cssi/SciSciGPT-SciSciNet huggingface dataset:
Atrial Fibrillation: Embracing the Unknown.

In 1874, Edme Felix Alfred Vulpian observed the irregular atrial electrical behavior and termed it “fremissement fibrillaire” [(1)][1]. The magnitude of the atrial fibrillation (AF) problem ensures funding of discovery and development of diagnostic and therapeutic modalities [(2)][2]. Its
Snorkeling and scuba diving with manta rays: encounters, norms, crowding, satisfaction, and displacement

This research note examined encounters, norms, crowding, satisfaction, and displacement among people snorkeling and scuba diving with manta rays at sites in Hawaii. These sites are popular with up ...
Role of clay minerals on soil organic matter stabilization and humification

An understanding of organic C dynamics in soils is necessary to develop management options to enhance soil organic C sequestration. The objective of this research was to study the distribution of newly formed humic materials into mineralogical distinct clay-size fractions of a silt loam soil. Oats (Avena sativa L), grown under simulated no-tillage conditions, were pulse labeled with "CO2. After senescence, the surface residue was removed and the labeled roots were allowed to decompose in the soil for 360 days. The soil clay fraction (<2 ym) was separated into coarse, medium, and fine clay size-fractions (0.2-2.0, 0.02-0.2 and <0.02 iim, respectively) by centrifugation. X-ray diffraction indicated that quartz, illite, and kaolinite were the dominant mineral phases in the coarse clay fraction while smectite was the dominant mineral phase in the fine clay fraction. The organic C content in the coarse and fine clay fractions (3.70 and 3.93%, respectively) were similar. Scintillation analysis indicated an increase in 14C specific activity in all
From Local to Global

As we have seen in the previous chapters most of the existing methods in optimization focus on the very important problem of computing feasible points that satisfy necessary optimality conditions (Kuhn-Tucker points). In the previous chapter, we studied a special class of minimax problems for which a characterization of its global solutions was obtained.
Carvalho, Ana M. editor. Português em contato. Ibero-americana/Vervuert, 2009.

A coletânea organizada por Ana Maria Carvalho e uma contribuicao ate agora unica aos estudos linguisticos relativos ao portugues. Como aponta a organizadora, esta e a primeira obra a se dedicar ao estudo do portugues em situacoes de contato. O livro traz a luz artigos a respeito da lingua portuguesa nos quatro cantos do mundo—literalmente. A coletânea e dividida por regioes geograficas, com estudos que abordam o contato do portugues com outras linguas na Africa, America, Asia e Europa.
Early Detection of Epileptic Activity on EEG Signals using Phase-Preserving Quantization Method

This paper demonstrates the use of a data decimation method, called phase-preserving quantization (PPQ), for early seizure prediction. PPQ consists of a) amplifying and filtering the neural signals around the frequency band of interest, and b) compressing the filtered signal using a 1-bit quantizer with a 0-V single-threshold decision. The ability of PPQ to retain phase information and predict seizure events while compressing the signal resolution to a single bit is demonstrated using electroencephalography (EEG) recordings from the Children's Hospital Boston-MIT (CHB-MIT) EEG database. Results show 97% accuracy when calculating synchrony values using PPQ, which is an improvement of 7% when compared to previously published results. The presented improved method enables the early detection of seizure events, resulting in a decrease in phase synchrony computation time while allowing an increase in the number of recording channels that can be screened when using EEG.
Diarrhea in Llama and Alpaca Crias

Neonatal and juvenile diarrhea are common complaints among owners of cattle, sheep, pigs, horses, and goats. Microbial causes are usually blamed, although in some cases nutritional or other considerations come in to play. The most commonly identified pathogens are viruses and protozoa. These are relatively self-limiting, and clinical signs are more related to fluid and electrolyte loss than anything else. For ruminants and pigs especially, various products have been developed which specifically address water, base and salt loss. Various antibody and vaccine preparations are available to directly combat the causative organisms, but with the exception of Eimeria, antimicrobial treatment is usually not considered necessary.
Evaluation of Pseudoreader Study Designs to Estimate Observer Performance Results as an Alternative to Fully Crossed, Multireader, Multicase Studies.

Rationale and Objectives To examine the ability of a pseudoreader study design to estimate the observer performance obtained using a traditional fully crossed, multireader, multicase (MRMC) study. Materials and Methods A 10-reader MRMC study with 20 computed tomography datasets was designed to measure observer performance on four novel noise reduction methods. This study served as the foundation for the empirical evaluation of three different pseudoreader designs, each of which used a similar bootstrap approach for generating 2000 realizations from the fully crossed study. Our three approaches to generating a pseudoreader varied in the degree to which reader performance was matched and integrated into the pseudoreader design. One randomly selected simulation was selected as a “mock study” to represent a hypothetical, prospective implementation of the design. Results Using the traditional fully crossed design, figures of merit) (95% CIs) for the four noise reductions methods were 68.2 (55.5–81.0), 69.6 (58.4–80.8), 70.8 (60.2–81.4), and 70.9 (60.4–81.3), respectively. When radiologists’ performances on the fourth noise reduction method were used to pair readers during the mock study, there was strong agreement in the estimated figures of merits with estimates using the pseudoreader design being within ±3% of the fully crossed design. Conclusion Fully crossed MRMC studies require significant investment in resources and time, often resulting in delayed implementation or minimal human testing before dissemination. The pseudoreader approach accelerates study conduct by combining readers judiciously and was found to provide comparable results to the traditional fully crossed design by making strong assumptions about exchangeability of the readers.
Abstract 799: Aberrant mitochondrial protein involvement through early PDAC initiation and progression using multiplexed DNA-PAINT and correlative histology

