cssi/SciSciGPT-SciSciNet huggingface dataset:
Automated Grading of Gliomas using Deep Learning in Digital Pathology Images: A modular approach with ensemble of convolutional neural networks

Brain glioma is the most common primary malignant brain tumors in adults with different pathologic subtypes: Lower Grade Glioma (LGG) Grade II, Lower Grade Glioma (LGG) Grade III, and Glioblastoma Multiforme (GBM) Grade IV. The survival and treatment options are highly dependent of this glioma grade. We propose a deep learning-based, modular classification pipeline for automated grading of gliomas using digital pathology images. Whole tissue digitized images of pathology slides obtained from The Cancer Genome Atlas (TCGA) were used to train our deep learning modules. Our modular pipeline provides diagnostic quality statistics, such as precision, sensitivity and specificity, of the individual deep learning modules, and (1) facilitates training given the limited data in this domain, (2) enables exploration of different deep learning structures for each module, (3) leads to developing less complex modules that are simpler to analyze, and (4) provides flexibility, permitting use of single modules within the framework or use of other modeling or machine learning applications, such as probabilistic graphical models or support vector machines. Our modular approach helps us meet the requirements of minimum accuracy levels that are demanded by the context of different decision points within a multi-class classification scheme. Convolutional Neural Networks are trained for each module for each sub-task with more than 90% classification accuracies on validation data set, and achieved classification accuracy of 96% for the task of GBM vs LGG classification, 71% for further identifying the grade of LGG into Grade II or Grade III on independent data set coming from new patients from the multi-institutional repository.
DNA Unwinding by CRISPR-Cas9 Studied using Site-Directed Spin Labeling

In a type II clustered, regularly interspersed, short palindromic repeats (CRISPR) system, RNAs derived from the CRISPR locus complex with the CRISPR-associated (Cas) protein Cas9 to form an RNA-guided nuclease that cleaves double-stranded DNAs sequence-specifically. In recent years, the CRISPR-Cas9 system has been successfully adapted for genome engineering in a wide range of organisms; however, its mechanism of function at the molecular level remains to be fully understood. A key step in Cas9 target selection is the unwinding of the target DNA duplex to allow formation of a three-stranded R-loop, in which the guide segment of the RNA is base-paired to the protospacer segment residing at one of the DNA strands. Here, we investigate DNA deformation and unwinding in Streptococcus pyogenes Cas9 (SpyCas9) complexes using the method of site-directed spin labeling (SDSL) with electron paramagnetic resonance (EPR) spectroscopy. Nucleotide-independent nitroxide labels were attached at selected sites of a target DNA duplex, and labeled DNAs were assembled with SpyCas9 and the corresponding RNA, resulting in minimal perturbation of native activity. EPR measurements revealed distinct increases in inter-strand distances along the target DNA duplex in the Cas9 complex, consistent with DNA deformation and unwinding. Importantly, the inter-strand distances increased non-uniformly along the protospacer segment of the DNA, indicating a varying degree of DNA unwinding within the region complementary to the guide RNA. Additional work is ongoing to more clearly understand the mechanism of DNA unwinding and its connection with target cleavage by Cas9.
An inexpensive high-temperature optical fiber thermometer

Abstract An optical fiber thermometer consists of an optical fiber whose tip is coated with a highly conductive, opaque material. When heated, this sensing tip becomes an isothermal cavity that emits like a blackbody. This emission is used to predict the sensing tip temperature. In this work, analytical and experimental research has been conducted to further advance the development of optical fiber thermometry. An inexpensive optical fiber thermometer is developed by applying a thin coating of a high-temperature cement onto the tip of a silica optical fiber. An FTIR spectrometer is used to detect the spectral radiance exiting the fiber. A rigorous mathematical model of the irradiation incident on the detection system is developed. The optical fiber thermometer is calibrated using a blackbody radiator and inverse methods are used to predict the sensing tip temperature when exposed to various heat sources.
Cell-laden microfluidic microgels for tissue regeneration

Regeneration of diseased tissue is one of the foremost concerns for millions of patients who suffer from tissue damage each year. Local delivery of cell-laden hydrogels offers an attractive approach for tissue repair. However, due to the typical macroscopic size of these cell constructs, the encapsulated cells often suffer from poor nutrient exchange. These issues can be mitigated by incorporating cells into microscopic hydrogels, or microgels, whose large surface-to-volume ratio promotes efficient mass transport and enhanced cell–matrix interactions. Using microfluidic technology, monodisperse cell-laden microgels with tunable sizes can be generated in a high-throughput manner, making them useful building blocks that can be assembled into tissue constructs with spatially controlled physicochemical properties. In this review, we examine microfluidics-generated cell-laden microgels for tissue regeneration applications. We provide a brief overview of the common biomaterials, gelation mechanisms, and microfluidic device designs that are used to generate these microgels, and summarize the most recent works on how they are applied to tissue regeneration. Finally, we discuss future applications of microfluidic cell-laden microgels as well as existing challenges that should be resolved to stimulate their clinical application.
Maternal transfer of mercury to songbird eggs.

