cssi/SciSciGPT-SciSciNet huggingface dataset:
Visual Estimation of the Severity of Aortic Stenosis and the Calcium Burden by 2-Dimensional Echocardiography Is It Reliable?

OBJECTIVES Guidelines have recommended aortic valve surgery in asymptomatic patients with severe aortic stenosis and a large aortic valve calcium burden. The purpose of this study was to determine whether visual assessment of aortic valve calcium and stenosis severity are reliable based on 2-dimensional echocardiography alone. METHODS We prospectively enrolled 68 patients with aortic stenosis and compared them with 30 control participants without aortic stenosis. All had aortic valve calcium score assessment by computed tomography. In a random order, 2-dimensional images without hemodynamic data were independently reviewed by 2 level 3-trained echocardiographers, who then classified these patients into categories based on aortic valve calcium and stenosis severity. RESULTS The 68 patients (mean age ± SD, 74 ± 10 years) were classified as having mild (n = 28), moderate (n = 22), and severe (n = 18) aortic stenosis. When the observers were asked to grade the degree of valve calcification, the agreement between them was poor (κ = 0.33-0.39). The visual ability to determine stenosis severity compared with Doppler echocardiography had high specificity (81% and 88% for observers 1 and 2). However, sensitivity was unacceptably low (56%-67%), and the positive predictive value was poor (44%-50%). Agreement was fair (κ= 0.58-0.69) between the observers for determining severe stenosis. CONCLUSIONS Our results suggest that visual assessment of aortic valve calcium has high interobserver variability; the visual ability to determine severe aortic stenosis has low sensitivity but high specificity. Our results may have important implications for treatment of patients with aortic stenosis and guiding the use of handheld echocardiography. Further research with larger cohorts is needed to validate the variability, sensitivity, and specificity reported in our study.
A history of computing course with a technical focus

Many courses on the history of computing are designed for a general student audience, and as such, include fewer technical details than one might find in a typical CS course. While this approach is appropriate in some contexts, it risks losing the interest of the students who could perhaps benefit most from the subject-namely, future computer scientists. This paper describes a technically-oriented History of Computing course which we taught at the University of Utah in 2008. Like other History of Computing courses, ours included a significant amount of writing and discussion. However, inasmuch as our course was created specifically for CS students, we also incorporated several "hands-on" programming exercises and demonstrations, giving students actual experience with the computing environments of the past. Students and faculty alike have responded enthusiastically to this dual-faceted approach.
Automated QoS-oriented cloud resource optimization using containers

Optimizing the deployment of software in a cloud environment is one approach for maximizing system Quality-of-Service (QoS) and minimizing total cost. A traditional challenge to this optimization is the large amount of benchmarking required to optimize even simplistic cloud systems. This paper introduces $$\hbox {C}^2$$C2RAM, an new approach to enable rapid, optimized deployment of software onto a cloud environment by substantially reducing the number of benchmarks required. $$\hbox {C}^2$$C2RAM continues to perform some benchmarking, and therefore its predictions of application QoS metrics, such as throughput and latency, are very accurate. Our results show a maximum difference of 1.06 % between $$\hbox {C}^2$$C2RAM predicted QoS and empirically measured QoS. Moreover, $$\hbox {C}^2$$C2RAM can be provided with QoS requirements for each software in the system, and will ensure that each requirement is met before presenting a deployment plan.
Being Middle-class in India: A Way of Life

Henrike Donner is currently Professor for Indian Society and Culture at the Centre for Modern Indian Studies, Georg-August Universitat, Got tingen, Germany . Here search interests include urban an thropology , gender and kinship.
Antenarratives of organizational change: The microstoria of Burger King’s storytelling in space, time and strategic context

This research extends our understanding of organizational sensemaking through storytelling to highlight complex processes of organizational change in space, time and strategic context. We focus on the concept of antenarratives, how managers’ and other stakeholders’ fragmented speculations regarding futures may legitimate or resist organizational change. Antenarratives are not yet fully-formed narratives, but rather pieces of organizational discourse that help to construct identities and interests. We explain the theoretical relevance of Russian socio-linguist Mikhail Bakhtin’s space and time conceptualizations (chronotopes) for strategic narratives of change, and illustrate how antenarratives play important roles in narrative chronotopes. We relate German philosopher Martin Heidegger’s reasons for being in relation to others (existential ontology) to stakeholders’ and organizational identities, and to antenarrative glimpses in Bakhtin’s chronotopes. Through these theorizations, we contribute to conversati...
Evaluation of Acoustic Properties of Lightweight, Granular Materials

The noise reduction capability of perlite and polyimide μspheres are compared to fiberglass and foam. The insertion loss of the treatments applied between aluminum panels is measured. The tests are performed with the particulate both packaged and unpackaged. The packaging consists of paper honeycomb. Results indicate that the polyimide μspheres have good noise reduction and low weight when unpackaged. The honeycomb packaging is heavy and overwhealms the lightweight particulate. An interesting combination of fiberglass and μspheres shows good reduction when applied to a single plate. Lodengraf phenomena associated with the particulate are observed and described.
Empirical Performance of Covariates in Education Observational Studies.

