cssi/SciSciGPT-SciSciNet huggingface dataset:
Atrial Septal Defect

Atrial septal defect (ASD) is a hole in the atrial septum that allows blood flow to shunt between the left and right atria. These defects are generally characterized as secundum type (hole in the septum primum) and sinus venosus type (hole in the atrial septum that is associated with the superior vena cava/inferior vena cava and accompanying anomalous pulmonary venous return). The “ostium primum ASD” is better termed “partial atrioventricular (AV) canal” because it is generally associated with a cleft or zone of apposition in the anterior left AV valve leaflet (see Chap. 9). Figure 7.1 shows a composite view of the most common types of ASD, including the ostium primum ASD (partial AV canal), but the zone of apposition in the anterior leaflet of the left AV valve is not shown. A single atrium has no remnant of atrial septal tissue and is generally thought to be a partial AV canal with absence of the septum primum and septum secundum. Patients with a patent foramen ovale or a “stretched” patent foramen ovale generally have small interatrial communications. The difference between a patent foramen ovale and a secundum ASD involves the amount of residual septum primum and its relationship to the septum secundum, which is superiorly located. These two septa are situated in different planes, in a flaplike configuration. The septum secundum is superior and slightly lateral in location; the septum primum is inferior and slightly medial. If the planes of the septa are brought together and there is enough tissue in the septum primum to effectively cause closure of the defect, then the hole is a patent foramen ovale. If there is not enough septum primum to effectively close the hole, then the hole is a secundum ASD.
Editorial: Tox21 Challenge to Build Predictive Models of Nuclear Receptor and Stress Response Pathways As Mediated by Exposure to Environmental Toxicants and Drugs

Tens of thousands of chemicals with poorly understood biological properties are released into the environment each day. High-throughput screening (HTS) is potentially a more efficient and cost-effective alternative to traditional toxicity tests. Using HTS, one can profile chemicals for potential adverse effects and prioritize a manageable number for more in-depth testing. Importantly, it can provide clues to mechanism of toxicity. The Tox21 program has generated >50 million quantitative high-throughput screening (qHTS) data points. A library of several thousands of compounds, including environmental chemicals and drugs, is screened against a panel of nuclear receptor and stress response pathway assays. The National Center for Advancing Translational Sciences (NCATS) has organized an International data challenge in order to “crowd-source” data and build predictive toxicity models. This Challenge asks a “crowd” of researchers to use these data to elucidate the extent to which the interference of biochemical and cellular pathways by compounds can be inferred from chemical structure data. The data generated against the Tox21 library served as the training set for this modeling Challenge. The competition attracted participants from 18 different countries to develop computational models aimed at better predicting chemical toxicity. The winning models from nearly 400 model submissions all achieved >80% accuracy. Several models exceeded 90% accuracy, which was measured by area under the receiver operating characteristic curve (AUC-ROC). Combining the winning models with the knowledge already gained from Tox21 screening data are expected to improve the community’s ability to prioritize novel chemicals with respect to potential human health concern.
Dimensions and Indicators of Patients' Perceived Nursing Care Quality in the Hospital Setting

Nursing professionals have noted the impact of cost-containment strategies on nursing care quality in the hospital setting. However, there is a lack of scientific data to demonstrate the impact. The author reviewed 53 published data-based primary studies of patient satisfaction with nursing care (PSNC) from 1982 to the present and identified 13 published PSNC instruments. The author performed content analysis of the published instruments and identified the dimensions and indicators of patients' perceived structure, process, and outcomes attributed to nursing care. The needs for further development of instruments to assess patients' perceived nursing care quality are identified.
Bioethics - Part 2: Is it compassion, personal autonomy, or ulterior utilitarian motives at heart?

Following the publication of the first part of this article, “Bioethics – Should they encourage the killing of unwanted newborn infants?” dealing with bioethics and infanticide,[6] I received correspondence from a former colleague, Dr. Richard L. Elliot, Director of Medical Ethics at Mercer University, contending there is little difference among medical and biomedical ethicists; that my characterization of bioethicists as utilitarian moralists (useful agents of the state) may not be accurate; and that autonomy (and personal choice) is given “high priority” by bioethicists.[2] I beg to differ on all counts.
CeO 2 and ZnO Nanoparticles Change the Nutritional Qualities of Cucumber (Cucumis sativus)

