cssi/SciSciGPT-SciSciNet huggingface dataset:
Cushing’s Syndrome and Glucocorticoid Excess

Cushing’s syndrome (CS) results from exogenous or endogenous glucocorticoid excess and can exert clinical signs and symptoms to various degrees depending on individual tissue sensitivities determined by the distribution and function of glucocorticoid receptors. Endogenous CS is divided into adrenocorticotropic hormone (ACTH)-dependent or adrenocorticotropic hormone (ACTH)-independent. Among ACTH-dependent CS, the most frequent (~85%) form is Cushing’s disease (CD) caused by an ACTHoma within or outside (ectopic) the pituitary gland. Approximately 5% of ACTH-dependent forms of CS are related to ectopic ACTH secretion from a neuroendocrine tumor, with the remaining 10% of CS cases caused by an adrenal tumor or adrenal hyperplasia oversecreting glucocorticoids including cortisol. Hypertension is a major cardiovascular risk factor and occurs frequently in patients with CS. Such patients also may have other cardiovascular risk factors including insulin resistance, diabetes mellitus, obesity, endothelial dysfunction, and hyperlipidemia. In this chapter, we provide a brief overview on the diagnosis and therapy of CS, including three case study illustrations.
Neurocognitive Function after Cardiac Surgery: From Phenotypes to Mechanisms

For half a century, it has been known that some patients experience neurocognitive dysfunction after cardiac surgery; however, defining its incidence, course, and causes remains challenging and controversial. Various terms have been used to describe neurocognitive dysfunction at different times after cardiac surgery, ranging from "postoperative delirium" to "postoperative cognitive dysfunction or decline." Delirium is a clinical diagnosis included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Postoperative cognitive dysfunction is not included in the DSM-5 and has been heterogeneously defined, though a recent international nomenclature effort has proposed standardized definitions for it. Here, the authors discuss pathophysiologic mechanisms that may underlie these complications, review the literature on methods to prevent them, and discuss novel approaches to understand their etiology that may lead to novel treatment strategies. Future studies should measure both delirium and postoperative cognitive dysfunction to help clarify the relationship between these important postoperative complications.
Abstract WMP35: The Characteristics of Infectious Intracranial Aneurysm and Indication of Cerebral Angiogram in Infective Endocarditis (IE)

Introduction: Infectious intracranial aneurysm (IIA) can complicate infective endocarditis (IE). We aim to describe the characteristics of IIA and to assess indications for cerebral angiography. Me...
Multi-rate higher order singular value decomposition for enhanced non-contrast ultrasound Doppler imaging of slow flow

In this work a multi-rate higher order singular value decomposition (MRHOSVD) framework for enhanced non-contrast ultrasound Doppler imaging is proposed. Our method is based on Tucker decomposition of multidimensional plane wave ultrasound echo data at multiple temporal resolutions simultaneously. We present simulation and in vivo results where the new method outperforms classic singular value clutter filtering in separation of blood activities from tissue motions with significant bandwidth overlap.
Local BDNF delivery to the injured cervical spinal cord using an engineered hydrogel enhances diaphragmatic respiratory function

We developed an innovative biomaterial-based approach to repair the critical neural circuitry that controls diaphragm activation by locally delivering brain-derived neurotrophic factor (BDNF) to injured cervical spinal cord. BDNF can be used to restore respiratory function via a number of potential repair mechanisms; however, widespread BDNF biodistribution resulting from delivery methods such as systemic injection or lumbar puncture can lead to inefficient drug delivery and adverse side effects. As a viable alternative, we developed a novel hydrogel-based system loaded with polysaccharide-BDNF particles self-assembled by electrostatic interactions that can be safely implanted in the intrathecal space for achieving local BDNF delivery with controlled dosing and duration. Implantation of BDNF hydrogel after C4/C5 contusion-type spinal cord injury (SCI) in female rats robustly preserved diaphragm function, as assessed by in vivo recordings of compound muscle action potential and electromyography amplitudes. However, BDNF hydrogel did not decrease lesion size or degeneration of cervical motor neuron soma, suggesting that its therapeutic mechanism of action was not neuroprotection within spinal cord. Interestingly, BDNF hydrogel significantly preserved diaphragm innervation by phrenic motor neurons (PhMNs), as assessed by detailed neuromuscular junction morphological analysis and retrograde PhMN labeling from diaphragm using cholera toxin B. Furthermore, BDNF hydrogel enhanced the serotonergic axon innervation of PhMNs that plays an important role in modulating PhMN excitability. Our findings demonstrate that local BDNF hydrogel delivery is a robustly effective and safe strategy to restore diaphragm function after SCI. In addition, we demonstrate novel therapeutic mechanisms by which BDNF can repair respiratory neural circuitry.SIGNIFICANCE STATEMENT Respiratory compromise is a leading cause of morbidity and mortality following traumatic spinal cord injury (SCI). We used an innovative biomaterial-based drug delivery system in the form of a hydrogel that can be safely injected into the intrathecal space for achieving local delivery of brain-derived neurotrophic factor (BDNF) with controlled dosing and duration, while avoiding side effects associated with other delivery methods. In a clinically relevant rat model of cervical contusion-type SCI, BDNF hydrogel robustly and persistently improved diaphragmatic respiratory function by enhancing phrenic motor neuron (PhMN) innervation of the diaphragm neuromuscular junction and by increasing serotonergic innervation of PhMNs in ventral horn of the cervical spinal cord. These exciting findings demonstrate that local BDNF hydrogel delivery is a safe and robustly effective strategy to maintain respiratory function after cervical SCI.
Anisotropic Aerogels by Photolithography