Prior to pancreatic ductal adenocarcinoma (PDAC), pancreatic acini cells change their morphology through pancreatic intraepithelial neoplasia (PanIN) stages, becoming increasingly dysplastic as stroma and tissue hypoxia increase. This increasing hypoxia forms a cancer promoting microenvironment, wherein we propose metabolic changes trigger aberrant mitochondrial networks form healthy tissue. We developed tissue superresolution imaging to directly quantify structural mitochondrial response through patient histology, whereby DNA-PAINT can provide super-resolution detail decoupled from photo bleaching to visualize mitochondria through tissue layers. Expanding from preliminary data, target mitochondrial dynamics proteins’ organization will also be correlated to PanIN stages. Introduction: Early oncogene involvement in PDAC progression links to metabolic and mitochondrial regulatory changes. Typically nutrient deprivation and hypoxia trigger cell death from increased reactive oxygen species production and organelle damage which trigger apoptosis, yet these prolonged effects can be cancer promoting when less severe. Mitochondrial dynamics and proteins related to mitochondrial fission and fusion can reduce apoptotic signaling, enhance aerobic glycolysis, and increase ROS to allow cancer progression. Materials and Methods: Adapting from previous proof of concept, mitochondria (TOM20) within formalin-fixed paraffin embedded (FFPE) tissue sections were imaged with stochastic optical reconstruction microscopy (STORM). In brief: cadaver healthy pancreas FFPE tissue samples underwent deparafinization, antigen retrieval, indirect immuno-labeling with AlexaFluor647, TIRF illumination with a 60x objective was used for data collection, whereby data processing was conducted using the open-source FIJI and custom MATLAB software. Results and Discussion: Preliminary data shows proof of principle that both STORM and DNA-PAINT can be correlated to histological staining of human pancreas. Conclusions: Superresolution imaging reveals ultrastructural details of mitochondria in FFPE patient samples not resolved via conventional fluorescence imaging. Through quantitative feature analysis, we would be able to correlate aberrant mitochondria structure and abundance to PDAC progression. Acknowledgements: Funding provided by the Cancer Early Detection Advanced Research (CEDAR) Center of OHSU Knight Cancer Institute. Citation Format: Matthew J. Rames, Fehmi Civitci, Ting Zheng, Josiah Wagner, Jason Link, Xiaolin Nan. Aberrant mitochondrial protein involvement through early PDAC initiation and progression using multiplexed DNA-PAINT and correlative histology [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 799.
Endoscopic Closure of Full-Thickness Gastrointestinal Defects

Although traditionally considered a contraindication to endoscopy, full-thickness GI tract defects now fall well within the realm of the therapeutic endoscopist. An ever-increasing number of devices are available to assist in both definitive and nondefinitive closure as well as in the adjunct therapies required prior to closure. As experience with these tools has expanded, a greater number, larger, and more complex defects are being managed endoscopically. Such closure should be undertaken by advanced therapeutic endoscopists who are capable of performing the interventions outlined in this chapter and often occur within the confines of multispecialty care teams. Ultimately, endoscopic closure of full-thickness GI defects has the potential to eliminate surgical intervention in some patients and offer a chance at closure for patients who have been deemed nonsurgical candidates.
Physiological and clinical studies of GRF and GH.

Publisher Summary This chapter reviews the physiological and clinical studies of growth hormone (GH) and growth hormone releasing factor (GRF). GRF is the last of the classical hypothalamic hormones isolated. The isolation of GRF was only possible by the identification of peripheral GRF-secreting tumors. A major problem in isolating GRF was the minute amount of peptide presents in the hypothalamus, which, in addition, contained high concentrations of the GH release-inhibiting hormone, somatostatin. Its application to animal and human studies has opened a new horizon in GH physiology and pathophysiology. The pulsatile pattern of GH secretion in several mammalian species is accounted for by a dynamic interaction of hypothalamic somatostatin and GRF at the somatotroph. The increased GH secretion of the male rat is accounted for at least in part by increased percentage of somatotrophs, increased GH secretion per cell, and increased sensitivity to GRF. Studies with GRF in GH-deficient subjects have demonstrated that the majority of these patients do not suffer from a pituitary defect, but instead from a hypothalamic neurosecretory defect giving rise to GRF deficiency. Preliminary data demonstrate that GRF accelerates growth in GH-deficient children. GRF offers the prospect of restoring endogenous GH secretion to children and adults with GH deficiency. In addition, it appears that to restore pulsatile GH secretion GRF may be administered either in a pulsatile or continuous fashion. The tight regulation of GH by nutritional factors and the known metabolic effects of GH suggest that it is an important regulator of metabolism.
Anne Braden: Southern Patriot

Anne Braden was a white woman raised in Anniston, Alabama, who fought racism in her adopted home of Louisville, Kentucky, in the South, and throughout the nation for half a century until her death ...
A Phase I Study of Bortezomib in Combination with ICE (BICE) in Patients with Relapsed/Refractory Classical Hodgkin Lymphoma

