cssi/SciSciGPT-SciSciNet huggingface dataset:
Calculation of multielement airfoil flows, including flap wells

A calculation method for multielement airfoils based on an interactive boundary-layer approach using an improved Cebeci-Smith eddy viscosity formulation is described. Results are first presented for single airfoils at low and moderate Reynolds numbers in order to demonstrate the need to calculate transition for accurate drag polar prediction and the ability of the improved Cebeci-Smith turbulence model to predict flows with extensive separation, and therefore to predict maximum lift coefficient, (cl)max. Results, in terms of pressure distributions and lift and drag coefficients, are presented for a series of twoelement airfoils with flaps or slats. The method is extended to the computation of configurations with flap wells. Results show that the same accuracy can be reached as for faired geometries. A slight compressibility effect was accounted for by introducing compressibility corrections to the HessSmith panel method. Again, the importance of the compressibility effects and the turbulence model on stall, and the need to calculate the onset of transition, are demonstrated. Recommendations are then made for the preferred approach to predicting the aerodynamic performance of multielement airfoils for use as a practical and efficient design tool.
Direct simulations of low Reynolds number turbulent channel flow with EMHD control

We present results of numerical simulations of turbulence control in saltwater channel flows using electromagnetic (EM) forces. The control actuators are millimeter-sized micro-tiles flush-mounted in the lower channel wall. This arrangement closely models one of the experimental designs proposed and developed by Bandyopadhyay at NUWC [1,2]. We have studied two main secondary flow patterns (UV and WV) and both static and pulsed forcing. We have observed very low net drag reduction, with a maximum of 1 — 2%. However, we have also found localized regions where the reduction is as high as 10% versus the uncontrolled flow. The method of pulsing the EM force appears promising but we have not found any resonance mechanism thus far, at the low Reynolds numbers of this study. The turbulence intensities appear to be only weakly correlated with the reduction in drag. The change in net drag does not appear to scale linearly on the magnitude of the EM forcing in the cases we have considered. Flow visualizations in the WV case indicate that the mean secondary flow above the actuators consists of two pairs of counter-rotating vortices: the normal velocity is wall-ward and is accompanied by strong spanwise wall jets.
When Social Capital Hurts: The Role of Human Capital Experience and Fit

While studies have argued for and found benefits from transacting with social affiliates, it remains unclear how and when they lead to inferior outcomes for professionals and consumers. Building on social and human capital theories, I argue that social affiliations in uncertain markets can lead to unanticipated downsides that reduce overall performance when human capital considerations are supplanted by an effort to avoid opportunism. I test my argument using a novel approach that pairs data from the Wasatch Front Regional Multiple Listing Service in Utah with hand-collected data on geographically assigned LDS (Mormon) congregation boundaries. This setting allows me to identify listings for which real estate agents and home sellers share a common church congregation affiliation, and to both independently and jointly explore the impact of social affiliations and human capital on transaction outcomes. I find that on average agents sell comparable homes for 2% more and 3.5 days quicker, as well as exert more care and effort through marketing, when listing for affiliates. However, consistent with my theory, I find that sellers are much more likely to use inexperienced agents or agents with poor fit (i.e., specialize primarily in buying homes) when affiliations are present. Such cases result in lower sale prices and reduced agent performance, suggesting a downside to social ties from human capital deficiencies. These results indicate a more nuanced view of social capital is needed that incorporates the selection process and the potential for poor fit in transactions.
Clinical characteristics and therapy of cytomegalovirus infection in 138 infant cases

Objective: To investigate the clinical characteristics and therapy of cytomegalovirus(CMV) infection in infants. Methods: Clinical characteristics and outcome were retrospectively analyzied of in 138 infants infected CMV diagnosed in our hospital. Results: One hundred thirty-eight cases(male 80,female 58) were diagnosed by the positive of serum CMV-IgM and or blood / urine CMV-DNA-PCR. The admission age was 9 d to 3-year-old.Ninety-nine patients were diagnosed as pneumonia,18 showed lung function detects. Sixty- two cases were diagnosed as infant hepatitis,1 showed cirrhosis,1 showed liver degeneration,30 showed hyperbilirubin(2 cases as kernicterus,3 as biliary atresia,1 as choledochal cyst,3 as glycogen accumulation disorder). Ten cases were diagnosed as hemolytic anemia. Six cases were diagnosed as ITP. Fivteen cases were diagnosed as abnormal brain development,including 1 case of hydrocephalus,2 cases of cerebral tuberous sclerosis,3 cases of backward movement,3 cases of mental retardation,2 cases of epilepsy. There were brainstem auditory evoked potential abnormalities in 16 cases,10 showed bilateral hearing impairment,1 showed glaucoma. And 8 cases were diagnosed as congenital heart disease. Three cases were diagnosed as multiple malformations. Five cases were diagnosed as persistent enteritis. Seven cases were diagnosed as malnutrition,Three cases were diagnosed aslaryngeal cartilage dysplasia. One case were diagnosed as selective IgA deficiency,1 case were diagnosed as hereditary metabolic disease. Eleven cases complicated with multiple infection complicated with respiratory failure and shock in 2 cases.After treatment,114 patients recovered,19 patients quitted therapy and 5 died. Conclusions: Clinical manifestations of CMV infection were diverse in infants and young children,the most common is pneumonia,and followed by the hepatobiliary system involvement. Central nervous system damage could cause abnormal brain development,auditory nerve damage, and backward movement and so on. Small number of cases may be associated with other malformations,and even multiple malformations. Most of the CMV infection in infants have the good prognosis,and just a few is poor prognosis,or even death.
Hygienic evaluation for preliminary design of public places in a subway station

