cssi/SciSciGPT-SciSciNet huggingface dataset:
Current options and controversies in the treatment of high-risk patients with early-stage non-small-cell lung cancer: a surgeon’s perspective

SUMMARY While lobectomy remains the standard of care for stage I non-small-cell lung cancer in low-to-moderate-risk patients, treatment options for the medically inoperable or high-risk population have been more challenging. Understanding what defines this high-risk/inoperable population and what treatment options are currently available are outlined in this perspective. The spectrum of surgical therapy from lobectomy to sublobar resection with or without brachytherapy will also be evaluated. Furthermore, the evolution of stereotactic body radiation therapy (SBRT) in the treatment of stage I non-small-cell lung cancer and other nonsurgical treatment options currently available will be evaluated. This will provide an understanding of comparative studies of these modalities, as well as important clinical trials on the horizon.
High‐yield retroviral production using a temperature‐modulated two‐stage operation

For clinical trials, large amounts of high-titer retroviral supernatants are required. However, retroviral concentration is relatively low compared with other viral vectors. Moreover, less than half of retroviral vectors suspended in a collected supernatant are infectious because of their short half-lives. In this study, a culture medium of ecotropic retrovirus-producing GP+E86/LNCX cells in tissue culture dishes was circulated through a reservoir, which was arranged with an incubator or ice-bath stage. Titers determined from the retroviral supernatant circulated through an ice-cold reservoir increased for a week from the beginning of retroviral production, while the titers from static production with circulation through the 37°C reservoir reached a plateau after 3 days of retroviral production. After 5 days, 10 times more infectious retroviruses were obtained by circulating and keeping the majority of supernatant longer in the cold reservoir than in the production vessel at 37°C in comparison with the number collected from the static tissue culture dish without circulating the culture medium. Furthermore, the concentration of transduction inhibitors in the supernatant was decreased along with the retardation of retroviral decay at low temperature. The two-stage operation developed in this study should be easily applied to large-scale bioreactors for mass production of high-titer retroviral supernatants. © 2005 Wiley Periodicals, Inc.
Multi-visit of Kalman filtering for semantic object tracking

In this paper, we propose a new approach to simultaneously estimate the motion parameters and shape parameters of a rigid object over the image sequence while the object is in motion. Our approach applies the Kalman filter multiple times to sequentially reduce the error of feature point correspondences and to generate an accurate motion parameter by propagating the object motion uncertainty over the image frame as well as optimally establishing the feature correspondences on the basis of template-based optical flows. Some preliminarily experimental results are shown to verify our proposed approach.
Line emission from stellar winds in active galactic nuclei

This dissertation presents synthetic spectra and response functions of the red giant stellar line emission model of active galactic nuclei. Our results agree with the fundamental line emission characteristics of active galactic nuclei within the model uncertainties if the following additional assumptions are made: 1) the mean stellar mass loss rates decrease with distance from the black hole, and 2) the mean ionization parameters are lower than those postulated in Kazanas (1989). For models with enhanced mass loss, the zero-intensity-full-widths of the line profiles are proportional to the black hole mass to the power of 1/3. This scaling relation suggests that the black hole masses of NLS1s (narrow-line Seyfert 1s) are relatively low. Models with enhanced mass loss also predict minimum line/continuum delays that are proportional to the zero-intensity-full-widths of the profiles. Because of their high column densities, these models yield triangle-shaped response functions, which are not generally observed. On the other hand, models without enhanced mass loss yield line-continuum delays that are proportional to the square root of the continuum luminosity, which is constant with empirical results. Models with high enough intercloud (interstellar) medium densities and a BLR-occulting accretion disk have line shifts. The broadest line emission and absorption profile components of lines similar to C IV, N V, and O VI are redshifted. Conversely, the narrowest emission and absorption profile components are blueshifted in such models. These results appear to agree with observations (e.g., Done & Krolik 1996).
Training in the Student Assistance Process: An undergraduate course for preservice teachers

According to statistical data, adolescent substance abuse and indulgence in other risky behaviors continue to rise. Acts of school violence by young people have cut across all socioeconomic and ethnic groups. Preservice teachers need the knowledge and skills to identify these at-risk students and to intervene before the behavior cannot be controlled. This paper describes the first-year implementation of a course in student assistance training for preservice teachers prior to their student teaching experience. Student Assistance Programs are based on a multidisciplinary model of community agencies and schools working together. Although the course was funded by a grant from the Pennsylvania Department of Education, this paper explains how a similar course can be offered at a nominal cost. Preservice teachers' insights into understanding at-risk behavior will help identify ways that teacher education programs can prepare future teachers for some of the at-risk behaviors they will encounter in their classrooms.
The EMC course: bridging the gap between academic preparation and industrial needs

A course entitled 'Designing for Electromagnetic Compatibility' was recently offered at North Dakota State University. The course had both a lecture and measurements component. A unique supplement to the measurements component was made possible by area industries. This study describes the course development and content. >
Low Vibration Sensitivity MEMS Resonators