Background: The proteasome inhibitor bortezomib induces cell cycle arrest and apoptosis of Hodgkin lymphoma (HL) cells. We have demonstrated that bortezomib’s single agent efficacy was limited in heavily pretreated HL patients. However, preclinical work has shown that bortezomib may synergize with chemotherapy. Thus, we evaluated the combination of bortezomib plus ICE chemotherapy in patients with relapsed/refractory HL. Methods: Eligibility: Relapsed/refractory classical HL, Only 1 prior chemotherapy regimen, Prior treatment with anthracycline-containing regimen, No prior ASCT. Regimen: ICE (Moskowitz, C et al 2001). Bortezomib on D1 and D4 at dose levels of 0 = 1 mg/m2, 1 = 1.3 mg/m2, 2 = 1.5 mg/m2. Neulasta given on D5. Cycles were repeated on D14 if platelet count is ≥ 100,000/mm3 and ANC is ≥ 1,000/mm3. After 3 cycles CTs and PET/CT were performed to evaluate response. Hematologic DLT was defined as grade 4 thrombocytopenia or neutropenia lasting greater than 2 weeks. Results: 13 patients enrolled (6 primary refractory and 7 relapsed HL). Median age 32 (range 21–39). 3 patients were treated at dose levels 0 and 1 and 7 patients were treated at dose level 2. 12 patients were evaluable for toxicity and response. The ORR was 75% with 25% CR (1 primary refractory, 2 relapsed) and 50% PR (1 primary refractory, 5 relapsed). PET/CT scans showed negativity in all patients who responded to treatment. 8/9 patients who responded to treatment underwent ASCT (1 patient declined ASCT). All patients who underwent ASCT had successful pheresis and engraftment. At median follow-up of 12 months all 8 patients treated with ASCT are free of relapse. Treatment was well tolerated with no DLTs noted. Reversible grade 4 neutropenia and thrombocytopenia occurred respectively in 33% and 50% of the patients. Median day for retreatment for cycle 2 was D20 and for cycle 3 was D21. There have been no toxicities of peripheral neuropathy, febrile neutropenia, or infection. Conclusions: Our data suggests favorable tolerability and efficacy of bortezomib plus ICE in patients with relapsed/refractory Hodgkin lymphoma. We are planning to confirm these promising results in a randomized phase II trial.
Effective reduction in stress induced postoperative hyperglycemia in bariatric surgery by better carb loading.

Abstract Background Preoperative carbohydrate loading is a recommended component of enhanced recovery protocols (ERP’s), however the impact on postoperative stress-induced insulin resistance remains poorly studied in both diabetics and non-diabetics. Methods Using our ERP, a preoperative grape juice group (Grape) was compared to the use of 25 g maltodextrin/3 g citrulline (G.E.D.™, SOF Health, LLC) for carbohydrate loading. Results The population included 171 patients (Grape n = 96; GED n = 75). Glycemic variability was significantly worse for the Grape group on POD 0 in both non-diabetic (70% vs 41%; p Conclusion Following bariatric surgery, the impact of stress induced hyperglycemia is primarily on POD 0 in non-diabetics whereas the effect extends into POD 1 for diabetics. Preoperative loading with G.E.D.™ versus grape juice is associated with a significantly lower rate of glycemic variation and postoperative insulin requirement, demonstrating that drink composition and treatment process reduces the severity of postoperative stress induced hyperglycemia in bariatric surgery patients.
Omnichannel Marketing: The Challenge of Data-Integrity

Channels have traditionally been viewed as intermediaries that facilitate the transfer of products from manufacturers to consumers. Innovations in digital technologies help firms to integrate the customer experience across channels and devices. This new phenomenon is referred to as “omnichannel marketing.” Existing research on omnichannel marketing has emphasized that this means that firms need to integrate and optimize across channels rather than within channels. In this paper, we argue that questions of data integrity are now at the forefront of the challenges that firms face embarking on omnichannel marketing strategy. The emergence of digital platforms, AI-powered assistants, and mobile devices have led to even more voluminous and diverse data, beyond simple binary formats, being created about consumers. However, we argue that tracking consumers across so many different devices and touchpoints is problematic, especially when the firm does not control that channel. We discuss two technologies that firms are using to address these challenges of data-tracking: Machine Learning and Blockchain. Firms now need to use machine learning to attempt to track consumers across different touchpoints and predict their response to marketing actions. Firms can also use a variety of blockchain technologies to better ensure data is tracked in a robust way across different devices. Last, we highlight that the need for individual-level tracking implied by omnichannel marketing and the technologies deployed to address this need are often in tension with consumer privacy, and that firms need to recognize the tradeoffs between optimizing omnichannel marketing strategies and consumer privacy.
First, Do No Harm: An Analysis of Prescribing Behavior

Econometric analysis is used to explore contributing factors to widespread opioid abuse in the United States. Using county-level data from the Centers for Disease Control and Prevention (CDC), multiple linear regressions are performed to estimate the correlation of opioid prescribing rates on accidental drug poisoning mortality. Based on the model presented in this paper, statistical significance is shown correlating drug overdose deaths and opioid prescribing rates. Given low importation of illegal prescription opioids and the high likelihood of transitioning to heroin from prescription opioids, it suggests physicians play a key role in the supply of prescription opioids used by individuals with opioid use disorder.
Method for Analytically Finding the Nullspace of Stiffness Matrix for Both Zeroth-Order and Higher Order Curl-Conforming Vector Bases in Unstructured Meshes

