cssi/SciSciGPT-SciSciNet huggingface dataset:
Neighbourhood approximation using randomized forests

Leveraging available annotated data is an essential component of many modern methods for medical image analysis. In particular, approaches making use of the “neighbourhood” structure between images for this purpose have shown significant potential. Such techniques achieve high accuracy in analysing an image by propagating information from its immediate “neighbours” within an annotated database. Despite their success in certain applications, wide use of these methods is limited due to the challenging task of determining the neighbours for an out-ofsample image. This task is either computationally expensive due to large database sizes and costly distance evaluations, or infeasible due to distance definitions over semantic information, such as ground truth annotations, which is not available for out-of-sample images. This article introduces Neighbourhood Approximation Forests (NAF), a supervised learning algorithm providing a general and e cient approach for the task of approximate nearest neighbour retrieval for arbitrary distances. Starting from an image training database and a user-defined distance between images, the algorithm learns to use appearance-based features to cluster images approximating the neighbourhood structured induced by the distance. NAF is able to e ciently infer nearest neighbours of an out-of-sample image, even when the original distance is based on semantic information. We perform experimental evaluation in two di erent scenarios: i) age prediction from brain MRI and ii) patch-based segmentation of unregistered, arbitrary field of view CT images. The results demonstrate the performance, computational benefits, and potential of NAF for di erent image analysis applications.
Correction of the Bilateral Question Mark Ear Deformity Using Double-Opposing Z-Plasty and a Chondrocutaneous Flap

Objective: To describe an alternative technique for correcting a rare and complex ear deformity. Introduction: The question mark ear deformity has been described as a congenital cleft between the helix and the lobule in addition to a prominent ear. Here we describe a novel technique using double-opposing Z-plasty and a chondrocutaneous flap to correct the deformity without significant reduction in auricle height or creation of a donor-site defect. Methods: An anterior/posterior double-opposing Z-plasty and a superiorly based chondrocutaneous flap were designed at the level of the cleft. Flaps were raised full thickness, and Mustarde and Furnas sutures were placed to reduce the prominence. The flaps were then transposed and reapproximated. Of note, all anterior and posterior skin flaps were used in the repair to minimize diminution of ear height. Pre- and postoperative measurements and photographs of the ears were taken. Results: Postoperatively, all flaps were viable, and there was no evidence of skin nec...
Total replacement of the hip for avascular necrosis in sickle cell disease

Total hip replacement was performed in 27 hips of patients who had sickle cell anaemia with avascular necrosis of the femoral head. The disease was bilateral in 11 patients. Considerable medical problems were encountered although most of the patients had exchange transfusion before surgery (86%), which prevented postoperative sickle cell crises in all but two cases. At the primary operation hard sclerotic bone was seen in nine femora with complete obliteration of the femoral canal. There were four femoral fractures, three following perforation of the shaft due to this hard bone. There was a very high morbidity due to loosening in both cemented and uncemented prostheses. With a rate of 59% over a cumulative 5.5 year period, revision was being performed at an average of only 43 months. Surgeons should be aware of these problems.
Re: A systematic review of patients' experiences of adverse events in health care.

Dear Editor—We are writing regarding a systematic review by Harrison et al. [1]. We contacted the corresponding author to understand why they excluded studies regarding patient perspectives on adverse drug events. Dr. Harrison responded in a personal email communication on 19 October …
India: The Awakening of M-Commerce

This chapter presents our perspective on the evolution of m-commerce in India, where the telecommunications sector was privatized in 1992 and further deregulated in 1999. The chapter introduces the leading mobile telecom players and relates them to the emerging trends. Intertwined with this narrative are descriptions of specific m-commerce cases which deploy SMS in just about every application. These cases are further analyzed using the CLIP framework, illustrating the Indian markets’ adaptive capacity to employ low-end technology to deliver high-end solutions. The chapter concludes with lessons drawn from the Indian experience, and outlines some directions for future research.
Cholesterol Granuloma of Nasal Septum

Cholesterol granulomas are inflammatory deposits commonly found in the mastoid antrum and air cells of temporal bone. They rarely occur in the nose. Here, we report an extremely rare case of cholesterol granuloma in the nasal septum, and include a short literature review. The clinical characteristics, pathology, and surgical treatment are also discussed.
Program Options in Baccalaureate Clinical Laboratory Science Programs

This survey was conducted to determine the availability of mechanisms for articulation and nontraditionalprogram optionsin clinical laboratory science (medical technology) programs. Questionnaires were sent to all baccalaureate-level medical technology (ist) (MT) programs throughout the United States in February 1987. A total of 87 schools (65%) responded. Seventy-one percent of the respondents either already had articulation mechanisms or were planning to institute mechanisms within a year. Equivalency examinations and direct transfer of medical laboratory technician (MLT) professional courses were most commonly offered. A part-time curriculum was the most frequently available nontraditional program option. While the majority of the surveyed programs were offering mechanisms and /or options to aid in the progression from MLT to MT, mechanisms offered were those that best fit into existing traditional curricula. More nontraditional alternatives should be made available to better meet the needs of MLT graduates. We recommend a shared responsibility between MLT and MT programs for the education of clinical laboratory personnel.
Comparison of Characteristics of Patients Undergoing Heart Transplantation at the Same Hospital in Two Different Time Periods (1997-2012 and 2013-2015).

