cssi/SciSciGPT-SciSciNet huggingface dataset:
Electronic physiologic and subjective data acquisition in home-dwelling heart failure patients: An assessment of patient use and perception of usability.

Abstract Background The current approach to the outpatient management of heart failure involves patients recollecting what has happened to them since their last clinic visit. But patients' recollection of their symptoms may not be sufficiently accurate to optimally manage their disease. Most of what is known about heart failure is related to patients' diurnal symptoms and activities. Some mobile electronic technologies can operate continuously to collect data from the time patients go to bed until they get up in the morning. We were therefore interested to evaluate if patients would use a system of selected patient-facing devices to collect physiologic and subjective state data in and around the patients' period of sleep, and if there were differences in device use and perceptions of usability at the device level Methods This descriptive observational study of home-dwelling patients with heart failure, between 21 and 90 years of age, enrolled in an outpatient heart failure clinic was conducted between December 2014 and June 2015. Patients received five devices, namely, body weight scale, blood pressure device, an iPad-based subjective states assessment, pulse oximeter, and actigraph, to collect their physiologic (body weight, blood pressure, heart rate, blood oxygen saturation, and physical activity) and subjective state data (symptoms and subjective states) at home for the next six consecutive nights. Use was defined as the ratio of observed use over expected use, where 1.0 is observed equals expected. Usability was determined by the overall System Usability Scale score. Results Participants were 39 clinical heart failure patients, mean age 68.1 (SD, 12.3), 72% male, 62% African American. The ratio of observed over expected use for the body weight scale, blood pressure device, iPad application, pulse oximeter and actigraph was 0.8, 1.0, 1.1, 0.9, and 1.9, respectively. The mean overall System Usability Scale score for each device were 84.5, 89.7, 85.7, 87.6, and 85.2, respectively. Conclusions Patients were able to use all of the devices and they rated the usability of all the devices higher than expected. Our study provides support for at-home patient-collected physiologic and subjective state data. To our knowledge, this is the first study to assess the use and usability of electronic objective and subjective data collection devices in heart failure patients' homes overnight.
Molecularly based criteria for shear banding in transient flow of entangled polymeric fluids

Dissipative particle dynamics simulations of polymeric melts in a start-up of shear flow as a function of ramp time to its steady state value is studied. Herein, we report the molecular findings showing the effect of ramp time on the formation of shear banded structures and chain relaxation behavior. Specifically, it is shown that shear banding emerges at a rapid start-up; however, homogeneous shear prevails when the deformation rate ramp time is sufficiently slow. This finding is in full consistency with prior continuum level linear stability analysis of shear banding in start-up of shear flows as well as experimental observations of entangled DNA and polymer solutions. Further, it has been revealed that the ratio of the longest chain orientation relaxation time to that of the time for the imposed deformation rate to reach its steady state value plays a central role in determining whether local strain inhomogeneities that lead to the formation of shear banded flow structures are created. In addition, we have shown that the gradient of the number of entanglements along the velocity gradient direction should reach a critical value for the creation of localized strain inhomogeneity. Moreover, the relation between the local process leading to shear banded flows and the relaxation mechanism of the chain is discussed. Overall, a molecular picture for the interrelation between the longest chain orientation and stress relaxation time, local inhomogeneities, and shear banding has been proposed and corroborated with extensive analysis.
Learning from Demonstrations Through the Use of Non-rigid Registration

We consider the problem of teaching robots by demonstration how to perform manipulation tasks, in which the geometry (including size, shape, and pose) of the relevant objects varies from trial to trial. We present a method, which we call trajectory transfer, for adapting a demonstrated trajectory from the geometry at training time to the geometry at test time. Trajectory transfer is based on non-rigid registration, which computes a smooth transformation from the training scene onto the testing scene. We then show how to perform a multi-step task by repeatedly looking up the nearest demonstration and then applying trajectory transfer. As our main experimental validation, we enable a PR2 robot to autonomously tie five different types of knots in rope.
Berkshire Beyond Buffett: The Enduring Value of Values

Berkshire Hathaway, the $300 billion conglomerate that Warren Buffett built, is among the world's largest and most famous corporations. Yet, for all its power and celebrity, few people understand Berkshire, and many assume it cannot survive without Buffett. This book proves them wrong. In a comprehensive portrait of the corporate culture that unites Berkshire's subsidiaries, Lawrence A. Cunningham unearths the traits that assure the conglomerate's continued prosperity. Riveting stories of each subsidiary's origins, triumphs, and journey to Berkshire reveal how managers generate economic value from intangibles like thrift, integrity, entrepreneurship, autonomy, and a sense of permanence. Rich with lessons for those wishing to profit from the Berkshire model, this engaging book is a valuable read for entrepreneurs, business owners, managers, family business members, and investors, and it is an important resource for scholars of corporate stewardship. General readers will enjoy learning how an iconoclastic businessman transformed a struggling textile company into a corporate legacy.
Sintering of LiF Fluxed SrTiO3