The stiffness matrix in a vector finite-element method has a nullspace whose size grows linearly with the matrix size. Finding it numerically can be computationally expensive. However, the nullspace is important in many applications from solving the low-frequency breakdown problem to developing fast solvers. In this article, an analytical method to generate the nullspace of the stiffness matrix is developed, not only for the zeroth-order but also for any higher order vector basis function in arbitrary unstructured meshes. Using the mesh information, we are able to analytically construct the nullspace without any difficulty, thus avoiding solving an eigenvalue problem for finding the nullspace. The proposed analytical method has been applied to a variety of 2-D and 3-D irregular meshes for various orders of vector basis functions. Comparisons with the reference nullspace obtained from a brute-force eigenvalue solution have validated the proposed analytical method. The proposed work has also been applied to efficiently solve the low-frequency breakdown problem in a full-wave solver and perform fast layout parasitics extraction.
Clathrin-Independent Endocytosis of GABAA Receptors in HEK 293 Cells†

The endocytosis of GABA(A) receptors was investigated in HEK 293 cells expressing receptor alpha1beta2- and alpha1beta2gamma2-subunit combinations. For assessment of internalized receptors by radioimmunoassay or immunofluorescence, a triple c-myc epitope was introduced into the amino terminus of the beta2 subunit. An assay based on biotin inaccessibility was used for alpha1 subunits. GABA(A) alpha1beta2- and alpha1beta2gamma2-subunit receptors were internalized with a t(1/2) of 5.5 min at 37 degrees C. With both subunit combinations, phorbol 12-myristate 3-acetate enhanced internalization by nearly 100%. Treatment of the cells with hypertonic sucrose prevented both the basal and phorbol ester-induced endocytosis of GABA(A) receptors. GF 109203X, an inhibitor of protein kinase C, blocked the stimulation by phorbol ester but had no detectable effect on basal receptor endocytosis. Coexpression with a dominant-negative mutant of dynamin (K44A) led to a 100% enhancement of GABA(A) receptor internalization, while the endocytosis of beta(2)-adrenergic receptors was completely prevented. The results indicate that the endocytosis of GABA(A) alpha1beta2-subunit receptors in HEK cells is constitutive, positively modulated by activation of protein kinase C, and occurs by a mechanism that requires neither the participation of a GABA(A) receptor gamma2 subunit nor a clathrin-mediated pathway.
Development of CFD-based aerodynamic parameters for a multi-sided cylinder

Abstract High mast light poles (HMLP) are used nationwide on major interstates and at local intersections for luminary purposes in the United States. The HMLPs are subjected to major oscillatory wind loading which may cause fatigue and earlier life expediency failure. From the concerns that HMLP failures would lead to pedestrian harm, extensive studies were performed to develop a standard model of behavior for high wind loads and vortex shedding that can be used for future design. Numerical modeling with the use of Computational Fluid Dynamics (CFD) is proposed to simulate the typical shape (dodecagonal cylinders) of the HMLPs and be validated with wind tunnel experiments. The k-ω based SAS-SST turbulence model will be used to handle the turbulence closure for the fully turbulent flow regime. The work done will look at validating static and dynamic force coefficients of a dodecagonal cylinder at different orientations. In addition, the lock-in behavior will be simulated to determine the applicability of modern CFD approaches to be able to perform the oscillatory behavior of a dodecagonal cylinder. Added mass cases also will be examined to determine the damping effects on an unsteady cylinder as additional in-depth study.
Autonomous Refueling Strategies using Vehicle-to-Infrastructure Communication in Smart Cities

Recently self-driving vehicles have attracted tremendous attention from all walks of life. A problem facing self-driving vehicles is when to stop for gas. In this paper, we study the autonomous refueling strategies using vehicle-to-infrastructure communication in smart cities. We set three goals for our strategies: not to stop too late, nor too early, and get relatively cheap gas. To satisfy these goals, we relate our problem to the Gusein-Zade's version of the secretary problem and provide a solution framework where we divide the distance a vehicle can travel from a full tank to an empty tank into Density Observation Section, Secretary Section, and the Critical Section. To predict the number of gas stations a vehicle will encounter in the future, we use the Constant Density Approximation (CDA) method and the Machine Learning (ML) method. Simulation results comparing the proposed CDA and ML algorithms with the ground truth algorithm show that both perform nearly as well as the ground truth in satisfying all three goals.
Synchronization and locking in oscillators with flexible periods.