Objective To evaluate preliminary design of public places in a subway station.Methods Analogy surveys,hygiene survey,engineering and health checklist were used.Results In analogy subway station hall,qualification rates of PM10,formaldehyde,noise were 70%,90% and 90% respectively;Qualification rates of temperature,humidity,wind speed,CO,CO2,total bacteria,total bacteria in air conditioning ducts,total number of fungi,beta-hemolytic streptococcus and Legionella pneumophila in cooling and condensate water were all 100%.The following issues existed: lack of air purification and disinfection devices for air-conditioning,new air ducts and return air duct failing to be connected with the unit.The project site,construction health,public layout,air conditioning and ventilation exhaust facilities,muffler shock facilities,water supply and drainage facilities,auxiliary health facilities and preliminary design of related parameters were in line with the hygiene requirements,but there were lack of the sanitation facilities for air conditioning and the control facilities for vectors and waste collection,and other design flaws the EMF protection facilities,health management and emergency relief measures were not considered.Conclusion The main health facilities and the preliminary design of parameters were consistent with the standards and regulatory requirements.The basic principle of technical design for public health to eliminate or control the health hazards was feasible.The existed design flaws should be improved in the next stage of design.
The Embracing Flows: Process and Structure in the Moverments of Information and Energy

Broadly speaking, information has something to do with order or organization within a system of elements. The thermodynamic concept of entropy is also associated with such systems, although in an inverse relationship. When we attempt to put these two apparently coordinated schemas of order and disorder together, all kinds of difficulties arise. I will briefly examine contemporary efforts to unify these two ways of conceiving order and show that they are substantially incompatible. In this process I will draw some distinctions that will lead to a broader reconciliation of the concepts of order and information. I will then attempt to re-evaluate the fundamental models behind these dissonant traditions for formulating order in an attempt to reframe a synthesis of conceptual structures that are mutually reconcilable. I will try to show that such a synthesis can finally make sense of the stubborn inconsistencies that persist in the ways Newtonian dynamics, thermodynamics and biology utilize the implicitly conflicting arrows of time.
Regulation of NaCl entry into Necturus gallbladder epithelium by protein kinase C

The role of protein kinase C in the regulation of the mode of NaCl entry into Necturus gallbladder epithelial cells was determined from the rate and magnitude of ouabain-induced cell swelling in the presence of inhibitors. Stimulation of protein kinase C by phorbol ester increased the rate of cell swelling from the control value of 2.9% to 4.7%/min and caused the predominant apical membrane transport mechanism for NaCl to switch from bumetanide-sensitive Na-Cl cotransport to amiloride-sensitive parallel exchange. Na-Cl cotransport could be restored as the predominant mode of NaCl entry by treatment of stimulated tissues with the kinase inhibitors 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7) and calphostin C. Therefore the mechanism of NaCl transport across the apical membrane can be controlled by the activity of protein kinase C.
Modeling of femtosecond electromagnetic pylses from large-apertyre photocondyctors

The generation of millimeter and sub-millimeter radiation with subpicosecond pulse durations using large-aperture biased photoconductors is being pursued experimentally by a number of groups.1-3 Theoretical modeling of the radiated electromagnetic pulse from these devices has been developed for the near field;1 however, to our knowledge a detailed analysis of the radiated electromagnetic pulse in the far field has not been performed. Far field calculations are important since most of the experimental data on sub-millimeter wave generation has been acquired in the far field. We develop here a simple model using the current surge picture2 to describe the far field radiation from a biased large-aperture photoconducting emitter triggered by an ultrashort optical pulse.
Methods to simulate rubbing of topical formulation for in vitro skin permeation studies.

Abstract Rubbing a topical formulation on skin is generally assumed to enhance drug penetration. The aim of this study was to demonstrate different techniques such as using glass rod, rheometer, and gloved finger for rubbing a 2% salicylic acid gel on skin and investigate their effect on in vitro permeation of salicylic acid through dermatomed porcine ear skin. The studies included evaluation of the gel’s rheological properties, gel distribution on skin surface, in vitro permeability, drug distribution in skin, skin extraction recovery, and mass balance. Rubbing with a gloved finger resulted in a uniform gel layer with a thickness of 49.61 ± 15.33 μm on the skin surface. No significant difference between the different test groups was observed in terms of the cumulative amount of drug that permeated in 24 h ( p > 0.05). Drug levels in stratum corneum, epidermis, and dermis were also analyzed. Rubbing with gloved finger delivered significantly higher amount of drug into the skin layers as compared to other test groups ( p 0.05). Amount of drug extracted from skin was reliably correlated to the actual drug levels in skin (R 2 = 0.99). Considering drug amounts in different compartments, mass balance ranged from 75.86 ± 2.90% to 80.44 ± 2.99%.
Selective dry etching using inductively coupled plasmas. Part II. InN/GaN and InN/AlN

