cssi/SciSciGPT-SciSciNet huggingface dataset:
An adaptive paradigm for human space settlement

Abstract Because permanent space settlement will be multigenerational it will have to be viable on ecological timescales so far unfamiliar to those planning space exploration. Long-term viability will require evolutionary and adaptive planning. Adaptations in the natural world provide many lessons for such planning, but implementing these lessons will require a new, evolutionary paradigm for envisioning and carrying out Earth-independent space settlement. I describe some of these adaptive lessons and propose some cognitive shifts required to implement them in a genuinely evolutionary approach to human space settlement.
How the Al-Aulaqi Lawsuit Threatens to Undermine International Humanitarian Law

In 2010 the ACLU filed a lawsuit that attempted to enjoin the Obama Administration from continuing to target Anwar al-Aulaqi. An integral part of the legal basis for that lawsuit was the claim that the targeting of al-Aulaqi as a member of AQAP in Yemen was occurring "outside of armed conflict." Although the lawsuit was dismissed on procedural grounds, this short essay examines the ACLU's central legal argument that strikes in Yemen were occurring outside of armed conflict and therefore beyond the scope of IHL (International Humanitarian Law). If this proposed limitation on the scope of IHL were accepted it would effectively turn IHL on its head. Such a limitation would fundamentally undermine IHL by offering sanctuaries to groups like al Qaeda and AQAP that until now were disfavored because their conduct (targeting civilians and blending in with the civilian population) was antithetical to IHL's core purposes of protecting the civilian population from harm.
Strategic communication

We model games where players strategically exchange messages in a language for reasoning and strategically update their reasoning. The language for the stage game incorporates awareness and knowledge and extends [14]'s propositional quantification to quantification over all sentences in the language. The updating of reasoning is modeled as a strategic choice of the players and the dynamics of the logic provide constraints for this strategic update choice. A communication game is constructed using an underlying incomplete information game, the strategic choice of messages and the strategic and logic dynamics. Multiple games are described varying by how the game theoretic type-space relates to the language for reasoning.
Federal subsidization and state Medicaid provision

Abstract This paper explores the determination of state Medicaid provision in the United States and quantifies the effects of federal subsidization on Medicaid provision. The U.S. federal government matches every state at least one dollar for each dollar that the state spends on Medicaid. We measure the effect of the subsidy by constructing a multi-regional, heterogeneous-agent, dynamic general equilibrium model with incomplete insurance markets and calibrating it to the U.S. economy. In the model, state governments take the federal subsidy as given and implement Medicaid policy according to the decision of the median voter. The benchmark economy delivers a close approximation to the Medicaid coverage rate in 2012. To measure the effect of the federal subsidy, we set the subsidy to zero and find that state Medicaid coverage declines by 9%. We then study the mechanism determining Medicaid provision and find a positive relationship between progressivity of the tax structure and Medicaid coverage.
An Experimental Approach to the Development of a Socio-Economic Model

E VEERYONE is familiar with studies which describe the effect of various types of social legislation and, on a grander scale, studies which describe the operation of an entire economy.' From studies of this nature it is sometimes possible to make predictions of future happenings. However, the multiplicity and diversity of the factors involved in a modern industrial economy render it extremely difficult to conduct controlled experiments with social institutions. For research purposes it is desirable to have a simple society with a limited number of factors so that control over "interfering" variables may be established. In an effort to bring a socio-economic system into the sociology laboratory where it would be possible to control many factors, the game of "Monopoly" was seized upon as a likely starting point.2 Instructions accompanying this favorite parlor game state,
Treatment Planning with the Multi-Leaf Collimator

The value of three-dimensional graphics in the planning of radiation treatments using treatment machines equipped with a multi leaf collimator system is examined. Methods are described for preparing patient anatomical data for treatment planning and for defining the parameter settings of the treatment machine from these data.
Gastrointestinal Bleeding in Acute Ischemic Stroke: A Population-Based Analysis of Hospitalizations in the United States.

Background and Objective Over half of all patients admitted with acute ischemic stroke (AIS) suffer gastrointestinal complications. Our goal was to determine the burden of gastrointestinal bleeding (GIB) in hospitalized patients with AIS using the largest, all-payer, inpatient database in the United States. Methods The Nationwide Inpatient Sample (2002-2011) was queried to identify all adult patients with a primary diagnosis of AIS with and without a secondary diagnosis of GIB. We used multivariable analyses, adjusting for pertinent confounders, to identify risk factors for GIB in AIS patients and to determine the effect of GIB on in-hospital complications and outcomes. Results Of 3,988,667 patients hospitalized for AIS, there were 49,348 cases of GIB (1.24%). In multivariable analysis, patients with a history of peptic ulcer disease (odds ratio [OR]: 2.45, 95% confidence interval [CI]: 2.10-2.86) and liver disease (OR: 2.42, 95% CI: 2.26-2.59) were more likely to suffer GIB. Patients suffering from GIB were more likely to require intubation (OR: 2.04, 95% CI: 1.95-2.13) and blood transfusion (OR: 11.31, 95% CI: 11.00-11.63). The occurrence of GIB increased hospital length of stay by an average of 5.8 days and total costs by $14,120 per patient (all P Conclusions GIB occurrence in patients with AIS is relatively rare but is associated with poor in-hospital outcomes, including mortality. We identified risk factors associated with GIB in AIS, which allows physicians to monitor patient populations at the highest risk.
Integration of $N-1$ Contingency Analysis With Systematic Transmission Capacity Expansion Planning: ERCOT Case Study

