cssi/SciSciGPT-SciSciNet huggingface dataset:
Nationwide Quality of Hospice Care: Findings From the Centers for Medicare & Medicaid Services Hospice Quality Reporting Program.

Abstract Context With increasing use of the Medicare hospice benefit, policymakers recognize the need for quality measurement to assure that terminally ill patients receive high-quality care and have the information they need when selecting a hospice. Toward these goals, Centers for Medicare & Medicaid Services has been collecting standardized patient-level quality data via the Hospice Item Set (HIS) since July 1, 2014. Objective This article presents a first look at the national hospice HIS quality data. Methods We calculated seven quality measures using the HIS data. These measures are endorsed by the National Quality Forum and focus on important care processes hospice providers are required to perform at admission, including discussion of patient preferences regarding life-sustaining treatments, care for spiritual and existential concerns, and symptom management (pain, opioid-induced constipation, and dyspnea). Results Our sample included 1,218,786 hospice patients discharged from 3922 hospices from October 1, 2014 to September 30, 2015. More than 90% of patients received screenings and assessments captured by six of the seven quality measures. The only exception was pain assessment, for which the national mean score was 78.2%. A small number of hospices (156, 4.0%) had perfect scores for all seven quality measures. Conclusions Most hospices conduct critical assessments and discuss treatment preferences with patients at admission, although few hospices have perfect scores.
A MMSE-based joint timing synchronization and channel estimation scheme for two-way amplify-and-forward relay networks

Abstract In the two-way relay networks, the receive nodes are difficult to retrieve the mixture of signals transmitted from different terminal nodes with unknown timing offsets and unknown channel information. This paper presents a joint timing synchronization and channel estimation scheme for two-way amplify-and-forward relay networks to solve this problem. Based on a well-designed training sequence arrangement, delayed timing offset and cascaded channel impulse responses (CIR) in different transmit-relay-receive links can be obtained. The proposed approach utilizes three procedures to acquire timing offsets, inter-terminal delay (ITD), and cascaded CIRs at each terminal node. First, a coarse timing offset (CTO) estimation algorithm is applied to find CTO and ITD. Then, the generalized maximum-likelihood estimation algorithm with an observation vector is exploited to obtain relative timing indices and the corresponding cascaded CIR estimates in all transmit-relay-receive links. Finally, the fine time adjustment based on the minimum mean squared error criterion is performed to reacquire timing offsets, revise the ITD estimate, and reconstruct cascaded CIR estimates. From the simulation results, the proposed approach has excellent timing synchronization and channel estimation performance under multipath fading channels with line-of-sight and non-line-of-sight propagation.
Parenting Stress and Social Support among Cross-national and Traditional Families

As a result of globalization, the number of cross-national couples in the United States is on the rise. However, a primary conclusion of the past research on such marriages has been subsumed under general intermarriages. The results of these studies focused on the challenges confronted by couples in potential conflicts caused by their disparate cultural backgrounds. Place of residence, language issues, societal stereotypes, extended families, and cultural complexity were identified in most qualitative studies as stressors most likely to contribute to a greater levels of parenting stress. A relatively small proportion of the literature in this area has focused on childrearing which was recognized as a flashpoint for more conflicts in these marriages. Thus, this study sought to compare the level of parenting stress and social support between cross-national and traditional families. Purposeful sampling was used to recruit 159 parents from both cross-national (82) and traditional (77) families in Western New York area. This study adopted the Parental Stress Scale (PSS), Family Support Scale (FSS), and self-developed questionnaire. Basic statistics and multiple regression analysis were applied. The results suggested parents from cross-national families do not experience higher level parenting stress comparing to their counterparts in traditional families. However, the number of children and cultural influences were found significantly related to parenting stress in cross-national families. In other words, the more children in a family and more distinct cultural difference between couples strongly contribute to the level of parenting stress among cross-national families.
Enhanced Fusion of Deep Neural Networks for Classification of Benchmark High-Resolution Image Data Sets

Accurate land cover classification and detection of objects in high-resolution electro-optical remote sensing imagery (RSI) have long been a challenging task. Recently, important new benchmark data sets have been released which are suitable for land cover classification and object detection research. Here, we present state-of-the-art results for four benchmark data sets using a variety of deep convolutional neural networks (DCNN) and multiple network fusion techniques. We achieve 99.70%, 99.66%, 97.74%, and 97.30% classification accuracies on the PatternNet, RSI-CB256, aerial image, and RESISC-45 data sets, respectively, using the Choquet integral with a novel data-driven optimization method presented in this letter. The relative reduction in classification errors achieved by this data driven optimization is 25%–45% compared with the single best DCNN results.
Introduction: Scope and Objectives

The principal goal of this book is to present a comprehensive theory of how human beings learn and retain large bodies of organized subject matter in classroom and similar learning environments. Its scope is limited to “reception” learning and retention of potentially meaningful instructional material. “Reception” learning refers to the situation where the total content of the learning task (what is to be learned) is presented to the learner rather than independently discovered by him. That is, the learner is merely required to comprehend the material meaningfully and to incorporate (internalize) it and make it available or functionally reproducible for future use.
ATLAS: A Framework for Geospatial Visualization

