cssi/SciSciGPT-SciSciNet huggingface dataset:
Application of ARIMA model on prediction of malaria incidence

Objective To explore the applications of time series ARIMA model and fit the predictive model of malaria incidence.Methods ARIMA model was established based on the month malaria incidences from 1996 to 2005 in Huaiyuan County of Anhui Province.Parameters of the model were estimated through maximum likelihood method;the structure was determined according to criteria of residual un-correlation and concision,and the order of model was confirmed through Akaike Information Criterion(AIC) and Schwarz Bayesian Criterion(BSC).The constructed model was used to predict the month incidence in 2006 and the result was compared with the actual incidence.Results ARIMA(0,1,1)×(0,1,1)12 model can appropriately fit the malaria incidence with the least estimated variance of 0.60,AIC=187.00,SBC=193.58,and the mathematic formulation was(1-B)(1-B12)Zt=(1-0.591B)(1-0.281B12)at.The predicted month incidences were consistent with the actual values with the average estimated error of 0.03.Conclusion The ARIMA model can be used to fit the trend of malaria incidence in time series and to forecast for the malaria incidence with high prediction precision of short-term time series.
Use of SSRI Antidepressants in 6 Cities along Yangtze River Valley During the Period 2006-2008

OBJECTIVE: To probe into the status quo and tendency of the utilization of SSRI antidepressants in 6 cities along Yangtze River valley during the period 2006-2008.METHODS: The SSRI antidepressants used in 157 hospitals in 6 cities along Yangtze River valley during the period 2006-2008 were analyzed statistically with regard to the order in consumption sum and DDDs by using defined daily dose as index.RESULTS: The total consumption sum of the antidepressants in the 6 cities increased year on year,an increase of 23.20% in 2008 and 21.13% in 2007 over the previous year,and the total DDDs increased by 19.96% in 2008 and 21.43% in 2007,respectively over the previous year.Paroxetine,Fluoxetine and Sertraline took the lead in consumption all the time.CONCLUSION: The consumption amount of antidepressants increased significantly and the market of the new antidepressants such as Escit-alopram is promising.
Daily associations between emotional functioning and alcohol involvement: Moderating effects of response inhibition and gender

Abstract Background Research has linked tonic and variable mood to problematic alcohol use, both between- and within-subjects. Indices of behavioral control have moderated these links, at least at the between-subjects level. The current study examines daily associations between indices of emotional functioning and alcohol involvement as a function of response inhibition. Methods College student drinkers ( n = 74; 58.11% female) were enrolled in a study on emotion and alcohol use. Participants completed a stop-signal task as an index of response inhibition. They then carried a personal data device for 21 days, reporting daily on mood, alcohol use, and acute alcohol use disorder symptoms. Mood instability was the mean square of successive differences from daily mood assessments. Results There were 1309 person days (622 drinking days) available for analysis. Pre-drinking mood instability was positively associated the likelihood of drinking and drinks consumed on drinking days. The former association was diminished among women with high response inhibition. Pre-drinking positive mood was positively associated the likelihood of drinking and drinks consumed on drinking days. The latter association was diminished among women with high response inhibition. Pre-drinking negative mood was positively associated with drinks consumed on drinking days among women with low response inhibition. Finally, pre-drinking positive mood was associated with acute alcohol use disorder symptoms among those with low response inhibition. Conclusions These results suggest that interventions targeting positive mood may be particularly important. Further, developing ways to improve response inhibition control may broadly influence negative drinking outcomes by affecting multiple mood-drinking associations.
Psychotropic medications and their effects on sexual function: Diagnosis, biology, and treatment approaches.

Background The recognition and treatment of sexual side effects caused by psychotropic agents have become topics of increasing clinical concern. Gaps in our understanding of the biology of sex and in our knowledge of the effect of Axis I disorders on sexual functioning have made both recognition of sexual side effects and a coherent treatment approach to these side effects difficult. Method The author reviews case reports, case series, and animal studies derived from a MEDLINE search for English language articles on the topics of the effects of psychiatric disorders on sexual functioning, the biology of sex, rates of sexual dysfunction associated with each medication class, and treatment approaches when these side effects occur. Results In evaluating sexual function in patients taking psychotropic medications, clinicians should first consider other potential causes of sexual dysfunction. In general, dopamine increases sexual behavior, serotonin inhibits it, while norepinephrine has conflicting effects. Sexual side effects have been described in association with all the major classes of psychotropic medications. Neuroleptics are often associated with sexual side effects. Priapism, seen with neuroleptics and trazodone, should be treated as a urological emergency. Anxiolytics cause mild, nonspecific sexual side effects as do the mood stabilizers. Among the antidepressants, the more powerful serotonergic medications--e.g., the serotonin selective reuptake inhibitors (SSRIs), clomipramine, and MAO inhibitors--may cause more sexual side effects than the tricyclics. Potential strategies to treat antidepressant-induced sexual side effects include lowering the dose, waiting, and switching to another agent. A number of specific antidotes, such as cyproheptadine and yohimbine, have been reported to reverse these side effects in a limited number of cases. Conclusion Clinicians must be aware of and specifically ask about medication-induced sexual side effects. More effective treatments of these side effects must await much needed double-blind studies of various approaches, especially those to treat SSRI-induced sexual dysfunction.
On the Relation of Working Memory and Multitasking: Memory Span and Synthetic Work Performance

