cssi/SciSciGPT-SciSciNet huggingface dataset:
100 Cases of Hemipelvectomy: A Personal Experience

This operation should be the initial treatment in such diseases as high-lying soft part sarcomas of the lower extremity, melanoma, and squamous carcinoma of the skin of the distal extremity when nodal disease exists, and in those bone tumors not amenable to radiation therapy, viz., osteogenic sarcoma and chondrosarcoma of the femur and pelvic bones.
Mitochondrial UPR in Cancer

Cancer cells are characterized by mutations in both the nuclear and mitochondrial genomes as well as by an oxidative environment. Both of these events can lead to misfolding of proteins and result in proteotoxic stress. While accumulation of misfolded proteins in the cytoplasm can be directly limited by the activity of the 26S proteasome, the presence of misfolded proteins within the lumen of organelles represents an additional challenge. The unfolded protein response (UPR) was first described as the result of accumulation of misfolded proteins in the lumen of the endoplasmic reticulum (UPRER). More recently, however, activation of a distinct UPR in response to the accumulation of misfolded proteins in the lumen of the mitochondria (UPRmt) has begun to be appreciated. Major advances in the molecular characterization of the UPRmt have been made in C. elegans in the context of its role in the control of longevity. This chapter however focuses specifically on the role of the UPRmt to maintain the integrity of the mitochondrial network in face of oxidative stress during oncogenic transformation in mammalian cells. Further, since the matrix and the intermembrane space have drastically distinct protein quality control capacities, the relative contribution of each subcompartment to the activation of the UPRmt is described. In addition, the role of the UPRmt in the elimination of damaged mitochondrion from the mitochondrial network of cancer cells by mitophagy is also discussed. Overall, the picture that emerges is that the UPRmt represents a multilayer response coordinating an array of “mito-protective” outcomes. Given the critical importance of the metabolic reprogramming of the mitochondria in cancer cells, the study of the UPRmt is rapidly gaining more attention.
Try-CybSI: A Platform for Trying Out Cybersecurity

The IEEE Cybersecurity Initiative developed a user-friendly, cloud-based, interactive platform for hosting tools and demonstrations: Try-CybSI. The goal is to help practitioners and students gain practical familiarity with tools and widespread attacks' behavior.
Intracranial Capillary Hemangioma in the Posterior Fossa of an Adult Male

Intracranial capillary hemangioma (ICH) is a rare entity, with approximately 24 reported cases in the literature. There are only three reported cases of ICH in an adult male. In this case report, we describe the fourth documented case of ICH in an adult male and, to the best of our knowledge, the first ever documented case of ICH in the posterior fossa of an adult male. We also discuss its imaging appearance and differential diagnosis.
Gamification and Brand Engagement on Facebook: An Exploratory Case Study

In recent years organizations have recognized the indirect value customers add to a brand through their engagement online in word of mouth, product ideas, and increased interactions with the business and other consumers. This has sparked a focus on methods for increasing this customer value by encouraging brand engagement on social media. One method increasingly used to encourage brand engagement is the use of game elements, or gamification. Despite its popularity, the majority of gamification strategies fail. Our research investigates the use and efficacy of gamification elements (challenge, curiosity, fantasy, and control) by organizations in their efforts to promote brand engagement on social media. We find that although gamification elements in general are associated with greater brand engagement, a successful social media strategy will carefully consider the type of elements they use in order to achieve the highest value.
Using SiC MOSFET in switched-capacitor converter for high voltage applications

This paper addresses a study of output voltage of a switched capacitor step down converter for a high voltage application. The proposed design is 3:4 Series to parallel switched capacitor converter based on capacitors and switches only. The Slow Switching Limit Impedance was theoretically calculated and proven. The Slow Switching Limit Impedance has an inverse relation with switching frequency and the capacitor's size. A minimum value of the Slow Switching Limit Impedance is desired; however, that requires a high switching frequency. Increasing the switching frequency might produce losses from switching devices. To maintain the output voltage by keeping switching losses low, a wide bandgap silicon carbide SiC MOSFET was used in this work. The output voltage and its ripple were tested and compared when ideal switches or SiC MOSFET was used. The comparison between ideal switches and SiC MOSFET was applied under several values of the switching frequency. When the f sw increases, a SiC MOSFET successfully shows its ability to keep the switching losses suitable. The LTspice software have been used to simulate the proposed switched capacitor, and the results have been analyzed and discussed.
Flexible DFT-S-OFDM: Solutions and Challenges

Discrete Fourier transform spread orthogonal DFT-S-OFDM, adopted in 3GPP LTE uplink, enables the synthesis of block-based single carrier waveforms with various bandwidths by changing the size of the DFT-spread block. Conceptually, it also allows a transition between block-based multicarrier and single-carrier schemes when multiple DFT-spread blocks are employed in the structure. Recently, it has been shown that DFT-S-OFDM can also accommodate an internal guard period that offers flexibility on the duration of the guard periods without affecting the symbol duration. In this article, we present further modifications of DFT-S-OFDM that offer improvements in flexibility and discuss the latest enabling techniques on this topic. Considering the flexibility introduced by DFTs-OFDM and its variations, the DFT-S-OFDM family also offers a set of promising waveforms for 5G networks, which will require a flexible physical layer.
HRCT features in children with severe asthma in a regional centre - A retrospective analysis