ABSTRACTThis article summarizes results from 12 empirical evaluations of observational methods in education contexts. We look at the performance of three common covariate-types in observational studies where the outcome is a standardized reading or math test. They are: pretest measures, local geographic matching, and rich covariate sets with a strong theory of treatment selection. Overall, the review demonstrates that although the pretest often reduces bias in observational studies, it does not always eliminate it. Its performance depends on the pretest's correlation with treatment selection and the outcome, and whether preintervention trends are present. We also find that although local comparisons are prioritized for matching, its performance depends on whether comparable no-treatment cases are available. Otherwise, local comparisons may produce badly biased results. In cases where researchers have a strong theory of selection and rich covariate sets, observational methods perform well, but additional r...
Analysing of Chinese Interlanguage's Consonants' Pronunciation of Vietnam Students

Chinese, as the targeted language for Vitenam students' learning, has a phenomenon of cross during the process of Pronunciation learning, that is to say, the students have to depend on the same or similar pronunciations of their mother tongue, and get rid of the negative effects of their mother tongue to the targeted language. Therefore, the article takes interlanguage's consonants' pronunciation of Vietnam students as researching object, and uses the way of experimental phonetics to have acoustics analysis, and then finds out biased errors of pronunciation so as to improve Chinese teaching.
Transcultural performances of ethnicity

In Chapter 5, I examined how the Runa Takiks and their wives and mothers performed gender and how the contexts of their interactions shaped these performances. In this chapter, I look closer at context in my discussion on how the male musicians performed ethnicity. Following the definitions of Jenkins (2008) and Liebscher and Daily-O’Cain (2013), and similar to my own interpretations of gender and identity, I define ethnicity not as something one has, but rather as something one does—as ‘complex repertoires which people experience, learn and “do” in their daily lives’ (Jenkins 2008, p. 15).
A dinuclear cyanide-bridged complex, [(DMF)4(H2O)3LuCo(CN)6]·H2O

The crystal structure of the bimetallic cyanide bridged complex [(DMF)4(H2O)3LuCo(CN)6]·H2O (1) was obtained by single-crystal X-ray diffraction. The central lutetium(III) ion is eight coordinate arranged in a square antiprism while the cobalt(III) ion is six coordinate, oriented octahedrally. Molecules in the crystal lattice are held together by a network of hydrogen bonding. Crystallization of 1 occurs in the centrosymmetric monoclinic space group P21/c (No. 14) with a = 13.875(2), b = 8.8352(9), c = 24.633(2) A β = 96.392(8)° and Z = 4.
Convertible Debt Issuance & Target Leverage Adjustments

I study the target leverage and partial adjustment activity of firms that issue convertible bonds. Convertibles may help target adjustment efforts by lowering issuance transaction costs and reducing interest expenses. Nevertheless, convertible debt can increase liabilities for an unknown amount of time until the bond matures or converts. Although the average issue greatly increases debt levels, I find that issuers - both above and below their target leverage - experience faster adjustments when convertible debt is offered. Firms continue to experience faster adjustments throughout the life of the convertible bond. The speed of adjustment results are robust to concurrent capital structure changes.
Tuning the polarity of charge carriers using electron deficient thiophenes

Thiophene-1,1-dioxide (TDO) oligomers have fascinating electronic properties. We previously used thermopower measurements to show that a change in charge carrier from hole to electron occurs with increasing length of TDO oligomers when single-molecule junctions are formed between gold electrodes. In this article, we show for the first time that the dominant conducting orbitals for thiophene/TDO oligomers of fixed length can be tuned by altering the strength of the electron acceptors incorporated into the backbone. We use the scanning tunneling microscope break-junction (STM-BJ) technique and apply a recently developed method to determine the dominant transport channel in single-molecule junctions formed with these systems. Through these measurements, we find that increasing the electron affinity of thiophene derivatives, within a family of pentamers, changes the polarity of the charge carriers systematically from holes to electrons, with some systems even showing mid-gap transport characteristics.
Making Complexity Your Friend: Reframing Social Theory for the Anthropocene

AbstractThis article uses the dilemma of climate change as an entry point to explore the utility of a complexity framework for a more comprehensive social science of environmental sustainability. A theory of complex adaptive systems (CAS) is especially appropriate for the Anthropocene, a newly proposed geological period defined around humanity’s impact on the biosphere. Aspects of complexity theory have been entering public consciousness through popular accounts of climate “tipping points” and “emergent” change—the risk that Earth’s climate could shift into a new pattern in a relatively short time period. Social structures, including capitalism, are complex systems, as are social movements. The paper reviews CAS research with special attention to applications in social ecology. It discusses two case studies of exemplary research on human management of environmental resources and one case study of the antiglobalization movement, all conceived within a complexity framework. The central argument is that comp...
Effects of surface structural disorder and surface coverage on isotopic fractionation during Zn(II) adsorption onto quartz and amorphous silica surfaces

