cssi/SciSciGPT-SciSciNet huggingface dataset:
SCVIR Annual Meeting Film Panel Session: Diagnosis and Discussion of Case 1

A previously healthy 22-year-old Colombian man presented with recurrent fevers, cough, hemoptysis, and weight loss. He was treated with various antibiotics for presumed pneumonia without clinical response. Noncontrast high-resolution CT of the chest was performed (Fig 1.1). An empiric course of steroids produced only transient improvement. Multiple HIV tests and blood cultures were negative, as were bronchoscopy and bone marrow biopsy. Blood work demonstrated an elevated erythrocyte sedimentation rate (.90 mm/h). Lower extremity Doppler sonography revealed no evidence of deep venous thrombosis. Transesophageal echocardiography identified an 8 mm right atrial mass. Contrast-enhanced CT (Fig 1.2) was performed. The patient then underwent limited right thoracotomy with resection of the posterior segment of the right lower lobe. Pathologic examination revealed chronic pleuritis, hemorrhagic infarct, and organizing thrombus within the small pulmonary arteries. The right atrial mass was resected. Pathologic examination showed it to be composed entirely of thrombus. No organisms were seen and all cultures were negative. Postoperatively, the patient continued to experience fevers to 105°F that did not resolve with parenteral antibiotics. After receiving cyclosporine, his fever decreased and he experienced no further hemoptysis. Repeat CT showed no change in the size of the left pulmonary artery aneurysm, but the thickness of the wall diminished, and there was apparent improvement in the right pulmonary artery aneurysm, with a decrease in size and thickness of the aneurysm wall. He remained symptom-free for 3 months while undergoing empiric immunosuppression; however, he developed recurrent fevers and blood-tinged sputum, which progressed to frank hemoptysis, requiring hospitalization. Corticosteroid therapy was initiated and CT demonstrated an increase in the size of the left lower lobe pulmonary artery aneurysm with interim aneurysmal dilation of several sub-
The Long-Range Stiffness and Local Mobility of Double-Stranded DNA

Theoretical conformational analysis provides a basis for understanding the unique features of double-stranded DNA in terms of its chemical architecture. The well-known stiffness of the chain as a whole derives from the sequence of heterocyclic bases, while the local mobility of the constituent nucleotides reflects the structural complexity of the sugar–phosphate backbone.
Opening Address: Human Life in the Arctic

Man’s involvement in the Arctic goes back almost to the beginning of civilization and, since time immemorial, the forbidden boreal horizons have lured adventurers to the challenging circumpolar regions.
CRT-300.01 Performance Characteristics of Alcohol-Mediated Endovascular Renal Denervation

Efficient and safe neurolysis is key to performing a successful renal denervation procedure. Chemical neurolysis based on the perivascular infusion of alcohol via endovascular technique represents a safe and effective method which includes performance characteristics essential to the procedure. The
Integrating systematics and biogeography to disentangle the roles of history and ecology in biotic assembly

Aim We develop a conceptual framework for integrating evolutionary history and ecological processes into studies of biotic assembly. Location Global. Methods We use theoretical and empirical examples to demonstrate that species distributions are non-random outcomes of first-order processes of biotic evolution: allopatry (isolation of populations), speciation and dispersion of biotas across landscapes. We then outline generalizable steps for integrating methods of phylogenetic and historical biogeographical analyses into studies of biotic assembly. Results We present a framework that can be applied to any biotic assemblage amenable to phylogenetic and historical biogeographical analyses, can accommodate changes in spatial extent and temporal scale, and will facilitate comparison of assembly processes across biotas. Additionally, we demonstrate the utility of an historical approach for providing context to ecological influences on evolutionary processes, such as trait evolution. Main conclusions By focusing on reconstructing the histories of individual lineages, an historical approach to assembly analysis can reveal the timing and underlying processes guiding biotic assembly, making it possible to disentangle the roles of history and ecology in the assembly process.
Fast-neutron-induced potential background near the Q value of neutrinoless double- β decay of Ge 76

The $^{76}\mathrm{Ge}$(n,p)$^{76}\mathrm{Ga}$ reaction and the subsequent $\ensuremath{\beta}$ decay of $^{76}\mathrm{Ga}$ to $^{76}\mathrm{Ge}$ has been used to excite the 3951.89-keV state of $^{76}\mathrm{Ge}$, which decays by the emission of a 2040.70-keV $\ensuremath{\gamma}$ ray. Using high-purity germanium detectors, the associated pulse-height signal may be undistinguishable from the potential signal produced in neutrinoless double-$\ensuremath{\beta}$ decay of $^{76}\mathrm{Ge}$ with its $Q$ value of 2039.0 keV. At 20-MeV neutron energy the production cross section of the 2040.70-keV $\ensuremath{\gamma}$ ray is approximately 0.1 mb.
Resource sharing in cyber-physical systems: modelling framework and case studies