Due to technological advances in data collection and distribution methods, data is increasing in size and complexity. Challenges and opportunities have emerged in the design of data visualization tools, particularly in the visualization of geospatial and multidimensional data. Traditional visualization approaches are falling behind as they lack effective design solutions for usability issues posed by the complex relationship between spatial and numeric data. Interdisciplinary approaches are essential to address issues in geovisualization, thus the field of human-computer interaction can act as a useful lens upon the problems of data discovery within seemingly disparate fields such as climate and agricultural sciences. ATLAS is a tool for the discovery and visualization of multidimensional geospatial data (MDGSD) and aims to aid data discovery. It proposes a new approach to the visualization of MDGSD: creating a single, 'multi-modal' interface for both spatial and time-series information. Benefits and failures inherent in this approach were identified though user testing. Tests were administered to nine college students pursuing various fields of study. Preliminary analysis of data suggests that participants recognize a relationship between the spatial and time-series information; however, subjects disagreed about the significance of colors across them. Our future work aims to utilize eye tracking data to determine whether data discovery is successfully enabled in ATLAS by examining how participants visually assess and connect the data. ATLAS offers insight on the emerging opportunities of interdisciplinary work in human-computer interaction and data visualization.
Characterizing wind gusts in complex terrain

Abstract. Wind gusts are a key driver of aerodynamic loading, especially for tall structures such a bridges and wind turbines. However, gust characteristics in complex terrain are not well understood and common approximations used to describe wind gust behavior may not be appropriate at heights relevant to wind turbines and other structures. Data collected in the Perdigao experiment are analyzed herein to provide a foundation for improved wind gust characterization and process-level understanding of flow intermittency in complex terrain. High-resolution observations from sonic anemometers and vertically pointing Doppler lidars are used to conduct a detailed study of gust characteristics with a specific focus on the parent distributions of nine gust parameters (that describe velocity, time, and length scales), their joint distributions, height variation, and coherence in the vertical and horizontal planes. Best-fit distributional forms for varying gust properties show good agreement with those from previous experiments in moderately complex terrain but generate nonconservative estimates of the gust properties that are of key importance to structural loading. Probability distributions of gust magnitude derived from vertically pointing Doppler lidars exhibit good agreement with estimates from sonic anemometers despite differences arising from volumetric averaging and the terrain complexity. Wind speed coherence functions during gusty periods (which are important to structural wind loading) are similar to less complex sites for small vertical displacements (10 to 40 m), but do not exhibit an exponential form for larger horizontal displacements (800 to 1500 m).
A nonlinear kinetic-rheology model for reversible scission and deformation of unentangled wormlike micelles

We compare the predictions of the Vasquez–Cook–McKinley (VCM) [P. a. Vasquez et al., J. Non-Newton. Fluid. Mech. 144, 122–139 (2007)] model, which treats wormlike micelles as Hookean dumbbells that break at half-length to form two shorter dumbbells, to an analogous Brownian dynamics (BD) simulation of the same physical model. We find a discrepancy between VCM model predictions and trace it to the absence in the VCM model of the spatial position of the nascent breakage point in the long micelle, which is needed to satisfy microscopic reversibility of breakage and fusion. We incorporate microscopic reversibility in the VCM model by extending an ensemble-averaged bead-spring phase space model of Wiest et al. [J. Chem. Phys. 90, 587 (1989)] to include reversible scission of two-spring chains. The revision tracks the conformations of the two halves of the long micelle and transmits this information to the short micelles upon breakage and thereby recovers complete agreement with the BD results. A general method is offered for retaining this information in populations of micelles of many different lengths, represented by an ensemble of many-spring chains. The new model also offers the prospect of including additional physics, such as flow-enhanced micelle growth or breakage, and the ability to check the accuracy of closure approximations using parallel BD simulations.We compare the predictions of the Vasquez–Cook–McKinley (VCM) [P. a. Vasquez et al., J. Non-Newton. Fluid. Mech. 144, 122–139 (2007)] model, which treats wormlike micelles as Hookean dumbbells that break at half-length to form two shorter dumbbells, to an analogous Brownian dynamics (BD) simulation of the same physical model. We find a discrepancy between VCM model predictions and trace it to the absence in the VCM model of the spatial position of the nascent breakage point in the long micelle, which is needed to satisfy microscopic reversibility of breakage and fusion. We incorporate microscopic reversibility in the VCM model by extending an ensemble-averaged bead-spring phase space model of Wiest et al. [J. Chem. Phys. 90, 587 (1989)] to include reversible scission of two-spring chains. The revision tracks the conformations of the two halves of the long micelle and transmits this information to the short micelles upon breakage and thereby recovers complete agreement with the BD results. A general method...
Examining Parent Anger and Emotion Regulation in the Context of Intensive Parenting

The purpose of this study was to examine the relationship between intensive parenting attitudes (IPAs), emotion regulation (ER), and parent anger among mothers of young children (N = 227). The rese...
Mind and epistemic constructivism: Wang Yangming and Kant