A general method is presented that allows fabrication of sol–gel materials with anisotropic physical properties. The gelation solvent is exchanged with a suitable solution of precursors and suitable chemical reactions are triggered in irradiated regions of the monoliths. The physical properties of the exposed regions can be varied almost at leisure by changing the precursors. For example, metal and sulfide nanoparticles can be formed inside the pores of the matrices and these nanoparticles change optical absorption, emission and index of refraction of the exposed regions. Polymers can be attached to the walls of the matrix pores, and this allows modulation of mechanical strength, hydrophobicity and optical properties. The character of the patterns can be adapted to the specific applications by varying the precursor solution. Single-photon reactions are used to generate patterns that start on the surface of the monoliths and extend within the bulk of the monoliths. Precursors that react when exposed to ionizing radiation are employed to create high aspect ratio patterns, and precursors that are dissociated by multiphoton processes are used to produce three-dimensional architectures. Physical properties and possible applications of the monoliths are discussed.
Conceptual design and optimization of a tilt-rotor micro air vehicle

Abstract The conceptual design and optimization of a tilt-rotor Micro Air Vehicle (MAV) for a well-defined mission are performed. The objective of this design cycle is to decrease the design time in order to efficiently create a functional tilt-rotor drone. A flight mission is firstly defined for a tilt-rotor MAV performing hovering and cruise flight scenarios. Secondly, a complex wing shape is chosen and modeled in order to determine the final shape. The initial shape is scaled in order to acquire an arbitrary wingspan of one meter. For the specific area and wingspan, the aspect ratio of the designed wing shape is found to be equal to 2.32. Thirdly, a constraint analysis of the MAV is performed by using an energy balance analysis for six different flight scenarios. This analysis yields the required power loading and wing loading. Fourthly, the weight of the vehicle is estimated using both statistical and computational methods. After estimating the total weight and the wing loading of the MAV, the surface of the wing is determined, yielding a final wingspan of 0.76 m. Subsequently, considering the total weight of the designed MAV, the needed lift coefficient is determined. Fifthly, using the lift coefficient in conjunction with XLFR5, a batch of airfoils is selected and analyzed to evaluate the aerodynamic coefficients of the wing with each airfoil. This analysis ultimately leads to the optimum airfoil being selected. Finally, design of the fuselage and tail, internal components selection, and servo-mechanisms design are carried out prior to a stability analysis. All these proposed steps are needed to design efficient and functional tilt-rotor MAVs.
Modeling and Analysis of Photovoltaic Electrochemical System Using Module-Level Power Electronics

The design of a model PV-electrolysis system using a practical water electrolyzer and a commercial solar module is presented and its day-long operation simulated. The fact that photovoltaic electrochemical (PV-EC) devices do not always operate under 1-Sun illumination is often overlooked, which implies that the PV source may not always provide sufficient voltage for electrolyzer operation. The energy transferred between the source and load of such a system is studied quantitatively under two coupling configurations. Modeling shows that voltage-matching with module-level power-electronics (MLPE) increases the net energy transferred between the source and the load by 14% compared to direct coupling. The benefit of MLPE will increase as difference between the operating voltage of the system and the maximum power point of the source increases.
The Challenge of Variable Costs in Decisions Based on Cost-Effectiveness Evidence: A Case Study for Brodalumab.

Background Payers often consider cost-effectiveness studies for new drugs when making decisions on coverage, formulary position, and budgets; however, cost-effectiveness studies are often calculated using estimated pricing before a drug's launch. If the drug's price changes on or after launch, or if rebate programs are initiated, cost-effectiveness studies need to be updated to prevent payers from making decisions using inaccurate value assumptions, which can lead to unexpected financial impacts and potentially delay patient access to drugs. Objective To evaluate how lower at-launch drug pricing versus initial estimated pricing affects cost-effectiveness ratios and potentially influences treatment decisions, using the case study of brodalumab, a biologic drug indicated for the treatment of moderate-to-severe plaque psoriasis. Methods We compared the estimated cost-effectiveness of brodalumab, which was published in a December 2016 Institute for Clinical and Economic Review (ICER) report based on estimated pricing, with the drug's cost-effectiveness based on its actual pricing after its approval. Discussion The 2016 ICER report on the cost-effectiveness of targeted immunomodulators indicated for the treatment of moderate-to-severe plaque psoriasis, brodalumab's price was estimated to be $4267 by averaging the cost of its likely competitors. Brodalumab's effectiveness as a treatment for moderate-to-severe plaque psoriasis is high in clinical trials, but its estimated cost placed it as the fourth most cost-effective targeted immunomodulatory drug in the ICER report. On its approval in February 2017, brodalumab's newly estimated base price was $3900, based on its prelaunch price. Calculations using this base price placed brodalumab as the most cost-effective option among targeted immunomodulators in this setting. At the time this current article was written, brodalumab's cost was $3500, making it even more cost-effective. Conclusion Because payers, providers, and patients are all concerned with achieving better outcomes for the often painful and disfiguring disease of plaque psoriasis, while controlling costs, updating cost-effectiveness data when new pricing information becomes available may reveal significant cost differences to help stakeholders make better decisions about their population's healthcare outcomes and costs.
A Time Series Analysis of the IT Stock Market during the 2007 – 2009 Recession

