cssi/SciSciGPT-SciSciNet huggingface dataset:
Dynamics and Equilibrium for Single Step Hole Transport Processes in Duplex DNA

The dynamics of single step hole transport processes from a guanine cation radical (G+·) to GG, GGG and deazaguanine (Z) secondary electron donors separated by one or two A:T base pairs have been investigated by means of nanosecond time-resolved absorption spectroscopy with kinetic modeling. Photoinduced electron transfer from G to a stilbenedicarboxamide (Sa) hairpin linker is used to generate a G+·/Sa−· radical ion pair separated by two or three A:T base pairs. The occurrence of hole transport from G+· to the secondary donors results in an increase in the Sa−· decay time. Kinetic modeling provides both the forward and return rate constants for hole transport, from which the hole transport equilibrium constant and free energy can be obtained. No other experimental method has yielded equilibrium data. Hole transport dynamics depend on the identity of the secondary donor, the number and identity of the bases separating the primary and secondary donor, and the location of the donor within the same strand as the primary donor or in the complementary strand. Secondary GG and GGG donors form very shallow hole traps, whereas Z forms a much deeper hole trap. These results are correlated with other transient absorption studies, selected strand cleavage data, and current theories of charge transport in DNA.
Abstract 6: What Proportion of High-Cost Patients’ Inpatient Spending is Preventable?

Objective: A small proportion of patients accounts for a substantial proportion of healthcare spending in the U.S., and the majority of costs in this group are due to inpatient hospitalizations. Many interventions targeting high-cost patients have aimed to prevent hospitalizations for common medical conditions. However, there is surprisingly little data on the proportion of inpatient hospitalizations among high-cost patients that are potentially preventable. We sought to determine the proportion and dollar value of preventable hospitalizations among the high-cost Medicare population, and if these patterns differ for non-high-cost beneficiaries. Methods: We assigned standardized costs to each inpatient and outpatient service contained in standard 5% Medicare files from 2009. Patients under the age of 65, those with any Medicare Advantage enrollment, and those who died during in 2009 were excluded. Costs were summed across the year and across settings for each patient in our sample. We defined those in the top decile of cost as “high-cost” patients. We then used the Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQIs) to identify potentially preventable hospitalizations. These include conditions such as heart failure, diabetes, hypertension, and asthma, for which good outpatient care can potentially prevent the need for hospitalization. We calculated the proportion of short-stay acute-care hospital costs that were accounted for by these preventable hospitalizations for the high-cost and non-high-cost patient groups. All costs are projected to the total Medicare sample. Results: There were 1,710,989 patients in our sample. High-cost patients were older (median age 75 versus 73), more often male (43.2% versus 39.3%), and more often black (12% versus 9%) than non-high-cost patients, and had a higher burden of comorbid illnesses. Inpatient spending, projected to the total Medicare population, was $90.3 billion. The 10% of Medicare patients that made up the “high-cost” cohort accounted for 72% ($65 billion) of all inpatient spending. However, within the high-cost group, only 9.7% of the spending ($6.3 billion) was due to preventable hospitalizations, while the remaining 90.3% ($58.9 billion) was spent on other causes of hospitalization. Within the non-high-cost group, though their overall spending was lower, a slightly higher proportion of hospitalizations were potentially preventable (14.7%, or $3.7 billion). Conclusions: Though high-cost patients account for the majority of inpatient spending, fewer than one in ten of their hospitalizations are potentially preventable through better outpatient care. Thus, focusing on outpatient interventions such as case management may not be optimally targeted. We also need strategies that make hospital care more efficient so that each episode of inpatient care is less expensive regardless of its cause.
Delivery of human mesenchymal stem cells following experimental bone marrow transplantation

227 Objectives Mesenchymal stem cells (MSCs) have shown promise as treatment for graft-versus-host disease (GvHD) following allogeneic bone marrow transplantation (alloBMT). Mechanisms mediating in vivo effects of MCSs remain largely unknown, including whether their biodistribution pattern correlates with treatment effect. The purpose of this study is to develop in vivo imaging techniques to track cell distributions in the context of GvHD when MSCs are delivered through artery or vein. Methods Human MSCs (hMSCs) were injected into allogeneic and syngeneic BMT recipient mice via either carotid artery (IA) or tail vein (TV). Biodistribution was measured using both bioluminescence imaging (BLI) after hMSCs transduction with a reporter gene system containing luciferase and planar scintigraphic imaging when the cells were labeled with [99mTc]-HMPAO. Results IA injection resulted in whole-body hMSC distribution that persisted over two weeks in alloBMT recipients, while cells were cleared in the syngeneic animals within one week. Although hMSCs initially accumulated in the lungs in both transplant groups, more cells migrated to other organs in alloBMT recipient mice including the intestines, as measured by in vivo BLI and scintigraphy, and confirmed by ex vivo BLI imaging, immunohistochemistry, and quantitative RT-PCR. In contrast, TV hMSCs were mainly entrapped in the lung with a smaller fraction of cells traveling to the GvHD target organs like the intestines. Conclusions This study demonstrates the potential use of arterial injection to alter hMSC biodistribution in order to more effectively deliver hMSCs to target tissues. In vivo imaging played a vital role for the assessment of biodistributions of hMSCs delivered via different routes.
Using multi-channel data with multi-level modeling to assess in-game performance during gameplay with Crystal Island

