cssi/SciSciGPT-SciSciNet huggingface dataset:
Homoclinic solutions for a higher order difference equation with p-Laplacian

Abstract We study a higher order difference equation defined on Z with p -Laplacian and containing both advance and retardation. By using the critical point theory, sufficient conditions are obtained for the existence of infinitely many homoclinic solutions of the equation. The proof is based on the fountain theorem in combination with the variational technique. In particular, considerable effort has been made in the paper to construct a variational framework for the problem under study. Some known results in the literature are extended and complemented.
Classification of Acute Respiratory Failure

Acute respiratory failure can result from a wide variety of etiologies. Hypoxemia is the hallmark of this condition and is responsible for the major clinical signs and symptoms. The use of arterial blood gas analysis is the cornerstone of diagnosis and is also critical in the subsequent evaluation of the effectiveness of therapy. Treatment must be individualized and coordinated in the setting of an intensive care unit.
Morphology of the Neuroendocrine System of the Pink Bollworm and Histological Changes in the Neurosecretory Cells of the Brain during Induction, Maintenance, and Termination of Diapause,

Based on location and reactions to histological stains, 8 types of neurosecretory (NS) cells were observed in the brain of the pink bollworm, Pectinophora gossypiella (Saunders). In addition, NS cells were found in the frontal ganglion and corpus cardiacum. Substantial changes in staining intensity and size of perikarya and nuclei occurred in several NS cell types during maintenance and termination of diapause. Changes were most prominent in M-1 and M-2 cells, but most types showed larger amounts of stainable granular cytoplasmic inclusions during diapause.
A New Method to Characterize Dislocation Loops

White-beam synchrotron X-ray topography has been used to study the circular, prismatic, [0001] dislocation loops which are commonly-observed on the (0001) plane in polycrystalline, freshwater ice. A new method, involving detailed analyses of the effects of beam divergence on the loop images, has been developed to determine whether a loop is of vacancy or interstitial type. In an 0002 image, one half of a loop (projected as an ellipse) appears as a single image and the other half as a double image. Experimentally, it was found that the 0002 vector drawn from the center of a loop passes through the single image if the loop is of vacancy-type and through the double image if a loop is of interstitial-type. This method of loop characterization was confirmed by performing theoretical analyses of both the dislocation image widths and their strain fields.
Several Results on Trees

As known,trees play an important role in research of graph theory and complex networks.Let nd(G) denote the number of vertices of degree d in a graph G.By means of the formula n1(T)=2+(d-2)nd(T) for computing the number of vertices of degree one,it proves that △(G)+D(G)≤n+1 for any connected graph G on n vertices,and moreover a planar graph G has its number of faces as 2 φ(G)=4+(d-2)nd(G).
Sex Offending and the Transition From Adolescence to Adulthood A Cross-Lagged Analysis of General Offending and Sexual Assault in College Males

The purpose of this study was to determine the direction of the general offending–sexual assault relationship in young males transitioning from late adolescence to early adulthood. It was predicted that the path leading from general offending to sexual assault would be significant and the path leading from sexual assault to general offending would be non-significant. This hypothesis was tested in a convenience sample of 851 male college students using three waves of data. Four cross-lagged correlations were compared after controlling for race, relationship status, blame attributions, and precursors for each predicted variable. Consistent with the hypothesis, both general offending leading to sexual assault pathways were statistically significant and both sexual assault leading to general offending pathways were not non-significant. Supplemental analyses revealed that more than half the specific non-sexual offenses contributing to the general offending score were capable of predicting general offending, in...
Specifying Energy Efficient Motors in Industry Standards

Despite the promotions of energy-conscious organizations, premium efficient motors are not being specified by industry nor included in industry specifications. We propose that manufacturers of motors and drives, consultants and users who serve on industry standards committees make an effort to revise standards to include efficiency levels and call attention to life cycle costs relative to motors and drives.
Landscape-scale characteristics of forest tornado damage in mountainous terrain

Landscape patterns created by natural disturbance such as windstorms can affect forest regeneration, carbon cycling, and other ecological processes. We develop a method for remotely measuring tornado damage severity and describe landscape-scale patterns of tornado damage. We examine the extent and distribution of damage severity and gaps created by tornadoes, and examine how topographic variation can influence tornado damage severity. Focusing on two April 2011 tornadoes that struck the Chattahoochee National Forest (CNF) in Georgia and the Great Smoky Mountains (GSM) in Tennessee, we used supervised classification of aerial photographs to map damage severity. We report the extent and distribution of damage severity from each track and characterize patterns of damage using FragStats. Using topographic overlays, we test hypotheses regarding how physiographic features such as valleys and ridges affect tornado damage severity. Tornado damage severity estimates were significantly correlated with ground-truth measurements. The 64-km CNF track damaged 1712 ha (>25 % severity), while the 26-km GSM track damaged 1407 ha. Tornado damage severity was extremely variable and frequency of gap sizes drastically decreased with size, with many small gaps and few very large gaps, consistent with other types of wind damage. Damage severity declined as tornadoes ascended ridges and increased as they descended ridges. This effect was more consistent on shallow slopes relative to steeper slopes. This study outlines an objective methodology for remotely characterizing tornado damage severity. The results from this study fill an important gap in ecological understanding of the spatial components of the forest tornado disturbance regime.
Tumor-bone interactions: There is no place like bone