Abstract Metal ion-mineral surface interactions and the attendant isotopic fractionation depend on the properties of the mineral surface and the local atomic-level chemical environment. However, these factors have not been systematically examined for phases of the same composition with different levels of surface disorder. We present pH-dependent adsorption edges, X-ray absorption spectra, and isotopic measurements to illustrate the effects of surface structural disorder and surface coverage on zinc(II) (Zn(II)) surface complexation and isotope fractionation. Our results demonstrate that Zn(II) surface complexes on quartz and amorphous silica (SiO 2(am) ) transition from octahedral to tetrahedral coordination by oxygen as surface coverage increases. In low ionic strength solutions (I = 0.004 M) and at low surface loadings (Γ −2 ), Zn(II) adsorbs to the quartz surface predominantly as outer-sphere octahedral complexes (R Zn-O = 2.05 A) with no significant isotopic fractionation (Δ 66/64 Zn aqueous-sorbed = −0.01 ± 0.06‰) from aqueous Zn(II). In contrast, under similar chemical conditions and surface loading, outer-sphere Zn(II) adsorption complexes are not observed on SiO 2(am) surfaces. At high ionic strength (I = 0.1 M) and low surface loading (Γ −2 ), inner-sphere, monodentate octahedral Zn(II) complexes (R Zn-O = 2.05–2.07 A) are observed on both quartz and SiO 2(am) surfaces. At the same ionic strength (I = 0.1 M) and higher surface loading (Γ = 0.6–1.4 μmol m −2 ), Zn(II) forms inner-sphere, monodentate tetrahedral complexes (R Zn-O = 1.98 A) at the quartz surface. On the SiO 2(am) surface under similar chemical conditions and surface loading, Zn(II) forms dominantly inner-sphere, monodentate tetrahedral complexes with shorter Zn O bond distances (R Zn-O = 1.94 A). Despite different coordination numbers, the measured equilibrium isotope fractionation factors for inner-sphere octahedral and tetrahedral complexes versus dissolved Zn, under the same conditions and on the same silica substrate, are not distinguishable beyond uncertainties. However, there is a larger measured equilibrium isotope fractionation with preferential sorption of heavy Zn as inner-sphere complexes on SiO 2(am) (Δ 66/64 Zn aqueous-sorbed = −0.94 ± 0.11‰) than on quartz (Δ 66/64 Zn aqueous-sorbed = −0.60 ± 0.11‰).The propensity for Zn(II) to occur in tetrahedral and octahedral coordination with oxygen may help explain these observations. We posit that the low energetic difference between octahedral and tetrahedral Zn(II) may be why changes in inner-sphere Zn(II) coordination numbers with increasing coverage do not manifest as distinguishable isotope fractionations or as an observable alteration to the macroscopic sorption edges. Thus, we attribute the larger magnitude of Zn isotope fractionation on SiO 2(am) compared to quartz to differences in the bonding environments on the two types of silica surfaces rather than to a change in the coordination number of Zn(II).
A Recursive Algorithm for Wideband Temporal Spectrum Sensing

Wideband spectrum sensing techniques determine which portions of a given spectrum band are occupied or idle in the frequency domain. The idle portions represent spectrum holes that can potentially be exploited by secondary or unlicensed users. Existing methods for wideband sensing, however, do not take into account the temporal activity of the primary or licensed users within the spectrum band. We propose an algorithm that identifies primary user activity over a wide spectrum band and provides a statistical characterization of the primary user signals in the band. The algorithm applies hidden Markov modeling to a hierarchically partitioned representation of the spectrum band, together with a recursive tree search. Different from existing wideband sensing algorithms, the proposed wideband temporal sensing method is able to accurately detect spectrum holes even in the presence of bursting primary user signals. Moreover, the hidden Markov modeling of the primary user signals enables the accurate detection and the prediction of primary user activity over time. Numerical results demonstrate the significant performance gain of the proposed algorithm over existing wideband spectrum sensing algorithms, particularly in the presence of low duty-cycle primary user signals.
Customization of biliopancreatic limb length to modulate and sustain antidiabetic effect of gastric bypass surgery.

Biliopancreatic limb length in gastric bypass modulates multiple antidiabetic mechanisms, analogous to the dose-response relationship of a drug. With a longer biliopancreatic limb, Roux limb hypert...
Association of Psoriasis With Comorbidity Development in Children With Psoriasis.

