cssi/SciSciGPT-SciSciNet huggingface dataset:
Outcomes of pediatric severe traumatic brain injury patients treated in adult trauma centers with and without added qualifications in pediatrics — United States, 2009

Pediatric traumatic brain injury (TBI) is an important public health problem and little is known about site of care and outcomes of children with severe TBI. Across the country, most injured children are treated in adult trauma centers (ATCs). Recent literature suggests that ATCs with added qualifications in pediatrics (ATC-AQs) can have improved outcomes for pediatric trauma patients overall. This study characterizes the population of pediatric severe TBI patients treated at ATCs and investigates the effect of treatment at ATC-AQs versus ATCs on mortality. Using the 2009 National Trauma Data Bank, pediatric (age 0–17 years old) severe TBI (head Abbreviated Injury Scale score ≥3) patient visits at level I and II ATCs and ATC-AQs were analyzed for patient and hospital characteristics. The primary outcome was in-patient mortality. Multivariate analysis was performed on propensity score weighted populations to investigate effect of treatment at ATC-AQs versus ATCs on survival. A total of 7,057 pediatric severe TBI patient visits in 398 level I and II trauma centers were observed, with 3,496 (49.5%) at ATC-AQs and 3,561 (50.5%) at ATCs. The mortality rate was 8.6% at ATC-AQs versus 10.3% at ATCs (p =0.0144). After adjusting for differences in case mix, patient, and hospital characteristics, mortality was not significantly different for patients treated in ATC-AQs versus ATCs (aOR = 0.896, 95% CI = 0.629–1.277). Mortality was significantly associated with age, length of hospital stay, firearm injury, GCS score, and head AIS (p <0.0001). Higher mortality odds were also associated with being uninsured (aOR = 2.102, 95% CI = 1.159–3.813), and the presence of additional non-TBI severe injuries (aOR = 1.936 95% CI = 1.175-3.188). After defining comparable populations, this study demonstrated no significant difference in mortality for pediatric severe TBI patients treated at ATC-AQs versus ATCs. Being younger, uninsured, and having severe injuries was associated with increased mortality. This study is limited by the exclusion of transferred patients and potentially underestimates differences in outcomes. Further research is needed to clarify the role of ATC additional pediatric qualifications in the treatment of severe TBI.
Psychiatric Consultation with Patients Who Refuse Medical Care

Ethical and pragmatic issues which are related to patient refusal of medical care are considered and a comprehensive approach to psychiatric evaluation and management presented. Legal interventions...
Organ donation without brain death

In this issue, Winston Chiong joins the long list of scholars who have argued that the current justifications for whole brain death are incoherent. Chiong instead recommends "brain death without definitions." To put his article in perspective, however, it is important to remember that the only reason a concept of brain death is needed at all is to facilitate the recovery of organs for transplantation. In other words, if we could consider "organ donation without brain death," we could obviate the need to find ever more creative ways of supporting this beleaguered concept. Brain death is needed, the argument goes, so we can conform with the so-called "dead donor rule," which is an implicit assumption that vital organs should never be removed from patients before they have been declared dead. If a physician removed a vital organ from a patient before the patient was declared dead, then the physician would be guilty of homicide. Brain death is needed because it allows for a patient to be declared dead while the patient's organs are still being perfused by a beating heart. Consider, however, that the majority of all deaths that occur in an intensive care unit follow the physical removal of mechanical ventilation. In these cases, just as in the case of a physician removing organs before a patient is declared dead, an action of the physician is the proximate cause of death. Nonetheless, the death is attributed to the disease, not to the physician. Why do we attribute moral responsibility to the disease in one case, and to the physician in the other? Clearly this point is only a hint of an alternative ethical perspective. Much more would need to be said before we ever let a physician remove a patient's vital organs before the patient was dead. But it helps show that the idea is not outlandish. There is also little reason to think that this idea would cause any public outrage. Leading newspapers frequently report that patients were kept alive so that their organs could be removed, yet one never sees letters to the editor wondering why doctors are killing patients. A recent survey showed that a third of the public would accept organ removal from patients they considered alive. (1) Nor is it only the "uninformed public" that holds these views. Consider the comments of Dr. Sanjay Gupta, a neurosurgeon in Atlanta and senior medical correspondent for CNN, on a recent segment of Larry King Live devoted to the case of Susan Torres, a pregnant brain-dead woman who was sustained until her fetus was viable. …
Antimicrobial Resistance with Focus on β-Lactam Resistance in Gram-Negative Bacilli