Cancer whether from solid tumors or in the form of hematologic malignancies frequently spreads to bone where it will disrupt the balance of bone remodeling between bone formation and resorption. Cancer patients with skeletal complications will experience severe clinical consequences affecting their quality of life, the worst of all being that cancer in bone remains incurable. As research and our understanding of these pathologies are progressing, the intricate interactions between cancer cells and bones are being revealed showing us that the affinity of cancer cells for bone is already determined in the primary tumor or how cancer cells can prepare the metastatic niche prior to colonizing the skeleton. These complex processes are regulated by multiple genes that cooperate to ensure cancer cell growth and survival, despite the treatments developed. In this chapter, we will review the mechanisms controlling the different steps leading to overt metastases and how these could be used to develop new therapies to prevent skeletal complications of malignancies or to cure cancer from bone.
Framework for Analysis

In trying to understand Soviet-Russian behaviour, and the conduct of the USSR’s foreign relations, especially with its neighbours, an analyst is overwhelmed by the abundance of explanatory theories of Soviet behaviour which proliferated in the West. These contending theories attracted passionate proponents, who claimed to know and present the Soviet ‘reality’. However, to follow a theory is ultimately to adopt a particular observational framework, and to create a ‘new reality’. Some of the theories of Soviet foreign policy are mutually compatible, others are contradictory.
A survey of methods for time series change point detection

Change points are abrupt variations in time series data. Such abrupt changes may represent transitions that occur between states. Detection of change points is useful in modelling and prediction of time series and is found in application areas such as medical condition monitoring, climate change detection, speech and image analysis, and human activity analysis. This survey article enumerates, categorizes, and compares many of the methods that have been proposed to detect change points in time series. The methods examined include both supervised and unsupervised algorithms that have been introduced and evaluated. We introduce several criteria to compare the algorithms. Finally, we present some grand challenges for the community to consider.
Cloud seeding clears the air

Scientists have long wanted to manipulate the weather. The most common idea is that clouds can he "seeded" to produce rain in areas of drought, but an equally important goal is to clear fog around airports and other areas where visibility is impaired. In the last several years, my team at the University of Utah has developed a new seeding technique that can clear supercooled cloud and fog on a scale several times larger than a commercial airport. The method, which can he applied from a vehicle on the ground, has been used to clear airports, cities and roads, and has recently helped NATO peace-keeping operations at Bosnian airports.
Information Control, Transparency, and Social Media: Implications for Corruption

Although the research linking social media and corruption is still in infancy, it provides important insights. It has been shown that social media can prove to be an important tool in fighting corruption. At the same time, freedom on the net is under threat in many parts of the world with governments using a variety of methods, including designing vague and flexible security laws as well as employing technological means, to censor the content that can be shared and accessed by net users. This chapter discusses the implications that government control over information can have for the effects of social media on corruption. It suggests that freedom on the net and the anonymity of net users must be protected if the effects of social media on corruption are to be fully realized.
Preservice Elementary Teachers’ Instructional Practices and the Teaching Science as Argument Framework

The research reported in this study examines the very first time the participants planned for and enacted science instruction within a “best-case scenario” teacher preparation program. Evidence from this study indicates that, within this context, preservice teachers are capable of implementing several of the discursive practices of science called for in standards documents including engaging students in science investigations and constructing evidence-based explanations. The participants designed experiences that allowed their students to interact with natural phenomena, gather evidence, and craft explanations of natural phenomenon. The study contends that the participants were able to achieve such successes due to their participation in a teacher education program and field placement, which were designed using a comprehensive, conceptual framework. Video of the participant’s teaching and annotated self-analysis videos served as the primary data for this study. Implications for future research and elementary science teacher education are discussed.
Utilizing microsphere-based enhanced-intensity laser ablation for nanopatterning polymers

We use rigorous scattering matrix simulations to develop a pathway for synthesizing nanopatterns on polymer surfaces. We consider a system in which the polymer surfaces are initially coated with periodic microspheres in a close packed lattice. When such a lattice is irradiated with a laser of desired wavelength and power, the electric field intensity beneath the spheres is enhanced by more than an order of magnitude, generating localized heating that can remove nanometersize volume of the material in a periodic array of nanocavities. The array of glass spheres can be self-assembled on any curved surface, and these spheres can be utilized as an optical lens to focus light energy within the surface. Our simulations show that the depth and size of the nano-cavities depends critically on the size of microspheres.
Two Photon Holographic Stimulation System for Cellular-Resolution Interrogation of Olfactory Coding

We developed an all-optical multiphoton system for efficient, high rate (>100 fps) simultaneous stimulation and imaging of olfactory bulb neurons. Integration with an olfactory delivery setup, allows to dissect olfactory coding in behaving mice.
Atrial fibrillation decision support tool: Population perspective.