Abstract Game-based learning environments (GBLEs) have been touted as the solution for failing educational outcomes. In this study, we address some of these major issues by using multi-level modeling with data from eye movements and log files to examine the cognitive and metacognitive self-regulatory processes used by 50 college students as they read books and completed the associated in-game assessments (concept matrices) while playing the C rystal I sland game-based learning environment. Results revealed that participants who read fewer books in total, but read each of them more frequently, and who had low proportions of fixations on books and concept matrices exhibited the strongest performance. Results stress the importance of assessing quality vs. quantity during gameplay, such that it is important to read books in-depth (i.e., quality), compared to reading books once (i.e., quantity). Implications for these findings involve designing adaptive GBLEs that scaffold participants based on their trace data, such that we can model efficient behaviors that lead to successful performance.
Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature.

Issues. Mobile phone use has increased dramatically and concurrent with rapid developments in mobile phone-based health interventions. The integration of text messaging interventions promises to optimise the delivery of care for persons with substance dependence with minimal disruption to clinical workflows. We conducted a systematic review to assess the acceptability, feasibility and clinical impact of text messaging interventions for persons with illicit drug and alcohol dependence. Approach. Studies were required to evaluate the use of text messaging as an intervention for persons who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition criterion for a diagnosis of illicit drug and/or alcohol dependence. Authors searched for articles published to date in MEDLINE (pubmed.gov), the Cochrane Library, EMBASE, CINAHL, Google Scholar and PsychINFO. Key Findings. Eleven articles met the search criteria for this review and support the acceptability and feasibility of text messaging interventions for addressing illicit drug and alcohol dependence. Most studies demonstrated improved clinical outcomes, medication adherence and engagement with peer support groups. Text messaging interventions also intervened on multiple therapeutic targets such as appointment attendance, motivation, self-efficacy, relapse prevention and social support. Implications. Suggestions for future research are described, including intervention design features, clinician contact, privacy measures and integration of behaviour change theories. Conclusion. Text messaging interventions offer a feasible platform to address a range of substances (i.e. alcohol, methamphetamine, heroin and alcohol), and there is increasing evidence supporting further larger-scale studies. [Tofighi B, Nicholson JM, McNeely J, Muench F, Lee JD. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature. Drug Alcohol Rev 2017;00:000-000]
Effects of medical trainees’ weight‐loss history on perceptions of patients with obesity

Context Medical professionals often express weight-biased attitudes. Prior research suggests that people who overcome a challenge are critical of individuals who struggle to overcome the same challenge. Thus, medical trainees who have successfully achieved and maintained weight loss may express greater weight bias and more critical attitudes toward patients with obesity who fail to overcome these challenges. Objectives This study was designed to determine the effects of medical trainees’ weight-loss history on weight-biased attitudes and responses to patients with varying weight-loss outcomes. Methods An online survey was completed by 219 medical students and internal medicine residents. Participants’ weight-biased attitudes were assessed before they were randomly assigned to read one of three patient vignettes in which the patient lost no weight, lost/regained weight, or lost/maintained weight. Independent measures included trainee gender, trainee weight loss and maintenance, and the three experimental conditions of patient outcomes. Dependent measures included the Anti-Fat Attitudes (AFA) Questionnaire's Willpower and Dislike subscales, ratings (on a scale of 1–7) of compassion, frustration, and blame toward the patients presented in the vignettes, and perceptions of the physician–patient alliance. All analyses controlled for trainee body mass index. Results Among trainees, 67.1% reported having successfully lost weight. Of those who had lost weight, 79.5% reported maintaining their weight loss. Trainees who had successfully lost/maintained weight expressed less compassion toward patients across vignettes (5.4 ± 1.2 versus 5.9 ± 1.2; p<0.05), and more blame toward the patient who lost/regained weight than did trainees who had lost/regained weight (3.4 ± 1.3 versus 2.3 ± 1.3; p<0.01). Overall, the patient who did not lose weight was viewed most negatively, followed by the patient who lost/regained (all p-values < 0.05). Female (but not male) trainees who had successfully lost weight expressed stronger weight-biased attitudes on the AFA scales than did those who had never lost weight (all p-values < 0.01). Conclusions Medical trainees’ personal success with weight loss and maintenance may negatively affect their perceptions of patients with obesity who struggle with weight management.
Invisible invariants and abstract interpretation