β-Lactam antibiotics are the most frequently prescribed antibiotics worldwide. Therefore, it is not surprising that resistance to this very important class of agents poses an increasingly complex and perplexing problem for physicians. Among the variety of mechanisms that can provide resistance to β-lactam antibiotics in gram-negative bacilli, the production of β-lactamase is by far the single most important factor. With the introduction of newer β-lactam agents observed changes in β-lactamases include the increased prevalence of older enzymes, the appearance of new enzymes, and alteration in the level of expression of the enzymes. These changes have been responsible for resistance to newer cephalosporins, monobactams, carbapenems, and β-lactamase inhibitor/β-lactam drug combinations. Resistance to β-lactam antibiotics has also emerged through alterations in the targets of the drugs, the penicillin-binding proteins, and through alterations in outer membrane permeability of the organisms to the drugs. With some β-lactam agents, multiple mechanisms must be acquired before clinically relevant levels of resistance are attained. This is especially true for carbapenems and fourth generation cephalosporins. Nevertheless, resistance to β-lactam antibiotics is on the rise among clinical isolates of gram-negative bacilli, and only through more judicious use of these agents can their usefulness for treatment and prevention of infections be preserved.
Fault tolerance in the Block-Shift Network

The Block Shift Network (BSN) is a new topology for interconnection networks in multiprocessor systems. BSN is a class of networks defined by several parameters, and has a constant number of links/node for some given parameters. Many popular networks such as the hypercube, the shuffle-exchange, and the complete networks, are instances of the BSN for different parameters. Performance of BSN has been evaluated through analysis, simulation, and design of typical parallel algorithms on it. The results indicate that BSN surpasses the hypercube in several respects while retaining most of the hypercube advantages, especially when the traffic has the locality property. As the size and complexity of a system increase, however, the reliability aspects become equally important and should be included in the system-performance study. This paper discusses the reliability issue of BSN. Several reliability measures, including network connectivity, network diagnosability, and 2-terminal reliability, are obtained through analysis. This paper shows that the BSN not only surpasses the hypercube in performance as confirmed before, but also has comparable reliability to the hypercube under similar conditions. BSN is also very flexible in balancing its cost and performance. One can increase two parameters to enhance the performance and reliability of the BSN, while it is impossible to do so in the hypercube once its size is fixed. The BSN can be an effective interconnection network for future parallel computer systems.
Transient and Steady-State Experimental Comparison Study of Effective Thermal Conductivity of Al2O3∕Water Nanofluids

Nanofluids are being studied for their potential to enhance heat transfer, which could have a significant impact on energy generation and storage systems. However, only limited experimental data on metal and metal-oxide based nanofluids, showing enhancement of the thermal conductivity, are currently available. Moreover, the majority of the data currently available have been obtained using transient methods. Some controversy exists as to the validity of the measured enhancement and the possibility that this enhancement may be an artifact of the experimental methodology. In the current investigation, Al 2 O 3 /water nanofluids with normal diameters of 47 nm at different volume fractions (0.5%, 2%, 4%, and 6%) have been investigated, using two different methodologies: a transient hot-wire method and a steady-state cut-bar method. The comparison of the measured data obtained using these two different experimental systems at room temperature was conducted and the experimental data at higher temperatures were obtained with steady-state cut-bar method and compared with previously reported data obtained using a transient hot-wire method. The arguments that the methodology is the cause of the observed enhancement of nanofluids effective thermal conductivity are evaluated and resolved. It is clear from the results that at room temperature, both the steady-state cut-bar and transient hot-wire methods result in nearly identical values for the effective thermal conductivity of the nanofluids tested, while at higher temperatures, the onset of natural convection results in larger measured effective thermal conductivities for the hot-wire method than those obtained using the steady-state cut-bar method. The experimental data at room temperature were also compared with previously reported data at room temperature and current available theoretical models, and the deviations of experimental data from the predicted values are presented and discussed.
Education, English Language Proficiency, And Earnings Of Male Immigrants In The U.S. Labor Market

Using samples of male Mexican and Chinese immigrants taken from 1990 Census PUMS data, this paper investigates the determinants of English language proficiency (ELP) and its effect on male immigrants’ earnings. The findings are: 1) the educational attainments are crucial in improving ELP; 2) the effects of ELP on earnings are significant for both Chinese and Mexican immigrants and among all educational categories. The importance of educational attainment and ELP on the immigrants’ economic success is reestablished.
Multimodality Brain Tumor Imaging: MR Imaging, PET, and PET/MR Imaging

Standard MR imaging and CT are routinely used for anatomic diagnosis in brain tumors. Pretherapy planning and posttreatment response assessments rely heavily on gadolinium-enhanced MR imaging. Advanced MR imaging techniques and PET imaging offer physiologic, metabolic, or functional information about tumor biology that goes beyond the diagnostic yield of standard anatomic imaging. With the advent of combined PET/MR imaging scanners, we are entering an era wherein the relationships among different elements of tumor metabolism can be simultaneously explored through multimodality MR imaging and PET imaging. The purpose of this review is to provide a practical and clinically relevant overview of current anatomic and physiologic imaging of brain tumors as a foundation for further investigations, with a primary focus on MR imaging and PET techniques that have demonstrated utility in the current care of brain tumor patients.
Pharmacokinetics and Metabolism of Anticancer Drugs

The design of cancer chemotherapeutic agents would already have evolved from empiricism to rationalism if a unique structural feature exists that specifically confers anticancer activity on a chemical substance. In reality, the structures of anticancer drugs vary widely; this structural diversity dictates a similar diversity in the pharmacokinetics and metabolism of these drugs. Generally however, the pharmacological disposition and metabolism of a particular class of anticancer agents, the antimetabolites, closely mimic those of their natural counterparts, and a reasonable extrapolation can frequently be made.
Hinged external fixation in the treatment of knee dislocations: a prospective randomized study.

