cssi/SciSciGPT-SciSciNet huggingface dataset:
Sodium Excretion and the Risk of Cardiovascular Disease in Patients With Chronic Kidney Disease

Importance Patients with chronic kidney disease (CKD) are at an increased risk of cardiovascular disease (CVD) compared with the general population. Prior studies have produced contradictory results on the association of dietary sodium intake with risk of CVD, and this relationship has not been investigated in patients with CKD. Objective To evaluate the association between urinary sodium excretion and clinical CVD events among patients with CKD. Design, Setting, and Participants A prospective cohort study of patients with CKD from 7 locations in the United States enrolled in the Chronic Renal Insufficiency Cohort Study and followed up from May 2003 to March 2013. Exposures The cumulative mean of urinary sodium excretion from three 24-hour urinary measurements and calibrated to sex-specific mean 24-hour urinary creatinine excretion. Main Outcomes and Measures A composite of CVD events defined as congestive heart failure, stroke, or myocardial infarction. Events were reported every 6 months and confirmed by medical record adjudication. Results Among 3757 participants (mean age, 58 years; 45% women), 804 composite CVD events (575 heart failure, 305 myocardial infarction, and 148 stroke) occurred during a median 6.8 years of follow-up. From lowest ( P = .007) for composite CVD events, 1.34 (95% CI, 1.03-1.74; P = .03) for heart failure, and 1.81 (95% CI, 1.08-3.02; P = .02) for stroke after multivariable adjustment. Restricted cubic spline analyses of the association between sodium excretion and composite CVD provided no evidence of a nonlinear association ( P = .11) and indicated a significant linear association ( P Conclusions and Relevance Among patients with CKD, higher urinary sodium excretion was associated with increased risk of CVD.
Magnetic resonance imaging provides evidence for remodeling of the right ventricle after single-lung transplantation for pulmonary hypertension

Background In end-stage pulmonary hypertension (PH), the degree of right ventricular (RV) dysfunction has been considered so severe as to require combined heart-lung transplantation. Nevertheless. left ventricular (LV) and RV hemodynamics return to relatively normal levels after single-lung transplantation (SLT) alone. Accordingly, to test the hypothesis that LV and RV systolic function improves after SLT and that the dilated, thick-walled RV reverts to more normal geometry, we used cine MRI and finite-element (FE) analysis to study patients with end-stage PH. Methods and Results Seven patients with end-stage PH underwent cine MRI before and after SLT, and eight normal volunteers were also imaged with cine MRI. Short-axis images at the midventricular level were analyzed with customized image-processing software. The LV and RV ejection fractions, velocity of fiber shortening, RV end-diastolic (ED) and end-systolic (ES) chamber areas, and RV ES and ED wall thicknesses were calculated directly from the MRI images. Two-dimensional FE models of the heart were constructed from the MRI images at early diastole. LV and RV pressures were measured in the patients with a cardiac catheterization before and after SLT. Models were solved to yield diastolic LV, RV, and septal wall stresses. By use of a nonlinear optimization algorithm, LV and RV diastolic material properties were determined by minimization of the least-squares difference between FE model-predicted and MRI-measured LV, RV, and epicardial chamber areas and circumferences. The results demonstrated a substantial reduction in RV wall stress after SLT (1.8X10 5 dynes/cm 2 pre-SLT to 2X10 4 dynes/cm 2 post-SLT ; P<.001). The average RV diastolic elastic modulus was reduced significantly after SLT (1.5 X 10 6 dynes/cm 2 pre-SLT to 1X10 5 dynes/cm 2 post-SLT ; P=.01), but there was no change in the LV elastic modulus. RV velocity of fractional shortening increased significantly after SLT (0.23 pre-SLT to 0.58 post-SLT, P=.02), and RV ED and ES wall thicknesses were reduced significantly (ED, 0.86 cm pre-SLT to 0.65 cm post-SLT, P=.03 and ES, 1.06 cm pre-SLT to 0.72 cm post-SLT, P=.005). Conclusions These results provide evidence supporting the contention that LV and RV systolic function improved after SLT for end-stage PH and that the RV underwent significant remodeling within 3 to 6 months after lung transplantation.
Summary Databases and Model Repositories

Publisher Summary This chapter describes the conceptual framework of summary databases. A Summary Database (SDB) is a review article but is structured as entries in a database rather than as one narrative, storing such high-level data as assertions, summaries, hypotheses, tables, and figures that encapsulate the state of knowledge in a particular domain. A model repository is a database that not only provides access to computational models, but also links each model to the empirical and summary databases—to provide evidence for hypotheses in the model or to data—to test predictions from simulation runs made with the model. This chapter illustrates the general considerations on model repositories, such as brain models on the web, neuroscholar, neurohomology, and some future plans. A summary is a brief statement or description that summarizes a more complex body of text such as graphics, tables, or graphs, etc. In the SDBs that have been developed and stored in USCBP to date, the supporting data are called clumps for summaries directly within the databases. The schematic capture system to ease the creation and viewing of the modular structure of modules written in NSL has also been developed.
Communality Estimation and Improvement