There is lack of information about the effects of nanoparticles (NPs) on cucumber fruit quality. This study aimed to determine possible impacts on carbohydrates, proteins, mineral nutrients, and antioxidants in the fruit of cucumber plants grown in soil treated with CeO2 and ZnO NPs at 400 and 800 mg/kg. Fourier transform infrared spectroscopy (FTIR) was used to detect changes in functional groups, while ICP-OES and μ-XRF were used to quantify and map the distribution of nutrient elements, respectively. Results showed that none of the ZnO NP concentrations affected sugars; however at 400 mg/kg, CeO2 and ZnO NPs increased starch content. Conversely, CeO2 NPs did not affect starch content but impacted nonreducing sugar content (sucrose). FTIR data showed changes in the fingerprint regions of 1106, 1083, 1153, and 1181, indicating that both NPs altered the carbohydrate pattern. ZnO NPs did not impact protein fractionation; however, CeO2 NPs at 400 mg/kg increased globulin and decreased glutelin. Both CeO2 an...
Effectiveness of dominant aggregate size range – interstitial component criteria for consistently enhanced cracking performance of asphalt mixtures in the field

This study primarily focused on evaluating the effectiveness of dominant aggregate size range – interstitial component (DASR-IC) criteria established for the purpose of asphalt mixture design and c...
Language Resources for Multi-Modal Dialogue Systems.

This paper reviews a resource base of software agents for hub-based architectures, which can be used generally for advanced dialogue systems research and deployment. The problem of domain-specificity of dialogue managers is discussed, and we describe an approach to it developed at CSLI, involving a domain-general dialogue manager with application specific “Activity Models”. We also describe relevant grammar development tools.
Methods of Web Service Composition

This chapter explains methods of web service composition using the formalism of the previous chapter.
An empirical assessment of a univariate time series for demand planning in a demand-driven supply chain

Many firms use customer orders time series as the basis of their forecasting and demand planning. However, there are other firms that use sales orders (shipments). Our research focused on evaluating and understanding the implications of using sales orders (shipments) to plan for a supply chain. We evaluated the structural difference between customer orders time series and sales orders time series. An experiment was conducted using a set of 48-month and a set of 576-month (long) normally distributed, randomly generated customer orders time series and shipment time series. The time series were statistically evaluated periodically by rolling the data and then comparing them using a two-sample comparison in Statgraphics Centurion XVII software. The series were then used to generate periodic forecast and their forecasts statistically tested using two-sample comparison. We found a statistically significant difference between the two series for both the 48-period time series and the extended 576-period time series. Our results show that customer orders time series is statistically different from shipment timer series due to censorship. Forecasts generated from customer orders and sales orders time series exhibit statistically significant difference. Using shipment time series to forecast and plan for a demand-driven supply chain causes a perpetual state of under-inventory.
Flux Linkage Detection Based Ground Fault Identification and System Diagnosis in High-Resistance Grounding Systems

High-resistance grounding (HRG) is preferred in many industrial applications where the operation continuity is critical under ground fault conditions, such as pulp, paper, oil refining, chemical, glass, and metal industries. This is due to: 1) continuity of service; 2) minimized productivity impact with the scheduled system downtime; and 3) improved safety concerns—elimination of phase to ground arc flash hazards, suppression of transient line to ground overvoltages, and minimization of the equipment damage at the point of ground fault. However, there are also some drawbacks in accurately detecting and locating a ground fault in adjustable speed drive (ASD) systems: 1) the HRG fault current (1–10 A) cannot reliably trip the overcurrent protection function in drives; 2) the existing methods are based on the line voltage/frequency (50/60 Hz), making it hard to detect and locate low-voltage/low-frequency ground faults; and 3) with the existing methods, the possible fault locations will be manually checked one by one using an Ammeter by a trained technician. This paper will present a flux linkage detection based HRG fault identification method for ASD systems. The proposed method can solve: 1) reliable HRG fault detection with wide motor speed range; 2) the HRG fault can be easily identified in multiple systems; and 3) the identification process is performed by the proposed system diagnosis method, no trained technician is required during the identification process.
Toward a Safer Tomorrow: Cybersecurity and Critical Infrastructure

With the discovery of the Stuxnet worm in June 2010 came the first documented cyber-attack on critical infrastructure that resulted in mass physical damage. This attack spurred governments and private industry owners of Critical Infrastructure to inspect their cybersecurity practices with the hopes of improving their protection methodologies. While this introspective approach has helped owners and operators of critical infrastructure realize the startling deficiency of security in this area, it has also spawned many attempts to remediate these problems that do not solve the underlying causes of the existing gaps in protection. In this chapter, three “post-Stuxnet” cyber-attacks against critical infrastructure sectors in three different countries are investigated—the USA, Germany, and Turkey. This analysis details the vectors of attack in each incident, the resulting impact, and measures that have been taken by both the public and private sectors in each country to bolster the security posture of their infrastructure after the incident. The result indicates common issues among all three incidents, namely faults in the design of the underlying control systems used and a dichotomy between the actions taken by corresponding governments and private industry. In order to address these faults, there needs to be scalable and risk-based processes to improve supporting processes of cybersecurity in critical infrastructure—namely information sharing, accountability, and risk assessment. This research provides insights into the effects of recent destructive cyber-attacks and the divide between governments and private industry, as well as lapses in security programs that prevents the effective defense of critical infrastructure.
Marian Szyrocki, Martin Opitz: Neue Beiträge zur Literaturwissenschaft, Vol. IV. Berlin: Rütten & Loening, 1956. Pp. 227. DM 10.50.