Background: Our hypothesis was that patients treated with hinged external fixators as an adjunct to multiple-ligament reconstruction would have fewer reconstruction failures than patients treated without external fixation. Methods: In this prospective randomized study, patients with a knee dislocation either underwent ligament reconstruction with placement of an external hinged knee brace following surgery (Group A) or underwent ligament reconstruction with placement of a hinged external fixator (Compass Knee Hinge) for six weeks instead of the brace (Group B). The patients were followed clinically and were evaluated with physical examination, Lysholm and International Knee Documentation Committee knee scores, visual analog scale pain scores, and status regarding return to work and activities. Results: One hundred patients with 103 knee dislocations were enrolled. Seventy-seven patients with seventy-nine dislocations (thirty-two in Group A and forty-seven in Group B), with a minimum follow-up interval of twelve months, were available for evaluation. The mean duration of follow-up was thirty-nine months (range, twelve to eighty-six months). Nine patients (29%) in Group A had failed reconstructions compared with seven (15%) in Group B (p = 0.15). Group-A patients had twenty-two (21%) of 105 reconstructed individual ligaments fail compared with eleven (7%) of 157 reconstructed ligaments in Group B. The difference in ligament failure was significant (p 0.8), with more favorable results for the patients managed with the external fixation. Conclusions: Hinged external fixation as a supplement to reconstruction following knee dislocation was associated with fewer failed ligament reconstructions compared with external bracing. Patients presenting with highly unstable knee dislocations should be considered for hinged external fixation to supplement initial reconstructive procedures. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. Peer Review: This article was reviewed by the Editor-in-Chief and one Deputy Editor, and it underwent blinded review by two or more outside experts. The Deputy Editor reviewed each revision of the article, and it underwent a final review by the Editor-in-Chief prior to publication. Final corrections and clarifications occurred during one or more exchanges between the author(s) and copyeditors.
Hearing aid use among older U.S. adults; the national health and nutrition examination survey, 2005-2006 and 2009-2010.

Objectives The authors estimated the proportion of older adults in the United States who report hearing aid use among those likely to benefit. To more fully understand what factors underlie the low proportion of hearing aid use, the authors examined a variety of socio-demographic correlates as well as measures of health care access and insurance status in relation to hearing aid use among potential hearing aid candidates. Design The study makes use of cross-sectional data collected during 2005-2006 and 2009-2010 as part of the National Health and Nutrition Examination Survey. The 1636 adults aged 70 years and older were selected by using a complex sampling design and comprise a nationally representative sample. In addition to self-reported hearing aid use, data on pure-tone thresholds, perceived hearing ability, place for routine health care, time since last hearing test, type of insurance coverage, and socio-demographic characteristics including age, sex, race/ethnicity, family size, and income-to-poverty ratio were collected. The analytical sample consisted of 601 adults who had a better-ear pure-tone average of ≥35 dB HL at 500, 1000, and 2000 Hz or who reported moderate or worse hearing ability. Results One third of the potential hearing aid candidates reported current use of hearing aids. The authors observed a 28 to 66% greater prevalence of hearing aid use among older adults in the upper four fifths of the income-to-poverty distribution compared with those in the bottom one fifth. Compared with people who had their hearing tested 5 to 9 years ago, those with more recent hearing tests were more than two to three times as likely to be a current hearing aid user. No differences were observed by age after adjusting for pure-tone average and no differences were observed by sex after adjusting for perceived hearing ability. No differences were observed by place of routine health care or by type of insurance coverage. Conclusions Use of hearing aids is low among older adults who might benefit. Identifying and surmounting barriers to hearing aid use, especially among low-income adults, remains an important objective for hearing health care in the United States.
An Experimental Study of the Stability of a Four-Vortex System