Abstract Two interhalogen plasma chemistries, ICl and IBr, have been examined for selective dry etching of InN over GaN and AlN. Maximum selectivities of 55 for InN/GaN and 20 for InN/AlN were achieved with ICl, and 30 for InN/GaN and 14 for InN/AlN, respectively, with IBr. There are two reasons for these results—the relatively high volatility of the InI3 etch product and the lower bond strength of InN relative to the other two binary nitrides. Both interhalogen plasma chemistries appear promising for use in electronic device fabrication.
Induced and spontaneous hemodynamic oscillations in cerebral and extracerebral tissue for coherent hemodynamics spectroscopy

We report preliminary results of a study for investigating the spatial homogeneity of induced and spontaneous oscillations in the concentration of oxyhemoglobin on the scalp/skull layer of two human subjects. Hemodynamic oscillations were induced by modulation of arterial blood pressure, which triggers the cerebral autoregulation mechanism. Induced hemodynamic oscillations are used in coherent hemodynamics spectroscopy to derive physiological parameters of interest for medical diagnostics. For example, our dedicated mathematical model translates typical near-infrared spectroscopy observables, like the amplitude and phase relationship of the oscillations of oxy- and deoxyhemoglobin concentrations into capillary and venous blood transit times, cutoff frequency of the autoregulation process, and other parameters related to microvascular blood volume. In this study, we focused on the phase relationship between the oscillations of oxyhemoglobin concentrations in three optical channels, two of which feature a short (5 mm) source-detector separation (sampling the scalp/skull only) and the third one features a long (30 mm) source-detector separation (sampling both extracerebral and cerebral tissues). The two main goals of the study were: a) to compare the coherence of induced and spontaneous oscillations; b) to assess if induced and spontaneous oscillations may be assumed to be uniform in the extracerebral layer. This was assessed by studying the phase relationship of oscillations in oxyhemoglobin concentration at the two short source-detector separations. About point a) we verified that induced oscillations have a higher incidence of coherence than spontaneous oscillations: 74% for induced oscillations, and 30% for spontaneous oscillations. About point b) the results show an overall trend for both spontaneous and induced oscillations to be homogeneous or “quasi-homogeneous” in the extracerebral tissue; however, we observed cases where a significant non-zero phase difference was measured, indicating spatial heterogeneity. We propose a method for taking into account the possible inhomogeneous behavior of the oscillations in the scalp/skull in order to increase the accuracy of measurements of cerebral hemodynamic oscillations.
We Must Not Be Enemies

In response to rise of nationalist populism, this article suggests ways to understand and respond to those involved. Trump supporters. Political commentators characterized the political environment as a battle between enlightened globalists and prejudiced nationalists. While not excusing racism, xenophobia, misogyny, and other forms of discrimination, the article argues that globalists overlook the importance of communal bonds for people’s well-being, and that their misunderstanding of communitarian values has contributed to the rise of right-wing populism. The article suggests that globalist values and community values can be reconciled, and that fostering communities can help bridge the gap between the two camps.
Towards program theory validation: Crowdsourcing the qualitative analysis of participant experiences.

Abstract This exploratory study examines a novel tool for validating program theory through crowdsourced qualitative analysis. It combines a quantitative pattern matching framework traditionally used in theory-driven evaluation with crowdsourcing to analyze qualitative interview data. A sample of crowdsourced participants are asked to read an interview transcript and identify whether program theory components (Activities and Outcomes) are discussed and to highlight the most relevant passage about that component. The findings indicate that using crowdsourcing to analyze qualitative data can differentiate between program theory components that are supported by a participant’s experience and those that are not. This approach expands the range of tools available to validate program theory using qualitative data, thus strengthening the theory-driven approach.
Abstract 18359: Long Term Follow-up of Aortic Coarctation Repair Using Leg-arm Blood Pressure Difference to Assess Hemodynamic Profiles

Introduction: Patients with successfully repaired coarctation (CoA) need long term follow up due to the risk of abnormal arterial elasticity and complications of hypertension. We hypothesize that even subtle hemodynamic abnormalities are marked by lack of a blood pressure standing wave effect to the lower extremities (arm ≥ leg systolic BP: ARM Group) and is associated with elevated aortic flow velocities, increased left ventricular posterior wall thickness (LVPWd), higher arm BP and a greater requirement for interventions compared to subjects with the normal standing wave effect (leg > arm SBP: LEG Group). Methods: CoAs repaired between 1990 and 2008 with at least two documented right arm and leg SBPs at clinic visits along with M-mode, 2D and Doppler echocardiography were selected. The largest recorded peak instantaneous (PeakV) and mean velocities (MeanV) in the descending aorta were reviewed, as were measures of the proximal transverse arch (TA) and LVPWd. Measurements were indexed by Z-score. Patient...
Development of Antiherpes Virus Agents on the Basis of Virus Induced Enzymes