Importance Children with psoriasis are at increased risk for comorbidities. Many children with psoriasis are also overweight or obese; it is unknown whether the increased risk of comorbidities in these children is independent of obesity. Objective To determine the risk of elevated lipid levels (hyperlipidemia/hypertriglyceridemia), hypertension, metabolic syndrome, polycystic ovarian syndrome, diabetes, nonalcoholic liver disease, and elevated liver enzyme levels in children with and without psoriasis, after accounting for obesity. Design, Setting, and Participants This was a retrospective cohort study of claims data from Optum Laboratories Data Warehouse (includes 150 million privately insured and Medicare enrollees). A cohort of 29 957 children with psoriasis (affected children) and an age-, sex-, and race-matched comparator cohort of 29 957 children without psoriasis were identified and divided into 4 groups: (1) nonobese, without psoriasis (reference cohort); (2) nonobese, with psoriasis; (3) obese, without psoriasis; and (4) obese, with psoriasis. Main Outcomes and Measures Risk of developing comorbidities (Cox proportional hazards regression). Results The overall mean (SD) age of those included in the cohort was 12.0 (4.4) years, and 16 034 (53.5%) were girls. At baseline, more affected children were obese (862 [2.9%] vs 463 [1.5%];P Conclusions and Relevance Children with psoriasis are at greater risk of developing obesity, hyperlipidemia, hypertension, diabetes, metabolic syndrome, polycystic ovarian syndrome, nonalcoholic liver disease, and elevated liver function enzyme levels than children without psoriasis. While psoriasis is a small independent risk factor for the development of these comorbidities, obesity is a much stronger contributor to comorbidity development in children with psoriasis.
Inheritance on the Fringes of Marriage

This Article explores the inheritance rights of individuals situated at the fringes of marital relationships—fiances, spouses who are in the process of divorcing, and permanently separated spouses. The Article examines whether these categories of individuals ought to enjoy rights to forced shares of an estate comparable to those that ordinary spouses can claim by assaying the rationales for a forced share in relation to these fringe categories. The Article also considers whether lawmakers should infer that the typical decedent would wish to provide at death for individuals falling into these categories. The Article conducts the first-ever empirical study of this question by recourse to an internet survey of fiances, spouses in the midst of divorcing, and permanently separated spouses. The Article proposes changes in intestacy law, the law of implied bequests, and implied revocation of bequests on the basis of this survey. Finally, the Article seeks to locate the issue of fringe categories of beneficiaries within the broader context of relationship theory.
PORPHYRIA CUTANEA TARDA ASSOCIATED WITH CHRONIC GRANULOCYTIC LEUKEMIA TREATED WITH BUSULFAN (MYLERAN).

A patient with chronic granulocytic leukemia terminating in "blast crisis" and marked porphyria is presented. Quantitative porphyrin studies revealed: urinary uroporphyrin 8894 to 11,453 µg./24 hours, urinary coproporphyrin 107-486 µg./24 hours, fecal coproporphyrin 55-116 µg./Gm. dry weight and fecal protoporphyrin 22-38 µg./Gm. dry weight. A review of the clinical aspects of porphyria is briefly presented, together with some speculation as to the etiology of the porphyria in the present case. The possibility is present that the busulfan therapy either initiated the disorder or triggered its development from a previously occult state. If so, this would be another manifestation of busulfan toxicity, of which pigmentation is the most common.
Pediatric Anesthesia and Sedation for Interventional Radiology

As interventional radiology evolves, the emerging technological advances and increased complexity of procedures challenge the anesthetic technique. In infants and children, even the simplest procedures may require a general anesthetic to provide safe and motionless conditions. Indications for general anesthesia or sedation, aside from the inability to remain motionless on one’s own, include the need for intermittent breath holding during image acquisition. Further indications for an endotracheal intubation may include those situations in which there is a risk of vasospasm (cerebral angiography and embolization). In these circumstances, controlled ventilation with purposeful hypercarbia can promote vasodilatation.
Diabetes, Type 2

Type 2 diabetes mellitus is a heterogeneous metabolic disorder defined by the presence of hyperglycemia and characterized by disturbances in carbohydrate, protein, and lipid metabolism. Hyperglycemia results from a combination of resistance to insulin action and an inadequate compensatory insulin secretory response.
Horizontal Diffusion in Ocean Dumping Experiments

During two experiments monitoring ocean dumping operations in the Gulf of Mexico and off Arecibo, Puerto Rico, a number of drifters were tracked with a ship-borne radar and aerial photographs of the plumes were analyzed by use of the results of drifter experiments in the Gulf of Mexico. Horizontal eddy diffusivity was determined from increases of the variances of the drifter positions with time and were calculated with Okubo’s method (1976). The variances of drifter positions did not increase with time when the wind speed exceeded critical values off Puerto Rico. It was speculated that the wind rows caused the drifter convergence during the Puerto Rico experiments. The speculation is partially confirmed by analyzing the aerial photos of the plumes which show striations along the direction of the prevailing winds.
On the Effect of the Planetary Boundary Layer Parameterizations in Mesoscale Numerical Weather Prediction