An experiment is currently being conducted at the University of Notre Dame to investigate the interactions, and ultimately the instabilities, that persist in a four-vortex wake. A wake consisting of four trailing vortices was created in Notre Dame’s atmospheric boundary layer wind tunnel. The advantage of this tunnel is the long test section, which permits the observation of wake interactions at distances up to thirty wake-spans downstream of the point of generation. The wake was created by four high aspect ratio wing models such that the circulation strength and the spacing between each vortex in the wake may be controlled. The principle aim of this study is to experimentally determine the optimal configurations, based on circulation strength and spacing, that are consistent with the rapid amplification of certain wake vortex instability modes. The primary method for evaluating the experimental facility has been flow visualization. Helium bubbles were introduced into the core region of individual vortices to visualize these wake structures. This paper presents some early results from the visualization of the four-vortex wake. These results suggest that the use of helium bubbles is a suitable method for visualizing wake vortices for the full length of the test section.
CDKL5 Mutations in Boys With Encephalopathy and Early-Onset Intractable Epilepsy

Clinical and EEG data of 3 Italian boys (ages 3, 9, and 13 years) with severe early-onset encephalopathy, mental retardation, facial dysmorphisms, and intractable epilepsy were found to carry missense mutations in the CDKL5 gene, in a report from Troina, Italy.
Dexamethasone accelerates differentiation of A6 epithelia and increases response to vasopressin

When seeded heavily on a porous tissue culture dish, A6 cells, derived from the kidney of Xenopus laevis, form a highly differentiated epithelium within 4-6 days. When dexamethasone is added to the culture medium, morphological differentiation is completed by day 2, a time at which the control (untreated) is still a disorganized multilayer of cells. In addition to the morphologically evident monolayer of cuboidal cells, the accelerated differentiation is expressed as high transepithelial electrical resistance, short-circuit current, and adenylate cyclase response to vasopressin. When grown on impermeable plastic tissue culture dishes, A6 epithelia are less differentiated and do not respond to vasopressin. With the addition of dexamethasone at the time of seeding on a plastic tissue culture dish, vasopressin responsive adenylate cyclase activity is expressed, albeit at a slower rate than when grown on a porous surface. In addition, dexamethasone treatment of mature epithelia grown on a porous surface results, in hours, in an increase in the adenylate cyclase response to vasopressin. These results reveal two previously unrecognized interactions between adrenal steroid hormones and vasopressin, namely, accelerated differentiation and increased responsiveness of adenylate cyclase.
Olympic Technologies: Tokyo 2020 and Beyond: The Urban Technology Metropolis

The Olympic Games bring tremendous impacts to host cities, yet little attention has been paid to the variety and novelty in urban technologies that are introduced through the mega-event vehicle. This paper argues that urban transformation associated with the Olympic Games increasingly spans the technological sphere. As a path-breaker the Olympic bid of Tokyo foreshadows a technological revolution that will make the capital of Japan the most advanced urban technology metropolis in the world. This is significant, as this pioneer for the city of the future may yield many valuable insights given the rapid implementation and acceleration of technological innovation proceeding into 2020. Consequently, lessons on how this technology may impact our society can be derived.
Organ Electrodermal Diagnostics

The location of the skin zone at which a high degree of rectification (after the skin breakthrough effect has been obtained) and increased impedance are observed indicates which particular organ is diseased. The degree of rectification and difference in impedance indicate the extent of the pathological process within this organ. These findings created the groundwork for a new noninvasive diagnostic method: organ electrodermal diagnostics (OED). OED initiates a separate generation of medical diagnostics which gets access to the priceless diagnostic information circulating in the sensory nervous system. Therefore, OED detects diseased internal organs/body parts (“regional diagnostics”) and precisely estimates the activity of disease within these organs/body parts, but does not directly explain the cause of pathology. Clinical trials confirmed that OED is a reliable bioelectronic method with high rates of sensitivity, specificity, and predictive values. OED produces unequivocal diagnostic results immediately, with no need for any additional calculations. The use of optimal measuring parameters ensures accurate diagnostic results while avoiding any unpleasant sensations. Special attention should be paid to the ability of OED to investigate organs that are not easily accessible by means of standard diagnostic methods. Furthermore, it makes a rapid assessment of all internal organs possible. The OED procedure is painless, easy to perform, quick, and cost effective.
Atomic Spectra and Quantum Numbers

From the viewpoint of a planetary model of the atom, the discrete emission spectrum of hydrogen (and the other elements) made no sense. After all, like planets orbiting the sun, electrons should be able to orbit an atomic nucleus at any conceivable frequency. So according to the Maxwell’s theory of electrodynamics, they should be capable of emitting every conceivable color of light. But atomic gases typically emit (and absorb) only particular colors. Moreover, orbiting electrons should continually emit radiation—and hence lose energy—spiraling into the atomic nucleus. The atom should thus be unstable.
Uniformization of Asymptotic Expansions

We develop a general technique for uniformizing asymptotic expansions. A basic formula for uniformizing counterterms is constructed by nesting an increasing number of extensions. Two successive extensions are shown to contain the counterterms for both secular terms and for singular perturbation terms. Simple examples are used to illustrate the method. A general constructive procedure is outlined to determine the counterterms from the nonuniformities arising in the direct perturbation expansion. A relationship is established between the secular perturbation counterterms and the singular perturbation counterterms. Finally, a brief review is given of the main results obtained so far and of the open problems.
Windshield Metrology: Simultaneous measurement of wedge angle and layer thickness