Cyber-physical systems (CPSs) have attracted significant research interest because of their promising applications across different domains; nonetheless, how to effectively model CPSs in real applications is still a challenge. In this article, a resource sharing-based framework (RSBF) for CPSs is developed to enable flexible modelling of a wide range of CPSs and systems of CPSs, with specific focus on resource sharing. RSBF combines elements from graph theory and social welfare to describe complex arrangements of overlapping task and resource communities in CPSs, with the objective of maximising CPS utility through decentralised control. The framework implementation is validated through three case studies: scheduling in smart factories, energy distribution in smart grids and information routing in multi-robot systems. Results show that RSBF can successfully represent the dissimilar systems under study. Furthermore, performance analysis on benchmark scheduling problems yields near-optimal results with less...
Development of the Tree-ring Width Chronologies in the High-elevation Regions in the Middle and East Tianshan Mountains

In this paper, the tree-ring cores collected from six sites in three high-elevation regions (i.e., Miquan, Mori and Barkol) in the middle and east Tianshan Mountains, an arid and semi-arid region in northwest China, during the period from September to October 2002, are used to develop six tree-ring width chronologies using standard dendrochronological methods. The tree-ring cores were collected from the trees of Picea schrenkiana Fisch growing at four high-elevation sites in Miquan and Mori and of Larix sibirica Ledb growing at two high-elevation sites in Barkol. More than twenty trees were drawn at breast height, and two cores were drawn from each tree in different directions. The sampling cores were mounted in wooden strips, sanded to 600 grits until resolving late-wood boundaries. At last the measured rings were checked using Cofacha software and line plots. The results show that all the average correlation coefficients (R) between sample series and master series at six sampling sites exceed 0.6. Picea schrenkiana Fisch from Mori A and B are regarded as the superior conditions from mean ring-width (R.W.), mean sensitivity (M.S.) and lose-ring ratios of these results. The measured and crossdated ring-width series from each tree is standardized. A chronology is developed for each site. In order to develop the reliable chronologies, we take samples of subsample signal strength above 0.8 (i.e. sss≥0.8) as the beginning for developing the chronologies. Thus, these chronologies are extended to the year of 2002, and the longest chronology has 321 years in all dependable chronologies. The results of correlation and principal component (PC) analysis in all dependable chronologies show that the tree growth among tree species makes a great deal of difference. The statistical results of the chronologies in different tree species show that the standard deviations of the standardized chronologies are higher than those of the residual chronologies, but the mean sensitivity of the residual chronologies is high. Most of the statistics in the common interval analysis at six sampling sites are higher in the residual chronologies than that in the standard chronologies, which reveal that the residual chronologies of some sampling sites of different tree species at high-elevation regions in the middle and east Tianshan Mountains contain more environmental information than the corresponding standard chronologies. These conclusions are important for the tree-ring research in arid and semi-arid areas.
Adenovirus-mediated expression of hepatic lipase in LCAT transgenic mice.

In order to evaluate the coordinate role that he- patic lipase (HL) and 1ecithin:cholesterol acyltransferase (LCAT) play in modulating HDL particle heterogeneity and function in vivo we utilized recombinant adenovirus to ex- press HL in control and LCAT transgenic mice. Adenovirus- mediated expression of human HL in control (n = 4, LCAT activity = 42 2 1 nmol/ml per h) and LCAT-tg mice (n = 4, LCAT activity = 3566 I 93 nmol/ml per h) resulted in post heparin HL activities of 24358 5 6080 and 27266 2 7985 nmol/ml per min, respectively. Overexpression of HL led to significant reductions in total cholesterol, phospholipids, and HDL cholesterol in both LCAT-tg (62,62, and 63%, P< 0.05) and control mice (68,63, and 78%, P< 0.01) as well as to the formation of more homogenous HDL. However, compared to control animals, the reductions in the plasma concentrations of HDL-cholesterol and apoA-I were less in LCAT-tg mice (HDL-cholesterol: -62 t 15% vs. -78 +- 15%, P = 0.18; apoA-I: -36 2 7% vs. -76 2 8%, P < 0.0005). Gel filtration analysis revealed that in LCAT-tg mice the apoE-rich HDL, was preferentially reduced by expression of HL in vivo. Com- pared to control mice the reduction in the apoA-I/A-I1 HDL in transgenic mice was significantly less indicating that a sub- set of HDL in LCAT transgenic mice are resistant to the action of HL.M These combined data support a role for both HL and LCAT in modulating HDL heterogeneity and function, properties which may ultimately affect the ability of LCAT transgenic mouse HDL to function in the process of reverse cholesterol transport.-Dugi, K. A, B. L. Vaisman, N. Sakai, C. L. Knapper, S. M. Meyn, H. B. Brewer, Jr., and S. Santama- rina-Fojo. Adenovirus-mediated expression of hepatic lipase in LCAT transgenic mice. ,J Lipid Res. 1997. 38: 1822-1832.
Unstable Intraventricular Conduction Disorders

Unstable bundle branch blocks may be tachycardia dependent, bradycardia dependent, or rate independent. When appearing at the "critical" rates or "critical" cycle lengths they may seem to be rate independent. Conversely, "true" rate-independent blocks may be reversible or irreversible. Determining if a rate-unrelated block may disappear can be difficult because irreversile bundle branch block seems to develop through a slow process in time during which rate-dependent, rate-independent, and even normal conduction alternate in successive electrocardiograms.
Pneumonia is associated with a high risk of mortality after pancreaticoduodenectomy.