This chapter discusses the possible solutions to the problem of estimating communalities. Thurstone's original suggestion for improving the communality estimates was to compute communalities at the end of a solution and to insert them as new estimates for a new iteration. This process was to be repeated until the communalities reached some asymptotic value to some predetermined number of decimal places. This suggestion was seldom heeded until computer solution became possible, and even today relatively few computer programs provide for such iteration to obtain stabilized values. The chapter presents the maximum-likelihood method. It is a method of factoring, which assumes that the number of factors is known rather than the communalities. The method makes an attempt to estimate population loadings instead of merely fitting the observed fallible correlation matrix. This iterative solution can be contrasted with the Horst–Hotelling solution in connection with the principal-factor method as follows: (1) the correlation matrix is used with unities in the diagonals, but these are corrected in the iteration process so that factors, and not components, are obtained; (2) the weights involve iterating not only the factor loadings but also the uniquenesses.
Associated Risk Factors and Complications in Vascular Surgery Patients Requiring Unplanned Postoperative Reintubation.

Objective To determine the frequency of reintubation within 30 days in vascular surgery patients and the associated risk factors and complications. Design Retrospective cohort study with univariate and multivariate analyses of risk factors and outcomes from data collected by the American College of Surgeons National Surgical Quality Improvement Program. Setting All institutions participating in the American College of Surgeons National Surgical Quality Improvement Program. Participants All patients older than 18 undergoing vascular surgery. Interventions Not applicable. Measurements and Main Results A reintubation rate of 2.2% among vascular surgery patients within the first 30 days was demonstrated. Reintubation was associated positively with increased age, low body mass index, poor functional status, smoking status, chronic obstructive pulmonary disease, congestive heart failure, and increased anesthesia and surgical times. In addition, specific procedures were found to have significantly increased rates of reintubation, including bypass surgery, thrombectomy, and open thoracic and abdominal aorta surgery. Reintubation was associated positively with all measured complications, including a quadrupled length of average hospital stay (19.8 v 5.5 days), a 10-fold risk of mortality (33.9% v 2.6%), and a 40-fold risk of cardiac arrest (22.4% v 0.5%). Conclusions Patients undergoing major vascular surgery represent a high-risk population for unplanned postoperative reintubation. Preoperative evaluation should include the consideration of the positively associated risk factors found in this study. Due to the significant morbidity associated with unplanned reintubation, additional work is needed to identify risk factors amenable to optimization in the preoperative period.
Phxnlme: An R package that facilitates pharmacometric workflow of Phoenix NLME analyses

Abstract Background and objective Pharmacometric analyses are integral components of the drug development process, and Phoenix NLME is one of the popular software used to conduct such analyses. To address current limitations with model diagnostic graphics and efficiency of the workflow for this software, we developed an R package, Phxnlme, to facilitate its workflow and provide improved graphical diagnostics. Methods Phxnlme was designed to provide functionality for the major tasks that are usually performed in pharmacometric analyses (i.e. nonlinear mixed effects modeling, basic model diagnostics, visual predictive checks and bootstrap). Various estimation methods for modeling using the R package are made available through the Phoenix NLME engine. The Phxnlme R package utilizes other packages such as ggplot2 and lattice to produce the graphical output, and various features were included to allow customizability of the output. Interactive features for some plots were also added using the manipulate R package. Results Phxnlme provides enhanced capabilities for nonlinear mixed effects modeling that can be accessed using the phxnlme() command. Output from the model can be graphed to assess the adequacy of model fits and further explore relationships in the data using various functions included in this R package, such as phxplot() and phxvpc.plot(). Bootstraps, stratified up to three variables, can also be performed to obtain confidence intervals around the model estimates. With the use of an R interface, different R projects can be created to allow multi-tasking, which addresses the current limitation of the Phoenix NLME desktop software. In addition, there is a wide selection of diagnostic and exploratory plots in the Phxnlme package, with improvements in the customizability of plots, compared to Phoenix NLME. Conclusions The Phxnlme package is a flexible tool that allows implementation of the analytical workflow of Phoenix NLME with R, with features for greater overall efficiency and improved customizable graphics. Phxnlme is freely available for download on the CRAN repository ( https://cran.r-project.org/web/packages/Phxnlme/ ).
Ten-Year Temporal Trends in Medical Complications After Acute Intracerebral Hemorrhage in the United States

