cssi/SciSciGPT-SciSciNet huggingface dataset:
Computed tomography-based treatment planning for high-dose-rate brachytherapy using the tandem and ring applicator: influence of applicator choice on organ dose and inter-fraction adaptive planning.

Three dimensional planning for high-dose-rate (HDR) brachytherapy in cervical cancer has been highly recommended by consensus guidelines such as the American Brachytherapy Society (ABS) and the Groupe Europeen de Curietherapie - European Society for Radiotherapy and Oncology (GEC-ESTRO). In this document, we describe our experience with computed tomography (CT)-based planning using the tandem/ring applicator. We discuss the influence of applicator geometry on doses to organs at risk (OARs), namely the bladder, rectum, and sigmoid. Through example cases with dose prescribed to point A, we demonstrate how adaptive planning can help achieve constraints to the OARs as per guidelines.
The influence of interfacial slip on two‐phase flow in rough pores

The migration and trapping of supercritical CO2 (scCO2) in geologic carbon storage is strongly dependent on the geometry and wettability of the pore network in the reservoir rock. During displacement, resident fluids may become trapped in the pits of a rough pore surface forming an immiscible two-phase fluid interface with the invading fluid, allowing apparent slip flow at this interface. We present a two-phase fluid dynamics model, including interfacial tension, to characterize the impact of mineral surface roughness on this slip flow. We show that the slip flow can be cast in more familiar terms as a contact-angle (wettability) dependent effective permeability to the invading fluid, a non-dimensional measurement which relates the interfacial slip to the pore geometry. The analysis shows the surface roughness induced slip flow can effectively increase or decrease this effective permeability, depending on the wettability and roughness of the mineral surfaces. Configurations of the pore geometry where interfacial slip has a tangible influence on permeability have been identified. The results suggest that for large roughness features, permeability to CO2 may be enhanced by approximately 30% during drainage, while the permeability to brine during re-imbibition may be enhanced or diminished by 60%, depending on the contact angle with the mineral surfaces and degrees of roughness. For smaller roughness features, the changes in permeability through interfacial slip are small. A much larger range of effective permeabilities are suggested for general fluid pairs and contact angles, including occlusion of the pore by the trapped phase.
Biomaterials for Craniofacial Bone Regeneration

Functional reconstruction of craniofacial defects is a major clinical challenge in craniofacial sciences. The advent of biomaterials is a potential alternative to standard autologous/allogenic grafting procedures to achieve clinically successful bone regeneration. This article discusses various classes of biomaterials currently used in craniofacial reconstruction. Also reviewed are clinical applications of biomaterials as delivery agents for sustained release of stem cells, genes, and growth factors. Recent promising advancements in 3D printing and bioprinting techniques that seem to be promising for future clinical treatments for craniofacial reconstruction are covered. Relevant topics in the bone regeneration literature exemplifying the potential of biomaterials to repair bone defects are highlighted.
Percutaneous closure of patent foramen ovale vs. medical treatment for patients with history of cryptogenic stroke: A systematic review and meta-analysis of randomized controlled trials.

Abstract Background Patients with history of cryptogenic stroke are more likely to have a patent foramen ovale (PFO) and should be managed with antithrombotic agents, while the alternative option is percutaneous closure of PFOs. Our aim was to perform a meta-analysis of randomized controlled trials (RCTs) comparing percutaneous closure vs. medical treatment for patients with PFO and prior cryptogenic stroke. Methods Medline, Scopus and Cochrane databases were reviewed. A random-effect model meta-analysis was used and I-square was utilized to assess the heterogeneity. New ischemic stroke was defined as the primary endpoint. A sensitivity analysis was performed for Amplatzer device. Subgroup analyses were performed for different patient and PFO characteristics for the composite endpoints as defined by the included RCTs. Results In total of 3440 patients were included in this meta-analysis. Closure devices were superior to medical therapy for prevention of recurrent ischemic strokes (HR = 0.29; CI: 0.02–0.56), but were associated with increased risk of new onset of atrial fibrillation (AF) and atrial flutter (RR = 4.67; CI: 2.22–9.81). However, in the sensitivity analysis for Amplatzer device, there was no difference between the two groups in new onset of atrial arrhythmias. Closure devices were superior across all different subgroups when compared to medical treatment with the exception of patients with a small shunt. Conclusion This meta-analysis shows that closure devices for patients with PFO and history of cryptogenic stroke can significantly decrease the risk of a new ischemic stroke. The use of Amplatzer device was not associated with increased risk of newly diagnosed atrial arrhythmias.
The Entrainment and Screening of Returning and Postspawning Adult Salmonids at Irrigation Canals of the Umatilla River, Oregon

Abstract Anadromous salmonids can be vulnerable to entrainment at diversion intake structures on streams, effectively trapping fish in irrigation canals and removing them from a population. Currently little is known about how the differences in timing and direction of movement among adult salmonids contribute to their risk of entrainment and how successful they are at escaping irrigation canals. Potential routes of escape include passing against water currents and through the headgate of an irrigation canal intake or by navigating through screen and bypass infrastructure primarily designed to return juvenile fish to a stream. In this study, passive integrated transponders (PIT tags) were used to track the movement of adult Chinook Salmon Oncorhynchus tshawytscha (n = 573), Coho Salmon Oncorhynchus kisutch (n = 39), and anadromous Rainbow Trout Oncorhynchus mykiss (steelhead, n = 853) as they entered areas of the Umatilla River basin (Oregon) with irrigation canals and as they attempted to escape irrigatio...
An interactome perturbation framework prioritizes damaging missense mutations for developmental disorders

