cssi/SciSciGPT-SciSciNet huggingface dataset:
Surgically remediable complications of myocardial infarction.

S HOCK and ventricular failure after acute myocardial infarction generally are related to the degree of loss of contractile muscle and therefore complicate large infarctions or repeated infarction of previously damaged hearts.’ Less frequent but often more dramatic complications of acute infarction follow disruption of strategic structures, such as the interventricular septum or papillary muscles, producing shock and acute or chronic ventricular failure. Infarction of the free wall may be followed by acute rupture or by the development of chronic and sometimes disabling aneurysms. Surgical correction of septal and papillary muscle rupture and of chronic aneurysms antedated coronary artery bypass grafting, and the indications for surgery have become more clearly defined. The management of patients with these complications in the critical period preceding operation has also evolved considerably in recent years. Catheterization of the right heart at the bedside now permits rapid diagnosis of acute septal or papillary muscle rupture and allows continuous monitoring of the effects of treatment with vasodilators, intraaortic balloon counterpulsation, and inotropic or systemic pressor agents.‘.3 Such monitoring helps to predict the need for emergent surgery. Radionuclide imaging methods are of increasing help in estimating ventricular function and assessing wall motion4.’ Definitive cardiac catheterization, with ventriculography and coronary angiography, has proved safe even after recent infarction.h Induction of anesthesia for surgery has been improved by monitoring of right heart pressures and by the use of vasodilators and intraaortic balloon counterpulsation when needed. Early physiologic and pathologic changes in the infarcted heart determine the proper timing of surgical therapy and are therefore reviewed briefly here.
The Enigmatic Persistence of Anorexia Nervosa

ObjectiveIn this review, based on recent advances in cognitive neuroscience, the author presents a formulation in which the marked persistence of anorexia nervosa can be usefully understood as a well-ingrained maladaptive habit.MethodThe author reviewed the relevant literature on the development and course of anorexia nervosa and interpreted critical features in light of developments in cognitive neuroscience.ResultsAnorexia nervosa is a well characterized disorder with remarkable persistence both across history and among affected individuals. Food restriction, the salient behavioral feature of the disorder, often begins innocently but gradually takes on a life of its own. Over time, it becomes highly entrenched and resistant to change through either psychological or pharmacological treatment. Cognitive neuroscience has described two related but distinct processes that underlie the acquisition of new patterns of behavior, namely, action-outcome and stimulus-response learning. It is likely that both proces...
AERONET-based models of smoke-dominated aerosol near source regions and transported over oceans, and implications for satellite retrievals of aerosol optical depth

Abstract. Smoke aerosols from biomass burning are an important component of the global aerosol system. Analysis of Aerosol Robotic Network (AERONET) retrievals of aerosol microphysical/optical parameters at 10 sites reveals variety between biomass burning aerosols in different global source regions, in terms of aerosol particle size and single scatter albedo (SSA). Case studies of smoke observed at coastal/island AERONET sites also mostly lie within the range of variability at the near-source sites. Differences between sites tend to be larger than variability at an individual site, although optical properties for some sites in different regions can be quite similar. Across the sites, typical midvisible SSA ranges from ~ 0.95–0.97 (sites dominated by boreal forest or peat burning, typically with larger fine-mode particle radius and spread) to ~ 0.88–0.9 (sites most influenced by grass, shrub, or crop burning, typically smaller fine-mode particle radius and spread). The tropical forest site Alta Floresta (Brazil) is closer to this second category, although with intermediate SSA ~ 0.92. The strongest absorption is seen in southern African savannah at Mongu (Zambia), with average midvisible SSA ~ 0.85. Sites with stronger absorption also tend to have stronger spectral gradients in SSA, becoming more absorbing at longer wavelengths. Microphysical/optical models are presented in detail so as to facilitate their use in radiative transfer calculations, including extension to UV (ultraviolet) wavelengths, and lidar ratios. One intended application is to serve as candidate optical models for use in satellite aerosol optical depth (AOD) retrieval algorithms. The models presently adopted by these algorithms over ocean often have insufficient absorption (i.e. too high SSA) to represent these biomass burning aerosols. The underestimates in satellite-retrieved AOD in smoke outflow regions, which have important consequences for applications of these satellite data sets, are consistent with the level of underestimated absorption.
PGTOOL: an automatic interactive program generation tool for testing new-generation memory devices

PGTOOL generates pattern and timing source files for device testing on the 1937 memory test system. Using macro files that describe the main sequence and testing specifications for patterns and timing, PGTOOL communicates this information in pictures, making programming faster, easier, and less prone to errors. The program combines automatic code generation with a graphics interface, resulting in higher-quality test programs, generated up to 87% faster than those created by conventional methods. >
Sampling from structured populations: Some issues and answers