This essay explores the philosophical insights of Zhu Xi, Wang YangMing, Kant, and Husserl and therefore proposes a new epistemic constructivism. It demonstrates that a knowing mind is a constructo...
The Criticality Index Development for Steering Evasive Maneuver Based on Mixed H 2 /H ∞ Control with Parameter Uncertainties

Braking and steering are the typical crash avoidance maneuvers to overcome a hazardous situation. Generally, braking is a preferred measure at low speed and steering becomes an efficient alternative as speed increases. However, determining the optimum evasive maneuver in all hazardous situations is challenging since a complete evaluation of all driving complications is difficult to achieve. This paper proposes a methodology to evaluate steering evasive maneuver using mixed $H_{2}/H_{\infty}$ control in the presence of parameter uncertainties. Vehicle side slip angle and evasive trajectory tracking errors are considered for stability and tracking performance. D-stability is employed in order to consider the transient response of the controller. Then, the criticality index is developed by solving sets of linear matrix inequalities (LMIs) and bilinear matrix inequalities (BMIs) to evaluate steering evasive maneuver.
On Vitality of the Brand of Sports Stars and Its' Keeping

With the development of market economic and commercial running of sports stars,the sports stars have become products.The life-force is important to them.In this paper the author points out that enhancing the level of technology and innate quality or property,being cautious to choice a represented product and actively to take part in movement of public fare are necessary ways to maintain the life-force.
The role of intravenous iron in cancer-related anemia.

Patients with cancer may have an absolute or functional iron deficiency as a result of their disease or its treatment. These conditions can lead to an insufficient supply of iron for incorporation into erythrocytes during supportive care with erythropoiesis-stimulating proteins for chemotherapy. The use of supplemental iron therapy is well established in patients with chronic kidney disease and anemia, but less well studied in the oncology/hematology setting. Furthermore, the use of oral iron formulations in patients with cancer and anemia is limited by poor absorption in the duodenum, arduous dosing requirements (three times a day), and a high likelihood of gastrointestinal side effects. Two recent studies have shown that intravenous (IV) iron (iron dextran or ferric gluconate) increases the hematopoietic response rates in cancer patients who were receiving chemotherapy and treated with epoetin alfa (Procrit) for anemia. The effects on hemoglobin levels and measures of iron metabolism were notably greater with IV iron formulations than with oral iron formulations. The results from several ongoing trials of IV iron in patients treated with epoetin alfa or darbepoetin alfa (Aranesp) for chemotherapy-induced anemia should lead to a greater understanding of the role of IV iron supplementation in improving the hematopoietic responses in these patients.
Review of Rhode Island Physician Loss-of-Licensure Cases, 2009-2019

Disciplinary actions against physicians are uncommon, and loss of license is less common. This unmatched, case-control, and descriptive study reviews disciplinary actions involving physician loss-of-license cases from January 1, 2009, to December 31, 2019. There were 82 physician loss-of-license cases involving 66 physicians, which were categorized by age, sex, and specialty and were compared to 4,347 non-disciplined controls. In this study, males (OR 4.69, p<0.001) were associated with an increased risk of loss of license; age was a separate risk factor (OR 1.24, p<0.05). Preventive strategies are discussed to reduce future physician loss of license.
In-situ re-crystallization of heavily-irradiated Gd2Ti2O7

Abstract Gadolinium titanate (Gd2Ti2O7, or GTO) and other lanthanide pyrochlores are interesting candidates for actinide waste disposal and fast ion conduction because the relevant material properties are intimately dependent on local cation structure. Therefore, a deep understanding of the kinetics associated with cation ordering and disordering is required if such material properties are to be tuned for specific device designs. To this end, single crystals of GTO were irradiated with 190 keV helium ions to a total fluence of 1 × 1017 ions/cm2, amorphizing the sample surface to a depth of ~1 μm and resulting in significant He bubble accumulation. FIB lamellae lifted out from the irradiated sections were examined during heat treatment in the (scanning) transmission electron microscope. Two distinct stages of the re-crystallization of the amorphized material were observed. The material near the end of the ions’ range transformed first and with the same orientation as the pristine material. This was due to the close proximity of the pristine material and the presence of small defect fluorite seeds, but the propagation of this growth front was frustrated by the large pores (formerly bubbles) in the He accumulation layer. This was followed by heterogeneous nucleation of new crystallites at random orientations at the top of the He accumulation layer, which is attributed to the high surface area associated with the many small He bubbles in that region. It is inferred that the kinetics of grain growth in this material are significantly faster than the kinetics of grain nucleation.
Two- or 3-Dimensional Echocardiography–Derived Cardiac Output Cannot Replace the Pulmonary Artery Catheter in Cardiac Surgery