It is well known that the stability of crystal oscillator references is undermined in high-g environments [1,2]. This can result in failure of communications systems relying on the crystal as a frequency reference. Lower vibration sensitivity is theoretically achievable by replacing the crystal with a micro electromechanical (MEMS) resonator. In this paper we present an electrostatically actuated Lame resonator that has vibration sensitivity (0.91 ppb/g) comparable to the best high-g insensitive crystal oscillators.
Temperature-dependent wettability on a titanium dioxide surface

Controlling surface wettability, expressed in terms of contact angle, is a significant issue in nanotechnology. In this paper, through extensive molecular dynamics simulations, we show that the contact angle of water droplet on a TiO2 surface is considerably influenced by the temperature variations, i.e. as the temperature increases, the contact angle decreases and the surface becomes more hydrophilic. We address the issue of accurate force fields and determine the partial charges that can closely reproduce the experimental contact angle. Detailed understanding of the temperature-dependent variation of contact angle is developed by hydrogen bonding analysis.
Correction to "Computer-aided design optimization of FDM-FM communication systems"

Equations (10) and (12) of the above-named article are corrected. the original article appears in ibid., vol. COM-17, pp. 403-412, June 1969.
Heart Activity and Autistic Behavior in Infants and Toddlers With Fragile X Syndrome

Abstract The present study contrasted physiological arousal in infants and toddlers with fragile X syndrome to typically developing control participants and examined physiological predictors early ...
Biological markers of carcinogenic exposure in the aluminum smelter industry--a systematic review.

Exposure monitoring programs have been used in the aluminum smelter industry for decades to decrease the risk of cancer from exposure to polycyclic aromatic hydrocarbons (PAHs). Biological monitoring of PAHs incorporates all routes of exposure. Measuring postshift urinary 1-hydroxypyrene (1OHP), a metabolite of pyrene, determines worker's daily PAH exposures, while measuring DNA adducts reflect chronic exposures to PAHs. We reviewed the scientific literature to identify changes over time in (1) 1OHP levels, (2) DNA adduct levels, and (3) other contributing factors associated with 1OHP and DNA adduct levels in the aluminum smelter industry. No trends were observed in 1OHP and DNA adduct levels. This could be due to variable selection of study populations and poorly identified job tasks that prevent comparison of jobs across plants and times, unassessed worker exposure variability, and the impact of cumulative exposures. Thus, it cannot be demonstrated that the use of biological monitoring to estimate PAH e...
A Brief Evaluation of Precipitation from the North American Regional Reanalysis

Abstract Several aspects of the precipitation climatology from the North American Regional Reanalysis (NARR) are analyzed and compared with two other reanalyses and one set of gridded observations over a domain encompassing the United States. The spatial distribution, diurnal cycle, and annual cycle of precipitation are explored to establish the reliability of the reanalyses and to judge their usefulness. While the NARR provides a much improved representation of precipitation over that of the other reanalyses examined, some inaccuracies are found and have been highlighted as a warning to potential users of the data.
ANALYSIS OF STATISTICAL EQUILIBRIUM MODELS OF GEOSTROPHIC TURBULENCE

Statistical equilibrium lattice models of coherent structures in geostrophic turbulence, formulated by discretizing the governing Hamiltonian continuum dynamics, are analyzed. The first set of results concern large deviation principles (LDP's) for a spatially coarse-grained process with respect to either the canonical and/or the microcanonical formulation of the model. These principles are derived from a basic LDP for the coarse-grained process with respect to product measure, which in turn depends on Cramer's Theorem. The rate functions for the LDP's ´ give rise to variational principles that determine the equilibrium solutions of the Hamiltonian equations. The second set of results addresses the equivalence or nonequivalence of the microcanonical and canonical ensembles. In particular, necessary and sufficient conditions for a correspondence between microcanonical equilibria and canonical equilibria are established in terms of the concavity of the microcanonical entropy. A complete characterization of equivalence of ensembles is deduced by elementary methods of convex analysis. The mathematical results proved in this paper complement the physical reasoning and numerical computations given in a companion paper, where it is argued that the statistical equilibrium model defined by a prior distribution on potential vorticity fluctuations and microcanonical conditions on total energy and circulation is natural from the perspective of geophysical applications. Large Deviation Principle, Cramer's Theorem, Coarse Graining,
Responding to the Challenges and Opportunities of Aircraft Design Education in Graduate Programs

The relationship between industry and academia has historically been a delicate one, characterized by the gap between what workforce employers want and what academia delivers. Despite significant efforts, only in rec ent years have tangible advances been made regarding the role that future employers have on th e academic formation of engineering students. The development of a solid knowledge base, as well as analytical and non-technical skills, have been repeatedly identified as highly d esirable attributes. Efforts to steer academic programs in this direction have traditiona lly focused on undergraduate education, particularly on capstone senior design projects. Gr aduate aircraft design programs have received marginal attention in this regard, even wh en they feature unique characteristics that translate to challenges and opportunities of p articular interest. This paper examines said features of graduate aircraft design programs and presents a curriculum that has been matured over several years to meet the aforementioned needs of employers. An assessment of the curriculum’s success based on student survey s is presented.
Courts and Crisis Regimes: A Theory Sketch with Asian Case Studies