The method of Invisible Invariants provides a way to verify safety properties of infinite parameterized classes of finite-state systems using finite-state model checking techniques. This paper looks at invisible invariants from the point of view of abstract interpretation. Viewed in this way, the method suggests a generic strategy for computing abstract fixed points in the case where the best abstract transformer has a high computational cost. This strategy requires only that we can reasonably segregate the infinite concrete state space into finite subsets of increasing size or complexity. We observe that in domains for which the computation of the best abstract transformer may require an exponential number of calls to a theorem prover, we can sometimes reduce the number of theorem prover calls to just one, without sacrificing accuracy.
Controlled growth and Atomic-scale Characterization of Two-dimensional hexagonal boron nitride crystals

Abstract Two-dimensional (2D) hexagonal boron nitride (h-BN) is a fascinating material for variety of applications such as graphene-based devices, transparent/bendable electronics, and deep ultraviolet emitters. However, its technological applications are contingent upon tunable and scalable growth. Here, we demonstrate reproducible and tunable growth of high-quality h-BN crystals on Cu via chemical vapor deposition (CVD) through a precise control of the BN precursor’s flow during growth. We present synthesis of both epitaxially-grown triangular flakes and large-area continuous films with tunable thickness ranging from monolayer to 11-layer thick. Using a combination of electron microscopy imaging, spectroscopy, and diffraction analysis, we thoroughly study morphology, thickness, chemistry, grain size, and atomic structure of the grown h-BN crystals. This study could pave the way for developing controlled and reproducible growth of high-quality h-BN crystals with tunable thickness and morphology.
Membrane-particle complexes in cultured mouse foot pad cells exposed toMycobacterium thamnopheos

Certain temporal studies designed to investigate the phagocytosis ofMycobacterium thamnopheos by cultured mouse foot pad (MFP) cells has revealed an accumulation of glycogen-like particles in the bacterial and animal cells. These particles have been seen only when the two cell types are exposed to one another. The particles inM. thamnopheos resemble either alpha or beta glycogen, while those in the MFP cells appear as beta glycogen routinely associated with smooth membranes forming cisternal spaces. The particles may be within the spaces or external to them. Membrane-particle complexes are frequently seen in association with MFP cell cytoplasmic lipid inclusions. The factors responsible for the presence of these particles are not known, nor is it known why the particles are present at all time intervals studied in some cultures but totally absent in others.
A framework for incorporating general domain knowledge into latent Dirichlet allocation using first-order logic

Topic models have been used successfully for a variety of problems, often in the form of application-specific extensions of the basic Latent Dirichlet Allocation (LDA) model. Because deriving these new models in order to encode domain knowledge can be difficult and time-consuming, we propose the Foldċall model, which allows the user to specify general domain knowledge in First-Order Logic (FOL). However, combining topic modeling with FOL can result in inference problems beyond the capabilities of existing techniques. We have therefore developed a scalable inference technique using stochastic gradient descent which may also be useful to the Markov Logic Network (MLN) research community. Experiments demonstrate the expressive power of Foldċall, as well as the scalability of our proposed inference method.
Response to When Less is More: Cultivating a Community in Relationship With God

I appreciate the opportunity to respond to Lisa Graham McMinn’s insightful article. She presented a series of ideas that resonate with discussions of community that we must continually explore in C...
Optic Nerve Regeneration: Considerations on Treatment of Acute Optic Neuropathy and End-Stage Disease

Acute and chronic optic neuropathies lead to irreversible vision loss, prompting considerations of regenerative therapy. Th e insult commonly occurs primarily in the anterior optic nerve, which leads to degeneration of retinal ganglion cells (RGCs) and their axons and loss of oligodendrocytes. We review important aspects of optic nerve regeneration and animal models of disease. Preclinical studies in animals showed that approaches that improve RGC survival and axon regeneration include neurotrophic factor delivery, genetic manipulation, visual stimulation, and cell therapies, but impact on glia must be also considered. While intravitreal delivery of molecules has been most commonly used, direct targeting of the optic nerve should be considered. Treatment can differ if targeting acute or subacute vs. chronic optic neuropathies, depending on whether most RGC axons and somata are still present and salvageable, or if somata and axons are gone and need to be replaced. Combined neuron- and glia-directed treatments may lead to more successful vision restoration.
Clinical complications and outcomes of angiographically negative subarachnoid hemorrhage.