(1958). Marian Szyrocki, Martin Opitz. The Germanic Review: Literature, Culture, Theory: Vol. 33, No. 1, pp. 67-70.
Pavement performance evaluation models for South Carolina

This paper develops pavement performance evaluation models using data from primary and interstate highway systems in the state of South Carolina, USA. Twenty pavement sections are selected from across the state, and historical pavement performance data of those sections are collected. A total of 8 models were developed based on regression techniques, which include 4 for Asphalt Concrete (AC) pavements and 4 for Jointed Plain Concrete Pavements (JPCP). Four different performance indicators are considered as response variables in the statistical analysis: Present Serviceability Index (PSI), Pavement Distress Index (PDI), Pavement Quality Index (PQI), and International Roughness Index (IRI). Annual Average Daily Traffic (AADT), Free Flow Speed (FFS), precipitation, temperature, and soil type (soil Type A from Blue Ridge and Piedmont Region, and soil Type B from Coastal Plain and Sediment Region) are considered as predictor variables. Results showed that AADT, FFS, and precipitation have statistically significant effects on PSI and IRI for both JPCP and AC pavements. Temperature showed significant effect only on PDI and PQI (p < 0.01) for AC pavements. Considering soil type, Type B soil produced statistically higher PDI and PQI (p < 0.01) compared to Type A soil on AC pavements; whereas, Type B soil produced statistically higher IRI and PSI (p < 0.001) compared to Type A soil on JPCP pavements. Using the developed models, local transportation agencies could estimate future corrective actions, such as maintenance and rehabilitation, as well as future pavement performances.
WITHDRAWN: More Than Meets the Eye: TV News, Priming, and Public Evaluations of the President

This content has been removed under this ISBN. It exists on ScienceDirect at the following URL: http://www.sciencedirect.com/science/book/9780125319560 .
Weakly-supervised audio event detection using event-specific Gaussian filters and fully convolutional networks

Audio event detection aims at discovering the elements inside an audio clip. In addition to labeling the clips with the audio events, we want to find out the temporal locations of these events. However, creating clearly annotated training data can be time-consuming. Therefore, we provide a model based on convolutional neural networks that relies only on weakly-supervised data for training. These data can be directly obtained from online platforms, such as Freesound, with the clip-level labels assigned by the uploaders. The structure of our model is extended to a fully convolutional networks, and an event-specific Gaussian filter layer is designed to advance its learning ability. Besides, this model is able to detect frame-level information, e.g., the temporal position of sounds, even when it is trained merely with clip-level labels.
Landscape Maintenance Firms: II. Pest Management Practices

Abstract Landscape maintenance firms in Georgia were surveyed to obtain information regarding pesticide usage and factors that would facilitate adoption of non-chemical pest control measures. The trend in pest control from 1988 to 1993 was toward greater usage of non-chemical control measures. The usage trend for chemicals during that period was an increase for fungicides/bactericides and herbicides and a decrease for insecticides, with growth regulator use remaining steady. Over half (55%) of the pesticides were used for turf management. All firms expect to use about the same amount of pesticides over the next 5 years while increasing the use of non-chemical control measures. Opportunities were identified for landscape architects and university personnel to help landscape maintenance firms reduce the need for pesticides. The two most frequently identified opportunities for university personnel were to sponsor local workshops with specific training for workers on integrated pest management (IPM) practices...
The Value of Real-Time GNSS to Earthquake Early Warning

GNSS-based earthquake early warning (EEW) algorithms estimate fault-finiteness and unsaturated moment magnitude for the largest, most damaging earthquakes. Because large events are infrequent, algorithms are not regularly exercised and insufficiently tested on few available datasets. We use 1300 realistic, time-dependent, synthetic earthquakes on the Cascadia megathrust to rigorously test the Geodetic Alarm System. Solutions are reliable once six GNSS stations report static offsets, which we require for a “first alert.” Median magnitude and length errors are -0.15±0.24 units and -31±40% for the first alert, and -0.04±0.11 units and +7±31% for the final solution. We perform a coupled test of a seismic-geodetic EEW system using synthetic waveforms for a Mw8.7 scenario. Seismic point-source solutions result in severely underestimated PGA. Geodetic finite-fault solutions provide more accurate predictions at larger distances, thus increasing warning times. Hence, GNSS observations are essential in EEW to accurately characterize large (out-of-network) events and correctly predict ground motion.
Mathematical Modeling and Analysis of Converter Slagging and Steelmaking Process by Replacing Part of Lime with Limestone