Heart transplantation (HT) increases at some centers each year and decreases at others. We examined characteristics of patients having HT at the same hospital in 2 different time periods (1997–2012 and 2013–2015) by 2 different surgical groups. We compared certain clinical and morphological finding in 291 patients having HT 1997 to 2012 to finding in 228 other patients having HT from 2013 to 2015. Several significant (p 2 -vs- 26.5 kg/m 2 ), and mean heart weight was lower in both men (509 g -vs- 549 g) and women (422 g -vs- 454 g). There were insignificant (p >0.05) differences in gender, frequency of massive cardiac adiposity, underlying cardiac condition, frequency of coronary heart disease, and frequency of previous insertion of a left ventricular assist device. In conclusion, certain characteristics of patients having HT at one Texas hospital changed in several respects in 2 time periods corresponding to changes in surgeons doing the HTs.
DISCUSSION ON DEVELOPMENT STRATEGY OF MINING INDUSTRY IN DA BIE SHAN OF HE NAN PROVINCE

The paper expounds general theory on development strategy of mining industry, then it discusses practical problems. The cheap resources are superior in the region, not basic resources. Therefore, it is real choice that basic resources should be developed so as to make mining industry play basic industrial role and drive the industry in lower reaches of river and establish material basis. Meanwhile regional superior should be utilized and cheap resources should be developed in order to make mining industry become initiative industry which can accumulate fund and support economic development.
The HealthCare.gov project

This case describes the development of the HealthCare.gov website front-end, systems and databases supporting the implementation of the Affordable Care Act. In late October 2013, US Health and Human Services Secretary Kathleen Sebelius and US Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner appear before a Congressional subcommittee to apologize about system glitches. The case gives students an opportunity to consider project risks that affected this huge systems development effort, and to consider how to ensure that millions of uninsured or underinsured Americans would be able to sign up for affordable health insurance.
THE CRITICAL ANALYSIS ON DIAGNOSIS OF DISSEMINATED INTRAVASCULAR COAGULATION WITH SCREENING TESTS–A SCORING SYSTEM AND RELATED LITERATURE REVIEW

Background: The aim of this study is to assess confidence in the diagnosis of Disseminated Intravascular Coagulation (DIC); to evaluate the clinical significance of the haemostatic tests; to disclose any respective associations of such tests with patients’ prognosis; and to review the related literature. It is a retrospective case series study in Changhua Christian Hospital, Taiwan. Methods: Ninety-four patients’ data were analyzed. A scoring system was constructed retrospectively. Results: Hypotheses were postulated and proved. Each patient had a minimal score of 5, whereas those patients who had reached (increased) their scores were to the full or even over the maximal level (6 or 9) respectively. There was almost no correlation between age and Prothrombin Time (PT). The correlation between age and platelet count, and that between age and fibrinogen were positively minor respectively, whereas that of Activated Partial Thromboplastin Time (APTT) was +0.208. The correlations between APTT and PT, platelet count, fibrinogen respectively were significant. About 45.67% of patients had plasma fibrinogen >200 mg/dL, while 22.23% had <100 mg/dL. A paradox was observed. The finding of such a limited package of the screening tests was discussed. Related literature with regard to the clinical significance and pitfalls, as well as limitations and strengths of these haemostatic tests were reviewed and evaluated. Conclusion: There are 14 points of impression with clinical significance outlined. Keywords: DIC, Surgical Intensive Care Unit, Laboratory diagnosis, Haemostatic test, Screening test.
Moorestown platform: Based on lincroft SoC designed for next generation smartphones

■ Moorestown: Based on Lincroft SoC, Designed for ▪ High Performance for amazing Internet Experience ▪ Dramatically Lower Power - Upto 50x lower idle power ▪ Small Size for Next Generation Smartphones ■ Lincroft High Performance Innovation ▪ Wide range of scalable frequencies for multimedia blocks ▪ Intel Hyper threading technology ▪ Bus Turbo Technology ▪ Burst Mode technology ▪ Intel 45nm SoC High-K process technology ■ Lincroft Low Power Innovation ▪ Low power architecture features ▪ Enhanced Geyserville to support ULFM ▪ CPU C-states ▪ Lincroft Distributed Power Gating
A rare case of follicular lymphoma with transformation to diffuse large B-cell lymphoma and transdifferentiation to histiocytic sarcoma