Background and Purpose— Data on medical complications after intracerebral hemorrhage (ICH) are sparse. We assessed trends in the prevalence of urinary tract infection, pneumonia, sepsis, deep venous thrombosis (DVT), pulmonary embolism, acute renal failure (ARF), and acute myocardial infarction after ICH in the United States. Methods— A total of 575 211 adult ICH cases were identified from the 2004 to 2013 Nationwide Inpatient Sample. Weighted complication risks were computed by sex and mechanical ventilation status. Multivariate models were used to evaluate trends in complications and assess their association with in-hospital mortality, cost, and length of stay. Results— Overall risks of urinary tract infection, pneumonia, sepsis, DVT, pulmonary embolism, ARF, and acute myocardial infarction after ICH were 14.8%, 7.8%, 4.1%, 2.7%, 0.7%, 8.2%, and 2.0%, respectively, but risk differed by sex and mechanical ventilation status. From 2004 to 2013, odds of DVT and ARF increased, whereas odds of pneumonia, sepsis, and mortality declined over time. All complications were associated with >2.5-day increase in length of stay and >$8000 increase in cost. ARF and acute myocardial infarction were associated with increased mortality in all patients; sepsis and pneumonia were associated with increased mortality only in nonmechanical ventilation patients, whereas urinary tract infection and DVT were associated with reduced mortality in all patients. Conclusions— Despite significant mortality reduction, ARF and DVT risk after ICH have increased, whereas odds of sepsis and pneumonia have declined over the last decade. All complications were associated with increased cost and length of stay, but their associations with mortality were variable, likely due in part to survival bias. Innovative strategies are needed to prevent ICH-associated medical complications.
Understanding discrete capillary-wave turbulence using a quasi-resonant kinetic equation

Experimental and numerical studies have shown that, with sufficient nonlinearity, the theoretical capillary-wave power-law spectrum derived from the kinetic equation (KE) of weak turbulence theory can be realized. This is despite the fact that the KE is derived assuming an infinite domain with continuous wavenumber, while experiments and numerical simulations are conducted in realistic finite domains with discrete wavenumbers for which the KE theoretically allows no energy transfer. To understand this, we first analyse results from direct simulations of the primitive Euler equations to elucidate the role of nonlinear resonance broadening (NRB) in discrete turbulence. We define a quantitative measure of the NRB, explaining its dependence on the nonlinearity level and its effect on the properties of the obtained stationary power-law spectra. This inspires us to develop a new quasi-resonant kinetic equation (QKE) for discrete turbulence, which incorporates the mechanism of NRB, governed by a single parameter expressing the ratio of NRB and wavenumber discreteness. At , the QKE recovers simultaneously the spectral slope and the Kolmogorov constant (corrected from the original derivation) of the theoretical continuous spectrum, which physically represents the upper bound of energy cascade capacity for the discrete turbulence. For , the obtained spectra represent those corresponding to a finite domain with insufficient nonlinearity, resulting in a steeper spectral slope and reduced capacity of energy cascade . The physical insights from the QKE are corroborated by direct simulation results of the Euler equations.
Rising Thyroid Cancer Incidence in Southern India: An Epidemic of Overdiagnosis?

Background Thyroid cancer incidence is rising in high-income countries. This increase in disease burden is attributed to the phenomenon of overdiagnosis. Objective We aimed to investigate trends in thyroid cancer rates in India, focusing on the state of Kerala in southern India, which has reported a high incidence of the disease. Design Population-based study using data from the National Cancer Registry Program. Participants We used data from the Population Based Cancer Registries for Thiruvananthapuram (capital of Kerala state), Delhi, Mumbai, Bangalore, and Chennai. We used data for three reporting periods from 2005 to 2014 (represented as 2006, 2009, and 2012). Main Outcome Measures We reported the age-adjusted incidence rate (AARi) and mortality rate (AARm) per 100,000 women and the proportion of thyroid cancers diagnosed in females per 100 cancer cases. Results During 2006, the AARi for thyroid cancer in women in Thiruvananthapuram was 6.9 per 100,000, rising to 10 in 2009 and 13.3 in 2012. There was a 93% increase in incidence rates over less than a decade. The AARis in the other four cities were stable. In 2012, Thiruvananthapuram had at least a fourfold higher incidence compared with other regions. Thyroid was the primary site in one of every 10 cancers diagnosed in Thiruvananthapuram, and large numbers of patients were <40 years of age. The AARm remained stable in all regions. Conclusion We reported a high burden of thyroid cancer in Kerala, India, which is most likely due to overdiagnosis.
What is safety?: Miracles, benefit-risk assessments, and the “right to try”

Public discourse is full of quick solutions to health care problems like cancer and rare diseases. Among these is Right to Try legislation for experimental therapies. Right to Try legislation is based on the premise that all experimental agents in clinical trials are safe and guaranteed to produce miracles. Unfortunately, this notion is at odds with expert understanding, which indicates that the benefits and risks of drug products can only be understood together and evaluated incrementally and over time. The current manuscript examines why benefit to risk considerations, a lynchpin of the ethical conduct of clinical research since the Nuremberg Code, might be easily elided from public discourse. This paper considers guidelines for regulatory writing, which routinely separate discussions of effectiveness and safety, as a possible source for some confusion. The internationally-accepted ICH M4E (Common Technical Document) guideline published in 2016 now provides additional guidance for composing Benefits and Risks Conclusions, which weigh and consider effectiveness and safety together. Yet fundamental differences in understanding the "safety" of medicinal products continue to exist between experts in biomedicine, politicians, and healthcare activists. Examining differences in the understanding of "safety" between experts and non-experts also may help explain the source for flawed logic about the safety of investigational products in Right To Try narratives. No drug product is 100% safe. Continuing to weigh benefits and risks together is an important intellectual practice necessary to safeguard human health worldwide, and testing clinical safety is the only way to provide meaningful protections to patients. Science, not miracles, can ensure the protection of patients in clinical research as well as clinical practice. Weighing benefits and risks is an essential intellectual act that informs public health. Science, not miracles, can guide this work.
Familial manganese-induced neurotoxicity due to mutations in SLC30A10 or SLC39A14

