cssi/SciSciGPT-SciSciNet huggingface dataset:
Minimizing Complications from Systemic Glucocorticosteroid Use

Glucocorticosteroids (GCS) are among the most important and commonly used drugs avilable to dermatologists. A thorough knowledge of the normal hypothalamic-pituitary-adrenal axis as well as the pharmacology of, clinical therapy guidelines for, and adverse reactions to GCS, is imperative for proper usage of these agents. This article covers the numerous strategies for minimizing the side effects and complications of these drugs, including methods for monitoring patients and management with diet and nutritional supplements.
Criminal Justice Contact and Treatment Utilization Among People With Mental Illness and Substance Use Disorders

Objective:This study examined whether a history of criminal justice involvement is related to the use of contemporaneous mental health and substance abuse treatment among adults experiencing co-occurring disorders.Methods:Pooled 2009–2013 data from the National Survey on Drug Use and Health were used to analyze patterns of mental health and substance abuse treatment utilization of 8,740 adults with past-year co-occurring disorders.Results:Individuals with a criminal history were more likely than those without a criminal history to receive both types of treatment or substance abuse treatment alone.Conclusions:The criminal justice system appears to be facilitating mental health and substance abuse treatment among people experiencing co-occurring disorders but may also be overreliant on substance abuse treatment alone.
Laboring Under Chávez: Populism for the Twenty-first Century

This analysis addresses two interrelated questions: what were labor conditions like under Hugo Chavez? and what do those conditions suggest about the relationship between populism and leftism in Latin America? The answer to the first question is unequivocal. Despite its socialist rhetoric, the Chavez regime fragmented and weakened organized labor, undermined collective bargaining, and exploited vulnerable workers in cooperatives. Thus the regime's primary foible was not its radical leftism but its pursuit of populist control at the expense of the leftist goals of diminishing the domination of marginalized groups and expanding their autonomous participation in civil society. This appraisal of labor politics under Chavez indicates substantial tension between the realization of these leftist goals and populist governance. It further suggests the need to distinguish more clearly between leftism and populism and their respective impacts on democracy.
Ice cover, winter circulation, and exchange in Saginaw Bay and Lake Huron

Winter circulation exerts a strong control on the release and timing of nutrients and contaminants from bays into the adjoining lakes. To estimate winter residence times of solutes in the presence of ice cover, we used an ice model coupled to hydrodynamic, thermal and solute transport models of Saginaw Bay and Lake Huron for two low (2010 and 2013) and two high (2009 and 2014) ice years. The models were tested using temperature data from thermistor chains and current data from ADCP moorings deployed during the wintertime. Simulated water temperatures compared favorably to lake-wide average surface temperatures derived from NOAA's AVHRR satellite imagery. Simulated results of ice cover are in agreement with observed data from the Great Lakes Ice Atlas. Our results indicate that ice cover significantly dampens water movement producing almost stagnant conditions around February. Estimates of residence times for Saginaw Bay (defined as the e-folding flushing time based on vertically integrated dye concentrations) show that the mean residence times in a low ice year (2013) are 2.2 months for the inner bay, and 3.5 months for the entire bay. The corresponding numbers for a high ice year (2014) are 4.9 and 5.3 months, respectively. Considering the entire bay, solutes stored in the bay can be expected to be released into the lake between March (low ice year) and April (high ice year). These results are expected to aid in understanding the behavior of contaminants in the Great Lakes during the winter months and in early spring.
Thoracoscopic division of vascular rings

Abstract Background/Purpose Vascular rings are traditionally treated via an open thoracotomy. In recent years the use of thoracoscopy has increased. Herein we report our experience with thoracoscopic division of vascular rings in pediatric patients. Methods We reviewed all patients who underwent thoracoscopic or open division of a vascular ring at our institution between 2007 and 2015. We analyzed patient demographics, presenting symptoms, diagnostic imaging modality, ring anatomy, operative details, complications, and symptom resolution. Results Thirty-one patients underwent thoracoscopic division of a vascular ring while sixteen had open operations. Median age was 24 months in the thoracoscopic group and 13 months in the open group. Operative time averaged 74 min (thoracoscopic) and 95 min (open). There were no mortalities at 30 days. There was complete symptom resolution in 71% of thoracoscopic patients and 63% of open. Patients in the thoracoscopic group had decreased ICU admissions (10% vs. 94%), chest tube use (62% vs. 100%), chylothorax (6% vs. 38%) and overall length of stay (1.7 days vs. 5 days). Conclusions Thoracoscopic division of vascular rings in pediatric patients is a feasible alternative to open division and is associated with comparable rates of symptom resolution and decreased length of hospital stay and chylothorax. Level of evidence III.
On the densities of tantalum, niobium, and vanadium

To calculate the elastic constants of a particular metal from ultrasonic measurements, the mass density must be known. Techniques have been employed for tantalum, niobium, and vanadium by numerous investigators. For each metal, a range of mass densities has been used in the calculations. This is reflected in the elastic constants reported. An attempt to resolve the discrepancies is made.
International by Design: International Accreditation Perspectives for Nonprofit Management Education