This is an interesting case of a 53-year-old Caucasian male with a history of recurrent follicular lymphoma (FL) treated with chemotherapy. After 12 years, he developed lymphadenopathy and had an axillary lymph node biopsy which showed transformation to Diffuse Large B-cell lymphoma (DLBCL) with background FL. The patient was treated with chemotherapy and his course was complicated by cellulitis/abscess formation of the right thigh. Computerized Tomography scan showed a large necrotic nodal conglomerate within the right inguinal region measuring 7.8 cm × 5.1 cm and an excisional biopsy was performed. The lymph node architecture was effaced by sheets of large, atypical, pleomorphic cells with open/vesicular chromatin and scattered prominent nucleoli. Focal areas showed residual/recurrent FL, grade I-II. Immunohistochemical stains showed that the large neoplastic cells express CD4, CD68, CD163, BCL-6, lysozyme, CD45 and S-100. The morphologic and immunophenotypic findings are consistent with histiocytic sarcoma (HS). Fluorescence in-situ hybridization studies of the HS showed translocation t(14;18)(q32;q21), a gene rearrangement involving 3q27(BCL6), and gain of 14q32(IgH). The patient’s prior FL and DLBCL were shown to have the same translocation t(14;18)(q32;q21). The molecular findings show a common cell lineage between all three diagnoses confirming that FL can transform into DLBCL and transdifferentiate into HS.
Influence of Successful Chronic Hepatitis C Virus Treatment with Ledipasvir/Sofosbuvir on Warfarin Dosing Requirements in Four Veterans.

tudy Objective To describe international normalized ratio (INR) trends and warfarin dosage adjustments required for four veterans who were receiving warfarin therapy and started treatment for hepatitis C virus (HCV) with ledipasvir/sofosbuvir with or without ribavirin. Design Case series. Setting Pharmacist-led anticoagulation clinic in a Veterans Affairs Health Care System. Patients Four patients aged 59–66 years who were receiving warfarin and had stable, therapeutic INRs and started ledipasvir/sofosbuvir therapy with or without ribavirin for HCV infection. Measurements and Main Results All four patients developed subtherapeutic INRs after the addition of ledipasvir/sofosbuvir with or without ribavirin. An increase in weekly warfarin dose ranging from 14–67% was required, with changes in warfarin doses starting 2–3 weeks after ledipasvir/sofosbuvir initiation. Two patients required dose reductions after HCV treatment completion, whereas the other two did not. Use of the Drug Interaction Probability Scale indicated that the interaction between warfarin and ledipasvir/sofosbuvir was doubtful (score of 1 [two patients]) or possible (score of 4 [two patients]). The mechanism of this interaction is unknown but may be related to improvements in hepatic function during HCV treatment. Conclusion To our knowledge, this is the first case series describing a possible drug interaction between warfarin and ledipasvir/sofosbuvir (with or without ribavirin). Close monitoring is warranted when ledipasvir/sofosbuvir is initiated in patients receiving anticoagulation therapy with warfarin, especially those with evidence of cirrhosis prior to treatment. This is particularly important in the first month after starting treatment and the first month after completion. Failure to monitor and achieve therapeutic INR after HCV therapy completion may have the potential to result in adverse outcomes.
An enhanced run-time kernel visual debugger

Tremendous work has been achieved in operating system development. These efforts handed from both experienced and non-experienced developers targeting several milestones. Missing the full vision of operating system subsystems and hardware/software interaction brought up the desire for debugging the code. Ease of use and higher capabilities of the debugger were main goals for software vendors to satisfy developer requirements. Many subgoals were achieved on the way to reach the optimal debugger and many user requirements were added for such debugger. For instance, kernel initialization and multithreading are main issues should be addressed by the optimal debugger but only very few covering such issues. Several kernel debuggers exist for solving similar issues but only very few support line-by-line debugging at run-time. Furthermore, good visualization for in-detailed issues is main goal of such debugger in addition to the illusion of some performance measurements to the code being monitored. This paper presents a generic practical approach for operating system source code debugging in graphical mode with line-by-line tracing support. In the context of this approach, system boot up and performance evaluation of two operating system schedulers are addressed.
Microbial mutualism dynamics governed by dose-dependent toxicity of cross-fed nutrients

Microbial interactions, including mutualistic nutrient exchange (cross-feeding), underpin the flow of energy and materials in all ecosystems. Metabolic exchanges are difficult to assess within natural systems. As such, the impact of exchange levels on ecosystem dynamics and function remains unclear. To assess how cross-feeding levels govern mutualism behavior, we developed a bacterial coculture amenable to both modeling and experimental manipulation. In this coculture, which resembles an anaerobic food web, fermentative Escherichia coli and photoheterotrophic Rhodopseudomonas palustris obligately cross-feed carbon (organic acids) and nitrogen (ammonium). This reciprocal exchange enforced immediate stable coexistence and coupled species growth. Genetic engineering of R. palustris to increase ammonium cross-feeding elicited increased reciprocal organic acid production from E. coli, resulting in culture acidification. Consequently, organic acid function shifted from that of a nutrient to an inhibitor, ultimately biasing species ratios and decreasing carbon transformation efficiency by the community; nonetheless, stable coexistence persisted at a new equilibrium. Thus, disrupting the symmetry of nutrient exchange can amplify alternative roles of an exchanged resource and thereby alter community function. These results have implications for our understanding of mutualistic interactions and the use of microbial consortia as biotechnology.
Use of Simple Continuum Solutions in Finite Element Alternating Method for Fracture Problems