Identifying disease-associated missense mutations remains a challenge, especially in large-scale sequencing studies. Here we establish an experimentally and computationally integrated approach to investigate the functional impact of missense mutations in the context of the human interactome network and test our approach by analyzing ~2,000 de novo missense mutations found in autism subjects and their unaffected siblings. Interaction-disrupting de novo missense mutations are more common in autism probands, principally affect hub proteins, and disrupt a significantly higher fraction of hub interactions than in unaffected siblings. Moreover, they tend to disrupt interactions involving genes previously implicated in autism, providing complementary evidence that strengthens previously identified associations and enhances the discovery of new ones. Importantly, by analyzing de novo missense mutation data from six disorders, we demonstrate that our interactome perturbation approach offers a generalizable framework for identifying and prioritizing missense mutations that contribute to the risk of human disease.
The importance and nature of the water vapor budget in nature and models

This paper reviews the role of water vapor in climate sensitivity, the factors determining water vapor concentrations, comparisons of observed and model behavior of water vapor, and indirect and direct approaches to determining the actual climate feedback.
Modeling Perimenopause in Sprague–Dawley Rats by Chemical Manipulation of the Transition to Ovarian Failure

Various age-related diseases increase in incidence during perimenopause. However, our understanding of the effects of aging compared with hormonal changes of perimenopause in mediating these disease risks is incomplete, in part due to the lack of an experimental perimenopause model. We therefore aimed to determine whether manipulation of the transition to ovarian failure in rats via the use of 4-vinylcyclohexene diepoxide (VCD) could be used to model and accelerate hormonal changes characteristic of perimenopause. We examined long-term (11 to 20 mo), dose-dependent effects of VCD on reproductive function in 1- and 3-mo-old female Sprague–Dawley rats. Twenty-five daily doses of VCD (80 or 160 mg/kg daily compared with vehicle alone) depleted ovarian follicles in a dose-dependent fashion in rats of both ages, accelerated the onset of acyclicity, and caused dose-dependent increases in follicle-stimulating hormone that exceeded those naturally occurring with age in control rats but left serum levels of 17β−estradiol unchanged, with continued ovarian production of androstenedione. High-dose VCD caused considerable nonovarian toxicities in 3-mo-old Sprague–Dawley rats, making this an unsuitable model. In contrast, 1-mo-old rats had more robust dose-dependent increases in follicle-stimulating hormone without evidence of systemic toxicity in response to either VCD dose. Because perimenopause is characterized by an increase in follicle-stimulating hormone with continued secretion of ovarian steroids, VCD acceleration of an analogous hormonal milieu in 1-mo-old Sprague–Dawley rats may be useful for probing the hormonal effects of perimenopause on age-related disease risk.
Cholera: recent updates.

Purpose of reviewIn this review, we will examine updates in cholera epidemiology, advances in our understanding of pathogenesis and protective immunity, and changes to prevention strategies.Recent findingsNew modeling techniques and molecular epidemiology have led to advancements in our understandin
Upward P-cliticization, accent shift, and extraction out of PP

The paper explores how syntax influences the mapping of clitics to the prosodic structure in a dialect of Bosnian/Croatian/Serbian (BCS) that allows accent shift from nouns and adjectives to proclitics. I show that clitics preceding hosts of different morphological and syntactic complexity in the output of the syntax map to prosody differently. I establish a new correlation between the accent shift and the syntactic mobility of the host. Specifically, in a number of cases with adjectival hosts, accent can shift from the adjective to the proclitic preceding it only if the adjective is able to separate from the noun it modifies. I argue that prepositions in BCS cliticize to their host in the syntax in an upward fashion. I extend this analysis to a number of cases where non-constituents appear to be undergoing syntactic movement in BCS. The proposed analysis of cliticization also has important ramifications for the theory of phases and Abels’s (2003a) generalization that complements of phasal heads cannot move. I show that it explains away several cases where phasal complements appear to be moving out of phases in contexts with clitics, removing several potential problems for the phase-based system.
Early inspired oxygen and intermittent hypoxemic events in extremely premature infants are associated with asthma medication use at 2 years of age

Extremely premature infants are at risk for childhood wheezing. Early respiratory support and intermittent hypoxemia (IH) events may be associated with adverse breathing outcomes. A single-center retrospective cohort study of 137 premature infants <28 weeks gestational age characterized the associations of cumulative oxygen, cumulative mean airway pressure, IH, and oxygen saturation (SpO2) on the primary outcome of prescription asthma medication use at 2-year follow-up. Relative risk was calculated by generalized estimating equations. Reported asthma medication use was 46%. At 1–3 days of age, elevated cumulative oxygen exposure, increased daily IH, and lower mean SpO2 (adjusted for gestational age and sex) and increased cumulative mean airway pressure exposure (unadjusted) were associated with asthma medication use. Increased oxygen and frequent IH events during just the first 3 days of age may help identify extremely premature newborns at risk for symptomatic childhood wheezing requiring prescription asthma medications.
CEO network centrality and corporate cash holdings

The social network centrality of Chief Executive Officers (CEOs) has received tremendous attention in recent research. This study examines how CEO network centrality relates to corporate cash holdings. We find a significant negative relation between CEO network centrality and the level of corporate cash holdings, suggesting that firms with higher-centrality CEOs hold less cash. Our results still hold after a battery of robustness checks.
Dysfunctional hypoglossal nerve stimulator after electrical cardioversion: A case series.

