cssi/SciSciGPT-SciSciNet huggingface dataset:
Trends Over 4 Decades in Disability-Free Life Expectancy in the United States.

Objectives. To examine changes over 40 years (1970–2010) in life expectancy, life expectancy with disability, and disability-free life expectancy for American men and women of all ages.Methods. We used mortality rates from US Vital Statistics and data on disability prevalence in the community-dwelling population from the National Health Interview Survey; for the institutional population, we computed disability prevalence from the US Census. We used the Sullivan method to estimate disabled and disability-free life expectancy for 1970, 1980, 1990, 2000, and 2010.Results. Over the 40 years, there was a steady increase in both disability-free life expectancy and disabled life expectancy. At birth, increases in disabled life and nondisabled life were equal for men (4.5 years); for women, at birth the increase in life with disability (3.6 years) exceeded the increase in life free of disability (2.7 years). At age 65 years, the increase in disability-free life was greater than the increase in disabled life.Concl...
Data Analysis for Total Internal Reflection Fluorescence Microscopy

In the microscopes we use to analyze total internal reflection fluorescence (TIRF), the emitted fluorescence is split chromatically, using dichroic filters, into either two or three different colors ("channels"). In our two-color instrument, the green emission wavelengths (405-488 nm; for imaging green fluorescent protein [GFP]-tagged proteins) and far-red emission wavelengths (650-800 nm; for imaging Alexa-647-labeled microtubules) are projected onto the upper and lower halves, respectively, of a single camera. A single filter can be swapped to collect near-red wavelengths (561-640 nm; for imaging mCherry, or Alexa-568-labeled microtubules) instead of far-red. Our three-color instrument is very similar except that the green, near-red, and far-red color ranges are projected onto three separate cameras. In either case, the different colors can be imaged simultaneously. Typically, we collect images at 10 frames/sec for ∼200 sec. We have developed a series of semiautomated image analysis programs, written in LabView, to obtain the brightness, residence time, and mobility of individual particles bound to single microtubules. The basic analysis steps are straightforward and could also be implemented using ImageJ or Matlab. For convenience, this protocol describes the analysis of a single microtubule. Data from many microtubules across many experimental trials are needed to obtain robust conclusions that are independent of stochastic and trial-to-trial variability.
Stability Analysis of Multirate Sampled--Data Systems

In this paper, new sufficient conditions for stability of asynchronous sampled-data systems are presented. A new robust stability problem is proposed and preliminary results onthis problem is given.
Achieving organizational change in health-care through people and culture: a commentary.

Organizational change has been a consistent and growing theme in health care management, and research on the topic reflects this interest. Amid continuously rising health care costs, major regulatory and policy reform, and technological evolution, health care executives continue to search for effective models and methods of leading and directing change to position their organizations in an increasingly unstable industry and sector. As industry leaders look for answers, researchers have shown a growing interest in understanding how health care organizations are evolving to fit the needs of the new marketplace.
A perverse quality incentive in surgery: implications of reimbursing surgeons less for doing laparoscopic surgery

Surgery is one of the highest priced services in health care, and complications from surgery can be serious and costly. Recently, advances in surgical techniques have allowed surgeons to perform many common operations using minimally invasive methods that result in fewer complications. Despite this, the rates of open surgery remain high across multiple surgical disciplines. This is an expert commentary and review of the contemporary literature regarding minimally invasive surgery practices nationwide, the benefits of less invasive approaches, and how minimally invasive compared with open procedures are differentially reimbursed in the United States. We explore the incentive of the current surgeon reimbursement fee schedule and its potential implications. A surgeon’s preference to perform minimally invasive compared with open surgery remains highly variable in the U.S., even after adjustment for patient comorbidities and surgical complexity. Nationwide administrative claims data across several surgical disciplines demonstrates that minimally invasive surgery utilization in place of open surgery is associated with reduced adverse events and cost savings. Reducing surgical complications by increasing adoption of minimally invasive operations has significant cost implications for health care. However, current U.S. payment structures may perversely incentivize open surgery and financially reward physicians who do not necessarily embrace newer or best minimally invasive surgery practices. Utilization of minimally invasive surgery varies considerably in the U.S., representing one of the greatest disparities in health care. Existing physician payment models must translate the growing body of research in surgical care into physician-level rewards for quality, including choice of operation. Promoting safe surgery should be an important component of a strong, value-based healthcare system. Resolving the potentially perverse incentives in paying for surgical approaches may help address disparities in surgical care, reduce the prevalent problem of variation, and help contain health care costs.
Hospital for Special Surgery ACL Registry: 2-Year Outcomes Suggest Low Revision and Return to OR Rates

Background Anterior cruciate ligament (ACL) injuries are among the most common knee injuries. Patient outcomes, rate of subsequent operations, and rate of subsequent ACL reconstruction following primary ACL reconstruction need to be evaluated.
Nonholonomic tomography. I. The Born rule as a connection between experiments