Abstract We evaluated the maternal transfer of mercury to eggs in songbirds, determined whether this relationship differed between songbird species, and developed equations for predicting mercury concentrations in eggs from maternal blood. We sampled blood and feathers from 44 house wren (Troglodytes aedon) and 34 tree swallow (Tachycineta bicolor) mothers and collected their full clutches (n = 476 eggs) within 3 days of clutch completion. Additionally, we sampled blood and feathers from 53 tree swallow mothers and randomly collected one egg from their clutches (n = 53 eggs) during mid to late incubation (6–10 days incubated) to evaluate whether the relationship varied with the timing of sampling the mother's blood. Mercury concentrations in eggs were positively correlated with mercury concentrations in maternal blood sampled at (1) the time of clutch completion for both house wrens (R2 = 0.97) and tree swallows (R2 = 0.97) and (2) during mid to late incubation for tree swallows (R2 = 0.71). The relationship between mercury concentrations in eggs and maternal blood did not differ with the stage of incubation when maternal blood was sampled. Importantly, the proportion of mercury transferred from mothers to their eggs decreased substantially with increasing blood mercury concentrations in tree swallows, but increased slightly with increasing blood mercury concentrations in house wrens. Additionally, the proportion of mercury transferred to eggs at the same maternal blood mercury concentration differed between species. Specifically, tree swallow mothers transferred 17%–107% more mercury to their eggs than house wren mothers over the observed mercury concentrations in maternal blood (0.15–1.92 μg/g ww). In contrast, mercury concentrations in eggs were not correlated with those in maternal feathers and, likewise, mercury concentrations in maternal blood were not correlated with those in feathers (all R2
Deregulation and Wheeling

This paper addresses the concept of deregulation as it is being discussed in the USA where Deregulation: Replacement of a system of privately owned, state regulated electric utilities by a competitive system wherein at least the generators are privately owned and operated without state or federal regulation.
Wellness in Sickness and Health (The W.I.S.H. Project): Advance Care Planning Preferences and Experiences Among Elderly Latino Patients.

OBJECTIVE To assess advance care planning (ACP) preferences, experiences, and comfort in discussing end-of-life (EOL) care among elderly Latinos. METHODS Patients aged 60 and older from the Los Angeles County and University of Southern California (LAC+USC) Medical Center Geriatrics Clinic (n = 41) participated in this intervention. Trained staff conducted ACP counseling with participants in their preferred language, which included: (a) pre-counseling survey about demographics and EOL care attitudes, (b) discussion of ACP and optional completion of an advance directive (AD), and (c) post-session survey. RESULTS Patients were primarily Spanish speaking with an average of 2.7 chronic medical conditions. Most had not previously documented (95%) or discussed (76%) EOL wishes. Most were unaware they had control over their EOL treatment (61%), but valued learning about EOL options (83%). Post-counseling, 85% reported comfort discussing EOL goals compared to 66% pre-session, and 88% elected to complete an AD. Nearly half of patients reported a desire to discuss EOL wishes sooner. CONCLUSIONS Elderly Latino patients are interested in ACP, given individualized, culturally competent counseling in their preferred language. CLINICAL IMPLICATIONS Patients should be offered the opportunity to discuss and document EOL wishes at all primary care appointments, regardless of health status. Counseling should be completed in the patient's preferred language, using culturally competent materials, and with family members present if this is the patient's preference. Cultural-competency training for providers could enhance the impact of EOL discussions and improve ACP completion rates for Latino patients.
Algorithmic Convergence in Abstract g-Fractional Calculus

The novelty of this chapter is the design of suitable algorithms for solving equations on Banach spaces.
Depressed collector performance on the NRL quasioptical gyrotron

A simple, single-stage collector has been tested on the quasioptical gyrotron (QOG) experiment at the Naval Research Laboratory (NRL). This is the first application of a depressed collector to a high-power gyrotron, and was relatively easily accomplished due to the natural separation of the electron beam and the output power in the QOG. Collector efficiencies as high as 50% and overall efficiencies up to 16.1% were observed. The output power reached 431 kW with an overall efficiency of 12.7% and a collector efficiency of 40.7%. The collector efficiency was limited in this experiment due to interception of a portion of the electron beam on an undepressed section of the beam guide.
The Interpersonal Sunk-Cost Effect:

The sunk-cost fallacy-pursuing an inferior alternative merely because we have previously invested significant, but nonrecoverable, resources in it-represents a striking violation of rational decision making. Whereas theoretical accounts and empirical examinations of the sunk-cost effect have generally been based on the assumption that it is a purely intrapersonal phenomenon (i.e., solely driven by one's own past investments), the present research demonstrates that it is also an interpersonal effect (i.e., people will alter their choices in response to other people's past investments). Across eight experiments ( N = 6,076) covering diverse scenarios, I documented sunk-cost effects when the costs are borne by someone other than the decision maker. Moreover, the interpersonal sunk-cost effect is not moderated by social closeness or whether other people observe their sunk costs being "honored." These findings uncover a previously undocumented bias, reveal that the sunk-cost effect is a much broader phenomenon than previously thought, and pose interesting challenges for existing accounts of this fascinating human tendency.
States of Consciousness: The Pulses of Experience