This paper reviews some sampling issues that are common to many Bell System surveys. We discuss various aspects of two-stage sampling designs, and emphasize sampling from populations with multiple characteristics. The hierarchical structure of the population in many surveys makes the use of multistage sampling techniques attractive. In populations with multiple characteristics, often not every characteristic is common to every unit. We consider some special designs for sampling from such populations. Finally, we discuss some issues in network sampling. Two recent Bell System surveys are used to illustrate most of the ideas discussed. One of the surveys deals with the estimation of traffic characteristics far various classes of service, while the other one is a survey of baseband transmission impairments.
Washout of 133Xenon Gas from the Lungs: Comparison with Nitrogen Washout

The regional distribution of pulmonary ventilation is nonuniform in health and disease. Single and multiple breath techniques have been developed to assess this nonuniformity. Limitations of these expired gas techniques include: identification of only several of the component washout exponentials and preferential representation in this single curve of the better ventilated spaces. In ten normal persons and eight patients we assessed the washout of ventilation by three simultaneous techniques and obtained three clearance curves: nitrogen washout with 100 percent O2; washout of 133Xe at the mouth with 100 percent O2; clearance of 133Xe from the patients' lung fields. A scintillation camera/computer system was utilized to provide clearance curves for 133Xe from selected zones of interest varying from both lungs to sublobar regions. In normal persons all three curves were superimposable. In patients with diffuse lung disease the expired curve for N2 and 133Xe at the mouth were abnormal but superimposable, while the xenon clearance over the lung fields revealed slower and more abnormal clearances. These latter curves provided an appreciation of the presence, localization, and extent of both slow and fast spaces.
3D-Wave Propagation Analysis of Indoor Wireless Channels Utilizing Hybrid Methods

A full 3D hybrid method for analyzing electromagnetic wave propagation in buildings with realistic wall types and structures is presented. This hybrid method combines full-wave techniques which are used for the analysis of one unit cell of inhomogeneous periodic walls with a ray-tracing-like field calculation for the interaction between the walls. Consequently, the method can overcome the inadequacy of traditional ray-tracing in the presence of inhomogeneous periodic wall structures like cinderblock, rebar structure, etc. but is still computationally tractable. Because of this, both indoor wireless channel characterizations and signal fading statistics are shown to be more accurate with this method. Numerical results of the hybrid method are presented for two simple scenarios and validated with theory and measurement. Furthermore, numerical results for a realistic indoor scene are given and compared to a scene where the periodic walls are replaced with effective homogeneous walls. For both setups, the propagation channel is characterized, fast fading signal statistics are extracted and the inadequacies of the homogeneous wall implementation are pointed out.
The Age of the Earth & Its Importance to Biology

Biology textbooks tend to assert the correctness of evolutionary concepts but mention very little of the evidence that supports them. This gives the impression that evolutionary theory is poorly supported, which discourages acceptance of the theory. A case in point is the age of the Earth. Biology textbooks usually mention that the planet is ~4.6 billion years old but neither tell how that was determined nor give evidence that the method (radiometric dating) is reliable. Students are therefore given insufficient reason to doubt that the Earth is any older than the 6000 years that the Genesis account suggests. Here, therefore, I review the evidence for an old Earth, to provide a concise but thorough reference for teachers who wish to supplement the meager information in textbooks with further details. Earth’s age is relevant to biology because an old Earth is necessary for macroevolution to occur and also because some dating methods (e.g., dendrochronology, varves) use materials of biological origin.
To Annotate More Accurately or to Annotate More

The common accepted wisdom is that blind double annotation followed by adjudication of disagreements is necessary to create training and test corpora that result in the best possible performance. We provide evidence that this is unlikely to be the case. Rather, the greatest value for your annotation dollar lies in single annotating more data.
Mathematical Models of Growth Allowances for Public Utility Regulation---A Synthesis

The construction and application of mathematical models which aid in the determination of fair rates of return for regulated industries is a development of potentially great importance to both the theoretician and the purchaser of regulated industry services. This paper shows that the two apparently dissimilar models of fair rates of return under conditions of growth found in the literature are derivable from a third more general model of such a process. The relative usefulness of the models is discussed, along with the validity of the behavioral assumptions that underlie the models.
The pharmacology of neurotransmission in semicircular canals

Current evidence has established acetylcholine as the efferent neurotransmitter in the inner ear vestibular system and an excitatory amino acid, possibly glutamate, as the afferent neurotransmitter. The efferent neurotransmitter exerts a biphasic effect on vestibular sensory cell activity and the actions of the afferent transmitter are modulated by adenosine through negative feedback control of release. The leading candidate for the role of afferent neurotransmitter in labyrinthine systems is glutamate. In the semicircular canal glutamate, in moderate doses, causes an increase in evoked and spontaneous activity. This effect is blocked by glutamate blockers such as d-alpha amino adipate. However, there is some evidence to suggest that glutamate acts on the sensory cells themselves rather than postsynaptically on the afferent neuronal dendrites. Other neurochemicals such as GABA have also been proposed to the afferent neurotransmitter but, the evidence for these is not nearly as strong as that supporting glutamate's candidacy. >
Extrachromosomal gene amplification in acute myeloid leukemia; Characterization by metaphase analysis, comparative genomic hybridization, and semi‐quantitative PCR