Due to the global financial crisis leading to one of the worst recession in the US in mid-2007, the need to study the stock trend and its impact on the economy has become essential. In this paper, we perform a time series analysis of the NASDAQ stock trends of the Information Technology (IT) industry during the 2007-2009 recession and compare with the immediate pre-recession and post-recession periods. The IT industry has been the zenith in the growth of the US economy. To study these trends, we used Python, an open source programming language that is used for data intensive applications. It is seen that due to the housing bubble that occurred during the recession, the worst impact during this period was in mid of 2009.
Endoscopic Resection of a Cerebellopontine Angle Epidermoid Cyst via a Retrosigmoid Approach

A variety of lesions may arise within the cerebellopontine angle (CPA). Schwannomas and meningiomas are most commonly found in this location; however epidermoid cysts may also be found in this area. Here, we present the case of a 31-year-old man with severe right facial pain. Magnetic resonance imaging (MRI) demonstrated a right CPA mass that had heterogenous intensity on T2-weighted imagining and restricted diffusion on diffusion-weighted imaging. The patient was offered resection of the mass for treatment of his facial pain via an endoscopic retrosigmoid approach. We provide a video that illustrates the steps taken to resect this mass endoscopically. The mass was white and friable. The tumor was resected using a combination of sharp dissection with the microscissors and round knife and aspiration. As the tumor was removed, the 5th nerve was visualized deep to the tumor. The tumor was freed from any adhesions and was resected piecemeal. The round knife was used to free the tumor from surrounding venous structures. The brainstem and origin of the trigeminal nerve were visualized with further tumor debulking. We moved inferiorly to resect the remainder of the tumor. We worked around the surrounding vasculature to resect the tumor. Advancing the endoscope farther, we visualized Meckel's cave. The wound was irrigated and closed in standard fashion. Tissue pathology confirmed a diagnosis of epidermoid cyst. The vast majority of the mass was removed and the patient had resolution of his facial pain postoperatively. The link to the video can be found at: https://youtu.be/fSw5sw8xQz0 .
Risk of cancer in infertile women: analysis of US claims data.

Study question Is female infertility associated with higher risk of cancer? Summary answer Although absolute risks are low, infertility is associated with higher risk of cancer compared to a group of non-infertile women. What is known already Infertile women are at higher risk of hormone-sensitive cancers. Information on risk of non-gynecologic cancers is rare and conflicting, and the effect of pregnancy on these risk associations is known for only a minority of cancer types. Study design, size, duration Retrospective cohort analysis between 2003 and 2016 using an insurance claims database. Participants/materials, setting, methods In all, 64 345 infertile women identified by infertility diagnosis, testing or treatment were compared to 3 128 345 non-infertile patients seeking routine gynecologic care. Women with prior diagnosis of cancer or within 6 months of index event were excluded. Main outcomes were development of any malignancy and individual cancers as identified by ICD-9/ICD-10 codes. Results were adjusted for age at index date, index year, nulliparity, race, smoking, obesity, number of visits per year and highest level of education. Main results and the role of chance Infertile women had an overall higher risk of developing cancer compared to non-infertile women (2.0 versus 1.7%, adjusted hazard ratio (aHR) = 1.18; CI: 1.12-1.24). In addition, the risk of uterine cancer (0.10 versus 0.06%, aHR = 1.78; CI: 1.39-2.28), ovarian cancer (0.14 versus 0.09%, aHR 1.64; CI: 1.33-2.01), lung cancer (0.21 versus 0.21%, aHR = 1.38; CI: 1.01-1.88), thyroid cancer (0.21 versus 0.16%, aHR = 1.29; CI: 1.09-1.53), leukemia (0.10 versus 0.06%, aHR = 1.55; CI: 1.21-1.98) and liver and gallbladder cancer (0.05 versus 0.03%, aHR = 1.59; CI: 1.11-2.30) were higher in infertile women compared to non-infertile women. In a subgroup analysis of women in each cohort who became pregnant and had a delivery during enrollment, the risk of uterine and ovarian cancer were similar between infertile and non-infertile women. In a subgroup analysis excluding women with PCOS and endometriosis from both cohorts, the risk of uterine cancer was similar between infertile and non-infertile women. Limitations, reasons for caution Absolute risk of cancer was low, average follow up for each individual was limited, and average age at index date was limited. Insurance databases have known limitations. Wider implications of the findings Using claims-based data, we report that infertile women may have a higher risk of certain cancers in the years after infertility evaluation; continued follow up should be considered after reproductive goals are achieved. Study funding/competing interest(s) None.
Role of transforming growth factor-∃ in the progression of head and neck squamous cell carcinoma in a murine model.