Recent research has identified working memory as a critical component of multitasking ability. These studies showed that working memory accounted for multitasking variance over-and-above that predicted by other cognitive, personality, and experience-based variables. However, a limitation of these previous studies was that the tasks selected to measure working memory were dual-tasks themselves. The purpose of the current research was to determine if working memory measures must be dual-tasks to predict multitasking performance, or if other types of working memory measures that do not rely upon the dual-task methodology predict multitasking just as well, if not better. Three different serial order memory span tasks (one dual-task and two single-task) and one multitask were administered to a sample of healthy young adults. The results showed that single- and dual-task working memory measures predicted multitasking to a similar degree. The results indicate there is something fundamental about working memory's relationship with multitasking ability.
The effect of previsit education in breast cancer patients: A study of a shared-decision-making tool

To enhance shared decision-making for patients with breast cancer, we developed an evidence-based educational breast cancer video (BCV) providing an overview of breast cancer biology, prognostic in...
Complexities of Left Atrial Analysis: More Than Meets the Eye?

Left atrial (LA) size is an important marker for the chronicity of elevated left ventricular (LV) filling pressures and a powerful predictor of adverse cardiovascular outcomes, including stroke, development of atrial fibrillation, congestive heart failure, and death.1 Among the different parameters available for assessing LA size, including diameter, area, and volumes, the latter has been shown to be the most accurate and robust predictor of cardiovascular outcomes.2 Accordingly, a significant amount of interest has recently emerged toward establishing the most accurate echocardiographic method to measure LA volumes. In this regard, Badano et al3 must be commended for completing the first study, published in this issue of Circulation: Cardiovascular Imaging , providing normal reference values for both 2-dimensional (2D) and 3-dimensional (3D) LA volumes together with phasic function indices in a relatively large group of normal subjects over a wide range of ages. As the authors accurately expressed in their article: “availability of reference values…is a prerequisite for routine clinical application.”3 See Article by Badano et al Historically, LA size was initially assessed using M-mode echocardiography acquired from the parasternal long-axis view. In this transducer position, the antero-posterior dimension of the LA was recorded. Because this measurement is highly reproducible, it was widely adopted by echocardiography laboratories worldwide. It soon became obvious, however, that the LA does not dilate symmetrically in all directions when it enlarges. In fact, there is data to suggest that left atrial enlargement in the antero-posterior direction is constricted by the presence of the spine and sternum, and accordingly, most of the LA enlargement tends to occur in the superior-inferior direction.4 Because of this, the use of m-mode echocardiography was strongly discouraged in the American Society of Echocardiography 2005 chamber quantification guidelines, and measurements of LA volumes were recommended for clinical practice. …
Pediatric Treatment Guidelines for Philadelphia Positive (Ph+) Chronic Myelogenous Leukemia (CML): What Are They in Today’s Imatinib Era?

Background: The treatment of pediatric Philadelphia positive (Ph+) chronic myelogenous leukemia (CML) in the era of the tyrosine kinase inhibitors (TKI) continues to evolve with the role of allogeneic hematopoietic cell transplantation (allo-HCT) in these patients becoming more controversial. Imatinib has completely replaced allo-HCT for adult CML patients presenting in first chronic phase, reserving HCT for TKI resistant and/or advanced stage patients (accelerated phase and blast crisis). Whether treatment strategies in 2008 have changed for CML in pediatrics, from heavily allo-HCT based to TKI based medical therapy, is presently unclear. Methods: Thirty-two pediatric centers across the United States and Canada were surveyed regarding current treatment practices for CML in order to explore treatment practices in 2008. The survey targeted primary pediatric oncologists and bone marrow transplant physicians regarding their treatment approach for CML in terms of upfront therapy, utility of allo-HCT, use of TKI (including their role in the post-HCT setting) and how response to therapy was monitored. Results: Twenty-three of the thirty-two centers completed the survey to provide a completion rate of 72% (Table 1). Sixty-three percent of survey responders recommended allo-HCT, when a matched sibling donor was available, for patients with CML in first chronic phase. Regarding the use of TKI in the post-HCT setting, 9 of 27 (33%) physicians reported using imatinib as maintenance therapy post-HCT as a means to prevent relapse. All physicians reported using PCR techniques for bcr-abl of either bone marrow, peripheral blood or both to monitor treatment response with frequencies ranging from monthly to every six months. Conclusion: Treatment of pediatric CML appears variable and center dependent. This survey identified a trend toward less allo-HCT for CML in 2008 compared to years past. Despite the trend toward less HCT, the pediatric treatment consensus in 2008 for CML remains MSD allo-HCT when available. Use of imatinib was recognized by all survey responders as standard of care in upfront therapy, but the use of imatinib or other TKI in the post-HCT setting as maintenance therapy remains in question. Prospective pediatric clinical trials will be necessary to determine the optimal strategy for CML in children. Table 1. Pediatric Centers
Protein-Adsorbed Magnetic-Nanoparticle-Mediated Assay for Rapid Detection of Bacterial Antibiotic Resistance