Herpes Viruses induce many disease entities in humans. Unfortunately, the drugs currently used in the clinical treatment of herpes virus infectious diseases all have substantial toxicity (1,2,3). Recently, several nucleoside analogs such as AraA, 5-alkyl dUrd and Acycloguanine were shown to be effective against herpes simplex virus type 1 infectious diseases without having much toxicity in humans (4–10) however, they all have their own limitation of use. For example, 5-alkyl-dUrd and acycloguanosine will not be active against herpes virus which cannot induce thier virus specific thymidine kinase (TK) (6,11) or herpes virus which could induce a virus specific TK but cannot recognize either compound as its substrate. AraA toxicity will be affected by the amount of adenosine deaminase in human cells. Therefore, it is important to develop more specific antiherpes virus agents for the treatment of herpes virus induced diseases, particularly in patients undergoing cancer chemotherapy or with immune deficiencies.
Atlastins mediate selective autophagy of the endoplasmic reticulum

The selective lysosomal degradation (autophagy) of entire organelles is required for cellular homeostasis, and its dysregulation is involved in degenerative disorders such as Parkinson9s Disease. While autophagy of mitochondria (mitophagy) is becoming better understood, other forms of organelle autophagy are relatively unexplored. Here we develope multiple quantitative assays to measure organelle autophagy using flow cytometry, microscopy, and Western blotting. Focusing on autophagy of the endoplasmic reticulum (ER-phagy), we show that these assays allow facile measurement of ER-phagy, and that ER-phagy is inhibited by knockdown of either core autophagy components or the recently reported FAM134B ER-phagy receptor. Using these assays, we further identify that Atlastins, the ER-resident GTPases involved in ER membrane morphology, are key positive effectors of ER-phagy. Atlastin-depleted cells have decreased ER-phagy under starvation conditions, and Atlastin9s role in ER-phagy requires both a functional GTPase domain and proper ER localization. The three Atlastin family members functionally compensate for one another during ER-phagy and may form heteromeric complexes with one another. We also find that Atlastins act downstream of the FAM134B ER-phagy receptor. We propose that during ER-phagy, Atlastins remodel ER membrane to separate pieces of FAM134B-marked ER for efficient autophagosomal engulfment. Human mutations in Atlastins lead to hereditary spastic paraplegia, and our results suggest that this disease may be linked to deficiencies in ER-phagy rather than ER morphology.
Heat Capacity of Saturated and Compressed Liquid Dimethyl Ether at Temperatures from (132 to 345) K and at Pressures to 35 MPa

Molar heat capacities at constant volume (Cv) of dimethyl ether have been measured with an adiabatic calorimeter. Temperatures range from the triple point to 345 K, and pressures up to 35 MPa. Measurements were conducted on liquid in equilibrium with its vapor and on compressed liquid samples. The samples are of high purity, as verified by chemical analysis. Calorimetric quantities are reported for the two-phase (Cv(2)), saturated-liquid (Cσ or Cx′), and single-phase (Cv) molar heat capacities. Low temperature Cv(2) data were employed to estimate vapor pressures for values less than 340 kPa by applying a thermodynamic relationship between the two-phase internal energy U(2) and the temperature derivatives of the vapor pressure. Vapor pressures were calculated at temperatures as low as the triple-point temperature. The principal sources of uncertainty are the temperature rise measurement and the change-of-volume work adjustment. The expanded relative uncertainty (with a coverage factor k = 2 and thus a two-...
PI3-kinase, Akt, mTOR, and Treatment

Abstract Originally discovered in 1984, the phosphatidylinositol-3′ kinases (PI3-kinases, PI3Ks) are a family of conserved intracellular lipid kinases that propagate signal cascades implicated in insulin and growth receptor signaling, cell proliferation, motility, and vesicular trafficking. The PI3-kinase pathway is one of the most commonly activated pathways in cancer and the focus of intense effort to capitalize on its therapeutic potential. Much progress has been made not only in defining the genomic landscape of human gliomas but also in the sensible implementation of targeted therapeutics to maximally impact signaling response. Data defining compensatory mechanisms after single agent signaling inhibition and combination therapy in addition to understanding molecular mechanisms of resistance and tumor heterogeneity will be needed to fully exploit cancer vulnerabilities related to PI3K-dependence in an era of precision medicine. The results of multiple ongoing clinical trials utilizing PI3-kinase inhibitors will aid in the design of more effective, personalized treatment.
The Fed and Lehman Brothers: Setting the Record Straight on a Financial Disaster

The bankruptcy of the investment bank Lehman Brothers was the pivotal event of the 2008 financial crisis and the Great Recession that followed. Ever since the bankruptcy, there has been heated debate about why the Federal Reserve did not rescue Lehman in the same way it rescued other financial institutions, such as Bear Stearns and AIG. The Fed's leaders from that time, especially former Chairman Ben Bernanke, have strongly asserted that they lacked the legal authority to save Lehman because it did not have adequate collateral for the loan it needed to survive. Based on a meticulous four-year study of the Lehman case, The Fed and Lehman Brothers debunks the official narrative of the crisis. It shows that in reality, the Fed could have rescued Lehman but officials chose not to because of political pressures and because they underestimated the damage that the bankruptcy would do to the economy. The compelling story of the Lehman collapse will interest anyone who cares about what caused the financial crisis, whether the leaders of the Federal Reserve have given accurate accounts of their actions, and how the Fed can prevent future financial disasters.
Evaluation of the potential immunotoxicity of 3-monochloro-1,2-propanediol in Balb/c mice: II. Effect on thymic subset, delayed-type hypersensitivity, mixed-lymphocyte reaction, and peritoneal macrophage activity