Introduction: International guidelines (EuropeanRespiratorySociety) recommend that High Resolution Computed Tomography (HRCT) be considered in children with severe asthma (requiring high dose inhaled corticosteroids) if they have an atypical presentation,however, the evidence around this investigation is lacking. Few studies have evaluated whether HRCT is useful for diagnosing co-morbidities or alternative diagnoses in children with asthma. Aims and Objectives: To evaluate the frequency of co-morbidities (e.g.bronchiectasis) or alternative diagnoses (e.g. bronchiolitis obliterans) with CT chest in severely asthmatic children. Methods: We retrospectively analysed the reports of all chest HRCT scans performed in children with severe asthma, in our regional paediatric hospital, over an eight year period. To ensure the accuracy of diagnosis two consultant radiologists with respiratory expertise reviewed the scans of 7 children whose original report suggested either bronchiectasis or bronchiolitis obliterans. Results: We reviewed (n=68) CT scans from 67 children (4-16 years) with severe asthma. One child had a repeat scan. Conclusion: Our results suggest that HRCT may help identify other diagnoses in some children and these findings had implications on their clinical management.
Preparation and structure of Na2Ag5Fe3(P2O7)4 -Ag metal composite: Insights on electrochemistry

Ag7Fe3(P2O7)4 is a 3D structured material which has been recently studied as a possible cathode material for lithium batteries. Notably, Na7Fe3(P2O7)4 is reported to be a fast-ion conductor, yet poor electrical conductor. Here, partial replacement of Na+ for Ag+ yielded Na2Ag5Fe3(P2O7)4 pyrophosphate framework where the formation of Ag metal is proposed to increase the intrinsic low electrical conductivity of this polyanion electrode. Specifically, the Ag5Na2Fe3(P2O7)4 -Ag composite is synthesized via chemical reduction of Ag7Fe3(P2O7)4 using NaBH4. The occupancy of Ag+ and Na+ in each site was determined via Rietveld analysis of the diffraction pattern. Electrochemistry of the Ag5Na2Fe3(P2O7)4 -Ag metal composite was explored with voltammetry and galvanostatic charge/discharge cycling. The Ag5Na2Fe3(P2O7)4 -Ag metal composite electrodes displayed good rate capability assisted by the presence of Ag metal from the chemical reduction and in-situ electrochemical formation of a Ag conductive network.
Exosomes confer chemoresistance to pancreatic cancer cells by promoting ROS detoxification and miR-155-mediated suppression of key gemcitabine-metabolising enzyme, DCK.

Exosomes confer chemoresistance to pancreatic cancer cells by promoting ROS detoxification and miR-155-mediated suppression of key gemcitabine-metabolising enzyme, DCK
Night-to-Night Variability in Sleep Disordered Breathing and the Utility of Esophageal Pressure Monitoring in Suspected Obstructive Sleep Apnea

Study Objective:Esophageal manometry (Pes) is the gold standard to detect repetitive episodes of increased respiratory effort followed by arousal (RERAs). Because RERAs are not included in the apne...
A Comprehensive Approach to Lower Extremity Free-tissue Transfer.

Background The purpose of this study was to introduce a comprehensive approach to lower extremity free-tissue transfer and report the clinical outcome that has been achieved with this approach. Methods The comprehensive approach developed by the author includes patient selection, flap selection, selection of the recipient vessels, flap dissection, flap preparation, microvascular anastomosis, flap inset, immediate postoperative care, intermediate postoperative care, and further follow-up care. Each part of this approach has its own special considerations. In an 8-year period, 28 consecutive lower extremity free-tissue transfers were performed in 28 patients by the author. The clinical outcomes were recorded based on the success of free-tissue transfer, any reoperations related to the revision of microvascular anastomosis, and any partial or total flap loss during an 8-year follow-up. Results All 28 lower extremity free-tissue transfers were performed successfully. All patients were discharged home once they tolerated dangling. No reoperations were needed for revision of microvascular anastomosis. No total or partial flap loss was encountered. Overall success of free-tissue transfer to the lower extremity in this series was 100%. Conclusions An ideal outcome of free-tissue transfer to the lower extremity can be accomplished with this comprehensive approach developed by the author. With good surgical judgment, adequate microsurgical skill, step-by-step intraoperative execution, and a protocol-driven clinical practice, the reconstructive surgeon should be able to improve his or her success for free-tissue transfer to the lower extremity.
Scaling Up Automated Verification: A Case Study and Formal-IDE for the Construction of High Integrity Software