Antibiotic susceptibility tests have been used for years as a crucial diagnostic tool against antibiotic-resistant bacteria. However, due to a lack of biomarkers specific to resistant types, these approaches are often time-consuming, inaccurate, and inflexible in drug selections. Here, we present a novel susceptibility test method named protein-adsorbed nanoparticle-mediated matrix-assisted laser desorption–ionization mass spectrometry, or PANMS. Briefly, we adsorb five different proteins (β-casein, α-lactalbumin, human serum albumin, fibrinogen, and avidin) onto the surface of Fe3O4. Upon interaction with bacteria surface, proteins were displaced from the nanoparticle surface, the amounts of which were quantified by matrix-assisted laser desorption ionization mass spectrometry. We find that the protein displacement profile was different distinctive among different bacteria strains and, in particular, between wild-type and drug-resistant strains. More excitingly, we observe bacteria resistant to drugs of ...
Markers of dietary protein intake are associated with successful weight loss in the POUNDS Lost trial.

Summary To assess the association of markers for dietary protein intake, measures of dietary adherence and demographic variables with weight loss in the POUNDS Lost study over the first 6 months and again between 6 and 24 months using data from those who completed each period. This is a secondary analysis of pooled data on completers assigned to one of four diets: 65%C/15%P/20%F (AP/LF), 55%C/25%P/20%F (HP/LF), 45%C/15%P/40%F (AP/HF) or 35%C/25%P40%F (HP/HF) in the POUNDS Lost study. Urinary nitrogen excretion, dietary adherence measured by 24-h recall and attendance at sessions, age (above and below 50 years), gender, race/ethnicity and activity by pedometry were analysed. Increased spread between protein intake at baseline and protein at 6 or 24 months, assessed by urinary nitrogen excretion, was associated with greater weight loss from baseline to 2 years. At 6 and 24 months, older age, male gender, body mass index > 30 kg m−2 and adherence to the fat and protein diets were associated with more weight loss. None of these variables was associated with a regain from 6 to 24 months. Weight regain for women in the highest carbohydrate (65%) group was significantly greater (−4.4 kg [95% CI: −5.9, −3.0]) than for women in the lowest carbohydrate group (−1.8 kg [95% CI: −3.2, −0.4 kg]) (P for interaction = 0.012). An increased spread in the difference between baseline and follow-up protein intake was associated with greater weight loss, consistent with the ‘protein spread theory’. Women eating the highest carbohydrate diet regained more weight from 6 to 24 months.
PRKCH regulates hematopoietic stem cell function and predicts poor prognosis in acute myeloid leukemia

Acute myeloid leukemia (AML) cells often co-opt normal hematopoietic stem cell (HSC) programs to drive neoplastic proliferation, and HSC-related gene expression signatures have been identified as biomarkers for poor prognosis in AML patients. We sought to identify new regulators of HSCs and AML cells from previously published HSC and leukemia stem cell (LSC) gene expression signatures. We identified PRKCH (protein kinase C eta) as a gene that is highly expressed in both mouse and human HSCs, as well as in LSCs from independent cohorts of AML patients. Prkch deletion in mice resulted in impaired HSC function. PRKCH was most highly expressed in undifferentiated (FAB M0) subtype AML, and high expression correlated with TP53 and RUNX1 mutations, high-risk cytogenetic features, and poor overall survival. Prkch deletion in an Flt3-ITD/Runx1 mutant mouse AML model did not extend survival. Thus, PRKCH is necessary for normal HSC function; its expression predicts poor survival in AML patients, but it is not required for AML to develop.
Impact of Stroke Center Certification on Mortality After Ischemic Stroke: The Medicare Cohort From 2009 to 2013.

Background and Purpose—An increasing number of hospitals have been certified as primary stroke centers (PSCs). It remains unknown whether the action toward PSC certification has improved the outcom...
Prevalence and determinants of end-of-life chemotherapy use in patients with metastatic breast cancer.

Cessation of chemotherapy in the last few weeks of life could be an important quality-of-care benchmark. Proportion of metastatic breast cancer patients who receive end-of-life chemotherapy is not well described. We aimed to determine the prevalence and determinants of end-of-life chemotherapy use in patients with metastatic breast cancer. A retrospective cohort study using a prospectively collated database of patients with metastatic breast cancer who died between January 1, 2010, and September 30, 2014, was conducted. End-of-life chemotherapy (EOLC) use was defined as receipt of chemotherapy within 2 weeks of death (EOLC2) and receipt of chemotherapy within 4 weeks of death (EOLC4). Patients who did not receive any chemotherapy in the last 4 weeks before death were categorized as non-EOLC. We identified 274 patients with metastatic breast cancer, of whom 28 received EOLC2 (10.2%) and 62 received EOLC4 (22.6%). In comparison with non-EOLC, patients receiving EOLC4 were younger and had greater disease burden. Patients in EOLC4 group received more number of lines of chemotherapy. In a multivariable analysis, younger age at metastatic disease and greater number of metastatic organ systems involved were predictors of end-of-life chemotherapy use. Prevalence of the use of end-of-life chemotherapy in our cohort was higher than previously described. More end-of-life chemotherapy was used in younger women, and those with greater disease burden. Earlier initiation of end-of-life discussions may be targeted to such patients.
Police Violence and the Underreporting of Crime