In the context of quantum tomography, we recently introduced a quantity called a partial determinant [C. Jackson and S. J. van Enk, Phys. Rev. A 92, 042312 (2015)]. Partial determinants (PDs) are explicit functions of the collected data that are sensitive to the presence of state preparation and measurement correlated errors. As such, PDs bypass the need to estimate state preparation or measurement parameters individually. In the present work, we suggest a theoretical perspective for the PD. We show that the PD is a holonomy and that the notions of state, measurement, and tomography can be generalized to nonholonomic constraints. To illustrate and clarify these abstract concepts, direct analogies are made to parallel transport, thermodynamics, and gauge field theory. This paper is the first of a two-part series where the following paper is about scalable generalizations of the PD in multiqudit systems, with possible applications for debugging a quantum computer.
Optical biopsy using fluorescence spectroscopy for prostate cancer diagnosis

Native fluorescence spectra are acquired from fresh normal and cancerous human prostate tissues. The fluorescence data are analyzed using a multivariate analysis algorithm such as non-negative matrix factorization. The nonnegative spectral components are retrieved and attributed to the native fluorophores such as collagen, reduced nicotinamide adenine dinucleotide (NADH), and flavin adenine dinucleotide (FAD) in tissue. The retrieved weights of the components, e.g. NADH and FAD are used to estimate the relative concentrations of the native fluorophores and the redox ratio. A machine learning algorithm such as support vector machine (SVM) is used for classification to distinguish normal and cancerous tissue samples based on either the relative concentrations of NADH and FAD or the redox ratio alone. The classification performance is shown based on statistical measures such as sensitivity, specificity, and accuracy, along with the area under receiver operating characteristic (ROC) curve. A cross validation method such as leave-one-out is used to evaluate the predictive performance of the SVM classifier to avoid bias due to overfitting.
FOLFOX Induced Takotsubo Cardiomyopathy Treated with Impella Assist Device

Chemotherapy induced cardiotoxicity is becoming increasingly prevalent with several new agents being used recently. The incidence of Takotsubo cardiomyopathy due to 5-fluorouracil based chemotherapeutic regimens like FOLFOX is not uncommon. It is also seen with platinum based chemotherapy. Most of these patients have reversible cardiotoxicity and the cardiac function recovers within a short period with supportive treatment. Here we have a patient who presented with cardiogenic shock after 5 days of receiving FOLFOX regimen for colorectal adenocarcinoma. She was treated with a percutaneous left ventricular assist device, Impella CP, for hemodynamic support with excellent outcome.
Restoring trust in the police: Why female officers reduce suspicions of corruption

Recent studies show a clear link between women in government and reduced concerns about corruption. Until now, it remains unclear which underlying attitudes about women explain the perception that they will reduce corruption. Using a survey question about adding women to a police force, with an embedded experimental treatment, we examine three distinct stereotypes that might explain the power of women to reduce concerns about corruption: gender stereotypes of women as more ethical and honest, the perception of women as political outsiders, and beliefs that women are generally more risk averse. We find that people do perceive women as more effective at combating corruption, and these perceptions are greatly enhanced when information about women's outsider status and risk aversion is provided.
Clinical Outcomes of Cervical Facet Fractures Treated Nonoperatively With Hard Collar or Halo Immobilization.

Study Design:Retrospective review.Objectives:To evaluate the rate of nonoperative treatment failure for cervical facet fractures while secondarily validating computed tomography–based criteria prop...
Overall and Subgroup Prevalence of Crohn Disease Among Patients With Hidradenitis Suppurativa: A Population-Based Analysis in the United States.

Importance Limited evidence supports a link between hidradenitis suppurativa (HS) and Crohn disease (CD), and this relationship has not been established in the United States. Objective To evaluate the prevalence of CD among patients with HS in the United States and to determine the strength of association between the 2 conditions. Design, Setting, and Participants Cross-sectional analysis of data from 51 340 patients with HS identified using electronic health records data in the Explorys multiple health system data analytics and research platform, which includes data from more than 50 million unique patients across all US census regions. Main Outcomes and Measures Primary outcome was diagnosis of CD. Results Of the 18 455 660 total population considered, 51 340 had HS (35 000 women). Of these patients with HS, 29 010 (56.5%) were aged 18 to 44 years; 17 580 (34,2%), 45 to 64 years; and 4750 (9.3%), 65 years or older. Prevalence of CD among patients with HS was 2.0% (1025/51 340), compared with 0.6% (113 360/18 404 260) among those without HS (P Conclusions and Relevance These data suggest that patients with HS are at risk for CD. Gastrointestinal symptoms or signs suggestive of CD warrant additional evaluation by a gastroenterologist.
Ursodeoxycholic acid versus phenobarbital for cholestasis in the Neonatal Intensive Care Unit.