The densification of SrTiO3 using LiF as a sintering aid was investigated. In the temperature range 700 to 900°C, the sintering kinetics of ½ to 2w% LiF doped SrTiO3 appears to be controlled by liquid phase sintering. Densification was found to be a function of cation stoichiometry and temperature as well as LiF content. For example, 2w% LiF additions with 4 hour sintering at 910°C, specimens of composition Sr1.03TiO3 achieved a density of 96% TD, whereas, for the same treatment of those of compositions Sr98 TiO3 achieved only 75% TD. The interaction between LiF and SrTiO3 is very complex and both X-ray diffraction and weight loss measurements suggest that it might involve the formation of Li and F containing compounds.
Visibility-based distributed deployment of robotic teams in polyhedral terrains

Due to recent technological advances, robotic swarms are currently a largeinterest for surveillance, disaster response, and exploration. In order to solve thisproblem, we develop distributed deployment strategies for 1.5D and 2.5D polyhedralterrains that are inuenced by research in computational geometry, graph theory,and distributed controls. Similarly to the guarding of art gallery problems, we guardan environment through the collective visibility of a team of robots. We considerscenarios where the robots are constrained to moving on the ground in 1.5D and 2.5Dpolyhedral terrains. Our objective is to determine strategies for deploying robots in polyhedral terrains that guarantees complete visibility of the terrain.In the 1.5D polyhedral terrain, we determine a set of locations, that guaranteesthat the terrain is completely visible when occupied. We then develop a setof instructions that each robot distributively executes in order to occupy the set oflocations. Finally, we nd a closed-form expression for the time required for the 1.5Ddeployment strategy to complete that scales with the size of the terrain.In the 2.5D polyhedral terrain, we develop a set of instructions for the robots tofollow that collectively explores, colors, and guards the polyhedral terrain. We denerules for the agents to label certain locations that must be occupied in order to achievecomplete visibility, inspired by coloring of planar graphs. Finally, we characterize thebest and worse time complexity for the algorithm
Chylothorax following posterior cervical decompression – A rare & unusual complication

Background: A chylothorax is a rare cause of pleural effusion resulting in the accumulation of chyle in the pleural space due to disruption or obstruction of the thoracic duct or its tributaries. We present an extremely unusual cause for a chylothorax following posterior cervical decompression. Case Report: A 27 year-old-female with a history of persistent neck pain presented with acute onset lower limb paralysis, retention and paraesthesia. Urgent MRI demonstrated cord compression at the level of C7 and she was transferred to a tertiary centre and underwent posterior cervical decompression. Four weeks post-operatively she presented with worsening dyspnoea and a chest radiograph demonstrated a moderate right-sided effusion. Intercostal chest drain was inserted and drained greasy purulent fluid initially thought to represent an empyema, however her inflammatory markers remained within normal parameters. Furthermore pleural glucose was 4.5mmol/L. As a result of the greasy appearance further analysis revealed elevated triglycerides at 10.4mmol/L. A CT neck and thorax was unremarkable other than the effusion. She was commenced upon a fat-free diet and the drain output significantly improved from >2L/day to 300-600mls/day. In addition she was referred for consideration of thoracic duct ligation. Discussion: Chylothorax is a rare complication recognised following anterior spinal surgery, however is reported in only a handful of cases of following a posterior approach. This therefore highlights the need to consider chylothorax in any patient presenting with a pleural effusion following spinal surgery and need for specific analysis of fluid for triglycerides and chylomicrons to confirm or refute a diagnosis.
Three-dimensional volumetric assessment of coronary artery calcification in patients with stable coronary artery disease by OCT

AIMS There is a lack of a reliable technique to quantify coronary artery calcification (CAC). Hence, we used optical coherence tomography (OCT) to quantitate three-dimensional CAC volume to examine its association with plaque characteristics. METHODS AND RESULTS A total of 250 patients with stable angina undergoing OCT imaging before PCI were included. CAC volume was calculated from every frame of the culprit lesion and divided into tertiles (low, intermediate and high). Quantitative calcium characteristics were assessed in 107 patients who underwent both OCT and IVUS. Increase in CAC volume was associated with reduced lipid volume index, lipid length and number of lipid plaques. Diabetes and LDL cholesterol predicted less coronary calcification whereas age and prior MI predicted increased CAC after adjusting for all clinical factors. Lipid volume index (ρ=-0.001 [-0.003 to -0.00003]; p=0.04) and mean calcium depth (ρ=-0.02 [-0.02 to -0.01]; p=0.000) were inversely related to CAC volume after adjusting for all OCT characteristics, whereas cap thickness increased with increase in CAC volume (ρ=0.01 [0.002-0.03]; p=0.02) only in unadjusted analysis. Regression analysis demonstrated a significant correlation between calcium length (ρ=0.83; p<0.001) and calcium arc (ρ=0.86; p<0.001) measured by IVUS and OCT. CONCLUSIONS Target lesions with high CAC volume are characterised by reduced plaque lipid content and calcium closer to the luminal border. Fibrous cap thickness increased with increase in calcium volume.
Dissociable Substrates Underlie the Production of Abstract and Concrete Nouns (P5.193)