2165 In an orthotopic model of head and neck squamous cell carcinoma (HNSCC) in immunocompetent mice (SCC VII/SF), we determined the vaccine efficiency of recombinant vaccinia virus expressing IL-2 (rvv-IL-2). Despite significant tumor regression, vaccine efficiency was restricted by recurrence and loco-regional metastasis. In this study we examined the mechanism of immune escape in this model. We determined the frequency and activities of CD4+/CD25+ regulatory T cells and immune suppressive myeloid CD11b+/CD31+/Gr-1+ cells in rvv-IL-2 vaccinated and control mice. These populations of suppressor cells do not appear to have any role in immune suppression in this model. Assay of expression of a number of immune modulatory molecules in tumor lesions demonstrated high expression of TGF-β, IL-10, GM-CSF and iNOS. Among these, the expression of TGF-β was most abundant. Although the cultured SCC VII/SF cells did not express TGF-β, tumor tissues express high levels of activated TGF-β and sera of tumor-bearing mice had high levels of TGF-β. Expression of TGF-β receptors, (TGFBR I and TGFBR II) in SCC VII/SF cells was significantly lower compared to normal mouse epithelial cells. Low concentrations of TGF-β stimulated the growth of cultured SCC VII/SF cells. TGF-β stimulated invasion of SCCVII/SF cells in Matrigel Invasion Chambers. TGF-β treated SCC VII/SF cells secreted VEGF in the culture media. TGF-β present in the sera of tumor-bearing mice inhibited the biological activities of T and NK cells. Tumor infiltrating lymphocytes from rvv-IL-2 vaccinated mice also showed lower biological activities compared to splenocytes and immune cells in tumor draining lymph nodes. We concluded from these data that loss of TGF-β receptors from SCC VII/SF cells resulted in the disruption of TGF-β signaling and accumulation of activated TGF-β in tumor microenvironment. Accumulated TGF-β in tumor microenvironment promoted the growth of the tumor cells and disrupted the biological activities of the immune cells in tumor microenvironment. Moreover, TGF-β stimulated the invasion of SCC VII/SF cells. Increased secretion of VEGF by TGF-β augmented the metastatic activities of SCC VII/SF cells. For successful immunotherapy in this model it would be necessary to reduce the level of TGF-β in tumor microenvironment. Supported in part by NIH grant RO1 CA 89748.
Photo-auxiliary approach to control excited state reactivity: Cross [2+2]-photocycloaddition of oxazolidinone based hydrazides

Abstract Chiral oxazolidinone based hydrazides undergo efficient cross [2 + 2]-photocycloaddition upon visible light illumination. Oxazolidinone functionality acted as an energy harvesting photo-auxiliary. The cross [2 + 2]-photocycloaddition proceeded efficiently from the excited state with moderate to excellent isolated yield of the photoproduct. The photo-auxiliary can be conveniently removed post-photoreaction, which highlights the versatility of this strategy.
Planar graphs with girth 20 are additively 3-choosable

Abstract The additive choice number of a graph G , denoted by ch Σ ( G ) , is the minimum positive integer k such that, whenever each vertex is given a list of at least k positive integers, vertex labels can be chosen from respective lists in such a way that adjacent vertices have distinct sums of labels on their neighbors. Recently, bounds on the additive choice number have been proven for planar graphs under certain girth assumptions. In this paper, we prove that ch Σ ( G ) ≤ 3 for the planar graph G with girth at least 20. Our approach uses the Combinatorial Nullstellensatz to streamline arguments within a proof using the discharging method.
2485 Identifying Barriers for Same-Day Discharge of Minimally Invasive Hysterectomies