Objectives/hypothesis Upper airway stimulation has demonstrated marked improvements in apnea-hypopnea index, oxygen desaturation index, and quality-of-life measures in patients with moderate to severe obstructive sleep apnea (OSA) who cannot tolerate continuous positive airway pressure. Cardiac arrhythmias are common in patients with OSA and can require electrical cardioversion. We describe the first four reported cases of hypoglossal nerve stimulator (HGNS) dysfunction after electrical cardioversion and illustrate our operative approach to device troubleshooting and repair. Study design Retrospective case series. Methods A retrospective review of 201 HGNS implantations performed at two academic institutions revealed four cases of HGNS device dysfunction after electrical cardioversion requiring surgical revision. Preoperative and postoperative device performance metrics and electrical cardioversion specifications were retrospectively assessed and compiled for this case series. The senior authors (R.J.S., M.S.B.) detail operative planning and approach for HGNS implantable pulse generator (IPG) replacement. Results At least two patients with HGNS device dysfunction had received cardioversion via anterolateral electrode pad placement. Three patients had received multiple shocks. All four patients experienced a change in device functionality or complete cessation of functionality after electrocardioversion. Operatively, each patient required replacement of the IPG, with subsequent intraoperative interrogation revealing proper device functionality. Conclusion Counseling for patients with HGNS undergoing external electrical cardioversion should include possible device damage and need for operative replacement. Anteroposterior electrode pad placement should be considered for patients with HGNS who require electrocardioversion. Operative replacement of an HGNS system damaged by electrocardioversion begins with IPG replacement and intraoperative device interrogation. Level of evidence 4 Laryngoscope, 129:1949-1953, 2019.
The image-based multiscale multigrid solver, preconditioner, and reduced order model

Abstract We present a novel image-based multiscale multigrid solver that can efficiently address the computational complexity associated with highly heterogeneous systems. This solver is developed based on an image-based, multiresolution model that enables reliable data flow between corresponding computational grids and provides large data compression. A set of inter-grid operators is constructed based on the microstructural data which remedies the issue of missing coarse grid information. Moreover, we develop an image-based multiscale preconditioner from the multiscale coarse images which does not traverse through any intermediate grid levels and thus leads to a faster solution process. Finally, an image-based reduced order model is designed by prolongating the coarse-scale solution to approximate the fine-scale one with improved accuracy. The numerical robustness and efficiency of this image-based computational framework is demonstrated on a two-dimensional example with high degrees of data heterogeneity and geometrical complexity.
Multiwell Plate Impedance Analysis of a Nanowell Array Sensor for Label-Free Detection of Cytokines in Mouse Serum

We present a novel method for label-free detection of tumor necrosis factor alpha (TNF-α) in serum after immobilization by electric field. Detection of proteins in blood using label-free impedance-based techniques is difficult due to high salt concentration of the matrix, which results in charge screening. The nanowell array sensor provides enhanced electrochemical sensitivity by electric field focusing in the nanoscale volume wells. Here, an on-chip multiwell plate sensing platform was fabricated and tested. The sensor performance through testing in mouse serum at protein concentrations between 10 and 500 ng/l has been demonstrated. This detection modality is advantageous to many label-free electronic sensors in that signal power scales will increase in salt concentration, thus improving the sensitivity of the platform.
Mensch-Roboter-Kollaboration in der Medizin

Wahrend die Mensch-Roboter-Kollaboration in der Industrie Einzug halt und die normativen Vorgaben der einschlagigen Richtlinien den schutzzaunlosen Einsatz von Industrierobotern seit einigen Jahren erlauben, ist dies in der Medizintechnik schon viel langer moglich. Wie kann das sein? Zu erwarten ware doch, dass in der Medizin noch viel strengere Regeln gelten als in der Produktion. Dieser Beitrag gibt einen Einblick in die Hintergrunde und stellt einige konkrete Anwendungen dar.
Inferring Maps of Cellular Structures from MRI Signals using Deep Learning

1H MRI maps brain anatomy and pathology non-invasively through contrasts generated by exploiting inhomogeneities in tissue micro-environments. Inferring histopathological information from MRI findings, however, remains challenging due to the absence of direct links between MRI signals and specific tissue compartments. Here, we show that convolutional neural networks, developed using co-registered multi-contrast MRI and histological data of the mouse brain, can generate virtual histology from MRI results. Our networks provide maps that mirror histological stains for axons and myelin with enhanced specificity compared to existing MRI markers. Furthermore, by introducing random perturbations to the inputs, the relative contribution of each MRI contrast within the networks can be estimated and guide the optimization of MRI acquisition. We anticipate our method to be a starting point for translation of MRI results into easy-to-understand virtual histology for neurobiologists and provide resources for developing novel MRI contrasts.
Epidemics as an adaptive driving force determining lifespan setpoints