OBJECTIVE: Examine the production of abstract and concrete nouns in patients with neurodegenerative disease using the Cookie Theft picture description. BACKGROUND: In a previous study, we observed a double dissociation in abstract and concrete word knowledge between the semantic variant of primary progressive aphasia (svPPA) and the behavioral variant of frontotemporal dementia (bvFTD). Compared to age-matched healthy controls, bvFTD patients were significantly more impaired for abstract nouns than for concrete nouns, and their poor abstract knowledge related to atrophy in the inferior frontal gyrus. In contrast, svPPA patients were significantly more impaired for concrete nouns compared to abstract nouns, associated with atrophy to the left temporal lobe. In this study, we test if the same neural regions that are critical for effective abstract and concrete word comprehension also play a role in the production of abstract and concrete words. DESIGN/METHODS: We assess the production of abstract and concrete nouns in 42 bvFTD and 21 svPPA patients using an oral description of the Cookie Theft picture. Patients met published diagnostic criteria, and concreteness or abstractness of each word was calculated using Brysbaert concreteness ratings (Brysbaert, Warriner & Kuperman, 2014). RESULTS: We observe the same double dissociation pattern during production as we previously saw with comprehension: bvFTD patients produce a smaller proportion of abstract nouns than svPPA patients. Moreover, the average concreteness rating for all nouns produced by svPPA patients is lower than for bvFTD. Regression analyses demonstrated that decreased abstract noun production in bvFTD relates to atrophy in the left inferior frontal gyrus. In addition, decreased concrete noun production in svPPA relates to atrophy in the left inferior temporal lobe. CONCLUSIONS: These results corroborate the finding that abstract and concrete nouns are represented in partially dissociable anatomic regions. Disclosure: Dr. Cousins has nothing to disclose. Dr. Ash has nothing to disclose. Dr. Grossman has received personal compensation for activities with GE Whitney Symposium as an invited speaker. Dr. Grossman has received personal compensation in an editorial capacity for Neurology.
Book Review: Aging in Rural Places Policies, Programs, and Professional Practice

Since this is a book review, I do not know if an abstract is warranted. If so, please let me know, and I can provide additional information. Thank you for your consideration.
Reproductive performance and herd exit dynamics of lactating dairy cows managed for first service with the Presynch-Ovsynch or Double-Ovsynch protocol and different duration of the voluntary waiting period

The objective of this experiment was to evaluate the reproductive performance and herd exit dynamics of dairy cows managed for first service with programs varying in method of submission for insemination and voluntary waiting period (VWP) duration. Holstein cows from a commercial farm in New York were randomly allocated to receive timed artificial insemination (TAI) after the Double-Ovsynch protocol (GnRH, 7 d later PGF2α, 3 d later GnRH, 7 d later GnRH, 7 d later PGF2α, 56 h later GnRH, and 16 to 18 h later TAI) at 60 ± 3 d in milk (DIM) (DO60 = 458), TAI after Double-Ovsynch at 88 ± 3 DIM (DO88 = 462), or a combination of AI at detected estrus (starting at 50 ± 3 d in milk) and TAI with the Presynch-Ovsynch protocol (PGF2α, 14 d later PGF2α, 12 d later GnRH, 7 d later PGF2α, 56 h later GnRH, and 16 to 18 h later TAI; PSOv = 450). Subsequent artificial insemination (AI) services were conducted at detected estrus or the Ovsynch protocol (32 ± 3 d after AI GnRH, 7 d later PGF2α, 56 h later GnRH, and 16 to 18 h later TAI) for cows not reinseminated at detected estrus. In a subgroup of cows, cyclicity (based on progesterone concentration), uterine health (vaginal discharge and uterine cytology), and BCS were evaluated at baseline (DO60 and DO88 = 33 ± 3 DIM; PSOv = 34 ± 3 DIM), beginning of the synchronization protocol (DO60 = 33 ± 3 DIM; DO88 = 61 ± 3 DIM; PSOv = 34 ± 3 DIM), and within -5 (PSOv) or -10 d (DO) of the VWP end (DO60 = 50 ± 3 DIM; DO88 = 78 ± 3 DIM; PSOv = 45 ± 3 DIM). Effects of treatments were assessed with multivariable statistical methods relevant for each outcome variable. Cows in the DO88 treatment had delayed time to pregnancy during lactation (DO60 vs. DO88 hazard ratio = 1.53, 95% confidence interval = 1.32 to 1.78; PSOv vs. DO88 hazard ratio = 1.37, 95% confidence interval = 1.19 to 1.61) and, within multiparous cows, the DO88 and PSOv treatments had greater risk of leaving the herd than cows in the DO60 treatment (DO88 vs. DO60 hazard ratio = 1.49, 95% confidence interval = 1.11 to 2.00; PSOv vs. DO60 hazard ratio = 1.39, 95% confidence interval = 1.03 to 1.85). Cows in the DO88 treatment had improved uterine health, greater BCS, and reduced incidence of anovulation than cows in DO60 and PSOv; however, overall pregnancy per AI 39 ± 3 d after AI was similar for the 3 treatment groups. In summary, reproductive management strategies that led to similar average DIM to the first service (∼60 d) through a combination of AI at estrus with TAI (PSOv) or all TAI (DO60) resulted in reduced time to pregnancy after calving when compared with an all TAI program (DO88) with a VWP of 88 d. Within the multiparous cow group, those that received all TAI with a VWP duration of 60 d were less likely to leave the herd than cows in the other treatments.
Relationships to Aquatic Animal Production