Although neonates and young infants with cholestasis are commonly treated with either phenobarbital or ursodeoxycholic acid (ursodiol), there is no evidence that phenobarbital is effective for this indication. Our objective was to compare the effectiveness of ursodiol and phenobarbital for the treatment of cholestasis in a diverse NICU population. This is a retrospective cohort study including infants with cholestasis who were admitted to a Level IV NICU between January 2010 and December 2015. Drug courses of phenobarbital and ursodiol were identified within the medical record, and medical, demographic, and drug information were extracted. The primary outcome was reduction in direct bilirubin. Sixty-eight infants provided a total of 112 courses of drug therapy for comparison. Diverse medical diagnoses were captured in the patient cohort. Ursodiol was significantly more effective in reducing direct bilirubin than was phenobarbital (− 1.89 vs + 0.76 mg/dL; − 33.33 vs + 13.0 umol/L, p-value 0.03), even after controlling for baseline cholestasis severity, intrauterine growth restriction status, and lipid lowering therapy (− 2.16 vs + 0.27 mg/dl; − 36.94 vs + 4.62 umol/L, p-value 0.03). There was no improvement in direct bilirubin in the majority of infants treated with phenobarbital. Phenobarbital, as compared to ursodiol, has limited efficacy for the reduction of direct bilirubin in neonates and young infants with cholestasis. Given new data regarding the potential neurotoxicity of phenobarbital in the developing brain, providers may choose to avoid phenobarbital in the treatment of cholestasis in infants.
ARGON LASER THERAPY OF DIABETIC RETINOPATHY

Diabetes mellitus is the second leading cause of new adult blindness in the United States; retinopathy accounts for 84% of blindness in diabetics. Over 60 % of diabetics develop retinopathy after having had diabetes for 15 or 20 years (Goldberg & Fine, 1968). These data indicate the significance of diabetic retinopathy. Proliferative retinopathy is responsible for blindness in over 90 % of the blind diabetics under 40 (Whittington, 1964). Exudative retinopathy accounts for most blindness in the elder diabetics.
The Perception of Speech in Early Infancy

Publisher Summary The perception of speech sounds by young infants is one of the earliest indications that an infant is attending to linguistically relevant information and might reflect the infant's biological predispositions, which destine him to acquire language. The human infant's behavior might provide clues to an understanding of the seemingly special kinds of behavior that the infants of a species, human and non-human, display when the signal is one that is part of the species' communicative repertoire. The data gathered during the research on the infant's perception of speech sounds indicates that the human infant makes discriminations that depend upon fine temporal and frequency changes in a complex auditory array. Infants demonstrate perceptual constraints when listening to speech that could be characterized as adult like and appear to be predisposed to perceive certain speech-sound categories, such as vowel and fricative categories. The mechanisms posited to account for these abilities are highly speculative.
Press-Fit Condylar Total Knee Arthroplasty 5- to 9-year Follow-up Evaluation

Abstract Between November 1984 and December 1987, 378 consecutive Press-Fit Condylar (PFC, Johnson & Johnson Professional, Raynham, MA) total knee arthroplasties were performed in 290 patients. The average age at surgery was 67 years (range, 22–91 years). The average follow-up period was 6.5 years (range, 5–9 years). Scoring was carried out according to the Knee Society scoring system. The average preoperative knee score was 28, and the average postoperative knee score was 88. The average preoperative functional knee score was 49, and the average postoperative functional knee score was 72. Ninety-five percent of the patients had no pain on level walking and were satisfied with their functional result. The average postoperative knee flexion was 110°. No implant showed any evidence of radiographic loosening. There were 17 complications, all requiring reoperation. Complications included excessive wear of a metal-backed patella in 8 knees. If complications resulting from the earlier use of a metal-backed patella are eliminated, the overall complication rate is 2.9%, which is comparable to or lower than the rates for other total knee systems with similar follow-up periods.
Decoding Asynchronous Reaching in Electroencephalography Using Stacked Autoencoders

Electroencephalography (EEG)-based brain–computer interfaces (BCIs) that decode cortical activity in reaching and grasping movements can enable natural upper limb motor control. In this paper, we studied the performance of stacked autoencoders in decoding asynchronous reaching movements in the dominant upper limb using EEG. Five individuals without any motor disabilities performed three self-paced reaching tasks while the endpoints of the arm movements were recorded with a motion tracker. Power spectral densities of the relevant cortical signals were extracted among eight bandwidths in the range of 1-45Hz to train a stacked autoencoder. For comparison, convolutional neural network (CNN) and traditional linear decoding using principal component analysis (PCA) for feature selection and linear discriminant analysis (LDA) for classification were also used. An average classification accuracy of 79±5.5% (best up to 88±6%) was achieved from all subjects on wide frequency band (1-45Hz) in offline analysis with stacked autoencoders while average classification accuracies of 68±9.1% (best up to 74±9.1%) with PCA-LDA and 49±13.8% (best up to 56±7.2%) with CNN were achieved. The simultaneous dimensionality reduction and feature extraction capabilities of stacked autoencoders can have significant advantages in BCI applications.
Visualizing Income Inequality and Mobility Together

Research and public conversations about income inequality and intergenerational mobility will benefit from a new approach that jointly visualizes these two measures. The new mobility table proposed...
Deep Brain Stimulation for Memory Modulation: A New Frontier.