This work aims to show through a detailed case study that scaling up automated verification to larger non-trivial data structures is not only possible, but when combined with appropriate tool support, can be made more comprehensible and practicable to users in a variety of settings, including the undergraduate curriculum. The study involves an interplay of multiple components annotated with formal interface contracts and the components are all designed to be modular, reusable, and amenable to automated verification and analysis. The components are built using a formal integrated development environment (F-IDE). The plan is to evaluate the F-IDE in an upper-level undergraduate software engineering course in the Spring semester at Clemson University.
Optic Nerve, Visual Pathways, Oculomotor System, and Consequences of Intracranial Injury

The sequelae of neuro-ophthalmic injury are varied, including decreased visual acuity, limitation of ocular motility, visual field deficits, and impairment of visual processing. The neuro-ophthalmic status of a trauma patient should be carefully reviewed following high impact trauma, especially in cases of head injury. Signs of neuro-ophthalmic involvement may be difficult to assess if the patient is obtunded or comatose, yet early management is often critical to prevent severe morbidity or mortality. This chapter reviews traumatic damage to the optic nerve, visual pathways, and oculomotor system. The authors outline the use of CT and MRI for diagnosis of orbital and head trauma. Traumatic optic neuropathy is defined through clinical examples, and controversies in the treatment of traumatic optic neuropathy with conservative management, steroids, or surgical decompression are summarized. The presentation and management of traumatic pupillary abnormalities, Adie’s tonic pupil, and Horner syndrome are described. The authors highlight the range of ophthalmic manifestations that may follow head trauma, including injury associated with skull base fractures, arterial or venous injury, direct penetrating trauma to visual pathways, and traumatic brain injury (TBI). Finally, the authors describe the oculomotor system and how to diagnose and manage traumatic injury of cranial nerves III, IV, or VI. The material will enable the practitioner to recognize neuro-ophthalmic manifestations of eye and head trauma, promptly diagnose, and efficiently manage these patients.
Evaluating the benefits of relaxed BEOL pitch for deeply scaled ICs

CMOS scaling improves transistor density and lower the cost per transistor at a cost to other factors. Tall, narrowly spaced wires have made lateral coupling capacitance dominant for the deeply scaled CMOS back-end-of-line (BEOL) metals, which impacts worst-case timing and noise. Narrow wires further impact electromigration, yield and reliability. Since the densest routing does not certainly provide the best overall design quality, we systematically evaluate the impacts of relaxing the BEOL (r-BEOL) pitch. To implement sample designs, we used a commercial 28 nm CMOS technology and standard physical synthesis tools. Evaluation of these sample 28 nm designs show that relaxing the pitch brings improved signal integrity, design-for-manufacturability (DFM), and timing closure, at modest cost to area and no cost to performance. This suggests that r-BEOL might be a more optimal approach for low and medium volume products where the design and masks cost can dominate the cost of the wafers.
Decomposition of postural movements in individuals with mild TBI while reaching to intercept a moving virtual target

The study analyzed postural and arm movement coordinations in patients with traumatic brain injury (TBI) while standing and reaching for a target moving in a 3D virtual environment. Thirteen individuals with mild TBI and 13 height, sex, and age-matched healthy control individuals were involved. While standing in front of the screen, the participants interacted with the projected environment by reaching for virtual targets. Coordination was analyzed as the percentage of reach-to-intercept cycle time during which their movement toward the target was decomposed with 0% indicating simultaneous motion in three planes or 100% indicating motion in one or two planes only. Decomposition was calculated for the postural movements (DIp), arm movements (DIa), and arm-postural coordination (DIa-p). The latter index represented the percentage of reach-to-intercept cycle time during which either the posture or arm moved alone. DIp and DIa-p were larger in the TBI group compared to the control group (p < 0.01). In the TBI group, DIp and DIa-p correlated negatively with postural stability (r = - 0.71 and r = - 0.60; p < 0.01). Results suggest that individuals with TBI decompose postural and arm-postural coordinations during a reach-to-intercept task. This may be either a result of impaired postural control or an effort to compensate for instability. These abnormalities should be taken into consideration while planning physical therapy programs for individuals after brain injury.
Improving upon Bogardus: Creating a More Sensitive and Dynamic Social Distance Scale

Since 1925, the Bogardus Social Distance Scale has been a staple in social science research. This scale, which is often used to study prejudice and intergroup relations, asks participants to self-disclose their feelings of acceptance for members of out-groups. Ranging from 1 (no social distance) to 7 (greatest social distance), the scale measures respondents’ perceived sense of intimacy or closeness to those in groups that are different from their own. This study shows the utility of adding a unique intensity score (iScore) dimension to the Bogardus scale by combining it with a Likert scale to produce a new measure. This improved measure provides a greater level of precision, sensitivity, and nuance than the traditional Bogardus Social Distance Scale. The study offers a direct comparison of the traditional Bogardus and new iScore results. Findings demonstrate the advantages of using an iScore.
Attitudinal Factors and Personal Characteristics Influence Support for Shellfish Aquaculture in Rhode Island (US) Coastal Waters