Objectives: Three-dimensional (3D) transesophageal echocardiography (TEE) has been shown to be more accurate than 2D TEE for the evaluation of the left ventricular outflow tract area. The aim of the present study was to compare the agreement of 3D echocardiography–derived cardiac output (CO) with thermodilution-derived CO (TDCO) before and after cardiopulmonary bypass (CPB). Design This was a prospective observational study of patients who underwent cardiac surgery between 2016 and 2018. Setting Weill Cornell Medicine, a single large academic medical center. Participants The study comprised 78 patients undergoing elective cardiac surgery. Interventions CPB, TEE, pulmonary artery catheter, and elective cardiac surgery. Measurements and Main Results Two-dimensional CO, 3D CO-diameter, and 3D CO-area values pre-CPB were strongly correlated with one another both pre-CPB and post-CPB. The 3D CO-diameter and the 3D CO-area were mildly correlated, with TDCO measurements pre-CPB (r = 0.46 and 0.39, respectively) and post-CBP (r = 0.43 and 0.47, respectively). Pre-CPB 3D CO-diameter had the most agreement with TDCO in terms of bias (–0.13 L/min); however, the limits of agreement (LOA) were wide (–2.2- to- 2.45 L/min). Post-CPB, 3D CO-diameter had the most agreement with TDCO in terms of bias (0.41) but with wide LOA (–3.29 to 2.47). All pre-CPB echocardiography–derived CO (2D CO, 3D CO-diameter, 3D CO-area) had more agreement with TDCO than did post-CPB measurements. Conclusions Three-dimensional CO measurements were only modestly correlated with pulmonary artery catheter–derived CO pre-bypass and post-bypass. Despite low bias, the wide LOA from 2D CO, 3D CO-diameter, and 3D-area compared with TDCO suggested that the 2 methods are not interchangeable.
Congenital Inferior Vena Cava Atresia Presenting as Extensive Thrombosis in Adulthood

Mr. R is a 56-year-old man with a history of HTN and motor vehicle accident with L1 burst fracture and uncomplicated repair three months ago. His current illness began with an ED visit for management of 2 weeks of epigastric pain, nausea, and vomiting. CT abdomen revealed liver nodularity but no other pathology. He was discharged after intravenous fluids and pain medication. He returned to the ED one week later with a chief complaint of worsening painful left leg swelling for 2 days, described as throbbing. He also complained of pleuritic chest pain. He had no …
High frequency of acute promyelocytic leukemia among Latinos with acute myeloid leukemia.

A high frequency (24%) of acute promyelocytic leukemia (APL) was noted among acute myelocytic leukemia (AML) cases at the Los Angeles County-University of Southern California (LAC-USC) Medical Center, in comparison with the expected frequency of 5% to 15%. Because of the high proportion of Latinos in this center, we questioned if APL is more common in this ethnic group. The proportion of APL among the 80 AML patients of Latino origin was significantly higher (30; 37.5%) when compared with the 62 non-Latinos (4; 6.5%) (P = .00001). In an attempt to verify this finding on a larger group of patients, we analyzed 276 pathologically verified cases of AML in patients aged 30 to 69 years from the entire County of Los Angeles, registered on an ongoing population-based epidemiologic study of AML. APL was more frequent among the 47 Latinos (24.3%) than in the 229 non-Latinos (8.3%) (P = .0075). APL is seen in younger patients with AML, but Latino AML patients also had a higher frequency of APL after accounting for their younger age (age-adjusted odds ratio for APL among Latinos in LAC-USC Medical Center, 9.4 [95% confidence interval (CI) 2.9, 30] P = .0002; among Latinos in the population-based study, 3.0 [95% CI 1.3 to 6.9] P = .01). The different ethnic distribution of AML was found to be due to a higher proportion of APL cases per se, and not to a lower proportion of any other French-American-British subtype (P = .0004). These results, from two different populations of AML patients, indicate that Latinos with AML have a higher likelihood of the APL subtype of disease, which may suggest a genetic predisposition to APL and/or exposure to distinct environmental factor(s).
Anterolateral thigh osteomyocutaneous flap in head and neck: Lessons learned

Background Concerns regarding iatrogenic femur fracture may deter adoption of the anterolateral thigh osteomyocutaneous (ALTO) flap as an alternative reconstructive technique for large composite defects of the head and neck. We describe the evolution of our experience with this flap and the lessons learned in femur management. Methods Records from a prospective database (July 2009-January 2020) were reviewed to identify patients with composite osseous free tissue reconstructions. Venous thromboembolic events (VTE), femur fracture, estimated blood loss (EBL), procedure time, blood transfusions, and length of stay (days) were compared for ALTO flaps prior to and after the adoption of intramedullary fixation protocol. Results ALTO represented 10.5% (n = 23) of total osseus (n = 219) flaps. For large composite reconstructions with either ALTO flap, double flap (n = 2), or subscapular mega flaps (n = 14), ALTO flaps were most frequently used (59%, n = 23/59). There were no differences in operative time prior to and after implementation of prophylactic fixation [median (range): 5.4 (1.7-19.2) vs. 5.8 (1.7-15.0), p = .574]. Additionally, there were no differences in VTE, femur fracture, EBL, blood transfusion, or length of stay (p > .05) with adoption of prophylactic intramedullary fixation. Conclusions The ALTO flap represents a useful tool to consider in the armamentarium of reconstructive options for large through and through defects of the head and neck. In our experience, the ALTO flap is a reasonable alternative to subscapular or double flap reconstructions and especially in the setting of unusable fibular flaps or when bone need exceeds that available from the scapula.
ITRIX - an AI Enabled Solution for Orchestration of Recovery Instructions