A set of concepts for the comparison of the institutional roles of judiciaries is used to sketch a preliminary theory of the interactions of courts and crisis regimes. Case studies of the Philippines, India, and Pakistan supreme courts in the 1970s explore how their crisis regimes responded to the independence, impartiality, scope, and depths of their supreme courts' decision making and how those courts were or were not able to maintain their performance of other functions and their institutional positions relative to the crisis rulers. The case studies suggest that the most usual relations between courts and crisis regimes involve efforts to restrict the scope and depth, in preference to the independence and impartiality of the courts' decision making. In addition, the judiciary backs down when faced with opportunities to assert its authority by challenging the legitimacy of the crisis regime and exerting its regime limiter/citizen rights protector function.
China's Economic Prospects and Their Global Implications

I will delineate some special features of the Chinese economy and discuss the general implications of these features for the rest of the world. I will also comment on China's economic prospects in terms of the major constraints it has to overcome in order to sustain its economic development. Finally, I'll concentrate on some trade and exchange-rate issues that are particularly relevant to Sino-US economic relations.
The Implementation of WR

In this chapter, a description of the implementation of the WR algorithm in the RELAX2 program is given. We start with a brief overview of the steps performed in the RELAX2 program when simulating a circuit. A detailed description of the major steps is contained in the sections that follow.
A Review of Systemic Treatment in Metastatic Triple-Negative Breast Cancer:

Patients with breast cancer along with metastatic estrogen and progesterone receptor (ER/PR)- and human epidermal growth factor receptor 2 (HER2)-negative tumors are referred to as having metastatic triple-negative breast cancer (mTNBC) disease. Although there have been many new treatment options approved by the Food and Drug Administration for ER/PR-positive and Her2/neu-amplified metastatic breast cancer, relatively few new agents have been approved for patients with mTNBC. There have been several head-to-head chemotherapy trials performed within the metastatic setting, and much of what is applied in clinical practice is extrapolated from chemotherapy trials in the adjuvant setting, with taxanes and anthracyclines incorporated early on in the patient’s treatment course. Select synergistic combinations can produce faster and more significant response rates compared with monotherapy and are typically used in the setting of visceral threat or symptomatic disease. Preclinical studies have implicated other possible targets and mechanisms in mTNBC. Ongoing clinical trials are underway assessing new chemotherapeutic strategies and agents, including targeted therapy and immunotherapy. In this review, we evaluate the standard systemic and future treatment options in mTNBC.
Recurrent Herpes Simplex Type-2 Meningoencephalitis as a Stroke Mimicker (P02.265)

Objective: To describe an unusual case of recurrent herpetic meningoencephalitis presenting with only naming difficulties thus mimicking a stroke Background Herpes simplex meningoencephalitis (HSE) is an acute or subacute illness that causes both general and focal signs of cerebral dysfunction. Although fever,headache and confusion are cardinal features,no pathognomonic clinical findings reliably distinguish HSE from other neurologic disorders.We report a case of a 70year old gentleman who presented with anomia initiating a stroke work-up which was negative.A thorough physical exam (PE) revealed genital vesicles (GV) followed by spinal tap (ST) consistent with HSE. Design/Methods: Case Report. Results: A 70year old gentleman woke up with word finding difficulty.Patient had a normal CT brain wo contrast at nearby ER.The symptoms had persisted for a day when he presented to us and a stroke alert was called.He was afebrile and his BP148/90mmHg.PE showed difficulty in naming common objects with preserved comprehension,reading,writing and repetition.He had no other focal neurological deficits.Routine labs were normal.MRI brain wo contrast showed periventricular white matter disease,no evidence of infarction.A repeat thorough PE revealed GVconsistent with Herpes genitalis.ST showed WBC 175/ul with 75% lymphocytes,RBC 70/ul,glucose 50mg/dl and protein 70mg/dl.PCR for Herpes was negative as were gram stain,bacterial and fungal cultures.30 minute EEG had 10-12Hz background,no PLEADS. I.V. acyclovir was started with improvement in symptoms within 3 days and completed the course for 14 days with complete resolution of symptoms.He presented with similar complaints 2 months later to a different facility initiating stroke work-up before being transferred to our service.A repeat ST showed WBC 20/ul with positive Herpes simplex type2 by PCR consistent with mollaret9s meningitis. Conclusions: HSE can have protean manifestations and thus can be a common challenging clinical problem. In patients who present with aphasia in whom MRI does not show an infarct thorough PE and ST might be necessary to rule out HSE. Disclosure: Dr. Govindarajan has nothing to disclose. Dr. Morren has nothing to disclose. Dr. Malpe has nothing to disclose. Dr. Salgado has nothing to disclose.
Formlessness and Cultural Recreation