The classification process of American nonprofit sectors is diverse and complex. The classification process at the international level is further complicated by sector hybrid organizations responding to diverse national legal systems and diverse sociopolitical contexts. In this paper, I address some of these complexities with nonprofit organizational cases from East Africa and Western Europe and nonprofit-related educational programs. I offer recommendations to incorporate this diversity into the definitions of accreditation criteria for nonprofit management education with the aim of preparing students for the 21st century.
Antimicrobial Resistance of Anaerobic Bacteria

Infections caused by anaerobic bacteria are common, and may be serious and life-threatening. Anaerobes are the predominant components of the bacterial flora of normal human skin and mucous membranes [1] and they are a common cause of bacterial infections of endogenous origin. Because of their fastidious nature, they are difficult to isolate from infectious sites and are often overlooked. Their isolation requires appropriate methods of collection, transportation, and cultivation of specimens [2–5]. Treatment of anaerobic bacterial infections is complicated by the relatively slow growth of these organisms (which makes diagnosis in the laboratory only possible after several days), by the frequent polymicrobial nature of the infection, and by the growing resistance of anaerobic bacteria to antimicrobial agents.
Does NCEP screening detect abnormal lipoprotein levels

Source Citation Bush TL, Riedel D. Screening for total cholesterol. Do the National Cholesterol Education Program's recommendations detect individuals at high risk of coronary heart disease? Circul...
[Keynote 1] Internet of vehicles: From intelligent grid to autonomous cars

Summary form only give, as follows. Provides an abstract of the keynote presentation and a brief professional biography of the presenter. The complete presentation was not made available for publication as part of the conference proceedings. Traditionally, the vehicle has been the extension of the man's ambulatory system, docile to the driver's commands. Recent advances in communications, controls and embedded systems have changed this model, paving the way to the Intelligent Vehicle Grid. The car is now a formidable sensor platform, absorbing information from the environment, from other cars (and from the driver) and feeding it to other cars and infrastructure to assist in safe navigation, pollution control and traffic management. The next step in this evolution is just around the corner: the Internet of Autonomous Vehicles. Pioneered by the Google car, the Internet of Vehicles will be a distributed transport fabric capable to make its own decisions about driving customers to their destinations. Like other important instantiations of the Internet of Things (e.g., the smart building), the Internet of Vehicles will not merely upload data to the Internet. It will have its own communications, storage, intelligence, and learning capabilities to anticipate the customers' intentions. The concept that will help transition to the Internet of Vehicles is the Vehicular Cloud, the equivalent of Internet cloud for vehicles, providing the basic services required by the autonomous vehicles. This talk will trace the evolution from Intelligent Vehicle Grid to Autonomous, Internet-connected Vehicles, and Vehicular Cloud.
Promoting Pulmonary Arterial Growth via Right Ventricle-to-Pulmonary Artery Connection in Children With Pulmonary Atresia, Ventricular Septal Defect, and Hypoplastic Pulmonary Arteries

Background:Complete repair of pulmonary atresia (PA) ventricular septal defect (VSD) with hypoplastic or absent native pulmonary arteries, often with major aortopulmonary collateral arteries (MAPCA...
The presence of human enteric viruses in sewage and their removal by conventional sewage treatment methods.

Publisher Summary This chapter deals with the presence of human enteric viruses in sewage, and their removal by conventional sewage treatment methods. The control of communicable diseases represents one of man's most challenging problems. The agents of these diseases are many in form and number, their individual importance being dependent on the prevailing conditions in the community. These diseases are many in number and vary greatly in their clinical manifestations, ranging in severity from very mild cases, which may escape the attention of a physician entirely, to the paralytic and fatal cases of poliomyelitis and aseptic meningitis. The presence of large numbers of these viruses in feces and sewages has been well documented. The possible transmission of poliomyelitis and other enteric diseases warrants careful consideration of the removal of their agents from the water supply. Considerable work must be done in these areas before evaluation of the sewage treatment processes can become refined. The importance of adequate treatment cannot be overemphasized; however, low transmission of these agents may be extremely significant. The sewage treatment methods such as storage, primary sedimentation, trickling filters, activated sludge, disinfection, settled sludge, and oxidation lagoons are discussed in this chapter.
Cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in four US-Affiliated Pacific Islands between 2007 and 2015.