This paper presents ITRIX (IT Recovery Instructions eXtraction)- a solution that automates the complex manual process of creating executable recovery plans from textual documents describing IT environment disaster recovery procedure. The solution applies natural language processing and deep learning to identify textual content that contain recovery instructions and information relevant to disaster recovery. This enables rapid creation and review of recovery plans resulting in 80% reduction in time taken to generate them.
Human IL-10-producing B cells have diverse states induced from multiple B cell subsets

Regulatory B cells (Bregs) can suppress immune responses through the secretion of IL-10 and other anti-inflammatory cytokines. This immunomodulatory capacity holds therapeutic potential, yet a definitional immunophenotype for enumeration and prospective isolation of B cells capable of IL-10 production remains elusive. We therefore applied mass cytometry to simultaneously quantify cytokine production and immunophenotype in human peripheral B cells across a range of stimulatory conditions and timepoints. While multiple B cell subsets produced IL-10, no phenotype uniquely identified IL-10+ B cells and a significant portion of IL-10+ B cells co-expressed the proinflammatory cytokines IL-6 and TNFα. Despite this heterogeneity, we found operationally tolerant liver transplant recipients had a unique enrichment of IL-10+, but not TNFα+ or IL-6+, B cells as compared to transplant recipients receiving immunosuppression. Thus, human IL-10-producing B cells constitute an induced, transient state arising from a diversity of B cell subsets that may contribute to maintenance of immune homeostasis.
The impact of social capital on the outcomes of innovation intermediation process

In today's open business environments, innovation happens in globally dispersed organizations that exchange technological knowledge across increasingly permeable boundaries. Innovation intermediaries operate as middle-men between solution seekers (companies seeking technological knowledge for solving their problems) and problem solvers (experts with specialized knowledge and solutions); thus, they help to connect suppliers and customers of technological knowledge. To be successful, intermediaries need to understand the solution seeker's problem and reach to their networks of contacts or connections with various experts to match the right expert to the right problem. The literature indicates that there are two different focuses in social capital, i.e., bridging (or broadening of the network) and bonding (or deepening of the relationship). In this study, a research model and hypotheses are developed to investigate the relationship between social capital and outcomes of intermediary process. The hypotheses are tested with the data from a government-sponsored intermediary organization in Thailand, called iTAP. The findings support the synergistic view of social capital which indicates that both bonding and bridging are necessary for the intermediation process to be successful.
3-D Computer Animation

Publisher Summary This chapter emphasizes the ideas and concepts that give 3-D computer animation its special character and quality. 3-D computer animation system is a complex subject that not only includes computer graphics but other branches of computer technology, such as operating systems, programming languages, information structures, and hardware design. The chapter discusses the importance of visual perception phenomena to using CRT graphic displays. The perception of moving images on a CRT display is possible because of a phenomenon known as the persistence of vision. A well-known example of 3-D picture generation is the Evans and Sutherland Picture System, which does the transformations, clipping, and perspective in hardware. This approach represents an extremely powerful and useful technique for many applications, such as real-time simulations of an aircraft landing on the deck of an aircraft carrier or airstrip at night. The chapter describes the technique of using a refresh buffer to display pictures in computer graphics. The chapter also discusses the application of three animation systems: the case western reserve system, the graphics symbiosis system, and anima II.
Metabolism of Poly-β-Hydroxybutyrate: Effect of Mild Alkaline Extraction on Native Poly-β-Hydroxybutyrate Granules

Mild alkaline extraction of native poly-β-hydroxybutyrate (PHB) granules results in the solubilization of a protein fraction. Both the solubilized protein fraction and the extracted granules are essentially devoid of PHB synthetase activity unless recombined. The protein fraction has been separated by chromatography into two components (A-I and A-II). A-I but not A-II can be recombined with extracted granules to give rise to PHB synthetase activity. Extracted granules no longer require pretreatment with activator or trypsin but are directly susceptible to hydrolysis by Rhodospirillum rubrum depolymerase. Addition of A-II or A-I prevents the direct hydrolysis by depolymerase. The inhibition is reversed by activator or trypsin. We conclude that native granules are associated with a protein inhibitor which prevents the hydrolysis of PHB by depolymerase unless the protein is destroyed by trypsin, removed by alkaline extraction, or modified by activator.
The prevalence of pediatric voice and swallowing problems in the United States.

Objectives/Hypothesis Determine the prevalence of pediatric voice and swallowing problems in the United States. Methods The 2012 National Health Interview Survey pediatric voice and language module was analyzed, identifying children reporting a voice or swallowing problem in the preceding 12 months. In addition to demographic data, specific data regarding visits to health care professionals for voice or swallowing problems, diagnoses given, and severity of voice or swallowing problem were analyzed. Results An estimated 839 ± 89 thousand children (1.4% ± 0.1%) reported a voice problem. Overall, 53.5% ± 1.9% were given a diagnosis for the voice problem and 22.8% ± 4.6% received voice services. Laryngitis (16.6% ± 5.5%) and allergies (10.4% ± 4.0%) were the most common diagnoses. A total of 16.4% graded the voice problem as a “big” or “very big” problem. An estimated 569 ± 63 thousand children (0.9% ± 0.1%) reported a swallowing problem. A total of 12.7% ± 3.8% received swallowing services and 13.4% ± 1.6% were given a diagnosis for their swallowing problem. Neurological problems were the most common diagnoses (11.1% ± 4.5%). A total of 17.9% graded the swallowing problem as a “big” or “very big” problem. Conclusion These data provide the first insight into the prevalence of childhood voice and swallowing problems, which affect approximately 1% of children annually. A relative minority seek care for their problem, despite the disease impact. Level of Evidence 4. Laryngoscope, 125:746–750, 2015
Clock quantum Monte Carlo technique: An imaginary-time method for real-time quantum dynamics

