cssi/SciSciGPT-SciSciNet huggingface dataset:
Impact of Transcatheter Intervention on Myocardial Deformation in Patients with Coarctation of the Aorta.

Myocardial deformation measured by speckle tracking echocardiography can detect subtle abnormalities of left ventricular function before an obvious abnormality in traditional echocardiographic parameters such as ejection fraction is seen. We hypothesized that patients with coarctation of the aorta (CoA) may have impaired myocardial deformation that may persist even after successful transcatheter intervention. This is a retrospective study to assess the myocardial deformation in patients undergoing transcatheter intervention of CoA. The data were compared with age-matched normal controls. Echocardiographic parameters were obtained before, immediately and at median 6 months (range 3–8 months) after transcatheter intervention. Myocardial deformation indices were obtained off-line using Tomtec 2D Cardiac Performance Analysis Software. Repeated measure ANOVA was used to compare the indices between three time points. Independent sample t test or Chi-square test was used to compare data between groups. Twenty-four patients (age 13.5 ± 7.7 years) underwent successful transcatheter CoA intervention (stent 19, balloon angioplasty five) improving CoA peak gradient in the catheterization laboratory from 27.1 ± 11.3 to 4.5 ± 3.0 mmHg (p < 0.001). To compare with normal controls (n = 25, age 14.5 ± 1.9 years), fraction shortening was significantly higher in pre-intervention CoA patients (40.4 ± 7.1 vs. 33.8 ± 2.4 %, p < 0.001). In contrast, CoA patients had significantly abnormal left ventricular longitudinal strain compared to normal controls (−14.9 ± 2.6 vs. −20.5 ± 1.8 %, p < 0.001). In CoA patients, left ventricular longitudinal strain improved immediately and 3–8 months after intervention (−18.0 ± 2.9 and −17.6 ± 2.9 %, p < 0.007) but continued to be abnormal compared to normal controls. Patients with CoA had impaired myocardial deformation compared to normal controls. Myocardial mechanics improved but did not normalize even after successful transcatheter intervention on CoA in the short term.
Effect of Gender on the Risk of Neurologic Events and Subsequent Outcomes in Patients With Left Ventricular Assist Devices.

Previous studies have shown that women with continuous-flow left ventricular assist devices (LVADs) are at greater risk of neurologic events. However, the relation between neurologic events and subsequent outcomes by gender is not well understood. We aimed to identify gender differences in the risk of neurologic events in patients with LVAD and the impact of time-dependent neurologic event on all-cause mortality by gender. Our study included 34 women and 157 men who received a HeartMate II LVAD at the University of Rochester Medical Center, Rochester, New York, from May 5, 2008, to June 5, 2014. Neurologic event was defined as a transient ischemic attack or cerebrovascular accident (hemorrhagic or ischemic). During a median follow-up of 25 months, 16 women (47%) and 20 men (13%) had neurologic events. Among patients with neurologic events, 7 women (44%) and 9 men (45%) died. Women had a 4.67-fold greater risk of neurologic events (hazard ratio [HR] 4.67, 95% confidence interval [CI] 2.26 to 9.66, p
Empirical Spectral Distributions of Sparse Random Graphs

We study the spectrum of a random multigraph with a degree sequence \({\mathbf {D}}_n=(D_i)_{i=1}^n\) and average degree 1 ≪ ωn ≪ n, generated by the configuration model, and also the spectrum of the analogous random simple graph. We show that, when the empirical spectral distribution (ESD) of \(\omega _n^{-1} {\mathbf {D}}_n \) converges weakly to a limit ν, under mild moment assumptions (e.g., Di∕ωn are i.i.d. with a finite second moment), the ESD of the normalized adjacency matrix converges in probability to \(\nu \boxtimes \sigma _{{\text{SC}}}\), the free multiplicative convolution of ν with the semicircle law. Relating this limit with a variant of the Marchenko–Pastur law yields the continuity of its density (away from zero), and an effective procedure for determining its support. Our proof of convergence is based on a coupling between the random simple graph and multigraph with the same degrees, which might be of independent interest. We further construct and rely on a coupling of the multigraph to an inhomogeneous Erdős-Renyi graph with the target ESD, using three intermediate random graphs, with a negligible fraction of edges modified in each step.
Theoretical and Empirical Background

This chapter provides an overview of the theoretical and empirical background to this book. The first part of this chapter presents the relevant theoretical concepts. Starting out with the notion of focus in alternative semantics, I will turn to the prosodic realization of focus, the grammar of association with focus, and different groups of focus particles. I will then compare the inferences triggered by focus particles to that of bare focus marking and I will discuss pragmatic factors that might influence the perception of contrast. The second part of this chapter discusses previous findings on the role of focus structure in language processing and the representation of focus alternatives. Starting from early work on focus processing, it is shown that most previous work was devoted to focus effects on prominence, not taking into account the role of focus in evoking alternatives. Finally, a few previous studies are discussed which provide evidence that focus alters the representation of informational-structural alternatives.
Psychometric Study of the Pain Drawing.