Over the last few years, two rare, familial diseases that lead to the onset of manganese (Mn)-induced neurotoxicity have been discovered. Loss-of-function mutations in SLC30A10, a Mn efflux transporter, or SLC39A14, a Mn influx transporter, increase Mn levels in blood and brain, and induce severe neurotoxicity. The discoveries of these genetic diseases have transformed our understanding of Mn homeostasis, detoxification, and neurotoxicity. Current knowledge about the mechanisms by which mutations in these transporters alter Mn homeostasis to induce human disease is reviewed here.
Clinical Predictors and Natural History of Disease Extension in Patients with Ulcerative Proctitis.

BACKGROUND A proportion of patients with initial presentation of ulcerative proctitis (UP) progress to more extensive colitis. We sought to characterize the natural history and identify clinical predictors of extension in UP. METHODS We performed a retrospective cohort study of participants with a new diagnosis of UP from January 2000 to December 2015. We used Cox proportional hazard modeling to identify predictors of disease extension. RESULTS We identified 169 new cases of UP with a median age of diagnosis of 40 years (range: 16-91 yr) and a median follow-up of 4.3 years (range: 3.3-15.1 yr). Fifty-three (31%) patients developed extension over the follow-up time. Compared with nonextenders, the need for immunosuppressive or biologic therapy was significantly higher among extenders (34% versus 2.6%, P < 0.001). In multivariable analyses, compared with UP cases with body mass index <25, the adjusted hazard ratios of extension were 1.75 (95% confidence interval [CI], 0.95-3.23) and 2.77 (95% CI, 1.07-7.14) among overweight and obese patients, respectively (Ptrend = 0.03). Similarly, patients with a history of appendectomy or endoscopic finding of moderate to severe disease had a higher risk of extension (adjusted hazard ratio = 2.74, 95% CI, 1.07-7.01 and 1.96, 95% CI, 1.05-3.67, respectively). CONCLUSIONS In a retrospective cohort study, we show that appendectomy, body mass index, and endoscopic activity at the time of diagnosis of proctitis are associated with an increased risk of extension. In addition, our data suggest that extenders are more likely to require immunosuppressive or biologic therapy.
Utilizing Digital Image Correlation (DIC) in Asphalt Pavement Testing

The digital image correlation (DIC) technique as a displacement and strain measurement method is one of the newest measurement technologies employed in asphalt pavement testing. Although DIC was introduced for material testing in the early 1980s; this technology is not yet being used to its highest potential as a reliable and flexible method for measuring displacements and strains and, more importantly, for investigating cracking phenomena and fracture characteristics in asphalt pavement testing. This research aimed to study the requirements for ensuring a reliable and accurate DIC system and to demonstrate areas where the technique could be used to provide an edge over traditional measurement methods. Using proprietary two-dimensional DIC software, the parameters that affect the accuracy of test results were evaluated and the proper analysis configurations for investigating cracked areas were determined. The results showed that the DIC technique, if used properly, is an extremely powerful tool for studying damage progression and fracture characteristics in the fatigue and fracture testing of asphalt concrete.
A Wideband Variable Gain LNA With High OIP3 for 5G Using 40-nm Bulk CMOS

This letter presents a CMOS wideband variable gain LNA for 28-GHz 5G integrated phased-array transceivers preserving high third-order intercept point (OIP3) at all gain settings. The prototype LNA has three stages providing digitally controlled gain optimized for higher IIP3 at lower gain. The stages are coupled together using double-tuned transformers for maximum group delay flatness. Fabricated in a 40-nm CMOS process, it achieves 18–26 dB gain at 1-dB gain step with 12–14.5 dBm OIP3 and 3.3–4.3 dB noise figure, while consuming 21.5–31.4 mW across 26–33 GHz frequency range. The root-mean-square error of the gain steps is less than 0.38 dB.
Obesity and chronic kidney disease.