A case of acute myeloid leukemia (M-3) with complex karyotypic aberrations and double minute (dmin) chromosomes is presented. The patient had no history of prior exposure to mutagenic or carcinogenic agents or of other malignancies. She died from CNS involvement six weeks after the initial diagnosis. We used comparative genomic hybridization to identify the amplified sequences presumed to represent the dmin of the leukemic cells; the tumor/normal ratios indicated increased signal intensity at 8q24. This localization prompted investigation by semi-quantitative PCR that revealed amplification of the MYC oncogene. The extent of chromosome aberrations and the oncogene amplification, both linked with poor prognosis, may relate to the rapid course of this patient's disease. © 1993 Wiley-Liss, Inc.
Vertical Mixing in the Indonesian Thermocline

Abstract Western Pacific central and tropical waters characterized by a subsurface salinity maximum spread into the Indonesian seas as part of the Indonesian throughflow. Within the Indonesian seas this salinity maximum is attenuated and, in some places, completely removed. A simple advection-diffusion model verifies the importance of vertical mixing in the transformation of Western Pacific waters to Indonesian thermocline water. The profiles indicate a predominant North Pacific presence in most of the seas, although some South Pacific water is present in the eastern ses of Halmahera, Seram, and Banda. The main interocean route is through the western seas of Sulawesi, Makassar, and Flores, while the flow pathway in the eastern seas is less certain. The Banda Sea can be renewed from either the northern passages (Halmahera and Maluku) or from the south via the Flores Sea. Using representative basin property profiles derived from the archieved data allows determination of a range of vertical diffusivities an...
Renal Transplant Arterial Stenosis Treated With Bare-Metal Versus Drug-Eluting Stents: Comparison of Treatment Outcomes

Abstract Introduction This study aims to evaluate outcomes of bare-metal stents (BMS) versus drug-eluting stents (DES) in patients who undergo stenting for transplant renal arterial stenosis. Materials and Methods We retrospectively reviewed records of renal transplantation patients who underwent transplant renal arterial stenting from September 2009 to September 2013. All stents greater than 5 mm were excluded to allow for equivalent comparison between the DES and BMS groups. Statistical comparisons were performed using a two-tailed Fischer exact test, and analysis of continuous variables was analyzed using a one-way analysis of variance. Results The final study population included a total of 18 patients who received either BMS or DES (11 and 7 patients, respectively) for transplant renal arterial stenosis. The most common indications for stenting were increasing creatinine level and abnormal Doppler velocities. There were more re-interventions with BMS (n = 4/11) than DES (n = 0/7), but the trend was not statistically significant ( P = .12). Three patients who received BMS had a clinically significant decrease in blood pressure versus 4 in the DES group ( P = .33). Six patients who received BMS had a clinically significant decrease in creatinine level versus 3 in the DES group ( P = 1.0). Conclusion There is an absolute but not statistically significant difference in the incidence of restenosis requiring repeat intervention between the BMS and DES groups. No difference was detected in clinical success as measured by decreases in blood pressure or creatinine. Future larger studies are needed to corroborate these findings.
The internet of multimedia nano-things in the Terahertz band

Nanotechnology is providing the engineering community with a new set of tools to design and manufacture advanced devices which are able to generate, process and transmit multimedia content at the nanoscale. The wireless interconnection of pervasively deployed multimedia nano-devices with existing communication networks and ultimately the Internet defines a truly cyber physical system which is further referred to as the Internet of Multimedia Nano-things (IoMNT). This paper discusses the state of the art and major research challenges in the realization of this novel networking paradigm, which has innumerable applications in the biomedical, defense, environmental and industrial fields. Fundamental research challenges and future research trends are outlined in terms of multimedia data and signal processing, Terahertz channel modeling for communication among nano-things, and protocols for the Internet of Multimedia Nano-Things. These include novel medium access control techniques, addressing schemes, neighbor discovery and routing mechanisms, a novel QoS-aware cross-layer communication module, and novel security solutions for the IoMNT.
Selection of an Inertial Measurement Unit for High Accuracy CubeSat Attitude Determination

Inertial Measurement Units (IMUs) are a key element of the attitude determination system in the vast majority of spacecraft operating in Low Earth Orbit and beyond. Recent advances in electronics miniaturization have led to a wide array of IMUs that are appropriate for the stringent power and volume limitations associated with spacecraft that conform to the CubeSat standard. However, many of these IMUs are commercially produced for applications other than space operations, and little information regarding their performance in the space environment is available. Moreover, CubeSat programs rarely have sufficient time in their schedule to perform detailed tests of attitude determination components. This paper will describe an ongoing effort at NASA Ames Research Center to characterize the performance of three different IMUs under consideration for future CubeSat missions. The tests were carried out in a new lab at NASA Ames whose focus is the development of advanced avionics systems for CubeSats. The test campaign and the lab in which the tests are being performed is described herein.
Immunohistochemical characterization of two new monoclonal antibodies (LN-4, LN-5) reactive with human macrophage subsets and derived malignancies in B5-fixed, paraffin-embedded tissues