The performance of the finite element alternating (FEAM) method for two-dimensional crack problems is studied with respect to a polynomial pressure distribution fitted to the crack face stresses. The FEAM alternates between the analytical solution of crack in an infinite plate subjected to arbitrary polynomial distribution and a finite element solution of an uncracked body to satisfy the required boundary conditions in the crack problem. In this paper, the FEAM is applied to embedded crack and edge crack problems. For embedded crack problems, all of the constant, linear, and quadratic ( N=0,1, or 2, respectively) pressure distributions yield very accurate results with this algorithm with 4 to 5 iterations. The edge crack problems, on the other hand, require much higher order polynomials distributions (N=5 to 6) to yield accurate solutions. For slant edge crack problems, the mode-I stress-intensity factors have better accuracy than the mode-II stress-intensity factors for the same convergence tolerance.
Careers at the rapidly shifting human-technology frontier: Global engagement, local impact

The last decade has witnessed some rapid progress in science and technology, and the human-technology frontier has shifted considerably. In this talk, I argue that in the information technology community, and in the engineering community in general, career paths in this changed world should include not only technical fields but also administrative fields, entrepreneurship, science and technology education, and very importantly, policy and diplomacy at local, national and international levels. Adopting such a broad viewpoint would open up many interesting and highly satisfactory career paths, and may bring personal and professional fulfillment in unexpected ways. Technical education and training should provide a highly transferable skill-set that can be valuable in many other fields, including that of national and international science and technology policy.
Patient and Physician Assessment of Surgical Scars: A Systematic Review.

ImportanceSurgical scarring affects patients by distracting the gaze of onlookers, disrupting social interactions, and impairing psychosocial health. Patient and physician agreement regarding ideal...
Src-mediated regulation of the PI3K pathway in advanced papillary and anaplastic thyroid cancer

Advanced stages of papillary and anaplastic thyroid cancer continue to be plagued by a dismal prognosis, which is a result of limited effective therapies for these cancers. Due to the high proportion of thyroid cancers harboring mutations in the MAPK pathway, the MAPK pathway has become a focal point for therapeutic intervention in thyroid cancer. Unfortunately, unlike melanoma, a similar responsiveness to MAPK pathway inhibition has yet to be observed in thyroid cancer patients. To address this issue, we have focused on targeting the non-receptor tyrosine kinase, Src, and we and others have demonstrated that targeting Src results in inhibition of growth, invasion, and migration both in vitro and in vivo, which can be enhanced through the combined inhibition of Src and the MAPK pathway. Therefore, we examined the efficacy of the combination therapy across a panel of thyroid cancer cell lines representing common oncogenic drivers (BRAF, RAS, and PIK3CA). Interestingly, combined inhibition of Src and the MAPK pathway overcomes intrinsic dasatinib resistance in cell lines where both the MAPK and PI3K pathways are inhibited, which we show is likely due to the regulation of the PI3K pathway by Src in these responsive cells. Interestingly, we have mapped downstream phosphorylation of rpS6 as a key biomarker of response, and cells that maintain rpS6 phosphorylation likely represent drug tolerant persisters. Altogether, the combined inhibition of Src and the MAPK pathway holds great promise for improving the overall survival of advanced thyroid cancer patients with BRAF and RAS mutations, and activation of the PI3K pathway and rpS6 phosphorylation represent important biomarkers of response for patients treated with this therapy.
Optimizing Cognitive Rehabilitation: Effective Instructional Methods

Part 1. Foundations. 1. Introduction and Overview. 2. The Research Evidence. 3. The Learning Context: Beyond Practice (What They Didn't Teach You in Graduate School), with Rik Lemoncello and Eva van Leer. 4. The Training Framework: Plan, Implement, and Evaluate (PIE). Part 2. The Training Procedures. 5. Training Facts and Concepts. 6. Training Functional Multistep Routines. 7. Training the Use of External Cognitive Aids. 8. Training the Use of Metacognitive Strategies. 9. Training Social Skills. Conclusion: Now What?
Real-Time Processing of Continuous Doppler Signals for High-Speed Monitoring of Rail Tracks

In the rail industry, existing railroad tracks are carrying heavier and heavier train loads, instead of constructing new rails and distributing trainload tonnage [1,2]. As the average load per track increases, there is a growing concern about the critical flaws in the rail. Consequently, it is necessary to assess the rail integrity by means of rapid nondestructive detection of rail defects.
KINETICS AND MECHANISM OF ACTIVATED LIVER ALCOHOL DEHYDROGENASE

The mechanism of hydrogen transfer catalyzed by horse liver alcohol dehydrogenase with amidinated amino groups was studied with steady state kinetics. Hydroxybutyrlmidylation of the enzyme increases the maximum velocities of the enzymatic reactions and the rates of dissociation of the enzyme-coenzyme complexes. Primary deuterium isotope effects obtained for oxidation of [1,1-D 2 ]-benzyl alcohol and for reduction of a series of para -substituted benzaldehydes indicate that the turnover numbers reflect the rates of interconversion of central complexes. The magnitudes and signs of the ρ values obtained for oxidation of p -substltuted benzyl alcohols and for reduction of p -substituted benzaldehydes suggest that transfer of hydrogen occurs via concerted hydride and proton transfer in which only a small amount of charge develops in the transition state. The rate of oxidation of benzyl alcohol depends upon a group with a pK of 8.4, which must be unprotonated for maximum activity, but which allows partial activity in its protonated form. The maximum velocity for benzaldehyde reduction catalyzed by native enzyme required protonation of a group with a pK of 8.0. The pH effects for both enzymes can be explained by a coherent model in which a water (or hydroxide) molecule coordinated to the zinc ion acts as a proton donor (or acceptor) and the state of protonation of His-51 modulates the rate of transfer of hydrogen.
Computational Modeling of Deep Brain Stimulation