In quantum information theory, there is an explicit mapping between general unitary dynamics and Hermitian ground-state eigenvalue problems known as the Feynman-Kitaev clock Hamiltonian. A prominent family of methods for the study of quantum ground states is quantum Monte Carlo methods, and recently the full configuration interaction quantum Monte Carlo (FCIQMC) method has demonstrated great promise for practical systems. We combine the Feynman-Kitaev clock Hamiltonian with FCIQMC to formulate a technique for the study of quantum dynamics problems. Numerical examples using quantum circuits are provided as well as a technique to further mitigate the sign problem through time-dependent basis rotations. Moreover, this method allows one to combine the parallelism of Monte Carlo techniques with the locality of time to yield an effective parallel-in-time simulation technique.
System demonstration: geospatial data and mobile computing for field data collection systems

Mobile computing for survey data collection has focused on implementing paper-based procedures for field activities on handheld and tablet devices using a structured client-server model. The goal of Project Battuta has been to develop next-generation field and infrastructure technologies for mobile data collection, with an emphasis on using digital geospatial information resources within the field data collection process. To do so requires a new paradigm for field data collection that draws upon the ability to integrate distributed geospatial information resources in a mobile environment, modern computing paradigms for mediated infrastructures that increase the simplicity and flexibility of the users interactions with data resources in the computer-assisted field data collection environment. Our demo will provide a look into the use of handheld computers in this environment that builds off of our extended infrastructure model.
Inverse engineering: A methodology for learning models to support engineering design

Synthesis tasks in engineering design are currently performed by iteratively using computer-based analysis simulators in a generate-and-test fashion. In the inverse engineering methodology machine learning techniques are used to learn bi-directional models which can directly provide synthesis support. This greatly reduces design iterations. Inverse engineering provides decision-making support during the early stages of design. The authors focus on supporting early product design in parameterized domains. They present the three main phases of the inverse engineering methodology and briefly describe the model formation and selection phases. The emphasis is on the final model-utilization phase where the models learned are used by the design engineer to efficiently explore the tradeoffs in the design space in an interactive fashion. Two examples from the early design of combustion chambers for diesel engines are presented. >
Immunological effects of honey bee (Apis mellifera) venom using BALB/c mice.

H. M. Hyre and R. A. Smith. Immunological effects of honey bee (Apis mellifera) venom using BALB/c mice. Toxicon24, 435 – 440, 1986. — Honey bee venom at concentrations up to 50 μg/ml was not toxic in vitro for unstimulated murine splenic lymphocytes, as assayed by tritiated thymidine incorporation. However, venom concentrations greater than 6 μg/ml significantly (P<0.01) inhibited concanavalin A (con A) simulation of murine lymphocytes. In contrast to this finding, the splenic lymphocytes from mice receiving 4 s.c. injections of honey bee venom on alternate days were significantly (P<0.01) enhanced in their proliferative response to con A compared to a sham-injected group of mice. Mice injected with the venom prior to and following an injection of sheep red blood cells produced significantly more direct IgM plaques (P<0.02) than the sham-injected group. In this study both suppression and enhancement of immune reactivity was seen using honey bee venom when assayed on the splenic lymphocytes of BALB/c mice.
Purification and Characterization of Hamster Liver Microsomal 7α-Hydroxycholesterol Dehydrogenase SIMILARITY TO TYPE I 11β-HYDROXYSTEROID DEHYDROGENASE

Abstract While studying the bile acid synthetic pathway of hamsters, we discovered an NADP+-dependent liver microsomal 7α-hydroxycholesterol dehydrogenase (7α-HCD) activity that was not observed in rat liver microsomal fractions. The hamster liver microsomal 7α-HCD was purified to homogeneity using 2′,5′-ADP and cholic acid-agarose affinity chromatography. 7α-HCD displayed a molecular weight of approximately 34,000 on SDS-polyacrylamide gel electrophoresis; it is an intrinsic membrane protein of the hamster liver endoplasmic reticulum and exists as a multimeric aggregate in pure form. Partial N-terminal amino acid sequence analysis showed that 7α-HCD had high sequence similarity to human 11β-hydroxysteroid dehydrogenase (11β-HSD; 24/30 amino acid identity). TheK m values for corticosterone and 7α-hydroxycholesterol were 1.2 and 1.9 μm, respectively, for purified 7α-HCD; both reactions displayed identicalV max values (approximately 170 nmol/min/mg of protein). The IC50 of carbenoxolone, a competitive inhibitor of 11β-HSD, was 75 nm for 7α-hydroxycholesterol dehydrogenation and 210 nm for corticosterone dehydrogenation. The tissue-specific expression in hamster was as follows: adrenal ≥ liver > kidney > testis ≫ brain > lung. Microsomal 7α-HCD is uniquely expressed in hamster liver and to some extent in human liver but not in rat liver. Western blot analysis with two antibodies elicited against an N-terminal peptide of the human 11β-HSD and purified hamster liver 7α-HCD, respectively, suggested the presence of multiple forms of 7α-HCD in hamster liver, most likely due to the existence of a family of 11β-HSD proteins. Since 7-oxocholesterol is a potent inhibitor of cholesterol 7α-hydroxylase, alternative mechanisms for regulation of bile acid synthesis may exist in human and hamster liver due to production of this metabolite and its potential as an oxysterol.
Tailored Lagrangian Relaxation for the open pit block sequencing problem