This study explores public interests associated with shellfish aquaculture development in coastal waters of Rhode Island (US). Specifically, we examine (1) the levels of public support for (or opposition to) shellfish aquaculture development and (2) factors driving the levels of support, using survey data and ordinal logistic regressions. Results of the analysis identify several key attitudinal factors affecting individual’s support for shellfish aquaculture in Rhode Island (RI). The level of support is positively associated with attitudes related to shellfish aquaculture’s benefits to the local economy and its role as a nutritional food option, and negatively influenced by attitudes related to aquaculture farms’ effects on aesthetic quality and their interference with other uses. Findings highlight that support for (or opposition to) aquaculture in RI is driven more by attitudes associated with social impacts than by those associated with environmental impacts. The level of support is also affected by personal characteristics related to an individual’s participation in recreational activities. For instance, bicycle riders tend to be supportive of shellfish aquaculture while respondents who participate in sailing and birding are less supportive. By identifying the broader public’s interests in shellfish aquaculture, findings from this study and others like it can be used to address public concerns, incorporate public perceptions and attitudes into permitting decisions, and develop outreach targeted at specific stakeholder groups.
Improving Student Behavior in Art Classrooms: An Exploratory Study of CW-FIT Tier 1:

Disruptive student behavior, a common concern for teachers, presents particular challenges for those who teach art. Class-Wide Function-Related Intervention Teams (CW-FIT) is a multitiered intervention for implementing effective classroom management strategies aligned with schoolwide positive behavior interventions and supports. CW-FIT has proven effective in general education classrooms, with its emphasis on social skills instruction, teacher praise, group contingency, and positive reinforcement. This first study of CW-FIT implementation in elementary art classrooms examined its effects on student on-task behavior. The researchers used a single-subject (AB) design in one classroom and reversal designs (ABAB) in two classrooms. Results indicated student on-task behavior significantly improved, and the teacher was able to implement CW-FIT with fidelity as well as increase her praise-to-reprimand ratios. Both teacher and students found the intervention to be socially valid. Study implications and limitation...
The Role of the Visor Flap in Scalp Reconstruction: A Case Series of 21 Patients.

Background Full-thickness scalp defects pose a reconstructive problem, especially in the setting of infection, chemotherapy/radiation, and underlying cranial defects. Current options include dermal matrices, skin grafts, and local flaps. Local flaps often fail, requiring subsequent microvascular free flap reconstruction. Objective To describe the visor flap, a novel bipedicled advancement flap design, and its role in reconstruction of scalp defects. Methods A retrospective review of 21 adult patients who developed scalp defects reconstructed using the visor flap from 2013 to 2017. The visor flap is a large bipedicled advancement flap design with a triangular extension at the base, which allows redistribution of a large surface area of the scalp. Results All 21 patients achieved complete and viable soft tissue coverage of the recipient site, but 19.0% developed complications unrelated to flap viability, requiring reoperation (infected bone flap, epidural hematoma, and recurrent glioblastoma with subdural abscess). Only 1 patient required conversion to free flap reconstruction due to cerebrospinal fluid leak. Etiologies included cancer (76.1%), cerebrovascular disease (19.0%), and traumatic brain injury (4.8%). Preoperative radiation (42.9%), bone/hardware exposure (57.1%), and previous craniotomy (85.7%) were widely prevalent. Defect size ranged from 3 to 50 cm2 (mean, 16.9 cm2), and flap size ranged from 90 to 500 cm2 (mean, 222 cm2). Conclusion The visor flap provides an innovative solution for closure of scalp defects. This technique optimizes immediate closure of tissue compromised by infection or chemotherapy/radiation without burning bridges to more complex reconstructive options.
Sonography of Traumatic Cranial Hemorrhage

A large body of literature has accumulated during the past decade concerning the value of sonography in the diagnosis of intracranial hemorrhage in neonates. Most of this literature has dealt with the hemorrhages of germinal matrix origin occurring in the premature infant 1. 10. There has been very little written about the value of this diagnostic modality in the management of traumatic intracranial hemorrhage. For example, in a recently published monograph on pediatric head trauma there is only one illustration of a sonogram and no description of its use as a diagnostic tool11. This is partially related to the relative infrequency of traumatic hemorrhage in infancy. It seems appropriate, therefore, to review the role of sonography in craniocerebral trauma of infancy.
An Adaptive GPSR Routing Protocol for VANETs