Two monoclonal antibodies (LN-4, LN-5) reactive to human macrophages in B5 formalin-fixed, paraffin-embedded tissue sections have been produced by using deparaffinized cell extracts of peripheral blood mononuclear cells. Both monoclonal antibodies were initially identified on paraffin-embedded sections of hyperplastic lymph nodes by using the immunoperoxidase staining procedure. Specificity screens on normal human tissues show that LN-4 and LN-5 stain the cytoplasm of macrophages and histiocytes in hematopoietic organs including Kupffer's cells of the liver and Langerhans' cells of the skin. LN-4 also showed strong positivity with acini of the stomach, whereas LN-5 was positive with mantle zone B lymphocytes of the lymph node and spleen, spermatogonia, and chief cells of the stomach. Both antibodies were strongly reactive with cases of true histiocytic lymphoma but, except for infiltrating macrophages, were entirely negative in Hodgkin's disease and non-Hodgkin's lymphomas. In all cases of nodular sclerosis Hodgkin's disease, LN-4 was positive in macrophagelike cells present in the collagen bands surrounding the Hodgkin's lesions. Both monoclonal antibodies were also positive in macrophages and histiocytes present in a variety of benign lymphoid lesions including persistent generalized lymphadenopathy, Gaucher's disease, sinus histiocytosis, and dermatopathic lymphadenopathy. Because of their specificity for human macrophages, and their ability to stain B5-fixed, paraffin-embedded tissues, LN-4 and LN-5 are important new reagents for the diagnosis and classification of malignant and benign histiocytic lesions.
Nanocrystal Size and Quantum Yield in the Upconversion of Green to Violet Light with CdSe and Anthracene Derivatives

We investigate the parameters affecting the upconversion of visible light in a hybrid organic–inorganic system based on CdSe nanocrystal (NC) sensitizers, 9-anthracene carboxylic acid (9-ACA) transmitter, and diphenylanthracene (DPA) annihilator. Seven wurtzite CdSe NCs ranging in photoluminescence quantum yield (PLQY) from 2.0% to 11%, and in diameter from 2.7 to 5.1 nm, were used in combination with the 9-ACA and DPA molecules. Using 2.7 nm diameter CdSe NCs, we show that the upconversion quantum yield has a quadratic to linear dependence on NC sensitizer concentration. Additionally, upconversion efficiency correlates positively with 9-ACA surface coverage on CdSe NCs and NC PLQY but negatively with particle size. This work clearly illustrates the path toward designing nanocrystal–molecule combinations with high upconversion efficiency that have potential applications in the fields of bioimaging, solar energy conversion, and data storage.
Celiac Disease and Localization-Related Epilepsies

The incidence of silent celiac disease (CD) in children with idiopathic localization epilepsies and the indications for routine CD screening were determined in a study of 72 patients (31 girls and 41 boys; mean age 12.6 years; age at onset 6.4 years) observed over a 5 year period at the Institute of Neurology and Gastroenterology, University Magna Graecia of Catanzaro, Italy.
Multicomponent Palliative Care Interventions in Advanced Chronic Diseases: A Systematic Review.

Background:Many patients live with serious chronic or terminal illnesses. Multicomponent palliative care interventions have been increasingly utilized in patient care; however, it is unclear what i...
Thick single-crystal silicon MEMS with high-aspect-ratio vertical air gaps

This paper presents recent advances in the HARPSS micromachining technology, which enables implementation of movable Single Crystal Silicon (SCS) structures with high aspect ratio vertical air gaps on low-resistivity silicon substrate. This is suitable for applications of micro-gravity accelerometers, low voltage tunable capacitors, and high-resolution gyroscopes that require aspect ratios as large as 100:1 to achieve high sensitivity and wide tuning range. The single-sided HARPSS process eliminates the need for double-sided processing, and wafer bonding to subsequently package the device. The device thickness and gap spacing can be varied in a wide range, 30-150mm and 0.2-2mm respectively, to select the performance range. The movable MEMS elements are made of bulk silicon substrate, resulting in higher mass, higher quality factor (Q), and better shock resistance, compared to using polysilicon (poly) as the movable structure. This process provides a mechanism for creating corrugation in SCS electrodes to reduce the Brownian noise of sensors. This technique realxes the need to reduce the noise by using the maximum available mass and through-wafer etch. The corrugations are created by a DRIE technique for etching poly surrounded by oxide inside the isolation trenches. Also, uniform capacitive gap spacings are created by growing sacrificial oxide inside the trenches.
Randomized, Controlled Trial of Fractional Carbon Dioxide Laser Resurfacing Followed by Ultrashort Incubation Aminolevulinic Acid Blue Light Photodynamic Therapy for Actinic Keratosis.