BACKGROUND In the coming years the number of patients with cognitive disorders, such as Alzheimer disease and traumatic brain injury, is expected to dramatically increase, leading to an ever-increasing societal cost. Unfortunately, few medical and pharmacologic treatments have shown tangible benefit in the treatment of these diseases. Deep brain stimulation (DBS) is an established surgical technique to address multiple conditions, including Parkinson disease and essential tremor. Data from patients being treated with DBS, as well as those being monitored for seizures with depth electrodes, have suggested improvement in memory with electrical neuromodulation. METHODS MEDLINE was searched from inception through March 2018 using the keywords “DBS,” “Deep Brain Stimulation,” “Memory,” “Memory Modulation,” and “Cognition.” Studies evaluating the effect of DBS on memory and learning were shortlisted and reviewed. RESULTS Efforts to stimulate various nodes within the memory circuitry suggest that the variable effects may result from different mechanisms, including alteration of neural firing patterns, increased activity across several regions, and amplification of neural plasticity. Some of these targets, such as the entorhinal cortex, hippocampus, and nucleus basalis of Meynert, have shown promising results with regards to modulation of memory. CONCLUSIONS Given the aging population and increasing numbers of patients with memory impairment from neurodegenerative diseases, interest in neuromodulation for memory enhancement will likely expand. Further work should employ more sophisticated responsive stimulation parameters and precise spatial targeting that may lead to an effective stimulation strategy for memory enhancement.
The Impact of Alvimopan on Return of Bowel Function After Major Spine Surgery - A Prospective, Randomized, Double-Blind Study.

BACKGROUND Pain management following major spine surgery requires high doses of opioids and is associated with a risk of opioid-induced constipation. Peripheral mu-receptor antagonists decrease the gastrointestinal complications of perioperative systemic opioid administration without antagonizing the analgesic benefits of these drugs. OBJECTIVE To investigate the impact of alvimopan in opioid-naive patients undergoing major spine surgery. METHODS Patients undergoing >3 levels of thoracic and/or lumbar spine surgery were enrolled in this prospective, randomized, double-blind study to receive either alvimopan or placebo prior to and following surgery. Opioid consumption; pain scores; and time of first oral intake, flatus, and bowel movement were recorded. RESULTS A total of 24 patients were assigned to the active group and 25 were assigned to the placebo group. There was no significant difference in demographics between the groups. Postoperatively, the alvimopan group reported earlier time to first solid intake [median (range): alvimopan: 15 h (3-25) vs placebo: 17 h (3-46), P < .001], passing of flatus [median (range): alvimopan: 22 h (7-63) vs placebo: 28 h (10-58), P < .001], and first bowel movement [median (range): alvimopan: 50 h (22-80) vs placebo: 64 h (40-114), P < .001]. The alvimopan group had higher pain scores (maximum, minimum, and median); however, there was no significant difference between the groups with postoperative opioid use. CONCLUSION This study shows that the perioperative use of alvimopan significantly reduced the time to return of bowel function with no increase in postoperative opioid use despite a slight increase in pain scores.
Taking the Fall for Kids: A Journey to Reducing Pediatric Falls.

Abstract Purpose To reduce harm related to pediatric falls, a quality improvement project was conducted at a children's hospital. Design and methods An interprofessional team designed and implemented evidence-based interventions to align with the hospital's journey to reduce patient harm. These interventions included selection and implementation of a fall risk assessment tool, implementation of fall bundle elements, and implementation of fall prevention education to patients and families. Surveys, audits, and rate of falls were used to evaluate the project. Results Fall bundle compliance increased from 27% to 88% and there were zero patient falls in five out of the six months after implementation a comprehensive pediatric fall prevention program. Conclusions Implementing pediatric-specific, evidence-based interventions can help to reduce patient falls. There was a substantial increase in fall bundle compliance and a decrease in falls and falls with injury. Practice Implications: Engagement and empowerment of clinical nurses in the quality improvement process design and implementation can substantially improve patient outcomes and patient safety while reducing harm. Future research is needed to determine factors that promote enhanced reporting needed to determine the true incidence of patient falls in pediatric inpatient and outpatient settings.
An Acquired Cervical Dural Arteriovenous Fistula After Cervical Anterior Fusion: Case Report and Literature Review.