The fast topology change and high-speed mobility of vehicles, as well as the limited radio range, usually lead to wrong packet forwarding decisions in highly dynamic Vehicular Ad Hoc Network (VANET). This type of environment makes data routing very challenging. Position-based routing protocols are popular for VANET due to the availability of GPS devices. Geographic Perimeter Stateless Routing (GPSR) has been widely adopted to cope up with VANET challenges. Nevertheless, there are still improvements that could be incorporated into GPSR to make it more reliable and efficient. In this paper, we describe an Adaptive GPSR (AGPSR), including additional information in the Neighbors Table to select the best path and bypass the nodes that delivered the previous packets in recovery mode. This approach can avoid possible link-breakage due to for instance a road accident. We compared our results with the traditional GPSR using the Simulation of Urban MObility (SUMO) and Network Simulator-version 3 (NS-3) for both static and mobility scenarios. Our results show that the proposed AGPSR strategy has better performance than traditional GPSR when packet delivery ratio, lost packets and hop count are used as performance metrics.
AIR POLLUTION EXPOSURE AND TELOMERE LENGTH IN HIGHLY EXPOSED SUBJECTS IN BEIJING, CHINA

Background and Aims. Shortened leukocyte telomere length (LTL) is a marker of cardiovascular risk that has been recently associated w ith long-term exposure to ambient particulate matter (PM). How ...
One health and the agricultural transition in food animal production

Abstract In the spirit of this important new journal, this paper seeks to explore the implications of agricultural transitions for human and animal health, as well as the sustainability of regional and global ecosystems. To understand the broad reach of these transitions this paper draws on the concept of One Health, which emphasizes the relatedness of human, animal, and environmental health in disease control and prevention strategies. Agricultural transitions are an important part of human history from the Neolithic to the present. These transitions began with simple developments in technology and social organization followed by increasingly more complex innovations that have responded to and stimulated profound changes in human society as well as the life of domesticated animals. Transitions in agriculture have stimulated transitions in diet and culture, leading to a feedback demand for further changes in agriculture to support new dietary practices and cultural conditions. In the 20th century, these transitions in agriculture have occurred with increasing speed and depth, involving fuel powered vehicles and machinery, synthetic chemicals that advance agronomy through supplying essential nutrients such as nitrogen and through controlling pests and weeds, and biotechnological methods for improving crop strains and animal breeds. The latest transition is industrialization, involving technology as well as the management and economics of agricultural production. These transitions are so profound and far reaching that it is appropriate to define them as revolutions with far reaching implications for human society as well as the natural world from microbes to the planet. In this paper I focus on the last transition as it has been expressed in food animal production, including poultry, livestock, fish and other aquatic biota, recognizing that the transitions in plant production were essential to this transition.
Applying Blended Learning Techniques: Perspectives from Chemical Engineering Computation

The use of active learning techniques in engineering classrooms has been limited despite substantial evidence supporting their efficacy in helping students construct problem-solving expertise. A blended classroom, which combines online and in-class learning, was employed in a Chemical Engineering Computation class to address instructional challenges and enhance student learning outcomes. The use of pre-class online videos, concept questions, and in-class peer instruction are shown to enhance and improve the students’ perceived learning experience.
Positive stationary solutions and spreading speeds of KPP equations in locally spatially in homogeneous media

The current paper is concerned with positive stationary solutions and spatial spreading speeds of KPP type evolution equations with random or nonlocal or discrete dispersal in locally spatially inhomogeneous media. It is shown that such an equation has a unique globally stable positive stationary solution and has a spreading speed in every direction. Moreover, it is shown that the localized spatial inhomogeneity of the medium neither slows down nor speeds up the spatial spreading in all the directions.
Biodiesel: History of an innovation to keep the world moving

The history of biodiesel dates back to mid-19th century when transesterification of vegetable oils was discovered. It took another half century for the world to realize its potential as fuel. Through the 20th century, two World wars and other regional turmoil increased the quest for energy security among nations. This chapter presents the history of biodiesels from the perspective of its development from vegetable oils, animal fats. Usage of biodiesel and straight vegetable oil before World war, and how the energy crises sparked the intense development of these fuels around the globe towards the end of 20th century.
Pharmacist-Provided Diabetes Education and Management in a Diverse, Medically Underserved Population.

Diabetes prevalence continues to rise in the United States, affecting more than 30 million people (9.4% of the population) in 2015 (1). Diabetes is expensive in terms of both direct medical costs and indirect costs of disability, lost work productivity, and premature death. The estimated cost of diabetes in the United States was $245 billion in 2012 (2). Optimizing care by facilitating glycemic control, patient education, preventive health screenings, and adherence to the treatment regimen have been suggested as methods to decrease the cost of this disease (3). There are inequalities in the disease burden of diabetes in the United States. The prevalence, incidence, and complications rates of diabetes are higher in non-Hispanic black, Hispanic, and American Indian/Alaska Native populations (4,5). Minority, low-income, and uninsured people have a higher risk for omissions of recommended diabetes prevention services (6). Furthermore, people who are non-English–speaking may experience barriers to effective diabetes medication management, including prohibitive costs of medications, hindered communication, knowledge deficits, and difficulties in understanding (7). The American Diabetes Association consistently identifies the promotion of health equity for populations disparately affected by diabetes as an advocacy priority (8). Federally Qualified Health Centers (FQHCs) provide primary care, behavioral health services, dental care, and other health care services to medically underserved populations. These safety-net clinics work to reduce barriers to health and health care in low-income populations disproportionately affected by chronic disease by increasing access to health care providers and medications (9,10). In 2016, FQHCs provided care to more than 26 million patients, more than half of whom had an income below the federal poverty level. The Health Resources and Services Administration (HRSA) reported in its 2016 health center data report that 32.1% of the more than 2 million patients with diabetes receiving care at FQHCs had …
CONVERSION OF HYPOTHYROIDISM TO HYPERTHYROIDISM: A RARE CLINICAL PHENOMENON.