Entrainment of a nonlinear oscillator by a periodic external force is a much studied problem in nonlinear dynamics and characterized by the well-known Arnold tongues. The circle map is the simplest such system allowing for stable N: M entrainment where the oscillator produces N cycles for every M stimulus cycles. There are a number of experiments that suggest that entrainment to external stimuli can involve both a shift in the phase and an adjustment of the intrinsic period of the oscillator. Motivated by a recent model of Loehr et al. [J. Exp. Psychol.: Hum. Percept. Perform. 37, 1292 (2011)], we explore a two-dimensional map in which the phase and the period are allowed to update as a function of the phase of the stimulus. We characterize the number and stability of fixed points for different N: M-locking regions, specifically, 1:1, 1:2, 2:3, and their reciprocals, as a function of the sensitivities of the phase and period to the stimulus as well as the degree that the oscillator has a preferred period. We find that even in the limited number of locking regimes explored, there is a great deal of multi-stability of locking modes, and the basins of attraction can be complex and riddled. We also show that when the forcing period changes between a starting and final period, the rate of this change determines, in a complex way, the final locking pattern.
How to Shop, Store, and Cook Food like Mrs. Consumer: The Refrigerator, Women, and the Italian Home

Examining the arrival and diffusion of the refrigerator in Italy, an American invention and one of the key symbols of Italy’s postwar economic miracle, the chapter reveals Giovanni Borghi’s, head of the Italian domestic appliance company Ignis, efforts to bring American modernity to his company and its refrigerators. This chapter also analyzes the refrigerator’s effect on the relationship between Italian women, the home, and food. While the appliance brought many Italian women into a modern and technologically advanced domestic world, refrigerator publicity material did not always promote modern and progressive female societal roles, elevating instead the image of the “angel of the hearth,” the traditional casalinga (housewife), who was dedicated to the home, to being a mother and wife, and nothing else.
General impulsivity in binge-eating disorder.

Background The nature and significance of impulse-control difficulties in binge-eating disorder (BED) are uncertain. Most emerging research has focused on food-specific rather than general impulsivity. The current study examines the clinical presentation of patients with BED categorized with and without clinical levels of general impulsivity. Method A total of 343 consecutive treatment-seeking patients with BED were categorized as having BED with general impulsivity (GI+; N = 73) or BED without general impulsivity (GI−: N = 270) based on structured diagnostic and clinical interviews. The groups were compared on demographic, developmental, and psychological features, and on rates of psychiatric and personality comorbidity. Results Individuals with BED and general impulsivity (GI+) reported greater severity of eating-disorder psychopathology, greater depressive symptoms, and greater rates of comorbidity than those without general impulsivity (GI−). Conclusions A subtype of individuals with BED and general impulsivity may signal a more severe presentation of BED characterized by heightened and broader psychopathology. Future work should investigate whether these impulse-control difficulties relate to treatment outcomes.
L’homoérotisme en autotraduction : Le cas de Sud / South de Julien Green

Ecrivain translingue de nationalite americaine, Julien Green (1900-1998) a ecrit une grande variete de romans, pieces, nouvelles, et essais, ainsi que l’un des journaux intimes les plus longs du vingtieme siecle. Parmi ses textes bilingues se trouve une piece d’inspiration homoerotique, Sud (1953), que l’auteur a traduite en anglais comme South (1959) avec l’aide de sa soeur, Anne Green. Quoique l’homoerotisme des personnages des oeuvres de Green ait deja ete examine dans certains textes critiques, l’evolution de cet homoerotisme dans une piece autotraduite comme celle de Sud / South n’a pas encore ete etudiee de pres. Dans cet article, on montrera ainsi comment cet auteur a transforme le drame de l’amour homosexuel de sa premiere piece, Sud (1953), dans son autotraduction, South (1959), et les effets de ces changements linguistiques sur le lecteur. Plus precisement, on analysera comment Green a employe une approche translative du moins-dit pour cacher la plupart de l’intrigue centrale de la version traduite de sa piece. A cause de multiples coupures, revisions, et ajouts en autotraduction, l’amour du lieutenant Ian Wiczewski pour le jeune Erik Mac Clure, ainsi que l’orientation homosexuelle d’Edouard Broderick, sont moins visibles dans South que dans Sud. Par consequent, Sud et South apparaissent comme deux versions bien disparates de la meme oeuvre.
A Cost-Benefit Analysis of a Condom Social Marketing Program in Tanzania

This paper uses the revealed preference, willingness-to-pay approach to estimate the benefits in a cost-benefit analysis of a condom social marketing (CSM) program in Tanzania. The demand curve used to derive the consumer surplus had unit elasticity and it was estimated from a cross-section sample of 1,272 persons. People were willing to pay different prices for the condoms because perceived quality varied. Net-benefits were close to zero for the minimum estimate that ignored external benefits. With external benefits included, the CSM program was judged socially worthwhile with our best-estimate producing a benefit-cost ratio ranging from 1.31 to 1.72.
Home health care utilization trend, predictors, and association with early rehospitalization following endovascular transcatheter aortic valve replacement

BACKGROUND/PURPOSE Home healthcare (HHC) utilization is associated with higher rates of rehospitalization in patients with heart failure and transcatheter mitral valve repair. This study sought to assess the utilization, predictors, and the association of HHC with 30-day readmission in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS/MATERIALS We queried the Nationwide Readmission Database from January 2012 to December 2017 for TAVR discharges with and without HHC referral. Using multivariate analysis, we identified predictors of HHC utilization, and its association with outcomes. RESULTS Of 60,950 TAVR discharges, 21,724 (35.7%) had HHC referral. On multivariable analysis, female sex (OR, 1.34; 95% CI, 1.29-1.40), non-elective admission (OR, 1.49; 95% CI, 1.42-1.56), diabetes mellitus (OR, 1.09; 95% CI, 1.05-1.13), prior stroke (OR, 1.06; 95% CI, 1.01-1.12), anemia (OR, 1.16; 95% CI, 1.11-1.21), and in-hospital complications including cardiogenic shock (OR, 1.37; 95% CI, 1.16-1.50), cardiac arrest (OR, 1.22; 95% CI, 1.00-1.50), stroke (OR, 2.62; 95% CI, 2.20-3.18), and new Permanent pacemaker (OR, 1.49; 95% CI, 1.41-1.58) were identified as independent predictors of HHC referral. HHC utilization was associated with longer median length of stay (4 days vs. 2 days, P < 0.001), higher rate of 30-day all-cause (15.5% vs. 10.6%, P < 0.001) and heart failure (2.1%vs. 1.1%, P < 0.001) readmission rates compared to those without HHC. CONCLUSIONS Our study identified a vulnerable group of TAVR patients that are at higher risk of 30-day readmission. Evidence-based interventions proven effective in reducing the burden of readmissions should be pursed in these patients to improve outcomes and quality of life.
Onset of Θ' to Θ Phase Transformation in Al-Cu Alloys