Background Aminolevulinic acid (ALA) photodynamic therapy (PDT) is an established treatment option for actinic keratosis (AK), and recently fractional carbon dioxide (CO2) laser was shown to improve outcomes; but studies of short incubation photosensitizer are lacking. Objective Assess the efficacy of short incubation ALA followed by blue light PDT with and without previous fractional CO2 treatment for the treatment of AK. Methods Randomized, paired split-design, controlled trial of fractional CO2 followed by ultrashort 15-minute versus 30-minute incubation ALA and blue light PDT for the treatment of AK on the face. Results The complete clearance rates (CRs) at 8 weeks after ALA PDT with and without FxCO2 at 30- and 15-minute ALA incubation times were 89.78% (+FxCO2) versus 71.20% CR (-FxCO2) at 30', and 86.38% (+FxCO2) versus 69.23% (-FxCO2) at 15' ALA incubation. All lesion improvements were statistically significant. Conclusion This randomized, comparative paired group controlled clinical study demonstrates that ultrashort 15- and 30-minute incubation ALA PDTs are of limited efficacy for the treatment of AK. Pretreatment with fractional ablative resurfacing yields statistically significant greater AK clearance with ALA-PDT at ultrashort ALA incubations followed by blue light.
Inequalities in Math: Using the Algebra Classroom as a Site for Social Justice

This article examines what can happen when issues of Social Justice and Equity are explored in a 7th grade Algebra classroom. While the project was met with resistance along the way and it was clear that there was not a great deal of support from other teachers or administration, my classroom became a place of rich dialogue, critical inquiry and vibrant discussion. Work like this is indispensable to providing students with a framework for social justice and equity in their own lives.
A Simulation Framework for Assessing Physical and Wildlife Impacts of Oil and Gas Development Scenarios in Southwestern Wyoming

Foreseeable natural gas development in southwestern Wyoming has the potential to increase sagebrush fragmentation and risks to resident wildlife species. The ability to balance future development with conservation goals, however, is enhanced by advances in directional-drilling technologies that use multiple wells per pad and produce less surface disturbance than conventional drilling methods. To evaluate the conservation potential of this technology, I developed an energy footprint model that simulates well, pad, and road patterns for oil and gas recovery options that vary in well types (vertical and directional) and number of wells per pad and use simulation results to quantify physical and wildlife-habitat impacts. I applied the model to assess tradeoffs among 10 conventional and directional-drilling scenarios in a natural gas field in southwestern Wyoming. Scenarios spanned a gradient in the number of vertical and directional wells, and in number of pads (2000 to 250), but all extracted the same amount of gas over a 15-year period. Reducing pad numbers with directional-drilling technology reduced surface disturbance area and impacts on spatially extensive habitats (48–96% of study area) such as sagebrush-obligate songbird habitat, elk winter range, and sagebrush core area. Impacts declined for spatially restricted mule deer migration corridors (24% of study area) and greater sage-grouse leks until energy infrastructure densities within corridors and near leks were similar to the initial landscape. Scenario simulations and tradeoff assessments such as illustrated in this study are intended to help decision-makers identify development designs that best achieve both energy and conservation goals.
The production mechanisms of traits: Reflections on two amazing decades

Abstract I am filled with a great deal of gratitude to see the progress, diversity, and excitement of research on within-person variability in personality. I argue for the value of studying states of a diverse array of contents, as represented in this special issue. The value of studying states is represented by four advances states facilitate: (i) evaluating the multipotency of personality; (ii) discovering the production mechanisms by which traits cause trait manifestations; (iiii) testing the causal effects of personality; and (iv) opening up new approaches to questions about personality. I present a series of conceptual commitments that enhance the value of studying states, and then I discuss how and why those conceptual commitments actually do enhance the value of studying states.
Optimization of suspended graphene NEMS devices for electrostatic discharge applications

As IC technologies continue scaling down, traditional electrostatic discharge (ESD) devices can no longer meet the demands of modern protection, prompting the need for novel device structures. A novel and unique approach to ESD protection using suspended graphene ribbon devices is presented. It has been demonstrated the ribbon's electro-mechanical response to a sudden surge of charge, such as an ESD event, can be tuned by changing the ribbon and device geometry. This not only simplifies device design but also allows us to fulfill critical ESD parameters with an almost zero leakage current. Reliability issues involving the pull-in voltage and ribbon/device's geometric design are addressed. Furthermore, a new method of measuring graphene's yield stress was developed. The yield stress of polycrystalline CVD graphene was found to be lower than reported values for pristine single crystalline graphene, supporting and adding to the limited number of studies in the literature. Our results show how fundamental understanding of the coupled electromechanical response of graphene could lead to direct impact on Si integrated circuit technology.
Rare event simulation for potential wake encounters