This paper examines the relationship between police violence and the reporting of crime. Utilizing original data from a large-scale household survey conducted in Costa Rica from October 2013 to April 2014 (n = 4,200), we find that the observation of police violence significantly reduces citizens’ willingness to report crime. The implications of this finding are explored using a game-theoretic model of crime, crime reporting, and police misconduct. The model reveals that although the prospect of police violence against criminals may generate a degree of deterrence for criminal behavior, permissiveness toward police violence also raises expectations about the likelihood of police abuse against law-abiding citizens. Consistent with our empirics, this reduces citizens’ propensity to report crime, thereby fostering a climate of impunity for criminal activity.
Interplay between Microbes and the Circadian Clock

Circadian rhythms influence virtually all life forms on our planet, a notion that opens the question on how the circadian cycles of individual organisms may interplay with each other. In mammals, a potentially dangerous environmental stress is represented by encounters with infectious agents. Microbial attack is a major risk for organismal homeostasis and therefore needs to be efficiently counteracted by mechanisms implemented by the host immune system. Accumulating evidence shows that the immune system may anticipate an emerging pathogenic exposure through an enhanced inflammatory state. Notably, the circadian clock orchestrates these anticipatory responses to fluctuating conditions in the external world. In this article, we review the current knowledge about the relationship between the circadian clock and pathogenic infections. We discuss the role of the circadian clock against infection and specific pathogens, the core clock proteins involved in the defense mechanisms, and the specific tissue or cell type in which they function to counteract the infection. Finally, circadian oscillations in the gut microbiome composition and its possible role in protecting against foodborne pathogen colonization are presented.
High-resolution photoelectron spectroscopy of TiO3H2-: Probing the TiO2- + H2O dissociative adduct.

Slow electron velocity-map imaging spectroscopy of cryogenically cooled TiO3H2− anions is used to probe the simplest titania/water reaction, TiO20/− + H2O. The resultant spectra show vibrationally resolved structure assigned to detachment from the cis-dihydroxide TiO(OH)2− geometry based on density functional theory calculations, demonstrating that for the reaction of the anionic TiO2− monomer with a single water molecule, the dissociative adduct (where the water is split) is energetically preferred over a molecularly adsorbed geometry. This work represents a significant improvement in resolution over previous measurements, yielding an electron affinity of 1.2529(4) eV as well as several vibrational frequencies for neutral TiO(OH)2. The energy resolution of the current results combined with photoelectron angular distributions reveals Herzberg-Teller coupling-induced transitions to Franck-Condon forbidden vibrational levels of the neutral ground state. A comparison to the previously measured spectrum of ba...
Clinical Factors Associated With ICU-Specific Care Following Supratentoral Brain Tumor Resection and Validation of a Risk Prediction Score.

Objectives:The postoperative management of patients who undergo brain tumor resection frequently occurs in an ICU. However, the routine admission of all patients to an ICU following surgery is controversial. This study seeks to identify the frequency with which patients undergoing elective supratent
Development of Smart Interior Environmental Mobile App for Health Monitoring

Migraines are the sixth most disabling disease in the world, affecting more than 1 billion people worldwide and are just one illness affected by environmental triggers due to changes to that occur inside the home. Due to migraines similarities to sinus headaches, migraines affected by environmental triggers can often be misdiagnosed. The development of a smart interior environmental mobile app for health monitoring is designed to take in environmental data from a user's surroundings, i.e. temperature, humidity, pressure and altitude, while also taking in user data about their chronic illnesses affected by environmental changes. These two datasets are then combined and utilized to define a user's common environment and chronic illness attacks. Once the data has been collected, an iOS app analyzes the illness in terms of the changes going on in the environment, looking for correlations that exist, common trigger points and areas of concern in the user's home environment, such as temperature, humidity, etc. This device is targeted at those who suffer from migraine attacks and believe that there is some environmental factor contributing to their migraines. This paper discusses an Internet of Things (IoT) health monitoring analyzer design used to aide user's suffering from migraines and recognize trigger areas in their environment to assist in living a healthier lifestyle.
Fuel for a better future at UVA