In this paper, we propose a method for $N-1$ contingency constrained transmission capacity expansion planning (TCEP), which is formulated as a mixed-integer programming (MIP) problem. In relatively well-designed power systems, a single outage of a majority of lines will not usually cause overload on other lines in most loading conditions. Thus they will not affect the feasible region and the optimal answer of the TCEP optimization problem, and can be safely removed from contingency analysis if we can identify them. A contingency identification index is developed to detect these lines and create variable contingency lists (VCL) for different network loading conditions. In our proposed method, we use results of a relaxed version of the original problem as a lower bound answer in the first step, and integrate contingencies into TCEP in the next steps to solve this optimization problem faster while still satisfying $N-1$ criterion. For solving TCEP with contingencies, two options are offered, i.e., option A that uses an updated system as its base case (original existing network together with selected lines by the relaxed problem) and option B that uses the original existing network as its base case (without results of the relaxed problem). Option A is faster than option B because it usually should select fewer new lines compared to B, but cannot guarantee optimality. Option B provides the optimal answer while taking more computational time. An ERCOT case study is used to show capabilities of the proposed method for solving large scale problems, and the numerical result demonstrates this method is much faster than the integrated MIP method that directly incorporates all contingencies.
Application of a Stated Choice Approach to Assessing Public Preferences for Wildlife Conservation Funding

ABSTRACTLimited funds for wildlife conservation require difficult choices about allocation of resources. One consideration is public preferences. While traditional attitudinal approaches can provide information about preferences for conservation efforts aimed at individual species, stated choice models offer a more suitable approach for exploring the complexity of public support across multiple species, through an examination of individuals’ choices in tradeoff situations. Using a survey in the American Southwest, we explored residents’ preferences for allocating funds for species based on factors that describe those species; species status, origin, and use. Species origin (native or non-native) and use (game or non-game) were more important as a whole than species status (declining, common, or extirpated). Further, respondents generally prioritized native (over non-native), game (over non-game), and declining (over common or extirpated). We discuss the implications of these findings for communication eff...
Predictive modeling in Clostridium acetobutylicum fermentations employing Raman spectroscopy and multivariate data analysis for real-time culture monitoring

The coupling of optical fibers with Raman instrumentation has proven to be effective for real-time monitoring of chemical reactions and fermentations when combined with multivariate statistical data analysis. Raman spectroscopy is relatively fast, with little interference from the water peak present in fermentation media. Medical research has explored this technique for analysis of mammalian cultures for potential diagnosis of some cancers. Other organisms studied via this route include Escherichia coli , Saccharomyces cerevisiae , and some Bacillus sp. , though very little work has been performed on Clostridium acetobutylicum cultures. C. acetobutylicum is a gram-positive anaerobic bacterium, which is highly sought after due to its ability to use a broad spectrum of substrates and produce useful byproducts through the well-known Acetone-Butanol-Ethanol (ABE) fermentation. In this work, real-time Raman data was acquired from C. acetobutylicum cultures grown on glucose. Samples were collected concurrently for comparative off-line product analysis. Partial-least squares (PLS) models were built both for agitated cultures and for static cultures from both datasets. Media components and metabolites monitored include glucose, butyric acid, acetic acid, and butanol. Models were cross-validated with independent datasets. Experiments with agitation were more favorable for modeling with goodness of fit (QY) values of 0.99 and goodness of prediction (Q 2 Y) values of 0.98. Static experiments did not model as well as agitated experiments. Raman results showed the static experiments were chaotic, especially during and shortly after manual sampling.
Network Performance Analysis of Radar Network Against the Background of Distributed Network

Against the background of distributed network, performance evaluation plays an important role in validation of radar net countermeasures and tactic research.The system structure and characteristic have been studied according to the complex network theory.The network structure model and performance evaluation model are both presented and the problems in the system evaluation are also solved in a brand new way.The simulations of the networked structure model to testify the ability of information communication have been conducted and the results have proved its value in guiding the system construction and performance evaluation.Moreover, the Optimal Guideline Process is applied to the model and the integrated quantified evaluation is realized based on the hierarchy model of network performance.
Why I am not a cognitive psychologist

distinguish between (1) the selective action of that environment during the evolution of the species, (2) its effect in shaping and maintaining the repertoire of behavior which converts each member of the species into a person, and (3) its role as the occasion upon which behavior occurs. Cognitive psychologists study these relations between organism and environment, but they seldom deal with them directly. Instead they invent internal surrogates which become the subject matter of their science. Take, for example, the so-called process of association. In Pavlov's experiment a hungry dog hears a bell and is then fed. If this happens many times, the dog begins to salivate when it hears the bell. The standard mentalistic explanation is that the dog "associates" the bell with the food. But it was Pavlov who associated them! "As
Metabolism of ezlopitant, a nonpeptidic substance P receptor antagonist, in liver microsomes: enzyme kinetics, cytochrome P450 isoform identity, and in vitro-in vivo correlation