A mesoscale 14 layer sigma-coordinate primitive equation model with 157 × 117 grid points at each layer has been developed for NASA. The horizontal grid length is 48 km and the upper boundary is chosen at 100 mb. This model includes a planetary boundary layer (PBL) parameterization scheme based on generalized similarity theory, concept of free convection, turbulent kinetic energy equation, surface energy budget and soil-surface moisture budget. Realistic features such as short and long wave radiation, cloudiness, static stability of the atmosphere, time varying PBL depth, entrainment at the top of the PBL, as well as heat conduction and moisture supply from the soil below the surface are included. Two case studies are shown to illustrate the effect of the PBL physics in severe storm development. In the 4 June 1980 case, model simulation shows that differential surface temperature and differential development of the mixed layer triggered the inland sea breeze effect which led to strong convection and tornado outbreak in the vicinity of Grand Island of Nebraska. The differential surface temperature was caused by downslope adiabatic warming, warm advection, spatial variation in initial surface temperature and soil moisture content. In the 2 April 1982 case, the model simulation shows a sharp horizontal gradient of the PBL depth in the proximity of Paris, Texas where severe thunderstorms and tornadoes occurred. It is displayed that one of the factors that triggered the blitz was the underrunning of the moist air out from beneath the lid of the PBL along its lateral boundary. Results of 40 additional case studies support the conclusion that the inclusion of full physics of the PBL plays an important role in the prediction of the severe storm development. On the contrary, runs with constant surface temperature, constant PBL depth and constant drag coefficient parameterization produce markedly different and less realistic mesoscale circulation systems.
Treatment of Comorbid Anxiety Disorders Across the Life span

Decades of research on people with anxiety disorders has shown that comorbidity is the rule, not the exception. While not surprising, given the overlap in symptoms and etiology, this has a number of implications in both clinical and research realms. This chapter will examine how comorbidity influences treatment, as well as how treatment can influence comorbidity. Overall, research in the past 15 years has shown that both transdiagnostic and specific treatments can be effective, although much research remains before we have a full understanding of which works better.
ON A SUBSET SELECTION PROCEDURE FOR THE MOST PROBABLE EVENT IN A MULTINOMIAL DISTRIBUTION

Publisher Summary This chapter focuses on a subset selection procedure for the most probable event in a multinomial distribution. The problem of selecting the particular one of the k multinomial cells with the highest probability was first studied under the indifference zone formulation by Bechhofer, Elmaghraby, and Morse who proposed a fixed sample procedure. Under the same formulation, Cacoullos and Sobel inspired by the Banach match-box problem investigated an inverse sampling procedure. A multistage variant of this was studied by Alam, Seo and Thompson. A fixed sample procedure for selecting a subset containing the cell with the largest probability was proposed by Gupta and Nagel. This chapter discusses an inverse sampling procedure for the same problem. It presents a procedure R along with a derivation of the expression for the P(CS|R). Asymptotically, the infimum is attained when all the k cell-probabilities are equal.
Diferences in the reported carotenoid dietary intake and circulating carotenoid serum levels of the Hispanic and Anglo breast cancer (BC) survivors enrolled in the WHEL study.

Proc Amer Assoc Cancer Res, Volume 46, 2005 486 Background: Data on BC & carotenoid consumption in Hispanic women are limited. Studies have shown BC incidence is lower in women who consume a diet high in vegetables & fruits. Methods: The Women’s Healthy Eating & Living (WHEL) Study is an ongoing 7-sites randomized controlled trial examining the hypothesis that a plant-based dietary pattern affects the course of cancer & longevity. The study enrolled 3088 women within 4 years of primary diagnosis, stage I (≥1 cm), II, IIIA BC who completed standard therapy. Aim of study: To correlate baseline reported carotenoid intake with measured circulating serum carotenoid levels (lutein + zeaxanthin, βcryptoxanthin, lycopene, α & βcarotenes) of the 165 Hispanic women in the WHEL Study, & an age-matched sub-sample of Anglo BC survivors. Nutritional Data System version 4.0 was used to measure total daily consumption of fruit, vegetables from 4-day repeated 24-hour recalls & HPLC with ultraviolet detection (Nierenberg & Nann, 1992) was used to measure circulating serum carotenoid levels. Results: All participants reported eating 5 or more daily servings of fruits & vegetables, even after adjusting for age & time since diagnosis, with foreign-born Anglo participants consuming the highest number of daily servings (6.9±4.1), followed by foreign-born Hispanics (6.2±3.1), US-born Anglos (5.8±2.9), & US-born Hispanics, with the lowest intake (5.0±2.6). Statistical significant differences for βcarotene (p<.05), βcryptoxanthin (p<.01) & lutein + zeaxanthin (p<.05) intake were observed between foreign-born participants who had lived longer in US (5721.1±5595.9, 115.0±171.5 & 3129.2±2305.7, consecutively), & US-born participants (4811.9±6233.2, 73.6±116.4 & 2491.4±2572.5, consecutively), regardless of ethnicity. The same trend was observed among the same participants when assessing their circulating serum βcryptoxanthin (0.2334±0.1756 vs. 0.1582±0.1104, p<.01) & lutein + zeaxanthin levels (0.4227±0.2288 vs. 0.3569±0.1924, p<.05). In general, statistically significant correlations were observed among the reported carotenoid intake & the measured serum carotenoid circulating levels (p≤.01) for Anglo participants, whereas, in Hispanic participants only αcarotene & lutein + zexanthin were significantly correlated with their serum circulating levels (p≤.01). Conclusion: All study participants reported consuming NCIs recommended daily servings of fruits & vegetables, regardless of ethnicity. The highest reported intake of carotenoids was observed among Anglo & Hispanic foreign-born participants who had lived longer in the US, with Anglo participants reporting their carotenoid intake more accurately than Hispanic participants. The latter indicates the need to develop culturally-sensitive dietary instruments to better capture the carotenoid intake of Hispanic BC survivors.
Relationship between procedural characteristics and cerebrovascular events after transcatheter aortic valve replacement