Objective To define the in-hospital course, complications, short- and long-term functional outcomes of patients with angiographically negative subarachnoid hemorrhage (anSAH), particularly those with aneurysmal-pattern anSAH (aanSAH). Methods Retrospective cohort study of patients with aneurysmal subarachnoid hemorrhage (aSAH), aanSAH, and perimesencephalic-pattern anSAH (panSAH) treated at a single tertiary referral center between January 2006 and April 2018. Ninety-nine patients with anSAH (33 aanSAH and 66 panSAH) and 464 patients with aSAH were included in this study. Outcomes included symptomatic hydrocephalus requiring CSF drainage, need for ventriculoperitoneal shunt, radiographic vasospasm, delayed cerebral ischemia (DCI), radiographic infarction, disability level within 1 year of ictus, and at last clinical follow-up as defined by the modified Rankin Scale. Results Patients with aanSAH and panSAH had similar rates of DCI and radiologic infarction, and patients with aanSAH had significantly lower rates compared to aSAH ( p ≤ 0.018). Patients with aanSAH were more likely than those with panSAH to require temporary CSF diversion and ventriculoperitoneal shunt ( p ≤ 0.03), with similar rates to those seen in aSAH. Only one patient with anSAH died in the hospital. Compared to those with aSAH, patients with aanSAH were significantly less likely to have a poor functional outcome within 1 year of ictus (odds ratio 0.26, 95% confidence interval 0.090–0.75) and at last follow-up (hazard ratio 0.30, 95% confidence interval 0.19–0.49, p = 0.002). Conclusions DCI is very uncommon in anSAH, but patients with aanSAH have a similar need for short- and long-term CSF diversion to patients with aSAH. Nevertheless, patients with aanSAH have significantly better short- and long-term outcomes.
Deep Reinforcement Learning for Detecting Malicious Websites.

Phishing is the simplest form of cybercrime with the objective of baiting people into giving away delicate information such as individually recognizable data, banking and credit card details, or even credentials and passwords. This type of simple yet most effective cyber-attack is usually launched through emails, phone calls, or instant messages. The credential or private data stolen are then used to get access to critical records of the victims and can result in extensive fraud and monetary loss. Hence, sending malicious messages to victims is a stepping stone of the phishing procedure. A \textit{phisher} usually setups a deceptive website, where the victims are conned into entering credentials and sensitive information. It is therefore important to detect these types of malicious websites before causing any harmful damages to victims. Inspired by the evolving nature of the phishing websites, this paper introduces a novel approach based on deep reinforcement learning to model and detect malicious URLs. The proposed model is capable of adapting to the dynamic behavior of the phishing websites and thus learn the features associated with phishing website detection.
Multispectral surface emissivity from VIRTIS on Venus Express

Abstract The surface composition of Venus is mostly inaccessible to remote observation due to the dense cloud cover. There are five spectral windows that show measurable thermal emission from the surface at night. The VIRTIS spectrometer on Venus Express observed three of these windows over much of the southern hemisphere of Venus. We use these data along with Magellan altimetry to map surface emissivity. The data are initially processed to correct for instrumental straylight from the dayside of Venus and to improve wavelength registration. These corrected data are then inverted to emissivity at 1020, 1100, and 1180 nm wavelength using lookup tables created by an atmospheric radiative transfer model. As in earlier studies we find residual trends of surface emissivity with respect to the Magellan altimetry that is used in the model to determine surface temperature and thickness of the atmosphere. A new observation is that these trends vary significantly from region to region, indicating some lateral variability of atmospheric parameters, most likely near surface atmospheric temperature. The trends are consistent over hundreds to thousands of km, thus it is possible to correct for them heuristically. In two regions studied in this paper there are significant deviations from the background emissivity which are associated with some geologic features. The high noise in 1100 and 1180 nm maps derived from VIRTIS data result in large uncertainties of spectral shape. The VIRTIS instrument was not designed for this task and future observations could provide high signal to noise ratio maps in at least 5 distinct bands diagnostic of major rock types and minerals.
Risk of Bleeding from Primary Thromboprophylaxis (PTP) in Patients with Solid Cancer Receiving Chemotherapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (RCT)

Abstract Introduction: Thrombosis is the second leading cause of death in cancer patients. Hypothetically, prognosis might be improved by preventing thrombotic events by PTP. PTP has to be outweighed with the bleeding risk from PTP benefit. Moreover, PTP in ambulatory cancer patients remains uncertain. We performed a systematic review and meta-analysis of RCTs to determine the risk of major bleeding (MB) and clinically relevant non-major (CRNM) bleeding from PTP with low-molecular weight heparins (LMWH) in solid cancer patients receiving chemotherapy. Methods: We systematically conducted a comprehensive literature search using MEDLINE and EMBASE databases through May 31, 2016. The RCTs with MB and CRNM bleeding as safety outcomes were included in the analysis. Mantel-Haenszel method was used to calculate the estimated pooled risk ratio (RR), and risk difference (RD) with 95% confidence interval (CI). Random effects model was applied. Results: 12 RCTs with a total of 8643 patients were eligible for analysis. Dalteparin, nadroparin, certoparin, semuloparin and bemiparin were used in the studies. 9 studies utilized prophylactic doses, while one used intermediate doses and 2 employed therapeutic dose. The PTP duration was from 6 weeks to 6 months. MB events were reported in 67 (1.486%) patients on PTP compared to 46 (1.112%) in control group. The pooled RR for MB was statistically nonsignificant at 1.341 (95% CI: 0.917 to 1.960, P = 0.130). CRNM bleeding events were noted in 209 (4.637%) in PTP group and 106 (2.563%) in control group. The RR for CRNM bleeding was statistically significant at 1.729 (95% CI: 1.017 to 2.938, P = 0.043). The absolute RD in CRNM bleeding was 0.020 (95% CI: 0.004 to 0.035, P = 0.012) with an estimated number needed to harm (NNH) of 48 to cause one CRNM bleeding event. Conclusions: Approximately 60 patients are needed to be treated with PTP to prevent one symptomatic venous thrombosis among all ambulatory unselected cancer patients on chemotherapy in a previous meta-analysis. Our meta-analysis revealed that PTP contributed an increase in CRNM bleeding events with NNH of 48. The risk of bleeding should not be underestimated and more RCTs are required before making any recommendations. Download : Download high-res image (157KB) Download : Download full-size image Download : Download high-res image (138KB) Download : Download full-size image Download : Download high-res image (168KB) Download : Download full-size image Disclosures Oo: Daiichi Sankyo: Research Funding.
China in Anglo-American relations: the Cairo Conference, November 22–26 and December 2–7, 1943