ABSTRACT Objective We present a patient with long standing hypothyroidism who developed hyperthyroidism secondary to Graves disease. Recognition of this disease phenomenon is crucial to ensure prompt diagnosis and close follow-up. Methods The patient was evaluated with thyroid function testing and thyroid antibody testing. Further evaluation included ophthalmologic examination and radioactive iodine uptake imaging. Results A 56-year-old female with past medical history of human immunodeficiency virus, hepatitis C infection, and hypothyroidism presented for evaluation of thyroid disease. She had been off of levothyroxine for the last 8 months due to biochemical findings of thyrotoxicosis. Her family history was significant for hyperthyroidism and hypothyroidism. Laboratory tests were consistent with hypothyroidism so levothyroxine was restarted. Physical exam showed lid lag and proptosis. Ophthalmologic evaluation found bilateral 23 mm proptosis. Additional lab testing was positive for thyroid peroxidase antibody and thyroid stimulating immunoglobulin. Following levothyroxine use, the patient developed subclinical hyperthyroidism and thyroid replacement was stopped. The patient remained euthyroid for 1 year off of levothyroxine. Following 1 year, she developed mild hyperthyroidism with increased radioactive iodine uptake. She was placed on propranolol for symptomatic relief. Months later, thyroid function testing normalized. Conclusion In Graves disease, hypothyroidism and conversion of hypothyroidism to hyperthyroidism are rare, yet important to recognize, clinical phenomenon. The stimulatory and inhibitory properties of thyroid-stimulating hormone receptor antibodies are speculated to play a role in individuals with alternating hypothyroidism and hyperthyroidism. These individuals can present a diagnostic and therapeutic challenge. Clinicians must maintain a high clinical suspicion for this disease entity. Abbreviations FT4 free thyroxine HAART highly active antiretroviral therapy HIV human immunodeficiency virus TBAb thyroid-stimulating hormone receptor blocking antibodies TRAbs thyroid-stimulating hormone receptor antibodies TSAb thyroid-stimulating antibodies TSH thyroid-stimulating hormone
A patient-centered framework for health systems engineering in gastroenterology: improving inpatient colonoscopy bowel preparation

Inpatient colonoscopy bowel preparation (ICBP) is frequently inadequate and can lead to adverse events, delayed or repeated procedures, and negative patient outcomes. Guidelines to overcome the complex factors in this setting are not well established. Our aims were to use health systems engineering principles to comprehensively evaluate the ICBP process, create an ICBP protocol, increase adequate ICBP, and decrease length of stay. Our goal was to provide adaptable tools for other institutions and procedural specialties. Patients admitted to our tertiary care academic hospital that underwent inpatient colonoscopy between July 3, 2017 to June 8, 2018 were included. Our multi-disciplinary team created a protocol employing health systems engineering techniques (i.e., process mapping, cause-effect diagrams, and plan-do-study-act cycles). We collected demographic and colonoscopy data. Our outcome measures were adequate preparation and length of stay. We compared pre-intervention (120 ICBP) vs. post-intervention (129 ICBP) outcomes using generalized linear regression models. Our new ICBP protocol included: split-dose 6-L polyethylene glycol-electrolyte solution, a gastroenterology electronic note template, and an education plan for patients, nurses, and physicians. The percent of adequate ICBPs significantly increased with the intervention from 61% pre-intervention to 74% post-intervention (adjusted odds ratio of 1.87, p value = 0.023). The median length of stay decreased by approximately 25%, from 4 days pre-intervention to 3 days post-intervention (p value = 0.11). By addressing issues at patient, provider, and system levels with health systems engineering principles, we addressed patient safety and quality of care provided by improving rates of adequate ICBP.
Complexity of deformation mechanism in neutron-irradiated 304L austenitic stainless steel at microstructural scale