Objectives The objective was to assess the impact of procedural characteristics on risk of stroke or transient ischaemic attack (TIA) after transcatheter aortic valve replacement (TAVR). Methods We included 370 consecutive patients who underwent balloon-expandable TAVR from 1 November 2008 to 30 June 2014. Procedural characteristics that may be associated with stroke/TIA were assessed. The primary outcome was stroke/TIA at 30 days. A propensity score was constructed using a logistic regression model with 29 parameters. Cox proportional hazards models were used with a propensity score covariate. Results Mean age was 80.9±7.9 years and mean Society of Thoracic Surgeons score was 8.3±5.0. The total number of balloon dilations ranged from 2 to 7. Out of 370 patients, 13 patients (3.5%) suffered stroke/TIA in the first 30 days after TAVR. In univariate analysis, postdeployment balloon dilation (PD) (HR 3.8, 95% CI 1.24 to 11.61; p=0.02) and emergent cardiopulmonary bypass (CPB) (HR 9.66, 95% CI 2.66 to 35.15; p Conclusion Postdilation as compared with total number of dilations, and emergent CPB were independently associated with increased risk of clinical neurological events in the first 30 days after TAVR. Reduction in balloon postdilation with appropriate valve sizing may reduce the risk of stroke or TIA after TAVR.
The Role of Renewable Energy in Bridging the Electricity Gap in Africa

This paper explores the role renewable energy can play in supporting sustainable electricity access in Africa, with a particular focus on the challenges in Sub-Saharan Africa. The studies in this review highlight various power system analyses across multiple regions in Africa. These studies provide high-resolution multi-criteria data for geographic siting of renewable energy, assess the scale of generation expansion needed to achieve universal access, and demonstrate innovative modeling techniques that plan for on-grid and off-grid systems concurrently. This review also highlights the challenges of power sector finance in Africa and discusses the emerging literature on broadening energy planning beyond techno-economic approaches. Altogether, these studies enable a deeper understanding of the benefits of renewable energy adoption and integration in the region. Africa is experiencing a persistent, complex, and multi-faceted electricity gap. Renewable energy presents opportunities for Africa to achieve full electricity access in an economically, environmentally, and socially sustainable manner.
Augmentative and alternative communication interventions are effective for adolescents and adults with autism spectrum disorder, but more work is needed

Q What AAC interventions are used, and what are their effects, for adolescents and adults with autism spectrum disorder (ASD)?Design: Systematic review.Data sources: Studies included in this review...
Drivability life of pavement: a new numeric in pavement management system

In recent years, the Colorado Department of Transportation (CDOT) developed Drivability Life (DL) index to estimate useable pavement service life for roadway segments. The DL process is similar in ...
Mental health delivery in primary care: The perspectives of primary care providers.

Abstract Purpose To explore perspectives of primary care providers (PCPs), including physicians and nurse practitioners (NPs), about delivery of mental health care in primary care settings. Methods We used a qualitative descriptive designed convenience sample of physicians (N = 12) and NPs (N = 14) through face-to-face interviews in New York State. Results Three themes emerged: 1) prioritization of patient needs; 2) applicability of mental health care in primary care settings; and 3) physician and NP approaches to mental health care. Conclusions PCPs recognized importance of addressing patients' mental health care needs and barriers in primary care practices.
Less may be more: shifting paradigm toward minimally invasive gastrectomy for locally advanced gastric cancer.

Gastric cancer is the fifth most common malignancy and the third leading cause of cancer-related mortality worldwide (1). Despite evidence demonstrating improved outcomes with multimodality therapy (i.e., perioperative chemotherapy or adjuvant chemotherapy with/without radiotherapy), complete margin-negative surgical resection remains the mainstay of treatment (2).
Cartoon Contracts and the Proactive Visualization of Law