China’s participation in the Cairo Conference in late November and early December 1943 served as a highwater mark for China’s diplomatic standing during World War Two. Spurred by President Roosevelt’s wish to elevate China and Chinese leader Chiang Kai-shek’s international standing to one of the “Big Four” allies along with British Prime Minister Winston Churchill and Soviet leader Joseph Stalin, Chiang sought to make the most of his first, and only, appearance on the international war-time stage by pressing for China’s interests to be addressed. Assisted by American General Joseph Stilwell, Chiang pushed for the Americans and British to commit to a major military operation in Burma in addition to a long list of requests. However much Roosevelt wished to honor the Chinese requests, he came up against British resistance, and although, by this time, the Americans were contributing far more to the fighting of the war, the relationship between Roosevelt and Churchill, between the Americans and the British, took precedence over any and all Chinese needs. Cairo may have marked the peak of China’s international influence during the war, but it failed to overcome the far greater bond that connected the USA and Great Britain.
Coagulation, hemostasis, and transfusion during liver transplantation

Liver disease is associated with complex disturbances of hemostasis that affect both the pro- and anticoagulant systems. This results in a "rebalanced" coagulation system that may result in bleeding diathesis or increased clot formation. Conventional coagulation models of coagulation such as the waterfall cascade model and conventional coagulation tests are not able to reflect these complex changes as they only account for deficiencies of the pro-coagulant system. Viscoelastic tests such as rotational thromboelastometry or thromboelastography may be more suitable to assess coagulation and guide transfusions in liver transplants. Specific recommendations for transfusion of platelets, fresh frozen plasma, cryoprecipitate, and fibrinogen as well as factor concentrates are discussed. In general transfusion should not only be guided by laboratory values but it also includes a clinical assessment of clot formation.
Driving Markov Chains to Desired Equilibria via Linear Programming

Categorical time series arise frequently in both biomedical and sports analytics settings. For instance, [1] considers EEG measurements of infants’ sleep states, where each state is an element of {"quiet sleep", "indeterminate sleep", "active sleep", "awake"}. In our previous work [2] , we have modeled substitutions of players in NBA basketball games—here each state corresponds to a group of five players on the court. We consider modeling such systems using Markov chains. We must then estimate the entries of either the transition matrix, for discrete-time Markov chains (DTMCs), or the transition rate matrix, for continuous-time Markov chains (CTMCs). In both cases, we have access to closed-form maximum likelihood estimators (MLEs). If we decide to use a DTMC model, to estimate the transition probability from state i to state j , we simply count the number of transitions from i to j present in the data, and divide by the total number of transitions from i to any state. This is the MLE. The MLE is consistent: assume the data is generated by an irreducible, recurrent DTMC with transition probabilities p ij . Then, given time series of length N , as N → ∞, the MLE estimates ${\hat p_{ij}}$ converge to p ij with probability 1. We have stated these results for DTMCs; for CTMCs, the story is analogous.
The Importance of the Northeastern Gulf of Mexico to Foraging Loggerhead Sea Turtles

Identification of high-use foraging sites where imperiled sea turtles are resident remains a globally-recognized conservation priority. In the biodiverse Gulf of Mexico (GoM), recent telemetry studies highlighted post-nesting foraging sites for federally threatened loggerhead turtles (Caretta caretta). Our aim here was to discern loggerhead use of additional northern GoM regions that may serve as high-use foraging sites. Thus, we used satellite tracking and switching state-space modeling to show that the Big Bend region off the northwest Florida coast is a coastal foraging area that supports imperiled adult female loggerhead turtles tracked from different nesting subpopulations. From 2011 – 2016, we satellite-tagged 15 loggerheads that nested on four distinct beaches around the GoM: Dry Tortugas National Park, FL; Everglades National Park, FL; St. Joseph Peninsula, FL; and Gulf Shores, AL. Turtles arrived at their foraging ground in the Big Bend region between June and September and remained resident in their respective foraging sites for an average of 198 tracking days, where they established mean home ranges (95% kernel density estimate) 232.7 km2. Larger home ranges were in deeper water; 50% kernel density estimate centroid values were a mean 26.4 m deep and 52.7 km from shore. The Big Bend region provides a wide area of suitable year-round foraging habitat for loggerheads from at least 3 different nesting subpopulations. Understanding where and when threatened loggerheads forage and remain resident is key for designing both surveys of foraging resources and additional protection strategies that can impact population recovery trajectories for this imperiled species.
Quantitative contrast-enhanced ultrasound of the brain on twin fetal lambs maintained by the extrauterine environment for neonatal development (EXTEND): initial experience