Cultural change is a complex process of gradual and dialectical movement. Thus, Russia’s long-standing authoritarian mode of government seems to ensure the continuity of traditional patterns. With the Soviet decline, however, many Western researchers claimed that these patterns no longer held. Several scholars found that Soviet/Russian attitudinal patterns were closer to those in developed or developing Western democracies.1 Some even argued that Russian political culture would not resist efforts to democratize.2 Essentially denying the continued strength of authority relationships, these scholars focused on changing demographic patterns that indicated a more modern, democratically oriented, political culture.
Impact of formation water geochemistry and crude oil biodegradation on microbial methanogenesis

Abstract Converting non-producible crude oil to CH4 via methanogenic crude oil biodegradation in oil reservoirs could serve as one way to increase our energy profile. Yet, field data supporting the direct relationship between methanogenesis and crude oil biodegradation are sparse. Indicators of methanogenesis, based on the formation water and gas geochemistry (e.g. alkalinity, δ13C–CO2) were compared with indicators of crude oil biodegradation (e.g. pristane/phytane and n-alkane ratios) from wells in the Wilcox Group of Louisiana to determine if increases in extent of methanogenesis were related to increases in extent of crude oil biodegradation. Shallow wells (393–442 m depth) contained highly biodegraded oils associated with low extent of methanogenesis, while the deepest (> 1208 m) wells contained minimally degraded oils and produced fluids suggesting a low extent of methanogenesis. Mid-depth wells (666–857 m) in the central field had the highest indicators of methanogenesis and contained moderately biodegraded oils. Little correlation existed between extents of crude oil biodegradation and methanogenesis across the whole transect (avg. R2 = 0.13). However, when wells with the greatest extent of crude oil biodegradation were eliminated (3 of 6 oilfields), better correlation between extent of methanogenesis and biodegradation (avg. R2 = 0.53) was observed. The results suggest that oil quality and salinity impact methanogenic crude oil biodegradation. Reservoirs indicating moderate extent of crude oil biodegradation and high extent of methanogenesis, such as the central field, would be good candidates for attempting to enhance methanogenic crude oil biodegradation as a result of the observations from the study.
Personalized Versus Generic Patient Handouts: Tools to Improve Patient Knowledge on Treatment Options and Perioperative Care

In modern prostate cancer clinics, patients have ample access to Internet resources and books ordered from Amazon.com. Therefore, the amount of time they spend with the surgeon is much smaller than their personal reading time potential. Time with the surgeon is precious and clinics are busy. A well written handout can organize a patient’s thoughts and questions, and help increase your influence versus competing sources. In this chapter we offer a sample from my clinic using a broader version that is amenable to personalization with details you want patients to know. The format of the chapter gives step-by-step topics to consider and a sampling of what I provide.
Assessment of Resolution of Ventilator Associated Pneumonia

Ventilator associated pneumonia (VAP) is the most frequent infectious complication in critically ill patients, associated with a prolonged length of stay in the intensive care unit (ICU) and a significantly increased risk of death [1, 2]. The attributable mortality of VAP varies with the infecting organism and with the patient population [3]; for example, mortality is higher in patients with acute respiratory distress syndrome (ARDS) [4], as well as in medical compared to surgical patients with VAP. The natural history of resolution of VAP is not well defined, but mortality of VAP has been well studied, and the clinical predictors of mortality have also been characterized [5, 6, 7]. It is reasonable to assume that patients at a high risk of death from VAP are more likely to have delayed resolution, or prolonged recovery, if they survive an episode of VAP [7].
Solution Focused Brief Therapy: A Systematic Review and Meta-Summary of Process Research

This article presents a systematic review of the process research on solution-focused brief therapy (SFBT). We searched published and unpublished studies in English across five databases, five major journals, two book chapters, and four websites to locate studies that investigate why and how SFBT works. Thirty-three studies that used various research methods were located and included for further analysis using a meta-summary approach. The findings supported the significance of the co-construction process within SFBT and the effects of specific types of SFBT techniques. The most empirical support was found for the strength-oriented techniques in comparison to the other techniques and for the co-construction of meaning. Current studies require replications with larger samples and experimental designs that study SFBT process in relationship to outcomes.
Two automatic calibration algorithms for left ventricle boundary estimation in X-ray images

Non-homogeneous mixing of the dye with the blood in the left ventricle and low contrast in the apex zone causes pixel-based classifiers to yield boundaries which are not close physician traced boundaries. They have a systematic positional and orientational bias, with under-estimation in the apex zone. This paper develops two calibration algorithms, the identical coefficient and the independent coefficient. These algorithms transform the two sets of given training boundaries: physician traced and the classifier, to yield the off-line parameters, depending upon the number of partitions of the database. Vertices of the left ventricle boundary are then estimated on-line by applying these transformed parameters. The performance of the calibration system based on the polyline distance metric yields a mean error of 3.7 and 3.6 millimeters for above algorithms over 6/spl times/10/sup 4/ vertices in the data base of 291 patient studies. Both calibration algorithms remove the bias and reduce the boundary error in the apex zone. For end-diastole frame the system reduces the error by 8.5 millimeters in the apex zone over the pixel-based classifier boundaries produced by image processing algorithms.
Abstract 155: Contribution of Foamy Monocytes to Nascent Atherosclerosis