Background Pancreatectomy is associated with a high complication rate that varies between 40–60%. Although many specific complications have been extensively studied, postoperative pneumonia has received little attention. Methods Patients undergoing pancreaticoduodenectomy ( n = 1,090) and distal pancreatectomy ( n = 436) from 2002 to 2014 at Thomas Jefferson University Hospital were retrospectively assessed for postoperative pneumonia. Incidence, predictive factors, and outcomes were determined. Results Pneumonia was diagnosed in 4.3% of patients after pancreaticoduodenectomy and 2.5% after distal pancreatectomy. The majority of the pneumonias were attributed to aspiration (87.2% and 81.8%, respectively). Pneumonias were more frequently severe (Clavien-Dindo grades 4 or 5) in the pancreaticoduodenectomy group compared to the distal pancreatectomy group (55.3% vs 9.1%, P = .006). Post-pancreaticoduodenectomy pneumonia predictors included delayed gastric emptying (odds ratio 8.2, P P = .005), and chronic obstructive pulmonary disease (odds ratio 3.1, P = .049). In the post-pancreaticoduodenectomy group, pneumonia was associated with a very high 90-day mortality compared with those who did not have pneumonia (29.8% vs 2.1%, P P Conclusion Pneumonia after pancreaticoduodenectomy is an uncommon but highly morbid event and is associated with a substantially increased risk of perioperative death.
Excessive ERK-dependent synaptic clustering drives enhanced motor learning in the MECP2 duplication syndrome mouse model of autism

Autism-associated genetic mutations may produce altered learning abilities by perturbing the balance between stability and plasticity of synaptic connections in the brain. Here we report an increase in the stabilization of dendritic spines formed during repetitive motor learning in the mouse model of MECP2-duplication syndrome, a high-penetrance form of syndromic autism. This increased stabilization is mediated entirely by spines that form cooperatively in clusters. The number of clusters formed and stabilized predicts the mutant9s enhanced motor learning and memory phenotype, reminiscent of savant-like behaviors occasionally associated with autism. The ERK signaling pathway, which promotes cooperative plasticity between spines, was found to be hyperactive in MECP2-duplication motor cortex specifically after training. Inhibition of ERK signaling normalizes clustered spine stabilization and rescues motor learning behavior in mutants. We conclude that learning-associated dendritic spine clustering stabilized by hyperactive ERK signaling drives abnormal motor learning and memory consolidation in this model of syndromic autism.
Evaluation of the Prognostic Implications of Pro- and Anti-Angiogenic Cytokines in 311 Patients with Untreated Chronic Lymphocytic Leukemia.

Background: Angiogenesis has been found to be an important regulator in the disease progression of both solid tumors and hematologic malignancies. In solid tumors, the balance of pro and anti-angiogenic factors appears to be a critical factor in tumorigenesis, with disturbance in favor of angiogenesis promoting tumor growth and metastasis. This observation led to the concept of an “angiogenic switch” where pro-angiogenic influences outweigh anti-angiogenic factors. Patients with CLL have detectable levels of plasma and cellular pro and anti-angiogenic cytokines as well as abnormal neovascularization in the marrow and lymph nodes. Limited studies of pro-angiogenic cytokines have suggested that inter-patient variation in serum/plasma and cellular levels of these markers may have prognostic implications. We evaluated pro- and anti-angiogenic cytokines in a large sample of patients with CLL to evaluate the presence of angiogenic switching and its implications for disease progression. Methods: In a prospective, longitudinal study, we analyzed the serum/plasma, intracellular(determined by flow cytometry), and CLL B cell secreted (24 hour medium values) levels of pro-angiogenic cytokines (VEGF, bFGF) and an anti-angiogenic cytokine (Thrombospondin [TSP]) in 311 patients with previously untreated CLL. VEGF:TSP and bFGF:TSP ratios were calculated to evaluate for evidence of angiogenic switching (higher ratio suggests a pro-angiogenic phenotype). The relationship of angiogenic cytokines to Rai stage, IgV H gene mutation status, % CD38 protein expression, and time to treatment (TTT) from the date of sample were evaluated (median follow-up=11 months). Sequential samples were available on >90% of patients and were evaluated to assess if changes in levels of angiogenic cytokines occurred in patients requiring treatment. Results: Serum, cellular, and secreted levels of VEGF, bFGF, and TSP showed no correlation with Rai stage, IgV H gene mutation (continuous variable), or % expression of CD38 (continuous variable). However, among patients with Rai stage 0-II disease, individuals with lower TSP levels ( Conclusions: Angiogenic cytokines appear to have prognostic significance in patients with previously untreated early stage CLL. Importantly, we report the original observation that the ratio of bFGF (pro-angiogenic) to TSP (anti-angiogenic) correlates with time to treatment as a continuous variable. This result provides further evidence that angiogenic switching relates to clinical progression in CLL. Longer follow-up of this cohort is needed to fully define the prognostic implications of angiogenic cytokines in CLL and determine if integration of these markers with other prognostic parameters improves risk stratification for early stage patients.
Sterile Abscess with Subsequent Iatrogenic Draining Sinus Tract Formation 3 Years After FiberWire and ENDOBUTTON Distal Biceps Brachii Tendon Repair: A Case Report.