3-Monochloro-1,2-propanediol (MCPD) is a well-known by-product of acid-hydrolyzed soy sauce during its manufacturing process. To evaluate the immunotoxicity of MCPD, we investigated its effect on the thymic subset, delayed-type hypersensitivity, mixed-lymphocyte reaction and peritoneal macrophage activity. MCPD was administered by gavage for 14 days at 0, 25, 50, and 100 mg/kg/day to female Balb/c mice. The thymic subsets and annexin-V positive cells in thymic cells were quantified by flow cytometry. Mixed-lymphocyte reaction, delayed-type hypersensitivity and peritoneal macrophage activity were assessed. The mixed-lymphocyte reaction and delayed-type hypersensitivity were not significantly changed. However, there were significant increases in the apoptosis of mice treated with high dose of MCPD compared to the vehicle control. A significant decrease in the CD4+CD8+ thymic subset of mice treated with high dose of MCPD was observed. The activity of peritoneal macrophage was significantly reduced in high dose group. These results indicate that MCPD could modulate the immune function in Balb/c mice.
Learning Opportunities Provided by Domain-Oriented Design Environments

Information overload, the advent of high-functionality systems, and a climate of rapid technological change have created new problems and challenges for education and training. New instructional approaches are needed to circumvent the difficult problems of coverage (i.e., trying to teach people everything that they may need to know in the future) and obsolescence (i.e., trying to predict what specific knowledge someone will need in the future). Learning on demand is a promising approach to address these problems for the following reasons: (1) it contextualizes learning by allowing it to be integrated into work rather than relegating it to a separate phase; (2) it lets learners see for themselves the usefulness of new knowledge for actual problem situations, thereby increasing the motivation for learning new skills and information; and (3) it makes new information relevant to the task at hand.
Institutional Logics and Accountability: Advancing an Integrated Framework in Nonprofit–Public Partnerships

Public and nonprofit management literature has focused more on formal accountability and less on emerging informal structures that are present in the pilot stages of partnerships. This study uses a phenomenological approach to examine the institutional logics of partner organizations and offers an integrated framework for how these logics may translate into accountability structures in a nonprofit—public partnership (NPPP). This framework advances a basis for the mechanisms present when an individual organization’s or agency’s institutional logics must be reconciled in the context of accountability. The analysis points to emerging challenges and cross pressures within the NPPP that are driving a need for comprehensive evaluation measures, established processes for business planning, and written agreements such as memorandums of understanding to provide clear definitions of partnership roles. Public managers designing or joining pilot partnerships need to be aware that mismatched institutional logics and perceptions of accountability can occur, and these dynamics may lead to a variety of hybrid measures to ensure future sustainability of interorganizational relationships.
Clinical Yield of a Molecular Diagnostic Panel for Enteric Pathogens in Adult Outpatients With Diarrhea and Validation of Guidelines-Based Criteria for Testing.

Background Molecular diagnostic panels for enteric pathogens offer increased sensitivity and reduced turnaround time. However, many pathogen detections do not change clinical management, and the cost is substantial. Methods We performed a retrospective chart review of adult outpatients with diarrhea at the University of Virginia who had samples tested by the FilmArray Gastrointestinal Panel (BioFire Diagnostics, Salt Lake City, UT) to identify the clinical yield and to validate the clinical criteria for testing recommended in the 2017 Infectious Diseases Society of America (IDSA) guidelines. Results We analyzed 629 tests sent from adult outpatients with diarrhea between March 23, 2015, and July 18, 2016. A pathogen was detected in 127 of 629 specimens (20.2%). The most common pathogens were enteropathogenic Escherichia coli (47, 7.5%), norovirus (24, 3.8%), enteroaggregative E. coli (14, 2.2%), Campylobacter (9, 1.4%), and Salmonella (9; 1.4%). The clinical yield of testing was low, with antimicrobial treatment clearly indicated for only 18 subjects (2.9%) and any change in clinical management indicated for 33 subjects (5.2%). Following the clinical criteria for diagnostic testing from the 2017 IDSA guidelines, which suggest diagnostic testing for patients with fever, abdominal pain, blood in stool, or an immunocompromising condition, would have reduced testing by 32.3% without significantly reducing the clinical yield (sensitivity, 97.0%; 95% confidence interval [CI], 84.2%-99.9%; negative predictive value, 99.5%; 95% CI, 97.3%-100.0%). Conclusions The clinical yield of molecular diagnostic testing in this population was low. Compliance with IDSA guidelines in adult outpatients with diarrhea could reduce testing by approximately one-third.
TAVR Thrombosis in Patient Supported with Durable Left Ventricular Assist Device