Purpose The objectives of the study were to (1) assess the extent to which interrater reliability of pain drawing location and dispersion scoring methods are similar across pain disciplines in a sample of patients with cancer treatment-induced neuropathic pain (N = 56) and (2) investigate indicators of validity of the pain drawing in this unique sample. Methods Patients undergoing cancer therapy completed the Brief Pain Inventory Body Map, the MD Anderson Symptom Inventory, and the McGill Pain Questionnaire. Results Intraclass correlation coefficients among medical and psychology professionals ranged from .93-.99. Correlations between pain drawing score and symptom burden severity ranged from .29-.39; correlations between pain drawing score and symptom burden interference ranged from .28-.34. Patients who endorsed pain in the hands and feet more often described their pain as electric, numb, and shooting than patients without pain in the hands and feet. They also endorsed significantly more descriptors of neuropathic pain. Conclusions Results suggest a similar understanding among members of a multidisciplinary pain team as to the location and dispersion of pain as represented by patients' pain drawings. In addition, pain drawing scores were related to symptom burden severity and interference and descriptors of neuropathic pain in expected ways.
Coauthorship network in transportation research

Abstract The field of transportation research has been accelerating in the last decade. In this paper, we examine the structure of scientific collaboration in transportation research by building a coauthorship network using publication metadata from 22 transportation journals. In this network, a vertex represents a researcher and an edge represents the collaboration (coauthorship) between a pair of researchers. To build an accurate network, we propose and apply an efficient author name correction algorithm. The obtained network provides us with a tool to understand patterns of collaborations in transportation research. The results show an increasing trend of collaboration over the studied period (1990–2015), but different journals exhibit different patterns. We characterize the structural properties of this network and compute several centrality measures to quantify the performance/impact of researchers and their collaborations in the research community. This study could serve as a tool to qualitatively and quantitatively understand scientific collaborations in transportation research.
Integrated BVD control plans for beef operations

Infection of cattle with bovine viral diarrhea virus (BVDV) can result in a wide assortment of disease manifestations. Diseases related to BVDV cause economic losses to cattle producers throughout the world due to decreased performance, loss of milk production, reproductive wastage, and increased risk of morbidity and mortality. There are three broad types of BVDV infection: acute, fetal, and persistent. It is persistent infection that is predominantly responsible for perpetuating the virus in cattle populations, and animals persistently infected with BVDV are an important target for control of transmission. The approach to BVDV control must be multidimensional, with consideration for all tools at our disposal including strategic management of the production system, diagnostic investigation, and vaccination. Decisions regarding BVDV control should factor into consideration the strategy's potential to decrease risk for transmission and its cost. Producers must first know with reasonable certainty if the virus is circulating in the herd. If the virus is found in the herd, then the appropriate actions are those that minimize the harmful effects of infection or work to eliminate the virus. If the virus is not present in the herd, then the appropriate actions are those that keep the herd free of BVDV and minimize losses should the virus be introduced. Recently, a new website was created to consolidate BVDV information in a single location on the internet: www.bvdinfo.org.
Presentation of the 2014 Paleontological Society Medal to Erle G. Kauffman

Good evening members of the Paleontological Society, friends of paleontology, and guests. It is both a distinct honor and pleasure for me to have nominated and be the citationist for Erle Galen Kauffman as a recipient of the Paleontological Society Medal. Put simply, he is one of the most influential paleontologists of his generation. Erle was born and grew up in Washington, DC and eventually found his way to the University of Michigan where he received his Bachelor’s, Master’s, and culminated with his Ph.D. in 1961. From there, he started his professional career at the Smithsonian Institution, and initiated a number of very fruitful collaborations with colleagues both at that institution, most notably with Norm Sohl, and with numerous colleagues both nationally and internationally that would characterize the rest of his career. From there, he relocated to his beloved Colorado and started teaching at the CU-Boulder in 1980. In his last relocation, he moved to Indiana University in 1996 where he is currently a Professor Emeritus. In considering the qualities that make Erle such a worthy recipient of this distinguished medal, I think it is best to look at three components: his research, his mentorship of aspiring paleontologists, and his approach to life. But I think we also have to look beyond those aspects and consider his unwavering passion for the discipline, his ability to meld paleontology with a range of other disciplines, his emphasis on using field-based observations to delve into various pressing problems in the geosciences, his unceasing willingness to share his knowledge with all, and his mode of engaging all around him. As a scientist, Erle’s impact on the discipline reflects his interests in integrating paleontology into the broader spectrum of the Geosciences. This reflects the seemingly limitless range of his interests, knowledge base, and energy—an approach …
Cloud-Based Cognitive Premise Security System Using IBM Watson and IBM Internet of Things (IoT)

This paper is a humble effort to demonstrate how we can capitalize on democratized artificial intelligence, commoditized internet of things, and convert our regular consumable hardware into a cost-efficient cognitive premise security system. Today, most of the commercial organizations either choose human security guards or deploy costly biometric systems to enable premise security. This approach is a stepping stone to replace such costly hardware with a convenient, reliable, scalable, and smart alternative that is built using IBM Watson and IBM internet of things.
Methods of Estimating Kidney Function for Drug Dosing in Special Populations.