Case: We report a case of a sterile abscess with subsequent sinus tract formation mimicking infection 3 years after uncomplicated distal biceps brachii tendon repair with FiberWire suture in a 42-year-old man. The preoperative workup for infection was unremarkable. Intraoperative culture specimens confirmed the absence of infection. Excision of the sinus tract and FiberWire-ENDOBUTTON construct was curative. At the 1-year follow-up, there had been no recurrence of symptoms. Conclusion: Foreign-body inflammatory reactions should be considered in the differential diagnosis of patients with apparent infection with a history of FiberWire suture fixation and negative serologic workup.
Chronic PM2.5 exposure and risk of infant bronchiolitis and otitis media clinical encounters

Chronic particulate matter less than 2.5μm in diameter (PM2.5) exposure can leave infants more susceptible to illness. Our objective is to estimate associations of the chronic PM2.5 exposure with infant bronchiolitis and otitis media (OM) clinical encounters. We obtained all first time bronchiolitis (n=18,029) and OM (n=40,042) clinical encounters among children less than 12 and 36 months of age, respectively, diagnosed from 2001 to 2009 and two controls per case matched on birthdate and gestational age from the Pregnancy to Early Life Longitudinal data linkage system in Massachusetts. We applied conditional logistic regression to estimate odds ratios (OR) and confidence intervals (CI) per 2-μg/m3 increase in lifetime average satellite based PM2.5 exposure. Effect modification was assessed by age, gestational age, frequency of clinical encounter, and income. We examined associations between residential distance to roadways, traffic density, and infant bronchiolitis and OM risk. PM2.5 was not associated with infant bronchiolitis (OR=1.02, 95% CI=1.00, 1.04) and inversely associated with OM (OR=0.97, 95% CI=0.95, 0.99). There was no evidence of effect modification. Compared to infants living near low traffic density, infants residing in high traffic density had elevated risk of bronchiolitis (OR=1.23, 95% CI=1.14, 1.31) but not OM (OR=0.98, 95% CI=0.93, 1.02) clinical encounter. We did not find strong evidence to support an association between early-life long-term PM2.5 exposure and infant bronchiolitis or OM. Bronchiolitis risk was increased among infants living near high traffic density.
Earth eco-building: textile-reinforced earth block construction

Abstract Compacted earth block and adobe respond directly to the demands of sustainable building: low embodied energy, high specific heat capacity, inherent phase change properties, locally available in nearly all regions of the world. Because of its resistance to codification by traditional engineered quantification, however, earthen construction has remained largely relegated to the global south and, in Northern Europe, to bespoke small-market construction. Our research considers how the addition of natural fibre and recoverable textile components can lend compressed earth block building structural resilience and more predictable material qualities relative to human comfort and building longevity. Through our own and combinatory research, we have developed a decision tool to customize textile and fibre components to local climatic, soil and seismic conditions. The customized components, conceived as a kit of parts we have termed the ‘Just-Add-Earth Kit’, ship pre-templated to the site, serving to regulate construction, much like formwork or centering, but remaining in place after construction to serve as tensile reinforcing. The result is a carbon-neutral, locally appropriate construction with excellent interior climate characteristics as much at home in the developed world as in the developing world.
Evolutionary Origins and Functions of the Stress Response

Because the stress response is so often associated with negative events, its utility has often been neglected. The selective advantages that shaped the evolution of the stress system and its regulation mechanisms is an essential foundation for understanding its costs and why HPA activity so often seems excessive.
Reflections on Teaching App Inventor for Non-Beginner Programmers: Issues, Challenges and Opportunities.

App Inventor has been used successfully to teach introduction to programming course for CS/IS/IT and Non-CS majors. Now, researchers are looking on how to include the tool in the curriculum of more advanced computing courses. This paper presents some Issues, Challenges and Opportunities observed while teaching courses on Mobile Application Development with App Inventor. In particular, this paper discusses the following topics that instructors should take into consideration when designing their courses with App Inventor: Pre-Requisite for the course, Visual vs. Textual Programming, Planning and Designing Apps, the use of Web Services, students new to Event-driven programming, the use of database and SQL, Lists, designing User Interfaces, discussing Data communications, and the Use versus the Creation of objects. The paper shows that App Inventor has great potential to be used for teaching more advanced computing concepts. For some of the topics, students may be required to have more than just basic programming skills.
Generalized ellipsometry characterization of sculptured thin films made by glancing angle deposition