The goal of this Article is to apply the lens of visual legal rhetoric and visual literacy to the current visualization movement in Proactive Law and Legal Design in their efforts to promote visual, non-verbal communication in contracts through cartoon, comic book, and highly pictorial legal instruments. The lens will be applied to evaluate and critique five aspects of proactive visual legal instruments: • Immediate Visual Context, • Immediate Verbal Context, • Visual Cultural Context, • Mise en Scene and Arrangement, and • Visual Rhetoric, Ethics and Professionalism This Article will analyze whether highly visual contracts and legal instruments fulfill the potential for greater access to and understanding of contract terms particularly with regard to audiences whose language skills and cultural experience might make the comprehension and acceptance of purely verbal contracts more difficult. Although legal communication in general and contracts in particular have been dominated by text for centuries, the contemporary study of visual communication in cognitive psychology and neuroscience, data visualization and rhetorical topics of arrangement, and contemporary visual legal rhetoric demands attention to the proactive approach to law and its call for increased visualization in legal communication. When visuals can overcome barriers in communication that words alone cannot, contracts and other legal instruments can be made more universal in their application, interpretation, performance, and enforcement.
Investigating travel time satisfaction and actual versus ideal commute times: A path analysis approach

Abstract Introduction This paper investigates relationships between travel time satisfaction and both ideal commute time (ICT) and reported actual commute time (ACT). Methods Based on an online questionnaire survey of 628 commuters in Portland, Oregon, this study uses path analysis models to explore factors associated with travel time satisfaction, ICT and ACT, and commute time dissonance (ACT − ICT). Results Consistent with past research, few people desire zero travel time and more commuters are satisfied than dissatisfied with their typical travel time, but most people commute for longer-than-ideal durations. Model results reveal a strong negative relationship between ACT and satisfaction, a weak positive direct association between ICT and satisfaction, and a negative link between commute time dissonance and satisfaction. Furthermore, active modes (walking and cycling) induce higher satisfaction with travel time and lower dissonance, while public transit riders are more satisfied but also more dissonant compared to automobile users. Few socio-demographic and work-related attributes are significant, suggesting the need to account for additional subjective personal characteristics (e.g., attitudes, personality).
Modeling, Identification, and Flow Control for a Microfluidic Device using a Peristaltic Pump *

This paper presents a method for modeling and controlling pressure at the inlet of a microfluidic lab-on-a-chip device using a peristaltic pump. The principle idea is to alter the voltage provided to a DC peristaltic pump based on the pressure measured at the inlet of the microfluidic device, as a simple, low-cost alternative to standard microfluidic flow control instrumentation. The model accounts for varying resistance and periodic peristaltic pump oscillations, accounting for variable viscosity of the fluid. A model capturing major phenomena with respect to pressure and flow at the inlet of the microfluidic device was developed using the extended Bernoulli equation and peristaltic pump geometry. A proportional-integral-derivative (PID) control system was implemented to achieve specified pressure across varying viscosities. Excellent agreement is obtained between experimental and simulation results using the proposed model. This pressure model can be used to determine various pump and fluidic characteristics in operation of a microfluidic lab-on-a-chip device.
Why Is So Much Redistribution In-Kind and Not in Cash? Evidence from a Survey Experiment

Basic economic theory prescribes that redistribution typically take the form of cash rather than in-kind goods and services, since cash lets the recipient choose how to use the resources, thereby maximizing benefits to the recipient. Notwithstanding this benefit, among the trillions of dollars of annual transfers in the United States, redistribution is mostly—and increasingly—in-kind. We help explain why with novel survey experiments to better-understand Americans’ preferences regarding the structure of government redistribution. Our survey experiment offers a large, demographically representative sample of respondents a hypothetical choice between a cash transfer and a transfer that can only be spent on a bundle of “necessities.” We make three main points. First, survey respondents overwhelmingly preferred in-kind over cash transfers to the poor. The most important reason for this choice is paternalism: the belief that the poor will not spend cash on the right things. The preference for in-kind was common to a majority of virtually all segments of the general population, though not to a sample of elites. Second, stated preferences suggest that respondents are willing to redistribute considerably more in-kind than in cash. We also surveyed the poor, who preferred receiving cash, but not as strongly as the general population preferred redistributing in-kind. The modesty of this preference among the poor in part comes from a sizable minority that preferred in-kind redistribution, which many anticipated functioning as a self-control mechanism. Third, a randomized treatment explaining the value of choice significantly increased the preference for cash over in-kind, but it did not change the overall preference for in-kind.
Your favorite color makes learning more precise and adaptable

Learning from reward feedback is essential for survival but can become extremely challenging with myriad choice options. Here, we propose that learning reward values of individual features can provide a heuristic for estimating reward values of choice options in dynamic, multi-dimensional environments. We hypothesized that this feature-based learning occurs not just because it can reduce dimensionality, but more importantly because it can increase adaptability without compromising precision of learning. We experimentally tested this hypothesis and found that in dynamic environments, human subjects adopted feature-based learning even when this approach does not reduce dimensionality. Even in static, low-dimensional environments, subjects initially adopted feature-based learning and gradually switched to learning reward values of individual options, depending on how accurately objects9 values can be predicted by combining feature values. Our computational models reproduced these results and highlight the importance of neurons coding feature values for parallel learning of values for features and objects.
The Influence of the Negative Properties of Heaving Soil on the Stability of Frame-Rod Structural Systems