Background Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. The recent availability of direct oral anticoagulants (DOACs) with comparable efficacy and improved safety compared with warfarin alters the balance between risk factors for stroke and benefit of anticoagulation. Our objective was to examine the impact of DOACs as an alternative to warfarin on the net benefit of oral anticoagulant therapy (OAT) in a real-world population of AF patients. Methods This is a retrospective cohort study of patients with paroxysmal or persistent nonvalvular AF. We updated an A trial F ibrillation D ecision S upport T ool (AFDST) to include DOACs as treatment options. The tool generates patient-specific recommendations based upon individual patient risk factor profiles for stroke and major bleeding using quality-adjusted life-years (QALYs) calculated for each treatment strategy by a decision analytic model. The setting included inpatient and ambulatory sites in an academic health center in the midwestern United States. The study involved 5,121 adults with nonvalvular AF seen for any ambulatory visit or inpatient hospitalization over the 1-year period (January through December 2016). Outcome measure was net clinical benefit in QALYs. Results When DOACs are a therapeutic option, the AFDST recommends OAT for 4,134 (81%) patients and no antithrombotic therapy or aspirin for 489 (9%). A strong recommendation for OAT could not be made in 498 (10%) patients. When warfarin is the only option, OAT is recommended for 3,228 (63%) patients and no antithrombotic therapy or aspirin for 973 (19%). A strong recommendation for OAT could not be made in 920 (18%) patients. In total, 1,508 QALYs could be gained if treatment were changed to that recommended by the AFDST. Conclusions Availability of DOACs increases the proportion of patients for whom oral anticoagulation therapy is recommended in a real-world cohort of AF patients and increased projected QALYs by more than 1,500 when all patients are receiving thromboprophylaxis as recommended by the AFDST compared with current treatment.
Does adjuvant radiation provide any survival benefit after an R1 resections for pancreatic cancer

Abstract Background The benefit of adding external beam radiation to adjuvant chemotherapy in patients that have undergone a margin positive resection for early stage, pancreatic ductal adenocarcinoma has not been determined definitively. Methods The National Cancer Data Base was queried to evaluate the utility of adjuvant radiation in patients with pathologic stage I–II pancreatic ductal adenocarcinoma who underwent upfront pancreatoduodenectomy with a positive margin (margin positive resection) between 2004 and 2013. Results In the study, 1,392 patients met inclusion criteria, of whom 263 (18.9%) were lymph node-negative (pathologic stages IA, IB, IIA) and 1,129 (81.1%) were node-positive (pathologic stage IIB); 938 (67.4%) patients received adjuvant radiation and chemotherapy, while 454 (32.6%) received adjuvant chemotherapy alone. Cox modeling stratified by nodal status demonstrated the benefit of radiation to be statistically significant only in node positive patients (hazard ratio 0.81, 95% confidence interval, 0.71–0.93). Node-positive patients receiving adjuvant radiation and chemotherapy had an adjusted median survival of 17.5 months vs 15.2 months for those receiving adjuvant chemotherapy alone (P = .003). In patients who had negative nodes, there was no difference in overall survival with radiation (22.5 vs 23.6 months, P = .511). Conclusion Addition of radiation to adjuvant chemotherapy after a margin positive resection confers a survival benefit albeit limited (about 2 months) in patients with node-positive pancreatic head cancer. (Surgery 2017;160:XXX-XXX.)
The Impact of Youth Language on Linguistic Landscapes in Kenya and Tanzania

Twenty-first-century youths are dynamic and so is their language. Their use of language informs both micro and macro language policies and language use in different domains. With the added advantage of the social media where the local meets the global, this type of language practice may be viewed as a linguistic revolt from below. It is well established that many African countries have legitimized their former colonial languages to serve official roles at the expense of local languages. However, in the often pervasively multilingual communities, language use in informal settings best reflects how ordinary people use language in daily life. Therefore, based on data collected in the cities of Nairobi and Mombasa in Kenya and Dar es Salaam and Arusha in Tanzania between 2012 and 2016, this chapter reports on how youth language is manifested in advertisements that are displayed on city signage. The chapter argues that the realities of a liberalized global economy have shifted the focus from corporate to small-scale entrepreneurs, thus elevating the youth to a position where they are not only consumers but also innovators and determinants of the linguistic direction in their respective speech communities. This is due to the fact that their innovation has caught the attention of the market that taps into youth language as a resource. Therefore, using an eclectic sociolinguistic approach that borrows from ideology, identity, language policy, and audience design approaches, the chapter investigates and reports on how linguistic landscapes utilize youth language to mirror these changes in the major cities of Kenya and Tanzania. This kind of approach allows for a recognition and reconfiguration of language policies that are based on evolving local linguistic ideologies that were never considered in past language policy formulations.
Epidemiology and disease management of Stewart's disease of corn in Iowa