Generalized ellipsometry, a non-destructive optical characterization technique, is employed to determine geometrical structure parameters and anisotropic dielectric properties of highly spatially coherent three-dimensionally nanostructured thin films in the spectral range from 400 to 1700 nm. The analysis of metal slanted columnar thin films fabricated by glancing angle deposition reveals their monoclinic optical properties and their optical response can be modeled with a single homogeneous biaxial layer. This homogeneous biaxial layer approach is universally applicable to sculptured thin films and effective optical properties of the nanostructured thin films are attained. We provide a nomenclature and categorization for sculptured thin films based on their geometry and structure. A piecewise homogeneous biaxial layer approach is described, which allows for the determination of principal optical constants of chiral and achiral multi-fold and helical sculptured thin films. It is confirmed that such sculptured thin films have modular optical properties. This characteristic can be exploited to predict the optical response of sculptured thin films grown with arbitrary sequential substrate rotations. As an alternative model approach, an anisotropic effective medium approximation based on the Bruggeman formula is presented, which provides results comparable to the homogeneous biaxial layer approach and in addition provides the volume fraction parameters for slanted columnar thin films and their depolarization factors.
Consequences Following Distal Femoral Growth Plate Violation in an Ovine Model With an Intramedullary Implant: A Pilot Study.

Background Retrograde femoral nailing in skeletal immature patients would broaden the surgical options for fracture care and reconstructive procedures but involves violation of the open, active distal femoral physis with the potential for growth disturbance. The tolerance for putting a large diameter metal implant across the physis is largely unknown. The purpose of this pilot investigation was to define the upper limit of cross-sectional violation with a metal implant before causing premature growth arrest or inhibition using a sheep model. Methods Eighteen sheep underwent placement of a retrograde, intramedullary implant at 3-months of age through an open distal femoral physis. The cross-sectional area of the physis was measured preoperatively and implants were selected that violated 3% to 8% of the cross-sectional area of the physis. Growth across the distal femoral physis was examined radiographically following surgery. Following euthanasia, both operative and no operative femurs were removed to compare differences in maximal lengths. Results The distal femora grew an average of 10.6±2.2 mm radio graphically after implantation. When compared with control specimens, only operative specimens with 8% of physeal violation demonstrated significant growth discrepancy with operative femurs measuring Conclusion Distal femoral growth continues across the physis when 3% to 7% of the cross-sectional area of the physis is violated using a retrograde intramedullary implant. Specimens with 8% of growth violation demonstrated significant growth inhibition. As such, retrograde nailing through the distal femoral physis appears safe up to 7%. On the basis of previous anatomic data in humans and average nail sizes, violations of >6% of the physis with pediatric retrograde nailing would be uncommon. These findings suggest that retrograde nailing may be a viable option and merits further study. Level of evidence Level IV-case series.
Stability and Boundedness

In this chapter we provide a brief introduction to difference calculus including basic material on Volterra difference equations. Using the z-transform we state some known theorems regarding stability of the zero solution of Volterra difference equations of convolution types. We move on to introducing Lyapunov functions for autonomous difference equations and state some known results concerning stability and boundedness. In Section 1.3 we introduce the concept of total stability and its correlation with uniform asymptotic stability for perturbed Volterra difference equations.
IDH3α regulates one-carbon metabolism in glioblastoma

Mutation or transcriptional up-regulation of isocitrate dehydrogenases 1 and 2 (IDH1 and IDH2) promotes cancer progression through metabolic reprogramming and epigenetic deregulation of gene expression. Here, we demonstrate that IDH3α, a subunit of the IDH3 heterotetramer, is elevated in glioblastoma (GBM) patient samples compared to normal brain tissue and promotes GBM progression in orthotopic glioma mouse models. IDH3α loss of function reduces tricarboxylic acid (TCA) cycle turnover and inhibits oxidative phosphorylation. In addition to its impact on mitochondrial energy metabolism, IDH3α binds to cytosolic serine hydroxymethyltransferase (cSHMT). This interaction enhances nucleotide availability during DNA replication, while the absence of IDH3α promotes methionine cycle activity, S-adenosyl methionine generation, and DNA methylation. Thus, the regulation of one-carbon metabolism via an IDH3α-cSHMT signaling axis represents a novel mechanism of metabolic adaptation in GBM.
CREDIT COUNSELING AND CONSUMER CREDIT TRAJECTORIES

Nonprofit credit counseling provides consumers with financial education, individualized financial counseling, and debt restructuring. Despite potential benefits, relatively little is known about its efficacy. This study uses administrative data to assess the relationship between counseling and consumer credit outcomes. We estimate difference‐in‐difference models to analyze credit outcomes for a counseled group relative to a matched comparison group for six quarters after a baseline period. We find evidence of a substantial credit shock around the time of counseling. Post‐treatment, counseling is associated with a persistent reduction in debt even after accounting for bankruptcies, foreclosures, debt charge‐offs, or participation in debt consolidation programs. (JEL D12)
Patients with pulmonary hypertension presenting to the emergency department.