A common strategic and tactical decision in open pit mining is to determine the sequence of extraction for notional three-dimensional production blocks so as to maximize the net present value of the extracted orebody while adhering to precedence and resource constraints. This problem is commonly formulated as an integer program with a binary variable representing if and when a block is extracted. In practical applications, the number of blocks can be large and the time horizon can be long, and therefore, instances of this NP-hard precedence-constrained knapsack problem can be difficult to solve using an exact approach. The problem is even more challenging to solve when it includes explicit minimum resource constraints. We employ three methodologies to reduce solution times: (i) we eliminate variables which must assume a value of 0 in the optimal solution; (ii) we use heuristics to generate an initial integer feasible solution for use by the branch-and-bound algorithm; and (iii) we employ Lagrangian relaxation, using information obtained while generating the initial solution to select a dualization scheme for the resource constraints. The combination of these techniques allows us to determine near-optimal solutions more quickly than solving the monolith, i.e., the original problem. We demonstrate our techniques to solve instances containing 25,000 blocks and 10 time periods, and 10,000 blocks and 15 time periods, to near-optimality.
Effect of alcohol septal ablation in patients with hypertrophic cardiomyopathy on left-ventricular mechanical dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging

Patients with hypertrophic cardiomyopathy (HCM) may have delayed septal activation and left ventricular (LV) mechanical dyssynchrony, and may improve after alcohol septal ablation (ASA). This study used phase analysis of gated SPECT myocardial perfusion imaging (MPI) to evaluate septal activation and LV dyssynchrony in HCM patients pre- and post-ASA. Phase analysis was applied to 28 controls, and 32 HCM patients having rest MPI pre- and post-ASA to assess septal-lateral mechanical activation delay (SLD) and consequent LV dyssynchrony. In addition, phase analysis was applied to another group of 30 patients having serial MPI to measure variability of the LV dyssynchrony parameters on serial studies. ASA significantly reduced SLD and improved LV synchrony in the HCM patients with SLD < 0° due to earlier activation of the lateral wall relative to the septum. Based on the measured variability, 12 HCM patients had significant (Z < -1.65, P < 0.05) and 4 had moderate (Z < -1.00, P < 0.15) improvement in LV synchrony post-ASA. SLD < 0° predicted improvement in LV synchrony after ASA with a sensitivity of 81% and a specificity of 88%. SLD and LV dyssynchrony were frequent in HCM patients. HCM patients, whose septal activation became later than lateral activation, had significant reduction in septal activation delay and improvement in LV synchrony after ASA.
Factors limiting academic participation in the development of large mathematical software packages

The December 1975 SIGNUM meeting of Software for Partial Differential Equations seemed to formalize a trend which over the past few years has become ever more evident. Namely, the the development of medium and large scale software packages, say anything more than five hundred statements, is a project which can no longer be carried out in a university. Such projects are now almost wholly within the province of industrial and governmental laboratories. As can be seen from the program of the meeting (ACM SIGNUM Newsletter 10, 1975; No. 4, pp. 2-3), only two our of seventeen papers came from universities and one of these two papers concerned itself with a modest size algorithm for solving systems of linear algebraic equations. The reasons for this state of affairs are not hard to find. It is expensive to develop such software, and it is not altogether appropriate in a university to tie up manpower and money in such extensive undertakings. After all, departments of mechanical engineering do not build boilers, or perhaps, since new program development involves much innovation, a more accurate analogy would be to say that departments of aeronautical engineering do not build new jetliners. Also, because of tight money and excess personnel, pressures on faculty to "Produce" have increased and producing means publishing.
Infectious Diarrheas: Acute, Chronic, and Iatrogenic

Excerpt In both health and disease, the lumen of the gut is an intricate ecosystem that yields its mysteries grudgingly. Despite this complexity, the last decade has produced a virtual revolution i...
Transient and steady-state analysis of a manufacturing system with setup changes