Disease forecasting has been an important disease management component for Stewart's disease (Pantoea stewartii subsp. stewartii (syn. Erwinia)) of corn (Zea mays). To date, forecasting for Stewart's disease has been based exclusively on the examination of winter air temperatures for Dec., Jan., and Feb. Three forecasting models: Stevens (predictor of the early wilt phase of Stewart's disease), Stevens-Boewe (predictor of the late leaf blight phase of Stewart's disease), and Iowa State Model (predictor of the prevalence of Stewart's disease), were examined for their ability to accurately predict the prevalence of Stewart's disease in Iowa. Prevalence data were obtained from field inspections records for seed corn fields conducted under the auspices of the Iowa Department of Agriculture and Land Stewardship for the years between 1972 and 2003. Parameter coefficients for the three models were obtained using weighted binary logistic regression (weights were the number of fields inspected each season in a county) of seed com inspection and air temperature data between 1972 and 1999 {n = 786 county-years). All three models indicated increased odds for Stewart's disease with warmer winter air temperatures. An internal bootstrap validation of each model indicated that the Stevens model had a maximum error between the predicted and calibrated probabilities of 10%, while the other two models had maximum errors of 1 % or less. External validation using 154 independent county-years of seed corn inspection and
Combinatorial and Transformational Aspects of Euler’s Speculum Musicum

The paper examines the structural and conceptual differences between the Speculum musicum from Euler’s 1774 De Harmoniae, and the nineteenth-century Tonnetz, but also examines how Euler’s conception of intervals as paths within the Speculum anticipates a combinatorial conception of interval that underlies contemporary transformational theories.
Micropropagation of Sego Lily

The Sego lily (Calochortus nuttallii T. & G.) produces showy flowers and is a wild species indigenous to the western United States. A 3- to 5-fold increase in shoots per month was achieved when basal sections of bulbs were cultured on Schenk and Hildebrandt medium containing 88 mM sucrose and 8.9 µM 6-benzyladenine (BA) and subcultured every 28 d on the same medium but containing 88 mM sucrose, 2.2 µM BA, and 1.0 µM indole-3-butyric acid. Roots formed from 94% of shoots cultured at 13 °C on medium containing 88 mM sucrose and 2.7 µM α-naphthalene acetic acid. Bulbs formed at the base of shoots cultured on medium containing 263 mM sucrose.
Delineating the role of cooperativity in the design of potent PROTACs for BTK

Proteolysis targeting chimeras (PROTACs) are heterobifunctional small molecules that simultaneously bind to a target protein and an E3 ligase, thereby leading to ubiquitination and subsequent degradation of the target. They present an exciting opportunity to modulate proteins in a manner independent of enzymatic or signaling activity. As such, they have recently emerged as an attractive mechanism to explore previously “undruggable” targets. Despite this interest, fundamental questions remain regarding the parameters most critical for achieving potency and selectivity. Here we employ a series of biochemical and cellular techniques to investigate requirements for efficient knockdown of Bruton’s tyrosine kinase (BTK), a nonreceptor tyrosine kinase essential for B cell maturation. Members of an 11-compound PROTAC library were investigated for their ability to form binary and ternary complexes with BTK and cereblon (CRBN, an E3 ligase component). Results were extended to measure effects on BTK–CRBN cooperative interactions as well as in vitro and in vivo BTK degradation. Our data show that alleviation of steric clashes between BTK and CRBN by modulating PROTAC linker length within this chemical series allows potent BTK degradation in the absence of thermodynamic cooperativity.
Vaginal Mesh for Prolapse: An Epidemiologic and Historical Perspective

The process for introducing new surgical devices differs from drug evaluations. The US Food and Drug Administration (FDA) often clears medical devices through the 510(k) process, which evaluates safety by substantial equivalence to another device. New drug evaluations, however, assess both premarket efficacy and safety. Transvaginal mesh kits for pelvic organ prolapse were initially cleared in 2004 based on predicate synthetic suburethral slings and hernia mesh. Reported serious complications associated with transvaginal mesh use led to a 2008 FDA public health notification and 2011 safety communication. Subsequently, the FDA issued 522 orders for post-market surveillance data to all manufacturers of transvaginal mesh kits. Some companies ceased transvaginal mesh manufacturing, while others invested millions in research to satisfy these orders. Recently, the American Urogynecologic Society (AUGS) partnered with the FDA, other major medical societies, manufacturers, and representatives from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), to develop the Pelvic Floor Disorders Registry (PFDR), which launched the initial 522 studies. In addition, AUGS and the American College of Obstetricians and Gynecologists (ACOG) published and reaffirmed a committee document on vaginal placement of mesh in 2011 and 2015. In 2012, AUGS published guidelines for credentialing surgeons on transvaginal mesh use. Finally, in 2016, the FDA reclassified vaginal mesh devices from class II to class III, requiring manufacturers to provide premarket data. Careful patient selection, better surgeon training, advances in mesh design, and increased post-market surveillance of transvaginal mesh devices will lead to improved safety, decreased complications, and better long-term outcomes for women.
Agriculture and Economic Development in the Middle East

Several observations may be safely made regarding agriculture in the Middle East: it has continued to be the major economic sector in the region; it has developed conspicuously in the last two decades although the gains have been seriously diminished by the increase in population; agriculture still has a great potential for change and development, given the natural endowments of the region. The path to such development, if one can be identified, has not been clearly charted in the literature.
Enantiopure 2,3-dihydro-4-pyridones as synthetic intermediates: a concise asymmetric synthesis of (+)-allopumiliotoxin 267A.