Abstract Objectives Pulmonary hypertension (PH) patients represent a complex subset of patients in the emergency department (ED), yet little is known about their presentations and outcomes. The objective of this study is to analyze the demographics, dispositions and the rates of return visits for PH patients visiting the ED, focusing on PH patients identified as having high frequency visits. Methods We performed a retrospective cohort analysis of all patients with ICD-9-CM and ICD-10-CM codes corresponding to PH presenting to an academic medical center emergency department during a 21-month period. The primary outcome was patients with high frequency ED visits, defined as 4 or more visits in a 12-month period. Secondary outcomes included ED dispositions, return ED visits, hospital length of stay, and in-hospital mortality. Results Six hundred and eighty four unique patients with a coded diagnosis of PH visited the emergency department a total of 1447 times. Eighty-four patients (12.28%) were identified as having high frequency visits. Factors associated with high frequency ED visits included male sex, liver disease, rheumatologic disease, and having Group 1 PH. PH patients’ admission rate was substantial at 56.60%, and their inpatient mortality was increased (6.7% vs 3.7% for all admissions from ED, P Conclusion PH patients in this study had frequent return ED visits, as well as elevated admission and readmission rates. Factors associated with high frequency ED visits included male sex, liver disease, rheumatologic disease, and Group 1 PH. PH patients also had increased mortality rates compared to the general ED population.
Esophageal dysmotility and other preoperative factors associated with acid suppressive therapy after fundoplication.

AbstractBackground and aims: Acid suppressive therapy (AST) is frequently used after fundoplication. Prior studies show that most patients requiring AST after fundoplication have normal esophageal ...
Rehabilitation Process of Upper Limbs Muscles through EMG Based Video Game

This paper presents a human-computer interface system using Electromyography (EMG) signals to design a computer-based video game that enhances the muscle strength and can be used for rehabilitation of fist, wrist or forearm muscles. This game encompasses the rehabilitation of the muscle in itself by asking the user to move the muscle and measure the potential difference generated due to action potential using MyoWare muscle sensors kit. This newly generated raw EMG signal is passed on to Arduino, which is interfaced with a computer through a Graphical User Interface (GUI) based computer game, coded and designed in MATLAB. The gaming console presents an interesting and enjoyable platform as a modern treatment approach for stroke rehabilitation and provides an opportunity to practice activities that are not or cannot be practiced within the clinical environment. It encourages a higher number of repetitions than traditional therapy tasks without the supervision of an expert. However, due to the higher computational delay of 2 to 5 seconds between two consecutive input operations, MATLAB is not suitable for creating a real-time virtual gaming environment. The primary objective of the paper is to design and evaluate the effects of an interactive video game environment for upper limb muscle rehabilitation. Secondary outcomes included process limitations and adverse events based on the current equipment and techniques used.
Ectomycorrhizae determine chestnut seedling growth and drought response

Although agriculture focuses on row crops in the Midwestern US, chestnut (Castanea) would be a possible multipurpose agroforestry crop in erodible locations within this region. As ectomycorrhizal (ECM) colonization is often crucial for tree establishment and production, we addressed the importance of ECM colonization on chestnut performance by assessing: (1) natural ECM colonization in an established chestnut orchard, and (2) the effect of ECM inoculation on seedling establishment and drought response in a greenhouse. We selected 50 Chinese American hybrid chestnuts trees in a commercial orchard and assessed their level of mycorrhizal colonization in relation to distance from an adjacent forest, the source of inoculum. In the green house, we grew 80 seedlings from this orchard with and without mycorrhizal inoculation. Half were harvested to assess inoculation success and biomass; the remainder were subjected to experimental water stress which was evaluated with chlorophyll fluorescence using Fv/Fm values. In the orchard planted with uninoculated plants, ECM colonization decreased with distance from adjacent oak forest (P = 0.015), the putative ECM source, with an average of 29% root tips colonized. ECM inoculation increased seedling aboveground biomass by 16.4% in the greenhouse and generated 1.14 times more, but smaller stomata on leaves. Water stress in ECM inoculated seedlings also recovered faster from an experimental drought having significantly higher Fv/Fm value (P = 0.004) than uninoculated seedlings. Our study clearly indicates that ectomycorrhizal colonization can help chestnut trees in their early growth and stress tolerance and should be included into field plantings to minimize dependence on agricultural amendments.
Video-Based Wetting Detection For Blended Fabrics

Textile scientists are seeking for automated ways to understand the wicking phenomenon of blended fabrics from recorded videos at the pixel level. In response to such need, we design a video-based method for detecting pixels that will become wet and for estimating the timestamps of wetting events, which is the first step toward characterizing the wicking phenomenon. Since the wicking behaviors of the blended fabrics can be very different from one yarn to another within a small spatial region, simple frame-level thresholding with morphological preprocessing steps does not fit this application scenario. In this paper, we analyze for each pixel the color variation along the time for the wetting event detection. We develop an iterative merging algorithm rooted from the likelihood ratio test to obtain a coarse-level timestamp. The timestamp is then refined using a parametric curve fitted to a small neighborhood. Experimental results show that our automated method can achieve satisfactory wetting detection performance when the generated binary wetting-event video is compared with the raw wicking video.
Guide to Monitorships: An Academic Perspective