The enzyme kinetics of the metabolism of ezlopitant in liver microsomes from various species have been determined. The rank order of the species with regard to the in vitro intrinsic clearance of ezlopitant was monkey >> guinea pig > rat >> dog > human. CJ-12,764, a benzyl alcohol analog, was observed as a major metabolite, and a dehydrogenated metabolite (CJ-12,458) was equally important in human liver microsomes. Scale-up of the liver microsomal intrinsic clearance data and correcting for both serum protein binding and nonspecific microsomal binding yielded predicted hepatic clearance values that showed a good correlation with in vivo systemic blood clearance values. Including microsomal binding was necessary to achieve agreement between hepatic clearance values predicted from in vitro data and systemic clearance values measured in vivo. Cytochrome P450 (CYP) 3A4, 3A5, and 2D6 demonstrated the ability to metabolize ezlopitant to CJ-12,458 and CJ-12,764. However, in liver microsomes, the CYP3A isoforms appear to play a substantially more important role in the metabolism of ezlopitant than CYP2D6, as assessed through the use of CYP-specific inhibitors, correlation to isoform-specific marker substrate activities, and appropriate scale-up of enzyme kinetic data generated in microsomes containing individual heterologously expressed recombinant CYP isoforms. The apparent predominance of CYP3A over CYP2D6 is consistent with observations of the pharmacokinetics of ezlopitant in humans in vivo.
Improved lymphocyte cytotoxicity against murine renal cell carcinoma.

Abstract In this paper we describe the generation of antibody dependent cellular cytotoxicity against a murine renal cell carcinoma. Using human recombinant interleukin-2 and in vitro adherence to plastic, we generated lymphokine activated killer and adherent lymphokine activated killer cells. Adherent lymphokine activated killer cells had significant (p
A pilot study of attachment style and emotional experience in adolescent girls with loss of control eating

ABSTRACTThe established link between attachment insecurity and disinhibited eating may in part be explained by social problems, negative mood, and/or physiologic ‘stress’; however, these mechanisms have not been tested in adolescents with loss of control (LOC) eating. We therefore examined associations among attachment styles, social problems, negative emotions, and autonomic indices in 32 adolescent girls with recurrent LOC eating (body mass index z-score = 2.2 ± 0.4; age = 14.9 ± 1.6 years). Participants completed the Behavioral Systems Questionnaire to assess relational styles (secure, preoccupied, avoidant) and the Beck Depression Inventory to assess depressive symptoms. Parents completed the Child Behavior Checklist to assess teen social problems. Ecological momentary assessment (EMA) of real-world negative affect and social problems was collected for two weeks, and ambulatory monitoring of autonomic indices for two days. Preoccupied attachment was positively associated with depressive symptoms (n = ...
The Influence of Regulatory Focus on the Effect of Product Cues

The purpose of this study is to explore the extent to which informational cues interact with individuals’ motivational states during their evaluation of a product. This article confirms the interaction effects between informational cues and motivational states by examining product attributes and advertising appeals as informational cues, and regulatory focus as a motivational state. The results from three studies indicate that consumers with promotion focus find extrinsic cues as more important and have more favorable evaluation toward a product with superior extrinsic cues. Prevention-focused consumers, however, perceive intrinsic cues of a product as more important, and thus have more favorable evaluation toward a product with superior intrinsic cues.
Abstract 231: Coronary Artery Bypass Grafting is Superior to Percutaneous Coronary Intervention for Multivessel Coronary Disease in Chronic Kidney Disease

Introduction: Randomized clinical trials comparing coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) have generally excluded patients with chronic kidney disease, and observational comparisons have been inconclusive. Hypothesis: We examined whether initial revascularization with CABG is associated with lower risks of death and coronary events compared with PCI among patients with chronic kidney disease and multivessel coronary disease. Methods: We identified adults aged ≥30 years in Kaiser Permanente of Northern California with multivessel coronary disease who underwent initial revascularization between 1996 and 2008. Patients were followed for the outcomes of death, acute coronary syndrome, or repeat revascularization until December 31, 2008. We calculated the estimated glomerular filtration rate (eGFR, in mL/min per 1.73 m2) using the CKD-EPI equation and stratified the cohort into three eGFR categories: ≥60, 45-59, and <45. Patients on maintenance dialysis were excluded. We used Cox regression and adjusted for age, sex, race, Hispanic ethnicity, cardiovascular and other comorbidities, medication use, smoking status, dipstick proteinuria, hemoglobin, cholesterol, index year and local health care facility. Results: Among 22,361 adults receiving CABG (n=16,219) or PCI (n=6142), 26% had baseline eGFR 45-59, and 15% had baseline eGFR <45. Patients receiving PCI were more often female and more often had a history of acute myocardial infarction. The median follow-up was 5.3 years for CABG patients and 3.7 years for PCI patients. CABG was associated with significantly lower risks of death, acute coronary syndrome and repeat revascularization at all levels of kidney function, even after adjustment for potential confounders and longitudinal use of cardiovascular medications (Figure). Conclusions: Among adults with chronic kidney disease and multivessel coronary disease, initial revascularization with CABG is associated with lower risks of death and coronary events compared with PCI. Our findings support conducting adequately-powered randomized clinical trials comparing coronary revascularization strategies specifically in patients with chronic kidney disease. ![Graphic][1] [1]: /embed/inline-graphic-1.gif
Mapping the Human Body: A GIS Perspective