Abstract Background Cervical cancer incidence in the US-Affiliated Pacific Islands (USAPIs) is double that of the US mainland. American Samoa, Commonwealth of Northern Mariana Islands (CNMI), Guam and the Republic of Palau receive funding from the Centers for Disease Control (CDC) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to implement cervical cancer screening to low-income, uninsured or under insured women. The USAPI grantees report data on screening and follow-up activities to the CDC. Materials and methods We examined cervical cancer screening and follow-up data from the NBCCEDP programs in the four USAPIs from 2007 to 2015. We summarized screening done by Papanicolaou (Pap) and oncogenic human papillomavirus (HPV) tests, follow-up and diagnostic tests provided, and histology results observed. Results A total of 22,249 Pap tests were conducted in 14,206 women in the four USAPIs programs from 2007–2015. The overall percentages of abnormal Pap results (low-grade squamous intraepithelial lesions or worse) was 2.4% for first program screens and 1.8% for subsequent program screens. Histology results showed a high proportion of cervical intraepithelial neoplasia grade 2 or worse (57%) among women with precancers and cancers. Roughly one-third (32%) of Pap test results warranting follow-up had no data recorded on diagnostic tests or follow-up done. Conclusion This is the first report of cervical cancer screening and outcomes of women served in the USAPI through the NBCCEDP with similar results for abnormal Pap tests, but higher proportion of precancers and cancers, when compared to national NBCCEDP data. The USAPI face significant challenges in implementing cervical cancer screening, particularly in providing and recording data on diagnostic tests and follow-up. The screening programs in the USAPI should further examine specific barriers to follow-up of women with abnormal Pap results and possible solutions to address them.
A Case Study Competition Among Methods for Analyzing Large Spatial Data

The Gaussian process is an indispensable tool for spatial data analysts. The onset of the “big data” era, however, has lead to the traditional Gaussian process being computationally infeasible for modern spatial data. As such, various alternatives to the full Gaussian process that are more amenable to handling big spatial data have been proposed. These modern methods often exploit low-rank structures and/or multi-core and multi-threaded computing environments to facilitate computation. This study provides, first, an introductory overview of several methods for analyzing large spatial data. Second, this study describes the results of a predictive competition among the described methods as implemented by different groups with strong expertise in the methodology. Specifically, each research group was provided with two training datasets (one simulated and one observed) along with a set of prediction locations. Each group then wrote their own implementation of their method to produce predictions at the given location and each was subsequently run on a common computing environment. The methods were then compared in terms of various predictive diagnostics. Supplementary materials regarding implementation details of the methods and code are available for this article online.
Is It Ethical to Use Genealogy Data to Solve Crimes

Information from online genealogy services might be used in manners not anticipated by consumers, including as forensic evidence in crime solving. The authors discuss the informed consent, privacy,...
Biogeography and Evolution of the Cercocebus-Mandrillus Clade: Evidence from the Face

Numerous lines of evidence indicate that mangabeys are not a natural group and that terrestrial mangabeys (genus Cercocebus) are more closely related to mandrills and drills (genus Mandrillus) than they are to arboreal mangabeys (genus Lophocebus). Available field data indicate that Cercocebus mangabeys and Mandrillus share a foraging regime characterized by a reliance on hard object foods and habitual aggressive use of the forelimbs during foraging. These behaviors are reflected in the dentition and limb anatomy of terrestrial mangabeys and Mandrillus to the exclusion of Lophocebus, Papio and Theropithecus. In this study, we examine variation in several facial characters in mangabey skulls to test biogeographic hypotheses about interrelationships of the Cercocebus-Mandrillus clade. All mangabeys possess depressed cheekbones, however the extent of maxillary excavation is much less pronounced in all Cercocebus spp., particularly in C. torquatus. Mandrills exhibit little suborbital excavation. In Mandrillus and Cercocebus, the paranasal ridges run medially towards the incisors while in Lophocebus albigena, they run towards the canines. The extent of nasal ridge development—a striking feature in male mandrills—varies considerably in Cercocebus but is most pronounced in C. torquatus. Additionally, Mandrillus spp. and C. torquatus exhibit virtually identical orientations and development of the temporal lines. Based on these cranial features, we suggest that C. agilis exhibits the primitive cranial morphology while the derived condition is shared by C. torquatus and Mandrillus. The hypothesis that C. torquatus is the sister taxon of Mandrillus is concordant with Grubb’s (1978, 1982) hypothesis for the evolution and radiation of terrestrial mangabeys.
Drug-Induced Cognitive Impairment

Drug-induced cognitive impairment is a common cause of delirium and is frequently a confounding factor in dementia. Predisposing conditions for delirium include age, brain disease and addiction to alcohol and/or drugs. The elderly are at particular risk because of multiple diseases, multiple drug use and alterations of drug metabolism associated with age. Sedatives such as benzodiazepines have a particularly high risk of cognitive impairment. Centrally acting sympathetic antihypertensive agents, sedating antipsychotic drugs, opioids, digitalis, anti-Parkinsonian drugs, antidepressants and corticosteroids are also associated with greater risk relative to other classes of medications. Cognitive impairment due to medication may be reduced by recognition of the problem. The risk of drug-induced impairment may be minimised by strategies which optimise overall health, avoidance of unnecessary medications, and selection of medications least likely to cause delirium.
Development of a Diagnostic Twin Screw Extruder to Characterize Fuel Production for Tokamaks