This paper deals with the optimal scheduling of a one-machine two-product manufacturing system with setup, operating in a continuous time dynamic environment. The machine is reliable. A known constant setup time is incurred when switching over from a part to the other. Each part has specified constant processing time and constant demand rate, as well as an infinite supply of raw material. The problem is formulated as a production flow control problem. The objective is to minimize the sum of the backlog and inventory costs incurred over a finite planning horizon. The global optimal solution, expressed as an optimal feedback control law, provides the optimal production rate and setup switching epochs as a function of the state of the system (backlog and inventory levels). For the steady-state, the optimal cyclic schedule (Limit Cycle) is determined. This is equivalent to solving a one-machine two-product Lot Scheduling Problem. To solve the transient case, the system's state space is partitioned into mutually exclusive regions such that with each region is associated an optimal control policy. A novel algorithm (Direction Sweeping Algorithm) is developed to obtain the optimal state trajectory (optimal policy that minimizes the sum of inventory and backlog costs) for this last case.
Resolvin E1, an endogenous lipid mediator derived from omega-3 eicosapentaenoic acid, protects against 2,4,6-trinitrobenzene sulfonic acid-induced colitis

Resolvin E1 (RvE1; 5S,12R,18R-trihydroxyeicosapentaenoic acid) is an antiinflammatory lipid mediator derived from omega-3 fatty acid eicosapentaenoic acid (EPA). At the local site of inflammation, aspirin treatment enhances EPA conversion to 18R-oxygenated products, including RvE1, which carry potent antiinflammatory signals. Here, we obtained evidence for reduced leukocyte infiltration in a mouse peritonitis model, where the administration of EPA and aspirin initiated the generation of RvE1 in the exudates. Similar results were obtained with the administration of synthetic RvE1, which blocked leukocyte infiltration. RvE1 also protected against the development of 2,4,6-trinitrobenzene sulfonic acid-induced colitis. The beneficial effect was reflected by increased survival rates, sustained body weight, improvement of histologic scores, reduced serum anti-2,4,6-trinitrobenzene sulfonic acid IgG, decreased leukocyte infiltration, and proinflammatory gene expression, including IL-12 p40, TNF-α, and inducible nitric oxide synthase. Thus, the endogenous lipid mediator RvE1 counter-regulates leukocyte-mediated tissue injury and proinflammatory gene expression. These findings show an endogenous mechanism that may underlie the beneficial actions of omega-3 EPA and provide targeted approaches for the treatment of intestinal inflammation.
Disseminated disease due to Mycobacterium chelonei treated with amikacin and cefoxitin. Absence of killing with either agent and possible role of granulocytes in clinical response

Disseminated disease due to rapidly growing mycobacteria is manifested by positive blood cultures and multiple skin and subcutaneous abscesses. A patient had T-cell lymphoma and disseminated disease; he also had neutropenia intermittently. Single-agent therapy with amikacin sulfate or cefoxitin sodium was not adequate during periods of neutropenia, and combination therapy was necessary to control the infection. Clinical response correlated with detectable serum inhibitory levels of the antimicrobial agents. Surprisingly, the organism was not killed by either amikacin or cefoxitin, a finding that correlated with the absence of serum bactericidal levels. This case suggests that granulocytes may play a role in the host's response to this organism, and determination of serum inhibitory and possible bactericidal levels may be useful in monitoring therapy.
Rank 5 association schemes and triality

Abstract Symmetric association schemes having a parabolic of rank 3 and corank 2 satisfying a certain uniformity condition can be interpreted on the one hand as linked strongly regular designs (analogous to linked symmetric designs) and on the other as geometries. Classical triality associated with the groups O + 8 ( q ) provides a family of examples with rank 3, corank 2 parabolics and sporadic examples are associated with the groups L 3 (4), U 6 (2) and U 3 (5). The triality examples and the U 3 (5) example are flag-transitive viewed as geometries. Results include a characterization on the level of parameters of the triality schemes leading to a characterization of the schemes using results of Cameron and Drake, and a proof (as a Cayley exercise) of simple connectivity of the example associated with U 3 (5).
Hypoxia Regulates Vascular Endothelial Growth Factor Gene Expression in Endothelial Cells Identification of a 5′ Enhancer

Vascular endothelial growth factor (VEGF) is a potent mitogen specific for endothelial cells. Its expression is dramatically induced by low oxygen tension in a variety of cell types, and it has been suggested to be a key mediator of hypoxia-induced angiogenesis. Although VEGF action is targeted to endothelial cells, it is generally believed that these cells do not express VEGF. In addition, the mechanisms by which hypoxia regulates VEGF production remain unclear. We report in the present study that pulmonary artery endothelial cells do not express VEGF under basal conditions; however, significant VEGF mRNA levels accumulate when these cells are exposed to hypoxia. Using a DNA fragment containing human VEGF promoter sequence, we identified a 28-bp element that is necessary and sufficient to upregulate transcription in response to hypoxia. This element can act as a hypoxia-specific enhancer when placed upstream or downstream from a heterologous promoter. The enhancer includes, in addition to an octamer homologous to the hypoxia-inducible factor-1 (HIF-1) consensus, a sequence that resides 3' to the consensus. Although this sequence may not be involved in the binding of HIF-1, it is absolutely required for the enhancer activity and may be the binding site for certain constitutive binding proteins. The expression of VEGF by endothelial cells in response to hypoxia may provide an important mechanism by which endothelial cell permeability and proliferation is regulated in an autocrine manner.