Strategic decisions regarding fuels used to meet the University of Virginia's current and future steam demand require an in-depth understanding of the operations of the University of Virginia's Main Heat Plant. The current mix of fossil fuels that the Main Heat Plant depends on to heat the University is constrained in numerous ways, including: the University of Virginia's natural gas allotments, the contractual curtailments on natural gas set by the City of Charlottesville, the University of Virginia's commitment to reducing greenhouse gas emissions, and financial costs. This paper focuses on developing an 8760 (24 hours × 365 days) model that compares multiple what-if scenarios on key measures through simulating the performance of the plant during a year at one hour increments. These scenarios evaluate the effects of changes to the aforementioned constraints and also to increases in demand. Operators at the Main Heat Plant will use the model through an interface that allows them to observe the performance of the system and explore different alternatives by selecting specific scenarios. Summary graphics for parameters such as greenhouse gas emissions, fuel usage, and cost provide decision makers in the plant and in University of Virginia administration with information needed to make strategic decisions regarding the Main Heat Plant and related fuel agreements. The simulated results were validated through a comparison against actual data collected from July 2016 to June 2017, resulting in 65% of modeled fuel states, matching the historical fuel states for the same periods.
Acoustic Emission and Serrated Yielding in Alpha Brass

ABSTRACT The nature of serrated yielding in alpha-brass was investigated using an acoustic emission technique. The acoustic emission results indicate that the region of the serrated yielding can be divided into two portions in terms of the dislocation process. It is considered that both multiplication and unpinning processes occur at the smaller strain levels in the serrated yielding region and only multiplication process occurs at the higher strain levels.
A Historical Understanding of Contraception

Potions, pessaries, magic rituals, and infusions to prevent conception or cause abortion have been used since the days of the Pharaohs. The folklore of many cultures includes practices, generally relegated to women, that today seem dangerous, bizarre, and perhaps even erotic. Insertion of some sort of barrier—dung, lard, beeswax, silver balls— was frequently described. A number of nineteenth-century historians were particularly intrigued by a practice reported in some primitive cultures of women ejecting sperm with violent thrusts of the pelvis. In Western culture, transmission of contraceptive information was carried on largely by midwives, who dominated birthing until the eighteenth century. The preferred method at that time was a sponge or cotton tampon soaked in spermicide and attached to a string for retrieval.
Neuropsychological Assessment of Attention

The clinical assessment of attention usually depends on three sources of information: (1) psychometric tests designed to measure other cognitive functions, which provide indirect information about attention; (2) specific neuropsychological tests of attention; and (3) direct behavioral observation and measurement. As attention is a multifaceted process, the assessment of attention requires that the clinician obtain information about the characteristics of the patient’s performance under different conditions. Therefore, to adequately assess attention, it is usually necessary to use more than one test. In this chapter, we discuss some of the approaches to the clinical assessment of attention, taking into consideration these three sources of information. The initial discussion focuses on the traditional methods of assessing attention. The reader is encouraged to review Lezak (1983) for a more detailed account of the actual test procedures and norms for tests of attention and executive functioning. At the end of the chapter, we discuss several experimental assessment methods.
A Comparison of Eight Models

In the testing of a scientific model or theory, one rarely has a general measure of goodness-of-fit, a universal yardstick by which one accepts or rejects the model. Indeed, science does not and should not work this way; a theory is kept until a better one is found. One way that science does work is by comparing two or more theories to determine their relative merits in handling relevant data. In this paper we present a comparison of eight models for learning by using each to analyze the data from the same experiment.1 A primary goal of any learning model is to predict correctly the learning curve—proportions of correct responses versus trials. Almost any sensible model with two or three free parameters, however, can closely fit the curve, and so other criteria must be invoked when one is comparing several models. A criterion that has been used in recent years is the extent to which a model can reproduce the fine-grain structure of the response sequences. Many properties can be and have been invented for this purpose. Fourteen such properties are used in this paper. A summary index of how well one model fits the fine-grain detail of data compared with another model is the likelihood ratio. There are three objections to this measure, however. First, for many models it is very difficult to compute. Second, its use obscures the particular strengths and weaknesses of a model and so fails to suggest why the model is inadequate. Third, it may be especially sensitive to uninteresting differences between the model and the experiment. Therefore we do not use likelihood ratios in this paper. A satisfactory prediction of the sequential properties of learning data from a single experiment is by no means a final test of a model. Numerous other criteria—and some more demanding—can be specified. For example, a model
Abstract TP407: Combination of Minocycline and Neural Stem Cells Ameliorates Neurological Deficit in Aged Stroke Mice With Delayed Tpa Treatment

The great promise of using stem cells to treat stroke has been inhibited by challenges to stem cell survival in the toxic environment of post-stroke tissue. Reperfusion (removal of clot) can be ach...
Molecular thermodynamic modeling of aqueous Na+-K+-Mg2+-Ca2+-SO42− quinary system

Abstract As part of the effort to develop a comprehensive molecular thermodynamic model for high salinity produced water based on the electrolyte nonrandom two-liquid theory, this work presents the model results for the aqueous Na+-K+-Mg2+-Ca2+-SO42− quinary system. With the binary interaction parameters fully parameterized for the water-electrolyte pairs and the electrolyte-electrolyte pairs, the model satisfactorily describes the thermodynamic properties for the aqueous quinary system and its binary, ternary, and quaternary subsystems for the temperature range 273.15–473.15 K and the salt concentrations up to saturation. The model results are compared with the salt solubility and thermodynamic data available for the subsystems with special attention to systems involving (Ca2+ SO42−).
Abstract 1419: Metastasis and cancer stem cell markers identify two colorectal cancer subtypes with different molecular and clinical features