Monitorships are a common part of the suite of sanctions for corporate misconduct. Prosecutors show an increasing interest in actively reforming corporate criminals and seem to favor using monitors for the job. Judges, too, can and do impose sentences that involve monitor-directed reform. The role of the corporate monitor, in light of its new-found prominence, has come under increasing scrutiny by academics. The general tenor of the resulting discourse has been one of concern, namely that monitors do too much or too little, the wrong thing or the right thing in the wrong way. Corporate lawyers and academics generally incline towards the efficiencies of private ordering, which is reflected in their preference for relatively hands-off sanctions, such as fines. Monitor-directed corporate reform is anything but hands-off. This chapter sounds a relatively rare note of enthusiasm for the criminal justice potential of the corporate monitor. When private ordering becomes corrupted by familiar pathologies of the organizational setting – agency costs, collective action barriers, or ineffective information channels – a more hands-on approach may be the most effective remedy. As instruments of criminal justice, monitors and the promise of reform they bring should be evaluated in light of the goals of corporate criminal law. Monitors may be uniquely situated as the most promising agents for achieving the goals of corporate criminal law. In fact, when corporate monitors are effectively used, they may obviate the need for any other form of corporate sanction.
Understanding the role of nurse practitioners, physician assistants and other nursing staff in HIV pre-exposure prophylaxis care in the United States: a systematic review and meta-analysis

Although pre-exposure prophylaxis (PrEP) was approved for primary HIV prevention by the Federal Drug Administration in 2012, PrEP utilization has been suboptimal. A body of literature and programs has emerged to examine the role of nurse practitioners (NPs), physician assistants and nursing staff in PrEP care. This review aims to understand the current status of non-physician health providers in PrEP care implementation in the United States. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance, we conducted a comprehensive literature search using multiple databases to identify peer-reviewed articles that examined the role of non-physician health providers in the implementation of PrEP. Four major databases of studies using observational study design, randomized control trials and mixed-method study design were screened from November 2019 to January 2020 were searched. Two independent reviewers examined eligibility and conducted data extraction. We employed random-effects model aims to capture variances of estimates across studies. A total of 26 studies with 15,789 health professionals, including NPs (18, 95% CI = 14,24%), physician assistants (6, 95% CI = 2, 10%), nursing staff (26, 95% CI = 18–34%), and physicians (62,95% CI = 45, 75%), were included in the analysis. The odds of prescribing PrEP to patients among NPs were 40% (OR = 1.40, 95% CI = 1.02,1.92) higher than that among physicians, while the likelihood of being willing to prescribe PrEP was similar. On the other hand, the odds of being aware of PrEP (OR = 0.63, 95% CI = 0.46, 0.87) was 37% less in nursing professionals than that among physicians. Although the limited number and scope of existing studies constrained the generalizability of our findings, the pattern of PrEP care implementation among non-physician health providers was described. To achieve wider PrEP care implementation in the U.S., increasing awareness of PrEP among all health providers including both physicians and non-physicians is a key step.
Label-free brain tumor imaging using Raman-based methods.

Label-free Raman-based imaging techniques create the possibility of bringing chemical and histologic data into the operation room. Relying on the intrinsic biochemical properties of tissues to generate image contrast and optical tissue sectioning, Raman-based imaging methods can be used to detect microscopic tumor infiltration and diagnose brain tumor subtypes. Here, we review the application of three Raman-based imaging methods to neurosurgical oncology: Raman spectroscopy, coherent anti-Stokes Raman scattering (CARS) microscopy, and stimulated Raman histology (SRH). Raman spectroscopy allows for chemical characterization of tissue and can differentiate normal and tumor-infiltrated tissue based on variations in macromolecule content, both ex vivo and in vivo. To improve signal-to-noise ratio compared to conventional Raman spectroscopy, a second pulsed excitation laser can be used to coherently drive the vibrational frequency of specific Raman active chemical bonds (i.e. symmetric stretching of –CH2 bonds). Coherent Raman imaging, including CARS and stimulated Raman scattering microscopy, has been shown to detect microscopic brain tumor infiltration in fresh brain tumor specimens with submicron image resolution. Advances in fiber-laser technology have allowed for the development of intraoperative SRH as well as artificial intelligence algorithms to facilitate interpretation of SRH images. With molecular diagnostics becoming an essential part of brain tumor classification, preliminary studies have demonstrated that Raman-based methods can be used to diagnose glioma molecular classes intraoperatively. These results demonstrate how label-free Raman-based imaging methods can be used to improve the management of brain tumor patients by detecting tumor infiltration, guiding tumor biopsy/resection, and providing images for histopathologic and molecular diagnosis.
Microglia-derived interleukin-10 accelerates post-intracerebral hemorrhage hematoma clearance by regulating CD36