Species-specific limits to lifespan (lifespan setpoint) determine the life expectancy of any given organism. Whether limiting lifespan provides an evolutionary benefit or is the result of an inevitable decline in fitness remains controversial. The identification of mutations extending lifespan suggests that aging is under genetic control, but the evolutionary driving forces limiting lifespan have not been defined. By examining the impact of lifespan on pathogen spread in a population, we propose that epidemics drive lifespan setpoints' evolution. Shorter lifespan limits infection spread and accelerates pathogen clearance when compared to populations with longer-lived individuals. Limiting longevity is particularly beneficial in the context of zoonotic transmissions, where pathogens must undergo adaptation to a new host. Strikingly, in populations exposed to pathogens, shorter-living variants outcompete individuals with longer lifespans. We submit that infection outbreaks can contribute to control the evolution of species' lifespan setpoints.
Recorder 2.0: Efficient parallel I/O tracing and analysis

Recorder is a multi-level I/O tracing tool that captures HDF5, MPI-I/O, and POSIX I/O calls. In this paper, we present a new version of Recorder that adds support for most metadata POSIX calls such as stat, link, and rename. We also introduce a compressed tracing format to reduce trace file size and run time overhead incurred from collecting the trace data. Moreover, we add a set of post-mortem and visualization routines to our new version of Recorder that manage the compressed trace data for users. Our experiments with four HPC applications show a file size reduction of over 2× and reduced post-processing time by 20% when using our new compressed trace file format.
Childhood Environmental Adversity and Career Decision-Making Difficulty: A Life History Theory Perspective:

Although research has examined and supported the role of environmental adversity in career decision-making, little is known about the prediction power of childhood environmental adversity for caree...
Reading Bayle, Again: A Survey of the Interpretive Landscape and A Defense of the Academic-Moral Knowledge Reading

Since the Enlightenment, there have been almost as many different interpretations of Bayle’s philosophical thought as there have been interpreters. At one end of the spectrum, the complexity and seeming ambiguity of Bayle’s arguments, as well as his criticisms of rational theology, have been cited as evidence by proponents of an ironic and critical interpretation of Bayle as a libertin clandestin. At the other end of the spectrum are interpretations that consider Bayle’s skepticism about the ability of reason to establish certainty as evidence of a kind of heterodox Huguenot fideism. In this work, I explain in detail the interpretive problems associated with Bayle, trace the development of the major positions along the spectrum, examine representative examples of each kind of interpretation, and show that a viable Labroussean-inspired interpretation can be developed that responds to lacunae in the most systematic recent interpretation of Bayle, developed by Gianluca Mori.
Categorical symmetry and noninvertible anomaly in symmetry-breaking and topological phase transitions

The authors show that one of the strongly correlated gapless states at the critical point of Landau symmetry breaking transition has an unbroken dual algebraic (n-1)-symmetry G^(n-1) in n-dimensional space, in addition to the usual unbroken symmetry G.
Looking the Other Way: The Screening Role of (Weak) Internal Monitoring

Internal monitoring is a cardinal responsibility of the board of directors, many of which have been subject to relentless criticism of conceding too much power to the managers and allowing them too much latitude. We analyze the role of internal monitoring in a dynamic adverse selection model, in which managers have unobservable ability and must be given rents through a compensation contract in exchange for revealing their private information. Monitoring has two effects: an ex-post disciplining effect, whereby more intense monitoring limits the information advantage and the rents for managers with higher ability; and an ex-ante screening effect, whereby weaker monitoring allows firms to attract better managers. We show an optimal level of monitoring intensity that balances the disciplining effect and the screening effect exists, even when monitoring is intrinsically costless and can be made arbitrarily strong. We empirically test these predictions and find that less monitoring by the board is indeed associated with on average more capable managers, and the relationship between monitoring intensity and firm value is hump-shaped in the data. Although the lack of monitoring is often viewed as a failure of internal governance, our analysis suggests it is a plausible tactic for attracting and retaining talented managers.
Hirudotherapy in the management of post-intubation macroglossia