Background Formation of a dural arteriovenous fistula (DAVF) after lumbar spine decompression in the lumbar spine has been reported as a late complication, but is extremely rare in the cervical spine. Case Description A 57-year-old man who underwent a C5-6, C6-7 anterior fusion 5 years previously for cervical myelopathy at another hospital presented with progressive gait disturbance and thermal hypoalgesia on the right side of the body. Magnetic resonance imaging showed flow voids in the spinal cord dorsally at the C4-7 level, which had not been detected before the initial operation. Digital subtraction angiography showed a fistulous connection at the C7 level between the perimedullary vein and a segmental artery from the right vertebral artery, which was diagnosed as a DAVF. Surgical interruption of the intradural draining vein with multilevel posterior cervical decompression was performed, and his symptoms improved. Conclusions To the best of our knowledge, this is the first report of a DAVF developing after multilevel anterior cervical discectomy and fusion. All the published cases of secondary DAVF, especially after spinal surgery, are reviewed.
Team learning from human demonstration with coordination confidence

Among an array of techniques proposed to speed-up reinforcement learning (RL), learning from human demonstration has a proven record of success. A related technique, called Human-Agent Transfer, and its confidence-based derivatives have been successfully applied to single-agent RL. This article investigates their application to collaborative multi-agent RL problems. We show that a first-cut extension may leave room for improvement in some domains, and propose a new algorithm called coordination confidence (CC). CC analyzes the difference in perspectives between a human demonstrator (global view) and the learning agents (local view) and informs the agents’ action choices when the difference is critical and simply following the human demonstration can lead to miscoordination. We conduct experiments in three domains to investigate the performance of CC in comparison with relevant baselines.
The Changing Ecosystem of News and Challenges for Freedom of the Press

The ecosystem of news has changed beyond the imagination of anyone living when the First Amendment was drafted. Changes in the private industry of the press leave some communities with no local news coverage.A majority of people in the United States now receive news selected for them by a computer-based mathematical formula derived from their past interests, producing echo chambers with few opportunities to learn, understand, or believe what others are hearing as news. Traditional news media—now called “legacy media”—is shrinking, cutting staff, and relying on freelancers. Meanwhile, digital platforms surge in usage, profits, and revenues from advertising, which are used to stimulate engagement and collect data to further target users. This contributes to a world in which fewer than one-third of those surveyed trust mass media to report the news fully and accurately—the lowest number since such surveys began. The recent indictment of thirteen Russians for disrupting the 2016 United States presidential election by spreading divisive and false messages through Facebook, Google, and Twitter underscores what Alexander Meiklejohn put so well: reliable press expression is fundamental to democratic self-governance. What can be done when transformations in technology, economics, and communications jeopardize the production and distribution of, and trust in, news that is essential in a democratic society?
Lymphoma Risk and Screening in IBD

Our understanding of the risk of lymphoma in inflammatory bowel disease (IBD) is confounded by conflicting data, the impact of immunosuppressive medications on that risk, and the introduction of newer agents in the management of IBD. As we alter how we strategize, stratify, and combine therapies, this risk will also alter. Recent data is reassuring in downplaying the risk of lymphoma associated with anti-TNF therapies specifically and brings to the forefront legitimate concerns of thiopurine (6-MP, azathioprine) use, especially in young men. This chapter will discuss the impact of IBD and IBD therapies on overall lymphoma risk. We will also discuss the role of Epstein-Barr virus (EBV) in the development of lymphoma and our evolving understanding of the risk of hepatosplenic T-cell lymphoma (HSTCL) with IBD therapies.
The articulation of American English /l/: A study of gestural synergy and antagonism

Abstract: In certain historical changes, /l/’s have been lost and have prevented the phonological fronting of back vowels. An electromyographic study of selected tongue muscles was undertaken to discover the myodynamic reasons for these effects. It was found that American English /l/ shows less muscle activity for the posterior velarization gesture after back vowels than after a front vowel, while a velarization gesture is correlated with lessened tongue tip activity. There is preliminary evidence lending credence to the speculation that a gesture for a non-high back vowel before /l/ might be more forceful when the liquid is velarized, thus explaining the retarding effect of an /l/ upon a preceding vowel in certain historical cases.
Receptive Ecumenism in Africa : Lessons Learned from the Actual Faith of Everyday Christians

My argument in this chapter is that in order to discuss the state of the ecumenical movement in Africa, one should not be looking at joint statements by churches as is the case in the West, or joint commissions by different church denominations. Rather, one should be looking at the everyday experiences of Christians in Africa; one should follow their actual faith which may appear confusing to some but which has deep and intelligible structures of meaning for those who have the patience to dig deeper into Africa’s religious history. I propose that ecumenical dialogues in Africa should concentrate more on understanding the meaning of the stories of actual faith of everyday Africans and what they reveal about what the Spirit is saying to the churches. Understanding the nature, character and value in these common expressions of religiosity in Africa should be preferred rather than the undue emphasis on the tenuous horizon of differences on doctrine between African churches. I propose that the grassroots ecumenical gift offer us rich materials for inter-cultural understanding, which could shift ecumenical dialogue from narratives of contamination and condemnation to redemptive narratives of grace and gifts.
Strategies to optimize stereotactic radiosurgery plans for brain tumors with volumetric-modulated arc therapy