A concise asymmetric synthesis of (+)-allopumiliotoxin 267A has been accomplished using an enantiopure dihydropyridone building block. The synthesis is highly stereoselective and requires 10 steps ...
Using herbicides to control interfering understories in the Allegheny hardwood stands, 2. Sharpening the tools in the toolbox

Dense rhizomatous herbaceous ferns such as hay-scented fern (Dennstaedtia punctilobula) and New York fern (Thelypteris noveboracensis), graminoids such as bearded shorthusk (Brachelytrum erectum), Danthonia spp., and Carex sp. ground cover, and woody understories of striped maple (Acer pensylvanicum), American beech (Fagus grandifolia), and sweet birch (Betula lenta) are found throughout the Allegheny Plateau region and beyond (Allegheny National Forest 1995, Horsley 1991). Considerable evidence suggests these ground cover layers are caused by long-term browsing by overabundant white-tailed deer (Horsley et al. 2003, Tilghman 1989). Once these plants occupy the understory, they interfere strongly with the regeneration and establishment of desirable woody species (Horsley 1993a, 1993b; Horsley and Marquis 1983). Established methods for controlling interfering plants have been used since the 1980s (Horsley 1988b, Horsley and Bjorkbom 1983, Horsley and Marquis 1983). Earlier research in the Allegheny hardwood type showed that a tank mix of the herbicides glyphosate and sulfometuron methyl effectively, economically, and safely removes interfering plants and minimizes their impact on regeneration so desirable hardwood species can become established (Horsley 1981, 1982, 1988a, 1990a, 1990b, 1991, 1994; Horsley and Marquis 1983; McCormick et al. 1991). The herbicide application is typically associated with a shelterwood seed cut to promote the establishment of desirable woody species (Horsley and Marquis 1983). Since the early research was completed, changes in products labeled for forestry use and differences among contractors often have resulted in operational reports of unacceptable and incomplete control of the targeted species.
A game-theoretic approach to nuclear fuel cycle transition analysis under uncertainty

Abstract We present a novel methodology for optimizing nuclear fuel cycle transitions that incorporates a game-theoretic approach and captures interactions among multiple decision makers. The methodology is demonstrated using a two-person sequential game with uncertainty, where the two players represent a policy maker and an electric utility company, though the method generalizes to any number and type of individual decision making entities. Coupled with a sophisticated nuclear fuel cycle simulator, rich transition scenarios may be analyzed to identify robust transition strategies. These strategies explicitly treat uncertainties using a stochastic programming approach, devising optimal near-term hedging strategies that simultaneously consider all possible states of the world, maintaining flexibility to allow for intelligent recourse decisions once uncertainties are resolved. In the demonstration game, reactor technology and fuel cycle scheme adopted by the electric utility are shown to depend on both the policy maker’s decisions and the distributions over uncertain technological and economic outcomes.
MIMIC-CXR, a de-identified publicly available database of chest radiographs with free-text reports

Chest radiography is an extremely powerful imaging modality, allowing for a detailed inspection of a patient's chest, but requires specialized training for proper interpretation. With the advent of high performance general purpose computer vision algorithms, the accurate automated analysis of chest radiographs is becoming increasingly of interest to researchers. Here we describe MIMIC-CXR, a large dataset of 227,835 imaging studies for 65,379 patients presenting to the Beth Israel Deaconess Medical Center Emergency Department between 2011-2016. Each imaging study can contain one or more images, usually a frontal view and a lateral view. A total of 377,110 images are available in the dataset. Studies are made available with a semi-structured free-text radiology report that describes the radiological findings of the images, written by a practicing radiologist contemporaneously during routine clinical care. All images and reports have been de-identified to protect patient privacy. The dataset is made freely available to facilitate and encourage a wide range of research in computer vision, natural language processing, and clinical data mining.
Circumferential Resection Margin as a Hospital Quality Assessment Tool for Rectal Cancer Surgery

Background Circumferential resection margin (CRM) status is an important predictor of outcomes after rectal cancer operation, and is influenced not only by operative technique, but also by incorporation of a multidisciplinary treatment strategy. This study sought to develop a risk-adjusted quality metric based on CRM status to assess hospital-level performance for rectal cancer operation. Study Design We conducted a retrospective observational cohort study of 58,374 patients with resected stage I to III rectal cancer within 1,303 hospitals who were identified from the National Cancer Database (2010 to 2015). The number of observed cases with a positive CRM (≤ 1 mm) was divided by the risk-adjusted expected number of cases with positive CRM to form the observed-to-expected (O/E) ratio. Secondary endpoint was overall survival. Results The overall rate of CRM positivity was 15.9%. Based on the O/E ratio for 1,139 hospitals, 147 (12.9%) and 103 (9.0%) were significantly worse and better performers, respectively. The majority of hospitals (n = 570) performed as expected. Positive CRMs using criteria of 0 mm and 0.1 to 1 mm were associated with a significantly shorter 5-year overall survival of 49% and 63.5% (hazard ratio 1.67; 95% CI, 1.57 to 1.76 and hazard ratio 1.19; 95% CI, 1.12 to 1.26) than negative CRM > 1 mm of 74.1% (all p Conclusions CRM-based O/E ratio is a robust hospital-based quality measure for rectal cancer operation. It allows facilities to compare their performance with that of centers of similar characteristics and helps identify underperforming, at-risk, and high-performing centers. National quality-improvement initiatives for rectal cancer should focus on ensuring high-quality data collection and providing ready access to risk-adjusted comparative metrics.
PM&R Training in Amputation Rehabilitation: Past, Present and Future