Relationships between pond soils or sediment and aquatic animal production are mostly indirect. Soil affects nutrient concentrations in the water, which, in turn, influence plant productivity. In extensive pond culture, aquatic animal production is the culmination of the food web that has its base in plant production (Fig. 5.1). Plants also are the primary source of dissolved oxygen in most ponds, but plant respiration and plant residues also exert an oxygen demand. Pond soils can be a source of toxic metabolites that can enter the water and harm aquatic animals. Suspended soil particles reduce light transmission through the water and adversely impact plant productivity and photosynthetic oxygen production. Sedimentation can smother aquatic organisms and destroy fish nesting sites. Suboptimal soil texture and pH may limit production of benthos, which is the food of many aquatic animals.
Exogenous Hormone Use and Endometrial Cancer in U.S. Black Women

Background: Although endometrial cancer risk differs among white and black women, few data on its associations with exogenous hormone use in the latter group are available. Studies have reported lower endometrial cancer risk among users of oral contraceptives (OCs), but higher risk among users of estrogen-only female menopausal hormones (FMHs). Evidence for the risk among estrogen plus progestin FMHs users is equivocal. Methods: We followed 47,555 Black Women9s Health Study participants with an intact uterus from 1995 through 2013. Data on exogenous hormone use, covariates, and endometrial cancer were obtained biennially. Self-reported incident cases of endometrial cancer were confirmed by medical records or cancer registries whenever possible. We estimated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression. Results: We observed 300 endometrial cancer cases during 689,546 person-years of follow-up. Compared with never use, ≥10 years9 duration of OC use was associated with lower risk (multivariable IRR = 0.45, 95% CI, 0.27–0.74), but risk was higher among current users of estrogen-only (IRR = 3.78, 95% CI, 1.69–8.43) and estrogen plus progestin FMH (IRR = 1.55, 95% CI, 0.78–3.11). Risk was not increased among former users of estrogen-only (IRR = 0.87, 95% CI, 0.44–1.72) or estrogen plus progestin FMH (IRR = 0.63, 95% CI, 0.36–1.09). Conclusions: Current use of estrogen-only and estrogen plus progestin FMH was associated with increased risk of endometrial cancer. Risk appeared lower among former users of estrogen plus progestin FMH. Long-term OC use was associated with reduced risk. Impact: Our results are generally consistent with those among white women. Cancer Epidemiol Biomarkers Prev; 27(5); 558–65. ©2018 AACR .
Estimation of the thermal conductivity of composites

In this article we introduce the concept of homogenization for the approximation of the effective thermal conductivity of composites. A simple algebraic approximation method is proposed and shown to yield an upper bound for the effective conductivity. Numerical results are given for uni-directional carbon-carbon composites which demonstrate the validity of the approach.
The Religious Career of Vairocanavajra – A Twelfth-Century Indian Buddhist Master from Daksina Kośala

L'A. presente ici la traduction complete de la biographie religieuse sans precedent de Vairocanavajra (maitre bouddhiste indien du XIe siecle) et disserte sur ses deux sections distinctes. Puis il expose ce que l'on peut glaner d'autres sources disponibles concernant son role de professeur au Tibet et ses efforts de traducteur. Pour finir, grâce a la comparaison avec une edition des textes tibetains de cette biographie, il montre comment 'Gos Lo tsāba Gzhon nu dpal (1392-1481) a adapte la biographie de Bla ma Zhang dans son important recueil de biographies religieuses, The Blue Annals.
ENSO, Atlantic Climate Variability, and the Walker and Hadley Circulations

This chapter describes and discusses the Walker and Hadley circulations associated with the El Nino/Southern Oscillation (ENSO), the Atlantic “Nino”, the tropical Atlantic meridional gradient variability, the Western Hemisphere warm pool (WHWP), and the North Atlantic Oscillation (NAO). During the warm phase of ENSO, the Pacific Walker circulation, the western Pacific Hadley circulation, and the Atlantic Hadley circulation are observed to be weakened, whereas the eastern Pacific Hadley circulation is strengthened. During the peak phase of the Atlantic Nino, the Atlantic Walker circulation weakens and extends eastward and the Atlantic Hadley circulation strengthens. The tropical Atlantic meridional gradient variability corresponds to a meridional circulation in which the air rises over the warm sea surface temperature (SST) anomaly region, flows toward the cold SST anomaly region aloft, sinks in the cold SST anomaly region, then crosses the equator toward the warm SST region in the lower troposphere. During periods when the NAO index is high, the atmospheric Ferrei and Hadley circulations are strengthened, consistent with surface westerly and easterly wind anomalies in the North Atlantic and in the middle to tropical Atlantic, respectively. The chapter also discusses a tropo-spheric bridge by the Walker/Hadley circulation that links the Pacific El Nino with warming of the tropical North Atlantic (TNA) and the WHWP.
Imaging Techniques Other than Mammography for the Detection and Diagnosis of Breast Cancer