The medicinal use of leeches (hirudotherapy) is intimately connected to the history and practice of medicine. Here we describe a novel case of hirudotherapy in an intubated patient with macroglossia related to oral trauma and venous congestion. The patient was a 23-year-old woman with a history of morbid obesity initially admitted to an outside hospital with acute hypoxic respiratory failure secondary to COVID-19 pneumonia. She received early treatment with supplemental oxygen, dexamethasone, remdesivir, and tocilizumab but developed worsening respiratory failure requiring intubation on hospital day 13. Despite neuromuscular blockade and proning, she remained difficult to oxygenate and was transferred to our hospital 24 days after admission. Weaning of pharmacologic paralysis was complicated by ongoing ventilator dyssynchrony, and she continued to require deep sedation with multiple agents, including phenobarbital. Her respiratory status gradually improved, but weaning of sedation was marked by agitation and tongue biting. On day 50, significant isolated tongue edema was noted. Further trauma was observed on the ventral aspect of the swollen tongue where it came into contact with the teeth. High-level ventilatory support precluded tracheostomy, and conservative management with repositioning of the endotracheal tube and insertion of a bite block did not resolve the edema. The otolaryngology service was consulted, and the decision was made to trial an application of medicinal leeches. The patient received two courses of hirudotherapy with packing of the oropharynx to prevent leech migration, resulting in significant improvement of her edema. Among already mechanically ventilated patients, macroglossia remains a rare but documented complication. Endotracheal tube position and proning are the most frequently implicated etiologies. In this instance, oral trauma from tongue-biting coupled with impaired lymphovascular return from extrinsic impingement on the swollen tongue were thought to be the cause. Therapeutic options are limited and include ice, elevation, bite block placement, intravenous steroids, manual reduction and compression wrapping. In extreme cases, tracheostomy and even partial glossectomy have been performed. Hirudotherapy is well described in modern clinical practice among facial reconstructive surgeons for the management of venous congestion and resultant compromise of pedicle or microvascular tissue-free transfer flaps. Few case reports in the trauma literature have described its use with macroglossia on presentation, but its use in cases of post-intubation trauma appears novel. Given the frequent contribution of venous congestion in intubated patients with macroglossia, hirudotherapy should be considered a logical treatment modality in cases where conservative measures are unsuccessful.
TLife-LSTM: Forecasting Future COVID-19 Progression with Topological Signatures of Atmospheric Conditions

Understanding the impact of atmospheric conditions on SARS-CoV2 is critical to model COVID-19 dynamics and sheds a light on the future spread around the world. Furthermore, geographic distributions of expected clinical severity of COVID-19 may be closely linked to prior history of respiratory diseases and changes in humidity, temperature, and air quality. In this context, we postulate that by tracking topological features of atmospheric conditions over time, we can provide a quantifiable structural distribution of atmospheric changes that are likely to be related to COVID-19 dynamics. As such, we apply the machinery of persistence homology on time series of graphs to extract topological signatures and to follow geographical changes in relative humidity and temperature. We develop an integrative machine learning framework named Topological Lifespan LSTM (TLife-LSTM) and test its predictive capabilities on forecasting the dynamics of SARS-CoV2 cases. We validate our framework using the number of confirmed cases and hospitalization rates recorded in the states of Washington and California in the USA. Our results demonstrate the predictive potential of TLife-LSTM in forecasting the dynamics of COVID-19 and modeling its complex spatio-temporal spread dynamics.
RISC-V Resource-Constrained Cores: A Survey and Energy Comparison

Resource-Constrained electronic devices targeting IoT applications need a microcontroller to control their operation, and hence this microcontroller should be energy efficient to increase battery life. One of the emerging open-source processors ISA is RISC-V; as an open-source, it provides a great opportunity for innovation and creativity in designing processor cores. This study targets to survey open-source RISC-V cores and classify them as high-performance and resource-constrained. Afterward, we shortlist the most optimized cores for resource-constrained devices. Seven shortlisted cores are implemented using an ASIC prototyping platform as a unified technology and are compared using resource utilization and energy consumption profile to find the most energy efficient core. We proposed a method to evaluate the energy consumption using power and performance values. Results showed Ibex core to have the best energy consumption characteristics with 8.7 Coremark iterations/mJ over the ASIC prototyping platform.
Lessons for Treating Structural Heart Patients During the COVID-19 Pandemic and Beyond

We sought to compare characteristics and outcomes of structural heart disease (SHD) patients treated during the regional peak of the COVID-19 pandemic (“COVID era”) compared with historical control...
Culp’s Hill: Key to Union Success at Gettysburg

Brigadier General George S. Greene’s position on Culp’s Hill during the Battle of Gettysburg is arguably the crucial lynchpin of July 2, 1863. Had this position at the barb of the fishhook defensive line fallen, Confederate General Robert E. Lee and his army would then have been positioned to take Cemetery Hill, thus breaking the curve of the hook on the Union right. This most likely would have sent the Union into retreat, leaving the direct route to Washington unguarded. Fortunately, valiant efforts were made by men like Generals George S. Greene and Henry H. Lockwood in order to preserve the Union Army’s possession of the hill and, as a result, preserve the Union itself. While leaders distinguished themselves during the Battle of Gettysburg with exceptional decision-making and ingenuity, the battle for Culp’s Hill also embodied the personal cost these decisions made, as evidenced by the experience of Marylanders who literally fought their neighbors. [excerpt]
Chapter 13. Antifungal Agents

Publisher Summary This chapter discusses essential aspects of the history, pathological diagnosis and physiology, mycological aspects, host response, serology, treatment, clinical manifestation, and laboratory diagnosis of human aspergillosis, and the more recent topic of aflatoxins. The superinfections most commonly seen in illicit drug users are discussed followed by commonly seen fungal infections such as candidiasis and aspergillosis. The role of the radiologist in the diagnosis of opportunistic pulmonary fungal infections and their symptoms are discussed. The chapter also discusses specific fungal infections that include phycomycosis, aspergillosis, and nocardiosis. Chronic mucocutaneous candidiasis in immunosuppressed patients and patients with genetically determined diseases is reviewed; treatment with immunoreconstitution, 5-FC, clotrimazole or amphotericin B is discussed. The combination of immunoreconstitution, drug therapy, the importance of iron deficiency and other nutritional factors are also discussed followed by a review of clinical aspects of the mycotoxicoses in man and animals.
Surgery for Prominent Ears