States of Consciousness extends Thomas Natsoulas' development of the psychology of consciousness by giving sustained attention to the stream of consciousness and its component 'pulses of experience'. Natsoulas' unrivalled scholarship across psychology, philosophy and cognate fields means that very often surprising connections are made between the works of leading theorists of consciousness, including Brentano, Mead, Bergmann, Strawson, James, Freud, Skinner, Hebb, Gibson, O'Shaughnessy and Woodruff Smith. At a time when interest in consciousness and the brain is growing rapidly, this book provides an in-depth analysis of sophisticated psychological accounts that pertain to consciousness. Its breadth of coverage and interdisciplinary nature will be of interest to postgraduates and specialists in a range of fields, particularly the history of psychology and philosophy of mind.
The Soul in Generation and the Animation of the Foetus

The role of the soul in generation was a subject for controversy, rooted in Aristotle’s definition of anima. The classic questions concerning the soul in generation, which we find in Fernel, his contemporaries and successors, arise from this definition of anima. Put briefly, they are: is the seed animate, or is it an instrument of an “external efficient” as Cremonini called it? If the latter, is this external cause the parents, God, Nature, the heavens? Is the anima (as form) the same thing as species? And, related to this, how are the faculties or actions of a complex living creature such as a man, composed of parts of different forms or species, integrated into a functioning whole?
Case 3: A Strange Computerized ECG Interpretation

A 38-year-old man is scheduled for vasectomy reversal. He is healthy except for a history of several anxiety attacks, after a death of his youngest child, 6 months before this procedure. His symptoms included shortness of breath, palpitations, and dizziness. He denies any history of cardiac or neurological disease, syncope, exercise-induced chest symptoms, and any family risk factors for coronary artery disease. He states he is fit and his wife concurred that he exercises regularly. Since the patient was deemed healthy and not scheduled for major surgery, he was not evaluated in the Anesthesia Preoperative Assessment Clinic prior to surgery.
Initial Validation of the Toulouse St. Louis University Mini Falls Assessment in Older Adults.

Falls are one of the most prevalent health issues facing older adults. This study examines the validity of the Toulouse-St. Louis University Mini Falls Assessment (TSLUMFA). Objectives were to validate the TSLUMFA by testing if it differentiates between prior non fallers (n=80) and fallers (n=23), and predicts future falls as well as or better than the gold standard Tinetti Gait and Balance Instrument (TGBI). Examine if the subset of FRAIL Scale items on the TSLUMFA distinguishes between previous non fallers (n=75) and fallers (n=20), and predicts future falls as well as or better than the TGBI. Identify TSLUMFA cut offs scores for fall risk. Prospective validation study. Participants were ambulatory patients presenting to the SLU Geriatrics Clinic. 103 ambulatory older adults. Fall risk was assessed using the three assessments. Outcome measures were previous falls and follow up falls. TSLUMFA, FRAIL, and TGBI differentiated between previous fallers and non fallers. A TSLUMFA score 3 should be analyzed by TSLUMFA. The TSLUMFA’s advantage is that it pinpoints areas that will directly benefit from therapy to reduce falls.
Membrane structure of the human immunodeficiency virus gp41 fusion peptide by molecular dynamics simulation: II. The glycine mutants

In this work, molecular dynamics (MD) simulation of the interaction of three mutants, G3V, G5V and G10V, of the human immunodeficiency virus (HIV) gp41 16-residue fusion peptide (FP) with an explicit palmitoyloleoylphosphatidyl-ethanolamine (POPE) lipid bilayer was performed. The goals of this work are to study the correlation of the fusogenic activity of the FPs with the mode of their interaction with the bilayer and to examine the roles of the many glycine residues in the FP in the fusion process. The results of this work corroborate the main conclusion of our earlier MD work of the WT FP and several mutants with polar substitution. These two studies provide correlation between the mode of insertion and the fusogenic activity of these peptides and support the hypothesis that an oblique insertion of the fusion domain of the viral protein is required for fusogenic activity. Inactive mutants interact with the bilayer by a surface-binding mode. The results of this work, combined with the results of our earlier work, show that, while the secondary structures of the wild-type FP and its mutants do not affect the fusogenic activities, the conformational flexibility appears to be an important factor. The active WT FP and its partially active mutants, G3Vand G5V, all have significant conformational transitions at one of the glycine sites. They occur at Gly 5 in FPwt, at Gly 10 in FP-G5Vand at Gly 13 in FP-G3V. Thus, a glycine site in each of these active (or partially active) FPs provides conformational flexibility. On the other hand, the inactive mutants FP-G10V, FP-L9R and FP-V2E do not have any conformational transitions except at either terminus and thus possess no conformational flexibility. Thus, the results of this work support the suggestion that the role of glycine residues in the fusion domain is to provide the necessary conformational flexibility for fusion activity. The glycines also form a ‘‘glycine strip’’ in the FP that locates on one (the less hydrophobic) face of the helix (the ‘‘sided helix’’). However, whether this ‘‘glycine strip’’ is disrupted or not does not seem to correlate with the retention of fusogenic activities. Finally, although the FLGFL (8–12) motif is absolutely conserved in the HIV fusion domain, a well-structured motif stabilized by hydrogen bonding does not appear to be required for activity. In fact, hydrogen bonding in this motif was found to be missing in FP-G3Vand FP-G5V. Both of these mutants are partially active. D 2002 Elsevier Science B.V. All rights reserved.
In Vivo Study of the Influence of Gravity on Cortical and Cancellous Bone Velocity