International guidelines recommend the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) method to monitor kidney function in chronic kidney disease using either creatinine- or cystatin C-based estimation methods. The choice of an estimation method to determine dosage for renally eliminated drugs is not as clear. For the majority of currently marketed drugs, the Cockcroft-Gault equation with the Jaffe method, a non-isotope dilution mass spectrometry, standardized serum creatinine, was used to estimate kidney function to recommend dosing adjustment in kidney impairment. As the Cockcroft–Gault equation cannot be converted for isotope dilution mass spectrometry-traceable creatinine values and clinical laboratories now report estimated glomerular filtration (eGFR) rate by the Modified Diet in Renal Disease (MDRD) Equation or CKD-EPI, the eGFR is now more widely accepted for dosage adjustment recommendations. Cockcroft-Gault, MDRD Equation, and CKD-EPI creatinine-based methods were developed in specific populations, which included either none or a low proportion of obese individuals, pregnant women, older adults, and those with significant comorbid conditions. Clinical studies in these special populations have identified significant decreased accuracy, precision, and bias in the creatinine-based methods. Newer cystatin C-based estimation methods may significantly improve the ability to estimate kidney function to determine doses in the future. At this time, the increased cost and lack of standardization of serum cystatin C hinder routine use.
Utility of alkaloids as chemical and biomarkers for quality, efficacy, and safety assessment of botanical ingredients.

Abstract Background Selecting the appropriate chemical and bio-markers for monitoring the quality, efficacy, and safety is critical for efficient and reliable assessment of traditional medicines derived from botanical sources. Chemical markers have been implicated primarily in establishing the analytical methodologies aiming at verification of the botanical sources of the raw materials, the extracts, and the finished products such as botanical dietary supplements and nutraceuticals. In addition, they have been employed in differentiation between crude or raw (unprocessed) and processed plant extracts, and identification as well as determination of potential toxicants and adulterants in herbal medicines. Additionally, these chemical markers are utilized for selection of efficient methods for extraction of plants. Further, biomarkers have been exploited in determination of the pharmacokinetic properties of bioactive herbal constituents. Alkaloids, unlike other plant constituents, are uniquely characterized by having basic properties, and possessing substantial and diverse pharmacological effects. These features make alkaloids attractive components for functioning as chemical and biomarkers in determining the quality of botanical ingredients where this class of phytochemicals prevail or is responsible for lending biological effects. Purpose The aim of the review is to exhibit the function of alkaloids as biomarkers and chemical markers in the evaluation of quality, efficacy, and safety of medicinal herbs and their commercial products. Methods Literature acquisition was accomplished using the most commonly accessed scholarly search engines including SciFinder, PubMed, and Google Scholar. Secondly, the full-texts which are relevant to the topic were included in this review. This was followed by a thorough and detailed analysis of the collected information. Results The literature search with main emphasis on the roles of alkaloids in the evaluation of quality, efficacy and safety of herbal medicines was evaluated to provide all succinct information in one place. Compilation of such critical information is expected to help the reader to appreciate alkaloids as important markers in the quality control of herbal drugs and products. Conclusion The current review article covers the fundamental roles played by alkaloids as chemical and biomarkers in assessing the essential parameters of the quality of botanical ingredients, as briefly described earlier. The utilization of alkaloids as biomarkers to determine the efficacy-linked pharmacokinetic parameters is limited to reviewing studies on human subjects.
The Human Family: Evolutionary Origins and Adaptive Significance

Family relationships are a key component of human evolution. The extent and duration of offspring care is extraordinary, and unique in the huge informational transfer via language. Kin relationships are bilateral, variable, multigenerational, and intergroup. Mating relationships are also variable, usually influenced by kin, and generate important affinal linkages in traditional cultures. These aspects of human sociality are biologically embedded in neurological and physiological mechanisms. Analysis of genetic, hormonal and neural mechanisms can provide clues into the evolution of the emotional and cognitive systems that underpin the human family.
The Future of Coding: A Comparison of Hand-Coding and Three Types of Computer-Assisted Text Analysis Methods:

Advances in computer science and computational linguistics have yielded new, and faster, computational approaches to structuring and analyzing textual data. These approaches perform well on tasks l...
A Surface Plasmon Resonance Biosensor for Real-Time Immunologic Detection of Escherichia coli O157:H7