Ear prominence is the most common congenital de­formity. Correcting the prominent ear is usually a very gratifying procedure for both the patient and the surgeon (Fig. 65.1). The goal of otoplasty therefore is to reposition the ear so that the ear occupies a closer angle to the skull while maintaining a natural appear­ance. A natural appearance is one with smooth curves without sharp angles, step­offs or irregularities, with a sufficiently deep postauricular sulcus.
The mode-centric M-Gaussian distribution: A model for right skewed data

Abstract Scientific data are often nonnegative, right skewed and unimodal. For such data, the Mode-Centric M-Gaussian distribution is a basic model. It is R-symmetric and has mode as the centrality parameter. It is variously analogous enough to the Gaussian distribution to regard the Gaussian twin. In this paper, the essentials, namely the concept of R-symmetry, the M-Gaussian distribution, the roles of the mode and harmonic variance as, respectively, the centrality and dispersion parameters of the M-Gaussian distribution, are introduced. The pivotal role of the M-Gaussian family in the class of R-symmetric distributions and the estimation, testing, and characterization properties are discussed. The similarities between the Gaussian and the M-Gaussian distributions, namely the G–M-G analogies, are summarized. The work on the model, which is currently in progress, and the possible significance of the M-Gaussian in statistical applications such as regression analysis, Bayesian statistics and sequential analysis are outlined.
Case 20: Who to Trust

You are an assistant professor in a large university department. As a keen, budding researcher, you have attended all the department’s research meetings and have partaken in the discussions. An interesting clinical research project is presented by a senior researcher in the department. You show an obvious interest. The study involves measuring vital signs during general anesthesia and taking blood samples for bioactive agents. The next day the senior researcher stops you in the hall and asks you if you would like to be involved in the study. You are delighted. Your main job will be to measure the bioactive agents after all the samples have been collected.
Target fragment angular distributions from the interaction of 3. 0 GeV and 12. 0 GeV /sup 12/C with /sup 197/Au and /sup 238/U

Target fragment angular distributions have been measured using radioanalytical techniques for the interaction of 3.0 and 12.0 GeV $^{12}\mathrm{C}$ with $^{197}\mathrm{Au}$ and $^{238}\mathrm{U}$. For the reaction of 3.0 GeV $^{12}\mathrm{C}$ ions with $^{197}\mathrm{Au}$ and $^{238}\mathrm{U}$, angular distributions were obtained for eight different target fragments ($89\ensuremath{\le}A\ensuremath{\le}155$), and seven different target fragments ($43\ensuremath{\le}A\ensuremath{\le}149$), respectively. In the interaction of 12.0 GeV $^{12}\mathrm{C}$ with $^{197}\mathrm{Au}$ and $^{238}\mathrm{U}$, the angular distributions of six different target fragments ($43\ensuremath{\le}A\ensuremath{\le}155$) from each target were measured. All the fragments observed from $^{197}\mathrm{Au}$ target fragmentation show forward peaked angular distributions; from $^{238}\mathrm{U}$ target fragmentation, typical neutron-rich fission fragment nuclides show isotropic distributions in the laboratory system, while the rest of the fragments show forward peaked distributions similar to those observed in $^{197}\mathrm{Au}$ target fragmentation. The observed angular distributions are consistent with the values of previously measured $\frac{F}{B}$ ratios and are compared with predictions of the intranuclear cascade model. The measured angular distributions are used to test the validity of two step vector model of high energy reactions.NUCLEAR REACTIONS Relativistic heavy ion reaction, target fragmentation, target fragment angular distributions for 3.0 and 12.0 GeV $^{12}\mathrm{C}$ + $^{197}\mathrm{Au}$, $^{238}\mathrm{U}$; two step vector model, intranuclear cascade model.
Rationality in Information Systems Support to Decision Making

Management information systems serve business organizations by providing information for decision making. Various types of systems serve different types of decision contexts. The philosophic basis of information system support is discussed. The rational (or normative) philosophy is widely used, and appears in business theory in the form of agency theory and transaction cost analysis. While this approach has been valuable in some contexts, there are other contexts where the rational approach has limited in utility for real business decision making. Decision makers need to consider subjective factors to enable them to cope with the high levels of uncertainty, incomplete understanding, and imperfect data typical of dynamic open systems. There are alternative philosophies upon which to base decision-making that are appropriate for specific decision contexts. Churchman identified empirical, multi-perspective frameworks, dialectic, and cause-and-effect inquiring systems as alternatives to the rational (normative) system. A number of information system tools, such as decision support systems, expert systems, and group support systems can be supported by models based on philosophies other than rational models. A more empirically based philosophy, with decision-makers balancing hypothesis generation and observations of performance, is often more appropriate. The relationship between Churchman's inquiring systems and information system types are discussed.
Clinical features and biomarkers of concussion and mild traumatic brain injury in pediatric patients