This paper aims to review the available literature for amputee rehabilitation training throughout history and current times while giving a preview of future endeavors. There is limited literature available regarding specifics of amputee care training in PM&R. There have been some advances with creation of fellowships but most of the literature shows a clear need to increase and improve amputee rehabilitation training and education to ensure the growing population is appropriately cared for. Amputee care played a huge role in the development of the field of PM&R and is still a critical part of education for physiatrists. However, this article points out the need to continue to improve and offer new opportunities for all physiatrists.
Hospital and Surgeon Medicare Reimbursement Trends for Total Joint Arthroplasty.

Abstract Background Over 1 million total joint arthroplasties (TJAs) are performed every year in the United States, creating Medicare cost concerns for policy makers. The purpose of this study is to evaluate recent trends in Medicare utilization and reimbursements to hospitals/surgeons for TJAs between 2012 and 2017. Methods We tracked annual Medicare claims and payments to TJA surgeons using publicly available Medicare databases and aggregated data at the county level. Descriptive statistics and multivariate regression models were used to evaluate trends in procedure volume, utilization (per 10,000 Medicare beneficiaries), and reimbursement rates and to examine associations between county-specific variables and TJA utilization and reimbursements. Results Between 2012 and 2017, there was an 18.9% increase in annual primary TJA volume (357,500 cases in 2012 to 425,028 cases in 2017) and a 2.0% increase in annual primary TJA per capita utilization (73.4 cases per 10,000 Medicare beneficiaries in 2012 to 74.8 in 2017). The Midwest and the South had higher utilization rates compared with the Northeast and West (P Conclusions Despite increasing TJA volume and utilization, surgeon reimbursements have continued to decline, whereas hospital payments and hospital charges have increased significantly more than surgeon charges. Cost containment efforts will need to address other expenditures such as hospital costs and implant costs to better align financial risks and incentives for TJA surgeons.
Carbon Nanodots Derived from Urea and Citric Acid in Living Cells: Cellular Uptake and Antioxidation Effect

Carbon nanodots (CNDs), reported as polyatomic carbon domains surrounded by amorphous carbon frames, have drawn extensive attention due to their easy-to-synthesis, outstanding electronic properties, and superior biocompatibility. However, substantial assessments regarding their biological performance are still needed, considering the complex nature of this type of relatively new nanoparticles. In this report, CNDs derived from urea and citric acid (U-CNDs) are investigated in the treatment of two cell lines, EA.hy926 and A549 cells, to examine the biocompatibility, cellular uptake, and antioxidation effect. The intracellular uptake study suggests an energy-dependent transport process into the cells mainly involving macropinocytosis and lipid raft-mediated endocytosis pathways. Moreover, the U-CNDs mostly target the mitochondria and present strong antioxidative effects by scavenging reactive oxygen species (ROS) in cells. Overall the findings in this report manifest that the U-CNDs could serve as a bioimaging reagent and antioxidant causing little deleteriousness in the respects of viability, plasma membrane integrity, and mitochondrial activity in both cell lines, and demonstrate some efficacy for inhibiting the metabolic activities of A549 cancer cells at higher concentration.
Quantum Capacity Bounds of Gaussian Thermal Loss Channels and Achievable Rates With Gottesman-Kitaev-Preskill Codes

Gaussian thermal loss channels are of particular importance to quantum communication theory since they model realistic optical communication channels. Except for special cases, the quantum capacity of Gaussian thermal loss channels is not yet quantified completely. In this paper, we provide improved upper bounds of the Gaussian thermal loss channel capacity, both in energy-constrained and unconstrained scenarios. We briefly review Gottesman-Kitaev-Preskill (GKP) codes and discuss their experimental implementation. We then prove, in the energy-unconstrained case, that a family of GKP codes achieves the quantum capacity of Gaussian thermal loss channels up to at most a constant gap from the improved upper bound. In the energy-constrained case, we formulate a biconvex encoding and decoding optimization problem to maximize entanglement fidelity. Then, we solve the biconvex optimization heuristically by an alternating semi-definite programming method and report that, starting from Haar random initial codes, our numerical optimization yields a hexagonal GKP code as an optimal encoding in a practically relevant regime.
Blame the Brain: Neuroscience for Action in Criminal Courtrooms