With the development of an artificial environment to support the extremely premature infant, advanced imaging techniques tested in this extrauterine system might be beneficial to evaluate the fetal brain. We evaluated the feasibility of (a) performing contrast-enhanced ultrasound (CEUS) and (b) quantifying normal and decreased brain perfusion in fetal lambs maintained on the extrauterine environment for neonatal development (EXTEND) system. Twin premature fetal lambs (102 days of gestational age) were transferred to the EXTEND system. Twin B was subjected to sub-physiological flows (152 mL/kg/min) and oxygen delivery (15.9 mL/kg/min), while Twin A was maintained at physiological levels. We administered Lumason contrast agent into the oxygenator circuit and performed serial CEUS examinations. We quantified perfusion parameters and generated parametric maps. We also recorded hemodynamic parameters, serum blood analysis, and measurements across the oxygenator. Postmortem MRIs were performed. No significant changes in hemodynamic variables were attributable to CEUS examinations. On gray-scale images, Twin B demonstrated ventriculomegaly and progressive parenchymal volume loss culminating in hydranencephaly. By CEUS, Twin B demonstrated decreased peak enhancement and decreased overall parenchymal perfusion when compared to Twin A by perfusion parameters and parametric maps. Changes in perfusion parameters were detected immediately following blood transfusion. Postmortem MRI confirmed ultrasonographic findings in Twin B. In this preliminary experience, we show that CEUS of the brain is feasible in fetal lambs maintained on the EXTEND system and that changes in perfusion can be quantified, which is promising for the application of CEUS in this extrauterine system supporting the premature infant.
Distributed Leadership in Collegiate Esports

Background.Current research supports the use of recreational games in higher education settings for student development. Team-based esports in collegiate settings offer leadership experiences analo...
Changes in Regional Hospital-Identified Clostridioides difficile Infection, 2015–2018

Background: Regional changes in United States C. difficile infection (CDI) are not well understood but important for targeting prevention strategies. Methods: Community-onset (CO) CDI was defined as positive C. difficile stool tests collected on or before hospital day 3 (where admission was day 1), reported by acute-care hospitals to the CDC NHSN over 3 years: year 1, July 1, 2015–June 30, 2016; year 2, July 1, 2016–June 30, 2017; year 3, July 1, 2017–June 30, 2018. Healthcare facility-onset CDI (HO-CDI) was similarly defined but with stool collection after hospital day 3. Hospital referral regions (HRRs) were defined by the Dartmouth Atlas of Health Care, and they represent 306 healthcare markets. Standardized infection ratios (SIRs) were calculated using separate multivariable models for (1) CO-CDI events in an emergency department/observation unit (ED/Obs), (2) CO-CDI events among inpatients, and (3) HO-CDI, accounting for facility-level factors, They resulted in ratios of observed to predicted infections, similar to established methods. SIRs were pooled within each facility to create a hospital-identified SIR by summing observed and predicted events for CO-CDI events in both testing locations and HO-CDI events, then pooled by HRR by summing all facility observed and predicted events within the region. Data from facilities not within an HRR were excluded. Results: Total CO-CDI (ED/Obs and inpatient) and HO-CDI events decreased, even as the number of reporting facilities slightly increased over the 3-year period (Fig. 1). Among 306 HRRs in year 3, the median number of hospitals was 10 (IQR, 6–17), with a median of 526 (IQR, 272–1,002) hospital-identified CDI events per HRR. Variables significantly associated with CDI incident rate and included in SIR models 1–3 included C. difficile test type, hospital type, teaching affiliation, hospital bed size, and presence of an ED/Obs unit. Intensive care unit capacity was included in models 2 and 3, and the ratio of hospital admissions to emergency department encounters in model 1. Pooled mean HRR hospital-identified C. difficile SIRs decreased each year (0.972, 0.914, and 0.838), and decreases also varied by HRR (Fig. 2). Conclusions: National decreases in a combined hospital-identified C. difficile SIR are widespread but may be more aggregated in particular regions. Although SIR adjustments were limited to facility-level factors, aggregation of CDI SIR by HRR may be useful for infection preventionists and public health authorities to further understand regional CDI patterns. Funding: None Disclosures: None
Exploiting circadian memory to hasten recovery from circadian misalignment