This chapter describes a novel application and interpretation of geography and mapping, applying the concepts and technology of Geographic Information Systems (GIS) at the scale of the human body. We also explore the use of spatial statistics as an adjunct to GIS to gain further understanding of the patterns found in maps. Despite the technical computational challenges, there are several reasons why a spatial or “geographic” perspective in this context is particularly useful. The concept of spatial contiguity is central to our understanding of disease. Different body systems, like the gastrointestinal, nervous or cardiovascular system, have a spatial organization. Disease in one region often spreads outward to neighboring regions, or along networks like the lymphatic system or vascular system. The spatial location of disease affects the ability to detect and treat it. Exploring and analyzing the particular effect of location on clinical outcomes thus becomes a crucial tool in understanding the disease process and improving diagnosis and treatment. The examples given and issues raised will hopefully stimulate further inquiry, and generate additional solutions to the challenge of representing and analyzing the human anatomy from a spatial perspective.
Elevated Hemi-diaphragms as a Cause of ST-segment Elevation: A case report and review of literature

While ST-segment elevation (STE) on ECG is widely recognized as representing myocardial infarction or injury such as coronary occlusion or pericarditis, STE may occasionally ensue from non-cardiac etiologies. Indeed, gastrointestinal disorders causing STE are not well documented in the literature. We present a case wherein extreme abdominal distension and hemi-diaphragm elevation resulted in extrinsic cardiac and epicardial coronary compression manifesting as STE. Subsequent relief of the abdominal distension resulted in resolution of STE representing a noncoronary cause of STE. A brief literature review, illustrating the importance of considering abdominal etiologies as a cause of STE is provided.
Sampling and Analysis in Genetic Studies on Wood

In some ways, working with wood is quite easy because the bole of a tree contains a permanent record of wood development. Thus one can see what wood was produced 5 or 10 years ago because it is still there and the actual cell structure has not changed. Cell chemistry can change with time but cell anatomy remains reasonably constant. Within-tree stress as the tree ages can alter cell anatomy to some degree.
Genomics: risk and outcomes in cardiac surgery.

Coronary artery bypass graft surgery is associated with several frequent postoperative adverse events. Outcome prediction is valued by patients and practioners, because it provides some measure of balancing risks and benefits and provides expensive or higher-risk therapies to individuals at highest risk. Surgeons and anesthesiologists traditionally have relied on demographic, preoperative, and intraoperative risk factors to predict outcomes after cardiac surgery. Yet, such predictions often have poor positive and negative predictive value for the individual patient. Perioperative genetics attempts to determine the impact of an individual's genetic variation on the risk of developing adverse postoperative outcomes. In this article, the authors discuss emerging evidence that a patient's genetic makeup predisposes him or her to adverse outcomes following cardiac surgery and provide examples from perioperative bleeding, myocardial injury/infarction, and atrial fibrillation.
Modeling of memristor device & analysis of stability issues

A robust physical model governing trap assisted inelastic tunneling mechanism for the conducting area of a memristor device with an intermediate thickness dielectric (<100nm) has been developed. This model takes into account, the contribution of both the oxygen vacancies and the defects within the oxide responsible for the significant increase of charge carriers through this non-volatile memory device. A one dimensional simulator has been designed here that shows reasonable compatibility between the practically obtained values with that of the simulated ones. Here tunneling of electrons between variable energy states of the different layer materials within the device, dominates the switching mechanism that involves a strong non-linearity of the electric field dependence.
Global attractors of some predator–prey reaction–diffusion systems with density-dependent diffusion and time-delays

Abstract This paper deals with a two-species and a three-species predator–prey reaction diffusion systems where the diffusion coefficients are density dependent and time-delays are involved in the reaction functions. The diffusion terms are of porous medium type which are degenerate and the boundary conditions are of Neumann type. The aim of the paper is to investigate the asymptotic behavior of the time-dependent solution in relation to various steady-state solutions of the system. This includes the existence of a unique positive classical solution, global attraction of a steady-state solution, and stability or instability of various semitrivial solutions and the positive steady-state solution.
Speed up the coherent scattering tomographic imaging (Conference Presentation)