Deep brain stimulation (DBS) is an effective clinical treatment for several medically refractory neurological disorders. However, even after decades of clinical success, explicit understanding of the response of neurons to applied electric fields remains limited, and scientific definition of the therapeutic mechanisms of DBS remains elusive. In addition, it is presently unclear which electrode designs and stimulation paradigms are optimal for maximal therapeutic benefit and minimal side-effects with DBS. Detailed computer modeling of DBS has emerged recently as a powerful technique to enhance our understanding of the effects of DBS and to create a virtual testing ground for new stimulation strategies. This chapter summarizes the fundamentals of neurostimulation modeling, presents some scientific contributions of computer models to the field of DBS, and demonstrates the application of DBS modeling tools to augment the clinical utility of DBS.
A note about periodic and g-periodic points in semiflows

We discuss the relations between the notions of syndetic and g-syndetic submonoids of topological monoids, and the relations between the notions of periodic and g-periodic points in semiflows.
Patient-Reported Outcomes with Chimeric Antigen Receptor T Cell Therapy: Challenges and Opportunities

Abstract Patient-reported outcomes (PROs) are an important tool to assess the impact of a new therapy on symptom burden and health-related quality of life (HRQoL). Chimeric antigen receptor T (CAR-T) cell therapies have been approved for use in relapsed or refractory leukemia and lymphoma based on promising efficacy in clinical trials. However, data are lacking on patient-reported toxicity and impact on HRQoL. This review provides an overview of the incorporation of PROs in CAR-T cell therapy and the specific challenges in this context. The first step is to demonstrate feasibility of PRO monitoring in the acute phase after CAR-T cell infusion. Apart from core PRO domains like physical functioning, disease-related symptoms, and symptomatic adverse effects, important measures to consider are cognitive functioning and financial toxicity. Because there are no validated PRO instruments in the setting of CAR-T cell therapy, universally validated measures like Patient-Reported Outcomes Measurement Information System (PROMIS) could be considered, which is also recommended in the setting of hematopoietic stem cell transplantation. Given the timeline of toxicities with CAR-T cell therapy, PRO instruments should be administered at baseline and at least weekly in the first 30 days. Subsequently, frequent monitoring of PROs in the first year might be helpful in identifying short- and intermediate-term toxicities, functional limitations, and neuropsychiatric effects. The major potential challenge in acute phase would be missing data when patients develop severe cytokine release syndrome or neurotoxicity. Designing a strategy for handling missing data is crucial. The long-term safety of CAR-T cell therapy is not well characterized because of short follow-up in most studies reported thus far. PROs should be measured at least yearly after the first year to identify potential late effects like cognitive deficit or autoimmune manifestations. Collaboration between institutions performing cellular therapy and engagement with patients, clinicians, and statisticians with expertise in PROs are crucial for setting a comprehensive agenda on integration of PROs with CAR-T cell therapy.
Hand held optical coherence tomography probe for simultaneous anterior chamber and posterior segment imaging using a single light source (Conference Presentation)

Optical coherence tomography (OCT) allows for non-contact, high resolution, volumetric imaging of biological tissue and has become an indispensable ophthalmic imaging technique. However, conventional, commercial OCT systems require a cooperative, sitting patient typically stabilized by a head and/or chin rests. Additionally, current clinical systems are designed for imaging either the anterior or posterior segment of the eye exclusively. While these limitations are not severe in the ophthalmic clinic, they do limit the use of OCT in other more challenging medical environments where novel “whole eye” imaging could provide value, such as in the military theater or emergency department (ED). One solution to eliminate the need for a patient to sit upright and be stabilized during imaging would be a hand-held probe positioned and stabilized by the photographer or physician. Here we describe a hand-held OCT probe for simultaneous imaging of the anterior chamber (13.3 mm diameter field-of-view) and posterior segment (40° as measured from the pupil nodal point) simultaneously. The use of polarization multiplexing allows for two independent imaging channels which enable a wide posterior segment field-of-view and the ability to control the posterior segment path length and focal depth independently from the anterior chamber channel. Additionally, the probe was designed for a relatively compact form factor.
Too Big: Rebuild by Design: A Transformative Approach to Climate Change

When Hurricane Sandy hit the New York and New Jersey coasts in October 2012, the region was immobilized for days. Although Sandy’s status was reduced from a Category 3 hurricane at its peak to a Ca...
Modeling Regional Transmission and Containment of a Healthcare-associated Multidrug-resistant Organism