An interferometric apparatus to simultaneously measure individual layer thickness and wedge angle profiles in multilayer windshields is described along with its measurement reproducibility. A hand-held probe is used to simplify alignment to the windshield surface.
Utilization of a Partially Non-aqueous Electrolyte for the Spatial Mapping of Mg Corrosion Using a Model Mg–Al Electrode

In-situ techniques to spatially map micro-galvanic corrosion are particularly important for alloys with heterogeneous microstructures. In particular, scanning electrochemical microscopy (SECM) has been utilized to map microstructural features on Mg which may control the corrosion rate. However, rapid corrosion rates of Mg in fully aqueous environments interfere with mapping capabilities. A mixed aqueous and non-aqueous electrolyte, containing methanol and H2O, is proposed which is capable of mapping the active corrosion on Mg with time. However, thorough understanding the effect of methanol additions on the corrosion rate was required. Therefore, the intrinsic corrosion rates of Mg in varying amounts of methanol (0–100 wt%) were investigated using electrochemical impedance spectroscopy (EIS) by exploring the corrosion rate on an Al wire embedded in Mg as a galvanic couple. The nature of the non-aqueous electrolyte on the EIS response is discussed. The evolution of this intrinsic corrosion behavior at the galvanic couple was investigated using a combination of optical microscopy, SECM and mixed potential theory.
Applying the Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI) in Myeloablative MUD Transplants Predicts NRM and OS Using a Modified 2-Tier Scoring System.

Abstract Background: The HCT-CI is a recently developed comorbidity score which has been adapted to hematopoietic stem cell transplantation, and identified 3 risk groups with increased non-relapse mortality (NRM) and lower overall survival (OS) (Blood 2005; 106:2912). We determined the HCT-CI score in a cohort of patients who underwent myeloablative MUD transplantation in a single arm, institutional trial assessing the efficacy of a combination of cyclosporine, methotrexate and prednisone for GVHD prophylaxis. Methods: The analysis included all patients undergoing MUD transplant from 1996–2006 who received GVHD prophylaxis with cyclosporine 2 mg/kg iv BID from day −2, methotrexate 15 mg/m2 iv on day +1 and 10 mg/m2 iv on days +3 and +6, and methylprednisolone 0.25 mg/kg iv BID beginning on day +7 and tapering from day +28. Patients were stratified by disease risk per CIBMTR classification. The comorbidities were obtained by retrospective chart review and scored according to the HCT-CI score. Results: 150 patients (median age 40) received the 3 drug-regimen, including 38% with low-, 34% with intermediate- and 28% with high-risk disease. Diagnoses included acute leukemia in 50%, MDS in 12%, CML in 15%, lymphoma in 18%, and multiple myeloma in 3.0%. Conditioning regimens included Cy-TBI in 64% and Bu-Cy in 21%. Source of stem cells was PBSC in 47.3% and marrow in 50.7%. HCT-CI scores of 0, 1–2 or ≥3 were found in 17%, 30% and 53% of patients evaluated. The majority of comorbidities were pulmonary (72%). With a median follow-up of 46 weeks, day 100 and 5-year OS were 82.7 and 33%, with a 23% and 50.4% cumulative incidence of NRM. Five year relapse-related mortality was 15.8%. Although higher HCT-CI scores were associated with increased NRM and decreased OS, no statistically significant differences were detected when using the published HCT-CI grouping of 0, 1–2 and ≥3. Unadjusted hazard ratio (HR) for inferior survival were 0.9 (CI 0.47–1.85, P=.79) and 1.65 (CI 0.885–3.090, P=.11) for scores 1–2 and ≥3, respectively. We then determined an alternate prognostic model based on 2 groups. Statistical modeling separated patients with a score of 0–3 (n=97, 64%) and ≥4 (n=53, 35.6%), with a 3 month and 5 year OS of 84% and 45% versus 52% and 10%, respectively (P Conclusions: While our data confirm that the HCT-CI score is predictive of NRM and OS in a high-risk MUD transplant cohort, we were unable to detect statistically significant differences between the 3 risk groups defined in the original score. A modified 2-group scoring system readily stratified the patient population into low-risk and high-risk risk groups with scores of 0–3 and ≥4, respectively, that was predictive of OS and NRM. This simplified, 2-tiered scoring system will have utility in clinical decision-making and in defining patient populations eligible for clinical trials. Additional single and multi-institutional analyses will ultimately determine the optimal applications of the HCT-CI score.
Adapting cities, adapting the curriculum