A flying aircraft produces two coherent rotating vortices of air in its trail. If another aircraft flies into one of these vortices, it can experience an un-commanded roll. Because of the potential risk, wake separation standards exist to significantly reduce the probability of such events. Thus, wake encounters are inherently rare. As new procedures and technologies are proposed to increase the capacity of the airspace, rare-event simulation is necessary to evaluate to the safety of proposed changes. This paper explores the performance of a rare-event splitting technique in the context of estimating probabilities of potential wake encounters. The goal is to identify good strategies for the splitting method while using a relatively simple model for the wakes. Suggestions for the choice of the level function and the locations of levels are given.
Biofeedback in Psychiatry

There has been widespread interest in the application of biofeedback techniques to the treatment of psychiatric, psychosomatic, and other disorders. Although experimental research on biofeedback is extensive and systematic, the clinical literature is characterized by anecdotal and single case reports and inadequately controlled studies with small samples. In a Task Force Report, Stroebel (1979) concluded that no convincing evidence supported the application of biofeedback as a specific treatment for any psychiatric disorder listed in DSM-III. Other authors share Stroebel’s appraisal of the literature (Rickles, Onada, & Doyle, 1982). However, biofeedback has been attractive to practitioners, apparently because of its objectivity and its ability to manage physiological and psychological manifestations of illness. Biofeedback fits in with contemporary orientation toward brief therapy and the practical management of psychiatric symptoms.
Incremental evolution of trainable neural networks that are backwards compatible

Supervised learning has long been used to modify the artificial neural network in order to perform classification tasks. However, the standard fully-connected layered design is often inadequate when performing such tasks. We demonstrate that evolution can be used to design an artificial neural network that learns faster and more accurately. By evolving artificial neural networks within a dynamic environment, the artificial neural network is forced to use learning. This strategy combined with incremental evolution produces an artificial neural network that outperforms the standard fully-connected layered design. The resulting artificial neural network can learn to perform an entire domain of tasks, including those of reduced complexity. Evolution alone can be used to create a network that performs a single task. However, real world environments are dynamic and thus require the ability to adapt to changes.
Variability in Use Among Ski Areas: A Statistical Study of the California Market Region.

Skiing is an important and rapid growth recreation industry. During the 1963–64 season, skiers spent $35.1 million in the pursuit of this activity in California alone. This paper develops analytica...
Comparing clinical characteristics and treatment outcomes between Veterans and non-Veterans with hoarding disorder.

Abstract Background Because Veterans have higher rates of mental health conditions and both physical and mental health comorbidities are known to affect treatment outcomes, the purpose of this investigation was to compare the rates of risk factors for poor hoarding treatment outcomes between Veterans and non-Veterans with hoarding disorder (HD). This is the first study to investigate differences between Veterans and non-Veterans with HD. Material and methods Baseline data were used from three different treatment studies of adults with hoarding disorder (n = 159). Demographic characteristics, baseline hoarding symptom severity, baseline medical and psychiatric comorbidities, and treatment attrition and response were compared between Veterans and non-Veterans. Results Veterans were significantly less likely to be employed than non-Veterans. Veterans did not report significantly more severe hoarding symptoms at baseline when compared to non-Veterans. Veterans reported having a greater mean number of overall medical and psychiatric comorbidities. Veterans were more likely than non-Veterans to meet criteria for major depressive disorder and post-traumatic stress disorder. There was no significant difference in the rate of attrition between Veterans and non-Veterans and Veterans were not significantly more likely to be classified as treatment responders. Conclusion Many similarities were observed between the two groups, including demographic characteristics, hoarding symptom severity, and rates of treatment response. Given that Veterans with HD may suffer from greater medical and psychiatric comorbidities, clinicians should ensure that their clients are receiving adequate medical care and that any other psychiatric comorbidities should be addressed in conjunction for treatment with HD.
Adaptive Review for Mobile MOOC Learning via Multimodal Physiological Signal Sensing - A Longitudinal Study

Despite the great potential, Massive Open Online Courses (MOOCs) face major challenges such as low retention rate, limited feedback, and lack of personalization. In this paper, we report the results of a longitudinal study on AttentiveReview2, a multimodal intelligent tutoring system optimized for MOOC learning on unmodified mobile devices. AttentiveReview2 continuously monitors learners' physiological signals, facial expressions, and touch interactions during learning and recommends personalized review materials by predicting each learner's perceived difficulty on each learning topic. In a 3-week study involving 28 learners, we found that AttentiveReview2 on average improved learning gains by 21.8% in weekly tests. Follow-up analysis shows that multi-modal signals collected from the learning process can also benefit instructors by providing rich and fine-grained insights on the learning progress. Taking advantage of such signals also improves prediction accuracies in emotion and test scores when compared with clickstream analysis.
Characterization of cell fusion in an experimental mouse model of endometriosis