Twin screw extrusion is anticipated to meet the pellet fueling demands of tokamak fusion devices. The twin-screw design principle has been proven by a functional prototype extruder at Oak Ridge Nat...
Accelerating Electromigration Wear-Out Effects Based on Configurable Sink-Structured Wires

In this work, we propose a novel electromigration (EM) wear-out acceleration technique for fast EM reliability-testing and aging-analysis of practical VLSI chips. The new acceleration technique is based on the observation that sink structures have a significant impact on the lifetime of multisegment interconnect wires. We develop a new configurable sink-structured interconnect wire in which the current in the sink segment can be activated/deactivated dynamically during operation. Using this method, we show how an interconnect structure, which is initially immortal to EM effects, can be induced to fail very quickly. Furthermore, we use a robust failure scheme which considers both early and late failures depending on the wire topology and current direction. The most significant contribution of the proposed work is that it enables EM accelerated testing at low temperature and voltage. This feature enables the testing of EM wear-out in isolation without invoking other reliability effects which are also accelerated by the traditional stressing conditions. Using the proposed method, we can achieve a lifetime reduction from 10+ years to a few days, or even hours, at relatively low temperatures, which is very desirable for practical EM testing of typical nanometer CMOS ICs.
Scalable Behavioral Emulation of Extreme-Scale Systems Using Structural Simulation Toolkit

With extremely large design spaces for algorithm and architecture to be explored, there is a need for fast and scalable performance modeling tools for preparing HPC application codes. Behavioral Emulation (BE) is a recent coarse-grained modeling and simulation methodology that has been proposed to solve this co-design problem. In this paper, we introduce a distributed parallel simulation library for Behavioral Emulation called BE-SST, integrated into the Structural Simulation Toolkit (SST). BE-SST provides simple interfaces and framework for development of coarse-grained BE models which can be extended to model new notional architectures. BE-SST also supports Monte Carlo simulations to generate meaningful distributions and summary statistics rather than a single datum for performance. In this paper, we present BE-SST simulations of two existing large DOE machines (Vulcan and Titan), which have been validated against actual testbed measurements and showed 5-10% error. These validated system models (up to 128k cores) are used to make blind predictions of application performance on systems larger than the current machines (up to 512k cores) - a crucial simulator feature for design-space exploration of notional systems. We further studied BE-SST in terms of scalability and performance, simulating up to a million cores, with BE-SST running on more than 2k parallel processes. BE-SST shows good scalability with a linear increase in memory usage and simulation time with increase in simulated system size, and a peak speedup of 7x over single process simulation. With ease of use and good scaling, we assert that BE-SST can significantly speed up design-space exploration.
SOME OBSERVATIONS ON THE BACTERIAL QUALITY OF INSTANT NONFAT DRY MILK IN CONSUMER PACKAGES1

Summary Samples of instant nonfat dry milk in consumer-size packages were collected over a period of 12 months for bacteriological analysis. Highest average bacterial count was obtained at 30 C. The average bacterial count of all 72 samples was 1900 per g. Counts ranged from 18,000 to less than 300 per g. Statistical analysis of the data indicated that higher total counts might have been obtained using a plate incubation temperature below 30 C. Of 1350 isolates obtained from the samples, 13.5% were gram-positive cocci. The remainder of the organisms were gram-positive rods. There was a tendency for samples having higher bacterial counts to have a higher proportion of cocci.
Comprehensive cooperative deep deterministic policy gradients for multi-agent systems in unstable environment

Nowadays, intelligent unmanned vehicles, such as unmanned aircraft and tanks, are involved in many complex tasks in the modern battlefield. They compose the networked intelligent systems with varying degrees of operational autonomy, which will continue to be used increasingly on the future battlefield. To deal with such a highly unstable environment, intelligent agents need to collaborate to explore the information and achieve the entire goal. In this paper, we will establish a novel comprehensive cooperative deep deterministic policy gradients (C2DDPG) algorithm by designing a special reward function for each agent to help collaboration and exploration. The agents will receive states information from their neighboring teammates to achieve better teamwork. The method is demonstrated in a real-time strategy game, StarCraft micromanagement, which is similar to a battlefield with two groups of units.
Volveré y seré millones: los cuerpos de Evita en Tomás Eloy Martínez y Néstor Perlongher