Infiltration of monocytes into the arterial wall and subsequent differentiation into macrophages, which take up lipoproteins to become foam cells, is a key step in atherogenesis. We reported that apoE -/- mice on high fat diet (HFD) for 12 weeks had foamy monocytes, characterized as intracellular lipid droplets, in blood. However, atherosclerosis starts early in apoE -/- mice after HFD, and it is unknown when foamy monocytes first appear in blood of apoE-/-mice after HFD and whether foamy monocytes contribute to nascent atherosclerosis. In the current study, apoE -/- and wild-type (WT) mice were fed HFD or normal diet (ND) for 1-5 weeks. Monocyte numbers increased in apoE -/- mice from 1 week on HFD. Importantly, foamy monocytes began appearing in blood of apoE -/- mice within 1 week on HFD. The proportion of foamy to total monocytes increased from ~20% at 1 week to ~40% at 5 weeks on HFD. The majority (~85%) of foamy monocytes were CD11c + while the majority of nonfoamy monocytes were CD11c - in apoE -/- mice on HFD. Foamy monocytes also expressed higher levels of TNF-α and scavenger receptors including CD36 and CD204 than nonfoamy monocytes. Cholesteryl-ester-rich VLDL were isolated from apoE -/- mice on HFD, labeled with DiI and intravenously injected into apoE-/- mice on ND (recipients). At 3 hours post injection, both CD11c + and CD11c - monocytes in recipients took up VLDL, becoming DiI + . At 24 hours post injection, ~95% of the DiI + monocytes became CD11c + , suggesting that VLDL uptake, which would cause foamy monocyte formation, induced monocyte phenotypic change to CD11c + . Along with the early appearance of CD11c + foamy monocytes, atherosclerosis started early in apoE -/- mice on HFD. Proportions of CD11c + /CD11b + cells examined by flow cytometry and mRNA levels of CD11c and inflammatory markers such as IL-6 and IL-1β increased in aorta of apoE -/- mice within 3 weeks on HFD compared to those of apoE -/- mice on ND or of WT on ND or HFD. In vitro assay revealed that foamy monocytes adhered more avidly to VCAM-1 under fluid shear stress. In summary, appearance of foamy monocytes and aortic atherosclerotic lesions began early in apoE -/- mice fed HFD. Foamy monocytes may contribute to nascent atherosclerosis via infiltration into arterial wall and production of inflammatory markers.
Analysis of loss mechanisms in Ag 2 ZnSnSe 4 Schottky barrier photovoltaics

Recently, a new type of photovoltaic device based on an n-type Ag2ZnSnSe4 (AZTSe) absorber was demonstrated with an efficiency of over 5%. This work examines in detail several critical loss mechanisms in FTO/AZTSe/MoO3/ITO Schottky barrier devices. It is shown that the Schottky barrier height in the present devices under illumination is only ∼0.82 eV. With a barrier height of this magnitude, the device has an upper-bound of only 6.4% to the efficiency. Second, the AZTSe thin films used in the present devices exhibit exceptionally short minority carrier lifetimes (≤225 ps), as probed using two-photon spectroscopy. Third, hysteresis is observed in the J–V response of these devices. Pulsed electrical measurements reveal that reverse-bias voltage pulses create residual shunts in the device proportional to the pulse amplitude and duration. Reversible Ag-doping of the MoO3 buffer is proposed as an explanation of the observed shunting upon reverse bias. Therefore, improving the contact materials and the minority...
Deformable Multi-Body Systems

The dynamics of deformable bodies, viewed as multi-body systems, are studied using the prior geometric developments. For each example, a suitable finite-dimensional configuration manifold is identified, and a Lagrangian function is obtained, using physical principles, that is defined on the tangent bundle of the configuration manifold. Variational methods are used to derive Euler–Lagrange equations and Hamilton’s equations. Special features of the dynamics are studied.
Cure Monitoring of Composite Structure Using Mechanical Impedance Analysis (MIA)

Very few techniques are sufficiently sensitive and reproducible to be used effectively as an in-process, real-time tool for cure monitoring of composite structures. In conventional cure cycles a fixed cure schedule with temperature monitoring, usually according to the prepreg manufacturer’s instruction, is followed. But these fixed cure cycles do not precisely control the cure conditions of complex integrated structures of which the dimensions are large and variable. This is especially true if the structure contains various prepreg properties and forms. A closed loop feedback control of cure and automation of composite structure production have yet to be realized.
Post-diagnosis weight loss as a prognostic factor in non-small cell lung cancer.