Due to its superficial location and nonosseous content, the breast can be examined by a larger selection of imaging techniques than almost any other organ in the body. This discussion involves the current roles of ultrasound computed tomography (CT) scanning, transillumination, and magnetic resonance imaging in evaluating the breast for the presence of cancer.
The Wonderful Wizard of Marketing: L. Frank Baum as Producer and Promoter

This chapter examines L. Frank Baum’s transformation of Oz from story to brand in the context of late-nineteenth and early-twentieth-century shifts in markets and consumption patterns. We discuss Baum’s long career in sales, his contributions to the fledgling marketing profession, and his use of state-of-the-art marketing strategies and technologies to sustain Oz. For 20 years, Baum was the brand manager of Oz, until his death in 1919. We conclude with an analysis of what Oz offered its original consumers, speculating how—given the historical and cultural circumstances in which it was first produced and consumed—Oz achieved such unprecedented success during Baum’s lifetime.
Implantable Biofuel Cells Operating In Vivo—Potential Power Sources for Bioelectronic Devices

Implantable devices harvesting energy from biological sources and based on electrochemical transducers are currently receiving high attention. The energy collected from the body can be utilized to activate various microelectronic devices. This article is an overview of the recent research activity in the area of enzyme-based biofuel cells implanted in biological tissue and operating in vivo. The electrical power extracted from the biological sources presents use for activating microelectronic devices for biomedical applications. While some microelectronic devices can work within a fairly broad range of electrical operating conditions, others, such as pacemakers, require precise voltage levels and voltage regulation for correct operation. Thus, certain classes of electronic devices powered by implantable energy sources will require careful attention not only to energy and power considerations, but also to voltage scaling and regulation. This requires appropriate interfacing between the energy harvesting device and the energy consuming microelectronic device. The paper focuses on the problems in the present technology as well as offers their potential solutions. Lastly, perspectives and future applications of the implanted biofuel cells are also discussed. The considered examples include a pacemaker and a wireless signal transfer system powered by a implantable biofuel cell extracting electrical energy from biological sources.
How Do you Make Sociology out of Data? Robert K. Merton’s Course in Theorizing (Soc 213–214)

How do you use theory effectively in empirical research; and how can you learn to do this in a practical way? This is a crucial question to answer for any sociologist; and it is addressed in this article by presenting and analyzing the contents of a course on theorizing that Robert K. Merton taught during 1942–1954 at Columbia University. In teaching this class Merton was probably the first sociologist to single out the topic of theorizing as its own distinct area of knowledge, study and teaching. He also pioneered a new kind of theorizing in sociology, centered around the use of systematic empirical data. In presenting Merton’s arguments, special attention has been paid to the tools for theorizing that he devised, such as respecification, reconceptualization and levels analysis. Next to nothing of this material is discussed in Merton’s published writings. It is suggested that underlying Merton’s work in theory is the idea that it is only through theory that data can become sociology.
Pulmonary mechanics measurements by respiratory inductive plethysmography and esophageal manometry: Methodology for infants on non-invasive respiratory support.

Background Infants are commonly supported with non-invasive ventilation (NIV) such as nasal CPAP and high flow nasal cannula (HFNC). These modes utilize a nasal/oral interface precluding use of a traditional airway flow sensor, such as a pneumotachometer (PNT), needed for pulmonary mechanics (PM) measurements. Respiratory Inductive Plethysmography (RIP), when properly calibrated, records tidal volume non-invasively from chest wall movements. Our aim was to integrate RIP into an existing neonatal pulmonary function testing system to measure PM in infants on NIV and to compare measurements of dynamic lung compliance (CL) and resistance (RL) using RIP with those obtained using a PNT. Design/methods RIP ribcage (RC) and abdominal (ABD) signals were recorded simultaneously with the flow signal from a PNT; transpulmonary pressure was estimated using an esophageal catheter. Two calibration algorithms were applied to obtain RC and ABD scaling factors. Results Forty PM measurements were performed on 25 infants (GA 31.5±2.9 weeks; birth weight 1598±510 g; median age 7 days). Correlation coefficients for RIP- vs. PNT-based PM were r2 = 0.987 for CL and r2 = 0.997 for RL. From Bland-Altman analysis, the mean bias (±95% CI) between RIP and PNT methods was -0.004±0.021 ml/cmH2O/kg for CL and 0.7±2.9 cmH2O/(L/sec) for RL. The upper, lower limits of agreement (±95% CI) were 0.128±0.037, -0.135±0.037 ml/cmH2O/kg for CL and 18.6±5.1, -17.2±5.1 cmH2O/(L/sec) for RL. Conclusion Properly calibrated RIP may be a useful tool with sufficient diagnostic accuracy for PM measurements without need for a nasal/oral airflow sensor in infants receiving NIV.
Host Transcriptomics as a Tool to Identify Diagnostic and Mechanistic Immune Signatures of Tuberculosis