Abstract The deformation mechanisms of neutron-irradiated 304 L stainless steel have been investigated using the in-situ electron backscattered diffraction (EBSD) technique. To decipher the role of irradiation, a detailed analysis was performed on irradiated miniature samples and compared with nonirradiated samples. At three levels of engineering strain, —0.0%, 4.8%, and 14.5%—microstructural features as well as EBSD were recorded at the identical location during in-situ deformation testing. Post-mortem analysis of the EBSD data revealed that the neutron-irradiated samples had higher fractions of the slip bands even at low amounts of deformation. Along with the slip bands, the neutron-irradiated sample showed the twins and martensitic phase formed almost parallel to the slip bands. In addition, the image results also indicated that the formation of twins and phases associated with the slip bands. A detailed mechanistic understanding has been investigated to identify the (111)γ planes orientation with respect to the loading direction associated with the formation of twins and martensite. The newly formed deformation twins and martensite were also found to maintain this relationship when they existed together.
Tailoring Interlayer Excitons in 2D Van Der Waals Heterostructures with Molecular Functionalization

Two-dimensional (2D) van der Waals (vdW) heterostructures from transition metal dichalcogenide (TMDC) semiconductors offer a new class of interlayer excitons with promising optoelectronic properties for the next-generation optoelectronics such as excitonic devices and spintronics. To realize such applications, the unique properties of interlayer excitons must be thoroughly understood and precisely controlled. This work introduces a new strategy to selectively modulate interlayer excitons by functionalizing organic chromophore molecules. We explored two dye molecules, tetracyanoquinodimethane (TCNQ) and eosin Y (EY), and deposited their uniform layers on vdW heterostructures from MoS2 and WSe2 monolayers. We demonstrate that photoinduced charge transfer between MoS2 and WSe2 may be promoted or suppressed by the organic layers, thus affecting the photoluminescence (PL) emissions. Kelvin probe force microscopy (KPFM) shows that dark-state doping may also affect the interlayer excitons, yet we find that photoinduced charge transfer plays a dominant role. Our results elucidate interlayer excitons at the heterointerfaces and lay the foundation for diverse optoelectronic applications.
Limitations of Perturbative Renormalization and the Challenges of the Standard Model

In contrast with the paradigm of effective Quantum Field Theory (EFT), realistic Renormalization Group (RG) flows approaching fixed points are neither perturbative nor linear. We argue that overlooking these limitations is necessarily linked to many unsolved puzzles challenging the Standard Model of particle physics (SM). Here we show that the analysis of non-linear attributes of RG flows near the electroweak scale can recover the full mass and flavor structure of the SM. It is also shown that this analysis brings closure to the “naturalness” puzzle without impacting the cluster decomposition principle of EFT.
Solar System Time Scales from Long-Lived Radioisotopes in Meteorites and Planetary Materials

Long-lived radioactive isotopes, defined here as those that have half-lives in excess of a few hundred million years, have been utilized for chronology since the early part of the twentieth century. The past several decades have seen significant advances in the precision and accuracy of chronological information based on the decay of long-lived radioisotopes, particularly in the mass spectrometric techniques for measurement of isotope ratios and in the determination of relevant decay constants. Chronometers based on the decay of radioisotopes essentially date the time of isotopic closure following a chemical event that fractionated the parent element from the daughter element. Assuming that parent/daughter isotope ratios can be determined accurately and precisely and that the decay constant is known, meaningful age information based on such chronometers may only be obtained if (1) there was complete equilibration of the isotopic composition of the daughter element prior to fractionation of the parent element from the daughter element and (2) there has been no disturbance of isotope systematics following the isotopic closure event that is to be dated.
Large-Scale ASP Replication of Database-Driven Portals

Web portal applications that dynamically generate results in response to user requests are more popular than ever. Such portal applications usually consist of a business logic component and a very large database, or databases that hold the portal’s content. Despite efforts to speed up response generation, ever-rising user demand means that replication of a portal’s logic and database will be needed at some point as other methods to keep up with demand (faster databases and content caching for example) have limits. This article explains issues surrounding the replication of a single full-scale database-driven portal application. In addition to the issues of replicating a single, unsophisticated application, it also anticipates a future in which portal applications offer multiple levels of service to users, and large application service providers (ASPs) host and replicate many portal applications on networks of servers. An ASP must replicate complex portal applications in order to satisfy user demand while minimizing operating costs. ASPs will need mature tools for making replication decisions and deploying and otherwise managing their replication system. To that end, this article highlights two prototype software packages, ACDN and DATE/DASIM, that address some aspects of replica management by ASPs. Using the two prototypes as a starting point and recalling single portal replication issues, a set of features for a mature ASP replication management systems are proposed.
Making system configuration more declarative

System administration can be difficult and painstaking work, yet individual users must typically administer their own personal systems. These personal systems are therefore likely to be misconfigured, undependable, brittle, and insecure, which restricts their wider adoption. Because updating the configuration of today's systems involve imperative updates in place, a system's correctness ultimately depends on the correctness of every install and uninstall it has ever performed; because these updates are local in scope, there is no easy way to specify or check desired properties for the whole system. We present a more checkable declarative approach to system configuration that should improve system integrity and make systems more dependable. As in the earlier Vesta system, we define a system model as a function that we can apply to a collection of system parameters to produce a statically typed, fully configured system instance; models can reference and thereby incorporate submodels, including submodels exported by each program in the system. We further check each system instance against established system policies that can express a variety of additional ad hoc rules defining which system instances are acceptable. Some system policies are expressible using additional type rules, while others must operate outside the type system. A preliminary design and implementation of this approach are under way for the Singularity OS, and we hope to specify and check a number of ad hoc system properties for Singularity-based personal systems.
Radio Luminosity Functions