There has been increasing awareness of the incidence and potential long-term consequences of mild traumatic brain injury (mTBI) in children and young adults. While parents, school systems, and athletic programs are clamoring for evidence-based guidelines, the field remains primitive in understanding the factors resulting in a spectrum of individual outcomes, most of which are complete, but some of which are not. In this article, we discuss the definition, epidemiology, clinical presentation, course, and outcomes of mTBI, with a focus on the pediatric population as the context for reviewing the mechanisms and pathophysiology mediating, and biomarkers reflective of, more significant concussion-induced brain injury. Our goal is to present a general overview of the features of mTBI in the pediatric population in order to provide a conceptual model for pediatricians and pediatric subspecialists. This model emphasizes the importance of establishing actionable, noninvasive biomarkers that are reflective of brain injury and that may identify those pediatric patients who can benefit from earlier and more aggressive interventions. We will focus on the specific features of mTBI in pediatric patients; although given the relative lack of research in the pediatric population, we will also extrapolate from research on adults.
Simulink Code Generation: Tutorial for Generating C Code from Simulink Models using Simulink Coder

This document explains all the necessary steps in order to generate optimized C code from Simulink Models. This document also covers some general information on good programming practices, selection of variable types, how to organize models and subsystems, and finally how to test the generated C code and compare it with data from MATLAB.
4H-SiC 15kV n-IGBT physics-based sub-circuit model implemented in Simulink/Matlab

A physics-based 15kV 4H-SiC n-IGBT sub-circuit model implemented in Simulink/Matlab is demonstrated in this work. Two-phase voltage ramp during the switching before and after punch through is well predicted. Simulated with a simple 4H-SiC Schottky diode model, the switching results is experimentally verified. The current bump during turn-off and current overshoot during turn-on are well-predicted and can be explained by the instantaneous output capacitances of the IGBT and Schottky diode. The computing speed for the full turn-on and off with stray inductance is approximately 2 minutes.
A Dual-Rate Sampling Multivariable Self-Tuning Regulator

This paper describes a new dual-rate sampling multivariable self-tuning regulator that specifically handles the situation where the computations of multivariable self-tuning regulator fail to be performed within a single sampling period. For fast responding systems the algorithm proposed here ensures better performance and requires fewer computations in comparison with the single-rate sampling self-tuning regulator.
He 3 ( He 3 , 2 p ) He 4 Total Cross-Section Measurements Below the Coulomb Barrier

Measurements of total cross sections for $^{3}\mathrm{He}(^{3}\mathrm{He},2p)^{4}\mathrm{He}$ have been made for center-of-momentum energies between 80 keV and 1.1 MeV. A continuously recirculating differentially pumped gas target system was employed to minimize uncertainties in energy loss and straggling. A calorimetric device was used to integrate the beam current within the target gas. Proton angular distributions were measured at seven energies. The measured cross-section factor, $S(E)$, was fitted to a linear function of energy for ${E}_{\mathrm{c}.\mathrm{m}.}l500$ keV: $S({E}_{\mathrm{c}.\mathrm{m}.})={S}_{0}+{{S}_{0}}^{\ensuremath{'}}{E}_{\mathrm{c}.\mathrm{m}.}$, where ${S}_{0}=({5.0}_{\ensuremath{-}0.4}^{+0.6})$ MeVb and ${{S}_{0}}^{\ensuremath{'}}=(\ensuremath{-}1.8\ifmmode\pm\else\textpm\fi{}0.5)$ b. The formula $S({E}_{\mathrm{c}.\mathrm{m}.})={S}_{0}+{{S}_{0}}^{\ensuremath{'}}{E}_{\mathrm{c}.\mathrm{m}.}+\frac{1}{2}{{S}_{0}}^{\ensuremath{'}\ensuremath{'}}{E}_{\mathrm{c}.\mathrm{m}.}^{2}$, with ${S}_{0}=5.2$ MeVb, ${{S}_{0}}^{\ensuremath{'}}=\ensuremath{-}2.8$ b, and ${{S}_{0}}^{\ensuremath{'}\ensuremath{'}}=2.4$ b Me${\mathrm{V}}^{\ensuremath{-}1}$ gives a good representation of $S(E)$ over the entire range of energies studied here.
Excessive Ambitions (II)

Following an earlier article criticizing excessive uses of rational-choice modeling and statistical analyses in the social sciences, the present article argues that much of normative political theory, notably many theories of optimal institutional design, also suffer from various forms of overreaching. It is argued that both attempts to design democratic institutions that will track independently denied good outcomes and attempts to choose good democratic decision-makers are bound to fail. The article also presents a positive alternative, inspired by Jeremy Bentham's Political Tactics: institutional designers should reduce as much as possible the impact of self-interest, emotion, prejudice and cognitive bias on the decision-makers, and then let the chips fall where they may.Comments on this paper can be found at:http://ssrn.com/abstract=2207083 http://ssrn.com/abstract=2207106
Acetic Acid, 2,2,2‐Trichloro‐, Trimethylsilyl Ester