Introduction Aortic incompetence (AI) is very common complication after continuous flow left ventricular assist device (LVAD) implantation, and can result in increased symptoms for LVAD patients. Recent advances in Transcatheter Aortic Valve Replacement (TAVR) technology has resulted in this becoming a potential therapeutic avenue for LVAD patients with AI. We report a case of TAVR implantation in a patient supported with a LVAD complicated by thrombosis. Case Report A 61-year-old female presented with STEMI. She was treated with primary PCI, but had progressive cardiogenic shock and was placed on VA-ECMO. Due to high PRA, she was unable to be listed for primary transplantation and underwent implantation of a Heartware LVAD (Medtronic) as bridge to decision. Her post-operative course was complicated by recurrent GI bleeding. Over the following 12 months, she was noted to have worsening AI on routine echocardiography, with worsening symptoms that persisted despite hemodynamic and echocardiographic-guided LVAD optimization. After heart team review, her anatomy was deemed appropriate for TAVR and she underwent implant of a 26mm Evolut Pro (Medtronic). The procedure was complicated by post-implant complete heart block on POD #4 requiring pacemaker implantation. She was discharged from the hospital, however over the next 3 months had recurrent episodes of low flow alarms that continued despite LVAD speed and medication optimization. A transthoracic echocardiogram did not reveal any abnormalities, although it was unable to visualize the TAVR leaflets. A multiphase 4D CT Angiogram was performed to rule out LVAD outflow graft obstruction, which revealed extensive hypoattenuating leaflet thickening involving all 3 leaflets of the TAVR with absent leaflet motion consistent with thrombosis of the prosthetic valve leaflets (See Figure). She was started on intravenous anticoagulation (unfractionated heparin), but this had to be ceased due to hemodynamically significant GI bleeding requiring multiple transfusions. LVAD speed was also attempted to be increased to minimize risk of aortic valve opening, but this was unable to be continued due to recurrent low flow LVAD alarms. Repeat imaging 3 months later showed continual thrombosis, and she has remained stable while awaiting transplantation. Summary We describe a novel complication of TAVR in LVAD patients. This case highlights the major diagnostic and management dilemmas that should be considered as this management strategy becomes more widespread in this patient population.
Significance of Autoantibodies

The field of autoimmune neurological disorders is rapidly expanding, and novel autoantibodies and their neuronal antigens continue to be discovered. Autoimmunity targeting brain proteins is enigmatic, because traditionally, the central nervous system (CNS) is viewed as immune-privileged. However, the discovery of the lymphatic and glymphatic circulation in the CNS demonstrates the interaction between the CNS and the immune response. Furthermore, the barriers protecting the brain from direct exposure to the immune response can be compromised by inflammations, infection, or injury. A compromised blood–brain barrier, or blood–cerebrospinal fluid barrier, will allow egress of neuronal antigens to regional and peripheral lymphoid organs and may lead to the initiation of an autoimmune response. Peripheral autoantibodies or intrathecally produced autoantibodies can reenter the CNS. Besides being useful diagnostic markers, these autoantibodies may be involved in the pathogenesis of the disease by mechanisms such as complement-dependent cytotoxicity (CDC), antibody-dependent cell-mediated cytotoxicity (ADCC), and modulation of receptor function. The effect of a neural autoantibody depends not only on the nature of its antigen but also on the antibody’s Ig isotype or IgG subclass. We will discuss different causes of neurological autoimmunity and pathogenic mechanisms involved in neurological autoimmune diseases. Finally, we will discuss naturally occurring IgM autoantibodies and IgG4 autoantibodies with protective and reparative functions and appropriate treatment options.
Cardiomyocyte cell cycling, maturation, and growth by multinucleation in postnatal swine

Abstract Aims Cardiomyocyte (CM) cell cycle arrest, decline of mononucleated-diploid CMs, sarcomeric maturation, and extracellular matrix remodeling are implicated in loss of cardiac regenerative potential in mice after birth. Recent studies show a 3-day neonatal regenerative capacity in pig hearts similar to mice, but postnatal pig CM growth dynamics are unknown. We examined cardiac maturation in postnatal pigs and mice, to determine the relative timing of developmental events underlying heart growth and regenerative potential in large and small mammals. Methods and Results Left ventricular tissue from White Yorkshire-Landrace pigs at postnatal day (P)0 to 6 months (6mo) was analyzed to span birth, weaning, and adolescence in pigs, compared to similar physiological timepoints in mice. Collagen remodeling increases by P7 in postnatal pigs, but sarcomeric and gap junctional maturation only occur at 2mo. Also, there is no postnatal transition to beta-oxidation metabolism in pig hearts. Mononucleated CMs, predominant at birth, persist to 2mo in swine, with over 50% incidence of mononucleated-diploid CMs at P7-P15. Extensive multinucleation with 4-16 nuclei per CM occurs beyond P30. Pigs also exhibit increased CM length relative to multinucleation, preceding increase in CM width at 2mo-6mo. Further, robust CM mitotic nuclear pHH3 activity and cardiac cell cycle gene expression is apparent in pig left ventricles up to 2mo. By contrast, in mice, these maturational events occur concurrently in the first two postnatal weeks alongside loss of cardiac regenerative capacity. Conclusions Cardiac maturation occurs over a 6mo postnatal period in pigs, despite a similar early-neonatal heart regenerative window as mice. Postnatal pig CM growth includes increase in CM length alongside multinucleation, with CM cell cycle arrest and loss of mononucleated-diploid CMs occurring at 2mo-6mo. These CM characteristics are important to consider for pig preclinical studies and may offer opportunities to study aspects of heart regeneration unavailable in other models.
Comparison of Human H3N2 Antibody Responses Elicited by Egg-Based, Cell-Based, and Recombinant Protein-Based Influenza Vaccines During the 2017-2018 Season.