This study presents new information obtained using ultrasound on the elasticity and anisotropy of human bone tissue in normal conditions and on their changes in the absence of gravity. Strict bedrest maintained for twelve weeks was used to simulate the absence of gravity encountered in space flight. The elastic properties of bone were assessed via the ultrasound velocity, measured noninvasively and nondestructively using a novel device developed in our laboratory for these studies, based on the principles of UCR (Ultrasound Critical-angle Reflectometry).
Distemper vaccine in pregnant ferrets and mink.

The Wisconsin FXNO strain of attenuated live-virus egg-propagated distemper vaccine apparently did not cross the placental barrier when given to pregnant mink and ferrets. No deleterious effect was observed on the mink or ferret foetuses.
Acquired methemoglobinemia from phenazopyridine use.

Phenazopyridine-induced methemoglobinemia is relatively rare with fewer than ten cases reported over the past 35 years. We describe a case of phenazopyridine-induced methemoglobinemia that is unique in the way the patient presented and how initial workup was completed. The patient presented with lethargy, diarrhea, light-headedness, and headaches, with past medical history of breast cancer, seizures, and recent dysuria for which she had been taking phenazopyridine. She was noted to have a persistent hypoxemia despite supplemental oxygen delivery and a shunting process was considered, with pulmonary embolus and methemoglobinemia due to phenazopyridine use being of chief concern. She was stabilized, and confirmation of original diagnosis was made at the main ED and treatment successfully rendered with good effect. Methemoglobinemia, while rare, can be associated with use of over-the-counter medicines and should be considered as part of a broad differential. This case serves to emphasize the importance of a thorough history and physical—tools especially helpful when at a satellite facility with relatively limited resources.
Characterization and Modeling of a SiC MOSFET's Turn-On Overvoltage

Switching transient overvoltage is inevitable in hard switching applications, and the faster switching speed of SiC MOSFETs suggests even worse overvoltage. This paper focuses on the turn-on overvoltage. To understand its nature, the switching transient is analyzed, and it shows the turn-on overvoltage is largely independent of load current condition. This phenomenon is verified by characterizing the turn-on overvoltage of a SiC MOFET and a SiC Schottky diode. Finally, a SPICE-based model is also built to understand the switching transient more accurately, and the modeling method can accurately predict the turn-on overvoltage and help select device voltage rating.
No Increased Mortality After TIPS Compared with Serial Large Volume Paracenteses in Patients with Higher Model for End-Stage Liver Disease Score and Refractory Ascites

To compare survival after transjugular intrahepatic portosystemic shunt (TIPS) creation versus serial large volume paracenteses (LVP) in patients with refractory ascites and higher Model for End-Stage Liver Disease (MELD) scores. In this retrospective study, from 1/1/2013 to 10/1/2018, 478 patients (294 male; mean age 58, range 23–89) underwent serial LVP (n = 386) or TIPS (n = 92) for ascites. Propensity-matched cohorts were constructed based on age, MELD, Charlson comorbidity index, varices, and hepatic encephalopathy. Survival was analyzed using a Cox proportional hazards model in which MELD score and TIPS were treated as time-dependent covariates. An interaction term was used to assess the impact of TIPS versus serial LVP on survival as a function of increasing MELD. In the overall patient sample, higher MELD score predicted worse survival after either serial LVP or TIPS [hazard ratio (HR) = 1.13; p < 0.001], but there was no significant interaction between TIPS and higher MELD score conferring worse survival (HR = 1.01; p = 0.55). In 92 propensity-matched serial LVP and 92 TIPS patients, higher MELD score predicted worse survival after either serial LVP or TIPS (HR = 1.19; p < 0.001), but there was no significant survival interaction between TIPS and higher MELD (HR = 0.97; p = 0.22). In 30 propensity-matched serial LVP patients and 30 TIPS patients with baseline MELD greater than 18, TIPS did not predict worse survival (HR = 0.97; p = 0.94). Higher MELD predicts poorer survival after either serial LVP or TIPS, but TIPS creation is not associated with worse survival compared to serial LVP in patients with higher MELD scores Level 4, case series.
Education prioritization and language spread

Abstract Given the importance of language for state building, many governments undertake language planning efforts to ensure their citizens can speak an – if not, the – official language. Yet the mere act of designating a language as official is not sufficient for the language to be widely spoken across the population. In this paper we ask, what explains official language spread? We argue whether citizens can speak an official language – either as a first or second language – depends on how much the government prioritizes the education ministry. Governments that allocate more resources – financial, political, and human capital – to the education ministry are more likely to spread the official language. We assess this argument first with a case study of Singapore 1965−1985. We intentionally pick a successful case to elucidate the mechanisms linking education prioritization to language spread. To demonstrate the mechanisms are not Singapore-specific, we run a second test. The statistical analysis employs original cross-national, over-time (1978–2009) measures of budget allocation ranks, minister ranks, and ministry cabinet ranks. The results suggest a strong effect between education prioritization and language spread.
Validating Reports of Chronic Conditions in the Medicare CAHPS Survey.