Introduction Colorectal cancer (CRC) falls among the top prevalent cancer types with lethal outcome both in the United States and worldwide. The heterogeneity of CRC highlights the importance of identifying molecular markers for meaningful classification and prognosis. The recently published Consensus Molecular Subtypes (CMS) represent a widely-used molecular subtyping of CRC. However, our analyses indicate that clear heterogeneity still exists in some CMSs. To better classify CRC, we performed the following study. Methods We collected from literature 19 gene markers classified as metastasis or cancer stem cell (CSC) markers in CRC. We then examined their expression in 622 CRC samples by The Cancer Genome Atlas (TCGA), and validated the findings using another published dataset, GSE39582, with 566 CRC samples. Results We found among the 19 gene markers examined, 9 genes cluster into two oppositely co-expressed groups (VEGFC, SMAD4, TNIK, ITGB1, CD44 and ALCAM in group 1 and VEGFB, OTUB1 and DLL4 in group 2). Principal component analysis and hierarchical sample clustering of theses 9 genes identify two subtypes among the samples of each CMS, particularly CMS2 and CMS4. We named the two subtypes S1, which corresponds to increased expression in group 1 genes, and S2, which corresponds to higher expression of group 2 genes. Analysis of cancer hallmarks indicates a strong enrichment of six pathways (androgen response, protein secretion, mitotic spindle, UV response down, PI3K and TGF-β signaling), a common and defining feature of the S1 subtype in all CMSs. Immune activation pathways and most immune cells are strongly enriched in the S1 subtype of CMS4 samples only. Conversely, S2 is the subtype that exhibits immune activation across CMS2 samples. Tumor microenvironment signatures indicate more lymph vessels and stromal invasion in S1 samples within CMS4. However, within CMS2, a higher leukocyte fraction and invasive signature feature the S2 subtype. The epithelial and proliferative signatures are associated with the S1 subtype in general, but more prominently within CMS2. Consistent with the invasive signature of S2 samples in CMS2, the analysis of TCGA clinical data indicates increased lymphatic invasion, metastasized tumors and worse overall survival for them. On the other hand, GSE39582 clinical data show that worse overall survival is associated with the S1 subtype in CMS4. Conclusion Each of CMS2 and CMS4 can be further divided into two subtypes, S1 and S2. While S2 may define more aggressive CMS2 cancers, S1 can be linked to worse prognosis in CMS4 patients. Citation Format: Burair Alsaihati, Shaying Zhao. Metastasis and cancer stem cell markers identify two colorectal cancer subtypes with different molecular and clinical features [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1419.
MXene Materials for the Electrochemical Nitrogen Reduction—Functionalized or Not?

We use density functional theory calculations to study a group of 2D materials known as MXenes toward the electrochemical nitrogen reduction reaction (NRR) to ammonia. So far, all computational stu...
To fix or not to fix: Delayed repair of anterior flail in the frail and multiply injured

A 72-year-old male with a history of atrial fibrillation, remote stroke, hypertension, and chronic obstructive pulmonary disease presented following a high-speed motor vehicle collision. Injuries included bilateral segmental rib fractures with radiographic anterior flail and a right acetabular fracture. Secondary to thoracic trauma, mechanical ventilation was required and the patient underwent surgical stabilization of left-sided fractures utilizing by 75, 75, 115, and 50 mm plates for ribs 3, 4, 5, and 6, respectively, early in his hospital course followed by fixation of the right hemipelvis. A trial of extubation was unsuccessful. During reintubation, he developed marked abdominal distension and large volume pneumoperitoneum with signs of compartment syndrome. Emergent decompressive laparotomy revealed a perforated posterior prepyloric gastric ulcer that was repaired. Intensive care unit course was complicated by 72 h of multisystem organ failure; however, he recovered and was again nearing the point of ventilator liberation. Right-sided rib stabilization, albeit it delayed, was performed with fixation of 3, 4, 5, and 6 accomplished with long-segment plates bridging to costal cartilage in order to achieve stability. Dense inflammation and callous formation were encountered prolonging operative time. Tracheostomy was performed 3 days postoperatively, despite minimal ventilator requirements, given ongoing secretions and development of pseudomonal pneumonia. The patient was weaned to tracheostomy collar with in-line speaking valve within 2 weeks. This case highlights surgical rib stabilization in a frail, multiply injured patient through which ventilator wean was expedited and rehabilitation potential was optimized.
Tibial access for supra-inguinal embolization in extremely obese patients