The θʹ to θ phase transformation that occurs during overaging in Al-Cu alloys is detrimental for their mechanical properties. Experiments suggest that the onset of this transformation is dependent on the temperature and duration of thermal exposure, but the microstructural conditions which trigger this transformation are still unclear. In this study, the critical conditions associated with the onset of θʹ to θ phase transformation are predicted using thermodynamic analysis. We compare the predicted microstructural conditions with both new and previously reported microstructural observations, and also test the predictions using phase field modeling. This multi-pronged approach suggests that the tendency of a θʹ particle to transform into the θ phase depends primarily on temperature, particle size, and particle aspect ratio. We define a "critical" aspect ratio below which θʹ to θ phase transformation becomes thermodynamically favored and show how this critical aspect ratio increases with both temperature and particle volume. With this approach, the intimate link between phase stability, morphological stability, and coarsening resistance for θʹ precipitates in Al-Cu alloys is illustrated.
Timing of Anti-Coagulation after Acute Ischemic Stroke and its relationship to risk of Intracranial Hemorrhage (P1.3-003)

Objective: To review the risk of hemorrhagic conversion of ischemic stroke in patients with underlying atrial fibrillation based on stroke volume and time of initiation of therapeutic anticoagulation (AC). Background: The mainstay of secondary stroke prevention in the setting of underlying atrial fibrillation is anti-coagulation. However, after a large acute ischemic stroke, the concerns for hemorrhagic transformation are thought to outweigh the benefits of resuming or initiating anti-coagulation often resulting in a significant delay in treatment. There is paucity of data to guide Neurologists in adequately assessing the risk to benefit ratio of anti-coagulation in this setting. Currently, there is a variation in clinical practice and most expert opinions suggest initiating anti-coagulation within 14 days of stroke. Design/Methods: We performed a retrospective chart analysis of patients discharged from Stony Brook University Hospital during the calendar years 2013 – 2017 with the diagnoses of both ischemic stroke and atrial fibrillation. Patients started on DOACs as well as Vitamin K antagonists were included. We assessed the cerebral infarct volume through manual selection of hyperintense lesions on diffusion weighted image MRI sequences followed by semi-automated volume segmentation and measurement using Olea Sphere version 3.0 volumetric analysis software. Results: Out of the first 200 charts reviewed, 112 patients qualified for the study. Anti-coagulation was started on 67 patients in the first 2 days after stroke, 17 had AC initiated on days 3–5, 7 on days 6–7, 10 on days 7–14, and 11 after day 14. The stroke volumes ranged from 0.09 ml to 160.33 ml. There were no incidences of symptomatic hemorrhagic conversions and none of the patients had recurrent stroke while waiting to be started on AC. Conclusions: Analysis of first 112 patients reveals no increased risk of hemorrhage after AC initiation regardless of stroke volume or day of initiation. Disclosure: Dr. Shehzad has nothing to disclose. Dr. Stefanowski has nothing to disclose. Dr. Jones has nothing to disclose. Dr. Gauger has nothing to disclose. Dr. Stemke has nothing to disclose. Dr. Bangiyev has nothing to disclose. Dr. Fiorella has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Medtronic, Codman, Sequent Medical, Microvention. Dr. Fiorella has received compensation for serving on the Board of Directors of Vascular Simulations . Dr. Fiorella has received royalty, license fees, or contractual rights payments from Codman/JnJ. Dr. Fiorella has received research support from Siemens, Penumbra, Sequent Medical, Microvention. Dr. Guido has nothing to disclose.
Robust Deep Reinforcement Learning for Quadcopter Control.

Deep reinforcement learning (RL) has made it possible to solve complex robotics problems using neural networks as function approximators. However, the policies trained on stationary environments suffer in terms of generalization when transferred from one environment to another. In this work, we use Robust Markov Decision Processes (RMDP) to train the drone control policy, which combines ideas from Robust Control and RL. It opts for pessimistic optimization to handle potential gaps between policy transfer from one environment to another. The trained control policy is tested on the task of quadcopter positional control. RL agents were trained in a MuJoCo simulator. During testing, different environment parameters (unseen during the training) were used to validate the robustness of the trained policy for transfer from one environment to another. The robust policy outperformed the standard agents in these environments, suggesting that the added robustness increases generality and can adapt to non-stationary environments. Codes: https://github.com/adipandas/gym_multirotor
Identification of CD4+ Sub-population of Resident Cardiac Fibroblasts Linked to Myocardial Fibrosis