Background Cachexia and its most visible manifestation, weight loss, represent important poor prognostic factors for patients with non-small cell lung cancer. This work examines how severity of weight loss as an indicator of cachexia affects outcomes. Methods In a retrospective observational study of electronic medical records, patients with non-small cell lung cancer were monitored for weight loss from an initial assessment (within 2 months of index diagnosis) to a landmark at 5 months (at least 3 months after initial assessment). Patients who survived to the landmark were then followed to determine the association of baseline body mass index (BMI) and weight loss during the assessment period with outcomes. Patients were clustered to determine how BMI and weight loss related to survival as approximated by time of last appearance in the database, a strong proxy for time of death. Results Twelve thousand one hundred and one patients were divided into 5 cachexia risk groups based on a combination of weight loss and initial BMI. More severe groups demonstrated progressively worse outcomes, with the most severe group surviving for a median of 263 days (95% CI 254-274) from index and having a 1-year survival rate of 31%. The least severe group survived for a median of 825 days from index (95% CI 768-908) and had a 1-year survival rate of 78%. Cachexia risk group was a stronger predictor of survival than any baseline variable, including disease stage, performance status, or age. Conclusions In this study, we showed that increasing weight loss and, to a lesser extent, decreasing BMI, led to substantially worse outcomes for non-small cell lung cancer patients independent of other variables. We suggest risk score groups that provide an improved approach for identifying poor prognosis patients with the greatest need.
Energy density from second shape variations of the von Neumann entropy

We compute the local second variation of the von Neumann entropy of a region in theories with a gravity dual. For null variations our formula says that the diagonal part of the quantum null energy condition (QNEC) is saturated in every state, thus providing an equivalence between energy and entropy. We prove that the formula holds at leading order in $1/N$ and further argue that it will not be affected at higher orders. We conjecture that the QNEC is saturated in all interacting theories. We also discuss the special case of free theories, and the implications of our formula for the averaged null energy condition, quantum focusing conjecture (QFC), and gravitational equations of motion. We show that the leading-order gravitational equations of motion, Einstein's equations, are equivalent to the leading-order saturation of the QFC for Planck-width deformations.
Intention of Older Women to Consume 100% Watermelon Juice for Vascular Health: An Application of Theory of Planned Behavior.

To strengthen randomized controlled trials (RCT) evaluating the efficacy of 100% watermelon juice on vascular function of older women, theory-driven behavioral analysis as well as comparative sensory analysis of the intervention and placebo were conducted. The Theory of Planned Behavior was adopted to assess psychosocial determinants of intention to consume watermelon juice. Sensory attributes were assessed utilizing hedonic scales. Analysis included Structural Equation Modeling with maximum likelihood. The measurement model provided a good fit (x2 = 70.22, df = 38; RMSEA = 0.07, CFI = 0.98; NFI = 0.95). Attitude (γ = 0.36), subjective norm (γ = 0.43), and perceived behavioral control (γ = 0.21,) were significant predictors (p < 0.001) of intention. Participants identified no significant differences in sensorial attributes between beverages, thereby minimizing sensory bias and discrimination. Similar approaches may help other RCT investigating novel foods and bioactive compounds bridge gaps between efficacy and effectiveness.
Thermosensitive Liposomes for Image-Guided Drug Delivery

Liposomes have been employed as cancer therapy clinically since the 1990s, with the primary benefit of reduced toxicity but no appreciable efficacy improvement. Thermosensitive liposomes (TSLs) are specifically formulated such that they release the encapsulated drug when exposed to hyperthermic temperatures in the fever range (~40-42°C) and have been investigated as cancer therapy for several decades, with first clinical trials initiated in the last decade. Combined with localized hyperthermia, TSLs allow precise drug delivery to a targeted region. Typically, the targeted tissue is exposed to localized hyperthermia facilitated by an image-guided hyperthermia device. Thus, TSLs enable image-guided drug delivery where drug is delivered to a tissue region identified by medical imaging. Recent TSL formulations are based on the more recent paradigm of intravascular triggered release, where drug is released rapidly (within seconds) while TSLs pass through the vasculature of the heated tissue region. The drug released within the blood then extravasates and is taken up by cancer cells. These TSLs enable up to 20-30 times higher tumor drug uptake compared to infusion of unencapsulated drug, and the dose locally delivered to the heated region can be modulated based on heating duration. This chapter reviews various TSL formulations, the different anticancer agents that have been encapsulated, as well as targeted cancer types. Further, the various hyperthermia devices that have been used for image-guided hyperthermia are reviewed, focusing on those that have been employed in human patients.
Pharmaceutical Additive Manufacturing: a Novel Tool for Complex and Personalized Drug Delivery Systems

Inter-individual variability is always an issue when treating patients of different races, genders, ages, pharmacogenetics, and pharmacokinetic characteristics. However, the development of novel dosage forms is limited by the huge investments required for production line modifications and dosages diversity. Additive manufacturing (AM) or 3D printing can be a novel alternative solution for the development of controlled release dosages because it can produce personalized or unique dosage forms and more complex drug-release profiles. The primary objective of this manuscript is to review the 3D printing processes that have been used in the pharmaceutical area, including their general aspects, materials, and the operation of each AM technique. Advantages and shortcomings of the technologies are discussed with respect to practice and practical applications. Thus, this review will provide an overview and discussion on advanced pharmaceutical AM technologies, which can be used to produce unique controlled drug delivery systems and personalized dosages for the future of personalized medicine.
Quantifying Biomarkers of Cognitive Dysfunction and Neuronal Network Hyperexcitability in Mouse Models of Alzheimer’s Disease: Depletion of Calcium-Dependent Proteins and Inhibitory Hippocampal Remodeling