Study Objective Minimally invasive surgery (MIS) has provided patients with decreased post-surgical pain, faster recovery, and shorter hospital stay. Currently, the trend with MIS procedures is to have same-day discharge. The purpose of this study is to determine which patient-based and post-surgical factors are barriers to same-day discharge and lead to hospital re-admission. Design Quality assurance, retrospective cohort study. Setting Single academic institution Patients or Participants Chart review for patients undergoing laparoscopic, vaginal, laparoscopic assisted vaginal or robotic hysterectomy from July 2014 to April 2017. Cohort of 541 patients from 18-84 years-old with a mean age of 48. Interventions No interventions. Descriptive study of post-operative hospital stay following surgery. Measurements and Main Results We performed an electronic medical record chart review to evaluate time in the recovery room following surgery, route of hysterectomy, reasons for prolonged hospital stay, and re-admission. Out of 541 patients, 395 (73%) were general gynecology patients and 146 (27%) were urogynecology patients. Despite the goal of same-day discharge, only 252 (47%) of patients were discharged the same day. Of those patients, 83% were vaginal hysterectomies and 84% were laparoscopic hysterectomies that were discharged in less than 6 hours. 145 (99.3%) urogynecology patients stayed admitted overnight. There was an association between length of case, urogynecology patients, and overnight stay (OR 1.23, CI 1.006 - 1.521), but no association was found between length of stay in recovery with estimated blood loss. There was no statistical significance (p>0.05) between hours of recovery room stay with emergency room visits or re-admissions. Conclusion The majority of the patients in the cohort were not discharged the same-day given that data was altered by urogynecology patients despite having MIS procedures. Barriers to same-day discharge included length of procedure, voiding dysfunction and pain. Further studies include implementing enhanced recovery after surgery and voiding trials for same-day discharge, as well as evaluating urogynecology patients separate from general gynecologic procedures.
INTEREST GROUP SESSION—WOMEN’S ISSUES: FROM MENOPAUSE TO MEDICARE: CONTRIBUTIONS FROM COHORT STUDIES OF AGING WOMEN’S HEALTH

Although some countries have well-established birth cohorts for research on aging, few US projects have followed the evolution of women’s health from midlife through older age, leaving gaps in understanding their health and ignoring a window of time spanning age groups during which women may benefit from health promotion and prevention efforts. Cohort studies of midlife and older women’s health have begun to address this gap, providing opportunities to advance our understanding of both reproductive and healthy aging, including multiple racial/ethnic groups and US regions. Studying existing cohorts of aging women provides investigators with opportunities to: track changes over time, identifying trajectories of health along with aging; clarify antecedent-consequent relationships; identify how historical events may be related to emergent patterns of health; incorporate common data elements that allow comparisons within and across cohorts over time; and introduce new measures/indicators, such as genomic markers. This symposium will provide a foundation for future research using existing databases from studies providing longitudinal health-related measures of women as they age. Opportunities for conducting new analyses on midlife and older women’s health will be described for four large cohort studies: two studies of women exclusively -- the Study of Women’s Health Across the Nation and the Women’s Health Initiative – and two studies with large numbers of women participants – the Baltimore Longitudinal Study of Aging and the Rancho Bernardo Study of Healthy Aging. Unique and common considerations for answering future questions about women’s health from menopause to Medicare in these studies will be discussed.
A comparative analysis between LINMAP, paired comparison method and naturalistic ranking in different data display contexts

This article presents a comparative analysis between two widely used decision-making methods, LINMAP and paired comparison method (PCM), using three different judging contexts. Decision makers ranked alternatives (for LINMAP) and criteria (for PCM) for contexts involving quantitative data only, qualitative data only, and a mix between the two. Attribute weights were calculated and final rankings of alternatives were deducted and compared to a naturalistic ranking of alternatives by the decision makers. LINMAP was found to be the closest match to a naturalistic decision-making. It was also found that incorporating qualitative data or a mixture between qualitative and quantitative data in multi-attribute decision-making problems was more consistent with the naturalistic ranking of alternatives.
Presymptomatic Testing and Confidentiality in the Age of the Electronic Medical Record.

Objective:Recent introduction of a commercial electronic medical record (EMR) system at the authors’ institution raised a number of questions about documenting visits for presymptomatic testing for...
The role of yoga in treating stress-related symptoms in dental hygiene students

Context: Research has provided evidence for yoga's effectiveness in the prevention and treatment of pain and stress, both of which have been implicated as significant negative moderators of student performance and experience. Aims: This study investigated the feasibility and preliminary impact of a 10-week yoga intervention with dental hygiene students to reduce perceptions of stress and stress-related symptoms. Settings and Design: Students self-selected into a yoga treatment versus control condition. They completed stress and pain measures at four time points during and after the intervention or control period of 10-weeks. Methods: Participants were students enrolled in a dental hygiene program. All 77 participants completed a 10-week study, self-selecting into an intervention or control group. They completed three self-report questionnaires assessing pain and stress, administered at baseline, mid-point, postintervention, and two follow-ups. The 10-week yoga intervention consisted of 10 90-min yoga sessions that provided check-ins, breathing exercises, sequences of postures, relaxation exercises, and closing meditations. Statistical Analysis Used: Independent samples t-tests were used to compare perceived stress levels of participants in the control versus treatment groups. Paired t-test was used to assess differences in stress-related symptom levels across time. Results: Results suggested that a yoga intervention is feasible for this group and that active yoga practice can lower perceived stress across multiple domains and across time. Conclusions: A specially adapted and designed 10-week yoga protocol appears to be an accessible option for dental hygiene programs that seek to support their students in improving overall wellbeing.
Chapter 9: Buying What’s for Sale?: Running, Flirting, and Fashion at the Skirt Chaser 5k Race Series

The Skirt Chaser 5k race, which ran from 2007 to 2014, uniquely gave women a 3-minute head start over male racers, reinforcing cultural norms with regard to male athletic superiority and heteronormativity.
CellSegmenter: unsupervised representation learning and instance segmentation of modular images