Infiltration with inflammatory T-cells and accumulation of cardiac myofibroblasts are hallmarks of cardiac fibrosis and maladaptive remodeling. The origin, identity, and functions of the resident cardiac cells involved in this process are, however, unclear. To determine the identity of cells contained in regions exhibiting fibrosis, mass cytometry profiling was performed using resident human ventricular cardiac fibroblasts and right ventricle autopsy tissues from individuals diagnosed with pulmonary hypertension and SUGEN/hypoxia rats. Results showed that a subpopulation of resident myocardial fibroblasts expresses increased levels of CD4+, a helper T-cell surface marker, in addition to mesenchymal markers in humans and rats. Characterization of the resident cardiac fibroblast subpopulation, both structurally and functionally, using transcriptome and secretome analysis of the secreted cytokines, chemokines, proteins, and metabolites, evidenced that IL-1β induces a phenotypic switch of human cardiac fibroblasts from mesenchymal to CD4+ lymphoidal lineage in vitro. RNA sequencing (RNA-seq) analysis of FACS-sorted CD4-expressing cardiac fibroblasts further revealed that the transcriptome of such IL-1β-induced CD4+ fibroblast population exhibited classical lymphoidal and stem cell-like signatures. Lastly, reversal of cell clustering, phosphorylation of MAPK p38 and NF-κB p65, and phenotypic switching was achieved with the administration of an IL-1R antagonist. In conclusion, we have identified a subpopulation of cardiac fibroblasts which exhibits structural and functional attributes of both mesenchymal and lymphoid cells which is induced by IL-1b-IL-1R-NFkB pathway for differentiation of cardiac fibroblast cells. These data suggest that cardiac fibroblast transdifferentiation during inflammation may form the basis for maladaptive remodeling during myocardial fibrosis. Non-standard abbreviations: IL-1B; Interleukin-1-beta, CD4; Cluster of differentiation, aSMA; alpha smooth muscle actin, MAPK; mitogen activated protein kinases, NFkB; Nuclear Factor kappa-light-chain- enhancer of activated B cells; IL-1R; Interleukin-1-receptor
Static Stochastic Programming Models

When formulating a stochastic programming problem, we usually start from a deterministic problem that we call underlying deterministic problem. Then, observing that some of the parameters are random, we formulate another problem, the stochastic programming problem, by taking into account the probability distribution of the random elements in the underlying problem. When decision can or has to be made in the presence of randomness, at one single step, i.e., we do not wait for the occurrence of any event or realization of some random variable(s), then we say that the stochastic programming model is static. The two words: model and problem are used as synonyms. In the strict sense, the model specifies the assumptions made concerning the system in mathematical terms and identifies system parameters with mathematical objects. Having these, we formulate a problem to be solved and use the obtained result for descriptive or operative purposes.
Overview of the Compact Ignition Tokamak

A national team has developed a baseline concept for a Compact Ignition Tokamak (CIT). The CIT mission is to achieve ignition and provide experimental capability to study the behavior of burning plasmas. The design uses large magnetic fields on axis (about 10 T) and large plasma currents (about 9–10 MA). The magnet structure derives high strength from the use of a copper-Inconel composite plate design in the nose region of the toroidal field (TF) coil and in the ohmic heating solenoid. Inertial cooling is used; liquid nitrogen temperatures are established at the beginning of each pulse. Capability is provided to operate either with a divertor or limiter based plasma. The design is very compact (1.32-m major radius, 0.43-m plasma radius), has 16 TF coils, and has 16 major horizontal access ports, about 30 cm by 80 cm, located between TF coils. The schedule is for a construction project to be authorized for the period FY 1988–93.
Effect of vagus nerve stimulation upon excitability of the canine ventricle. Role of sympathetic-parasympathetic interactions.

The effect of vagus nerve stimulation on ventricular excitability was studied in 28 dogs under various conditions of adrenergic neural tone. Strength-interval curves were delineated from the apex of the right ventricular endocardium with a transvenous bipolar catheter. Vagus nerve stimulation in both closed chest and open chest dogs shifted the strength-interval curve 6 to 8 msec later into electrical diastole (P < 0.001). Left stellate ganglion stimulation shifted the strength-interval curve 9 to 11 msec earlier into diastole (P < 0.001). The effect of simultaneous left stellate ganglion and vagus nerve stimulation was not significantly different from that of left stellate ganglion stimulation alone. The influence of vagus nerve stimulation on the strength-interval curve under basal conditions was abolished by acute beta adrenergic blockade with propranolol. It is concluded that vagus nerve stimulation affects ventricular excitability as well as vulnerability by opposing the effects of sympathetic neural tone.
ADEQUACY OF CHEMOPROPHYLAXIS ALONE IN PREVENTION OF CENTRAL NERVOUS SYSTEM (CNS) LEUKEMIA IN CHILDREN WITH STANDARD RISK ACUTE LYMPHOCYTIC LEUKEMIA (S-ALL)