A mathematical model of converter slagging and steelmaking process by replacing part of lime with limestone is established. The rate equations of oxidation reactions and lime dissolution in converter under the limestone substitution proportion increasing from 25 to 50% can be obtained and the effects of limestone substitution proportion on the variations of the composition of hot metal, slag and converter gas during the steelmaking process are investigated. In the process of converter slagging and steelmaking by replacing part of lime with limestone, increasing the hot metal temperature and the lance height could be favor to increase the content of FeO in the slag and accelerate the limestone decomposition and dissolution. With the limestone substitution proportion increasing from 25 to 50%, the maximum of oxygen supply ratio increases from 10.7 to 19.7% and the temperature drop of converter bath is 8–60 °C.
Structural Identification Using the Applied Element Method: Advantages and Case Study Application

Structural identification has continued to develop into a versatile tool for developing high fidelity analytical models of large civil structures that accurately reflect the measured in-service response. The results of successful structural identification have been applied to validate the performance of innovative systems and improve assessments of response analysis for operational and extreme loads. Furthermore, the developing field of vibration-based damage detection has sought to employ structural identification for long-term performance monitoring and condition assessment of aged structures. Overwhelmingly, the finite element method has served as the analytical framework for such models. However, alternative physics engines, such as the Applied Element Method, offer distinct advantages over the finite element method both with respect to the computational considerations in the identification process and with respect to the use of the calibrated model for assessment of structural response to extreme loads. A general framework for structural identification with applied elements is discussed, and advantages are contrasted with traditional finite element approaches. A case study application, a prestressed concrete double-tee joist roof tested in a full-scale building, is presented to demonstrate the approach and emphasize these advantages.
Predictive validity of the R-URICA.

OBJECTIVES Measuring client motivation to change, and then using information from that assessment to plan and conduct treatment, has been of great interest to therapists. Researchers have modified a measure of motivation to change to develop the R-URICA (Tambling & Johnson, 2012, Fam. J., 20, 59). DESIGN This manuscript presents the results of an exploration of the validity of the R-URICA in a sample of individuals in couple therapy. Sample included 581 couples from a treatment-as-usual sample of counselling clinic clients. This study presents the results of inquiry into the ways in which scores on the R-URICA are modified over time in therapy, an indicator of the predictive validity of the instrument. MEASURES R-URICA, RDAS. RESULTS Results indicated that scores on the Action Subscale of the R-URICA change over time, indicating that therapy positively impacts this aspect of motivation to change. Results also suggested that the aspects of the R-URICA are related to where couples present for couple therapy and changes in dyadic adjustment in couple therapy. PRACTITIONER POINTS Practitioners should inquire about motivation to change at the outset of therapy. Further, practitioners should be sensitive to differences in motivation to change among families or couples as not all clients may be equally motivated. Practitioners may wish to devote time to engagement of male partners in therapy as males are more variable in their motivation to change and seem to impact outcomes. Practitioners may wish to consider the use of the R-URICA as an alternative measure of motivation to change in therapy.
Shaving Percentage Points Off Administrative Costs

How much money should a firm or health and welfare fund expect to save by moving away from full insurance? This sounds like a straightforward question that ought to yield to a fairly objective answer, based on a range of experiences. Instead, the answer seems strangely elusive and tangled in individual opinion. One problem is time and the press of expanding responsibilities—few managers have adequate time to spend in sharing business experiences and knowledge with others in analogous circumstances. Another is the complexity of the question and the number of variables involved. Each firm is different and the only safe way to estimate the potential cost savings is to dissect them into component parts and talk in terms of ranges, with a margin for error. But this approach introduces other errors, since the component parts are in some ways inseparable. Money saved in one sphere may well reappear, whether recognized or not, as money lost in another.
A soluble cytochrome of the b-type from a green alga, Monostromasp.

Abstract During a previous study of c -type cytochromes in various algae, the presence of a soluble cytochrome of the b -type in a water-extract of a green seaweed, Monostroma nitidum , was noted. This b -type cytochrome exhibited an absorption maximum for the α-band at approximately 560 mμ and occurred in an amount comparable to that of Monostroma cytochrome 553 (Katoh, 1959) . Inasmuch as there has been no report concerned with a soluble cytochrome of the b -type from algal material, the isolation and characterization of this new heme protein was undertaken. This report describes the purification and some of the properties of this b -type cytochrome.
Gender and Trauma in the Near-Death Experience: An Epidemiological and Theoretical Analysis

In this article, I explore the nature of the “fear-death experience” (FDE) by way of an epidemiological analysis, and discuss the FDE as one of several causal theories of the near-death experience (NDE). I then pursue two hypotheses: (1) if the FDE model is correct, one would expect to find that a number of NDEs are preceded by traumatic experiences; and (2) if the FDE model is correct, one would expect to find that more NDEs are experienced by males than females. Chi-squared analyses on data from more than 500 NDE cases revealed that the first hypothesis cannot be rejected, while the second hypothesis can be rejected. I discuss the theoretical implications of these findings.
The Child Trauma Screen: A Follow‐Up Validation