BACKGROUND The H3N2 component of egg-based 2017-2018 influenza vaccines possessed an adaptive substitution that alters antigenicity. Several influenza vaccines include antigens that are produced through alternative systems, but a systematic comparison of different vaccines used during the 2017-2018 season has not been completed. METHODS We compared antibody responses in humans vaccinated with Fluzone (egg-based, n = 23), Fluzone High-Dose (egg-based, n = 16), Flublok (recombinant protein-based, n = 23), or Flucelvax (cell-based, n = 23) during the 2017-2018 season. We completed neutralization assays using an egg-adapted H3N2 virus, a cell-based H3N2 virus, wild-type 3c2.A and 3c2.A2 H3N2 viruses, and the H1N1 vaccine strain. We also performed enzyme-linked immunosorbent assays using a recombinant wild-type 3c2.A hemagglutinin. Antibody responses were compared in adjusted analysis. RESULTS Postvaccination neutralizing antibody titers to 3c2.A and 3c2.A2 were higher in Flublok recipients compared with Flucelvax or Fluzone recipients (P < .01). Postvaccination titers to 3c2.A and 3c2.A2 were similar in Flublok and Fluzone High-Dose recipients, though seroconversion rates trended higher in Flublok recipients. Postvaccination titers in Flucelvax recipients were low to all H3N2 viruses tested, including the cell-based H3N2 strain. Postvaccination neutralizing antibody titers to H1N1 were similar among the different vaccine groups. CONCLUSIONS These data suggest that influenza vaccine antigen match and dose are both important for eliciting optimal H3N2 antibody responses in humans. Future studies should be designed to determine if our findings directly impact vaccine effectiveness. CLINICAL TRIALS REGISTRATION NCT03068949.
Graphite creep negation during flash spark plasma sintering under temperatures close to 2000 °C

Abstract Graphite creep has high importance for applications using high pressures (100 MPa) and temperatures close to 2000 °C. In particular, the new flash spark plasma sintering process (FSPS) is highly sensitive to graphite creep when applied to ultra-high temperature materials such as silicon carbide. In this flash process taking only a few seconds, the graphite tooling reaches temperatures higher than 2000 °C resulting in its irreversible deformation. The graphite tooling creep prevents the flash spark plasma sintering process from progressing further. In this study, a finite element model is used to determine FSPS tooling temperatures. In this context, we explore the graphite creep onset for temperatures above 2000 °C and for high pressures. Knowing the graphite high temperature limit, we modify the FSPS process so that the sintering occurs outside the graphite creep range of temperatures/pressures. 95% dense silicon carbide compacts are obtained in about 30 s using the optimized FSPS.
Novel approaches in marginal zone lymphoma: Systematic review.

e20089Background: Marginal zone lymphoma represents no more than 17% of NHLs and there is no standard of care. We reviewed the efficacy of novel drugs with main focus on ORR and PFS/OS (when availa...
Neutrophil extracellular trap inhibition increases inflammation, bacteraemia and mortality in murine necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disease affecting primarily premature infants. The disease is characterized by intestinal inflammation and leucocyte infiltration, often progressing to necrosis, perforation, systemic inflammatory response and death. Neutrophil extracellular traps (NETs), denoting nuclear DNA, histone and antimicrobial protein release, have been suggested to play a role in NEC. This study aimed to determine the role of NETs in NEC and explore the effect of chloramidine, a NET inhibitor, on a murine NEC-like intestinal injury model. Blood and intestinal tissues were collected from infants diagnosed with ≥ Stage II NEC, and levels of nucleosomes and NETs, respectively, were compared with those of case-matched controls. In mice, NEC was induced with dithizone/Klebsiella, and mice in the treatment group received 40 mg/kg chloramidine. Bacterial load, intestinal histology, plasma myeloperoxidase and cytokine levels, and immunofluorescent staining were compared with controls. Nucleosomes were significantly elevated in both human and mouse NEC plasma, whereas NET staining was only present in NEC tissue in both species. Chloramidine treatment increased systemic inflammation, bacterial load, organ injury and mortality in murine NEC. Taken together, our findings suggest that NETs are critical in the innate immune defence during NEC in preventing systemic bacteraemia.
A Social Life of Pots in Southern Africa

The movement of objects both within and across contexts often helps to define social relations. This article explores this notion by focusing on five specific examples of pottery production and use...
The Efficacy of Radiofrequency Ablation for Pain Management in Patients with Pre-Existing Hardware at the Site of Ablation