Testing of foods for the presence of pathogenic organisms requires methods different than those employed in the clinical laboratory. In foods there could be very low levels of pathogenic bacteria and the organisms are often in a poor physiological state because of exposure to stressful conditions in the food environment or to stresses encountered during food processing and storage. The organism must be identified in the presence of a large population of competing flora. Therefore, a period of enrichment culturing of the sample in liquid growth medium is usually required in order to allow the organism to recover from injury and to allow for selective growth of low numbers of the target bacteria to detectable levels. Traditional methods for detection and identification of pathogenic bacteria in foods and other samples have relied on the use of specific microbiological media to isolate and enumerate viable bacterial cells followed by a series of biochemical and serological tests for confirmation.
The Case against a Grand Unification Theory

Theories and design principles of a general nature will be far too weak to be of much value to the practitioners. We should develop specialized theories that are applicable in specific domains, and we should work on binding these theories and principles much like the way we structure large systems today. Functional programming, for instance, provides impressive facilities for modularization, programming in layers and program integration. However, several important areas are not covered by the functional style of programming: non-determinism, persistent storage management, and matrix-based computations, for instance. There seem to be no easy extensions of functional-based system to include these domains.I suggest that we abandon the idea of a Grand Unification Theory, and design specialized theories that handle a few things well. We should be studying how the capabilities of functional programming and object-based programming, for instance, can be integrated, different theories being applicable in each domain. The challenge lies in seamless integration. This proposal amounts to a strong prescription for empiricism, that we have to do a large number of experiments to understand where theories can play a role, and which kinds of theories would be most appropriate and when. Examples of a few small theories will be given and their effectiveness and limitations will be illustrated.
Wall Shear in a Compliant Cast of a Human Artery Perfused With a Non-Newtonian Fluid, and Its Correlation With Intimal Thickness

There is indirect evidence that fluid dynamics plays a role in atherogenesis, presumably reflecting the response of the vessel wall to the adjacent flow field. To illuminate this response, we seek relationships between fluid mechanical variables in the arterial flow and the morphology at corresponding sites in the arterial wall. The primary morphologic variable used to date has been intimal thickness. To obtain near-wall fluid dynamic data of sufficient resolution, we prepare replicas of human vascular segments, perfuse them with physiologically realistic flows, and measure fluid velocities at multiple sites near the walls of these casts by laser Doppler anemometry (LDA).
Emergent flat band lattices in spatially periodic magnetic fields

Motivated by the recent discovery of the Mott insulating phase and unconventional superconductivity due to the flat bands in twisted bilayer graphene, we propose more generic ways of getting two-dimensional (2D) emergent flat-band lattices using either 2D Dirac materials or ordinary electron gas (2DEG) subject to moderate periodic orbital magnetic fields with zero spatial average. We find stark contrast between Schr\"odinger and Dirac electrons, i.e., the former show recurring ``magic'' values of the magnetic field when the lowest band becomes flat, whereas, for the latter, the zero-energy bands are asymptotically flat without magicness. By examining the Wannier functions localized by the smooth periodic magnetic fields, we are able to explain these nontrivial behaviors using minimal tight-binding models on a square lattice. In particular the magicness of the 2DEG can be understood in terms of destructive quantum interference similar to classic flat-band lattice models. The two cases can be interpolated by varying the $g$ factor or effective mass of a 2DEG and by taking into account the Zeeman coupling, which also leads to flat bands with nonzero Chern numbers for each spin. Our paper provides flexible platforms for exploring interaction-driven phases in 2D systems with on-demand superlattice symmetries.
A Comparison of Modern Localization Techniques in Wireless Sensor Networks (WSNs)

Wireless Sensor Networks (WSNs) has acquired a well-known significance in the domain of sensor networks due to the advancement in past decade by the introduction of Internet of Things (IoT). WSNs comprises of sensor and the basic purpose of sensor is to collect, analyze and transmit the information to the target node/sensor. Therefore, it is necessary to identify target area of sensor node. In WSNs, it is achieved through applications of various algorithms and techniques known as localization techniques. These localization approaches help in determining the actual geographical location of sensor nodes. The main focus of this paper is to provide a comparative study of different localization techniques used in WSNs. This paper significantly helps the students, researchers and practitioners in this domain for selecting right localization technique as per the given WSNs requirements.
Agreement of treatment recommendations based on digital vs plaster dental models.

Introduction The purpose of this study was to investigate differences in orthodontists' treatment plans based on digital models compared with plaster models. Additionally, we assessed whether digital or plaster models influence the reliability of orthodontists' treatment plans, as well as the amount of time required to arrive at the plan. Methods Sixteen orthodontists planned treatment for 20 patients at 2 time points using either the same or different model formats (digital or plaster). The treatment plan decisions and time spent making the plans were recorded. The permutation test and a random effects model were used to analyze the data. Results The treatment plans arrived at with digital and plaster models were similar. With respect to extractions, the mean difference between digital and plaster formats was 11.9% (95% CI, 7.5%-16.3%). For surgery, the mean difference was 9.4% (95% CI, 5.0%-13.8%). There was no significant difference in the agreement rate between those who viewed models in different formats compared with those who viewed models twice in the same format (P >0.05). The time spent to plan treatment with plaster models was not significantly different from the time spent with digital models (P = 0.87). Conclusions Based on this study, digital models can be substituted for plaster models with no significant differences in the final plans, the reliability of the plans, and the time required to create the plan.
UNIT 14.6 Analysis of Protein S-Nitrosylation