Purpose of reviewTo review recent advances in the epidemiology, pathophysiology, clinical features, and treatment of obesity-related kidney disease.Recent findingsStudies have confirmed that obesity is associated with increased risk of developing chronic kidney disease (CKD). This risk extends to th
Determining the Effect of Training on Uncertainty Visualization Evaluations

Traditional studies in uncertainty visualization often require naive participants to complete complex, domain-specific tasks in order to examine how effectively a visualization conveys uncertainty to support decision making. However, without assessing whether participants understand such tasks, it can be difficult to determine whether differences in performance are due to a given visualization or to varying degrees of comprehension. Although training is commonly administered to non-experts, to date, training has not been a focal point in uncertainty visualization research. In this paper, we evaluated how variations in training, coupled with assessments of knowledge acquisition and application, can inform uncertainty visualization research. Overall, we found significant performance differences based on training condition, illustrating how training influences task comprehension, which in turn influences decision making. This study serves to highlight training as a critical component of uncertainty visualization studies by quantifying performance variations due to training.
Measuring the Cost of Universal Service for Posts

The recent introduction of legislation designed to reduce the scope of the postal monopoly, in the United States and elsewhere, has sharpened interest in understanding the cost borne by a postal operator when it serves customers at noncompensatory prices.2 The measurement of such universal service obligation costs (USO) is directly relevant to the scope of entry restriction. A rationale sometimes employed for granting an exclusive franchise to a postal operator is that such restrictions are necessary to finance the cost of universal service.3 That is, the postal operator is simultaneously charged with serving all customers, irrespective of cost differentials, and allowed, via the exclusive privilege on letter carriage, to charge certain customers prices above cost to fund the mandated lossmaking activities. Since there necessarily exists some vector of prices that eliminates all loss-making mail flows, rendering profitable any flows for which the price is less than the willingness to pay and eliminating the rest, the USO is intimately related to the constraint that postal operators offer services of the same quality at uniform prices, despite cost differences. An additional limit generally placed upon the prices chosen by the postal operator is that the universal services be provided at an “affordable rate.”
The Behavior of Organizations

In this chapter we offer a theory that can explain the similarities and differences in the managerial priorities and tactics of charities and for-profit providers. We do not attribute much importance to legal form but rather focus on conditions in the organizations’ niches. The chapter is divided into three sections. The first reviews research that examines the different outputs and outcomes of charities and for-profits. Second, we review theories and research proffered by the sociology and management literatures to gain perspective on what might explain managerial priorities and tactics. Finally, we use recent advances in niche theory to shed light on why many charities have priorities and tactics similar to for-profits while others remain quite distinct. In the course of this exercise we hope to introduce a framework for studying organizations—both for-profits and charities—that will prove useful for students of macro-organizational behavior.
Determinants of private health insurance coverage among Mexican American men 2010-2013.

Background Private health insurance (PHI) represents the largest source of insurance for Americans. Hispanic Americans have one of the lowest rates of PHI coverage. The largest group in the US Hispanic population are Mexican Americans; they account for about two in every three Hispanics. One in every three Mexican Americans aged 64 years and under did not have health insurance coverage. Mexican Americans have the most unfavorable health insurance coverage of any population group in the nation. Objectives The objective is to determine the factors associated with the gap in PHI coverage between Mexican American and non-Hispanic American men. Methods This study used the National Health Interview Surveys (2010-2013) as the sample. A non-linear Oaxaca-Blinder decomposition was run, estimating the explained and unexplained gap in PHI coverage between the groups. Several robustness tests of the model were also included. Results This study estimates that 44.4% of employed Mexican American men are covered by PHI compared to 79.5% of non-Hispanic American men. Nearly 60% of employed Mexican American men were found to be foreign born, 35% have an educational attainment less than a high school degree, and 40% are likely to have language barriers. Decomposition results show that income, low educational attainment, being foreign-born, and language barriers diminished the probability of private health insurance coverage for Mexican Americans, and that 10% of the gap is unexplained. Conclusions Most of the difference in the PHI rate between Mexican American men and non-Hispanic men is explained by observable differences in group characteristics: education, language, and immigration status. About 10% of the difference can be attributed to discrimination under the traditional interpretation of an Oaxaca-Blinder decomposition. The PHI rate gap is large and persistent for Mexican American men.
Major emergency orthopaedic surgery in patients with a concomitant acute coronary event following trauma

This paper is a short series description of our experience with five cases managed surgically for orthopaedic trauma and who suffered meanwhile an acute coronary event. Five polytrauma, multiply fractured patients were treated in our institution for various lesions, including an open femur and knee articular fractures, major fractures around the pelvis and hips. They had suffered around the same time an acute coronary event complicating the orthopaedic management. One patient was treated for the orthopaedic condition as a delayed emergency, with a five day retard due to pre-operative pulmonary oedema. Four patients had cardiac evaluation, angiogram or echocardiogram. The patients were managed by a multi-disciplinary team. One patient died post-operatively due to multiple complications, and four patients survived with a good functional outcome. Patients with acute orthopaedic polytrauma presenting concomitant acute coronary events should be treated by multi-disciplinary teams, allowing early surgical management in a safe cardio-vascular and stable haemodynamic status.
Interpreting basal sediments and plant fossils in kettle lakes: insights from Silver Lake, Michigan, USA

We report on pollen, plant macrofossils, and associated lithostratigraphy of a sediment core extracted from the base of Silver Lake, a kettle lake in northern Lower Michigan, USA, which reveal a co...
Development and psychometric evaluation of a questionnaire to measure cancer patients' perception of care coordination.