This article is the second of two on teaching about sustainability and cities in geography. The first article set the scene by assessing sustainability initiatives and arguing that the most profoun...
Gender and Institutions in Post-Transition Executives

Significant research has examined the rise of women to positions of parliamentary and legislative power throughout the world. Much less research has considered women as executives, although this is rapidly changing. Yet, even with this new research on executives, very little of it has focused on what women do once elected to executive office, and it has often overlooked post-transition democracies. Post-transition democracies are unique because they have recently undergone regime change, they face institutional fluidity in their new democratic institutions, and they often struggle with democratic governance. This chapter offers some theoretical insights into how political institutions affect the election of women and women’s governing in executive office, emphasizing the specific nuances of gender and executives in post-transition democracies.
Microprocessors and Multiprocessing

Multiprocessing, previously a rather expensive task, now can be performed cheaply and efficiently by microprocessors. But what is multiprocessing? Intepretation of this term is frequently confusing. In a general sense, multiprocessing is the use of a number of processors to carry out a single task, partitioned into subtasks and usually executed at the same time. Assume, for example, that an application requires a throughput equivalent to a microprocessor operating at a clock rate of 60 MHz. Such a device would be hard to find and quite costly to construct. If, however, the application is divided into, say, 10 subtasks, each of which is executed concurrently by 10 different microprocessors, an effectively high throughput results. This, of course, is only a rough definition of multiprocessing.
Transform with no Parameters Based on Extrema Points for Non-stationary Signal Analysis

Signal transforms are very important tools to extract useful information from scientific, engineering, or medical raw data. Unfortunately, traditional transform techniques impose unrealistic assumptions on the signal, often producing erroneous interpretation of results. Well-known integral transforms, such as short-time Fourier transform, though have fast implementation algorithms (e.g., FFT), are still computationally expensive. They have multiple parameters that should be tuned, and it is not readily clear how to tune them for long-duration non-stationary signals. To solve these problems, one needs a computationally inexpensive transform with no parameters that will highlight important data aspects. We propose a simple transform based on extrema points of the signal. The transform value at a given point is calculated based on the distance and magnitude difference of two extrema points it lies between, rather than considering every point around it. We discuss implementation of the developed algorithm and show examples of successfully applying the transform to noise-corrupted synthetic signals and to sleep studies detecting delta wave in brain EEG signal. Ideas for improvement and further research are discussed.
An Object-Oriented Database for Project Cost Compilation

Larger construction companies generally have several on-going projects at one time, many internationally. The ability to make corporate decisions in a timely manner for these companies becomes critical to avoid costly corrective measures. The information necessary for making such decisions comes from a large pool of corporate data. In order to efficiently process large amount of data, an information model for multiple project management is essential. In this research, an information model based on Cost is designed and presented (OCIM, Object-oriented Cost Information Model). A prototype system is developed based on the model using an object-oriented database. Using the periodical update feature of the prototype system, an immediate access to necessary information by the user is made possible. The different levels of information abstraction are also achieved to meet the different level of the user.
EPBC: E fficient P ublic B lockchain C lient for lightweight users

Public blockchains provide a decentralized method for storing transaction data and have many applications in different sectors. In order for a user to track transactions, a simple method is that every user keeps a local copy of the entire public ledger. Since the size of a ledger keeps growing, this method becomes increasingly less practical, especially for lightweight users such as IoT devices and smartphones. In order to deal with this problem, there have been some proposals. However, existing solutions either achieve a limited storage reduction (e.g., simple payment verification), or rely on some strong security assumption (e.g., the use of trusted server). We propose EPBC, a novel and efficient transaction verification scheme for public ledgers, which only requires lightweight users to store a small amount of data that is independent of the size of the blockchain. We analyze EPBC's performance and security, and discuss its integration with existing public ledger systems. Experimental results confirm that EPBC is practical for lightweight users.
Cortical features of locomotion-mode transitions via non-invasive EEG

This study investigates the neural features of locomotion mode transitions (i.e., level-ground walking to stair ascent) from non-invasive electroencephalography (EEG) signals. A systematic EEG processing method was implemented to reduce artifacts. Source localization using independent component analysis and k-mean clustering algorithm revealed the involvement of four clusters in the brain (Left and Right Occipital Lobe, Posterior Parietal Cortex, and Motor Cortex) during the walking tasks. Our results show significant differences in spectral power in the Occipital cluster between level-ground (LW) and stair (SA) walking. Additionally, significant increases in spectral power were detected up to 1.4 second before the critical transition time (LW to SA). The findings have implications for developing noninvasive lower-limb neuroprostheses that predict, rather than respond to, the user gait intentions. This work is a further step toward the development of a multimodal Neural-machine Interface (NMI) that fuses EEG and electromyography (EMG) signals for intuitive and flexible control of power prosthetic legs.
Simple and robust referencing system enables identification of dissolved-phase xenon spectral frequencies