Radiofrequency ablation (RFA) is an interventional procedure that provides pain relief by using thermal energy to disrupt peripheral nerves carrying nociceptive signals back to the central nervous system. In the past, having implantable hardware at the planned site of RFA was considered to confer increased risk of adverse outcomes given the theoretical risk of heating of the hardware components. The present study examines patient outcomes to determine whether the efficacy of RFA was affected by the presence of implanted hardware directly at the site. This was a retrospective case–control study that included 52 patients who received RFA procedures in the presence of hardware at the site of RFA and a control group of 170 patients who received RFA procedures in the absence of hardware. Data were collected from electronic medical records entered into an Excel sheet and then analyzed using SPSS version 22. Outcomes tested included post procedure pain scores, percent, and duration of improvement, if any. We found no statistically significant difference in measured outcomes between either group. This study provides some evidence in support of the theory that RFA procedures performed on patients with pre-existing hardware have similar efficacy when compared to their hardware-free counterparts.
Bostock v. Clayton County, Georgia, and its Effect on Pennsylvania's LGBTQ Community

Workplace discrimination presents a severe and pervasive barrier to equality for LGBTQ people. This article explains the Supreme Court’s recent decision in Bostock v. Clayton County, Georgia, and examines its impact on Pennsylvania’s LGBTQ community. The article outlines state, local, and federal workplace protections available to LGBTQ Pennsylvanians prior to the decision and tracks the development of Title VII doctrine regarding LGBTQ workers prior to Bostock. The article then explains the majority’s opinion in Bostock, describes its implications for LGBTQ Pennsylvanians, and outlines work that remains to be done to ensure full protection for this vulnerable group.
Inside the adolescent voice: A qualitative analysis of the appeal of different tobacco products.

Introduction While cigarette use has decreased, adolescents' overall use of tobacco (e.g. e-cigarettes, cigars, and hookah) has increased. The purpose of this qualitative study is to highlight the decision-making process of adolescents to use certain products over others and why certain tobacco products appeal to them. Methods Twenty-five participants were recruited from a larger study surveying adolescents' perceptions and tobacco use (772 high school students). The participants were involved in one-on-one semi-structured phone interviews on the appeal of different tobacco products. Interviews were recorded, transcribed verbatim, and analyzed by identifying relevant codes and themes. Results Participants for this study had a mean age of 16.4 (SD=1.2) years; over half (14/25) were female. Three major themes emerged from the interviews: 1) social context and circumstances to use, including using and sharing with peers, and reducing boredom; 2) importance of flavors, smell, taste, smoke tricks, and accessibility of products; and 3) misperceptions and misinformation of product risks. Conclusions The findings that emerged showed why participants favored certain tobacco products, especially e-cigarettes, over others. The results support areas for future research and practice, and inform how interventions can better address the appeal of different tobacco products to ultimately prevent adolescent use.
Failure and Success in Political Polling and Election Forecasting

The recent successes and failures of political polling invite several questions: Why did the polls get it wrong in some high-profile races? Conversely, how is it that polls can perform so well, eve...
The Psycholinguistics of Spoken Word Recognition

The process of mapping acoustic-phonetic level input to a lexical representation is multi-faceted. Models of spoken word recognition provide a variety of processing architectures and make different assumption(s) regarding the unit(s) of representation used in the exchange of information from signal-to-word and the nature of information flow through the system. The current models provide a backdrop for a discussion of some of the advances and debates in the field. Some of the issues considered are: early versus delayed commitment to a lexical hypothesis, consequences of multiple activation, segmentation and lexical access, the processing and representation of phonological variants, and the role of attention in spoken word recognition.
New Vistas in Neuromuscular Blockers

The medication drawer of a modern anesthesiology workstation may contain up to five neuromuscular-blocking drugs (NMBs): succinylcholine, vecuronium, rocuronium, and possibly pancuronium and cisatracurium. With such an extensive armamentarium for providing muscle relaxation, why would an anesthesiologist require additional compounds? Although the depolarizing neuromuscular-blocking compound succinylcholine has been at anesthesiologists’ disposal since 1952 and remains the sole short-acting neuromuscular-blocking agent capable of providing adequate conditions for rapid tracheal intubation, succinylcholine nevertheless possesses an adverse effect profile well known to all practicing anesthesiologists: muscle fasciculations, hyperkalemia, cardiac arrest, and increased intraocular and intracranial pressures. Vecuronium, rocuronium, and pancuronium all possess a much more favorable adverse effect profile, but all three exhibit altered pharmacokinetics in the setting of end-organ perturbations. Cisatracurium is currently the only clinically available nondepolarizing neuromuscular-blocking compound with organ-independent metabolism and thus a lack of cumulative effects; however, this compound has an intermediate duration of action, a high potency, and therefore a relatively slow onset of action insufficient for rapidly securing a patient’s airway. Clearly, additions to the current armamentarium of neuromuscular-blocking compounds would prove useful in clinical practice, and the search for new molecules to fill the clinical voids has been ongoing since the 1970s.
Human-Like Motion from Physiologically-Based Potential Field

The challenge of synthesizing motion behaviors is a long-standing problem in robotics. With the recent advent of complex humanoid systems, this challenge grows ever demanding. Due to their anthropomorphic design, humanoids should move in a human-like manner to facilitate movement within man-made environments and to accommodate interaction with their biological counterparts. Common control strategies for emulating human motion involve generating joint space trajectories or learning specific motions, but these approaches require off-line computations and do not generalize well to related tasks. There is a pressing need for a framework where natural motion is generated in real-time for a large range of tasks.