Although the importance of care coordination (CC) is well-recognized, cancer patients often receive poorly coordinated care across varied care settings and different oncology providers. Efforts to improve cancer care are hampered by lack of adequate measures. In this two-part, mixed-method study, we describe the development, refinement, and validation of a new care coordination instrument (CCI) designed to assess cancer patients’ perception of CC. In Study 1, an initial CCI was developed incorporating questions based on literature review. The items were then modified following four field tests conducted in a large academic hospital with oncology nurses (n = 20) and cancer patients (n = 120). This modified instrument was used to determine whether the CCI was able to distinguish CC between two practices (30 GI and 30 myeloma patients) within the same hospital setting. In Study 2, 68 patients receiving community-based care participated in seven focus groups. Based on these discussions, the CCI items were again refined, and psychometric evaluation was conducted to assess the quality of the instrument. Based on field tests, 3 domains of the CCI, Communication, Navigation, and Operational, were defined as critical components of CC. The Operational domain evaluates efficiency of care and is unique to this CCI. The field test demonstrated that GI patients reported significantly better CC Overall and for the Communication and Navigation domains (all p < .05). In Study 2, patients expressed concordance with the CCI items and their CC experiences, establishing validity of the CCI. Qualitative analysis of the focus group discussions indicated that the items with the highest frequencies of participants’ comments were related to the concepts of Navigator, Team, Survey, and Communication. Quantitative analysis identified items with a limited response range or high rates of “neutral” responses; accordingly, those items were removed. The final CCI survey is a 29 item, multiple-choice questionnaire with excellent reliability, Cronbach’s α = .922. We developed a novel, patient-centered tool with excellent psychometric properties that can be utilized across varied practice settings to assess patients’ perception of cancer care coordination. Not required; retrospectively registered ClinicalTrials.gov NCT03594006 20 July 2018.
Heart Failure Duration Association with Gastrointestinal Bleeding Post Left Ventricular Assist Device

Purpose Gastrointestinal bleeding (GIB) is a frequent post left ventricular assist device (LVAD) co-morbidity with gastrointestinal angiodysplasia (GIAD) commonly implicated. Timing of LVAD therapy is variable, but no study has specifically analyzed duration of pre-LVAD heart failure on GI bleeding outcomes after VAD implantation. Methods Between February 2007 and June 2019, 389 patients underwent primary LVAD implantation at our clinic. Median age at implant was 62 years (range, 18-82 years) and 306 (79%) were male. Etiology of heart failure was ischemic in 182 patients (47%) and indication for implant was destination therapy in 266 (69%). Axial flow pump was utilized in 282 (73%) and centrifugal flow in 105 (27%). Median preoperative duration of heart failure was 8.9 years. Results Early mortality occurred in 27/387 patients (7%). Follow-up was available in all 350 early survivors for a median of 1.8 years (920 years of patient support). There were 462 GI bleeding events in the 350 early survivors during the follow up time period. Figure 1 shows the relative hazard of GIB as time from heart failure diagnosis to LVAD implant increases and suggests a possible nonlinear trend for time from heart failure diagnosis to LVAD implant between 1000 and 6000 days and lowest relative hazard of GIB. There are wider confidence bands below 3000 days and above 6000 days so it cannot be concluded that hazard of GIB decreases in these ranges. This approached statistical significance (P=0.06) supporting a possible trend. Conclusion GI bleeding events are common after LVAD implant and a longer preoperative duration of heart failure prior to LVAD implant may increase burden of this adverse event. This would be a powerful factor in considering someone for LVAD implant earlier rather than protracted heart failure management if clinically indicated.
The association between participation and quality of life indicators with hospitalizations in ambulatory adults with spinal cord injury.

Study design Statistical modeling of self-report assessments (SRA) as predictors of future hospitalizations, measured by administrative billing data. Objectives To examine the relationships between self-reported participation and quality of life (QOL) indicators and future hospital admissions among ambulatory adults with chronic spinal cord injury (SCI). Setting Data were collected from participants living in and utilizing hospitals in the state of South Carolina. Methods Participants were identified through the South Carolina SCI Surveillance System Registry. Between 2011 and 2015, 615 ambulatory adults (>18 years old) with chronic (>1-year), traumatic SCI completed mailed SRA. Participant socio-demographic, injury, health, participation, and QOL indicators were assessed using self-report data. Administrative billing data were used to measure hospital utilization in nonfederal, South Carolina hospitals in the year following the SRA. Results Prior year discharges, current pressure ulcers, number of chronic conditions, walking 150 feet more often (never, less than once per week, at least once per week, once or twice per day, or several times per day), and greater home life satisfaction were associated with an increased risk of subsequent hospitalization. Walking 10 feet more frequently and greater global satisfaction were associated with a decreased risk of hospital admission. Conclusions Specific participation and QOL items may increase the risk of hospitalization in ambulatory adults with SCI. Further study is necessary to understand better the relationships between walking distance and frequency, home life and global satisfaction, and inpatient admissions.
Three (Not So) Easy Pieces