Conventional X-ray computed tomography (CT) only reconstructs the attenuation map. X-ray coherent scattering computed tomography (CSCT) probes the angular-dependent scattering profiles of the three-dimensional (3D) object, achieving a high structural specificity among materials with similar electron density. However, due to the low level of interaction of coherent scattering and the 3D scattering profiles of crystalline materials, the real-life anomaly detection using coherent scattering signature posed challenges in acquisition speed, algorithm efficiency, reconstruction quality, and detection accuracy. In this invited talk, we will discuss the efforts in accelerating the image acquisition speed while maintaining object-specific information from the Optical Imaging System Lab at the University of Central Florida. Specifically, the talk will be focus on maximize the system detection efficiency and improve the classification/reconstruction performance for low photon detection level to meet the need of practical detection.
Pathological roles of iron in cardiovascular disease

Iron is an essential mineral required for a variety of vital biological functions. Despite being vital for life, iron also has potentially toxic aspects. Iron has been investigated as a risk factor for coronary artery disease (CAD), however, iron's toxicity in CAD patients still remains controversial. One possible mechanism behind the toxicity of iron is "ferroptosis", a newly described form of irondependent cell death. Ferroptosis is an iron-dependent form of regulated cell death that is distinct from apoptosis, necroptosis, and other types of cell death. Ferroptosis has been reported in ischemiareperfusion (I/R) injury and several other diseases. Recently, we reported that ferroptosis is a significant form of cell death in cardiomyocytes. Moreover, myocardial hemorrhage, a major event in the pathogenesis of heart failure, could trigger the release of free iron into cardiac muscle and is an independent predictor of adverse left ventricular remodeling after myocardial infarction. Iron deposition in the heart can now be detected with advanced imaging methods, such as T2 star (T2*) cardiac magnetic resonance imaging, which can non-invasively predict iron levels in the myocardium and detect myocardial hemorrhage, thus existing technology could be used to assess myocardial iron. We will discuss the role of iron in cardiovascular diseases and especially with regard to myocardial I/R injury.
On the Relative Importance of Wind Forcing and Nonlinear Interactions in the Downshift of a Gravity Wave Wavenumber Spectrum

Under wind forcing, the deep water gravity wave amplitude spectrum experiences a shift of the spectral peak and its neighboring wave numbers toward lower wave numbers (downshift). This downshifting as the waves respond to a wind field is widely believed to be caused by the nonlinear interactions that govern the intrinsic wave dynamics. We investigate this process by integrating the Krasitskii equations in the presence of driving and dissipation. These equations make no a priori assumptions regarding the wave amplitude probability distribution function. Numerical results indicate that while nonlinear interactions play a role, the dominant cause of the downshift is the functional dependencies on wave number which are at the very least required for such a wind forcing term to have the correct dimensions.
Copyright Preemption and the Right of Publicity

This article addresses the conflict between an ever-expanding right of publicity and the federally guaranteed rights provided by copyright law. This conflict is highlighted in the Wendt v. Host International case in which the actors George Wendt and John Ratzenberger from Cheers used the right of publicity to prevent the show's creators from licensing the use of the Norm and Cliff characters in the decor of a chain of airport bars. Even though the licensing of the characters was explicitly allowed under copyright law, the Ninth Circuit held that the right of publicity prevented the creators from doing so. Similarly, performers have successfully used the right of publicity to prevent the making of sound-alike recordings even though the Copyright Act explicitly permits such recordings. The vast majority of courts have not preempted the right of publicity even when it conflicts with clearly established copyright law. This is true, in part, because most courts have relied almost exclusively on the preemption clause of the Copyright Act which is ambiguous and difficult to apply. Neither courts nor scholars have looked much beyond the Copyright Act's explicit preemption clause when considering preemption of publicity rights. This article proposes a new approach to analyzing copyright preemption - one which incorporates the broader principles of the Supremacy Clause to determine when copyright law should preempt the right of publicity. The article then presents a practical test for determining when the right of publicity stands as an obstacle to copyright law and should therefore be preempted.
Characteristics and Outcomes of Small Cell Lung Cancer Detected by CT Screening.

Background Previous studies with a limited number of patients have reported divergent findings on whether screening can detect small cell lung cancer (SCLC) at an earlier stage and whether there might be a survival benefit. Methods This study examined the characteristics of SCLC detected by using low-dose CT (LDCT) screening in the National Lung Screening Trial, a randomized study of individuals at high risk for developing lung cancer comparing LDCT imaging vs chest radiography. SCLC was denoted as screen detected if diagnosed ≤ 1 year of a positive screen or after a longer period but with no time gap between diagnostic procedures of > 1 year; interval detected if diagnosed ≤ 1 year of a negative screen; and nonscreen detected if the subject did not receive any screens or otherwise as postscreening. Results A total of 143 cases of SCLC were diagnosed, including 49 (34.2%) screen detected, 15 (10.5%) interval detected, and 79 (55.2%) nonscreened/postscreening. Of the screening phase-diagnosed cases (ie, screen or interval detected), a higher proportion of SCLC cases compared with NSCLC cases were interval detected (23% vs 5%; P Conclusions “Early detection” with the use of LDCT imaging had no impact on SCLC outcomes. A successful screening modality should ideally detect SCLC earlier than when it can be detected on LDCT scans.
Contemporary Outcomes of Peripheral Bypass Compared with Amputation in Octogenarians.