We introduce CellSegmenter, a structured deep generative model and an amortized inference framework for unsupervised representation learning and instance segmentation tasks. The proposed inference algorithm is convolutional and parallelized, without any recurrent mechanisms, and is able to resolve object-object occlusion while simultaneously treating distant non-occluding objects independently. This leads to extremely fast training times while allowing extrapolation to arbitrary number of instances. We further introduce a transparent posterior regularization strategy that encourages scene reconstructions with fewest localized objects and a low-complexity background. We evaluate our method on a challenging synthetic multi-MNIST dataset with a structured background and achieve nearly perfect accuracy with only a few hundred training epochs. Finally, we show segmentation results obtained for a cell nuclei imaging dataset, demonstrating the ability of our method to provide high-quality segmentations while also handling realistic use cases involving large number of instances.
Pre-Emptive Decline

Why do hegemonic powers appear to have so few viable policy levers with which to cope with their fears of decline, and often adopt policies that are least well-suited, if not antithetical to the task? In this work I suggest that status threat generates a set of typical and quite maladaptive responses at both the individual/organizational level, and in the context of popular political culture, that exacerbate decline. This phenomenon, “pre-emptive decline,” is evident in both elite-driven policy and mass political responses and is reviewed here in maladaptive courses of action adopted in 19th century Britain, and in the contemporary United States.
You never forget your first? Impact of interview timing on institutional rank order.

OBJECTIVE To analyze the impact of interview date on the applicant rank for Neurology residencies in the United States. METHODS A multi-institutional retrospective review of interview dates and applicant rank list data for the National Resident Matching Program (NRMP) was conducted for five Neurology programs, totaling 1932 interviewed applicants over a combined total of 31 interview years. For each candidate, the interview date and applicant rank were abstracted along with the total number of interviews for that season. Statistical analyses were completed on the cumulative institution data set as well for each individual institution to assess for a possible relationship between interview date and applicant rank. RESULTS The cumulative institutional analysis showed that the mean applicant rank decreased as the interview season progressed. Applicants who interviewed on the first day of the interview season were ranked 11.4% higher than those who interviewed on the last interview day. Additionally, applicants interviewed on the first interview day more likely to be ranked higher when compared to all other interview dates. Independent analysis of each program's data identified comparable, statistically significant, differences in mean applicant rank and interview position at three out of the five institutions. CONCLUSIONS This study evaluated the impact of interview order on the ranking of applicants by Neurology residency programs, noting a temporal relationship with applicant rank and interview date. The primacy bias appreciated in our data merits further evaluation in other medical specialties. Strategies to minimize the impact of this bias should be employed by residency programs who use medical matching services.
Airborne 2,5-dimethylfuran as a marker to indicate exposure to indoor tobacco and biomass burning smoke

Abstract Smoke from domestic tobacco smoking and biomass burning is the most harmful indoor air pollutant. This study aimed to evaluate 2,5-dimethylfuran (DMF) as a marker to indicate exposure to environmental tobacco smoke (ETS) and biomass burning smoke (BBS) in households. The evaluation consisted of three indoor air monitoring campaigns in (1) 8 apartments with different smoking scenarios, (2) 76 apartments in a Metropolitan city, and (3) 26 homes in two rural areas. All the air samples were collected in a passive way using thermal desorption (TD) tubes and analyzed by TD-gas chromatography/mass spectrometry (GC/MS). The indoor smoking experiments showed that TD tubes could detect DMF even when the occupant smoked one cigarette every day. In urban homes, DMF detection had a substantial agreement with smoking status, indicated by a Kappa coefficient of 0.67. In rural homes, DMF was detected at high concentrations in homes with biomass burning. Along with DMF, the TD tubes could detect and quantify over 70 other volatile organic compounds (VOCs), allowing exposure and risk assessment for indoor smoke. In conclusion, monitoring DMF with TD tubes offers an easy, low-cost approach to measure domestic ETS and BBS exposures. This method has the potential to measure exposure to outdoor smoke from wildfire and agricultural burning.
Formability Characterization of Fiber Reinforced Polymer Composites Using a Novel Test Method

Fiber reinforced polymer composites are often used as a replacement for metal alloys because of the superior strength to weight ratio. However, a major drawback of these materials is the lack of formability caused by the low strain to failure ratio that does not allow the material to follow tooling contours into deep drawn shapes or tight radii. Composite materials have a multiscale hierarchical structure where micro and meso scale effects (fiber and tow scales) contribute to the macro structural response (laminate scale). In particular, during forming, different deformation occurs simultaneously at every scale. Currently, the amount of quantifiable and comparable forming data for both continuous and discontinuous fiber reinforced polymer composites, including a multi-scale understanding of the deformation response, is limited because of the lack of a testing system. This article proposes a novel test method and an apparatus called “the forming fixture” for testing the tow formability of fiber reinforced polymer composites by determining the required load to form an uncured resin impregnated fiber tow sample into a stretch drawn profile. Test results from forming of Hexcel (Stamford, CT) IM7-G continuous carbon fiber impregnated with Huntsman (The Woodlands, TX) RDM 2019-053 resin system, in the temperature range of 21°C–121°C, are discussed to demonstrate the use of the proposed apparatus including representative data. Results showed consistency and repeatability, validating the reliability of the novel method. The test aided in defining the forming behavior of the material in real time both visually (e.g. sample failure location) and as forming load versus displacement curves. A novel forming metrics, relating the maximum drawing depth with no failure and the maximum forming load, is defined to compare and select different fiber and resin formulations. Widespread adoption of the forming fixture will reduce reliance on a “trial and error” approach during the the forming process.
Defining a Path Toward the Use of Fast-Scan Cyclic Voltammetry in Human Studies