By the time I became an attending, my memory of the terror of that first bedside presentation was completely lost to me.
Avascular necrosis in systemic sclerosis patients: a case-based review of demographics, presentation, and management

Avascular necrosis (AVN) is a pathologic process involving death of bony tissue resulting from loss of blood supply from various causes. Various traumatic and nontraumatic causes of AVN are known, including systemic autoimmune diseases. AVN has been well described in patients with autoimmune diseases such as systemic lupus erythematosus, but in systemic sclerosis (SSc) patients, there have been limited case reports and case series. There have only been three case reports of AVN in multiple anatomic sites (multifocal AVN) reported in SSc patients in the literature. We present a case of multifocal AVN in an SSc patient and a review of literature on the previously reported cases of SSc-related AVN in terms of demographics, clinical presentation, and management. To our knowledge, this is the only literature review of reported AVN cases in SSc patients.
Impact of warning labels on reducing health halo effects of nutrient content claims on breakfast cereal packages: A mixed-measures experiment.

Abstract Chile recently implemented a food labeling law that requires packaged foods with sugar, saturated fats, sodium, and/or calorie content that exceeds government-defined thresholds to carry a front-of-package warning for each excessive nutrient. This law does not prohibit the use of nutrient content (NC) marketing claims on packages, as long as the claims do not directly contradict the warnings. Yet, having NC claims alongside nutrient warnings might send mixed messages confusing consumers about the overall healthiness of a product. The present study tests the co-occurrence of warning labels and NC claims in breakfast cereal packages on product perceptions and behavioral intentions of Chilean adults in a 3 (warnings: none, high calorie, high calorie/high sugar) × 3 (NC claims: none, fiber/wholegrain, low fat/cholesterol-free) mixed-measures experiment. Fiber-related claims had a main effect leading to more positive ratings of the product, compared to having no NC claims or fat-related claims. These positive ratings extended beyond perceptions of the fiber content to perceptions of overall healthiness, naturalness, quality, vitamin content, and intentions to purchase and recommend the product—a health halo effect. No significant interaction between warnings and NC claims was found. However, warnings had a main effect on perceptions irrespective of the presence of NC claims, with one warning significantly reducing ratings, dampening any halo effects, and two warnings further dampening any effects. These findings indicate that warning labels can mitigate, but not eliminate the influences of NC claims on consumer perceptions of product healthiness.
Zurückbleiben – ein migrationshistorischer Perspektivwechsel

Not only migrants are changed by their experiences; those left behind are also affected in significant ways. Their changes and experiences when their relatives and friends chose to migrate had till now not been the topic of much historical research. Scholars of historical migration have mostly focused on one half of the story: on the ways of the migrants. Migration means always separation and change; but also those staying behind and the structures at home will change by the departure of the former compatriots. Those staying behind have to say goodbye and to accept the realities of separation. Social and economic positions are vacant after the leave of the migrants, they have to be filled again and the whole social configuration has to be newly arranged. As an example for the broad topic, the article focuses on those left behind by emigrants from Germany during the Nazi period.
Outer Approximations of Minkowski Operations on Complex Sets via Sum-of-Squares Optimization

We study the problem of finding closed-form outer approximations of Minkowski sums and products of sets in the complex plane. Using polar coordinates, we pose this as an optimization problem in which we find a pair of contours that give lower and upper bounds on the radial distance at a given angle. Through a series of variable transformations we rewrite this as a sum-of-squares optimization problem. Numerical examples are given to demonstrate the performance.
Analytics for Good: Predicting Secondary Education Attainment with Text Analytics

Factors influencing secondary educational attainment (staying in high school) are well characterized, but several shortcomings of current educational attainment theory preclude a real-time and wide-scope understanding of the issue. Further insight could be provided by text analytic technology. In this article, the authors review the current status of secondary educational attainment and its associated theories, and identify areas of weakness which could be reinforced by adopting text analytic research methods. The authors conclude with a discussion of potential applications of text analytic research within school systems aimed at equipping educators and counselors with additional resources to more accurately pinpoint intervention efforts.
Tracking of partials in music signals using Kalman filtering: modeling and analysis

In this paper we propose a method for tracking of partials in music signals using Kalman filtering. Our observations are frequency and amplitude of peaks from spectral representation of short segments of music signal. These peaks are detected using a novel technique. We also introduce a set of state-space models for evolution of partials in time. Parameters of these models can be estimated by statistical analysis of a large database of musical sounds. Since Kalman filter is sensitive to the accuracy of these parameters, we propose some robust filters that can improve the performance of our tracker and discuss the possibility of using them.
Nucleic Acid Mimetics