BACKGROUND Chronic limb threatening ischemia in octogenarians presents unique treatment challenges in patients with multiple comorbidities and variable functional status. Endovascular interventions offer a better risk profile; however, this is not always a feasible option for anatomic or disease-specific reasons. This study compares outcomes of peripheral bypass versus amputation in octogenarians. METHODS The American College of Surgeon's National Surgical Quality Improvement Program database was queried from 2013 to 2016 for patients >80 years undergoing femoral-popliteal bypass (FPB), femoral-tibial bypass, or popliteal-tibial bypass with vein or prosthetic graft versus above-knee amputation (AKA) or below-knee amputation. Patients presenting with systemic inflammatory response syndrome, sepsis, septic shock, or a leukocytosis >11,000 were excluded. Patient demographics, risk factors, and 30-day unadjusted outcomes were analyzed. Multivariate regression analysis was then performed to compare risk adjusted 30-day morbidity and mortality. RESULTS The bypass group contained 2226 patients compared with 1253 patients in the amputation group. AKA represented 59.9% of the amputation group. The largest portion of bypasses were FPBs at 58.6%. Total preoperative functional dependence was 1.3% for bypass versus 18.2% for amputation (P-value, <0.01). Risk factors for amputation over bypass included age, minority race, American Society of Anesthesiologists class IV-V, diabetes, congestive heart failure, dialysis, preoperative open wound, facility of origin, and functional dependence. Unadjusted 30-day mortality was 3.6% for bypasses and 7.7% for amputations (P-value, <0.01), with an in-hospital mortality of 2.0% vs. 3.2% and a mortality after discharge of 1.6% vs. 4.5%, respectively (P-value <0.01). Unadjusted morbidity was not significantly different between the 2 groups (18.7% bypass vs. 17.8% amputation, P-value, 0.52). After multivariate risk adjustment, there was no statistically significant difference in mortality or morbidity between the groups. CONCLUSIONS Contemporary risk-adjusted 30-day morbidity and mortality for bypass versus amputation in octogenarians show no significant difference. These data demonstrate that aggressive surgical limb salvage can be safe in well-selected patients in this age group.
Reducing radiotherapy target volume expansion for patients with HPV-associated oropharyngeal cancer

Abstract Purpose To evaluate clinical outcomes and patterns of failure using a direct gross tumor volume to planning target volume expansion in patients with p16-positive oropharyngeal squamous cell carcinoma. Methods and materials We performed a retrospective review of patients with p16-positive oropharyngeal squamous cell carcinomas treated between 2002 and 2017 with primary radiotherapy with or without concurrent systemic therapy. Patient and disease characteristics associated with disease control and clinical outcomes were analyzed by Cox proportional hazards regression and Kaplan-Meier analyses. Imaging at the time of first failure was used to categorize failure patterns. Results We identified 134 patients with a median follow-up of 56.2 months (range 8.2–160.2 months). Local and regional control at 5 years was 91.5% (95% CI: 86.8–96.4%), and 90.8% (95% CI: 85.6–96.2%), respectively. Of the 14 locoregional failures, there were 10 in-field (Type A), 3 marginal (Type B), and 1 geographic (Type E). Age >70 years (HR 5.42; 95% CI: 1.87–15.68) and T4 versus T1-3 (HR 4.09; 95% CI: 1.01–2.65) were associated with increased rates of locoregional failure on multivariate analysis. The rate of gastrostomy tube retention at one year was 6.0% (range 2.8–12.7%). Conclusions Management of patients with p16-positive oropharyngeal squamous cell carcinoma using definitive radiotherapy and a high-dose planning target volume created without a gross tumor volume to clinical tumor volume expansion resulted in high locoregional control with the vast majority of failures occurring within the high-dose field. These data warrant prospective evaluation of this technique as a therapy de-intensification approach.
Estimating Individualized Daily Self-Reported Affect with Wearable Sensors

Wearable sensors (smart watches, health/fitness trackers, etc.) are experiencing an explosion in popularity. Their pervasiveness allows for effective data collections to quantify human behavior in natural settings, enriching traditional behavioral science research opportunities. In this paper, we focus on the problem of affect estimation from sensor-generated data, whereas ground truth is available to us in the form of daily self-reported affective states. First, our analysis shows that individuals’ self-reported affect labels exhibit low variance, with a few samples deviating significantly from average observations, which may relate to experiencing out-of-the-ordinary events. Second, we explore different machine learning models as well as label transformation techniques to directly infer the self-reported scores from available sensor data. Experimental results show that mixed effects model and label transformation are able to better estimate the individual daily affect. This work poses the basis for future sensor-based individualized and real-time affective digital and/or clinical interventions.
Clinical characteristics of acute lower extremity deep venous thrombosis diagnosed by duplex in patients hospitalized for coronavirus disease 2019.