Extreme obesity is a risk factor for hemorrhagic complications of femoral access (FA). Femoral lines, hematomas, pelvic binders and coagulopathy in the trauma scenario may also add difficulty and/or risk to FA. Radial access (RA) for routine peripheral endovascular procedures has been popularized owing to decreased hemorrhagic complications, increased patient satisfaction, and decreased operator radiation dose. However, though uncommon, cerebrovascular complications from RA approach are a known risk. Relatively recently, tibial access (TA) has been used for lower extremity peripheral vascular disease interventions. The advantages of TA mirror that of RA, with few and mostly minor complications, and the risk of iatrogenic cerebral embolization is nil. We report the feasibility of TA for supra-inguinal embolization in two extremely obese patients {body mass index > 40 kg/m2} following motor vehicle accidents. Commercially available base and microcatheters were used to perform embolization of the affected lower abdominal or pelvic arteries in standard fashion via a novel trans-tibial artery approach.
A Comparison of Semi-Automated Brown Adipose Tissue Segmentation Methods

1400 Introduction: Human brown adipose tissue (BAT) is a thermogenically active fat that has been proposed as a potential target for obesity treatment. BAT presence, activity, and volume are commonly assessed using 18F-fluorodeoxyglucose (FDG) positron emission tomography / computed tomography (PET/CT) imaging performed following a cold activation protocol. Accurate segmentation of BAT tissue is necessary in order to effectively characterize metabolic activity and tissue mass. The aim of this study was to compare various BAT segmentation methods. Methods: Healthy volunteers under 35 years of age, with a BMI less than 25, were eligible to participate in this prospective, IRB-approved study. Eligible subjects underwent FDG PET/CT following a cold intervention intended to activate BAT. As part of a repeatability study, a series of volunteers underwent repeat imaging within 7 days. Active BAT was then segmented using the BARCIST 1.0 criteria, as well several other published BAT segmentation methods and (Table 1). BAT segmentation using the PET Response Criteria in Solid Tumors (PERCIST) 1.0 method was also tested. Using MIM 6.9, areas on FDG PET/CT images where BAT is typically located were segmented manually. This manual segmentation was then reduced using the threshold combinations shown in table 1 to produce the final BAT volume of interest (BATVOI). The 9 semi-automated segmentation methods were compared by calculating the BATVOI volume mean, standard deviation (SD), standard error, and 95% confidence interval. Additionally, each segmentation was scored visually (by a trained human reader) using a Likert scale from -3 to 3 with a score of -3 corresponding to a significant underestimation of BAT volume and a score of 3 to a significant overestimation of BAT volume. A score of 0 would indicate an ideal estimation of active BAT volume. Results: A total of 35 subjects were enrolled in this study and active BAT was detected in 27 subjects, resulting in a total of 44 PET images. Representative images of each BAT segmentation method are shown in a supplemental figure. Median active BAT volumes, as determined using the 9 threshold combinations, are shown in figure 1 and figure 2 shows how each individual BAT volume varied between the segmentation methods. Segmentation method 1 resulted in the highest active BAT volumes and range of volumes, with a median (IQR) of 241.6 (59.7-547.5). Segmentation method 5 resulted in the lowest active BAT volumes and range of volumes, with a median (IQR) of 40.0 (0.2-130.2). Mean visual determination scores for each method are provided in table 1. Visual determination showed BARCIST 1.0 and segmentation methods 1, 2, 3, and 4 overestimated BAT volume and segmentation methods 5, 6, 7, and 8 underestimated BAT volume. Conclusions: These threshold combinations vary greatly in segmented BAT volume. Interestingly, using a visual determination, a PERCIST 1.0 method appeared to most accurately segment BAT. Future studies are necessary to determine if BARCIST 1.0 should be refined.
Low temperature CO oxidation by doped cerium oxide electrospun fibers

We investigated CO oxidation behavior of doped cerium oxide fibers. Electrospinning technique was used to fabricate the inorganic fibers after burning off polymer component at 600 °C in air. Cu, Ni, Co, Mn, Fe, and La were doped at 10 and 30 mol% by dissolving metal salts into the polymeric electrospinning solution. 10 mol% Cu-doped ceria fiber showed excellent catalytic activity for low temperature CO oxidation with 50% CO conversion at just 52 °C. This 10 mol% Cu-doped sample showed unexpected regeneration behavior under simple ambient air annealing at 400 °C. From the CO oxidation behavior of the 12 samples, we conclude that absolute oxygen vacancy concentration estimated by Raman spectroscopy is not a good indicator for low temperature CO oxidation catalysts unless extra care is taken such that the Raman signal reflects oxide surface status. The experimental trend over the six dopants showed limited agreement with theoretically calculated oxygen vacancy formation energy in the literature.
Management of Acute Kidney Injury in Coronavirus Disease 2019

Acute kidney injury is a common complication in hospitalized patients with coronavirus disease 2019. Similar to acute kidney injury associated with other conditions such as sepsis and cardiac surgery, morbidity and mortality are much higher in patients with coronavirus disease 2019 who develop acute kidney injury, especially in the intensive care unit. Management of coronavirus disease 2019–associated acute kidney injury with kidney replacement therapy should follow existing recommendations regarding modality, dose, and timing of initiation. However, patients with coronavirus disease 2019 are very hypercoagulable, and close vigilance to anticoagulation strategies is necessary to prevent circuit clotting. During situations of acute surge, where demand for kidney replacement therapy outweighs supplies, conservative measures have to be implemented to safely delay kidney replacement therapy. A collaborative effort and careful planning is needed to conserve dialysis supplies, to ensure that treatment can be safely delivered to every patient who will benefit for kidney replacement therapy.
Design and Validation of a Soft Robotic Ankle-Foot Orthosis (SR-AFO) Exosuit for Inversion and Eversion Ankle Support