Tuberculosis (TB) is a major infectious disease worldwide, and is associated with several challenges for control and eradication. First, more accurate diagnostic tools that better represent the spectrum of infection states are required; in particular, identify the latent TB infected individuals with high risk of developing active TB. Second, we need to better understand, from a mechanistic point of view, why the immune system is unsuccessful in some cases for control and elimination of the pathogen. Host transcriptomics is a powerful approach to identify both diagnostic and mechanistic immune signatures of diseases. We have recently reported that optimal study design for these two purposes should be guided by different sets of criteria. Here, based on already published transcriptomics signatures of tuberculosis, we further develop these guidelines and identify additional factors to consider for obtaining diagnostic vs. mechanistic signatures in terms of cohorts, samples, data generation and analysis. Diagnostic studies should aim to identify small disease signatures with high discriminatory power across all affected populations, and against similar pathologies to TB. Specific focus should be made on improving the diagnosis of infected individuals at risk of developing active disease. Conversely, mechanistic studies should focus on tissues biopsies, immune relevant cell subsets, state of the art transcriptomic techniques and bioinformatics tools to understand the biological meaning of identified gene signatures that could facilitate therapeutic interventions. Finally, investigators should ensure their data are made publicly available along with complete annotations to facilitate metadata and cross-study analyses.
Electrofulguration in the advanced management of antibiotic-refractory recurrent urinary tract infections in women.

Objective To evaluate the long-term efficacy of electrofulguration in women with recurrent urinary tract infections. Methods After institutional review board approval, a retrospective study of women who underwent electrofulguration alone was carried out. All patients had recurrent urinary tract infections defined as three or more urinary tract infections/year, and a preoperative office cystoscopy showing inflammatory lesions, categorized by location: urethra, bladder neck, trigone and beyond the trigone. All lesions were cauterized during outpatient electrofulguration under anesthesia. On 6-month postoperative office cystoscopy, endoscopic success was defined as resolution of all lesions previously seen and no new lesions. The primary outcome was urinary tract infections/year, with urinary tract infection defined as antibiotic treatment for urinary tract infection-like symptoms and/or for positive urine culture. Clinical cure was defined as no further urinary tract infections, clinical improvement as less than three urinary tract infections/year, and clinical failure as three or more urinary tract infections/year. Results Of 95 women who met the study criteria between 2004 and 2016, 62 (65%) were endoscopically successful, and 33 (35%) were endoscopic failures based on postoperative cystoscopy. Among all patients, over a median follow-up period of 4.9 years, the median number of urinary tract infections/year was 0.8. Endoscopically successful patients had fewer urinary tract infections/year compared with endoscopic failures (0.6 vs 0.9, P = 0.03). Clinically, 14 (15%) patients were cured, 69 (73%) were improved and 12 (13%) failed. Compared with clinically improved patients, clinical failures were more likely to have infections with multiple organisms (92% vs 35%, P Conclusions In our experience, nearly two-thirds of women with recurrent urinary tract infection can be successfully treated with electrofulguration, and >80% experience long-term clinical cure or improvement in urinary tract infections.
Pyrroles from TosMIC and substituted N-acyl-2,3-dihydro-4-pyridones: A short access to a 4-azaisoindole unit

Abstract We investigated the reactions of substituted N-acyl-2,3-dihydro-4-pyridones with TosMIC reagent under various basic conditions to generate novel pyrrole products. These products were then transformed to substituted azaisoindoles in a couple of steps.
Drivers of cost differences between US breast cancer survivors with or without lymphedema.

Breast cancer–related lymphedema is an adverse effect of breast cancer surgery affecting nearly 30% of US breast cancer survivors (BCS). Our previous analysis showed that, even 12 years after cancer treatment, out-of-pocket healthcare costs for BCS with lymphedema remained higher than for BCS without lymphedema; however, only half of the cost difference was lymphedema-related. This follow-up analysis examines what, above and beyond lymphedema, contributes to cost differences. This mixed methods study included 129 BCS who completed 12 monthly cost diaries in 2015. Using Cohen’s d and multivariable analysis, we compared self-reported costs across 13 cost categories by lymphedema status. We elicited quotes about specific cost categories from in-person interviews with 40 survey participants. Compared with BCS without lymphedema, BCS with lymphedema faced 122% higher mean overall monthly direct costs ($355 vs $160); had significantly higher co-pay, medication, and other out-of-pocket costs, lower lotion costs; and reported inadequate insurance coverage and higher costs that persisted over time. Lotion and medication expenditure differences were driven by BCS’ socioeconomic differences in ability to pay. Elevated patient costs for BCS with lymphedema are for more than lymphedema itself, suggesting that financial coverage for lymphedema treatment alone may not eliminate cost disparities. The economic challenges examined in this paper have long been a concern of BCS and advocates, with only recent attention by policy makers, researchers, and providers. BCS identified potential policy and programmatic solutions, including expanding insurance coverage and financial assistance for BCS across socioeconomic levels.
Use of Hospital Referral Regions in Evaluating End-of-Life Care.