Recent years have seen a sustained interest in the development of circadian reentrainment strategies to limit the deleterious effects of jet lag. Due to the dynamical complexity of many circadian models, phase-based model reduction techniques are often an imperative first step in the analysis. However, amplitude coordinates that capture lingering effects (i.e., memory) from past inputs are often neglected. In this work, we focus on these amplitude coordinates using an operational phase and an isostable coordinate framework in the context of the development of jet-lag amelioration strategies. By accounting for the influence of circadian memory, we identify a latent phase shift that can prime one's circadian cycle to reentrain more rapidly to an expected time-zone shift. A subsequent optimal control problem is proposed that balances the trade-off between control effort and the resulting latent phase shift. Data-driven model identification techniques for the inference of necessary reduced order, phase-amplitude-based models are considered in situations where the underlying model equations are unknown, and numerical results are illustrated in both a simple planar model and in a coupled population of circadian oscillators.
Cochlear Implantation Outcomes in Observed Vestibular Schwannoma: A Preliminary Report.

ObjectiveOver the last decade there has been a trend toward observation for small nongrowing vestibular schwannoma (VS). Even without tumor growth, patients commonly experience ipsilateral hearing ...
Plant life span and response to inoculation with vesicular-arbuscular mycorrhizal fungi

To determine the relative responsiveness to and dependency on vesicular-arbuscular mycorrhizae (VAM) of annual and perennial plants, this study compared the responses of congeneric, sympatric pairs of species in the grass genera Panicum and Bromus to inoculation with two VAM fungal isolates from the genus Glomus. When inoculated with G. intraradices, the perennials P. virgatum and B. inermus showed significantly greater response at both high and low phosphorus (P) than did the annuals P. capillare and B. secalinus. Responsiveness of perennials was significant at both P levels, whereas annuals responded significantly only at low P. Neither Bromus species responded strongly to inoculation with G. etunicatum. Overall, the perennial grasses were more responsive and dependent than were the annuals. A survey of 26 studies including 84 plant-VAM fungus combinations yielded similar patterns of responsiveness in relation to P level and plant life span, especially for grasses. The greater responsiveness of perennial grasses to VAM infection must be considered within the suite of life history traits used to erect hypotheses concerning successional replacement of annuals by perennials in graminoid-dominated ecosystems.
The World is Open

The world is open: How web technology is revolutionizing education (2009), by Curtis J. Bonk, is an enlightening journey into the world of Web 2.0 resources and the future (and present) of global educational opportunities. The book follows in the footsteps of Thomas L. Friedman's The world is flat: A brief history of the twenty-first century (2005). Bonk carries Friedman's thought into the realm of education, with the idea of an open world arising from the widespread and uninhibited accessibility of educational opportunities and resources. For Bonk, the world's openness means "anyone can now learn anything from anyone at anytime" (p. 13). The journey begins with e-books and ends with networks of personalized learning. The reader is treated to an amazing variety of openers that have helped to make the world of today a different educational environment than it was even 10 or 20 years ago. These openers are tools, resources, conceptual frameworks, and environments that conjoin to create a more open world. Bonk' s 10 major openers include e-learning and blended learning, open source and free software, leveraged resources and open courseware, learning object repositories and portals, open information communities, electronic collaboration, alternate reality, and real-time mobility and portability. Bonk uses anecdotal stories to convince the reader of the power of the 10 openers. This reader needed no convincing. Bonk' s optimistic tone and sure grasp of the myriad of tools and resources available in the world of e-learning today were too far compelling to resist. On one hand, this book was difficult to read. Pages were so full of resources, I could not help but look up and explore each resource mentioned. The spirit of discovery in the book slowed my progress. On the other hand, the book was an easy read. Every few pages, Bonk described a new resource with the potential to change the educational landscape of tomorrow. This book is full of the excitement that surrounds Web 2.0 and new media technologies. Bonk is careful to avoid being bogged down in the details of each technology, and leaves it in the reader's hands to experiment with each tool and resource. He only includes scholarly material when necessary to drive home a point, making The world is open a popular and vividly enchanting
Consumption and asset prices

Abstract Employing aggregate consumption data to test the consumption-based capital asset pricing model (CCAPM) is likely to lead to a specification error since a significant portion of consumers live from paycheck-to-paycheck and, therefore, are constrained in their ability to intertemporally allocate consumption. Furthermore, these consumers lack the savings needed to directly influence an equilibrium between consumption expenditures and asset returns. Using consumption expenditures grouped by consumer income, this paper examines the issue of whether the CCAPM is more consistent with the consumption of unconstrained (high-income) consumers as compared to constrained (low-income) consumers. Several traditional methods of analyzing the CCAPM are explored utilizing five time series of consumption expenditures delineated by consumer income. This approach allows us to indirectly test whether liquidity constraints affect the CCAPM without imposing additional specification on the model. Overall, the tests fail to find any discernible patterns across income groups that are consistent with the idea that liquidity constraints bind lower income consumers.
From Politics to Rights and Back Again: Some Legal Realism on Election Law Litigation