S-nitrosylation is the binding of an NO group to a cysteine or other thiol. Like phosphorylation, S-nitrosylation is a precisely targeted and rapidly reversible post-translational modification that serves as an on/off switch for protein function during cell signaling. However, unlike phosphorylation, S-nitrosylation of proteins occurs nonenzymatically and is mediated, at least in part, by redox-regulated chemical reactions in cells. Alterations in pH, pO2, cellular reductants, transition metals, and UV light lead to the loss and/or gain of S-NO bonds. Due to the redox-sensitive nature of the modification, analysis of protein S-nitrosylation is technically difficult, since the S-NO bond is easily disrupted during sample preparation. In addition, the level of S-nitrosylated proteins in cells approaches the limit of detection of currently available technology. Despite these technical challenges, several useful methods have been developed recently to measure protein S-nitrosylation in biological samples, and these are described in this unit. Keywords: nitric oxide; S-nitrosylation; Saville assay; chemical reduction/chemiluminescence; DAN assay; DAF-2 assay; DAF gel assay; biotin switch assay; anti-SNO immunofluorescence
Cost-Effectiveness of Intranasal Naloxone Distribution to High-Risk Prescription Opioid Users.

Abstract Objectives To determine the cost-effectiveness of pharmacy-based intranasal naloxone distribution to high-risk prescription opioid (RxO) users. Methods We developed a Markov model with an attached tree for pharmacy-based naloxone distribution to high-risk RxO users using 2 approaches: one-time and biannual follow-up distribution. The Markov structure had 6 health states: high-risk RxO use, low-risk RxO use, no RxO use, illicit opioid use, no illicit opioid use, and death. The tree modeled the probability of an overdose happening, the overdose being witnessed, naloxone being available, and the overdose resulting in death. High-risk RxO users were defined as individuals with prescription opioid doses greater than or equal to 90 morphine milligram equivalents (MME) per day. We used a monthly cycle length, lifetime horizon, and US healthcare perspective. Costs (2018) and quality-adjusted life-years (QALYs) were discounted 3% annually. Microsimulation was performed with 100 000 individual trials. Deterministic and probabilistic sensitivity analyses were conducted. Results One-time distribution of naloxone prevented 14 additional overdose deaths per 100 000 persons, with an incremental cost-effectiveness ratio (ICER) of $56 699 per QALY. Biannual follow-up distribution led to 107 additional lives being saved with an ICER of $84 799 per QALY compared with one-time distribution. Probabilistic sensitivity analyses showed that a biannual follow-up approach would be cost-effective 50% of the time at a willingness-to-pay (WTP) threshold of $100 000 per QALY. Naloxone effectiveness and proportion of overdoses witnessed were the 2 most influential parameters for biannual distribution. Conclusion Both one-time and biannual follow-up naloxone distribution in community pharmacies would modestly reduce opioid overdose deaths and be cost-effective at a WTP of $100 000 per QALY.
Claiming freedom: race, kinship, and land in nineteenth-century Georgia

Karen Cook Bell uses a series of historical snapshots to trace aspects of African American oppositional communities in the Georgia lowcountry over the course of the eighteenth and nineteenth centur...
E-Journaling for All Communication Classes.

E-journaling invites students to reflect upon and synthesize their experiences, readings, discussions, and presentations in a series of electronic entries, usually viewed only by the student and th...
Causes, Predictors, and Trends of Unplanned Readmissions after Elective Endovascular Embolization of Cerebral Aneurysms.

Abstract Background: 30- and 90-day readmissions (dRA) are being increasingly scrutinized as quality metrics for hospital and provider performances. Little information regarding risk factors for readmission after elective endovascular treatment (EVT) of an unruptured cerebral aneurysm (UCA) is available. Methods: The Nationwide Readmissions Database was used to identify patients who underwent elective endovascular embolization of an unruptured aneurysm between 2010 and 2014. The primary outcomes of interest were unplanned readmissions occurring within 30 or 90 days of discharge. Binary logistic regressions were used to identify variables related to patients’ demographics, comorbidities, and index hospital admission that were associated with 30dRA and 90dRA. Results: A total of 8588 patients met the inclusion criteria for 30dRA analysis and 7289 patients were eligible for 90dRA analysis. The 5-year 30dRA and 90dRA readmission rates were 7.1% and 13.5%, respectively. The annual incidences of 30dRAs and 90dRAs between 2010 and 2014 decreased significantly (pooled odds ratio (OR) for 30dRA: .874, 95% confidence interval (CI) .765-.998; pooled OR for 90dRA: .841, 95% CI .755-.938). Patients in higher income quartiles experienced decreased odds of 30dRA and 90dRA. Nonroutine disposition following the index admission and greater comorbidity burdens were associated with higher likelihoods of both 30dRA and 90dRA. The presence of pulmonary or cardiac complications was associated with increased odds of 90dRA. Conclusion: Readmission rates after elective EVT of UCAs decreased between 2010 and 2014. We identified several novel risk factors for both 30dRAs and 90dRAs that can be used to identify patients who are at highest risk of readmission.
A Unique Signature of Cardiac-Induced Cranial Forces During Acute Large Vessel Stroke and Development of a Predictive Model