PURPOSE Prescription practice in SRS plans for brain tumors differs significantly for different modalities. In this retrospective study, the strategies to optimize SRS plans for brain tumors with volumetric arc therapy (VMAT) were presented. METHODS Fifty clinically treated cases were stratified by the maximum target size into two groups (≥ 2 cm in 25 cases and <2 cm but ≥1 cm in 25 cases), which were optimized using traditional LINAC MLC-based approaches with the average prescription isodose line (P-IDL) of (91.4 ± 0.6)%. Four to five plans have been created for each case with variation of the P-IDL from 65% to 90%. The optimization strategies to select an optimal P-IDL, to use tuning structures within the target and beyond as well as to use NTO (normal tissue objectives), were applied to all new plans. RESULTS The optimal P-IDL was found to be around 75%. After applying the new optimization strategies with an average P-IDL of 74.8%, the mean modified gradient index (mGI) and V12 were reduced by 25% and 35%, respectively for both groups. The Paddick conformity index (PCI) was averagely improved by 8%. The average homogeneity index (HI) and focal index (FI) were increased by 22% and 50%, respectively. The mGI was inversely proportional to the PTV volumes. The shape of the dose distribution in target was also changed from concave to convex. The comparison of PCI with historical data from other institutes and modalities shows that the plans in this study have the best conformity near the target. CONCLUSIONS With the new optimization strategies for VMAT SRS plan of brain tumor more conformal plans in both high and intermediate dose region (~50% of the PD) were created, in which the dose in the core of the target was notably increased while V12 and mGI were significantly decreased, and PCI was improved. The mGI was inversely proportional to the PTV volumes. The optimal P-IDL is around 75%. The average PCI is the best in this study compared with the published historical data. These strategies are applicable to treatment planning for multiple brain and liver tumors where sparing the tissue peripheral to the target is critical.
Pulmonary Artery Sarcoma is a Predominantly Bilateral Disease: Insight from a 55 Case Single Center Experience

Purpose Pulmonary artery sarcoma (PAS) is an exceedingly rare disease with historically poor survival. PAS is often mistaken for chronic thromboembolic pulmonary hypertension (CTEPH) owing to similarities in clinical presentation. Controversy exists regarding need to definitively differentiate PAS from CTEPH prior to surgical therapy. Furthermore lung resection would seem inferior palliation to tumor endarterectomy in a predominantly bilateral disease dominated by hemodynamic compromise. Methods Retrospective review of all patients who underwent pulmonary endarterectomy (PEA) and tumor resection surgery at a single institution between March 1992 and February 2019, identified 55 patients diagnosed with PAS. Results In this series of 55 patients (23 male, 32 female, age 23-82 years), median time from symptom onset to diagnosis was 8 months (IQR 5-12 months). Many patients were severely limited on initial assessment (median WHO Functional Class III). Forty-six patients (83.6%) had suspected PAS diagnosis prior to surgery. Preoperative testing identified bilateral disease (37/50 V/Q scans, 39/46 CTA) and PA mass (35/55) in majority of cases. Fifty patients (90.9%) had pathologically-confirmed bilateral pulmonary involvement, while 20 also had valvular or intracardiac tumor extension resected at time of surgery. A majority of sarcomas (87%) were classified as undifferentiated or intimal subtype and 64% were high-grade. PEA resulted in significant improvement in hemodynamics [mPAP decreased by 6 mmHg (p Conclusion PAS is a rare disease with poor prognosis. Tumor endarterectomy may alleviate symptoms and increase life-expectancy. Knowledge that PAS is a predominantly bilateral disease (90.9% in our series), suggests lung resection would rarely if ever be curative, whereas PEA can be diagnostic and effective treatment of hemodynamic compromise. Furthermore, earlier surgical treatment may enable earlier referral and tolerability of adjuvant chemoradiation or immunotherapy resulting in improved survival.
Heterojunction Bipolar Transistors and Monolithically Integrated Photoreceivers Among Other Applications

Few years ago when preparing for an invited talk to a primarily female audience composed of middle school students with their mothers, counselors, and teachers I decided to display my career as winding path timeline. It started when I deviated from “Going to Medical School dreams” to Physics and then changed the field to Electrical Engineering and getting a graduate degree.
Site-Selective Peptide Macrocyclization.

Cyclized peptides have seen a rise in popularity in the pharmaceutical industry as drug molecules. As such, new macrocyclization methodologies have become abundant in the last several decades. However, efficient methods of cyclization without the formation of side products remain a great challenge. Herein, we review cyclization approaches that focus on site-selective chemistry. Site selectivity in macrocyclization decreases the generation of side products, leading to a greater yield of the desired peptide macrocycles. We will also take an in-depth look at the new exclusively intramolecular N-terminal site-selective CyClick strategy for the synthesis of cyclic peptides. The CyClick method uses imine formation between an aldehyde and the N terminus. The imine is then trapped by a nucleophilic attack from the second amidic nitrogen in an irreversible site-selective fashion.
Ferroptosis of epithelial ovarian cancer: genetic determinants and therapeutic potential