Background The Centers for Disease Control and Prevention (CDC) recently published interim guidance for a public health response to contain novel or targeted multidrug-resistant organisms (MDROs). We assessed the impact of implementing the strategy in a US state using a mathematical model. Methods We used a deterministic compartmental model, parametrized via a novel analysis of carbapenem-resistant Enterobacteriaceae data reported to the National Healthcare Safety Network and patient transfer data from the Centers for Medicare and Medicaid Services. The simulations assumed that after the importation of the MDRO and its initial detection by clinical culture at an index hospital, fortnightly prevalence surveys for colonization and additional infection control interventions were implemented at the index facility; similar surveys were then also implemented at those facilities known to be connected most strongly to it as measured by patient transfer data; and prevalence surveys were discontinued after 2 consecutive negative surveys. Results If additional infection-control interventions are assumed to lead to a 20% reduction in transmissibility in intervention facilities, prevalent case count in the state 3 years after importation would be reduced by 76% (interquartile range: 73-77%). During the third year, these additional infection-control measures would be applied in facilities accounting for 42% (37-46%) of inpatient days. Conclusions CDC guidance for containing MDROs, when used in combination with information on transfer of patients among hospitals, is predicted to be effective, enabling targeted and efficient use of prevention resources during an outbreak response. Even modestly effective infection-control measures may lead to a substantial reduction in transmission events.
Propertius Through the Looking Glass: A Fragmentary Glance at the Construction of Pound's Homage

Between 1912 and 1914, manic Ezra Pound was weaving a diffuse but tensile international web of poets, writers, artists. and publishers which was perforce rent to threads by World War I. In Hugh Selwyn Mauberley, Pound indicted this war as obscene and unnecessary. This essay is an attempt to demonstrate how the Homage to Sextus Propertius was constructed out of bits and pieces of Propertius to meet these Poundian objectives.
Derivation of notochordal cells from human embryonic stem cells reveals unique regulatory networks by single cell‐transcriptomics

Intervertebral disc degeneration (IDD) is a public health dilemma as it is associated with low back and neck pain, a frequent reason for patients to visit the physician. During IDD, nucleus pulposus (NP), the central compartment of intervertebral disc (IVD) undergo degeneration. Stem cells have been adopted as a promising biological source to regenerate the IVD and restore its function. Here, we describe a simple, two-step differentiation strategy using a cocktail of four factors (LDN, AGN, FGF, and CHIR) for efficient derivation of notochordal cells from human embryonic stem cells (hESCs). We employed a CRISPR/Cas9 based genome-editing approach to knock-in the mCherry reporter vector upstream of the 3' untranslated region of the Noto gene in H9-hESCs and monitored notochordal cell differentiation. Our data show that treatment of H9-hESCs with the above-mentioned four factors for 6 days successfully resulted in notochordal cells. These cells were characterized by morphology, immunostaining, and gene and protein expression analyses for established notochordal cell markers including FoxA2, SHH, and Brachyury. Additionally, pan-genomic high-throughput single cell RNA-sequencing revealed an efficient and robust notochordal differentiation. We further identified a key regulatory network consisting of eight candidate genes encoding transcription factors including PAX6, GDF3, FOXD3, TDGF1, and SOX5, which are considered as potential drivers of notochordal differentiation. This is the first single cell transcriptomic analysis of notochordal cells derived from hESCs. The ability to efficiently obtain notochordal cells from pluripotent stem cells provides an additional tool to develop new cell-based therapies for the treatment of IDD.
Containing classroom discussions of current social and political issues

This paper attends to the emotional and affective relations that manifest through political discussions in secondary classrooms. In particular, the focus is on the dynamics of classrooms during dis...
The Gendered Politics of Congressional Elections

Are female candidates less likely than male candidates to attract votes or win elections? We conduct a large-n longitudinal analysis employing survey and observational data from every two-party congressional race over a 12-year period (2006–2018) and connect individual-level theory and evidence with aggregate-level results. We demonstrate that candidate gender significantly influences congressional vote-choice and election outcomes. Holding other variables constant, we show that male Republican and male independent voters are significantly less likely to vote for female Democratic candidates, but do not assess a similar penalty on female Republican candidates. Perceived ideological distance does not explain the lack of support for female Democrats—however, variation in candidate quality does: Female Democratic candidates can attract the support of male Republican and male independent voters when they have a qualifications advantage, but are penalized when they are merely “as qualified.” At the aggregate-level, female Democratic candidates with a qualifications advantage are as likely as males to win elections; but are significantly less likely than males to win when qualifications are held constant. The proportion of male Republicans and male independents in a district determines the extent of the penalty, with women’s electoral prospects declining as this proportion increases. Women can win, but they need to be highly qualified and strategic about the races in which they emerge. These findings contribute to our understanding of the micro- and macro-level factors that shape women’s electoral fortunes; and advance the goal of representational equality by helping candidates and campaigns concentrate their efforts on the most winnable voters and districts.
Randomized Controlled Trial of Balloon Dilation in Treatment of Subglottic Stenosis With a Rabbit Model.