Los estudios criticos que se han dedicado a Evita son numerosos y variados, entre estos se destacan tres tendencias principales que intentan explicar la naturaleza de Eva como simbolo nacional. Aquella que lee Evita como mito (Julie Taylor), aquella que la define como fetiche (Diana Taylor, John Kraniauskas) y por ultimo, aquella que la ve como totem (Susana Rosano). Sin embargo, las multiplicidades que caracterizan la Evita nacional, o mejor, las Evitas nacionales, cuya contestacion se revela sobre todo en el plano de la representacion literaria, escapan esas interpretaciones. Entender el mecanismo de produccion en la literatura de las muchas Evitas muestra, por un lado, la complejidad y el desacuerdo detras de uno de los simbolos argentinos mas relevantes para aproximarse a los sentidos de lo nacional y por otro, las ambivalencias fundantes del discurso peronista. En este ensayo, a traves del analisis de “Evita vive” (1975) de Nestor Perlongher y Santa Evita (1995) de Tomas Eloy Martinez, dos de los textos literarios sobre Evita en que el cuerpo es el disparador de la narracion, quiero proponer la exhibicion ficcional del cadaver de Evita como el lugar donde se disputan los significados de lo nacional. En las dos obras el cuerpo de Eva padece una forma de sparagmos, en la medida en que es descuartizado y diseminado por todo el territorio. Al individuar la multiplicidad como el principio de funcionamiento de Evita, los textos de Martinez y Perlongher revelan la naturaleza oscura de su simbologia y la imposibilidad de conciliar un sentido unitario sobre lo nacional.
Case Studies of Traditional Disruptive Technologies

This chapter will present several well-known business case studies of traditional disruptive technologies and their origins, process, and impact.
An experimental investigation of the effects of massive film cooling on the aerodynamics of a turbine airfoil

Abstract : The effects of massive film cooling through multiple rows of discrete holes on the aerodynamics of a typical two-dimensional turbine airfoil have been studied experimentally using a single blade positioned in a contoured channel. The channel walls, shaped to simulate the presence of adjacent airfoils in a cascade, were both porous and movable to allow adjustment of the flow direction and airfoil surface pressure. Electrically heated air was used as the primary flow, while room temperature coolant air was emitted from five rows of discrete holes on each airfoil surface to film cool the regions aft of mid-chord. Hole geometries angled in the spanwise, chordwise, and vertical directions were employed to achieve coolant-to-inlet mass rate ratios as high as 0.05 for blowing from the single blade.
Augmented Reality Bites: “Playtest” and the Unstable Now

In Black Mirror’s (2011–) “Playtest”, a cash-strapped American traveler agrees to test a prototype augmented reality video game for money. Before long, the unsuspecting gamer is in deep, experiencing visualizations of an increasingly profound, disturbing and ultimately lethal order. “Playtest” suggests the seductiveness and annihilative potential of virtual and augmented reality technologies. But beneath its moral tale is a horror narrative of societal anxieties regarding the disorienting pace of advanced technological life. This is symbolized through the main character’s inability to maintain his connection to the real due to a devastating experience with the virtual—an encounter notably instigated by the other. Considering key instabilities of the advanced computational “now”, including (1) the body/machine divide, (2) memory and forgetting and (3) a unitary sense of time, this chapter unveils how “Playtest” represents far more than an anxiety narrative about the corrosive effects of video games.
Unilateral Vocal Fold Immobility After Prolonged Endotracheal Intubation.

Importance Endotracheal intubation and mechanical ventilation are life-saving treatments for acute respiratory failure but are complicated by significant rates of dyspnea and dysphonia after extubation. Unilateral vocal fold immobility (UVFI) after extubation can alter respiration and phonation, but its incidence, risk factors, and pathophysiology remain unclear. Objectives To determine the incidence of UVFI after prolonged (>12 hours) mechanical ventilation in a medical intensive care unit and investigate associated clinical risk factors for UVFI after prolonged mechanical ventilation. Design, Setting, and Participants This subgroup analysis of a prospective cohort study was conducted in a single-center medical intensive care unit from August 17, 2017, through May 31, 2018, among 100 consecutive adult patients who were intubated for more than 12 hours. Patients were identified within 36 hours of extubation and recruited for study enrollment. Those with an established tracheostomy prior to mechanical ventilation, known laryngeal or tracheal pathologic characteristics, or a history of head and neck radiotherapy were excluded. Exposure Invasive mechanical ventilation via an endotracheal tube. Main Outcomes and Measures The incidence of UVFI as determined by flexible nasolaryngoscopy. Results One hundred patients (62 men [62%]; median age, 58.5 years [range, 19.0-87.0 years]) underwent endoscopic evaluation after extubation. Seven patients had UVFI, of which 6 cases (86%) were left sided. Patients with hypotension while intubated (odds ratio [OR], 10.8; 95% CI, 1.6 to ∞), patients requiring vasopressors while intubated (OR, 16.7; 95% CI, 2.4 to ∞), and patients with a preadmission diagnosis of peripheral vascular disease (OR, 6.2; 95% CI, 1.2-31.9) or coronary artery disease (OR, 5.1; 95% CI, 1.0-25.5) were more likely to develop UVFI. Conclusions and Relevance Unilateral vocal fold immobility occurred in 7 of 100 patients in the medical intensive care unit who were intubated for more than 12 hours. Unilateral vocal fold immobility was associated with inpatient hypotension and preadmission vascular disease, suggesting that ischemia of the recurrent laryngeal nerve may play a role in disease pathogenesis.
Abstract BS1-2: Genome regulation by long noncoding RNA genes