Cell fusion is involved in the development of some adult organs, is implicated in the pathogenesis of specific types of cancer, and is known to participate in repair/regeneration processes mediated by bone-marrow-derived cells (BMDCs). Endometriosis is a disease characterized by growth of functional endometrial tissue outside of the uterine cavity. Endometriosis shares some molecular properties with cancer and BMDCs home to endometriosis lesions in a mouse model. Our objective was to determine if cell fusion can occur in endometriosis and establish whether bone-marrow-derived cells participate in cell fusion events in lesions. We employed a Cre-Lox system to identify cell fusion events in a mouse model of endometriosis. Fused cells were detected in endometriotic lesions, albeit at a low frequency (∼1 in 400 cells), localized to the stromal compartment, and displayed restricted proliferation. Using 5-fluorouracil-based nongonadotoxic bone marrow transplantation model, we demonstrate that bone marrow cells represent a principal cell source for fusion events in lesions. Cell fusion progeny uniformly lacked expression of selected markers of hematopoietic, endothelial, and epithelial markers, though they expressed the mesenchymal/stromal markers Sca-1 and CD29. This study is the first to describe the phenomenon of cell fusion in endometriosis and points to a mesenchymal population derived from cell fusion events with limited proliferative activity, properties previously attributed to endometrial stem cells. Their putative role in the pathogenesis of the disease remains to be elucidated.
The Longitudinal Influence of 10th Grade Extracurricular Activity Involvement: Implications for 12th Grade Academic Practices and Future Educational Attainment.

Although extracurricular activity involvement during high school is linked with positive academic outcomes, less is known about the longitudinal effects or the mediators of this association. The current investigation assessed the influence of 10th grade extracurricular activity involvement on educational attainment. The sample for this study (N = 11,720; 52.9% female) was drawn from the Education Longitudinal Study of 2002, a nationally representative, longitudinal investigation. Both breadth and intensity of extracurricular activity involvement in the 10th grade were linked with educational attainment eight years after high school. For breadth, the association was mediated by increased educational expectations in the 12th grade. The results are discussed in terms of the implications and importance of extracurricular activity involvement.
Use of direct oral anticoagulants in the treatment of left ventricular thrombi: A tertiary center experience and review of the literature

Direct oral anticoagulants can potentially provide a more convenient oral alternative for the management of left ventricular thrombi than Warfarin. These medications do not require frequent monitoring and have less drug-drug interactions. Randomized controlled trials are needed to further demonstrate their efficacy and safety in this setting.
Scattering of elastic waves by a general anisotropic basin. Part 2: a 3D model

Scattering of plane harmonic waves by a three-dimensional basin of arbitrary shape embedded within elastic half-space is investigated by using an indirect boundary integral equation approach. The materials of the basin and the half-space are assumed to be the most general anisotropic, homogeneous, linearly elastic solids without any material symmetry (i.e. triclinic). The unknown scattered waves are expressed in terms of three-dimensional triclinic time harmonic full-space Green's functions. The results have been tested by comparing the surface response of semi spherical isotropic and transversely isotropic basins for which the numerical solutions are available. Surface displacements are presented for a semicircular basin subjected to a vertical incident plane harmonic pseudo-P-, SV-, or SH-wave. These results are compared with the motion obtained for the corresponding equivalent isotropic models. The results show that presence of the basin may cause significant amplification of ground motion when compared to the free-field displacements. The peak amplitude of the predominant component of surface motion is smaller for the anisotropic basin than for the corresponding isotropic one. Anisotropic response may be asymmetric even for symmetric geometry and incidence. Anisotropic surface displacement generally includes all three components of motion which may not be the case for the isotropic results. Furthermore, anisotropic response strongly depends upon the nature of the incident wave, degree of material anisotropy and the azimuthal orientation of the observation station. These results clearly demonstrate the importance of anisotropy in amplification of surface ground motion.
Nanostructured Hydrogels for Tissue Engineering and Regenerative Medicine

Abstract Hydrogels encompass hydrated and porous structures but their usage is limited due to mechanical fragility. To overcome these traditional limitations, various nanoparticles such as such as metallic, carbon based, organic and polymeric have been incorporated into polymeric network. These nanostructured hydrogels have enhanced mechanical, chemical and biological properties for various biomedical and bioengineering applications. The focus of this chapter is to introduce the field of nanostructured hydrogels and provide an overview on recent advancements. Particularly, different strategies of nanocomposite hydrogel fabrication will be highlighted and discussed with special emphasis on their biomedical and bioengineering applications.
Intranasal corticosteroids and saline: Usage and adherence in chronic rhinosinusitis patients.