ObjectivesIdentify the effects of balloon dilation duration and topical ciprofloxacin-dexamethasone application in treatment of subglottic stenosis.Study DesignRandomized controlled trial.SettingAn...
Risk for Nephrogenic Systemic Fibrosis After Exposure to Newer Gadolinium Agents: A Systematic Review.

This systematic review compares the risk for nephrogenic systemic fibrosis after exposure to newer versus older gadolinium-based contrast agents.
Implementation of Network Source Authentication and Path Validation Using Orthogonal Sequences

The ability of a network node to verify where traffic is coming from and what path that traffic traversed is important for developing secure network protocols and defense mechanisms against attacks. Cryptographic approaches to source authentication and path validation can have significant computational requirements and thus may not be well-suited for high-performance networks. In prior work, we have described Orthogonal Sequence Verification, which uses orthogonal capabilities based on inner product computations, which can be easily realized by basic bitwise operations in a processor. In this paper, we present the results from a prototype implementation of this technique, which shows that the proposed approach is feasible for implementation in practical networks.
Pure electronic metal-insulator transition at the interface of complex oxides

In complex materials observed electronic phases and transitions between them often involve coupling between many degrees of freedom whose entanglement convolutes understanding of the instigating mechanism. Metal-insulator transitions are one such problem where coupling to the structural, orbital, charge, and magnetic order parameters frequently obscures the underlying physics. Here, we demonstrate a way to unravel this conundrum by heterostructuring a prototypical multi-ordered complex oxide NdNiO3 in ultra thin geometry, which preserves the metal-to-insulator transition and bulk-like magnetic order parameter, but entirely suppresses the symmetry lowering and long-range charge order parameter. These findings illustrate the utility of heterointerfaces as a powerful method for removing competing order parameters to gain greater insight into the nature of the transition, here revealing that the magnetic order generates the transition independently, leading to an exceptionally rare purely electronic metal-insulator transition with no symmetry change.
Abstract 146: Nitric Oxide Favors Sca-1+ Vascular Progenitor Cell Differentiation Toward Endothelial Cells

Introduction: Treatment outcomes for severe atherosclerosis are limited by neointimal hyperplasia and restenosis. Nitric oxide (NO) is a potent inhibitor of neointimal hyperplasia, but its effects ...
Exposure to Nicotine and Toxicants Among Dual Users of Tobacco Cigarettes and E-Cigarettes: Population Assessment of Tobacco and Health (PATH) Study, 2013-2014.

Introduction Concurrent use of tobacco cigarettes and e-cigarettes ("dual use") is common among tobacco users. Little is known about differences in demographics and toxicant exposure among subsets of dual users. Aims and methods We analyzed data from adult dual users (current every/some day users of tobacco cigarettes and e-cigarettes, n = 792) included in the PATH Study Wave 1 (2013-2014) and provided urine samples. Samples were analyzed for biomarkers of exposure to nicotine and selected toxicants (tobacco-specific nitrosamine NNK [NNAL], lead, cadmium, naphthalene [2-naphthol], pyrene [1-hydroxypyrene], acrylonitrile [CYMA], acrolein [CEMA], and acrylamide [AAMA]). Subsets of dual users were compared on demographic, behavioral, and biomarker measures to exclusive cigarette smokers (n = 2411) and exclusive e-cigarette users (n = 247). Results Most dual users were predominant cigarette smokers (70%), followed by daily dual users (13%), non-daily concurrent dual users (10%), and predominant vapers (7%). Dual users who smoked daily showed significantly higher biomarker concentrations compared with those who did not smoke daily. Patterns of e-cigarette use had little effect on toxicant exposure. Dual users with high toxicant exposure were generally older, female, and smoked more cigarettes per day. Dual users who had low levels of biomarkers of exposure were generally younger, male, and smoked non-daily. Conclusions In 2013-2014, most dual users smoked cigarettes daily and used e-cigarettes occasionally. Cigarette smoking appears to be the primary driver of toxicant exposure among dual users, with little-to-no effect of e-cigarette use on biomarker levels. Results reinforce the need for dual users to stop smoking tobacco cigarettes to reduce toxicant exposure. Implications With considerable dual use of tobacco cigarettes and e-cigarettes in the United States, it is important to understand differences in toxicant exposure among subsets of dual users, and how these differences align with user demographics. Findings suggest most dual users smoke daily and use e-cigarettes intermittently. Low exposure to toxicants was most common among younger users, males, and intermittent smokers; high exposure to toxicants was most common among older users, females, and heavier cigarette smokers. Results underscore the heterogeneity occurring within dual users, and the need to quit smoking cigarettes completely in order to reduce toxicant exposure.
Degrees of Cross-Sectional-Area Luminal Narrowing of the Four Major Epicardial Coronary Arteries in Patients With Otherwise Functionally and Anatomically Normal Hearts

