resolution structure of the protein with four ligands at high occupancy is determined. Both the number of ligands bound and their occupancy is higher using on-grid soaking of microcrystals compared with much larger crystals treated similarly and investigated by X-ray crystallography. These results indicate that on-grid soaking ligands into microcrystals results in efficient uptake of ligands into protein microcrystals.