Purpose To assess the effect of macroscopic susceptibility gradients on the gas-phase referenced dissolved-phase 129 Xe (DPXe) chemical shift (CS) and to establish the robustness of a water-based referencing system for in vivo DPXe spectra. Methods Frequency shifts induced by spatially varying magnetic susceptibility are calculated by finite-element analysis for the human head and chest. Their effect on traditional gas-phase referenced DPXe CS is then assessed theoretically and experimentally. A water-based referencing system for the DPXe resonances that uses the local water protons as reference is proposed and demonstrated in vivo in rats. Results Across the human brain, macroscopic susceptibility gradients can induce an apparent variation in the DPXe CS of up to 2.5 ppm. An additional frequency shift as large as 6.5 ppm can exist between DPXe and gas-phase resonances. By using nearby water protons as reference for the DPXe CS, the effect of macroscopic susceptibility gradients is eliminated and consistent CS values are obtained in vivo, regardless of shimming conditions, region of interest analyzed, animal orientation, or lung inflation. Combining in vitro and in vivo spectroscopic measurements finally enables confident assignment of some of the DPXe peaks observed in vivo. Conclusion To use hyperpolarized xenon as a biological probe in tissues, the DPXe CS in specific organs/tissues must be reliably measured. When the gas-phase is used as reference, variable CS values are obtained for DPXe resonances. Reliable peak assignments in DPXe spectra can be obtained by using local water protons as reference. Magn Reson Med 80:431-441, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
Optimization of Tube Potential for Radiation Dose Reduction in CT

Tube potential is an important scanning parameter that should be optimized in clinical CT in order to improve image quality or reduce radiation dose. The main benefit of lower tube potentials is the improved enhancement of contrast materials relative to higher tube potentials. However, there is usually increased image noise at lower tube potentials, especially for larger patient sizes. This tradeoff between contrast enhancement and noise requires that patient size and diagnostic task be carefully considered when selecting the optimal tube potential for radiation dose reduction. In addition, CT x-ray tube and generator limitations, scanning speed, and artifacts must also be considered. This chapter describes the basic principles of optimal tube potential for radiation dose reduction in CT and provides a summary of recent development on automatic selection of optimal tube potential.
Quantitative Materials Characterization of Elastic Plates Using Air-Coupled Leaky Lamb Waves

The signal-to-noise penalty of air or gas-coupled ultrasonics has so far limited its application principally to feasibility demonstration experiments and qualitative assessments of material condition [1–3]. In most cases to date, use of air-coupled ultrasound to estimate material properties has been performed by observing the phase-matched transmitted signal amplitude and correlating this occurrence with the plate wavespeed. While this approach has approximate validity, other experimental conditions, including geometry and frequency, as we have shown [4], can significantly alter the estimate of material properties made only on the basis of phase-matched amplitude extrema. In addition, since the acoustic impedance mismatch is so large in air-coupled measurements, material damping plays a greatly enhanced role in determining the nature of the transmitted or reflected field.
Animal Models in Retinoblastoma Research

Many animal models of retinoblastoma exist, each of which recapitulates some, but not all, of the features of human disease. The most commonly used models that are available are described in this chapter. These include various genetic and xenograft models of retinoblastoma and include a multitude of species, such as mice, rats, rabbits, pigs, and nonhuman primates. A wide array of uses of animal models in retinoblastoma research are presented here, including those for the study of tumor biology and response to treatment, assessment of pharmacokinetics, and measurement of chemotherapeutic toxicity and efficacy for drug discovery. Importantly, we discuss the relative strengths and limitations of each model. Factors for investigators to consider in designing various types of experiments are highlighted, including type of tumor model (genetic or xenograft), immune status (native, immunologically naive, genetically immunocompromised, or pharmacologically immunosuppressed), and choice of species. While a particular model may be ideal for a certain use, no single model is appropriate for all experiments. Species-specific factors are especially critical when studying regional and local chemotherapy delivery.
An Assessment of an Outpatient Urology Clinic’s Compassion, Comfort and Knowledge of Transgender Care

AbstractIntroduction:Transgender patients face significant barriers to care, including providers who lack compassion, comfort and knowledge. We assessed the preparedness of an outpatient urology cl...
Green Optical Networking for Big Data Transfer

Recent advances in computing and sensing techniques lead to the generation of tons of data that needs to be processed in distributed computing infrastructures (e.g., datacenters). In this paper, we focus on applying optical networking techniques for supporting the big data transfer between datacenters. In particular, we propose a green optical networking scheme, namely predictive and incremental grooming (PI-grooming), which makes the traffic grooming decision based on the existing flow assignment, the current traffic demands, and the expected future traffic demands to achieve energy-efficient communication. We conduct large-scale simulations to evaluate the performance of the proposed PI-grooming scheme. The results show that PI-grooming can save energy by up to 25% compared to existing baseline solutions.
Alcohol withdrawal is associated with poorer outcome in acute ischemic stroke