Although the prevalence of exposure to potentially traumatic events and associated outcomes among children is well documented, widespread trauma screening remains limited. This study provides additional data supporting the psychometrics of the Child Trauma Screen (CTS), a free, brief, empirically derived measure that was intended as a trauma screen for use across child-serving systems. Participants were an ethnically diverse sample of 187 children aged 6-18 years recruited from an urban children's community mental health clinic. At intake, children and their caregivers completed the CTS and other standardized measures of posttraumatic stress disorder, externalizing behavior, anxiety, and depression. Results indicated that the CTS had strong properties on both child and caregiver reports, including internal consistency (Cronbach's α = .78 for both), convergent validity (r = .83 and r = .86), divergent validity (mean across measures and reporters, r = .31; range r = .01-.70), and criterion validity (sensitivity = 0.83 and 0.76; specificity = 0.95 and 0.79, correct classification 89.3% and 81.4%). Suggested cut points and recommendations for using the CTS as a trauma screen are provided. This study provides further empirical support for the use of the CTS as a brief trauma screening measure and provides recommendations for further research.
Oliveira, Emanuelle K. F. Writing Identity: The Politics of Contemporary Afro-Brazilian Literature. Purdue UP, 2007.

Emanuelle Oliveira’s work is an important contribution to research on Afro-Brazilian writers of today. The focus is on writers affiliated with the Cadernos Negros series and Quilombhoje , two components of a literary movement initiated in 1978 and located in Sao Paulo.
X-ray mirror surface figure correction with nanometre precision controlled by layer stresses simulated by FEA.

Hard X-rays with energies higher than several kiloelectronvolts can be focused to spot sizes below 10 nm with the present synchrotron beamlines, offering unique advantages for the chemical, elemental and structure analysis of matter. Nevertheless, a surface precision on the nanometre scale for the focusing optics is required and remains the main hurdle limiting X-ray analytical techniques with single-nanometre spatial resolution. On the other hand, to preserve the wavefront properties of coherent X-ray beams, precise control of the reflective mirror surface quality at the nanometre scale is demanded for X-ray free-electron laser applications. In this work, the surface shape of a multilayer-coated X-ray mirror is controlled by layer stresses. The desired surface profile of the mirror is differentiated to its second order to obtain its corresponding curvature profile. With a step size of 1 mm along the mirror length, different coating thicknesses are applied to create different layer thermal stresses from uniform temperature change. The mirror surface profile can be obtained by integrating the curvature profile to its second order and further corrected by moving constant values for the slope and height. The technical process is simulated by finite element analysis (FEA). A case study showed that the residual slope error and the residual height error between the desired shape and the FEA result are 0.22 µrad (r.m.s.) and 1.42 nm (r.m.s.), respectively.
Women Artists, Silhouettes, and Waxworks

This chapter examines silhouettes and waxworks by late eighteenth- and nineteenth-century women artists in order to consider the ways in which these mysterious artifacts represent traces of the embodied presence of specific individuals. Viewing a silhouette connects the observer directly to the moment of the object’s creation—staging a kind of reenactment scenario across time. The extraordinary skill and technique of silhouette artists such as Isabella Beetham (1750–1825) and her daughter Jane Read (c. 1773–1800) provide insight into modes of late eighteenth-century style, gesture, and expression. In the second part of the chapter, I turn to waxworks, specifically to Madame Tussaud’s self-portraits. Encountering waxworks involves a sense of tangibility that disrupts the boundaries between spectators and objects. Silhouettes and waxworks are both quintessential tourist objects because they are things that are specifically connected to technologies of presence. I argue that the particular properties of silhouettes and waxworks as media are analogous to how women have appeared and disappeared in the archives, as well as the ways in which women’s embodied experiences are mediated through material representations that both preserve and obscure their presence.
Performance Analysis of Elliptic Curves for Real-Time Video Encryption

The use of real-time video streaming is increasing day-by-day, and its security has become a serious issue now. Video encryption is a challenging task because of its large frame size. Video encryption can be done with symmetric key as well as asymmetric key encryption. Among different asymmetric key encryption technique, ECC performs better than other algorithms like RSA in terms of smaller key size and faster encryption and decryption operation. In this work, we have analyzed the performance of 18 different ECC curves and suggested some suitable curves for real-time video encryption.
Risk factors for infection and evaluation of Sepsis-3 in patients with trauma.