[25436-07-1] C5H9Cl3O2Si (MW 235.56) InChI = 1S/C5H9Cl3O2Si/c1-11(2,3)10-4(9)5(6,7)8/h1-3H3 InChIKey = HAIZQIKYAKUOBN-UHFFFAOYSA-N (used as a source of CCl3 anion for reactions with aldehydes and ketones; source of dichlorocarbene under FVP conditions; used for trimethylsilylation of alcohols, amines, thiols, amides, and alkynes) Alternate Names: trimethylsilyl trichloroacetate. Physical Data: d 1.245 g mL−1, fp 28 °C, bp 70–73 °C, η: 20/D 1.44. Form Supplied in: colorless liquid,commercially available. Solubility: soluble in common organic solvents. Preparative Method: it is prepared in one step by silylation of trichloroacetic acid with hexamethyldisiloxane in the presence of catalytic sulfuric acid (eq 1).1 Can also be prepared by a more convenient procedure involving the reaction of sodium trichloroacetate with chlorotrimethylsilane in the presence of 18-crown-6 and toluene (eq 2).2 (1) (2) Handling, Storage, and Precautions: acutely toxic by inhalation, skin, and eyes. Use under fume hood with proper PPE.
Binding of colloidal gold-labeled salivary proline-rich proteins to Actinomyces viscosus type 1 fimbriae.

Salivary proline-rich proteins (PRPs), which were purified from parotid saliva, were adsorbed onto 15-nm-diameter gold particles to visualize specific binding of the salivary molecules to Actinomyces viscosus type 1 fimbriae. Negatively stained preparations incubated with PRP-gold conjugates but not bovine serum albumin-gold complexes bound specifically to bacteria possessing type 1 fimbriae, A. viscosus T14V-J1 and 5519. Binding of the PRP-gold probes to strains deficient in type 1 fimbriae, i.e., strains 5951 (type 2 fimbriae only) and 147 (no fimbriae), was negligible. Images
Superposition of impulse activity in a rapidly-adapting afferent unit model

Mechanosensory afferent units consist of a parent axon, the peripheral axonal arborization, and the branch terminal mechanoreceptors. The present work uses a mathematical model to describe the contribution of a given number of rapidly-adapting mechanoreceptors to the impulse pattern of their parent axon. In the model, impulses initiated by any driven mechanoreceptor instantaneously propagate orthodromically and antidromically. The model also incorporates the axonal absolute refractory period as well as ortho- and antidromically elicited recovery cycles. In separate computations, periodic or random (Poisson process) trains of short-duration stimuli at constant amplitude are delivered to a given number (N = 2-30) of co-innervated mechanoreceptors. The superposition of component impulse trains always departs from the theoretical ideal (Poisson process). Such departures are attributable to: (i) the number of driven mechanoreceptors, when N is small, (ii) axonal absolute refractory period, during maximal amplitude stimulation, and (iii) antidromic recovery cycles as well as absolute refractoriness, during submaximal-amplitude stimulation. Computations reveal that this "instantaneous reset" model results in the elimination of information extracted by driven mechanoreceptors. Model predictions with Poisson stimulation at varied amplitudes are compared to G-hair afferent unit responses to analogous stimulation. Qualitatively opposite results with respect to parent axonal impulse patterns imply that the axonal arborization is not simply a substrate for impulse propagation from branch terminals to parent axon.
Prosthetic treatment of maxillofacial patients.

Abstract All patients with suspected oral malignancy should have early consultation with a maxillofacial prosthodontist. Such consultation is an asset to pre- and postoperative treatment planning. Preoperative records can be used to construct the prostheses needed to facilitate early healing and patient rehabilitation. The construction of a permanent prosthesis is easier following proper postoperative treatment. The rehabilitation of maxillofacial patients requires a team effort, with each specialty deserving equal importance. Although prosthetic correction is the last phase of treatment, periodic review and examination by all the disciplines concerned are imperative.
Nonequilibrium fluctuation-induced transport

Ratchetlike devices can rectify symmetric, unbiased nonequilibrium noise resulting in fluctuation-induced currents. We study some simple models to investigate the dependence of a nonequilibrium steady-state current on the characteristic features of the ratchet and the applied noise. It turns out that the magnitude and the direction of the induced current depend not only on the shape of the ratchet, but also on the statistics of the fluctuations.
A comparison of dorzolamide–timolol combination versus the concomitant drugs

Abstract PURPOSE: To compare the intraocular pressure (IOP) lowering effect of fixed combination dorzolamide 2% and timolol 0.5% therapy to that of concomitant administration of a topical beta-blocker and dorzolamide. METHODS: Seventy-four consecutive glaucoma patients were changed from a regimen including a topical beta-blocker and dorzolamide to the fixed combination dorzolamide–timolol in 1 eye, with the other eye used as the control. The average IOP readings before and 1 month after the change were compared. RESULTS: The mean baseline IOP in the entire study population was 19.4 ± 4.2 mm Hg in the study eyes and 16.9 ± 4.2 mm Hg in the control eyes. Four weeks after the medication change, the mean IOP was 17.3 ± 3.9 mm Hg in the study eyes ( P P = .02). The difference between the mean IOP change of 2.1 mm Hg in the study eyes and 0.8 mm Hg in the control eyes was found to be statistically significant ( P = .01). CONCLUSION: These findings suggest that the fixed combination dorzolamide–timolol therapy achieves additional lowering of the intraocular pressure compared with the concomitant administration of a beta-blocker and dorzolamide.