The Supreme Court is often criticized for being too rights-oriented in its treatment of campaign finance regulation, particularly by reformers who feel that elected officials should have more discretion to negotiate what are essentially political bargains at the heart of such reforms. This paper looks at the evidence from the critical case in this policy area, Buckley v. Valeo, to argue that political advocacy has been at least as important as rights mobilization in campaign finance cases. Examining the formal pleadings and oral argument in Buckley, I find that neither the plaintiffs nor the defense argued for all that was allowed under the rights jurisprudence of the time. Instead, each side’s legal arguments reflected its political interests – attempting to remake a fairly well-balanced legislative policy into a system that benefited one set of electoral competitors over another. The case therefore recalls the tenets of legal realism, in that political preferences affected actors’ interpretations of the relevant constitutional rules. In fact, the example demonstrates the need to expand the legal realists’ analysis, looking beyond the judges in constitutional cases to investigate the political interests and litigational strategies of the parties to the dispute.
Disorders of Impulse Control

Reviewed in this chapter are the research and theory concerning conditions that have in common deficits in impulse control, or disinhibitory psychopathology. Emphasized in particular are the substance use disorders and pathological gambling. Disorders of impulse control are prevalent in all societies and place high costs on the affected individuals, as well as their friends, family members, and often the rest of society. Because they often co-occur within the same individuals, it is useful clinically and conceptually to understand their psychopathology from a common theoretical perspective. For each of the specific variants of disinhibitory psychopathology, there appears to be multiple etiological mechanisms that convey risk for their development. We have termed these mechanisms positive affect regulation, negative affect regulation, pharmacological vulnerability (in the case of substance use disorders), and deviance proneness. It seems likely that attention to these underlying mechanisms will permit a refinement of diagnosis and provide starting points for new approaches to prevention and treatment. Considered as well are pathologies and etiologies recognized within the research and clinical literature to be specific to individual substance use and pathological gambling disorders. Keywords: abuse; addiction; alcohol; dependence; disinhibition; drug; gambling; impulse; substance
History and Perspectives in Scattering Theory. A Strictly Personal View

This summer institute was mostly concerned with a variety of scattering theory that originated in the middle fifties. It may be interesting to recall the circumstances and motivation for the revision and reconstruction that was begun in this period.
An asynchronous two-way relay system with full delay diversity in time-varying multipath environments

We consider design of asynchronous OFDM-based diamond two-way-relay (DTWR) systems in time-varying frequency-selective (doubly-selective) fading channels such as underwater acoustic (UWA) channels. In a DTWR channel, two users exchange their messages with the help of two relays. Most of the existing work on asynchronous DTWR systems assume only small relative propagation delays between the received signals at each node. However, in practical systems, significant delays may take place. Our proposed system is able to tolerate the delay even if it exceeds the length of the OFDM block which is almost inevitable in UWA channels. We provide analytical and numerical results to verify the advantages of the proposed scheme in mitigating large delays in different fading conditions.
Perturbative pole mass in QCD

It is widely believed that the pole mass of a quark is infrared finite and gauge independent to all orders in perturbation theory. This seems not to have been proved in the literature. A proof is provided here.
Risk of redocumenting penicillin allergy in a cohort of patients with negative penicillin skin tests.

BACKGROUND Even though electronic documentation of allergies is critical to patient safety, inaccuracies in documentation can potentiate serious problems. Prior studies have not evaluated factors associated with redocumenting penicillin allergy in the medical record despite a proven tolerance with a penicillin skin test (PST). OBJECTIVE Assess the prevalence of reinstating inaccurate allergy information and associated factors thereof. DESIGN We conducted a retrospective observational study from August 1, 2012 to July 31, 2013 of patients who previously had a negative PST. We reviewed records from the hospital, long-term care facilities (LTCF), and primary doctors' offices. SETTING Vidant Health, a system of 10 hospitals in North Carolina. SUBJECTS Patients with proven penicillin tolerance rehospitalized within a year period from the PST. MEASUREMENTS We gauged hospital reappearances, penicillin allergy redocumentation, residence, antimicrobial use, and presence of dementia or altered mentation. RESULTS Of the 150 patients with negative PST, 55 (37%) revisited a Vidant system hospital within a 1-year period, of whom 21 were LTCF residents. Twenty (36%) of the 55 patients had penicillin allergy redocumented without apparent reason. Factors associated with penicillin allergy redocumentation included age >65 years (P = 0.011), LTCF residence (P = 0.0001), acutely altered mentation (P < 0.0001), and dementia (P < 0.0001). Penicillin allergy was still listed in all 21 (100%) of the LTCF records. CONCLUSIONS At our hospital system, penicillin allergies are often redocumented into the medical record despite proven tolerance. The benefits of PST may be limited by inadequately removing the allergy from different electronic/paper hospital, LTCF, primary physician, and community pharmacy records. Journal of Hospital Medicine 2013;8:615–618. © 2013 Society of Hospital Medicine