The discovery of extensive transcription of long noncoding RNAs (lncRNAs) provide an important new perspective on the centrality of RNA in gene regulation. I will discuss genome-scale strategies to discover and characterize lncRNAs, including RNA chemical modifications and RNA structures. LncRNAs form extensive networks of ribonucleoprotein (RNP) complexes with numerous chromatin regulators, and target these enzymatic activities to appropriate locations in the genome. Long noncoding RNAs can function as modular scaffolds to specify higher order organization in RNP complexes and in chromatin states. A new emerging theme is that DNA elements that mediate lncRNA expression can also have powerful effects in controlling chromatin neighborhoods, which alter oncogene expression and activity. The importance of these modes of regulation is underscored by the newly recognized roles of long RNAs in human diseases. Citation Format: HY Chang. Genome regulation by long noncoding RNA genes [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr BS1-2.
Wave Excitation Force Prediction of a Heaving Wave Energy Converter

Optimal control strategies for wave energy converters (WECs) commonly require noncausal knowledge of the incident wave to maximize energy production. To enable these control methods, the prediction capabilities of two autoregressive (AR) models are evaluated. This work utilized autoregressive methods to predict the wave excitation force since they can be implemented in real time to adapt to changing conditions. The two models evaluated in this work are AR and AR with exogenous inputs (ARX) models. These models describe the wave propagation between two devices. To substantiate the validity of the predictions presented here, the wave excitation force was also estimated using an extended Kalman filter (EKF). The EKF incorporated nonlinear heave models of each body to determine the wave excitation force that was formulated as a harmonic disturbance to each system. The combination of the EKF and the AR models presents an opportunity to evaluate the prediction capabilities of what can be currently implemented on board WECs in real time; there is no need for offline training or postprocessed filtering of the wave. The ARX model incorporating excitation force data from other deployed bodies (the exogenous input) is shown to significantly improve the performance of the wave excitation force prediction. It is concluded that WECs in a wave farm may be able to improve their energy harvesting performance through enhancing their prediction capabilities by using wave estimation data gathered from other WECs. Experimental data from a two-body wave tank test is used for this work.
Anxiety disorders in patients with cardiopulmonary diseases: A brief review

Abstract This manuscript reviews the current literature involving clinical anxiety and cardiopulmonary disease, considers the hypothesized physiological mechanisms for anxiety, and discusses the use of exercise as a treatment for both anxiety and cardiopulmonary diseases. The literature summary consists of original investigations, meta-analysis, commentaries, and review publications in order to better understand the biological and psychological mechanisms for using exercise as treatment and to provide details specific to cardiopulmonary disease and anxiety management. A gap in the literature exists concerning the anxiolytic effects of exercise as a psychological and physical treatment in cardiopulmonary populations. The findings from this review support further investigation into the use of exercise to ameliorate the burden of anxiety in cardiopulmonary disease patients. This review evaluates the current literature surrounding cardiopulmonary disease and anxiety. A systematic literature search identified articles discussing the prevalence, association, and risk of anxiety in cardiopulmonary patients. Though depression is often studied in this population, recent investigation supports a need for further research regarding anxiety in cardiopulmonary patients. Treatment to manage patients’ psychological profile can reduce exacerbations of known disease, reduce hospital readmission, and improve functional capacity, and overall quality of life.
Get in Touch With Dendritic Epithelial T Cells

Innate and adaptive immune systems continuously interchange information and orchestrate their immune responses to protect the host. γδT cells play crucial roles, as they incorporate both innate and adaptive immune characteristics. Dendritic epidermal T cells (DETC) are specialized γδT cells, which are uniquely positioned to rapidly respond to skin wounds and infections. Their elongated dendrite morphology allows them to be in continuous contact with multiple neighboring keratinocytes and Langerhans cells. Cellular interactions are fundamental to the formation, activation and maintenance of immune cell functions during steady state and pathology. Recent technological advances, especially in the field of cellular imaging, have contributed greatly to the characterization of complex cellular interactions in a spatiotemporally resolved manner. In this review, we will highlight the often-underappreciated function of DETC and other γδT cells during steady state and an ongoing immune response. More specifically, we discuss how DETC-precursors are shaped in the fetal thymus during embryogenesis as well as how direct cell-cell interactions of DETC with neighboring epidermal cells shape skin homeostasis and effector functions. Furthermore, we will discuss seminal work and recent discoveries made in the γδT cell field, which have highlighted the importance of γδT cells in the skin, both in humans and mice.
Cryoballoon Ablation of Atrial Fibrillation in Octogenarians