Objective To determine the association between alcohol abuse (AA) and alcohol withdrawal (AW) with acute ischemic stroke (AIS) outcomes. Methods All adult AIS admissions in the United States from 2004 to 2014 were identified from the National Inpatient Sample (weighted n = 4,438,968). Multivariable-adjusted models were used to evaluate the association of AW with in-hospital medical complications, mortality, cost, and length of stay in patients with AIS. Results Of the AA admissions, 10.6% of patients, representing 0.4% of all AIS, developed AW. The prevalence of AA and AW in AIS increased by 45.2% and 40.0%, respectively, over time (p for trend 50% increased odds of urinary tract infection, pneumonia, sepsis, gastrointestinal bleeding, deep venous thrombosis, and acute renal failure compared to those without AW. Patients with AW were also 32% more likely to die during their AIS hospitalization compared to those without AW (odds ratio 1.32, 95% confidence interval 1.11–1.58). AW was associated with ≈15-day increase in length of stay and ≈$5,000 increase in hospitalization cost (p Conclusion AW is associated with increased cost, longer hospitalizations, and higher odds of medical complications and in-hospital mortality after AIS. Proactive surveillance and management of AW may be important in improving outcomes in these patients.
Hydraulic conductivity of bentonite-polymer geosynthetic clay liners to coal combustion product leachates

Abstract Hydraulic conductivity of seven geosynthetic clay liners (GCLs) to synthetic coal combustion product (CCP) leachates were evaluated in this study. The leachates are chemically representative of typical and worst scenarios observed in CCP landfills. The ionic strength (I) of the synthetic CCP leachates ranged from 50 mM to 4676 mM (TCCP-50, LRMD-96, TFGDS-473, LR-2577, HI-3179 and HR-4676). One of the GCLs contained conventional sodium bentonite (Na–B) and the other six contained bentonite-polymer (B–P) mixture with polymer loadings ranging from 0.5% to 12.7%. Hydraulic conductivity tests were conducted at an effective confining stress of 20 kPa. The hydraulic conductivity of the Na–B GCLs were >1 × 10−10 m/s when permeated with all six CCP leachates, whereas the B–P GCLs with sufficient polymer loading maintained low hydraulic conductivity to synthetic CCP leachates. All the B–P GCLs showed low hydraulic conductivity ( 5% showed low hydraulic conductivity (
Functional Near-Infrared Spectroscopy (fNIRS) in Neuroergonomics

This chapter focuses on functional near-infrared spectroscopy (fNIRS) and its applications in the field of neuroergonomics. Due to the small, portable, and flexible nature of fNIRS, it has been able to track the neurocognitive behavior of participants during complex and ambulatory activities. This chapter presents a comprehensive summary and review of fNIRS technology with respect to its design, implementation, and measurements. The three different types of fNIRS that exist—continuous wave, frequency domain, and time domain—are further explained through example studies of each tool in action. We also provide detailed technological information on numerous studies that focus on the four main topics that fNIRS has frequently been used for: driving, mental workload, motor function, and decision-making. It then concludes with the directions and potential applications that fNIRS can be used for in the future. The main purpose of this chapter is to show the necessity and value of fNIRS in research and how it is able to provide accurate information in situations that would have otherwise been inaccessible.
Breakfast Skipping, Body Composition, and Cardiometabolic Risk: A Systematic Review and Meta-Analysis of Randomized Trials

Objective The objective of this study was to evaluate the effect of skipping breakfast on body composition and cardiometabolic risk factors. Methods This study conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating breakfast skipping compared with breakfast consumption. Inclusion criteria included age ≥ 18, intervention duration ≥ 4 weeks, ≥ 7 participants per group, and ≥ 1 body composition measure. Random-effects meta-analyses of the effect of breakfast skipping on body composition and cardiometabolic risk factors were performed. Results Seven RCTs (n = 425 participants) with an average duration of 8.6 weeks were included. Compared with breakfast consumption, breakfast skipping significantly reduced body weight (weighted mean difference [WMD] = -0.54 kg [95% CI: -1.05 to -0.03], P = 0.04, I2 = 21.4%). Percent body fat was reported in 5 studies and was not significantly different between breakfast skippers and consumers. Three studies reported on low-density lipoprotein cholesterol (LDL), which was increased in breakfast skippers as compared with breakfast consumers (WMD = 9.24 mg/dL [95% CI: 2.18 to 16.30], P = 0.01). Breakfast skipping did not lead to significant differences in blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, C-reactive protein, insulin, fasting glucose, leptin, homeostatic model assessment of insulin resistance, or ghrelin. Conclusions Breakfast skipping may have a modest impact on weight loss and may increase LDL in the short term. Further studies are needed to provide additional insight into the effects of breakfast skipping.