Cranial accelerometry is used to detect cerebral vasospasm and concussion. We explored this technique in a cohort of code stroke patients to see whether a signature could be identified to aid in the diagnosis of large vessel occlusion (LVO) stroke. A military-grade three-axis accelerometer was affixed to a headset. Accelerometer and electrocardiogram (ECG) outputs were digitized at 1.6 kHz. We call the resulting digitized signals the “headpulse.” Three-minute recordings were performed immediately after computed tomography (CT) angiography (CTA) and/or immediately before and after attempted mechanical thrombectomy in patents with suspected stroke. The resulting waveforms were inspected by eye and then subjected to supervised machine learning (MATLAB Classification Learner R2018a) to train a model using fivefold cross-validation. Of 42 code stroke subjects with recordings, 19 (45%) had LVO and 23 (55%) had normal CTAs. In patients without LVO, ECG-triggered waveforms followed a self-similar time course revealing that the headpulse is highly coupled to the cardiac contraction. However, in most patients with LVO, headpulses showed little cardiac contraction correlation. We term this abnormality “chaos” and parameterized it with 156 measures of trace-by-trace variation from the ECG-signal-averaged mean for machine learning model training. Selecting the best model, using biometric data only, we properly classified 15/19 LVOs and 20/23 non-LVO patients, with receiver operating characteristic curve area = 0.79, sensitivity of 73%, and specificity of 87%, P < 0.0001. Headpulse waveforms following thrombectomy showed return of cardiac contraction correlation. Headpulse recordings performed on patients with suspected acute stroke significantly identify those with LVO. The lack of temporal correlation of the headpulse with cardiac contraction and resolution to normal may reflect changes in cerebral blood flow and may provide a useful technique to triage stroke patients for thrombectomy using a noninvasive device.
Significant Regional Variability Yet Similar Survival in Heart Transplantation Utilizing Increased Risk Donor Hearts

Purpose Heart transplantation remains the gold standard for the treatment of patients with advanced heart failure. Heart transplant volumes in the United States (US) have increased over the past five years. The use of Center for Disease Control and Prevention (CDC) Increased Risk (IR) donors has also increased. We sought to investigate geographic patterns of CDC IR donor heart utilization per United Network for Organ Sharing (UNOS) region and subsequent survival outcomes. Methods Data were obtained from the UNOS database. All adult patients (age >18 years) undergoing OHT from 2008 through 2018 were included. We examined the use of CDC IR donor hearts across the 11 UNOS regions. Using the FREQ procedure, we evaluated the number of CDC IR donors per region and transplant utilization rate of CDC IR donors per region. We conducted a multivariable Cox regression model to examine one year survival of CDC IR donor recipients based on region after adjusting for covariates. Results 89,083 donor hearts were evaluated. Of these donors, 16,133 (18.11%) were CDC IR donors. When evaluating frequency of CDC IR donors across regions, region 2 had the highest number of CDC IR donors (n=2,394, 14.84%), however the lowest frequency of transplanting CDC IR donors (n=700, 29.24%). Region 7 had the highest frequency of transplanting CDC IR donors with a transplantation frequency of 35.36% (n=408). In multivariable Cox modeling, there is no demonstrable difference in one year survival of CDC IR donor transplant recipients across region. Conclusion There is significant variability in the availability and utilization of CDC IR donor hearts for OHT as stratified by UNOS region. Despite this, there is no difference in survival for OHT recipients when receiving a CDC IR donor heart based on region. These positive survival results and the identification of significant regional variability should encourage the consideration of CDC IR donors in under-utilized regions.
Measuring Family-Centered Practice in Child Welfare:

Although family-centered practice has been implemented nationwide in child welfare, measures for evaluating family-centered practice have not been well-established. This study aimed to evaluate the...
A randomized pilot trial of topiramate for alcohol use disorder in veterans with traumatic brain injury: Effects on alcohol use, cognition, and post-concussive symptoms