Objective Intranasal saline irrigations and intranasal corticosteroids are supported by level-1 evidence for medical management of chronic rhinosinusitis (CRS). We sought to study adherence with these medications. Methods Prospective study of 174 patients with CRS. Patients reported their usage of intranasal saline irrigation and intranasal corticosteroid over the preceding 3 months, at presentation, and a subsequent follow-up visit 3 to 12 months later. Adherence was defined as reported medication usage for ≥6 days per week. Results At the time of presentation, 44.3% of patients were using an intranasal corticosteroid spray or irrigation ≥6 days/week, whereas only 24.1% were using saline irrigation ≥6 days per week. At follow-up, 60.3% of patients were using either an intranasal corticosteroid spray or irrigation ≥6 days per week, whereas 35.6% were using saline irrigation ≥6 days per week. Adherence with intranasal corticosteroids was associated with comorbid asthma (adjusted odds ratio [OR] = 2.68, 95% confidence interval [CI]: 1.10-6.50, P = 0.029), allergy (OR = 2.22, 95% CI: 1.05-4.71, P = 0.037), and change in 22-item Sinonasal Outcome Test score (OR = 0.98, 95% CI: 0.96-0.99, P = 0.027). Use of intranasal corticosteroid sprays versus irrigations (OR = 2.56, 95% CI: 0.84-7.83, P = 0.099) was suggestive of association with improved adherence. Adherence with intranasal saline irrigation was associated with age (OR = 1.02, 95% CI: 1.01-1.05, P = 0.034). Conclusion Usage and adherence with intranasal steroids and saline may be low in CRS patients even with management in a tertiary level, subspecialty rhinology clinic. Adherence with medications represents a major opportunity for improving patient care and outcomes, specifically by targeting patients with lower disease burden and improving convenience of medications. Level of evidence 2C Laryngoscope, 130:852-856, 2020.
Multiple Instance Learning for Malignant vs. Benign Classification of Lung Nodules in Thoracic Screening Ct Data

Multiple Instance Learning (MIL) is proposed for Computer Aided Diagnosis (CADx) without predefined Regions Of Interest (ROIs) from lung cancer screening thoracic CT scans. The method was used to classify nodules as malignant or benign on 225 malignant and 210 benign samples from the publicly available Lung Image database consortium Image Collection (LIDC-IDRI). Subsequent to feature selection based on the Gray Level Co-occurrence Matrix (GLCM), 5-fold cross-validation was carried out where training was performed on 4 folds with testing on the 5th fold in a round robin fashion. The classification was performed with Support Vector Machines for Multiple-Instance Learning (MI-SVM) classifier. The proposed method has been compared to the Single Instance Learning (SIL) paradigm based on ground truth regions provided by radiologists and to other state of the art methodologies and was proven to outperform them with resulting average Receiver Operating Characteristic Area Under Curve (AUC), Specificity, Sensitivity and Accuracy of: 0.9767, 0.9524, 0.9111 and 0.9310 respectively.
Unscheduled return visits to the emergency department with ICU admission: A trigger tool for diagnostic error.

Abstract Background It is believed that patients who return to the Emergency Department (ED) and require admission are thought to represent failures in diagnosis, treatment or discharge planning. Screening readmission rates or patients who return within 72 h have been used in ED Quality Assurance efforts. These metrics require significant effort in chart review and only rarely identify care deviations. Objective This study was conducted to evaluate the yield of reviewing ED return visits that resulted in an ICU admission. This study was conducted to evaluate the yield of reviewing ED return visits that resulted in an ICU admission. We planned to assess if the return visits with ICU admission were associated with deviations in care, and secondarily, to understand the common causes of error in this group. Methods Retrospective review of patients presenting to a university affiliated ED between January 1, 2005 and December 31, 2015 and returned within 14 days requiring ICU admission. Results From 1,106,606 ED visits, 511 patients returned within 14 days and were admitted to an ICU. 223 patients returned for a reason related to the index visit (43.6%). Of these related returns, 31 (13.9%) had a deviation in care on the index visit. When a standard diagnostic process of care framework was applied to these 31 cases, 47.3% represented failures in the initial diagnostic pathway. Conclusion Reviewing 14-day returns leading to ICU admission, while an uncommon event, has a higher yield in the understanding of quality issues involving diagnostic as well as systems errors.
Efficacy of Thermal and Chemical Methods of Nebulizer Disinfection of CF Pathogens

Introduction: Previous studies demonstrate thermal and chemical disinfection methods recommended by the CF Foundation kill common strains of CF pathogens. Aim: Few studies have examined killing of large numbers of phenotypically varied clinical isolates from the CF lung. We hypothesize all will be killed by boiling and ethanol but some strains will be resistant to hydrogen peroxide killing. Methods: We have collected over 115 de-identified respiratory CF isolates including Pseudomonas aeruginosa, Staphylococcus aureus, Burkholderia sp., Stenotrophomonas maltophila, and Achromobacter xylosoxidans. Bacteria were grown overnight in lysogeny broth and 10 µl (1:100 dilution) placed on three locations of a PARI®LC Plus nebulizer. Bacteria were dried and subjected to a disinfection method (boiling H2O for 20 min, 3.0% hydrogen peroxide soak for 30 min, or 70% ethanol soak for 5 min) or no treatment (control). Inoculated areas were swabbed to agar plates and incubated at 35°C overnight. Colonies were then counted to determine the efficacy of disinfection compared with control. Results: Preliminary results show effective disinfection for all isolates tested to date (n=10) for all three methods. Conclusions: Thus far there is no difference in efficacy comparing disinfection techniques. Investigation continues to determine if this is true for all isolates in our collection. Any recommended disinfection practice utilized by CF patients has to be effective for the phenotypically diverse pathogens encountered in the CF lung.