This article outlines the significance of some major STS theorists (Latour 1993, Galison 1997, Dumit 2004, Haraway 1991, Knorr-Cetina 1999) as a means of examining the ways in which STS perspectives can, if integrated into criminal courtrooms, enrich our understanding of contemporary neuroscience and society. In this paper, I trace the co-production of neuroscientific and legal knowledges through a study of functional magnetic resonance imaging (fMRI) scans in criminal courtrooms. In following the social life of such brain scans, I demonstrate how brain images are assembled, how they travel from one context (e.g. a lab) to another (e.g., a courtroom or a magazine), and how they are put to persuasive use in legal contexts. I argue law-science interactions in the U.S. courtroom have become sites of epistemic contestations over meanings of truth, justice, personhood, and expert knowledges in U.S. society and politics. In reframing this epistemic contest towards a "serviceable truth" (Jasanoff 2015) of neurolegal knowledge in action, I conclude with insights as to how legal and neuroscientific experts and laypeople alike might navigate the uneven diffusion of knowledge in U.S. criminal proceedings.
Heart Failure Care Delivery in the COVID-19 Era: The Patients' Perspective.

Purpose: The SARS-CoV-2 pandemic is changing healthcare delivery around the world with hospital systems experiencing a dramatic decline in patient volumes. Surveying our center’s heart failure (HF) clinic population, we aimed to understand our patients’ perception of coronavirus disease 2019 (COVID-19) and care delivery preferences. Methods: Patients with chronic HF presenting either in-person or virtually were approached to complete a ten question, anonymous, voluntary survey. Acutely decompensated patients and heart transplant recipients were excluded. Results: 109 patients completed the survey. Average age was 62 ± 14 years, 67% were male, and 59% had HF with reduced ejection fraction (HFrEF). Overall, patients were worried about contracting COVID-19 and believed they were prone to more severe infection given their underlying HF. However, they were not hesitant to initiate healthcare contact for symptoms and preferred in-person appointments over virtual visits. Although the difference did not reach statistical significance, female patients and those with HF with preserved ejection fraction (HFpEF) were more concerned. Conclusions: Patients with HF are concerned about their increased risk of contracting COVID-19. However, they are actively seeking healthcare contact and prefer in-person over virtual visits.
A Candidate Genetic Risk Factor for Vascular Disease: A Common Mutation in Methylenetetrahydrofolate Reductase

Hyperhomocysteinaemia has been identified as a risk factor for cerebrovascular, peripheral vascular and coronary heart disease1−4. Elevated levels of plasma homocysteine can result from genetic or nutrient-related disturbances in the trans-sulphuration or re-methylation pathways for homocysteine metabolism1,5−7. 5,10-Methylenetetrahydrofolate reductase (MTHFR) catalyzes the reduction of 5,10-methylenetetrahydrofolate to 5-methyltetra-hydrofolate, the predominant circulatory form of folate and carbon donor for the re-methylation of homocysteine to methionine. Reduced MTHFR activity with a thermolabile enzyme has been reported in patients with coronary and peripheral artery disease5,6. We have identified a common mutation in MTHFR which alters a highly-conserved amino acid; the substitution occurs at a frequency of approximately 38% of unselected chromosomes. The mutation in the heterozygous or homozygous state correlates with reduced enzyme activity and increased thermolability in lymphocyte extracts; in vitro expression of a mutagenized cDNA containing the mutation confirms its effect on thermolability of MTHFR. Finally, individuals homozygous for the mutation have significantly elevated plasma homocysteine levels. This mutation in MTHFR may represent an important genetic risk factor in vascular disease.
Militias at the Millennium: A Test of Smelser's Theory of Collective Behavior

Critically important to Neil Smelser's theory of collective behavior is the idea that people join radical social movements because they experience strain. A social movement arises to reassure participants that something is being done to redress the underlying source of strain. Militia presence and activity on the Internet (especially Usenet) is a phenomenon that can be studied within Smelser's framework. Militia watchers contend that those who join the militias have experienced the kinds of strain to which Smelser refers. The purpose of this article is to analyze the content of Internet traffic of U.S. militias in order to test the thesis outlined above. It uses militia Web sites and militia messages posted to Usenet (N =1196) as primary data to test Smelser's theory. Information was gathered on 171 men and women from 28 U.S. militias who posted messages to Usenet from 1998-2001. Based on the militiamen/women studied, Smelser's thesis is generally confirmed. Most experienced some form of social stress or strain prior to or during the time that they were in the militias, and most conditions for social movement development as specified by Smelser were met and confirmed by the data.
Correcting Cardiorespiratory Noise in Resting-state Functional MRI Data Acquired in Critically Ill Patients