Epithelial ovarian cancer (OVCA) is the most lethal gynecologic cancer. Current treatment for OVCA involves surgical debulking of the tumors followed by combination chemotherapies. While most patients achieve complete remission, many OVCA will recur and develop chemo-resistance. Whereas recurrent OVCA may be treated by angiogenesis inhibitors, PARP inhibitors, or immunotherapies, the clinical outcomes of recurrence OVCA are still unsatisfactory. One new promising anti-tumor strategy is ferroptosis, a novel form of regulated cell death featured by lipid peroxidation. In this review, we have summarized several recent studies on the ferroptosis of OVCA. Also, we summarize our current understanding of various genetic determinants of ferroptosis and their underlying mechanisms in OVCA. Furthermore, ferroptosis can be combined with other standard cancer therapeutics, which has shown synergistic effects. Therefore, such a combination of therapeutics could lead to new therapeutic strategies to improve the response rate and overcome resistance. By understanding the genetic determinants and underlying mechanisms, ferroptosis may have significant therapeutic potential to improve the clinical outcome of women with OVCA.
Experience of percutaneous tracheostomy in critically ill COVID-19 patients.

Background: Coronavirus disease 2019 (COVID-19) is a highly contagious disease that causes respiratory failure. Tracheostomy is an essential procedure in critically ill COVID-19 patients; however, it is an aerosol-generating technique and thus carries the risk of infection transmission. We report our experience with percutaneous tracheostomy and its safety in a real medical setting. Methods: During the COVID-19 outbreak, 13 critically ill patients were admitted to the intensive care unit (ICU) at Daegu Catholic University Medical Center between February 24 and April 30, 2020. Seven of these patients underwent percutaneous tracheostomy using Ciaglia Blue Rhino. The medical environment, percutaneous tracheostomy method, and COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) results were retrospectively reviewed. After treatment, the COVID-19 infection status of healthcare personnel was investigated by RT-PCR. Results: The ICU contained negative pressure cohort areas and isolation rooms, and healthcare personnel wore a powered air-purifying respirator system. We performed seven cases of percutaneous tracheostomy in the same way as in patients without COVID-19. Five patients (71.4%) tested positive for COVID-19 by RT-PCR at the time of tracheostomy. The median cycle threshold value for the RNA-dependent RNA polymerase was 30.60 (interquartile range [IQR], 25.50-36.56) in the nasopharynx and 35.04 (IQR, 28.40-36.74) in sputum. All healthcare personnel tested negative for COVID-19 by RT-PCR. Conclusion: Percutaneous tracheostomy was performed with conventional methods in the negative pressure cohort area. It was safe to perform percutaneous tracheostomy in an environment of COVID-19 infection.
Treatment of Adolescent e-Cigarette Use: Limitations of Existing Nicotine Use Disorder Treatment and Future Directions for e-Cigarette Use Cessation.

Electronic cigarette use ("vaping") has surged in the United States since the mid-2010s. From 2011 to 2018, current e-cigarette use among high school students escalated from 1.5% to 20.8% (∼3.05 million youths),1 countering downward trends in combustible nicotine product use (21.8% in 2011 to 13.9% in 2018).1 Although preventing the initial uptake of vaping is crucial, for the millions of adolescents who have taken up this behavior-many of whom express interest in quitting (eg, 44.5% of current, adolescent non-light e-cigarette users in one US national representative sample)2-it is critically important to help them quit vaping so as to curtail future substance use disorders and other health consequences. Here, we discuss several challenges around adolescent vaping treatment, and highlight research areas in urgent need of attention.
A fresh look at thiamine deficiency—new analyses by the global thiamine alliance

Severe thiamine (vitamin B1 ) deficiency is generally regarded as a problem affecting mostly infants in low-income communities of Southeast Asia and adult alcoholics regardless of their location. However, recent scholarship shows that the disorders associated with thiamine deficiency may also affect heretofore unsuspected populations, and that the scope of disorders, including some long-lasting neurocognitive consequences, is broader than previously thought.
A Multidimensional Approach to Infectious Diseases

During the devastating plague of Athens in the 5th century BC, the historian Thucydides noted that survivors of the epidemic could freely care for the sick without any risk of repeated infection. It was not until over two millennia later that Pasteur’s seminal work brought about the widespread acceptance of germ theory, which demonstrated that microorganisms could cause and spread illness. This new paradigm of disease revolutionized the fields of medicine and public health, ultimately enabling our contemporary understanding of infection, immunity and epidemiology. The field of infectious diseases has evidently wielded a powerful influence on medical investigation throughout human history. With Volume III, Issue II of The Journal of Global Health, we aim to reexamine this critical subject within the context of the modern era.
School nutrition laws in the US: do they influence obesity among youth in a racially/ethnically diverse state?