Hematoma size after intracerebral hemorrhage (ICH) significantly affects patient outcome. However, our knowledge of endogenous mechanisms that underlie hematoma clearance and the potential role of the anti-inflammatory cytokine interleukin-10 (IL-10) is limited. Using organotypic hippocampal slice cultures and a collagenase-induced ICH mouse model, we investigated the role of microglial IL-10 in phagocytosis ex vivo and hematoma clearance in vivo. In slice culture, exposure to hemoglobin induced IL-10 expression in microglia and enhanced phagocytosis that depended on IL-10-regulated expression of CD36. Following ICH, IL-10-deficient mice had more severe neuroinflammation, brain edema, iron deposition, and neurologic deficits associated with delayed hematoma clearance. Intranasal administration of recombinant IL-10 accelerated hematoma clearance and improved neurologic function. Additionally, IL-10-deficient mice had weakened in vivo phagocytic ability owing to decreased expression of microglial CD36. Moreover, loss of IL-10 significantly increased monocyte-derived macrophage infiltration and enhanced brain inflammation in vivo. These results indicate that IL-10 regulates microglial phagocytosis and monocyte-derived macrophage infiltration after ICH and that CD36 is a key phagocytosis effector regulated by IL-10. Leveraging the innate immune response to ICH by augmenting IL-10 signaling may provide a useful strategy for accelerating hematoma clearance and improving neurologic outcome in clinical translation studies.
[The role of advance care planning and palliative care in new york city during COVID-19 pandemic]

New York City faced an explosive spread of Coronavirus disease 2019 (COVID-19), causing the city's death toll to spike owing to the high virulence of COVID-19. The health care system was on the verge of collapse. Advance care planning (ACP), informed assent, and palliative care played significant roles in supporting patient self-determination and dignity, facilitating decision making, and promoting better care. The importance of these strategies was revisited. Learning from the COVID-19 pandemic in New York City, it is anticipated that several approaches such as ACP and palliative intervention may attract more attention and become increasingly essential to the healthcare system in Japan.
Supervisor synthesis of POMDP via automata learning

Abstract Partially observable Markov decision process (POMDP) is a comprehensive modeling framework that captures uncertainties from sensing noises, actuation errors, and environments. Traditional POMDP planning finds an optimal policy for reward maximization. However, for safety-critical applications, it is often necessary to guarantee system performance described by high-level temporal logic specifications. Hence, we are motivated to develop a supervisor synthesis framework for POMDP with respect to given formal specifications. We propose an iterative learning-based algorithm, which can learn a permissive policy in the form of a deterministic finite automaton. A human–robot collaboration case study validates the proposed algorithm.
An Autopsy of the Clean Power Plan

The fate of EPA's vaunted Clean Power Plan was sealed a little after midnight on Wednesday, November 9, 2016, when the election results indicated that Donald Trump will serve as the next President. My conclusion is that the CPP was probably legal, but that was precisely the problem. Multiple legal doctrines needed to be stacked on top of one another in order to sustain the rule. In other words, the CPP rests on the understanding that a statute enacted 47 years ago to reduce harmful air pollution also delegates lawmaking power to an agency that did not exist at the time to choose between two conflicting statutory provisions to regulate emissions of a categorically different kind of pollutant, even though those regulations displace traditional state authority over energy generation and even though Congress refused to enact such a statute specifically authorizing such regulations. I will examine each of these issues in turn, and then explain why they are especially troubling when combined.
The Brand Defense

Declining worker power—and increasing employer power—has suppressed wage growth and increased inequality. This decline is reinforced by contradictions in law that strengthen employers’ bargaining leverage over workers. This Article exposes those contradictions, tracing how employers have exploited the consumer rights revolution to devise brand protections and defenses that justify their control over vertically-disintegrated labor markets. The Article takes a systemic view of intellectual property, antitrust, and work law to uncover their interconnected protection of employers’ brand rights at the expense of worker power. Based on the insights derived from this analysis, it proposes a suite of doctrinal and regulatory reforms to work law, antitrust doctrine, and trademark licensing, all as a means of “defetishizing” brand and reversing the trend of declining worker power. The Article first describes the legal infrastructure devised by employers to strengthen their licensing rights and leverage their trademarks and brand-based value while using consumer welfare-focused brand defenses to immunize them from both antitrust and work law liability. It exposes the contradictory assumptions and incoherent doctrine that has emerged under these three intersecting legal frameworks which, together, create a system where “heads employers win, tails workers lose”. It next describes the economic effects of legal brand defenses on workers and inequality. It outlines the mainstream economic justifications for regimes that protect licensor branding rights—and their immense value for franchisors and outsourcing firms—even as the workplace restructuring they enable places downward pressure on workers’ wages and bargaining leverage. Finally, it proposes doctrinal and regulatory reforms in work, antitrust, and trademark law to limit employer leveraging of brand defenses at the expense of workers.
The Qualified Business Income Deduction: Testing the Limits

William C. Hood explains and illustrates how the QBID is calculated, with an emphasis on dealing with the limits.