The naturally occurring nucleic acids have the ability to selectively recognize complementary partners, and by self-assembly create supramolecular structures capable of storage of genetic information. Chemists are interested in mimicking the makeup and properties of nucleic acids to aid in the understanding of the natural systems, and to create functional nanomaterials for a broad range of potential applications. Nucleobase analogs, including fluorescent, hydrophobic, and inorganic bases, have been successfully incorporated into modified DNA and RNA strands. Analogs of the sugar-phosphate backbone have been constructed to increase the strength of binding between strands, and to create alternative scaffolds for both natural and synthetic nucleobases. Synthetic analogs with a combination of nucleobase and backbone mimics provide routes toward materials with tuned physical properties geared toward specific functions. This review first describes the properties of nucleic acids that serve as models for creation of synthetic analogs before presenting recent research in each of these categories of mimics. Keywords: DNA; biomimetic; molecular recognition; self-assembly; ligandoside; metallobase
Impact of high-risk classification by FISH: an Eastern Cooperative Oncology Group (ECOG) study E4A03

Lenalidomide with dexamethasone is a standard induction treatment regimen for newly diagnosed myeloma (although a Federal Drug Administration indication is still absent). In the context of the Phase 3 clinical trial E4A03 (lenalidomide plus dexamethasone in low or high doses), we queried whether a fluorescence in situ hybridization (FISH)-based genetic classification into high risk (HR) and standard risk (SR) multiple myeloma (MM) would remain clinically significant. Of 445 E4A03 patients, 126 had FISH analysis; 21 were classified HR with t(4;14), t(14;16), or 17p13 deletions. Median survival follow-up approached 3 years. Patients with FISH data tended to be younger and healthier compared to the rest of the study population and, consequently, had superior overall survival (OS) results. Within the FISH cohort, shorter OS in the HR versus SR group (P = 0·004) corresponded to a hazard ratio of 3·48 [95% confidence interval: (1·42-8·53)], an effect also observed in multivariate analysis. Two-year OS rates were 91% for SR MM and 76% for HR MM. There was also evidence of interaction between risk status and treatment (P = 0·026). HR patients were less likely to attain good partial response (SR 46% and HR 30%, Odds Ratio = 2·0 [0·7-5·6]), but overall response rates were not different. FISH-based risk classification retained prognostic significance in patients receiving lenalidomide-based induction.
Control of adenylate cyclase by divalent cations and agonists: Analysis of interactions by the hill equation

Abstract The analysis by the Hill equation of the results of adenylate cyclase (ATP pyrophosphate-lyase (cyclizing), (EC 4.6.1.1) activation in human granulocytes resulted in the following findings: the adenylate cyclase agonists have no effect on guanyl nucleotide and divalent cation activation or inhibition of the adenylate cyclase activity since the Hill coefficients for Gpp(NH)p, Mg2+ and Ca2+ were not affected by (±)- isoproterenol , histamine or prostaglandin E1. The fact that the Hill coefficient for five adenylate cyclase agonists (prostaglandin E1, (±)- isoproterenol , histamine, (−)-adrenalin and (±)- noradrenalin was approximately 0.5 or less rules out the possibility that there is a cooperation among the catalytic subunits of the adenylate cyclase. The inhibitory action of Ca2+ on the adenylate cyclase activity can be attributed to a competition between Ca2+ and Mg2+ that results in a replacement of Mg2+ by Ca2+ at the intracellular Mg2+ binding site. The Hill coefficient for Mg2+ was 1.8, 2.1 and 1.7 at 0, 0.1 and 0.5 mM Ca2+ but decreased significantly to 1.1 at 1 mM Ca2+. The exposure of whole cells to Mg2+ Ca2+, prostaglandin E1 and ionophore A23187 has indicated a diverse action of divalent cations on the cyclic AMP formation. Our data suggest that Ca2+ and Mg2+ potentiate the prostaglandin E1 stimulatory effect on cyclic AMP production, Ca2+ at the extracellular and Mg2+ at the intracellular site of the adenylate cyclase complex. In contrast, prostaglandin E1-stimulated cyclic AMP formation was inhibited when Ca2+ and Mg2+ acted at the reverse sites.
Computer Music Workstations I Have Known and Loved

This paper introduces a set of design criteria and points of current debate in the development of computer music workstations. It surveys the systems of the last ten years and makes several subjective comments on the design and implementation of computer-based tools for music composition, production, and live performance. The intent is to focus the reader's attention on the issues of hardware architecture and soft- ware support in defining computer-based tools and instruments.
Optimal Rotation Problems in Channel Routing

In the channel routing problem, a problem arising in the design of layout systems, two rows of terminals which are opposite each other, have to be connected. We study what effect the rotation of one row of terminals has on the cost measures of the routing phase. The cost measures we consider are the density, which is proportional to the width of the channel, the crossing number, which is closely related to the number of crossings between two wires in the channel, and the length of nets, which is related to the wire length needed in the routing. We present algorithms for determining the rotations which minimize each of these cost measures. The algorithms can also be used for solving optimal offset problems.