Abstract Objective Little is known about coronavirus disease 2019 (COVID-19)-associated hypercoagulability. We sought to characterize patients with deep venous thrombosis (DVT) identified after admission for COVID-19. Methods All adult patients admitted to Montefiore Medical Center from March 1, 2020, to April 10, 2020, and undergoing lower extremity venous duplex for DVT evaluation were included. Patients admitted with suspicion of COVID-19 were divided into severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive and SARS-CoV-2 negative groups based on in-hospital test results. Patients without clinical suspicion for COVID-19 were not tested. A retrospective case-control study design was used to identify potential risk factors for DVT in patients with COVID-19. Demographic, radiographic, and laboratory values were abstracted and analyzed. Results During the study period, 3404 patients with confirmed COVID-19 were admitted to the hospital. Of the 135 SARS-CoV-2 patients who underwent duplex scanning, there were 18 (13.3%) noted to have DVT compared with 72 of the 711 patients (10.1%) who were either SARS-CoV-2 negative or untested. The odds ratio for DVT in COVID-19 was 1.35 (95% confidence interval, 0.78-2.34; P = .289). Baseline characteristics for COVID-19 patients with and without DVT were overall similar. COVID-19 patients with DVT had an elevated median first d -dimer (18.88 μg/mL [interquartile range (IQR), 7.79-20.00] vs 2.55 μg/mL [IQR, 1.45-6.28]; P = .002; reference value, d -dimer (median, 11.93 μg/mL [IQR, 8.25-16.97] vs 3.54 μg/mL [IQR, 2.05-8.53]; P d -dimer levels at the time of the duplex (13.61 μg/mL [IQR, 4.04-19.97] vs 3.58 μg/mL [IQR, 2.51-9.62]; P = .055) and median ferritin levels (1679.0 ng/mL [IQR, 1168.0-2577.0] vs 1103.0 ng/mL [IQR, 703.5-2076.5]; P = .055; reference range, 25-270 ng/mL). Twelve of the 18 patients with COVID who developed DVT did so despite chemical thromboprophylaxis, and 2 developed DVT despite therapeutic anticoagulation Conclusions We found only a modestly increased risk of DVT in patients with COVID-19, likely underestimated owing to limitations in duplex testing early in the epidemic. Elevated d -dimer and a less elevated fibrinogen are associated with DVT in patients with COVID-19 who seem to form thrombus despite conventional chemical thromboprophylaxis. Additionally, an increasing d -dimer over time may be a reflection of the development of DVT in patients with COVID-19.
Sleep, self-management, neurocognitive function, and glycemia in emerging adults with Type 1 diabetes mellitus: A research protocol.

Type 1 Diabetes (T1D) affects 1.6 million Americans, and only 14% of emerging adults ages 18-25 years achieve targets for glycemic control (A1C < 7.0%). Sleep deficiency, including habitual short sleep duration (<6.5 hr total sleep time and high within-person variability in total sleep time), is associated with poorer glycemic control. Emerging adults with T1D have a more pronounced sleep extension on weekends compared with matched controls, consistent with sleep deficiency; however, associations among sleep variability and glycemic control have not been explored in this population. Sleep deficiency may affect the complex higher-order neurocognitive functioning needed for successful diabetes self-management (DSM). We report the protocol for an ongoing study designed to characterize sleep and the associations among sleep deficiency, neurocognitive function, DSM, diabetes quality of life, and glycemia among a sample of 40 emerging adults with T1D. We monitor sleep via wrist-worn actigraphy and glucose via continuous glucose monitoring concurrently over 14 days. We are collecting data on self-report and objective sleep, a 10-min psychomotor vigilance test on a PVT-192 device, a 3-min Trail Making Test on paper, and questionnaires, including twice-daily Pittsburgh sleep diaries using Research Electronic Data Capture (REDCap)TM . Results from this study will be used to support the development and testing of the efficacy of a tailored sleep self-management intervention that may improve total sleep time, sleep variability, neurocognitive function, DSM, glycemic control, and glucose variability among emerging adults with T1D.
What millimeter-wavelength radar reflectivity reveals about snowfall: an information-centric analysis

Abstract. The ability of single-frequency, millimeter-wavelength radar reflectivity observations to provide useful constraints for retrieval of snow particle size distribution (PSD) parameters, snowfall rates, and snowfall accumulations is examined. An optimal estimation snowfall retrieval that allows analyses of retrieval uncertainties and information content is applied to observations of near-surface W-band reflectivities from multiple snowfall events during the 2006–2007 winter season in southern Ontario. Retrieved instantaneous snowfall rates generally have uncertainties greater than 100 %, but single-event and seasonal snow accumulations from the retrieval results match well with independent collocated measurements of accumulations. Absolute fractional differences are mainly below 30 % for individual events that have more substantial accumulations and, for the season, 12.6 %. Uncertainties in retrieved snowfall rates are driven mainly by uncertainties in the retrieved PSD parameters, followed by uncertainties in particle model parameters and, to a lesser extent, the uncertainties in the fallspeed model. Uncertainties attributable to assuming an exponential distribution are negligible. The results indicate that improvements to PSD and particle model a priori constraints provide the most impactful path forward for reducing uncertainties in retrieved snowfall rates. Information content analyses reveal that PSD slope is well-constrained by the retrieval. Given the sensitivity of PSD slope to microphysical transformations, the results show that such retrievals, when applied to radar reflectivity profiles, could provide information about microphysical transformations in the snowing column. The PSD intercept is less well constrained by the retrieval. While applied to near-surface radar observations in this study, the retrieval is applicable as well to radar observations aloft, such as those provided by profiling ground-based, airborne, and satellite-borne radars under lighter snowfall conditions when attenuation and multiple scattering can be neglected.
Cationic π-Conjugated Polyelectrolyte Shows Antimicrobial Activity by Causing Lipid Loss and Lowering Elastic Modulus of Bacteria