Background The Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey includes items about chronic conditions, health history, and self-rated health. Questions remain about the concordance between patient reports and administrative sources on questions related to health history. Objective To validate CAHPS measures of chronic conditions against claims-based measures from the Medicare Chronic Conditions Warehouse (CCW). Methods We linked CAHPS responses from 301,050 fee-for-service Medicare beneficiaries in 2010-2012 with summaries of their claims in the CCW and identified nearest equivalent measures of conditions across sources. We calculated sensitivities and specificities for conditions and estimated regression models to assess the effects of patient characteristics on the sensitivity. Results The sensitivity of CAHPS measures differed across conditions, ranging from 0.513 for history of stroke to 0.773 for history of cancer. Sensitivity was generally lower for older beneficiaries, those reporting good self-rated health, and those with fair or poor mental health. Specificity was 0.904 or greater for all conditions, up to 0.961 for stroke. Conclusions Despite difference in timeframes and definitions of conditions, the measured sensitivities demonstrated reasonable validity. Variation in sensitivity is consistent with covariates that either directly measure health severity within a diagnosis or can be construed as a proxy for severity of illness.
Long-term, disease-specific outcomes of thymic malignancies presenting with de novo pleural metastasis

Abstract Objective Treatment of patients with thymic malignancies metastatic to the pleura or pericardium is challenging, and benefits of aggressive treatment are unclear. We sought to characterize the long-term outcomes in this population. Methods We retrospectively identified patients who underwent resection for de novo thymic malignancies metastatic to the pleura between May 1997 and December 2017. Patients with pleural recurrence after prior thymectomy were excluded. Patient demographics, perioperative treatments, pathologic findings, and postoperative outcomes were collected. Descriptive statistics and Kaplan–Meier analyses were performed. Results Seventy-two patients were included (median age, 51 years [range 25-80]; 36/72 women [50%]). Pathologic diagnosis was thymoma in 57 patients (79%) and thymic carcinoma in 15 patients (21%). Most patients (67/72; 93%) received chemotherapy, radiation, or both. Forty-eight patients underwent thymectomy with pleurectomy, 7 patients underwent extrapleural pneumonectomy, 10 patients underwent thymectomy alone, and 7 patients were unresectable. Macroscopic complete resection was achieved in 52 patients (73%). Five-, 10-, and 15-year overall survivals were 73%, 51%, and 18%, respectively, and median overall survival was 11 years (median follow-up, 5.9 years). Forty-six patients (64%) had disease progression (median time to progression, 2.2 years). Repeat episodes of progression and treatment were common (median, 3 episodes/patient). The longest disease-free interval was 12.4 years. Thirteen patients (18%) remain disease-free; 7 patients (10%) were disease-free for more than 5 years. The longest ongoing survival without progression or reintervention is 9.9 years. Conclusions Prolonged survival and, in some cases, cure can be achieved in patients with thymic malignancies metastatic to the pleura or pericardium. Aggressive multimodality therapy may be appropriate for select patients.
Emergency Triage of Highly Infectious Diseases and Bioterrorism

Emergency medical services are a key element in health systems for the evaluation and treatment of patients exposed to highly infectious diseases or bioterrorism agents. Triage and early identification at any point of care can have a significant impact on the prevention and management of these diseases. This chapter reviews triage practices, including early isolation and decontamination, of highly infectious diseases and bioterrorism agents at different health system levels.
Video Analysis of Student Challenges and Interactions in Computational Thinking-integrated Botany

This study aimed to understand elementary students' challenges and interactions in computational thinking-integrated botany through robotics activities. Data was collected from screen-casting videos and analyzed using Collaborative Computing Observation Instrument (CCOI), a web-based analysis instrument with nodes and paths that classify and specify students' computing experience. The results revealed that all participants engaged in independent work for most of the time, with short interactions on 1) general computer technology issues; 2) software navigating issues; 3) questions about academic content; 4) computing discussion with the instructor; 5) informing the instructor about task accomplishment. The findings of this study will provide important insights to CS researchers, educators, and elementary teachers regarding CT-integration research and practice.
The diagnostic value of video capsule endoscopy for Meckel's diverticulum in children.

Background: Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and is also an important cause of bloody stool and anemia in children. However, there are few data about video capsule endoscopy (VCE) for MD in children. This study aimed to evaluate the diagnostic value of VCE for MD in children. Materials and methods: children who underwent VCE for obscure gastrointestinal bleeding from October 1st 2015 to August 31st 2019 at the Children’s Hospital of Fudan University were included in this retrospective study. Medical data, VCE data and Meckel’s scans, etc. were collected for each patient. Results: sixteen patients were diagnosed with MD by VCE, including 13 males and 3 females. The age of the patients ranged from 4 years to 13 years, with an average of 7.8 ± 2.7 years. Lower gastrointestinal tract bleeding was the main symptom for patients with MD, including hematochezia (75 %) and melena (25 %). Of the VCE findings, 14 patients had double lumen signs and 2 showed protruding lesions. Among the 16 patients diagnosed with MD by VCE, 14 patients were diagnosed with MD by Meckel’s scan, 3 with MD by abdominal enhanced CT and 14 patients were diagnosed with MD by surgery. During the follow-up, bleeding occurred sporadically in patient 12 and the reason is still unknown. Conclusions: VCE is useful for the diagnosis of MD and should be used as a valuable and less invasive examination to confirm or establish a diagnosis.
From Nihilism to Opportunity: The Educational Potential of the Electronic Health Record.