Luminosity functions give the space densities of source populations as functions of spectral luminosity. They constrain source physics, clustering, cosmological evolution, and contributions to the radiation background. Extragalactic radio sources span eight decades of luminosity, so dividing them into luminosity ranges effectively separates them by energy generation mechanism and other fundamental properties. Multivariate luminosity functions divide the source population in additional ways (e.g., by optical morphology, optical absolute magnitude, or radio spectral index) selected to emphasize particular source characteristics.
Minimal Realization Problems for Hidden Markov Models

This paper addresses two fundamental problems in the context of hidden Markov models (HMMs). The first problem is concerned with the characterization and computation of a minimal order HMM that realizes the exact joint densities of an output process based on only finite strings of such densities (known as HMM partial realization problem). The second problem is concerned with learning a HMM from finite output observations of a stochastic process. We review and connect two fields of studies: realization theory of HMMs, and the recent development in spectral methods for learning latent variable models. Our main results in this paper focus on generic situations, namely, statements that will be true for almost all HMMs, excluding a measure zero set in the parameter space. In the main theorem, we show that both the minimal quasi-HMM realization and the minimal HMM realization can be efficiently computed based on the joint probabilities of length $N$ strings, for $N$ in the order of ${\cal O}(\log_{d}(k))$ . In other words, learning a quasi-HMM and an HMM have comparable complexity for almost all HMMs.
The Kidnapping of Edgardo Mortara: Contemporary Lessons in the Child Welfare Wars

This Article examines the contemporary implications of the celebrated 19th Century case of Edgardo Mortara, a six-year-old Italian Jewish child forcibly removed from his family by papal police so that he could be raised by Christians. The kidnapping of this young boy serves as a template for understanding the inherent limitations of the so-called ‘best interest‘ standard, which is still used routinely to justify well-meant but unnecessary interventions into the lives of families who are fully capable of caring for their own children. As evidenced by Edgardo's story, there are old themes inherent in the tension between the rights of families and the State's obligation as parens patriae to protect its children from harm. The Article examines the broad contours of the ongoing debate over the permissible scope of state intervention to protect child welfare. It highlights the tension between the traditions of family autonomy and due process that shelter modern families from such intrusion, and the state's legitimate parens patriae interest in taking steps necessary to guard a child at risk. It then revisits the story of Edgardo Mortara and the aftermath of his kidnapping, suggesting that these competing notions of due process and parens patriae explain much of the battle that defined the future of a boy whose parents' only offense was having been born Jewish. The Article seeks to project the lessons of Edgardo's story into contemporary child welfare history by exploring several more recent episodes that echo many of the same disturbing concerns, concluding that the cautions arising from Edgardo's kidnapping continue to resonate today, and that concerns over unfettered state authority should not be taken lightly.
Implied Private Rights of Action under Federal Law

In Touche Ross & Co. v. Redington, the Supreme Court held that a private right of action could not be implied under section 17(a) of the Securities Exchange Act of 1934. Although the Court's decision certainly has significance for those litigants who sought to invoke that provision, the ultimate impact of the holding reaches far beyond the confines of section 17(a). Analysis of the opinion reveals that the Redington Court has markedly altered the four-prong test of Cort v. Ash in determining whether a private cause of action should be implied under a federal statute. The Court's decision in Redington, however, cannot be viewed in isolation. A short time prior to that holding, in Cannon v. University of Chicago, the Court implied a private cause of action under Title IX of the Education Amendments of 1972. In so ruling, however, the Court's opinion was colored by one concurring opinion and two dissenting opinions which foreshadowed the coming of Redington. The purpose of this article is to assess the implication of private, rights of action under federal law. First, for background purposes, Cort and its progeny will be discussed. The article will then examine the Court's decisions in Cannon and Redington. In conclusion, the article will suggest how the federal courts should confront the issue of the implication of private rights of action.
Singular corrections to the Fermi-liquid theory

We show that the singularities in the dynamical bosonic response functions of a two-dimensional Fermi liquid give rise to universal nonanalytic corrections to the results of the Fermi-liquid theory. In particular, we find a ${T}^{2}$ term in the specific heat, linear-in-$T$ terms in the effective mass and in the uniform spin susceptibility ${\ensuremath{\chi}}_{s}(Q=0,T),$ and $|Q|$ term in ${\ensuremath{\chi}}_{s}(Q,T=0).$ The existence of these terms has been the subject of recent controversy, which is resolved in this paper. We present exact expressions for all nonanalytic terms to second order in a generic interaction $U(Q)$ and show that the nonanalytic terms originate exclusively from forward- and backward-scattering of particles with zero total momentum.