A significant proportion of AF patients with advanced age are being treated in clinical practice. Cryoballoon ablation of AF, given its shorter procedure time and comparable efficacy to radiofrequency ablation, has rapidly become a commonly used tool for AF ablation. Data regarding the outcomes of cryoballoon ablation of AF in octogenarians are limited because of the exclusion of this age group in the previous studies. The authors report outcomes of 15 octogenarian AF patients undergoing index cryoballoon ablation at a single centre. The mean age of the included patients was 83 ± 3 years. In total, 13 patients (87%) presented with paroxysmal AF, and two (13%) had long-standing persistent AF. At 6 and 12 months of follow-up, freedom from AF was 80% and 70%, respectively. None of the patients suffered any procedure-related complications. Cryoballoon ablation appears to be a safe and effective approach for treating symptomatic AF refractory to antiarrhythmic drug therapy in octogenarian patients, based on outcomes in this cohort. These findings require further validation in prospective randomised studies with larger sample sizes.
Epidemiology of Pulmonary Embolism

Venous thromboembolism (VTE) is a major cause of morbidity and mortality worldwide. Incidence of VTE and associated mortality is affected by the presence of risk factors, associated comorbid conditions, increased sensitivity and specificity of diagnostic testing, and advancement of VTE treatment options. In this chapter, we will discuss epidemiology of VTE in general, and then further focus on epidemiology of VTE based on various factors like age, gender, ethnicity, mortality, and impact of acquired and genetic VTE-related risk factors.
Association Between Industry Payments to Physicians and Device Selection in ICD Implantation.

Importance Little is known about the association between industry payments and medical device selection. Objective To examine the association between payments from device manufacturers to physicians and device selection for patients undergoing first-time implantation of a cardioverter-defibrillator (ICD) or cardiac resynchronization therapy-defibrillator (CRT-D). Design, Setting, and Participants In this cross-sectional study, patients who received a first-time ICD or CRT-D device from any of the 4 major manufacturers (January 1, 2016-December 31, 2018) were identified. The data from the National Cardiovascular Data Registry ICD Registry was linked with the Open Payments Program’s payment data. Patients were categorized into 4 groups (A, B, C, and D) corresponding to the manufacturer from which the physician who performed the implantation received the largest payment. For each patient group, the proportion of patients who received a device from the manufacturer that provided the largest payment to the physician who performed implantation was determined. Within each group, the absolute difference in proportional use of devices between the manufacturer that made the highest payment and the proportion of devices from the same manufacturer in the entire study cohort (expected prevalence) was calculated. Exposures Manufacturers’ payments to physicians who performed an ICD or CRT-D implantation. Main Outcomes and Measures The primary outcome of the study was the manufacturer of the device used for the implantation. Results Over a 3-year period, 145 900 patients (median age, 65 years; 29.6% women) received ICD or CRT-D devices from the 4 manufacturers implanted by 4435 physicians at 1763 facilities. Among these physicians, 4152 (94%) received payments from device manufacturers ranging from $2 to $323 559 with a median payment of $1211 (interquartile range, $390-$3702). Between 38.5% and 54.7% of patients received devices from the manufacturers that had provided physicians with the largest payments. Patients were substantially more likely to receive devices made by the manufacturer that provided the largest payment to the physician who performed implantation than they were from each other individual manufacturer. The absolute differences in proportional use from the expected prevalence were 22.4% (95% CI, 21.9%-22.9%) for manufacturer A; 14.5% (95% CI, 14.0%-15.0%) for manufacturer B; 18.8% (95% CI, 18.2%-19.4%) for manufacturer C; and 30.6% (95% CI, 30.0%-31.2%) for manufacturer D. Conclusions and Relevance In this cross-sectional study, a large proportion of ICD or CRT-D implantations were performed by physicians who received payments from device manufacturers. Patients were more likely to receive ICD or CRT-D devices from the manufacturer that provided the highest total payment to the physician who performed an ICD or CRT-D implantation than each other manufacturer individually.
Slithering CSF: Cerebrospinal Fluid Dynamics in the Stationary and Moving Viper Boa, Candoia aspera

In the viper boa (Candoia aspera), the cerebrospinal fluid (CSF) shows two stable overlapping patterns of pulsations: low-frequency (0.08 Hz) pulses with a mean amplitude of 4.1 mmHg that correspond to the ventilatory cycle, and higher-frequency (0.66 Hz) pulses with a mean amplitude of 1.2 mmHg that correspond to the cardiac cycle. Manual oscillations of anesthetized C. aspera induced propagating sinusoidal body waves. These waves resulted in a different pattern of CSF pulsations with frequencies corresponding to the displacement frequency of the body and with amplitudes greater than those of the cardiac or ventilatory cycles. After recovery from anesthesia, the snakes moved independently using lateral undulation and concertina locomotion. The episodes of lateral undulation produced similar influences on the CSF pressure as were observed during the manual oscillations, though the induced CSF pulsations were of lower amplitude during lateral undulation. No impact on the CSF was found while C. aspera was performing concertina locomotion. The relationship between the propagation of the body and the CSF pulsations suggests that the body movements produce an impulse on the spinal CSF.
The Manchurian Plague and COVID-19: China, the United States, and the "Sick Man," Then and Now.