An admission at 2:00 am, a stack of paper charts to shuffle through (at least they were not lost), illegible handwriting to decipher, a trip to radiology to try and find the chest film and hoping it was not at the back of the roller board, a critical laboratory test that had to be repeated because
Estimating Stochastic Poisson Intensities Using Deep Latent Models

We present methodology for estimating the stochastic intensity of a doubly stochastic Poisson process. Statistical and theoretical analyses of traffic traces show that these processes are appropriate models of high intensity traffic arriving at an array of service systems. The statistical estimation of the underlying latent stochastic intensity process driving the traffic model involves a rather complicated nonlinear filtering problem. We develop a novel simulation methodology, using deep neural networks to approximate the path measures induced by the stochastic intensity process, for solving this nonlinear filtering problem. Our simulation studies demonstrate that the method is quite accurate on both in-sample estimation and on an out-of-sample performance prediction task for an infinite server queue.
A Mechanized Pediatric Elbow Joint Powered by a De-Based Artificial Skeletal Muscle*

To increase the acceptability of exoskeletons, there is growing attention toward finding an alternative soft actuator that can safely perform at close vicinity of the human body. In this study, we investigated the capability of the dielectric elastomer actuators (DEAs), for muscle-like actuation of rehabilitation robots. First, an artificial skeletal muscle was configured using commercially available stacked DEAs arranged in a 3x4 array of three parallel fibers consisting of four DEAs connected in series. The shortening and force generation capabilities of this artificial muscle were then measured. An alternate 3x5 version of this muscle was mounted on the forearm of an upper extremity phantom model to actuate its elbow joint. The actuation capability of this muscle was then tested under various tensile loads, 1 N to 4 N, placed at the center of mass of the forearm+hand of the phantom model. The active range of motion and angular velocity of the phantom model’s tip of the hand were measured using a motion capture system. The 3×4 artificial muscle produced 30.47 N of force and 5.3 mm of maximum shortening. The 3x5 artificial muscle was capable of actuating the elbow flexion 19.5o with 16.2 o/s angular velocity in the sagittal plane, under a 1 N tensile load. The active range of motion was substantially reduced as the tensile loads increased, which limits the capability of these muscles in the current upper extremity exoskeleton design.
Exploring the composition, phase separation and structure of AgFe alloys for magneto-optical applications

Abstract Bimetallic alloys with large discrepancies in atomic radii and crystal structure typically yield systems that are highly immiscible, even at high temperatures. The AgxFe1−x binary system has limited solid and liquid solubility and thus phase separated Ag + Fe alloys should result. Furthermore, Ag has interesting plasmonic properties and Fe is a strong ferromagnet, thus magneto-plasmonic nanoparticles/films should result due to their phase separation. We have leveraged a combinatorial sputter deposition to synthesize thin films with a large AgxFe1−x (0.19
Memory integration into visual perception through infancy, childhood, and adulthood.

We compared the influence of prior knowledge on visual perception in infants, children, and adults in order to explore the developmental trajectory by which prior knowledge is integrated with new sensory input. Using an identical task across age groups, we tested how participants' accumulated experience affected their ability to judge the relative saturation levels within a pair of sequentially-presented stimuli. We found that infants and children, relative to adults, showed greater influence of the current observation and reduced influence of memory in their perception. In fact, infants and children outperformed adults in discriminating between different levels of saturation, and their performance was less biased by previously-experienced exemplars. Thus, the development of perceptual integration of memory leads to less precise discrimination in the moment, but allows observers to make use of their prior experience in interpreting a complex sensory environment.
Missing power: Nostalgia and disillusionment among Southern California water engineers:

California’s sprawling network of aqueducts and dams is often cited as the embodiment of a high-modernist approach to resource management. But while once widely celebrated, in recent decades this i...
Effect of Mixing Enhancement Devices on Turbulence in Separate Flow Nozzles

This paper presents the effects of several mixing enhancement devices on turbulence in jet nozzles. The topics include: 1) The Advanced Subsonic Technology (AST) Program; 2) Test Programs SFNT97 and SFNT2K; 3) Facility; 4) Mixing Enhancement Nozzles; 5) IR reductions; 6) Schlieren of Chevrons; and 7) Aeroacoustics of Enhanced Mixing-Paradigm. This paper is presented in viewgraph form.
Biochemical characterization of the yeast vacuolar H(+)-ATPase.