This article discusses the influence of the negative properties of heaving soil on the stability of frame-rod structural systems during the operation of buildings and structures. It is known that the loads and influences arising during the operation of buildings and structures can lead to loss of stability of both an individual element and the entire structural system as a whole. It is extremely difficult to accident-free work operation of buildings and structures, the foundation layer of which are heaving soils. Therefore, it is necessary to develop a methodology for determining the critical stability parameters of frame-rod structural systems that takes into account the heaving properties of base soils. In the process of loss of stability, elements of frame-rod structural systems under the influence of force factors due to the influence of constrained conditions can experience both passive and active bifurcation. With the manifestation of the negative properties of heaving soils, vertical deformations of the base occur, which can lead to a change in the type of bifurcation of both an individual element and the entire structural system as a whole. Based on the assumption that the element will pass from passive bifurcation to active at the moment when the work performed by internal forces is compensated by the work of the heaving forces, an expression is obtained to determine the critical deformation of the base soil. A statically indefinable single-span frame is considered, the right strut of which is loaded with force P and the left one with force αP. Using the displacement method, the critical stability parameters of the specified rod system were determined before and after the manifestation of the negative properties of the base soil. Based on the numerical analysis, it was concluded that the right pillar of the frame loses stability actively, involving the left one in the general bifurcation. After manifestation of the negative properties of the base soil, the type of bifurcation of the frame elements changes, leading to significant changes in the stability parameters. In this case, the critical deformation of the heaving linearly increases with an increase in the geometric dimensions of the frame and decreases with an increase in the load application coefficient α at 0,6 α> 1,0, these parameters are directly proportional.
The Clinical Spectrum of PTEN Hamartoma Tumor Syndrome: Exploring the Value of Thyroid Surveillance.

Introduction Phosphatase and tensin homolog (PTEN) hamartoma tumor syndrome (PHTS) comprises a collection of clinical features characterized by constitutional variants in PTEN. Several guidelines recommend thyroid screening, beginning at the pediatric age at the time of PHTS diagnosis; however, the benefits of early surveillance has not been well defined. Methods We conducted a retrospective investigation of patients followed up at the Children's Hospital of Philadelphia with a diagnosis of PHTS between January 2003 and June 2019. In total, 81 patients younger than 19 years were identified. Results The most common clinical feature at presentation was macrocephaly (85.1%), followed by impaired development (42.0%), skin/oral lesions (30.9%), and autism spectrum disorder (27.2%). A total of 58 of 81 patients underwent thyroid surveillance, with 30 patients (51.7%) found to have a nodule(s). Ultimately, 16 patients underwent thyroidectomy, with 7.4% (6/81) diagnosed with thyroid cancer. All thyroid cancer patients were older than 10 years at diagnosis, and all displayed low-invasive behavior. Of the patients younger than 10 years at the time of thyroid ultrasound (US) surveillance, 71.4% (15/21) had a normal US. The remaining 6 patients had thyroid nodules, including 4 undergoing thyroid surgery with benign histology. Discussion/conclusion Patients with macrocephaly, impaired cognitive development and thyroid nodules, and/or early-onset gastrointestinal polyps should undergo constitutional testing for PHTS. There does not appear to be a clinical advantage to initiating thyroid US surveillance before 10 years of age. In PHTS patients with a normal physical examination, thyroid US surveillance can be delayed until 10 years of age.
High-Dose Amoxicillin/Clavulanate No Better than Standard Dose for Acute Sinusitis in Adults.

This study found no significant difference between the standard-dose and high-dose regimens of amoxicillin/clavulanate for treating acute sinusitis in adults. It is important to note that both doses are minimally superior to placebo.
An Online Optimization Approach for Plug-in Electric Vehicle Integration into the Electrical Grid

The trend in sustainable transportation systems has led to an increase in the number of plug-in electric vehicles (PEVs). However, a major issue associated with widespread PEV deployment is the potential adverse impact of vehicle charging on the power grid. One way to address increase in demand from PEVs and avoid aggravated peak loads is through vehicle-to-grid (V2G) applications. This study develops an online optimization model for scheduling the centralized charging and discharging of a significant number of PEVs in a smart parking lot. The optimization problem is formulated using a rolling horizon method with objectives to meet the requirements of the electric vehicle owners while considering grid and aggregator needs. Finally, the model is used in a simulated problem to demonstrate the optimal solution.
Acquisition and Transmission of Fusarium oxysporum f. sp. vasinfectum VCG 0114 (Race 4) by Stink Bugs.

Fusarium oxysporum f. sp. vasinfectum VCG 0114 (race 4; i.e., FOV4) is an emerging pathogen that causes severe root rot and wilt of cotton. FOV4 is seed-borne, but the mode of seed invasion is unce...
Variations in the Aldosterone-Stimulating Activity of Angiotensin: Causes and Physiological Significance

Angiotensin raises blood pressure and increases aldosterone secretion. Variations in the pressor potency of angiotensin have been studied in considerable detail, but variations in its aldosterone- stimulating activity have received little attention. My associates and I have found that this latter parameter shows interesting and important fluctuations.