In this article, I explore the historical resonances between China’s 1911 pneumonic plague and our current situation with COVID-19. At the turn of the 20th century, China was labeled “the Sick Man ...
High-Dimensional Ordinary Differential Equation Models for Reconstructing Genome-Wide Dynamic Regulatory Networks

The gene regulatory network (GRN) is a complex control system and plays a fundamental role in the physiological and development processes of living cells. Focusing on the ordinary differential equation (ODE) modeling approach, we propose a novel pipeline for constructing high-dimensional dynamic GRNs from genome-wide time course gene expression data. A five-step procedure, i.e., detection of temporally differentially expressed genes, clustering genes into functional modules, identification of network structure, parameter estimate refinement and functional enrichment analysis, is developed, combining a series of cutting-edge statistical techniques to efficiently reduce the dimension of the problem and to account for the correlations between measurements from the same gene. In the key step of identifying the network structure, we employ the advanced parameter estimation and statistical inference methods to perform model selection for the ODE models. The proposed pipeline is a computationally efficient data-driven tool bridging the experimental data and the mathematical modeling and statistical analysis. The application of the pipeline to the time course gene expression data from influenza-infected mouse lungs has led to some interesting findings of the immune process in mice and also illustrated the usefulness of the proposed methods.
Buddhist Visual Worlds II: Practices of Visualization and Vision

This article discusses Buddhist meditative practices that make use of visual worlds. First among these are practices of “visualization,” which involve visual scenes created in the mind's eye. Buddhist traditions contain a variety of these techniques, and use them for a diverse set of purposes: devotion, cultivating mental focus, generating mindsets and motivations, and transforming personal identity. Though less common, Buddhists also have traditions that involve practices of “vision,” where meditators seek spontaneous experiences of luminosity that are seen with the eyes rather than simply created in imagination. The article examines several of these visionary practices, with particular emphasis on meditative techniques found in the Kālacakra and Great Perfection traditions.
Optimizing Schedule of Administration in Phase I Clinical Trials

Historically, phase I clinical trials of new agents have been designed to find a safe dose from a small set of possible doses. Typically, toxicity is defined based on one or possibly two cycles of chemotherapy so that it can be scored relatively quickly after the start of therapy. The study treats cohorts of patients according to an outcome-adaptive statistical design or algorithm for choosing successive doses, and the resulting data are used to determine an acceptable or maximum tolerable dose (MTD). However, in most clinical settings, physicians administer multiple courses of an agent to a patient and monitor long-term toxicity that may be related to the agent's cumulative effects. Furthermore, some patients may receive one or more modifications or delays of their planned treatment course due to low-grade (non–dose limiting) toxicity from previous administrations. To address these situations, we have proposed a new paradigm for phase I clinical trials that determines a maximum tolerable schedule (MTS) of administration, rather than a conventional MTD (Braun, Yuan, and Thall, 14). The design is based on the time to toxicity of each patient rather than a binary indicator. The model and method account for the patient's entire sequence of administrations, with the overall hazard of toxicity modeled as the sum of a sequence of dose-dependent hazards, each associated with one administration. As patients are enrolled, data monitoring and decision making are done continuously throughout the trial using an outcome-adaptive Bayesian design that optimizes the schedule in terms of the overall risk of toxicity. We illustrate this new methodology with a clinical trial in allogeneic bone marrow transplantation. Keywords: phase I trial; bone marrow transplantation; dose escalation; maximum tolerated dose; maximum tolerated schedule
Resident Understanding of ACGME Core Competencies

Competency-based training and evaluation is a central requirement of all accredited residency training, yet there is little indication that it is sufficiently recognizable in the transition between undergraduate and graduate medical education.The purpose of this study was to assess applicants’ knowledge of the ACGME’s six core competencies, which guide the curriculum of all the ACGME accredited graduate medical education programs.Between November, 2011 and February, 2012, applicants to ACGME accredited residency programs at a single hospital completed a questionnaire asking them to list the six core competencies and articulate the words in the organization’s acronym. Aggregated responses from 72 applicants were tabulated and recorded. Twenty-seven students (38%) were unable to name a single competency correctly. Four students (6%) were able to name 5/6 core competencies. On average, students were able to name fewer than two of the core competencies. Students fared slightly better when asked to identify what the acronym “ACGME” means. Eight students (11%) were able to name all five components. Three students (4%) were unable to name a single component of the acronym “ACGME.” On average, students were able to name three parts of the acronym.Despite beginning their medical education two years after the widespread implementation of the ACGME core competencies, these graduating medical students had little recall and implied understanding of the core competencies used to evaluate them as residents. There is a need for more collaboration and alignment between the nation’s medical schools and the ACGME in terms of educating medical students on the increasing importance of competency-based training and evaluation in the medical profession. Journal of Nature and Science, 1(2):e3 9 , 2015.