BACKGROUND/OBJECTIVES Little is known about the separate or combined effects of state and national nutrition policies regulating food and beverages in schools on child overweight/obesity (OV/OB) and related racial/ethnic disparities. We investigated the influence of school nutrition policies enacted in California, independently and in combination with the United States' national policy "Healthy Hunger Free Kids Act" (HHFKA) on childhood OV/OB and racial/ethnic disparities. SUBJECTS/METHODS An interrupted time series design was used with data from 12,363,089 child-level records on 5th- and 7th-graders in California public schools to estimate sex- and racial/ethnic-specific time trends in OV/OB prevalence during three periods: before the California nutrition policies (2002-2004); when only California policies were in effect (2005-2012); and when they were in effect simultaneously with HHFKA (2013-2016). RESULTS Before the state's policies, OV/OB prevalence increased annually among children in most subgroups. Improvements in OV/OB trends were observed for almost all groups after the California policies were in effect, with further improvements after the addition of HFFKA. The total change in annual log-odds of OV/OB, comparing the periods with both state and federal policies versus no policies, ranged from -0.08 to -0.01 and varied by grade, sex, and race/ethnicity. Within each sex and grade, the greatest changes were among African-American (-0.08 to -0.02, all p < 0.05) followed by Latino children (-0.06 to -0.01, all p < 0.05). Although disparities narrowed among these groups versus White children after the dual policy period, disparities remained large. CONCLUSIONS State and national nutrition policies for schools may have contributed to containing the upward trend in childhood OV/OB and racial/ethnic OV/OB disparities within California. However, sizable OV/OB prevalence and disparities persist. To end the epidemic, promote healthy weight and increase health equity, future efforts should strengthen state and national policies to improve food quality in schools, particularly those serving populations with the highest OV/OB prevalence.
Is It Time for Some Unpleasant Monetarist Arithmetic

Sargent and Wallace (1981) published "Some Unpleasant Monetarist Arithmetic" 40 years ago. Their central message was that a central bank may not have the power to determine the long-run rate of inflation without fiscal support. In a policy regime where the fiscal authority is non-Ricardian, an attempt on the part of the central bank to lower inflation may end up backfiring. I develop a structural model to illustrate this result through the use of a diagram. In addition, I use the model to explain how low inflation, low interest rates, and high primary budget deficits can coexist. I also use the model to explain why it is easier for a central bank to lower inflation than to raise it. I conclude with some recommendations for state-contingent monetary policy.
Comment on “A Gibbs Sampler for a Class of Random Convex Polytopes,” by Pierre E. Jacob, Ruobin Gong, Paul T. Edlefsen, and Arthur P. Dempster

The achievement documented in this article is an important milestone for the Dempster–Shafer theory of belief functions. Fifty-five years after Art Dempster first introduced his simplicial method f...
Linear Models for Regression and Classification

This chapter discusses linear regression and classification, the foundations for many more complex machine learning models. We begin with a motivating example considering an object in free fall to then use regression to find the acceleration due to gravity. This example then leads to a discussion of least squares regression and various generalizations using logarithmic transforms. The topic of logistic regression is presented as a classification method, with an example given to predict failure of a part based on the temperature it was exposed to. Then the topic of regularization based on the ridge, lasso, and elastic net regression methods is presented as a means to select variables and prevent overfitting. These methods are then used in the case study to determine the laws of motion of a pendulum using data.
Rambling-trembling center-of-pressure decomposition reveals distinct sway responses to simulated somatosensory deficit.

Abstract Background Falls in older adults are often multifactorial, but can be linked to diminished sensation capabilities from age-related neural degeneration. Rambling-trembling (RM-TR) decomposition may provide insight into the relation between sensorineural function and postural sway, with both research and clinical applications. Research question What are the effects of perturbed somatosensation on RM-TR-derived measures of center of pressure (COP) during quiet standing? Methods Fifty-two healthy young adults (22.10 ± 1.88 years) participated in the study. Participants stood on two force plates with a standardized stance width and foot angle, with eyes open (EO) or eyes closed (EC). Foam with different thicknesses ranging from 1/8″ to 1″ (F1-F4) was placed under the feet to interfere with intact sensory input and simulate varying degrees of somatosensory deficit. Force and moment data were used to calculate COP, RM, and TR time series. Mean velocity, acceleration, and jerk in the anteroposterior (AP) and mediolateral direction (ML) were extracted for comparison. Results The EO condition remained relatively constant regardless of foam thickness. The EC condition showed increasing changes from baseline to each of the foam conditions. COP captures the smallest change in foam thickness, but RM provides a robustness across parameters that is not found in COP or TR. RM jerk in the AP direction showed significantly greater changes from baseline to F4 than the COP or TR counterparts. In the ML direction, TR jerk showed a sharper contrast between foam conditions than COP and RM. Significance Findings suggest that RM-TR-derived measures may act as a compliment to, or provide a greater degree of sensitivity than, traditional COP measures and aid in the initial detection and monitoring of fall risk in aging and pathological populations.
A 100 Gb/s PAM4 Two-Segment Silicon Microring Resonator Modulator

We demonstrate a two-segment silicon microring resonator modulator with 100 Gb/s PAM4 modulation. The microring modulator exhibits a FSR of ~ 5.7 nm, a Q factor of ~ 3600, a DC extinction ratio of ~ 13 dB, an electro-optical bandwidth of ~ 40 GHz, and a phase shift efficiency $\boldsymbol{V_{\pi} \cdot L}\ \mathbf{of}\ \boldsymbol{\sim 1 \mathrm{V}}\cdot \text{cm}$ .