Fast Scan Cyclic Voltammetry (FSCV) has been used for decades as a neurochemical tool for in vivo detection of phasic changes in electroactive neurotransmitters in animal models. Recently, multiple research groups have initiated human neurochemical studies using FSCV or demonstrated interest in bringing FSCV into clinical use. However, there remain technical challenges that limit clinical implementation of FSCV by creating barriers to appropriate scientific rigor and patient safety. In order to progress with clinical FSCV, these limitations must be first addressed through 1) appropriate pre-clinical studies to ensure accurate measurement of neurotransmitters and 2) the application of a risk management framework to assess patient safety. The intent of this work is to bring awareness of the current issues associated with FSCV to the scientific, engineering, and clinical communities and encourage them to seek solutions or alternatives that ensure data accuracy, rigor and reproducibility, and patient safety.
Green’s Function

Earlier we considered the phenomenon of a grounded conducting surface surrounding a charged body. We saw that the surface acquired an induced charge, and the combined potential of the charge on the body and the induced charge on the surface equals zero on the surface.
Plasma carotenoids and breast cancer risk in the Cancer Prevention Study II Nutrition Cohort

Several circulating carotenoids have been inversely associated with postmenopausal breast cancer risk in large cohort studies and a pooled analysis. Whether associations differ by tumor or participant characteristics remains unclear. We investigated the associations of plasma carotenoids with postmenopausal breast cancer risk overall and by estrogen receptor (ER) status, tumor stage, smoking status, and body mass index, in a case–control study nested in the Cancer Prevention Study II Nutrition Cohort. A total of 496 invasive breast cancer cases diagnosed between blood draw in 1998–2001 and June 30, 2007 and matched 1:1 with controls on race, birth date, and blood draw date were included. Multivariable-adjusted conditional and unconditional logistic regression models were used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs). Plasma α-carotene above the lowest quartile was associated with significant 40–43 % lower risk of invasive breast cancer risk (fourth vs. first quartile OR 0.60, 95 % CI 0.41–0.87, P-trend = 0.037) after adjustment for multiple covariates. This inverse association was strengthened after further adjustment for other plasma carotenoids and total fruit and vegetable intake (fourth vs. first quartile OR 0.50, 95 % CI 0.29–0.85, P-trend = 0.041). Other plasma carotenoids or total carotenoids were not associated with breast cancer risk. The inverse association of α-carotene with breast cancer remained for ER+, but not for ER− tumors, although test for heterogeneity was not statistically significant (P-heterogeneity = 0.49). These results suggest that higher plasma α-carotene is associated with lower risk of invasive breast cancer.
Comparative Evaluation of Excitation Schemes for Multi-Shaker Testing of Bridges

Many researchers are working to develop more rational, robust and timely condition evaluation approaches for the nation’s inventory of aging and deteriorating bridges. Dynamic characterizations of bridges using forced or ambient vibration testing techniques have received much attention in this regard since the measurements can effectively capture and describe the actual in situ properties and behavior of the structure. The dynamic excitation is an important consideration for bridge vibration testing applications. It is challenging and expensive to adequately excite a full-scale bridge for forced vibration testing using one or two traditional dynamic shakers, and ambient vibration testing requires assumptions related to the nature of the unmeasured dynamic excitation that cannot be easily validated. The writers have been evaluating a new approach for multiple-input, multiple-output forced vibration testing of short to medium span bridges that employs a spatially distributed network of low-cost exciters. Forced vibration testing of a large-scale, laboratory model structure was performed using the prototype multi-shaker excitation system to identify the optimal dynamic excitation signals. Deterministic multisine signals and stochastic burst random signals with various durations and force levels were evaluated with the system. The resulting system identifications and the merits of the different excitation signals are presented and compared.
The caffeine analogue, 1-hexyl-3-propyl-7-methylxanthine inhibits malignant transformation and stimulates apoptosis and intracellular cAMP content in JB6 cells