Resting-state functional MRI (rs-fMRI) is being used to develop diagnostic, prognostic, and therapeutic biomarkers for critically ill patients with severe brain injuries. In studies of healthy volunteers and non-critically ill patients, prospective cardiorespiratory data are routinely collected to remove non-neuronal fluctuations in the rs-fMRI signal during analysis. However, the feasibility and utility of collecting cardiorespiratory data in critically ill patients on a clinical MRI scanner are unknown. We concurrently acquired rs-fMRI (TR=1250ms), cardiac and respiratory data in 23 critically ill patients with acute severe traumatic brain injury (TBI), and 12 healthy control subjects. We compared the functional connectivity results after denoising with cardiorespiratory data (i.e., RETROICOR) with the results obtained after standard bandpass filtering. Rs-fMRI data in 7 patients could not be analyzed due to imaging artifacts. In 6 of the remaining 16 patients (37.5%), cardiorespiratory data were either incomplete or corrupted. In both patients and control subjects, the functional connectivity corrected with RETROICOR did not significantly differ from that corrected with bandpass filtering of 0.008-0.125 Hz. Collectively, these findings suggest that there is a limited feasibility and utility to prospectively acquire high-quality cardiorespiratory data during rs-fMRI in critically ill patients with severe TBI for physiological correction.
Externalizing Childhood Sexual Abuse with Adult Survivors

Abstract The externalization of client problems can have the effect of increasing clients' perceived sense of empowerment. The use of letter writing and drawing techniques are discussed as externalization techniques that can be helpful in group work with sexual abuse survivors.
Heavy-Tailed Processes for Selective Shrinkage

Heavy-tailed distributions are frequently used to enhance the robustness of regression and classification methods to outliers in output space. Often, however, we are confronted with "outliers" in input space, which are isolated observations in sparsely populated regions. We show that heavy-tailed stochastic processes (which we construct from Gaussian processes via a copula), can be used to improve robustness of regression and classification estimators to such outliers by selectively shrinking them more strongly in sparse regions than in dense regions. We carry out a theoretical analysis to show that selective shrinkage occurs, provided the marginals of the heavy-tailed process have sufficiently heavy tails. The analysis is complemented by experiments on biological data which indicate significant improvements of estimates in sparse regions while producing competitive results in dense regions.
Scan chain fault diagnosis with fault dictionaries

Scan based diagnostic schemes implicitly assume that the scan path itself is fault-free. However, the logic circuitry associated with the scan chain can occupy a considerable area of the chip and hence should not be neglected during fault diagnosis. In this work we propose a simple extension to the scan chain to diagnose faults in scan chains based upon fault dictionaries.
Environmental Heterogeneity: Temporal and Spatial

Environments experienced by living organisms can be heterogeneous in a variety of ways. Variation in time and in space have distinct consequences for the fitness of plants and animals, and elicit different types of evolutionary responses through natural selection. Keywords: phenotypic plasticity; genetic polymorphism; habitat selection; genetic diversity
Analysis of Metabolomics Datasets with High-Performance Computing and Metabolite Atlases

Even with the widespread use of liquid chromatography mass spectrometry (LC/MS) based metabolomics, there are still a number of challenges facing this promising technique. Many, diverse experimental workflows exist; yet there is a lack of infrastructure and systems for tracking and sharing of information. Here, we describe the Metabolite Atlas framework and interface that provides highly-efficient, web-based access to raw mass spectrometry data in concert with assertions about chemicals detected to help address some of these challenges. This integration, by design, enables experimentalists to explore their raw data, specify and refine features annotations such that they can be leveraged for future experiments. Fast queries of the data through the web using SciDB, a parallelized database for high performance computing, make this process operate quickly. By using scripting containers, such as IPython or Jupyter, to analyze the data, scientists can utilize a wide variety of freely available graphing, statistics, and information management resources. In addition, the interfaces facilitate integration with systems biology tools to ultimately link metabolomics data with biological models.
A Game of Cat and Mouth

The protozoan parasite Toxoplasma gondii has been remarkably successful, infecting 30 to 50% of the world9s population, many of whom are asymptomatic. In their Perspective, Volkman and Hartl discuss new work (Suet al.) that reveals the secret of the parasite9s success. The three predominant strains of T. gondii -sibling progeny of a single cross that took place 10,000 years ago-all show greatly enhanced oral transmission between intermediate vertebrate hosts.
On the Non-Existence of Transformations to Normal Form in Celestial Mechanics

Kolmogorov (1954) has shown that under rather general conditions a Hamiltonian of the form: $$ H=\lambda_{1} p_{1}+\lambda_{2} p_{2}+A_{0}\left (q_{1},q_{2}\right)+A_{1}\left ( q_{1},q_{2} \right )p_{1}+A_{2}\left ( q_{1}, q_{2}\right)p_{2}+\sum_{i+j=2}^{\infty} A_{ij}\left ( q_{1},q_{2} \right )p_{1}^{i}p_{2}^{j} $$ can be reduced to the form: $$ H=\lambda_{1} p_{1}+\lambda_{2} p_{2}+\sum_{i+j=2}^{\infty} A_{ij}\left ( q_{1},q_{2} \right )p_{1}^{i}p_{2}^{j} $$ by a suitable canonical transformation, that is the constant and the linear terms periodic in q 1 , q 2 can be eliminated from the Hamiltonian. This implies in particular that p i = 0, q i = λ i (t - τ i ) is a solution of the canonical differential equations in terms of the new variables.