Background: Hospital referral regions (HRRs) are often used to characterize inpatient referral patterns, but it is unknown how well these geographic regions are aligned with variation in Medicare-financed hospice care, which is largely provided at home. Objective: Our objective was to characterize the variability in hospice use rates among elderly Medicare decedents by HRR and county. Methods: Using 2014 Master Beneficiary File for decedents 65 and older from North and South Carolina, we applied Bayesian mixed models to quantify variation in hospice use rates explained by HRR fixed effects, county random effects, and residual error among Medicare decedents. Results: We found HRRs and county indicators are significant predictors of hospice use in NC and SC; however, the relative variation within HRRs and associated residual variation is substantial. On average, HRR fixed effects explained more variation in hospice use rates than county indicators with a standard deviation (SD) of 10.0 versus 5.1 percentage points. The SD of the residual error is 5.7 percentage points. On average, variation within HRRs is about half the variation between regions (52%). Conclusions: The magnitude of unexplained residual variation in hospice use for NC and SC suggests that novel, end-of-life-specific service areas should be developed and tested to better capture geographic differences and inform research, health systems, and policy.
Further SAR on the (Phenylsulfonyl)piperazine Scaffold as Inhibitors of the Aedes aegypti Kir1 (AeKir) Channel and Larvicides

Zika virus (ZIKV), dengue fever (DENV) and chikungunya (CHIKV) are arboviruses that are spread to humans from the bite of an infected adult female Aedes aegypti mosquito. As there are no effective vaccines or therapeutics for these diseases, the primary strategy for controlling the spread of these viruses is to prevent the mosquito from biting humans through the use of insecticides. Unfortunately, the commonly used classes of insecticides have seen a significant increase in resistance, thus complicating control efforts. Inhibiting the renal inward rectifier potassium (Kir) channel of the mosquito vector Aedes aegypti has been shown to be a promising target for the development of novel mosquitocides. We have shown that Kir1 channels play key roles in mosquito diuresis, hemolymph potassium homeostasis, flight, and reproduction. Previous work from our laboratories identified a novel (phenylsulfonyl)piperazine scaffold as potent AeKir channel inhibitors with activity against both adult and larval mosquitoes. Herein, we report further SAR work around this scaffold and have identified additional compounds with improved in vitro potency and mosquito larvae toxicity.
A Method To Personalize Blood Chemistry Reference Intervals: Getting To Patient Centric Laboratory Medicine Using Electronic Medical Record Data In Chronic Heart Failure Patients

Introduction Emerging evidence suggests heart failure (HF) patients exhibit excess mortality at serum potassium levels within reference intervals (RI) typically derived from “healthy” outpatient populations. We explored generalizability to renal profile analytes measured longitudinally in hospitalized chronic HF patients. Methods Our IRB exempted retrospective cohort included inpatient HF visits between 2009-2018 with at least two renal profiles (Glucose, K, Cl, Na, Cr, BUN, Total CO2 and eGFR). Analyte levels were divided into bins. Patient-level risk (odds ratio, OR) was computed for each bin using Cox multivariate regression analysis analyses adjusted for covariates indexed to a composite outcome of hospital mortality or discharge to hospice (surrogate for 180-day mortality). Each patient's mean visit analyte levels were plotted as a function of respective ORs using restricted cubic spline curves. Findings Study patients (13,128 with 22,621 visits) included 43% females 57% males (78±12 years). Significant (P 1) at 107mmol/L and 4.4mmol/L, which are inside typical “high normal” reference. A risk protective effect (OR Conclusion Reporting analyte levels as a function of context-specific risk versus RI may identify “protective” or lower risk targets while improving interpretation of longitudinal treatment response and prognosis.
Board Independence and Information Asymmetry in Family Firms vs. Non-Family Firms

This study investigates the role of independent board members in insider-controlled firms by examining the effectiveness of independent boards in reducing information asymmetry in family versus non-family firms. We show a negative relation between the proportion of independent directors and information asymmetry, proxied by trading volume, the bid-ask spread, and price volatility. We also find negative relation is more pronounced for a family firm versus a non-family firm. These results are robust after controlling for the endogenous choice of board members in various models. Our findings ease the concern that founding families may over-ride independent boards and exhibit opportunistic behavior.
Quo vadis, Alsek? Climate-driven glacier retreat may change the course of a major river outlet in southern Alaska

Abstract Climate change-induced glacier retreat can have substantial localized impacts that often go unnoticed in the sparsely populated regions where they occur. Here we predict that retreat of Grand Plateau Glacier, in southern Alaska, USA, will reroute the outlet of a major river with consequences for human activity in this remote region. The glacier terminus separates Alsek Lake and the present Alsek River outlet from Grand Plateau Lake. In response to thinning and retreat of that terminus, both lakes have more than doubled in size since 1958. Laser altimetry shows that terminus thinning continued at rates of up to 10 m/yr from 2017 to 2020. Radar soundings show that the bed of the thinning glacier terminus extends to >400 m below sea level, and that the two lakes will become conjoined within at most a few decades as the terminus further retreats. We predict that Alsek River will then abandon its present Dry Bay outlet channel in favor of the much steeper outlet of Grand Plateau Lake, 28 km to the southeast. Anadromous fish and associated predators in the lower Alsek will need to adapt to this change. Traditional and modern human activities centered on Dry Bay include commercial fishing, subsistence and sport hunting and fishing, and the finishing point for a world-renowned wilderness rafting expedition. Under present management guidelines, those activities cannot be relocated to the predicted future outlet, which sits within the federally designated wilderness of Glacier Bay National Park.
Rise UP!: A content analytic study of how collective action is discussed within White nationalist videos on YouTube:

There are worldwide concerns about the rise of White nationalism and its implications for intergroup relations in multicultural societies. Social media, in particular, has allowed far-right groups ...
Reconciling Western & Traditional Medicine

The Journal of Global Health seeks to provide students with a medium to facilitate public health dialogue in an increasingly interconnected world, a world that both greatly enables and poses new challenges to the study of human health. In a globalized world, we sometimes lose sight of the most fundamental and critical component of global health: health, in and of itself. We urge you to reflect on the meaning of the word “health.” What does it mean to be healthy?
On restricted mean time in favor of treatment

The restricted mean time in favor (RMT-IF) of treatment is a nonparametric effect size for complex life history data. It is defined as the net average time the treated spend in a more favorable state than the untreated over a prespecified time window. It generalizes the familiar restricted mean survival time (RMST) from the two-state life-death model to account for intermediate stages in disease progression. The overall estimand can be additively decomposed into stage-wise effects, with the standard RMST as a component. Alternate expressions of the overall and stage-wise estimands as integrals of the marginal survival functions for a sequence of landmark transitioning events allow them to be easily estimated by plug-in Kaplan-Meier estimators. The dynamic profile of the estimated treatment effects as a function of follow-up time can be visualized using a multilayer, cone-shaped "bouquet plot." Simulation studies under realistic settings show that the RMT-IF meaningfully and accurately quantifies the treatment effect and outperforms traditional tests on time to the first event in statistical efficiency thanks to its fuller utilization of patient data. The new methods are illustrated on a colon cancer trial with relapse and death as outcomes and a cardiovascular trial with recurrent hospitalizations and death as outcomes. The R-package rmt implements the proposed methodology and is publicly available from the Comprehensive R Archive Network (CRAN).
A scoping review of literature using speech recognition technologies by individuals with disabilities in multiple contexts.

Purpose Speech recognition technology (SRT) is increasingly available and may provide opportunities for individuals with disabilities to participate in necessary activities and meaningful occupations. This inquiry methodically collects and reports on research related to SRT for individuals with disabilities and impairments. Materials and methods Using the Arksey and O'Malley framework and PRISMA guidelines, five databases were queried and indexes of 11 journals were hand-searched for relevant articles. Articles were included if they were published after 2005, involved SRT, written in English, and participants(s) had a disability. Articles were charted, categorised for level of evidence, and findings were summarised. Results and conclusions Of the 78 articles that were retrieved, 13 met inclusion criteria and were organised into 4 categories: SRT in primary and secondary education, in post-secondary education, for daily living, and without a specified context. No included articles considered SRT in vocational contexts. It was determined that SRT is a tool that may improve participation and independence of individuals with disabilities in multiple contexts. Most studies reviewed were non-empirical. Opportunities exist for providers to continue to develop a rigorous body of knowledge for the use of SRT to meet educational, vocational and daily living needs.IMPLICATIONS FOR REHABILITATIONSpeech recognition technology (SRT) provides a method of access that is widely available in mainstream technology devices such as personal computers, smartphones and mobile devices, and smart speakers/daily living aids.SRT may improve participation and independence of individuals with disabilities in contexts such as primary and secondary education, post-secondary education, and with independent living tasks.Many studies examining SRT are non-empirical, and there is an opportunity for assistive technology professionals and other providers who use assistive technology to continue to develop a rigorous body of knowledge.
Eliminating protein interference when quantifying potato reducing sugars with the miniaturized Somogyi-Nelson assay.

Abstract Reducing sugar (RS) quantification is essential in the potato industry because RS content plays a vital role in potato quality, acrylamide formation, post-harvest management, and new variety development. A miniaturized Somogyi-Nelson (SN) analysis can effectively and accurately quantify RS. However, soluble proteins in potatoes interfere with SN analysis. Our research goal was to develop an applicable deprotinization procedure without influencing the precision of the SN analysis. Results showed ethanol effectively removed potato proteins and, unlike other chemicals (salts, acids), ethanol did not affect SN accuracy. Protein removal also can be achieved by heating and pH adjustment, but the ethanol-based procedure provides a simpler alternative. RS content measured by the miniaturized SN assay after deproteinization by ethanol was precise and validated by HPAEC-PAD. Data from 118 potao juicies showed that a commonly used biochemical analyzer obtained a lower reducing sugar content than the deprotinization-SN assay because fructose was not identified by the biochemical analyzer. Results demonstrate the reliability of quantifying potato RS with the SN assay following the ethanol-based deproteinization.