High levels of Aβ impair neuronal function at least in part by disrupting normal synaptic transmission and causing dysfunction of neural networks. This network dysfunction includes abnormal synchronization of neuronal activity resulting in epileptiform activity. Over time, this aberrant network activity can lead to the depletion of calcium-dependent proteins, such as calbindin, Fos, and Arc, and compensatory inhibitory remodeling of hippocampal circuits, including GABAergic sprouting and ectopic expression of the inhibitory neuropeptide Y (NPY) in dentate granule cells. Here we present detailed protocols for detecting and quantifying these alterations in mouse models of Alzheimer's disease (AD) by immunohistochemistry. These methods are useful as surrogate measures for detecting chronic aberrant network activity in models of AD and epilepsy. In addition, since we have found that the severity of these changes relates to the degree of Aβ-dependent cognitive impairments, the protocols are useful for quantifying biomarkers of cognitive impairment in mouse models of AD.
Strengthening the Health Workforce through the ECHO Stages of Participation: Participants’ Perspectives on Key Facilitators and Barriers:

Introduction:Project Extension for Community Health Outcomes (ECHO) was originally developed by the University of New Mexico’s Health Science Center (UNMHSC) to build the capacities of primary-care...
Tricritical phenomena in bimodal polymer solutions: II. Turbidity measurements in the three-phase region

Abstract The turbidities of four bimodal mixtures of polystyrene in methylcyclohexane have been measured in the three-phase region near the tricritical point. The results from eight different wavelengths have been analyzed to obtain the correlation lengths ξ and the susceptibilities χ. χ and ξ are strongly correlated, so it is their ratio χ/ξ that is determined most precisely. As the tricritical point is approached, all three quantities diverge, as expected from the classical mean-field theory. Although the uncertainties are larger than wished for, it appears that the Griffiths first sums get increasingly larger as the tricritical point is approached, and probably diverge in the same way as has been observed for other tricritical systems.
Noteworthy Cardiac Surgical Literature 2018: Value-Based Bundled Payments, Opioid Crisis and Cardiac Surgery, Percutaneous Suction Thrombectomy for Intracardiac/Caval Thrombus and Vegetations, and Minimally Invasive Left Ventricular Assist Device Placement.

There has been tremendous evolution in the care of cardiac surgical patients in 2018. In this article, 4 topics of considerable impact on cardiac surgical care in the current landscape are reviewed...
Early medical therapy for acute laryngeal injury (ALgI) following endotracheal intubation: a protocol for a prospective single-centre randomised controlled trial

Introduction Respiratory failure requiring endotracheal intubation accounts for a significant proportion of intensive care unit (ICU) admissions. Little attention has been paid to the laryngeal consequences of endotracheal intubation. Acute laryngeal injury (ALgI) after intubation occurs at the mucosal interface of the endotracheal tube and posterior larynx and although not immediately manifest at extubation, can progress to mature fibrosis, restricted glottic mobility and clinically significant ventilatory impairment. A recent prospective observational study has shown that >50% of patients intubated >24 hours in an ICU develop ALgI. Strikingly, patients with AlgI manifest significantly worse subjective breathing at 12 weeks. Current ALgI treatments are largely surgical yet offer a marginal improvement in symptoms. In this study, we will examine the ability of a postextubation medical regime (azithromycin and inhaled budesonide) to improve breathing 12 weeks after ALgI. Methods and analysis A prospective, single-centre, double-blinded, randomised, control trial will be conducted at Vanderbilt Medical Center. Participants will be recruited from adult patients in ICUs. Participants will undergo a bedside flexible nasolaryngoscopy for the identification of ALgI within 72 hours postextubation. In addition, participants will be asked to complete peak expiratory flow measurements immediately postintubation. Patients found to have ALgI will be randomised to the placebo control or medical therapy group (azithromycin 250 mg and budesonide 0.5 mg for 14 days). Repeat peak expiratory flow, examination of the larynx and patient-reported Clinical COPD (chronic obstructive pulmonary disease) Questionnaire, Voice Handicap Index and 12-Item Short Form Health Survey questionnaires will be conducted at 12 weeks postextubation. Consented patients will also have patient-specific, disease-specific and procedure-specific covariates abstracted from their medical record. Ethics and dissemination The Institutional Review Board (IRB) Committee of the Vanderbilt University Medical Center has approved this protocol (IRB #171066). The findings of the trial will be disseminated through peer-reviewed journals, national and international conferences. Trial registration number NCT03250975
Interactions of multiple gene alterations in colorectal liver metastases.