Cationic, π-conjugated oligo-/polyelectrolytes (CCOEs/CCPEs) have shown great potential as antimicrobial materials to fight against antibiotic resistance. In this work, we treated wild-type and ampicillin-resistant (amp-resistant) Escherichia coli (E. coli) with a promising cationic, π-conjugated polyelectrolyte (P1) with a phenylene-based backbone and investigated the resulting morphological, mechanical, and compositional changes of the outer membrane of bacteria in great detail. The cationic quaternary amine groups of P1 led to electrostatic interactions with negatively charged moieties within the outer membrane of bacteria. Using atomic force microscopy (AFM), high-resolution transmission electron microscopy (TEM), we showed that due to this treatment, the bacterial outer membrane became rougher, decreased in stiffness/elastic modulus (AFM nanoindentation), formed blebs, and released vesicles near the cells. These evidences, in addition to increased staining of the P1-treated cell membrane by lipophilic dye Nile Red (confocal laser scanning microscopy (CLSM)), suggested loosening/disruption of packing of the outer cell envelope and release and exposure of lipid-based components. Lipidomics and fatty acid analysis confirmed a significant loss of phosphate-based outer membrane lipids and fatty acids, some of which are critically needed to maintain cell wall integrity and mechanical strength. Lipidomics and UV-vis analysis also confirmed that the extracellular vesicles released upon treatment (AFM) are composed of lipids and cationic P1. Such surface alterations (vesicle/bleb formation) and release of lipids/fatty acids upon treatment were effective enough to inhibit further growth of E. coli cells without completely disintegrating the cells and have been known as a defense mechanism of the cells against cationic antimicrobial agents.
The Cost of Innovation and Evidence in Cardiac Surgery

This review summarizes a systematic analysis of 216 randomized trials of cardiovascular interventions performed during 2008-2019, according to the source of trial funding. The systematic analysis showed that on average the results of each trial would change significance if only 5 patients experienced different outcomes. Industry-sponsored trials were more likely to use composite endpoints, noninferiority designs, and twice as likely as nonindustry trials to report results favoring the device arm. Over 80% of industry trials used reporting strategies or "spin" suggesting the device arm was advantageous versus fewer than half of non-industry trials. The review discusses the implications of these findings.
A pilot clinical trial of oral tetrahydrouridine/decitabine for noncytotoxic epigenetic therapy of chemoresistant lymphoid malignancies.

Abstract One mechanism by which lymphoid malignancies resist standard apoptosis-intending (cytotoxic) treatments is genetic attenuation of the p53/p16-CDKN2A apoptosis axis. Depletion of the epigenetic protein DNA methyltransferase 1 (DNMT1) using the deoxycytidine analog decitabine is a validated approach to cytoreduce malignancy independent of p53/p16. In vivo decitabine activity, however, is restricted by rapid catabolism by cytidine deaminase (CDA). We, therefore, combined decitabine with the CDA-inhibitor tetrahydrouridine and conducted a pilot clinical trial in patients with relapsed lymphoid malignancies: the doses of tetrahydrouridine/decitabine used (∼10/0.2 mg/kg orally (PO) 2×/week) were selected for the molecular pharmacodynamic objective of non-cytotoxic, S-phase dependent, DNMT1-depletion, guided by previous Phase 1 studies. Patients with relapsed/refractory B- or T-cell malignancies (n = 7) were treated for up to 18 weeks. Neutropenia without concurrent thrombocytopenia is an expected toxicity of DNMT1-depletion and occurred in all patients (Grade 3/4). Subjective and objective clinical improvements occurred in 4 of 7 patients, but these responses were lost upon treatment interruptions and reductions to manage neutropenia. We thus performed parallel experiments in a preclinical in vivo model of lymphoma to identify regimen refinements that might sustain DNMT1-targeting in malignant cells but limit neutropenia. We found that timed-alternation of decitabine with the related molecule 5-azacytidine, and combination with inhibitors of CDA and de novo pyrimidine synthesis could leverage feedback responses of pyrimidine metabolism to substantially increase lymphoma cytoreduction but with less neutropenia. In sum, regimen innovations beyond incorporation of a CDA-inhibitor are needed to sustain decitabine DNMT1-targeting and efficacy against chemo-resistant lymphoid malignancy. Such potential solutions were explored in preclinical in vivo studies.
Obstacles to food security, food pantry use, and educational success among university students: a mixed methods approach.

Purpose. This study contrasts views of university students with very low or high food security scores with respect to: obstacles to healthy eating, food pantry use, and managing dietary and educati...