Abstract Background We aim to examine the risk factors associated with infection in trauma patients and the Sepsis-3 definition. Methods This was a retrospective cohort study of adult trauma patients admitted to a Level I trauma center between January 2014 and January 2016. Results A total of 1499 trauma patients met inclusion criteria and 15% (n = 232) had an infection. Only 19.8% (n = 46) of infected patients met criteria for Sepsis-3, with the majority (43%) of infected cases having a Sequential Organ Failure Assessment (SOFA) score greater on admission compared to the time of suspected infection. In-hospital death was 7% vs 9% (p = 0.65) between Sepsis-3 and infected patients, respectively. Risk factors associated with infection were female sex, admission SOFA score, Elixhauser score, and severe injury (P Conclusion Patients with trauma often arrive with organ dysfunction, which adds complexity and inaccuracy to the operational definition of Sepsis-3 using changes in SOFA scores. Injury severity score, comorbidities, SOFA score, and sex are risk factors associated with developing an infection after trauma.
Adversarial data poisoning attacks against the PC learning algorithm

Data integrity is a key component of effective Bayesian network structure learning algorithms, namely PC algorithm, design and use. Given the role that integrity of data plays in these outcomes, th...
Energy dissipation analysis for inelastic reinforced concrete and steel beam-columns

Abstract Presented is a thermodynamics based methodology for computing energy dissipation in inelastic beam-column elements. Theoretical formulation for energy storage and dissipation in uniaxial steel fiber and concrete fiber models is derived from the principles of thermodynamics, in conjunction with a few assumptions on energy transformation and dissipation. Proposed methodology is implemented in Real-ESSI Simulator and illustrated through a number of numerical examples on beam-columns and frame models under various loading conditions. It is shown that the consideration of plastic free energy in addition to plastic work, is necessary to correctly evaluate energy dissipation in nonlinear beam-column elements. Results of energy analysis indicates that the difference between plastic work and plastic dissipation could be significant, and that the ratio between them evolves with time.
Early and Midterm Outcomes in High-risk Single-ventricle Patients: Hybrid Vs Norwood Palliation

Background Although overall outcomes have improved for single-ventricle patients, substantial morbidity and mortality remain for certain high-risk groups. The hybrid stage I procedure is an alternative to the Norwood operation for stage I palliation, but it remains unclear whether it is associated with improved outcomes in high-risk patients. Methods This single-center, nested, case-control study included high-risk patients with a systemic right ventricle who underwent hybrid stage I or Norwood palliation from January 2000 to December 2016. High-risk features included prematurity Results The study included 96 patients (35 hybrid, 61 Norwood). Despite improved 30-day survival in hybrid patients (91% vs 66%, P Conclusions There remains significant morbidity and mortality among high-risk single-ventricle infants. Despite an early survival benefit, hybrid stage I palliation has not been associated with improved midterm outcomes at our center.
Local Action, Global Impact: From Domination To Partnership By Design

Global changes often begin when people take action locally. Communities around the globe are involved in creative community-based actions that promote mutual respect, social and economic justice, and gender and environmental balance. Insights from ecological thinking, systems thinking, quantum reality, and integral vision perspectives offer new ways to understand the terms ’local’ and ‘global’, and their context. Also, today more than ever, cultural transformation models of domination and partnership coexist and are intertwined in our societal context. To advance partnership, then, requires exercising of conscious intention and choice. Design, with its goal to create, can effectively catalyze the partnership model in global and local contexts. Reviewing global examples (UNESCO Creative Cities Network, the Intergovernmental Panel on Climate Change, and Project Drawdown) and local examples (the National Loon Center in Crosslake, Minnesota and the Southwest Hmong Community Center in Tracy, Minnesota) will show a way to advance partnership more rapidly: using a design thinking/systems thinking lens, insights from ecology and other fields, conscious intention, and the choice of partnership over domination at every opportunity.
Estimating Costs of Implementing Stroke Systems of Care and Data-Driven Improvements in the Paul Coverdell National Acute Stroke Program

Purpose and objectives We evaluated the costs of implementing coordinated systems of stroke care by state health departments from 2012 through 2015 to help policy makers and planners gain a sense of the potential return on investments in establishing a stroke care quality improvement (QI) program. Intervention approach State health departments funded by the Paul Coverdell National Acute Stroke Program (PCNASP) implemented activities to support the start and proficient use of hospital stroke registries statewide and coordinate data-driven QI efforts. These efforts were aimed at improving the treatment and transition of stroke patients from prehospital emergency medical services (EMS) to in-hospital care and postacute care facilities. Health departments provided technical assistance and data to support hospitals, EMS agencies, and posthospital care agencies to carry out small, rapid, incremental QI efforts to produce more effective and efficient stroke care practices. Evaluation methods Six of the 11 PCNASP-funded state health departments in the United States volunteered to collect and report programmatic costs associated with implementing the components of stroke systems of care. Six health departments reported costs paid directly by Centers for Disease Control and Prevention-provided funds, 5 also reported their own in-kind contributions, and 4 compiled data from a sample of their partners' estimated costs of resources, such as staff time, involved in program implementation. Costs were analyzed separately for PCNASP-funded expenditures and in-kind contributions by the health department by resource category and program activity. In-kind contributions by partners were also analyzed separately. Results PCNASP-funded expenditures ranged from $790,123 to $1,298,160 across the 6 health departments for the 3-year funding period. In-kind contributions ranged from $5,805 to $1,394,097. Partner contributions (n = 22) ranged from $3,912 to $362,868. Implications for public health Our evaluation reports costs for multiple state health departments and their partners for implementing components of stroke systems of care in the United States. Although there are limitations, our findings represent key estimates that can guide future program planning and efforts to achieve sustainability.
A 12.08-TOPS/W All-Digital Time-Domain CNN Engine Using Bi-Directional Memory Delay Lines for Energy Efficient Edge Computing