The advancements in next generation sequencing have expanded the information available in clinical practice. Alterations of TP53 , APC , RAS , PIK3CA , and SMAD4 are present in more than 10% of patients with colorectal liver metastases (CLM). Of these genes, TP53 , RAS and SMAD4 were associated with worse survival in patients undergoing CLM resection. Testing multiple gene alterations provides a more precise prognosis for patients undergoing CLM resection and may be useful for better clinical decision making
Characterization of ripplocation mobility in graphite

Recent work suggests that layered solids deform through buckling of basal planes. When isolated locally, as in graphite, these buckles, termed ripplocations, behave superficially similar to disloca...
Use of the GORE® CARDIOFORM Septal Occluder for percutaneous closure of secundum atrial septal defects: Results of the multicenter U.S. IDE trial

OBJECTIVE To evaluate safety and efficacy of the GORE® CARDIOFORM Septal Occluder for percutaneous transcatheter closure of ostium secundum atrial septal defects. BACKGROUND The GORE® CARDIOFORM septal occluder is a double-disc, low profile, soft, conformable device, with distinct advantages over the GORE® HELEX® Septal Occluder. METHODS Subjects were enrolled in this single arm prospective study from 21 U.S. sites, and followed for 3 years. Primary endpoint was 6 month composite clinical success, comprised of technical success (implantation and retention of device), closure success (normalization of right heart size), no 30 day serious adverse events, and no device embolization or reintervention. Secondary endpoints included technical success, procedure success (technical success and ≤ 2 mm residual shunt at procedure conclusion), closure success (clinically insignificant or no residual shunt), and safety (freedom from 30 day serious adverse events and 6-month device events). RESULTS Between October 2012 and May 2015, 50 pivotal and 350 continued access subjects underwent attempted transcatheter GORE® CARDIOFORM Septal Occluder implantation. Median age was 6.9 years, and mean static defect diameter 9.7 ± 3.1 mm. Device placement was achieved in 93.5% (374/400). Composite clinical success was 90.2% and clinical closure success was 98.8% at 6 months. Freedom from serious adverse events was 98.3% at 30 days, with no device embolizations or reinterventions through 6 months. CONCLUSIONS The GORE® CARDIOFORM Septal Occluder has high composite clinical success and safety, performing well in defects ≤17 mm by stop flow stretched diameter. Single, multifenestrated, and deficient retroaortic tissue defects were well represented and successfully treated.
Life at the corner of poverty and sexual abjection: lewdness, indecency, and LGBTQ youth

In recent memory, equality has been the watchword of gay advocacy. The achievement (and now defense) of same-sex marriage has relied on this attractive constitutional principle to which we can attribute substantial gains, from parenting rights to workplace protections. Equality has been so prominent in the past decade that it could slip one’s memory that before equality, the constitutional principle to which the gay advocacy community was most devoted was privacy. Indeed, if one were to dig below the equality foundation upon which recent victories such as Obergefell rest, one would find the debt to privacy in the sediment. Privacy does not, however, serve all members of the lgbtq community equally well and may in fact injure the interests of those who lack privacy entirely. It is widely known that lgbtq youth are overrepresented among the homeless in the U.S. They are, as a result, subject to an excess of police attention for everything from public urination to sleeping on park benches. This chapter argues that homeless lgbtq youth inhabit a peculiar location at the intersection of vagrancy — a legal status finding its roots in pre-Elizabethan England — and sexual/gender deviance. These two identity-shaping forces combine to mark lgbtq youth as irreducibly lewd and indecent, rendering them uniquely susceptible to arrest for criminal offenses that they practically embody.
On applicability and uniqueness of the correspondence principle to pie-shaped wedge (“wedge paradox”) with various boundary conditions

Abstract A new paradigm for re-examination of the concept of the correspondence principle (originally due to Dundurs) in association with the much-studied issue of “wedge paradox” is presented. This study connects for the first time two parallel streams of research: (i) Carothers-Sternberg-Koiter’s wedge paradox study and (ii) Williams' eigenfunction approach. First, a three-dimensional eigenfunction expansion approach for determination of the asymptotic (singular) stress fields in the vicinity of the fronts of infinite wedges of finite thickness, subjected to various wedge-flank boundary conditions, is presented. This analysis is then exploited to establish rigorous rules or conditions, which would depend on the prescribed wedge-flank boundary conditions, the related state of deformation and the elastic property (Poisson’s ratio), for validity (or lack thereof) of the assumptions implicit in the heuristic enunciation of the correspondence principle. More important, a hitherto unavailable analysis for uniqueness (or lack thereof) of the prevalence of such a heuristically postulated correspondence is also developed. Finally, the present study offers both mathematical as well as (heretofore missing) physical explanations behind the working of the correspondence principle.
Treating Alcohol Problems in the Context of Other Drug Abuse

People seeking treatment for alcohol problems frequently abuse other drugs as well, such as tobacco, cocaine, marijuana, methamphetamine, and opiates. The problem of polydrug use raises important issues for treatment providers. A person who abuses multiple drugs may have a more difficult time stopping drinking and a higher risk for relapse to alcohol use after treatment. Conversely, a person who successfully stops drinking may offset this achievement by substituting another drug for alcohol. Successful treatment must take into account both alcohol- and drug-related issues, with particular emphasis on assessment, motivation, treatment design, and outcome evaluation.