Proc Amer Assoc Cancer Res, Volume 47, 2006 4723 Caffeine has been shown to have an inhibitory effect on carcinogenesis and a toxic effect on a number of different cell lines. Different xanthine derivatives (caffeine analogues) are known and used as specific and nonspecific phosphodiesterases (PDE) inhibitors. The PDE are responsible for the hydrolysis of cellular second messengers, such as cAMP. Increasing cAMP is a general counter-regulatory mechanism for attenuating the MAP kinase activation pathways. The effect of cAMP on MAP kinase activation pathways depends on both the cell type and the type of tyrosine kinase receptor. For example, agents that increase intracellular cAMP concentration block growth factor-stimulated ERKs activation in a number of cell types. The ability of caffeine analogues to inhibit cAMP-PDE activity has been reported to be enhanced with increases in the alkyl chain length at the 1 and 3-positions of the xanthine skeleton. We found that several xanthine compounds inhibited cell transformation and stimulated apoptosis in JB6 Cl41 mouse skin epidermal cells. Within the 1,3,7-trialkylxanthine group of caffeine analogues, Xt 79 was one of most effective at inhibiting cell transformation. We used Western blot analysis to study the effect of Xt 79 on the expression of several proteins in EGF-stimulated JB6 Cl41 cells. The results indicated that Xt 79 inhibited phosphorylation of MEK1/2, ERK1/2, and activity of PKA. Xt79 also stimulated an increase in cAMP level. The IC50 (for toxicity) of Xt 79 was much less than the ICT50 (inhibition of cell transformation). Taken together, these findings suggest that Xt 79 may be utilized as a potential anticancer agent.
Gonadoblastoma: Clinicopathologic correlation in six patients☆

Abstract Six patients with a total of nine gonadoblastomas are presented; three-and possibly a fourth-had dysgerminomatous overgrowth which was massive in two patients. Calcification detected by abdominal films was present in three sufficient for preoperative diagnosis. All patients were found to have a Y stem line on peripheral leukocyte chromosome cultures except one patient, who had a 46 XX/45 XO karyotype. She was found to have Y chromatin bodies in the germ cells of her tumor which was in a normal ovary found at exploration for an ectopic pregnancy. Three were found in virilized phenotypic females investigated for amenorrhea, and two for therapy of pelvic masses due to dysgerminomatous overgrowth. Y chromatin studies are reported on gonadal tissue.
Intracellular trafficking of GABAA receptors

Some of the mechanisms that control the intracellular trafficking of GABA(A) receptors have recently been described. Following the synthesis of alpha, beta, and gamma subunits in the endoplasmic reticulum, ternary receptor complexes assemble slowly and are inefficiently inserted into surface membranes of heterologous cells. While beta3, beta4, and gamma2S subunits appear to contain polypeptide sequences that alone are sufficient for surface targeting, these sequences are neither conserved nor essential for surface expression of heteromeric GABA(A) receptors formed from alpha1beta or alpha1betagamma subunits. At the neuronal surface, native GABA(A) receptor clustering and synaptic targeting require a gamma2 subunit and the participation of gephyrin, a clustering protein for glycine receptors. A linker protein, such as the GABA(A) receptor associated protein (GABARAP), may be necessary for the formation of GABA(A) receptor aggregates containing gephyrin. A substantial fraction of surface receptors are sequestered by endocytosis, another process which apparently requires a GABA(A) receptor gamma2 subunit. In heterologous cells, constitutive endocytosis seems to predominate while, in cortical neurons, internalization is evoked when receptors are occupied by GABA(A) agonists. After constitutive endocytosis, receptors are relatively stable and can be rapidly recycled to the cell surface, a process that may be regulated by protein kinase C. On the other hand, a portion of the intracellular GABA(A) receptors derived from ligand-dependent endocytosis is apparently degraded. The clustering of GABA(A) receptors at synapses and at coated pits are two mechanisms that may compete for a pool of diffusable receptors, providing a model for plasticity at inhibitory synapses.
QoPS: A QoS Based Scheme for Parallel Job Scheduling

Although job scheduling has been much studied, the issue of providing deadline guarantees in this context has not been addressed. In this paper, we propose a new scheme, termed as QoPS to provide Quality of Service (QoS) in the response time given to the end user in the form of guarantees in the completion time to submitted independent parallel jobs. To the best of our knowledge, this scheme is the first one to implement admission control and guarantee deadlines for admitted parallel jobs.
Cytopathology, histopathology, and colposcopy in the management of cervical neoplasia

Abstract Investigation of the patient with atypical cervical cytology has classically included cold conization as the ultimate procedure necessary to establish a definitive histologic diagnosis. Nevertheless, it has been demonstrated that residual atypia is found in 10 to 30 per cent of the “coned cervices”, and recent or late complications have been recorded. This study of 196 consecutive cases of cervical atypia suggests that if the results of the various investigative techniques indicate a degree of cellular abnormality no greater than carcinoma in situ definitive therapy can be carried out without conization.
Severe Diphenhydramine Dependence and Withdrawal: Case Report

This report describes a case of diphenhydramine dependence and withdrawal in a 34-year-old woman with schizophrenia. Anticholinergic medications have the potential for dependence. A characteristic withdrawal syndrome can develop after abrupt cessation of high-dose anticholinergics. This patient presented with an anticholinergic withdrawal syndrome manifest by pyrexia, hypertension, bowel and bladder incontinence, and increased muscle tone. Diphenhydramine is considered a relatively safe medication. This case highlights its potential for abuse and reminds us of the features of its characteristic withdrawal syndrome.