Abstract Background Topiramate is an effective treatment for alcohol use disorder (AUD) and has also been used in the care of mild traumatic brain injury (mTBI). This pilot study aimed to obtain a preliminary assessment of topiramate’s efficacy in reducing alcohol use and post-concussive symptoms, and its potential negative impact on cognitive function in 32 Veterans with co-occurring AUD and mTBI. Methods This was a prospective 12-week, randomized, double-blind, placebo-controlled pilot study of flexible-dose topiramate or placebo. Primary outcome was reduction of drinking days per week within the topiramate arm. Secondary outcomes included between group comparisons of alcohol use and craving, post-concussive symptoms, and cognitive function. Results Drinking days per week significantly decreased within both the topiramate and placebo arm. There were no significant treatment-by-week interactions on alcohol use/craving, or post-concussive symptoms in intent-to-treat analyses. In per-protocol analyses, topiramate significantly reduced number of drinks per week compared with placebo. Topiramate transiently impaired verbal fluency and working memory. Processing speed, cognitive inhibition, and mental flexibility significantly improved between weeks 1 and 12, regardless of treatment arm. Conclusions Significant improvement occurred in both the topiramate and placebo groups over 12 weeks of treatment in alcohol use and post-concussive symptoms. Among treatment completers there was greater reduction of alcohol use in the topiramate arm. Topiramate was also associated with negative but transient effects on cognitive function. Results suggest both a possible benefit for topiramate treatment in reducing alcohol use and some potential for negative cognitive effects in Veterans with AUD and mTBI.
Dissecting Hessian: Understanding Common Structure of Hessian in Neural Networks

Hessian captures important properties of the deep neural network loss landscape. We observe that eigenvectors and eigenspaces of the layer-wise Hessian for neural network objective have several interesting structures -- top eigenspaces for different models have high overlap, and top eigenvectors form low rank matrices when they are reshaped into the same shape as the weight matrix of the corresponding layer. These structures, as well as the low rank structure of the Hessian observed in previous studies, can be explained by approximating the Hessian using Kronecker factorization. Our new understanding can also explain why some of these structures become weaker when the network is trained with batch normalization. Finally, we show that the Kronecker factorization can be combined with PAC-Bayes techniques to get better generalization bounds.
Apical PAR complex proteins protect against epithelial assaults to create a continuous and functional intestinal lumen

Sustained polarity and adhesion of epithelial cells is essential for the protection of our organs and bodies, and this epithelial integrity emerges during organ development amidst numerous morphogenetic assaults. Using the developing C. elegans intestine as an in vivo model, we investigated how epithelial cells maintain integrity through cell division and elongation to build a functional tube. Live-imaging revealed that apical PAR complex proteins PAR-6/Par6 and PKC-3/aPkc remained apical during mitosis while apical microtubules and microtubule-organizing center (MTOC) proteins were transiently removed. Intestine-specific depletion of PAR-6, PKC-3, and the aPkc regulator CDC-42/Cdc42 caused persistent gaps in the apical MTOC as well as in other apical and junctional proteins after cell division and in non-dividing cells that elongated. Upon hatching, gaps coincided with luminal constrictions that blocked food, and larvae arrested and died. Thus, the apical PAR complex maintains apical and junctional continuity to construct a functional intestinal tube.
Predictors of Caregiver Participation in an Engagement Strategy to Increase Initiation into a Family-Based Preventive Intervention.

Previous studies have shown that engagement strategies can help increase enrollment and initiation of families in evidence-based preventive programs under natural service delivery settings. However, little is known about factors that predict completion of these engagement strategies. This study aimed to examine predictors (i.e., perceived need, perceived barriers, and sociocultural context) of caregiver participation in an evidence-based engagement call strategy. This call was expected to increase initiation into a school-based, family-focused prevention program. In addition, this study examined engagement call completion as a predictor of program initiation among already enrolled families. Participants included ethnically diverse families recruited from three Title I schools (n = 413) who were randomized to receive the prevention program. Results showed that interparental conflict—an indicator of perceived need—was associated with an increased likelihood of completing the engagement call. Furthermore, caregivers from low-socioeconomic status (SES), foreign-born, Spanish-speaking, Hispanic families were more likely to complete the call relative to those from low- and mid-SES, US born, English-speaking, ethnically diverse families. Importantly, engagement call completion was associated with an increased likelihood of program initiation. These findings provide limited support that families with higher perceived needs are more likely to participate in an evidence-based engagement call strategy. Results suggested that the call strategy provides a promising way to reduce attrition from family prevention programs, which is commonly observed between enrollment and initiation. Project Number: R01 DA035855; Date of Registration: 06/15/2014.
Understanding Laboratory Testing for SARS-CoV-2

The SARS-CoV-2 pandemic has impacted millions of lives worldwide. Molecular assays and serological tests have been approved under EUA (emergency use authorization) by the FDA (food and drug administration), given these unprecedented times. These tests are not only critical for confirming the clinical diagnosis and making therapeutic decisions but also play an important role in the understanding of the epidemiology of the pandemic. There is limited experience with currently available tests and differences may exist among tests even using similar technology. The focus of this review is to improve clinicians' understanding of SARS-CoV-2 test procedures including their limitations. We discuss the impact of different host and environmental factors on test results.
Return to Play and Performance in Golfers After Total Knee Arthroplasty: Does Component Type Matter?:

Background:Golf is a popular sport among patients undergoing total knee arthroplasty (TKA). The golf swing requires significant knee rotation, which may lead to changes in golfing ability postopera...
A heuristic tool to assess regional impacts of renewable energy infrastructure on conservation areas

Abstract Wind and hydropower are important renewable components of national energy portfolios, but their infrastructure negatively affects biodiversity. Regional development requires identification of scenarios that minimize the cumulative impacts of multiple facilities. We introduce the cumulative impact plot (CIP) to quantify cumulative impacts of renewable energy development within a region. Summed impacts of facilities are plotted as a function of the number of facilities, with facilities ranked by increasing (the best-case scenario) or decreasing (worst-case scenario) individual impact. These curves represent lower and upper bounds to which alternative development scenarios (e.g., facilities ranked by generating capacity) can be compared. We used CIPs to assess overlap of potential wind and hydropower facilities with two types of conservation area in the United States: (1) federally protected lands and (2) critical habitats of federally threatened and endangered species. We evaluated two alternative scenarios: facilities ranked by (A) decreasing generating capacity and (B) increasing distance from urban centers. Differences between the best-case and worst-case scenarios were large, thus revealing opportunities to develop facilities with limited impact on conservation areas. Alternative scenarios maximizing energy density generally resulted in conservation area overlap intermediate to best-case and worst-case scenarios. CIPs can also identify the proportion of wind versus hydropower favored under alternative scenarios. Build-out scenarios aimed at minimizing conservation area overlap favor hydropower, whereas alternative scenarios favor wind power. We conclude that CIPs can (1) complement—but should not replace—project-level environmental impact assessment, (2) integrate strategic, cumulative, and scenario-based assessments, and (3) harness rapidly growing geospatial data.
Effects of balance training with stroboscopic glasses on postural control in chronic ankle instability patients.

Individuals with chronic ankle instability (CAI) are believed to rely more on visual information during postural control due to impaired proprioceptive function, which may increase the risk of injury when their vision is limited during sports activities. OBJECTIVES To compare (1) the effects of balance training with and without stroboscopic glasses on postural control and (2) the effects of the training on visual reliance in patients with CAI. DESIGN A randomized controlled clinical trial. METHODS Twenty-eight CAI patients were equally assigned to one of 2 groups: strobe or control group. The strobe group wore stroboscopic glasses during a 4-week balance training. Static postural control, a single-leg hop balance test calculated by Dynamic Postural Stability Index (DPSI), and the Y-Balance test (YBT) were measured. During the tests, there were different visual conditions: eyes-open (EO), eyes-closed (EC), and strobe vision (SV). Romberg ratios were then calculated as SV/EO, and EC/EO and used for statistical analysis. RESULTS The strobe group showed a higher pretest-posttest difference in velocity in the medial-lateral direction and vertical stability index under SV compared with the control group (p < .05). The strobe group showed higher differences in EC/EO for velocity in the medial-lateral and anterior-posterior directions, and 95% confidence ellipse area (p < .05), and in SV/EO for velocity in the medial-lateral, 95% confidence ellipse area, and YBT-anterior direction (p < .05). CONCLUSION The 4-week balance training with stroboscopic glasses appeared to be effective in improving postural control and altering visual reliance in patients with CAI.
Brain damage in alcoholics: altered states of unconsciousness.

It has become popular in recent years to employ the concept of “altered states of consciousness” in attempting to understand the behavioral effects of various drugs including alcohol (Jones, 1974; Mello and Mendelson, 1969; Tart, 1969). Such a concept appears to have value in considering the acute effects of drugs in which a transient alteration in the brain has occurred and where it is recognized by the drug taker as a temporary change from an ongoing non-drug state. For example, most people who drink alcohol report altered subjective states or changed consciousness. But what about the effects of chronic drug use in persons who are no longer using drugs? Are there altered states of consciousness? From the occurrence of “flash-backs” such as LSD-25 users have described (i.e., where the former drug-taker during abstinence has an altered state of consciousness similar to that which he experienced while taking the drug) it seems clear that such experiences are possible with certain drugs. The so called “dry-drink” phenomenon has been reported in some alcoholics. However, these are relatively sporadic and transient episodes. Of much greater permanence and consistency are the behavioral changes suggestive of altered brain states, in the presence of a clear consciousness, in chronic alcoholics.
How Does the New York Constitution Compare the U.S. Constitution

One of the most interesting, and certainly most litigated, defamation questions in New York State is when constitutional protection should be afforded speech that arguably would be regarded as opinion. In resolving that question, the New York Court of Appeals has decided that the New York State Constitution affords greater protection for speech than does the federal constitution. While the New York standard seems to be far more generous in protecting speech than the federal standard, it may be that in the vast majority of cases, the outcomes would be the same under either state or federal analysis. The two standards use different routes to get to more or less the same place. Both standards ultimately focus on whether a reasonable reader would understand the statement to be asserting a fact about the plaintiff.