This paper presents a soft robotic ankle-foot orthosis (SR-AFO) exosuit designed to provide support to the human ankle in the frontal plane without restricting natural motion in the sagittal plane. The SR-AFO exosuit incorporates inflatable fabric-based actuators with a hollow cylinder design which requires less volume than the commonly used solid cylinder design for the same deflection. The actuators were modeled and characterized using finite element analysis techniques and experimentally validated. The SR-AFO exosuit was evaluated on healthy participants in both a sitting position using a wearable ankle robot and a standing position using a dual-axis robotic platform to characterize the effect of the exosuit on the change of 2D ankle stiffness in the sagittal and frontal planes. For both sitting and standing test protocols, a trend of increasing ankle stiffness in the frontal plane was observed up to 50 kPa while stiffness in the sagittal plane remained relatively constant over pressure levels. During quiet standing, the exosuit could effectively change eversion stiffness at the ankle joint from about 20 to 70 Nm/rad at relatively low- pressure levels (< 30 kPa). Eversion stiffness was 84.9 Nm/rad at 50 kPa, an increase of 387.5% from the original free foot stiffness.
Enhanced Environmental Cleaning to Reduce Rates of Clostridioides difficile Infection on Oncology Units

Background: Clostridioides difficile infection (CDI) is a major contributor to morbidity and mortality in patients with hematologic malignancy. Due to both immunosuppression and frequent antibiotic exposures, up to one-third of inpatients receiving chemotherapy or stem-cell transplant develop CDI. Transmission of C. difficile in healthcare facilities occurs due to environmental surface contamination and hand carriage by healthcare workers from colonized and infected patients. We investigated the effectiveness of enhanced room cleaning in collaboration with environmental services (EVS) staff to prevent CDI transmission and infection. Methods: From April 1, 2018, to September 30, 2018, a multimodal enhanced cleaning intervention was implemented on 2 oncology units at the Hospital of the University of Pennsylvania. This intervention included real-time feedback to EVS staff following ATP bioluminescence monitoring. Additionally, all rooms on the intervention units underwent UV disinfection after terminal cleaning. We performed a system-level cohort study, comparing rates of CDI on the 2 study units to historic and 2 concurrent control units. Historic and concurrent control units received UV disinfection only for rooms with prior occupants with MRSA or CDI. All units during the intervention period received education on the importance of environmental cleaning for infection prevention. Mixed-effects Poisson regression was used to adjust for system-level confounders. Results: A median of 1.34 CDI cases per 1,000 patient days (IQR, 1.20–3.62) occurred during the 12-month baseline period. There was a trend toward a reduced rate of CDI across all units during the intervention period (median, 1.19; IQR, 0.00–2.47; P = .13) compared with all units during the historical period. Using mixed-effects Poisson regression, accounting for the random effects of study units, the intervention was associated with an incidence rate ratio for C. difficile of 0.72 compared to control units (95% CI, 0.53–0.97; P = .03). Average room turnaround time (TAT) increased across all units during the study period, from 78 minutes (IQR 74–81) to 92 minutes (IQR, 85–96; P < .001). Within the intervention period, TAT was higher on intervention units (median, 94 minutes; IQR, 92–98) compared to concurrent control units (median, 85; IQR, 80–92; P = .005). Conclusions: Enhanced environmental cleaning, including UV disinfection of all patient rooms and ATP bioluminescent monitoring with real-time feedback, was associated with a reduction in the incidence of CDI. Funding: None Disclosures: None
Systemic Therapy for Chondrosarcoma

Chondrosarcoma subtypes differ in clinical presentation, prognosis, and response to therapy. Diagnosis and treatment should be managed by multidisciplinary teams in sarcoma referral centers. Surgery represents the most effective modality for localized chondrosarcoma. In the setting of recurrent or advanced disease, current systemic therapies are relatively effective in only few subtypes including mesenchymal and dedifferentiated chondrosarcoma. Further research into the pathophysiology and genetic drivers of this disease will inform about future drug development for advanced stage chondrosarcoma.
Volumetric and Acoustic Properties of Phenylboronic Acid in Water at Selected Temperatures

Measurements of density and speed of sound are reported for phenylboronic acid–water solutions for molalities ranging from 0.0098 to 0.1490 mol⋅kg−1 and temperatures ranging from 288.15 K to 313.15 K. Several thermodynamic parameters for phenylboronic acid–water solutions have been calculated from the experimental data. The capability of phenylboronic acid to have strong solute–solvent interactions and weaker solute–solute interactions in aqueous solutions has been revealed and the results of this investigation are consistent with molecular model images generated using Spartan 04 modeling.