In this article, we demonstrate an energy efficient convolutional neural network (CNN) engine by performing multiply-and-accumulate (MAC) operations in the time domain. The multi-bit inputs are compactly represented as a single pulse width encoded input. This translates into reduced switching capacitance ( $C_{\mathrm{ DYN}}$ ), compared to baseline digital implementation, and can enable low power neural network computing in an edge device. The time-domain CNN engine employs a novel bi-directional memory delay line (MDL) unit to perform signed accumulation of input and weight products. The proposed MDL design leverages standard digital circuits and does not require any capacitors and complex analog-to-digital converters (ADCs) to realize the convolution operation, thereby enabling easy scaling across the process technology nodes. Four speed-up modes and a configurable MDL length are supported to address throughput versus accuracy trade-off of the time-domain computing approach. Delay calibration units have been accommodated to mitigate the process variation induced delay mismatch among concurrently operating MDL units. The proposed time-domain MDL design implements a LeNet-5 CNN engine in a commercial 40-nm CMOS process achieving an energy efficiency of 12.08 TOPS/W, a throughput of 0.365 GOPS at 537 mV in the 16 $\times $ speed-up mode. 40-nm CMOS test-chip measurements over 100 MNIST images show 97% classification accuracy. Simulation results over the entire 10 000 MNIST validation dataset images taking into account the circuit non-ideal effects of the MDL-based time-domain approach show a classification accuracy of 98.42%. The test-chip is operational down to the near-threshold voltage (up to 375 mV) while maintaining the classification accuracy over 90% in the 1 $\times $ speed-up mode. Furthermore, two methods of scaling MDLs to multi-bit weights are proposed. Simulation results for 1000-class AlexNet over 50 000 ImageNet validation dataset images show classification accuracy loss within 1% when compared with software implementation. The proposed MDL based time-domain approach performing 1-bit/8-bit weight and 8-bit input MAC operations when compared with the corresponding baseline digital implementations shows 2.09 $\times $ −2.32 $\times $ higher energy efficiency and 2.22 $\times $ −3.45 $\times $ smaller area.
Is substance use disorder more prevalent in patients with hidradenitis suppurativa

Abstract Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women and is associated with significant physical and psychosocial impact. Recent studies have reported an increased prevalence of substance abuse among patients with HS, including increased alcohol, opioid, and cannabis use. Whether substance use disorder is more prevalent among patients with HS is controversial because these data come from small studies and a major confounder is that patients with HS are often prescribed opioids for HS-associated pain. This review summarizes the current literature on substance use in HS to investigate whether substance use disorder is more likely in this patient population. We also highlight possible cofounders and areas of unmet need in HS that are potential causes of abuse, such as adequate pain control and impaired quality of life, and suggest opportunities for provider intervention. Evidence suggests that there is an increased prevalence of substance use disorder in patients with HS, but the full extent is still difficult to determine. However, with early screening and appropriate referrals to specialists, dermatologic providers may properly intervene and prevent substance use disorder in patients with HS.
When is Topic Avoidance Unsatisfying?Examining Moderators of the Association Between Avoidance and Dissatisfaction

Despite theoretical arguments that avoiding certain topics can be functional, there is consistent evidence that avoiding topics tends to be associated with dissatisfying relationships. This disparity between theory and empirical findings suggests a need to understand better the connection between topic avoidance and relational dissatisfaction. The current study, which is grounded in communication privacy management theory (Petronio, 2002), examines this issue by investigating moderators of the connection between avoidance and dissatisfaction. Data were gathered from 114 parent-child dyads and 100 heterosexual dating couples. Results suggested that the associations between topic avoidance and relational dissatisfaction were moderated by individuals' motivations for avoidance and by personal and relational characteristics that are conceptually linked to such motivations. These findings are consistent with theoretical arguments that topic avoidance can be benign-and even helpful-in some relational circumstances.
Power Sharing of Offshore Wind Farm and Onshore Grid in Integrated VSC Controlled Multi-Terminal HVDC System

This paper focuses on the power sharing amongst the Voltage Source Converters (VSC) in a Multi-Terminal High Voltage DC (MT-HVDC) system. A four terminal VSC-HVDC system is modeled in PSCAD/EMTDC that connects Offshore Wind Farms (OWF) with the onshore grids via VSCs which share the available power based on the voltage droop. This is achieved by effectively controlling the voltage droop setting. Besides presenting the voltage droop-based power sharing scheme, this paper also compares the total losses on both AC and DC side as the power injection from OWF is changed due to converter outage and changes in the wind speed. A cost comparison has been presented where the line, converter, transformer losses and the generator fuel costs have been considered. The simulation results along with the cost comparison reflect the benefits of having the maximum power being supplied from the wind farms via HVDC.
The Affordable Care Act: Implications for underserved populations with head & neck cancer.