Described herein are necropsy findings in the 4 major (left main, left anterior descending, left circumflex, and right) epicardial coronary arteries in 86 patients aged 10-70 years who never had symptoms of myocardial ischemia, and at autopsy had otherwise anatomically normal hearts. All 86 died of a non-cardiovascular condition. In each of these patients all 4 major epicardial coronary arteries were excised intact from the heart, divided into 5-mm segments, and each segment prepared for histologic examination. The degrees of cross-sectional area (CSA) narrowingwere determined from histologic examination of each 5-mm segment. The degree of narrowing in each 5 mm segment was divided into 4 categories: 0% to 25%, 26% to 50%, 51% to 75%, and 76% to 100%. Twelve patients (14%) had ≥1 artery narrowed >75% in CSA, a single artery in 9 patients, and 2 arteries in each of 3 patients. In contrast to the relative infrequency of narrowing >75%, narrowing 51-75% was common, and was present in 36 (42%) of the 86 patients. Of the 258 major coronary arteries (excludes the left main) studied in the 86 patients, 15 (6%) were narrowed >75%, and 70 (24%) were narrowed 51% to 75% in CSA. Even mild narrowing (26% to 50%) of the left main coronary artery (66 patients) was generally accompanied by 51% to 75% or greater narrowing of at least one of the other major coronary arteries. In conclusion, even hearts which have functioned normally and are otherwise anatomically normal, usually have some degree of atherosclerotic plaque in the major epicardial coronary arteries.
Epigenetics in kidney diseases

Epigenetics examines heritable changes in DNA and its associated proteins except mutations in gene sequence. Epigenetic regulation plays fundamental roles in kidney cell biology through the action of DNA methylation, chromatin modification via epigenetic regulators and non-coding RNA species. Kidney diseases, including acute kidney injury, chronic kidney disease, diabetic kidney disease and renal fibrosis are multistep processes associated with numerous molecular alterations even in individual kidney cells. Epigenetic alterations, including anomalous DNA methylation, aberrant histone alterations and changes of microRNA expression all contribute to kidney pathogenesis. These changes alter the genome-wide epigenetic signatures and disrupt essential pathways that protect renal cells from uncontrolled growth, apoptosis and development of other renal associated syndromes. Molecular changes impact cellular function within kidney cells and its microenvironment to drive and maintain disease phenotype. In this chapter, we briefly summarize epigenetic mechanisms in four kidney diseases including acute kidney injury, chronic kidney disease, diabetic kidney disease and renal fibrosis. We primarily focus on current knowledge about the genome-wide profiling of DNA methylation and histone modification, and epigenetic regulation on specific gene(s) in the pathophysiology of these diseases and the translational potential of identifying new biomarkers and treatment for prevention and therapy. Incorporating epigenomic testing into clinical research is essential to elucidate novel epigenetic biomarkers and develop precision medicine using emerging therapies.
Anglo-Portuguese Cooperation in Eighteenth-Century Atlantic South America

Historians of modern Argentina and Uruguay have amply demonstrated the magnitude of British economic and political investment in nineteenth-century Rio de la Plata, which led for the integration of the region as part of what would be called the British Informal Empire. The British invasions of 1806 and 1807 have also attracted the attention of historians of the region; nevertheless, few scholarly works examined the significance and role of the British presence in Rio de la Plata in the early eighteenth century. Despite lacking a colonial presence in the area, British merchants and investors had access to Spanish markets in Atlantic South America through the South Sea Company (1715–1737). After the end of the British Asiento in Rio de la Plata (1737), British merchants found ways of staying in the region, often by converting to Catholicism and utilizing Luso-Brazilian commercial and political networks, both in Brazil and in Colonia do Sacramento. By forming partnerships and utilizing longstanding networks of legal and illegal trade in Colonia do Sacramento, Rio de Janeiro, and other Brazilian ports, British merchants found ways of conducting trade, tapping silver and hides, and penetrating Spanish overseas markets during the eighteenth century. This chapter examines the British presence in the eighteenth-century Rio de la Plata and the informal strategies deployed by Anglo-Saxon, Luso-Brazilian, and Spanish-American merchants. The private nature of these British South Atlantic enterprises, often publicly traded in the City of London, also reveals the deep connections between European capitalism, empire, and slave societies in Iberian territories in the Americas. While Portugal depended on British manufactures and naval power, British merchants counted on Luso-Brazilian ports, networks, and logistics to penetrate Spanish South Atlantic markets.
Heterogeneous substrate binding in a glutamate transporter homologue

Integral membrane glutamate transporters couple the concentrative substrate transport to ion gradients. There is a wealth of structural and mechanistic information about this family, including kinetic models of transport. Recent studies have revealed transport rate heterogeneity in an archaeal glutamate transporter homologue GltPh, inconsistent with simple kinetic models. The structural and mechanistic determinants of this heterogeneity remain undefined. In a mutant form of GltPh, we demonstrate substrate binding heterogeneity in the outward-facing state, modulated by temperature and salts. We observe similar trends in wild-type GltPh that correlate with changes in the transport rate. Extensive cryo-EM analysis of the fully bound mutant GltPh provides multiple potential explanations of heterogeneous substrate binding. At equilibrium, we show subtle differences in tilts of protomers in the outward-facing state and configurations of the substrate-binding pocket. Within seconds of substrate binding, we observe perturbed helical packing of the extracellular half of the substrate-binding domain. Some or all of these may contribute to the heterogeneity observed in binding and transport.