Abstract The yeast vacuolar proton-translocating ATPase was isolated by two different methods. A previously reported purification of the enzyme (Uchida, E., Ohsumi, Y., and Anraku, Y. (1985) J. Biol. Chem. 260, 1090-1095) was repeated. This procedure consisted of isolation of vacuoles, solubilization with the zwitterionic detergent ZW3-14, and glycerol gradient centrifugation of the solubilized vacuoles. The fraction with the highest specific activity (11 mumol of ATP hydrolyzed mg-1 min-1) included eight polypeptides of apparent molecular masses of 100, 69, 60, 42, 36, 32, 27, and 17 kDa, suggesting that the enzyme may be more complex than the three-subunit composition proposed from the original purification. The 69-kDa polypeptide was recognized by antisera against the catalytic subunits of two other vacuolar ATPases and labeled with the ATP analog 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole, indicating that it contains all or part of the catalytic site. A monoclonal antibody was prepared against this subunit. Under nondenaturing conditions, the antibody immunoprecipitated eight polypeptides, of the same molecular masses as those seen in the glycerol gradient fraction, from solubilized vacuolar vesicles. All eight of these polypeptides are therefore good candidates for being genuine subunits of the enzyme. The structure and function of the yeast vacuolar H+-ATPase were further characterized by examining the inhibition of ATPase activity by KNO3. In the presence of 5 mM MgATP, 100 mM KNO3 inhibited 71% of the ATPase activity of vacuolar vesicles, and the 69- and 60-kDa subunits (and possibly the 42-kDa subunit) were removed from the vacuolar membrane to a similar extent. At concentrations of less than 200 mM KNO3, the stripping of the ATPase subunits and the inhibition of ATPase activity were dependent on the presence of MgATP, suggesting that this is a conformation-specific disassembly of the enzyme. The yeast vacuolar H+-ATPase is a multisubunit enzyme, consisting of a combination of peripheral and integral membrane subunits. Its structure and subunit composition are very similar to other vacuolar ATPase, and it shares some characteristics with the F1F0-ATPases.
Dual Systems of Family Law: A Comment

M UCH LEGAL REASONING seems to follow the model of a litigious, adversary context. The method has its proven merits as an intellectual tool facilitating discussion, even though at times issues are dichotomized and differences of opinion unduly stressed. While adopting this method, I shall try to provide a synthesis. The article by Professors Thomas P. Lewis and Robert J. Levy, Family Law and Welfare Policies-The Case for "Dual Systems," published in this symposium,' is difficult to evaluate for a reason that illustrates a recurrent problem of legal scholarship. The article was prompted by Professor Jacobus tenBroek's major effort, California's Dual System of Family Law: Its Origin, Development, and Present Status, which appeared in three installments in the Stanford Law Review.2 As an inevitable consequence the comments of Lewis and Levy cannot be fully appreciated unless tenBroek's work is closely read, followed by a second reading of the Lewis and Levy paper. Most readers cannot be expected to engage in this circular process. Ideally authors of critical essays should assume that only rarely will the original source be consulted in its totality. Perhaps an individual page reference will be checked. Even this may not be done by the reader, and the argumentation and comments of the critic are likely to be taken at face value. The critic is vested with a factual power over the subject matter, a situation that may inadvertently result in injustice. This imposes a responsibility on him, related to what may loosely be called "academic due process," to present his views in a fashion that incorporates the reasoning contained in the original source. Since incorporation by mere reference is not satisfactory, the original reasoning must somehow be made part of the critical essay, a very difficult task requiring close identifications. If the approach of the critic is essentially negative, he may face a contradictory, perhaps an impossible task. This is his dilemma. Professors Lewis and Levy have made a diligent effort to do justice to Professor tenBroek's work. In an effort to enunciate his thoughts, they have inserted large quotes.3 Perhaps even this is not quite satisfactory.
Placing Children in Context: Parents, Foster Care, and Poverty

This chapter advocates a returned focus on children as members of an existing family within a larger community as the means for grounding the child welfare system. It begins with an overview of federal involvement in foster care, starting with the 1909 White House Conference on Dependent Care, to show the historical relationship between aid to children and in-home care. The chapter discusses the relationship between poverty and the abuse and neglect system. It provides a fuller examination of the implications of the 1997 changes in abuse and neglect policy for poor children. The chapter also concludes by suggesting alternative approaches to the current abuse and neglect system that will keep children safe in their families, exploring many means for dissolving the perceived dichotomy: protecting children and preserving families. Children and their parents need not be seen as autonomous and potentially conflicting rights-bearers in order to respect interests of both in their shared relationship, and to protect them from harm.
Spiro K. Antiochos Receives 2013 John Adam Fleming Medal: Response

Thank you, Jim Klimchuk, for this far too generous citation, and thank you very much, my AGU colleagues, for honoring me with the Fleming Medal. When I consider the list of excellent scientists who have been awarded the Fleming Medal, I am humbled that you have included me in their company. I am especially proud that this award is from AGU because only later in my career did I change my science focus and join AGU. This was the best professional decision I have ever made. As a result, I have met many wonderful colleagues. I've always loved doing research, but my colleagues in AGU have made it so much more enjoyable. Also, moving to AGU gave me the opportunity to participate in truly exciting science. My present position is that of senior scientist for space weather at NASA Goddard. It is interesting to note that the field of space weather science did not even exist when I started my career. I was very fortunate to be part of the beginning of a new field and, as a result, to be able to participate in the explosive advances of space weather science over the past 2 decades.
Skeletal muscle myotubes in severe obesity exhibit altered ubiquitin-proteasome and autophagic/lysosomal proteolytic flux.