Abstract Purpose This study was done to determine the direct impact implementation of the Affordable Care Act (ACA) on patients with Head and Neck Cancer (HNCA) in states that chose to expand Medicaid compared to in states that did not, as well as assess whether this impact varied among different demographic groups. Materials and methods The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of HNCA diagnosed from 2011 to 2014. Rates of uninsured status were compared before and after Medicaid expansion and contrasted between states that did and did not expand coverage, stratified by patient and tumor characteristics, and assessed via multivariate regression. Results Overall rates of uninsured status (UR) were decreased by 63.08% in states that expanded coverage (ES) but only by 2.6% in states that did not (NS). In NS, there was an increase in proportion of black patients who were uninsured over the study period (13.7%, p = 0.077) whereas in ES, this proportion decreased by 73.3%. When stratified by primary site, patients with laryngeal cancer had the highest UR with an increase by 16.7% in NS and a decrease by 70.5% in ES. Multivariate analysis yielded predictors of uninsured status including residence in a NS, Hispanic ethnicity, and black race. Conclusions Implementation of the ACA resulted in expanded insurance coverage for patients diagnosed with HNCA concentrated mainly in states that expanded Medicaid coverage and for patients derived from vulnerable populations, including black and Hispanic patients. In states that did not expand Medicaid, vulnerable populations were disproportionately affected.
Free Fatty Acid-Induced Peptide YY Expression Is Dependent on TG Synthesis Rate and Xbp1 Splicing

Gut-derived satiety hormones provide negative feedback to suppress food intake and maintain metabolic function in peripheral tissues. Despite the wealth of knowledge of the systemic effects of these hormones, very little is known concerning the mechanisms by which nutrients, such as dietary fats, can promote the expression of genes involved in L-cell hormone production. We have tested the role of various dietary fats and found that after hydrolysis into free fatty acids (FFA’s), there is a differential response in the extent to which they induce PYY gene and protein production. The effect of FFA’s also seems to relate to triglyceride (TG) re-esterification rate, with MUFA re-esterifying faster with lower PYY production. We have also found that there are differences in potency of FFA’s based on their desaturation patterns in vitro. The potency effect of FFA’s is influenced by the rate of TG re-esterification, such that the longer FFA’s are in contact with L-cells, the more PYY they produce. We found that chronic consumption of high-fat diets enables the small intestine to re-esterify FFA’s into TG faster and earlier which resulted in a blunted postprandial PYY response. Lastly, we found that FFA’s induce X-box-binding protein-1 activation (Xbp1s) in L-cells and that adenoviral delivery of Xbp1s was sufficient to induce PYY gene expression. Taken together, the present work indicates that dietary fat can induce satiety, in part, prior to re-esterification. Chronic high-fat diet consumption increases the rate of re-esterification which diminishes satiety and may lead to increased food intake. Targeting intestinal TG synthesis may prove beneficial in restoring obesity-associated reductions in postprandial satiety.
Frontal Sinus Fractures: 10-Year Contemporary Experience at a Level 1 Urban Trauma Center.

ABSTRACT Frontal sinus fractures account for 5% to 15% of all facial fractures, and have traditionally been associated with high kinetic energy blunt injury. Surgical management is largely focused on minimizing potentially serious sequelae including frontal sinus dysfunction, CSF leak, and significant cosmetic deformity. An institutional database of 1944 patients presenting with maxillofacial fractures over a 10-year period was queried. Demographics, mechanism of injury, yearly trends, surgical approaches, and follow-up data were examined. A total of 160 (8.3%) patients presented with at least 1 fracture of the frontal sinus anterior table, posterior table, or frontal sinus outflow tract during the study period. The average annual number of cases was 15.9 ± 5.7 per year with a peak of 21.5 ± 4.0 cases during the 2014 to 2015 period and a decline to 8.5 ± 1.5 cases/year from 2016 to 2017. Among those patients with falls, 61.5% (n = 40) were a result of tripping or fainting at a height of <6 ft. 55.6% of fracture types were isolated to the anterior table, but fracture location was not significantly associated with operative intervention. Cases of operative fracture type had a higher rate of both displacement and comminution compared to nonoperative fractures (P < 0.00001). Of all patients presenting with frontal sinus fractures, 75% of cases were managed nonoperatively. However, many patients presented with falls and other seemingly low energy injuries which are not traditionally associated with frontal sinus trauma. These results highlight the need for continued follow-up even in otherwise low-risk urban populations in order to avoid long term sinus dysfunction.