The neurotoxicity resulting from the combination of cranial irradiation and intrathecal methotrexate (IT MTX) for prophylaxis of CNS leukemia led to the use of IT MTX alone in S-ALL (WBC<50,000/mm3). From July 1978 to February 1983 thirty-nine children with S-ALL (14 boys, 25 girls; ages 1-6/12 to 14-5/12 years; WBC 900-37,200/mm3) received IT MTX alone for CNS prophylaxis. All the patients received the same induction, consolidation and maintenance multi-drug systemic treatment and IT MTX alone for CNS prophylaxis. Therapy was discontinued at 3 years in those patients remaining in complete continuous remission. With a median observation period of 32+ months the following relapse rate was observed: a) isolated CNS: 3 patients (7.6%) at 11, 22, and 35 months; b) simultaneous CNS and bone marrow (BM): 1 patient (2.5%); c) BM alone: 13 patients (33%). The isolated CNS relapse rate of 7.6% utilizing IT MTX alone in S-ALL compares favorably with studies utilizing a combination of cranial irradiation and IT MTX. We conclude that the administration of IT MTX during induction and maintenance therapy provides adequate CNS prophylaxis for S-ALL and justifies the ommission of cranial irradiation in these children.
Characterizing Small Subbasins: A Case Study From Coastal Oregon

A fine-grained statistically robust probability sample of stream segments is used to compare two small (<20,000 hectare) subbasins of the Tillamook watershed, north coastal Oregon. The two subbasins are matched with respect to several variables (size, coastal climates), but vary in terms of geology and consequently land use. A total of 67 wadeable + non-wadeable sites were identified for sampling in the two subbasins (combined) over two field seasons from a sampling universe consisting of the River Reach File 3 (blue lines on 1:100,000 maps). Target variables include an extensive array of physical habitat endpoints, selected water chemistry endpoints, species composition, and relative abundance of both benthic macroinvertebrates and fish. Field protocols generally followed those of the U.S. EPA’s Environmental Monitoring and Assessment Program (EMAP).
The Nature of Science in Science Education: An Introduction

After providing a definition of the nature of science (NOS) for science education, we argue that a pragmatic consensus exists regarding NOS topics most important for a scientifically literate society. Hence, NOS instruction should take a more prominent role in the science curriculum. While the relationship between a teacher's NOS knowledge and their pedagogical decision-making is not straight- forward, we maintain that a complex interplay does exist. While more science coursework and research experience have been suggested to improve science teachers' understanding of NOS, neither approach is empirically supported. However, explicit attempts at NOS instruction in science teacher education have been effective. This article, which is an abridged version of one appearing in McComas (1998), concludes with the suggestion of a desired state for NOS instruction. Hence, it is vital that science teachers and their students gain an understanding of the nature of science, a hybrid field blending aspects of various social studies of science such as the history, sociology and philosophy of science with research from the cognitive science into a rich and useful description of what science is and how it functions.
Phase II study of paclitaxel therapy for unresectable biliary tree carcinomas.

PURPOSETo evaluate the efficacy of paclitaxel administered to patients with unresectable adenocarcinomas of the gallbladder and biliary tree over 3 hours every 21 days.PATIENTS AND METHODSFifteen patients with unresectable and/or metastatic carcinoma of the gallbladder and bile ducts received intravenous paclitaxel over 3 hours after premedication with dexamethasone, diphenhydramine, and cimetidine. Treatment was repeated every 21 days, and one complete course of therapy was comprised of two such 21-day treatment cycles. The initial dose of paclitaxel was 170 mg/m2, and this was elevated to 200 mg/m2 due to tolerance within the initial patient cohort.RESULTSAll patients were assessable for both toxicity and response: 11 with bile duct cancer and four with gall-bladder carcinoma. Forty-three cycles of therapy were delivered during the trial (median, two), and one patient remains on treatment. No complete or partial responses were noted, although two patients achieved minor responses that lasted 2 and 2+ mo...
Land Mammal High-Resolution Geochronology, Intercontinental Overland Dispersals, Sea Level, Climate, and Vicariance

The generally well developed and understood stratigraphic record associated with fossil mammals in North America is combined with independent chronological data sets that foster the development of high-resolution geochronology in nonmarine sequences. An updated chronology for all North American mammal ages (or subdivisions) is utilized to examine the tempo and mode of overland mammal immigration/ emigration episodes during the Cenozoic Era. In addition to the thirty or more "background" dispersals involving only a few taxa, ten major immigration/emigration episodes are recorded during the Cenozoic Era in North America. All are important for evaluating the dispersal pattern, as well as for mammal age boundary definition. For the Paleogene interval, major immigration/ emigration episodes define the following mammal ages (or intervals): Clarkforkian, Wasatchian, late Uintan, and Chadronian, with the Wasatchian and late Uintan being especially noteworthy. The interval that embraces the late Arikareean mammal age is the first immigration episode of the Neogene interval, but the events recognized in the early and late Hemingfordian mammal ages, respectively, are the most impressive. An important, "medial" Clarendonian emigration is reflected in the North American basis for the Old World "Hipparion " Datum. The events that define the beginning of the Hemphillian and late Blancan mammal ages also are founded on important immigrant first occurrences, but for the first time in the Neogene interval involve taxa from South America as well as from Asia. At other times, either there is no effective immigration or, if present, it involves only a few (four or less) taxa (= "background"). In certain intervals, apparently lowered sea level had no effect on dispersal, but in an even larger number of cases immigration took place in spite of what appears to have been times of relative sea-level highstand. Thus tectonic, climatic, and other factors must be considered to account for North America's dispersal history during the Cenozoic Era.