Objective Whole-body protein metabolism is dysregulated with obesity. The goal of the study was to determine whether activity and expression of major protein degradation pathways are compromised specifically in human skeletal muscle with obesity. Methods Primary human skeletal muscle (HSkM) cell cultures were utilized since cellular mechanisms can be studied absent of hormones and contractile activity that could independently influence metabolism. HSkM from 10 lean women (BMI ≤ 26.0 kg/m2) and 8 women with severe obesity (BMI ≥ 39.0) were examined basally and when stimulated to atrophy (serum and amino acid starvation). Results HSkM from obese donors had a lower proportion of type I myosin heavy chain and slower flux through the autophagic/lysosomal pathway. During starvation, flux through the ubiquitin-proteasome system diverged according to obesity status, with a decrease in lean subjects and an increase in HSkM from subjects with obesity. HSkM in obesity also displayed elevated proteasome activity despite no difference in proteasome content. Atrophy-related gene expression and myotube area were similar in myotubes derived from individuals with and without obesity under basal and starved conditions. Conclusions Our data indicate that muscle cells in lean individuals and in those with severe obesity have innate differences in management of protein degradation, which may explain their metabolic differences.
Improved array self calibration with large sensor position errors for closely spaced sources

Self-calibration algorithms estimate both source directions-of-arrival (DOAs) and perturbed array response vector parameters, such as sensor locations. Calibration errors are usually assumed to be small and a first order approximation to the perturbed array response vector is often used to simplify the estimation procedure. We improve on a previously presented technique that eliminates the small error assumption. The improved technique has better performance for closely spaced sources for both small and large calibration errors.
Is continuous monitoring the answer to incidentally observed fetal heart rate decelerations

Objective. We examined the interventions and outcomes of pre-term patients with an incidentally identified fetal heart rate (FHR) deceleration and otherwise reassuring FHR pattern admitted for continuous FHR monitoring (FM).Methods. A case series was compiled of patients with at least 36 h of continuous FM secondary to a FHR deceleration. Data on demographics, delivery and perinatal outcomes, medical and obstetric history were extracted from medical records. FHR tracings were reviewed for quantity and type of decelerations.Results. Ninety-seven patients met inclusion criteria. The median length of time monitored was 4 days with a median of four decelerations a day. Fifty-eight percent of patients were delivered during the same admission primarily for a non-reassuring FHR tracing with a mean delivery gestational age of 33.7 weeks. Patients with resolution of their decelerations delivered at a mean gestational age of 35.8 weeks. No patients with a resolution of decelerations presented later with an intraute...
Efficiency calibration of the first multilayer-coated holographic ion-etched flight grating for a sounding rocket high-resolution spectrometer

We have fabricated the four flight gratings for a sounding rocket high-resolution spectrometer using a holographic ion-etching technique. The gratings are spherical (4000-mm radius of curvature), large (160 mm × 90 mm), and have a laminar groove profile of high density (3600 grooves/mm). They have been coated with a high-reflectance multilayer of Mo/Si. Using an atomic force microscope, we examined the surface characteristics of the first grating before and after multilayer coating. The average roughness is approximately 3 A rms after coating. Using synchrotron radiation, we completed an efficiency calibration map over the wavelength range 225–245 A. At an angle of incidence of 5° and a wavelength of 234 A, the average efficiency in the first inside order is 10.4 ± 0.5%, and the derived groove efficiency is 34.8 ± 1.6%. These values exceed all previously published results for a high-density grating.
Targeting platelet aggregation: CD39 gene transfer augments nucleoside triphosphate diphosphohydrolase activity in injured rabbit arteries.

Abstract Background. CD39, the major endothelial nucleoside triphosphate diphosphohydrolase (NTPDase), plays an important role in local thromboregulation. We hypothesized that balloon injury (BI) leads to an acute reduction in arterial NTPDase activity that could be restored by a targeted gene delivery strategy. Methods. Recombinant adenoviral vectors containing human CD39 (Ad-CD39) or β-galactosidase (Ad-LacZ) were used. Endothelial (ECs) and smooth muscle cells (SMCs) were infected in vitro and NTPDase activity measured. New Zealand white rabbits (N = 28) underwent bilateral iliofemoral artery balloon injury, followed by incubation with Ad-CD39, Ad-LacZ, or vehicle. Explanted vessels were analyzed for NTPDase activity and localization of CD39 expression by immunohistochemistry. Deposition of fluorescent-labeled platelets was studied 3 days after injury and vector treatment. Results. In vitro, Ad-CD39 infection resulted in a greater than 40-fold increase in adenosine diphosphatase activity in ECs and a 3-fold increase in SMCs. In vivo, CD39 transgene expression localized to the luminal aspect of Ad-CD39-treated vessels. BI resulted in an acute reduction in vessel wall NTPDase activity (P